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    Lab Tracking Form

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    api-236864051

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Lab Tracking Form

    Uploaded by

    api-236864051
    876 views5 pages

    Original Title

    lab tracking form

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    © Attribution Non-Commercial (BY-NC)

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    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    876 views5 pages

    Lab Tracking Form

    Uploaded by

    api-236864051

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5
    At a glance
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    The document provides a tracking form and reference for blood chemistry and complete blood count (CBC) test results, including normal ranges for many measurements.

    Tests included are for glucose, hemoglobin A1C, insulin, BUN, creatinine, electrolytes, liver enzymes, lipids, thyroid, vitamins, hormones, and complete blood cell counts.

    Optimal ranges are provided for each measurement in both standard US and international (SI) units.

    FUNCTIONAL CHEMSCREEN and CBC RESULTS

    TRACKING FORM STANDARD U.S. UNITS


    NAME:

    DATE OF TEST:

    TEST

    OPTIMAL

    Glucose
    HgB A1C
    Fasting Insulin
    BUN
    Creatinine
    Sodium
    Potassium
    Chloride
    CO2
    Anion Gap

    75 86
    <4.5%
    <5
    10 16
    0.8 1.1
    135 142
    4.0 4.5
    100 106
    25 30
    7 12
    3.5 5.9 male
    3.0 5.5 female
    6.9 7.4
    4.0 5.0
    9.5 10.0
    3.0 4.0
    70 100
    10 30
    10 30
    140 200
    0.1 1.2 (>2.6)
    0 0.2 (>0.8)
    0.1 1.0 (>1.8)
    10 30
    2.4 2.8
    1.4 2.1
    10 16
    85 130
    30 70
    250 350
    25 30%
    160 180
    70 80
    <100
    >55
    1.3 2.0
    3.0 3.25
    90 168
    1.0 1.5
    6.0 11.9
    <0.55 male
    <1.5 female
    < 7.2
    200 300
    50 65
    500 640 male
    250 380 female
    15 26.5 male
    1.4 2.2 female
    10 30 male

    Uric Acid
    Total Protein
    Albumin
    Calcium
    Phosphorous
    Alk Phos
    SGOT(AST)
    SGPT(ALT)
    LDH
    total Bilirubin
    direct
    indirect
    GGTP
    Globulin
    A/G ratio
    BUN/Creat.
    Total iron
    Ferritin
    TIBC
    % Sat
    Cholesterol
    Triglycerides
    LDL
    HDL
    TSH
    Free T-3
    Total T-3
    Free T-4
    T-4 thyroxine
    Hs-CRP
    Homocysteine
    Fibrinogen
    Vitamin D
    DHEA Sulfate
    Free
    Testosterone
    Estradiol

    Weatherby & Associates, LLC

    RESULT

    FASTING: Y / N
    NOTES

    www.BloodChemistryAnalysis.com

    FUNCTIONAL CHEMSCREEN and CBC RESULTS


    TRACKING FORM STANDARD U.S. UNITS
    Complete Blood Count
    TEST
    WBC
    RBC
    Hemoglobin
    Hematocrit
    MCV
    MCH
    MCHC
    Platelets
    RDW
    Neutrophils
    Lymphs
    Monocytes
    Eosinophils
    Basophils

    OPTIMAL

    RESULT

    NOTES

    5.0 7.5
    4.2 4.9 male
    3.9 4.5 fem
    14 15 male
    13.5 14.5 fem
    40 48 male
    37 44 female
    82 89.9
    28 31.9
    32 35
    150 385 x 1000
    <13
    40 60%
    24 44%
    0 7%
    0 3%
    0 1%

    Comments:_____________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    Weatherby & Associates, LLC

    www.BloodChemistryAnalysis.com

    CONVERSION CHART FOR CONVERTING STANDARD US UNITS


    INTO STANDARD INTERNATIONAL UNITS
    TEST
    Glucose
    HgB A1C
    BUN
    Creatinine
    Sodium
    Potassium
    Chloride
    CO2
    Anion Gap
    Uric Acid
    Total Protein
    Albumin
    Calcium
    Phosphorous
    Alk Phos
    SGOT(AST)
    SGPT(ALT)
    LDH
    Bilirubin values
    GGTP
    Globulin
    A/G ratio
    BUN/Creat.
    Total iron
    Cholesterol
    Triglycerides
    LDL
    HDL
    Chol/HDL
    Ferritin
    TIBC
    TSH
    T-3
    Free T-3
    T-4 thyroxine
    Free T-4
    FTI/ T-7
    WBC
    RBC
    Hemoglobin
    Hematocrit
    MCV
    MCH
    MCHC
    Platelets
    RDW
    Neutrophils
    Lymphs
    Monocytes
    Eosinophils
    Basophils

