OT: Blood Tests

Has anyone here had any unaccountable results from routine blood tests within the last couple of years? My lifestyle hasn't changed one jot since at least 2010, but lately I'm getting liver function results tending to indicate I'm becoming some sort of dipsomaniac even though my alcohol consumption is and has been embarrassingly very moderate. So I'm wondering if the testing methodology has simply become more sensitive in recent years? After all, many of us work in developing fields where improvements in instrument sensitivity are continuous and on- going and it would be daft to assume that the same hasn't also happened in blood screening. But would they tell us? I doubt it. Any excuse on the part of our nanny state to wag fingers and tell us we're very, very naughty. Permissible limits of every natural free/cheap antidepressant they happen to disapprove of are periodically lowered as we all know: salt, sugar, fat, alcohol, sunshine, nicotine; the war against quality of life (other than that obtainable via pricey Big Pharma's chemical concoctions) is unending. Anyone got any info?
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On 27/02/2016 00:25, Cursitor Doom wrote:

There have always been a band of normal limits for most blood chemistry.
Perhaps you should ask for earlier test information and see if that have changed, or whether the limits of "normal" have changed.
If it's a one-off unusual result, I would ask for a re-test and surprised the doc hasn't suggested that already?
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another thing in the last two years is that Urine tests throw up blood in the urine about one time in two. I can understand why, what with hard water and obvious passing of kidney stones and lifetime stretching of the urethras, its hardly surprising if the insides get damaged. Brian
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On Sat, 27 Feb 2016 01:19:33 +0000, Fredxxx wrote:

That's the nub of it, yes.

That happened a couple of years ago. I got a "one-off unusual result", got called back for a re-test after which they told me everything was fine. I was particularly careful to not modify my regime *one iota* between those two tests - yet the results improved. I suspect they're refining their test procedures to be more sensitive to 'red flags' on the one hand, and shrinking the 'normal range' on the other in order to catch potential health issues at an earlier stage. But I have nothing to go on but my hunches. Hence the appeal for info from anyone who might have inside knowledge of any such recent changes to testing methodology.
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On Sat, 27 Feb 2016 00:25:57 -0000 (UTC), Cursitor Doom

Why are you having routine kidney function tests? Should I be having them? The only proactive test my practice has done is to call me in to put my arm in an automatic sphygmomanometer in reception. Or are you in Bupa?
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On 27/02/16 01:27, Graham. wrote:

he isnt. Liver function.

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On 27/02/2016 01:27, Graham. wrote: ...

...
Routine liver function tests are normal if you are on certain, fairly common, types of medication. At least two of the pills I take require them, to ensure that they are not causing long term damage.
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The only proactive test my practice has done

Well that's one more than my practice has ever done for me, in the 20 years I've been with them!
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On 27/02/2016 00:25, Cursitor Doom wrote:

Liver function can be affected by many things; alcohol is only one of them. Get another test and if it's the same make sure they follow up by checking all possibilities.
There are many tests all called 'liver function' and they tell the docs many different things.
Bill
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On 27/02/2016 04:22, Bill Wright wrote:

GGT 5-85 iu/l A.S.T. 5-40 iu/l A.L.T. 5-36 iu/l Alkaline Phosphatase 25-130 iu/l Albumin 35-50 Bilirubin 2-26 umol/l
Some people have permanently elevated bilirubin which gives them very slightly yellowy tinged eyes, but doesn't do any harm.
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On 28/02/2016 19:44, Andrew wrote:

Those could well be the reference ranges for the lab you are quoting. Another lab most definitely is not the same - and it has separate ranges for M & F. I'll just quote GGT:
Gamma glutamyl transferase male: 10 - 71 IU/L female: 6 - 42 IU/L
http://pathology.bsuh.nhs.uk/pathology/Default.aspx?tabid 8#GGT
Varying ranges, whilst understandable, are a hazard in medicine.
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On 28/02/2016 20:19, polygonum wrote:

All UK pathology labs (including the ones run by charities) now adhere to national quality controls and standards and the analysers (thanks to digital electronics and computers) are now pretty well standard across the UK.
There was a problem with biochemistry results back in the 70's when I was a lab technician, because they could vary widely from hospital to hospital. It was less of a problem with haematology because virtually every lab used control samples from Coulter electonics, so either they were all right, or all wrong, or their regular bleaching, cleaning schedules were a bit amiss. Getting an accurate platelet count back in the 70's was a problem for even a certain teaching hospital in London. This was because they weren't using their Autotechnicon platelet counter properly :-), an issue which we at Barts were well aware of.
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On 29/02/2016 09:19, Andrew wrote:

It is simply not the case that there are national standards for all lab tests - neither the units nor the ranges. Were that the case, we would not need pathology harmony:
http://www.pathologyharmony.co.uk/
They only claim standardisation for FBC (one of the most frequent sets of blood tests) from 2013. And that is just the units - not the reference ranges.
Though I accept that they all have to adhere to quality standards which are nationally set. I am advised by my tame lab test developer that some tests are very much less good than others for clear scientifically explainable reasons. One I can give you straight off is the possibility of antibody interference. Some tests are pretty much immune to interference whereas others are most definitely susceptible. The effect of the result can be very significant - but the cause would often be missed (and hence, misinterpreted) by medics.
"By 31st March 2013 units for reporting FBC should be standardised including the Haemoglobin level and MCHC as g/L"
http://www.pathologyharmony.co.uk/Harmony%20%28approved%29%20%20FBC%20units%20Harmony%20Communique%20Final%2004%2004%202012.pdf
GGT ( ♀ 7 – 33 IU/L; ♂ 11 – 51 IU/L)
http://www.derbyhospitals.nhs.uk/easysiteweb/getresource.axd?assetid 772
GGT GAMMA GLUTAMYL TRANSFERASE (GGT) F ( 0 - 31 ) M ( 0 - 58 ) iu/L
http://www.bhrhospitals.nhs.uk/Downloads/services/bhrut-pathology-biochemistry-reference-range-2478-0212.pdf
Gamma-Glutamyl aminotransferase (GGT) Reference Range ♂ 0 – 50 U/L ♀ 0 – 32 U/L
http://www.homerton.nhs.uk/our-services/services-a-z/p/pathology/clinical-biochemistry/biochemistry-tests/g/gamma-glutamyl-aminotransferase-%28ggt%29/
In my particular area of interest, which is not liver, I see that though the units are (mostly) standardised, the ranges are very far from. Regularly we see ranges where the top of the range for one lab is only just above the bottom of the range for another lab.
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On Sat, 27 Feb 2016 00:25:57 -0000 (UTC), Cursitor Doom

You need to discuss it with your doctor. Unfortunately, some GP practices seem reluctant to tell their patients any detail about their test results. Whether this is because they take the old fashioned view that 'doctor knows best, and the patient must just accept what they say', or whether they just don't have the time, I don't know, but I'm sure some of the former still persists. Insist on detailed results and a discussion.
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Might be an age thing: where they test for age related changes. I have had a similar experience where the NHS were convinced I drank heavily. Have a look at familial fatty liver syndrome. This appears to have come down my mother's side of the family and leads to a type 2 diabetes risk.
I have no idea how they got the idea but, apart from dietary recommendations and a low dose of Statins they just do a regular liver function test.
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Tim Lamb

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On 27/02/2016 09:31, Tim Lamb wrote:

My doc almost accused me of being a secret drinker when that gamma thing test was higher than it should have been. My own hunch is that if you had a stiff drink the night before the test, you might fail quite spectacularly. The next test, 3 months later, was normal but I didn't imbibe the night before. ISTR reading that the test is regarded as a waste of time in some medical quarters.
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Gamma glutamyl transferase (gamma-GT) is pretty sensitive to alcohol consumption in the short term, and a single elevated result shouldn't automatically be cause for concern. Your GP should know that.
http://labtestsonline.org.uk/understanding/analytes/ggt/tab/test/
P.
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What you did the day before can upset tests. I had a kidney function test which gave an alarming result. I went and read up on the test before going back to the GP, and discovered you should do no significant exercise or body-building, nor each more than 100g of protein in the day or two beforehand. GP didn't know this either. I'd done 1200 kCals on the bike and eaten half a chicken the night before!
A retest without those gave a normal result.
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On Sat, 27 Feb 2016 11:32:37 +0000, Andrew Gabriel wrote:

Good point.
My eGFR goes up and down for no apparent reason. At my next test I will try no exercise, no protein, and plenty of water to flush the kidneys. See if that makes a difference.
Cheers
Dave R
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Not really - IIRC it gives the long term results of drinking (and perhaps other things)
If someone is 'done' for drink driving and banned, perhaps for a second time or with a very high blood alcohol count, they may need to take a medical before getting their licence back. The idea being it will show if they drink a lot - therefore likely rarely sober - rather than just testing for alcohol at that point in time.
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