Aluminum is an attacker of our central nervous system. Studies show that toxic metals contribute to brain diseases by producing oxidative stress and aluminum is one of the worst offenders.

Aluminum accumulates in the bones, hair, kidneys, brain, lungs, liver and thyroid where it competes with calcium for absorption and can affect skeletal mineralization and can be detected by taking a simple urine test.

Exposure can occur from daily consumption of female/male cosmetics and hygiene products including industrial exposure, cooking supplies and aerosol sprays. Aluminum levels may be increased in patients on dialysis and in patients with renal failure and Alzheimer’s disease. This measure is very sensitive to aluminum containing medications, e.g., aluminum-containing antacids, such as Mylanta and Maalox and may continue to test as elevated for a prolonged period of time even after the medication is stopped.

AFP concentrations are increased in patients with liver cancer, hepatitis, and liver cirrhosis. Increased levels in severe hepatitis indicate liver cell regeneration. Thus, the absence of AFP in patients with fulminant hepatitis is considered a poor prognostic sign.

AFP concentrations decline to normal levels with effective therapy. Persistently elevated levels suggest residual disease; rising levels suggest disease progression or recurrence.

Clinical Use: Distinguishs between seminomatous and non-seminomatous testicular germ cell cancer. Monitors therapy and detect recurrence in individuals with non-seminomatous testicular germ cell cancer. Determines prognosis in individuals with fulminant hepatitis. Monitors therapy in individuals with hepatocellular carcinoma and monitors hepatitis B carriers for evidence of liver cancer

Amylase is an enzyme that helps digest carbohydrates. Amylase It is made in the pancreas and it is the glands that makes saliva. When the pancreas has a disease or is inflamed, amylase releases into the blood. A test can be done to measure the level of this enzyme in your blood.

The most common cause of elevation of serum amylase is inflammation of the pancreas (pancreatitis). In acute pancreatitis, serum amylase begins to rise within 6-24 hours, remains elevated for a few days and returns to normal in 3-7 days. Other causes of elevated serum amylase are inflammation of salivary glands (mumps), biliary tract disease and bowel obstruction. Elevated serum amylase can also be seen with drugs (e.g., morphine) which constrict the pancreatic duct sphincter preventing excretion of amylase into the intestine.

ABO grouping is a test performed to determine an individual's blood type. It is based on the premise that individuals have antigens on their red blood cells (RBCs) that correspond to the 4 main blood groups: A, B, O, or AB.

ABO type and Rh are needed to identify candidates for Rh immune globulin and to assess the risk of hemolytic disease of the newborn

Test Includes: Includes Isoleucine, Leucine, Phenylalanine, Tyrosine, Tryptophan, Valine

Twenty percent of the human body is made up of protein. Protein plays a crucial role in almost all biological processes and amino acids are the building blocks of it. A large proportion of our cells, muscles and tissue is made up of amino acids, meaning they carry out many important bodily functions, such as giving cells their structure. They also play a key role in the transport and the storage of nutrients. Amino acids have an influence on the function of organs, glands, tendons and arteries. They are furthermore essential for healing wounds and repairing tissue, especially in the muscles, bones, skin and hair as well as for the removal of all kinds of waste deposits produced in connection with the metabolism.

Aspirin (which inhibits platelet cyclo-oxygenase) reduces the risk of thrombosis in cardiovascular disease by impairing platelet function. Patients who do not respond to the platelet inhibitory effects of aspirin are designated as "ASPIRIN RESISTANT". The measurement of 11-DEHYDROTHROMBOXANE B2 in urine (the principal metabolite of platelet cyclo-oxygenase derived thromboxane B2) indicates lack of aspirin responsiveness.

Studies have found that between 5 percent and 45 percent of patients have this problem, but doctors do not routinely test for it. Increasing degrees of aspirin resistance may correlate independently with increasing risk of cardiovascular events. Aspirin resistance can be detected by laboratory tests of platelet thromboxane A2 production or platelet function that depend on platelet thromboxane production. Knowing if you’re aspirin resistant could be potentially lifesaving.

Includes: Almond, Cashew Nut, Codfish, Cow's Milk, Egg White, Hazelnut, Peanut, Salmon, Scallop Sesame Seed, Shrimp, Soybean, Tuna Walnut, Wheat

This test takes a lot of guess work out of your daily diet. If you have IBS, rashes, or even a life threatening food you have to avoid, this test can be very important to your over all health.

Accurate diagnosis of food allergy is important not only for avoidance of foods that may cause a reaction, but also to avoid unnecessary dietary restrictions that may adversely affect quality of life.

The Food Allergy Profile provides rapid and convenient measurement of food-specific IgE antibodies. The profile includes allergens associated with common food allergies and is useful in confirming or excluding suspected food allergies. Results can help direct subsequent testing and management options, including trial elimination diet, oral food challenge, and further evaluation of non-IgE-related reactions.

Arsenic is widely distributed in the earth's crust. Arsenic is used in some pesticides and industrial applications. Arsenic toxicity can cause skin changes, respiratory illness, nausea and vomiting, and other effects.

A wide range of signs and symptoms may be seen in positive arsenic poisoning which including headache, nausea, vomiting, diarrhea, abdominal pain, hypotension, fever, hemolysis, seizures, and mental status changes. Symptoms of chronic poisoning, also called arseniasis, are mostly insidious and nonspecific. The gastrointestinal tract, skin, and central nervous system are usually involved. Nausea, epigastric pain, colic abdominal pain, diarrhea, and paresthesias of the hands and feet can occur.

Bismuth metal is used to manufacture alloys, catalysts, ceramics, cosmetics, magnets, paints, pharmaceuticals, semiconductors, and x-ray contrast media; excessive use or exposure to Bismuth containing medications may cause renal damage and other adverse effects. Bismuth is used as an antidiarrheal; it is the active ingredient in such “Pink Bismuth” preparations as Pepto-Bismol, as well as the 2004 reformulation of Kaopectate. It is also used to treat some other gastro-intestinal diseases. The mechanism of action of this substance is still not well documented, however it can remain in the kidney for years in patients treated with bismuth compounds. In chronic poisoning, all organs are affected. In the skin a lichen planus-like rash, in the mouth stomatitis with a blue black gum line. Inflammation and inclusion bodies in the liver, kidney, and bone are characteristic. In the brain, the lesions will cause encephalitis.

Bordetella pertussis is the cause of whooping cough that may occur in unimmunized individuals. B. parapertussis is a related organism that causes a similar but milder disease. Pertussis, a more commonly known as whooping cough, is a contagious, respiratory disease caused by the bacterium Bordetella pertussis. The illness is characterized by a prolonged paroxysmal cough, which is often accompanied by an inspiratory whoop. Disease presentation varies with age and history of previous exposure or vaccination. Young infants may present to a clinic or hospital with apnea and no other disease symptoms. Adults and adolescents with some immunity may exhibit only mild symptoms or have the typical prolonged paroxysmal cough. In all persons, cough can continue for months.

A complete blood count is used as a screening test for various disease states including anemia, leukemia and inflammatory processes.

Test includes: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet Count, MPV and Differential (Absolute and Percent - Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Basophils) If abnormal cells are noted on a manual review of the peripheral blood smear or if the automated differential information meets specific criteria, a full manual differential will be performed.

The comprehensive metabolic panel (CMP) is used as a baseline screening tool to assess organ function and check for serious conditions such as diabetes, liver disease, and kidney disease. The CMP may also be ordered to monitor various known conditions, such as hypertension, and to monitor people taking specific medications for any kidney, or liver-related side effects. Getting your CMP regularly is a great health screening tool.

Test includes: Albumin, Albumin/Globulin Ratio (calculated), Alkaline Phosphatase, ALT, AST, BUN/Creatinine Ratio (calculated), Calcium, Carbon Dioxide, Chloride, Creatinine with GFR Estimated, Globulin (calculated), Glucose, Potassium, Sodium, Total Bilirubin, Total Protein, Urea Nitrogen

The lipid profile is used as part of a cardiac risk assessment to help determine an individual's risk of heart disease and to help make decisions about what treatment may be best if there is borderline or high risk. Lipids are a group of fats and fat-like substances that are important constituents of cells and sources of energy. Monitoring and maintaining healthy levels of these lipids is important in staying healthy

Test includes: Total Cholesterol, HDL Cholesterol, Triglycerides, LDL-Cholesterol (calculated), Cholesterol/HDL Ratio (calculated), Non-HDL Cholesterol (calculated)

The level of C-Reactive Protein in the blood is should normally be low. 

