Blood Work

Select the bloodwork panel you are most interested in. Each panel gives a description of what is tested. Purchase the panel and we will be in contact with you right away to explain the next steps in receiving your results.

UNDERSTAND YOUR HEALTH

General Health Tests For The Answers You Need

Vitamin B12 or Cobalamin, is a key player in the metabolism and creation of energy in all human tissues and cells.  All B vitamins including B12 are water soluble which means it is hard to take too much.  B12 is also important in DNA synthesis, amino acid and fatty acid metabolism.  B12 plays key roles in the maintenance and normal function of the brain and nervous system. B12 is also a critical element in the creation of myelin for nerves and maturation of red blood cells from bone marrow. This nutrient is especially critical for all athletes.  It is also at risk for being low for most women around their menstrual cycle.  The heavier the flow the larger the chance for deficiency is.

 

Do I Need This Test?

Have You Had?

·         Fatigue

·         Depression

·         Weakness disturbed vision

·         irritability

·         depression

·         changes in the way you think, feel and behave

·         Anxiety

·         Brain Fog

·         breathlessness

·         feeling faint

·         headaches

·         pale skin

·         noticeable heartbeats

 

What Other Tests Should I Look For These Issues?

Anemia Panel, Testosterone, CBC, CMP, Thyroid Panel

Testosterone

 

Testosterone is critical for overall health.  Testosterone is always reduced with stress and age.  Many people start to have testosterone levels start to drop after the age of 35-40.  Regardless of what many people think both men AND WOMEN need testosterone.  Many younger women 30+ that have high stress from young children and a busy life have lower testosterone levels that can manifest in many different symptoms/issues.

Do I Need This Test?

Have You Had Any?

·         Fatigue

·         Anxiety

·         Increased Fat

·         Weak muscles

·         Soreness

·         Bone loss/osteoporosis

·         Foggy headed

·         Depression

·         Low Sex Drive

·         Low Sexual Pleasure Male and Female

 

Things To Remember

Testosterone helps heal and repair muscles.  This means that it can help biceps and leg muscles, however never forget that the heart is a muscle that needs to repair and regenerate.  Also, the arteries and veins have muscles in them.  If the muscles in the veins get weak and soft the chance for DVT increases.  While many people think of testosterone as a quality of life hormone it should be looked at as a quantity of life hormone as well.

 

What Does This Panel Look For?

Testosterone Free:  How much testosterone is available to bind to a receptor and make things happen.

Testosterone Total: Total amount of testosterone free and bound.

 

What Other Tests Should I look At For These Symptoms?

Full male or female panel, thyroid panel, anemia panel, Hormone panel, Energy Panel

 

No Fasting

 

 

ESTROGEN

 

 

Estrogens are in the steroid chemical family.  Estrogens are found in both men and women and are important to both.  In men they help transport fats and regulate cholesterol.  In women they help develop breast, uterus, and along with progesterone regulate the menstrual cycle.  Estrogen is also a critical hormone for pregnancy.  For adult women outside of pregnancy estrogen levels do not have to be very high for quality of life and normal function.  Symptoms of low estrogen include: vaginal dryness, hot flashes, night sweats, headaches, mood swings. 

 

Do I Need This Test?

Have You Had

·         Testosterone Therapy

·         Abnormal Menstrual Cycles

·         Hot Flashes

·         Mood Swings

·         Estrogen therapy

·         Trouble Conceiving

·         Headaches

·         Vaginal Dryness

·         Night Sweats

·         Menstrual Cramps

·         Miscarriages

 

 

Other Tests I Should Look at for These Issues

Testosterone, CBC, CMP,

 

 

 

NO Fast

 

 

CBC – Complete Blood Count

CBC

What is included in a CBC?

A standard CBC includes:  

Red blood cell (RBC) tests:  

  • Red blood cell (RBC) count is the total number of red blood cells in your blood.
  • Hemoglobin measures the amount of the oxygen-carrying protein in the blood, which gives a good idea of the number of red blood cells in the blood.
  • Hematocrit measures the percentage of your total blood volume that consists of red blood cells.

Hemoglobin and Hematocrit are what is referred to as H&H.  This is what is looked at for testosterone therapy.  When these numbers go up the blood becomes thicker.  As the blood becomes thicker it puts more pressure on the blood vessels.  This is an important marker to look at.  If it gets high it is important to donate blood to decrease the pressure on the blood vessels.

 

  • Red blood cell indices provide information on the physical features of the RBCs:
    • Mean corpuscular volume (MCV) is a measurement of how big the RBC is.
    • Mean corpuscular hemoglobin (MCH) is the measurement of the average amount of hemoglobin inside the RBC.
    • Mean corpuscular hemoglobin concentration (MCHC) is a measurement of the average concentration of hemoglobin in the RBC.
    • Red cell distribution width (RDW) is the variation in the size of the RBC.
  • The CBC may also include reticulocyte count, which shows the count/percentage of newly released young red blood cells in your blood sample.

White blood cell (WBC) tests:  

  • White blood cell (WBC) count is a count of the total number of white blood cells.
  • White blood cell differential The WBC differential identifies the individual categories of WBC (neutrophils, lymphocytes, monocytes, eosinophils, and basophils). This can be listed as a total number or a fraction of the total WBC.

Platelet tests:  

  • The platelet count is the number of platelets in the blood.
  • Mean platelet volume (MPV) is a measurement of the size of platelets.
  • Platelet distribution width (PDW) It reflects how uniform platelets are in size.

 

All blood tests give us clues as to the health of a person or a bodily system.  If there are any numbers that are out of normal ranges or you have any questions ALWAYS consult your primary care physician.  All systems in the body are interconnected so one test result often triggers the need for other tests your primary healthcare provider will know of additional places to look.  

 

What Other Tests Should I look For With This Test?

A CMP is almost always ordered with a CBC, these two tests a CBC, CMP are a standard baseline in blood testing. 

 

 

 

 

 

NO Fasting

CMP – Comprehensive Metabolic Panel

 

The comprehensive metabolic panel (CMP) is a panel of 14 different tests that all help look at your metabolism.  Including: Glucose, electrolytes, liver, and kidney health. 

 

The CMP tests for:  

  • Glucose – the primary fuel source for the body used primarily by the muscles, heart and brain. Without proper levels energy starts to decrease and mental function can deteriorate into complete collapse. This helps show hypoglycemia and can indicate diabetes.
  • Calcium – A critical element in the body used for heart, nerves, muscles, bones and the formation of blood clots.

Proteins

  • Albumin – a protein made in the liver; it accounts for about 60% of the protein in the blood.
  • Total Protein – measures albumin as well as all other proteins in blood; proteins are important building blocks for all cells in the body.

Electrolytes—these are minerals that are in the tissues and blood in the form of dissolved salts. Electrolytes help move nutrients into the cells and help remove wastes out of the cells. They help maintain a healthy water balance and help stabilize the body’s acid-base (pH) level. The 4 tests for electrolytes are:  

  • Sodium – critical for normal nerve and muscle function
  • Potassium – critical for cell metabolism and muscle function, helping to transmit messages between nerves and muscles
  • Bicarbonate (Total CO2) – helps to maintain the body’s acid-base balance (pH)
  • Chloride – helps to regulate the amount of fluid in the body and maintain the acid-base balance

Kidney Tests

  • Blood urea nitrogen (BUN) – waste product filtered out of the blood by the kidneys; as kidney function decreases, the BUN level rises. This can also help determine hydration needs.
  • Creatinine – waste product produced in the muscles; it is filtered out of the blood by the kidneys so blood levels are a good indication of how well the kidneys are working. This test can be higher in athletes as supplementation and muscle break down from exercise can increase these levels.

Liver Tests

  • Alkaline phosphatase (ALP) – enzyme found in bone, liver, and other tissues; higher levels of ALP in the blood are most commonly caused by liver disease or bone disorders.
  • Alanine amino transferase (ALT, SGPT) – enzyme found mostly in the cells of the liver and kidney; a test for commonly used for detecting liver damage. These levels may be higher in athletes, especially in those that are training harder or in a new way.
  • Aspartate amino transferase (AST, SGOT) – enzyme found especially in cells in the heart and liver; also a useful test for detecting liver damage

Bilirubin – Bilirubin is a normal waste product after breaking down hemoglobin from blood.  Since it is normally filtered out by the liver it can show liver function levels. If Bilirubin levels get too high it will often cause Jaundice which can lead to further damage and yellowing of the skin and eyes.

Thyroid Panel

 

The thyroid is a small gland just above the collar bones in the neck.  This gland most famously helps to regulate metabolism/energy.  However, it also works with several other systems in the body such as eyes, hair, temperature, and brain function.

