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To screen for APC-R associated with venous thromboembolic disorders.

Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA Test, ANA Screen IFA with Reflex to Titer and pattern IFA Test, ANA with Reflex Test, Antinuclear Antibody Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

When is an ANA Screen test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does an ANA Screen blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with an ANA Screen test:

  • ENA Panel
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Complement
  • AMA
  • Centromere antibody
  • Histone Antibody

Conditions where an ANA Screen test is recommended:

  • Autoimmune Disorders
  • Lupus
  • Rheumatoid Arthritis
  • Sjogren Syndrome
  • Scleroderma

How does my health care provider use an ANA Screen test?

One of the most often performed tests to diagnose systemic lupus erythematosus is the antinuclear antibody test. It serves as the first step in the evaluation process for autoimmune diseases that might impact various body tissues and organs.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.



Description: Apo A1 and B is a blood test that measures that amount of Apolipoprotein A1 and Apolipoprotein B in the blood’s serum along with the ratio between B/A1. This test is used to assess cardiovascular risk. Low levels of APO A1 are associated with Coronary Artery Disease (CAD) and are said to predict CAD better then triglycerides and HDL does.

Also Known As: Apo A1 and B Test, Apo A1 Test, Apo B Test, APOAB Test, Apolipoprotein B-100 Test, Apolipoprotein Evaluation Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for 12 hours is required.

When are Apolipoprotein A1 and B tests ordered?

Apolipoprotein A-I and B, as well as other lipid tests, may be ordered as part of a screening to identify a person's risk of cardiovascular disease.

Apo A-I is a protein that plays a key function in lipid metabolism and is the most abundant protein in HDL, or "good cholesterol." Excess cholesterol in cells is removed by HDL, which transports it to the liver for recycling or elimination. Apo A-I levels tend to rise and fall with HDL levels, and apo A-I deficits are linked to an increased risk of CVD.

Apo B is a protein that plays a role in lipid metabolism and is the major protein component of lipoproteins including VLDL and LDL, popularly known as "bad cholesterol." Apo B concentrations are similar to LDL-C concentrations.

What does Apolipoprotein A1 and B blood tests check for?

Lipids are transported throughout the bloodstream by apolipoproteins, which mix with them. Lipoproteins are held together by apolipoproteins, which protect the water-repellent lipids at their core.

Lipoproteins are cholesterol or triglyceride-rich proteins that transport lipids throughout the body for cell absorption. HDL, on the other hand, is like an empty cab or taxi. It travels to the tissues to collect excess cholesterol before returning it to the liver. Cholesterol is either recycled for future use or eliminated in bile in the liver. The only mechanism for cells to get rid of excess cholesterol is by HDL reverse transport. It protects the arteries and, if enough HDL is present, it can even reverse the formation of fatty plaques, which are deposits caused by atherosclerosis and can contribute to cardiovascular disease.

Sticking with the taxi analogy, the driver is Apolipoprotein A. It permits HDL to be detected and bound by receptors in the liver at the end of the transport by activating the enzymes that load cholesterol from the tissues into HDL. Apolipoprotein A is divided into two types: apo A-I and apo A-II. Apo A-I has a higher prevalence than apo A-II. Apo A-I concentrations can be evaluated directly, and they tend to rise and fall in tandem with HDL levels. Deficiencies in apo A-I are linked to an increased risk of cardiovascular disease.

Chylomicrons are lipoprotein particles that transport dietary fats from the digestive system to tissue, primarily the liver, via the bloodstream. These dietary lipids are repackaged in the liver and combined with apo B-100 to create triglyceride-rich VLDL. This combo is similar to a taxi with a full load of passengers and apo B-100 as the driver. The taxi moves from place to place in the bloodstream, releasing one passenger at a time.

Triglycerides are removed from VLDL by an enzyme called lipoprotein lipase, which produces intermediate density lipoproteins first, then LDL. VLDL contains one molecule of apo B-100, which is kept as VLDL loses triglycerides and shrinks to become the cholesterol-rich LDL. Apo B-100 is detected by receptors on the surface of many different types of cells in the body. The absorption of cholesterol into cells is aided by these receptors.

LDL and apo B-100 transport cholesterol that is essential for cell membrane integrity, sex hormone generation, and steroid production. Excess LDL, on the other hand, can cause fatty deposits in artery walls, as well as blood vessel hardening and scarring. Atherosclerosis is a condition in which fatty deposits restrict blood arteries. The risk of a heart attack increases as the atherosclerotic process progresses.

