Alcohol

Description: A Gamma Glutamyl Transferase or GGT test is a test that measures that level of GGT in your blood’s serum to check for a variety of conditions related to liver health such as hepatitis or cirrhosis along with diabetes and heart health.

Also Known As: Gamma Glutamyltransferase GGT test, Gamma-Glutamyl Transferase Test, Gamma-Glutamyl Transpeptidase Test, Gamma-GT Test, GGTP Test, GTP Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a GGT test ordered?

When someone has an increased ALP level, a GGT test may be ordered. Even if no symptoms are present, an ALP test may be conducted alone or as part of a standard liver panel to screen for liver disease. When the ALP test results are high but the other tests in the liver panel are not, a GGT test may be ordered.

When a person has indications or symptoms that imply liver disease, GGT may be administered in conjunction with or as a follow-up to other liver function tests. The following are some of the signs and symptoms of liver damage:

• Weakness and exhaustion
• Appetite loss.
• Vomiting and nausea
• Swelling and/or pain in the abdomen
• Jaundice
• Urine that is dark in color and feces that is light in color
• Pruritus

GGT may also be done after someone with a history of alcohol abuse has finished alcohol treatment to ensure that the treatment program is being followed.

What does a GGT blood test check for?

Glutamyl transferase is an enzyme found throughout the body, with the liver having the highest amount of it. GGT levels in the blood are raised in most disorders that affect the liver or bile ducts. This test determines the amount of GGT present in a blood sample.

GGT is normally present in tiny amounts, however when the liver is harmed, the level of GGT might grow. When any of the bile ducts that convey bile from the liver to the intestines become clogged, GGT levels are usually the first liver enzyme to become elevated in the blood. It's the most sensitive liver enzyme test for diagnosing bile duct issues because of this.

However, because it can be raised with many types of liver disorders, the GGT test is not highly specific and is not effective in differentiating between various causes of liver damage. As a result, the GGT test is not suggested for usage on a regular basis. It can, however, be used in conjunction with other tests to determine the source of a high alkaline phosphatase level, which is another liver enzyme.

In liver disorders, both GGT and ALP are elevated, whereas only ALP is elevated in diseases that impact bone tissue. As a result, GGT can be used as a follow-up test to establish whether an elevated ALP result is related to liver or bone illness.

When even small amounts of alcohol are consumed, GGT levels can sometimes rise. Chronic heavy drinkers have higher levels than persons who drink less than 2 to 3 drinks per day or who only drink heavily on rare occasions. The GGT test can be used to determine whether someone is suffering from acute or chronic alcoholism.

Lab tests often ordered with a GGT test:

• AST
• ALT
• ALP
• Bilirubin
• Hepatic Function Panel
• Ethanol
• Comprehensive Metabolic Panel

Conditions where a GGT test is recommended:

• Liver Disease
• Alcoholism
• Hepatitis
• Cirrhosis

Commonly Asked Questions:

How does my health care provider us a GGT test?

The gamma-glutamyl transferase test can be used to figure out why your alkaline phosphatase is high. In bile duct illness and several liver diseases, both ALP and GGT are increased, while only ALP is elevated in bone disease. As a result, if a person's GGT level is normal but their ALP is high, the culprit is most likely bone disease.

The GGT test can be used to diagnose liver disease and bile duct blockages. Other liver tests such as ALT, AST, ALP, and bilirubin are frequently ordered in conjunction with or as a follow-up to this test. An elevated GGT level shows that a person's liver is being damaged in general, but it does not particularly point to a condition that could be causing the damage.

GGT can be used to test for chronic alcohol abuse and to monitor for alcohol use in patients undergoing alcoholism or alcoholic hepatitis therapy.

What do my GGT test results mean?

An high GGT level indicates that the liver is being harmed by a condition or disease, but it does not specify what that ailment or disease is. In general, the higher the level, the worse the liver damage. Elevated levels can be caused by liver illnesses like cirrhosis or hepatitis, but they can also be caused by other conditions like congestive heart failure, diabetes, or pancreatitis. They can also be caused by alcohol misuse or the use of liver-toxic medications.

A GGT test result that is low or normal suggests that a person does not have liver disease or has not recently consumed alcohol.

A high GGT level can help rule out bone disease as the source of an elevated ALP level, but if GGT is low or normal, bone disease is the most likely explanation.

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

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. 

