Need Help Understanding Your Results

This page provides general explanations of the screening tests and results at your leisure.

Please be advised that these are general explanations and guidelines only, and are not specific to you or your individual screening results. For details specific to you and your results, please make an appointment with your health care provider to discuss them.

Screening results that fall OUTSIDE Campbell County Health's reference ranges (reported on the right side of the report form) will be marked with an L or H immediately behind the value. Values that are deemed "critical" values will be marked with L* or H* immediately behind the value.

Screening values that are outside the CCH reference ranges:

May show that you had eaten shortly before your blood was drawn.
May mean there was a problem with drawing your blood.
May indicate possible problems needing medical evaluation.

IT IS NOT POSSIBLE TO DIAGNOSE OR TREAT ANY DISEASE OR HEALTH PROBLEM WITH THIS BLOOD SCREEN ALONE. It can help you learn more about your body and detect potential problems in early stages when treatment or changes in personal health habits can be most effective.

You and your healthcare provider can learn a great deal about your health from a sample of your blood. Laboratory tests help in several ways. Sometimes test results will be abnormal before you have any symptoms. For those times when symptoms have developed, laboratory test results may help confirm that a problem does exist.

A normal test result is just as significant as an abnormal result. When a result is normal, it not only helps to rule out disease, but it also establishes a baseline for you. Each person has his or her own "normal" baseline. A person's own result is the best baseline for monitoring any change that takes place in the future. If any of your values are significantly different than previous results but still normal, contact your health care provider.

Medications and Fasting

Over-the-counter medications, prescription drugs, alternative medications, alcohol consumption and your fasting time may affect blood chemistry screening results. Your health care provider must have a complete and honest picture of your use of medications in order to effectively evaluate your health status. If all the needed information is provided, time and money will be saved. A 12-hour fast is recommended for the most accurate results.

LEARN MORE AT LAB TESTS ONLINE

Results

Biometric Measurements

Biometric screenings are evaluations that look at your past, current, and potential future health conditions. This Biometric data that was collected at your wellness screening includes: blood pressure, oximetry, height, weight, body fat, and may also include a blood screen.

Heart Rate: A normal resting heart rate for adults ranges from 60-100 beats per minute. A lower heart rate at rest may indicate more efficient heart function and better cardiovascular fitness. If a resting heart rate is consistently above 100 beats per minute, follow up with a physician is recommended to determine a cause. Keep in mind that several factors can influence one’s heart rate including: activity level, fitness level, air temperature, body position (standing or lying), emotions, body size, and medications.
Oximetry: Oximetry is a basic measure of the blood’s oxygen carrying capacity. Optimal range is 93%-100%. Oximetry ranges below 93% may indicate hypoxia, a condition when the body is deprived of inadequate oxygen supply. This could indicate other medical conditions that should be followed up with a physician.
Blood Pressure: Blood pressure is the pressure exerted by the blood against the vessel walls. It varies based on many factors including: age, health, physical condition, elasticity of the vessel walls, the volume and viscosity of the blood, and the strength of the heartbeat. It is important to remember that a single blood pressure reading is not diagnostic. If a blood pressure reading is high, recheck it and follow up with a physician it if remains elevated.
Normal- less than 120 systolic and less than 80 diastolic
Elevated- 120-129 systolic and less than 80 diastolic
High Blood Pressure (Hypertension Stage 1)- 130-139 systolic and 80-89 diastolic
High Blood Pressure (Hypertension Stage 2)- 140 or higher systolic and 90 or higher diastolic
Hypertensive crisis- higher than 180 systolic and higher than 120 diastolic
Body Mass Index (BMI): BMI is a measure for human body shape based off of an individual’s height and weight.
Underweight <18.5
Normal 18.5-24.9
Over Weight 25-29.9
Obese 30+

Body Fat

The body fat percentage is the total weight of fat divided by total body weight. This can then help determine ones lean body weight and fat body weight. Lean body weight is the mass of the non-fat parts of a body like muscle, organs, blood, and water. Fat body weight is the fat accumulation in tissues.

Age Male/Female Classification
18-39, 8-21%/21-33%, Optimal
40-59, 11-22%/23-35%, Optimal
60+, 12-25%/22-36%, Optimal

Blood Typing

Blood typing is used to determine an individual's blood group and what type of blood or blood components the person can safely receive. It is important to ensure that there is compatibility between a person who requires a transfusion of blood or blood components and the ABO and Rh type of the unit of blood that will be transfused. A potentially fatal transfusion reaction can occur if a unit of blood containing an ABO antigen to which a person has an antibody is transfused to that person.

Red blood cells (RBCs) have markers or antigens on the surface of the cells. Two major antigens or surface identifiers on human RBCs are the A and B antigens. Blood is grouped according to the presence or absence of these antigens. People whose red blood cells have A antigens are considered to be blood group A; those with B antigens are group B; those with both A and B antigens are group AB; and those who do not have either of these markers are considered to have blood group O. Another important surface antigen is called Rh factor. If it is present on the red blood cells, a person's blood type is Rh+ (positive); if it is absent, the person's blood is type Rh- (negative).

Our bodies naturally produce antibodies against the A and B antigens we do not have on our red blood cells. For example, a person who is blood type A will have antibodies directed against the B antigens on red blood cells and someone who is type B will have anti-A antibodies and so on.

The following table indicates the type of antibodies a person is expected to have based on their blood type.

Bloodtype A, B antigen
Bloodtype B, A antigen
Bloodtype AB, Neither antigen
Bloodtype O, A and B antigens

The results of blood typing will determine if a person is group A, B, AB, or O and if he or she is Rh negative or positive depending on what antigens are present on the person's red blood cells. The results will tell the physician what blood or blood components will be safe for the person to receive.

A positive, can safely receive blood that is A positive, A negative, O positive, O negative
A negative, can safely receive blood that is A negative, O negative
B positive, can safely receive blood that is B positive, B negative, O positive, O negative
B negative can safely receive blood that is B negative, O negative
AB positive can safely receive blood that is AB positive, AB negative, A positive, A negative, B positive, B negative, O positive, O negative
AB negative can safely receive blood that is AB negative, A negative, B negative, O negative
O positive can safely receive blood that is O positive, O negative
O negative can safely receive blood that is O negative

The results will tell a pregnant woman whether she is Rh positive or negative and whether she may be a candidate for receiving Rh immune globulin to prevent her from potentially developing antibodies against her fetus' blood cells.

