Variation in Blood Tests

I had taken a blood test in May of 2005 and my LDH was in the normal range at 147 ML where the reference range is 89ML to 215ML. Six months later had another blood test and LDH was at 160ML. I assume this is a minor elevation and was wondering if LDH enzyme fluctuates like this in a normally healthy person. Also my absolute lymphocytes fluctuated from 32.7 to 37.4 where the normal range is 15 to 48. I assume this is a minor elevation as well?

[Kevin Pho, MD]

The LDH is within the normal range - extremely elevated levels can be seen in diseases of tissue damage or inflammation.  Lab variation can also account for the fluctuating levels.

Lymphocytes can also fluctuate without a given range.  The fact that it remains in the normal range is suggestive that a major disease isn't present.  

High counts can be suggestive of cancer or infection.  Low counts is suggestive of a disease in the immune system.

Repeating these tests can be considered to ensure they aren't rising.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[B_Johnson]

LDH is a rather nospecific marker of cell damage.  Usually fluctuations within the normal range are representative of normal cell turnover.  

If you are interested, LDH can be further broken down in to several subtypes which can isolate the organ of damage.  But this is only indicated in elevations or where clinical presentation of something like MI is in question.


Your Lymphocyte count is normal as well.  There are many types of white blood cells.  A lymphocyte is just one type and is involved in fighting viral infections and cell signalling within the immune system.  These different popluations of cells should always occur within a certain range of percent of the overall white blood cell populations.

For example if you had an infection the number of neutrophils you produce would increase and this in turn would lower the lymphocyte percent because now the dominant type of white cell is the the neutrophil.

Very low lymphocyte count can be a sign of AIDS or immunodeficiency.  Very high counts can be a sign of myelodysplasias such as leukemia.

Numbers within the normal range or just above or below are usually just your body just responding normally to a dynamic environment.