Dr. Basuki Nath Bhagat
Family Physician
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I just had my annual laboratory report. I am a 72-year-old male, 5 feet 11 inches, weighs 152 lbs, and have a cholesterol of 135 mg/dL. Several values were out of range for the first time: WBC 3400 per microliter of blood, monocytes 12 %, CO2 32 mEq/L, and protein 6.1 g/dL. Are these all somehow related, and what might they suggest? All other values are normal. I have zero symptoms and exercise aggressively daily (swim, bike, walk, 1400 to 1600 'active' calories burned). I have zero symptoms, other than perhaps, and I believe I am in excellent health. I am taking Amlodipine 10, Atorvastatin 80, Advair, Tamsulosin, Omeprazole 20, and Montelukast 10.
Hi,
Welcome to icliniq.com.
I understand your concern.
It is good to read that you maintain a daily habit of exercise.
You have mentioned the following laboratory values:
WBC (white blood cells): 3400 per microliter of blood.
Monocytes: 12 %.
Total protein: 6.1 g/dL.
CO2 (carbon dioxide): 31 mEq/L.
The normal white blood cell count range is between 4,000 and 11,000 per microliters. You have the value of WBC, which is just below the lower limit. At this value, there is nothing to worry about. What are the RBC (red blood cells), Hb (hemoglobin), and platelet count levels? Normal monocytes range is between 2 % to 8 %. Your value is 12 % means it is high and might suggest some response to infection. If it is due to some infection, the overall WBC count should be high, but the WBC count is low. You do not have any symptoms, and hence this value is not alarming. However, you should repeat the test after a few weeks. Normal values of CO2 in adults are 23 to 30 mEq/L. Do you have a habit of smoking?
Can you share the rest of the ABG (arterial blood gas) values to correlate better?
The normal serum protein level is 6 to 8 g/dl. Your value is 6.1 g/dl which is within the normal range and suggests adequate protein intake in the diet. All the slight out-of-range values are not alarming, and I need a reply to the above questions and if there is any other medical history, if available, to correlate laboratory values. Please reply to the above questions to guide you further.
I hope you find it helpful.
Kind regards.
Patient's Query
Hi doctor,
The hospital laboratory where my blood was drawn has slightly different ranges than those you refer to. It has a WBC normal range beginning at 4500 per microliter, monocytes top of the normal range is 10.0 %, C02 top of the range at 31 m, and total protein normal range beginning at 6.4 g/dL. So a little higher on two of these, and a little lower on the other two, as compared to your references above. I do not smoke tobacco. RBC is 4.72 million cells per microliter, hemoglobin is 15.1 grams per deciliter, and platelets are 171,000 per microliter of blood, which I consider low to normal. I see globulin at 2.0 g/dL, albumin at 4.1, bilirubin at 0.8 g/dl, and the A/G ratio at 2.1. I appreciate any additional analysis you can share. Thank you again.
Hi,
Welcome back to icliniq.com.
I understand your concern.
Each laboratory has a slightly different range of values of a particular parameter. WBC is usually in the range of 4,500 to 11,000 WBCs per microliter. Your other CBC (complete blood count) parameters are normal and within the range. I am looking at RBC and platelet values to see whether they are in the range or below the lower limit. Your RBC and platelet values are in the range, meaning the bone marrow is working fine.
The present WBC count is leukopenia, but this value is not alarming given that there are no symptoms. Therefore, I suggest a repeat CBC test after a one-month gap and a differential count look at WBC and monocyte count. CO2 is just above the normal upper limit. It has a huge differential interpretation, which should be narrowed down according to medical history and other ABG values like bicarbonate value, O2 value, pH of the blood, etc. I would need parameters, as mentioned earlier, values of ABG to analyze CO2 level value but do not worry about it. This value is also not alarming, and I suggest continuing your daily exercise.
Your protein and differential protein parameter is normal and signifies good nutritional health. I am glad to read that at the age of 72, you are doing aerobic exercise daily, and laboratory values are almost normal except a few, which is also not alarming. If you redo the test again, you can follow this chat to easily compare the laboratory values, which is the interpretation if required. The above laboratory values would become normal till then. Please follow up if you have any further related queries about it.
I hope you find it helpful.
Kind regards.
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