Thyroid Pharmacist Recommended Tests

TP - Root Cause Thyroid Panel #1 contains the following tests.

•  T3 Reverse (RT3), LC/MS/MS #90963
•  T3, Free #34429
•  T4, Free #866
•  Thyroid Peroxidase and Thyroglobulin Antibodies #7260
•  TSH #899

"IMPORTANT - Please note that Quest only returns values up to 900 for the Thyroid Peroxidase Antibodies test. 

TP - Root Cause Thyroid Panel #2 contains the following tests.

• T3, Free #34429 (1 Biomarkers)
• Thyroid Peroxidase and Thyroglobulin Antibodies #7260 (2 Biomarkers)
• T4, Free #866 (1 Biomarkers)
• TSH #899 (1 Biomarkers)

"IMPORTANT - Please note that Quest only returns values up to 900 for the Thyroid Peroxidase Antibodies test.

TP - Basic Thyroid Panel

• T3, Free
• T4, Free
• TSH

Patient Preparation 

Fasting specimen is preferred. Patient should be free from medications for 2 days.  IMPORTANT DO NOT DISCONTINUE MEDICATIONS WITHOUT THE SUPERVISION AND APPROVAL OF YOUR PHYSICIAN.

Clinical Significance

Alpha MSH is a 13 amino acid peptide (1665 kD) with serine at the N terminal end and amidated valine at the C terminal end. Alpha MSH is derived from pro-opiomelanocorticotropin, a precursor protein which contains within its structure, the sequence of ACTH, beta MSH and gamma MSH. The amino acid sequence of alpha MSH is identical to ACTH 1-13 in humans. Alpha MSH stimulates melanosome dispersion within dermal melanocytes and melanin biosynthesis within epidermal melanocytes. It also stimulates aldosterone synthesis. Plasma alpha MSH increases in humans with high fever due to endotoxin. Average plasma alpha MSH has been found higher in AIDS patients and also in obese men with insulin resistance.

Babesia serological testing is used to diagnose infection by the Babesia tick-borne protozoan. Infection may cause hemolytic anemia.

Bartonella Species Antibodies (IgG, IgM) with Reflex to Titer. Includes Bartonella henselae IgG, IgM; Bartonella quintana IgG, IgM.

Additional charges my apply if one or more of the following reflex tests are run by the lab. If B. henselae (IgG) screen is positive, the B. henselae (IgG) titer will be performed at an additional charge (CPT code(s): 86611).
If B. quintana (IgG) screen is positive, the B. quintana (IgG) titer will be performed at an additional charge (CPT code(s): 86611).
If B. henselae (IgM) screen is positive, the B. henselae (IgM) titer will be performed at an additional charge (CPT code(s): 86611).
If B. quintana (IgM) screen is positive, the B. quintana (IgM) titer will be performed at an additional charge (CPT code(s): 86611).

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 

Average Processing Time: 1 to 2 days

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: Ulta Lab Tests provides CBC test results from Quest Diagnostics as they are reported. Often, different biomarker results are made available at different time intervals. When reporting the results, Ulta Lab Tests denotes those biomarkers not yet reported as 'pending' for every biomarker the test might report. Only biomarkers Quest Diagnostics observes are incorporated and represented in the final CBC test results provided by Ulta Lab Tests. 

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

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.

Average Processing Time: 1 to 2 days 

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. 

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

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

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

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

Conditions where a Comprehensive Metabolic Panel test is recommended: 

• Diabetes
• Kidney Disease
• Liver Disease
• Hypertension

Commonly Asked Questions: 

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

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

What do my Comprehensive Metabolic Panel test results mean? 

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

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

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

Is there anything else I should know? 

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

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

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

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

Please note the following regarding BUN/Creatinine ratio: 

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

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

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

The Copeptin test is used in the diagnosis of central diabetes insipidus and in the differential diagnosis of central or nephrogenic diabetes insipidus. It is a reliable surrogate marker for arginine vasopressin (AVP).

