All Stress and Fatigue Tests

Stress and Fatigue Testing and health information

Did you know that over 40% of Americans experience more daily stress than they're comfortable with? Here's why it's so important to order lab tests to monitor for stress, anxiety, and fatigue.

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This panel contains Cortisol, A.M. #4212, which requires the patient to have their specimen collected between 7 a.m. - 9 a.m.

This panel contains Cortisol, A.M. #4212, which requires the patient to have their specimen collected between 7 a.m. - 9 a.m.

Ulta - Stress & Steroid Hormone Addendum

Some of your hormones are in response to stress. DHEA, Testosterone and Cortisol should properly respond to the stresses and demands of your life and lifestyle.

  • Cortisol, A.M.
  • DHEA Sulfate, Immunoassay
  • Testosterone, Total And Free And Sex Hormone Binding Globulin

Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

This panel contains Cortisol, A.M. #4212, which requires the patient to have their specimen collected between 7 a.m. - 9 a.m.

Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

17-Hydroxypregnenolone, LC/MS/MS

Clinical Significance

17-Hydroxypregnenolone is useful in the diagnosis of 3-Beta-Hydroxylase enzyme deficiency, a rare cause of congenital adrenal hyperplasia, and 17-Hydroxylase (P450c17) enzyme deficiency.


Description: 17-hydroxyprogesterone is a test that is measuring the levels of 17-OHP in the blood. 17-OHP is used to detect and monitor the treatment processes for congenital adrenal hyperplasia.

Also Known As: 17-OHP Test, 17-OH Progesterone Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a 17-Hydroxyprogesterone test ordered?

The 17-OHP test is regularly ordered as part of a newborn screening and may be repeated if the screening test results are elevated to confirm the initial findings.

When an infant or young kid exhibits signs and symptoms of adrenal insufficiency or CAH, a 17-OHP test may be administered.

When the milder type of CAH is suspected, this test may be ordered in older children or adults. When a girl or woman is having symptoms that could be caused by CAH or another illness, such as PCOS, the 17-OHP test can be used.

Boys and men may be tested if they are experiencing early puberty or infertility.

When a person is diagnosed with 21-hydroxylase deficiency, a 17-OHP test may be ordered on a regular basis to assess treatment effectiveness.

What does a 17-Hydroxyprogesterone blood test check for?

17-hydroxyprogesterone is a steroid hormone that is created during the cortisol production process. This test detects and/or evaluates congenital adrenal hyperplasia, a hereditary disorder characterized by decreased adrenal cortisol and aldosterone production and increased male sex hormone production.

Cholesterol is the source of 17-OHP. It is a precursor of active steroid hormones, rather than an active steroid hormone.

Cortisol is a hormone produced by the adrenal glands that aids in the breakdown of protein, carbohydrates, and fats, regulates the immune system, and maintains blood pressure. Other steroid hormones produced by the adrenal glands include aldosterone, which helps regulate salt levels and blood pressure, and androgens, which, like testosterone, cause male sexual characteristics and other consequences.

The processes in the synthesis of cortisol necessitate the use of several enzymes. Inadequate levels of cortisol are produced when one or more of these enzymes are insufficient or malfunctioning, as is the case with CAH. CAH is caused by a partial or total loss of the enzyme 21-hydroxylase, which accounts for around 90% of cases.

The adrenal gland grows in size because a low level of cortisol induces an increase in the level of a specific pituitary hormone that drives adrenal growth and hormone production. The increased size and activity, however, are insufficient to overcome the cortisol production bottleneck. Other chemicals that do not require the faulty enzyme, such as 17-hydroxyprogesterone and androgens, are created in excess. This is why 17-OHP testing can aid in the detection of CAH.

CAH is a set of hereditary illnesses characterized by cortisol-related enzyme deficits and caused by particular gene mutations. A mutation in the 21-hydroxylase gene causes around 90% of CAH cases, which can be diagnosed by an increase in 17-OHP in the blood. When both genes, one from each parent, contain mutations that reduce or cease the activity of the enzyme for which the gene codes, the disease is caused. Parents could be carriers, and carriers could not show any symptoms.

CAH with 21-hydroxylase deficiency can be inherited in two forms: severe and mild.

