Dr Johnson provides feedback on all out of range private blood tests. Some examples, and reports can be seen here. Patient names have been removed and personal data that may link patients to reports has also been removed. Dr Johnson reports on all out of range results as part of this private blood testing service.
By providing a doctor's comment on all out of range results, Blue Horizon Medicals goes further than any other provider to ensure that your health status is professionally realised.
The copper level is on the low side. Copper based enzymes regulate various metabolic functions in our bodies - such as energy production, iron metabolism, connective tissue formation, and normal nerve function.Copper deficiency can result from malnutrition, reduced absorption from the gut, or even excessive zinc intake. Symptoms include deficiencies in blood cells, bone and other connective tissue problems, and symptoms of nerve disorders - tingling, pain or weakness. Marginal copper imbalance has been associated with impaired immune system function, loss of bone density, and increased risk of heart and neurological diseases. I advise you to speak to your usual doctor about this finding - further testing may be indicated.
The creatinine kinase (CK) level is on the high side. A common cause of this elevation is recent exercise (CK is an enzyme released from damaged or inflamed muscle). Some medication can lead to CK elevation, most commonly statin drugs prescribed for high cholesterol. If significantly raised you may have symptoms of muscle aching predominantly. If you had severe chest pain in the past few days prior to the test you should alert your usual doctor without delay - CK can be elevated because of heart muscle damage. If not, a repeat measurement in a few weeks time would be reasonable if you have any concerns about the cause of this small rise in CK levels.
The very small rise in CA15-3 is unlikely to be of significance unless you have a history of breast cancer. This antigen is usually tested to gauge response from treatment of breast cancer. Other conditions can cause a rise in the antigen, including pregnancy and lactation and several non-cancerous conditions (including benign breast or ovarian disease, endometriosis, pelvic inflammatory disease and hepatitis).
If you have any concerns it would be sensible to discuss the result with your usual doctor.
Low Vitamin B12 levels can lead to Pernicious Anaemia (PA), a state of deficiency of the red blood cells in which there is reduced quality and number. Characteristically, the red blood cells are enlarged in this state (if the deficiency is severe and longstanding). Vitamin B12 is commonly found in many foods, particularly meats. Deficiency can develop if intake of the vitamin is reduced or if absorption from the gut is impaired. Poor absorption owing to a deficiency of Intrinsic Factor (IF) is the underlying reason for PA.
Vitamin B12 deficiency in the longer run can lead to nervous system disorders - with sensation changes, loss of power or co-ordination, gut disorders and (rarely) dementia or mental illness. Lower level deficiency has been associated with a range of symptoms such as fatigue, memory impairment, irritability, depression and personality changes.
This result demonstrates anaemia (deficiency of red blood cells). There are a number of potential causes. The negative haemaglobinopathy screen means that sickle cell disease is NOT present (a relatively common cause of the types of changes in the red cells described by the haematologist). The list of possible causes of the anaemia and associated described changes include asplenia (absent spleen following trauma for example), and radiotherapy. Howell–Jolly bodies are also seen in haemolytic anemia, megaloblastic anaemia, hereditary spherocytosis, and myelodysplastic syndrome (MDS). Ten percent of patients with coeliac disease also present with splenic atrophy, with subsequent development of Howell–Jolly bodies. This is not an exhaustive list - I recommend you discuss this result with your usual doctor as referral to a haematologist is probably indicated.
There is Vitamin D insufficiency. Vitamin D is manufactured in our skin as a direct result of sunlight exposure. One potential complication of prolonged Vitamin D lack is osteomalacia, a disease which causes severe structural deformities to the skeleton. Lower level Vitamin D deficiency can lead to a number of non specific symptoms, including possibly chronic fatigue (experts have for many years noted an association between sufferers of chronic fatigue syndrome or myalgic encephalitis (CFS or ME) and low blood levels of Vitamin D). It has been estimated that between 50-70% of people living in the northern Europe (where daylight length reduces your chances of receiving adequate sunlight in the winter) are deficient in this vitamin by March each year. Symptoms of vitamin D deficiency include chronic pain, weak bones, frequent infections (recent research has detected an association between vitamin D deficiency and severe pneumonia), depression and fatigue.
