See the report.

Your Health Screening Report

 

2017_health_report_assessment

Extremely Detailed

What really makes us stand out from other health screening providers is the quality of the Doctor's report that you will recieve within 7 days of your nurse attendance. Not only is it extremely detailed, it is also easy to understand. We present clear and relevant clinical information that will be taken seriously by your own GP, and it is delivered quickly. We don't risk your personal details being compromised by placing the report online and we don't include pointless graphs. 

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Report Information

This gives you information on how to read your report and where everything can be found. This ties in with the personal letter regarding your health screen by one of our Doctors.


 

 

Pathology Alert Summary

At a glance you are immediately able to tell which blood tests are within normal limits and which may require further attention. Each health screening test will be examined in more detail later on in the report and if any "red lights" appear our Doctor will also pass comment in his accompanysing letter. The laboratory report itself appears at the back of the report as an appendix giving your actual results and reference ranges, and the blood test figures are also mentioned, when appropriate, throughout the report.


Assessment Report Summary

This section of the report is a summary of the bio markers, cardiac related data, modifiable risk factors and risk assessments. Clinical risk is given as a traffic light alert. Green indicates a low clinical risk, whereas a yellow or a red traffic light would indicate a moderate to high clinical risk that needs alerting to or action taken.

 

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Full Blood Count Assessment

 

White Blood Cell Count

The WBC (white blood cell) count is a common test within a health assessment and is a measure of your body's ability to fight infection. A normal WBC level can be interpreted as a sign that the first line of defence against invasion by bacteria or other disease causing organisms is intact and functioning. Moderately elevated white cell counts are a sign of acute infection, while very high counts of abnormal white cells are encountered with leukaemia (a relatively rare form of blood cancer).

Red Blood Cell Count

The RBC (red blood cell) count is the number of red blood cells present. It can vary considerably, and a marginally low or high health screening reading may not imply a problem. Significantly reduced numbers within any health check can be associated with anaemia (a deficiency in red cell production, or excessive loss of blood), and very high numbers are seen in polycythaemia (a condition which can be caused by smoking, living at altitude or just because the bone marrow makes too many red cells).

Haemoglobin Level

The haemoglobin level is probably the most useful single measure of red blood cell health. Haemoglobin is the pigment that gives red blood cells their colour and is responsible for carrying oxygen around the body. Anaemia (red cell deficiency) is usually detected through finding a low haemoglobin level, and the type of anaemia can be determined by looking at other blood count measures. This is one of the most useful health investigation tests within the full blood count.

Haemaocrit Level

HCT (haematocrit) is a measure of blood concentration (the higher the score, the more concentrated the blood). A high haematocrit may mean simply dehydration, but it could indicate polycythaemia - which is a situation in which too many red cells are present, and which has many causes including smoking. A low haematocrit could be due to good hydration, pregnancy or recent blood loss.

Mean Cell Volume

The MCV (mean cell volume) is a measure of the average red blood cell size. It can be particularly useful to distinguish between types of anaemia - a low MCV is associated with iron deficiency, while a large MCV is seen with vitamin B12 and Folate deficiency for example.  Also used in occupational and DVLA assessments when evaluating excess alcohol intake.

MCHC

The MCHC (mean cell haemoglobin concentration) is a similar measure to MCH, and has broadly the same application.

Platelets

Platelets are, thank goodness, in plentiful supply in the bloodstream. They are involved with the clotting process (which begins the repair process in the event of an injury to the body). Too many platelets leads to a state known as thrombocytosis, which may result in clotting when it is not required - for example, DVT (Deep Vein Thrombosis) after travel, heart attack, or a stroke. Too few platelets can lead to easy bruising or uncontrolled bleeding, and is state known as thrombocytopenia. Both of these conditions are therefore easily picked up in this home health screening.

Red Cell Distribution Width

RDW (red cell distribution width) is a mark of red blood cell health - the 'wider' this health screening reading, the more variable are the sizes of red cell seen in the sample. Higher RDW values can be seen in anaemic states.

Neutrophils

Neutrophils are the most prevalent white blood cell, and are the first on the scene following injury. Infection will lead to a rise in this level, and a very steep rise will be encountered in a relatively rare type of cancer known as leukaemia. A short term drop which is often seen during health screening is common during recovery from infection, while persisting low levels can be a sign of immune deficiency (which can lead to increased susceptibility from infection).

Lymphocytes

Lymphocytes are the types of white blood cell which manufacture antibodies against invading organisms and are essential for a normal immune response. Infection will lead to high levels, while low levels may indicate problems with the immune response.

Monocytes

Monocytes are a type of white blood cell. They are involved in fighting infection from invading organisms.

