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The antinuclear antibody (ANA) test is used as a primary test to help evaluate a person for autoimmune disorders that affect many tissues and organs throughout the body (systemic) and is most often used as one of the tests to help diagnose systemic lupus erythematosus (SLE).
A positive ANA test result means that autoantibodies are present. In a person with signs and symptoms, this suggests the presence of an autoimmune disease, but further evaluation is required to assist in making a final diagnosis.
Testing for thyroid antibodies, such as thyroid peroxidase antibody (TPO), is primarily ordered to help diagnose an autoimmune thyroid disease and to distinguish it from other forms of thyroid dysfunction. Thyroid autoantibodies develop when a person’s immune system mistakenly targets components of the thyroid gland or thyroid proteins, leading to chronic inflammation of the thyroid (thyroiditis), tissue damage, and/or disruption of thyroid function.
Negative test results mean that thyroid autoantibodies are not present in the blood at the time of testing and may indicate that symptoms are due to a cause other than autoimmune. However, a certain percentage of people who have autoimmune thyroid disease do not have autoantibodies. If it is suspected that the autoantibodies may develop over time, as may happen with some autoimmune disorders, then repeat testing may be done at a later date.
Thyroid peroxidase (TPO), an enzyme normally found in the thyroid gland, plays an important role in the production of thyroid hormones. A TPO test detects antibodies against TPO in the blood. If you've been diagnosed with thyroid disease, your doctor may recommend a TPO antibody test — in addition to other thyroid tests — to help determine the cause.
The presence of TPO antibodies in your blood suggests that the cause of thyroid disease is an autoimmune disorder, such as Hashimoto's disease or Graves' disease. In autoimmune disorders, your immune system makes antibodies that mistakenly attack normal tissue. Antibodies that attack the thyroid gland cause inflammation and impaired function of the thyroid.
Your doctor may also order a TPO antibody test if you are pregnant and have an autoimmune disease, especially one that involves the thyroid, such as Hashimoto's disease or Graves' disease.
Some people with TPO antibodies may not have thyroid disease. However, the presence of TPO antibodies may increase the risk of future thyroid disorders. If you have normal thyroid function with TPO antibodies, your doctor may recommend periodic checkups to watch for future thyroid problems.
Blood typing is used to determine an individual’s blood group, to establish whether a person is blood group A, B, AB, or O and whether he or she is Rh positive or Rh negative.
The results of blood typing will determine if a person is type A, B, AB, or O and if he or she is Rh negative or positive.
The results will tell the healthcare provider what blood or blood components will be safe for the person to receive.
This test looks for the hormone BNP in your blood. BNP stands for brain natriuretic peptide. It is made inside the pumping chambers of your heart when pressure builds up from heart failure. The test is an important tool for healthcare providers to diagnose heart failure quickly.
Heart failure happens when your heart is not pumping blood well. This causes cells inside your heart to release BNP. This opens up blood vessels in your body to take pressure off your heart. A BNP blood test correctly shows heart failure about 90% of the time.
The BNP test can help your healthcare provider diagnose heart failure, plan treatment, see how well the treatment is working, and figure out when it is safe for you to leave the hospital. The BNP test can show how serious your heart failure is now and how severe your heart failure will be in the future.
The basic metabolic panel (BMP) is used to check the status of a person’s kidneys and their electrolyte and acid/base balance, as well as their blood glucose level – all of which are related to a person’s metabolism. It can also be used to monitor hospitalized patients and people with certain known conditions, such as hypertension and hypokalemia.
Results of the tests that are part of the BMP are typically evaluated together to look for patterns of results. A single abnormal test result may mean something different than if several test results are abnormal.
Cancer antigen 27.29 (CA 27.29) is a blood test that is done specifically for people with breast cancer. It is one of the breast cancer tumor markers that can be used to monitor the course of the disease. One version of this test is called the " truquant BR radioimmunoassay test."
