What To Do When Your Blood Test Results Come Back Wrong

Understanding Blood Test Results

Blood tests are a vital diagnostic tool, providing insight into your health status. But sometimes results come back indicating issues that don't seem to fit your situation. Many factors can cause test results to be inaccurate or misleading. By learning more about common testing pitfalls, you can have a productive discussion with your doctor when values appear off.

Test Errors and Variations

No test is 100% perfect. The following can lead to erroneous blood test results:

• Lab errors - sample mix-ups, analysis mistakes
• Poor sample quality - hemolysis, clotting
• Improper test methodology
• Normal biological variations - hormones, cholesterol

Discuss the possibility of a lab mishap or natural fluctuation with your physician if a result seems inexplicable.

Misinterpreting Normal Ranges

Reference ranges only indicate what's average in the general population. But your normal may differ based on factors like:

• Age
• Sex
• Ethnicity
• Fitness level
• Altitude

A value inside the reference interval could still be abnormal for your physiology. Share your complete health profile so your doctor can properly interpret your results.

When Blood Cell Counts Don't Add Up

Full blood counts measure your levels of red cells, white cells, and platelets. Erroneous results in these areas warrant further investigation.

Questionable Red Blood Cell Counts

Too many or few red blood cells (high or low hematocrit) may signal issues like:

• Anemia
• Blood loss
• Bone marrow problems
• Dehydration
• Kidney disease

But results can also be thrown off by factors like smoking, living at high altitudes, or drinking too much alcohol. Verify a suspicious hematocrit with a retest before jumping to conclusions.

Dubious White Blood Cell Counts

High white blood cell counts (leukocytosis) typically indicate:

• Infection
• Inflammation
• Stress
• Blood cancers
• Immune disorders

But counts can temporarily rise after intense exercise, smoking, labor, or surgery. Low counts (leukopenia) may signal autoimmune disorders, marrow damage, or nutritional deficiencies - but can also reflect a weak sample or lab error. Investigate further if white cell counts seem suspicious.

Questionable Platelet Levels

Platelets help blood clot. Too few (thrombocytopenia) could improperly indicate:

• Clotting disorders
• Cancers
• Viral infections
• Spleen damage

But certain foods, medicines, exercise, and pregnancy can also temporarily lower platelet levels without signaling disease. High platelets (thrombocytosis) might incorrectly point to problems like inflammation, cancer, or iron deficiency when other factors are responsible. Have any abnormal platelet counts rechecked.

When Kidney Function Markers Don't Add Up

Kidney function tests like creatinine, BUN, and estimated glomerular filtration rate (eGFR) can be misleading at times. Issues that may falsely alter results include:

Muscle Mass Impacts Creatinine

Creatinine comes from muscle, so levels are higher in muscular individuals. Elevated creatinine could improperly suggest kidney dysfunction in bodybuilders when kidneys are actually healthy.

Protein Intake Affects BUN

High protein diets can raise BUN without indicating kidney trouble. Similarly, low protein intake can lower BUN even in kidney disease. Comparing BUN to creatinine provides more insight.

GFR Varies With Age, Sex, and Race

eGFR is calculated from creatinine but adjusted for demographics. Still, eGFR may overestimate kidney function in the elderly, women, and African Americans. Combining markers gives the best assessment.

If renal function tests seem off-base, your doctor will consider muscle mass, diet, hydration, other conditions, and medications to make an accurate kidney assessment. Retesting may provide clarity.

When Liver Enzymes Don't Align With Reality

Liver function tests like ALT, AST, and bilirubin can be falsely altered by factors unrelated to actual liver health.

Muscle Breakdown Raises ALT and AST

These enzymes appear with muscle damage from intense training, injuries, or drugs like statins. Levels usually normalize after ceasing activity. Liver disease can’t be ruled out, but other evidence is needed.

Gilbert's Syndrome Explains High Bilirubin

This benign genetic condition causes mild jaundice from elevated bilirubin. Unless other liver markers are also elevated, there’s no cause for concern.

Discuss all liver test results in context of your full health picture. Repeat testing and additional markers like GGT, albumin, and INR provide more definitive diagnoses.

When Thyroid Hormones Don't Align With Symptoms

Thyroid issues may be missed or incorrectly diagnosed based on total T4, T3, and TSH levels alone. Causes of mismatched blood and symptom thyroid profiles include:

Normal TSH with High T4 and T3

This profile can signal hyperthyroidism, but is more commonly seen in pregnancy, after acute illnesses, or with certain drugs and supplements. Clinical correlation is key.

Normal TSH with Low T4 and T3

This suggests hypothyroidism but can also reflect problems with pituitary gland function. Again, symptoms and other analytic tests provide clarification.

Symptoms Without Abnormal Labs

Some patients have thyroid symptoms despite normal blood work. This may indicate a conversion problem or thyroid autoantibodies attacking gland tissue. Expanded testing can solve the puzzle.

Work with an endocrinologist or thyroid specialist if your blood tests and symptoms don’t match. Retesting and additional markers like antibodies and free T3/T4 levels can provide clarity.

When Cholesterol Levels Don't Jibe

Cholesterol testing has limitations that can produce results inconsistent with cardiovascular risk. For example:

Normal Results Despite High Heart Disease Risk

Some genetic disorders leave HDL, LDL, and triglycerides deceptively normal. Advanced tests like hs-CRP, Lp(a), and ApoB more accurately predict risk.

False High Triglycerides

Things like recent meals, alcohol use, medications, and exercise before testing can falsely spike triglyceride readings. Retesting while fasting gives a more valid gauge.

Low HDL Despite Heart Disease

Some drugs like anabolic steroids and beta blockers artificially lower HDL, masking its cardioprotective effect. The ratio of total cholesterol to HDL counts is more telling.

Talk to your doctor if your cholesterol profile seems at odds with your lifestyle, risk factors, and symptoms. Advanced lipid testing and imaging studies like coronary calcium scans may provide added clarity.

When Blood Sugar Levels Mislead

Glucose tests can be falsely altered by factors unrelated to diabetes risk, including:

Normal Fasting Glucose; Elevated A1C

This mismatch suggests prediabetes or early type 2 diabetes but can also reflect day-to-day glucose variability not captured by fasting tests alone. An oral glucose tolerance test provides more insight.

High Fasting Glucose; Normal A1C

This may reflect development of diabetes but can also indicate conditions like stress hyperglycemia, metabolic syndrome, and adrenal dysfunction. Retesting while healthy can clarify.

Normal Glucose; Symptomatic Hypoglycemia

People with reactive hypoglycemia often have normal standard tests. More advanced testing after meals uncovers problematic glucose spikes and crashes.

Discuss any confusing glucose results with your doctor to determine if further testing is needed for an accurate diabetes assessment.

Take a Proactive Approach

By understanding common testing limitations and ambiguities, you can have productive discussions with your doctor when blood work findings just don’t seem right. Ask questions, share contextual health details, and request retesting or more advanced assays as needed to get clarity.

While some results may ultimately prove inaccurate, valid abnormal findings are an opportunity to catch issues early when they are most treatable. With your doctor’s help, puzzling blood test results can be deciphered to reveal important health insights and guide appropriate intervention.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.