Blood work has become a staple of responsible health and wellness. Yet somehow the general public's familiarity with and understanding of even the most baseline test values is lacking. For those interested in seeing the picture being painted by their bloodwork I've written up a small guide to define each of the metrics commonly found in scripts for those with T1D and draw some potential implications in what the value means for our health.
1. Complete Blood Count (CBC) and Immune Markers
The Complete Blood Count (CBC) helps assess overall health, immune system function, and potential infections or inflammation.
White Blood Cell Metrics (WBCs - Immune Cells)
Auto WBC (White Blood Cell Count)
Measures total white blood cells.
High WBCs can indicate infection or inflammation, common in autoimmune conditions.
Low WBCs may suggest immune suppression.
Neutrophils % & Neutrophils Abs Auto
Neutrophils are the first responders to infection.
High neutrophils may indicate infection or inflammation.
Low neutrophils may be seen in autoimmune suppression.
Lymphocytes % & Lymphocytes Absolute
Lymphocytes include T-cells and B-cells, crucial in autoimmune activity.
High levels may suggest an active immune response, while low levels can indicate immune dysfunction.
Eosinophils % & Eosinophils Absolute
Elevated eosinophils are often linked to allergic reactions, gut inflammation, or parasites.
Some autoimmune conditions can also raise eosinophil levels.
Basophils % & Basophils Absolute
Basophils are involved in allergic responses and histamine release.
Elevated levels may suggest chronic inflammation or an allergic response.
Monocytes Absolute
Monocytes help remove damaged cells and support immune defense.
Elevated levels can indicate chronic inflammation or autoimmune activity.
nRBC (Nucleated Red Blood Cells)
Rare in healthy adults but may appear if bone marrow is producing red blood cells quickly, often seen in stress responses or inflammation.
Immature Granulocyte & Absolute Immature Granulocyte
These are young immune cells released during infection or inflammation.
Higher levels may indicate an active immune system response, which can be relevant in early T1D diagnosis.
Marker | Low Value May Indicate | High Value May Indicate |
Auto WBC (White Blood Cell Count) | - Immune suppression - Chronic illness (e.g., autoimmune disease, HIV, bone marrow disorders) - Malnutrition or vitamin deficiencies (B12, folate) | - Infection (bacterial, viral, or fungal) - Inflammation (autoimmune diseases, chronic stress) - Leukemia or blood disorders |
Neutrophils % & Neutrophils Abs Auto | - Weakened immune response - Chronic infection (e.g., tuberculosis) - Bone marrow suppression | - Acute bacterial infections - Inflammation (e.g., rheumatoid arthritis, autoimmune disease) - Stress response or steroid use |
Lymphocytes % & Lymphocytes Absolute | - Immunodeficiency (HIV, chronic infections) - High cortisol levels (stress or steroid use) | - Viral infections (mononucleosis, hepatitis, COVID-19) - Autoimmune conditions (T1D, lupus) |
Eosinophils % & Eosinophils Absolute | - Acute stress response (high cortisol suppresses eosinophils) - Severe infection | - Allergies, asthma - Parasitic infections - Autoimmune diseases (celiac, lupus) |
Basophils % & Basophils Absolute | - Acute allergic response (depletion during anaphylaxis) - High stress or steroid use | - Chronic allergies, asthma - Chronic inflammation (ulcerative colitis, Crohn’s) |
Monocytes Absolute | - Bone marrow suppression - Chronic stress | - Chronic infection (tuberculosis, Epstein-Barr virus) - Autoimmune diseases (lupus, rheumatoid arthritis) |
nRBC (Nucleated Red Blood Cells) | - Bone marrow suppression - Aplastic anemia | - Severe anemia - Bone marrow stress or chronic hypoxia |
Immature Granulocyte & Absolute Immature Granulocyte | - Bone marrow suppression - Chronic illness (e.g., cancer, immune dysfunction) | - Early-stage infection - Acute inflammation (sepsis, severe bacterial infections) |
2. Red Blood Cell Metrics (RBCs - Oxygen Transport & Circulation)
RBC (Red Blood Cell Count)
Measures the total number of red blood cells.