The Vitamin B12 level is elevated. This is not a significant overdose, as B12 is well tolerated by humans even in very high concentrations, and is usually a result of supplementation or following a diet rich in the vitamin. Some advocate high doses of Vitamin B12 to combat the development of Alzheimer's disease.
The total cholesterol level of 4.7 is below that recommended by most authorities, but the LDL (the component of cholesterol that is associated with development of cardiovascular disease) is high at 3.2 However, the HDL (the component of cholesterol thought to be protective against heart disease) is above (therefore good) at 1.1. The ratio formed by dividing cholesterol by HDL is probably the better guide to primary risk from cholesterol (ie the risk from cholesterol alone, if there is no established heart disease, high blood pressure or diabetes for example) - at 4.3 it is just above the ideal score of 4 or lower, which implies your risk of developing heart disease from cholesterol induced damage alone is perhaps not as high as the headline total level might suggest. In fact, your risk of developing heart disease over the next 5 years from cholesterol induced damage alone is probably a little better than average for your age (see the section on QRISK, P.15). Your QRISK score of 1:361 is reassuring though it could be improved - for example, by decreasing the LDL level and increasing your level of exercise, this score might be bettered a little. Your absolute risk of cardiovascular disease is dependent upon on a number of factors however, including weight, blood pressure, whether you smoke or are diabetic or not, and family history. I suggest you make an appointment to discuss the implications for you with your usual GP, if you have any concerns.
The low lactate dehydrogenase level is not a concern, neither is the very small rise in MCHC.
If you are not taking Thyroxine medication, it would be wise to keep an eye on this level - either by reference to previous results if known or by checking thyroid function again in 6 months time or so. There is a possibility that hypothyroidism (underactive thyroid gland) will develop if the Thyroxine level fails to rise (a low level implies reduced Thyroxine production from the thyroid gland). Even though thyroid antibody testing is negative it is still possible to develop thyroid disease, although it is less likely.
If you have, or develop, any symptoms suggestive of thyroid illness I advise you to make contact with your usual doctor.
The triglyceride level is very high. A high triglyceride level is associated with an increased risk of pancreatitis, and possibly with heart disease and stroke. Sometimes high triglycerides are a sign of poorly controlled type 2 diabetes, low levels of thyroid hormones (hypothyroidism), liver or kidney disease, or rare genetic conditions that affect how your body converts fat to energy. High triglycerides could also be a side effect of taking medications such as beta blockers, diuretics and steroids.
You may wish to discuss these lipid results with your usual doctor or practice nurse. A little attention to your diet could bring your cholesterol closer to the ideal range (ie total below 5, % HDL to greater than 20%), and the triglyceride level to below 2.3. Usually that would mean reducing the intake of rich fatty foods, especially dairy products, but medication may be needed to bring about significant reduction - I suggest you discuss this finding with your usual doctor too.
The slightly reduced transferrin saturation and borderline low ferritin level may be signs of mild iron deficiency. However the other markers of iron store levels are all normal (UIBC, total iron binding capacity and serum iron) which together suggest the problem is marginal only. There are many potential causes of iron deficiency - broadly encompassing blood loss, decreased intake of iron from the diet or decreased absorption of iron from the gut. I suggest you discuss this result with your usual doctor if you have any concerns, but the likelihood is that the body's iron levels are close to acceptable limits.
The uric acid level is high. Elevated levels can lead to gout, an acute inflammatory condition affecting the joints, most commonly the big toe. Gout can be caused by medication (often diuretics are to blame) and a few rare conditions, but is usually without cause. If you have or have had a red swollen painful joint or joints, and were not aware of the possibility of gout, I advise you to discuss this finding with your usual doctor.
