"A complete blood count is a measure of the various cells within the blood. Red blood cells and hemoglobin are responsible for carrying oxygen to the body and carbon dioxide out of the body. The red blood cell count is the absolute number of red blood cells in the blood. A high level can be associated with problems with cardiovascular function, tobacco abuse, stress, high altitude or dehydration. A low count may indicate anemia, or problems with bone marrow or kidney function.

The complete blood count or "CBC" can be very helpful to assess for the end result of serious nutrient deficiencies. In fact, one of the most common finding of severe iron deficiency is anemia.

White blood cells are part of the immune system and are responsible for fighting off infection. In terms of immune system activation, the white blood count should be within the reference range, unless, of course, there is active infection. There are several types of white blood cells, each with a specific job to do in terms of fighting off threats to the body.

Neutrophils are involved in fighting off bacterial and other infections and are elevated in tissue injury, inflammation, stress, certain metabolic conditions, metastatic cancer and in response to some medications.

Lymphocytes identify foreign substances in the body and produce antibodies against them. Monocytes are increased in response to infection, particularly infection with viral or parasitic agents. They can also be increased in response to chronic infection, inflammatory bowel disease, leukemia and certain cancers.

Eosinophils are typically involved with allergies and parasitic infections. Basophil levels can be elevated in conditions involving inflammation and allergic reactions.

Platelets are involved in the process of blood clotting. When a blood vessel is damaged, platelets clump together and help to initiate clotting. Abnormal platelet counts are found in a number of blood-related and autoimmune diseases.

ADVANCED BIOMARKERS: BUN, Creatinine, eGFR

Your kidneys are vital organs that filter waste and water from your bloodstream and excrete them as urine. They also help to regulate our body's electrolytes including sodium, potassium, chloride, and bicarbonate. Creatinine and urea (blood urea nitrogen or BUN) are two waste products that your kidneys filter out and excrete in the urine. When the kidneys are not functioning optimally, levels of BUN and creatinine can build up causing elevated levels of these biomarkers. eGFR stands for estimated glomerular filtration rate and is a mathematical calculation that takes into account muscle mass to "estimate" proper kidney function. If the eGFR is less than 60 ml/min then this is an indication of significant diminished function that needs to be further evaluated. Ideally, we like to see eGFR >100 ml/min.

People with mild or even moderate diminished kidney function typically do not experience symptoms; therefore, kidney biomarker evaluation may be the only indication that the kidneys are not functioning well.

ADVANCED BIOMARKERS: AST, ALT, ALP, TBili

The liver performs over 500 vital functions. Some of the most important functions include its role in carbohydrate and protein metabolism, production of blood clotting factors, storage of vitamins and minerals, the formation and secretion of bile, and the breakdown of potentially harmful substances like alcohol, certain medications, and other toxins.

Biomarkers that reflect liver function are used to detect disease or damage to the liver or bile ducts. Bile ducts are small drainpipes that carry bile (a digestive fluid) from the liver to the gallbladder and from the gallbladder to the small intestine. If a duct becomes blocked, by a gallstone or tumor, waste can build up in the bile duct system and in the bloodstream.

These liver markers can elevate with a number of conditions. One I commonly see in my practice is fatty liver. If a person has belly fat, this same fat can deposit in the liver and damage liver cells. Damage to liver cells can be picked up with these biomarkers. Other common reasons for liver enzyme elevation are alcoholism and certain medications - statins, and sometimes, high dose niacin and long term use of NSAIDS (think motrin, ibuprofen). Liver enzymes can also elevate with infections, auto-immune hepatitis, and liver cancer.

Tip: If you have known liver disease or kidney disease or are taking blood pressure medication or potassium supplements, it is recommended you follow these biomarkers every 3-4 months. If you consistently indulge in alcohol, or routinely take over the counter non-steroidal anti-inflammatories (NSAIDS) for pain, high dose niacin or statins, you should also cautiously monitor your liver function.

ADVANCED BIOMARKERS: Albumin, Total Protein, Globulin

The liver makes and stores protein. A good way to check the overall health of the liver is to see if the liver proteins are normal. If these numbers are very low, there may be malnutrition or liver damage. It is common to see low protein levels in alcoholics or in people who have long-standing liver disease.

Total protein is made of two principal biomarkers - albumin and globulin. Albumin usually is 60% of all of the total protein, leaving about 40% to globulin.

Elevated albumin is uncommon but can be seen with hemoconcentration (look for high hemoglobin and hematocrit). Low albumin levels are much more common. This usually results from decreased production due to liver disease or acute inflammation! That is right, albumin is a NEGATIVE inflammatory marker, meaning with inflammation albumin levels will sometimes go down!

Malnutrition and maldigestion can also result in lower albumin levels. Addison's disease and protein nephropathy (kidney disease) are less common causes of lower levels of albumin due to albumin wasting in the urine (they pee out too much protein.)

As I stated earlier, about 40% of all total protein is made up of globulins. Ever heard of immunoglobulins? That's right our immune system proteins are included in this measurement.

High levels of globulin (with a normal albumin) can be seen commonly in chronic inflammation, infection, and some cancers (plasma cell, lymphomas, multiple myelomas). Other less common elevations of globulin (with normal albumin) occur with parasites, immune-mediated diseases, and pregnancy."- Dr. Alan Hopkins

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