Excessive Clotting Disorders

The Antiphospholipid Antibody Panel is a comprehensive test that measures nine biomarkers associated with antiphospholipid syndrome (APS). APS is an autoimmune disorder that can lead to recurrent miscarriages, thrombosis, and pregnancy complications. The panel includes tests for beta-2-glycoprotein I antibodies, phosphatidylserine antibodies, and cardiolipin antibodies. This comprehensive testing will provide your healthcare provider with important information about your risk for APS and allow them to tailor your treatment accordingly.

This comprehensive testing will provide your healthcare provider with important information about your risk for APS and allow them to tailor your treatment accordingly. If you have been diagnosed with APS, it is important to see your healthcare provider regularly and follow their treatment recommendations. Sometimes, treatment with blood thinners or other medications may be necessary to prevent serious complications. Most people with APS can lead healthy, normal lives with proper management.

What is included in the antiphospholipid panel?

The panel includes tests for

• Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
• Phosphatidylserine Antibodies (IgG, IgA, IgM)
• Cardiolipin Antibodies (IgA, IgG, IgM)

What is the antiphospholipid antibody panel test for?

The Antiphospholipid Antibody Panel is a comprehensive test that measures nine biomarkers associated with antiphospholipid syndrome (APS). APS is an autoimmune disorder that can lead to recurrent miscarriages, thrombosis, and pregnancy complications. The panel includes tests for beta-2-glycoprotein I antibodies, phosphatidylserine antibodies, and cardiolipin antibodies. This comprehensive testing will provide your healthcare provider with important information about your risk for APS and allow them to tailor your treatment accordingly.

What do the results of an antiphospholipid antibody panel test mean?

A positive result on any of the panel tests suggests that you have antibodies associated with APS in your blood. This does not necessarily indicate that you have APS, but it raises your chances of having the disorder. Your healthcare professional will analyze your results and, if necessary, conduct more tests.

What follow-up is necessary after an antiphospholipid antibody panel test?

If you have a positive result on any of the tests in the panel, your healthcare provider will likely order additional testing to confirm the diagnosis of APS. Once APS has been diagnosed, it is important to see your healthcare provider regularly and follow their treatment recommendations. Treatment with blood thinners or other drugs may be required in some cases to avoid serious consequences. With careful management, most persons with APS can live healthy, regular lives.

Is APS the same as lupus?

No, APS is an autoimmune condition that can cause thrombosis, repeated miscarriages, and pregnancy difficulties. Chronic inflammatory disease called lupus can harm several organs. Although they are both autoimmune illnesses, the two conditions are not the same.

Is APS an autoimmune disease?

Yes, APS is an autoimmune condition. When the body's immune system targets healthy cells and tissues, autoimmune disorders result. In APS, the immune system assaults the ubiquitous phospholipids present in all cells. This can result in repeated miscarriages, thrombosis, and problems during pregnancy.

What are the symptoms of APS?

The most common symptom of APS is recurrent miscarriages. Other symptoms may include thrombosis, pregnancy complications, and stroke. Many people with APS do not have any symptoms.

What are the causes of APS?

The exact causes of APS remain unknown. However, it is believed to be a result of both genetic and environmental influences.

What are the risks of APS?

APS can lead to recurrent miscarriages, thrombosis, and pregnancy complications. If left untreated, APS can also lead to stroke or heart attack.

How is APS diagnosed?

APS is typically diagnosed with a blood test. The Antiphospholipid Antibody Panel is a comprehensive test that measures nine different biomarkers that are associated with APS. Your healthcare practitioner will assist you in interpreting your results and, if required, order more tests.

How is APS treated?

There is no cure for APS. However, it is treatable with medicine and lifestyle modifications. Medications may include blood thinners or other medications to prevent serious complications. Lifestyle changes may include avoiding smoking, maintaining a healthy weight, and managing stress. With proper management, most people with APS can lead healthy, normal lives.

What is the prognosis for APS?

The prognosis for APS is generally good. Most people with APS can lead healthy, normal lives with proper diagnosis and treatment. However, APS can lead to serious complications if it is not properly managed. Recurrent miscarriages, thrombosis, and pregnancy complications are the most common complications associated with APS. If left untreated, APS can also lead to stroke or heart attack.

What are the three antiphospholipid antibodies?

The three antiphospholipid antibodies are beta-2-glycoprotein I, phosphatidylserine, and cardiolipin. These antibodies are associated with APS and can lead to recurrent miscarriages, thrombosis, and pregnancy complications.

Description: The C-Reactive Protein (CRP) test measures the levels of C-reactive protein, a substance produced by the liver in response to inflammation in the body. It is a non-specific marker of inflammation and is used to evaluate the presence and intensity of inflammation. The CRP test helps healthcare providers assess the severity of an inflammatory condition and monitor response to treatment.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a C-Reactive Protein test ordered?

A C-Reactive Protein (CRP) test may be ordered in several situations to assess a patient's inflammation levels:

1. Infection or Inflammatory Diseases: The test is ordered when a patient shows signs of infection or has symptoms of inflammatory diseases such as rheumatoid arthritis, lupus, or inflammatory bowel disease.

2. Monitoring Response to Treatment: For patients with known inflammatory conditions, the CRP test helps healthcare providers monitor the effectiveness of treatment and track changes in inflammation levels over time.

3. Cardiovascular Risk Assessment: The CRP test may be ordered as part of a cardiovascular risk assessment to identify individuals at higher risk of developing heart disease or to assess the severity of existing cardiovascular conditions.

4. Post-Surgery Monitoring: After surgical procedures, the CRP test can be ordered to monitor post-operative inflammation levels and identify any complications or infections.

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:

A C-Reactive Protein (CRP) test is commonly ordered for:

1. Inflammatory Diseases: The test helps assess the severity of inflammatory diseases such as rheumatoid arthritis, lupus, vasculitis, or inflammatory bowel disease.

2. Infections: Elevated CRP levels can indicate the presence of infections, whether bacterial, viral, or fungal, and help healthcare providers identify the site of inflammation.

3. Cardiovascular Diseases: The CRP test is used as part of cardiovascular risk assessment to identify individuals at higher risk of developing heart disease or to assess the severity of existing cardiovascular conditions.

Commonly Asked Questions:

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

Healthcare providers use the results of a C-Reactive Protein (CRP) test to:

1. Assess Inflammation Levels: Elevated CRP levels indicate the presence and intensity of inflammation in the body, helping healthcare providers evaluate the severity of an inflammatory condition.

2. Monitor Treatment Response: Regular CRP testing allows healthcare providers to monitor the effectiveness of treatments for inflammatory conditions and track changes in inflammation levels over time.

3. Guide Diagnosis and Further Testing: Elevated CRP levels, combined with other clinical findings, can help healthcare providers diagnose and differentiate between different inflammatory conditions and guide the need for further diagnostic tests or evaluations.