Calcium, Magnesium, Phosphorus

Muscle and Bone Health
Healthy bones and muscle make up the bulk of our musculoskeletal system. Osteoporosis is a condition in which bones become porous and brittle. Those with poor bone density are likely to fracture a bone in the common regions of the hip, wrist, or spine. Because bone density declines with age, it is important to practice health habits such as weight bearing exercise and eating a diet rich in magnesium, calcium, and phosphorus.

Magnesium: Magnesium is a mineral that is vital for energy production, muscle contraction, nerve function, and the maintenance of strong bones.

Optimal Range: 1.7-2.4 mg/dL

High levels may indicate:

Kidney disease
Excessive Supplementation

Symptoms: nausea, muscle weakness, loss of appetite, irregular heart rate.

Low levels may indicate:

Excessive alcohol use
Severe malnutrition
Prolonged Diarrhea
Digestive Disorders

Symptoms: nausea, loss of appetite, fatigue, confusion, muscle cramps, seizure, irregular heart rate, and numbness or tingling.

Foods rich in Magnesium: Green leafy vegetables, nuts and seeds, legumes, cereals, whole grains, and fish.

Calcium: Calcium is the most abundant and one of the most important minerals in the body. It is essential for cell signaling and the proper functioning of muscles, nerves, and the heart. Calcium is needed for blood clotting and is crucial for the formation, density, and maintenance of bones. Ninety-nine percent of calcium in your body is found in your bones, and only one percent is in the blood.

Optimal Range: 8.6-10.3 mg/dL

High levels may indicate:

Cancers of the bone
Excessive use of antacids
Hyperparathyroidism
Excessive Vitamin D intake
Hormone disorders

Foods Rich in Calcium:

Milk, cheese, and other dairy foods
Green leafy veggies such as broccoli and cabbage
Nuts, soybeans, and tofu

Phosphorus: is closely related to calcium in bone development. Most phosphorus in the body is found in bones.

Optimal Range: 2.3-4.3 mg/dL

Low Levels may indicate:

Kidney disease

High Levels may indicate:

Starvation or malnutrition
Muscle weakness

Foods Rich in Phosphorus: Protein rich foods such as meats, poultry, fish, nuts, beans, and dairy products

Cholesterol, Lipids, Triglycerides

Heart Health
Heart disease is the leading cause of death in the United States for a majority of ethnicities including African Americans, Hispanics, and Caucasians. For American Natives, Pacific Islanders, and Asians it is second to cancer. Understanding cholesterol and taking proactive steps to monitor it is one of the key components to maintaining clear arteries and prevent blood clots.

Cholesterol: is an essential fat found in nearly every body tissue. Elevated levels have been shown to be associated with a higher risk of heart disease and clogged blood vessels.

Optimal Range: 120-200mg/dL

High Density Lipoprotein (HDL) Cholesterol: is a protein part of the total cholesterol. It is referred to as the “good cholesterol” because it acts as a scavenger, and removes cholesterol from the artery walls. It has been shown that the HIGHER the HDL cholesterol the LOWER the risk for developing heart disease.

Optimal Range: 40-96mg/dL

Low Density Lipoprotein (LDL): is a protein part of the total cholesterol. This is what is referred to as “bad cholesterol” because it forms deposits on artery walls. These deposits can build up and lead to a heart attack or stroke. It has been shown the LOWER the amount of LDL cholesterol, the LOWER the risk of developing heart disease.

Optimal Range: 53-130mg/dL

Cholesterol/HDL Ratio: This ration is obtained by comparing the total cholesterol level to the HDL cholesterol level. It has been shown that the higher this number, the greater the risk for coronary heart disease. A high HDL cholesterol level will result in a lower ratio, which means lower risk. This could be true even if the total cholesterol level is high. This ratio appears to best measure the lipid associated risk of you developing coronary heart disease.

3.0 or below = low risk
3.1-4.4 = average risk
4.5-5.0 = increased risk
5.1-6.4 = high risk
6.5 or higher = extreme risk

Triglycerides: are a fatty substance in the blood which acts as a major form of stored energy. This is blood fat that may be related to a higher risk of heart disease. Elevated levels may be caused by foods high in saturated fats and alcohol. It is recommended that you fast for 10-12 hours to obtain an accurate result for this test. Low values are not considered significant.

Highly Sensitive C-Reactive Protein (hsCRP): Studies have shown that the combination of cardiovascular hsCRP with the cholesterol to HDL ratio is the strongest independent predictor of peripheral artery disease. Cardiovascular CRP may also help identify patients at risk for first myocardial infarction (MI) even with low-to-moderate risk lipid levels.

How to reduce your risk of heart disease:

Increase antioxidant intake with more fruits and vegetables to decrease oxidation of LDL cholesterol and reduce lipid plaque formation
Increase fiber intake with whole grain breads, cereals, pastas, as well as fruits and vegetables. Fiber binds to LDL cholesterol and takes it to the liver for excretion
Increase Omega-3 fatty acid intake through fish and nuts (almonds, pistachios, walnuts) to decrease inflammation
Limit saturated fat intake from high fat meats and dairy
Avoid trans-fatty acids from fast food and fried food
Decrease simple sugar intake and processed foods
Moderate alcohol intake (limit 1 serving of alcohol per day for women and 2 for men)
Smoking cessation
Weight loss
Regular activity (The American Heart Association recommends 40 minutes of moderate intensity exercise 3-4x a week)

Complete Blood Count (CBC) Screen

A Guide to Your Complete Blood Count (CBC) Screen

What is a Complete Blood Count?

The complete blood count is one of the most commonly ordered blood screening tests and is used to present a general picture of a person’s overall health. The CBC is a test that evaluates the cells that circulate in blood. Blood consists of three types of cells suspended in fluid called plasma: white blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs). The results of a CBC can provide information about not only the number of cell types but also can give an indication of the physical characteristics of some of the cells. A standard CBC includes the following:

White Blood Cell Count (WBC)
White Blood Count Differential
Red Blood Cell Count (RBC)
Hemoglobin Concentration (HGB)
Hematocrit Value (HCT)
RBC Indices - which includes mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW)
Platelet Count (PLT) - including mean platelet volume (MPV)

White Blood Cell Count (WBC)
White blood cells (leukocytes) are important for your body’s defense system. White blood cells are larger than red blood cells, but there are fewer of them.

