Iron Deficiency Anemia Test

Iron Deficiency Anemia Test and health information

Have you been feeling particularly weary, angry, or noticing that your skin appears paler than usual? Iron deficiency anemia is a disorder that can affect anyone. This is the most frequent kind of anemia in the world. 

Iron deficiency anemia can affect everyone; however, it is more common in women than males. It can have significant health repercussions if left unchecked. 

Iron deficiency anemia is anemia caused by a deficiency of iron in the body, as the name implies. Iron is a mineral that is stored predominantly in red blood cells. Your bone marrow stores it as well, albeit in smaller levels. 

You have fewer red blood cells if you have anemia of any kind, which is harmful since red blood cells deliver oxygen throughout your body and eliminate waste like carbon dioxide. Your entire health will begin to suffer if your body does not have enough blood cells. 

Because the first symptoms are typically mild and develop slowly, iron deficiency anemia can go undiagnosed for years. This is significant because a shortage of oxygen in the blood can harm your organs, including your heart and lungs if left untreated. It can also cause delays in children's development. 

Do you think you may benefit from an iron-deficient anemia test? 

Order your iron deficiency anemia tests below to determine if you have low red blood cell counts, hemoglobin levels, or hematocrit levels, and measure your serum ferritin level, which together can help you figure out if you have iron-deficiency anemia. 

Select your tests for anemia from the list below. Get your results in 24 to 48 hours online after your specimen collection. 

Find out more about this condition by clicking here. You'll learn about the risk factors for this, how it happens, what it looks like, how it's treated, the long-term effects, diagnosis, and how to get an iron deficiency anemia test.


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Description: Iron and Total Iron Binding Capacity is a blood panel used to determine iron levels in your blood, your body’s ability to transport iron, and help diagnose iron-deficiency and iron overload.

Also Known As: Serum Iron Test, Serum Fe Test, Iron Binding Capacity Test, IBC Test, Serum Iron-Binding Capacity Siderophilin Test, TIBC Test, UIBC Test, Iron Lab Test, TIBC Blood test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Iron and Total Iron Binding Capacity test ordered?

When a doctor feels that a person's symptoms are caused by iron overload or poisoning, an iron and TIBC test, as well ferritin assays, may be done. These may include the following:

  • Joint discomfort
  • Weakness and exhaustion
  • Energy deficiency
  • Pain in the abdomen
  • Suffering from a lack of sexual desire
  • Problems with the heart

When a child is suspected of ingesting too many iron tablets, a serum iron test is required to detect the poisoning and to determine its severity.

A doctor may also request iron and TIBC when the results of a standard CBC test are abnormal, such as a low hematocrit or hemoglobin, or when a doctor suspects iron deficiency based on signs and symptoms such as:

  • Chronic tiredness/fatigue
  • Dizziness
  • Weakness
  • Headaches
  • Skin that is pale

What does a Iron and Total Iron Binding Capacity blood test check for?

Iron is a necessary ingredient for survival. It is a vital component of hemoglobin, the protein in red blood cells that binds and releases oxygen in the lungs and throughout the body. It is required in small amounts to help form normal red blood cells and is a critical part of hemoglobin, the protein in RBCs that binds oxygen in the lungs and releases it as blood circulates to other parts of the body.

By detecting numerous components in the blood, iron tests are ordered to determine the quantity of iron in the body. These tests are frequently ordered at the same time, and the data are analyzed together to determine the diagnosis and/or monitor iron deficiency or overload.

The level of iron in the liquid component of the blood is measured by serum iron.

Total iron-binding capacity is a measurement of all the proteins in the blood that may bind to iron, including transferrin.

The percentage of transferrin that has not yet been saturated is measured by the UIBC. Transferrin levels are also reflected in the UIBC.

Low iron levels can cause anemia, resulting in a decrease in the production of microcytic and hypochromic RBCs. Large amounts of iron, on the other hand, might be hazardous to the body. When too much iron is absorbed over time, iron compounds build up in tissues, particularly the liver, heart, and pancreas.

Normally, iron is absorbed from food and distributed throughout the body by binding to transferrin, a liver protein. About 70% of the iron delivered is used in the synthesis of hemoglobin in red blood cells. The rest is stored as ferritin or hemosiderin in the tissues, with minor amounts being utilized to make other proteins like myoglobin and enzymes.

Insufficient intake, limited absorption, or increased dietary requirements, as observed during pregnancy or with acute or chronic blood loss, are all signs of iron deficiency. Excessive intake of iron pills can cause acute iron overload, especially in children. Excessive iron intake, genetic hemochromatosis, multiple blood transfusions, and a few other disorders can cause chronic iron overload.

Lab tests often ordered with a Iron and Total Iron Binding Capacity test:

  • Complete Blood Count
  • Ferritin
  • Transferrin
  • Zinc Protoporphyrin

Conditions where a Iron and Total Iron Binding Capacity test is recommended:

  • Anemia
  • Hemochromatosis

How does my health care provider use a Iron and Total Iron Binding Capacity test?

The amount of circulating iron in the blood, the capacity of the blood to carry iron, and the amount of stored iron in tissues can all be determined by ordering one or more tests. Testing can also assist distinguish between different types of anemia

The level of iron in the blood is measured by serum iron.

Total iron-binding capacity is a measurement of all the proteins in the blood that may bind to iron, including transferrin. The TIBC test is a useful indirect assessment of transferrin because it is the predominant iron-binding protein. In response to the requirement for iron, the body generates transferrin. Transferrin levels rise when iron levels are low, and vice versa. About one-third of the binding sites on transferrin are used to transport iron in healthy humans.

The reserve capacity of transferrin, or the part of transferrin that has not yet been saturated, is measured by UIBC. Transferrin levels are also reflected in the UIBC.

The iron test result, as well as TIBC or UIBC, are used to calculate transferrin saturation. It represents the proportion of transferrin that is iron-saturated.

Ferritin is the major storage protein for iron inside cells, and serum ferritin represents the quantity of stored iron in the body.

These tests are frequently ordered together, and the results can assist the doctor figure out what's causing the iron deficit or overload.

Additional information about iron

A balance between the quantity of iron received into the body and the amount of iron lost is required to maintain normal iron levels. Because a tiny quantity of iron is lost each day, a deficiency will develop if too little iron is consumed. In healthy persons, there is usually enough iron to prevent iron deficiency and/or iron deficiency anemia, unless they eat a bad diet. There is a greater need for iron in some circumstances. People who have persistent gut bleeding or women who have heavy menstrual periods lose more iron than they should and can develop iron deficiency. Females who are pregnant or breastfeeding lose iron to their babies and may develop an iron shortage if they do not consume enough supplemental iron. Children may require additional iron, especially during periods of rapid growth, and may suffer iron shortage.

Low serum iron can also arise when the body is unable to adequately utilize iron. The body cannot correctly utilize iron to generate additional red cells in many chronic disorders, particularly malignancies, autoimmune diseases, and chronic infections. As a result, transferrin production slows, serum iron levels drop because little iron is absorbed from the stomach, and ferritin levels rise. Malabsorption illnesses like sprue syndrome can cause iron deficiency.

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


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Description: Iron is a blood test used to determine iron levels in your blood, your body’s ability to transport iron, and help diagnose iron-deficiency and iron overload.

Also Known As: Serum Iron Test, Serum Fe Test, Iron Total Test, IBC Test, Iron Lab Test, Iron Blood test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: The patient should be fasting 9-12 hours prior to collection and collection should be done in the morning.

When is an Iron Total test ordered?

When a doctor feels that a person's symptoms are caused by iron overload or poisoning, an iron test, as well ferritin assays, may be done. These may include the following:

  • Joint discomfort
  • Weakness and exhaustion
  • Energy deficiency
  • Pain in the abdomen
  • Suffering from a lack of sexual desire
  • Problems with the heart

When a child is suspected of ingesting too many iron tablets, a serum iron test is required to detect the poisoning and to determine its severity.

A doctor may also request iron testing when the results of a standard CBC test are abnormal, such as a low hematocrit or hemoglobin, or when a doctor suspects iron deficiency based on signs and symptoms such as:

  • Chronic tiredness/fatigue
  • Dizziness
  • Weakness
  • Headaches
  • Skin that is pale

What does an Iron Total blood test check for?

Iron is a necessary ingredient for survival and is a critical component of hemoglobin, the protein in red blood cells that binds oxygen in the lungs and releases it to other parts of the body. It is required in small amounts to help form normal red blood cells and is a critical part of hemoglobin, the protein in RBCs that binds oxygen in the lungs and releases it as blood circulates to other parts of the body.

By detecting numerous components in the blood, iron tests are ordered to determine the quantity of iron in the body. These tests are frequently ordered at the same time, and the data are analyzed together to determine the diagnosis and/or monitor iron deficiency or overload.

The level of iron in the liquid component of the blood is measured by serum iron.

Low iron levels can cause anemia, resulting in a decrease in the production of microcytic and hypochromic RBCs. Large amounts of iron, on the other hand, might be hazardous to the body. When too much iron is absorbed over time, iron compounds build up in tissues, particularly the liver, heart, and pancreas.

Normally, iron is absorbed from food and distributed throughout the body by binding to transferrin, a liver protein. About 70% of the iron delivered is used in the synthesis of hemoglobin in red blood cells. The rest is stored as ferritin or hemosiderin in the tissues, with minor amounts being utilized to make other proteins like myoglobin and enzymes.

Insufficient intake, limited absorption, or increased dietary requirements, as observed during pregnancy or with acute or chronic blood loss, are all signs of iron deficiency. Excessive intake of iron pills can cause acute iron overload, especially in children. Excessive iron intake, genetic hemochromatosis, multiple blood transfusions, and a few other disorders can cause chronic iron overload.

Lab tests often ordered with an Iron Total test:

  • Complete Blood Count
  • Ferritin
  • Transferrin
  • Zinc Protoporphyrin

Conditions where an Iron Total test is recommended:

  • Anemia
  • Hemochromatosis

How does my health care provider use an Iron Total test?

The amount of circulating iron in the blood, the capacity of the blood to carry iron, and the amount of stored iron in tissues can all be determined by ordering one or more tests. Testing can also assist distinguish between different types of anemia

The level of iron in the blood is measured by serum iron.

Total iron-binding capacity is a measurement of all the proteins in the blood that may bind to iron, including transferrin. The TIBC test is a useful indirect assessment of transferrin because it is the predominant iron-binding protein. In response to the requirement for iron, the body generates transferrin. Transferrin levels rise when iron levels are low, and vice versa. About one-third of the binding sites on transferrin are used to transport iron in healthy humans.

The reserve capacity of transferrin, or the part of transferrin that has not yet been saturated, is measured by UIBC. Transferrin levels are also reflected in the UIBC.

The iron test result, as well as TIBC or UIBC, are used to calculate transferrin saturation. It represents the proportion of transferrin that is iron-saturated.

Ferritin is the major storage protein for iron inside cells, and serum ferritin represents the quantity of stored iron in the body.

These tests are frequently ordered together, and the results can assist the doctor figure out what's causing the iron deficit or overload.

Additional information about iron

A balance between the quantity of iron received into the body and the amount of iron lost is required to maintain normal iron levels. Because a tiny quantity of iron is lost each day, a deficiency will develop if too little iron is consumed. In healthy persons, there is usually enough iron to prevent iron deficiency and/or iron deficiency anemia, unless they eat a bad diet. There is a greater need for iron in some circumstances. People who have persistent gut bleeding or women who have heavy menstrual periods lose more iron than they should and can develop iron deficiency. Females who are pregnant or breastfeeding lose iron to their babies and may develop an iron shortage if they do not consume enough supplemental iron. Children may require additional iron, especially during periods of rapid growth, and may suffer iron shortage.

Low serum iron can also arise when the body is unable to adequately utilize iron. The body cannot correctly utilize iron to generate additional red cells in many chronic disorders, particularly malignancies, autoimmune diseases, and chronic infections. As a result, transferrin production slows, serum iron levels drop because little iron is absorbed from the stomach, and ferritin levels rise. Malabsorption illnesses like sprue syndrome can cause iron deficiency.

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


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Description: A Ferritin test is a blood test that measures Ferritin levels in your blood’s serum to evaluate the level of iron stored in your body.

Also Known As: Ferritin Serum Test, Ferritin Test, Ferritin Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Ferritin test ordered?

When a CBC test’s implies iron deficiency anemia due to small red blood cells or low hematocrit and hemoglobin levels, the ferritin test, and other iron tests, may be requested, even if other clinical symptoms have not yet arisen.

There are frequently no physical symptoms in the early stages of iron insufficiency. Symptoms rarely develop before hemoglobin falls below dangerous levels. However, when the iron deficit continues, symptoms emerge, prompting a doctor to order ferritin and other iron-related testing. The following are the most prevalent symptoms of iron deficiency anemia:

  • Chronic tiredness/fatigue
  • Weakness
  • Dizziness
  • Headaches
  • Skin that is pale

Shortness of breath, ringing in the ears, sleepiness, and irritability may occur as iron levels are reduced. Chest pain, headaches, limb pains, shock, and even heart failure may occur as the anemia worsens. Learning impairments can occur in children. There are some symptoms that are specific to iron deficiency, in addition to the usual signs of anemia. Pica, a burning feeling in the tongue or a smooth tongue, ulcers at the corners of the mouth, and spoon-shaped finger- and toe-nails are only a few of the symptoms.

When iron overload is suspected, a ferritin level may be requested. Iron overload symptoms differ from person to person and tend to worsen over time. They are caused by an excess of iron in the blood and tissues. Among the signs and symptoms are:

  • Joint discomfort
  • Weakness and exhaustion
  • Loss of weight
  • Energy deficiency
  • Pain in the abdomen
  • Suffering from a lack of sexual desire
  • Hair loss on the body
  • Congestive heart failure is an example of a cardiac issue

Other iron tests including a genetic test for hereditary hemochromatosis may be conducted to confirm the existence of iron excess.

What does a Ferritin blood test check for?

Ferritin is an iron-containing protein that stores iron in cells in its most basic form. The amount of total iron stored in the body is reflected in the little amount of ferritin released into the blood. This test determines how much ferritin is present in the blood.

About 70% of the iron consumed by the body is integrated into the hemoglobin of red blood cells in healthy humans. The remaining 30% is stored primarily as ferritin or hemosiderin, which is a combination of iron, proteins, and other elements. Hemosiderin and ferritin are typically found in the liver, although they can also be found in the bone marrow, spleen, and skeletal muscles.

Iron stores are depleted and ferritin levels fall when available iron is insufficient to meet the body's needs. This can happen owing to a lack of iron, poor absorption, or an increased need for iron, such as during pregnancy or if you have a condition that causes persistent blood loss. Before any indicators of iron shortage appear, significant loss of iron reserves may occur.

When the body absorbs more iron than it needs, iron storage and ferritin levels rise. Chronic iron absorption causes a gradual buildup of iron compounds in organs, which can eventually lead to organ malfunction and failure. Even on a typical diet, this happens in hemochromatosis, a hereditary disorder in which the body absorbs too much iron.

Lab tests often ordered with a Ferritin test:

  • Complete Blood Count
  • Iron Total
  • Iron Total and Total Iron binding capacity
  • Transferrin
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Zinc Protoporphyrin

Conditions where a Ferritin test is recommended:

  • Anemia
  • Hemochromatosis
  • Lead poisoning
  • Pregnancy
  • Restless Leg Syndrome

How does my health care provider use a Ferritin test?

The ferritin test is used to determine the amount of iron a person has in their body. To determine the existence and severity of iron shortage or iron overload, the test is sometimes ordered in conjunction with an iron test and a TIBC test.

One source of iron overload can be the use of iron supplements.

What does my ferritin lab test result mean?

Ferritin levels are frequently measured alongside other iron tests.

Ferritin levels are low in iron deficient people and high in people who have hemochromatosis or have had several blood transfusions.

Ferritin is an acute phase reactant that can be elevated in persons who have inflammation, liver illness, chronic infection, autoimmune disorders, or cancer. Ferritin isn't commonly utilized to detect or monitor these problems.

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


Ferritin, Iron and Total Iron Binding Capacity (TIBC)

  • Ferritin
  • Iron and Total Iron Binding Capacity (TIBC)

Ferritin, Iron and TIBC Panel contains: Ferritin, Iron and Total Iron Binding Capacity (TIBC)


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Description: Transferrin is a blood test used to measure the amount of transferrin in the blood's serum. It is used to evaluate if there is a proper amount of iron being transport throughout the body. A test called Total Iron Binding Capacity, or TIBC, will tell you how much of that transferrin is capable of transporting, or binding to the iron in the blood.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for at least 12 hours is required

When is a Transferrin test ordered?

When a doctor wants to analyze or monitor a person's nutritional health, a transferrin test may be ordered along with additional tests like prealbumin.

What does a Transferrin blood test check for?

The primary protein in the blood that bonds to iron and transfers it across the body is transferrin. Total iron binding capacity, unsaturated iron binding capacity, and transferrin saturation are all measures of how much transferrin is available to bind to and transport iron.

The transferrin serum test, along with TIBC, UIBC, and transferrin saturation, measures the blood's ability to bind and transport iron, and is an indicator of iron storage.

Lab tests often ordered with a Transferrin test:

  • Iron Total
  • Iron Total and Total Iron Binding Capacity
  • Ferritin
  • Complete Blood Count (CBC)
  • Hemoglobin
  • Hematocrit
  • Reticulocyte Count

Conditions where a Transferrin test is recommended:

  • Iron Deficiency Anemia
  • Hemochromatosis
  • Liver Disease
  • Malnutrition

How does my health care provider use a Transferrin test?

When assessing a person's nutritional state or liver function, a transferrin test is commonly performed. Transferrin will be low in people with liver disease because it is produced in the liver. Transferrin levels fall when there isn't enough protein in the diet, so this test is used to keep track of your diet.

What do my transferrin test results mean?

The findings of transferrin testing are frequently compared to the results of other iron tests.

If you have the following conditions, you may have a low transferrin level:

  • Hemochromatosis
  • Anemia caused by a build-up of iron in the body can cause a variety of symptoms.
  • Malnutrition
  • Inflammation
  • Hepatitis
  • A kidney ailment that causes protein loss in the urine such as nephrotic syndrome

When there is an iron deficit, transferrin saturation decreases, and when there is an overabundance of iron, such as in iron overload or poisoning, it increases.

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: Methylmalonic Acid, also known as MMA, is a blood test used to detect Vitamin B12 deficiency early on before an individual becomes deficient or when there is a mild deficiency already present. MMA can also be used to diagnose methylmalonic acidemia in newborns.

Also Known As: MMA Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Methylmalonic Acid test ordered?

When a vitamin B12 test result comes back low, an MMA test may be performed, sometimes coupled with a homocysteine test.

Asymptomatic persons with a higher risk of vitamin B12 insufficiency, such as the elderly, or those using certain medicines for a long period, such as Metformin, are also given MMA. If the two tests are not scheduled together, an MMA test may be ordered as a follow-up to an increased homocysteine level.

When a doctor fears that an acutely unwell child has inherited methylmalonic acidemia, MMA testing may be recommended.

What does a Methylmalonic Acid blood test check for?

Methylmalonic acid is a naturally occurring chemical that is required for human metabolism and energy generation. Vitamin B12 aids in the conversion of methylmalonyl CoA to succinyl Coenzyme A in one step of metabolism. If there isn't enough B12, the MMA concentration rises, resulting in an increase in MMA levels in the blood and urine. Methylmalonic acid levels that are high in the blood or urine are a sensitive and early sign of vitamin B12 insufficiency.

Anemia and the formation of big red blood cells can occur as a result of vitamin B12 deficiency over time. It can also induce neuropathy symptoms including numbness and tingling in the hands and feet, as well as mental or behavioral problems like cognitive impairment, disorientation, irritability, and depression in severe cases. Though some patients may have some degree of neuropathy, an increased concentration of MMA may frequently be detected before blood cell alterations and full-blown symptoms appear.

Although the link between MMA and B12 has been recognized for over 40 years, MMA testing is not widely used, and there is no consensus on its clinical relevance. Some doctors believe that MMA is a better indicator of bioavailable B12 than the standard vitamin B12 test since a considerable portion of B12 detected in the blood is bound to proteins and is not biologically active. Others feel that measuring MMA and homocysteine can help detect early and mild B12 insufficiency. Others believe that many moderate deficits diagnosed do not evolve to more serious deficiencies and so do not require identification or treatment.

Methylmalonic acidemia is a rare metabolic condition that affects roughly 1 in 25,000 to 100,000 people. Testing babies for high levels of MMA could help doctors diagnose it. Screening for this disease is required in all 50 states in the United States. This condition prevents babies from converting methylmalonyl Coenzyme A to succinyl Coenzyme A.

Lab tests often ordered with a Methylmalonic Acid test:

  • Vitamin B12
  • Folate
  • Homocysteine
  • Intrinsic Factor Antibody
  • Complete Blood Count (CBC)
  • Reticulocyte Count
  • Parietal Cell Antibody

Conditions where a Methylmalonic Acid test is recommended:

  • Vitamin B12 Deficiency
  • Folate Deficiency
  • Anemia

How does my health care provider use a Methylmalonic Acid test?

The methylmalonic acid test can be used to determine a vitamin B12 deficiency that is mild or early. It can be ordered alone or in conjunction with a homocysteine test as a follow-up to a vitamin B12 test result that falls below the normal range.

MMA is a chemical produced in the body in extremely minute amounts. It is required for metabolism and the creation of energy. Vitamin B12 aids in the conversion of methylmalonyl CoA to succinyl Coenzyme A in one step of metabolism. If there isn't enough B12, the MMA level rises, resulting in an increase in MMA levels in the blood and urine. Methylmalonic acid levels in the blood or urine can be used to detect vitamin B12 insufficiency early.

There are currently no standards for screening asymptomatic adults for vitamin B12 deficiency, however those at high risk without symptoms, such as the elderly or those taking particular drugs for a long time, may require confirmation with MMA and/or homocysteine.

The MMA test is quite sensitive in detecting a B12 deficiency. It is the preferred confirmatory test for a B12 deficiency because it is more specific than homocysteine.

MMA testing may be conducted in some cases to assist detect methylmalonic acidemia, a rare inherited metabolic condition. In all 50 states in the United States, newborn screening programs currently require testing for this disease.

What do my Methylmalonic Acid test results mean?

Early stages of B12 deficiency may be evident if MMA and homocysteine levels are elevated while vitamin B12 levels are mildly diminished. This could indicate a decrease in B12 availability in the tissues.

If only the homocysteine level is high but not the MMA, the person may be deficient in folate. This distinction is critical because treating anemia with folate treats the anemia but not the brain damage, which may be irreparable.

If both MMA and homocysteine levels are within normal limits, a B12 shortage is unlikely.

Infants with the rare hereditary illness methylmalonic acidemia may have moderately to severely high levels of MMA.

Reduced MMA levels are uncommon and are not considered clinically significant.

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


Osmotic (RBC) Fragility is used to assess disorders of the erythrocyte membrane. Increased osmotic fragility is found in hereditary spherocytosis, other RBC membrane disorders, and in idiopathic acquired hemolytic anemias. Diminished fragility is seen in conditions in which target cells are found.

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Description: Reticulocytes are red blood cells that are not fully developed yet. The reticulocyte test is used to measure the amount of underdeveloped red blood cells.

Also Known As: Retic Count Reticulocyte Percent Test, Reticulocyte Index Test, Corrected Reticulocyte Test, Reticulocyte Production Index Test, RPI Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Reticulocyte Count test ordered?

A reticulocyte count may be requested in the following situations:

  • A low RBC count, as well as a low hemoglobin and hematocrit, are found on a complete blood count.
  • A doctor wants to check the function of the bone marrow.
  • Paleness, loss of energy, exhaustion, weakness, shortness of breath, and/or blood in the stool are signs and symptoms of anemia or persistent bleeding.
  • A disorder known to impact RBC production, such as iron deficiency anemia, vitamin B12 or folate deficiency, or renal illness, has been recognized and is being treated.
  • A person is receiving radiation or chemotherapy.
  • A bone marrow transplant has been performed.

When a person has an increased quantity of RBCs and an elevated hemoglobin and hematocrit, a blood test is performed to evaluate the degree and pace of RBC overproduction.

What does a Reticulocyte Count blood test check for?

Reticulocytes are young red blood cells that have just been created. The number and/or percentage of reticulocytes in the blood is determined by a reticulocyte test, which is a reflection of recent bone marrow function or activity.

Red blood cells are made in the bone marrow, where blood-forming stem cells differentiate and grow into reticulocytes, which then mature into mature RBCs. When compared to mature RBCs, reticulocytes have a volume of about 24 percent more. Although adult RBCs do not have a nucleus like most other cells in the body, reticulocytes still contain some genetic material. Reticulocytes lose the last traces of RNA as they mature, and most of them are fully matured within a day of being released from the bone marrow into the bloodstream. The reticulocyte count or percentage is an excellent measure of a person's ability to manufacture enough red blood cells in their bone marrow.

RBCs last around 120 days in circulation, and the bone marrow must constantly manufacture new RBCs to replace those that have aged and degraded or have been lost due to hemorrhage. Normally, a steady number of RBCs is maintained in the blood by replacing deteriorated or lost RBCs on a regular basis.

A range of diseases and conditions, including those that cause severe bleeding, can impair the creation of new RBCs and/or their survival. These situations can cause an increase or decrease in the number of RBCs, as well as a change in the reticulocyte count.

Reticulocyte % higher than normal: Anemia is caused by a lack of RBCs in the blood due to acute or chronic bleeding or enhanced RBC breakdown (hemolysis). The body adjusts for this loss or responds to deficiency anemia treatment by increasing RBC production and releasing RBCs into the bloodstream before they mature. When this happens, the number and percentage of reticulocytes in the blood grows until the bone marrow's production capacity is reached or until a sufficient number of RBCs replaces those that were lost.

A lower-than-normal percentage of reticulocytes: When the bone marrow isn't working properly, RBC production can suffer. A bone marrow condition, such as aplastic anemia, can cause this. Other causes that might cause decreased production include liver cirrhosis, kidney disease, cancer treatments such as radiation or chemotherapy, a low amount of the hormone erythropoietin, or dietary shortages such as iron, vitamin B12, or folate. As old RBCs are eliminated from the blood but not entirely replaced, there are fewer RBCs in circulation, poorer hemoglobin and oxygen-carrying capacity, a lower hematocrit, and a lower number of reticulocytes.

Due to excessive RBC production by the bone marrow, both the reticulocyte and RBC counts might occasionally rise. This could be caused by increased erythropoietin production, diseases that cause chronic RBC overproduction (polycythemia vera), or cigarette smoking.

Some medications can increase or reduce the number of reticulocytes in the body.

Lab tests often ordered with a Reticulocyte Count test:

  • Complete Blood Count (CBC)
  • Red Blood Cell Count
  • Hemoglobin
  • Hematocrit
  • Blood Smear
  • Erythropoietin
  • Vitamin B12
  • Folate
  • Haptoglobin
  • G6PD
  • Iron Total
  • Iron and Total Iron Binding Capacity
  • Ferritin

Conditions where a Reticulocyte Count test is recommended:

  • Anemia
  • Bone Marrow Disorders
  • Myeloproliferative Neoplasms

How does my health care provider use a Reticulocyte Count test?

A reticulocyte test is used to assess the number and/or percentage of reticulocytes in the blood to aid in the diagnosis of red blood cell abnormalities such as anemia and bone marrow illnesses. Reticulocytes are young red blood cells that have just been created. Before being released into the circulation, they develop and mature in the bone marrow.

The reticulocyte test can be used in the following situations:

  • To help determine the reason of aberrant results on a complete blood count, RBC count, hemoglobin, or hematocrit.
  • To see if the bone marrow is appropriately functioning and reacting to the body's need for red blood cells.
  • To aid in the detection and differentiation of various kinds of anemia
  • To track how well people are responding to treatments, such as those for iron deficiency anemia.
  • To track the activity of the bone marrow after therapies like chemotherapy.
  • To keep track of how well you're doing after a bone marrow transplant.

A reticulocyte count is usually done using an automated device and can be done in conjunction with a complete blood count, which includes an RBC count, hemoglobin, and hematocrit. It is possible to report either an absolute number of reticulocytes or a percentage of reticulocytes. The number of reticulocytes is compared to the total number of red blood cells as a percentage:

[ Number of Reticulocytes / Total Red Blood Cells ] X 100 = Reticulocyte Percentage

Several more tests, in addition to a reticulocyte count, can be done to further screen someone for a disorder that affects RBC production. Here are a few examples:

  • Iron testing
  • Haptoglobin
  • G6PD
  • Erythropoietin
  • Vitamin B12 and Folate

Following up on abnormal results from early tests, a bone marrow aspiration and biopsy may be performed. This is an invasive operation that is not performed on everyone. If necessary, it can, however, supply extra information.

What do my reticulocyte count test results mean?

The results must be carefully evaluated in conjunction with the results of other tests, such as a red blood cell count, hemoglobin, hematocrit, or a complete blood count. The reticulocyte count, in general, reflects recent bone marrow activity. The results could reveal whether a disease or condition is present that is causing an elevated need for new RBCs, as well as whether the bone marrow is capable of meeting that demand. Overproduction of RBCs may be detected in some cases.

When anemia is present and the bone marrow responds adequately to the demand for more RBCs, the bone marrow will create more and allow for the early release of more immature RBCs, resulting in an increase in the number of reticulocytes in the blood.

A high reticulocyte count along with low RBCs, hemoglobin, and hematocrit may indicate the following conditions:

  • When a person bleeds, the number of reticulocytes increases after a few days to make up for the loss of red blood cells. If someone has chronic blood loss, the marrow will try to keep up with the need for new RBCs by increasing the number of reticulocytes.
  • Anemia is caused by an increase in the breakdown of RBCs in hemolytic anemia. To compensate, the bone marrow boosts RBC production, resulting in a high reticulocyte count.
  • Hemolytic illness of the newborn: Similar to hemolytic anemia, this syndrome causes an increase in RBC destruction.

For example, a low reticulocyte count with low hemoglobin, low red blood cells, and low hematocrit can be detected when:

  • Anemia due to a lack of iron
  • Folic acid deficiency or pernicious anemia
  • Aplastic anemia is a kind of anemia that occurs when the
  • Radiation therapy is a type of treatment that uses a
  • Infection or malignancy can induce bone marrow failure.
  • A low level of erythropoietin can be caused by severe kidney disease.
  • Alcoholism
  • Endocrine illness

When a person has anemia, the percentage of reticulocytes in their blood may appear to be higher than the total number of RBCs. A calculation known as a corrected reticulocyte count or reticulocyte index may be reported to get a more accurate estimate of bone marrow function. When a person's hematocrit is compared to a normal hematocrit reading, the RI is computed. The reticulocyte production index and an immature reticulocyte fraction are two more estimates that may be presented. The IRF was once known as the reticulocyte maturity index, but it is currently the most widely used phrase to describe the younger percentage of reticulocytes.

The existence of a disease or condition is indicated by the reticulocyte test, however it is not specifically diagnostic of any disease. It's a warning that more research is needed, as well as a method for monitoring therapy effectiveness.

When reticulocyte numbers increase after chemotherapy, a bone marrow transplant, or treatment for an iron, vitamin B12, or folate shortage, bone marrow RBC production is on the mend.

A high reticulocyte count can indicate an overproduction of RBCs in people who do not have anemia or have a high RBC count. This can be caused by a variety of factors, including:

  • Polycythemia vera
  • Excess erythropoietin-producing tumor

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


Test not available in the following States: CA, MD, NY, PA and RI.


Soluble Transferrin Receptor (sTFR) values can be within normal limits over a broad range of body iron stores and is elevated only when there is functional (i.e. cellular) iron deficiency. It is usually not affected by chronic disease states, sTFR levels are about 6% higher in people in high altitudes (above 5200 ft/1600 m) and in African-Americans. Reference value may not apply to pregnant females and recent or frequent blood donors.

Description: The Zinc Protoporphyrin test is a blood test that measures levels of zinc protoporphyrin in your blood to screen for lead exposure and iron deficiency anemia.

Also Known As: ZP Test, ZPP Test, Free Erythrocyte Protoporphyrin Test, FEP Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Zinc Protoporphyrin test ordered?

When long term exposure to lead is known or suspected, ZPP may be done in addition to a lead test.

When an individual participates in a program for occupational lead monitoring or when they regularly come into contact with lead through a pastime, such as working with stained glass, the test may be required.

ZPP may be requested when there is a suspicion of iron insufficiency in children or adolescents or as a screening test for the condition.

What does a Zinc Protoporphyrin blood test check for?

Small levels of zinc protoporphyrin are typically found in red blood cells, although the level may rise in lead poisoning and iron shortage patients. The ZPP level in the blood is determined by this test.

It is first required to understand heme in order to comprehend how lead poisoning and iron deficiencies impact the ZPP level. The protein hemoglobin, which is found in red blood cells and delivers oxygen from the lungs to the body's tissues and cells, must have heme as one of its constituent parts.

An iron atom is inserted into the core of a molecule known as protoporphyrin to complete the process of heme synthesis. When zinc is present, as in lead poisoning, or when iron cannot be inserted into the body, as in iron shortage, protoporphyrin combines with zinc to create zinc protoporphyrin. Since ZPP cannot bind to oxygen, it has no functional function in red blood cells.

Lab tests often ordered with a Zinc Protoporphyrin test:

  • Iron Total
  • Iron and Total Iron Binding Capacity
  • Ferritin
  • Hemoglobin
  • Hematocrit
  • Complete Blood Count (CBC)

Conditions where a Zinc Protoporphyrin test is recommended:

  • Lead poisoning
  • Iron Deficiency Anemia

How does my health care provider use a Zinc Protoporphyrin test?

Iron deficiency in children and chronic lead poisoning in adults are the two main conditions for which zinc protoporphyrin is prescribed.

Red blood cells often contain modest levels of the chemical ZPP. The majority of the protoporphyrin in red blood cells interacts with iron to create heme, which is the oxygen-carrying molecule in hemoglobin. When there is not enough iron available to produce heme, as in iron deficiency, or when lead is present and prevents the synthesis of heme, as in lead poisoning, zinc joins with protoporphyrin instead of iron. With these conditions, the blood's ZPP concentration will increase.

To test for chronic lead exposure, ZPP testing may be requested in addition to a lead level. People who reside in older homes and hobbyists who work with materials containing lead may be more susceptible to contracting lead poisoning. Lead levels may be enhanced in those who inhale lead-containing dust, touch lead directly, contaminate their hands, and then eat. Lead and ZPP levels in children who eat lead-containing paint chips may be raised.

The Occupational Safety & Health Administration highly advises that a ZPP test be done each time a lead level is requested in an industrial setting in order to monitor an employee's exposure to lead. Both are required since ZPP does not alter fast when a person's source of lead exposure is eliminated and it does not represent recent or acute lead exposure. ZPP is most effective at determining a person's average lead exposure over the previous 3–4 months.

As readings do not increase until lead concentrations are over the permissible threshold, ZPP is not sensitive enough to be used as a lead screening test in children. The Centers for Disease Control and Prevention have established a very low level as the maximum lead concentration deemed acceptable for children. To identify lead exposure in this age range, tests that assess the blood lead levels are performed.

The ZPP test may be requested in order to detect iron insufficiency in children at an early stage. Most young people will have elevated ZPP levels prior to showing any signs or symptoms of anemia, which is one of the early indicators of inadequate iron storage. To confirm iron insufficiency, more detailed testing of iron status are needed.

What do my Zinc Protoporphyrin test results mean?

Typically, there is very little ZPP in the blood. The cause of a disruption in heme production can be inferred from an increase in ZPP, but the explanation is not always clear. Iron deficiency and lead poisoning are the main causes of increases in ZPP.

It's crucial to consider a person's history, clinical observations, and the outcomes of additional tests including ferritin, lead, and a complete blood count when evaluating ZPP levels. The patient may suffer from both lead toxicity and iron deficiencies.

ZPP represents the average lead level over the past three to four months in situations of chronic lead exposure. A ZPP test, however, cannot identify the quantity of lead that is now present in the blood as well as the amount that is present in the organs and bones. Following exposure, ZPP values increase more gradually than blood lead concentrations, and they take longer to decline once lead exposure has ended.

The most frequent cause of an increase in ZPP in children is iron insufficiency. Following iron supplementation, a declining ZPP value over time certainly suggests a successful course of treatment.

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


Description: A Vitamin B12 test is a blood test that measures the level of Vitamin B12 in the blood’s serum and is used to detect Vitamin B12 deficiency.

Also Known As:  B12 Test, Cobalamin Test, Vitamin B12 test, Serum B12 Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: No preparation required. 

When is a Vitamin B12 test ordered?  

When a complete blood count and/or blood smear, performed as part of a health checkup or anemia evaluation, reveal a low red blood cell count with the presence of big RBCs, vitamin B12 levels may be ordered. A high mean corpuscular volume implies that the RBCs have grown in size. 

When a person exhibits the following signs and symptoms of a deficit, testing for B12 levels may be necessary: 

  • Diarrhea 
  • Dizziness 
  • Muscle weakness, fatigue 
  • Appetite loss. 
  • Skin that is pale 
  • Irregular heartbeats, rapid heart rate 
  • Breathing problems 
  • Tongue and mouth ache 
  • In the feet, hands, arms, and legs, there is tingling, numbness, and/or burning 
  • Confusion or obliviousness 
  • Paranoia 

When a person is at risk of deficiency, such as those with a history of malnutrition or a condition associated to malabsorption, B12 tests may be required. 

Individuals being treated for malnutrition or a B12 or folate deficit may have these tests done on a frequent basis to see how effective their treatments are. This could be part of a long-term therapy plan for people who have a disease that causes chronic deficiency.  

What does a Vitamin B12 blood test check for? 

Vitamin B12 is a member of the vitamin B complex. It is required for the creation of normal red blood cells, tissue and cell healing, and the synthesis of DNA, the genetic material in cells. Vitamin B12 is a nutrient that the body cannot make and must be obtained through the diet. 

Vitamin B12 deficiency is detected by measuring vitamin B12 in the liquid portion of the blood. 

A B12 deficiency can cause macrocytic anemia, which is characterized by red blood cells that are bigger than normal. Megaloblastic anemia is a kind of macrocytic anemia marked by the generation of fewer but larger RBCs known as macrocytes, as well as cellular abnormalities in the bone marrow. Reduced white blood cell and platelet count are two other test results linked to megaloblastic anemia. 

B12 is also necessary for nerve function, and a lack of it can induce neuropathy, which causes tingling and numbness in the hands and feet of those who are affected. 

B12 deficiency is most commonly caused by a lack of vitamin B12 in the diet or supplements, insufficient absorption, or an increased requirement, such as during pregnancy. 

Lab tests often ordered with a Vitamin B12 test: 

  • Folate 
  • Methylmalonic Acid (MMA) 
  • Homocysteine 
  • Vitamin B1 
  • Vitamin B2 
  • Vitamin B3 
  • Vitamin B5 
  • Vitamin B6 
  • Vitamin B7 
  • Rheumatoid factor 

Conditions where a Vitamin B12 test is recommended:

  • Vitamin B12 Deficiency 
  • Pernicious Anemia 
  • Nerve Damage 
  • Malabsorption 
  • Malnutrition 

How does my health care provider use a Vitamin B12 test? 

Vitamin B12 and folate are frequently used in conjunction to detect deficiencies and to aid in the diagnosis of anemias such as pernicious anemia, an inflammatory condition that inhibits B12 absorption. 

B12 and folate are two vitamins that the body cannot generate and must be obtained from the diet. They are essential for the creation of normal red blood cells, tissue and cell repair, and the synthesis of DNA, the genetic material in cells. B12 is required for normal nerve function. 

B12 and folate tests can also be used to assess someone who is experiencing mental or behavioral changes, especially in the elderly. A B12 test can be ordered with or without folate, as well as with other screening laboratory tests like a complete blood count, comprehensive metabolic panel, antinuclear antibody, C-reactive protein, and rheumatoid factor to help determine why a person is exhibiting signs and symptoms of a nerve condition. 

B12 and folate tests can also be performed in conjunction with a variety of other tests to assess a person's overall health and nutritional status if they have signs and symptoms of substantial malnutrition or dietary malabsorption. People with alcoholism, liver disease, stomach cancer, or malabsorption diseases including celiac disease, inflammatory bowel disease, or cystic fibrosis may fall into this category. 

Testing may be performed to assess the success of treatment in patients with known B12 and folate deficits. This is especially true for people who cannot absorb B12 and/or folate effectively and must be treated for the rest of their lives. 

Folate levels in the blood's serum might fluctuate depending on a person's recent diet. Because red blood cells contain 95 percent of circulating folate, a test to evaluate folate levels inside RBCs could be employed instead of or in addition to the serum test. Some doctors believe that the RBC folate test is a better predictor of long-term folate status and is more clinically useful than serum folate, however there is no consensus on this. 

Homocysteine and methylmalonic acid are two more laboratory tests that can be used to detect B12 and folate deficits. In B12 deficiency, both homocysteine and MMA are high, whereas in folate deficit, only homocysteine, not MMA, is elevated. This distinction is critical because treating anemia with folate treats the anemia but not the brain damage, which may be irreparable. 

What do my Vitamin B12 test results mean? 

Normal B12 and folate levels may indicate that a person does not suffer from a deficiency and that the signs and symptoms they are experiencing?are caused by something else. Normal levels, on the other hand, may indicate that a person's stored B12 and/or folate has not yet been depleted. 

A health practitioner may order a methylmalonic acid test as an early sign of B12 deficiency if a B12 level is normal but a deficiency is still suspected. 

A low B12 and/or folate level in a person with signs and symptoms implies a deficiency, although it does not always indicate the severity of the anemia or related neuropathy. Additional tests are frequently performed to determine the source of the deficit. Low B12 or folate levels can be caused by a variety of factors. 

Dietary folate or B12 deficiency, which?is uncommon in the United States. It can be evident in people who are malnourished in general and vegans who do not eat any animal products. Folate deficiency has become extremely rare since the development of fortified cereals, breads, and other grain products. 

Both B12 and folate deficits can be caused by diseases that prevent them from being absorbed in the small intestine. These may include the following: 

  • Pernicious anemia 
  • Celiac disease 
  • Crohn's disease and ulcerative colitis are examples of inflammatory bowel disease. 
  • Bacterial overgrowth or the presence of parasites in the intestines, such as tapeworms 
  • Long-term usage of antacids or H2 proton pump inhibitors reduces stomach acid production. 
  • Absorption can be considerably reduced by surgery that removes part of the stomach or the intestines, such as gastric bypass. 
  • Insufficiency of the pancreas 
  • Chronic alcoholism or heavy drinking 
  • Some treatments, such as metformin, omeprazole, methotrexate, or anti-seizure medications like phenytoin, are used. 
  • Increased requirements for healthy fetal development, all pregnant women require an increased amount of folate and are advised to consume 400 micrograms of folic acid every day. The need for folate is higher in those who have cancer that has spread or who have chronic hemolytic anemia. 
  • Smoking 

If a person is being treated for a B12 or folate deficit with supplements, normal or higher findings suggest that the treatment is working. 

High amounts of B12 are uncommon, and they aren't routinely evaluated clinically. If a person has a condition such chronic myeloproliferative neoplasm, diabetes, heart failure, obesity, AIDS, or severe liver disease, their vitamin B12 level may be elevated. High B12 levels can also be caused by using estrogens, vitamin C, or vitamin A. 

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


Description: A B12 and Folate test measures the levels of B12 and folic acid in the blood. These results can be used to determine a B12 and/or folate deficiency and evaluate a person's nutritional status. Anemia and Neuropathy can also be evaluated using the results from this test.

Also Known As: Vitamin B12 and Folate test, Cobalamin and Folic Acid Test, Vitamin B12 and Vitamin B9 Test, Vitamin B12 Test, Vitamin B9 Test, Cobalamin Test, Folic Acid Test, Folate Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is Vitamin B12 and Folate panel test ordered?

When a complete blood count and/or blood smear, performed as part of a health checkup or anemia evaluation, reveal a low red blood cell count with the presence of big RBCs, B12 and folate levels may be ordered. A high mean corpuscular volume, in particular, implies that the RBCs are enlarged.

When a person exhibits the following signs and symptoms of a deficit, testing for B12 and folate levels may be necessary.

  • Diarrhea
  • Dizziness
  • Muscle weakness, fatigue
  • Appetite loss.
  • Skin that is pale
  • Irregular heartbeats, rapid heart rate
  • Breathing problems
  • Tongue and mouth ache
  • In the feet, hands, arms, and legs, there is tingling, numbness, and/or burning 
  • Confusion or obliviousness
  • Paranoia

When a person is at risk of deficiency, such as those with a history of malnutrition or a condition associated to malabsorption, B12 and folate testing may be ordered.

Individuals being treated for malnutrition or a B12 or folate deficit may have these tests done on a frequent basis to see how effective their treatments are. This could be part of a long-term therapy plan for people who have a disease that causes chronic deficiency.

What does a Vitamin B12 and Folate panel blood test check for?

The B complex of vitamins includes vitamins including vitamin B12 and folate. They are required for the creation of normal red blood cells, tissue and cell repair, and the synthesis of DNA, the genetic material in cells. Both are nutrients that the body cannot make and must be obtained from the diet.

Vitamin B12 and folate tests diagnose vitamin deficiencies by measuring vitamin levels in the liquid section of the blood. The amount of folate in red blood cells is sometimes tested as well.

Folate is a naturally occurring form of the vitamin, whereas folic acid is a supplement that can be added to foods and beverages. Leafy green vegetables, dry beans and peas, citrus fruits, yeast, and liver all contain it. Vitamin B12, also known as cobalamin, can be found in animal-based foods such red meat, fish, poultry, milk, yogurt, and eggs. Fortified cereals, breads, and other grain products have become key sources of B12 and folate in recent years.

A lack of B12 or folate can cause macrocytic anemia, a condition in which red blood cells are bigger than normal. Megaloblastic anemia is a kind of macrocytic anemia marked by the generation of fewer but larger RBCs known as macrocytes, as well as cellular abnormalities in the bone marrow. Reduced white blood cell and platelet counts are two more test results linked to megaloblastic anemia.

B12 is also necessary for nerve function, and a lack of it can induce neuropathy, which causes tingling and numbness in the hands and feet of those who are affected.

Folate is required for cell division, which occurs in the developing fetus. In a growing fetus, a lack of folate during early pregnancy can raise the chance of neural tube abnormalities such spina bifida.

B12 and folate deficiency is most commonly caused by not getting enough of the vitamins through diet or supplements, poor absorption, or increased requirement, as observed during pregnancy:

  • Dietary deficiencies are uncommon in the United States since many meals and beverages are fortified with vitamins that the body stores. Adults normally have many years' worth of vitamin B12 and around three months' worth of folate stored in their liver. Dietary deficiencies normally do not manifest symptoms until the body's vitamin supplies have been exhausted. Vegans and their breast-fed infants can suffer from B12 deficiency.
  • Inadequate absorption—the absorption of vitamin B12 is a multi-step process. B12 is normally released from food by stomach acid and then bound to intrinsic factor, a protein produced by parietal cells in the stomach, in the small intestine. After being absorbed by the small intestine and bound by carrier proteins, the B12-IF complex reaches the blood. B12 absorption is hampered if any of these processes are disrupted by a disease or condition.
  • Increased demand—this can occur as a result of a range of diseases and disorders. When a woman is pregnant or nursing, in early childhood, with malignancies, or with chronic hemolytic anemias, there is an increased demand for folate.

Lab tests often ordered with a Vitamin B12 and Folate panel test:

  • Complete Blood Count
  • Methylmalonic Acid
  • Homocysteine
  • Vitamin B1
  • Vitamin B3
  • Vitamin B5
  • Vitamin B6
  • Vitamin B7
  • Intrinsic Factor Antibody
  • Parietal Cell Antibody
  • Reticulocyte Count

Conditions where a Vitamin B12 and Folate panel test is recommended:

  • Neural Tube Defects
  • Vitamin B12 and Folate Deficiencies
  • Anemia
  • Alcoholism
  • Malnutrition
  • Celiac Disease
  • Malabsorption
  • Neuropathy
  • Inflammatory Bowel Disease

How does my health care provider use a Vitamin B12 and Folate panel test?

Separate tests for vitamin B12 and folate are frequently used in conjunction to detect deficiencies and to aid in the diagnosis of anemias such as pernicious anemia, an inflammatory condition that inhibits B12 absorption.

B12 and folate are two vitamins that the body cannot generate and must be obtained from the diet. They're needed for red blood cell creation, tissue and cell repair, and DNA synthesis, which is the genetic material in cells. B12 is required for normal nerve function.

B12 and folate tests can also be used to assess someone who is experiencing mental or behavioral changes, especially in the elderly. A B12 test can be ordered with or without folate, as well as with other screening laboratory tests like a complete blood count, comprehensive metabolic panel, antinuclear antibody, C-reactive protein, and rheumatoid factor, to help determine why a person is exhibiting signs and symptoms of a nerve disorder.

B12 and folate tests can also be performed in conjunction with a variety of other tests to assess a person's overall health and nutritional status if they have signs and symptoms of substantial malnutrition or dietary malabsorption. People with alcoholism, liver disease, stomach cancer, or malabsorption diseases including celiac disease, inflammatory bowel disease, or cystic fibrosis may fall into this category.

Testing may be performed to assess the success of treatment in patients with known B12 and folate deficits. This is especially true for people who cannot absorb B12 and/or folate effectively and must be treated for the rest of their lives.

Folate levels in the blood's liquid part might fluctuate depending on a person's recent diet. Because red blood cells contain 95 percent of circulating folate, a test to evaluate folate levels inside RBCs could be employed instead of or in addition to the serum test. Some doctors believe that the RBC folate test is a better predictor of long-term folate status and is more clinically useful than serum folate, however there is no consensus on this.

Homocysteine and methylmalonic acid are two more laboratory tests that can be used to detect B12 and folate deficits. In B12 deficiency, both homocysteine and MMA are high, whereas in folate deficit, only homocysteine, not MMA, is elevated. This distinction is critical because treating anemia with folate treats the anemia but not the brain damage, which may be irreparable.

What do my Vitamin B12 and Folate test results mean?

Normal B12 and folate levels may indicate that a person does not suffer from a deficiency and that the signs and symptoms are caused by something else. Normal levels, on the other hand, may indicate that a person's stored B12 and/or folate has not yet been depleted.

A health practitioner may request a methylmalonic acid test as an early sign of B12 insufficiency if a B12 level is normal but a deficiency is still suspected.

A low B12 and/or folate level in a person with signs and symptoms implies a deficiency, although it does not always indicate the severity of the anemia or related neuropathy. Additional tests are frequently performed to determine the source of the deficit. Low B12 or folate levels can be caused by a variety of factors, including:

Dietary folate or B12 deficiency is uncommon in the United States. It can be evident in people who are malnourished in general and vegans who do not eat any animal products. Folate deficiency has become extremely rare since the development of fortified cereals, breads, and other grain products.

Both B12 and folate deficits can be caused by diseases that prevent them from being absorbed in the small intestine. These may include the following:

  • Pernicious anemia.
  • Celiac disease
  • Crohn's disease and ulcerative colitis
  • Bacterial overgrowth or the presence of parasites in the intestines, such as tapeworms
  • Long-term usage of antacids or H2 proton pump inhibitors reduces stomach acid production.
  • Absorption can be considerably reduced by surgery that removes part of the stomach or the intestines, such as gastric bypass.
  • Insufficiency of the pancreas
  • Chronic alcoholism or heavy drinking
  • Some treatments, such as omeprazole, metformin, methotrexate, and/or anti-seizure medications like phenytoin.
  • Increased requirement for healthy fetal development, all pregnant women require an increased amount of folate and are advised to consume 400 micrograms of folic acid every day. People who have cancer that has spread or who have chronic hemolytic anemia require more folate.
  • Smoking

If a person is taking supplements to treat a B12 or folate deficiency, normal or higher findings indicate that the treatment is working.

High amounts of B12 are uncommon, and they aren't routinely evaluated clinically. If a person has a condition such chronic myeloproliferative neoplasm, diabetes, heart failure, obesity, AIDS, or severe liver disease, their vitamin B12 level may be elevated. High B12 levels can also be caused by using estrogens, vitamin C, or vitamin A.

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


Vitamin B12 Binding Capacity, Unsaturated (Transcobalamin)

Clinical Significance

Vitamin B12 Binding Capacity, Unsaturated (Transcobalamin), binds and transports vitamin B12 in the circulation. Increased concentrations are associated with patients with myeloproliferative disorders. Decreased concentrations are seen in individuals with megaloblastic anemia or Transcobalamin deficiency.

Alternative Name(s) 

Transcobalamin, B12 Binding Capacity


Vitamin B2 is involved in metabolism of fats, carbohydrates, and protein. The clinical manifestations of deficiency are non-specific. Clinical manifestations include mucocutaneous lesions of the mouth and skin, corneal vascularization, anemia, and personality changes.

Description: The CRP test is used to identify and/or monitor inflammation in patients.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a C-Reactive Protein test ordered?

When a person's medical history and signs and symptoms indicate that they may have a significant bacterial infection, a CRP test may be recommended. When a newborn displays signs of infection or when a person has sepsis symptoms including fever, chills, and rapid breathing and heart rate, it may be ordered.

It's also commonly requested on a regular basis to check illnesses like rheumatoid arthritis and lupus, and it's routinely repeated to see if medication is working. This is especially effective for inflammation issues because CRP levels decrease as inflammation decreases.

What does a C-Reactive Protein blood test check for?

C-reactive protein is a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. After trauma or a heart attack, with active or uncontrolled autoimmune illnesses, and with acute bacterial infections like sepsis, markedly higher levels are reported. CRP levels can rise by a thousand-fold in response to inflammatory diseases, and their elevation in the blood can occur before pain, fever, or other clinical signs. The test detects inflammation caused by acute situations or monitors disease activity in chronic diseases by measuring the level of CRP in the blood.

The CRP test is not a diagnostic tool, although it can tell a doctor if inflammation is occurring. This information can be combined with other indicators like signs and symptoms, a physical exam, and other tests to establish whether someone has an acute inflammatory disorder or is having a flare-up of a chronic inflammatory disease. The health care provider may next do additional tests and treatment.

This CRP test should not be confused with the hs-CRP test. These are two separate CRP tests, each of which measures a different range of CRP levels in the blood for different purposes.

Lab tests often ordered with a C-Reactive Protein test:

  • Sed Rate (ESR)
  • Procalcitonin
  • ANA
  • Rheumatoid Factor
  • Complement

Conditions where a C-Reactive Protein test is recommended:

  • Arthritis
  • Autoimmune Disorders
  • Pelvic Inflammatory Disease
  • Inflammatory Bowel Disease
  • Sepsis
  • Vasculitis
  • Systemic Lupus Erythematosus
  • Meningitis and Encephalitis

Commonly Asked Questions:

How does my health care provider use a C-Reactive Protein test?

A health practitioner uses the C-reactive protein test to diagnose inflammation. CRP is an acute phase reactant, a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. The CRP test is not a diagnostic test for any ailment, but it can be used in conjunction with other tests to determine whether a person has an acute or chronic inflammatory disorder.

CRP, for example, can be used to detect or track substantial inflammation in someone who is suspected of having an acute ailment like:

  • Sepsis is a dangerous bacterial infection.
  • An infection caused by a fungus
  • Inflammation of the pelvis

People with chronic inflammatory diseases can use the CRP test to detect flare-ups and/or see if their medication is working. Here are a few examples:

  • Inflammatory bowel disease
  • Arthritis, which can take many forms.
  • Autoimmune disorders, examples include lupus and vasculitis

CRP is occasionally requested in conjunction with an erythrocyte sedimentation rate, another inflammatory test. While the CRP test is not specific enough to diagnose an illness, it does serve as a broad marker for infection and inflammation, alerting doctors to the need for more testing and treatment. A variety of additional tests may be used to determine the source of inflammation, depending on the probable cause.

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

CRP levels in the blood that are high or rising indicate the existence of inflammation, but they don't tell you where it is or what's causing it. A high CRP level can establish the presence of a severe bacterial infection in people who are suspected of having one. High levels of CRP in persons with chronic inflammatory disorders indicate a flare-up or that treatment isn't working.

When the CRP level rises and then falls, it indicates that the inflammation or infection is diminishing and/or responding to treatment.

Is there anything else I should know about C-Reactive Protein?

CRP levels can rise during pregnancy, as well as with the use of birth control tablets or hormone replacement therapy. Obese people have also been found to have higher CRP levels.

In the presence of inflammation, the erythrocyte sedimentation rate test will also rise; however, CRP rises first and then falls faster than the ESR.

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


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. 


This panel is designed to evaluate a patient for the presence of potentially reversible (i.e., secondary) causes of dementia such as Vitamin B12 deficiency, hypothyroidism, hypoparathyroidism, anemia, hypoxia or hypercapnia, hepatic and renal encephalopathies, diabetes, and dehydration. The panel includes a Complete Blood Count, TSH, Vitamin B12, Folate, and a Comprehensive Metabolic Panel. It is modeled after the recommendations of the American Academy of Neurology (AAN), a National Institutes of Health Consensus Panel, the European Federation of Neurological Societies (EFNS), and others.1-4

Description: Fecal Globulin by immunochemistry is a test that measures the amount of blood present in fecal samples. The results from the fecal globulin test can be used to detect a lower gastrointestinal disorder. It is recommended to be a part of the routine physical examination.

Also Known As: Fecal Immunochemical Test, Fecal Occult Blood Test, Stool Occult Blood Test, FIT, FOBT

Collection Method: Fecal specimen collected from toilet water and brushed onto InSure® FOBT test card

Specimen Type: Fecal Specimen

Test Preparation: No preparation required

When is a Fecal Globin test ordered?

When a person chooses fecal occult blood testing as a method of colon cancer screening, the American Cancer Society and other major healthcare organizations recommend yearly testing. The American Cancer Society and others recommend that colon cancer screening begin around age 50 for the general population, but it may begin earlier if a person has a family history of colon cancer.

An FOBT may be ordered by a doctor if a patient has unexplained anemia that could be caused by gastrointestinal bleeding.

What does a Fecal Globin test check for?

The majority of colon cancer cases begin with the formation of benign intestinal polyps. Benign polyps are quite common in adults over 50, and while the majority do not cause health problems, some can turn malignant and spread to other parts of the body. These finger-like growths protrude into the rectum or the intestinal cavity. They can be delicate and bleed on occasion, as when food debris rubs against them.

The blood expelled is normally not visible in the stool, but a fecal occult blood test or a fecal immunochemical test can detect it. The FOBT and FIT are effective colorectal cancer screening techniques because this small amount of blood may be the earliest and sometimes only evidence of early colon cancer. A guaiac-based test, an over-the-counter flushable reagent pad, and an immunochemical technique are all options for testing.

It is advised that at least three stool samples be taken on different days be tested. According to the American Cancer Society, a single test performed during a digital rectal exam at a doctor's office is not recommended since it may not be sensitive enough to detect cancer. Because collecting feces on three different days increases the chances of identifying cancer, the home FOBT or FIT is advised. Additionally, those who choose this type of colon cancer screening should be screened every year.

Lab tests often ordered with a Fecal Globin test:

  • Complete Blood Count (CBC)
  • Calprotectin

Conditions where a Fecal Globin test is recommended:

  • Colon Cancer

How does my health care provider use a Fecal Globin test?

The fecal occult blood test, also known as the fecal immunochemical test, is primarily used to screen for early colon cancer. The majority of colon cancer cases begin with the formation of benign intestinal polyps. People over the age of 50 are more likely to develop benign polyps. The majority are non-cancerous, however some can develop malignant.

Blood in the stool could be the only sign of early cancer, so if caught early, therapy can begin right away, increasing the chances of a cure.

What do my Fecal Occult Blood test results mean?

Normally, the fecal occult blood test is negative.

A positive test result for the guaiac-based FOBT shows that abnormal bleeding is occurring anywhere in the digestive tract. Ulcers, diverticulosis, polyps, inflammatory bowel disease, hemorrhoids, blood eaten owing to bleeding gums or nosebleeds, or benign or malignant tumors could all cause blood loss.

A positive result for the fecal immunochemical test shows abnormal bleeding in the lower digestive tract. Other sources of blood, such as those found in the diet, do not generate a positive result since this test only identifies human hemoglobin. Furthermore, hemoglobin from upper digestive tract hemorrhage is broken down before reaching the lower digestive tract and is undetectable by the FIT. As a result, the FIT is a more precise test than the gFOBT.

Follow-up testing is required after a positive result from either the guaiac-based FOBT or the immunochemical FIT. Direct imaging of the colon and rectum is generally used.

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


The fecal occult blood test is an immunochromatographic fecal occult blood test that qualitatively detects human hemoglobin from blood in fecal samples. This is a useful screening aid for detecting primarily lower gastrointestinal (G.I.) disorders that may be related to iron deficiency anemia, diverticulitis, ulcerative colitis, polyps, adenomas, colorectal cancers or other G.I. lesions that can bleed. It is recommended for use by health professionals as part of routine physical examinations and in screening for colorectal cancer or other sources of lower G.I. bleeding.

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Description: A Folate test measures the levels of folic acid in the blood. These results can be used to determine a folate deficiency and evaluate a person's nutritional status. Anemia and Neuropathy can also be evaluated using the results from this test.

Also Known As: Folate Serum Test, Folic Acid Test, Vitamin B9 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Folate test ordered?

When a complete blood count and/or blood smear, performed as part of a health checkup or anemia evaluation, reveal a low red blood cell count with the presence of big RBCs, B12 and folate levels may be ordered. A high mean corpuscular volume, in particular, implies that the RBCs are enlarged.

When a person exhibits the following signs and symptoms of a deficit, testing for folate levels may be necessary.

  • Diarrhea
  • Dizziness
  • Muscle weakness, fatigue
  • Appetite loss.
  • Skin that is pale
  • Irregular heartbeats, rapid heart rate
  • Breathing problems
  • Tongue and mouth ache
  • In the feet, hands, arms, and legs, there is tingling, numbness, and/or burning 
  • Confusion or obliviousness
  • Paranoia

When a person is at risk of deficiency, such as those with a history of malnutrition or a condition associated to malabsorption, folate testing may be ordered.

Individuals being treated for malnutrition or a folate deficit may have these tests done on a frequent basis to see how effective their treatments are. This could be part of a long-term therapy plan for people who have a disease that causes chronic deficiency.

What does a Folate blood test check for?

The B complex of vitamins includes vitamins including vitamin B12 and folate. They are required for the creation of normal red blood cells, tissue and cell repair, and the synthesis of DNA, the genetic material in cells. Both are nutrients that the body cannot make and must be obtained from the diet.

Vitamin B9 tests, also known as folate tests, diagnose vitamin deficiencies by measuring vitamin levels in the liquid section of the blood. The amount of folate in red blood cells is sometimes tested as well.

Folate is a naturally occurring form of the vitamin, whereas folic acid is a supplement that can be added to foods and beverages. Leafy green vegetables, dry beans and peas, citrus fruits, yeast, and liver all contain it. Vitamin B12, also known as cobalamin, can be found in animal-based foods such red meat, fish, poultry, milk, yogurt, and eggs. Fortified cereals, breads, and other grain products have become key sources of B12 and folate in recent years

A lack of folate can cause macrocytic anemia, a condition in which red blood cells are bigger than normal. Megaloblastic anemia is a kind of macrocytic anemia marked by the generation of fewer but larger RBCs known as macrocytes, as well as cellular abnormalities in the bone marrow. Reduced white blood cell and platelet counts are two more test results linked to megaloblastic anemia.

Folate is required for cell division, which occurs in the developing fetus. In a growing fetus, a lack of folate during early pregnancy can raise the chance of neural tube abnormalities such spina bifida.

Folate deficiency is most commonly caused by inadequate intake of the vitamin through diet or supplements, poor absorption, or increased bodily requirement, as observed during pregnancy:

  • Dietary deficiencies are uncommon in the United States since many meals and beverages are fortified with vitamins that the body stores. Adults normally have around three months' worth of folate stored in their liver. Dietary deficiencies normally do not manifest symptoms until the body's vitamin supplies have been exhausted.
  • Increased demand—this can occur as a result of a range of diseases and disorders. When a woman is pregnant or nursing, in early childhood, with malignancies, or with chronic hemolytic anemias, there is an increased demand for folate.

Lab tests often ordered with a Folate test:

  • Complete Blood Count
  • Methylmalonic Acid
  • Homocysteine
  • Vitamin B1
  • Vitamin B3
  • Vitamin B5
  • Vitamin B6
  • Vitamin B7
  • Vitamin B12
  • Intrinsic Factor Antibody
  • Parietal Cell Antibody
  • Reticulocyte Count

Conditions where a Folate test is recommended:

  • Neural Tube Defects
  • Vitamin B12 and Folate Deficiencies
  • Anemia
  • Alcoholism
  • Malnutrition
  • Celiac Disease
  • Malabsorption
  • Neuropathy
  • Nervous System Disorders
  • Inflammatory Bowel Disease

How does my health care provider use a Folate test?

Separate tests for vitamin B12 and folate are frequently used in conjunction to detect deficiencies and to aid in the diagnosis of anemias such as pernicious anemia, an inflammatory condition that inhibits B12 absorption.

B12 and folate are two vitamins that the body cannot generate and must be obtained from the diet. They're needed for red blood cell creation, tissue and cell repair, and DNA synthesis, which is the genetic material in cells. B12 is required for normal nerve function.

B12 and folate tests can also be used to assess someone who is experiencing mental or behavioral changes, especially in the elderly. A B12 test can be ordered with or without folate, as well as with other screening laboratory tests like a complete blood count, comprehensive metabolic panel, antinuclear antibody, C-reactive protein, and rheumatoid factor, to help determine why a person is exhibiting signs and symptoms of a nerve disorder.

B12 and folate tests can also be performed in conjunction with a variety of other tests to assess a person's overall health and nutritional status if they have signs and symptoms of substantial malnutrition or dietary malabsorption. People with alcoholism, liver disease, stomach cancer, or malabsorption diseases including celiac disease, inflammatory bowel disease, or cystic fibrosis may fall into this category.

Testing may be performed to assess the success of treatment in patients with known B12 and folate deficits. This is especially true for people who cannot absorb B12 and/or folate effectively and must be treated for the rest of their lives.

Folate levels in the blood's liquid part might fluctuate depending on a person's recent diet. Because red blood cells contain 95 percent of circulating folate, a test to evaluate folate levels inside RBCs could be employed instead of or in addition to the serum test. Some doctors believe that the RBC folate test is a better predictor of long-term folate status and is more clinically useful than serum folate, however there is no consensus on this.

Homocysteine and methylmalonic acid are two more laboratory tests that can be used to detect B12 and folate deficits. In B12 deficiency, both homocysteine and MMA are high, whereas in folate deficit, only homocysteine, not MMA, is elevated. This distinction is critical because treating anemia with folate treats the anemia but not the brain damage, which may be irreparable.

What do my Folate Serum test results mean?

Normal folate levels may indicate that a person does not suffer from a deficiency and that the signs and symptoms are caused by something else. Normal levels, on the other hand, may indicate that a person's stored folate has not yet been depleted.

A low folate level in a person with signs and symptoms implies a deficiency, although it does not always indicate the severity of the anemia or related neuropathy. Additional tests are frequently performed to determine the source of the deficit. Low folate levels can be caused by a variety of factors.

Dietary folate deficiency is uncommon in the United States. It can be evident in people who are malnourished in general and vegans who do not eat any animal products. Folate deficiency has become extremely rare since the development of fortified cereals, breads, and other grain products.

Folate deficits can be caused by diseases that prevent them from being absorbed in the small intestine. These may include the following:

  • Pernicious anemia.
  • Celiac disease
  • Crohn's disease and ulcerative colitis
  • Bacterial overgrowth or the presence of parasites in the intestines, such as tapeworms
  • Long-term usage of antacids or H2 proton pump inhibitors reduces stomach acid production.
  • Absorption can be considerably reduced by surgery that removes part of the stomach or the intestines, such as gastric bypass.
  • Insufficiency of the pancreas
  • Chronic alcoholism or heavy drinking
  • Some treatments, such as metformin, omeprazole, methotrexate, or anti-seizure medications like phenytoin.
  • Increased requirement for healthy fetal development, all pregnant women require an increased amount of folate and are advised to consume 400 micrograms of folic acid every day. People who have cancer that has spread or who have chronic hemolytic anemia require more folate.
  • Smoking

If a person is taking supplements to treat a folate deficiency, normal or higher findings indicate that the treatment is working.

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


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Description: A Glucose test is a blood test used to screen for, diagnose, and monitor conditions that affect glucose levels such as prediabetes, diabetes, hyperglycemia, and hypoglycemia.

Also Known As: Fasting Blood Glucose Test, FBG Test, Fasting Blood Sugar Test, FBS Test, Fasting Glucose Test, FG Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting required

When is a Glucose test ordered?

Diabetes screening is recommended by several health groups, including the American Diabetes Association and the United States Preventive Services Task Force, when a person is 45 years old or has risk factors.

The ADA recommends retesting within three years if the screening test result is within normal limits, but the USPSTF recommends testing once a year. Annual testing may be used to monitor people with prediabetes.

When someone exhibits signs and symptoms of high blood glucose, a blood glucose test may be conducted.

Diabetics are frequently asked to self-check their glucose levels multiple times a day in order to monitor glucose levels and choose treatment alternatives as suggested by their doctor. Blood glucose levels may be ordered on a regular basis, along with other tests such as A1c, to track glucose control over time.

Unless they show early symptoms or have had gestational diabetes in a prior pregnancy, pregnant women are routinely screened for gestational diabetes between the 24th and 28th week of pregnancy. If a woman is at risk of type 2 diabetes, she may be tested early in her pregnancy, according to the American Diabetes Association. When a woman has type 1, type 2, or gestational diabetes, her health care provider will normally order glucose levels to monitor her condition throughout the duration of her pregnancy and after delivery.

What does a Glucose blood test check for?

A fasting glucose test measures glucose. Glucose is the major energy source for the body's cells and the brain and nervous system's only source of energy. A consistent supply must be provided, and a somewhat constant level of glucose in the blood must be maintained. The glucose level in the blood can be measured using a variety of methods. 

Fruits, vegetables, breads, and other carbohydrate-rich foods are broken down into glucose during digestion, which is absorbed by the small intestine and circulated throughout the body. Insulin, a hormone generated by the pancreas, is required for the use of glucose for energy production. Insulin promotes glucose transport into cells and instructs the liver to store surplus energy as glycogen for short-term storage or triglycerides in adipose cells.

Normally, blood glucose rises slightly after you eat or drink, and the pancreas responds by releasing insulin into the blood, the amount of which is proportional to the size and substance of the meal. The level of glucose in the blood declines as glucose enters the cells and is digested, and the pancreas responds by delaying, then ceasing the secretion of insulin.

When blood glucose levels fall too low, such as between meals or after a strong activity, glucagon is released, which causes the liver to convert some glycogen back into glucose, so boosting blood glucose levels. The level of glucose in the blood remains pretty steady if the glucose/insulin feedback loop is working appropriately. When the balance is upset and the blood glucose level rises, the body strives to restore it by boosting insulin production and removing excess glucose through the urine.

Several diseases can cause the equilibrium between glucose and pancreatic hormones to be disrupted, resulting in high or low blood glucose. Diabetes is the most common cause. Diabetes is a collection of illnesses characterized by inadequate insulin production and/or insulin resistance. Untreated diabetes impairs a person's ability to digest and utilize glucose normally. Type 1 diabetes is diagnosed when the body is unable to produce any or enough insulin. People with prediabetes or type 2 diabetes are insulin resistant and may or may not be able to produce enough of the hormone.

Organ failure, brain damage, coma, and, in extreme situations, death can result from severe, sudden fluctuations in blood glucose, either high or low. Chronically high blood glucose levels can harm body organs like the kidneys, eyes, heart, blood vessels, and nerves over time. Hypoglycemia can harm the brain and nerves over time.

Gestational diabetes, or hyperglycemia that exclusively arises during pregnancy, can affect some women. If left untreated, this can result in large babies with low glucose levels being born to these mothers. Women with gestational diabetes may or may not acquire diabetes later in life.

Lab tests often ordered with a Glucose test:

  • Complete Blood Count
  • Iron Total and Total Iron binding capacity
  • Hemoglobin A1c
  • Lipid Panel
  • Urinalysis Complete
  • TSH
  • CMP
  • Insulin
  • Microalbumin
  • Fructosamine
  • C-Peptide

Conditions where a Glucose test is recommended:

  • Diabetes
  • Kidney Disease
  • Insulin Resistance
  • Pancreatic Diseases
  • Hyperglycemia
  • Hypoglycemia

Commonly Asked Questions:

How does my health care provider use a Glucose test?

The blood glucose test can be used for a variety of purposes, including:

  • Detect hyperglycemia and hypoglycemia
  • Screen for diabetes in those who are at risk before symptoms appear; there may be no early indications or symptoms of diabetes in some circumstances. As a result, screening can aid in detecting it and allowing treatment to begin before the illness worsens or complications emerge.
  • Aid in the detection of diabetes, prediabetes, and gestational diabetes.
  • Monitor your blood sugar levels and manage your diabetes

Glucose levels should be monitored in those who have been diagnosed with diabetes.

Between the 24th and 28th week of pregnancy, glucose blood tests are performed to assess pregnant women for gestational diabetes. Pregnant women who have never been diagnosed with diabetes should be screened and diagnosed using either a one-step or two-step strategy, according to the American Diabetes Association and the US Preventive Services Task Force.

Other tests, including diabetic autoantibodies, insulin, and C-peptide, may be used in conjunction with glucose to assist in detecting the reason of elevated glucose levels, differentiate between type 1 and type 2 diabetes, and assess insulin production.

What does my glucose test result mean?

High blood glucose levels are most commonly associated with diabetes, but they can also be caused by a variety of other diseases and ailments.

Hypoglycemia is defined by a drop in blood glucose to a level that triggers nervous system symptoms before affecting the brain. The Whipple triad is a set of three criteria for diagnosing hypoglycemia.

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


Description: The Glucose 6 Phosphate Dehydrogenase, or G6PD, test is used to determine if you inherited a G6PD deficiency.

Also Known As: G6PD Test, G6PD Enzyme Test, RBC G6PD test, G-6-P-D Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Glucose-6-Phosphate Dehydrogenase test ordered?

When a person develops signs and symptoms of hemolytic anemia, G6PD enzyme testing is done. When someone has experienced an episode of elevated RBC destruction but the crisis has passed, testing may be done.

When other lab test findings point to hemolytic anemia, testing may be performed. 

When alternative causes of anemia and jaundice have been eliminated and several weeks have passed since an acute episode, G6PD activity testing is usually recommended.

If available, newborn screening can be done in the first day or two after birth.

What does a Glucose-6-Phosphate Dehydrogenase blood test check for?

The enzyme glucose-6-phosphate dehydrogenase is involved in the creation of energy. It is found in all cells, including red blood cells, and aids in the protection of these cells against some hazardous by-products of cellular metabolism. RBCs with a G6PD deficit are more susceptible to splitting apart under specific situations. To assist diagnose a deficit, this test analyzes the quantity of G6PD in RBCs.

G6PD insufficiency is a hereditary condition. When people who have inherited this illness are exposed to a trigger like stress, infection, certain medicines, or another substance, the structure of their red blood cells changes significantly. Heinz bodies are deposits formed by hemoglobin, the life-sustaining, oxygen-transporting protein found in RBCs. When exposed to fava beans, some people have these symptoms, which is known as "favism." RBCs might break apart more easily as a result of these alterations, resulting in a reduction in the quantity of RBCs. Hemolytic anemia occurs when the body is unable to manufacture enough RBCs to replace those that have been destroyed. Symptoms include jaundice, weakness, exhaustion, and/or shortness of breath.

G6PD insufficiency is the most common enzyme deficiency, affecting over 400 million individuals worldwide. It can be found in as many as 10% of African-American men and 20% of African men. People from the Mediterranean and Southeast Asia are also susceptible.

Due to mutations or alterations in the G6PD gene that produce lower enzyme activity, G6PD deficiency is inherited and handed down from parent to kid. G6PD insufficiency has approximately 440 different forms. The G6PD gene is found on the X chromosome, which is inherited from both parents. Because men have only one X and one Y chromosome, the G6PD gene is only found on the X chromosome. If a guy gets the single X chromosome with a mutated gene, he may have G6PD deficiency.

Women inherit two copies of the G6PD gene since they have two X chromosomes. Women with only one mutant gene produce enough G6PD to show no symptoms most of the time, although they may show a minor version of the deficit in stressful settings. A mother can also carry the single altered gene to any male children she has. Women with two defective gene copies, which could lead to G6PD deficiency, are uncommon.

In infants, G6PD deficiency is a prevalent cause of chronic jaundice. This can result in substantial brain damage and mental impairment if left untreated.

The majority of persons with G6PD deficiency can live relatively normal lives, however there is no specific treatment for it other than prevention. They must be cautious and avoid pharmaceuticals like aspirin, phenazopyridine, and rasburicase, as well as antibiotics with "sulf" in the name and dapsone, anti-malarial treatments with "quine" in the name, foods like fava beans, and chemical chemicals like naphthalene. Fava beans, often known as broad beans, are widely farmed in the Mediterranean region. Acute viral and bacterial infections can cause hemolytic anemia and blood acid levels to rise. Individuals should seek a thorough list of these triggers from their healthcare provider. The list on the G6PD Deficiency Favism Association website is a nice place to start.

RBCs are destroyed at a faster rate in hemolytic anemia, and the person affected feels pale and tired as their ability to provide oxygen to their body decreases. Jaundice can be observed in severe cases of RBC breakdown. The majority of these episodes are self-limiting, but if a substantial number of RBCs are lost and the body is unable to replenish them quickly enough, the affected person may require a blood transfusion. If not addressed, this illness can be fatal. Chronic anemia can afflict a small number of people with G6PD deficiency.

Lab tests often ordered with a Glucose-6-Phosphate Dehydrogenase test:

  • Complete Blood Count (CBC)
  • Reticulocyte Count
  • Bilirubin
  • Hemoglobin
  • Red Blood Cell Count
  • Lactate Dehydrogenase (LD)
  • Haptoglobin

Conditions where a Glucose-6-Phosphate Dehydrogenase test is recommended:

  • Hemolytic Anemia

How does my health care provider use a Glucose-6-Phosphate Dehydrogenase test?

The enzyme assay for glucose-6-phosphate dehydrogenase is used to screen for and diagnose G6PD deficiency. It could be used to screen children who were born with unexplained chronic jaundice. Currently, babies are not routinely tested for G6PD deficiency; however, this depends on the state that offers the service. According to the National Newborn Screening and Genetics Resource Center, two states, Pennsylvania and the District of Columbia, offer G6PD testing as part of their newborn screening panel as of November 2014.

G6PD is an enzyme present in all cells, including red blood cells, that protects them against hazardous by-products of cellular metabolism. RBCs with a G6PD deficit are more susceptible to splitting apart under specific situations.

People of any age who have experienced unexplained episodes of hemolytic anemia, jaundice, or dark urine may benefit from G6PD testing to assist establish a diagnosis. G6PD deficiency may be suspected if the person had a recent viral or bacterial illness or was exposed to a recognized trigger, followed by a hemolytic event.

G6PD testing may be repeated on occasion to validate initial findings. A simple qualitative test is usually used in screening tests to determine if a person has a high amount of G6PD in his or her cells. A quantitative test will be used to determine the actual quantity of enzyme activity during confirmation testing.

G6PD levels are normal in newly generated cells in the most prevalent form of G6PD deficiency seen in people of African heritage, but decline by up to 75% as RBCs age. As a result, testing should be delayed for several weeks after a hemolytic episode has passed. The older, more fragile G6PD-deficient RBCs are often killed during the episode, leaving the newer, less deficient cells to be tested, potentially hiding a G6PD deficiency.

Although genetic testing is not commonly performed, it can be requested as a follow-up to an enzyme test that suggests a deficiency in order to discover which G6PD mutations are present. There are currently around 440 G6PD gene variants that can produce varied degrees of deficiency based on the mutation and the specific person. Some mutations have no effect on the activity of the G6PD enzyme. The G6PD mutations have been divided into five groups by the World Health Organization, depending on the enzyme levels and their influence on the affected person's health. During testing, however, only the most prevalent G6PD mutations are discovered. If a certain mutation is known to exist in a family line, tests to detect that mutation can be performed.

What do my Glucose-6-Phosphate Dehydrogenase test results mean?

A deficit is indicated by a low level of G6PD enzyme. When exposed to a trigger, an affected person is more likely to develop symptoms. However, the findings cannot be utilized to forecast how an affected individual will react in a specific situation. Symptom severity varies from person to person and from episode to episode.

If a male has a normal G6PD enzyme level, he is unlikely to have a deficit, and if anemia is present, it is most likely due to another cause. If the test was done during a bout of hemolytic anemia, it should be redone several weeks later once the RBC population has replenished and matured.

Carriers, who have one mutant and one normal gene copy, will have some G6PD-deficient RBCs and others that are not. G6PD levels in these women are normally normal or near normal, and they rarely exhibit symptoms. A carrier will have a normal or low normal G6PD level, therefore they may not be discovered by G6PD screening, but they will be detected by a G6PD confirmation test, which measures the overall quantity of enzyme present in the cells. It's worth noting that a rare female with two defective gene copies will almost certainly have a large drop in G6PD levels.

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



Do You Need an Iron Deficiency Anemia Test? What You Need to Know

Have you been feeling overly tired, irritable, or maybe noticing your complexion looks a little paler than usual? You could be suffering from a condition called iron deficiency anemia. This type of anemia is the most common type in the world.

Anyone can suffer from iron deficiency anemia, but it affects more women than men. If left untreated, it can lead to serious health consequences. Read on to learn more about this condition, including risk factors, causes, symptoms, treatment, long-term effects, diagnosis, and how you can get an iron deficiency anemia test.

About Iron Deficiency Anemia

Iron deficiency anemia, as its name states, is anemia that is caused by a lack of iron in your body. Iron is a mineral that is primarily stored in your red blood cells. It is also stored in your bone marrow, but in lesser amounts.

If you suffer from any type of anemia, you have a decreased level of red blood cells, which is problematic because red blood cells carry oxygen throughout your body and remove waste such as carbon dioxide. If your body does not have enough blood cells, your overall health will start to suffer.

Because the initial symptoms can be mild and may come on slowly, iron deficiency anemia can often go years without a diagnosis. This is problematic because, if left untreated, a lack of oxygen in the blood can damage your organs, including your heart and lungs. It can also cause developmental delays in children.

Risk Factors and for Iron Deficiency Anemia

While anyone can suffer from iron deficiency anemia, certain groups of people are at a higher risk. Women who are pregnant or breastfeeding are at a greater risk for developing iron deficiency anemia because their bodies require additional iron stores to help support their developing child. A good prenatal vitamin should contain iron to help combat this potential issue.

Small children can also be at risk for iron deficiency anemia. This is usually due to calcium intake coupled with a picky diet. Calcium is needed for growth and development in children, but it can also make it difficult for the body to absorb iron.

If your child drinks a lot of milk but does not eat other sources of iron, he or she may be at risk. You can look for foods that are fortified with iron to help prevent iron deficiency anemia.

Finally, vegetarians are at a higher risk for developing iron deficiency anemia because meat contains higher levels of iron than vegetables. If you are a vegetarian, it is important to replace meat with other iron-rich foods in your diet, such as legumes or tofu.

Causes of Iron Deficiency Anemia

You have already learned that a lack of iron causes iron deficiency anemia. There are several different reasons why your body could be low on iron.

Since iron is stored in your red blood cells, any type of loss of blood is a major risk factor. Blood loss could be from an accident or injury, internal bleeding, regular blood donations, or heavy menstrual periods in women.

Certain medical conditions cause internal bleeding that could lead to iron deficiency anemia as well. Some of these conditions include:

  • Stomach ulcers
  • Hemorrhoid
  • Colon cancer
  • Ulcerative colitis
  • Endometriosis in women

If you suffer from any of these conditions, it is important to regularly keep track of your iron levels.

Over-the-counter pain relievers may seem harmless, but regular use of them can also cause the lining of the stomach to bleed, which could also lead to iron deficiency anemia. If you take over-the-counter pain medications, make sure you follow the packaging instructions to avoid complications. 

Certain conditions that affect the gastrointestinal tract, such as Celiac Disease, also make it difficult for the body to absorb iron. If you suffer from Celiac Disease or another condition that makes it difficult to absorb iron, you should regularly test your blood and iron levels.

Finally, a lack of iron in your diet can also lead to iron deficiency anemia. This is not as common of a cause in the United States, since many foods, such as breakfast cereals, are fortified with iron. Foods that are naturally high in iron include:

  • Meat (particularly red meats)
  • Eggs
  • Seafood
  • Dark green vegetables
  • Sweet potatoes
  • Whole grain products
  • Strawberries
  • Watermelon
  • Dried fruits
  • Beans
  • Tofu

If you do suffer from iron deficiency anemia, it can be difficult to treat it with dietary changes alone. It is best to get a diagnosis and talk to your healthcare provider to devise an appropriate treatment plan.

Symptoms of Iron Deficiency Anemia

Symptoms of iron deficiency anemia can vary by person and range in severity. They may include:

  • An unusual paleness or a lack of color in your skin
  • Irritability (mood swings)
  • A lack of energy, tiredness, fatigue
  • A rapid or irregular heartbeat
  • A swollen or painful tongue
  • Pica (a condition where you have a desire to eat peculiar substances such as dirt or ice)
  • An enlarged Spleen 
  • Cold hands and feet
  • Chest pain
  • Shortness of breath
  • Brittle nails

If you experience any of these symptoms, you should have your blood levels tested. In the early stages of iron deficiency anemia, the symptoms often start off mild, with symptoms such as tiredness or irritability, and progress to more dangerous symptoms, such as irregular heartbeat, if it is left untreated.

Treatment for Iron Deficiency Anemia 

Treatment for iron deficiency anemia can be as simple as taking iron supplements. However, you will want to test your blood levels or iron levels first. Too much iron can be toxic, so you do not want to take supplements if you do not need them.

You will also want to make sure that iron deficiency anemia is truly the cause of your symptoms. Many of the symptoms listed above could be caused by other, more serious conditions. It is always a good idea to rule out these conditions with a comprehensive lab test.

If you believe you have iron deficiency anemia after viewing your lab tests, you should contact your healthcare provider. Depending on how low your blood levels are, you may need a prescription supplement, an intravenous supplement, or other medical care.

If you are prescribed an iron supplement or recommended to take an over-the-counter one, try taking it with orange juice, grapefruit juice or another beverage high in vitamin C. It can be difficult for your body to absorb iron, especially through iron supplements. Vitamin C naturally helps your body absorb iron.

Long Term Effects of Iron Deficiency Anemia

If left untreated, iron deficiency anemia can have serious health consequences. Your heart must work harder to make up for the lack of oxygen. This can lead to a condition called tachycardia, which is characterized by an abnormally fast heartbeat or even lead to heart failure.

A lack of iron also affects your body’s immune system. This causes you to be more susceptible to various illnesses and infections.

Pregnant women suffering from iron deficiency anemia are also at an increased risk of going into premature labor. They are also more likely to suffer from postnatal depression and may pass low iron levels onto their child.

How Iron Deficiency Anemia is Diagnosed

Iron deficiency anemia is diagnosed through a few simple blood tests. If you have not had blood work done in a while, the most common way to start is to get a test that measures your complete blood count (CBC). A CBC test measures the total amount of all parts of your blood, including your red and white blood cells, hemoglobin, hematocrit, and blood platelets.

In iron deficiency anemia, both hemoglobin and hematocrit levels are low. Adult women should have a hematocrit range of 34.9 to 44.5 percent. Adult males should have a range between 38.8 and 50 percent. Any levels lower than that could be a sign of iron deficiency anemia.

A normal hemoglobin level for adult females is between 12.3 and 15.3 grams per deciliter. For adult males, the range should be between 14.0 and 17.5. If your levels are outside of that range, you should contact your primary healthcare provider for advice on how to proceed.

There are many ways to get tested, but the simplest approach is to order a lab test online. Ulta Lab Tests offers a complete CBC test for a very affordable price. 

Additional Lab Testing

CBC test is a good start, but it is not the only way to gauge your iron levels. Another iron deficiency anemia lab test is the total iron-binding capacity (TIBC) test. This is typically a secondary test if you notice problems with your CBC test or if you have recently had a CBC test done.

TIBC test tells you how well your body can carry iron throughout your body. It is a good way to help your healthcare provider distinguish between iron deficiency anemia or other related disorders.

transferrin lab test can also aid in the diagnosis of iron deficiency anemia. This lab test measures your body’s iron-binding capacity. Transferrin is a protein that helps regulate iron absorption. It is helpful in determining your body’s iron balance.

Finally, a ferritin test can be helpful in diagnosing iron deficiency anemia. Ferritin is a protein in your blood that stores iron. Low ferritin levels are often a sign of iron deficiency anemia.

These tests may sound overwhelming, but Ulta Lab Tests makes it easy by offering anemia test panels. Simply type ‘anemia’ in the search bar or check out the complete list here. If you have questions, you can get live support online with a customer service agent to determine which test or test package is right for you.

What to do After You Receive Your Results

Ulta Lab Tests will send the results of your test directly to you. If you have any questions, you can reach out to their trained staff for support. If you receive an abnormal test, Ulta Lab Tests will send an additional notification to ensure you understand the results.

Whether your results are within normal levels or not, you should send them to your healthcare provider. Your doctor can implement an appropriate plan or may wish to see additional tests.

Benefits of an Iron Deficiency Anemia Test with Ulta Lab Tests

There are several benefits to ordering your lab test through Ulta Lab Tests. First, you can rest assured, knowing that your test results are secure and confidential. You also do not need insurance or a doctor’s referral, which saves you time and money.

Ulta Lab Tests offers very affordable test rates, cheaper than going through a doctor’s office. This is because we use state of the art technology and keep overhead costs low to pass the savings along to our customers.

After you have selected the test that is right for you, use the location feature to find the patient service center that is closest to your home or office. Ulta Lab Tests has 2,100 approved bloodwork centers. All test specimens are carefully processed at nationally certified locations.

Waiting for lab test results often causes additional worry or anxiety. With Ulta Lab Tests, you will receive your results quickly within one to two business days for most tests. 

Ordering Your Test with Ulta Lab Tests

Now that you have learned a little more about iron deficiency anemia, it is time to take charge of your health and order the iron deficiency anemia test that is right for you today. Click here to viewall that Ulta Lab Tests has to offer.