Please enable JavaScript.

Coggle requires JavaScript to display documents.

Assessment and Diagnostics/ Functional Testing (Cholesterol…

- - - - They work by passing an electrical current through the body using electrodes
        and monitoring the level of electrical resistance to the current.
         Different tissues, eg. Muscles, bone, fat will resist the electrical current to
        different degrees, depending on the water content and membrane health.
      - Issue – foot to foot vs. hand to foot
      - Advantages: this method of body composition analysis is very
        simple and quick to perform
      - Disadvantages: The equipment is relatively expensive with
        prices ranging into the thousands. Most reliable methods use
        pads which electrodes are attached to and are very expensive.
      - Reliability:
        – The impedance measure is affected by body hydration status, body
        temperature, time of day, cutaneous infection and therefore requires
        well controlled conditions to get accurate and reliable measurements.
        – If a person is dehydrated, the amount of fat will likely be overestimated
  - - - Advantages:
        simple
        calculation. Correlated
        with CVD and Diabetes
        Type 2 risk.
        • Disadvantages:
        Lean
        muscular athletes have
        higher weight relative to
        height, as do pregnant
        women. This does not
        increase risk of disease.
    - - Estimate visceral adiposity risk.
        
        Predictive of CVD and Diabetes risk when:
        
        94cm (> 37”) - White and Black men
        
        90cm (> 35”) for Asian men
        
        80cm (> 31.5”) for ALL women
        RED FLAG: 102 cm in men and 88 cm in women – Significant risk requiring
        urgent intervention. (Adult Treatment Panel III (ATPIII) definition of the
        metabolic syndrome).
    - - The waist circumference is divided by the hip circumference.
        • Waist to Hip Ratio (WHR) = Gw / Gh (Gw = waist girth, Gh = hip girth)
      - Waist-to-hip ratio is highly predictive of increased risk of cardiovascular disease and type 2
        diabetes as well as some cancers when:
        – Men > 0.9
        – Women > 0.85
    - - Waist to height ratio (WHtR) is a better screening tool than BMI or WC for
        screening adults for cardiometabolic risk factors, and is a strong predictor of
        mortality risk
        • Keeping waist circumference measurement to less than half your height is ideal
        • Initial research suggest children as young as 5 can be screened in this way
- - - - Only 10-30% of all B12 in the body is bound to HoloTC however it is the
        only way B12 that can actually be uptaken by cells. Hence it is often
        called Active B12.
      - Whilst it is technically available to some (not all) labs in the UK, it is very
        expensive and many have not heard of it or do not know how to interpret
        the test.
        Reference range: >30pmol/L
- - - - Haemoglobin (Hb) – to determine degree of anaemia and polycythemia, evaluate
        treatment of anaemia, screen for dehydration.
      - – Red blood cell count (RBCs) – to evaluate anaemia and screen for dehydration
      - Packed cell volume (% of RBCs to plasma) - PCV is reduced in Fe deficiency
        anaemia, increased in polycythemia and may be increased in B12 def. anaemia
      - White blood cell count (WBCs) – body's ability to respond to infection and
        inflammation
        
        Leukocyte Count (WCC)
        • Part of the FBC, this test indicates possible infection, inflammatory
        disease, bone marrow failure, haematological or other malignancy
        
        Leukocyte Differential Count
        • Measures neutrophils (phagocytic WBC), monocytes (macrophagesphagocytosis
        and presentation of antigens to T cells), eosinophils
        (high with allergies, parasites), basophils (contains histamine and
        serotonin) and lymphocytes (T and B cells) present
        
        HIGH LEVELS
        
        High levels: >7.5 X 109
        /L
        
        High Adrenaline levels (Stress)
        
        High refined food intakes
        
        Intestinal parasites, asthma and adrenal dysfunction
        
        LOW LEVELS
        
        Low levels: <5.5 X 109
        /L
        
        Raw food diets
        
        Multiple food allergies
        
        B12, B6 and folate anaemia
        
        Chronic intestinal parasite infection
      - – Mean cell/corpuscular volume (MCV) – ie. Size of RBC’s; used to differentiate
        cause of anaemia B12/folic acid deficiency (macro) or Fe or B6 (micro)
        
        Microcytic hypochromic
        – small, pale RBCs could indicate iron deficiency anaemia
        • Macrocytic normochromic
        – larger size but normal colour RBCs may indicate folate or Vitamin B12
        deficiency
      - Mean cell/corpuscular haemoglobin (MCH) – average weight of Hb in cell;
        used to differentiate cause of anaemia; high = B12/Folic acid; low = Fe or B6
      - – Mean cell/corpuscular haemoglobin concentration (MCHC) – average
        concentration of Hb in RBCs; used to monitor anaemia therapy
      - – Platelet count – evaluating bleeding disorders
      - FERRITIN
        
        Most of the iron stored in the body is attached to ferritin
        
        SERUM FERRITIIN most sensitive lab test for iron deficiency anemia
        
        RAISED EQUALS
        
        iron overload disorders such as haemochromatosis and porphyria, acute
        malnourishment (e.g. anorexia nervosa) and as a marker for inflammation
        
        High Ferritin levels are associated with increased risk of CVD, Cancer and oxidative
        stress
        
        NORMAL RANGE
        10-120ug/L although some doctors suggest that this range should be
        increased to 50-120ug/L for a more accurate assessment.
      - Transferrin or Total Iron Binding
        Capacity (TIBC)
        
        Iron is transported in the blood bound to a protein called transferrin
        
        NORMAL RANGE 44.8 – 62.7 umol/L
        
        LOW MAY MEAN
        haemochromotosis (with increased serum Fe, % transferrin
        saturation and ferritin)
        
        HIGH MAY MEANiron deficiency anaemia.
- - - - • Obesity
        • Poorly controlled diabetes
        • An underactive thyroid (hypothyroidism)
        • PCOS
        • Kidney disease
        • Regularly eating more calories than you burn
        • High sugar consumption
        • Drinking excess alcohol
        • Certain medicines may also raise triglycerides
        • E.g. Hormonal medication and steroids
        • Certain types of high cholesterol and high triglycerides are genetic
    - - 1.8 in SI units
        • The TG/HDL-C concentration ratio was used because the higher the
        value, the greater the risk of CHD, and the more likely the individual
        is to be insulin resistant/hyperinsulinemic, with the additional
        abnormalities associated with this defect in insulin action.
- - - - • Assessment of hirsutism or virilisation in females
        • Investigation of testicular failure or precocious puberty in males
        – Increased levels may be found in women with hirsutism or virilisation
        – Levels are increased in males with precocious puberty
        – Decreased levels are found in males with testicular failure
        – In plasma, testosterone is bound to SHBG, so abnormal levels of SHBG may cause
        a discrepancy between free and total testosterone
  - - - • Diagnosis of precocious puberty.
        • Monitoring of oestrogen therapy is only possible if the drug being administered is
        oestradiol.
        • Monitoring ovulation induction in in vitro fertilisation.
        • Assessment of women with suspected hypothalamic or pituitary disease.
        • Female
        Early follicular phase: 100-200 pmol/L
        Preovulatory phase: 500-1700 pmol/L
        Luteal phase: 500-900 pmol/L
        Postmenopausal: 70-200 pmol/L.