A high CRP result or increasing amount of CRP in the blood suggests the presence of inflammation however it will not identify its location or the cause. In individuals suspected of having a serious bacterial infection, a high CRP can be confirmatory. In people with chronic inflammatory conditions, high levels of CRP suggest a flare-up or that treatment has not been effective. If the CRP level is initially elevated and drops, it means that the inflammation or infection is subsiding and/or responding to treatment.

Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk. If you intend to evaluate cardiovascular risk (Hs-CRP) is needed.

Ongoing  inflammation is a sign  of potential in heart disease; studies have shown that high levels of CRP, taken by high-sensitivity CRP (hs-CRP), can be a marker of atherosclerosis.      hs-CRP is an important predictor for cardiovascular disease including myocardial infarction, cerebrovascular events, peripheral vascular disease, and sudden cardiac death in individuals without a history of heart disease. In patients with acute coronary disease, CRP level predicts mortality and cardiac complications. High CRP levels foreshadow a worse prognosis in patients with acute coronary syndromes. hs-CRP is also a marker of other chronic disease such as metabolic syndrome. Adding a hs-CRP test along with other cardiovascular related tests can be very essential to help aid your doctor provide you with the most effective treatment. 

Ceruloplasmin, is a glycoprotein produced in the liver and transports more than 95 percent of the copper in blood. Copper plays an important role in the body by aiding crucial bodily processes. These include producing energy, forming connective tissue, and helping the central nervous system function. Decreased levels of ceruloplasmin are found in Wilson's Disease, fulminant liver failure, intestinal malabsorption, renal failure resulting in proteinuria, chronic active hepatitis and malnutrition. Elevated levels are found in primary biliary cirrhosis, pregnancy (first trimester), oral contraceptive use and in acute inflammatory conditions since ceruloplasmin is an acute phase reactant.

Copper is an essential element that is a cofactor of many enzymes. Copper metabolism is disturbed in Wilson's disease, Menkes disease, primary biliary cirrhosis, and Indian childhood cirrhosis. Copper concentrations increase in acute phase reactions and during the third trimester of pregnancy. Copper concentrations are decreased with nephrosis, malabsorption, and malnutrition. Copper concentrations are also useful to monitor patients, especially preterm newborns, on nutritional supplementation. Results of copper are often interpreted together with ceruloplasmin.

One of the best ways to detect Copper deficiency is intracellular, or red blood cell (RBC) vs a regular copper test.

Copper is an essential element that is a cofactor of many enzymes. Copper metabolism is disturbed in Wilson's disease, Menkes disease, primary biliary cirrhosis, and Indian childhood cirrhosis. Copper concentrations increase in acute phase reactions. Copper concentrations are decreased with nephrosis, malabsorption, and malnutrition. Copper concentrations are also useful to monitor patients, especially preterm newborns, on nutritional supplementation. Results of copper are often interpreted together with ceruloplasmin

Chromium is a naturally occurring heavy metal that is commonly used in industrial processes and can cause severe health effects in humans. The primary health impacts from chromium are damage to the gastrointestinal, respiratory, and immunological systems, as well as reproductive and developmental problems.

A large percentage of patients with gastrointestinal tumors (such as pancreatic, liver, gastric, colorectal tumors) and some other malignancies have been shown to have elevated serum  CA 19-9 levels. Serum CA 19-9 levels may be useful for monitoring disease activity or predicting relapse following treatment. CA 19-9 should not be used as a screening test.

CA 27.29 may be useful for monitoring patients with various cancers. Elevated CA 27.29 levels are associated with metastatic breast cancer and sometimes with primary breast cancer. CA 27.29 is also elevated in ovarian, liver, pancreatic and lung cancer, as well as in the nonmalignant conditions detailed in the table below. Rising levels suggest lack of therapeutic response and/or progressive disease, whereas decreasing levels suggest response to treatment and disease regression. CA 27.29 elevations in patients with a history of breast cancer and no clinical evidence of disease suggest recurrence.

CA 15-3 may be useful for monitoring patients with metastatic breast cancer and certain ovarian cancers. The CA 15-3 values from sequential samples have a high correlation with the clinical course in most patients with metastatic breast cancer. Benign diseases of the breast and liver may cause elevated results.

The CA 125 level can provide prognostic information in the follow-up management of patients with ovarian carcinoma. The assay should be used as an adjunctive test in the management of ovarian cancer patients. 

Increased serum CEA levels have been detected in persons with primary colorectal cancer and in patients with other malignancies involving the gastrointestinal tract, breast, lung, ovarian, prostatic, liver and pancreatic cancers. Elevated serum CEA levels have also been detected in patients with nonmalignant disease, especially patients who are older or who are smokers. CEA levels are not useful in screening the general population for undetected cancers. However, CEA levels provide important information about patient prognosis, recurrence of tumors after surgical removal, and effectiveness of therapy.

C-Peptide is useful in the evaluation of pancreatic beta cell function (e.g., helping distinguish type 1 from type 2 diabetes mellitus, or monitoring patients who have received islet cell or pancreatic transplants) and for determining the source of insulin in patients with hyperinsulinemic hypoglycemia. (e.g., distinguishing insulin-secreting tumors from exogenous insulin administration). It is also sometimes measured as an additional means (more resistant to hemolysis than is insulin itself) for evaluating glucose tolerance tests. 

Candida albicans is a dimorphic fungus that grows both as yeast and filamentous cells and one of the few species of the Candida genus that cause the infection candidiasis in humans.

Albicans is a common member of human gut flora and is detectable in the gastrointestinal tract in 40% of healthy adults. The Candida antigen tests typically monitors three specific antibodies and the Candida antigen itself: 

IgG antibodies

IgG is the predominant antibody formed from secondary exposure to antigen, and reflects a past or ongoing infection. It is produced as IgM antibody levels decrease after primary exposure. IgG activates complement, and assists the phagocytic system to eliminate antigen from the extravascular space. The IgG antibodies represent the major class of human immunoglobulins and are evenly distributed throughout both our intra- and extravascular fluids. Note that specific IgG antibodies may persist for many years after an infection has been eradicated. 

IgA antibodies

IgA is found in mucous secretions and is important in local (mucosal) immunity.Although representing only 15-20% of our human serum immunoglobulins, are the predominant antibody class found in seromucus secretions. High levels of specific IgA antibodies against Candida species as measured in serum are thought to be associated with mucosal epithelial, tracheobronchial, and genito-urinary candida infections. 

IgM antibodies

IgM is the first antibody formed after primary exposure to antigen. IgM readily activates complement, and assists the phagocytic system to eliminate antigen from the intravascular space. IgM are confined in the body to our intravascular tissues and are generally regarded as the predominant immunoglobulins involved in early infections. Often, upon reinfection, IgM antibody levels may not be as elevated as in earlier infections. 

Candida antigen'

The detection of Candida antigen in serum is evidence that mucosal and immunological barriers have been overwhelmed

Test for myocardial infarction and skeletal muscle damage. Elevated results may be due to: myocarditis, myocardial infarction (heart attack), muscular dystrophy, muscle trauma or excessive exercise.

Chronic stress and elevated cortisol levels can increase your risk to a list of various chronic diseases in addition to severe depression and altered hormones and a poor quality of life.  A cortisol AM test is done to find problems of the pituitary gland or adrenal glands, such as making too much or too little hormones. The cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid) hormone produced by the adrenal gland.

Your doctor may recommend you to also take a Cortisol PM test in conjunction with AM Cortisol.

Chronic stress and elevated cortisol levels can increase your risk to a list of various chronic diseases in addition to severe depression and altered hormones and a poor quality of life. A cortisol PM test is done to find problems of the pituitary gland or adrenal glands, such as making too much or too little hormones. The cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid) hormone produced by the adrenal gland.

Your doctor may recommend you to also take a Cortisol AM test in conjunction with PM Cortisol.

Cystatin C is a protein that is produced by the cells in your body. When kidneys are working well, they keep the level of cystatin C in your blood just right.

