Below are short descriptions of common laboratory tests.
Those that may be included in a routine Personal Wellness Profile are:
· Blood Pressure Click here to order lab tests
· Lipid Profile* – Total cholesterol, LDL, HDL, triglycerides for a Personal Wellness Profile
· PSA (men)
· Faecal Occult Blood** (50+ yrs)
· ECG
Note: There are specific requirements for the following tests:
* Lipid Profile and Fasting Blood Glucose - nothing but water for at least 10 hours before the blood is drawn.
** Faecal Occult Blood - only a speck of stool is required. It is preferable to avoid meat for three days before collecting the sample.
For a more extensive Profile, the following may also be included:
· ESR
· Uric Acid (may be extended to a full range of Renal Function Tests)
· Liver Function Tests
Click here to order laboratory tests
Albumin
This important protein keeps water inside your blood vessels. When your albumin level is too low, water can leak out of the blood vessels into other parts of your body and cause swelling.
Approximately two-thirds of the total protein circulating in the blood is albumin. A low level of albumin can be caused by malnutrition, too much water in the body, liver disease (albumin is made by the liver), kidney disease, severe injury such as burns or major bone fractures, and slow bleeding over a long period of time.
Alkaline Phosphatase
Alkaline phosphatase is an enzyme that is found in nearly all tissues of the body, the most important being bone and liver. Minor increases are sometimes observed with the normal aging process.
A high level of alkaline phosphatase in your blood may indicate bone, liver or bile duct disease.
Certain drugs may also cause high levels. Because of bone growth, growing children normally have a higher level than adults.
The first figure in your blood pressure reading is the "systolic" pressure; the level to which the pressure rises when the heart pumps. The second figure is the "diastolic" pressure; the level to which the pressure falls when the heart relaxes between beats. A healthy teen-ager has a blood pressure of around 90/60. In early adulthood, it may rise to 110/70, and ideally it should stay below 120/80 for the rest of your life. Note that one reading does not mean much (unless it is very high). It is the AVERAGE blood pressure that is important, and that requires several readings to establish.
Your blood pressure may fall during illness, but there is no such disease as "low blood pressure", as is commonly believed.
Many people will experience a gradual rise in blood pressure with age, usually - but not always - as a result of weight gain and declining fitness. If the blood pressure goes above 140/90 the doctor will diagnose "hypertension". However, ANY INCREASE over 115/70 carries an increased risk of stroke, heart disease, etc; the bigger the rise, the greater the risk.
Weight loss, salt restriction, stress management and exercise will help to lower your blood pressure, but if all else fails, it will be necessary to take medication to bring the blood pressure below 140/90.
BUN (Blood Urea Nitrogen) and Creatinine
Urea and creatinine are two waste products which are constantly being produced by the breakdown of protein and the remodeling of muscle tissue.
A small amount of creatinine also is always being released from muscles.
(The "nitrogen" in BUN refers to the nitrogen at the end of the urea molecule that is measured.)
Both substances are filtered through the kidneys. An elevated blood urea nitrogen or creatinine may indicate that the kidneys are not functioning well or that other disease is present.
Dehydration commonly leads to elevated levels of BUN and creatinine.
Creatinine also may be increased as a result of muscle damage during trauma, or in muscle-wasting diseases such as muscular dystrophy.
A low BUN level may be caused by liver disease, a low protein, high carbohydrate diet, or too much water intake.
Calcium
Ninety-nine percent of the calcium in the body is in the bones, but the other one percent is very important for the proper function of nerves, enzymes, muscles, and blood clotting. The parathyroid gland is the main regulator of calcium in the body, and since it maintains an equilibrium, calcium levels cannot be interpreted as an indicator of osteoporosis.
Low levels of calcium in the blood are associated with malnutrition. High levels can be caused by bone disease, excess intake of antacids and milk (often seen in people with ulcers), excess intake of Vitamin D, and hyperparathyroidism.
Electrolytes
Sodium is regulated by the kidneys and adrenal glands. Potassium is also controlled very carefully by the kidneys and is important for the proper functioning of the nerves and muscles, particularly the heart. Chloride is almost always associated with a high or low level of sodium or potassium.
There are numerous causes of high and low sodium levels, but the most common causes of low sodium are diuretic usage, diabetes drugs like chlorpropamide, and excessive water intake in patients with heart or liver disease.
Any value for potassium outside the expected range, high or low, requires medical evaluation. This is especially important if you are taking a diuretic (water pill) or heart pill (Digitalis, Lanoxin, etc.).
Borderline high or low levels of chloride have very little significance.
CO2 reflects the acid status of your blood. Low CO2 levels can be due to either to increased acidity from uncontrolled diabetes, kidney disease, metabolic disorders, or low CO2 can be due to chronic hyperventilation.
