Guide to Common Laboratory Tests for Eating Disorder Patients

Transcription

1 GuidetoCommonLaboratoryTestsforEatingDisorderPatients Test Measure Description Reference Range** CompleteBloodCount Seebelow Levelsofmultiple See (CBC) blood individual components counts WhiteBlood Cell(WBC) Count RedBlood Cell(RBC) Count Hemoglobin (HGB) Hematocrit (HCT) Mean Corpuscular Volume (MCV) Measures immunesystem functioning (includes basophils, eosinophils, lymphocytes, monocytes, neutrophils) Countofthe actualnumberof redbloodcellsper volumeofblood. RBCsdeliver oxygen throughoutthe body. Proteinusedby redbloodcellsto distributeoxygen toothertissues andcellsinthe body Percentofblood thatisoccupied byredbloodcells Measuresthesize ofredbloodcells Platelet Createclotsor scabstoprevent orstopbleeding Comprehensive MetabolicPanel Seebelow Assessescurrent statusofkidneys, liver,and electrolyte andacid/base balanceaswellas bloodsugarand bloodproteins Glucose Bloodsugarlevel attimeoftesting Total Protein Totalproteinlevel inbloodfluid Albumin Smallprotein producedinliver 4,000 10,000 WBCs/mcL AbnormalHigh AbnormalLow Notes Infection, inflammation, traumato tissue,high physicalor emotional stress,anemia Fluidlossdueto diarrheaor dehydration Malnutritioncan leadtodecrease inoneormore ofthesetypesof cells.decrease isnottypically correlatedwith increasedriskof infection Anemia Anemia % Anemia Anemia 150, ,000 platelets permcl See individual counts mg/dl Malnutrition; VitaminB deficiency Diabetes; excessivefood intake;useof diuretics Hypothyroidism; starvation Unusualwith eatingdisorders Malnutrition Dehydration Malnutrition g/dl Asuddendropin glucose(<70mg/dl) canhaveserious medical complications

2 Total Calcium Amountof calcium circulatingin blood mg/dl Sodium Electrolyte (meq/l) Potassium Electrolyte (meq/l) Bicarbonate Electrolyte mmol/l Chloride Electrolyte mmol/l BUN Kidneyfunction 7 20 mg/dl Creatinine Kidneyfunction mg/dl LiverPanel(Hepatic FunctionPanel/Liver FunctionTests/LFTs) Seebelow See individual counts Dehydration Dehydration from inadequatefluid intake Dehydration Vomiting; metabolic alkalosis Lowblood proteinlevels (albumin);low magnersium; vitamind deficiency;high phosphorus level Sodiumlossdue todiureticuse; overhydration (Somepatients will overhydrate,or "fluidload," priortobeing weighedin orderto temporarily increaseweight) Vomiting; diureticuse Metabolic acidosis IfAlbuminlevelis low,"ionized calcium"level shouldbeordered insteadoftotal calcium.abnormal calciumlevelscan causeserious cardiac complications. Abnormallevelscan causeserious medical complications Abnormallevelscan causeserious cardiac complications Abnormallevelscan causeserious medical complications Vomiting; diureticuse Dehydration Malnutrition; overhydration (seenoteabout "fluidloading" above);verylow proteindiet Dehydration Unusualandnot causefor concern Therelationship betweenliver enzymesisabit complicated. Overall,weknow lowbmiandlow percentbodyfatare correlatedwith elevatedliver enzymesandthat theseenzymes, whenelevated,can beamarkerofliver damage. Occasionallyliver enzymesbecome

3 LiverPanel(Hepatic FunctionPanel/Liver FunctionTests/LFTs) Alkaline Phosphotase Seebelow See individual counts Liverenzyme/liver function ALT/SGPT Liverenzyme/liver function AST/SGOT Liverenzyme/liver function Bilirubin Liverwaste product/liver function SerumFerritin Assessesiron storesinbody 30to120 IU/L 9to60 IU/L 10to40 IU/L mg/dl ng/ml Therelationship betweenliver enzymesisabit complicated. Overall,weknow lowbmiandlow percentbodyfatare correlatedwith elevatedliver enzymesandthat theseenzymes, whenelevated,can beamarkerofliver damage. Occasionallyliver enzymesbecome elevatedduring refeeding,though thisistypically temporary,and onceweight stabilizes,enzymes returntonormal. Elevatedliver enzymescan reflectliver damageor inflammation dueto malnutrition. Elevatedliver enzymescan reflectliver damageor inflammation dueto malnutrition. Elevatedliver enzymescan reflectliver damageor inflammation dueto malnutrition. Elevatedliver enzymescan reflectliver damageor inflammation dueto malnutrition. Malnutrition; irondeficiency anemia

4 SerumIron Bloodironlevel mcg/dl LipidProfile Total Cholesterol HighDensity Cholesterol LowDensity Cholesterol <200 mg/dl (5.18 mmol/l) "Good cholesterol" >50mg/dl (1.5 mmol/l) "Badcholesterol" <130 mg/dl (3.37 mmol/l) Triglycerides <150 mg/dl (1.7 mmol/l) SerumMagnesium Electrolyte 1.7to2.2 mg/dl SerumPhosphorus mg/dl Amylase U/L ThyroidPanel TSH Thyroid stimulating miu/l hormone T3 Triiodothyronine 100to200 ng/dl T4 Thyroxine 4.5to11.2 (mcg/dl) Transthyretin (Prealbumin) Urinalysis,Macroand Micro Assesses nutritionalstatus mg/dl Malnutrition; irondeficiency anemia Dehydration; useof magnesiumcontaining laxatives Lowcalcium levels;useof phosphatecontaining laxatives Chronic vomiting Malnutrition; diureticuse; nonmagnesiumcontaining laxativeabuse Malnutrition; diureticuse; chronicantacid use Hypothyroidism Hyperthyroidism Hyperthyroidism Hypothyroidism Hyperthyroidism Hypothyroidism; malnutrition Malnutrition; hyperthyroidism Abnormallevels duringrefeeding cancauseserious medical complications Abnormallevels duringrefeeding cancauseserious medical complications

5 OtherTests Electrocardiogram (EKG) FullVitalSigns Measuresheart rateand heartbeat regularity Including orthostatics (measuring blood pressure andpulsein various positions) and temperature Malnutritionandbinge/purgebehaviorscanleadtodecreasedheart rate,slowpulse,and/orirregularitiesinheartbeatknownas bradychardia.electrolyteimbalancesandhypotensioncanalsoleadto cardiaccomplications.thesesymptomscanbeincrediblydangerous,and frequentlycanonlybeassessedthroughanekgscan. Malnutritionandbinge/purgebehaviorscanleadtohypothermia, dehydration,andhypotension(lowbloodpressure).makesureand mentionifyourchildhasbeencomplainingofdizziness,lightheadedness orhashadanyfaintingspells.bloodpressure relatedcomplicationscan bedeadly. ChartcourtesyofMarenSchiessMSN,APRN BC **Referencerangesvaryfromlabtolab,soyoushouldalwaysusethereference rangesonthelabreportifthey redifferentfromtherangesonthischart. All AbnormalHigh/Low descriptionsrefertointerpretationsofhighorlowresults thatarecommonlyassociatedwitheatingdisordersymptoms.loworhighresults onthesetestsmayalsohavealternateexplanations.askyourphysicianfor additionalinformation. Allboldandunderlinedtestsarehighpriority makesureandrequestthesefrom yourdoctor Allpinkhighlightedtestsmeasurethingsthatarepotentiallycritical/dangerous Formoreinformationontheseandotherlaboratorytests,thefollowingsiteshave reliableinformation: specifictest)