If you have an abnormally high concentration of cystatin C in your blood, it means you may have a kidney condition, such as chronic kidney disease. Higher levels of cystatin C may also be caused by diabetes, cancer, HIV, hyperthyroidism, or hypothyroidism.

C. trachomatis infections are the leading cause of sexually transmitted diseases in the United States. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. It is also the most frequent cause of non-gonococcal urethritis in men. Among women, the consequences of Chlamydial infections are severe if left untreated. 

Approximately half of Chlamydial infections are asymptomatic.

Neisseria gonorrhoeae (gonococci) is the causative agent of gonorrhea. In men, this disease generally results in anterior urethritis accompanied by purulent exudate. In women, the disease is most often found in the cervix, but the vagina and uterus may also be infected.

C. trachomatis infections are the leading cause of sexually transmitted diseases in the united states. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. It is also the most frequent cause of non-gonococcal urethritis in men. Among women, the consequences of chlamydial infections are severe if left untreated. Approximately half of chlamydial infections are asymptomatic.

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

Cadmium is a naturally occurring element that is mined and used in industrial production because of its durability. Excessive cadmium exposure can damage lungs, kidneys, and the digestive tract. Cadmium is an extremely toxic metal the kidney is the principal organ targeted by chronic exposure to cadmium. Cadmium nephrotoxicity may follow chronic inhalation or ingestion. Cadmium is a heavy metal of considerable toxicity with destructive impact on most organ systems. It is widely distributed in humans, the chief sources of contamination being cigarette smoke, welding, and contaminated food and beverages. Cadmium toxicity contributes to a large number of health conditions, including the major diseases such as heart disease, cancer and diabetes.

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

Coenzyme Q10 (CoQ10) is a fat soluble cofacter that is essential for energy producing metabolic pathways and for the proper functioning of the mitochondrial oxidative system. With insufficient CoQ10, the electron transfer activity of the mitochondria decreases, resulting in a net failure to produce the energy necessary to run the cell. Tissues with high energy demand have even greater demands for CoQ10. For example, heart muscle, which continually exerts a pumping action for an entire lifetime, has an immense need for the cofactor. Studies demonstrate the effectiveness of supplemental coenzyme Q10 in cardiomyopathy, myocardial dysfunction, and congestive heart failure. CoQ10 is also a powerful antioxidant like vitamins E and C, and thus serves the role of neutralizing excess free radicals. It is now well established that the control of excessive free radical activity is key in preventing/delaying the progression of degenerative diseases.

This test goes far beyond your basic lipid test, for starters this test helps to reclassify a patients cardiovascular risk. Nearly half of all heart attack patients were found to have no prior risk which would indicate they were heading toward an attack. Cardio IQ Ion Mobility tests directly detects,  measures and quantifies the number and size of all lipoprotein subfractions.  Knowing what particles make up your LDL and HDL cholesterol may be important. Ion Mobility Technology provides subclass separation that will allow your healthcare provider to identify your cardiovascular risk over time. Following the change in your lipid profile as you respond to diet, exercise and possible medication to reduce your cardiovascular risk is important. Ion Mobility provides the opportunity to determine if treatment is working and if not, optimize the aggressiveness of therapy to hopefully make a difference that can be seen in the Ion Mobility measurement and graphical representation of your LDL and HDL particles.

Ion mobility fractionation is the latest technology in the evolution of advanced lipid subclass measurement. There is a correlation between increased risk of premature heart disease with decreasing size of LDL particles. Ion mobility offers the only direct measurement of lipoprotein particle size and concentration for each lipoprotein from HDL3 to large VLDL. 

Apolipoprotein B (APO B) has been reported to be a powerful indicator of CAD. In some patients with CAD, APO B is elevated even in the presence of normal LDL cholesterol. Apo B is a protein that is involved in the metabolism of lipids and is the main protein constituent of lipoproteins such as very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL, the “bad cholesterol”). Concentrations of apo B tend to mirror those of LDL-C. There are two major forms of Apolipoprotein B, B-100 and B-48. B-100, synthesized in the liver, is the major protein in VLDL, IDL, and LDL cholesterol. B-48, synthesized in the intestines, is essential for the assembly and secretion of chylomicrons. Patients with increased concentrations of Apolipoprotein B are at increased risk of atherosclerosis.

This test assesses your risk of cardiovascular disease, Lipoprotein(a) [Lp(a)] is composed of a low density lipoprotein particle and one apolipoprotein B100 molecule linked by a disulfide bond to apolipoprotein(a) [apo(a)]. Apo(a) differs in size due to a variable number of kringle IV repeats. This variation gives rise to multiple Lp(a) isoforms within a population but not within an individual. Genetically determined isoforms with fewer kringle IV repeats are associated with higher Lp(a) blood levels. Lp(a) possesses structural homology with plasminogen and plasmin and can potentially increase cardiovascular disease (CVD) risk by antiplasminogen activity.

Increased blood levels of Lp(a) are associated with increased risk of atherosclerosis, leading to coronary heart disease (CHD), myocardial infarction, and premature CHD. Increased levels are also associated with ischemic stroke.

Digoxin is a drug used to treat heart failure and this test is used for therapeutic Drug Monitoring. Digoxin is a cardiac glycoside derived from the digitalis plant. It is used to treat congestive heart failure and atrial dysrhythmias. Digoxin levels are monitored to assure adequate therapeutic levels are achieved and to avoid toxicity.

D-Dimer is one of the measurable by-products of activation of the fibrinolytic system. Quantitation of D-Dimer assesses fibrinolytic activation and intravascular thrombosis. D-Dimer is of particular value in excluding the diagnosis of venous thromboembolism among patients at high risk.

This test will detect prior and post vaccination to these 3 diseases: diphtheria, pertussis (whooping cough), and tetanus. 

Diphtheria: is an infection caused by the bacterium Corynebacterium diphtheriae. Diphtheria causes a thick covering in the back of the throat. It can lead to difficulty breathing, heart failure, paralysis, and even death. According to the CDC Vaccines are recommended for infants, children, teens and adults to prevent diphtheria. 

Pertussis: a respiratory illness commonly known as whooping cough, is a very contagious disease caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins (poisons), which damage the cilia and cause airways to swell.

Tetanus: is an infection caused by bacteria called Clostridium tetani. When the bacteria invade the body, they produce a poison (toxin) that causes painful muscle contractions. Another name for tetanus is "lockjaw" because it often causes a person's neck and jaw muscles to lock, making it hard to open the mouth or swallow. According to the CDC vaccines are recommended for infants, children, teens and adults to prevent tetanus.

Dehydroepiandrosterone (DHEA) is a hormone that comes from the adrenal gland. It is also made in the brain. DHEA leads to the production of androgens and estrogens (male and female sex hormones). DHEA levels in the body begin to decrease after age 30.

Dehydroepiandrosterone (DHEA) is a hormone that comes from the adrenal gland. It is also made in the brain. DHEA leads to the production of androgens and estrogens (male and female sex hormones). DHEA levels in the body begin to decrease after age 30.

The enzyme (a substance produced by the body to help bring about a biochemical reaction) called 5α-reductase synthesises DHT from testosterone in areas like the prostate and hair follicles, as well as the testes and adrenal glands. Essentially DHT is made from testosterone and helps the body grow and regulate itself. But while testosterone is at the core of the balding process, dihydrotestosterone (DHT) is now thought to be the main culprit. DHT, a derivative of the male hormone testosterone, is the enemy of hair follicles on your head.

Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgM is typically detectable at clinical presentation, then declines to undetectable levels within a month in young children and within 3 months in other individuals. VCA-IgG is typically detectable at clinical presentation, and persists for life. EBNA IgG typically appears during convalescence (3-4 months after clinical presentation) and remains detectable for life.

Elevated levels of serum erythropoietin (EPO) occur in patients with anemias due to increased red cell destruction in hemolytic anemia and also in secondary polycythemias associated with impaired oxygen delivery to the tissues, impaired pulmonary oxygen exchange, abnormal hemoglobins with increased oxygen affinity, constriction of the renal vasculature, and inappropriate EPO secretion caused by certain renal and extrarenal tumors. Normal or depressed levels may occur in anemias due to increased oxygen delivery to tissues, in hypophosphatemia, and in polycythemia vera.

