Blood Test

How to Quickly and Easily Understand Your Blood Tests Without A Medical Degree The Simplified Patient Reference Guide By Ronald J. Grisanti D. C. Limits of Liability/Disclaimer of Warranty The author, Ronald Grisanti and publisher, Busatti Corporation have made their best effort to produce a high quality, informative and helpful book. The author and Publisher make no representation or warranties with respect to the accuracy, applicability, fitness or completeness of the contents of this program. They accept no liability of any kind for any losses or damages caused or alleged to be caused directly or indirectly, from using the information contained in this book. This book is not intended for use as a source of any legal or medical advice. The Publisher wants to stress that the information contained herein may be subject to varying international, federal, state and/or local laws or regulations. The purchaser or reader of this publication assumes responsibility for the use of these materials and information. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen. How to Quickly and Easily Understand Your Blood Tests Without A Medical Degree Copyright  © 2004 Busatti Corporation All right reserved worldwide Busatti Corporation and Ronald Grisanti own all right, title, and interest in this publication. No part of this book may be reproduced, distributed, or transmitted in any form, in whole or in part, or by any means, mechanical or electronic, including photocopying and recording, or by any information storage and retrieval system, or transmitted by email, without permission in writing from the Publisher. 2 About the Author Dr. Ronald Grisanti is a practicing chiropractic physician since 1981. In addition to earning his doctorate in chiropractic medicine, Dr. Grisanti is a Board Certified Chiropractic Orthopedist and Board Certified Sports Physician. He is presently completing his Master’s Degree in Nutrition from the University of Bridgeport. In addition, Dr. Grisanti has had extensive training in Functional Diagnostic Medicine and frequently consults with patients suffering with difficult to diagnose health problems like fibromyalgia, chronic fatigue syndrome, diabetes, hypertension, depression, anxiety, acid reflux and other challenging health conditions. His admirable success record has earned him the title, â€Å"Your Medical Detective. † Dr. Grisanti has discovered that many health problems can be successful treated once the underlying cause has been found. He is known for his tenacity and strong will to find the root cause of a patient’s health problem. In 2001, with his ever-growing love for research, Dr. Grisanti launched his weekly medical report titled, â€Å"The Grisanti Report† and has written over 400 articles on a host of medical conditions. His weekly reports have gained worldwide attention and are now read in over 40 countries around the world. His list of subscribers has grown into the thousands. Just recently, Dr. Grisanti launched his exclusive membership site called YourMedicalDetective. com. Dr. Grisanti invites you to take a tour of his new site. Go to www. YourMedicalDetective. com 3 This site gives you exclusive, in-depth information and tools to help you and your doctor track down the real cause of your health challenges and solve them. Dr. Grisanti would like to thank you for purchasing his digital book titled â€Å"How to Quickly and Easily Understand Your Blood Tests Without A Medical Degree. † I believe you will benefit from a book that finally makes sense out of your blood chemistry results. Take care and enjoy the book. 4 Table of Contents Glucose Sodium Potassium Magnesium Chloride Blood Urea Nitrogen (BUN) Creatinine BUN/Creatinine Ratio Uric Acid Phosphorus Calcium Albumin Calcium Albumin Ratio Globulin A/G Ratio Alkaline Phosphorus SGOT/AST and SGPT/ALT GGT LDH Total Protein Iron Ferritin Triglycerides Cholesterol LDL Cholesterol HDL Cholesterol Cholesterol/HDL Ratio CO2 White Blood Cell Count Neutrophils Monocytes Lymphocytes Eosinophils Basophils Red Blood Cells Hemoglobin Hematocrit Platelets Reticulocyte Count MCV MCH T3 T4 T7 T3 Update TSH Erythrocyte Sedimentation Rate (ESR) 5 Comprehensive Blood Test Guide Don't you just hate when you get your blood test back and you have absolutely no idea what all those numbers mean on a standard chemistry profile? Well now you can use this book to help you understand your test a bit better. GLUCOSE Glucose: This is the chief source of energy for all living organisms. A level greater than 105 in someone who has fasted for 12 hours suggests a diabetic tendency. If this level is elevated even in a non-fasting setting one must be concerned that there is a risk for developing diabetes. This is an incredibly powerful test and can predict diabetes ten years or more before one develops the strict definition of diabetes which is levels greater than 120. Common Causes of Glucose Increase: Diabetes, poor carbohydrate utilization, syndrome X Less Common Causes of Glucose Increase: Cerebral lesions, uremia, pregnancy, intracranial pressure, cushing's disease, hyperthyroidism, chronic