    Weatherby & Associates, LLC

    US UNITS
    mg/dL
    %
    mg/dL
    mg/dL
    mEq/L
    mEq/L
    mEq/L
    mEq/L
    mEq/L
    mg/dL
    g/dL
    g/dL
    mg/dL
    mg/dL
    U/L
    U/L
    U/L
    U/L
    mg/dL
    U/L
    g/dL
    Ratio
    Ratio
    mg/dL
    mg/dL
    mg/dL
    mg/dL
    mg/dL
    Ratio
    ng/mL
    g/dL
    IU/mL
    ng/dL
    pg/dl
    g/dL
    ng/dl
    x 103/mm3
    x 106/mm3
    g/dL
    %
    Microns3
    pg
    g/dL
    x 103/mm3
    Calculated
    %
    %
    %
    %
    %

    CONVERSION FACTOR
    Multiply
    Divide
    0.05551
    0.01
    0.357
    88.4
    1
    1
    1
    1
    1
    59.48
    10
    10
    0.250
    0.3229
    1
    1
    1
    1
    17.1
    1
    10
    1
    1
    0.1791
    0.02586
    0.01129
    0.02586
    0.02586
    1
    1
    0.1791
    1
    0.01536
    0.01536
    12.87
    12.87
    1
    1
    1
    10
    0.01
    1
    1
    1
    1
    1
    1
    1
    1
    1
    1

    S.I. UNITS
    mmol/L
    mmol/L
    mol/dL
    mmol/L
    mmol/L
    mmol/L
    mmol/L
    mmol/L
    mol/dL
    g/L
    g/L
    mmol/L
    mmol/L
    U/L
    U/L
    U/L
    U/L
    mol/dL
    U/L
    g/L
    Ratio
    Ratio
    mol/dL
    mmol/L
    mmol/L
    mmol/L
    mmol/L
    Ratio
    g/L
    mol/dL
    mIU/L
    nmol/L
    pmol/L
    nmol/L
    pmol/L
    109/L
    10`12/L
    g/L
    1
    fL
    pg
    1
    109/L
    Calculated
    %
    %
    %
    %
    %

    www.BloodChemistryAnalysis.com

    FUNCTIONAL CHEMSCREEN and CBC RESULTS


    TRACKING FORM STANDARD INTERNATIONAL UNITS
    NAME:
    TEST
    Glucose
    HgB A1C
    Fasting Insulin
    BUN
    Creatinine
    Sodium
    Potassium
    Chloride
    CO2
    Anion Gap
    Uric Acid
    Total Protein
    Albumin
    Calcium
    Phosphorous
    Alk Phos
    SGOT(AST)
    SGPT(ALT)
    LDH
    total Bilirubin
    direct
    indirect
    GGTP
    Globulin
    A/G ratio
    BUN/Creat.
    Total iron
    Ferritin
    TIBC
    % Sat
    Cholesterol
    Triglycerides
    LDL
    HDL
    TSH
    Free T-3
    Total T-3
    Free T-4
    T-4 thyroxine
    Hs-CRP
    Homocysteine
    Fibrinogen
    Vitamin D
    DHEA Sulfate
    (g/liter)
    Free
    Testosterone
    Estradiol

    DATE OF TEST:
    OPTIMAL

    RESULT

    FASTING: Y / N
    NOTES

    4.16 4.77
    <0.045
    <35.88
    3.57 5.71
    70.7 97.2
    135 142
    4.0 4.5
    100 106
    25 30
    7 12
    208 351 male
    178 327 female
    69 74
    40 50
    2.38 2.50
    0.97 1.29
    70 100
    10 30
    10 30
    140 200
    1.7 20.5 (>44.5)
    0 3.4
    (>13.7)
    1.7 17.1 (>30.8)
    10 30
    24 28
    1.5 2.0
    13 17
    15.22 23.27
    30 70
    44.8 62.7
    0.25 0.30
    4.14 4.66
    0.79 0.90
    <2.59
    >1.42
    1.3 2.0
    4.6 5.0
    1.4 2.6
    12.9 19.3
    77 154
    <22 male
    <60 female
    < 7.2
    5.88 8.82
    100 160
    5000 6400 male
    2500 3800 female
    4.31 76.1 male
    0.4 0.63 female
    36.7 110.1 male

    Weatherby & Associates, LLC

    www.BloodChemistryAnalysis.com

    FUNCTIONAL CHEMSCREEN and CBC RESULTS


    TRACKING FORM STANDARD INTERNATIONAL UNITS
    Complete Blood Count
    TEST
    WBC
    RBC
    Hemoglobin
    Hematocrit
    MCV
    MCH
    MCHC
    Platelets
    RDW
    Neutrophils
    Lymphs
    Monocytes
    Eosinophils
    Basophils

    OPTIMAL

    RESULT

    NOTES

    5.0 7.5
    4.2 4.9 male
    3.9 4.5 female
    140 150 male
    135 145 female
    0.40 0.48 male
    0.37 0.44 female
    82 89.9
    28 31.9
    32 35
    150 385 x 1000
    <13
    40 60%
    24 44%
    0 7%
    0 3%
    0 1%

    Comments:_____________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    Weatherby & Associates, LLC

    www.BloodChemistryAnalysis.com

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