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Name : Miss. KANCHAN GUPTA Patient UID.
: 5091591
Age/Gender : 22 Yrs/Female Visit No. : 24732405270006
Referred Client : LDPL1648-HEALTH care path lab Collected on : 27-May-2024 10:00AM
Referred By : SELF Received on : 27-May-2024 02:32PM
Doctor Name : Reported on : 27-May-2024 05:42PM
Sample Type : Sod.Fluoride - F - 14754592,Serum - 14754593, - ,Whole Blood EDTA - 14754591
HAEMATOLOGY
Test Name Results Unit Bio. Ref. Interval
BLOOD GROUP (ABO & RH TYPING)
Blood Grouping O
Methodology: Forward & Reverse
RH Typing POSITIVE
Methodology: Forward & Reverse
CLINICAL COMMENT
There are 22 blood group systems, including the ABO, Rh, and Kell blood groups which contain antigens that can provoke the most severe transfusion reactions.The Rh
blood group is one of the most complex blood groups known in humans. From its discovery 60 years ago where it was named (in error) after the Rhesus monkey, it has
become 2nd in importance only to the ABO blood group in the field of transfusion medicine. The significance of the Rh blood group is related to the fact that the Rh antigens
are highly immunogenic. In the case of the D antigen, individuals who do not produce the D antigen will produce anti-D if they encounter the D antigen on transfused RBCs
(causing HTR) or on fetal RBCs (causing HDN). For this reason, the Rh status is routinely determined in blood donors, transfusion recipients, and in mothers-to-be.
False-positive results with Rh typing may result from a positive direct antiglobulin test (DAT) result (coating of red cells with alloantibodies), rouleaux formation (can be
seen with patients with multiple myeloma), or contamination, or reagents. False-positive results may also be seen when high-protein Rh reagents that contain 20% protein or
other high molecular weight additives are used for typing.
False -negative results with Rh typing may result from the use of incorrectly diluted red cell suspensions, reagent deterioration, failure to follow the manufacturer's
directions, or inappropriate techniques.
*** End Of Report ***
Page 1 of 13
Name : Miss. KANCHAN GUPTA Patient UID. : 5091591
HAEMATOLOGY
HBA1C -GLYCOSYLATED HEMOGLOBIN
Hb A1C, GLYCOSYLATED Hb 5.00 % Non-Diabetic < 6.0
Methodology: by HPLC Good Control 6.0-7.0
Weak Control 7.0-8.0
Poor control > 8.0
Estimated Average Glucose 96.80 mg/dL 68-125
INTERPRETATION
AS PER AMERICAN DIABETES ASSOCIATION (ADA)