nephritis, infections, first 24 hours after a severe burn, pancreatitis, cerebral lesions, uremia, early hyperpituitarism Common Causes of Glucose Decrease: Fasting Hypoglycemia Clinical Note: LDH will frequently be decreased or in the low normal with Fasting Hypoglycemia, however, LDH will almost ALWAYS be decreased with Reactive Hypoglycemia Less Common Causes of Glucose Decrease: liver damage, pancreatic adenoma, addison's disease (adrenal insufficiency), starvation, late hypopituitarism Carcinoma of islet tissue Clinical Adult Range: 70-115 mg/dL Optimal Adult Range: 85-100 mg/dL Red Flag Range 250 mg/dL Clinical Notes: Order Glycohemoglobin (HGB A1C) with serum glucose values above 160 and to monitor diabetics under therapy Nutrition Tip: Thiamine Defi ciency has been linked to increase in glucose levels 6 SODIUM Sodium: This element plays an important role in salt and water balance in your body. A low level in the blood can be caused by too much water intake, heart failure, or kidney failure. A low level can also be caused by loss of sodium in diarrhea, fluid or vomiting. A high level can be caused by too much intake of salt or by not enough intake of water. Clinical Adult Range: 135-145 Optimal Adult Range: 140-144 Red Flag Range 155 mmol/L Common Causes of Sodium Increase: Nephritis (kidney problems), dehydration, hypercorticoadrenalism (increased adrenal function) Clinical Notes: Water Softeners have been linked to cause an increase in sodium Common Causes of Sodium Decrease: Reduced kidney filtration, diarrhea, Addison’s disease, adrenal hypo-function POTASSIUM Potassium: This element is found primarily inside the cells of the body. Low levels in the blood may indicate severe diarrhea, alcoholism, or excessive use of water pills. Low potassium levels can cause muscle weakness and heart problems. Clinical Adult Range: 3. 5-5. 0 Optimal Adult Range: 4. 0-4. 6 Red Flag Range 6. mmol/L Common Causes of Potassium Increase: Adrenal hypo-function, cortisol resistance, acidosis, ongoing tissue destruction Common Causes of Potassium Decrease: Diarrhea, diuretic use, kidney problems, adrenal hyperfunction Less Common Causes of Potassium Decrease: Anemia, overdosage of testosterone, hereditary periodic paralysis, hypertension Nutrition Tip: Excessive licorice consumption has been linked to lower potassium levels 7 MAGNESIUM Magnesium: This important element is found in the arteries, heart, bone, muscles, nerves, teeth. Clinical Adult Range: 1. 7-2. 4 Optimal Adult Range: 2. 2-2. 6 Red Flag Range 1. 6 mg/dL Common Causes of Creatinine Increase: Kidney Problems, Gout Clinical Note: If Creatinine is 1. or higher in a male over the age of 40, Prostate Hypertrophy MUST be ruled out Less Common Causes of Creatinine Increase: Renal Hypertension, uncontrolled diabetes, congestive heart failure, urinary tract infection, dehydration Clinical Note: Suspect early nephritis ( kidney disease) if creatinine is between 2-4 mg/dL. Suspect severe nephritis is creatinine is between 4-35 mg/dL Common Causes of Creatinine Decrease: Amyotonia congenita BUN/CREATININE RATIO BUN/Creatinine Ratio: increased values may indicate catabolic st ates, dehydration, circulatory failure leading to fall in renal blood flow, congestive heart failure, acute and chronic renal (kidney) failure, urinary tract obstruction, prostatic enlargement, high protein diet. Decreased values may indicate overhydration, low protein/high carbohydrate diet, pregnancy Clinical Adult Range: 6-10 Optimal Adult Range: 10-16 Red Flag Range 30 Common Causes of BUN/Creatinine Ratio Increase: Kidney problems Less Common Causes of BUN/Creatinine Ratio Increase: Catabolic states, prostatic hypertrophy, high protein diet, dehydration, shock Common Causes of BUN/Creatinine Ratio Decrease: Low protein/high carbohydrate diet, pregnancy 10 URIC ACID Uric Acid: Uric acid is the end product purine metabolism. High levels are seen in gout, infections, high protein diets, and kidney disease. Low levels generally indicate protein and molybdenum (trace mineral) deficiency, liver damage or an overly acid kidney. Clinical Female Range: 2. 4-6. 0 mg/dL Clinical Male Range: 3. 4-7. 0 mg/dL Optimal Female Range: 3. 0-5. 5 mg/dL Optimal Male Adult Range: 3. 5-5. 9 mg/dL Red Flag Range 9. mg/dL Common Causes of Uric Acid Increase: Gout, kidney problems, arteriosclerosis, arthritis Les s Common Causes of Uric Acid Increase: Metallic poisoning (mercury, lead), intestinal obstruction, leukemia, polycythemia, malignant tumors, drug diuretics Common Causes of Uric Acid Decrease: Chronic B-12 or folate anemia, pregnancy Less Common Causes of Uric Acid Increase: Salicylate and atrophine therapy Nutrition Tip: If the uric acid is low with a normal MCV and MCH, a molybdenum deficiency may be present PHOSPHORUS Phosphorus: Phosphorus is closely associated with calcium in bone development. Therefore most of the phosphate in the body is found in the bones. But the phosphorus level in the blood is very important for muscle and nerve function. Very low levels of phosphorus in the blood can be associated with starvation or malnutrition and this can lead to muscle weakness. High levels in the blood are usually associated with kidney disease. However the blood must be drawn carefully as improper handling may falsely increase the reading. Clinical Adult Range: 2. 