Liver Disease

Advanced Liver Health - Advanced

Advanced Liver Health - Comprehensive

Acetaminophen is an analgesic agent that may be hepatotoxic when ingested in quantities exceeding 150 mg/kg.

Description: An Albumin test is a blood test used to screen for a diagnose kidney disease, liver disorders, and evaluate a patient’s nutritional status.

Also Known As: ALB Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is an Albumin test ordered?

A panel of tests is commonly ordered as part of a health check, including an albumin test.

If a person exhibits any of the following signs of a liver problem, an albumin test may be requested along with other tests:

• skin or eyes turning yellow
• weakness, exhaustion
• Unaccounted-for weight loss
• reduced appetite
• edema and/or pain in the abdomen
• Dark feces and pale urine
• Itching

When someone exhibits the following nephrotic syndrome symptoms, for example:

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

An albumin test may also be requested by a medical professional to assess or track a patient's nutritional condition. A reduction in albumin, however, needs to be carefully examined because, in addition to starvation, albumin concentrations respond to a number of other diseases.

What does an Albumin blood test check for?

The liver produces a protein called albumin. It has numerous roles and makes up roughly 60% of the blood's overall protein content. The amount of albumin in the blood is determined by this test.

Albumin nourishes tissues, transports hormones, vitamins, medicines, and chemicals like calcium throughout the body, and prevents fluid from seeping out of blood vessels. When factors affect the liver's ability to produce albumin, increase protein breakdown, increase protein loss through the kidneys, and/or increase plasma volume, albumin levels may decline to a greater or lower extent.

Low blood albumin can result from two key factors, including:

• Severe liver disease: Since the liver produces albumin, its level may drop with loss of liver function; however, this is usually only the case in cases of severe liver illness.
• Kidney disease: One of the kidneys' numerous jobs is to preserve plasma proteins like albumin so that they don't pass through the urine production process with other waste materials. High levels of albumin are found in the blood, and when the kidneys are working well, very little albumin is excreted in the urine. However, the ability to preserve albumin and other proteins starts to deteriorate if a person's kidneys become harmed or ill. Chronic disorders like diabetes and hypertension are prone to this. Extremely large amounts of albumin are lost through the kidneys in nephrotic syndrome.

Lab tests often ordered with an Albumin test:

• Hepatic Function Panel
• Comprehensive Metabolic Panel
• Urine Albumin
• Urinalysis
• Total Protein
• Creatinine
• Blood Urea Nitrogen (BUN)
• Renal Panel

Conditions where an Albumin test is recommended:

• Liver Disease
• Kidney Disease
• Malnutrition
• Proteinuria

How does my health care provider use an Albumin test?

An albumin test is widely used to assess a person's general health state since it is typically included in the panels of tests run as part of a health check, such as a thorough metabolic panel.

Albumin may also be used in a variety of situations to aid in the diagnosis of disease, to track changes in health status due to therapy or disease progression, and as a screen that may suggest the need for other types of testing because it can be low in a range of diseases and disorders.

The liver produces albumin, a protein that nourishes cells, prevents fluid from seeping out of blood vessels, carries hormones, vitamins, medications, and other chemicals like calcium throughout the body.

A creatinine, blood urea nitrogen, or renal panel may be ordered in addition to an albumin test to assess liver function or in conjunction with one of these tests to assess kidney function. Additionally, albumin can be requested to assess a person's nutritional status.

What do my Albumin test results mean?

The results of an albumin test are assessed in conjunction with those from other tests carried out concurrently, such as those in a comprehensive metabolic panel or during follow-up.

A low albumin level could be a red flag and a sign that more research may be necessary. A low albumin level could indicate a short-term issue that will go away on its own or it could indicate an acute or chronic disease that calls for medical attention.

When conditions affect albumin production, increase protein breakdown, increase protein loss, and/or expand plasma volume, albumin levels may decline to a greater or lower extent. Additional testing may be carried out to look into a low result, depending on the patient's medical history, signs and symptoms, and physical examination.

Low albumin levels may signal liver illness. To pinpoint precisely which sort of liver illness may be present, liver enzyme tests or a liver panel may be prescribed. However, until the disease has progressed to an advanced degree, a person with liver disease may have normal or nearly normal albumin levels. For instance, albumin is frequently low in cirrhotic individuals while albumin is typically normal in most chronic liver illnesses that have not progressed to cirrhosis.

Low albumin levels can be a sign of illnesses where the kidneys are unable to stop albumin from leaking into the urine and being lost. In this situation, tests for creatinine, BUN, or a renal panel may be requested, along with measurements of the albumin or protein levels in the urine.

Inflammation, shock, and starvation are among conditions that can cause low albumin levels. They may exhibit symptoms of diseases like Crohn's disease or celiac disease, which affect how well the body absorbs and digests protein, as well as circumstances where significant amounts of protein are wasted from the intestines.

A low albumin level can also occur in a number of different illnesses, including:

• Infections
• Burns
• Surgery
• chronic disease
• Cancer
• Diabetes
• Hypothyroidism
• the cancer syndrome
• Plasma volume enlargement brought on by congestive heart failure and occasionally pregnancy
• Dehydration can cause high albumin levels, albeit this condition is not routinely tracked or detected by the test.

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

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Alkaline Phosphatase test ordered?

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

What does an Alkaline Phosphatase test check for?

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

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

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

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

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

Lab tests often ordered with an Alkaline Phosphatase test:

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

Conditions where an Alkaline Phosphatase test is recommended:

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

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

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

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

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

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

What do my Alkaline Phosphatase test results mean?

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

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

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

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

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

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

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

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

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

When the Total Alkaline Phosphatase activity is increased, the Isoenzymes are useful in determining the source of the increased activity.

Description: The Alpha-1-Antitrypsin Quantitative test measures levels of the alpha-1-antitrypsin protein in the blood.

Also Known As: Alpha1-antitrypsin Test, A1AT Test, AAT Test, Alpha 1 Antitrypsin Serum Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is an Alpha-1-Antitrypsin test ordered?

When Alpha-1 antitrypsin tests may be prescribed:

• Jaundice that lasts more than a week or two in a baby, an enlarged spleen, fluid buildup in the belly, persistent itching, and other symptoms of liver damage are present.
• A person with COPD, elevated, sensitive skin lesions that develop into ulcers, granulomatosis with polyangiitis, or unexplained airway widening may be of any age.
• Wheezing, a persistent cough, bronchitis, shortness of breath after exercise, and/or other emphysema symptoms often appear in people under the age of 40. This is particularly true when the person is not a smoker, has not been exposed to known lung irritants, and when the lung damage appears to be low in the lungs.
• Someone has an alpha-1 antitrypsin deficiency that runs in their family.
• A person wants to know how likely it is that their child would experience the same problems as their impacted family member.

The American Thoracic Society advised AAT testing in their 2003 guidelines when people were diagnosed with diseases like:

• Young age for onset of emphysema and/or absence of clear risk factors for the condition, such as smoking
• Bronchiectasis
• difficult-to-treat asthma Unknown origin of liver disease
• Panniculitis with necrosis

The Alpha-1 Foundation suggests AAT testing for all people with:

• COPD
• illness of the liver with no known cause
• Panniculitis with necrosis
• Polyangiitis and granulomatosis
• mysterious bronchiectasis

The Alpha-1 Foundation also advises providing genetic counseling and AAT testing to people who have immediate or extended family members who have an aberrant AAT gene.