Optimal Range: 3.7-10.7 K/mm3

When you have an infection, an increased number of white blood cells are sent form the bone marrow to attack the bacteria or virus that is causing the infection. An increased number of white blood cells may occur with mild infections, appendicitis, pregnancy, leukemia, allergic reactions, hemorrhage, and hemolysis. Strenuous exercise, emotional distress, and anxiety can also cause an increase in WBC. A low white blood cell count makes it harder for your body to fight off an infection. People with a low WBC are more likely to catch colds or other infectious diseases. Low WBC counts may be seen in overwhelming infections like mumps, lupus, cirrhosis of the liver, HIV, and cancer. In addition, radiation therapy and certain types of drug therapy tend to lower the WBC.

Red Blood Cell Count (RBC)
Red blood cells (erythrocytes) are the most common type of cell in the blood. Red blood cells are continuously produced by the bone marrow in healthy adults. The typical lifespan of an RBC is 120 days; thus the bone marrow must continually produce new RBCs to replace those that age and disintegrate or are lost through bleeding. The cells contain hemoglobin, which carries oxygen and carbon dioxide throughout the body.

Optimal Range: 3.95- 5.35 M/mm3

If the concentration of red blood cells and/or the amount of hemoglobin in the blood drops below normal, a person is said to have anemia and may have symptoms such as fatigue and weakness. Much less frequently, there may be too many RBCs in the blood (erythrocytosis or polycythemia). In extreme cases, this can interfere with the flow of blood through the small veins and arteries. Some examples that produce a low RBC include:

Acute or chronic blood loss
RBC destruction (e.g., hemolytic anemia, etc.),
Nutritional deficiency (e.g., iron deficiency, vitamin B12 or folate deficiency),
Bone marrow disorders or damage, chronic inflammatory disease
Chronic kidney disease

Though not as common, some conditions that cause high RBC are:

Excessive dehydration
Pulmonary disease
Congenital Heart Disease
Kidney or tumor that produces excess erythropoietin
Smoking
Living at high altitude
Certain genetic disorders

Hemoglobin (HGB)
Hemoglobin is the iron-containing protein found in all red blood cells (RBCs) that gives the cells their characteristic red color. Hemoglobin enables RBCs to bind to oxygen in the lungs and carry it to tissues and organs throughout the body. The oxygen is used by the cells to produce energy. It also helps transport a small portion of carbon dioxide, a product of cell metabolism, from tissues and organs to the lungs, where it is exhaled.

Optimal Range: 12.0-16.0 gm/dL

Hemoglobin results usually mirror RBC results and causes. People with a low hemoglobin level most often have anemia and usually have a low red blood cell count and a low hematocrit. Signs of symptoms of anemia - paleness, shortness of breath, fatigue - will start to show when the hemoglobin is too low. Hemoglobin increases with altitude adaptation. In general, females have lower red blood cell counts and hemoglobin values than men.

Hematocrit (HCT)
A hematocrit is a test that measures the proportion of a person's blood that is made up of red blood cells (RBCs). Blood consists of RBCs, white blood cells (WBCs), and platelets suspended in a fluid portion called plasma. The hematocrit is a ratio of the volume of red blood cells to the volume of all these components together, called whole blood. The value is expressed as a percentage or fraction.

Optimal Range: 36.0-48.0%

Hematocrit measurement is useful in identifying anemia, and red cell production within the circulatory system. Hematocrit increases with altitude training or dehydration. Women generally have lower hematocrit values than men.

What are Indices?

Indices are values which measure hemoglobin, hematocrit, and platelet components found in red blood cells. These indices include:

MCV: Mean cell volume, measures the average size of the red blood cells.

Optimal Range: 81.0-101.0 fl

MCH: Mean cell hemoglobin, reflects the average weight of hemoglobin found in the red blood cell.

Optimal Range: 27.9-33.3 PG

MCHC: Mean cell hemoglobin concentration, reflects the average amount of hemoglobin in the red blood cell.

Optimal Range: 31.9-35.9 g/dL

RDW: Red cell distribution width is a histogram (visual), which reflects the distribution of the size of the red blood cell population.

Optimal Range: 10.5-14.5%

MPV: Mean platelet volume, reflects the average volume of platelets.

Optimal Range: 5.7-11.7 fl

Platelets
Platelets, also called thrombocytes, are special cell fragments that play an important role in normal blood clotting.

Optimal Range: 140-410 K/mm3

Platelet counts are often done if you are prone to bruising or if you are about to have surgery. A person who does not have enough platelets may be at an increased risk of excessive bleeding and bruising, while an overabundance of platelets can cause excessive clotting. The platelet count may change with bleeding disorders, heart disease, diabetes, inflammatory disorders, and anemias.

What is a Differential Blood Count?
There are five different types of white cells that make up the differential blood count. White blood cells (leukocytes) come in several shapes and sizes and can be identified by the laboratory instrument known as a hematology analyzer, or under a microscope.

Neutrophils: the most populous of the circulating white cells, they are also the shortest lived in circulation. After the production and release by the marrow, they only circulate for about eight hours before proceeding to the tissues, where they live for about a week.

Optimal Range: 41.4-74.4%

A high neutrophil count may be seen in infections, some cancers, arthritis, and sometimes when the body is under stress (for example after surgery, trauma, or a heart attack). A decreased neutrophil count may indicate certain viral infections, severe, overwhelming infections, leukemia, lupus, drug reactions, anaphylactic shock, enlarged spleen, and damage to bone marrow.

Lymphocytes: normally makes up 25% of total white blood cells. They occur in three forms (the differential does not distinguish among them): B cells, which function primarily to produce antibodies associated with immunity, T cells, which recognize foreign substances and process them for removal and natural killer cells, which directly attack and kill abnormal cells such as cancer cells or infected cells. They are the second most populous of the circulating white blood cells.

Optimal Range: 24.0-44.0%

An increased number of lymphocytes may be produced with a viral infection, bacterial infections, acute stress, chronic inflammatory disorders, and leukemia’s. A decreased number of lymphocytes may occur with chemo therapy and HIV.

