LABS INFORMATION
Complete Wellness Panel
The Complete Wellness Panel and can be considered an essential wellness panel for those over 30- years of age and, in particular, for those with significant stress or concomitant health conditions/concerns.
The Complete Wellness Panel includes a collection of 22 screenings commonly ordered during a yearly health check-up. This panel measures the basics and also incorporates cortisol, lipoprotein (a), apolipoprotein B, and fibrinogen activity (Factor I).
Lp(a) is a lipoprotein consisting of an LDL molecule with another protein (Apolipoprotein (a)) attached to it. Lp(a) is similar to LDL-C but does not respond to typical strategies to lower LDL-C such as diet, exercise, or most lipid-lowering drugs. Since the level of Lp(a) appears to be genetically determined and not easily altered, the presence of a high level of Lp(a) may help to identify individuals who might benefit from more aggressive treatment of other risk factors. Elevated levels of apo B correspond to high levels of LDL-C and non-HDL-C, which are associated with an increased risk of cardiovascular disease.
Fibrinogen is an acute-phase reactant, meaning that fibrinogen levels may rise sharply in any condition that causes inflammation or tissue damage. Increased fibrinogen levels may be present with infections, cancer, cardiovascular disease, inflammatory conditions, trauma, and heavy smoking.
Complete Men’s Hormone Panel
The Complete Male Hormone Panel provides a thorough evaluation of hormone levels associated with overall health and aging, along with indicators that may reveal contributing factors to hormone imbalance. This panel also includes 33 general health markers such as CBC, CMP, complete thyroid panel, iron panel, lipid panel, high sensitivity-CRP, homocysteine, blood glucose markers (hemoglobin A1c and fasting insulin), and adrenal function markers (morning cortisol, DHEA-S), uric acid, RBC-magnesium and Prostate-specific Antigen (free:total ratio) lactic acid dehydrogenase, and vitamin D 25-OH.
Tests specific to this panel include estradiol, FSH and LH, sex hormone-binding globulin, DHT (dihydrotestosterone), and testosterone (total and bioavailable). In men, estradiol levels may increase over time and may be associated with cardiovascular risk, prostate disorders, and weight gain. In men, the follicle-stimulating hormone stimulates the testes to produce mature sperm and also promotes the production of androgen-binding proteins. Luteinizing hormone 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. The majority (about 60% to 90%) of serum total testosterone is associated with sex hormone-binding globulin; this fraction is tightly bound and biologically unavailable to its target tissues. The remaining bioavailable testosterone is mostly bound to albumin, with only a small fraction (approximately 0.5% to 2%) circulating in the free form. Free testosterone is the form of testosterone that can diffuse into the tissues and act on receptors and is considered the active fraction by many clinicians. Free testosterone assessment is recommended as a primary or secondary measure of androgen activity in men (and women).
The primary screening test for the diagnosis of hypoandrogenism in men is the measurement of total testosterone in serum in a morning sample. Low concentrations of testosterone in serum should be confirmed by repeat measurement. Determination of free testosterone can be of value in men with borderline total testosterone because alterations in SHBG levels can markedly affect the concentration of biologically available free testosterone. Factors and conditions that tend to increase SHBG (sex hormone- binding globulin) concentrations in men include aging, hyperthyroidism, estrogens, HIV disease, anticonvulsant therapy, and liver disease. Issues that typically decrease SHBG concentrations in men include obesity, diabetes mellitus, hypothyroidism, glucocorticoid therapy, androgenic steroid therapy, nephrotic syndrome, and acromegaly. DHT is the most potent hormone among the androgens and is considered a pure androgen as it cannot convert into estrogen. It is formed primarily in peripheral tissues of the body, where it exerts its effects. Testosterone converts to DHT by the action of the 5 alpha-reductase enzymes at these target tissues. As with any other disease, a deficiency or an excess of the DHT hormone leads to specific pathologies such as prostate cancer, male androgenic alopecia, and benign prostatic hyperplasia.
