Blood Health
The Blood Health category brings together biomarkers that reflect the function and integrity of one of the body’s most vital systems. Blood biomarkers give important insights into oxygen transport, nutrient status, immune activity, inflammation, and clotting ability.
Abnormal results may serve as an early warning sign of conditions such as anemia, infections, clotting disorders, autoimmune disease, or chronic illness.
Hemoglobin, Hematocrit, Reticulocytes, and Ferritin help detect anemia, iron deficiency, or blood loss.
Transferrin, TIBC, and Iron Saturation provide a deeper look at iron metabolism and storage.
Specialized hemoglobin markers (Hemoglobin A, Hemoglobin F, Sickle Cell Screen) detect inherited blood disorders such as sickle cell disease or thalassemia.
Platelet Count, Plateletcrit, and Immature Platelet Fraction assess clotting capacity and bleeding risk.
D-Dimer and Fibrinogen are key for evaluating blood clot formation and breakdown, often used in suspected deep vein thrombosis (DVT) or pulmonary embolism (PE).
Coagulation factors (Factor V, VII, VIII, IX, X, XI activity) and genetic tests like Factor V Leiden identify inherited or acquired clotting disorders.
C-Reactive Protein (CRP) and Cardiac CRP measure systemic inflammation and cardiovascular risk.
CRP/ESR ratio provides context in autoimmune or chronic inflammatory conditions.
White blood cell counts, immature cells, and large unstained cells (LUC) reflect infection, immune dysfunction, or bone marrow issues.
Copper, RBC Magnesium, Ammonia, and RBC Glutathione offer clues about metabolic balance and oxidative stress.
Erythropoietin (EPO) helps evaluate red blood cell production and the role of the kidneys and bone marrow.
Cryoglobulins, Porphyrins, Porphobilinogen Deaminase, and Delta-Aminolevulinic Acid support diagnosis of rare metabolic or autoimmune conditions.
Beta-2 Glycoprotein I antibodies (IgA, IgG, IgM) are linked to increased clotting risk in antiphospholipid syndrome.
Thrombin–Antithrombin Complex and PAI-1 Activity provide advanced insights into clot formation and breakdown (fibrinolysis).
Blood health biomarkers are valuable in both routine checkups and specialized diagnostics. They help to:
Detect anemia, iron deficiency, or nutrient-related blood disorders
Identify hidden inflammation or autoimmune activity
Evaluate bleeding and clotting risk (e.g., before surgery or in suspected thrombosis)
Diagnose genetic conditions such as hemoglobinopathies or clotting mutations
Monitor the effectiveness of treatments like iron therapy, anticoagulants, or anti-inflammatory medications
Understanding your blood test results helps you connect lab values to your overall well-being. From common tests like ferritin and CRP to advanced markers for clotting factors or porphyrins, each biomarker offers valuable clues about your body’s internal balance—guiding more informed healthcare decisions.
Optimal range: 0 - 1500 pg/mg Cr
AspirinWorks® 11-Dehydrothromboxane B2 (11-dhTXB2) with Creatinine - Aspirin (which inhibits platelet cyclooxygenase) reduces the risk of thrombosis in cardiovascular disease by impairing platelet function. Patients who do not respond to the platelet inhibitory effects of aspirin are designated as "aspirin resistant". The measurement of 11-dhTXB2 in urine (the principal metabolite of platelet cyclooxygenase derived thromboxane B2) may be used in individuals with cardiovascular disease prior to initiation of aspirin therapy, or in individuals non-responsive to aspirin therapy.
Optimal range: 0.02 - 0.09 Units
Absolute Reticulocyte Count (ARC) is a critical blood test used to assess the bone marrow's ability to produce red blood cells (RBCs), essential for diagnosing and managing various hematological conditions. Reticulocytes are immature red blood cells, and their absolute count indicates the rate of RBC production. This test is particularly vital for patients with anemia or those undergoing treatments like chemotherapy, as it helps determine whether the bone marrow is responding adequately.
Reference range: MM, MS, MZ, FM, SZ, SS, ZZ, FS, FZ, FF
Your phenotype or genotype are basically the letters given to the two alleles that make up your Alpha-1 gene. Your phenotype or genotype (e.g. ZZ, MZ, MS, etc.) is important because it can give you a general idea of how at risk you are.
Phenotypes and genotypes of Alpha-1 are reported as letters of the alphabet. These letter assignments were first made when starch gel electrophoresis was the common technique used for testing phenotypes. In this system, the phenotype was determined by how fast the AAT protein moved in a gel. The system was designed so the normal protein moved about halfway up the gel and, therefore, the normal protein was assigned a letter from the middle of the alphabet: M. The most common deficient AAT protein moved hardly at all and was assigned the letter Z.
Optimal range: 101 - 187 mg/dL
Alpha-1 antitrypsin deficiency is a hereditary disorder in which a lack or low level of the enzyme alpha-1 antitrypsin damages the lungs and liver.
Optimal range: 11 - 55 µmol/L
Ammonia is a waste product naturally produced in the body. It primarily comes from the digestion of protein by bacteria in the intestines.
Optimal range: 9 - 67 U/L
Angiotensin-converting enzyme (ACE) is an enzyme that helps regulate blood pressure.
An increased blood level of ACE is sometimes found in sarcoidosis, a systemic disorder of unknown cause that often affects the lungs but may also affect many other body organs, including the eyes, skin, nerves, liver, and heart.
Optimal range: 0 - 26 U/mL
Beta-2 glycoprotein 1 antibody is an autoantibody that is associated with inappropriate blood clotting. This test detects and measures one class (IgA) of beta-2 glycoprotein 1 antibodies.
Optimal range: 0 - 21 SGU
The assay contributes to the diagnosis of antiphospholipid syndrome (APS). The clinical symptoms of APS alone are not sufficiently specific to make a definitive diagnosis. Laboratory tests thus play an important role in the diagnosis of the disease. In patients with APS, autoantibodies are formed that bind to phospholipids like cardiolipin or to phospholipid-binding proteins like beta-2-glycoprotein.
Detection of these autoantibodies is an integral part of the classification criteria issued by the International Society on Thrombosis and Hemostasis.
Beta-2-glycoprotein I is a 50 KD protein cofactor required by anti-cardiolipin antibodies (ACA) to bind to cardiolipin and other phospholipid molecules.
Optimal range: 0 - 33 SMU
The assay contributes to the diagnosis of antiphospholipid syndrome (APS). The clinical symptoms of APS alone are not sufficiently specific to make a definitive diagnosis. Laboratory tests thus play an important role in the diagnosis of the disease. In patients with APS, autoantibodies are formed that bind to phospholipids like cardiolipin or to phospholipid-binding proteins like beta-2-glycoprotein.
Detection of these autoantibodies is an integral part of the classification criteria issued by the International Society on Thrombosis and Hemostasis.
Beta-2-glycoprotein I is a 50 KD protein cofactor required by anti-cardiolipin antibodies (ACA) to bind to cardiolipin and other phospholipid molecules.
Optimal range: 22 - 29 mmol/L
The bicarbonate content of serum or plasma is a significant indicator of electrolyte dispersion and anion deficit. Together with pH determination, bicarbonate measurements are used in the diagnosis and treatment of numerous potentially serious disorders associated with acid-base imbalance in the respiratory and metabolic systems. Some of these conditions are diarrhea, renal tubular acidosis, carbonic anhydrase inhibitors, hyperkalemic acidosis, renal failure, and ketoacidosis.
Reference range: Type A, Type B, Type AB, Type O, O negative, O positive, A negative, A positive, B negative, B positive, AB negative, AB positive
Optimal range: 0 - 3 mg/L , 0 - 0.3 mg/dL
C-reactive protein (CRP) is a liver-produced protein that rises in response to inflammation, and it is measured through a CRP or high-sensitivity CRP (hs-CRP) test. The standard CRP test detects significant inflammation caused by infections or chronic diseases like rheumatoid arthritis, while the hs-CRP test is more sensitive and used primarily to assess cardiovascular risk. Elevated CRP levels indicate inflammation but do not specify its cause or location, requiring further diagnostic tests. CRP levels also help monitor treatment effectiveness for inflammatory conditions. High CRP is associated with an increased risk of heart disease, though lifestyle changes and medications like statins can help manage it. Despite the value of CRP as an inflammation marker, its levels can fluctuate due to various factors like smoking, obesity, and infections.
Optimal range: 0 - 3 mg/L
What is C-reactive protein (CRP)?
C-reactive protein (CRP) is a protein the liver produces in the presence of infection or inflammatory disease such as rheumatoid arthritis. When you have an infection, the white blood cells act to fight it by producing a number of proteins, some of which stimulate the liver to produce CRP. The blood level of CRP has been used for many years to evaluate the level of inflammation or infection.
How does CRP relate to cardiovascular risk?
Your level of C-reactive protein can be an indicator of how at risk you are for developing cardiovascular problems. This is because the development of atherosclerosis (laying down of cholesterol inside the blood vessel walls) is associated with inflammation within the vessel walls. The result is higher levels of CRP in patients with atherosclerosis than in those without atherosclerosis.
Optimal range: 2 - 4 g/L
Optimal range: 80 - 158 ug/dL , 12.59 - 24.87 umol/L
Copper serum is one of the diagnostic methods of ascertaining whether a patient is suffering from some kind of liver problem or from a genetic disease called Wilson’s disease.
Optimal range: 0.5 - 1.5 ug/ml
The "Copper, Whole Blood" test by Labcorp measures the concentration of copper in whole blood, providing insight into the body's copper status. Copper is an essential trace mineral involved in various physiological processes, including energy production, iron metabolism, immune function, and the synthesis of collagen and neurotransmitters.
Optimal range: 0 - 0.8 Ratio
CRP/ESR Ratio is a calculated value that compares levels of C-reactive protein (CRP) to the erythrocyte sedimentation rate (ESR)—two common markers used to detect inflammation in the body. This ratio can provide deeper insight into the type and intensity of inflammation, helping to distinguish between different causes of inflammatory responses.
C-reactive protein (CRP) is a protein produced by the liver in response to acute inflammation. Its levels rise quickly within hours of tissue injury or infection.
Erythrocyte Sedimentation Rate (ESR) measures how quickly red blood cells settle at the bottom of a test tube in one hour. It increases more slowly and reflects more chronic or long-term inflammation.
Reference range: None detected, Detected
Optimal range: 0 - 0.49 mg/L FEU
D-Dimer is a protein fragment (small piece) that's made when a blood clot dissolves in your body.
Optimal range: 0 - 500 ng/mL FEU , 0 - 0.5 ug/mL FEU
The D-Dimer, Quantitative test is a crucial laboratory tool used primarily to assess the likelihood of clotting disorders such as deep vein thrombosis, pulmonary embolism, and disseminated intravascular coagulation. This test measures the concentration of D-Dimer, a small protein fragment produced when a blood clot dissolves, in the blood. A normal D-Dimer level can help rule out certain clotting disorders in patients with low or moderate risk, while elevated levels may indicate active clot formation and breakdown. However, elevated D-Dimer levels are not specific to thrombosis and can also be seen in other conditions like infection, inflammation, trauma, or cancer. Therefore, interpreting D-Dimer results requires consideration of the patient's overall clinical condition, symptoms, and other diagnostic tests. A high D-Dimer level alone does not confirm thrombosis but suggests the need for further investigation to identify the underlying cause.
Optimal range: 0 - 4.5 mg/24 hr
The Delta Aminolevulinic Acid, Urine, 24 Hour test can help diagnose porphyrias, lead or mercury poisoning and aid in the evaluation of certain neurological problems with abdominal pain.
Delta Aminolevulinic Acid may be increased in attacks of acute intermittent porphyria. Acute intermittent porphyria is a rare autosomal dominant disease characterized by a deficiency of hydroxymethylbilane synthase (HMBS). It presents with abdominal pain, nausea, vomiting, peripheral neuropathy, and seizures. Treatment for acute attacks is intravenous heme.
Delta Aminolevulinic Acid is also increased also in tyrosinemia. Tyrosinemia is a genetic disorder characterized by problems breaking down the amino acid tyrosine, which is a building block of most proteins. If the condition is untreated, tyrosine and its byproducts build up in tissues and organs, which can lead to serious health problems.
Optimal range: 2.6 - 18.5 mIU/ml
Erythropoietin, also known as EPO, is a hormone that the kidneys produce to stimulate production and maintenance of crucial red blood cells. The hormone does this in two ways: First, it stimulates bone marrow cells to produce red blood cells. Then, it works to protect the cells from destruction once they are in the body.
Optimal range: 0 - 0.86 ng/mg
F2-Isoprostane, prostaglandin-like compounds formed from the free radical-mediated oxidation of arachidonic acid, are the ‘gold standard’ for measuring oxidative stress in the body.
F2-Isoprostane also have potent biological effects associated with inflammation and therefore may mediate chronic disease initiation and progression.
Additionally, F2-Isoprostane may also act as potent vasoconstrictors via thromboxane formation in the endothelium and promote platelet activation resulting in thrombus formation.
The F2-Isoprostane test may be performed on individuals at risk of future cardiovascular disease due to lifestyle risks, or those with a family history of cardiovascular disease.
Testing of F2 -Isoprostanes is determined by an individual’s medical history, but may be performed semi-annually or annually as necessary. If the initial test result is abnormal, then follow-up testing may be performed within 3-6 months following treatment.
Optimal range: 60 - 177 %
The Factor IX Activity assay is a blood test that measures the activity of factor IX. This is one of the proteins in the body that helps the blood clot.
Reference range: Normal / Not detected, Abnormal / Detected
Venous thromboembolism is a complex condition that can be caused by a combination of genetic factors, lifestyle choices, and specific situations. One key genetic risk factor is the presence of a specific change in the F5 gene, known as Factor V Leiden (c.1601G>A or p. Arg534Gln variant). People who carry one copy of this variant are 6 to 8 times more likely to develop venous thromboembolism, while those with two copies (one from each parent) face an approximately 80 times higher risk. The risk increases even further for individuals who carry both the Factor V Leiden variant and another variant called c.*97G>A in the F2 gene, making them about 20 times more susceptible. Certain combinations of genetic factors, including both mentioned variants, could further elevate this risk.
Optimal range: 51 - 186 %
The factor VII assay is a blood test to measure the activity of factor VII. This is one of the proteins in the body that helps the blood clot.
Optimal range: 56 - 140 %
This test measures the activity of factor VIII, a blood-clotting protein. The test can find out whether you have hemophilia A or another clotting disorder. Because blood-clotting proteins work together to stop bleeding, the test may be done as part of an overall screening for the proteins involved in clotting.
Optimal range: 76 - 183 %
The factor X assay is a blood test to measure the activity of factor X -- one of the substances involved in blood clotting (coagulation).
Optimal range: 60 - 150 %
Optimal range: 30 - 400 µg/dL , 30 - 400 ng/mL , 5.37 - 71.6 µmol/L , 30 - 400 ug/L
Ferritin is a protein that serves as a storehouse for iron in the body. When iron supplies dwindle, ferritin releases some into the blood. Therefore, a blood ferritin test is an indication of how much iron is stored in the body. Iron is used primarily by red blood cells to carry oxygen to other cells, and as such Ferritin is vital to blood health.
Optimal range: 15 - 150 ng/mL , 15 - 150 ug/L
Ferritin is a protein that serves as a storehouse for iron in the body.
When iron supplies dwindle, ferritin releases some into the blood. Therefore, a blood ferritin test is an indication of how much iron is stored in the body. Iron is used primarily by red blood cells to carry oxygen to other cells, and as such Ferritin is vital to blood health.
Optimal range: 193 - 507 mg/dL , 1.93 - 5.07 g/L
It’s used to determine the level of fibrinogen in your blood. Fibrinogen, or factor I, is a blood plasma protein that’s made in the liver. Fibrinogen is one of 13 coagulation factors responsible for normal blood clotting.
Optimal range: 149 - 353 mg/dL
Fibrinogen is a soluble protein in the plasma that is broken down to fibrin by the enzyme thrombin to form clots.
Optimal range: 3.8 - 14.2 Units
Glucose 6-Phosphate Dehydrogenase, often abbreviated as G6PD (or G-6-PD), plays a critical role in the body's cellular function. This enzyme is vital for the health of all cells, but it's particularly crucial for red blood cells.
G6PD helps cells manage oxidative stress. Oxidative stress occurs when there's an imbalance between the production of harmful free radicals (unstable molecules that can damage cells) and the body's ability to counteract their harmful effects through neutralization with antioxidants. G6PD aids in the production of NADPH, a molecule that plays a key role in the antioxidant defense system of cells. Specifically, NADPH helps maintain the supply of glutathione, a powerful antioxidant that protects red blood cells from damage.
The importance of G6PD comes into the spotlight when we consider its role in maintaining the integrity and functionality of red blood cells. These cells are responsible for transporting oxygen from the lungs to the rest of the body and returning carbon dioxide back to the lungs for exhalation. Because red blood cells are continuously exposed to oxygen, they are particularly susceptible to oxidative damage. G6PD ensures that red blood cells can protect themselves against such damage and thus, maintain their crucial function in oxygen transportation.
Optimal range: 1100 - 5000 umole/L
Glutathione (GSH) is a tripeptide (λ-glutamyl-cysteinylglycine) synthesized by most cells, serving as a critical marker of cellular health and resilience against toxic stress. In erythrocytes, GSH levels are a sensitive indicator of the body's intracellular GSH status and overall cellular well-being. It is the most abundant non-protein thiol in mammalian cells, playing key roles in various biological processes, such as detoxifying harmful compounds (xenobiotics), neutralizing reactive oxygen species, regulating cellular redox balance, and maintaining the oxidative state of vital protein sulfhydryl groups. Additionally, GSH supports immune function. Intracellular GSH concentrations are significantly higher than plasma levels, with plasma GSH largely derived from the liver.
Optimal range: 33 - 346 mg/dL , 0.33 - 3.46 g/L
Haptoglobin is a protein that your liver produces. It combines with hemoglobin, which transports oxygen to your organs and tissues via the red blood cells. The haptoglobin test is a test for hemolytic anemia.
Optimal range: 96 - 100 %
Hemoglobin A, featured prominently on the Thalassemia and Hemoglobinopathy Comprehensive (COMP) panel, is a critical component in diagnosing and managing blood disorders. This panel is an essential tool used to detect various forms of thalassemia and hemoglobinopathies, conditions characterized by abnormal hemoglobin production. Hemoglobin A, the most common form of hemoglobin in adults, is composed of two alpha and two beta globin chains.
Optimal range: 0 - 2 %
Hemoglobin F, an integral component analyzed in the Thalassemia and Hemoglobinopathy Comprehensive (COMP) panel, holds significant diagnostic value in the field of hematology. This panel is extensively utilized to detect and manage various blood disorders, specifically thalassemia and hemoglobinopathies, which involve abnormal hemoglobin production or structure. Hemoglobin F, or fetal hemoglobin, normally present in high levels in fetuses and newborns, is comprised of two alpha and two gamma globin chains. Its proportion in adult blood is typically low but can be elevated in certain hematological conditions.
Optimal range: 0.61 - 16.68 %
The Immature Reticulocyte Fraction (IRF) measures the percentage of young red blood cells (RBCs) in the bloodstream, indicating the bone marrow's RBC production rate. High IRF suggests active bone marrow response, as seen in recovery from anemia, while low IRF indicates inadequate marrow activity, common in conditions like aplastic anemia. IRF is essential in diagnosing and monitoring red blood cell disorders, differentiating anemias caused by decreased production versus increased destruction. It's also key in evaluating treatment effectiveness, particularly in patients with chronic kidney disease or undergoing chemotherapy. Its inclusion in advanced hematology analyzers underscores its clinical significance in hematologic condition management.
Optimal range: 0 - 7.2 %
Circulating immature platelets, also known as the immature platelet fraction (IPF), is the term that defines much larger platelets that have been recently released from the bone marrow, presence of which show the thrombopoietic activity of the marrow.
They represent the most recently produced platelets released into the circulation by regenerated BM megakaryocytes. These types of platelets are the analogs of reticulocytes and are similarly large; moreover, they contain elevated amounts of cytoplasmic RNA and decrease in size and RNA content as they age. The number and proportion of immature platelets reflect the rate of thrombopoiesis; the values of these parameters rise and fall concomitantly with the platelet production rate.
Optimal range: 0 - 23 %
The Immature Reticulocyte Fraction (IRF) test is a vital diagnostic tool in the field of hematology, offering crucial insights into the health and functionality of the bone marrow. IRF measures the percentage of immature reticulocytes (young red blood cells) in the blood, providing an early indication of bone marrow response, especially in conditions like anemia. This test is key for diagnosing various types of anemia, assessing bone marrow recovery post-chemotherapy, or monitoring the effectiveness of treatments for conditions affecting red blood cell production.
Optimal range: 27 - 159 µg/dL , 4.83 - 28.46 µmol/L , 27 - 159 umol/L
Iron - the basics:
- Iron is supplied by the diet.
- As much as 70% of the iron in the body is found in the hemoglobin of the red blood cells (RBCs).
- The other 30% is stored in the form of ferritin and hemosiderin (=iron-storage complex within cells, not widely available).
- About 10% of the ingested iron is absorbed in the small intestine and transported to the plasma.
- Abnormal levels of iron are characteristic of many diseases, including iron-deficiency anemia and hemochromatosis (=Iron overload).
Optimal range: 9 - 30.4 umol/L
Iron is an essential element required for the production of hemoglobin. Without it, red blood cells cannot reproduce in the body. Doctors are also finding a connection of iron to hair regrowth in the body.
Optimal range: 121 - 224 U/L
Lactate dehydrogenase (LDH) is an enzyme that helps the process of turning sugar into energy for your cells to use. LDH is present in many kinds of organs and tissues throughout the body, including the liver, heart, pancreas, kidneys, skeletal muscles, brain, and blood cells.
Lactate dehydrogenase may be elevated due to liver disease, hypothyroidism, skeletal muscle damage, anemia (hemolytic, pernicious), fractures. May be decreased due to reactive hypoglycemia, insulin resistance, ketosis.
Optimal range: 0 - 0.4 x 10E3/ml
Large unstained cells (LUC) are cells that are activated lymphocytes and peroxidase-negative cells. They are not stem cells, normal lymphocytes (white blood cells) or virocytes. They may indicate viral infections or inflammation.
Optimal range: 0 - 4.5 %
Large unstained cells (LUC) are cells that are activated lymphocytes and peroxidase-negative cells. They are not stem cells, normal lymphocytes (white blood cells) or virocytes. They may indicate viral infections or inflammation.
Reference range: Normal, Moderate
Macrocytosis is a notable hematological condition characterized by the presence of abnormally large red blood cells (RBCs) in the bloodstream, a crucial marker in blood tests for various health assessments. This condition, detectable through a Complete Blood Count (CBC) test, typically indicates that the red blood cells are larger than their normal size, often measured by the Mean Corpuscular Volume (MCV).
Optimal range: 4.2 - 6.8 mg/dL , 1.73 - 2.79 mmol/L
Hundreds of enzymatic reactions in the body depend on magnesium for energy production, nerve transmission, muscle contraction, and blood vessel function. A deficiency of this critical element within the cell may be seen with the RBC magnesium test.
Optimal range: 0 - 0 %
Nucleated Red Blood Cells (NRBCs) are immature red blood cells that have not yet expelled their nucleus. In a typical Complete Blood Count (CBC) test, the presence of NRBCs is significant and can provide valuable insights into a patient's health. While NRBCs are common in the bone marrow, where red blood cells are produced, they usually do not circulate in peripheral blood. Therefore, the appearance of NRBCs in a CBC test panel is noteworthy and often indicates an abnormality or a stress response within the body.
The percentage of NRBCs in blood can be crucial for diagnosing various conditions. Normally, these cells are filtered out of the bloodstream as they mature in the bone marrow, so their presence in a CBC indicates that the bone marrow is releasing cells into the bloodstream prematurely. This can occur due to several reasons, such as severe anemia, hypoxia, bone marrow disorders, or other conditions that disrupt normal red blood cell production. In such cases, the bone marrow may be overactive or under stress, leading to the premature release of these immature cells.
Optimal range: 0 - 0 / 100 WBCs
The term 'NRBC' – 'nucleated red blood cells' – refers to precursor cells of the red blood cell lineage which still contain a nucleus.
Optimal range: 0 - 2 nmol/L
Oxidized phospholipids are found on all apoB-containing lipoproteins, namely, LDL, VLDL, and especially Lp(a). When taken up by the artery wall, oxidized lipoproteins accelerate atherosclerosis, thereby, increasing the risk of myocardial infarctions, strokes, and calcific aortic valve stenosis. Oxidized phospholipids are highly pro-inflammatory and contribute to many diseases of aging.
Clinicians can use OxPL-apoB levels to reclassify patients into higher or lower risk categories allowing better personalized care.
Optimal: <2.0 nM/L
Borderline: 2.0-3.0 nM/L
Increased Risk: >3.0 nM/L
Optimal range: 7 - 20 nmol/L/sec
PBG Deaminase (also called porphobilinogen deaminase, uroporphyrinogen I synthase, or hydroxymethylbilane synthase) is a key enzyme in the heme biosynthesis pathway — the process by which your body makes heme, a vital component of hemoglobin, myoglobin, and other important proteins.
Heme is essential for transporting oxygen in the blood and for many cellular processes, including energy production and detoxification. PBG Deaminase is the third enzyme in this pathway and plays a critical role in converting porphobilinogen (PBG) into hydroxymethylbilane, which eventually becomes heme.
Optimal range: 0 - 31.1 IU/ml
Plasminogen Activator Inhibitor 1 (PAI-1) Activity is a marker measured in a blood test that helps understand how easily your blood clots or dissolves clots, playing a crucial role in your body's ability to manage bleeding and healing. PAI-1 is a protein produced by various cells in your body, including those lining your blood vessels and fat cells. It acts as a natural brake in the clot-dissolving process; when its levels are within a normal range, it helps maintain a delicate balance between forming clots to stop bleeding and breaking them down to keep blood vessels clear and prevent blockages.
Reference range: Negative, Positive
The Platelet Antibodies, Indirect (IgG, IgM, IgA) panel, featuring the Platelet Ab, Indirect (IgA) test, is a significant diagnostic asset in the realms of hematology and immunology, particularly for assessing conditions like thrombocytopenia (low platelet count) and platelet dysfunction. The Platelet Ab, Indirect (IgA) component specifically measures the presence of immunoglobulin A (IgA) antibodies that target platelets. These antibodies are crucial in diagnosing autoimmune conditions where the immune system mistakenly attacks and destroys its own platelets, leading to thrombocytopenia.
Reference range: Negative, Positive
The Platelet Antibodies, Indirect (IgG, IgM, IgA) panel, featuring the Platelet Ab, Indirect (IgG) test, is a critical diagnostic tool in the field of hematology and immunology, particularly in the evaluation of thrombocytopenia (low platelet count) and platelet dysfunction disorders. The Platelet Ab, Indirect (IgG) test specifically measures the presence of immunoglobulin G (IgG) antibodies that are directed against platelets. These antibodies play a significant role in various autoimmune conditions, where the body’s immune system mistakenly targets and destroys its own platelets, leading to a decreased platelet count.
Reference range: Negative, Positive
The Platelet Antibodies, Indirect (IgG, IgM, IgA) panel, which includes the Platelet Ab, Indirect (IgM) test, is a crucial diagnostic tool in the realm of hematology and immunology, specifically for evaluating thrombocytopenia and platelet dysfunction disorders. The Platelet Ab, Indirect (IgM) test focuses on detecting the presence of immunoglobulin M (IgM) antibodies targeting platelets. These IgM antibodies are important in identifying autoimmune conditions and other disorders where the body's immune system erroneously attacks and destroys its own platelets, leading to a reduced platelet count.
Optimal range: 0.22 - 0.24 %
PCT is the volume occupied by platelets in the blood as a percentage and calculated according to the formula PCT = platelet count × MPV / 10,000 (25-27).
Reference range: Normal, Slight
Polychromasia is a significant hematological condition characterized by the presence of variously colored red blood cells (RBCs) in a blood smear. This condition, often indicative of an ongoing process in the bone marrow where red blood cells are produced, is crucial for medical diagnostics. Polychromasia arises when immature red blood cells, known as reticulocytes, are released prematurely into the bloodstream.
Optimal range: 7 - 20 nmol/L
The Porphobilinogen Deaminase, Whole Blood test is used to a) confirm a diagnosis of acute intermittent porphyria (AIP) following a positive urine porphobilinogen (PBG) test and/or b) to evaluate disease risk in family members of an individual with a confirmed diagnosis of AIP.
Porphobilinogen deaminase, also known as uroporphyrinogen I synthase, is commonly confused with uroporphyrinogen III synthase, the enzyme deficient in congenital erythropoietic porphyria (CEP).
The porphyrias are a group of inherited disorders resulting from enzyme defects in the heme biosynthetic pathway. Acute intermittent porphyria (AIP) is caused by diminished erythrocyte activity of porphobilinogen deaminase (PBGD), also known as uroporphyrinogen I synthase or hydroxymethylbilane synthase (HMBS).
Onset of AIP typically occurs during puberty or later. Individuals may experience acute episodes of neuropathic symptoms.
Optimal range: 1 - 5.6 mcg/L
Function of this test:
a) To monitor porphyria cutanea tarda (PCT)
Porphyria cutanea tarda (PCT) is a rare disorder characterized by painful, blistering skin lesions that develop on sun-exposed skin (photosensitivity). Affected skin is fragile and may peel or blister after minor trauma. Liver abnormalities may also occur.
b) To confirm diagnosis of suspected variegate porphyria (VP)
Variegate porphyria (VP) is classified as both a cutaneous and an acute porphyria. It can present with chronic blistering cutaneous manifestations and/or acute attacks of neurovisceral manifestations that may become chronic.
c) To comfirm erythropoietic protoporphyria (EPP)
Erythropoietic protoporphyria (EPP) is an inherited porphyria resulting in the accumulation of protoporphyrins in red blood cells that causes acute, painful photosensitivity and potential liver disease. It typically presents in early childhood with immediate pain and crying upon exposure to bright sunlight.
Optimal range: 0 - 1.2 Ratio
The PTT-LA Ratio is an essential part of lupus anticoagulant (LA) testing. It is calculated using a modified partial thromboplastin time (PTT) test that employs a low-phospholipid reagent, making it highly sensitive to the presence of lupus anticoagulant. A normal PTT-LA ratio is typically ≤1.20.
An elevated PTT-LA ratio may suggest the presence of lupus anticoagulant—an antibody that paradoxically increases the risk of blood clots, even though it prolongs clotting times in laboratory tests. This test is commonly performed alongside other assays, such as the dilute Russell viper venom time (dRVVT), as part of a comprehensive lupus anticoagulant panel.
Optimal range: 0 - 40 seconds
PTT-LA screen helps to help investigate the cause of a blood clot (thrombotic episode); to evaluate a prolonged partial thromboplastin time (PTT); to help determine the cause of recurrent miscarriages, or as part of an evaluation for antiphospholipid syndrome; the tests are not used to diagnose the chronic autoimmune disorder systemic lupus erythematosus (SLE), commonly known as lupus.
Optimal range: 25 - 30 pg
Reticulocyte Hemoglobin Equivalent (Retic Hgb Equivalent) is an invaluable marker in hematology, gaining prominence for its role in assessing iron status and erythropoiesis in clinical settings. This marker measures the hemoglobin content in reticulocytes, which are immature red blood cells recently released from the bone marrow. Retic Hgb Equivalent provides critical insights into the iron available for new red blood cell production, making it a vital tool for diagnosing and managing iron deficiency anemia and other disorders of red blood cell production.
Optimal range: 0.6 - 2.6 %
Reticulocytes are newly produced, relatively immature red blood cells (RBCs). A reticulocyte test determines the number and/or percentage of reticulocytes in the blood and is a reflection of recent bone marrow function or activity.
Optimal range: 30.89 - 40.59 pg
Reticulocyte hemoglobin (Ret-He) is a crucial indicator in hematology, measuring hemoglobin in immature red blood cells, or reticulocytes. It's pivotal for diagnosing and managing anemia, especially iron deficiency anemia. Ret-He offers an early sign of iron deficiency, aiding in prompt intervention. This measure is more dynamic than traditional markers like serum ferritin, reflecting real-time iron availability for red blood cell production. Its inclusion in modern blood count analyzers underscores its importance in accurate diagnosis and patient care in iron-related disorders.
Optimal range: 25000 - 90000 cells/uL
Reticulocytes are red blood cells that are still developing. They are also known as immature red blood cells. Reticulocytes are made in the bone marrow and sent into the bloodstream. About two days after they form, they develop into mature red blood cells. These red blood cells move oxygen from your lungs to every cell in your body.
Reference range: Negativ, Positive
A sickle cell screen, also known as a sickle cell test or sickle cell screening, is a medical test used to determine whether an individual carries a gene mutation associated with sickle cell disease (SCD). Sickle cell disease is a genetic disorder that affects the shape of red blood cells, causing them to become rigid and assume a characteristic "sickle" shape. These misshapen red blood cells can lead to various health problems, including pain, anemia, and organ damage.
Reference range: Normal, Present
Stomatocytes are a unique type of red blood cells (RBCs) characterized by their distinct mouth-like shape, playing a significant role in the field of hematology and medical diagnostics. These cells, identifiable under a microscope, present with a central, slit-like area devoid of hemoglobin, giving them their characteristic appearance. The presence of stomatocytes in a blood smear is a key indicator in diagnosing various hematological disorders, including hereditary stomatocytosis, a rare condition affecting the membrane of red blood cells.
Optimal range: 0 - 4.3 ng/mL
The Thrombin Antithrombin Complex (TAT) marker is an important blood test used to evaluate the balance between clot formation and dissolution in the body, which is crucial for understanding certain blood clotting disorders.
Thrombin is a protein that plays a central role in the blood clotting process, helping to convert fibrinogen into fibrin, which forms the basic structure of a blood clot.
