Laboratory Report #39
September 2026 WellMed Laboratory Assessment
Report Identification
Laboratory: WellMed
Order Date: September 22, 2026
Results Reported: September 23–28, 2026
Ordering Physician: Jeffrey A. George, MD
Report Type: Third-Quarter 2026 Laboratory Assessment
Physician Note — September 24, 2026:
“Labs reviewed. Will discuss at upcoming appointment.”
Initial Summary of Lab Data
1. Autoimmune and Inflammatory Markers
| Test | Result | Flag | Reference Range |
|---|---|---|---|
| ANA — Homogeneous Pattern | 1:640 | H | — |
| Anti-dsDNA Antibodies | 2.6 EIA U/mL | — | 0.0–10.0 |
| Anticardiolipin Ab, IgA | <9 APL U/mL | — | 0–11 |
| C-Reactive Protein (CRP) | <1.0 mg/L | — | 0.0–5.0 |
| ESR, Westergren | 18 | — | 0–20 |
Interpretation
The ANA remains positive at a 1:640 homogeneous pattern. Anti-dsDNA and anticardiolipin IgA, however, are within their respective laboratory reference ranges.
The inflammatory markers are also within the WellMed reference ranges:
- CRP <1.0 mg/L
- ESR 18
Compared with June 2026, when ANA was reported at 1:1280 homogeneous and ESR at 6, the September measurements differ, but individual ANA titers and ESR values can vary. These results are best preserved as longitudinal observations rather than interpreted from a single comparison.
2. Complete Blood Count
| Test | Result | Flag | Reference Range |
|---|---|---|---|
| WBC | 4.27 K/µL | L | 4.60–11.20 |
| RBC | 4.18 M/µL | L | 4.20–5.80 |
| Hemoglobin | 12.4 g/dL | L | 13.5–18.0 |
| Hematocrit | 38.6% | L | 40.0–54.0 |
| MCV | 92.3 fL | — | 80.0–102.0 |
| MCH | 29.7 pg | — | 27.0–34.0 |
| MCHC | 32.1 g/dL | — | 32.0–36.0 |
| RDW | 13.00% | — | 10.00–15.00 |
| Platelets | 182 K/µL | — | 100–400 |
| MPV | 10.0 fL | — | 7.5–11.5 |
Note: Because this was the least-clear photograph, the CBC values above should be checked once against the original paper before being treated as permanent Health Inventory data.
Differential
| Test | Result | Reference Range |
|---|---|---|
| Neutrophils | 51.8% | 38.0–80.0% |
| Absolute Neutrophils | 2.21 K/µL | 1.60–7.00 |
| Lymphocytes | 32.1% | 18.0–49.0% |
| Absolute Lymphocytes | 1.37 K/µL | 0.70–3.10 |
| Monocytes | 11.0% | 0.0–13.0% |
| Absolute Monocytes | 0.47 K/µL | 0.10–0.90 |
| Eosinophils | 4.2% | 0.0–8.0% |
| Absolute Eosinophils | 0.18 K/µL | 0.00–0.60 |
| Basophils | 0.7% | 0.0–2.0% |
| Absolute Basophils | 0.03 K/µL | 0.00–0.20 |
| NRBC | 0.0% | — |
Interpretation
The CBC shows mild anemia with normal-sized red blood cells:
Hemoglobin 12.4 ↓ + Hematocrit 38.6 ↓ + RBC 4.18 ↓ + MCV 92.3 normal
This is a normocytic pattern.
Hemoglobin had been 13.6 g/dL in June 2026, so the September result represents a decrease and warrants continued longitudinal monitoring.
WBC is also slightly below WellMed’s reference interval at 4.27 K/µL, although the individual absolute white-cell differential counts shown on this report remain within their printed reference ranges.
3. Iron Status
| Test | Result | Reference Range |
|---|---|---|
| Ferritin | 117.3 ng/mL | 23.9–336.2 |
| Iron | 103 µg/dL | 50–212 |
| Iron Saturation | 35% | 15–50% |
| Total Iron Binding Capacity | 298 µg/dL | 250–450 |
| Unsaturated Iron Binding Capacity | 195 µg/dL | 155–300 |
Interpretation
The measured iron markers are within their respective reference ranges.
