In this essay, I'll discuss a true pillar of contemporary medicine: laboratory tests that necessitate the collection of blood samples.
The term "checking labs," "performing bloodwork," or even "checking blood" is occasionally used to describe this process.
This is something that most elderly individuals have experienced. For example, it is virtually difficult to be admitted to a hospital without first having bloodwork drawn, and it is a standard element of most emergency department care. It is also common for such testing to be performed as part of a yearly checkup, commonly known as a "full physical."
The final point to mention is that blood testing is frequently — though not always — highly useful when it comes to diagnosing and treating many of the common problems that plague older persons.
Do you feel exhausted and depleted of energy? There are a number of things we should look for, including anemia and thyroid disorders.
Are you disoriented and delirious? Bloodwork can be used to check on the electrolytes of an elderly individual (they can be thrown off by a medication side-effect, as well as by other causes). Furthermore, blood tests can provide us with valuable information about infection, renal function, and a variety of other conditions.
Blood testing, like a lot of other aspects of medical treatment, is definitely overdone. However, it is frequently an acceptable and vital aspect of evaluating the health-care needs of an elderly person. As a result, I often prescribe or suggest blood tests for older patients in my practice as a geriatrician.
Historically, test findings were evaluated by doctors and only a limited amount of information was shared with patients and their families. In today's world, however, it is becoming more normal for patients to ask questions regarding their test findings and to become more aware about this part of their health in general.
To the contrary, one of my most important advice to older individuals and their family caregivers is to always ask for a copy of your laboratory test results. (Be sure to document it in your personal health record, too!)
It will be much easier to retrieve this information if you ever have questions about your health or need to consult another doctor in the future.
In this post, I'll list and quickly describe the blood tests that are most typically used in the main medical treatment of older persons, as well as the reasons for their usage.
To be more specific, I'll go over four "panels" of blood tests that are often requested, and then I'll go over six additional blood tests that I think are very beneficial.
To put it another way, we're going to go through my top 10 blood tests for the healthcare of aging folks today.
I'll wrap off with some practical suggestions for you to bear in mind when it comes to blood testing and other medical procedures.
There are four main "panels" used in laboratory blood testing.
1. Obtain a complete blood count (CBC)
What it measures: A complete blood count (CBC) is a combination of tests that look at the cells in your blood. It is commonly associated with the following outcomes:
It is the quantity of white blood cells per microliter of blood that is measured as the white blood cell count (WBCs).
The amount of red blood cells in a microliter of blood is referred to as the red blood cell count (RBCs).
How many grams of this oxygen-carrying protein are present in a deciliter of blood is known as hemoglobin (Hgb).
the proportion of blood that is made up of red blood cells (hematocrit, or Hct).
The mean corpuscular volume (MCV) of red blood cells is defined as the average size of red blood cells.
a measure of how many platelets (a smaller cell involved in clotting blood) are present per microliter of blood (platelet count, Plts).
It is also possible to request the CBC "with differential." This indicates that white blood cells are divided into subtypes according to their function. More information about the CBC test may be found at Medline: CBC blood test (in English). Check out Medline's Blood differential test for more information on how the white blood cell count differential test works and what it could reveal about a person's health.
What the CBC is frequently used for is as follows:
A person's red blood cell count, hemoglobin level, and hematocrit are all below normal levels, which indicates anemia.
I go into much detail on anemia here: A Look at 10 Common Causes of Anemia in the Older Adult, as well as Questions to Ask.
When a person is fighting an illness, his or her white blood cell count will often increase. Some drugs, such as corticosteroids, can also induce an increase in the number of white blood cells in the bloodstream.
If the number of different types of blood cells (such as red blood cells, white blood cells, and platelets) is low, this may indicate that there is a problem with the bone marrow itself.
It is possible for an older person's platelet count to be lower than normal on occasion (or even higher than normal). This generally necessitates more investigation.
2. The metabolic panel in its most basic level (basic electrolyte panel)
Even while it is feasible to obtain a single electrolyte measurement, it is much more frequent for electrolytes to be done as part of a panel of seven or eight assays. This is sometimes referred to as a "chem-7," and it typically consists of the following components:
Sodium Potassium Chloride is a chemical compound that contains sodium, potassium, and chlorine.
Carbon dioxide (CO2) (sometimes known as "bicarbonate" since it is the chemical form of carbon dioxide that is more frequent in the bloodstream) is a gas that exists in the atmosphere and the bloodstream.
Urea nitrogen in the blood (BUN)
Creatinine (which is frequently accompanied with an estimated "glomerular filtration rate," or "eGFR" result) is a marker of kidney function.
Glucose
What the basic metabolic panel is commonly used for is as follows:
Electrolytes such as sodium and potassium can become excessively high or excessively low as a result of medication adverse effects.
