Marisssa Clausing: Hello. My name is Marissa Clausing. And I am your Wellness Coordinator with Wellworks For You, your wellness program provider. And I'm here today to talk to you about your labs that San Juan does for you. And just to explain a little bit more about each of those tests, San Juan provides you with 18 different lab tests that they do for you. So, I'm going to talk just a little bit about each one of them, what the test is, what they're looking for. And at the end, we'll talk about what to do, depending on where our levels are for these.

So, the first one we're going to talk about is sodium. So, all of these, again, they test in your blood, just when they take that blood, when you come in for your test. They all come out of this same sample. So, sodium is the key to helping send electrical signals between cells and controlling the amount of fluid in your body. So, your body needs sodium for your cells to work the right way, and most foods actually have sodium in them. The most common form of course is table salt that we're all familiar with. And then, your body loses a certain amount of sodium each day through sweat. Sometimes if you're sweating really hard you can feel that salt on your body when it dries off. And then, also when you go to the bathroom you lose sodium as well. So, too much or too little of sodium can cause some serious health problems. And this is why, you know, they test for it.

Potassium, the next one, in the right amounts, this helps your nerves and muscles talk to each other. It moves nutrients into and out of your cells and it helps your heart function. So kidney disease is a common cause of a high potassium level. And again, either too high or too low of potassium can cause a problem such as heart problems. Low potassium can also cause muscle cramps. And you might feel that sometimes when you go for a run and you have low potassium and you get a cramp. Some common foods that contain potassium well known is bananas, also avocados, beets, oranges, orange juice, pumpkins, spinach. So, a lot of common foods can help you get that potassium level up.

Chloride, so you may have heard of electrolytes and the role they play in keeping you hydrated and healthy. So, one of these important electrolytes is the mineral chloride. So, it works with the other electrolytes that we just talked about, sodium and potassium, and it helps to balance the acids and bases in your body. It also helps to move fluid in and out of your cells. And so if your chloride levels drop, you can become sick and dehydrated. And if your levels are too high, it often means your kidneys aren't working properly. So, you can start to see how all these things are, you know, related to each other and can have effects, on different parts of your body. So, very fortunate that San Juan provides this detailed panel of lab work for you all.

So, carbon dioxide, CO2, an odorless gas, it's a waste product that your body makes when it uses food for energy. Your blood carries the carbon dioxide to your lungs. And when you exhale, you breathe out the carbon dioxide. Again, having too much or too little can be the sign of a health problem.

Your BUN, B-U-N, the blood urea nitrogen is a normal waste product created in your liver as it breaks down certain proteins found in your food. Urea nitrogen travels through the blood to your kidneys, which filter out all but a small amount. Urea nitrogen exits from your body when you urinate. And when your kidneys are healthy, they remove it, usually leaving just a small amount in your blood. But when your kidneys are not healthy, they leave more of it behind. So if your levels are outside the normal range, this might mean either your liver or kidneys are not working well.

Next up, glucose, commonly known as blood sugar. This is the primary type of sugar in the body, and it comes from carbohydrates found in foods. Glucose, it's essential for providing energy to cells throughout the body, including your brain cells. Your glucose level fluctuates throughout the day as you eat, as you exercise, and you sleep, and stress hormones also play a role. People with diabetes, of course, should monitor their glucose levels closely to make sure they remain within the appropriate target range. And when glucose levels are too high or too low, it can have serious health consequences such as nerve damage, kidney damage, and heart disease.

Creatinine, this is a test to measure how well your kidneys are performing their job of filtering waste from your blood. It's a chemical compound left over from energy-producing processes in your muscles, and healthy kidneys filter the creatinine out of your blood, and it exits your body as a waste product in your urine. So, your BUN-creatinine ratio is a blood test that compares the levels of the blood urea nitrogen to the creatinine in your blood, and this ratio helps assess kidney function and can provide insights into various health conditions. A high ratio may indicate conditions such as dehydration, heart failure, or gastrointestinal bleeding. A low ratio might suggest liver disease or malnutrition.

Next up is calcium. One again that we are all familiar with, calcium. It's one of the most important minerals in your body, and most of it is stored in your bones of course. Your body requires calcium to maintain healthy bones and teeth, and it's essential for keeping your nerves, heart, and muscles functioning properly as well.