By effectively utilizing the results of a C-Reactive Protein (CRP) test, healthcare providers can assess inflammation levels, monitor treatment response, and make informed decisions regarding patient care, including treatment adjustments and further investigations if necessary.

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

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

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

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

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

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

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

Description: A Cardiolipin Antibody test is a blood test used to detect antibodies to cardiolipin which may be causing a patient issues with forming blood clots.

Also Known As: Anticardiolipin Antibodies Test, aCL Antibody Test, Cardiolipin IgG Antibody Test, Cardiolipin IgA Antibody Test, Cardiolipin IgM Antibody Test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

When is a Cardiolipin Antibodies test ordered?

Cardiolipin antibody testing is frequently requested as part of an excessive clotting workup when a person exhibits blood clot-related symptoms, especially when such symptoms reoccur. Depending on where the clot is, different signs and symptoms may be present.

As a follow-up to a protracted PTT test, testing may also be mandated when a woman has experienced repeated miscarriages and/or in conjunction with lupus anticoagulant testing. If a cardiolipin antibody is found, the test may be repeated several weeks later to see if it is a transient or persistent antibody.

When a person exhibits the signs and symptoms of an autoimmune condition and/or receives a positive ANA test result, a test for cardiolipin antibodies may also be prescribed since it may give the doctor further details to help make a diagnosis. If cardiolipin antibodies are not found in a patient with a known autoimmune disease like lupus, further testing may be required to check for the emergence of these antibodies.

What does a Cardiolipin Antibodies test check for?

The immune system creates cardiolipin antibodies, which are autoantibodies that wrongly target the body's own cardiolipins, which are located in the cell and platelet membranes. These autoantibodies may have an unidentified impact on the body's capacity to control blood coagulation. Cardiolipin antibodies are discovered with this test in the blood.

Cardiolipins and other phospholipids in their family are lipid molecules that are crucial to the blood clotting process. Cardiolipin antibodies work by attacking cardiolipins and are linked to a higher risk of repeated, unneeded blood clots in arteries and veins, such the deep veins of the legs or the lungs. They could also be linked to preterm labor, pre-eclampsia, recurrent miscarriages, low platelet counts, and low platelet counts.

The most prevalent antiphospholipid antibody is a class of autoantibodies called cardiolipins that are linked to excessive clotting and autoimmune conditions like lupus. They are usually found in conjunction with other antiphospholipid antibodies, including anti-beta-2 glycoprotein 1 and lupus anticoagulant. Additionally, they might be momentarily picked up in older people, those with HIV/AIDS, some malignancies, and acute infections.

An individual may be diagnosed with antiphospholipid syndrome if they have blood clots that aren't supposed to, have repeated miscarriages, have cardiolipin antibodies, or have another antiphospholipid antibody. A primary or secondary APS may be used. While secondary APS is linked to an autoimmune condition, primary APS is not always connected to a related autoimmune disorder.

Lab tests often ordered with a Cardiolipin Antibodies test:

• ANA Screen
• Lupus Anticoagulant Testing
• Beta-2 Glycoprotein 1 Antibodies
• Phosphatidylserine Antibodies

Conditions where a Cardiolipin Antibodies test is recommended:

• Antiphospholipid Syndrome
• Autoimmune Disorders
• Excessive Clotting Disorders

How does my health care provider use a Cardiolipin Antibodies test?

Cardiolipin antibody tests are routinely used to assist identify the underlying cause of:

• An unexplained blood clot
• Multiple miscarriages
• a prolonged coagulation PTT result; in this context, the test is frequently conducted in conjunction with lupus anticoagulant testing

If cardiolipin antibodies are discovered during an initial test, they are typically checked again 12 weeks later to see if their presence is permanent or transient. Cardiolipin antibodies may emerge at any moment in the future, therefore if a person with a known autoimmune condition tests negative for them, they may be retested in the future.

IgG, IgM, and/or IgA are the three kinds of cardiolipin antibodies that may be found in the blood. IgG and IgM are the two most often examined antibodies. IgA cardiolipin antibody testing may be required, nevertheless, if these tests come back negative and clinical suspicions persist.

Along with cardiolipin antibody tests, other tests including anti-beta-2 glycoprotein 1 antibody and lupus anticoagulant testing may also be carried out.

What do my Cardiolipin Antibodies test results mean?

A negative result only indicates that there are no cardiolipin antibodies present or none that are present in the blood at the time of the test.

Of all the antiphospholipid antibodies, cardiolipin antibodies are the most widespread. It is common to find them in a person's blood temporarily as a result of an infection or medication, as well as in old people who don't have any symptoms. Even though the low to moderate levels of antibody present in these circumstances are frequently insignificant, they still need to be assessed along with any signs, symptoms, and/or other clinical data.

When tested again 12 weeks later, moderate to high levels of cardiolipin antibodies that were present the first time are likely still present. This particular antibody may be linked to an increased risk of excessive clotting or recurrent miscarriages.

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

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.

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

Average Processing Time: 1 to 2 days

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

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

Collection Method: Blood draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Prothrombin Time with INR test ordered?

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

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

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

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

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

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

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

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

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

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

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

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

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

Conditions where a Prothrombin Time with INR test is recommended:

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

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

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

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

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

What do my PT and INR test results mean?

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

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

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

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

Description: A Prothrombin with INR and Partial Thromboplastin Times test is used to diagnose and monitor bleeding disorders or excessive clotting disorders. The biomarkers in the test are used to measure the time it takes for the blood to form a clot.

Also Known As: Pro Time with INR Test, Prothrombin Time and International Normalized Ratio test, Prothrombin Time PT with INR Test, Prothrombin Time with INR Test, Prothrombin with INR, Protime with INR, PT Test, Activated Partial Thromboplastin Time Test, aPTT test, PTT Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Prothrombin with INR and Partial Thromboplastin Time test ordered?

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

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

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

When a person has the following symptoms, the PTT may be ordered along with other tests, such as a PT:

• Bleeding that isn't explained or bruises that isn't easy to get rid of
• A blood clot in a vein or artery is a serious condition.
• Disseminated intravascular coagulation
• A chronic disorder that affects hemostasis, such as liver disease

A PTT can be requested in the following situations:

• When a person develops a blood clot or a woman has repeated miscarriages, as part of a lupus anticoagulant, anticardiolipin antibodies, or antiphospholipid syndrome examination
• When a person is on standard heparin therapy, the two are overlapped and both the PTT and PT are monitored until the person has stabilized. When a person is switched from heparin therapy to extended warfarin therapy, the two are combined and both the PTT and PT are monitored until the person has stabilized
• Prior to surgery, if there is a high risk of blood loss and/or if the patient has a history of bleeding, such as frequent or severe nasal bleeds and easy bruising, which could suggest the presence of a bleeding problem

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

The prothrombin time with INR and partial thromboplastin time is a test that determines a person's capacity to make blood clots properly. The international normalized ratio, or INR, is a calculation based on the results of a PT that is used to track people who are taking the blood thinner warfarin. The PTT evaluates the number and function of specific proteins known as coagulation factors, which are crucial in blood clot formation.

