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Wellness #4 Extensive Blood and Urine Test Panel

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A Wellness #4 Extensive Blood and Urine Test Panel includes a CMP, Lipid Panel, Thyroid Panel with TSH, CBC, CRP, Hemoglobin A1c, Urinalysis, CEA, CA 27-29, CA 19-9, Vitamin D, Vitamin A, Vitamin B1, Vitamin B6, Vitamin B12, Vitamin E, Vitamin C, Beta Carotene, Folate, Testosterone Total and Free, Estradiol, FSH, LH, and DHEAs.

Test Code: 2166

CPT Code: See Individual Tests

Also Known As:


See Individual Test

Specimen Type: Blood and Urine


Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen. Refrain from taking vitamin C supplements, fruits, and alcohol 24 hours before the collection and biotin for 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.  As of 3/28/22, there is a temporary 7-day delay in results for this test.


Please note: Any result for the Testosterone Free (Direct) and Total Testosterone Test in excess of 1500 will be reported as >1500

Sample Report

Test Code: 2240

CPT Code: See Individual Tests

Also Known As:


See Individual Test

Specimen Type: Blood and Urine


Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen. Refrain from taking vitamin C supplements, fruits, and alcohol 24 hours before the collection and biotin for 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 Wellness #4 is an extensive series of tests that require multiple vials of blood to be collected.  Please remember to drink plenty water prior to testing so you will be well hydrated.


The Wellness #2 Essential Blood Test Panel provides a detailed and comprehensive profile of overall health by utilizing data from 55 separate laboratory tests including:

Comprehensive Metabolic Panel (14 tests):

Glucose: The glucose test identifies blood sugar levels, the most direct way to not only discover diabetes, but to evaluate options for controlling the disease as well.

Uric Acid: The uric acid test measures the amount of uric acid found in a blood sample. Uric acid is produced in two ways, from digesting food you eat and from the natural breakdown of your body’s cells.

Kidney Profile:

BUN or Urea Nitrogen: Indicates kidney function by measuring the by-product of protein metabolism eliminated through the kidneys.

Creatinine, Serum: Indicates kidney function.  

BUN/Creatinine Ratio: Provides assessment of kidney function by dividing the BUN by the Creatinine.

Glomerular Filtration (eGFR): Provides an assessment of the kidney’s filtering capacity.

Uric Acid: Another by-product of protein metabolism eliminated through the kidneys. Uric acid is also an indicator of kidney function

Liver Panel:

Protein, Total: When paired with albumin, measures the body’s state of nutrition.

Albumin Serum: One of the major proteins in the blood. It reflects the body’s general state of nutrition.  

Globulin, Total: Another major group of proteins in the blood, comprising the infection fighting antibodies.  

Albumin/Globulin Ratio: This ratio is calculated by dividing the albumin by the globulin. 

Bilirubin, Total: A chemical involved with liver functions. Elevated concentrations may lead to jaundice. 

Alkaline Phosphatase: A body protein important in identifying proper liver and bone functionality. 

Aspartate Aminotransferase (AST or SGOT): An enzyme found in liver, heart muscle, skeletal and other organs. Abnormalities in concentration levels may indicate liver disease.

Alanine Aminotransferase (ALT or SGPT): An enzyme found mainly in the liver. Abnormalities may indicate liver disease.

Lactate Dehydrogenase (LDH): An enzyme found mostly in the heart, muscles, liver, kidney, brain, and red blood cells. When an organ of the body is damaged, LDH is released in greater quantity into the bloodstream.

GGT: Also known as Gamma-glutamyl transpeptidase, GGTP Formal name: Gamma-glutamyl transferase helps to detect liver and bile duct injury. Some doctors use it in all people they suspect of having liver disease, others use it only to help explain the cause of other changes or if they suspect alcohol abuse.

Fluids & Electrolytes:

Sodium, Serum: Sodium is one of the most important salts in the body fluid, critical to helping maintain the body's water balance and the electrical activity of muscles and nerves.

Potassium: Helps control the muscles and nerves.

Chloride Serum:Helps ensure electrolyte balance in the body, similar to sodium.

Carbon Dioxide, Total: Ordered as part of an electrolyte panel. The electrolyte panel is used to help detect, diagnose and monitor electrolyte imbalances.

Lipid Panel With Total Cholesterol:HDL Ratio:

Cholesterol, Total: A sterol in the blood used to assess heart health. Knowing your cholesterol level is just as essential as knowing your blood pressure. High cholesterol levels often indicate an increased risk of coronary heart disease.

Triglycerides: Fat in the blood, responsible for providing energy to the body’s cells. Triglycerides should remain less than 400 mg/dl even when the body is in a non-fasting state.  

HDL Cholesterol: High-density lipoproteins, or “good” cholesterol, take cholesterol away from the cells and transport it back to the liver for removal or processing. Low HDL can result from a lack of exercise and smoking, while people with high levels of HDL may have lower chances of heart disease. 