Description: The cytomegalovirus antibodies test is used to detect antibodies to cytomegalovirus in the blood’s serum from a recent or past infection.

Also Known As: CMV Test, CMV Antibodies Test, CMV IgG IgM Test, Cytomegalovirus Test, Cytomegalovirus IgG IgM Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a Cytomegalovirus Antibodies test ordered?

When a younger person, a pregnant woman, or an immune-compromised individual exhibits flu- or mono-like signs and symptoms, CMV tests, as well as tests for influenza, mononucleosis, and EBV, may be requested.

When a health care provider is assessing the effectiveness of antiviral therapy, one or more CMV tests might be requested at regular intervals.

CMV antibody testing may be requested as a screening test to discover if a person has been exposed to CMV in the past when they are a candidate for an organ or marrow transplant.

What does a Cytomegalovirus Antibodies blood test check for?

Cytomegalovirus is a widespread virus that is found all over the world but only rarely causes symptoms. CMV infection affects between 50 and 85 percent of individuals in the United States. The majority of persons get infected as children or young adults and have no noticeable symptoms or health problems.

CMV testing entails measuring CMV antibodies, immunological proteins produced in response to CMV infection, or detecting the virus itself. Culturing CMV or detecting the virus's genetic material in a fluid or tissue sample might be used to identify the virus during an active infection.

During an active infection, CMV can be discovered in a variety of body fluids, including saliva, urine, blood, breast milk, sperm, vaginal secretions, and cerebrospinal fluid. Close personal touch or interaction with infected materials, like as diapers or toys, makes it easy to spread to others. CMV, like other members of the herpes family, becomes dormant or latent after the initial "primary" infection has cured. Unless a person's immune system is considerably impaired, cytomegalovirus can live in them for the rest of their lives without creating any symptoms. The virus may reactivate if this occurs.

In three scenarios, CMV can cause serious health problems:

• Primary CMV infection in young adults can induce a flu-like or mononucleosis-like disease. Extreme weariness, fever, chills, body pains, and/or headaches are common symptoms of this ailment, which normally goes away in a few weeks.
• Primary CMV infection in babies can result in major physical and developmental issues. This happens when a pregnant woman becomes infected for the first time and then distributes the infection to her unborn child through the placenta. Most infected neonates appear healthy at birth, but within a few months, they may develop hearing or vision abnormalities, pneumonia, convulsions, and/or impaired mental development. Some babies are stillborn, while others show signs including jaundice, anemia, an enlarged spleen or liver, and a small head when they are born.
• CMV can cause significant disease and death in people who have weaker immune systems. This includes those living with HIV/AIDS, people who have undergone organ or bone marrow transplants, and people who are receiving cancer chemotherapy. People with weakened immune systems who become infected for the first time may have the most severe symptoms, and their CMV infection may be active for a long time. Those who have previously been exposed to CMV may experience reactivation of their infection. Their eyes, digestive tract, lungs, and brain could all be affected. Spleen and liver problems are also possible, and people who have had organ or bone marrow transplants may have some rejection. Active CMV also weakens the immune system, making it easier for secondary infections like fungal infections to develop.

Lab tests often ordered with a Cytomegalovirus antibodies test:

• Epstein Barr Virus Antibodies
• Herpes 1 and 2
• Varicella Zoster Virus

Conditions where a Cytomegalovirus antibodies test is recommended:

• Epstein Barr Virus
• HIV
• Herpes
• Chicken Pox and Shingles

How does my health care provider use a Cytomegalovirus antibodies test?

Cytomegalovirus testing is performed to see if someone has an active CMV infection based on their signs and symptoms. It's sometimes ordered to see if someone has ever been infected with CMV before.

CMV is a widespread virus that affects a large percentage of the population but rarely produces symptoms or serious health concerns. In neonates and persons with weaker immune systems, such as transplant recipients, cancer patients, people taking immunosuppressive medicines, and people living with HIV, primary CMV infection can cause serious sickness and consequences.