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

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

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

The PT test is normally done in seconds and the results are compared to a normal range that represents PT levels in healthy people. The normal ranges will fluctuate because the reagents used to perform the PT test differ from one laboratory to the next and even within the same laboratory over time. For people taking the anticoagulant warfarin, a World Health Organization committee developed and recommended the use of the Internationalized Normalized Ratio, which is calculated based on the PT test result, to standardize results across different laboratories in the United States and around the world.

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

Lab tests often ordered with a Prothrombin with INR and Partial Thromboplastin Time test:

• Fibrinogen Activity
• Platelet Count
• Complete Blood Count (CBC)
• D-Dimer
• Lupus Anticoagulant
• ACT
• Von Willebrand Factor
• Antiphospholipid Antibodies
• Warfarin Sensitivity Testing

Conditions where a Prothrombin with INR and Partial Thromboplastin Time test is recommended:

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

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

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

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

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

The PTT is mostly used to look into unexplained bleeding or clotting. It may be ordered in conjunction with a prothrombin time test to assess hemostasis, the body's process of forming blood clots to stop bleeding. Excessive bleeding or clotting issues are frequently investigated with these tests as a starting point.

Coagulation factors are proteins that have a role in hemostasis and the development of blood clots. When an injury occurs and bleeding begins, coagulation factors are triggered in a series of events that finally assist in the formation of a clot.

Prekallikrein and high molecular weight kininogen, as well as coagulation factors XII, XI, IX, VIII, X, V, II, and I, are all assessed using the PTT. The coagulation factors VII, X, V, II, and I are evaluated in a PT test. A health practitioner can determine what type of bleeding or clotting condition is present by combining the findings of the two tests. The PTT and PT aren't diagnostic, but they can help you figure out if you need more tests.

The following are some examples of PTT applications:

• To detect coagulation factor deficit; if the PTT is extended, additional tests can be performed to ascertain whether coagulation factors are deficient or malfunctioning, or to see if the blood contains an antibody to a coagulation factor.
• Nonspecific autoantibodies, such as lupus anticoagulant, can be detected and are linked to clotting episodes and recurrent miscarriages. As a result, PTT testing may be included in a clotting disorder panel to aid in the investigation of recurrent miscarriages or the diagnosis of antiphospholipid syndrome. The LA-sensitive PTT, a version of the PTT, could be used for this.
• Heparin is an anticoagulant medicine that is given intravenously or by injection to prevent and treat blood clots; it is used to monitor routine heparin anticoagulant therapy. PTT is extended as a result of it. Heparin must be constantly managed when it is used for medicinal purposes. If too much is given, the patient may bleed excessively; if not enough is given, the patient may continue to clot.

The PTT and PT tests are sometimes used to screen for potential bleeding tendencies before surgical or other invasive treatments based on carefully acquired patient histories.

Other tests that may be done in conjunction with a PTT or in response to aberrant results include:

• Platelet count — should be checked often during heparin therapy to detect any thrombocytopenia caused by the drug.
• Thrombin time testing – used to rule out the possibility of heparin contamination.
• Fibrinogen testing - to rule out a low level of fibrinogen as the cause of a delayed PTT.
• A second PTT test is conducted after a first PTT is delayed by mixing the person's plasma with pooled normal plasma.  If the PTT time returns to normal, it indicates that one or more coagulation factors in the person's plasma are deficient. If the condition persists, it could be caused by the presence of an aberrant specific factor inhibitor or nonspecific lupus anticoagulant.
• Coagulation factor tests are used to determine how active coagulation factors are. They can identify low protein levels or proteins that aren't working properly. A coagulation factor's antigen level is occasionally tested.
• If the presence of lupus anticoagulant is suspected, a test for dilute Russell viper venom may be performed.
• Von Willebrand factor is a test that is sometimes conducted to see if von Willebrand disease is causing a prolonged PTT.

What do my PT with INR and PTT test results mean?

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

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

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

PTT findings are usually available in seconds. A normal clotting function is usually indicated by a PTT result that falls within a laboratory's reference interval. However, a single coagulation factor deficiency may be present in low to moderate amounts. The PTT should not be extended until the factor levels have dropped to 30% to 40% of normal. Lupus anticoagulant may also be present, but it is unlikely to affect the PTT result. A more sensitive LA-sensitive PTT or a dilute Russell viper venom time can be used to test for the lupus anticoagulant if it is suspected.

A delayed PTT indicates that clotting is taking longer than usual and could be caused by a number of factors. This frequently indicates that the body's clotting ability is being harmed by a coagulation factor deficit or a particular or nonspecific antibody. Defects in coagulation factors can be acquired or inherited.

It's possible that prolonged PTT tests are caused by:

• Von Willebrand disease is the most prevalent inherited bleeding disorder, and it inhibits platelet function because von Willebrand factor levels are low.
• Hemophilia A and B are two more inherited bleeding disorders that are caused by a lack of factors VIII and IX, respectively.
• Other coagulation factors, such as factors XII and XI, are deficient.

Deficiencies in acquired factors:

• A vitamin K insufficiency. Vitamin K is required for the production of clotting factors. Vitamin K deficiency is uncommon, but it can occur as a result of a poor diet, malabsorption issues, or the use of certain antibiotics over an extended period of time, for example.
• Because the liver produces the majority of coagulation components, liver illness might result in extended PT and PTT. PT is more likely to be prolonged than PTT in patients with liver disease and vitamin K insufficiency.
• A nonspecific inhibitor, such as lupus anticoagulant—the presence of these inhibitors is usually linked to abnormal clotting, but they can also lengthen the PTT. For further information, see the individual test articles.
• Antibodies that selectively target certain coagulation factors, such as antibodies that target factor VIII, are known as specific inhibitors. They can form in people who are receiving factor replacements or they can develop spontaneously as an autoantibody in people who have a bleeding condition. Factor-specific inhibitors have the potential to induce serious bleeding.
• Heparin is an anticoagulant that will prolong a PTT if it is present in the sample as a contaminant or as part of anticoagulation therapy. The goal PTT for anticoagulant therapy is usually 1.5 to 2.5 times longer than the pretreatment level.
• The PTT is not used to monitor warfarin anticoagulation therapy, but it may be influenced by it. The PT is commonly used to track warfarin therapy.
• Anticoagulation therapy with a direct thrombin inhibitor or a direct factor Xa inhibitor are examples of other anticoagulants.
• Leukemia, severe bleeding in pregnant women prior to or after delivery, and recurrent miscarriages can all cause elevated PTT levels

The PTT results are frequently combined with the PT results to determine what ailment is present.

