Inflammatory Bowel Syndrome (IBS)

IBS Lab Tests and health information

Looking for a better way to detect, diagnose, and monitor IBS?

If you've been struggling with IBS for a while and haven't found relief, it's time to get tested.

Ulta Lab Tests offers the latest laboratory testing technology from Quest Diagnostics to help you get the most accurate diagnosis possible. While there is no one-size-fits-all answer to IBS, laboratory tests can help identify the underlying cause of your symptoms and help guide treatment planning.

You can order tests to help you identify any underlying conditions that may be causing your symptoms and monitor your disease progression over time. This allows you to develop an individualized treatment plan specifically for you.

You can start feeling better sooner rather than later with an accurate diagnosis. Laboratory tests provide precise information that can lead to an effective treatment plan tailored just for you.

Benefits of lab tests to detect, diagnose and monitor IBS.

Laboratory tests have several benefits for detecting, diagnosing, and monitoring irritable bowel syndrome (IBS). Some of the key benefits are:

  • Improved accuracy of diagnosis: Laboratory tests can help to confirm the diagnosis of IBS by ruling out other possible causes of the symptoms, such as inflammatory bowel disease (IBD) or celiac disease.
  • Identification of underlying conditions: In some cases, lab tests can help to identify underlying conditions that may be contributing to the symptoms of IBS, such as an infection, food intolerance, or small intestinal bacterial overgrowth.
  • Monitoring disease progression: Laboratory tests can be used to monitor the progression of IBS and the effectiveness of treatment, such as measuring changes in gut inflammation and the gut microbiome.
  • Improved treatment planning: Laboratory tests can provide valuable information for developing an individualized treatment plan for IBS, including dietary recommendations and the selection of appropriate medications.
  • Increased patient understanding: Lab tests can help to educate patients about their condition and the potential causes of their symptoms, empowering them to take a more active role in their care.

Learn more about the benefits of lab tests for IBS by checking out the tests and articles below for IBS.


Name Matches

IMPORTANT – This panel contains Culture, Urine, Routine #395 which can Reflex to additional testing and charges, detailed below, if Culture is positive.

If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge.  Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149).

Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

  • ORG ID 1. $ 12.45 
  • ORG ID 2. $ 23.95 
  • PRESUMPTIVE ID 1. $ 12.45 
  • PRESUMPTIVE ID 2. $ 23.95 
  • SUSC-1  $14.95 
  • SUSC-2  $28.95

The Key Blood Tests for IBS Diagnosis (And How to Monitor It)

  • C-Reactive Protein (CRP) [ 4420 ]
  • CBC (includes Differential and Platelets) [ 6399 ]
  • Comprehensive Metabolic Panel (CMP) [ 10231 ]
  • Culture, Blood [ 389 ]
  • Culture, Urine, Routine [ 395 ]
  • Endomysial Antibody Scr (Iga) W/Refl To Titer [ 15064 ]
  • Fecal Globin by Immunochemistry (InSure®) [ 11290 ]
  • Ferritin [ 457 ]
  • Gliadin (Deamidated Peptide) Antibody (IgA) [ 11228 ]
  • Immunoglobulin A [ 539 ]
  • Iron and Total Iron Binding Capacity (TIBC) [ 7573 ]
  • Prothrombin with INR and Partial Thromboplastin Times [ 4914 ]
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS [ 92888 ]
  • Reticulin IgG Screen with Reflex to Titer [ 16530 ]
  • Sed Rate by Modified Westergren (ESR) [ 809 ]
  • Tissue Transglutaminase (tTG) Antibody (IgA) [ 8821 ]
  • Urea Breath Test, Infrared (Ubit) [ 14839 ]
  • Vitamin B12 (Cobalamin) and Folate Panel, Serum [ 7065 ]
     

The Key Blood Tests for IBS Diagnosis (And How to Monitor It)

  • C-Reactive Protein (CRP) [ 4420 ]
  • CBC (includes Differential and Platelets) [ 6399 ]
  • Comprehensive Metabolic Panel (CMP) [ 10231 ]
  • Ferritin [ 457 ]
  • Immunoglobulin A [ 539 ]
  • Iron and Total Iron Binding Capacity (TIBC) [ 7573 ]
  • Tissue Transglutaminase (tTG) Antibody (IgA) [ 8821 ]

The Key Blood Tests for IBS Diagnosis (And How to Monitor It)

  • C-Reactive Protein (CRP) [ 4420 ]
  • CBC (includes Differential and Platelets) [ 6399 ]
  • Comprehensive Metabolic Panel (CMP) [ 10231 ]
  • Fecal Globin by Immunochemistry (InSure®) [ 11290 ]
  • Ferritin [ 457 ]
  • Immunoglobulin A [ 539 ]
  • Iron and Total Iron Binding Capacity (TIBC) [ 7573 ]
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS [ 92888 ]
  • Tissue Transglutaminase (tTG) Antibody (IgA) [ 8821 ]
  • Vitamin B12 (Cobalamin) and Folate Panel, Serum [ 7065 ]
     

The Key Blood Tests for IBS Diagnosis (And How to Monitor It)

  • C-Reactive Protein (CRP) [ 4420 ]
  • CBC (includes Differential and Platelets) [ 6399 ]
  • Comprehensive Metabolic Panel (CMP) [ 10231 ]
  • Fecal Globin by Immunochemistry (InSure®) [ 11290 ]
  • Ferritin [ 457 ]
  • Gliadin (Deamidated Peptide) Antibody (IgA) [ 11228 ]
  • Immunoglobulin A [ 539 ]
  • Iron and Total Iron Binding Capacity (TIBC) [ 7573 ]
  • Prothrombin with INR and Partial Thromboplastin Times [ 4914 ]
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS [ 92888 ]
  • Tissue Transglutaminase (tTG) Antibody (IgA) [ 8821 ]
  • Vitamin B12 (Cobalamin) and Folate Panel, Serum [ 7065 ]
     

IMPORTANT – This panel contains Culture, Urine, Routine #395 which can Reflex to additional testing and charges, detailed below, if Culture is positive.

If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge.  Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149).

Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

  • ORG ID 1. $ 12.45 
  • ORG ID 2. $ 23.95 
  • PRESUMPTIVE ID 1. $ 12.45 
  • PRESUMPTIVE ID 2. $ 23.95 
  • SUSC-1  $14.95 
  • SUSC-2  $28.95

The Key Blood Tests for IBS Diagnosis (And How to Monitor It)

  • C-Reactive Protein (CRP) [ 4420 ]
  • CBC (includes Differential and Platelets) [ 6399 ]
  • Comprehensive Metabolic Panel (CMP) [ 10231 ]
  • Culture, Blood [ 389 ]
  • Culture, Urine, Routine [ 395 ]
  • Fecal Globin by Immunochemistry (InSure®) [ 11290 ]
  • Ferritin [ 457 ]
  • Gliadin (Deamidated Peptide) Antibody (IgA) [ 11228 ]
  • Immunoglobulin A [ 539 ]
  • Iron and Total Iron Binding Capacity (TIBC) [ 7573 ]
  • Prothrombin with INR and Partial Thromboplastin Times [ 4914 ]
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS [ 92888 ]
  • Reticulin IgG Screen with Reflex to Titer [ 16530 ]
  • Tissue Transglutaminase (tTG) Antibody (IgA) [ 8821 ]
  • Urea Breath Test, Infrared (Ubit) [ 14839 ]
  • Vitamin B12 (Cobalamin) and Folate Panel, Serum [ 7065 ]
     

Description: The CRP test is used to identify and/or monitor inflammation in patients.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a C-Reactive Protein test ordered?

When a person's medical history and signs and symptoms indicate that they may have a significant bacterial infection, a CRP test may be recommended. When a newborn displays signs of infection or when a person has sepsis symptoms including fever, chills, and rapid breathing and heart rate, it may be ordered.

It's also commonly requested on a regular basis to check illnesses like rheumatoid arthritis and lupus, and it's routinely repeated to see if medication is working. This is especially effective for inflammation issues because CRP levels decrease as inflammation decreases.

What does a C-Reactive Protein blood test check for?

C-reactive protein is a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. After trauma or a heart attack, with active or uncontrolled autoimmune illnesses, and with acute bacterial infections like sepsis, markedly higher levels are reported. CRP levels can rise by a thousand-fold in response to inflammatory diseases, and their elevation in the blood can occur before pain, fever, or other clinical signs. The test detects inflammation caused by acute situations or monitors disease activity in chronic diseases by measuring the level of CRP in the blood.

The CRP test is not a diagnostic tool, although it can tell a doctor if inflammation is occurring. This information can be combined with other indicators like signs and symptoms, a physical exam, and other tests to establish whether someone has an acute inflammatory disorder or is having a flare-up of a chronic inflammatory disease. The health care provider may next do additional tests and treatment.

This CRP test should not be confused with the hs-CRP test. These are two separate CRP tests, each of which measures a different range of CRP levels in the blood for different purposes.

Lab tests often ordered with a C-Reactive Protein test:

  • Sed Rate (ESR)
  • Procalcitonin
  • ANA
  • Rheumatoid Factor
  • Complement

Conditions where a C-Reactive Protein test is recommended:

  • Arthritis
  • Autoimmune Disorders
  • Pelvic Inflammatory Disease
  • Inflammatory Bowel Disease
  • Sepsis
  • Vasculitis
  • Systemic Lupus Erythematosus
  • Meningitis and Encephalitis

Commonly Asked Questions:

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

A health practitioner uses the C-reactive protein test to diagnose inflammation. CRP is an acute phase reactant, a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. The CRP test is not a diagnostic test for any ailment, but it can be used in conjunction with other tests to determine whether a person has an acute or chronic inflammatory disorder.

