# How do I compare results when there are different normal ranges?



## Cheracup (Sep 23, 2010)

OK, so this is a bit off topic since the lab results in question are white blood cells. I need to figure out how to compare results when there are different ranges for 'normal' so I can see if my trend of decreasing numbers continues.

Here's the story - I'm being followed by a PA at the Endo's office for a pituitary tumor and hypo. After my visit last Thursday, I noticed that my WBCs had been decreasing in numbers over a period of 3 weeks. When my PA didn't return my calls, I went to see a GP to have it evaluated. He kind of blew me off - looking only at the numbers, and didn't even bother doing a physical exam. He did another CBC, but unfortunately, his lab isn't as detailed, so I didn't get the differential numbers I was looking for. He's sending my blood to the lab at the hospital for a more thorough view of what is happening.

Anyone good at statistics? Here are my numbers with ranges:

Sept 18: WBC 5.7 Range 4.5 - 11 (Providence lab)
Oct 18: WBC 4.2 Range 4.4 - 11 (Endocrine Lab)
Nov 15: WBC 3.9 Range 4.4 - 11 (Same Endocrine Lab)
Nov 22: WBC 4.3 Range 5.0 - 11 (GP office Lab)

So, is the 4.3 on a 5.0 - 11.0 range higher or lower than a 3.9 on a 4.4 - 11 range?

The WBC component that is concerning is the number of monocytes -going from .6 to .4 to .1 in the manner of 8 weeks. (Normal range .3 to .8). Low white blood cells /specifically low monocytes is an indication of a few types of leukemia ... which is why I want to stay on top of this.

Sorry for the LONG message - I look forward to hearing from the lab experts / math whizzes on the board! THANK YOU for any feedback you can provide!

Happy Thanksgiving


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## GD Women (Mar 5, 2007)

Don't know exactly what you are looking for.

3.9 is off by 5 points from bottom range
4.3 is off by 7 points from bottom range - this would be lower.

My WBC is out on the low end of range few times as well, same Lab.
off by 1.1 out of Labs low range. I guess its not a big deal for now.

Don't know if that helps or what you asked, but its the beast I can do. I'm not a math whiz either.


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## lainey (Aug 26, 2010)

White blood cells are the disease fighting cells. Naturally, depending on what you have going on in your body, they can vary quite a bit. Overall low cell count means slightly lower immunity, but only really if they don't increase when called upon to fight disease.

http://www.nlm.nih.gov/medlineplus/ency/article/003643.htm

http://www.ehow.com/about_5606257_signs-monocytes-blood-cell-count.html

Keep in mind that when you hear about someone who is immunocompromised due to low counts, they are talking counts of almost zero.

There are also some medications that can lower your counts.

You likely didn't get a rise out of you doctor because the fluctuations that you see fall into the normal range of what the doctor sees from such tests on a regular basis. I do know that sometimes lab values are guidelines, and there isn't always a problem unless the person has particularly high or low numbers--liver tests, for example, are not really abnormal until they come back several times the normal range--blood count tests tend to work the same way.

The kinds of leukemia that lower white cell counts are the acute kind--ie. they develop rapidly. I'm looking at : http://www.leukemia-lymphoma.org/all_page.adp?item_id=7026 Do you really have a lot of the other symptoms of this that there is a cause for concern?


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## Andros (Aug 26, 2009)

Cheracup said:


> OK, so this is a bit off topic since the lab results in question are white blood cells. I need to figure out how to compare results when there are different ranges for 'normal' so I can see if my trend of decreasing numbers continues.
> 
> Here's the story - I'm being followed by a PA at the Endo's office for a pituitary tumor and hypo. After my visit last Thursday, I noticed that my WBCs had been decreasing in numbers over a period of 3 weeks. When my PA didn't return my calls, I went to see a GP to have it evaluated. He kind of blew me off - looking only at the numbers, and didn't even bother doing a physical exam. He did another CBC, but unfortunately, his lab isn't as detailed, so I didn't get the differential numbers I was looking for. He's sending my blood to the lab at the hospital for a more thorough view of what is happening.
> 
> ...


Good question. This is why the same lab should be used consistently and also why we always need the ranges posted w/results. Different labs use different methology, subsequently different ranges.

Actually it is what it is. You can do a mean average but I don't think that would be very enlightening to be honest w/you.


