Blood Count

The complete blood count test measures the health of your blood and its components WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs).   

The CBC evaluates your overall health and can detect many diseases. Order your CBC test from Ulta Lab Tests today with confidential results online in 24 to 48 hours.

Below the list of tests is a guide that explains and answers your questions on what you need to know about complete blood count tests, along with information on how you can use these lab tests to learn and track your health.


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A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

NOTE: Only measurable biomarkers will be reported.


Before ordering this test consider The Complete Blood Count (CBC) with Differential and Platelets Blood Test (Test # 6399) which is a better value.

In Quest's internal studies of more than two thousand patient samples, no significant abnormalities were detected with manual differentials associated with test code 20253 that were not otherwise identified thru the test code 6399 CBC Reflex cascade.

This test is a CBC reflex test and it will include the components of the CBC (Includes Diff/PLT) with Smear Review based upon the test results of the following analytes if are above or below ranges as outlined in the test.

 
 
  • WBC 
  • Hemoglobin 
  • Hematocrit 
  • Platelet 
  • MCV 
  • MCH 
  • MCHC 
  • RBC 
  • RDW 
  • Relative Neutrophil % 
  • Relative Lymphocyte % 
  • Relative Monocyte % 
  • Eosinophil 
  • Basophil 
  • Platelet 

Absolute Lymphocyte Count includes: WBC, Absolute Lymphocytes, % Lymphocytes, % Reactive Lymphocytes

Clinical Significance

Increased understanding of immunodeficiency syndrome and AIDS have identified the importance of absolute lymphocyte count in addition to the specific cell type such as CD4 lymphocytes. In pediatric ages up to 14 years old, acute infectious lymphocytosis is a clinical disorder, suspected to be of enterovirus-Coxsackie A subgroup that may have upper respiratory symptoms, fever, diarrhea and abdominal pain or a totally asymptomatic clinical course. Other conditions with absolute lymphocytosis are B. pertussis infection and lymphocytic leukemoid reaction. The most commonly known lymphocytosis with atypical morphology is due to cytomegalovirus and infectious mononucleosis. The malignant forms of absolute lymphocytosis are mostly due to lymphoproliferative disorders.


This panel is designed to evaluate a patient for the presence of potentially reversible (i.e., secondary) causes of dementia such as Vitamin B12 deficiency, hypothyroidism, hypoparathyroidism, anemia, hypoxia or hypercapnia, hepatic and renal encephalopathies, diabetes, and dehydration. The panel includes a Complete Blood Count, TSH, Vitamin B12, Folate, and a Comprehensive Metabolic Panel. It is modeled after the recommendations of the American Academy of Neurology (AAN), a National Institutes of Health Consensus Panel, the European Federation of Neurological Societies (EFNS), and others.1-4

Usual method for determining anemia. Used to calculate indices.

Usual method for determining anemia. Used to calculate indices.

The detection and proper identification of hemoglobinopathies and thalassemias is an important aspect of the evaluation of patients with anemia, microcytosis and erythrocytosis.

A complete blood count used as a screening test for various disease states to include: Anemia, leukemia and inflammatory processes.

A complete blood count is used as a screening test for various disease states including anemia, leukemia and inflammatory processes.

Clinical Significance

Assists in evaluating helper and suppressor cell immune status in immunodeficiency diseases such as AIDS.


Includes

  • CBC (includes Differential and Platelets)
  • Antibody Screen, RBC with Reflex to Identification, Titer, and Antigen Typing 
  • ABO Group and Rh Type
  • RPR (Diagnosis) with Reflex to Titer and Confirmatory Testing
  • Hepatitis B Surface Antigen with Reflex Confirmation*
  • Rubella Antibody (IgG), Immune Status
  •  
  • If Antibody Screen is positive, Antibody Identification, Titer, and Antigen Typing will be performed at an additional charge (CPT code(s): 86870, 86886, 86905).
  • If RPR screen is reactive, RPR Titer and FTA Confirmatory testing will be performed at an additional charge (CPT code(s): 86593, 86780).
  • If Hepatitis B Surface Antigen is positive, confirmatory testing based on the manufacturer's FDA approved recommendations will be performed at an additional charge (CPT code(s): 87341).
  •  

