CMP -14 Test

The Comprehensive Metabolic Panel (CMP) is typically a group of 14 specific tests that have been approved, named, and assigned a CPT code (a Current Procedural Terminology number) as a panel by Medicare (although labs may adjust the number of tests up or down). Since the majority of insurance companies also use these names and CPT codes in their claim processing, this grouping of tests has become standardized throughout the United States. The CMP is a frequently ordered panel that gives your doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood sugar and blood proteins. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed.

The CMP is used as a broad screening tool to evaluate organ function and check for conditions such as diabetes, liver disease, and kidney disease. The CMP may also be ordered to monitor known conditions, such as hypertension, and to monitor patients taking specific medications for any kidney- or liver-related side effects. If your doctor is interested in following two or more individual CMP components, he may order the entire CMP because it offers more information.

The CMP is routinely ordered as part of a blood work-up for a medical exam or yearly physical and is collected by inserting a needle into a vein in your arm. Although it may be performed on a random basis, the CMP sample is usually collected after a 10 to 12 hour fast (no food or liquids other than water). While the individual tests are sensitive, they do not usually tell your doctor specifically what is wrong. Abnormal test results or groups of test results are usually followed-up with other specific tests to confirm or rule out a suspected diagnosis.

The CMP includes:


Both increased and decreased levels can be significant.

Proteins


Albumin, a small protein produced in the liver, is the major protein in serum. Total protein measures albumin as well as all other proteins in serum. Both increases and decreases in these test results can be significant.

Electrolytes


The concentrations of sodium and potassium are tightly regulated by the body as is the balance between the four tests. Electrolyte (and acid-base) imbalances can be present with a wide variety of acute and chronic illnesses. Chloride and CO2 tests are rarely ordered by themselves.

Kidney Tests


BUN and creatinine are waste products filtered out of the blood by the kidneys. Increased concentrations in the blood may indicate a temporary or chronic decrease in kidney function. When not ordered as part of the CMP, they are still usually ordered together.

Liver Tests


ALP, ALT, and AST are enzymes found in the liver and other tissues, while bilirubin is a waste product of the liver. All can be found in elevated concentrations in the blood with liver disease or dysfunction.

Lipid Panel Test Profile

The lipid profile is a group of tests that are often ordered together to determine risk of coronary heart disease. They are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels or hardening of the arteries (atherosclerois). The lipid profile typically includes:


An extended profile may also include:
• Very low density lipoprotein cholesterol (VLDL-C)

Sometimes the report will include additional calculated values such as the Cholesterol/HDL ratio or a risk score based on lipid profile results, age, sex, and other risk factors.

How is the lipid panel test profile sample collected for testing? 
A blood sample is obtained by inserting a needle into a vein in the arm. Sometimes a drop of blood is collected by puncturing the skin on a fingertip. This fingerstick sample is typically used when a lipid profile is being measured on a portable testing device, for example, at a health fair. You need to fast for 9-12 hours before having your blood drawn; only water is permitted.

How is a lipid profile test used? 
The lipid profile is used to help determine your risk of heart disease and to help guide you and your health care provider in deciding what treatment may be best for you if you have borderline or high risk. The results of the lipid profile are considered along with other known risk factors of heart disease to develop a plan of treatment and follow-up. Depending on your results and other risk factors, treatment options may involve life-style changes such as diet and exercise or lipid-lowering medications such as statins.

When is the lipid profile test ordered? 
It is recommended that healthy adults with no other risk factors for heart disease be tested with a fasting lipid profile once every five years. You may be screened using only a cholesterol test and not a full lipid profile. However, if the cholesterol test result is high, you may have follow-up testing with a lipid profile.

If you have other risk factors or have had a high cholesterol level in the past, you should be tested more regularly and you should have a full lipid profile.

For children and adolescents at low risk, lipid testing is usually not ordered routinely. However, screening with a lipid profile is recommended for children and youths who are at an increased risk of developing heart disease as adults. Some of the risk factors are similar to those in adults and include a family history of heart disease or health problems such as diabetes, high blood pressure (hypertension), or being overweight. High-risk children should have their first lipid profile between 2 and 10 years old, according to the American Academy of Pediatrics. Children younger than 2 years old are too young to be tested.