Antithrombin, on the other hand, is a protein that helps regulate blood clot formation by inhibiting thrombin and other enzymes involved in the coagulation process.
When thrombin is generated in the bloodstream, it binds to antithrombin, forming the thrombin-antithrombin complex.
Optimal range: 150 - 400 µl
Thrombocytes are one of three types of blood cell found in our bodies. Along with red blood cells and white blood cells, thrombocyte levels are assessed with a comprehensive blood count, which can be done as a part of a general health check up or in response to specific symptoms.
Optimal range: 250 - 450 ug/dL , 44.75 - 80.55 µmol/L , 250 - 450 g/L , 250 - 450 umol/L
Total iron-binding capacity (TIBC) is a blood test to see if you have too much or too little iron in the blood. Iron is vital in that it transports oxygen around the body. Frequently, a TIBC is ordered along with several other tests to determine the cause of conditions like anemia or to assess blood health in general.
Optimal range: 200 - 390 mg/dL , 2 - 3.9 g/L
Transferrin is the main protein in the blood that binds to iron and transports it throughout the body. A transferrin test directly measures the level in the blood.
Optimal range: 1.9 - 4.4 mg/L
The Transferrin Receptor, a critical protein in iron metabolism, plays a pivotal role in diagnosing and managing iron-related disorders, making it an essential biomarker in modern medical diagnostics. This receptor, found on the surface of most cells, particularly erythroblasts, binds to transferrin, the primary iron transport protein in the blood, facilitating the uptake of iron into cells. Measuring the levels of soluble transferrin receptor (sTfR) in the blood provides crucial insights into the body's iron status, especially in distinguishing between iron deficiency anemia and anemia of chronic disease.
Optimal range: 15 - 55 %
Transferrin saturation (TSAT) is the ratio of serum iron and total iron-binding capacity. All three measurements are used to help determine the cause of iron levels that are abnormally high or abnormally low. TS may also be used to identify the presence and type of anemia.
Optimal range: 131 - 425 µg/dL , 23.45 - 76.08 µmol/L , 131 - 425 umol/L
Unsaturated Iron-Binding Capacity (UIBC) is an important marker often measured in blood tests to evaluate iron status in the body. Essentially, UIBC represents the reserve capacity of transferrin, a protein that binds iron and transports it through the bloodstream. When a healthcare provider measures UIBC, they are determining how much transferrin is not currently bound to iron. This information is crucial because it helps to assess whether there is too much or too little iron in the body. For instance, a high UIBC indicates that there is a large amount of transferrin available for binding, which usually suggests iron deficiency. Conversely, a low UIBC might indicate that most of the transferrin is already saturated with iron, pointing to conditions like iron overload or hemochromatosis. By combining UIBC with other iron-related tests, such as serum iron and Total Iron-Binding Capacity (TIBC), healthcare providers can gain a comprehensive understanding of a patient's iron metabolism. This helps in diagnosing various conditions related to iron imbalances, enabling appropriate treatment plans to be formulated.
Optimal range: 50 - 200 BU/mL
(Von Willebrand Factor Glycoprotein Ib-Mutant Activity)
VWF GPIbM Activity is a specialized test that measures the functional activity of von Willebrand factor (VWF) — a protein essential for normal blood clotting. This assay assesses how well VWF can bind to platelets, a key step in the formation of a blood clot to stop bleeding.
The test uses a mutant form of platelet receptor GPIbα (glycoprotein Ib alpha) to detect VWF activity, which makes it more stable, sensitive, and specific than older tests like the ristocetin cofactor assay (VWF:RCo).
VWF GPIbM Activity is used primarily in the diagnosis and classification of von Willebrand disease (VWD), the most common inherited bleeding disorder.
Optimal range: 0.3 - 2 mmol/L
Lactate is a byproduct of cell metabolism, primarily produced in muscles, and exists mostly in the blood due to the body’s neutral pH. This biomarker is measured in blood or cerebrospinal fluid (CSF) to evaluate oxygen availability and mitochondrial function. Normally, lactate levels are low, but excess production can occur when oxygen delivery is insufficient or energy production is disrupted, leading to conditions like hyperlactatemia or lactic acidosis. These states can result from hypoxia, increased lactate production, or impaired clearance, potentially causing symptoms such as muscle weakness, rapid breathing, nausea, or even coma if severe.
Lipid Panel
A lipid panel—also known as a cholesterol test or lipid profile—is a blood test used to measure key markers of cardiovascular health. It checks levels of:
HDL-C (high-density lipoprotein) – the "good" cholesterol
LDL-C (low-density lipoprotein) – the "bad" cholesterol
These biomarkers help assess your risk for heart disease, stroke, and other cardiovascular conditions.
Heart disease is the leading cause of death globally. A lipid panel test provides essential insights into your cholesterol balance and helps detect risks early—before symptoms appear.
Regular testing is especially important if you:
Have high blood pressure, diabetes, or a family history of heart disease
Follow a high-fat or high-sugar diet
Are overweight or physically inactive
Smoke or drink alcohol regularly
Understanding your lipid panel can help you and your healthcare provider make informed decisions about:
Lifestyle changes (diet, exercise, weight management)
Preventive medications (such as statins)
Monitoring existing conditions like hypertension or diabetes
Improving your cardiovascular health starts with simple steps:
Eat heart-healthy foods: more fiber, healthy fats, fewer processed foods
Exercise regularly: at least 150 minutes of moderate activity per week
Avoid tobacco and limit alcohol intake
Manage stress and sleep well
Track your numbers and follow your provider’s guidance
Most adults should have a lipid panel done every 4 to 6 years, but you may need more frequent testing if you:
Are over age 45 (men) or 55 (women)
Have existing cardiovascular conditions
Take medications that affect cholesterol
A lipid panel is used to assess your risk for heart disease and stroke by measuring your cholesterol and triglyceride levels.
Fasting is often recommended for 9–12 hours before the test, especially if triglycerides are being measured. Always follow your lab or provider's instructions.
While reference ranges may vary slightly, general goals are:
Total cholesterol: < 200 mg/dL
LDL: < 100 mg/dL
HDL: > 60 mg/dL
Triglycerides: < 150 mg/dL
Tracking your lipid panel results over time with HealthMatters.io can help detect trends, evaluate treatment effectiveness, and reduce your risk of serious cardiovascular events. At HealthMatters, you can securely upload and analyze your cholesterol test results in one place—empowering you with data-driven insights to take control of your heart health.
Optimal range: 0 - 20 %
The marker %sdLDL-C refers to the percentage of small, dense low-density lipoprotein cholesterol in your blood. To understand this, let's break down the components. Cholesterol is a waxy substance found in all the cells of your body and is necessary for making hormones, vitamin D, and substances that help you digest foods. However, not all cholesterol is created equal, and it's carried through your bloodstream attached to proteins called lipoproteins. Low-density lipoprotein (LDL), often called "bad" cholesterol, can build up in the walls of your arteries, making them hard and narrow. Within the LDL family, there are particles of varying sizes, with small, dense LDL (sdLDL) being one kind. These smaller particles are thought to be more atherogenic, meaning they have a higher propensity to promote the buildup of fatty plaques in your arteries, which can lead to cardiovascular diseases such as heart attacks and strokes. The "%sdLDL-C" marker measures the proportion of these small, dense LDL particles out of the total LDL cholesterol. A higher percentage indicates a greater presence of these risky cholesterol particles, signaling a higher risk of developing heart disease.
Optimal range: 0 - 0.8 Ratio
Studies have shown that the ratio of apolipoprotein A-1:apolipoprotein B may correlate better with increased risk of coronary artery disease (CAD) than total cholesterol, and LDL:HDL ratio.
Optimal range: 160 - 200 mg/dL
ApoA-I, or Apolipoprotein A-I, plays a crucial role in understanding heart health and managing potential risks related to cardiovascular diseases. ApoA-I is the main protein component of high-density lipoprotein (HDL) in the blood. HDL is often referred to as "good cholesterol" because it helps transport cholesterol from the arteries to the liver, where it can be processed and removed from the body. This process is essential for maintaining healthy artery walls and preventing the build-up of plaques that can lead to heart attacks and strokes. Higher levels of ApoA-I and consequently HDL are generally associated with a lower risk of heart disease. The measurement of ApoA-I in a lipid panel provides valuable information about a person's HDL levels and overall cardiovascular health. By assessing ApoA-I, healthcare providers can better understand an individual's risk for heart disease and tailor treatment plans to improve heart health, such as recommending lifestyle changes or prescribing medication to manage cholesterol levels effectively.
Optimal range: 2.7 - 4.3 mg/dL
Apolipoprotein E (APOE) is a protein that plays a crucial role in the metabolism of fats (lipids) in the body. It is primarily involved in transporting cholesterol and other lipids through the bloodstream to be used, stored, or eliminated. APOE is a key component of lipoproteins, which are molecules that carry cholesterol and fats to and from cells.
APOE is also known for its genetic variations, which can influence cholesterol levels, cardiovascular health, and even neurological function. However, in lab tests, the focus is usually on APOE levels in the blood, which may indicate how effectively the body manages lipid metabolism.
Optimal range: 0 - 5 ×100%
Optimal range: 0 - 1 times avg.
The CHD Risk is based on the T. Chol/HDL ratio. Other factors affect CHD Risk such as hypertension, smoking, diabetes, severe obesity, and family history of premature CHD.
Optimal range: 0 - 370 mg/dL , 0 - 3.7 g/L
Fibrinogen is a key marker included in the Inflammation and Oxidation Test panel by Boston Heart Diagnostics, primarily due to its critical role in the body's clotting process and its association with inflammation. Essentially, fibrinogen is a blood plasma protein that's converted into fibrin by the action of the enzyme thrombin during blood clot formation. This process is crucial for stopping bleeding and initiating the healing process following an injury. However, elevated levels of fibrinogen can indicate an increased risk of clot formation within the blood vessels, which is a significant concern because it can lead to blockages, thereby increasing the risk of heart attacks and strokes.
Optimal range: 6.8 - 29 ug/ml
Glycomark (1,5-anhydroglucitol) indicates poor control of blood glucose spikes; specifically frequent hyperglycemic events over the past two weeks (not evidentfrom HbA1c). Postprandial hyperglycemia is associated with Cardiovascular disease and reduction of hyperglycemic events appear to decrease macro- and microvascular complications in diabetic patients. Low 1,5-AG is also associated with renal damage. Hemoglobin A1c (HbA1c) – estimates the average blood glucose concentration for the life of the red blood cell (120 days).
Optimal range: 17.5 - 64 %
Monitoring the HDL % of Total Cholesterol is a valuable tool in assessing cardiovascular health. A higher HDL percentage indicates a more favorable cholesterol profile and a reduced risk of heart disease. By maintaining a healthy lifestyle through proper diet, regular exercise, and smoking cessation, you can help improve your HDL percentage and support long-term heart health.
Optimal range: 39 - 80 mg/dL , 1.01 - 2.07 mmol/L
High-density lipoprotein cholesterol (HDL-C) or “good” cholesterol is known to decrease the risk of heart attack and stroke by removing “bad” cholesterol from the blood. It is typically assessed through a lipid profile, which measures “good” cholesterol, “bad” cholesterol, and total cholesterol. A healthcare professional may order a lipid profile when an individual is at an increased risk for heart disease or routinely in healthy adults to monitor cardiovascular health.
HDL-C transports cholesterol from the peripheral tissues and vessel walls to the liver for processing and metabolism into bile salts. Unlike LDL-C, HDL-C is often referred to as “good cholesterol” — it is thought that the process of bringing cholesterol from the peripheral tissue to the liver protects against atherosclerosis.
- Decreased HDL-C levels are considered atherogenic.
- Increased HDL-C levels are considered to protect against atherosclerosis.
Optimal range: 0.5 - 5 Ratio
The ratio of high density lipoprotein cholesterol/triglycerides is a calculated measure.
Optimal: >0.50
Borderline: 0.25–0.50
Increased Risk: <0.25
Optimal range: 0 - 1 mg/L
C-reactive protein (CRP) is a general indicator of inflammation in the body. The inflammation can be acute and caused by infection or injury. Inflammation can also be chronic, which typically points toward more serious diseases. High-sensitivity CRP (hs-CRP) tests are commonly ordered to determine your risk of cardiovascular disease.
Optimal range: 0 - 20 mg/dL
IDL Cholesterol is a plasma lipoprotein. Cholesterol and triglycerides are insoluble in water and therefore these lipids must be transported in association with proteins. Lipoproteins are complex particles with a central core containing cholesterol esters and triglycerides surrounded by free cholesterol, phospholipids, and apolipoproteins, which facilitate lipoprotein formation and function.
Optimal range: 0 - 99.1 mg/dL , 0 - 2.57 mmol/L
Low-density lipoprotein cholesterol (LDL-C) is a critical biomarker in assessing cardiovascular health, commonly known as "bad" cholesterol due to its association with increased risk of heart disease. LDL-C is one of the primary lipoproteins responsible for transporting cholesterol to cells throughout the body. While cholesterol is essential for building cell membranes and producing hormones, excess LDL-C can lead to the formation of plaque in the arteries. This plaque buildup, or atherosclerosis, can restrict blood flow, making arteries less flexible and more prone to blockages. Elevated levels of LDL-C are a significant risk factor for developing coronary artery disease, stroke, and peripheral artery disease. Therefore, maintaining optimal LDL-C levels is crucial for heart health. Health experts recommend regular screening through a lipid profile, which measures LDL-C along with high-density lipoprotein cholesterol (HDL-C), total cholesterol, and triglycerides. A comprehensive understanding of LDL-C and its impact on the body is essential for preventing cardiovascular diseases and promoting overall well-being.
Optimal range: 0.5 - 3 Ratio
LDL/HDL cholesterol ratio is the ratio of two types of lipids in the blood. LDL stands for low density lipoprotein or “bad cholesterol” and HDL stands for high density lipoprotein or “good cholesterol.”
Optimal range: 1.5 - 3.2 Ratio
The ratio of leptin to adiponectin appears to be a sensitive indicator for a variety of adverse health conditions.
Leptin is a hormone produced by adipocytes to provide a satiety signal to the hypothalamus. Elevated circulating levels of leptin are associated with adipose tissue abundance and a leptin resistance. High levels of this adipokine have pro-inflammatory effects, and leptin accelerates arterial foam cell formation.
Adiponectin improves insulin sensitivity and stimulates glucose uptake and hepatic fatty acid oxidation. Very low levels of this anti-inflammatory adipokine may increase the risk for CVD and some cancers.
Optimal range: 0 - 469 pmol/L
MPO identifies vulnerable plaque due to the breakdown of cells lining the blood vessels. This breakdown leads to white blood cells attacking the vessel wall and marks the progression of cardiovascular disease. Your result is in the desirable range suggesting that you may have a low probability of plaque rupture if cardiovascular disease is present.
MPO levels are associated with an increased risk for:
- Cardiovascular disease
- Myocardial infarction
Optimal range: 0 - 130 mg/dL , 0 - 3.37 mmol/L
Your non-HDL cholesterol result refers to your total cholesterol value minus your HDL cholesterol. Your lipid panel results normally include four numbers:
- low-density lipoprotein (LDL) cholesterol;
- high-density lipoprotein (HDL) cholesterol;
- triglycerides; and
- total cholesterol.
Optimal range: 10 - 170 ng/mL
Oxidized LDL is LDL cholesterol (the “bad” cholesterol) that has been modified by oxidation. Oxidized LDL triggers inflammation leading to the formation of plaque in the arteries, also known as atherosclerosis. Oxidized LDL may also play a role in increasing the amount of triglycerides the body produces, as well as increasing the amount of fat deposited by the body. In turn, fat tissue can enhance the oxidation of LDL, creating a vicious cycle.
Optimal range: 0 - 0.55 Ratio
Optimal range: 0 - 60 U/L
Oxidized LDL is LDL cholesterol (the “bad” cholesterol) that has been modified by oxidation. Oxidized LDL triggers inflammation leading to the formation of plaque in the arteries, also known as atherosclerosis. Oxidized LDL may also play a role in increasing the amount of triglycerides the body produces, as well as increasing the amount of fat deposited by the body. In turn, fat tissue can enhance the oxidation of LDL, creating a vicious cycle.
Optimal range: 0 - 224 nmol/min/mL
The PLAC test is used to determine Lp-PLA2 in serum or plasma.
Lp-PLA2 stands for Lipoprotein-Associated Phospholipase A2.
The test is used to determine your cardiovascular risk disease, myocardial infarction and ischemic stroke associated with atherosclerosis. In recent years, a number of studies have been published pointing to Lp-PLA2 as a marker for determining cardiovascular risk.
Lp-PLA2 activity is to be used in conjunction with clinical evaluation and a risk assessment as an aid in predicting risk of coronary heart disease (CHD) in people with no prior history of cardiovascular events.
Optimal range: 0 - 151 nmol/min/mL
Lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet activating factor acetylhydrolase, is an inflammatory enzyme that circulates bound mainly to low-density lipoproteins and has been found to be localized and enriched in atherosclerotic plaques. In multiple clinical trials, Lp-PLA2 activity has been shown to be an independent predictor of coronary heart disease and stroke in the general population. Measurement of Lp-PLA2 may be used along with traditional cardiovascular risk factor measures for identifying individuals at higher risk of cardiovascular disease events. Clinical management may include beginning or intensifying risk reduction strategies.
Optimal range: 0 - 35 mg/dL
Small dense LDL cholesterol (sdLDL-c) has been established to be highly associated with metabolic disorder.
Small dense LDL cholesterol (sdLDL-c), is a distinct LDL cholesterol subclass, which is associated with raised TG and decreased HDL-c levels in adiposity and diabetes, playing a distinct metabolic role in atherosclerosis.
The results of recent studies demonstrate that LDL fractions have different atherogenicity, with sdLDL being more atherogenic than larger LDL subfractions. sdLDL is characterized by the enhanced ability to penetrate the arterial wall that makes it a potent source of cholesterol for the development of atherosclerotic plaque. Importantly, longer circulation times of sdLDL result in multiple atherogenic modifications of sdLDL particles in plasma, further increasing its atherogenicity. Study of the sdLDL role in the development of atherosclerosis and CVD is hindered by significant variations in LDL fractionation results obtained by different methods.
Optimal range: 0 - 0.34 Ratio
Optimal range: 0 - 199 mg/dL , 0 - 5.15 mmol/L
Your total cholesterol score is calculated using the following equation: HDL + LDL + 20 percent of your triglyceride level.
With HDL cholesterol, higher levels are better. Low HDL cholesterol puts you at a higher risk for heart disease. With LDL cholesterol, lower levels are better. High LDL cholesterol puts you at a higher risk for heart disease.
Optimal range: 0 - 5 Ratio
The total cholesterol /HDL ratio is the proportion of one type of cholesterol to all the other cholesterol in the blood. Total cholesterol includes three substances HDL, LDL, and VLDL.
Optimal range: 0 - 149 mg/dL , 0 - 1.68 mmol/L
Triglycerides are a type of fat and the primary way our bodies store unused energy. While triglycerides are necessary for a healthy life, excessive amounts can put you at a higher risk for developing cardiovascular disease. Typically, a healthcare professional will look at triglyceride levels along with high-density lipoprotein, low-density lipoprotein, and total cholesterol to determine your risk of heart disease.
Optimal range: 0 - 2 Ratio
The Triglycerides to HDL (High-Density Lipoprotein) Ratio is a metric that is often used in the medical field to evaluate cardiovascular risk. This ratio is calculated by dividing the triglyceride level by the HDL cholesterol level, both of which are part of a standard lipid panel blood test.
An elevated Triglycerides to HDL Ratio is often indicative of an unfavorable lipid profile that can be associated with increased cardiovascular risk. Specifically:
→ Insulin Resistance and Metabolic Syndrome: A high ratio is frequently seen in individuals with insulin resistance, which is a condition where the body's cells become less responsive to the effects of insulin. This resistance can be a precursor to type 2 diabetes. It's also a component of the metabolic syndrome, a cluster of conditions that, together, increase the risk for heart disease, stroke, and type 2 diabetes.
→ Atherogenic Dyslipidemia: This refers to a combination of high triglycerides, low HDL cholesterol, and an increase in small, dense LDL particles. These small, dense particles are believed to be more atherogenic, meaning they're more likely to contribute to the formation of plaques in the arteries compared to larger, buoyant LDL particles.
→ Increased Cardiovascular Risk: Several studies have shown that individuals with a higher Triglycerides to HDL Ratio have an increased risk of heart disease. The ratio may be a more powerful predictor of cardiovascular events than either parameter (triglycerides or HDL) alone.
→ Other Associations: Beyond cardiovascular implications, a high ratio might be associated with other health issues, including non-alcoholic fatty liver disease (NAFLD).
It's important to note that while the Triglycerides to HDL Ratio can provide valuable insight, it's just one piece of the puzzle. A comprehensive assessment of heart disease risk should consider other factors, such as LDL cholesterol levels, blood pressure, family history, smoking status, and other individualized risk parameters. Always consult with a healthcare professional for a complete evaluation of cardiovascular risk.
Optimal range: 0 - 30 Ratio
This is a ratio calculated by dividing very low density lipoprotein cholesterol by triglycerides.
A high ratio is linked to abnormal lipid metabolism and increased risk of CVD events.
Optimal: <0.20
Borderline: 0.20 – 0.30
Increased Risk: >0.30
Optimal range: 0 - 0.2 Ratio
The VLDL-C/TG Ratio is a specialized marker used to evaluate your cardiovascular health more accurately. VLDL stands for Very Low-Density Lipoprotein Cholesterol, which is one of the five major types of lipoproteins that transport fats and cholesterol in the body. TG stands for triglycerides, another type of fat in your blood. Both VLDL-C and TG are important because they can impact your risk of developing heart disease. The VLDL-C/TG ratio is calculated by dividing the VLDL cholesterol level by the triglyceride level. This ratio can help doctors understand more about the composition and size of the particles carrying cholesterol in your blood. Smaller, denser particles are often considered more harmful because they can more easily penetrate the lining of arteries and form plaques, which can lead to blockages. By analyzing this ratio, healthcare providers can gain insights into your lipid profile and cardiovascular risk, beyond what traditional cholesterol tests offer. A high VLDL-C/TG ratio might indicate an increased risk for cardiovascular disease and could prompt further investigation or intervention to manage this risk. Understanding this marker can be crucial in tailoring a more effective treatment plan to protect your heart health.
If your levels are borderline:
A borderline elevated VLDL-C/TG ratio means that while your levels are not in the high-risk category, they are not entirely in the clear, either. This could imply a slightly increased risk of developing conditions like heart disease, especially if accompanied by other risk factors such as high LDL cholesterol, low HDL cholesterol, hypertension, smoking, diabetes, or a family history of heart disease.
It's important to consider this marker in the context of a comprehensive lipid profile and your overall health. For some individuals, borderline elevated levels may prompt lifestyle modifications and possibly medical interventions to reduce the risk of cardiovascular disease. This might include changes in diet, increased physical activity, weight management, and possibly medication. Regular monitoring and a holistic approach to health can help manage this risk effectively. If you have borderline elevated VLDL-C/TG ratio levels, it's essential to discuss with your healthcare provider the best strategies for you to maintain or improve your cardiovascular health.
Electrolytes
Electrolytes are essential minerals found in your blood, urine, and other bodily fluids that carry an electric charge. They are crucial for a myriad of bodily functions. Key electrolytes include sodium, potassium, calcium, bicarbonate, magnesium, chloride, and phosphate. Each plays a vital role: sodium helps control fluids in the body, affecting blood pressure; potassium is key for nerve and muscle function, including the heart; calcium is essential for bone health and plays a role in muscle and nerve function as well as blood clotting; magnesium is involved in over 300 biochemical reactions in the body, including muscle and nerve function, blood glucose control, and blood pressure regulation; chloride helps maintain a normal balance of body fluids and is essential for digestion; bicarbonate helps maintain the body's acid-base balance (pH); and phosphate is important for bone health, energy storage, and nerve function.
Testing electrolyte levels in the blood is important because it helps diagnose and monitor a variety of conditions. Abnormal electrolyte levels can be a sign of dehydration, kidney disease, heart problems, and other health issues. For instance, high sodium levels might indicate dehydration or a kidney problem, while low potassium could be a sign of a condition such as hypokalemia, which can affect heart rhythm. Regular electrolyte testing is particularly important for those with chronic illnesses, those taking certain medications (like diuretics or heart medications), and athletes who may be at risk of electrolyte imbalances due to excessive sweating. By monitoring these levels, healthcare providers can identify problems early on and intervene appropriately to maintain health and prevent more serious complications.
Optimal range: 8 - 16 mEq/L
The Anion Gap blood test is used to check the balance of acids and bases in your body. It’s calculated from common electrolytes in your blood, mainly sodium, chloride, and bicarbonate (sometimes potassium is included). This balance is important for healthy kidney function, metabolism, and overall chemical stability in your body.
A normal Anion Gap usually means your blood chemistry is balanced. A high Anion Gap may point to extra acid in the blood (metabolic acidosis), which can occur with kidney disease, uncontrolled diabetes, severe dehydration, or certain poisonings. A low Anion Gap is less common and may be related to low protein levels (especially albumin), medication effects, or other electrolyte shifts.
The Anion Gap is not a diagnosis on its own. Doctors use it alongside other lab results, your health history, and symptoms to understand the cause of any imbalance. If your value is outside the normal range, further testing may be needed.
A slightly low or slightly elevated Anion Gap is often not a cause for concern on its own. Mild shifts can happen due to temporary changes in hydration, medications, or lab variation. Your doctor will usually look for patterns in other test results and may repeat the test to confirm. If the change persists, further evaluation may be recommended to rule out underlying issues.
Optimal range: 4.5 - 5.6 mg/dL , 1.12 - 1.4 mmol/L
Calcium is an important mineral found throughout the body. It is important for bone health, cell communication, blood clotting, muscle contraction, and nerve cell function. Ionized serum calcium is the biologically active form of calcium in the blood.
Optimal range: 1.6 - 2.3 mg/dL , 0.66 - 0.95 mmol/L
Along with calcium, phosphorus, sodium, potassium, and chloride, magnesium is one of the six essential minerals required by the human body in significant quantities. Involved in more than 300 enzyme reactions in the body, magnesium is necessary for bone formation, muscle activity, nerve transmission, energy production, and blood pressure regulation. It also plays an important role in blood sugar balance, as well as the metabolism of carbohydrates, fats, and proteins. Low magnesium status is directly associated with increased risk of metabolic syndrome, type 2 diabetes, and cardiovascular disease.
Optimal range: 275 - 295 mOsm/kg
Osmolality measures the concentration of dissolved particles in a fluid, such as blood, urine, or stool, providing insights into the body’s water balance and kidney function. The osmolality test evaluates the concentration of key substances like sodium, potassium, chloride, glucose, and urea. By assessing these levels, the test helps detect imbalances that may affect hydration, kidney health, and electrolyte status.
In blood osmolality, sodium plays a central role as the main electrolyte, working alongside potassium, chloride, and bicarbonate (CO2) to maintain electrical neutrality and acid-base balance in the body. Sodium intake through diet is typically regulated by the kidneys, which either conserve or excrete sodium to keep blood levels stable.
Optimal range: 60 - 130 µg/dL , 9.18 - 19.89 µmol/L
Zinc is a primary nutrient that we need to thrive. It’s used in a variety of functions through the body including wound healing and creation of DNA. In North America, zinc deficiencies are rare and an unusually high level of zinc in the blood usually indicates iron deficiency or lead poisoning.
Liver Health
The liver, one of the most vital organs in the human body, performs a range of critical functions including detoxification, protein synthesis, and the production of biochemicals necessary for digestion. This category encompasses a variety of tests and markers designed to evaluate the health and functionality of the liver.
Key tests in this category include liver function tests (LFTs) like Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), and Bilirubin, which are essential for assessing the liver's ability to process toxins, produce proteins, and manage bilirubin, a byproduct of red blood cell breakdown. Other significant markers include Gamma-Glutamyl Transferase (GGT), which can indicate liver damage or disease, and albumin and total protein levels, reflecting the liver's synthetic capacity.
Elevated or decreased levels of these markers can signal various liver conditions, ranging from hepatitis, fatty liver disease, cirrhosis, to potential impacts from medications or alcohol consumption. This category can provide valuable insights into these markers, offering detailed descriptions of each test, what its results might indicate, and how they fit into the broader context of liver health and overall wellness.
Understanding liver health is crucial for early detection and management of liver-related conditions, as well as for monitoring the impact of lifestyle choices and medications on liver function. This category serves as a key tool for individuals looking to maintain or improve their liver health, offering accessible and comprehensive information to support informed health decisions. Whether you are undergoing routine health checks, managing an existing liver condition, or simply aiming to enhance your health and well-being, the this category is an invaluable resource for navigating and understanding the complex world of liver health diagnostics.
Optimal range: 0 - 0.01 g/dL
The biomarker Abnormal Protein Band 1 is part of a blood test called "Protein Electrophoresis".
Protein electrophoresis is a test that measures specific proteins in the blood. The test separates proteins in the blood based on their electrical charge. The protein electrophoresis test is often used to find abnormal substances called M proteins (the M stands for "monoclonal").
Optimal range: 0 - 20 u
Actin (Smooth Muscle) Antibody (IgG) - Actin is the major antigen to which smooth muscle antibodies react in autoimmune hepatitis.
F-Actin IGG antibodies are found in 52-85% of patients with Autoimmune Hepatitis (AIH) or chronic active hepatitis and in 22% of patients with Primary Biliary Cirrhosis (PBC). Anti-Actin antibodies have been reported in 3-18% of sera from normal healthy controls.
Optimal range: 2.9 - 4.4 g/dL , 29 - 44 g/L
Serum protein electrophoresis (SPEP) is an easy, inexpensive method of separating proteins based on their net charge, size, and shape. The 2 major types of protein present in the serum are albumin and the globulin proteins.
Albumin is the major protein component of serum and represents the largest peak that lies closest to the positive electrode. Albumin is the first peak on the electrophoretogram and is usually a tall thin peak. The albumin concentration by ELP is usually lower than that from the Modular P.
Globulins make up a much smaller fraction of the total serum protein but represent the primary focus of interpretation of serum protein electrophoresis.
The various proteins in body fluids are subjected to a controlled electric current, fractionating them into a typical pattern of bands or peaks that then can be measured. The proteins are divided into six groups, called prealbumin (rarely detected on serum or urine protein electrophoresis), albumin, alpha 1, alpha 2, beta, and gamma. The beta fraction may be further divided into beta 1 and beta 2 subgroups.
Optimal range: 0 - 0.4 g/dL , 0 - 4 g/L
Protein in the serum is made up of albumin (∼ 60%) and globulin.
Globulins are divided into alpha-1, alpha-2, beta, and gamma globulins.
Optimal range: 0.4 - 1 g/dL , 4 - 10 g/L
Globulins are divided into alpha-1, alpha-2, beta, and gamma globulins.
Reference range: legs are sore, arms are sore
Optimal range: 0.7 - 1.3 g/dL
Protein in the serum is made up of albumin (∼60%) and globulin. Together with albumin, globulin forms the total protein level on a blood test lab report. It includes carrier proteins, enzymes, clotting factors, and, predominantly, antibodies.
Globulin is categorized into three main groups:
Optimal range: 0.4 - 0.6 g/dL , 4 - 6 g/L
There are four main types of globulins. They are called
- alpha 1,
- alpha 2,
- beta,
- and gamma.
Optimal range: 0.2 - 0.5 g/dL , 2 - 5 g/L
There are four main types of globulins. They are called
- alpha 1,
- alpha 2,
- beta,
- and gamma.
Optimal range: 0 - 10 umol/L
Bile acids are compounds that are made in the liver and stored in the gall bladder. Bile acids help with digestion of foods, particularly fat. When food is eaten, the body sends a signal to the gall bladder to contract and push bile acids into the small intestine. The bile acids mix with the food in the intestine and break down large, complex fats into small particles that can be absorbed more easily.
Optimal range: 0 - 10 umol/L
Bile acids are a group of molecules produced by the liver from cholesterol and play a vital role in the digestion and absorption of fats and fat-soluble vitamins in the small intestine. They are components of bile, a fluid that is released into the intestines to help break down fats. A lab panel can measure the levels of bile acids in the blood, which is an important marker for assessing liver function and health. Elevated levels of bile acids in the blood can indicate liver disease or conditions that impair bile flow, such as cholestasis. This is because when the liver is damaged or the bile ducts are blocked, bile acids can accumulate in the liver and spill into the bloodstream. On the other hand, lower levels might be seen in certain conditions affecting the production of bile acids. Therefore, measuring bile acids can help diagnose and monitor liver diseases, evaluate the severity of liver dysfunction, and guide treatment decisions. This test is particularly useful in diagnosing and monitoring conditions that affect bile acids metabolism or bile flow, providing crucial information for the effective management of liver-related disorders.
Optimal range: 0 - 0.4 mg/dL , 0 - 6.84 µmol/L
Bilirubin is a waste byproduct of the breakdown of red blood cells. Yellow in coloration, bilirubin is filtered out of the blood by the liver and excreted in stool by the intestines. Bilirubin tests are done when a disease or blockage of the liver is suspected. Direct bilirubin differs from indirect bilirubin in that it is bound to a sugar and is therefore water soluble.
Optimal range: 0.2 - 0.9 mg/dL , 3.42 - 15.39 umol/L
The Indirect Bilirubin test measures how much bilirubin is in your blood. It originates from the breakdown of hemoglobin in the red blood cells, but must be removed by your liver.
Optimal range: 1801 - 3637 IU/L
Serum cholinesterase is a blood test that looks at levels of 2 substances that help the nervous system work properly. They are called acetylcholinesterase and pseudocholinesterase. Your nerves need these substances to send signals.
Acetylcholinesterase is found in nerve tissue and red blood cells. Pseudocholinesterase is found primarily in the liver.
Serum cholinesterase, also known as pseudocholinesterase (PCHE), is a type of cholinesterase found in the blood that plays a crucial role in the breakdown of certain chemicals, including acetylcholine. It is distinct from acetylcholinesterase, found at nerve endings, and it has a different substrate specificity.