The placenta converts DHEA-S produced by the fetal adrenals to Estriol and other estrogens. Estriol is useful in assessing the fetal adrenals and placenta during pregnancy. More commonly, Estriol is one of the maternal serum biochemical markers used to screen for common chromosomal trisomies, especially Down syndrome. Experts suggest that abnormal Estriol levels can lead to various disease conditions in the body.

Estrone is primarily derived from metabolism of androstenedione in peripheral tissues, especially adipose tissues. Individuals with obesity have increased conversion of androstenedione to Estrone leading to higher concentrations. In addition, an increase in the ratio of Estrone to Estradiol may be useful in assessing menopause in women.

Estrogens are secreted by the gonads, adrenal glands, and placenta. Total estrogens provide an overall picture of estrogen status for men and women.

Measuring the circulating levels of estradiol is important for assessing the ovarian function and monitoring follicular development for assisted reproduction protocols. Estradiol plays an essential role throughout the human menstrual cycle. Elevated estradiol levels in females may also result from primary or secondary ovarian hyperfunction. Very high estradiol levels are found during the induction of ovulation for assisted reproduction therapy or in pregnancy. Decreased estradiol levels in females may result from either lack of ovarian synthesis (primary ovarian hypofunction and menopause) or a lesion in the hypothalamus-pituitary axis (secondary ovarian hypofunction). Elevated estradiol levels in males may be due to increased aromatization of androgens, resulting in gynecomastia.

Much of estradiol is bound to proteins. The unbound portion and estradiol bound to proteins with low affinity reflect the free concentration. The free estradiol may better correlate with medical conditions than the total estradiol concentrations.

Useful in the diagnosis of hypochromic, microcytic anemias. Decreased in iron deficiency anemia and increased in iron overload. Decreased ferritin levels are associated with iron deficiency anemia. Elevated levels, on the other hand, are associated with sideroblastic anemia, hemochromatosis, and acute iron poisoning. Ferritin may also be increased in acute and chronic liver disease (including hepatitis and hepatoma), in non-iron deficiency anemia (aplastic, megaloblastic, hemolytic, thalassemia major and minor, spherocytosis, porphyria cutanea tarda), alcoholism, pregnancy, malignancy (leukemia, lymphoma, Hodgkin’s disease, renal cell carcinoma), infection, inflammation (arthritis), hyperthyroidism, Gaucher’s disease, acute myocardial infarction, and following a recent blood transfusion. In acute phase reactions, a bone marrow stain may be required to detect concurrent iron deficiency anemia. 

Fibrinogen is essential for the formation of a blood clot. Deficiency can produce mild to severe bleeding disorders. Low fibrinogen levels can also cause thrombosis due to an increase in coagulation activity. Thrombosis refers to the formation of a blood clot inside of a blood vessel. The clot blocks the normal flow of blood through the circulatory system. This can lead to serious medical conditions such as heart attack and stroke.

 Folic acid deficiency is common in pregnant women, alcoholics, in patients whose diets do not include raw fruits and vegetables, and in people with structural damage to the small intestine. The most reliable and direct method of diagnosing folate deficiency is the determination of folate levels in both erythrocytes and serum. Low folic acid levels, however, can also be the result of a primary vitamin B12 deficiency that decreases the ability of cells to take up folic acid.

It's responsible for the growth of ovarian follicles. Follicles produce estrogen and progesterone in the ovaries and help maintain the menstrual cycles in women. In men, FSH is a part of the development of the gonads as well as sperm production. The FSH test measures the level of FSH found in your blood. This test is also useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.

The FTA-ABS is a specific treponemal assay to detect antibody to t. Pallidum. The FTA-ABS becomes reactive 4-6 weeks after infection. Unlike the nontreponemal tests, once the FTA-ABS test becomes reactive, it will remain reactive for many years. Since the reactivity found with the FTA-ABS does not indicate response to therapy, it is not suitable for monitoring treatment. The FTA-ABS test does not distinguish between syphillis and other treponematoses such as yaws, pinta and bejil.

t. Pallidum: Treponema pallidum is a spirochaete bacterium with subspecies that cause treponemal diseases such as syphilis, bejel, pinta, and yaws. The treponemes have a cytoplasmic and an outer membrane.

FSH and LH are secreted by the anterior pituitary in response to gonadotropin-releasing hormone (GNRH) secreted by the hypothalamus. In both males and females, FSH and LH secretion is regulated by a balance of positive and negative feedback mechanisms involving the hypothalamic-pituitary axis, the reproductive organs, and the pituitary and sex steroid hormones. FSH and LH play a critical role in maintaining the normal function of the male and female reproductive systems. Abnormal FSH levels with corresponding increased or decreased levels of LH, estrogens, progesterone, and testosterone are associated with a number of pathological conditions. Increased FSH levels are associated with menopause and primary ovarian hypofunction in females and primary hypogonadism in males. Decreased levels of FSH are associated with primary ovarian hyper-function in females and primary hypergonadism in males. Normal or decreased levels of FSH are associated with polycystic ovary disease in females. In males, LH is also called interstitial cell-stimulating hormone (ICSH). Abnormal LH levels with corresponding increased or decreased levels of FSH, estrogens, progesterone, and testosterone are associated with a number of pathological conditions. Increased LH levels are associated with menopause, primary ovarian hypofunction, and polycystic ovary disease in females and primary hypo-gonadism in males. Decreased LH levels are associated with primary ovarian hyperfunction in females and primary hyper-gonadism in males.

 Elevated GGT is found in all forms of liver disease. Measurement of GGT is used in the diagnosis and treatment of alcoholic cirrhosis, as well as primary and secondary liver tumors. It is more sensitive than alkaline phosphatase, the transaminases, and leucine aminopeptidase in detecting obstructive jaundice, cholangitis, and cholecystitis. Normal levels of GGT are seen in skeletal diseases; thus, GGT in serum can be used to ascertain whether a disease, suggested by elevated alkaline phosphatase, is skeletal or hepatobiliary.

Serum glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders including diabetes mellitus, idiopathic hypoglycemia, and pancreatic islet cell neoplasm.

Useful for rapid diagnosis of Haemophilus influenzae (Type B) as a cause of bacterial meningitis.

The hemoglobin A1c test may be used to screen for and diagnose diabetes and prediabetes in adults. A1c is frequently used to help newly diagnosed diabetics determine how elevated their uncontrolled blood glucose levels have been over the last 2-3 months. The test may be ordered several times while control is being achieved, and then at least twice a year to verify that good control is being maintained

IgM antibodies to Hepatitis A suggest a current, acute or recent Hepatitis A infection. Viral hepatitis is a common form of liver disease that affects roughly 1% to 2% of the United States population. It is caused by a diverse group of hepatotropic agents that lead to liver inflammation and cell death.

This assay is used to determine immune status for Hepatitis B as ≥10 mIU/mL as per CDC Guidelines. Hepatitis B surface antibody quantitation is used to determine hepatitis B immune status, ie, to determine if the patient has developed immunity against the hepatitis B virus. Such immunity may develop following exposure to the hepatitis B virus or its vaccine.

Patients at higher risk of exposure to the virus include:

• Infants born to infected mothers
• Sex partners of infected persons
• People with more than 1 sex partner in the last 6 months
• People with a history of sexually transmitted infection
• Men who have sex with men
• Injection drug users
• Household contacts of an infected person
• Healthcare and safety workers who have contact with blood and body fluids
• People who have lived or traveled in an area in which hepatitis B is common
• People who live or work in a prison

Testing is not recommended routinely following vaccination. It is advised only for people whose subsequent clinical management depends on knowledge of their immune status. These people include:

• Chronic hemodialysis patients
• Immunocompromised people, including those with HIV infection, hematopoietic stem-cell transplant recipients, and people receiving chemotherapy
• Infants born to women who test positive for the hepatitis B surface antigen
• Sex partners of people who test positive for the hepatitis B surface antigen
• Healthcare and public safety workers who have contact with blood or body fluids

Useful in monitoring therapy and/or disease progression. Reportable range is 15 to 100,000,000 IU/mL (1.18-8.00 Log IU/mL).

Hepatitis D Virus (HDV) infection occurs in association with HBV infection. A positive result for HDV total antibody may indicate either acute or chronic HDV infection.

