Health Assessment Report
ExampleComprehensive blood test · 13 biomarkers
Patient details
- Name
- Sanne de Vries
- Gender
- Female
- Age
- 34 years
- Date of birth
- 12-03-1992
Test details
- Test Date
- 18-06-2026
- Report date
- 21-06-2026
- Location
- Amsterdam Zuid
- Laboratory
- Star-SHL
13
Total Markers
10
In Range
3
Needs Attention
Overall Assessment
Your blood test shows a largely healthy picture. Of the thirteen values measured, ten fall within the reference range. Three need attention: your vitamin D and ferritin are low, and your total cholesterol sits just above the upper limit.
None of these findings is worrying. All three respond well to diet, lifestyle and, where needed, supplementation.
Key Findings
Vitamin D low (46 nmol/L)
AttentionBelow the target of 75 nmol/L. This is very common in the Netherlands, particularly between October and April. Fatigue, muscle weakness and reduced immunity are the symptoms most often associated with it.
Ferritin low (18 µg/L)
AttentionYour iron stores are limited while your hemoglobin is still normal. This pattern often precedes anaemia and explains fatigue even before the Hb has dropped.
Cholesterol slightly raised (5.1 mmol/L)
AttentionJust above the 5.0 limit. Your HDL is high and your LDL is normal, so the overall risk profile stays favourable. This value alone does not call for treatment.
Thyroid, liver and kidneys are fine
GoodTSH, ALT and eGFR all sit comfortably within range. There is no indication of a thyroid, liver or kidney problem.
No sign of inflammation
GoodYour hsCRP is 0.8 mg/L. This value is sensitive to low-grade inflammation and is low here, which is favourable for long-term cardiovascular risk.
Detailed Analysis
Vitamins
AttentionYour vitamin D is 46 nmol/L, below the target of 75. Your vitamin B12, at 312 pmol/L, is comfortably sufficient.
Vitamin D is mostly produced in the skin under the influence of sunlight. At Dutch latitudes that is barely possible between October and April, which makes a value like this ordinary in winter and spring. That does not make it unimportant: vitamin D contributes to bone formation, muscle strength and immune function.
Minerals
AttentionYour ferritin is 18 µg/L, just under the lower limit of 20. Ferritin is the storage form of iron, and that store depletes before hemoglobin falls.
That is exactly what we see here: your hemoglobin is still normal (8.4 mmol/L), but the reserve your body draws on is small. Fatigue is a well-recognised symptom of this combination, even without anaemia.
Cardiovascular
AttentionYour total cholesterol is 5.1 mmol/L, just above the 5.0 limit. What matters more than that single number is the composition: your HDL is 1.8 mmol/L (higher is better), your LDL 2.9 mmol/L (under the 3.0 limit) and your triglycerides 0.9 mmol/L (low).
This is a favourable profile. The raised total is largely a consequence of your high HDL, and HDL is protective. Looking at the total alone would give a misleading impression here.
Hematology
NormalYour hemoglobin is 8.4 mmol/L and therefore within range. There is no anaemia. Do note the low ferritin above — it deserves attention precisely because the hemoglobin is still good.
Thyroid
NormalYour TSH is 1.9 mU/L. That sits in the middle of the reference range and is consistent with a normally functioning thyroid. With a TSH in this range, additional free T4 testing is not needed.
Metabolic
NormalYour fasting glucose is 4.9 mmol/L. There is no indication of disturbed glucose metabolism or diabetes.
Inflammation
NormalYour hsCRP is 0.8 mg/L, below the 3.0 limit. This test is more sensitive than standard CRP and is used to detect low-grade inflammation. A low value is favourable.
Liver
NormalYour ALT is 22 U/L, within range. This enzyme is released when liver cells are damaged; a normal value is consistent with a healthy liver.
Kidney
NormalYour eGFR is 96 mL/min/1.73m². This is a calculated measure of how much blood your kidneys filter per minute, and this value is normal for your age.
Recommendations
Supplement vitamin D
Take 25 to 50 micrograms (1000 to 2000 IU) of vitamin D3 daily, with your main meal — vitamin D is fat-soluble and absorbs better that way. Retest after three months to confirm the value is rising.
Rebuild your iron stores through diet
Red meat, lentils, tofu and dark leafy greens are the main sources. Combine them with vitamin C: a glass of orange juice with the meal raises absorption considerably. Tea and coffee do the opposite — leave an hour between them.
Talk to your GP before starting an iron supplement. Too much iron is harmful, and at a ferritin of 18 diet is often enough.
Leave the cholesterol alone
Your profile is favourable enough that a slightly raised total cholesterol needs no action here. Keep your current lifestyle and have it measured again in a year.
