RED BLOOD CELL ELEMENTS

LAB#: B000000-0000-0
PATIENT: Sample Patient
SEX: Male
AGE: 3
CLIENT#: 12345
DOCTOR:
Doctor's Data, Inc.
3755 Illinois Ave.
St. Charles, IL 60174
NUTRIENT ELEMENTS
RESULT
REFERENCE PERCENTILE
ELEMENTS
g/g
RANGE 2.5
th
16
th
50
th
84
th
97.5
th
Calcium
8
8- 31
Magnesium
56
36- 64
Potassium mEq/g
85
65- 95
Phosphorus
611
480- 745
Copper
0.61
0.52- 0.89
Zinc
12.3
8- 14.5
Iron
939
745- 1050
Manganese
0.012
0.007- 0.030
Chromium
0.0008
0.0003-0.0060
Selenium
0.27
0.19- 0.38
Boron
0.084
0.01- 0.110
Vanadium
0.0002
0.0001-0.0020
Molybdenum
0.0011
0.0005-0.0020
POTENTIALLY TOXIC ELEMENTS
TOXIC RESULT REFERENCE PERCENTILE
ELEMENTS
g/g
RANGE 95
th
99
th
Arsenic
0.002
< 0.010
Cadmium
< 0.0008
< 0.005
Lead
0.009
< 0.090
Mercury
< 0.001
< 0.010
Thallium
< 0.0001
< 0.0005
SPECIMEN DATA
Comments:
Date Collected: 12/30/2005 Methodology: ICP-MS
Date Received: 1/3/2006 g/g = ppm
Date Completed: 1/5/2006
V10.01
DOCTORS DATA, INC. ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420 CLIA ID NO: 14D0646470 MEDICARE PROVIDER NO: 148453
Lab number: B000000-0000-0 Packed Cell Page: 1
Patient: Sample Patient Client: 12345
PACKED BLOOD CELL ELEMENTS REPORT
INTRODUCTION
This analysis of elements in packed blood cells was performed by ICP-Mass Spectroscopy
following acid digestion of the specimen in a closed microwave system. For a given element,
these procedures measure the sum of the amounts of surface-adhering and intracellular content,
regardless of chemical form. For units of measurement, mg/l is approximately equivalent to ppm,
and mcg/l is approximately equivalent to ppb.
The packed cells are not washed, and therefore, a very small amount of residual plasma
remains as part of the specimen. Washing would eliminate some important plasma membrane-
bound elements. Because the cells are not washed, the DDI reference range may vary from
published ranges for intracellular content of washed erythrocytes. Blood cell specimens that are
not adequately centrifuged, per the kit instructions, may yield distorted or invalid results because
of excess plasma content.
Packed blood cell analysis is intended to be a diagnostic method of assessing insufficiency or
excess of elements that have important functions inside blood cells or on blood cell membranes.
Additional testing of whole blood or serum/plasma or other body tissues may be necessary for
differential diagnosis of imbalances. Additional testing also may be necessary to assess specific
dysfunctions of assimilation, transport, retention, or excretion of elements. Packed blood cell
element analysis is additionally intended to determine elevated or excessive levels of five
potentially toxic elements that can accumulate in erythrocytes: antimony, arsenic, cadmium, lead,
and mercury.
If an element is sufficiently abnormal per the blood cell measurement, a descriptive text is
included with the report. For elements with essential or beneficial functions, a text will print if the
measured result is below -1.5 standard deviations from the mean of the reference population, or if
the result is above +1.5 standard deviations from the mean of the reference population. For
potentially toxic elements, a text prints whenever the measured result exceeds the expected
range. If no descriptive element texts follow this introductory discussion, then all essential cell
elements were measured to be within +1.5 SD, and all measured potentially toxic elements were
within expected ranges.
Doctors Data states the reference range as +1 SD from the mean of the reference population.
This is considered to be the nutritionally and physiologically optimal range for elements with
essential or beneficial functions. Physiological imbalance corresponds to levels beyond +1 SD but
pathological consequences are not expected until the blood level is beyond +2 SD. Element levels
beyond +2 SD may only be temporary nutritional problems or they may reflect a failure of
homeostasis to control blood quantities. Pathological consequences depend upon cell and tissue
functions which are disrupted by such levels.
CALCIUM LOW
Only a very small portion of total blood calcium (Ca) resides inside erythrocytes or on the outer
surface of the plasma membrane of erythrocytes; this measurement combines both fractions
because the packed cells are not washed. Typically, washing would remove up to 90% of total
1999-2005 Doctors Data, Inc.
Lab number: B000000-0000-0 Packed Cell Page: 2
Patient: Sample Patient Client: 12345
packed blood cell Ca. Washed, packed erythrocytes from normal individuals are expected to
contain from about 0.325 to about 0.7 mcg/ml of Ca. Per DDI procedures, unwashed, packed
erythrocytes from normal individuals are expected to have about 10 to 20 mcg/ml (10 to 20 ppm)
Ca on and inside the cells. From these levels, it is obvious that, under normal conditions, the Ca
bound to the outer surface of the cell membrane dominates the total packed cell Ca level.
A finding of subnormal, unwashed packed blood cell Ca is consistent with: cell fragility, fatty
acid abnormalities in the plasma membrane of erythrocytes, or with use of calcium channel-
blocker medications. Exposure to toxic chemicals or xenobiotics may lessen cell ability to bind Ca.
Calcium deficiency or vitamin D deficiency may also feature low packed cell Ca, but low packed
cell Ca is more likely to be related to cell membrane problems or cell structure.
Individuals with hemolytic anemia or sickle cell anemia typically have increased intracellular
erythrocyte Ca and may have decreased membrane-bound Ca. Low or high overall packed cell
Ca can result (often, the Ca is higher than normal). Cell Ca levels also depend on the degree of
cell oxygenation; abnormally structured erythrocytes that are deoxygenated contain more Ca.
Such cells usually have excess permeability to sodium and potassium.
Other diagnostic tests suggested by a finding of low packed cell Ca include: blood chemistry
analysis including serum Ca level, CBC with differential, iron assimilation study (serum Fe, ferritin,
TIBC, saturation), cell morphology study, markers for xenobiotic toxicity, erythrocyte membrane
fatty acid analysis, vitamin E assessment, and vitamin D assessment.
BIBLIOGRAPHY FOR BLOOD CELL CALCIUM, LOW
1. Harrison D.G. and C. Long, The Calcium Content of Erythrocytes J. Physiology 199, 1968 pp
367-81.
2. Altman P.L. and D.S. Dittmer, eds, Biology Data Book 2nd ed, vol. III, FASEB, Bethesda, MD
pp 1751-52.
3. Palek J., Red Cell Calcium Content and Transmembrane Calcium Movements in Sickle Cell
Anemia J. Lab. Clin. Med. 89(6), June 1977 pp 1365-71.4. Eaton J.W. et al, Elevated
Erythrocyte Calcium and Sickle Cell Disease Nature 246, Nov. 1993 pp 105-106.5. ORear E.A.
et al. Problems in Measurement of Erythrocyte Calcium Am. J. Hematology 11, 1981 pp 283-92.
1999-2005 Doctors Data, Inc.