CRP, for example, can be used to detect or track substantial inflammation in someone who is suspected of having an acute ailment like:

  • Sepsis is a dangerous bacterial infection.
  • An infection caused by a fungus
  • Inflammation of the pelvis

People with chronic inflammatory diseases can use the CRP test to detect flare-ups and/or see if their medication is working. Here are a few examples:

  • Inflammatory bowel disease
  • Arthritis, which can take many forms.
  • Autoimmune disorders, examples include lupus and vasculitis

CRP is occasionally requested in conjunction with an erythrocyte sedimentation rate, another inflammatory test. While the CRP test is not specific enough to diagnose an illness, it does serve as a broad marker for infection and inflammation, alerting doctors to the need for more testing and treatment. A variety of additional tests may be used to determine the source of inflammation, depending on the probable cause.

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

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

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

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

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

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

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


Description: Sed Rate is a blood test that is used to measure the rate that red blood cells fall to the bottom of a test tube. The measurement is based how many cells fall within one hour. This test can be used to determine infection or inflammation.

Also Known As: Erythrocyte Sedimentation Rate Test, ESR Test, Sed Rate Test, Sedimentation Rate Test, Westergren Sedimentation Rate Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Sed Rate test ordered?

When a condition or disease is believed to be causing inflammation in the body, an ESR may be ordered. Several inflammatory illnesses can be identified using this test. It may be requested, for example, if arthritis is suspected of producing joint inflammation and pain, or if inflammatory bowel disease is suspected of causing digestive symptoms.

When a person develops symptoms of polymyalgia rheumatica, systemic vasculitis, or temporal arteritis, such as headaches, neck or shoulder discomfort, anemia, pelvic pain, poor appetite, joint stiffness, and unexplained weight loss, a doctor may recommend an ESR. To follow the development of specific illnesses, the sed rate test can also be routinely ordered.

A health practitioner may wish to repeat the ESR before undertaking a full workup to look for disease.

What does a Sed Rate blood test check for?

The erythrocyte sedimentation rate is a test that evaluates the degree of inflammation in the body indirectly. The test evaluates the rate at which erythrocytes fall in a blood sample that has been placed in a tall, thin, vertical tube. The millimeters of clear fluid present at the upper portion of the tube after one hour are reported as the results.

When a drop of blood is inserted in a tube, the red blood cells settle out slowly, leaving just a small amount of transparent plasma. In the presence of an increased number of proteins, particularly proteins known as acute phase reactants, red cells settle at a faster pace. Inflammation raises the levels of acute phase reactants such as C-reactive protein and fibrinogen in the blood.

An inherent component of the immune system's response is inflammation. It could be chronic, showing symptoms over time with conditions like autoimmune illnesses or cancer, or acute, showing symptoms right away after a shock, injury, or infection.

The ESR is a non-specific indication that can rise in a number of disorders; it is not a diagnostic test. It provides you with a fundamental understanding of whether you have an inflammatory condition or not.

Given the availability of more recent, specialized tests, there have been reservations about the ESR's utility. The ESR test, on the other hand, is commonly used to diagnose and monitor temporal arteritis, systemic vasculitis, and polymyalgia rheumatica. Extremely high ESR values can aid in differentiating between rheumatic diseases. Furthermore, ESR may still be a viable alternative in some cases, such as when newer tests are unavailable in resource-constrained places or while monitoring the progression of a disease.

Lab tests often ordered with a Sed Rate test:

  • C-Reactive Protein
  • ANA
  • Rheumatoid Factor

Conditions where a Sed Rate test is recommended:

  • Vasculitis
  • Autoimmune Disorders
  • Rheumatoid Arthritis
  • Osteoarthritis
  • Celiac Disease
  • Lupus
  • Chronic Fatigue Syndrome
  • Juvenile Rheumatoid Arthritis
  • Inflammatory Bowel Disease

How does my health care provider use a Sed Rate test?

The erythrocyte sedimentation rate is a non-specific, very straightforward test that has been used for many years to detect inflammation associated with infections, malignancies, and autoimmune illnesses.

Because an elevated ESR often indicates the presence of inflammation, but does not tell the health practitioner where the inflammation is in the body or what is causing it, it is referred to as a non-specific test. Other illnesses besides inflammation may have an impact on an ESR. As a result, other tests, such C-reactive protein, are routinely paired with the ESR.

ESR is used to identify temporal arteritis, systemic vasculitis, and polymyalgia rheumatica, among other inflammatory illnesses. A notably elevated ESR is one of the crucial test results used to support the diagnosis.

This test can be used to track disease activity and treatment response in both of the disorders mentioned above, as well as several others including systemic lupus erythematosus.

What do my Sed Rate test results mean?

Because ESR is a non-specific inflammatory measure that is influenced by a variety of circumstances, it must be used in conjunction with other clinical findings, the individual's medical history, and the results of other laboratory tests. The health practitioner may be able to confirm or rule out a suspected illness if the ESR and clinical data match.

Without any signs of a specific condition, a single elevated ESR is usually insufficient to make a medical conclusion. A normal result does not, however, rule out inflammation or illness.

Inflammation, as well as anemia, infection, pregnancy, and aging, can cause a moderately raised ESR.

A severe infection with a rise in globulins, polymyalgia rheumatica, or temporal arteritis are common causes of an extremely high ESR. Depending on the person's symptoms, a health practitioner may employ various follow-up tests, such as blood cultures. Even if there is no inflammation, people with multiple myeloma or Waldenstrom's macroglobulinemia have extraordinarily high ESRs.

Rising ESRs may suggest increased inflammation or a poor response to therapy when monitoring a condition over time; normal or falling ESRs may indicate an adequate response to treatment.

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


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

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

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

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

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

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

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

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. 


Brief Description: A Vitamin D test is a blood test used to determine if you have a Vitamin D deficiency and to monitor Vitamin D levels if you are on supplementation.

Also Known As: Ergocalciferol Test, Vitamin D2 Test, Cholecalciferol Test, Vitamin D3 Test, Calcidiol Test, 25-hydroxyvitamin D Test, Calcifidiol Test, 25-hydroxy-vitamin D Test, Vitamin D Total Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required.

When is a Vitamin D test ordered?

When calcium levels are inadequate and/or a person exhibits symptoms of vitamin D deficiency, such as rickets in children and bone weakening, softness, or fracture in adults, 25-hydroxyvitamin D is frequently ordered to rule out a vitamin D deficit.

When a person is suspected of having a vitamin D deficiency, the test may be requested. Vitamin D deficiency is more common in older folks, people who are institutionalized or homebound and/or have minimal sun exposure, people who are obese, have had gastric bypass surgery, and/or have fat malabsorption. People with darker skin and breastfed babies are also included in this category.

Before starting osteoporosis medication, 25-hydroxyvitamin D is frequently requested.

What does a Vitamin D blood test check for?

Vitamin D is a group of chemicals that are necessary for the healthy development and growth of teeth and bones. The level of vitamin D in the blood is determined by this test.

Vitamin D is tested in the blood in two forms: 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. The primary form of vitamin D found in the blood is 25-hydroxyvitamin D, which is a relatively inactive precursor to the active hormone 1,25-dihydroxyvitamin D. 25-hydroxyvitamin D is routinely evaluated to assess and monitor vitamin D status in humans due to its longer half-life and higher concentration.

Endogenous vitamin D is created in the skin when exposed to sunshine, whereas exogenous vitamin D is taken through foods and supplements. Vitamin D2 and vitamin D3 have somewhat different molecular structures. Fortified foods, as well as most vitamin preparations and supplements, include the D2 form. The type of vitamin D3 produced by the body is also used in some supplements. When the liver and kidneys convert vitamin D2 and D3 into the active form, 1,25-dihydroxyvitamin D, they are equally effective.

Some tests may not differentiate between the D2 and D3 forms of vitamin D and just report the total result. Newer methods, on the other hand, may record D2 and D3 levels separately and then sum them up to get a total level.

Vitamin D's major function is to assist balance calcium, phosphorus, and magnesium levels in the blood. Vitamin D is necessary for bone growth and health; without it, bones become fragile, misshapen, and unable to mend themselves properly, leading to disorders such as rickets in children and osteomalacia in adults. Vitamin D has also been proven to influence the growth and differentiation of a variety of other tissues, as well as to aid in immune system regulation. Other illnesses, such as autoimmune and cancer, have been linked to vitamin D's other roles.

According to the Centers for Disease Control and Prevention, two-thirds of the US population has adequate vitamin D, while one-quarter is at risk of inadequate vitamin D and 8% is at risk of insufficiency, as defined by the Institute of Medicine's Dietary Reference Intake.

The elderly or obese, persons who don't receive enough sun exposure, people with darker skin, and people who take certain drugs for lengthy periods of time are all at risk of insufficiency. Adequate sun exposure is usually defined as two intervals of 5-20 minutes each week. Vitamin D can be obtained through dietary sources or supplements by people who do not get enough sun exposure.

This test has 3 Biomarkers

  • Vitamin D Total which is a combined measurement of Vitamin D, 25-Oh, D2 and Vitamin 25-Oh, D3
  • Vitamin D, 25-Oh, D2 which is a measurement of ergocalciferol Vitamin D, which is Vitamin D obtained through plant sources. 
  • Vitamin D, 25-Oh, D3 which is a measurement of cholecalciferol Vitamin D, which is Vitamin D obtained through animal sources.