Retest after three months
Vitamin D and ferritin respond to supplementation and diet within a few months. A check after three months — vitamin D, ferritin and hemoglobin — will show whether the approach is working.
Next Steps
There is no urgency. Start the vitamin D supplementation and the dietary changes, and have vitamin D, ferritin and hemoglobin measured again after three months.
Contact your GP if the fatigue persists despite this approach, or if new symptoms appear. This report does not replace a consultation.
Your Test Results
Cardiovascular
4What It Measures
This test measures the total amount of cholesterol circulating in your blood, combining all lipoprotein fractions.
When Levels Are High
High total cholesterol typically does not cause symptoms but increases cardiovascular risk over time. Regular screening helps detect elevations early.
Lifestyle Tips
A balanced diet low in saturated fat, regular exercise, healthy weight maintenance, and not smoking support healthy cholesterol levels.
What It Measures
Cholesterol does not dissolve in blood, so it travels packaged inside lipoproteins: spheres with a fatty core and a protein coat. HDL stands for high-density lipoprotein, the smallest and densest type. The test does not measure those particles themselves, but the amount of cholesterol inside them. That distinction matters more than it looks: the result tells you something about the cargo, not about the number of particles and not about how well they do their job. HDL particles are the collection service of cholesterol transport. They take cholesterol up from cells around the body, including the foam cells in an early plaque in the artery wall, and deliver it to the liver, which disposes of it through the bile. This is called reverse cholesterol transport, and it is why a high HDL was seen as protective for decades. In the Netherlands the result is reported in mmol/l. Unlike LDL, the laboratory prints only a lower limit here, no upper limit, and that lower limit differs by sex: 1.0 mmol/l for men and 1.2 mmol/l for women. The difference is physiological. Oestrogen gives women a higher average HDL, so the bar sits higher for them. The practical consequence: a value of 1.1 mmol/l is normal in a man and too low in a woman. Do not simply compare your number with your partner's. One relationship you need to know in order to read the result: HDL moves inversely with triglycerides. A transfer protein swaps cholesterol out of the HDL particles in exchange for triglycerides from the fat-rich particles. The HDL particle ends up loaded with triglycerides, loses cholesterol and is cleared faster. Anyone with a lot of triglycerides in the blood is therefore left with a low HDL almost automatically. In practice a low HDL is rarely a stand-alone problem; it is usually the shadow of a raised triglyceride value and of the insulin resistance behind it. You do not need to fast for an HDL test. HDL barely changes after a meal, unlike triglycerides.
Lifestyle Tips
Start with the honest message: HDL is not a value you should try to push up directly. The trials in which HDL was raised substantially with drugs did not reduce cardiovascular events. An HDL number that goes up without anything changing in the underlying metabolism gains you nothing. So treat HDL as a yardstick for your metabolic health, and direct your effort at what genuinely improves that health. HDL rising along with it is a pleasant by-product, not a goal. What demonstrably helps: <ul><li><strong>Stopping smoking.</strong> Smoking lowers HDL, and the value recovers after quitting. It is also by far the measure with the largest gain for your cardiovascular risk.</li><li><strong>Less abdominal fat.</strong> Visceral fat and insulin resistance are the main reason HDL drops. Weight loss raises HDL modestly and lowers triglycerides at the same time.</li><li><strong>Endurance training.</strong> Regular aerobic exercise genuinely raises HDL, but modestly: meta-analyses put it at roughly 0.05 to 0.1 mmol/l, built up over months. Duration per session weighs more heavily than intensity.</li><li><strong>Fewer fast carbohydrates and less alcohol.</strong> Both lower your triglycerides, and because HDL moves inversely with triglycerides, your HDL comes up along with it.</li></ul> One thing not to do: drink alcohol in order to raise your HDL. Alcohol does raise the value, but that is a cosmetic effect without health gain, and the downsides of alcohol far outweigh it. If you use androgens or anabolic agents, that is by far the strongest influence on your HDL, and it is an unfavourable one. Discuss it openly with your doctor. And finally: never change anything about cholesterol-lowering medication on your own initiative on the basis of an HDL result. That medication targets LDL and ApoB, not HDL.
