Fibromyalgia

Fibromyalgia Testing and health information

If you want to learn more about fibromyalgia tests, you're in the right place! Find out what you should know about the types of fibromyalgia symptoms, causes, treatments, tests, and more here.


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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.


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.


 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.


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. 


Description: Creatine Kinase is a test that is measuring for the level of CK in the blood’s serum. CK is found in the heart tissue and the skeletal muscle. This test can be used to determine if there has been damage done to the muscles.

Also Known As: CK Test, Total Ck Test, Creatine Phosphokinase, CPK Test, CPK Level

Collection Method: Blood draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Creatine Kinase Total test ordered?

When muscle injury is suspected, a CK test may be requested, as well as at regular intervals to monitor for continuing damage. When a muscle illness, such as muscular dystrophy, is suspected, or when someone has suffered physical trauma, such as crushing injuries or major burns, it may be ordered. The test may be ordered if a person is experiencing symptoms of muscular damage, such as:

  • Muscle aches and pains
  • Muscle deterioration
  • Urine that is dark in color

When a person has nonspecific symptoms, testing may be recommended, especially if they are using a drug or have been exposed to a substance that has been associated to potential muscle damage.

What does a Creatine Kinase Total blood test check for?

The enzyme creatine kinase is found in the brain, heart, skeletal muscle, and other organs. When there is muscle injury, more CK is released into the bloodstream. The quantity of creatine kinase in the blood is measured in this test.

Skeletal muscles produce the little quantity of CK that is routinely found in the blood. An increase in CK can be caused by any disorder that causes muscular injury and/or interferes with muscle energy generation or usage. Strenuous activity and muscle inflammation, known as myositis, as well as muscle illnesses such muscular dystrophy, can raise CK levels. Rhabdomyolysis, or the severe breakdown of skeletal muscle tissue, is linked to a large increase in CK levels.

Lab tests often ordered with a Creatine Kinase Total test:

  • CK-MB
  • Myoglobin
  • Troponin
  • Lipid Panel
  • Hs-CRP
  • Homocysteine
  • Lipoprotein Fractionation, Ion Mobility

Conditions where a Creatine Kinase Total test is recommended:

  • Endocrine System and Syndromes
  • Lupus
  • Rheumatoid Arthritis
  • Heart Attack

How does my health care provider use a Creatine Kinase Total test?

A creatine kinase test can be used to detect muscle inflammation or damage caused by muscle illnesses such muscular dystrophy, or to help diagnose rhabdomyolysis if signs and symptoms are present. Other blood chemistry tests, such as electrolytes, BUN, or creatinine, may be conducted in addition to CK. A urine myoglobin test may be requested as well.

Muscle injury can present with few or vague symptoms such as weakness, fever, and nausea, which can also be associated with a range of other illnesses. In these circumstances, a healthcare practitioner may utilize a CK test to detect muscle injury, particularly if the person is taking a statin, using ethanol or cocaine, or has been exposed to a known toxin linked to probable muscle damage. A CK test may be used to assess and monitor muscle damage in those who have been physically injured.

Muscle injury can be tracked using a series of CK tests to evaluate if it improves or worsens. If a CK is increased and the site of muscle damage is unknown, a healthcare provider may order CK isoenzymes or a CK-MB as follow-up tests to differentiate between the three forms of CK: CK-MB, CK-MM, and CK-BB.

The CK test was originally one of the most common tests used to diagnose a heart attack, but the troponin test has mostly superseded it in the United States. The CK test, on the other hand, may be used to detect a second heart attack that occurs soon after the first.

What do my Creatine Kinase test results mean?

A high CK level, or a spike in levels in subsequent samples, often suggests that muscle injury has occurred recently, although it does not identify the location or origin of the damage. Serial test findings that peak and then begin to decline indicate that new muscle damage has subsided, whereas increasing and persistent elevations indicate that new muscle damage has persisted.

Increased CK levels can be detected in a range of muscular disorders caused by a variety of factors. Depending on the severity of muscle damage, people's CK levels may be significantly to severely elevated. Rhabdomyolysis patients may have CK levels that are 100 times higher than usual, and in some cases even higher.

Normal CK levels could mean there hasn't been any muscle injury or that it happened a few days before the test.

Following severe exercise, such as weight lifting, contact sports, or long exercise sessions, moderately elevated CK levels may be observed.

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


Description: Anti-CCP is a test that measure the amount of cyclic citrullinated peptide in the blood. Anti-CCP is an autobody and it can be used to determine the if a person has Rheumatoid Arthritis.

Also Known As: ACPA, Anti-CCP, Anti-citrulline Antibody, Anti-cyclic Citrullinated Peptide, Anti-Cyclic Citrullinated Peptide (CCP) Antibody IgG, CCP, CCP Antibody, Citrullinated Peptide (CCP) IgG, Cyclic Citrullinated Peptide Antibody, Cyclic Citrullinated Peptide CCP Antibody IgG.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Cyclic Citrullinated Peptide IgG Antibody test ordered?

When someone displays indications and symptoms that could be attributable to previously undiagnosed inflammatory arthritis or has been diagnosed with undifferentiated arthritis, a CCP antibody test is usually ordered along with an RF test. When clinical indications and symptoms lead a health practitioner to suspect RA, it may be ordered as a follow-up test following a negative RF test. In most cases, RA affects many joints in a symmetrical pattern. The following are possible signs and symptoms:

  • Painful, heated, swollen joints in the hands and wrists.
  • Pain that affects the neck, shoulds, elbows, hips, knees, and/or feet.
  • In the morning, affected joints are stiff, although this improves over the day.
  • Fatigue
  • Fatigue
  • Underneath the skin, nodules form, especially at the elbows
  • An overall sensation of unwellness

What does a Cyclic Citrullinated Peptide IgG Antibody blood test check for?

Cyclic citrullinated peptide antibodies are autoantibodies directed against cyclic citrullinated peptides produced by the immune system. Anti-CCP antibodies are detected and measured in the blood with this test.

Citrulline is created in the body as a byproduct of the amino acid arginine metabolism. This conversion may occur at a faster rate in joints with rheumatoid arthritis. Citrulline alters the structure of proteins, triggering an immunological response that results in the production of autoantibodies against joint proteins. The CCP antibody test aids in the diagnosis of RA and can help identify persons with the disease's more quickly erosive type.

RA is a chronic, systemic autoimmune disease that affects the hands, foot, and other joints throughout the body, causing inflammation, discomfort, stiffness, and degenerative changes. It can strike anyone at any age, but it commonly strikes between the ages of 40 and 60, with women accounting for roughly 75 percent of those affected. The prognosis and course of RA are both unpredictable. It could take a long time to develop and progress, or it could happen quickly. In some people, it may go into remission, and in others, it may completely disappear. If left untreated, RA can impair a person's life expectancy and render many people unable to work within a few years.

There are a number of treatments available to help reduce the difficulties of RA, but they all hinge on getting a proper diagnosis and starting treatment before severe joint damage occurs. The basic blood test for detecting RA and distinguishing it from other types of arthritis and other inflammatory processes has been rheumatoid factor. However, RF's sensitivity and specificity aren't optimal; it can be negative in persons with RA symptoms but positive in those who don't. According to studies, the CCP antibody test has a sensitivity and specificity that is comparable to or better than RF, and it is more likely to be positive in patients with early RA.

CCP antibody testing, along with RF, is included in the American College of Rheumatology's (ACR) 2010 Rheumatoid Arthritis Classification Criteria for diagnosing rheumatoid arthritis. CCP antibodies can be found in roughly 50-60% of persons with early RA, as early as 3-6 months following the onset of symptoms, according to the ACR. Early detection and diagnosis of RA allows healthcare practitioners to start aggressive treatment early on, reducing complications and tissue damage.