When patients take specific types of drugs, such as certain blood pressure meds or diuretics, their electrolytes are frequently evaluated.
The amount of carbon dioxide in the blood reflects the acidity of the blood.
The function of the kidneys and the function of the lungs can both have an impact on this. A severe illness can also cause changes in the acidity of the blood.
The most often utilized parameters to assess renal function are creatinine and BUN values. Both of these values can rise if kidney function is momentarily compromised (for example, as a result of dehydration or a drug side effect) or persistently impaired (for example, as a result of renal disease).
It is usual for elderly persons to experience at least a slight decline in kidney function at some point.
When a person's kidney function is impaired, several drugs must be administered at a different dosage.
Using the patient's age and creatinine level, laboratories can now compute what is known as a "estimated glomerular filtration rate," which indicates the filtering capability of the kidneys and is used to diagnose renal disease. This is regarded to be a more accurate indicator of renal function than solely depending on creatinine and BUN levels to determine kidney function.
The amount of sugar in the blood is represented by the glucose levels.
The presence of undetected diabetes or poorly treated diabetes might explain why they are greater than usual.
Hypoglycemia is a condition in which blood glucose levels are abnormally low (below normal). It is frequently induced by diabetic medicines, and it may signal that the dosage of these medications should be reduced.
More information about these tests may be found at Medline: Basic Metabolic Panel. From this page, you may access links to further sites that describe each of the electrolytes and metabolic components listed above in greater detail, as well as the most prevalent reasons for results that are unusually high or low in each case.
3. A metabolic panel with a wide range of tests
What it measures: This panel covers all of the components listed above in the standard metabolic panel, as well as an extra seven items that are often included. As a result, it's commonly referred to as a "chem-14" panel, which stands for chemical 14. The comprehensive panel includes the following tests in addition to the seven tests contained in the basic panel (see above):
Calcium
Protein in its totality
Albumin
Bilirubin is a kind of blood bilirubin (total)
Alkaline phosphatase is an enzyme that helps to break down alkaline phosphatase.
AST is an abbreviation for the acronym for the acronym for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the abbreviation for the ab (aspartate aminotransferase)
ALTERNATE (alanine aminotransferase)
The following are some of the applications of the complete metabolic panel:
Calcium levels are often controlled by the kidneys as well as by specific hormones in the body.
Blood calcium levels are not always a reliable indicator of calcium intake or the overall amount of calcium stored in the bones and other tissues of the body.
High or low calcium levels in the blood can induce a variety of symptoms, including cognitive problems, and are often indicative of an underlying medical condition. They can also be brought on by some types of medicine, among other things.
Albumin is a protein that is found in high concentrations in the circulation. The liver is responsible for its production.
Low albumin levels may suggest an issue with the liver or a problem with the body's ability to keep albumin circulating in the blood.
Low albumin levels can be caused by malnutrition.
AST and ALT are enzymes that are found in the liver cells of animals.
Increased levels of these enzymes are frequently indicative of a disease with the liver. There are a lot of health issues that might cause this to occur, including drugs.
bilirubin is a colorless substance generated by the liver that normally drains down the bile ducts and into the small intestine. In addition to this, some bilirubin is associated with the breakdown of red blood cells.
The presence of gallstones or another condition obstructing the bile ducts might result in a rise in bilirubin.
Alkaline phosphatase can be found throughout the body, but it is particularly abundant in the bile ducts and in bone.
Typically, elevated levels are caused by either a blockage in the liver or an issue with the bone metabolism.
More information on these tests, as well as the potential reasons of aberrant findings, may be found at Medline: Comprehensive Metabolic Panel.
4. A lipid (cholesterol) panel was performed.
What it measures: The different forms of cholesterol and associated lipids found in the bloodstream are measured by these procedures. The following people are generally on the panel:
Cholesterol in total
High-density lipoprotein (HDL) cholesterol, sometimes known as "good" cholesterol, is a kind of cholesterol that is produced by the liver.
Triglycerides
Low-density lipoprotein (LDL) cholesterol, sometimes known as "bad" cholesterol, is a kind of cholesterol that is produced by the liver.
LDL levels are typically determined depending on the findings of the other three tests.
Before getting their cholesterol levels examined, it is common practice to require people to fast. This is due to the fact that triglycerides can rise after a meal, resulting in a falsely low LDL cholesterol reading being computed. Researchers have discovered that fasting is not always essential; it is inconvenient and has been shown to make a minimal effect in test results in the vast majority of instances.
What the lipid panel is commonly used for is as follows:
These tests are often used to assess the risk of cardiovascular disease in elderly people.
A statin is a type of drug that is used to treat high levels of total or LDL cholesterol that are higher than normal in the body. They can also be minimized by making dietary modifications.