LDL Cholesterol: Low-density lipoproteins, or “bad” cholesterol, contain the highest percentage of cholesterol and are thought of as responsible for depositing cholesterol on the artery walls. 

Total Cholesterol/HDL Ratio: This ratio is calculated by dividing the total cholesterol by the HDL cholesterol, and is used by healthcare professionals to determine your relative risk for developing heart disease.

Thyroid Panel with Thyroid-Stimulating Hormone (TSH): 

The thyroid gland synthesizes, stores and releases hormones. The hormones secreted are iodine-containing amino acids, thyroxine (T4) and triiodo-thyronine (T3). The thyroid hormones influence a diversity of metabolic processes including weight control, energy level and heart rate. This comprehensive test helps to evaluate thyroid hormones that control the body's metabolic rate and includes: Total T-4 (Thyroxine), T-3 uptake, Free—Thyroxine Index (FTI), T-7 and Thyroid-Stimulating Hormone (TSH).

Complete Blood Count (CBC) With Differential and Platelets:

A complete blood count (CBC) provides critical information about the numbers and kinds of cells in the blood, especially platelets, white blood cells and red blood cells. A CBC helps physicians identify the cause of such symptoms as bruising, weakness, or fatigue. Further, a CBC also helps diagnose infections, anemia, and many other conditions and disorders. The CBC provides information on your:

WBC: White blood cells are the body's primary defense against disease. White blood cells help fight infection. 

RBC: Red blood cells are responsible for carrying oxygen to and carbon dioxide away from all cells. Iron deficiency will lower RBC.

Hemoglobin: A chemical compound inside red cells that transports oxygen through the bloodstream to all cells of the body. Oxygen is needed for healthy organs. Hemoglobin gives the red color to blood. 

Hematocrit: Hematocrit measures the amount of space red blood cells take up in the blood. It is reported as a percentage.

Lymphocytes: The results of this and basophils, eosinophils, monocytes and neutrophils deal with white blood cell function. Important to the body's defense against infection. Also important in the assessment of nutritional status. 

Monocytes: The results of this and basophils, eosinophils, lymphocytes and neutrophils deal with white blood cell function. Important to the body's defense against infection. Also important in the assessment of nutritional status. 

MCH Mean: Corpuscular Hemoglobin is one way to measure the average hemoglobin concentration within red blood cells, which varies from normal with different diseases.

MCHC Mean: Corpuscular hemoglobin concentration. 

MCV Mean: Corpuscular volume measures red blood cell volume.

Neutrophils: The results of this and basophils, eosinophils, lymphocytes and monocytes deal with white blood cell function. Important to the body's defense against infection and also important in the assessment of nutritional status.

Platelets: Blood cell particles involved with the forming of blood clots. 

RDW: Red cell distribution width (RDW) is a calculation of the variation in the size of your RBC's. In some anemias, such as pernicious anemia, the amount of variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis) causes an increase in the RDW.

Mineral and Bone: 

Iron, Total: An abnormally low test result may indicate iron deficiency anemia.

Calcium: A mineral essential for development and maintenance of healthy bones and teeth. It is important also for the normal function of muscles, nerves and blood clotting.

Phosphorus: Together with calcium, it is essential for healthy development of bones and teeth. Associated with hormone imbalance, bone disease and kidney disease. It is found mainly in bones and teeth. Note that a temporary drop in phosphorus level can be seen after a meal.

C Reactive Protein hs (Cardiac Risk Assessment), also known as the C-reactive protein blood test, is used to evaluate the level of inflammation in the body.  The test is commonly ordered to monitor conditions such as arthritis, pelvic inflammatory disease, inflammatory bowel disease, and coronary artery disease.  The test is also used to measure the presence of infection after surgery and the level of damage sustained from a heart attack. 

CRP is a protein that is released into the blood stream when there is inflammation or injury in the body.  The C-reactive protein blood test is often used to assess risk of coronary artery disease and heart disease.  In coronary artery disease the coronary arteries start to swell and narrow.  As this occurs more CRP is released into the blood, so high levels of CRP in the blood could indicate inflammation in the coronary arteries.  This inflammation increases one’s risk of the artery becoming completely blocked and causing a heart attack.  However, a high level of CRP in the blood does not specifically indicate that the inflammation is in the arteries – it could be anywhere in the body.  For this reason, the C-reactive protein blood test is usually only ordered to assess heart attack risk when someone has already presented with other risk factors.

The C-reactive protein blood test can be used to aid in the diagnosis and treatment of a number of conditions, and results may be interpreted differently based on the how the test is being used.  In general, though, a higher than normal level of CRP in the blood indicates that there is inflammation in the body.