Reference Group HbA1c in %
Non diabetic adults >=18 years < 5.7
At risk (Prediabetes) 5.7 - 6.4
Diagnosing Diabetes >= 6.5
CLINICAL NOTES
In vitro quantitative determination of HbA1c in whole blood is utilized in long term monitoring of glycemia.The HbA1c level correlates with the mean glucose concentration
prevailing in the course of the patient's recent history (approx - 6-8 weeks) and therefore provides much more reliable information for glycemia monitoring than do determinations
of blood glucose or urinary glucose. It is recommended that the determination of HbA1c be performed at intervals of 4-6 weeks during Diabetes Mellitus therapy. Results of HbA1c
should be assessed in conjunction with the patient's medical history, clinical examinations and other findings.
Some of the factors that influence HbA1c and its measurement [Adapted from Gallagher et al ]
1. Erythropoiesis
- Increased HbA1c: iron, vitamin B12 deficiency, decreased erythropoiesis.
- Decreased HbA1c: administration of erythropoietin, iron, vitamin B12, reticulocytosis, chronic liver disease.
2. Altered Haemoglobin-Genetic or chemical alterations in hemoglobin: hemoglobinopathies, HbF, methemoglobin, may increase or decrease HbA1c.
3. Glycation
- Increased HbA1c: alcoholism, chronic renal failure, decreased intraerythrocytic pH.
- Decreased HbA1c: certain hemoglobinopathies, increased intra-erythrocyte pH.
4. Erythrocyte destruction
- Increased HbA1c: increased erythrocyte life span: Splenectomy.
- Decreased A1c: decreased RBC life span: hemoglobinopathies, splenomegaly, rheumatoid arthritis or drugs such as antiretrovirals, ribavirin & dapsone.
5. Others
- Increased HbA1c: hyperbilirubinemia, carbamylated hemoglobin, alcoholism, large doses of aspirin, chronic opiate use,chronic renal failure
- Decreased HbA1c: hypertriglyceridemia,reticulocytosis, chronic liver disease, aspirin, vitamin C and E,splenomegaly, rheumatoid arthritis or drugs
Note:
1.Shortened RBC life span –HbA1c test will not be accurate when a person has a condition that affects the average lifespan of red blood cells (RBCs), such as hemolytic anemia
or blood loss. When the lifespan of RBCs in circulation is shortened, the A1c result is falsely low and is an unreliable measurement of a person's average glucose over time.
2.Abnormal forms of hemoglobin – The presence of some hemoglobin variants, such as hemoglobin S in sickle cell anemia, may affect certain methods for measuring A1c. In
these cases, fructosamine can be used to monitor glucose control.
estimated Average Glucose (eAG) : based on value calculated according to National Glycohemoglobin Standardization Program (NGSP) criteria.
Page 2 of 13
HAEMATOLOGY
COMPLETE BLOOD COUNT (CBC)
HAEMOGLOBIN (Hb) 10.1 g/dL 12.0-15.0
Methodology: colorimetric method
RED BLOOD CELLS- RBC COUNT 4.58 millions/mm³ 3.8 - 4.8
Methodology: electric impedance
PACKED CELL VOLUME (PCV) -HEMATOCRIT 32.6 % 40.0-50.0
Methodology: Pulse Height detection method
MCV 71.18 fL 83-101
Methodology: Automated/Calculated
MCH 22.05 pg 27.0-32.0
Methodology: by Automated/Calculated
MCHC 30.98 g/dL 31.5-34.5
RED CELL DISTRIBUTION WIDTH (RDW-CV) 18.0 % 11.6-14.0
RED CELL DISTRIBUTION WIDTH (RDW-SD) 46.4 fL 39.0- 46.0
MENTZER INDEX 15.54
Methodology: Calculated
PLATELET COUNT 224 10^3/µL 150-410
PLATELET DISTRIBUTION WIDTH (PDW) 18.2 fL 9.00-17.00
PCT(PLATELETCRIT) 0.287 % 0.108-0.282
MEAN PLATELET VOLUME - MPV 12.8 fL 7.00-12.0
Methodology: Plt Histogram
P-LCC 111.00 % 30.0-90.0
TOTAL LEUKOCYTE COUNT (TLC) 8.11 10^3/µL 4.00-10.0
DIFFERENTIAL LEUCOCYTE COUNT
Neutrophils 56.7 % 40 - 80
Methodology: Flow cytometry/Manual
Lymphocytes 32.6 % 20 - 40
Eosinophils 4.6 % 1.00-6.00
Monocytes 5.7 % 2.00-10.0
Basophils 0.4 % 0.00-1.00
Page 3 of 13
ABSOLUTE NEUTROPHIL COUNT 4.60 10^3/µL 2.00-7.00
ABSOLUTE LYMPHOCYTE COUNT 2.65 10^3/µL 1.00-3.00
ABSOLUTE EOSINOPHIL COUNT 0.37 10^3/µL 0.02-0.50
ABSOLUTE MONOCYTE COUNT 0.46 10^3/µL 0.20-1.00
ABSOLUTE BASOPHIL COUNT 0.03 10^3/µL 0.02-0.10
CLINICAL NOTES
A complete blood count (CBC) is used to evaluate overall health and detect wide range of disorders, including anemia, infection and leukemia.
There have been some reports of WBC and platelet counts being lower in venous blood than in capillary blood samples ,although still within these reference ranges.
POSSIBLE CAUSES OF ABNORMAL PARAMETERS:-