Lab tests often ordered with a Vitamin D test:

  • Complete Blood Count
  • CMP
  • Iron and TIBC
  • Calcium
  • Phosphorus
  • PTH
  • Magnesium

Conditions where a Vitamin D test is recommended:

  • Kidney Disease
  • Osteoporosis
  • Lymphoma
  • Cystic Fibrosis
  • Autoimmune Disorders
  • Celiac Disease
  • Malabsorption
  • Malnutrition

Commonly Asked Questions:

How does my health care provider use a Vitamin D test?

Determine whether a deficit or excess of vitamin D is causing bone weakening, deformity, or improper calcium metabolism.

Because PTH is required for vitamin D activation, it can aid in diagnosing or monitoring problems with parathyroid gland function.

Because vitamin D is a fat-soluble vitamin that is absorbed from the intestine like a fat, it can help monitor the health of people with conditions that interfere with fat absorption, such as cystic fibrosis and Crohn's disease.

People who have had gastric bypass surgery and may not be able to absorb adequate vitamin D should be closely monitored.

When vitamin D, calcium, phosphorus, and/or magnesium supplementation is suggested, it can help assess the success of the treatment.

What do my Vitamin D results result mean?

Despite the fact that vitamin D techniques differ, most laboratories use the same reference intervals. Because toxicity is uncommon, researchers have focused on the lower limit and what cut-off for total 25-hydroxyvitamin D shortage implies.

A low blood level of 25-hydroxyvitamin D could indicate that a person isn't getting enough sunlight or dietary vitamin D to meet his or her body's needs, or that there's an issue with absorption from the intestines. Seizure medications, notably phenytoin, might occasionally interfere with the liver's generation of 25-hydroxyvitamin D.

Vitamin D insufficiency has been linked to an increased risk of some malignancies, immunological illnesses, and cardiovascular disease.

Excessive supplementation with vitamin pills or other nutritional supplements frequently results in a high level of 25-hydroxyvitamin D.

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


Description: A B12 and Folate test measures the levels of B12 and folic acid in the blood. These results can be used to determine a B12 and/or folate deficiency and evaluate a person's nutritional status. Anemia and Neuropathy can also be evaluated using the results from this test.

Also Known As: Vitamin B12 and Folate test, Cobalamin and Folic Acid Test, Vitamin B12 and Vitamin B9 Test, Vitamin B12 Test, Vitamin B9 Test, Cobalamin Test, Folic Acid Test, Folate Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is Vitamin B12 and Folate panel test ordered?

When a complete blood count and/or blood smear, performed as part of a health checkup or anemia evaluation, reveal a low red blood cell count with the presence of big RBCs, B12 and folate levels may be ordered. A high mean corpuscular volume, in particular, implies that the RBCs are enlarged.

When a person exhibits the following signs and symptoms of a deficit, testing for B12 and folate levels may be necessary.

  • Diarrhea
  • Dizziness
  • Muscle weakness, fatigue
  • Appetite loss.
  • Skin that is pale
  • Irregular heartbeats, rapid heart rate
  • Breathing problems
  • Tongue and mouth ache
  • In the feet, hands, arms, and legs, there is tingling, numbness, and/or burning 
  • Confusion or obliviousness
  • Paranoia

When a person is at risk of deficiency, such as those with a history of malnutrition or a condition associated to malabsorption, B12 and folate testing may be ordered.

Individuals being treated for malnutrition or a B12 or folate deficit may have these tests done on a frequent basis to see how effective their treatments are. This could be part of a long-term therapy plan for people who have a disease that causes chronic deficiency.

What does a Vitamin B12 and Folate panel blood test check for?

The B complex of vitamins includes vitamins including vitamin B12 and folate. They are required for the creation of normal red blood cells, tissue and cell repair, and the synthesis of DNA, the genetic material in cells. Both are nutrients that the body cannot make and must be obtained from the diet.

Vitamin B12 and folate tests diagnose vitamin deficiencies by measuring vitamin levels in the liquid section of the blood. The amount of folate in red blood cells is sometimes tested as well.

Folate is a naturally occurring form of the vitamin, whereas folic acid is a supplement that can be added to foods and beverages. Leafy green vegetables, dry beans and peas, citrus fruits, yeast, and liver all contain it. Vitamin B12, also known as cobalamin, can be found in animal-based foods such red meat, fish, poultry, milk, yogurt, and eggs. Fortified cereals, breads, and other grain products have become key sources of B12 and folate in recent years.

A lack of B12 or folate can cause macrocytic anemia, a condition in which red blood cells are bigger than normal. Megaloblastic anemia is a kind of macrocytic anemia marked by the generation of fewer but larger RBCs known as macrocytes, as well as cellular abnormalities in the bone marrow. Reduced white blood cell and platelet counts are two more test results linked to megaloblastic anemia.

B12 is also necessary for nerve function, and a lack of it can induce neuropathy, which causes tingling and numbness in the hands and feet of those who are affected.

Folate is required for cell division, which occurs in the developing fetus. In a growing fetus, a lack of folate during early pregnancy can raise the chance of neural tube abnormalities such spina bifida.

B12 and folate deficiency is most commonly caused by not getting enough of the vitamins through diet or supplements, poor absorption, or increased requirement, as observed during pregnancy:

  • Dietary deficiencies are uncommon in the United States since many meals and beverages are fortified with vitamins that the body stores. Adults normally have many years' worth of vitamin B12 and around three months' worth of folate stored in their liver. Dietary deficiencies normally do not manifest symptoms until the body's vitamin supplies have been exhausted. Vegans and their breast-fed infants can suffer from B12 deficiency.
  • Inadequate absorption—the absorption of vitamin B12 is a multi-step process. B12 is normally released from food by stomach acid and then bound to intrinsic factor, a protein produced by parietal cells in the stomach, in the small intestine. After being absorbed by the small intestine and bound by carrier proteins, the B12-IF complex reaches the blood. B12 absorption is hampered if any of these processes are disrupted by a disease or condition.
  • Increased demand—this can occur as a result of a range of diseases and disorders. When a woman is pregnant or nursing, in early childhood, with malignancies, or with chronic hemolytic anemias, there is an increased demand for folate.

Lab tests often ordered with a Vitamin B12 and Folate panel test:

  • Complete Blood Count
  • Methylmalonic Acid
  • Homocysteine
  • Vitamin B1
  • Vitamin B3
  • Vitamin B5
  • Vitamin B6
  • Vitamin B7
  • Intrinsic Factor Antibody
  • Parietal Cell Antibody
  • Reticulocyte Count

Conditions where a Vitamin B12 and Folate panel test is recommended:

  • Neural Tube Defects
  • Vitamin B12 and Folate Deficiencies
  • Anemia
  • Alcoholism
  • Malnutrition
  • Celiac Disease
  • Malabsorption
  • Neuropathy
  • Inflammatory Bowel Disease

How does my health care provider use a Vitamin B12 and Folate panel test?

Separate tests for vitamin B12 and folate are frequently used in conjunction to detect deficiencies and to aid in the diagnosis of anemias such as pernicious anemia, an inflammatory condition that inhibits B12 absorption.

B12 and folate are two vitamins that the body cannot generate and must be obtained from the diet. They're needed for red blood cell creation, tissue and cell repair, and DNA synthesis, which is the genetic material in cells. B12 is required for normal nerve function.

B12 and folate tests can also be used to assess someone who is experiencing mental or behavioral changes, especially in the elderly. A B12 test can be ordered with or without folate, as well as with other screening laboratory tests like a complete blood count, comprehensive metabolic panel, antinuclear antibody, C-reactive protein, and rheumatoid factor, to help determine why a person is exhibiting signs and symptoms of a nerve disorder.

B12 and folate tests can also be performed in conjunction with a variety of other tests to assess a person's overall health and nutritional status if they have signs and symptoms of substantial malnutrition or dietary malabsorption. People with alcoholism, liver disease, stomach cancer, or malabsorption diseases including celiac disease, inflammatory bowel disease, or cystic fibrosis may fall into this category.

Testing may be performed to assess the success of treatment in patients with known B12 and folate deficits. This is especially true for people who cannot absorb B12 and/or folate effectively and must be treated for the rest of their lives.

Folate levels in the blood's liquid part might fluctuate depending on a person's recent diet. Because red blood cells contain 95 percent of circulating folate, a test to evaluate folate levels inside RBCs could be employed instead of or in addition to the serum test. Some doctors believe that the RBC folate test is a better predictor of long-term folate status and is more clinically useful than serum folate, however there is no consensus on this.

Homocysteine and methylmalonic acid are two more laboratory tests that can be used to detect B12 and folate deficits. In B12 deficiency, both homocysteine and MMA are high, whereas in folate deficit, only homocysteine, not MMA, is elevated. This distinction is critical because treating anemia with folate treats the anemia but not the brain damage, which may be irreparable.

What do my Vitamin B12 and Folate test results mean?

Normal B12 and folate levels may indicate that a person does not suffer from a deficiency and that the signs and symptoms are caused by something else. Normal levels, on the other hand, may indicate that a person's stored B12 and/or folate has not yet been depleted.

A health practitioner may request a methylmalonic acid test as an early sign of B12 insufficiency if a B12 level is normal but a deficiency is still suspected.