A lipid profile may also be ordered at regular intervals to evaluate the success of lipid-lowering lifestyle changes such as diet and exercise or to determine the effectiveness of drug therapy such as statins.

HbA1c Test

The A1c test and eAG calculation are used primarily to monitor the glucose control of diabetics over time. The goal of those with diabetes is to keep their blood glucose levels as close to normal as possible. This helps to minimize the complications caused by chronically elevated glucose levels, such as progressive damage to body organs like the kidneys, eyes, cardiovascular system, and nerves. The A1c test and eAG result give a picture of the average amount of glucose in the blood over the last few months. They can help you and your doctor know if the measures you are taking to control your diabetes are successful or need to be adjusted.

The A1c test is frequently used to help newly diagnosed diabetics determine how elevated their uncontrolled blood glucose levels have been. It may be ordered several times while control is being achieved, and then several times a year to verify that good control is being maintained.

When is the HbA1c test ordered? 
Depending on the type of diabetes that you have, how well your diabetes is controlled, and your doctor, your A1c may be measured 2 to 4 times each year. The American Diabetes Association recommends testing your A1c at least twice a year. When someone is first diagnosed with diabetes or if control is not good, A1c may be ordered more frequently.

What does the HbA1c test result mean? 
A1c is currently reported as a percentage, and it is recommended that diabetics aim to keep their A1c below 7%. The report for your A1c test also may include an estimated Average Glucose (eAG), which is a calculated result based on your A1c levels. The purpose of reporting eAG is to help you relate your A1c results to your everyday glucose monitoring levels. The formula for eAG converts percentage A1c to units of mg/dL or mmol/L so that you can compare it to your glucose levels from home monitoring systems or laboratory tests.

It should be noted that the eAG is still an evaluation of your glucose over the last couple of months. It will not match up exactly to any one daily glucose test result. The American Diabetes Association has adopted this calculation and provides a calculator and information on the eAG on their web site.

A nondiabetic person will have an A1c between 4% and 6%. The closer a diabetic can keep their A1c to 6% without experiencing excessive hypoglycemia, the better their diabetes is in control. As the A1c and eAG increase, so does the risk of complications.

Is there anything else I should know about the HbA1c test? 
The A1c test will not reflect temporary, acute blood glucose increases or decreases. The glucose swings of someone who has “brittle” diabetes will not be reflected in the A1c.

AIf you have a hemoglobin variant, such as sickle cell hemoglobin (hemoglobin S), you will have a decreased amount of hemoglobin A. This may limit the usefulness of the A1c test in monitoring your diabetes. If you have anemia, hemolysis, or heavy bleeding, your test results may be falsely low. If you are iron deficient, you may have an increased A1c measurement. If you have had a recent transfusion, then your A1c will be falsely increased (blood preservative solutions contain high glucose levels) and not accurately reflect your glucose control for 2 to 3 months.

Thyroid-stimulating hormone Test (TSH)

The TSH test is often the test of choice for evaluating thyroid function and/or symptoms of hyper- or hypothyroidism. It is frequently ordered along with or preceding a T4 test. Other thyroid tests that may be ordered include a T3 test and thyroid antibodies (if autoimmune-related thyroid disease is suspected).  

TSH testing is used to:


When is the thyroid stimulating hormone test ordered? 
The doctor may order a TSH test when a patient has symptoms of hyper- or hypothyroidism and/or when a patient has an enlarged thyroid gland. It may be ordered at regular intervals to monitor the effectiveness of treatment when a patient is being treated for a known thyroid disorder.

TSH screening is routinely performed in the United States on newborns as part of each state’s newborn screening program. The American Thyroid Association recommends that adults older than age 35 be screened for thyroid disease with a TSH test every five years, although other organizations, such as the U.S. Preventive Services Task Force, challenge this recommendation. Several organizations recommend instead screening women over 50 or those at high risk for thyroid disorders, such as pregnant and postpartum women.

