Excessive Clotting Disorders

Blood clots can happen to anybody and are often the result of excessive blood clotting disorders. Early diagnosis is critical, and that's why blood clotting tests are so important. Learn what these conditions are and the benefits of testing for them. Find the right blood clotting tests with Ulta Lab Tests and get reliable blood work, secure testing, and quick and confidential tests results.

Below the list of tests is a guide that explains and answers your questions on what you need to know about blood clotting tests, along with information on excessive clotting disorders, signs, symptoms, and diagnosis.


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Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk.

Cardiolipin Antibodies (IgA, IgG, IgM)

  • Cardiolipin Antibody (IgA) 
  • Cardiolipin Antibody (IgG) 
  • Cardiolipin Antibody (IgM) 

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly systemic lupus erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.


Cardiolipin Antibodies (IgG, IgM)

  • Cardiolipin Antibody (IgG) 
  • Cardiolipin Antibody (IgM) 

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly systemic lupus erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.


Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis and primary Sjögren's syndrome.

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Useful in the diagnosis of hypochromic, microcytic anemias. Decreased in iron deficiency anemia and increased in iron overload.


Screening test for abnormalities of coagulation factors that are involved in the extrinsic pathway. Also used to monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders.

PT-Screening test for deficiencies of plasma coagulation factors other than Factors VII and XIII. The test is also used to monitor patients on heparin therapy. PTT-Screening test for abnormalities of coagulation factors that are involved in the extrinsic pathway. Also used to monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders.

D-Dimer is one of the measurable by-products of activation of the fibrinolytic system. Quantitation of D-Dimer assesses fibrinolytic activation and intravascular thrombosis. D-Dimer is of particular value in excluding the diagnosis of venous thromboembolism among patients at high risk.

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

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

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

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

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

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

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

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


Aids in diagnosis of decreased activity of Protein C characterized by recurrent venous thrombosis. Acquired deficiencies associated with Protein C include: oral anticoagulant therapy, liver disease, vitamin K deficiency, malignancy, consumptive DIC, surgery, trauma, antibodies to Protein C and hepatic immaturity of the newborn.

Comprehensive test assesses the total level of protein and its functional activity in determining Protein C deficiency, which is strongly prothrombotic, and may require long-term anticoagulation therapy. In the presence of low Protein C Activity, Protein C Antigen helps to confirm and to classify Protein C Deficiency as Type I or Type II. Protein C is a highly thrombophilic protein.

In the presence of low Protein C Activity, Protein C Antigen is useful in classifying the deficiency as Type I or II.

Aids in diagnosis of congenital deficiencies characterized by recurrent venous thrombosis. Acquired deficiencies associated with Protein C include: oral anticoagulant therapy, liver disease, vitamin K deficiency, malignancy, consumptive DIC, surgery, trauma, antibodies to Protein C and hepatic immaturity of the newborn.

Factor V (Leiden) Mutation is a point mutation that causes resistance of Factor V protein degradation by activated protein C (APC). This mutation is associated with increased risk of venous thrombosis.

Preferred test in patients with Lupus anticoagulant, on heparin or direct thrombin inhibitors, or on Factor VIII concentrates.

This test is useful to evaluate a prolonged aPTT. The most common form of hemophilia is caused by a deficiency of Factor VIII. Hemophilia A is an X-linked disorder affecting between 1 in 5000 to 10000 males.

The factor X assay is a blood test to measure the activity of factor X. This is one of the proteins in the body that helps the blood clot.


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Elevated levels of homocysteine are observed in patients at risk for coronary heart disease and stroke.

Lupus anticoagulants (LA) are members of a family of antibodies with phospholipid specificity. LA may be defined as an immunoglobulin, IgG or IgM or a mixture of both, that interferes with one or more of the in vitro phospholipid (PL) dependent tests of coagulation. These antibodies are not associated with a hemorrhagic diathesis, but rather have been linked to thrombotic events. In addition to thrombosis other clinical complications have been associated with the presence of LA. These include strokes, nonbacterial thrombotic endocarditis, livedo reticularis and a variety of obstetrical complications such as intrauterine fetal death, recurrent spontaneous abortion, fetal growth retardation, early onset preeclampsia and chorea gravidarum.

Limitations The purpose of this test is to determine if you have two, one, or no copies of either of two mutations in the MTHFR gene, C677T and A1298C.


At least 100,000 people in the United States die from blood clots yearly, and medical treatments for them exceed $10 billion every year. 