PTT testing may be shortened as a result of:

• Disseminated intravascular coagulation—circulating procoagulants shorten the PTT in the early phases of DIC.
• Extensive cancer
• An acute-phase reaction is a disease that causes significant tissue inflammation or trauma, which causes factor VIII levels to rise. It's frequently a one-time occurrence that isn't tracked with a PTT test. The PTT will return to normal once the condition that caused the acute phase reaction is resolved.

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

Description: The D-Dimer Quantitative test is used to evaluate fibrinolytic activation and intravascular thrombosis.

Also Known As: Fragment D-Dimer Test, Fibrin Degradation Fragment Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a D-Dimer test ordered?

When a patient presents to the emergency room with signs of a dangerous disease, D-dimer testing is frequently prescribed.

When a patient exhibits signs of pulmonary embolism or deep vein thrombosis, a D-dimer test may be prescribed.

When a doctor suspects that another condition other than deep vein thrombosis or pulmonary embolism is the likely cause of symptoms, D-dimer is particularly helpful. It is a rapid, non-invasive method that can help rule out excessive or irregular coagulation. However, it should not be taken if a clinical examination indicates that there is a high likelihood of pulmonary embolism.

To help in the diagnosis of disseminated intravascular coagulation, a D-dimer test coupled with a PT, PTT, fibrinogen, and platelet count may be prescribed for someone who exhibits symptoms like bleeding gums, nausea, vomiting, intense muscle and abdominal pain, seizures, and decreased urine output. When someone is receiving therapy for DIC, D-dimer orders may also be placed periodically to help track the condition's development.

What does a D-Dimer blood test check for?

One of the protein fragments created when a blood clot dissolves in the body is called D-dimer. Normally, it goes unnoticed until the body is generating and dissolving blood clots. Its blood level may then increase as a result. D-dimer in the blood is found using this test.

The body starts a process known as hemostasis when a blood vessel or tissue is injured and starts bleeding in order to form a blood clot that will eventually stop the bleeding. A fibrin net is created by the crosslinking of fibrin threads, which are produced as a result of this process. Platelets and that net work together to contain the blood clot that is forming until the wound has healed.

The body utilizes an enzyme called plasmin to break the thrombus into small pieces so that it can be eliminated after the area has had time to heal and the clot is no longer required. Known as fibrin degradation products, the fragments of the breaking down fibrin in the clot are made up of different sized bits of crosslinked fibrin. D-dimer, one of the last byproducts of fibrin breakdown, can be detected in blood samples and quantified. When blood clots are formed and broken down significantly in the body, the level of D-dimer in the blood may increase.

The D-dimer test's strength is that it can be utilized in a hospital emergency room setting to assess the likelihood of a clot's existence for a person who is at low or moderate risk for blood clotting and/or thrombotic embolism. If the D-dimer test is negative, a thrombus is extremely unlikely to be present. A positive D-dimer test, however, cannot indicate the presence or absence of a clot. It suggests that additional testing is necessary.

Unwanted blood clot formation is related to a number of variables and diseases. Deep vein thrombosis, which causes clots to form in the body's deep veins, most usually in the legs, is one of the most frequent. These clots have the potential to become very large and obstruct blood flow to the legs, resulting in swelling, discomfort, and tissue damage. It is possible for a fragment of the clot to separate and spread to different bodily regions. This "embolus" may become lodged in the lungs and result in pulmonary embolism. Up to 300,000 deaths in the U.S. are attributed to pulmonary embolisms brought on by DVT each year.

Clots can develop in different places, though they most frequently do so in the veins of the legs. Any of these places may benefit from D-dimer measurements to aid in the discovery of clots. For instance, myocardial infarction is brought on by clots in the coronary arteries. When the heart is pounding irregularly or when the valves are damaged, clots are more likely to form on the lining of the heart or its valves. Additionally, clots can develop in big arteries due to atherosclerosis-related constriction and damage. Such clot fragments may break off and create an embolus, which stops an artery in another organ, such the kidneys or the brain.

In addition to other tests, D-dimer measurements may be requested to assist in the diagnosis of disseminated intravascular coagulation. DIC is a condition when the body's clotting factors are activated and subsequently depleted. This causes multiple small blood clots to form while also making the victim susceptible to heavy bleeding. It is a challenging, occasionally fatal illness that can develop following a number of medical procedures, infections, toxic snake bites, liver diseases, and postpartum conditions. While the underlying ailment gets better, measures are taken to support the affected person. In DIC, the D-dimer level is frequently very high.

Lab tests often ordered with a D-Dimer test:

• PT and INR
• PTT
• Fibrinogen Activity
• Platelet Count
• Complete Blood Count (CBC)

Conditions where a D-Dimer test is recommended:

• Excessive Clotting
• Disseminated Intravascular Coagulation
• Pulmonary Embolism
• Deep Vein Thrombosis

How does my health care provider use a D-Dimer test?

D-dimer tests are used to assist in excluding the possibility of an unexpected blood clot.

This test can assist establish whether more testing is required to evaluate diseases and conditions that lead to hypercoagulability, or a propensity to clot unnecessarily.

A D-dimer level can be used to monitor DIC therapy effectiveness and aid in the diagnosis of disseminated intravascular coagulation.

What do my D-Dimer test results mean?

The likelihood that a person examined does not have an acute ailment or disease that causes aberrant clot formation and breakdown increases if the D-dimer result is normal or negative. The majority of medical professionals concur that a negative D-dimer test is most reliable and helpful when it is performed on individuals who are thought to have a low to moderate risk of thrombosis. The test is employed to assist in excluding coagulation as the root of the symptoms.

A high level of fibrin breakdown products may be present if the D-dimer test is positive. It does not specify the location or origin, but rather suggests that there may be major blood clot development and disintegration in the body. For instance, it might be caused by disseminated intravascular coagulation or venous thromboembolism. In DIC, the D-dimer level is frequently very high.

However, because a number of different causes might result in a raised level, an elevated D-dimer does not always mean that a clot is present. Elevated amounts may be present in diseases or conditions where fibrin is not regularly eliminated, such as liver illness, or diseases or conditions where fibrin is not normally cleared, such as recent surgery, trauma, infection, heart attack, and several malignancies. D-dimer is therefore rarely used to exclude VTE in hospitalized patients.

During pregnancy, fibrin is also produced and degraded, which could cause a rise in D-dimer levels. The D-dimer test, combined with a PT, PTT, fibrinogen, and platelet count, may be utilized, however, to help detect DIC in a woman who is pregnant or who is soon after giving birth. Her D-dimer level will be exceedingly high if the woman has DIC.

D-dimer is advised as an additional test. The D-dimer test should only be performed to rule out deep vein thrombosis and not to confirm a diagnosis because it is a sensitive test but has low specificity. When the clinical likelihood of pulmonary embolism is high, it shouldn't be utilized to treat the condition. Follow-up and additional testing may be necessary for both elevated and normal D-dimer levels. Further investigation using diagnostic imaging is necessary for patients with positive D-dimer tests and those who have a moderate to high risk for DVT.