5-4. 5 Optimal Adult Range: 3. 2-3. 9 Red Flag Range 5. 0 mg/dL Common Causes of Phosphorus Increase: Parathyroid dysfunction, kidney dysfunction, excessive phosphoric acid in soft drinks. Important Fact: Children will have an increase in Phosphorus due to normal bone growth. In addition, people with fractures will usually reveal an increase. Less Common Causes of Phosphorus Increase: Bone tumors, edema, ovarian hyper-function, diabetes, excess intake of vitamin D Common Causes of Phosphorus Decrease: Parathyroid Hyper-function, osteomalacia, rickets 11 Less Common Causes of Phosphorus Decrease: Diabetes, liver dysfunction, protein malnutrition, neurofibromatosis, myxedema Nutrition Tip: Phosphorus is frequently decreased with diets high in refined sugars Clinical Note: Suspect Vitamin D deficiency with low levels of calcium, phosphorus and increased levels of alkaline phosphorus Clinical Note: Phosphorus is a general indicator of digestive function. Consider hypochlorhydria when phosphorus is below 3. 0 and total serum globulin is greater than 3. 0 or less than 2. 4 CALCIUM Calcium: Calcium is the most abundant mineral in the body. It is involved in bone metabolism, protein absorption, fat transfer, muscular contraction, transmission of nerve impulses, blood clotting, and heart function. It is highly sensitive to elements such as magnesium, iron, and phosphorous as well as hormonal activity, vitamin D levels, CO2 levels and many drugs. Diet, or even the presence of calcium in the diet has a lot to do with â€Å"calcium balance† – how much calcium you take in and how much you lose from your body. Clinical Adult Range: 8. 5-10. 8 Optimal Adult Range: 9. 7-10. 1 Red Flag Range 12. 0 mg/dL Common Causes of Calcium Increase: Hyperparathyroidism Less Common Causes of Calcium Increase: Tumor of the thyroid, hypervitaminosis (excess Vitamin D), multiple myeloma, neurfibromatosis, osteoporosis, ovarian hypo-function, adrenal hypo-function Clinical Note: Serum protein influences calcium levels. Calcium goes up with increased protein and goes down with decreased protein Common Causes of Calcium Decrease: Hypoparathyroidism, pregnancy, hypochlorhydria, kidney dysfunction Less Common Causes of Calcium Decrease: Vitamin D deficiency, diarrhea, celiac disease, protein malnutrition, chemical/heavy metal toxicity, HPA-axis dysfunction Clinical Fact: Poor intestinal fat absorption may be suspected with low levels of calcium, bilirubin and phosphorus Nutrition Note: Pancreatic enzyme deficiency may be suspected with low levels of calcium, triglycerides and increased levels of LDH 12 Clinical Note: Circadin rhythm abnormality should be a primary consideration with calcium levels either above or below normal ALBUMIN Albumin: The most abundant protein in the blood, it is made in the liver and is an antioxidant that protects your tissues from free radicals. It binds waste products, toxins and dangerous drugs that might damage the body. Is also is a major buffer in the body and plays a role in controlling the precise amount of water in our tissues. It serves to transport vitamins, minerals and hormones. Lower levels are seen in poor diets, diarrhea, fever, infections, liver disease, kidney disease, third-degree burns, edemas or hypocalcemia. Clinical Adult Range: 3. 0-5. 5 Optimal Adult Range: 4. 0-4. 4 Red Flag Range 90U/L Common Causes of GGT Increase: Biliary obstruction, alcoholism, cholangitis/cholecystitis (bile duct and gall bladder inflammation) Clinical Note: If GGT is greater than 150 U/L with a serum bilirubin of over 2. 8 mg/dL, strongly suspect biliary obstruction. Seek immediate medical attention Clinical Note: If GGT values are five times igher than the clinical range suspect pancreatitis Less Common Causes of GGT Increase: Brucellosis, hepatitis, mononucleosis, bacterial and viral infection, malignancy, congestive heart failure biliary. Nutrition Note: Low levels of GGT may indicate a B-6 deficiency. Additional Clinical Notes: Food allergy/sensitivity is a very common finding with biliary dysfunction LDH Lactate Dehydrogenase (LDH): LDH is an enzyme found in all tissues in the body. A high level in the blood can result from a number of different diseases such as hepatitis, anemia etc. Also, slightly elevated levels in the blood are common and usually do not indicate disease. The most common sources of LDH are the heart, liver, muscles, and red blood cells. Clinical Adult Range: 60-225U/L Optimal Adult Range: 140-200U/L Red Flag Range ;250U/L Common Causes of LDH Increase: Liver/biliary dysfunction, pulmonary embolism, myocardial infarction, tissue inflammation, tissue destruction, malignancy anywhere in the body, several types of anemias Clinical Note: LDH will frequently increase with low thyroid function Clinical Note: LDH is frequently increased with birth control usage 16 Nutrition Note: Decrease LDH may indicate reactive hypoglycemia. (Check glucose) TOTAL PROTEIN Total Protein: This is a measure of the total amount of protein in your blood. Total protein is the combination of albumin and total globulin and is affected by the albumin and total globulin. A low or high total protein does not indicate a specific disease, but it does indicate that some additional tests may be required to determine if there is a problem. Clinical Adult Range: 6. 