What does the thyroid stimulating hormone test result mean? 
NOTE: This test has no single number that identifies an abnormal result. Your lab report (see a sample report) should include a range of numbers (reference range) that identifies what is expected for you based on your age, sex, and the method used in that laboratory. You can find more information about expected results at Reference Ranges and What They Mean. Lab Tests Online strongly recommends that you discuss the meaning of your test results with your doctor.

A high TSH result often means an underactive thyroid gland that is not responding adequately to the stimulation of TSH due to some type of acute or chronic thyroid dysfunction. Rarely, a high TSH result can indicate a problem with the pituitary gland, such as a tumor producing unregulated levels of TSH. A high TSH value can also occur when patients with a known thyroid disorder (or those who have had their thyroid gland removed) are receiving too little thyroid hormone medication.

A low TSH result can indicate an overactive thyroid gland (hyperthyroidism) or excessive amounts of thyroid hormone medication in those who are being treated for an underactive (or removed) thyroid gland. Rarely, a low TSH result may indicate damage to the pituitary gland that prevents it from producing adequate amounts of TSH.

Whether high or low, an abnormal TSH indicates an excess or deficiency in the amount of thyroid hormone available to the body, but it does not indicate the reason why. An abnormal TSH test result is usually followed by additional testing to investigate the cause of the increase or decrease.

The following table summarizes test results and their potential meaning:

TSH	T4	T3	Interpretation
High	Normal	Normal	Mild (subclinical) hypothyroidism
High	Low	Low or normal	Hypothyroidism
Low	Normal	Normal	Mild (subclinical) hyperthyroidism
Low	High or normal	High or normal	Hyperthyroidism
Low	Low or normal	Low or normal	Nonthyroidal illness; Rare pituitary (secondary) hypothyroidism

Is there anything else I should know about the TSH test? 
Many medications — including aspirin and thyroid-hormone replacement therapy — may affect thyroid gland function test results, so tell your doctor about any drugs you are taking.

When your doctor adjusts your dose of thyroid hormone, it is important to wait at least one to two months before checking your TSH again so that your new dose can have its full effect.

Extreme stress and acute illness may also affect TSH test results, and results may be low during the first trimester of pregnancy.

Testosterone Testing

Testosterone testing is used to diagnose several conditions in men, women, and boys. These conditions include:



When is a testosterone test ordered? 
In boys, the test is ordered, often along with the FSH and LH tests, if puberty is delayed or slow in developing. Although there are differences from individual to individual as to when puberty begins, generally by the age of 10 years, there are hormonal and physical manifestations of the onset of puberty. A delay can occur if the testes do not produce enough testosterone or if the pituitary does not produce enough LH.

The test also can be ordered if a young boy seems to be undergoing a very early (precocious) puberty with obvious secondary sex characteristics, such as an enlarged penis, development of muscle mass, and growth of body hair. Causes of precocious puberty in boys, due to increased testosterone, include various tumors and congenital adrenal hyperplasia.

In men, the test may be ordered when infertility is suspected or if the patient has a decreased sex drive or erectile dysfunction, all of which can result from low testosterone levels.

In women, testosterone testing may be done if a patient has irregular or no menstrual periods, is having difficulty getting pregnant, or appears to have masculine features, such as facial and body hair, male pattern baldness, and a low voice. Testosterone levels can rise because of tumors that develop in either the ovary or adrenal gland or because of other conditions, such as polycystic ovarian syndrome (PCOS).

What does the testosterone test result mean? 
NOTE: This test has no single number that identifies an abnormal result. Your lab report (see a sample report) should include a range of numbers (reference range) that identifies what is expected for you based on your age, sex, and the method used in that laboratory. You can find more information about expected results at Reference Ranges and What They Mean. Lab Tests Online strongly recommends that you discuss the meaning of your test results with your doctor.

There is great variability in testosterone levels between men and a broad range in age-related values for testosterone. It is normal for testosterone levels to decline as men age.