CA 27.29 is an antigen—that is, a specific type of protein present on the surface of cells and is produced by a gene called MUC-1. CA-27 is a "glycoproteins," (glyco means sugar) and may be present on the surface of epithelial cells like breast cancer cells. Breast cancer cells can shed copies of the CA 27.29 protein into the bloodstream too.
A blood CA 27.29 measurement is ordinarily less than 40 U/ml. With cancer, Ca-27 levels may increase, the higher the value, the greater the likelihood this may indicate the presence of cancer.
Cancer Antigen 125 (CA-125) is a tumor marker primarily used to monitor therapy during treatment for ovarian cancer. CA-125 is also used to detect whether cancer has come back after treatment is complete. A series of CA-125 tests that shows rising or falling concentrations is often more useful than a single result.
If CA-125 levels fall during therapy, this generally indicates that the cancer is responding to treatment. If CA-125 levels rise or stay the same, then cancer may not be responding to therapy. High CA-125 levels after treatment are may indicate that cancer has come back.
The complete blood count (CBC) is often used as a broad screening test to determine an individual’s general health status.
A health practitioner typically evaluates and interprets results from the components of the CBC together. Depending on the purpose of the test, a number of additional or follow-up tests may be ordered for further investigation.
A cyclic citrullinated peptide (CCP) antibody test may be ordered along with or following a rheumatoid factor (RF) test to help diagnose rheumatoid arthritis (RA) and to assess the severity and probable course of the disease (prognosis). Inflammatory markers may also be measured at this time, such as ESR and C-reactive protein (CRP).
When people with signs and symptoms of arthritis are positive for both CCP antibody and RF, it is very likely that they have RA and it is likely that they may develop a more rapidly progressive and severe form of the disease. When people are positive for CCP antibody but not RF, or have low levels of both, and have clinical signs that suggest RA, then it is likely that they have early RA or that they will develop RA in the future.
Chlamydia and Gonorrhea urine analysis is used to screen for, diagnose, and verify successful treatment of infections caused by the bacteria Chlamydia trachomatis and Neisseria gonorrhoeae. Chlamydia and Gonorrhea are two of the most common bacterial sexually transmitted diseases (STD) in the U.S. and can cause serious complications if not treated. Screening for, diagnosing, and treating chlamydia is very important to prevent long-term complications and spread of the infection to others.
A positive test indicates active chlamydia and/or gonorrhea infection that requires treatment with a course of antibiotics.
A negative test means only that there is no evidence of infection at the time of the test. It is important for those who are at increased risk to have screening tests performed on an annual basis to check for possible infection, especially since re-infection is common, particularly among teenagers.
If you are infected, your sexual partner(s) should be tested and treated as well.
The comprehensive metabolic panel (CMP) is used as a broad screening tool to evaluate organ function and check for conditions such as diabetes, liver disease, and kidney disease. The CMP may also be ordered to monitor known conditions, such as hypertension, and to monitor people taking specific medications for any kidney- or liver-related side effects. If a health practitioner is interested in following two or more individual CMP components, he or she may order the entire CMP because it offers more information.
Results of the tests that are part of the CMP are typically evaluated together to look for patterns of results. A single abnormal test result may mean something different than if several test results are abnormal. For example, a high result on just one of the liver enzyme tests has different implications than high results on several liver enzyme tests.
Creatine phosphokinase (CPK) is an enzyme found primarily in muscles. This includes the muscles in the heart.
Any muscle injury or damage can cause a rise in the blood level of CPK. For example, a person would likely have a high CPK after a fall. A high CPK also occurs when someone has a heart attack.
Inflammation in the muscles, called myositis, will raise the CPK level. Usually, people with myositis have aches and pains and muscle weakness.
Some people persistently have a CPK that is higher than normal because of decreased excretion of CPK through the kidneys. This is seen most often in people with kidney disease.
Today, taking a statin drug is one of the most common reasons for a high blood level of CPK. This occurs so commonly that doctors do not routinely order CPK blood tests when a person is taking a statin.
