Written by Lawal Joanna (Jojo Talks Med)

When we talk about Chemistry, it is easy to picture acids, bases and titrations.

Clinical Chemistry in human medicine is a whole lot more complex than that.

Chemical pathology (Clinical Chemistry/ Clinical Pathology) is a branch of Medical Laboratory Science that deals with investigating the biochemical basis of disease. It involves analyzing bodily fluids like blood and urine to diagnose, monitor, and treat various conditions.

I like to think of Chemical pathology as a subtler realm than other fields of MLS. It is a field with less drama, more numbers and a symphony of biochemical signals.

In Chemical Pathology, it is easy to see how silence of symptoms does not necessarily mean absence of disease, it may be hidden in data waiting to be analysed and interpreted.

What Chemical Pathology is really about

What if disease didn’t look like anything under a microscope but only got expressed as data?

That is where Chemical pathology comes in.

Chemical pathology as the name implies studies body fluids such as blood, urine, saliva, cerebrospinal fluid etc to measure specific chemical substances and see how they differ from normal ranges.

These differences are what point us to organ function, metabolic imbalance, and systemic disease.

In haematology, we saw how a microscope can intricately reveal a parasite, well here in Chemical pathology, the tools such as analyzers, spectrophotometers, selective electrodes may look less exciting but they produce results that describe either the harmony or discord of your body’s chemistry.

In this unit, the Plain bottle (red top tube) is the most commonly used bottle for routine tests requiring serum. Other tests require bottles like Lithium heparin bottle (Green top tube) for plasma chemistry tests, Fluoride oxalate bottle (Grey top tube) for glucose tests, the Universal bottle for urinalysis and Haematology’s favorite EDTA for specialised chemistry tests like HBA1c.

The routine work in Chemical pathology involves a wide spectrum of highly necessary investigations that provide clues about organ health.

For instance, Tests like Liver Function Test, fondly called LFT by Chemical Pathologists, is used to assess liver health and detect liver injury. It includes enzymes like ALT (Alanine Aminotransferase) and AST (Aspartate Aminotransferase), ALP (Alkaline phosphate), GGT (Gamma - Glutamyl Transferase) as well as substances such as bile and albumin.

We also have Renal Function Tests which evaluate how well the kidneys filter waste products from the blood. It includes Urea, Creatinine and Electrolytes.

Another common test is Blood Glucose testing which assesses sugar metabolism and is useful in detecting diabetes mellitus.

Others include Lipid Profile strongly linked to Cardiovascular disease , Electrolytes, Cardiac Markers and Thyroid Function Tests to name a few.

Whew, the Chemical pathology lab often has a lot of analysis going on, hence the heavy use of automation in this unit.

Every number, every fluctuation is a chemical reflection of physiology or pathology and interpreting that correctly can make the difference between early detection and missed diagnosis.

The Real Value of Chemical Pathology

The root of Chemical pathology is how results only matter when interpreted correctly. In Chemical pathology, nothing is loud or glaring, every evidence occurs as numbers on a screen or a white sheet.

If Cross matching in Haematology taught us that an oversight could be fatal, Chemical pathology teaches us that one misinterpreted result may set a patient on the wrong recovery journey.

Reference ranges run the show in Chemical Pathology. Every single parameter has a range that is standard and anything outside of that is considered abnormal and a red flag.

Trends matter and small changes might mean big disease shifts.

Those numbers are not just digits, they are stories of stress, disease, imbalance, recovery and adaptation. It takes a skilled professional in person of the Chemical Pathologist to evaluate the results and interpret them accurately. Knowing what tests to run, when to run them and what the results mean for the patient is truly a responsibility.

Chemical Pathology Might Just be ART

Chemical pathology has a beauty I feel is easy to ignore bit beauty all the same. Performing procedures sometimes feels less like running tests and more like watching chemistry unfold itself into beautiful hues.

You add a reagent and you mix, then incubate and all of a sudden, a clear sample transforms into something golden, purple, deep blue or pink, each color carrying deep meaning about the internal chemistry of the body.

But those hues? Always a wonder to bring to life in the lab. It speaks of transformation, turning the invisible processes into visible evidence.

Be honest, it is kind of poetic!

Three Lessons Chemical Pathology Teaches About Life

Small numbers can wield powerful meaning

Subtle shifts in levels of metabolites reveal deep diseases just like how the number Zero makes the difference between Thousand and Tens of Thousands. This shows how small choices can lead to larger consequences in life.

Patterns matter more than noise

Life is hardly ever random, it’s rhythmic, patterned, interpretable if we learn to recognize and interpret the signals it tends to throw our way.

Skill sharpens Insight

We must be skilled in seeing truths for what is it is to turn facts into actionable points just as a chemical pathologist skillfully does so in the lab.

In all, Chemical pathology has proven itself to be where we listen to the body’s chemical narrative, turning numbers into diagnosis.

Next, we will step into a whole new world, tiny as it may be yet unrelenting.

Till then, Stay Curious.

Written by Lawal Joanna (Jojo Talks Med)