Blood test interpretation
 

Forget HIPPA I need some help understanding my blood test results - my Dr. did not explain so I could understand and my research on the net did not help either. Forum members, take this as a compliment, I know that I will get some great info back, thanks in advance. I should mention that I did see on the net something about vigorous exercise in close proximity to a blood test may effect results but I could find no further info. I am not even sure when I worked out in relationship to my early AM fasting blood sample.

Over the last couple of years I have been riding and exercising at a high level (for a 60 yr old). I have lost over 110 lbs mostly through exercise. I had a Lipid Panel, Hepatic Function Panel and Homocysteine, cardiovascular blood test done. The out of range results were:HDL 25 - Dr. said this was unusual since the only thing he knows that raises HDL is exercise. All other Lipids were good, including Triglycerides which were 600 before exercise program and were 68 this time. In the Hepatic Function Panel my Protein (5.5) and Globulin (1.9) were Low and Alkaline Phosphatase (133), AST (61) and ALT (83) were all above range.

I believe in general HDL is increased most by exercise. But I also believe that it can be improved by increasing intake of Omega-3 fatty acids. I take flax seed oil pills everyday to get more omega-3. Certain oily fish are also high in omega-3.

I can't answer your question on the liver test. I'd only suggest you search the internet or try webmd for info.

I found this on the Internet on your AP, ASP, and ALT levels: These tests have a meaning, but they generally cannot be interpreted without clinical information. They are probably most useful to track, or follow a particular problem, but even then they often "bounce around" greatly.


What did your Doctor say about these levels.

The liver is crammed full of enzymes, part of whose job is to detoxify unwanted chemicals in the diet or produced in body chemical reactions. The three liver enzymes you mentioned, (ALP, AST, ALT) are measured in blood, and represent small amounts of enzyme that leak out of liver cells normally. Mild elevations are sometimes seen as a benign effect of some prescription drugs, and may not be a concern if they're only a bit above normal. In serious liver disease the enzyme levels can rise to many multiples of normal levels. Having said that, don't take my word for it...I'm not your doctor.

You may not be my Doc but you told me more than he did - I do take Lipitor, Plavix and Toprol, maybe that caused the slight elevation.

Lipitor may be the cause or be abetting the minor elevations in the liver function tests. These elevations you report are fairly trivial in the scheme of liver disease. When I worked at a plasma bank as a screener the Feds put in a strict upper limit on the AST of 40 as a proxy for the then unavailable hepatitis C test. It knocked about 5% of the donors off the rolls. Most of the elevations were related to 6pk a day habits common in the clientele. Since you were extremely overweight in the past you likely have some degree of fatty liver disease (no big deal) and if there is any background of alcohol in your younger days the liver would also have taken some hits, again no big deal, but the combo may well account for the LFT variances. If your lipitor dose is 10-20mg occasional LFT checks at 6mo intervals are in order. If you are on 40-80mg dosages more frequent ones for awhile to see if there is any trend. If the LFTs don't change over a year or two then any concern should be relieved. Plavix is a kind of big gun to use unless you have a stent somewhere or already had a cerebral, anginal or infarctional cardiac event or have major peripheral vascular disease. The peripheral vascular dz scenario is unlikely with your biking success. Plavix adds 20-30% to aspirin's platelet aggregation inhibition at most and at $5/day, even if someone else is paying for it, is a lot of $ for small gains in the absence of a stent.
I see a fair number of little old ladies (LOL) with huge hematomas from minor falls that are secondary to their plavix. Aspirin in 81mg doses gives you 80% of the platelet inhibition needed for prevention purposes for potential cardiac and cerebral disease.
If you already have HAD such an event then plavix is in order, if not....
Steve

I get blood screenings every year as part of my health package at work. I'mout of the normal range in seven or eight categories each year, the same categories. If your MD has seen the results, you're o.k. or he would have ordered more tests or made some diagnosis. Ranges are only average. Many of us are out of the ranges simply because our body chemistry is a little different. For example, my RBC and hematocrit are always below the range, yet I'm not anemic nor am I suffereing from any disease. I simply have lower amounts (not much lower, but out of the range). Get teted every year and compare results. Once you have a base line, greater deviations are easy to spot.

Lipitor 20 mg - I had three blockages, because of the location (in back of heart) my Dr. wanted to try medication, diet and exercise. Everytime I ask about cutting back the medication his response is that statistically those who take the medications have less heart attacks and thus I should continue taking the medicine. I was a fairly frequent beer drinker when I was young but I quit drinking almost 28 years ago.

Sounds like you are stuck in that gray zone where the literature is extrapolated from those who definitely do need and benefit from plavix and those that could do without.
In that case I would agree with your MD, and give plavix the benefit of the doubt. Blockages are potential infarcts and you are doing extremely well from what you say so I would continue the program but get your LFTs checked at 4-6mo intervals to see if they are stable or if they are trending in the wrong direction. Statins have two well defined problem areas: liver toxicity and muscle toxicity. I stopped lipitor becaue of the muscle aspect: on rides longer that 30 miles my legs ached like crazy for 6-8 hrs after the ride. They still ache but it is very mild and takes 45-55mi to make them ache now off lipitor.
Steve