However, if you take a statin and have muscle aches, then a CPK blood test helps determine if you should stop the statin or lower the dose. A person taking a statin who has muscle aches and high CPK is at risk for developing a condition of severe muscle breakdown called rhabdomyolysis. This condition can result in kidney failure.
The C-Reactive protein (CRP) test is used by a health practitioner to detect inflammation. CRP is an acute phase reactant, a protein made by the liver and released into the blood within a few hours after tissue injury, the start of an infection, or other cause of inflammation. The CRP test is not diagnostic of any condition, but it can be used together with signs and symptoms and other tests to evaluate an individual for an acute or chronic inflammatory condition.
The level of CRP in the blood is normally low.
A high or increasing amount of CRP in the blood suggests the presence of inflammation but 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.
The test for dehydroepiandrosterone sulfate (DHEA-S) is ordered along with tests for testosterone and several other male hormones (androgens) to:
- Evaluate adrenal gland function
- Distinguish DHEA-S-secreting conditions that are caused by the adrenal glands from those that originate in the testicles or rarely in the ovaries (ovarian tumors)
- Help diagnose tumors in the outer layer (cortex) of the adrenal gland (adrenocortical tumors) and adrenal cancers
- Help diagnose congenital adrenal hyperplasia and adult-onset adrenal hyperplasia
A normal DHEA-S level, in addition to other normal male hormone (androgen) levels, likely indicates that the adrenal gland is functioning normally. Rarely, DHEA-S may be normal when an adrenal tumor or cancer is present but is not secreting hormones.
The Dilantin (phenytoin) test is used to measure and monitor the amount of phenytoin in the blood and to determine whether drug concentrations are in the therapeutic range. It may be ordered every few days when a person first begins taking phenytoin to help adjust the dose to the desired blood level. The test is then ordered at regular intervals and as needed to monitor blood concentrations. One or more phenytoin tests may be ordered if a person starts or stops taking additional medications (to judge their effect, if any, on phenytoin levels) and may be ordered if the person has a seizure or if a health practitioner suspects toxicity.
The therapeutic ranges for adults taking phenytoin have been established at 10.0-20.0 mcg/mL for total phenytoin (bound plus unbound) and 1.0-2.0 mcg/mL for free phenytoin (unbound only). The range for percent free phenytoin is 8-14%.
Estrogen tests are used to detect a deficiency or excess in a woman and to help diagnose a variety of conditions associated with this imbalance. They may also be used to help determine the timing of a woman’s ovulation and may be ordered to monitor the health status of the developing baby and placenta during pregnancy. In a man, estrogen testing may be performed to detect a hormone excess and its cause.
Normal estrogen results depend upon the sex and age of the person being tested. With women, it also depends upon their menstrual cycle or whether they are pregnant. Reference ranges will vary somewhat between laboratories, both in normal values listed and in units used.
The ferritin test is ordered to assess a person’s iron stores in the body. The test is sometimes ordered along with an iron test and a TIBC to detect the presence and severity of iron deficiency or iron overload.
Ferritin levels are often evaluated in conjunction with other iron tests. A summary of the changes in iron tests seen in various diseases of iron status is shown in the table below.
Fructosamine testing may be used to help a person with diabetes monitor and control his or her blood glucose level. The level of fructosamine in the blood is a reflection of glucose levels over the previous 2-3 weeks. (See the “What is being tested?” section for more on this.)
A high fructosamine means that a diabetic’s average glucose over the previous 2 to 3 weeks has been elevated. In general, the higher the fructosamine level, the higher the average blood glucose level. Monitoring the trend of values may be more important than a single high value. A trend from a normal to a high fructosamine level may indicate that a person’s glucose control is not adequate. This, however, does not pinpoint the cause. A review and adjustment to the person’s diet and/or medication may be required to help get the person’s glucose under control. Acute illness and significant stress can also temporarily raise blood glucose levels so these factors may also be taken into account when interpreting results.
