Assessment and diagnostics Flashcards
What are 4 examples of anthropometric testing?
waist, BMI, weight, body composition, heigh, waist-hip ratio
What can we use stool to investigate?
detection of parasites, yeast or bacteria; digestive function
What can we use saliva to test?
DNA, hormones, antibodies
What are 4 urine investigations?
hormones, intestinal permeability, detox metabolites, toxic metal clearance, mitochondria metabolites, bone turnover rate
What is an example of non-invasive and invasive tests?
Non-invasive: saliva, urine, stool
Invasive: blood
What 4 investigations can be done with blood?
blood glucose, nutritional status, allergies, homocysteine levels, lipid and cholesterol levels
What 2 measures can be made with hair?
minerals and toxic metal levels
What tests can be done in clinic? (6)
waist, waist-hip ratio, height, blood spotting test, urine dipstick, BMI, bio-impedance analysis
What is an adv and disadv of BMI?
Adv - indicator of CVD and type 2 diabetes
Disadv - cannot be used on learn muscular athletes
What are the RF numbers for waist numbers?
102 men
88 women
What are the numbers for waist-hip ratio indicating increased risk of CVD and type 2 diabetes?
> 0.9 men
>0.85 women
describe how bio impedance analysis works.
send an electric impulse through the body and the resistance is measure. Fat and muscle resist at different rates
Explain how the size of RBC determines the cause of anaemia.
small RBC - iron or B6 deficiency anaemia
large RBC - B12 or folate deficiency anaemia
Explain how the MCH determines the cause of anaemia.
high haemoglobin - B12 or folate
low haemoglobin - iron or B2
What is platelet count for?
evaluate blooding disorders
What is microcytic hypo chromic? What is macrocytic normochronic?
microcytic hypochronic - small, pale RBC (iron or B6)
Macro normochromic - large, normal coloured RBC (folate or B12)
What does serum ferritin indicate? What does ferritin have to drop below to indicate this disease?
most sensitive lab test for iron deficiency
33ug/L
What does high ferritin levels indicates?
high levels indicate CVD, cancer and oxidative stress
What is transferrin for?
iron is transport in blood bound to a protein called transferrin.
What is there reference range for transferrin? What does low and high transferrin indicate?
44.8-62.7 umol/L
low - haemochromatosis
high - iron deficiency anaemia
Explain why it is necessary to do B12 testing for anaemia.
we need to do B12 because full blood count can indicate anaemia but cannot be easily differentiate between folate and B12
Explain why MMA is tested alongside B12 for anaemia
MMA is necessary to help determine how B12 is used as a coenzyme. High MMA indicates low B12 because MMA converts to succinyl-CoA when there is sufficient B12.
What is the gold standard of B12 testing?
holotranscobalamin because it is the transport protein which uptakes B12 into cells
What is C-reactive protein for?
general marker for inflammation and infection
What is ESR used for and stand for?
It is the rate at which erythrocytes settle out of anti-coagulation in 1 hr and indicates inflammation
What does low ESR indicate
polycythemia, sickle cell anaemia, congestive heart disease
What is ALT and AST used to indicate?
ALT and AST indicate the degree of inflammation
ALT indicates liver damage only whereas AST indicate muscle damage in other organs like cardiovascular
What is ALP for and what does it indicate?
Alkaline phosphatase; enzymes found mainly in bile ducts of the liver and low levels indicate zinc deficiency
What is gamma GT a marker for? And what must be over to indicate high levels of this?
Marker for oxidation and over 40 for high oxidative damage
What diseases does LD (lactate dehydrogenase) indicate?
liver disease and myocardial disease, skeletal disease, liver disease, muscle disorders
What does the LFT test indicate?
inflammation and infection, damage of liver
What is the difference between LDL, HDL and VLDL?
LDL – cholesterol from liver to cells, HDL – cholesterol from cells to liver, VLDL – newly synthesized triglycerides move from liver to adipose tissue
What is hyperlipidaemia?
high lipid levels
What is dyslipidemia?
disorder of lipoprotein metabolism include lipoprotein overproduction or deficiency
Name 4 diseases which cause high TG.
overweight, diabetes, PCOS, hypothyroidism
What are good markers for insulin resistance in overweight patients?
