Congestive Heart Failure (CHF)

Description: An Alkaline Phosphatase test or ALP is a blood test that is used to screen for and monitor liver disease, bone disorders, and gallbladder disease.

Also Known As: ALP Test, Alk Phos Test, Alkp Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Alkaline Phosphatase test ordered?

An ALP test may be requested as a standard laboratory test, frequently in conjunction with a liver panel of further assays. When a person exhibits signs of a liver or bone issue, it is frequently requested in conjunction with a number of additional tests.

What does an Alkaline Phosphatase test check for?

An enzyme called alkaline phosphatase is present in many bodily tissues. The cells that make up bone and the liver have the highest quantities of ALP. Liver illness or bone diseases are the most frequent causes of high blood levels of ALP. The blood's concentration of ALP is determined by this test.

ALP is located in the liver on the margins of cells that converge to form bile ducts, which are minuscule tubes that transport bile from the liver to the bowels, where it is required to aid in the digestion of dietary fat. Osteoblasts, specialized cells involved in bone production, are responsible for producing ALP in bone. Isoenzymes, which are produced in unique forms by each type of tissue, are ALP.

For instance, when one or more bile ducts are obstructed, ALP blood levels may significantly rise. Gallbladder inflammation or gallstones may be the cause of this. Blood ALP levels rise slightly more subtly in cirrhosis, liver cancer, hepatitis, and when liver-toxic medications are used.

Increased ALP levels can result from any condition that promotes excessive bone growth, including bone diseases like Paget's disease. Because their bones are still growing, children and adolescents often have higher blood ALP levels. Because of this, the ALP test needs to be interpreted differently for children and adults.

It is feasible to distinguish between the various ALP forms generated by various bodily tissues. A test may be run to identify which isoenzyme is elevated in the blood if it is unclear from clinical signs and symptoms whether the cause of a high ALP test result is liver or bone illness.

Lab tests often ordered with an Alkaline Phosphatase test:

• AST
• ALT
• GGT
• Bilirubin
• Comprehensive Metabolic Panel
• Hepatic Function Panel
• Alkaline Phosphatase Isoenzymes

Conditions where an Alkaline Phosphatase test is recommended:

• Lier Disease
• Hepatitis
• Cirrhosis
• Jaundice
• Osteoporosis
• Paget’s Disease
• Vitamin D Deficiency

How does my health care provider use an Alkaline Phosphatase test?

Using the alkaline phosphatase test, liver disease and bone diseases can be found.

Damaged liver cells produce more ALP into the blood under situations that harm the liver. Because ALP levels are particularly high at the margins of the cells that unite to form bile ducts, this test is frequently used to identify obstructed bile ducts. Blood levels of ALP are frequently high when one or more of them are blocked, such as by a tumor.

ALP levels in the blood can be impacted by any illness or disease that hinders bone development or increases bone cell activity. For instance, an ALP test may be used to identify tumors that have metastasized to the bones or to identify Paget's disease, a condition that results in deformed bones. This examination could occasionally be used to track the progress of patients being treated for Paget's disease or other bone disorders such vitamin D insufficiency.

Tests for the ALP isoenzyme may be performed to identify the cause if ALP readings are elevated but it is unclear whether this is related to liver or bone illness. To distinguish between liver and bone illness, one may additionally perform a GGT test and/or a test for 5'-nucleotidase. The levels of GGT and 5'-nucleotidase are elevated in liver illness but not in disorders of the bones.

What do my Alkaline Phosphatase test results mean?

High ALP typically indicates the presence of a disease that increases bone cell activity or liver damage.

The liver is typically where the elevated ALP is coming from if other liver tests, such as bilirubin, aspartate aminotransferase, or alanine aminotransferase, are also high. The high ALP is probably the result of liver illness if GGT or 5-nucleotidase levels are also elevated. If one of these two tests comes out normal, a bone issue is probably to blame for the high ALP. The ALP is typically coming from bone if calcium and/or phosphorus readings are abnormal.

A test for ALP isoenzymes may be required to differentiate between bone and liver ALP if it is unclear from signs and symptoms or other regular testing whether the high ALP is from the liver or bone.

ALP test findings are typically analyzed alongside those of other liver disease testing. ALP is commonly significantly less increased than AST and ALT in several types of liver illness, such as hepatitis. ALP and bilirubin may increase substantially higher than AST or ALT when the bile ducts are obstructed. ALP levels in liver cancer may also be higher.

ALP may be elevated in some bone illnesses, such as Paget's disease, which causes enlarged and misshapen bones, or in some cancers that extend to the bone.

ALP levels will eventually drop or return to normal if Paget's disease is successfully treated in a patient. ALP levels should fall if someone with liver or bone cancer responds to therapy.

Other illnesses include Hodgkin's lymphoma, congestive heart failure, ulcerative colitis, and specific bacterial infections can cause moderately high ALP.

ALP levels may briefly drop after cardiac bypass surgery or blood transfusions. Levels may drop as a result of a zinc deficiency. Hypophosphatasia, a rare genetic bone metabolism condition, can result in extremely low levels of ALP that persist for a long time. Wilson disease, protein insufficiency, and malnutrition are further potential reasons of low ALP.

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

Description: The BNP test measures levels of B-Type Natriuretic peptide in your blood plasma to detect heart failure.

Also Known As: Brain Natriuretic Peptide Test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

When is a B-Type Natriuretic Peptide test ordered?

When a person exhibits signs and symptoms that could indicate heart failure, a doctor may request a BNP test.

When someone is in a crisis or has symptoms that could be due to heart failure, testing may be done in the emergency room to identify if they have heart failure or another medical problem.

When a person is being treated for heart failure, several BNP tests may be performed throughout time to track the effects of the treatment.

What does a B-Type Natriuretic Peptide blood test check for?

N-terminal propeptide and B-type natriuretic peptide are chemicals created and released when the heart is strained and working hard to pump blood. BNP and NT-proBNP tests are used to detect and evaluate heart failure by measuring their levels in the blood.

Because it was first discovered in brain tissue, BNP was given the name brain natriuretic peptide. The left ventricle of the heart is the primary producer of BNP. It has to do with blood volume and pressure, as well as the amount of work the heart has to do in pumping blood around the body. The heart produces small amounts of a precursor protein called pro-BNP on a regular basis. The enzyme corin then cleaves pro-BNP, releasing the active hormone BNP and an inactive fragment, NT-proBNP, into the bloodstream.

