Blood Test

10 Lab Tests Every Woman Should Have

Staying on top of your health means not waiting until you're sick before you see a doctor. Troubleshoot with regular screening.

Regular screening means you can pick up on minor abnormalities and address them before they become a much bigger problem. Make time every six months to visit your GP and be sure to request these 10 lab tests every woman should have as part of a routine check-up.

1. Full Blood Count

This test gives the breakdown of the three main cell groups in your blood – red blood cells, white blood cells and platelets.

The red blood cells contain haemoglobin, a protein bound to iron. This is where the red colour comes from but also haemoglobin has the crucial role of carrying oxygen around the body, making it available for all cells to use for energy creation. Low haemoglobin levels are a clue that there is not enough blood in the system. This is either because not enough is being made, or too much is being lost. If not enough is being made that might indicate that either the body is low in essential nutrients like iron, B12 or folic acid. It may also hint at a problem with the bone marrow where blood cells are made. The kidneys also play a role in blood production, so patients with kidney disease often have reduced blood levels. Causes of blood loss leading to anaemia can include heavy menstruation or very slow blood loss from a stomach ulcer.

On the other hand, too much haemoglobin can make the blood too thick causing clots in the brain (stroke), heart (heart attack) or the lungs (pulmonary embolism). Too much haemoglobin can happen in heavy smokers as the body adapts to try to increase the oxygen carrying capacity of the blood, this also happens in high altitude regions where the air is lower in oxygen. The body compensates by creating more haemoglobin. Occasionally, too much haemoglobin might simply be the result of faulty overproduction by the bone marrow, a condition called polycythaemia.

The white blood cells are our army against infection. There are six main types of white blood cells that have roles to play in different types of infections. Some strains of white cells target bacteria, while others target viruses and fungal infections. Abnormal white cell counts can indicate acute infection, impaired immunity or even signal a problem with the bone marrow where white blood cells are produced.

The platelets help our blood to clot. If the platelet count is low, you will be more prone to bleeding. One of the most common causes of low platelet levels is liver damage, usually due excess alcohol. High platelet counts again make the blood too thick and sticky increasing the risk of blood clots. In both cases, abnormal platelet levels can be a sign that the bone marrow is not working properly.

2. Kidney Function

The kidneys are the cleansing and recycling system for our blood. But they do more than just that. They also produce hormones that are involved in regulating our blood levels and our bone strength. A kidney blood test actually includes six different components. But the most important two are urea and creatinine levels. They are combined into a formula that takes into account gender, age, ethnicity and average weight to give what is known as the estimated glomerular filtration rate (EGFR). The EGFR tells us whether the filtration mechanism of the kidneys is working properly. There are five stages of kidney disease with stage one being mild disease and stage five irreversible disease requiring dialysis or transplantation.

The two most common causes of kidney disease are diabetes and hypertension, they account for over two thirds of kidney disease cases. Since these two diseases are so widespread globally, it’s only a matter of time before kidney disease levels will increase to terrifying levels. Getting your kidneys checked regularly means that any early disease can be picked up and addressed, preventing progression to the more severe stages. Keeping your kidneys health very much comes down to improving lifestyle by losing weight and eating better, a lower sugar diet improves diabetes and a low salt diet improves blood pressure. Adequate hydration is also very important, your mum was right when she said to drink 8 glasses of water a day.

Liver Function Test

3. Liver Function

The liver is like the processing and distribution center of your body, carrying out over 300 separate, complex functions. It processes blood cells that are old and no longer needed and like the kidneys, helps the body recycle useful nutrients and chemicals through the biliary system. It also helps the body filter out toxins like alcohol. The liver plays a very important role in helping produce essential chemical complexes from cholesterol which is needed to make a number of hormones, including all your sex hormones, to blood clotting factors that keep your blood at just the right level of runniness. It’s also so an energy storage powerhouse and plays a very important role in supporting your immune system. 

A liver function tests looks at a few different components including protein, liver enzyme levels and bilirubin levels. Abnormal protein levels may indicate a problem with your immune system. Raised liver enzymes are most commonly caused by liver inflammation either due to alcohol or poor diet. A healthy liver should look like a very lean cut of steak. An inflamed liver starts to get a marbling effect, looking more like a ribeye steak. This is called fatty liver. For people who are overweight or obese, elevated liver enzymes can be a warning sign that you are headed towards diabetes. Abnormal liver enzymes not caused by alcohol or diet, might be a sign of infection including hepatitis. In most cases, the liver can be restored to health simply by making better lifestyle choices like reducing alcohol, cutting down on fructose containing foods and losing weight. But left unchecked, fatty liver can lead to permanent liver damage called cirrhosis. 3% of people with cirrhosis will go on to develop liver cancer.