Cholesterol is a waxy, fatlike substance, classified as a lipid, that's found in all tissues in humans and other animals. Foods from animal sources (e.g., eggs, meat, poultry, fish, dairy products) contain cholesterol, but plant-derived foods do not. So when you eat a big juicy steak or hamburger, you're consuming cholesterol; when you chomp on a carrot or apple, you're not. Interestingly, the majority of cholesterol in your blood is manufactured by your own body - mainly by your liver - and only about 20% of blood cholesterol comes from the food you eat. And despite all of the nasty things you've heard about cholesterol, you really need a certain amount of it to live: cholesterol is essential to your body's cell membranes, to the insulation of your nerves, and to the production of certain hormones. It's also used by your liver to make bile acids, which help to digest your food. After infancy, your body makes all of the cholesterol it needs; you don't need to consume any more to stay healthy.
The downside of cholesterol is its buildup on the walls of your arteries which may cause bumps or plaques to form. This plaque can narrow or even block your arteries, resulting in heart attack, stroke, or other serious health problems.
How much cholesterol you have in your blood is influenced primarily by diet, heredity, and metabolic diseases such as diabetes. Smoking and lack of exercise can also cause, or contribute to, high blood cholesterol levels.
Today, doctors realize there's more to the blood cholesterol story than just "high cholesterol." They consider the relative blood levels of two different kinds of cholesterol; namely, HDL or "good" cholesterol, and LDL or "bad" cholesterol.
Total blood cholesterol below 200 is desirable. Once your blood cholesterol hits 240, your risk for cardiovascular disease doubles. Also risky is "bad" LDL cholesterol over 130 and "good" HDL cholesterol below 35 (below 40 for women). High HDL cholesterol (60 or more) can actually reduce your chance of having a heart attack.
Besides changes in diet, low and high values can be associated with thyroid disorders, stress, caffeine, and even little influences such as your posture when the blood was being drawn.
Patients should therefore not be alarmed with small swings in absolute values, but consider the range over several tests.
Cholesterol/HDL Ratio (Coronary Risk Factor)
This number is obtained by comparing the total cholesterol level to the HDL cholesterol level. The higher this ratio, the greater the risk for coronary disease.
A high HDL will result in a lower ratio, meaning a lower risk. This can be true even if the total cholesterol is elevated.
The CBC provides information pertaining to three kinds of cells in the blood: the production of red blood cells (RBC), the production of white blood cells (WBC) and Platelets.
The CBC is most frequently used as a screening test, as an anemia check, and as a test for infection, but it is also used in the diagnosis and treatment of a large number of other conditions.
Creatinine is the breakdown product of creatine, which is used for skeletal muscle contraction, and is excreted entirely by the kidneys. Unlike BUN it is little affected by dehydration, malnutrition or liver function. An elevated creatinine may indicate that the kidneys are not functioning well.
Creatinine may also be increased as a result of muscle damage during trauma, or in muscle-wasting diseases such as muscular dystrophy
Bilirubin - Direct
This is a test for a specific form of bilirubin that is formed in the liver and excreted in the bile.
Normally very little of this form of bilirubin is found in the blood.
However, in liver disease, some of this form leaks into the blood, so even a slightly high level of direct bilirubin indicates a problem with the liver cells.
Ferritin
Ferritin is the most reliable serum indicator of total stores of iron in the body.
It is a convenient means of diagnosing iron deficiency anemia, iron overload conditions and also distinguishing between iron deficiency anemia and the anemias of inflammation or chronic liver disease in which iron stores and ferritin are generally increased.
Ferritin levels are decreased in anemias due to iron deficiency, chronic or acute haemorrhage, and aplastic anemia.
Ferritin levels are increased in anemias due to inflammations, chronic liver disease and leukemias.
A recent study released from Finland (1992) showed a strong association between high levels of stored iron (over 200 ng/ml) and coronary risk, especially when abnormally high levels of LDL are present.
GLU. Transpeptidase (GGT, Gamma-Glutaml Transferase)
This is an enzyme that is found primarily in the liver. Decreased values are not clinically significant, but elevated values are most often associated with drinking too much alcohol.
Certain medications, liver disease or bile duct disease can cause elevated levels.
Globulin
This is a group of proteins in your blood that helps to fight infections.
It is actually comprised of about 60 different proteins including alpha, beta and gamma globulins.
Some of the proteins in this group play an important role in clotting and unclotting.
Having a high or low level of this protein may indicate the need for further testing of the individual proteins that make up this group.
Blood Glucose(sugar) - Fasting
The body uses the food you eat to grow and be active. Much, if not most, of the energy for the body's tasks comes from a sugar called glucose. Glucose is part of the table sugar and starches we taste in our foods. It is delivered in the blood to the cells of the body. A Fasting blood glucose between 95 and 120 mg/dl could be an early sign of diabetes, and a 2-hour post-prandial blood sugar is recommended to make sure.
The level of blood glucose is controlled, in part, through a hormone called insulin that regulates the delivery of glucose from the blood into the cells.
Insulin is made in the beta cells of the pancreas and is secreted into the blood stream in response to a rise of blood glucose levels.
Insulin enables the glucose to enter the body's cells. Without insulin, the cells "lock out" the glucose to a great degree.