High RBC, Hb, or HCT - dehydration, polycythemia, shock, chronic hypoxia
Low RBC, Hb, or HCT - anemia, thalassemia, and other hemoglobinopathies
Low MCV - microcytic anemia
High MCV - macrocytic anemia, liver disease
Low WBC - sepsis, marrow hypoplasia
High WBC - acute stress, infection, malignancies
Low platelets - risk of bleeding
High platelets - risk of thrombosis
Notes
1.Macrocytic Anemia/Dimorphic Anemia can have low platelet count.
2.Microcytic Anemia/Leucocytosis can have Reactive thrombocytosis.
For microcytic indices a Mentzer index of less than 13 suggests that the patient may have thalassemia trait, and an index of more than 13 suggests that the patient may
have iron deficiency.
Reference ranges are from Dacie and Lewis Practical Hematology 12th edition(2016)
Page 4 of 13
BIOCHEMISTRY
CALCIUM-SERUM
CALCIUM , Serum 10.22 mg/dL 8.4 - 10.6
Methodology: BAPTA
CLINICAL NOTES
A blood calcium test is ordered to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth. The test may also be
ordered if a person has symptoms of a parathyroid disorder, malabsorption, or an overactive thyroid. To help diagnose the underlying problem, additional tests are often
done to measure ionized calcium, urine calcium, phosphorus, magnesium, vitamin D, parathyroid hormone (PTH) and PTH-related peptide (PTHrP). PTH and vitamin D are
responsible for maintaining calcium concentrations in the blood within a narrow range of values. Measuring urine calcium can help determine whether the kidneys are
excreting the proper amount of calcium,
Serum calcium is decreased (hypocalcemia) in following conditions-

-Hypoparathyroidism,Pseudohypoparathyroidism
-Vitamin D deficiency (either from intake deficiency or decreased conversion/activation) or resistance (osteomalacia and rickets)
-Chronic renal diseases (eg, renal acidosis, Fanconi syndrome),Chronic liver disease and biliary obstructive diseases
-Magnesium deficiency (PTH glandular release is magnesium-dependent),Hyperphosphatemia,Hypoalbuminemia
-Overexpression of fibroblast growth factor 23 (oncogenic osteomalacia)
-Severe calcium dietary deficiency,Hungry bone syndrome,Severe pancreatitis (calcium saponification),Massive transfusion
Serum calcium is Increased (hypercalcemia) in following conditions-