This 4th generation HIV Ag/Ab Combo assay is intended to be used as an aid in the diagnosis of HIV1/HIV2 infection, including acute or primary HIV-1 infection.

The hematocrit blood test determines the percentage of red blood cells (RBC's) in the blood. Blood is composed mainly of red blood cells and white blood cells suspended in an almost clear fluid called serum. The hematocrit test indicates the percentage of blood by volume that is composed of red blood cells. The condition called "anemia" results from having too few red blood cells. Anemia causes a variety of symptoms. The hematocrit is a basic test that can tell a physician a lot about a person's health. This test is the usual method for determining anemia.

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.

hCG may reach detectable limits within 7-10 days of conception. hCG is produced by the placenta and reaches a peak between the 7th and 10th week of gestation. hCG is a glycoprotein hormone produced by the syncytiotrophoblast of the placenta and secreted during normal pregnancy and with pathologic conditions such as hydatidiform mole, choriocarcinoma and testicular neoplasm. 

This test should be used only to determine pregnancy

A liver panel may be used to screen for liver damage, especially if someone has a condition or is taking a drug that may affect the liver. A comprehensive metabolic panel (CMP), which is often performed as part of a general health checkup, may be ordered instead of a liver panel for routine screening. This group of tests includes most of the liver panel as well as additional tests that evaluate other organs and systems within the body.

A liver panel may be used to screen for liver damage, especially if someone has a condition or is taking a drug that may affect the liver. A comprehensive metabolic panel (CMP), which is often performed as part of a general health checkup, may be ordered instead of a liver panel for routine screening. This group of tests includes most of the liver panel as well as additional tests that evaluate other organs and systems within the body.

Helicobacter pylori is a gram-negative microaerophilic curved bacillus with an affinity for human gastric mucosa. H. pylori has been identified as an important pathogen in the upper GI tract. The casual relationship between H. pylori and chronic active gastritis, duodenal ulcers, and gastric ulcers has been well documented. BreathTek™ UBiT® for H. pylori is a non-invasive, non-radioactive method for detecting urease activity associated with H. pylori infection. It is FDA approved to confirm cure and offers 95.2% sensitivity and 89.7% specificity compared with endoscopic methods.

HHV-6 is a distinct herpes virus that typically causes a self-limiting illness in patients who are not immunocompromised. In some patients, especially if immumocompromised, HHV-6 can cause febrile convulsions in infants, encephalitis mononucleosis-like symptoms, and hepatitis.

A hemoglobinopathy evaluation is a group of tests that identifies abnormal forms of or suggests problems with production of hemoglobin in order to screen for and/or diagnose a hemoglobin disorder.

The detection and proper identification of hemoglobinopathies and thalassemias is an important aspect of the evaluation of patients with anemia, microcytosis and erythrocytosis

Histamine is a mediator of the allergic response. Histamine release causes itching, flushing, hives, vomiting, syncope, and even shock. In addition, some patients with gastric carcinoids may exhibit high concentrations of histamine

Heterophile antibodies, in patients with infectious mononucleosis, may be present as early as the fourth day of illness, and by the twenty-first day of illness, 90% of patients will exhibit a positive test. The Epstein-Barr virus causes infectious mononucleosis.

An elevated concentration of homocysteine is an independent risk factor for cardiovascular disease. When used in conjunction with methylmalonic acid (MMA), these tests are useful to diagnose and monitor vitamin B12 (cobalamin) and folic acid deficiency and are often useful in evaluating macrocytosis (an elevated MCV, an erythrocytic index).

Clinical Use:

-Diagnose homocystinuria, vitamin B12 deficiency, and folate deficiency

-Assess risk of cardiovascular disease (CVD), stroke, and dementia (including Alzheimer disease)

-Monitor therapy in patients with elevated homocysteine levels

For diagnosis of allergic disease. A normal IgE level does not exclude the possible presence of an allergic disorder.

Increased IgG is associated with acute and chronic inflammations, monoclonal IgG myeloma, autoimmune diseases; decreased IgG is found in selective IgG deficiency, Bruton's Disease, and acquired immune deficiency.

Elevations in serum lactate dehydrogenase occur from myocardial infarction, liver disease, pernicious and megaloblastic anemia, pulmonary emboli, malignancies, and muscular dystrophy. Since lactic dehydrogenase is present in many body tissues, it's diagnosis usefulness is limited. Tissue specificity may be enhanced by isoenzyme analysis.

Serum measurements are useful in the diagnosis of iron deficiency and hemochromatosis, hemolytic anemia, acute liver disease, anemia.

Serum iron quantification is useful in confirming the diagnosis of iron-deficiency anemia or hemochromatosis. The measurement of total iron binding in the same specimen may facilitate the clinician's ability to distinguish between low serum iron levels caused by iron deficiency from those related to inflammatory neoplastic disorders. The assay for iron measures the amount of iron which is bound to transferrin. The total iron binding capacity (TIBC) measures the amount of iron that would appear in blood if all the transferrin were saturated with iron. It is an indirect measurement of transferrin concentrations but expressed as an iron measurement. To obtain the percent saturation, the serum iron is divided by the TIBC which gives the actual amount of saturated transferrin. The percent saturation is low in iron deficiency and high in iron storage diseases.

Assists in evaluating helper and suppressor cell immune status in immunodeficiency diseases such as AIDS.

Clinical Use:

-Determines immune status of patients with HIV infection

-Monitors anti-retroviral and immunosuppressive therapy

-Differential diagnosis of congenital and acquired immune deficiencies  

Includes

Absolute Lymphocytes, Percentage CD4, Absolute CD4, Percentage CD8, Absolute CD8, CD4/CD8 Ratio (calculated)

Lithium is used to treat manic-depressive disorders and the manic phase of affective disorders, including mania. The therapeutic window is relatively small. Therapeutic drug monitoring is useful to optimize dose and avoid toxicity.

Lactic acid is the endproduct of the anaerobic metabolism of glucose. The blood lactic acid concentration is affected by its production in muscle cells and erythrocytes and its rate of metabolism in the liver. During exercise, blood lactate can increase up to ten times of normal levels.

Confirmatory evidence for diagnosis of pancreatitis. The blood test for lipase is most often used, along with an amylase test, to help diagnose and monitor acute pancreatitis. It may also be used to diagnose and monitor chronic pancreatitis and other disorders that involve the pancreas.

Lipase testing is also occasionally used in the diagnosis and follow-up of cystic fibrosis, celiac disease, and Crohn disease.

Lyme disease is caused by a bacterium borrelia burgdorferi and is transmitted by ticks. EIA is the screening test with high sensitivity for antibody detection. Immunoblot testing qualitatively examines with high specificity antibodies in a patient's specimen. Immunoblot testing is appropriate for confirming a detected EIA test result. 

Tick-borne diseases are caused by infections transmitted to humans via a tick vector such as the deer tick, dog tick, wood tick, and Lone Star tick. In the United States, transmission occurs primarily in the spring and summer months. Causative agents include bacteria (including rickettsia), viruses, and protozoa. The incidence varies by geographic location and causative agent.

Blood lead level analysis is performed to evaluate the body burden of lead. Lead is a cumulative protoplasmic poison that may be ingested, inhaled, or absorbed directly through the skin. Toxic effects are categorized as gastrointestinal, central nervous system, neuromuscular, hematologic, renal, or constitutional. Common symptoms include constipation, anorexia, abdominal pain, weight loss, fatigue, and a characteristic peripheral neuropathy (wrist drop). Severe poisoning may lead to nephropathy, encephalopathy, convulsions, and even death.

Lead poisoning may result from occupational exposure (mining, smelters, sheet metal, battery manufacture, automobile radiator repair, demolition work, alloys, and metal plating). Poisoning may also occur subsequent to exposure to leaded containers, lead clay, glazed pottery, solder, paints, and bullets (wound).

Infants and children aged 9 months to 6 years are particularly susceptible to the effects of lead due to greater gastrointestinal absorption. Lead exposure can lead to irreversible IQ deficits, poor academic achievement, reduced attention span, and hyperactivity.

