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Anemia #3 Extreme Blood and Stool Test Panel

An Anemia #3 Extreme Blood and Stool Test Panel includes an Iron w/TIBC, Transferrin, Ferritin, Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP-14), Vitamin B12, Folic Acid, Hemoglobin Solubility, Homocysteine, Occult Blood Fecal, and Reticulocyte Count.

Test Code: 860

Also Known As:

Methodology: See Individual Tests

Preparation: You must take your lab order to the lab to obtain a proper specimen container before collection. Fasting for 12 hours required. Stop biotin consumption at least 72 hours prior to the collection. Must draw before Schilling test, transfusions or B12 therapy is started.

Test Results: 3-5 days. May take longer based on weather, holiday or lab delays.

Test Code: 2196

Also Known As:

Methodology: See Individual Tests

Preparation: You must take your lab order to the lab to obtain a proper specimen container before collection. Fasting for 12 hours required. Stop biotin consumption at least 72 hours prior to the collection. Must draw before Schilling test, transfusions or B12 therapy is started.

Test Results: 3-5 days. May take longer based on weather, holiday or lab delays.


The Iron and Total Iron-binding Capacity test is used for testing differential diagnosis of anemia, evaluation of thalassemia and possible sideroblastic anemia, and the evaluation of iron poisoning. Specimen collection must be done before patient is given therapeutic iron or blood transfusion. Iron determinations on patients who have had blood transfusions should be delayed at least four days.

Ferritin is 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 that is found in the blood, and 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 in those taking birth control pills. It is low in cancer, liver disease, kidney disease, chronic inflammation, hereditary transferrin deficiency, or when there are excessive amounts of iron in the body.

A Complete Blood Count (CBC) gives important information about the numbers and kinds of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your health professional check any symptoms, such as fatigue, weakness, or bruising, that you may have. A CBC also helps your health professional diagnose conditions, such as infection, anemia, and several other disorders.  Test includes: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelets, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

CMP-14 Includes:
Glucose-Blood sugar level,
the most direct test to diagnose diabetes, may be used not only to identify diabetes, but also to evaluate how one controls the disease.
Kidney Profile Bun or Urea Nitrogen A by-product of protein metabolism eliminated through the kidneys, BUN is an indicator of kidney function. Creatinine, Serum Indicates kidney function. Bun/Creatinine Ratio Calculated by dividing the BUN by the Creatinine. Glomerular Filtration (eGFR) Provides an assessment of the kidney's filtering capacity.
Fluids & Electrolytes Sodium- is important in the body's water balance and the electrical activity of nerves and muscles and one of the major salts in body fluid. Potassium Helps to control the muscles and nerves. Chloride- Similar to sodium, chloride helps to maintain the body's electrolyte balance. Carbon Dioxide- Total Used in detecting, evaluating, and monitoring electrolyte imbalances. Calcium- A mineral essential for development and maintenance of healthy teeth and bones. It is important also for the normal function of nerves, muscles and blood clotting.
Liver panel Protein, Total A measure of the state of nutrition in the body together with albumin. Albumin Serum a major protein in the blood and a reflection of the general state of nutrition. Globulin, Total A major group of proteins in the blood that comprise the infection fighting antibodies. Albumin/Globulin Ratio Calculated by dividing the albumin by the globulin. Bilirubin, Total A chemical that is involved with liver functions. High concentrations of bilirubin may result in jaundice. Alkaline Phosphatase A body protein that is important in diagnosing proper bone and liver functions. Aspartate Aminotransferase (AST or SGOT) an enzyme that is found in skeletal and heart muscle, liver and other organs. Abnormalities may represent liver disease. Alanine Aminotransferase (ALT or SGPT) an enzyme that is found primarily in the liver. Abnormalities may represent liver disease.

Vitamin B12 - Vitamin B12 levels help 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- Folic acid levels detect folate deficiency and monitor folate defiency 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 presence of hemoglobin S; detect sickling hemoglobins; evaluate hemolytic anemia, undiagnosed hereditary anemia with morphologic (sickle-like) abnormalities on peripheral blood smear. 

Homocysteine is 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 suggest that people with elevated homocysteine levels have a much greater risk of heart attack or stroke than those with normal levels. Additionally, increased concentrations of homocysteine have been linked to an increase in blood clots, which can lead to strokes, heart attack 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 highly specific for bleeding in the lower gastrointestinal tract, and should 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 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 seen with guaiac-based tests, and provides a sensitivity and specificity that is superior to guaiac. Immunochemical fecal occult blood tests utilize antihuman hemoglobin antibodies to detect the globin portion of undegraded human hemoglobin in stool. While hemoglobin from the upper gastrointestinal tract is mostly degraded by bacterial and digestive enzymes 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 with drugs, vitamins, or other substances that can produce false results, thereby eliminating the need for dietary or drug restrictions prior to patient specimen collection.

Reticulocytes 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.

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