However, in males, a decreased testosterone level may indicate hypothalamic or pituitary disease or damage to the testes. Genetic diseases also can cause decreased testosterone production in young men (Klinefelter’s, Kallman’s, and Prader-Willi syndromes) or testicular failure and infertility (as in myotonic dystrophy, a form of muscular dystrophy). A decreased testosterone level also can indicate impaired testosterone production because of acquired damage to the testes, such as alcoholism, physical injury, or viral diseases like mumps.

Increased testosterone levels in males can indicate testicular tumors , adrenal tumors that are producing testosterone, or use of androgens (also called anabolic steroids). Increased testosterone in boys is usually the cause of early puberty.

In women, increased testosterone levels can indicate PCOS or an ovarian or adrenal gland tumor.

Is there anything else I should know about testosterone testing? 
Alcoholism and liver disease in males can decrease testosterone levels. Drugs, including androgens and steroids, can also decrease testosterone levels. Prostate cancer responds to androgens, so many men with advanced prostate cancer receive drugs that lower testosterone levels.

Women taking estrogen therapy may have increased testosterone levels. Anticonvulsants, barbiturates, and clomiphene can cause testosterone levels to rise.

Prostate-specific Antigen Test (PSA)

The total PSA test and digital rectal exam (DRE) are ordered to screen both asymptomatic and symptomatic men for prostate cancer. Since the DRE can cause a temporary elevation in PSA, the blood is usually collected prior to performing the DRE. If either the PSA or the DRE are found to be abnormal, then the doctor may choose to follow this testing with a prostate biopsy and perhaps imaging tests, such as an ultrasound. If the DRE is normal but the PSA is moderately elevated, the doctor may order a free PSA test to look at the ratio of free to total PSA. This can help to distinguish between prostate cancer and other non-cancer causes of elevated PSA. Since the total PSA test can be elevated temporarily for a variety of reasons, a doctor may order another PSA a few weeks after the first to determine if the PSA is still elevated.

The cPSA is a relatively new test that may be ordered, along with the DRE, as an alternative to the total PSA. There is hope that this test could be more specific than the total PSA (better at detecting cancer-related PSA), but findings have been mixed and its ultimate clinical utility has yet to be established. The cPSA is an option that doctors can discuss with their patients. Its use may expand and/or be better defined as additional studies are conducted and findings are reported.

If prostate cancer is diagnosed, then the total PSA may be used as a monitoring tool to help determine the effectiveness of treatment. It may also be ordered at regular intervals after treatment to detect recurrence of the cancer.

In cases where the cancer appears to be slow-growing and the doctor and patient decide to monitor its progress rather than pursue immediate treatment (called “watchful waiting”), total PSA levels are ordered at frequent intervals to monitor the change in PSA over time.

When is the PSA test ordered? 
There is no consensus among the experts currently about when the PSA test should be ordered to screen asymptomatic males. Over-diagnosing, identifying cases of prostate cancer that may never cause significant health problems, must be balanced against missing the detection of aggressive cancers. There are national organizations, such as the National Cancer Institute and Centers for Disease Control and Prevention, that do not recommend routine screening at this time. Others, such as the American Cancer Society (ACS), recommend that doctors offer total PSA tests and DRE annually to all men, beginning at age 50 and to those at an increased risk of prostate cancer, such as American men of African descent and men with a family history of the disease, beginning at age 40 or 45. The ACS recommends that doctors discuss the testing options, benefits, and potential side effects with their male patients so that they can make informed choices. (See Prostate Cancer Screening for Adults and Adults 50 and Up.) The total PSA test and DRE may also be ordered when a patient has symptoms that could be due to prostate cancer, such as difficult, painful, and/or frequent urination, back pain, and/or pelvic pain. Since these symptoms are seen with a variety of other conditions, including infection and prostatitis, the doctor will also frequently order other tests, such as a urine culture. Some of these conditions can themselves cause temporary increases in PSA levels. If a total PSA level is elevated, a doctor may order a repeat test a few weeks later to determine whether the PSA concentrations have returned to normal.