-Hyperparathyroidism (primary, such MEN type 1, hyperplasia, adenoma, or carcinoma; or secondary, from chronic kidney injury and hyperphosphatemia)
-Malignancies (humoral hypercalcemia of malignancy) that secrete PTH–related protein, especially squamous cell carcinoma of lung and renal cell carcinoma
-Vitamin D excess,Vitamin A intoxication,Milk-alkali syndrome
-Multiple myeloma, owing to bone lesions,Paget disease of bone with prolonged immobilization,Sarcoidosis,Other granulomatous disorders
-Familial hypocalciuria hypercalcemia,Addison disease
-Thyrotoxicosis,Hypothyroidism, owing to prolongation of vitamin D action as its metabolism is slowed down
-Drug exposure: Some drugs that can increase serum calcium are as follows antacids (some), calcium salts, long-term thiazide therapy, lithium
Page 5 of 13
BIOCHEMISTRY
BLOOD GLUCOSE FASTING
BLOOD GLUCOSE FASTING 100.10 mg/dL 59-100
Methodology: Hexokinase
CLINICAL NOTES
Elevated glucose levels (hyperglycemia) are most often encountered clinically in the setting of diabetes mellitus, but they may also occur with pancreatic neoplasms,
hyperthyroidism, and adrenocortical dysfunction. Decreased glucose levels (hypoglycemia) may result from endogenous or exogenous insulin excess, prolonged starvation,
or liver disease.
Fasting Glucose 2 HOURS PP Glucose Diagnosis
<100 <140 Normal
100 to 125 140 to 199 Pre Diabetes
>126 >200 Diabetes
Impaired glucose tolerance (IGT) fasting, means a person has an increased risk of developing type 2 diabetes but does not have it yet. A level of 126 mg/dL or above,
confirmed by repeating the test on another day, means a person has diabetes. IGT (2 hrs Post meal), means a person has an increased risk of developing type 2 diabetes
but does not have it yet. A 2-hour glucose level of 200 mg/dL or above, confirmed by repeating the test on another day, means a person has diabetes
Note: Blood glucose level is maintained by a very complex integrated mechanism involving a critical interplay of the release of hormones and action of enzymes on key
metabolic pathways. If postprandial glucose is lower than fasting glucose, it is termed as postprandial reactive hypoglycemia (PRH). The possible cause of PRH are high
insulin sensitivity, exaggerated response of insulin and glucagon-like peptide 1, defects in counter-regulation, very lean individuals, anxious individuals, after massive weight
reduction, women with lower body overweight physical activity prior test, hypoglycemic medication, deliberately eating less or eat a non-carbohydrate meal before testing.
Ref : American Diabetes association standards of medical care.
Page 6 of 13
BIOCHEMISTRY
LIVER FUNCTION TEST (LFT) - EXTENDED
BILIRUBIN TOTAL 1.03 mg/dL 0.10 - 1.20
Methodology: Diazonium Ion Blanked
DIRECT BILIRUBIN(CONJUGATED), Serum 0.22 mg/dl 0.00-0.20
Methodology: Diazo Method
INDIRECT BILIRUBIN,Serum 0.81 mg/dL 0.80
SGPT (ALT), SERUM 11.40 U/L 0-35
Methodology: UV without P5P
SGOT (AST) ,SERUM 24.80 IU/L 0.0-32.0
Methodology: UV without P5P
ALKALINE PHOSPHATASE ,Serum 75.5 U/L 53-128
Methodology: IFCC
GAMMA GLUTAMYL TRANSFERASE (GGT) 15.50 U/L 12.0-43.0
Methodology: IFCC
TOTAL PROTEIN , Serum 8.8 g/dL 6.00-8.30
Methodology: Biuret
Albumin,Serum 4.80 g/dL 3.2-5.20
Methodology: BCG
GLOBULIN,SERUM 4 g/dL 2.30-4.50
A/G Ratio ,Serum 1.20 1.0 - 2.3
SGOT/SGPT RATIO 2.18
COMMENT
These are group of tests that can be used to detect the presence of liver disease, distinguish among different types of liver disorders, gauge the extent of known liver
damage, and monitor the response to treatment. Most liver diseases cause only mild symptoms initially, but these diseases must be detected early. Some tests are
associated with functionality (e.g., albumin), some with cellular integrity (e.g., transaminase), and some with conditions linked to the biliary tract (gamma-glutamyl transferase
and alkaline phosphatase). Conditions with elevated levels of ALT and AST include hepatitis A,B ,C ,paracetamol toxicity etc.Several biochemical tests are useful in the
evaluation and management of patients with hepatic dysfunction. Some or all of these measurements are also carried out (usually about twice a year for routine cases) on
those individuals taking certain medications, such as anticonvulsants, to ensure that the medications are not adversely impacting the person's liver.
Reference ranges are from Teitz fundamental of clinical chemistry 8th ed (2018)
Page 7 of 13
BIOCHEMISTRY
KIDNEY FUNCTION TEST (KFT)-BASIC
UREA - SERUM 15.7 mg/dL 15.0 - 40.0
Methodology: Urease UV
CREATININE-SERUM 0.54 mg/dL 0.40-1.10
Methodology: Jaffe Kinetic
URIC ACID - SERUM 3.90 mg/dL 2.40 - 6.00
Methodology: Colorimetric
SODIUM (SERUM) 138.2 mmol/L 135 - 150
Methodology: ISE
POTASSIUM-SERUM 4.77 mmol/L 3.5 - 5.5
Methodology: ISE
CHLORIDE ,Serum 105.10 mmol/L 94 - 110
Methodology: ISE
BLOOD UREA NITROGEN (BUN) 7.34 mg/dL 8.00-23.0
BUN/CREATININE RATIO 13.59 Ratio 10-20:1 Normal
UREA / CREATININE RATIO 29.07 Ratio 40-100:1 Normal
INTERPRETATION
Kidney function tests are group of tests that can be used to evaluate how well the kidneys are functioning.Creatinine is a waste product produced by muscles from the breakdown
of a compound called creatine. In blood, it is a marker of GFR ,in urine, it can remove the need for 24-hour collections for many analytes or be used as a quality assurance tool
to assess the accuracy of a 24-hour collection . It is removed from the body by the kidneys, which filter almost all of it from the blood and release it into the urine. This test
measures the amount of creatinine in the blood and/or urine.Creatine is part of the cycle that produces energy needed to contract muscles. Both creatine and creatinine are
produced by the body at a relatively constant rate. Since almost all creatinine is filtered from the blood by the kidneys and released into the urine, blood levels are usually a
good indicator of how well the kidneys are working.
REMARK-The amount of creatinine you produce depends on your body size and your muscle mass. For this reason, creatinine levels are usually slightly higher in men than in
women and children.Certain drugs are nephrotoxic hence KFT is done before and after initiation of treatment with these drugs.
Higher creatinine than normal level may be due to: • Blockage in the urinary tract • Kidney problems, such as kidney damage or failure, infection, or reduced blood flow • Loss of
body fluid (dehydration) • Muscle problems, such as breakdown of muscle fibers • Problems during pregnancy, such as seizures (eclampsia)), or high blood pressure caused by
pregnancy (preeclampsia)
Lower than normal creatinine level may be due to: • Myasthenia Gravis • Muscular dystrophy.Low serum creatinine values are rare; they almost always reflect low muscle mass.
Page 8 of 13
BIOCHEMISTRY
LIPID PROFILE BASIC
CHOLESTEROL -TOTAL 124.00 mg/dL <200 Desirable
Methodology: Cholesterol Oxidase,Esterase,Peroxidase 200-239 Borderline high risk
>240 High risk
TRIGLYCERIDES - SERUM 65.60 mg/dL <150
Methodology: Enzymatic End Point
CHOLESTEROL - HDL (DIRECT) 37.60 mg/dL >40 Recommended Range
Methodology: Direct Enzymatic Colorimetric
NON-HDL CHOLESTEROL 86.40 mg/dL <130
CHOLESTEROL-LDL (DIRECT) 73.28 mg/dL <130 Recommended Range
VLDL ,SERUM 13.12 mg/dL 0.00 - 45.0
Methodology: Spectrophotmetry/Calculated
CHOL/HDL Ratio 3.30 Ratio 3.40-4.40
LDL/HDL Ratio 1.95 Ratio 1.0-3.5
HDL/LDL CHOLESTEROL RATIO 0.51 Ratio <3.50
REFERENCE RANGES AS PER NCEP ATP III GUIDLINES
TOTAL CHOLESTEROL mg/dl HDL mg/dl LDL mg/dl TRIGLYCERIDES mg/dl

