Acidosis and Alkalosis

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

Description: The Comprehensive Metabolic Panel (CMP) test is a widely used blood test that provides valuable insights into a patient's overall health and helps evaluate the function of various organs and systems in the body. It measures a comprehensive set of chemical substances in the blood, including electrolytes, kidney and liver function markers, glucose, and protein levels. The CMP test offers a comprehensive overview of the body's metabolic state and aids in diagnosing and monitoring various conditions.

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

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred.

Average Processing Time: 1 to 2 days 

When is a Comprehensive Metabolic Panel test ordered:  

A Comprehensive Metabolic Panel (CMP) test may be ordered in several situations to assess a patient's health:

1. Routine Health Check-ups: Doctors often include a CMP test as part of routine check-ups to assess overall health, screen for underlying conditions, and establish a baseline for future comparisons.

2. Evaluation of Organ Function: The CMP test provides valuable information about the function of vital organs such as the liver, kidneys, and pancreas. It helps detect abnormalities or diseases affecting these organs, such as liver disease, kidney dysfunction, or diabetes.

3. Monitoring Medications or Treatments: Patients undergoing certain medications or treatments, such as those that may impact liver or kidney function, require regular monitoring through CMP tests to ensure the treatments are well-tolerated and effective.

4. Investigation of Symptoms: When patients present with symptoms like fatigue, abdominal pain, jaundice, frequent urination, or unexplained weight loss, a CMP test can aid in identifying potential underlying causes or imbalances.

What does a Comprehensive Metabolic Panel blood test check for? 

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

The following tests are included in the CMP: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

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

Conditions where a Comprehensive Metabolic Panel test is recommended: 

A Comprehensive Metabolic Panel (CMP) test can assist in diagnosing and monitoring various conditions or diseases, including:

1. Liver Diseases: The CMP helps identify liver diseases such as hepatitis, cirrhosis, or liver damage due to alcohol abuse or medication toxicity.

2. Kidney Diseases: Abnormalities in kidney function markers on the CMP test can indicate conditions like chronic kidney disease, kidney infections, or kidney stones.

3. Diabetes or Glucose Imbalances: The CMP provides crucial information on blood glucose levels, aiding in the diagnosis and management of diabetes or identifying glucose imbalances.

4. Electrolyte Imbalances: Abnormal levels of electrolytes detected by the CMP can indicate conditions such as dehydration, kidney dysfunction, or hormonal disorders.

Commonly Asked Questions: 

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

Health care providers use the results of a Comprehensive Metabolic Panel (CMP) test to:

1. Diagnose Medical Conditions: Abnormalities in CMP test results can help healthcare providers diagnose various conditions such as liver disease, kidney dysfunction, diabetes, or electrolyte imbalances.

2. Monitor Treatment Effectiveness: Regular CMP tests allow healthcare providers to monitor the impact of treatments or medications on organ function, glucose control, or electrolyte balance.

3. Evaluate Overall Health: The CMP test provides a comprehensive snapshot of the patient's metabolic state and aids in evaluating overall health, identifying potential risk factors, and guiding further investigations if necessary.

By effectively utilizing the results of a Comprehensive Metabolic Panel (CMP) test, healthcare providers can diagnose conditions, monitor treatment progress, and make informed decisions regarding patient care and management.

What do my Comprehensive Metabolic Panel test results mean? 

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

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

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

Is there anything else I should know? 

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

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

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

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

Please note the following regarding BUN/Creatinine ratio: 

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

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

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

Description: A Urinalysis complete test is a urine test that is used to screen for, diagnose, and monitor a variety of conditions and diseases urinary tract infections and kidney disorders.

Also Known As: Urine Test, Urine Analysis Test, UA Test, urine microscopic examination Test, Urinalysis Test, Complete Urinalysis Test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Urinalysis Complete test ordered?

A urinalysis test may be ordered when a person undergoes a routine wellness examination, is admitted into a hospital, will have surgery, or is having a prenatal checkup.

When a person visits a doctor with symptoms of a urinary tract infection or another urinary system ailment, such as kidney disease, a urinalysis will almost certainly be prescribed. The following are some possible signs and symptoms:

• Pain in the abdomen
• Backache
• Urination that is painful or occurs frequently
• Urine with blood in it

Testing may also be conducted at regular intervals to track the progress of a condition.

What does a Urinalysis Complete test check for?

A urinalysis is a series of examinations done on urine that are physical, chemical, and microscopic. The tests identify and/or measure a number of elements in the urine, including cells, cellular fragments, and microbes. These elements include byproducts of healthy and unhealthy metabolism.

