Clinical Chemistry

Amazing Value for Extensive Blood Chemistry
- The BH #290

(3-4 Business Day Turnaround)

Why Do Blood Chemistry Testing?

Blood chemistry testing provides a vast amount of information regarding the health of the patient and could disclose information about disease states which either exist or are likely to develop. Common markers on blood chemistry tests give insight into: renal function, electrolyte levels, liver function, bone health, protein digestion, thyroid health, coronary risk factors, lipid profiles, anemia and iron issues, levels of blood cell types (including erythrocytes, leukocytes, lymphocytes and platelets) and blood sugar control.

What is special about the BH #290 Expanded Chemistry Profile?

In addition to providing all of the standard markers seen on common lab panels, the BH #290 Expanded Chemistry Profile also includes the following markers and screens that provide critical information regarding the assessment of patients’ health status:

Thyroid Screen

T3 Uptake – T3 Uptake provides an estimate of thyroxine binding globulin in the body, the protein that carries most of the T3 and T4 in the blood. These bound hormones serve as the reservoir of available thyroid hormone as contrasted with unbound hormone which is the “free” or “bioactive” fraction.

T4 – This test is for T4 or thyroxine and it measures both the bound and free fractions of the hormone. Less than 1% of T4 is in the unbound bioactive form.

Free Thyroxine Index – Free Thyroxine Index is an estimate of the amount of Free T4 in the blood based on the amount of thyroxine binding globulin present.

TSH Ultra Sensitive (the most advanced, highly sensitive assay of TSH available on the market today) – Thyroid stimulating hormone (TSH) is a hormone released by the pituitary gland that triggers the thyroid gland to produce thyroid hormones. Assessing levels of TSH in the blood is considered to be an important method of detecting thyroid problems.

Free T3 – Measures the free fraction/bio-active form of T-3 in serum. T-3 and T-4 are involved in the negative feedback mechanism on TSH levels/response.

Free T4 – Measures the free fraction/bio-active form of T-4 in serum. T-3 and T-4 are involved in the negative feedback mechanism on TSH levels/response.
Free fraction measurement of hormones provides a true functional assessment.

Coronary Risk Screen

Cholesterol – Cholesterol is a wax-like substance that is produced in the liver and is also introduced into the body from dietary sources. It is transported in the blood by carrier proteins called lipoproteins that allow it to be soluble in serum and thereby transported to all parts of the body. Cholesterol, a critical component of cell membranes, is also the raw material from which all of the body’s steroidal hormones are made and plays an essential role in the formation of vitamin D and bile salts. Too much cholesterol in the blood, however, can cause deposits of cholesterol inside arteries. These plaques can narrow the artery enough to block blood flow. This process known as atherosclerosis commonly occurs in the coronary arteries which nourish the heart.

Triglycerides – Triglycerides are composed of a glycerol molecule to which three fatty acid chains are attached. These high energy fatty acid chains provide much of the energy that the body’s cells need to function. During times when triglycerides are not available from dietary sources the liver produces triglycerides itself. While there is no direct evidence that elevated triglycerides pose an independent risk for heart disease, they invariably accompany other major risk factors. However, it is clear that when triglycerides are elevated, HDL (the good) cholesterol levels decrease.

HDL – High-density lipoproteins transport cholesterol from the blood stream back to the liver for processing and elimination from the body. HDL makes it less likely that excess cholesterol in the blood will be deposited in the coronary arteries. Therefore HDL cholesterol is often referred to as the “good” cholesterol.

LDL (Direct) – A direct measurement (not a calculated value) of low-density lipoproteins that transport cholesterol from the liver to the rest of the body. When there is too much LDL cholesterol in the blood, it can be deposited on coronary artery walls. Therefore LDL cholesterol is often referred to as the “bad” cholesterol.
The body needs both HDL and LDL, therefore the terms “good” and “bad” are not absolute.

VLDL – Very low-density lipoproteins (VLDLs) have higher lipid content and lower protein content than LDL. VLDL transports cholesterol from the liver to the body. When there is too much VLDL cholesterol in the blood, it can be deposited on coronary artery walls.

CHOL/HDL – Reports the ratio of total cholesterol to HDL cholesterol and risk factor for men and women for cardiovascular disease.

