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Blood Lipids

HDL-C 

HDL Cholesterol is the measure of cholesterol carried in the particles called high density lipoproteins. HDL is known as the good cholesterol and a protective lipoprotein fraction, because the high density lipoproteins usually carry harmful cholesterol molecules away from the vessel walls back to the liver where they are metabolized. This healthy process is called reverse cholesterol transport. Optimally HDL levels should be above 40 for men and above 50 for women.

LDL-C Direct

Low density lipoprotein-cholesterol. Bad cholesterol that can build up in arteries and increase risk of heart disease and stroke.

Neutral Fat (MB)

A glycerol molecule bound to three fatty acids (triglyceride). They are neutral because they do not contain any basic or acidic groups. They are often found in the thigh and torso area of the body where they provide insulation to keep warm and provide body fuel reserves.

Non-HDL-C

 Total Cholesterol minus HDL cholesterol.

 

Total Cholesterol

This represents the total amount of cholesterol circulating in the blood, including good (HDL-C) and bad (LDL-C) cholesterol.

Triglycerides

 High levels in the blood this type of fat is unhealthy.

Blood-Lipo & Apolipo Protiens

Apo-A-1

Apolipoprotein A-I, which is the major protein component of high density lipoprotein (HDL) in plasma. The encoded preproprotein is proteolytically processed to generate the mature protein, which promotes cholesterol efflux from tissues to the liver for excretion, and is a cofactor for lecithin cholesterolacyltransferase (LCAT), an enzyme responsible for the formation of most plasma cholesteryl esters.

Apo B

This represents a better measure of the lipoproteins in your blood that you need to keep in check. High levels can lead to plaque that causes heart disease. Apo B helps to unlock the doors to cells and carries cholesterol to them.

Apo B: Apo A-1 ration

The apo B/A-1 is a stronger predictor of cardiovascular events than LDL, HDL, or Total Cholesterol, Triglycerides, or Lipid Ratios. Individuals with seemingly normal LDL cholesterol (< 3.3 mmol/L, 127.1 mg/dL) may in fact have high apo B values, revealing the presence of many small, dense LDL particles, thus indicating substantial risk.


HDL-P
 

This represents the actual number of HDL (good) particles in the blood.


HDL2-C

Is associated with better health. Some studies have shown it to increase with exercise. One of the important functions of HDL is to transport cholesterol from the cells and tissue back to the liver. High HDL-cholesterol is good as it takes cholesterol out of cells and the blood and helps to prevent excess cholesterol. HDL also removes cholesterol deposited in the walls of blood vessels.


LDL-P
 

This (LDL particle number) measures the actual number of LDL particles (particle concentration, nmol/L). It appears that LDL-P may be a stronger predictor of cardiovascular events than LDL-C. Low LDL-P is a much stronger predictor of low risk than low LDL-C. In fact, about 30 – 40% of those with low LDL-C may have elevated LDL-P.

Source: http://www.ncbi.nlm.nih.gov/pubmed/19657464


Lp(a) Mass

It is the worst form of LDL and is an inherited trait that can increase risk of heart disease and stroke.


sdLDL-C
 

Small dense, low density lipoproteins are more likely to damage your artery wall as they can enter more easily than the larger particles.

Blood-Other

Albumin 

It is a protein made by the liver that keeps fluid from leaking out of blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body. An albumin test may be ordered as part of a liver panel to evaluate liver function or with a creatinine, blood urea nitrogen (BUN), or renal panelto evaluate kidney function. Albumin may also be ordered to evaluate a person’s nutritional status.

Circulating immune complex (CIC) 

This evaluates the immune system, whose function is to defend the body against such invaders as bacteria and viruses. The immune system also plays a role in the control of cancer, and is responsible for the phenomena of allergy, hypersensitivity, and rejection problems when organs or tissue are transplanted. One of the ways the immune system protects the body is by producing proteins called antibodies. Antibodies are formed in response to another type of protein called an antigen (anything foreign or different from a natural body protein). Immune complex reactions occur when large numbers of antigen-antibody complexes accumulate in the body. Circulating immune complexes (CICs) are detectable in a variety of systemic disorders such as rheumatological, autoimmune, allergic diseases; viral, bacterial infections and malignancies.