When the heart’s left ventricle is stretched, the levels of BNP and NT-proBNP generated rise dramatically. This signifies that the heart is working harder and having more difficulty keeping up with the needs of the body. This might happen as a result of heart failure or other disorders that affect the heart and circulatory system. The term “heart failure” can be deceptive. It doesn’t mean the heart has stopped beating; it simply indicates it isn’t pumping blood as efficiently as it should be. This reduced capacity will be reflected in an increase in circulating BNP or NT-proBNP.

Lab tests often ordered with a B-Type Natriuretic Peptide test:

• Troponin I
• Creatine Kinase (CK)
• Myoglobin
• Hs-CRP
• NT-proBNP
• Comprehensive Metabolic Panel (CMP)
• Electrolytes
• Complete Blood Count (CBC)

Conditions where a B-Type Natriuretic Peptide test is recommended:

• Congestive Heart Failure
• Heart Disease
• Angina
• Heart Attack
• Acute Coronary Syndrome

How does my health care provider use a B-Type Natriuretic Peptide test?

B-type natriuretic peptide testing is most commonly used to identify, diagnose, and assess the severity of heart failure. It can be used in conjunction with other cardiac biomarker tests to detect heart stress and damage, or it can be used in conjunction with lung function tests to differentiate between causes of shortness of breath. X-rays of the chest and an ultrasound test called echocardiogram may be used.

Heart failure can be misdiagnosed as other illnesses, and it can coexist with them. BNP levels can aid doctors in distinguishing between heart failure and other issues like pulmonary illness. Because the therapies are typically diverse and must be started as soon as possible, a precise diagnosis is critical.

Although BNP is commonly used to detect heart failure, an elevated level in those who have had an acute coronary syndrome implies a higher risk of repeat episodes. As a result, a health care provider can use BNP to assess the risk of a future cardiac attack in someone who has ACS.

What do my BNP test results mean?

Higher-than-normal results indicate that a person has heart failure, and the level of BNP in the blood is linked to the severity of the condition. BNP levels beyond a certain threshold are generally linked to a poor prognosis.

The person's symptoms are most likely caused by anything other than heart failure if the results are normal.

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

Description: A Basic Metabolic Panel is a blood test used to screen for, diagnose, and monitor a variety of conditions and diseases such as diabetes and kidney disease.  

Also Known As: BMP, Chemistry Panel, Chemistry Screen, Chem 7, Chem 11, BMP Test, SMA 7, SMAC7, Basic Metabolic Test, Chem Test, Chem Panel Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred. 

When is a Basic Metabolic Panel test ordered?  

A BMP may be requested as part of a standard physical examination. 

The panel is frequently ordered in hospital emergency rooms because its components provide vital information regarding a person's renal state, electrolyte and acid/base balance, blood glucose, and calcium levels. Significant changes in these test results can suggest serious issues such as renal failure, insulin shock or diabetic coma, respiratory distress, or abnormalities in heart rhythm. 

What does a Basic Metabolic Panel blood test check for? 

The basic metabolic panel (BMP) is a 9-test panel that provides essential information to a health practitioner about a person's current metabolic status, including kidney health, blood glucose level, electrolyte and acid/base balance. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the BMP test: 

• 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 also 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. 

• 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. 

• Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

• Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood Urea Nitrogen (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 Basic Metabolic Panel test: 

• Complete Blood Count with Differential and Platelets
• Hemoglobin A1c
• Iron and Total Iron Binding Capacity
• Lipid Panel
• Insulin
• Vitamin B12 and Folate
• C-Reactive Protein

Conditions where a Basic Metabolic Panel test is recommended: 

• Diabetes 
• Kidney Disease 
• Liver Disease 

Commonly Asked Questions: 

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

The basic metabolic panel (BMP) is used to evaluate a person's kidney function, electrolyte, acid/base balance, and blood glucose level, all of which are linked to their metabolism. It can also be used to keep track of hospitalized patients and persons with known illnesses like hypertension and hypokalemia. 

If a health practitioner wants to track two or more separate BMP components, the full BMP might be ordered because it contains more information. Alternatively, when monitoring, the healthcare provider may order specific tests, such as a follow-up glucose, potassium, or calcium test, or an electrolyte panel to track sodium, potassium, chloride, and CO2. If a doctor needs further information, he or she can request a comprehensive metabolic panel (CMP), which is a collection of 21 tests that includes the BMP. 

What do my Basic Metabolic Panel results mean? 

The results of the tests included in the BMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. 

Out-of-range results on any of the BMP's tests can be caused by a number of things, including kidney failure, breathing issues, and diabetes-related consequences. 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? 

The results of the BMP components can be influenced by a range of prescription and over-the-counter medicines. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide them with a thorough medical history because many other circumstances can influence how your results are interpreted. 

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 BUN/Creatinine ratio test is a blood test that measures levels of Urea Nitrogen and Creatinine in your blood and is useful in the diagnosis of renal disease.

Also Known As: Urea Nitrogen and Creatinine Ratio test, BUN test, Urea test, Urea Nitrogen test, Creat test, Blood Creatinine Test, Serum Creatinine Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a BUN Creatinine Ratio test ordered?

BUN is a component of the BMP and CMP, two categories of widely-used tests:

• as part of a regular health examination
• prior to beginning the use of specific pharmacological therapy, determine how well the kidneys are functioning.
• When a patient who is critically ill visits the emergency room or is admitted to the hospital

When kidney problems are suspected during a hospital stay, BUN is frequently ordered along with creatinine or a renal panel. Kidney dysfunction can show several indications and symptoms, such as:

• fatigue, inability to focus, poor appetite, or difficulty sleeping
• Swelling or puffiness, especially in the face, wrists, abdomen, thighs, or ankles or around the eyes
• Foamy, bloody, or coffee-colored urine
• a reduction in the urine's volume
• problems urinating, such as a burning sensation or an unusual discharge, or a change in frequency, particularly at night
• discomfort in the middle of the back, below the ribs, and next to the kidneys
• elevated blood pressure

BUN may also be required for:

• Patients with long-term illnesses or conditions like diabetes, congestive heart failure, and myocardial infarction should have regular kidney function checks.
• monitoring renal function and treatment at frequent intervals in individuals with known kidney disease
• Monitoring kidney function both before and after taking specific medications
• When a CT scan is anticipated, furthermore to a creatinine
• periodically to check on the efficiency of the dialysis

During a health examination, a routine metabolic panel that includes creatinine may be ordered. It might be prescribed if a patient is critically ill or if a doctor has reason to believe that their kidneys aren't functioning properly. Kidney dysfunction can show several indications and symptoms, such as:

• fatigue, inability to focus, poor appetite, or difficulty sleeping
• Swelling or puffiness, especially in the face, wrists, abdomen, thighs, or ankles, or around the eyes
• Foamy, bloody, or coffee-colored urine
• a reduction in the urine's volume
• problems urinating, such as a burning sensation or an unusual discharge, or a change in frequency, particularly at night
• discomfort in the middle of the back, below the ribs, and next to the kidneys
• elevated blood pressure

When a person has a known kidney ailment or a condition that could impair kidney function, a creatinine blood test may be prescribed along with a BUN test, urine albumin, and other tests on a regular basis. When a CT scan is anticipated, before and throughout some medication regimens, as well as before and after dialysis, both BUN and creatinine may be requested to check the efficacy of treatments.

