Find test for SRL 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: 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: 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: 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:

• 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: 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 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: SAME DAY

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: SAME DAY

Pre-Test Information: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To measure or monitor your estrogen levels; to detect an abnormal level or hormone imbalance as a cause of your signs and symptoms; to monitor treatment for infertility or symptoms of menopause; sometimes to test for fetal-placental status during early stages of pregnancy
• When To Get Tested?
• Women: when you show symptoms of a hormone imbalance, such as abnormal vaginal bleeding, lack of menstrual periods, unusual and/or early or late sex organ development; when you are undergoing infertility treatment or therapy for menopause symptoms; when you are pregnant and your healthcare practitioner wants to monitor the health of your placenta and developing baby, if it is a high-risk pregnancy
• Men: when you have signs of feminization, such as enlarged breasts (gynecomastia)
• Test Preparation Needed?
• None, but the timing of a woman's sample will be correlated with her menstrual cycle or, if pregnant, with the gestational age of the baby.
• What is being tested?
• Estrogens are a group of steroids that are responsible for the development and function of reproductive organs and the formation of secondary sex characteristics in women. Along with another hormone, progesterone, they help regulate the menstrual cycle, are involved in the growth of breasts and the uterus, and help maintain a healthy pregnancy. Though considered the main sex hormones for women, they are also found in men and play a role in bone metabolism and growth in both sexes. Estrogen tests measure one of three components: estrone (E1), estradiol (E2), or estriol (E3) in the blood or urine.
• Estrone (E1) is directly converted from androstenedione (from the adrenal gland) or indirectly from other androgens. E1 can also be produced by the ovaries and placenta, testicles, and adipose (fat) tissues. E2 and E1 can be converted into each other as needed. E1 is the primary estrogen in men and in post-menopausal women.
• Estradiol (E2) is primarily produced in the ovaries under stimulation of FSH and LH in pre-menopausal women and in the testicles in men. E2 is converted from E1 in post-menopausal women. It is the most potent estrogen and the one that is present in the highest concentration in non-pregnant, pre-menopausal women. E2 levels vary depending on a woman's age and reproductive status. They are a good marker of ovarian function.
• Estriol (E3) is produced by the placenta, with concentrations rising throughout a woman's pregnancy. Increasing levels are an indication of the health of the pregnancy and developing baby. Estriol is part of the second trimester maternal serum screen, a test performed to evaluate fetal risk due to certain chromosomal abnormalities. Very low levels of E3 are present in non-pregnant women or men.
• Estrogen in Girls and Women
• The types and amounts of estrogen normally present in a woman's blood will vary throughout her lifetime. Levels vary during each menstrual cycle, during pregnancy, and on a daily basis.
• At Birth
• Estradiol (E2) and estrone (E1) are high but fall within a few days. Concentration levels are minimal during early childhood.
• At Puberty
• Concentrations of E2 and E1 begin to rise as puberty approaches. These estrogens are responsible for the development of breasts, uterine growth, and (with other hormones) the onset and regulation of menstruation. A moderate amount of E1 is present from puberty to menopause. This concentration will vary during the day but is otherwise relatively stable.
• During Menstruation
• The menstrual cycle is approximately 28 days long and consists of two phases, follicular phase (day 1-14) and luteal phase (day 15-28). During each cycle, estradiol (E2) and several other hormones normally rise and then fall in a specific sequence.
• During Pregnancy
• Estriol (E3) is the primary estrogen present during pregnancy. It is produced by the placenta, starts to rise in the eighth week of pregnancy, and continues to rise throughout the pregnancy. A sharp increase of E3 occurs approximately 4 weeks prior to the onset of labor. Estriol circulating in maternal blood is quickly cleared out of the body. Each measurement of estriol is a snapshot of what is happening with the placenta and fetus, but there is also natural daily variation in estriol concentrations.
• E1 also rises during pregnancy, increasing as much as 10-fold between weeks 24 and 40. After delivery, E1 falls and E3 again becomes essentially undetectable.
• During Menopause
• Estrone (E1) is the primary estrogen present during menopause. E2 concentrations significantly decrease as ovarian production wanes and eventually stabilize at a low level.
• Estrogen in Boys and Men
• The types and amounts of estrogen normally present in a man's blood change, but they vary much less over time than a woman's and they are much lower.