Ferritin 

This is a protein that binds iron and transports it through the bloodstream. Very high levels can indicate problems with your body’s ability to store iron. Increased ferritin levels can also occur when insulin resistance and/or inflammation are present in the body, indicating increased risk for heart disease and diabetes.

Total Iron Binding Capacity (TIBD)

This is a medical laboratory test that measures the blood’s capacity to bind iron with transferrin. TIBC is usually higher than normal when the body’s iron supplies are low. This can occur with:

Iron deficiency anemia
Pregnancy (late)
Lower-than-normal TIBC may mean:
Anemia due to red blood cells being destroyed too quickly (hemolytic anemia)
Lower-than-normal level of protein in the blood (hypoproteinemia)
Inflammation
Liver disease, such as cirrhosis
Malnutrition
Decrease in red blood cells from the intestines not properly absorbing vitamin B12 (pernicious anemia)
Sickle cellmanemia


Total Protein
 

This is a rough measure of all of the proteins in the plasma portion of your blood. Proteins are important building blocks of all cells and tissues; they are important for body growth and health. Total protein measures the combined amount of two classes of proteins, albumin and globulin.

CBC

Basophils

An increased percentage of basophils may be due to: after splenectomy, allergic reaction, chronic myelogenous leukemia, collagen vascular disease, myeloproliferative disease, or varicella infection. A decreased percentage of basophils may be due to: acute infection, cancer, or severe injury.

**It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

 

Eosinophils

An increased percentage of eosinophils may be due to: Addison disease, allergic reaction, cancer, chronic myelogenous leukemia, collagen vascular disease, hypereosinophilic syndromes, or parasitic infection.

**It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

 

Hematocrit

This measures the percentage of a person’s total blood volume that consists of red blood cells.

Hemoglobin

This is an iron-rich protein in red blood cells that carries oxygen. The blood test measures the total amount of this oxygen-carrying protein in the blood, which generally reflects the number of red blood cells in the blood.


Immature Granulocytes

With the exception of blood from neonates or pregnant women, the appearance of immature granulocytes in the peripheral blood indicates an early-stage response to infection, inflammation or other stimuli of the bone marrow. Being able to detect them quickly and reliably opens doors to new diagnostic possibilities for related disorders. Current areas of research regarding the diagnostic significance of circulating immature granulocytes focus on the early and rapid discrimination of bacterial from viral infections, particularly in children, recognizing bacterial infection in neonates, and the early recognition of bacterial infection and sepsis in adults, which is of vital importance in particular for intensive care patients.

Lymphocytes

Lymphocytes are a part of the white blood cells. They are made up of ‘T’ cells which remove foreign objects that are not supposed to be in the body and ‘B’ cells which are instrumental in the immune system. They produce antibodies when a suspicious foreign object is found in the blood. The other type of lymphocyte is the natural killer cell. They simply kill any object found in the cell that is considered to be abnormal such as tumor cells or infections. Lymphocytes are associated with infections and diseases. An elevation in the level of lymphocytes is considered to be a sign of a viral infection. An increased percentage of lymphocytes may be due to: chronic bacterial infection, infectious hepatitis, infectious mononucleosis, lymphocytic leukemia, multiple myeloma, viral infection (such as mumps or measles)

A decreased percentage of lymphocytes may be due to: chemotherapy, leukemia, radiation therapy or exposure, sepsis, steroid use and HIV which is a cause for extremely low levels of ‘T’ cells.

**It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

 

MCH 

This (Mean corpuscular hemoglobin) is a calculation of the average amount of hemoglobin inside a single red blood cell.


MCHC

This (Mean corpuscular hemoglobin concentration) is a calculation of the average concentration of hemoglobin inside a single red blood cell.