This is particularly relevant to the mild normocytic anemia identified on the CBC. The September laboratory results do not show the typical laboratory pattern of iron deficiency, although determining the cause of anemia requires the broader clinical picture rather than these measurements alone.
4. Kidney Function
| Test | Result | Flag | Reference Range |
|---|---|---|---|
| BUN | 32 mg/dL | H | 7–25 |
| Creatinine | 0.9 mg/dL | — | 0.6–1.5 |
| Estimated GFR | 81.64 | — | ≥60.00 |
Interpretation
BUN remains elevated, while creatinine is within WellMed’s reference range and estimated GFR remains above the laboratory’s ≥60 threshold.
The longitudinal measurements now include:
| Date | BUN | Creatinine | eGFR |
|---|---|---|---|
| June 2024 | 40 | 0.92 | 81 |
| November 2024 | 33 | 0.88 | 83 |
| September 2026 | 32 | 0.9 | 81.64 |
This demonstrates a persistent elevated-BUN pattern alongside relatively stable creatinine and estimated filtration measurements. High protein intake and hydration status can influence BUN, but the laboratory results alone do not establish the cause.
5. Glucose and Metabolic Chemistry
| Test | Result | Reference Range |
|---|---|---|
| Glucose | 84 mg/dL | 65–99 |
| Sodium | 140 mmol/L | 135–152 |
| Potassium | 4.4 mmol/L | 3.5–5.5 |
| Chloride | 102 mmol/L | 95–109 |
| CO₂ | 29 mmol/L | 20–32 |
| Calcium | 9.8 mg/dL | 8.3–10.7 |
Interpretation
All of these measurements fall within WellMed’s stated reference ranges.
Because fasting status is not documented on the supplied pages, the glucose result should simply be recorded as 84 mg/dL, within the laboratory reference interval, rather than characterized as a fasting glucose.
6. Liver and Protein Markers
| Test | Result | Reference Range |
|---|---|---|
| Albumin | 4.0 g/dL | 3.5–5.5 |
| Alkaline Phosphatase | 51 U/L | 10–130 |
| ALT/SGPT | 28 U/L | 5–41 |
| AST/SGOT | 27 U/L | 5–34 |
| Total Bilirubin | 0.7 mg/dL | 0.0–1.5 |
| Total Protein | 7.1 g/dL | 6.0–8.5 |
Interpretation
The liver enzymes, bilirubin, albumin, and total protein shown on this report are within their respective WellMed reference ranges.
7. Thyroid Function
| Test | Result | Reference Range |
|---|---|---|
| TSH, 3rd Generation | 0.67 µIU/mL | 0.46–5.33 |
| Free T4 | 1.11 ng/dL | 0.58–1.64 |
| Free T3 | 2.27 pg/mL | 1.90–3.50 |
Interpretation
All three thyroid measurements fall within the WellMed reference intervals.
This is particularly useful because earlier Function Health testing had reported Free T3 below that laboratory’s reference range. The September WellMed Free T3 is within WellMed’s range.
Because laboratory methods and reference intervals can differ, this should be recorded as a new longitudinal finding rather than described as proof that the previous lower Free T3 has resolved.
8. Standard Lipid Panel
| Test | Result | Flag | Reference Range |
|---|---|---|---|
| Total Cholesterol | 252 mg/dL | H | 100–199 |
| LDL Cholesterol | 168 mg/dL | H | 0–99 |
| HDL Cholesterol | 73 mg/dL | — | 40–150 |
| Triglycerides | 54 mg/dL | — | 0–149 |
| Cholesterol/HDL Ratio | 3.5 | — | 0.0–5.0 |
Interpretation
Total cholesterol and LDL-C are above WellMed’s stated reference ranges. HDL, triglycerides, and cholesterol/HDL ratio are within the printed ranges.
The longitudinal standard lipid record is now:
| Date | Total Cholesterol | LDL-C | HDL-C | Triglycerides |
|---|---|---|---|---|
| June 2024 | 220 | 136 | 75 | 50 |
| November 2024 | 243 | 141 | 94 | 52 |
| December 2025 | 256 | 151 | 89 | 60 |
| June 2026 | 284 | 183 | 82 | 85 |
| September 2026 | 252 | 168 | 73 | 54 |
Compared with June 2026, September shows lower total cholesterol, LDL-C, HDL-C, and triglycerides. The September report does not include advanced lipid markers such as ApoB or LDL particle number, so those June findings remain important for the broader cardiovascular assessment.