Antibody testing on blood samples can be used to detect if someone has been exposed recently or previously. IgM and IgG are the two types of CMV antibodies produced in response to a CMV infection, and one or both might be seen in the blood.

The first antibodies produced by the body in response to a CMV infection are IgM antibodies. Within a week or two of the initial exposure, they are present in the majority of people. Antibody production of IgM increases for a brief period before declining. CMV IgM antibody levels frequently decline below detectable levels after many months. When latent CMV is triggered, more IgM antibodies are generated.

The body produces IgG antibodies several weeks after the original CMV infection, which defend against secondary infections. IgG levels rise during active infection, then level off as the CMV infection fades and the virus becomes dormant. After being exposed to CMV, a person's blood will contain quantifiable amounts of CMV IgG antibodies for the rest of their lives. Along with IgM testing, CMV IgG antibody testing can be used to establish the existence of a current or previous CMV infection.

CMV antibody testing can be used to determine immunity to primary CMV infections in people who are awaiting organ or bone marrow transplantation, as well as in HIV/AIDS patients. CMV infection is common and causes minimal difficulties in those with healthy immune systems, hence general population screening is uncommon.

What do my CMV IgG and IgM test results mean?

When interpreting the findings of CMV testing, caution is advised. The results are compared to clinical data, such as signs and symptoms, by a health professional. It's not always easy to tell the difference between a latent, active, or reactivated CMV infection. This is attributable to a number of factors, including:

A healthy individual who has been infected with CMV will carry the virus for the rest of their lives. CMV can reactivate on a regular basis, frequently in a subclinical manner, shedding small amounts of virus into body fluids but causing no symptoms.

Even if the individual has an active case of CMV, an immune-compromised person may not have a significant antibody response to the infection; the person's IgM and IgG levels may be lower than predicted.

It's possible that the virus isn't present in large enough numbers in the fluid or tissue being analyzed to be detected.

A symptomatic person with positive CMV IgG and IgM has most likely been exposed to CMV for the first time or has had a previous CMV infection reactivated. IgG levels can be measured again 2 or 3 weeks later to confirm this. A high IgG level is less essential than an increasing level. If the IgG level in the first and second samples differs by fourfold, the person is infected with CMV.

A positive CMV IgM and negative IgG indicates that the person was infected recently.

In someone who is symptomatic, a negative IgG and/or IgM or low levels of antibodies may indicate that the person has a problem other than CMV or that their immune system is not responding correctly.

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

Description: The EBV antibody test is used to measure the antibodies present in the immune system. EBV tests are used to help diagnose mononucleosis (mono) by ruling out EBV and to differentiate between EBV infection and other infections that present with the same symptoms.

Also Known As: EBV Antibody Test, EBV Ab Test, EBV Test, EBV Panel, Epstein Barr Virus (EBV) Panel, Epstein Barr Virus EBV Antibody Panel

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is an Epstein-Barr Virus Antibody Panel test ordered?

When someone has symptoms that imply mono but a negative mono test, or when a pregnant woman has flu-like symptoms and her healthcare provider wants to know if the symptoms are caused by EBV or another microorganism, EBV antibody testing may be recommended.

When a healthcare provider wishes to know if they've been exposed to EBV before, testing might be ordered. When a healthcare provider wants to follow antibody concentrations or when the first test was negative but the healthcare practitioner still feels the person's symptoms are due to EBV, testing may be repeated.

What does an Epstein-Barr Virus Antibody Panel blood test check for?

The Epstein-Barr virus is a virus that causes a mild to moderate sickness in most people. Epstein-Barr virus blood tests detect EBV antibodies in the blood and aid in the diagnosis of EBV infection.

The Epstein-Barr virus produces a highly common infection. Most persons in the United States are infected with EBV at some point in their life, according to the Centers for Disease Control and Prevention. The virus is very contagious and can readily spread from one person to another. It is found in infected people's saliva and can be spread by intimate contact, such as kissing or sharing utensils or cups.