Homocysteine – Homocysteine is an amino acid that is produced in the human body. It participates in essential metabolic pathways and is often converted into other amino acids for use by the body. Elevated homocysteine levels may irritate the endothelial cells lining blood vessels leading to blockages in arteries (atherosclerosis). It also can interact with blood proteins and cells making blood clotting easier than it should and can oxidize cholesterol into a more damaging form. Supplementing with folic acid and vitamins B6 and B12 can help to reduce homocysteine levels in the blood.

Lipoprotein (a) – Lipoprotein (a) consists of LDL cholesterol linked by a disulfide bond to a large hepatically derived glycoprotein, apolipoprotein (a). Elevated lipoprotein (a) can potentially promote cardiovascular disease in two ways. Its apolipoprotein portion could promote an aggregation of blood factors entrapping cells, resulting in the blockage of an artery or its LDL cholesterol portion can be oxidized and impair endothelial cell function and create atherosclerotic plaque. The levels of lipoprotein (a) in the bloodstream are largely genetically determined. Estrogen replacement therapy in postmenopausal women and high dose niacin has been reported to lower lipoprotein (a) levels. Lipoprotein (a) is frequently elevated with acute as well as chronic bacterial infections.

CRP – C-reactive protein is released by the body in response to acute injury, infection or other inflammatory stimuli. As a marker of systemic inflammation, CRP is a powerful predictor of first and recurrent cardiovascular events.

CPK – Also known as Creatine Kinase (CK), CPK is an enzyme catalyzing the breakdown of phosphocreatine to phosphoric acid and creatine. CPK is a measure of the breakdown of muscle tissue (muscle wasting). It is very likely that CPK will be elevated if blood is drawn a day or two after a weight bearing workout. However, CPK could also be elevated in cases of severe catabolism where skeletal muscle is being broken down to provide glucose to the brain and in cases of heart wasting where something is attacking heart tissue. Any elevated CPK result is automatically reflexed to a myocardial branch fraction at no additional charge to rule out heart muscle wasting.

Celiac/Gluten Sensitive Enteropathy Screen

In this unique screen, we assess critical markers that relate to celiac disease and sub-clinical gluten intolerance. Celiac is defined by Total Serum IgA within range, elevated IgA to transglutaminase and either elevated IgA or IgG to the gliadin peptide of gluten. Sub-clinical gluten intolerance is defined by Total Serum IgA within range and either elevated IgA or IgG to the gliadin peptide of gluten. Celiac disease and sub-clinical gluten intolerance are autoimmune states that occur due to a genetic intolerance to the gliadin polypeptide resulting in a mucotoxic inflammatory response of the lining of the small intestine.

Total Serum IgA – Total serum IgA is used to qualify the IgA levels for anti-gliadin and anti-transglutaminase and to rule out compromised systemic immunity. Individuals with Selective IgA deficiency may have a clinical or sub-clinical gluten sensitive enteropathy (GSE) with anti-gliadin IgA and anti-transglutaminase IgA reported within normal ranges.

Anti-Gliadin Antibodies (IgA, IgG) – The gliadin peptide comprises 50% of gluten (the protein component of wheat and other related grains). One can have a genetic predisposition to immunologic sensitivity to gliadin. This sensitivity can be manifested as mucosal inflammation of the gastrointestinal tract. Such inflammation can remain sub-clinical and persist for decades or demonstrate the very overt symptoms of celiac disease.

Anti-Transglutaminase Antibody (IgG) – This marker measures antibody to the complex of the gliadin peptide and transglutaminase, an enzyme involved in digesting gliadin. People with a genetic intolerance to gliadin lack the ability to properly digest it into its component amino acids. As a result the body forms auto-antibodies to the complex of human tissue transglutaminase and the gliadin polypeptide.

Anemia Screen

Iron – It is important to know serum iron levels in order to interpret abnormal red blood cell (RBC), hemoglobin (HGB) or hematocrit (HCT) levels. When serum iron is known, the amount of iron (inorganic) available to convert to hemoglobin (organic iron) is known, allowing the practitioner to differentiate between low iron and an iron utilization problem.

