Adrenal Insufficiency and Addison Disease

The Adrenal Complete Panel includes the following tests 

• Aldosterone/Plasma Renin Activity Ratio, LC/MS/MS
• Comprehensive Metabolic Panel (CMP)
• CORTISOL, LC/MS/MS, SALIVA, 4 SAMPLES
• DHEA Sulfate, Immunoassay 
• Iron, Total
• Lipid Panel with Ratios
• Magnesium
• Sex Hormone Binding Globulin (SHBG)

This panel contains both Cortisol, A.M. #4212 and Cortisol, P.M. #4213, which will require the patient to visit the patient service center twice in one day.

• First visit between 7 a.m. - 9 a.m. to have Cortisol, A.M. #4212 drawn along with most of the panel
• Second visit between 3 p.m. – 5 p.m. to have Cortisol, P.M. #4213 drawn.

This panel contains both Cortisol, A.M. #4212 and Cortisol, P.M. #4213, which will require the patient to visit the patient service center twice in one day.

• First visit between 7 a.m. - 9 a.m. to have Cortisol, A.M. #4212 drawn along with most of the panel
• Second visit between 3 p.m. – 5 p.m. to have Cortisol, P.M. #4213 drawn.

The Adrenal Insufficiency and Addison Disease Panel contains the following tests:

• 21- Hydroxylase Antibody
• ACTH, Plasma
• Aldosterone, LC/MS/MS 
• Comprehensive Metabolic Panel (CMP)
• Cortisol, A.M.
• Cortisol, P.M.
• DHEA Sulfate, Immunoassay 
• Magnesium
• Plasma Renin Activity, LC/MS/MS

Description: Aldosterone and Renin tests are blood tests often ordered together to test patients with low potassium or high blood pressure.

Also Known As: Aldosterone Test, Renin Test, Aldosterone and Renin Ratio Test, Aldosterone and Renin Activity Test, PRA Test, Plasma Renin Activity Test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

Average Processing Time: 5 to 6 days

When is an Aldosterone and Plasma Renin Activity test ordered?

When someone has high blood pressure, a blood aldosterone test and a renin test are generally requested together, especially if the person also has low potassium. Even if potassium levels are within normal limits, testing may be necessary if standard drugs fail to control high blood pressure or if hypertension develops at a young age. Because primary aldosteronism is a potentially curable form of hypertension, it’s critical to catch it early and effectively treat it.

When a healthcare practitioner suspects adrenal insufficiency or Addison disease, aldosterone levels, along with additional testing, are occasionally recommended. The aldosterone stimulation test, also known as ACTH stimulation, measures aldosterone and cortisol levels to identify whether a person has Addison disease, reduced pituitary function, or a pituitary tumor. After ACTH stimulation, a natural outcome is an increase in cortisol and an increase in aldosterone.

What does an Aldosterone and Plasma Renin Activity blood test check for?

Aldosterone is a hormone that helps to maintain proper sodium and potassium levels in the circulation as well as regulate blood volume and blood pressure. Renin is an enzyme that regulates the production of aldosterone. The levels of aldosterone and renin in the blood and/or the amount of aldosterone in the urine are measured in these tests.

The adrenal glands, which are positioned on the top and outside portions of each kidney, create aldosterone. Aldosterone increases sodium retention and potassium elimination via the kidneys. Renin is a protein generated by the kidneys that regulates the activity of the hormone angiotensin, which stimulates the production of aldosterone by the adrenal glands.

Renin is released by the kidneys when blood pressure drops or the sodium chloride concentration in the tubules of the kidney decreases. Renin breaks down the blood protein angiotensinogen to produce angiotensin I, which is then transformed to angiotensin II by a second enzyme. Angiotensin II constricts blood vessels and increases the synthesis of aldosterone. Overall, this boosts blood pressure while maintaining appropriate salt and potassium levels.

Aldosterone overproduction or underproduction can be caused by a number of factors. Because renin and aldosterone are so closely associated, they’re frequently examined jointly to figure out what’s causing an aberrant aldosterone level.

Lab tests often ordered with an Aldosterone and Plasma Renin Activity test:

• Electrolytes
• Potassium
• Cortisol
• Aldosterone
• Plasma Renin Activity

Conditions where an Aldosterone and Plasma Renin Activity test is recommended:

• Adrenal Insufficiency
• Addison Disease
• Hypertension
• Endocrine Syndromes
• Conn Syndrome

How does my health care provider use an Aldosterone and Plasma Renin Activity test?

Aldosterone and renin tests are performed to determine whether the adrenal glands are producing enough aldosterone and to differentiate between potential causes of excess or insufficiency. Aldosterone can be detected in the blood or in a 24-hour urine sample, which determines how much aldosterone is excreted in the urine over the course of a day. Renin is always counted in milligrams per milliliter of blood.

Primary aldosteronism, commonly known as Conn syndrome, is a condition that produces high blood pressure and can be detected with these tests. If the test is positive, stimulation and suppression testing can be used to further examine aldosterone production.

The highest levels of aldosterone and renin are in the morning, and they fluctuate throughout the day. The position of the body, stress, and a number of prescribed medications all have an impact on them.

What do my aldosterone and plasma renin activity test results mean?

Conn syndrome is characterized by the adrenal glands overproducing aldosterone, which is usually caused by a benign tumor in one of the glands. A high aldosterone level causes increased salt reabsorption and potassium loss by the kidneys, resulting in an electrolyte imbalance. High blood pressure, headaches, and muscle weakness are signs and symptoms, especially if potassium levels are very low.

When someone has hypertension and their blood potassium is lower than usual, it's time to look for aldosteronism. Blood is drawn from both of the adrenal veins and tested to see whether there is a difference in the amount of aldosterone produced by both of the adrenal glands to establish whether only one or both are impacted.

Secondary aldosteronism, which is more prevalent than primary aldosteronism, is caused by anything other than an adrenal gland condition that causes excess aldosterone. Any disorder that reduces blood flow to the kidneys, lowers blood pressure, or lowers sodium levels could cause it. Congestive heart failure, liver cirrhosis, kidney illness, and pregnancy toxemia can all cause secondary aldosteronism. It's also typical when you're dehydrated. The cause of aldosteronism is usually clear in these circumstances.

The most common cause of secondary aldosteronism is renal artery stenosis, which is a constriction of the blood arteries that supply the kidney. High renin and aldosterone levels produce high blood pressure, which can be treated with surgery or angioplasty. A catheter is introduced via the groin and blood is collected straight from the veins draining the kidney to see if only one kidney is damaged. If one side's result is much higher than the other, this suggests that the artery is narrowed.

Adrenal insufficiency is the most common cause of low aldosterone. Dehydration, low blood pressure, a low salt level in the blood, and a high potassium level are all symptoms. Congenital adrenal hyperplasia, a disorder in which babies lack an enzyme needed to create cortisol, can reduce aldosterone production in some circumstances.

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

Description: The C-Reactive Protein (CRP) test measures the levels of C-reactive protein, a substance produced by the liver in response to inflammation in the body. It is a non-specific marker of inflammation and is used to evaluate the presence and intensity of inflammation. The CRP test helps healthcare providers assess the severity of an inflammatory condition and monitor response to treatment.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a C-Reactive Protein test ordered?

A C-Reactive Protein (CRP) test may be ordered in several situations to assess a patient's inflammation levels:

1. Infection or Inflammatory Diseases: The test is ordered when a patient shows signs of infection or has symptoms of inflammatory diseases such as rheumatoid arthritis, lupus, or inflammatory bowel disease.

2. Monitoring Response to Treatment: For patients with known inflammatory conditions, the CRP test helps healthcare providers monitor the effectiveness of treatment and track changes in inflammation levels over time.

3. Cardiovascular Risk Assessment: The CRP test may be ordered as part of a cardiovascular risk assessment to identify individuals at higher risk of developing heart disease or to assess the severity of existing cardiovascular conditions.