MCV

This (Mean corpuscular volume) is a measurement of the average size of a single red blood cell.

Monocytes

Measures the number or percentage of monocytes, which are white blood cells that move out of the circulating blood and into the tissues, where they mature into macrophages. An increased percentage of monocytes may be due to: chronic inflammatory disease, leukemia, parasitic infection, tuberculosis, viral infection (for example, infectious mononucleosis, mumps, or measles.

**It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.


Neutrophil

Measures the number or percentage of neutrophils, which are normally the most abundant circulating white blood cells and respond quickly to infection. Any infection or acute stress increases your number of white blood cells. High white blood cell counts may be due to inflammation, an immune response,or blood diseases such as leukemia. An increased percentage of neutrophils may be due to: acute infection, acute stress, eclampsia, gout, myelocytic leukemia, rheumatoid arthritis, rheumatic fever, thyroiditis, or trauma.
A decreased percentage of neutrophils may be due to: aplastic anemia, chemotherapy, influenza (flu), radiation therapy or exposure, viral infection, or widespread severe bacterial infection.

**It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

Platelets

A platelet count that’s lower than normal (thrombocytopenia) or higher than normal (thrombocytosis) is often a sign of an underlying medical condition, or it may be a side effect from medication. If your platelet count is outside the normal range, you’ll likely need additional tests to diagnose the cause.


RBC

A red blood cell count that’s higher than normal (erythrocytosis), or high hemoglobin or hematocrit levels, could point to an underlying medical condition, such as polycythemia vera or heart disease.

RDW

Red cell distribution width is a parameter that measures variation in red blood cell size or red blood cell volume. RDW is elevated in accordance with variation in red cell size (anisocytosis), ie, when elevated RDW is reported on complete blood count, marked anisocytosis (increased variation in red cell size) is expected on peripheral blood smear review.


WBC

A low white blood cell count (leukopenia) may be caused by a medical condition, such as an autoimmune disorder that destroys white blood cells, bone marrow problems or cancer. Certain medications also can cause white blood cell counts to drop. If your white blood cell count is higher than normal, you may have an infection or inflammation. Or, it could indicate that you have an immune system disorder or a bone marrow disease. A high white blood cell count can also be a reaction to medication.

Fatty Acids, Omega-3

Fatty acids are the core building blocks of cellular membranes making them critical for cell membrane structure and function as well as local signaling. Essential fatty acids (EFAs) cannot be synthesized by the human body and must be obtained in the diet or through supplementation. EFAs are transformed into local hormonal mediators called eicosanoids, a process vital in the ability of the body’s immune system to repair and protect itself and to regulate inflammation.
Evaluating essential and metabolic fatty acids can be helpful for patients with inflammatory disorders, cardiovascular issues, hormonal disorders, autoimmune disorders, arthridities, senile neurological degeneration, mental and behavioral disorders, attention deficit hyperactivity disorder (ADHD), insulin resistance and obesity, and hair and skin related conditions.

Alpha linolenic acid (ALA)

α-Linolenic acid is an n−3 fatty acid. It is one of two essential fatty acids, so called because they are necessary for health and cannot be produced within the human body. They must be acquired through diet. Alpha Linolenic acid is a kind of omega-3 fatty acid found in plants. It is found in flaxseed oil, and in canola, soy, perilla, and walnut oils. Alphalinolenic acid is similar to the omega-3 fatty acids that are in fish oil, called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

ALA has an important role in reducing chronic disease through conversion to EPA and DHA, as well as through its own unique metabolic activities. Additionally, what many fail to understand is the critical need for both plant- and fish-based omega-3s, especially considering the increasing predominance of omega-6 fatty acids in the diet.

ALA is the true “essential” omega-3 fatty acid, because it is the parent fatty acid of the omega-3 family and must be obtained from foods. ALA consumption may reduce the risk of heart disease and other inflammatory diseases by reducing inflammatory compounds called cytokines and eicosanoids.