Urine is produced by the kidneys, two fist-sized organs located on either side of the spine near the base of the rib cage. The kidneys help the body regulate its water balance, filter wastes from the blood, and store proteins, electrolytes, and other molecules for later use. To get rid of everything unnecessary, urine travels from the kidneys to the ureters, bladder, and urethra before exiting the body. The color, amount, concentration, and content of urine will change slightly every time a person urinates due to the varied elements in urine, despite the fact that pee is normally yellow and clear.

By screening for components in the urine that aren't typically present and/or monitoring aberrant levels of specific substances, many illnesses can be caught early on. Glucose, bilirubin, protein, red and white blood cells, crystals, and germs are among examples. They could be present because of the following reasons:

• The body responds to an elevated amount of the substance in the blood by attempting to remove the excess through urine.
• There is a problem with the kidneys.
• As with bacteria and white blood cells, there is a urinary tract infection present.

Three separate phases make up a full urinalysis:

• The color and clarity of the urine are assessed using a visual examination.
• Chemical examination, which determines the concentration of urine and tests for roughly 9 chemicals that provide useful information about health and disease.
• Microscopic inspection that identifies and counts the different types of cells, casts, crystals, and other components found in urine, such as bacteria and mucus.

When abnormal results are found, or if a healthcare provider requests it, a microscopic analysis is usually performed.

It may be essential to repeat the test if the findings of a urinalysis are abnormal, and further other urine and blood tests may be needed to help establish a diagnosis, if the results are abnormal.

Lab tests often ordered with a Urinalysis Complete test:

• Complete Blood Count
• Iron Total and Total Iron binding capacity
• Hemoglobin A1c
• Lipid Panel
• CMP
• TSH
• Urine Culture
• Bilirubin Fractionated
• Glucose

Conditions where a Urinalysis Complete test is recommended:

• Diabetes
• Kidney Disease
• Liver Disease
• Hypertension
• Pregnancy
• Hematuria
• Proteinuria
• Kidney Stones

How does my health care provider use a Urinalysis Complete test?

A urinalysis is a series of tests that can diagnose a variety of disorders. It can be used to screen for and/or diagnose a variety of illnesses, including urinary tract infections, renal abnormalities, liver diseases, diabetes, and other metabolic disorders, to name a few.

Urinalysis may be used in conjunction with other tests, such as urine albumin, to monitor the progress of treatment in patients with diseases or conditions like diabetes or kidney disease.

What do my urinalysis complete test results mean?

There are numerous ways to interpret the results of a urinalysis. Unusual results are a warning sign that something isn't right and needs further testing.  To connect the urinalysis results with an individual's symptoms and clinical findings and to look for the causes of aberrant findings, other targeted tests must be done, such as a complete blood count, metabolic panel, or urine culture.

It is more likely that a problem must be addressed the higher the concentration of the atypical component, such as noticeably increased levels of protein, glucose, or red blood cells. On the other hand, the outcomes do not inform the medical professional as to what led to the finding or whether it is a transient or ongoing sickness.

A normal urinalysis does not rule out the possibility of disease. Early in a disease process, some persons will not release elevated amounts of a drug, and others will release them irregularly throughout the day, which means they could be overlooked by a single urine sample. Small amounts of substances may be undetectable in very dilute urine.

NOTE: Only measurable biomarkers will be reported.

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

Description: A Lactate Dehydrogenase or LD test is a blood test that measure the level of the enzyme Lactate Dehydrogenase in your blood’s serum and can be used to detect a wide variety of disorders including liver disease, kidney disease, infections, and pancreatitis.

Also Known As: LD Test, LDH Test, Lactic Acid Dehydrogenase Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Lactate Dehydrogenase test ordered?

When a health practitioner feels that a disease or condition is causing cellular or tissue damage, an LD level, coupled with other tests such as a comprehensive metabolic panel, may be requested. More specific tests, such as alanine transaminase, aspartate aminotransferase, or alkaline phosphatase, may be used to identify the illness and pinpoint which organs are affected if LD is increased. Total LD levels may be ordered at regular intervals to monitor the course and/or resolution of the acute or chronic issue once it has been diagnosed.

When a person has had muscle damage or injury, or when they have signs and symptoms of hemolytic anemia, LD levels may be ordered.

When a person has been diagnosed with cancer, LD testing may be performed on a regular basis.

When a person exhibits signs and symptoms of meningitis, or when there is an accumulation of fluid around the heart, lungs, or abdomen, this test may be recommended.

What does a Lactate Dehydrogenase blood test check for?

Lactate dehydrogenase is an energy-producing enzyme found in nearly all of the body's cells, with the highest concentrations in the heart, liver, muscles, kidneys, lungs, and blood cells; bacteria also produce LD. This test determines the amount of LD in the blood or other bodily fluids.