Elevated urinary lead concentration is indicative of chronic lead toxicity. Urinary lead concentrations may be used to monitor detoxification therapy. Lead interferes with the metabolism of calcium and Vitamin D. High blood lead levels in children can cause consequences which may be irreversible including learning disabilities, behavioral problems, and mental retardation. At very high levels, lead can cause convulsions, coma and death. Too much lead can damage various systems of the body including the nervous and reproductive systems and the kidneys, and it can cause high blood pressure and anemia. Lead accumulates in the bones and lead poisoning may be diagnosed from a blue line around the gums. Lead is especially harmful to the developing brains of fetuses and young children and to pregnant women.

Elevated urinary lead concentration is indicative of chronic lead toxicity. Urinary lead concentrations may be used to monitor detoxification therapy.

Mercury, a highly toxic metal, is present in select industrial environments and in contaminated ocean fish. Urinary measurements are appropriate for assessing ongoing exposure to inorganic mercury.

Mumps is an acute, usually self-limited systemic illness characterized by parotidites, high fever and fatigue. One third of infections are asymptomatic. A live attenuated vaccine is available. The mumps EIA IgG antibody test is sufficiently sensitive to establish immune status of the patient.

Magnesium measurements are used in the diagnosis and treatment of hypomagnesemia (abnormally low plasma levels of magnesium) and hypermagnesemia (abnormally high plasma levels of magnesium). Magnesium is decreased in chronic nephritis, acute pancreatitis, and alcoholic cirrhosis. It is increased in acute or chronic renal failure and Addison's Disease.

Magnesium is an essential trace element. Deficiency leads to irritability, neuromuscular abnormalities, cardiac and renal damage. Its salts are used as antacids and cathartics. Excessive amount may cause CNS depression, loss of muscle tone, respiratory and cardiac arrest.

Manganese deficiency produces growth disorders, alters skeletal and cartilage formation and impairs reproduction. Industrial workers absorb manganese mainly through the lungs.

Methaqualone ("quaaludes") is a central nervous system depressant, with similar effects to barbiturates, and has been prescribed as an anti-anxiety medication or sleep aid. This drug is no longer manufactured or distributed in the United States, and true positive patient samples are uncommon. The detection of methaqualone in serum or urine is useful in the detection of abuse by individuals, resultant treatment for those individuals, and possibly in assisting with criminal prosecution.

Norovirus is the major cause of nonbacterial gastroenteritis associated with outbreaks and sporadic cases in humans. Norovirus affects all age groups, with an incubation period of 24 to 48 hours and typically lasts up to 3 days with symptoms of nausea, vomiting, diarrhea, abdominal cramps, headache and fever. Detection of viral antigen in stool helps confirm individual cases and define outbreaks.

Nickel toxicity is associated with allergy, asthma, urticaria, erythema multiforme, contact dermatitis, and hand eczema.

Organic acidurias are a group of inborn errors of metabolism that may lead to acute life-threatening illness, developmental delays, and metabolic decompensation. Positive results may warrant confirmation by alternative specific methods. Organic acidurias are inherited disorders resulting from a deficient enzyme or transport protein. Although most are autosomal recessive disorders, several are X-linked. The more than 60 described organic acidurias affect many metabolic pathways including amino acid metabolism, lipid metabolism, purine and pyrimidine metabolism, the urea cycle, the Krebs cycle, and fatty acid oxidation. These disorders are characterized by a wide variety of symptoms such as lethargy, coma, hypotonia, seizures, ataxia, vomiting, failure to thrive, developmental delay, liver disease, neutropenia, thrombocytopenia, osteomalacia, and osteoporosis. Severity of presentation is highly variable as is age of onset, and patients may not present with the most characteristic features. Laboratory results commonly indicate metabolic acidosis, increased anion gap, hyperammonemia, hypoglycemia, lactic acidemia, ketosis, or abnormal lipid patterns. Treatment may be based on dietary restrictions and/or supplementation with cofactors (eg, riboflavin or cobalamin) or conjugating agents (eg, carnitine or sodium benzoate); however, there is no effective therapy for some of the disorders.

Serum osmolality is increased in hypernatremia, hyperglycemia, uremia, ethanol, methanol, or ethylene glycol overdoses, and in diabetes insipidus.

This test helps check your body's water balance. Your doctor may order this test if you have signs of any of the following:

-Low sodium (hyponatremia) or water loss

-Poisoning from harmful substances such as ethanol, methanol, or ethylene glycol

-Problems producing urine

In healthy people, when osmolality in the blood becomes high, the body releases antidiuretic hormone (ADH).

This hormone causes the kidneys to reabsorb water. This results in more concentrated urine. The reabsorbed water dilutes the blood. This allows blood osmolality to fall back to normal.

Low blood osmolality suppresses ADH. This reduces how much water the kidneys reabsorb. Dilute urine is passed to get rid of the excess water, which increases blood osmolality back toward normal.

For assessing the concentrating ability of the kidney.

Pregnenolone may be called known as the mother hormone.  All other steroids including testosterone and estrogen are derived from this hormone called Pregenolone. It is very important to maintain optimal pregnenolone levels in the blood, which are critical for a healthy hormone balance. Pregnenolone is also important for proper brain development, cognition, memory, and mood. These dramatic effects on the brain are why pregnenolone is known as a neuro-active steroid. According to studies by the age of 75 our bodies produce 60% less pregnenolone than the levels produced in our mid-thirties. For this reason pregnenolone is one of the biomarkers of aging. Like counting the rings of a tree, by measuring the level of pregnenolone at any given point of a person’s life, it is often possible to make an educated guess as to his or her age.

Proinsulin is used to detect and monitor excessive hormone production from insulinomas. Proinsulin is the prohormone precursor to insulin made in the beta cells of the islets of Langerhans, specialized regions of the pancreas. In humans, proinsulin is encoded by the INS gene.

Elevated serum PSA concentrations have been reported in men with prostate cancer, benign prostatic hypertrophy, and inflammatory conditions of the prostate.

Prostate cancer is the most commonly detected cancer in men in the United States, affecting approximately 1 out of every 6 men. It is the second leading cause of cancer death among men in the United States. Although prostate cancer is thought to begin when men are in their thirties and forties, it is most often diagnosed after age 65. Prevalence increases with age

Screening test for abnormalities of coagulation factors that are involved in the extrinsic pathway. Also used to monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders.

Serum phosphorus (Phosphate) levels alone are of limited diagnostic value and should be correlated with serum calcium levels. An increased phosphorus with decreased calcium suggests either hypoparathyroidism or renal disease. A decreased phosphorus and an increased calcium suggests hyperparathyroidism or sarcoidosis. When both calcium and phosphorus are decreased diagnostic considerations include malabsorption, vitamin D deficiency and renal tubular acidosis. Increased phosphorus and normal or increased calcium suggests Milk-alkali syndrome or hypervitaminosis D.

A progesterone test measures the amount of the hormone progesterone in a blood sample. Progesterone is a female hormone produced by the ovaries during release of a mature egg from an ovary (ovulation). Progesterone helps prepare the lining of the uterus (endometrium) to receive the egg if it becomes fertilized by a sperm. If the egg is not fertilized, progesterone levels drop and menstrual bleeding begins. During pregnancy, the placenta also produces high levels of progesterone, starting near the end of the first trimester and continuing until the baby is born. Levels of progesterone in a pregnant woman are about 10 times higher than they are in a woman who is not pregnant. Some types of cancer cause abnormal progesterone levels in men and women.

-Helps find the cause of infertility.

-Monitors the success of medicines for infertility or the effect of treatment with progesterone.

-Helps determine whether ovulation is occurring.

-Assess the risk of miscarriage.

-Monitors the function of the ovaries and placenta during pregnancy.

-Helps to diagnose a problem with the adrenal glands and some types of cancer.

Prolactin is a hormone released by the pituitary gland. The prolactin test measures the amount of prolactin in the blood.

Prolactin is usually measured when checking for pituitary tumors and the cause of:

Breast milk production that is not related to childbirth (galactorrhea)

Decreased sex drive (libido) in men and women, Impotence, Infertility, Irregular or no menstrual periods (amenorrhea.)

Rubella (German Measles) is a common and usually benign viral infection of children. IgM antibody is detectable 11-25 days after the onset of exanthem, in most individuals 15-25 days after vaccination, and in 90-97% of infants with congenital rubella between 2 weeks and 3 months after birth. Acute and convalescent IgG titers may be interpreted to identify a >30% rise in the antibody index. A positive IgG antibody indicates successful immunization or past exposure.