The test for follicle-stimulating hormone (FSH), a hormone associated with reproduction and the development of eggs in women and sperm in men, has several uses.
Results of an FSH test are typically considered with results of other hormone tests, such as LH, estrogens, and/or testosterone.
The blood glucose test may be used to:
- Detect high blood glucose (hyperglycemia) and low blood glucose (hypoglycemia)
- Screen for diabetes in people who are at risk before signs and symptoms are apparent; in some cases, there may be no early signs or symptoms of diabetes. Screening can, therefore, be useful in helping to identify it and allowing for treatment before the condition worsens or complications arise.
- Help diagnose diabetes, prediabetes and gestational diabetes
- Monitor glucose levels in people diagnosed with diabetes
High levels of glucose most frequently indicate diabetes, but many other diseases and conditions can also cause elevated blood glucose.
This test determines if you are allergic or hypersensitive to Gluten. Gluten is a combination of proteins that can be found in some grains like wheat, rye, and barley, or as an additive in many processed foods.
Most gluten-sensitive people have a high IgG-gliadin antibody test results.
Gluten allergies and sensitivities are typically less severe than other gluten-related conditions like Celiac disease. Symptoms of a gluten allergy may include abdominal discomfort, bloating, gas, constipation or diarrhea when they eat gluten products. These symptoms often cease when gluten is cut from the diet.
The human chorionic gonadotropin (hCG) test is done to check for the hormone hCG in blood or urine. Some hCG tests measure the exact amount. Some just check to see if the hormone is present. HCG is made by the placenta during pregnancy. The test can be used to see if a woman is pregnant. Or it can be done as part of a screening test for birth defects.
HCG may also be made by certain tumors, especially those that come from an egg or sperm. (These are called germ cell tumors.) HCG levels are often tested in a woman who may have tissue that is not normal growing in her uterus. The test also may be done to look for molar pregnancy or cancer inside the uterus. Several hCG tests may be done after a miscarriage to be sure a molar pregnancy is not present. In a man, hCG levels may be measured to help see if he has cancer of the testicles.
Heavy metals testing is used to screen for or to diagnose heavy metal poisoning in those who may have been acutely or chronically exposed to one or more heavy metals and to monitor excessive metal concentrations in those who work with various heavy metals. Such occupations include construction work, mining, radiator repair shops, and firing ranges. Testing is also conducted to monitor the effectiveness of chelation therapy, a treatment to rid the body of high amounts of a heavy metal.
Care must be taken in the interpretation of heavy metals tests. A low level of a heavy metal in the blood does not necessarily mean that excessive exposure has not occurred. Heavy metals do not stay in the blood and will not be present in the urine for extended periods of time. Lead, for instance, migrates from the blood into the body’s organs and over time is incorporated into the bones. If someone was chronically exposed to lead, then that person might have lead in his or her blood, urine, organs, and bones.
The main use for the Hemoccult (aka fecal occult blood test (FOBT) or the fecal immunochemical test (FIT)) is as a screen for early colon cancer. Most cases of colon cancer begin with the development of benign intestinal polyps. Benign polyps are relatively common in people over the age of 50. Most are harmless, but some can become cancerous.
The fecal occult blood test is normally negative.
For the guaiac-based FOBT, a positive test result indicates that abnormal bleeding is occurring somewhere in the digestive tract. This blood loss could be due to ulcers, diverticulosis, polyps, inflammatory bowel disease, hemorrhoids, blood swallowed due to bleeding gums or nosebleeds, or benign or cancerous tumors.
The hemoglobin test is often used to check for anemia, usually along with a hematocrit or as part of a complete blood count (CBC). The test may be used to screen for, diagnose, or monitor a number of conditions and diseases that affect red blood cells (RBCs) and/or the amount of hemoglobin in the blood. Hemoglobin is the iron-containing protein found in all red blood cells that enable RBCs to bind to oxygen in the lungs and carry it to tissues and organs throughout the body.
