Want to learn more? Check out some of the many resources available:

Transcription

1 Want to learn more? Check out some of the many resources available: American Cancer Society Tel: Web: Education, research, support, and treatment information American Diabetes Association Tel: Web: Education, nutrition, programs, and research information American Heart Association Tel: Web: Heart, stroke education, CPR, and program information National Kidney Foundation Tel: Web: Education, tissue donation, and program information American Lung Association Web: Free Web-based smoking cessation program, education, research, and tobacco control information Need information? Contact: Health Care Services GPC Corporate Office: SCS Corporate Office: Customer Care: Forest Park: SouthernLifeStyle For more information on line: log onto mysource, choose the SouthernLifeStyle tab. OptumHealth 24-hour health line: SouthernLifeStyleRewards: For Safety & Health Resources visit:

2 Reviewing Your Lab Tests: The Basics SouthernLifeStyle

3 Reviewing Your Lab Tests: The Basics SouthernLifeStyle Overview Laboratory tests can provide beneficial information to help evaluate an individual s health status. It is important that you promptly discuss any unusual or abnormal test results with your health care provider. The tests alone are not sufficient to diagnose or treat any disease or problem. However, the information can be a resource for you and your health care provider to find out more about your body and to screen for potential problems or monitor health-related conditions. Early detection of health problems allows for early treatment and positive lifestyle changes which can have the greatest impact on your health. Lab tests may show variations due to many things such as race, age, sex, lifestyle characteristics such as diet, alcohol intake, level of physical activity, and use of prescription and nonprescription medications. The collection and/or handling of the specimen can also affect the test results. Almost all laboratoriess set test result ranges that apply to 95% of healthy people. Thus, 5% of healthy individuals may fall outside this normal range, even when there are no health related problems. When tests are performed on a panel of tests, it is likely that 1 or 2 may be slightly out of the normal range. A test result that is out of the normal range does not necessarily mean there is something wrong. The brief summary of profile tests and information on positive lifestyle measures that follows is not intended to be comprehensive or to replace reviewing the test results with your health care provider. Glucose The test is a measure of the sugar level in the blood. High values are associated with eating before the test and diabetes. Your health care provider may recommend the test to help diagnose diabetes if you have symptoms of hyperglycemia (high blood sugar) such as increased thirst, increased urination, fatigue, blurred vision, or wounds that are slow to heal or if you have symptoms of hypoglycemia (low blood sugar) including sweating, hunger, trembling, blurred vision, or anxiety. 1

4 Levels: The normal range for a fasting glucose is mg/dl. According to the American Diabetic Association, diabetes is diagnosed with a fasting plasma glucose of 126 or more, generally tested again on a subsequent day. A fasting glucose level of signals pre-diabetes. Other tests your health care provider may recommend include a glucose tolerance test (which involves drinking a sugary drink followed by several blood glucose tests) to diagnose diabetes or pre-diabetes or a glycohemoglobin (Alc) test to assess control of blood sugar over the past 3 months (see page 13 for additional A1c information). Diabetes is a disease caused when the body does not produce or properly use insulin. Insulin is necessary to convert foods to energy for daily life. Checking glucose levels is important because diabetes is a silent disease, and can cause damage to the eyes, nerves, and kidneys before an individual knows they have the condition. Although the cause of diabetes is unknown, several factors have been shown to play a role including: age of 45 or older, being overweight, high blood pressure, having a family history of diabetes, having diabetes during pregnancy, or a woman who has had a baby weighing more than nine pounds at birth. Uncontrolled diabetes increases risk for numerous medical problems, including: cardiovascular disease (heart attack, stroke risk), kidney disease, retinopathy (which can cause blindness), and neuropathy (nerve damage that can affect many body systems including nerves in the feet, leading to decreased or loss of feeling). Measures to lower your risk for diabetes include keeping your weight in control, being active most days of the week, and eating a healthy diet that is low in fat and high in fruits, vegetables, and whole grain foods (for more information on these healthy lifestyle measures, see the section What can you do to control cholesterol and triglycerides levels? in the Fat in the Blood section, page 8). Diabetes treatment: Individuals with a diagnosis of diabetes (or pre-diabetes) should consult with their health care provider on a regular basis for medical management of the condition (which may include glucose lowering medications) and counseling about diet, weight management, physical activity, and other beneficial lifestyle modifications. Keeping blood sugar under control is an extremely important measure to help decrease the risk of developing other health related problems. 2