Monocytes: Monocytes are produced by the marrow, circulate for five to eight days, and then enter the tissues. When entering the tissues they can either transform into macrophages (cells that eat bacteria, viruses and parasites and are able to present them to other immune cells) or dendritic cells (process antigens and present them to T-cells).

Optimal Range: 0.0-10.0%

High levels of monocytes may indicate chronic infections, infections within the heart, collagen vascular diseases (lupus, rheumatoid arthritis), and leukemia’s. Low levels of Monocytes may indicate bone marrow damage, or leukemia.

Eosinophils: eosinophils play two roles in your immune system: destroying foreign substances and regulating inflammation.

Optimal Range: 0.0-4.7%

A high eosinophil count often indicates allergies, asthma, skin diseases, drug reactions, inflammatory disorders (celiac disease, inflammatory bowel disease), parasitic infections, and some cancers, lymphomas, and leukemia’s. Low levels of eosinophils are usually not medically significant. Low levels may indicate stress or acute inflammatory states.

Basophils: the basophils are the least numerous of the white cells. They are easily recognized by their very large deep purple granules. Basophils serve as mediators of inflammatory responses, especially hypersensitivity reactions.

Optimal Range: 0.0-1.6%

A high basophil may indicate rare allergic reactions, inflammation (rheumatoid arthritis, ulcerative colitis), and some leukemia’s. Low levels of basophils are usually not medically significant. Low levels may indicate stress or acute inflammatory states.

Diabetes Screen (Glucose & Hemoglobin A1C)

Diabetes Screen
Glucose: This test measures the amount of glucose in the blood or urine. Glucose is the primary energy source for the body’s cells and the only energy source for the brain and nervous system. A steady supply must be available for use, and a relatively constant level of glucose must be maintained in the blood.

Optimal Range: 70-100 mg/dL

Normally, blood glucose rises slightly after a meal and insulin is released by the pancreas into the blood in response, with the amount corresponding to the size and content of the meal. As glucose moves into the cells and is metabolized, the level in the blood drops and the pancreas responds by slowing, then stopping the release of insulin.

High levels also called hyperglycemia may present the following symptoms:

Increased thirst, usually with frequent urination
Fatigue
Blurred vision
Slow-healing infections

Low levels also called hypoglycemia may present the following symptoms:

Sweating
Hunger
Trembling
Anxiety
Confusion
Blurred Vision

Hemoglobin A1C: an A1C is a reflection of mean glucose levels for the previous 1-3 months.

HEMOGLOBIN A1C APPROX/GLUCOSE mg/dl INTERPRETATION: GLYCEMIA CONTROL

4.0-6.0 63-125 Non-diabetic or very good control
5.0-6.0 141 Upper limit of target for diabetes in control
6.5-7.0 156 Marginal control: Take action above this level
>7.0 >156 Poor control: Take action to lower

HIV

Human immunodeficiency virus (HIV) is the cause of AIDS (acquired immunodeficiency syndrome). This test detects antibodies produced in response to an HIV infection.

An HIV infection may initially cause no symptoms or cause flu-like symptoms that resolve after a week or two. This is followed by a simmering infection that may cause few symptoms for a decade or more. If the infection is not treated, eventually symptoms of AIDS emerge and begin to progressively worsen. Over time, HIV destroys the immune system and leaves a person's body vulnerable to debilitating infections.

However, a negative screening test means only that there is no evidence of disease at the time of the test. It is important for those who are at increased risk of HIV infection to have screening tests performed on a yearly basis to check for possible exposure to the virus.

If someone tests positive for HIV on both the initial screen and supplemental testing, he is considered to be infected with HIV. HIV cannot be cured, but early diagnosis allows for treatment that can help to suppress levels of virus in the body (viral load) and slow progression of the disease.

Hormone Health (Estradiol, Progesterone, Testosterone & FSH)

Hormone Health

Estradiol: Estradiol levels are used in evaluating ovarian function.

Increased levels of estrogens are seen in:

Normal menstrual cycle
Early (precocious) puberty
Gynecomastia
Tumors of the ovary, testes, or adrenal glands
Hyperthyroidism
Cirrhosis

Decreased levels of estrogen are seen in:

Turner syndrome
Hypopituitarism
Hypogonadism
Failing pregnancy (estriol)
Eating disorder anorexia nervosa
After menopause (estradiol)
PCOS (Polycystic ovarian syndrome, Stein-Levanthal syndrome)
Extreme endurance exercise

Progesterone: Progesterone is used to determine the cause of infertility, track ovulation, help diagnose an ectopic or failing pregnancy, monitor the health of a pregnancy, and to help diagnose the cause of abnormal uterine bleeding.

This test measures the level of progesterone in the blood. Progesterone is a steroid hormone whose main role is to help prepare a woman's body for pregnancy; it works in conjunction with several other female hormones.

Increased progesterone levels also are seen occasionally with:

Some ovarian cysts
Non-viable pregnancies known as molar pregnancies
A rare form of ovarian cancer
Overproduction of progesterone by the adrenal glands
Congenital adrenal hyperplasia (CAH)

Low levels of progesterone may be associated with:

Toxemia late in pregnancy
Decreased function of ovaries
Lack of menstruation (amenorrhea)

Testosterone: a steroid hormone (androgen) produced by special endocrine tissue (the Leydig cells) in the male testicles. It is also produced by the adrenal glands in both males and females and, in small amounts, by the ovaries in females. This test measures the level of testosterone in the blood.

Testosterone testing is used to diagnose several conditions in men, women, girls, and boys. Examples of some of these conditions include:

Delayed or precocious (early) puberty in boys
Decreased sex drive in men and women
Erectile dysfunction in men
Infertility in men and women
Testicular tumors in men
Hypothalamus or pituitary disorders
Hirsutism and virilization in girls and women

Males
The normal range for testosterone levels in men is broad and varies by stage of maturity and age. It is normal for testosterone levels to slowly decline starting in the third decade of life. The rate may increase in men who are obese or chronically ill and with the use of certain medications.