Since a hemoglobin level is often performed as part of a complete blood count (CBC), results from other components are taken into consideration. A rise or drop in the hemoglobin level must be interpreted in conjunction with other parameters, such as RBC count, hematocrit, reticulocyte count, and/or red blood cell indices. Age, sex, and race are other factors to be considered. In general, hemoglobin mirrors the results of the RBC count and hematocrit.
This test is used to help diagnose a liver infection due to the hepatitis A virus (HAV). There are several causes of hepatitis and the accompanying symptoms, so this test may be used to determine if the symptoms are due to hepatitis A.
Results of hepatitis testing may indicate the following:
|HAV IgM||HAV IgG or Total Antibody (IgM and IgG)||Results Indicate|
|Positive||Not Performed||Acute or recent HAV infection|
|Negative||Positive||No active infection but previous HAV exposure; has developed immunity to HAV or recently vaccinated for HAV|
|Not Performed||Positive||Has been exposed to HAV but does not rule out acute infection|
|Not Performed||Negative||No current or previous HAV infection; vaccine may be recommended if at risk|
A total antibody test detects both IgM and IgG antibodies but does not distinguish between them.
If the total antibody test or hepatitis A IgG result is positive and someone has never been vaccinated against HAV, then the person has had past exposure to the virus. About 30% of adults over age 40 have antibodies to hepatitis A.
Hepatitis B virus (HBV) tests may be used for a variety of reasons. Some of the tests detect antibodies produced in response to HBV infection; some detect antigens produced by the virus, and others detect viral DNA.
The tests for hepatitis B may be ordered individually but are often ordered in some combination, depending on the reason for testing. Results of the tests are typically evaluated together. Sometimes the meaning of one result depends on the result of another test. However, not all tests are performed for all people.
Hepatitis C tests are used to screen for and diagnose a hepatitis C virus (HCV) infection, to guide therapy and/or to monitor the treatment of an HCV infection.
An HCV antibody test is typically reported as “positive” or “negative.”
Results of HCV viral load testing are reported as a number if the virus is present. If no virus is present or if the amount of virus is too low to detect, the result is often reported as “negative” or “not detected.”
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.
Liver panel test results are not diagnostic of a specific condition; they indicate that there may be a problem with the liver. In a person who does not have symptoms or identifiable risk factors, abnormal liver test results may indicate a temporary liver injury or reflect something that is happening elsewhere in the body – such as in the skeletal muscles, pancreas, or heart. It may also indicate early liver disease and the need for further testing and/or periodic monitoring.
HIV antibody and HIV antigen (p24) testing is used to screen for and diagnose HIV infections. Early detection and treatment of HIV infection and immune system monitoring can greatly improve long-term health and survival. Also, if a person knows his or her HIV status, it may help change behaviors that can put him or her and others at risk.
A negative test for HIV antigen and/or HIV antibody usually indicates that a person does not have an HIV infection. A negative screening test means only that there is no evidence of disease at the time of the test, however. It is important for those who are at increased risk of HIV infection to have screening tests performed on a yearly basis to check for possible exposure to the virus.
The homocysteine test may be used a few different ways:
- A health practitioner may order a homocysteine test to determine if a person has a vitamin B12 or folate deficiency. The homocysteine concentration may be elevated before B12 and folate tests are abnormal. Some health practitioners may recommend homocysteine testing in malnourished individuals, the elderly, who often absorb less vitamin B12 from their diet, and individuals with poor nutrition, such as drug or alcohol addicts.
- Homocysteine may be ordered as part of a screen for people at high risk for heart attack or stroke. It may be useful for someone who has a family history of coronary artery disease but no other known risk factors, such as smoking, high blood pressure, or obesity. However, the exact role that homocysteine plays in the progression of cardiovascular disease has not been established, so the utility of the screening test continues to be questioned. Routine screening, such as that done for total cholesterol, has not been recommended.
