Urinalysis with reflex to culture testing is done when the first urinalysis results are not normal or when doctors think the person might have a urinary tract infection, kidney disease, or another problem with their urinary tract. Several conditions may necessitate urinalysis with reflex testing. Urinary tract infections (UTIs) are a common reason for reflex testing, as it helps healthcare providers identify the specific bacteria causing the infection and determine the most effective antibiotic treatment. Kidney diseases, such as glomerulonephritis or renal tubular acidosis, may also require reflex testing for accurate diagnosis and management. Conditions like hematuria (blood in urine) or proteinuria (protein in urine) warrant further investigation, as they may indicate underlying kidney disease or urinary tract neoplasms. Pregnant women may undergo reflex testing to monitor for gestational diabetes and preeclampsia. NOTE: You need to visit the lab near you to submit two separate specimens in containers provided by the lab. NOTE: The culture will ONLY be performed if any of the following Urinalysis results are applicable:
•Presence of Leukocyte esterase alone
•Presence of WBCs (>5/hpf) alone
•Presence of Yeast
•Presence of Bacteria and the presence of WBCs (>5/hpf) or Leukocyte esterase
•Presence of Nitrite and the presence of WBCs (>5/hpf) or Leukocyte esterase
The adrenal gland produces a hormone known as dehydroepiandrosterone (DHEA). It is also made in the brain. DHEA leads to the production of androgens and estrogens (male and female sex hormones). DHEA levels in the body begin to decrease after age 30. Lower DHEA levels are found in people with hormonal disorders, HIV/AIDS, Alzheimer's disease, heart disease, depression, diabetes, inflammation, immune disorders, and osteoporosis. Corticosteroids, birth control taken by mouth, and agents that treat psychiatric disorders may reduce DHEA levels.
Protein, Gloublin and Albumin - The major proteins seen in the serum are albumin and globulin-the latter being primarily alpha 1 and alpha 2 globulin, beta globulin and gamma globulin. Albumin accounts for more than 50% of the total serum proteins. The albumin to globulin (A/G) ratio has been used as an index of disease state, however, it is not a specific marker for disease because it does not indicate which specific proteins are altered. The normal A/G ratio is 0.8-2.0. The A/G ratio can be decreased in response to a low albumin or to elevated globulins. Total globulins may be increased in some chronic inflammatory diseases (TB, syphilis) multiple myeloma, collagen disease, and rheumatoid arthritis. Decreased levels are seen in hepatic dysfunction, renal disease and various neoplasms.
Lactate dehydrogenase (LD) is an enzyme that is found in almost all of the body's cells, but only a small amount of it is usually detectable in the blood. LD is released from the cells into the bloodstream when cells are damaged or destroyed. Because of this, the LD test can be used as a general marker of injury to cells. Although there is some overlap, each of the five LD isoenzymes tends to be concentrated in specific body tissues. This panel provides 5 types of isoenzymes to detect if LD is coming from the heart, red blood cells, kidneys, lungs, white blood cells, lymph nodes, muscle, or liver.
The LDH (lactate dehydrogenase) blood test measures the level of LDH in your blood. LDH is an enzyme in many body organs and tissues, including the heart, liver, muscles, and red blood cells. The LDH test is often used to help diagnose and monitor various medical conditions, such as anemia, heart attack, and liver disease. It may also be ordered to check for tissue damage or monitor treatment effectiveness for specific conditions. Since lactic dehydrogenase is present in many body tissues, its diagnostic usefulness is limited. Tissue specificity may be enhanced by LDH isoenzyme analysis.
This test is not the sensitive estradiol test but the regular one. It is not recommended for men (it is adequate for pre-menapausal women). The results from this test are usually available 2 business days faster than the sensitive estradiol test.
