For a true partnership to exist between doctor and patient, there has to be a free flow of information in both directions. Here is where we often hit a snag. While there is practically no barrier to keep your doctor from understanding you as a patient, you might be at a disadvantage in trying to understand your doctor. Sooner or later, the doctor’s explanations will involve medical language and concepts with which few patients are familiar.
This is especially true in the highly specialized field of medical testing. You may have heard of cholesterol, glucose, or Triglycerides tests, but are likely unfamiliar with bilirubin, alkaline phosphatase, or hematocrit tests. These lesser known tests could be far more important to finding out specifically what is going on for you than any of the more common tests. This is why it matters to be informed.
There are more than fifty common laboratory tests, all which could play a decisive role in diagnosis and treatment. Over five hundred other tests are done far less frequently, but nevertheless could prove important in individual cases.
Most doctors do not have the time to explain very much about your tests. An explanation could well take longer than the entire examination. With a waiting room full of patients, doctors often are in no position to attempt to teach a quick course in biology. A broad generalization is usually the best you can expect. For example: “Your urine and blood chemistry are fine. Only your red blood cells are slightly on the low-side, but you should not worry about it.” Or: “your creatinine—that is, your kidney-function test—was a bit high. I would like to run it again.”
Why in the world should you not worry if your red blood cells were low? Why does the doctor want to run the creatinine test again, without more information, you can be confused and frustrated.
There are also doctors who believe that your test results are not your concern. A little knowledge, they warn, could be a dangerous thing; you might draw the wrong conclusion and worry needlessly. After all, it has taken them years of training and experience to interpret test results properly. So, they tell you nothing.
And they have a valid point. Unless you do get a complete explanation, you might be better off not knowing anything at all. Even if they did have the time, most doctors probably could not give you such a thorough explanation. They are usually familiar with these tests in term of highly technical language, and would find it difficult to translate them into everyday words and concepts.
Of all the hundreds of different laboratory test your doctor can choose form, the most common are the basic screens. These consists of urinalysis, with a half dozen different tests; a blood chemistry profile, which includes up to twenty-one different tests; and a complete blood count, which usually adds up to another dozen tests. Two important points to keep in mind:
First, urine and blood tests are not merely checks to see whether your urine and blood are all right. They are much more than that. Your blood and your urine accumulate form throughout your body. In one way or another, they have come in contact with virtually every cell of your body, and thus carry within them many of the countless by-products of the various organs. By examining your blood and urine for different factors, your doctor is, in effect, taking a look at some of the most inaccessible organs of your body.
Second, your doctor will rarely, if ever, order just these screening tests without giving you a thorough physical before making a diagnosis. During the physical, the doctor has more tangible ways of checking your organs and the state of your health in general. These are all probably familiar to you. They range from looking into your eyes, ears, and throat to listening to your heart, feeling for your liver—and always, asking a lot of questions.
Thus you are really getting two physicals: the blood and urine screening tests and the doctor’s actual examination. What usually happens is that the one confirms or amplifies the findings of the other.
For example, if we give you an examination and find you in top-notch health, the chances are that your tests will come back essentially normal, confirming those findings. If, on the hand, if you go to the Dr. with a yellowish tinge to your skin and eyeballs, complaining of nausea and pain in the abdominal area, the blood and urine tests would most likely confirm the diagnosis of jaundice due to liver disorder.
From the doctor’s point of view, lab tests have another purpose; they provide a measurable record of your state of health, at this particular time. This information also protects Drs. from unwarranted malpractice suits. Tests make it more likely that if you get a second opinion in a similar time frame, the results will generally be the same.
But protecting the doctor by confirming a diagnosis is by no means the main reason for such a large assortment of tests: the best doctors are more intent on helping patients than constantly worrying about the legal ramifications of illness. The main reason for testing is to uncover illnesses, which would otherwise go undetected, possibly until it was too late. Numerous diseases, such as leukemia or diabetes, can make themselves known through subtle changes in the blood or urine months, or even years before they could be detected through a routine physical examination.