Docosahexaenoic acid (DHA) 

This is essential for the growth and functional development of the brain in infants. DHA is also required for maintenance of normal brain function in adults. The inclusion of plentiful DHA in the diet improves learning ability, whereas deficiencies of DHA are associated with deficits in learning. DHA is taken up by the brain in preference to other fatty acids. The turnover of DHA in the brain is very fast, more so than is generally realized.  DHA is present in fatty fish (salmon, tuna, mackerel) and mother’s milk. DHA is present at low levels in meat and eggs, but is not usually present in infant formulas.

Fish oil decreases the proliferation of tumour cells, whereas arachidonic acid, a longchain n-6 fatty acid, increases their proliferation. These opposite effects are also seen with inflammation, particularly with rheumatoid arthritis, and with asthma. DHA has a positive effect on diseases such as hypertension, arthritis, atherosclerosis, depression, adult-onset diabetes mellitus, myocardial infarction, thrombosis, and some cancers.

Epidemiological studies have shown a strong correlation between fish consumption and reduction in sudden death from myocardial infarction. The reduction is approximately 50% with 200 mg day(-1)of DHA from fish. DHA is the active component in fish. Not only does fish oil reduce triglycerides in the blood and decrease thrombosis, but it also prevents cardiac arrhythmias. The association of DHA deficiency with depression is the reason for the robust positive correlation between depression and myocardial infarction.

Docosapentaenoic acid (DPA)

This an elongated version of EPA, is starting to gain recognition in the scientific community for its role in improving human health, particularly in controlling inflammation. In order to get to know DPA, it is important to understand the unique benefits it can deliver that EPA and DHA cannot.

What is unique about DPA?
• DPA inhibits platelet aggregation more efficiently than EPA or DHA, meaning it hinders the formation potentially of deadly blood clots
• It is a precursor for oxylipins, anti-inflammatory and neuroprotective compounds
• DPA stimulates endothelial cell migration much more efficiently than EPA, meaning a stronger protection from atherosclerotic diseases such as coronary heart disease
• It is incorporated into phospholipids faster than EPA, meaning the fatty acids can cross the blood barrier and be utilized by the body more efficiently.

In a study conducted by the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, blood levels of DPA, a marker for DPA consumption, had the strongest association with healthy C-reactive protein (CRP) levels in middle-aged men when compared to other omega-3s such as EPA and DHA. DPA has also shown to have a more direct biological role in the inhibition of cyclooxygenase, an enzyme that produces the prostaglandin hormones that sparks inflammation.

Eicosapentaenoic acid (EPA)

EPA is a polyunsaturated fatty acid (PUFA) that acts as a precursor for prostaglandin-3 (which inhibits platelet aggregation), thromboxane-3, and leukotriene-5 eicosanoids. It is obtained in the human diet by eating oily fish or fish oil, e.g. cod liver, herring, mackerel, salmon, menhaden and sardine, and various types of edible seaweed and phytoplankton. It is also found in human breast milk. The human body converts alpha-linolenic acid (ALA) to EPA. ALA is itself an essential fatty acid, an appropriate supply of which must be ensured.

The efficiency of the conversion of ALA to EPA, however, is much lower than the absorption of EPA from food containing it. Because EPA is also a precursor to docosahexaenoic acid (DHA), ensuring a sufficient level of EPA on a diet containing neither EPA nor DHA is harder both because of the extra metabolic work required to synthesize EPA and because of the use of EPA to metabolize into DHA. Medical conditions like diabetes or certain allergies may significantly limit the human body’s capacity for metabolization of EPA from ALA.

Getting more EPA in your diet has positive effects on coronary heart disease, high triglycerides (fats in the blood), high blood pressure, and inflammation. Omega 3’s including EPA have shown positive benefits for depression, rheumatoid arthritis, menopause, mentstrual pain, Raynaud Syndrome, lupus, lung and kidney diseases, type 2 diabetes, obesity, ulcerative colitis, Crohn disease, anorexia nervosa, burns, osteoarthritis, osteoporosis, and early stages of colorectal cancer.

