FUNCTIONAL CHEMSCREEN and CBC RESULTS

TRACKING FORM STANDARD U.S. UNITS

NAME:

DATE OF TEST:

TEST

OPTIMAL

Glucose
HgB A1C
Fasting Insulin
BUN
Creatinine
Sodium
Potassium
Chloride
CO2
Anion Gap

75 86
<4.5%
<5
10 16
0.8 1.1
135 142
4.0 4.5
100 106
25 30
7 12
3.5 5.9 male
3.0 5.5 female
6.9 7.4
4.0 5.0
9.5 10.0
3.0 4.0
70 100
10 30
10 30
140 200
0.1 1.2 (>2.6)
0 0.2 (>0.8)
0.1 1.0 (>1.8)
10 30
2.4 2.8
1.4 2.1
10 16
85 130
30 70
250 350
25 30%
160 180
70 80
<100
>55
1.3 2.0
3.0 3.25
90 168
1.0 1.5
6.0 11.9
<0.55 male
<1.5 female
< 7.2
200 300
50 65
500 640 male
250 380 female
15 26.5 male
1.4 2.2 female
10 30 male

Uric Acid
Total Protein
Albumin
Calcium
Phosphorous
Alk Phos
SGOT(AST)
SGPT(ALT)
LDH
total Bilirubin
direct
indirect
GGTP
Globulin
A/G ratio
BUN/Creat.
Total iron
Ferritin
TIBC
% Sat
Cholesterol
Triglycerides
LDL
HDL
TSH
Free T-3
Total T-3
Free T-4
T-4 thyroxine
Hs-CRP
Homocysteine
Fibrinogen
Vitamin D
DHEA Sulfate
Free
Testosterone
Estradiol

Weatherby & Associates, LLC

RESULT

FASTING: Y / N
NOTES

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FUNCTIONAL CHEMSCREEN and CBC RESULTS

TRACKING FORM STANDARD U.S. UNITS
Complete Blood Count
TEST
WBC
RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
Platelets
RDW
Neutrophils
Lymphs
Monocytes
Eosinophils
Basophils

OPTIMAL

RESULT

NOTES

5.0 7.5
4.2 4.9 male
3.9 4.5 fem
14 15 male
13.5 14.5 fem
40 48 male
37 44 female
82 89.9
28 31.9
32 35
150 385 x 1000
<13
40 60%
24 44%
0 7%
0 3%
0 1%

Comments:_____________________________________________________________________
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Weatherby & Associates, LLC

www.BloodChemistryAnalysis.com

CONVERSION CHART FOR CONVERTING STANDARD US UNITS

INTO STANDARD INTERNATIONAL UNITS
TEST
Glucose
HgB A1C
BUN
Creatinine
Sodium
Potassium
Chloride
CO2
Anion Gap
Uric Acid
Total Protein
Albumin
Calcium
Phosphorous
Alk Phos
SGOT(AST)
SGPT(ALT)
LDH
Bilirubin values
GGTP
Globulin
A/G ratio
BUN/Creat.
Total iron
Cholesterol
Triglycerides
LDL
HDL
Chol/HDL
Ferritin
TIBC
TSH
T-3
Free T-3
T-4 thyroxine
Free T-4
FTI/ T-7
WBC
RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
Platelets
RDW
Neutrophils
Lymphs
Monocytes
Eosinophils
Basophils

Weatherby & Associates, LLC

US UNITS
mg/dL
%
mg/dL
mg/dL
mEq/L
mEq/L
mEq/L
mEq/L
mEq/L
mg/dL
g/dL
g/dL
mg/dL
mg/dL
U/L
U/L
U/L
U/L
mg/dL
U/L
g/dL
Ratio
Ratio
mg/dL
mg/dL
mg/dL
mg/dL
mg/dL
Ratio
ng/mL
g/dL
IU/mL
ng/dL
pg/dl
g/dL
ng/dl
x 103/mm3
x 106/mm3
g/dL
%
Microns3
pg
g/dL
x 103/mm3
Calculated
%
%
%
%
%

