Iron and Total Iron-binding Capacity (TIBC) - The iron and TIBC blood test quantifies iron serum and total iron-binding capacity (TIBC). Iron serum measures iron levels in the blood, while TIBC measures the total amount of iron that transferrin can bind (transferrin is the primary protein that binds to iron and transports it throughout the body). These quantities are used to calculate transferrin saturation, an indicator of the body's iron status. In iron-deficiency states, iron levels are low while the TIBC is higher, resulting in low transferrin saturation. In iron overload states, iron levels are high while the TIBC is low or normal, resulting in increased transferrin saturation.
Ferritin - A protein in the body that binds to iron, most iron stored in the body is bound to ferritin. It is found in the liver, skeletal muscles, spleen, and bone marrow. There is only a small amount of ferritin found in the blood. The amount of ferritin in the blood shows how much iron is stored in your body.
Transferrin - Tests the plasma protein that binds to iron and then transports it through the circulation. TIBC measures the total amount of iron that the transferrin can bind. The two tests are different and are reported in different units (g/L for transferrin and umol/L for TIBC), they essentially measure the same thing. Transferrin blood levels are used to evaluate iron deficiency and anemia. High transferrin levels are found in pregnancy, iron deficiency, and those taking birth control pills. It is low in cancer, liver disease, kidney disease, chronic inflammation, hereditary transferrin deficiency, or excessive amounts of iron in the body.
Complete Blood Count (CBC) With Differential and Platelets
A CBC is a comprehensive screening test that can help diagnose a wide range of illnesses and diseases, including anemia, leukemia, bleeding disorders, and infections. The CBC provides the following information:
- White Blood Cells (WBC) - The body's primary defense against disease and helps to fight infection.
- Red Blood Cells (RBC) - Responsible for carrying oxygen to and carbon dioxide away from all cells. Iron deficiency will lower the RBC count.
- Hemoglobin - A chemical compound inside red cells that transports oxygen through the bloodstream to all cells of the body. Hemoglobin gives the red color to blood.
- Hematocrit - Measures the amount of space red blood cells take up in the blood. It is reported as a percentage.
- Lymphocytes - This result, along with basophils, eosinophils, monocytes, and neutrophils, deal with white blood cell function.
- Monocytes - This result, along with basophils, eosinophils, lymphocytes, and neutrophils, deal with white blood cell function.
- Neutrophils - This result, along with basophils, eosinophils, lymphocytes, and monocytes, deal with white blood cell function.
- Mean Corpuscular Hemoglobin (MCH) - The average hemoglobin concentration within a red blood cell.
- Mean Corpuscular Hemoglobin Concentration (MCHC) - The average hemoglobin concentration percentage within a red blood cell.
- Mean Corpuscular Volume (MCV) - The average size of red blood cells.
- Platelets - Blood cell particles associated with the forming of blood clots.
- Red Cell Distribution Width (RDW) - Measures the amount of red blood cell variation in volume and size.
Comprehensive Metabolic Panel (CMP-14) with eGRF Blood Test
- Glucose - Blood sugar level, the most direct test to screen for diabetes and also used in diabetes management.
- Kidney Profile
- Bun or Urea Nitrogen (BUN) - An indicator of kidney function.
- Creatinine, Serum - An indicator of kidney function.
- Bun/Creatinine Ratio - Calculated by dividing BUN by creatinine. This ratio can suggest conditions including dehydration or intestinal bleeding.
- Estimated Glomerular Filtration Rate (eGFR) - Measures kidney function to determine kidney disease stage and detect early kidney damage.
- Liver Panel
- Protein, Total - Assists in determining liver and kidney function and nutritional health.
- Albumin Serum - One of the major proteins essential for the healthy function of the liver and kidney.
- Globulin, Total - One of the major proteins that assist the blood to clot properly and also comprises infection-fighting antibodies.
- Albumin/Globulin Ratio - Calculated by dividing albumin by globulin. When paired with other test results, this ratio can assist in the diagnosis of a variety of liver problems.
- Bilirubin, Total - Aids in the detection of hepatitis, sickle cell, anemia, cirrhosis, alcohol, and drug abuse. High concentrations may result in jaundice.
