Section 7.1 Laboratory

Laboratory Report #31

Date

Collection Date: November 13, 2023
Report Date: November 14, 2023

Laboratory

Labcorp

Ordering Physician

Dr. Billy R. Boring, Jr.

Report Type

Comprehensive Annual Health Evaluation and Anemia Recovery Assessment

Laboratory testing included:

Complete Blood Count (CBC) with Differential
Comprehensive Metabolic Panel (CMP)
Urinalysis
Lipid Panel
Iron and Total Iron Binding Capacity (TIBC)
Vitamin B12 and Folate
Cortisol
ACTH
Magnesium
Ferritin

Original Report

PDF: Labcorp – November 13, 2023

One-Page Summary

Purpose of Testing

This comprehensive laboratory evaluation was performed approximately two months after the September 2023 evaluation that documented the lowest hemoglobin level of the 2023 anemia episode. The primary goals were to:

Determine whether the anemia was improving or worsening.
Evaluate possible nutritional causes of anemia.
Reassess iron status.
Monitor kidney function, metabolic health, cardiovascular risk factors, thyroid-related health, and overall wellness.

This report is a major turning point in the Health Inventory because it documents complete recovery of hemoglobin levels without evidence of iron deficiency, inflammation, autoimmune disease, or kidney dysfunction as the cause of the prior anemia.

Major Findings

1. Complete Blood Count (CBC)

Results

Test	Result	Interpretation
WBC	4.3 ×10³/µL	Normal
RBC	4.36 ×10⁶/µL	Normal
Hemoglobin	13.1 g/dL	Normal
Hematocrit	39.7%	Normal
MCV	91 fL	Normal
Platelets	183 ×10³/µL	Normal

Interpretation

This report documents a remarkable improvement in the anemia trend.

Hemoglobin Trend

Date	Hemoglobin
December 2022	13.8
June 2023	12.3
July 2023	11.8
September 2023	11.3
November 2023	13.1

The hemoglobin increase from 11.3 → 13.1 g/dL represents a return to the normal reference range.

The anemia remained:

Normocytic
Normochromic
Temporary

The historical graph on page 4 clearly demonstrates the recovery pattern.

2. Iron Evaluation

Results

Iron

95 µg/dL

TIBC

287 µg/dL

Iron Saturation

33%

Ferritin

95 ng/mL

Reference Range:

Ferritin: 30–400 ng/mL

Interpretation

Iron status was normal.

Findings:

Adequate iron availability.
Normal iron storage.
No evidence of iron deficiency anemia.

This confirms that the 2023 anemia was not caused by insufficient iron.

3. Vitamin Evaluation

Vitamin B12

Result

>2000 pg/mL

Reference Range:

232–1245 pg/mL

Flag: High

Folate

Result

>20.0 ng/mL

Reference Range:

3.0 ng/mL

Interpretation

Both vitamin levels were more than adequate.

The elevated B12 likely reflects supplementation rather than disease.

These results exclude:

Vitamin B12 deficiency
Folate deficiency

as explanations for the earlier anemia.

4. Kidney Function

Results

BUN: 23 mg/dL
Creatinine: 1.01 mg/dL
eGFR: 72 mL/min/1.73 m²

Interpretation

Kidney function remained stable.

The trend chart on page 5 demonstrates:

Creatinine remained within a narrow range.
eGFR remained above 59.

There is no laboratory evidence that kidney disease contributed to the anemia.

5. Liver Function

Results

AST: 31 IU/L
ALT: 30 IU/L
Alkaline Phosphatase: 67 IU/L
Bilirubin: 0.5 mg/dL

Interpretation

Liver function remained normal.

6. Urinalysis

Results

Normal:

No protein
No glucose
No blood
No ketones
Negative nitrite
Negative leukocyte esterase

Minor finding:

pH: 8.0 (slightly alkaline)

Interpretation

Urinalysis was reassuring.

No evidence of:

Kidney protein loss
Urinary infection
Blood loss through urine

7. Lipid Panel

Results

Test	Result
Total Cholesterol	249 mg/dL
LDL Cholesterol	151 mg/dL
HDL Cholesterol	88 mg/dL
Triglycerides	60 mg/dL

Interpretation

The lipid pattern is notable:

Positive:

HDL increased significantly (60 → 88).
Triglycerides remained very low (60).

Area for continued discussion:

LDL remained elevated at 151 mg/dL.

The cardiovascular trend table on page 5 shows LDL stability since December 2022.

8. Hormonal and Metabolic Testing

Cortisol

7.1 µg/dL

ACTH

22.4 pg/mL

Magnesium

2.3 mg/dL

Interpretation

These values were within expected laboratory ranges and did not suggest adrenal dysfunction.

Overall Interpretation

This November 2023 laboratory evaluation represents one of the most important reports in your Health Inventory. It documents that the unexplained normocytic anemia seen throughout mid-2023 resolved spontaneously.

The evaluation also demonstrated:

Normal iron stores
Normal vitamin levels
Stable kidney function
Normal liver function
Normal urinalysis
Stable metabolic health
Stable thyroid-related status (previously documented)
No evidence of autoimmune disease

The cause of the temporary anemia remains uncertain, but the resolution without intervention is a major finding.

Longitudinal Significance

This report contributes to:

CBC Trend Table
Hemoglobin Trend Table
Hematocrit Trend Table
Ferritin Trend Table
Iron Status Trend Table
Kidney Function Trend Table
Lipid Trend Table
Medical History Timeline
Section 3.7 – History of Systemic Inflammatory Illness

Clinical Importance

⭐⭐⭐⭐⭐ Major Recovery Milestone

This report closes the 2023 anemia episode.

The sequence:

September 2023: Hemoglobin 11.3
November 2023: Hemoglobin 13.1

shows a significant spontaneous recovery.

This is important because it demonstrates that:

The anemia was not progressive.
The anemia was not caused by iron deficiency.
The anemia was not associated with kidney failure.
The anemia was not associated with obvious autoimmune disease.

Key Changes Since Previous Report

Compared with September 12, 2023:

Hemoglobin improved 11.3 → 13.1 g/dL.
Hematocrit improved 33.9% → 39.7%.
RBC improved 3.73 → 4.36 ×10⁶/µL.
Ferritin decreased slightly but remained normal (144 → 95 ng/mL).
Creatinine remained stable (0.93 → 1.01 mg/dL).
LDL remained unchanged (151 mg/dL).
HDL improved (60 → 88 mg/dL).

Related Reports

September 12, 2023 – Anemia Evaluation
July 19, 2023 – CBC Follow-up
June 28, 2023 – Comprehensive Evaluation
December 7, 2022 – Annual Health Evaluation
Hematology Trend Table
Cardiovascular Trend Table
Medical History Timeline

Navigation

Previous Report: September 12, 2023 – Anemia Evaluation
Next Report: 2024 Laboratory Evaluation
Return to Laboratory Library
Return to Health Inventory

Observation

This report is particularly valuable when preparing for future physician visits because it shows the complete story of the 2023 anemia:

June–September 2023: Progressive normocytic anemia developed.
September 2023: Lowest point (Hemoglobin 11.3).
November 2023: Full recovery documented.

The workup also shows what was not responsible:

Not iron deficiency.
Not B12 deficiency.
Not folate deficiency.
Not kidney disease.
Not obvious autoimmune disease.

This is exactly the type of longitudinal information that transforms the Health Inventory from a collection of isolated lab reports into a meaningful medical history.