Which Blood Tests are Recommended for Athletes?


Your blood is vital to your health, it is the lifeline to every organ in the body and it is a goldmine in terms of health monitoring. Any significant alteration will impair your performance often to the level you feel weak and fatigued. Why do you think athletes such as Lance Armstrong went to extreme lengths to blood dope? Anyway, here is a quick primer on blood components and what is worth measuring as a health check up.


Let us start with investigation of fatigue. Where fatigue is due to a medical cause the main things to rule out are anaemia and vitamin deficiency. Here is a good guide to finding what is wrong:


Athletes go through their red blood cells and iron stores more quickly than the average 120 days adult, typically in half this time. This is presumably due to the combination of blood loss and mechanical stress causing red blood cell breakdown (but also sweat loss, inflammation loss, and micro bleeding). Iron is continuously being lost during exercise, there is no innate mechanism to replace it, so sufficient iron must either come through the diet or supplementation

The amount of ferritin in the blood reflects the total level of iron stored within your body. Ferritin levels can be raised due to inflammation. Very high levels of ferritin indicate a large build up of iron in the body which can be due to a hereditary condition called haemochromatosis. Low ferritin levels are often caused by iron deficiency which can lead to anaemia and the production of small red blood cells. A high iron diet would include red meat, shellfish, spinach, liver, legumes, pumpkin seeds, sesame seeds, quinoa, turkey, broccoli, tofu, dark chocolate, oats, sesame seeds, coconut milk, and fortified cereals,green leafy vegetables, seeds, beans and dried fruit.

Now let’s consider a more general blood workup, for lipids (fats), glucose (sugar), hormones and inflammation………

Lipids and Blood Count

Lipid Profile is used to help determine heart disease risk and to help decide treatment if you are borderline or high risk. The results of the lipid profile and other known risk factors of heart disease are considered to develop treatment and follow-up. Depending on your results and other risk factors, treatment options may involve diet and exercise changes or lipid-lowering medications such as statins. Test Includes: Cholesterol, HDL (the “good” cholesterol), LDL (the “bad” cholesterol), VLDL, Triglycerides, and the Ratio of Good cholesterol to total.

Complete Blood Count (CBC) With Differential and Platelets: A complete blood count (CBC) gives important information about the numbers and kinds of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your health professional check any symptoms, such as fatigue, weakness, or bruising, that you may have. A CBC also helps your health professional diagnose conditions, such as infection, anemia, and several other disorders. Test includes: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelets, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs).

White Blood Count = 5.0–7.5

Neutrophils = 40–60%. Higher = viruses, autoimmunity, or detoxification challenges

Monocytes = 0–7%. Higher = liver dysfunction, prostate problems, or recovering from infection (or Epstein Barr virus)

Eosinophils = 0–3%. Higher = food sensitivities, environmental allergies, or parasites

Basophils = 0–1%. Higher = tissue inflammation

Metabolic Profile

Metabolic Panel (Fluids & Electrolytes) is a group of laboratory tests ordered to give information about the current status of your liver, kidneys, and electrolyte and acid/base balance, blood sugar and blood proteins. Blood sugar level, the most direct test to discover diabetes or prediabetes, may be used not only to identify diabetes, but also to evaluate how one controls the disease. Sodium One of the major salts in the body fluid, sodium is important in the body’s water balance and the electrical activity of nerves and muscles.
Potassium Helps to control the nerves and muscles. Chloride Similar to sodium, it helps to maintain the body’s electrolyte balance. Carbon Dioxide Used to help detect, evaluate, and monitor electrolyte imbalances. Calcium A mineral essential for development and maintenance of healthy bones and teeth. It is important also for the normal function of muscles, nerves and blood clotting).

Liver panel Protein, Total Together with albumin, it is a measure of the state of nutrition in the body. Albumin Serum one of the major proteins in the blood and a reflection of the general state of nutrition. Globulin, Total A major group of proteins in the blood comprising the infection fighting antibodies. Albumin/Globulin Ratio Calculated by dividing the albumin by the globulin. Bilirubin, Total A chemical involved with liver functions. High concentrations may result in jaundice. Alkaline Phosphatase A body protein important in diagnosing proper bone and liver functions. Aspartate Aminotransferase (AST or SGOT) an enzyme found in skeletal and heart muscle, liver and other organs. Abnormalities may represent liver disease. Alanine Aminotransferase (ALT or SGPT) an enzyme found primarily in the liver. Abnormalities may represent liver disease. |

Hormones and Proteins

C-Reactive Protein (CRP) Blood Test, High Sensitivity (Cardiac Risk Assessment): A C-reactive protein (CRP) test is a blood test that measures the amount of C-reactive protein in your blood. C-reactive protein measures general levels of inflammation in your body, high levels of CRP are caused by infections and several long-term diseases. However, a CRP test cannot show where the inflammation is located or what is causing it, other tests will be needed to find the cause and location of the inflammation.