A low B12 and/or folate level in a person with signs and symptoms implies a deficiency, although it does not always indicate the severity of the anemia or related neuropathy. Additional tests are frequently performed to determine the source of the deficit. Low B12 or folate levels can be caused by a variety of factors, including:

Dietary folate or B12 deficiency is uncommon in the United States. It can be evident in people who are malnourished in general and vegans who do not eat any animal products. Folate deficiency has become extremely rare since the development of fortified cereals, breads, and other grain products.

Both B12 and folate deficits can be caused by diseases that prevent them from being absorbed in the small intestine. These may include the following:

  • Pernicious anemia.
  • Celiac disease
  • Crohn's disease and ulcerative colitis
  • Bacterial overgrowth or the presence of parasites in the intestines, such as tapeworms
  • Long-term usage of antacids or H2 proton pump inhibitors reduces stomach acid production.
  • Absorption can be considerably reduced by surgery that removes part of the stomach or the intestines, such as gastric bypass.
  • Insufficiency of the pancreas
  • Chronic alcoholism or heavy drinking
  • Some treatments, such as omeprazole, metformin, methotrexate, and/or anti-seizure medications like phenytoin.
  • Increased requirement for healthy fetal development, all pregnant women require an increased amount of folate and are advised to consume 400 micrograms of folic acid every day. People who have cancer that has spread or who have chronic hemolytic anemia require more folate.
  • Smoking

If a person is taking supplements to treat a B12 or folate deficiency, normal or higher findings indicate that the treatment is working.

High amounts of B12 are uncommon, and they aren't routinely evaluated clinically. If a person has a condition such chronic myeloproliferative neoplasm, diabetes, heart failure, obesity, AIDS, or severe liver disease, their vitamin B12 level may be elevated. High B12 levels can also be caused by using estrogens, vitamin C, or vitamin A.

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


Clinical Significance
Micronutrient, Vitamin B12 - B12 is decreased in pernicious anemia, total or partial gastrectomy, malabsorption and certain congenital and biochemical disorders.

Patients must be 18 years of age or greater.

Reference Range(s)
≥18 years    200-1100 pg/mL
Reference range not available for individuals <18 years for this micronutrient test.


Description: A Vitamin B12 test is a blood test that measures the level of Vitamin B12 in the blood’s serum and is used to detect Vitamin B12 deficiency.

Also Known As:  B12 Test, Cobalamin Test, Vitamin B12 test, Serum B12 Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: No preparation required. 

When is a Vitamin B12 test ordered?  

When a complete blood count and/or blood smear, performed as part of a health checkup or anemia evaluation, reveal a low red blood cell count with the presence of big RBCs, vitamin B12 levels may be ordered. A high mean corpuscular volume implies that the RBCs have grown in size. 

When a person exhibits the following signs and symptoms of a deficit, testing for B12 levels may be necessary: 

  • Diarrhea 
  • Dizziness 
  • Muscle weakness, fatigue 
  • Appetite loss. 
  • Skin that is pale 
  • Irregular heartbeats, rapid heart rate 
  • Breathing problems 
  • Tongue and mouth ache 
  • In the feet, hands, arms, and legs, there is tingling, numbness, and/or burning 
  • Confusion or obliviousness 
  • Paranoia 

When a person is at risk of deficiency, such as those with a history of malnutrition or a condition associated to malabsorption, B12 tests may be required. 

Individuals being treated for malnutrition or a B12 or folate deficit may have these tests done on a frequent basis to see how effective their treatments are. This could be part of a long-term therapy plan for people who have a disease that causes chronic deficiency.  

What does a Vitamin B12 blood test check for? 

Vitamin B12 is a member of the vitamin B complex. It is required for the creation of normal red blood cells, tissue and cell healing, and the synthesis of DNA, the genetic material in cells. Vitamin B12 is a nutrient that the body cannot make and must be obtained through the diet. 

Vitamin B12 deficiency is detected by measuring vitamin B12 in the liquid portion of the blood. 

A B12 deficiency can cause macrocytic anemia, which is characterized by red blood cells that are bigger than normal. Megaloblastic anemia is a kind of macrocytic anemia marked by the generation of fewer but larger RBCs known as macrocytes, as well as cellular abnormalities in the bone marrow. Reduced white blood cell and platelet count are two other test results linked to megaloblastic anemia. 

B12 is also necessary for nerve function, and a lack of it can induce neuropathy, which causes tingling and numbness in the hands and feet of those who are affected. 

B12 deficiency is most commonly caused by a lack of vitamin B12 in the diet or supplements, insufficient absorption, or an increased requirement, such as during pregnancy. 

Lab tests often ordered with a Vitamin B12 test: 

  • Folate 
  • Methylmalonic Acid (MMA) 
  • Homocysteine 
  • Vitamin B1 
  • Vitamin B2 
  • Vitamin B3 
  • Vitamin B5 
  • Vitamin B6 
  • Vitamin B7 
  • Rheumatoid factor 

Conditions where a Vitamin B12 test is recommended:

  • Vitamin B12 Deficiency 
  • Pernicious Anemia 
  • Nerve Damage 
  • Malabsorption 
  • Malnutrition 

How does my health care provider use a Vitamin B12 test? 

Vitamin B12 and folate are frequently used in conjunction to detect deficiencies and to aid in the diagnosis of anemias such as pernicious anemia, an inflammatory condition that inhibits B12 absorption. 

B12 and folate are two vitamins that the body cannot generate and must be obtained from the diet. They are essential for the creation of normal red blood cells, tissue and cell repair, and the synthesis of DNA, the genetic material in cells. B12 is required for normal nerve function. 

B12 and folate tests can also be used to assess someone who is experiencing mental or behavioral changes, especially in the elderly. A B12 test can be ordered with or without folate, as well as with other screening laboratory tests like a complete blood count, comprehensive metabolic panel, antinuclear antibody, C-reactive protein, and rheumatoid factor to help determine why a person is exhibiting signs and symptoms of a nerve condition. 

B12 and folate tests can also be performed in conjunction with a variety of other tests to assess a person's overall health and nutritional status if they have signs and symptoms of substantial malnutrition or dietary malabsorption. People with alcoholism, liver disease, stomach cancer, or malabsorption diseases including celiac disease, inflammatory bowel disease, or cystic fibrosis may fall into this category. 

Testing may be performed to assess the success of treatment in patients with known B12 and folate deficits. This is especially true for people who cannot absorb B12 and/or folate effectively and must be treated for the rest of their lives. 

Folate levels in the blood's serum might fluctuate depending on a person's recent diet. Because red blood cells contain 95 percent of circulating folate, a test to evaluate folate levels inside RBCs could be employed instead of or in addition to the serum test. Some doctors believe that the RBC folate test is a better predictor of long-term folate status and is more clinically useful than serum folate, however there is no consensus on this. 

Homocysteine and methylmalonic acid are two more laboratory tests that can be used to detect B12 and folate deficits. In B12 deficiency, both homocysteine and MMA are high, whereas in folate deficit, only homocysteine, not MMA, is elevated. This distinction is critical because treating anemia with folate treats the anemia but not the brain damage, which may be irreparable. 

What do my Vitamin B12 test results mean? 

Normal B12 and folate levels may indicate that a person does not suffer from a deficiency and that the signs and symptoms they are experiencing?are caused by something else. Normal levels, on the other hand, may indicate that a person's stored B12 and/or folate has not yet been depleted. 

A health practitioner may order a methylmalonic acid test as an early sign of B12 deficiency if a B12 level is normal but a deficiency is still suspected. 

A low B12 and/or folate level in a person with signs and symptoms implies a deficiency, although it does not always indicate the severity of the anemia or related neuropathy. Additional tests are frequently performed to determine the source of the deficit. Low B12 or folate levels can be caused by a variety of factors. 

Dietary folate or B12 deficiency, which?is uncommon in the United States. It can be evident in people who are malnourished in general and vegans who do not eat any animal products. Folate deficiency has become extremely rare since the development of fortified cereals, breads, and other grain products. 

Both B12 and folate deficits can be caused by diseases that prevent them from being absorbed in the small intestine. These may include the following: 

  • Pernicious anemia 
  • Celiac disease 
  • Crohn's disease and ulcerative colitis are examples of inflammatory bowel disease. 
  • Bacterial overgrowth or the presence of parasites in the intestines, such as tapeworms 
  • Long-term usage of antacids or H2 proton pump inhibitors reduces stomach acid production. 
  • Absorption can be considerably reduced by surgery that removes part of the stomach or the intestines, such as gastric bypass. 
  • Insufficiency of the pancreas 
  • Chronic alcoholism or heavy drinking 
  • Some treatments, such as metformin, omeprazole, methotrexate, or anti-seizure medications like phenytoin, are used. 
  • Increased requirements for healthy fetal development, all pregnant women require an increased amount of folate and are advised to consume 400 micrograms of folic acid every day. The need for folate is higher in those who have cancer that has spread or who have chronic hemolytic anemia. 
  • Smoking 

If a person is being treated for a B12 or folate deficit with supplements, normal or higher findings suggest that the treatment is working. 

High amounts of B12 are uncommon, and they aren't routinely evaluated clinically. If a person has a condition such chronic myeloproliferative neoplasm, diabetes, heart failure, obesity, AIDS, or severe liver disease, their vitamin B12 level may be elevated. High B12 levels can also be caused by using estrogens, vitamin C, or vitamin A. 

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


Description: Iron and Total Iron Binding Capacity is a blood panel used to determine iron levels in your blood, your body’s ability to transport iron, and help diagnose iron-deficiency and iron overload.