Complete Women’s Hormone Panel
Some of the signs and symptoms of female hormone imbalance include irregular menstrual cycles, infertility, hot flashes and night sweats, persistent weight gain, hair loss, pelvic pain, fatigue, cold hands and feet, premenstrual syndrome, heavy menstrual bleeding, and breast discharge.
This panel of 28 tests assesses hormone balance, overall health, and healthy aging by measuring specific hormone levels and other markers that can be indicators of hormone imbalance. The particular analytes addressed in this panel are the estrogens, testosterone, progesterone, thyroid hormones, sex hormone-binding globulin, the adrenal gland biomarkers DHEA and cortisol, FSH and LH, markers of glucose regulation (insulin, HbA1c). Also included are fundamental blood test markers such as the CBC with differential, comprehensive metabolic panel, an iron panel, a lipid panel, magnesium, and vitamin D.
Estradiol is the primary female sex hormone responsible for regulating the menstrual cycle, skin elasticity, bone strength, and health of both the bladder and vagina. Estradiol is the most potent estrogen and present in the highest concentration in non-pregnant, premenopausal women. Estradiol is an excellent marker for ovarian function.
Estrone is directly converted from androstenedione or indirectly from other androgens. Estrone is the primary estrogen in men and postmenopausal women. Estriol 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.
Progesterone is essential for balancing the powerful effects of estrogen. An imbalance between these two hormones is linked to weight gain, insomnia, anxiety, depression, migraine, cancer, uterine fibroids, ovarian cysts, and osteoporosis. Progesterone is responsible for preparing the body for pregnancy and is used to establish the presence of a functioning corpus luteum and luteal cell function; to evaluate the functional state of the corpus luteum in infertility patients; assess placental function during pregnancy and as part of the ovarian function test.
Cortisol produced by the adrenal glands, combined with DHEA-S, provides essential information about the adrenal function and immune system function since the two systems are interconnected. DHEA is the precursor to testosterone and estrogens; therefore, the DHEA concentration will affect the concentration of these (and other) hormones.
Free and weakly bound testosterone (FWBT), also referred to as bioavailable testosterone, reflects an individual’s biologically active, circulating testosterone. Elevated levels of FWBT are observed in female hirsutism. Decreased FWBT levels have been associated with diminished libido and loss of bone density. Testosterone in conjunction with estrogen is crucial in minimizing hot flashes, sleep disturbances, night sweats, and vaginal dryness.
The pituitary gland synthesizes both the follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Each is clinically useful in distinguishing between primary gonadal failure and secondary (hypothalamic/pituitary) causes of gonadal failure, menstrual disturbances, fertility, and amenorrhea. FSH and LH both vary throughout the menstrual cycle, with peaks at the time of ovulation.
The liver produces sex hormone-binding globulin (SHBG), which transports testosterone, dihydrotestosterone, and estradiol in the blood as biologically inactive forms. Changes in SHBG levels can affect the amount of these hormones available to be used by the body’s tissues.
Thyroid disease is the second most common endocrine disorder affecting women of reproductive age. When untreated during pregnancy, it is associated with an increased risk of miscarriage, placental abruption, hypertensive disorders, and growth restriction.
Fasting glucose (included in the CMP), along with the biomarker hemoglobin A1c, provides insightful information about glucose metabolism and, when abnormal, can be an indicator of prediabetes, insulin resistance, or diabetes. The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months by measuring the percentage of glycated hemoglobin in the blood. The estimated average glucose converts the patient’s HbA1c percentage point into an average blood glucose level. Like HbA1c, eAG (estimated Average Glucose) evaluates a patient’s overall success at controlling glucose levels and helps patients understand the monitoring of their long-term treatment. It’s important to note that blood glucose dysregulation is related to metabolic syndrome, obesity, inflammation, and oxidative stress. Also, insulin resistance may be a critical factor in polycystic ovarian syndrome.