In diabetes, some children and adults don't make enough insulin; or enough insulin is made, but the cells are "resistant" to the insulin. In either case, the blood glucose rises to a level that is too high: "hyperglycemia."
Despite the high levels of blood glucose, the cells are, in effect, starving in the midst of plenty.
The kidneys, faced with an excessively high level of blood glucose, dump some out through the urine.
When people test their urine for sugar, that's one of the things that they're looking for: the spill-over of the excess sugar into their urine.
A high Fasting blood glucose (more than 120 mg/dl) level in someone who has fasted for 10-12 hours is usually a sign of diabetes.
It may also indicate other problems (for instance, hyperthyroidism). A low glucose level (<40 mg/ dl) may mean too much insulin in your blood resulting in hypoglycemia.
On the other hand, low levels may also result from improper specimen preparation and require a redraw.
People with diabetes can follow their glucose levels using any of a number of home meters.
These give an accurate portrait of glucose levels within the range usually needed to manage daily care, but sometimes, such as when the sugar levels are very high or very low, a more accurate measurement needs to be done by a laboratory.
A glucose level also can be part of the testing a doctor uses to decide if diabetes is a problem for someone who wasn't aware of it.
But by itself, a single fasting blood glucose usually doesn't provide enough information to make that decision.
One abnormally high blood glucose level may not mean anything significant. More thorough testing of several blood glucose levels may be needed to diagnose diabetes.
The body uses the food you eat to grow and be active. Much, if not most, of the energy for the body's tasks comes from a sugar called glucose. Glucose is part of the table sugar and starches we taste in our foods. It is delivered in the blood to the cells of the body. Two hours after a meal, the blood sugar should return to normal levels (less than 120 mg/dl). If it remains above 130 mg/dl this is usually a sign of diabetes.
The level of blood glucose is controlled, in part, through a hormone called insulin that regulates the delivery of glucose from the blood into the cells, where it is used or stored.
Insulin is made in the beta cells of the pancreas and is secreted into the blood stream in response to the rise of blood glucose levels.
Insulin enables the glucose to enter the body's cells. Without insulin, the cells "lock out" the glucose to a great degree.
In diabetes, some children and adults don't make enough insulin; or enough insulin is made, but the cells are "resistant" to the insulin. In either case, the blood glucose rises to a level that is too high: "hyperglycemia."
Despite the high levels of blood glucose, the cells are, in effect, starving in the midst of plenty.
The kidneys, faced with an excessively high level of blood glucose, dump some out through the urine.
When people test their urine for sugar, that's one of the things that they're looking for: the spill-over of the excess sugar into their urine.
People with diabetes can follow their glucose levels using any of a number of home meters.
These give an accurate portrait of glucose levels within the range usually needed to manage daily care, but sometimes, such as when the sugar levels are very high or very low, a more accurate measurement needs to be done by a laboratory.
High Density Lipoprotein (HDL) is considered the "good" cholesterol. One of the important roles of HDL cholesterol in the body is to carry cholesterol away from your arteries to your liver for metabolism. The more HDL cholesterol you have, the more cholesterol can be carried away and not clog your arteries.
There is growing evidence that a low HDL cholesterol level correlates to an increased risk for coronary heart disease (CHD), therefore low HDL (<35mg/dl) is classified as a major risk factor.
Higher values of HDL are generally found in people who exercise regularly, don't smoke and maintain a normal weight. For those who drink alcohol, low regular intake (1-2 drinks per day) also appears to raise HDL levels.
PCV (HCT, Hematocrit)
This test measures the portion of the blood volume that is made up by red blood cells.
A haematocrit of 40 means that 40% of the red blood cells are composed of red cells.
The results of this test will show you whether you are anemic (low volume of red blood cells), polycythemic (too many red blood cells), or normal.
Haemoglobin
Haemoglobin is the iron-containing protein found in red blood cells. The haemoglobin level is thus a good indication of the body's oxygen carrying capacity.
Haemoglobin forms an easily reversed bond with both oxygen and carbon dioxide, thus enabling the red blood cells to function as the oxygen transport system to the tissues of the body.
Low and high values are found in patients with anaemia and polycythemia respectively.
Inorganic Phosphorous (Phosphate)
The phosphate level in the blood is very important for muscle and nerve function.
Approximately 85% is found within the bone in a complex with calcium, the remaining 15% exists in the blood as a phosphate salt. High levels of serum phosphorous an be caused by hypoparathyroidism, kidney failure or increase dietary intake.
Very low levels of serum phosphorous can be caused by starvation or malnutrition and this can lead to muscle weakness.
Iron
The body uses iron to make haemoglobin and to help transfer oxygen to the muscles. Because serum iron levels may vary significantly during the day, specimens should be drawn in the morning.
Low iron levels are characteristic of many diseases including iron deficient anemia.
Causes of iron deficiency are (1) insufficient iron intake (2) inadequate absorption of iron from the intestines (try drinking orange juice in morning) (3) increased requirements for iron as in growing children (4) loss of blood as in excessive menstruation or a bleeding ulcer.
If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function up to par.