A free PSA is primarily ordered when a patient has a moderately elevated total PSA that does not appear to be caused by a non-cancer-related condition. The results give the doctor additional information about whether a patient is at an increased risk of having prostate cancer and help with the decision of whether to biopsy the prostate.

The total PSA may be ordered during treatment of patients who have been diagnosed with prostate cancer to verify the effectiveness of treatment and at regular intervals after treatment to monitor for cancer recurrence. It is also ordered at regular intervals when a patient with cancer is participating in “watchful waiting” and not currently treating their prostate cancer.

What does the PSA test result mean? 
The normal value for total PSA has been set at less than 4.0 ng/ml (nanograms per milliliter of blood). There are some that feel that this level should be lowered to 2.5 ng/ml in order to detect more cases of prostate cancer. Others argue that this would exacerbate over-diagnosing and over-treating cancers that are not clinically significant.

There is agreement that patients with a total PSA level greater than 10.0 ng/ml are at an increased risk for prostate cancer (more than a 67% chance, according to the ACS). Levels between 4.0 ng/ml and 10.0 ng/ml may indicate prostate cancer (about a 25% chance, according to the ACS), BPH, or prostatitis. These conditions are more common in the elderly, as is a general increase in PSA levels. Concentrations of total PSA between 4.0 ng/ml and 10.0 ng/ml are often referred to as the “gray zone.” It is in this range that the free PSA is the most useful. When patients in the gray zone have decreased levels of free PSA, they have a higher probability of prostate cancer; when they have elevated levels of free PSA, the risk is diminished. The ratio of free to total PSA can help the doctor decide whether or not a prostate biopsy should be performed.

When the cPSA test is used as a screening tool, increased levels may indicate an increased risk of prostate cancer, while lower levels indicate a decreased risk.

In addition to the introduction of the free PSA and cPSA tests, there have been efforts to increase the usefulness of the total PSA as a screening tool. While none of these efforts have been widely accepted yet, researchers are studying them and some doctors are utilizing them. They include:


During treatment for prostate cancer, the PSA level should begin to fall. At the end of treatment, it should be at very low or undetectable levels in the blood. If concentrations do not fall to very low levels, then the treatment has not been fully effective. Following treatment, the PSA test is performed at regular intervals to monitor the patient for recurrence. Since even tiny increases can be significant, patients may want to have their monitoring PSA tests done by the same laboratory each time so that testing variation is kept to a minimum.

Is there anything else I should know about the PSA test? 
Prostate manipulation by biopsy or resection of the prostate will significantly elevate PSA levels. The blood test should be done before surgery or six weeks after manipulation.

Rigorous physical activity affecting the prostate, such as bicycle riding, may cause a temporary rise in PSA levels. Excessive doses of some chemotherapeutic drugs, such as cyclophosphamide and methotrexate, may increase or decrease PSA levels.

In some men, PSA may rise temporarily due to other prostate conditions, especially infection. A recent study found that in about half of men with a high PSA, values later return to normal. Some authorities recommend that a high PSA should be repeated (between 6 weeks and 3 months after the high PSA) before taking any further action. Some physicians will prescribe a course of antibiotics if there is evidence that there is infection of the prostate.

Iron and Total Iron-binding Capacity Test (TIBC)

TIBC is typically measured along with serum iron to evaluate people suspected of having either iron deficiency or iron overload. The iron concentration divided by TIBC gives the transferrin saturation, which is a more useful indicator of iron status than iron or TIBC alone. In healthy people, about 20-50% of available sites in transferrin are used to transport iron. In iron deficiency, iron is low, but TIBC is increased, and transferrin saturation becomes very low. In iron overload states such as hemochromatosis, iron will be high and TIBC will be low or normal, causing the transferrin saturation to increase.

It is customary to test for transferrin (instead of TIBC) when evaluating a patient's nutritional status or liver function. Because it is made in the liver, transferrin will be low with liver disease. Transferrin levels also drop when there is not enough protein in the diet, so this test can be used to monitor nutrition.

When is the TIBC test ordered? 
TIBC may be ordered along with serum iron when it appears that you have too much or too little iron in your system. If you have anemia, especially if the red cells are microcytic and hypochromic, iron tests are usually performed. If your doctor suspects that you may have too much iron, or if you have a family history of hemochromatosis, iron and TIBC may be used to see if further testing is needed.