What does a BUN Creatinine Ratio test check for?

When protein is broken down into its constituent parts in the liver, urea is produced as a waste product. Ammonia is created during this process, and it is later changed into the less harmful waste product urea. This examination counts the urea nitrogen levels in the blood.

Ammonia and urea both contain nitrogen as an ingredient. Because urea contains nitrogen and because the body excretes excess nitrogen via urea/urea nitrogen, the terms urea and urea nitrogen are sometimes used interchangeably. The liver releases urea into the blood, which travels to the kidneys where it is removed from the circulation and discharged as urine. Since this is a continuous process, urea nitrogen levels in the blood are typically low and steady.

The majority of illnesses or ailments that affect the liver or kidneys have the potential to have an impact on the blood's urea content. Urea concentrations in the blood will increase if the liver produces more urea or if the kidneys are not functioning properly and are having trouble removing wastes from the blood. BUN values may decrease if severe liver illness or injury prevents the synthesis of urea.

Muscles release creatinine as a waste product after breaking down a substance called creatine. The kidneys eliminate creatinine from the body by filtering nearly all of it from the blood and releasing it into the urine. The creatinine level in the blood and/or urine is determined by this test.

The process that creates the energy required to contract muscles includes creatine. The body produces both creatine and creatinine at a fairly steady rate. Blood levels are typically a good indication of how well the kidneys are functioning since the kidneys filter almost all of the creatinine from the blood and release it into the urine. The amount created is influenced by a person's size and muscular mass. As a result, men's creatinine levels will be a little bit greater than those of women and children.

Calculations that are used to assess kidney function can be done using data from a blood creatinine test in conjunction with data from other tests, including a 24-hour urine creatinine test.

Lab tests often ordered with a BUN Creatinine Ratio test:

• Urine Protein
• eGFR
• Creatinine Clearance
• Comprehensive Metabolic Panel
• Basic Metabolic Panel
• Cystatin C
• Renal Panel
• Urinalysis
• Microalbumin
• Beta-2 Microglobin

Conditions where a BUN Creatinine Ratio test is recommended:

• Kidney Disease
• Diabetes
• Hypertension
• Proteinuria

How does my health care provider use a BUN Creatinine Ratio test?

The creatinine test and blood urea nitrogen tests are primarily used to assess kidney function under various conditions, aid in the diagnosis of kidney illness, and keep track of persons who have either acute or chronic renal failure or dysfunction. When requested as a component of a renal panel, basic metabolic panel, or comprehensive metabolic panel, it may also be used to assess a person's overall health state.

When protein is digested in the liver, urea is produced as a waste product. The liver releases urea into the blood, which travels to the kidneys where it is removed from the circulation and discharged as urine. Since this is a continuous process, urea nitrogen levels in the blood are typically low and steady. However, the level of urea in the blood will increase if the kidneys become diseased or damaged and are unable to remove waste products from the blood.

The kidneys are a pair of bean-shaped organs that are situated on the right and left sides of the back at the base of the ribcage. They include around a million nephrons, which are very small blood filtering organs. Blood is continuously filtered via a glomerulus, a tiny collection of looping blood arteries, in each nephron. Water and tiny molecules can pass through the glomerulus, while blood cells and bigger molecules are retained. Each glomerulus has a little tube attached to it that gathers the fluid and molecules that flow through it and reabsorbs what the body can use. Urine is created by the leftover waste.

Creatinine and BUN tests may be performed to monitor for renal dysfunction and the efficacy of treatment if the results are abnormal or if a person has an underlying condition known to impact the kidneys, such as diabetes or high blood pressure. Before some procedures, such a CT scan, that can call for the use of medications that can harm the kidneys, such as creatinine and BUN tests in the blood may also be prescribed to assess renal function.

What do my BUN Creatinine Ratio test results mean?

BUN levels that are higher indicate poor renal health. This could be brought on by failure, injury, or acute or chronic renal disease. A condition that reduces blood flow to the kidneys, such as congestive heart failure, shock, stress, a recent heart attack, or serious burns, as well as conditions that impede urine flow or dehydration, may also be to blame.

When there is excessive protein breakdown, a considerable rise in the amount of protein in the diet, or gastrointestinal bleeding, BUN values may be increased.

Low BUN levels are rare and typically not reason for alarm. The BUN test is not typically used to diagnose or monitor these disorders, but they may appear in severe liver illness, malnutrition, and occasionally when a person is overhydrated.

BUN values may be normal even in the presence of substantial malfunction in the other kidney if one kidney is fully functional.

Blood creatinine levels that are higher than normal point to renal disease or other disorders that have an impact on kidney function. These may consist of:

For instance, infections or autoimmune illnesses can cause kidney blood vessels to enlarge or become damaged.

• infection of the kidneys with bacteria
• death of kidney cells brought on by chemicals or medications, for instance, in the tiny tubes of the kidneys
• Urinary tract obstruction can be brought on by prostate disease, kidney stones, or other conditions.
• reduced renal blood flow brought on by shock, dehydration, congestive heart failure, atherosclerosis, or diabetes-related problems

Although they are uncommon, low blood creatinine levels are often not a cause for alarm. They can be observed in diseases that cause a loss of muscular mass.

As part of a creatinine clearance test, 24-hour urine creatinine levels are compared to blood levels.

There are no established reference ranges for single, random urine creatinine values. They are typically used in conjunction with other exams to compare levels of other chemicals detected in urine. The urine albumin test, the urine albumin/creatinine ratio, and the urine protein test are a few examples.

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

Description: A hs-CRP or High Sensitivity C-Reactive Protein test is a blood test used to accurately detect lower concentrations of the protein C-Reactive Protein. This test is used to evaluate your risk of cardiovascular and heart disease and to check for inflammation and many other issues.