What does an Alpha-1-Antitrypsin blood test check for?

A blood protein called alpha-1 antitrypsin shields the lungs from harm from enzymes that have been activated. To help with the diagnosis of alpha-1 antitrypsin deficiency, laboratory tests detect the amount of AAT in blood or find aberrant forms of AAT that a person has inherited.

The most significant enzyme that AAT aids in inactivating is elastase. Elastase is a white blood cell termed a neutrophil that is created as part of the body's normal response to inflammation and injury. Elastase disassembles proteins so that the body can eliminate and recycle them. Elastase will also start to degrade and harm lung tissue if its activity is not controlled by AAT.

The gene that codes for AAT is inherited twice every person. The protease inhibitor gene is what it is known as. Because of the co-dominance of this gene, the body produces half of its AAT from each copy of the SERPINA1 gene. Less AAT and/or AAT with diminished function are produced if there is a change or mutation in one or both of the gene copies.

Alpha-1 antitrypsin deficiency is a condition that affects a person whose AAT production falls below 30% of normal. Emphysema, a progressive lung illness, is a serious danger for people with this disorder to experience in their early adult years. The lung damage likely to happen sooner and be more severe if they smoke or are exposed to occupational dust or fumes.

AAT that is dysfunctional of a particular sort builds up in the cells of the liver, where it is created. As AAT accumulates in these cells, it starts to produce aberrant protein chains, which then start to kill the cells and harm the liver. AAT-deficient neonates are jaundiced and suffer liver damage in about 10% of cases. These infants may need a liver transplant to survive in serious circumstances. The most frequent genetic cause of liver disease in children is presently AAT deficiency.

Adults with an AAT deficiency are more likely to develop liver cancer, cirrhosis, and chronic liver disease. Adults with AAT insufficiency rarely experience symptoms or indicators of liver damage, nevertheless. The hereditary gene mutation determines the amount and function of the AAT. The SERPINA1 gene contains more than 120 distinct alleles, however only a few of them are widespread. 90% of Americans have two copies of the typical, "wild type," M gene. S and Z are the aberrant genes that are most frequently found.

Lab tests often ordered with an Alpha-1-Antitrypsin test:

• Protein Electrophoresis
• Total Protein
• Hepatic Function Panel
• Blood Gases

Conditions where an Alpha-1-Antitrypsin test is recommended:

• Lung Disease
• Liver Disease
• Asthma

How does my health care provider use an Alpha-1-Antitrypsin test?

When a patient has early onset emphysema or chronic obstructive pulmonary disease but no clear risk factors, such as smoking or exposure to lung irritants like dust or fumes, alpha-1 antitrypsin testing is utilized to help diagnose alpha-1 antitrypsin deficiency as the cause. It may also be applied to asthmatics who continue to have breathing difficulties despite receiving treatment.

Other symptoms of unexplained liver injury, such as prolonged jaundice, are also diagnosed with the use of testing. This can be done on anyone of any age, but is typically done on infants and young children.

A person with a family history of alpha-1 antitrypsin deficiency may also undergo testing to identify whether they have one or two copies of the SERPINA1 gene.

There are typically three different AAT exam kinds. One or more of these could be applied to assess a person:

• The protein alpha-1 antitrypsin in blood is measured by alpha-1 antitrypsin.
• Testing for the phenotype of alpha-1 antitrypsin assesses the quantity and kind of AAT being produced and contrasts it with typical patterns.
• To determine if the typical wild type M allele or variant alleles are present in the SERPINA1 gene, alpha-1 antitrypsin genotyping testing can be utilized. This test won't find every variant, but it will find the most prevalent ones as well as those that might be frequent in a specific region or family. Other family members may be examined to determine their own risk of acquiring emphysema and/or liver dysfunction as well as the possibility that their children may inherit the condition after the sick person's SERPINA1 gene alleles have been determined.

Although gene sequencing for AAT is uncommon, it might be required to find uncommon alleles and make a precise diagnosis.

What do my Alpha-1-Antitrypsin test results mean?

Alpha-1 antitrypsin deficiency may be present in a person whose blood has a low amount of AAT, according to the test results. The risk of developing emphysema and other conditions linked to AAT insufficiency increases with decreasing AAT levels.

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

Description: The Alpha-Fetoprotein and AFP-L3 test is a blood test used to detect the protein alpha-fetoprotein which is produced by the liver.

Also Known As: AFP Test, Total AFP Test, AFP-L3 Test, Alpha-Fetoprotein Tumor Markers, Alpha-Fetoprotein Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 5 to 6 days

When is an Alpha-Fetoprotein and AFP-L3 test ordered?

An AFP blood test may be ordered by a healthcare provider:

• When abdominal masses are felt during a medical examination or imaging testing reveal possible malignancies, it is likely that someone has liver cancer or certain malignancies of the testicles or ovaries.
• When someone has been diagnosed with and treated for cancer of the liver, testicles, or ovaries, the success of treatment is being assessed.
• When someone is being watched for a recurrence of cancer
• Patients with persistent hepatitis or liver cirrhosis should be followed up on.
• When a person has chronic liver illness, an AFP-L3 percent is occasionally ordered to help evaluate the risk of hepatocellular carcinoma, test the efficiency of hepatocellular carcinoma treatment, or monitor for recurrence.

What does an Alpha-Fetoprotein and AFP-L3 blood test check for?

Alpha-fetoprotein is a protein produced predominantly by the liver of a developing baby and the yolk cavity of a developing embryo. When a baby is born, AFP levels are usually high and then rapidly drop. Liver injury and certain malignancies can drastically raise AFP levels. This test determines the amount of AFP in your blood.

When the liver cells regenerate, AFP is generated. AFP can be continuously high in chronic liver illnesses such hepatitis and cirrhosis. Certain cancers can produce extremely high quantities of AFP. Because of this, the AFP test can be used as a tumor marker. Many persons with hepatocellular carcinoma and hepatoblastoma, a kind of liver cancer that affects babies, have elevated levels of AFP. They're also discovered in certain persons who have testicular or ovarian cancer.

There are various different types of AFP. The normal AFP test measures total AFP, which includes all of the AFP variations. In the United States, this is the most common AFP test.

One of the AFP variations is known as L3 because of its propensity to attach to a protein called Lens culinaris agglutinin in the lab. The AFP-L3 percent test compares the quantity of AFP-L3 to the total amount of AFP and is a relatively recent test. Increased L3 levels are linked to a higher likelihood of developing hepatocellular carcinoma in the near future, as well as a worse prognosis, because L3-related malignancies are more aggressive.

AFP-L3 can be higher in people with hepatocellular carcinoma than in those with benign liver disorders who have low total AFP. In Japan, tumor markers such as total AFP and AFP-L3 are utilized in conjunction with ultrasound to monitor hepatocellular carcinoma. This procedure differs from that in the United States and Europe, but healthcare practitioners in the United States occasionally order the two tests.

Lab tests often ordered with an Alpha-Fetoprotein and AFP-L3 test:

• CEA
• CA-125
• hCG Tumor Marker
• DCP

Conditions where an Alpha-Fetoprotein and AFP-L3 test is recommended:

• Ovarian Cancer
• Testicular Cancer

How does my health care provider use an Alpha-Fetoprotein and AFP-L3 test?