The Hemoglobin A1C is primarily used as a means of calculating average levels glucose in the blood over an extended period of time.  This test is used to evaluate glucose levels in the blood over the 2 to 3 months previous to the test.  This test is very important in managing one’s diabetes.  Scientists believe that keeping the blood sugar in the body within normal range can help individuals with diabetes to avoid many of the risks and side effects that people with diabetes often face.  The benefit of the hemoglobin A1c blood test is that is provides information on overall glycemic health over a several month period.  Other blood tests of glucose level are highly sensitive to determining glucose levels at the time the test is taken, but they do not give information on average glucose blood levels.  The test works by measuring the hemoglobin A1c level.  Hemoglobin is stored in the red blood cells.  When glucose levels are high, the sugar starts to combine with the hemoglobin.  It takes the body 8 to 12 weeks to bring hemoglobin A1c levels back to normal.  Therefore, if hemoglobin A1c levels are high, that means that there has been a high level of glucose in the blood over the last 2 to 3 months. 

Urinalysis Complete with Microscopic Examination - This test is useful in the evaluation of conditions such as urinary tract infection (UTI), dehydration, and kidney stones. Detects abnormalities of urine and urinary tract infection (UTI); diagnoses and manages renal diseases, urinary tract infection, urinary tract neoplasms, systemic diseases, and inflammatory or neoplastic diseases adjacent to the urinary tract. 

Test includes:  Color, appearance, specific gravity, pH, protein, glucose, occult blood, ketones, leukocyte esterase, nitrite, bilirubin, urobilinogen, and microscopic examination of urine sediment.

Cancer Angtigens:

The carcinoembryonic antigen (CEA) test is used to find how widespread cancer is for some types of the disease, especially colon cancer. It is also used to check the success of treatment for colon cancer. CEA levels may be measured both before and after surgery to evaluate both the success of the surgery and the person's chances of recovery and during treatment with chemotherapy. This provides information about how well the treatment is working and to moitor whether the cancer has returned after treatment.

Cancer antigen 27.29 (CA 27-29) is used to predict early recurrence of disease in patients with treated carcinoma of the breast.  CA 27.29 is highly associated with breast cancer, although levels are elevated in several other malignancies. CA 27.29 also can be found in patients with benign disorders of the breast, liver, and kidney, and in patients with ovarian cysts.

The CA 19-9 test is used to monitor pancreatic, liver, gastrointestinal, and colorectal malignancies.  A high amount of CA 19-9 is most commonly caused by pancreatic cancer. But it can also be caused by the other cancers and by infections in your liver, gallbladder, and pancreas.



Vitamin D 25-Hydroxy is essential in the growth and formation of healthy bones and teeth. Without it, children can develop a bone-malformation condition known as rickets, and adults can develop osteomalacia, which is characterized by weakness, softness or fractures of the bones. Vitamin D also helps regulate levels of calcium, phosphorus and magnesium in the blood, and has been shown to influence the growth of other tissues in the body as well as the regulation of the immune system. Vitamin D deficiency has been implicated in the development of conditions such as cancer, heart disease‚ osteoporosis and multiple sclerosis.

Vitamin A serum test is used to determine vitamin A levels in the blood. Vitamin A is needed for growth and for strong teeth and bones. With age, it helps keep your skin and eyes healthy. Vitamin A is present in liver, dairy products, fish liver oils, dark green and yellow-orange vegetables, and in fruits. Too much vitamin A may cause symptoms that include itchy skin, headache, and hair loss.

Vitamin B1, Whole Blood Test detects the classic vitamin B1deficiency disease known as beriberi. Also called thiamine, it is a B complex vitamin. It is found in many foods and is vitally important to keeping a body operating properly. Thiamin (vitamin B1) helps the body's cells change carbohydrates into energy. The main role of carbohydrates is to provide energy for the body, especially the brain and nervous system. Thiamin also plays a role in muscle contraction and conduction of nerve signals.

Vitamin B6 is a coenzyme involved in amino acid metabolism and hemoglobin synthesis. It is also necessary for the nervous system and immune system. Deficiency of vitamin B6 has been implicated in a wide variety of clinical conditions including inflammation of the skin and mouth, nausea, vomiting, dizziness, weakness and anemia.

Vitamin B12 is necessary for the formation of normal red blood cells, nerve function, and tissue and cellular repair. It is not produced in the human body, but rather ingested when consuming foods such as red meat, poultry, fish, milk, eggs and fortified products such as certain breakfast cereals and breads. Deficiencies can be caused by malabsorption (when a disease or other condition interferes with the absorption process) or insufficient dietary intake, although this is unusual in the United States due to the number of food items that have added B12. Vegans and those who do not consume animal products may be more prone to deficiencies.