Severe forms can result in kids being born with severe aldosterone and cortisol deficits, necessitating medical treatment. This severe variant is most commonly found in infancy or early childhood through regular newborn screening. It may manifest in early childhood with signs and symptoms such as vomiting, listlessness, lack of energy, not eating properly, failure to thrive, dehydration, and low blood pressure if it is not found through screening, especially with severe sickness.

Excess male sex hormones can cause the development of male characteristics in females. Female babies' sex organs may not be obviously male or female, making it difficult to tell their gender at first. During childhood and adolescence, females may have excessive hair development on the face and body, as well as other male secondary sexual traits such as irregular menstruation. Men with this disorder may not appear different at birth, but they might develop sexual traits early in life, putting them at risk for fertility problems later in life.

Only partial lack of the enzyme may be present in the milder, though more prevalent type of CAH caused by 21-hydroxylase deficiency. This kind of CAH, also known as late-onset or non-classical CAH, can manifest symptoms at any age during childhood, adolescence, or adulthood. Symptoms might be nonspecific, develop slowly over time, and differ from one person to the next. Though this type of CAH is rarely life-threatening, it can cause growth, development, and puberty issues in children, as well as infertility in adults.

Lab tests often ordered with a 17-Hydroxyprogesterone test:

  • Cortisol
  • ACTH
  • Testosterone
  • Androstenedione
  • Pregnenolone

Conditions where a 17-Hydroxyprogesterone test is recommended:

  • Congenital Adrenal Hyperplasia
  • Polycystic Ovary Syndrome
  • Adrenal Insufficiency
  • Addison Disease
  • Endocrine Syndromes
  • Infertility

How does my health care provider use a 17-Hydroxyprogesterone test?

The 17-hydroxyprogesterone test is used to detect congenital adrenal hyperplasia and can be used in the conjunction with other tests to diagnose and track CAH.

In the United States, the 17-OHP test is frequently ordered as part of newborn screening to detect CAH caused by a lack of 21-hydroxylase.

The 17-OHP test can be used to screen for CAH in older children and adults before symptoms develop, or to confirm a CAH diagnosis in persons who are already experiencing symptoms.


The presence of 17-OHP in the blood can help doctors diagnose CAH in older children and people who have a milder, "late-onset" variant of the disease.

A 17-OHP test, along with plasma renin activity, androstenedione, and testosterone assays, may be used to evaluate the success of treatment if someone is diagnosed with 21-hydroxylase insufficiency.

In women with symptoms such as abundant face and body hair and irregular periods, a 17-OHP test, along with other hormone testing, may be done to help rule out CAH. Women with probable polycystic ovarian syndrome and infertility, as well as those with suspected adrenal or ovarian malignancies, fall under this category.

False-positive results have been reported with 17-OHP testing, particularly the newborn screening test. Other tests may be performed if the level is higher but not to the point where it is indicative of CAH.

As a follow-up test, an ACTH test may be ordered. ACTH stimulation causes a significant increase in 17-OHP levels in CAH.

CYP21A2 gene mutations that cause the disorder may be detected by genetic testing.

A karyotype test may be ordered as a follow-up test to discover chromosome problems and to assist in determining the gender of a newborn.

Electrolytes may be ordered to determine the sodium and potassium levels of a person.

What do my 17 Hydroxyprogesterone test results mean?

If a newborn or infant has highly elevated 17-OHP levels, he or she is most likely suffering from CAH. If a person's levels are somewhat elevated, he or she may have a milder case of CAH or an 11-beta-hydroxylase deficiency.

The absence of CAH due to a 21-hydroxylase deficit is most often shown by normal 17-OHP findings.

In a person with CAH, low or declining amounts suggest a positive response to treatment. High or rising levels may suggest that treatment has to be changed.

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

Clinical Significance

21- Hydroxylase Antibody - 21-Hydroxylase Antibody is present in patients with autoimmune destruction of the adrenal glands, leading to Addison's disease. Antibody is also seen in autoimmune polyglandular syndrome.

Determination of ACTH is useful in differentiating between primary and secondary adrenocortical hypo- and hyperfunctional disorders: Addison's disease, Cushing's syndrome, adrenal carcinoma, ectopic ACTH syndrome, and adrenal nodular hyperplasia.