Circulating antibodies to platelets have been associated with immune and drug-induced thrombocytopenia. Elevated levels of platelet - associated antibodies may occur in autoimmune thrombocytopenia, as well as thrombocytopenia associated with carcinoma, AIDS, and connective tissue diseases. Both circulating and associated platelet antibodies may play a role in platelet destruction. Platelet antibodies may consist of a single isotype (IgG, IgM, or IgA) or any combination of isotypes.

Platelets must be present in adequate numbers and have proper function to aid in hemostasis.

A complete blood count used as a screening test for various disease states to include: anemia, leukemia and inflammatory processes

Most Popular
Use in evaluating erythropoietic activity.

Includes

  • Hemoglobin A, Hemoglobin F, Hemoglobin A2 (Quant), Hemoglobin A2 Prime, Hemoglobin S, Hemoglobin C, Hemoglobin D, Hemoglobin G, Hemoglobin Lepore, Hemoglobin E, Hemoglobin Barts, Variant Hemoglobin, HPLC, Hemogram (Red Blood Cell Count, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW), Ferritin and Interpretation
  •  
  • This is a reflexive profile. Additional testing, such as molecular tests, will be added at an additional charge, if indicated.
  •  
  • If results suggest sickling hemoglobin, Sickle Cell Screen will be performed at an additional charge (CPT code(s): 85660). 
  •  
  • If results suggest an unstable hemoglobin based on % of the variant and pattern seen on HPLC and Electrophoresis , Unstable Hemoglobin (Isopropanol) will be performed at an additional charge (CPT code(s): 83068).
  •  
  • If the hemogram shows microcytosis or decreased MCH or both and, there is no evidence of beta thalassemia (i.e., normal A2 and HbF), Alpha Globin common mutation analysis will be performed at an additional charge (CPT code(s): 81257). In consultation with the client, this test may also be performed (at an additional charge) in an individual with a normal hemogram for genetic counseling purposes as individuals with mild alpha thalassemia commonly have a normal hemogram and normal fractions.
  •  
  • If HPLC or CZE, point to an unidentified alpha globin variant, the sample will be sent for DNA sequencing and Alpha Globin Complete will be performed at an additional charge (CPT code(s): 81259).
  •  
  • If the genotyping results for the common deletions do not match the phenotype, Alpha Globin Gene Deletion or Duplication will be performed at an additional charge (CPT code(s): 81269) and Alpha Globin Complete will be performed at an additional charge (CPT code(s): 81259).
  •  
  • If a rare beta globin variant cannot be definitively identified by HPLC or CZE, Beta Globin Complete will be performed at an additional charge (CPT code(s): 81364).
  •  
  • If result suggests Hereditary persistence of fetal hemoglobin or Delta beta thalassemia or a beta thalassemia with negative beta globin sequencing, Beta globin gene dosage assay will be performed at an additional charge (CPT code(s) 81363).
  •  
  • Gamma globin gene sequencing or delta globin gene sequencing may be added at an additional charge, if clinically indicated. These tests are performed at an outside reference lab. Not applicable to CA and FL clients.
  • If a reflex test is added, Genotype/phenotype review will be added at an additional charge (CPT code(s) 80500).

 