What does the TIBC test result mean? 
NOTE: This test has no single number that identifies an abnormal result. Your lab report (see a sample report) should include a range of numbers (reference range) that identifies what is expected for you based on your age, sex, and the method used in that laboratory. You can find more information about expected results at Reference Ranges and What They Mean. Lab Tests Online strongly recommends that you discuss the meaning of your test results with your doctor.

A high TIBC or transferrin usually indicates iron deficiency, but it is also increased in pregnancy and with use of oral contraceptives. A low TIBC or transferrin may occur if you have hemochromatosis, certain types of anemia in which iron accumulates, malnutrition, inflammation, liver disease, or nephrotic syndrome (a kidney disease that causes loss of protein in urine).

C-Reactive Protein (hsCRP) – Cardiac test

There are two different tests for CRP. The standard test measures a much wider range of CRP levels but is less sensitive in the lower ranges. The hs-CRP test can more accurately detect lower concentrations of the protein (it is more sensitive), which makes it more useful than the CRP test in predicting a healthy person's risk for cardiovascular disease.

hs-CRP is promoted by some as a test for determining the potential risk level for cardiovascular disease, heart attacks, and strokes. The current thinking is that hs-CRP can play a role in the evaluation process before one encounters one of these health problems. More clinical trials that involve measuring hs-CRP levels are currently underway in an effort to better understand its role in cardiovascular events and may eventually lead to guidelines on its use in screening and treatment decisions.

When is the C-reactive protein test ordered? 
hs-CRP usually is ordered as one of several tests in a cardiovascular risk profile, often along with tests for cholesterol and triglycerides. Some experts say that the best way to predict risk is to combine a good marker for inflammation, like hs-CRP, along with the lipid profile.

What does the C-reactive protein test result mean? 
NOTE: This test has no single number that identifies an abnormal result. Your lab report (see a sample report) should include a range of numbers (reference range) that identifies what is expected for you based on your age, sex, and the method used in that laboratory. You can find more information about expected results at Reference Ranges and What They Mean. Lab Tests Online strongly recommends that you discuss the meaning of your test results with your doctor.

People with higher hs-CRP values have the highest risk of cardiovascular disease, and those with lower values have less of a risk. Specifically, individuals who have hs-CRP results in the high end of the normal range have 1.5 to 4 times the risk of having a heart attack as those with hs-CRP values at the low end of the normal range.

The American Heart Association and US Centers for Disease Control and Prevention have defined risk groups as follows:


These values are only a part of the total evaluation process for cardiovascular diseases. Additional risk factors to be considered are elevated levels of cholesterol, LDL-C, triglycerides, and glucose. In addition, smoking, having high blood pressure (hypertension), and being diabetic also increase the risk level.

Is there anything else I should know about the C-reactive protein test? 
Taking nonsteroidal anti-inflammatory drugs ((NSAIDs like aspirin, ibuprofen, and naproxen) or statins may reduce CRP levels in blood. Both anti-inflammatory drugs and statins may help to reduce the inflammation, thus reducing CRP.

Because the hs-CRP test can serve as a marker for inflammation, it is important that any person having this test be in a healthy state in order for the results to be of any value in predicting the risk of coronary disease or heart attack. Any recent illness, tissue injury, infection, or other general inflammation will raise the amount of CRP and give a falsely elevated estimate of risk.

Women on hormone replacement therapy have been shown to have elevated hs-CRP levels, suggesting that this test may be useful in predicting future cardiovascular events.

Since the hs-CRP and CRP tests measure the same molecule, people with chronic inflammation, such as those with arthritis, should not have hs-CRP levels measured. Their CRP levels will be very high due to the arthritis—often too high to be measured or meaningful using the hs-CRP test.

