Biochemistry - interpretation

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[UPDATED MARCH 2022]

See also Commonly used blood tests and what they mean

Introduction

Biochemistry tests tell us about the workings of the liver, kidneys, pancreas with some clues about calcium balance (parathyroids and vitamin D). There are many more sensitive tests available, just because all the results are normal does not necessarily mean that all is well!

Kidney function

Urea or Creatinine

If low then this points to a low protein diet. If high this may mean dehydration or poor kidney function. If high always check a glomerular filtration rate (GFR).

Sodium

This too is tightly regulated. If it is too low this may point to adrenal problems, kidney problems or lack of salt in the diet. Low sodium should always be taken seriously. Slightly high levels points to dehydration.

Potassium

Potassium varies according to diet! Low potassium means there is a lack of vegetables in the diet. Bananas may be rich in potassium but they are high glycaemic index, so beware!

Glomerular filtration rate

Should be above 90ml/min. If not, then the kidneys are not functioning as well as they should and this needs investigating with Full blood count, Multistix urine test, blood pressure and ultrasound of kidneys. If all is normal then the The general approach to maintaining and restoring good health should be applied. One should also consider Chemical poisons and toxins, including drugs, allergy or poor mitochondrial function. This needs checking regularly for progress.

Poor kidney function is often due to poor blood supply - see Arteriosclerosis - what causes it and how to prevent it or low cardiac output Low blood pressure and postural hypotension.

Liver Function

Bilirubin

A raised bilirubin always needs investigating for possible liver disease. However a high normal bilirubin means one is a slow detoxifier. Those people with borderline results may be diagnosed with Gilbert’s syndrome. The problem for people who are slow detoxifiers is that they are at increased risk of toxic stress from within the body - see Fermentation in the gut and CFS and from toxic stress out side the body - see Chemical poisoning - general principles of diagnosis and treatment.

Aspartate transaminase (AST) and alanine transferase (ALT)

If high - this points to liver damage

Alkaline phosphatase

If high this means damage to liver, muscle or bone.

Lactate dehydrogenase

Again, if high then this points to tissue damage or overload. The lactate could come from the fermenting gut - see Fermentation in the gut and CFS or from poor mitochondrial function with switch into anaerobic metabolism producing loads of lactic acid - see CFS - The Central Cause: Mitochondrial Failure. Which tissue is producing lactic acid can be discerned by doing Lactate dehydrogenase studies.

Other metabolic indicators

Calcium

It is the corrected calcium level that is the important reading. Calcium levels do not reflect dietary intake but control. Too high is a potential emergency and must always be taken seriously - it can point to high parathormone levels - this should be measured as a matter of urgency. See Parathormone Wikipedia:Parathyroid hormone

Too low a calcium is nearly always due to vitamin D deficiency. See Vitamin D Home Test Kit.

Measuring calcium levels tells us very little about bone density! A high calcium could point to calcium being stripped out of bone and therefore osteoporosis.

Uric acid

High uric acid can point to poor Antioxidant status profile. Also see Gout.

Blood sugar or glucose

The normal ranges for blood sugar are creeping up because this reflects high glycaemic index Western diets. A normal blood sugar should lie between 3.6 and 5.8 mmol/l. Blood sugar is the petrol of our car - highly essential, but also highly dangerous! It must be tightly regulated. If the blood sugar lies above or below this range then this points to hypoglycaemia which is a pre-diabetic condition. See Hypoglycaemia - the full story. Just because the blood sugar is within the normal range does not mean all is well - it may fluctuate widely through the day depending on diet, micronutrient status, exercise, stress, chemical poisoning and so on. A single blood test is a snap shot - ideally one needs a video - this is called a glucose tolerance test. However, a good test of hypoglcaemia is Short chain fatty acids.

Triglycerides

This reflects blood sugar and insuln levels. If blood sugar goes too high, insulin is produced which shunts sugar into triglycerides. This is typical of someone with wobbly blood sugar level and hypoglycaemia one moment, and with hyperglycaemia the next. It is a pre-diabetic condition and should always be taken very seriously. Action needed!

Cholesterol

It is vital to get a breakdown of good and bad cholesterol! See Cholesterol - the whys and wherefores

Amylase

This enzyme is produced by the pancreas to digest starch in the gut. If the pancreas is damaged, amylase leaks into the blood stream. So a high level indicates pancreatic damage. In acute pancreatitis, levels may rise over 1,000 Ul.

Total protein, albumin and globulin

Protein is a resource for healing and repair as well as a carrier molecule for hormones, minerals etc. Albumin maintains the osmolarity of blood. Globulin is an immune system protein which may rise with immune activity. One can also do electrophoresis of globulin to look for paraprotein disease.

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