Find test for Lucid Medical Diagnostics

Pre-Test Information: N/A

Test Type: Blood

Test Description:

• Why Get Tested?
• To screen for liver damage and/or to help diagnose liver disease
• When To Get Tested?
• When a healthcare practitioner thinks that you have symptoms of a liver disorder, such as abdominal pain, nausea and vomiting, jaundice (yellowish discoloration of the skin or white of the sclerae), or potential exposure to hepatitis viruses; it can also be ordered as part of a comprehensive metabolic panel (CMP) when you have a routine health exam.
• What is being tested?
• Alanine aminotransferase (ALT) is an enzyme found mostly in the cells of the liver and kidney. Much smaller amounts of it are also found in the heart and muscles. Normally, ALT levels in blood are low, but when the liver is damaged, ALT is released into the blood and the level increases. This test measures the level of ALT in the blood and is useful for early detection of liver disease.
• The function of ALT is to convert alanine, an amino acid found in proteins, into pyruvate, an important intermediate in cellular energy production. In healthy individuals, ALT levels in the blood are low. When the liver is damaged, ALT is released into the blood, usually before more obvious signs of liver damage occur, such as jaundice.
• The liver is a vital organ located in the upper right side of the abdomen, just beneath the rib cage. It is involved in many important functions in the body. The liver helps to process the body's nutrients, manufactures bile to help digest fats, produces many important proteins such as blood clotting factors and albumin, and breaks down potentially toxic substances into harmless ones that the body can use or eliminate.
• A number of conditions can cause damage to liver cells, resulting in an increase in ALT. The test is most useful in detecting damage due to hepatitis (inflammation of the liver) or as a result of drugs or other substances that are toxic to the liver.
• ALT is commonly tested in conjunction with aspartate aminotransferase (AST), another liver enzyme, as part of a liver panel. Both ALT and AST levels usually rise whenever the liver is being damaged, although ALT is more specific for the liver and, in some cases, may be the only one of the two to be increased. An AST/ALT ratio may be calculated to aid in distinguishing between different causes and severity of liver injury and to help distinguish liver injury from damage to heart or muscles.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To screen for and help diagnose a liver disorder or kidney disease; sometimes to evaluate nutritional status, especially in hospitalized patients
• When To Get Tested?
• Routinely as part of the blood tests done for a health exam or prior to a planned surgery; when a healthcare practitioner thinks that you have symptoms of a liver disorder or kidney disease; sometimes when you have unintended weight loss or have symptoms associated with malnutrition
• What is being tested?
• Albumin is a protein made by the liver. It makes up about 60% of the total protein in the blood and plays many roles. This test measures the level of albumin in the blood.
• Albumin keeps fluid from leaking out of blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body. Levels of albumin may decrease, to a greater or lesser degree, when conditions interfere with its production by the liver, increase protein breakdown, increase protein loss via the kidneys, and/or expand the volume of plasma, the liquid portion of blood (diluting the blood).
• Two important causes of low blood albumin include:
• Severe liver disease—since albumin is produced by the liver, its level can decrease with loss of liver function; however, this typically occurs only when the liver has been severely affected.
• Kidney disease—one of the many functions of the kidneys is to conserve plasma proteins such as albumin so that they are not released along with waste products when urine is produced. Albumin is present in high concentrations in the blood, and when the kidneys are functioning properly, virtually no albumin is lost in the urine. However, if a person's kidneys become damaged or diseased, they begin to lose their ability to conserve albumin and other proteins. This is frequently seen in chronic diseases, such as diabetes and hypertension. In nephrotic syndrome, very high amounts of albumin are lost through the kidneys.

TAT: Daily

Pre-Test Information: N/A

Test Type: Blood

Test Description:

• Why Get Tested?
• To detect an elevated level of ammonia in the blood that may be caused by severe liver disease, kidney failure, or certain rare genetic disorders; to help investigate the cause of changes in behavior and consciousness; to help diagnose hepatic encephalopathy or Reye syndrome
• When To Get Tested?
• When someone with or without liver disease or kidney failure experiences mental changes or lapses into a coma; when a newborn experiences frequent vomiting and increased lethargy or when a child has continuous vomiting and unusual sleepiness during recovery from a viral illness, such as the flu or chickenpox
• What is being tested?
• Ammonia is a waste product formed primarily by bacteria in the intestines during the digestion of protein. If not processed and cleared from the body appropriately, excess ammonia can accumulate in the blood. This test measures the amount of ammonia in the blood.
• Ammonia is normally transported in the blood to the liver, where it is converted into two substances called urea and glutamine. The urea is then carried to the kidneys, where it is eliminated in the urine. If this "urea cycle" does not complete the breakdown of ammonia, ammonia builds up in the blood and can pass from the blood into the brain.
• Ammonia is toxic to the brain. For example, when liver function is significantly reduced due to disorders such as cirrhosis or hepatitis, ammonia and other compounds processed by the liver can accumulate in the brain and cause a condition called hepatic encephalopathy.
• Hepatic encephalopathy causes mental and neurological changes that can lead to confusion, disorientation, sleepiness, and eventually to coma and even death.
• Infants and children with increased ammonia levels may vomit frequently, be irritable, and be increasingly lethargic. Left untreated, they may experience seizures, have difficulty breathing, and may lapse into a coma.
• Problems with ammonia processing can arise from conditions such as:
• Severe liver disease – damage limits the ability of the liver to process ammonia; spikes in ammonia blood levels may be seen in people with stable liver disease, especially following a triggering event such as gastrointestinal bleeding or an electrolyte imbalance.
• Decreased blood flow to the liver – ammonia is less able to get to the liver to be processed.
• Reye syndrome – a rare condition that affects the blood, brain, and liver; it typically causes a rise in ammonia levels and a fall in glucose. It affects primarily children and young adults. In most cases, it follows and appears to be triggered by a viral infection, such as the flu or chickenpox. Children who are given aspirin are at an increased risk.
• Kidney (renal) failure – the kidneys are unable to effectively rid the body of urea, leading to a build-up of ammonia in the blood.
• Rare genetic disorder such as a defect in the urea cycle – a deficiency in one of the enzymes necessary to complete the conversion of ammonia to urea.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help diagnose and monitor sarcoidosis; to help differentiate this systemic condition from other disorders causing similar symptoms
• When To Get Tested?
• When you have granulomas that produce small bumps under the skin, a lingering cough, red watery eyes, and/or other symptoms suggestive of sarcoidosis; regularly when you have active sarcoidosis to monitor its course
• What is being tested?
• Angiotensin-converting enzyme (ACE) is an enzyme that helps regulate blood pressure. An increased blood level of ACE is sometimes found in sarcoidosis, a systemic disorder of unknown cause that often affects the lungs but may also affect many other body organs, including the eyes, skin, nerves, liver, and heart., This test measures the amount of ACE in the blood.
• A classic feature of sarcoidosis is the development of granulomas, small tumor-like masses of immune and inflammatory cells and fibrous tissue that form nodules under the skin and in organs throughout the body. Granulomas change the structure of the tissues around them and, in sufficient numbers, they can cause damage and inflammation and may interfere with normal functions. The cells found at the outside borders of granulomas can produce increased amounts of ACE. The level of ACE in the blood may increase when sarcoidosis-related granulomas develop.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To detect liver damage and/or to help diagnose liver disease
• When To Get Tested?
• When a healthcare practitioner thinks that you have symptoms of a liver disorder, such as abdominal pain, nausea and vomiting, jaundice (yellow skin), or potential exposure to a hepatitis virus; as part of a comprehensive metabolic panel when you have a routine health exam
• What is being tested?
• Aspartate aminotransferase (AST) is an enzyme found in cells throughout the body but mostly in the heart and liver and, to a lesser extent, in the kidneys and muscles. In healthy individuals, levels of AST in the blood are low. When liver or muscle cells are injured, they release AST into the blood. This makes AST a useful test for detecting or monitoring liver damage.
• The liver is a vital organ located in the upper right-hand side of the abdominal area just beneath the rib cage. It is involved in many important functions in the body. The liver helps to process the body's nutrients, manufactures bile to help digest fats, produces many important proteins such as blood clotting factors, and breaks down potentially toxic substances into harmless ones that the body can use or excrete.
• A number of conditions can cause injury to liver cells and may cause increases in AST. The test is most useful in detecting liver damage due to hepatitis, drugs toxic to the liver, cirrhosis, or alcoholism. AST, however, is not specific for the liver and may be increased in conditions affecting other parts of the body.
• An AST test is often performed along with an alanine aminotransferase (ALT) test. Both are enzymes found in the liver that become elevated in the blood when the liver is damaged. A calculated AST/ALT ratio is useful for differentiating between different causes of liver injury and in recognizing when the increased levels may be coming from another source, such as heart or muscle injury.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• As part of an electrolyte panel or metabolic panel to identify or monitor an electrolyte imbalance or acid-base (pH) imbalance
• When To Get Tested?
• During a routine health exam or as recommended by your healthcare practitioner if you are experiencing symptoms such as weakness, confusion, prolonged vomiting, or breathing problems that could indicate an electrolyte imbalance or an acid-base imbalance (acidosis or alkalosis)
• What is being tested?
• Bicarbonate is an electrolyte, a negatively charged ion that is used by the body to help maintain the body's acid-base (pH) balance. It also works with the other electrolytes (sodium, potassium, and chloride) to maintain electrical neutrality at the cellular level. This test measures the total amount of carbon dioxide (CO2) in the blood, which occurs mostly in the form of bicarbonate (HCO3-). The CO2 is mainly a by-product of various metabolic processes.
• Measuring bicarbonate as part of an electrolyte or metabolic panel may help diagnose an electrolyte imbalance or acidosis or alkalosis. Acidosis and alkalosis describe the abnormal conditions that result from an imbalance in the pH of the blood caused by an excess of acid or alkali (base). This imbalance is typically caused by some underlying condition or disease.
• The lungs and kidneys are the major organs involved in regulating blood pH through the removal of excess bicarbonate.