The Thyroid panel helps to determine any fluctuations in thyroid function that can lead to disease processes.  It can help determine hypothyroidism (to low thyroid) and hyperthyroidism (to high thyroid).  Once you know the levels of the thyroid there are several ways to repair these issues, however you first have to know.

 

Do I Need This Test?

If you have any of these symptoms a thyroid panel might be the right test for you.

·         Fatigue

·         Increased sensitivity to cold

·         Constipation

·         Dry skin

·         Weight gain

·         Puffy face

·         Hoarseness

·         Muscle weakness

·         Elevated blood cholesterol level

·         Foggy headed

 

·         Impaired memory

·         Enlarged thyroid gland (goiter)

·         Muscle aches, tenderness and stiffness

·         Pain, stiffness or swelling in your joints

·         Heavier than normal or irregular menstrual periods

·         Thinning hair

·         Slowed heart rate

·         Depression

·         Anxiety

 

 

What Other Tests Should I look At For These Issues?

Other lab tests go with these symptoms include: Full male and female wellness panel, testosterone panel, hormone panel, energy panel, and anemia panel.

 

What does the lab panel tell us?

  1. Thyroid Stimulating Hormone (TSH): This shows how hard your pituitary gland is telling the thyroid to make thyroid hormones T3 and T4.
  2. T4 Total: This is the amount of thyroxin that is bound and free in the blood. Thyroxin is the precursor to T3(triiodothyronine).
  3. Free T3: Triiodothyronine is the active form of thyroid hormone. Free T3 is the amount that is floating around ready to work.
  4. Free T4: This is the amount of T4 that has not bound to any other proteins.
  5. Thyroid Peroxidase antibodies (TPO): This test helps determine certain autoimmune diseases like Graves’ disease or Hashimoto thyroiditis.

 

 

No fasting

Blood types are based on the markers (specific carbohydrates or proteins) or antigens on the surface of red blood cells (RBCs). Two major antigens or surface identifiers on human RBCs are the A and B antigens. Another important surface antigen is called Rh. Blood typing detects the presence or absence of these antigens to determine a person’s ABO blood group and Rh type.

People whose red blood cells have A antigens are in blood group A, those with B antigens are group B, those with both A and B antigens are in group AB, and those who do not have either of these markers are in blood group O.

If the Rh protein is present on the red blood cells, a person’s blood type is Rh+ (positive); if it is absent, the person’s blood is type Rh- (negative).

Our bodies naturally produce antibodies against the A and B antigens that we do not have on our red blood cells. For example, a person who is blood type A will have anti-B antibodies directed against the B antigens on red blood cells and someone who is type B will have anti-A antibodies directed against the A antigens. People with type AB blood have neither of these antibodies, while those with type O blood have both.

The following table indicates the type of antibodies a person is expected to have based on their blood type.

a person with blood type …

will have antibodies to …

A

B antigen

B

A antigen

AB

Neither antigen

O

A and B antigens

These antibodies are useful for determining a person’s blood type and help determine the types of blood that he or she can safely receive (compatibility). If a person who is group A with antibodies directed against the B antigen, for example, were to be transfused with blood that is type B, his or her own antibodies would target and destroy the transfused red blood cells, causing severe, potentially fatal complications. Thus, it is critical to match a person’s blood type with the blood that is to be transfused.

Unlike antibodies to A and B antigens, antibodies to Rh are not produced naturally. That is, Rh antibodies develop only after a person who does not have Rh factor on his or her red blood cells (Rh negative) is exposed to Rh positive red blood cells. This can happen during pregnancy or birth when an Rh-negative woman is pregnant with an Rh-positive baby, or sometimes when an Rh-negative person is transfused with Rh-positive blood. In either case, the first exposure to the Rh antigen may not result in a strong response against the Rh positive cells, but subsequent exposures may cause severe reactions.

 

CBC – Complete Blood Count

CBC

What is included in a CBC?

A standard CBC includes:  

Red blood cell (RBC) tests:  

  • Red blood cell (RBC) count is the total number of red blood cells in your blood.
  • Hemoglobin measures the amount of the oxygen-carrying protein in the blood, which gives a good idea of the number of red blood cells in the blood.
  • Hematocrit measures the percentage of your total blood volume that consists of red blood cells.

Hemoglobin and Hematocrit are what is referred to as H&H.  This is what is looked at for testosterone therapy.  When these numbers go up the blood becomes thicker.  As the blood becomes thicker it puts more pressure on the blood vessels.  This is an important marker to look at.  If it gets high it is important to donate blood to decrease the pressure on the blood vessels.

 

  • Red blood cell indices provide information on the physical features of the RBCs:
    • Mean corpuscular volume (MCV) is a measurement of how big the RBC is.
    • Mean corpuscular hemoglobin (MCH) is the measurement of the average amount of hemoglobin inside the RBC.
    • Mean corpuscular hemoglobin concentration (MCHC) is a measurement of the average concentration of hemoglobin in the RBC.
    • Red cell distribution width (RDW) is the variation in the size of the RBC.
  • The CBC may also include reticulocyte count, which shows the count/percentage of newly released young red blood cells in your blood sample.

White blood cell (WBC) tests:  

  • White blood cell (WBC) count is a count of the total number of white blood cells.
  • White blood cell differential The WBC differential identifies the individual categories of WBC (neutrophils, lymphocytes, monocytes, eosinophils, and basophils). This can be listed as a total number or a fraction of the total WBC.

Platelet tests:  

  • The platelet count is the number of platelets in the blood.
  • Mean platelet volume (MPV) is a measurement of the size of platelets.
  • Platelet distribution width (PDW) It reflects how uniform platelets are in size.

 

All blood tests give us clues as to the health of a person or a bodily system.  If there are any numbers that are out of normal ranges or you have any questions ALWAYS consult your primary care physician.  All systems in the body are interconnected so one test result often triggers the need for other tests your primary healthcare provider will know of additional places to look.  

 

What Other Tests Should I look For With This Test?

A CMP is almost always ordered with a CBC, these two tests a CBC, CMP are a standard baseline in blood testing. 

 

 

 

 

 

NO Fasting

 

 

CMP – Comprehensive Metabolic Panel

 

The comprehensive metabolic panel (CMP) is a panel of 14 different tests that all help look at your metabolism.  Including: Glucose, electrolytes, liver, and kidney health. 

 

The CMP tests for:  

  • Glucose – the primary fuel source for the body used primarily by the muscles, heart and brain. Without proper levels energy starts to decrease and mental function can deteriorate into complete collapse. This helps show hypoglycemia and can indicate diabetes.
  • Calcium – A critical element in the body used for heart, nerves, muscles, bones and the formation of blood clots.

Proteins

  • Albumin – a protein made in the liver; it accounts for about 60% of the protein in the blood.
  • Total Protein – measures albumin as well as all other proteins in blood; proteins are important building blocks for all cells in the body.

Electrolytes—these are minerals that are in the tissues and blood in the form of dissolved salts. Electrolytes help move nutrients into the cells and help remove wastes out of the cells. They help maintain a healthy water balance and help stabilize the body’s acid-base (pH) level. The 4 tests for electrolytes are:  

  • Sodium – critical for normal nerve and muscle function
  • Potassium – critical for cell metabolism and muscle function, helping to transmit messages between nerves and muscles
  • Bicarbonate (Total CO2) – helps to maintain the body’s acid-base balance (pH)
  • Chloride – helps to regulate the amount of fluid in the body and maintain the acid-base balance

Kidney Tests

  • Blood urea nitrogen (BUN) – waste product filtered out of the blood by the kidneys; as kidney function decreases, the BUN level rises. This can also help determine hydration needs.
  • Creatinine – waste product produced in the muscles; it is filtered out of the blood by the kidneys so blood levels are a good indication of how well the kidneys are working. This test can be higher in athletes as supplementation and muscle break down from exercise can increase these levels.

Liver Tests

  • Alkaline phosphatase (ALP) – enzyme found in bone, liver, and other tissues; higher levels of ALP in the blood are most commonly caused by liver disease or bone disorders.
  • Alanine amino transferase (ALT, SGPT) – enzyme found mostly in the cells of the liver and kidney; a test for commonly used for detecting liver damage. These levels may be higher in athletes, especially in those that are training harder or in a new way.
  • Aspartate amino transferase (AST, SGOT) – enzyme found especially in cells in the heart and liver; also a useful test for detecting liver damage

Bilirubin – Bilirubin is a normal waste product after breaking down hemoglobin from blood.  Since it is normally filtered out by the liver it can show liver function levels. If Bilirubin levels get too high it will often cause Jaundice which can lead to further damage and yellowing of the skin and eyes.