When used to track the effectiveness of DIC treatment, decreasing levels signify success while rising levels could mean treatment failure.

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

Description: A Complete Blood Count (CBC) test is a common laboratory test that provides valuable insights into a patient's overall health and helps detect potential blood disorders or abnormalities. It examines the three major components of blood: red blood cells (RBCs), white blood cells (WBCs), and platelets. By measuring various parameters related to these blood cells, the CBC test offers essential information for diagnosis, monitoring, and treatment planning.

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

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

Average Processing Time: 1 to 2 days

When is a Complete Blood Count test ordered?  

A CBC test may be ordered in various situations. These include:

1. Routine Check-ups: Doctors often include a CBC test as part of routine check-ups to assess overall health and screen for any underlying blood-related conditions.

2. Evaluation of Symptoms: When a patient presents with unexplained symptoms such as fatigue, weakness, frequent infections, bruising, or excessive bleeding, a CBC test can help identify potential causes or abnormalities.

3. Monitoring Chronic Conditions: Patients with chronic conditions like anemia, infections, autoimmune disorders, or blood-related diseases require regular CBC tests to monitor their condition, track treatment effectiveness, and adjust therapies accordingly.

4. Pre-Surgical Assessment: Prior to surgery or invasive medical procedures, doctors order CBC tests to evaluate a patient's blood cell counts and ensure their ability to handle the procedure safely.

What does a Complete Blood Count test check for? 

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

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

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

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

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

RBCs (Red Blood Cells) 

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

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

Platelets 

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

Lab tests often ordered with a Complete Blood Count test: 

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

Conditions where a Complete Blood Count test is recommended: 

A CBC test can assist in diagnosing and monitoring various conditions or diseases, including:

1. Anemia: CBC helps identify different types of anemia, such as iron deficiency anemia, vitamin B12 deficiency anemia, or autoimmune hemolytic anemia.

2. Infections: An abnormal CBC count can indicate the presence of an infection, whether bacterial, viral, or fungal. It provides information about the severity and type of infection.

3. Leukemia: CBC abnormalities may suggest the presence of certain blood cancers, including leukemia. Further tests are necessary to confirm the diagnosis.

4. Inflammatory Disorders: Conditions like rheumatoid arthritis, lupus, or vasculitis can cause changes in the CBC results, indicating ongoing inflammation or autoimmune processes.

Commonly Asked Questions: 

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

Health care providers use the results of a CBC test to:

1. Confirm Diagnoses: Abnormal CBC findings help in diagnosing specific conditions or diseases, such as anemia, infections, blood disorders, or certain cancers.

2. Monitor Treatment Progress: Regular CBC tests allow doctors to evaluate the effectiveness of treatments or therapies and make necessary adjustments based on blood cell count improvements or changes.

3. Guide Further Investigations: If CBC results indicate abnormalities, doctors may recommend additional specialized tests or refer the patient to a hematologist or other relevant specialists for further evaluation and diagnosis.

By understanding the purpose, significance, and applications of a CBC test, patients and healthcare providers can utilize this valuable diagnostic tool to aid in the management of various health conditions and ensure optimal patient care.

What do my Complete Blood Count results mean? 

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

What do my Differential results mean? 

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

What do my Platelet results mean? 

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

NOTE: Ulta Lab Tests provides CBC test results from Quest Diagnostics as they are reported. Often, different biomarker results are made available at different time intervals. When reporting the results, Ulta Lab Tests denotes those biomarkers not yet reported as 'pending' for every biomarker the test might report. Only biomarkers Quest Diagnostics observes are incorporated and represented in the final CBC test results provided by Ulta Lab Tests. 

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

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

Reflex Parameters for Manual Slide Review

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

The Protein S Functional (also known as Protein S, Activity) test assesses protein activity to determine its ability to regulate blood clotting and screen for an excessive clotting disease. 

This Protein S Functional test measures protein S activity to evaluate if they regulate blood clotting appropriately and to screen for a potential blood clotting issue.

This Protein S Functional test can be ordered to assess protein S activity to see whether blood clotting is being adequately regulated and to check for potential blood clotting disorders. Blood clot formation is controlled by the interaction of proteins S and C. Hemostasis, also referred to as bleeding, takes place when a blood vessel is damaged. In order to restrict blood loss until the blood artery has healed, platelets, which are blood cells, team up with proteins S and C (coagulation factors) to create a clot at the wound. For a stable clot to form, there must be enough platelet count, and coagulation factors and each must be in good working order. 

A deficiency or malfunction of these proteins may result in excessive blood clotting or a condition known as deep vein thrombosis (DVT). Deep vein thrombosis may begin in the arms or legs and move to the lungs, causing a potentially fatal pulmonary embolism (PE). 

An underlying health problem such as: 

• Pregnancy 
• Hepatic disease 
• Renal disease 
• Virulent diseases (HIV/AIDS). 
• Cancer 
• Use of Warfarin (Coumadin®) 
• In certain cases, it may be a genetic disorder. 

Protein S exists in two states, free and bound, but only the free form binds to protein C. Consequently, protein S deficits can be classified into three groups: 

• Deficiency owing to insufficient quantity 
• Deficiency owing to improper function 
• Deficiency due to lower quantities of free protein S, but normal levels of total protein S 

Individuals who have suffered excessive blood clots in unexpected areas or blood clots for unexplained reasons should consider ordering this test. This test can also assist in determining if the lower protein S activity is the result of a deficiency or a rare malfunction.

What does elevated Protein S activity indicate? 
In most cases, elevated Protein S levels are clinically insignificant and not connected with medical issues. Activity and concentrations of protein C and Protein S antigens indicate normal clotting control. A low level of Protein S activity might result in abnormal or excessive blood coagulation. 

What causes low Protein S activity?
Acquired Protein S deficiency is caused by a condition such as liver illness, nephrotic syndrome, some infections, oral contraceptives, vitamin K deficiency, surgery, or chemotherapy. 

What is the severity of Protein S deficiency? 
Individuals with modest Protein S deficiency are susceptible to developing deep vein thrombosis (DVT) in the deep veins of the arms or legs. A pulmonary embolism, a potentially fatal blood clot, can result from a DVT that enters the bloodstream and lodges in the lungs (PE) 

What is the functional test for protein S? 
Protein S aids in blood coagulation regulation. A deficiency of this Protein or an issue with its function may lead to the formation of blood clots in veins. This test is also used to screen the relatives of individuals with known Protein S deficiency. This test is sometimes used to determine the cause of repeated miscarriages. 

What should your levels of Protein S be? 
Typically, these percentage values should range between 60 and 150. There may be minor variations between testing centers. Low amounts of protein S may raise the risk of blood clots, although high levels do normally not cause for worry. 