A high CRP (C reactive protein) is associated with inflammation (as seen, for example, with arthritis or gout - see above - or infection) from some cause. It is not an exact test, and is non specific. An elevated CRP is not a normal finding and its presence should lead to further investigation to establish the cause. It would be sensible to discuss this result with your doctor.
The lactate dehydrogenase (LDH) level is slightly elevated. LDH is found in almost all tissues but only a small amount of it is detectable in the blood. It usually stays within the cells. When cells are damaged or destroyed, LDH enters the blood. LDH is used as a general marker of injury to cells, and many cells can release it to varying degrees. Elevations of LDH may be measured either as a total LDH or as LDH isoenzymes (subgroups). A total LDH level is an overall measurement of five different LDH isoenzymes. A level of 306 is a marginal rise and is probably of no major concern, though may be indicative of gout (see above). If you wish to be certain this is not the beginning of an upward trend it would be reasonable to retest it in a few weeks time.
The small elevation in RDW is of no concern.
There is evidence of past infection from Toxoplasma. This is a common parasitic infection, passed from sheep, cats or dogs for example, which usually causes no or few symptoms. Those at risk are unborn babies - if the mother is infected with the parasite while pregnant, it is possible the baby will be born with abnormalities. If the disease is encountered at any other time the risk of complication is very low. In this case, there is no evidence that there is any active current infection. The implication is therefore that you are immune from re-infection from this parasite.
There is evidence of immunity against the Varicella (chicken pox) virus. As the laboratory states, if there has been no recent rash suggestive of chicken pox, this would imply previous exposure and subsequent immunity (protection against further infection).
There is no evidence of previous infection from or vaccination against Rubella (German measles).
There is no evidence of previous infection from HIV, Syphilis, Hepatitis B or Hepatitis C viruses.
Haemoglobinopathy screening is unremarkable - the relative proportion of various forms of haemoglobin are within normal limits.
The neutrophil (a type of white cell) count is borderline low but this would not normally be a concern. A co mon explanation would be a recent infection (eg common cold) causing a temporary drop in the level. Repeat testing in a few weeks time would be useful to check the level was not falling, but I would not say it is essential unless you have any specific concerns about immune cell function (eg frequent colds and other minor infections). The finding of a low basophil count is not likely to be of great concern.
The small rise in total iron binding capacity, and borderline low ferritin level, may both be signs of mild iron deficiency. However the other markers of iron store levels are all normal (UIBC, transferrin saturation and serum iron) which together suggest the problem is marginal only, if at all. There are many potential causes of iron deficiency - broadly encompassing blood loss, decreased intake of iron from the diet or decreased absorption of iron from the gut. I suggest you discuss this result with your usual doctor if you have any concerns, but the likelihood is that the iron levels are within acceptable limits.
Having a low level of low density lipoprotein is a favourable finding, and is associated with a lower lifetime risk of developing cardiovascular (heart and blood vessel) disease. Your absolute risk of developing heart and vascular disease throughout life is dependent though on a number of factors including weight, blood pressure, whether you decide to smoke or develop diabetes, and family history.
The finding of a low level of creatinine is of no concern and in fact implies there is excellent kidney function.
Similarly, the marginal rises in red cell count and the RDW are of little significance.
The adrenocorticotropic hormone (ACTH) level is high. ACTH is produced by the the pituitary gland which is a small organ located just below the brain. It controls the production of another hormone called cortisol, which is produced by the adrenal glands. Cortisol helps to break down protein, sugar, and fat from the diet, and helps to regulate blood pressure and the body's ability to fight infection. Cortisol is also one of the hormones that helps you deal with stress. Cortisol levels should peak in the morning and be at their lowest in the evening.
A high level of ACTH in a private blood test is associated with decreased cortisol production - this can lead to a condition known as Addison's disease. I recommend you speak to your usual doctor about this finding - usually a referral to an endocrinologist would be advisable (if this has not already been made).