Guide 2 — report in hand

Types of blood tests: the main panels and what each measures

The main types of blood tests come in panels: blood count, metabolic, lipid, liver, kidney, thyroid, iron. What each one measures and what it leaves open.

Key figures

251,891
participants in the Cochrane review: general health checks did not reduce mortality[1]
+20%
more new diagnoses over six years in people offered checks, with no better outcomes[2]
29
guidelines compared on iron deficiency, with widely varying thresholds[6]
30 µg/L
ferritin threshold from a Swiss consensus, often above the lower limit printed on a report[7]

A panel is a group, not a list

What arrives as thirty numbered lines is really a handful of small panels, and inside each one the lines are meant to be read against each other. Hemoglobin with MCV and ferritin. ALT with AST and GGT. Creatinine with eGFR and your hydration.

That is why reading a report top to bottom rarely works, and why each page here explains a panel rather than a marker.

Why a single value says little

A single out-of-range number, read on its own, is the quickest way to the wrong conclusion. The same raised ALT does not mean the same thing after a bout of flu, after a heavy dinner, or after starting a new medicine.

So every page in this section starts from the group: which lines make it up, which one is read first, and which combinations are worth a question to your doctor.

What a routine panel shows, and what it does not

Routine blood work describes how a few large systems are behaving today: blood cells, sugar, kidneys, liver, thyroid, lipids, iron. It is not a cancer screen, it does not test for most infections, and it leaves out vitamin D or B12 unless they were asked for.

More lines do not buy more protection. A Cochrane systematic review of 17 randomized trials and 251,891 participants found that general health checks offered to adults had no effect on total, cancer or cardiovascular mortality. In one of those trials, people offered checks received 20% more new diagnoses over six years, without any change in outcomes.

Some lines are fragile for technical reasons rather than medical ones. Potassium is the classic case: red cells damaged during collection release it into the sample and raise the result, which is why laboratories measure the degree of hemolysis and reject samples beyond a threshold.

Four readings that changed recently

Four lines are read differently today than a few years ago, which matters whenever you compare a new report with an older one.

  1. LipidsSince 2016, European guidance measures them without fasting by default: after an ordinary meal, triglycerides move little and HDL not at all.
  2. KidneysIn 2021 a joint US task force recommended a creatinine equation without the race variable, so an older eGFR and a recent one may not be calculated the same way.
  3. IronThresholds for iron deficiency vary widely across 29 guidelines; a Swiss consensus places ferritin at 30 µg/L in people without inflammation.
  4. ThyroidFor a raised TSH with a normal free T4, a 2023 review finds no proof that hormone replacement helps; age, symptoms and the TSH level decide.

Where to start

If your report is a long sheet, begin with the full blood panel guide, which explains how the groups fit together and what a check-up can and cannot tell you. Then go to the group that carries your flagged lines: blood count, metabolic panel, lipids, liver, kidneys, thyroid or iron.

The articles in this guide

PillarFull blood panel: what’s included and what it can detectThere is no single official “full panel”. What you have in your hands is a stack of small panels, and each one is read as a group of lines rather than line by line.ArticleCBC with differential: what it measures and what it can showThree cell families, counted and measured. The value of a CBC is in how the lines relate to one another, which is why reading it top to bottom misses the point.ArticleWhat is a comprehensive metabolic panel (CMP)? 14 tests in 4 groupsSodium does not tell you how much salt you eat. It tells you how much water you are carrying relative to the salt already there, which is why a low sodium is almost always a water problem.ArticleLipid panel blood test: what it measures and what your results meanFour or five lines, one of which is not a reference range at all. Reading a lipid panel means knowing which is which.ArticleLiver function test panel: what’s included and why enzymes riseMost of a liver panel does not measure how well the liver works. It measures enzymes that leak when liver cells are irritated, which is a different question.ArticleThyroid blood test results: how to read TSH, T4 and T3TSH is not a thyroid hormone, and it moves the opposite way to the gland. Once that is clear, most of a thyroid panel reads itself.ArticleRenal function panel: what it measures and why one result isn’t CKDCreatinine is a waste product, eGFR is an estimate calculated from it, and neither is a diagnosis on a single day.ArticleIron panel blood test: what it includes and what low or high meansFerritin is your iron store, transferrin saturation is what is circulating, and the threshold that separates deficient from adequate is genuinely disputed.

Your own results

Your blood test results, explained line by line

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Sources

Guidelines, consensus statements and peer-reviewed studies. Every figure on this page comes from one of them. Preprints are not cited.

  1. Systematic review

    General health checks in adults for reducing morbidity and mortality from disease

    Cochrane Database of Systematic Reviews · 2019doi:10.1002/14651858.CD009009.pub3

  2. Systematic review

    General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis

    BMJ · 2012doi:10.1136/bmj.e7191

  3. Verification study

    Effects of the hemolytic index on the test results of a dry chemistry analyzer and a verification of the hemolytic interference threshold

    Annals of Palliative Medicine · 2022doi:10.21037/apm-22-292

  4. Consensus statement

    Fasting is not routinely required for determination of a lipid profile: a joint consensus statement from the European Atherosclerosis Society and the European Federation of Clinical Chemistry and Laboratory Medicine

    European Heart Journal · 2016doi:10.1093/eurheartj/ehw152

  5. Recommendation

    A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease

    American Journal of Kidney Diseases · 2021doi:10.1053/j.ajkd.2021.08.003

  6. Systematic review

    Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review

    The American Journal of Clinical Nutrition · 2015doi:10.3945/ajcn.114.103366

  7. Expert consensus

    Swiss Delphi study on iron deficiency

    Swiss Medical Weekly · 2019doi:10.4414/smw.2019.20097

  8. Review

    Subclinical hypothyroidism, outcomes and management guidelines: a narrative review and update of recent literature

    Current Medical Research and Opinion · 2023doi:10.1080/03007995.2023.2165811