Blood Tests for Neurological Disorders

Neurological Disorders and health information

Blood tests monitor levels of therapeutic drugs used to treat neurological disorders, identify the medical causes of neuropathy, and help diagnose dementia and or rule out medical conditions adversely affecting the neurological system. 

Order your lab tests for neurological disorders today, and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests. Take control with Ulta Lab Tests today!


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The tricyclics are used to treat depression. Nortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.


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Clinical Significance

Aripiprazole (Abilify®) is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression. The analysis of aripiprazole is used to monitor compliance with drug therapy.


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

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a C-Reactive Protein test ordered?

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

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

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

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

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

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

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

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

Conditions where a C-Reactive Protein test is recommended:

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

Commonly Asked Questions:

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

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

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

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

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

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

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

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

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

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

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

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

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

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


Carnitine, LC/MS/MS Includes: Carnitine, Total; Carnitine, Free; Carnitine, Esters; Esterified/Free Ratio

 

Clinical Significance

Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary). Primary carnitine deficiency is an autosomal recessively inherited genetic condition that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter. Secondary carnitine deficiency can be seen in some disease states or in patients on carnitine-poor diets, but is also seen in a number of metabolic disorders. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitine ester is excreted in the urine, leading to a depletion of carnitine in the patient


Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with Differential and Platelets test, Hemogram test  

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances. 

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. 

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results. 

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count. 

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity. 

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances. 

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC. 

Lab tests often ordered with a Complete Blood Count test: 

  • Reticulocytes
  • Iron and Total Iron Binding Capacity
  • Basic Metabolic Panel
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Epstein-Barr Virus
  • Von Willebrand Factor Antigen

Conditions where a Complete Blood Count test is recommended: 

  • Anemia
  • Aplastic Anemia
  • Iron Deficiency Anemia
  • Vitamin B12 and Folate Deficiency
  • Sickle Cell Anemia
  • Heart Disease
  • Thalassemia
  • Leukemia
  • Autoimmune Disorders
  • Cancer
  • Bleeding Disorders
  • Inflammation
  • Epstein-Barr Virus
  • Mononucleosis

Commonly Asked Questions: 

How does my health care provider use a Complete Blood Count test? 

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

NOTE: Only measurable biomarkers will be reported. Certain biomarkers do not appear in healthy individuals. 

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

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

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

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

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

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

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

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

Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

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

Collection Method: 

Blood Draw 

Specimen Type: 

Serum 

Test Preparation: 

9-12 hours fasting is preferred. 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

What does a Comprehensive Metabolic Panel blood test check for? 

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

The following tests are included in the CMP: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

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

Conditions where a Comprehensive Metabolic Panel test is recommended: 

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension

Commonly Asked Questions: 

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

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

What do my Comprehensive Metabolic Panel test results mean? 

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

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

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

Is there anything else I should know? 

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

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

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

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

Please note the following regarding BUN/Creatinine ratio: 

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

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

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


The Digestive Health - Advanced contains the following tests

  • C-Reactive Protein (CRP) 
  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Ferritin
  • Folate, Serum
  • Iron and Total Iron Binding Capacity (TIBC)
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS 
  • Transferrin
  • Vitamin B12 (Cobalamin) 
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


Digestive Health - Basic contains the following tests

  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


Digestive Health - Basic Plus contains the followwing tests: 

  • C-Reactive Protein (CRP) 
  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Ferritin
  • Iron and Total Iron Binding Capacity (TIBC)
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

 Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


Digestive Health - Comprehensive contains the following tests: 

  • C-Reactive Protein (CRP) 
  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Ferritin
  • Folate, Serum
  • Gliadin (Deamidated Peptide) Antibody (IgA) 
  • Gliadin (Deamidated Peptide) Antibody (IgG) 
  • Iron and Total Iron Binding Capacity (TIBC)
  • Lipid Panel with Ratios
  • Magnesium
  • Prealbumin 
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS 
  • Transferrin
  • TSH
  • Vitamin A (Retinol)
  • Vitamin B12 (Cobalamin) 
  • Vitamin K
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age, 

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


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Description: A Glucose test is a blood test used to screen for, diagnose, and monitor conditions that affect glucose levels such as prediabetes, diabetes, hyperglycemia, and hypoglycemia.

Also Known As: Fasting Blood Glucose Test, FBG Test, Fasting Blood Sugar Test, FBS Test, Fasting Glucose Test, FG Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting required

When is a Glucose test ordered?

Diabetes screening is recommended by several health groups, including the American Diabetes Association and the United States Preventive Services Task Force, when a person is 45 years old or has risk factors.

The ADA recommends retesting within three years if the screening test result is within normal limits, but the USPSTF recommends testing once a year. Annual testing may be used to monitor people with prediabetes.

When someone exhibits signs and symptoms of high blood glucose, a blood glucose test may be conducted.