The incubation period is a period of several weeks following initial EBV exposure before related symptoms manifest. The virus multiplies in number during the acute primary infection. There is a drop in viral levels and a remission of symptoms after this, but the virus never totally disappears. EBV that stays latent in a person's body for the rest of their lives may reawaken, although it normally causes little problems unless the person's immune system is severely damaged.

The majority of people are infected with EBV as children and have few or no symptoms. When an infection arises in adolescence, however, it can lead to infectious mononucleosis, sometimes known as mono, which is characterized by fatigue, fever, sore throat, swollen lymph nodes, an enlarged spleen, and occasionally an enlarged liver. About 25% of infected teens and young adults experience these symptoms, which normally go away within a month or two.

Mono is usually diagnosed based on symptoms and the results of a full blood count and a mono test. About 25% of people with mono don't create heterophile antibodies, resulting in a negative mono test; this is especially true in youngsters. Antibodies to the EBV virus can be tested to see if the symptoms these people are having are due to a current infection with the virus.

The most prevalent cause of mono is EBV. Other causes of mono, according to the CDC, include CMV, hepatitis A, hepatitis B, or hepatitis C, rubella, and toxoplasmosis. It can be difficult to tell the difference between EBV and these other infections at times. For example, diagnosing the etiology of symptoms of a viral disease in a pregnant woman may be critical. Testing can assist distinguish between a primary EBV infection, which has not been demonstrated to harm a developing baby, and a CMV, herpes simplex virus, or toxoplasmosis infection, which can cause pregnancy difficulties and harm the fetus.

It's also crucial to rule out EBV infection and check for other possible explanations of symptoms. Those suffering from strep throat, a bacterial infection caused by group A streptococcus, must be recognized and treated with antibiotics. It's possible to have strep throat instead of mono, or to have both at the same time.

There are several assays for different types and classes of EBV antibodies. Antibodies are proteins produced by the body as part of an immune response to antigens from the Epstein-Barr virus. The amount of each of these EBV antibodies rises and declines as the illness proceeds during a primary EBV infection. Antibodies in the blood can help with diagnosis and can tell a doctor about the stage of illness and whether it's a current, recent, or past infection.

Antibody Viral Capsid Antigen-IgM antibody is commonly identified in the blood at this time. After being exposed to the virus, it appears for roughly 4 to 6 weeks before disappearing.

Antibody to VCA-IgG It appears during acute infection, with the maximum level at 2 to 4 weeks, then gradually decreases, stabilizes, and is present for the rest of one's life.

Antibody to the early antigen appears during the acute infection phase and subsequently fades; about 20% of people infected will have detectable amounts for several years after the EBV infection has cleared.

Lab tests often ordered with an Epstein-Barr Virus Antibody Panel test:

• Mononucleosis
• Complete Blood Count (CBC)
• White Blood Cell Count (WBC)
• Blood Smear
• Cytomegalovirus
• Toxoplasmosis

Conditions where an Epstein-Barr Virus Antibody Panel test is recommended:

• Mononucleosis
• Influenza
• Pregnancy
• Epstein-Barr Virus

How does my health care provider use an Epstein-Barr Virus Antibody Panel test?

If a person is symptomatic but has a negative mono test, blood tests for Epstein-Barr virus antibodies can help diagnose EBV infection, the most prevalent cause of infectious mononucleosis.

One or more EBV antibody tests, along with testing for cytomegalovirus, toxoplasmosis, and other infections, may be ordered in pregnant women with signs of a viral disease to assist distinguish between EBV and disorders that generate similar symptoms.

These tests may be conducted for asymptomatic people to see if they've been exposed to EBV before or are vulnerable to a primary EBV infection. This is not regularly done, but it may be requested if someone has been in intimate contact with a person who has mono, such as a teenager or an immunocompromised person.