The Adrenal Complete Panel includes the following tests 

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

Determination of aldosterone is useful in the diagnosis and evaluation of primary aldosteronism, selective hypoaldosteronism, edematous states, and other conditions of electrolyte imbalance

The Aldosterone-renin ratio is used to screen for primary aldosteronism

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

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.

Androstenedione is useful when evaluating patients with androgen excess and managing patients with Congenital Adrenal Hyperplasia (CAH).

Antiadrenal Antibody Screen With Reflex To Titer

This is a reflex test that may require additional tests to be run at additional cost to the patient.

If  Adrenal Antibody Screen is positive, Adrenal Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

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.

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Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low level of calcium may result in tetany.

HDL Cholesterol is inversely related to the risk for cardiovascular disease. It increases following regular exercise, moderate alcohol consumption and with oral estrogen therapy. Decreased levels are associated with obesity, stress, cigarette smoking and diabetes mellitus.

Description: Ion Mobility Lipoprotein Fractionation is a test that uses a gas-phase technology to separate the lipid particles by size. As each particle is separated, they are counted.

Also Known As: LDL Particle Testing, LDL-P Test, LDL Subclass Test, sdLDL Test, LDL Fractionations Test, LDL Particle Size Test, LDL Particle Number Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required

When is a Lipoprotein Fractionation test ordered?

When someone has a personal or family history of early cardiovascular disease, this testing may be ordered as part of an overall evaluation of cardiac risk, especially if the person does not have typical cardiac risk factors like high cholesterol, high LDL cholesterol, high triglyceride, low HDL cholesterol, smoking, obesity, inactivity, diabetes, and/or hypertension.

When a person with elevated LDL-P and/or a high proportion of tiny, dense LDL particles has undertaken cholesterol-lowering treatment or lifestyle adjustments, the healthcare practitioner may conduct LDL lipoprotein subfraction testing, as well as other lipid tests, to assess treatment success.

Although LDL-P is not typically suggested as a screening test, some healthcare practitioners are using it in conjunction with a battery of other cardiac risk tests to evaluate a person's overall risk of getting CVD.

What does a Lipoprotein Fractionation blood test check for?

Low-density lipoproteins are lipid-transporting particles that travel throughout the body. Protein, cholesterol, triglyceride, and phospholipid molecules are all present in each particle. As they move through the bloodstream, their makeup changes. Lipoprotein particles range in size from large and fluffy to small and dense, depending on which molecules are eliminated and which are added. The relative amounts of particles with different characteristics in the blood are determined by LDL particle testing. Subfractionation testing is a term used to describe this process.

Traditional lipid testing determines the amount of LDL cholesterol in the blood but does not assess the number of LDL particles. Increased numbers of small, dense LDL particles have been linked to inflammation and are more likely to produce atherosclerosis than fewer light, fluffy LDL particles, according to some research. Researchers believe that the existence of an elevated quantity of sdLDL could be one of the reasons why some people have heart attacks while having relatively low total and LDL cholesterol levels.

The number of sdLDL particles in a person's blood is determined in part by genetics, in part by sex, and in part by lifestyle and overall health. Increased levels of sdLDL are linked to certain diseases and disorders, like as diabetes and hypertension.

By examining a person's triglyceride and high-density lipoprotein cholesterol levels, it is usually able to estimate whether they have a high amount of sdLDL particles. Typically, these tests are done as part of a lipid profile. People with high triglycerides and low HDL-C have higher levels of sdLDL. More sdLDL is connected with a triglyceride level greater than 120 mg/dL and an HDL-C level less than 40 mg/dL in men and less than 50 mg/dL in women.

Other lipoprotein particles, such as HDL and VLDL, can also be subfractionated, however these tests are generally utilized in research settings and are not discussed on this page.

Lab tests often ordered with a Lipoprotein Fractionation test:

  • Lipid Panel
  • HDL Cholesterol
  • LDL Cholesterol
  • Direct LDL
  • Apolipoprotein A-1
  • Apolipoprotein B
  • Lipoprotein (a)
  • Triglycerides
  • Homocysteine
  • Hs-CRP
  • VAP

Conditions where a Lipoprotein Fractionation test is recommended:

  • Cardiovascular Disease
  • Heart Disease

How does my health care provider use a Lipoprotein Fractionation test?