5 Waste Products Uric Acid UricAcid is a waste product excreted mostly in urine. High values may be associated with numerous disorders including gout, arthritis, liver disease, kidney problems, obesity, and with the use of some diuretic medications ( water pills ). Blood Urea Nitrogen (BUN) is generally used with a test for creatinine, to check kidney function. High values may indicate that the kidneys are not functioning as well as they should. Possible causes of high levels are dehydration, high protein diets, strenuous exercise, kidney disorders, or health problems causing decreased blood flow to the kidneys such as congestive heart failure or shock. Pregnancy may cause a lower level. Creatinine is used to monitor how well your kidneys filter waste products from the blood. High values, especially with high BUN levels, may indicate problems with the kidneys. Creatinine may also increase with muscle injury or taking creatine supplements. Glomerular Filtration Rate Estimated (egfr) provides an assessment of the filtering capacity of the kidney and is used to help determine kidney function. It is calculated from serum creatinine and varies with age, sex, and race. Diabetes and high blood pressure are the leading risk factors for chronic kidney disease. eger values less than 60 mi/mm/i.73m2 should be discussed with your health care provider. The calculation for this test is not applicable for individuals over 70 years or less than 18 years of age. Electrolytes Sodium, along with chloride, helps maintain proper blood volume and blood pressure. It is regulated by the kidneys and adrenal glands. There are numerous causes of high and low sodium levels. Common causes of low sodium levels include taking medications such as diuretics ( water pills ) or diabetes drugs, or individuals with certain types of heart or liver disease drinking excessive amounts of water. High sodium levels can be associated with dehydration, edema (swelling), or a variety of diseases. Potassium is very important for the proper functioning of the nerves and muscles, particularly the heart. Levels are closely controlled by the kidneys, and any value outside the expected range, whether high or low, requires medical evaluation. This is particularly important for those taking medications such as diuretics ( water pills ) or heart pills (Digitalis, Lanoxin, etc.). Low levels can result from loss of body fluids such as excessive sweating, vomiting, or diarrhea or taking medications such as diuretics. The most common cause of high levels is kidney disease. Chloride (along with sodium) helps maintain proper blood volume and blood pressure, and also plays a role in maintaining proper ph of body fluids. Increased levels 3

6 of chloride usually indicate dehydration, but can also occur with any other problem that causes high blood sodium levels. Decreased values can occur with any disorder that causes low blood sodium levels and may also result from prolonged vomiting, chronic diarrhea, emphysema, or other chronic lung disease. Minerals Calcium is one of the most important minerals in the body and is found mostly in bones. Calcium levels do not tell how much calcium is in the bones but how much is circulating in the blood. Levels are checked to diagnose and monitor numerous conditions relating to the bones, heart, nerves, kidneys, and teeth. An elevated value can be due to excess parathyroid hormone, excess thyroid hormone, excess Vitamin D intake, or taking medications such as thiazide type diuretics ( water pills ). A low calcium level can be due to insufficient parathyroid hormone, low protein levels, insufficient dietary calcium intake, chronic kidney failure, bone disease, or certain medications such as Fosamax (for osteoporosis) or furosemide type diuretics ( water pills ). Phosphorus is often checked to help diagnose health conditions that cause problems with the body s use of calcium. Changes in levels can be due to numerous disorders. Low levels of phosphorus may be due to high levels of calcium, low levels of thyroid hormone, chronic antacid use, or Vitamin D deficiencies. High levels may be associated with kidney failure, insufficient parathyroid hormone, diabetic ketoacidosis, or excess phosphate supplementation. Proteins Albumin is the most abundant protein in the blood and performs many functions including nourishing tissues, keeping fluid from leaking out of the blood vessels, and also serves as a transporter for hormones, vitamins, minerals, and drugs. Decreased levels may be related to liver or kidney problems, inflammation, shock, or being malnourished. This test can provide information about overall health and nutrition status. High values are often associated with dehydration. Certain drugs such as growth hormones, insulin, and anabolic steroids may also cause high levels. Globulin is the antibody protein important for fighting disease. As with albumin, globulin is a test that can provide information about overall health and nutrition status. High levels can be seen in certain types of cancer, autoimmune disorders, kidney disease, liver disease, chronic infection, and severe dehydration. Low levels can be associated with chronic liver or kidney disease, immune system problems, emphysema, or leukemia. 4