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## Cheracup (Sep 23, 2010)

Thanks so much, GD ~ that was a very simple explaination. I also came to the same conclusion looking at the fact that the last result was 5 deviations lower on a 66 deviation range, and the recent one was 7 deviations lower on a 60 deviation range.

Thankfully, I will be quite busy today and will not have too much time on my hands to 'fret'!

Happy Holidays!


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## Cheracup (Sep 23, 2010)

Thanks for your thoughful reply, Lainey. I have a few symptoms, but they are so similar to Hypo - that it's difficult to differentiate and determine what is new or unusual. I was starting to feel a bit better, then the last few days I have been exhausted, kind of like a flu, I have a low grade fever, I'm sweating profusely, have a hard time breathing when I do even the simple task of getting ready for the day, etc.

We checked the Cabergoline that I take for the tumor, and it isn't one of the meds that can cause low blood cell count.

He was a bit concerned that my endocrinologist may be titrating my synthroid up too quickly and he's recommended a 2nd opinion. We discussed that it makes sense to remove the pituitary tumor instead of taking a medicine to shrink the tumor and Synthroid to manage the resulting Hypo - something that my current Endo (the PA) doesn't agree with.

Happy Holidays!


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## Cheracup (Sep 23, 2010)

Thanks for the reply, Android. I'm a bit confused about your statement 'it is what it is' ... because the 'what it is' has relevance. I have an answer to my question though, so that's good. I agree that using the same lab is extremely helpful, but the GP thought it would be good to have another lab involved. I don't understand it ... but this Doc came highly recommended, so I didn't question it.

The GP thought for sure that my WBC count would be back within normal range and said if my level was lower, he would refer me to a hematologist - so I expect that referral later today. I was just trying to figure out on my own if the level was, in fact, lower - and my foggy hypo brain wasn't able to wrap itself around the numbers.

Happy Holidays!


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## Andros (Aug 26, 2009)

Cheracup said:


> Thanks for the reply, Android. I'm a bit confused about your statement 'it is what it is' ... because the 'what it is' has relevance. I have an answer to my question though, so that's good. I agree that using the same lab is extremely helpful, but the GP thought it would be good to have another lab involved. I don't understand it ... but this Doc came highly recommended, so I didn't question it.
> 
> The GP thought for sure that my WBC count would be back within normal range and said if my level was lower, he would refer me to a hematologist - so I expect that referral later today. I was just trying to figure out on my own if the level was, in fact, lower - and my foggy hypo brain wasn't able to wrap itself around the numbers.
> 
> Happy Holidays!


I was a bit misleading. The statement implies, "Darn it all; why did they use 2 labs?" In other words, "No backing up and doing it over."

I am concerned for you and please do let us know when you are going to get in to see the hematologist.

You are in my thoughts and prayers for all of this.


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## dantetila (Jul 24, 2010)

Hi,

I can`t add much to the rest of the posters here, as they have done a great job, but I can give you a bit of positive news.

I saw a hematologist because my RBC was always around 3.5 when the range was 4.5 - 6. Also my WBC was anywhere between 3.7 - 4.5 for about 6 months. The hematologist saw my numbers and said she would not be concerned until the numbers were much lower and sent me on my way. Since then my numbers have rebounded.

I`m sure all will work out, keep us posted!


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## GD Women (Mar 5, 2007)

My WBC are like dantetila and I agree with dantetila said. Mine seem to fluctuate back and forth. Doctor has shown no concern as yet. Although the last two test I had done were out of Labs. I'm not concerned. Good luck with yours.


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## CA-Lynn (Apr 29, 2010)

Different labs have different normal ranges, based on their compiled results.

In any case, ALL of your labs are normal [according to my lab, which lists its normal range as 3.8 - 10.8]. It's possible that your low normal was the result of a barely symptomatic, minor viral infection at the time.

I wouldn't give it another thought. But that's just me.


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## Cheracup (Sep 23, 2010)

CA-Lynn: Not sure how you come to the conclusion that your lab's range is the ideal ... 
my doctor doesn't regard my labs as normal at all and has referred me to a hematologist. His first thought was a viral infection, which is why he assumed my WBCs would be up with the next blood draw. When they remained low, he wanted to get a specialist involved just to be on the safe side.

One thing that changed on this CBC was my Monocyte % was high (14 on a scale of 2 -10) - which is another reason for the referral.

It may end up being nothing at all - but I am worth having it checked. I'm not a fan of Doctors (or co-pays or co-insurance), but I am a fan of feeling better and getting healthy!


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