PRECAUTION: Fish oil capsules have both DHA and EPA. DO NOT give supplements with EPA to a child unless your pediatrician tells you to because they upset the healthy balance between DHA and EPA during early development.

 

HS-Omega-3 index (RBC EPA+DHA)a

The HS-Omega-3 Index is the EPA+DHA content of red blood cells (RBCs) expressed as a percent of total identified RBC fatty acids. It is measured using a proprietary methodology developed over several years of research. Although intake of omega-3 fatty acids is related to cardiovascular risk, EPA and DHA measurements can provide a more accurate prediction of clinical events. The sum of EPA and DHA, expressed as a percentage of total phospholipid fatty acids, is called the omega-3 index. The index can be used as an indicator of risk for sudden cardiac death and nonfatal cardiovascular events and as a therapeutic target.  It can also be used to assess adherence to omega-3 therapy and/or success or failure of such therapy.

**Many fish sources are known to be toxic due to contaminated waters. Take care in finding sources from clean waters and not from fish farms. As a food look for wild caught varieties, and as a supplement make sure the source is pure and not rancid.

Fatty Acids, Omega-6

Omega-6 fatty acids are precursors to endocannabinoids, lipoxins, and specific eicosanoids.Omega-6 fatty acids are essential fatty acids. They are necessary for human health, but the body cannot make them. You have to get them through food. Along with omega-3 fatty acids, omega-6 fatty acids play a crucial role in brain function, and normal growth and development. As a type of polyunsaturated fatty acid (PUFA), omega-6s help stimulate skin and hair growth, maintain bone health, regulate metabolism, and maintain the reproductive system.

Medical research on humans found a correlation (correlation does not imply causation) between the high intake of omega-6 fatty acids from vegetable oils and disease in humans. However, biochemistry research has concluded that air pollution, heavy metals, smoking, second-hand smoke, Lipopolysaccharides, lipid peroxidation products (found mainly in vegetable oils, roasted nuts and roasted oily seeds) and other exogenous toxins initiate the inflammatory response in the cells which leads to the expression of the COX-2 enzyme and subsequently to the temporary production of inflammatory promoting prostaglandins from arachidonic acid for the purpose of alerting the immune system of the cell damage and eventually to the production of anti-inflammatory molecules (e.g. lipoxins & prostacyclin) during the resolution phase of inflammation, after the cell damage has been repaired.

Modern Western diets typically have ratios of omega-6 to omega-3 in excess of 10 to 1, some as high as 30 to 1; the average ratio of omega-6 to omega-3 in the Western diet is 15:1-16.7:1. Humans are thought to have evolved with a diet of a 1-to-1 ratio of omega-6 to omega-3 and the optimal ratio is thought to be 4 to 1 or lower,  although some sources suggest ratios as low as 1:1.

Arachidonic acid (AA) 

This is an omega-6 unsaturated fatty acid your body requires to function properly. The National Institutes of Health reports that this fatty acid can be made in the body if you consume adequate amounts of linoleic acid in your diet. In our diet, the most commonly consumed omega-6 fatty acid is Arachidonic Acid (AA) found in meats, eggs and dairy products.  This particular omega-6 fatty acid is vital for muscle growth, brain development and maintaining a healthy nervous system; but our body does not require much of this omega active and when consumed in excess, it can promote inflammation. When we have an excess of AA in our body, it prevents LA from converting into GLA.

The ratio between the omega-6 arachidonic acid (AA) and the marine omega-3 essential fatty acids eicosapentaoenic acid (EPA) and docosahexaoenic acid (DHA) reflects mood related wellness. This Index should be below 1:1. If above 1:1 you may benefit from changing your diet.

