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Requires Fasting Blood Draw
- Sample required: one 10 mL SST (tiger top) decanted serum;
one 5 mL EDTA (lavender top) blood
- Lab reporting time: 3 - 4 business days
Chemistry Profile | Electrolyte
Screen | Coronary Risk Screen
Thyroid Screen | Complete
Blood Count
Chemistry Profile
BUN: Urea is the chief end product of protein metabolism.
It is formed almost entirely by the liver from both protein
digestion and protein metabolism in the liver. BUN should
only be determined on fasting patients since there is an increase
in the blood values after ingestion of protein.
CREATININE: This body excretion is formed by the spontaneous
decomposition of creatine, an intrinsic substance in the contraction
mechanism of muscle. It differs from BUN in that it is unaffected
by protein intake or gender.
BUN/CREAT RATIO: Assessing this ratio is critical when the
value is 10 or less in antidiuretic hormone (ADH), also known
as vasopressin insufficiency.
URIC ACID: This is also a compound which can be found in
kidney stones. As the uric acid content of the urine increases
the urinary pH will increase as high as 7.0. This causes the
uric acid to be converted to sodium urate.
BILIRUBIN, TOTAL: Bilirubin is an orange-yellow pigment found
in bile. It is formed when hemoglobin, the red-colored pigment
of red blood cells that carries oxygen to tissues, breaks
down. Small amounts of bilirubin are present in blood from
damaged or old red cells that have died.
ALKALINE P-TASE (AP): This enzyme in serum causes hydrolysis
of monophosphate at an optimal pH of 9.0 to 10.0. It is commonly
elevated in children who are still developing bone. It is
abnormally elevated in liver, bone, or intestinal dysfunction
and will be elevated in several types of cancer.
ALBUMIN: Produced almost entirely in the liver, albumin is
responsible for about 80% of the colloid-osmotic pressure
between blood and tissue fluids.
GLOBULIN: Total globulin is valuable in assessing degenerative
inflammatory and infectious processes. It also can indicate
the need for digestive HCL support. Total globulins are a
combination of alpha 1, alpha 2, beta, and gamma fractions.
A/G RATIO: The value of the A/G ratio is not precise due
to the countless number of variables in the fractions (Total
Globulins and Albumin) associated with various metabolic states.
Abnormal A/G ratios usually reflect a general index of liver
dysfunction.
GLUCOSE, FASTING: Hyperglycemia and hypoglycemia, caused
by a variety of conditions, are both hard on the body. Severe,
acute high or low blood glucose levels can be life threatening,
causing organ failure, brain damage, coma, and, in extreme
cases, death. Chronically high blood glucose levels can cause
progressive damage to body organs such as the kidneys, eyes,
cardiovascular system, and nerves. Untreated hyperglycemia
that arises during pregnancy, in the form of gestational diabetes,
can cause mothers to give birth to large babies who may have
low glucose levels. Chronic hypoglycemia can lead to brain
and nerve damage.
SGOT/AST (aspartate aminotransferase): This enzyme is involved
in the transfer of D-Amino nitrogen of aspartic acid to Alpha-Ketoglutamic
acid, resulting in the synthesis of glutamic acid, alpha-keto
acid, and oxaloacetic acid. SGOT/AST acts as a catalyst in
amino acid metabolism during glycolysis with resultant energy
release. AST levels are also often compared with levels of
other liver enzymes, such as alkaline phosphatase (AP), and
alanine aminotransferase (ALT), to help determine the form
of liver disease present.
SGPT/ALT (alanine aminotransferase): Functionally similar
to SGOT. However, it is not increased as much in cardiac problems.
In liver dysfunction it is increased more and does not return
to normal as fast as SGOT/AST. A SGPT/ALT relationship to
the Krebs Cycle is seen in the liver as it releases it from
fatty acid storage.
LDH: Lactic Dehydrogenase represents a group of enzymes involved
in carbohydrate metabolism. LDH enzymes participate in lactate
and pyruvate utilization. With heart attacks, LDH values will
be the highest on the second and third days after the damage
occurs.
CALCIUM: Calcium is absorbed from the upper part of the small
intestine. The amount of absorption depends upon the acidity
of the intestinal contents and the amount of phosphate present.
Calcium relates to bone metabolism, the drawing of the fats
through the intestinal wall, muscle contraction, transmitting
nerve impulses and protein absorption. The amount of protein
in the blood affects the calcium level. Calcium provides a
mobilizing factor in trauma, infections, and stress and is
used rapidly for the repair of tissue in conjunction with
Vitamin A and C, Magnesium, Phosphorus and unsaturated fatty
acids. Calcium exists in the ionized form (about 55 percent)
and the non-diffusible portion (about 45 percent) that is
bound to protein, chiefly albumin.
CALCIUM IONIZED: Calcium is one of the most important minerals
in the body. About 99% of it is found in the bones, and most
of the rest circulates in the blood. Roughly half of the calcium
is referred to as free or ionized, and is metabolically active;
the remaining half, referred to as "bound" calcium,
is attached to protein and other compounds and is inactive.