Blood clots can happen to anybody and are often the result of excessive blood clotting disorders. Early diagnosis is critical, and that's why blood clotting tests are so important.

Millions of people struggle with blood clotting disorders, and the best thing you can do is take action. Keep reading this guide to learn everything you need to know about blood clotting disorders and blood clotting tests.

What Are Excessive Blood Clotting Disorders

Often, we don't think about the process that happens when we wound or cut ourselves. The human body is an amazing machine, and it forms blood clots to stop the bleeding. Once the bleeding stops, the body should naturally break down and remove the clots.

But when you have excessive blood clotting disorders, this process is interrupted. This excessive blood clotting can be very dangerous, causing clots to form and travel to major arteries and organs. When your blood clots too much, it's referred to as a hypercoagulable state. 

Hypercoagulable states can be severe, especially when they aren't immediately identified and treated. If you're in a hypercoagulable state, you're at an increased risk of forming clots in your major arteries and blood vessels called an embolus or thrombus.

Blood clots in the veins (venous system) travel through the bloodstream and cause deep vein thrombosis in the leg, arm, liver, lungs, or intestines. 

Risk factors for Excessive Blood Clotting Disorders

Certain risk factors can lead to excessive blood clotting. Genetic risk factors include having family members with blood clots or if you have a history of unexplained miscarriages or blood clots before the age of 40.

Acquired risk factors include dehydration, smoking, overweight or obesity, pregnancy, and birth control pills or hormone replacement therapy.

Causes of Excessive Blood Clotting Disorders

What causes excessive clotting disorders and hypercoagulable states? Usually, hypercoagulable states are either genetic or an acquired condition that results from trauma, surgery, or certain medical conditions. 

Genetic or inherited hypercoagulable conditions include:

  • Factor V Leiden, which is the most common
  • Being deficient in natural clotting proteins like antithrombin and protein C
  • Prothrombin gene mutation
  • High levels of homocysteine
  • Elevated levels of factor VIII, factor IX, and  factor XI

You can also have a hypercoagulable state if you have abnormalities in your fibrinolytic system. Your fibrinolytic system functions by removing and breaking down clots after the initial injury heals. If this system doesn't function properly, then problems start to occur. Acquired conditions that cause hypercoagulable states include:

  • Cancers, especially leukemia
  • Certain medications used to treat cancer
  • Recent surgery or trauma
  • Hormone replacement therapy
  • Obesity
  • Pregnancy
  • Recent airplane travel
  • Heart failure or a heart attack
  • Stroke
  • Prolonged bed rest
  • Liver disease
  • Vitamin K deficiency

The liver plays a huge role in the clotting process, and acute or chronic liver disease as clotting factor VIII is usually increased.

Symptoms of Excessive Blood Clotting Disorders

Symptoms of excessive blood clotting disorders depend on the type you have and what the causes are from. But typical symptoms commonly include:

  • Bleeding
  • Bruising easily
  • Leg pain, swelling, and tenderness if clots present
  • Shortness of breath
  • Chest pain
  • Feeling lightheaded and faint
  • Anxiety
  • Coughing up blood

If you have a blood clotting disorder from liver disease, you'll experience symptoms like jaundice, abdominal pain, swelling, feeling unwell, and nausea.

Diagnosis of Excessive Blood Clotting Disorders

Your doctor will first take your personal and family medical history if it's suspected you have a clotting disorder. Your doctor will ask you if you have a family history of abnormal blood clotting or a history of blood clots before the age of 50.

After discussing signs and symptoms, your doctor will likely send you laboratory testing to further evaluate your blood for potential clotting problems. 

Common lab tests include a PT-INR, aPTT, fibrinogen level, and a complete blood count. Genetic tests such as factor V Leiden will be done if you have a strong family history of blood clotting disorders.

Lab Tests for Excessive Blood Clotting Disorders

Clotting disorder lab tests are key to confirming a diagnosis. Depending on your symptoms and medical history, there are different blood tests for blood clotting disorders and blood coagulation.

First, a prothrombin time (PT) with INR is one of the first coagulation blood tests to check. The PT with INR screens for any abnormalities in your coagulation factors. This test is also used to study people with both hereditary and genetic disorders.

The partial thromboplastin time (aPTT) tests for deficiencies in coagulation factors except for factors VII and XIII.