Desirable <200 Low <40 Optimal <100 Normal <150
Near Optimal 100-129
Borderline High 200-239 High >60 Borderline High 150-199
Borderline High 130-159
High 160-189 High 200-499
High >240 - -
Very High >190 Very High >500
ALERT!!! 10-12 hours fasting is mandatory for lipid parameters.If not,values might fluctuate.
CLINICAL NOTES
Lipid profile is initial screening tool for abnormalities in lipids. The results of this test can identify certain genetic diseases & can determine approximate risks for
cardiovascular disease, certain forms of pancreatitis. Hypertriglyceridemia is indicative of insulin resistance when present with low HDL & elevated LDL, while elevated TG
is risk factor for coronary artery disease,especially when low HDL is present.TG of 500mg/dL or more can be concerning for development of pancreatitis.
Remark-Measurements in the same patient can show physiological & analytical variations. 3 serial samples 1 week apart are recomended for Total Cholesterol, TG, HDL &
LDL Cholesterol.As per NCEP guidelines, all adults above the age of 20 years should be screened for lipid status.Selective screening of children above the age of 2 years
with a family history of premature cardiovascular disease or those with at least one parent with high total cholesterol is recommended.NCEP Identifies elevated Triglycerides
as an independent risk factor for Coronary Heart Disease (CHD) .
Page 9 of 13
BIOCHEMISTRY
IRON PROFILE BASIC
IRON -Serum 60.90 ug/dL 59.0-145.0
Methodology: Ferrozine-no Deproteinization
UIBC-SERUM 231.20 ug/dL 110 - 370
Methodology: NiTRO-PSAP
TOTAL IRON BINDING CAPACITY 292.10 ug/dL 240-450
TRANSFERRIN SATURATION 20.85 % 15.0-50.0
CLINICAL NOTES
The serum iron test is used to measure the amount of iron that is in transit in the body – the iron that is bound to transferrin in the blood. Along with other tests, it is used to
help detect and diagnose iron deficiency or iron overload. Testing may also be used to help differentiate various causes of anemia.The amount of iron present in the blood
will vary throughout the day and from day to day. For this reason, serum iron is almost always measured with other iron tests, including ferritin, transferrin, and calculated
total iron-binding capacity (TIBC) and transferrin saturation.Serum ferritin appears to be in equilibrium with tissue ferritin and is a good indicator of storage iron in normal
subjects and in most disorders. In patients with some hepatocellular diseases, malignancies and inflammatory diseases, serum ferritin is a disproportionately high estimate of
storage iron because serum ferritin is an acute phase reactant. In such disorders iron deficiency anemia may exist with a normal serum ferritin conc. In the presence of
inflammation, persons with low serum ferritin are likely to respond to iron therapy.
Increased Levels
-Iron overload – Hemochromatosis, Thalassemia & Sideroblastic anemia
-Malignant conditions - Acute myeloblastic & Lymphoblastic leukemia, Hodgkin’s disease & Breast carcinoma
-Inflammatory diseases - Pulmonary infections, Osteomyelitis, Chronic UTI,
-Rheumatoid arthritis, SLE, burns,Acute & Chronic hepatocellular disease
Decreased Levels
-Iron deficiency anemia
Page 10 of 13
IMMUNOLOGY
VITAMIN B12 : CYANOCOBALAMIN
VITAMIN B12 : CYANOCOBALAMIN 320.00 pg/mL 211 - 911
Methodology: ECLIA
CLINICAL NOTES
Vitamin B12 performs many important functions in the body, but the most significant function is to act as coenzyme for reducing ribonucleotides to deoxyribonucleotides, a
step in the formation of genes. Inadequate dietary intake is not the commonest cause for cobalamine deficiency. The most common cause is malabsorption either due to
atrophy of gastric mucosa or diseases of terminal ileum. Cobalamine deficiency leads to Megaloblastic anemia and demyelination of large nerve fibres of spinal cord.
Sources of Vitamin B12 are liver, shellfish, fish, meat, eggs, milk, cheese & yogurt.
Decreased Levels
-Dietary deficiency: Vegetarians
-Lack of Intrinsic factor: Total or partial gastrectomy, Atrophic gastritis, Intrinsic factor antibodies
-Malabsorption: Regional ileitis, resected bowel, Tropical Sprue, Celiac disease, pancreatic
-insufficiency, bacterial overgrowth & achlorhydria
-Loss of ingested vitamin B12: fish tapeworm
-Congenital disorders: Orotic aciduria & transcobalamine deficiency
-Increased demand: Pregnancy specially last trimester
Increased Levels
-Chronic renal failure, Congestive heart failure, Acute & Chronic Myeloid Leukemia, Polycythemia vera,Carcinomas with liver metastasis, Liver disease, Drug induced
cholestasis & Protein malnutrition
Note: To differentiate vitamin B12 & folate deficiency, measurement of Methyl malonic acid in urine & serum Homocysteine level is suggested
Page 11 of 13
IMMUNOLOGY
VITAMIN D 25-HYDROXY CHOLECALCIFEROL
VITAMIN D(25 OH) ,SERUM 9.55 ng/mL Deficiency <20
Methodology: ECLIA Insufficiency 20-30
Sufficiency 30-100
Toxicity >100
CLINICAL NOTES-
Vitamin D is essential for strong bones, because it helps the body use calcium from the diet. Traditionally, vitamin D deficiency has been associated with rickets, a disease
in which the bone tissue doesn't properly mineralize, leading to soft bones and skeletal deformities. But increasingly, research is revealing the importance of vitamin D in
protecting against a host of health problems.
Symptoms and Health risks of vitamin D deficiency