Eosinophils

Eosinophils are another type of white blood cell. High levels are associated with allergic conditions (such as asthma) and some tropical diseases (such as tapeworm) and is therefore a valuable test to have within a health screening without having to order specific tests for suspected conditions.

Basophils

Basophils are another category of white blood cell. They are not very abundant and are probably less important than the other categories of white blood cell.

ESR

ESR is a blood test that is used as a non specific, general measure of inflammation. This is no longer included in this health screen as we now use C Reactive Protein, ( CRP ) as it is a better measure of general inflammation.

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Kidney Risk Factors and Blood Tests.

 

There are factors that are taken into consideration when calculating your Kidneys at risk including your blood pressure, BMI and smoking status, and we also look at the following blood tests. 

Sodium

Sodium is an essential electrolyte involved in a number of bodily functions. The kidneys regulate its level in the body.  High or low levels can be seen in a number of diseases, and the level can be influenced either way by prescribed medication (eg diuretics can cause a drop in sodium).

Potassium

Potassium is another essential electrolyte, whose level in the blood is largely determnined by the kidneys.  Like sodium, screening for low or high levels of potassium can indicate a problem with health due to disease or inappropriate medication. Potassium levels are very sensitive to storage - if there is any delay in testing, the level is often higher than would otherwise be expected. Normally, it is readily apparent if the rise is due to storage change as other test results will usually be normal.

Urea

Urea, like creatinine, is a waste product of normal bodily function - its level in the blood is controlled entirely by the kidneys. Rising levels of Urea that are detected in your pathology results may indicate kidney disease or damage, although small rises may also be a sign of dehydration. Low levels are of no concern.

Creatinine

Creatinine, like urea, is a waste product of bodily processes. The kidneys control its elimination from the blood. A rise in creatinine within a health screening, especially if urea levels are also high, will usually mean there is a degree of compromise of the kidneys. Small rises can be a sign of dehydration. Low levels are of no concern.


 

 

Liver risk factors and blood tests.

We cross reference your reported alcohol intake and your reported symptoms of poor health with eight liver function tests (LFTs).

Protein - Proteins are indespensible as transporters of many other essential molecules around the body. Within your health screening high levels can be seen in disorders of over production such as myeloma, low levels can be found in conditions of failure to produce protein (eg liver disease) or excessive loss from the body (such as malnutrition or kidney disease) 

 

Globulin - Globulins are another category of protein which form the basis of antibodies (produced by Lymphocytes). Low levels within a health screening (hypogammaglobulinaemia) can be seen in immune deficiency or excessive loss from the kidneys. Higher levels may be a sign of gammaglobulinopathy or myeloma - a state of excessive production of globulin by some of the lymphocytes. 

 

Bilirubin - Bilirubin is formed in the liver from the natural breakdown of old red blood cells. High levels (known as jaundice) can be seen in liver disease or in excess red cell breakdown (haemolytic anaemia). Marginally raised levels are not uncommon in some healthy individuals - this state is known as Gilbert's syndrome, and is not a cause for great concern.

 

ALP - ALP (alkaline phosphatase) is an enzyme involved with bone production. High levels are common during periods of active bone growth (eg children) but at other times a high level may indicate abnormal bone activity - eg Paget's disease, or sometimes cancer. High levels when health screening are also associated with liver disease, especially gall bladder inflammation. 

 

ALT - ALT (alanine transaminase) is a liver enzyme. Elevated levels of this enzyme within a health screening can imply inflammation of liver cells (eg hepatitis), as damaged liver cells will release this enzyme into the blood. Often AST and ALT will be simultaneously elevated, and when both are high it is more likely that there inflammation of the liver is present. Small elevations can be seen in viral illness. 

 

GGT - GGT (gamma GT) is a liver enzyme. High levels are most commonly encountered when alcohol has been drunk at higher than recommended levels in the preceding few weeks. Some medication can lead to higher levels of this enzyme also.

 

AST - AST (aspartate transaminase) is a liver enzyme. Elevated levels within a health screening can suggest liver cell inflammation is present, as damaged liver cells will release this enzyme into the blood stream. Often AST and ALT will be simultaneously elevated, and when both are high it is more likely that there inflammation of the liver is present. Small elevations can be seen in viral illness. 

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Lipid Panel and Heart Disease.

We examine the risk group that you fall in and look to see if you are within a desirable range for your Cholesterol levels. The full Lipid panel includes

Cholesterol, total. - Cholesterol is a form of fat (lipid) bound to protein known as a lipoprotein, and is an essential component of all cell membranes (boundaries) - but an excess of it during a health screening is linked to an increased risk of heart and blood vessel disease. The total figure is useful, but it is more helpful to know the levels of the two parts which make up the bulk of the cholesterol molecule - HDL and LDL.