 

Testosterone

 

Testosterone is critical for overall health.  Testosterone is always reduced with stress and age.  Many people start to have testosterone levels start to drop after the age of 35-40.  Regardless of what many people think both men AND WOMEN need testosterone.  Many younger women 30+ that have high stress from young children and a busy life have lower testosterone levels that can manifest in many different symptoms/issues.

Do I Need This Test?

Have You Had Any?

·         Fatigue

·         Anxiety

·         Increased Fat

·         Weak muscles

·         Soreness

·         Bone loss/osteoporosis

·         Foggy headed

·         Depression

·         Low Sex Drive

·         Low Sexual Pleasure Male and Female

 

Things To Remember

Testosterone helps heal and repair muscles.  This means that it can help biceps and leg muscles, however never forget that the heart is a muscle that needs to repair and regenerate.  Also, the arteries and veins have muscles in them.  If the muscles in the veins get weak and soft the chance for DVT increases.  While many people think of testosterone as a quality of life hormone it should be looked at as a quantity of life hormone as well.

 

What Does This Panel Look For?

Testosterone Free:  How much testosterone is available to bind to a receptor and make things happen.

Testosterone Total: Total amount of testosterone free and bound.

 

What Other Tests Should I look At For These Symptoms?

Full male or female panel, thyroid panel, anemia panel, Hormone panel, Energy Panel

 

No Fasting

 

 

ESTROGEN

 

 

Estrogens are in the steroid chemical family.  Estrogens are found in both men and women and are important to both.  In men they help transport fats and regulate cholesterol.  In women they help develop breast, uterus, and along with progesterone regulate the menstrual cycle.  Estrogen is also a critical hormone for pregnancy.  For adult women outside of pregnancy estrogen levels do not have to be very high for quality of life and normal function.  Symptoms of low estrogen include: vaginal dryness, hot flashes, night sweats, headaches, mood swings. 

 

Do I Need This Test?

Have You Had

·         Testosterone Therapy

·         Abnormal Menstrual Cycles

·         Hot Flashes

·         Mood Swings

·         Estrogen therapy

·         Trouble Conceiving

·         Headaches

·         Vaginal Dryness

·         Night Sweats

·         Menstrual Cramps

·         Miscarriages

 

 

Other Tests I Should Look at for These Issues

Testosterone, CBC, CMP,

 

 

 

NO Fast

 

 

CBC – Complete Blood Count

CBC

What is included in a CBC?

A standard CBC includes:  

Red blood cell (RBC) tests:  

  • Red blood cell (RBC) count is the total number of red blood cells in your blood.
  • Hemoglobin measures the amount of the oxygen-carrying protein in the blood, which gives a good idea of the number of red blood cells in the blood.
  • Hematocrit measures the percentage of your total blood volume that consists of red blood cells.

Hemoglobin and Hematocrit are what is referred to as H&H.  This is what is looked at for testosterone therapy.  When these numbers go up the blood becomes thicker.  As the blood becomes thicker it puts more pressure on the blood vessels.  This is an important marker to look at.  If it gets high it is important to donate blood to decrease the pressure on the blood vessels.

 

  • Red blood cell indices provide information on the physical features of the RBCs:
    • Mean corpuscular volume (MCV) is a measurement of how big the RBC is.
    • Mean corpuscular hemoglobin (MCH) is the measurement of the average amount of hemoglobin inside the RBC.
    • Mean corpuscular hemoglobin concentration (MCHC) is a measurement of the average concentration of hemoglobin in the RBC.
    • Red cell distribution width (RDW) is the variation in the size of the RBC.
  • The CBC may also include reticulocyte count, which shows the count/percentage of newly released young red blood cells in your blood sample.

White blood cell (WBC) tests:  

  • White blood cell (WBC) count is a count of the total number of white blood cells.
  • White blood cell differential The WBC differential identifies the individual categories of WBC (neutrophils, lymphocytes, monocytes, eosinophils, and basophils). This can be listed as a total number or a fraction of the total WBC.

Platelet tests:  

  • The platelet count is the number of platelets in the blood.
  • Mean platelet volume (MPV) is a measurement of the size of platelets.
  • Platelet distribution width (PDW) It reflects how uniform platelets are in size.

 

All blood tests give us clues as to the health of a person or a bodily system.  If there are any numbers that are out of normal ranges or you have any questions ALWAYS consult your primary care physician.  All systems in the body are interconnected so one test result often triggers the need for other tests your primary healthcare provider will know of additional places to look.  

 

What Other Tests Should I look For With This Test?

A CMP is almost always ordered with a CBC, these two tests a CBC, CMP are a standard baseline in blood testing. 

 

 

 

 

 

NO Fasting

CMP – Comprehensive Metabolic Panel

 

The comprehensive metabolic panel (CMP) is a panel of 14 different tests that all help look at your metabolism.  Including: Glucose, electrolytes, liver, and kidney health. 

 

The CMP tests for:  

  • Glucose – the primary fuel source for the body used primarily by the muscles, heart and brain. Without proper levels energy starts to decrease and mental function can deteriorate into complete collapse. This helps show hypoglycemia and can indicate diabetes.
  • Calcium – A critical element in the body used for heart, nerves, muscles, bones and the formation of blood clots.

Proteins

  • Albumin – a protein made in the liver; it accounts for about 60% of the protein in the blood.
  • Total Protein – measures albumin as well as all other proteins in blood; proteins are important building blocks for all cells in the body.

Electrolytes—these are minerals that are in the tissues and blood in the form of dissolved salts. Electrolytes help move nutrients into the cells and help remove wastes out of the cells. They help maintain a healthy water balance and help stabilize the body’s acid-base (pH) level. The 4 tests for electrolytes are:  

  • Sodium – critical for normal nerve and muscle function
  • Potassium – critical for cell metabolism and muscle function, helping to transmit messages between nerves and muscles
  • Bicarbonate (Total CO2) – helps to maintain the body’s acid-base balance (pH)
  • Chloride – helps to regulate the amount of fluid in the body and maintain the acid-base balance

Kidney Tests

  • Blood urea nitrogen (BUN) – waste product filtered out of the blood by the kidneys; as kidney function decreases, the BUN level rises. This can also help determine hydration needs.
  • Creatinine – waste product produced in the muscles; it is filtered out of the blood by the kidneys so blood levels are a good indication of how well the kidneys are working. This test can be higher in athletes as supplementation and muscle break down from exercise can increase these levels.

Liver Tests

  • Alkaline phosphatase (ALP) – enzyme found in bone, liver, and other tissues; higher levels of ALP in the blood are most commonly caused by liver disease or bone disorders.
  • Alanine amino transferase (ALT, SGPT) – enzyme found mostly in the cells of the liver and kidney; a test for commonly used for detecting liver damage. These levels may be higher in athletes, especially in those that are training harder or in a new way.
  • Aspartate amino transferase (AST, SGOT) – enzyme found especially in cells in the heart and liver; also a useful test for detecting liver damage

Bilirubin – Bilirubin is a normal waste product after breaking down hemoglobin from blood.  Since it is normally filtered out by the liver it can show liver function levels. If Bilirubin levels get too high it will often cause Jaundice which can lead to further damage and yellowing of the skin and eyes.

 

Dihydrotestosterone

 

DHT is critical for the development of male genitalia during development.  DHT is also important during the maturation of the penis, testicles, seminal vesicles and prostate as men develop into maturity.  Male pattern hair growth on the face, pubic, and body depend on DHT levels as well.  The enzyme 5α-reductase is used to convert testosterone into DHT.

Levels of DHT are normally significantly less than that of testosterone in most areas of the body.  DHT is normally 1/10 to 1/20 the concentration of testosterone, however, certain tissues like the prostate can have 10 times the amount of DHT vs the rest of the body.  For this reason, it is important to check the levels of DHT to ensure the prostate is not at risk for cancer.

  DHT is responsible for:

  • Prostate enlargement- This is critical during puberty, however, if DHT levels stay high for too long prostate cancer risk start to increase markedly.
  • Facial, axillary, pubic, and over all body hair growth.
  • Scalp and forehead recession style hair loss- Male pattern balding. This can happen in women as well if the levels of DHT get too high.

 

Who Should Get This Test?

Anyone who is or has:

·         On Testosterone therapy

·         Is worried about going bald

·         Has had any prostate enlargement issues

·         Has a personal or family history of prostate cancer

·         Has excessive body hair

 

What Other Tests Go With This?

Testosterone, PSA, CBC, CMP, Estrogen/Estradiol

 

 

Thyroid Panel

 

The thyroid is a small gland just above the collar bones in the neck.  This gland most famously helps to regulate metabolism/energy.  However, it also works with several other systems in the body such as eyes, hair, temperature, and brain function.