In the fluid component of the blood, just a little quantity of LD is normally measurable. When cells are injured or destroyed, LD is released into the bloodstream. As a result, an LD blood level is a non-specific indicator of tissue damage elsewhere in the body. It cannot be used to determine the underlying cause or location of cellular damage on its own. It can, however, be used in conjunction with other blood tests to assist diagnose and/or monitor disorders that cause tissue damage, such as liver or blood diseases, or cancer.

Fluid can accumulate or the components of the fluid present can change when there is damage, inflammation, or infection in a specific area of the body, such as the brain, heart, or lungs. The amount of LD in the fluid could help you figure out what's wrong. When a person has bacterial meningitis, for example, LD levels in the cerebrospinal fluid are usually high. The LD test, in combination with other tests, can be used to detect whether fluid buildup around the heart, lungs, or abdominal cavity is caused by injury or inflammation or by an imbalance of fluid pressure inside blood vessels and blood protein levels. Some fluids that can be analyzed using an LD test are listed in the article on Body Fluid Analysis.

Lab tests often ordered with a Lactate Dehydrogenase test:

• Comprehensive Metabolic Panel
• Haptoglobin
• Hepatic Function Panel

Conditions where a Lactate Dehydrogenase test is recommended:

• Liver Disease
• Kidney Disease
• Lung Diseases
• Heart Disease
• Heart Attack
• Anemia
• Meningitis
• Pancreatic Diseases
• Testicular Cancer
• Ovarian Cancer
• Lymphoma
• Leukemia

How does my health care provider use a Lactate Dehydrogenase test?

A lactate dehydrogenase test is a non-specific test that can be used to diagnose a variety of diseases and disorders. When cells are injured or destroyed, LD, an enzyme found in practically all of the body's cells, is released from the cells into the fluid portion of blood. As a result, the presence of LD in the blood is a general sign of tissue and cellular damage. In the presence of certain disorders, the amount of LD may also grow in other types of body fluids.

A blood test for LD may be used:

• As a broad measure of whether or not acute or chronic tissue injury exists and how severe it is
• To diagnose and track the progression of illnesses such as anemia and severe infections.
• To aid in the staging, prognosis, and/or monitoring of cancers such as germ cell tumors, lymphoma, leukemia, melanoma, and neuroblastoma, as well as lymphoma, leukemia, melanoma, and neuroblastoma.

Body fluids are subjected to an LD test for a variety of reasons:

• To aid in the evaluation of cerebrospinal fluid and the differentiation between bacterial and viral meningitis
• To identify whether the build up of fluid is related to an injury and inflammation or to an imbalance of pressure within blood vessels and the amount of protein in the blood by evaluating other body fluids such as peritoneal, pleural, or pericardial fluid. This information is useful in determining therapy options.

Other fluids that can be tested using an LD test are included in the article on Body Fluid Analysis.

What do my lactate dehydrogenase test results mean?

LD values that are elevated usually indicate tissue damage. As cellular death begins, LD levels normally climb, peak after a period of time, and then begin to diminish. LD levels are raised in a number of situations, indicating that it has a wide tissue distribution.

Elevated LD levels may be seen with:

• Hemolytic anemia
• Pernicious anemia 
• Infectious mononucleosis
• Meningitis
• Encephalitis
• HIV
• Sepsis
• Intestinal and pulmonary infarctions
• Acute kidney disease
• Acute hepatitis
• Acute muscle damage
• Pancreatitis
• Fractures of the bones
• Malignancies of the testicles, lymphoma, or other cancers

A high level of LD in the blood may suggest that cancer treatment has failed. A high level is associated with a poorer prognosis for cancer patients. Moderately high LD blood levels may remain in several chronic and progressive diseases. LD levels that are low or normal do not usually indicate a concern. When a high amount of ascorbic acid is consumed, low levels can occur.

Fluids in the body:

• Cerebrospinal fluid—a high LD implies bacterial meningitis, whereas a low or normal amount indicates viral meningitis is more likely.
• Pericardial fluid, peritoneal fluid, or pleural fluid with a high LD is an exudate, while fluid with a low LD is a transudate. Cirrhosis or congestive heart failure are the most common causes of transudates. Exudates can have a variety of causes, and determining the cause usually necessitates additional testing.

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

Description: A Phosphate or phosphorus test is a blood test that measures the level of phosphorus in your blood’s serum to screen for conditions associated with abnormal phosphorus levels such as kidney, liver, and bone disease.

Also Known As: Inorganic Phosphate Test, P Test, Phosphate as Phosphorus Test, Phosphorus Test, Phosphate Test, PO4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Phosphate test ordered?

Because modestly elevated phosphorus levels normally do not induce symptoms, phosphorus testing is usually done after an abnormal calcium test and/or when signs of abnormal calcium, such as fatigue, muscle weakness, cramps, or bone issues, are evident.