9. Major Findings
Autoimmune and Inflammatory
- ANA remains positive at 1:640 homogeneous.
- Anti-dsDNA is within the laboratory reference range.
- Anticardiolipin IgA is within range.
- CRP is <1.0 mg/L.
- ESR is 18, within the WellMed range of 0–20.
Blood Health
- Hemoglobin decreased to 12.4 g/dL.
- Hematocrit is 38.6%.
- RBC is 4.18 M/µL.
- MCV remains normal at 92.3 fL.
- The pattern is consistent with mild normocytic anemia.
- WBC is mildly below the WellMed reference interval at 4.27 K/µL.
- Platelets remain within range at 182 K/µL.
- Iron studies are within their stated reference ranges.
Kidney Function
- BUN remains elevated at 32 mg/dL.
- Creatinine remains stable at 0.9 mg/dL.
- eGFR is 81.64.
Thyroid
- TSH 0.67
- Free T4 1.11
- Free T3 2.27
All are within the WellMed reference intervals.
Cardiovascular
- Total cholesterol 252 mg/dL — high
- LDL-C 168 mg/dL — high
- HDL-C 73 mg/dL
- Triglycerides 54 mg/dL
Metabolic, Liver, and Electrolyte Findings
The glucose, measured electrolytes, calcium, liver enzymes, bilirubin, albumin, and total protein are within the reference intervals printed on the report.
10. Overall Assessment
The September 2026 WellMed assessment adds an important third-quarter data point to the longitudinal Health Inventory.
Several findings remain stable or reassuring within the laboratory’s reference ranges: CRP, ESR, anti-dsDNA, anticardiolipin IgA, creatinine/eGFR, glucose, electrolytes, liver chemistry, iron studies, and the three measured thyroid hormones.
Four areas deserve continued longitudinal attention:
1. Persistent ANA positivity
ANA remains strongly positive at a homogeneous titer of 1:640, while the disease-specific anti-dsDNA result on this report is within range.
2. Reappearance of mild normocytic anemia
Hemoglobin has declined from 13.6 g/dL in June to 12.4 g/dL in September. The normal MCV and iron studies make the longitudinal anemia history particularly relevant.
3. Persistently elevated BUN with stable filtration measurements
BUN remains above range, while creatinine and eGFR remain similar to documented 2024 values.
4. Continued elevation of LDL cholesterol
LDL-C remains above WellMed’s reference range at 168 mg/dL. This should continue to be considered alongside the more detailed cardiovascular markers obtained through Function Health and the overall cardiovascular history.
11. Physician Discussion Points
For the next review with Dr. George, the most useful questions arising directly from this report are:
- Does the return of mild normocytic anemia warrant additional evaluation or simply repeat monitoring at the December laboratory assessment?
- Does the slightly low WBC require follow-up given that the differential counts remain within their reference ranges?
- Is any additional evaluation needed for the persistent BUN elevation given the stable creatinine and eGFR?
- How should the September LDL-C of 168 be interpreted alongside the advanced lipid markers from June 2026?
- Should the current thyroid treatment remain unchanged given the September TSH, Free T4, and Free T3 results?
For future review with Dr. Saifi, the particularly relevant results are the ANA 1:640 homogeneous, dsDNA 2.6, CRP <1.0, ESR 18, CBC, and iron studies.
Laboratory Report #39 — Summary
September 2026 WellMed Laboratory Assessment
The September 2026 WellMed testing documents low inflammatory markers within the laboratory reference ranges, persistent ANA positivity without elevated dsDNA or anticardiolipin IgA on the tests provided, stable creatinine and estimated filtration, normal iron studies, thyroid measurements within WellMed ranges, and preserved metabolic/liver chemistry.
The principal findings for continued monitoring are mild normocytic anemia, mildly low WBC, persistently elevated BUN, and elevated LDL cholesterol.
This report should now become:
Section 7.1 — Laboratory Library
Laboratory Report #39 — September 2026 WellMed Laboratory Assessment
And I would stop there for the moment. Report #39 is now established. The next step should be maintenance rather than creating anything new: use these September results to make a small number of precise updates to the existing 7.2 analyses and 7.3 trend tables.
