10 essential blood tests · 2017-03-23 · 10 essential blood tests –part 2 dr. dicken weatherby...
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10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 1
10EssentialBloodTestsPART2
TheBloodChemistryWebinarsWithDR.DICKENWEATHERBYCreatoroftheBloodChemistrySoftware
Presents
HeartDisease,Inflammation,&EssentialBloodTests#2to#4:
Fibrinogen,C-Reactiveprotein,andHomocysteine,
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 2
EssentialTest#2Fibrinogen
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 3
Fibrinogen- Whyisitimportant?
1.Levelsincreasewithtissueinflammationortissuedestruction.
2.Itisvitalpartofthecoagulationprocess3.Higherlevels tipinthefavorofclotformation4.Thiscanhappenatthesiteofrupturedcoronaryplaque
5.CanleadtoMIifdislodged6.↑fibrinogencanalsoleadtogrowthofplaqueformation
Fibrinogen- OptimalRange
200– 300mg/dLor
5.9– 8.8µmol/L
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 4
ElevatedLevelsofFibrinogen
1. CardiovascularDisease:– M.I.– CoronaryHeartDisease
2. Cancer3. Medications
Fibrinogen:Summary• Fibrinogenlevelsshouldbecheckedin
patientsatriskforheartdisease,stroke,andwithcancer,especiallycoloncancer
• Tryandreducepatients’fibrinogenlevelstoaround200– 300mg/dlor5.9– 8.8µmol/L
• Thismaybedifficultbutanyreductioninfibrinogenmaycorrelatewithareducedriskofheartattack,stroke,ancancer
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 5
EssentialTest#3C-Reactiveprotein
C-ReactiveProteinOptimalRanges
Men:<0.55mg/L
Women<1.5mg/L
10EssentialBloodTests– Part2Dr.DickenWeatherby
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WhatcausesincreasedCRP?
• Diet• Peridontal Disease• Smoking• HighBloodPresure• SyntheticFemaleHormones
ElevatedCRPLevels• Increasedriskofcardiovasculareventsheartdiseaseandstroke
• IncreasedAlzheimer’srisk• Depression• Diabetes
10EssentialBloodTests– Part2Dr.DickenWeatherby
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EssentialTest#4Homocysteine
CausesofElevatedHomocysteine
• B-vitamin deficiency• Genetic factors• Remethylation deficits• increasing age• kidney impairment
10EssentialBloodTests– Part2Dr.DickenWeatherby
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Homocysteine overload increases the risk of disease
in healthy people and magnifies adverse effects in
those with pre-existing conditions.
Homocysteine-OptimalRanges
Men:<7.2μmol/LWomen<7.2μmol/L
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 9
DiseasesAssociatedwithElevatedHomocysteine
• Cardiovascular disease: Heart attacks and atherosclerosis
• Stroke• Colon cancer• Cervical cancer• Depression• Alzheimer’s disease
Homocysteine- Summary• ElevatedHomocysteineassociatedwithagrowinglistofdiseases
• Testinallyouradultpatients• Keeplevelsbelow7.2• ModulateelevatedlevelswithB6,B12,folateandtrimethylclycine
10EssentialBloodTests– Part2Dr.DickenWeatherby
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EssentialTest#5:ThyroidStimulatingHormone
(TSH)
ThyroidOptimalRangesOptimal Range
TSH 1.3 – 3.0 mIU/L
Total T4 6.0 – 11.9 µg/dL77 – 154 nmol/L
Total T3 90 – 168 ng/dl1.4 – 2.6 nmol/L
Free T3 3.0 – 3.5 ng/dl300 – 350 pg/dl
Free T4 1.0 – 1.5 ng/dL12.9 – 19.3 pmol/L
Reverse T3 10 – 25 ng/dl0.15 – 0.27 ng/ml
10EssentialBloodTests– Part2Dr.DickenWeatherby
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ThyroidDysfunction• Hypothyroidism
– Primary– Secondary– T4underconversion(lowT3Syndrome)
• Iodineinsufficiency• Seleniuminsufficiency• Hyperthyroidism
PrimaryHypothyroidism-Pattern
• TSH>2.0• NormalordecreasedtotalT4level(<6.0
mcg/dL)• NormalordecreasedT-3(<90ng/dl)• NormalordecreasedfreeT4(<1.0ng/dl),• NormalordecreasedfreeT3(<3.0ng/dlor
300pg/dl)• Thyroidantibodiesoftenelevated
10EssentialBloodTests– Part2Dr.DickenWeatherby
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SecondaryHypothyroidism-Pattern