Also Known As: Serum Iron Test, Serum Fe Test, Iron Binding Capacity Test, IBC Test, Serum Iron-Binding Capacity Siderophilin Test, TIBC Test, UIBC Test, Iron Lab Test, TIBC Blood test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Iron and Total Iron Binding Capacity test ordered?

When a doctor feels that a person's symptoms are caused by iron overload or poisoning, an iron and TIBC test, as well ferritin assays, may be done. These may include the following:

  • Joint discomfort
  • Weakness and exhaustion
  • Energy deficiency
  • Pain in the abdomen
  • Suffering from a lack of sexual desire
  • Problems with the heart

When a child is suspected of ingesting too many iron tablets, a serum iron test is required to detect the poisoning and to determine its severity.

A doctor may also request iron and TIBC when the results of a standard CBC test are abnormal, such as a low hematocrit or hemoglobin, or when a doctor suspects iron deficiency based on signs and symptoms such as:

  • Chronic tiredness/fatigue
  • Dizziness
  • Weakness
  • Headaches
  • Skin that is pale

What does a Iron and Total Iron Binding Capacity blood test check for?

Iron is a necessary ingredient for survival. It is a vital component of hemoglobin, the protein in red blood cells that binds and releases oxygen in the lungs and throughout the body. It is required in small amounts to help form normal red blood cells and is a critical part of hemoglobin, the protein in RBCs that binds oxygen in the lungs and releases it as blood circulates to other parts of the body.

By detecting numerous components in the blood, iron tests are ordered to determine the quantity of iron in the body. These tests are frequently ordered at the same time, and the data are analyzed together to determine the diagnosis and/or monitor iron deficiency or overload.

The level of iron in the liquid component of the blood is measured by serum iron.

Total iron-binding capacity is a measurement of all the proteins in the blood that may bind to iron, including transferrin.

The percentage of transferrin that has not yet been saturated is measured by the UIBC. Transferrin levels are also reflected in the UIBC.

Low iron levels can cause anemia, resulting in a decrease in the production of microcytic and hypochromic RBCs. Large amounts of iron, on the other hand, might be hazardous to the body. When too much iron is absorbed over time, iron compounds build up in tissues, particularly the liver, heart, and pancreas.

Normally, iron is absorbed from food and distributed throughout the body by binding to transferrin, a liver protein. About 70% of the iron delivered is used in the synthesis of hemoglobin in red blood cells. The rest is stored as ferritin or hemosiderin in the tissues, with minor amounts being utilized to make other proteins like myoglobin and enzymes.

Insufficient intake, limited absorption, or increased dietary requirements, as observed during pregnancy or with acute or chronic blood loss, are all signs of iron deficiency. Excessive intake of iron pills can cause acute iron overload, especially in children. Excessive iron intake, genetic hemochromatosis, multiple blood transfusions, and a few other disorders can cause chronic iron overload.

Lab tests often ordered with a Iron and Total Iron Binding Capacity test:

  • Complete Blood Count
  • Ferritin
  • Transferrin
  • Zinc Protoporphyrin

Conditions where a Iron and Total Iron Binding Capacity test is recommended:

  • Anemia
  • Hemochromatosis

How does my health care provider use a Iron and Total Iron Binding Capacity test?

The amount of circulating iron in the blood, the capacity of the blood to carry iron, and the amount of stored iron in tissues can all be determined by ordering one or more tests. Testing can also assist distinguish between different types of anemia

The level of iron in the blood is measured by serum iron.

Total iron-binding capacity is a measurement of all the proteins in the blood that may bind to iron, including transferrin. The TIBC test is a useful indirect assessment of transferrin because it is the predominant iron-binding protein. In response to the requirement for iron, the body generates transferrin. Transferrin levels rise when iron levels are low, and vice versa. About one-third of the binding sites on transferrin are used to transport iron in healthy humans.

The reserve capacity of transferrin, or the part of transferrin that has not yet been saturated, is measured by UIBC. Transferrin levels are also reflected in the UIBC.

The iron test result, as well as TIBC or UIBC, are used to calculate transferrin saturation. It represents the proportion of transferrin that is iron-saturated.

Ferritin is the major storage protein for iron inside cells, and serum ferritin represents the quantity of stored iron in the body.

These tests are frequently ordered together, and the results can assist the doctor figure out what's causing the iron deficit or overload.

Additional information about iron

A balance between the quantity of iron received into the body and the amount of iron lost is required to maintain normal iron levels. Because a tiny quantity of iron is lost each day, a deficiency will develop if too little iron is consumed. In healthy persons, there is usually enough iron to prevent iron deficiency and/or iron deficiency anemia, unless they eat a bad diet. There is a greater need for iron in some circumstances. People who have persistent gut bleeding or women who have heavy menstrual periods lose more iron than they should and can develop iron deficiency. Females who are pregnant or breastfeeding lose iron to their babies and may develop an iron shortage if they do not consume enough supplemental iron. Children may require additional iron, especially during periods of rapid growth, and may suffer iron shortage.

Low serum iron can also arise when the body is unable to adequately utilize iron. The body cannot correctly utilize iron to generate additional red cells in many chronic disorders, particularly malignancies, autoimmune diseases, and chronic infections. As a result, transferrin production slows, serum iron levels drop because little iron is absorbed from the stomach, and ferritin levels rise. Malabsorption illnesses like sprue syndrome can cause iron deficiency.

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


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Description: A Ferritin test is a blood test that measures Ferritin levels in your blood’s serum to evaluate the level of iron stored in your body.

Also Known As: Ferritin Serum Test, Ferritin Test, Ferritin Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Ferritin test ordered?

When a CBC test’s implies iron deficiency anemia due to small red blood cells or low hematocrit and hemoglobin levels, the ferritin test, and other iron tests, may be requested, even if other clinical symptoms have not yet arisen.

There are frequently no physical symptoms in the early stages of iron insufficiency. Symptoms rarely develop before hemoglobin falls below dangerous levels. However, when the iron deficit continues, symptoms emerge, prompting a doctor to order ferritin and other iron-related testing. The following are the most prevalent symptoms of iron deficiency anemia:

  • Chronic tiredness/fatigue
  • Weakness
  • Dizziness
  • Headaches
  • Skin that is pale

Shortness of breath, ringing in the ears, sleepiness, and irritability may occur as iron levels are reduced. Chest pain, headaches, limb pains, shock, and even heart failure may occur as the anemia worsens. Learning impairments can occur in children. There are some symptoms that are specific to iron deficiency, in addition to the usual signs of anemia. Pica, a burning feeling in the tongue or a smooth tongue, ulcers at the corners of the mouth, and spoon-shaped finger- and toe-nails are only a few of the symptoms.

When iron overload is suspected, a ferritin level may be requested. Iron overload symptoms differ from person to person and tend to worsen over time. They are caused by an excess of iron in the blood and tissues. Among the signs and symptoms are:

  • Joint discomfort
  • Weakness and exhaustion
  • Loss of weight
  • Energy deficiency
  • Pain in the abdomen
  • Suffering from a lack of sexual desire
  • Hair loss on the body
  • Congestive heart failure is an example of a cardiac issue

Other iron tests including a genetic test for hereditary hemochromatosis may be conducted to confirm the existence of iron excess.

What does a Ferritin blood test check for?

Ferritin is an iron-containing protein that stores iron in cells in its most basic form. The amount of total iron stored in the body is reflected in the little amount of ferritin released into the blood. This test determines how much ferritin is present in the blood.

About 70% of the iron consumed by the body is integrated into the hemoglobin of red blood cells in healthy humans. The remaining 30% is stored primarily as ferritin or hemosiderin, which is a combination of iron, proteins, and other elements. Hemosiderin and ferritin are typically found in the liver, although they can also be found in the bone marrow, spleen, and skeletal muscles.

Iron stores are depleted and ferritin levels fall when available iron is insufficient to meet the body's needs. This can happen owing to a lack of iron, poor absorption, or an increased need for iron, such as during pregnancy or if you have a condition that causes persistent blood loss. Before any indicators of iron shortage appear, significant loss of iron reserves may occur.

When the body absorbs more iron than it needs, iron storage and ferritin levels rise. Chronic iron absorption causes a gradual buildup of iron compounds in organs, which can eventually lead to organ malfunction and failure. Even on a typical diet, this happens in hemochromatosis, a hereditary disorder in which the body absorbs too much iron.

Lab tests often ordered with a Ferritin test:

  • Complete Blood Count
  • Iron Total
  • Iron Total and Total Iron binding capacity
  • Transferrin
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Zinc Protoporphyrin

Conditions where a Ferritin test is recommended:

  • Anemia
  • Hemochromatosis
  • Lead poisoning
  • Pregnancy
  • Restless Leg Syndrome

How does my health care provider use a Ferritin test?

The ferritin test is used to determine the amount of iron a person has in their body. To determine the existence and severity of iron shortage or iron overload, the test is sometimes ordered in conjunction with an iron test and a TIBC test.

One source of iron overload can be the use of iron supplements.

What does my ferritin lab test result mean?

Ferritin levels are frequently measured alongside other iron tests.

Ferritin levels are low in iron deficient people and high in people who have hemochromatosis or have had several blood transfusions.

Ferritin is an acute phase reactant that can be elevated in persons who have inflammation, liver illness, chronic infection, autoimmune disorders, or cancer. Ferritin isn't commonly utilized to detect or monitor these problems.

