The Secret Meaning of Labs

Lab data is a great resource for identifying and tracking health issues.  Routine lab analysis includes CBC (complete blood count), basic metabolic panel (BMP or blood chemistries), lipid panel and urinalysis.  There are a multitude of more specialized studies such as: A1c, done for diabetes control; blood coagulation test done for bleeding abnormalities or to monitor anticoagulant medications; and liver panel, done to monitor liver function.  Those are the easy ones!  Specialized lab tests require specialized equipment and include proteins studies like electrophoresis, immunoglobulins and light chains, often found in myeloma. 

But let’s keep it simple and focus on what we can learn from the CBC.  The obvious includes the white blood cell count (WBC), hemoglobin (HG), and platelet count (PLT).  The WBC, if elevated may indicate infection.  The type of infection would determine the type of treatment, typically antibiotics.  If the WBC remains elevated over time, it could possibly point to a leukemia, requiring treatment determined by more in-depth studies.  On the converse side, if the WBC is decreased, called leukopenia (leuko=white cell, penia= decreased), it may show bone marrow dysfunction, autoimmune disorders, or immunosuppression.  Of course, more tests and studies would ascertain the cause and therefore the treatment. 

The HG, when decreased, commonly identifies anemia.  Treatment of anemia depends on the cause of the anemia.  Very common in the senior population, is iron deficiency anemia.  In that case, an iron supplement would be given, either orally or through an IV.  Severe anemia is treated with blood transfusions.  Since the HG carries oxygen, a person severely anemic could be short of breath.  At times, that symptom helps direct the diagnostician to cause and treatment.  An increase in HG is known as polycythemia (poly=many, cyt=cell, emia=blood).  Polycythemia, although rare, is very serious.  Without treatment, it could be fatal.  Treatment depends on severity, but also includes phlebotomy (blood letting in the old, old, old days) or medication.  HG may also be elevated d/t smoking or residing in a high altitude.

The function of platelets is to form clots to stop bleeding.  A decreased count is called thrombocytopenia (thrombo=plt, cyt=cell, penia=decreased). It makes sense that a decreased PLT count would put someone at risk for bleeding.  Common areas to first identify the problem might be frequent nose bleeds, bleeding gums or light bleeding from the GI tract.  It doesn’t take rocket science to realize this may present a simple problem like a nosebleed or a life-threatening emergency requiring hospitalization and transfusions.  Again, the cause of thrombocytopenia would determine appropriate treatment.  A condition of too many PLTs is call thrombocythemia (I bet you can figure that one out!).  This condition would cause more clots than needed by the body, a very dangerous situation that my end in a stroke or heart damage.  Medications are necessary to treat and prevent complications.