Can a lack of Protein S induce a stroke? 
In young populations, Protein S deficiency is an uncommon cause of recurrent ischemic stroke. 

How can Protein S insufficiency be treated? 
If you have Protein S deficiency but have never had a blood clot, you will likely not need therapy unless certain conditions apply. Heparin, warfarin, rivaroxaban, apixaban, and dabigatran are anticoagulants that are commonly prescribed. 

How does a protein deficiency manifest itself? 
Protein insufficiency manifests as fatigue, weakness, hair loss, brittle nails, and dry skin. Protein deficit is particularly prevalent among vegans, vegetarians, individuals over the age of 70, and those with digestive disorders such as celiac disease and Crohn's disease. 

Aspirin and protein S deficiency: can it help? 
Many specialists recommend that women with Protein S deficiency, a history of fetal death, and severe or recurrent eclampsia get prophylactic-dose low molecular weight heparin (LMWH) medication during pregnancy, with the LMWH prophylaxis continuing for 6 weeks postpartum.

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.

Description: Homocysteine is an amino acid that is present in every cell. There is a small amount present as it is an amino acid that changes quickly into other needed products in the body.

Also Known As: Homocysteine Cardiac Risk Test, Homocysteine Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for at least 8 hours is preferred

Average Processing Time: 2 to 3 days

When is a Homocysteine test ordered?

When a doctor feels a person may be deficient in vitamin B12 or folate, he or she may request this test. At first, the signs and symptoms are vague and ambiguous. People who have an early deficit may be diagnosed before they show any visible symptoms. Other persons who are impacted may experience a range of moderate to severe symptoms, including:

• Diarrhea
• Dizziness
• Weakness and exhaustion
• Appetite loss
• Paleness
• Heart rate that is quite fast
• Breathing problems
• Tongue and mouth ache
• In the feet, hands, arms, and legs, there is tingling, numbness, and/or burning

Depending on an individual's age and other risk factors, homocysteine may be requested as part of determining a person's risk of developing cardiovascular disease. It may also be ordered after a heart attack or stroke to aid in treatment planning.

When newborn screening identifies an increased level of methionine or if an infant or kid shows signs and symptoms of homocystinuria, this test may be ordered. Babies with this illness will appear normal at birth, but if left untreated, they will develop symptoms such as a displaced lens in the eye, a long slender build, long thin fingers, and skeletal abnormalities within a few years.

What does a Homocysteine blood test check for?

Homocysteine is an amino acid that is found in trace amounts in all of the body's cells. The body generally converts homocysteine to other compounds fast. Because vitamins B6, B12, and folate are required for homocysteine metabolism, elevated levels of the amino acid could indicate a vitamin deficit. The level of homocysteine in the blood is determined by this test.

Increased homocysteine levels have also been linked to an increased risk of coronary heart disease, stroke, peripheral vascular disease, and artery hardening. Homocysteine has been linked to cardiovascular disease risk through a variety of processes, including damage to blood vessel walls and support for the production of abnormal blood clots, but no direct linkages have been established. Several studies have also found no benefit or reduction in CVD risk with folic acid and B vitamin supplementation. The American Heart Association does not believe it to be a significant risk factor for heart disease at this time.

Homocysteine levels in the blood can also be dramatically increased by a rare genetic disorder known as homocystinuria. In homocystinuria, one of multiple genes is mutated, resulting in a defective enzyme that prevents the normal breakdown of methionine, the precursor of homocysteine. Methionine is one of the eleven necessary amino acids that the body cannot make and must therefore be obtained from food.

Homocysteine and methionine build up in the body without the necessary enzyme to break them down. Babies born with this condition appear normal at birth, but develop symptoms such as a long slender build, a dislocated lens in the eye, long thin fingers, osteoporosis, skeletal abnormalities, and a significantly increased risk of thromboembolism and atherosclerosis, which can lead to premature CVD within a few years.

In addition to intellectual disability, mental illness, a little low IQ, behavioral issues, and seizures, artery blockages can induce intellectual disability, mental illness, and seizures. Some of them can be avoided if homocystinuria is diagnosed early, which is why all states screen neonates for the disease.

Lab tests often ordered with a Homocysteine test:

• Vitamin B12
• Folate
• MTHFR Mutation
• Intrinsic Factor Antibody

Conditions where a Homocysteine test is recommended:

• Vitamin B12 and Folate Deficiency
• Heart Attack
• Heart Disease
• Stroke

How does my health care provider use a Homocysteine test?

The homocysteine test can be used in a variety of ways, including:

A homocysteine test may be ordered by a doctor to see if a person is deficient in vitamin B12 or folate. Before B12 and folate tests are abnormal, the homocysteine level may be raised. Homocysteine testing may be recommended by some health professionals in malnourished people, the elderly, who absorb less vitamin B12 from their diet, and people who have poor nutrition, such as drug or alcohol addicts.

For those at high risk of a stroke or heart attack, homocysteine testing may be requested as part of a health screening. It could be beneficial for someone who has a family history of coronary artery disease but no other recognized risk factors like smoking, high blood pressure, or obesity. However, because the specific role of homocysteine in the course of cardiovascular disease is unknown, the screening test's efficacy continues to be questioned.

If a health professional believes that an infant or kid has homocystinuria, tests for both urine and blood homocysteine can be utilized to assist diagnose the genetic condition. As part of their newborn screening in the United States, all babies are regularly tested for excess methionine, a symptom of homocystinuria. If a baby's test results are positive, urine and blood homocysteine tests are frequently used to confirm the results.

What do my homocysteine test results mean?

Homocysteine levels may be high in cases of suspected malnutrition, vitamin B12, or folate insufficiency. If a person does not consume enough B vitamins and/or folate through diet or supplements, the body may be unable to convert homocysteine into forms that the body can use. The level of homocysteine in the blood may rise in this scenario.

According to studies conducted in the mid- to late-1990s, those with high homocysteine levels have a substantially higher risk of heart attack or stroke than those with normal levels. The study of the relationship between excessive homocysteine levels and heart disease is still ongoing. However, considering that multiple trials studying folic acid and B vitamin supplementation have found no benefit or reduction in CVD risk, the use of homocysteine levels for risk assessment of cardiovascular disease, peripheral vascular disease, and stroke is now questionable.

A 2012 research study using various datasets, including 50,000 persons with coronary heart disease, called into question the possibility of a cause-and-effect relationship between homocysteine levels and heart disease. Although the American Heart Association recognizes a link between homocysteine levels and heart attack/stroke survival rates, it does not consider high homocysteine to be a major CVD risk factor.

While the AHA does not advocate for widespread use of folic acid and B vitamins to reduce the risk of heart attack and stroke, it does advocate for a balanced, nutritious diet and advises doctors to consider total risk factors as well as nutrition when treating cardiovascular disease.