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


Description: Fecal Globulin by immunochemistry is a test that measures the amount of blood present in fecal samples. The results from the fecal globulin test can be used to detect a lower gastrointestinal disorder. It is recommended to be a part of the routine physical examination.

Also Known As: Fecal Immunochemical Test, Fecal Occult Blood Test, Stool Occult Blood Test, FIT, FOBT

Collection Method: Fecal specimen collected from toilet water and brushed onto InSure® FOBT test card

Specimen Type: Fecal Specimen

Test Preparation: No preparation required

When is a Fecal Globin test ordered?

When a person chooses fecal occult blood testing as a method of colon cancer screening, the American Cancer Society and other major healthcare organizations recommend yearly testing. The American Cancer Society and others recommend that colon cancer screening begin around age 50 for the general population, but it may begin earlier if a person has a family history of colon cancer.

An FOBT may be ordered by a doctor if a patient has unexplained anemia that could be caused by gastrointestinal bleeding.

What does a Fecal Globin test check for?

The majority of colon cancer cases begin with the formation of benign intestinal polyps. Benign polyps are quite common in adults over 50, and while the majority do not cause health problems, some can turn malignant and spread to other parts of the body. These finger-like growths protrude into the rectum or the intestinal cavity. They can be delicate and bleed on occasion, as when food debris rubs against them.

The blood expelled is normally not visible in the stool, but a fecal occult blood test or a fecal immunochemical test can detect it. The FOBT and FIT are effective colorectal cancer screening techniques because this small amount of blood may be the earliest and sometimes only evidence of early colon cancer. A guaiac-based test, an over-the-counter flushable reagent pad, and an immunochemical technique are all options for testing.

It is advised that at least three stool samples be taken on different days be tested. According to the American Cancer Society, a single test performed during a digital rectal exam at a doctor's office is not recommended since it may not be sensitive enough to detect cancer. Because collecting feces on three different days increases the chances of identifying cancer, the home FOBT or FIT is advised. Additionally, those who choose this type of colon cancer screening should be screened every year.

Lab tests often ordered with a Fecal Globin test:

  • Complete Blood Count (CBC)
  • Calprotectin

Conditions where a Fecal Globin test is recommended:

  • Colon Cancer

How does my health care provider use a Fecal Globin test?

The fecal occult blood test, also known as the fecal immunochemical test, is primarily used to screen for early colon cancer. The majority of colon cancer cases begin with the formation of benign intestinal polyps. People over the age of 50 are more likely to develop benign polyps. The majority are non-cancerous, however some can develop malignant.

Blood in the stool could be the only sign of early cancer, so if caught early, therapy can begin right away, increasing the chances of a cure.

What do my Fecal Occult Blood test results mean?

Normally, the fecal occult blood test is negative.

A positive test result for the guaiac-based FOBT shows that abnormal bleeding is occurring anywhere in the digestive tract. Ulcers, diverticulosis, polyps, inflammatory bowel disease, hemorrhoids, blood eaten owing to bleeding gums or nosebleeds, or benign or malignant tumors could all cause blood loss.

A positive result for the fecal immunochemical test shows abnormal bleeding in the lower digestive tract. Other sources of blood, such as those found in the diet, do not generate a positive result since this test only identifies human hemoglobin. Furthermore, hemoglobin from upper digestive tract hemorrhage is broken down before reaching the lower digestive tract and is undetectable by the FIT. As a result, the FIT is a more precise test than the gFOBT.

Follow-up testing is required after a positive result from either the guaiac-based FOBT or the immunochemical FIT. Direct imaging of the colon and rectum is generally used.

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


Clinical Significance

Tissue Transglutaminase Antibody, IgA, is useful in diagnosing gluten-sensitive enteropathies, such as Celiac Sprue Disease, and an associated skin condition, dermatitis herpetiformis.

Alternative Name(s) 

Celiac Disease, tTG Antibody, Transglutaminase, Tissue Antibody IgA, Dermatitis Herpetiformis, tTG IgA


Tissue Transglutaminase Antibody, IgG, is useful in diagnosing gluten-sensitive enteropathies, such as Celiac Sprue Disease, and an associated skin condition, dermatitis herpetiformis in patients who are IgA-deficient.

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Immunoglobulin A (IgA)

Test Highlight

 

   

Clinical Use

  • Diagnose IgA deficiencies

  • Determine etiology of recurrent infections

  • Diagnose infection

  • Diagnose inflammation

  • Diagnose IgA monoclonal gammopathy

Clinical Background

IgA is the first line of defense for the majority of infections at mucosal surfaces and consists of 2 subclasses. IgA1 is the dominant subclass, accounting for 80% to 90% of total serum IgA and greater than half of the IgA in secretions such as milk, saliva, and tears. IgA2, on the other hand, is more concentrated in secretions than in blood. IgA2 is more resistant to proteolytic cleavage and may be more functionally active than IgA1.

IgA deficiency is the most prevalent isotype deficiency, occurring in 1/400 to 1/700 individuals. Many patients with IgA deficiency are asymptomatic, while others may develop allergic disease, repeated sinopulmonary or gastroenterologic infections, and/or autoimmune disease. Individuals with complete absence of IgA (<5 mg/dL) may develop autoantibodies to IgA after blood or intravenous immunoglobulin infusions and may experience anaphylaxis on repeat exposure. 

Elevated serum IgA levels are associated with infection, inflammation, or IgA monoclonal gammopathy.

 

Detection of antibodies to gliadin, one of the major protein components of gluten, is a sensitive assay useful in diagnosing celiac disease. However, gliadin antibodies may be found in individuals without celiac disease; thus gliadin antibody assays are less specific than assays measuring antibodies to endomysium and transglutaminase. Recent work has revealed that gliadin-reactive antibodies from celiac patients bind to a very limited number of specific epitopes on the gliadin molecule. Further, deamidation of gliadin results in enhanced binding of gliadin antibodies. Based on this information, assays using deamidated gliadin peptides bearing the celiac-specific epitopes have much higher diagnostic accuracy for celiac disease when compared to standard gliadin antibody assays.

Detection of antibodies to gliadin, one of the major protein components of gluten, is a sensitive assay useful in diagnosing celiac disease. However, gliadin antibodies may be found in individuals without celiac disease; thus gliadin antibody assays are less specific than assays measuring antibodies to endomysium and transglutaminase. Recent work has revealed that gliadin-reactive antibodies from celiac patients bind to a very limited number of specific epitopes on the gliadin molecule. Further, deamidation of gliadin results in enhanced binding of gliadin antibodies. Based on this information, assays using deamidated gliadin peptides bearing the celiac-specific epitopes have much higher diagnostic accuracy for celiac disease when compared to standard gliadin antibody assays.

Detection of antibodies to gliadin, one of the major protein components of gluten, is a sensitive assay useful in diagnosing celiac disease. However, gliadin antibodies may be found in individuals without celiac disease; thus gliadin antibody assays are less specific than assays measuring antibodies to endomysium and transglutaminase. Recent work has revealed that gliadin-reactive antibodies from celiac patients bind to a very limited number of specific epitopes on the gliadin molecule. Further, deamidation of gliadin results in enhanced binding of gliadin antibodies. Based on this information, assays using deamidated gliadin peptides bearing the celiac-specific epitopes have much higher diagnostic accuracy for celiac disease when compared to standard gliadin antibody assays.

Endomysial Antibody (IgA) Screen with Reflex to Titer.

If Endomysial Antibody (IgA) Screen is positive, Endomysial Antibody Titer will be performed at an additional charge.

IMPORTANT - AN ADDITIONAL CHARGE OF $48.50 WILL BE APPLIED FOR THE Endomysial Antibody Titer test if run by the lab.


Anti-Reticulin IgG occurs most frequently in patients with gluten sensitive enteropathy, i.e. celiac disease and dermatitis herpetiformis.

 

Note: If Reticulin Antibody (IgG) Screen is Positive, Reticulin (IgG) Titer will be performed at an addtional charge.


Description: A blood culture test is a blood used to identify illness causing bacteria and fungus in a patients blood.

Also Known As: Blood Culture Test, Blood Fungus Test, Blood Bacteria Test, Bacterial Blood Test, Fungal Blood Test, Blood Fungi Test, Sepsis Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Important: Aerobic culture, anaerobic culture. If culture is positive, identification will be performed at an additional charge (CPT code(s): 87076 or 87106 or 87077 or 87140 or 87143 or 87147 or 87149).
Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

When is a Blood Culture test ordered?

When a patient exhibits sepsis symptoms, which show that bacteria, fungus, or their toxic byproducts are harming the body, a healthcare professional may order blood cultures.

Drawing blood cultures might be suitable when symptoms are present in patients who are at a higher risk of developing a systemic infection due to previous infections, surgeries, prosthetic heart valve replacements, or immunosuppressive medication. Blood cultures are taken more frequently from babies and young children since they may have an infection but not always display the classic sepsis symptoms.

What does a Blood Culture test check for?

Blood cultures are techniques used to find the source of an illness in the blood and detect it. Although viruses, yeasts, and other fungi as well as bacteria can potentially cause bloodstream infections, they are less prevalent. This article concentrates on the use of blood cultures to find and identify bacteria and fungus in the blood, though blood can also be used to test for viruses.