When symptoms suggest kidney or gastrointestinal problems, phosphorus testing may be recommended in conjunction with other tests.

Testing for both phosphorus and calcium levels may be conducted at regular intervals to assess therapy effectiveness when problems causing abnormal phosphorus and/or calcium levels are discovered.

When a person develops diabetes or shows signs of an acid-base imbalance, their phosphorus levels may be monitored.

What does a Phosphate blood test check for?

Phosphorus is a mineral that forms organic and inorganic phosphate compounds when it reacts with other elements. When it comes to testing, the terms phosphorus and phosphate are frequently interchanged, but a serum phosphorus/phosphate test measures the amount of inorganic phosphate in the blood.

Energy production, muscle and neuron function, and bone formation all require phosphorus. They also serve as a buffer, assisting in the maintenance of the body's acid-base equilibrium.

Phosphorus enters the body through the food we eat. It can be found in a wide variety of meals and is quickly absorbed by the intestines. About 70-80 percent of the phosphates in the body combine with calcium to help build bones and teeth, another 10% is located in muscle, and about 1% is found in nerve tissue. The rest can be found in cells all across the body, where they are mostly employed to store energy.

In normal circumstances, only about 1% of total body phosphates are found in the blood. Phosphorus is found in a wide range of foods, including beans, peas, and almonds, cereals, dairy products, eggs, meat, poultry, and fish. The body regulates how much phosphorus/phosphate it takes from the intestines and how much it excretes through the kidneys to maintain phosphorus/phosphate levels in the blood. The combination of parathyroid hormone, calcium, and vitamin D affects phosphate levels as well.

Malnutrition, malabsorption, acid-base imbalances, hypercalcemia, and illnesses that impact kidney function can all cause phosphorus shortages. Phosphorus excesses can occur as a result of high phosphorus ingestion, hypocalcemia, or kidney disease.

Often, a person with a mild to severe phosphorus deficit has no symptoms. Muscle weakness and disorientation are common symptoms of severe phosphorus insufficiency. Muscle cramps, confusion, and even convulsions can be caused by a severe excess of phosphorus, which is comparable to the symptoms of low calcium.

Lab tests often ordered with a Phosphate test:

• Calcium
• Complete Blood Count
• Iron Total
• Iron Total and Total Iron binding capacity
• Magnesium
• Comprehensive Metabolic Panel
• Vitamin D
• Parathyroid Hormone

Conditions where a Phosphate test is recommended:

• Kidney Disease
• Diabetes
• Acidosis
• Alkalosis
• Hyperparathyroidism
• Hypoparathyroidism
• Malnutrition
• Alcoholism
• Hypothyroidism

How does my health care provider use a Phosphate test?

Phosphorus tests are frequently requested in conjunction with other tests, such as calcium, parathyroid hormone, and/or vitamin D, to aid in the diagnosis and/or monitoring of various calcium and phosphorus abnormalities.

While phosphorus tests are most typically done on blood samples, urine samples are sometimes used to evaluate phosphorus clearance by the kidneys.

What does my Phosphorus test result mean?

Hypophosphatemia can be caused by or linked to:

• Hypercalcemia 
• Diuretics overuse
• Malnutrition
• Alcoholism
• Burns that are severe
• Ketoacidosis in diabetics
• Hypothyroidism
• Hypokalemia
• Use of antacids on a regular basis
• Rickets and osteomalacia

Hyperphosphatemia can be caused by or linked to:

• Failure of the kidneys
• Hepatitis
• Hypoparathyroidism
• Ketoacidosis in diabetics
• Phosphate supplementation

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

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting required

Average Processing Time: 1 to 2 days

When is a Glucose test ordered?

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

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

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

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

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

What does a Glucose blood test check for?

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

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

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

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

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

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

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

Lab tests often ordered with a Glucose test:

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

Conditions where a Glucose test is recommended:

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

Commonly Asked Questions:

How does my health care provider use a Glucose test?

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

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

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

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

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

What does my glucose test result mean?

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

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

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

Lactate Dehydrogenase (LD) is an enzyme that is present in many different organs and tissues. LD Isoenzymes (LDI) are useful in distinguishing the different isoenzymes expressed differentially in tissues and organs, e.g., cardiac muscle, skeletal muscle, and liver.

Description: The electrolyte panel test is a blood test that measures levels of electrolytes in the blood’s serum.

Also Known As: Lytes Panel, Anion Gap Panel, Electrolyte Test, Lytes Test, Anion Gap Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Electrolyte Panel test ordered?

