Find test for Pragathi Healthcare

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: Same Day

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: Same Day

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?
• 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: Same Day

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: Same Day

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: Same Day

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: Same Day

Pre-Test Information:

• Minimum 12 hours fasting is mandatory

Test Type: Serum

Test Description:

• Why Get Tested?
• To determine your body's total iron storage capacity; to help diagnose iron deficiency or iron overload
• When To Get Tested?
• When you have low hemoglobin and hematocrit on a complete blood count (CBC); when your healthcare practitioner suspects that you may have too little iron (iron deficiency) or too much iron (iron overload) in the body
• Test Preparation Needed?
• You may be instructed to have your blood drawn in the morning and/or fast for 12 hours before the test; in this case, only water is permitted. Follow any instructions from your healthcare practitioner and/or from the laboratory performing the test.
• What is being tested?
• Ferritin is a protein that contains iron and is the primary form of iron stored inside of cells. The small amount of ferritin that is released and circulates in the blood is a reflection of the total amount of iron stored in the body. This test measures the amount of ferritin in the blood.
• Iron is an essential trace element and nutrient that, among other functions, is necessary for the production of healthy red blood cells (RBCs). The body cannot produce iron and must absorb it from the foods we eat or from supplements.
• In healthy people, most of the iron absorbed by the body is incorporated into the hemoglobin of red blood cells. Most of the remaining is stored as ferritin or as hemosiderin, with additional small amounts used to produce other proteins such as myoglobin and some enzymes. Ferritin and hemosiderin are present primarily in the liver but also in the bone marrow, spleen, and skeletal muscles.
• When the level of iron is insufficient to meet the body's needs, the level of iron in the blood drops, iron stores are depleted and ferritin levels decrease. This may occur because:
• Not enough iron is consumed (either foods or supplements)
• The body is unable to absorb iron from the foods eaten in conditions such as celiac disease
• There is an increased need for iron such as during pregnancy or childhood, or due to a condition that causes chronic blood loss (e.g., peptic ulcer, colon cancer).
• Insufficient levels of circulating and stored iron may eventually lead to iron deficiency anemia (decreased hemoglobin). In the early stage of iron deficiency, no physical effects are usually seen and the amount of iron stored may be significantly depleted before any signs or symptoms of iron deficiency develop. If a person is otherwise healthy and anemia develops over a long period of time, symptoms seldom appear before the hemoglobin in the blood drops below the lower limit of normal.
• However, as the iron-deficiency progresses, symptoms eventually begin to appear. The most common symptoms of iron deficiency anemia include fatigue, weakness, dizziness, headaches and pale skin.
• Conversely, iron storage and ferritin levels increase when more iron is absorbed than the body needs. Absorbing too much iron over time can lead to the progressive buildup of iron compounds in organs and may eventually cause their dysfunction and failure. An example of this is hemochromatosis, a rare genetic disease in which the body absorbs too much iron, even on a normal diet. Additionally, iron overload can occur when a person undergoes repeated blood transfusions.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To evaluate fertility issues, the health of your reproductive organs (ovaries or testicles), or pituitary function
• In children, to evaluate early or delayed puberty
• When To Get Tested?
• For women, when you are having difficulty getting pregnant or are having irregular or no menstrual periods
• For men, when your partner cannot get pregnant, or you have a low sperm count, low muscle mass or decreased sex drive
• When your healthcare practitioner thinks that you have symptoms of a pituitary disorder or hypothalamic disorder
• When a healthcare practitioner suspects that a child has delayed or earlier than expected puberty
• Test Preparation Needed?
• No test preparation is needed, but a woman's sample should be collected at specific times during her menstrual cycle.
• What is being tested?
• Follicle-stimulating hormone (FSH) is a hormone associated with reproduction and the development of eggs in women and sperm in men. This test measures FSH in the blood.
• FSH is made by the pituitary gland, a small organ located in the center of the head behind the sinus cavity at the base of the brain. Control of FSH production is a complex system involving the hypothalamus in the brain, the pituitary gland, and the hormones produced by the ovaries or testicles. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to release FSH and luteinizing hormone (LH), a closely related hormone also involved in reproduction.
• In women of childbearing age, FSH stimulates the growth and maturation of eggs (follicles) in the ovaries during the follicular phase of the menstrual cycle. The menstrual cycle is divided into the follicular and the luteal phases, with each phase lasting about 14 days. During this follicular phase, FSH initiates the production of estradiol by the follicle, and the two hormones work together in the further development of the egg follicle. Near the end of the follicular phase, there is a surge of FSH and luteinizing hormone. Release of the egg from the ovary (ovulation) occurs shortly after this surge of hormones. The hormone inhibin as well as estradiol and progesterone help control the amount of FSH released by the pituitary gland. FSH also facilitates the ability of the ovary to respond to LH.