Lab tests often ordered with a Cyclic Citrullinated Peptide IgG Antibody test:

  • Rheumatoid Factor
  • Sed Rate (ESR)
  • C-Reactive Protein
  • ANA

Conditions where a Cyclic Citrullinated Peptide IgG Antibody test is recommended:

  • Rheumatoid Arthritis
  • Autoimmune Disorders

How does my health care provider use a Cyclic Citrullinated Peptide IgG Antibody test?

To help diagnose rheumatoid arthritis and assess the severity and likely course of the disease, a cyclic citrullinated peptide antibody test may be ordered in conjunction with or after a rheumatoid factor test. Inflammatory indicators such as ESR and C-reactive protein may also be tested at this time.

Cyclic citrullinated peptide antibodies are autoantibodies directed against cyclic citrullinated peptides produced by the immune system.

CCP antibody testing may also be conducted to assess the likelihood of RA developing in persons with undifferentiated arthritis, or those who have symptoms that imply RA but do not yet fulfill the American College of Rheumatology's criteria. According to the American College of Rheumatology, roughly 95% of persons with a positive CCP antibody will develop RA in the future. It is critical to discover RA early in order to make informed treatment recommendations.

What do my CCP Antibody test results mean?

When persons with arthritis symptoms test positive for both CCP antibody and RF, they almost certainly have RA and are at risk of developing a more rapidly progressing and severe version of the illness. When patients show clinical indications of RA and are positive for CCP antibody but not RF, or have low levels of both, it is likely that they have early RA or will develop RA in the future.

When people have a positive RF but no CCP antibody, clinical signs and symptoms are more important in evaluating whether they have RA or another inflammatory illness. It is less likely that someone gets RA if they are negative for both CCP antibody and RF. However, it should be noted that RA is a clinical diagnosis that can be made even if autoantibody testing are negative.

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


Fibromyalgia Exclusion Panel - contains tests to identify conditions that have symptoms like fibromyalgia, which include Sjögren syndrome, rheumatoid arthritis, lupus, and thyroid disease

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


Measurement of serum 25-OH vitamin D concentrations provide a good index of circulating vitamin D activity in patients not suffering from renal disease. Lower than normal 25-OH vitamin D levels can result from a dietary deficiency, poor absorption of the vitamin or impaired metabolism of the sterol in the liver. A 25-OH vitamin D deficiency can lead to bone diseases such as rickets and osteomalacia. Above normal levels can lead hypercalcemia. This assay employs liquid chromatography tandem mass spectrometry to independently measure and report the two common forms of 25-hydroxy vitamin D: 25OH D3 - the endogenous form of the vitamin and 25OH D2 - the analog form used to treat 25OH Vitamin D3 deficiency. While this assay will produce accurate Vitamin D results on patients of any age, it is specifically indicated for infants less than 3 years of age.


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Description: RF is a blood test that is measuring the amount of rheumatoid factor that is present in the blood’s serum. It is used along with other tests to diagnose rheumatoid arthritis.

Also Known As: RF Test, Rheumatoid Arthritis Factor Test

Collection Method: Blood Draws

Specimen Type: Serum

Test Preparation: No preparation required

When is a Rheumatoid Factor test ordered?

When a person has RA signs and symptoms, an RF test may be ordered. Pain, warmth, swelling, and morning stiffness in the joints are common symptoms, as are nodules under the skin and, if the disease has progressed, signs of enlarged joint capsules and cartilage and bone loss on X-rays. When the first RF test is negative but the symptoms persist, the RF test may be repeated.

A cyclic citrullinated peptide antibody test may be ordered along with RF or if the RF result is negative to help diagnose RA in someone who has joint inflammation but does not yet fit the criteria for RA.

Additional autoimmune-related tests, such as an ANA, as well as other markers of inflammation, such as a CRP and Sed Rate, as well as a CBC to examine blood cells, may be ordered in addition to the RF test.

What does a Rheumatoid Factor blood test check for?

The autoantibody rheumatoid factor is an immunoglobulin M protein produced by the body's immune system. Autoantibodies attack a person's own tissues, mistaking them for "foreign" tissue. While the biological role of RF is unknown, its presence can be used to detect inflammatory and autoimmune activities. This test identifies and quantifies radiofrequency in the bloodstream.

The RF test is an important tool in the diagnosis of rheumatoid arthritis. A RF test will be positive in about 80% of people with RA. RF, on the other hand, can be found in persons with a range of different illnesses, including as Sjögren syndrome, as well as persistent bacterial, viral, and parasite infections, and some malignancies. It can be noticed in patients who have lung, liver, or kidney disease, and it can also be detected in a tiny percentage of healthy persons.

Lab tests often ordered with a Rheumatoid Factor test:

  • Cyclic Citrullinated Peptide Antibody
  • ANA
  • Sed Rate
  • C-Reactive Protein
  • Immunoglobulins

Conditions where a Rheumatoid Factor test is recommended:

  • Rheumatoid Arthritis
  • Autoimmune Disorders

How does my health care provider use a Rheumatoid Factor test?

The rheumatoid factor test is used to diagnose rheumatoid arthritis and to distinguish it from other types of arthritis or diseases that generate similar symptoms.

While the clinical picture is critical in the diagnosis of RA, some signs and symptoms, particularly in the early stages of the disease, may not be present or follow a predictable pattern. Additionally, the signs and symptoms may not always be easy to distinguish because people with RA may also have other connective tissue disorders such Raynaud phenomenon, scleroderma, autoimmune thyroid problems, and systemic lupus erythematosus and present symptoms of these disorders. When RA is suspected, the RF test is one of several tools that can be used to aid determine a diagnosis.

What do my Rheumatoid Factor test results mean?

The results of the RF test must be interpreted in the context of a person's symptoms and medical history.

The presence of large amounts of RF in persons with symptoms and clinical indications of rheumatoid arthritis indicates that they are likely to develop RA. Higher RF levels are associated with a worse prognosis and more severe illness.

A negative RF test does not rule out the possibility of RA. Around 20% of persons with RA will have very low levels of RF or none at all. In these circumstances, a positive CCP antibody test can be utilized to confirm RA.

Sjögren syndrome, systemic lupus erythematosus, sarcoidosis tuberculosis, syphilis, HIV/AIDS, hepatitis, scleroderma, infectious mononucleosis, cancers such as leukemia and multiple myeloma, or disease of the liver, lung, or kidney may all produce positive RF test These other disorders are neither diagnosed or monitored with the RF test.

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


Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis. Rheumatoid factor is an antibody that is detectable in the blood of 80% of adults with rheumatoid arthritis. Rheumatoid can be detected in the blood of normal individuals and of those with other autoimmune diseases that are not rheumatoid arthritis. In people with rheumatoid arthritis, high levels of rheumatoid factor can indicate a tendency toward more aggressive disease and/or a tendency to develop rheumatoid nodules and rheumatoid lung disease. Rheumatoid factor is actually an antibody that can bind to other antibodies. Antibodies are normal proteins in our blood that are important parts of our immune system. Rheumatoid factor is an antibody that is not usually present in the normal individual. Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. Rheumatoid factor is present in about 80% of adults (but a much lower proportion of children) with rheumatoid arthritis.

Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis. Rheumatoid factor is an antibody that is detectable in the blood of 80% of adults with rheumatoid arthritis. Rheumatoid can be detected in the blood of normal individuals and of those with other autoimmune diseases that are not rheumatoid arthritis. In people with rheumatoid arthritis, high levels of rheumatoid factor can indicate a tendency toward more aggressive disease and/or a tendency to develop rheumatoid nodules and rheumatoid lung disease. Rheumatoid factor is actually an antibody that can bind to other antibodies. Antibodies are normal proteins in our blood that are important parts of our immune system. Rheumatoid factor is an antibody that is not usually present in the normal individual. Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. Rheumatoid factor is present in about 80% of adults (but a much lower proportion of children) with rheumatoid arthritis.

Description: Sed Rate is a blood test that is used to measure the rate that red blood cells fall to the bottom of a test tube. The measurement is based how many cells fall within one hour. This test can be used to determine infection or inflammation.

Also Known As: Erythrocyte Sedimentation Rate Test, ESR Test, Sed Rate Test, Sedimentation Rate Test, Westergren Sedimentation Rate Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Sed Rate test ordered?

When a condition or disease is believed to be causing inflammation in the body, an ESR may be ordered. Several inflammatory illnesses can be identified using this test. It may be requested, for example, if arthritis is suspected of producing joint inflammation and pain, or if inflammatory bowel disease is suspected of causing digestive symptoms.

When a person develops symptoms of polymyalgia rheumatica, systemic vasculitis, or temporal arteritis, such as headaches, neck or shoulder discomfort, anemia, pelvic pain, poor appetite, joint stiffness, and unexplained weight loss, a doctor may recommend an ESR. To follow the development of specific illnesses, the sed rate test can also be routinely ordered.

A health practitioner may wish to repeat the ESR before undertaking a full workup to look for disease.

What does a Sed Rate blood test check for?

The erythrocyte sedimentation rate is a test that evaluates the degree of inflammation in the body indirectly. The test evaluates the rate at which erythrocytes fall in a blood sample that has been placed in a tall, thin, vertical tube. The millimeters of clear fluid present at the upper portion of the tube after one hour are reported as the results.

When a drop of blood is inserted in a tube, the red blood cells settle out slowly, leaving just a small amount of transparent plasma. In the presence of an increased number of proteins, particularly proteins known as acute phase reactants, red cells settle at a faster pace. Inflammation raises the levels of acute phase reactants such as C-reactive protein and fibrinogen in the blood.

An inherent component of the immune system's response is inflammation. It could be chronic, showing symptoms over time with conditions like autoimmune illnesses or cancer, or acute, showing symptoms right away after a shock, injury, or infection.

The ESR is a non-specific indication that can rise in a number of disorders; it is not a diagnostic test. It provides you with a fundamental understanding of whether you have an inflammatory condition or not.

Given the availability of more recent, specialized tests, there have been reservations about the ESR's utility. The ESR test, on the other hand, is commonly used to diagnose and monitor temporal arteritis, systemic vasculitis, and polymyalgia rheumatica. Extremely high ESR values can aid in differentiating between rheumatic diseases. Furthermore, ESR may still be a viable alternative in some cases, such as when newer tests are unavailable in resource-constrained places or while monitoring the progression of a disease.

Lab tests often ordered with a Sed Rate test:

  • C-Reactive Protein
  • ANA
  • Rheumatoid Factor

Conditions where a Sed Rate test is recommended:

  • Vasculitis
  • Autoimmune Disorders
  • Rheumatoid Arthritis
  • Osteoarthritis
  • Celiac Disease
  • Lupus
  • Chronic Fatigue Syndrome
  • Juvenile Rheumatoid Arthritis
  • Inflammatory Bowel Disease

How does my health care provider use a Sed Rate test?

The erythrocyte sedimentation rate is a non-specific, very straightforward test that has been used for many years to detect inflammation associated with infections, malignancies, and autoimmune illnesses.

Because an elevated ESR often indicates the presence of inflammation, but does not tell the health practitioner where the inflammation is in the body or what is causing it, it is referred to as a non-specific test. Other illnesses besides inflammation may have an impact on an ESR. As a result, other tests, such C-reactive protein, are routinely paired with the ESR.

ESR is used to identify temporal arteritis, systemic vasculitis, and polymyalgia rheumatica, among other inflammatory illnesses. A notably elevated ESR is one of the crucial test results used to support the diagnosis.

This test can be used to track disease activity and treatment response in both of the disorders mentioned above, as well as several others including systemic lupus erythematosus.

What do my Sed Rate test results mean?

Because ESR is a non-specific inflammatory measure that is influenced by a variety of circumstances, it must be used in conjunction with other clinical findings, the individual's medical history, and the results of other laboratory tests. The health practitioner may be able to confirm or rule out a suspected illness if the ESR and clinical data match.

Without any signs of a specific condition, a single elevated ESR is usually insufficient to make a medical conclusion. A normal result does not, however, rule out inflammation or illness.

Inflammation, as well as anemia, infection, pregnancy, and aging, can cause a moderately raised ESR.

A severe infection with a rise in globulins, polymyalgia rheumatica, or temporal arteritis are common causes of an extremely high ESR. Depending on the person's symptoms, a health practitioner may employ various follow-up tests, such as blood cultures. Even if there is no inflammation, people with multiple myeloma or Waldenstrom's macroglobulinemia have extraordinarily high ESRs.

Rising ESRs may suggest increased inflammation or a poor response to therapy when monitoring a condition over time; normal or falling ESRs may indicate an adequate response to treatment.

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


Anti-skeletal muscle antibody titers of >1: 80 have been reported to be present in the serum of 30% of patients with Myasthenia Gravis, 95% of patients with Myasthenia Gravis and thymoma, and 25% of patients with thymoma.

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Description: A RT3 test is a laboratory test that checks for Reverse T3 levels in your blood’s serum.

Also Known As: T3 Reverse test, REVT3 Test, RT3 Test, T3R Test, Reverse T3 Test, Reverse Triiodothyronine Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is this test ordered?

Reverse T3 is used to identify stress on the body due to many factors including extreme dieting, surgery, liver and kidney disease, insulin dependent diabetes, serious injury, and chronic alcohol consumption.

What is being tested?

Reverse T3 is a derivative of Thyroxine T4. T4 becomes the active thyroid hormone Triiodothyronine T3 when it loses one of its iodine atoms. T4 is also converted by the body into Reverse T3, which is an inactive version of T3 that lacks T3's metabolic function. Reverse T3 is thought to be produced by the body to conserve energy during times of severe illness and stress.

Related Tests and Panels:

  • T3 Free
  • T3 Total
  • T4 Free
  • T4 Total
  • TSH
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Related Conditions:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer
  • Kidney Disease
  • Liver Disease
  • Alcoholism
  • Stress
  • Diabetes

How is the Reverse T3 test used by my healthcare provider?

Results of a Reverse T3 test are used in combination with results of T4 tests, T3 Tests, thyroid antibodies, and TSH in assessing a patient’s symptoms and thyroid function.

What does my Reverse T3 test result mean?

High levels of T3 Reverse indicate that an excessive amount of T4 is being converted into Reverse T3 instead of active T3. This can cause signs of hypothyroidism, a thyroid condition often referred to as underactive thyroid, even when other thyroid hormones are within normal ranges. Elevated levels of RT3 levels can also be a sign of illness and stress and as the body converts more T4 into Reverse T3 when experiencing illnesses and stress.

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


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Description: A T3 Total test is a blood test that measures triiodothyronine levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hyperthyroidism.

Also Known As: Total T3 Test, Triiodothyronine Test, T3 Test, Bound T3

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T3 Total test ordered?

When a person's TSH test results are abnormal, a total T3 test may be recommended. When a person has symptoms that imply hyperthyroidism, it may be requested as part of the investigational workup, especially if the free T4 level is not elevated.

The following are possible signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Total T3 may be ordered at regular intervals to monitor a known thyroid disease or to assess the efficacy of hyperthyroidism treatment.