4. Post-Surgery Monitoring: After surgical procedures, the CRP test can be ordered to monitor post-operative inflammation levels and identify any complications or infections.

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

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

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

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

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

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

Conditions where a C-Reactive Protein test is recommended:

A C-Reactive Protein (CRP) test is commonly ordered for:

1. Inflammatory Diseases: The test helps assess the severity of inflammatory diseases such as rheumatoid arthritis, lupus, vasculitis, or inflammatory bowel disease.

2. Infections: Elevated CRP levels can indicate the presence of infections, whether bacterial, viral, or fungal, and help healthcare providers identify the site of inflammation.

3. Cardiovascular Diseases: The CRP test is used as part of cardiovascular risk assessment to identify individuals at higher risk of developing heart disease or to assess the severity of existing cardiovascular conditions.

Commonly Asked Questions:

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

Healthcare providers use the results of a C-Reactive Protein (CRP) test to:

1. Assess Inflammation Levels: Elevated CRP levels indicate the presence and intensity of inflammation in the body, helping healthcare providers evaluate the severity of an inflammatory condition.

2. Monitor Treatment Response: Regular CRP testing allows healthcare providers to monitor the effectiveness of treatments for inflammatory conditions and track changes in inflammation levels over time.

3. Guide Diagnosis and Further Testing: Elevated CRP levels, combined with other clinical findings, can help healthcare providers diagnose and differentiate between different inflammatory conditions and guide the need for further diagnostic tests or evaluations.

By effectively utilizing the results of a C-Reactive Protein (CRP) test, healthcare providers can assess inflammation levels, monitor treatment response, and make informed decisions regarding patient care, including treatment adjustments and further investigations if necessary.

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

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

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

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

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

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

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

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

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

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred.

Average Processing Time: 1 to 2 days 

When is a Comprehensive Metabolic Panel test ordered:  

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

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

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

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

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

What does a Comprehensive Metabolic Panel blood test check for? 

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

The following tests are included in the CMP: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

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

Conditions where a Comprehensive Metabolic Panel test is recommended: 

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

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

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

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

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

Commonly Asked Questions: 

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

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

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

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

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

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

What do my Comprehensive Metabolic Panel test results mean? 

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

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

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

Is there anything else I should know? 

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

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

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

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

Please note the following regarding BUN/Creatinine ratio: 

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

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

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

Description: A cortisol test measures the amount of cortisol your body. These levels will start off high in the morning and throughout the say they become lower. At midnight they are typically at their lowest level. Someone who works a night shift or has an irregular sleep schedule may have a different pattern. This test can be used to determine Cushing's or Addison's Disease.

Also Known As: Cortisol Total Test, Cortisol Saliva Test, Cortisol 4 Specimen Test, 4 Specimen Cortisol Test, Cortisol Free Test, Cortisol Kit Test

Collection Method: Saliva Collection Kit. [For instructions, scroll down to the bottom]

Specimen Type: Saliva

Test Preparation: No preparation required

Average Processing Time: 5 to 6 days

When is a Cortisol 4 Sample test ordered?

When a person has symptoms that point to a high level of cortisol and Cushing syndrome, a cortisol test may be recommended.

Women with irregular menstrual periods and increased facial hair may be tested, and children with delayed development and small stature may also be tested.

When someone exhibits symptoms that point to a low cortisol level, adrenal insufficiency, or Addison disease, this test may be ordered.

What does a Cortisol 4 Sample Saliva test check for?

Cortisol is a hormone that plays a function in protein, lipid, and carbohydrate metabolism. It has an effect on blood glucose levels, blood pressure, and immune system regulation. Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Cortisol is a hormone that is produced into the urine and found in the saliva. This test determines how much cortisol is present in the blood, urine, or saliva.

Cortisol levels in the blood usually rise and fall in a pattern known as "diurnal variation." It reaches its highest point early in the morning, then gradually decreases over the day, reaching its lowest point around midnight. When a person works irregular shifts and sleeps at different times of the day, this rhythm might fluctuate, and it can be disrupted when a disease or condition inhibits or stimulates cortisol production.

The adrenal glands, two triangle organs that sit on top of the kidneys, generate and emit cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Cushing syndrome is a collection of signs and symptoms associated with an unusually high cortisol level. Cortisol production may be increased as a result of:

• Large doses of glucocorticosteroid hormones are given to treat a range of ailments, including autoimmune illness and certain cancers.
• Tumors that produce ACTH in the pituitary gland and/or other regions of the body.
• Cortisol production by the adrenal glands is increased as a result of a tumor or abnormal expansion of adrenal tissues.

Rarely, CRH-producing malignancies in various regions of the body.

Cortisol production may be reduced as a result of:

• Secondary adrenal insufficiency is caused by an underactive pituitary gland or a pituitary gland tumor that prevents ACTH production.
• Primary adrenal insufficiency, often known as Addison disease, is characterized by underactive or injured adrenal glands that limit cortisol production.

After quitting glucocorticosteroid hormone medication, especially if it was abruptly stopped after a long time of use.

Lab tests often ordered with a Cortisol 4 Sample Saliva test:

• Cortisol PM
• Cortisol AM
• Cortisol Total
• ACTH
• Aldosterone
• 17-Hydroxyprogesterone
• Growth Hormone

Conditions where a Cortisol 4 Sample test is recommended:

• Addison’s Disease
• Cushing’s Syndrome
• Endocrine Syndromes
• Hypertension
• Pituitary Disorders

How does my health care provider use a Cortisol 4 Sample test?

A cortisol test can be used to detect Cushing syndrome, which is characterized by an excess of cortisol, as well as adrenal insufficiency or Addison disease, which are characterized by a deficiency of cortisol. Cortisol is a hormone that regulates protein, lipid, and carbohydrate metabolism, among other functions. Cortisol levels in the blood normally increase and fall in a "diurnal variation" pattern, rising early in the morning, dropping during the day, and reaching their lowest point around midnight.

The adrenal glands generate and excrete cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Blood cortisol testing assesses both protein-bound and free cortisol, but urine and saliva cortisol testing assesses only free cortisol, which should be in line with blood cortisol levels. Multiple blood and/or saliva cortisol levels collected at various times, such as 8 a.m. and 4 p.m., can be used to assess cortisol levels and diurnal variation. A 24-hour urine cortisol sample will not reveal diurnal variations; instead, it will assess the total quantity of unbound cortisol voided over the course of 24 hours.

If an elevated amount of cortisol is found, a health professional will conduct additional tests to confirm the results and discover the cause.

If a person's blood cortisol level is abnormally high, a doctor may order additional tests to be sure the high cortisol is indeed abnormal. Additional testing could involve monitoring 24-hour urinary cortisol, doing an overnight dexamethasone suppression test, and/or obtaining a salivary sample before sleep to detect cortisol at its lowest level. Urinary cortisol testing necessitates collecting urine over a set length of time, usually 24 hours. Because ACTH is released in pulses by the pituitary gland, this test can assist evaluate whether a raised blood cortisol level is a true rise.

An ACTH stimulation test may be ordered if a health practitioner feels that the adrenal glands are not releasing enough cortisol or if initial blood tests reveal insufficient cortisol production.

ACTH stimulation is a test that measures the amount of cortisol in a person's blood before and after a synthetic ACTH injection. Cortisol levels will rise in response to ACTH stimulation if the adrenal glands are functioning normally. Cortisol levels will be low if they are damaged or not working properly. To distinguish between adrenal and pituitary insufficiency, a lengthier variant of this test can be used.

What do my Cortisol test results mean?

Cortisol levels are typically lowest before bedtime and highest shortly after awakening, though this pattern can be disrupted if a person works rotating shifts and sleeps at various times on separate days.

