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Level 1 General Health Screening

As well as a variety of general lifestyle, health and wellness questions, your Level 1 General Health Screening includes the following medical assessments.

Blood Pressure

A blood pressure test is a simple way of checking if your blood pressure is too high or too low.

Blood pressure is the term used to describe the strength with which your blood pushes on the sides of your arteries as it’s pumped around your body.

High blood pressure (hypertension) can put a strain on your arteries and organs, which can increase your risk of developing serious problems such as heart attacks and strokes.

Low blood pressure (hypotension) isn’t usually as serious, although it can cause dizziness and fainting in some people.

A blood pressure test is the only way to find out if your blood pressure is too high or too low, because most people won’t have any obvious symptoms. Having a test is easy and could save your life.


Pulse

Measuring the pulse gives important information about your health. Any change from your normal heart rate can indicate a health problem. Fast pulse may signal an infection or dehydration. In emergency situations, the pulse rate can help determine if the person’s heart is pumping.

Pulse measurement has other uses as well. During or immediately after exercise, the pulse rate gives information about your fitness level and health.

Normal Results

For resting heart rate:

  • Newborns 0 to 1 month old: 70 to 190 beats per minute
  • Infants 1 to 11 months old: 80 to 160 beats per minute
  • Children 1 to 2 years old: 80 to 130 beats per minute
  • Children 3 to 4 years old: 80 to 120 beats per minute
  • Children 5 to 6 years old: 75 to 115 beats per minute
  • Children 7 to 9 years old: 70 to 110 beats per minute
  • Children 10 years and older, and adults (including seniors): 60 to 100 beats per minute
  • Well-trained athletes: 40 to 60 beats per minute

What Abnormal Results Mean

Resting heart rates that are continually high (tachycardia) may mean a problem. Talk to your health care provider about this. Also discuss resting heart rates that are below the normal values (bradycardia).

A pulse that is very firm (bounding pulse) and that lasts for more than a few minutes should be checked by your provider as well. An irregular pulse can also indicate a problem.

A pulse that is hard to locate may mean blockages in the artery. These blockages are common in people with diabetes or hardening of the artery from high cholesterol. Your provider may order a test known as a Doppler study to check the blockages.


Peak Expiratory Flow

Peak flow is a measure of how quickly you can blow air out of your lungs.  If you have asthma, you may sometimes have narrow airways. This will make it more difficult to blow the air out of your lungs quickly and can change your peak flow score. Your peak flow score is also called your peak expiratory flow (PEF). 

PEF is measured by taking a full breath in and blowing out as hard and fast as you can into a small hand-held device called a peak flow meter.  

Alongside a clinical history, and other tests like spirometry, peak flow can suggest you have asthma.


Oxygen Saturation

Pulse oximetry is a test to measure the level of oxygen in your blood. This is called your oxygen saturation level. It’s a simple, painless test that uses a sensor placed on your fingertip or earlobe.

Having a lung condition may mean your blood oxygen levels are lower than they should be. Pulse oximetry can help to understand if you might have a lung condition. It can also be used to monitor an existing lung condition.  

The more the lungs are damaged, the more likely there is to be a problem with your oxygen levels.

The test may be done once to help diagnose a lung condition. It can also be used to measure your oxygen levels over time. For example, during exercise like walking or when you are asleep. 


Temperature

Body temperature is a measure of how well your body can make and get rid of heat. The body is very good at keeping its temperature within a safe range, even when temperatures outside the body change a lot.

  • When you are too hot, the blood vessels in your skin widen to carry the excess heat to your skin’s surface. You may start to sweat. As the sweat evaporates, it helps cool your body.
  • When you are too cold, your blood vessels narrow. This reduces blood flow to your skin to save body heat. You may start to shiver. When the muscles tremble this way, it helps to make more heat.

Part of your brain called the hypothalamus continually adjusts your body temperature to maintain an optimal environment for your body functions. Body temperatures vary with gender, age, overall health, and environmental factors. Your normal body temperature is approximately 37°C or 98.6 degrees Fahrenheit.

A fever is usually when your body temperature is 37.8°C or higher. You may feel warm, cold or shivery. Fever helps your body fight infections by stimulating your immune system (your body’s natural defence). By increasing your body’s temperature, a fever makes it harder for the bacteria and viruses that cause infections to survive.


Blood Glucose

High blood sugar and diabetes may not cause symptoms in the early stages. A fasting blood sugar test is the most common test done to screen for diabetes, usually starting at age 35. If you have no other diabetes risk factors, you should be tested every 3 years (in some cases, more often if your weight is rising).