Symptoms of bone pain and muscle weakness can mean you have a vitamin D deficiency. However, for many people, the symptoms are subtle. Yet, even without
symptoms, too little vitamin D can pose health risks. Low blood levels of the vitamin have been associated with Increased risk of cardiovascular disease, Cognitive
impairment in older adults, Severe asthma in children & Cancer.
Research suggests that vitamin D could play a role in the prevention and treatment of a number of different conditions, including type1 and type 2 diabetes, hypertension,
glucose intolerance, and multiple sclerosis.
Causes of vitamin D deficiency

-Peoplle following a strict vegan diet.
-Exposure to sunlight is limited,
-Vitamin D malabsorption- like Crohn's disease, cystic fibrosis, and celiac disease,
-Dietary deficiency
-Severe Hepatocellular disease
-Drugs like Anticonvulsants
-Nephrotic syndrome
Increased levels
-Vitamin D intoxication
Page 12 of 13
IMMUNOLOGY
THYROID PROFILE : T3, T4 & TSH(TFT)
TRIODOTHYRONINE TOTAL (T3) 1.68 ng/mL 0.70-2.04
Methodology: ECLIA
THYROXINE TOTAL (T4) 9.10 ug/dl 5.1-14.1
Methodology: ECLIA
THYROID STIMULATING HORMONE (TSH) 1.466 µIU/ml 0.35-5.50
Methodology: ECLIA
NOTE-TSH levels are subject to circardian variation,reaching peak levels between 2-4 AM and min between 6-10 PM. The variation is the order of 50% hence time of the day has influence on the
measures serum TSH concentration.Dose and time of drug intake also influence the test result.
Transient increase in TSH levels or abnormal TSH levels can be seen in some non thyroidal conditions,simoultaneous measurement of TSH with free T4 is useful in evaluating differantial diagnosis.
INTERPRETATION-Ultra Sensitive 4th generation assay