• As a woman ages and menopause approaches, ovarian function wanes and eventually ceases. As this occurs, FSH and LH levels rise.
• In men, FSH stimulates the testicles to produce mature sperm and also promotes the production of androgen binding proteins. FSH levels are relatively constant in men after puberty. Less is known about FSH levels in aging men.
• In infants and children, FSH levels rise shortly after birth and then fall to very low levels by 6 months in boys and 1-2 years in girls. Concentrations begin to rise again before the beginning of puberty and the development of secondary sexual characteristics.
• Disorders affecting the hypothalamus, pituitary, and/or the ovaries or testicles can cause the production of too much or too little FSH, resulting in a variety of conditions such as infertility, abnormal menstrual cycles, or early (precocious) or delayed puberty.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help monitor your blood glucose (sugar) levels over time if you have diabetes, especially if it is not possible to monitor your diabetes using the hemoglobin A1c test; to help determine the effectiveness of changes to your diabetic treatment plan that might include changes in diet, exercise or medications, especially if they were made recently
• When To Get Tested?
• When you have diabetes and your healthcare practitioner wants to evaluate your average blood glucose level over the last 2-3 weeks
• What is being tested?
• Fructosamine is a compound that is formed when glucose combines with protein. This test measures the total amount of fructosamine (glycated protein) in the blood.
• Glucose molecules will permanently combine with proteins in the blood in a process called glycation. These proteins include albumin, the principal protein in the fluid portion of blood (serum), as well as other serum proteins and hemoglobin, the major protein found inside red blood cells (RBCs). The more glucose that is present in the blood, the greater the amount of glycated proteins that are formed. These combined molecules persist for as long as the protein or RBC is present in the blood and provide a record of the average amount of glucose that has been present in the blood over that time period.
• Since the lifespan of RBCs is about 120 days, glycated hemoglobin (hemoglobin A1c) represents a measurement of the average blood glucose level over the past 2 to 3 months. Serum proteins are present in the blood for a shorter time, about 14 to 21 days, so glycated proteins, and the fructosamine test, reflect average glucose levels over 2 to 3 weeks.
• Keeping blood glucose levels as close as possible to normal helps individuals with diabetes to avoid many of the complications and progressive damage associated with elevated glucose levels. Good diabetic control is achieved and maintained by daily (or even more frequent) self-monitoring of glucose levels in people treated with insulin and by occasional monitoring of the effectiveness of treatment using the A1c test or the fructosamine test.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To evaluate for a possible liver disease or bile duct disease or to differentiate between liver and bone disease as a cause of elevated alkaline phosphatase (ALP); sometimes to screen for or monitor alcohol abuse
• When To Get Tested?
• When you have symptoms of a liver or bile duct disorder or as follow up when you have an increased ALP level
• Test Preparation Needed?
• GGT levels fall after meals; you may be instructed to fast (nothing to eat or drink except water) for at least 8 hours prior to the test. You may also be asked to stop drinking alcohol or taking certain prescription medications.
• What is being tested?
• Gamma-glutamyl transferase (GGT) is an enzyme that is found in many organs throughout the body, with the highest concentrations found in the liver. GGT is elevated in the blood in most diseases that cause damage to the liver or bile ducts. This test measures the level of GGT in a blood sample.
• Normally, GGT is present in low levels, but when the liver is injured, the GGT level can rise. GGT is usually the first liver enzyme to rise in the blood when any of the bile ducts that carry bile from the liver to the intestines become obstructed, for example, by tumors or stones. This makes it the most sensitive liver enzyme test for detecting bile duct problems.
• However, the GGT test is not very specific and is not useful in differentiating between various causes of liver damage because it can be elevated with many types of liver diseases, such as liver cancer and viral hepatitis, as well as other non-hepatic conditions, such as acute coronary syndrome. For this reason, the GGT test is not recommended for routine use by itself. However, it can be useful in conjunction with other tests and in determining the cause of a high alkaline phosphatase (ALP) level, another enzyme found in the liver.
• Both GGT and ALP are increased in liver diseases, but only ALP will be increased with diseases affecting bone tissue. Therefore, GGT can be used as a follow up to an elevated ALP to help determine if the high ALP result is due to liver or bone disease.
• GGT levels are sometimes increased with consumption of even small amounts of alcohol. Higher levels are found more commonly in chronic heavy drinkers than in people who consume less than 2 to 3 drinks per day or who only drink heavily on occasion (binge drinkers). The GGT test may be used in evaluating someone for acute or chronic alcohol abuse.