Also Known As: hsCRP Test, Cardiac CRP Test, high sensitivity C-reactive protein Test, CRP Test for heart disease.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a hs-CRP test ordered?

There is currently no consensus on when to get an hs-CRP test. It may be beneficial for treatment purposes to order hs-CRP for those that have kidney disease, diabetes or inflammatory disorders.

It's possible that hs-CRP will be tested again to confirm that a person has persistently low levels of inflammation.

What does a hs-CRP blood test check for?

C-reactive protein is a protein found in the blood that rises in response to infection and inflammation, as well as after trauma, surgery, or a heart attack. As a result, it's one of numerous proteins referred to as acute phase reactants. The high-sensitivity CRP test detects low levels of inflammation in the blood, which are linked to an increased risk of developing cardiovascular disease.

According to the American Heart Association, CVD kills more people in the United States each year than any other cause. A number of risk factors have been related to the development of CVD, including family history, high cholesterol, high blood pressure, being overweight or diabetic, however a considerable number of people with few or no recognized risk factors will also acquire CVD. This has prompted researchers to investigate for new risk variables that could be causing CVD or could be used to identify lifestyle modifications and/or treatments that could lower a person's risk.

High-sensitivity CRP is one of an increasing number of cardiac risk markers that may be used to assess an individual's risk. According to certain research, monitoring CRP with a highly sensitive assay can assist identify the risk level for CVD in persons who appear to be healthy. CRP levels at the higher end of the reference range can be measured with this more sensitive test. Even when cholesterol levels are within an acceptable range, these normal but slightly elevated levels of CRP in otherwise healthy persons might indicate the future risk of a heart attack, sudden cardiac death, stroke, and peripheral artery disease.

Lab tests often ordered with a hs-CRP test:

• Complete Blood Count
• Lipid Panel
• Comprehensive Metabolic Panel
• Lp-Pla2
• Glucose

Conditions where a hs-CRP test is recommended:

• Heart Attack
• Heart Disease
• Cardiovascular Disease
• Stroke

How does my health care provider use a hs-CRP test?

A test for high-sensitivity C-reactive protein can be used to assess a person's risk of cardiovascular disease. It can be used in conjunction with a lipid profile or other cardiac risk markers, such as the lipoprotein-associated phospholipase A2 test, to provide further information regarding the risk of heart disease.

CRP is a protein that rises in the bloodstream as a result of inflammation. A continuous low level of inflammation, according to studies, plays a crucial role in atherosclerosis, the narrowing of blood vessels caused by the build-up of cholesterol and other lipids, which is typically linked to CVD. The hs-CRP test successfully detects low levels of C-reactive protein, indicating low but chronic inflammation, and so aids in predicting a person's risk of developing CVD.

Some specialists believe that high-sensitivity CRP is a good test for assessing CVD, heart attacks, and stroke risk, and that it can help in the evaluation process before a person gets one of these health problems. Some experts believe that combining a good marker for inflammation, such as hs-CRP, with a lipid profile is the best way to predict risk. This test has been recommended by several organizations for persons who are at a moderate risk of having a heart attack in the following ten years.

What does my hs-CRP test result mean?

Even when cholesterol levels are within an acceptable range, high levels of hs-CRP in otherwise healthy people have been found to predict an elevated risk of future heart attacks, strokes, sudden cardiac death, and/or peripheral arterial disease.

Higher hs-CRP concentrations indicate a higher risk of cardiovascular disease, while lower values indicate a lower risk. Individuals with hs-CRP values at the high end of the normal range are 1.5 to 4 times more likely than those with low levels of hs-CRP to have a heart attack.

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

Description: The proBNP N-Terminal test measures levels of B-Type Natriuretic peptide in your blood plasma to detect heart failure.

Also Known As: Brain Natriuretic Peptide Test, proBNP test,

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Dietary supplements containing biotin may interfere in assays and may skew results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.

When is an N-Terminal proBNP test ordered?

When a person exhibits signs and symptoms that could indicate heart failure, a doctor may request a BNP test.

When someone is in a crisis or has symptoms that could be due to heart failure, testing may be done in the emergency room to identify if they have heart failure or another medical problem.

When a person is being treated for heart failure, several BNP tests may be performed throughout time to track the effects of the treatment.

What does an NT-proBNP blood test check for?

N-terminal propeptide and B-type natriuretic peptide are chemicals created and released when the heart is strained and working hard to pump blood. BNP and NT-proBNP tests are used to detect and evaluate heart failure by measuring their levels in the blood.

Because it was first discovered in brain tissue, BNP was given the name brain natriuretic peptide. The left ventricle of the heart is the primary producer of BNP. It has to do with blood volume and pressure, as well as the amount of work the heart has to do in pumping blood around the body. The heart produces small amounts of a precursor protein called pro-BNP on a regular basis. The enzyme corin then cleaves pro-BNP, releasing the active hormone BNP and an inactive fragment, NT-proBNP, into the bloodstream.

When the heart’s left ventricle is stretched, the levels of BNP and NT-proBNP generated rise dramatically. This signifies that the heart is working harder and having more difficulty keeping up with the needs of the body. This might happen as a result of heart failure or other disorders that affect the heart and circulatory system. The term “heart failure” can be deceptive. It doesn’t mean the heart has stopped beating; it simply indicates it isn’t pumping blood as efficiently as it should be. This reduced capacity will be reflected in an increase in circulating BNP or NT-proBNP.

Lab tests often ordered with an NT-proBNP test:

• Troponin I
• Creatine Kinase (CK)
• Myoglobin
• Hs-CRP
• BNP
• Comprehensive Metabolic Panel (CMP)
• Electrolytes
• Complete Blood Count (CBC)

Conditions where an NT-proBNP test is recommended:

• Congestive Heart Failure
• Heart Disease
• Angina
• Heart Attack
• Acute Coronary Syndrome

How does my health care provider use an NT-proBNP test?

Pro B-type natriuretic peptide testing is most commonly used to identify, diagnose, and assess the severity of heart failure. It can be used in conjunction with other cardiac biomarker tests to detect heart stress and damage, or it can be used in conjunction with lung function tests to differentiate between causes of shortness of breath. X-rays of the chest and an ultrasound test called echocardiogram may be used.

Heart failure can be misdiagnosed as other illnesses, and it can coexist with them. proBNP levels can aid doctors in distinguishing between heart failure and other issues like pulmonary illness. Because the therapies are typically diverse and must be started as soon as possible, a precise diagnosis is critical.