On the other hand, if there is too much iron in the body, this can cause injury to the heart, pancreas, joints, testicles, ovaries, etc.
Iron excess is found in the hereditary disease called haemochromatosis and this disease can be found in about 3 out of every 1000 people.
LD (Lactate Dehydrogenase) or LDH
The most common source of LD is the heart, liver, muscles, and red blood cells. Slightly elevated values are common and usually do not indicate disease.
LD is released into the blood when one of these organs or cells is damaged in some way including extreme vitamin deficiency and certain anaemias resulting in red cell destruction.
Very high LD values can be the result of improper blood collection procedures.
Low Density Lipoprotein (LDL) is generally referred to as the "bad" cholesterol or the atherogenic component of the lipoproteins responsible for depositing cholesterol onto the artery walls.
Elevated LDL is strongly associated with heart disease although not a predictor.
LDL is a calculated value, according to Friedewald's formula: LDL=T.Chol-HDL-Trig/5.
When Triglycerides are greater than 400 mg/dl, the calculation is invalid.
Trig/5 actually represents the calculation for VLDL or Very Low Density Lipoprotein.
Magnesium
This element is found primarily inside the cells of the body.
A low magnesium level in the blood may indicate severe malnutrition, alcoholism, or excessive use of diuretics.
A very low level of magnesium in the blood can cause your muscles to tremble.
This test measures the number of platelets in a cubic millimeter of blood. Platelets (thrombocytes) are tiny cell-like structures which play a major role in blood clotting.
When bleeding occurs, the platelets swell, stick together, and form a sticky plug that helps stop bleeding.
Platelets are produced in the bone marrow and thus can be low in bone marrow disease, after excessive radiation or chemotherapy, or anemias caused by vitamin B12 or folic acid deficiency.
An increased platelet count may be found in certain types of cancers, infections, pregnacy, strenuous exercise, iron-deficiency anemia, removal of the spleen, and inflammatory disorders.
Decreased values (less than 50 thousand/cmm) can result in spontaneous bleeding.
Potassium
This element is found primarily inside of cells and helps regulate the electrical activity of the muscles, including the heart, and affects the acid-base and fluid levels in the body.
Unusually high or low levels are most often the result of taking certain drugs or supplements and can be of critical clinical significance.
Low levels can be found in patients on diuretics or in patients not receiving enough potassium.
A low potassium level can cause muscle weakness and heart problems. A high potassium level can be found in kidney disease or in overuse of potassium supplements.
Protein Bound Glucose
This new test measures the amount of glucose that circulates in your blood bound to protein. PBG levels provide an indication of your average blood glucose level over the preceeding 7 - 15 days, and help to confirm the glucose result you have today.
The combination of the PBG result and the glucose result provide a much better indication of your body's glucose metabolism than either test alone.
Red Cell Count
The red blood cells, packed with haemoglobin, have the primary function of transporting oxygen from the lungs to the tissues, and returning carbon dioxide back to the lungs to be exhaled.
Normal values are slightly less for women and even less for children and infants. The RBC test determines the number of red blood cells in one cubic millimeter of blood.
If the RBC is low (anemia), the body tissues may not get all the oxygen they need.
If it is too high (polycythemia), the blood cells may be at increased risk of clumping together in the smallest blood vessels (capillaries).
Polycythemia may be due to lack of oxygen to the tissues (high altitude, smoking, chronic lung disease) or a decrease in body fluid volume usually accompanied by loss of iron (low fluid intake, vomiting, diarrhea, profuse sweating).
MCHC
MCHC, MCV and MCH describe the size and haemoglobin concentration of red blood cells.
MCHC (Mean Corpuscular Haemoglobin Concentration) - is the amount of haemoglobin in an average red blood cell. Greater than normal values suggest anemia due to deficiency of folic acid or vitamin B12.
MCV (Mean Corpuscular Volume) - indicates whether the cells are of normal size. A high MCV is also found with alcoholism. Less than normal values are consistent with iron deficiency anemia or thalassemia (an inherited defect of haemoglogin).
MCH (Mean Corpuscular Haemoglobin) - gives the weight of haemoglobin in an average red blood cell.
ASP. Transaminase (SGOT,AST)
The enzyme SGOT (often called serum aspartate transaminase, AST) is found in high concentration in the heart and liver and in moderately large amounts in the skeletal muscle, kidneys and pancreas.
After myocardial injury, the SGOT level rises within 6 to 10 hours, peaks at 12 to 48 hours, and returns to normal in approximately 3 to 4 days.
A characteristic rise in SGOT level occurs in more than 95% of patients with proven myocardial infarction.
ALA. Transaminase (SGPT, ALT, Alanine Aminotransferase)
This enzyme is found mainly in the liver, unlike the other enzymes which are also produced in other cells (such as lung, kidney and muscle).
If the level is high, your doctor will probably order the test repeated.
If it is high on the second sample, it strongly suggest liver disease and further testing for hepatitis is recommended.
Bilirubin - Total
Bilirubin is the orange-yellow pigment formed by the spleen during the breakdown of haemoglobin (red blood cells) in the blood that makes the plasma or serum part of your blood yellow.
