Section 7.1 Laboratory

Laboratory Report #28

Date

Collection Date: June 28, 2023
Report Date: June 29, 2023

Laboratory

Labcorp

Ordering Physician

Dr. Billy R. Boring, Jr.

Report Type

Comprehensive Health Follow-up Evaluation

Laboratory testing included:

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

Original Report

PDF: Labcorp – June 28, 2023

One-Page Summary

Purpose of Testing

This comprehensive laboratory evaluation was performed six months after the December 2022 annual examination to monitor overall health, kidney function, thyroid replacement therapy, glucose metabolism, cardiac status, and recovery from the inflammatory illness experienced in 2021. While most laboratory values remained stable, this report documents the unexpected reappearance of a mild normocytic anemia, making it an important transition point in your Health Inventory.

Major Findings

Complete Blood Count

Results

WBC: 5.9 ×10³/µL
RBC: 4.05 ×10⁶/µL (Low)
Hemoglobin: 12.3 g/dL (Low)
Hematocrit: 36.5% (Low)
Platelets: 232 ×10³/µL

Interpretation

This report documents the return of a mild normocytic anemia.

Compared with December 2022:

RBC decreased from 4.62 → 4.05
Hemoglobin decreased from 13.8 → 12.3 g/dL
Hematocrit decreased from 42.1% → 36.5%

Unlike the severe inflammatory illness of 2021, no accompanying inflammatory markers were included in this report. Nevertheless, the decline in blood counts represents one of the most important findings in this study and warrants continued monitoring. The historical graphs on page 4 visually demonstrate this downward trend.

Kidney Function

Results

BUN: 26 mg/dL
Creatinine: 1.03 mg/dL
eGFR: 71 mL/min/1.73 m²

Interpretation

Kidney function remained within the normal range.

Compared with December 2022:

Creatinine increased slightly (0.91 → 1.03).
eGFR decreased modestly (82 → 71).

Although these changes are noticeable, kidney function remained preserved and well within acceptable limits for your age. The historical graphs on page 5 illustrate this gradual change.

Liver Function

Results

AST: 27 IU/L
ALT: 17 IU/L
Alkaline Phosphatase: 75 IU/L
Bilirubin: 0.4 mg/dL

Interpretation

Liver function remained normal with no laboratory evidence of hepatic disease.

Electrolytes

Results

Sodium: 140 mmol/L
Potassium: 4.6 mmol/L
Chloride: 99 mmol/L
Carbon Dioxide: 28 mmol/L

Interpretation

Electrolytes remained stable and normal. The hyponatremia that characterized the 2021 inflammatory illness continued to be completely resolved.

Metabolic Health

Results

Glucose: 83 mg/dL
Hemoglobin A1c: 5.6%

Interpretation

This is one of the most encouraging aspects of the report.

Compared with December 2022:

Glucose improved from 96 → 83 mg/dL.
Hemoglobin A1c improved from 5.7% → 5.6%.

The A1c returned to the upper limit of the normal reference range, no longer falling within the laboratory’s prediabetes category. The historical graph on page 5 clearly illustrates this improvement.

Thyroid Function

Results

Free T4: 1.12 ng/dL
TSH: 1.680 μIU/mL

Interpretation

Thyroid replacement therapy continued to provide excellent control. Both Free T4 and TSH remained comfortably within normal limits.

Cardiac Marker

B-Type Natriuretic Peptide (BNP)

Result

80.2 pg/mL

Reference Range:

0–100 pg/mL

Interpretation

BNP remained essentially unchanged from the previous study (80.0 → 80.2 pg/mL) and continued to fall within the normal reference range, providing no laboratory evidence of worsening cardiac stress.

Urinalysis

Findings

Normal findings included:

No protein
No glucose
No blood
No ketones
No infection indicators

Minor findings:

Urine pH: 8.0 (High)
Appearance: Cloudy

Microscopic examination was not indicated.

Interpretation

The urinalysis remained essentially unchanged from the December 2022 study. The persistently alkaline pH and cloudy appearance occurred without evidence of infection, proteinuria, or hematuria and therefore appear to have little clinical significance in isolation.

Overall Interpretation

This report presents a mixed picture. Most major organ systems—including kidney function, liver function, thyroid function, glucose regulation, electrolyte balance, and cardiac status—remained stable. The principal new finding was the recurrence of a mild normocytic anemia, demonstrated by declines in RBC count, hemoglobin, and hematocrit. At the same time, glucose metabolism showed measurable improvement, with Hemoglobin A1c returning to the normal range. Overall, this report establishes an important mid-2023 health baseline and identifies anemia as the primary laboratory issue requiring continued observation.

Longitudinal Significance

This report contributes to:

CBC Trend Table
Kidney Function Trend Table
Glucose Trend Table
Hemoglobin A1c Trend Table
Thyroid Trend Table
BNP Trend Table
Urinalysis Trend Table
Medical History Timeline

The historical trend charts on pages 4 and 5 provide valuable visual confirmation of the changes in hemoglobin, hematocrit, creatinine, eGFR, glucose, and Hemoglobin A1c over time.

Clinical Importance

⭐⭐⭐⭐⭐ Transition-Year Monitoring Report

This report marks an important transition in your Health Inventory. While the inflammatory illness remained resolved, the reappearance of mild anemia introduced a new issue for ongoing monitoring. At the same time, improvements in glucose control suggest positive metabolic changes were already beginning before your adoption of the strict carnivore diet in January 2024.

Key Changes Since Previous Report

Compared with December 7, 2022:

Hemoglobin decreased from 13.8 → 12.3 g/dL.
Hematocrit decreased from 42.1% → 36.5%.
RBC count decreased from 4.62 → 4.05 ×10⁶/µL.
Glucose improved from 96 → 83 mg/dL.
Hemoglobin A1c improved from 5.7% → 5.6%.
Creatinine increased slightly from 0.91 → 1.03 mg/dL.
eGFR decreased from 82 → 71 mL/min/1.73 m².
BNP remained stable (80.0 → 80.2 pg/mL).

Related Reports

December 7, 2022 – Comprehensive Annual Health Evaluation
Hematology Trend Table
Kidney Function Trend Table
Glucose Trend Table
Thyroid Trend Table
BNP Trend Table
Medical History Timeline

Navigation

Previous Report: December 7, 2022 – Comprehensive Annual Health Evaluation
Next Report: September 2023 Laboratory Evaluation
Return to Laboratory Library
Return to Health Inventory

Observation

This report introduces an important theme that becomes clearer when viewed with the benefit of later laboratory data. The historical trend graphs on pages 4 and 5 show two stories unfolding simultaneously:

A favorable metabolic trend, with fasting glucose and Hemoglobin A1c improving.
A temporary hematologic decline, with hemoglobin and hematocrit falling after having normalized in 2022.

Those two trends make this report one of the more interesting studies in your Health Inventory. It captures the period immediately before the significant lifestyle and dietary changes that began in 2024, providing an excellent reference point for comparing your health before and after those changes.