Lab Values Reference | Enchanted Medical Aesthetics

GLP-1 / Weight Management — Pre-Prescription Lab Panel

All labs below are required by the prescribing APRN/PA before initiating semaglutide, tirzepatide, retatrutide, or any GLP-1/incretin therapy. Repeat every 6 months on therapy. Results must be documented in Aesthetic Record prior to first dispense.

🔬 Required Labs — Baseline & Every 6 Months

CMP (Comprehensive Metabolic Panel)Sodium, potassium, chloride, CO₂, BUN, creatinine, glucose, calcium, total protein, albumin, ALT, AST, ALP, bilirubin — full metabolic and hepatic/renal baselineFull panel

CBC (Complete Blood Count)Rule out anemia, infection, or hematologic conditions; monitor nutritional status during caloric restrictionFull panel

Thyroid Panel (TSH + Free T3/T4)GLP-1 black box: contraindicated in MTC/MEN2 history; hypothyroidism affects weight loss response and energyTSH: 0.4–4.0 mIU/L

Lipid PanelBaseline cardiovascular risk assessment; GLP-1s improve lipid profiles — document pre-treatment to show benefitChol <200 · LDL <100 · HDL >60 · TG <150

Fasting InsulinInsulin resistance screening — essential metabolic context for weight management; helps identify candidates who may benefit most from GLP-1 therapy2–25 µIU/mL

HbA1c (Hemoglobin A1c)Screens for undiagnosed diabetes; establishes glycemic baseline; monitors response to therapy every 6 monthsNormal: 4.0–5.6%
Pre-DM: 5.7–6.4%
Goal (DM): <6.5%

📅 Monitoring Schedule

Baseline (Before First Dose)All 6 panels required before prescribing. Results must be in chart before first dispense.Required

Every 6 Months On TherapyRepeat all 6 panels to monitor response, safety, and organ function throughout treatmentRequired

Weight / BMIClinical monitoring at every visit to document progressEvery visit

Blood Pressure & Heart RateEspecially important with tirzepatide and retatrutide — both can elevate HREvery visit

Amylase / Lipase (PRN)Order immediately if patient reports abdominal pain — GLP-1s associated with pancreatitis riskIf symptoms

Urine Pregnancy TestGLP-1s contraindicated in pregnancy — confirm negative before each renewal if applicableAs indicated

⚠ When PCP / Specialist Clearance Is Required Before Prescribing

Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia type 2 (MEN2) — GLP-1 agents are CONTRAINDICATED. Do not prescribe without oncology/endocrinology clearance.

Active or history of pancreatitis — GLP-1s are associated with acute pancreatitis risk. Gastroenterology clearance required before initiating.

Diabetic patients (HbA1c ≥6.5% or on insulin/sulfonylureas) — coordinating provider must communicate with prescribing PCP or endocrinologist to prevent hypoglycemia and medication duplication.

Significant renal impairment (GFR <30 ml/min or Stage 3b+ CKD) — nephrology or PCP clearance required; dose adjustment or contraindication may apply.

Significant hepatic impairment (ALT/AST >3× upper limit of normal) — hepatology or PCP clearance before initiating.

Active cardiovascular disease, recent MI (<3 months), or uncontrolled arrhythmia — cardiology clearance required, especially for tirzepatide/retatrutide (HR elevation).

Active or recent history of eating disorder (anorexia, bulimia, ARFID) — psychiatric/behavioral health clearance required before initiating appetite-suppressing therapy.

Pregnancy or breastfeeding — GLP-1s contraindicated. Must have negative pregnancy test and confirm not breastfeeding before prescribing.

Patients on warfarin or other narrow therapeutic index anticoagulants — GLP-1s alter gastric emptying and may affect drug absorption. PCP/hematology coordination required.

Uncontrolled hypertension (BP >160/100 mmHg) — optimize blood pressure control first; PCP notification recommended.

Significant psychiatric conditions (active suicidal ideation, uncontrolled severe depression) — psychiatric clearance recommended; GLP-1s may have CNS effects.

Patients under 18 years old — pediatric prescribing is outside the scope of Enchanted Medical Aesthetics. Refer out.

