Jake Ames, MD, HMD Puerto Vallarta, Mexico Some Optimal Blood Lab levels May 22, 2024 The Complete Blood Count (CBC)Erythrocytes: Adult males: 4.7 to 6.1 million/mcL Hemoglobin: Adult men: 14-18 g/dL Adult women: 12-16 g/dL Hematocrit: 41% to 50%. Plaquettes (Platelets): 150,000 to 450,000 per microliter (mcL) of blood. MCV: This measures the size of your red blood cells Normal values are 80-100 fL. I consider 90 fL the upper limit. Above 90 fL, I usually see a vitamin B12 and/or methyl folate deficiency, liver disease, alcoholism, and sometimes hypothyroidism. A low MCV is usually seen in iron or copper deficiency. Lead poisoning and thalassemia can cause a low MCV. Common diseases occur commonly in medicine, so a low MCV is usually due to iron deficiency. White Blood Cell Count (WBC): White blood cells are also called leukocytes. Their normal range is 4,300-10,800/cubic mm. I like to see the WBC around 6-8/cubic mm. A low or low normal WBC is usually due to low cortisol, low RBC copper, and/or chronic mercury toxicity. Smokers will usually have a WBC in the high range of normal. A severe acute viral infection can cause a low WBC. Chemotherapy, cancer, lymphoma, AIDS, radiation therapy, aplastic anemia, lupus, sarcoidosis, hypersplenism, and some leukemias can also cause a low WBC. This list is not exhaustive. Neutrophils mainly destroy and ingest bacteria. Levels are high when one has a bacterial pneumonia or a severe bacterial infection. Their range is 45-75%. Whenever you see a low normal or low neutrophil count or percent neutrophil count suspect low cortisol. Eosinophils and Basophils are high in moderate to severe allergy patients. In Mexico I see eosinophils elevated in people with parasites. Monocytes are scavenger cells, which remove foreign material, dead bacteria, and viruses. Lymphocytes fight viral infections. You may see the percent lymphocyte count elevated in someone with cortisol deficiency. For CPK use the lab’s reference ranges. Types of CPK Isoenzymes: 1. CPK-MB (Cardiac Muscle): This isoenzyme is found primarily in cardiac muscle and is released into the bloodstream when the heart muscle is damaged, such as during a heart attack: 2. CPK-MM (Skeletal Muscle): This isoenzyme is found primarily in skeletal muscle and is released into the bloodstream when muscle tissue is damaged, such as during muscle injury or disease: 3. CPK-BB (Brain): This isoenzyme is found primarily in the brain and is released into the bloodstream when brain tissue is damaged, such as during a stroke or head injury. Functions of CPK Isoenzymes: 1. Muscle Function: CPK isoenzymes play a crucial role in muscle function, particularly in the contraction and relaxation of muscle fibers: 2. Energy Production: CPK isoenzymes help to produce energy for muscle contractions by converting creatine and ATP into phosphocreatine and ADP: 3. Damage Indication: Elevated levels of CPK isoenzymes in the bloodstream can indicate muscle damage or disease, such as a heart attack, muscle injury, or stroke. Clinical Significance: 1. Diagnosis: CPK isoenzymes are used to diagnose muscle damage or disease, such as a heart attack, muscle injury, or stroke: 2. Monitoring: CPK isoenzymes can be used to monitor the progression of muscle damage or disease and to assess the effectiveness of treatment: 3. Prognosis: Elevated levels of CPK isoenzymes can indicate a poor prognosis for patients with muscle damage or disease. Conclusion: CPK isoenzymes are an important aspect of muscle function and play a crucial role in diagnosing and monitoring muscle damage or disease. Understanding the different forms of CPK isoenzymes and their functions can help healthcare professionals provide better care for patients with muscle-related conditions. Vitamin B12: Always keep your level over the reference range. If your urine is pink, you can cut back on vitamin B12. If your vitamin B12 levels are greater than the reference range, and your neutrophils are hypersegmented (normal is 3-5 nuclear lobes, hypersegmented is 6 or more nuclear lobes), then you are probably low on methyl folate. CRP-HS: Your level should be less than 1 mg/L: Fibrinogen: Your level should be less than 300 mg/dL. The lower range is 150 mg/dL: Homocysteine: 4–6 umol/L LP-PLA2: Use the labs reference ranges LIPOPROTEIN (a): 20 milligrams per deciliter (mg/dL): There are no optimal ranges for thyroid hormone, since most patients have type 2 hypothyroidism, but keep TSH below 2 mU/L.Four to five out of ten of my patients are low on thyroid hormone. Read the