When the bilirubin level in the blood is very high for a period of time, the whites of your eyes and your skin may become yellow.
This is known as jaundice. Bilirubin is transported to the liver for excretion by attaching to the blood protein "albumin".
A high bilirubin level in the blood can be caused by too many red cells being destroyed (haemolytic disease), by liver disease, or by a blockage of bile ducts.
Fasting can also cause a slight increase in total bilirubin.
Total Protein
This figure generally reflects the body's nutritional state, and is the sum of the albumin and globulin figures.
High and low levels don't necessarily indicate disease, but may indicate the need for further testing.
This is a blood fat. The relationship of moderate elevations to higher risk for heart disease is controversial unless cholesterol is also high.
An excessive amount of triglycerides (more than 450 mg/dl) in the blood can contribute to arterial hardening (atherosclerosis) due to fatty deposits.
High triglycerides are generally caused by high dietary intake of carbonhydrate, alcohol, sugars and yeast breads and are best treated with a change in diet unless a familial trait.
Uric acid is the end product of the breakdown of purines in your body. The level of uric acid in the blood is affected by a diet rich in purines; that is, food such as kidney, liver and pancreas. Also stress, alcohol and certain diuretics may raise the level. Decreased levels are not associated with any clinical symptoms and can be the result of poor kidney function.
A high level of uric acid in your blood may cause gouty arthritis (often referred to as the "King's Disease") or kidney stones.
WBC (White Blood Cell Count)
The white blood cells are an important part of the immune system for fighting off infection. If a bacterial infection is present, the number of white blood cells may increase dramatically. Certain medications including aspirin and several antibiotics may cause elevated values.
On the other hand, the WBC may or may not increase in viral infections. An increased WBC is called leukocytosis and may also suggest tissue damage (e.g., heart attack, cancer, cirrhosis of the liver, burns), collagen disease (e.g., rheumatoid arthritis), smoking, severe stress, surgery, fever) or any of a variety of other diseases (e.g., kidney failure, anemia).
Very high levels may suggest leukemia.
A decreased WBC value is called leukopenia and may indicate a disorder of white cell production
(e.g., aplastic anemia, pernicious anemia), viral infections, malaria, alcoholism, or uncontrolled diabetes.
Decreased values may also be due to certain drugs including several antibiotics.
Special Consideration: The WBC may vary as much as 2000 per cubic millimeter from day to day as a result of exercise, stress, smoking, digestion or minor infection.
Often included in a WBC test is the differential of the white blood cells into five or six types, each of which plays a somewhat different role in the body's immune response and thus helps in pinpointing a diagnosis.
These types are reported as a percentage of the total and also on some lab reports as the absolute number (percent times the actual WBC).
Normal range of values will vary from lab to lab and may be higher in children.
Neutrophils
These are classically associated with bacterial or viral infection.
They may sometimes may be seen as band forms (even more suggestive of infection).
Neutrophils can also be elevated in trauma, inflammation, or burns.
Lymphocytes
These often rise or fall with a viral infection; for example, mononucleosis, chicken pox.
High levels can be a sign of leukemia (very high levels or abnormal forms). They are also elevated in tuberculosis, reaction to drugs, Crohn's disease, vasculitis, thyroid problems, and Addison's disease (underactive adrenal gland).
Monocytes
Can rise with various forms of blood cancer, infections with bacteria, protozoa, sarcoidosis, and in autoimmune diseases.
Eosinophils
Typically found with allergies or parasitic infection.
Sometimes seen in skin disease, cancer, thyroid problems, or in autoimmune conditions.
Basophils
Typically found with allergies or parasitic infection.
Sometimes seen in skin disease, cancer, thyroid problems, or in autoimmune conditions.
TSH
TSH stands for thyrotropin-stimulating hormone and it is produced in the pituitary gland.
Your body produces more TSH when it wants the thyroid gland to manufacture more thyroid hormone (T3 and T4).
Therefore if your thyroid gland is not producing enough hormone (hypothyroidism) the TSH level will rise in an attempt to stimulate the thyroid to make more.
Conversely if the thyroid is producing too much hormone (hyperthyroidism) then the TSH drops to try and cause the thyroid to slow its production of hormone.
Free T3, T4 (T7 & FTI)
These two measures check the thyroid hormone levels more directly. Often the combination of the two is used and is called a T7.
T4 is the major hormone made by the thyroid and the body can convert it to T3 which is also active within the body.
A test of T3 is somewhat indirect and the result is often expressed as a percentage. By multiplying the percentage by the T4 level we get the T7 or Free Thyroxine Index (FTI).
ESR (Erythrocyte Sedimentation Rate)
This refers to the speed at which the red blood cells settle to the bottom of a column of blood in a glass tube. It is not a test that is specific for any one condition but may give a clue to the presence of a problem.
The rate depends on the amount of certain proteins in the blood. The long list of conditions that can increase the sedimentation rate includes infections, certain inflammatory conditions (for example, active rheumatoid arthritis or lupus), and some malignant disorders.