Description: A Magnesium test is a blood test that measures magnesium levels in your blood’s serum and is useful in determining the cause of abnormal levels of magnesium, calcium, and or potassium, and is useful in the evaluation of a wide variety of disorders such as diabetes, kidney disease, and malabsorption.

Also Known As: Magnesium Serum Test, Mg Test, Mag Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Magnesium test ordered?

Magnesium tests may be requested by health professionals as a follow-up to chronically low calcium and potassium levels in the blood. It may also be ordered if a person is experiencing muscle weakness, cramping, twitching, disorientation, seizures, or cardiac arrhythmias, which could be caused by a magnesium deficit.

As part of an evaluation of malabsorption, malnutrition, diarrhea, or alcoholism, a health practitioner may prescribe a magnesium level to check for a deficit. Testing may also be done if someone is taking drugs that cause the kidneys to excrete magnesium. When magnesium and/or calcium supplementation is required, the level of magnesium in the blood can be measured at regular intervals to ensure that the medication is working.

A magnesium test, along with kidney function tests such as a BUN and creatinine, may be given on a regular basis when someone has a kidney problem or uncontrolled diabetes to help monitor renal function and ensure that the person is not excreting or retaining excessive quantities of magnesium.

What does a Magnesium Serum test check for?

The magnesium test measures the amount of magnesium in your blood’s serum. Magnesium is a mineral that supports healthy bones, neuron function, muscle contraction and energy production. It enters the body through the diet and is then processed by the small intestine and colon. Tissues, cells, and bones all contain the element magnesium. It is challenging to determine the total magnesium content from blood tests alone since only 1% of the magnesium present in the body is accessible in the blood. However, this test is still useful for figuring out a person's magnesium levels.

Small levels of magnesium can be found in a range of meals, including green vegetables like spinach, whole grains, and nuts. Magnesium is commonly found in foods that contain dietary fiber. The body regulates how much magnesium it receives and excretes or conserves in the kidneys to keep its magnesium level stable.

Magnesium deficiency can occur as a result of malnutrition, malabsorption-related disorders, or excessive magnesium loss via the kidneys. Magnesium overload can occur as a result of taking magnesium-containing antacids or a decrease in the kidneys' ability to eliminate magnesium.

There may be no or few nonspecific symptoms in someone with mild to severe magnesium insufficiency. Loss of appetite, nausea, muscle cramps, confusion, exhaustion, seizures, changes in heart rate, and tingling or numbness are all symptoms of persistent or severe deficits. They can also wreak havoc on calcium metabolism and worsen calcium deficiency. Muscle weakness, nausea, loss of hunger or cravings, and an erratic heart rate are some of the symptoms of excess magnesium, which are similar to those of deficiency.

Lab tests often ordered with a Magnesium test:

• Complete Blood Count
• Calcium
• Iron Total and Total Iron binding capacity
• Potassium
• Comprehensive Metabolic Panel
• Lipid Panel
• Phosphorus
• Parathyroid Hormone
• Vitamin D
• Glucose

Conditions where a Magnesium test is recommended:

• Hypomagnesemia
• Hypermagnesemia
• Kidney Disease
• Hypothyroidism
• Diabetes
• Alcoholism
• Malnutrition
• Malabsorption
• Diarrhea
• Dehydration
• Parathyroid Diseases
• Addison Disease
• Adrenal Insufficiency

How does my health care provider use a Magnesium test?

Magnesium levels in the blood are measured with a magnesium test. Atypical magnesium levels are most frequently found in conditions or illnesses that result in insufficient or excessive renal excretion of magnesium or impaired intestinal absorption of magnesium. Magnesium levels can be measured to determine the severity of kidney issues, uncontrolled diabetes, as well as to diagnose gastrointestinal diseases.

Because a low magnesium blood level can lead to chronically low calcium and potassium levels over time, it may be tested to help diagnose calcium, phosphorus, potassium, and/or parathyroid hormone – another component of calcium regulation – problems.

Magnesium levels can be checked on a regular basis to monitor the response to oral or intravenous magnesium supplements, and calcium supplementation can be monitored using calcium and phosphorus tests.

What does my Magnesium test result mean?