What It Measures
LDL stands for low-density lipoprotein, a particle that carries cholesterol through the blood. The LDL cholesterol result tells you how much cholesterol sits inside all of those particles together. It is a measure of cargo, not of particle number; that number is better approximated by non-HDL cholesterol and apolipoprotein B. What most people do not know is that LDL is rarely measured in a routine lipid panel. It is calculated. The classic Friedewald equation subtracts HDL from your total cholesterol and then subtracts the cholesterol sitting in the triglyceride-rich particles: LDL = total cholesterol minus HDL minus triglycerides divided by 2.2, with everything in mmol/l. That divisor of 2.2 is a fixed assumption about the ratio between triglycerides and VLDL cholesterol. The assumption is what makes a lipid panel cheap, and it is also the reason an LDL result can simply be wrong. The equation fails in four predictable ways. <table><thead><tr><th>Situation</th><th>What happens to the calculated LDL</th></tr></thead><tbody><tr><td>Triglycerides above roughly 4.5 mmol/l</td><td>The equation is no longer valid; most laboratories will not report a calculated LDL at all</td></tr><tr><td>A low LDL together with raised triglycerides</td><td>The equation underestimates LDL, precisely in treated high-risk people who can least afford an underestimate</td></tr><tr><td>A non-fasting sample</td><td>The meal raises triglycerides, and that rise feeds straight into the division</td></tr><tr><td>Type III dysbetalipoproteinaemia</td><td>The fixed triglyceride-to-VLDL ratio does not hold in this rare disorder, which makes the result unusable</td></tr></tbody></table> More accurate alternatives exist. The Martin-Hopkins method replaces the fixed divisor with a factor that varies with a person's own triglycerides and non-HDL. The Sampson-NIH equation holds up to roughly 9 mmol/l of triglycerides. There is also a direct LDL assay, which measures the cholesterol in LDL particles itself and therefore does not depend on triglycerides; direct assays are, however, less well standardised between manufacturers, so two laboratories can report different numbers for the same blood. So always know which kind of number you are holding. A calculated LDL is no more reliable than the three values it was built from.
Lifestyle Tips
Start with the cause, not with the diet. If your LDL has risen unexpectedly, have an underlying cause ruled out first, with the thyroid at the top of the list. Only then does a conversation about food make sense. The biggest effect on LDL comes from the type of fat in your diet, not the amount. Replacing saturated fat, meaning butter, hard cooking fats, fatty meat and full-fat dairy, with unsaturated fat from vegetable oils, nuts, seeds and oily fish measurably lowers LDL. Swapping saturated fat for fast carbohydrates instead does not produce that effect. Soluble fibre helps as well: oats and barley, pulses, fruit and vegetables bind bile acids in the gut, which makes the liver pull more cholesterol out of the blood. Plant sterols and stanols, added to some margarines and dairy products, also lower LDL; discuss with your doctor or pharmacist whether that makes sense in your situation. Exercise and weight loss mainly improve your triglycerides and your HDL and usually lower LDL only modestly. They remain worthwhile, because your risk is determined by more than one number. Stopping smoking does not lower LDL, but it lowers your cardiovascular risk faster than anything else you can do. One firm boundary to close on: never adjust lipid-lowering medication on your own, and do not stop it after a favourable self-ordered result. That result is often favourable precisely because of the medication.
What It Measures
This test measures the level of triglycerides in your blood after fasting. Levels reflect recent dietary intake, alcohol consumption, and metabolic function.
Lifestyle Tips
Limit sugar and refined carbohydrates, reduce alcohol intake, exercise regularly, and maintain a healthy weight. These changes can significantly reduce triglyceride levels.
Hematology
1What It Measures
Haemoglobin (Hb) is the iron-containing protein in your red blood cells that binds oxygen. It picks up oxygen in your lungs, carries it around your body, and takes carbon dioxide back on the return trip. This test measures how much haemoglobin is present per litre of blood. In the Netherlands the result is usually reported in mmol/l; internationally g/dl is more common. The value is measured as standard within the complete blood count. Because almost all the oxygen in your blood is bound to haemoglobin, this value tells you directly how much oxygen your blood can carry. Your doctor will therefore almost always assess haemoglobin together with haematocrit, the red cell count and MCV.
Lifestyle Tips
Dietary iron is the foundation: red meat, legumes, wholegrain products and dark leafy greens. Vitamin C with a meal improves the absorption of plant-based iron, while coffee and tea inhibit it. Do not start iron supplements on your own initiative. Supplementing without a demonstrated deficiency is not useful and too much iron can be harmful; have your ferritin measured first. Drink enough before a blood draw: dehydration concentrates your blood and can artificially raise the result. A persistently low or high value should always be investigated by a doctor, because the underlying cause matters more than the number itself.
Inflammation
1What It Measures
This test uses a highly sensitive assay to detect low concentrations of CRP that standard CRP tests cannot measure. It reflects subtle, chronic inflammation associated with vascular health.
Lifestyle Tips
Regular exercise, a Mediterranean-style diet, maintaining a healthy weight, and not smoking may help lower hs-CRP levels. Stress management and adequate sleep also contribute to reducing chronic inflammation.