Significantly elevated homocysteine concentrations in the urine and blood indicate that an infant is likely to have homocystinuria and need additional testing to confirm the reason of the increase.

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

Description: The Lupus Anticoagulant Evaluation test is used to screen for lupus anticoagulants, also known as antibodies with phospholipid-protein specificity.

Also Known As: LA Test, LAC Test, Lupus Anticoagulant Panel Test, Lupus Inhibitor Test, LA Sensitive PTT Test, PTT-LA Test,

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

Average Processing Time: 3 to 4 days

Test Includes Reflexes:

PTT-LA and dRVVT with Reflex Confirmations

• If PTT-LA Screen is prolonged (>40 seconds), then Hexagonal Phase Confirmation will be performed at an additional charge (CPT code(s): 85598).
• If Hexagonal Phase Confirmation is positive or weakly positive, then Thrombin Clotting Time will be performed at an additional charge (CPT code(s): 85670).
• If dRVVT Screen is prolonged (>45 seconds), then dRVVT Confirm will be performed at an additional charge (CPT code(s): 85597).
• ?If dRVVT Confirm is positive, then dRVVT 1:1 Mixing Study will be performed at an additional charge (CPT code(s): 85613).

When is a Lupus Anticoagulant test ordered?

Testing for lupus anticoagulant is recommended in addition to other tests when:

• A vein or artery has had an inexplicable blood clot; signs and symptoms might range from exhaustion, sweating, and rapid breathing with a pulmonary embolism to discomfort, swelling, and discolouration in the leg with deep vein thrombosis.
• A person can have APS symptoms, which may resemble the ones listed above.
• A woman has repeated miscarriages.
• A individual undergoes an extended PTT test.
• Particularly for people being tested for APS, testing is typically repeated about 12 weeks after the initial results to ensure that the presence of lupus anticoagulant is still present.

A doctor may occasionally repeat one or more of the lupus anticoagulant screening tests, typically the PTT, on a person who first tests negative for the substance but who nonetheless has an autoimmune disease like lupus to see if the antibody has grown since the previous time the test was conducted. The reason for this is because the lupus anticoagulant could manifest in the person at any time.

What does a Lupus Anticoagulant blood test check for?

Autoantibodies, which are made by the immune system that mistakenly target specific parts of the body's own cells, are lupus anticoagulants. They specifically target phospholipids and phospholipid-associated proteins that are present in the cell's outermost layer. These autoantibodies raise a person's chance of getting a blood clot by interfering with the blood clotting process in a mechanism that is not completely understood. A battery of tests known as lupus anticoagulant testing can find LA in blood.

The name of the lupus anticoagulant test may sound strange or be unclear for two reasons:

• Although LA testing is not used to diagnose lupus and LA are commonly absent in lupus patients, lupus anticoagulants were originally discovered in patients with the inflammatory disease. LA can also happen to persons who have other medical issues or take certain medications. About 2-4% of the general population has antibodies, and those with no known risk factors can nevertheless develop them.
• Since LA really reduces clotting in laboratory tests used to assess coagulation, the term "anticoagulant" is a part of the name. For instance, they prevent the clotting-causing chemical processes in the partial thromboplastin time test, which is frequently used to gauge clotting. However, the presence of LA in the human body is linked to a higher risk of unneeded blood clot formation. It's important to note that lupus anticoagulant doesn't by itself make the body bleed.

Lupus anticoagulant cannot be readily measured and is not detectable by a single test. Utilizing a panel of consecutive tests for which there is no standardization, LA is typically detected.

Initial testing usually consists of one or more phospholipid-based assays, such as the PTT, the LA-sensitive PTT, or the diluted Russell viper venom test. All of these tests track the length of time needed for a sample to clot; LA increases that length of time.

To confirm or rule out the presence of lupus anticoagulant, certain follow-up tests are carried out according on the outcomes of these initial tests.

LA may make it more likely for blood clots to form in arteries and veins, frequently in the legs' veins. These clots have the potential to obstruct blood flow to any area of the body, resulting in pulmonary embolism, heart attack, or stroke. LA is linked to repeated miscarriages as well. It has been hypothesized that LA may directly destroy the tissue of the placenta, impairing its development, and that LA may also induce clots to form that clog blood arteries of the placenta, impairing growth of the unborn baby.

One of the three principal antiphospholipid antibodies linked to a higher risk of thrombosis and antiphospholipid antibody syndrome, an autoimmune condition characterized by excessive blood clot formation and pregnancy-related problems, is the lupus anticoagulant. Beta-2 glycoprotein 1 antibody and cardiolipin antibodies make up the other two. Both separately and collectively, they enhance a person's propensity to clot improperly. If all three antibodies are present, people with APS are more likely to clot. However, those with LA seem to experience thrombosis more frequently.

Antiphospholipid antibodies do not always cause symptoms. About 5% of healthy adults have antiphospholipid antibodies.

Lab tests often ordered with a Lupus Anticoagulant test:

• Antiphospholipid Antibodies
• PTT
• Thrombin Time
• PT and INR
• Homocysteine
• Cardiolipin Antibodies
• Protein C and S
• Factor V Leiden Mutation
• Beta-2 Glycoprotein 1 Antibodies

Conditions where a Lupus Anticoagulant test is recommended:

• Excessive Clotting Disorders
• Autoimmune Disorders
• Lupus
• Antiphospholipid Syndrome

How does my health care provider use a Lupus Anticoagulant test?

Testing for lupus anticoagulant is a set of procedures used to find the anticoagulant in blood. An autoantibody called LA is linked to excessive blood clot formation. Testing with LA may be done to assist identify the root cause of:

• a mysterious blood clot in an artery or vein
• Multiple miscarriages
• an extended PTT test without explanation. LA testing assists in determining if a prolonged PTT is caused by a nonspecific inhibitor, such as the lupus anticoagulant, or a nonspecific inhibitor, such as an antibody against a particular coagulation factor.

Using LA testing also allows for:

• Antiphospholipid syndrome is diagnosed with testing for cardiolipin antibody and anti-beta2-glycoprotein I.
• To help with the diagnosis of an excessive clotting condition, tests like factor V Leiden or proteins C and S are often used.
• Identifying the transient or persistent nature of the lupus anticoagulant

There is no single test or established process to identify LA in blood, and it cannot be quantified directly. The presence or absence of the autoantibody is determined by a set of tests:

• It is advised to perform two tests to find lupus anticoagulant. The two assays with the highest sensitivity are the LA-sensitive PTT and the dilute Russell viper venom test, both of which utilize very little phospholipid reagent. To confirm or rule out the presence of lupus anticoagulant, follow-up testing is done. These may consist of:
• Mixing study: A PTT or DRVVT is run on the mixture after an equal volume of patient plasma and "normal" pooled plasma have been combined.
• Correction/neutralization: A PTT-LA or DRVVT is carried out after adding an excessive amount of phospholipids to the patient sample.