The tumor marker alpha-fetoprotein is used to detect and diagnose malignancies of the liver, testicles, and ovaries. Despite the fact that the test is frequently done to monitor persons with chronic liver illnesses including cirrhosis, chronic hepatitis B, or hepatitis C who have an elevated lifetime risk of developing liver cancer, most current guidelines do not advocate it. An AFP test, together with imaging studies, may be ordered by a healthcare provider to try to diagnose liver cancer in its earliest and most treatable stages.

If a person has been diagnosed with hepatocellular carcinoma or another type of AFP-producing cancer, an AFP test may be done on a regular basis to assess treatment response and disease recurrence.

When comparing the amount of the AFP variation AFP-L3 to the total amount of AFP, an AFP-L3 percent is occasionally ordered. The AFP-L3 percent test is not extensively used in the United States, but it is becoming more popular in other nations, such as Japan. The test is used to assess the risk of developing hepatocellular carcinoma, particularly in people with chronic liver disease, as well as the response of the cancer to treatment.

What do my Alpha-fetoprotein test results mean?

Increased AFP levels can suggest the presence of cancer, such as liver cancer, ovarian cancer, or testicular germ cell tumors. However, not all cancers of the liver, ovary, or testicles produce substantial amounts of AFP.

Other malignancies, such as stomach, colon, lung, breast, and lymphoma, might sometimes have elevated levels, but it is rarely ordered to check these illnesses. Cirrhosis and hepatitis are two disorders that can generate elevated levels.

When using AFP as a monitoring tool, lower levels suggest a therapeutic response. If concentrations do not considerably drop after cancer therapy, usually to normal or near-normal levels, some tumor tissue may still be present.

If AFP levels start to rise, the cancer is most likely to return. However, because AFP levels can be deceiving in hepatitis or cirrhosis, AFP levels can be misleading. If AFP levels are not raised prior to therapy, the test will not be useful in monitoring treatment effectiveness or detecting recurrence.

People with chronic liver disease have a higher chance of getting liver cancer when their AFP levels rise from normal to moderately raised to significantly elevated. When total AFP and AFP-L3 percent are highly higher, the person is more likely to develop or have hepatocellular carcinoma in the next year or two. In persons with chronic hepatitis and cirrhosis, however, both AFP and AFP-L3 percent concentrations might be increased and fluctuate. In these circumstances, a significant increase in AFP is more essential than the test result's numerical value.

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

Description: An Alanine Aminotransferase Test is a blood test that is used to screen for and diagnose liver disease.

Also Known As: Alanine Aminotransferase Test, Alanine Transaminase Test, GPT Test, SGPT Test, Serum Glutamic Pyruvic Transaminase Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is an Alanine Transaminase test ordered?

When a person undergoes a standard health examination, ALT may be ordered as part of a full metabolic panel.

When a person has signs and symptoms of a liver problem, a healthcare provider will usually prescribe an ALT test.

Because many people with minor liver damage have no signs or symptoms, ALT may be ordered alone or in combination with other tests for persons who are at an elevated risk for liver disease. With modest liver injury, ALT levels will rise even if there are no other symptoms.

ALT may be ordered on a frequent basis during the course of treatment to establish whether the medication is effective when it is used to monitor the treatment of persons with liver disease.

What does an Alanine Transaminase blood test check for?

Alanine aminotransferase is an enzyme found mostly in liver and kidney cells. It's also found in much lesser concentrations in the heart and muscles. This test determines the amount of ALT in your blood.

The enzyme ALT converts alanine, a protein amino acid, into pyruvate, an important intermediary in cellular energy production. ALT levels in the blood are low in healthy people. ALT is released into the bloodstream when the liver is injured, frequently before more evident indications of liver injury, such as jaundice, appear. As a result, ALT is a useful test for detecting liver disease early on.

The liver is a critical organ positioned directly behind the rib cage on the upper right side of the abdomen. It is engaged in a variety of vital bodily functions. The liver aids in the digestion of nutrients, creates bile to aid in fat digestion, produces a variety of essential proteins such as blood clotting factors and albumin, and breaks down potentially hazardous compounds into safe substances that the body may utilize or discard.

Damage to liver cells can be caused by a variety of factors, resulting in an elevation in ALT. The test is most useful for detecting damage caused by hepatitis or medications or other toxins that are harmful to the liver.

As part of a liver panel, ALT is frequently tested alongside aspartate aminotransferase, another liver enzyme. When the liver is injured, both ALT and AST levels rise, albeit ALT is more specific for the liver and may be the only one to rise in some circumstances. An AST/ALT ratio can be used to help distinguish between different types of liver injury and their severity, as well as to distinguish liver injury from heart or muscle damage.

Lab tests often ordered with an Alanine Transaminase test:

• AST
• ALP
• GGT
• Bilirubin
• Liver Panel
• Comprehensive Metabolic Panel
• Albumin
• Total Protein
• Prothrombin Time
• Hepatitis Panel General

Conditions where a an Alanine Transaminase test is recommended:

• Liver Disease
• Hepatitis
• Jaundice
• Cirrhosis
• Alcoholism
• Wilson Disease
• Hemochromatosis

How does my health care provider use an Alanine Transaminase test?

The alanine aminotransferase test is commonly used to diagnose liver damage. It's frequently ordered as part of a liver panel or complete metabolic panel with aspartate aminotransferase to screen for and/or diagnose liver disease.

ALT is an enzyme found mostly in liver and kidney cells. ALT is released into the bloodstream when the liver is injured. As a result, ALT is a useful test for detecting liver disease early on.

Although ALT is more specific to the liver than AST, they are both considered to be two of the most significant tests for detecting liver impairment. When AST is directly compared to ALT, an AST/ALT ratio is calculated. This ratio can assist distinguish between different types of liver disease and identify cardiac or muscle harm.

To assess which type of liver illness is present, ALT values are frequently matched to the results of other tests such as alkaline phosphatase, total protein, and bilirubin.

ALT is frequently requested to monitor the therapy of people with liver disease to evaluate if it is effective, and it can be ordered alone or in combination with other tests.

What do my ALT test results mean?

A low ALT level in the blood is normal and anticipated. The most prevalent cause of ALT levels that are higher than normal is liver disease.

Acute hepatitis and viral infections are the most common causes of very elevated ALT values. ALT levels are normally elevated for 1-2 months after acute hepatitis, but they might take up to 3-6 months to return to normal. ALT levels may also be significantly raised as a result of exposure to liver-toxic medications or other chemicals, or in situations that produce reduced blood flow (ischemia) to the liver.

In chronic hepatitis, ALT levels are frequently less than four times normal. Because ALT levels in this scenario regularly fluctuate between normal and slightly elevated, the test may be ordered frequently to observe if a trend emerges. Other reasons of mild ALT elevations include bile duct obstruction, cirrhosis, heart damage, alcohol addiction, and liver cancers.

ALT is frequently used in conjunction with an AST test or as part of a liver panel. See the Liver Panel article for more information on ALT values in relation to other liver tests.

The ALT level is usually greater than the AST level in most forms of liver disorders, and the AST/ALT ratio is low. There are a few exceptions: in alcoholic hepatitis, cirrhosis, and heart or muscle injury, the AST/ALT ratio is frequently more than 1, and it may be greater than 1 for a day or two after the onset of acute hepatitis.

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

IMPORTANT - The specimen for this test must be collected at a patient service center that can collect, store and transport frozen samples as outlined below.  

IMPORTANT: Before ordering this lab test, check and confirm with the selected patient service center to ensure that they can collect, store and transport frozen samples as outlined below.