• The lungs flush acid out of the body by exhaling CO2. Raising and lowering the respiratory rate alters the amount of CO2 that is breathed out, and this can affect blood pH within minutes.
• The kidneys eliminate acids in the urine and they regulate the concentration of bicarbonate (HCO3-, a base) in blood. Acid-base changes due to increases or decreases in HCO3- concentration occur more slowly than changes in CO2, taking hours or days.
• Any disease or condition that affects the lungs, kidneys, metabolism, or breathing has the potential to cause acidosis or alkalosis.
• The bicarbonate test gives a healthcare practitioner a rough estimate of your acid-base balance. This is usually sufficient, but measurements of gases dissolved in the blood (blood gases) may be done if more information is needed. Bicarbonate is typically measured along with sodium, potassium, and possibly chloride in an electrolyte panel as it is the balance of these molecules that gives the healthcare practitioner the most information.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To evaluate the health of your kidneys; to help diagnose kidney disease; to monitor the effectiveness of dialysis and other treatments related to kidney disease or damage
• When To Get Tested?
• As part of a routine comprehensive or basic metabolic panel (CMP or BMP) during a health exam; when you have signs and symptoms that may be due to kidney disease or you have a condition that may cause or be worsened by kidney dysfunction; at regular intervals when you are being treated for kidney disease or damage
• What is being tested?
• Urea is a waste product formed in the liver when protein is metabolized into its component parts (amino acids). This process produces ammonia, which is then converted into the less toxic waste product urea. This test measures the blood urea nitrogen (BUN) level in the blood. Sometimes, a BUN to creatinine ratio is calculated to help determine the cause of elevated levels.
• Nitrogen is a component of both ammonia and urea. Urea and urea nitrogen are referred to somewhat interchangeably because urea contains nitrogen and because urea/urea nitrogen is the "transport method" used by the body to rid itself of excess nitrogen. Urea is formed in and released by the liver into the blood and is carried to the kidneys, where it is filtered out of the blood and released into the urine. Since this is an ongoing process, there is usually a small but stable amount of urea nitrogen in the blood. However, when the kidneys cannot filter wastes out of the blood due to disease or damage, then the level of urea in the blood will rise.
• The kidneys are a pair of bean-shaped organs that are located at the bottom of the ribcage in the right and left sides of the back. Within them are about a million tiny blood filtering units called nephrons. In each nephron, blood is continually filtered through a microscopic cluster of looping blood vessels, called glomerulus. The glomerulus allows the passage of water and small molecules but retains blood cells and larger molecules. Attached to each glomerulus is a tiny tube (tubule) that collects the fluid and molecules that pass through the glomerulus and then reabsorbs what still can be used by the body. The remaining waste forms urine.
• Most diseases or conditions that affect the kidneys or liver have the potential to affect the amount of urea present in the blood. If increased amounts of urea are produced by the liver or if the kidneys are not working properly and have difficulty filtering wastes out of the blood, then urea levels will rise in the blood. If significant liver damage or disease inhibits the production of urea, then BUN levels may fall.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To screen for, diagnose, and monitor a range of medical conditions
• When To Get Tested?
• As part of a routine metabolic panel; when you have symptoms of a disorder, or known presence of one, affecting your kidneys, bones, thyroid, parathyroid, or nerves or when symptoms of significantly increased or decreased calcium concentrations are present; when someone is critically ill, to monitor ionized calcium levels; when someone has certain types of cancer; when someone is being treated for abnormal calcium levels, to evaluate the effectiveness of treatment
• What is being tested?
• Calcium is the most abundant and one of the most important minerals in the body. It is essential for cell signaling and the proper functioning of muscles, nerves, and the heart. Calcium is needed for blood clotting and is crucial for the formation, density, and maintenance of bones and teeth. This test measures the amount of calcium in the blood or urine, which reflects the amount of total and ionized calcium in the body.
• About 99% of calcium is found complexed in the bones, while the remaining 1% circulates in the blood. Calcium levels are tightly controlled; if there is too little absorbed or ingested, or if there is excess loss through the kidney or gut, calcium is taken from bone to maintain blood concentrations. Roughly half of the calcium in the blood is "free" and is metabolically active. The remaining half is "bound" to proteins, primarily albumin and to a lesser extend globulins, with a smaller amount complexed to anions, such as phosphate, and these bound and complexed forms are metabolically inactive.
• There are two tests to measure blood calcium. The total calcium test measures both the free and bound forms. The ionized calcium test measures only the free, metabolically active form.
• Some calcium is lost from the body every day, filtered from the blood by the kidneys and excreted into the urine and sweat. Measurement of the amount of calcium in the urine is used to determine how much calcium the kidneys are eliminating.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• Primarily to monitor cancer treatment, including response to therapy and recurrence; as an indicator of the amount of cancer or size of tumor present (tumor burden) and to assist in cancer staging; occasionally as follow up to a positive screening test for cancer, to compare whether the level falls to normal (indicating that the cancer was all likely removed) after treatment for the cancer
• When To Get Tested?
• When you have been diagnosed with colon, pancreas, breast, lung, ovarian, medullary thyroid or other cancer prior to starting cancer treatment and then, if elevated, at intervals during and after therapy; occasionally when cancer is suspected but not confirmed – to aid in its detection
• What is being tested?
• Carcinoembryonic antigen (CEA) is a protein that is present in certain tissues of a developing baby (fetus). By the time a baby is born, it drops to a very low level. In adults, CEA is normally present at very low levels in the blood but may be elevated with certain types of cancer. This test measures the amount of CEA in the blood to help evaluate individuals diagnosed with cancer.
• CEA is a tumor marker. Originally, it was thought that CEA was a specific marker for colon cancer, but further study has shown that an increase in CEA may be seen in a wide variety of other cancers. CEA can also be increased in some non-cancer-related conditions, such as inflammation, cirrhosis, peptic ulcer, ulcerative colitis, rectal polyps, emphysema, and benign breast disease, and in smokers. For this reason, it is not useful as a general cancer screening tool, but it does have a role in evaluating response to cancer treatment. When an individual has been diagnosed with cancer, an initial baseline test for CEA may be performed. If this level is elevated, then subsequent serial testing of CEA may be performed to monitor the cancer as the individual undergoes treatment.