0-8. 5g/dL Optimal Adult Range: 7. 1-7. 6g/dL Red Flag Range 8. g/dL Common Causes of Prote in Increase: Dehydration, â€Å"early† carcinoma, multiple myeloma (should be correlated with serum protein electrophoresis) Less Common Causes of Protein Increase: malignancy, diabetes, rheumatoid arthritis Common Causes of Protein Decrease: Protein malnutrition, digestive inflammation (colitis, gastritis) Less Common Causes of Protein Decrease: hypothyroidism, leukemia, adrenal hyper-function, congestive heart failure Nutrition Note: If protein and calcium are found to be on the low side of the optimal range suspect poor protein absorption. Additional Nutrition Notes: Decreased protein, cholesterol and SGPT may indicate fatty liver congestion IRON Iron: The body must have iron to make hemoglobin and to help transfer oxygen to the muscle. If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function up to par. If this test is low you should consider getting a Ferritin test, especially if you are a female who still has menstrual cycles. Clinical Adult Range: 40-150ug/ml Optimal Adult Range: 50-100ug/ml Red Flag Range 200ug/ml Common Causes of Iron Increase: Hemochromomatosis, liver dysfunction, iron therapy, pernicious and hemolytic anemia Less Common Causes of Iron Increase: cooking with iron utensils 17 Common Causes of Iron Decrease: Pathologic bleeding (especially in geriatric population), iron deficiency anemia Less Common Causes of Protein Decrease: chronic infections, kidney and liver problems Nutrition Note: Increased iron with decreased hemocrit (HCT) suggests intrinsic factor deficiency Clinical Notes: An iron evaluation is not complete without ordering Ferritin (see below) FERRITIN Ferritin: This test is considered the â€Å"gold standard† in documenting iron deficiency anemia. Low levels below 25 indicate a need for iron. High levels may an inflammatory disorder, infections, rheumatoid arthritis, chronic kidney disease Clinical Male Adult Range: 33-236ng/mL Clinical Female Adult Range (before menopause): 11-122ng/mL Clinical Female Adult Range (after menopause): 12-263ng/mL Optimal Male Adult Range: 20-200ng/mL Optimal Female Adult Range (before menopause): 10-110ng/mL Optimal Female Adult Range(after menopause): 20-200ng/mL Red Flag Range 500ng/mL Common Causes of Ferritin Increase: Iron overload, hemochromatosis Less Common Causes of Ferritin Increase: inflammation, liver disease, rheumatoid arthritis Common Causes of Ferritin Decrease: Iron deficiency nemia Less Common Causes of Ferritin Decrease: Free radical pathology Clinical Notes: Serum ferritin greater than 1000 suspect hemochromatosis Clinical Notes: Iron overload and/or hemochromatosis are silent and can result in cirrhosis of the liver, bacterial infections, dementia, arteriosclerosis, diabetes and stroke Nutrition Note: Doctors specializing in chelation have found a correlation with increased iron and arteriosclerosis. TRIGLYCERIDES Triglycerides: These are fats used as fuel by the body, and as an energy source for metabolism. Increased levels are almost always a sign of too much carbohydrate intake and hyperlipidism. Decreased levels are seen in hyperthyroidism, malnutrition and malabsorption. 18 Clinical Adult Range: 50-150mg/dL Optimal Adult Range: 70-110mg/dL Red Flag Range 350mg/dL Common Causes of Triglycerides Increase: Hyperlipidism, diabetes, alcoholism Less Common Causes of Triglycerides Increase: Hypothyroidism, early stages of fatty liver Common Causes of Triglycerides Decrease: chemical/heavy metal overload, liver dysfunction, hyper thyroid function Clinical Notes: Resistive exercise training has been found to be effective in lowering elevated triglycerides CHOLESTEROL Cholesterol: Group of fats vital to cell membranes, nerve fibers and bile salts, and a necessary precursor for the sex hormones. High levels indicate diet high in carbohydrates/sugars. Low levels indicate low fat diet, malabsorption, anemia, liver disorders, carbohydrate sensitivity. Cholesterol values below 140 are considered one of the four OMINOUS signs. Clinical Adult Range: 120-200mg/dL Optimal Adult Range: 150-180mg/dL Red Flag Range 400mg/dL Common Causes of Cholesterol Increase: Early stages of diabetes, fatty liver, arteriosclerosis, hypothyroidism Less Common Causes of Cholesterol Increase: biliary obstruction, multiple sclerosis, pregnancy Common Causes of Cholesterol Decrease: Liver dysfunction, chemical/heavy metal overload, hyperthyroidism, viral hepatitis, free radical pathology Nutrition Note: Increased cholesterol levels have been found to be lowered y the amino acid methionine Clinical Notes: Cholesterol level below 130 is considered an Ominous sign Clinical Notes: If cholesterol is above 220 with a SGPT below 10 suspect liver congestion/fatty liver LDL CHOLESTEROL LDL Cholesterol: LDL is the cholesterol rich remnants of the lipid transport vehicl e VLDL (very-low density lipoproteins) there have been many studies to correlate the association between high levels of LDL and arterial arteriosclerosis. 