Testosterone Free (Direct) Serum Test with Total Testosterone: High free testosterone in men and women can have significant impacts on health and behavior. Testosterone is believed to play an important role in bone and muscle strength and libido in women. Testosterone is a steroid hormone (androgen) that is produced by special endocrine tissue (the Leydig cells) in the male testes. Its production is controlled and controlled by luteinizing hormone (LH), which is manufactured in the pituitary gland. Testosterone works within a negative feedback mechanism, so as testosterone increases, LH decreases, while increased LH causes decreased testosterone. Testosterone levels are diurnal and peak in the early morning hours (about 4:00 to 8:00 am), and have the lowest levels in the evening (about 4:00 to 8:00 pm). Levels increase after exercise as well, but decrease with age. Nearly two-thirds of testosterone circulates in the blood bound to sex-hormone binding protein and slightly less than one-third is bound to albumin. A small percent circulates in the blood as free testosterone. The concentration of free testosterone is very low, normally 50% of total circulating testosterone is bound to sex hormone-binding globulin, SHBG, and most of the remaining is bound to albumin.

Aldolase: An enzyme that helps convert glucose into energy. It is found throughout the body but is primarily found in high levels in muscle tissue. It is elevated in the bloodstream when a patient has muscle or liver damage or disease. High levels are found in progressive Duchenne muscular dystrophy (MD). Elevations occur in carriers of MD, in limb-girdle dystrophy and other dystrophies, in dermatomyositis, polymyositis, and trichinosis, but not in neurogenic atrophies (eg, multiple sclerosis or in myasthenia gravis).

Growth Hormone (HGH) Serum Test: HGH is one of several endocrine hormones such as progesterone, testosterone, estrogen, melatonin and DHEA that decline in production as we age. As the name suggests, human Growth Hormone is an endocrine hormone that makes humans grow. HGH is critical for tissue repair, muscle growth, healing, bone strength, brain function, physical and mental health, energy, and metabolism. The rate that HGH is produced at peaks during adolescence, at time when normal growth is accelerated and production of HGH will decrease with age, 14% each year on average. While GH is not as active in adults, it aids in regulating bone density, muscle mass, and lipid metabolism. Deficiencies can lead to decreased less muscle mass, bone densities, and altered lipid levels.

Homocysteine, an amino acid normally found in the body has a metabolism that is linked to that of several vitamins, especially folic acid, B6, and B12, and deficiencies of those vitamins may cause elevated levels of homocysteine. Studies suggest that those with elevated homocysteine levels have a much greater risk of heart attack or stroke than those with average levels. Increased concentrations of homocysteine have been associated with increased tendency to form in appropriate blood clots. This can lead to heart attack, strokes, and blood vessel blockages in any part of the body.


Glucose Health looks for diabetes, prediabetes and related problems with glucose control.

Haemoglobin A1c (HbA1c) is formed from glucose and haemoglobin. The amount of HbA1c is directly correlated to the amount of glucose in your bloodstream and provides an average picture of glucose levels over the last 2–3 months. It is therefore considered one of the best indicators for pre-diabetes and is also used by people with diabetes to keep their levels in control. If you are not a known diabetic and your levels are above the normal range, try the following

  • Quit smoking to get hemoglobin A1c levels down.
  • Eat balanced and healthy diet
  • Exercise, losing weight
  • Adopt a healthy lifestyle to keep your blood sugar levels in control.

Insulin Optimal value = 2–5 μIU/ml

Low fasting insulin can be an excellent market for assessing longevity, correlating to glycemic variability — essentially how often your blood sugar is elevated. A high fasting insulin level is associated with a greater risk of cancer mortality. In addition, cancer patients who eat the highest amount of insulin-producing foods experience worsened cancer and increased overall mortality. Furthermore, high insulin levels can predict cancer mortality, even when controlling for variables such as diabetes, obesity and metabolic syndrome. In older adults with type 2 diabetes, the level of insulin use also predicts mortality.