Excess cortisol and Cushing syndrome are indicated by an increased or normal cortisol level shortly after awakening, as well as a level that does not diminish by bedtime. If the excess cortisol is not suppressed after an overnight dexamethasone suppression test, the 24-hour urine cortisol is elevated, or the late-night salivary cortisol level is elevated, the excess cortisol is likely due to abnormal increased ACTH production by the pituitary or a tumor outside of the pituitary, or abnormal production by the adrenal glands. Additional tests will aid in determining the root of the problem.

If the person examined responds to an ACTH stimulation test and has insufficient cortisol, the problem is most likely due to insufficient ACTH production by the pituitary. If the person does not respond to the ACTH stimulation test, the problem is most likely to be with the adrenal glands. Secondary adrenal insufficiency occurs when the adrenal glands are underactive as a result of pituitary dysfunction and/or insufficient ACTH synthesis. Adrenal injury causes decreased cortisol production, which is referred to as primary adrenal insufficiency or Addison disease.

Once an irregularity has been found and linked to the pituitary gland, adrenal glands, or another source, the health practitioner may utilize additional testing, such as a CT scan, to determine the extent of any gland damage.

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

Cortisol, LC/MS/MS, Saliva Collection Kit

1. Pick up the Cortisol, LC/MS/MS, Saliva Collection Kit from the Patient Service Center that is selected when placing the order.

Collection Instructions

1.  Remove the swab from the Salivette.
2. Follow times to collect as told by your physician
   a. Place the swab in the mouth, e.g. in your cheek, where it should remain for 2 minutes without chewing. If an extremely small amount of saliva is produced, leave the swab in the mouth for longer.

b. Return the swab with the absorbed saliva to the Salivette.
c. Replace the stopper.

1. Label each saliva collection tube with the following information

              a. patient name

              b. date of birth (DOB)

              c. date and time of collection

Refrigerate the Salivette immediately after collection

Return Collected Samples & Patient Requisition Directly to Patient Service Center within 48hrs of collection

Storage instructions

1. Specimen should be stored at refrigerated temperature prior to returning to the Patient Service Center .
2. Do not use this kit on children under 3 years of age or any patient with increased risk of swallowing or choking.

Description: A cortisol test measures the amount of cortisol in the blood. These levels will start off high in the morning and throughout the say they become lower. At midnight they are typically at their lowest level. Someone who works a night shift or has an irregular sleep schedule may have a different pattern. This test can be used to determine Cushing's or Addison's Disease.

Also Known As: Cortisol AM Test, Cortisol Total Test, Cortisol Test, Cortisol Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Specimen must be drawn between 7 a.m. and 9 a.m. Test is not recommended for patients receiving prednisone/prednisolone therapy due to cross reactivity with the antibody used in this test.

Average Processing Time: 1 to 2 days

When is a Cortisol AM test ordered?

When a person has symptoms that point to a high level of cortisol and Cushing syndrome, a cortisol test may be recommended.

Women with irregular menstrual periods and increased facial hair may be tested, and children with delayed development and small stature may also be tested.

When someone exhibits symptoms that point to a low cortisol level, adrenal insufficiency, or Addison disease, this test may be ordered.

What does a Cortisol AM blood test check for?

Cortisol is a hormone that plays a function in protein, lipid, and carbohydrate metabolism. It has an effect on blood glucose levels, blood pressure, and immune system regulation. Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Cortisol is a hormone that is produced into the urine and found in the saliva. This test determines how much cortisol is present in the blood, urine, or saliva.

Cortisol levels in the blood usually rise and fall in a pattern known as "diurnal variation." It reaches its highest point early in the morning, then gradually decreases over the day, reaching its lowest point around midnight. When a person works irregular shifts and sleeps at different times of the day, this rhythm might fluctuate, and it can be disrupted when a disease or condition inhibits or stimulates cortisol production.

The adrenal glands, two triangle organs that sit on top of the kidneys, generate and emit cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. A certain amount of cortisol must be produced for normal adrenal, pituitary gland, and brain function.

Cushing syndrome is a collection of signs and symptoms associated with an unusually high cortisol level. Cortisol production may be increased as a result of:

• Large doses of glucocorticosteroid hormones are given to treat a range of ailments, including autoimmune illness and certain cancers.
• Tumors that produce ACTH in the pituitary gland and/or other regions of the body.
• Cortisol production by the adrenal glands is increased as a result of a tumor or abnormal expansion of adrenal tissues.

Rarely, CRH-producing malignancies in various regions of the body.

Cortisol production may be reduced as a result of:

• Secondary adrenal insufficiency is caused by an underactive pituitary gland or a pituitary gland tumor that prevents ACTH production.
• Primary adrenal insufficiency, often known as Addison disease, is characterized by underactive or injured adrenal glands that limit cortisol production.

After quitting glucocorticosteroid hormone medication, especially if it was abruptly stopped after a long time of use.

Lab tests often ordered with a Cortisol AM test:

• Cortisol PM
• ACTH
• Aldosterone
• 17-Hydroxyprogesterone
• Growth Hormone

Conditions where a Cortisol AM test is recommended:

• Addison’s Disease
• Cushing’s Syndrome
• Endocrine Syndromes
• Hypertension
• Pituitary Disorders

How does my health care provider use a Cortisol AM test?

A cortisol test can be used to detect Cushing syndrome, which is characterized by an excess of cortisol, as well as adrenal insufficiency or Addison disease, which are characterized by a deficiency of cortisol. Among other things, the hormone cortisol controls how proteins, lipids, and carbohydrates are metabolized. Cortisol levels in the blood normally increase and fall in a "diurnal variation" pattern, rising early in the morning, dropping during the day, and reaching their lowest point around midnight.

The adrenal glands generate and excrete cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. Cortisol production and release are triggered by ACTH in the adrenal glands. A certain amount of cortisol must be produced for normal brain, pituitary, and adrenal gland function.

Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Blood cortisol testing assesses both protein-bound and free cortisol, but urine and saliva cortisol testing assesses only free cortisol, which should be in line with blood cortisol levels. Multiple blood and/or saliva cortisol levels collected at various times, such as 8 a.m. and 4 p.m., can be used to assess cortisol levels and diurnal variation. A 24-hour urine cortisol sample will not reveal diurnal variations; instead, it will assess the total quantity of unbound cortisol voided over the course of 24 hours.

If an elevated amount of cortisol is found, a health professional will conduct additional tests to confirm the results and discover the cause.

If a person's blood cortisol level is abnormally high, a doctor may order additional tests to be sure the high cortisol is indeed abnormal. Additional testing could involve monitoring 24-hour urinary cortisol, doing an overnight dexamethasone suppression test, and/or obtaining a salivary sample before sleep to detect cortisol at its lowest level. Urinary cortisol testing necessitates collecting urine over a set length of time, usually 24 hours. Because ACTH is released in pulses by the pituitary gland, this test can assist evaluate whether a raised blood cortisol level is a true rise.

An ACTH stimulation test may be ordered if a health practitioner feels that the adrenal glands are not releasing enough cortisol or if initial blood tests reveal insufficient cortisol production.

The purpose of ACTH stimulation is to compare the levels of cortisol in a person's blood before and after receiving an injection of synthetic ACTH. If the adrenal glands are healthy, the reaction to ACTH stimulation will be an increase in cortisol levels. Low amounts of cortisol will result if they are broken or not functioning properly. To distinguish between adrenal and pituitary insufficiency, a lengthier variant of this test can be used.

What do my Cortisol AM test results mean?

Cortisol levels are typically lowest before bedtime and highest shortly after awakening, though this pattern can be disrupted if a person works rotating shifts and sleeps at various times on separate days.

Excess cortisol and Cushing syndrome are indicated by an increased or normal cortisol level shortly after awakening, as well as a level that does not diminish by bedtime. If the excess cortisol is not suppressed after an overnight dexamethasone suppression test, the 24-hour urine cortisol is elevated, or the late-night salivary cortisol level is elevated, the excess cortisol is likely due to abnormal increased ACTH production by the pituitary or a tumor outside of the pituitary, or abnormal production by the adrenal glands. Additional tests will aid in determining the root of the problem.