Kidney
1What It Measures
eGFR estimates the volume of blood that your kidneys filter per minute, expressed in millilitres per minute per 1.73 square metres of body surface area. It is calculated using blood <a href="/en/biomarkers/creatinine">creatinine</a> or cystatin C levels, combined with factors such as age and sex. A normal eGFR is generally above 90 mL/min. Values between 60 and 89 may indicate mildly reduced function, 30 to 59 suggests moderate impairment, 15 to 29 indicates severe reduction, and below 15 may indicate kidney failure. You can estimate your own value with our <a href="/en/tools/kidney-function-calculator">kidney function calculator</a>.
Lifestyle Tips
Protect your kidney function by managing blood pressure and blood sugar levels within healthy ranges. Stay well hydrated and maintain a balanced diet that is not excessively high in sodium or protein. Engage in regular physical activity, maintain a healthy weight, and avoid smoking. Limit the use of over-the-counter pain medications, particularly NSAIDs, which can damage the kidneys over time. Always discuss medication use with your healthcare provider.
Liver
1What It Measures
ALT is an enzyme found predominantly in liver cells. When liver cells are damaged or inflamed, ALT is released into the bloodstream, causing levels to rise. This test measures the concentration of ALT in your blood. Because ALT is more specific to the liver than other enzymes like AST, it is considered one of the most reliable markers of liver health.
Lifestyle Tips
Limit alcohol consumption, as excessive intake is a common cause of elevated ALT levels. Maintain a healthy weight through balanced nutrition and regular exercise, as non-alcoholic fatty liver disease is increasingly common. Review all medications and supplements with your healthcare provider, as some may affect liver function. Stay well hydrated and include liver-supportive foods such as leafy greens, cruciferous vegetables, and foods rich in antioxidants.
Metabolic
1What It Measures
This test measures blood glucose after fasting for at least 8 hours. It reflects your body's baseline ability to regulate blood sugar without the influence of recent food intake.
Lifestyle Tips
Maintain a balanced diet with controlled portions, regular physical activity, a healthy weight, and adequate sleep. Limit refined sugars and processed carbohydrates. These lifestyle factors play a key role in blood sugar management.
Minerals
1What It Measures
This test measures the amount of ferritin in your blood. Low ferritin indicates depleted iron stores, while high ferritin may suggest iron overload or inflammation.
When Levels Are Low
Symptoms of low ferritin may include fatigue, weakness, pale skin, brittle nails, hair loss, headaches, and difficulty concentrating. Low ferritin can precede iron-deficiency anaemia.
Lifestyle Tips
Include iron-rich foods such as lean red meat, poultry, fish, beans, and fortified cereals. Pair iron-rich foods with vitamin C sources to enhance absorption. Avoid drinking tea or coffee with meals, as they can reduce iron absorption.
Thyroid
1What It Measures
This test measures thyroid-stimulating hormone (TSH) in your blood. TSH is released by the pituitary gland to signal the thyroid to produce hormones. When thyroid hormone levels are low, TSH typically rises; when they are high, TSH usually falls. It is often the first test used to evaluate thyroid function.
Lifestyle Tips
Supporting healthy TSH levels may include eating a balanced diet with adequate iodine, selenium, and zinc, managing stress effectively, maintaining regular sleep patterns, and exercising moderately. Some people find that avoiding excessive soy or processed foods may be helpful. Always follow your healthcare provider's guidance for thyroid management.
Vitamins
2What It Measures
This test measures the level of 25-hydroxyvitamin D in your blood, which is the main circulating form of vitamin D and the most reliable indicator of your overall vitamin D status.
When Levels Are Low
Symptoms of low vitamin D may include fatigue, bone pain, muscle weakness, frequent infections, and mood changes such as feelings of low mood. In severe cases, it may be associated with bone softening or increased fracture risk.
Lifestyle Tips
Aim for regular, safe sun exposure of around 15–20 minutes daily when possible. Include vitamin D-rich foods such as fatty fish, egg yolks, and fortified dairy products. Consider supplementation during winter months after consulting your healthcare provider.
What It Measures
This test measures the total vitamin B12 level in your blood, expressed in pmol/l. It may help assess whether your body has adequate B12 for blood cell production and nervous system maintenance. Your healthcare provider can place results in clinical context.
Lifestyle Tips
Foods considered rich in B12 include meat, fish, eggs, and dairy products. Those following plant-based diets may benefit from fortified foods or supplements. Absorption may decrease with age, so regular monitoring could be helpful. Discuss options with your healthcare provider.
Assessed by a BIG-registered doctor
This report was prepared by a BIG-registered doctor. It does not replace a personal medical consultation. Always consult your general practitioner if you have questions.