What does a T3 Total blood test check for?

T3 is one of two key hormones produced by the thyroid gland, a small butterfly-shaped organ near the base of the throat that sits flat across the windpipe. Thyroxine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T3 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's physiologically active form. Tests can determine the amount of free T3 or total T3 in the blood.

A feedback system controls T3 and T4 production. The hypothalamus releases thyrotropin releasing hormone when thyroid hormone levels in the blood drop, which prompts the pituitary gland to create and release thyroid-stimulating hormone. The thyroid gland is thus stimulated to create and/or release more thyroid hormones as a result of TSH. T4 is the most common thyroid hormone produced. This hormone is generally inactive, but in the liver and other tissues, it is transformed into the considerably more active T3.

If the thyroid gland produces too much T4 and T3, the person may have symptoms like uneasiness, hand tremors, weight loss, sleeplessness, and puffiness around dry, itchy eyes. The person's eyes may be unable to move normally and appear to be glaring in some circumstances. The eyeballs may also appear to bulge in some circumstances.

If the thyroid gland does not produce enough thyroid hormones, the person may experience weight gain, dry skin, lethargy, and constipation, which are all signs and symptoms of hypothyroidism and a slower metabolism. Thyroid hormone levels in the blood might be low or high due to thyroid malfunction, or in rare cases, insufficient or excessive TSH production due to a pituitary issue.

Autoimmune illnesses are the most common causes of thyroid dysfunction. Hyperthyroidism is caused by Graves disease, but it can also be caused by thyroiditis, thyroid malignancy, or high TSH production. Total T3 can be used to diagnose and monitor the impact of certain disorders on thyroid hormone production.

Lab tests often ordered with a T3 Total test:

  • TSH
  • T3 Free
  • T4 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T3 Total test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T3 Total test?

Thyroid function is measured with a total triiodothyronine test. It's usually ordered to assist identify hyperthyroidism, but it can also be used to track a person's therapy for a thyroid problem.

Thyroid hormones T3 and T4 are generated by the thyroid gland. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. Thyroid-stimulating hormone boosts T4 and T3 synthesis and release. The liver and other tissues convert T4 into T3 as needed.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood tests.

Because the majority of T3 is coupled to protein, total T3 can be influenced by protein levels and binding ability, but free T3 is unaffected. Some professional standards, however, advocate total T3, thus either test can be used to evaluate thyroid function. To assist diagnose Graves disease, an autoimmune illness that is the most prevalent cause of hyperthyroidism, free T3 or total T3 may be ordered together with thyroid antibodies.

Following an abnormal TSH, a total T3 test is generally done, especially if the free T4 test is not high.

What does my T3 Total Test result mean?

Thyroid hormone levels that are high or low suggest a mismatch between the body's needs and supplies, but they don't inform the doctor what's causing the excess or deficiency.

If someone is being treated for hyperthyroidism with anti-thyroid medication and their free or total T3 levels are normal, the medicine is likely beneficial in treating the illness. If the free or total T3 or free T4 levels are high, the medication isn't working to address the problem, and the person may be having hyperthyroidism symptoms.

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


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Description: A T3 Free test is a blood test that measures unbound triiodothyronine levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hyperthyroidism.

Also Known As: Free T3 Test, Free Triiodothyronine Test, FT3 Test, T3F Test, Unbound T3 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T3 Free test ordered?

When a person's TSH test results are abnormal, a free T3 test may be recommended. When a person has symptoms that imply hyperthyroidism, it may be requested as part of the investigational workup, especially if the free T4 level is not elevated.

The following are possible signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Free T3 may be ordered at regular intervals to monitor a known thyroid disease or to assess the efficacy of hyperthyroidism treatment.

What does a T3 Free test check for?

T3 is one of two key hormones produced by the thyroid gland, a small butterfly-shaped organ near the base of the throat that sits flat across the windpipe. Thyroxine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T3 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's physiologically active form. Tests can determine the amount of free T3 or total T3 in the blood.

A feedback system controls T3 and T4 production. The hypothalamus releases thyrotropin releasing hormone when thyroid hormone levels in the blood drop, which prompts the pituitary gland to create and release thyroid-stimulating hormone. The thyroid gland is thus stimulated to create and/or release more thyroid hormones as a result of TSH. T4 is the most common thyroid hormone produced. This hormone is generally inactive, but in the liver and other tissues, it is transformed into the considerably more active T3.

If the thyroid gland produces too much T4 and T3, the person may have symptoms like uneasiness, hand tremors, weight loss, sleeplessness, and puffiness around dry, itchy eyes. The person's eyes may be unable to move normally and appear to be glaring in some circumstances. The eyeballs may also appear to bulge in some circumstances.

If the thyroid gland does not produce enough thyroid hormones, the person may experience weight gain, dry skin, lethargy, and constipation, which are all signs and symptoms of hypothyroidism and a slower metabolism. Thyroid hormone levels in the blood might be low or high due to thyroid malfunction, or in rare cases, insufficient or excessive TSH production due to a pituitary issue.

Autoimmune illnesses are the most common causes of thyroid dysfunction. Hyperthyroidism is caused by Graves disease, but it can also be caused by thyroiditis, thyroid malignancy, or high TSH production. Total T3 can be used to diagnose and monitor the impact of certain disorders on thyroid hormone production.

Lab tests often ordered with a T3 Free test:

  • TSH
  • T3 Total
  • T4 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T3 Free test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T3 Free test?

Thyroid function is measured with a free triiodothyronine test. It's usually ordered to assist identify hyperthyroidism, but it can also be used to track a person's therapy for a thyroid problem.

Thyroid hormones T3 and T4 are generated by the thyroid gland. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. Thyroid-stimulating hormone boosts T4 and T3 synthesis and release. The liver and other tissues convert T4 into T3 as needed.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood tests.

Because the majority of T3 is coupled to protein, total T3 can be influenced by protein levels and binding ability, but free T3 is unaffected. Some professional standards, however, advocate total T3, thus either test can be used to evaluate thyroid function. To assist in diagnosing Graves disease, an autoimmune illness that is the most prevalent cause of hyperthyroidism, free T3 or total T3 may be ordered together with thyroid antibodies.

Following an abnormal TSH, a free T3 test is generally done, especially if the free T4 test is not high.

What does my T3 Free result mean?

Thyroid hormone levels that are high or low suggest a mismatch between the body's needs and supplies, but they don't inform the doctor what's causing the excess or deficiency.

If someone is being treated for hyperthyroidism with anti-thyroid medication and their free or total T3 levels are normal, the medicine is likely beneficial in treating the illness. If the free or total T3 or free T4 levels are high, the medication isn't working to address the problem, and the person may be having hyperthyroidism symptoms.

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


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Description: A T4 Total test is a blood test that measures thyroxine free levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hypothyroidism.

Also Known As: Total T4 Test, Total Thyroxine Test, T4 Test, T4, T4 Total Test, Bound T4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T4 Total test ordered?

When a person exhibits symptoms of hyperthyroidism or hypothyroidism, a Total T4 test may be administered, especially if a TSH test result is abnormal.

Hyperthyroidism can cause the following signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following symptoms:

  • gaining weight
  • Skin that is dry
  • Constipation
  • Intolerance to the cold
  • Skin that is puffy
  • Hair loss
  • Fatigue
  • Women's menstrual irregularities

When a person is being treated for a thyroid problem, Total T4 testing, along with other thyroid tests, may be requested on a regular basis.

Thyroid testing will most likely be ordered early and late in the pregnancy, as well as for a period after delivery, to monitor the mother and baby in pregnant women with thyroid abnormalities.