The Centers for Disease Control and Prevention recommends ordering a variety of tests to assess whether a person is vulnerable to EBV, as well as to detect a recent or earlier infection, or a reactivated EBV infection.

What do my Epstein Barr Virus antibody test results mean?

When interpreting the findings of EBV antibody testing, caution is advised. The person being tested's indications and symptoms, as well as his or her medical history, must be considered. A healthcare provider may seek the advice of an infectious disease specialist, particularly one who is familiar with EBV testing.

If someone tests positive for VCA-IgM antibodies, they are most likely infected with EBV and may be in the early stages of the illness. Even though the mono test was negative, the individual is most likely to be diagnosed with mono if they also have symptoms linked with it.

If a person's VCA-IgG and EA-D IgG tests come back positive, it's quite likely that they have an active or recent EBV infection.

If VCA-IgM is negative but VCA-IgG and an EBNA antibody are positive, the person tested most likely had an EBV infection before.

If a person is asymptomatic and negative for VCA-IgG, he or she has most likely never been exposed to EBV and is hence susceptible to infection.

In general, growing VCA-IgG levels suggest a current EBV infection, whereas dropping values indicate a recently resolved EBV infection. However, EBV antibody concentrations must be interpreted with caution because the amount of antibody present is unrelated to the severity of the infection or the length of time it will remain. High amounts of VCA-IgG may be present, and they may stay that way for the rest of one's life.

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

Reference Range(s)

Epstein-Barr Virus VCA Antibody (IgM)

U/mLInterpretation

• <36.00 Negative
• 36.00-43.99Equivocal
• >43.99Positive

Epstein-Barr Virus VCA Antibody (IgG)

U/mLInterpretation

• <18.00 Negative
• 18.00-21.99Equivocal
• >21.99Positive

Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

U/mLInterpretation

• <18.00 Negative
• 18.00-21.99Equivocal
• >21.99Positive

Description: The Epstein-Barr Virus, or EBV, test is used to find the EBV antibodies that may be present. Most individuals are affected with EBV during childhood or adolescent. This test will show if the IgG antibodies are still present from an infection within 6 months.

Also Known As: EBV Ab to Early Antigen D Test, EA-D IgG Ab Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is an Epstein-Barr Virus Early Antigen D IgG Antibody test ordered?

When someone has symptoms that imply mono but a negative mono test, or when a pregnant woman has flu-like symptoms and her healthcare provider wants to know if the symptoms are caused by EBV or another microorganism, EBV antibody testing may be recommended.

When a healthcare provider wishes to know if they've been exposed to EBV before, testing might be ordered. When a healthcare provider wants to follow antibody concentrations or when the first test was negative but the healthcare practitioner still feels the person's symptoms are due to EBV, testing may be repeated.

What does an Epstein-Barr Virus Early Antigen D IgG Antibody blood test check for?

The Epstein-Barr virus is a virus that causes a mild to moderate sickness in most people. Epstein-Barr virus blood tests detect EBV antibodies in the blood and aid in the diagnosis of EBV infection.

The Epstein-Barr virus produces a highly common infection. Most persons in the United States are infected with EBV at some point in their life, according to the Centers for Disease Control and Prevention. The virus is very contagious and can readily spread from one person to another. It is found in infected people's saliva and can be spread by intimate contact, such as kissing or sharing utensils or cups.

The incubation period is a period of several weeks following initial EBV exposure before related symptoms manifest. The virus multiplies in number during the acute primary infection. There is a drop in viral levels and a remission of symptoms after this, but the virus never totally disappears. EBV that stays latent in a person's body for the rest of their lives may reawaken, although it normally causes little problems unless the person's immune system is severely damaged.

The majority of people are infected with EBV as children and have few or no symptoms. When an infection arises in adolescence, however, it can lead to infectious mononucleosis, sometimes known as mono, which is characterized by fatigue, fever, sore throat, swollen lymph nodes, an enlarged spleen, and occasionally an enlarged liver. About 25% of infected teens and young adults experience these symptoms, which normally go away within a month or two.