Some illnesses could be a life threatening or could be merely something to watch. Early diagnosis through medical tests may enable the doctor to head off the disease altogether, or to start treatment at an early stage when there is a much better chance of recovery.
Getting informed about medical testing offers you an advantage. You may learn how to avoid some of the hazards of our technological environment, which can drastically alter test results, and, in fact in many cases cause severe illness. You could learn how to give your doctor highly pertinent information which might otherwise have been thought unimportant, even under direct prodding. Such information could provide your doctor with the missing link that helps makes a proper diagnosis.
There is still another reason for knowing as much about medical testing as you possibly can. It will give you a unique view of how your body works; what principles it seems to obey; how intricate are its countless processes; how delicate the balance between functioning and malfunctioning. You may realize how precious your health is and begin to care of yourself properly and with the devotion you deserve.
The following test results are explained in lay terminology, to make it easier to understand the reasons for many of the life style changes we at Natural Cures are recommending.
Blood has four major components: red and white blood cells, platelets and serum.
Complete Blood Count (CBC) indicates the total number of read and white blood cells. It will identify and name several different type white blood cells, analyze their functions, and percentage levels. The “normal or average range” listed on your test report represents an average of all people tested, including the HEALTHY and UNHEALTHY. To simply imply or indicate an average range to be “normal” is misleading and inaccurate.
Chemistry Blood Profile
Enzymes levels in the blood stream
The next for tests, LDH, SGOT, SGPT, and Alkaline Phosphatase are measures of enzyme levels in your blood serum. A rise in enzyme levels reflect tissue damage.
Other Tests
This is an important blood test to be aware of and consider doing in addition to undergoing standard blood testing procedures. Live blood analysis is an excellent source of information and is excellent for confirming existing results, finding previously unsighted issues and is great for children.
Darkfield Microscopy of Live Blood Analysis is a way of studying live whole blood cells under a specially adapted microscope that projects the dynamic image onto a video screen. This allows you to view your inner terrain. Digestive, eliminative and immune functions can be assessed as well as the presence of bacteria and other micro-organisms.
The darkfield microscopic examination of the freshly taken live blood is one of the most important examinations of the holistic medicine. It enables one to view the inner terrain (milieu) and to examine the functions of the red blood cells. It also shows the evolutionary stages of the smallest proteins (endobionts), which are found in every human body. One will be able to see any developed structures such as bacterial, virus and fungus. The darkfield examination shows the state of the blood cells, endobionts and the plasma in a functional and structural way, making bacterial processes and fungal pre-stages in the blood clearly visible.
The darkfield examination is most suitable for the evaluation of patients with chronic diseases; for those who are prone to infections; for recurrent bacterial problems; for Candida and other fungal problems and also to answer questions concerning chronic problems of metal toxicity (e.g. amalgam disturbances).
The examination is very motivating for the patient because the results can be discussed and demonstrated live on the screen. It cannot be replaced by any other blood examination, neither by normal microscope examination, nor by blood tests sent to laboratories. The blood rapidly changes its function with changes of the inner terrain after taking a sample.
How is the examination carried out?
Using a small fine needle, a drop of blood is taken from the finger and directly placed on a glass slide. Without fixation or coloring, the blood is examined right after taking it through a special darkfield microscope with up to 1000x enlargement. The patient can follow the process via video transmission on a large screen. The standard examination lasts approximately 15 minutes. A skilled practitioner will watch the blood over a longer period of time to see how it evolves. The blood will then be examined again several hours after taking the sample. This procedure informs us about the speed of degeneration of the cells, it reveals cell resilience, immune system activity and degenerative tendency.
We recommend repeating this examination every 3 months during the isopathic and immune biological therapy. For general health maintenance once a year is ideal.
