Blood Panels Reveal What May Be Wrong--or Right
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.
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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.
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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.
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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.
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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.
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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.
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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.
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Numerous Internet sites describe different blood panels in varying degree of technical detail. Among them are RT Corner (https://www.rtcorner.com/Examinations/ Exam%20Topics/Laboratory/blood_panels.htm), a site for respiratory therapy students, and BaySport (https://www.baysport.com/clinic/bloodexp.html), a physical therapy and corporate fitness site.