Mono is usually diagnosed based on symptoms and the results of a full blood count and a mono test. About 25% of people with mono don't create heterophile antibodies, resulting in a negative mono test; this is especially true in youngsters. Antibodies to the EBV virus can be tested to see if the symptoms these people are having are due to a current infection with the virus.

The most prevalent cause of mono is EBV. Other causes of mono, according to the CDC, include CMV, hepatitis A, hepatitis B, or hepatitis C, rubella, and toxoplasmosis. It can be difficult to tell the difference between EBV and these other infections at times. For example, diagnosing the etiology of symptoms of a viral disease in a pregnant woman may be critical. Testing can assist distinguish between a primary EBV infection, which has not been demonstrated to harm a developing baby, and a CMV, herpes simplex virus, or toxoplasmosis infection, which can cause pregnancy difficulties and harm the fetus.

It's also crucial to rule out EBV infection and check for other possible explanations of symptoms. Those suffering from strep throat, a bacterial infection caused by group A streptococcus, must be recognized and treated with antibiotics. It's possible to have strep throat instead of mono, or to have both at the same time.

There are several assays for different types and classes of EBV antibodies. Antibodies are proteins produced by the body as part of an immune response to antigens from the Epstein-Barr virus. The amount of each of these EBV antibodies rises and declines as the illness proceeds during a primary EBV infection. Antibodies in the blood can help with diagnosis and can tell a doctor about the stage of illness and whether it's a current, recent, or past infection.

Antibody to the early antigen appears during the acute infection phase and subsequently fades; about 20% of people infected will have detectable amounts for several years after the EBV infection has cleared.

Lab tests often ordered with an Epstein-Barr Virus Early Antigen D IgG Antibody test:

• Mononucleosis
• Complete Blood Count (CBC)
• White Blood Cell Count (WBC)
• Blood Smear
• Cytomegalovirus
• Toxoplasmosis

Conditions where an Epstein-Barr Virus Early Antigen D IgG Antibody test is recommended:

• Influenza
• Pregnancy

How does my health care provider use an Epstein-Barr Virus Early Antigen D IgG Antibody test?

If a person is symptomatic but has a negative mono test, blood tests for Epstein-Barr virus antibodies can help diagnose EBV infection, the most prevalent cause of infectious mononucleosis.

One or more EBV antibody tests, along with testing for cytomegalovirus, toxoplasmosis, and other infections, may be ordered in pregnant women with signs of a viral disease to assist distinguish between EBV and disorders that generate similar symptoms.

These tests may be conducted for asymptomatic people to see if they've been exposed to EBV before or are vulnerable to a primary EBV infection. This is not regularly done, but it may be requested if someone has been in intimate contact with a person who has mono, such as a teenager or an immunocompromised person.

The Centers for Disease Control and Prevention recommends ordering a variety of tests to assess whether a person is vulnerable to EBV, as well as to detect a recent or earlier infection, or a reactivated EBV infection.

What do my Epstein Barr Virus Early Antigen D antibody test results mean?

When interpreting the findings of EBV antibody testing, caution is advised. The person being tested's indications and symptoms, as well as his or her medical history, must be considered. A healthcare provider may seek the advice of an infectious disease specialist, particularly one who is familiar with EBV testing.

If a person's VCA-IgG and EA-D IgG tests come back positive, it's quite likely that they have an active or recent EBV infection.

In general, growing VCA-IgG levels suggest a current EBV infection, whereas dropping values indicate a recently resolved EBV infection. However, EBV antibody concentrations must be interpreted with caution because the amount of antibody present is unrelated to the severity of the infection or the length of time it will remain. High amounts of VCA-IgG may be present, and they may stay that way for the rest of one's life.

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

Description: A Ferritin test is a blood test that measures Ferritin levels in your blood’s serum to evaluate the level of iron stored in your body.

Also Known As: Ferritin Serum Test, Ferritin Test, Ferritin Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Ferritin test ordered?