Serum cholinesterase is often measured through blood tests and is utilized as a biomarker for various health conditions, particularly those related to the liver's synthetic function.
Abnormal levels of serum cholinesterase can be indicative of liver dysfunction and can be monitored for acute poisoning detection. Its measurements are valuable in assessing liver function and overall health.
Typically, normal pseudocholinesterase values range between 8 and 18 units per milliliter (U/mL) or 8 and 18 kilounits per liter (kU/L).
Note: Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.
Optimal range: 0 - 1.3 Units
The FIB-4 Index, a non-invasive and widely used clinical tool, is instrumental in the assessment of liver fibrosis, particularly in patients with chronic liver diseases such as Hepatitis C and Non-Alcoholic Fatty Liver Disease (NAFLD). This index, calculated using a simple formula that incorporates age, platelet count, and liver enzyme tests (AST and ALT levels), offers a cost-effective and easily accessible means of evaluating liver health.
Optimal range: 0 - 1.29 index
If your FIB-4 Index result shows an Indeterminate risk for advanced liver fibrosis, it means that your score falls within a range where the risk of significant liver scarring (fibrosis) is uncertain. This does not confirm or rule out advanced liver fibrosis but suggests that further testing may be needed for a more definitive assessment.
The FIB-4 Index is a non-invasive biomarker used to estimate liver fibrosis risk. It is calculated using age, AST (aspartate aminotransferase), ALT (alanine aminotransferase), and platelet count. The score is typically interpreted with the following cutoffs:
If your FIB-4 result falls in the indeterminate range, your healthcare provider may:
An indeterminate FIB-4 result means further evaluation is needed to clarify your liver fibrosis status. It does not confirm serious liver disease but suggests that monitoring and possibly additional testing are advisable.
Optimal range: 0.4 - 1.8 g/dL , 4 - 18 g/L
Gamma globulin is a major class of immunoglobulins found in the blood, including many of the most common antibodies circulating in the blood.
The gamma globulin band consists of 5 immunoglobulins:
- 80% is immunoglobulin G (IgG)
- 15% is immunoglobulin A (IgA)
- 5% is immunoglobulin M (IgM)
- 0.2% is immunoglobulin D (IgD)
- A trace is immunoglobulin E (IgE)
Optimal range: 0 - 65 U/L , 0 - 65 IU/L
Gamma-Glutamyl Transferase (GGT) is an enzyme most commonly associated with the liver. GGT tests are often run to determine the cause and extent of liver damage or to monitor treatment of alcohol abuse disorders. While an elevated GGT score may be a cause for concern, a normal or low score is generally not.
Optimal range: 0 - 20 Units
The presence of mitochondrial antibodies can be used in conjunction with clinical findings and other laboratory tests to aid in the diagnosis of primary biliary cirrhosis (PBC). PBC is a chronic disease in which the bile ducts in your liver are slowly destroyed.
Optimal range: 18 - 38 mg/dL
The prealbumin screen is a blood test that may be used to see if you are getting enough nutrition in your diet. This may be because you have a chronic condition. Or it may be because you have an infection or inflammation, or you suffered a trauma.
Prealbumin is a protein that is made mainly by your liver. Your body uses it to make other proteins. Prealbumin also carries thyroid hormones in the blood
Optimal range: 14 - 35 mg/dL
Evaluate protein malnutrition, total parenteral nutrition, and liver dysfunction. Values are decreased in inflammatory processes, malignancy, protein malnutrition, and protein wasting diseases of the gut or kidney. Values are increased in Hodgkin's disease.
Metabolic Health
This category is a vital section dedicated to providing insights into the complex and multifaceted aspects of metabolic health. Metabolism, the process by which our bodies convert what we eat and drink into energy, is a fundamental aspect of our overall health. This category encompasses a broad range of tests and markers that are crucial in evaluating the efficiency and health of your body's metabolic processes.
Key components in this category include tests for blood glucose levels, insulin sensitivity, and HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), which are pivotal in assessing the risk and management of diabetes, insulin resistance, and other metabolic syndromes. Additionally, markers like HbA1c provide valuable insights into long-term glucose control, reflecting average blood sugar levels over the previous two to three months.
Metabolic health is also closely linked with lipid metabolism, making lipid profile tests, including cholesterol, HDL, LDL, and triglycerides, an integral part of this category. These markers offer crucial information about heart health and the risk of cardiovascular diseases. Furthermore, the category delves into tests for thyroid function, such as TSH, Free T3, and Free T4, as the thyroid plays a critical role in regulating metabolism.
This category also addresses other important markers and hormones that influence metabolism, like leptin, which regulates appetite and fat storage, and cortisol, the stress hormone that can impact metabolic functions. These tests are essential for understanding how various aspects of lifestyle, such as diet, exercise, stress, and sleep, interplay with your metabolic health.
This category is designed not just for individuals who are managing specific metabolic disorders, but also for those aiming to optimize their overall health and well-being. Understanding your metabolic health is key to preventing chronic diseases, maintaining a healthy weight, and achieving optimal energy levels. With detailed descriptions of each test and interpretation of results, this category offers a comprehensive resource for anyone looking to deepen their understanding of their body's metabolic functions and take proactive steps towards maintaining or improving their metabolic health. Whether you're seeking to understand more about how your body processes nutrients, regulate your weight, or prevent metabolic diseases, this category provides the essential tools and information to guide you on your journey to better health.
Optimal range: 1.5 - 4.2 %
% Free Testosterone is a vital biomarker used to evaluate hormonal health, particularly in men, but also in women. Unlike total testosterone, which measures the overall amount of testosterone in the bloodstream, % Free Testosterone specifically represents the proportion of testosterone that is not bound to proteins like sex hormone-binding globulin (SHBG). This "free" testosterone is biologically active, meaning it is available to interact with cells and exert effects on the body, such as influencing muscle growth, fat distribution, mood, and sexual function. Because free testosterone plays a critical role in these physiological processes, measuring its percentage can provide a more accurate picture of an individual's hormonal balance than total testosterone levels alone.
Optimal range: 1.5 - 3.2 %
% Free Testosterone (Dialysis) measures the percentage of testosterone in your blood that is unbound and biologically active, using the highly accurate equilibrium dialysis method. Unlike total testosterone, which includes both bound and unbound hormone, this test focuses on the free fraction that directly influences energy, libido, muscle mass, mood, and more. It’s especially useful when total testosterone levels are borderline or symptoms suggest a hormone imbalance. Elevated levels may point to conditions like PCOS or low SHBG, while decreased levels can indicate hypogonadism, aging, or elevated SHBG. This test provides a clearer picture of hormonal health, particularly in men and women with unexplained symptoms.
Optimal range: 7.5 - 28.4 mcg/mL
1,5-Anhydroglucitol (1,5-AG) is a monosaccharide that plays a critical role as a biomarker in the assessment of intermediate glycemic control in individuals, particularly those with diabetes. Unlike conventional markers such as glycated hemoglobin (HbA1c), which reflects average blood glucose levels over a period of approximately two to three months, 1,5-AG offers a more immediate view of glycemic control, usually reflecting fluctuations in blood glucose levels over a shorter period of one to two weeks.
This distinct temporal sensitivity arises from its unique physiological mechanism: 1,5-AG is typically maintained at a constant level in the bloodstream, but when blood glucose levels rise above the renal threshold (approximately 180 mg/dL), glucose competes with 1,5-AG for reabsorption in the kidneys. As a result, elevated blood glucose levels lead to an increased excretion of 1,5-AG in urine, thereby reducing its serum concentration.
Optimal range: 8.7 - 30.5 nmol/L
Folates function as cofactors in the transfer and utilization of one carbon groups. These reactions are essential for the production of purines and pyrimidines for DNA synthesis. Folates also play a major role in the regeneration of methionine from homocysteine. In pregnancy, poor body stores of folates may lead to neural tube defects, such as spina bifida.
Optimal range: 0.1 - 0.8 Ratio
AC/FC, which stands for Acylcarnitine to Free Carnitine ratio, is an important marker used in the assessment of metabolic health, particularly in diagnosing and managing metabolic disorders related to fatty acid metabolism. Carnitine is a vital molecule that helps transport fatty acids into the mitochondria, the energy powerhouses of cells, where they are broken down to produce energy. The AC/FC ratio reflects the balance between acylcarnitines, which are fatty acids bound to carnitine, and free carnitine, which is available for further transport activities. This ratio can provide insights into how efficiently the body is processing and utilizing fatty acids.
Optimal range: 5 - 30 nmol/ML
Acylcarnitine is a crucial molecule in the body, playing a significant role in the metabolism of fatty acids. Essentially, it acts as a transporter that helps move fatty acids into the mitochondria, the energy powerhouses of our cells, where they can be broken down and used for energy production. The process begins when fatty acids bind to carnitine, forming acylcarnitine, which can then cross the mitochondrial membrane. Once inside the mitochondria, the fatty acids are released from carnitine and undergo a process called beta-oxidation, which ultimately generates ATP, the energy currency of cells. Measuring levels of acylcarnitines in the blood can provide valuable insights into metabolic health. Abnormal levels may indicate metabolic disorders such as fatty acid oxidation defects, which can lead to energy production issues and accumulation of toxic substances in the body. Therefore, understanding and monitoring acylcarnitine levels is important for diagnosing and managing various metabolic conditions.
Optimal range: 2.5 - 12.3 ug/ml
The adiponectin blood test determines the levels of adiponectin in blood. It is used to diagnose metabolic disorders such as Type 2 diabetes. Adiponectin is a hormone that is released from fat cells and will help to control the inflammation of tissue. The hormone will also boost insulin sensitivity and increases the breakdown of fatty acid in the liver. This process will, in turn, decrease the manufacturing of glucose by the liver. A low result might suggest Type 2 diabetes mellitus or metabolic syndrome.
Optimal range: 13 - 100 ug/ml
Adiponectin is a crucial marker often included in metabolic test panels to provide insights into an individual's metabolic health. This protein hormone, produced and secreted by fat cells, plays a significant role in regulating glucose levels and fatty acid breakdown in the body. High levels of adiponectin are associated with a lower risk of several metabolic disorders, including type 2 diabetes, obesity, and cardiovascular disease. Essentially, adiponectin enhances the body's sensitivity to insulin, making it an important indicator of metabolic syndrome and insulin resistance.
Optimal range: 0 - 20 mcg/min
What is Albumin Excretion Rate?
The Albumin Excretion Rate (AER) measures the amount of albumin (a type of protein) excreted in the urine over a set period, usually in a 24-hour sample. It is a valuable marker for assessing kidney function, particularly in detecting early kidney damage or disease, such as diabetic nephropathy or hypertension-related kidney issues.
Why is it Important?
Albumin is normally present in very small amounts in urine, as the kidneys filter out waste but retain essential proteins. However, when the kidneys are damaged or stressed, they may leak albumin into the urine in higher amounts. Elevated levels of albumin in the urine can indicate kidney dysfunction, even before more noticeable symptoms arise. Monitoring AER is especially important in individuals with diabetes, hypertension, or other risk factors for kidney disease.
Optimal range: 0 - 30 mg/g creat
This test is useful in the management of patients with relatively early diabetes mellitus to assist in avoiding or delaying the onset of diabetic renal disease.
Albumin/Creatinine Ratio is the first method of preference to detect elevated protein. The recommended method to evaluate albuminuria is to measure the Albumin/Creatinine Ratio in a spot urine sample.
Optimal range: 0 - 15 IU/ml
The marker "Anti-Thyroglobulin Antibody" is serving as an essential tool in assessing autoimmune thyroid disorders, such as Hashimoto's thyroiditis and Graves' disease.
Thyroglobulin itself is a protein produced by the thyroid gland, playing a pivotal role in the synthesis of thyroid hormones. However, in certain autoimmune conditions, the body's immune system mistakenly identifies thyroglobulin as a foreign substance, leading to the production of anti-thyroglobulin antibodies. The presence and concentration of these antibodies can be indicative of an underlying autoimmune thyroid condition.
What if results are borderline elevated?
When Anti-Thyroglobulin Antibody levels are borderline elevated, it suggests a potential, mild autoimmune reaction against the thyroid gland, but interpretation depends on the overall clinical picture. Healthcare providers typically recommend a combination of symptom evaluation, further thyroid function tests, and periodic monitoring of antibody levels to detect any changes over time. The presence of risk factors such as a family history of autoimmune diseases and the patient's symptoms are also considered in assessing the likelihood of developing a thyroid disorder. In some cases, lifestyle modifications or early medical interventions may be advised to manage symptoms and support thyroid health, highlighting the importance of a proactive and informed approach to borderline results.
Optimal range: 0.68 - 2.16 ng/mL
C-Peptide, measured through the Liquid Chromatography-Tandem Mass Spectrometry (LC/MS/MS) method, represents a significant advancement in medical diagnostics, offering unparalleled accuracy in assessing pancreatic beta-cell function and insulin production. This test is crucial for differentiating type 1 and type 2 diabetes, as well as for identifying insulinoma, a rare pancreatic tumor. The C-Peptide test, especially when combined with LC/MS/MS technology, provides a highly sensitive and specific measure of C-Peptide levels, far surpassing traditional immunoassays in precision.
Optimal range: 1.1 - 4.4 ng/mL , 0.36 - 1.46 nmol/L
Other names: insulin C-peptide, connecting peptide insulin, proinsulin C-peptide
C-peptide is a substance made in the pancreas, along with insulin.
What is insulin?
Insulin is a hormone that controls the body's glucose (blood sugar) levels. Glucose is your body's main source of energy. If your body doesn't make the right amount of insulin, it may be a sign of diabetes.
Optimal range: 0.4 - 2.1 ng/mL
Measuring C-peptide is an accurate way to find out how much insulin your body is making.
These are the reference ranges for C-Peptide, Ultrasensitive:
Adults 8:00 a.m. fasting: 0.4 - 2.1 ng/mL
2 Hours Post Prandial (Sustacal): 1.2 - 3.4 ng/mL
2 Hours Post Glucose: 2.0 - 4.5 ng/mL
Optimal range: 16 - 31 mg/dL , 0.16 - 0.31 g/L
Ceruloplasmin is a copper-containing enzyme that plays a role in the body's iron metabolism. This test measures the amount of ceruloplasmin in the blood.
Optimal range: 1.7 - 4 mg/g Creat.
Choline is an essential nutrient involved in various physiological processes, including cell membrane structure, lipid metabolism, and neurotransmitter synthesis. When measured in a urine sample as choline (mg/g creatinine), this biomarker can provide valuable insights into an individual's choline status and overall metabolic health. The measurement of choline in urine is often normalized to creatinine levels to account for variations in urine concentration, making the value more reliable and comparable across different samples and individuals. Interpreting choline levels in urine requires considering dietary intake, as choline is obtained from foods such as eggs, meat, fish, and certain vegetables.
Optimal range: 0.1 - 2.1 ug/L
The Chromium, Plasma test is a valuable diagnostic tool for assessing chromium levels in the body. It plays a critical role in monitoring both deficiency and toxicity, particularly in individuals with metabolic disorders, those at risk of environmental exposure, or those undergoing chromium supplementation therapy. Understanding the results in the context of the patient’s clinical presentation is key to managing chromium-related health issues effectively.
Optimal range: 1.4 - 10 mg/L
Coenzyme Q10, commonly referred to as CoQ10, plays an essential role in the body's energy production and is found in every cell, particularly in the mitochondria, which are often described as the powerhouses of the cells. It is involved in the production of adenosine triphosphate (ATP), which is a major energy currency of the cell. This makes CoQ10 crucial for the health and functioning of virtually all body systems and organs. In the context of cardiovascular health, CoQ10's importance cannot be overstated. It helps maintain the optimal functioning of heart cells, as well as supports the cardiovascular system's overall health.
What does a borderline low result mean?
If your CoQ10 levels are borderline low, it suggests that while your levels aren't definitively below what's considered normal, they're close to the lower limit of the normal range. This can indicate a potential risk for conditions that CoQ10 is known to influence, such as heart disease or muscular disorders. It might also suggest a reduced capacity for energy production in your cells, which could lead to symptoms like fatigue or muscle weakness. In some cases, borderline low levels of CoQ10 could prompt a healthcare provider to recommend dietary adjustments, supplementation, or further monitoring to ensure levels don't fall into a definitively low range that could impact health more significantly.
Optimal range: 20 - 320 mg/dL
Creatinine is the endproduct of creatine metabolism. Creatine is present primarily in muscle and the amount of creatinine produced is related to total skeletal muscle mass. Daily creatinine production is fairly constant except when there is massive injury to muscle. The kidneys excrete creatinine very efficiently and blood levels and daily urinary excretion of creatinine fluctuates very little in healthy normal people. Since blood and daily urine excretion of creatinine shows minimal fluctuation, creatinine excretion is useful in determining whether 24-hour urine specimens for other analytes (e.g., protein) have been completely and accurately collected.
Optimal range: 12 - 22 pmol/mL
Cyclic AMP (Cyclic adenosine-3′-5′-monophosphate) serves as a 2nd messenger in signal transmission of many hormones, such as adrenaline, ACTH, LH, FSH, glucagon, and calcitonin.
Optimal range: 0 - 40 DRI Score
If you’ve recently had lab tests and noticed the Diabetes Risk Index (DRI) on your results, you might be wondering what it means. This test is designed to assess your risk of developing type 2 diabetes, a chronic condition that affects how your body processes sugar (glucose). Here’s an easy-to-understand guide to help you make sense of this important biomarker.
What Is the Diabetes Risk Index (DRI)?
The Diabetes Risk Index (DRI) is a lab measurement that combines various biomarkers to estimate your risk of developing type 2 diabetes. It uses advanced algorithms to analyze specific factors in your blood and provide a clear picture of your risk level. Think of it as a personalized health snapshot that helps predict your likelihood of diabetes in the near future.
Optimal range: 0 - 50 DRI Score
If you’ve recently had lab tests and noticed the Diabetes Risk Index (DRI) on your results, you might be wondering what it means. This test is designed to assess your risk of developing type 2 diabetes, a chronic condition that affects how your body processes sugar (glucose). Here’s an easy-to-understand guide to help you make sense of this important biomarker.
What Is the Diabetes Risk Index (DRI)?
The Diabetes Risk Index (DRI) is a lab measurement that combines various biomarkers to estimate your risk of developing type 2 diabetes. It uses advanced algorithms to analyze specific factors in your blood and provide a clear picture of your risk level. Think of it as a personalized health snapshot that helps predict your likelihood of diabetes in the near future.
Optimal range: 4 - 22 ng/dL , 40 - 220 pg/mL
Dihydrotestosterone (DHT) is a potent androgen—a type of sex hormone—that plays a key role in the development of male sexual characteristics. It is primarily active during fetal development and puberty in individuals assigned male at birth, and it contributes to traits like body hair, prostate growth, and male-pattern baldness. While DHT is present in people of all sexes, its role is more prominent in male reproductive physiology.
Optimal range: 30 - 85 ng/dL
Dihydrotestosterone is a hormone that stimulates the development of male characteristics
Optimal range: 68 - 114 mg/dL , 3.77 - 6.33 mmol/L
Your estimated Average Glucose (eAG) number is calculated from the result of your A1c test. Like the A1c, the eAG shows what your average blood sugars have been over the previous 2 to 3 months, but instead of a percentage, the eAG is in the same units (mg/dl) as your blood glucose meter.
Optimal range: 0 - 6.6 u
Free androgen index is a measure of how much testosterone is free and available for use by the body. Much of the testosterone present in the blood is bound to SHBG, and when bound to SHBG, testosterone is inactive. The free androgen index indicates how much testosterone is free and is calculated from total testosterone and SHBG levels. Therefore, high free androgen index results indicate high levels of free testosterone, which can occur with polycystic ovary syndrome and cause menstrual problems, abnormal hair growth and fertility issues.
Optimal range: 0 - 17 uU/mL
Free insulin, a critical biomarker in diabetes research and management, refers to the fraction of insulin in the bloodstream that is not bound to proteins, making it readily available to regulate blood sugar levels. This marker provides a more accurate representation of insulin activity compared to total insulin, which includes both bound and unbound forms.
Optimal range: 35 - 155 pg/mL , 3.5 - 15.5 ng/dL , 10.09 - 44.67 pmol/L
Testosterone is the primary male sex hormone in humans. A healthcare professional may order a free testosterone blood test if you’re experiencing sexual problems or a secondary condition, like hyperthyroidism, is suspected.
Optimal range: 0.7 - 2 pg/dL
Optimal range: 200 - 600 pmol/L
A free testosterone test for men is a critical diagnostic tool in evaluating and managing a variety of health conditions, primarily those related to hormonal balance and reproductive health. Testosterone, a vital male hormone, plays a significant role in several physiological processes including muscle mass and strength, bone density, fat distribution, and sexual function. While total testosterone measures the overall level of the hormone in the blood, free testosterone specifically refers to the fraction of testosterone that is not bound to proteins in the blood and is therefore biologically active and readily available to tissues.
Optimal range: 0.06 - 0.18 ng/mL
A free testosterone test for men is a critical diagnostic tool in evaluating and managing a variety of health conditions, primarily those related to hormonal balance and reproductive health. Testosterone, a vital male hormone, plays a significant role in several physiological processes including muscle mass and strength, bone density, fat distribution, and sexual function. While total testosterone measures the overall level of the hormone in the blood, free testosterone specifically refers to the fraction of testosterone that is not bound to proteins in the blood and is therefore biologically active and readily available to tissues.
Optimal range: 0 - 4.2 pg/mL
Although Testosterone is generally viewed as a male-only hormone, women’s ovaries also make small amounts of testosterone. It helps many organs and body processes in women. Free testosterone and albumin-bound testosterone are also referred to as bioavailable testosterone. This is the testosterone that is easily used by your body.
Optimal range: 8.7 - 25.1 pg/mL
Although Testosterone is generally viewed as a male-only hormone, women’s ovaries also make small amounts of testosterone. It helps many organs and body processes in women. Free testosterone and albumin-bound testosterone are also referred to as bioavailable testosterone. This is the testosterone that is easily used by your body.
Optimal range: 1.6 - 2.9 %
Optimal range: 0 - 285 umol/L
Fructosamine is found in the plasma of both normal and diabetic individuals. “Fructosamine” is the term used to describe proteins that have been glycated (ie, are derivatives of the nonenzymatic reaction product of glucose and albumin). It has been advocated as an alternative test to hemoglobin A1c for the monitoring of long-term diabetic control. Fructosamine and hemoglobin A1c do not measure exactly the same thing, since fructosamine has a shorter half-life and appears to be more sensitive to short-term variations in glucose levels; however, this is not necessarily a disadvantage. Fructosamine is clearly superior in patients with abnormal hemoglobins because of the interference of abnormal hemoglobins in the anion-exchange chromatography methods for Hb A1c. Published reference interval for apparently healthy subjects between age 20 and 60 is 205−285 μmol/L and in a poorly-controlled diabetic population is 228−563 μmol/L with a mean of 396 μmol/L.
Optimal range: 520 - 700 pg/mL
Optimal range: 0 - 0.5 nmol/L
Glutamic acid decarboxylase is an enzyme found in brain and pancreas that converts glutamic acid (glutamate) into GABA, an inhibitory neurotransmitter. The glutamic acid decarboxylase test is a test that looks for antibodies directed against the glutamic acid decarboxylase enzyme.
Optimal range: 20 - 41 mmol/mol
Glycated hemoglobin, commonly known as HbA1c, is a form of hemoglobin that is chemically linked to glucose. Hemoglobin is a protein in red blood cells that normally carries oxygen throughout your body. When glucose (sugar) in your bloodstream attaches to hemoglobin, it forms HbA1c. The higher your blood glucose levels, the more glycated hemoglobin is formed. Doctors use the HbA1c test as a marker to get an average of an individual's blood sugar levels over the past two to three months. This test is crucial for managing diabetes, as it helps to evaluate how well a person is keeping their blood glucose levels in check. Unlike daily blood sugar tests, which can fluctuate greatly from day to day and hour to hour, HbA1c provides a more stable and long-term gauge of blood sugar control. This makes it an essential tool not only for diagnosing diabetes but also for monitoring the effectiveness of treatment plans.
Optimal range: 0 - 200 umol/L
Glycated Serum Protein (GSP) is the amount of glucose attached to total serum proteins that indicate the average amount of glucose in the blood over the previous two to three weeks.
Glycated Serum Protein (GSP) serves as a 2-3 week indicator of average blood glucose, closing the information gap between daily blood glucose and HbA1c monitoring. Studies have shown that GSP can be reliably used in medical conditions which impact red blood cell life span thus decreasing the accuracy of HbA1c measurements.
Optimal: <200 µmol/L
Borderline: 200-250 µmol/L (may indicate increased risk of diabetes mellitus)
Increased Risk: >250 µmol/L
Optimal range: 4.8 - 5.6 %
The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the commonly used tests to diagnose prediabetes and diabetes, and is also the main test to help you and your health care team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is really important if you have diabetes.
An A1C test can show your average glucose level for the past three months because:
→ Glucose sticks to hemoglobin for as long as the red blood cells are alive.
→ Red blood cells live about three months.
→ High A1C levels are a sign of high blood glucose from diabetes. Diabetes can cause serious health problems, including heart disease, kidney disease, and nerve damage. But with treatment and lifestyle changes, you can control your blood glucose levels.
Optimal range: 100 - 200 %
The marker HOMA-B (Homeostatic Model Assessment for Beta-cell Function) is an important clinical tool used for assessing the function of beta cells in the pancreas. Beta cells play a crucial role in the body's glucose metabolism by producing and secreting insulin, the hormone responsible for regulating blood sugar levels. HOMA-B is calculated based on fasting blood glucose and fasting insulin levels, providing an estimate of beta-cell function.
Optimal range: 0 - 2 Units
HOMA-IR stands for "Homeostatic Model Assessment for Insulin Resistance".
The meaningful part of the acronym is “insulin resistance”. It marks for both the presence and extent of any insulin resistance that you might currently express. It is a terrific way to reveal the dynamic between your baseline (fasting) blood sugar and the responsive hormone insulin.
- Less than 1 means you are insulin-sensitive (Optiomal)
- Greater than 1.9 indicates early insulin resistance.
- Greater than 2.9 indicates significant insulin resistance.
Insulin, a hormone secreted by your pancreas, helps the body use glucose for fuel. When the body becomes insulin resistant, the pancreas will increase its production of insulin to compensate, but increased levels of insulin can damage your overall health and make it very difficult to lose weight.
If insulin resistance is left untreated, it can lead to the development of pre-diabetes, Type 2 diabetes mellitus or other metabolic conditions, like heart disease and fatty liver disease.
Why take the HOMA-IR test?
When insulin resistance is identified early, it can be reversed. Using the HOMA-IR to identify subtle insulin resistance, even before it is evident in more traditional screening measures like hemoglobin HA1c (HA1c) and fasting blood sugar.
The HOMA-IR tool is a validated, non-invasive tool to assess the relationship between glucose and insulin. If elevated, it can guide you to make diet and lifestyle changes that will bring your HOMA-IR score down into the insulin-sensitive range, lose weight, and improve your health.
HOMA-IR and CVD:
HOMA-IR is an independent predictor of CVD in type 2 diabetes. The improvement of insulin resistance might have beneficial effects not only on glucose control but also on CVD in patients with type 2 diabetes.
Optimal range: 50 - 150 Units
What is the HOMA-S test?
The HOMA-S test is a quanatitative insulin sensitivity check index/homeostasis model assessment for insulin sensitivity.
The HOMA-S test is a valuable tool for predicting the risk of developing diabetes and other metabolic conditions by assessing insulin sensitivity. It can help individuals take proactive measures to prevent the onset of diabetes or manage their condition effectively if diagnosed early.
Optimal range: 0 - 14.5 µmol/L , 0 - 14.5 umol/L
Homocysteine is an amino acid that requires vitamin B12 and folate to be used by our bodies. As such, homocysteine blood tests are often ordered to identify vitamin B12 / folate deficiency.
Rarely, an abnormally high level of homocysteine indicates a rare genetic disorder called homocystinuria.
Optimal range: 52 - 328 ng/mL
The IGF-1, LC/MS test is a highly accurate and specific method used to measure Insulin-Like Growth Factor 1 (IGF-1), a hormone that reflects growth hormone (GH) activity and plays a key role in growth, metabolism, and tissue repair. This test is commonly used to evaluate growth disorders, diagnose and monitor acromegaly (GH excess), assess growth hormone deficiency (GHD), and guide GH or IGF-1 replacement therapy. Unlike standard immunoassays, which can be affected by IGF binding proteins and yield inaccurate results, the LC/MS method precisely measures intact IGF-1 with high sensitivity and minimal interference. It also allows for detection of rare IGF-1 variants and provides standardized results based on sex- and age-adjusted reference ranges. IGF-1 levels are interpreted using Z-scores, where values above +2.0 may suggest GH excess, below -2.0 may indicate GHD, and values within ±2.0 are typically considered normal. LC/MS testing is especially useful in patients undergoing long-term treatment, as it provides consistent and reliable measurements—making it a preferred tool in endocrine evaluation and therapy management.
Optimal range: 2.6 - 24.9 uIU/ml , 26 - 249 pmol/L
Insulin is a vital hormone produced by the pancreas, an organ located behind the stomach that plays a key role in both digestion and blood sugar regulation. Acting like a key, insulin allows the body’s cells to absorb glucose from the bloodstream for energy while also signaling the liver, muscles, and fat tissue to store excess glucose for later use. When insulin is insufficient or the body becomes resistant to it—a condition known as insulin resistance—glucose accumulates in the blood, increasing the risk of serious health complications. Diabetes is a chronic condition that results when the body either doesn’t produce enough insulin, as in type 1 diabetes (often due to autoimmune destruction of insulin-producing beta cells), or cannot use insulin effectively, as in type 2 diabetes, which is commonly linked to lifestyle factors, genetics, and age. A temporary form, gestational diabetes, can also occur during pregnancy due to hormonal changes that cause insulin resistance. Insulin resistance itself may develop silently and is influenced by factors such as excess abdominal fat, physical inactivity, poor diet, certain medications, and genetic predisposition. If left unmanaged, it can progress to prediabetes and eventually to type 2 diabetes. Early detection is critical and is often done using the Hemoglobin A1C test, which measures average blood glucose levels over the past three months and helps define normal, prediabetic, and diabetic ranges. Supporting healthy insulin function is essential not only for energy metabolism but also for reducing the risk of related conditions like non-alcoholic fatty liver disease and cardiovascular disease, underscoring the importance of proactive blood sugar management for long-term health.
Optimal range: 0 - 0.4 U/mL
The anti-insulin antibody test checks to see if your body has produced antibodies against insulin.
Antibodies are proteins the body produces to protect itself when it detects anything "foreign," such as a virus or transplanted organ.
Optimal range: 0 - 66 Score
A score below 33 is optimal. The insulin resistance score correlates with steady state glucose levels achieved during an insulin suppression test, a standard research test for insulin resistance. The score is based on insulin and C-peptide results.
The Insulin Resistance Score, a pivotal metric in the realm of metabolic health, serves as a critical tool for assessing the body's sensitivity to insulin and identifying the risk of developing conditions like type 2 diabetes, cardiovascular disease, and metabolic syndrome.
Optimal range: 1.5 - 14.9 uIU/ml
The marker "Insulin, Free (Bioactive)" refers to a test that measures the level of unbound, bioactive insulin in the blood. This measurement is particularly useful for understanding the concentration of insulin that is actively available in the bloodstream, separate from any insulin that may be bound to antibodies. Patients with diabetes, especially those who are being treated with insulin injections, may develop antibodies to insulin. These antibodies can bind to injected insulin, making it difficult to accurately assess how much insulin is freely available to act on cells and regulate blood sugar levels. The "Insulin, Free (Bioactive)" test helps in interpreting blood sugar levels and their relationship to insulin injections in such insulin-treated patients by measuring the portion of insulin that is not bound to antibodies and is free to act on cells. This information can be crucial for managing diabetes effectively, as it provides a clearer picture of the patient's insulin dynamics and how well their treatment regimen is working.
Optimal range: 0 - 16 uIU/ml
Insulin, Intact, LC/MS/MS is an advanced and precise laboratory test utilized to measure intact insulin levels in the blood, employing the state-of-the-art Liquid Chromatography-Tandem Mass Spectrometry (LC/MS/MS) technology. This test stands out for its exceptional accuracy and specificity, making it a crucial tool in diagnosing and managing various disorders related to insulin production and regulation, including diabetes mellitus, insulinoma (a rare tumor of the pancreas that produces insulin), and other metabolic conditions.
Optimal range: 64 - 240 ng/dL , 8.36 - 31.37 nmol/L
Insulin-Like Growth Factor 1 (IGF-1) is a hormone that is similar in structure to insulin and works with Growth Hormone to reproduce and regenerate cells.
Growth Hormone, made by the pituitary gland, stimulates the liver to produce IGF-1 and IGF-1 subsequently stimulates growth in cells throughout the body, leading to growth and development (as in the womb and through adolescence), strengthening of tissues (improving bone density, building muscle), and healing (skin, bones, gut lining, etc.), depending on what the body needs.
Optimal range: 40 - 92 mcg/L
Iodine is an essential element that is required for thyroid hormone production.
Optimal range: 0 - 3.3 ng/mL , 0 - 3.3 mcg/L
Monitoring molybdenum levels in the blood is crucial for ensuring proper enzyme function, detoxification, and overall metabolic health. While deficiencies are rare, they can have serious consequences. Conversely, excess molybdenum can lead to toxicity, particularly in those with high environmental or occupational exposure. Regular assessment, particularly for at-risk individuals, ensures that molybdenum levels remain within a healthy range.
Optimal range: 0.07 - 0.88 mmol/L
Nonesterified Fatty Acids (NEFAs), also known as Free Fatty Acids (FFAs), are a type of fatty acid that circulate in the bloodstream without being attached to a glycerol molecule. They play a crucial role in energy metabolism, serving as a major energy source during fasting or periods of increased energy demand.