📋 Documentation Reminder: All baseline labs must be reviewed and documented in Aesthetic Record by the prescribing APRN/PA before first dispense. A copy of labs (or notation of date, ordering provider, and results) must be in the patient chart. Labs older than 12 months should be repeated before initiation. If labs were ordered externally, obtain records before prescribing.

Patient Visit Schedule

Visit	Timing	Purpose & Actions
Visit 1	Initial Consult	Intake, history, consent, measurements (weight, BMI, muscle mass, BMR), lab draw — all 6 panels ordered. Patient does NOT start medication yet.
Visit 2	Program Start	Review labs with patient, prescribe GLP-1, dispense or send prescription, education on injection technique, side effect management, dietary guidelines. Prescribe Zofran PRN for nausea and stool softener prophylactically.
Visit 3	Week 8	Weight, BMI, muscle mass, BMR. Assess tolerability, side effects, titration readiness. Refill or dose adjustment as indicated. Review dietary/lifestyle compliance.
Visit 4	Week 16	Weight, BMI, muscle mass, BMR. Progress review, dose optimization. Discuss response — if not achieving expected weight loss, evaluate adherence, dose, or add adjunct therapy (B12, BioBoost, MegaBurn).
Visit 5	Week 24	Repeat all 6 labs (6-month mark). Full clinical review, weight, BMI, muscle mass, BMR. Assess continued need for therapy, maintenance planning, or transition to lower maintenance dose.

📊 Body Composition — Measured at Every Visit: Weight · BMI · Muscle Mass (preserving lean mass is a key clinical goal — GLP-1s can cause muscle loss alongside fat loss) · BMR (Basal Metabolic Rate) (tracks metabolic adaptation during caloric restriction). Document all measurements in Aesthetic Record at each visit to track trends over the program.

How Semaglutide Works — Mechanism & Clinical Evidence

⚙ Mechanism of Action

GLP-1 Receptor AgonistMimics the endogenous incretin hormone GLP-1, naturally released from intestinal L-cells in response to food intake

Hypothalamic Satiety SignalingActivates GLP-1 receptors in the arcuate nucleus — increases satiety, reduces hunger drive, and slows gastric emptying so patients feel full longer

Glucose-Dependent Insulin SecretionStimulates insulin release from pancreatic β-cells ONLY when blood glucose is elevated — minimal hypoglycemia risk in non-diabetic patients

Glucagon SuppressionSuppresses glucagon from α-cells, reducing hepatic glucose output and improving overall glucose control

CNS Dopamine / Reward PathwayActs on dopaminergic reward circuits — reduces food cravings and hedonic eating behavior, independent of the satiety effect

Once-Weekly Dosing~1-week half-life achieved via fatty acid side chain + albumin binding — allows weekly SQ administration with slow titration to minimize GI side effects

📊 Key Clinical Trial Data

STEP 1 Trial — Semaglutide 2.4 mgMean body weight reduction: 14.9% over 68 weeks vs 2.4% placebo. 86% of participants lost ≥5% body weight.

SELECT Trial — CardiovascularSemaglutide 2.4 mg reduced major adverse cardiovascular events (MACE) by 20% in non-diabetic patients with obesity + CVD. First obesity drug to show CV benefit.

SURMOUNT-1 — Tirzepatide 15 mgMean weight reduction: 22.5% over 72 weeks. 96% of participants lost ≥5%. Superior to semaglutide in head-to-head comparisons.

Retatrutide Phase 2 TrialMean weight reduction: 24.2% at 48 weeks at 12 mg dose — highest recorded in any incretin trial to date. Phase 3 ongoing.

Muscle Mass Consideration~25–40% of weight lost on GLP-1 therapy is lean muscle mass. This is why monitoring muscle mass and encouraging resistance exercise + adequate protein intake is critical at every visit.