In the United States, thyroid hormone screening is routinely performed on babies as part of newborn screening programs.

What does a T4 Total blood test check for?

The thyroid gland, a small butterfly-shaped structure that lays on the windpipe towards the bottom of the throat, produces one of two primary hormones: thyroxine. Triiodothyronine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T4 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's biologically active form. This test determines how much Bound T4 is present in the blood.

A feedback loop controls T4 production. The hypothalamus releases thyrotropin releasing hormone, which encourages the pituitary gland to generate and release thyroid-stimulating hormone when the amount of T4 in the blood drops. The thyroid gland is thus stimulated to produce and/or release more T4 as a result of TSH. TSH release is blocked as T4 content in the blood rises.

T4 accounts for over 90% of thyroid hormones. The thyroid gland releases accumulated T4 into circulation when the body requires it. T4 is either free or bound to protein in the blood. The amount of free T4 in the body is just about 0.1 percent of total T4. In the liver or other tissues, T4 is converted to T3. T3, like T4, is mainly attached to protein, however the physiologically active forms of T3 and T4 are the free versions. Free T3 in circulation is 4 to 5 times more active than free T4.

Dry skin, weight gain, cold intolerance, weariness, and irregular menstruation are among signs of hypothyroidism that occur when the thyroid gland does not produce enough T4 due to thyroid malfunction or insufficient TSH. Myxedema, or severe untreated hypothyroidism, can cause heart failure, convulsions, and coma. Hypothyroidism in children can slow growth and sexual development.

When the thyroid gland generates too much T4, the rate of a person's body functions increases, resulting in hyperthyroidism symptoms such as anxiety, increased heart rate, difficulty sleeping, weight loss, puffiness and dry itchy eyes, and hand tremors.

The most prevalent causes of thyroid dysfunction are connected to autoimmune illnesses. Hyperthyroidism is caused by Graves disease, while hypothyroidism is caused by Hashimoto thyroiditis. Thyroiditis, thyroid malignancy, and excessive or insufficient TSH production can all induce hyperthyroidism or hypothyroidism. By measuring Total T4, the influence of these variables on thyroid hormone synthesis can be recognized and monitored.

Note: Free T4 Index (T7) will only be calculated and reported if test code code 861 (T3 Uptake) is ordered as well.

Lab tests often ordered with a T4 Total test:

  • TSH
  • T3 Total
  • T3 Free
  • T4 Free
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T4 Total test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T4 Total test?

Total thyroxine tests are used to assess thyroid function and detect thyroid disorders, such as hyperthyroidism and hypothyroidism, after the thyroid stimulating hormone level has been found to be abnormal.

The thyroid gland produces T4 and another hormone called triiodothyronine. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. TSH promotes the thyroid gland's synthesis and release of T4 and T3.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood testing. The total T4 test has been around for a long time, but it is influenced by the quantity of protein in the blood that can bind to the hormone. The active form of thyroxine, free T4, is unaffected by protein levels. Many people believe that the free T4 test is a more accurate reflection of thyroid hormone activity, and it has largely supplanted the total T4 test.

A Total T4 test can be used in conjunction with or after a TSH test, and occasionally with a free T3 test to:

  • Help diagnose the cause of hyperthyroidism and hypothyroidism by detecting too much or too little thyroid hormone.
  • Differentiate between thyroid disorders.
  • Assist in the diagnosis of pituitary diseases
  • Assist in the diagnosis of infertility in women
  • In an individual with a known thyroid condition, track the effectiveness of treatment.
  • Monitor patients with pituitary disease to ensure that their thyroid is still operating, and thyroid hormone medication should be monitored if it isn't.
  • Monitor patients with thyroid cancer whose tumors respond to TSH. TSH and T4 levels will be monitored on a regular basis to ensure that adequate thyroid hormone is being administered to maintain TSH low while keeping T4 high.

In the United States, babies are routinely tested for T4 and TSH levels to rule out congenital hypothyroidism, which can lead to mental retardation if left untreated.

Thyroid abnormalities can sometimes be detected using Total T4 and TSH, however professional opinions differ on who should be screened and when they should start.

Thyroid antibodies, as well as a Total T4 test, may be ordered if a health practitioner suspects someone has an autoimmune-related thyroid problem.

What does my T4 Total result mean?

In general, high total T4 levels suggest an overactive thyroid gland, while low total T4 levels suggest an underactive thyroid gland. The test results are not diagnostic in and of themselves, but they will urge the health care provider to conduct additional testing to determine the reason of the excess or deficiency.

A range of temporary and chronic thyroid disorders are linked to both decreased and increased total T4 levels. A pituitary gland issue could be indicated by low total T4 levels along with a low TSH level, or by high total T4 levels combined with a high TSH.

When thyroid tests are done to monitor treatment for thyroid or pituitary diseases, the results will tell the doctor whether the treatment is working and/or if a dose adjustment is required. People with hyperthyroidism, for example, have their total T4, total T3, and TSH levels examined on a regular basis while taking anti-thyroid medicines to ensure that the drugs are effective and to reduce doses if thyroid hormone levels fall too low. TSH and total T4 levels are monitored on a frequent basis in hypothyroid patients to ensure that the correct dose of thyroid hormone is being given to bring TSH levels back to normal.

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


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Description: A T4 Free test is a blood test that measures thyroxine free levels in your blood’s serum to evaluate your thyroid’s health and to screen for, diagnose, and monitor thyroid disorders such as hypothyroidism.

Also Known As: Free T4 Test, Free Thyroxine Test, FT4 Test, T4F Test, T4 Free Test, Unbound T4 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a T4 Free test ordered?

When a person exhibits symptoms of hyperthyroidism or hypothyroidism, a free T4 test may be administered, especially if the TSH test is abnormal.

Hyperthyroidism can cause the following signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following symptoms:

  • gaining weight
  • Skin that is dry
  • Constipation
  • Intolerance to the cold
  • Skin that is puffy
  • Hair loss
  • Fatigue
  • Women's menstrual irregularities

When a person is being treated for a thyroid problem, free T4 testing, along with other thyroid tests, may be requested on a regular basis.

Thyroid testing will most likely be ordered early and late in the pregnancy, as well as for a period after delivery, to monitor the mother and baby in pregnant women with thyroid abnormalities.

In the United States, thyroid hormone screening is routinely performed on babies as part of newborn screening programs.

What does a T4 Free blood test check for?

The thyroid gland, a small butterfly-shaped structure that lays on the windpipe towards the bottom of the throat, produces one of two primary hormones: thyroxine. Triiodothyronine is the other primary thyroid hormone, and together they help govern the rate at which the body utilizes energy. T4 in the blood is almost entirely linked to protein. The remaining portion is free and is the hormone's biologically active form. This test determines how much free T4 is present in the blood.

A feedback loop controls T4 production. The hypothalamus releases thyrotropin releasing hormone, which encourages the pituitary gland to generate and release thyroid-stimulating hormone when the amount of T4 in the blood drops. The thyroid gland is thus stimulated to produce and/or release more T4 as a result of TSH. TSH release is blocked as T4 content in the blood rises.

T4 accounts for over 90% of thyroid hormones. The thyroid gland releases accumulated T4 into circulation when the body requires it. T4 is either free or bound to protein in the blood. The amount of free T4 in the body is just about 0.1 percent of total T4. In the liver or other tissues, T4 is converted to T3. T3, like T4, is mainly attached to protein, however the physiologically active forms of T3 and T4 are the free versions. Free T3 in circulation is 4 to 5 times more active than free T4.