Phosphate (as Phosphorus) - Serum phosphorus (Phosphate) levels alone are of limited diagnostic value and should be correlated with serum calcium levels. An increased phosphorus with decreased calcium suggests either hypoparathyroidism or renal disease. A decreased phosphorus and an increased calcium suggests hyperparathyroidism or sarcoidosis. When both calcium and phosphorus are decreased diagnostic considerations include malabsorption, vitamin D deficiency and renal tubular acidosis. Increased phosphorus and normal or increased calcium suggests Milk-alkali syndrome or hypervitaminosis D.
This test measures levels of drenocorticotropic hormone (ACTH), which is also called adrenocorticotropin and corticotropin, a hormone made in the anterior pituitary gland that tells the adrenal glands to release cortisol, DHEA, and aldosterone. The ACTH plasma test quantifies the blood's level of ACTH. A patient's blood is drawn for the test and then sent to a lab for examination. The test findings enable the diagnosis of ailments such as Addison's disease, Cushing's syndrome, and adrenal tumors
Cortisol (hydrocortisone) is the most prominent glucocorticosteroid, and it is essential for the maintenance of several body functions. The most important physiological effects of cortisol are that it raises blood sugar levels (enhances gluconeogenesis, or breaks down glucose) and lowers inflammation and the immune system.
This test for adrenal insufficiency includes 4 measurements of your salivary Cortisol level during one day. Cortisol, also known as the "stress hormone" can be either too high or too low which may be a sign of adrenal distress.
This panel is the most inclusive of all offered on the site for men who want a wide picture of their health or who are considering starting testosterone replacement therapy. It provides a baseline overview of your sex hormones, thyroid gland, adrenal function, metabolic function, cholesterol, prostate, and overall health. Tests included:
Renin, also known as angiotensinogenase, is an enzyme that the kidneys produce to regulate aldosterone production. It’s also essential in the renin–angiotensin aldosterone system (RAAS) which maintains your body’s fluid balance and blood pressure. Aldosterone is the primary of several endogenous members of the class of mineralocorticoids in humans. Aldosterone tends to promote sodium and water retention, and lower plasma postasium concentrations.
Blood typing is used to determine an individual's blood group, to establish whether a person is blood group A, B, AB, or O and whether he or she is Rh positive or Rh negative.
Thyroxine-binding globulin (TBG) is a globulin that binds thyroid hormones in circulation. It is one of three transport proteins (along with transthyretin and serum albumin) responsible for carrying the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the bloodstream. Of these three proteins, TBG has the highest affinity for T4 and T3 but is present in the lowest concentration. Despite its low concentration, TBG carries the majority of T4 in the blood plasma.
The Cardio IQ® Insulin Resistance Score (IR), which uses fasting insulin and C-peptide measurements to estimate a person's likelihood of having insulin resistance. It eliminates the need for multiple samples and reduces the chance of errors that can occur with some other tests. Having a high score (indicating a greater probability of insulin resistance) was linked to an increased risk of developing type 2 diabetes, even after accounting for other risk factors. An IR score of <33 suggests that an individual has normal insulin sensitivity. Fasting Required for 10-12 hours. Water only.
A score of 33 to 66 suggests that an individual has >4-fold greater odds of having IR compared with an individual with a score <33 .
A score >66 suggests that an individual has >15-fold greater odds of having IR compared to an individual with a score
This is the most accurate progesterone test that has no potential interactions and can detect very low levels in men and women. Since it is performed with liquid chromatography and mass spectrometry, results are available after 5 to 7 business days.
Vitamin D is essential for bone health and many metabolic processes. The body derives it from sunlight and food sources. Many people do not get enough sunlight or do not consume enough vitamin D rich foods. This test is important to determine if you need vitamin D supplementation or if your current supplementation is effective.
This Testosterone Panel Includes 5 Tests: Note: Despite SHBG not being listed on the lab requisition form under "Testosterone, Free, Bioavailable, and Total, Males (Adult)," rest assured the results include this critical component, as it's necessary for calculating bioavailable testosterone.