• AdecreasedTSH(<1.30)• NormalordecreasedtotalT4level(<6.0mcg/dL)
• NormalordecreasedT-3(<90ng/dl)• NormalordecreasedfreeT4(<1.0ng/dl),
• NormalordecreasedfreeT3(<3.0ng/dlor300pg/dl)
• Symptomsofhypothyroidism
T4ConversionHypothyroidismLowT3SyndromePattern
• NormalTSH• LowtotalT3(<90)• LowfreeT3(<3.00),• NormaltotalT4• NormalfreeT4• IncreasedreverseT3(>25)
10EssentialBloodTests– Part2Dr.DickenWeatherby
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ThyroidAntibodies• Anti-thyroglobulin antibody(Tg-Ab)
• ThyroidReceptorantibodies(TR-Ab andnewerTSI)
• Thyroidperoxidase antibody(TPO–Ab)
EssentialTest#6HemoglobinA1C
10EssentialBloodTests– Part2Dr.DickenWeatherby
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HemoglobinA1C-Background
• Measuresglycosolation inRBCs• Thelongerbloodglucoseremainshighthegreatertheglycosolation
• HGBA1Creflectsaverageglucosecontroloverpast120days
HemoglobinA1COptimalRange
IdealtokeepHemoglobinA1Cbetween4.5– 5.5%
10EssentialBloodTests– Part2Dr.DickenWeatherby
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HemoglobinA1CWhyisitimportant?
• Monitoringlong-termglucosecontrolindiabeticsandpre-diabetics
• EvaluatingCardiacrisk
EssentialTest#7VitaminD
10EssentialBloodTests– Part2Dr.DickenWeatherby
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VitaminD- Role• Skeletalsystem• Glucosemetabolism• Cardiovascularsystem• Immunesystem• Adrenalhormonesynthesis
VitaminDReferenceRanges
• AssessVitaminDbychecking25(OH)vitaminD• Deficientlevels: <20ng/ml(<50nmol/L)• Insufficientlevels: 20– 40ng/ml(50– 100nmol/L)• Optimallevels: 40– 65ng/ml(100– 160nmol/L)• Excesslevels: >100ng/ml(>250nmol/L)
10EssentialBloodTests– Part2Dr.DickenWeatherby
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EssentialTests#8- #10HormoneTesting
DHEA,Estradiol,andTestosterone
EssentialBloodtest#8
DHEA-S
10EssentialBloodTests– Part2Dr.DickenWeatherby
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DHEAReferenceRanges• Normalreferencerange:
– Men:280– 640μg/dL– Women:65– 380μg/dL
• Optimalreferencerange:– Men:400– 500μg/dL– Women:350– 430μg/dL
LowDHEALevels• Mooddisorders• Sexualdysfunction• Coronaryarterydisease• Osteoporosis• Increasedinsulinresistance
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 19
EssentialBloodtest#9
Estradiol
Estradiol- ReferenceRanges
• Normalreferencerange:– Men:<54pg/ml– Women:0– 528pg/ml
• Optimalreferencerange:– Men:10– 30pg/mL– Women352– 528pg/mL
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 20
EstradiolinWomen• Lowestradiolincreasesriskofosteoporosis
andbonefracture• Estradiolmayimprovequalityoflifein
menopausalwomen• Migraineheadaches• Increasedlevelsofestradiolinwoman
suggestanincreasedriskofbreastorendometrialcancer
EstradiolandMen• low levels of estradiol in men
affect bone density and risk of fractures if too low
• Low estradiol increase risk of osteoporosis
• High estradiol and coronary artery disease
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 21
EssentialBloodtest#10
FreeTestosterone
FreeTestosterone- ReferenceRanges
• Normalreferencerange:– Men:6.6– 26.5pg/ml– Women:0– 2.2pg/ml
• Optimalreferencerange:– Men:15– 26.5pg/mL– Women:1.4– 2.2pg/mL
10EssentialBloodTests– Part2Dr.DickenWeatherby
©Weatherby&Associates,LLChttp://BloodChemSoftware.com 22
LowTestosteroneLevelsinMen
• Diminishedlibido• Erectiledysfunction• Lossofmuscletone• Increasedabdominalfat• Lowbonedensity• Metabolicsyndrome• Diabetes• Heartdisease
Lowtestosteroneasamajorcardiacriskfactor
• Age,HDLlevels,andfreetestosterone
• Increasedriskofstroke• Heartfailure• Increasedglycation
10EssentialBloodTests– Part2Dr.DickenWeatherby
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ImportanceoftestosteroneinWomen
• Musclestrength• Bonemass• Sexualfunction• Mood• Bodycomposition
SUMMARY