TAT: Same Day

Pre-Test Information:

• Minimum 12 hours fasting is mandatory

Test Type: Blood

Test Description:

• Why Get Tested?
• To help determine whether you are at an increased risk of developing diabetes; to help diagnose diabetes and prediabetes; to monitor diabetes and to aid in treatment decisions
• When To Get Tested?
• As part of a health checkup or when you have risk factors for or symptoms of diabetes; after first diagnosis with diabetes, every 3-4 months or about 120 days to ensure that your glycemic goals are met and/or maintained or when your therapy plan has changed
• What is being tested?
• Hemoglobin A1c, also called A1c or glycated hemoglobin, is hemoglobin with glucose attached. The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months by measuring the percentage of glycated hemoglobin in the blood.
• Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). There are several types of normal hemoglobin, but the predominant form – about 95-96% – is hemoglobin A. As glucose circulates in the blood, some of it spontaneously binds to hemoglobin A.
• The higher the level of glucose in the blood, the more glycated hemoglobin is formed. Once the glucose binds to the hemoglobin, it remains there for the life of the red blood cell – normally about 120 days. The predominant form of glycated hemoglobin is referred to as A1c. A1c is produced on a daily basis and slowly cleared from the blood as older RBCs die and younger RBCs (with non-glycated hemoglobin) take their place.
• An A1c test may be used to screen for and diagnose diabetes or risk of developing diabetes. Standards of medical care in diabetes from the American Diabetes Association (ADA) state that diabetes may be diagnosed based on A1c criteria or blood glucose criteria (e.g., the fasting blood glucose (FBG) or the 2-hour glucose tolerance test).
• A1c is also used to monitor treatment for individuals diagnosed with diabetes. It helps to evaluate how well your glucose levels have been controlled by treatment over time. For monitoring purposes, an A1c of less than 7% indicates good glucose control and a lower risk of diabetic complications for the majority of people with diabetes.
• However, the ADA and the European Association for the Study of Diabetes (EASD) recommend that the management of glucose control in people with type 2 diabetes be more "patient-centered." It is recommend that people work closely with their healthcare practitioner to select a goal that reflects each person's individual health status and that balances risks and benefits.