With this method it was proven that co-relations exist between blood parasites, symbionts, bacteria and fungi. The main proven fact is that chronic diseases are created by increasing sickness tendencies of the endobionts and that bacteria, viruses and fungi developed in the human body, or are changed to pathogenic agents of diseases depending upon the inner terrain (determined by acid-base balance, protein content and level of trace elements). The existence of pre-stages, which are not yet able to make one ill but that can endanger an illness, can also be found in the darkfield examination. Therefore, it is also an important preventative examination.
Ferritin is an iron binding protein as opposed to the inorganic iron, which is usually used in iron supplements. It is rapidly absorbed and free of the gastrointestinal side effects, namely constipation frequently found with other iron products. Ferritin does not promote oxidation to the extent of the inorganic irons, nor does it deplete antioxidant defenses.
Iron is a structural component of hemoglobin, which carries oxygen to every cell in your body. About 70% of your total body iron is present as hemoglobin, 3% is present in your muscles as myoglobin, and the rest is found in ferritin, which, together with hemosiderin, forms the major storage sources of iron.
Women lose iron with menstruation and require a greater intake than men. Many pre-menopausal women have low ferritin (iron storage) levels. Infants, adolescents, pregnant women, the elderly, vegetarians, and those with low stomach acid are frequently iron deficient.
Iron deficiency is the most prevalent nutritional deficiency worldwide. Those at highest risk for iron deficiency are vegans, vegetarians, teenagers, children, junk food eaters, pre or peri-menopausal women, the elderly, those with recurrent infections, those chronically using aspirin or non-steroidal anti-inflammatory pain medicines, and those with chronic gastrointestinal disorders.
Chronically low iron causes numerous adverse changes in your immune system, resulting in recurrent colds, flues, and other infections. Many children with repeated infections are suffering form low iron levels.
Iron carries and releases oxygen from your red blood cells and is the main determinant of the oxygen supply to your cells.
Iron participates in the energy production systems in your body by several mechanisms and low iron leads to chronic fatigue and lethargy.
Iron status significantly relates to cognitive performance and mood by impacting your brain neurotransmitter function. Decreased iron levels lead to poor concentration, impaired attention span, poor learning, and low moods.
The best blood test for determining iron status is serum ferritin, which measures the level of stored iron available in your body.
Symptoms of Deficiency:
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Urinalysis can reveal diseases that have gone unnoticed because they do not produce striking signs or symptoms. Examples include diabetes mellitus, various forms of glomerulonephritis, and chronic urinary tract infections.
The most cost-effective device used to screen urine is a paper or plastic dipstick. This microchemistry system has been available for many years and allows qualitative and semi-quantitative analysis within one minute by simple but careful observation. The color change occurring on each segment of the strip is compared to a color chart to obtain results. However, a careless doctor, nurse, or assistant is entirely capable or misreading or misinterpreting the result. Microscopic urinalysis requires only a relatively inexpensive light microscope.
The first part of a urinalysis is direct visual observation. Normal, fresh urine is pale to dark yellow or amber in color and clear. Normal urine volume is 750 to 2000 ml/24hr.
Turbidity or cloudiness may be caused by excessive cellular material or protein in the urine or may develop from crystallization or precipitation of salts upon standing at room temperature or in the refrigerator. Clearing of the specimen after addition of a small amount of acid indicates that precipitation of salts is the probable cause of turbidity.
A red or red-brown (abnormal) color could be from a food dye, eating fresh beets, a drug or the presence of either hemoglobin or myoglobin. If the sample contained many red blood cells, it would be cloudy as well as red.
Urine dipstick chemical
If sp gr is not > 1.022 after a 12 hour period without food or water, renal concentrating ability is impaired and the patient either has generalized renal impairment or nephrogenicxc diabetes insipidus. In end-stage renal disease, sp gr ends to become 1.007 to 1.010.
Any urine having a specific gravity over 1.035 is either contaminated, contains very high levels of glucose, or the patient may have recently received high-density radiopaque dyes intravenously for radiographic studies or low molecular weight dextran solutions. Subtract 0.004 for every 1% glucose to determine non-glucose solute concentration.