An interesting fact is that hypertension is an early indicator of insulin resistance. As insulin levels increase, a hormone called aldosterone also increases. Aldosterone causes us to retain sodium, which causes us to retain water. Reducing dietary sodium has a modest effect on hypertension but does not address the root cause of elevated insulin levels. It only works for a small subset of people.

Finally, let’s look at a wide range of possible blood screening tests……



Vitamin B12 is absorbed by the body through diet and is often measured alongside folate. Like folate it has an important role to play in the production of healthy red blood cells but also has a function in nerve health. Both vitamin B12 and folate should be kept within the normal range to avoid different forms of anaemia and therefore to keep energy levels at normal levels. Deficiencies in B12 can lead to anaemia.


Alanine aminotransferase (ALT) is an enzyme found mostly in the liver. Only small amounts are usually found in the blood. However, if the liver or your muscles are damaged an increased level of ALT will be released into the bloodstream. ALT can therefore be elevated due to excessive alcohol and also after strenuous exercise. To keep your liver healthy keep your alcohol intake within recommended guidelines and include nutrient dense sources of food such as whole grains, fruit and vegetables in your diet.


Albumin (ALB) is a protein made in the liver which circulates in the blood. The amount of albumin in the blood is directly associated with liver function and nutritional health. Low levels are associated with problems in the liver or kidneys and is also linked to severe inflammation. A decreased level of albumin is also apparent when your body cannot absorb nutrients sufficiently, for example in low protein diets. Higher than normal levels can indicate dehydration. As albumin has a key role in the transportation of calcium it can also be used as a marker in the assessment of bone health.


Alkaline phosphatase (ALP) is an enzyme found in several tissues including the liver, bone, kidney and bowel. High levels are most commonly associated with problems in the liver or bone. Levels of ALP can also increase when the body is healing fractures or during pregnancy. To ensure your levels are in the healthy range eat a healthy diet and keep alcohol intake within recommended guidelines. Try and balance your overall energy intake according to your body’s requirements and eat a high level of nutrient rich foods such as whole grains, fruit and vegetables.


Basophils help to protect the body against infection and make up 1% of the total white blood cell count. An abnormal increase in the level of basophils can indicate an infection or inflammation which can leave you feeling tired and weak. A low count can be expected as they are the least abundant white blood cell in the body. Even if your result is low, your immune system may still be working effectively. You can improve the efficiency of your immune system by ensuring sufficient intake of micronutrients such as zinc, iron, vitamin A, C and E and by staying well hydrated.


Bilirubin is produced by the liver when breaking down red blood cells and only small amounts are normally present in the blood. Bilirubin levels increase if too many red blood cells are destroyed or if the liver cannot remove bilirubin from the blood fast enough which can result in jaundice. Raised levels of bilirubin can also be caused by a hereditary condition called Gilbert’s syndrome or through excessive alcohol. To keep your levels in the healthy range keep within the recommended guidelines for alcohol and ensure a good balanced diet rich is natural food sources rather than processed food.


There is more calcium in the body than any other mineral. It has several important functions including helping to build and maintain strong bones and teeth, regulating muscle contractions and ensuring the blood clots normally. Because the majority of measured calcium is bound to proteins your corrected calcium result should be used for interpretation. You can improve your calcium levels through foods such as milk, cheese and green leafy vegetables such as broccoli and cabbage.


Cortisol is a steroid hormone and is released when the body feels under stress. Anxiety, a restricted diet or over-training can all cause cortisol levels to rise. Levels can also be influenced by infection, trauma or problems with the pituitary or adrenal gland. High levels of cortisol can lead to increased blood pressure, high blood sugar levels, muscle weakness and weight gain. Low levels can lead to fatigue, low blood pressure, weight loss and muscle weakness. Due to the peaks and troughs, random cortisol is pretty inaccurate and 24hr UFC cortisol is better, alternatives are synacthen test and dexamethasone suppression test.


Creatine Kinase (CK) is an enzyme found mainly in the brain, skeletal muscles and heart. It has an important role to play in energy production and muscle contraction. When muscles are damaged CK leaks into the blood stream. Levels can therefore become raised due to injury or stress to muscle tissue particularly after exercise but should return to normal after a recovery period.