TAT: Same Day

Pre-Test Information:

• Minimum 12 hours fasting is mandatory

Test Type: Serum

Test Description:

• Why Get Tested?
• Along with other iron tests, to determine your blood iron level; along with other tests, to help diagnose iron-deficiency anemia or iron overload
• When To Get Tested?
• When you have low hemoglobin and hematocrit on a complete blood count (CBC); when your healthcare practitioner suspects that you may have too little iron (deficiency) or too much iron (overload) in your body
• Test Preparation Needed?
• You may be instructed to have your blood drawn in the morning and/or fast for 12 hours before sample collection; in this case, only water is permitted. Follow any instructions from your healthcare practitioner and/or from the laboratory performing the test.
• What is being tested?
• Iron is an essential nutrient that, among other functions, is required for the production of healthy red blood cells (RBCs). It is a critical part of hemoglobin, the protein in RBCs that binds oxygen in the lungs and releases it as blood circulates to other parts of the body. The serum iron test measures the amount of iron in the liquid portion of blood.
• Serum iron is almost always measured with other iron tests, such as serum ferritin, transferrin and total iron-binding capacity (TIBC). These tests are often ordered at the same time and the results interpreted together to help diagnose and/or monitor iron deficiency or iron overload.
• The body cannot produce iron and must absorb it from the foods we eat or from supplements. Once absorbed, it is transported throughout the body by binding to transferrin, a protein produced by the liver.
• In healthy people, most of the iron absorbed is incorporated into the hemoglobin inside RBCs. The remainder is stored in the tissues as ferritin or hemosiderin, with additional small amounts used to produce other proteins such as myoglobin and some enzymes.
• When the level of iron is insufficient to meet the body's needs, the iron level in the blood drops and iron stores are depleted. This may occur because:
• Not enough iron is consumed (either foods or supplements)
• The body is unable to absorb iron from the foods eaten in conditions such as celiac disease
• There is an increased need for iron, such as during pregnancy or childhood, or due to a condition that causes chronic blood loss (e.g., peptic ulcer, colon cancer)
• Insufficient levels of circulating and stored iron may eventually lead to iron deficiency anemia (decreased hemoglobin). In the early stage of iron deficiency, no physical effects are usually seen and the amount of iron stored may be significantly depleted before any signs or symptoms of iron deficiency develop. If a person is otherwise healthy and anemia develops over a long period of time, symptoms seldom appear before the hemoglobin in the blood drops below the lower limit of normal.
• However, as the iron-deficiency progresses, symptoms eventually begin to develop. The most common symptoms of anemia include fatigue, weakness, dizziness, headaches and pale skin. (Read the article on Anemia to learn more.)
• On the other hand, too much iron can be toxic to the body. Iron blood levels and iron storage increase when more iron is absorbed than the body needs. Absorbing too much iron can lead to progressive accumulation and damage to organs such as the liver, heart, and pancreas. An example of this is hemochromatosis, a genetic disease in which the body absorbs too much iron, even on a normal diet. Additionally, iron overdose can occur when someone consumes more than the recommended amount of iron.

TAT: Same Day

Pre-Test Information:

• Minimum 12 hours fasting is mandatory

Test Type: Serum

Test Description:

• Why Get Tested?
• To give your healthcare practitioner additional information about your risk of developing heart disease; as part of a cardiac risk assessment
• When To Get Tested?
• When you have a family history of heart disease at a young age; when you have heart disease or have had a heart attack or stroke but your lipid panel results are normal or show only mildly elevated cholesterol and/or low-density lipoprotein cholesterol (LDL-C)
• Test Preparation Needed?
• Lipoprotein (a) does not require test preparation. However, Lp(a) is often performed at the same time as a lipid panel and fasting for 9-12 hours may be required for the lipid panel. In this case, only water is permitted.
• What is being tested?
• Lipoprotein (a) or Lp(a) is one type of lipoprotein that carries cholesterol in the blood. It consists of a low-density lipoprotein (LDL) molecule with another protein (Apolipoprotein (a)) attached to it. This test measures the Lp(a) level in the blood to help evaluate your risk of developing cardiovascular disease (CVD).
• Like LDL cholesterol (the "bad" cholesterol), Lp(a) is considered a risk factor for CVD. However, Lp(a) does not respond to typical strategies to lower LDL cholesterol such as diet, exercise, or most lipid-lowering medications, such as statins. The amount of Lp(a) that you have is determined by the genes you inherited, and it remains relatively constant over your lifetime. A high level of Lp(a) is thought to contribute to your overall risk of CVD, making this test potentially useful as a cardiovascular risk marker.
• The protein portion of Lp(a) consists of:
• Apolipoprotein B (Apo B) – a protein that is involved in the breakdown (metabolism) of lipids and is the main protein constituent of lipoproteins such as LDL and very low-density lipoprotein (VLDL)
• Apolipoprotein (a) – a second protein component, which is attached to the Apo B. Apolipoprotein (a) has an unusual structure and is thought to inhibit clots from being broken down normally. The size of the apolipoprotein(a) portion of Lp(a) varies in size from person to person and tends to be smaller in Caucasians than in those of African ancestry. The significance of the variation in size in contributing to CVD risk is complex, but there is some evidence that smaller size increases risk. Most Lp(a) tests do not measure the size of apolipoprotein (a) because they measure and report only the level of Lp(a) in blood.
• Since about 50% of the people who have heart attacks have a normal cholesterol level, researchers have sought other factors that may have an influence on heart disease. It is thought that Lp(a) may be one such factor. Lp(a) has two potential ways to contribute to heart risk:
• Lp(a) can promote deposits of LDL cholesterol in blood vessel walls and the formation of plaque 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.
• Apo(a) has a structure that can inhibit enzymes that dissolve clots, so Lp(a) may promote the formation of clots in the arteries.
• For these reasons, Lp(a) may be more of a risk factor for atherosclerosis than LDL cholesterol.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To evaluate fertility issues or the health of your reproductive organs (ovaries or testicles); for women, to determine whether you have ovulated (released an egg from the ovary); to evaluate pituitary function
• In children, to evaluate early or delayed puberty
• When To Get Tested?
• For women, when you are having difficulty getting pregnant or are having irregular or heavy menstrual periods; when you are tracking ovulation during your menstrual cycle
• For men, when your partner cannot get pregnant or you have a low sperm count, low muscle mass or decreased sex drive
• When your healthcare provider thinks that you have symptoms of a pituitary disorder or hypothalamic disorder
• When a healthcare practitioner suspects that a child has delayed or earlier than expected puberty
• Test Preparation Needed?
• No test preparation is needed, but a woman's sample should be collected at specific times during her menstrual cycle.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help investigate unexplained flow of breast milk (galactorrhea), abnormal nipple discharge, absence of menstrual periods, and/or infertility in women; in men, to help diagnose the cause of decreased libido and/or erectile dysfunction; to detect and monitor a pituitary tumor that produces prolactin (prolactinoma)
• When To Get Tested?
• When you have symptoms of elevated prolactin, such as vision problems and headaches; during a workup for infertility; for follow-up of macroprolactin; when a man has low testosterone; periodically to monitor for recurrence of a pituitary tumor
• Test Preparation Needed?
• None; however, the sample should be collected 3 to 4 hours after waking.
• What is being tested?
• Prolactin is a hormone whose primary role is to promote breast milk production (lactation). It is normally elevated in women during pregnancy and just after childbirth. It is normally low in men and non-pregnant women. This test measures the amount of prolactin in the blood.
• Prolactin is produced by the front portion (anterior) of the pituitary gland, a grape-sized organ found at the base of the brain. The brain chemical dopamine and hormone estrogen control prolactin production and release from the pituitary gland. During pregnancy, the hormones prolactin, estrogen, and progesterone stimulate breast development and milk production. Following childbirth, prolactin helps initiate and maintain the breast milk supply. If a woman does not breastfeed, her prolactin level soon drops back to pre-pregnancy levels. If she does nurse, suckling by the infant plays an important role in the release of prolactin. There is a feedback mechanism between how often the baby nurses and the amount of prolactin released by the pituitary as well as the amount of milk produced.