Dry skin, weight gain, cold intolerance, weariness, and irregular menstruation are among signs of hypothyroidism that occur when the thyroid gland does not produce enough T4 due to thyroid malfunction or insufficient TSH. Myxedema, or severe untreated hypothyroidism, can cause heart failure, convulsions, and coma. Hypothyroidism in children can slow growth and sexual development.

When the thyroid gland generates too much T4, the rate of a person's body functions increases, resulting in hyperthyroidism symptoms such as anxiety, increased heart rate, difficulty sleeping, weight loss, puffiness and dry itchy eyes, and hand tremors.

The most prevalent causes of thyroid dysfunction are connected to autoimmune illnesses. Hyperthyroidism is caused by Graves disease, while hypothyroidism is caused by Hashimoto thyroiditis. Thyroiditis, thyroid malignancy, and excessive or insufficient TSH production can all induce hyperthyroidism or hypothyroidism. By measuring free T4, the influence of these variables on thyroid hormone synthesis can be recognized and monitored.

Lab tests often ordered with a T4 Free test:

  • TSH
  • T3 Total
  • T3 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies

Conditions where a T4 Free test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

How does my health care provider use a T4 Free test?

Free thyroxine tests are used to assess thyroid function and detect thyroid disorders, such as hyperthyroidism and hypothyroidism, after the thyroid stimulating hormone level has been found to be abnormal.

The thyroid gland produces T4 and another hormone called triiodothyronine. They aid in the regulation of the rate at which the body expends energy and are governed by a feedback system. TSH promotes the thyroid gland's synthesis and release of T4 and T3.

The majority of T4 and T3 in the blood is attached to protein, while just a small amount is free. Total T4, free T4, total T3, and free T3 can all be measured in blood testing. The total T4 test has been around for a long time, but it is influenced by the quantity of protein in the blood that can bind to the hormone. The active form of thyroxine, free T4, is unaffected by protein levels. Many people believe that the free T4 test is a more accurate reflection of thyroid hormone activity, and it has largely supplanted the total T4 test.

A free T4 test can be used in conjunction with or after a TSH test, and occasionally with a free T3 test to:

  • Help diagnose the cause of hyperthyroidism and hypothyroidism by detecting too much or too little thyroid hormone.
  • Differentiate between thyroid disorders.
  • Assist in the diagnosis of pituitary diseases
  • Assist in the diagnosis of infertility in women
  • In an individual with a known thyroid condition, track the effectiveness of treatment.
  • Monitor patients with pituitary disease to ensure that their thyroid is still operating, and thyroid hormone medication should be monitored if it isn't.
  • Monitor patients with thyroid cancer whose tumors respond to TSH. TSH and T4 levels will be monitored on a regular basis to ensure that adequate thyroid hormone is being administered to maintain TSH low while keeping T4 high.

In the United States, babies are routinely tested for T4 and TSH levels to rule out congenital hypothyroidism, which can lead to mental retardation if left untreated.

Thyroid abnormalities can sometimes be detected using free T4 and TSH, however professional opinions differ on who should be screened and when they should start.

Thyroid antibodies, as well as a free T4 test, may be ordered if a health practitioner suspects someone has an autoimmune-related thyroid problem.

What does my T4 Free result mean?

In general, high free T4 levels suggest an overactive thyroid gland, while low free T4 levels suggest an underactive thyroid gland. The test results are not diagnostic in and of themselves, but they will urge the health care provider to conduct additional testing to determine the reason of the excess or deficiency.

A range of temporary and chronic thyroid disorders are linked to both decreased and increased free T4 levels. A pituitary gland issue could be indicated by low free T4 levels along with a low TSH level, or by high free T4 levels combined with a high TSH.

When thyroid tests are done to monitor treatment for thyroid or pituitary diseases, the results will tell the doctor whether the treatment is working and/or if a dose adjustment is required. People with hyperthyroidism, for example, have their free T4, free T3, and TSH levels examined on a regular basis while taking anti-thyroid medicines to ensure that the drugs are effective and to reduce doses if thyroid hormone levels fall too low. TSH and free T4 levels are monitored on a frequent basis in hypothyroid patients to ensure that the correct dose of thyroid hormone is being given to bring TSH levels back to normal.

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


Description: Thyroid Peroxidase and Thyroglobulin are blood tests used to detect thyroid antibodies to check for thyroid autoimmune disorders.

Also Known As: Thyroid Autoantibodies Test, Antithyroid Antibodies Test, Thyroid Peroxidase Antibody Test, Thyroperoxidase Antibody Test, TPO Test, Anti-TPO Test, Antithyroglobulin Antibody Test, TgAb Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Thyroid Peroxidase and Thyroglobulin Antibodies test ordered?

When a person has irregular TSH and/or free T4 test results, symptoms of low or high thyroid hormone levels, or the appearance of a goiter, testing may be performed, especially if the reason is considered to be an autoimmune condition.

Hypothyroidism can produce a variety of symptoms, including:

  • Gaining weight
  • Fatigue
  • Skin that is dry
  • Hair loss
  • Cold intolerance
  • Constipation

Hyperthyroidism can produce symptoms such as:

  • Sweating
  • Heart rate that is quite fast
  • Anxiety
  • Tremors
  • Fatigue
  • Sleeping problems 
  • Sudden weight loss
  • Eyes that protrude

If a pregnant woman has a known autoimmune thyroid illness, or if another autoimmune disorder is suspected, one or more thyroid antibodies may be ordered early in the pregnancy and again at the end. These tests are performed to see if the newborn is at risk for thyroid problems. Thyroid antibodies can pass the placenta, causing hypothyroidism or hyperthyroidism in a newborn or developing kid.

Thyroid antibody testing may also be recommended if a person with another autoimmune condition has thyroid dysfunction symptoms and/or has reproductive problems that a healthcare provider suspects are caused by antibodies.

What does a Thyroid Peroxidase and Thyroglobulin Antibodies blood test check for?

Thyroid antibodies are antibodies that form when an individual's immune system incorrectly attacks the thyroid gland or thyroid protein components, causing chronic thyroid inflammation, tissue destruction, and/or thyroid function disruption. Specific thyroid antibodies in the blood are detected and quantified using laboratory techniques.

The thyroid gland is a tiny, butterfly-shaped gland in the throat that rests flat against the windpipe. Thyroxine and triiodothyronine, the two key hormones it generates, are critical in regulating the pace at which the body uses energy. Thyroid stimulating hormone stimulates the thyroid to generate T4 and T3 as needed by the body's feedback system. This mechanism aids in the maintenance of a reasonably constant level of thyroid hormones in the blood. Thyroid antibodies can cause chronic diseases and autoimmune disorders linked with hypothyroidism or hyperthyroidism, such as Graves disease or Hashimoto thyroiditis, when they interfere with this process.

Thyroid antibody testing includes the following:

  • Thyroid peroxidase antibody
  • Thyroglobulin antibody

Lab tests often ordered with a Thyroid Peroxidase and Thyroglobulin Antibodies test:

  • T3 Free
  • T3 Total
  • T4 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • TSH

Conditions where a Thyroid Peroxidase and Thyroglobulin Antibodies test is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

Commonly Asked Questions:

How does my health care provider use a Thyroid Peroxidase and Thyroglobulin Antibodies test?

Thyroid antibodies, such as thyroid peroxidase antibody, are tested to assist diagnose and differentiate autoimmune thyroid disease from other types of thyroid failure. Thyroid antibodies form when a person's immune system mistakenly targets thyroid gland or thyroid protein components, causing chronic thyroid inflammation, tissue destruction, and/or thyroid function disruption.

To aid in the diagnosis and/or monitoring of an autoimmune thyroid condition, one or more of the following tests may be used:

  • Thyroid peroxidase antibody, an antibody that targets thyroid peroxidase enzyme in the thyroid gland, can be seen in Graves disease and Hashimoto thyroiditis.
  • Thyroglobulin antibody is an antibody that targets thyroglobulin, the thyroid hormone's storage form.

