Are you healthy and wondering whether it is worthwhile to undergo regular preventive examinations? They saved many people’s lives, because the detection of early symptoms of the disease influences prognosis and treatment.
The basic test that proves the state of the organism is the complete blood count. The scope of morphology includes the designation:
— red blood cell (RBC) count. Reduction in the number of red blood cells is one of the parameters indicative of anemia that can lead to anemia, a lack of adequate iron levels. However, an increase in their titer is most often observed in the case of dehydration or polycythemia.
— white blood cell (WBC) count. Increasing their number physiologically is sometimes observed under the influence of stress, pregnancy, sometimes it is significant in bacterial, viral and sometimes fungal infections, that is, generally speaking: in inflammation, in some neoplastic diseases (leukemia) and during steroid therapy. On the other hand, the decrease in leukocytes occurs, among others, in some forms of leukemia, in wasting conditions, bone marrow diseases, severe infections and collagen diseases.
— hemoglobin (Hb) concentration – normal ranges for this parameter are established depending on gender and age. Low hemoglobin levels occur in anemia, sometimes in pregnancy (lowest is around week 32), due to iron deficiency or impairment of its ability to use it to form the basic hemoglobin unit of haem. Additionally, in hyperhydration and cachexia syndromes. On the other hand, elevated hemoglobin levels are characteristic of dehydration as a result of prolonged diarrhea and vomiting, intense sweating, poisoning and the aforementioned polycythemia.
– hematocrit (Ht) values – depends on the number of red blood cells and their volume. Hematocrit tells about the balance of all components of the peripheral blood and plasma proteins. A significant increase in hematocrit is most often associated with inflammation of the body, severe diarrhea, vomiting, burns, excessive sweating – that is, dehydration of the body without losing plasma proteins. Increased values are found in certain neoplastic diseases and chronic lung diseases. On the other hand, values below the norm are used in the rapid diagnosis of acute hemorrhages in HED departments. Low values, together with the level of retirement blood cells and Hb, indicating iron deficiency anemia, differentiate from anemia with a different origin (e.g. lack of vitamin B12 or folic acid). Liver, bone marrow and neoplastic diseases associated with impaired protein metabolism are also characterized by low hematocrit.
The MCV, MCH, and MCHC, described below, are enumerated parameters that aid in diagnosing the source of anemia:
– mean red blood cell volume (MCV) – a decreased red blood cell volume is typical of iron deficiency anemia and an increased volume of anemia caused by vitamin B12 deficiency.
– mean blood hemoglobin content (MCH) and mean blood hemoglobin concentration (MCHC): determination of blood hemoglobin concentration is an integral part of the blood count and is the basic test in the diagnosis of anemia.
– RET reticulocytes: in modern hematological diagnostics an indicator of the correct process of RET erythrocyte formation. Determined in the treatment of anemia in order to confirm the recovery of the erythrocyte pool after hemorrhages and after chemo- and radiotherapy.
– platelet count (PLT): a reduction in the number of platelets (thrombocytopenia) can occur under the influence of certain drugs, in leukemia, tuberculosis, in viral infections, in kidney failure, and after radiotherapy and chemotherapy. In contrast, an increase in the number of platelets occurs in chronic inflammatory diseases, myeloid leukemia, blood cancer, ulcerative enteritis, tuberculosis and cirrhosis.
In addition to morphology, it is very important to perform a test that enables the assessment of lipid metabolism. This is called lipidogram. There should be a good balance between total cholesterol, LDL cholesterol (the so-called bad cholesterol), good HDL cholesterol and triglycerides.
Increased parameters are first used to model the diet. In the absence of success and still elevated values of total and LDL cholesterol or triglycerides, therapy for hypercholesterolemia is started.
The state of liver cells – hepatocytes – is evidenced by transaminases, i.e. liver enzymes, the activity of which increases as a result of their damage or destruction, e.g. in hypoxia or under the influence of toxins or viruses. Liver enzymes include:
– Aspartate aminotransferase (AST), which is found in liver cells (hepatocytes), but also in the heart muscle, kidneys and brain. The concentration of aminotransferase may increase in diseases of these organs.
– Alanine aminotransferase (ALT) spilling mainly into hepatocytes. The assessment of its concentration can be used as one of the parameters of the assessment of liver damage on the viral, toxic (paints, varnishes, poisons) or drug-related background.
– High concentration of GGTP, or Gamma-glutamyltransferase, may occur with alcohol abuse, cholestasis, advanced forms of fibrosis, cancer, jaundice, prolonged exposure to a toxic environment or the abuse of drugs, e.g. painkillers.