Anion gap is a measurement to check for the acid-base balance of your blood and/or an electrolyte imbalance in your blood. The anion gap is a calculation of the difference between the amounts of some negatively charged electrolytes, such as chloride and bicarbonate, and the amount of positively charged electrolytes, such as sodium in your blood. So, the anion gap reveals whether your blood has an imbalance of electrolytes or if your blood is too acidic or too basic. If you have too much acid in your blood, it's called acidosis. If your blood is too basic, you may have a condition called alkalosis.

Next up is A1c. This measures the average blood glucose levels over the past two to three months. It does this by assessing the percentage of hemoglobin, which is a protein in red blood cells, that's coated with sugar. And the purpose is it's used to diagnose and monitor diabetes and pre-diabetes. And unlike the daily blood sugar tests or the glucose test, the A1c provides a long-term view of your glucose. And that can help manage diabetes more effectively.

 So, next up is the EGFR. This is the glomerular filtration rate, and it's a measure of how well your kidneys are removing waste from your blood. Testing a person's GFR directly requires many blood draws over a long period of time. So, most health care providers, including San Juan, use the eGFR, which just involves the single blood test and a calculation. So, this eGFR measures how much blood these filters clean every minute.

Cholesterol, another common one we're familiar with here, and the total cholesterol number represents all the cholesterol being carried by all the major lipoproteins in your blood. Generally, this is not as useful in assessing your cardiovascular risk as the other measurements included in the lipid panel, which we're about to get into as well.

So, triglycerides are the fat in the bloodstream that come from food. High triglyceride levels may be associated with metabolic syndrome or type 2 diabetes, and they can also increase your cardiovascular risk independent of cholesterol levels. High levels raise heart disease and type 2 diabetes risk and are of particular concern in women.

HDL, which is your high-density lipoproteins, kind of in contrast to HDL, which we'll get into in a second here, you actually want higher levels of HDL. It's also known as the good cholesterol. This helps clear the bad cholesterol from the bloodstream and takes it to the liver. So then, getting into the LDL, the low-density lipoprotein, this is often known as the bad cholesterol, because this is the cholesterol that causes buildup and blockages in the arteries. So typically, there is an elevation of health risks when these are too high.

So, San Juan also tests your ratio of your LDL to your HDL. And of course, this is the relationship between these two types of cholesterol. And to calculate it, you divide the LDL by the HDL. So for example, if your LDL is 100 and your HDL is 50, your ratio is going to be 2. One study was found that those with an LDL-HDL ratio above 2.5 had a higher risk of heart disease than those with a score below that threshold. So because the HDL cholesterol pairs off with LDL to remove it from your bloodstream, the lower the ratio, the better. So, that means if somebody has a very high HDL, but also high LDL, their ratio might be considered okay, even though the LDL on its own is in a risky range for heart disease. Someone with normal values of both, on the other hand, may have a high risk of heart disease. So really, the ratio is more important than the numbers independently, because of how they work together.

So, a male-specific test then is the PSA, this is the prostate specific antigen test. It measures the amount of PSA in your body. And it reveals, of course, if you have elevated PSA levels, this is a protein that your prostate gland makes. And normal and cancerous prostate tissue make PSA, but prostate cancer tends to produce PSA in higher amounts. Catching prostate cancer early with a PSA test increases your chance of effective treatment, but followups do need to be made to confirm anything there. Elevated PSA levels don't necessarily mean you have cancer. You, of course, have to get more tests there. It's just a good indication that something needs to get looked into.

So after you get your blood tests done with San Juan, you can check in your San Juan patient portal one week after the draw. And then, if you have any questions or concerns about your results, we encourage you to contact your primary care provider. If you do not currently have a primary care provider, we definitely encourage you to find one. And you can do that right on the San Juan website at sanjuanregional.com/find-a-doc.

So again, if you have questions about any of these tests or your results, please follow up with your primary care provider to discuss. And thank you all for listening today. If you have any questions about your wellness program at all, feel free to use that contact button or the chat function in your Wellworks For You portal as well. Thanks so much.