Complete Blood Count Test (CBC) With Differential

The CBC is used as a broad screening test to check for such disorders as anemia, infection, and many other diseases. It is actually a panel of tests that examines different parts of the blood and includes the following



When is a complete blood count ordered? 
The CBC is a very common test. Many patients will have baseline CBC tests to help determine their general health status. If they are healthy and they have cell populations that are within normal limits, then they may not require another CBC until their health status changes or until their doctor feels that it is necessary.

If a patient is having symptoms such as fatigue or weakness or has an infection, inflammation, bruising, or bleeding, then the doctor may order a CBC to help diagnose the cause. Significant increases in WBCs may help confirm that an infection is present and suggest the need for further testing to identify its cause. Decreases in the number of RBCs (anemia) can be further evaluated by changes in size or shape of the RBCs to help determine if the cause might be decreased production, increased loss, or increased destruction of RBCs. A platelet count that is low or extremely high may confirm the cause of excessive bleeding or clotting and can also be associated with diseases of the bone marrow such as leukemia.

Many conditions will result in increases or decreases in the cell populations. Some of these conditions may require treatment, while others will resolve on their own. Some diseases, such as cancer (and chemotherapy treatment), can affect bone marrow production of cells, increasing the production of one cell at the expense of others or decreasing overall cell production. Some medications can decrease WBC counts while some vitamin and mineral deficiencies can cause anemia. The CBC test may be ordered by the doctor on a regular basis to monitor these conditions and drug treatments.

What does the complete blood count test result mean? 
NOTE: This test has no single number that identifies an abnormal result. Your lab report (see a sample report) should include a range of numbers (reference range) that identifies what is expected for you based on your age, sex, and the method used in that laboratory. You can find more information about expected results at Reference Ranges and What They Mean. Lab Tests Online strongly recommends that you discuss the meaning of your test results with your doctor.

The following table explains what increases or decreases in each of the components of the CBC may mean. To download an expanded, printable version of this table, click here.

Test	Name	Increased/Decreased
WBC	White Blood Cell	May be increased with infections, inflammation, cancer, leukemia; decreased with some medications (such as methotrexate), some autoimmune conditions, some severe infections, bone marrow failure, and congenital marrow aplasia (marrow doesn't develop normally)
% Neutrophil	Neutrophil/Band/Seg/Gran	This is a dynamic population that varies somewhat from day to day depending on what is going on in the body. Significant increases in particular types are associated with different temporary/acute and/or chronic conditions. An example of this is the increased number of lymphocytes seen with lymphocytic leukemia. For more information, see Blood Smear and WBC.
% Lymphs	Lymphocyte
% Mono	Monocyte
% Eos	Eosinophil
% Baso	Basophil
Neutrophil	Neutrophil/Band/Seg/Gran
Lymphs	Lymphocyte
Mono	Monocyte
Eos	Eosinophil
Baso	Basophil
RBC	Red Blood Cell	Decreased with anemia; increased when too many made and with fluid loss due to diarrhea, dehydration, burns
Hgb	Hemoglobin	Mirrors RBC results
Hct	Hematocrit	Mirrors RBC results
MCV	Mean Corpuscular Volume	Increased with B12 and Folate deficiency; decreased with iron deficiency and thalassemia
MCH	Mean Corpuscular Hemoglobin	Mirrors MCV results
MCHC	Mean Corpuscular Hemoglobin Concentration	May be decreased when MCV is decreased; increases limited to amount of Hgb that will fit inside a RBC
RDW	RBC Distribution Width	Increased RDW indicates mixed population of RBCs; immature RBCs tend to be larger
Platelet	Platelet	Decreased or increased with conditions that affect platelet production; decreased when greater numbers used, as with bleeding; decreased with some inherited disorders (such as Wiskott-Aldrich, Bernard-Soulier), with Systemic lupus erythematosus, pernicious anemia, hypersplenism (spleen takes too many out of circulation), leukemia, and chemotherapy
MPV	Mean Platelet Volume	Vary with platelet production; younger platelets are larger than older ones

Is there anything else I should know? 
While no specific pre-testing restrictions are necessary, it is best to avoid a fatty meal prior to having your blood drawn.

Normal CBC values for babies and children may be different from adults and need to be considered when interpreting data.