Clinical Significance

Thalassemia and Hemoglobinopathy Comprehensive Evaluation - Thalassemia and hemoglobinopathies are disorders related to hemoglobin pathophysiology. Although hemoglobinopathies and thalassemias are two genetically distinct disease groups, the clinical manifestations of both include anemia of variable severity and variable pathophysiology.
Thalassemias are group of autosomal recessive disorder of hemoglobin synthesis characterized by the reduction in the rate of synthesis of globin chain of one or more globin chain. The decreased synthesis of globin chain may result from gene deletion, non-sense mutation or mutation that affects the transcription or stability of mRNA products. Thalassemias are classified by the type and magnitude of decreased synthesis of the globin chain and severity of the clinical symptoms. The clinical manifestation ranges from mild anemia with microcytosis to fatal severe anemia.
In the alpha-thalassemias, there is absence or decreased production of beta-globin subunits, whereas in the beta- thalassemias, there is absent or reduced production of beta globin subunits. Rare thalassemias affecting the production of delta or gamma globin subunits have also been described but are not clinically significant disorders.
The beta-thalassemias can be sub-classified into those in which there is total absence of normal beta globin subunit synthesis or accumulation, the beta-zero thalassemias, and those in which some structurally normal beta globin subunits are synthesized, but in markedly decreased amounts, the beta-plus thalassemias. The alpha-thalassemia syndromes however, are usually caused by the deletion of one or more alpha globin genes and are sub-classified according to the number of alpha globin genes that are deleted (or mutated): one gene deleted (alpha-plus thalassemia); two genes deleted on the same chromosome or in cis (alpha-zero thalassemia); three genes deleted (HbH disease); or four genes deleted (hydrops fetalis with Hb Bart's).
Hemoglobinopathies results from the abnormal structure of One of the globin chains of the hemoglobin molecule (mutation of alpha and/or beta globin chain resulting in a variant form of Hemoglobin A). They are inherited single- gene disorders and in most cases, they are inherited as autosomal co-dominant traits. A large number (>800) of variants of hemoglobin (Hb) have been recognized. They are identified by capital letters (eg, Hb A or Hb S), or by the city in which the variant was first discovered (eg, Hb Koln).
Alpha chain variants usually form less than 25% of the total hemoglobin because the mutation typically occurs in one of the four genes that codes for alpha globin chain. For beta globin variants in the heterozygous state the variant forms more than 25% but less than 50% of the total hemoglobin. Ranked in order of relative frequency, these are: Hb S (sickle cell disease and trait), C, E, Lepore, G-Philadelphia, D-Los Angeles, Koln, Constant Spring, O-Arab, and others.
Most common beta globin variants include HbS, HbC, HbD, HbE and HbG. A mutation in one beta globin subunit results in a combination of variant and normal hemoglobin and denotes carrier or trait status, also known as the heterozygote state. Mutations in both beta globin subunits result in disease based on a homozygous expression such as sickle cell anemia (HbSS). Other diseases under sickle cell disease (SCD) are HbSE, HbSC and HbS beta-thalassemia.


Most commonly utilized test to monitor characteristic response to infection. Diagnostically useful for diseases such as leukemia, leukocyte disorders, as well as monitoring therapy of these diseases.

A screening test for various disease states to include leukemia and inflammatory processes.


A complete blood count (CBC) is a blood test that your doctor may order to get an in-depth examination of your health. 

If you're looking to take control and improve your health, it's important that you have an understanding of what exactly a CBC measures. That's why today, we've got a complete CBC explained guide to help you understand what a CBC test is and where your test results should be.

Are you looking to learn more about how to understand your complete blood count? We've created a complete guide to help you understand. Keep reading to learn more!

CBC Explained: What Is a Complete Blood Count?

A complete blood count test is often called a CBC test. This blood test provides a medical professional with an important look at the health of one's blood. The information that a CBC test provides professionals can help lead to a diagnosis of cancer, an infection, anemia, and other health conditions.

A CBC test measures the white blood cells, the red blood cells, and the blood platelets found in your blood. This is one of the most commonly ordered blood tests, as it's a great way for doctors to take a peek into your overall health without excessive testing.

What Biomarkers Are Measured? 

Fifteen biomarkers are measured with a complete blood cell test. Here are the biomarkers that are measured and what they each mean for your health:

Red Blood Cell Count

Red blood cells are the most plentiful type of cell found in your blood. Surprisingly, nearly half of the volume of your blood is comprised of red blood cells.

The primary function of the red blood cell is to gather up oxygen from the lungs, move it through your body, and leave it with your tissues. What makes red blood cells so unique is that they have hemoglobin, which is a protein that carries iron.

