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Blood chemistry testing provides a vast amount of
information regarding the health of the patient and could
disclose information about disease states which either exist
or are likely to develop. Common markers on blood chemistry
tests give insight into: renal function, electrolyte levels,
liver function, bone health, protein digestion, thyroid health,
coronary risk factors, lipid profiles, anemia and iron issues,
levels of blood cell types (including erythrocytes, leukocytes,
lymphocytes and platelets) and blood sugar control.
In addition to providing popular chemistry markers the BHD #290 Expanded
Chemistry Profile also includes the following markers and
screens that provide critical information regarding the assessment
of patients' health status:
T3 Uptake – T3 Uptake provides an
estimate of thyroxine binding globulin in the body, the protein
that carries most of the T3 and T4 in the blood. These bound
hormones serve as the reservoir of available thyroid hormone
as contrasted with unbound hormone which is the “free” or
“bioactive” fraction.
T4 – This test is for T4 or thyroxine and
it measures both the bound and free fractions of the hormone.
Less than 1% of T4 is in the unbound bioactive form.
Free Thyroxine Index – Free Thyroxine Index
is an estimate of the amount of Free T4 in the blood based
on the amount of thyroxine binding globulin present.
TSH Ultra Sensitive (the most advanced,
highly sensitive assay of TSH available on the market today)
– Thyroid stimulating hormone (TSH) is a hormone
released by the pituitary gland that triggers the thyroid
gland to produce thyroid hormones. Assessing levels of TSH
in the blood is considered to be an important method of detecting
thyroid problems.
Free T3 – Measures the free fraction/bio-active
form of T-3 in serum. T-3 and T-4 are involved in the negative
feedback mechanism on TSH levels/response.
Free T4 – Measures the free fraction/bio-active
form of T-4 in serum. T-3 and T-4 are involved in the negative
feedback mechanism on TSH levels/response.
Cholesterol – Cholesterol is a wax-like
substance that is produced in the liver and is also introduced
into the body from dietary sources. It is transported in the
blood by carrier proteins called lipoproteins that allow it
to be soluble in serum and thereby transported to all parts
of the body. Cholesterol, a critical component of cell membranes,
is also the raw material from which all of the body's steroidal
hormones are made and plays an essential role in the formation
of vitamin D and bile salts. Too much cholesterol in the blood,
however, can cause deposits of cholesterol inside arteries.
These plaques can narrow the artery enough to block blood
flow. This process known as atherosclerosis commonly occurs
in the coronary arteries which nourish the heart.
Triglycerides – Triglycerides are composed
of a glycerol molecule to which three fatty acid chains are
attached. These high energy fatty acid chains provide much
of the energy that the body's cells need to function. During
times when triglycerides are not available from dietary sources
the liver produces triglycerides itself. While there is no
direct evidence that elevated triglycerides pose an independent
risk for heart disease, they invariably accompany other major
risk factors. However, it is clear that when triglycerides
are elevated, HDL (the good) cholesterol levels decrease.
HDL – High-density lipoproteins transport
cholesterol from the blood stream back to the liver for processing
and elimination from the body. HDL makes it less likely that
excess cholesterol in the blood will be deposited in the coronary
arteries. Therefore HDL cholesterol is often referred to as
the “good” cholesterol.
LDL (Direct) - A direct measurement (not a calculated
value) of low-density lipoproteins that transport cholesterol
from the liver to the rest of the body. When there is too
much LDL cholesterol in the blood, it can be deposited on
coronary artery walls. Therefore LDL cholesterol is often
referred to as the "bad" cholesterol.
The body needs both HDL and LDL, therefore the terms
“good” and “bad” are not absolute.
VLDL – Very low-density lipoproteins (VLDLs)
have higher lipid content and lower protein content than LDL.
VLDL transports cholesterol from the liver to the body. When
there is too much VLDL cholesterol in the blood, it can be
deposited on coronary artery walls.
CHOL/HDL – Reports the ratio of total cholesterol
to HDL cholesterol and risk factor for men and women for cardiovascular
disease.
Homocysteine – Homocysteine is an amino
acid that is produced in the human body. It participates in
essential metabolic pathways and is often converted into other
amino acids for use by the body. Elevated homocysteine levels
may irritate the endothelial cells lining blood vessels leading
to blockages in arteries (atherosclerosis). It also can interact
with blood proteins and cells making blood clotting easier
than it should and can oxidize cholesterol into a more damaging
form. Supplementing with folic acid and vitamins B6 and B12
can help to reduce homocysteine levels in the blood.