TAT: Tue, Sat: 1 pm

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To measure the amount of ceruloplasmin in the blood; to help diagnose Wilson disease; sometimes to help identify conditions associated with copper deficiencies
• When To Get Tested?
• When you have jaundice, fatigue, abdominal pain, behavioral changes, tremors, or other symptoms that a health practitioner thinks may be due to Wilson disease or, rarely, to copper deficiency; at intervals when monitoring is recommended
• What is being tested?
• Ceruloplasmin is a copper-containing enzyme that plays a role in the body's iron metabolism. This test measures the amount of ceruloplasmin in the blood.
• Copper is an essential mineral that plays a role in the regulation of iron metabolism, formation of connective tissue, energy production at the cellular level, and the function of the nervous system. It is absorbed from food and liquids by the intestines and then transported to the liver, where it is stored or used to produce a variety of enzymes.
• The liver binds copper to a protein to produce ceruloplasmin and then releases it into the bloodstream. About 95% of the copper in the blood is bound to ceruloplasmin. Because of this, the ceruloplasmin test can be used along with one or more copper tests to help diagnose Wilson disease, an inherited disorder that can lead to excess storage of copper in the liver, brain, and other organs.

TAT: Daily

Pre-Test Information:

• 8 hours fasting is mandatory
• Minimum 12 hours fasting is mandatory

Test Type: Serum

Test Description:

• Why Get Tested?
• To determine your risk of developing heart disease
• When To Get Tested?
• Screening: as part of a regular health exam with a lipid profile when no risk factors for heart disease are present; once every four to six years in adults; children should have a lipid profile screening at least once between the ages of 9 and 11 and then again between the ages of 17 and 21.
• Monitoring: may be done more frequently and at regular intervals as part of a lipid profile when risk factors for heart disease are present, when prior results showed high risk levels, and/or when undergoing treatment for unhealthy lipid levels
• Test Preparation Needed?
• If this test is to be performed as part of a complete lipid profile, fasting for 9 to 12 hours typically will be required; only water is permitted. Your healthcare practitioner may decide that you may be tested without fasting. Follow any instructions you are given and tell the person drawing your blood whether or not you have fasted. For youths without risk factors, testing may be done without fasting.
• What is being tested?
• High-density lipoprotein (HDL cholesterol, HDL-C) is one of the classes of lipoproteins that carry cholesterol in the blood. HDL-C consists primarily of protein with a small amount of cholesterol. It is considered to be beneficial because it removes excess cholesterol from tissues and carries it to the liver for disposal. Hence, HDL cholesterol is often termed "good" cholesterol. The test for HDL cholesterol measures the amount of HDL-C in blood.
• High levels of cholesterol have been shown to be associated with the development of hardening of the arteries (atherosclerosis) and heart disease. When cholesterol levels in the blood increase (not enough is removed by HDL), it may be deposited on the walls of blood vessels. These deposits, termed plaques, can build up, causing vessel walls to become more rigid, and may eventually narrow the openings of blood vessels, constricting the flow of blood.
• A higher level of blood HDL-C is usually associated with a lower risk of developing plaques, lowering the risk of heart attack or stroke.