Definitive diagnosis must be based on results of further tests specific to the disorder under consideration as suggested by the history of illness, findings on a physical examination, and the results of other laboratory procedures.
ANA ( Anti-Nuclear Antibody)
This is a non-specific test that can be positive in patients with different types of arthritis and autoimmune diseases including lupus and rheumatoid arthritis.
This tests is expressed in titers such as 1:640 . The higher titers ( 1:320, 1: 640, 1:1280) are seen usually with lupus. The lower titers ( 1:40, 1:80, 1:160) are usually seen with other rheumatic diseases.
A positive test even with a high titer does not necessarily indicates presence of lupus since ANA test is non-specific. A more specific series of tests should be done in a patient with positive ANA to confirm or rule out diagnosis of lupus. These tests as well as an examination by a Rheumatologist ( Specialist for Arthritis and Osteoporosis) can determines if patient indeed has lupus.
Rheumatoid Factor
The rheumatoid factor (RF) is an antibody directed at one's own body. This antibody is believed to be responsible for the tissue destruciton found in rheumatoid arthritis.
RF can be found in up to 5% of healthy elderly adults. However it is much less common in healthy young people. It also can be found in a number of illnesses such as hepatitis, mononucleosis, cirrhosis of the liver, tuberculosis, and several others.
This means that false-positive results are quite common and establishing a diagnosis requires a proper history and examination as well. Generally, the higher the level of RF the more severe the disease. Unfortunately up to 20% of people with rheumatoid arthritis have no RF or only very low levels.
Quite commonly, young people with juvenile rheumatoid arthritis have no RF in their blood.
C-Reactive Protein (CRP) and ESR (Erythrocyte Sedimentation Rate)
These are non-specific tests that can be due to infections or arthritis and autoimmune diseases.
The ESR is usually expressed as a number while CRP may be reported as positive or negative.
While a positive or elevated ESR or CRP often indicates that there is a problem that needs to be investigated, a normal ESR or negative CRP does not mean that there is nothing wrong with the patient. In fact a patient may have severe arthritis but with a normal ESR and CRP.
If you suffer from pain and stiffness, these tests may be helpful only if they are positive. Negative tests as indicated above do not rule out arthritis or autoimmune diseases. A consultation with a Rheumatologist ( Specialist for Arthritis and Osteoporosis) can often be very helpful in determining the cause of your pain and stiffness and getting proper treatment for it.
PSA (Prostate Specific Antigen)
This substance is made by all prostate glands but in general cancerous prostate tissue makes more. It is important to realize that an enlarged prostate (which all men have by age 50) will make more PSA than a normal one. In this case there is no increased risk of cancer. The rate of change of your PSA is probably one of the best markers for cancer. If the PSA rises greater than about 1.0/year there is a higher risk, but by no means does it mean there is a cancer.
Caution should be exercised when interpreting the PSA as it may be elevated for reasons other than prostate cancer; for example, benign enlargment, prostatitis, recent ejaculation , prostate examination and instrumentation. Also, prostate cancer may be present in spite of a normal PSA in up to 20 percent of patients. This test should therefore be done in combination with a digital rectal examination by your family doctor.
Free PSA
This measures the proportion of the PSA that is not bound to protein in the blood stream and is expressed as a percentage. It appears that non-cancerous (benign) tissue produces PSA that binds more easily to protein. Therefore a low Free PSA is more suggestive of cancer.
The test for HbA1c indicates how well you have controlled your diabetes over the last few months. Even though you may have some very high or very low blood glucose values, HbA1c will give you a picture of the average amount of glucose in your blood over that time period. The result can help you and your doctor know if the measures you are taking to control your diabetes are successful.
Depending on the type of diabetes that you have, how well your diabetes is controlled, and your doctor, your HbA1c may be measured 2 to 4 times each year. The American Diabetes Association recommends testing your HbA1c: 4 times each year if you have type 1 or type 2 diabetes and use insulin; or 2 times each year if you have type 2 diabetes and do not use insulin.
A healthy person without diabetes will have an HbA1c between 4% and 6%. If you are diabetic, the closer your HbA1c is to 6%, the better your diabetes is in control. For every 1% increase in HbA1c, blood glucose increases approximately 30 mg/dL.
If you have an abnormal type of hemoglobin, such as sickle cell hemoglobin, accurate results will depend on the method used to measure your HbA1c. If you have hemolysis or heavy bleeding, your test results may be falsely low. Finally, if you are iron deficient, this may raise your HbA1c measurement.
The kidneys remove waste material, minerals, fluids, and other substances from the blood for elimination in the urine. Urine can therefore contain hundreds of different bodily waste products. Many factors (such as diet, fluid intake, exercise, and kidney function) affect what is in urine.
Over 100 different tests can be done on urine. However, a routine urinalysis usually involves the following tests.
Color: Many factors such as fluid balance, diet, medications, or disease can affect urine color. The intensity of the color generally indicates how concentrated the urine is, with pale or colorless urine being dilute and deep yellow urine being concentrated. However, vitamin B supplements can turn urine bright yellow. Reddish-brown urine may be caused by taking certain medications, eating blackberries or beets, or by blood in the urine.