Lipoprotein (a) – Lipoprotein (a) consists
of LDL cholesterol linked by a disulfide bond to a large hepatically
derived glycoprotein, apolipoprotein (a). Elevated lipoprotein
(a) can potentially promote cardiovascular disease in two
ways. Its apolipoprotein portion could promote an aggregation
of blood factors entrapping cells, resulting in the blockage
of an artery or its LDL cholesterol portion can be oxidized
and impair endothelial cell function and create atherosclerotic
plaque. The levels of lipoprotein (a) in the bloodstream are
largely genetically determined. Estrogen replacement therapy
in postmenopausal women and high dose niacin has been reported
to lower lipoprotein (a) levels. Lipoprotein (a) is frequently
elevated with acute as well as chronic bacterial infections.
CRP – C-reactive protein is released by
the body in response to acute injury, infection or other inflammatory
stimuli. As a marker of systemic inflammation, CRP is a powerful
predictor of first and recurrent cardiovascular events.
CPK – Also known as Creatine Kinase (CK),
CPK is an enzyme catalyzing the breakdown of phosphocreatine
to phosphoric acid and creatine. CPK is a measure of the breakdown
of muscle tissue (muscle wasting). It is very likely that
CPK will be elevated if blood is drawn a day or two after
a weight bearing workout. However, CPK could also be elevated
in cases of severe catabolism where skeletal muscle is being
broken down to provide glucose to the brain and in cases of
heart wasting where something is attacking heart tissue. Any
elevated CPK result is automatically reflexed to a myocardial
branch fraction at no additional charge to rule out heart
muscle wasting.
In this unique screen, we assess critical markers
that relate to celiac disease and sub-clinical gluten intolerance.
Celiac is defined by Total Serum IgA within range, elevated
IgA to transglutaminase and either elevated IgA or IgG to
the gliadin peptide of gluten. Sub-clinical gluten intolerance
is defined by Total Serum IgA within range and either elevated
IgA or IgG to the gliadin peptide of gluten. Celiac disease
and sub-clinical gluten intolerance are autoimmune states
that occur due to a genetic intolerance to the gliadin polypeptide
resulting in a mucotoxic inflammatory response of the lining
of the small intestine.
Total Serum IgA – Total serum IgA is used
to qualify the IgA levels for anti-gliadin and anti-transglutaminase
and to rule out compromised systemic immunity. Individuals
with Selective IgA deficiency may have a clinical or sub-clinical
gluten sensitive enteropathy (GSE) with anti-gliadin IgA and
anti-transglutaminase IgA reported within normal ranges.
Anti-Gliadin Antibodies (IgA, IgG) – The
gliadin peptide comprises 50% of gluten (the protein component
of wheat and other related grains). One can have a genetic
predisposition to immunologic sensitivity to gliadin. This
sensitivity can be manifested as mucosal inflammation of the
gastrointestinal tract. Such inflammation can remain sub-clinical
and persist for decades or demonstrate the very overt symptoms
of celiac disease.
Anti-Transglutaminase Antibody (IgG) –
This marker measures antibody to the complex of the gliadin
peptide and transglutaminase, an enzyme involved in digesting
gliadin. People with a genetic intolerance to gliadin lack
the ability to properly digest it into its component amino
acids. As a result the body forms auto-antibodies to the complex
of human tissue transglutaminase and the gliadin polypeptide.
Iron – It is important to know serum iron
levels in order to interpret abnormal red blood cell (RBC),
hemoglobin (HGB) or hematocrit (HCT) levels. When serum iron
is known, the amount of iron (inorganic) available to convert
to hemoglobin (organic iron) is known, allowing the practitioner
to differentiate between low iron and an iron utilization
problem.
Iron Binding Capacity – Iron Binding Capacity
is an indirect measure of transferrin. A small percentage
of the body's iron is in transport, traveling in the bloodstream
attached to a molecule called transferrin. Normally about
30% of available transferrin iron binding sites are occupied.
Iron Binding Capacity is measured by determining the number
of “available spaces” on unoccupied transferrin.
Percent Iron Saturation (Iron divided by Iron Binding
Capacity) – Represents the percentage of available
transferrin sites occupied by iron.