TG/HCL ratio
What diseases do FSH indicate?
gonadal hypo function and suspected pituitary tumour
what disease do high LH indicate?
primary gonadal failure
What test confirms PCOS?
high FSH/LH
What are increased testosterone levels in females and males indicate?
hiureutism in females, decreased level =testosterone failure in males
What does progesterone indicate?
investigates fertility
What 3 disease do PSAs indicate?
benign prostatic hypertrophy, prostate cancer, prostatitis,
what does high TSH and low TSH indicate?
high - hypothyroidism
low - hyperthyroidism
What is the RAST test?
test for IgE antibodies to diagnose allergies
what is the first line of allergy testing?
skin prick allergy testing
What diseases are indicated by high and low levels of WBC?
high - high adrenal levels, high refined food intake, intestinal parasites, asthma, adrenal dysfunction
low - raw food diet, food allergies, B12, B6 and folate anaemia, chronic intestinal parasite
What does MMA stand for?
Methylmalonic acid
What are some over the counter tests?
blood glucose, blood cholesterol, food intolerances, PSA, litmus paper (pH saliva/urine), pregnancy test/ovulation test, H.pylori test
How do I calculate BMI?
weight/(H x H)
How do you take waist circumference?
find top of hip bone, find bottom of rib cage. mid point between. Breath in and take measurement
How do you calculate hip-waist ratio?
Gw/Gh
What do high homocysteine levels indicate?
risk for CVD, strokes and other inflammatory diseases
What does haemoglobin A1C/glycated haemoglobin for?
blood glucose levels over past 3-4 month
What insulin levels indicate hypoglycaemia?
less than 5 mU/L
What are auto-antibiodies?
immunoglobulins towards self that are high in autoimmune states
What are the 3 thyroid antibodies we can test for?
anti-thyroid peroxidase (TPO), anti-thyroglobulin antibodies (TG), anti-thyrotropin receptor (TRAbs) antibodies
What do subclinical hypothyroidism test results show?
high TSH but normal T4
What are the disadvantages of RAST test?
expensive, you need to know what specific antibodies are tested
how do skin prick allergy testing work?
localised IgE mediated histamine release by mast cells causes a red, swollen, itchy skin
List 8 common IgE allergens.
latex, peanut, dog fur, penicillin, egg, gluten, cows milk, cheese
What is the most nutritionally relevant vit D test?
25-OH-Vitamin D
What do low levels of vit D indicate?
increased inflammation, autoimmunity, cancer, infections
What is number is vit D consider deficient?
25 nmol/L is agree to be deficient but 50nmol/L is what many labs believe
What is gold zone for vitamin D?
70-80nmol/L
What is organic acid testing?
tested via urine for organic acids, provides a metabolic snap shot of a clients overall health giving neurotransmitter health, digestive state, mitochondrial health and detox ability
How can we test for food intolerances?
IgE mediated allergies (true allergy - involves degranulation of mast cells) or IgG mediated intolerances (not truly immunologically mediated)
how do IgE mediated allergies work?
IgE antibodies form to an antigen and then bind to mast cells receptors triggering mast cell degranulation and histamine release
How does increased sensitivity to food happen?
IgG antibodies and regular exposure to a unvaried diet, along with leaky gut increases sensitivity to foods
Why would a client react to food?
lack of chewing, low HCl, leaky gut, candida, lack of beneficial bacteria, inflammatory processes
How can we test for intestinal permeability?
sugar absorption, urinary excretion test, zonulin tests (stool or serum), lipolysaccharides in serum tests
How does sugar absorption tests work?
low digestible disaccharide solution - urine is collected after ingestion and the presence of sugar detected giving a marker for intestinal permeability
How does zonulin mark raised intestinal permeability?
protein that opens gap junctions in response to infection. linked to coeliacs and diabetes type 2
How do lipopolysaccharidess act as a marker for intestinal permeability?
lipopolysaccharides (LPS) are what covers the outer walls of gram neg bacteria which activates the immune system. High levels = inflammation, autoimmune
What is SIBO?
normal commensal flora from large intestine which have transmigrated or growth out of balance in SI
When do we test for SIBO?
bloating, excessive burping, halitosis and flatulance but symptoms get work with sulphur food, diarrhoar, constipation (worse with fibre), symptoms worsen with probiotics
How do we test for SIBO?
breath test to detect hydrogen/methane levels because high levels of bacteria ferment lactulose which produces these gases so we must give lactulose to the person first
What is salivary full hormone profile?
several collection points throughout month and looks at melatonin, DHEA and cortisol levels
What do serum hormonal tests test?
progesterone, oestradiol, testosterone, LH and FSH
what are dried urine analysis for?
overview of sex and adrenal hormones alongside metabolites, used with day 19-22
what nutrients can hair analysis test us about?
ca, mg, na, k, cu, zn, fe, Se, cr, mn, p, co, b
also mercury and cadmium (heavy metals)