MAGNESIUM: Magnesium is one of the most frequently encountered
intracellular metallic ions, only potassium occurs in larger
amounts. It plays an important role in numerous enzyme systems.
It exists in the plasma where about 75 to 85 percent in the
unbound (ionic) state and the remainder in the protein-bound
form. When attempting to increase or decrease magnesium levels
supplementally, the five parts of calcium to one part of magnesium
in the blood, should be observed.
IRON: A common mistake is to run a red blood count and indices
without running a serum iron. Without the serum iron value,
the amount of iron (inorganic) available to convert to hemoglobin
(organic iron) is unknown. Therefore, anytime the HGB, HCT
or RBC levels are found to be abnormal, with a normal or increased
serum iron, an iron utilization problem must be investigated;
i.e. the need for folic acid, B12, B6 or copper.
GGTP (gamma glutamyl transpeptidase): The GGTP test is a
more rapid, sensitive and specific indicator of liver problems
than AP and in certain conditions than SGPT-ALT. It is elevated
in all common forms of liver dysfunction/disease and is even
more elevated in bile duct disease and alcoholism.
Electrolyte Screen
SODIUM: Sodium is the most abundant cation in the extra-cellular
fluid. It is of the greatest importance in osmotic regulation
of extra-cellular fluid balance, acid balance, and renal,
cardiac and adrenal functions. Sodium helps to maintain normal
acidity in the urine, is involved in the transmission of nerve
impulses and is required for maintenance of the sodium-potassium
pump.
POTASSIUM: Potassium is the chief ion found in the intra-cellular
fluid. Only a small part of the total body potassium is contained
in the serum. Serum potassium values range from 3.5 to 5.0
mmol/L while the levels in intra-cellular fluid are 15 to
20 times this amount. While only a part of total body potassium
is found in the serum, proper serum values are critical to
normal physiology, especially adrenal, heart, and renal functions.
It is essential in the maintenance of pH of blood and urine
and maintenance of osmotic pressure preventing edema and general
muscle fatigue. Potassium should always be viewed in relation
to the other electrolytes.
CHLORIDE: Chloride is an electrolyte. When combined with
sodium it is mostly found in nature as "salt." Chloride
is important in maintaining the normal acid-base balance of
the body and, along with sodium, in keeping normal levels
of water in the body. Chloride generally increases or decreases
in direct relationship to sodium, but may change without any
change in sodium when there are problems with too much acid
or base in your body.
CARBON DIOXIDE: CO2 is the amount of base bound as bicarbonate
in the blood, which are available for the neutralization of
the fixed acids, such as lactic acid and HCl. It should be
made clear that CO2 refers only to the base bound as bicarbonate
and not the total base of the blood. It represents the reserve
alkali readily available for the neutralization of the acids.
Conditions involving primary CO2 excess and deficit cannot
be determined by CO2 alone. Serum chlorides must be checked
for the inverse values when metabolic acidosis or alkalosis
is suspect.
Thyroid Screen
T-3 UPTAKE: In spite of its name, this measurement has nothing
to do with actual serum T-3 levels. It is done by measuring
the in vitro partition of 125/1-labeled triiodothronine (T-3)
between the patient's serum and a specifically treated resin
previously charged with the radio-active T-3. In this test
the unsaturated thyroid binding globulin (TBG) competes with
resin for the radio-active T-3. The binding of labeled hormone
to the resin beads is thus inversely proportional to the unsaturated
thyroxine-binding globulin (hyperthyroidism) show an increase
in T-3 binding to the resin; conversely, a relative increase
in the unsaturated thyroxine-binding (hypothyroidism) results
in a low T-3 uptake by the resin.
T-4 RIA: This measurement is done by radio-immune assay (RIA).
In this analysis T-4 and 125/1-labeled thyroxine compete for
binding sites on a specific antibody. After an appropriate
incubation period, the antigen-antibody complex is precipitate
by the addition of polyethylene glycol. The presence of unlabeled
T-4 causes a decrease in the percent labeled T-4 bound to
the antibody (isotope dilution). The T-4 content of the serum
is determined by comparing its isotope diluting ability to
series of standards containing known concentrations of T-4.
FREE THYROXINE INDEX: T-7 is an estimate (index) related
to free T-4 levels in serum calculated as the product of T-4
and a T-3 test result. The T-3 uptake result is inversely
proportional to unsaturated thyroid binding globulin (UTBG)
in serum, and that free T-4 varies directly with total T-4
and inversely with UTBG levels. It is quite possible to obtain
a normal T-7 with an abnormal T-3 uptake or T-4 findings.
Also, aberrant results may occur in patients whose TBG is
abnormal.
TSH-ULTRA SENSITIVE: Simply stated, a reduction of T-3 and
T-4 causes an increase in TSH; and increase in both causes
TSH to decrease.