Low magnesium levels in the blood can suggest that a person isn't getting enough magnesium or is excreting too much. Deficiencies are most commonly encountered in:

• Low nutritional intake 
• Gastrointestinal conditions
• Diabetes that is uncontrolled
• Hypoparathyroidism
• Use of a diuretic for a long time
• diarrhea that lasts for a long time
• Following surgery
• Burns that are severe
• Pregnancy toxicity

Magnesium levels in the blood are rarely elevated as a result of food sources, but rather as a result of an excretion problem or excessive supplementation. Increased levels can be cause by:

• Failure of the kidneys
• Hyperparathyroidism
• Hypothyroidism
• Dehydration
• Diabetic acidosis
• Addison's disese
• Use of antacids or laxatives containing magnesium

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

Metanephrines, Fractionated, Free, LC/MS/MS, Plasma

Patient Preparation: Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise prior to collection. Overnight fasting is preferred. Patients should be relaxed in either a supine or upright position before blood is drawn.

Limitations: False-positive results have been observed in patients with either chronic kidney disease or hypertension.

Clinical Significance: Normetanephrine (NM) and metanephrine (MN) are the extra-neuronal catechol-o-methyl transferase (COMT) metabolites of the catecholamines norepinephrine and epinephrine, respectively. Measurement of plasma metanephrines is more sensitive (but may be less specific) than measurement of catecholamines for the detection of pheochromocytoma. Proper interpretation of results requires awareness of recent medication/drug history (e.g., antyhypertensive agents, alcohol, cocaine) and other pre-analytical factors (e.g., stress, severe congestive heart failure, myocardial infarction) that influence release of catecholamines and metanephrines.

Drug Monitoring, Alcohol Metabolite, Quantitative, Urine

Clinical Significance
Drug Monitoring, Alcohol Metabolite, Quantitative, Urine - Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are minor metabolite of ethanol metabolites and excreted in urine for a longer time than ethanol. Positive EtG and/or EtS test results thus provide a strong indication that the person has recently consumed alcohol, even when ethanol is no longer detectable. The test is a definitive assay using liquid chromatography mass spectroscopy (LC/MS/MS) methodology. Therapeutic urine drug monitoring of these metabolites is important for ensuring compliance to treatment strategies. Urine or oral fluid are the specimens of choice for routine monitoring of patients taking prescription drugs. Use of serum/plasma should be limited to anuretic patients, or where a patient's clinical appearance does not coincide with their prescribed medications. No single monitoring approach provides adequate information about the pattern or dose of patient drug use. Safest prescribing habits should include a combination of tools and laboratory test results to correctly detect drug use patterns.

Includes
If you require medMATCH for this order code, you must also order code 39158 - Prescribed Drugs, medMATCH®. If 39158 is ordered, all Drug Monitoring order codes will be treated as medMATCH.
 
If this test code is not ordered with 39158, all medMATCH result codes will be DNR’d.
.
Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS)

Reference Range(s)
Ethyl Glucuronide (ETG)    <500 ng/mL
Ethyl Sulfate (ETS)    <100 ng/mL

Alternative Name(s)
Prescription Drug Monitoring,Pain Management

Drug Monitoring, Panel 6 with Confirmation, Urine

Clinical Significance
Drug Monitoring, Panel 6 with Confirmation, Urine - The test is a screening assay using a homogeneous enzyme immunoassay method of analysis. Presumptive positive screen results are reflexed to a more specific and sensitive liquid chromatography mass spectroscopy (LC/MS/MS) test. Therapeutic urine drug monitoring is important for ensuring compliance to treatment strategies, as well as ensuring non-diversion for illicit purposes. Urine or oral fluid are the specimens of choice for routine monitoring of patients taking prescription drugs. Use of serum/plasma should be limited to anuretic patients, or where a patient's clinical appearance does not coincide with their prescribed medications. No single monitoring approach provides adequate information about the pattern or dose of patient drug use. Safest prescribing habits should include a combination of tools and laboratory test results to correctly detect drug use patterns. Urine drug test results equal to or greater than cutoff are reported as positive and results less than cutoff are reported as negative. Quantitative values cannot be used to assess the drug dose, because the drug is extensively metabolized and excreted in the urine.

Includes
If you require medMATCH for this order code, you must also order code 39158 - Prescribed Drugs, medMATCH®. If 39158 is ordered, all Drug Monitoring order codes will be treated as medMATCH.
 