These tests may be conducted to determine the reason of an enlarged thyroid or other symptoms linked to low or high thyroid hormone levels. When other thyroid test findings, such as total or free T3, free T4, and/or TSH, indicate thyroid dysfunction, testing may be done as a follow-up.

A thyroid antibody test or several thyroid antibody tests may be conducted to see if a person with an autoimmune disorder is at risk of thyroid dysfunction. Disorders like rheumatoid arthritis, systemic lupus erythematosus, and pernicious anemia can cause this.

A thyroglobulin test may be used to monitor someone who is being treated for thyroid cancer. The thyroglobulin antibody test is utilized in this scenario to see if the antibody is present in the person's blood and will interfere with the thyroglobulin level test.

What do my Thyroid Antibodies test results mean?

Negative test results show that thyroid antibodies were not detected in the blood at the time of testing, implying that symptoms are caused by anything other than autoimmune disease. However, antibodies are absent in a small number of persons with autoimmune thyroid disease. Repeat testing may be done at a later date if it is suspected that the antibodies will develop over time, as with several autoimmune illnesses.

Thyroid antibodies can be identified in a range of thyroid and autoimmune conditions, including thyroid cancer, type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases, with mild to moderately high levels.

Thyroid autoimmune disorders such as Hashimoto thyroiditis and Graves disease are usually associated with significantly elevated amounts.

Thyroid antibodies, in general, indicate the presence of an autoimmune thyroid illness, and the higher the level, the more likely it is. Antibody levels that grow over time may be more relevant than steady levels because they may suggest an increase in the severity of autoimmune illness. All of these antibodies can increase the risk of hypothyroidism or hyperthyroidism in a growing baby or infant if they are present in a pregnant mother.

If a person with thyroid cancer has thyroglobulin antibodies, the testing for thyroglobulin levels may be hampered. This could suggest that the thyroglobulin test can't be utilized as a tumor marker or to track a person's thyroid cancer progression. The presence of thyroglobulin antibodies has little effect on some testing procedures, including mass spectrometry. The thyroglobulin test can be utilized as a tumor marker when tested in these methods, regardless of whether or not thyroglobulin antibodies are present. If a method is utilized that is impacted by thyroglobulin antibodies, the antibodies' levels can be used as a tumor marker to monitor thyroid cancer. If they first remain high or fall low but then rise over time, the treatment was ineffective and the malignancy is likely to continue or recur. If the levels are dropping and/or have dropped to low or undetectable levels, the therapy is more likely to have been successful in eradicating the malignancy.

Thyroid antibodies can be found in a small percentage of patients who are otherwise healthy. The incidence of these antibodies is higher in women, increases with age, and implies an increased risk of developing thyroid illness in the future for thyroid peroxidase antibodies. If a person has a thyroid antibody but no obvious thyroid disease, the healthcare professional will monitor the person's health over time. While the majority of people will never have thyroid problems, a small percentage will.

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


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Description: A TSH test is a blood test that measures thyroid stimulating hormone levels in your blood’s serum and is used to screen for and monitor treatment of thyroid disorders such as hypothyroidism and hyperthyroidism.

Also Known As: Thyroid Stimulating Hormone Test, Thyrotropin Test, TSH test, Thyroid Test, TSH Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a TSH test ordered?

When a person has symptoms of hyperthyroidism or hypothyroidism, or an enlarged thyroid gland, a doctor may order a TSH test.

Hyperthyroidism can cause the following signs and symptoms:

  • Heart rate has increased.
  • Anxiety
  • Loss of weight
  • Sleeping problems
  • Hand tremors.
  • Weakness
  • Diarrhea
  • Visual disturbances, light sensitivity
  • Puffiness around the eyes, dryness, discomfort, and, in some cases, bulging of the eyes are all possible side effects.

Hypothyroidism can cause the following signs and symptoms:

  • gaining weight
  • Skin that is dry
  • Constipation
  • Intolerance to the cold
  • Skin that is puffy
  • Hair loss is a common problem.
  • Fatigue
  • Women's menstrual irregularities

When a person is being treated for a thyroid disease, TSH may be ordered at regular intervals. The American Thyroid Association suggests waiting 6-8 weeks after changing a person's thyroid medication dose before testing their TSH level again.

In the United States, TSH screening is routinely performed on newborns shortly after birth as part of each state's newborn screening program.

What does a TSH blood test check for?

The pituitary gland, a small structure beneath the brain and beyond the sinus cavities, produces thyroid-stimulating hormone. TSH causes thyroxine and triiodothyronine to be released into the bloodstream by the thyroid gland. These thyroid hormones aid in the regulation of the body's energy usage. This test determines how much TSH is present in the blood.

The feedback mechanism that the body utilizes to maintain consistent quantities of thyroid hormones in the blood includes TSH and its regulatory hormone, thyrotropin releasing hormone, which comes from the hypothalamus. TSH synthesis by the pituitary gland increases as thyroid hormone concentrations fall. TSH stimulates the thyroid gland, a small butterfly-shaped gland that lays flat against the windpipe at the base of the throat, to produce and release T4 and T3. Thyroid production turns on and off to maintain generally steady levels of thyroid hormones in the blood when all three organs are operating regularly.

When the thyroid produces excessive amounts of T4 and T3, the affected person may have hyperthyroidism symptoms such as high heart rate, weight loss, agitation, hand tremors, itchy eyes, and difficulty sleeping. The most prevalent cause of hyperthyroidism is Graves disease. It is a chronic autoimmune condition in which the immune system creates antibodies that mimic TSH, causing the thyroid hormone to be produced in excessive levels. As a result, the pituitary gland may produce less TSH, resulting in a low blood level.

Weight gain, dry skin, constipation, cold intolerance, and weariness are all symptoms of hypothyroidism, a condition in which the thyroid produces fewer thyroid hormones. In the United States, Hashimoto thyroiditis is the most prevalent cause of hypothyroidism. It's an autoimmune disease in which the immune system attacks the thyroid, causing inflammation and destruction as well as the generation of autoantibodies. The thyroid generates low levels of thyroid hormone in Hashimoto thyroiditis. The pituitary gland may create more TSH, resulting in a high blood level.

TSH values, on the other hand, do not necessarily indicate or predict thyroid hormone levels. TSH is produced abnormally in some persons and does not work properly. Despite having normal or modestly increased TSH values, they frequently develop hypothyroidism. Thyroid hormone levels can be high or low in a variety of thyroid illnesses, regardless of the amount of TSH in the blood.

TSH levels may be elevated or lowered in rare cases due to pituitary dysfunction. In addition to pituitary dysfunction, an issue with the hypothalamus can cause hyperthyroidism or hypothyroidism.

Lab tests often ordered with a TSH test:

  • T3 Free
  • T3 Total
  • T4 Free
  • T4 Total
  • T3 Reverse
  • T3 Uptake
  • Thyroid Peroxidase
  • Thyroglobulin Antibodies
  • Thyroid Panel

Conditions where a test TSH is recommended:

  • Hyperthyroidism
  • Hypothyroidism
  • Hashimotos
  • Graves’ Disease
  • Autoimmune Diseases
  • Thyroid Cancer

Commonly Asked Questions:

How does my health care provider use a TSH test?

Thyroid function and/or symptoms of a thyroid problem, such as hyperthyroidism or hypothyroidism, are frequently assessed with the thyroid-stimulating hormone test.