1.Primary hyperthyroidism is accompanied by ↑serum T3 & T4 values along with ↓ TSH level.
2.Low TSH,high FT4 and TSH receptor antibody(TRAb) +ve seen in patients with Graves disease
3.Low TSH,high FT4 and TSH receptor antibody(TRAb) -ve seen in patients with Toxic adenoma/Toxic Multinodular goiter
4.HighTSH,Low FT4 and Thyroid microsomal antibody increased seen in patients with Hashimotos thyroiditis
5.HighTSH,Low FT4 and Thyroid microsomal antibody normal seen in patients with Iodine deficiency/Congenital T4 synthesis deficiency
6.Low TSH,Low FT4 and TRH stimulation test -Delayed response seen in patients with Tertiary hypothyroidism
7.Primary hypothyroidism is accompanied by ↓ serum T3 and T4 values & ↑serum TSH levels
8.Normal T4 levels accompanied by ↑ T3 levels and low TSH are seen in patients with T3 Thyrotoxicosis
9.Normal or↓ T3 & ↑T4 levels indicate T4 Thyrotoxicosis ( problem is conversion of T4 to T3)
10.Normal T3 & T4 along with ↓ TSH indicate mild / Subclinical Hyperthyroidism .
11.Normal T3 & ↓ T4 along with ↑ TSH is seen in Hypothyroidism .
12.Normal T3 & T4 levels with ↑ TSH indicate Mild / Subclinical Hypothyroidism .
13.Slightly ↑ T3 levels may be found in pregnancy and in estrogen therapy while ↓ levels may be encountered in severe illness , malnutrition , renal failure and during therapy with drugs like
propanolol.
14.Although ↑ TSH levels are nearly always indicative of Primary Hypothroidism ,rarely they can result from TSH secreting pituitary tumours.
DURING PREGNANCY - REFERENCE RANGE for TSH IN uIU/mL (As per American Thyroid Association)
1st Trimester : 0.10-2.50 uIU/mL
2nd Trimester : 0.20-3.00 uIU/mL
3rd Trimester : 0.30-3.00 uIU/mL
The production, circulation, and disintegration of thyroid hormones are altered throughout the stages of pregnancy.
REMARK-Assay results should be interpreted in context to the clinical condition and associated results of other investigations. Previous treatment with corticosteroid therapy may result in lower TSH
levels while thyroid hormone levels are normal. Results are invalidated if the client has undergone a radionuclide scan within 7-14 days before the test. Abnormal thyroid test findings often found in
critically ill patients should be repeated after the critical nature of the condition is resolved.TSH is an important marker for the diagnosis of thyroid dysfunction.Recent studies have shown that the
TSH distribution progressively shifts to a higher concentration with age ,and it is debatable whether this is due to a real change with age or an increasing proportion of unrecognized thyroid disease in
the elderly.
Page 13 of 13

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Name : Miss. KANCHAN GUPTA Patient UID.

*** End Of Report ***

AS PER AMERICAN DIABETES ASSOCIATION (ADA)

Non diabetic adults >=18 years < 5.7

At risk (Prediabetes) 5.7 - 6.4

Diagnosing Diabetes >= 6.5

*** End Of Report ***

POSSIBLE CAUSES OF ABNORMAL PARAMETERS:-

*** End Of Report ***

Serum calcium is decreased (hypocalcemia) in following conditions-

Serum calcium is Increased (hypercalcemia) in following conditions-

*** End Of Report ***

Ref : American Diabetes association standards of medical care.

*** End Of Report ***

*** End Of Report ***

*** End Of Report ***

TOTAL CHOLESTEROL mg/dl HDL mg/dl LDL mg/dl TRIGLYCERIDES mg/dl

*** End Of Report ***

*** End Of Report ***

*** End Of Report ***

Symptoms and Health risks of vitamin D deficiency

Causes of vitamin D deficiency

*** End Of Report ***

INTERPRETATION-Ultra Sensitive 4th generation assay

*** End Of Report ***

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