Preferred Specimen(s) 

2 mL frozen plasma collected in an EDTA (lavender-top) tube

Collection Instructions 

Collect blood from stasis-free vein of patient (e.g., no tourniquet). Patient should not clench fist during collection, as muscular exertion often increases venous ammonia levels. Patient should avoid smoking prior to phlebotomy since smoking increases plasma ammonia levels. Tubes should be filled completely and kept tightly stoppered at all times. Place immediately on ice. Separate plasma from cells within 20 minutes and freeze plasma immediately.

Transport Temperature 

Frozen

Specimen Stability 

Room temperature: Unstable
Refrigerated: Unstable
Frozen -20° C: 72 hours
Frozen -70° C: 7 days

Reject Criteria 

Hemolysis • Lipemia • Received thawed • PPT Potassium EDTA (white-top) tube

Description: Ammonia Plasma is a blood test that checks for ammonia levels in your blood’s plasma, and is often ordered by physician’s after sever illness and/or mental changes in a patient to check for ammonia toxicity.

Also Known As: NH3 Test, NH3 Plasma Test, Ammonia Blood Test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is an Ammonia test ordered?

An ammonia test may be required if an infant exhibits any of these symptoms within the first few days after delivery:

• Irritability
• Vomiting
• Lethargy
• Seizures

A medical professional may order an ammonia test if a child exhibits these symptoms a week after a viral infection like the flu or chicken pox or if they think the child might have Reye syndrome.

An ammonia level may be requested to help determine the source of the change in consciousness when individuals exhibit mental changes, disorientation, tiredness, or slide into a coma and may have liver disease or renal failure. When a person suddenly becomes more acutely ill, an ammonia level as well as other liver function tests may be requested in patients with stable liver disease.

What does an Ammonia blood test check for?

A byproduct of the breakdown of protein in the intestines, ammonia is largely produced by bacteria. Excess ammonia can build up in the blood if it is not properly digested and eliminated from the body. This examination calculates the blood's ammonia level.

Normally, ammonia travels through the blood to the liver, where it is transformed into the compounds urea and glutamine. Once at the kidneys, the urea is removed through the urine. Ammonia builds up in the blood and can enter the brain if this "urea cycle" does not completely break down the ammonia.

The brain is poisonous to ammonia. For instance, ammonia and other substances processed by the liver can build up in the brain and induce a condition known as hepatic encephalopathy when liver function is considerably impaired as a result of diseases like cirrhosis or hepatitis.

Mental and neurological abnormalities brought on by hepatic encephalopathy can result in confusion, disorientation, tiredness, eventually a coma, and even death.

Children and infants with elevated ammonia levels may vomit often, get agitated, and become progressively more sluggish. If untreated, they could develop respiratory problems, suffer seizures, or fall into a coma.

Lab tests often ordered with an Ammonia test:

• Hepatic Function Panel
• ALT
• AST
• ALP
• Glucose
• Electrolytes Panel
• Renal Panel
• Comprehensive Metabolic Panel

Conditions where an Ammonia test is recommended:

• Liver Disease
• Kidney Disease
• Cirrhosis
• Hepatitis

How does my health care provider use an Ammonia test?

The ammonia test is used to identify blood levels of ammonia that are elevated and may be brought on by conditions such severe liver illness, kidney failure, Reye syndrome, or a rare hereditary defect of the urea cycle. The test may be employed to aid in determining what is causing a person's changes in behavior and consciousness.

Ammonia is a waste product that the body naturally produces. It primarily results from bacteria in the intestines digesting protein. Excess ammonia can build up in the blood and travel into the brain, where it is poisonous, if the liver is not properly cleansed from the body and processing it.

In order to determine the etiology of a coma or to support the diagnosis of Reye syndrome or hepatic encephalopathy brought on by different liver illnesses, an ammonia test may be requested along with additional tests like glucose, electrolytes, kidney, and liver function tests. A uncommon urea cycle malfunction may also be diagnosed and the severity of the condition assessed using an ammonia level.

There is still debate over the clinical usefulness of the ammonia test for hepatic encephalopathy treatment monitoring among healthcare professionals. Blood ammonia levels do not accurately predict the severity of hepatic encephalopathy since the illness can be brought on by the accumulation of several poisons in the blood and brain.

What do my Ammonia test results mean?

The signs and symptoms of the individual may be brought on by an ammonia level in the blood that is much higher than normal. This signals that the body is not adequately removing and digesting ammonia from the body.

An abnormally high level in newborns can also be a sign of newborn hemolytic illness in addition to a hereditary urea cycle enzyme deficit or abnormality. Newborns frequently experience moderate, brief elevations in ammonia levels, which can rise and fall without manifesting any symptoms.

When children and teens with symptoms have elevated ammonia levels and low glucose levels, Reye syndrome may be present. A higher quantity can also be a sign of an unidentified urea cycle enzymatic malfunction.

An increased ammonia level in both children and adults may signal significant liver or renal impairment that has compromised the body's capacity to eliminate ammonia and that the brain may be harmed. Acute or persistent illnesses frequently act as triggers, raising ammonia levels to the point that a patient has trouble excreting the ammonia.

If a person's blood ammonia level is normal, it's possible that something other than too much ammonia is to blame for their signs and symptoms. Normal ammonia levels do not, however, rule out hepatic encephalopathy. Ammonia levels in the brain may be significantly greater than those in the blood, and other wastes may also play a role in modifications to mental processes and consciousness. This can make it challenging to relate a person's symptoms to ammonia blood levels.

With some types of hypertension, such as essential and malignant, the quantity of ammonia may be reduced.

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

Description: Amylase is a blood test that is used to measure the amount of amylase in the blood’s serum. It is used to assess for and detect a pancreatic disorder.

Also Known As: Amy Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is an Amylase test ordered?

When a person displays symptoms of a pancreatic disease, a blood amylase test may be conducted.

• Abdominal or back pain that is severe
• Fever
• Appetite loss.
• Nausea

A urine amylase test may be requested in conjunction with or after a blood amylase test. A health practitioner may conduct one or both of these tests on a regular basis to evaluate the success of treatment and see whether amylase levels are increasing or decreasing over time.

What does an Amylase blood test check for?

Amylase is one of numerous pancreatic enzymes that aid in carbohydrate digestion. This test detects the presence of amylase in the blood.

Amylase is produced from the pancreas into the duodenum, the first region of the small intestine, where it aids in the digestion of carbohydrates. Other organs, including the salivary glands, generate it as well.

Amylase is normally found in modest amounts in the blood and urine. Increased levels of amylase are released into the blood when pancreatic cells are harmed, as in pancreatitis, or when the pancreatic duct is obstructed by a gallstone or, in rare situations, a pancreatic tumor. This raises amylase levels in the blood.

Lab tests often ordered with an Amylase test:

• Lipase
• Trypsin
• Trypsinogen

Conditions where an Amylase test is recommended:

• Cystic Fibrosis
• Pancreatic Cancer
• Pancreatic Diseases
• Pancreatitis

How does my health care provider use an Amylase test?

An amylase test is used to identify and track acute pancreatitis. It's frequently ordered in conjunction with a lipase test. It can also be used to detect and track chronic pancreatitis and other pancreas-related conditions.

A urine amylase test may be requested as well. Its level will usually correspond to blood amylase concentrations, but the rise and decrease will occur later. A urine creatinine clearance test may be ordered in conjunction with a urine amylase test to determine the ratio of amylase to creatinine filtered by the kidneys. Because poor kidney function might result in a decreased rate of amylase clearance, this ratio is used to assess renal function.