Fibrinogen Activity Clauss test measures your level of fibrinogen. Fibrinogen is necessary to form blood clots, and deficiencies in this can lead to severe bleeding disorders.

The D-Dimer quantitative is useful for measuring the activation of the fibrinolytic system and is useful in detecting blood clots in the venous system.

factor V (Leiden) mutation analysis test checks for mutations of the factor V protein that leads to blood clotting disorders and deep venous thrombosis.

complete blood count (CBC) measures your platelets and blood components and can detect problems with your platelet levels.

Other blood tests for clotting disorders include:

FAQS About Excessive Blood Clotting Disorders

Are you wondering what deep vein thrombosis (DVT) is? A DVT is a blood clot that forms in your leg veins, usually in the calf.

What is a pulmonary embolism (PE)? A PE is caused by a blood clot that originates in your leg or groin, breaks free, and travels to the lungs' arteries.

Do men or women have more of a risk of developing blood clots? The risk between men and women is just about equal.

What can you do during travel to prevent blood clots? Be sure to stop every hour or so and stand up and stretch. Even if you're traveling in an airplane, flex your toes and move your feet and ankles regularly to keep the blood flowing.

Blood Clotting Tests at Ulta Lab Tests

Ulta Lab Tests offers highly accurate tests, allowing you to make the best decisions about your health. Here are some awesome things to love about Ulta Lab Tests:

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Order your blood clotting lab tests today, and you'll have results securely online in 24 to 48 hours in most cases.

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What is Deep Vein Thrombosis (DVT)? It happens when a blood clot forms in a vein. DVTs mostly occur in a deep vein in the thigh or calf. Additionally, they can occur in deep veins in other parts of the body like arms, abdomen, or pelvis. These clots slow or block blood from returning to the lungs and heart by restricting the flow of blood.  

Clots occur easily in some people than others. Excessive blood clotting disorders can lead to the occurrence of DVTs. Pre-existing conditions, lifestyle choices, or medications increase the risk of blood clots. It is rare to have a predisposition because of inherited genes.  

Deep Vein Thrombosis keeps growing if left untreated. If DVT continues to grow, it obstructs the vein and cause pain, discoloration, swelling, inflammation, and may lead to permanent damage.  An increased risk for another DVT and long-term complications, known as postthrombotic syndrome (PTS), can occur after treatment. After a DVT, PTS can lead to chronic symptoms, such as long-term swelling, aching, pain, tiredness, heaviness, darkened skin, cramping, non-specific discomfort, or bluish tinge in the affected areas like arm or leg.  

However, the clot in its original location is not the greatest danger with DVT. The greatest danger is the risk of thromboembolism, which happens when a blood vessel is obstructed in a different part of the body. Pulmonary embolism (PE) occurs when part of a blood clot blocks blood flow to the lungs by breaking off and traveling to the lungs. PE is a medical emergency because it threatens life.  

Both PE and Deep Vein Thrombosis do not form in arteries, but they form in the body’s veins. So, they are grouped into venous thromboembolism (VTE). According to the Centers for Disease Control and Prevention (CDC), VTE affects around 900,00 people in the United States. Also, VTE kills 60,000 to 100,000 of the people affected, but most people die from PE. The first symptom of around 25% of people with PE is sudden death.  

DVT causes long term complications in around 30-50% of those with DVT. DVT and/or PE will occur within ten years in about 30% of people.  

Risk Factors 

Some conditions and factors increase the risk of DVT. For people with one or more conditions or factors, this increases their risk. And the resulting risk is cumulative. For instance, having an inherited risk increases the risk if the person uses oral contraceptives or smokes.  

You are not born with the most common risk factors. You acquire them later in life. Making changes can help lower the risk of blood clots in some of these factors.  

Here are some of the acquired risk factors:

  • Age – as you get older, the risk of clots increases.  
  • Chronic conditions like lung disease, kidney diseases such as nephrotic syndrome, heart disease such as congestive heart failure, and recent or recurrent cancer.  
  • Placing catheter in a central vein – a tube, which is placed into the main vein of the body, is used to administer fluids and medications. It is usually used when DVTs occur in the upper body.  
  • Hormone estrogen increasing – Hormone estrogen increases during pregnancy and after three months of delivery, and it increases from medications such as hormone replacement therapy or estrogen-based birth control. 
  • Your history of DVT – Having a blood clot increases the risk of having another one.  
  • Immobility – sitting or staying in bed for a long period slows blood flow. Why? The calf muscles do not help in blood circulation because they do not contract. Venous stasis, which is also known as “coach-class syndrome,” happens when something slows blood flow for several hours. This usually happens when someone is put on prolonged bed rest or during a long plane ride.  
  • Surgery – orthopedic surgeries like knee or hip surgeries and surgery that involves the pelvis or abdomen may lead to an activation of tissue factors. Activation of tissue factors increases the risk of immobility during surgery and the risk of clotting.  
  • Staying in hospital – 50% of blood clots happen after surgery or after a hospital stay and when the person is staying in the hospital.  
  • Antiphospholipid syndrome (APS) – this is an excessive clotting disorder 
  • Inflammatory bowel disease 
  • Injury to the vein – blood clots are formed by an injury to the walls of veins. Muscle injuries, fractures, or other trauma can cause injury to the vein.  
  • Smoking  
  • Obesity 
  • It is rare for inherited genetic variations to increase the risk of inappropriate clotting. The following are the common inherited risk factors. 
  • Deficiency in protein S, protein C, or antithrombin  
  • Factor II mutation – prothrombin 20210 mutation 
  • Activated protein C resistance – Factor V Leiden mutation  

Signs and Symptoms  

More than half of people with DVT do not have noticeable signs and symptoms. Although some of these people have a few noticeable signs and symptoms, however, symptoms can develop suddenly or gradually if you do not have them.

Here are the signs and symptoms:

  • You will see swelling due to the buildup of fluid in the affected leg. 
  • You will feel pain or tenderness in the affected leg. If clots develop rapidly, it can cause more pain.  
  • You will see redness or warmth of the skin in the leg.  
  • The clot may break and travel to the lungs, causing a pulmonary embolism (PE). The signs and symptoms of pulmonary embolism can develop quickly. The following are the signs and symptoms of PE.  
  • Your chest pains worsen when you take a deep breath or cough  
  • You cough up blood  
  • You have difficulty breathing  
  • You experience fast or irregular heartbeat  
  • You may faint or have very low blood pressure  

Laboratory Tests 

Evaluation is done to estimate the probability of the person having DVT before doing a test. When doing an evaluation, there are so many factors, such as signs and symptoms and the person’s medical history, that are taken into consideration.  

Once the valuation is complete, a D-dimer test is first done if the person’s pre-test probability is low to medium. If the result of the D-dimer test is negative, it rules out a DVT. A DVT or any other conditioner causes a positive result. For diagnosis, this requires one or more imaging tests. 

D-dimer test is not done if the person’s pre-test probability is high for a DVT. In this case, one or more imaging tests are done.  

These are the steps from the American College of Physicians (ACP), the American Academy of Family Physicians (AAFP), and the American Society of Hematology (ASH).  

An initial evaluation can be done with some general laboratory tests. Here are some of the general laboratory tests that can be done with an initial evaluation.  

Complete blood count – the test is for evaluating blood components like cell fragments and platelets that help in blood clotting   

partial thromboplastin time (PTT) and prothrombin time (PT) – these tests are for evaluating the amount and function of the blood clotting factors.  

A person diagnosed with a DVT and does not have classic risk factors, or a person is under 50 years and has DVT, or the person in an unusual location needs more tests. Additional tests are used for determining the underlying cause. Also, these additional tests are for determining the risk of having recurrent DVTs.  

There following are the tests that are done when a person is being treated for a DVT:

Antiphospholipid antibodies like lupus anticoagulant – for diagnosing antiphospholipid syndrome (APS) 

Prothrombin 20210 mutation (factor II) and factor V Leiden – for detecting inherited risk factors. It is done if the person has a recurrent blood clot. It is not done during the first DVT.  

Treatment for a DVT and the existing blood clots can affect some tests. So, the only way to do these tests is by treating and resolving the clot. Therefore, healthcare practitioners determine the cause of a person’s DVT by ordering the following test several weeks or months later. The tests are used for detecting deficiency in blood clotting factors.  

Antithrombin  

Protein S and protein C  

Here are the tests for monitoring treatment:

PT/INR – the test is for monitoring warfarin therapy  

PTT – the test is monitoring standard heparin therapy  

Heparin anti-Xa – the test is for monitoring both standard low molecular weight heparin (LMHW) therapy and heparin therapy   

Warfarin sensitivity testing – the test is done when warfarin therapy is prescribed, and the test is for determining sensitivity and resistance to warfarin. And it helps healthcare practitioners in selecting appropriate doses.