 

Triglycerides - Triglycerides are a category of fat found in the blood. Triglycerides effectively store energy for later use by the body. High triglyceride levels within a health screening are associated with pancreatitis, and possibly heart disease and strokes. Some medication can cause the level to rise, as can poorly controlled diabetes.

 

HDL Cholesterol - HDL (high density liporoprotein) is the component of cholesterol that is associated with good health, and high levels within a health sceren are linked to reduced risk of heart and blood vessel disease.

 

Cholesterol/HDL ratio - The cholesterol/HDL ratio demonstrates the proprtion of HDL compared to total cholesterol present - the closer to 4.5 mmol/L (or 20% if expressed as %HDL of total cholesterol) this figure is within a health screening, the lower the overall risk of heart or blood vessel disease from cholesterol induced damage.

 

LDL Cholesterol - LDL (low density lipoprotein) is the component of cholesterol that is associated with higher risk of heart and blood vessel disease. The ideal level within a health screening is below 2.5 mmol/L

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Iron and Iron Storage.

By looking at SIX aspects of Iron storage our Doctor is better able to assess any Iron storage disorders than by looking at one alone.

UIBC - The UIBC (unsaturated iron binding capacity) is a measure of the body's ability to store iron. The higher it is within a health screen, the less iron there is in reserve. This test can be used to detect iron deficiency, and also conditions of iron excess (such as haemochromatosis). It is an equivalent test to TIBC.

 

IRON - The serum iron level is a measure of the circulating iron in the blood. It tells us (along with TIBC/UIBC, transferrin and ferritin) the state of the body's iron reserves. An excess in a health screening can indicate disorders of iron storage (such as haemochromatosis), while low levels may indicate (along with changes in TIBC/UIBC, transferrin saturation and ferritin) iron deficiency.

 

TIBC - The TIBC (total iron binding capacity) is a measure of the body's ability to store iron. The higher the level within a health screening, the less iron there is in reserve. This test can be used to detect iron deficiency, and also conditions of iron excess (such as haemochromatosis). It is an equivalent test to UIBC.

 

Transferrin Saturation - Transferrin saturation, like TIBC/UIBC, is a measure of iron storage. The higher the level within a health screening, the greater the amount of iron stored.  This test can be used to detect iron deficiency, and also conditions of iron excess (such as haemochromatosis)

Ferritin is a protein found in the blood which carries iron. Like TIBC/UIBC, and transferrin saturation, it can tell us how much iron is stored in the body. The higher the level within a health screening, the greater the amount of iron stored.  This test can be used to detect iron deficiency, and also conditions of iron excess (such as haemochromatosis). Ferritin can also be raised if inflammation is present in the body somewhere.

Haemoglobin Level - The haemoglobin level is probably the most useful single measure of red blood cell health. Haemoglobin is the pigment that gives red blood cells their colour and is responsible for carrying oxygen around the body. Anaemia (red cell deficiency) is usually detected through finding a low haemoglobin level, and the type of anaemia can be determined by looking at other blood count measures. This is one of the most useful health screening tests within the full blood count.


 

Thyroid Blood Tests.

We look at thyroid status using TSH and FT4. Changes in the TSH alone may indicate underlying thyroid problems within a health screening, although it is generally believed that FT4 is the most reliable indicator of thyroid status - ie whether the gland is over-active or under-active.

TSH - The TSH (thyroid stimulating hormone) is a hormone manufactured in the pituitary gland (found in the brain). It s role is to stimulate thyroxine production in the thyroid gland (found in the neck). A high level within a health screening is associated with an underactive thyroid gland (hypothyroidism) and a low level is found if the thyroid gland is over-active (hyperthyroidism). Changes in the TSH  level alone can indicate underlying thyroid problems even if the thyroxine levels are normal. 

 

Free T4 - FT4 (free thyroxine) is the active form of thyroxine, released from the thyroid gland in the neck. Its role is to control metabolism - release of energy from all cells of the body. A lack of thyroxine leads to, for example, tiredness and weight gain, whereas an excess will lead to weight loss, rapid heart rate and anxiety. It is generally believed that this level (FT4) is the most reliable indicator of thyroid status - ie whether the gland is over-active (hyperthyroidism) or underactive (hypothyroidism). 

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Diabetes - Blood Glucose test and risk factors.

We screen your Blood Glucose Level or HbA1C, as well as looking at your diabetic risk factors.

Glucose - Glucose is the form of sugar that is transported around the body in blood to provide energy for all bodily functions. A very common blood test, but an essential part of any health screening, high levels are diagnostic of diabetes mellitus, a state in which the body is unable to handle glucose adequately. Low levels can occur in healthy individuals on occasion, but if sustained, a low level of glucose may indicate an underlying problem with how sugar levels are maintained by the body. As we recommend that you fast for your health screening this will be reported as a FASTING blood glucose level.