An amylase test on peritoneal fluid may be used to assist diagnose pancreatitis in some instances, such as when there is a buildup of fluid in the abdomen.

Amylase tests are often used to track the progress of pancreatic cancer treatment and after gallstone resection that has resulted in gallbladder attacks.

What do my Amylase test results mean?

A high level of amylase in the blood may suggest the presence of a pancreas problem.

Amylase levels in the blood often rise to 4 to 6 times higher than the highest reference value, also known as the upper limit of normal, in acute pancreatitis. The increase happens within 4 to 8 hours following a pancreas damage and usually lasts until the cause is effectively treated. In a few days, the amylase levels will return to normal.

Amylase levels in chronic pancreatitis are initially fairly increased, although they frequently decline over time as the pancreas deteriorates. Returning to normal levels may not signal that the source of damage has been rectified in this scenario. The size of the amylase rise does not indicate the severity of pancreatic illness.

Amylase levels may also be elevated in persons who have pancreatic duct obstruction or pancreatic cancer.

Urine amylase levels rise in lockstep with blood amylase levels and remain elevated for several days after blood levels have returned to normal.

A high amount of amylase in the peritoneal fluid can indicate acute pancreatitis, but it can also indicate other abdominal problems including a clogged intestine or poor blood supply to the intestines.

A low amylase level in the blood and urine of a person with pancreatitis symptoms could indicate that the amylase-producing cells in the pancreas have been permanently damaged. Reduced levels can also be caused by renal illness or pregnancy toxemia.

Increased blood amylase levels along with normal to low urine amylase levels could indicate the presence of a macroamylase, a harmless compound of amylase and other proteins that builds up in the bloodstream.

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

Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA Test, ANA Screen IFA with Reflex to Titer and pattern IFA Test, ANA with Reflex Test, Antinuclear Antibody Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

IMPORTANT Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

When is an ANA Screen test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does an ANA Screen blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with an ANA Screen test:

• ENA Panel
• Sed Rate (ESR)
• C-Reactive Protein
• Complement
• AMA
• Centromere antibody
• Histone Antibody

Conditions where an ANA Screen test is recommended:

• Autoimmune Disorders
• Lupus
• Rheumatoid Arthritis
• Sjogren Syndrome
• Scleroderma

How does my health care provider use an ANA Screen test?

One of the most often performed tests to diagnose systemic lupus erythematosus is the antinuclear antibody test. It serves as the first step in the evaluation process for autoimmune diseases that might impact various body tissues and organs.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

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

Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA, ANA Screen IFA with Reflex to Titer and pattern IFA, ANA with Reflex, Antinuclear Antibody Screen, DNA-DS Antibody Test, DNA-DS Test, Anti ds-DNA Test, Scl-70 Antibody Test, Anti Scl-70 test, sjogren’s antibody test, SSA-A antibody test, SS-B Antibody test, Sm Antibody Test, Rnp Antibody Sm Rnp Antibody Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge - $13.00

When is a Comprehensive ANA IFA Panel test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does a Comprehensive ANA IFA Panel blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with a Comprehensive ANA IFA Panel test:

• ENA Panel
• Sed Rate (ESR)
• C-Reactive Protein
• Complement
• AMA
• Autoantibodies
• Centromere antibody
• Histone Antibody
• Nuclear Antibody

Conditions where a Comprehensive ANA IFA Panel test is recommended:

• Autoimmune Disorders
• Lupus
• Rheumatoid Arthritis
• Sjogren Syndrome
• Scleroderma

How does my health care provider use a Comprehensive ANA IFA Panel?

The antinuclear antibody test is one of the most common tests used to identify systemic lupus erythematosus. It is used as a primary test to assist evaluate a person for autoimmune illnesses that affect multiple tissues and organs throughout the body.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

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

 

Description: An ANCA screen is used to detect antineutrophil cytoplasmic antibodies in your blood to test for autoimmune vasculitis and to differentiate between Crohn’s disease and ulcerative colitis when testing for inflammatory bowel disease.

Also Known As: ANCA test, cANCA test, pANCA test, Serine Protease 3 test, Acticytoplasmic Test, 3-ANCA test, PR3-ANCA Test, MPO-ANCA test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 5 to 6 days

When is an ANCA Screen test ordered?

When a person exhibits symptoms and signs that point to systemic autoimmune vasculitis, an ANCA test must be performed. Early indications of the illness could include a fever, weariness, weight loss, aches in the muscles and/or joints, and nocturnal sweats. As the illness worsens, damage to blood arteries all throughout the body may result in the signs and symptoms of consequences affecting different tissues and organs.

When a patient exhibits symptoms that point to inflammatory bowel disease and the doctor wants to differentiate between Crohn's disease and ulcerative colitis, they may be prescribed an ANCA test together with an anti-Saccharomyces cerevisiae antibody test.

What does an ANCA Screen test check for?

The immune system of a person makes autoantibodies called antineutrophil cytoplasmic antibodies that wrongly target and attack proteins found in the person's neutrophils. These autoantibodies are found in the blood and their concentration is determined by ANCA testing. The autoantibodies that target the proteins myeloperoxidase and proteinase 3 are two of the most prevalent forms or subgroups of ANCA.

An individual's blood sample is combined with neutrophils for the test, which is then put on a slide and stained fluorescently. Under a microscope, ANCA will exhibit a pattern of fluorescence if they are present. Atypical ANCA, perinuclear, or cytoplasmic ANCA are possible classifications for the pattern. Alternately, a direct ELISA assay can be used in the laboratory to check for myeloperoxidase or proteinase 3 antibodies. When investigating possible vasculitis cases, fluorescence and ELISA testing are frequently combined.

ANCA may be found in a number of autoimmune conditions that result in organ failure, tissue damage, and inflammation.

Systemic vasculitis is a group of diseases characterized by blood vessel deterioration and injury. Due to blood channel narrowing and obstruction, which results in a reduction in blood supply, it can harm tissue and organs. Aneurysms, which are weak spots in the walls of blood vessels that have the potential to burst, can also be created. The degree of autoimmune activity and the areas of the body affected by systemic vasculitis determine the symptoms that an affected person may experience. There are a few forms of systemic vasculitis that are closely linked to ANCA production:

• Polyangiitis and granulomatosis
• Miniature polyangiitis
• Polyangiitis along with eosinophilic granulomatosis
• Nodular polyarteritis

The most typical cases of cANCA/PR3 antibodies and pANCA/MPO antibodies include granulomatosis with polyangiitis and microscopic polyangiitis, respectively. To varied degrees of responsiveness, both may be present in all three categories.

An instance of inflammatory bowel disease known as ulcerative colitis is characterized by inflamed and harmed tissues in the colon's lining. UC and Crohn disease, another kind of IBD that can affect any section of the intestinal tract, can be challenging to distinguish from one another. Atypical ANCA is typically seen in UC patients, but only 20% of CD patients may be positive.

Lab tests often ordered with an ANCA Screen test:

• Antibody Panel
• Complete Blood Count (CBC)
• Sed Rate
• C-Reactive Protein
• Urinalysis
• ASCA
• Calprotectin
• Lactoferrin

Conditions where an ANCA Screen test is recommended:

• Autoimmune Disorders
• Vasculitis
• Inflammatory Bowel Disease

How does my health care provider use an ANCA Screen test?