Normal Results

If you had a fasting blood glucose test, a level between 70 and 100 mg/dL (3.9 and 5.6 mmol/L) is considered normal.

If you had a random blood glucose test, a normal result depends on when you last ate. Most of the time, the blood glucose level will be 125 mg/dL (6.9 mmol/L) or lower.

What Abnormal Results Mean

If you had a fasting blood glucose test:

  • A level of 100 to 125 mg/dL (5.6 to 6.9 mmol/L) means you have impaired fasting glucose, a type of prediabetes. This increases your risk of developing type 2 diabetes and you should consult with your provider.
  • A level of 126 mg/dL (7 mmol/L) or higher usually means you have diabetes.

If you had a random blood glucose test:

  • A level of 200 mg/dL (11 mmol/L) or higher often means you have diabetes.
  • Your provider will order a fasting blood glucose, A1C test, or glucose tolerance test, depending on your random blood glucose test result.
  • In someone who has diabetes, an abnormal result on the random blood glucose test may mean that the diabetes is not well controlled. Talk with your provider about your blood glucose goals if you have diabetes.

Other medical problems can also cause a higher-than-normal blood glucose level, including:

  • Overactive thyroid gland
  • Pancreatic cancer
  • Swelling and inflammation of the pancreas (pancreatitis)
  • Stress due to trauma, stroke, heart attack, or surgery
  • Rare tumors, including pheochromocytoma, acromegaly, Cushing syndrome, or glucagonoma

A lower-than-normal blood glucose level (hypoglycemia) may be due to:

  • Hypopituitarism (a pituitary gland disorder)
  • Underactive thyroid gland or adrenal gland
  • Tumor in the pancreas (very rare)
  • Too little food
  • Too much insulin or other diabetes medicines
  • Liver or kidney disease
  • Weight loss after weight loss surgery
  • Vigorous exercise

Some medicines can raise or lower your blood glucose level. Before having the test, tell your provider about all the medicines you are taking.

For some people, mainly those who are thin and young, a fasting blood sugar level below 70 mg/dL (3.9 mmol/L) may be normal.


Ketones

Ketones are a type of chemical that your liver produces when it breaks down fats.

Your body uses ketones for energy typically during fasting, long periods of exercise, or when you don’t have as many carbohydrates. You can have low levels of ketones in your blood without it being a problem.

But high levels of ketones in your blood is a sign that something isn’t quite right. 

When ketones build-up in the blood, they can become acidic and lead to something called diabetic ketoacidosis (DKA). This can be life-threatening, so you need to know what the symptoms of DKA are, how to check for them and how to get treatment straight away. 

If you have type 1 diabetes, you’re more at risk of experiencing DKA than people with other types of diabetes. But if you have type 2 and use insulin then you should still look out for the signs of DKA. 

Normal blood ketone levels can be different from person to person. 

If the ketone levels in your blood are high, you’re at risk of DKA.

Ketogenic diet

Some people follow a ketogenic diet to lose weight, sometimes called the keto diet. This is a very low carb diet that produces ketones in their blood.


Following a keto diet does not necessarily cause DKA. A keto diet leads to ketosis when your body breaks down stored fat to convert it into energy.


Total Cholesterol

What is cholesterol?

Cholesterol is a waxy, fat-like substance that’s found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But if you have too much cholesterol in your blood, you have a higher risk of coronary artery disease.

  • Total cholesterol – a measure of the total amount of cholesterol in your blood. It includes both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
  • LDL (bad) cholesterol – the main source of cholesterol buildup and blockage in the arteries
  • HDL (good) cholesterol – HDL helps remove cholesterol from your arteries

What affects my cholesterol levels?

A variety of things can affect cholesterol levels. These are some things you can do to lower your cholesterol levels:

  • Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level. Foods that have high levels of saturated fats include some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
  • Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL (bad) cholesterol, total cholesterol, and triglyceride levels. It also raises your HDL (good) cholesterol level.
  • Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
  • Smoking. Cigarette smoking lowers your HDL (good) cholesterol. HDL helps to remove bad cholesterol from your arteries. So a lower HDL can contribute to a higher level of bad cholesterol.

Things outside of your control that can also affect cholesterol levels include:

  • Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL (bad) cholesterol levels tend to rise.
  • Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
  • Race. Certain races may have an increased risk of high blood cholesterol.


Triglycerides

The triglyceride level is a blood test to measure the amount of triglycerides in your blood. Triglycerides are a type of fat.