Creatinine is a waste product which is produced from creatine, a compound which has a major role in the production of energy needed for muscle contraction. The level of creatine produced will vary according to body size and muscle mass. Creatinine is removed from the body by the kidneys and released in urine. The levels of creatinine in blood is therefore a good indication of kidney function.


C-reactive protein (crp) measures the amount of inflammation in your body. High levels are associated with an increased risk of developing cardiovascular disease and stroke. However, as CRP is a marker for general inflammation, it cannot identify the source of inflammation. Levels may also be raised due to a number of reasons including recent infections (especially bacterial), intense bursts of exercise or conditions such as arthritis. As hs-CRP levels can fluctuate significantly, regular testing is recommended to establish a trend.


eGFR is used as an indication of how well your kidneys are functioning. Testing GFR directly is complicated, levels are therefore estimated based on your creatinine levels. Results can be influenced by a number of factors including muscle mass and weight. Individuals with high muscle mass will have higher levels which may be outside the normal range, and vise versa for individuals with low muscle mass. Creatinine and eGFR levels will rise immediately following strenuous exercise but should then return to baseline following recovery.


Eosinophils protect the body by responding to allergies and by resisting some infections. Raised levels can be associated with allergy or parasitic infection. Eosinophils only make up a small percentage (1–3%) of the total white blood cell count. You can improve the efficiency of your immune system by staying hydrated and ensuring a balanced diet with a high intake of fruit and vegetables such as tomatoes and carrots, together with herbs and spices e.g tumeric and cumin.


Folate is not produced by the body but is supplied through diet. It plays an important role in the formation of healthy red blood cells as well as the repair of tissues. The folate test is useful in the evaluation of anaemia. Low levels may indicate a degree of deficiency.


Follicle stimulating hormone (FSH) regulates the functions of the reproductive system. In women, FSH stimulates follicle growth in the ovary before the release of an egg, while in men FSH stimulates the production of sperm. Low levels of FSH can therefore cause fertility problems in both men and women and can indicate a malfunction in the ovaries or testes. During the menopause/peri-menopause FSH and LH levels in women will rise: FSH between 13–25.8 and LH result higher than your FSH level is suggestive of perimenopause. FSH above 25.8 is consistent with perimenopause/menopause. FSH <13 is not suggestive of the menopause but diagnosis should be made on the basis of symptoms.


Free androgen index (FAI) is an estimate of the amount of free testosterone in the bloodstream. It is calculated using the test results of testosterone (total) and sex hormone-binding globulin (SHBG). Low levels in men can lead to a low libido, while high levels in women can lead to the growth of facial and body hair as well as fertility problems.


Gamma GT (GGT) is an enzyme, which is predominantly found in the liver. GGT levels can increase if the liver is damaged or if there is a blockage obstructing the flow of bile. The GGT test is extremely sensitive and can be elevated due to many reasons including the consumption of alcohol or other drugs/medication. To keep levels within the healthy range limit your consumption of alcohol to within the recommended guidelines and eat a healthy balanced diet.


Globulin is a general term used to describe more than 60 proteins found in the blood. If globulins are not within the correct level this can impair the body’s ability to fight infection, clot or carry nutrients to the muscles. Low and high levels are associated with a wide range of health conditions including problems with the bowel, kidney or liver. To keep levels within the healthy range limit your consumption of alcohol to within the recommended guidelines and eat a healthy balanced diet.


The haematocrit (HCT) test measures the volume of space in your blood which is made up of red blood cells. Low levels can suggest anaemia which means that an insufficient supply of oxygen is reaching your tissues resulting in a loss of energy. The main nutrient for all red blood cells is iron. As the best source of iron is red meat, those following a vegetarian or vegan diet may find it harder to absorb adequate quantities.


Haemoglobin is a protein found in blood. Its role is to carry oxygen to cells throughout the body and return carbon dioxide back to the lungs. A low level can indicate anaemia and may result in reduced energy. Anaemia has many causes including nutritional deficiency. By improving your haemoglobin you can improve your organ and tissue functions and increase your overall energy levels. High haemoglobin levels are indicative of too many red cells which could be due to a number of conditions.


HDL (high-density lipoprotein) works as a scavenger, picking up and carrying away excess cholesterol in your arteries and transporting it to the liver where it can be eliminated. It is therefore known as ‘good cholesterol’ with higher levels being a positive health benefit. In general people with high HDL are at lower risk of heart disease. Those with low HDL are at a higher risk. The best way to increase your HDL is through exercise.