4. Calcium

Calcium is a multitasker and has many roles in the body. It helps your circulatory system pump blood around your body, it’s necessary for muscle contraction, it carries messages between your brain cells allowing the brain to send instructions to the rest of the body. And of course, we all know that we need calcium to maintain bone strength and dental health. If you aren’t getting enough calcium in your diet, your body will start removing it from the bones leading to bone weakness and pain, increasing the risk of bone fractures. Calcium levels that are too high may signify a problem with the parathyroid gland. After menopause, women slowly lose bone density over time putting them at higher risk for serious bone fractures and this makes it even more important to take care of your bones when you are young so that they will withstand the inevitable thinning that happens with ageing.

Vitamin D Test

5. Vitamin D

Vitamin D is known as the sunshine vitamin.  UVB radiation on our skin converts cholesterol into vitamin D. It is a wonder vitamin known best for its importance in maintaining bone strength. But also, vitamins D has other amazing properties. It helps strengthen the immune system adding a protective advantage against infection. It plays a pivotal role in the brain by keeping calcium, the brain messenger, in balance. Vitamin D also helps reduce depression and can help with mood stability. Some studies suggest it may even promote weight loss. Vitamin D deficiency has been linked to a number of health problems such as dementia, diabetes, autism, schizophrenia and various cancers.

6. Lipids

Many people know of this as a cholesterol test. It’s important to get a full lipid profile checked which includes not only good (high density lipoprotein HDL) and bad (low density lipoprotein LDL) cholesterol, but also triglycerides. The danger with high cholesterol especially LDL and triglycerides, is that they are a major risk factor for heart disease. Imagine emptying oil from a frying pan down your kitchen sink drain. Over time that oil builds up inside the plumbing eventually leading to a blockage and you need to get the plumber in. It’s the same principle with the body. Too much cholesterol circulating in your bloods overtime causes blockages in the arteries causing heart attacks and strokes.  

7. Thyroid Function

The thyroid gland is a very important organ situated at the base of the neck. Its role is to control metabolism in the body, essentially how effectively you burn energy. About 12% of people have thyroid problems and women are up to 8 times more likely than men to have thyroid disturbance. This can happen in two ways. If the thyroid gland is over-active you may experience weight loss, palpitations, anxiety and even loss of periods. In the long term an untreated overactive thyroid can lead to bone thinning and heart problems. An underactive thyroid is much more common and causes weight gain, hair loss, depression and heavy periods. Other than feeling awful, the danger of an untreated underactive thyroid is that it is linked to higher cholesterol levels that increase the risk of serious cardiovascular complications like heart attacks. Any type of thyroid disease can cause infertility.

iron rich spinach

8. Iron

Iron is the element that makes our blood the beautiful red colour that it is. Iron – haem, is bound to protein – globulin, in our blood, creating haemoglobin, the compound that takes inhaled oxygen from our lungs and transports it all around the body for use in energy production. Without iron, our cells become starved of oxygen and can’t perform their functions properly. Low iron levels cause lethargy, shortness of breath, chest pains, palpitations, lack of sex drive and even depression. Women are at particular risk of low iron because of our monthly cycles. Other groups at risk of iron deficiency are vegetarians and vegans. Too much iron is also dangerous. Hereditary haemochromatosis is a common genetic disorder that causes too much iron to be stored in the body. The symptoms of iron overload can include headaches, abdominal pain, lethargy, joint pains, loss of libido and more seriously liver and heart problems.

9. Hba1c

Glycated haemoglobin (hba1c) is a test that measures how much haemoglobin in the blood stream has sugar attached to it. If there is too much sugar in the blood stream, the hba1c level rises and this can be an indication of pre-diabetes or diabetes. In recent years, the hba1c has become recognised as a suitable alternative diagnostic test for diabetes. Traditionally, a diabetes test called the glucose tolerance test, involved fasting, drinking a glucose load and staggered blood tests over a two-hour period. The hba1c is less labour intensive and in some places, such as where I work, there are point of care machines which give you a result in 7 minutes from a simple finger prick test!

10. ACR

This one is actually a urine test but it is really important for screening of very early kidney disease that may not yet show up on a blood test. The albumin creatinine ratio (ACR) looks for protein in the urine. Healthy kidneys should be recycling protein back into the body. But where there is microscopic damage to the kidneys for example from obesity or high blood pressure or diabetes, the kidneys become a bit leaky and protein starts appearing in the urine. Protein in the urine is not only a marker of early kidney disease, it is also associated with an increased cardiovascular risk.

The takeaway is to stay on top of your health by being ahead of any problems with regular screening starting with these 10 lab tests every woman should have. 7% of hospital admissions each year could have been prevented by regular check-ups with a GP. You don’t wait for your teeth to fall out before you see a dentist, so why would you wait for your body to fall apart before you see a doctor?

If you have anything you want to ask, or if there’s a topic you’d like me to write about just let me know.

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