A low testosterone level (hypogonadism) may be due to:

Hypothalamic or pituitary disease
Genetic diseases that can cause decreased testosterone production in young men (Klinefelter, Kallman, and Prader-Willi syndromes) or testicular failure and infertility (as in myotonic dystrophy, a form of muscular dystrophy)
Impaired testosterone production because of acquired damage to the testes, such as from alcoholism, physical injury, or viral diseases like mumps

Increased testosterone levels in males can indicate:

Testicular tumors
Adrenal tumors that are producing testosterone
Use of androgens (also called anabolic steroids)
Early puberty of unknown cause in boys
Hyperthyroidism
Congenital adrenal hyperplasia

Females
In women, testosterone levels are normally low. Increased testosterone levels can indicate:

PCOS
Ovarian or adrenal gland tumor
Congenital adrenocortical hyperplasia

FSH (Follicle Stimulating Hormone): FSH is often used in conjunction with other tests (LH, testosterone, estradiol, and progesterone) in the workup of infertility in both men and women. FSH levels are used to help determine the reason a man has a low sperm count. FSH levels are also useful in the investigation of menstrual irregularities and to aid in the diagnosis of pituitary disorders or diseases involving the ovaries or testes. In children, FSH and LH are used to diagnose delayed or precocious (early) puberty.

Women
In women, FSH and LH levels can help to differentiate between primary ovarian failure (failure of the ovaries themselves) and secondary ovarian failure (failure of the ovaries due to disorders of either the pituitary or the hypothalamus). Increased levels of FSH and LH are consistent with primary ovarian failure. Some causes of primary ovarian failure are listed below.

Developmental defects:

Failure to develop ovaries (ovarian agenesis)
Chromosomal abnormality, such as Turner's syndrome
Defect in the steroid production by the ovaries, such as 17 alpha hydroxylase deficiency

Premature ovarian failure due to:

Radiation
Chemotherapy
Autoimmune disease

Chronic failure to ovulate (anovulation) due to:

Polycystic ovary syndrome (PCOS)
Adrenal disease
Thyroid disease
Ovarian tumor

When a woman enters menopause and her ovaries stop working, FSH levels will rise.

Low levels of FSH and LH are consistent with secondary ovarian failure due to a pituitary or hypothalamic problem. Low FSH serum levels have been associated with increased risk of ovarian cancer.

Men
In men, high FSH levels are due to primary testicular failure. This can be due to developmental defects in testicular growth or to testicular injury, as indicated below.

Developmental defects:

Failure to develop gonads (gonadal agenesis)
Chromosomal abnormality, such as Klinefelters syndrome

Testicular failure:

Viral infection (mumps)
Trauma
Radiation
Chemotherapy
Autoimmune disease
Germ cell tumor

Low levels are consistent with pituitary or hypothalamic disorders.

Premature Development
High levels of FSH and LH with the development of secondary sexual characteristics at an unusually young age are an indication of precocious puberty. This is much more common in girls than in boys. This premature development can have many different underlying causes that need to be diagnosed and treated. Some of the causes include:

Central nervous system lesions
Hormone-secreting tumors
Ovarian tumors or cysts
Testicular tumors

Normal prepubescent levels of LH and FSH in children exhibiting some signs of pubertal changes may indicate a benign form of precocious puberty with no underlying or discernable cause or may just be a normal variation of puberty.

In delayed puberty, LH and FSH levels can be normal or below what is expected for a youth within this age range. A test for LH response to GnRH may need to be performed along with other testing to diagnose the reason for the delayed puberty. Some of the causes for delayed puberty can include:

Gonadal (ovary or testes) failure
Hormone deficiency
Turner's syndrome (chromosomal abnormality in girls)
Klinefelter's syndrome (chromosomal abnormality in boys)
Chronic infections
Cancer
Eating disorder (anorexia nervosa)

Iron Function

Iron Function: The body must have iron to make hemoglobin and to help transfer oxygen to the cells. If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function up to par. On the other hand, too much iron in the body can cause injury to the heart, pancreas, joints, testicles, ovaries, etc. Iron excess is found in the hereditary disease called hemochromatosis which occurs in about 3 of every 1000 people. Any value outside the specified reference range should be evaluated by your health care provider.

Iron deficiency (anemia) signs and symptoms:

Extreme fatigue
Weakness
Pale skin
Chest pain, fast heartbeat or shortness of breath
Headache, dizziness or lightheadedness
Cold hands and feet
Inflammation or soreness of your tongue
Brittle nails
Severe infection or bleeding
Unusual cravings for non-nutritive substances, such as ice, dirt or starch
Poor appetite, especially in infants and children with iron deficiency anemia

Some people with hereditary hemochromatosis (high iron) never have symptoms. Early signs and symptoms often overlap with those of other common conditions. Common symptoms include:

Joint pain
Abdominal pain
Fatigue
Weakness

Later signs and symptoms of the disease may include:

Diabetes
Rheumatoid Arthritis
Impotence
Heart failure
Liver failure

TIBC (total iron binding capacity): Iron is transported in your blood bound to a protein called transferrin. Transferrin transports the iron in your body from the iron storage sites to where it is needed. It also transports iron, when not needed, back to the storage sites. High levels indicate iron deficiency. Low levels indicate possible iron excess or malnutrition.

Optimal Range: 260-400 ug/dL

High levels may indicate:

Iron deficiency

Low levels may indicate:

Malnutrition
Iron excess

Iron Saturation Index: obtained by comparing the total iron level to the TIBC level. It is a simple way to compare the amount of iron in the blood to the capacity of blood to transport iron. With iron deficiency anemia, you will typically see low iron and low saturation index.

Optimal Range: 15-50%

Ferritin: the chief storage form of iron in the body. Ferritin is measured when the iron saturation index is low or high. High levels of ferritin may indicate iron excess, inflammation or liver disease. Low levels of ferritin indicate anemia or iron deficiency. Any value outside the specified reference range should be evaluated by your health care provider.

Optimal Range: Female: 6-159 ng/ml

Male: 28-397 ng/ml

High levels may indicate:

Iron excess
Inflammation

Low levels may indicate:

Iron deficiency

Kidney & Electrolyte Function (BUN, Creatinine, Sodium, Chloride, Potassium)

Kidney & Electrolyte Function

The main job of the kidney is to filter the blood, excreting waste products into the urine while preserving essential elements. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.

