Section 7.1 Laboratory

Laboratory Report #27

Date

Collection Date: December 7, 2022
Report Date: December 9, 2022

Laboratory

Labcorp

Ordering Physician

Dr. Billy R. Boring, Jr.

Report Type

Comprehensive Annual Health Evaluation

Laboratory testing included:

Complete Blood Count (CBC) with Differential
Comprehensive Metabolic Panel (CMP)
Routine Urinalysis
Lipid Panel
Hemoglobin A1c
Free T4
TSH
B-Type Natriuretic Peptide (BNP)

Original Report

PDF: Labcorp – December 7, 2022

One-Page Summary

Purpose of Testing

This comprehensive annual evaluation was performed approximately one year after the peak of your systemic inflammatory illness. The purpose was to assess overall health, monitor recovery from the inflammatory episode, evaluate cardiovascular and metabolic health, monitor thyroid replacement therapy, and establish a new long-term baseline. The results demonstrate that recovery remained stable, with continued normal blood counts, preserved kidney and liver function, and normal thyroid and cardiac markers. The principal ongoing concerns were elevated cholesterol and a Hemoglobin A1c that remained in the prediabetes range.

Major Findings

Complete Blood Count

Results

WBC: 6.1 ×10³/µL
Hemoglobin: 13.8 g/dL
Hematocrit: 42.1%
Platelets: 262 ×10³/µL

Interpretation

The complete blood count was entirely normal.

Compared with the inflammatory illness of 2021:

Hemoglobin improved from a low of approximately 11.4 g/dL to 13.8 g/dL.
Red blood cell count and hematocrit returned to normal.
White blood cell and platelet counts remained normal.

This confirms complete recovery from the inflammatory anemia that developed during the 2021 illness.

Kidney Function

Results

BUN: 21 mg/dL
Creatinine: 0.91 mg/dL
eGFR: 82 mL/min/1.73 m²

Interpretation

Kidney function remained excellent and stable.

There continued to be no laboratory evidence that the previous inflammatory illness caused lasting kidney injury.

Liver Function

Results

AST: 28 IU/L
ALT: 20 IU/L
Alkaline Phosphatase: 89 IU/L
Bilirubin: 0.4 mg/dL

Interpretation

Liver function tests remained comfortably within normal limits, demonstrating continued healthy hepatic function.

Electrolytes

Results

Sodium: 139 mmol/L
Potassium: 4.5 mmol/L
Chloride: 98 mmol/L
Carbon Dioxide: 27 mmol/L

Interpretation

Electrolytes were completely normal.

The significant hyponatremia (129 mmol/L) documented during the inflammatory illness in October 2021 remained fully resolved.

Lipid Profile

Results

Total Cholesterol: 226 mg/dL (High)
LDL Cholesterol: 151 mg/dL (High)
HDL Cholesterol: 60 mg/dL
Triglycerides: 86 mg/dL

Interpretation

The lipid profile continued to show mixed findings.

Positive features included:

HDL cholesterol remained protective.
Triglycerides remained low.

Areas for continued monitoring:

Total cholesterol increased slightly.
LDL cholesterol increased from 140 → 151 mg/dL and remained above the recommended range.

This pattern continued to support ongoing cardiovascular risk assessment and discussion with your cardiologist.

Metabolic Health

Results

Fasting Glucose: 96 mg/dL
Hemoglobin A1c: 5.7%

Interpretation

Fasting glucose remained normal.

Hemoglobin A1c decreased slightly from 5.8% to 5.7%, but remained within the laboratory’s prediabetes range. While this represents a slight improvement, continued monitoring and lifestyle management remained appropriate.

Thyroid Function

Results

Free T4: 1.36 ng/dL
TSH: 1.300 μIU/mL

Interpretation

Thyroid function remained well controlled. Both Free T4 and TSH were comfortably within the normal reference ranges, indicating effective thyroid hormone replacement therapy.

Cardiac Marker

B-Type Natriuretic Peptide (BNP)

Result

80.0 pg/mL

Reference Range:

0–100 pg/mL

Interpretation

BNP remained within the normal laboratory range.

Although higher than the value measured after recovery in 2021, it remained well below the abnormal level documented in August 2020 (612.9 pg/mL) and did not indicate laboratory evidence of significant cardiac stress. This result should be interpreted together with your cardiologist’s clinical assessment.

Urinalysis

Findings

No protein
No glucose
No blood
No ketones
No infection indicators

Minor observations:

Urine pH: 8.0 (slightly elevated)
Appearance: Cloudy

Microscopic examination was not indicated based on the routine findings.

Interpretation

Overall, the urinalysis was reassuring, with no evidence of kidney disease, urinary tract infection, or protein loss. The mildly alkaline pH and cloudy appearance, in the absence of other abnormalities, are generally nonspecific findings.

Overall Interpretation

This report documents excellent overall recovery and stable health one year after the inflammatory illness of 2021. Blood counts, kidney function, liver function, thyroid function, electrolytes, BNP, and urinalysis were all reassuring. The major ongoing laboratory findings were elevated LDL cholesterol and a Hemoglobin A1c that remained in the prediabetes range despite a normal fasting glucose. Overall, this report establishes a strong post-recovery baseline before your transition to the dietary changes that began in 2024.

Longitudinal Significance

This report contributes to:

CBC Trend Table
Kidney Function Trend Table
Liver Function Trend Table
Lipid Trend Table
Glucose Trend Table
Thyroid Trend Table
BNP Trend Table
Urinalysis Trend Table
Medical History Timeline

It represents your first comprehensive annual laboratory evaluation after recovery from the inflammatory illness.

Clinical Importance

⭐⭐⭐⭐⭐ Post-Recovery Baseline

This report is one of the most important long-term follow-up studies because it demonstrates that recovery from the 2021 inflammatory illness was sustained across virtually every major organ system. It also establishes the laboratory baseline immediately before the lifestyle and dietary changes that would later influence your metabolic profile.

Key Changes Since Previous Comprehensive Evaluation

Compared with April 2022:

Hemoglobin improved from 13.1 → 13.8 g/dL.
Kidney function remained stable.
Liver function remained normal.
Sodium remained normal (139 mmol/L).
Total cholesterol increased from 222 → 226 mg/dL.
LDL cholesterol increased from 140 → 151 mg/dL.
Hemoglobin A1c improved slightly from 5.8% → 5.7%.
BNP remained within the normal range (80 pg/mL).
Thyroid function remained stable.

Related Reports

October 13, 2021 – Peak Systemic Inflammatory Illness Evaluation
December 15, 2021 – Recovery Evaluation
April 12, 2022 – Recovery Monitoring Evaluation
Lipid Trend Table
Glucose Trend Table
BNP Trend Table
Thyroid Trend Table
Cardiovascular Summary
Medical History Timeline

Navigation

Previous Report: July/August 2022 – Specialized Mast Cell Evaluation Series
Next Report: 2023 Comprehensive Annual Laboratory Evaluation
Return to Laboratory Library
Return to Health Inventory

Observation

This report closes an important chapter in your Health Inventory. Looking back over the previous two years, the progression is remarkably clear:

2021: Severe systemic inflammatory illness with marked elevation of ESR and CRP, anemia, and hyponatremia.
2022: Recovery confirmed through repeated normalization of inflammatory markers and restoration of blood counts.
December 2022: A stable comprehensive annual evaluation demonstrating recovery across virtually every organ system.

From this point forward, your Laboratory Library begins a new phase. Rather than documenting recovery from illness, the focus shifts toward long-term optimization of cardiovascular, metabolic, and inflammatory health—the same areas that remain central to your current Health Inventory and discussions with your physicians.