Low-density lipoprotein particle testing determines the number, size, density, and/or electrical charge of LDL particles. It may be useful in determining cardiac risk in patients with a personal or family history of heart disease at a young age, particularly if their total cholesterol and LDL cholesterol levels are not markedly increased. LDL subfraction testing is usually done in conjunction with or after a lipid profile.

While the LDL-C test is a good predictor of cardiovascular disease risk for many people, research has indicated that certain persons with healthy LDL-C levels nonetheless have an increased risk of CVD. Similarly, even if their LDL-C is at a safe level, people with chronic diseases like diabetes may be at higher risk. The quantity of LDL particles and/or their size has been recommended as an additional factor to consider when assessing CVD risk in these populations. Lipoprotein subfraction testing may be done in these situations to further assess a person's CVD risk.

LDL-P is sometimes requested to see how well a treatment is working at reducing the quantity of tiny, dense LDL particles.

LDL subfraction testing has been employed in clinical settings, although VLDL or HDL subfraction testing is primarily used in research. This is because LDL cholesterol has been established as the key risk factor for heart disease, and LDL assessment has received increased attention in research and development.

What do my Lipoprotein Fractionation test results mean?

The method and reporting format utilized in an LDL-P test, as well as the person's total cholesterol, LDL-C, VLDL, and/or HDL cholesterol, are all reflected in the results. Because different methods divide subclasses based on different physical qualities, results may not be immediately comparable from one method to the next or from one laboratory to the next.

Usually, the result is evaluated in context of a lipid profile and the risk it implies:

  • If a person has a high number of mostly tiny, dense LDL and an elevated LDL-P, this result will enhance the person's risk of cardiovascular disease beyond the risk associated with total LDL.
  • If a person only has large, fluffy LDL and a low LDL-P, this discovery will not put them at any greater risk.

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

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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required.

When is a Vitamin D test ordered:

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

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

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

What does a Vitamin D blood test check for?

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

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

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

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

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

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

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

This test has 3 Biomarkers

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

Lab tests often ordered with a Vitamin D test:

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

Conditions where a Vitamin D test is recommended:

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

Commonly Asked Questions:

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

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

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

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

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

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

What do my Vitamin D results result mean?

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

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

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

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

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

HDL cholesterol is inversely related to the risk for cardiovascular disease. It increases following regular exercise, moderate alcohol consumption and with oral estrogen therapy. Decreased levels are associated with obesity, stress, cigarette smoking and diabetes mellitus.

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CoQ10 (Coenzyme Q10)

Coenzyme Q10 (CoQ10) is a substance similar to a vitamin. It is found in every cell of the body. Your body makes CoQ10, and your cells use it to produce energy your body needs for cell growth and maintenance. It also functions as an antioxidant, which protects the body from damage caused by harmful molecules.

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, 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,
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

A shocking statistic you may not know is that 55 percent of Americans experience stress during the day. That’s about one in two people! 

It’s a statistic that should get one concerned, considering what stress can do to our bodies. 

If you feel overwhelmed by stress in your day-to-day life, you should consider a stress lab test. A lab test can check various biomarkers that can help establish whether or not your well-being is taking a hit from your level of stress. 

Let’s start by learning more about stress.

What is Stress? 

Stress is the body’s reaction upon being put under pressure by internal or external stimuli. Whenever your body responds to stressful stimuli, you may have a physical, emotional, or mental response. 

It is normal for every person to deal with stress at a point in their life. It may have come about due to the loss of a loved one, dismissal from your job, or any other occurrence that made your body trigger a stress response. 

Then again, stress shouldn’t always be considered a negative thing. You could have experienced stress because you landed a new job, had your first child, or due to any other positive occurrence. Such stressors open up your mind, making you more conscious about your surroundings. 

Despite that, stress significantly affects our bodies. Whenever we’re subjected to positive or negative stressors, stress can shift the normal levels of our bodily hormones. 

Risk Factors for Stress 

We’ve already mentioned that stress is a normal part of life. As such, everyone is bound to experience it at one point in life. 