The Thyroid panel helps to determine any fluctuations in thyroid function that can lead to disease processes.  It can help determine hypothyroidism (to low thyroid) and hyperthyroidism (to high thyroid).  Once you know the levels of the thyroid there are several ways to repair these issues, however you first have to know.

 

Do I Need This Test?

If you have any of these symptoms a thyroid panel might be the right test for you.

·         Fatigue

·         Increased sensitivity to cold

·         Constipation

·         Dry skin

·         Weight gain

·         Puffy face

·         Hoarseness

·         Muscle weakness

·         Elevated blood cholesterol level

·         Foggy headed

 

·         Impaired memory

·         Enlarged thyroid gland (goiter)

·         Muscle aches, tenderness and stiffness

·         Pain, stiffness or swelling in your joints

·         Heavier than normal or irregular menstrual periods

·         Thinning hair

·         Slowed heart rate

·         Depression

·         Anxiety

 

 

What Other Tests Should I look At For These Issues?

Other lab tests go with these symptoms include: Full male and female wellness panel, testosterone panel, hormone panel, energy panel, and anemia panel.

 

What does the lab panel tell us?

  1. Thyroid Stimulating Hormone (TSH): This shows how hard your pituitary gland is telling the thyroid to make thyroid hormones T3 and T4.
  2. T4 Total: This is the amount of thyroxin that is bound and free in the blood. Thyroxin is the precursor to T3 (triiodothyronine).
  3. Free T3: Triiodothyronine is the active form of thyroid hormone. Free T3 is the amount that is floating around ready to work.
  4. Free T4: This is the amount of T4 that has not bound to any other proteins.
  5. Thyroid Peroxidase antibodies (TPO): This test helps determine certain autoimmune diseases like Graves’ disease or Hashimoto thyroiditis.

 

 

No fasting

 

Reverse T3

 

Reverse T3 is normally looked at for autoimmune issues at the thyroid gland.  Issues that arise from this are similar to hashimoto disease.  Reverse T3 or rT3 competes with normal T3 at the thyroid binding sites.  This can shut down normal thyroid function and end up giving you hypothyroid issues.  This can lead to weight gain, decreased energy, loss of mental focus, poor workouts, decreased overall body temperature and low IGF1 levels.  This is a good test for anyone of any age. 

 

Thyroid Panel

 

The thyroid is a small gland just above the collar bones in the neck.  This gland most famously helps to regulate metabolism/energy.  However, it also works with several other systems in the body such as eyes, hair, temperature, and brain function.

The Thyroid panel helps to determine any fluctuations in thyroid function that can lead to disease processes.  It can help determine hypothyroidism (to low thyroid) and hyperthyroidism (to high thyroid).  Once you know the levels of the thyroid there are several ways to repair these issues, however you first have to know.

 

Do I Need This Test?

If you have any of these symptoms a thyroid panel might be the right test for you.

·         Fatigue

·         Increased sensitivity to cold

·         Constipation

·         Dry skin

·         Weight gain

·         Puffy face

·         Hoarseness

·         Muscle weakness

·         Elevated blood cholesterol level

·         Foggy headed

 

·         Impaired memory

·         Enlarged thyroid gland (goiter)

·         Muscle aches, tenderness and stiffness

·         Pain, stiffness or swelling in your joints

·         Heavier than normal or irregular menstrual periods

·         Thinning hair

·         Slowed heart rate

·         Depression

·         Anxiety

 

 

What Other Tests Should I look At For These Issues?

Other lab tests go with these symptoms include: Full male and female wellness panel, testosterone panel, hormone panel, energy panel, and anemia panel.

 

What does the lab panel tell us?

  1. Thyroid Stimulating Hormone (TSH): This shows how hard your pituitary gland is telling the thyroid to make thyroid hormones T3 and T4.
  2. T4 Total: This is the amount of thyroxin that is bound and free in the blood. Thyroxin is the precursor to T3 (triiodothyronine).
  3. Free T3: Triiodothyronine is the active form of thyroid hormone. Free T3 is the amount that is floating around ready to work.
  4. Free T4: This is the amount of T4 that has not bound to any other proteins.
  5. Thyroid Peroxidase antibodies (TPO): This test helps determine certain autoimmune diseases like Graves’ disease or Hashimoto thyroiditis.

 

 

No fasting

 

Reverse T3

 

Reverse T3 is normally looked at for autoimmune issues at the thyroid gland.  Issues that arise from this are similar to hashimoto disease.  Reverse T3 or rT3 competes with normal T3 at the thyroid binding sites.  This can shut down normal thyroid function and end up giving you hypothyroid issues.  This can lead to weight gain, decreased energy, loss of mental focus, poor workouts, decreased overall body temperature and low IGF1 levels.  This is a good test for anyone of any age. 

 

 

 

CBC – Complete Blood Count

CBC

What is included in a CBC?

A standard CBC includes:  

Red blood cell (RBC) tests:  

  • Red blood cell (RBC) count is the total number of red blood cells in your blood.
  • Hemoglobin measures the amount of the oxygen-carrying protein in the blood, which gives a good idea of the number of red blood cells in the blood.
  • Hematocrit measures the percentage of your total blood volume that consists of red blood cells.

Hemoglobin and Hematocrit are what is referred to as H&H.  This is what is looked at for testosterone therapy.  When these numbers go up the blood becomes thicker.  As the blood becomes thicker it puts more pressure on the blood vessels.  This is an important marker to look at.  If it gets high it is important to donate blood to decrease the pressure on the blood vessels.

 

  • Red blood cell indices provide information on the physical features of the RBCs:
    • Mean corpuscular volume (MCV) is a measurement of how big the RBC is.
    • Mean corpuscular hemoglobin (MCH) is the measurement of the average amount of hemoglobin inside the RBC.
    • Mean corpuscular hemoglobin concentration (MCHC) is a measurement of the average concentration of hemoglobin in the RBC.
    • Red cell distribution width (RDW) is the variation in the size of the RBC.
  • The CBC may also include reticulocyte count, which shows the count/percentage of newly released young red blood cells in your blood sample.

White blood cell (WBC) tests:  

  • White blood cell (WBC) count is a count of the total number of white blood cells.
  • White blood cell differential The WBC differential identifies the individual categories of WBC (neutrophils, lymphocytes, monocytes, eosinophils, and basophils). This can be listed as a total number or a fraction of the total WBC.

Platelet tests:  

  • The platelet count is the number of platelets in the blood.
  • Mean platelet volume (MPV) is a measurement of the size of platelets.
  • Platelet distribution width (PDW) It reflects how uniform platelets are in size.

 

All blood tests give us clues as to the health of a person or a bodily system.  If there are any numbers that are out of normal ranges or you have any questions ALWAYS consult your primary care physician.  All systems in the body are interconnected so one test result often triggers the need for other tests your primary healthcare provider will know of additional places to look.  

 

What Other Tests Should I look For With This Test?

A CMP is almost always ordered with a CBC, these two tests a CBC, CMP are a standard baseline in blood testing. 

 

 

 

 

 

NO Fasting

 

 

CMP – Comprehensive Metabolic Panel

 

The comprehensive metabolic panel (CMP) is a panel of 14 different tests that all help look at your metabolism.  Including: Glucose, electrolytes, liver, and kidney health. 

 

The CMP tests for:  

  • Glucose – the primary fuel source for the body used primarily by the muscles, heart and brain. Without proper levels energy starts to decrease and mental function can deteriorate into complete collapse. This helps show hypoglycemia and can indicate diabetes.
  • Calcium – A critical element in the body used for heart, nerves, muscles, bones and the formation of blood clots.

Proteins

  • Albumin – a protein made in the liver; it accounts for about 60% of the protein in the blood.
  • Total Protein – measures albumin as well as all other proteins in blood; proteins are important building blocks for all cells in the body.

Electrolytes—these are minerals that are in the tissues and blood in the form of dissolved salts. Electrolytes help move nutrients into the cells and help remove wastes out of the cells. They help maintain a healthy water balance and help stabilize the body’s acid-base (pH) level. The 4 tests for electrolytes are:  

  • Sodium – critical for normal nerve and muscle function
  • Potassium – critical for cell metabolism and muscle function, helping to transmit messages between nerves and muscles
  • Bicarbonate (Total CO2) – helps to maintain the body’s acid-base balance (pH)
  • Chloride – helps to regulate the amount of fluid in the body and maintain the acid-base balance

Kidney Tests

  • Blood urea nitrogen (BUN) – waste product filtered out of the blood by the kidneys; as kidney function decreases, the BUN level rises. This can also help determine hydration needs.
  • Creatinine – waste product produced in the muscles; it is filtered out of the blood by the kidneys so blood levels are a good indication of how well the kidneys are working. This test can be higher in athletes as supplementation and muscle break down from exercise can increase these levels.