- Alkaline Phosphatase - A protein vital in detecting bone disorders and liver disease.
- Aspartate Aminotransferase (AST or SGOT) - An enzyme helpful in evaluating liver function. An elevated level is an indication of hepatitis.
- Alanine Aminotransferase (ALT or SGPT) - An enzyme helpful in identifying liver damage. Abnormalities may represent liver disease.
- Fluids & Electrolytes
- Sodium - One of the major salts in body fluid. Sodium is important in water balance and the electrical activity of nerves and muscles.
- Potassium - Helps to control the nerves and muscles.
- Chloride - Similar to sodium, it helps to maintain the body's electrolyte balance.
- Carbon Dioxide, Total - Used to help detect, evaluate, and monitor electrolyte imbalances.
- Calcium - A mineral essential for the development and maintenance of healthy bones and teeth. It is also important for the normal function of muscles, nerves, and blood clotting.
Vitamin B12 - Helps to diagnose the causes of anemia and neuropathy (nerve damage), evaluate nutritional status in some, and monitor the effectiveness of B12 deficiency or folate deficiency treatment. B12 and folate are primarily ordered to diagnose the cause of macrocytic anemia.
Folic Acid - Detects folate deficiency and monitor folate deficiency therapy. Folic acid levels are ordinarily measured with red cell folates and vitamin B12 levels. Measurement of both red cell folate levels and serum constitutes a reliable means of determining the existence of folate deficiency. Folic acid tests are recommended for patients with anemia, as B12 and folate are primarily ordered to help diagnose the cause of macrocytic anemia.
Hemoglobin Solubility - Qualitative determination of the presence of hemoglobin S; detect sickling hemoglobins; evaluate hemolytic anemia, undiagnosed hereditary anemia with morphologic (sickle-like) abnormalities on a peripheral blood smear.
Homocysteine - An amino acid that can be linked to several vitamins like folic acid, B6, and B12. Deficiencies of these vitamins may cause elevated levels of homocysteine. Research suggests that people with elevated homocysteine levels have a much greater heart attack or stroke risk than those with normal levels. Additionally, increased homocysteine concentrations have been linked to increased blood clots, leading to strokes, heart attacks, and blood vessel blockages in any part of the body.
Occult Blood Fecal - A screening test for colorectal cancer, diverticulitis, colitis, polyps, and adenomas should be highly sensitive and specific for bleeding in the lower gastrointestinal tract and encourage patient compliance with obtaining a proper specimen. Guaiac-based tests for occult blood in stool suffer from a number of drawbacks, leading to a reduction in their sensitivity as well as the production of false-positive results. These drawbacks include:
- Detection of heme present in the stool, which can originate from bleeding anywhere in the gastrointestinal tract
- Inability to distinguish human heme from heme present in many foods, such as dietary meats
- Indiscriminate detection of peroxidase activity, which is present in a wide range of fruits and vegetables
- Reaction with drugs and other substances that can cause false-negative results
Detection of fecal occult blood by immunoassay eliminates the drawbacks of guaiac-based tests and provides superior sensitivity and specificity to guaiac. Immunochemical fecal occult blood tests utilize antihuman hemoglobin antibodies to detect the globin portion of undegraded human hemoglobin in the stool. While bacterial and digestive enzymes mostly degrade hemoglobin from the upper gastrointestinal tract before reaching the large intestine, hemoglobin from lower gastrointestinal tract bleeding undergoes less degradation and remains immunochemically reactive. Thus, these tests are specific for lower gastrointestinal tract bleeding. Additionally, immunochemical fecal occult blood tests do not react with animal hemoglobin, peroxidase compounds, or drugs, vitamins, or other substances that can produce false results, thereby eliminating the need for dietary or drug restrictions before patient specimen collection.
Reticulocytes - When stained with a fluorescent reagent, can be differentiated from mature red cells and other cell populations by light scatter, direct measurements, and opacity characteristics when using an automated hematology analyzer equipped with reticulocyte counting technology. Reticulocytes are expressed as a percentage in a total of 1000 RBCs.