• A common cause of an abnormally elevated prolactin level is a prolactinoma, a tumor of the pituitary gland that causes excess production of prolactin. Prolactinoma is the most common type of pituitary tumor and is usually benign. They develop more frequently in women but are also found in men. Symptoms can arise both from the unintended effects of excess prolactin, such as milk production in a woman who is not pregnant or nursing and, rarely, in a man (galactorrhea), as well as from the size and location of the tumor.
• If the anterior pituitary gland and/or the tumor enlarge significantly, it can put pressure on the optic nerve, causing headaches and problems with vision. It can also interfere with the other hormones that the pituitary gland produces. In women, prolactinomas can cause infertility and irregularities in menstruation, while in men these tumors can cause a gradual loss in sexual function and libido. Left untreated, prolactinomas may eventually damage the surrounding tissues.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help diagnose thyroid disorders and to monitor treatment of hypothyroidism and hyperthyroidism; sometimes a TSH test is used to screen newborns for congenital hypothyroidism; there is no consensus within the medical community as to whether screening of adults should be done.
• When To Get Tested?
• When you have signs and symptoms of hyperthyroidism or hypothyroidism and/or an enlarged thyroid (goiter) or when you have a thyroid nodule (a small lump on the thyroid gland that may be solid or a fluid-filled cyst); when you are being treated for a thyroid disorder
• Test Preparation Needed?
• No test preparation is needed. However, certain medications, multivitamins and supplements can interfere with the TSH test, so tell your healthcare practitioner about any prescribed or over-the-counter drugs and/or supplements that you are taking. If you take thyroid hormone as treatment for thyroid disease, it is recommended that your blood sample be drawn before you take your dose for that day. Acute illness may affect TSH test results. It is generally recommended that thyroid testing be avoided in hospitalized patients or deferred until after a person has recovered from an acute illness.
• What is being tested?
• Thyroid-stimulating hormone (TSH) is produced by the anterior pituitary gland, a small organ located below the brain and behind the sinus cavities. TSH stimulates the thyroid, a small butterfly-shaped gland located inside the neck in front of the windpipe, by binding to the TSH receptor to release the hormones thyroxine (T4) and triiodothyronine (T3) into the blood. This test measures the amount of TSH in the blood.
• T4 and T3 help control the rate at which the body uses energy. Most of the hormone produced by the thyroid is T4. This hormone is relatively inactive, but it is converted into the much more active T3 in the liver and other tissues.
• TSH, along with its regulatory hormone thyrotropin releasing hormone (TRH), which comes from the hypothalamus, is part of the feedback system that the body uses to maintain stable amounts of thyroid hormones in the blood.
• When thyroid hormone levels decrease in the blood, the pituitary gland produces more TSH in response to TRH stimulation. TSH in turn stimulates the thyroid to produce and release more T4 and T3.
• When thyroid hormone levels increase in the blood, the pituitary gland produces less TSH, and the thyroid produces less T4 and T3.
• When all three organs (hypothalamus, pituitary and thyroid) are functioning normally, thyroid production is regulated to maintain relatively stable levels of thyroid hormones in the blood.
• If the thyroid releases inappropriately large amounts of T4 and T3, the affected person may experience symptoms associated with overactive thyroid (hyperthyroidism), such as rapid heart rate, weight loss, nervousness, hand tremors, irritated eyes, and difficulty sleeping. Graves disease is the most common cause of hyperthyroidism. It is a chronic autoimmune disorder in which the affected person's immune system produces autoantibodies that act like TSH, bind and activate the TSH receptor, leading to the production of excessive amounts of thyroid hormone. In response, the pituitary produces less TSH, usually leading to a low level in the blood.
• If there is decreased production of thyroid hormones by the thyroid (underactive thyroid or hypothyroidism), the person may experience symptoms such as weight gain, dry skin, constipation, cold intolerance, and fatigue. Hashimoto thyroiditis is the most common cause of hypothyroidism in the U.S. It is a chronic autoimmune condition in which the immune response causes inflammation and damage to the thyroid as well as the production of autoantibodies. However, the autoantibodies do not cause the hypothyroidism. The detection of thyroid-related autoantibodies (e.g., thyroperoxidase autoantibodies and/or thyroglobulin autoantibodies) indicate that thyroid autoimmunity is present. These autoantibodies can be detected in Graves disease or Hashimoto thyroiditis. With Hashimoto thyroiditis, the thyroid produces low levels of thyroid hormone. In response, the pituitary normally produces more TSH, usually resulting in a high level in the blood.
• However, the level of TSH alone does not always predict or reflect thyroid hormone levels. Some people with pituitary disease produce an abnormal form of TSH that does not function properly. They often have hypothyroidism despite having normal or even mildly elevated TSH levels.
• Rarely, pituitary dysfunction may result in increased or decreased amounts of TSH. In addition to pituitary dysfunction, hyperthyroidism or hypothyroidism can occur if there is a problem with the hypothalamus (insufficient or excessive TRH).