Some signs and symptoms of kidney dysfunction include:

Fatigue, lack of concentration, poor appetite, or trouble sleeping
Swelling or puffiness, particularly around the eyes or in the face, wrists, abdomen, thighs or ankles
Urine that is foamy, bloody, or coffee-colored
A decrease in the amount of urine
Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night
Mid-back pain (flank), below the ribs, near where the kidneys are located
High blood pressure

BUN (blood urea nitrogen): a waste product from protein breakdown in the liver. It is excreted by the kidneys. If kidney function is impaired, or is a person is dehydrated, the BUN level will increase. Internal blood loss, high protein diets, and/or strenuous exercise can also cause a high BUN level. A low BUN level may be the result of liver disease, poor diet, pregnancy, or drinking too much water.

Optimal Range: 7-22 mg/dL

High levels may indicate:

Dehydration
Internal blood loss
High protein diets
Strenuous exercise
Heart failure

Low levels may indicate:

Drinking too much water
Liver disease or damage
Poor diet
Pregnancy

Creatinine: One way to measure kidney function is to determine how well the kidney can filter and excrete creatinine, an easily measured waste product of muscle metabolism. In certain types of kidney disease, the ability of the kidneys to clear the bloods creatinine decreases the blood levels of creatinine increase. High values require medical evaluation by your health care provider, especially when associated with high BUN results.

Optimal Range: 0.40-1.30mg/dL

High levels may indicate:

Damage to or swelling of blood vessels in the kidneys (glomerulonephritis) caused by, for example, infection or autoimmune diseases
Bacterial infection of the kidneys (pyelonephritis)
Death of calls in the kidneys’ small tubes (acute tubular necrosis) caused by, for example drugs or toxins
Prostate disease, kidney stone, or other causes of urinary tract obstruction
Reduced blood flow to the kidney due to shock, dehydration, congestive heart failure, atherosclerosis, or complications of diabetes

Sodium: one of the body’s principal minerals, regulated by the kidneys. It plays an important role in water balance in your body in order to maintain proper fluid balance in the cells to help manage muscle and nerve control. Numerous drugs, including diuretics, certain blood pressure medications and steroids, may alter the sodium level. Any abnormal value should be evaluated by your health care provider.

Optimal Range: 135-146 mEq/L

High levels may indicate:

Excessive salt intake
Dehydration
Kidney disease or injury
Diabetic ketoacidosis
High levels of aldosterone due to a high-sodium diet or by not drinking enough water

Low levels may indicate:

Diarrhea
Vomiting
Excessive sweating
Drinking too much water
Poor nutrition
Underactive adrenal glands or thyroid gland, heart failure, kidney failure, kidney disease, cirrhosis, etc

Chloride: a mineral in the body that comes from salt in the diet. Chloride is involved with water balance in the body and a high level may indicate severe dehydration, certain kidney disorders or hyperventilation. A low chloride level may result from excessive vomiting, diarrhea, severe burns, excessive sweating or kidney failure. Borderline low or high levels of chloride have very little significance.

Optimal Range: 98-108 mEq/L

High levels may indicate:

Severe dehydration
Hyperventilation
Kidney disease

Low levels may indicate:

Excessive vomiting
Diarrhea
Severe burns
Excessive sweating
Kidney failure

Potassium: one of the body's principal minerals, found primarily inside cells. Potassium helps maintain water balance as well as proper function of nerves and muscles. Low or high levels in the blood are of critical significance and should be evaluated by your health care provider. This is especially important if you are taking a diuretic or heart medication.

Optimal Range: 3.5-5.1mEq/L

Low Levels may indicate:

High levels of aldosterone made by the adrenal glands
Conditions such as; severe burns, cystic fibrosis, alcoholism, Cushing’s syndrome, kidney disease

High Levels may indicate:

Kidney or liver disease
Too much medication
Bodily injury
Vomiting and/or diarrhea
Medicines, such as diuretics, are a common cause of low potassium levels
Dehydration
Poor nutrition

Liver Function

Liver function tests are blood tests used to help diagnose and monitor liver disease or damage. Albumin, Globulins, Total Protein, Total Bilirubin, Direct Bilirubin, Alkaline Phosphatase, ALT, AST, and GGT are measurements of certain enzymes and proteins found in your blood.

Some of these tests measure how well the liver is performing its normal functions of producing protein and clearing bilirubin, a blood waste product. Other liver function tests measure enzymes that liver cells release in response to damage or disease. Abnormal liver function test results don't always indicate liver disease. Your doctor will explain your results and what they mean.

Albumin: the most plentiful protein in the blood. Approximately two-thirds of the total protein circulating in the blood is albumin. It is produced primarily in the liver and helps keep the fluid portion of the blood within the blood vessels. When your albumin level is too low, water can leak into other parts of your body causing swelling. This can be caused by malnutrition, too much water in the body, liver or kidney disease, severe injury or major bone fractures and slow bleeding of a long period of time.

Optimal Range: 3.4-5.0

Low levels may indicate:

Too much water in the body

High levels may indicate:

Severe Dehydration
Liver Disease
Kidney Disease
Severe injury or major bone fractures
Slow bleeding
Malnutrition

Globulins: proteins that can be formed in the liver or the immune system. Globulins have many functions, transporting a variety of things such as fats and hormones acting as infection fighters to help the body defend itself. If your globulin level is abnormal, your health care provider may want to measure some of the individual proteins that make up this group.

High levels may indicate:

Diseases of the blood, such as multiple myeloma, Hodgkin’s lymphoma, leukemia, or hemolytic anemia.
Autoimmune disease, such as rheumatoid arthritis, lupus, autoimmune hepatitis or sarcoidosis.
Kidney disease
Liver disease
Tuberculosis

Total Protein: a measure of the total amount of protein in your blood over the course of the past few days. A low or high level of protein does not indicate specific disease, but it does mean that some additional tests may be required to determine if there is a problem.

Optimal Range: 6.4-8.2gm/dL

ALB/Globulin Ratio: A simple way to tell is the albumin or globulin levels in the blood are abnormal is to compare the level of albumin to the level of globulin in your blood. If both the albumin and globulin results fall within the specified reference range, then a high or low A/G Ratio result is not generally considered significant.

Low levels may indicate:

Kidney disease
Cirrhosis of the Liver
Autoimmune diseases

High levels may indicate:

Genetic deficiencies
Leukemia

Bilirubin, Total: the pigment in the blood that makes the plasma or serum part of your blood yellow. Bilirubin comes from the breakdown of old red blood cells in the blood.