LDL-C levels, which are typically ordered as part of a lipid profile, tend to mimic Apo B-100 levels. Many experts believe that apo B levels will eventually show to be a more accurate predictor of CVD risk than LDL-C. Others disagree, believing that vitamin B is only a modestly superior choice and that it should not be used on a regular basis. The clinical utility of apo B, as well as other developing cardiac risk markers including apo A-I, Lp(a), and hs-CRP, is still unknown.

Lab tests often ordered with Apolipoprotein A1 and B tests:

  • Cholesterol Total
  • HDL Cholesterol
  • LDL Cholesterol
  • Triglycerides
  • Lipid Panel
  • Lipoprotein (a)
  • Homocysteine
  • hs-CRP
  • Lipoprotein Fractionation, Ion Mobility

Conditions where Apolipoprotein A1 and B tests are recommended:

  • Cardiovascular Disease
  • Heart Attack
  • Stroke
  • Congestive Heart Failure
  • Angina

How does my health care provider use Apolipoprotein A1 and B tests?

An apo B/apo A-I ratio can be determined by ordering both an apo A-I and an apo B test. To assess the risk of developing CVD, this ratio is sometimes used instead of the total cholesterol/HDL ratio.

An apo A-I test may be ordered in the following situations:

Assist in the diagnosis of apo A-I deficiency caused by genetic or acquired diseases.

Assist those with a personal or family history of heart disease, high cholesterol, or triglycerides in their blood.

Keep track of how well lifestyle changes and lipid therapies are working.

An apo A-I test can be ordered in conjunction with an apo B test to determine the apo B/apo A-I ratio. This ratio is occasionally used instead of the total cholesterol/HDL ratio to assess the risk of developing CVD.

As an alternative to non-HDL-C, Apo B levels may be ordered to assess the success of lipid treatment.

An apo B test may be conducted in rare circumstances to assist determine a genetic issue that causes apo B overproduction or underproduction.

What do my Apolipoprotein A1 and B test results mean?

Low apo A-I levels are linked to low HDL levels and slowed elimination of excess cholesterol from the body. Low levels of apo A-I, as well as high levels of apo B, are linked to a higher risk of cardiovascular disease.

Deficiencies in apo A-I are caused by a number of hereditary diseases. Abnormal lipid levels, notably excessive amounts of low-density lipoprotein, are common in people with certain illnesses. They frequently have a higher rate of atherosclerosis. Low apo A-I levels are caused by several genetic diseases.

Raised apo B levels are linked to elevated LDL-C and non-HDL-C levels, and are linked to an increased risk of cardiovascular disease. Elevations may be caused by a high-fat diet and/or a reduction in LDL clearance from the blood.

A direct cause of abnormal apo B levels is some hereditary diseases. Familial combined hyperlipidemia, for example, is an inherited condition that causes excessive cholesterol and triglyceride levels in the blood. Apolipoprotein B deficiency, also known as Bassen-Kornzweig syndrome, is a relatively rare hereditary disorder that results in unusually low amounts of apo B.

A variety of underlying diseases and other factors might result in abnormal apo B levels.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


BNP is increased in congestive heart failure, left ventricular hypertrophy, acute myocardial infarction, coronary angioplasty, and hypertension. Elevations are also observed in pulmonary hypertension (indicating right ventricular dysfunction), acute lung injury, hypervolemic states, chronic renal failure and cirrhosis. Decreasing levels indicate therapeutic response to anti-hypertensive therapy.

Description: A Basic Metabolic Panel is a blood test used to screen for, diagnose, and monitor a variety of conditions and diseases such as diabetes and kidney disease.  

Also Known As: BMP, Chemistry Panel, Chemistry Screen, Chem 7, Chem 11, BMP Test, SMA 7, SMAC7, Basic Metabolic Test, Chem Test, Chem Panel Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred. 

When is a Basic Metabolic Panel test ordered?  

A BMP may be requested as part of a standard physical examination. 

The panel is frequently ordered in hospital emergency rooms because its components provide vital information regarding a person's renal state, electrolyte and acid/base balance, blood glucose, and calcium levels. Significant changes in these test results can suggest serious issues such as renal failure, insulin shock or diabetic coma, respiratory distress, or abnormalities in heart rhythm. 

What does a Basic Metabolic Panel blood test check for? 

The basic metabolic panel (BMP) is a 9-test panel that provides essential information to a health practitioner about a person's current metabolic status, including kidney health, blood glucose level, electrolyte and acid/base balance. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the BMP test: 

  • Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

  • Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. Calcium is also used for blood clot formation and the formation and maintenance of bones and teeth. 

  • Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

  • Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

  • Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

  • Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

  • Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

  • Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

  • Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood Urea Nitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Basic Metabolic Panel test: 

  • Complete Blood Count with Differential and Platelets
  • Hemoglobin A1c
  • Iron and Total Iron Binding Capacity
  • Lipid Panel
  • Insulin
  • Vitamin B12 and Folate
  • C-Reactive Protein

Conditions where a Basic Metabolic Panel test is recommended: 

  • Diabetes 
  • Kidney Disease 
  • Liver Disease 

Commonly Asked Questions: 

How does my health care provider use a Basic Metabolic Panel test? 

The basic metabolic panel (BMP) is used to evaluate a person's kidney function, electrolyte, acid/base balance, and blood glucose level, all of which are linked to their metabolism. It can also be used to keep track of hospitalized patients and persons with known illnesses like hypertension and hypokalemia. 

If a health practitioner wants to track two or more separate BMP components, the full BMP might be ordered because it contains more information. Alternatively, when monitoring, the healthcare provider may order specific tests, such as a follow-up glucose, potassium, or calcium test, or an electrolyte panel to track sodium, potassium, chloride, and CO2. If a doctor needs further information, he or she can request a comprehensive metabolic panel (CMP), which is a collection of 21 tests that includes the BMP. 

What do my Basic Metabolic Panel results mean? 

The results of the tests included in the BMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. 

Out-of-range results on any of the BMP's tests can be caused by a number of things, including kidney failure, breathing issues, and diabetes-related consequences. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

The results of the BMP components can be influenced by a range of prescription and over-the-counter medicines. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide them with a thorough medical history because many other circumstances can influence how your results are interpreted. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 


Description: A hs-CRP or High Sensitivity C-Reactive Protein test is a blood test used to accurately detect lower concentrations of the protein C-Reactive Protein. This test is used to evaluate your risk of cardiovascular and heart disease and to check for inflammation and many other issues.

Also Known As: hsCRP Test, Cardiac CRP Test, high sensitivity C-reactive protein Test, CRP Test for heart disease.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a hs-CRP test ordered?

There is currently no consensus on when to get an hs-CRP test. It may be beneficial for treatment purposes to order hs-CRP for those that have kidney disease, diabetes or inflammatory disorders.

It's possible that hs-CRP will be tested again to confirm that a person has persistently low levels of inflammation.

What does a hs-CRP blood test check for?

C-reactive protein is a protein found in the blood that rises in response to infection and inflammation, as well as after trauma, surgery, or a heart attack. As a result, it's one of numerous proteins referred to as acute phase reactants. The high-sensitivity CRP test detects low levels of inflammation in the blood, which are linked to an increased risk of developing cardiovascular disease.

According to the American Heart Association, CVD kills more people in the United States each year than any other cause. A number of risk factors have been related to the development of CVD, including family history, high cholesterol, high blood pressure, being overweight or diabetic, however a considerable number of people with few or no recognized risk factors will also acquire CVD. This has prompted researchers to investigate for new risk variables that could be causing CVD or could be used to identify lifestyle modifications and/or treatments that could lower a person's risk.

High-sensitivity CRP is one of an increasing number of cardiac risk markers that may be used to assess an individual's risk. According to certain research, monitoring CRP with a highly sensitive assay can assist identify the risk level for CVD in persons who appear to be healthy. CRP levels at the higher end of the reference range can be measured with this more sensitive test. Even when cholesterol levels are within an acceptable range, these normal but slightly elevated levels of CRP in otherwise healthy persons might indicate the future risk of a heart attack, sudden cardiac death, stroke, and peripheral artery disease.

Lab tests often ordered with a hs-CRP test:

  • Complete Blood Count
  • Lipid Panel
  • Comprehensive Metabolic Panel
  • Lp-Pla2
  • Glucose

Conditions where a hs-CRP test is recommended:

  • Heart Attack
  • Heart Disease
  • Cardiovascular Disease
  • Stroke

How does my health care provider use a hs-CRP test?

A test for high-sensitivity C-reactive protein can be used to assess a person's risk of cardiovascular disease. It can be used in conjunction with a lipid profile or other cardiac risk markers, such as the lipoprotein-associated phospholipase A2 test, to provide further information regarding the risk of heart disease.

