Multiple Myeloma

Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

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

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

What does a Complete Blood Count test check for? 

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

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

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

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

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

RBCs (Red Blood Cells) 

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

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

Platelets 

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

Lab tests often ordered with a Complete Blood Count test: 

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

Conditions where a Complete Blood Count test is recommended: 

• Anemia
• Aplastic Anemia
• Iron Deficiency Anemia
• Vitamin B12 and Folate Deficiency
• Sickle Cell Anemia
• Heart Disease
• Thalassemia
• Leukemia
• Autoimmune Disorders
• Cancer
• Bleeding Disorders
• Inflammation
• Epstein-Barr Virus
• Mononucleosis

Commonly Asked Questions: 

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

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

What do my Complete Blood Count results mean? 

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

What do my Differential results mean? 

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

What do my Platelet results mean? 

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

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

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

Reflex Parameters for Manual Slide Review

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: A Complete Blood Count or CBC (H/H, RBC, Indices, WBC, Plt) test is a blood test that measures many important features of your blood and counts your red blood cells, white blood cells, and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen.

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

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a CBC test ordered?

The complete blood count is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary.

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding.

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working.

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis.

What does a CBC blood test check for?

The complete blood count is a blood test that determines the number of cells in circulation. White blood cells, red blood cells, and platelets 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. The following items are included in a conventional CBC:

• White blood cell count.
• RBC count, hemoglobin, hematocrit, and RBC indicators such as mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width are all used to assess red blood cells. The reticulocyte count may or may not be included in the RBC evaluation.
• Platelet count; may or may not include mean platelet volume and platelet distribution width in platelet evaluation

The CBC focuses on three different types of cells:

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. 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 in order to combat bacterial infection. The amount of white blood cells in the body may increase as a result of allergies. A viral infection may cause an increase in white blood cell production. Abnormal white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count.

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, 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. 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 CBC 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 CBC test is recommended:

• Anemia
• Aplastic Anemia
• Iron Deficiency Anemia
• Vitamin B12 and Folate Deficiency
• Sickle Cell Anemia
• Heart Disease
• Thalassemia
• Leukemia
• Autoimmune Disorders
• Cancer
• Bleeding Disorders
• Inflammation
• Epstein-Barr Virus
• Mononucleosis

Commonly Asked Questions:

How does my health care provider use a CBC test?

The complete blood count is a common, comprehensive screening test used to measure a person's overall health status. It can be used for a variety of purposes, including:

• To check for a variety of ailments and disorders.
• Assist in the diagnosis of a variety of illnesses, including anemia, infection, inflammation, bleeding disorders, and leukemia, to mention a few.
• After a diagnosis has been made, keep an eye on the patient's condition and/or the treatment's effectiveness.
• Treatments that are known to influence blood cells, such as chemotherapy or radiation therapy, should be monitored.

A complete blood count is a set of tests that assesses the three types of cells that circulate in the bloodstream. The following items are included in a CBC:

White blood cells, which are part of the body's defensive system against infections and cancer, as well as playing a role in allergies and inflammation, are assessed:

• The total number of white blood cells in a person's blood sample is measured by a white blood cell count.

Red blood cells, which transport oxygen throughout the body, are assessed as follows:

• The quantity of red blood cells in a person's blood sample is measured by a red blood cell count.
• The overall amount of oxygen-carrying protein in the blood is measured by hemoglobin, which generally indicates the number of red blood cells in the blood.
• Hematocrit is a measurement of how many red blood cells make up a person's total blood volume.
• RBC indices are calculations that give information about the physical features of RBCs:
• The average size of a single red blood cell is measured by the mean corpuscular volume.
• The average quantity of hemoglobin inside a single red blood cell is calculated as mean corpuscular hemoglobin.
• The average concentration of hemoglobin inside a single red blood cell is calculated as mean corpuscular hemoglobin concentration.
• The red cell distribution width is a measurement of RBC size variation.

The reticulocyte count, which is a measurement of the absolute count or percentage of immature red blood cells in the blood, may also be included in the CBC.

Platelets, which are cell fragments that are critical for proper blood coagulation, are assessed as follows:

• The number of platelets in a person's blood sample is known as the platelet count.

With a CBC, the mean platelet volume can be reported. It's a calculation of platelet size on average.

A CBC can also reveal the platelet distribution width. It reflects the size uniformity of platelets.

Can a blood transfusion affect my CBC results?

Yes, a recent blood transfusion will have an effect on your CBC test results.

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 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.

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

NOTE: Only measurable biomarkers will be reported.

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

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.

Immunoglobulin A (IgA)

Protein Electrophoresis, Random Urine (UPEP)

Includes

Total Protein, Protein Electrophoresis, Creatinine

Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

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

Collection Method: 

Blood Draw 

Specimen Type: 

Serum 

Test Preparation: 

9-12 hours fasting is preferred. 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

What does a Comprehensive Metabolic Panel blood test check for? 

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

The following tests are included in the CMP: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

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

Conditions where a Comprehensive Metabolic Panel test is recommended: 

• Diabetes
• Kidney Disease
• Liver Disease
• Hypertension

Commonly Asked Questions: 

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

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

What do my Comprehensive Metabolic Panel test results mean? 

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

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

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

Is there anything else I should know? 

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

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

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

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

Please note the following regarding BUN/Creatinine ratio: 

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

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

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

Description: A Calcium test is a blood test that is used to screen for, diagnose, and monitor a wide range of medical conditions.

Also Known As: Ca Test, Serum Calcium Test, Calcium Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Calcium test ordered?

A blood calcium test is frequently requested during a general medical evaluation. It's usually part of the comprehensive metabolic panel or the basic metabolic panel, two sets of tests that can be done during an initial evaluation or as part of a routine medical checks.