In rough terms, trace positive results (which represent a slightly hazy appearance in urine) are equivalent to 10mg/100 ml or about 150 mg/24 hours (the upper limit of normal). 1+ corresponds to about 200-500 mg/24 hours, a 2+ to 0.5-1.5 gm/24 hours, a 3+ to 2-5 gm/24 hours, and a 4+ represents 7 gm/24 hours or greater.
Methodology
A sample of well-mixed urine (usually 10-15 ml) is centrifuged in a test tube at relatively low speed (about 2-3,000 rpm) for 5-10 minutes until a moderately cohesive button is produced at the bottom of the tube. The supernate is decanted and a volume of 0.2 to 0.5 ml is left inside the tube. The sediment is resuspended in the remaining supernate by flicking the bottom of the tube several times. A drop of resuspended sediment is poured onto a glass slide and coverslipped.
Examination
The sediment is first examined under low power to identify most crystals, casts, squamous cells, and other large objects. The numbers of casts seen are usually reported as number of each type found per low power field (LPF). Example: 5-10 hyaline casts/L casts/LPF. Since the number of elements found in each field may vary considerably from one field to another, several fields are averaged. Next, examination is carried out at high power to identify crystals, cells, and bacteria. The various types of cells are usually described s the number of each type found per average high power field (HPF). Example: 1-5 WBC/HPF.
Red Blood Cells
Hematuria is the presence of abnormal numbers of red cells in urine due to: glomerular damage, tumors which erode the urinary tract anywhere along its length, kidney trauma, urinary tract stones, renal infarcts, acute tubular necrosis, upper and lower urinary tract infections, nephrotoxins, and physical stress. Red cells may also contaminate the urine from the vagina in menstruating women or from trauma produced by bladder catherization. Theoretically, no red cells should be found, but some find their way into the urine even in very healthy individuals. However, if one or more red cells can be found in every high power field, and if contamination can be ruled out, the specimen is probably abnormal.
Red Blood Cells (RBCs) may appear normally shaped, swollen by dilute urine (in fact, only cell ghosts and free hemoglobin may remain), or created by concentrated urine. Both swollen, partly hemolyzed RBCs and crenated RBCs are sometimes difficult to distinguish from WBCs in the urine. In addition, red cell ghosts may simulate yeast. The presence of dysmorphic RBCs in urine suggests a glomerular disease such as glomerulonephritis. Dysmorphic RBCs have odd shapes as a consequence of being distorted via passage through the abnormal glomerular structure.
White Blood Cells
Pyuria refers to the presence of abnormal numbers of leukocytes that may appear with infection in either the upper or lower urinary tract or with acute glomerulonephritis. Usually, the WBCs are granulocytes. White cells from the vagina, especially in the presence of vaginal and cervical infections, or the external urethral meatus in men and women may contaminate the urine.
WBCs
If two or more leukocytes per each high power field appear in non-contaminated urine, the specimen is probably abnormal. Leukocytes have lobed nuclei and granular cytoplasm.
Epithelial Cells
Renal tubular epithelial cells, usually larger than granulocytes, contain a large round or oval nucleus and normally slough into the urine in small numbers. However, with nephritic syndrome and in conditions leading to tubular degeneration, the number sloughed is increased.
When lipiduria occurs, these cells contain endogenous fats. When filled with numerous fat droplets, such cells are called oval fat bodies. Oval fat bodies exhibit a “Maltese cross” configuration by polarized light microscopy.
Transitional epithelial cells from the renal pelvis, ureter, or bladder have more regular cell borders, larger nuclei, and smaller overall size than squamous epithelium. Renal tubular epithelial cells are smaller and rounder than transitional epithelium, and their nucleus occupies more of the total cell volume.
Squamous epithelial cells from the skin surface or from the outer urethra can appear in urine.
The significance is that they represent possible contamination of the specimen with skin flora.
Urine Casts
Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron). The proximal convoluted tubule (PCT) and loop of Henle are not locations for cast formation. Hyaline casts are composed primarily of a mucoprotein (Tamm-Horsfall protein) secreted by tubule cells. The Tamm-Horsfall protein secretion (green dots) is illustrated in the diagram below, forming a hyaline cast in the collecting duct.