Iron Binding Capacity – Iron Binding Capacity is an indirect measure of transferrin. A small percentage of the body’s iron is in transport, traveling in the bloodstream attached to a molecule called transferrin. Normally about 30% of available transferrin iron binding sites are occupied. Iron Binding Capacity is measured by determining the number of “available spaces” on unoccupied transferrin.

Percent Iron Saturation (Iron divided by Iron Binding Capacity) – Represents the percentage of available transferrin sites occupied by iron.

Ferritin – About 30% of the iron in the body is stored as ferritin in the liver, bone marrow and spleen. Ferritin is composed of 24 identical protein subunits that store iron ions for future use. The amount of ferritin in the body reflects the amount of iron stored in the body.

Transferrin – Transferrin is the protein that transports iron in the blood. Most transferrin is produced in the liver. Transferrin regulates the release of iron from storage into the general circulation.

Vitamin B-12 – Vitamin B-12 helps maintain healthy nerve cells and red blood cells and also helps to make DNA. It is also known as cobalamin because it contains the metal cobalt. Vitamin B-12 is released from proteins in food during digestion then combines with intrinsic factor which is produced in the stomach. This complex can then be absorbed by the intestinal tract. Pernicious anemia is an anemia caused by malabsorption of Vitamin B12. This is usually caused by decreased production of intrinsic factor.

Folic Acid – Folic Acid, a B vitamin, helps the body form red blood cells and aids in DNA formation. It is also important in preventing neural tube birth defects and metabolizing homocysteine. Vitamin B12 helps keep folate in its active form, allowing it to keep homocysteine levels low.

Glycemic Control Screen

All markers on this screen are critical to understand how well the body is regulating blood sugar. It is important to know where serum insulin and serum cortisol levels are in relation to fasting glucose levels in evaluating a patient’s glycemic control status.

Insulin, Fasting – Insulin is a protein hormone that is secreted in response to a rise in blood levels of sugar and amino acids after eating. Insulin promotes the entry of glucose, fatty acids and amino acids into cells and also promotes glycogen, protein and lipid synthesis.

Glucose, Fasting – Glucose is the end product of carbohydrate metabolism and the chief source of energy for living organisms. Excess glucose is converted to glycogen and stored in the liver and muscles for later use and beyond that it is converted to fat and stored in adipose tissues.

Cortisol, Fasting – In the context of this screen, cortisol is a glucocorticoid that is responsible for gluconeogenesis, the process of converting amino acids and fats to glucose to meet the body’s needs for glucose. A normal fasting glucose is not normal if the fasting cortisol is elevated.

Amylase – Amylase is used as a marker for pancreatic function, helps to identify pancreatic dysfunction, including possible pathology.

Autoimmune Markers

Rheumatoid (RA) Factor – Detects the presence of an autoantibody in the blood to a fragment of the IgG immunoglobulin. Rheumatoid factor becomes elevated when the body is in a state of inflammation. The presence of Rheumatoid Factor indicates that your patient may have rheumatoid arthritis. Positive Rheumatoid Factor test results are found in the majority of cases of rheumatoid arthritis (RA). In addition, many patients with high levels of Rheumatoid Factor in their blood have Sjögren’s syndrome, a systemic inflammatory disorder that affects the mucous membranes. Many patients with RA also have Sjögren’s syndrome. Other causes of a positive Rheumatoid Factor test in the absence of RA or Sjögren’s syndrome are endocarditis; systemic lupus erythematosus (lupus); tuberculosis; syphilis; sarcoidosis; cancer; viral infection; or disease of the liver, lung, or kidney. Your patient may also test positive if they have received skin or kidney grafts from a person who does not have their identical genetic profile.

ANA (Antinuclear Antibody) Screen – Generally, the more elevated a patient’s titer of ANA the higher the association with SLE (systemic lupus erythematosus), therefore the greater likelihood that the patient has SLE. ANA are antibodies against one or more elements within a biological cell, involved in the machinery of translating genomic message into proteins. These antibodies can destroy cells. If a positive ANA result is found, additional tests can be done to identify the particular antibody that is causing the ANA to be positive and thus the particular disease process that is likely to be occurring. If your patient has a positive ANA, BioHealth will automatically reflex to fluorescent antibodies for specific antibody identification at no additional cost.

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