19 Clinical Adult Range: 50mg/dL Clinical Adult Female Range: ;55mg/dL Optimal Adult Male Range: ;55mg/dL Optimal Adult Male Range: ;60mg/dL Red Flag Range 3. 0) may indicate intestinal parasites LYMPHOCYTES Lymphocytes: elevated in acute and chronic infections. Decreased in viral infection and immune deficiency Clinical Adult Range: 20-40 percent of total WBC Optimal Adult Range: 25-40 percent of total WBC Red Flag Range 55 percent of total WBC 22 Common Causes of Lymphocytes Increase: Chronic viral or bacterial infection, Childhood diseases (measles, mumps, chicken-pox, rubella, etc. ), HIV, Hepatitis Less Common Causes of Lymphocytes Increase: Chemical/heavy metal toxicity Common Causes of Lymphocytes Decrease: Active infections Clinical Notes: Suspect a viral infections when the lymphocytes increase to a point that either equal or exceeds the neutrophil level EOSINOPHILS Eosinophils: Elevated in allergic conditions, skin diseases, parasitic diseases Clinical Adult Range: 0-7 percent of total WBC Optimal Adult Range: 0-3 percent of total WBC Red Flag Range 55 percent of total WBC Common Causes of Eosinophils Increase: Allergic condition (asthma), food sensitivities, parasitic infection Less Common Causes of Eosinophils Increase: Chemical/heavy metal toxicity, Hodgkin’s disease, ovarian and bone tumors BASOPHILS Basophils: Elevated in Infections Clinical Adult Range: 0-2 percent of total WBC Optimal Adult Range: 0-1 percent of total WBC Red Flag Range 2. 0% Common Causes of Reticulocyte Count Increase: Internal bleeding Common Causes of Reticulocyte Count Decrease: Vitamin b-12, B-6 and folic acid anemia MCV Mean Corpuscular Volume (MCV) The MCV indicates the volume occupied by the average red blood cell Clinical Adult Range: 81. 0-99. 0cu. microns Optimal Adult Range: 82. 0-89. 9cu. microns Red Flag Range 95. 0cu. microns Common Causes of MCV Count Increase: Vitamin B-12/Folic Acid Anemia Common Causes of MCV Count Decrease: Iron anemia, internal bleeding Clinical Notes: If the MCV is ;89. 9 and the MCH is ;31. 9, suspect Vitamin B-12 or folic anemia. This should be confirmed with a serum or urinary methylmalonic (vitamin B-12) and a serum or urinary homocysteine (folic acid and vitamin B-6) Clinical Notes: If iron, ferritin are normal and MCV, MCH, Hemoglobin and Hematocrit are all decreased, suspect a toxic metal body burden MCH Mean Corpuscular Hemoglobin (MCH) The MCV indicates the volume occupied by the average red blood cell Clinical Adult Range: 26. 0-33. 0micro-micro grams Optimal Adult Range: 27. 0-31. 9micro-micro grams Red Flag Range 34. 0micro-micro grams Common Causes of MCV Count Increase: Vitamin B-12/Folic Acid Anemia Common Causes of MCV Count Decrease: Iron anemia, internal bleeding 26 Clinical Notes: If the MCV is ;89. 9 and the MCH is ;31. 9, suspect Vitamin B-12 or folic anemia. This should be confirmed with a serum or urinary methylmalonic (vitamin B-12) and a serum or urinary homocysteine (folic acid and vitamin B-6) Clinical Notes: If iron, ferritin are normal and MCV, MCH, Hemoglobin and Hematocrit are all decreased, suspect a toxic metal body burden T3 T3 (Tri-Iodothyronine): T-3 is a thyroid hormone produced mainly from the peripheral conversion of thyroxine (T-4) Clinical Adult Range: 22-33% Optimal Adult Range: 26-30% Common Causes of T3 Increase: Hyperthyroidism Common Causes of T3 Decrease: Hypothyroidism T4 T-4 (Tetra-Iodothyronine): T-4 is the major hormone secreted by the thyroid gland. Clinical Adult Range: 4. 0-12. 0mcg/dL Optimal Adult Range: 7. 0-8. 5mcg/dL Common Causes of T4 Increase: Hyperthyroidism Common Causes of T3 Decrease: Hypothyroidism, anterior pituitary hypofunction T7 T7 (FTI-Free Thyroxine Index) FTI is an estimate, calculated from T-4 and T-3 uptake. Clinical Adult Range: 4. 0-12. 0mcg/dL Optimal Adult Range: 7. 0-8. 5mcg/dL Common Causes of T7 Increase: See T-3 uptake Common Causes of T3 Decrease: See T-3 uptake T-3 UPTAKE T-3 Uptake T-3 uptake measures the unsaturated binding sites on the thyroid bindng proteins 27 Clinical Adult Range: 22-36% Optimal Adult Range: 27-37% Red Flag Range 39 percent of uptake Common Causes of T-3 Uptake Increase: Thyroid hyperfunction Less Common Causes of T-3 Uptake Increase: Kidney dysfunction, salicylates toxicity and protein malnutrition Common Causes of T3 Decrease: Thyroid hypo-function TSH TSH (Thyroid Stimulating Hormone): is used to confirm or rule out suspected hypothyroidism when T3, T4, T7 are essentially normal and clinical signs suggest hypothyroidism Clinical Adult Range: 0. 4-4. 4mlU/L Optimal Adult Range: 2. 0-4. 0mlU/L Red Flag Range 10. 0mlU/L Common Causes of TSH Increase: Thyroid hypofunction Less Common Causes of TSH Increase: liver dysfunction Common Causes of TSH Decrease: Thyroid hyper-function, anterior hypofunction Clinical Notes: The axillary temperature (underarm) will frequently be