If this test code is not ordered with 39158, all medMATCH result codes will be DNR’d.
.
Initial screen of 6-Acetylmorphine, Alcohol Metabolites, Amphetamines, Barbiturates, Benzodiazepines, Marijuana Metabolite, Cocaine Metabolite, Methadone Metabolite, Opiates, Oxycodone, Phencyclidine drug classes. Specimen validity consisting of Creatinine, Oxidant, and pH testing.
If screen of drug class is positive, a confirmation of the drug class will be performed at an additional charge (CPT code(s): dependent upon the confirmed drug class).

Confirmation includes the following analytes within their associated drug class:

• 6-Acetylmorphine: 6-Acetylmorphine
• Alcohol Metabolites: Ethyl Glucuronide (ETG), Ethyl Sulfate (ETS)
• Amphetamines: Amphetamine, Methamphetamine
• Barbiturates: Amobarbital, Butalbital, Pentobarbital, Phenobarbital, Secobarbital
• Benzodiazepines: Alphahydroxyalprazolam, Alphahydroxymidazolam, Alphahydroxytriazolam, Aminoclonazepam, Hydroxyethylflurazepam, Lorazepam, Nordiazepam, Oxazepam, Temazepam
• Marijuana Metabolite: Marijuana Metabolite
• Cocaine Metabolite: Benzoylecgonine
• Methadone Metabolite: EDDP, Methadone
• Opiates: Codeine, Hydrocodone, Hydromorphone, Morphine, Norhydrocodone
• Oxycodone: Noroxycodone, Oxycodone, Oxymorphone
• Phencyclidine: Phencyclidine

Methodology
Screen: Immunoassay (IA) • Confirmation: Mass Spectrometry (MS)

Reference Range(s)
See Laboratory Report

Alternative Name(s)
Prescription Drug Monitoring,Pain Management

Drug Monitoring, Alcohol Metabolite, with Confirmation, Urine

Clinical Significance
Drug Monitoring, Alcohol Metabolite, with Confirmation, Urine - Ethyl glucuronide and ethyl sulfate are metabolites of ethanol (alcohol) that may be present in urine after ingestion of, or exposure to, drinks, foods, medication or other products containing ethyl alcohol. Incidental exposure to alcohol-containing products such as mouthwash or hand sanitizer have also been shown to produce positive alcohol metabolites test results. LC-MS/MS testing detects EtG and EtS regardless of the source. Therefore, we encourage you to interpret alcohol metabolite test results in light of the clinical picture.

Includes
If you require medMATCH for this order code, you must also order code 39158 - Prescribed Drugs, medMATCH®. If 39158 is ordered, all Drug Monitoring order codes will be treated as medMATCH.
 
If this test code is not ordered with 39158, all medMATCH result codes will be DNR’d.
.
Initial screen of the Alcohol Metabolites drug class. If screen is positive, a confirmation will be performed at an additional charge (CPT code(s): 80321 HCPCS: G0480).
Confirmation includes the following analytes: Ethyl Glucuronide (ETG), Ethyl Sulfate (ETS)

Reference Range(s)
Alcohol Metabolites    <500 ng/mL
  Ethyl Glucuronide (EtG)    <500 ng/mL
  Ethyl Sulfate (EtS)    <100 ng/mL

Alternative Name(s)
Prescription Drug Monitoring,Pain Management

Drug Monitoring, Panel 7 with Confirmation, Urine

Clinical Significance
Drug Monitoring, Panel 7 with Confirmation, Urine - The test is a screening assay using a homogeneous enzyme immunoassay method of analysis. Presumptive positive screen results are reflexed to a more specific and sensitive liquid chromatography mass spectroscopy (LC/MS/MS) test. Therapeutic urine drug monitoring is important for ensuring compliance to treatment strategies, as well as ensuring non-diversion for illicit purposes. Urine or oral fluid are the specimens of choice for routine monitoring of patients taking prescription drugs. Use of serum/plasma should be limited to anuretic patients, or where a patient's clinical appearance does not coincide with their prescribed medications. No single monitoring approach provides adequate information about the pattern or dose of patient drug use. Safest prescribing habits should include a combination of tools and laboratory test results to correctly detect drug use patterns. Urine drug test results equal to or greater than cutoff are reported as positive and results less than cutoff are reported as negative. Quantitative values cannot be used to assess the drug dose, because the drug is extensively metabolized and excreted in the urine.

Includes
If you require medMATCH for this order code, you must also order code 39158 - Prescribed Drugs, medMATCH®. If 39158 is ordered, all Drug Monitoring order codes will be treated as medMATCH.
 