⚠ Side Effects to Monitor

NauseaMost common — especially at initiation and dose increases. Typically improves after 4–8 weeks. Prescribe Zofran (ondansetron) 4 mg ODT PRN at program start. Advise eating smaller meals slowly.Very Common

ConstipationGLP-1s slow GI motility significantly. Prescribe stool softener prophylactically at program start — do not wait for patient to develop symptoms. Colace (docusate) or MiraLax daily. Increase water intake.Very Common

Vomiting / DiarrheaGI side effects typically dose-related. Hold titration if persistent. Ensure adequate hydration — risk of dehydration and secondary renal impairment.Common

Injection Site ReactionsRedness, bruising, nodule at injection site. Rotate sites (abdomen, thigh, upper arm). Warm injection to room temp before use.Common

Fatigue / Low EnergyEspecially early in treatment and during dose increases. May correlate with caloric restriction. Assess B12 levels — add B12 or lipotropic injections (BioBoost, MegaBurn) as adjunct.Common

HeadacheOften due to dehydration or reduced caloric intake. Encourage fluid intake.Common

Hair Loss (Telogen Effluvium)Stress of rapid weight loss can trigger temporary hair shedding 2–4 months into treatment. Counsel patients proactively — usually self-resolving. Ensure adequate protein and micronutrient intake.Notable

PancreatitisRare but serious. Order amylase/lipase immediately if patient reports severe abdominal pain radiating to back. Discontinue GLP-1 if pancreatitis confirmed.Rare — Monitor

Elevated Heart RateMean HR increase of 2–4 BPM (more with tirzepatide/retatrutide). Monitor at every visit. Flag if sustained HR >100 BPM.Monitor

Thyroid C-Cell TumorsBlack box warning — rodent studies only. Contraindicated in personal/family history of MTC or MEN2. No confirmed human cases to date but must be screened.⚠ Black Box

💡 Clinical Pearls

Prescribe Zofran at StartOndansetron (Zofran) 4 mg ODT — prescribe PRN at Visit 2 before patient takes first dose. Nausea is the #1 reason patients discontinue. Proactive management dramatically improves retention.

Prescribe Stool Softener ProphylacticallyStart Colace (docusate sodium) 100 mg daily or MiraLax at Visit 2. Do not wait for constipation to develop. GLP-1 slows gastric motility from day 1.

Titrate Slowly — Hold if NeededIt is always appropriate to hold a dose escalation if the patient is experiencing significant GI side effects. Staying at a lower dose longer is better than losing the patient to side effect intolerance.

Protein Intake — Minimum 1g/kg Body WeightCounsel patients to prioritize protein at every meal to preserve muscle mass. 25–40% of weight lost on GLP-1 is lean mass without resistance training and adequate protein.

Resistance ExerciseStrongly encourage resistance training 2–3× per week alongside GLP-1 therapy to counteract muscle loss and maintain BMR long-term.

HydrationPatients eat less and may drink less. Dehydration risk is real — especially with GI side effects. Counsel minimum 64 oz water daily. Monitor renal function (CMP) every 6 months.

Add Lipotropic Injections as AdjunctB12, BioBoost, or MegaBurn injections complement GLP-1 therapy — support energy, fat metabolism, and B-vitamin levels during caloric restriction. Discuss at Visit 2 or 3.

Warm Medication Before InjectionAllow vial to sit at room temperature 15–30 min before drawing up. Reduces injection site discomfort significantly.

Counsel on PlateauWeight loss typically slows or plateaus around weeks 12–16. This is normal and does not mean the medication has stopped working. Reinforce lifestyle adherence and stay the course before changing dose.

Hair Loss CounselingCounsel proactively at Visit 2 that temporary hair shedding is common 2–4 months in. It is a stress response to rapid weight change and typically reverses. Recommend biotin, protein, and micronutrient support.

GLP-1 Agent Comparison — Semaglutide vs Tirzepatide vs Retatrutide

Feature	Semaglutide	Tirzepatide	Retatrutide
Class	GLP-1 agonist	GIP + GLP-1 dual agonist	GIP + GLP-1 + Glucagon triple agonist
FDA Status	Approved (Wegovy 2.4 mg for obesity)	Approved (Zepbound for obesity)	⚠ Investigational — NOT approved
Avg Weight Loss	~15% (STEP 1 trial)	~22.5% (SURMOUNT-1)	~24.2% (Phase 2 trial)
Dosing	0.25 mg → 2.4 mg weekly	2.5 mg → 15 mg weekly	1 mg → 12 mg weekly
Vial Form (Enchanted)	Liquid — mg/mL concentration	Liquid — mg/mL concentration	Lyophilized — 30 mg or 60 mg + 3 mL BAC
GI Side Effects	Moderate — nausea, constipation, vomiting	More pronounced — especially at initiation	Most pronounced — triple receptor activity
Heart Rate Effect	+2–3 BPM mean increase	+2–4 BPM mean increase	More pronounced — glucagon receptor elevates HR
CV Evidence	SELECT: 20% reduction in MACE ✅	SURPASS-CVOT: CV benefit confirmed ✅	Phase 3 ongoing — no CV data yet
Best For	First-line, established safety profile, CV disease history	Greater weight loss needed, insulin resistance, T2DM	Maximum weight loss potential, refractory cases, research context