NEFAs can be derived from the breakdown of stored triglycerides in adipose tissue, and they are also released in response to various physiological conditions, including stress, exercise, and fasting.
Optimal range: 22 - 237 ng/dL , 0.22 - 2.37 ng/mL
Pregnenolone is a chemical substance that is a precursor to all steroid hormones.
Optimal range: 0 - 18.8 pmol/L
Proinsulin is the precursor of insulin and C-peptide. Following synthesis, proinsulin is packaged into secretory granules, where it is processed to C-peptide and insulin by prohormone convertases and carboxypeptidase E.
Only 1% to 3% of proinsulin is secreted intact. However, because proinsulin has a longer half-life than insulin, circulating proinsulin concentrations are in the range of 5% to 30% of circulating insulin concentrations on a molar basis, with the higher relative proportions seen after meals and in patients with insulin resistance or early type 2 diabetes. Proinsulin can bind to the insulin receptor and exhibits 5% to 10% of the metabolic activity of insulin.
Optimal range: 93 - 198 ug/L
Selenium is a vital micronutrient with broad roles in health, including antioxidant defense, thyroid hormone regulation, and immune function. Monitoring selenium levels through the Selenium, Serum/Plasma test is important for identifying deficiencies, toxicities, and supporting overall health, especially in at-risk populations.
Optimal range: 10 - 57 nmol/L
Sex Hormone Binding Globulin (SHBG) Serum (Male) is a protein produced by the liver that binds to sex hormones, particularly testosterone and estrogen, and transports them in the blood. When SHBG levels are measured, it provides insight into the amount of testosterone available for the body's tissues to use. This is important because only a fraction of testosterone is free and biologically active, while the rest is bound to SHBG and other proteins. High levels of SHBG can reduce the amount of free testosterone, potentially leading to symptoms of low testosterone such as fatigue, decreased libido, and mood changes. Conversely, low SHBG levels might indicate conditions like obesity, hypothyroidism, or type 2 diabetes. By assessing SHBG levels, healthcare providers can better understand a patient's hormonal balance and tailor treatments for conditions related to hormonal imbalances, ensuring a more comprehensive approach to men's health.
The standard male reference range for Sex Hormone Binding Globulin (SHBG) typically varies depending on the laboratory and the specific testing methods used. However, a common reference range for adult males is approximately 10 to 57 nmol/L. It's important to note that reference ranges can differ slightly between labs, so it's always best to refer to the specific range provided by the testing laboratory, such as Labcorp, for the most accurate interpretation of results.
Optimal range: 24.6 - 122 nmol/L
Sex hormone-binding globulin is a protein that binds primarily to testosterone, making it biologically unusable by our bodies. For this reason, an abnormal level of SHBG indicates that too much or too little testosterone is present in the tissues. In men, this can cause sexual issues like erectile dysfunction or infertility. In women, it can cause irregular menstruation or excess facial hair growth. A healthcare professional may order a SHBG test when total testosterone levels do not fit with one or more of the above-mentioned symptoms.
What are normal SHBG levels?
The normal ranges for SHBG concentrations in adults are:
Males: 10 to 57 nanomoles per liter (nmol/L)
Females (nonpregnant): 18 to 144 nmol/L
Men typically have lower SHBG levels than women. However, a man’s SHBG level will usually increase with age as his testosterone levels drop.
Pregnancy usually raises SHBG levels. They typically return to normal after childbirth.
Optimal range: 1.2 - 4.3 Units
The T7 Index is used to calculate Free T4, one of the two active thyroid hormones in your bloodstream.
Optimal range: 9 - 46 %
Free and weakly bound testosterone (FWBT), also referred to as bioavailable testosterone, is thought to reflect an individual's biologically active, circulating testosterone. FWBT includes free testosterone and testosterone that is bound to albumin. FWBT does not include sex hormone binding globulin-bound testosterone. The SHBG-bound fraction is biologically inactive because of the high binding affinity of SHBG for testosterone. The rapid dissociation of “weakly bound” testosterone from albumin results in the availability of essentially all albumin-bound testosterone for steroid-receptor interaction.
The measurement of free and weakly bound testosterone in women, when used in conjunction with the assay of the DHEA-S and SHBG, can be used to establish etiology of hirsutism.
Optimal range: 3 - 18 %
Free and weakly bound testosterone (FWBT), also referred to as bioavailable testosterone, is thought to reflect an individual's biologically active, circulating testosterone. FWBT includes free testosterone and testosterone that is bound to albumin. FWBT does not include sex hormone binding globulin-bound testosterone. The SHBG-bound fraction is biologically inactive because of the high binding affinity of SHBG for testosterone. The rapid dissociation of “weakly bound” testosterone from albumin results in the availability of essentially all albumin-bound testosterone for steroid-receptor interaction.
The measurement of free and weakly bound testosterone in women, when used in conjunction with the assay of the DHEA-S and SHBG, can be used to establish etiology of hirsutism.
Optimal range: 0 - 9.5 ng/dL
Free and weakly bound testosterone (FWBT), also referred to as bioavailable testosterone, is thought to reflect an individual's biologically active, circulating testosterone. FWBT includes free testosterone and testosterone that is bound to albumin. FWBT does not include sex hormone binding globulin-bound testosterone. The SHBG-bound fraction is biologically inactive because of the high binding affinity of SHBG for testosterone. The rapid dissociation of “weakly bound” testosterone from albumin results in the availability of essentially all albumin-bound testosterone for steroid-receptor interaction.
The measurement of free and weakly bound testosterone in women, when used in conjunction with the assay of the DHEA-S and SHBG, can be used to establish etiology of hirsutism.
Optimal range: 0.7 - 7.9 pg/mL
The marker "Testosterone, Free, Calculated (Female)" is an important parameter in assessing various health conditions and understanding the hormonal balance in females. Testosterone, although typically associated with males, is also a vital hormone in females, playing crucial roles in muscle strength, bone density, and sexual function. Unlike males, where testosterone is the primary sex hormone, females produce it in much smaller quantities. Its levels in the female body can be indicative of various health conditions, making its measurement and understanding critical in medical practice.
Free testosterone refers to the fraction of testosterone that is not bound to proteins in the blood and is, therefore, available to tissues. The majority of testosterone in the bloodstream is bound to two proteins: sex hormone-binding globulin (SHBG) and albumin. The "free" portion of testosterone is biologically active, meaning it can interact with cells and potentially affect the body. Calculated free testosterone estimates the amount of testosterone that is not bound to SHBG or albumin, providing insights into the hormone's active levels. This calculation typically involves measuring total testosterone, SHBG, and sometimes albumin, using these values in a formula to estimate free testosterone levels.
Optimal range: 42.3 - 190 pg/mL
Free testosterone is a key biomarker that measures the biologically active portion of testosterone circulating in the bloodstream. Unlike total testosterone, which includes both bound and unbound hormones, free testosterone represents the immediately available hormone that directly impacts physiological functions.
Optimal range: 264 - 916 ng/dL , 2.64 - 9.16 ng/mL , 9.16 - 31.79 nmol/L
This test assesses the level of the hormone testosterone in your bloodstream. Testosterone, an androgen, is primarily responsible for the development of male characteristics. It is synthesized in the testes for males, ovaries for females, and the adrenal glands.
During puberty in males, testosterone induces several changes, including the growth of hair, muscles, penis, and testes, along with a deepening of the voice. It continues to be produced in adult males, promoting sex drive and aiding in sperm maturation.
Females also produce small amounts of testosterone in their ovaries, contributing to various bodily functions.
The pituitary gland in the brain regulates testosterone production by releasing signaling hormones such as luteinizing hormone.
Optimal range: 0 - 1.7 nmol/L
Testosterone is a male sex hormone or androgen. It is generally low in women and children, but it can be elevated in certain diseases. A certain level of testosterone is important for development and maturation in both genders.
Optimal range: 0.5 - 8.5 ng/dL
Testosterone is the main hormone responsible for the development of secondary sex characteristics in men. Testosterone is produced mainly in the testicles and partially by the adrenal glands. In women, low levels of testosterone are produced by the adrenal glands. In men, about half of blood testosterone is present in an inactive form (bound to SHBG), and the other half is present in a free form or weakly bound to albumin. The total free and albumin-bound forms constitute bioavailable testosterone. Total testosterone levels are generally an accurate representation of the biological activity of testosterone in the tissues. Certain conditions may interfere with this interpretation. In such cases, free or bioavailable testosterone levels are clinically more useful.
Optimal range: 110 - 575 ng/dL
Bioavailable testosterone, a crucial hormone in men's health, plays an essential role in maintaining various bodily functions. This form of testosterone, which is readily available for the body's use, significantly influences muscle strength, bone density, and sexual function.
Optimal range: 0.1 - 0.85 ng/dL
Testosterone, though commonly associated with male physiology, is an essential hormone in females as well. Free testosterone represents the unbound form of the hormone, which is biologically active and available to the body’s tissues. It plays a crucial role in numerous physiological functions and maintaining overall health.
Optimal range: 8 - 60 ng/dL , 0.28 - 2.08 nmol/L
Testosterone is a male sex hormone produced in a woman’s ovaries in small amounts as well. Combined with estrogen, the female sex hormone, testosterone helps with the growth, maintenance, and repair of a woman’s reproductive tissues, bone mass, and human behaviors.
Optimal range: 0.02 - 0.1 Ratio
The testosterone-cortisol ratio is a valuable tool for understanding the balance between anabolic and catabolic processes in your body. Monitoring and optimizing this ratio can enhance physical performance, ensure adequate recovery, and maintain overall hormonal health. Whether you're an athlete, a clinician, or a fitness enthusiast, the T/C ratio offers crucial insights into your body’s physiological state and responses to various stressors.
Optimal range: 0 - 55 ng/mL
Thyroglobulin is the protein precursor of thyroid hormone and is made by normal well differentiated benign thyroid cells or thyroid cancer cells.
Optimal range: 0 - 1 IU/L , 0 - 10 IU/ml
What is the Thyroglobulin Antibody test?
→ A thyroglobulin antibody test looks for certain antibodies that attack the thyroid. The presence of thyroglobulin antibodies may indicate an autoimmune condition.
→ A thyroglobulin antibody test is used to determine if you have an underlying thyroid issue.
→ Your healthcare provider may decide to order a thyroglobulin antibody test (which can also be called an antithyroglobulin antibody test or thyroid antibody test) to evaluate the level of antibodies present in your bloodstream.
Thyroid antibodies are destructive to the thyroglobulin protein, so your healthcare provider may order a thyroglobulin antibody test to gain a clearer understanding of what could be causing you to feel unwell.
You may need a thyroid antibody test if you have symptoms of Hashimoto's disease or Graves' disease. But first, your provider will usually order blood tests to check your thyroid hormone levels to see if you have hyperthyroidism or hypothyroidism. Thyroid hormone tests include T3, T4, and TSH (thyroid-stimulating hormone).
Optimal range: 0 - 40 ng/mL
Thyroglobulin (Tg) is a protein produced by the thyroid gland and plays a key role in the production of thyroid hormones. Measuring thyroglobulin levels can be an important diagnostic tool, particularly for individuals with thyroid cancer or other thyroid-related conditions. One of the most reliable methods for testing thyroglobulin levels is through Radioimmunoassay (RIA).
Optimal range: 0 - 1.75 IU/L
The Thyrotropin Receptor Ab test detects the autoantibody that's associated with Graves' disease. An antibody is a specialized protein made by your immune system. Antibodies are custom made to kill pathogens in your body, such as viruses or bacteria.
Thyrotropin is also called thyroid-stimulating hormone, or TSH. TSH binds to receptors on the thyroid gland to tell it to produce thyroid hormone. The thyrotropin receptor antibody mimics TSH, so when it's present, it directs the thyroid to keep releasing hormone when your body doesn't need it. That results in high levels of thyroid hormones, which is what causes symptoms. If the thyrotropin receptor antibody is present, it's an indicator of Graves' disease.
Optimal range: 14 - 31 ug/ml
Thyroid-binding globulin (TBG) is produced in the liver and is the primary circulating (transport) protein that binds thyroid hormones3,5,3’-triiodothyronine (T3) and thyroxine (T4) and carries them in the bloodstream.
Optimal range: 0 - 200 ug/g Creatinine
TMA (Trimethylamine) and TMAO (trimethylamine N-oxide) are key biomarkers in understanding the connection between diet, gut microbiota and heart health.
TMA is a small molecule produced by the gut microbiota when we digest certain dietary components like choline, lecithin and L-carnitine which are found in red meat, eggs and dairy.
Once TMA is formed in the gut it’s absorbed into the blood and transported to the liver where it’s converted to TMAO by the enzyme flavin-containing monooxygenase 3 (FMO3).
High levels of TMAO have been linked to increased risk of cardiovascular disease (CVD) like atherosclerosis, heart attacks and strokes. TMAO is thought to contribute to atherosclerosis by promoting cholesterol deposition in the artery walls and inhibiting reverse cholesterol transport. TMAO can also influence platelet function and increase the risk of thrombosis. Research has shown TMA and TMAO can be used as biomarkers of dietary intake and microbiota activity, linking specific dietary patterns to CVD risk. So measuring TMA and TMAO in the blood can be a useful tool in clinical settings to predict and manage CVD risk. Reducing TMAO production through dietary changes such as reducing TMA precursors or altering gut microbiota through probiotics or other interventions has been suggested as a way to mitigate CVD risk associated with high TMAO levels.
Optimal range: 0 - 70 mg/g Creat.
Trimethylamine N-oxide (TMAO) is a small organic compound that has garnered significant attention in recent years due to its association with cardiovascular health and disease. TMAO is derived from the oxidation of trimethylamine (TMA), which is produced by gut microbiota during the digestion of certain dietary nutrients, particularly choline, lecithin, and L-carnitine. These nutrients are predominantly found in red meat, eggs, dairy products, and some fish. Once TMA is absorbed into the bloodstream, it travels to the liver, where it is converted into TMAO by the enzyme flavin-containing monooxygenase 3 (FMO3).
Optimal range: 0 - 6.2 uM
TMAO (trimethylamine-N-oxide) is a metabolite derived from gut bacteria. This test can powerfully predict future risk for heart attack, stroke, and death in people who appear otherwise healthy.
TMAO is a compound produced by the liver after intestinal bacteria digest certain nutrients: L-carnitine (found in red meat) and lecithin (found in egg yolks, meats and full-fat dairy products). Lecithin is also pumped into the intestines as a component of bile, so all individuals, regardless of diet, feed their gut microbes lecithin and have potential for elevated levels of TMAO.
Optimal range: 0 - 17 uU/mL
Total insulin is a critical marker used to measure the overall insulin levels in the bloodstream, which can provide valuable insights into a person's metabolic health. Insulin is a hormone produced by the pancreas that plays a vital role in regulating blood sugar levels by facilitating the uptake of glucose into cells. By assessing total insulin levels, healthcare professionals can determine how effectively the body is responding to glucose and insulin, which is essential for diagnosing and managing conditions like diabetes, insulin resistance, and metabolic syndrome. Elevated total insulin levels can indicate insulin resistance, where the body's cells are less responsive to insulin, often leading to high blood sugar levels and, eventually, type 2 diabetes. Conversely, low insulin levels can point to conditions such as type 1 diabetes, where the pancreas produces little or no insulin. Monitoring total insulin is crucial for understanding an individual's risk for these conditions and for tailoring appropriate dietary, lifestyle, and medical interventions to maintain optimal health. Regular monitoring can help detect early changes in insulin sensitivity, enabling timely interventions to prevent the progression of metabolic disorders.
Optimal range: 2 - 4.4 pg/mL , 1.3 - 2.86 nmol/L
Triiodothyronine (T3) is the most biologically active thyroid hormone in humans. It is sometimes called total triiodothyronine because it includes both free triiodothyronine and triiodothyronine bound to proteins.
Optimal range: 0 - 1 U/L
TSH receptor antibodies are antibodies that are often present in the serum of patients with Graves’ disease that are directed against the TSH receptor, often causing stimulation of this receptor with resulting hyperthyroidism.
What is Graves’ disease?
Graves' disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats.
Optimal range: 0 - 0 U/mL
The Zinc Transporter 8 (ZnT8) antibody is a marker of significant interest in the field of endocrinology, particularly in relation to diabetes.
ZnT8 is a protein that plays a critical role in the insulin secretion process within the pancreas. It is involved in the transport of zinc ions into insulin-containing secretory vesicles, a step that is essential for the proper storage and processing of insulin.
The presence of antibodies against ZnT8 is indicative of an autoimmune response, where the body's immune system mistakenly targets and attacks the cells that produce insulin, leading to the destruction of these cells. This autoimmune response is a hallmark of Type 1 diabetes, making the ZnT8 antibody a valuable biomarker for early detection and diagnosis of the disease. Identifying the presence of ZnT8 antibodies can help in distinguishing Type 1 diabetes from other types of diabetes, which is crucial for determining the most effective treatment strategy. Moreover, the detection of ZnT8 antibodies can also be used for identifying individuals at risk of developing Type 1 diabetes, allowing for early intervention and potentially delaying or preventing the onset of the disease.
Vitamins & Minerals
Vitamins and minerals are substances obtained from food and supplements needed for normal growth and body processes. Deficiencies in certain vitamins and minerals can interfere with normal body function.
This category encompasses essential nutrients crucial for various bodily functions. It includes tests for vitamins like Vitamin D, which is vital for bone health, and B-vitamins, important for energy metabolism and nerve function. Analyzing these biomarkers helps in detecting deficiencies or excesses and in guiding dietary and supplementation choices for optimal health.
Optimal range: 60 - 228 nmol/L
2-Methylcitric acid (MCA) is a vital biomarker for diagnosing and managing inherited metabolic disorders, particularly propionic acidemia (PA) and methylmalonic acidemia (MMA). This organic acid builds up when propionyl-CoA metabolism is disrupted, leading to its condensation with oxaloacetate through the action of citrate synthase.
Optimal range: 0 - 20 Units
An antiparietal cell antibody test is a blood test that looks for antibodies against the parietal cells of the stomach. The parietal cells make and release a substance that the body needs to absorb vitamin B12.
Optimal range: 221 - 3004 pg/mL
Biotin, also known as Vitamin B7, is a water-soluble B-complex vitamin that plays a critical role in various metabolic processes and is commonly included in blood panel tests to assess nutritional status. It acts as a coenzyme for carboxylase enzymes, pivotal in the synthesis of fatty acids, amino acids, and the generation of glucose from non-carbohydrate sources. Biotin is essential for the proper functioning of the nervous system and plays a role in maintaining skin, hair, and mucous membrane health.
Optimal range: 24.8 - 81.5 pg/mL
Calcitriol is the active form of Vitamin D. It is also known as 1,25(OH)2D. Calcitriol has long been known for its important role in regulating body levels of calcium and phosphorus, and in mineralization of bone.
Optimal range: 6 - 77 mcg/dL
The Carotene marker in a blood panel is a significant indicator of dietary intake and absorption of carotenoids, primarily beta-carotene, a precursor to Vitamin A. Beta-carotene, found abundantly in fruits and vegetables like carrots, sweet potatoes, and leafy greens, is renowned for its antioxidant properties and its role in maintaining healthy vision, skin, and immune function.
Optimal range: 3 - 91 ug/dL
Beta-carotene is a crucial biomarker for assessing vitamin A status, reflecting both dietary intake and overall health. It plays a significant role in antioxidant defense, vision, and immune function, and its measurement can help diagnose and manage various nutritional and health-related conditions.
Optimal range: 0.8 - 1.75 ug/ml , 12.59 - 27.54 umol/L
Copper is part of enzymes, which are proteins that help biochemical reactions occur in every cell. Copper is involved in the absorption, storage and metabolism of iron. The symptoms of a copper deficiency are similar to iron deficiency anemia. The liver makes a special protein, ceruloplasm, to transport copper and help convert iron to a form that can be used by other tissues.
Optimal range: 44 - 342 nmol/L
Optimal range: 0 - 7.5 ng/mL
Des-γ-carboxy Prothrombin (DCP), also known as Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II), is a unique and clinically significant biomarker often included in blood panels, particularly in the context of liver health and hepatocellular carcinoma (HCC) screening. DCP is an abnormal form of prothrombin, a vital protein for blood coagulation, produced in the liver. It arises when there is a deficiency of vitamin K or a dysfunction in the carboxylation system within the liver cells. In healthy individuals, prothrombin is fully carboxylated in the presence of vitamin K, allowing it to play its crucial role in the coagulation cascade. However, in certain pathological conditions, particularly in the presence of hepatic malignancies such as HCC, the capacity for complete carboxylation is impaired, leading to the release of partially carboxylated or completely uncarboxylated prothrombin, identified as DCP.
Optimal range: 25.1 - 165 pmol/L
Holotranscobalamin (HoloTC) is the bioactive form of vitamin B12 circulating in the body. It is the only form that can be readily absorbed and utilized by cells, making it an essential marker for determining vitamin B12 levels. Unlike serum B12, which reflects both active and inactive forms, HoloTC offers a more accurate and sensitive measure of B12 status. This makes it a critical tool for detecting early vitamin B12 deficiency, especially when used alongside other markers such as methylmalonic acid (MMA) and homocysteine.
Optimal range: 0 - 1.1 AU/mL
Intrinsic factor antibodies are proteins produced by the immune system that are associated with pernicious anemia. This test detects intrinsic factor antibody (IF antibody) circulating in blood.
Reference range: Negative, Positive
Intrinsic factor is a protein that is produced by the parietal cells of the stomach. It binds to vitamin B12, thereby allowing absorption of the vitamin by intestinal cells. In pernicious anemia, an autoimmune disorder, autoantibodies are formed against intrinsic factor leading to its deficiency. The lack of intrinsic factor then causes malabsorption of vitamin B12 and subsequent anemia. Autoantibodies can also be formed directly against the parietal cells which similarly leads to inadequate intrinsic factor activity and vitamin B12 deficiency.
Optimal range: 16.6 - 27.7 nmol/L
- Manganese is an important factor in many critical biochemical processes including antioxidant function.
- Manganese is a mineral element that is both nutritionally essential and has the potential to be very toxic. This fact is further complicated by the small range of dosage for clinical benefit and toxicity with serious consequences.
- The principle antioxidant enzyme within our mitochondria (energy) is superoxide dismutase and the enzymes requires manganese for optimal performance.
- Manganese is also required for normal skeletal development and cartilage synthesis.
- Wound healing is also impacted by manganese, as the synthesis of collagen in skin cells is dependent on the presence of adequate manganese.
- Manganese is also important functioning as a co-factor in the metabolism of carbohydrates, amino acids and cholesterol.
- Manganese is considered anti-osteoporotic and anti-arthritic.
Optimal range: 8 - 18.7 ug/L
Blood manganese testing provides crucial information about manganese status in your body. Understanding test results helps manage both deficiency and toxicity risks. Regular monitoring is essential for at-risk individuals and those with related health conditions.
Optimal range: 0 - 378 nmol/L , 0 - 0.38 nmol/ML
Methylmalonic acid is a compound that reacts with vitamin B-12 to produce coenzyme A (CoA). When vitamin B-12 deficiencies occur, methylmalonic acid levels increase.
Optimal range: 5.2 - 72.1 ng/mL
Niacin (nicotinic acid) is a water-soluble vitamin that is also referred to as vitamin B3.
Nicotinamide (nicotinic acid amide) is the derivative of niacin that is incorporated into the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP).
Both nicotinic acid and nicotinamide are absorbed from the normal diet. Nicotinamide is the form of vitamin B3 that is commonly found in nutritional supplements and used to fortify foods. Nicotinic acid is available both over the counter and with a prescription as a cholesterol-lowering agent.
Optimal range: 0 - 5 ng/mL
Niacin (nicotinic acid) is a water-soluble vitamin that is also referred to as vitamin B3.
Nicotinamide (nicotinic acid amide) is the derivative of niacin that is incorporated into the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP).
Optimal range: 2.8 - 4.1 mg/dL , 0.9 - 1.32 mmol/L
Along with calcium, sodium, potassium, magnesium and chloride, phosphorus is one of the six essential minerals required by the human body in significant quantities.
Phosphorus is a mineral involved in DNA and RNA synthesis, part of ATP, helps activate enzymes. May be elevated due to Vit D toxicity, hypoparathyroidism, kidney dysfunction. May be decreased due to poor absorption, Vit D deficiency, elevated insulin, high carb diets, diarrhea, poor protein digestion.
Optimal range: 3.4 - 4.8 mmol/L
Potassium (Plasma) is a vital electrolyte that helps regulate nerve signals, muscle contractions (including the heart), and fluid balance in the body. It plays a key role in maintaining healthy blood pressure and overall cellular function.
3.4 – 4.8 mmol/L
Low potassium (hypokalemia) can cause fatigue, muscle weakness, cramps, irregular heartbeat, and, in severe cases, life-threatening complications. It may result from fluid loss (vomiting, diarrhea), certain medications (like diuretics), or underlying health conditions.
High potassium (hyperkalemia) may cause muscle weakness, numbness, or dangerous heart rhythm disturbances. It’s often linked to kidney issues, medications that affect potassium balance, or excessive potassium supplementation.
Since potassium levels are tightly regulated by the kidneys, even small imbalances can be clinically significant. If your potassium level falls outside the normal range, follow up with your healthcare provider to determine the cause and next steps.
Optimal range: 90 - 111 mmol/L
Potassium, RBC (Red Blood Cell Potassium) measures the concentration of potassium inside your red blood cells, rather than in your blood plasma. While standard potassium tests assess levels in the fluid portion of the blood, this test gives insight into longer-term intracellular potassium status—which is where the majority of your body's potassium is actually stored.
Optimal range: 5 - 50 mcg/L
Pyridoxal 5'-Phosphate (PLP), also known as the active form of vitamin B6, is a versatile and essential coenzyme in various enzymatic reactions in the body, particularly in amino acid metabolism. Serving as a coenzyme for over 100 enzymes, PLP plays a pivotal role in biochemical processes including transamination, decarboxylation, and glycogen phosphorylase activity. Its transaminase activity is crucial for the synthesis and breakdown of amino acids, aiding in the interconversion between amino acids and alpha-keto acids.
Optimal range: 3 - 30 mcg/L
Pyridoxic Acid (PA), often referred to as B6Pro, is a significant metabolite of Vitamin B6 that serves as a reliable biomarker for assessing vitamin B6 status in the body. Vitamin B6, a collective term for several related compounds including pyridoxal, pyridoxine, and pyridoxamine, is essential for numerous physiological functions, particularly those involved in amino acid metabolism, neurotransmitter synthesis, and hemoglobin formation. When Vitamin B6 is metabolized in the body, it is primarily converted into Pyridoxic Acid, which is then excreted in the urine.
Optimal range: 1.6 - 6.1 mg/dL
RBP is a sensitive marker of undernutrition and the monitoring of its serum concentration allows the monitoring of nutritional status.
Retinol-binding protein (RBP) is an unglycosylated protein synthesised by the liver. The role of RBP is to transport retinol (vitamin A) from the liver to the target tissues (retina, skin, etc.) in the bloodstream. This protein is then metabolized, filtered and reabsorbed in the kidney.
Optimal range: 1 - 19 mcg/L
Riboflavin, also known as Vitamin B2, is a water-soluble vitamin that plays a crucial role in energy production, cellular function, and metabolism. It is a component of two major coenzymes, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), which are key players in the metabolism of carbohydrates, fats, and proteins, facilitating the production of energy (ATP) in the body. Riboflavin is also essential for the regeneration of glutathione, one of the body's main antioxidants, thus playing a significant role in protecting cells from oxidative stress and damage. Additionally, Vitamin B2 is involved in the conversion of other B vitamins, including niacin (B3) and pyridoxine (B6), into their active forms, making it essential for maintaining overall B vitamin metabolism. Its role extends to the development and function of the skin, lining of the digestive tract, blood cells, and many other parts of the body.
Optimal range: 650 - 1340 pg/mL
Vitamin B12 binding capacity, unsaturated (transcobalamin) refers to the ability of transcobalamin, a protein in the blood, to bind to and transport vitamin B12 within the body. Transcobalamin plays a crucial role in the transport of vitamin B12 from the intestines to various tissues where it is utilized in essential physiological processes.
Optimal range: 20.1 - 62 ug/dL , 0.72 - 2.21 umol/L
Vitamin A is one of the fat-soluble vitamins required for health. It’s especially important for vision, skin and mucous membranes found surrounding all organs. Vitamin A provides free radical-fighting functions for immunity and for anti-aging.
Optimal range: 66.5 - 200 nmol/L , 22.43 - 67.46 ng/mL
Vitamin B1, also called thiamine, is important for nervous system and muscle function. Thiamine acts as a coenzyme for carbohydrate and amino acid metabolism. It also is essential for the production of hydrochloric acid.
Optimal range: 78 - 185 nmol/L
Vitamin B1, also known as Thiamine, plays a crucial role in maintaining optimal blood health. As a water-soluble vitamin, it is essential for the proper functioning of the circulatory system and is particularly vital in the metabolism of glucose, which is the primary energy source for the body and especially important for the brain and nervous system. Thiamine helps in the production of red blood cells and in the maintenance of healthy endothelial cells, which line the blood vessels, thus ensuring efficient nutrient and oxygen transport throughout the body.
Optimal range: 232 - 1245 pg/mL , 171.22 - 918.81 pmol/L , 232 - 1245 ng/L
Vitamin B12 is essential in many basic bodily functions. High levels are not usually cause for concern, but low levels may indicate a medical deficiency or disease. In America, food such as cereal and grains are enriched with many essential vitamins, including vitamin B12. For this reason, dietary deficiency is rare.
Optimal range: 6.2 - 39 nmol/L
Vitamin B2, also known as Riboflavin, is a vital nutrient that plays an essential role in maintaining overall health, particularly in energy metabolism and cellular function. As a key component of the B-vitamin family, Riboflavin is crucial for breaking down proteins, fats, and carbohydrates, facilitating the conversion of nutrients into usable energy for the body. Its impact on energy production makes it especially important for maintaining a healthy metabolic rate. Additionally, Vitamin B2 is instrumental in maintaining the health of the skin, eyes, blood cells, and mucous membranes, promoting good vision and skin health. It also aids in the absorption of other nutrients, particularly iron, and is essential for growth and development. Found in a variety of foods including milk, eggs, lean meats, green vegetables, and enriched grains and cereals, Riboflavin is readily available through a balanced diet.
Optimal range: 6.2 - 39 nmol/L
Vitamin supplementation within 24 hours prior to blood draw may affect the accuracy of results.
Vitamin B2 is involved in metabolism of fats, carbohydrates, and protein. The clinical manifestations of deficiency are non-specific.
Clinical manifestations include mucocutaneous lesions of the mouth and skin, corneal vascularization, anemia, and personality changes.
Optimal range: 137 - 370 ug/L
Vitamin B2, measured in whole blood, is a vital biomarker for assessing nutritional status and guiding health interventions. Its importance in energy metabolism, antioxidant defense, and cellular repair underscores the need for adequate riboflavin levels in the body. Whole blood testing offers a reliable and comprehensive reflection of long-term riboflavin status, making it a valuable tool in both clinical and preventive healthcare.
Optimal range: 0 - 110 ng/mL
The Vitamin B3 marker on a blood panel, representing Niacin or Nicotinic Acid levels, is a critical indicator of nutritional health and metabolic function. Vitamin B3 plays a pivotal role in numerous cellular processes, primarily in energy production and the synthesis of fatty acids and cholesterol. Its significance in the blood panel lies in its ability to regulate metabolism, particularly in converting nutrients into energy, making it essential for the maintenance of healthy skin, nerves, and digestive systems. Adequate levels of Vitamin B3 in the blood are crucial for preventing deficiency disorders like pellagra, characterized by dermatitis, diarrhea, and dementia.
Optimal range: 0.5 - 8.45 ug/ml
Other names: Niacin / Nicotinamide / Nicotinic Acid
Niacin (nicotinic acid) is a water-soluble vitamin that is also referred to as vitamin B3.
Nicotinamide (nicotinic acid amide) is the derivative of niacin that is incorporated into the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP).
Optimal range: 0 - 275 ng/mL
Vitamin B5, scientifically known as Pantothenic Acid, is a crucial nutrient whose levels are often measured in blood panels to assess overall health and nutritional status. As an essential component of coenzyme A, Vitamin B5 is fundamental in various metabolic processes, including the synthesis and breakdown of fats, proteins, and carbohydrates. This makes it vital for energy production and the proper functioning of several bodily systems. The presence of adequate Vitamin B5 levels in a blood panel is indicative of good health, as it supports adrenal function, aids in the production of red blood cells, and is essential for synthesizing cholesterol and certain hormones.
Optimal range: 3.4 - 65.2 ug/L , 13.76 - 263.81 nmol/L
Vitamin B6 is a water-soluble vitamin involved in energy production, synthesis of hemoglobin, serotonin, dopamine, and amino acids, and other enzymatic reactions in the body.
Optimal range: 2.1 - 21.7 ng/mL
The Vitamin B6 (Plasma) marker on a blood panel is an essential indicator of nutritional and metabolic health, reflecting the levels of Pyridoxine in the body. Vitamin B6 is crucial in numerous biochemical reactions, particularly in amino acid metabolism, neurotransmitter synthesis, and hemoglobin formation. It plays a significant role in cognitive development, immune function, and the regulation of mood, owing to its involvement in creating important neurotransmitters like serotonin and norepinephrine. Adequate levels of Vitamin B6 in the blood are indicative of good dietary intake and proper absorption, as the vitamin is found in a variety of foods, including poultry, fish, potatoes, chickpeas, and bananas.
Optimal range: 0.05 - 0.83 ng/mL
Vitamin B7, or biotin, is an essential nutrient with diverse roles in energy metabolism, gene regulation, and maintaining healthy skin, hair, and nails. Though deficiency is rare, testing for biotin levels can be useful in certain clinical contexts, particularly when symptoms suggest a metabolic or nutritional imbalance. Awareness of biotin supplementation is crucial, especially for patients undergoing lab testing, to prevent test interference.