If this test code is not ordered with 39158, all medMATCH result codes will be DNR’d.
.
Initial screen of 6-Acetylmorphine, Alcohol Metabolites, Amphetamines, Barbiturates, Benzodiazepines, Marijuana Metabolite, Cocaine Metabolite, Methadone Metabolite, Opiates, Oxycodone drug classes. Specimen validity consisting of Creatinine, Oxidant, and pH testing.
If screen of drug class is positive, a confirmation of the drug class will be performed at an additional charge (CPT code(s): dependent upon the confirmed drug class).
Confirmation includes the following analytes within their associated drug class:
6-Acetylmorphine: 6-Acetylmorphine
Alcohol Metabolites: Ethyl Glucuronide (ETG), Ethyl Sulfate (ETS)
Amphetamines: Amphetamine, Methamphetamine
Barbiturates: Amobarbital, Butalbital, Pentobarbital, Phenobarbital, Secobarbital
Benzodiazepines: Alphahydroxyalprazolam, Alphahydroxymidazolam, Alphahydroxytriazolam, Aminoclonazepam, Hydroxyethylflurazepam, Lorazepam, Nordiazepam, Oxazepam, Temazepam
Marijuana Metabolite: Marijuana Metabolite
Cocaine Metabolite: Benzoylecgonine
Methadone Metabolite: EDDP, Methadone
Opiates: Codeine, Hydrocodone, Hydromorphone, Morphine, Norhydrocodone
Oxycodone: Noroxycodone, Oxycodone, Oxymorphone

Alternative Name(s)
Prescription Drug Monitoring,Pain Management

Drug Monitoring, Panel 8 with Confirmation, Urine

Clinical Significance
Drug Monitoring, Panel 8 with Confirmation, Urine - The test is a screening assay using a homogeneous enzyme immunoassay method of analysis. Presumptive positive screen results are reflexed to a more specific and sensitive liquid chromatography mass spectroscopy (LC/MS/MS) test. Therapeutic urine drug monitoring is important for ensuring compliance to treatment strategies, as well as ensuring non-diversion for illicit purposes. Urine or oral fluid are the specimens of choice for routine monitoring of patients taking prescription drugs. Use of serum/plasma should be limited to anuretic patients, or where a patient's clinical appearance does not coincide with their prescribed medications. No single monitoring approach provides adequate information about the pattern or dose of patient drug use. Safest prescribing habits should include a combination of tools and laboratory test results to correctly detect drug use patterns. Urine drug test results equal to or greater than cutoff are reported as positive and results less than cutoff are reported as negative. Quantitative values cannot be used to assess the drug dose, because the drug is extensively metabolized and excreted in the urine.

Includes
If you require medMATCH for this order code, you must also order code 39158 - Prescribed Drugs, medMATCH®. If 39158 is ordered, all Drug Monitoring order codes will be treated as medMATCH.
 
If this test code is not ordered with 39158, all medMATCH result codes will be DNR’d.
.
Initial screen of 6-Acetylmorphine, Alcohol Metabolites, Amphetamines, Benzodiazepines, Buprenorphine, Marijuana Metabolite, Cocaine Metabolite, MDMA, Opiates, Oxycodone drug classes. Specimen validity consisting of Creatinine, Specific Gravity, Oxidant, and pH testing.
If screen of drug class is positive, a confirmation of the drug class will be performed at an additional charge (CPT code(s): dependent upon the confirmed drug class).
Confirmation includes the following analytes within their associated drug class:
6-Acetylmorphine: 6-Acetylmorphine
Alcohol Metabolites: Ethyl Glucuronide (ETG), Ethyl Sulfate (ETS)
Amphetamines: Amphetamine, Methamphetamine
Benzodiazepines: Alphahydroxyalprazolam, Alphahydroxymidazolam, Alphahydroxytriazolam, Aminoclonazepam, Hydroxyethylflurazepam, Lorazepam, Nordiazepam, Oxazepam, Temazepam
Buprenorphine: Buprenorphine, Norbuprenorphine
Marijuana Metabolite: Marijuana Metabolite
Cocaine Metabolite: Benzoylecgonine
MDMA: MDA, MDMA
Opiates: Codeine, Hydrocodone, Hydromorphone, Morphine, Norhydrocodone
Oxycodone: Noroxycodone, Oxycodone, Oxymorphone

Alternative Name(s)
Prescription Drug Monitoring,Pain Management