Semaglutide — GLP-1 Receptor Agonist

How It Works

Single receptor: GLP-1 receptor only
Mimics endogenous GLP-1 released by intestinal L-cells after eating
Hypothalamic satiety signaling — reduces hunger drive and increases fullness
Slows gastric emptying — extends postprandial satiety
Glucose-dependent insulin secretion — stimulates insulin only when glucose is elevated (low hypoglycemia risk)
Suppresses glucagon from α-cells
CNS dopamine pathway — reduces food cravings and hedonic eating
~1-week half-life via fatty acid + albumin binding — enables once-weekly dosing

Key Trial Data & Clinical Notes

STEP 1: 14.9% mean weight loss at 68 weeks vs 2.4% placebo. 86% lost ≥5% body weight
SELECT: 20% reduction in MACE (CV death, MI, stroke) in non-diabetic obese patients with CVD — first obesity drug with confirmed CV benefit
Most established safety data of the three agents
First-line choice for patients with CVD history or highest risk concern
GI side effects moderate — Zofran PRN + prophylactic stool softener at program start
Titration: 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg (hold each step 4 weeks minimum)

Tirzepatide — GIP + GLP-1 Dual Agonist

How It Works — The Dual Difference

Two receptors simultaneously: GIP + GLP-1
GLP-1 component: Same hypothalamic satiety, gastric emptying, insulin secretion, glucagon suppression as semaglutide
GIP component (the key differentiator):
- GIP receptors in adipose tissue — promotes fat redistribution and reduces fat storage directly
- GIP in bone — positive effects on bone mineral density
- GIP in brain — complementary satiety signaling via different neural circuits
- GIP may reduce GLP-1-mediated nausea by modulating GI motility more gently
Dual agonism = additive-to-synergistic weight loss effects vs either receptor alone
Enhanced peripheral insulin sensitivity via GIP in muscle and adipose — important for insulin-resistant patients
~5-day half-life via fatty diacid modification — once-weekly dosing

Key Trial Data & Clinical Notes

SURMOUNT-1: 22.5% mean weight loss at 72 weeks (15 mg dose). 96% of participants lost ≥5%. Superior to semaglutide in all head-to-head comparisons
SURPASS-CVOT: Confirmed cardiovascular benefit
Superior weight loss to semaglutide — good choice when maximum efficacy needed or patient had suboptimal response to semaglutide
GI side effects more pronounced at initiation — especially nausea and diarrhea. More aggressive proactive management needed (Zofran + stool softener mandatory)
HR elevation slightly more than semaglutide — monitor at every visit
Better for: insulin resistance, T2DM, patients needing >15% weight loss, semaglutide non-responders
Titration: 2.5 → 5 → 7.5 → 10 → 12.5 → 15 mg (hold each step 4 weeks minimum)

Retatrutide — GIP + GLP-1 + Glucagon Triple Agonist ⚠ Investigational

⚠ NOT FDA-approved. Investigational compound — prescriber authorization and informed consent required before dispensing.