This test assists in the diagnosis of rheumatoid arthritis. Rheumatoid factor is 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. Central nervous system vasculitis is a rarely described complication of rheumatoid arthritis. As with rheumatoid vasculitis in general, the cause of CNS vasculitis in rheumatoid arthritis (RA) is unknown.

A renal panel is a group of tests that may be performed together to evaluate kidney (renal) function. The tests measure levels of various substances, including several minerals, electrolytes, proteins, and glucose (sugar), in the blood to determine the current status of the kidneys.

Use in evaluating erythropoietic activity. A reticulocyte test is used to determine the number and/or percentage of reticulocytes in the blood to help evaluate conditions that affect red blood cells (RBCs), such as anemia or bone marrow disorders. Reticulocytes are newly produced, relatively immature red blood cells. They form and mature in the bone marrow before being released into the blood.

Rubella is an acute exanthematous viral infection of children and adults. Rash, fever and lymphadenopathy characterize the illness. While many infections are subclinical, this virus has the potential to cause fetal infection with resultant birth defects. Diagnosis of a Rubella infection is best made serologically. In the absence of a current or recent infection, a demonstration of specific IgG on a serum sample is evidence of immunity to Rubella.

Useful in differentiating inflammatory and neoplastic diseases and as an index of disease severity. CRP is also useful in monitoring inflammatory disease states.

Selenium is a key component of a number of functional selenoproteins required for normal health. The best know of these are the antioxidant glutathione peroxidase enzymes. Selenium plays an important role in the control of thyroid hormone metabolism and is important for proper reproductive performance.

Thyroid stimulating hormone (TSH) is one of the most important hormones currently used to diagnose thyroid abnormalities. This glycoprotein is secreted by the pituitary and stimulates release of thyroxine (T4) and triiodothyronine (T3) from the thyroid gland. TSH release from the pituitary is controlled by thyrotropin releasing hormone (TRH) stimulation and negative feedback from free T3 and free T4. In general, TSH appears to be the more sensitive indicator of thyroid hormone status.

A free or total triiodothyronine (free T3 or total T3) test is used to assess thyroid function. It is ordered primarily to help diagnose hyperthyroidism and may be ordered to help monitor treatment of a person with a known thyroid disorder. T3 and T4 (thyroxine) are hormones produced by the thyroid gland. This test is used to diagnose hyperthyroidism and to clarify thyroid status in the presence of a possible protein binding abnormality.

Total T3 measurements are used to diagnose and monitor treatment of hyperthyroidism and are essential for recognizing T3 toxicosis.

The assay may be useful in the diagnosis of nonthyroidal illness (NTI). Patients with NTI have low T3 concentrations and increased concentrations of rT3. RT3 may be useful in neonates to distinguish euthyroid sick syndrome from central hypothyroidism.

Decreased: Pregnancy, estrogens, hyperproteinemia, acute intermittent porphyria.
Increased: Androgens, hyperproteinemia, stress, acute liver disease.
This assay is a measure of available thyroid hormone binding sites and should be interpreted with thyroxine levels.

For diagnosis of hypothyroidism and hyperthyroidism. Free thyroxine (free T4) tests are used to help evaluate thyroid function and diagnose thyroid diseases, including hyperthyroidism and hypothyroidism, usually after discovering that the thyroid stimulating hormone (TSH) level is abnormal.

Measurement of thyroglobulin antibodies is useful in the diagnosis and management of a variety of thyroid disorders including Hashimoto's thyroiditis, Graves' disease and certain types of goiter.

Testosterone circulates almost entirely bound to transport proteins: Normally less than 1-2% is free. The principal transport protein for testosterone is known as sex hormone binding globulin (SHBG) or testosterone-estradiol binding globulin (TeBG). Testosterone measurements are used to assess erectile dysfunction, infertility, gynecomastia, and osteoporosis and to assess hormone replacement therapy.

Tetanus is a serious illness caused by Clostridium bacteria. The bacteria live in soil, saliva, dust, and manure. The bacteria can enter the body through a deep cut, like those you might get from stepping on a nail, or through a burn.

The infection causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw. This makes it impossible to open your mouth or swallow. Tetanus is a medical emergency. You need to get treatment in a hospital.

A vaccine can prevent tetanus. It is given as a part of routine childhood immunization. Adults should get a tetanus shot, or booster, every 10 years. If you get a bad cut or burn, see your doctor - you may need a booster. Immediate and proper wound care can prevent tetanus infection.

Tyrosine or 4-hydroxyphenylalanine is one of the 22 amino acids that are used by cells to synthesize proteins. It is a non-essential amino acid with a polar side group.

Do you suspect a patient or family member on drugs? If you have concerns or doubts that someone you know is taking dangerous substances, knowing can be done with a simple urine test.

The TP-PA test is designed to be used as an aid in the confirmation of atibodies to the treponemal organisms that cause syphilis. Other diseases such as yaws or pinta give positive results.

Uranium is used as a fuel for nuclear reactors, armor piercing ammunition and guidance devices. Certain uranium compounds are used in the leather and wood industries for stains and dyes and coming back from war zones overseas. Uranium exposure may cause elevations of beta-2-microglobulin.

The adverse effects on human health include the following:

• Lung cancer
• Reactive airway disease
• Neurological abnormalities
• Vision degradation
• Lymphoma and other cancers
• Birth defects in offspring

Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various disease states. Microscopic examination helps to detect the presence of cells and other formed elements

Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various diseases.

Serum uric acid measurements are useful in the diagnosis and treatment of numerous renal and metabolic disorders, including renal failure, gout, leukemia, psoriasis, starvation or other wasting conditions, and in patients receiving cytotoxic drugs.

An estimated 68% to 77% of patients have suboptimal (<30 ng/mL) levels of vitamin D. This important nutrient promotes skeletal health by enhancing the intestinal absorption of calcium and phosphorus. 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 to hypercalcemia

Test is used to determine vitamin B6 deficiency or overdosage, for monitoring treatment, and to evaluate wellness and health.

Vitamin B12 is decreased in pernicious anemia, total or partial gastrectomy, malabsorption and certain congenital and biochemical disorders.

Vitamin C is an antioxidant involved in connective tissue metabolism, drug-metabolizing systems, and mixed-function oxidase systems to list a few. Vitamin C deficiency causes scurvy; manifestations include impaired formation of mature connective tissue, bleeding into the skin, weakness, fatigue, and depression.

Deficiency of vitamin E may cause extensive neuropathy in young children and, in addition, is suspect as a possible cause of motor and sensory neuropathy in older children and in adults. One likely cause of vitamin E deficiency is intestinal malabsorption, resulting from bowel disease, pancreatic disease, or chronic cholestasis. Other causes of malabsorption of vitamin E include celiac disease, cystic fibrosis, and intestinal lymphangiectasia.

Vanillylmandelic acid (VMA) is the major urinary product resulting from the metabolic degradation of catecholamine, norepinephrine and epinephrine. Elevated concentrations of VMA are commonly found in cases of catecholamine secreting tumors such as pheochromocytoma, neuroblastoma, and ganglioneuroma.

Drugs which can interfere with testing due to physiologic response: clonidine, L-dopa, methocarbamol, monoamine oxidase inhibitors, reserpine, salicylates.

High levels of VLDL cholesterol have been associated with the development of plaque deposits on artery walls, which narrow the passage and restrict blood flow. VLDL (Bad) Cholesterol. Expand Section. VLDL contains the highest amount of triglycerides. VLDL is considered a type of bad cholesterol, because it helps cholesterol build up on the walls of arteries.

High serum viscosity may be most commonly observed in patients with Waldenström's macroglobulinemia and multiple myeloma. Patients with high viscosity may have capillary occlusion, stasis hypoxia, and acidosis.

Patient population is primarily children and adolescents to confirm a diagnosis of type 1 diabetes.

Zinc is an essential element involved in a myriad of enzyme systems including wound healing, immune function, and fetal development. Zinc measurements are used to detect and monitor industrial, dietary, and accidental exposure to zinc. Also, zinc measurements may be used to evaluate health and monitor response to treatment.