Although proBNP is commonly used to detect heart failure, an elevated level in those who have had an acute coronary syndrome implies a higher risk of repeat episodes. As a result, a health care provider can use BNP to assess the risk of a future cardiac attack in someone who has ACS.

What do my proBNP N-Terminal test results mean?

Higher-than-normal results indicate that a person has heart failure, and the level of proBNP in the blood is linked to the severity of the condition. proBNP levels beyond a certain threshold are generally linked to a poor prognosis.

The person's symptoms are most likely caused by anything other than heart failure if the results are normal.

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

Clinical Significance

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

Description: The Cholesterol Total test is a blood test used to check levels of cholesterol in your blood’s serum to determine risk of heart disease.

Also Known As: Blood Cholesterol Test, Total Cholesterol Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: If a cholesterol measurement is to be performed along with triglycerides, the patient should be fasting for at least 9 hours.

When is a Cholesterol Total test ordered?

Cholesterol testing is advised as a screening test for all persons without heart disease risk factors at least once every four to six years. It is frequently combined with a standard physical examination.

When a person has one or more risk factors for heart disease, their cholesterol is tested more frequently.

Children and young people should have their lipid profiles checked for elevated cholesterol. Between the ages of 9 and 11, and again between the ages of 17 and 21, they should be tested. Children and teenagers who are at a higher risk of developing heart disease as adults should be screened with a lipid profile earlier and more frequently. A family history of heart disease or health problems such as diabetes, high blood pressure, or being overweight are some of the risk factors, which are comparable to those in adults. Cholesterol testing is indicated when a child's BMI is at or above the 85th percentile. Laboratory testing to evaluate cholesterol levels may be recommended every two years for an obese adolescent.

According to the American Academy of Pediatrics, high-risk children should receive their first cholesterol test between the ages of 2 and 8. Children under the age of two are not eligible for testing. The fasting test should be repeated in three to five years if the initial results are not alarming.

Total cholesterol tests may be conducted at regular intervals as part of a lipid profile to assess the success of lipid-lowering lifestyle changes like diet and exercise, or to determine the efficacy of medication therapy like statins. Adults on statins should have a fasting lipid profile done 4 to 12 weeks after commencing therapy and then every 3 to 12 months after that to ensure that the drug is effective, according to the American College of Cardiology and the American Heart Association.

What does a Cholesterol Total blood test check for?

Cholesterol is a vital component of life. It creates cell membranes in all of the body's organs and tissues. Hormones required for development, growth, and reproduction are produced using it. It produces bile acids, which are necessary for food absorption. The total cholesterol transported in the blood by lipoproteins is measured by the cholesterol test.

Lipoproteins are complex particles that carry a small quantity of cholesterol in the blood. Each particle comprises a mixture of protein, cholesterol, triglyceride, and phospholipid molecules, and they are classed as high-density lipoproteins, low-density lipoproteins, or very low-density lipoproteins based on their density. LDL-C particles, also known as "bad" cholesterol, deposit cholesterol in tissues and organs whereas HDL-C particles take excess cholesterol away for disposal.

It is critical to monitor and maintain good cholesterol levels in order to stay healthy. The body manufactures the cholesterol it needs to function correctly, although some cholesterol comes from food. If a person has a hereditary propensity to high cholesterol levels or consumes too many foods high in saturated and trans unsaturated fats, the amount of cholesterol in their blood may rise, posing a health risk. Plaques on the walls of blood arteries may form as a result of excess cholesterol in the circulation. Plaques can constrict or block blood channel openings, resulting in artery hardening (atherosclerosis) and an increased risk of a variety of health problems, including heart disease and stroke.

Lab tests often ordered with a Cholesterol Total test:

• Lipid Panel
• HDL Cholesterol
• LDL Cholesterol
• Triglycerides
• Lipoprotein Fractionation Ion Mobility

Conditions where a Cholesterol Total test is recommended:

• Heart Disease
• Cardiovascular Disease
• Heart Attack
• Stroke

How does my health care provider use a Cholesterol Total test?

The total cholesterol test is used alone or in conjunction with a lipid profile to assist forecast an individual's risk of developing heart disease and to help determine what treatment may be required if the risk is borderline or high. It can also be used to evaluate the effectiveness of treatment once it is started as part of a lipid profile

Cholesterol testing is considered a normal aspect of preventative healthcare because high blood cholesterol has been linked to artery hardening, heart disease, and an increased risk of mortality from heart attacks.

The results of the cholesterol test and other components of the lipid profile, as well as other recognized heart disease risk factors, are utilized to build a treatment and follow-up strategy. Treatment options may include lipid-lowering medicines such as statins or lifestyle changes such as diet and exercise regimens.

What do my Cholesterol test results mean?

Healthy lipid levels, in general, aid in the maintenance of a healthy heart and reduce the risk of heart attack or stroke. To evaluate a person's overall risk of heart disease, if therapy is necessary, and, if so, which treatment will best serve to minimize the person's risk, a healthcare practitioner will consider total cholesterol results and the other components of a lipid profile, as well as other risk factors.

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Electrolyte Panel test ordered?

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

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

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

What does an Electrolyte Panel test check for?

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

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

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

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

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

Lab tests often ordered with an Electrolyte Panel test:

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

Conditions where an Electrolyte Panel test is recommended:

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

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

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

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

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

The electrolyte panel includes tests for the following electrolytes:

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

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

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

What do my electrolyte panel test results mean?

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

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

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

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

Description: A 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.

Galectin-3

Clinical Significance

A galectin-3 test may be ordered for the identification of individuals with chronic heart failure at elevated risk of disease progression.

Performing Laboratory 

Cleveland HeartLab, Inc 
6701 Carnegie Avenue, Suite 500
Cleveland, OH 44103-4623

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for at least 8 hours is preferred

When is a Homocysteine test ordered?

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

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

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

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

What does a Homocysteine blood test check for?

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

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

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

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

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

Lab tests often ordered with a Homocysteine test:

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

Conditions where a Homocysteine test is recommended:

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

How does my health care provider use a Homocysteine test?

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

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

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

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

What do my homocysteine test results mean?

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

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

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

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

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

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

Description: 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.

Description: Iron is a blood test 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 Total Test, IBC Test, Iron Lab Test, Iron Blood test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: The patient should be fasting 9-12 hours prior to collection and collection should be done in the morning.

When is an Iron Total test ordered?

When a doctor feels that a person's symptoms are caused by iron overload or poisoning, an iron 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 testing 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 an Iron Total blood test check for?