If the subject of the examination reacts to an ACTH stimulation test and has insufficient cortisol levels, the issue is most likely brought on by the pituitary's insufficient production of ACTH. The adrenal glands are most likely the source of the issue if the subject does not react to the ACTH stimulation test.

An additional test, like as a CT scan, may be used by the medical professional to evaluate the degree of any gland damage once an irregularity has been identified and related to the pituitary gland, the adrenal glands, or another cause.

Important: Patient needs to have the specimen collected between 7 a.m.-9 a.m.

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

Description: A cortisol test measures the amount of cortisol in the blood. These levels will start off high in the morning and throughout the say they become lower. At midnight they are typically at their lowest level. Someone who works a night shift or has an irregular sleep schedule may have a different pattern. This test can be used to determine Cushing's or Addison's Disease.

Also Known As: Cortisol PM Test, Cortisol Total Test, Cortisol Test, Cortisol Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Must be drawn between 3 and 5 p.m.

Average Processing Time: 1 to 2 days

When is Cortisol PM test ordered?

When a person has symptoms that point to a high level of cortisol and Cushing syndrome, a cortisol test may be recommended.

Women with irregular menstrual periods and increased facial hair may be tested, and children with delayed development and small stature may also be tested.

When someone exhibits symptoms that point to a low cortisol level, adrenal insufficiency, or Addison disease, this test may be ordered.

What does a Cortisol PM blood test check for?

Cortisol is a hormone that plays a function in protein, lipid, and carbohydrate metabolism. It has an effect on blood glucose levels, blood pressure, and immune system regulation. Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Cortisol is a hormone that is produced into the urine and found in the saliva. This test determines how much cortisol is present in the blood, urine, or saliva.

Cortisol levels in the blood usually rise and fall in a pattern known as "diurnal variation." It reaches its highest point early in the morning, then gradually decreases over the day, reaching its lowest point around midnight. When a person works irregular shifts and sleeps at different times of the day, this rhythm might fluctuate, and it can be disrupted when a disease or condition inhibits or stimulates cortisol production.

The adrenal glands, two triangle organs that sit on top of the kidneys, generate and emit cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Cushing syndrome is a collection of signs and symptoms associated with an unusually high cortisol level. Cortisol production may be increased as a result of:

• Large doses of glucocorticosteroid hormones are given to treat a range of ailments, including autoimmune illness and certain cancers.
• Tumors that produce ACTH in the pituitary gland and/or other regions of the body.
• Cortisol production by the adrenal glands is increased as a result of a tumor or abnormal expansion of adrenal tissues.

Rarely, CRH-producing malignancies in various regions of the body.

Cortisol production may be reduced as a result of:

• Secondary adrenal insufficiency is caused by an underactive pituitary gland or a pituitary gland tumor that prevents ACTH production.
• Primary adrenal insufficiency, often known as Addison disease, is characterized by underactive or injured adrenal glands that limit cortisol production.

After quitting glucocorticosteroid hormone medication, especially if it was abruptly stopped after a long time of use.

Lab tests often ordered with a Cortisol PM test:

• Cortisol Total
• Cortisol AM
• Cortisol Saliva
• ACTH
• Aldosterone
• 17-Hydroxyprogesterone
• Growth Hormone

Conditions where a Cortisol PM test is recommended:

• Addison’s Disease
• Cushing’s Syndrome
• Endocrine Syndromes
• Hypertension
• Pituitary Disorders

How does my health care provider use a Cortisol PM test?

A cortisol test can be used to detect Cushing syndrome, which is characterized by an excess of cortisol, as well as adrenal insufficiency or Addison disease, which are characterized by a deficiency of cortisol. Cortisol is a hormone that regulates protein, lipid, and carbohydrate metabolism, among other functions. Cortisol levels in the blood normally increase and fall in a "diurnal variation" pattern, rising early in the morning, dropping during the day, and reaching their lowest point around midnight.

The adrenal glands generate and excrete cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Blood cortisol testing assesses both protein-bound and free cortisol, but urine and saliva cortisol testing assesses only free cortisol, which should be in line with blood cortisol levels. Multiple blood and/or saliva cortisol levels collected at various times, such as 8 a.m. and 4 p.m., can be used to assess cortisol levels and diurnal variation. A 24-hour urine cortisol sample will not reveal diurnal variations; instead, it will assess the total quantity of unbound cortisol voided over the course of 24 hours.

If an elevated amount of cortisol is found, a health professional will conduct additional tests to confirm the results and discover the cause.

If a person's blood cortisol level is abnormally high, a doctor may order additional tests to be sure the high cortisol is indeed abnormal. Additional testing could involve monitoring 24-hour urinary cortisol, doing an overnight dexamethasone suppression test, and/or obtaining a salivary sample before sleep to detect cortisol at its lowest level. Urinary cortisol testing necessitates collecting urine over a set length of time, usually 24 hours. Because ACTH is released in pulses by the pituitary gland, this test can assist evaluate whether a raised blood cortisol level is a true rise.

An ACTH stimulation test may be ordered if a health practitioner feels that the adrenal glands are not releasing enough cortisol or if initial blood tests reveal insufficient cortisol production.

ACTH stimulation is a test that measures the amount of cortisol in a person's blood before and after a synthetic ACTH injection. Cortisol levels will rise in response to ACTH stimulation if the adrenal glands are functioning normally. Cortisol levels will be low if they are damaged or not working properly. To distinguish between adrenal and pituitary insufficiency, a lengthier variant of this test can be used.

What do my Cortisol PM test results mean?

Cortisol levels are typically lowest before bedtime and highest shortly after awakening, though this pattern can be disrupted if a person works rotating shifts and sleeps at various times on separate days.

Excess cortisol and Cushing syndrome are indicated by an increased or normal cortisol level shortly after awakening, as well as a level that does not diminish by bedtime. If the excess cortisol is not suppressed after an overnight dexamethasone suppression test, the 24-hour urine cortisol is elevated, or the late-night salivary cortisol level is elevated, the excess cortisol is likely due to abnormal increased ACTH production by the pituitary or a tumor outside of the pituitary, or abnormal production by the adrenal glands. Additional tests will aid in determining the root of the problem.

If the person examined responds to an ACTH stimulation test and has insufficient cortisol, the problem is most likely due to insufficient ACTH production by the pituitary. If the person does not respond to the ACTH stimulation test, the problem is most likely to be with the adrenal glands. Secondary adrenal insufficiency occurs when the adrenal glands are underactive as a result of pituitary dysfunction and/or insufficient ACTH synthesis. Adrenal injury causes decreased cortisol production, which is referred to as primary adrenal insufficiency or Addison disease.

Once an irregularity has been found and linked to the pituitary gland, adrenal glands, or another source, the health practitioner may utilize additional testing, such as a CT scan, to determine the extent of any gland damage.

Patient needs to have the specimen collected between 3 p.m - 5 p.m.

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

Description: A cortisol test measures the amount of cortisol in the blood. These levels will start off high in the morning and throughout the say they become lower. At midnight they are typically at their lowest level. Someone who works a night shift or has an irregular sleep schedule may have a different pattern. This test can be used to determine Cushing's or Addison's Disease.

Also Known As: Cortisol Total Test, Cortisol Test, Cortisol Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Test not recommended when patient is on prednisone/prednisolone therapy due to cross reactivity with the antibody used in this test

Average Processing Time: 1 to 2 days

When is a Cortisol Total test ordered?

When a person has symptoms that point to a high level of cortisol and Cushing syndrome, a cortisol test may be recommended.

Women with irregular menstrual periods and increased facial hair may be tested, and children with delayed development and small stature may also be tested.

