Blood Panels Reveal What May Be Wrong--or Right

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http://www.latimes.com/print/health/20010101/t000000203.html

Monday, January 1, 2001

Blood Panels Reveal What May Be Wrong--or Right

By DENISE HAMILTON

Doctors often tell patients who come to them with ailments or sometimes

for checkups that they'd like to order a " blood panel. " Most of us nod,

having some vague idea that this means a medical laboratory will analyze our

blood for various chemicals and proteins, which will in turn tell the doctor

various things about our health.

To find out in more detail what the term means, Health consulted Dr.

Pamela Kushner, a primary care physician who sits on the communications

committee of the American Academy of Family Physicians. Kushner, an

associate clinical professor at UC Irvine Medical Center, also has a private

practice out of Long Beach Memorial Center.

Question: What does a blood panel test for, and what do the results tell us?

Answer: It's a battery of blood tests that are specific to what doctors are

looking for. The most common is probably a chemistry panel. It's also called

a " chem profile, " and it usually includes 10 to 14 different tests--it

varies by which medical lab you use. But it's a basic screening for what's

wrong. Let's say you come in and you're fatigued, suffering from general

malaise. The doctor's probably going to order a chem panel. It's cheaper

than ordering the tests separately. A typical chem panel includes testing

your electrolytes, potassium, sodium chloride--the basic components that are

necessary for your blood to function normally. Some doctors order chem

panels every time you have a physical. Others order specific tests based on

your history.

* * *

Q: What are some of the other common blood panels?

A: There are dozens of them. There's a liver panel where the doctor

looks at enzymes that the liver uses to clean the blood. An elevation could

mean the patient has a chronic infection such as hepatitis. A renal panel

looks at how your kidneys function. A thyroid panel can detect signs of

thyroid disease. Then you can go into disease panels. There's a lupus panel,

a prenatal panel. There are so many.

* * *

Q: Is there a blood panel for cholesterol?

A: Yes, that's the lipid panel, and its an important one. It checks

your cholesterol, triglicerides, HDL [high-density lipoproteins] and LDL

[low-density lipoproteins]. HDL is the " good " cholesterol. As for LDL, if

you're an average healthy person, your LDL should be under 160. If you have

any risk factors for heart disease, your LDL should be less than 130. If you

have diabetes, history of stroke or known heart disease, then your LDL

should be less than 100. If your cholesterol is fine, then a lot of time the

doctor won't check it again for five years. But if you have any known risk

factors, most doctors will order a full lipid panel every year.

* * *

Q: Can we list those risk factors?

A: Risk factors for heart disease include hypertension, obesity,

sedentary lifestyle, family history of heart disease, smoking, diabetes or

history of stroke.

* * *

Q: Can the average layperson decipher a blood panel without a doctor's

help?

A: The panel comes back with a series of numbers, but you wouldn't know

what it means unless you're a medical professional. Also, some people want

to go over each particular test, but everything needs to be taken in very

general terms and in context. For instance, chloride results mean nothing

without looking at sodium and potassium results. And all these chemistry

panels have a lot more value when compared to the previous one. I may not

think much of the fact that your sodium's a little low but if I check it a

year later and its significantly lower, then it might be a clue to a

disease. You're checking for patterns.

* * *

Q: Does it make any difference if you're enrolled in a health

maintenance organization or see a private physician? What should patients

ask for?

A: With HMOs, if you don't have a diagnosis, you are unlikely to get a

blood panel unless you specifically ask for it. When HMO patients do get a

blood panel, they may want to ask for a copy for their records. Why? Because

often HMO patients see different doctors. It might also be a worthwhile

thing to do if you're the type of person who changes doctors, insurance or

jobs a lot. That's because certain changes over time can signify problems.

* * *

Q: Any last words?

A: Don't be afraid to ask. You should be able to talk to your doctor,

he or she works for you. It's empowering yourself as a patient.

* * *

Numerous Internet sites describe different blood panels in varying

degree of technical detail. Among them are RT Corner

(http://www.rtcorner.com/Examinations/

Exam%20Topics/Laboratory/blood_panels.htm), a site for respiratory therapy

students, and BaySport (http://www.baysport.com/clinic/bloodexp.html), a

physical therapy and corporate fitness site.