ANCA antibody tests can be used to:

• Assist in the detection and diagnosis of granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis, among other types of autoimmune vasculitis. This test may occasionally be performed to keep tabs on the patient's progress in therapy or to spot a relapse of certain illnesses.
• Help distinguish between Crohn's disease and ulcerative colitis, two prevalent varieties of inflammatory bowel illness.

ANCA are immune system-generated autoantibodies that wrongly target proteins in a person's neutrophils. Myeloperoxidase and proteinase 3 are the targets of the majority of ANCA subgroups.

There are two possible exam types:

• ANCA testing are most frequently carried out with indirect immunofluorescence microscopy. Neutrophils and serum samples are combined to allow any potential autoantibodies to interact with the cells. A fluorescent stain is applied to the sample before it is placed on a slide. After that, the slide is studied under a microscope to identify any patterns. MPO antibodies are linked to the perinuclear pattern, while PR3 antibodies are linked to the cytoplasmic pattern. Atypical ANCA is yet another potential pattern.
• Antibodies to proteinase 3 and myeloperoxidase can be evaluated separately and specifically using an immunoassay technique.

ANCA, MPO, and PR3 are three tests that some labs will run as a panel, while others will only run MPO and PR3 if the initial ANCA test is positive.

Erythrocyte sedimentation rate and/or C-reactive protein tests to check for inflammation, complete blood counts to measure and assess white and red blood cells, and urinalysis, blood urea nitrogen, and creatinine tests to assess kidney function are additional tests that may be carried out to help with diagnosis. Viral tests for hepatitis or CMV may be prescribed for some patients.

What do my ANCA Screen test results mean?

Care must be taken while interpreting ANCA test results and many considerations must be made. A doctor will take into account clinical symptoms in addition to the outcomes of laboratory testing and other kinds of examinations, such imaging investigations.

Positive results from the ANCA, PR3, and/or MPO tests aid in confirming the diagnosis of systemic autoimmune vasculitis and identifying its many subtypes. However, a biopsy of an afflicted spot is frequently needed to confirm a diagnosis.

Results from negative ANCA tests indicate that an autoimmune vasculitis is not likely to be the cause of a person's symptoms.

Multiple ANCA patterns may be observed for a successful outcome using the indirect immunofluorescence microscopy method.

Perinuclear fluorescence is especially prominent close to the nucleus. In about 90% of samples MPO antibodies will be present with a pANCA pattern.

Fluorescence that is cytoplasmic spreads throughout the cell's cytoplasm. In about 85% of samples PR3 antibodies will be present with a cANCA pattern.

Very little or no fluorescence indicates negative ANCA.

If the ANCA test is positive, another test is run to figure out how much antibody is actually present. The term for this is titer. A serum sample is diluted in stages to determine the titer, and the presence of the antibody is checked after each dilution. The titer is the highest dilution at which the antibody can be found. The titer is 1:64, for instance, if a serum tests positive after being diluted 64 times. More antibody is found in the blood the greater the titer.

ANCA levels can fluctuate over time and are occasionally used in a broad sense to monitor disease activity and/or therapeutic response; nevertheless, titer levels may be variable in certain patients, inadequately reflecting the status of remission or relapse.

More than 80% of individuals with active granulomatosis with polyangiitis have a positive PR3 antibody test and a positive cANCA or pANCA.

Indicators of microscopic polyangitis, glomerulonephritis, eosinophilic granulomatosis with polyangiitis, and Goodpasture syndrome include positive tests for MPO antibodies and a positive pANCA. Other autoimmune diseases such systemic lupus erythematosus, rheumatoid arthritis, and Sjögren syndrome may also exhibit MPO and pANCA.

Patients with signs of an inflammatory bowel illness may benefit from ANCA testing.

If the atypical ANCA is positive and the ASCA is negative, ulcerative colitis is probably present.

As long as ASCA is positive and atypical ANCA is negative, Crohn's disease is most likely present. Even if ANCA and/or ASCA tests are negative, a person may nonetheless have UC, CD, or another IBD.

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

Description: An Aspartate Aminotransferase Test is a blood test that is used to screen for and diagnose liver disease.

Also Known As: Aspartate Aminotransferase Test, Serum Glutamic-Oxaloacetic Transaminase Test, SGOT Test Transaminase, Serum AST Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is an Aspartate Aminotransferase test ordered?

When someone undergoes a standard health examination, an AST test may be requested as part of a full metabolic panel.

When a person exhibits indications and symptoms of a liver problem, an AST test may be ordered along with numerous other tests.

Because many persons with minor liver damage have no signs or symptoms, AST may be ordered alone or in combination with other tests for people who are at an elevated risk for liver disease.

When AST is used to evaluate the effectiveness of treatment for people with liver disease, it may be ordered on a frequent basis during the course of treatment.

What does an Aspartate Aminotransferase blood test check for?

Aspartate aminotransferase is an enzyme found in cells all over the body, but especially in the heart and liver, as well as the kidneys and muscles to a lesser amount. AST levels in the blood are typically low in healthy people. AST is released into the bloodstream when liver or muscle cells are damaged. As a result, AST can be used to detect or monitor liver disease.

The liver is a critical organ found directly behind the rib cage in the upper right side of the abdomen. It is engaged in a variety of vital bodily functions. The liver aids in the digestion of nutrients, creates bile to aid in fat digestion, manufactures numerous vital proteins such as blood clotting factors, and breaks down potentially hazardous compounds into safe substances that the body may utilize or expel.

A variety of disorders can harm liver cells and cause AST levels to rise. The test is most effective in detecting liver damage caused by hepatitis, liver-toxic medications, cirrhosis, or alcoholism. AST, on the other hand, is not particular to the liver and can be elevated in diseases affecting other organs.

Alanine aminotransferase testing is frequently combined with an AST test. When the liver is injured, both of these enzymes become high in the bloodstream. A computed AST/ALT ratio can help distinguish between different types of liver injury and determine whether elevated levels are due to something else, such as a heart or muscle injury.

Lab tests often ordered with an Aspartate Aminotransferase test:

• GGT
• ALT
• ALP
• Bilirubin
• Hepatic Function Panel
• Comprehensive Metabolic Panel (CMP)
• Albumin
• Total Protein

Conditions where an Aspartate Aminotransferase test is recommended:

• Liver Disease
• Hepatitis
• Jaundice
• Alcoholism
• Cirrhosis
• Wilson Disease
• Hemochromatosis

How does my health care provider use an Aspartate Aminotransferase test?

The aspartate aminotransferase blood test is commonly used to identify liver disease. It is frequently ordered in conjunction with alanine aminotransferase, another liver enzyme, or as part of a liver panel or comprehensive metabolic panel to screen for and/or diagnose liver problems.

Although ALT is more specific for the liver than AST and is more usually elevated than AST, both are regarded to be two of the most significant tests for detecting liver impairment. When AST is directly compared to ALT, an AST/ALT ratio is calculated. This ratio can be used to differentiate between different types of liver disease and hepatic harm from heart or muscle damage.

To assess which type of liver illness is present, AST levels are frequently compared to the results of other tests such as alkaline phosphatase, total protein, and bilirubin.

AST is frequently evaluated to monitor the treatment of people with liver disease, and it can be ordered alone or in combination with other tests.

AST is sometimes used to monitor persons who are receiving potentially hazardous drugs for the liver. If the person's AST levels rise, he or she may be moved to another medicine.

What do my AST test results mean?

Low AST levels in the blood are typical and anticipated.