7 A/G Ratio is a mathematical calculation using the albumin and globulin levels. Bilirubin This pigment is removed from the blood by the liver. Elevated levels may result in jaundice (yellowing of the skin), a condition warranting further health care provider evaluation to determine the cause. Health care providers may monitor bilirubin levels when jaundice is present to determine if it is caused from breakdown of red blood cells or liver problems. Low levels are probably not significant. Enzymes Alkaline phosphatase is an enzyme that helps cells work properly and is mostly found in the bones and the liver. High levels may be associated with those who are growing (children and pregnant women) or when damage to bones or liver has occurred, or with the presence of gallstones. Low values are probably not significant. LDH is n enzyme present in all the cells in the body. Anything which damages cells, including blood drawing itself, may raise amounts in the blood. The test alone is not specific for determining the underlying cause of injury or damage. If blood is not processed promptly and properly, high levels may also occur. AST/SGOT, ALT/SGPT are also enzymes that help cells work properly. They may be elevated from a variety of medical conditions including liver problems such as hepatitis, excess alcohol ingestion, muscle injury and recent heart attack. GGT is an enzyme that helps cells work properly and is monitored to detect liver or bile duct injury. Unlike the alkaline phosphatase, it is not elevated with bone growth or damage. The level is high in those with chronic alcohol use. Low values are probably not significant. Iron, Serum Normal iron levels are maintained by a balance between the amount of iron taken into the body and the amount of iron lost. Iron deficiency is a common cause of anemia (too few red blood cells, which are needed to carry oxygen throughout the body). Anemia may also result from chronic diseases and chronic infections where the body cannot properly use iron to make more red blood cells. Too much iron can lead to damage to a number of organs, including the heart, liver, pancreas, and joints. The most common cause of excess iron is hemochromatosis, an inherited disease. Iron rich foods are listed on the following page. Consult your health care provider regarding dietary measures and also prior to taking iron supplements. 5

8 Ferritin Ferritin is a protein found inside cells that stores iron so your body can use it later. A ferritin test measures the amount of iron in the body. Iron is important for red blood cell production. Low ferritin levels correlate with low body iron. Anemia, menstruation, infections, inflammatory disorders, disorders of excessive iron storage and blood transfusions may impact the results. Food, Standard Amount Iron (mg) Calories Clams, canned, drained, 3 oz Fortified ready-to-eat cereals (various), 1 oz Oysters, eastern, wild, cooked, moist heat, 3 oz Organ meats (liver, giblets), various, cooked, 3 oz Fortified instant cooked cereals (various), 1 packet varies Soybeans, mature, cooked, 1/2 cup Pumpkin and squash seed kernels, roasted, 1 oz White beans, canned, 1/2 cup Blackstrap molasses, 1 tbsp Lentils, cooked, 1/2 cup Spinach, cooked from fresh, 1/2 cup Beef, chuck, blade roast, lean, cooked, 3 oz Beef, bottom round, lean, 0 fat, all grades, cooked, 3 oz Kidney beans, cooked, 1/2 cup Sardines, canned in oil, drained, 3 oz Beef, rib, lean, 1/4 fat, all grades, 3 oz Chickpeas, cooked, 1/2 cup Duck, meat only, roasted, 3 oz Lamb, shoulder, arm, lean, 1/4 fat, choice, cooked, 3 oz Prune juice, 3/4 cup Shrimp, canned, 3 oz Cowpeas, cooked,1/2 cup Ground beef, 15% fat, cooked, 3 oz Tomato puree, 1/2 cup Lima beans, cooked, 1/2 cup Soybeans, green, cooked, 1/2 cup Navy beans, cooked, 1/2 cup Refried beans, 1/2 cup Beef, top sirloin, lean, 0 fat, all grades, cooked, 3 oz Tomato paste, 1/4 cup (USDA Dietary Guidelines 2005 Appendix B-3, Food Sources of Iron, Available: 6