Low RBCs may indicate anemia or nutrient deficiencies (e.g., B12, folate, iron).
High RBCs may be linked to dehydration or stress response.
Hematocrit (HCT)
Percentage of blood volume occupied by RBCs.
Low levels indicate anemia or fluid overload, while high levels suggest dehydration or increased RBC production.
MCV (Mean Corpuscular Volume)
Measures the size of RBCs.
Low MCV suggests iron deficiency anemia.
High MCV suggests B12 or folate deficiency.
MCH (Mean Corpuscular Hemoglobin)
Measures the amount of hemoglobin per red blood cell.
Low MCH indicates iron-deficiency anemia.
High MCH can indicate B12 or folate deficiency.
MCHC (Mean Corpuscular Hemoglobin Concentration)
Measures the concentration of hemoglobin inside RBCs.
Low levels suggest iron deficiency anemia, while high levels may indicate hereditary blood disorders.
RDW (Red Cell Distribution Width)
Measures the variation in RBC size.
High RDW indicates nutrient deficiencies (iron, B12, folate).
Marker | Low Value May Indicate | High Value May Indicate |
Hematocrit (HCT) | - Anemia (nutrient deficiencies, chronic disease) - Overhydration | - Dehydration - Lung disease, polycythemia |
MCV (Mean Corpuscular Volume) | - Iron deficiency anemia (microcytosis) - Chronic disease anemia | - B12 or folate deficiency (macrocytosis) - Liver disease, alcoholism |
MCH (Mean Corpuscular Hemoglobin) | - Iron deficiency anemia - Chronic disease anemia | - B12 or folate deficiency - Hyperthyroidism |
MCHC (Mean Corpuscular Hemoglobin Concentration) | - Iron deficiency anemia | - Hereditary spherocytosis (a rare blood disorder) |
RDW (Red Cell Distribution Width) | - Chronic stable anemia (no variation in RBC size) | - Nutrient deficiency (iron, B12, folate deficiency) - Inflammatory conditions (autoimmune diseases) |
3. Platelet Metrics (Clotting & Inflammation)
Platelets
Help with blood clotting.
Low platelets may indicate autoimmune destruction (ITP, lupus).
High platelets can suggest inflammation or chronic disease.
MPV (Mean Platelet Volume)
Measures the size of platelets.
High MPV suggests increased platelet production due to inflammation.
Marker | Low Value May Indicate | High Value May Indicate |
Platelets | - Blood clotting disorders (ITP, leukemia) - Chronic infections | - Inflammation - Iron deficiency anemia - Bone marrow disorders |
MPV (Mean Platelet Volume) | - Poor platelet production (bone marrow disorder) | - Increased platelet activation (chronic inflammation, blood clotting risk) |
4. Electrolytes and Kidney Function
The Comprehensive Metabolic Panel (CMP) evaluates electrolyte balance, kidney function, and metabolic health.
Sodium (Na+), Potassium (K+), Chloride (Cl-)
These regulate hydration, nerve function, and blood pressure.
Imbalances may indicate dehydration, kidney issues, or insulin deficiency.
High potassium (hyperkalemia) is common in diabetic ketoacidosis (DKA).
CO2 (Bicarbonate)
Helps maintain acid-base balance.
Low levels suggest metabolic acidosis, common in DKA.
Anion Gap
A high anion gap can indicate ketoacidosis, a serious complication in T1D.
BUN (Blood Urea Nitrogen) & Creatinine
Measure kidney function.
High levels may indicate early kidney damage (diabetic nephropathy).
BUN/Creatinine Ratio
Helps differentiate between kidney dysfunction and dehydration.