Gamma linoleic acid (GLA) 

When we consume anti-inflammatory nutrients such as GLA, it balances the inflammatory properties of AA and other pro-inflammatory nutrients. GLA provides a completely different set of benefits with its much-needed anti-inflammatory properties.
As mentioned, an excess of some types of omega-6 fatty acids can cause abnormal inflammation in our body, and we need GLA to neutralize and reverse this effect.  The primary sources of GLA are borage, evening primrose, echium, black currant seed and hempseed.  Of all these sources, borage contains the highest amount of naturally occurring GLA.  GLA also shows promise in lowering low-density lipoprotein (LDL) and triglyceride levels, while increasing high-density lipoprotein (HDL) concentration. Unlike other omega-6 fatty acids we don’t have to worry about consuming too much GLA.  Studies conducted using borage oil show that GLA is safe, even in larger amounts.

Gamma linolenic acid (GLA) is an unusual omega-6 fatty acid with powerful implications for human health. Adequate GLA is required to maintain a healthy balance of anti-inflammatory signaling molecules in the body. The enzyme that produces GLA from dietary fats decreases in activity with aging and in certain chronic conditions. Increasing GLA intake overcomes this deficiency and can restore a healthy balance to suppress chronic inflammation. GLA also may help to prevent inflammation-related changes implicated in the development of atherosclerosis and cancer. GLA has proven benefits in inflammatory diseases such as eczema, asthma, and rheumatoid arthritis.


Linoleic acid (LA)
 

This is a carboxylic acid. Linoleic acid belongs to one of the two families of essential fatty acids, which means that the human body cannot synthesize it from other food components. It is found in nuts, butter, seeds and vegetable oils.  Usually this fatty acid gets digested in our body and converted to another omega-6 fatty acid, GLA, delivering a range of health benefits arising from its anti-inflammatory effects.

Fatty Acids, Other

CIS-Monounsaturated Fatty Acids

These are Monounsaturated fatty acids.Monounsaturated fats (MUFAs) are good fats. Liquid at room temperature, they turn solid when they are chilled. Common sources of MUFAs are olive oil, avocados and nuts. Monounsaturated fats are a healthy alternative to the trans fats and refined polyunsaturated fats you find in most processed foods. These fats in the diet are beneficial and lower heart disease risk. It can help lower your LDL (bad) cholesterol level. Cholesterol is a soft, waxy substance that can cause clogged, or blocked, arteries (blood vessels). Keeping your LDL level low reduces your risk of heart disease and stroke

Having a monounsaturated fatty acid index of < 19.0% increases heart disease risk, and indicates the need to increase intake of olive oil and or canola oil in salads or use more of these oils in cooking. Monounsaturated fatty acids have one double bond in the fatty acid chain with all of the remainder carbon atoms being single-bonded.

Saturated Total

This fat is a type of fat in which the fatty acids all have single bonds. These fats are saturated with hydrogen and carbon atoms.

A fat is made of two kinds of smaller molecules: monoglyceride and fatty acids. Fats are made of long chains of carbon (C) atoms. Some carbon atoms are linked by single bonds (-C-C-) and others are linked by double bonds (-C=C-). Double bonds can react with hydrogen to form single bonds. They are called saturated, because the second bond is broken up and each half of the bond is attached to (saturated with) a hydrogen atom. Most animal fats are saturated.

Trans fats

These are made through the chemical process of hydrogenation of oils. Hydrogenation solidifies liquid oils and increases the shelf life and the flavor stability of oils and foods that contain them. Trans fats wreak havoc with the body’s ability to regulate cholesterol and they drive up the LDL (“bad”) cholesterol which increases the risk of coronary artery heart disease and stroke. It’s also associated with a higher risk of developing type 2 diabetes. Trans fats, or trans fatty acids, are a form of unsaturated fat. Unlike saturated fats, which have no double bonds, unsaturated fats have at least one double bond in their chemical structure. This double bond can be either in the “cis” or “trans” configuration, which relates to the position of hydrogen atoms around the double bond. Basically… “cis” means “same side,” which is the most common structure. But trans fats have the hydrogen atoms on opposite sides, which can be a problem. The bottom line is trans fats are unsaturated fats with a specific chemical structure, where the hydrogen atoms are on opposite sides of the double bond.