An electrolyte panel may be requested as part of a regular screening or as a diagnostic tool when an individual symptoms, such as:

• Accumulation of fluid
• Weakness Nausea or vomiting
• Confusion
• Heartbeat irregularity

It is usually requested as part of an examination when a person has an acute or chronic illness, as well as at regular intervals when a person has a disease or condition, or is receiving medication that can induce an electrolyte imbalance. Electrolyte tests are frequently requested at regular intervals to evaluate the therapy of disorders such as high blood pressure, heart failure, lung ailments, and liver and kidney disease.

What does an Electrolyte Panel test check for?

Electrolytes are minerals that are found as dissolved salts in bodily tissues and blood. Electrolytes help transfer nutrients into and waste out of the body's cells, maintain a healthy water balance, and control the body's acid/base level as electrically charged particles.

The electrolyte panel determines the concentrations of sodium, potassium, chloride, and bicarbonate in the blood.

Sodium, potassium, and chloride are all found in a person's diet. By reabsorption or disposal into the urine, the kidneys assist in maintaining correct levels. The lungs regulate CO2 and provide oxygen. The body produces CO2, which is balanced with bicarbonate. The total balance of these substances is a sign of how well various essential biological functions are working. They play a role in a variety of biological activities, including cardiac and skeletal muscle contraction, as well as nerve impulse conduction.

A fluid, electrolyte, or pH imbalance can be caused by any disease or condition that changes the volume of fluid in the body, such as dehydration, or affects the lungs, kidneys, metabolism, or respiration. To ensure the appropriate functioning of metabolic processes and the supply of the right quantity of oxygen to tissues, normal pH must be maintained within a limited range of 7.35-7.45 and electrolytes must be in balance.

The anion gap, which is a value calculated from the results of an electrolyte panel, is a related "test." It indicates the difference in charge between positively and negatively charged ions. Although an aberrant anion gap is non-specific, it can indicate the presence of hazardous chemicals or metabolic or respiratory problems.

Lab tests often ordered with an Electrolyte Panel test:

• Basic Metabolic Panel (BMP)
• Comprehensive Metabolic Panel (CMP)
• Creatinine
• Glucose

Conditions where an Electrolyte Panel test is recommended:

• Acidosis
• Alkalosis
• Kidney Disease
• Hypertension
• Dehydration
• Congestive Heart Failure

How does my health care provider use an Electrolyte Panel test?

An electrolyte, fluid, or pH imbalance is detected using the electrolyte panel. It's commonly ordered as part of a normal physical examination. It is available as a standalone test or as part of a basic or comprehensive metabolic panel. Other tests like as BUN, creatinine, and glucose may be included in these panels.

Electrolyte measures can be used to assess illnesses including dehydration, kidney disease, lung disease, or heart disease that induce electrolyte imbalances. Repeat testing can then be performed to track the progress of treatment for the ailment that caused the imbalance.

Because electrolyte and acid-base imbalances can occur in a wide range of acute and chronic disorders, the electrolyte panel is commonly used to assess patients in both the emergency room and the hospital.

The electrolyte panel includes tests for the following electrolytes:

• Sodium—the majority of sodium in the body is located in extracellular fluid, which is situated outside of cells and helps to regulate the quantity of water in the body.
• Potassium is an electrolyte that is mostly present inside the body's cells. The plasma, or liquid portion of the blood, contains a modest but vital amount of potassium. Potassium levels must be monitored since even modest variations might alter the heart's rhythm and ability to contract.
• Chloride—this electrolyte travels in and out of cells to assist maintain electrical neutrality, and its level is usually the same as sodium's.
• Bicarbonate—the primary function of bicarbonate, which is produced and reabsorbed by the kidneys, is to maintain a constant pH level and, secondarily, to maintain electrical neutrality.

An anion gap calculation may be included in the electrolyte panel data.

If a person has an electrolyte imbalance, such as sodium or potassium, the health practitioner may prescribe additional testing of that specific electrolyte, as well as monitoring the imbalance until it resolves. If someone has an acid-base imbalance, a health care provider may prescribe blood gas tests, which measure the pH, oxygen, and carbon dioxide levels in an arterial blood sample to assist assess the severity of the problem and track its progress.

What do my electrolyte panel test results mean?

Several disorders and diseases can induce high or low electrolyte levels. They are often influenced by the amount of food taken and absorbed by the body, the amount of water in the body, and the amount excreted by the kidneys. They are also influenced by hormones like aldosterone, which conserves sodium while promoting potassium disposal, and natriuretic peptides, which stimulate sodium excretion via the kidneys.

People with malfunctioning kidneys, for example, may retain an excessive amount of water in their bodies. This has the effect of diluting sodium and chloride, lowering their quantities below normal. People who have lost a lot of fluid, on the other hand, may have higher potassium, sodium, and chloride levels. Some diseases, such as heart disease and diabetes, can disrupt the body's fluid and electrolyte balance, resulting in abnormal electrolyte levels.