Coronary Risk Screen
CHOLESTEROL: A white crystalline substance, C27H45OH, found
in animal tissues and various foods, that is normally synthesized
by the liver and is important as a constituent of cell membranes
and a precursor to steroid hormones. Its level in the bloodstream
can influence the pathogenesis of certain conditions, such
as the development of atherosclerotic plaque and coronary
artery disease
TRIGLYCERIDES: Triglycerides are esters of glycerol and fatty
acids. Since they and cholesterol travel in the blood stream
together, they should be assessed together.
HDL: A complex of lipids and proteins in approximately equal
amounts that functions as a transporter of cholesterol in
the blood. High levels are associated with a decreased risk
of atherosclerosis and coronary heart disease.
LDL: A complex of lipids and proteins, with greater amounts
of lipid than protein, which transports cholesterol in the
blood.
CHOL/HDL RATIO: A ratio of lipids for determining possible
cardiac risk factors.
Complete Blood Count
WBC: Leukocytes of the peripheral blood are divided into
two groups, the granulocytes and the non-granulocytes. An
increase or decrease in the total number of white blood cells
is the result of an increase or decrease in one or more of
the above fractions; hence, it is essential that a differential
count be taken in addition to the total white blood count
to ascertain where the increase or decrease is occurring.
White blood cells are much fewer in number than red blood
cells and have lower specific activity. The total white blood
count (total WBC) is valuable in screening the system's defense
mechanism against infection and virus (inflammation). Serious
abnormal findings in the total WBC or any segment is justification
to conduct a serum protein electophoresis (SPE).
RBC: Red Blood Cells are increased in nephritis, kidney stones,
urinary tract infection, benign prostate hypertrophy, renal
hypertension, renal free radical problems, sickle cell anemia,
hemophilia, rheumatic fever, congestive heart failure, diverticulitis
of the colon, S.L.E, heavy metal body burdens, toxic effects
of non-medicinal gases.
HGB (Hemoglobin): There are considerable physiological variations
in the hemoglobin levels of healthy individuals. Caution is
advised when interpreting values somewhat above or below the
average as pathological. The infant has a higher hemoglobin
which soon declines to a level somewhat lower than the adult
levels. Low values persist through childhood with a tendency
to low values in the elderly. Hemoglobin should be evaluated
with HC, RBC and the indices to determine anemia and the type
of anemia. Serum iron as well as total globulin, uric acid,
ceruloplasmin and ferritin should also be evaluated if possible.
Hemoglobin is the most abundant protein found within the red
blood cell. The hemoglobin indicates the amount of intracellular
iron; hence its value in determining anemia.
HCT (Hematocrit): The packed cell volume (HCT) is the percentage
of total volume occupied by packed red blood cells when a
given volume of whole blood is centrifuged at a constant speed
for constant period of time. The HCT is one of the most precise
methods of determining the degree of anemia or polycythemia.
MCV (Mean Corpuscular Volume): This measurement indicates
the volume in cubic micron occupied by an average single red
blood cell. MCV increase or decrease along with an increase
or decrease in MCH is a significant finding for folic acid
and/or B12 need (increase) or iron, copper or B6 need (decrease).
MCV and MCH should always be viewed together.
MCH (Mean Corpuscular Hemoglobin): Indicates the weight of
hemoglobin in a single red blood cell. MCH increase or decrease
along with an increase or decrease in MCV is a significant
finding for folic acid and/or B12 needed. A decrease in MCH
with a decrease in MCV indicates an iron, copper, or B6 needed.
MCHC (Mean corpuscular hemoglobin concentration): Indicates
the average hemoglobin concentration per volume (100ml) of
packed red blood cells.
PLATELETS: Platelets are concerned with the clotting of the
blood and also clot retraction.
SEG %: A type of neutrophil, its primary function is in phagocytosis.
BANDS: Non-segmented neutrophils (metamylocytes) are the
youngest forms that are normally found in the peripheral blood.
These forms increase in the presence of acute infections with
or without an absolute increase in the total WBC.
LYMPH %: Lymphocytes help to destroy the toxic products of
protein metabolism. Lymphocytes originate from lymphoblasts
in the spleen, lymph glands, tonsils, thymus, bone marrow,
and possibly the appendix.
MONO %: Monocytes phagocytize some bacteria, particulate
matter, and protozoa. In the inflammatory process neutrophils
predominate for about three days, then they break up and the
monocytes remain to phagocytize fragments of cells, etc; hence,
the reason for an elevation of the monocytes during the recovery
phase of infection.
EOS %: Eosinophils have an important role in detoxification,
disintegration and removal of protein. Eosinophils are commonly
elevated in allergy sensitivity and parasites.
BASO %: With inflammation, basophils deliver heparin to the
effected tissue to prevent clotting.
Logical Sequence of Testing
The logical sequence of using this test as an initial or a
follow-up test is determined by a variety of individual considerations,
including the patient's chief complaint, the array of signs
and symptoms, the chronicity of the condition, the tests previously
taken, and the judgment of the practitioner. Technical assistance
is available from BioHealth Diagnostics' support staff.
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