How It Works — The Triple Mechanism

Three receptors simultaneously: GIP + GLP-1 + Glucagon
GLP-1 component: Hypothalamic satiety, gastric emptying, insulin secretion, glucagon suppression (same as semaglutide)
GIP component: Adipose fat redistribution, enhanced insulin sensitivity, complementary satiety (same as tirzepatide)
Glucagon receptor — the novel addition:
- Glucagon receptor agonism in the liver → increases hepatic glucose output AND hepatic fat oxidation (lipolysis)
- Raises basal metabolic rate via thermogenesis — patients burn more calories at rest
- The glucagon component is the primary driver of retatrutide's superior weight loss vs dual agonists
- Creates a powerful metabolic shift: GLP-1 reduces intake, GIP improves fat handling, glucagon increases energy expenditure
Net effect: the most potent weight loss mechanism of any currently available incretin agent
Reconstitution (Enchanted): 30 mg + 3 mL BAC = 10 mg/mL | 60 mg + 3 mL BAC = 20 mg/mL

Key Trial Data & Clinical Notes

Phase 2 trial: 24.2% mean weight loss at 48 weeks (12 mg) — highest ever recorded in any incretin therapy trial
Phase 3 trials ongoing — no long-term CV outcome data yet
Most pronounced GI side effects of all three agents — triple receptor activity creates more GI motility impact. Aggressive prophylactic management essential
Most pronounced HR elevation — glucagon receptor agonism increases heart rate more than GLP-1 or GIP alone. Monitor HR at every visit. Flag sustained HR >100 BPM
BP changes — glucagon receptor can affect blood pressure. Monitor BP at every visit
Same thyroid C-cell tumor black box as all GLP-1 agents
Informed consent must explicitly document investigational status
Titration: 1 → 2 → 4 → 8 → up to 12 mg weekly (4-week intervals). Not all patients need or tolerate max dose
Best for: refractory cases, patients who did not achieve adequate response on sema or tirz, maximum weight loss needed in appropriate candidate

Vital Signs

Temperature36.5–37.3°C (97.8–99°F)

Blood Pressure (Systolic)100–140 mmHg

Blood Pressure (Diastolic)60–100 mmHg

Heart Rate60–100 BPM

Respiration12–20 breaths/min

O₂ Saturation95–100%

Basic Metabolic Panel (BMP)

Sodium (Na+)135–145 mEq/L

Potassium (K+)3.5–5.0 mEq/L

Chloride (Cl-)95–105 mEq/L

Magnesium (Mg2+)1.5–2.5 mg/dL

Calcium (Ca2+)9–11 mg/dL

BUN7–20 mg/dL

Creatinine0.6–1.2 mg/dL

Total Protein6.2–8.2 g/dL

Albumin3.4–5.4 g/dL

Glucose (fasting)70–100 mg/dL

CBC — Complete Blood Count

RBC (males)4.5–5.5 × 10¹²/L

Hemoglobin (male)14–18 g/dL

Hemoglobin (female)12–16 g/dL

Hematocrit (male)39–54%

Hematocrit (female)36–48%

WBC4,500–11,000/µL

Neutrophils1.8–7.8 × 10⁹/L (56%)

Lymphocytes1–4.8 × 10⁹/L (34%)

Monocytes0–0.8 × 10⁹/L (4%)

Eosinophils0–0.45 × 10⁹/L (2.7%)

Basophils0–0.2 × 10⁹/L (0.3%)