Knowing which electrolytes are out of balance can assist a health care provider in determining the underlying cause and making treatment recommendations to restore appropriate balance. An electrolyte imbalance, if left untreated, can cause dizziness, cramping, irregular heartbeat, and even death.

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

Description: A Potassium test is normally part of an electrolyte panel or Comprehensive Metabolic panel to help diagnose and monitor any electrolyte imbalances.

Also Known As: K Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Potassium test ordered?

When patients get a normal medical exam or are being assessed for a serious illness, potassium levels may be required.

When a healthcare provider is diagnosing and monitoring hypertension, diabetic ketoacidosis, and renal disease, as well as monitoring a patient on dialysis, diuretic medication, or intravenous fluids, potassium tests may be performed at regular intervals.

What does a Potassium blood test check for?

Potassium is a necessary electrolyte for cell metabolism. It assists in the delivery of nutrients into cells and the removal of waste materials from cells. It also plays a role in muscle function by assisting in the transmission of messages between neurons and muscles. This test determines how much potassium is present in the blood and/or urine.

Potassium, along with other electrolytes like sodium, chloride, and bicarbonate, aids in fluid regulation and maintains a stable acid-base balance in the body. Potassium is found in all body fluids, although it is concentrated in the cells. Only a trace amount is found in fluids outside of cells and in the blood's liquid portion.

The majority of the potassium we require comes from the foods we eat, and most people consume enough potassium. The body consumes what it needs and excretes the rest through the urine. The body works to keep the potassium level in the blood within a restricted range. Aldosterone, a hormone generated by the kidney's adrenal glands, is the key regulator.

Because potassium levels in the blood are so low, even little adjustments can have a big impact. There might be major health effects if potassium levels are either low or too high; a person may get shock, respiratory failure, or heart rhythm abnormalities. An abnormal potassium level can affect neuron and muscle function; for example, the heart muscle's capacity to contract may be impaired.

Lab tests often ordered with a Potassium test:

• Chloride
• Sodium
• Bicarbonate
• Electrolytes
• Basic Metabolic Panel (BMP)
• Comprehensive Metabolic Panel (CMP)
• Aldosterone
• Renin

Conditions where a Potassium test is recommended:

• Hypertension
• Acidosis
• Alkalosis
• Kidney Disease
• Heart Disease
• Conn Syndrome
• Addison Disease

How does my health care provider use a Potassium test?

A potassium test is used to detect irregular potassium values, such as high and low potassium. It's frequently utilized as part of a standard physical's electrolyte panel or basic metabolic panel.

Potassium is a necessary electrolyte for cell metabolism. It assists in the delivery of nutrients into cells and the removal of waste materials from cells. It also has a role in muscular function, assisting in the transmission of messages between nerves and muscles, as well as heart function.

The potassium test can be used to detect and/or monitor kidney disease, which is the most prevalent cause of elevated potassium levels in the blood. When someone has diarrhea and vomiting, excessive sweating, or a range of symptoms, it can also be utilized to check for abnormal levels. Many disorders can cause elevated potassium levels in the blood. If metabolic acidosis is suspected, or if high blood pressure or other indications of disease are present, a healthcare practitioner may order this test, along with others, to discover an electrolyte imbalance. When there are symptoms involving the heart, potassium in particular might be assessed.

The potassium test can also be used to track the effects of medicines that cause potassium loss in the kidneys, such as diuretics, or pharmaceuticals that reduce potassium clearance from the body, resulting in high potassium levels.

What do my Potassium test results mean?

Conditions that cause high potassium levels include:

• Kidney failure
• The disease Addison's
• Tissue damage Infection
• Diabetes
• Dehydration
• Too much potassium intake
• Excessive IV potassium in individuals receiving intravenous fluids
• Nonsteroidal anti-inflammatory medicines, ACE inhibitors, beta blockers, and potassium-sparing diuretics are among the pharmaceuticals that can induce excessive potassium in a tiny percentage of persons.

Low potassium levels can be detected in a variety of situations, including:

• Conn syndrome
• Diarrhea and vomiting.
• An acetaminophen overdose complication
• When someone with diabetes takes insulin, their potassium level may drop, especially if they have not properly managed their diabetes.
• Low potassium is usually caused by "water pills," and if someone is taking them, their potassium level will be checked on a regular basis by their healthcare professional.

Furthermore, medicines including corticosteroids, beta-adrenergic agonists like isoproterenol, alpha-adrenergic antagonists like clonidine, antibiotics like gentamicin and carbenicillin, and the antifungal amphotericin B can cause potassium loss.