Iron is essential for the production of healthy red blood cells, specifically haemoglobin which transports oxygen around the body. Low levels of iron will result in fatigue and eventually lead to iron deficiency anaemia. There can be a number of reasons for iron deficiency including a poor diet or poor absorption, the latter of which can be caused by intensive exercise. The best source of iron is red meat, therefore people following a vegetarian or vegan diet can find it hard to absorb sufficient amounts.


LDL (low-density lipoprotein) is known as bad cholesterol because it can transport more cholesterol around the body than needed, leading to a build up on the walls of arteries. The higher the levels of LDL the higher the risk of developing heart disease. By lowering your LDL levels you can decrease the risk of cardiovascular disease. You can reduce your LDL by increasing the amount of unsaturated fat in your body by eating foods such as avocado or nuts & seeds.


Luteinising hormone (LH) plays a key role in the human reproductive system. In men, LH aids the production of testosterone to support sperm production, whilst in women, it plays a key role in ovulation. High or low levels of luteinising hormone are associated with problems with fertility and irregular periods. As women enter the menopause levels of LH will naturally rise, whilst levels in adult males tend to stay relatively constant throughout their lives.


Lymphocytes help protect the body against infection. They usually make up around 25% of the total white blood cell count. Low levels of lymphocytes can suggest a weakness in your immune system, whilst a high level can indicate infection (particularly viral) or increased level of inflammation. You can improve the efficiency of your immune system by staying hydrated and eating a good well balanced diet.

MAGNESIUM (SERUM) Optimal range = 6.0–6.5 mg/dl

Magnesium is an essential trace element and is important to maintaining good health. It performs a wide range of functions including maintenance of strong bones, keeping blood pressure normal, muscle contraction and energy production. Magnesium is supplied to the body through diet. Low magnesium in-take can affect calcium levels. Good sources of magnesium include vegetables such as broccoli and nuts.


Mean cell haemoglobin (MCH) is a measurement of the amount of haemoglobin inside your red blood cells. High or low results can indicate different forms of anaemia leading to fatigue. This can be caused by nutritional deficiencies such as iron or B12. Above normal levels can also be a sign of dehydration.


Mean corpuscular haemoglobin concentration (MCHC) measures the concentration of haemoglobin inside your red blood cells. MCHC, MCV and MCH all help to identify different forms of anaemia. Decreased MCHC values can be a sign of iron deficiency anaemia.


Mean corpuscular volume (MCV) indicates the average size of your red blood cells. High levels of MCV can sometimes be a sign of anaemia often caused by vitamin B12 or folic acid deficiency, whilst low levels are associated with iron deficiency. Both can lead to a reduction in energy and fatigue.


Mean platelet volume (MPV) is a measurement of the average size of blood platelets which play an important role in clotting. The higher the MPV the larger the average platelet size. The lower the number the smaller the average platelet size. Platelets that are more recently released from the bone marrow are usually larger in size. High MPV can be caused by iron or vitamin D deficiency.


Monocytes ingest bacteria and foreign particles in the blood which are harmful to the body. They usually make up around 5–10% of the total white blood cell count. An abnormally high level can be a sign of infection whilst low levels can mean that you have an increased susceptibility to infection. You can’t directly influence you monocyte count be you can improve the overall efficiency of your immune function through good nutrition.


Neutrophils help protect your body against infection and are the most abundant of white blood cell in the body. Neutrophils play an important role in the body’s inflammatory response and help to remove damaged cells and invading microorganisms. Low levels of neutrophils can indicate a weakness in your immune system, whilst a high level can suggest infection (particularly bacterial) or increased inflammation.


Oestradiol is the main form of oestrogen in women and levels will naturally reduce with age and decrease during the peri-menopausal stage, with a large decrease occurring at the start of menopause when the ovaries stop producing eggs. For example post-menopause women can expect their levels to fall below 100 IU/L. Low levels can cause mood swings, fatigue and a decrease in bone density leading to an increased risk of osteoporosis.


Omega 6 and omega 3 are essential fatty acids are consumed through diet within a recommended ratio of 3:1. They are involved in a number of important functions including the regulation of blood pressure and inflammation, and therefore have an important role in protecting the body against heart disease. As Omega 6 is pro-inflammation while omega 3 is neutral, a diet which contains a lot of omega 6 and too little omega 3 will increase inflammation. Conversely, a diet with high levels of omega 3 and low levels of omega 6 will reduce inflammation.