What do my Lupus Anticoagulant test results mean?

The outcomes of the several LA tests either point in the direction of LA or away from it. The lab report could be a little technical, but it typically gives an explanation of the findings and indicates if LA is present or not. The best people to interpret the results of LA testing, like the results of other tests for clotting problems, are medical professionals with experience in excessive clotting diseases.

Even though the initial LA tests may differ, they often start with a PTT that is extended. Normal PTT results could indicate the absence of LA. The LA-sensitive PTT may be required since the test may not be sensitive enough to identify LA.

To help with the diagnosis of antiphospholipid syndrome, lupus anticoagulant testing is frequently combined with tests for cardiolipin antibody and anti-beta2-glycoprotein I antibodies.

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

Description: The MTHFR gene is responsible for making Methylenetetrahydrofolate reductase, which is an enzyme that plays an important role in processing amino acids. This test will be used to determine if there is a DNA gene mutation with the MTHFR gene.

Also Known As: MTHFR Factor Test, MTHFR Mutation Test, MTHFR Gene Mutation Test, Methylenetetrahydrofolate Reductase Gene Test, MTHFR Disease Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Average Processing Time: 5 to 6 days

When is a Methylenetetrahydrofolate Reductase DNA Mutation Analysis test ordered?

When a person has excessive homocysteine levels, the MTHFR mutation test may be conducted, especially if the person has a personal or family history of early cardiovascular disease or thrombosis. When a close family has MTHFR gene mutations, it may be ordered, but it isn't always effective if that family member has normal homocysteine levels, and some labs and organizations advise against using it for thrombophilia screening.

What does a Methylenetetrahydrofolate Reductase DNA Mutation Analysis blood test check for?

The DNA code for the MTHFR enzyme is found in the methylenetetrahydrofolate reductase gene. Two of the most common mutations are detected by this test.

Homocystinuria, anencephaly, spina bifida, and other significant genetic illnesses can result from mutations or polymorphisms in the MTHFR gene. The MTHFR enzyme is required for the conversion of one type of B vitamin, folate, into another. It's also involved in the conversion of homocysteine to methionine, a crucial component of many proteins.

Homocysteine levels over normal indicate that the body is not digesting it adequately. A homocystinuria-causing mutation in the MTHFR gene could be one explanation. While there are at least seven different MTHFR mutations seen in persons with homocystinuria, only two DNA sequence variants known as single nucleotide polymorphisms are analyzed. Individuals can inherit one or both of the MTHFR variations, which are C677T and A1298C. These SNPs cause DNA changes that are linked to elevated homocysteine levels in the blood, which may raise the risk of early cardiovascular disease, abnormal blood clot formation, and stroke.

About 5-14 percent of the population in the United States is homozygous for C677T, which means they have two copies of the gene. The frequency varies with ethnicity, with individuals of Mediterranean descent having the highest frequency and those of African ancestry having the lowest.

The C677T variation causes the MTHFR enzyme to be less active and has a lower ability to handle folate and homocysteine. Reduced MTHFR enzyme activity slows down the homocysteine-to-methionine conversion process and can lead to a buildup of homocysteine in the blood when a person has two copies of the MTHFR C677T gene mutation or one copy of MTHFR C677T and one copy of A1298C.

The increase in homocysteine is usually mild to moderate, but the level of MTHFR enzyme activity varies from person to person. Even if a person has two copies of the MTHFR gene, proper folate consumption can "balance out" the effect of the MTHFR mutation, preventing elevated homocysteine levels.

According to some research, excessive levels of homocysteine in the blood may increase the risk of CVD by weakening blood vessel walls and encouraging plaque development and abnormal blood clotting. However, no direct link has been discovered between homocysteine levels and cardiovascular disease or thrombotic risk. See the Homocysteine article for further information.

Lab tests often ordered with a Methylenetetrahydrofolate Reductase DNA Mutation Analysis test:

• Homocysteine
• Vitamin B12
• Folate
• Lipoprotein Fractionation Ion Mobility
• Apolipoprotein Evaluation
• Lipid Panel
• Factor V Leiden Mutation

Conditions where a Methylenetetrahydrofolate Reductase DNA Mutation Analysis test is recommended:

• Heart disease
• Cardiovascular Disease
• Excessive Clotting Disorders
• Stroke
• Neural Tube Defects

How does my health care provider use a Methylenetetrahydrofolate Reductase DNA Mutation Analysis test?

The methylenetetrahydrofolate reductase mutation test is used to discover two mutations in the MTHFR gene that are linked to high homocysteine levels in the blood. It is not a common request.

If a person has a personal or family history of early cardiovascular disease or improper blood clots, this test may be done as a follow-up to a high homocysteine test. It may also be ordered in conjunction with other cardiac risk tests. However, its value in measuring CVD risk has yet to be proven, and some expert guidelines advise against using it for thrombosis screening.

If a person has a close family with known MTHFR genetic mutations, it may be ordered, especially if that person also has high homocysteine levels. The MTHFR C677T and A1298C gene variants are the most common and often tested. If someone in their family has a different mutation, that mutation should be checked.

An MTHFR test may be ordered in conjunction with other hereditary clotting risk tests, such as Factor V Leiden or prothrombin 20210 mutation tests, to assess a person's overall risk of developing dangerous blood clots.

Although the MTHFR mutation test can help establish the reason of high homocysteine levels, the utility of monitoring homocysteine levels is unclear. While some research suggests that high homocysteine levels increase the risk of cardiovascular disease and/or thrombosis, no direct correlation has been demonstrated. The American Heart Association does not suggest routine homocysteine testing as a cardiac risk measure. The American College of Medical Genetics and the College of American Pathologists both advise against testing for the C677T variation, citing its limited value in individuals with blood clots. Furthermore, the use of homocysteine levels to determine the risk of CVD, peripheral vascular disease, and stroke is controversial at this time, as multiple studies have found no benefit or reduction in risk in persons who took folic acid and vitamin B supplements to lower their homocysteine levels.

What do my MTHFR test results mean?

The results are usually reported as negative or positive, with the positive results naming the mutation. Frequently, the results are accompanied by an interpretation.

Only a small fraction of cases of high homocysteine are caused by genetic factors. MTHFR mutations C677T and A1298C are among the most frequent.

If a person has two copies of MTHFR C677T, or one copy of C677T and one copy of A1298C, it's likely that these hereditary mutations are causing or contributing to increased homocysteine levels.

Increased homocysteine levels are not usually linked to two copies of A1298C.

If the MTHFR mutation test results are negative, the C677T and A1298C mutations were not found, and the elevated homocysteine level is most likely attributable to something else. Other, more uncommon MTHFR genetic variants will be missed by standard testing.

MTHFR mutations, as well as other clotting risk factors like Factor V Leiden or PT 20210 mutations, may increase the risk of thrombosis.

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