Optimal range: 3 - 20 ng/mL , 6.8 - 45.32 nmol/L , 3 - 20 ug/L
Folate belongs to the B vitamin family and is used for healthy cell development. Folate is water-soluble and is expelled daily in urine. For this reason, it is important that our diets have enough folate in them to make up for the loss. Deficiency can easily be caused by conditions that impair absorption in the digestive tract.
Folate refers to the many forms of vitamin B-9. These include folic acid, dihydrofolate (DHF), tetrahydrofolate (THF), and more. The body uses B vitamins to create new cells.
Folic acid is a synthetic form of folate. Food manufacturers add it to many products because it does not occur naturally. Bread, pasta, rice, and breakfast cereals tend to contain added folic acid.
Folate Reference Ranges (ng/mL):
Optimal range: 0.2 - 2.3 mg/dL , 11.36 - 130.59 umol/L
Vitamin C is a water-soluble vitamin that functions in immunity, the synthesis of collagen and neurotransmitters, and protein metabolism. It’s an antioxidant that slows down aging. Deficiency is called scurvy.
Optimal range: 30 - 100 ng/mL , 74.88 - 249.6 nmol/L
Vitamin D is a fat-soluble vitamin in a family of compounds that includes vitamins D1, D2, and D3.
Vitamin D is both a nutrient we eat and a hormone our bodies make. It is a fat-soluble vitamin that has long been known to help the body absorb and retain calcium and phosphorus; both are critical for building bone.
Also, laboratory studies show that vitamin D can:
- reduce cancer cell growth,
- help control infections
- and reduce inflammation.
Many of the body’s organs and tissues have receptors for vitamin D, which suggest important roles beyond bone health, and scientists are actively investigating other possible functions.
Vitamin D helps your body absorb calcium and maintain strong bones throughout your entire life.
Vitamin D must go through several processes in your body before your body can use it. The first transformation occurs in the liver. Here, your body converts vitamin D to a chemical known as 25-hydroxyvitamin D, also called calcidiol.
Optimal range: 5.9 - 19.4 mg/L
Vitamin E, particularly in the form of alpha-tocopherol, is a critical antioxidant that helps protect cells from oxidative stress, supports cardiovascular and immune health, and prevents various conditions related to oxidative damage. Monitoring its levels through lab testing can be important for individuals with malabsorption disorders, poor dietary intake, or those at risk of oxidative stress-related diseases. Optimal vitamin E levels are essential for maintaining overall health and preventing potential complications.
Optimal range: 0.5 - 5.5 mg/L
Vitamin E is a family of eight related compounds, including four tocopherols and four tocotrienols. While alpha-tocopherol is the main form found in human tissues, gamma-tocopherol is the most common form in the U.S. diet, especially from soybean and corn oils. In contrast, European diets, which rely more on olive and sunflower oils, contain much less gamma-tocopherol—leading to significantly lower blood levels compared to Americans.
Vitamin E acts as a fat-soluble antioxidant, protecting cell membranes and polyunsaturated fatty acids from free radical damage. Gamma-tocopherol contributes to this defense, though it can be reduced when alpha-tocopherol is taken in high amounts through supplementation. Including multiple forms of vitamin E in the diet—through foods like nuts, seeds, and vegetable oils—supports a more complete antioxidant balance.
Optimal range: 7 - 25.1 mg/L
A vitamin E test measures the amount of vitamin E in your blood. Vitamin E (also known as tocopherol or alpha-tocopherol) is a nutrient that is important for many body processes. It helps your nerves and muscles work well, prevents blood clots, and boosts the immune system. Vitamin E is a type of antioxidant, a substance that protects cells from damage.
Optimal range: 0 - 4.4 mg/L
Vitamin E, particularly its beta and gamma tocopherol components, is a highly beneficial nutrient well-regarded for its antioxidant properties and vital role in maintaining overall health. As one of the eight forms of Vitamin E, beta-gamma tocopherol stands out for its potent ability to neutralize harmful free radicals in the body, thus playing a critical role in preventing oxidative stress, a key factor in the development of chronic diseases. This form of Vitamin E is essential for immune system function, skin health, and the prevention of inflammation-related disorders. It is naturally found in a variety of foods including nuts, seeds, and vegetable oils, making it easily accessible through a balanced diet.
Optimal range: 130 - 1500 pg/mL
Vitamin K is a fat-soluble vitamin crucial for blood clotting, bone health, and cardiovascular function. Assessing Vitamin K status is complex, as there is no single gold-standard biomarker. Several biomarkers are used to evaluate Vitamin K levels, each with its own strengths and limitations.
Optimal range: 0.1 - 2.2 ng/mL
Vitamin K1 is essential for blood clotting and bone health, and you can get it from various plant-based foods like leafy greens.
Optimal range: 878 - 1660 ug/dL , 8.78 - 16.6 mg/L
Zinc is an essential trace element. Subnormal levels are associated with alcoholic cirrhosis, cystic fibrosis, myocardial infarction, acute and chronic infections. High levels may be due to industrial exposure.
Muscle Health
Keeping your muscles healthy will help you to be able to walk, run, jump, lift things, play ... Healthy muscles let you move freely and keep your body strong.
Optimal range: 0 - 66 mcg/L
Myoglobin, Serum, is a key diagnostic marker, widely recognized in the medical field for its critical role in the early detection of muscle damage, including acute myocardial infarction (heart attack). Myoglobin is a small, oxygen-binding protein found primarily in heart and skeletal muscle tissues. When muscle tissue is damaged, myoglobin is rapidly released into the bloodstream, making its serum levels an important acute marker for muscle injury.
Kidney Health
Your kidneys help maintain blood pressure, keep the blood's acid-base level within a healthy range, and filter the blood so nutrients are absorbed and waste is passed out of the body as urine. Your kidney function reflects how well your kidneys are filtering your blood. Abnormal kidney function could result in the accumulation of waste products in the body, which can cause fatigue, headaches, nausea, and more.
Optimal range: 0.52 - 1.27 mg/L
Cystatin C is a small protein produced by nearly all cells in the body and released into the bloodstream. It is filtered out of the blood exclusively by the kidneys, making it a valuable indicator of kidney function. Under normal circumstances, your kidneys maintain a stable level of cystatin C in the blood. However, if kidney function begins to decline, cystatin C levels increase, often before other signs of kidney damage become apparent.
Optimal range: 0 - 2 mcmol/L
What is Oxalate?
Oxalate (or oxalic acid) is a naturally occurring substance found in many foods and also produced as a waste product in the body. It is not essential for human health and is typically excreted in the urine. In the bloodstream, oxalate levels are usually very low under normal circumstances.
The Oxalate, Serum/Plasma test measures the concentration of oxalate circulating in your blood. This test is primarily used to:
Evaluate primary or secondary hyperoxaluria (a condition of excessive oxalate production or absorption)
Assess risk for calcium oxalate kidney stones
Monitor kidney function in patients with known oxalate-related disorders
Help diagnose oxalate nephropathy, a rare but serious kidney condition
Optimal range: 9 - 23 Ratio
Optimal range: 3.8 - 8.4 mg/dL , 0.23 - 0.5 mmol/L , 226.02 - 499.63 µmol/L
Uric acid is a natural byproduct formed during the breakdown of our body’s cells and the food that we eat. Excess uric acid can be caused by either an overproduction of uric acid or inefficient removal of it from the blood. The most common affliction associated with excess uric acid is gout, a painful form of arthritis.
May indicate oxidative stress and elevated levels are associated with cardiovascular disease and diabetes. May be elevated due to gout, kidney dysfunction, excess alcohol intake, starvation, extreme calorie restriction, liver dysfunction, hemolytic anemia, excess fructose consumption, fungal infection, ketogenic diet, supplemental niacin, high protein diet, prolonged fasting, supplemental vitamin B3, excess acidity. May be decreased due to nutrient deficiencies (molybdenum, zinc, iron), oxidative stress, low purine intake (vegetarian or vegan), excess alkalinity.
Optimal range: 2.5 - 7 mg/dL
Uric acid is a waste product formed when the body breaks down purines, which are natural substances found in certain foods and cells. Uric acid levels are commonly assessed through blood tests as part of a metabolic or comprehensive health evaluation. In females, the normal reference range for uric acid is generally lower compared to males due to hormonal differences, particularly the effects of estrogen, which promotes uric acid excretion by the kidneys.
White Blood Cell Differential Test
The White Blood Differential Test measures the percentage (and absolute values) of each type of white blood cell (WBC) that you have in your blood.
Five different types of white blood cells, also called leukocytes, normally appear in the blood:
- Neutrophils
- Lymphocytes
- Monocytes
- Eosinophils
- Basophils
The test shows if the number of cells are in proper proportion with one another, and if there is more or less of one cell type.
What do abnormal results mean?
Any infection or acute stress increases your number of white blood cells. High white blood cell counts may be due to inflammation, an immune response, or blood diseases such as leukemia. It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.
Although your white blood cells account for only about 1 percent of your blood, their impact is significant. White blood cells are essential for good health and protection against illness and disease. Think of white blood cells as your immunity cells. In a sense, they are continually at war. They flow through your bloodstream to battle viruses, bacteria, and other foreign invaders that threaten your health. When your body is in distress and a particular area is under attack, white blood cells rush in to help destroy the harmful substance and prevent illness. White blood cells are produced inside the bone marrow and stored in your blood and lymphatic tissues. Because some white blood cells have a short lifespan of one to three days, your bone marrow is constantly producing them.
Optimal range: 0 - 750 cells/uL
Optimal range: 0 - 0 cells/uL
Optimal range: 0 - 0 cells/uL
Optimal range: 0 - 1 %
Lymphocytes are a type of white blood cell (leukocyte) involved in the immune response. Atypical lymphocytes are generally lymphocytes that have been activated to respond to a viral infection or sometimes a bacterial or parasitic infection.
A few atypical lymphocytes are probably of little clinical significance. A large number of atypical lymphocytes are often found in viral infections like mononucleosis, cytomegalovirus infections and hepatitis B. Toxoplasmosis, certain bacterial infections, medications, stress and autoimmune diseases can also be accompanied by a larger number of atypical lymphocytes.
Atypical lymphocytes can also be observed in patients with several viral infections, such as Epstein-Barr virus infection, cytomegalovirus infection, rubella, Hantavirus infection, viral hepatitis and HIV infection.
Several studies have shown that atypical lymphocytes have also been found in the peripheral blood and bronchoalveolar lavage (BAL) samples of COVID-19 patients. It may reflect the disease pathophysiology and provide important information about the diagnosis or prognosis of the disease.
Optimal range: 0 - 0 x10/9/l
Atypical lymphocytes, quantified as x10^9/L on a White Blood Cell (WBC) Differential panel, are a crucial diagnostic marker, indicative of various pathological conditions. These cells, larger than typical lymphocytes, often exhibit irregular shapes and a more abundant cytoplasm, which can be either pale or deeply basophilic. Their nucleus may be lobulated or indented, contrasting with the typical round or slightly indented nucleus of standard lymphocytes.
Optimal range: 0 - 6 %
Band neutrophils are the immature form of a white blood cell found in our bodies. All white blood cells act as a defense mechanism against stress and infection. An unusually high level of band neutrophils typically indicates the presence of a bacterial infection or inflammation of tissue.
Optimal range: 0 - 0.2 x10E3/uL , 0 - 200 cells/uL
Basophils are a type of white blood cell that helps defend against allergens, pathogens, and parasites. They have a short lifespan of one to two days and play a key role in the immune response.
As granulocytes, basophils contain histamine and heparin, which regulate inflammation. Histamine widens blood vessels, triggering allergy symptoms like sneezing and a runny nose, while heparin prevents excessive blood clotting.
Basophils also interact with immunoglobulin E (IgE), working alongside mast cells to release histamine and serotonin, amplifying allergic and inflammatory responses.
Though small in number, basophils are essential for immune defense and allergic reactions.
Optimal range: 0 - 1 %
Basophils are a type of white blood cell (leukocyte) that plays a key role in your immune system, particularly in defending your body against allergens, pathogens, and parasites. Despite their small numbers—they make up less than 1% of your white blood cells—basophils are essential in managing allergic reactions and inflammatory responses.
Optimal range: 0 - 0.4 x10E3/uL , 0 - 400 cells/mcL
Eosinophils are a type of white blood cell that helps defend against parasites, allergens, bacteria, and viruses. They make up less than 5% of all white blood cells but play a key role in immune responses.
An elevated eosinophil count may indicate infection or an allergic reaction, while very high levels could signal an underlying health condition.
Eosinophils destroy invading pathogens and contribute to inflammation, particularly in allergies, asthma, and eczema. While inflammation helps control infections, it can also damage surrounding tissues, making eosinophils both protective and a factor in allergic diseases.
Optimal range: 0 - 6 %
Eosinophils are a type of white blood cell (leukocyte) that play a key role in protecting your body from infections, allergens, and foreign invaders. These cells are part of your immune system and are responsible for defending against parasites, bacteria, fungi, and viruses. Eosinophils account for less than 5% of your total white blood cell count, but their presence is crucial in immune responses.
An increased number of eosinophils can indicate that your body is fighting an infection, managing an allergic reaction, or dealing with a more serious health condition if levels are significantly elevated.
Eosinophils are active participants in your immune system and have several critical functions, including:
Eosinophils are central to your body’s inflammatory response, particularly in cases of allergies. When your immune system identifies a threat, such as a parasite or allergen, eosinophils release chemicals to attack the invader. This process triggers inflammation, which helps isolate and control the immune response at the site of infection or irritation.
However, while inflammation is a protective mechanism, it can also lead to tissue damage in the surrounding area. Chronic inflammation, such as that seen in allergies, asthma, or eczema, can result in discomfort and other long-term health effects.
Eosinophils are a critical component of your immune system, playing a dual role in protecting your body and managing inflammatory responses. While they are essential for fighting infections and parasites, they also play a major role in allergic reactions, which can lead to chronic inflammation if left unmanaged. Monitoring eosinophil levels through blood tests can provide insights into your immune health and help diagnose underlying conditions.
Optimal range: 1.5 - 6.5 x10E3/µL
GRAN# (Absolute Granulocyte Count) measures the total number of granulocytes (a type of white blood cell) per microliter (uL) of blood. Granulocytes play a critical role in the immune system, helping the body fight infections and inflammation.
Granulocytes are a type of white blood cell (WBC) that contain granules filled with enzymes to destroy pathogens. They include:
Since neutrophils make up the majority of granulocytes, GRAN# is often closely related to the Absolute Neutrophil Count (ANC).
Optimal range: 39 - 78 %
Gran% (Granulocyte Percentage) represents the proportion of granulocytes—a type of white blood cell (WBC)—relative to the total WBC count in a Complete Blood Count (CBC) with Differential test. Granulocytes are a crucial part of the immune system, defending the body against infections and inflammation.
Optimal range: 0.7 - 3.1 x10E3/uL , 700 - 3100 cells/uL
Lymphocytes are a type of white blood cell essential for immune defense. They help the body fight infections, diseases, and foreign invaders. As part of the immune system, lymphocytes work alongside lymph nodes, tissues, and organs to protect against threats.
Lymphocytes identify and remember antigens (foreign substances like bacteria, viruses, and toxins). After encountering an antigen, some develop into memory cells, allowing for a faster, stronger response upon re-exposure. This mechanism is the basis for vaccinations.
Lymphocytes continuously monitor the body for threats, interacting with phagocytes (monocytes, macrophages) and dendritic cells to coordinate immune responses.
Optimal range: 20 - 40 %
Lymphocytes are a type of white blood cell that plays a vital role in your immune system. They help your body fight off diseases and infections by identifying and targeting harmful invaders like bacteria, viruses, and toxins. As part of a complex network of immune cells, lymph nodes, lymphatic tissues, and organs, lymphocytes are essential for maintaining your body’s defense system.
T Lymphocytes (T Cells):
B Lymphocytes (B Cells):
Natural Killer (NK) Cells:
Lymphocytes have the unique ability to remember antigens, which are foreign substances that trigger an immune reaction. After encountering an antigen, some lymphocytes become memory cells. These memory cells enable the immune system to respond faster and more effectively when exposed to the same antigen again. This mechanism is the foundation of how vaccines protect against certain diseases.
Lymphocytes are constantly surveying the body, searching for antigens—from the common cold to cancerous cells. They interact with other immune cells, such as phagocytes (e.g., monocytes and macrophages) and specialized cells like dendritic cells, to coordinate a targeted immune response.
In summary, lymphocytes are key players in your immune system, working to detect, respond to, and remember harmful invaders, ensuring long-term protection and immunity.
Optimal range: 0 - 0 %
Optimal range: 0 - 0.5 MM3
In a Complete Blood Count (CBC), the readings labeled MID# and MID% refer to the mid-sized cells population in the blood, which typically include monocytes, eosinophils, and basophils. These are types of white blood cells (WBCs), and these measurements give information about their absolute number and percentage relative to the total white blood cell count.
Optimal range: 2 - 6 %
In a Complete Blood Count (CBC), the readings labeled MID# and MID% refer to the mid-sized cells population in the blood, which typically include monocytes, eosinophils, and basophils. These are types of white blood cells (WBCs), and these measurements give information about their absolute number and percentage relative to the total white blood cell count.
Optimal range: 0.1 - 0.9 x10E3/uL , 0.1 - 0.9 x10^9/L , 0.1 - 0.9 abs , 100 - 900 cells/uL
Monocytes are a type of white blood cell (leukocyte) that plays a key role in immune defense. They circulate in the blood and tissues, identifying and eliminating viruses, bacteria, fungi, and infected cells.
When a pathogen enters the body, monocytes transform into macrophages or dendritic cells. Macrophages kill invaders, while dendritic cells alert other immune cells to respond.
Monocytes are the largest white blood cells, about twice the size of red blood cells. Although they are few in number, they are essential for protecting the body against infections.
Optimal range: 4 - 8 %
Monocytes are a type of white blood cell (leukocyte) that plays a critical role in your immune system. They help protect your body by identifying and eliminating harmful invaders, such as viruses, bacteria, fungi, and protozoa, while also removing infected or damaged cells.
Monocytes circulate in your bloodstream and move into tissues when needed. Once they encounter an invader or detect cellular damage, they can:
When germs or bacteria invade your body, monocytes transform into either macrophages or dendritic cells:
Monocytes are the largest type of white blood cell, roughly twice the size of red blood cells. While they are not as numerous as other white blood cells, their versatility and ability to coordinate immune responses make them essential in defending the body against infection and maintaining immune health.
Monocytes play a dual role:
Although monocytes are less abundant than other white blood cells, their size, adaptability, and role in signaling make them powerful defenders in the fight against infections. These immune cells are vital for recognizing threats, coordinating responses, and keeping your body healthy.
Optimal range: 0 - 0.1 %
Myelocytes are immature white blood cells, primarily found in the bone marrow, and their presence in a peripheral blood sample is unusual and significant. A white blood cell (WBC) differential test, which measures the types and numbers of white blood cells in the bloodstream, can detect myelocytes.
The presence of these cells often indicates a disruption in the normal maturation process of white blood cells, commonly due to a hematological condition or bone marrow disorder. Conditions such as chronic myelogenous leukemia (CML), other forms of leukemia, severe infections, or bone marrow stress can lead to the premature release of myelocytes into the bloodstream.
Optimal range: 0 - 2.9 Ratio
NLR (Neutrophil to Lymphocyte Ratio) is a biomarker that can be used as an indication of subclinical inflammation. NLR is a calculation based on the Absolute Neutrophil Count divided by the Absolute Lymphocyte Count determined by the peripheral blood CBC differential. This calculation, according to recent literature, is useful in assessing the likelihood of severe progression of disease in SARS-CoV-2 positive patients.
Optimal range: 1.4 - 7 x10E3/uL , 1400 - 7000 cells/uL
Neutrophils are the most abundant white blood cells, essential for immune defense. They are produced in the bone marrow and travel through the bloodstream and tissues to combat infections.
As phagocytic cells, neutrophils engulf and destroy bacteria, viruses, and other invaders at infection sites. They also play a role in the inflammatory response, helping the body react to allergens and injuries.
Neutrophils are clear in color and typically spherical when at rest, but they change shape to fight infections effectively.
Optimal range: 50 - 70 %
Neutrophils are the most abundant type of white blood cell (WBC) in the human body and are critical to your immune system's function. As phagocytic cells, their primary role is to engulf and destroy harmful invaders like bacteria and viruses, especially at the site of an injury or infection.
Beyond their role in combating infections, neutrophils are also involved in the body’s inflammatory response. They respond to allergens, injuries, or infections by releasing enzymes and signaling other immune cells, which contributes to inflammation—a natural process that helps protect and heal the body.
With their dual role in immunity and inflammation, neutrophils are indispensable for maintaining your overall health and defending against a wide range of pathogens.
Optimal range: 1.3 - 7 x10E3/uL
Polymorphs (Absolute), also known as the Absolute Neutrophil Count (ANC) or POLYS, ABS. COUNT, is a lab test that measures the number of neutrophils (a type of white blood cell) in a specific volume of blood, typically expressed in cells per microliter (cells/µL).
Neutrophils are a type of polymorphonuclear leukocyte (hence “polymorphs”), and they play a critical role in the body’s immune response, especially in defending against bacterial and fungal infections.
Optimal range: 40 - 75 %
Polymorphs (%), also referred to as Neutrophils (%), is a measurement of the proportion of neutrophils in your white blood cell (WBC) count. Neutrophils are a type of polymorphonuclear leukocyte, hence the term "polymorphs." They are the most abundant type of white blood cells and a key component of the body’s innate immune system, responsible for quickly responding to infections, particularly those caused by bacteria and fungi.
This test is commonly included in a Complete Blood Count (CBC) with differential, which shows the relative percentages of different types of white blood cells in your blood.
Optimal range: 1.5 - 8.5 cells/mcL
Neutrophils are the most abundant type of white blood cell in the found. They are phagocytic, meaning that they engulf and destroy things like bacteria and viruses at the site of an injury. Like all other white blood cells, they also play a part in our body’s inflammatory response to things like allergens.
Optimal range: 47 - 55 %
Neutrophils are the most abundant type of white blood cell found in the body. They are phagocytic, meaning that they engulf and destroy things like bacteria and viruses at the site of an injury. Like all other white blood cells, they also play a part in our body’s inflammatory response to things like allergens.
A slightly elevated result for segmented neutrophils may indicate a variety of potential conditions or responses in the body. Segmented neutrophils, also known as mature neutrophils, are a type of white blood cell that plays a crucial role in the immune response by helping to fight bacterial infections.
Here are some possible causes for a slightly elevated segmented neutrophil count:
Bacterial Infections: The most common cause of an increase in neutrophils is bacterial infections. Neutrophils are often mobilized in response to an infection to help combat invading bacteria.
Inflammation: Any form of inflammation in the body, including chronic inflammatory conditions like rheumatoid arthritis, can lead to an elevated neutrophil count.
Stress Response: Physical or emotional stress can trigger an increase in neutrophil levels. This could occur due to intense exercise, surgery, or other acute stressors.
Steroid Use: Certain medications, especially corticosteroids, can cause an increase in neutrophils as they suppress the activity of the immune system in other ways.
Tissue Damage: If there is tissue damage, such as trauma or burns, neutrophil levels may rise as part of the healing and inflammatory response.
Smoking: Smoking can cause mild elevations in neutrophil levels due to the chronic inflammatory effects of cigarette smoke on the respiratory system.
Leukemoid Reaction: A leukemoid reaction is a temporary increase in white blood cells, often due to a severe infection or inflammation, that can mimic leukemia but is not caused by cancer.
Other Causes: Conditions like pregnancy, certain cancers, or bone marrow disorders can sometimes result in elevated neutrophil counts.
In general, a slightly elevated count for segmented neutrophils is not necessarily concerning on its own, but it should be interpreted in the context of other symptoms, test results, and medical history. If there are any other abnormal findings or symptoms, it would be helpful to consult with a healthcare provider to determine the underlying cause.
Pancreas Health
The pancreas is a glandular organ in the digestive system and endocrine system of vertebrates. In humans, it is located in the abdominal cavity behind the stomach. It is an endocrine gland producing several important hormones, including insulin, glucagon, somatostatin, and pancreatic polypeptide which circulate in the blood. The pancreas is also a digestive organ, secreting pancreatic juice containing digestive enzymes that assist digestion and absorption of nutrients in the small intestine. These enzymes help to further break down the carbohydrates, proteins, and lipids in the chyme.
Optimal range: 28 - 100 IU/L
An amylase test measures the amount of amylase in your blood or urine. Amylase is an enzyme that helps your body break down carbohydrates during digestion. Most of the amylase is produced by your pancreas and salivary glands.
Normally, small amounts of amylase are present in your blood and urine. However, abnormal levels—either too high or too low—can be a sign of a disorder affecting the pancreas, salivary glands, or other health conditions.
Optimal range: 31 - 110 U/L
Our bodies use amylase for the digestion of carbohydrates. Primarily the pancreas produces it, and unusual levels of amylase in the blood may point to a problem with the pancreas or the gynecological organs in women. An amylase test is often done along with a lipase test to assess pancreatic health.
Optimal range: 13 - 78 U/L
Lipase is an enzyme produced by the pancreas and is used for digestion. Therefore, abnormal lipase levels are usually indicative of a pancreatic disorder. A healthcare professional may order a lipase test to diagnose or monitor such a condition.
Optimal range: 26.1 - 518.1 pg/mL
Pancreatic Polypeptide: A Key Marker for Pancreatic Health and Endocrine Function
Pancreatic Polypeptide (PP) is a 36-amino acid hormone secreted by the F-cells in the pancreas, playing an essential role in regulating digestive functions, pancreatic secretion, and appetite. As a critical component of the pancreas's endocrine system, it is involved in controlling pancreatic enzyme release and influencing gastrointestinal motility.
Optimal range: 169 - 773 ng/mL
Trypsin is an enzyme made in the pancreas that helps digest protein foods. In pancreatitis, trypsin levels increase in the blood. The trypsin test is the most accurate test for acute pancreatitis.
Urinalysis
A urinalysis is a test of your urine. A urinalysis is used to detect and manage a wide range of disorders, such as urinary tract infections (aka UTI), kidney disease and diabetes.
A urinalysis involves checking the appearance, concentration and content of urine. Abnormal urinalysis results may point to a disease or illness.
For example, a urinary tract infection can make urine look cloudy instead of clear. Increased levels of protein in urine can be a sign of kidney disease. Unusual urinalysis results often require more testing to uncover the source of the problem.
Why a urinalysis is performed:
Optimal range: 0.1 - 0.45 ug/mg creatinine
The "24 Hour Urine Iodine" test offered by Doctor's Data Laboratory is a diagnostic tool used to evaluate iodine levels in the body. This test is essential for assessing thyroid gland function, immune response, and estrogen metabolism. Iodine is a crucial element required for normal thyroid function and overall health, including metabolic regulation and neurological development. Insufficient iodine can lead to issues like thyroid deficiency, weight gain, loss of energy, goiter, and impaired mental function.
Optimal range: 0 - 30 mg/24 hr
Optimal range: 0 - 0 %
Albumin is one of the proteins found in your blood. If albumin shows up in your urine, it may be a sign of kidney damage.
Optimal range: 0 - 0 %
Alpha-2 globulins is a class of proteins that has many functions in the body and is involved in inflammation.
Optimal range: 0 - 0 %
Alpha-2 globulins is a class of proteins that has many functions in the body and is involved in inflammation.
Optimal range: 5 - 30 ug/L
The Aluminum, Urine Test by Labcorp is designed to monitor patients for both prior and ongoing exposure to aluminum. This test is especially important for patients at risk of aluminum toxicity, including:
- Infants on parenteral fluids, particularly those receiving parenteral nutrition
- Burn patients receiving intravenous albumin, especially those with coexisting renal failure
- Adult and pediatric patients with chronic renal failure, as they can accumulate aluminum more readily from medications and dialysate
- Adult patients on parenteral nutrition, although the risk has decreased in recent years
- Individuals with occupational or industrial exposure to aluminum
Optimal range: 0 - 32 ug/24 hr
The Aluminum, Urine 24-Hour Test is a diagnostic tool used to measure the amount of aluminum excreted in urine over a 24-hour period. This test is particularly valuable for assessing aluminum exposure and monitoring individuals at risk of aluminum toxicity. Aluminum, while naturally occurring in the environment, can become toxic when accumulated in the human body at elevated levels. Exposure to high levels of aluminum can occur through various sources, including environmental exposure, industrial settings, medical treatments, and certain medications.
Optimal range: 0 - 49 ug/g creat
The aluminum/creatinine (Al/Crt) ratio is a critical biomarker used to assess aluminum exposure and potential toxicity, especially in patients who are at risk of accumulating toxic levels of aluminum. This ratio is obtained by measuring the amount of aluminum excreted in the urine relative to creatinine, a waste product that reflects kidney function. By adjusting aluminum levels to creatinine, the test accounts for variations in urine concentration, making it a more accurate marker of aluminum exposure, especially in individuals with impaired renal function.
Reference range: None, Few, Many
In a urinalysis, the term "Amorphous Sediment" refers to a substance found in urine that lacks a defined shape under a microscope. The word "amorphous" literally means "without form" or "shapeless." When present in large amounts, this sediment typically consists of fine particles or crystals that do not have a clear, identifiable structure.
Reference range: Clear, Cloudy, Extremely Turbid, Turbid
Urine appearance can serve as an essential indicator of an individual's health status. Normal urine is typically clear and pale yellow in color, indicating proper hydration and the absence of significant health issues. However, various factors can influence urine appearance, such as hydration levels, diet, medications, and certain medical conditions.
Optimal range: 0 - 19 ug/L
Arsenic, a toxic heavy metal, can accumulate in the body. It may be of an organic or inorganic (toxic form) source. High levels cause GI distress, kidney problems, skin, heart and nervous system changes in health.
Optimal range: 0 - 50 ug/L
Arsenic is an element found in nature, and in man-made products, including some pesticides. Arsenic is widely distributed in the Earth’s crust. It is found in water, air, food, and soil.
Optimal range: 0 - 50 ug/24 hr
Arsenic is an element found in nature, and in man-made products, including some pesticides. Arsenic is widely distributed in the Earth’s crust. It is found in water, air, food, and soil.
Reference range: None seen/Few, Moderate, Detected
If bacteria grow in the urine culture test and you have symptoms of an infection or bladder irritation, it means you have a UTI (= Urinary tract infection).
Urine contains fluids, salts and waste products but is sterile or free of bacteria, viruses and other disease-causing organisms. A UTI occurs when bacteria from another source, such as the nearby anus, gets into the urethra. The most common bacteria found to cause UTIs is Escherichia coli (E. coli). Other bacteria can cause UTI, but E. coli is the culprit about 90 percent of the time.
E. coli normally lives harmlessly in the human intestinal tract, but it can cause serious infections if it gets into the urinary tract. In women, the trip from the anus to the urethra is a short one. This is the reason why "wiping front to back" after using the toilet is helpful in preventing UTI.
Optimal range: 0 - 0 %
Beta globulin proteins help carry substances, such as iron, through the bloodstream and help fight infection. They should normally not be detected in urine.
Optimal range: 0 - 0 mg/dL
Bilirubin is primarily derived from metabolism of hemoglobin. Only conjugated bilirubin is excreted into the urine and normally only trace amounts can be detected in urine.
Optimal range: 0 - 1 ug/L
Cadmium is a toxic heavy metal found in soil, water, and air. Plants may contain high levels; foods that tend to accumulate it include soy, rice, tobacco, sunflower seeds and leafy greens. Health problems result from cadmium exposure.
Reference range: None or few, Moderate, Many
Calcium oxalate crystals are the most common cause of kidney stones — hard clumps of minerals and other substances that form in the kidneys. These crystals are made from oxalate — a substance found in foods like green, leafy vegetables — combined with calcium. Having too much oxalate or too little urine can cause the oxalate to crystalize and clump together into stones.
Kidney stones can be very painful. They can also cause complications like urinary tract infections. But they are often preventable with a few dietary changes.
Optimal range: 0 - 0 mg/dL
Optimal range: 47 - 462 mg/24 hr , 1.17 - 11.53 mmol/24 hr
A calcium in urine test measures the amount of calcium in your urine. Calcium is one of the most important minerals in your body. You need calcium for healthy bones and teeth. Calcium is also essential for proper functioning of your nerves, muscles, and heart. Almost all of your body's calcium is stored in your bones.
Optimal range: 110 - 250 mmol/24 hr
Chloride is the most abundant ion outside of cells. It is important for maintaining osmotic pressure, nerve cell function, and fluid balance. The urine chloride test is used primarily in cases of suspected metabolic alkalosis.
Reference range: Yellow, Red, Hazy, Light orange, Dark Yellow, Dark Brown, Colorless
The color of your urine changes with your hydration level but may also change due to pigments in your food or while taking medication. Certain color changes may signal a health condition that needs medical attention.
Optimal range: 7.1 - 48.7 mcg/g creat
Coproporphyrin I is a porphyrin metabolite arising from heme synthesis.
Optimal range: 4.1 - 76.4 mcg/g creat
Coproporphyrin III is a porphyrin derivative.
Small amounts of porphyrins (coproporphyrin) are excreted in normal human urine. Coproporphyrin also is present in bile and feces.
Optimal range: 0.3 - 3 g/L , 30 - 300 mg/dL
A creatinine test reveals important information about your kidneys.
Creatinine is a chemical waste product of creatine, an amino acid made by the liver and stored in the liver. Creatinine is the result of normal muscle metabolism. The chemical enters your bloodstream after it’s broken down. Your kidneys remove it from your blood. The creatinine then exits the body through urination.
Optimal range: 0 - 0 mg/dL
Optimal range: 1400 - 2600 mg/d
The "Creatinine Urine Excretion" test is a valuable component of urinalysis that helps in evaluating the health and functioning of the kidneys. Essentially, this test measures the amount of creatinine that is expelled from the body through urine over a certain period, which is usually 24 hours.
