Re: Questions for Dr. Chung

Jason@xxxxxxxxxx (Jason) wrote in
news:Jason-2504071155510001@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx:

In article <Xns991D60310CCE2ccoughranucsdedu@xxxxxxxxxxxxx>, Charly
Coughran <ccoughran@xxxxxxxxxxxxxxxxxxxxxxxxx> wrote:

Jason@xxxxxxxxxx (Jason) wrote in
news:Jason-2404071452310001@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx:

Doctor Chung,

I have some questions re: to my latest blood test and urine test.


Reference ranges were listed on the blood test form for all items
except for these three items. Please check the PDR or other
reference books and list the standand reference ranges for these
three items:

This was NOT a 24 hour urine test--it was a spot test of urine.
urine sodium
urine potassium
urine chloride

Please comment on these results:
serum sodium 140 (135-145)
serum potassium 3.7 (3.5-5.1)
serum chloride 103 (98-107)

This was NOT a 24 hour urine electrolyte test--It was a spot test
of urine. urine sodium 20
urine potassium 25.3
urine chloride 26

TSH 7.56 high (0.27-4.2)

Differential
Eosinophils 6.5 high (0-4)

I found this quote in a book:

"Urine sodium concentration is useful in determining the cause of
hyponatremia. Urine sodium <20 mEq/L reflects sodium conservation
by the kidneys and is found in ECFV depletion and edematous
states CHF, nephrotic syndrome and cirrhosis."

I would appreciate your comments,
Jason



Published average reference ranges are useless in interpreting most
lab tests because there are inter lab variations of materials,
methods, and other circumstances. That is why they have reference
ranges printed with the results.

Further, lab tests cannot be interpreted in the absence of an exam
and a clinical history. For example, aspirin can affect TSH
results and a definitive interpretation would require T3 and T4
results as well.

Last, since the normal range is usually defined as + or - 2
standard deviations from the normal population mean, 95.4% of the
normal population is classified as having a value in the normal
range. This means that 2.3% of the normal population will test
slightly high and an equal number will test slightly low. If you
have a lab panel with a pile of tests, you become likely to be
slightly out of range on a test or two even if you are normal.

The disclaimers having been presented, you can get a wealth of
general information on lab test results at

http://www.labtestsonline.org/

~~~~~~~~~~~~~~~~~~~~

Charly,
Thanks--I'll visit the site. My doctor ignores items on blood tests
and urine tests that are within the reference ranges. That is the
major reason that I wanted the reference ranges for urine sodium,
urine potassium and urine chloride. If you have that info. in one of
your reference books, please post that information. I was not able
to find that info. in any website. I hope that the website that you
mentioned above has that information.
Thanks again,
jason

~~~~~~~~~~~~~~~~~~~~~~~~~



Let me reiterate. If you are given a standard reference value out of
some reference book, you will know no more than you do right now. If
you dig around the net, you can find a published normal range for
almost any test. That value will do you no good. Absent the normal
range for the laboratory which actually did the test, you cannot
interpret the test.

If you really feel compelled to chase meaningless numbers, a standard
reference in the field is _Tietz Textbook of Clinical Chemistry and
Molecular Diagnostics_. If there is a med school near you, their
library will have a copy. This is an area in which I would not trust
online sources.

--
-------
Charly Coughran
ccoughran@xxxxxxxxxxxxxxxxxxxxxxxxxx
.

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