Your platelet count is the number of platelets in a given volume of blood. As platelets are important to the clotting of blood, low levels can increase the risk of abnormal bleeding.


Progesterone is produced by the body during ovulation and levels will change during the menstrual cycle. Progesterone levels in the blood start to rise when an egg is released from the ovary and then fall if the egg is not fertilised. If the test is taken at the correct time (day 21 for a 28 day cycle) a result >30 suggests ovulation has occurred, whilst levels <5 indicate that the ovary has failed to release an egg. Post-menopause levels will drop to below 0.401.


Prolactin is a hormone produced by the pituitary gland. Slight increases can occur as part of a stress reaction. However, if your level is consistently high this can cause suppression of other pituitary hormones such as FSH and LH. High levels are expected during breast feeding as main role of prolactin is to produce milk.


Red blood cells are the most common type of blood cell in circulation. RBC distribution width (RDW) is a measurement of the variation in the size of your red blood cells. Normal red blood cells are usually of a similar size. Some nutritional deficiencies e.g. iron, folate or vitamin B12 can cause a variation in red blood cell size leading to an increase in RDW.


Red blood cells are an important transporter of oxygen, taking it from the lungs to cells around the body. By keeping your RBC within the normal range you can ensure your body receives sufficient quantities of oxygen. Low RBC is often an indication of anaemia which can be due to a number or causes including nutrition deficiency e.g. low iron, folate or B12.


SHBG is a protein which attaches itself to testosterone and controls how much of it is available to your body tissue. It is therefore useful in identifying testosterone deficiency in men and excess testosterone in women. High SHBG levels indicate less free testosterone is available to tissues which can lead to low libido in men and reductions in energy. Conversely, low SHGB levels indicate more total testosterone is available to the tissues which can lead in a condition known as Polycystic Ovary Syndrome in women.


Sodium is an electrolyte and plays a significant role in regulating water within the body as well as helping to regulate blood pressure. Too much sodium can cause high blood pressure in some cases, whilst too little sodium can lead to a decrease in blood pressure. After exercise, when the body has lost a lot of fluid, it is important to replace sodium through isotonic drinks or you can add a small amount of salt to squash.


Males = 700–900 ng/dl (total testosterone) 150–224 pg/ml (free testosterone)

Females = 35–45 ng/dl (total testosterone) 3.25–6.4 pg/ml (free testosterone)

Testosterone plays an important role throughout the body, affecting the brain, bone and muscle mass, fat distribution, the vascular system, energy levels, sexual functioning and fertility. Testosterone in men is particularly beneficial in sports which require strength or power and can also help to support bone health and energy levels. However, excessively high levels can be a risk to health. Testosterone levels in men will naturally decline with age. High levels in women is associated with Polycystic Ovary Syndrome.


Thyroglobulin is a protein produced and used by the thyroid gland to make the thyroid hormones thyroxine (T4) and triiodothyronine (T3). Elevated levels of thyroglobulin antibodies indicate that your thyroid gland is under attack from your immune system and this can affect the thyroid gland from working properly. Having raised antibodies can increase your risk of going on to develop a thyroid disorder and indicate an autoimmune condition.


Thyroid Peroxidase (TPO) is an enzyme found in the thyroid gland which plays an important role in converting thyroxine (T4) to the biologically active triiodothyronine (T3). High levels of thyroid peroxidase antibodies indicate that your thyroid gland is under attack from your immune system. Raised levels increase your risk of developing a thyroid condition over time and are often found in those who have already been diagnosed with a thyroid disorder.


Thyroid Stimulated Hormone (TSH) plays an important role in regulating the production of hormones by the thyroid gland. High levels of TSH can indicate an underactive thyroid which can lead to fatigue and weight gain, whilst low levels are often associated with an overactive thyroid which can cause mood swings and difficulty in sleeping. Foods which contain the B vitamin group can play a large role in ensuring optimal thyroid function.


A thyroxine (T4) test is used to check that the thyroid is performing properly. Thyroid hormones, such as thyroxine have a role to play in a wide range of the body’s functions including the maintenance of healthy bones and muscle control. An overactive thyroid can cause too much thyroxine to be released into the bloodstream, whilst an underactive thyroid can lead to too little thyroxine being produced. Both conditions can lead to weight gain and fatigue as well as our symptoms.