Liver Tests

  • Alkaline phosphatase (ALP) – enzyme found in bone, liver, and other tissues; higher levels of ALP in the blood are most commonly caused by liver disease or bone disorders.
  • Alanine amino transferase (ALT, SGPT) – enzyme found mostly in the cells of the liver and kidney; a test for commonly used for detecting liver damage. These levels may be higher in athletes, especially in those that are training harder or in a new way.
  • Aspartate amino transferase (AST, SGOT) – enzyme found especially in cells in the heart and liver; also a useful test for detecting liver damage

Bilirubin – Bilirubin is a normal waste product after breaking down hemoglobin from blood.  Since it is normally filtered out by the liver it can show liver function levels. If Bilirubin levels get too high it will often cause Jaundice which can lead to further damage and yellowing of the skin and eyes.

 

 

 

CoQ-10

 

Coenzyme Q-10 or CoQ-10 is extremely important for cellular metabolism.  CoQ-10 is a major component of the electron transport chain and is key component in aerobic cellular respiration.  These functions help to produce Adenosine Triphosphate (ATP).  Over 90% of all the energy in the human body is generated in this way.  Due to this the organs that require the most energy have the highest concentrations of CoQ-10 namely the heart, brain, liver, kidney and gut. This test is especially necessary for all athletes.

 

Do I Need This Test?

Do You Have a Personal or Family History of?

·         Heart attack

·         Cancer

·         Stroke

·         Muscular Weakness

·         Fatigue

·         Anxiety

·         Depression

·         Stress

·         Arterial Plaquing

·         Brain Fog

 

What Other Tests Should I Look at for These Issues?

B12, Anemia Panel, Testosterone, CBC, CMP

 

Vitamin D3 can be made in the body and thus should be considered a hormone more than a vitamin, however, for ease of understanding it will be referred to as a vitamin for this discussion.

Vitamin D3 significantly increases the ions that move into the body as well as into the cells and individual tissues.  This will allow tissues to function at a higher level, repair more, fight off disease, and produce more hormones and neurotransmitters.  The reason that research has shown that vitamin D3 helps with everything in the body is that everything in the body requires ions. 

Most people do not get enough of this vitamin or the precursors to the vitamin.  D3 helps to ensure bone density, keeps muscles (including the heart) moving, helps produce neurotransmitters to think clearly and avoid anxiety and depression, create energy in the form of ATP and many more things.  

The standard excepted lab value for excepted levels is 35, Dr. Chalmers likes most of his patients to have the minimum level to be 60, athletes need to be 80.

 

Do I Need This Test?

Are You or Do You Have?

  • An athlete
  • Have high stress
  • Have a physically taking job
  • Bone density issues
  • Osteoporosis
  • Have General Health questions
  • Fatigue
  • Anxiety
  • Depression
  • Get sick often
  • Have electrolyte issues
  • Have hormone regulation issues

 

What Other Tests Should I look At For These Issues?

Testosterone, Estrogen, CoQ10, anemia panel, CBC, CMP

DHEA-S

 

DHEA-S is a steroid hormone which is produced from the precursor cholesterol in the zona reticularis and broad fascia of the adrenal cortex.1 The determination of elevated DHEA-S values is an important aid in the diagnosis of hirsutism and virilism.2,4 In addition to a differential diagnosis of hirsutism and virilism, further indications for this parameter are all forms of androgenization, hyperprolactinemia, polycystic ovarian syndrome, and the exclusion of an androgen-producing tumor of the adrenal cortex.2 DHEA-S exhibits only a weak androgenic activity but can be metabolized to more active androgens, such as androstenedione and testosterone, which can indirectly cause hirsutism and virilism.2,5

From 7 years of age onwards, an increase in DHEA-S levels is observed which then gradually after the age of 30 begins to fall again.6 Only elevated DHEA-S concentrations are of clinical importance; other factors which can be responsible for DHEA-S excess production are genetic enzyme defects of the adrenal cortex (adrenogenital syndrome),7 hyperplasia of the adrenal cortex, as well as androgen-producing tumors.2

The rate of secretion of DHEA-S into the blood stream is only slightly more than the rate observed for DHEA. As a consequence of the DHEA-S half-life of approximately one day, the DHEA-S level is, however, about a thousand-fold greater.8 DHEA-S is relatively strongly bound to albumin, only a small portion is nonprotein bound, and none appears to be bound to sex hormone-binding globulin (SHBG).9 Due to its high concentration and low inter- and intra-day variability, DHEA-S is an excellent indicator of adrenal cortex androgen production.8,10

Together with testosterone, DHEA-S assays represent the assay of choice for initial screening tests to determine whether androgen values are elevated in hirsutism. Approximately 84% of the women suffering from hirsutism exhibit elevated androgen levels.11 The main purpose of this is to exclude the presence of androgen-producing tumors (from the adrenal cortex or the ovaries).7

 

Dihydrotestosterone:  

 

DHT is critical for the development of male genitalia during development.  DHT is also important during the maturation of the penis, testicles, seminal vesicles and prostate as men develop into maturity.  Male pattern hair growth on the face, pubic, and body depend on DHT levels as well.  The enzyme 5α-reductase is used to convert testosterone into DHT.

Levels of DHT are normally significantly less than that of testosterone in most areas of the body.  DHT is normally 1/10 to 1/20 the concentration of testosterone, however, certain tissues like the prostate can have 10 times the amount of DHT vs the rest of the body.  For this reason, it is important to check the levels of DHT to ensure the prostate is not at risk for cancer.

  DHT is responsible for: 

  • Prostate enlargement- This is critical during puberty, however, if DHT levels stay high for too long prostate cancer risk start to increase markedly. 
  • Facial, axillary, pubic, and over all body hair growth. 
  • Scalp and forehead recession style hair loss- Male pattern balding.  This can happen in women as well if the levels of DHT get too high.

 

Who Should Get This Test?

Anyone who is or has:

  • On Testosterone therapy
  • Is worried about going bald
  • Has had any prostate enlargement issues
  • Has a personal or family history of prostate cancer
  • Has excessive body hair

 

What Other Tests Go With This?

Testosterone, PSA, CBC, CMP, Estrogen/Estradiol

Diurnal Cortisol

 

Cortisol is a hormone that plays a role in the metabolism of proteins, lipids, and carbohydrates. It affects blood glucose levels, helps maintain blood pressure, and helps regulate the immune system. Most cortisol in the blood is bound to a protein; only a small percentage is “free” and biologically active. Free cortisol is secreted into the urine and is present in the saliva. This test measures the amount of cortisol in the blood, urine, or saliva.

The level of cortisol in the blood (as well as the urine and saliva) normally rises and falls in a “diurnal variation” pattern. It peaks early in the morning, then declines throughout the day, reaching its lowest level about midnight. This pattern can change when a person works irregular shifts (such as the night shift) and sleeps at different times of the day, and it can become disrupted when a disease or condition either limits or stimulates cortisol production.

Cortisol is produced and secreted by the adrenal glands, two triangular organs that sit on top of the kidneys. Production of the hormone is regulated by the hypothalamus in the brain and by the pituitary gland, a tiny organ located below the brain. When the blood cortisol level falls, the hypothalamus releases corticotropin-releasing hormone (CRH), which directs the pituitary gland to produce ACTH (adrenocorticotropic hormone). ACTH stimulates the adrenal glands to produce and release cortisol. In order for appropriate amounts of cortisol to be made, the hypothalamus, the pituitary, and the adrenal glands must be functioning properly.

The group of signs and symptoms that are seen with an abnormally high level of cortisol is called Cushing syndrome. Increased cortisol production may be seen with:

  • Administration of large amounts of glucocorticosteroid hormones (such as prednisone, prednisolone, or dexamethasone) to treat a variety of conditions, such as autoimmune disease and some tumors
  • ACTH-producing tumors, in the pituitary gland and/or in other parts of the body
  • Increased cortisol production by the adrenal glands, due to a tumor or due to excessive growth of adrenal tissues (hyperplasia)
  • Rarely, with tumors in various parts of the body that produce CRH

Decreased cortisol production may be seen with:

  • An underactive pituitary gland or a pituitary gland tumor that inhibits ACTH production; this is known as secondary adrenal insufficiency.
  • Underactive or damaged adrenal glands (adrenal insufficiency) that limit cortisol production; this is referred to as primary adrenal insufficiency and is also known as Addison disease.
  • After stopping treatment with glucocorticosteroid hormones, especially if stopped very quickly after a long period of use

 

Energy panel

CBC/CMP, Vitamin V12, Iron Assay, Estradiol, Testosterone, Vitamin D3, Thyroid panel

 

CMP – Comprehensive Metabolic Panel

 

The comprehensive metabolic panel (CMP) is a panel of 14 different tests that all help look at your metabolism.  Including: Glucose, electrolytes, liver, and kidney health. 