The pituitary gland, a small structure beneath the brain and beyond the sinus cavities, produces TSH. It's a part of the body's feedback system that keeps the thyroid hormones thyroxine and triiodothyronine in check and helps regulate the pace at which the body burns calories.

TSH tests are typically ordered in conjunction with or before a free T4 test. A free T3 test and thyroid antibodies are two further thyroid tests that can be ordered. TSH, free T4, and free T3 are sometimes ordered as part of a thyroid panel.

TSH is used to:

  • Diagnose a thyroid issue in a patient who is experiencing symptoms.
  • Check newborns for an underactive thyroid.
  • Monitor thyroid replacement therapy.
  • Monitor treatment of hyperthyroidism that involves medication.
  • Assist women in diagnosing and monitoring infertility issues.
  • Assist in determining the pituitary gland's function
  • Screen adults for thyroid issues and diseases.

What does my TSH blood test result mean?

A high TSH level could indicate that:

  • The person being examined has an underactive thyroid gland that isn't responding well to TSH stimulation owing to acute or chronic thyroid dysfunction.
  • If a person has hypothyroidism or has had their thyroid gland removed, the dose of thyroid hormone replacement medicine may need to be changed.
  • A patient with hyperthyroidism is taking too much anti-thyroid medication, and the dosage needs to be reduced.
  • There is a problem with the pituitary gland, such as a tumor that causes TSH levels to be out of control.

A low TSH level could imply the following:

  • An overactive thyroid gland
  • Thyroid hormone prescription taken in excess by patients being treated for an underactive thyroid gland.
  • Inadequate medication in an individual being treated for hyperthyroidism; nevertheless, after successful anti-thyroid treatment, TSH production may take a time to recover. This is why the American Thyroid Association recommends testing for thyroid hormones as well as TSH levels throughout treatment.
  • The pituitary gland has been damaged, preventing it from releasing enough TSH.

An abnormal TSH result, whether high or low, suggests an excess or deficiency in the quantity of thyroid hormone available to the body, but does not pinpoint the cause for the abnormal result. Additional testing is frequently performed after an abnormal TSH test result to determine the reason of the increase or decrease.

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


TSI stands for thyroid stimulating immunoglobulin. TSI tells the thyroid gland to swell and release excess amounts of thyroid hormone into the blood.

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: 25-hydroxyvitamin D Test, Vitamin D 25-Hydroxyvitamin 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 bones and teeth. 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. 

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. 

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 may not be able to absorb vitamin D adequately or have had gastric bypass surgery 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? 

Even though 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 source of vitamin D 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.


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

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

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required.

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.



Fibromyalgia is a disease about which much is not yet known. Because of the nature of the symptoms, it is often misdiagnosed as other conditions. For this reason, fibromyalgia tests can be a good idea for those who suspect they may be suffering from this condition.

If you suspect that you may have this disorder, you will want to learn more about some of the fibromyalgia lab tests that are available to you. Read on to find out about the symptoms, causes, management, and diagnosis of this disease.

Fibromyalgia Lab Tests

For some time, there was no known way to test specifically for fibromyalgia. For this reason, diagnosis often consists of testing to rule out other diseases. Doctors most often identify a condition as fibromyalgia by process of elimination.

Some of the diseases that have similar symptoms to fibromyalgia include hypothyroidism, chronic fatigue syndrome, lupus, rheumatoid arthritis. Often, doctors will perform blood tests to rule out these conditions. This includes testing such as a complete blood count test, an antinuclear antibody test to rule out rheumatoid arthritis, and thyroid hormone tests to rule out hypothyroidism.

Recently, there has been promising evidence to suggest that something called an FM/a test may be effective in diagnosing fibromyalgia. This test focuses on the level of cytokines within a blood sample. Abnormal levels of cytokines have been linked to fibromyalgia.

However, more clinical trials are needed to confirm the efficacy of this method of testing. The process of elimination is still a widely used method of a fibromyalgia diagnosis. 

What Is Fibromyalgia?

Fibromyalgia is a disease that affects the central nervous system. It is characterized by widespread pain throughout the body. People with fibromyalgia may be more physically sensitive. This is due to abnormalities in how the nervous system processes pain.

Fibromyalgia typically manifests itself in adults between the ages of 30 and 50. It is estimated that around 4 million adults (or 2% of the population) in the US suffer from this condition.

Risk Factors for Fibromyalgia

Although much is still not known about this disease and its causes, there are some things that can put you at a higher risk. Women, for example, are around 7 times more likely to have fibromyalgia than men. It is more common in adults, although children and elderly people can also develop it.

Certain diseases, such as lupus and rheumatoid arthritis can put patients at a higher risk of developing fibromyalgia. It is now believed that in many cases, family history may also have a part to play.

Causes of Fibromyalgia

The exact causes of fibromyalgia are still unknown. However, there are certain situations or conditions that can be triggers for the development of fibromyalgia.

Going through a stressful or traumatic event can precipitate the development of fibromyalgia. This could be a death of a loved one, an abusive relationship, a car accident, or any other type of physically or mentally stressful situation. Post-traumatic stress disorder has been linked to the development of fibromyalgia.

There is also some evidence to suggest that there could be a hereditary element to the condition. Scientists believe people may be more likely to develop fibromyalgia because of genes inherited from their parents.

Signs and Symptoms of Fibromyalgia

Fibromyalgia symptoms are similar to those of many other conditions. This makes it oftentimes difficult to diagnose.

The most common and prominent symptom is pain throughout the entire body. Even the slightest touch can feel painful to someone with fibromyalgia.

Pain can feel like a dull ache or a sharp sensation. For those with fibromyalgia, pain tends to be widespread and long-lasting. Patients may also experience sensitivity to other things such as light, sound, and temperature.

Other symptoms include fatigue, difficulty sleeping, brain fog, and stiffness in the joints. Fibromyalgia sufferers can find themselves experiencing difficulty moving after holding the same position for too long. Brain fog can come in the form of difficulty learning new things, memory loss, and feelings of dizziness.

In some patients, fibromyalgia can cause other conditions such as IBS, anxiety, or depression to develop. In women, it can often cause painful periods.

Fibromyalgia and Fibromyalgia Tests: Frequently Asked Questions

Because we do not know enough about fibromyalgia, it is common for patients not to have heard of it or know how it is diagnosed. Below are some of the most frequently asked questions pertaining to fibromyalgia and fibromyalgia tests.

Is there a Cure for Fibromyalgia?

At the moment, there is no known cure for fibromyalgia. It is a chronic disease, meaning it tends to last a long time in most patients. However, lifestyle changes and medication can help with the symptoms.

How Is Fibromyalgia Treated?

There are many different courses of treatment for fibromyalgia. Often, painkillers are prescribed to help with the pain levels. Doctors often also recommend antidepressants to many patients.

Other treatments, such as cognitive-behavioral therapy and occupational therapy, can have a positive effect. Your doctor may also suggest lifestyle changes such as exercise programs, a special diet, or relaxation techniques.

How Can I Be Tested for Fibromyalgia?

Research is being carried out into FM/a testing for fibromyalgia. However, the most common method of diagnosis remains via the process of elimination.

Tests such as erythrocyte sedimentation ratecyclic citrullinated peptide test, and rheumatoid factor will be carried out to rule out various conditions. Doctors also look for the presence of pain in four of five key areas of the body that has lasted for more than three months.

Order Your Fibromyalgia Lab Tests Today

Take charge of your health and track your progress with Ulta Lab Tests. With Ulta Lab Tests, you can be confident in the accuracy and reliability of your test results. You will receive your results securely and confidentially online in 24 to 48 hours for most tests.

Affordable, accessible, and confidential testing is guaranteed. If you're looking for answers and peace of mind regarding your health, order your fibromyalgia tests today.