Iron is a necessary ingredient for survival and is a critical component of hemoglobin, the protein in red blood cells that binds oxygen in the lungs and releases it to other parts of 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.

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 an Iron Total test:

• Complete Blood Count
• Ferritin
• Transferrin
• Zinc Protoporphyrin

Conditions where an Iron Total test is recommended:

• Anemia
• Hemochromatosis

How does my health care provider use an Iron Total 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.

Clinical Significance
Micronutrient, Iron - Serum measurements are useful in the diagnosis of iron deficiency and hemochromatosis.

Patients must be 18 years of age or greater.

Patient Preparation
Samples should be taken in the morning from patients in a fasting state, since iron values decrease by 30% during the course of the day and there can be significant interference from lipemia.
 

Reference Range(s)

Reference range not available for individuals <18 years for this micronutrient test.

Clinical Significance
Micronutrients, Mineral/Element Panel

Patients must be 18 years of age or greater.

Overnight fasting is required.
Refrain from taking vitamins or mineral supplements 3 days before specimen collection and from eating legumes and leafy vegetables 2 days before specimen collection.

Includes

• Micronutrient, Calcium
• Micronutrient, Chromium, Blood
• Micronutrient, Copper, Plasma
• Micronutrient, Iron
• Micronutrient, Magnesium, RBC
• Micronutrient, Manganese, Blood
• Micronutrient, Molybdenum, Blood
• Micronutrient, Selenium, Blood
• Micronutrient, Zinc, Plasma

Description: A Lipid Panel is a blood test that measures your cholesterol levels to evaluate your risk of cardiovascular disease. 

Also Known As: Lipid Profile Test, Lipid Test, Cholesterol Profile Test, Cholesterol Panel Test, Cholesterol Test, Coronary Risk Panel Test, lipid blood test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: Patient should be fasting 9-12 hours prior to collection.

When is a Lipid Panel test ordered?  

A fasting lipid profile should be done about every five years in healthy persons who have no additional risk factors for heart disease. A single total cholesterol test, rather than a complete lipid profile, may be used for initial screening. If the screening cholesterol test result is high, a lipid profile will almost certainly be performed. 

More regular testing with a full lipid profile is indicated if other risk factors are present or if earlier testing revealed a high cholesterol level. 

Other risk factors, in addition to high LDL cholesterol, include: 

• Smoking 
• Obesity or being overweight 
• Unhealthy eating habits 
• Not getting enough exercise and being physically inactive 
• Older age 
• Having hypertension 
• Premature heart disease in the family 
• Having experienced a heart attack or having pre-existing heart disease 

Diabetes or pre-diabetes is a condition in which a person has High HDL is a "negative risk factor," and its existence permits one risk factor to be removed from the total. 

The American Academy of Pediatrics recommends routine lipid testing for children and young adults. Children and teenagers who are at a higher risk of developing heart disease as adults should be screened with a lipid profile earlier and more frequently. A family history of heart disease or health problems such as diabetes, high blood pressure, or being overweight are some of the risk factors, which are comparable to those in adults. According to the American Academy of Pediatrics, high-risk children should be examined with a fasting lipid profile between the ages of 2 and 8. 

A lipid profile can also be done at regular intervals to assess the effectiveness of cholesterol-lowering lifestyle changes like diet and exercise, as well as pharmacological therapy like statins. 

What does a Lipid Panel blood test check for? 

Lipids are a class of fats and fat-like compounds that are essential components of cells and energy sources. The level of certain lipids in the blood is measured by a lipid profile. 

Lipoprotein particles transport two key lipids, cholesterol, and triglycerides, through the bloodstream. Protein, cholesterol, triglyceride, and phospholipid molecules are all present in each particle. High-density lipoproteins, low-density lipoproteins, and very low-density lipoproteins are the three types of particles assessed with a lipid profile. 

It's critical to keep track of and maintain optimal levels of these lipids in order to stay healthy. While the body creates the cholesterol required for normal function, some cholesterol is obtained from the diet. A high amount of cholesterol in the blood can be caused by eating too many foods high in saturated fats and trans fats or having a hereditary tendency. The excess cholesterol may form plaques on the inside walls of blood vessels. Plaques can constrict or block blood channel openings, causing artery hardening and raising the risk of a variety of health problems, including heart disease and stroke. Although the explanation for this is unknown, a high level of triglycerides in the blood is linked to an increased risk of developing cardiovascular disease. 

A lipid profile consists of the following elements: 

• Cholesterol total 
• HDL Cholesterol -?commonly referred to as "good cholesterol" since it eliminates excess cholesterol from the body and transports it to the liver for elimination. 
• LDL Cholesterol -?commonly referred to as "bad cholesterol" because it deposits excess cholesterol in the walls of blood arteries, contributing to atherosclerosis. 
• Triglycerides 

Lab tests often ordered with a Lipid Panel test:

• CBC (Blood Count Test) with Smear Review
• Comprehensive Metabolic Panel
• Direct LDL
• VLDL
• Lp-PLA2
• Apolipoprotein A1
• Apolipoprotein B
• Lipoprotein (a)
• Lipoprotein Fractionation Ion Mobility (LDL Particle Testing)

Conditions where a Lipid Panel test is recommended:

• Hypertension
• Cardiovascular Disease
• Heart Disease
• Stroke

Commonly Asked Questions: 

How does my health care provider use a Lipid Panel test? 

The lipid profile is used as part of a cardiac risk assessment to help determine an individual's risk of heart disease and, if there is a borderline or high risk, to help make treatment options. 

Lipids are a class of fats and fat-like compounds that are essential components of cells and energy sources. It's critical to keep track of and maintain optimal levels of these lipids in order to stay healthy. 

To design a therapy and follow-up strategy, the results of the lipid profile are combined with other recognized risk factors for heart disease. Treatment options may include lifestyle changes such as diet and exercise, as well as lipid-lowering drugs such as statins, depending on the results and other risk factors. 

A normal lipid profile test measures the following elements: 

• Total cholesterol is a test that determines how much cholesterol is present in all lipoprotein particles. 

• HDL Cholesterol — measures hdl cholesterol in particles, sometimes referred to as "good cholesterol" since it eliminates excess cholesterol and transports it to the liver for elimination. 

• LDL Cholesterol – estimates the cholesterol in LDL particles; sometimes known as "bad cholesterol" since it deposits excess cholesterol in blood vessel walls, contributing to atherosclerosis. The amount of LDL Cholesterol is usually estimated using the total cholesterol, HDL Cholesterol, and triglycerides readings. 