Complete Cardiovascular Panel
Cardiovascular disease continues to be the leading cause of death in the United States. One out of every three deaths in the US is related to cardiovascular disease. Nearly half of all heart attacks have no prior risk that would indicate the individual is in jeopardy of experiencing a cardiac event. Critical factors of cardiac risk assessment include the individual personal and family history as well as laboratory test markers. Individuals who can potentially benefit from laboratory test assessment include those with diabetes, high blood pressure, poor diet, smokers, overweight/obese, lack of exercise, and advancing age.
The Complete Cardiovascular Panel is built on the Basic Cardiovascular Panel, which is the first-line test to consider for assessing cardiovascular health. It measures the lipid profile via NMR, magnesium, and apolipoprotein assessment, as well as the CBC and comprehensive metabolic panel. This panel reports on health markers that indicate kidney and liver function, blood glucose regulation (via assessment of insulin, blood glucose, and hemoglobin A1c), and inflammation.
Included in this panel is the NMR LipoProfile Test. This test consists of the traditional lipid panel markers such as LDL-C, HDL-C, triglycerides, and total cholesterol. The lipid profile can help determine an individual’s risk of heart disease and to guide decisions about what treatment may be best if there is borderline or high risk.
NMR LDL-P is a management tool used with appropriate high-risk patients (type 2 diabetes mellitus, metabolic syndrome, CVD risk equivalent, statin-treated patients) to mediate response to treatment and guide adjustment in therapy. It is utilized in conjunction with other lipid measurements and clinical evaluations to aid in the management of lipoprotein disorders associated with cardiovascular disease. The NMR LipoProfile goes beyond the traditional markers by measuring LDL and HDL, particle size and number, and provides an Insulin Resistance Score, which is a laboratory-developed index associated with insulin resistance and diabetes risk. The IR Score can be used as one component of clinical assessment. Insulin resistance is the precursor to type 2 diabetes and manifests its earliest measurable abnormalities though changes in lipoproteins. The IR score may be a first alert to a heightened risk of developing T2DM. This panel also includes high-sensitivity C-reactive Protein (hs-CRP) and lipoprotein (a). Studies have shown that measuring CRP with a high sensitivity test can help identify the risk of CVD. This test is different from the regular CRP test, which detects elevated levels of CRP in people with infections and inflammatory diseases. The hs-CRP test measures CRP that is in the normal range for healthy people and can distinguish people with low normal levels from people with high normal levels. High normal levels of hs-CRP in otherwise healthy individuals are predictive of the future risk of heart attack, stroke, sudden cardiac death, and peripheral arterial disease, even when lipid levels are within acceptable ranges. Several groups have recommended that this test be used for people with a moderate risk of heart attack over the next ten years; however, there is not a consensus on how the analysis should be employed otherwise, nor on how frequently the test should be repeated. Lp(a) is a lipoprotein consisting of an LDL molecule with another protein (Apolipoprotein (a)) attached to it. Lp(a) is similar to LDL-C but does not respond to typical strategies to reduce LDL-C such as diet, exercise, or most lipid-lowering drugs. Since the level of Lp(a) appears to be genetically determined and not easily altered, the presence of a high level of Lp(a) may help to identify individuals who might benefit from more aggressive treatment of other risk factors. The apolipoprotein assessment test is included in the panel because studies have shown that the ratio of apolipoprotein A-1:apolipoprotein B may correlate better with an increased risk of coronary artery disease (CAD) than total cholesterol, and LDL:HDL ratio. The Complete Cardiovascular Panel is the next step up from the Basic Cardiovascular option and includes everything that it provides and then goes further by assessing gamma-glutamyl transferase (GGT), which can be increased by oxidative stress, liver/gallbladder conditions, and uric acid, and, when abnormal, can also be an indication of oxidative stress as well as gout. This panel reports on 19 health markers that indicate kidney and liver function, blood glucose regulation (via assessment of insulin, blood glucose, and hemoglobin A1c), and inflammation. This panel also incorporates a complete urinalysis, as well as vitamin D. Vitamin D has received widespread attention for its potential role in preventing cardiovascular disease and type 2 diabetes mellitus.
This panel should be considered for those individuals who have metabolic syndrome, which places them at higher risk of multiple chronic conditions, including diabetes, coronary heart disease, and cancer, as well as stroke.