TAT: Daily

Pre-Test Information:

• Minimum 12 hours fasting is mandatory

Test Type: Serum

Test Description:

• Why Get Tested?
• To determine your risk of developing heart disease; to monitor effectiveness of lipid-lowering therapy
• When To Get Tested?
• Screening: as part of a health exam with a lipid profile; every four to six years in adults with no risk factors for heart disease; youth should be tested at least once between the ages of 9 and 11 and once again between the ages of 17 and 21
• Monitoring: may be done more frequently and at regular intervals when risk factors for heart disease are present, when prior results showed high risk levels, and/or when undergoing treatment for unhealthy lipid levels
• Test Preparation Needed?
• Laboratory tests for LDL-C typically require a 9 to 12-hour fast; only water is permitted. Your healthcare practitioner may decide that you may be tested without fasting. Follow any instructions you are given and tell the person drawing your blood whether or not you have fasted. For youths without risk factors, testing may be done without fasting.
• What is being tested?
• Low-density lipoprotein (LDL cholesterol, LDL-C) is one type of lipoprotein that carries cholesterol in the blood. LDL-C consists mostly of cholesterol and similar substances with a small amount of protein. Most often, this test involves using a formula to calculate the amount of LDL-C in blood based on results of a lipid profile. Occasionally, LDL-C is measured directly.
• Monitoring and maintaining healthy levels of lipids is important for staying healthy. Eating too much of foods that are high in saturated fats and trans unsaturated fats (trans fats) or having an inherited predisposition can result in a high level of cholesterol in the blood. The extra cholesterol may be deposited in plaques on the walls of blood vessels. Plaques can narrow or eventually block the opening of blood vessels, leading to hardening of the arteries (atherosclerosis) and increased risk of numerous health problems, including heart disease and stroke.
• LDL-C is considered to be undesirable and is often called "bad" cholesterol because it deposits excess cholesterol in blood vessel walls and contributes to hardening of the arteries and heart disease. This is in contrast to high-density lipoproteins (HDL) that tend to transport cholesterol from the arteries to the liver. HDL is thought to protect against heart disease and so it is often called "good" cholesterol.
• The LDL-C test can help determine an individual's risk of heart disease and help guide decisions about what treatment may be best if the person is at borderline or high risk. The results are considered along with other known risk factors of heart disease to develop a plan of treatment and follow up. Treatment options may involve lifestyle changes such as diet and exercise or lipid-lowering medications such as statins.
• The results of a standard lipid profile, which consists of total cholesterol, HDL-C, and triglycerides, are usually used to calculate the amount of LDL-C in the blood. The results are entered into a formula that calculates the amount of cholesterol present in LDL (see below). In most cases, the formula provides a good estimate of the LDL-C, but it becomes less accurate with increased triglyceride levels when, for example, a person has not fasted before having blood drawn. In this situation, the only way to accurately determine LDL-C is to measure it directly. Direct measurement of LDL-C is less affected by triglycerides and can be used when an individual is not fasting or has significantly elevated triglycerides (above 400 mg/dL).

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help assess the risk of developing heart disease
• When To Get Tested?
• As part of a lipid profile during a regular medical exam (at least once every 4-6 years for adults; for children, at least once between the ages of 9 and 11 and again between the ages of 17 and 21); more frequently if you have risk factors for heart disease
• Test Preparation Needed?
• Current standards recommend that testing be done when you are fasting. For 9 to 12 hours before the test, only water is permitted. In addition, alcohol should not be consumed for 24 hours just before the test. Your healthcare practitioner may decide that you may be tested without fasting. Follow any instructions you are given and tell the person drawing your blood whether or not you have fasted.
• What is being tested?
• Very low-density lipoprotein (VLDL, VLDL-C) is one of the four major lipoprotein particles. The other three are high-density lipoprotein (HDL), low-density lipoprotein (LDL), and chylomicrons. Each particle contains a mixture of cholesterol, triglyceride, and protein, but in varying amounts unique to each type of particle. LDL contains the highest amount of cholesterol. HDL contains the highest amount of protein. VLDL and chylomicrons contain the highest amount of triglyceride.
• VLDL particles are released into the blood by the liver and circulate in the bloodstream, ultimately being converted into LDL as they lose triglyceride, having carried it to other parts of the body. According to the National Heart, Lung and Blood Institute's National Cholesterol Education Program Guidelines ATP III, there is growing evidence that VLDL plays an important role in atherogenesis, in which plaques form on the interior walls of arteries, narrowing these passageways and restricting blood flow, which can lead to heart disease and increase the risk of stroke.
• Currently, direct measurement of VLDL cholesterol requires specialized testing. However, since VLDL-C contains most of the circulating triglyceride (if a person is fasting) and since the composition of the different particles is relatively constant, it is possible to estimate the amount of VLDL-C based on the triglyceride value. To estimate VLDL-C, divide the triglyceride value by 5 if the value is in mg/dL or divide by 2.2 if the value is in mmol/L. In most cases, this formula provides a good estimate of VLDL-C.
• However, this formula becomes less accurate with increased triglyceride levels when, for example, a person has not fasted before having blood drawn. The calculation is not valid when the triglyceride level is greater than 400 mg/dl (4.5 mmol/L) because other lipoproteins are usually present. In this situation, VLDL-C may be measured directly using specialized testing.