• Triglycerides – triglycerides are measured in all lipoprotein particles, with the highest concentration in very-low-density lipoproteins. 

• As part of the lipid profile, several extra information may be presented. The results of the above-mentioned tests are used to determine these parameters. 

• VLDL Cholesterol — derived using triglycerides/5; this calculation is based on the typical VLDL particle composition. 

• Non-HDL Cholesterol - the result of subtracting total cholesterol from HDL Cholesterol. 

• Cholesterol/HDL ratio — total cholesterol to HDL Cholesterol ratio computed. 

An expanded profile may include the amount and concentration of low-density lipoprotein particles. Rather than assessing the amount of LDL cholesterol, this test counts the number of LDL particles. This figure is thought to more accurately reflect the risk of heart disease in some persons. 

What do my Lipid Panel test results mean? 

Healthy lipid levels, in general, aid in the maintenance of a healthy heart and reduce the risk of heart attack or stroke. A health practitioner would analyze the results of each component of a lipid profile, as well as other risk factors, to assess a person's total risk of coronary heart disease, if therapy is required, and, if so, which treatment will best serve to reduce the person's risk of heart disease. 

The Adult Treatment Panel III of the National Cholesterol Education Program published guidelines for measuring lipid levels and selecting treatment in 2002. The American College of Cardiology and the American Heart Association announced updated cholesterol therapy guidelines in 2013 to minimize the risk of cardiovascular disease in adults. These guidelines suggest a different treatment method than the NCEP guidelines. Cholesterol-lowering medications are now chosen based on the 10-year risk of atherosclerotic cardiovascular disease and other criteria, rather than on LDL Cholesterol or non-HDL Cholesterol objectives. 

The revised guidelines include an evidence-based risk calculator for ASCVD that may be used to identify people who are most likely to benefit from treatment. It's for adults between the ages of 40 and 79 who don't have a heart condition. The computation takes into account a number of characteristics, including age, gender, race, total cholesterol, HDL Cholesterol, blood pressure, diabetes, and smoking habits. The new guidelines also suggest comparing therapeutic response to LDL Cholesterol baseline readings, with decrease criteria varying depending on the degree of lipid-lowering medication therapy. 

Unhealthy lipid levels, as well as the presence of additional risk factors like age, family history, cigarette smoking, diabetes, and high blood pressure, may indicate that the person being examined needs to be treated. 

The NCEP Adult Treatment Panel III guidelines specify target LDL cholesterol levels based on the findings of lipid testing and these other main risk factors. Individuals with LDL Cholesterol levels over the target limits will be treated, according to the guidelines. 

According to the American Academy of Pediatrics, screening youths with risk factors for heart disease with a full, fasting lipid panel is advised. Fasting is not required prior to lipid screening in children who do not have any risk factors. For non-fasting lipid screening, non-high-density lipoprotein cholesterol is the preferred test. Non HDL Cholesterol is computed by subtracting total cholesterol and HDL Cholesterol from total cholesterol and HDL Cholesterol. 

Is there anything else I should know? 

The measurement of triglycerides in people who haven't fasted is gaining popularity. Because most of the day, blood lipid levels reflect post-meal levels rather than fasting levels, a non-fasting sample may be more representative of the "usual" circulating level of triglyceride. However, because it is still unclear how to interpret non-fasting levels for assessing risk, the current recommendations for fasting before lipid tests remain unchanged. 

A fasting lipid profile is usually included in a routine cardiac risk assessment. In addition, research into the utility of additional non-traditional cardiac risk markers, such as Lp-PLA2, is ongoing. A health care provider may use one or more of these markers to help determine a person's risk, but there is no consensus on how to use them and they are not widely available. 

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

Description: A Lipid Panel is a blood test that measures your cholesterol levels to evaluate your risk of cardiovascular disease.

Also Known As: Lipid Profile Test, Lipid Test, Cholesterol Profile Test, Cholesterol Panel Test, Cholesterol Test, Coronary Risk Panel Test, lipid blood test, Lipid w/Ratios Test, Cholesterol Ratio test, blood cholesterol Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Patient should be fasting 9-12 hours prior to collection.

When is a Lipid Panel with Ratios test ordered?

A fasting lipid profile should be done about every five years in healthy persons who have no additional risk factors for heart disease. A single total cholesterol test, rather than a complete lipid profile, may be used for initial screening. If the screening cholesterol test result is high, a lipid profile will almost certainly be performed.

More regular testing with a full lipid profile is indicated if other risk factors are present or if earlier testing revealed a high cholesterol level.

Other risk factors, in addition to high LDL cholesterol, include:

• Smoking
• Obesity or being overweight
• Unhealthy eating habits
• Not getting enough exercise and being physically inactive
• Older age
• Having hypertension
• Premature heart disease in the family
• Having experienced a heart attack or having pre-existing heart disease

Diabetes or pre-diabetes is a condition in which a person has High HDL is a "negative risk factor," and its existence permits one risk factor to be removed from the total.

The American Academy of Pediatrics recommends routine lipid testing for children and young adults. Children and teenagers who are at a higher risk of developing heart disease as adults should be screened with a lipid profile earlier and more frequently. A family history of heart disease or health problems such as diabetes, high blood pressure, or being overweight are some of the risk factors, which are comparable to those in adults. According to the American Academy of Pediatrics, high-risk children should be examined with a fasting lipid profile between the ages of 2 and 8.

A lipid profile can also be done at regular intervals to assess the effectiveness of cholesterol-lowering lifestyle changes like diet and exercise, as well as pharmacological therapy like statins.

What does a Lipid Panel with Ratios blood test check for?

Lipids are a class of fats and fat-like compounds that are essential components of cells and energy sources. The level of certain lipids in the blood is measured by a lipid profile.

Lipoprotein particles transport two key lipids, cholesterol and triglycerides, through the bloodstream. Protein, cholesterol, triglyceride, and phospholipid molecules are all present in each particle. High-density lipoproteins, low-density lipoproteins, and very low-density lipoproteins are the three types of particles assessed with a lipid profile.

It's critical to keep track of and maintain optimal levels of these lipids in order to stay healthy. While the body creates the cholesterol required for normal function, some cholesterol is obtained from the diet. A high amount of cholesterol in the blood can be caused by eating too many foods high in saturated fats and trans fats or having a hereditary tendency. The excess cholesterol may form plaques on the inside walls of blood vessels. Plaques can constrict or block blood channel openings, causing artery hardening and raising the risk of a variety of health problems, including heart disease and stroke. Although the explanation for this is unknown, a high level of triglycerides in the blood is linked to an increased risk of developing cardiovascular disease.