Electrolytes and Kidney Function
Marker | Low Value May Indicate | High Value May Indicate |
Sodium (Na+ - Blood hydration status) | - Dehydration (dilutional hyponatremia) - Adrenal insufficiency (low aldosterone) | - Dehydration - High cortisol levels (Cushing’s syndrome) |
Potassium (K+ - Nerve & Muscle Function) | - Insulin therapy (pushes K+ into cells) - Diuretic use (excess excretion) | - Kidney disease (reduced potassium excretion) - Metabolic acidosis |
Chloride (Cl- - Acid/Base Balance) | - Metabolic alkalosis - Addison’s disease | - Dehydration - Acidosis (respiratory or metabolic) |
CO2 (Bicarbonate - Acid/Base Balance) | - Metabolic acidosis (diabetes-related ketoacidosis) | - Metabolic alkalosis (vomiting, kidney disease) |
Anion Gap | - Hypoalbuminemia (low protein levels) - Metabolic alkalosis | - Ketoacidosis (DKA), lactic acidosis - Renal failure |
5. Blood Sugar and Metabolism
Glucose
Measures blood sugar levels.
High glucose is the primary indicator of diabetes.
Calcium
Important for bone health and nerve function.
Low levels may be linked to poor vitamin D status or kidney dysfunction.
Blood Sugar and Metabolism
Marker | Low Value May Indicate | High Value May Indicate |
Glucose | - Hypoglycemia (excess insulin, adrenal insufficiency) | - Diabetes (T1D, T2D) - Stress response (cortisol spikes) |
Calcium | - Kidney Dysfunction - Low Vitamin D - Liver Dysfunction | - Low Magnesium Levels - Excess Vitamin D - Adrenal Insufficiency |
6. Liver Function & Protein Metabolism
AST (Aspartate Aminotransferase) & ALT (Alanine Aminotransferase)
Liver enzymes that indicate liver health.
High levels may be seen in fatty liver disease, medication use, or metabolic stress.
Alkaline Phosphatase (ALP)
Important for bone and liver function.
High levels may indicate liver disease, bone disorders, or vitamin D deficiency.
Total Protein & Albumin
Measure nutritional status and liver function.
Low levels may indicate malnutrition or kidney disease.
A/G Ratio (Albumin/Globulin Ratio)
A balance between two types of proteins.
Changes may indicate immune disorders or chronic inflammation.
Total Bilirubin
A waste product from RBC breakdown.
High levels may suggest liver disease or hemolysis.
Globulin, Total
Measures immune-related proteins.
High levels may indicate inflammation or autoimmune disease.
eGFR (Estimated Glomerular Filtration Rate)
Measures kidney function.
A low eGFR suggests kidney impairment, common in long-term diabetes.
Marker | Low Value May Indicate | High Value May Indicate |
AST (Aspartate Aminotransferase) | Vitamin B6 deficiency, chronic kidney disease | Liver disease, muscle injury, metabolic stress |
ALT (Alanine Aminotransferase) | Vitamin B6 deficiency | Liver damage (fatty liver, medication-induced, metabolic dysfunction) |
Alkaline Phosphatase (ALP) | Nutrient deficiencies (zinc, magnesium, vitamin C) | Liver disease, bone disorders, gallbladder disease |
Total Protein & Albumin | Liver disease, malnutrition | Dehydration |
A/G Ratio (Albumin/Globulin Ratio) | Chronic inflammation, liver disease | High albumin (dehydration) |
Total Bilirubin | Liver disease, anemia | Hemolysis, liver dysfunction |
eGFR (Estimated Glomerular Filtration Rate) | Kidney disease | Normal or falsely high in low muscle mass |
Globulin, Total | Immune deficiency | Chronic infections, autoimmune disease |
Keep this tab handy if you ever come back from a doctor's visit not sure what you're looking at. Be an advocate for yourself and bring whatever questions or comments you have from the blood tests to the doctor. Acknowledge that each of the above variables are a single part of much larger systems. One deviation from the "normal" range may not mean much in isolation (or mean that anything is truly "wrong") but be mindful of consistencies across numerous readings or variables. Get to know the systems implicated if a measure or group of measures is out of range.
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