 

The CMP tests for:  

  • Glucose – the primary fuel source for the body used primarily by the muscles, heart and brain. Without proper levels energy starts to decrease and mental function can deteriorate into complete collapse. This helps show hypoglycemia and can indicate diabetes.
  • Calcium – A critical element in the body used for heart, nerves, muscles, bones and the formation of blood clots.

Proteins

  • Albumin – a protein made in the liver; it accounts for about 60% of the protein in the blood.
  • Total Protein – measures albumin as well as all other proteins in blood; proteins are important building blocks for all cells in the body.

Electrolytes—these are minerals that are in the tissues and blood in the form of dissolved salts. Electrolytes help move nutrients into the cells and help remove wastes out of the cells. They help maintain a healthy water balance and help stabilize the body’s acid-base (pH) level. The 4 tests for electrolytes are:  

  • Sodium – critical for normal nerve and muscle function
  • Potassium – critical for cell metabolism and muscle function, helping to transmit messages between nerves and muscles
  • Bicarbonate (Total CO2) – helps to maintain the body’s acid-base balance (pH)
  • Chloride – helps to regulate the amount of fluid in the body and maintain the acid-base balance

Kidney Tests

  • Blood urea nitrogen (BUN) – waste product filtered out of the blood by the kidneys; as kidney function decreases, the BUN level rises. This can also help determine hydration needs.
  • Creatinine – waste product produced in the muscles; it is filtered out of the blood by the kidneys so blood levels are a good indication of how well the kidneys are working. This test can be higher in athletes as supplementation and muscle break down from exercise can increase these levels.

Liver Tests

  • Alkaline phosphatase (ALP) – enzyme found in bone, liver, and other tissues; higher levels of ALP in the blood are most commonly caused by liver disease or bone disorders.
  • Alanine amino transferase (ALT, SGPT) – enzyme found mostly in the cells of the liver and kidney; a test for commonly used for detecting liver damage. These levels may be higher in athletes, especially in those that are training harder or in a new way.
  • Aspartate amino transferase (AST, SGOT) – enzyme found especially in cells in the heart and liver; also a useful test for detecting liver damage

Bilirubin – Bilirubin is a normal waste product after breaking down hemoglobin from blood.  Since it is normally filtered out by the liver it can show liver function levels. If Bilirubin levels get too high it will often cause Jaundice which can lead to further damage and yellowing of the skin and eyes.

 

 

CBC – Complete Blood Count

CBC

What is included in a CBC?

A standard CBC includes:  

Red blood cell (RBC) tests:  

  • Red blood cell (RBC) count is the total number of red blood cells in your blood.
  • Hemoglobin measures the amount of the oxygen-carrying protein in the blood, which gives a good idea of the number of red blood cells in the blood.
  • Hematocrit measures the percentage of your total blood volume that consists of red blood cells.

Hemoglobin and Hematocrit are what is referred to as H&H.  This is what is looked at for testosterone therapy.  When these numbers go up the blood becomes thicker.  As the blood becomes thicker it puts more pressure on the blood vessels.  This is an important marker to look at.  If it gets high it is important to donate blood to decrease the pressure on the blood vessels.

 

  • Red blood cell indices provide information on the physical features of the RBCs:
    • Mean corpuscular volume (MCV) is a measurement of how big the RBC is.
    • Mean corpuscular hemoglobin (MCH) is the measurement of the average amount of hemoglobin inside the RBC.
    • Mean corpuscular hemoglobin concentration (MCHC) is a measurement of the average concentration of hemoglobin in the RBC.
    • Red cell distribution width (RDW) is the variation in the size of the RBC.
  • The CBC may also include reticulocyte count, which shows the count/percentage of newly released young red blood cells in your blood sample.

White blood cell (WBC) tests:  

  • White blood cell (WBC) count is a count of the total number of white blood cells.
  • White blood cell differential The WBC differential identifies the individual categories of WBC (neutrophils, lymphocytes, monocytes, eosinophils, and basophils). This can be listed as a total number or a fraction of the total WBC.

Platelet tests:  

  • The platelet count is the number of platelets in the blood.
  • Mean platelet volume (MPV) is a measurement of the size of platelets.
  • Platelet distribution width (PDW) It reflects how uniform platelets are in size.

 

All blood tests give us clues as to the health of a person or a bodily system.  If there are any numbers that are out of normal ranges or you have any questions ALWAYS consult your primary care physician.  All systems in the body are interconnected so one test result often triggers the need for other tests your primary healthcare provider will know of additional places to look.  

 

What Other Tests Should I look For With This Test?

A CMP is almost always ordered with a CBC, these two tests a CBC, CMP are a standard baseline in blood testing. 

 

 

 

 

 

NO Fasting

 

 

 

B-12

 

Vitamin B12 or Cobalamin, is a key player in the metabolism and creation of energy in all human tissues and cells.  All B vitamins including B12 are water soluble which means it is hard to take too much.  B12 is also important in DNA synthesis, amino acid and fatty acid metabolism.  B12 plays key roles in the maintenance and normal function of the brain and nervous system. B12 is also a critical element in the creation of myelin for nerves and maturation of red blood cells from bone marrow. This nutrient is especially critical for all athletes.  It is also at risk for being low for most women around their menstrual cycle.  The heavier the flow the larger the chance for deficiency is.

 

Do I Need This Test?

Have You Had?

·         Fatigue

·         Depression

·         Weakness disturbed vision

·         irritability

·         depression

·         changes in the way you think, feel and behave

·         Anxiety

·         Brain Fog

·         breathlessness

·         feeling faint

·         headaches

·         pale skin

·         noticeable heartbeats

 

What Other Tests Should I Look For These Issues?

Anemia Panel, Testosterone, CBC, CMP, Thyroid Panel

 

 

 

Iron Assay

 

Oxygen is carried in your blood by hemoglobin.  Hemoglobin are made with iron, which is the main binding site for oxygen.  Without the proper amount of iron in your blood you will not be able to carry enough oxygen to maintain proper function, energy, athletic function or overall health.

An iron test or iron assay can look for the total amount of iron in the body by measuring certain substances in the blood.  When these tests are looked at together it gives a very good sense of how much iron is in the body and how well the body is using the iron.  Thus we can detect if there is too little or too much iron.

  • Serum Iron test—measures the amount of iron in the liquid portion of the blood.
  • Transferrin test—Transferrin is the protein that moves iron around in the body. Under normal conditions, transferrin is typically one-third saturated with iron.
  • TIBC or (total iron binding capacity)—measures the total amount of iron that can be bound by proteins in the blood. Since transferrin is the primary iron-binding protein, the TIBC test is a good indirect measurement of transferrin availability.
  • UIBC or (unsaturated iron binding capacity)—The UIBC test determines the reserve capacity of transferrin, i.e., the portion of transferrin that has not yet been saturated with iron.
  • Transferrin saturation—a calculation that reflects the percentage of transferrin that is saturated with iron (100 x serum iron/TIBC).
  • Serum Ferritin—reflects the amount of stored iron in the body.

Iron is normally absorbed from food in the small intestine and transported throughout the body by binding to transferrin, a protein produced by the liver. In healthy people, most of the iron transported is incorporated into the production of red blood cell hemoglobin. 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 level of iron in the blood drops and iron stores are depleted. This may occur because:

  • There is an increased need for iron, for example during pregnancy or childhood, or due to a condition that causes chronic blood loss (e.g., peptic ulcer, colon cancer)
  • 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

Insufficient levels of circulating and stored iron may eventually lead to iron-deficiency anemia (decreased hemoglobin and hematocrit, smaller and paler red cells). 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 anemia include fatigue, weakness, dizziness, headaches and pale skin. Read the article on Anemia to learn more.

Conversely, too much iron can be toxic to the body. 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 and builds up too much iron, even on a normal diet. Additionally, iron overdose can occur when someone consumes more than the recommended amount of iron.

 

 

ESTROGEN

 

 

Estrogens are in the steroid chemical family.  Estrogens are found in both men and women and are important to both.  In men they help transport fats and regulate cholesterol.  In women they help develop breast, uterus, and along with progesterone regulate the menstrual cycle.  Estrogen is also a critical hormone for pregnancy.  For adult women outside of pregnancy estrogen levels do not have to be very high for quality of life and normal function.  Symptoms of low estrogen include: vaginal dryness, hot flashes, night sweats, headaches, mood swings. 