9 Fat in the Blood Cholesterol level: When this fat-like substance is elevated in the blood, it is a major risk factor for heart and blood vessel disease. Although a certain amount of cholesterol is needed for proper body function, when the levels are too high, serious problems can result from the buildup of cholesterol in the walls of the arteries. Over time, hardening of the arteries (atherosclerosis) can result, causing blood flow to the heart to be slowed down or blocked. Since oxygen is carried by the blood to the heart, not getting enough blood (and oxygen) to your heart may cause chest pain. A complete blockage of the vessels results in a heart attack. Cholesterol monitoring: Many people do not know they have high blood cholesterol levels because the elevated level alone does not cause symptoms. Reducing cholesterol levels is important for everyone, regardless of their age, sex, or whether they have a history of heart disease or not. After age 20, it is recommended that cholesterol should be measured at least once every 5 years (or as directed by the physician elevated levels or other risk factors may result in a recommendation of more frequent monitoring). LDL (low-density lipoprotein) Cholesterol level: Considered the bad cholesterol because high LDL levels can result in cholesterol deposits forming in the arteries. Elevated levels should be discussed with your doctor. Depending on your individual risk factors for developing heart disease, elevated levels may impact treatment decisions made on your behalf. Those persons who have known coronary or vascular disease may be instructed by their doctor to get their LDL cholesterol well below 100. HDL (high-density lipoprotein) Cholesterol level: Considered the good cholesterol. HDL helps protect against heart disease because it helps remove excess cholesterol. Exercising is a measure that can increase HDL levels. VLDL (very low-density lipoprotein) Cholesterol level: Carries fat from the liver to other parts of the body (once the fat is unloaded, the remaining parts form LDLs). Triglycerides level: Most fat exists in this chemical form in food and in the body. Triglycerides in the blood plasma come from fatty foods eaten or made in the body from other food sources such as carbohydrates. Excess calories from a meal not immediately used are converted to triglycerides and transported to fat cells to be stored. High triglyceride levels have been associated with heart disease and also pancreatitis. Review the chart on the following page for cholesterol and triglyceride normal and out-of-range levels and track your personal levels. 7

10 Cholesterol Levels Total Cholesterol Category Less than 200 Desirable Mildly High 240 and above High LDL Cholesterol LDL-Cholesterol Category Less than 100 Optimal Near optimal/above optimal Borderline high High 190 and above Very high HDL Cholesterol HDL-Cholesterol Category 60 and above High; Optimal; associated with lower risk Less than 40 in men and less than 50 in women Low; considered a risk factor for heart disease Triglycerides Triglyceride Category Less than 150 Normal Mildly High High 500 or higher Very high 8

