I had a first time appointment with my doctor. She did a full set of labs. All came back OK other than Occult Blood 3+. For years a I’ve had microscopic blood in my urine. I have moved a lot so no further work up has been done. What does this mean exactly? It says negative 3+. How can I tell if it was done by dip stick or microscope? I have a follow up in a few weeks. Other high value was total cholesterol 224 and got D deficient. I also have high blood pressure. I’m in shape 49 years old and female.

Having blood in the urine is not normal.  In most cases, this is evaluated by a urologist initially.  The blood can be coming from anywhere in the urinary tract including the kidneys, ureters, or bladder.  If the urologist is unable to find the source of bleeding, then a kidney biopsy may be needed to determine the cause of blood in the urine.  Rarely, we find that the blood in the urine is a false dipstick test with no actual red blood cells present.  A dipstick test is commonly read out as 1+, 2+, 3+, or 4+.  An actual number of red blood cells present in the urine will be counted if a microscope was used to determine the red blood cells present.  Hence, this result will be read out as for example 5 – 10 RBC’s per high powered field (hpf).  Normal red blood cells (RBC’s) in the urine is less than 5 per hpf.

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