Urine potassium concentrations must be compared to blood potassium levels. Because the body generally removes excess potassium, the concentration in the urine may be higher than the blood. When the body loses too much potassium, it can also show up in the urine; in this situation, the blood level will be normal to low. If potassium levels in the blood are low due to insufficient consumption, urine concentrations will be low as well.

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

Description: The lactic acid test measures lactate levels in the blood’s plasma.

Also Known As: Lactate Test, L-Lactate Test, Lactate Plasma Test, Lactate Blood Test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: Sample should be collected without the use of a tourniquet, avoid hand-clenching. If a tourniquet has been used, it should be released for one minute prior to drawing blood. Collected blood should be cooled on ice immediately and separated from the cells within 3 hours.

Average Processing Time: 2 to 3 days

When is a Lactic Acid test ordered?

When someone exhibits indicators and symptoms of insufficient oxygen, such as:

• breathing difficulty
• quickly breathing
• Paleness
• Sweating
• Nausea
• muscle tremor
• Continent pain
• Coma

When a patient exhibits signs and symptoms that a medical professional believes are indicative of sepsis, shock, a heart attack, severe congestive heart failure, renal failure, or uncontrolled diabetes, the test may be prescribed.

Initial orders for the lactate test may include other tests to assess a patient’s status. If lactate is noticeably raised, it might be prescribed periodically to keep an eye on the situation.

When a person exhibits meningitis symptoms such severe headaches, fever, confusion, and loss of consciousness, CSF and blood lactate levels may be ordered.

What does a Lactic Acid Plasma test check for?

One of the chemicals created by cells as the body converts food into energy is lactate. It can occasionally be found in the form of lactic acid depending on pH. The majority of it will, however, be present in the blood as lactate because of the neutral pH that the body maintains. This examination determines how much lactate is present in the blood or, less frequently, the cerebrospinal fluid.

Blood and CSF lactate concentrations are typically low. When there is insufficient oxygen at the cellular level or when the body’s cells’ principal method of generating energy is interfered with, lactate is created excessively by muscle cells, red blood cells, brain cells, and other organs. Lactic acidosis can result from too much lactate.

The mitochondria, which are microscopic power plants found inside the majority of body cells, are where the majority of energy production in cells takes place. The mitochondria convert glucose and oxygen into ATP, the body’s main energy source. Aerobic energy production is what this is.

The body must switch to less effective energy production in order to digest glucose and make ATP when cellular oxygen levels drop if the mitochondria are not operating properly. Lactic acid, which is mostly produced as a byproduct and is digested by the liver, is what is known as anaerobic energy production.

When lactic acid is produced more quickly than the liver can eliminate it, it can build up in the body and blood.

Excess lactate could be a sign of one or more of the following:

• absence of oxygen
• a syndrome that results in excessive lactate production being present
• the existence of a disease that impairs the body’s ability to remove lactate

A person is considered to have hyperlactatemia when their lactic acid production considerably rises. As more lactic acid builds up, hyperlactatemia can proceed to lactic acidosis. Although the effects of hyperlactatemia are frequently compensated for by the body, lactic acidosis can be severe enough to upset the acid/base balance of an individual and result in symptoms including muscle weakness, fast breathing, nausea, vomiting, sweating, and even coma.

High lactate levels might result from a variety of illnesses.

Lab tests often ordered with a Lactic Acid test:

• Comprehensive Metabolic Panel (CMP)
• Electrolytes
• Drug Testing

Conditions where a Lactic Acid test is recommended:

• Kidney Disease
• Liver Disease
• Congestive Heart Failure
• Heart Attack
• Acidosis and Alkalosis
• Sepsis
• Meningitis and Encephalitis

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

The main purpose of the lactate test is to identify the presence of lactic acidosis, which is characterized by elevated lactate levels that disturb the body's acid-base balance.

It can occasionally be found in the form of lactic acid depending on pH. The majority of lactic acid will, however, remain present in the blood as lactate because of the body's ability to maintain a neutral pH.

The lack of sufficient oxygen in cells and tissues is the most frequent cause of lactic acidosis. This test can be performed to help identify and assess the severity of hypoxia and lactic acidosis in people who have a condition that may result in a reduction in the amount of oxygen given to cells and tissues, such as shock or congestive heart failure. In order to assess a person's acid/base balance and oxygenation, it may be ordered along with blood gases.

This test may be performed to assess a person who has an illness that can increase lactate levels and who exhibits acidosis-related symptoms because lactic acidosis can also result from disorders unrelated to oxygen levels. To identify whether an underlying ailment, such as liver or renal disease, is the cause of lactic acidosis, it may be requested in conjunction with groups of tests, such as the comprehensive metabolic panel, basic metabolic panel, or complete blood count.