11 What can you do to lower cholesterol and triglyceride levels? While many things affect cholesterol and triglyceride levels, some healthy lifestyle measures you can take to reduce these levels include: Diet Eat less fat and cholesterol: Reducing the amount of saturated fat and cholesterol in the diet helps lower your blood cholesterol and triglyceride levels. Limit fat calories to less than 1/3 of your total calories (depending on your health status, your physician may advise stricter limits). Avoid fats from animal sources such as butter, lard, and fatty meats and also vegetable sources such as coconut, palm, and partially hydrogenated oils which are found in many processed foods. Limit saturated fat intake to 7-10% of calories or less. Limit cholesterol to 300 milligrams per day (your health care provider may recommend 200 mg per day if you have high cholesterol). - Healthy fat choices: olive oil and canola oil these monounsaturated fats lower LDL cholesterol without lowering HDL can make up to 15% of total calories). Polyunsaturated fat such as safflower, sunflower, or corn oil can make up to 10% of calories (lowers LDL cholesterol, but also lowers the good HDL cholesterol). - Other wise choices include these in your diet: low fat or fat-free milk products, fish, beans, skinless poultry, and lean meats (avoid fried foods). Eat a variety of fruits and vegetables most are fat-free and provide fiber (which lowers cholesterol). Choose at least 5 servings per day. Eat a variety of grain products, including whole grains such as oatmeal, brown rice, wheat bread, crackers and tortillas (fiber helps to lower cholesterol). Additional note about triglycerides: Not only are levels affected by fat from food intake, levels are also increased by high calorie intake, especially from sugar and carbohydrates. Some wise choices include: Avoiding sugar-sweetened drinks, limit juice to 1/2 cup a day, avoid/limit sweetened baked goods and snacks foods such as potato and corn chips. Substituting with fruits and vegetables, sugar-free products, and whole grains (such as oatmeal, whole wheat bread, brown rice, dried beans and legumes). Substitute limited amounts of these snacks: low-fat cakes and cookies (limit to 2 to 3 servings per week), choose baked (instead of fried) snack products. 9

12 Weight Management Being overweight, in addition to being a risk factor for heart disease, also tends to raise cholesterol and triglyceride levels. Exercise Physical activity, in addition to aiding in weight management, can help lower LDL (bad) cholesterol and triglycerides and raise HDL (good) cholesterol levels and will also aid in weight management. Exercise regularly on most days for 30 minutes (speak with your doctor before starting any exercise program). Avoid or Limit Alcohol Women should have no more than 1 alcoholic drink per day, and men, no more than two. ( One drink means it has no more than 1-1/2 oz. of 80-proof spirits, 1 oz. of 100-proof spirits, 4 oz. of wine, or 12 oz. beer). Stop Smoking Smoking lowers your HDL (good) cholesterol and increases your risk of developing a variety of diseases including heart attack, stroke, and cancer. Heart Healthy Measures Control high blood pressure and diabetes through diet, weight loss, and medication (if prescribed), and regular monitoring. 10

13 Thyroid What is it? The thyroid is a gland located just below the Adam s apple that plays a very important role in controlling your body s metabolism. Thyroid hormones regulate how fast your body works and uses energy. The pituitary gland, which is located in the brain, sends thyroid-stimulating hormone (TSH) to the thyroid gland which regulates when the hormone is made. Thyroid Stimulating Hormone (TSH): This hormone regulates function of the thyroid gland. A high level indicates your thyroid is under active, and a low level indicates your thyroid is over active. Thyroxine (T4): Shows the total amount of the T4 (a thyroid hormone). High levels may be due to hyperthyroidism (excess thyroid hormone); however, levels may be affected when estrogen levels are higher from pregnancy, birth control pills or estrogen replacement therapy. T3 Resin Uptake (or Thyroid Uptake): T3 Resin Uptake (or Thyroid Uptake): This is a test of the proteins that carry thyroid hormone in your blood, and is not a test of thyroid hormone itself. It is used by doctors to estimate and how much T4 and T3 in the blood is free form and available to affect the body. A high or low test number may help diagnose high or low thyroid conditions. Complete Blood Count (CBC) The CBC is a panel of tests that checks different parts in the blood. It is a broad screening test used to screen and check for infection, anemia, and other medical disorders. The CBC test includes the following: White Blood Cell Count (WBC) is the number of white cells in the blood. WBC s are the first line of defense against diseases and infections, and are involved in reactions to allergies, tumors, and general body stress. A high or low number can be significant. WBC is increased with infection, inflammation, and certain types of leukemias. Low WBC can be associated with bone marrow disease, an enlarged spleen, some autoimmune conditions, some severe infections, and HIV infection (the vast majority are not related to HIV infection in our population). Counts of individual White Blood Cell types are included in the CBC: neutrophils, Lymphocytes (lymphs), monocytes, eosinophils (eos), and basophils (basos). 11