TAT: Tue, Sat: 1 pm

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To determine if you have been exposed to and/or poisoned by certain organophosphate chemicals found in pesticides; to monitor cholinesterase levels if you work with pesticides
• Sometimes to identify individuals with inherited pseudocholinesterase deficiency before they are given anesthesia with the muscle relaxant succinylcholine or to help determine the cause of prolonged apnea after surgical anesthesia
• When To Get Tested?
• When you have symptoms of pesticide poisoning or on a regular basis when you are at risk of exposure to organophosphates, such as through work in the agriculture industry and/or frequent use of
• organophosphate insecticides
• When you or a close relative have experienced prolonged apnea and muscle paralysis after use of the drug succinylcholine for a surgical operation
• What is being tested?
• Cholinesterases are enzymes that are involved in helping the nervous system to function properly. There are two separate cholinesterase enzymes in the body: (1) acetylcholinesterase, found in red blood cells as well as in the lungs, spleen, nerve endings, and the gray matter of the brain, and (2) pseudocholinesterase (butyrylcholinesterase), found in the serum as well as the liver, muscle, pancreas, heart, and white matter of the brain. Cholinesterase tests measure the activity of these enzymes.
• Acetylcholinesterase is involved in transmission of nerve impulses by breaking down acetylcholine, a chemical that helps to transmit signals across nerve endings. A decrease in the activity of the enzyme acetylcholinesterase results in excess acetylcholine at nerve endings. This can lead to overstimulation of nerves within body tissues and organs. Pseudochlinesterase is involved in processing and metabolizing drugs.
• The two most common reasons for testing activity levels in the blood are:
• Organophosphate pesticide exposure. Insecticides containing organophosphates can inhibit cholinesterase and pseudocholinesterase activity. Symptoms can be severe with acute exposure to these pesticides or can gradually appear with chronic exposure. Absorption can occur by inhalation, ingestion, or contact with the skin. Testing red blood cell acetylcholinesterase and serum pseudocholinesterase may be done to detect acute poisoning or to monitor those with occupational exposure to these chemicals, such as farm workers or those who work with industrial chemicals.
• Inherited pseudocholinesterase deficiency. Some individuals have an inherited deficiency due to a genetic variant of the enzyme pseudocholinesterase. This enzyme is used by the body to inactivate (metabolize) succinylcholine, a muscle relaxant that is commonly used during surgery. People who have low levels or defective pseudocholinesterase may experience prolonged effects of the drug, with protracted muscle paralysis and apnea following anesthesia. In addition, those who are homozygous for genetic variants may be at greater risk of adverse effects than those who are heterozygous. Pseudocholinesterase testing can be performed prior to surgery on those with a family history of prolonged apnea after use of succinylcholine to determine if they are at risk of complications related to this drug.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help diagnose Cushing syndrome or primary or secondary adrenal insufficiency (Addison disease); to detect conditions affecting the pituitary or adrenal glands
• When To Get Tested?
• When your healthcare provider suspects excess or deficient cortisol production
• Test Preparation Needed?
• You may be required to rest before sample collection. For a salivary cortisol test, you may be instructed to refrain from eating, drinking, or brushing your teeth for a period of time (may be some time between 15 to 30 minutes) prior to the test. Follow any instructions you are given.
• What is being tested?
• Cortisol is a hormone that plays a role in the metabolism of proteins, lipids, and carbohydrates. It affects blood glucose levels, helps maintain blood pressure, and helps regulate the immune system. Most cortisol in the blood is bound to a protein; only a small percentage is "free" and biologically active. Free cortisol is secreted into the urine and is present in the saliva. This test measures the amount of cortisol in the blood, urine, or saliva.
• The level of cortisol in the blood (as well as the urine and saliva) normally rises and falls in a "diurnal variation" pattern. It peaks early in the morning, then declines throughout the day, reaching its lowest level about midnight. This pattern can change when a person works irregular shifts (such as the night shift) and sleeps at different times of the day, and it can become disrupted when a disease or condition either limits or stimulates cortisol production.
• Cortisol is produced and secreted by the adrenal glands, two triangular organs that sit on top of the kidneys. Production of the hormone is regulated by the hypothalamus in the brain and by the pituitary gland, a tiny organ located below the brain. When the blood cortisol level falls, the hypothalamus releases corticotropin-releasing hormone (CRH), which directs the pituitary gland to produce ACTH (adrenocorticotropic hormone). ACTH stimulates the adrenal glands to produce and release cortisol. In order for appropriate amounts of cortisol to be made, the hypothalamus, the pituitary, and the adrenal glands must be functioning properly.
• The group of signs and symptoms that are seen with an abnormally high level of cortisol is called Cushing syndrome. Increased cortisol production may be seen with:
• Administration of large amounts of glucocorticosteroid hormones (such as prednisone, prednisolone, or dexamethasone) to treat a variety of conditions, such as autoimmune disease and some tumors
• ACTH-producing tumors, in the pituitary gland and/or in other parts of the body
• Increased cortisol production by the adrenal glands, due to a tumor or due to excessive growth of adrenal tissues (hyperplasia)
• Rarely, with tumors in various parts of the body that produce CRH
• Decreased cortisol production may be seen with:
• An underactive pituitary gland or a pituitary gland tumor that inhibits ACTH production; this is known as secondary adrenal insufficiency.
• Underactive or damaged adrenal glands (adrenal insufficiency) that limit cortisol production; this is referred to as primary adrenal insufficiency and is also known as Addison disease.
• After stopping treatment with glucocorticosteroid hormones, especially if stopped very quickly after a long period of use