Diabetics are frequently asked to self-check their glucose levels multiple times a day in order to monitor glucose levels and choose treatment alternatives as suggested by their doctor. Blood glucose levels may be ordered on a regular basis, along with other tests such as A1c, to track glucose control over time.

Unless they show early symptoms or have had gestational diabetes in a prior pregnancy, pregnant women are routinely screened for gestational diabetes between the 24th and 28th week of pregnancy. If a woman is at risk of type 2 diabetes, she may be tested early in her pregnancy, according to the American Diabetes Association. When a woman has type 1, type 2, or gestational diabetes, her health care provider will normally order glucose levels to monitor her condition throughout the duration of her pregnancy and after delivery.

What does a Glucose blood test check for?

A fasting glucose test measures glucose. Glucose is the major energy source for the body's cells and the brain and nervous system's only source of energy. A consistent supply must be provided, and a somewhat constant level of glucose in the blood must be maintained. The glucose level in the blood can be measured using a variety of methods. 

Fruits, vegetables, breads, and other carbohydrate-rich foods are broken down into glucose during digestion, which is absorbed by the small intestine and circulated throughout the body. Insulin, a hormone generated by the pancreas, is required for the use of glucose for energy production. Insulin promotes glucose transport into cells and instructs the liver to store surplus energy as glycogen for short-term storage or triglycerides in adipose cells.

Normally, blood glucose rises slightly after you eat or drink, and the pancreas responds by releasing insulin into the blood, the amount of which is proportional to the size and substance of the meal. The level of glucose in the blood declines as glucose enters the cells and is digested, and the pancreas responds by delaying, then ceasing the secretion of insulin.

When blood glucose levels fall too low, such as between meals or after a strong activity, glucagon is released, which causes the liver to convert some glycogen back into glucose, so boosting blood glucose levels. The level of glucose in the blood remains pretty steady if the glucose/insulin feedback loop is working appropriately. When the balance is upset and the blood glucose level rises, the body strives to restore it by boosting insulin production and removing excess glucose through the urine.

Several diseases can cause the equilibrium between glucose and pancreatic hormones to be disrupted, resulting in high or low blood glucose. Diabetes is the most common cause. Diabetes is a collection of illnesses characterized by inadequate insulin production and/or insulin resistance. Untreated diabetes impairs a person's ability to digest and utilize glucose normally. Type 1 diabetes is diagnosed when the body is unable to produce any or enough insulin. People with prediabetes or type 2 diabetes are insulin resistant and may or may not be able to produce enough of the hormone.

Organ failure, brain damage, coma, and, in extreme situations, death can result from severe, sudden fluctuations in blood glucose, either high or low. Chronically high blood glucose levels can harm body organs like the kidneys, eyes, heart, blood vessels, and nerves over time. Hypoglycemia can harm the brain and nerves over time.

Gestational diabetes, or hyperglycemia that exclusively arises during pregnancy, can affect some women. If left untreated, this can result in large babies with low glucose levels being born to these mothers. Women with gestational diabetes may or may not acquire diabetes later in life.

Lab tests often ordered with a Glucose test:

  • Complete Blood Count
  • Iron Total and Total Iron binding capacity
  • Hemoglobin A1c
  • Lipid Panel
  • Urinalysis Complete
  • TSH
  • CMP
  • Insulin
  • Microalbumin
  • Fructosamine
  • C-Peptide

Conditions where a Glucose test is recommended:

  • Diabetes
  • Kidney Disease
  • Insulin Resistance
  • Pancreatic Diseases
  • Hyperglycemia
  • Hypoglycemia

Commonly Asked Questions:

How does my health care provider use a Glucose test?

The blood glucose test can be used for a variety of purposes, including:

  • Detect hyperglycemia and hypoglycemia
  • Screen for diabetes in those who are at risk before symptoms appear; there may be no early indications or symptoms of diabetes in some circumstances. As a result, screening can aid in detecting it and allowing treatment to begin before the illness worsens or complications emerge.
  • Aid in the detection of diabetes, prediabetes, and gestational diabetes.
  • Monitor your blood sugar levels and manage your diabetes

Glucose levels should be monitored in those who have been diagnosed with diabetes.

Between the 24th and 28th week of pregnancy, glucose blood tests are performed to assess pregnant women for gestational diabetes. Pregnant women who have never been diagnosed with diabetes should be screened and diagnosed using either a one-step or two-step strategy, according to the American Diabetes Association and the US Preventive Services Task Force.

Other tests, including diabetic autoantibodies, insulin, and C-peptide, may be used in conjunction with glucose to assist in detecting the reason of elevated glucose levels, differentiate between type 1 and type 2 diabetes, and assess insulin production.

What does my glucose test result mean?

High blood glucose levels are most commonly associated with diabetes, but they can also be caused by a variety of other diseases and ailments.

Hypoglycemia is defined by a drop in blood glucose to a level that triggers nervous system symptoms before affecting the brain. The Whipple triad is a set of three criteria for diagnosing hypoglycemia.

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


Imipramine is a tricyclic antidepressnt drug used to treat depression. Therapeutic drug monitoring is used to optimize dose and to avoid toxicity.