Specific Gravity: This measures the amount of substances dissolved in the urine. It also indicates how well the kidneys are able to adjust the amount of water in urine. The higher the specific gravity, the more solid material is dissolved in the urine. When a person drinks a lot of liquid, the kidneys should produce greater than normal amounts of dilute urine. When a person drinks very little liquid, the kidneys should make only small amounts of concentrated urine.
pH: The pH measures how acidic or alkaline (basic) the urine is. A urine pH of 4 is strongly acidic, 7 is neutral (neither acidic nor alkaline), and 9 is strongly alkaline. Sometimes the pH of the urine may be adjusted by certain types of treatment. For example, efforts may be made to keep urine either acidic or alkaline to prevent formation of certain types of kidney stones.
Protein: Normally there is no protein in the urine. Sometimes a small amount of protein is released into the urine when a person stands up (this condition is called postural proteinuria). Fever, strenuous exercise, normal pregnancy, and some diseases (especially kidney disease) may also cause protein in the urine.
Glucose: Glucose is the type of sugar usually found in blood. Normally there is no glucose in urine. However, when the blood sugar level is very high, as in uncontrolled diabetes, it spills over into the urine. Glucose can also be present in urine when the kidneys are damaged or diseased.
Ketones: When fat is broken down for energy, the body produces by-products called ketones (or ketone bodies) and releases them into the urine. Large amounts of ketones in the urine may signal a dangerous condition known as diabetic ketoacidosis. A diet low in sugars and starches (carbohydrates), starvation, or prolonged vomiting may also cause ketones in the urine.
Other substances that may be measured during a urine test include:
Bilirubin: a compound formed by the breakdown of red blood cells and normally eliminated from the body in stool. Bilirubin is not normally found in urine. If it is present, it usually means the liver is damaged or the flow of bile from the gallbladder is blocked.
Urobilinogen: a compound formed by the breakdown of bilirubin and eliminated from the body mostly in stool. Only small amounts of urobilinogen are normally found in urine. Urobilinogen in urine can be a sign of liver disease (cirrhosis, hepatitis) or blockage of the flow of bile from the liver or gallbladder.
Interfering Factors
Blood from a woman's menstrual period can interfere with urine test results.
Many medications can interfere with urine test results. High doses of vitamin C (ascorbic acid) taken with certain antibiotics (such as tetracycline) can affect glucose, ketones, and protein test results.
Vitamin C (ascorbic acid) and some antibiotics such as erythromycin and trimethoprim (Trimpex) may cause crystals to form in urine.
Rough handling, contamination, or inadequate refrigeration of the urine sample can cause inaccurate test results.
In this test, urine is spun in a centrifuge so the solid materials (sediment) settle out. The sediment is spread on a slide and examined under a microscope.
Types of materials that may be found include:
Red or white blood cells. Normally, blood cells are not found in urine. Inflammation, disease, or injury to the kidneys, ureters, bladder or urethra can cause blood in urine. Strenuous exercise (such as running a marathon) can also cause blood in urine. White blood cells are often a sign of infection, cancer, or kidney disease.
Casts. Some types of kidney disease can cause plugs of material (called casts) to form in tiny tubes in the kidneys. The casts can then get flushed out into the urine. Casts can be made of different types of material, such as red or white blood cells, waxy or fatty substances, or protein. The type of cast can provide clues about the type of kidney disease that may be present.
Crystals. Healthy people often have only a few crystals in their urine. However, a large number of crystals, or the presence of certain types of crystals, may indicate kidney stones or a problem with how the body is using food (metabolism).
Bacteria, yeast cells, or parasites. Normally, there are no bacteria, yeast cells, or parasites in urine. Their presence can indicate an infection.
Specific gravity: Abnormally high specific gravity indicates very concentrated urine, which may be caused by not drinking enough liquid, loss of too much liquid (excessive vomiting, sweating, or diarrhea), or substances (such as sugar or protein) in the urine. Abnormally low specific gravity indicates dilute urine, which may be caused by drinking excessive amounts of liquid, severe kidney disease, or the use of diuretics.
pH: Some foods (such as citrus fruit and dairy products) and medications (such as antacids) can affect urine pH. A high (alkaline) pH can be caused by prolonged vomiting, a kidney disease, some urinary tract infections, and asthma. A low (acidic) pH may be a sign of severe lung disease (emphysema), uncontrolled diabetes, aspirin overdose, drinking an excessive amount of alcohol, drinking antifreeze (ethylene glycol), prolonged diarrhea, dehydration, or starvation.
Protein: Protein in the urine usually indicates kidney damage or disease that can be caused by conditions such as an infection, cancer, high blood pressure, diabetes, or systemic lupus erythematosus (SLE). Protein in the urine can also be caused by heart failure, leukemia, multiple myeloma, poison (lead or mercury poisoning), and a condition during pregnancy resulting in high blood pressure (preeclampsia).