14 Red Blood Cell Count (RBC) provides the number of red blood cells in a liter of blood. RBC s perform the vital functions of carrying oxygen to the cells and transporting carbon dioxide (a waste product) from the cells to the lungs to be exhaled from the body. Low counts are associated with anemia and can result in the body not getting the oxygen it needs. High counts can increase the risk of clumping of the red blood cells which can result in blockage of capillaries (tiny blood vessels). Hemoglobin (Hgb) and Hematocrit (Hct): Hemoglobin is a protein that transports oxygen in the red blood cells. Hematocrit is the percentage of space occupied by red blood cells in the blood. Hgb and Hct tests may be monitored by health care providers for conditions such as anemia, polycthemia, and bleeding problems. The Hgb level is measured, and the Hct is computed, thus some health care providers view the Hgb measurement as more reliable. Anemia can be due to nutrition, loss of blood, internal destruction of blood cells, chronic diseases such as liver or kidney problems, or bone marrow disorders resulting in decreased production of red blood cells in the bone marrow. High Hgb or Hct can be associated with dehydration, lung disease, the bone marrow producing too many red blood cells, living in high altitudes, or smoking. The following are tests that, in the presence of anemia, provide information to help the health care provider determine the type of anemia that is present: Mean Corpuscular Volume (MCV) measures the average RBC size. Mean Corpuscular Hemoglobin (MCH) calculates the average weight of hemoglobin inside the RBC s. Mean Corpuscular Hemoglobin Concentration (MCHC) calculates the concentration of hemoglobin inside the RBC s. Red Cell Distribution Width (RDW) calculates the variation in size of the RBC s. Platelet Count (PLT): Measures the number of cells that assist with clotting and prevent bleeding in response to damaged tissue. High counts can occur with bleeding, excess production by the bone marrow, or smoking. Low counts can occur from sudden blood loss, drug effects (such as heparin), sepsis type infections, chemotherapy, autoimmune disorders, entrapment of platelets in an enlarged spleen, or leukemia. Clumping of platelets in the collection tube can also produce a low platelet level. PSA: The PSA test measures the amount of prostate specific antigen (PSA) in the blood. 12

15 Elevated levels of PSA are associated with prostate cancer, but they may also be seen with inflammation of the prostate and benign prostatic hyperplasia (BPH). Levels also tend to increase with age in most men. A notable change in the level should be promptly discussed with your health care provider. The American Cancer Society (ACS) recommends that men consider being screened for prostate cancer between the ages of 40 and 50 depending on individual risk factors. Screening begins with the prostate-specific antigen (PSA) blood test, and the digital rectal exam (DRE) may also be done by your health care provider as a part of your screening. For men at high risk of developing prostate cancer, discussions on testing should begin by age 45. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65). This discussion should take place at age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age). After this discussion, those men who want to be screened should be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening. Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years. Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher. Additional testing available not included in the standard profiles CPK is an enzyme which is very useful for diagnosing diseases of the heart and skeletal muscle. This enzyme is the first to be elevated after a heart attack (3 to 4 hours). If CPK is high in the absence of heart muscle injury, this is a strong indication of skeletal muscle disease. Ferritin is a protein found inside cells that stores iron so your body can use it later. A Ferritin test measures the amount of iron in the body. Iron is important for red blood cell production. Low Ferritin levels correlate with low body iron. Anemia, menstruation, infections, inflammatory disorders, disorders of excessive iron storage and blood transfusions may impact the results. PA-AllIronHandouts.pdf (Print Pages) 13