For the sake of the liver and the whole body, you should not forget to test for HCV infection. It is a virus that causes hepatitis C. The infection is in most cases without characteristic symptoms and may manifest itself after many years in the form of cirrhosis or hepatocellular carcinoma. According to epidemiological studies, it is estimated that around 220-230 thousand people are infected with HCV in Poland. adults (data from 2013 PZH). Every 10th adult infected person does not know about their disease.
Hormone diagnostics is also important in caring for health. The most important tests that should be performed are:
– The basic picture of the functioning of the thyroid gland is obtained by checking:
TSH (thyrotropin) stimulates the thyroid gland to produce hormones. Low TSH can be an indication of an overactive thyroid gland, and high TSH is usually an underactive thyroid gland. Clinical symptoms are diagnosed by additional tests of thyroid hormones, ie FT4 and FT3.
The proper functioning of the body of men and women is conditioned by the cooperation of the functions of the pituitary gland, thyroid gland, parathyroid glands, adrenal cortex and gonads. There are several tests that marked preventive measures can confirm the existence of this harmony:
– Prolactin is responsible for breast growth in adolescence, it stimulates the mammary glands in pregnancy. Its excess (hyperprolactinaemia) causes disorders of the menstrual cycle and often non-ovulatory cycles.
– Lutrotropin (LH) stimulates ovulation, the production of progesterone, and in men it stimulates the secretion of testosterone. Increased LH concentration is observed, inter alia, in in pituitary adenomas, ovarian failure in women and testes in men. On the other hand, the reduced concentration is characteristic of: hypopituitarism, when taking ovulation-inhibiting agents, hormonal substitution, and also in anorexia.
– Follicle stimulating hormone (FSH) – in women it stimulates the growth and maturation of the ovarian follicle and in men it stimulates spermatogenesis. The determination of this hormone is performed in the diagnosis of infertility.
– Corticotropin ACTH – a hormone released from the pituitary gland. It stimulates the adrenal cortex to produce glucocorticosteroids, and to a lesser extent – aldosterone, androgens and estrogens. In the absence of corticotropin, the adrenal cortex disappears and the secretion of cortisol stops.
Cortisol – a stress hormone – is characterized by a circadian rhythm of secretion, as a result of which its concentration in blood serum is highest in the morning and lowest in the late evening hours. Secreted by the adrenal cortex.
Osteoporosis
In the interests of the health of the bones and spine, it is worth examining yourself for osteoporosis. It is a disease that makes our body bones more prone to fracture. A useful test in the diagnosis of osteoporosis is the examination of bone density (densitometry). The tests that determine the level of deficiencies in osteoporosis or help prevent it are: vitamin D, calcium, magnesium, phosphorus, osteocalcin, calcitonin and other modern markers of bone turnover.
Pregnancy
It is also worth conducting research in the diagnosis of past infections, especially those affecting the course of pregnancy.
– Chlamydia trachomatis is a test particularly important for pregnant women due to the possibility of transmitting the infection to the newborn, the probability of which is up to 80%. Testing for possible carrier status is recommended for all pregnant women, the more so as 75 percent. infected have no symptoms.
– CMV cytomegalovirus is another pathogen dangerous for pregnant women, which can cause various health complications in children who are infected in the womb or in the perinatal period, such as developmental delay, encephalitis or microcephaly.
– Toxoplasmosis is a parasitic disease. Usually, it is asymptomatic in pregnant women, therefore infection can only be detected through serological diagnosis. Infection during pregnancy may or may not cause placental inflammation and the passage of parasites into the fetus in this way.
The TORCH profile is recommended for women planning pregnancy in order to effectively monitor the emerging risks during pregnancy. In addition to those already mentioned, it includes: rubella, HSV, mononucleosis, mycoplasma and smallpox.
Oncological prophylaxis
Gynecological cytology should be one of the basic tests in the examination calendar of every woman, allowing the detection of precancerous lesions and cervical cancer. Depending on the woman’s age and diagnosis, cytology should be performed according to a calendar that protects against the development of the neoplastic process. Today, doctors often recommend liquid cytology (LBC), which is more accurate in diagnosing cervical cancer than traditional cytology. Both in the detection of precancerous conditions and the cancer cells themselves. The great advantage of the LBC technique is the possibility of performing additional diagnostic tests from the same sample. The exclusion of HPV or Chlamydia trachomatis infection is very prognostic.
BRCA1 testing may be performed in women with a family history of breast and ovarian cancer. This mutation in the gene increases the risk of developing these cancers.
On the other hand, a simple faecal occult blood test that should be performed every year after the age of 50 helps in detecting gastrointestinal cancers.
By performing these tests regularly, you can take better care of your health. And in the event of alarming results and confirmatory imaging tests, undergo therapy. It is also worth keeping your archival test results. The possibility of comparing them will help doctors ensure faster medical intervention and an individual approach to each of us.
Tekst: Leonard Logo
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