Platelets150–400 × 10⁹/L

ESR< 20 mm/hour

Serum Lactate0.5–1.0 mmol/L

Liver Function

ALT (SGPT)7–56 u/L

AST (SGOT)5–40 u/L

ALP40–120 u/L

Bilirubin (total)0.1–1.2 mg/dL

GGT (male)< 50 u/L

GGT (female)< 30 u/L

Urea10–20 mg/dL

Renal Function

Creatinine0.6–1.2 mg/dL

BUN7–20 mg/dL

GFR90–120 ml/min

Urine Specific Gravity1.010–1.030

Creatinine Clearance (F)85–125 ml/min

Creatinine Clearance (M)95–140 ml/min

Phosphorus2.5–4.5 mg/dL

Thyroid

TSH0.4–4.0 mIU/L

T3 (Triiodothyronine)100–200 ng/dL

T4 (Thyroxine)5.0–12.0 ug/dL

Blood Glucose & HbA1c

Fasting Glucose70–100 mg/dL

HbA1c — Non-diabetic4.0–5.6%

HbA1c — Pre-diabetic5.7–6.4%

HbA1c — Goal (Diabetic)< 6.5%

Lipid Panel

Total Cholesterol< 200 mg/dL

Triglycerides< 150 mg/dL

LDL< 100 mg/dL

HDL> 60 mg/dL

Coagulation

PT10–13 sec

PTT25–35 sec

aPTT (Heparin)30–40 sec

INR (normal)0.8–1.1

INR (on Warfarin)2–3

D-Dimer< 500 ng/mL

Fibrinogen200–400 mg/dL

Pancreas & ABGs

Amylase30–110 u/L

Lipase0–150 u/L

pH7.35–7.45

PaCO₂35–45 mmHg

PaO₂80–100 mmHg

HCO₃22–26 mEq/L

SaO₂95–100%

BMI Ranges

Underweight< 18.5

Healthy Weight18.5–24.9

Overweight25–29.9

Obese≥ 30

Lab Value Interpretations — High & Low

Basic Metabolic Panel

Sodium (Na+) 135–145 mEq/L

↑ Hypernatremia (>145)

↓ Hyponatremia (<135)

Net water loss
Excess sodium intake
Renal insufficiency
Cushing's syndrome
Severe vomiting

Diuretic use
GI impairment
Burns/wounds
Hypotonic IV fluids
Cirrhosis

Potassium (K+) 3.5–5.0 mEq/L

↑ Hyperkalemia (>5.0)

↓ Hypokalemia (<3.5)

Renal failure
Adrenal failure
ACE inhibitors
Excessive K+ intake
⚠ >7 mEq/L: cardiac arrest risk

Kidney disease
Diuretics
Vomiting/diarrhea
Excessive sweating
Potassium-poor diet

Calcium (Ca2+) 9–11 mg/dL

↑ Hypercalcemia (>11)

↓ Hypocalcemia (<9)

Hyperparathyroidism
Cancer
Immobilization
Vitamin D toxicity
Thiazides, lithium

Hypoparathyroidism
Vitamin D deficiency
Kidney disease
Symptoms: cramps, seizures, arrhythmia

BUN 7–20 mg/dL

↑ Azotemia (>20)

↓ Low BUN (<7)

Dehydration
Kidney disease
Heart failure
GI bleeding
High-protein diet

Malnutrition
Liver disease
Overhydration

Creatinine 0.6–1.2 mg/dL

↑ Hypercreatinemia (>1.2)

↓ Low Creatinine (<0.6)

Acute/chronic renal failure
Dehydration
Muscular dystrophy
Certain medications

Malnutrition
Age-related muscle loss
Pregnancy
Liver disease

Glucose (fasting) 70–100 mg/dL

↑ Hyperglycemia (>100)

↓ Hypoglycemia (<70)

Diabetes (T1, T2, gestational)
Sepsis
IV glucose
Pancreatitis
Can lead to DKA or HHS

Excess insulin
Skipped meals
Exercise intensity
Pituitary deficiency
Sx: shaking, sweating, confusion

CBC

WBC 4,500–11,000/µL

↑ Leukocytosis (>11,000)

↓ Leukopenia (<4,500)

Infections
Leukemia
Neoplasms
Inflammatory disease
Stress

Viral illnesses
Chemotherapy
Bone marrow deficiency
Radiation
Splenic deficiency

Platelets 150–400 × 10⁹/L

↑ Thrombocytosis (>400)

↓ Thrombocytopenia (<150)

Myelogenous leukemia
Splenectomy
Inflammation
Neoplasm/cancer

Autoimmune disease
Leukemia
Medications
↑ bleeding risk

Hemoglobin F: 12–16 | M: 14–18 g/dL

↑ Elevated Hgb

↓ Low Hgb (Anemia)

High altitude living
Long-term smoking
Polycythemia vera
Severe dehydration
Burns

Blood loss
Anemia
Bone marrow suppression
Leukemia
Splenomegaly

Liver Function

ALT 7–56 u/L

↑ Elevated ALT

↓ Low ALT

Viral hepatitis
Alcoholic liver disease
Medication/toxin damage
Liver cancer

Usually normal
Vitamin B6 deficiency
Smoking
Chronic kidney disease

AST 5–40 u/L

↑ Elevated AST

↓ Low AST

Cirrhosis/Hepatitis
Alcoholic liver disease
Rhabdomyolysis
Heart attack
Pancreatitis