 

Estrogen is broken down into 3 types:  estrone (E1), estradiol (E2), or estriol (E3)

 

  • Estrone (E1) is directly converted from androstenedione (from the adrenal gland) or indirectly from other androgens. E1 can also be produced by the ovaries as well as the placenta, testicles, and adipose (fat) tissues. E2 and E1 can be converted into each other as needed. E1 is the estrogen most commonly found in men and in post-menopausal

 

  • Estradiol (E2) is primarily produced in the ovaries in response to the hormone 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 will vary depending on a woman’s age and reproductive status. They are often used as a 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 should be checked in the second trimester maternal serum screen, a test performed to evaluate fetal risk due to certain chromosomal Very low levels of E3 are found in non-pregnant women or men.

 

NO Fast

 

D3

 

Vitamin D3 significantly increases the ions that move into the body as well as into the cells and individual tissues.  This will allow tissues to function at a higher level, repair more, fight off disease, and produce more hormones and neurotransmitters.  The reason that research has shown that vitamin D3 helps with everything in the body is that everything in the body requires ions.

Most people do not get enough of this vitamin or the precursors to the vitamin.  D3 helps to ensure bone density, keeps muscles (including the heart) moving, helps produce neurotransmitters to think clearly and avoid anxiety and depression, create energy in the form of ATP and many more things. 

The standard excepted lab value for excepted levels is 35, Dr. Chalmers likes most of his patients to have the minimum level to be 60, athletes need to be 80.

 

Do I Need This Test?

Are You or Do You Have?

·         An athlete

·         Have high stress

·         Have a physically taking job

·         Bone density issues

·         Osteoporosis

·         Have General Health questions

·         Fatigue

·         Anxiety

·         Depression

·         Get sick often

·         Have electrolyte issues

·         Have hormone regulation issues

 

What Other Tests Should I look At For These Issues?

Testosterone, Estrogen, CoQ10, anemia panel, CBC, CMP

 

 

CoQ-10

 

Coenzyme Q-10 or CoQ-10 is extremely important for cellular metabolism.  CoQ-10 is a major component of the electron transport chain and is key component in aerobic cellular respiration.  These functions help to produce Adenosine Triphosphate (ATP).  Over 90% of all the energy in the human body is generated in this way.  Due to this the organs that require the most energy have the highest concentrations of CoQ-10 namely the heart, brain, liver, kidney and gut.

CoQ-10 has three different versions or redox states:

  • Ubiquinone- This is the fully oxidized form.
  • Semiquinone/ Ubisemiquinone- This form is normally trapped in the cellular membrane and is not free floating. It is also viewed as a free radical due to the loss of an outer layer electron.
  • Ubiquinol– This is the fully reduced form.

    The critical role of Quinol is that it has a great ease at which it can drop and add electrons. In this manner it can act as an antioxidant and an electron donner for the electron transport chain.  It does this by use of iron sulfur clusters that can only change one electron at a time.

    While CoQ-10 is supposed to be very abundant in the body people often times show deficiencies in it. This comes from 2 major reasons.  One of which is a reduction in human biosynthesis which is quite complicated requiring a dozen different genes to complete properly.  Any deletion or mutation in one of the genes can greatly reduce the amount of CoQ-10 produced.  The other way we see low levels of CoQ-10 are due to increased use.  If a person is under stress, physical or psychological, they will use significantly more CoQ-10 than normal.  If these levels are not increased to meet the demand the body is left with a deficiency.  One of the most prominent and noticeable reasons that people have a deficiency in CoQ-10 levels is due to the use of medications like statin drugs.  These drugs severely impact the biosynthesis and thus leave the body with significantly low levels of CoQ-10.

Testosterone

 

Testosterone is critical for overall health.  Testosterone is always reduced with stress and age.  Many people start to have testosterone levels start to drop after the age of 35-40.  Regardless of what many people think both men AND WOMEN need testosterone.  Many younger women 30+ that have high stress from young children and a busy life have lower testosterone levels that can manifest in many different symptoms/issues.

Do I Need This Test?

Have You Had Any?

·         Fatigue

·         Anxiety

·         Increased Fat

·         Weak muscles

·         Soreness

·         Bone loss/osteoporosis

·         Foggy headed

·         Depression

·         Low Sex Drive

·         Low Sexual Pleasure Male and Female

 

Things To Remember

Testosterone helps heal and repair muscles.  This means that it can help biceps and leg muscles, however never forget that the heart is a muscle that needs to repair and regenerate.  Also, the arteries and veins have muscles in them.  If the muscles in the veins get weak and soft the chance for DVT increases.  While many people think of testosterone as a quality of life hormone it should be looked at as a quantity of life hormone as well.

 

What Does This Panel Look For?

Testosterone Free:  How much testosterone is available to bind to a receptor and make things happen.

Testosterone Total: Total amount of testosterone free and bound.

 

What Other Tests Should I look At For These Symptoms?

Full male or female panel, thyroid panel, anemia panel, Hormone panel, Energy Panel

 

No Fasting

 

 

Thyroid Panel

 

The thyroid is a small gland just above the collar bones in the neck.  This gland most famously helps to regulate metabolism/energy.  However, it also works with several other systems in the body such as eyes, hair, temperature, and brain function.

The Thyroid panel helps to determine any fluctuations in thyroid function that can lead to disease processes.  It can help determine hypothyroidism (to low thyroid) and hyperthyroidism (to high thyroid).  Once you know the levels of the thyroid there are several ways to repair these issues, however you first have to know.

 

Do I Need This Test?

If you have any of these symptoms a thyroid panel might be the right test for you.

·         Fatigue

·         Increased sensitivity to cold

·         Constipation

·         Dry skin

·         Weight gain

·         Puffy face

·         Hoarseness

·         Muscle weakness

·         Elevated blood cholesterol level

·         Foggy headed

 

·         Impaired memory

·         Enlarged thyroid gland (goiter)

·         Muscle aches, tenderness and stiffness

·         Pain, stiffness or swelling in your joints

·         Heavier than normal or irregular menstrual periods

·         Thinning hair

·         Slowed heart rate

·         Depression

·         Anxiety

 

 

What Other Tests Should I look At For These Issues?

Other lab tests go with these symptoms include: Full male and female wellness panel, testosterone panel, hormone panel, energy panel, and anemia panel.

 

What does the lab panel tell us?

  1. Thyroid Stimulating Hormone (TSH): This shows how hard your pituitary gland is telling the thyroid to make thyroid hormones T3 and T4.
  2. T4 Total: This is the amount of thyroxin that is bound and free in the blood. Thyroxin is the precursor to T3 (triiodothyronine).
  3. Free T3: Triiodothyronine is the active form of thyroid hormone. Free T3 is the amount that is floating around ready to work.
  4. Free T4: This is the amount of T4 that has not bound to any other proteins.
  5. Thyroid Peroxidase antibodies (TPO): This test helps determine certain autoimmune diseases like Graves’ disease or Hashimoto thyroiditis.

 

 

No fasting

 

 

 

 

 

Pregnancy and Gestational Age

 

Pregnancy hCG tests that give a positive or negative result (qualitative) detect the presence of hCG. These tests may be performed by a laboratory, at a healthcare practitioner’s office, or at home using a home pregnancy test kit. Methods will vary slightly but for most, a test strip is dipped into a collected cup of urine or exposed to a woman’s urine stream. A colored line (or other color change) appears within the time allotted per instructions, usually about 5 minutes. For accurate test results, it is important to carefully follow the test directions. (See the article on Home Testing for more on this.) If the test is negative, it is often repeated several days later. Since hCG rises rapidly, an initial negative test can turn positive within this time period.

Quantitative hCG testing, often called beta hCG (β-hCG), measures the amount of hCG present in the blood. It may be used to:

  • Confirm a pregnancy
  • Help diagnose an ectopic pregnancy, along with a progesterone test
  • Help diagnose and monitor a pregnancy that may be failing
  • Monitor a woman after a miscarriage

hCG blood measurements may also be used, along with a few other tests, as part of screening for fetal abnormalities. For more information on this use, see First Trimester Down Syndrome Screen or Second Trimester Maternal Serum Screening.

A quantitative hCG blood test may also be used as a tumor marker in some cancers. For more on this, see the article hCG Tumor Marker.

Occasionally, an hCG test is used to screen for pregnancy if a woman is to undergo a medical treatment, be placed on certain drugs, or have other testing, such as x-rays, that might harm the developing baby. This is usually done to help confirm that the woman is not pregnant. It has become standard practice at most institutions to screen all female patients for pregnancy using a urine or blood hCG test before a medical intervention, such as an operation, that could potentially harm a fetus.

When is it ordered?