Glucose: Some medications can cause glucose in the urine. Excess glucose in the urine is often caused by uncontrolled diabetes. Other conditions that may cause glucose in urine include a problem affecting the adrenal gland problem, liver damage, brain injury, certain types of poisoning, and certain kidney diseases that decrease their ability to reabsorb glucose from the urine.
Ketones: Ketones in the urine can indicate poorly controlled diabetes, a very low-carbohydrate diet, starvation (including disorders that result in poor nutrition such as anorexia nervosa or bulimia), alcoholism, or poisoning from drinking rubbing alcohol (isopropanol). Ketones are often found in the urine if a person avoids eating (fasts) for 18 hours or longer. This may occur when a person is sick and does not eat or has nausea and/or vomiting for an extended period of time. Low levels of ketones are sometimes found in the urine of a healthy pregnant woman.
Normal results may vary from lab to lab.
Other substances that may be measured during a urine test include:
Bilirubin: a compound formed by the breakdown of red blood cells and normally eliminated from the body in stool. Bilirubin is not normally found in urine. If it is present, it usually means the liver is damaged or the flow of bile from the gallbladder is blocked.
Urobilinogen: a compound formed by the breakdown of bilirubin and eliminated from the body mostly in stool. Only small amounts of urobilinogen are normally found in urine. Urobilinogen in urine can be a sign of liver disease (cirrhosis, hepatitis) or blockage of the flow of bile from the liver or gallbladder.
Interfering Factors
Blood from a woman's menstrual period can interfere with urine test results.
Many medications can interfere with urine test results. High doses of vitamin C (ascorbic acid) taken with certain antibiotics (such as tetracycline) can affect glucose, ketones, and protein test results.
Vitamin C (ascorbic acid) and some antibiotics such as erythromycin and trimethoprim (Trimpex) may cause crystals to form in urine.
Rough handling, contamination, or inadequate refrigeration of the urine sample can cause inaccurate test results.
The faecal occult blood test is used to check the stool (or faeces) for hidden traces of blood. This test is used primarily to detect colorectal cancer, but it can detect bleeding from anywhere along the digestive tract, so a positive test result can indicate many different disorders. It is recommended that this test be performed annually on all adults starting at age 50. If an individual is at high risk for colorectal cancer (for example, he or she has a family history of colorectal cancer), annual testing may begin earlier.
The test must be repeated after a positive result, with the patient eating no meat for three days. Some common causes of a positive result on a faecal occult blood test are: Peptic ulcer; Inflammation of intestines - which is sometimes caused by an infection; Cancer of the stomach, colon, or rectum; haemorrhoids; Aspirin or other medications that can irritate the digestive tract.
Certain foods and supplements must be avoided before the stool sample is collected because they can cause false results. Vitamin C supplements can mask the reaction so that blood will not be detected. Iron supplements and red meat in the diet can give false positive results. A patient is usually advised to avoid red meat, certain fruits and vegetables, vitamin C and iron supplements, and aspirin or other nonsteroidal anti-inflammatory drugs before the samples are taken. In addition, samples should not be collected when there is bleeding due to constipation, haemorrhoids, or menstruation.
HIV
HIV antibody testing is used to determine whether or not a person is infected with HIV. Early treatment of HIV infection and immune system monitoring can greatly improve long-term health. Also, knowing your HIV status may help you change behaviors that would put you and others at risk. Antibody testing will not detect HIV immediately after exposure, during the window before the development of antibodies. If you are tested too soon, your result may be negative despite the fact that you are infected. Because of this, repeat testing is important. You should have another HIV antibody test in 3 to 6 months from the time of a possible exposure to the virus.
Antibody testing for HIV should be ordered if you think you may have been exposed to HIV. Testing is recommended if: 1) You are sexually active (three or more sexual partners in the last 12 months). 2) You received a blood transfusion prior to1985, or a sexual partner received a transfusion and later tested positive for HIV. 3) You are uncertain about your sexual partner’s risk behaviors. 4) You are a male who has had sex with another male. 5) You have used street drugs by injection, especially when sharing needles and/or other equipment. 6) You have a sexually transmitted disease (STD). 7) You are a health care worker with direct exposure to blood on the job. 8) You are pregnant. (There are now treatments that can greatly reduce the risk that a pregnant woman who has HIV will give the virus to her baby.) 9) You are a woman who wants to make sure you are not infected with HIV before getting pregnant.
A healthy individual has no antibodies to HIV. If you test positive for HIV antibodies on both the ELISA and the Western Blot tests, you are considered to be infected with HIV.
An electrocardiogram or ECG is a recording of the
electrical activity within the heart obtained from the placement of various
electrodes on the skin surface. An ECG is performed to evaluate the heart rate
and rhythm. Disturbances in heart rhythm appearing on the ECG indicate that the
electrical component of the heart is malfunctioning. If you have suffered a
heart attack, for example, the electrocardiogram will help to pinpoint the area
and severity of heart muscle damage. If the pumping chamber of the heart is
enlarged as a result of overwork, it shows on the ECG.
Return to the top