- Tests for both a urine and blood homocysteine may be used to help diagnose homocystinuria if a health practitioner suspects that an infant or child may have this inherited disorder. In the U.S., all babies are routinely tested for excess methionine, a sign of homocystinuria, as part of their newborn screening. If a baby’s test is positive, then urine and blood homocysteine tests are often performed to confirm the findings.
In cases of suspected malnutrition or vitamin B12 or folate deficiency, homocysteine levels may be elevated. If an individual does not get enough B vitamins and/or folate through diet or supplements, then the body may not be able to convert homocysteine to forms that can be used by the body. In this case, the level of homocysteine in the blood can increase.
For companies who don't have an insurance plan for their employees, we are able to offer your employees an annual Wellness benefit.
We will send a professional phlebotomist to your company to obtain a biometric screening.
Cholesterol, Glucose, Blood Pressure, Height, Weight, and BMI
Cholesterol, Glucose and Blood Pressure
CMP, Cholesterol, Blood Pressure, Height, Weight and BMI
CMP, Cholesterol, Blood Pressure
Blood Pressure, Height, Weight
Glucose, blood urea nitrogen, creatinine, Uric Acid, Total bilirubin, SGOT, SGPT, gamma Glutamyltransferase, Alkaline Phosphatase, Lactate Dehydrogenase, Total Protein, Albumin, globulin and Calcium
HDL, Triglycerides, LDL, LDL/HDL Ratio
Serum iron, total iron-binding capacity (TIBC), and/or transferrin tests are usually ordered together and, subsequently, the transferrin saturation can be determined and used to assess how much iron is being carried in the blood. A ferritin test may also be used to evaluate a person’s current iron stores.
Serum iron levels are often evaluated in conjunction with other iron tests. A summary of the changes in iron tests seen in various diseases of iron status is shown in the table below.
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.
In general, healthy lipid levels help to maintain a healthy heart and lower the risk of heart attack or stroke. A health practitioner will take into consideration the results of each component of a lipid profile plus other risk factors to help determine a person’s overall risk of coronary heart disease, whether treatment is necessary and, if so, which treatment will best help to lower the person’s risk of heart disease.
Measles and mumps tests may be used to:
- Confirm that a person is immune to the viruses due to previous infections or vaccination
- Diagnose an active case of measles or mumps
- Detect, monitor, and track outbreaks for public health purposes
When measles or mumps IgM antibodies are present in someone who has not been recently vaccinated, then it is likely that the person has a current measles or mumps infection. When both IgM and IgG antibodies are present or there is a fourfold increase in concentrations between acute and convalescent IgG antibody tests, then it is likely that the person has a current or had a recent measles or mumps infection.
Nicotine, or its primary metabolite cotinine, is most often tested to evaluate tobacco use. Long-term smoking of tobacco products can increase the risk of developing many diseases including lung cancer, COPD, stroke, heart disease, and respiratory infections. Long-term tobacco use can also exacerbate asthma and help promote blood clot formation. In pregnant women, smoking can impair growth of the developing baby and lead to low birth weight babies.
In the blood, the nicotine level can rise within a few seconds of a puff on a cigarette. How much it rises depends on the amount of nicotine in the cigarette and the manner in which a person smokes, such as how deeply he or she inhales. The rate at which nicotine is metabolized and cotinine is cleared from the body also varies from person to person due to some genetic differences.
A potassium test is used to detect abnormal concentrations of potassium, including high potassium (hyperkalemia) and low potassium (hypokalemia). It is often used as part of an electrolyte panel or basic metabolic panel for a routine physical.
Potassium urine concentrations must be evaluated in association with blood levels. The body normally eliminates excess potassium, so the concentration in the urine may be elevated because it is elevated in the blood. It may also be elevated in the urine when the body is losing too much potassium; in this case, the blood level would be normal to low. If blood potassium levels are low due to insufficient intake, then urine concentrations will also be low.