When a person has a serious infection and/or the immune system is unable to contain it at its source, a blood infection often develops from another specific spot within the body. For instance, a urinary tract infection may spread from the bladder and/or kidneys into the circulation, travel throughout the body, infect other organs, and result in a serious and occasionally fatal systemic infection. Sometimes, the terms septicemia and sepsis are used synonymously to refer to this condition. While sepsis is the body's acute, overpowering, and occasionally lethal response to infection, septicemia refers to an infection of the blood. This ailment frequently need for quick and vigorous care, usually in a hospital's critical care unit.

The infection of the blood can lead to more severe consequences. A bloodstream infection may lead to endocarditis, an inflammation and infection of the heart's lining and/or heart valves. Although these infections are uncommon, patients with artificial heart valves or joints are more likely to develop systemic infections after surgery.

Blood infections are more common in people whose immune systems are compromised by underlying illnesses like leukemia or HIV/AIDS or by immunosuppressive medications used in chemotherapy. These people are more likely to contract blood infections because their immune systems are less able to destroy the microorganisms that occasionally enter the blood. Through the use of intravenous drugs, intravenous catheters, or surgical drains, bacteria and yeasts can also enter the circulation directly.

Before they are declared as negative, blood cultures are cultured for a number of days. If originally present in low numbers, some species of bacteria and fungi may develop more slowly than others and/or take longer to be discovered.

A blood culture that is positive identifies the exact bacteria that is infecting the patient, and susceptibility testing is done to determine which drugs are most likely to be helpful in treating the illness.

The blood culture testing procedure is automated, and devices continuously check the samples for bacterial or fungal development. This enables prompt results reporting and enables the medical professional to target antimicrobial medication specifically at the particular bacteria found in the blood. While awaiting the results of a blood culture, broad-spectrum antimicrobials are typically administered intravenously because therapy must be started as soon as feasible in situations of sepsis. Once the bacteria responsible for the infection is discovered, antimicrobial medication may be switched out for a more focused antibiotic therapy.

Lab Tests often ordered with a Blood Culture test:

  • Complete Blood Count (CBC)
  • Urine Culture
  • Susceptibility Testing

Conditions where a Blood Culture test is recommended:

  • Urinary Tract Infection
  • Skin Infection
  • Meningitis
  • Pneumonia
  • Encephalitis
  • Sepsis
  • Fungal Infection
  • Staph Infection
  • Septic Arthritis
  • Food and Waterborne Illness

How is this test used by my health care provider?

Blood cultures are used to determine the type of bacteria or fungi present, detect their presence in the blood, and direct treatment. A blood infection that can cause sepsis, a dangerous and potentially fatal consequence, is detected by testing. Testing is frequently carried out in a hospital setting because patients with suspected blood infections are frequently treated in intensive care units.

This article concentrates on the use of blood cultures to identify and detect bacteria and fungus, while blood samples may be used to detect viruses as well.

Additional related tests that might be carried out include:

Gram stain, a fast test for determining the sort of bacteria in question,

Testing for susceptibility identifies the medication that might be most successful at treating the infection.

The blood culture is frequently followed by a request for a complete blood count to see if the patient has an elevated white blood cell count, a sign of a possible infection. Sometimes additional testing is carried out, such as a chemistry panel to assess an individual's organ condition or a urine culture to assist in determining the origin of the initial illness. This is especially true if a person exhibits signs of a meningitis, pneumonia, or urinary tract infection.

What do my Blood Culture test results mean?

The presence of the same bacteria or fungi in two or more blood cultures indicates that the person being examined most likely has a blood infection with that microbe. The exact bacteria or fungi that are causing the infection are usually identified in the results.

Blood infections are dangerous conditions that require prompt treatment, frequently in a hospital. Sepsis is a complication that poses a serious risk to life, particularly in those with compromised immune systems. While awaiting the results of the blood culture or susceptibility testing, medical professionals who suspect sepsis may start patients on intravenous broad spectrum antibiotics that are efficient against a variety of bacteria. A more targeted antimicrobial agent for the bacteria or fungi found in the blood cultures may be used as treatment once the results are available.

A skin contaminant or infection may be present if one blood culture set is positive and the other is negative. Before making a diagnosis, the medical professional will take into account the patient's clinical condition and the type of bacteria or fungi discovered. In this instance, more testing might also be necessary.

After several days, blood culture sets that are negative indicate that there is a low likelihood that the patient has a blood illness brought on by bacteria or fungi. Additional testing, however, might be necessary if symptoms linger, including a fever that won't go away. Symptoms may persist despite negative blood culture results for a number of reasons, including

It may be necessary to perform additional blood cultures using specialized nutrient media in order to attempt and grow and identify the pathogen because some microorganisms are more difficult to grow in culture.

Blood culture bottles made to grow bacteria cannot be used to detect viruses. Additional laboratory testing would need to be carried out if the medical professional believes that the patient's symptoms could be due to a viral infection. Depending on the patient's clinical symptoms and the type of virus the doctor believes is the cause of the illness, certain tests may be prescribed.

Even though blood cultures are negative, sepsis may still be present based on the results of further tests that may be performed in conjunction with blood cultures. Some of them could be:

  • thorough blood count. An infection may be indicated by an elevated white blood cell count.
  • Complement. The concentration of C3 can rise.
  • An infection source that may have moved to the blood may be identified by a positive urine or sputum culture.

An examination of the CSF could point to the infection's origin.

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



Did you know that 2.4 million people visit their doctors for IBS treatment every year in the United States? 

To receive an IBS diagnosis, your medical professional will review the symptoms you've listed, as well as your family history, and complete a physical exam. In order to accurately diagnose you with this disease, doctors will also often order a blood test to rule out other potential health problems. 

If you've had pain related to your bowel movements, pain in your abdomen, or you've noticed changes in your bowel movements, talking to your doctor about your symptoms is important to get your health back on track. If you're looking to learn more about the blood tests that your doctor ordered for you or if you're looking to take your health into your own hands and order blood tests for yourself, we've come up with a complete guide to give you a better understanding of an IBS diagnosis. Keep reading to learn more! 

What Is Inflammatory Bowel Syndrome (IBS)?

Inflammatory bowel syndrome (IBS) is an extremely common disorder of the large intestine. Thankfully, most individuals with IBS experience relatively mild symptoms.

This means that the symptoms of IBS should not inhibit your everyday life. However, if they do, you may want to pay special attention to our section discussing IBD, which stands for irritable bowel disease.

A small number of individuals with IBS do experience severe signs and symptoms. However, most people can control their symptoms with lifestyle changes such as a diet adjustment and an exercise regimen. Patients with more severe symptoms may control their condition with medications and routine medical counseling.

Some patients believe that IBS causes damage to the bowel, but this is false.

Irritable bowel syndrome does not increase a patient's risk for colorectal cancer. In fact, it doesn't alter the bowel tissue in any way.

What Are the Risk Factors for Inflammatory Bowel Syndrome (IBS)?

Risk factors don't confirm the prevalence of a disease, but they are helpful in determining whether or not you're likely to have it. Here are some of the risk factors of IBS:

  • Young in age as most individuals with IBS receive a diagnosis before the age of 50
  • Female as IBS is more common in women
  • Genetic predisposition as both genes and environment play a role in the development of IBS
  • Prior or current history of mental health issues and/or abuse

These risk factors do not determine whether or not you have the disease, but they can act as a guide as you're navigating whether or not you're at-risk.

What Causes Inflammatory Bowel Syndrome (IBS)?

Even though IBS is very common, gastroenterologists are still astounded by the condition. In fact, some gastroenterologists claim that there isn't a definitive way to diagnose or track IBS. Although, more and more research is coming out about the condition.

There are a few different causes that researchers and physicians have discovered for IBS:

  1. Poor muscle contractions from the lining of the large intestine can cause differences in stool output as stronger, longer contractions cause gas, bloating, and diarrhea and short, weak contractions cause hard and dry stool.
  2. Abnormalities in the nerves that work in your digestive system may cause discomfort as the abdomen stretches due to gas or waste.
  3. An overabundance of bacteria in the gut.
  4. Resulting symptoms from a prior bacterial infection in the gut, such as gastroenteritis.
  5. A stressful environment, especially early in life.
  6. Changes in any microorganisms living in the gut, including bacteria, fungi, and viruses.

People living with IBS may have experienced one of these changes or many of these changes. The good thing is that most of these cases will not leave the individual with lasting damage. So, the patient just needs to work to overcome the discomfort that comes with the condition.

What Is the Difference Between IBS and IBD?

IBS stands for irritable bowel syndrome, while IBD stands for irritable bowel disease.

Irritable bowel disease is an autoimmune condition in which the body attacks the tissues in the large intestine. This can lead to swollen and damaged tissue that causes a variety of symptoms.

In most cases, patients who experience IBD have more significant symptoms than those who experience IBS. IBD can cause excruciating pain, preventing the individual with the condition from carrying on with the daily activities of life.

IBD is also linked with a greater risk for cancer, while IBS is not. If you feel that your symptoms are more serious, you can get your Inflammatory Bowel Disease (IBD) tests here.

What Are the Signs and Symptoms of Inflammatory Bowel Syndrome (IBS)?

There are three main types of IBS: IBS-D, IBS-C, and IBS-M. IBS-D describes patients who experience diarrhea most of the time, while IBS-C describes patients who experience constipation most of the time. IBS-M is a mixed form of the condition in which patients experience diarrhea and constipation about half of the time.

Depending on the kind of IBS you have, you're going to experience different symptoms. However, any chronic abnormality or inconsistency in your stool could point to IBS.