Your body makes some triglycerides. Triglycerides also come from the food you eat. Extra calories are turned into triglycerides and stored in fat cells for later use.

A test for high blood cholesterol levels is a related measurement and usually done at the same time.

Normal Results

Results may indicate:

  • Normal: Less than 150 mg/dL (1.69 mmol/L)
  • Borderline high: 150 to 199 mg/dL (1.69 to 2.25 mmol/L)
  • High: 200 to 499 mg/dL (2.26 to 5.64 mmol/L)
  • Very high: 500 mg/dL or above (5.65 mmol/L)

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

High triglyceride levels may be due to:

  • Cirrhosis or liver damage
  • Diet low in protein and high in carbohydrates
  • Underactive thyroid
  • Nephrotic syndrome (a kidney disorder)
  • Other medicines, such as female hormones
  • Poorly controlled diabetes
  • Disorder passed down through families in which there are high amounts of cholesterol and triglycerides in the blood

Overall, the treatment of elevated triglyceride levels focuses on increased exercise and changes in the diet. Drugs to lower triglyceride levels may be used to prevent pancreatitis for levels above 500 mg/dL.

Low triglyceride levels may be due to:

  • Low fat diet
  • Hyperthyroidism (overactive thyroid)
  • Malabsorption syndrome (conditions in which the small intestine does not absorb fats well)
  • Malnutrition


Uric Acid

Hyperuricemia happens if too much uric acid stays in your body. Uric acid is a waste product that’s created when your body breaks down chemicals called purines in food and drinks. Most uric acid dissolves in your blood, passes through your kidneys and leaves your body in your urine.

Hyperuricemia causes uric acid to clump together in sharp crystals. These crystals can settle in your joints and cause gout, a painful form of arthritis. They can also build up in your kidneys and form kidney stones.

Hyperuricemia is very treatable. You might need to change some aspects of your daily routine (like tweaking your diet or drinking more water). A healthcare provider might prescribe you medicine to lower your uric acid levels or treat any symptoms you’re experiencing.

How common is hyperuricemia?

Hyperuricemia is very common. One in 5 people has hyperuricemia.

Around 5% of people have gout. Men are four times more likely to develop gout than women.

How does hyperuricemia affect the body?

You might not notice you have hyperuricemia, especially if your levels are only slightly elevated. But over time, the buildup of uric acid in your blood can lead to pain and other symptoms. It can also cause damage throughout your body.

Untreated high uric acid levels can eventually lead to permanent damage in your:

  • Bones.
  • Joints.
  • Tendons.
  • Ligaments.

Research has also shown a link between high uric acid levels and other health conditions, including:

  • Kidney disease.
  • Heart disease.
  • High blood pressure.
  • Diabetes.
  • Fatty liver disease.
  • Metabolic syndrome.


Lactate

Lactate is one of the substances produced by cells as the body turns food into energy (cell metabolism), with the highest level of production occurring in the muscles. Depending on pH, it is sometimes present in the form of lactic acid. However, with the neutral pH maintained by the body, most of it will be present in the blood in the form of lactate. This test measures the amount of lactate in the blood or, less commonly, in the cerebrospinal fluid (CSF).

Normally, the level of lactate in blood and CSF is low. Lactate is produced in excess by muscle cells, red blood cells, brain, and other tissues when there is insufficient oxygen at the cellular level or when the primary way of producing energy in the body’s cells is disrupted. Excess lactate can lead to lactic acidosis.

The principal means of producing energy within cells occurs in the mitochondria, tiny power stations inside most cells of the body. The mitochondria use glucose and oxygen to produce ATP (adenosine triphosphate), the body’s primary source of energy. This is called aerobic energy production.

Whenever cellular oxygen levels decrease and/or the mitochondria are not functioning properly, the body must turn to less efficient energy production to metabolize glucose and produce ATP. This is called anaerobic energy production and the primary byproduct is lactic acid, which is processed (metabolized) by the liver.

Lactic acid can accumulate in the body and blood when it is produced faster than the liver can break it down.

Excess lactate may indicate one or a combination of the following:

  • Lack of oxygen (hypoxia)
  • The presence of a condition that causes increased lactate production
  • The presence of a condition that causes decreased clearance of lactate from the body

When lactic acid production increases significantly, the affected person is said to have hyperlactatemia, which can then progress to lactic acidosis as more lactic acid accumulates. The body can often compensate for the effects of hyperlactatemia, but lactic acidosis can be severe enough to disrupt a person’s acid/base (pH) balance and cause symptoms such as muscular weakness, rapid breathing, nausea, vomiting, sweating, and even coma.