Performance Measurements Essay

Performance measurements are used to characterize and define performance in a project. They are used to track and manage progress toward achieving specific project goals. Performance measurements help determine how decision-making processes of a project led to its success or failure, understanding these can help organizations make future improvements. It is a project manager’s responsibility to measure performance based on the triple constraints of time, budget, and quality of a project. There are many performance measurements a project manager can use based on the type of project at hand, this paper compares and contrasts the following measurements – * Earned Value * Customer Satisfaction * Requirements Performance Earned Value Earned Value measures work performed in terms of schedule and budget of a project. It helps identify schedule and budget mishaps in all areas of a project. â€Å"Earned Value is an approach where you monitor the project plan, actual work, and work-completed value to see if a project is on track. Earned Value shows how much of the budget and time should have been spent, with regard to the amount of work done so far† (Haughey, 2013). It measures current performance in a project, which helps project managers determine what the future performance will be. Using earned value, project managers can determine how much work is completed vs. , how much was expected to be completed at a certain point in a project. Based on the earned value, project managers can make changes to the way the project is progressing in terms of specific tasks, schedule, and budget to bring it back on track for successful completion. Earned Value provides the project manager with an objective way of measuring performance and predicting future outcomes. This can enable him or her to report progress with greater confidence and highlight any overrun earlier. This in turn, enables the management team to make cost and time allocation decisions earlier than would otherwise be the case†Ã¢â‚¬  (Haughey, 2013). Customer Satisfaction Customer satisfaction is a performance measure that determines if customer expectations are being met. At the end of a project, customer satisfaction is what determines if a project was a success or a failure. Project-driven organizations must consider customer satisfaction as a critical success factor. Organizations that deliver projects that disregard customer needs create negative experiences and ultimately cause huge problems for the organization† (Karim, 2012). Project managers must make sure customer expectations and requirements are in line with the project continually during the life of a project. Following are some of the steps he or she can take to ensure customer satisfaction – * Balance customer needs with company’s customer service needs. Make sure customer requirements are deliverable and clearly communicate those that aren’t. * Gather continual feedback from customers to measure their satisfaction and improve current processes. * Customer satisfaction should be given as much importance as time, budget, and quality in project. * Include and inform customers when any changes are made in a project. * Effective communication between the customer and Project manager, and between the project manager and project team is very important. Requirements performance Meeting requirements is a key factor in measuring project performance. It is important to make sure that the right requirements have been gathered, and they are detailed as clearly as possible. Requirements in a project can be both functional and non-functional. If a project is meeting all of its requirements, it can be a key factor that indicates if it will be a successful one. â€Å"To measure this factor you need to develop measures of fit, which means the solution completely satisfies the requirement. A requirements performance index can measure the degree to which project results meet requirements†¦ Fit criteria are usually derived some time after the requirement description is first written† (Pennypacker, n. d. ). In conclusion, there are many ways to measure project performance and each project has its unique set of performance measurements. Performance measurements are important to track the progress of a project and to make sure the project is on target. Performance measurements are used to monitor and control a project to ensure its successful completion.

Assignment Essay Example | Topics and Well Written Essays - 500 words - 5

Assignment - Essay Example Additionally, different from sex, which refer to biological dimension, gender is acquired through socialization. In fact, gender inequality consists in everywhere in the society. From birth, baby boys and baby girls are treated in different ways by their parents. According to MacDonald, parents always take care of their baby girls more carefully and gently. Besides, parents give different toys to different genders often unknowingly reinforcing gender stereotypes. For example, parents prefer to give computer games, vehicles and war toys to boys and dolls, dishes and jewelry boxes to girls. In addition, boys and girls are assigned different tasks when they are old enough to do some housework. Boys are usually asked to do maintenance chores, such as replacing bulbs and fixing roofs. Girls always end up doing domestic chores, such as cleaning rooms, cooking and shopping. Moreover, sociologists consider that the chores assigned to children can go on to effect children’s personal characteristics and future occupation choices. For instance, girls experienced in looking after their siblings may become nurses in future. Boys may learn computer science and in w ork IT areas and they may become engineers when they grow up. Some critics believe that the media should report the reality, while some others think the media can persuade the public into certain ideas. Among all kinds of TV programs, there are more male roles occurs than female ones. Indeed, the characters are significant different between male and female roles. According to Basow, male are always depicted typically aggressive, and heroic. Contrarily, female roles are various. In some video games, online games and electronic media women are objectified and are depicted in a poor light reinforcing negative stereotypes of women. Men are typically portrayed as â€Å"macho†, gun totting and as super heroes. These games encourage children to resort to violence as it desensitizes them against

Offsite manufacturing in the construction industry Essay

Offsite manufacturing in the construction industry - Essay Example Introduction and Context Too often construction projects conducted on site have exhibited inefficient project processes, low integration among team members, poor productivity levels, and poor performance in safety and health. In comparison the manufacturing sector does not normally experience these repercussions which has led some innovative mind in the industry to consider a better way. This turned out to be off site building, which has been noted to have many advantages over traditional construction (Ogden, 2007). In the light of the need for Zenith PM to develop a new strategy to improve its revenues and retain its skilled personnel, the company has identified off-site construction as its most viable option. Current thinking on offsite manufacturing New developments The off-site construction trend grew significantly in 2006 in various countries worldwide, partly because clients and contracts have come to realise its benefits in terms of lower cost, better quality, predictability o f outcome, sustainability, and better compliance with health and safety standards. The off-site industry is still in its infancy despite the rise in the demand for its products; at this point, the industry is still a diverse and fragmented group of technologies and off-site producers. There is certainly room for further development which, as the sector matures, will enhance standardisation and regulation so that clients and contractors could benefit from more reliable products and also more options per product. There are currently four off-site construction techniques where the manufacturing or fabrication is performed away from the project site and before the installation. Na and Bausman (2008) identified these as: (1) Offsite preassembly, referring to the process wherein different building materials, equipment, and prefabricated components are assembled at a remote location for later installation. It is focused on a system instead of a product. One example is roof trusses, or prea ssembled vessels complete with installations, platforms piping and ladders. (2) Hybrid systems are prefabricated building facilities, i.e. they are building units that are fully factory finished, complete with internal furnishes and building services. An example is a factory finished bathroom with interior finishing, plumbing, electrical service, and factory completed office rooms. (3) Panelized Building Systems are comprised of the structural frame, or building envelop, employing factory manufactured building panels. These consist more of factory-built components rather than completed modules – usually including the factory based fabrication like finished wall panels with cladding insulation, internal finishes, doors and windows. They are brought to the site and are there assembled and permanently secured (4) Modular buildings are popularly known as the factory-built homes of one or more units completely assembled or fabricated in a manufacturing plant far from the jobsite. They consist typically of multi-rooms with three-dimensional units, that are constructed and pre-assembled and already include installed trim work, electrical, mechanical, and plumbing. After fabrication, they are transported and assembled on site. Benefits and core challenges There are a host of benefits brought about by off-site construction that have been long-recognized by the HSE and other monitoring agencies. These include ‘predictability, quality assurance, faster construction times, less waste,