When someone exhibits symptoms that point to a low cortisol level, adrenal insufficiency, or Addison disease, this test may be ordered.

What does a Cortisol Total blood test check for?

Cortisol is a hormone that plays a function in protein, lipid, and carbohydrate metabolism. It has an effect on blood glucose levels, blood pressure, and immune system regulation. Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Cortisol is a hormone that is produced into the urine and found in the saliva. This test determines how much cortisol is present in the blood, urine, or saliva.

Cortisol levels in the blood usually rise and fall in a pattern known as "diurnal variation." It reaches its highest point early in the morning, then gradually decreases over the day, reaching its lowest point around midnight. When a person works irregular shifts and sleeps at different times of the day, this rhythm might fluctuate, and it can be disrupted when a disease or condition inhibits or stimulates cortisol production.

The adrenal glands, two triangle organs that sit on top of the kidneys, generate and emit cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Cushing syndrome is a collection of signs and symptoms associated with an unusually high cortisol level. Cortisol production may be increased as a result of:

• Large doses of glucocorticosteroid hormones are given to treat a range of ailments, including autoimmune illness and certain cancers.
• Tumors that produce ACTH in the pituitary gland and/or other regions of the body.
• Cortisol production by the adrenal glands is increased as a result of a tumor or abnormal expansion of adrenal tissues.

Rarely, CRH-producing malignancies in various regions of the body.

Cortisol production may be reduced as a result of:

• Secondary adrenal insufficiency is caused by an underactive pituitary gland or a pituitary gland tumor that prevents ACTH production.
• Primary adrenal insufficiency, often known as Addison disease, is characterized by underactive or injured adrenal glands that limit cortisol production.

After quitting glucocorticosteroid hormone medication, especially if it was abruptly stopped after a long time of use.

Lab tests often ordered with a Cortisol Total test:

• Cortisol PM
• Cortisol AM
• Cortisol Saliva
• ACTH
• Aldosterone
• 17-Hydroxyprogesterone
• Growth Hormone

Conditions where a Cortisol Test is recommended:

• Addison’s Disease
• Cushing’s Syndrome
• Endocrine Syndromes
• Hypertension
• Pituitary Disorders

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

A cortisol test can be used to detect Cushing syndrome, which is characterized by an excess of cortisol, as well as adrenal insufficiency or Addison disease, which are characterized by a deficiency of cortisol. Cortisol is a hormone that regulates protein, lipid, and carbohydrate metabolism, among other functions. Cortisol levels in the blood normally increase and fall in a "diurnal variation" pattern, rising early in the morning, dropping during the day, and reaching their lowest point around midnight.

The adrenal glands generate and excrete cortisol. The hypothalamus in the brain and the pituitary gland, a small organ below the brain, control the hormone's production. The hypothalamus produces corticotropin-releasing hormone when blood cortisol levels drop, which tells the pituitary gland to create ACTH. The adrenal glands are stimulated by ACTH to generate and release cortisol. The brain, pituitary, and adrenal glands must all be operating properly in order to produce enough levels of cortisol.

Only a small fraction of cortisol in the blood is "free" and biologically active; the majority is attached to a protein. Blood cortisol testing assesses both protein-bound and free cortisol, but urine and saliva cortisol testing assesses only free cortisol, which should be in line with blood cortisol levels. Multiple blood and/or saliva cortisol levels collected at various times, such as 8 a.m. and 4 p.m., can be used to assess cortisol levels and diurnal variation. A 24-hour urine cortisol sample will not reveal diurnal variations; instead, it will assess the total quantity of unbound cortisol voided over the course of 24 hours.

If an elevated amount of cortisol is found, a health professional will conduct additional tests to confirm the results and discover the cause.

If a person's blood cortisol level is abnormally high, a doctor may order additional tests to be sure the high cortisol is indeed abnormal. Additional testing could involve monitoring 24-hour urinary cortisol, doing an overnight dexamethasone suppression test, and/or obtaining a salivary sample before sleep to detect cortisol at its lowest level. Urinary cortisol testing necessitates collecting urine over a set length of time, usually 24 hours. Because ACTH is released in pulses by the pituitary gland, this test can assist evaluate whether a raised blood cortisol level is a true rise.

An ACTH stimulation test may be ordered if a health practitioner feels that the adrenal glands are not releasing enough cortisol or if initial blood tests reveal insufficient cortisol production.

ACTH stimulation is a test that measures the amount of cortisol in a person's blood before and after a synthetic ACTH injection. Cortisol levels will rise in response to ACTH stimulation if the adrenal glands are functioning normally. Cortisol levels will be low if they are damaged or not working properly. To distinguish between adrenal and pituitary insufficiency, a lengthier variant of this test can be used.

What do my Cortisol Total test results mean?

Cortisol levels are typically lowest before bedtime and highest shortly after awakening, though this pattern can be disrupted if a person works rotating shifts and sleeps at various times on separate days.

Excess cortisol and Cushing syndrome are indicated by an increased or normal cortisol level shortly after awakening, as well as a level that does not diminish by bedtime. If the excess cortisol is not suppressed after an overnight dexamethasone suppression test, the 24-hour urine cortisol is elevated, or the late-night salivary cortisol level is elevated, the excess cortisol is likely due to abnormal increased ACTH production by the pituitary or a tumor outside of the pituitary, or abnormal production by the adrenal glands. Additional tests will aid in determining the root of the problem.

If the person examined responds to an ACTH stimulation test and has insufficient cortisol, the problem is most likely due to insufficient ACTH production by the pituitary. If the person does not respond to the ACTH stimulation test, the problem is most likely to be with the adrenal glands. Secondary adrenal insufficiency occurs when the adrenal glands are underactive as a result of pituitary dysfunction and/or insufficient ACTH synthesis. Adrenal injury causes decreased cortisol production, which is referred to as primary adrenal insufficiency or Addison disease.

Once an irregularity has been found and linked to the pituitary gland, adrenal glands, or another source, the health practitioner may utilize additional testing, such as a CT scan, to determine the extent of any gland damage.

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

Brief Description: DHEA Sulfate is a blood test that is measuring the levels of Dehydroepiandrosterone Sulfate in the blood. It is often used to diagnose any problems in the adrenal glands such as cancer or a tumor. It can also be used to evaluate the cause of early puberty in young boys and male characteristics or appearance in women.

Also Known As: DHEA-SO4 Test, DHEAS Test, DHES1 Test, Dehydroepiandrosterone Sulfate Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a DHEA Sulfate test ordered?

When excess androgen production is suspected and/or a health practitioner wants to analyze a person's adrenal gland function, a DHEAS test, along with other hormone testing, may be requested.

It can be assessed when a woman exhibits signs and symptoms of amenorrhea, infertility, and/or virilization. The intensity of these alterations varies, but they may include:

• A huskier voice
• Hair on the face or on the body that is excessive
• Baldness in men
• Muscularity
• Acne
• The Adam's apple has been enlarged
• Breast size has shrunk

It may also be ordered if a young girl exhibits evidence of virilization or if a female infant's external genitalia are not clearly male or female.

When young males show indicators of premature puberty, such as a deeper voice, pubic hair, muscularity, and an enlarged penis before the age of typical puberty, DHEAS may be evaluated.

What does a DHEA Sulfate blood test check for?

Male sex hormone dehydroepiandrosterone sulfate is found in both men and women. This test determines the amount of DHEAS in your blood.

DHEAS:

• At puberty, it aids in the development of male secondary sexual traits.
• Can be transformed into more strong androgens like testosterone and androstenedione by the body.
• It has the ability to transform into estrogen.

DHEAS is almost entirely produced by the adrenal glands, with minor contributions from a woman's ovaries and a man's testicles.

It's a good indicator of how well the adrenal glands are working. Overproduction of DHEAS can be caused by malignant and non-cancerous adrenal tumors, as well as adrenal hyperplasia. DHEAS can be produced by an ovarian tumor in rare cases.