When a CBC test’s implies iron deficiency anemia due to small red blood cells or low hematocrit and hemoglobin levels, the ferritin test, and other iron tests, may be requested, even if other clinical symptoms have not yet arisen.

There are frequently no physical symptoms in the early stages of iron insufficiency. Symptoms rarely develop before hemoglobin falls below dangerous levels. However, when the iron deficit continues, symptoms emerge, prompting a doctor to order ferritin and other iron-related testing. The following are the most prevalent symptoms of iron deficiency anemia:

• Chronic tiredness/fatigue
• Weakness
• Dizziness
• Headaches
• Skin that is pale

Shortness of breath, ringing in the ears, sleepiness, and irritability may occur as iron levels are reduced. Chest pain, headaches, limb pains, shock, and even heart failure may occur as the anemia worsens. Learning impairments can occur in children. There are some symptoms that are specific to iron deficiency, in addition to the usual signs of anemia. Pica, a burning feeling in the tongue or a smooth tongue, ulcers at the corners of the mouth, and spoon-shaped finger- and toe-nails are only a few of the symptoms.

When iron overload is suspected, a ferritin level may be requested. Iron overload symptoms differ from person to person and tend to worsen over time. They are caused by an excess of iron in the blood and tissues. Among the signs and symptoms are:

• Joint discomfort
• Weakness and exhaustion
• Loss of weight
• Energy deficiency
• Pain in the abdomen
• Suffering from a lack of sexual desire
• Hair loss on the body
• Congestive heart failure is an example of a cardiac issue

Other iron tests including a genetic test for hereditary hemochromatosis may be conducted to confirm the existence of iron excess.

What does a Ferritin blood test check for?

Ferritin is an iron-containing protein that stores iron in cells in its most basic form. The amount of total iron stored in the body is reflected in the little amount of ferritin released into the blood. This test determines how much ferritin is present in the blood.

About 70% of the iron consumed by the body is integrated into the hemoglobin of red blood cells in healthy humans. The remaining 30% is stored primarily as ferritin or hemosiderin, which is a combination of iron, proteins, and other elements. Hemosiderin and ferritin are typically found in the liver, although they can also be found in the bone marrow, spleen, and skeletal muscles.

Iron stores are depleted and ferritin levels fall when available iron is insufficient to meet the body's needs. This can happen owing to a lack of iron, poor absorption, or an increased need for iron, such as during pregnancy or if you have a condition that causes persistent blood loss. Before any indicators of iron shortage appear, significant loss of iron reserves may occur.

When the body absorbs more iron than it needs, iron storage and ferritin levels rise. Chronic iron absorption causes a gradual buildup of iron compounds in organs, which can eventually lead to organ malfunction and failure. Even on a typical diet, this happens in hemochromatosis, a hereditary disorder in which the body absorbs too much iron.

Lab tests often ordered with a Ferritin test:

• Complete Blood Count
• Iron Total
• Iron Total and Total Iron binding capacity
• Transferrin
• Comprehensive Metabolic Panel
• Lipid Panel
• Zinc Protoporphyrin

Conditions where a Ferritin test is recommended:

• Anemia
• Hemochromatosis
• Lead poisoning
• Pregnancy
• Restless Leg Syndrome

How does my health care provider use a Ferritin test?

The ferritin test is used to determine the amount of iron a person has in their body. To determine the existence and severity of iron shortage or iron overload, the test is sometimes ordered in conjunction with an iron test and a TIBC test.

One source of iron overload can be the use of iron supplements.

What does my ferritin lab test result mean?

Ferritin levels are frequently measured alongside other iron tests.

Ferritin levels are low in iron deficient people and high in people who have hemochromatosis or have had several blood transfusions.

Ferritin is an acute phase reactant that can be elevated in persons who have inflammation, liver illness, chronic infection, autoimmune disorders, or cancer. Ferritin isn't commonly utilized to detect or monitor these problems.

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