Vitamin E plays a protective and restorative part in several body functions. It protects the body cells from oxidative damage and improves overall health of a person.  Deficiency of vitamin E may cause extensive neuropathy in young children and, in addition, is suspect as a possible cause of motor and sensory neuropathy in older children and in adults. One likely cause of vitamin E deficiency is intestinal malabsorption, resulting from bowel disease, pancreatic disease, or chronic cholestasis. Other causes of malabsorption of vitamin E include celiac disease, cystic fibrosis, and intestinal lymphangiectasia.

Vitamin C is a cofactor for protocollagen hydroxylase; it promotes the conversion of tropocollagen to collagen. Low values occur in malabsorption, alcoholism, scurvy, pregnancy, hyperthyroidism, and renal failure. Aids in several metabolic reactions and is therefore extremely important for digestion. It is an important antioxidant as well. Along with that, it helps in the formation of collagen which is a principal protein that structures the bones, muscles, cartilages and blood vessels. It aids in the maintenance of teeth, bones and capillaries and advances the absorption of iron. It also helps in maintaining healthy body tissues and a strong immune system. Having a high content of vitamin C leads to healthy gums. It improves vision and is extremely effective in healing wounds and burns. It also reduces the effects of sun exposure and decreases the blood sugar of people suffering from diabetes.

Beta Carotene is a substance found in carrots, apricots, sweet potatoes, pumpkin, cantaloupe, winter squash, mangos, collard greens, spinach, kale, broccoli, and other orange, red, and dark green fruits and vegetables. It is a carotenoid that may be made into vitamin A in the body. It is most efficiently made into retinol. Alpha-carotene and beta-cryptoxanthin are converted to vitamin A as well, but only half as efficiently as beta-carotene.

Folate or Folic acid is a B9 vitamin that our bodies uses to make new cells. It is important because it can help prevent major birth defects of the baby's brain and spine (anencephaly and spina bifida) by 50% to 70%. Women need folic acid every day, whether they're planning to get pregnant or not, for the healthy new cells the body makes daily. The amount of folate inside the red blood cell (RBC) is usually at a higher concentration inside the cell than in the serum. Folate may also be ordered to help in diagnosing the cause of behavioral or mental changes, especially in the elderly. Necessary for normal RBC formation, tissue and cellular repair, and DNA synthesis, folate is found in leafy green vegetables, citrus fruits, dry beans and peas, liver, and yeast.


Testosterone, Total and Free  Testosterone is a hormone that causes male characteristics. Blood level is used by men to investigate abnormal sexual development and sexual dysfunction. Small amounts are produced in women's ovaries and these levels are tested to evaluate virilization. The concentration of free testosterone is very low, typically <2% of total testosterone concentration. In most men and women, >50% of total circulating testosterone is bound to sex hormone-binding globulin, SHBG, and most of the other is bound to albumin.1 Routinely available assay methods used to measure total testosterone aren't sensitive enough to accurately quantitate the free testosterone fraction directly. Free testosterone is estimated in this test by a direct, analogue radioimmunoassay method. This test uses a labeled testosterone analogue that has a low binding affinity for both SHBG and albumin but is bound by antitestosterone antibody used in the assay. Since the analogue is unbound in the plasma, it competes with free testosterone for binding sites on an antitestosterone antibody that is immobilized on the surface of the polypropylene tube.

Estradiol There are three main estrogen fractions: estrone (E1), estradiol (E2), and estriol (E3). Estradiol (E2) is produced in men in the testes and adrenal glands. 

FSH and LH
Follicle-stimulating hormone (FSH) is made by the pituitary gland in the brain. Control of FSH production is a complex system involving hormones produced by the gonads (testes), the pituitary, and the hypothalamus.  Both estradiol and progesterone help the pituitary control the amount of FSH produced.  In men, FSH stimulates the testes to produce mature sperm and also promotes the production of androgen binding proteins. FSH levels are relatively constant in males after puberty. Luteinizing hormone (LH) is produced by the pituitary gland located in the brain. Testosterone provides negative feedback to the pituitary and the hypothalamus, helping to regulate the amount of LH secreted.

DHEA,S Dehydroepiandrosterone sulfate (DHEAS) is an androgen, a male sex hormone that is present in the blood of both men and women. It has a role to play in developing male secondary sexual characteristics at puberty, and it can be metabolized by the body into more potent androgens, such as testosterone and androstenedione, or can be changed into the female hormone estrogen. DHEAS is produced by the adrenal cortex, the outer layer of the adrenal glands, with smaller amounts being produced by  women's ovaries and men's testes. DHEAS secretion is controlled by the pituitary hormone adrenocorticotropic hormone (ACTH) and by other pituitary factors. Since DHEAS is primarily produced by the adrenal glands, it is useful as a marker for adrenal function. Cancers, Adrenal tumors, and hyperplasia can lead to the overproduction of DHEAS. While elevated levels may not be noticed in adult men, they can lead to amenorrhea and visible symptoms of virilization.





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