Usually not significant
Rare: B6 deficiency
Severe cirrhosis

Bilirubin 0.1–1.2 mg/dL

↑ Hyperbilirubinemia (>1.2)

↓ Rare

Cirrhosis
Hepatitis
Hemolytic anemia
Transfusion reaction
Chemotherapy

Rare — genetic conditions
Partial liver transplant

Thyroid

TSH 0.4–4.0 mIU/L

↑ High TSH = Hypothyroidism

↓ Low TSH = Hyperthyroidism

Hypothyroid Sx:

Fatigue, bradycardia
Cold intolerance
Constipation, weight gain
Primary cause: Hashimoto's
Tx: Levothyroxine

Hyperthyroid Sx:

Nervousness, tachycardia
Exophthalmos, weight loss
Enlarged thyroid (goiter)
Cause: Graves' disease
Tx: Methimazole/PTU

Acid-Base Disorders

Quick Rule: Respiratory = Opposite (pH↑, CO₂↓ = Alkalosis | pH↓, CO₂↑ = Acidosis) | Metabolic = Equal (pH↑, CO₂↑ = Alkalosis | pH↓, CO₂↓ = Acidosis)

Disorder	pH	PaCO₂	Causes	Symptoms
Respiratory Alkalosis Alkalosis	>7.45	<35 mmHg	Anxiety, sedatives, COPD, pain, fever, hyperventilation	Light-headedness, confusion, muscle twitching, seizures, dizziness
Respiratory Acidosis Acidosis	<7.35	>45 mmHg	Asthma, COPD, pulmonary fibrosis, CNS depression, pneumonia, opioids/benzos	SOB, confusion, fatigue, headaches; severe: coma, death
Metabolic Alkalosis Alkalosis	>7.45	>45 mmHg	Severe vomiting/diarrhea, dehydration, diuretics, steroids, antacids, hyperaldosteronism	Irritability, muscle twitching, cramps, fatigue, confusion, arrhythmia
Metabolic Acidosis Acidosis	<7.35	<35 mmHg	DKA, severe diarrhea, dehydration, aspirin/ethylene glycol poisoning, lactic acidosis, kidney disease	Severe vomiting, diarrhea, Kussmaul breathing, confusion, fruity breath (DKA)

ABG Normal Values

pH7.35–7.45

PaCO₂35–45 mmHg

PaO₂80–100 mmHg

HCO₃22–26 mEq/L

SaO₂95–100%

Lab Value Memory Tricks

9–11 mg/dL

Calcium

"Cal" in "Calcium" → remember "Call 911" → 9–11 mg/dL

7–20 mg/dL

BUN

Think Hamburger BUNs — a hamburger costs anywhere from $7 to $20.

3.5–5.0 mEq/L

Potassium

3–5 bananas in a bunch, and you want them half ripe → 3.5 to 5 mEq/L

95–105 mEq/L

Chloride

Think of a chlorinated pool — you go when it's sunny and HOT outside: 95–105°F

1.5–2.5 mg/dL

Magnesium

Magnifying glasses magnify objects by 1.5 to 2.5 times their regular size.

2.5–4.5 mg/dL

Phosphorus

"phor" in "phoSphoruS" → 4. "us" = you + me = 2. Don't forget the .5!

70–100 mg/dL

Glucose

Glucose = Energy. Energy declines in elderly years (70–100 years old).

4,500–11,000

WBCs

"Wanna Buy a Car for $4,500–$11,000?" — WBC! Also "Never Let Monkeys Eat Bananas" = Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils.

4.5–5.5 × 10¹²/L

RBCs

An adult human body has approximately 4.5–5.5 L of blood — same numbers as the normal RBC range.

12–16 (F) / 14–18 (M) g/dL

Hemoglobin

Females mature quicker: ages 12–16 → 12–16 g/dL. Males: 14–18 years old → 14–18 g/dL.

HCT = Hgb × 3

Hematocrit

To remember HCT, multiply Hgb by 3: Female Hgb 12–16 → HCT 36–48%. Male Hgb 14–18 → HCT 39–54%.

4.0–5.6%

HbA1c

HbA1c every 3 months for diabetics. After "3" = "4 5 6" — the three consecutive numbers are your normal range.

Lab Values Reference Guide