Even with glomerular injury causing increased glomerular permeability to plasma proteins with resulting proteinuria, most matrix or “glue” that cements urinary casts together is Tamm-Horsfall mucoprotein, although albumin and some globulins are also incorporated.
The factors which favor protein cast formation are low flow rate, high salt concentration, and low pH, all of which favor protein denaturation and precipitation, particularly that of the Tamm-Horsfall protein. Protein casts with long, thin tails formed at the junction of Henle’s loop and the distal convoluted tubule are called cylindroids. Hyaline casts can be seen even in healthy patients.
Red blood cells may stick together and form red blood cell casts. Such casts are indicative of glomerulonephritis, with leakage of RBCs from glomeruli, or severe tubular damage.
White blood cell casts are most typical for acute pyelonephritis, but they may also be present with glomerulonephritis. Their presence indicated inflammation of the kidney, because such casts will not form except in the kidney.
When cellular casts remain in the nephron for some time before they are flushed into the bladder urine, the cells may degenerate to become a coarsely granular casts, later a finely granular cast, and ultimately, a waxy cast. Granular and waxy casts are believed to derive from renal tubular cell casts. Broad casts are believed to emanate from damaged and dilated tubules and are therefore seen in end-stage chronic renal disease.
The so-called telescoped urinary sediment is one in which red cells, white cells, oval fat bodies and all types of casts are found in more or less equal profusion. The conditions which may lead to a telescoped sediment are: 1) lupus nephritis 2) malignant hypertension 3) diabetic glomerulosclerosis, and 4) rapidly progressive glomerulonephritis.
In end-stage kidney disease of any cause, the urinary sediment often become very scant because few remaining nephrons produce dilute urine.
Bacteria
Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room temperature. Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms.
Diagnosis of bacteriuria in case of suspected urinary tract infection requires culture. A colony count may also be done to see if significant numbers of bacteria are present. Generally, more than 100,000/ml of one organism reflects significant bacteriuria. Multiple organisms reflect contamination. However, the presence of any organism in catheterized or suprapubic tap specimens should be considered significant.
Yeast
Yeast cells may be contaminants or represent a true yeast infection. They are often difficult to distinguish from red cells and amorphous crystals but are distinguished by their tendency to bud. Most often they are Candida, which may colonize bladder, urethra, or vagina.
Crystals
Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates.
Very uncommon crystals include: cystine crystals in urine of neonates with congenital cystinuria or severe liver disease, tyrosine crystals with congenital tyrosinosis or marked liver impairment, or leucine crystals in patients with severe liver disease or with maple syrup urine disease.
Miscellaneous
General “crud” or unidentifiable objects may find their way into a specimen, particularly those that patients bring from home.
Spermatozoa can sometimes be seen. Rarely, pinworm ova may contaminate the urine. In Egypt, ova from bladder infestations with schistosomiasis may be seen.
Summary of Urine Testing
To summarize, a property collected clean-catch, midstream urine after cleansing of the urethral meatus is adequate for complete urinalysis. In fact, these specimens generally suffice even for urine culture. A period of dehydration generally precedes urine collection if testing of renal concentration is desired, but any specific gravity of 1.022 measured in a randomly collected specimen denotes adequate renal concentration, so long as there are no abnormal solutes in the urine.
Another important factor is the interval of time, which elapses form collection to examination in the laboratory. Changes in urine occur quickly after collection and include:
Urinalysis may not reflect the most accurate information if the urine sample is more than one hour old.
Therefore, make all attempts to get urine samples to the laboratory as quickly as possible.
We encourage and support you too be as informed as you can be. If after reading this article you still have questions regarding test procedures or test results be sure to ask your Dr. or primary care physician for more information. If you approach testing with a basic understanding, you put yourself into a better position to converse and know the questions to ask. This empowers you and everyone involved.
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