CRP is a protein that rises in the bloodstream as a result of inflammation. A continuous low level of inflammation, according to studies, plays a crucial role in atherosclerosis, the narrowing of blood vessels caused by the build-up of cholesterol and other lipids, which is typically linked to CVD. The hs-CRP test successfully detects low levels of C-reactive protein, indicating low but chronic inflammation, and so aids in predicting a person's risk of developing CVD.

Some specialists believe that high-sensitivity CRP is a good test for assessing CVD, heart attacks, and stroke risk, and that it can help in the evaluation process before a person gets one of these health problems. Some experts believe that combining a good marker for inflammation, such as hs-CRP, with a lipid profile is the best way to predict risk. This test has been recommended by several organizations for persons who are at a moderate risk of having a heart attack in the following ten years.

What does my hs-CRP test result mean?

Even when cholesterol levels are within an acceptable range, high levels of hs-CRP in otherwise healthy people have been found to predict an elevated risk of future heart attacks, strokes, sudden cardiac death, and/or peripheral arterial disease.

Higher hs-CRP concentrations indicate a higher risk of cardiovascular disease, while lower values indicate a lower risk. Individuals with hs-CRP values at the high end of the normal range are 1.5 to 4 times more likely than those with low levels of hs-CRP to have a heart attack.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


This test determines the subtypes of apoe which will aid in the risk assessment of corornary heart disease (CHD) and hyperlipoproteinemia.

Low levels of fibrinogen are associated with bleeding most commonly secondary to liver disease or Disseminated Intravascular Coagulation (DIC). Fibrinogen is an acute phase reactant and thus elevated levels may be associated with inflammation. Increased concentrations are also associated with increased risk of atherosclerosis.

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BNP is used to aid in the diagnosis of left ventricular dysfunction in heart failure. In contrast with BNP, a drug to treat left ventricular dysfunction does not interfere with the measurement of N-terminal pro-BNP.

Dietary supplements containing biotin may interfere in assays and may skew results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.


Description: A Prothrombin Time test will measure the speed of which your blood clots. This test can be used to detect a bleeding or clotting disorder or to determine in your blood is clotting too fast or too slow.

Also Known As: Pro Time with INR Test, Prothrombin Time and International Normalized Ratio test, Prothrombin Time PT with INR Test, Prothrombin Time with INR Test, Prothrombin with INR, Protime with INR, PT Test

Collection Method: Blood draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Prothrombin Time with INR test ordered?

When a person takes the anticoagulant medicine warfarin, a PT and INR are ordered on a regular basis to confirm that the prescription is working effectively and that the PT/INR is adequately extended. A doctor will prescribe them frequently enough to ensure that the treatment is having the desired effect, namely, boosting the person's clotting time to a therapeutic level while minimizing the danger of excessive bleeding or bruising.

When a person who isn't taking anticoagulants exhibits signs or symptoms of excessive bleeding or clotting, a PT may be ordered when they are experiencing:

  • Bleeding that isn't explained or bruises that isn't easy to get rid of
  • Nosebleeds
  • Gums that are bleeding
  • A blood clot in an artery or vein
  • Disseminated intravascular coagulation
  • A persistent disorder that affects hemostasis, such as severe liver disease

PT and PTT may be prescribed prior to surgery when there is a high risk of blood loss associated with the procedure and/or when the patient has a clinical history of bleeding, such as frequent or severe nosebleeds and easy bruising, which may indicate the presence of a bleeding problem.

What does a Prothrombin Time with INR blood test check for?

The prothrombin time is a test that determines a person's capacity to make blood clots properly. The international normalized ratio, or INR, is a calculation based on the results of a PT that is used to track people who are taking the blood thinner warfarin.

After chemicals are added to a person's blood sample, a PT measures how long it takes for a clot to develop. The PT is frequently used with a partial thromboplastin time to measure the number and function of proteins known as coagulation factors, which are essential for optimal blood clot formation.

When an injury develops in the body and bleeding ensues, the clotting process known as hemostasis begins. This process is aided by a series of chemical events known as the coagulation cascade, in which coagulation or "clotting" components are activated one by one, leading to the development of a clot. In order for normal clotting to occur, each coagulation factor must be present in appropriate quantities and operate effectively. Excessive bleeding can result from too little, while excessive clotting can result from too much.

There are two "pathways" that can trigger clotting in a test tube during a laboratory test, the extrinsic and intrinsic pathways. Both of these pathways subsequently converge to finish the clotting process. The PT test assesses how well all coagulation factors in the extrinsic and common routes of the coagulation cascade cooperate. Factors I, II, V, VII, and X are included. The PTT test examines the protein factors XII, XI, IX, VIII, X, V, II, and I, as well as prekallikrein and high molecular weight kininogen, which are all part of the intrinsic and common pathways. The PT and PTT examine the overall ability to generate a clot in a fair period of time, and the test results will be delayed if any of these elements are insufficient in quantity or are not operating effectively.

The PT test is normally done in seconds and the results are compared to a normal range that represents PT levels in healthy people. Because the reagents used to conduct the PT test vary from one laboratory to the next and even within the same laboratory over time, the normal ranges will change. The Internationalized Normalized Ratio, which is computed based on the PT test result, was developed and recommended for use by a World Health Organization committee to standardize results across various laboratories in the United States and around the globe for people taking the anticoagulant warfarin.

The INR is a formula that accounts for variations in PT reagents and enables for comparison of findings from different laboratories. When a PT test is performed, most laboratories report both PT and INR readings. However, the INR should only be used by people who are taking the blood thinner warfarin.

Lab tests often ordered with a Prothrombin Time with INR test:

  • Partial Thromboplastin Time
  • Fibrinogen Activity
  • Platelet Count
  • Complete Blood Count (CBC)
  • Coagulation Factors
  • Warfarin Sensitivity testing

Conditions where a Prothrombin Time with INR test is recommended:

  • Bleeding Disorders
  • Excessive Clotting Disorders
  • Vitamin K Deficiency
  • Liver Disease
  • DIC

How does my health care provider use a Prothrombin Time with INR test?

The prothrombin time is used to diagnose the origin of unexplained bleeding or abnormal blood clots, generally in conjunction with a partial thromboplastin time. The international normalized ratio is a calculation based on the results of a PT that is used to monitor people on the blood thinner warfarin.

Coagulation factors are proteins that are involved in the body's process of forming blood clots to assist stop bleeding. When an injury occurs and bleeding begins, coagulation factors are triggered in a series of events that finally assist in the formation of a clot. In order for normal clotting to occur, each coagulation factor must be present in appropriate quantities and operate effectively. Excessive bleeding can result from too little, while excessive clotting can result from too much.

The PT and INR are used to monitor the anticoagulant warfarin's efficacy. This medication influences the coagulation cascade's function and aids in the prevention of blood clots. It is given to those who have a history of recurrent abnormal blood clotting on a long-term basis. Warfarin therapy's purpose is to strike a balance between preventing blood clots and causing excessive bleeding. This equilibrium must be carefully monitored. The INR can be used to change a person's medication dosage in order to get their PT into the ideal range for them and their condition.

What do my PT and INR test results mean?

Most laboratories report PT findings that have been corrected to the INR for persons taking warfarin. For basic "blood-thinning" needs, these persons should have an INR of 2.0 to 3.0. Some people with a high risk of blood clot require a higher INR, about 2.5 to 3.5.

The outcome of a PT test is determined by the method utilized, with results measured in seconds and compared to a normal range defined and maintained by the laboratory that administers the test. This normal range is based on the average value of healthy persons in the area, and it will differ somewhat from test to lab. Someone who isn't on warfarin would compare their PT test result to the usual range provided by the laboratory that conducted the test.

A prolonged PT indicates that the blood is taking an excessive amount of time to clot. This can be caused by liver illness, vitamin K inadequacy, or a coagulation factor shortage, among other things. The PT result is frequently combined with the PTT result to determine what condition is present.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: Ion Mobility Lipoprotein Fractionation is a test that uses a gas-phase technology to separate the lipid particles by size. As each particle is separated, they are counted.

Also Known As: LDL Particle Testing, LDL-P Test, LDL Subclass Test, sdLDL Test, LDL Fractionations Test, LDL Particle Size Test, LDL Particle Number Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required

When is a Lipoprotein Fractionation test ordered?

When someone has a personal or family history of early cardiovascular disease, this testing may be ordered as part of an overall evaluation of cardiac risk, especially if the person does not have typical cardiac risk factors like high cholesterol, high LDL cholesterol, high triglyceride, low HDL cholesterol, smoking, obesity, inactivity, diabetes, and/or hypertension.

When a person with elevated LDL-P and/or a high proportion of tiny, dense LDL particles has undertaken cholesterol-lowering treatment or lifestyle adjustments, the healthcare practitioner may conduct LDL lipoprotein subfraction testing, as well as other lipid tests, to assess treatment success.

Although LDL-P is not typically suggested as a screening test, some healthcare practitioners are using it in conjunction with a battery of other cardiac risk tests to evaluate a person's overall risk of getting CVD.

What does a Lipoprotein Fractionation blood test check for?

Low-density lipoproteins are lipid-transporting particles that travel throughout the body. Protein, cholesterol, triglyceride, and phospholipid molecules are all present in each particle. As they move through the bloodstream, their makeup changes. Lipoprotein particles range in size from large and fluffy to small and dense, depending on which molecules are eliminated and which are added. The relative amounts of particles with different characteristics in the blood are determined by LDL particle testing. Subfractionation testing is a term used to describe this process.

Traditional lipid testing determines the amount of LDL cholesterol in the blood but does not assess the number of LDL particles. Increased numbers of small, dense LDL particles have been linked to inflammation and are more likely to produce atherosclerosis than fewer light, fluffy LDL particles, according to some research. Researchers believe that the existence of an elevated quantity of sdLDL could be one of the reasons why some people have heart attacks while having relatively low total and LDL cholesterol levels.

The number of sdLDL particles in a person's blood is determined in part by genetics, in part by sex, and in part by lifestyle and overall health. Increased levels of sdLDL are linked to certain diseases and disorders, like as diabetes and hypertension.

By examining a person's triglyceride and high-density lipoprotein cholesterol levels, it is usually able to estimate whether they have a high amount of sdLDL particles. Typically, these tests are done as part of a lipid profile. People with high triglycerides and low HDL-C have higher levels of sdLDL. More sdLDL is connected with a triglyceride level greater than 120 mg/dL and an HDL-C level less than 40 mg/dL in men and less than 50 mg/dL in women.

Other lipoprotein particles, such as HDL and VLDL, can also be subfractionated, however these tests are generally utilized in research settings and are not discussed on this page.

Lab tests often ordered with a Lipoprotein Fractionation test:

  • Lipid Panel
  • HDL Cholesterol
  • LDL Cholesterol
  • Direct LDL
  • Apolipoprotein A-1
  • Apolipoprotein B
  • Lipoprotein (a)
  • Triglycerides
  • Homocysteine
  • Hs-CRP
  • VAP

Conditions where a Lipoprotein Fractionation test is recommended:

  • Cardiovascular Disease
  • Heart Disease

How does my health care provider use a Lipoprotein Fractionation test?

Low-density lipoprotein particle testing determines the number, size, density, and/or electrical charge of LDL particles. It may be useful in determining cardiac risk in patients with a personal or family history of heart disease at a young age, particularly if their total cholesterol and LDL cholesterol levels are not markedly increased. LDL subfraction testing is usually done in conjunction with or after a lipid profile.

While the LDL-C test is a good predictor of cardiovascular disease risk for many people, research has indicated that certain persons with healthy LDL-C levels nonetheless have an increased risk of CVD. Similarly, even if their LDL-C is at a safe level, people with chronic diseases like diabetes may be at higher risk. The quantity of LDL particles and/or their size has been recommended as an additional factor to consider when assessing CVD risk in these populations. Lipoprotein subfraction testing may be done in these situations to further assess a person's CVD risk.

LDL-P is sometimes requested to see how well a treatment is working at reducing the quantity of tiny, dense LDL particles.

LDL subfraction testing has been employed in clinical settings, although VLDL or HDL subfraction testing is primarily used in research. This is because LDL cholesterol has been established as the key risk factor for heart disease, and LDL assessment has received increased attention in research and development.

What do my Lipoprotein Fractionation test results mean?

The method and reporting format utilized in an LDL-P test, as well as the person's total cholesterol, LDL-C, VLDL, and/or HDL cholesterol, are all reflected in the results. Because different methods divide subclasses based on different physical qualities, results may not be immediately comparable from one method to the next or from one laboratory to the next.

Usually, the result is evaluated in context of a lipid profile and the risk it implies:

  • If a person has a high number of mostly tiny, dense LDL and an elevated LDL-P, this result will enhance the person's risk of cardiovascular disease beyond the risk associated with total LDL.
  • If a person only has large, fluffy LDL and a low LDL-P, this discovery will not put them at any greater risk.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with Differential and Platelets test, Hemogram test  

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances. 

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. 

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results. 

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count. 

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity. 

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances. 

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC. 

Lab tests often ordered with a Complete Blood Count test: 

  • Reticulocytes
  • Iron and Total Iron Binding Capacity
  • Basic Metabolic Panel
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Epstein-Barr Virus
  • Von Willebrand Factor Antigen

Conditions where a Complete Blood Count test is recommended: 

  • Anemia
  • Aplastic Anemia
  • Iron Deficiency Anemia
  • Vitamin B12 and Folate Deficiency
  • Sickle Cell Anemia
  • Heart Disease
  • Thalassemia
  • Leukemia
  • Autoimmune Disorders
  • Cancer
  • Bleeding Disorders
  • Inflammation
  • Epstein-Barr Virus
  • Mononucleosis

Commonly Asked Questions: 

How does my health care provider use a Complete Blood Count test? 

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

NOTE: Only measurable biomarkers will be reported. Certain biomarkers do not appear in healthy individuals. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

Also Known As: CMP, Chem, Chem-14, Chem-12, Chem-21, Chemistry Panel, Chem Panel, Chem Screen, Chemistry Screen, SMA 12, SMA 20, SMA 21, SMAC, Chem test

Collection Method: 

Blood Draw 

Specimen Type: 

Serum 

Test Preparation: 

9-12 hours fasting is preferred. 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

What does a Comprehensive Metabolic Panel blood test check for? 

The complete metabolic panel (CMP) is a set of 20 tests that provides critical information to a healthcare professional about a person's current metabolic status, check for liver or kidney disease, electrolyte and acid/base balance, and blood glucose and blood protein levels. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the CMP: 

  • Albumin: this is a measure of Albumin levels in your blood. Albumin is a protein made by the liver that is responsible for many vital roles including transporting nutrients throughout the body and preventing fluid from leaking out of blood vessels. 

  • Albumin/Globulin Ratio: this is a ratio between your total Albumin and Globulin  

  • Alkaline Phosphatase: this is a measure of Alkaline phosphatase or ALP in your blood. Alkaline phosphatase is a protein found in all body tissues, however the ALP found in blood comes from the liver and bones. Elevated levels are often associated with liver damage, gallbladder disease, or bone disorder. 

  • Alt: this is a measure of Alanine transaminase or ALT in your blood. Alanine Aminotransferase is an enzyme found in the highest amounts in the liver with small amounts in the heart and muscles. Elevated levels are often associated with liver damage. 

  • AST: this is a measure of Aspartate Aminotransferase or AST. Aspartate Aminotransferase is an enzyme found mostly in the heart and liver, with smaller amounts in the kidney and muscles. Elevated levels are often associated with liver damage. 

  • Bilirubin, Total: this is a measure of bilirubin in your blood. Bilirubin is an orange-yellowish waste product produced from the breakdown of heme which is a component of hemoglobin found in red blood cells. The liver is responsible for removal of bilirubin from the body. 

  • Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

  • Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. 

  • Calcium: is used for blood clot formation and the formation and maintenance of bones and teeth. 

  • Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

  • Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

  • Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

  • Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Globulin: this is a measure of all blood proteins in your blood that are not albumin. 

  • Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

  • Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

  • Protein, Total: this is a measure of total protein levels in your blood. 
    Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

  • Sodium: this is a measure of sodium in your blood's serum. Sodium is a vital mineral for nerve and muscle cell function.

  • Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood UreaNitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

  • Complete Blood Count with Differential and Platelets
  • Iron and Total Iron Binding Capacity
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein

Conditions where a Comprehensive Metabolic Panel test is recommended: 

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension

Commonly Asked Questions: 

How does my health care provider use a Comprehensive Metabolic Panel test? 

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

What do my Comprehensive Metabolic Panel test results mean? 

The results of the tests included in the CMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. A high result on one of the liver enzyme tests, for example, is not the same as a high result on several liver enzyme tests. 

Several sets of CMPs, frequently performed on various days, may be examined to gain insights into the underlying disease and response to treatment, especially in hospitalized patients. 

Out-of-range findings for any of the CMP tests can be caused by a variety of illnesses, including kidney failure, breathing issues, and diabetes-related complications, to name a few. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

A wide range of prescription and over-the-counter medications can have an impact on the results of the CMP's components. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide a thorough history because many other circumstances can influence how your results are interpreted. 

What's the difference between the CMP and the BMP tests, and why would my doctor choose one over the other? 

The CMP consists of 14 tests, while the basic metabolic panel (BMP) is a subset of those with eight tests. The liver (ALP, ALT, AST, and bilirubin) and protein (albumin and total protein) tests are not included. If a healthcare provider wants a more thorough picture of a person's organ function or to check for specific illnesses like diabetes or liver or kidney disease, he or she may prescribe a CMP rather than a BMP. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 


Description: Creatine Kinase is a test that is measuring for the level of CK in the blood’s serum. CK is found in the heart tissue and the skeletal muscle. This test can be used to determine if there has been damage done to the muscles.

Also Known As: CK Test, Total Ck Test, Creatine Phosphokinase, CPK Test, CPK Level

Collection Method: Blood draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Creatine Kinase Total test ordered?

When muscle injury is suspected, a CK test may be requested, as well as at regular intervals to monitor for continuing damage. When a muscle illness, such as muscular dystrophy, is suspected, or when someone has suffered physical trauma, such as crushing injuries or major burns, it may be ordered. The test may be ordered if a person is experiencing symptoms of muscular damage, such as:

  • Muscle aches and pains
  • Muscle deterioration
  • Urine that is dark in color

When a person has nonspecific symptoms, testing may be recommended, especially if they are using a drug or have been exposed to a substance that has been associated to potential muscle damage.

What does a Creatine Kinase Total blood test check for?

The enzyme creatine kinase is found in the brain, heart, skeletal muscle, and other organs. When there is muscle injury, more CK is released into the bloodstream. The quantity of creatine kinase in the blood is measured in this test.

Skeletal muscles produce the little quantity of CK that is routinely found in the blood. An increase in CK can be caused by any disorder that causes muscular injury and/or interferes with muscle energy generation or usage. Strenuous activity and muscle inflammation, known as myositis, as well as muscle illnesses such muscular dystrophy, can raise CK levels. Rhabdomyolysis, or the severe breakdown of skeletal muscle tissue, is linked to a large increase in CK levels.

Lab tests often ordered with a Creatine Kinase Total test:

  • CK-MB
  • Myoglobin
  • Troponin
  • Lipid Panel
  • Hs-CRP
  • Homocysteine
  • Lipoprotein Fractionation, Ion Mobility

Conditions where a Creatine Kinase Total test is recommended:

  • Endocrine System and Syndromes
  • Lupus
  • Rheumatoid Arthritis
  • Heart Attack

How does my health care provider use a Creatine Kinase Total test?

A creatine kinase test can be used to detect muscle inflammation or damage caused by muscle illnesses such muscular dystrophy, or to help diagnose rhabdomyolysis if signs and symptoms are present. Other blood chemistry tests, such as electrolytes, BUN, or creatinine, may be conducted in addition to CK. A urine myoglobin test may be requested as well.

Muscle injury can present with few or vague symptoms such as weakness, fever, and nausea, which can also be associated with a range of other illnesses. In these circumstances, a healthcare practitioner may utilize a CK test to detect muscle injury, particularly if the person is taking a statin, using ethanol or cocaine, or has been exposed to a known toxin linked to probable muscle damage. A CK test may be used to assess and monitor muscle damage in those who have been physically injured.

Muscle injury can be tracked using a series of CK tests to evaluate if it improves or worsens. If a CK is increased and the site of muscle damage is unknown, a healthcare provider may order CK isoenzymes or a CK-MB as follow-up tests to differentiate between the three forms of CK: CK-MB, CK-MM, and CK-BB.

The CK test was originally one of the most common tests used to diagnose a heart attack, but the troponin test has mostly superseded it in the United States. The CK test, on the other hand, may be used to detect a second heart attack that occurs soon after the first.

What do my Creatine Kinase test results mean?

A high CK level, or a spike in levels in subsequent samples, often suggests that muscle injury has occurred recently, although it does not identify the location or origin of the damage. Serial test findings that peak and then begin to decline indicate that new muscle damage has subsided, whereas increasing and persistent elevations indicate that new muscle damage has persisted.

Increased CK levels can be detected in a range of muscular disorders caused by a variety of factors. Depending on the severity of muscle damage, people's CK levels may be significantly to severely elevated. Rhabdomyolysis patients may have CK levels that are 100 times higher than usual, and in some cases even higher.

Normal CK levels could mean there hasn't been any muscle injury or that it happened a few days before the test.

Following severe exercise, such as weight lifting, contact sports, or long exercise sessions, moderately elevated CK levels may be observed.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Creatine Kinase Isoenzymes is useful in the evaluation of myocardial disease. Isoenzyme MM is found in skeletal muscle whereas isoenzyme MB is increased in recent myocardial (heart) damage.

Clinical Significance

Bacterial sepsis constitutes one of the most serious infectious diseases. The detection of microorganisms in a patient's blood has importance in the diagnosis and prognosis of endocarditis, septicemia, or chronic bacteremia.

Includes

Aerobic culture, anaerobic culture. If culture is positive, identification will be performed at an additional charge (CPT code(s): 87076 or 87106 or 87077 or 87140 or 87143 or 87147 or 87149).
Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).