Pregnenolone is known as the mother hormone. All other steroids including testosterone and estrogen are derived from this important hormone. For this reason, optimal blood levels of pregnenolone are critical for a healthy hormone balance. This test uses liquid chromatography/mass spectrometry, the most accurate assay for hormones.
THIS IS THE MOST AFFORDABLE TESTOSTERONE TEST IN THE U.S. The most accurate way to measure total testosterone is with liquid chromatography/mass spectrometry. This panel also shows free testosterone percent by equilibrium dialysis and free testosterone calculated from percent free T. This test is more accurate for low and high testosterone blood levels (for men who expect high testosterone blood levels over 1,500 ng/dL, women, and children who usually have low T levels). It has no interferences with supplements or anabolics. Note: Results may take 5-7 business days. For a faster turnaround, choose this test instead: Testosterone, Free, Bioavailable and Total (With Lower & Upper Limit) plus SHBG
A single fasting growth hormone (GH) level is of limited value. The secretion of GH is episodic and pulsatile. GH has a half-life of 20 to 25 minutes. Testing for growth hormone deficiency or excess is best done as part of a dynamic test involving specific stimuli (see the online Endocrine Appendices: Growth Hormone Stimulation and Growth Hormone Suppression). Insulin-like growth factor-1 can also be useful in assessing growth hormone status.
Patients with diabetes may get a C-peptide test as a means of distinguishing type 1 diabetes from type 2 diabetes or Maturity onset diabetes of the young (MODY). Measuring C-peptide can help to determine how much of their own natural insulin a person is producing as C-peptide is secreted in equimolar amounts to insulin. C-peptide levels are measured instead of insulin levels because C-peptide can assess a person's own insulin secretion even if they receive insulin injections, and because the liver metabolizes a large and variable amount of insulin secreted into the portal vein but does not metabolize C-peptide, meaning blood C-peptide may be a better measure of portal insulin secretion than insulin itself.
Insulin-like Growth Factor 1, also known as IGF-1, is used as a biomarker for blood levels of human growth hormone. It is a hormone produced by the liver and other tissues which affects growth-promoting activities and glucose metabolism. The blood level of IGF-1 appears to fluctuate over 24 hours and is found to be related to growth hormone secretion.
Progesterone is a female hormone important for the regulation of ovulation and menstruation. It is also present in men in smaller concentrations. Progesterone is a steroid hormone that plays numerous roles within the human body. It is crucial to the production of sex hormones and corticosteroids, as well as playing a role as a neuro-steroid (brain function).
The serum iron test measures the amount of iron in your blood. The total iron-binding capacity (TIBC) test looks at how well the iron moves through your body.
A Magnesium RBC test can provide an earlier indicator of magnesium deficiency that a standard magnesium blood test. When levels are low, the body will pull magnesium from the cells to keep blood levels normal. In this case, a magnesium blood test may show normal levels while a magnesium RBC test will give a more accurate result.
This panel includes blood and urine tests commonly used by physicians to determine kidney dysfunction: Urinalysis, Comprehensive Metabolic Panel (CMP), Cystatin C and eGFR.
The cystatin C test (which also includes estimated creatinine clearance eGFR) can be done along with the creatinine or creatinine clearance test in cases where those tests aren’t appropriate, such as patients taking creatine supplements for bodybuilding. These supplements can increase creatinine and decrease creatinine clearance, which can alarm doctors who fear kidney dysfunction. This creatinine increase is not clinically relevant, but running a Cystatin C test can give physicians reassurance and allow the patient to keep taking that effective bodybuilding supplement.