Thanks to the hemoglobin found in your red blood cells, it can saturate themselves with oxygen and release it the tissues in your body that need it the most. Keeping a healthy balance of red blood cells is incredibly essential for your body to function normally. 

The red blood cell count detects the number of red blood cells that are in your blood. In addition, this test also shows how much oxygen your blood cells have the potential to carry.

If your red blood cell count is low, it could be a sign that your red blood cells are breaking down at an unsustainable rate. It could also be a sign that your red blood cells aren't being produced fast enough. When your red blood cells aren't being produced quickly enough, it's a sign that your body is lacking specific nutrients.

A healthy range for a RBC count in females is 3.80-5.10 million/uL and in males 4.20-5.80 million/uL, as reported by Quest.

Hemoglobin

Hemoglobin is vital to the red blood cell. The CBC measures the amount of hemoglobin found in your blood, as well as how much oxygen your red blood cells can carry.

For females, a standard range of hemoglobin is 11.7-15.5 g/dL. For men, a healthy range is between 13.2.0-17.1 g/dL, as reported through Quest.

Hematocrit

Hematocrit biomarker identifies how much blood as a percentage comes from red blood cells. It also is an indicator of how much oxygen your blood can carry. When your hematocrit levels are balanced, your body's physical performance is increased.

Plus, healthy levels of hematocrit can help to ensure the health of your cardiovascular system, which can reduce your risk of having a stroke.

For men, a healthy level of hematocrit is between 38.5% to 50%, while a healthy level for women is between 35% and 45%, as reported through Quest.

MCV

MCV is an abbreviation of the term mean corpuscular volume. Mean corpuscular volume measures the size of your red blood cells. Discovering the size of your red blood cells is important, as it's an indicator of how much oxygen your cells can carry.

Small red blood cells can be a tool in diagnosing an iron deficiency. In contrast, large red blood cells show that your body has the capability of carrying a more substantial amount of hemoglobin.

A normal range will fall between 80 to 100 femtoliters.

MCH

MCH is an abbreviation of the term mean corpuscular hemoglobin. MCH is one of the ways that is used to discover the average amount of hemoglobin that's in one red blood cell. Often paired with MCHC, this biomarker is used to find out the potential for the average red blood cell's ability to carry oxygen throughout your body.

You must keep in mind that MCH is simply an average. However, the normal range is between 27 to 33 picograms, as reported by Quest.

MCHC

MCHC is an abbreviation of the term mean corpuscular hemoglobin concentration. This is another biomarker used to discover how much hemoglobin is available in a single red blood cell.

You also should keep in the back of your mind that MCHC is an average. A healthy range for the MCHC test is between 32-36 g/dL, as reported by Quest.

RDW

RDW stands for _red blood cell distribution width. _This biomarker shows how unvarying the volume of your red blood cells is. The higher your RDW is is a sign that there's a significant dissimilarity among your red blood cells.

An iron deficiency, chronic inflammation, or a nutritional imbalance can contributing factors for a high RDW.

For males and females, a healthy RDW is between 11% to 15%, as reported by Quest.

Platelet Count

Platelets are the cells in your blood that are responsible for making sure that your blood can stick together enough to form a blood clot.

A healthy platelet count should range between 140-400 thousand/uL, as reported by Quest.

MPV

MPV is an abbreviation of the term _mean platelet volume. _This test measures the average size of the platelets that are found in your blood.

When your MPV levels are marked as high, it means that platelets are at a larger size than the average persons. This elevation could be a sign that your body is producing too many platelets.

If your MPV levels have been marked as low, it could mean that your body is destroying platelets too soon. As a result, your bone marrow is producing platelets too quickly.

White Blood Cell Differential Count

The white blood cell differential count is a summary of the different types of white blood cells that are found in your bloodstream. With the review of leukocytes, neutrophil, lymphocytes, basophils, monocytes, and eosinophils, you'll be provided with an in-depth look at your immune system.  