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To identify the presence of inflammation and to monitor response to treatment for an inflammatory disorder
• When To Get Tested?
• When your healthcare provider suspects that you have an acute condition causing inflammation, such as a serious bacterial or fungal infection or when you are suffering from an inflammatory disorder such as arthritis, an autoimmune disorder, or inflammatory bowel disease
• What is being tested?
• C-reactive protein (CRP) is a protein made by the liver. CRP levels in the blood increase when there is a condition causing inflammation somewhere in the body. A CRP test measures the amount of CRP in the blood to detect inflammation due to acute conditions or to monitor the severity of disease in chronic conditions.
• CRP is a non-specific indicator of inflammation and one of the most sensitive acute phase reactants. That means that it is released into the blood within a few hours after an injury, the start of an infection, or other cause of inflammation. Markedly increased levels can occur, for example, after trauma or a heart attack, with active or untreated autoimmune disorders, and with serious bacterial infections, such as in sepsis. The level of CRP can jump as much as a thousand-fold in response to bacterial infection, and its rise in the blood can precede pain, fever, or other signs and symptoms.
• The CRP test is not diagnostic, but it provides information to your healthcare practitioner as to whether inflammation is present, without identifying the source of the inflammation. This information can be used in conjunction with other factors such as signs and symptoms, physical exam, and other tests to determine if you have an acute inflammatory condition or are experiencing a flare-up of a chronic inflammatory disease. Your healthcare practitioner may then follow up with further testing and treatment.
• This standard CRP test is not to be confused with an hs-CRP test. These are two different tests that measure CRP and each test measures a different range of CRP level in the blood for different purposes:
• The standard CRP test measures high levels of the protein observed in diseases that cause significant inflammation. It measures CRP in the range from 8 to 1000 mg/L (or 0.8 to 100 mg/dL).
• The hs-CRP test precisely detects lower levels of the protein than that measured by the standard CRP test and is used to evaluate individuals for risk of cardiovascular disease. It measures CRP in the range from 0.3 to 10 mg/L. (See the article on hs-CRP.)

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To distinguish between skeletal muscle and heart muscle damage; sometimes to determine if you have had a heart attack (if the troponin test is not available); sometimes to detect a second or subsequent heart attack or to monitor for additional heart damage
• When To Get Tested?
• When you have an increased creatine kinase (CK) level and the healthcare practitioner wants to determine whether it is due to skeletal or heart muscle damage; when it is suspected that you have had a second heart attack or have ongoing heart damage
• What is being tested?
• Creatine kinase-MB (CK-MB) is a form of an enzyme found primarily in heart muscle cells. This test measures CK-MB in the blood.
• CK-MB is one of three forms (isoenzymes) of the enzyme creatine kinase (CK). These isoenzymes include:
• CK-MM (found in skeletal muscles and the heart)
• CK-MB (found mostly in the heart, but small amounts found in skeletal muscles)
• CK-BB (found mostly in the brain and smooth muscle, such as the intestines and uterus)
• CK is released from muscle cells and is detectable in the blood whenever there is muscle damage. The small amount of CK that is normally in the blood is primarily CK-MM. CK-BB almost never gets into the blood, and CK-MB will typically only be present in significant amounts when the heart is damaged. A CK test measures the total level but does not distinguish between the three isoenzymes. When there is an increased amount of CK present in the blood, the CK-MB test can be used to determine whether it is due to heart damage or is more likely to be related to skeletal muscle injury.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To evaluate the health of your kidneys; to help diagnose kidney disease; to monitor treatment for kidney disease
• When To Get Tested?
• Routinely as part of a comprehensive metabolic panel (CMP) or basic metabolic panel (BMP) when you have a health exam; when your have signs and symptoms that may be due to kidney disease or damage or when you have a condition that may affect your kidneys and/or be worsened by kidney dysfunction; at intervals to monitor treatment for kidney disease or kidney function while on certain medications
• Test Preparation Needed?
• You may be instructed to fast overnight or refrain from eating cooked meat; some studies have shown that eating cooked meat prior to testing can temporarily increase the level of creatinine. If a 24-hour urine sample is being collected, it is important to save all the urine produced during that time period.
• What is being tested?
• Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is removed from the body by the kidneys, which filter almost all of it from the blood and release it into the urine. This test measures the amount of creatinine in the blood and/or urine.
• Creatine is part of the cycle that produces energy needed to contract muscles. Both creatine and creatinine are produced by the body at a relatively constant rate. Since almost all creatinine is filtered from the blood by the kidneys and released into the urine, blood levels are usually a good indicator of how well the kidneys are working. The amount of creatinine you produce depends on your body size and your muscle mass. For this reason, creatinine levels are usually slightly higher in men than in women and children.
• The kidneys are a pair of bean-shaped organs that are located at the bottom of the ribcage in the right and left sides of the back. Within them are about a million tiny blood filtering units called nephrons. In each nephron, blood is continually filtered through a microscopic cluster of looping blood vessels, called glomerulus. The glomerulus allows the passage of water and small molecules but retains blood cells and larger molecules. Attached to each glomerulus is a tiny tube (tubule) that collects the fluid and molecules that pass through the glomerulus and then reabsorbs what still can be used by the body. The remaining waste forms urine.
• Results from a blood creatinine test may be used in combination with results from other tests, such as a 24-hour urine creatinine test, to calculate values that are used to evaluate kidney function.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To detect and monitor muscle damage; to help diagnose conditions associated with muscle damage; for heart attack detection, this test has been largely replaced by troponin T and I – markers more specific to cardiac tissue; however, it may sometimes be used to help detect a second or subsequent heart attack.
• When To Get Tested?
• When you have muscle weakness, muscle aches, and/or dark urine and your healthcare practitioner suspects muscle damage; sometimes to monitor for muscle injury resolution or persistence
• What is being tested?
• Creatine kinase (CK) is an enzyme found in the heart, brain, skeletal muscle, and other tissues. Increased amounts of CK are released into the blood when there is muscle damage. This test measures the amount of creatine kinase in the blood.
• The small amount of CK that is normally in the blood comes primarily from skeletal muscles. Any condition that causes muscle damage and/or interferes with muscle energy production or use can cause an increase in CK. For example, strenuous exercise and inflammation of muscles, called myositis, can increase CK as can muscle diseases (myopathies) such as muscular dystrophy. Rhabdomyolysis, an extreme breakdown of skeletal muscle tissue, is associated with significantly elevated levels of CK.