Many people do not experience symptoms of high or low calcium until their levels are dangerously high or low.

When a person has certain types of cancer, kidney illness, or has had a kidney transplant, calcium monitoring may be required. When someone is being treated for abnormal calcium levels, monitoring may be required to determine the effectiveness of medications such as calcium or vitamin D supplements.

What does a Calcium blood test check for?

Calcium is one of the most plentiful and vital minerals in the human body. It is required for cell signaling as well as the proper operation of muscles, nerves, and the heart. Calcium is essential for blood clotting as well as bone growth, density, and maintenance. This test determines how much calcium is present in the blood.

Calcium is found complexed in the bones for 99 percent of the time, while the remaining 1% circulates in the blood. Calcium levels are closely monitored; if too little is absorbed or consumed, or if too much is lost through the kidney or stomach, calcium is removed from bone to keep blood concentrations stable. Approximately half of the calcium in the blood is metabolically active and "free." The other half is "bound" to albumin, with a minor proportion complexed to anions like phosphate, and both of these forms are metabolically inactive.

Blood calcium can be measured using two different tests. The free and bound forms of calcium are measured in the total calcium test. Only the free, physiologically active form of calcium is measured in the ionized calcium test.

Lab tests often ordered with a Calcium test:

• Phosphorus
• Vitamin D
• Magnesium
• PTH
• Albumin
• Basic Metabolic Panel (BMP)
• Comprehensive Metabolic Panel (CMP)

Conditions where a Calcium test is recommended:

• Kidney Disease
• Thyroid Disease
• Alcoholism
• Malnutrition
• Parathyroid Diseases
• Breast Cancer
• Multiple Myeloma

How does my health care provider use a Calcium test?

A blood calcium test is used to screen for, diagnose, and monitor a variety of bone, heart, nerve, kidney, and tooth disorders. If a person has signs of a parathyroid disease, malabsorption, or an overactive thyroid, the test may be ordered.

A total calcium level is frequently checked as part of a standard health check. It's part of the comprehensive metabolic panel and the basic metabolic panel, which are both collections of tests used to diagnose or monitor a range of ailments.

When a total calcium result is abnormal, it is interpreted as a sign of an underlying disease. Additional tests to assess ionized calcium, urine calcium, phosphorus, magnesium, vitamin D, parathyroid hormone, and PTH-related peptide are frequently performed to assist determine the underlying problem. PTH and vitamin D are in charge of keeping calcium levels in the blood within a narrow range of values.

Measuring calcium and PTH combined can assist identify whether the parathyroid glands are functioning normally if the calcium is abnormal. Testing for vitamin D, phosphorus, and/or magnesium can assist evaluate whether the kidneys are excreting the right amount of calcium, and measuring urine calcium can help detect whether additional deficits or excesses exist. The balance of these many compounds is frequently just as critical as their concentrations.

The total calcium test is the most common test used to determine calcium status. Because the balance between free and bound calcium is usually constant and predictable, it is a reliable reflection of the quantity of free calcium present in the blood in most cases. However, the balance between bound and free calcium is altered in some persons, and total calcium is not a good indicator of calcium status. Ionized calcium measurement may be required in certain cases. Critically sick patients, those receiving blood transfusions or intravenous fluids, patients undergoing major surgery, and persons with blood protein disorders such low albumin are all candidates for ionized calcium testing.

What do my Calcium test results mean?

The amount of calcium circulating in the blood is not the same as the amount of calcium in the bones.

A feedback loop including PTH and vitamin D regulates and stabilizes calcium uptake, utilization, and excretion. Conditions and disorders that disturb calcium control can induce abnormal acute or chronic calcium elevations or declines, resulting in hypercalcemia or hypocalcemia symptoms.

Total calcium is usually tested instead of ionized calcium since it is easier to do and requires no additional treatment of the blood sample. Because the free and bound forms of calcium make up about half of the total, total calcium is usually a decent depiction of free calcium. Because nearly half of the calcium in blood is bonded to protein, high or low protein levels might alter total calcium test findings. In these circumstances, an ionized calcium test is more appropriate for measuring free calcium.

A normal total or ionized calcium test, when combined with other normal laboratory findings, indicates that a person's calcium metabolism is normal and blood levels are properly managed.

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

Clinical Significance
Micronutrient, Calcium - Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low level of calcium may result in tetany.

Patients must be 18 years of age or greater.

Reference Range(s) (mg/dL)
                        Male                  Female
18-19 years     8.9-10.4    8.9-10.4
20-49 years     8.6-10.3    8.6-10.2
>49 years        8.6-10.3    8.6-10.4
Reference range not available for individuals <18 years for this micronutrient test.

Clinical Significance
Micronutrients, Heavy Metals Panel, Blood

Patients must be 18 years of age or greater.

Includes

• Micronutrient, Arsenic, Blood
• Micronutrient, Cadmium, Blood
• Micronutrient, Cobalt, Blood
• Micronutrient, Lead, Blood
• Micronutrient, Mercury, Blood

Protein electrophoresis is a test that measures specific proteins in the blood. The test separates proteins in the blood based on their electrical charge. The protein electrophoresis test is often used to find abnormal substances called M proteins.

Lab will change code to Protein Electrophoresis, Serum #747

This is a client specific reflex test. Reflex criteria has been pre-defined by the ordering physician. Additional testing will be performed at an additional charge.

The reflex test is 

Urinary total proteins are negligible in health individuals. Concentrations are increased in patients with a wide variety of disease that impair renal function including diabetes, hypertension, Nephritic Syndrome, and drug nephrotoxicity.