Acute hepatitis and viral infections are the most common causes of very high AST values. AST values are normally elevated for 1-2 months after acute hepatitis, but they might take up to 3-6 months to recover to normal. AST levels can also be significantly high as a result of exposure to liver-toxic medications or other chemicals, as well as situations that produce reduced blood supply to the liver.

AST values are usually lower in chronic hepatitis, generally less than 4 times normal, and are more likely to be normal than ALT levels. With chronic hepatitis, AST levels typically fluctuate between normal and slightly elevated, so the test may be ordered repeatedly to detect the pattern. Other illnesses of the liver, particularly when the bile ducts are clogged, as well as cirrhosis and certain malignancies of the liver, can cause moderate increases. AST can also rise after a heart attack or a muscular damage, although to a far higher extent than ALT.

The AST test is frequently done in conjunction with the ALT test or as part of a liver panel. See the Liver Panel article for more information on AST values in relation to other liver tests.

The ALT level is usually greater than the AST level in most kinds of liver disease, and the AST/ALT ratio is low. There are a few exceptions: in alcoholic hepatitis, cirrhosis, hepatitis C virus-related chronic liver disease, and the first day or two of acute hepatitis or injury from bile duct obstruction, the AST/ALT ratio is frequently elevated. AST levels are generally substantially higher than ALT after cardiac or muscle injury, and they tend to stay higher than ALT for longer than they do after liver injury.

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

Description: Bilirubin Fractionated is a blood test that is used to screen for or monitor liver disorders, hemolytic anemia, and neonatal jaundice.

Also Known As: Total Bilirubin Test, TBIL Test, Neonatal Bilirubin Test, Direct Bilirubin Test, Conjugated Bilirubin Test, Indirect Bilirubin Test, Unconjugated Bilirubin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Bilirubin, Fractionated test ordered?

When someone shows evidence of abnormal liver function, a doctor will usually request a bilirubin test along with other laboratory tests. A bilirubin test may be ordered when a patient:

• Evidence of jaundice is visible.
• Has a history of excessive alcohol consumption
• Has a possible drug toxicity
• Has been exposed to viruses that cause hepatitis

Other signs and symptoms to look out for include:

• Urine with a dark amber tint.
• Nausea/vomiting
• Swelling and/or pain in the abdomen
• Fatigue and malaise which are common symptoms of chronic liver disease.

In babies with jaundice, measuring and monitoring bilirubin is considered routine medical therapy.

When someone is suspected of hemolytic anemia as a cause of anemia, bilirubin tests may be ordered. In this instance, it's frequently ordered in conjunction with other hemolysis-related tests such a complete blood count, reticulocyte count, haptoglobin, and LDH.

What does a Bilirubin, Fractionated blood test check for?

Bilirubin is an orange-yellow pigment that is largely formed as a byproduct of heme degradation. Heme is a component of hemoglobin, a red blood cell protein. Bilirubin is eventually digested by the liver, which allows it to be excreted from the body. This test assesses a person's liver function or aids in the diagnosis of anemias caused by RBC destruction by measuring the quantity of bilirubin in their blood.

After roughly 120 days in circulation, RBCs generally disintegrate. Heme is transformed to bilirubin as it is released from hemoglobin. Unconjugated bilirubin is another name for this type of bilirubin. Proteins transport unconjugated bilirubin to the liver, where sugars are linked to bilirubin to produce conjugated bilirubin. Conjugated bilirubin enters the bile and travels from the liver to the small intestines, where bacteria break it down further before it is excreted in the stool. As a result, bilirubin breakdown products give stool its distinctive brown hue.

A normal, healthy human produces a tiny quantity of bilirubin each day. The majority of bilirubin comes from damaged or degraded RBCs, with the rest coming from bone marrow or the liver. Small amounts of unconjugated bilirubin are normally discharged into the bloodstream, but there is almost no conjugated bilirubin. Laboratory tests can measure or estimate both types, and a total bilirubin result can be presented as well.

A person may appear jaundiced, with yellowing of the skin and/or whites of the eyes, if the bilirubin level in their blood rises. The pattern of bilirubin test results can provide information to the health care provider about the ailment that may be present. When there is an exceptional quantity of RBC destruction or when the liver is unable to handle bilirubin, unconjugated bilirubin levels may rise. Conversely, conjugated bilirubin levels can rise when the liver can process bilirubin but not transmit the conjugated bilirubin to the bile for elimination; this is most commonly caused by acute hepatitis or bile duct blockage.

In the first few days after birth, increased total and unconjugated bilirubin levels are fairly common in infants. This condition is known as "physiologic jaundice of the newborn," and it develops when the liver of a newborn is not yet mature enough to handle bilirubin. Physiologic jaundice in newborns usually goes away after a few days. RBCs may be damaged in newborn hemolytic illness due to blood incompatibility between the infant and the mother; in these circumstances, treatment may be necessary since large amounts of unconjugated bilirubin might harm the newborn's brain.

Increased total and conjugated bilirubin levels in infants can be caused by biliary atresia, an uncommon but life-threatening congenital disease. To avoid catastrophic liver damage that may necessitate liver transplantation during the first few years of life, this problem must be rapidly recognized and treated, usually with surgery. Despite early surgical therapy, some children may require liver transplants.

Lab tests often ordered with a Bilirubin, Fractionated test:

• CMP
• ALT
• ALP
• AST
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Complete Blood Count (CBC)
• Urinalysis
• GGT
• Reticulocyte Count

Conditions where a Bilirubin, Fractionated test is recommended:

• Jaundice
• Liver Disease
• Hepatitis
• Alcoholism
• Hemolytic Anemia

Commonly Asked Questions:

How does my health care provider use a Bilirubin, Fractionated test?

A bilirubin test is used to detect an abnormally high quantity of the substance in the blood. It can be used to figure out what's causing your jaundice and/or diagnose illnesses like liver disease, hemolytic anemia, and bile duct blockage.

Bilirubin is an orange-yellow pigment that is largely formed as a byproduct of heme degradation. Heme is a component of hemoglobin, a red blood cell protein. Bilirubin is eventually digested by the liver, which allows it to be excreted from the body. An increased blood level can be caused by any disorder that speeds up the breakdown of RBCs or impairs the processing and elimination of bilirubin.

Laboratory testing can measure or estimate two types of bilirubin:

Unconjugated bilirubin—unconjugated bilirubin is formed when heme is released from hemoglobin. Proteins transport it to the liver. Small levels of the substance may be found in the blood.

Sugars are attached to bilirubin in the liver, resulting in conjugated bilirubin. It enters the bile and travels from the liver to the small intestines before being excreted in the feces. In normal circumstances, there is no conjugated bilirubin in the blood.

A chemical test is usually done to determine the total bilirubin level first. If the total bilirubin level rises, a second chemical test can be used to detect water-soluble forms of bilirubin, known as "direct" bilirubin. The amount of conjugated bilirubin present can be estimated using the direct bilirubin test. The "indirect" amount of unconjugated bilirubin can be estimated by subtracting the direct bilirubin level from the total bilirubin level. The pattern of bilirubin test results can provide information to the healthcare professional about the ailment that may be present.

Bilirubin is measured in adults and older children to:

• Diagnose and/or monitor liver and bile duct disorders.
• Evaluate patients with hemolytic anemia
• Distinguish between the causes of jaundice in babies.

Only unconjugated bilirubin is raised in both physiologic jaundice and hemolytic illness of the infant.

Damage to the newborn's liver from neonatal hepatitis and biliary atresia will also raise conjugated bilirubin concentrations, which is generally the first indication that one of these less common disorders is present.