This lab test panel includes main blood test makers involved in hair loss in women and men: Complete Blood Count (CBC)- Can detect potential low hemoglobin and infections that can lead to hair loss. Ferritin- Low ferritin, an iron storage protein, has been linked to hair loss and slow down of hair growth. Iron and Total Iron Capacity (TIBC)- Low iron anemia has been linked to hair loss. Hyperandrogenism: Excessive male hormones (androgens): Total Testosterone (LC/MS), Free Testosterone (Equilibrium Ultrafiltration), DHEA-S, Dihydrotestosterone (DHT) Hypothyroidism and Hyperthyroidism: Thyroid Stimulation Hormone (TSH), Free Triidothyronine (Free T3)
This diabetes panel includes important tests usually prescribed for anyone living with Type 1 or Type 2 diabetes. It includes A1c, CMP, Urinialysis, Insulin, and Glucose Tolerance Test (GTT).
A prolactin blood test is used by doctors to evaluate sexual dysfunction or very low testosterone blood levels of unknown causes in both men and women.
The Urinalysis test panel screens for a variety of conditions including urinary tract infections ( UTI ), urinary bladder disease, kidney disease and diabetes. Tests included: Color, Appearance, Specific gravity, pH, Protein, Glucose, Occult blood, Ketones, Leukocyte esterase, Nitrite, Bilirubin, Urobilinogen, and Microscopic examination of urine sediment
The Rheumatoid Arthritis Factor is often evaluated in patients suspected of having any form of arthritis or destructive articular disease even though positive results can be due to other causes, and negative results do not rule out disease. But, in combination with signs and symptoms, it can play a role in both diagnosis and disease prognosis. It is part of the usual disease criteria of rheumatoid arthritis.
The reverse T3 test has to be done at the same time you do the free T3, and you then measure the ratio between the two by dividing the RT3 into the Free T3. The body produces the benign RT3 naturally to rid itself of excess of T4, but in some cases, such as high or low cortisol, RT3 is produced in excess, which can clog cell receptors from receiving T3. FT3 is usually twenty or more times higher than RT3. NOTE: Reverse T3 is analyzed using a specific technique called liquid chromatography/tandem mass spectrometry (LC/MS-MS). There's a special place in the U.S. where these precise machines needed for LC/MS panels run only on two specific days a week. So, sometimes the clock ticks a bit while we wait for samples to return from their initial collection points. Results may take 7 business days.
This test measures the amount of dihydrotestosterone (DHT) in the blood. Low DHT has been associated with low libido and high DHT has been linked to acne, hair loss and benign prostatic inflammation in a minority of men.
The thyroid stimulating hormone (TSH) is produced and secreted by the pituitary gland and stimulates the thyroid to produce T3 and T4. When TSH is elevated, low thyroid function may be indicated. If TSH is low it is indicative of high thyroid function. A study found that TSH was suppressed in all subjects after food, so fasting may be suggested although it is not reqired by Quest. Free T4 and Free T4 values did not change significantly after eating.
A blood pregnancy test is a medical test used to determine if a woman is pregnant by detecting the presence of the hormone hCG in her blood. Shortly after the fertilized egg implants into the uterine lining, the developing placenta produces the hormone known as hCG. This test is the Quantitative hCG test (also known as a beta hCG test) and measures the specific amount of hCG present in the blood. It can help determine how far along a pregnancy is, monitor the progress of the pregnancy, and detect potential issues like an ectopic pregnancy or a miscarriage. Blood pregnancy tests are more sensitive than over-the-counter urine pregnancy tests and can detect pregnancy earlier – as soon as 6 to 8 days after ovulation.
Estrone (E1) is one of the three estrogens, which also include estriol and estradiol. Estrone is the least abundant of the three and is considered a pro-hormone of estradiol.
To find out if sperm count is normalized in men using hCG plus TRT, several studies have found that 17OH-P blood level is correlated to intratesticular testosterone (ITT) required for the testicles to make sperm, so testing for this hormone could not only save time while optimizing HCG dose/frequency but also eliminate the need to perform testicular aspirations, a very difficult procedure to do. Sperm count does not stabilize until 6-8 weeks after starting hCG plus TRT, so knowing your 17OH-progesterone blood level can give you a quick way to determine if your hCG dose and frequency is adequate before your first follow-up semen analysis after 8 weeks.
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