Optimal Range: 0.0-1.0 mg/dL

High levels may indicate:

Red blood cells being destroyed (hemolyzed)
Liver disease
Blockage of bile ducts
Jaundice

Bilirubin, Direct: a specific form of bilirubin that is formed in the liver and excreted in the bile. Normally very little of this form is found in the blood. However, in liver disease, this form of bilirubin leaks into the blood so a high level of direct bilirubin may indicate a problem with the liver cells.

Optimal Range: 0.0-0.3 mg/dL

High levels may indicate:

Infection
Inherited diseases, such as Gilbert’s syndrome, a condition that affects how the liver processes bilirubin. Although jaundice may occur in some people with Gilbert’s syndrome, the condition is not harmful.
Diseases that cause liver damage: cirrhosis, hepatitis or mononucleosis
Diseases that cause blockage of the bile ducts: gallstones or cancer of the pancreas
Rapid destruction of red blood cells in the blood, such as from sickle cell disease or an allergic reaction to blood received during a transfusion
Reaction to medication

Low levels may indicate:

Reactions to medication

Alkaline Phosphatase: an enzyme that is found in many body tissues; most importantly found in the bone, liver, bile ducts and gut. A high level of alkaline phosphatase in your blood may indicate bone, liver or bile duct disease. Certain drugs may also cause increased levels. Growing children, because of bone growth, normally have higher levels than adults. Low values are generally not considered significant.

Optimal Range: 32-122 U/L

High levels may indicate:

Bone disease
Liver disease
Bile duct disease
Certain drugs

Low levels may indicate:

Conditions that lead to malnutrition (such as celiac disease) or are caused by a lack of nutrients in the diet (such as scurvy).

ALT (Alanine Aminotransferase): the ALT enzyme is found mainly in the liver. Damage from alcohol, strenuous exercise, overdose of acetaminophen and a number of diseases like hepatitis, cirrhosis, or fatty deposits can cause high values for AST and ALT (SGPT) and should be evaluated by your health care provider. Low values are generally not considered significant.

Optimal Range: 7-63 U/L

Mild to moderately high levels may indicate:

Alcohol abuse
Mononucleosis
Hepatitis
An overdose of acetaminophen (Tylenol)
Growth spurts, especially in young children

Very high levels may indicate:

Recent or severe liver damage
Lead poisoning
Drug reactions
Shock
Exposure to carbon tetrachloride
Decay of large tumor (necrosis)

AST (Aspartate Aminotransferase): the AST enzyme is found mainly in the heart, liver, and muscles. It is released into the blood stream when any of these organs are damaged. Increased levels are usually associated with liver disease or heart attacks.

Optimal Range: 9-45 U/L

Mild to moderately high levels may indicate:

Long-term chronic diseases, such as cirrhosis
A heart attack or heart failure
Mega dosing Vitamin A
Kidney or lung damage
Mononucleosis
Muscular dystrophy
Some types of cancer
A rare autoimmune disease that affects muscles (myositis)
Fatty deposits in the liver
Alcohol abuse
An overdose of acetaminophen (Tylenol)
Reaction to medication

Very high levels may indicate:

Recent or severe liver damage
Decay of large tumor (necrosis)
Shock

GGT (Gamma-Glutamltransferase): a very sensitive enzyme that is primarily found in the liver. Drinking too much alcohol, certain drugs, liver disease, stress, physical exertion, some common medications and bile duct disease can all cause high GGT in the blood. High values should be evaluated by your health care provider.

Optimal Range: 7-32 U/L

High levels may indicate:

Alcohol abuse
Stress, excessive exercise or injury
Flow from the liver is blocked (cholestasis)
Heart failure
Hepatitis
Liver necrosis, ischemia (lack of blood flow), or tumor.
Bone Disease
Cirrhosis of the liver

Prostate Specific Antigen (PSA)

Prostate Specific Antigen (PSA) An optional health screening for males
The PSA test is a blood test used primarily to screen for prostate cancer. The test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below a man's bladder.

PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood. The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels. Therefore, it’s important that abnormal levels be further evaluated by your health care provider.

Optimal Range: 0.0-4.0 ng/mL

Thyroid

Your thyroid is a small, butterfly-shaped gland situated at the base of the front of your neck, just below your Adam's apple. Hormones produced by the thyroid gland, triiodothyronine (T3) and thyroxine (T4), have an enormous impact on your health, affecting all aspects of your metabolism. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate, and help regulate the production of proteins.

TSH (thyroid stimulating hormone): is the pituitary hormone which controls thyroid gland function. TSH is what causes the thyroid to produce thyroid hormone (T3/T4). When the thyroid gland fails, due to primary disease of the thyroid, pituitary TSH increases. This is called Primary Hyperthyroidism. Both primary hyperthyroidism and hypothyroidism can be detected by the sensitive TSH method. In addition, the TSH test can tell if your dose of thyroid hormone is correct, should you be taking that medication.

Optimal Range: 0.27-5.76 ulU/m (per CCMH lab ranges)

High levels may indicate:

Congenital hypothyroidism (cretinism)
Exposure to mice (lab workers of veterinarians)
Primary hypothyroidism
Thyroid hormone resistance
TSH-dependent hyperthyroidism

Low levels may indicate:

Hyperthyroidism
TSH deficiency
Reaction to medication

T3: This test measures the amount of triiodothyronine (T3) in the blood. T3 is one of two major hormones produced by the thyroid gland. It is ordered primarily to help diagnose hyperthyroidism and may be ordered to help monitor the status of a person with a known thyroid disorder. T3 testing may be ordered along with thyroid antibodies to help diagnose Graves’ disease, an autoimmune disorder that is the most common cause of hyperthyroidism.

T4: The T4 test is primarily ordered in response to an abnormal TSH test result. This test is usually ordered when a person is showing signs of either hyperthyroidism or hypothyroidism.