Optimal range: 800 - 1800 mg/24 hr
What does the Creatinine, Ur 24hr test measure?
A creatinine urine test measures the amount of creatinine — a byproduct of muscle movement and meat digestion — in the urine.
This test is done to see how well your kidneys are working — this is useful for diagnosing or ruling out kidney disease and other conditions affecting the kidneys.
If creatinine levels fall outside the normal range, this does not always signal a problem, but it can sometimes indicate an issue with the kidneys. If the results are abnormal, a doctor is likely to order additional tests to check for kidney issues.
Creatinine can also be measured by a blood test.
Optimal range: 100 - 500 ug/L
The biomarker Creatinine-Corrected Urine Iodine is an essential measure in evaluating iodine levels in the body, normalized against creatinine levels in urine. This correction accounts for variations in urine concentration, making the results more accurate for assessing iodine status across different hydration levels.
What Is Iodine and Why Is It Important?
Iodine is a vital micronutrient required for the production of thyroid hormones, which regulate metabolism, growth, and development. Adequate iodine intake is particularly crucial during pregnancy, infancy, and childhood to support brain development and prevent thyroid dysfunction.
Why Correct for Creatinine?
Creatinine is a waste product of muscle metabolism, excreted at a relatively constant rate in urine. By correcting iodine levels against creatinine, the test provides a more reliable measure of iodine status, independent of factors like fluid intake or urine dilution.
Reference range: Normal, Abnormal
Optimal range: 0 - 99999 cfu/ml
Escherichia coli, commonly known as E. coli, is a significant bacterium often identified in urine culture panels, especially in the context of urinary tract infections (UTIs). This rod-shaped, Gram-negative bacterium is part of the normal flora of the human gut, but when it spreads to the urinary tract, it becomes a primary pathogen causing discomfort and health issues. A urine culture panel is a critical diagnostic tool used to detect and identify bacteria in urine samples, particularly E. coli, which is responsible for approximately 80-90% of UTIs. The presence of E. coli in a urine culture is a clear indication of infection, necessitating prompt and appropriate antibiotic treatment.
Optimal range: 0 - 0 %
The gamma-globulin fraction contains the immunoglobulins, a family of proteins that function as antibodies.
Optimal range: 0 - 15 mg/dL
Glucose is usually not present in urine, because in the kidneys glucose is reabsorbed from the filtrate of glomerulus, across the tubular epithelium of proximal tubule into the bloodstream.
Optimal range: 0 - 2.9 mcg/g creat
Heptacarboxyporphyrin is a Porphyrin.
Porphyrins are precursors of heme and usually only occur in urine in negligible amounts.
Optimal range: 0 - 5.4 mcg/g creat
Hexacarboxyporphyrin is a Porphyrin. Porphyrins are precursors of heme and usually only occur in urine in negligible amounts.
Optimal range: 0 - 1.9 casts/lpf
Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called urinalysis. Hyaline casts can be present in low numbers (0-1/LPF) in concentrated urine of otherwise normal patients and are not always associated with renal disease.
Optimal range: 100 - 460 ug/24 hr
Monitor exposure to iodine; evaluate for iodine deficiency disorders (IDDs), excessive iodine intake, or iodine in the workplace
Iodine is an essential element for thyroid hormone production. The Iodine 24 Hour Urine Test measures the amount of iodine excreted from the body. It monitors a person’s exposure to iodine and evaluates for iodine deficiency disorders, excessive iodine intake or iodine in the workplace.
Because levels of substances like iodine can fluctuate throughout the day, evaluating a urine collection over 24 hours can provide a more accurate evaluation than a urine test which only looks at a single collection.
Urinary Iodine levels can help determine if a person is getting healthy amounts of iodine from the food they eat. Unusually high or low levels of iodine can lead to a number of disorders such as hyperthyroidism or hypothyroidism.
This test is usually ordered when someone has had irregular results from thyroid tests such as TSH, T3 and T4. Pregnant and nursing women are often tested for iodine because deficiency can have adverse effects on pregnancy and cause developmental difficulties in infants.
Optimal range: 34 - 523 mcg/L
Measurement of urinary iodine excretion provides the best index of dietary iodine intake.
Optimal range: 28 - 544 ug/L
Monitor exposure to iodine; evaluate for iodine deficiency disorders (IDDs), excessive iodine intake, or iodine in the workplace
Iodine is an essential element for thyroid hormone production. It monitors a person’s exposure to iodine and evaluates for iodine deficiency disorders, excessive iodine intake or iodine in the workplace.
Urinary Iodine levels can help determine if a person is getting healthy amounts of iodine from the food they eat. Unusually high or low levels of iodine can lead to a number of disorders such as hyperthyroidism or hypothyroidism.
This test is usually ordered when someone has had irregular results from thyroid tests such as TSH, T3 and T4. Pregnant and nursing women are often tested for iodine because deficiency can have adverse effects on pregnancy and cause developmental difficulties in infants.
Optimal range: 0 - 0 Units
What are ketones?
Ketones are produced when the body burns fat for energy. Normally, your body gets the energy it needs from carbohydrates in your diet. But stored fat is broken down and ketones are made if your diet does not contain enough carbohydrate to supply the body with sugar (glucose) for energy or if your body can't use blood sugar (glucose) properly.
Having some ketones in your urine is normal. However, high ketone levels in urine may be a sign of too much acid in your body (ketoacidosis). The most common and life-threatening type of ketoacidosis is a complication of diabetes called diabetic ketoacidosis (DKA). If left untreated DKA can cause damage to organs and even death. This is why it is important to know the signs of ketonuria and when to check your ketone levels with a urine or blood test.
Reference range: Normal, Abnormal
When K. pneumoniae enters the urinary tract, it can lead to a UTI. A UTI can affect any part of the urinary system, including the urethra, kidneys, bladder, and ureters. Symptoms include a strong, frequent need to urinate, burning sensation during urination, pelvic pain, and cloudy, bloody, or strong-smelling urine. Women are at a greater risk for UTIs than men.
As a gram-negative, encapsulated, non-motile bacterium, it is inherently resistant to multiple antibiotics, making its role in UTIs particularly concerning. Klebsiella pneumoniae primarily inhabits the gastrointestinal tract but can become opportunistic in immunocompromised individuals or when introduced into typically sterile areas like the urinary tract. UTIs caused by this bacterium are often more complicated to treat due to its resistance to commonly used antibiotics, such as penicillins and cephalosporins.
Klebsiella pneumoniae ssp (subspecies) is known for its thick, prominent capsule, which is a key virulence factor. This capsule helps the bacteria evade the host's immune response, allowing it to establish infection more effectively. When it infects the urinary tract, it can lead to a range of symptoms, from mild bladder infections (cystitis) to severe kidney infections (pyelonephritis). The presence of this bacterium in the urinary tract can be particularly dangerous in hospital settings, where it may cause nosocomial infections.
The treatment of UTIs caused by Klebsiella pneumoniae often requires the use of more potent antibiotics, such as carbapenems or aminoglycosides, which are reserved for more severe infections due to their potential side effects and the risk of further promoting antibiotic resistance.
Optimal range: 0 - 80 mcg/L
Lead is a potentially toxic element found in paints, batteries, electronics, and ceramics as well as in air, soil, and water. A urine test is a noninvasive test that can detect high levels of lead and prevent potential health issues.
Optimal range: 0 - 29 ug/L
Lead is a potentially toxic element found in paints, batteries, electronics, and ceramics as well as in air, soil, and water. A urine test is a noninvasive test that can detect high levels of lead and prevent potential health issues.
Optimal range: 0 - 0 Units
Leukocyte esterase is a test used to detect a substance that suggests there are white blood cells in the urine. This may mean you have a urinary tract infection (UTI).
Optimal range: 0 - 0 %
M-protein is an abnormal protein produced by myeloma cells that accumulates in and damages bone and bone marrow.
Optimal range: 2 - 8 mmol/24 hr
Magnesium is a crucial mineral that plays an essential role in various physiological processes, including nerve function, muscle contraction, bone structure, and energy production. It is one of the most abundant cations in the human body, predominantly stored in bones, with a smaller proportion circulating in the blood and intercellular spaces. Maintaining an appropriate magnesium balance is vital for health, and disorders in magnesium homeostasis can lead to a variety of clinical problems. One method to assess magnesium levels is through a 24-hour urine test, which measures how much magnesium is excreted in the urine over the course of a day. This test can offer important insights into the body's magnesium metabolism, kidney function, and overall mineral balance.
Optimal range: 0.5 - 3 mcg/L
The "Manganese, 24 Hr, Urine" test measures the concentration of manganese in a 24-hour urine sample. Manganese is an essential trace element involved in various bodily functions, including metabolism, bone formation, and the functioning of the nervous system. It acts as a cofactor for several enzymes involved in antioxidant defense, collagen synthesis, and cellular energy production.
This test is primarily used to evaluate the levels of manganese excreted through urine, which can provide insights into exposure to manganese, particularly in individuals who work in environments where manganese is present (e.g., mining, welding, or certain industrial processes). Elevated manganese levels can indicate occupational or environmental exposure, while lower levels are typically not a concern, as manganese is essential in small amounts.
Optimal range: 0 - 19 ug/L
Mercury, abbreviated Hg, comes in inorganic and organic forms. Both are toxic when they accumulate in the body and are associated with serious health problems.
Optimal range: 0 - 20 ug/24 hr
SOURCES:
Mercury (Hg) has three forms:
Elemental (metallic)- older glass thermometers, fluorescent light bulbs, dental amalgams, folk remedies, combustion, electrical industry (switches, batteries, thermostats), solvents, wood processing
Organic (methyl mercury)- seafood, thimerosal (preservative), fungicides
Inorganic- skin lightening compounds, industrial exposure, folk medicine, lamps, photography, disinfectants
Optimal range: 0 - 5 ug/g creat
Optimal range: 0 - 25 ug/mmol
The Methyl Histamine to Creatinine Ratio (Methyl Histamine/Crea. ratio) is a clinical biomarker used primarily to assess histamine metabolism and to indirectly gauge mast cell activity. Methyl histamine is a metabolite of histamine, a key inflammatory mediator involved in allergic reactions, immune responses, and physiological regulation, such as in gastric acid secretion and neurotransmission.
Reference range: Rare, 1+
Other names: microscopic urine analysis, microscopic examination of urine, urine test, urine analysis, UA
Mucus in the urine is usually a common finding, as mucus is normally produced throughout the urinary tract to line it and protect it from can be a sign of a urinary or intestinal abnormality. However, excessive amounts of mucus in the urine or other changes to urine consistency or color.
The presence of some mucus filaments in the urine is normal and usually does not require treatment. However, if other abnormalities in the urine are noted, or if you have other symptoms, the doctor may recommended medications, depending on the underlying cause of the mucus.
A mild to moderate amount of mucus that appears thin and clear ir a normal finding. Urine tests that detect small amounts of mucus with no other abnormalities also does not require any medical intervention. However, copious amounts of mucus, or mucus that is thick, cloudy or pus-like may be a sign of infection or another condition. If you notice these symptoms, you should consult a gynecologist, urologist or family doctor for assessment and treatment as deemed necessary.
Optimal range: 0 - 0 Units
The presence of nitrates in urine is often considered a predictor of a urinary tract infection (UTI). Urinary tract infections are the most common cause of nitrites in urine. These occur when bacteria infect the bladder, ureters, or kidneys. Nitrites are byproducts of nitrogen waste. Bacteria responsible for an infection feed on this waste, breaking it down into nitrates, which can appear in the urine.
Optimal range: 50 - 1200 mOsm/kg
Osmolality (U), also known as urine osmolality, measures the concentration of dissolved particles, such as electrolytes, urea, and glucose, in urine. It provides insight into how well the kidneys are functioning and maintaining the body's fluid balance. By measuring urine osmolality, doctors can evaluate how the kidneys are responding to different conditions, such as dehydration or excessive fluid intake. This test is usually done by analyzing a urine sample, which helps determine the concentration of particles and offers important information about kidney health and the body's ability to regulate water and electrolytes.
Optimal range: 0 - 3.5 mcg/g creat
Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low levels in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Optimal range: 400 - 1300 mg/24 hr
Phosphorus is an essential mineral that plays a vital role in many bodily functions, including the formation of bones and teeth, energy production, and the functioning of cells and tissues. When it comes to urinalysis, the presence and levels of phosphorus can provide important information about a person's kidney function and overall health. The kidneys help regulate phosphorus levels in the blood, and when they are not functioning properly, phosphorus levels can become abnormal.
Optimal range: 0 - 10 ×10^6/L
Polymorphonuclear leukocytes (PMNs) are a type of white blood cell (WBC) that include neutrophils, eosinophils, basophils, and mast cells. PMNs are a subtype of leukocytes, which protect the body against infectious organisms.
PMNs are also known as granulocytes. They play a central role in the innate immune system.
In normal conditions, the most common PMN, by far, is the neutrophil. These make up the most significant amount of blood cells produced by the bone marrow and are the first line of defense in protecting the body from infection.
If your doctor tests your urine and finds too many leukocytes, it could be a sign of infection.
Optimal range: 50 - 300 mg
Porphyrins are natural chemicals in the body that help form many important substances in the body. One of these is hemoglobin, the protein in red blood cells that carries oxygen in the blood.
Optimal range: 25 - 125 mmol/24 hr
Potassium is an electrolyte that helps your cells and organs work. Your body needs it to digest food, keep your heart beating right, and various other activities. You get most of your potassium from foods. Your body uses what it needs, and your kidneys put the rest into your urine as waste.
Optimal range: 30 - 150 mg/24 hr
The 24-hour urine protein test measures the amount of protein excreted in urine over a 24-hour period. This can help detect kidney disease or other conditions that affect kidney function. The normal range for this test is less than 150 milligrams per day. Factors that can affect the results include dehydration, recent contrast material for an x-ray, vaginal fluids in urine, severe stress, strenuous exercise, and urinary tract infections
Optimal range: 0 - 200 mg/g creat
A Protein/Creatinine Ratio (PCR), also known as the Urine Protein Creatinine Ratio (UPCR) test, measures the levels of protein and creatinine in urine. This ratio helps evaluate kidney function and detect conditions like kidney disease or proteinuria (excess protein in the urine).
The UPCR test is valuable in diagnosing and monitoring kidney-related issues, including chronic kidney disease, diabetic nephropathy, and hypertensive nephropathy. Additionally, it can help healthcare providers determine the effectiveness of treatment plans for these conditions.
Optimal range: 5 - 7 cells / HPF
Pus cells refer to term given to the accumulation of dead white blood cells (WBCs) at the site of infection. When these pus cells are present in the human urine, the condition is known as Pyuria. It is normal for some pus cells to be present in the urine sample, however, an elevated number of pus cells in the urine sample are an indication of some underlying infection.
Optimal range: 0 - 2 /hpf
Red blood cells can enter the urine from the vagina in menstruation or from the trauma of bladder catheterization (a procedure used to diagnose and treat cardiovascular conditions).
Optimal range: 39 - 258 mmol/24 hr
Sodium is an important electrolyte (a mineral in your blood and other bodily fluids) that helps your body and cells function. It helps your body regulate how much fluid it retains.
Optimal range: 0 - 3 HPF
>10 x 106/L squamous epithelial cells indicate skin/mucosal contamination of the sample.
What are epithelial cells?
Epithelial cells are the cells on the body's surface, such as the skin, urinary tract, blood vessels, and organs. They act as a protective barrier, stopping viruses from entering the body. Besides the protective function, epithelial cells perform other functions as well, such as:
→ Help with sensory detection of taste, smell or sight as they transfer signals through the sensory nerve endings
→ Secrete hormones, enzymes, hormones, and fluids
→ Absorb certain substances, such as nutrients from the food
→ Epithelial cells in the kidney excrete waste, and epithelial cells in the sweat glands excrete sweat
→ Filter blood, dirt, and particles
→ Allow selective diffusion of materials to pass through
In general, epithelial cells act as a barrier between the outside and inside of your body, and help protect your body from viruses.
Optimal range: 23.3 - 132.4 mcg/g creat
Porphyrins are natural chemicals in the body that help form many important substances in the body such as hemoglobin, the protein in red blood cells that carries oxygen in the blood. Porphyrins are normally present at low concentrations in blood and other body fluids, such as urine.
Optimal range: 0 - 20 mg/dL
The Total Protein, Urine test measures the amount of protein in the urine and is an essential diagnostic tool for assessing kidney health. Healthy kidneys filter waste from the blood, keeping necessary proteins in the bloodstream and removing excess waste in the urine. However, when kidney function is compromised, proteins such as albumin can leak into the urine, indicating potential kidney damage.
Reference range: Undetected, Detected
Optimal range: 0 - 0 mg/d
Urine occult blood is a test to determine if there is blood present in the urine and is done, along with several other tests, during a routine analysis of the urine. Although some urine in the blood isn’t unusual, it can also indicate severe problems with the kidneys or cancer.
Optimal range: 5 - 7.5 pH
Urine pH is a test to assess the pH level of your urine and is done, along with several other tests, during a routine analysis of the urine. Although some fluctuation of urine pH is normal, excessively acidic or alkaline urine can indicate a problem with the kidneys or digestive system.
Optimal range: 1 - 1.03 SG
Urinalysis is a series of tests that analyze the chemical composition of urine to assess overall health. One important measurement in urinalysis is urine specific gravity (SG), which indicates the concentration of substances in the urine. This is typically done by dipping a test strip into the urine, where chemical reactions cause color changes that are then analyzed.
Urine specific gravity measures how concentrated urine is compared to pure water. The specific gravity of water is 1.000, and urine with no dissolved substances would have a similar reading. However, since urine naturally contains dissolved substances like salts, minerals, and waste products, a specific gravity of 1.000 is not possible in humans.
Optimal range: 0.2 - 2 mg/dL
Urobilinogen comes from the transformation of bilirubin, a product of the breakdown of hemoglobin in the red blood cells (=heme catabolism).
Urobilinogen is formed from bilirubin by intestinal bacteria in the duodenum (=the first part of the small intestine). Most urobilinogen is excreted in the feces (90%). A portion of it is absorbed back into the blood (around 10%). Around 5% is transported back to the liver and re-secreted into bile again. The remaining urobilinogen (5%) is transported by the blood into the kidneys where it is converted into yellow urobilin and is excreted giving urine its characteristic yellow color.
Optimal range: 4.1 - 22.4 mcg/g creat
Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low levels in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Optimal range: 0.7 - 7.4 mcg/g creat
Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low levels in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Optimal range: 0 - 10 /hpf
Urine is a generally thought of as a sterile body fluid, therefore, evidence of white blood cells or bacteria in the urine is considered abnormal and may suggest a urinary tract infection such as, bladder infection (cystitis), infection of kidney (pyelonephritis).
Reference range: None seen, Present
The presence of yeast in a urinalysis is an important marker that can indicate a potential infection or imbalance in the urinary tract. Yeast are fungi, and their presence in urine usually suggests a yeast infection, commonly caused by the fungus Candida. This type of infection is more prevalent in women, though men can also be affected. Symptoms often include itching, burning during urination, and a thick, white discharge. Various factors can contribute to the development of a yeast infection, such as antibiotic use, which disrupts the normal bacterial balance, diabetes, which provides excess sugar that can promote yeast growth, or a weakened immune system. Detecting yeast in a urinalysis involves examining a urine sample under a microscope.
Immune System
This category encompasses a variety of biomarkers that provide insights into the functioning and health of the immune system. It includes markers like 14.3.3 ETA PROTEIN, relevant for synovial inflammation in rheumatoid arthritis, Acetylcholine Receptor (AChR) Antibody, indicating neuromuscular junction disorders, and Activated partial thromboplastin time (APTT) for clotting time assessment. Other biomarkers like Alpha 2-Macroglobulins and various ANA screens offer insights into chronic liver diseases, autoimmune diseases, and the presence of autoantibodies. This comprehensive category aids in diagnosing, monitoring, and managing a wide range of immune-related conditions.
Optimal range: 0 - 0.2 ng/mL
The 14-3-3eta protein is a marker of synovial inflammation that is released into synovial fluid and peripheral blood in rheumatoid arthritis (RA) and erosive psoriatic arthritis.
Reference range: Negative, Positive
21-Hydroxylase Antibody is an autoantibody that targets 21-hydroxylase, a key enzyme involved in the production of cortisol and aldosterone in the adrenal glands. The presence of these antibodies is commonly associated with autoimmune adrenal insufficiency, particularly Addison’s disease.
This test is primarily used to:
- Diagnose autoimmune adrenal insufficiency (Addison’s disease)
- Differentiate autoimmune causes of adrenal failure from other causes (e.g., infections, genetic conditions, or medication-induced adrenal suppression)
- Identify individuals at risk for developing adrenal insufficiency, especially in people with other autoimmune diseases
Optimal range: 0 - 0.45 nmol/L
At the normal neuromuscular junction, a nerve cell tells a muscle cell to contract by releasing the chemical acetylcholine (ACh). ACh attaches to the ACh receptor — a pore or “channel” in the surface of the muscle cell — twisting it open and allowing an inward flux of electrical current that triggers muscle contraction.
Optimal range: 22.9 - 30.2 seconds
The Activated partial thromboplastin time (aPTT) test tells you how many seconds (s) it takes your blood to form a clot after body tissue(s) or blood vessel walls were injured.
Optimal range: 400 - 900 mU/g Hb
Adenosine Deaminase (ADA) is an enzyme that plays a vital role in the breakdown of adenosine, a building block of DNA and RNA. This enzyme is essential for the proper development and function of the immune system, especially for T lymphocytes (T cells), which are white blood cells that help the body fight infections and diseases. Without sufficient ADA activity, toxic byproducts can accumulate and disrupt immune function.
Optimal range: 110 - 276 mg/dL
- Alpha-2-Macroglobulin is produced in the liver.
- Increased concentrations are associated with patients with some chronic liver diseases, nephrotic syndrome, and diabetes.
- Decreased concentrations are associated with patients with pancreatitis, rheumatoid arthritis, and multiple myeloma.
Optimal range: 0 - 100 ng/mL , 0 - 100 pg/mL
Alpha Melanocyte Stimulating Hormone (α-MSH) is a peptide with diverse roles in the human body, particularly known for its involvement in skin pigmentation. It's a derivative of the larger pro-opiomelanocortin (POMC) molecule, which is a precursor for several other hormones. The primary function of α-MSH is to stimulate the production of melanin, the pigment responsible for skin and hair color, by acting on melanocytes, the cells in the skin that produce melanin. This process is essential for skin tanning and plays a role in protecting skin from UV radiation.
Optimal range: 0 - 10 units/ml
ANA IFA is a first line screen for detecting the presence of up to approximately 150 autoantibodies in various autoimmune diseases. A positive ANA IFA result is suggestive of autoimmune disease and reflexes to titer and pattern. Further laboratory testing may be considered if clinically indicated.
Antinuclear antibodies (ANA) are auto-antibodies against nuclear components, including double and single stranded DNA and histones. These antibodies can be detected with an ANA test. In this technique, a fluorescent-labeled immunoglobulin is used to detect immunoglobulin in the patient's serum against nuclear components.
Optimal range: 0 - 10 units/ml
ANA IFA is a first line screen for detecting the presence of up to approximately 150 autoantibodies in various autoimmune diseases. A positive ANA IFA result is suggestive of autoimmune disease and reflexes to titer and pattern. Further laboratory testing may be considered if clinically indicated.
Antinuclear antibodies (ANA) are auto-antibodies against nuclear components, including double and single stranded DNA and histones. These antibodies can be detected with an ANA test. In this technique, a fluorescent-labeled immunoglobulin is used to detect immunoglobulin in the patient's serum against nuclear components.
Optimal range: 0 - 0.01 Units
ANA IFA is a first line screen for detecting the presence of up to approximately 150 autoantibodies in various autoimmune diseases. A positive ANA IFA result is suggestive of autoimmune disease and reflexes to titer and pattern. Further laboratory testing may be considered if clinically indicated.
Reference range: Negative, Positive
The ANA Screen, IFA (Antinuclear Antibody Screen by Immunofluorescence Assay) is a key diagnostic test for detecting antinuclear antibodies, associated with autoimmune diseases like lupus and rheumatoid arthritis. This sensitive method uses fluorescent dye-tagged antibodies, visible under a microscope, to identify autoimmune activity. Although a positive result indicates autoimmune activity, it's not definitive for any specific disease, necessitating further tests for accurate diagnosis. The ANA Screen, IFA is vital for early detection and management of autoimmune disorders.
Reference range: <1:40 -- Negative, 1:40 to 1:80 -- Low Antibody Level, >1:80 -- Elevated Antibody Level
The ANA titer is a measure of the amount of ANA in the blood; the higher the titer, the more autoantibodies are present in the sample.
Patient samples are often screened for antinuclear antibodies after being diluted 1:40 and 1:160 in a buffered solution. If staining is observed at both the 1:40 and 1:160 dilutions, then the laboratory continues to dilute the sample until staining can no longer be seen under the microscope. The level to which a patient's sample can be diluted and still produce recognizable staining is known as the ANA "titer."
Optimal range: 0 - 20 Units
Serial testing shows that increasing amounts of IgG anti-C1q predict renal flares in SLE patients. Elevated serum titers of anti-C1q antibodies tend to be associated with proliferative forms of lupus, glomerulonephritis and subendothelial deposits of immune complexes.
Optimal range: 0 - 4 IU/ml
The anti-dsDNA test identifies the presence of these autoantibodies in the blood.
The test for anti-dsDNA, along with other autoantibody tests, may be used to help establish a diagnosis of lupus and distinguish it from other autoimmune disorders.
The anti-double-stranded DNA antibody (anti-dsDNA) is a specific type of ANA antibody found in about 30% of people with systemic lupus. Less than 1% of healthy individuals have this antibody, making it helpful in confirming a diagnosis of systemic lupus. The absence of anti-dsDNA, however, does not exclude a diagnosis of lupus.
The presence of anti-dsDNA antibodies often suggests more serious lupus, such as lupus nephritis (kidney lupus). When the disease is active, especially in the kidneys, high amounts of anti-DNA antibodies are usually present. However, the anti-dsDNA test cannot be used to monitor lupus activity, because anti-dsDNA can be present without any clinical activity. Three tests are currently used to detect anti-dsDNA antibodies, namely enzyme-linked immunosorbent assay (ELISA), the Crithidia luciliae immunofluorescence test, and a test called radioimmunoassay.
Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren syndrome and mixed connective tissue disease (MCTD).
Optimal range: 0 - 8 IU/ml
The anti-double stranded DNA (anti-dsDNA) tests are used to help diagnose and monitor lupus, also called systemic lupus erythematosus or SLE, a chronic inflammatory autoimmune disorder in which the immune system mistakenly targets the body’s own cells and tissues.
Your doctor may order an anti-dsDNA if you have a positive antinuclear antibody (ANA) test and symptoms associated with lupus, such as persistent fatigue, pain in your joints, and a red rash resembling a butterfly across the nose and cheeks. Anti-dsDNA tests are also periodically used to assess disease activity in people who have already been diagnosed with lupus.
Optimal range: 0 - 8 IU/ml
The Anti-dsDNA antibody test, particularly the Farr assay, is a highly specific diagnostic tool pivotal in the evaluation and management of systemic lupus erythematosus (SLE), a complex autoimmune disorder. Double-stranded DNA (dsDNA) antibodies are a type of antinuclear antibody (ANA) that specifically target the DNA within the cell nucleus. These antibodies are considered one of the hallmark indicators of SLE, with their presence being a key criterion in the diagnosis of the disease.
The Farr assay, a radioimmunoassay, is renowned for its high specificity in detecting anti-dsDNA antibodies. This assay utilizes radiolabeled DNA to capture antibodies from a patient's serum. The bound antibodies are then measured, providing a quantitative assessment of the anti-dsDNA antibodies present. A positive Farr assay is strongly indicative of SLE, as these antibodies are rarely found in healthy individuals or those with other autoimmune disorders.
Optimal range: 0 - 10 Units
Anti-Fodrin Ab, IgA (RDL) is a useful autoimmune marker for identifying immune system activity targeting glandular tissues, particularly in suspected Sjögren’s syndrome. It may be especially helpful in early-stage or seronegative cases, providing another diagnostic tool when traditional markers are absent. If you’re experiencing symptoms like dry mouth, dry eyes, or salivary gland swelling, this test can offer important insight.
Optimal range: 0 - 10 Units
Anti-Fodrin Ab, IgG (RDL) is a valuable marker for detecting autoimmune activity affecting the body’s moisture-producing glands. It plays a key role in supporting the diagnosis of Sjögren’s syndrome, especially when other antibodies are negative but symptoms persist. Early detection can lead to better symptom control and monitoring for related autoimmune conditions.
Reference range: Normal, Abnormal
The Anti-IgE test measures specific antibodies in your blood that target Immunoglobulin E (IgE), a molecule involved in allergic responses. This test can help identify allergy-related conditions and assess immune system health, especially if you're considering or are already undergoing anti-IgE treatment.
Optimal range: 0 - 20 CU
Anti-RNP antibodies are a key biomarker used in diagnosing autoimmune diseases, particularly mixed connective tissue disease (MCTD), where they are present in nearly all patients. These antibodies target the U1 small nuclear ribonucleoprotein (U1 snRNP) and are also found in other conditions such as systemic lupus erythematosus (SLE), scleroderma, and polymyositis, though in lower percentages. While high levels of anti-RNP antibodies are diagnostic of MCTD, they can also indicate milder disease manifestations in other autoimmune conditions, such as Raynaud's phenomenon and less severe renal involvement in SLE. Testing methods like ELISA and immunoblotting are commonly used to detect these antibodies, which provide valuable insights into autoimmune disease mechanisms but must be interpreted alongside clinical symptoms and other diagnostic results.
Optimal range: 0 - 7 U/mL
The Anti-Smith Antibody targets your body’s own proteins and is found almost exclusively in people with lupus. Though not all people with lupus have this antibody (only around 30%), those who do usually receive a diagnosis of lupus. Anti-Smith antibody is more common in blacks and Asians with SLE (around 60%) than in whites with SLE.
Optimal range: 0 - 12 APL U/mL
- Anticardiolipins are antibodies produced by the immune system against the platelet membrane phospholipids responsible for the coagulation of blood clots.
- Anticardiolipin antibodies are often responsible (with lupus anticoagulants and beta-2 glycoprotein antibodies) for the abnormal formation of clots in veins (phlebitis) and arteries (arterial thrombosis).
- They are involved in antiphospholipid syndrome, which occurs, for example, through repeated miscarriages during the second or third trimester of pregnancy.
There are three types of anticardiolipin antibodies: IgG, IgA and IgM.
Optimal range: 0 - 15 GPL U/mL
- Anticardiolipins are antibodies produced by the immune system against the platelet membrane phospholipids responsible for the coagulation of blood clots.
- Anticardiolipin antibodies are often responsible (with lupus anticoagulants and beta-2 glycoprotein antibodies) for the abnormal formation of clots in veins (phlebitis) and arteries (arterial thrombosis).
- They are involved in antiphospholipid syndrome, which occurs, for example, through repeated miscarriages during the second or third trimester of pregnancy.
There are three types of anticardiolipin antibodies: IgG, IgA and IgM.
Optimal range: 0 - 13 MPL
- Anticardiolipins are antibodies produced by the immune system against the platelet membrane phospholipids responsible for the coagulation of blood clots.
- Anticardiolipin antibodies are often responsible (with lupus anticoagulants and beta-2 glycoprotein antibodies) for the abnormal formation of clots in veins (phlebitis) and arteries (arterial thrombosis).
- They are involved in antiphospholipid syndrome, which occurs, for example, through repeated miscarriages during the second or third trimester of pregnancy.
There are three types of anticardiolipin antibodies: IgG, IgA and IgM.
Reference range: <1:80 (Negative), >1:80 (Positive)
The Antinuclear Antibody (ANA), HEp-2 Substrate, S test is a commonly used blood test to help diagnose autoimmune conditions. This test detects antinuclear antibodies—proteins made by your immune system that mistakenly attack healthy cells. These antibodies often target the nucleus of your cells, which is why they're called "antinuclear."
Reference range: Negative (<or=4), Indeterminate (5-9IU/mL), Positive (>or=10)
Antinuclear Antibodies (ANA) are a group of autoantibodies that target substances found in the nucleus of a cell. The ANA screen is a preliminary test used to detect the presence of these antibodies in the blood, which may indicate the presence of an autoimmune disorder. When an ANA screen yields a positive or indeterminate result, a Reflex ANA IFA (Indirect Fluorescent Antibody) test may be performed for a more detailed analysis. This test can identify specific patterns of fluorescence that correlate with various types of autoimmune diseases.
Additionally, the detection of double-stranded DNA (dsDNA) antibodies, through a reflex test, is especially significant as these are highly specific for systemic lupus erythematosus (SLE), a chronic autoimmune disease. The presence of dsDNA antibodies can be indicative of the disease activity and severity.
Optimal range: 0 - 0.99 Units
Antinuclear antibodies or ANAs are autoantibodies that react to substances within the nucleus of the cell. Antinuclear antibodies can react to almost anything with the nucleus including DNA, centromeres, histones, ribosomes, and other nuclear proteins.
Optimal range: 0 - 19 APS Units
This test is used as an aid in the diagnosis of certain autoimmune thrombotic disorders, such as antiphospholipid syndrome (aPS). Antibodies to PS/PT correlate with the presence of lupus anticoagulants (LA) and this test may be useful in cases with difficult LA test interpretation. This assay may also assist in the determination of risk for thrombosis as well as obstetric complications in patients with antiphospholipid antibodies.
Optimal range: 0 - 30 Units
This test is used as an aid in the diagnosis of certain autoimmune thrombotic disorders, such as antiphospholipid syndrome (aPS). Antibodies to PS/PT correlate with the presence of lupus anticoagulants (LA) and this test may be useful in cases with difficult LA test interpretation. This assay may also assist in the determination of risk for thrombosis as well as obstetric complications in patients with antiphospholipid antibodies.