16 HS-C Reactive Protein (HS-CRP) HS-CRP is a protein found in the blood and is considered a marker for heart specific inflammation which plays a role in the initiation and progression of cardiovascular disease. HS-CRP provides additional information about inflammation in the arteries something not determined by cholesterol testing alone. Inflammation (swelling) of the arteries increases your risk for health disease, heart attack, sudden death, stroke, and peripheral arterial disease. Other causes for elevated levels and sources of inflammation that are not associated with heart disease may include bacterial infection, polymyalgia, rheumatic, inflammatory bowel disease, and rheumatoid arthritis. Glycohemoglobin (Hemoglobin Al, Al c, or HbA1 c). Glycohemoglobin measures the amount of glucose chemically attached to your red blood cells. Since blood cells live about 3 months, the Alc provides your average glucose level for the last 3 months. A high level suggests poor diabetes control. According to the American Diabetes Association, a normal A1c level is less than 5.7 percent. Individuals that have prediabetes or considered to have a high risk of developing diabetes have A1c levels of 5.7 percent to 6.4 percent. Individuals with diabetes have A1c levels of 6.5 percent or higher. For individuals with diabetes, studies have shown that diabetes complication risks can be reduced by keeping A1c levels 7.0 percent or lower. See page 2 for more information on diabetes. Testosterone - Low testosterone is defined as less than 300 mg/dl of blood. The symptoms of low testosterone include low sex drive, erectile dysfunction, fatigue, mood problems, and sleep disturbances. Low testosterone is associated with several chronic medical conditions, including obesity, diabetes, depression, and possibly cardiovascular disease. It is not clear whether low testosterone causes these conditions, or if these conditions cause low testosterone levels. There are findings that low testosterone is common among men with metabolic syndrome-a group of risk factors that include abdominal fat, high glucose level, high blood pressure, low HDL(good) cholesterol, and high triglycerides. Metabolic syndrome is seen in conditions such as diabetes, heart disease, and vascular disease. Men with low testosterone symptoms whose lab tests show low testosterone levels will need to make their own decision about replacement therapy after consulting with their doctors. Lp(a) Measurement of lipoprotein(a) is now recommended in several patient subgroups for whom excess lipoprotein(a) may have important clinical consequences including patients with premature atherosclerosis patients with a strong family history of premature coronary heart disease (CHD) patients with elevated LDL-C and two or more risk factors, patients who have had coronary angioplasty in whom Lp(a) excess may increase the risk 14

17 of restenosis, and patients who have undergone coronary bypass graft surgery in whom Lp(a) excess may be associated with graft stenosis. The NMR LipoProfile test is a blood test designed to directly measure your LDL particle number (LDL-P). LDL is a Low Density Lipoprotein, or a particle that carries cholesterol. The basic Lipid profile uses cholesterol to estimate LDL levels. However, particle number and cholesterol sometimes disagree due to the varying amounts of cholesterol in each particle. When this disagreement occurs, heart disease risk is related to how many particles you have regardless of how much cholesterol is inside each particle. The NMR Lipoprofile is a more reliable measurement of LDL and provides your doctor with additional information to better manage LDL-related heart disease. This test is recommended for any participant who seeks a more accurate evaluation of their risk for heart disease, even when basic Lipid profile is normal. VAP Cholesterol Test is a comprehensive lipid profile that measures all 5 lipoprotein classes and their subclasses. It can be used to identify cardiovascular and cardio-metabolic risk, and includes Lp(a), a hereditary marker of risk. Physicians may utilize the VAP to personalize management and treatment of lipid disorders. Vitamin D It is estimated that 25%-57% of adults are deficient in vitamin D. There are two sources of vitamin D: diet and exposure to sunlight. In our present culture, few people receive adequate exposure to sunlight. Fatty fish oils contain vitamin D, and vitamin D is added to dairy products. Most other foods contain very little. It has been known for many years that vitamin D plays an important role in bone and joint health, but recent studies have shown that vitamin D deficiency may be associated with development of hypertension and cardiovascular disease, and some forms of cancer. Important reminders It is essential that you review your lab profile results with your health care provider and promptly discuss any unusual or abnormal test results. The brief summary of information supplied in this booklet should be used to supplement, and never to replace information or treatment to be provided by your health care provider. Need information? Contact: Health Care Services GPC Corporate Office: SCS Corporate Office: Customer Care: Forest Park: OptumHealth 24-hour health line: