Hair Loss (Alopecia)

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

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

When is an ANA Screen test ordered?

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

What does an ANA Screen blood test check for?

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

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

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

Lab tests often ordered with an ANA Screen test:

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

Conditions where an ANA Screen test is recommended:

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

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

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

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

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

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

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

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

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

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

What do my ANA test results mean?

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

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

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

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

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

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

Also Known As: ANA, ANA Screen IFA with Reflex to Titer and pattern IFA, ANA with Reflex, Antinuclear Antibody Screen, DNA-DS Antibody Test, DNA-DS Test, Anti ds-DNA Test, Scl-70 Antibody Test, Anti Scl-70 test, sjogren’s antibody test, SSA-A antibody test, SS-B Antibody test, Sm Antibody Test, Rnp Antibody Sm Rnp Antibody Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge - $13.00

When is a Comprehensive ANA IFA Panel test ordered?

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

What does a Comprehensive ANA IFA Panel blood test check for?

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

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

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

Lab tests often ordered with a Comprehensive ANA IFA Panel test:

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

Conditions where a Comprehensive ANA IFA Panel test is recommended:

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

How does my health care provider use a Comprehensive ANA IFA Panel?

The antinuclear antibody test is one of the most common tests used to identify systemic lupus erythematosus. It is used as a primary test to assist evaluate a person for autoimmune illnesses that affect multiple tissues and organs throughout the body.

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

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

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

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

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

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

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

What do my ANA test results mean?

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

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

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

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

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

 

Collection Instructions

Allow sample to clot for 30 minutes, spin at 3,000 RPM for 10 minutes and transfer serum to plastic, amber vial. If amber vial is not available, wrap tube in aluminum foil to protect from light. Freeze within 30 minutes and send frozen.

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.

Brief Description: DHEA Sulfate is a blood test that is measuring the levels of Dehydroepiandrosterone Sulfate in the blood. It is often used to diagnose any problems in the adrenal glands such as cancer or a tumor. It can also be used to evaluate the cause of early puberty in young boys and male characteristics or appearance in women.

Also Known As: DHEA-SO4 Test, DHEAS Test, DHES1 Test, Dehydroepiandrosterone Sulfate Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a DHEA Sulfate test ordered?

When excess androgen production is suspected and/or a health practitioner wants to analyze a person's adrenal gland function, a DHEAS test, along with other hormone testing, may be requested.

It can be assessed when a woman exhibits signs and symptoms of amenorrhea, infertility, and/or virilization. The intensity of these alterations varies, but they may include:

• A huskier voice
• Hair on the face or on the body that is excessive
• Baldness in men
• Muscularity
• Acne
• The Adam's apple has been enlarged
• Breast size has shrunk

It may also be ordered if a young girl exhibits evidence of virilization or if a female infant's external genitalia are not clearly male or female.

When young males show indicators of premature puberty, such as a deeper voice, pubic hair, muscularity, and an enlarged penis before the age of typical puberty, DHEAS may be evaluated.

What does a DHEA Sulfate blood test check for?

Male sex hormone dehydroepiandrosterone sulfate is found in both men and women. This test determines the amount of DHEAS in your blood.

DHEAS:

• At puberty, it aids in the development of male secondary sexual traits.
• Can be transformed into more strong androgens like testosterone and androstenedione by the body.
• It has the ability to transform into estrogen.

DHEAS is almost entirely produced by the adrenal glands, with minor contributions from a woman's ovaries and a man's testicles.

It's a good indicator of how well the adrenal glands are working. Overproduction of DHEAS can be caused by malignant and non-cancerous adrenal tumors, as well as adrenal hyperplasia. DHEAS can be produced by an ovarian tumor in rare cases.

DHEAS excess:

• In adult men, it may go unnoticed.
• In young boys, it can cause early puberty.
• Menstrual irregularities and the development of masculine physical traits in girls and women, such as excess body and facial hair
• Can result in a female infant being born with genitals that aren't clearly male or female

Lab tests often ordered with a DHEA Sulfate test:

• Testosterone
• ACTH
• FSH
• LH
• Prolactin
• Estrogen
• Estradiol
• Sex Hormone Binding Globulin
• 17-Hydroxyprogesterone
• Androstenedione

Conditions where a DHEA Sulfate test is recommended:

• PCOS
• Infertility
• Endocrine Syndromes
• Adrenal Insufficiency
• Congenital Adrenal Hyperplasia

How does my health care provider use a DHEA Sulfate test?

The dehydroepiandrosterone sulfate test is ordered in conjunction with testosterone and other male hormones assays to:

• Examine the adrenal glands' performance.
• Differentiate DHEAS-secreting disorders produced by the adrenal glands from those caused by the testicles or, in rare cases, the ovaries
• Adrenocortical tumors and adrenal malignancies can be diagnosed with this test.
• Assist in the diagnosis of congenital and adult-onset adrenal hyperplasia.

DHEAS levels are frequently examined in women, along with other hormones like FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovarian syndrome and rule out other reasons of infertility, lack of monthly cycle, and excess facial and body hair.

DHEAS levels, along with other hormones, may be requested to examine and diagnose the cause of young females developing masculine physical traits and young boys developing early puberty.

What do my DHEA-S test results mean?

A normal DHEAS level, together with other normal male hormone levels, suggests that the adrenal gland is working properly. When an adrenal tumor or cancer is present but not secreting hormones, DHEAS may be normal.

A high DHEAS blood level could indicate that the person's symptoms are caused or exacerbated by excessive DHEAS production. An elevated level of DHEAS, on the other hand, is not used to make a diagnosis of any particular condition; rather, it usually signals that further testing is required to determine the source of the hormone imbalance. An adrenocortical tumor, Cushing illness, adrenal cancer, or adrenal hyperplasia, as well as a DHEAS-producing ovarian tumor, can all cause high DHEAS.

DHEAS levels may be high in polycystic ovary syndrome, but they may also be normal, as PCOS is usually associated with ovarian androgen production.

Adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a disorder characterized by low levels of pituitary hormones that govern the generation and secretion of adrenal hormones, can all produce low DHEAS levels.

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

Description: Estradiol is a blood test that is used to measure the levels of Estradiol in the blood's serum. Estradiol is one of the Estrogen hormones in the body.  Estradiol, Ultrasensitive LC/MS/MS #30289 is a more appropriate test for children that have not yet started a menstrual cycle.

Also Known As: E2 Test, Estrogen 2 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Estradiol test ordered?

Tests for estradiol for women may be ordered if:

• After menopause, a woman may experience symptoms such as abnormal vaginal bleeding or irregular or absent menstrual cycles.
• When a woman is unable to conceive, a series of estradiol readings taken over the course of her menstrual cycle may be used to track follicle development before using in vitro fertilization procedures
• A woman is experiencing menopause symptoms such as hot flashes, night sweats, sleeplessness, and/or irregular or absent menstrual cycles.
• If a menopausal woman is on hormone replacement therapy, her doctor may order estrone levels on a regular basis to check her progress.

Men and young boys may be subjected to estradiol testing if:

• A boy's puberty is delayed, as evidenced by slow or delayed growth of testicles and penis, as well as a lack of deepening of voice or growth of body hair.
• Signs of feminization, such as larger breasts.

What does an Estradiol blood test check for?

Estradiol, or E2, is a component of Estrogen that is present in the blood. For women, Estradiol is something that should be produced naturally, and the body produces larger amounts of Estradiol during puberty and it fluctuates throughout the menstrual cycle. Estradiol is most prominent in women of reproductive age. Low levels are common in girls who have not yet had their first menstrual cycle and in women after their reproductive age.

Lab tests often ordered with an Estradiol test:

• Estrogen, Total, Serum
• Estriol
• Estrone
• Testosterone Free and Total
• Sex Hormone Binding Globulin
• FSH
• LH
• Progesterone

Conditions where an Estradiol test is recommended:

• Infertility
• Menopause
• Polycystic Ovarian Syndrome
• Hormone Imbalance
• Premature, delayed, or abnormal development of sex organs

Commonly Asked Questions:

How does my health care provider use an Estradiol test?

Estrogen tests are used to detect a deficit or excess of estrogen in a woman, as well as to aid in the diagnosis of a range of illnesses linked to this imbalance. They may also be ordered to monitor the health of the growing fetus and placenta during pregnancy, as well as to help predict the timing of a woman's ovulation. Estrogen testing can be used to detect a hormone excess and its origin in men.

In the case of girls and women

Estradiol testing may be requested for the following reasons:

• Diagnose early-onset puberty, which occurs when a girl develops secondary sex traits much earlier than anticipated, or late puberty, which occurs when a female develops secondary sex characteristics or begins menstruation later than predicted.
• Examine menstrual irregularities such as the absence of menstrual periods, infertility, and unusual vaginal bleeding.
• Evaluate ovary function and look for signs of ovarian failure.
• Serial measurements of estradiol can be used to track follicle development in the ovary in the days leading up to in vitro fertilization.
• Keep track of any hormone replacement therapy you're getting to help with your fertility.
• Keep track of menopausal hormone replacement medication, which is used to treat symptoms caused by estrogen insufficiency.
• Identify cancers that produce estrogen.
• As with breast cancer, keep an eye on anti-estrogen therapy.

Boys and men may be subjected to estradiol testing in order to:

• Assist in the diagnosis of delayed puberty
• Assist in determining the cause of larger breasts or other feminization indications.
• Detect an excess of relative estrogen due to a testosterone or androgen deficit.
• Identify cancers that produce estrogen.

What do my Estradiol test results mean?

Estradiol is one of the three Estrogens that have a large impact on the women's body throughout the menstrual cycle. When these hormones are too high or too low, it could cause irregular bleeding, infertility, complications with menopause, and delayed or premature puberty. Out of range levels can also be indicative of an ovarian condition such as PCOS. It is important to note that these values will fluctuate throughout a woman's cycle. The Estrogen hormones work together and if one is out of range, the others may also be out of range. It is recommended to follow up with a licensed healthcare professional to determine the best treatment if need.

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

IMPORTANT - Note this Estradiol test is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute in Estradiol, Ultrasensitive LC/MS/MS - #30289 at an additional charge of $34

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.

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.

Clinical Significance
Micronutrient, Folate

Patients must be 18 years of age or greater.

Reference Range(s)
≥18 years    >5.4 ng/mL
Reference range not available for individuals <18 years for this micronutrient test.

Clinical Significance
Micronutrients, Antioxidants Panel

Patients must be 18 years of age or greater.

Includes
Micronutrient, Coenzyme Q10 (CoQ10)
Micronutrient, Vitamin A (Retinol)
Micronutrient, Vitamin C
Micronutrient, Vitamin E

Patient Preparation
Overnight fasting required.
Avoid taking Coenzyme Q10 supplements the morning of the test.
Refrain from eating fruits or taking vitamin C supplements 24 hours prior to collection.

Reference Range(s)
Coenzyme Q10 (CoQ10)    >35 ug/mL
Vitamin A (Retinol)
18-19 years    26-72 mcg/dL
>19 years    38-98 mcg/dL
Reference range not available for individuals <18 years for this micronutrient test.

Vitamin C
Male ≥18 years    0.2-2.1 mg/dL
Female ≥18 years    0.3-2.7 mg/dL
Reference range not available for individuals <18 years for this micronutrient test.

Vitamin E
Alpha Tocopherol    ≥18 years    5.7-19.9 mg/L
Beta-Gamma Tocopherol    ≥18 years    <4.4 mg/L
Reference range not available for individuals <18 years for this micronutrient test.

Description: A Follicle Stimulating Hormone, or FSH, test is a blood test that measures the levels of FSH in the blood. This can be used to diagnose conditions related to the sex organs, early or late puberty, or a condition affecting the pituitary or hypothalamus. It is also used to predict ovulation, evaluate infertility and monitor during infertility treatment. Levels that are out of range can help, along with several other hormone test, to evaluate the cause of irregular menstrual cycles.

Also Known As: Follicle Stimulating Hormone Test, Follitropin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a FSH test ordered?

An FSH test may be recommended for a woman if she is having trouble conceiving or has irregular or absent menstrual periods.

When a woman's menstrual cycle has ended or grown erratic, FSH may be ordered to see if she has entered menopause.

When a man's spouse is unable to conceive, when he has a low sperm count, or when he has low muscle mass or diminished sex drive, for example, the test may be ordered.

When a health care provider detects a pituitary issue in a woman or a man, testing may be ordered. Because a pituitary problem can disrupt the production of a variety of hormones, other signs and symptoms may appear in addition to those described above. Fatigue, weakness, unexpected weight loss, and decreased appetite are just a few examples.

When a boy or girl does not seem to be entering puberty at the proper age, FSH and LH may be prescribed. Puberty symptoms include:

• Breast enlargement in young women
• Pubic hair development
• In boys, the testicles and penis grow.
• In girls, menstruation begins.

What does a FSH blood test check for?

FSH is a hormone linked to production and the development of eggs and sperm in both men and women. FSH is measured in the blood.

The pituitary gland, a grape-sized structure near the base of the brain, produces FSH. The hypothalamus in the brain, the pituitary gland, and hormones generated by the ovaries or testicles all work together to control FSH production. The hypothalamus secretes gonadotropin-releasing hormone, which causes the pituitary to secrete FSH and luteinizing hormone, a hormone that is closely related to FSH and is also important in reproduction.

During the follicular phase of the menstrual cycle, FSH increases the growth and maturation of eggs in the ovaries in women. The menstrual cycle is divided into two phases: follicular and luteal, each lasting approximately 14 days. During this follicular phase, FSH triggers the follicle's synthesis of estradiol, and the two hormones collaborate to help the egg follicle develop further. A surge of FSH and luteinizing hormone occurs near the end of the follicular period. Shortly after this burst of hormones, the egg is released from the ovary. The hormones inhibin, estradiol, and progesterone all help the pituitary gland regulate the quantity of FSH released. FSH also improves the ovary's ability to respond to LH.

Ovarian function declines and eventually quits as a woman matures and approaches menopause. FSH and LH levels rise as a result of this.

FSH induces the development of mature sperm in men's testicles, as well as the production of androgen binding proteins. After adolescence, men's FSH levels remain rather steady.

FSH levels rise early after birth in infants and children, then fall to very low levels by 6 months in boys and 1-2 years in girls. Prior to the onset of puberty and the development of secondary sexual characteristics, concentrations begin to rise again.

The production of too much or too little FSH can be caused by disorders affecting the brain, pituitary, ovaries, or testicles, resulting in infertility, irregular menstrual cycles, or early or delayed sexual development.

Lab tests often ordered with a FSH test:

• Estrogen
• Estradiol
• LH
• Testosterone
• Progesterone
• Androstenedione
• Sperm Analysis
• Anti-Mullerian Hormone
• Prolactin
• Sex Hormone Binding Globulin

Conditions where a FSH test is recommended:

• Infertility
• Menopause
• Pituitary Disorders
• Endocrine Syndromes
• PCOS

How does my health care provider use a FSH test?

There are various applications for the follicle-stimulating hormone test, which is a hormone linked to reproduction and the development of eggs in women and sperm in men.

The test can be used with additional hormone assays including luteinizing hormone, testosterone, estradiol, and/or progesterone in both women and men to help:

• Find out what's causing infertility.
• Diagnose conditions involving ovarian or testicular dysfunction.
• Aid in the diagnosis of diseases of the pituitary or hypothalamus, which can impact FSH production.

FSH levels are also relevant in women for:

• Menstrual irregularities are being investigated.
• Menopause start or confirmation prediction

FSH levels in males are used to determine the cause of a low sperm count.

FSH and LH are used to diagnose delayed or precocious puberty in children. Puberty timing irregularities could indicate a more significant disease involving the hypothalamus, pituitary gland, ovaries, testicles, or other systems. LH and FSH levels can help distinguish between benign symptoms and real disease. Once it's been determined that the symptoms are due to an actual condition, more testing can be done to figure out what's causing them.

What do my FSH test results mean?

FSH test findings are frequently combined with those from other hormone testing, such as LH, estrogens, and/or testosterone.

A high or low FSH level as part of an infertility workup is not diagnostic, but it does provide some insight into the cause. A hormone imbalance, for example, can influence a woman's menstrual cycle and/or ovulation. To make a diagnosis, a doctor will take into account all of the information gathered during the examination.

Women's Health

FSH and LH levels can assist distinguish between primary ovarian failure and secondary ovarian failure.

Primary ovarian failure is associated with high levels of FSH and LH.

Low FSH and LH levels are indicative of secondary ovarian failure caused by a pituitary or hypothalamic issue. Low FSH levels in the blood have been linked to an increased risk of ovarian cancer.

Men's Health

Primary testicular failure causes high FSH levels. As shown below, this can be the result of developmental problems in testicular growth or testicular damage.

Low levels are indicative of pituitary or hypothalamic dysfunction.

Children's Health

Precocious puberty is defined by high levels of FSH and LH, as well as the development of secondary sexual traits at an extremely young age. This occurs far more frequently in girls than in boys. This abnormal development is usually caused by a problem with the central nervous system, which can have a variety of causes.

Normal prepubescent LH and FSH levels in children who are showing signs of pubertal alterations could suggest a syndrome known as "precocious pseudopuberty." Elevated levels of the hormones estrogen or testosterone cause the signs and symptoms.

LH and FSH levels can be normal or below what is expected for a child of this age range in delayed puberty.

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

Description: A Follicle Stimulating Hormone, or FSH, test is a blood test that measures the levels of FSH in the blood. This can be used to diagnose conditions related to the sex organs, early or late puberty, or a condition affecting the pituitary or hypothalamus. It is also used to predict ovulation, evaluate infertility and monitor during infertility treatment. Levels that are out of range can help, along with several other hormone test, to evaluate the cause of irregular menstrual cycles.

A Luteinizing Hormone, or LH, Test is a test that measures the level of the LH in the blood. It is used to predict ovulation, evaluate infertility and monitor during infertility treatment, or identify a pituitary disorder. It can also help along with several other hormone test to evaluate the cause of irregular menstrual cycles.

Also Known As: Follicle Stimulating Hormone test, Follitropin Test, Luteinizing Hormone Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a FSH and LH test ordered?

An FSH and LH test may be recommended for a woman if she is having trouble conceiving or has irregular or absent menstrual periods.

When a woman's menstrual cycle has ended or grown erratic, FSH and LH may be ordered to see if she has entered menopause.

When a man's spouse is unable to conceive, when he has a low sperm count, or when he has low muscle mass or diminished sex drive, for example, the test may be ordered.

When a health care provider detects a pituitary issue in a woman or a man, testing may be ordered. Because a pituitary problem can disrupt the production of a variety of hormones, other signs and symptoms may appear in addition to those described above. Fatigue, weakness, unexpected weight loss, and decreased appetite are just a few examples.

What does a FSH and LH blood test check for?

FSH and LH are hormones linked to production and the development of eggs and sperm in both men and women. FSH and LH is measured in the blood.

The pituitary gland produces FSH and LH. The hypothalamus in the brain, the pituitary gland, and hormones generated by the ovaries or testicles all work together to control FSH and LH production. The hypothalamus secretes gonadotropin-releasing hormone, which causes the pituitary to secrete FSH and luteinizing hormone.

During the follicular phase of the menstrual cycle, FSH and LH increases the growth and maturation of eggs in the ovaries in women. The menstrual cycle is divided into two phases: follicular and luteal, each lasting approximately 14 days. During this follicular phase, FSH triggers the follicle's synthesis of estradiol, and the two hormones collaborate to help the egg follicle develop further. A surge of FSH and luteinizing hormone occurs near the end of the follicular period. Shortly after this burst of hormones, the egg is released from the ovary. The hormones inhibin, estradiol, and progesterone all help the pituitary gland regulate the quantity of FSH released. FSH also improves the ovary's ability to respond to LH.

Ovarian function declines and eventually quits as a woman matures and approaches menopause. FSH and LH levels rise as a result of this.

FSH induces the development of mature sperm in men's testicles, as well as the production of androgen binding proteins. After adolescence, men's FSH levels remain rather steady.

FSH levels rise early after birth in infants and children, and then quickly fall to low levels by 6 months of age in boys and  around 1 and half years of age in girls. Before puberty and the development of secondary sexual characteristics, FSH levels begin to rise again.

The production of too much or too little FSH and LH can be caused by disorders affecting the brain, pituitary, ovaries, or testicles, resulting in infertility, irregular menstrual cycles, or early or delayed sexual development.

Lab tests often ordered with a FSH and LH test:

• Estrogen
• Estradiol
• Testosterone
• Progesterone
• Androstenedione
• Sperm Analysis
• Anti-Mullerian Hormone
• Prolactin
• Sex Hormone Binding Globulin

Conditions where a FSH and LH test is recommended:

• Infertility
• Menopause
• Pituitary Disorders
• Endocrine Syndromes
• PCOS

How does my health care provider use a FSH and LH test?

There are various applications for the follicle-stimulating hormone and luteinizing hormone test, which are hormones linked to reproduction and the development of eggs in women and sperm in men.

The test can be used with additional hormone assays including luteinizing hormone, testosterone, estradiol, and/or progesterone in both women and men to help:

• Find out what's causing infertility.
• Diagnose conditions involving ovarian or testicular dysfunction.
• Aid in the diagnosis of diseases of the pituitary or hypothalamus, which can impact FSH production.

FSH and LH levels are also relevant in women for:

• Menstrual irregularities are being investigated.
• Menopause start or confirmation prediction

FSH and LH levels in males are used to determine the cause of a low sperm count.

FSH and LH are used to identify delayed or early puberty in children. Puberty timing irregularities could indicate a more significant disease involving the hypothalamus, pituitary gland, ovaries, testicles, or other systems. LH and FSH levels can help distinguish between benign symptoms and real disease. Once it's been determined that the symptoms are due to an actual condition, more testing can be done to figure out what's causing them.

What do my FSH and LH test results mean?

FSH and LH test findings are frequently combined with those from other hormone testing estrogens, and/or testosterone.

A high or low FSH level as part of an infertility workup is not diagnostic, but it does provide some insight into the cause. A hormone imbalance, for example, can influence a woman's menstrual cycle and/or ovulation. To make a diagnosis, a doctor will take into account all of the information gathered during the examination.

Women's Health

• FSH and LH levels can assist distinguish between primary ovarian failure and secondary ovarian failure.
• Primary ovarian failure is associated with high levels of FSH and LH.
• Low FSH and LH levels are indicative of secondary ovarian failure caused by a pituitary or hypothalamic issue. Low FSH levels in the blood have been linked to an increased risk of ovarian cancer.

Men's Health

• Primary testicular failure causes high FSH levels. As shown below, this can be the result of developmental problems in testicular growth or testicular damage.
• Low levels are indicative of pituitary or hypothalamic dysfunction.

Children's Health

• Precocious puberty is defined by high levels of FSH and LH, as well as the development of secondary sexual traits at an extremely young age. This occurs far more frequently in girls than in boys. This abnormal development is usually caused by a problem with the central nervous system, which can have a variety of causes.
• Normal prepubescent LH and FSH levels in children who are showing signs of pubertal alterations could suggest a syndrome known as "precocious pseudopuberty."
• For children with delayed puberty, LH and FSH levels can be normal or below what is expected for children of their age.

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

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.

Description: A Luteinizing Hormone, or LH, Test is a test that measures the level of the LH in the blood. It is used to predict ovulation, evaluate infertility and monitor during infertility treatment, or identify a pituitary disorder. It can also help along with several other hormone test to evaluate the cause of irregular menstrual cycles.

Also Known As: Luteinizing Hormone Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an LH test ordered?

LH testing may be ordered in adults when:

• A woman is having trouble conceiving or has irregular or non-existent menstrual cycles.
• When a woman's menstrual cycle has stopped or grown irregular, or it is suspected that she has entered menopause.
• When a man's partner is unable to conceive, when he has low testosterone levels, or when he has poor muscular mass or decreased sex drive.
• Unexplained weight loss, exhaustion and weakness, and decreased appetite are just a few examples of signs and symptoms that may be present when a health professional suspects a pituitary issue.

When a boy or girl does not appear to be entering puberty at the appropriate age, LH may be ordered. Puberty symptoms include:

• Breast enlargement in young women
• Pubic hair development
• Boys' testicles and penis grow.
• In girls, menstruation begins.

What does an LH blood test check for?

Luteinizing hormone is a hormone linked to reproduction and the stimulation of ovarian egg release in women, as well as testosterone production in males. This test determines how much luteinizing hormone is present in the blood.

The pituitary gland, a grape-sized structure near the base of the brain, produces LH. The hypothalamus in the brain, the pituitary gland, and the hormones generated by the ovaries and testicles all work together to control LH production.

Several hormones rise and fall in a certain order in premenopausal women's bodies during each menstrual cycle. LH increases ovulation and the generation of other hormones such as estradiol and progesterone during the menstrual cycle.

Each phase of a woman's menstrual cycle lasts roughly 14 days and is separated into follicular and luteal stages. A mid-cycle surge of follicle-stimulating hormone and LH occurs near the end of the follicular phase. Ovulation is triggered by this surge, which results in the rupture of the egg follicle on the ovary and the release of the egg.

The place where the egg follicle ruptured becomes a "corpus luteum" during the luteal phase. The corpus luteum is stimulated to begin generating progesterone by LH release. While FSH and LH levels decrease, progesterone and estradiol levels rise. If the egg is not fertilized, these hormone levels will drop after a few days. Menstruation begins, and then the cycle repeats itself.

Ovarian function declines and eventually quits as a woman matures and approaches menopause. FSH and LH levels rise as a result of this.

LH stimulates the testicles' Leydig cells to create testosterone in men. After adolescence, men's LH levels remain generally steady. A high level of testosterone sends negative feedback to the pituitary gland and hypothalamus, reducing the amount of LH released.

LH levels in newborns and youngsters peak shortly after delivery and then drop to extremely low levels. Levels begin to rise again at the age of 6-8 years, just before puberty and the development of secondary sexual traits.

Lab tests often ordered with an LH test:

• FSH
• Testosterone
• Progesterone
• Estrogen
• Estradiol
• Androstenedione
• Sperm Analysis
• Prolactin
• Anti-Mullerian Hormone
• Sex Hormone Binding Globulin

Conditions where an LH test is recommended:

• Infertility
• Menopause
• Pituitary Disorders
• Endocrine Disorders
• PCOS

How does my health care provider use an LH test?

There are various applications for the luteinizing hormone test, which is a hormone linked to production and the stimulation of the release of an egg from the ovary in women and testosterone synthesis in males.

LH is frequently used in conjunction with other tests in both women and men:

• In the investigation of infertility,
• To help with the diagnosis of pituitary diseases that impact LH production.
• To aid in the diagnosis of diseases involving the ovaries or testicles

FSH and LH are used to diagnose delayed and precocious puberty in children. Puberty timing irregularities could indicate a more significant disease involving the hypothalamus, pituitary gland, ovaries, testicles, or other systems. LH and FSH levels can help distinguish between benign symptoms and real disease. Once it's been determined that the symptoms are due to an actual condition, more testing can be done to figure out what's causing them.

LH is occasionally evaluated in response to gonadotropin releasing hormone treatment in those with evidence of impaired ovarian or testicular function to distinguish between problems involving the brain or pituitary gland. The hypothalamus produces GnRH, which stimulates the pituitary gland to release LH and FSH. A baseline blood sample is taken for this test, and then the subject is given a GnRH injection. Following that, blood samples are collected at predetermined intervals and the level of LH is monitored. This test can assist distinguish between a pituitary disorder, in which LH does not respond to GnRH, and a hypothalamic disorder, in which LH does respond to GnRH. It's also useful for determining if a child is precocious or delayed in puberty.

What do my LH test results mean?

Women's Health

Primary ovarian failure and secondary ovarian failure can be distinguished using LH and FSH levels.

Primary ovarian failure is characterized by elevated levels of LH and FSH.

Multiple LH tests can be done to detect the surge that precedes ovulation in women who are attempting to conceive. Ovulation has happened when LH levels rise.

Because a woman's ovaries stop working during menopause, her LH levels rise.

Secondary ovarian failure is characterized by low levels of LH and FSH, which indicate a problem with the pituitary or hypothalamus.

Men's Health

LH levels that are too high could suggest primary testicular failure. This can be caused by testicular injury or developmental problems in testicular growth.

Low levels of LH and FSH are detected in secondary testicular failure and reflect a pituitary or hypothalamic issue.

For both men and women

The LH response to GnRH can assist distinguish between secondary and tertiary dysfunction. After determining the baseline level of LH, a dosage of GnRH is administered through injection. The fact that the pituitary responded to the GnRH and that the level of LH increased afterward suggests a hypothalamic problem. A low amount of LH indicates that the pituitary did not respond to GnRH and points to a pituitary illness.

Children's

Precocious puberty is defined as high levels of LH and FSH together with the development of secondary sexual characteristics at an unusually young age in young children. This occurs far more frequently in girls than in boys. This abnormal development is usually caused by a problem with the central nervous system, which can have a variety of causes.

Normal FSH and LH levels with a few indications of puberty could indicate a benign form of precocious puberty with no underlying or discernible reason, or it could simply be a normal variation of puberty. LH and FSH levels can be normal or below what is expected for a child of this age range in delayed puberty. In addition to other tests, the LH response to GnRH test may aid in determining the cause of delayed puberty. Delay in puberty can be caused by a variety of factors.

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

Description: The RPR test is used to determine if a person has been infected with syphilis. An RPR can be used to monitor treatment for syphilis and the effectiveness of syphilis treatment. Syphilis testing is a two-part test. The first round of testing for syphilis is an RPR test. If these results come back positive, a second round of testing will be required. A positive RPR result will be followed by a second method that will be used to confirm the results. If the second syphilis test comes back positive, the affected person will be diagnosed with syphilis. If the second test comes back negative, it could mean that the first test is a false positive and more testing may be necessary.

Also Known As: Rapid Plasma Reagin with Reflex to Titer, Syphilis RPR, Syphilis Titer test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT

A positive RPR screen must be followed by a specific treponemal antibody test (e.g., FTA-ABS):

A positive result on the second method confirms the screening result and the affected person is diagnosed with syphilis.

A negative result on the treponemal test may mean that the initial RPR test was falsely positive. Further testing and investigation may be done to determine the cause of the false positive.

Limitations

False-positive results have been associated in patients with infections, pregnancy, autoimmune disease, old age, Gaucher disease, and malignancy.

When is a Syphilis RPR test ordered?

When a person shows signs and symptoms of syphilis, a syphilis test may be done.

Regardless of symptoms, a person should be tested for syphilis if they:

• Are being treated for gonorrhea or another sexually transmitted disease?
• If a woman is pregnant, she should be seen during the first prenatal visit, then again in the third trimester and at the time of delivery if she is at high risk.
• Are a man who has sex with other males; testing should be done at least once a year or every 3-6 months if the risk is significant.
• Engages in high-risk sexual behavior, such as having intercourse with several partners without protection.
• If you have HIV, you should get tested when you're initially diagnosed and then at least once a year after that; if you're at high risk, you should get tested more frequently.
• Has one or more partners who have tested positive for syphilis
• Officials from the Department of Public Health have told him or her that he or she has been exposed to an infected partner.

When a person has been treated for syphilis, the CDC recommends doing follow-up testing, such as assessing antibody levels, to ensure that the therapy was successful and the infection was cured.

What does a Syphilis RPR blood test check for?

Syphilis is a bacterial infection caused by Treponema pallidum that is primarily spread during sexual activity, such as by direct contact with a syphilis sore. The majority of common syphilis tests can detect antibodies in the blood that were produced in response to a T. pallidum infection. Some less common methods can be used to locate the bacterium or its genetic components.

Syphilis is easily treated with medications, but if left untreated, it can cause serious health concerns. A mother who is afflicted can convey the disease to her unborn child, which can have serious and even fatal effects for the newborn.

With syphilis, there are numerous stages that can occur:

• The primary stage of syphilis begins about 2-3 weeks following infection. One or more chancres emerge, usually on the body portion exposed to the chancre of the sexual partner, such as the penis or vaginal area. The chancre, on the other hand, is usually painless and may go unnoticed, especially if it is in the rectum or on the cervix, and it goes away within 4-6 weeks, mending whether or not the infected person is treated.
• If primary syphilis is left untreated, secondary syphilis can develop anywhere from 6 weeks to 6 months after the chancre initially emerges. It is characterized by a rough, red, and speckled skin rash that appears regularly on the palms of the hands and the bottoms of the feet and does not itch. Fever, weariness, enlarged lymph nodes, sore throat, and body aches are some of the other symptoms that can occur.
• Secondary syphilis can progress to a latent stage, during which an infected individual has no symptoms but still retains the infection, and this stage can remain for years if left untreated. If left untreated, roughly 15% of persons will develop late, or tertiary, syphilis issues. Bacteria can harm the heart, eyes, brain, neurological system, bones, joints, and practically any other component of the body in these situations. Neurosyphilis is a disease that affects the central nervous system. Tertiary syphilis can linger for years, leading to mental illness, blindness, other neurological issues, heart disease, and death in the ultimate stage.
• If left untreated, syphilis progresses.

The basic and secondary stages of syphilis are the most contagious. About a third of the approximately 63,000 new cases of syphilis reported to the CDC in 2014 were main or secondary stage syphilis. Eighty-three percent of these cases included guys having intercourse with other men.

Antibiotics, usually penicillin, can be used to cure syphilis. Infections that have been acquired recently can be rapidly healed; however, someone who has been infected for more than a year may require prolonged therapy.

Lab tests often ordered with a Syphilis RPR test:

• HIV Antibody
• HIV Antigen
• Gonorrhea
• Chlamydia
• Herpes 1 and 2
• Trichomonas
• STD Panel

Conditions where a Syphilis RPR test is recommended:

• Sexually Transmitted Diseases
• Syphilis
• Gonorrhea
• Chlamydia
• Herpes 1
• Herpes 2
• HIV and AIDS
• Pregnancy

How does my health care provider use a Syphilis RPR test?

Syphilis tests are used to detect and/or diagnose infection with the bacterium Treponema pallidum, which causes syphilis.

There are a variety of tests to choose from. The most common type of test is an antibody test.

Antibody tests identify antibodies in the blood and, occasionally, in the cerebrospinal fluid. Nontreponemal antibody test and treponemal antibody test are the two types of syphilis tests available. Syphilis screening can be done with any type, but it must be followed by a second test that employs a different approach to confirm a positive result and identify active syphilis:

Antibodies that aren't specifically directed towards the Treponema pallidum bacterium are detected by nontreponemal antibody testing. The body produces these antibodies when a person has syphilis, but they can also be produced in a variety of other situations. Because the tests are non-specific, false-positive findings can be produced by things like IV drug usage, pregnancy, Lyme disease, certain types of pneumonia, malaria, tuberculosis, or certain autoimmune disorders like lupus. A positive screening result must be double-checked with a more detailed test. Nontreponemal testing include the following:

RPR—in addition to screening, this test can be used to track syphilis therapy. Antibody levels are tested for this reason. When an initial test for treponemal antibodies is positive, it can also be used to confirm the existence of an active infection.

VDRL—in addition to blood, this test is largely used to identify neurosyphilis in the CSF.

Antibodies to T. pallidum are detected by treponemal antibody tests, which are blood tests. Because they are extremely specific for syphilis, they are unlikely to produce a positive result in other diseases. Once a person is infected and these antibodies form, they remain in the bloodstream for the rest of their lives. Nontreponemal antibodies, on the other hand, usually vanish within 3 years in a properly treated person. As a result, a positive treponemal screening result must be followed by a nontreponemal test in order to distinguish between an active infection and one that has been successfully treated in the past. FTA-ABS is a treponemal antibody test that is beneficial after the first 3-4 weeks after exposure. It can be used to assess antibodies to T. pallidum in the CSF to assist diagnose neurosyphilis in addition to blood testing.

• TP-PA—instead of FTA-ABS, this test is sometimes used because it is more specific and has less false positives.
• Another confirmatory approach is MHA-TP, which is presently used considerably less frequently.
• Immunoassays—Several automated tests have been developed in recent years, making them useful for screening applications.

What do my Syphilis test results mean?

A negative blood test indicates that there is most likely no infection. A negative screening test, on the other hand, simply states that there was no evidence of disease at the time of the test. Antibodies may not be detected for several weeks following bacterial contact. If a person is aware that he or she has been exposed, or if the risk of infection remains high, additional testing may be required. It is also critical for persons who are at a higher risk of contracting syphilis to get regular screening tests to check for infection.

A particular treponemal antibody test must be performed after a positive RPR or VDRL screen:

The infected person is diagnosed with syphilis once a positive result on the second method confirms the screening result.

A negative treponemal test result could indicate that the initial RPR or VDRL test was incorrectly positive. To discover the reason of the false positive, more testing and investigation may be conducted.

A treponemal antibody test, on the other hand, will be used as an initial test by a healthcare practitioner or laboratory. A positive result indicates the presence of syphilis antibodies in the blood, but because treponemal antibodies stay positive even after an infection is treated, it does not indicate whether the person is now afflicted or has previously been infected. Nontreponemal antibodies found with an RPR, on the other hand, usually vanish after 3 years in a properly treated person. If the initial treponemal test is positive, an RPR can be used to determine whether the infection is active or past. A positive RPR in this scenario would establish that the person has been exposed to syphilis and, if not previously treated, has an ongoing infection or, if treatment occurred more than 3 years ago, possible re-infection.

The results of one or more RPR titers may be used to monitor treatment and/or determine if treatment was successful. Antibodies to syphilis should be decreased after therapy. If the RPR was 1:256 before therapy, a number of 1:16 after treatment would indicate a reduced amount of antibody. The affected person may have a persistent infection or was reinfected if the titer stays the same or rises. The results can also be transformed to a whole number or reported as dilutions.

Nontreponemal antibodies fade away over time after effective treatment, whereas treponemal antibodies remain in the blood for the rest of one's life.

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

Description: Sex Hormone Binding Globulin test is a blood test that is often paired in testosterone testing for men suspected to have low testosterone and women with elevated testosterone.

Also Known As: SHBG Test, TeBG Test, Testosterone-Estrogen Binding Globulin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Sex Hormone Binding Globulin test ordered?

Sex Hormone Binding Globulin may be ordered by a healthcare provider to investigate infertility, diminished sex drive, and erectile dysfunction in males, or irregular cycles, infertility, and excess body and face hair in women, when total testosterone values do not appear to be consistent with the mentioned signs and symptoms.

What does a Sex Hormone Binding Globulin blood test check for?

SHBG is a liver-produced protein that strongly binds to the hormones testosterone, dihydrotestosterone, and estradiol. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. This test examines the amount of SHBG in the blood and is most commonly used to determine whether a person has too much or too little testosterone.

In men, SHBG binds roughly 45 percent to 65 percent of testosterone in the blood, with the rest weakly and reversibly linked to albumin. Only around 2% to 3% of testosterone is accessible to tissues as free testosterone, but testosterone that is weakly linked to albumin is also bioavailable and can be rapidly absorbed by the body's tissues.

In women, a somewhat higher percentage of testosterone is bound to SHBG in the blood than in men. SHBG is important in controlling the quantities of bioavailable male sex hormones and estrogens circulating throughout the body in women. Because SHBG has a stronger affinity for the androgens testosterone and DHT, women with low SHBG may experience signs and symptoms of androgen excess.

A total testosterone test does not differentiate between bound and unbound testosterone; instead, it determines the total amount of testosterone present. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the person's tissues. When a person's indications and symptoms do not match the results of a total testosterone test, a SHBG test may be conducted.

Lab tests often ordered with a Sex Hormone Binding Globulin test:

• Testosterone
• Estradiol
• Dihydrotestosterone
• FSH
• LH
• Estriol
• Estrone
• Albumin
• Prolactin

Conditions where a Sex Hormone Binding Globulin test is recommended:

• Polycystic Ovary Syndrome
• Infertility
• Liver disease
• Hyperthyroidism
• Eating disorders
• Pregnancy
• Cushing Syndrome
• Hypothyroidism

How does my health care provider use a Sex Hormone Binding Globulin test?

The sex hormone binding globulin test can be performed to determine whether a man has low testosterone or if a woman has too much testosterone. It can be used in conjunction with other tests to assess a person's sex hormone status.

SHBG is a protein that binds to testosterone, dihydrotestosterone, and estradiol, among other hormones. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. Changes in SHBG levels can have an impact on the amount of hormone accessible to the body's tissues.

To assess a person's current hormonal balance, tests for albumin and one or more additional sex hormones, such as prolactin, estradiol, and LH may be conducted.

In men

In order to diagnose the cause of infertility, diminished sex drive, or erectile dysfunction in an adult male, SHBG and total testosterone levels may be ordered. When total testosterone findings are contradictory with clinical symptoms, measuring SHBG in addition to testosterone is extremely beneficial.

Total testosterone in the blood is measured without distinguishing between bound and unbound testosterone; rather, it determines the total amount of testosterone in the blood. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the body's tissues.

With a simple total testosterone assessment, health practitioners can estimate bioavailable testosterone by measuring SHBG. Because less testosterone is accessible to the body's tissues, increased SHBG in males may be linked to symptoms of low testosterone levels.

Total testosterone should be measured in the initial screening for testosterone deficiency, according to the Endocrine Society's professional standards. If the results are abnormal, the test is repeated the next day. They propose one of the following if repeat readings are low-normal and/or SHBG is abnormal:

In women

The ovaries and adrenal glands produce modest amounts of testosterone in women. Even little increases in testosterone production can throw off the hormone balance, resulting in symptoms including irregular or missed periods, infertility, acne, and excessive face and body hair. These and other signs and symptoms are common in polycystic ovarian syndrome, a disorder marked by an overproduction of male sex hormones. SHBG and testosterone testing may be helpful in detecting and evaluating excess testosterone production and/or decreasing SHBG concentrations, as well as in evaluating women with PCOS.

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

Description: A RT3 test is a laboratory test that checks for Reverse T3 levels in your blood’s serum.

Also Known As: T3 Reverse test, REVT3 Test, RT3 Test, T3R Test, Reverse T3 Test, Reverse Triiodothyronine Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is this test ordered?

Reverse T3 is used to identify stress on the body due to many factors including extreme dieting, surgery, liver and kidney disease, insulin dependent diabetes, serious injury, and chronic alcohol consumption.

What is being tested?

Reverse T3 is a derivative of Thyroxine T4. T4 becomes the active thyroid hormone Triiodothyronine T3 when it loses one of its iodine atoms. T4 is also converted by the body into Reverse T3, which is an inactive version of T3 that lacks T3's metabolic function. Reverse T3 is thought to be produced by the body to conserve energy during times of severe illness and stress.

Related Tests and Panels:

• T3 Free
• T3 Total
• T4 Free
• T4 Total
• TSH
• T3 Uptake
• Thyroid Peroxidase
• Thyroglobulin Antibodies

Related Conditions:

• Hyperthyroidism
• Hypothyroidism
• Hashimotos
• Graves’ Disease
• Autoimmune Diseases
• Thyroid Cancer
• Kidney Disease
• Liver Disease
• Alcoholism
• Stress
• Diabetes

How is the Reverse T3 test used by my healthcare provider?

Results of a Reverse T3 test are used in combination with results of T4 tests, T3 Tests, thyroid antibodies, and TSH in assessing a patient’s symptoms and thyroid function.

What does my Reverse T3 test result mean?

High levels of T3 Reverse indicate that an excessive amount of T4 is being converted into Reverse T3 instead of active T3. This can cause signs of hypothyroidism, a thyroid condition often referred to as underactive thyroid, even when other thyroid hormones are within normal ranges. Elevated levels of RT3 levels can also be a sign of illness and stress and as the body converts more T4 into Reverse T3 when experiencing illnesses and stress.

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

Description: A T3 Total test is a blood test that measures triiodothyronine levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hyperthyroidism.

Also Known As: Total T3 Test, Triiodothyronine Test, T3 Test, Bound T3

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T3 Total test ordered?

When a person's TSH test results are abnormal, a total T3 test may be recommended. When a person has symptoms that imply hyperthyroidism, it may be requested as part of the investigational workup, especially if the free T4 level is not elevated.

The following are possible signs and symptoms:

• Heart rate has increased.
• Anxiety
• Loss of weight
• Sleeping problems
• Hand tremors
• Weakness
• Diarrhea
• Visual disturbances, light sensitivity
• Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Total T3 may be ordered at regular intervals to monitor a known thyroid disease or to assess the efficacy of hyperthyroidism treatment.

What does a T3 Total blood test check for?

T3 is one of two key hormones produced by the thyroid gland, a small butterfly-shaped organ near the base of the throat that sits flat across the windpipe. Thyroxine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T3 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's physiologically active form. Tests can determine the amount of free T3 or total T3 in the blood.

A feedback system controls T3 and T4 production. The hypothalamus releases thyrotropin releasing hormone when thyroid hormone levels in the blood drop, which prompts the pituitary gland to create and release thyroid-stimulating hormone. The thyroid gland is thus stimulated to create and/or release more thyroid hormones as a result of TSH. T4 is the most common thyroid hormone produced. This hormone is generally inactive, but in the liver and other tissues, it is transformed into the considerably more active T3.

If the thyroid gland produces too much T4 and T3, the person may have symptoms like uneasiness, hand tremors, weight loss, sleeplessness, and puffiness around dry, itchy eyes. The person's eyes may be unable to move normally and appear to be glaring in some circumstances. The eyeballs may also appear to bulge in some circumstances.

If the thyroid gland does not produce enough thyroid hormones, the person may experience weight gain, dry skin, lethargy, and constipation, which are all signs and symptoms of hypothyroidism and a slower metabolism. Thyroid hormone levels in the blood might be low or high due to thyroid malfunction, or in rare cases, insufficient or excessive TSH production due to a pituitary issue.

Autoimmune illnesses are the most common causes of thyroid dysfunction. Hyperthyroidism is caused by Graves disease, but it can also be caused by thyroiditis, thyroid malignancy, or high TSH production. Total T3 can be used to diagnose and monitor the impact of certain disorders on thyroid hormone production.

Lab tests often ordered with a T3 Total test:

• TSH
• T3 Free
• T4 Free
• T4 Total
• T3 Reverse
• T3 Uptake
• Thyroid Peroxidase
• Thyroglobulin Antibodies

Conditions where a T3 Total test is recommended:

• Hyperthyroidism
• Hypothyroidism
• Hashimotos
• Graves’ Disease
• Autoimmune Diseases
• Thyroid Cancer

How does my health care provider use a T3 Total test?

Thyroid function is measured with a total triiodothyronine test. It's usually ordered to assist identify hyperthyroidism, but it can also be used to track a person's therapy for a thyroid problem.

Thyroid hormones T3 and T4 are generated by the thyroid gland. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. Thyroid-stimulating hormone boosts T4 and T3 synthesis and release. The liver and other tissues convert T4 into T3 as needed.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood tests.

Because the majority of T3 is coupled to protein, total T3 can be influenced by protein levels and binding ability, but free T3 is unaffected. Some professional standards, however, advocate total T3, thus either test can be used to evaluate thyroid function. To assist diagnose Graves disease, an autoimmune illness that is the most prevalent cause of hyperthyroidism, free T3 or total T3 may be ordered together with thyroid antibodies.

Following an abnormal TSH, a total T3 test is generally done, especially if the free T4 test is not high.

What does my T3 Total Test result mean?

Thyroid hormone levels that are high or low suggest a mismatch between the body's needs and supplies, but they don't inform the doctor what's causing the excess or deficiency.

If someone is being treated for hyperthyroidism with anti-thyroid medication and their free or total T3 levels are normal, the medicine is likely beneficial in treating the illness. If the free or total T3 or free T4 levels are high, the medication isn't working to address the problem, and the person may be having hyperthyroidism symptoms.

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

Decreased: Pregnancy, estrogens, hyperproteinemia, acute intermittent porphyria.Increased: Androgens, hyperproteinemia, stress, acute liver disease.

Description: A T3 Free test is a blood test that measures unbound triiodothyronine levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hyperthyroidism.

Also Known As: Free T3 Test, Free Triiodothyronine Test, FT3 Test, T3F Test, Unbound T3 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T3 Free test ordered?

When a person's TSH test results are abnormal, a free T3 test may be recommended. When a person has symptoms that imply hyperthyroidism, it may be requested as part of the investigational workup, especially if the free T4 level is not elevated.

The following are possible signs and symptoms:

• Heart rate has increased.
• Anxiety
• Loss of weight
• Sleeping problems
• Hand tremors
• Weakness
• Diarrhea
• Visual disturbances, light sensitivity
• Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Free T3 may be ordered at regular intervals to monitor a known thyroid disease or to assess the efficacy of hyperthyroidism treatment.

What does a T3 Free test check for?

T3 is one of two key hormones produced by the thyroid gland, a small butterfly-shaped organ near the base of the throat that sits flat across the windpipe. Thyroxine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T3 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's physiologically active form. Tests can determine the amount of free T3 or total T3 in the blood.

A feedback system controls T3 and T4 production. The hypothalamus releases thyrotropin releasing hormone when thyroid hormone levels in the blood drop, which prompts the pituitary gland to create and release thyroid-stimulating hormone. The thyroid gland is thus stimulated to create and/or release more thyroid hormones as a result of TSH. T4 is the most common thyroid hormone produced. This hormone is generally inactive, but in the liver and other tissues, it is transformed into the considerably more active T3.

If the thyroid gland produces too much T4 and T3, the person may have symptoms like uneasiness, hand tremors, weight loss, sleeplessness, and puffiness around dry, itchy eyes. The person's eyes may be unable to move normally and appear to be glaring in some circumstances. The eyeballs may also appear to bulge in some circumstances.

If the thyroid gland does not produce enough thyroid hormones, the person may experience weight gain, dry skin, lethargy, and constipation, which are all signs and symptoms of hypothyroidism and a slower metabolism. Thyroid hormone levels in the blood might be low or high due to thyroid malfunction, or in rare cases, insufficient or excessive TSH production due to a pituitary issue.

Autoimmune illnesses are the most common causes of thyroid dysfunction. Hyperthyroidism is caused by Graves disease, but it can also be caused by thyroiditis, thyroid malignancy, or high TSH production. Total T3 can be used to diagnose and monitor the impact of certain disorders on thyroid hormone production.

Lab tests often ordered with a T3 Free test:

• TSH
• T3 Total
• T4 Free
• T4 Total
• T3 Reverse
• T3 Uptake
• Thyroid Peroxidase
• Thyroglobulin Antibodies

Conditions where a T3 Free test is recommended:

• Hyperthyroidism
• Hypothyroidism
• Hashimotos
• Graves’ Disease
• Autoimmune Diseases
• Thyroid Cancer

How does my health care provider use a T3 Free test?

Thyroid function is measured with a free triiodothyronine test. It's usually ordered to assist identify hyperthyroidism, but it can also be used to track a person's therapy for a thyroid problem.

Thyroid hormones T3 and T4 are generated by the thyroid gland. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. Thyroid-stimulating hormone boosts T4 and T3 synthesis and release. The liver and other tissues convert T4 into T3 as needed.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood tests.

Because the majority of T3 is coupled to protein, total T3 can be influenced by protein levels and binding ability, but free T3 is unaffected. Some professional standards, however, advocate total T3, thus either test can be used to evaluate thyroid function. To assist in diagnosing Graves disease, an autoimmune illness that is the most prevalent cause of hyperthyroidism, free T3 or total T3 may be ordered together with thyroid antibodies.

Following an abnormal TSH, a free T3 test is generally done, especially if the free T4 test is not high.

What does my T3 Free result mean?

Thyroid hormone levels that are high or low suggest a mismatch between the body's needs and supplies, but they don't inform the doctor what's causing the excess or deficiency.

If someone is being treated for hyperthyroidism with anti-thyroid medication and their free or total T3 levels are normal, the medicine is likely beneficial in treating the illness. If the free or total T3 or free T4 levels are high, the medication isn't working to address the problem, and the person may be having hyperthyroidism symptoms.

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

Description: A T4 Total test is a blood test that measures thyroxine free levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hypothyroidism.

Also Known As: Total T4 Test, Total Thyroxine Test, T4 Test, T4, T4 Total Test, Bound T4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T4 Total test ordered?

When a person exhibits symptoms of hyperthyroidism or hypothyroidism, a Total T4 test may be administered, especially if a TSH test result is abnormal.

Hyperthyroidism can cause the following signs and symptoms:

• Heart rate has increased.
• Anxiety
• Loss of weight
• Sleeping problems
• Hand tremors
• Weakness
• Diarrhea
• Visual disturbances, light sensitivity
• Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following symptoms:

• gaining weight
• Skin that is dry
• Constipation
• Intolerance to the cold
• Skin that is puffy
• Hair loss
• Fatigue
• Women's menstrual irregularities

When a person is being treated for a thyroid problem, Total T4 testing, along with other thyroid tests, may be requested on a regular basis.

Thyroid testing will most likely be ordered early and late in the pregnancy, as well as for a period after delivery, to monitor the mother and baby in pregnant women with thyroid abnormalities.

In the United States, thyroid hormone screening is routinely performed on babies as part of newborn screening programs.

What does a T4 Total blood test check for?

The thyroid gland, a small butterfly-shaped structure that lays on the windpipe towards the bottom of the throat, produces one of two primary hormones: thyroxine. Triiodothyronine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T4 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's biologically active form. This test determines how much Bound T4 is present in the blood.

A feedback loop controls T4 production. The hypothalamus releases thyrotropin releasing hormone, which encourages the pituitary gland to generate and release thyroid-stimulating hormone when the amount of T4 in the blood drops. The thyroid gland is thus stimulated to produce and/or release more T4 as a result of TSH. TSH release is blocked as T4 content in the blood rises.

T4 accounts for over 90% of thyroid hormones. The thyroid gland releases accumulated T4 into circulation when the body requires it. T4 is either free or bound to protein in the blood. The amount of free T4 in the body is just about 0.1 percent of total T4. In the liver or other tissues, T4 is converted to T3. T3, like T4, is mainly attached to protein, however the physiologically active forms of T3 and T4 are the free versions. Free T3 in circulation is 4 to 5 times more active than free T4.

Dry skin, weight gain, cold intolerance, weariness, and irregular menstruation are among signs of hypothyroidism that occur when the thyroid gland does not produce enough T4 due to thyroid malfunction or insufficient TSH. Myxedema, or severe untreated hypothyroidism, can cause heart failure, convulsions, and coma. Hypothyroidism in children can slow growth and sexual development.

When the thyroid gland generates too much T4, the rate of a person's body functions increases, resulting in hyperthyroidism symptoms such as anxiety, increased heart rate, difficulty sleeping, weight loss, puffiness and dry itchy eyes, and hand tremors.

The most prevalent causes of thyroid dysfunction are connected to autoimmune illnesses. Hyperthyroidism is caused by Graves disease, while hypothyroidism is caused by Hashimoto thyroiditis. Thyroiditis, thyroid malignancy, and excessive or insufficient TSH production can all induce hyperthyroidism or hypothyroidism. By measuring Total T4, the influence of these variables on thyroid hormone synthesis can be recognized and monitored.

Note: Free T4 Index (T7) will only be calculated and reported if test code code 861 (T3 Uptake) is ordered as well.

Lab tests often ordered with a T4 Total test:

• TSH
• T3 Total
• T3 Free
• T4 Free
• T3 Reverse
• T3 Uptake
• Thyroid Peroxidase
• Thyroglobulin Antibodies

Conditions where a T4 Total test is recommended:

• Hyperthyroidism
• Hypothyroidism
• Hashimotos
• Graves’ Disease
• Autoimmune Diseases
• Thyroid Cancer

How does my health care provider use a T4 Total test?

Total thyroxine tests are used to assess thyroid function and detect thyroid disorders, such as hyperthyroidism and hypothyroidism, after the thyroid stimulating hormone level has been found to be abnormal.

The thyroid gland produces T4 and another hormone called triiodothyronine. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. TSH promotes the thyroid gland's synthesis and release of T4 and T3.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood testing. The total T4 test has been around for a long time, but it is influenced by the quantity of protein in the blood that can bind to the hormone. The active form of thyroxine, free T4, is unaffected by protein levels. Many people believe that the free T4 test is a more accurate reflection of thyroid hormone activity, and it has largely supplanted the total T4 test.

A Total T4 test can be used in conjunction with or after a TSH test, and occasionally with a free T3 test to:

• Help diagnose the cause of hyperthyroidism and hypothyroidism by detecting too much or too little thyroid hormone.
• Differentiate between thyroid disorders.
• Assist in the diagnosis of pituitary diseases
• Assist in the diagnosis of infertility in women
• In an individual with a known thyroid condition, track the effectiveness of treatment.
• Monitor patients with pituitary disease to ensure that their thyroid is still operating, and thyroid hormone medication should be monitored if it isn't.
• Monitor patients with thyroid cancer whose tumors respond to TSH. TSH and T4 levels will be monitored on a regular basis to ensure that adequate thyroid hormone is being administered to maintain TSH low while keeping T4 high.

In the United States, babies are routinely tested for T4 and TSH levels to rule out congenital hypothyroidism, which can lead to mental retardation if left untreated.

Thyroid abnormalities can sometimes be detected using Total T4 and TSH, however professional opinions differ on who should be screened and when they should start.

Thyroid antibodies, as well as a Total T4 test, may be ordered if a health practitioner suspects someone has an autoimmune-related thyroid problem.

What does my T4 Total result mean?

In general, high total T4 levels suggest an overactive thyroid gland, while low total T4 levels suggest an underactive thyroid gland. The test results are not diagnostic in and of themselves, but they will urge the health care provider to conduct additional testing to determine the reason of the excess or deficiency.

A range of temporary and chronic thyroid disorders are linked to both decreased and increased total T4 levels. A pituitary gland issue could be indicated by low total T4 levels along with a low TSH level, or by high total T4 levels combined with a high TSH.

When thyroid tests are done to monitor treatment for thyroid or pituitary diseases, the results will tell the doctor whether the treatment is working and/or if a dose adjustment is required. People with hyperthyroidism, for example, have their total T4, total T3, and TSH levels examined on a regular basis while taking anti-thyroid medicines to ensure that the drugs are effective and to reduce doses if thyroid hormone levels fall too low. TSH and total T4 levels are monitored on a frequent basis in hypothyroid patients to ensure that the correct dose of thyroid hormone is being given to bring TSH levels back to normal.

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

Description: A T4 Free test is a blood test that measures thyroxine free levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hypothyroidism.

Also Known As: Free T4 Test, Free Thyroxine Test, FT4 Test, T4F Test, T4 Free Test, Unbound T4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T4 Free test ordered?

When a person exhibits symptoms of hyperthyroidism or hypothyroidism, a free T4 test may be administered, especially if the TSH test is abnormal.

Hyperthyroidism can cause the following signs and symptoms:

• Heart rate has increased.
• Anxiety
• Loss of weight
• Sleeping problems
• Hand tremors
• Weakness
• Diarrhea
• Visual disturbances, light sensitivity
• Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following symptoms:

• gaining weight
• Skin that is dry
• Constipation
• Intolerance to the cold
• Skin that is puffy
• Hair loss
• Fatigue
• Women's menstrual irregularities

When a person is being treated for a thyroid problem, free T4 testing, along with other thyroid tests, may be requested on a regular basis.

Thyroid testing will most likely be ordered early and late in the pregnancy, as well as for a period after delivery, to monitor the mother and baby in pregnant women with thyroid abnormalities.

In the United States, thyroid hormone screening is routinely performed on babies as part of newborn screening programs.

What does a T4 Free blood test check for?

The thyroid gland, a small butterfly-shaped structure that lays on the windpipe towards the bottom of the throat, produces one of two primary hormones: thyroxine. Triiodothyronine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T4 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's biologically active form. This test determines how much free T4 is present in the blood.

A feedback loop controls T4 production. The hypothalamus releases thyrotropin releasing hormone, which encourages the pituitary gland to generate and release thyroid-stimulating hormone when the amount of T4 in the blood drops. The thyroid gland is thus stimulated to produce and/or release more T4 as a result of TSH. TSH release is blocked as T4 content in the blood rises.

T4 accounts for over 90% of thyroid hormones. The thyroid gland releases accumulated T4 into circulation when the body requires it. T4 is either free or bound to protein in the blood. The amount of free T4 in the body is just about 0.1 percent of total T4. In the liver or other tissues, T4 is converted to T3. T3, like T4, is mainly attached to protein, however the physiologically active forms of T3 and T4 are the free versions. Free T3 in circulation is 4 to 5 times more active than free T4.

Dry skin, weight gain, cold intolerance, weariness, and irregular menstruation are among signs of hypothyroidism that occur when the thyroid gland does not produce enough T4 due to thyroid malfunction or insufficient TSH. Myxedema, or severe untreated hypothyroidism, can cause heart failure, convulsions, and coma. Hypothyroidism in children can slow growth and sexual development.

When the thyroid gland generates too much T4, the rate of a person's body functions increases, resulting in hyperthyroidism symptoms such as anxiety, increased heart rate, difficulty sleeping, weight loss, puffiness and dry itchy eyes, and hand tremors.

The most prevalent causes of thyroid dysfunction are connected to autoimmune illnesses. Hyperthyroidism is caused by Graves disease, while hypothyroidism is caused by Hashimoto thyroiditis. Thyroiditis, thyroid malignancy, and excessive or insufficient TSH production can all induce hyperthyroidism or hypothyroidism. By measuring free T4, the influence of these variables on thyroid hormone synthesis can be recognized and monitored.

Lab tests often ordered with a T4 Free test:

• TSH
• T3 Total
• T3 Free
• T4 Total
• T3 Reverse
• T3 Uptake
• Thyroid Peroxidase
• Thyroglobulin Antibodies

Conditions where a T4 Free test is recommended:

• Hyperthyroidism
• Hypothyroidism
• Hashimotos
• Graves’ Disease
• Autoimmune Diseases
• Thyroid Cancer

How does my health care provider use a T4 Free test?

Free thyroxine tests are used to assess thyroid function and detect thyroid disorders, such as hyperthyroidism and hypothyroidism, after the thyroid stimulating hormone level has been found to be abnormal.

The thyroid gland produces T4 and another hormone called triiodothyronine. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. TSH promotes the thyroid gland's synthesis and release of T4 and T3.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood testing. The total T4 test has been around for a long time, but it is influenced by the quantity of protein in the blood that can bind to the hormone. The active form of thyroxine, free T4, is unaffected by protein levels. Many people believe that the free T4 test is a more accurate reflection of thyroid hormone activity, and it has largely supplanted the total T4 test.

A free T4 test can be used in conjunction with or after a TSH test, and occasionally with a free T3 test to:

• Help diagnose the cause of hyperthyroidism and hypothyroidism by detecting too much or too little thyroid hormone.
• Differentiate between thyroid disorders.
• Assist in the diagnosis of pituitary diseases
• Assist in the diagnosis of infertility in women
• In an individual with a known thyroid condition, track the effectiveness of treatment.
• Monitor patients with pituitary disease to ensure that their thyroid is still operating, and thyroid hormone medication should be monitored if it isn't.
• Monitor patients with thyroid cancer whose tumors respond to TSH. TSH and T4 levels will be monitored on a regular basis to ensure that adequate thyroid hormone is being administered to maintain TSH low while keeping T4 high.

In the United States, babies are routinely tested for T4 and TSH levels to rule out congenital hypothyroidism, which can lead to mental retardation if left untreated.

Thyroid abnormalities can sometimes be detected using free T4 and TSH, however professional opinions differ on who should be screened and when they should start.

Thyroid antibodies, as well as a free T4 test, may be ordered if a health practitioner suspects someone has an autoimmune-related thyroid problem.

What does my T4 Free result mean?

In general, high free T4 levels suggest an overactive thyroid gland, while low free T4 levels suggest an underactive thyroid gland. The test results are not diagnostic in and of themselves, but they will urge the health care provider to conduct additional testing to determine the reason of the excess or deficiency.

A range of temporary and chronic thyroid disorders are linked to both decreased and increased free T4 levels. A pituitary gland issue could be indicated by low free T4 levels along with a low TSH level, or by high free T4 levels combined with a high TSH.

When thyroid tests are done to monitor treatment for thyroid or pituitary diseases, the results will tell the doctor whether the treatment is working and/or if a dose adjustment is required. People with hyperthyroidism, for example, have their free T4, free T3, and TSH levels examined on a regular basis while taking anti-thyroid medicines to ensure that the drugs are effective and to reduce doses if thyroid hormone levels fall too low. TSH and free T4 levels are monitored on a frequent basis in hypothyroid patients to ensure that the correct dose of thyroid hormone is being given to bring TSH levels back to normal.

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

Brief Description: Testosterone, Free (Dialysis) and Total, MS is a blood test used to detect abnormal levels of testosterone in both male and female patients, and diagnose causes of erectile dysfunction, infertility, virilization, polycystic ovary syndrome, and delayed or early puberty in children.

Also Known As: Total Testosterone, Free Testosterone, Testosterone Free and Total

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Free and Total Testosterone test ordered?

When infertility is suspected, or when a man has decreased sex drive or erectile difficulties, a testosterone test may be ordered. Other signs include a lack of beard and body hair, a loss of muscle mass, and the formation of breast tissue. Low total and bioavailable testosterone levels have also been linked to, or caused by, increased visceral fat, insulin resistance, and an increased risk of coronary artery disease.

The test is frequently ordered in conjunction with the FSH and LH tests in males who are experiencing delayed or slow puberty. Although the age at which puberty begins varies from person to person, it usually begins around the age of ten. The following are some of the signs and symptoms of delayed puberty:

• Muscle mass development is delayed.
• Voice not getting lower or a lack of body hair growth
• Growth of the testicles and penis is slowed or delayed.

When a young boy appears to be going through an early puberty with clear secondary sex traits, the test can be ordered. Various malignancies and congenital adrenal hyperplasia can cause early puberty in boys due to elevated testosterone.

When a woman has irregular or no menstrual cycles, is having trouble getting pregnant, or displays masculine traits such as abundant facial and body hair, male pattern baldness, and/or a low voice, testosterone testing may be done. Testosterone levels can rise as a result of malignancies in the ovary or adrenal gland, as well as other illnesses including polycystic ovarian syndrome.

What does a Testosterone Total and Free blood test check for?

In men, testosterone is the primary sex hormone. It's in charge of a man's physical appearance. Although it is thought to be a "masculine" sex hormone, it is found in both men and women's blood. This test determines the amount of testosterone in a person's blood.

Testosterone is primarily produced in the male testicles by unique endocrine tissue called Leydig cells. It's also made by the adrenal glands in both males and females, as well as the ovaries in females in modest amounts.

In males, testosterone promotes the formation of secondary sex characteristics such as penis size, body hair growth, muscle development, and a deeper voice. It is abundant in males during adolescence and adulthood in order to regulate sex drive and preserve muscle mass. Estradiol is the major sex hormone in females, and testosterone is converted to it in women.

The pituitary gland produces luteinizing hormone, which stimulates and regulates testosterone synthesis. Testosterone functions in a negative feedback loop: when testosterone levels rise, LH production falls, slowing testosterone production; lower testosterone levels cause higher LH production, which promotes testosterone production.

Testosterone levels fluctuate throughout the day, increasing in the early morning hours and dropping in the evening. Levels rise after activity and fall as people get older.

About two-thirds of testosterone is attached to sex-hormone binding globulin in the bloodstream, with the remaining one-third bound to albumin. Only a small percentage of testosterone is released into the bloodstream as free testosterone. The bioavailable fraction is the free plus albumin-bound testosterone, which can act on target tissues.

Lab tests often ordered with a Testosterone Free and Total test:

• Estradiol
• Dihydrotestosterone
• FSH
• LH
• Estrogens
• Estriol
• Estrone
• Albumin
• Prolactin
• Anti-mullerian Hormone
• Androstenedione
• Sex Hormone Binding Globulin

Conditions where a Testosterone Free and Total test is recommended:

• Polycystic Ovary Syndrome
• Alcoholism
• Mumps
• Hypothalamic disease
• Pituitary disease
• Infertility
• Liver disease
• Hyperthyroidism
• Eating disorders
• Pregnancy
• Cushing Syndrome
• Hypothyroidism
• Testicular cancer
• Adrenal insufficiency
• Congenital Adrenal Hyperplasia

Commonly Asked Questions:

How does my health care provider use a Testosterone Free and Total test?

In men, women, girls, and boys, testosterone testing is used to identify a variety of problems. Testosterone is the major sex hormone in males, and it is responsible for masculine physical traits. It is produced mostly by the testicles. Although it is thought to be a "male" sex hormone, it is found in both males and females.

The testosterone test can be used to determine whether or not you're experiencing:

• Delayed or early puberty in boys
• In both men and women, sex drive has decreased.
• Men's erectile dysfunction
• Male and female infertility
• Tumors of the testicles in men
• Disorders of the hypothalamus or pituitary gland
• Virilization and hirsutism in girls and women

A testosterone total test is usually used to diagnose a condition. The free and total testosterone test distinguishes between testosterone that is bound to proteins in the blood and testosterone that is not attached to proteins.

About two-thirds of testosterone is tied to SHBG in the blood, with the remaining one-third attached to albumin. Free testosterone circulates in a tiny percentage. Bioavailable testosterone is made up of free testosterone and testosterone bound to albumin, and it can operate on target tissues.

A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

Other tests and hormone levels may be performed in conjunction with testosterone testing, depending on the reason for testing. Here are a few examples:

• FSH
• LH
• Estrogen
• Estradiol
• SHBG
• DHEA-S
• Prolactin
• Androstenedione
• 17-Hydroxyprogesterone

What does my testosterone test result mean?

Males: 

Testosterone levels often begin to fall after the age of 30. Testosterone levels may drop more in obese or chronically unwell men, as well as with the use of certain drugs.

Hypogonadism can be caused by a variety of factors, including:

• Pituitary or hypothalamic illness
• Reduced testosterone production in young males can be caused by genetic disorders
• Possible infertility or testicular failure
• Acquired damage to the testes, such as from drinking, physical injury, or viral infections like mumps, reduces testosterone production.
• Diabetes

Healthcare practitioners may recommend testosterone replacement therapy to men who have consistently low testosterone levels and associated signs and symptoms. The Food and Drug Administration has not approved testosterone supplements to improve strength, sports performance, or avoid aging disorders. It's possible that using it for these purposes is dangerous.

Increased testosterone levels in men can mean one of several things:

• Tumors of the testicles
• Testosterone-producing tumors in the adrenal glands
• Use of anabolic steroids
• Early puberty in males due to an unknown cause
• Adrenal hyperplasia in toddlers and babies

Females:

Testosterone levels in women are typically low. Increased testosterone levels can mean one of the following things:

• Ovarian or adrenal gland tumor
• PCOS
• Adrenal hyperplasia that occurs at birth.

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

Helpful in assessing testicular function in males and managing hirsutism, virilization in females.

Description: Testosterone Free and Total with Sex Hormone Binding Globulin is a blood test used to detect abnormal levels of testosterone in both male and female patients, and diagnose causes of erectile dysfunction, infertility, virilization, polycystic ovary syndrome, and delayed or early puberty in children.

Also Known As: Total Testosterone Test, Free Testosterone Test, Testosterone Free and Total Test, Sex Hormone Binding Globulin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Testosterone Free and Total with Sex Hormone Binding Globulin test ordered?

When infertility is suspected, or when a man has decreased sex drive or erectile difficulties, a testosterone test may be ordered. Other signs include a lack of beard and body hair, a loss of muscle mass, and the formation of breast tissue. Low total and bioavailable testosterone levels have also been linked to, or caused by, increased visceral fat, insulin resistance, and an increased risk of coronary artery disease.

The test is frequently ordered in conjunction with the FSH and LH tests in males who are experiencing delayed or slow puberty. Although the age at which puberty begins varies from person to person, it usually begins around the age of ten. The following are some of the signs and symptoms of delayed puberty:

• Muscle mass development is delayed.
• Voice not getting lower or a lack of body hair growth
• Growth of the testicles and penis is slowed or delayed.

When a young boy appears to be going through an early puberty with clear secondary sex traits, the test can be ordered. Various malignancies and congenital adrenal hyperplasia can cause early puberty in boys due to elevated testosterone.

When a woman has irregular or no menstrual cycles, is having trouble getting pregnant, or displays masculine traits such as abundant facial and body hair, male pattern baldness, and/or a low voice, testosterone testing may be done. Testosterone levels can rise as a result of malignancies in the ovary or adrenal gland, as well as other illnesses including polycystic ovarian syndrome.

What does a Testosterone Total and Free with Sex Hormone Binding Globulin blood test check for?

In men, testosterone is the primary sex hormone. It's in charge of a man's physical appearance. Although it is thought to be a "masculine" sex hormone, it is found in both men and women's blood. This test determines the amount of testosterone in a person's blood.

Testosterone is primarily produced in the male testicles by unique endocrine tissue called Leydig cells. It's also made by the adrenal glands in both males and females, as well as the ovaries in females in modest amounts.

In males, testosterone promotes the formation of secondary sex characteristics such as penis size, body hair growth, muscle development, and a deeper voice. It is abundant in males during adolescence and adulthood in order to regulate sex drive and preserve muscle mass. Estradiol is the major sex hormone in females, and testosterone is converted to it in women.

The pituitary gland produces luteinizing hormone, which stimulates and regulates testosterone synthesis. Testosterone functions in a negative feedback loop: when testosterone levels rise, LH production falls, slowing testosterone production; lower testosterone levels cause higher LH production, which promotes testosterone production.

Testosterone levels fluctuate throughout the day, increasing in the early morning hours and dropping in the evening. Levels rise after activity and fall as people get older.

About two-thirds of testosterone is attached to sex-hormone binding globulin in the bloodstream, with the remaining one-third bound to albumin. Only a small percentage of testosterone is released into the bloodstream as free testosterone. The bioavailable fraction is the free plus albumin-bound testosterone, which can act on target tissues.

In many circumstances, measuring total testosterone is sufficient information for a healthcare provider. A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

SHBG is a liver-produced protein that strongly binds to the hormones testosterone, dihydrotestosterone, and estradiol. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. This test examines the amount of SHBG in the blood and is most commonly used to determine whether a person has too much or too little testosterone.

In men, SHBG binds roughly 45 percent to 65 percent of testosterone in the blood, with the rest weakly and reversibly linked to albumin. Only around 2% to 3% of testosterone is accessible to tissues as free testosterone, but testosterone that is weakly linked to albumin is also bioavailable and can be rapidly absorbed by the body's tissues.

In women, a somewhat higher percentage of testosterone is bound to SHBG in the blood than in men. SHBG is important in controlling the quantities of bioavailable male sex hormones and estrogens circulating throughout the body in women. Because SHBG has a stronger affinity for the androgens testosterone and DHT, women with low SHBG may experience signs and symptoms of androgen excess.

A total testosterone test does not differentiate between bound and unbound testosterone; instead, it determines the total amount of testosterone present. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the person's tissues. When a person's indications and symptoms do not match the results of a total testosterone test, a SHBG test may be conducted.

Lab tests often ordered with a Testosterone Free and Total with Sex Hormone Binding Globulin test:

• Estradiol
• Dihydrotestosterone
• FSH
• LH
• Estrogens
• Estriol
• Estrone
• Albumin
• Prolactin
• Anti-mullerian Hormone
• Androstenedione

Conditions where a Testosterone Free and Total with Sex Hormone Binding Globulin test is recommended:

• Polycystic Ovary Syndrome
• Alcoholism
• Mumps
• Hypothalamic disease
• Pituitary disease
• Infertility
• Liver disease
• Hyperthyroidism
• Eating disorders
• Pregnancy
• Cushing Syndrome
• Hypothyroidism
• Testicular cancer
• Adrenal insufficiency
• Congenital Adrenal Hyperplasia

Commonly Asked Questions:

How does my health care provider use a Testosterone Free and Total with Sex Hormone Binding Globulin test?

In men, women, girls, and boys, testosterone testing is used to identify a variety of problems. Testosterone is the major sex hormone in males, and it is responsible for masculine physical traits. It is produced mostly by the testicles. Although it is thought to be a "male" sex hormone, it is found in both males and females.

The testosterone test can be used to determine whether or not you're experiencing:

• Delayed or early puberty in boys
• In both men and women, sex drive has decreased.
• Men's erectile dysfunction
• Male and female infertility
• Tumors of the testicles in men
• Disorders of the hypothalamus or pituitary gland
• Virilization and hirsutism in girls and women

A testosterone total test is usually used to diagnose a condition. The free and total testosterone test distinguishes between testosterone that is bound to proteins in the blood and testosterone that is not attached to proteins.

About two-thirds of testosterone is tied to SHBG in the blood, with the remaining one-third attached to albumin. Free testosterone circulates in a tiny percentage. Bioavailable testosterone is made up of free testosterone and testosterone bound to albumin, and it can operate on target tissues.

A test for free or bioavailable testosterone may be performed in some circumstances, such as when the level of SHBG is abnormal, as it may more accurately indicate the presence of a medical issue.

Other tests and hormone levels may be performed in conjunction with testosterone testing, depending on the reason for testing. Here are a few examples:

• FSH
• LH
• Estrogen
• Estradiol
• SHBG
• DHEA-S
• Prolactin
• Androstenedione
• 17-Hydroxyprogesterone
• The sex hormone binding globulin test can be performed to determine whether a man has low testosterone or if a woman has too much testosterone. It can be used in conjunction with other tests to assess a person's sex hormone status.

SHBG is a protein that binds to testosterone, dihydrotestosterone, and estradiol, among other hormones. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. Changes in SHBG levels can have an impact on the amount of hormone accessible to the body's tissues.

To assess a person's current hormonal balance, tests for albumin and one or more additional sex hormones, such as prolactin, estradiol, and LH may be conducted.

In men

In order to diagnose the cause of infertility, diminished sex drive, or erectile dysfunction in an adult male, SHBG and total testosterone levels may be ordered. When total testosterone findings are contradictory with clinical symptoms, measuring SHBG in addition to testosterone is extremely beneficial.

Total testosterone in the blood is measured without distinguishing between bound and unbound testosterone; rather, it determines the total amount of testosterone in the blood. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the body's tissues.

With a simple total testosterone assessment, health practitioners can estimate bioavailable testosterone by measuring SHBG. Because less testosterone is accessible to the body's tissues, increased SHBG in males may be linked to symptoms of low testosterone levels.

Total testosterone should be measured in the initial screening for testosterone deficiency, according to the Endocrine Society's professional standards. If the results are abnormal, the test is repeated the next day. They propose one of the following if repeat readings are low-normal and/or SHBG is abnormal:

In women

The ovaries and adrenal glands produce modest amounts of testosterone in women. Even little increases in testosterone production can throw off the hormone balance, resulting in symptoms including irregular or missed periods, infertility, acne, and excessive face and body hair. These and other signs and symptoms are common in polycystic ovarian syndrome, a disorder marked by an overproduction of male sex hormones. SHBG and testosterone testing may be helpful in detecting and evaluating excess testosterone production and/or decreasing SHBG concentrations, as well as in evaluating women with PCOS.

What does my testosterone test result mean?

Males: 

Testosterone levels often begin to fall after the age of 30. Testosterone levels may drop more in obese or chronically unwell men, as well as with the use of certain drugs.

Hypogonadism can be caused by a variety of factors, including:

• Pituitary or hypothalamic illness
• Reduced testosterone production in young males can be caused by genetic disorders
• Possible infertility or testicular failure
• Acquired damage to the testes, such as from drinking, physical injury, or viral infections like mumps, reduces testosterone production.
• Diabetes

Healthcare practitioners may recommend testosterone replacement therapy to men who have consistently low testosterone levels and associated signs and symptoms. The Food and Drug Administration has not approved testosterone supplements to improve strength, sports performance, or avoid aging disorders. It's possible that using it for these purposes is dangerous.

Increased testosterone levels in men can mean one of several things:

• Tumors of the testicles
• Testosterone-producing tumors in the adrenal glands
• Use of anabolic steroids
• Early puberty in males due to an unknown cause
• Adrenal hyperplasia in toddlers and babies

Females:

Testosterone levels in women are typically low. Increased testosterone levels can mean one of the following things:

• Ovarian or adrenal gland tumor
• PCOS
• Adrenal hyperplasia that occurs at birth.

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