Optimal range: 0 - 30 Units
This test is used as an aid in the diagnosis of certain autoimmune thrombotic disorders, such as antiphospholipid syndrome (aPS). Antibodies to PS/PT correlate with the presence of lupus anticoagulants (LA) and this test may be useful in cases with difficult LA test interpretation. This assay may also assist in the determination of risk for thrombosis as well as obstetric complications in patients with antiphospholipid antibodies.
Optimal range: 76 - 128 %
Antithrombin Activity (ATIII), also known as AT III or AT 3, is a key biomarker that measures how effectively antithrombin, a natural anticoagulant protein, functions in the blood. Antithrombin is crucial for regulating clot formation by inhibiting thrombin and clotting factors like factor Xa, helping maintain a balance between clotting and bleeding. Normal ATIII activity ranges from 80% to 120%.
A decrease in ATIII activity may indicate inherited or acquired deficiencies and is often linked to conditions like deep vein thrombosis (DVT), pulmonary embolism, liver disease, nephrotic syndrome, disseminated intravascular coagulation (DIC), or vitamin K deficiency. While elevated ATIII activity is less common, it may occur during inflammation, certain stages of pregnancy, or after antithrombin supplementation or anticoagulant therapy.
Optimal range: 0.84 - 1.21 IU/ml
Reference range: Sleepy, Awake
Reference range: Negative, Positive
Optimal range: 0 - 32 IU/ml
Bordetella pertussis is the bacterium responsible for causing whooping cough, a highly contagious respiratory illness. The Bordetella pertussis toxin (PT) IgG antibody test is an immunoassay (IA) designed to detect the presence of IgG antibodies against the pertussis toxin. These antibodies are produced by the immune system in response to an infection with Bordetella pertussis or, in some cases, following vaccination.
The presence of IgG antibodies to the pertussis toxin can indicate either a past infection with Bordetella pertussis or a response to a recent vaccination, as the pertussis vaccine (DTP or DTaP) contains inactivated components of the toxin. This marker is particularly useful for diagnosing recent or past infections, as well as for assessing immunity in individuals who may have been vaccinated or exposed to the bacteria.
Optimal range: 19 - 37 mg/dL
Optimal range: 67 - 100 %
C1 inhibitor is a multispecific, protease inhibitor that is present in normal human plasma and serum, and which regulates enzymes of the complement, coagulation, fibrinolytic, and kinin-forming systems. The enzymes (proteases) regulated by this protein include the C1r and C1s subunits of the activated first component of complement, activated XIIa, kallikrein (Fletcher factor), and plasmin.
Optimal range: 21 - 39 mg/dL
Measurement of the C1 esterase inhibitor (the first component of the complement) is used to diagnose hereditary angioedema and to monitor levels of the inhibitor during treatment.
The complement system is a group of nearly 60 proteins in blood plasma or on the surface of some cells. The complement proteins work with your immune system to protect the body from infections. They also help remove dead cells and foreign material. There are nine major complement proteins. They are labeled C1 through C9.
In some rare cases people may inherit deficiency of some complement proteins. These people are prone to certain infections or autoimmune disorders.
Optimal range: 0 - 3.9 ug Eq/mL
Optimal range: 55 - 486 ng/mL
desArg = without arginine
C3a desArg is a cleavage product of C3 complement component activation. Elevated levels of C3a have been reported in patients with acute lyme disease, acute pancreatitis, systemic lupus erythematosus, and adult respiratory distress syndrome.
Optimal range: 0 - 2830 ng/mL
C4a Level by RIA (Radioimmunoassay) is an important test in immunology, offering insights into the body's immune response, particularly in the context of inflammation and autoimmune disorders. The C4a component is a part of the complement system, a group of proteins in the blood that play a crucial role in the body's defense against infections and in the process of inflammation. When the complement system is activated in response to a threat like an infection, C4a is produced as a byproduct. Measuring the levels of C4a, therefore, can help in understanding if the complement system is overactive, which is often the case in autoimmune diseases or during certain allergic reactions.
Optimal range: 0 - 11 APL
- Anticardiolipins are antibodies produced by the immune system against the platelet membrane phospholipids responsible for the coagulation of blood clots.
- Anticardiolipin antibodies are often responsible (with lupus anticoagulants and beta-2 glycoprotein antibodies) for the abnormal formation of clots in veins (phlebitis) and arteries (arterial thrombosis).
- They are involved in antiphospholipid syndrome, which occurs, for example, through repeated miscarriages during the second or third trimester of pregnancy.
There are three types of anticardiolipin antibodies: IgG, IgA and IgM.
Optimal range: 0 - 14 GPL
- Anticardiolipins are antibodies produced by the immune system against the platelet membrane phospholipids responsible for the coagulation of blood clots.
- Anticardiolipin antibodies are often responsible (with lupus anticoagulants and beta-2 glycoprotein antibodies) for the abnormal formation of clots in veins (phlebitis) and arteries (arterial thrombosis).
- They are involved in antiphospholipid syndrome, which occurs, for example, through repeated miscarriages during the second or third trimester of pregnancy.
There are three types of anticardiolipin antibodies: IgG, IgA and IgM.
Optimal range: 0 - 12 MPL
- Anticardiolipins are antibodies produced by the immune system against the platelet membrane phospholipids responsible for the coagulation of blood clots.
- Anticardiolipin antibodies are often responsible (with lupus anticoagulants and beta-2 glycoprotein antibodies) for the abnormal formation of clots in veins (phlebitis) and arteries (arterial thrombosis).
- They are involved in antiphospholipid syndrome, which occurs, for example, through repeated miscarriages during the second or third trimester of pregnancy.
There are three types of anticardiolipin antibodies: IgG, IgA and IgM.
Optimal range: 4 - 13 umol/L
Carnitine esters are special molecules in our bodies that help turn fat into energy. Think of them as tiny taxis that pick up fat from our bloodstream and take it into the mitochondria, the powerhouses of our cells. Inside the mitochondria, this fat is burned for fuel, giving us the energy we need to function. These esters are made when carnitine, a substance our bodies produce and also get from food, links up with fatty acids.
This process is super important, especially in parts of our body like the heart and muscles, which use a lot of energy and therefore burn a lot of fat. If our body doesn't handle these carnitine esters correctly, it can mess up how we use fat for energy. This can lead to different health issues, such as muscle weakness or problems with our metabolism (the chemical reactions that keep us alive and kicking).
Doctors can check the levels of these esters in our blood to see if everything is working right with our body's energy production. Sometimes, when there's a problem with this system, doctors recommend taking extra carnitine as a supplement. But, the benefits of taking these supplements are still being studied, and it's not yet clear how much they help with various health conditions.
Optimal range: 4 - 13 umol/L
Carnitine esters are a group of compounds formed when carnitine binds to fatty acids. These esters play a critical role in the transport of long-chain fatty acids into the mitochondria, where they are used for energy production. This process is essential for cellular metabolism, particularly in tissues with high energy demands, such as muscles and the heart.
In a Carnitine and Acylcarnitine panel, the measurement of carnitine esters (expressed in µmol/L) provides valuable insight into the body's ability to metabolize fatty acids and produce energy efficiently. Elevated or decreased levels of carnitine esters can indicate underlying metabolic or mitochondrial disorders, and abnormalities may suggest issues with fatty acid metabolism, such as primary carnitine deficiency or other metabolic conditions.
Optimal range: 19 - 48 umol/L
Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary). Primary carnitine deficiency is an autosomal recessively inherited genetic condition that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter. Secondary carnitine deficiency can be seen in some disease states or in patients on carnitine-poor diets, but is also seen in a number of metabolic disorders. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitine ester is excreted in the urine, leading to a depletion of carnitine in the patient.
Optimal range: 25 - 58 umol/L
Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary). Primary carnitine deficiency is an autosomal recessively inherited genetic condition that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter. Secondary carnitine deficiency can be seen in some disease states or in patients on carnitine-poor diets, but is also seen in a number of metabolic disorders. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitine ester is excreted in the urine, leading to a depletion of carnitine in the patient.
Optimal range: 0 - 20 Units
Anti-cyclic citrullinated peptide (anti-CCP) is an antibody present in most rheumatoid arthritis patients.
Optimal range: 0 - 100 units/ml
Centromere B Antibody is diagnostic for the form of scleroderma known as CREST (calcinosis, Raynaud's phenomenon, esophageal immotility, sclerodactyly, and telangiectasia).
With a high specificity and a prevalence of 80 to 95%, antibodies against centromeres are pathognomonic for the limited form of progressive systemic sclerosis and can be detected even before the onset of the disease. If the corresponding clinical indication is given, the quantitative determination of antibodies with a monospecific test system, e.g. the Anti-Centromeres ELISA, is recommended.
Optimal range: 0 - 99 units/ml
Help to diagnose drug-induced lupus (DIL) and systemic lupus erythematosus (SLE). Antibodies to both chromatin and histones have been found in patients with procainamide-induced lupus; however, patients with lupus induced by drugs such as quinidine, penicillamine, methyldopa, and acebutolol have antibodies to chromatin but not antihistone. Antichromatin antibodies are found in 50% to 90% of SLE patients and have been linked with proteinuria in SLE patients.
Antichromatin antibodies are more sensitive than anti-dsDNA antibodies in detecting active SLE.
Reference range: Negative, Positive
Coccidioides Antibodies by Complement Fixation (CF) is a serological blood test used to detect antibodies produced by the body in response to the fungal pathogen Coccidioides immitis/posadasii. This test is employed in diagnosing and monitoring coccidioidomycosis, commonly known as Valley Fever, caused by Coccidioides infection.
Valley fever (also called coccidioidomycosis or “cocci”) is a disease caused by a fungus that grows in the soil and dirt in some areas of California and the southwestern United States. People and animals can get sick when they breathe in dust that contains the Valley fever fungus. This fungus usually infects the lungs and can cause respiratory symptoms including cough, fever, chest pain, and tiredness.
This test is particularly useful for detecting meningitis (an inflammation of the protective membranes covering the brain and spinal cord) caused by the pathogen. A positive result indicates exposure to the fungus, but clinical correlation is necessary to determine the significance of the result. It's often used alongside other tests like immunodiffusion (ID) and IgM tests for a comprehensive diagnosis. The presence of antibodies suggests an active or recent asymptomatic infection, aiding in patient management and treatment evaluation.
Optimal range: 0 - 1 EIA Units
Coccidioides Ab, IgG, EIA refers to a laboratory test that detects IgG antibodies against the fungus Coccidioides immitis, which causes coccidioidomycosis, also known as Valley Fever. This test is used to diagnose and monitor infections caused by this fungus.
Specific IgG antibodies are produced during an initial antigen exposure, rising a few weeks after it begins, then decreasing and stabilizing. IgG antibodies form the basis of long-term protection against microorganisms.
Optimal range: 0 - 1 EIA Units
Optimal range: 10.3 - 20.5 mg/dL
Optimal range: 82 - 167 mg/dL
Measurements of serum complement components C3 is useful in the diagnosis and monitoring of immune complex disease e.g. SLE (Systemic lupus erythematosus) and some blood associated infectious diseases. Complement concentrations are acute phase proteins and may be normal, despite complement consumption, in some inflammatory and infective disorders. C3 alone is often decreased in infectious disease (septicaemia, endocarditis).
Measurement of serum complement is useful in the monitoring of specific immune complex diseases e.g SLE and infectious diseases post streptococcal disease, subacute bacterial endocarditis.
Optimal range: 69.2 - 273.6 ng/mL
C3 is the most abundant protein of the complement system. C3 can be cleaved in two divalent fragments, where C3b is the larger fragment. C3a is the smaller fragment that is released into the surrounding fluids. C3a can bind to receptors on basophils and mast cells triggering them to release their vasoactive amines (e.g. histamine). Because of the role of these biomarkers in anaphylaxis, C3a is called an anaphylatoxin. C3a is one of the most potent constrictors of smooth muscle cells. C3a has been shown to be a multifunctional pro-inflammatory mediator.
Optimal range: 12 - 38 mg/dL
Complement component 4 (C4) is a blood test that measures the activity of a certain protein. This protein is part of the complement system.
Optimal range: 215.7 - 2025.9 ng/mL
Complement C4a levels can be elevated in conditions associated with inflammation, such as autoimmune diseases, infections, and some neurological disorders. It can also be used in the evaluation of certain pregnancy-related conditions.
Optimal range: 5 - 8.6 mg/dL
Complement Component C1Q is a vital element in the field of immunology and diagnostic medicine, playing a crucial role in the assessment of autoimmune and inflammatory disorders. This component forms part of the complement system, a group of proteins that enhance (complement) the ability of antibodies and phagocytic cells to clear pathogens from an organism. C1Q specifically initiates the classical complement pathway, a critical part of the body's innate immune response. Testing for Complement Component C1Q levels is particularly significant in diagnosing conditions such as Systemic Lupus Erythematosus (SLE) and other rheumatic diseases.
Optimal range: 42 - 999999 U/mL
A total complement measurement, also known as a total hemolytic complement or a CH50 measurement, checks how well the complement system is functioning.
Complement was discovered by Jules Bordet as a heat-labile component of normal plasma that causes the opsonisation and killing of bacteria. The complement system refers to a series of >20 proteins, circulating in the blood and tissue fluids. Most of the proteins are normally inactive, but in response to the recognition of molecular components of microorganisms they become sequentially activated in an enzyme cascade – the activation of one protein enzymatically cleaves and activates the next protein in the cascade.
Optimal range: 31 - 60 U/mL
A total complement measurement, also known as a total hemolytic complement or a CH50 measurement, checks how well the complement system is functioning.
Complement was discovered by Jules Bordet as a heat-labile component of normal plasma that causes the opsonisation and killing of bacteria. The complement system refers to a series of >20 proteins, circulating in the blood and tissue fluids. Most of the proteins are normally inactive, but in response to the recognition of molecular components of microorganisms they become sequentially activated in an enzyme cascade – the activation of one protein enzymatically cleaves and activates the next protein in the cascade.
Optimal range: 0 - 20 Units
Cyclic citrullinated peptide antibodies are autoantibodies produced by the immune system that are directed against cyclic citrullinated peptides (CCP). This test detects and measures anti-CCP antibodies in the blood. Citrulline is naturally produced in the body as part of the metabolism of the amino acid arginine. However, in joints with rheumatoid arthritis (RA), this conversion may occur at a higher rate.
Reference range: Negative, Positive
The marker Cysticercosis (Taenia solium) refers to a diagnostic test used to detect the presence of antibodies against Taenia solium, the parasitic tapeworm responsible for cysticercosis. Cysticercosis is an infection that occurs when a person ingests eggs from the tapeworm, which are typically spread through contaminated food, water, or contact with infected feces. Once inside the body, the eggs hatch into larvae and can migrate to various tissues, including muscles, eyes, and the central nervous system, forming cysts. This can lead to a range of symptoms, depending on the location and number of cysts.
Optimal range: 29 - 42 seconds
Dilute Russell's viper venom time (dRVVT) is a laboratory test often used for detection of lupus anticoagulant (LA). Russell's viper venom [RVV] isolated from the snake Daboia russelii contains a potent activator of factor X which in the presence of phospholipid, prothrombin and calcium ions clots fibrinogen to fibrin. In individuals with a lupus anticoagulant the antibody binds to the phospholipid inhibiting the action of the RVV and prolonging the clotting time.
Reference range: Non-Protective <0.10, Protective >=0.10
Diphtheria antitoxoid antibodies are specific immunoglobulins (also known as antibodies) produced by the human immune system in response to the diphtheria toxoid vaccine or exposure to the bacterium Corynebacterium diphtheriae, which causes diphtheria.
What is Diphtheria?
Diphtheria is a serious bacterial infection that can lead to difficulty breathing, heart rhythm problems, and even death. It's caused by strains of bacteria called Corynebacterium diphtheriae that make toxin. Diphtheria spreads easily and happens quickly, and mainly affects the nose and throat. It's spread from person to person, usually through respiratory droplets, from coughing or sneezing.
Reference range: Negative, Positive
The evaluation of patients with suspected systemic rheumatic disease, especially systemic lupus erythematosus (SLE).
Reference range: <or=4 IU/mL: Negative, 5 - 9 IU/mL: Indeterminate, >or=10 IU/mL: Positive
Useful to evaluate patients with signs and symptoms consistent with lupus erythematosus (SLE).
Of the systemic lupus erythematosus (SLE)-specific antibodies the antibodies to double-stranded DNA (dsDNA) is the most common.
Testing for IgG antibodies to dsDNA is indicated in patients positive for anti-cellular antibody (ie, antinuclear antibody: ANA) homogeneous pattern using HEp-2 substrate by indirect immunofluorescence assay (IFA) along with clinical features compatible with SLE.
Optimal range: 0.8 - 1.2 Ratio
The dRVVT Confirm (dilute Russell's Viper Venom Test Confirm) measures the presence of lupus anticoagulants (LA), autoantibodies linked to clotting disorders and antiphospholipid syndrome (APS). It compares screening and confirmatory test phases, with a normal ratio (0.8–1.2) indicating no significant LA interference. Elevated ratios (>1.2) suggest LA presence and possible increased clotting risk, while low ratios (<0.8) are rare and usually not clinically relevant. This test is vital for diagnosing APS and evaluating unexplained blood clots or recurrent pregnancy loss, providing key insights for managing autoimmune or clotting conditions.
Optimal range: 0 - 45 seconds
Dilute Russell's viper venom time (dRVVT) is a laboratory test often used for detection of lupus anticoagulant (LA). Russell's viper venom [RVV] isolated from the snake Daboia russelii contains a potent activator of factor X which in the presence of phospholipid, prothrombin and calcium ions clots fibrinogen to fibrin. In individuals with a lupus anticoagulant the antibody binds to the phospholipid inhibiting the action of the RVV and prolonging the clotting time.
Optimal range: 0 - 1.2 Ratio
The dRVVT Screen Ratio is a key component of lupus anticoagulant (LA) testing. It is calculated from the dilute Russell's viper venom time (dRVVT) screen test, which uses a low-phospholipid reagent to increase sensitivity to lupus anticoagulant. A normal dRVVT screen ratio is typically less than 1.20, while an elevated ratio (≥1.20) may suggest the presence of LA. However, elevated results can also arise from coagulation factor deficiencies, anticoagulant medications, or other inhibitors.
The screen ratio is determined by dividing the patient’s plasma clotting time by the clotting time of normal pooled plasma. When the ratio is elevated, additional tests, such as mixing studies and confirmatory assays, are often performed to distinguish lupus anticoagulant from other causes of prolonged clotting times.
Optimal range: 0 - 29.9 IU/ml
Evaluating patients with signs and symptoms consistent with systemic lupus erythematosus (SLE).
Optimal range: 0 - 80 I.U./ml
The anti-double stranded DNA (anti-dsDNA) tests are used to help diagnose and monitor lupus, also called systemic lupus erythematosus or SLE, a chronic inflammatory autoimmune disorder in which the immune system mistakenly targets the body’s own cells and tissues.
Optimal range: 4 - 54 ug/L
The marker ECP on a LabCorp panel refers to Eosinophil Cationic Protein, a protein released by activated eosinophils—white blood cells involved in the body's immune response, particularly in allergic reactions and parasitic infections. ECP plays roles in immune regulation and has cytotoxic and neurotoxic properties.
Reference range: Negative, Positive
The Extractable Nuclear Antigen (ENA) Screen, often referred to as an ENA panel, is a diagnostic blood test designed to detect specific autoantibodies in the bloodstream. These autoantibodies are proteins produced by the immune system that mistakenly target and attack the body's own healthy tissues, rather than foreign invaders like bacteria or viruses. Identifying these autoantibodies is crucial for diagnosing certain autoimmune diseases.
Optimal range: 0 - 40 AU/mL
The ENA (Extractable Nuclear Antigens) to Smith (Sm) antibody test plays a pivotal role in the field of autoimmune diagnostics, particularly in the context of systemic lupus erythematosus (SLE). Smith antibodies are a subset of antinuclear antibodies (ANAs), specifically targeting proteins found within the cell nucleus, known as Sm antigens. These antigens are integral to the splicing of pre-mRNA, making them vital for cell function.
In autoimmune conditions like SLE, the body's immune system mistakenly targets its own tissues, with Smith antibodies being one of the markers of this aberrant immune response. The presence of Smith antibodies is considered highly specific for SLE; while they are not found in all patients with SLE, their presence is rarely observed in other diseases. This specificity makes the ENA to Sm antibody test an invaluable tool in the differential diagnosis of SLE, distinguishing it from other autoimmune disorders that may present with similar symptoms.
Reference range: No, Yes
The ENA-6 Reflexed test is a blood test used to help diagnose autoimmune diseases, particularly those that affect the connective tissues, such as Systemic Lupus Erythematosus (SLE), Sjögren's syndrome, scleroderma, and polymyositis. "ENA" stands for Extractable Nuclear Antigens, which are proteins found inside the nucleus of cells that can become targets of the immune system in autoimmune diseases. The "6" refers to six specific antigens included in this panel: SS-A (Ro), SS-B (La), Sm, RNP, Scl-70, and Jo-1. Each of these antigens is associated with different autoimmune conditions, and identifying antibodies against them can provide valuable clues for diagnosis. For example, antibodies against SS-A and SS-B are often found in patients with Sjögren's syndrome, while antibodies against Sm are highly specific for SLE.
Optimal range: 2 - 10 mcg/L
Eosinophil Cationic Protein (ECP) is a ribonuclease that is part of the RNase A superfamily, primarily associated with the body's immune response mechanisms, especially in the context of allergic reactions and parasitic infections.
ECP is released by eosinophils, a type of white blood cell that plays a crucial role in the body's immune defense system. Eosinophils are known to be involved in the modulation of immune responses and the mediation of inflammatory processes, particularly in allergic conditions such as asthma, rhinitis, and eczema, as well as in responses to parasitic infections.
The presence and concentration of ECP in bodily fluids are used as a biomarker to indicate the activation of eosinophils and the intensity of the inflammatory response. High levels of ECP are often associated with active disease states in conditions characterized by eosinophilic inflammation. For instance, in patients with asthma, elevated ECP levels can reflect the severity of airway inflammation and have been linked to disease exacerbation and decreased lung function. Similarly, in allergic rhinitis and atopic dermatitis, increased ECP levels correlate with symptom severity and the extent of eosinophilic involvement.
Optimal range: 3 - 109 pg/mL
Optimal range: 0 - 40 mm/hr
The erythrocyte sedimentation rate (ESR or sed rate) is a relatively simple, inexpensive, non-specific test that has been used for many years to help detect inflammation associated with conditions such as infections, cancers, and autoimmune diseases.
Optimal range: 0.13 - 0.42 Ratio
The esterified/free carnitine ratio, often measured in clinical settings, is a valuable indicator of carnitine metabolism balance within the body. This ratio compares the amount of carnitine bound to fatty acids (esterified carnitine) to the amount of carnitine in its free, unbound form. A balanced ratio is crucial for efficient energy production, as carnitine plays a key role in transporting fatty acids into mitochondria for oxidation.
Optimal range: 0 - 0.1 kU/L
The Wheat Allergy test looks for IgE antibodies which the body develops in response to proteins found in wheat.
Today almost a half of the calories consumed by the human population worldwide come from cereals, with wheat being the most popular grain in Europe and the Americas. Its use is so widespread that people suffering from gluten-related disorders have great difficulty in avoiding it. Flour and bran are used in the production of bread, muesli, breakfast cereals, pasta, bulgur, couscous, and pastries. Being a binding agent, wheat is added to cold cuts, desserts, ice cream, and cream. Starch is used for coating pills, pralines, and roasted coffee grains, as well as in cosmetic, paper, and chemical industries.
It is important to note that a wheat allergy is not the same as Celiac Disease.
Optimal range: 3.3 - 19.4 mg/L
Light chains are proteins produced by immune cells called plasma cells. Also called kappa light chains, they link together with other proteins (heavy chains) to form immunoglobulins (= antibodies) that target and neutralize specific threats to the body (= bacteria & viruses).
Optimal range: 0 - 26 mcg/mL
The Fusarium Proliferatum/Moniliforme IgG test measures IgG antibodies to specific environmental molds, indicating past or ongoing exposure. While elevated levels suggest immune system recognition of these molds, they do not diagnose an active infection, allergy, or illness. This test is most useful in evaluating possible mold-related conditions—such as hypersensitivity pneumonitis—in the context of symptoms and known exposure. It should be interpreted by a specialist, as reference ranges carry no direct disease significance.
Optimal range: 66 - 433 mg/dL
Gammaglobulin A refers to the portion of the gamma globulin protein fraction that includes Immunoglobulin A (IgA), a key antibody involved in immune defense. IgA is primarily found in mucosal areas such as the respiratory and gastrointestinal tracts, as well as in secretions like saliva, tears, and breast milk. It plays a crucial role in neutralizing pathogens at mucosal surfaces, helping prevent infections before they enter the bloodstream. While the term "gammaglobulin A" is sometimes used interchangeably with IgA, it more broadly reflects the presence of IgA within the gamma globulin class of serum proteins. Abnormal levels of gammaglobulin A—or more specifically, IgA—may indicate immune disorders, chronic infections, or certain inflammatory conditions.
Optimal range: 635 - 1741 mg/dL
Gamma globulin G, more precisely known as Immunoglobulin G (IgG), is the most abundant type of antibody in the human body, accounting for approximately 75% of all serum immunoglobulins. As a key component of the gamma globulin fraction of blood proteins, IgG plays a critical role in the immune system's defense against bacterial and viral infections. It is produced by plasma cells and circulates in the blood and extracellular fluid, where it recognizes and binds to specific antigens, marking them for destruction by other immune cells. IgG is also the only antibody class that can cross the placenta, providing passive immunity to newborns. Clinically, IgG levels are often measured to assess immune function or to diagnose conditions such as immunodeficiencies, chronic infections, or autoimmune diseases.
Optimal range: 45 - 281 mg/dL
Gamma globulin M, more accurately referred to as immunoglobulin M (IgM), is the first type of antibody produced by the immune system in response to an infection. It is a part of the gamma globulin fraction of serum proteins and plays a critical role in the body’s initial defense against pathogens. IgM is primarily found in the blood and lymphatic fluid, and because of its large size, it is especially effective at forming complexes with antigens and activating the complement system. Elevated levels of IgM can indicate recent or acute infections, autoimmune disorders, or certain types of blood cancers, while low levels may suggest immune deficiencies. As the immune response progresses, IgM is typically replaced by other immunoglobulins such as IgG, which provide longer-lasting immunity.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0 - 100 pg/mL
The Gastrin test is a simple blood test that checks for excess gastrin production. Gastrin is a hormone your stomach makes to fuel the release of gastric acid. Your body needs this to digest and absorb nutrients in your food, particularly proteins and amino acids.
Gastric acid is found inside cells called G cells. These are located in your stomach lining and the lining of your upper small intestine.
Optimal range: 0 - 400 umol/L
The GlycA test assesses a specific NMR signal, distinct from lipoprotein particle analysis, and is regarded as a potential marker of systemic inflammation, offering clinical utility comparable to high sensitivity C-reactive protein (hsCRP), fibrinogen, and other inflammation biomarkers. This NMR signal, termed "GlycA," originates from N-acetylglucosamine moieties on circulating glycoproteins' carbohydrate portions.
Reference range: Protective Antibody Level, Indeterminate for protective antibody, Nonprotective Antibody Level
Reference range: Negative, Positive
The marker Helicobacter pylori Abs, Serum, detected through a serology test using the immunochromatography method, is a crucial diagnostic tool in identifying infections caused by the Helicobacter pylori bacteria. This bacteria is known to cause various gastrointestinal issues, including peptic ulcers and chronic gastritis, and is also associated with an increased risk of stomach cancer. The test works by detecting specific antibodies in the blood that are produced in response to an H. pylori infection. The immunochromatography method is a simple and rapid technique that involves a test strip, which, when exposed to a blood sample, will show visible lines indicating the presence or absence of these antibodies.
Optimal range: 2.2 - 3.2 %
Hemoglobin A2 (Quant), a key parameter in the Thalassemia and Hemoglobinopathy Comprehensive (COMP) panel, is pivotal in diagnosing and managing various blood disorders. This comprehensive panel is designed to detect and monitor conditions involving abnormal hemoglobin, like thalassemia and hemoglobinopathies. Hemoglobin A2, which consists of two alpha and two delta globin chains, normally comprises a small fraction of the total hemoglobin in adults. The quantitative assessment of Hemoglobin A2 is essential, as its elevated levels are a hallmark feature in beta-thalassemia and other related hemoglobinopathies.
Optimal range: 0 - 11 seconds
The Hexagonal Phase Phospholipid test detects lupus anticoagulants (LA), autoantibodies linked to clotting disorders and antiphospholipid syndrome (APS). Using a specific phase of phospholipids, it sensitively identifies LA, which disrupt normal clotting processes. A positive result suggests an increased risk of blood clots or complications like recurrent miscarriages, while a negative result typically rules out LA as a factor. This test, often performed alongside others like dRVVT, is crucial for diagnosing APS and guiding treatment to manage clotting risks. Abnormal results should be reviewed with a healthcare provider for further evaluation and management.
Optimal range: 0 - 16 %
Chronic Urticaria (CU) is a common skin disorder affecting 1 to 6% of the general population.
Optimal range: 0 - 0.99 ng/mL
Histamine is a substance that is produced by the body as part of an allergic reaction.
Optimal range: 180 - 1800 nmol/L
Optimal range: 0 - 96 units/ml
This test distinguishes drug-induced lupus from other lupus variants and autoimmune conditions. Though not a definitive diagnostic tool, histone antibodies align with drug-induced lupus. It's often ordered alongside a positive ANA test and sometimes an anti-dsDNA test. Following drug-induced lupus diagnosis, discontinuing the drug is advised, with histone antibody tests for monitoring. These tests are ordered when an individual taking medication for weeks to years exhibits symptoms linked to drug-induced lupus, especially without prior autoimmune history. Symptoms include joint pain, fatigue, fever, myalgia, malar rash, sunlight sensitivity, and weight loss. CNS and kidney symptoms are rarer in drug-induced lupus compared to systemic lupus erythematosus (SLE). Post-drug discontinuation, the histone antibody test can track changes. A negative result suggests alternatives, yet drug-induced lupus is possible without histone antibodies.
Reference range: Positive, Negative
- To determine whether you have human leukocyte antigen B27 (HLA-B27) on the surface of your cells
- To help assess the likelihood that you have an autoimmune disorder associated with the presence of HLA-B27.
- Autoimmune disorders occur when the immune system mistakenly targets the body’s own cells and tissues.
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The HLA-B27 test is primarily ordered to help strengthen or confirm a suspected diagnosis of ankylosing spondylitis (AS), reactive arthritis, juvenile rheumatoid arthritis (JRA), or sometimes anterior uveitis. The HLA-B27 test is not diagnostic; that is, it is not a definitive test that can be used to diagnose or rule out a disorder. The result adds information and is one piece of evidence used along with the evaluation of signs, symptoms, and other laboratory tests to support or rule out the diagnosis of certain autoimmune disorders, such as ankylosing spondylitis and reactive arthritis.
The HLA-B27 test may be ordered as part of a group of tests used to help diagnose and evaluate conditions causing arthritis-like chronic joint pain, stiffness, and inflammation. This group of tests may include a rheumatoid factor (RF) with either an erythrocyte sedimentation rate (ESR) or a C-reactive protein (CRP). HLA-B27 is sometimes ordered to help evaluate someone with recurrent uveitis that is not caused by a recognizable disease process.
Optimal range: 344 - 2382 pg/mL
Transforming Growth Factor Beta 1 (TGF-β1) is a vital protein in human health, belonging to the broader TGF-β superfamily. This protein is a key regulator in numerous bodily functions, primarily focusing on cell growth, division, and development. Its role is crucial in maintaining the health and stability of tissues and organs. TGF-β1 is particularly significant in the body's healing processes. During wound repair and tissue regeneration, TGF-β1 acts as a critical coordinator, guiding cells in the repair and healing process. This function makes it an essential component in medical and health research, particularly in understanding wound healing mechanisms.
Optimal range: 0 - 168 ng/mL
Testing for IgE antibodies is essential in diagnosing and managing allergic diseases. IgE is linked to allergic reactions, and its level can indicate the severity of symptoms and the risk of severe reactions like anaphylaxis. Testing helps identify specific allergens, crucial for effective allergy management. It also monitors the effectiveness of treatments such as immunotherapy, where decreasing IgE levels signify positive responses. In chronic allergic conditions like asthma and eczema, IgE testing confirms diagnoses and guides treatment. Elevated IgE levels can even predict the development of allergies, especially in children, allowing for early intervention. Understanding IgE's role has also led to targeted therapies like anti-IgE monoclonal antibodies, effective in treating severe allergic asthma. Overall, IgE antibody testing is a key component in personalized allergy care.
Optimal range: 603 - 1613 mg/dL
IgG (Immunoglobulin G) is a vital part of your immune defense system. Abnormal levels—either too high or too low—can be a sign of chronic infection, autoimmune activity, immune deficiency, or other systemic conditions. Whether you're experiencing frequent infections or unexplained inflammation, this test offers critical insight into how your immune system is functioning and what steps may be needed next.
Reference range: Negative, Abnormal
Immunofixation electrophoresis or immunosubtraction capillary electrophoresis identifies the type of immunoglobulin protein(s) present as monoclonal bands on a protein electrophoresis pattern. Typically, this testing determines the presence and type of monoclonal proteins (e.g., IgG kappa).
Optimal range: 87 - 352 mg/dL , 0.87 - 3.52 g/L
Immunoglobulin A (IgA), one of the five primary immunoglobulins, plays a pivotal role in mucosal homeostasis in the gastrointestinal, respiratory, and genitourinary tracts, functioning as the dominant antibody of immunity in this role.