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 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: N/A

Test Type: Blood

Test Description:

• Why Get Tested?
• To determine whether you have an inherited G6PD deficiency
• When To Get Tested?
• When a child experienced persistent jaundice as a newborn for unknown reasons; when you have had one or more intermittent bouts of hemolytic anemia that may be triggered by an infection or certain medications
• Test Preparation Needed?
• Generally, none; however, if symptoms are acute, it is advised that you wait to be tested for at least several weeks after the episode has resolved.
• What is being tested?
• Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme involved in energy production. It is found in all cells, including red blood cells (RBCs) and helps protect them from certain toxic by-products of cellular metabolism. A deficiency in G6PD causes RBCs to become more vulnerable to breaking apart (hemolysis) under certain conditions. This test measures the amount of G6PD in RBCs to help diagnose a deficiency.
• G6PD deficiency is a genetic disorder. When individuals who have inherited this condition are exposed to a trigger such as stress, an infection, certain drugs or other substance(s), significant changes occur in the structure of the outer layer (cell membrane) of their red blood cells. Hemoglobin, the life-sustaining, oxygen-transporting protein within RBCs, forms deposits (precipitates) called Heinz bodies. Some individuals may experience these reactions when exposed to fava beans, a condition called "favism." With these changes, RBCs can break apart more readily, causing a decrease in the number of RBCs. When the body cannot produce sufficient RBCs to replace those destroyed, hemolytic anemia results and the individual may develop jaundice, weakness, fatigue, and/or shortness of breath.
• G6PD deficiency is the most common enzyme deficiency in the world, affecting more than 400 million people. It may be seen in up to 10% of African-American males and 20% of African males. It is also commonly found in people from the Mediterranean and Southeast Asia.
• G6PD deficiency is inherited, passed from parent to child, due to mutations or changes in the G6PD gene that cause decreased enzyme activity. There are over 440 variants of G6PD deficiency. The G6PD gene is located on the sex-linked X chromosome. Since men have one X and one Y sex chromosome, their single X chromosome carries the G6PD gene. This may result in a G6PD deficiency if a male inherits the single X chromosome with an altered gene.
• Since women have two X sex chromosomes, they inherit two copies of the G6PD gene. Women with only one mutated gene (heterozygous) produce enough G6PD that they usually do not experience any symptoms (i.e., asymptomatic), but under situations of stress, they may demonstrate a mild form of the deficiency. In addition, a mother may pass the single mutated gene to any male children. Rarely do women have two mutated gene copies (homozygous), which could result in G6PD deficiency.
• G6PD deficiency is a common cause of persistent jaundice in newborns. If left untreated, this can lead to significant brain damage and mental retardation.
• Most people with G6PD deficiency can lead fairly normal lives, but there is no specific treatment apart from prevention. They must be cautious and avoid certain medications such as aspirin, phenazopyridine and rasburicase, antibiotics with "sulf" in the name and dapsone, anti-malarial drugs with "quine" in the name, foods such as fava beans, and chemical substances such as naphthalene (found in moth balls). Note that fava beans, often called broad beans, are commonly grown in the Mediterranean area. Acute viral and bacterial infections can also initiate episodes of hemolytic anemia as well as elevated levels of acid in the blood (i.e., acidosis). Individuals should consult with their healthcare practitioner to get a comprehensive list of these triggers. A good starting point is the list found on the G6PD Deficiency Favism Association website.
• With hemolytic anemia, RBCs are destroyed at an accelerated rate and the person affected becomes pale and fatigued (anemic) as their capacity for providing oxygen to their body decreases. In severe cases of RBC destruction, jaundice can also be present. Most of these episodes are self-limiting, but if a large number of RBCs are destroyed and the body cannot replace them fast enough, then the affected person may require a blood transfusion. This condition can be fatal if not treated. A small percentage of those affected with G6PD deficiency may experience chronic anemia.

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:

• 8 hours fasting is mandatory

Test Type: Serum

Test Description:

• Why Get Tested?
• To help evaluate insulin production by the beta cells in the pancreas; to help diagnose the presence of an insulin-producing tumor in the islet cells of the pancreas (insulinoma); to help determine the cause of low blood glucose (hypoglycemia); to help identify insulin resistance, or to help determine when a type 2 diabetic might need to start taking insulin to supplement oral medications
• When To Get Tested?
• When you have low blood glucose levels with symptoms such as sweating, palpitations, dizziness, fainting; when you have diabetes and your healthcare practitioner wants to monitor your insulin production; sometimes when it is suspected that you have insulin resistance
• Test Preparation Needed?
• Typically, you will be asked to fast for 8 hours before the blood sample is collected. Occasionally, a healthcare practitioner may do testing when fasting is not possible, such as when a glucose tolerance test is done. In some cases, a healthcare practitioner may request that you fast longer than 8 hours.
• What is being tested?
• Insulin is a hormone that is produced and stored in the beta cells of the pancreas. It is secreted in response to elevated blood glucose following a meal and is vital for the transportation and storage of glucose, the body's main source of energy. Insulin helps transport glucose from the blood to within cells, thus helping regulate blood glucose levels, and has a role in lipid metabolism. This test measures the amount of insulin in the blood.
• Insulin and glucose blood levels must be in balance. After a meal, carbohydrates usually are broken down into glucose and other simple sugars. These are absorbed into the blood, causing the blood glucose level to rise, which in turn stimulates the pancreas to release insulin into the blood. As glucose moves into cells, the level in the blood decreases and release of insulin by the pancreas decreases.
• If an individual is not able to produce enough insulin, or if the body's cells are resistant to its effects (insulin resistance), glucose cannot reach most of the body's cells and the cells starve. Meanwhile, blood glucose rises to an unhealthy level. This can cause disturbances in normal metabolic processes that result in various disorders and complications, including kidney disease, cardiovascular disease, and vision and neurological problems.
• Diabetes, a disorder associated with high glucose levels and decreased insulin effects, can be a life-threatening condition. People with type 1 diabetes produce very little insulin and so eventually require insulin supplementation therapy. Type 2 diabetes is generally related to insulin resistance, which increases with time.
• With insulin resistance, many of the body's cells are unable to respond to the effects of insulin, leaving glucose in the blood. The body compensates by producing additional amounts of the hormone. This results in a high level of insulin in the blood (hyperinsulinemia) and over-stimulation of some tissues that have remained insulin-sensitive. Over time, this process causes an imbalance in the relationship between glucose and insulin and, without treatment, may eventually cause health complications affecting various parts of the body.
• In addition to type 2 diabetes, insulin resistance may be seen in those with polycystic ovary syndrome (PCOS), prediabetes or heart disease, metabolic syndrome, acanthosis nigricans, and with disorders related to the pituitary or adrenal glands.
• Other than in insulin resistance, hyperinsulinemia is most often seen in people with tumor of the islet cells in the pancreas (insulinomas) or with an excess amount of administered (exogenous) insulin. Hyperinsulinemia causes low blood sugar (hypoglycemia), which can lead to sweating, palpitations, hunger, confusion, blurred vision, dizziness, fainting, and seizures. Since the brain is dependent on blood glucose as an energy source, severe glucose deprivation due to hyperinsulinemia can lead fairly quickly to insulin shock and death.

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: N/A

Test Type: Serum

Test Description:

• Why Get Tested?
• To help detect a condition causing tissue damage, such as a blood or liver disease, and to monitor its progress; to help stage, determine prognosis, and/or response to treatment of certain cancers; to help evaluate body fluid (other than blood)
• When To Get Tested?
• Along with other tests, when a healthcare practitioner suspects that you have an acute or chronic condition that is causing tissue damage or cellular destruction; sometimes when you have been diagnosed with cancer; when you have symptoms of meningitis or have fluid accumulation in a specific part of your body
• What is being tested?
• Lactate dehydrogenase (LD or LDH) is an enzyme involved in energy production that is found in almost all of the body's cells, with the highest levels found in the cells of the heart, liver, muscles, kidneys, lungs, and in blood cells; bacteria also produce LD. This test measures the level of LD in the blood or sometimes other body fluids.
• Blood LD
• Only a small amount of LD is usually detectable in the fluid portion of the blood (serum or plasma). LD is released from the cells into the serum when cells are damaged or destroyed. Thus, an LD blood level is a non-specific marker for the presence of tissue damage somewhere in the body. By itself, it cannot be used to identify the underlying cause or location of the cellular damage. However, it may be used, in conjunction with other blood tests, to help evaluate for and/or monitor conditions that lead to tissue damage, such as liver or blood diseases or cancer.
• Fluid LD
• Sometimes when there is injury, inflammation, or infection within a specific area of the body, such as the brain, heart or lungs, fluid will accumulate or constituents of the fluid present will change. The level of LD present in the fluid may be useful in determining the cause. For example, LD is typically high in cerebrospinal fluid when an individual has bacterial meningitis. The LD test can also be used, along with other tests, to determine whether fluid accumulation, for example around the heart or lungs or in the abdominal cavity, is due to injury or inflammation (exudate) or due to an imbalance of fluid pressure inside blood vessels and the protein level in blood (transudate). The article on Body Fluid Analysis lists some fluids that may be evaluated using an LD test.

TAT: SAME DAY