Because excessive unconjugated bilirubin harms growing brain cells, it is critical to detect and treat an increased amount of bilirubin in a newborn. Mental retardation, learning and developmental impairments, hearing loss, eye movement disorders, and mortality are all possible outcomes of this damage.

What do my bilirubin test results mean?

In adults and children, increased total bilirubin, primarily unconjugated bilirubin, could be caused by:

• Hemolytic or pernicious anemia are two types of anemia.
• Reaction to a transfusion
• Cirrhosis
• Gilbert syndrome

When conjugated bilirubin levels are higher than unconjugated bilirubin levels, there is usually a problem with bilirubin removal by the liver cells. This can be caused by a variety of factors, including:

• Hepatitis caused by a virus
• Reactions to drugs
• Alcoholic hepatitis

When the bile ducts are blocked, conjugated bilirubin is raised more than unconjugated bilirubin. This can happen, for example, when:

• In the bile ducts, there are gallstones.
• Damaging of the bile ducts due to tumors

Increased bilirubin levels can also be caused by rare hereditary illnesses that involve aberrant bilirubin metabolism, such as Rotor, Dubin-Johnson, and Crigler-Najjar syndromes.

Low bilirubin levels are usually not a cause for worry and are not monitored.

A newborn's high bilirubin level may be transient and diminish within a few days to two weeks. However, if the bilirubin level exceeds a crucial threshold or rises rapidly, the cause must be investigated so that appropriate treatment can be started. Increased bilirubin levels can be caused by the rapid breakdown of red blood cells as a result of:

• Incompatibility of the mother's blood type with that of her child
• Infections that are present at birth
• oxygen deficiency
• Liver disease

Only unconjugated bilirubin is elevated in most of these disorders. In the rare disorders of biliary atresia and newborn hepatitis, increased conjugated bilirubin is found. To avoid liver damage, biliary atresia necessitates surgical surgery.

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

Measurement of the levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gallbladder obstructive disease.

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a BUN Creatinine Ratio test ordered?

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

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

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

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

BUN may also be required for:

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

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

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

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

What does a BUN Creatinine Ratio test check for?

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

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

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

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

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

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

Lab tests often ordered with a BUN Creatinine Ratio test:

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

Conditions where a BUN Creatinine Ratio test is recommended:

• Kidney Disease
• Diabetes
• Hypertension
• Proteinuria

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

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

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

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

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

What do my BUN Creatinine Ratio test results mean?

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

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

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

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

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

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

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

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

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

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

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

Description: The C-Reactive Protein test is used to identify and/or monitor inflammation in patients.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a C-Reactive Protein test ordered?

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

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

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

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

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

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

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

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

Conditions where a C-Reactive Protein test is recommended:

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

Commonly Asked Questions:

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

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

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

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

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

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

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

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

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

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

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

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

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

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

C4B is a complement binding protein that specifically binds 50% circulating protein S, a vitamin K dependent cofactor of protein C activation. Since C4B may be elevated in certain disease states, this may affect the available "free protein S" to engage in anticoagulant activity.

Description: The cancer antigen 19-9 test screens for a protein that exists on the surface of certain cancer cells. The CA 19-9 test can be used to measure the level of these proteins in the blood and is useful as a tumor marker.

Also Known As: Carbohydrate Antigen (CA) 19-9 Test, Cancer Antigen 19-9 Test, Cancer Antigen (CA) 19-9, Carbohydrate Antigen 19-9 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a CA 19-9 test ordered?

When a person has been diagnosed with pancreatic cancer or has signs and symptoms that could indicate pancreatic cancer, CA 19-9 may be ordered. Early warning signs and symptoms can be vague and ambiguous.

If CA 19-9 levels are initially increased in pancreatic cancer, a series of CA 19-9 tests may be conducted to assess response during therapy and on a frequent basis after treatment to assist detect recurrence.

When a healthcare practitioner suspects bile duct cancer in a person with a bile duct obstruction, CA 19-9 may be prescribed. CA 19-9 levels can spike due to non-cancerous reasons of bile duct obstruction, but they drop once the blockage is addressed. In these circumstances, re-checking CA 19-9 levels should be done at least a week or two after the blockage has been cleared.

What does a CA 19-9 blood test check for?

The protein cancer antigen 19-9 is found on the surface of some cancer cells. CA 19-9 does not cause cancer; rather, it is emitted by tumor cells and can be discovered in blood and other bodily fluids by laboratory tests. The level of CA19-9 is measured in this test.

Because CA 19-9 can be tested in the blood, it can be used as a tumor marker to track the progression of cancer. CA 19-9 levels are high in 70% to 95% of persons with advanced pancreatic cancer.

CA 19-9 levels may also be elevated in cancers of the gallbladder and bile ducts, colorectal cancer, gastric cancers, ovarian cancer, lung cancer, liver cancer, pancreatitis, thyroid disease, and liver disease, among other cancers, conditions, and diseases. CA 19-9 is found in trace levels in the blood of healthy humans. CA 19-9 cannot be utilized for screening or diagnosis by itself because it is not specific for pancreatic cancer.

Lab tests often ordered with a CA 19-9 test:

• Bilirubin
• Carcinoembryonic Antigen
• Hepatic Function Panel
• Tumor Markers

Conditions where a CA 19-9 test is recommended:

• Pancreatic Cancer
• Pancreatitis
• Colorectal Cancer
• Gastric Cancers
• Lung Cancer
• Ovarian Cancer
• Cystic Fibrosis
• Liver Cancer
• Thyroid Disease
• Liver Disease

How does my health care provider use a CA 19-9 test?

The CA 19-9 test, along with other tests like carcinoembryonic antigen, bilirubin, and/or a liver panel, can be used to evaluate and monitor someone who has been diagnosed with pancreatic cancer and is having treatment.

CA 19-9 can only be utilized as a tumor marker if it is produced in large amounts by the malignancy. CA 19-9 may be ordered to help evaluate and monitor persons with bile duct cancer because it is high in roughly 65 percent of those with this type of cancer.

The CA 19-9 test is insufficiently sensitive and specific to be used as a cancer screening test. Because non-cancerous diseases can induce elevated CA 19-9 levels, it is not yet effective for detection or diagnosis. Researchers are still looking at markers that can be used alone or in combination with CA 19-9 to help diagnose and screen for pancreatic cancer in its early stages, when it is most curable.

What do my CA 19-9 test results mean?

Healthy persons have low levels of CA 19-9, although numerous illnesses that affect the liver or pancreas can induce transitory spikes.

People with pancreatic cancer, other malignancies, and a variety of other diseases and ailments may have moderate to high levels. CA 19-9 levels are higher in cancers of the exocrine pancreas. This cancer develops in the tissues that manufacture food-digesting enzymes, as well as in the ducts that transport those enzymes to the small intestine. This kind of pancreatic cancer accounts for approximately 95% of all pancreatic cancers.

CA 19-9 levels that rise and then diminish over time may indicate that the treatment is functioning and/or that the malignancy was successfully removed during surgery. Levels that stay high or rise over time could suggest that treatment isn't working and/or that the cancer is reoccurring.

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

Low levels of fibrinogen are associated with bleeding most commonly secondary to liver disease or disseminated intravascular coagulation (DIC). Fibrinogen is an acute phase reactant and thus elevated levels may be associated with inflammation. Increased concentrations are also associated with increased risk of atherosclerosis.