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help evaluate thyroid gland function; to help diagnose thyroid disease; to monitor effectiveness of thyroid treatment; sometimes a free T4 is used to help diagnose congenital hypothyroidism in newborns
• When To Get Tested?
• When you have signs and symptoms of thyroid disease and/or an enlarged thyroid (goiter) or when you have a thyroid nodule (a small lump on the thyroid gland that may be solid or fluid-filled cyst), usually after an abnormal result on a TSH test; when you are being treated for a thyroid disorder
• Test Preparation Needed?
• None needed; however, certain medications, multivitamins and supplements can interfere with the free T4 test, so tell your healthcare provider about any prescribed or over-the-counter drugs and/or supplements that you are taking. If you take thyroid hormone as treatment for thyroid disease, it is recommended that your blood sample be drawn before you take your dose for that day. Acute illness may affect thyroid testing results. It is generally recommended that thyroid testing be avoided in hospitalized patients or deferred until after a person has recovered from an acute illness.
• What is being tested?
• Thyroxine (T4) is one of two major hormones produced by the thyroid gland, a small butterfly-shaped organ that lies flat across the windpipe at the base of the throat. The other major thyroid hormone is called triiodothyronine (T3) and together they help control the rate at which the body uses energy. Almost all of the T4 (and T3) found in the blood is bound to protein. The rest is free (unbound) and is the biologically active form of the hormone. This test measures the amount of free T4 in the blood.
• Most of the hormone produced by the thyroid is T4. This hormone is relatively inactive, but it is converted into the much more active T3 in the liver and other tissues.
• T4 levels are regulated by the feedback system that the body uses to maintain stable amounts of thyroid hormones in the blood. T3 and thyroid stimulating hormone (TSH), along with its regulatory hormone thyrotropin releasing hormone (TRH), which comes from the hypothalamus, are also part of the feedback system.
• When thyroid hormone levels decrease in the blood, the pituitary gland produces TSH in response to TRH stimulation. TSH in turn stimulates the thyroid by binding to the TSH receptor to produce and release T4 and T3.
• When thyroid hormone levels increase in the blood, the pituitary gland produces less TSH, and the thyroid produces less T4 and T3.
• When all three organs (hypothalamus, pituitary and thyroid) are functioning normally, thyroid production is regulated to maintain relatively stable levels of thyroid hormones in the blood.
• If the thyroid gland does not produce sufficient T4 and T3 (underactive thyroid), due to thyroid dysfunction or to insufficient TSH, then the affected person experiences symptoms of hypothyroidism such as weight gain, dry skin, cold intolerance, irregular menstruation, and fatigue. Hashimoto thyroiditis is the most common cause of hypothyroidism in the U.S. (See the article on Hashimoto thyroiditis for more details.)
• If the thyroid gland produces too much T4 and T3, the affected person may experience symptoms associated with overactive thyroid (hyperthyroidism), such as rapid heart rate, anxiety, weight loss, difficulty sleeping, tremors in the hands, and puffiness around dry, irritated eyes and in some cases, bulging eyes. Graves disease is the most common cause of hyperthyroidism. (See the article on Graves disease for more details.)
• Both hyperthyroidism and hypothyroidism can also be caused by thyroiditis, thyroid cancer, and excessive or deficient production of TSH. The effect of these conditions on thyroid hormone production can be detected and monitored by measuring the free T4.