Paradoxical Thinking Research Paper Example | Topics and Well Written Essays - 1250 words - 1

Paradoxical Thinking - Research Paper Example In this case, scientists are the best examples of people who practice paradox thinking in their daily life. Paradoxical thinking is based on suspicion and the internal feeling that the outcome of a certain thing, idea or experiment will turn out to be exactly as expected. Although the method might be the opposite of the normal or natural way of doing, the outcome should turn out to be the same or better than when the normal procedure is used. Paradoxical thinking is believed to produce extraordinary outcomes. An example of a brilliant demonstration of paradoxical thinking is by a famous scientist known as Faraday back in the 1830s. He discovered that when a current is moving through a wire, it bares the effect of deflection a magnetized needle thus can be applicable to a compass needle. He used this idea to create an electric motor which is currently used in electric transformers. The current world market has a lot of competition. Ideas are being generated every day and the technology keeps on advancing with the change in time. New products appear in the market everyday with manufacturers trying to outdo each other by modernism their products to meet the needs of the consumer. This has called for the alert of every company in order not to be left aside with the emerging trends of technology. Paradoxical thinking plays a key role in ensuring that the goods produced by various companies merge the current technology and are suitable to the consumers. Most companies have maintained their high performances in the world market because of using paradoxical thinking as a tool to outdo their competitors. The concept of this form of thinking is simply to do things the opposite of the intended way. This helps the company be unique and unpredictable. The Coca-Cola Company is one of the companies which have a team of staff who have mastered the art of paradoxical thinking. The

Assignment Example | Topics and Well Written Essays - 250 words - 43

Assignment Example Likely trained as a Priest himself, Fulcher of Chartres (c. 1059 - ?) was one of the earliest historians of the First Crusade (1095-1099), a military expedition undertaken by European Christians to regain the ‘Holy Lands’ and recapture Jerusalem. In the particular excerpt from Fulcher’s chronicle that I have assigned to you, Fulcher recounts Pope Urban II’s (1088-1099) speech at the Council of Clermont. This speech is thought to have launched the First Crusade. incumbent (someone currently holding an official position); diocese (bishopric or area under the authority of a particular bishop); patriarch (a leading bishop in the Orthodox Church of the Byzantine Empire); ecclesiastical (of or referring to the church); patriarchate (area under the authority of a particular patriarch); cathedral chapter (body of clergymen formed to advise a bishop or, in his absence, govern the particular area under his authority); cultic (of or pertaining to worship According to Barlett, Latin Europe is that component of Europe which was predominantly Roman Catholic from the very beginning. The zone had common characteristics in geographical and cultural context. Latin was the dominant language for communication with a combination of Latin and Roman culture. Internal differences existed in the Latin Europe of the early Middle Ages unlike Latin Europe of the later Middle Ages. (Bartlett, 1) The ‘Latins’ were also referred as ‘Franks’. In the initial half of the ninth century, the Christian West and the Franskish Empire shared the same boundary. Frankish Europe as per Bartlett’s definition is the land of Carolingians. This was the center of the West. Some parts of England, Northern Italy, France and West Germany were also included. During the High Middle Ages, this part of the Empire may be regarded as central. The religion was

Paper Topic in the direction Essay Example | Topics and Well Written Essays - 750 words

Paper Topic in the direction - Essay Example 6 years later, he developed a document that would abolish slavery Northwest (Jefferson,  12). He sticks to the decision of emancipating slaves who would be within the process of democracy. Abolition will be pushed until the owners of slave agree to free the human property in a wide spectrum of emancipation. Jefferson thought that the act was not democratic and was against the principles and rules of American Revolution for the nation to enact the abolition issue or for planters to let the slaves go. Although Jefferson continued advocating for abolition of slavery, the reality behind slavery was that it was becoming entrenched in the American system (Jefferson,  34). The population of slaves on Virginia increases tremendously from a figure of 292627 slaves in 1790s to 470000 in 1830s. Jefferson thought that the slave trade abolition would weaken the issue of slavery and increase its ultimate. Instead, the issue of slavery became more vast and profitable. Trying to eradicate the Vi rginia support for slavery, Jefferson discouraged crop cultivation that are labor intensive such as tobacco, and encouraged the product of less labor-intensive crops such as wine grapes, sugar maples, grained rice, and wheat. In 1800s, the most valuable commodity in Virginia was mainly slaves. His stance in ending the issue of slavery did not change. From mid 1770s until he died, Jefferson advocated a similar plan to gradually emancipate. First, the issue of transatlantic slave would be removed; secondly, the lawn owners would upgrade the violent features of slavery by improving the living conditions and moderating the punishment for the slaves. Thirdly, those born under the slavery regime would set free following abolition. Like the current leaders, Jefferson supported the removal of freed slaves that was present in US. His unintended effect on the plan was the objective of removing the issue