DHEAS excess:

• In adult men, it may go unnoticed.
• In young boys, it can cause early puberty.
• Menstrual irregularities and the development of masculine physical traits in girls and women, such as excess body and facial hair
• Can result in a female infant being born with genitals that aren't clearly male or female

Lab tests often ordered with a DHEA Sulfate test:

• Testosterone
• ACTH
• FSH
• LH
• Prolactin
• Estrogen
• Estradiol
• Sex Hormone Binding Globulin
• 17-Hydroxyprogesterone
• Androstenedione

Conditions where a DHEA Sulfate test is recommended:

• PCOS
• Infertility
• Endocrine Syndromes
• Adrenal Insufficiency
• Congenital Adrenal Hyperplasia

How does my health care provider use a DHEA Sulfate test?

The dehydroepiandrosterone sulfate test is ordered in conjunction with testosterone and other male hormones assays to:

• Examine the adrenal glands' performance.
• Differentiate DHEAS-secreting disorders produced by the adrenal glands from those caused by the testicles or, in rare cases, the ovaries
• Adrenocortical tumors and adrenal malignancies can be diagnosed with this test.
• Assist in the diagnosis of congenital and adult-onset adrenal hyperplasia.

DHEAS levels are frequently examined in women, along with other hormones like FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovarian syndrome and rule out other reasons of infertility, lack of monthly cycle, and excess facial and body hair.

DHEAS levels, along with other hormones, may be requested to examine and diagnose the cause of young females developing masculine physical traits and young boys developing early puberty.

What do my DHEA-S test results mean?

A normal DHEAS level, together with other normal male hormone levels, suggests that the adrenal gland is working properly. When an adrenal tumor or cancer is present but not secreting hormones, DHEAS may be normal.

A high DHEAS blood level could indicate that the person's symptoms are caused or exacerbated by excessive DHEAS production. An elevated level of DHEAS, on the other hand, is not used to make a diagnosis of any particular condition; rather, it usually signals that further testing is required to determine the source of the hormone imbalance. An adrenocortical tumor, Cushing illness, adrenal cancer, or adrenal hyperplasia, as well as a DHEAS-producing ovarian tumor, can all cause high DHEAS.

DHEAS levels may be high in polycystic ovary syndrome, but they may also be normal, as PCOS is usually associated with ovarian androgen production.

Adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a disorder characterized by low levels of pituitary hormones that govern the generation and secretion of adrenal hormones, can all produce low DHEAS levels.

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

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a GGT test ordered?

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

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

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

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

What does a GGT blood test check for?

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

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

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

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

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

Lab tests often ordered with a GGT test:

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

Conditions where a GGT test is recommended:

• Liver Disease
• Alcoholism
• Hepatitis
• Cirrhosis

Commonly Asked Questions:

How does my health care provider us a GGT test?

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

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

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

What do my GGT test results mean?

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

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

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

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

Description: Hemoglobin A1c is the protein Hemoglobin found in red blood cells, but with glucose attached to it. Hemoglobin A1c is used to check for and monitor diabetes as it shows average blood glucose levels over the past 2 to 3 months.

Also Known As: A1c Test, HbA1c Test, Glycohemoglobin Test, Glycated Hemoglobin Test, Glycosylated Hemoglobin Test, HbA1c Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Hemoglobin A1c test ordered?

A1c may be requested as part of a routine physical examination or when a practitioner suspects a patient of having diabetes due to characteristic signs or symptoms of high blood sugar, such as:

• Increased thirst and fluid intake
• Increased urination
• Increase in hunger
• Fatigue
• Vision is hazy
• Infections that take a long time to heal

Adults who are overweight and have the following additional risk factors may consider doing the A1c test:

• Physically inactive
• Diabetes in a first-degree relative
• Race/ethnicity that is at high risk such as African Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders
• Blood pressure that is high
• A lipid profile that is abnormal.
• Polycystic ovarian syndrome 
• Cardiovascular disease 
• Insulin resistance and other conditions links to insulin resistance

People who have not been diagnosed with diabetes but have been assessed to be at an increased risk of developing diabetes should have their A1c levels tested at least once a year.

Monitoring

The A1c test may be performed 2 to 4 times a year, depending on the type of diabetes a person has, how well their diabetes is controlled, and the healthcare provider's recommendations. If diabetics are fulfilling treatment goals and have stable glycemic control, the American Diabetes Association advises A1c testing at least twice a year. A1c may be ordered quarterly when someone is first diagnosed with diabetes or if control isn't good.

What does a Hemoglobin A1c blood test check for?

Hemoglobin A1c, often known as A1c or glycated hemoglobin, is hemoglobin that has been attached to glucose. By assessing the proportion of glycated hemoglobin, the A1c test determines the average quantity of glucose in the blood during the previous 2 to 3 months.

Hemoglobin is a protein present inside red blood cells that transports oxygen.

Glycated hemoglobin is generated in proportion to the amount of glucose in the blood. Once glucose attaches to hemoglobin, it stays there for the duration of the red blood cell's life, which is usually about 120 days. The most common kind of glycated hemoglobin is known as A1c. A1c is created on a daily basis and is gradually removed from the bloodstream as older RBCs die and younger RBCs replace them.

This test can be used to detect and diagnose diabetes, as well as the risk of developing it. According to the American Diabetes Association's standards of medical care in diabetes, diabetes can be diagnosed using either A1c or glucose.

This test can also be used to track the progress of a diabetic patient's treatment. It aids in determining how well a person's glucose levels have been controlled over time by medication. An A1c of less than 7% suggests good glucose control and a lower risk of diabetic complications for the majority of diabetics for monitoring reasons.

Lab tests often ordered with a Hemoglobin A1c test:

• Complete Blood Count
• Glucose
• Frucstosamine
• Albumin
• Comprehensive Metabolic Panel
• Microalbumin w/creatinine
• Lipid panel

Conditions where a Hemoglobin A1c test is recommended:

• Type 1 Diabetes
• Type 2 Diabetes

How does my health care provider use a Hemoglobin A1c test?

Adults can use the hemoglobin A1c test to screen for and diagnose diabetes and prediabetes.

A fasting glucose or oral glucose tolerance test should be done to screen or diagnose diabetes in these instances.

The A1c test is also used to track diabetics' glucose control over time. Diabetics strive to maintain blood glucose levels that are as close to normal as feasible. This helps to reduce the risks of consequences associated with chronically high blood sugar levels, such as progressive damage to body organs such as the kidneys, eyes, cardiovascular system, and nerves. The result of the A1c test depicts the average quantity of glucose in the blood over the previous 2-3 months. This can help diabetics and their healthcare professionals determine whether the steps they're taking to control their diabetes are working or if they need to be tweaked.

A1c is a blood test that is usually used to help newly diagnosed diabetics identify how high their uncontrolled blood glucose levels have been in the previous 2-3 months. The test may be ordered multiple times throughout the control period, and then at least twice a year after that to ensure that good control is maintained.

What does my Hemoglobin A1c test result mean?

HbA1c levels is currently reported as a percentage for monitoring glucose control, and it is suggested that most diabetics try to keep their hemoglobin A1c below 7%. The closer diabetics can keep their A1c to the therapeutic objective of less than 7% without experiencing abnormally low blood glucose, the better their diabetes is controlled. The risk of problems rises as the A1c rises.

However, a person with type 2 diabetes may have an A1c goal set by their healthcare professional. The length of time since diagnosis, the presence of other diseases as well as diabetes complications, the risk of hypoglycemia complications, life expectancy, and whether or not the person has a support system and healthcare resources readily available are all factors that may influence the goal.

For example, a person with heart disease who has had type 2 diabetes for many years without diabetic complications may have a higher A1c target set by their healthcare provider, whereas someone who is otherwise healthy and newly diagnosed may have a lower target set by their healthcare provider as long as low blood sugar is not a significant risk.