TAT: Daily

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help assess your risk of developing cardiovascular disease
• When To Get Tested?
• No current consensus exists on when to get tested; hs-CRP is often ordered in conjunction with other tests that are performed to assess risk of heart disease, such as a lipid panel (cholesterol, triglycerides, HDL-C, LDL-C) when your healthcare provider would like additional information on your risk.
• Test Preparation Needed?
• No test preparation is needed; however, you may be instructed to fast for 9-12 hours before the blood sample is taken if a lipid panel also is going to be done at the same time. You should be healthy at the time of the sample collection, without any recent illnesses, infections, inflammation, or injuries.
• What is being tested?
• C-reactive protein (CRP) is a protein that increases in the blood with inflammation and infection as well as following a heart attack, surgery, or trauma. Studies have suggested that a persistent low level of inflammation plays a major role in atherosclerosis, the narrowing of blood vessels due to build-up of cholesterol and other lipids, which is often associated with cardiovascular disease (CVD). The hs-CRP test accurately measures low levels of CRP to identify low but persistent levels of inflammation and thus helps predict a person's risk of developing CVD.
• There are two different tests that measure CRP and each test measures a different range of CRP level in the blood for different purposes:
• The standard CRP test measures markedly high levels of the protein to detect diseases that cause significant inflammation. It measures CRP in the range from 10 to 1000 mg/L. This test may be used to detect inflammation (see the article C-Reactive Protein).
• The hs-CRP test accurately detects lower levels of the protein than the standard CRP test. It measures CRP in the range from 0.5 to 10 mg/L. This test is used to evaluate individuals for risk of CVD.
• CVD causes more deaths in the U.S. each year than any other cause, according to the American Heart Association. A number of risk factors, such as family history, high cholesterol, high blood pressure, being overweight or diabetic, have been linked to the development of CVD, but a significant number of people who have few or no identified risk factors will also develop CVD. This fact has lead researchers to look for additional risk factors that might be either causing CVD or that could be used to determine lifestyle changes and/or treatments that could reduce a person's risk.
• High-sensitivity CRP is one of a growing number of cardiac risk markers that are used to help determine a person's risk. Some studies have shown that measuring CRP with a highly sensitive assay can help identify the risk level for CVD in apparently healthy people. This more sensitive test can measure CRP levels that are within the higher end of the reference range. These normal but slightly high levels of CRP in otherwise healthy individuals can predict the future risk of a heart attack, stroke, sudden cardiac death, and peripheral arterial disease, even when cholesterol levels are within an acceptable range.
• hs-CRP could be a marker not only in apparently healthy people, recent studies have shown. Adults with congenital heart disease (ACHD) with elevated CRP have worse functional status and exercise capacity, greater risk for death, or non-elective cardiovascular hospitalization.

TAT: Daily