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

Also Known As: Magnesium RBC Test, Magnesium Red Bood Cell Test, Mg Test, Mag test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Magnesium RBC test ordered?

Magnesium tests may be requested by health professionals as a follow-up to chronically low calcium and potassium levels in the blood. It may also be prescribed if a person exhibits symptoms of a magnesium deficiency, such as twitching, muscle weakness, cramping, disorientation, seizures, or cardiac arrhythmias.

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

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

What does a Magnesium RBC test check for?

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

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

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

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

Lab tests often ordered with a Magnesium RBC test:

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

Conditions where a Magnesium RBC test is recommended:

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

How does my health care provider use a Magnesium RBC test?

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

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

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

What does my Magnesium RBC test result mean?

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

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

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

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

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


The methylmalonic acid (MMA) test may be used to help diagnose an early or mild vitamin B12 deficiency. It may be ordered by itself or along with a homocysteine test as a follow-up to a vitamin B12 test result that is in the lower end of the normal range.


Methylmalonic acid is metabolized as methylmalonyl CoA from the catabolism of certain amino acids and fatty acids. Methylmalonyl CoA is then converted to Succinic acid by the following reaction: Methylmalonic Acid Methylmalonyl CoA Mutase + B12 Succinic Acid The enzyme Methylmalonyl CoA mutase requires Vitamin B12 (Cobalamin) as a cofacter. MMA is used to evaluate cobalamin deficiency. Elevated serum MMA reflects decreased tissue cobalamin levels and is an early indicator of vitamin B12 deficiency. Cobalamin dependent neurological disease with normal hematologic parameters and serum B12 levels is frequently associated with significant elevations of serum methylmalonic acid. Methylmalonic Acidemia is an autosomal recessive inborn error of metabolism, in which there is a deficiency of the enzyme methylmalonyl CoA mutase, resulting in a large accumulation of MMA in serum and urine. There is also a combined defect in the cobalamin pathway with elevation of both MMA and homocysteine.


Useful in the diagnosis of Myasthenia Gravis

Myasthenia Gravis is a neurological disorder characterized by a decrease in acetylcholine receptors. Patients exhibit skeletal muscle weakness and fatigability. Approximately 80% of patients with Myasthenia Gravis, excluding ocular involvement only, have detectable acetylcholine receptor antibody.

Acetylcholine Receptor Binding Antibody
Acetylcholine Receptor Blocking Antibody
Acetylcholine Receptor Modulating Antibody


Antibodies against myelin are found in multiple sclerosis and other neurological diseases. However, the diagnostic value of this serum antibody is controversial, as high titers in healthy subjects can also be detected. Antibodies against myelin-associated glycoproteins are present at times with Guillain-Barre syndrome.


Myelin Associated Glycoprotein (MAG)-SGPG Antibody (IgM)

Myelin associated glycoprotein (MAG) and sulphated glucuronyl paragloboside (SGPG) antibodies are present in a subgroup of sensory demyelinating neuropathies. Axonal neuropathies can present with only monoclonal IgM anti-SGPG activity. Presence of anti-SGPG antibodies alone is more characteristic of axonal non-demyelinating neuropathy. There is a relationship between the titer of anti-MAG antibodies and the degree of demyelination.

Result Name: MAG SGPG AB (IGM),EIA

Component Name: Myelin associated glycoprotein-sulfated glucuronic paragloboside Ab.IgM

 



Sensory-Motor Neuropathy Antibody Panel (Ganglioside) 

 

Includes

Ganglioside GM-1 Antibodies (IgG, IgM), EIA; Ganglioside GD1a Antibody (IgG, IgM), EIA; Ganglioside GD1b Antibody (IgG, IgM), EIA; Ganglioside GQ1b Antibody (IgG), EIA; Ganglioside Asialo-GM-1 Antibody (IgG, IgM), EIA

 

Clinical Significance

The presence of antibodies to the gangliosides GM1, Asialo-GM1, GD1a and GD1b has been associated with motor and sensorimotor neuropathies. High titers of antibody to GM1 are most typical of multifocal motor neuropathy; however, antibodies to other gangliosides are often present. In most cases of chronic immune neuropathies, anti-ganglioside antibodies are IgM class. IgG antibodies have been reported less often, generally associated with acute conditions. Many reports have found increased anti-asialo-GM1 antibody titers in patients with multifocal motor neuropathy, lower motor neuron disease, sensorimotor neuropathy, or motor neuropathy with or without multifocal block, Guillain-Barré Syndrome, and amyotrophic lateral sclerosis. There may be a relationship between titers of asialo-GM1 antibodies and clinical status in individual patients. In some lower motor neuron disorders, improvement in strength has occurred after therapeutic reduction in anti-asialo-GM1 antibody titers. Polyclonal GQ1b IgG antibody can serve as an aid in the diagnosis of acute ataxia neuropathy with ophthalmoplegia or of Miller-Fisher Syndrome.