For confirming pregnancy, the timing of testing depends on how accurate a woman is about the day she expects her menstrual period as well as the method used for testing. In general, blood tests are more sensitive than urine tests and can be done two days before a woman would expect her period to start. A urine or blood hCG test can be done reliably by 10 days after a missed menstrual period. Even using a urine test, a woman may be able to determine whether she is pregnant the day she misses her period, but the result could be falsely negative. Testing may be repeated at a later date if the first test is negative but pregnancy is still suspected.

Quantitative blood hCG tests may be ordered repeatedly over several days when a healthcare practitioner wants to identify or rule out an ectopic pregnancy or to monitor a woman after a miscarriage. In these cases, a woman may experience the normal signs and symptoms of pregnancy at first but then may develop others that indicate that the pregnancy is not progressing as expected.

Some signs and symptoms of ectopic pregnancy include:

  • Abnormal vaginal bleeding—because a woman is pregnant, she may not have a regular period but then may have light bleeding or spotting with an ectopic pregnancy
  • Low back pain
  • Pain or cramping in the lower abdomen or on one side of the pelvis

If untreated, signs and symptoms may get worse and may include:

  • Dizziness, weakness
  • Feeling faint or fainting
  • Low blood pressure
  • Pain in the shoulder area
  • Sudden, sharp pain in the pelvic area
  • Fever, flu-like symptoms
  • Vomiting

The area around an ectopic pregnancy may rupture and start to bleed, and, if undiagnosed, can lead to cardiac arrest and death.

An hCG test may be ordered prior to a medical procedure or treatment that might be harmful during pregnancy.

What does the test result mean?

A negative hCG result means that it is unlikely that a woman is pregnant. However, tests performed too early in a pregnancy, before there is a significant hCG level, may give false-negative results. The test may be repeated in one week if there is a strong possibility of pregnancy.

A positive hCG means that a woman is likely pregnant. However, false-positive tests can occur if a woman is post-menopausal or taking hormone supplements.

The blood level of hcG in a woman with an ectopic pregnancy usually rises at a slower rate than normal. Typically, hCG levels double every 48 to 72 hours for the first four weeks of a normal pregnancy, then slow to every 96 hours by six weeks. Those with failing pregnancies will also frequently have a longer doubling time early on or may even show falling hCG concentrations during the doubling period. hCG concentrations will drop rapidly following a miscarriage. If hCG does not fall to undetectable levels, it may indicate remaining hCG-producing tissue that will need to be removed (dilation and curettage – D&C).

A high hCG level may indicate that the pregnancy dating has been miscalculated, that there is a molar pregnancy, or that it is a multiple pregnancy.

What can cause a false-negative urine hCG?

Urine hCG tests may give a false-negative result if the urine is too diluted or if testing is done too soon in the pregnancy. Certain drugs such as diuretics and promethazine (an antihistamine) may cause false-negative urine results.

What can cause a false-positive result?

Drugs such as antihistamines, anti-anxiety medications, diuretics, anti-convulsants, anti-parkinson drugs, hypnotics, and tranquilizers may cause false-positive results.

The presence of protein in the urine (proteinuria), blood in the urine (hematuria), or excess pituitary gonadotropin may also cause a false-positive urine hCG test.

There are reports of false-positive blood hCG results due to the presence of certain types of antibodies that some individuals produce or fragments of the hCG molecule. Generally, if results are questionable, they may be confirmed by testing with a different method.

How does the test that I do at home myself compare with the results of a test done in a lab?

Home pregnancy testing is very similar to qualitative urine hCG testing performed in the laboratory, but there are factors surrounding its use that are important to note.

  • Home tests come with very specific directions that must be followed explicitly. If you are using a home test, follow the directions extremely carefully (see Home Testing). There can be variability in sensitivity to detecting the presence of hCG with different brands of home pregnancy kits.
  • Home tests are sometimes done too soon after the missed menstrual cycle to result in a positive test. It typically takes 10 days after a missed menstrual period before the presence of hCG can be detected by the urine test.
  • All urine hCG tests should be done on a first morning urine sample, if possible. Urine becomes more dilute after ingestion of liquids (coffee, juice, water, etc.) and urine hCG concentrations may become too low to register as positive.

Generally, when used correctly, the home test should produce the same result as the urine hCG test done by your healthcare practitioner. Blood testing for hCG is more sensitive than urine hCG testing, so sometimes a blood test will indicate pregnancy when the urine test is negative.

When is a blood hCG test ordered instead of a urine hCG?

Since hCG is not normally detected in the urine of a non-pregnant woman, a urine hCG is enough to confirm a pregnancy. This can also be done with a qualitative blood hCG test. Sometimes, however, it is important to know how much hCG is present to evaluate a suspected ectopic pregnancy or to monitor a woman following a miscarriage. In these circumstances, a healthcare practitioner will order a quantitative blood hCG test.

How many days after a miscarriage would it take for a urine pregnancy test to show a negative result?

Urine hCG decreases at about the same rate as serum hCG, which can take anywhere from 9 to 35 days, with a median of 19 days. However, the timeframe for when an hCG result will be negative is dependent on what the hCG level was at the time of the miscarriage. Frequently, miscarriages are monitored with quantitative blood hCG testing. If the levels of hCG do not fall to undetectable levels, some hCG-producing tissue may remain and have to be removed.

What is an ectopic pregnancy?

An ectopic pregnancy occurs when the fertilized egg (ovum) implants somewhere other than in the uterus. Nearly all ectopic pregnancies occur in the fallopian tube, giving the condition the moniker of “tubal pregnancy.” This is a serious condition needing immediate treatment. Women with ectopic pregnancies often have sharp, stabbing abdominal or pelvic pain and uterine bleeding. Usually, abnormally low levels of hCG are produced in ectopic pregnancies with slower-than-normal rates of increase. A physician that suspects an ectopic pregnancy might also test progesterone levels, which will be lower than in a non-ectopic pregnancy.

In the case of an ectopic pregnancy, hCG levels need to be rechecked regularly until they are undetectable. If hCG levels remain high, it might mean that the ectopic tissue wasn’t removed, which could require treatment by surgery or methotrexate, which causes the body to absorb the pregnancy tissue.

 

Progesterone

 

Progesterone is most often seen during pregnancy to maintain the corpus luteum and ensure a healthy fetus.  However, progesterone has also been shown to play a role in the normalmenstrual cycle and lower than normal progesterone levels can have adverse effects.  Often times women with PCOS (Polycystic Ovarian Syndrome) can find relief by regulating their progesterone levels either through medication or other natural solutions.

 

Common issues of low progesterone are:

Irregular Menstrual Cycles

Mood swings, anxiety or depression

Weight Gain

Miscarriage

Vaginal Dryness

Infertility

Headaches or Migraines

Hot Flashes

Fibroids, Endometriosis

As well as many other issues in women

 

Other tests associated with this test are:

Estrogen, Testosterone, pregnancy, Iron assay

 

PSA

 

Prostate specific antigen (PSA) is a test of the prostate most associated with detecting and tracking cancer.  There are 2 forms in the blood the bound cPSA and free or fPSA.  Most PSA tests are a test of total PSA which cPSA added to fPSA.  The PSA test is used as a tumor marker to track health of the prostate.  If the levels of the PSA get to high or go up too quickly prostatitis and prostate cancer can be of concern.  PSA can also be elevated in some cases of benign prostatic hypertrophy which can increase the size of the prostate but is not as dangerous.

Do I Need This Test?

If you are going doing testosterone replacement therapy

·         Anyone doing testosterone therapy

·         If you have slow or restricted urination

·         If you feel as though you cannot fully empty your bladder

·         Blood in the urine or seminal fluid

·         Waking to urinate at night

·         Anyone over the age of 45

·         If you have anyone in your family with a history of prostate cancer

·         Sudden onset or quickly advancing erectile dysfunction

·         Frequent urination

 

What Other Tests Should I look at for These Issues?

DHT, Testosterone, CBC, CMP

 

No Fast

 

TSH

 

 

Thyroid function test. Investigation of low thyroxine (T4) result; the differential diagnosis of primary hypothyroidism from normal, and the differential diagnosis of primary hypothyroidism from pituitary/hypothalamic hypothyroidism. TSH is high in primary hypothyroidism. Low TSH occurs in hyperthyroidism. Evaluation of therapy in hypothyroid patients receiving various thyroid hormone preparations: Low values are found in states of excessive thyroid replacement. Normal result on a sensitive TSH assay is acceptable evidence of adequate thyroid replacement.

Follow-up of patients who have had hyperthyroidism treated with radioiodine or surgery. Follow-up low T4 newborn results.

This third-generation TSH assay can be considered a test for thyroid disease. A result within the accepted reference interval provides strong evidence for euthyroidism.

 

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