Zinc is an essential element involved in a myriad of enzyme systems including wound healing, immune function, and fetal development. Zinc measurements are used to detect and monitor industrial, dietary, and accidental exposure to zinc. Also, Zinc measurements may be used to evaluate health and monitor response to treatment.

Vitamin K is a fat-soluble vitamin that is most well-known for the important role it plays in blood clotting. However, vitamin K is also absolutely essential to build strong bones and prevent heart disease, and it plays a crucial role in other bodily functions other than blood clotting. Vitamin K helps to prevent hardening of the arteries, which is a common factor in coronary artery disease and heart failure. Research suggests that vitamin K may help to keep calcium out of artery linings and other body tissues, where it can be damaging. Vitamin K helps to prevent hardening of the arteries, which is a common factor in coronary artery disease and heart failure. Research suggests that vitamin K may help to keep calcium out of artery linings and other body tissues, where it can be damaging.

The TSI test measures the level of thyroid-stimulating immunoglobulin (TSI) in your blood. High levels of TSI in the blood can indicate the presence of Graves’ disease, which is an autoimmune disorder that affects the thyroid gland. If you have Graves’ disease, you’re more likely to develop other autoimmune diseases such as type 1 diabetes or Addison’s disease. Graves' disease is a classic form of hyperthyroid disease, affecting approximately 0.4% of the population of the United States. It is caused by IgG immunoglobulins, collectively known as thyroid stimulating immunoglobulins (TSI). Patients who are candidates for antithyroid drug therapy may not respond to this treatment when TSI levels are markedly elevated. The determination of TSI can also assist in predicting hyperthyroidism in neonates, due to placental transmission of the immunoglobulins from a mother with hyperthyroidism.

Vitamin B1 is required for branched-chain amino acid and carbohydrate metabolism. Vitamin B1 deficiency is most often due to alcoholism or chronic illness. In the early stage, patients with vitamin B1 deficiency exhibit anorexia, irritability, apathy, and generalized weakness. Prolonged deficiency causes beriberi.

Myasthenia Gravis (MG) is an autoimmune neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. AChR binding autoantibodies are diagnostic of MG, and are found in 85-90% of MG patients. This assay aids in the differential diagnosis of conditions with MG-like muscle weakness and in monitoring therapeutic response. If binding antibodies are negative, assays for modulating and blocking antibodies should be considered.

Cysticercosis is caused by infection with the larval form (cysticercus) of the pork tapeworm Taenia solium. Clinical manifestations of cysticercosis most commonly result from the lodging of cysticerci in brain and neural tissue. Common symptoms of neurocysticercosis include seizures and convulsions. Antibodies from other parasitic infections, especially echinococcosis, may cross-react in the Cysticercus IgG ELISA.

The pork tapeworm responsible for causing cysticercosis is endemic to many parts of the developing world, including Latin America, Asia, and sub-Saharan Africa. The World Health Organization (WHO) estimates that cysticercosis affects about 50-100 million people worldwide. The incidence of cysticercosis has increased in the United States due to increased immigration from developing countries. Approximately 1,000 new cases of cysticercosis in the United States are reported annually. 

In men over 50 years with total PSA between 4.0 and 10.0 ng/mL, the percent (%) free PSA gives an estimate of the probability of cancer. In these circumstances the measurement of the % free PSA may aid in avoiding unnecessary biopsies.

Elevated levels of Prostate Specific Antigen (PSA) have been associated with benign and malignant prostatic disorders. Studies indicate that in men 50 years or older measurement of PSA is a useful addition to the digital rectal exam in the early detection of prostate cancer. In addition, PSA decreases to undetectable levels following complete resection of the tumor and may rise again with recurrent disease or persist with residual disease. Thus, PSA levels may be of assistance in the management of prostate cancer patients.

DHEA-S is the sulfated form of DHEA and is the major androgen produced by the adrenal glands. This test is used in the differential diagnosis of hirsute or virilized female patients and for the diagnosis of isolated premature adrenarche and adrenal tumors. About 10% of hirsute women with Polycystic Ovarian Syndrome (PCOS) have elevated DHEA-S but normal levels of other androgens.

A high DHEAS blood level may indicate that excess DHEAS production is causing or contributing to the person's symptoms. However, an increased level of DHEAS is not diagnostic of a specific condition; it usually indicates the need for further testing to pinpoint the cause of the hormone imbalance. An elevated DHEAS may indicate an adrenocortical tumor, Cushing disease, adrenal cancer, or adrenal hyperplasia, or rarely a DHEAS-producing ovarian tumor. A low level of DHEAS may be due to adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a condition that causes low levels of the pituitary hormones that regulate the production and secretion of adrenal hormones.

Omega-3 and omega-6 are types of essential fatty acids. We cannot make them on our own bodies, only from our own diets. Baseline and monitoring of individuals with known CVD (acute and chronic) to determine Rx and compliance. Identify patients with known CVD risk with low omega-3 levels who may be candidates for supplementation/therapy. Monitor patients on omega-3 supplementation/therapy to determine efficacy of treatment. Potential role in risk reduction for non-CVD outcomes-aged related macular degeneration, RA, cancer, etc. (early data).

Antinuclear antibodies (ANA) are a group of antibodies produced by a person's immune system when it fails to adequately distinguish between "self" and "non-self." These antibodies, known as autoantibodies, attack the body's own healthy cells and cause signs and symptoms such as tissue and organ inflammation, joint and muscle pain, and fatigue. ANA specifically target substances found in the nucleus of a cell, hence the name "antinuclear." The ANA test identifies the presence of these autoantibodies in the blood. The ANA test is one of the primary tests for helping to diagnose a suspected autoimmune disorder or ruling out other conditions with similar signs and symptoms.

Sex hormone binding globulin (SHBG) is a protein that is produced by the liver and binds tightly to the hormones testosterone, dihydrotestosterone (DHT), and estradiol (an estrogen). In this bound state, SHBG transports these hormones in the blood as biologically inactive forms. This test measures the level of SHBG in the blood and is most often used to help evaluate for testosterone deficiency or excess. In men, about 45% to 65% of testosterone in blood is normally bound to SHBG, with the remainder weakly and reversibly bound to albumin (the main protein in the blood). Only about 2% to 3% of testosterone is immediately available to the tissues as free testosterone, but testosterone that is weakly bound to albumin is also bioavailable and can be readily taken up by the body's tissues.

Testosterone circulates almost entirely bound to transport proteins: Normally less than 1-2% is free. The principal transport protein for testosterone is known as sex hormone binding globulin (SHBG) or testosterone-estradiol binding globulin (TeBG). Testosterone measurements are used to assess erectile dysfunction, infertility, gynecomastia, and osteoporosis and to assess hormone replacement therapy.

The NT-ProBNP test aids in the diagnosis of individuals suspected of congestive heart failure; is indicated for risk stratification of patients with acute coronary syndrome and congestive heart failure.

It also aids in assessing the increased risk of cardiovascular events and mortality for patients at risk of heart failure who have stable coronary artery disease.

Thrombin time is one of several tests that check if your blood is clotting normally. Thrombin time is a measure of how long the blood's plasma takes to form a clot. This test shows how long it takes fibrinogen to turn into fibrin.

Fetal fibronectin is a protein that performs two roles during pregnancy. It is produced by the placenta and acts as the glue that attaches the placenta to the uterine wall. In late pregnancy, it acts as a lubricant, aiding in the passage of the newborn through the vaginal canal. Amniotic fluid contains fetal fibronectin and when the membranes leak, can be detected in a cervicovaginal collection. This can be used as a predictor of pre-term delivery, defined as less than 37 weeks gestation.

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Testosterone circulates almost entirely bound to transport proteins: Normally less than 1-2% is free. The principal transport protein for testosterone is known as sex hormone binding globulin (SHBG) or testosterone-estradiol binding globulin (TeBG). Testosterone measurements are used to assess erectile dysfunction, infertility, gynecomastia, and osteoporosis and to assess hormone replacement therapy.

Testosterone circulates almost entirely bound to transport proteins: Normally less than 1-2% is free. The principal transport protein for testosterone is known as sex hormone binding globulin (SHBG) or testosterone-estradiol binding globulin (TeBG). Testosterone measurements are used to assess erectile dysfunction, infertility, gynecomastia, and osteoporosis and to assess hormone replacement therapy.