 

Osteoporosis risk scoring and Calcium blood test.

We have utilised an Osteoporosis risk scoring tool called QFRACTURE which estimates an individual's risk of developing fractures in the future. This has been shown to be more accurate in predicting risk than an ultrasound or Xray in many instances. We also examine Calcium  which apart from being essential to maintain bone strength has many other functions in the body such as enabling heart muscle contraction.

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LDH and Uric acid blood tests.

LDH - LDH (lactate dehydrogenase) is found in almost all tissues but only a small amount of it is detectable in the blood. It usually stays within the cells. When cells are damaged or destroyed, LDH enters the blood. LDH within a health screening is used as a general marker of injury to cells, and many cells can release it to varying degrees.  A total LDH level is an overall measurement of five different LDH isoenzymes (or subgroups). A rise in the level may indicate a problem with cell damage somewhere in the body. A low level is probably of little significance.

Uric Acid - Uric acid is a normal waste product of protein breakdown in the body. Low levels within a health screening are generally of no concern, but high levels can lead to gout - an acutely painful inflammation of the joints. High uric acid can also be associated with some medication (especially diuretics), diet or possibly be of genetic origin.


 

 

Blood Pressure and Resting Heart Rate.

Our nurse will examine your blood pressure and pulse and here we discuss the implications and how they relate to other risk factors that you may have.


 

Lipid based Cardiac Risk Scoring.

We use the QRISK algorithm, which is regarded as a gold standard tool for assessing your risk of a cardiovascular death. We also look at ways of reducing your risk and how this would shorten the odds!


 

Modifiable Lifestyle Assesments.

Comprising of

Nutritional risk scoring

A lifestyle assessment

Smoking status

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Stress Assessment

Your stress level is scored out of a possible 120 and we discuss what can be done to tackle stress.


 

Depression Assessment

The feeling of depression is deeper, longer and more unpleasant than the short periods of unhappiness that we all havbe from time to time. Your depression level is scored out of a possible 27 points.


 

  

PLUS V Level Pathology (Extra Tests)

 

Ferritin is a protein found in the blood which carries iron. Like TIBC/UIBC, and transferrin saturation, it can tell us how much iron is stored in the body. The higher the level within a health screening, the greater the amount of iron stored.  This test can be used to detect iron deficiency, and also conditions of iron excess (such as haemochromatosis). Ferritin can also be raised if inflammation is present in the body somewhere.

Vitamin D is an important vitamin, essential for good bone helath. It is manufactured in the skin through sunlight exposure, and is found in a number of foods. Prolonged Vitamin D lack can cause osteomalacia, a disease which causes severe structural deformities to the skeleton. Lower level Vitamin D deficiency can lead to a number of non specific symptoms, including chronic pain, weak bones, frequent infections  depression and fatigue. It has been estimated that between 50-70% of people living in the northern Europe (where daylight length reduces your chances of receiving adequate sunlight in the winter) are deficient in this vitamin by March each year which is why health screening for this important vitamin is essential.

 

C Reactive Protein is raised in any state where inflammation is present - such as infection or arthritis. In a general health screening it is not specific (that is, it cannot tell us what is wrong, only that something needs investigating further). The answer may be found in other blood test results or from examination. If it is negative, it is highly unlikely there is any inflammatory process present.

 

Vitamin B12 is an important vitamin, essential for the normal functioning of many body processes. Deficiency can lead to anaemia (poor quality red blood cells) and neurological (nerve) disorders. It is most abundant in meat products so vegetarians are more vulnerable to deficiency of this vitamin. Pernicious anaemia develops if uptake of vitamin B12 into the blood from the gut is absent or severely impaired, and even if a diet rich in the vitamin is taken, deficiency will occur if this disease is present. Recent evidence suggests that mild deficiency is probably more common than previously thought. Mild deficiency may explain the presence of fatigue and a host of other limiting symptoms which is why we have included it within the PLUS V and PLUS X health screening profiles.

 

Vitamin B9 - Folate (folic acid or Vitamin B9) is an important vitamin (in the B group), found mainly in green vegetables. It works in conjunction with vitamin B12 to maintain blood health. If taken by the pregnant female, it can reduce the risk of central nervous system defects such as spina bifida in unborn babies. While it is abundant in a balanced diet, it cannot be stored in the body so deficiency of this vitamin is potentially easily established and including it in a health screening is recommended..

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Full Laboratory Results

We also include your original Laboratory results which come complete with numerical levels and reference ranges.

 

Our Doctor's overall health screening summary.

25 pages is a lot to look through, so our Doctor will summarise the main points for you here, and suggest a follow up plan for you to follow.

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