CONVERSION FACTOR
Multiply
Divide
0.05551
0.01
0.357
88.4
1
1
1
1
1
59.48
10
10
0.250
0.3229
1
1
1
1
17.1
1
10
1
1
0.1791
0.02586
0.01129
0.02586
0.02586
1
1
0.1791
1
0.01536
0.01536
12.87
12.87
1
1
1
10
0.01
1
1
1
1
1
1
1
1
1
1

S.I. UNITS
mmol/L
mmol/L
mol/dL
mmol/L
mmol/L
mmol/L
mmol/L
mmol/L
mol/dL
g/L
g/L
mmol/L
mmol/L
U/L
U/L
U/L
U/L
mol/dL
U/L
g/L
Ratio
Ratio
mol/dL
mmol/L
mmol/L
mmol/L
mmol/L
Ratio
g/L
mol/dL
mIU/L
nmol/L
pmol/L
nmol/L
pmol/L
109/L
10`12/L
g/L
1
fL
pg
1
109/L
Calculated
%
%
%
%
%

www.BloodChemistryAnalysis.com

FUNCTIONAL CHEMSCREEN and CBC RESULTS

TRACKING FORM STANDARD INTERNATIONAL UNITS
NAME:
TEST
Glucose
HgB A1C
Fasting Insulin
BUN
Creatinine
Sodium
Potassium
Chloride
CO2
Anion Gap
Uric Acid
Total Protein
Albumin
Calcium
Phosphorous
Alk Phos
SGOT(AST)
SGPT(ALT)
LDH
total Bilirubin
direct
indirect
GGTP
Globulin
A/G ratio
BUN/Creat.
Total iron
Ferritin
TIBC
% Sat
Cholesterol
Triglycerides
LDL
HDL
TSH
Free T-3
Total T-3
Free T-4
T-4 thyroxine
Hs-CRP
Homocysteine
Fibrinogen
Vitamin D
DHEA Sulfate
(g/liter)
Free
Testosterone
Estradiol

DATE OF TEST:
OPTIMAL

RESULT

FASTING: Y / N
NOTES

4.16 4.77
<0.045
<35.88
3.57 5.71
70.7 97.2
135 142
4.0 4.5
100 106
25 30
7 12
208 351 male
178 327 female
69 74
40 50
2.38 2.50
0.97 1.29
70 100
10 30
10 30
140 200
1.7 20.5 (>44.5)
0 3.4
(>13.7)
1.7 17.1 (>30.8)
10 30
24 28
1.5 2.0
13 17
15.22 23.27
30 70
44.8 62.7
0.25 0.30
4.14 4.66
0.79 0.90
<2.59
>1.42
1.3 2.0
4.6 5.0
1.4 2.6
12.9 19.3
77 154
<22 male
<60 female
< 7.2
5.88 8.82
100 160
5000 6400 male
2500 3800 female
4.31 76.1 male
0.4 0.63 female
36.7 110.1 male

Weatherby & Associates, LLC

www.BloodChemistryAnalysis.com

FUNCTIONAL CHEMSCREEN and CBC RESULTS

TRACKING FORM STANDARD INTERNATIONAL UNITS
Complete Blood Count
TEST
WBC
RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
Platelets
RDW
Neutrophils
Lymphs
Monocytes
Eosinophils
Basophils

OPTIMAL

RESULT

NOTES

5.0 7.5
4.2 4.9 male
3.9 4.5 female
140 150 male
135 145 female
0.40 0.48 male
0.37 0.44 female
82 89.9
28 31.9
32 35
150 385 x 1000
<13
40 60%
24 44%
0 7%
0 3%
0 1%

Comments:_____________________________________________________________________
_______________________________________________________________________________
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_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Weatherby & Associates, LLC

www.BloodChemistryAnalysis.com