What “numbers” do I need to know about myself?

September 13th, 2014

I often have patients who know the mileage of their cars or how much money they have in each bank account, but they don’t know the important numbers regarding their health.  The next time you have an annual physical with your healthcare provider, ask about these lab values and get a copy of your labs so you can keep them on file and can refer to them when needed.

• Total Cholesterol– this should generally be below 200 for everyone.  If you have a history of heart disease or diabetes, your physician may want to see this number even lower.
• LDL “Low Density Lipoprotein”, aka “Bad Cholesterol”– this should be lower than 160 for everyone, but should definitely be lower than 130 if you are over 50 years old.  If you have diabetes, heart disease, your goal should be even lower.
• HDL “High Density Lipoprotein”, aka “Good Cholesterol”– this should be as high as possible.  If this number is above 59, it is considered a marker of reduced  chance of heart disease (as long as your other cholesterol numbers are normal)
• Blood Pressure– Elevated blood pressure leads to heart disease and stroke.  Blood pressure consists of two numbers.  The top is called the “systolic” and should be no more than 150, and the bottom is called the “diastolic” which should be no more than 90.
• Body Mass Index– This is calculated from your body weight and height.  A body mass index of 25-29 means your are likely overweight and this increases your risk of diabetes and high blood pressure.  30 and above indicates you are obese.  In certain populations such as Asians and Latinos, body mass index may not be accurate (underestimates risk).  For example, an Asian woman with a BMI of 22 is likely at higher risk of cardiovascular disease than a Caucasian woman with the same numbers.
• Fasting Blood Sugar– This is a test that you do after an 8 hour fast.  It tests for diabetes and pre-diabetes.  Numbers below 100 are considered normal.  100-125 are considered pre-diabetic state, and 126 and above can indicate diabetes.  In general, it takes years to develop type 2 diabetes, with a gradual progression.  It is important to recognize a rising trend in fasting blood glucose early and take steps to prevent the onset of diabetes.
• Creatinine– This is a measure of kidney function and varies based on body mass.  A lower creatinine generally indicates improved kidney function.  People with diabetes and high blood pressure need to make sure that this number is as low as possible.  A rising creatinine can sometimes indicate poor blood pressure control or poor sugar control.
• AST/ALT-  These are liver enzymes.  Again, they should be as low as possible.  Elevations of AST/ALT can indicate inflammation of the liver, known as hepatitis.  Common causes of liver enzyme elevation are fatty liver (occurs when your cholesterol/saturated fat intake is high), acetaminophen(Tylenol) use, alcohol ingestion, and viral hepatitis (Hepatitis A, B, and C).  If you drink any amount of alcohol, it is important to make sure these numbers are normal.  Current recommendations are no more than 2 alcoholic drinks in 24 hours for men and no more than 1 drink for women.
• Hemoglobin-  This is a test for anemia.  A low number can indicate blood loss either from not being able to make enough blood (such as in iron-deficiency) or losing blood which may occur with colon cancer.  For this reason, any anemia that is found needs immediate and thorough work-up.