What do lab results of 0.18 basophils, 34 alkaline phosphatase, 237 creatine kinase (CK), and 280 red cell folate indicate about my health?

Laboratory Results Interpretation

Direct Assessment

Your laboratory results show a low alkaline phosphatase (34 U/L) which is below the normal range (typically 45-115 U/L), while your basophil count (0.18 × 10⁹/L), creatine kinase (237 U/L), and red cell folate (280 nmol/L) appear within or near normal ranges for most laboratories. 1

Clinical Significance of Each Result

Low Alkaline Phosphatase (34 U/L)

• This is the most clinically significant abnormality in your panel, as values below 45 U/L are considered abnormal and warrant further evaluation 1
• Low alkaline phosphatase can indicate hypophosphatasia (a rare genetic bone disorder), malnutrition, zinc or magnesium deficiency, hypothyroidism, or vitamin B6 excess 2
• In elderly patients, alkaline phosphatase may be elevated in 10% or more of healthy individuals without pathologic significance, but low values remain clinically relevant 3
• You should undergo further evaluation including serum phosphate, calcium, vitamin B6 (pyridoxal-5-phosphate), and potentially genetic testing if hypophosphatasia is suspected 2

Basophil Count (0.18 × 10⁹/L)

• This value falls within the typical normal range (0.0-0.3 × 10⁹/L for most laboratories) 1
• Basophils represent 0-2% of total white blood cells normally, and your absolute count appears unremarkable 1
• No specific action is required for this result in isolation 1

Creatine Kinase (237 U/L)

• This value is mildly elevated above the typical upper limit of normal (approximately 200 U/L for most laboratories), though reference ranges vary by laboratory, sex, and muscle mass 1
• Mild CK elevations can result from recent exercise, intramuscular injections, muscle trauma, certain medications (statins), hypothyroidism, or early muscle disease 1
• If you have not engaged in strenuous physical activity recently, this should be rechecked in 2-4 weeks 1
• Persistent elevation warrants evaluation for thyroid function, medication review, and potentially CK isoenzyme analysis to determine if the elevation is from skeletal muscle (MM), cardiac muscle (MB), or brain tissue (BB) 4

Red Cell Folate (280 nmol/L)

• This value appears within the normal range (typical reference range 340-1020 nmol/L, though your value of 280 is slightly below some laboratory cutoffs) 1
• Red cell folate is a better indicator of long-term folate status than serum folate 1
• If this value is below your laboratory's reference range, folate supplementation may be warranted, particularly if you have macrocytic anemia, are pregnant, or have malabsorption 1

Recommended Clinical Approach

Immediate Actions

• Repeat alkaline phosphatase measurement to confirm the low value, as intraindividual biologic variation can cause discrepant results 5, 3
• Check serum calcium, phosphate, magnesium, zinc, and vitamin B6 levels to evaluate for nutritional deficiencies or hypophosphatasia 2
• Review your medication list for drugs that may lower alkaline phosphatase 3

Follow-up Testing

• If alkaline phosphatase remains low on repeat testing, measure urinary phosphoethanolamine and plasma pyridoxal-5-phosphate to evaluate for hypophosphatasia 2
• Recheck creatine kinase after avoiding strenuous exercise for 48-72 hours 1
• If CK remains elevated, obtain thyroid function tests and consider CK isoenzyme analysis 4

Clinical Pitfalls to Avoid

• Do not dismiss the low alkaline phosphatase as a laboratory error without confirmation, as persistent low values require investigation 5, 3
• Age-related physiologic changes can affect laboratory values, but low alkaline phosphatase is not a typical age-related finding 3
• Interpret results in the context of your clinical presentation rather than in isolation 6, 5
• Be aware that "normal" reference ranges may not apply to all populations, and borderline values may be clinically significant 3