TAT: Same Day

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help diagnose one cause of anemia or neuropathy; to evaluate nutritional status in some people; to monitor the effectiveness of treatment for vitamin B12 or folate deficiency
• When To Get Tested?
• When you have abnormal results on a complete blood count (CBC) with a blood smear showing large red blood cells (macrocytosis) or abnormal (hypersegmented) neutrophils; when you have symptoms of anemia (weakness, tiredness, pale skin) and/or of neuropathy (tingling or itching sensations, eye twitching, memory loss, altered mental status); when you are being treated for vitamin B12 or folate deficiency
• Test Preparation Needed?
• Biotin found in certain dietary supplements may interfere with testing. Certain medicines, such as cholchicine, neomycin, para-aminosalicylic acid, and phenytoin, may affect the test results; your healthcare provider will advise you on which ones to stop taking. Ask your healthcare practitioner or lab for specific instructions.
• What is being tested?
• Vitamin B12 and folate are two vitamins that are part of the B complex of vitamins. B12 and folate work with vitamin C to help the body make new proteins. They are necessary for normal red blood cell (RBC) and white blood cell (WBC) formation, repair of tissues and cells, and synthesis of DNA. Both are nutrients that cannot be produced in the body and must be supplied by the diet.
• Vitamin B12 and folate tests measure vitamin levels in the liquid portion of the blood (serum or plasma) to detect deficiencies. Sometimes the amount of folate inside red blood cells may also be measured.
• Vitamin B12, also called cobalamin, is found in foods from animals, such as red meat, fish, poultry, milk, yogurt, and eggs.
• Folate (Vitamin B9) refers to a natural occurring form of the vitamin, whereas folic acid refers to the supplement added to foods and drinks. Folate is found in leafy green vegetables, citrus fruits, dry beans and peas, liver, and yeast.
• In recent years, fortified cereals, breads, and other grain products have also become important dietary sources of B12 and folate (identified as "folic acid" on nutritional labels).
• A deficiency in either B12 or folate can lead to macrocytic anemia, where red blood cells are larger than normal. Megaloblastic anemia, a type of macrocytic anemia, is characterized by the production of fewer but larger RBCs called macrocytes, in addition to some cellular changes in the bone marrow. Other laboratory findings associated with megaloblastic anemia include decreased WBC count, RBC count, reticulocyte count, and platelet count.
• B12 is also important for nerve health and a deficiency can lead to varying degrees of neuropathy, nerve damage that can cause tingling and numbness in the affected person's hands and feet.
• Folate is necessary for cell division such as is seen in a developing fetus. Folate deficiency during early pregnancy can increase the risk of neural tube defects such as spina bifida in a growing fetus.
• B12 and folate deficiencies are most often caused by not getting enough of the vitamins through the diet or supplements, long-term use of certain medications, inadequate absorption, or by increased need as seen in pregnancy:
• Dietary deficiencies—these are uncommon in the United States because many foods and drinks are supplemented with these vitamins, which are stored by the body. Adults typically have several years' worth of vitamin B12 stored in the liver and about 3 months of stored folate. Dietary deficiencies do not usually cause symptoms until stores of the vitamins within the body have been depleted. B12 deficiencies are sometimes seen in vegans (those who do not consume any animal products) and in their breast-fed infants.
• Inadequate absorption—vitamin B12 absorption occurs in a series of steps. B12 is normally released from food by stomach acid and then, in the small intestine, is bound to intrinsic factor (IF), a protein made by parietal cells in the stomach. This B12-IF complex is then absorbed by the small intestine, bound by carrier proteins (transcobalamins), and enters the circulation. If a disease or condition interferes with any of these steps, then B12 absorption is impaired.
• Increased need—this can be seen with a variety of diseases and conditions. Increased demand for folate occurs when a woman is pregnant or nursing, in early childhood, with cancers, or with chronic hemolytic anemias.

TAT: Same Day