Complete Prenatal Panel
The Complete Prenatal Panel is a carefully selected group of 35 tests focused on a woman’s health before pregnancy. These tests can check for specific conditions and concerns that could harm the unborn baby or affect the mother’s health during the pregnancy. These tests can also help guide any treatment needed for a woman during pregnancy or a baby immediately after birth.
The Complete Prenatal Panel includes 35 standard tests such as a complete blood count, a metabolic profile, a lipid panel, an iron panel, a thyroid panel, and a comprehensive urinalysis. This panel also incorporates ABO Blood Grouping and RH typing, as well as provides an assessment of essential hormones such as luteinizing hormone, follicle-stimulating hormone, estradiol, progesterone, and DHEA-S. Additional critical components are the evaluation of the nutrient status of folate, vitamin B12, vitaminD, zinc, magnesium, iodine, and essential fatty acids (e.g., omega-3 and omega-6), as well as a screening for infectious diseases such as hepatitis B, HIV, rubella, and syphilis.
The Rubella virus, the cause of German measles, is usually a mild exanthem and often subclinical. However, when acquired in utero, the rubella virus can cause the congenital rubella syndrome (CRS), and lead to fetal demise, deafness, malformation, and mental retardation.
Syphilis, an infectious disease, is usually spread by sexual contact, such as through direct contact with a syphilis sore. An infected mother can also pass the infection to her fetus, with severe and potentially fatal consequences for the infant. The test that screens for hepatitis B is called the hepatitis B antigen and detects a protein produced by the virus, which can identify a hepatitis B infection even before it causes symptoms. It is crucial to detect active hepatitis B infections in pregnant women or women that are considering pregnancy because newborns are especially vulnerable to developing a chronic infection; up to 90% of those who become infected with hepatitis B in utero will become carriers. The Comprehensive Urinalysis with Microscopic Examination is also an essential part of this panel. A urinalysis is vital to assess the chemical constituents in the urine and the relationship to various disease states. A microscopic examination can detect the presence of abnormal urine cells and formed elements. Overall, the urinalysis can detect abnormalities in the urine, which helps assist in the diagnosis of renal diseases, urinary tract infections, urinary tract neoplasms, and systemic diseases. Complete Thyroid Panel The Complete Thyroid Panel includes 14 studies and provides a robust look at thyroid hormone production and metabolism, as well as overall health by including a comprehensive metabolic panel, a complete blood count with differential, a lipid profile, hemoglobin A1c, vitamin D, C-Reactive Protein, along with a urinalysis. The thyroid portion of this panel includes TSH, free thyroxine index, T3 uptake, total and free T4, and T3, reverse T3, thyroglobulin antibody (Tg-AB) and thyroperoxidase antibody (TPO-Ab).
The lipid panel measures overall cholesterol levels in the body. Lipids are various forms of fat in the body and include cholesterol types. Higher levels of low-density lipoprotein are associated with an increased risk of a heart attack. Thyroid dysfunction can also impact serum lipid levels. The Comprehensive Metabolic Panel (CMP) itself includes a combination of 14 health tests. The measurements included in the CMP provide a glimpse into the health of the body, its metabolism, and chemical balance. The CMP can also aid in determining how the liver and kidneys are functioning and where glucose, calcium, Protein, sodium, potassium, and chloride levels stand. The Complete Blood Count with Differential helps to give an overall view of general health and screens for a broad scope of diseases and conditions, as well as the body's ability to defend against infection.
The Comprehensive Urinalysis with Microscopic Examination is also an essential part of this panel. A urinalysis is vital to assess the chemical constituents in the urine and the relationship to various disease states. A microscopic examination can detect the presence of abnormal urine cells and formed elements. Overall, the urinalysis can detect abnormalities in the urine, which helps assist in the diagnosis of renal diseases, urinary tract infections, urinary tract neoplasms, and systemic diseases. Vitamin D has received widespread attention for its potential role in preventing cardiovascular disease and type 2 diabetes mellitus.