Keeping that in mind, researchers and scientists have been studying the main stressors in the patients’ lives. Below, we’ve listed the most prevalent stressors that may trigger the development of stress-related conditions: 

  • Loss of a partner 
  • Divorce 
  • Separation in marriage 
  • Incarceration 
  • Loss of a close relative 
  • Injury or sickness 
  • Marriage 
  • Dismissal from your job 
  • Marriage reunion 
  • Retirement 

If any of these has recently occurred or you’re currently going through any of these scenarios, you have to be mindful of the stress levels that are piling up. If you’re experiencing an abnormal level of stress, this could adversely affect your health. 

Ensure that you keep a keen eye on the common indicators of high stress levels. We’ll get to the details of that later on. 

Causes of Stress 

There are differences in how everyone experiences stress. When subjected to a stressor, some people may develop long-term illnesses. Some people may not experience any change even when subjected to several stressors. 

Typically, the stress you’re feeling is usually due to a significant occurrence in your life. However, what causes stress is how your body responds to such an occurrence. 

Our bodies convey a signal when subjected to stress. The signal travels throughout the body, alerting every cell of the occurrence that you’re experiencing or already went through. 

As a result, all the body systems react to the signal: your circulatory system, hormonal system, nervous system, respiratory system, and others. The response your body gives can be likened to what is experienced with the ‘flight-or-fight response.’ 

Whenever you experience stress, there’s a chain of chemical reactions that occurs. Again, how you respond to the various changes in your life is nothing out of the ordinary. 

Your body’s reaction is an adjustment to the stressor(s), and what you’re experiencing is the outcome of the changes. 

It’s possible to experience more severe symptoms and even develop sicknesses if your body doesn’t move on from this state. 

What are the signs and symptoms of Stress? 

We’ve already mentioned that stress affects all of the body’s systems. As such, numerous signs may show up whenever you’re stressed: 

  • Mood swings 
  • Feeling of being overburdened 
  • Struggling to relax 
  • Feeling lonely and/or low 
  • Keeping off family and friends 
  • Fatigue 
  • Nausea 
  • Headaches 
  • Chest pain 
  • Sleeping disorders 
  • Constant anxiety 
  • Recurrent sickness 
  • Low libido 
  • Dry mouth 
  • Constricted jaw 
  • Constant uneasiness 
  • Lapse of memory 
  • Inability to concentrate 
  • Negativity 
  • Appetite loss or gain 
  • Misjudgment 
  • Procrastination 
  • Excessive use of alcohol or drugs 

Every system in the body contributes to the symptoms of stress. This list is just the tip of the iceberg when it comes to how people feel due to stress. It is not uncommon for stress to culminate in strokes and heart attacks in some people. 

To avoid compromising your immune system or triggering other health problems, you need to suppress your stress levels. 

Diagnosing Stress 

You should see a medical professional if you’re experiencing a heightened level of stress. With their help, you can avoid being overwhelmed by stress. 

A common way to diagnose excessive stress is by evaluating your present social life. They’ll want to know if there have been recent changes or tough spells in your life. 

Another way is by running lab tests to identify any strong stress response by your body. 

Lab Tests to Observe the Effect of Stress on an Individual’s Health 

Cortisol is the most common test ordered when checking for chronic stress. Cortisol is also called the stress hormone. Your body releases cortisol when subjected to more stressors than it can handle.   

A health professional may also want to measure your testosterone and DHEA sulfate levels. Both males and females produce these sex hormones, and their levels can significantly go up when the body experiences too much stress. Such an increase can, in turn, result in other problems in the body. 

Get a Stress Lab Test with Ulta Labs Today! 

If you want to know your body’s stress level, consider a stress test from Ulta Lab Tests. We look for various biomarkers that are common indicators of stress and its effects on your health. Here’s why you should try Ulta Lab Test: 

  • Precise and dependable results that are out in 1 or 2 days for most tests 
  • Secure and confidential results 
  • No need for a doctor’s referral or insurance 
  • Affordable prices for all tests 
  • 100% guaranteed satisfaction 

Keep in mind that if the body experiences stress for too long, your well-being will likely suffer. Your body could be immunodeficient, and you could suffer acute and long-term diseases. 

Ulta Lab Tests helps you take the wheel when it comes to your health. Let us provide you with the answers you need so you can keep off stress.