Jump to content

  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.



  • Celiac.com Sponsor (A1):

    Celiac.com Sponsor (A1-M):

  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Test Results 101: Understanding Normal

gfb1

Recommended Posts

gfb1 Rookie
gfb1
Posted

Everybody gets their blood test results back in a haze of unreadable numbers and words. For all the cost, you'd think that the labs would invest in some decent printers, a legible font and maybe even a decently designed graphic (or two) -- [more on this to follow]. There is no reason that any person who can successfully navigate a newspaper or website should have trouble reading the results of a blood test panel.

To begin: what the hell is 'normal'??

as a good friend always reminds me:

there is no such thing as normal

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


70SS396 Newbie
70SS396
Posted

I'd be interested in hearing more. :)

JennyC Enthusiast
JennyC
Posted

There is a ton of QC done in the lab, and there is not as much variability as one might think. Proficiency tests are frequently done in which samples of unknown concentrations are sent to the lab and the results the lab gets must be within a certain range of the absolute value of the samples. QC is done with each new reagent lot and also with each instrument run. Certain reagents like UA test strips, antibodies, and enzymes have QC performed at the beginning of each shift. Labs are very careful to complete these practices, as they will have many problems with the joint commission, CAP, etc if they fail to comply and they would be at risk of losing their certification/accreditation. There are also defined criteria for tests (like what constitutes a 4+ white blood cell count on a specimen site slide), so they leave very little up for interpretation. Labs work very hard to ensure that their results are accurate and precise.

Serversymptoms Contributor
Serversymptoms
Posted

17 years old

I went on a gluten free diet before my blood test ( I was so far about 2 weeks gluten free). I got a phone call from the doctor ( after my mom question the hospital if results have came back since I've been concern about it) stating that the results were normal. My next appointment, my doctor was absent due to her plane arrival late in New York, the nurse remention the test results after overlooking my profile... when I ask could I review the results, she refused and the nurse and my mom explain that it was normal. I don't understand why I can't see the results, as I've told my mom that your usually allowed to see test results done on your blood. Reasons?

Well I'm about 90% sure I'm gluten intolerance, and I also think there is something wrong with my thyroid. I have all plus more symptoms of thyroid problems, along with coarse hair, skin condition around neck, dehydration, throat clicking (sometimes, but can easily make this clicking noise with my throat), neck pain/ stiffness and more....

Mother of Jibril Enthusiast
Mother of Jibril
Posted

This week I learned that it also pays to know which tests can be a little abnormal and still "no big deal" and which ones are a big deal when they go out of range. For example... if your liver enzymes are elevated a few points, no big deal. Once creatinine and BUN go out of range it means your kidneys are functioning at less than 40% capacity... stage 3 kidney disease (stage 5 means you need dialysis or a transplant). The reason the ranges are so wide is because mild kidney disease is pretty common in this country, thanks to the the high rates of diabetes, high blood pressure, and autoimmune disorders. Just being one or two standard deviations away from the norm doesn't always mean you're safe! Not everything fits into a neat little statistical bell curve where 90% of people are "normal" and the other 10% are not.

gfb1 Rookie
gfb1
Posted
  • Author
There is a ton of QC done in the lab, and there is not as much variability as one might think. Proficiency tests are frequently done in which samples of unknown concentrations are sent to the lab and the results the lab gets must be within a certain range of the absolute value of the samples. QC is done with each new reagent lot and also with each instrument run. Certain reagents like UA test strips, antibodies, and enzymes have QC performed at the beginning of each shift. Labs are very careful to complete these practices, as they will have many problems with the joint commission, CAP, etc if they fail to comply and they would be at risk of losing their certification/accreditation. There are also defined criteria for tests (like what constitutes a 4+ white blood cell count on a specimen site slide), so they leave very little up for interpretation. Labs work very hard to ensure that their results are accurate and precise.

absolutely.

way back; when i was helping to develop an analytical/clinical lab for hoffman-laroche (to assay dinosaur blood samples.... ) the linear portion of the standard curve had to have an R^2 value of 0.9999 (as in 99.99%). techniques have gotten better since the abacus, and using modern QC, the PRECISION of the assays might be 10-100 times better than that. the big 'BUT' in the room (ok, another bad joke i'll leave for another time) is that while the chemistry works, it is the biology that provides the variation.

there is no getting around statistical distributions.

gfb1 Rookie
gfb1
Posted
  • Author
This week I learned that it also pays to know which tests can be a little abnormal and still "no big deal" and which ones are a big deal when they go out of range. For example... if your liver enzymes are elevated a few points, no big deal. Once creatinine and BUN go out of range it means your kidneys are functioning at less than 40% capacity... stage 3 kidney disease (stage 5 means you need dialysis or a transplant). The reason the ranges are so wide is because mild kidney disease is pretty common in this country, thanks to the the high rates of diabetes, high blood pressure, and autoimmune disorders. Just being one or two standard deviations away from the norm doesn't always mean you're safe! Not everything fits into a neat little statistical bell curve where 90% of people are "normal" and the other 10% are not.

yes indeed. the biology is certainly the fun part!

based on my (very loose) plan for these little posts, i hope to discuss your last 2 statements in post #3. clinical labs and diagnosis have a very cozy, yet (imho) uncomfortable relationship. on the one hand, doctors make diagnoses based on the normal curve. yet for the individual being tested they are either sick or not. and, as we've all learned on the 'celiac bus', being sick and misdiagnosed stinks.

i certainly hope your 'learning' experience was not too painful and that you are well.

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


Mother of Jibril Enthusiast
Mother of Jibril
Posted
i certainly hope your 'learning' experience was not too painful and that you are well.