A progesterone test may be used:
- To help recognize and manage some causes of infertility. Since progesterone levels vary throughout the menstrual cycle, multiple (serial) measurements can be used for this purpose.
- To determine whether or not a woman has ovulated, when ovulation occurred, or to monitor the success of induced ovulation
- In early pregnancy to help diagnose an ectopic or failing pregnancy, along with human chorionic gonadotropin (hCG) testing
- To monitor a high-risk pregnancy to help evaluate placenta and fetal health
- If a woman is receiving progesterone injections to help support her early pregnancy, to help determine the effectiveness of the replacement treatment
- Along with other tests such as an FSH, LH, hCG, thyroid tests, clotting tests, and a complete blood count (CBC) to help determine the cause of abnormal uterine bleeding in non-pregnant women
Interpretation of progesterone test results depends on the reason for testing and requires knowledge of the point at which a woman is in her menstrual cycle or pregnancy. Progesterone levels usually start to elevate when an egg is released from the ovary, rise for several days, and then either continue to rise with early pregnancy or fall to initiate menstruation.
The PSA test and digital rectal exam (DRE) may be used to screen both asymptomatic and symptomatic men for prostate cancer. PSA is a protein produced primarily by cells in the prostate and most of the PSA is released into semen, but small amounts of it are also released into the blood. PSA exists in two forms in the blood: free (not bound) and complexed (cPSA, bound to other proteins). Lab tests can measure free PSA or total PSA (bound plus unbound).
PSA test results can be interpreted a number of different ways and there may be differences in cutoff values between different laboratories.
The so-called intact PTH is the most frequently ordered parathyroid hormone test. It is used to help diagnose the cause of a low or high calcium level and to help distinguish between parathyroid-related and non-parathyroid-related causes. It may also be used to monitor the effectiveness of treatment when an individual has a parathyroid-related condition. PTH is routinely monitored for people with chronic kidney disease or who are on dialysis.
A health practitioner will evaluate both calcium and PTH results together to determine whether the levels are appropriate and are in balance as they should be. If both PTH and calcium levels are normal, then it is likely that the body’s calcium regulation system is functioning properly.
A renal panel may be used to evaluate kidney function, to help diagnose kidney-related disorders, to screen those who may be at risk of developing kidney disease or to monitor someone who has been diagnosed with kidney disease.
Renal panel test results are not diagnostic but rather indicate that there may be a problem with the kidneys and that further testing is required to make a diagnosis and determine the cause. Results of the panel are usually considered together, rather than separately. Individual test results can be abnormal due to causes other than kidney disease, but taken together with risks and/or signs and symptoms, they may give an indication of whether kidney disease is present.
The rheumatoid factor (RF) test is primarily used to help diagnose rheumatoid arthritis (RA) and to help distinguish RA from other forms of arthritis or other conditions that cause similar symptoms.
The RF test must be interpreted in conjunction with a person’s symptoms and clinical history.
Rapid Plasma Reagin (RPR) or Syphilis tests are used to screen for and/or diagnose infection with Treponema pallidum, the bacterium that causes syphilis.
Care must be taken when interpreting results from tests for syphilis.
The erythrocyte sedimentation rate (ESR or sed rate) is a relatively simple, inexpensive, non-specific test that has been used for many years to help detect inflammation associated with conditions such as infections, cancers, and autoimmune diseases.
The result of an ESR is reported as the millimeters of clear fluid (plasma) that are present at the top portion of the tube after one hour (mm/hr).
A thyroid panel is used to evaluate thyroid function and/or help diagnose hypothyroidism and hyperthyroidism due to various thyroid disorders. The panel typically includes tests for:
- Thyroid-stimulating hormone (TSH)
- Free thyroxine (free T4)
- Total or free triiodothyronine (total or free T3)
If the feedback system involving the thyroid gland is not functioning properly due to one of a variety of disorders, then increased or decreased amounts of thyroid hormones may result. When TSH concentrations are increased, the thyroid will make and release inappropriate amounts of T4 and T3 and the person may experience symptoms associated with hyperthyroidism. If there is decreased production of thyroid hormones, the person may experience symptoms of hypothyroidism.