books, “Hypothyroidism Type 2: The Epidemic” by Mark Starr and “Hypothyroidism: The Unsuspected Illness” by Broda Barnes. Also read my great friend's Dr. David Brownstein's book on iodine and thyroid hormone. Purchase a digital basal thermometer accurate to 1/100 of a degree. Your afternoon resting oral temperature, at least 2 hours after lunch, should be between 36.7-37 degrees Celsius or 98.2-98.6 degrees Fahrenheit. Do this for five days. Your physician should ask you questions about the signs and symptoms of hypothyroidism and do a thorough exam. If your temperatures are low despite “normal” thyroid blood tests, try Synthyroid 25 mcg or 15 mg (1/4 grain) of desiccated pork thyroid. Albumin to Globulin Ratio (A/G): I like to see the A/G ratio around 2. The optimal Range is 1.7-2.2. Electrolytes: Keep potassium at 4.5 mEq/L to 5.0 mEq/L. Keep sodium at 140 mEq/L to 145 mEq/L.Keep chloride at 100 mEq/L to 105 mEq/L. Always use real sea salt or Himalayan salt. Most sea salt and Himalayan salt in Mexico has been poisoned with fluoride.Testosterone (male): Keep your level between 700 ng/dL to 1,200 ng/dL. Nighttime and morning erections are a better indicator of optimal testosterone levels. Too much testosterone will aromatize to estrogen. High estrogen can cause prostate enlargement, prostate cancer, and erectile dysfunction. Free Testosterone (male): Ideal free serum testosterone levels for most aging men are between 20-25 pg/mL. Total Testosterone (female): 70-130 ng/dL when using topical creams. It can be as high as 150-300 ng/dL 5 weeks after testosterone pellet insertion. Basically, look at libido. Look for acne on the face, scalp, upper chest or upper back if the testosterone is too high. Look for facial hair, especially above the lip, hair on the areola, and pubic hair that travels up to the navel like a man if the testosterone is too high: DHEA- sulfate: (male and female) 250 µg/dL to 300 µg/dL in men and women. Some women can’t go above 200 µg/dL without getting acne or facial hair. LH: Males Prepubertal: 0.3-6 IU/L Adult: 1.2-8.6 IU/LFemales: Follicular phase: 2.1-10.9 IU/L Mid-cycle: 19.2-103 IU/L Luteal phase: 1.2-12.9 IU/L Adult: 1.2-8.6 IU/L (similar to males)Progesterone Female: After menopause: Around 3 ng/mL Progesterone Male: Adult male: 0.2-0.9 ng/mL Cortisol Serum (morning): 5 to 25 mcg/dL (139-695 nmol/L): It should be above 300 nmol/L to rule about cortisol insufficiency.Pregnenolone: (male and female) 100 ng/dL to 248 ng/dL. Sometimes it can cause insomnia, so take pregnenolone in the morning. Sometimes it will raise aldosterone and raise one’s blood pressure. FSH (female): 5-20 mIU/mL in post-menopausal women. Under 5, possibly too much supplemental estrogen. Above 20, possibly not enough estradiol on board. Estradiol (men): 20 pg/mL to 30 pg/mL. High estrogen in men, can lead to an early death and erectile dystfuncion, but men need estradiol to achieve and maintain erections. Anastrazole (Arimidex ®) 1 mg ¼ tablet a week works for most men to lower estradiol. Estradiol (woman): Women keep your estradiol (E2) to estrone (E1) ratio at 2:1. Only estradiol subdermal pellets can do this. Estradiol creams usually give around a 1:1 ratio. Oral or sublingual estradiol will not give you a good ratio. The 2:1 E2 to E1 ratio protects women the most from breast cancer. Keep your estradiol and estrone blood labs in the reference range. Do not worry about the estradiol and estrone ranges. Keep the FSH 20 mlU/ml.You can use the labs reference ranges. Vitamin D:The reference range for the total 25 (OH) D level should be between 80-110 ng/mL. You can go higher on this if you’re supplementing your patient with vitamin K2 and checking urine calcium levels. Iron Panel: The entire iron panel should be in the labs reference range. Keep ferritin above 40 nanograms per milliliter: PSA total:0-2.5 ng/mL: PSA Free: 15 ng/ml IGF-1 Man: labs reference range IGF-1 Female:labs reference range: D- Dimer: In the labs reference range: ANA: Negative Cholesterol Total: 170 mg/ml. Keep the total cholesterol to HDL ratio 3: Triglycerides: Less than 200 milligrams per deciliter (mg/dL) for adults MTHFR: Negative: Telomer Length:Use the labs reference range for a chronological age between 20-30 years old. Western Blot Lyme IgM test from IgeneX Inc. A positive 39 band means you have Lyme disease. An equivocal 39 band means that you probably have Lyme disease. Doctors Data Hair Elements test: Nutritional minerals deviated to the right are usually very low unless one is supplementing with that mineral.