Yes. Thankfully I learned this lesson while my labs were still "normal." In a couple of weeks I'm having some more tests to figure out if the persistent protein and leukocytes in my urine are truly "no big deal" or something to watch carefully. Meanwhile... I'm feeling pretty good :) Doing my best not to end up on the "sick and misdiagnosed" wagon again.

I look forward to your upcoming posts!

Archived

This topic is now archived and is closed to further replies.

Go to topic listing
  • Celiac.com Sponsor (A19):


  • Member Statistics

    • Total Members
      131,855
    • Most Online (within 30 mins)
      7,748
    Tara M
    Newest Member
    Tara M
    Joined
  • Celiac.com Sponsor (A20):

  • Forum Statistics

    • Total Topics
      121.4k
    • Total Posts
      1m
  • Celiac.com Sponsor (A22):



  • Celiac.com Sponsor (A21):


  • Upcoming Events

  • Posts

    • cristiana
      Ibuprofen

      By cristiana · Posted

      @Colleen H   I am just curious,  when you were tested for coeliac disease, did the doctors find out if you had any deficiencies? Sometimes muscle pain can be caused by certain deficiencies, for example, magnesium, vitamin D, calcium, and potassium.   Might be worth looking into having some more tests.  Pins and needles can be neuropathy, again caused by deficiencies, such as iron and B12,  which can be reversed if these deficiencies are addressed. In the UK where I live we are usually only tested for iron, B12 and vitamin D deficiencies at diagnosis.   I was very iron anemic and supplementation made a big difference.  B12 was low normal, but in other countries the UK's low normal would be considered a deficiency.  My vitamin D was low normal, and I've been supplementing ever since (when I remember to take it!) My pins and needles definitely started to improve when my known deficiencies were addressed.  My nutritionist also gave me a broad spectrum supplement which really helped, because I suspect I wasn't just deficient in what I mention above but in many other vitamins and minerals.  But a word of warning, don't take iron unless blood tests reveal you actually need it, and if you are taking it your levels must be regularly monitored because too much can make you ill.  (And if you are currently taking iron, that might actually be making your stomach sore - it did mine, so my GP changed my iron supplementation to a gentler form, ferrous gluconate). Lastly, have you been trying to take anything to lessen the pain in your gut?  I get a sore stomach periodically, usually when I've had too much rich food, or when I have had to take an aspirin or certain antibiotics, or after glutening.  When this happens, I take for just a few days a small daily dose of OTC omeprazole.  I also follow a reflux or gastritis diet. There are lots online but the common denominators to these diets is you need to cut out caffeine, alcohol, rich, spicy, acidic food etc and eat small regularly spaced meals.   When I get a sore stomach, I also find it helpful to drink lots of water.  I also find hot water with a few slices of ginger very soothing to sip, or camomile tea.  A wedge pillow at night is good for reflux. Also,  best not to eat a meal 2-3 hours before going to bed. If the stomach pain is getting worse, though, it would be wise to see the doctor again. I hope some of this helps. Cristiana    
    • Me,Sue
      Knowing what to do when feeling unwell.

      By Me,Sue · Posted

      I was diagnosed with coeliac disease a couple of years ago [ish]. I love my food and a variety of food, so it's been hard, as it is with everyone. I try and ensure everything I eat doesn't contain gluten, but occasionally I think something must have got through that has gluten in. Mainly I know because I have to dash to the loo, but recently I have noticed that I feel nauseous after possibly being glutened. I think the thing that I have got better at is knowing what to do when I feel wiped out after a gluten 'episode'. I drink loads of water, and have just started drinking peppermint tea. I also have rehydration powders to drink. I don't feel like eating much, but eventually feel like I need to eat. Gluten free flapjacks, or gluten free cereal, or a small gluten free kids meal are my go to. I am retired, so luckily I can rest, sometimes even going to bed when nothing else works. So I feel that I am getting better at knowing how to try and get back on track. I am also trying to stick to a simpler menu and eat mostly at home so that I can be more confident about what I am eating. THANKS TO THOSE WHO REPLIED ABOUT THE NAUSEA .
    • Francis M
      The Happy Tart review

      By Francis M · Posted

      Thanks. Since the back and forth and promises of review and general stalling went on for more than six months, the credit company will no longer investigate. They have a cutoff of maybe six months.
    • Scott Adams
      The Happy Tart review

      By Scott Adams · Posted

      Is this the same restaurant? https://www.facebook.com/TheHappyTartFallsChurch/ Is it too late to take this up with your credit card company? Normally you have a few months to do a chargeback with them. It seems very odd that they are taking this approach with someone who is likely to be a regular customer--not a good business-minded way of handling things!
    • Scott Adams
      Stomach burning and neuropathy

      By Scott Adams · Posted

      Many people with celiac disease, especially those who are in the 0-2 year range of their recovery, have additional food intolerance issues which could be temporary. To figure this out you may need to keep a food diary and do an elimination diet over a few months. Some common food intolerance issues are dairy/casein, eggs, corn, oats, and soy. The good news is that after your gut heals (for most people who are 100% gluten-free this will take several months to two years) you may be able to slowly add some these items back into your diet after the damaged villi heal. This article may be helpful: The most common nutrient deficiencies associated with celiac disease that may lead to testing for the condition include iron, vitamin D, folate (vitamin B9), vitamin B12, calcium, zinc, and magnesium.  Unfortunately many doctors, including my own doctor at the time, don't do extensive follow up testing for a broad range of nutrient deficiencies, nor recommend that those just diagnosed with celiac disease take a broad spectrum vitamin/mineral supplement, which would greatly benefit most, if not all, newly diagnosed celiacs. Because of this it took me decades to overcome a few long-standing issues I had that were associated with gluten ataxia, for example numbness and tingling in my feet, and muscle knots--especially in my shoulders an neck. Only long term extensive supplementation has helped me to resolve these issues.        
×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.