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

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

Average Processing Time: 2 to 3 days

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.

Brief Description: An Insulin test is a blood test that measures the insulin levels in the blood's serum. It is a measurement that is heavily used in patients with diabetes.

Also Known As: Fasting Insulin Test, Insulin Assay Test, Insulin Serum Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: 9 Hours Fasting Required

Average Processing Time: 2 to 3 days

When is an Insulin test ordered?

Insulin levels are most commonly ordered after a low glucose result or when someone has acute or chronic symptoms of hypoglycemia.  Hypoglycemia can cause the following symptoms:

• Sweating
• Palpitations
• Hunger
• Brain fog
• Hazy vision
• Dizziness
• Fainting

Seizures and loss of consciousness are common in severe instances.

While low blood glucose can cause these symptoms, they can also be caused by other illnesses.

When a person has or is suspected of having insulin resistance, an insulin test may be performed. People with type 2 diabetes, polycystic ovary syndrome, prediabetes or cardiac disease, or metabolic syndrome may fall into this category.

After an insulinoma has been effectively removed, a health practitioner may arrange insulin and C-peptide testing to verify the effectiveness of treatment and subsequently order the tests on a regular basis to monitor for recurrence.

Periodic testing can also be performed to track the success of an islet cell transplant by determining the graft's insulin-producing capacity.

What does an Insulin blood test check for?

Insulin is a hormone produced in the pancreas' beta cells and stored there. It is necessary for the transfer and storage of glucose, the body's primary energy source. Insulin aids in the delivery of glucose from the bloodstream to cells, as well as the regulation of blood glucose levels and lipid metabolism. This test determines how much insulin is present in the blood.

The levels of insulin and glucose in the blood must be balanced. Carbohydrates are frequently broken down into glucose and other simple sugars after a meal. The blood glucose level rises, prompting the pancreas to produce insulin into the bloodstream. The amount of glucose in the blood reduces as it enters cells, and the amount of insulin released by the pancreas decreases.

If an individual is unable to produce enough insulin, or if the body's cells become resistant to its effects, glucose is unable to reach the majority of the body's cells, causing the cells to starve as blood glucose climbs to harmful levels. This can disrupt normal metabolic processes, leading to a variety of illnesses and difficulties, such as kidney disease, cardiovascular disease, and eyesight and neurological issues.

Diabetes is a life-threatening illness characterized by excessive glucose levels and diminished insulin action. People with type 1 diabetes produce relatively little insulin, necessitating the use of insulin supplements. Insulin resistance is a common cause of type 2 diabetes, which worsens over time.

Insulin resistance occurs when the body is unable to respond to insulin's effects. The body makes up for this by manufacturing more of the hormone. Hyperinsulinemia and overstimulation of some insulin-sensitive tissues happen as a result of this. This process generates an imbalance in the connection between glucose and insulin over time, which, if left untreated, can lead to health problems affecting numerous regions of the body.

Insulin resistance can be present in people with polycystic ovary syndrome, prediabetes or cardiac disease, metabolic syndrome, and diseases of the pituitary or adrenal glands, in addition to type 2 diabetes.

Hyperinsulinemia is most commonly seen in persons with tumors of the pancreatic islet cells or an excess of injected insulin, aside from insulin resistance. Low blood sugar is caused by hyperinsulinemia, which can cause sweating, hunger, palpitations, confusion, dizziness, blurred vision, seizures, and fainting. Because the brain relies on blood glucose for energy, severe glucose deprivation caused by hyperinsulinemia can swiftly result in insulin shock and death.

Lab tests often ordered with an Insulin test:

• Glucose
• Hemoglobin A1c
• C-Peptide
• Comprehensive Metabolic Panel

Conditions where an Insulin test is recommended:

• Diabetes
• Insulin Resistance
• PCOS
• Metabolic Syndrome

Commonly Asked Questions:

How does my health care provider use an insulin test?

Insulin testing can be used for a variety of purposes. Insulin is a hormone produced in the pancreas' beta cells and stored there. Insulin is a hormone that aids in the movement of glucose, the body's primary source of energy, from the bloodstream to the cells. Cells starve if a person produces too little insulin or is resistant to its effects. When someone produces too much insulin, such as when they have an insulin-producing tumor, symptoms of low blood glucose appear.

Insulin testing may be used to assist with the following:

• Diagnose an insulinoma, confirm that the tumor was successfully removed, and/or keep an eye out for recurrence.
• Determine the source of hypoglycemia in a person who has signs and symptoms.
• Recognize insulin resistance.
• In this instance, a C-peptide test may be used to monitor the quantity of insulin produced by the beta cells in the pancreas. As part of the conversion of proinsulin to insulin in the pancreas, the body produces both insulin and C-peptide at the same time. When a doctor wishes to know how much insulin is created by the body and how much comes from outside sources like insulin injections, both tests may be ordered. The C-peptide test indicates insulin produced by the pancreas, but the insulin test analyzes insulin from both sources.
• Determine when a type 2 diabetic may need to supplement oral medications with insulin.

Insulin tests can be ordered in conjunction with glucose and C-peptide tests. In addition to the glucose tolerance test, insulin levels are sometimes employed. To assess insulin resistance, blood glucose and insulin levels are tested at pre-determined time intervals in this circumstance.

What do my Insulin test result mean?

Insulin levels must be reviewed in the context of other diagnostic tests and symptoms.

Insulin levels can be elevated with:

• Acromegaly
• Cushing's syndrome
• Use of medications such as corticosteroids, levodopa, and oral contraceptives
• Intolerance to fructose or galactose
• Insulinomas
• Obesity
• Insulin resistance, as seen in type 2 diabetes and metabolic syndrome

Insulin levels can be low with:

• Diabetes 
• Hypopituitarism
• Chronic pancreatitis 
• Pancreatic cancer

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.

Average Processing Time: 1 to 2 days

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Lactate Dehydrogenase test ordered?

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

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

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

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

What does a Lactate Dehydrogenase blood test check for?

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

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

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

Lab tests often ordered with a Lactate Dehydrogenase test:

• Comprehensive Metabolic Panel
• Haptoglobin
• Hepatic Function Panel

Conditions where a Lactate Dehydrogenase test is recommended:

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

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

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

A blood test for LD may be used:

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

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

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

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

What do my lactate dehydrogenase test results mean?

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

Elevated LD levels may be seen with:

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

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

Fluids in the body:

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

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

Description: A 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.

Average Processing Time: 1 to 2 days

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.

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Magnesium test ordered?

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

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

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

What does a Magnesium Serum test check for?

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

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

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

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

Lab tests often ordered with a Magnesium test:

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

Conditions where a Magnesium test is recommended:

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

How does my health care provider use a Magnesium test?

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

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

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

What does my Magnesium test result mean?

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

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

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

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

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

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Phosphate test ordered?

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

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

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

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

What does a Phosphate blood test check for?

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

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

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

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

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

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

Lab tests often ordered with a Phosphate test:

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

Conditions where a Phosphate test is recommended:

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

How does my health care provider use a Phosphate test?

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

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

What does my Phosphorus test result mean?

Hypophosphatemia can be caused by or linked to:

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

Hyperphosphatemia can be caused by or linked to:

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

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

Description: Sex Hormone Binding Globulin test is a blood test that is often paired in testosterone testing for men suspected to have low testosterone and women with elevated testosterone.

Also Known As: SHBG Test, TeBG Test, Testosterone-Estrogen Binding Globulin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a Sex Hormone Binding Globulin test ordered?

Sex Hormone Binding Globulin may be ordered by a healthcare provider to investigate infertility, diminished sex drive, and erectile dysfunction in males, or irregular cycles, infertility, and excess body and face hair in women, when total testosterone values do not appear to be consistent with the mentioned signs and symptoms.