School programs Essay Example | Topics and Well Written Essays - 1750 words

School programs - Essay Example Briefly explain each innovation: one innovation for Pre-School Programs, one for Elementary School Programs, one for Middle School Programs, three for High School Programs and four for College Level Programs One innovation for pre-school programs is smaller classes that are based on a permissive model vs. an authoritarian or inoculation based pre-school program. Smaller classes that permit pre-school learners to explore the environment or educational materials as a preparation for learning can be considered as alternatives to large classes with rote drill learning methods. An example of an innovation in elementary school would be a participative and competitive spelling bee competition in class where all students were required to display and test knowledge vs. a rote, repetition and repeat spelling drill led by the teacher and followed by the class in unison. In Middle School, providing students a three hour period of intense guided instruction in a subject of specialization could be an innovation and reform that is an alternative to the relatively low amount of instructional time in classes and the general, homogenized nature of reproduction of class lectures and course material. In High Schools, increasing the level and quality of education in public schools is an important innovation, as is increasing the degree of personal and family choice in attending institutions. Making the 10th through 12th classes a more intensive time of study and preparation for students for future education and career choices is important. Increasing the student and family participation in school organization and management can lead to more feeling of involvement and ownership in institutions. Widening the areas of specialized studies by decreasing class or group sizes and increasing independent study ad research in subjects also build proficiencies in students. At the College or University level, implementing the reform of universal, free access to education is the most important and needed goal. That knowledge and learning is restricted by economics or socio-economic resources on a personal or family level leads to a divided society and class structure. Furthering student organization of classes and research would also build inclusion on campus. There are many options to cooperate to save costs in housing, food, books, etc. that are not undertaken because of the profit motive in education. Developing a more collective, self-organized, and non-profit approach to education at the university level is an important part of universal education reform practically. Students should have more freedom in designing their own areas of study, in both specialization and cross-disciplinary studies. Essay #2 - Try to chart the ways in which the American educational system (for publically funded schools) has historically attempted to reach its institutional goals. That means for you to sketch the ways our society has approached the process of education. Now try to explain ho w this process is mediated by having to keep attention on funding issues. The main goal of the American education system has been to provide a free or publicly funded educational opportunity from K-12 for all students or citizens of the country. The combinations of State, Local, and Federal taxes are used to this purpose. The higher education is based on student born costs that may be defrayed by the difference between public, or State-sponsored and subsidized schools, or private colleges and universities. The ideal of a broad general education as basis of citizenship developed from basic literacy requirements as a foundation for democratic citizenship. Nevertheless, the American system of education also is focused in producing

Brand audit assignment Essay Example | Topics and Well Written Essays - 4750 words

Brand audit assignment - Essay Example During this time, Cosmopolitan started to become more of a literary magazine, with the introduction of serial fiction and book reviews being published in the magazine for the first time. During this time, Walker not only managed to triple the magazines subscriptions, he also provided the magazine with a general direction that was continued when in 1889 John Brisben Walker purchased the magazine. During this time, top writers such as Rudyard Kipling, Ambrose Bierce, Jack London and Theodore Dreiser began writing for the Cosmopolitan regularly and it became one of America’s leading literary magazines. From the early 20th century to the 1940’s, the magazine continued to grow in nationwide circulations and became a full-fledged self proclaimed â€Å"Four book magazine†, publishing a combination of a novella, six to eight short stories, serials, six to eight articles and assorted features. However, during the late 1950’s the magazine began to lose some of its l oyal readership when the paperback and television started to become household commodities and took the focus off magazines. The Birth of the â€Å"Cosmo Girl† It was only in the 60’s that drastic change ensued and the magazine started out on its journey to become what it is today: a leading magazine catering to the â€Å"fun, fearless woman† of today who seeks information and advice about sex, relationships, fashion and their well-being. The magazine as it is today was reshaped at a point when it had become a general interest magazine, with rapidly declining profits and mass market appeal. At the time this change happened, American society on the whole was going through a phase of tentative change, women all over the country were beginning to realize the power of their own femininity and were beginning to explore the limits of their own sexuality. The predominantly male oriented society was becoming more open to freedom of thought and speech and women were start ing to look at avenues of work that were previously dominated by males. During that time, Helen Gurley Brown, a newly married copywriter, wrote a fictional account of a single girl who was living the kind of new and exciting life that women of that age wanted to live, a life where they had the freedom to do whatever they pleased and be happy without a stable man or relationship in their life. This new book, â€Å"Sex and the Single Girl† encouraged women to enjoy their sexuality without guilt, a topic which interested the woman of the 60’s so much that the book became an instant best-seller (Benjamin, J., 2009). The success of the book, and the frenzy of thank you notes from women who wanted further advice on their personal issues gave Helen Gurley Brown the idea of creating her own magazine which would allow her to address these women directly and give them advice about their personal issues regarding sex, relationships and health. This idea lead her to the Hearst Cor poration’s aging â€Å"general interest† magazine for Men and Women, The Cosmopolitan. The owners of the magazine were already planning to close it down and gave her the reigns to try out her new format in the hopes that she could breathe new life into the magazines declining circulation. This decision proved to be a remarkably apt one as the magazine’