TSH T3 T4 Interpretation

High Normal Normal Mild (subclinical) hypothyroidism
High Low Low or normal Hypothyroidism
Low Normal Normal Mild (subclinical) hyperthyroidism
Low High or normal High or normal Hyperthyroidism
Low Low or normal Low or normal Non-thyroidal illness; rare pituitary (secondary) hypothyroidism

Symptoms of Hypothyroidism:

Fatigue
Increased sensitivity to cold
Slowed heartrate
Muscle weakness
Elevated blood cholesterol level
Weight gain
Heavier than normal or irregular menstrual periods
Puffy face
Dry skin

Symptoms of Hyperthyroidism:

Sudden unplanned weight loss
Rapid heartbeat (tachycardia)
Increased anxiety, nervousness
Sweating
Changes in menstrual patterns
Enlarged thyroid gland (goiter)
Fatigue, muscle weakness
Difficulty sleeping
Skin thinning, fine brittle hair

Uric Acid (Gout)

Gout: Gout is a complex form of arthritis characterized by sudden, severe attacks of pain, tenderness, and redness in the joint typically at the base of the big toe. Although men are likely to get gout, women are increasingly at risk after menopause. Maintaining Uric Acid levels within optimal range can reduce your risk for Gout.

Some signs and symptoms of Gout include:

Intense joint pain. Gout usually affects the large joint of the big toe, but can occur in the ankles, feet, knees, hands, and wrists. The pain is likely to be most severe within the first 4 to 12 hours after it begins.
Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
Inflammation and redness. The affected joint or joints become swollen, tender, warm and red, feeling as if it is on fire.
Limited range of motion (ROM). Decreased joint mobility may occur as gout progresses.

Uric Acid: is the byproduct of the breakdown of the body’s own cells and proteins.

Optimal Range: 3.5-7.2 mg/dL

High levels may indicate:

Gout
Kidney Stones/disease
Arthritis
Stress
Chemotherapy/Radiation
Diuretic use
Fasting or starvation diets

Low levels may indicate:

Few forms of liver disease
Wilson’s disease or various forms of cancer (rare)
Poor protein intake
Drinking too much water
Poor nutrition
Large doses of aspirin (1,500 mg or more daily

Lifestyle suggestions to reduce Gout:

Replace or limit alcoholic beverages and drinks sweetened with fruit sugar (fructose) with water
Limit intake of foods high in purines such as organ meats, red meat, sardines, anchovies, and beans
Exercising regularly and maintaining a healthy weight will reduce your risk for Gout

Vitamin B12 and Folate

Vitamin B12 and Folate make up the B-vitamin group and are diverse in their function for the body. Like most of the B-vitamins, Vitamin B12 and Folate support your body’s metabolism, produces energy, and helps your body fight disease and infection. This blood test is used to measure levels of vitamin B12 and Folate in liquid portion of blood called plasma to detect deficiencies.

Vitamin B12: the most plentiful protein in the blood. Approximately two-thirds of the total protein circulating in the blood is albumin.

Optimal Range: 3.4-5.0

Folate: A sufficient folate (folic acid) count is important for a healthy pregnancy, reducing serious birth defects in the spine and brain.

Optimal Range: 2-20 ng/mL

Folate fortification in foods such as cereal, bread, and other grain products makes deficiency very rare. Although Vitamin B12 and folate deficiency is uncommon in the U.S., malabsorption conditions in the small intestine may be the primary reason for low values in the blood. These include:

Celiac disease and tropical sprue
General malnutrition in vegans who do not consume animals products, including milk and eggs
Bacterial overgrowth or the presence of parasites in the small intestines
Reduced stomach acid production from long-term use of antacids
Pernicious anemia, the most common cause of B12 deficiency
Surgical procedures that removes part of the stomach such as gastric bypass
Pancreatic insufficiency
Chronic alcohol use can cause B12 and/or folate deficiency due to poor intake and impaired release of B12 from dietary proteins
Use of drugs such as metformin and omeprazole which causes malabsorption due to a decrease in gastric acid
Use of anti-seizure medications such as phenytoin can decrease folate as can drugs such as methotrexate, which blocks folate absorption and utilization of folate in the metabolism
Increased need due to pregnancy for proper fetal development. Additionally, people with cancer that has spread or who have chronic hemolytic anemia have an increased need for folate

If a person with a B12 or folate deficiency is being treated with supplements or B12 injections, normal or elevated results indicate a positive response to treatment. High levels of B12 are uncommon and not usually clinically monitored. However, Vitamin B12 levels may increase in the event of:

Myeloproliferative disorder, diabetes, heart failure, severe liver disease, AIDs, and obesity

Vitamin D

Vitamin D is a fat soluble vitamin critical for growth and teeth. Vitamin D helps regulate calcium, phosphorus, and (to a lesser extent) magnesium levels in the blood. Without vitamin D, bones will be soft, malformed, and unable to repair themselves normally. Low vitamin D levels can result in muscle weakness or disease such as rickets in children and osteomalacia in adults. Vitamin D has also been shown to influence the growth and differentiation of many other tissues that help regulate the immune system which can cause immunity disorders and cancers.

A vitamin D test is used to:

Determine if bone weakness, bone malformation, or abnormal metabolism of calcium (reflected by abnormal calcium, phosphorus, PTH) is occurring as a result of a deficiency or excess of vitamin D
Help diagnose or monitor problems with parathyroid gland functioning since PTH is essential for vitamin D activation
Screen people who are at high risk of deficiency, as recommended by the National Osteoporosis Foundation, the Institute of Medicine, and the Endocrine Society
Help monitor the health status of individuals with diseases that interfere with fat absorption, such as cystic fibrosis and Crohn disease, since vitamin D is a fat-soluble vitamin and is absorbed from the intestine like a fat
Monitor people who have had gastric bypass surgery and may not be able to absorb enough vitamin D
Help determine the effectiveness of treatment when vitamin D, calcium, phosphorus, and/or magnesium supplementation is prescribed

A low blood level of 25-hydroxyvitamin D may indicate that a person is not getting enough exposure to sunlight or enough dietary vitamin D to meet his or her body's demand or that there is a problem with its absorption from the intestines. There is also evidence that vitamin D deficiency may increase the risk of some cancers, immune diseases, and cardiovascular disease.

Optimal Ranges:

< 20ng/mL Deficient
20-30ng/mL Insufficient
30-80ng/mL Sufficient
>125ng/mL Potentially harmful

Low levels may indicate:

Poor bone density which can lead to osteoporosis, falls and fractures
Depression
Rickets
Cardiovascular disease
Kidney disease
Tuberculosis
Immune dysfunction, influenza or respiratory infections
Hair loss
Hypertension
Different types of cancer

High levels may indicate:

Overdose of supplementation - not by diet or sun exposure
Calcium build up in the blood (hypercalcemia)
Kidney failure
Nausea, vomiting or diarrhea
Weakness
Frequent urination

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