What does a Sex Hormone Binding Globulin blood test check for?

SHBG is a liver-produced protein that strongly binds to the hormones testosterone, dihydrotestosterone, and estradiol. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. This test examines the amount of SHBG in the blood and is most commonly used to determine whether a person has too much or too little testosterone.

In men, SHBG binds roughly 45 percent to 65 percent of testosterone in the blood, with the rest weakly and reversibly linked to albumin. Only around 2% to 3% of testosterone is accessible to tissues as free testosterone, but testosterone that is weakly linked to albumin is also bioavailable and can be rapidly absorbed by the body's tissues.

In women, a somewhat higher percentage of testosterone is bound to SHBG in the blood than in men. SHBG is important in controlling the quantities of bioavailable male sex hormones and estrogens circulating throughout the body in women. Because SHBG has a stronger affinity for the androgens testosterone and DHT, women with low SHBG may experience signs and symptoms of androgen excess.

A total testosterone test does not differentiate between bound and unbound testosterone; instead, it determines the total amount of testosterone present. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the person's tissues. When a person's indications and symptoms do not match the results of a total testosterone test, a SHBG test may be conducted.

Lab tests often ordered with a Sex Hormone Binding Globulin test:

• Testosterone
• Estradiol
• Dihydrotestosterone
• FSH
• LH
• Estriol
• Estrone
• Albumin
• Prolactin

Conditions where a Sex Hormone Binding Globulin test is recommended:

• Polycystic Ovary Syndrome
• Infertility
• Liver disease
• Hyperthyroidism
• Eating disorders
• Pregnancy
• Cushing Syndrome
• Hypothyroidism

How does my health care provider use a Sex Hormone Binding Globulin test?

The sex hormone binding globulin test can be performed to determine whether a man has low testosterone or if a woman has too much testosterone. It can be used in conjunction with other tests to assess a person's sex hormone status.

SHBG is a protein that binds to testosterone, dihydrotestosterone, and estradiol, among other hormones. SHBG distributes these hormones in the blood as physiologically inactive versions when they are bound. Changes in SHBG levels can have an impact on the amount of hormone accessible to the body's tissues.

To assess a person's current hormonal balance, tests for albumin and one or more additional sex hormones, such as prolactin, estradiol, and LH may be conducted.

In men

In order to diagnose the cause of infertility, diminished sex drive, or erectile dysfunction in an adult male, SHBG and total testosterone levels may be ordered. When total testosterone findings are contradictory with clinical symptoms, measuring SHBG in addition to testosterone is extremely beneficial.

Total testosterone in the blood is measured without distinguishing between bound and unbound testosterone; rather, it determines the total amount of testosterone in the blood. In many circumstances, this is sufficient to determine if testosterone production is excessive or inadequate. However, if a person's SHBG level is abnormal, the total testosterone level may not accurately reflect the amount of testosterone available to the body's tissues.

With a simple total testosterone assessment, health practitioners can estimate bioavailable testosterone by measuring SHBG. Because less testosterone is accessible to the body's tissues, increased SHBG in males may be linked to symptoms of low testosterone levels.

Total testosterone should be measured in the initial screening for testosterone deficiency, according to the Endocrine Society's professional standards. If the results are abnormal, the test is repeated the next day. They propose one of the following if repeat readings are low-normal and/or SHBG is abnormal:

In women

The ovaries and adrenal glands produce modest amounts of testosterone in women. Even little increases in testosterone production can throw off the hormone balance, resulting in symptoms including irregular or missed periods, infertility, acne, and excessive face and body hair. These and other signs and symptoms are common in polycystic ovarian syndrome, a disorder marked by an overproduction of male sex hormones. SHBG and testosterone testing may be helpful in detecting and evaluating excess testosterone production and/or decreasing SHBG concentrations, as well as in evaluating women with PCOS.

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

Description: A Uric Acid test is a blood test that measures Uric Acid levels in your blood’s serum to screen for gout and monitor those undergoing chemotherapy or the development of kidney stones.

Also Known As: Serum Urate Test, UA Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Uric Acid test ordered?

When a healthcare provider suspects a patient has a high uric acid level, a uric acid blood test is ordered. Gout is a prevalent form of arthritis that affects some people who have excessive uric acid levels. Gout causes discomfort in the joints, most commonly in the toes but also in other joints. When cancer patients are undergoing chemotherapy or radiation therapy, the test is also ordered to verify that their uric acid levels do not rise dangerously high.

When a person has recurring kidney stones or gout and has to be monitored for the production of these stones, a urine uric acid test may be ordered.

What does a Uric Acid blood test check for?

Purines are broken down to form uric acid. Purines are nitrogen-containing molecules that can be found in all of the body's cells, including DNA. This test determines how much uric acid is present in the blood or urine.

Cells break down as they age and die, releasing purines into the bloodstream. Purines can also be obtained through the digestion of specific foods, such as liver, anchovies, mackerel, dried beans and peas, and alcoholic beverages, particularly beer. The kidneys remove the majority of uric acid from the body, which is then excreted in the urine, with the remaining excreted in the stool.

When too much uric acid is created or not enough is eliminated from the body, it can build up in the body, causing blood levels to rise. Excess uric acid can induce gout, which is characterized by joint inflammation caused by the production of uric acid crystals in the joint fluid. Excess uric acid can also build up in tissues like the kidney, resulting in kidney stones or failure.

Too much uric acid in the body can occur as a result of creating too much, not removing enough, or a combination of both. Uric acid levels can rise as a result of an increase in cell death, as seen with some cancer treatments, or as a result of a rare hereditary tendency to make too much uric acid. Reduced uric acid removal is frequently caused by reduced renal function as a result of kidney disease.

Lab tests often ordered with a Uric Acid test:

• Complete Blood Count
• Iron Total and Total Iron binding capacity
• Comprehensive Metabolic Panel
• Lipid Panel
• Urinalysis Complete

Conditions where a Uric Acid test is recommended:

• Arthritis
• Gout
• Kidney Disease

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

The uric acid blood test is used to diagnose gout by detecting elevated levels of this molecule in the blood. The test is also used to monitor uric acid levels in persons who are receiving cancer treatment such as chemotherapy or radiation. Rapid cell turnover can lead to a rise in uric acid levels as a result of such treatment.

The uric acid urine test is used to detect the source of recurring kidney stones and to monitor the production of stones in persons with gout.

What does my Uric Acid result mean?

Hyperuricemia is defined as blood uric acid levels that are higher than usual. It can be caused by the body creating too much uric acid or the kidneys failing to eliminate enough uric acid from the body. To determine the reason of uric acid overproduction or reduced elimination, more research is needed.

Purine break-down is affected by a number of genetic inborn defects. Increased uric acid production can be caused by cancer that has spread from its original place, leukemias, multiple myeloma, and cancer chemotherapy. Reduced uric acid elimination can be caused by chronic renal illness, acidosis, pregnancy toxemia, and alcoholism.

Increased uric acid levels can cause crystals to develop in the joints, resulting in the joint inflammation and pain associated with gout. Uric acid can form crystals or kidney stones, which can cause kidney injury.

Low uric acid levels in the blood are significantly less common than high ones, and they are rarely a cause for concern. Although low uric acid levels have been linked to liver and renal disease, Fanconi syndrome, toxic exposure, and in rare cases, a hereditary metabolic deficiency, these problems are usually detected by other tests and symptoms rather than a single low uric acid result.

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

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required.

Average Processing Time: 3 to 4 days

When is a Vitamin D test ordered?

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

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

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

What does a Vitamin D blood test check for?

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

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

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

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

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

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

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

This test has 3 Biomarkers

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

Lab tests often ordered with a Vitamin D test:

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

Conditions where a Vitamin D test is recommended:

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

Commonly Asked Questions:

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

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

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

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

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

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

What do my Vitamin D results result mean?

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

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

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

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

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