Ferritin – About 30% of the iron in the
body is stored as ferritin in the liver, bone marrow and spleen.
Ferritin is composed of 24 identical protein subunits that
store iron ions for future use. The amount of ferritin in
the body reflects the amount of iron stored in the body.
Transferrin – Transferrin is the protein
that transports iron in the blood. Most transferrin is produced
in the liver. Transferrin regulates the release of iron from
storage into the general circulation.
Vitamin B-12 – Vitamin B-12 helps maintain
healthy nerve cells and red blood cells and also helps to
make DNA. It is also known as cobalamin because it contains
the metal cobalt. Vitamin B-12 is released from proteins in
food during digestion then combines with intrinsic factor
which is produced in the stomach. This complex can then be
absorbed by the intestinal tract. Pernicious anemia is an
anemia caused by malabsorption of Vitamin B12. This is usually
caused by decreased production of intrinsic factor.
Folic Acid – Folic Acid, a B vitamin, helps
the body form red blood cells and aids in DNA formation. It
is also important in preventing neural tube birth defects
and metabolizing homocysteine. Vitamin B12 helps keep folate
in its active form, allowing it to keep homocysteine levels
low.
All markers on this screen are critical to understand
how well the body is regulating blood sugar. It is important
to know where serum insulin and serum cortisol levels are
in relation to fasting glucose levels in evaluating a patient's
glycemic control status.
Insulin, Fasting – Insulin is a protein
hormone that is secreted in response to a rise in blood levels
of sugar and amino acids after eating. Insulin promotes the
entry of glucose, fatty acids and amino acids into cells and
also promotes glycogen, protein and lipid synthesis.
Glucose, Fasting – Glucose is the end product
of carbohydrate metabolism and the chief source of energy
for living organisms. Excess glucose is converted to glycogen
and stored in the liver and muscles for later use and beyond
that it is converted to fat and stored in adipose tissues.
Cortisol, Fasting – In the context of this
screen, cortisol is a glucocorticoid that is responsible for
gluconeogenesis, the process of converting amino acids and
fats to glucose to meet the body's needs for glucose. A normal
fasting glucose is not normal if the fasting cortisol is elevated.
Amylase – Amylase is used as a marker for
pancreatic function, helps to identify pancreatic dysfunction,
including possible pathology.
Rheumatoid (RA) Factor – Detects the presence
of an autoantibody in the blood to a fragment of the IgG immunoglobulin.
Rheumatoid factor becomes elevated when the body is in a state
of inflammation. The presence of Rheumatoid Factor indicates
that your patient may have rheumatoid
arthritis. Positive Rheumatoid Factor test results are
found in the majority of cases of rheumatoid arthritis (RA).
In addition, many patients with high levels of Rheumatoid
Factor in their blood have Sjögren's syndrome, a systemic
inflammatory disorder that affects the mucous membranes. Many
patients with RA also have Sjögren's syndrome. Other
causes of a positive Rheumatoid Factor test in the absence
of RA or Sjögren's syndrome are endocarditis; systemic
lupus erythematosus (lupus) ; tuberculosis; syphilis
; sarcoidosis; cancer; viral infection; or disease of
the liver,
lung, or kidney. Your patient may also test positive if they
have received skin or kidney grafts from a person who does
not have their identical genetic profile.
ANA (Antinuclear Antibody) Screen – Generally,
the more elevated a patient's titer of ANA the higher the
association with SLE (systemic lupus erythematosus), therefore
the greater likelihood that the patient has SLE. ANA are antibodies
against one or more elements within a biological cell, involved
in the machinery of translating genomic message into proteins.
These antibodies can destroy cells. If a positive ANA result
is found, additional tests can be done to identify the particular
antibody that is causing the ANA to be positive and thus the
particular disease process that is likely to be occurring.
If your patient has a positive ANA, BioHealth will automatically
reflex to fluorescent antibodies for specific antibody identification
at no additional cost.
This unique marker differentiates Candida infections
between those that are compartmentalized within the GI tract
and those that are truly poly-systemic and require the use
of systemic anti-fungal drugs. Positive DA results have been
obtained several days to weeks before positive Candida blood
cultures and the normalization of D-Arabinitol levels has
been correlated with the therapeutic response in both humans
and animals.
This exclusive “Expanded Chemistry Profile” is available
only through BioHealth Diagnostics, Inc. (refer
to BHD #290 Technical Bulletin).
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