In the majority of individuals who experience IBS, there are times that the symptoms of this disease worsen, while there are other times where the symptoms improve or even completely disappear. The symptoms and signs of IBS vary from person to person, but the most commonly reported symptoms are: 

• Abdominal pain, cramping, or bloating that is typically relieved or partially relieved by passing a bowel movement
• Excess gas
• Diarrhea or constipation, sometimes alternating bouts of diarrhea and constipation
• Mucus in the stool
• Weight loss
• Diarrhea at night
• Rectal bleeding
• Iron deficiency anemia
• Unexplained vomiting
• Difficulty swallowing
• Persistent pain that isn't relieved by passing gas or a bowel movement 

Risk Factors 

Doctors aren't exactly sure what causes irritable bowel syndrome. However, there are several risk factors that seem to contribute to the likelihood of an individual developing IBS. These factors include: 

  • Age - While IBS can affect all age groups, it's more likely to affect people in their teens, all the way through their 40s. 
  • Gender - Women are twice as likely to develop IBS than men are. While it's not clear why women are more likely to develop this, many doctors believe that hormone fluctuations can cause the development of IBS.
  • Stress levels - Individuals with IBS often are seen to have trouble managing their stress levels. 
  • Family history - This disease seems to be passed down through families, while no research is available to support this theory. 

 

Key Lab Tests for IBS Diagnosis

Are you looking to learn more about the key lab tests that are used to diagnose someone with IBS? Here's everything you need to know: 

1. C-Reactive Protein (CRP)

CRP, also known as the C-Reactive Protein test, is a blood test that measures the amount of inflammation that's found in the body. This protein is created in the liver, and higher quantities of CRP are produced when the body is responding to inflammation.

In a healthy body, there aren't any C-Reactive Protein markers measured in the blood. However, in people with IBS or Celiac Disease, there CRP can be detected in the blood.


2. ESR

ESR stands for Erythrocyte Sedimentation Rate, which is a type of blood test that measures how quickly your red blood cells (erythrocytes) fall to the bottom of a test tube that contains your blood sample. In healthy patients, the erythrocytes slowly settle to the bottom of a test tube. 

When red blood cells fall to the bottom of a test tube quickly, it's an indicator that there's inflammation in your body. An ESR test can help doctors determine if you have a condition that causes inflammation, such as IBS. ESR tests are not only used to diagnose someone with IBS but can also help medical professionals monitor your health condition during treatment.


3. CBC

If your doctor suspects that you have IBS, a complete blood count (CBC) test must be completed. A CBC can help confirm this autoimmune condition if the main symptom that you're experiencing is diarrhea, which is an indication that you may have IBS-D. 

A complete blood count measures the number of red blood cells, the number of white blood cells, the total amount of hemoglobin available in your blood, the percentage of red blood cells in your blood, and platelet count. Having a CBC test completed can help your doctor to rule out other possible conditions, such as an infection, causing the symptoms that you're experiencing. 


4. Comprehensive Metabolic Panel

In some people who have IBS, a symptom that they'll report is weight loss. A comprehensive metabolic panel will allow medical professionals to evaluate your health to see if you have an underlying metabolic disorder. In addition, a comprehensive metabolic panel will provide the medical professionals with insight on if you're experiencing any electrolyte imbalances or dehydration if you're experiencing diarrhea. 


5. Vitamin D 25-Hydroxyvitamin D (D2, D3)

Recent studies have suggested that individuals with IBS are also experiencing  Vitamin D deficiency. While research hasn't yet made it clear why people with IBS experience a Vitamin D deficiency, ensuring that your body has a healthy level of Vitamin D promotes a healthy immune system bone health, and supports gut health.  


6. Vitamin B12

Several of the symptoms of IBS and a Vitamin B12 deficiency are very similar, which is why it's important to have your B12 levels checked before you receive a diagnosis. A Vitamin B12 blood test can tell medical professionals if the symptoms you're experiencing are a result of a vitamin deficiency. If your Vitamin B12 levels are in a healthy range, it can help your doctor to rule out symptom-related vitamin deficiency.  


7. Iron, Total and Total Iron Binding Capacity

Did you know that iron deficiency anemia is considered to be a gastroenterological disorder? That's because some of the leading causes of iron deficiency are due to menstruation blood and blood loss caused by gastrointestinal disease.

Blood loss in the intestine and/or the stomach can't be matched by iron absorption, which would cause an iron deficiency. Taking a look at your test results for your total iron and your iron-binding capacity (your body's ability to bind the protein to iron found in your blood) will provide medical professionals with insight into whether your IBD is causing anemia. As a result, this can help your doctor diagnose you with IBS or point them in the direction of another diagnosis, such as Crohn's disease. 


8. Ferritin

Iron in your body is stored in your body with the help of protein that's called ferritin test. By measuring the level of ferritin found in your body, doctors will be able to identify if you have inadequate levels of this vital protein. Low ferritin levels will show up on a blood test long before an iron deficiency would show on a complete blood count, which is why this blood test plays a vital part in diagnosing IBS or another type of gastrointestinal disease. 


9. Fecal Occult Blood

fecal occult blood test checks stool samples for hidden blood that isn't identifiable by the naked eye. If there's occult blood found in the stool, it's a warning sign that there are polyps in the rectum of the colon. In addition, occult blood found in the stool can be an indicating sign of colon cancer.

Since occult blood is only found in small amounts, a chemical process is used to identify if there's any occult blood in a fecal sample. Receiving this test will help your doctor to identify other possible hidden health conditions that you may be experiencing, resulting in a narrowed-down diagnosis. 


10. Anti-tissue Transglutaminase (anti-tTG) antibodies, IgA

Anti-tTg is a test that's used to diagnose celiac disease. Tissue transglutaminase is an enzyme that's responsible for fixing the damage in your body. In individuals with celiac disease, their bodies make antibodies to attack the enzyme. Testing positive for this antibody is a step towards receiving the proper diagnosis for the symptoms you're experiencing. 

11. Quantitative Immunoglobulin A (IgA)

This blood test measures the level of the immunoglobin antibodies in the blood, which are responsible for fighting off infection. If there's a high level of Quantitative Immunoglobulin A found in your test results, it's a sign that your body is experiencing inflammation. 

12. Deamidated Gliadin Peptide (DGP) antibodies, IgA

This blood test is used to identify the presence of Celiac disease. If your doctor is looking to rule out Celiac disease from the symptoms that you've listed, you'll have the DGP antibodies (deamidated gliadin peptide) levels measured to see how many antibodies you have available in your blood. 


13. Anti-Endomysial Antibodies (EMA), IgA

EMA is another blood test that's a routine test used to diagnose Celiac disease. Anti-Endomysial Antibodies are very similar to Anti-tTg antibodies. While they're more sensitive, a blood test measures the application, significance, and usefulness of the endomysial antibodies in people with Celiac disease. 


14. Anti-Reticulin Antibodies (ARA), IgA

Retucluin is the connecting tissues that surround the majority of the organs in your body. Anti-reticulin antibodies can be found as a test for autoantibody screens. A positive test result for this antibody is an indicator of Celiac disease. This blood test can help your doctor to rule out the Celiac disease diagnosis or act as proof of the disease in your body.


15. Anti-Actin IgA (F-actin)

Anti-actin antibodies are another antibody that's found in individuals with Celiac disease. The discovery of this antibody in your blood is predictive of the severity of your gluten sensitivity and is used as a tool to measure the severity of your Celiac disease (if you have it at all). 


16. Blood Culture

blood culture will let a doctor know if you have an infection, yeast, or parasites in your blood. A positive blood culture lets doctors know that you have bacteria or parasites in your blood. Depending on the infection or parasite that's in your blood, many of the symptoms that your experiencing may direct your doctor away from an IBS diagnosis and towards the invader that was found in your blood. 


17. Urine Culture

urine culture will check to see if there's any collagen degradation in your urine. Some studies have suggested that there's an impairment of the elastic lining of the color, which impacts the function of the colon. By comparing urine samples from individuals with IBS to healthy individuals, the biomarkers that are measured in your use can help doctors to differentiate between ulcerative colitis and Crohn's disease. 


18. Folate

Folate is a member of the B complex vitamin family and is responsible for working with Vitamin C to create new proteins. An adequate level of Folate in your blood is necessary for your body to produce white blood cells and red blood cells, repair cells, repair tissues, and is responsible for the synthesis of DNA.


19. Partial Thromboplastin Time (PTT, aPTT)

If your doctor suspects that your symptoms are related to your body having problems clotting your blood, they'll order a partial thromboplastin time test. PTT is a blood test that measures the amount of time that it takes for your blood to clot. 


20. Prothrombin Time and International Normalized Ratio (PT/INR)

Another test that's used to check to see if you have a potential bleeding disorder or an excessive clotting disorder. Prothrombin Time evaluates your body's ability to clot blood. International Normalized Ratio is a calculation that's made based on the results that PT showed about your body's coagulation ability. 

21. H. Pylori

Helicobacter pylori is a type of bacteria that can enter your body and wreak havoc on your digestive tract. If left untreated, it can cause ulcers in the upper part of your small intestine, which could lead to a possible infection. A doctor will order this blood test to see if this unhealthy bacteria is present in your digestive tract. 

Taking Back Control of Your Health

Receiving an IBS diagnosis can help get you on the right path to receive the medical treatment that's needed to improve your quality of life. Blood test results make it easier for your physician to properly diagnose you while also sorting out other potential health problems that could be affecting you.

Are you looking to learn more about the key blood tests that are used to diagnose IBS? Click here to take a look at our available tests!