Testosterone testing is used to diagnose several conditions in men, women, girls, and boys. Testosterone is the main sex hormone in men, produced mainly by the testicles, and is responsible for male physical characteristics. Although it is considered to be a “male” sex hormone, it is present in the blood of both males and females.
The normal range for testosterone levels in men is broad and varies by stage of maturity and age. It is normal for testosterone levels to slowly decline, usually after age 30. Testosterone may decrease more in men who are obese or chronically ill and with the use of certain medications.
In women, testosterone levels are normally low. Increased testosterone levels can indicate:
- Ovarian or adrenal gland tumor
- Congenital adrenal hyperplasia
Total iron-binding capacity (TIBC) is most frequently used along with a serum iron test to evaluate people suspected of having either iron deficiency or iron overload. These two tests are used to calculate the transferrin saturation, a more useful indicator of iron status than just iron or TIBC alone. In healthy people, about 20-40% of available transferrin sites are used to transport iron.
The results of transferrin tests, TIBC, or UIBC are usually evaluated in conjunction with other iron tests.
The thyroid-stimulating hormone (TSH) test is often the test of choice for evaluating thyroid function and/or symptoms of a thyroid disorder, including hyperthyroidism or hypothyroidism.
Whether high or low, an abnormal TSH indicates an excess or deficiency in the amount of thyroid hormone available to the body, but it does not indicate the reason why. An abnormal TSH test result is usually followed by additional testing to investigate the cause of the increase or decrease.
The urinalysis is a set of screening tests that can detect some common diseases. It may be used to screen for and/or help diagnose conditions such as urinary tract infections, kidney disorders, liver problems, diabetes or other metabolic conditions, to name a few.
Urinalysis results can have many interpretations. Abnormal findings are a warning that something may be wrong and should be evaluated further. A healthcare practitioner must correlate the urinalysis results with a person’s symptoms and clinical findings and search for the causes of abnormal findings with other targeted tests, such as a comprehensive metabolic panel (CMP), complete blood count (CBC), renal panel, liver panel, or urine culture (for urinary tract infection).
A vitamin D test is used to:
- Determine if bone weakness, bone malformation, or abnormal metabolism of calcium (reflected by abnormal calcium, phosphorus, PTH) is occurring as a result of a deficiency or excess of vitamin D
- Help diagnose or monitor problems with parathyroid gland functioning since PTH is essential for vitamin D activation
- Screen people who are at high risk of deficiency, as recommended by the National Osteoporosis Foundation, the Institute of Medicine, and the Endocrine Society
- Help monitor the health status of individuals with diseases that interfere with fat absorption, such as cystic fibrosis and Crohn disease since vitamin D is a fat-soluble vitamin and is absorbed from the intestine like a fat
- Monitor people who have had gastric bypass surgery and may not be able to absorb enough vitamin D
- Help determine the effectiveness of treatment when vitamin D, calcium, phosphorus, and/or magnesium supplementation is prescribed
Although there are differences among vitamin D methods, most laboratories utilize similar reference intervals. Because toxicity is rare, the focus has been on the lower limit and what cut-off for total 25-hydroxyvitamin D (D2 + D3) indicates deficiency.
Vitamin B12 and folate are separate tests often used in conjunction to detect deficiencies and to help diagnose the cause of certain anemias, such as pernicious anemia, an autoimmune disease that affects the absorption of B12.
Normal B12 and folate levels may indicate that a person does not have a deficiency and that the signs and symptoms are likely due to another cause. However, normal levels may reflect the fact that a person’s stored B12 and/or folate has not yet been fully depleted.