One who is suspected of having sepsis may also have an initial evaluation using the lactate test. If a person's lactate level is higher than normal, treatment will usually start right away. Sepsis patients have a much better chance of recovering if they are identified and treated right away.

When someone is being treated for a chronic condition like severe congestive heart failure or an acute condition like sepsis, shock, or heart attack, lactate levels may be requested periodically to help monitor hypoxia and response to treatment.

To help differentiate between bacterial and viral meningitis, a cerebrospinal fluid lactate test in addition to a blood lactate test may be prescribed.

What do my Lactic Acid test results mean?

A high blood lactate level indicates that a person has an illness or condition that makes lactate build up. In general, a higher rise in lactate indicates a more serious ailment. An increase in lactate can be a sign that organs are not working properly when it occurs in conjunction with low oxygen levels.

Yet having too much lactate is not a diagnostic sign. While diagnosing an underlying ailment or disease, a health professional must take into account a patient's medical history, physical exam, and the outcomes of additional diagnostic testing.

Elevated lactate levels can be caused by a variety of circumstances. Depending on how they generate lactic acidosis, they are divided into two classes.

The most prevalent type of lactic acidosis, type A, may develop from illnesses that make it difficult for a person to breathe in enough oxygen or that limit blood flow, which reduces the amount of oxygen delivered to the tissues. Type A conditions include, for example:

• trauma-related shock or severe blood loss
• Sepsis
• chest pain
• enlarged heart disease
• lung illness or respiratory failure that is severe
• buildup of fluid in the lungs
• extremely low red blood cell and/or hemoglobin levels

Type B lactic acidosis, which is caused by an excessive demand for oxygen or metabolic issues, is unrelated to oxygen delivery. Examples of causes of category B include:

• liver illness
• kidney illness
• inadequate management of diabetes
• Leukemia
• AIDS
• uncommon illnesses that cause glycogen storage
• use of specific medications, including metformin and salicylates
• exposure to poisons like methanol and cyanide

Many uncommon inherited metabolic and mitochondrial disorders, include forms of muscular dystrophy that impair healthy ATP generation

exercising vigorously, such as marathon runners

Lactate concentrations that gradually decline over time indicate a positive response to treatment when someone is receiving care for lactic acidosis or hypoxia.

Cerebrospinal fluid lactate concentrations that are much higher than normal or slightly elevated are more likely to be caused by viral meningitis in people who have the signs and symptoms of meningitis.

The lactate test gauges how much lactate is present in the blood at any given moment. The absence of lactic acidosis, the presence of adequate cellular oxygen, and/or the absence of lactic acidosis-related signs and symptoms are all indicated by a normal lactate level.

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

Collection Instructions

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

Clinical Significance

Urine chloride excretion approximates the dietary intake. The chloride content of most foods parallel that of sodium. An increase in urine chloride may result from water deficient dehydration, diabetic acidosis, Addison's disease, and salt-losing renal disease. Decreased urine levels are seen in congestive heart failure, severe diaphoresis and in hypochloremic metabolic alkalosis due to prolonged vomiting.

This test is intended for the diagnosis and monitoring of inherited disorders affecting multiple metabolic pathways. 

Organic acidurias are inherited disorders resulting from a deficient enzyme or transport protein. Although most are autosomal recessive disorders, several are X-linked. The more than 60 described organic acidurias affect many metabolic pathways including amino acid metabolism, lipid metabolism, purine and pyrimidine metabolism, the urea cycle, the Krebs cycle and fatty acid oxidation. These disorders are characterized by a wide variety of symptoms such as lethargy, coma, hypotonia, seizures, ataxia, vomiting, failure to thrive, developmental delay, liver disease, neutropenia, thrombocytopenia, osteomalacia and osteoporosis. Severity of presentation is highly variable as is age of onset, and patients may not present with the most characteristic features. Laboratory results commonly indicate metabolic acidosis, increased anion gap, hyperammonemia, hypoglycemia, lactic acidemia, ketosis, or abnormal lipid patterns. Treatment may be based on dietary restrictions and/or supplementation with cofactors (e.g., riboflavin or cobalamin) or conjugating agents (e.g., carnitine or sodium benzoate); however, there is no effective therapy for some of the disorders. 

Elevation of one or more organic acids is diagnostic for an organic aciduria; however, elevations should be interpreted in context with clinical findings and/or additional test results. See additional information for a table of selected organic acidurias and associated organic acid elevations. Since many organic acidurias are episodic, the diagnostic efficacy is maximized when the patient is expressing symptoms at the time of specimen collection. 

The test will be capable of diagnosing over 30 inherited metabolic defects, and will also allow physicians to determine dietary compliance or the effectiveness of dietary/cofactor therapy for their patients. It can also be used, alone or in conjunction with other tests, to confirm the findings of a positive expanded newborn screen.