A lipid profile consists of the following elements:

• Cholesterol total
• HDL Cholesterol - commonly referred to as "good cholesterol" since it eliminates excess cholesterol from the body and transports it to the liver for elimination.
• LDL Cholesterol - commonly referred to as "bad cholesterol" because it deposits excess cholesterol in the walls of blood arteries, contributing to atherosclerosis.
• Triglycerides
• Ratio of LDL to HDL cholesterol

Lab tests often ordered with a Lipid Panel with Ratios test:

• CBC (Blood Count Test) with Smear Review
• Comprehensive Metabolic Panel
• Direct LDL
• VLDL
• Lp-PLA2
• Apolipoprotein A1
• Apolipoprotein B
• Lipoprotein (a)
• Lipoprotein Fractionation Ion Mobility (LDL Particle Testing)

Conditions where a Lipid Panel with Ratios test is recommended:

• Hypertension
• Cardiovascular Disease
• Heart Disease
• Stroke

Commonly Asked Questions:

How does my health care provider use a Lipid Panel with Ratios test?

The lipid profile is used as part of a cardiac risk assessment to help determine an individual's risk of heart disease and, if there is a borderline or high risk, to help make treatment options.

Lipids are a class of fats and fat-like compounds that are essential components of cells and energy sources. It's critical to keep track of and maintain optimal levels of these lipids in order to stay healthy.

To design a therapy and follow-up strategy, the results of the lipid profile are combined with other recognized risk factors for heart disease. Treatment options may include lifestyle changes such as diet and exercise, as well as lipid-lowering drugs such as statins, depending on the results and other risk factors.

A normal lipid profile test measures the following elements:

• Total cholesterol is a test that determines how much cholesterol is present in all lipoprotein particles.
• HDL Cholesterol — measures hdl cholesterol in particles, sometimes referred to as "good cholesterol" since it eliminates excess cholesterol and transports it to the liver for elimination.
• LDL Cholesterol – estimates the cholesterol in LDL particles; sometimes known as "bad cholesterol" since it deposits excess cholesterol in blood vessel walls, contributing to atherosclerosis. The amount of LDL Cholesterol is usually estimated using the total cholesterol, HDL Cholesterol, and triglycerides readings.
• Triglycerides – triglycerides are measured in all lipoprotein particles, with the highest concentration in very-low-density lipoproteins.
• As part of the lipid profile, several extra information may be presented. The results of the above-mentioned tests are used to determine these parameters.
• VLDL Cholesterol — derived using triglycerides/5; this calculation is based on the typical VLDL particle composition.
• Non-HDL Cholesterol - the result of subtracting total cholesterol from HDL Cholesterol.
• Cholesterol/HDL ratio — total cholesterol to HDL Cholesterol ratio computed.

An expanded profile may include the amount and concentration of low-density lipoprotein particles. Rather than assessing the amount of LDL cholesterol, this test counts the number of LDL particles. This figure is thought to more accurately reflect the risk of heart disease in some persons.

What do my Lipid Panel test results mean?

Healthy lipid levels, in general, aid in the maintenance of a healthy heart and reduce the risk of heart attack or stroke. A health practitioner would analyze the results of each component of a lipid profile, as well as other risk factors, to assess a person's total risk of coronary heart disease, if therapy is required, and, if so, which treatment will best serve to reduce the person's risk of heart disease.

The Adult Treatment Panel III of the National Cholesterol Education Program published guidelines for measuring lipid levels and selecting treatment in 2002. The American College of Cardiology and the American Heart Association announced updated cholesterol therapy guidelines in 2013 to minimize the risk of cardiovascular disease in adults. These guidelines suggest a different treatment method than the NCEP guidelines. Cholesterol-lowering medications are now chosen based on the 10-year risk of atherosclerotic cardiovascular disease and other criteria, rather than on LDL-C or non-HDL-C objectives.

The revised guidelines include an evidence-based risk calculator for ASCVD that may be used to identify people who are most likely to benefit from treatment. It's for adults between the ages of 40 and 79 who don't have a heart condition. The computation takes into account a number of characteristics, including age, gender, race, total cholesterol, HDL-C, blood pressure, diabetes, and smoking habits. The new guidelines also suggest comparing therapeutic response to LDL-C baseline readings, with decrease criteria varying depending on the degree of lipid-lowering medication therapy.

Unhealthy lipid levels, as well as the presence of additional risk factors like age, family history, cigarette smoking, diabetes, and high blood pressure, may indicate that the person being examined needs to be treated.

The NCEP Adult Treatment Panel III guidelines specify target LDL cholesterol levels based on the findings of lipid testing and these other main risk factors. Individuals with LDL-C levels over the target limits will be treated, according to the guidelines.

According to the American Academy of Pediatrics, screening youths with risk factors for heart disease with a full, fasting lipid panel is advised. Fasting is not required prior to lipid screening in children who do not have any risk factors. For non-fasting lipid screening, non-high-density lipoprotein cholesterol is the preferred test. Non-HDL-C is computed by subtracting total cholesterol and HDL-C from total cholesterol and HDL-C.

Is there anything else I should know?

The measurement of triglycerides in people who haven't fasted is gaining popularity. Because most of the day, blood lipid levels reflect post-meal levels rather than fasting levels, a non-fasting sample may be more representative of the "usual" circulating level of triglyceride. However, because it is still unclear how to interpret non-fasting levels for assessing risk, the current recommendations for fasting before lipid tests remain unchanged.

A fasting lipid profile is usually included in a routine cardiac risk assessment. In addition, research into the utility of additional non-traditional cardiac risk markers, such as Lp-PLA2, is ongoing. A health care provider may use one or more of these markers to help determine a person's risk, but there is no consensus on how to use them and they are not widely available.

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.

Metanephrines, Fractionated, LC/MS/MS, 24-Hour Urine

Includes: Metanephrine, Normetanephrine, Total Metanephrines

Patient Preparation : It is preferable for the patient to be off medications for three days prior to collection. Patient should avoid tobacco, tea, coffee, for three days prior to specimen collection. Common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Medications which are alpha agonists (Aldomet), alpha blockers (Dibenzyline) should be avoided 18-24 hours prior to specimen collection.

Preferred Specimen(s) : 5 mL 24-hour urine with 25 mL 6N HCl collected in a 24-hour urine container 

Clinical Significance: Test is useful in the evaluation of pheochromocytoma.