The Five Different Types of WBC:

Separate from your red blood cells, white blood cells are also tested during a CBC test. Five different types of white blood cells are found in your bloodstream and include leukocytes, neutrophils, lymphocytes, basophils, and eosinophils.

Leukocytes

White blood cells are called leukocytes, which play a vital role in maintaining the healthy functioning of your immune system. This biomarker is your white blood cell count, which is also often called your leukocyte count.

A healthy range for your WBC is between 3.8-10.8 Thousand/uL, as reported by Quest.

Neutrophils

Neutrophils are the most commonly found white blood cells in your blood, making for about 70% of the white blood cells found in your body. They're the first response your body uses to fight against any infections that enter your bloodstream.

When low levels of neutrophil are found in your blood, it may be a sign that your body is fighting against a viral infection. Another cause of low neutrophil levels in your blood is a sign that your body is adapting to the stress it's been under while you're training to become an endurance athlete.

A healthy level of neutrophils is between 1500-7800 cells/uL, as reported by Quest.

Lymphocytes

Lymphocytes represent between 20% to 40% of the white blood cells circulating throughout your blood. This white blood cell is acting as a wall of protection against the constant beratement of bacteria and infections introduced to your body.

When there's a high amount of lymphocytes found in your blood, it's a sign that your body may have a bacterial infection or that it's your body response to acute stress.

A healthy range of lymphocytes is between 850-3900 cells/uL, as reported by Quest.

Basophils

Along with eosinophils, basophils are the least common type of white blood cells. If an increased amount of basophil cells are found in your bloodstream, it's a sign that your body could be fighting against an allergic reaction or an infection from a parasite.

A healthy level of basophils should be between 0-200 cells/uL, as reported by Quest.

Eosinophils

As another uncommon white blood cell, eosinophils are responsible for how your body reacts when you have an allergic reaction. High levels of eosinophils are a sign that your body is fighting off a type of infection.

A normal range of eosinophil is between 15-500 cells/uL, as reported by Quest.

Monocytes

This type of white blood cell is responsible for fighting off viruses, fungi, and bacteria. In terms of size, they're the largest white blood cell that is found in your bloodstream.

Formed in your bone marrow, this type of white blood cell is the first responder when there is a specific type of bacteria or germ that enters your body. They also play a large part in making sure that any damaged tissue is repaired correctly.

A healthy range of monocytes is between 200-950 cells/uL, as reported by Quest.

What Health Problems Can Be Identified by a CBC?

When the doctor orders a CBC, it may just be part of the physical exam preventative care that you're getting. The results of the biomarkers will provide your doctor with a better insight into how many blood cells that are in your body, how they're shaped, and how they're functioning.

If there is a concern for many health conditions, a CBC is a useful tool to use to eliminate the concern of any potential health conditions, as well as being helpful to diagnose health conditions.

Besides a physical exam, your doctor may order a complete blood count test if you have reported: 

  • Feeling sick
  • Have had a fever
  • Showing other signs of a possible infection, such as swollen lymph nodes
  • Feeling weak
  • Easy bruising
  • Excessive bleeding or your blood takes a while to clot
  • Feeling tired all the time
  • Losing weight without trying to
  • Take medications that could affect your blood count

Here's a list of conditions that your CBC test could help you and your doctor to identify: 

  • Anemia
  • Certain forms of cancer
  • Mineral deficiencies
  • Vitamin deficiencies
  • Inflammation
  • Dehydration
  • Heart disease
  • Autoimmune disorders
  • Infection
  • Bone marrow complications

If your doctor ordered this blood test and you were looking to have CBC explained, we hope that we were able to provide you with a better understanding. The results from a CBC blood test can be beneficial when your doctor is trying to rule out or diagnose a health condition.  

The Importance of a CBC Test

If you need help understanding the health of your blood, we'd love to help. We offer the CBC lab test as part of our selection of 1,500 lab tests, and we provide explanations on each biomarker.

You can select your lab tests, order directly online, choose a convenient patient service center near you, and review your test results typically in 1 to 2 days after your blood is collected.

Take charge of your health and get tested today at ultalabtests.com.