Total cholesterol is a value made up of the different cholesterol components — HDL, LDL and triglycerides. High total cholesterol can indicate an increased risk of heart disease. However, having a high total cholesterol doesn’t always mean that you are at an increased risk of heart disease. It is therefore important to look at each individual component. For example, total cholesterol levels can be high due to a high level of HDL or good cholesterol which actually lowers the risk of heart disease.


Total iron binding capacity (TIBC) results reflect the amount of iron in the body and should be viewed alongside iron and ferritin measurements. Typically TIBC levels will be high and iron levels low if you are iron deficient. Conversely, your TIBC level will be low and your iron level high if you have too much iron. It is important to maintain normal levels to prevent fatigue.


Total protein test is a measurement of albumin and globulin in the blood. The level of total protein in the blood is associated with liver and kidney function as well as nutritional status. As total protein alone cannot specifically identify a problem, results are interpreted alongside other liver function tests. High protein levels can sometimes be caused by dehydration.


Transferrin saturation is calculated using the results from iron and TIBC. Transferrin saturation is usually low in cases of iron deficiency and high if the body had too much iron. Too much or too little iron can have a range of negative health consequences including fatigue, headaches and weakness.


Triglyceride is the main form of fat found within our bodies. It is important for maintaining energy and provides the fuel for muscles to work. When you eat, excess calories which your body doesn’t need are converted into triglycerides. High levels can increase the risk of heart disease and pancreatitis. By lowering your triglycerides you can reduce the risk of heart disease. Triglyceride results can sometimes be raised if you’ve eaten before doing your blood test. If raised we recommend you repeat the test using a fasting blood sample i.e. first thing in the morning before food.


A Triiodothyronine (T3) test can indicate if the thyroid is performing properly. Triiodothyronine is the active form of Thyroxine (T4) and, as a thyroid hormone, plays an important role in many of the body’s functions including helping to regulate the body’s metabolism and muscle control. High levels of triiodothyronine may indicate an overactive thyroid the symptoms of which include fatigue, weight loss, irritability and irregular menstrual cycles. Low levels may indicate an underactive thyroid which can cause fatigue, weight gain and stiffness in muscles.


Both urea and creatinine are good indicators of whether the kidneys are working properly. Urea is a waste product which is formed in the liver when protein is metabolised. It is released by the liver into the bloodstream and carried to the kidneys where it is expelled within urine. If the kidneys are not performing correctly the level of urea in the blood will rise. Urea can also rise 2–3 days after intense exercise due to muscle breakdown and if your body is dehydrated.


Uric acid or urate is a chemical compound which is produced when the body breaks down certain foods which contain purines. Most uric acid is removed from the body by the kidneys. Too much uric acid in the blood can lead to the formation of solid crystals in the joints — a condition known as gout, a form of inflammatory arthritis. High levels can also lead to the formation of kidney stones.


Vitamin A is an essential nutrient and helps maintain normal vision particularly in dim light, the growth of healthy skin and bone development. Vitamin A also has an important role to play in helping the immune system fight infections. The body cannot make vitamin A, we are therefore reliant on dietary sources. The highest sources of vitamin A comes from liver, diary products, eggs and fish.


Vitamin D plays an essential role in our health including the development and preservation of healthy bones, boosting our immune system, muscle function, energy levels and helping to reduce inflammation. Most of the body’s vitamin D is produced in the skin following exposure to sunlight, so people living in the UK are more prone to be deficient in this vital vitamin. Levels >75nmol/L are recommended for optimal health, or >90nmol/L for athletes. As it is difficult to increase levels of vitamin D through diet alone, supplements are usually required.


Vitamin E is required for the proper functioning of many organs in the body. It has an important role to play in maintaining healthy skin, normal vision and the immune system. It also acts as an antioxidant which means it helps to slow down processes that can damage cells. Good sources of vitamin E include vegetable and rapeseed oil, eggs, cereals and seeds & nuts.


White blood cell count (WBC) is a count of the actual number of white blood cells per volume of blood. Your white blood cells make up your immune system and help to protect the body against illness and disease. Low levels indicate a weakness in the immune system which can be associated with a number of conditions. Higher levels are common when your body is trying to fight off an illness or during extreme physical stress either through injury, emotional stress or excessive exercise.

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