Total IgA (Immunoglobulin A), expressed in milligrams per deciliter (mg/dL), is a crucial marker in clinical immunology representing the predominant immunoglobulin class in mucosal secretions and the second most abundant immunoglobulin in serum. This glycoprotein plays a pivotal role in mucosal immunity, offering a primary line of defense against pathogens at mucosal surfaces, including the gastrointestinal, respiratory, and genitourinary tracts. Normal levels of Total IgA in the blood vary based on age and individual health conditions but typically range from 70 to 400 mg/dL in adults.
Optimal range: 0 - 14.11 mg/dL
Immunoglobulin D (IgD) is an antibody isotype that makes up about 1% of proteins in the plasma membranes of immature B-lymphocytes where it is usually coexpressed with another cell surface antibody called IgM.
Remains in the bloodstream to fight bacteria. Functions mainly as an antigen receptor on B cells that have not been exposed to antigens. It has been shown to activate basophils and mast cells to produce antimicrobial factors.
Optimal range: 0 - 114 kU/L
Immunoglobulin E (IgE) is a key antibody in the immune system, crucial for diagnosing and managing allergies. Testing for IgE is important for identifying specific allergens causing allergic reactions, which can range from mild symptoms like sneezing to severe, potentially life-threatening conditions like anaphylaxis. Measuring IgE levels helps in creating personalized treatment plans, including medication and immunotherapy. It's also used to monitor the effectiveness of allergy treatments and assess the severity of chronic conditions like asthma. Elevated IgE levels can indicate broader immune system issues, making it a valuable tool in immunological assessments. With allergies becoming more common, IgE testing is increasingly important in healthcare, aiding in better patient care in allergy and immunology.
Optimal range: 6 - 495 IU/ml
Immunoglobulin E (IgE) are antibodies produced by the immune system.
IgE antibodies are found in the lungs, skin, and mucous membranes. They cause the body to react against foreign substances such as pollen, fungus spores, and animal dander. They are also involved in allergic reactions to milk, some medicines, and some poisons.
Optimal range: 586 - 1602 mg/dL , 5.86 - 16.02 g/L
The most abundant immunoglobulin in human serum is immunoglobulin G (IgG) (approximately 80% of the total). IgG protein is comprised of molecules of 4 subclasses designated IgG1 through IgG4. Each subclass contains molecules with a structurally unique gamma heavy chain. Of total IgG, approximately 65% is IgG1, 25% is IgG2, 6% is IgG3, and 4% is IgG4. Molecules of different IgG subclasses have somewhat different biologic properties (eg, complement fixing ability and binding to phagocytic cells), which are determined by structural differences in gamma heavy chains. Clinical interest in IgG subclasses concerns potential immunodeficiencies (eg, subclass deficiencies) and IgG4-related diseases (eg, IgG4 elevations). The IgG subclass assay (IGGS / IgG Subclasses, Serum) is best for deficiency testing, and the IgG4 assay (IGGS4 / Immunoglobulin Subclass IgG4, Serum) is best for IgG4-related disease testing.
Optimal range: 26 - 217 mg/dL , 0.26 - 2.17 g/L
Immunoglobulin M (IgM) is the first antibody produced by the immune system in response to infection, playing a crucial role in early defense against bacteria and viruses. A blood test measuring IgM levels helps doctors evaluate immune health, diagnose immune deficiencies, distinguish between recent and past infections, and investigate autoimmune diseases or certain blood cancers. Elevated IgM may indicate a recent infection, autoimmune disorder, liver disease, or plasma cell cancer, while low IgM can signal immune deficiency, protein loss, or bone marrow problems. Results should always be interpreted alongside other tests and clinical symptoms, as IgM levels alone do not confirm a diagnosis.
Optimal range: 0 - 28 pg/mL
Interferon-gamma (IFN-γ or IFNG) is a critical cytokine in the immune system, essential for both innate and adaptive immunity. It is the only member of the type II interferon family and is primarily produced by natural killer (NK) cells, T helper 1 (Th1) cells, and cytotoxic T lymphocytes.
Reference range: <1:8, > or = 1:8, > or = 1:64
Influenza Type A antibody serum refers to the specific antibodies present in the blood serum that are directed against Influenza virus Type A, a highly variable virus responsible for seasonal flu epidemics and occasional pandemics. These antibodies are part of the body's adaptive immune response, produced by B cells as a defense mechanism following exposure to the virus or vaccination. The presence and concentration of these antibodies can be quantified through serological assays, such as hemagglutination inhibition (HI) assays, neutralization tests, and enzyme-linked immunosorbent assays (ELISA). The detection and quantification of Influenza Type A antibodies are crucial for several purposes: epidemiological surveillance, to assess the spread and impact of the virus in populations; vaccine efficacy studies, to evaluate the immune response elicited by flu vaccines; and individual diagnosis, to understand a person's immune status or history of exposure to the virus.
Reference range: <1:8, > or = 1:8, > or = 1:64
The marker "Influenza Type B Antibody Serum" refers to the presence of specific antibodies in the serum that are produced in response to infection with Influenza Type B virus or following vaccination against this virus. These antibodies are a crucial component of the immune response and serve as indicators of an individual's exposure to the virus or their immunization status. Influenza Type B is one of the three main types of influenza viruses (alongside Types A and C) that infect humans and can cause seasonal epidemics of disease. The presence of these antibodies is detected through serological assays, which are laboratory tests that measure the concentration of antibodies in the blood serum.
Optimal range: 0 - 31.2 pg/mL
Interleukin 2 (IL-2) is a pleiotropic (=having multiple effects from a single gene) cytokine produced primarily by mitogen- or antigen- activated T lymphocytes. Interleukin 2 is an important disease marker in hemophagocytic lymphohistiocytosis (HLH), but there are no published data on its diagnostic value in adults.
Optimal range: 0 - 1.8 pg/mL
Interleukin-6 is involved in inflammation and infection responses and also in the regulation of metabolic, regenerative, and neural processes.
Optimal range: 0 - 0.99 Units
This test measures the amount of antibodies to anti-Jo-1 in blood. It is used to help diagnose and manage muscle diseases that affects the immune system such as polymyositis (a type of chronic inflammation of the muscles) associated with autoimmune disease.
Optimal range: 0 - 90 units/ml
Presence of Jo-1 (antihistidyl transfer RNA [t-RNA] synthetase) antibody is associated with polymyositis and may also be seen in patients with dermatomyositis.
Polymyositis is one of a group of rare diseases called the inflammatory myopathies that involve chronic (long-standing) muscle inflammation and weakness, and in some cases, pain. Myopathy is a general term used to describe a number of conditions affecting the muscles. All myopathies can cause muscle weakness.
Jo-1 antibody is also associated with pulmonary involvement (interstitial lung disease), Raynaud phenomenon, arthritis, and mechanic's hands (implicated in antisynthetase syndrome).
Optimal range: 0.26 - 1.65 Ratio
Free light chains will normally be present in the blood at low levels, with a kappa/lambda ratio of approximately 0.26 to 1.65 for individuals with normal kidney function.
Excess production of free kappa or lambda chains can alter this ratio. Monoclonal free light chains are found in serum of patients with multiple myeloma, Waldenstrom's macroglobulinemia, mu-heavy chain disease, primary amyloidosis, light chain deposition disease, monoclonal gammopathy of undetermined significance, and lymphoproliferative disorders.
When the test is used to monitor a known plasma cell disorder, a decrease in the quantity of excess light chain and a more normal kappa/lambda ratio may indicate a response to treatment.
Decreased free light chains with a normal kappa/lambda ratio may be seen with a disorder that suppresses bone marrow cell production.
Reference range: <1:20, >1:20
Liver-Kidney Microsome IgG antibody (anti-LKM), as detected by indirect immunofluorescent antibody (IFA) techniques, may be observed in patients with autoimmune hepatitis type 2 (AIH-2), AIH-2 associated with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), viral hepatitis C or D, and some forms of drug-induced hepatitis. This IFA does not differentiate among the four types of LKM antibodies (LKM-1, LKM-2, LKM-3, and a fourth type that recognizes CYP1A2 and CYP2A6 antigens). Of these, anti-LKM-1 (cytochrome P450IID6) IgG antibodies are considered specific for AIH-2.
Optimal range: 0 - 20 Units
These antibodies target a human body’s produced enzyme called cytochrome P450 2D6, a protein found primarily in liver cells which catalyze many reactions involved in drug metabolism. The development of the LKM antibodies is strongly associated with type 2 autoimmune hepatitis.
Optimal range: 0 - 0.1 GPL
Lupus anticoagulants are antibodies against substances in the lining of cells. These substances prevent blood clotting in a test tube.
Optimal range: 3 - 12.8 ug/ml
Serum lysozyme has emerged as a valuable biomarker for monitoring disease progression and regression, particularly in cases of confirmed sarcoidosis. According to revised FAB (French, American, British) criteria, serum or urine lysozyme levels that are three times the normal limit fulfill one of the key diagnostic criteria for distinguishing M4/M5 acute myeloid leukemia with monocytic differentiation from M2 acute myeloblastic leukemia with maturation.
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Optimal range: 500 - 5000 ng/mL
Mannose Binding Lectin (MBL) is a key biomarker in the innate immune system, playing a crucial role in the body's first line of defense against pathogens. It is a pattern recognition molecule that binds specifically to carbohydrate structures, such as mannose and other sugars, found on the surface of a wide range of microorganisms, including bacteria, viruses, fungi, and parasites. Upon binding, MBL activates the lectin pathway of the complement system, leading to enhanced opsonization of the pathogen, phagocytosis, and eventual lysis or clearance of the invader.
Intermediate levels of MBL may suggest that the individual has a partial deficiency, which can vary in its clinical significance. Some people with intermediate MBL levels may have a normal immune response and not experience frequent infections, while others might be at a slightly increased risk, particularly when facing high pathogen loads or during periods of stress or immune suppression. Intermediate levels might not lead to major health problems in healthy individuals, but they can be an indicator of potential vulnerability in those with additional risk factors, such as chronic diseases or immune system deficiencies.
Overall, both low and intermediate MBL levels can contribute to varying degrees of immune susceptibility, but the clinical significance is often determined by other factors, such as genetic background, overall health, and the presence of coexisting conditions.
Reference range: Immune >16.4 AU/mL, Negative <13.5 AU/mL, Equivocal 13.5 - 16.4 AU/mL
The measles virus belongs to the Paramyxoviridae family, which also includes parainfluenza virus serotypes 1-4, mumps, respiratory syncytial virus (RSV), and metapneumovirus. Measles is highly contagious, primarily transmitted through direct contact with aerosolized droplets or respiratory secretions from infected individuals.
Optimal range: 45 - 396 pg/mL
Reference range: Immune >10.9, Equivocal 9 - 10.9, Negative <9.0
The mumps virus belongs to the Paramyxoviridae family, which also encompasses parainfluenza virus serotypes 1-4, measles, respiratory syncytial virus, and metapneumovirus. Mumps is highly contagious, primarily transmitted through inhaling infected respiratory droplets or secretions. After an incubation period of around two weeks, symptoms typically manifest suddenly, including low-grade fever, headache, and malaise.
Optimal range: 0.66 - 0.91 g/dL
PEP A2Glob, also known as Pepsinogen A2 Globulin, is a specific biomarker of considerable interest in the field of gastroenterology and digestive health. Pepsinogen, an inactive precursor of the enzyme pepsin, plays a critical role in protein digestion within the stomach. It is secreted by the gastric chief cells and is converted to active pepsin in the acidic environment of the stomach. The A2 globulin variant of pepsinogen, or PEP A2Glob, is one of the multiple isoforms of pepsinogen. Elevated levels of PEP A2Glob can be indicative of certain gastric conditions.
Optimal range: 0 - 10 U/mL
Anti-phosphatidylethanolamine (aPE) is an autoimmune condition characterized by the presence of circulating antibodies against phosphatidylethanolamine (PE), and is associated with clinical symptoms of thrombosis and repeated pregnancy loss.
Optimal range: 0 - 10 U/mL
Anti-phosphatidylethanolamine (aPE) is an autoimmune condition characterized by the presence of circulating antibodies against phosphatidylethanolamine (PE), and is associated with clinical symptoms of thrombosis and repeated pregnancy loss.
Optimal range: 0 - 10 U/mL
Anti-phosphatidylethanolamine (aPE) is an autoimmune condition characterized by the presence of circulating antibodies against phosphatidylethanolamine (PE), and is associated with clinical symptoms of thrombosis and repeated pregnancy loss.
Optimal range: 0 - 20 U/mL
The presence of phosphatidylserine antibodies may be associated with thrombosis, fetal loss and thrombocytopenia.
Optimal range: 0 - 10 U/mL
The presence of phosphatidylserine antibodies may be associated with thrombosis, fetal loss and thrombocytopenia.
Optimal range: 0 - 25 U/mL
The presence of phosphatidylserine antibodies may be associated with thrombosis, fetal loss and thrombocytopenia.
Optimal range: 4 - 43 ng/mL
PAI-1 is a serine protein inhibitor that is secreted in response to inflammatory reactions.
PAI-1 is the main inhibitor of tissue-type plasminogen activator (tPA) and urokinase plasminogen activator (uPA) and, as such, plays an important role in the regulation of fibrinolysis.
Plasminogen Activator Inhibitor (PAI-1) AG is useful to:
- aid in prognosis of occurrence or recurrence of thrombosis
- intentify heredity elevation or deficiency of plasminogen activator inhibitor type 1.
- determine the risk for veno-occlusive disease associated with bone marrow transplantation.
- aid diagnosis of impaired fibrinolysis
Optimal range: 0 - 10.6 %
Optimal range: 0 - 0.08 ng/mL
Procalcitonin is a marker of significant interest in the medical field, particularly when it comes to diagnosing and managing infections. Produced in response to a bacterial infection, procalcitonin levels in the blood can help doctors determine the severity of an infection or sepsis, a life-threatening response to infection. Unlike other markers that may rise in various conditions, procalcitonin is relatively specific to bacterial infections, making it a valuable tool for clinicians. When a patient presents symptoms of an infection, measuring procalcitonin levels can aid in deciding whether antibiotics are needed, as elevated levels are often indicative of a bacterial cause. On the other hand, low levels of procalcitonin might suggest a viral infection or another non-bacterial cause, potentially guiding a clinician away from unnecessary antibiotic use.
Reference range: Negative, Positive
Optimal range: 41 - 372 pmol/L
Prothrombin Fragment 1.2 is stable degradation product and its measurement in plasma can be used as a marker of Thrombin generation. Measurement of F1+2 has been used to diagnose Pre-thrombotic states and Thrombotic disorders and in addition to monitor the efficacy of treatment in these disorders.
Optimal range: 9 - 11.5 seconds
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot.
Optimal range: 0.8 - 1.1 seconds
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. A prothrombin time test can be used to check for bleeding problems. PT is also used to check whether medicine to prevent blood clots is working. A PT test may also be called an INR test. INR stands for 'international normalized ratio'.
Reference range: NEGATIVE, POSITIVE
The QUANTIFERON®-TB Gold Plus (QFT-Plus) test is a blood test used to check for latent tuberculosis (TB) infection. It’s often recommended for people who may have been around someone with TB or who are at higher risk of exposure, such as healthcare workers or people with weakened immune systems. This test helps detect TB bacteria that may be inactive in the body but could still cause health issues if they become active later on.
Optimal range: 0 - 13.9 IU/ml
The rheumatoid arthritis (RA) latex turbid test is a laboratory test that’s used to help your doctor diagnose rheumatoid arthritis and other autoimmune diseases.
Optimal range: 0.5 - 1 Ratio
The von Willebrand Factor Collagen Binding Activity to von Willebrand Factor Antigen ratio (vWF:CB/vWF:Ag) is a critical diagnostic parameter in the evaluation of von Willebrand Disease (VWD). This ratio provides essential information about the functional quality of von Willebrand Factor molecules relative to their quantity in circulation.
Optimal range: 14 - 20 seconds
The reptilase clotting time measures the rate of fibrin clot formation after the addition of reptilase, a proteolytic enzyme derived from the venom of Bothrops atrox, to citrated plasma.
Reptilase is a thrombin-like enzyme.
Unlike thrombin, which cleaves fibrinogen to produce fibrinopeptides A and B, reptilase cleaves the fibrinogen molecule to release only fibrinopeptide A.
Optimal range: 0 - 21.9 seconds
Optimal range: 0 - 7 u
RF, IgA by EIA (RDL) refers to the measurement of rheumatoid factor (RF) of the IgA subclass using an enzyme immunoassay (EIA), typically performed at RDL (Reference Diagnostic Laboratory). RF is an autoantibody directed against the Fc portion of immunoglobulin G (IgG) and is commonly associated with rheumatoid arthritis (RA) and other autoimmune conditions. While IgM-RF is the most commonly tested form, IgA-RF may provide additional diagnostic value, particularly in seronegative RA or cases with extra-articular manifestations. Elevated IgA-RF levels have been linked to more severe joint damage and systemic inflammation, and they may correlate with disease activity in rheumatoid arthritis and other autoimmune disorders. This test is typically used alongside other serological markers like IgM-RF, anti-CCP antibodies, and inflammatory markers to improve diagnostic accuracy and assess disease progression.
Optimal range: 0 - 7 u
RF, IgG by EIA (RDL) refers to the measurement of rheumatoid factor (RF) of the IgG class using enzyme immunoassay (EIA) at RDL (Rheumatology Diagnostic Laboratory). Rheumatoid factor is an autoantibody that targets the Fc region of IgG, and its presence is often associated with autoimmune conditions, particularly rheumatoid arthritis (RA) and other inflammatory diseases. While RF is most commonly measured as IgM, the IgG RF subtype can also contribute to disease mechanisms, including immune complex formation and chronic inflammation. Elevated IgG RF levels may indicate rheumatoid arthritis, Sjögren’s syndrome, or other connective tissue diseases, but can also be found in some infections and chronic inflammatory states. Since RF alone is not diagnostic, it is typically interpreted alongside other markers, such as anti-CCP antibodies, ESR, and CRP, to assess autoimmune disease activity.
Optimal range: 0 - 7 u
RF, IgM by EIA (RDL) is a laboratory test that measures rheumatoid factor (RF) of the IgM class using enzyme immunoassay (EIA) methodology. RF is an autoantibody that targets the Fc region of IgG antibodies and is commonly associated with autoimmune conditions, particularly rheumatoid arthritis (RA). Elevated RF IgM levels can indicate inflammatory or autoimmune diseases, including Sjogren’s syndrome, systemic lupus erythematosus (SLE), and other connective tissue disorders. However, RF can also be detected in some healthy individuals or those with chronic infections, making it important to interpret results alongside clinical symptoms and other diagnostic markers. The RDL designation refers to the reference diagnostic laboratory performing the test, ensuring standardized measurement and reliability.
Optimal range: 0 - 14 IU/ml
The Rheumatoid Factor (RF) test is a blood test commonly used to help diagnose rheumatoid arthritis (RA) and other autoimmune conditions. It measures the level of rheumatoid factor, a specific type of antibody in your blood.
Rheumatoid factor (RF) is an autoantibody—a protein made by the immune system that mistakenly targets the body’s own tissues. High levels of RF are often found in people with rheumatoid arthritis or Sjögren's syndrome, another autoimmune disorder.
However, testing positive for RF doesn't always mean you have RA. Some people—especially older adults—may have elevated RF levels without any underlying disease. Likewise, not everyone with RA will test positive for RF.
Optimal range: 0 - 14 Units
Rheumatoid Factor (RF) IgA is an IgA-class autoantibody that targets the Fc region of other immunoglobulins, similar to RF IgG and IgM. While RF (IgM) is the most commonly tested marker for rheumatoid arthritis (RA), RF (IgA) may provide additional insights into disease severity, progression, and immune system activity.
Optimal range: 0 - 6 u
Rheumatoid Factor (RF) IgG is an immunoglobulin G (IgG) autoantibody that targets the body’s own tissues, particularly the Fc region of other antibodies. While RF is commonly associated with rheumatoid arthritis (RA), its presence can also indicate other autoimmune conditions or chronic infections.
Optimal range: 0 - 3.5 Units
Rheumatoid Factor IgM (RF-IgM) is an antibody commonly measured to help diagnose rheumatoid arthritis (RA) and other autoimmune disorders. Rheumatoid factor is part of a group of antibodies that target the body's own tissues, often mistaking them for foreign invaders. Specifically, the IgM type of rheumatoid factor is the most commonly tested and can be found in the blood of many individuals with autoimmune diseases.
What does an equivocal result mean?
An "equivocal" result means the test result falls into a borderline or "gray area"—neither clearly positive nor clearly negative. This can happen when the measured levels of the biomarker (in this case, Rheumatoid Factor IgM) are slightly above normal but not high enough to be definitively considered positive.
In practice, an equivocal result suggests that:
Doctors often evaluate equivocal results in the context of other symptoms and tests, using the full clinical picture to guide further diagnosis and treatment.
Optimal range: 42 - 200 % normal
The Ristocetin Cofactor (RCoF) test is a critical diagnostic assay used to measure the functional activity of von Willebrand factor (vWF), a protein essential for blood clotting. This test plays a key role in diagnosing and managing von Willebrand disease (VWD), the most common inherited bleeding disorder. By assessing how well vWF promotes platelet aggregation in the presence of ristocetin, the RCoF test provides a quantitative measure of vWF function. It is highly specific for detecting dysfunctional vWF (e.g., in type 2 VWD) and is often paired with vWF antigen testing to differentiate between quantitative and qualitative defects. The test is also used to monitor treatment efficacy, assess surgical bleeding risks, and detect acquired von Willebrand syndrome. While factors like blood type, stress, or pregnancy can influence results, advances such as automated assays and recombinant ristocetin analogs have improved accuracy and efficiency, solidifying the RCoF test as an indispensable tool in hematology.
Optimal range: 0 - 20 Units
RNA Polymerase III antibodies are a specific type of autoantibody that can play a significant role in helping doctors understand certain health conditions. Imagine your body's immune system as a well-trained security system. Sometimes, this system mistakenly identifies parts of your own body as threats, producing antibodies against them - this is where RNA Polymerase III antibodies come into play. These antibodies target an enzyme called RNA Polymerase III, which is crucial for generating certain types of RNA molecules inside your cells.
Optimal range: 0 - 83 units/ml
RNP/Sm Antibody is an extractable nuclear antigen (ENA) associated with Mixed connective tissue disease (MCTD).
Extractable nuclear antigens (ENA) are autoantibodies in the blood that react with proteins in the cell nucleus. These proteins are known as “extractable” because they can be removed from cell nuclei using saline and represent six main proteins (Ro, La, Sm, RNP, Scl-70 and Jo1).
Autoantibodies are produced when a person’s immune system mistakenly targets and attacks the body’s own tissues. This attack can cause inflammation, tissue damage, and other signs and symptoms that are associated with an autoimmune disorder.
Certain autoimmune disorders are characteristically associated with the presence of one or more anti-ENA antibodies, such as mixed connective tissue disease (MCTD), lupus (SLE), Sjögren syndrome, scleroderma, and polymyositis/dermatomyositis. Autoantibody association can aid in the diagnosis of an autoimmune disorder and help distinguish between other autoimmune disorders.
Optimal range: 0 - 10 Units
The Ro-52kD Antibody is a type of autoantibody, meaning it is an antibody produced by the immune system that mistakenly targets and attacks the body's own tissues. Specifically, this antibody targets a protein that is 52 kilodaltons (kD) in size, which is why it is referred to as the Ro-52kD Antibody. This protein is found in various cells throughout the body, including those in the skin, joints, and internal organs. The presence of Ro-52kD Antibodies is commonly associated with autoimmune diseases, such as systemic lupus erythematosus (SLE) and Sjögren's syndrome. These conditions occur when the immune system becomes overactive and attacks the body’s own tissues, leading to inflammation and damage. The Ro-52kD Antibody can be detected through blood tests, which are often used by doctors to help diagnose these autoimmune diseases. Elevated levels of this antibody can indicate an active autoimmune process and may help guide treatment decisions. It is important for individuals with autoimmune diseases to be monitored regularly, as the presence of Ro-52kD Antibodies can provide valuable information about the progression and activity of their condition.
Reference range: Non-immune, Equivocal, Immune
A rubella blood test checks to see if you have antibodies to the rubella virus. Antibodies are proteins your immune system makes to help fight infections and keep you from getting sick. They're targeted to specific germs, viruses, and other invaders. Your doctor can tell a lot from the type of antibodies that you have in your blood.
Rubella, also called German measles or 3-day measles, isn't a problem for most people. It causes a mild fever and rash that go away in a few days. Most kids get vaccinated for it with the MMR (measles-mumps-rubella) or MMRV (which also includes chickenpox) shots.
But when you're pregnant, rubella can be very serious. If you get it in the first 4 months, your baby could have eye, hearing, or heart problems or be born too soon.
Reference range: Negative, Positive
Reference range: Negative, Positive
Optimal range: 0 - 13 AU/mL
The SARS-CoV-2 Semi-Quantitative IgG Antibody test is a blood test that measures the level of IgG antibodies your body has produced in response to the SARS-CoV-2 virus, the virus responsible for COVID-19. Unlike a qualitative test that gives a simple “positive” or “negative” result, this semi-quantitative test estimates the amount of antibody present and provides a numerical value — giving more detailed insight into your immune system’s response.
Optimal range: 0.8 - 25000 U/mL
The SARS-CoV-2 Spike Antibody Dilution test measures the concentration of IgG antibodies against the virus’s spike protein, providing a more precise view of your immune response than a simple positive/negative result. These antibodies usually appear after vaccination or past COVID-19 infection, and dilution testing is used when levels are too high for standard tests to measure accurately. A higher result generally reflects a stronger antibody presence, which may support faster immune recognition and a lower risk of severe illness, though protection varies by individual and variant. This test cannot tell you when exposure occurred, how long immunity will last, or whether you currently have COVID-19. Instead, it confirms immune recognition and offers valuable insight into your body’s response, while reminding that antibody levels are just one piece of your overall defense system.
Reference range: Negative, Positive
The SARS-CoV-2 Spike Ab Interp refers to the interpretation of antibodies directed against the spike (S) protein of the virus that causes COVID-19. This marker is typically included in antibody panels to evaluate your immune response following infection with SARS-CoV-2 or after vaccination with COVID-19 vaccines that target the spike protein (such as Pfizer-BioNTech, Moderna, or Novavax).
This test does not measure the antibody level itself, but instead provides an interpretation (positive, negative, equivocal) based on whether spike-specific antibodies are detected in your blood.
Optimal range: 0 - 0.2 O.D
The Schistosoma IgG Antibody marker on a panel from Labcorp is a diagnostic tool used to detect antibodies against Schistosoma, a type of parasitic worm that causes schistosomiasis. When someone is infected with Schistosoma, their immune system responds by producing specific antibodies, including IgG. The presence of Schistosoma IgG antibodies in a blood sample indicates that the person has been exposed to the parasite.
Reference Ranges:
Negative: Less than 0.20 OD. No significant level of IgG antibody to Schistosoma detected.
Indeterminate: 0.20 to 0.49 OD. It is recommended to repeat the assay with a paired sample after at least one month, when the results fall within this range.
Positive: Greater than or equal to 0.50 OD. Presumptive evidence of a current or past infection with Schistosoma species.
Serological results should be used as an aid in diagnosis and should not be interpreted as diagnostic by themselves.
Optimal range: 0 - 32 units/ml
Scl-70 is also known as Topoisomerase I Antibody.
Topoisomerase I antibodies were initially named Scl-70 based on immunoblot detection of a 70-kDa protein.
The prevalence of Scl-70 antibodies in SSc varies widely across geographies and ethnicities, ranging from 9% to 71%.
These antibodies are strongly associated with dcSSc but also occur in lcSSc.
The 2 main types of SSc are defined according to the pattern of skin involvement: limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc). In lcSSc, skin thickening is present distal to the elbows and knees, and facial skin thickening may or may not be present. In contrast, dcSSc is characterized by thickening of the skin of the whole extremity, as well as that of the anterior chest, abdomen, and back, with or without facial skin involvement. Multiple organs, including the heart, lungs, gastrointestinal tract, and kidneys, can be affected in both forms, though organ involvement is generally less severe in lcSSc. CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) occurs frequently in lcSSc but can also occur in longstanding dcSSc.
Optimal range: 0 - 20 mm/h
The marker Sed Rate by Modified Westergren, also known as the erythrocyte sedimentation rate (ESR) or sedimentation rate, is a common blood test used by doctors to measure inflammation in the body, which is the natural response to injury or infection, often involving the immune system.
This test specifically looks at how quickly red blood cells settle to the bottom of a test tube over the course of one hour. The faster the red blood cells settle, the higher the sed rate, indicating potential inflammation.
Reference range: Negative, Positive
The SEMI-QUANT RF biomarker is a powerful tool in autoimmune disease management. Whether for early detection of Rheumatoid Arthritis or ongoing monitoring of disease progression, its ability to provide a detailed measurement of RF levels makes it indispensable in clinical settings. For anyone facing autoimmune disorders, knowing your SEMI-QUANT RF levels can guide more personalized and effective care.
Reference range: Negative, Positive
Sickle Cell Screening (SCRN) is a vital medical procedure designed to detect sickle cell disease, a genetic blood disorder characterized by irregularly shaped red blood cells. This screening is crucial for early diagnosis and management, especially in newborns and individuals at high risk due to their ethnic background.
Optimal range: 3 - 20 ng/mL
Optimal range: 0 - 89 units/ml
Sm antibodies are specific for lupus erythematosus (LE) and occur in approximately 30% of LE patients. The levels of Sm antibodies remain relatively constant over time in patients with LE and are usually found in patients that also have RNP (ribonucleoprotein) antibodies.
Optimal range: 0 - 1 AI
SM/RNP Antibody is an extractable nuclear antigen (ENA) associated with Mixed connective tissue disease (MCTD).
Extractable nuclear antigens (ENA) are autoantibodies in the blood that react with proteins in the cell nucleus. These proteins are known as “extractable” because they can be removed from cell nuclei using saline and represent six main proteins (Ro, La, Sm, RNP, Scl-70 and Jo1).
Autoantibodies are produced when a person’s immune system mistakenly targets and attacks the body’s own tissues. This attack can cause inflammation, tissue damage, and other signs and symptoms that are associated with an autoimmune disorder.
Certain autoimmune disorders are characteristically associated with the presence of one or more anti-ENA antibodies, such as mixed connective tissue disease (MCTD), lupus (SLE), Sjögren syndrome, scleroderma, and polymyositis/dermatomyositis. Autoantibody association can aid in the diagnosis of an autoimmune disorder and help distinguish between other autoimmune disorders.
Optimal range: 0 - 19 Units
Smith/RNP (ENA) antibodies, predominantly of the IgG class, are a significant marker in the diagnostic landscape of autoimmune diseases, particularly systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD). These antibodies target specific proteins found in the cell nucleus, making them a crucial component in the array of antinuclear antibodies (ANAs) often tested for in autoimmune diagnostics.
In the context of SLE, the presence of Smith/RNP antibodies is relatively rare but highly specific. This means that while not all SLE patients have these antibodies, those who do are very likely to have SLE. This specificity makes Smith/RNP antibodies an invaluable tool in distinguishing SLE from other autoimmune disorders, which can often present with similar symptoms.
Reference range: Negative, Positive
Smooth Muscle Antibodies (SMA), identified through the Immunofluorescence Assay (IFA), are pivotal in diagnosing autoimmune liver diseases, particularly Autoimmune Hepatitis (AIH). SMA-IFA testing detects antibodies targeting actin, a protein in smooth muscle cells, often found in patients with AIH.
Optimal range: 0 - 40 AU/mL
The SS-B/La Antibody (IgG) is a biomarker used to detect the presence of specific autoantibodies in the blood, primarily associated with Sjögren’s syndrome and other autoimmune conditions like systemic lupus erythematosus (SLE). These antibodies target the SS-B/La protein, a small nuclear RNA-binding protein involved in normal cellular processes. A positive result for SS-B/La IgG indicates an autoimmune response, helping to diagnose or monitor conditions characterized by chronic inflammation, dry eyes, dry mouth, and systemic complications.
Optimal range: 0 - 91 units/ml
Anti-Ro (SS-A) is an autoantibody associated with SLE or Sjögren’s syndrome. Sjögren’s syndrome is an autoimmune disorder in which the body's immune system mistakenly reacts to the tissue in glands that produce moisture, such as tear and salivary glands.
Optimal range: 0 - 40 AU/mL
The SSA-52 (Ro52) (ENA) Antibody, IgG is an important biomarker commonly tested to help diagnose autoimmune conditions, particularly Sjögren’s syndrome and systemic lupus erythematosus (SLE). This antibody targets Ro52, a protein involved in cellular stress responses, and its presence can indicate immune system activity against the body’s own tissues. Elevated levels of SSA-52 (Ro52) antibodies are often associated with systemic and organ-specific autoimmune diseases, such as mixed connective tissue disease (MCTD), polymyositis, or certain types of interstitial lung disease.
Optimal range: 0 - 40 AU/mL
The SSA-60 (Ro60) Antibody, IgG biomarker is a specific autoantibody often tested as part of an ENA (Extractable Nuclear Antigen) panel to aid in diagnosing autoimmune conditions. Elevated levels of SSA-60 (Ro60) antibodies are commonly associated with Sjögren’s syndrome and systemic lupus erythematosus (SLE), indicating the immune system's abnormal targeting of Ro60 proteins, a component of RNA-protein complexes. This marker is particularly valuable in detecting autoimmune activity, even in cases where other tests may be inconclusive.
Optimal range: 0 - 73 units/ml
Anti-SS-B (anti-La) is an autoantibody associated with SLE or Sjögren’s syndrome. Sjögren’s syndrome is an autoimmune disorder in which the body's immune system mistakenly reacts to the tissue in glands that produce moisture, such as tear and salivary glands.
Optimal range: 0 - 200 units/ml
ssDNA is an autoimmune diagnostic test that detects autoantibodies against single stranded DNA (ssDNA).
Antibodies to single-stranded DNA is seen in a wide variety of autoimmune diseases, including systemic lupus erythematous (SLE), drug-induced lupus, rheumatoid arthritis (RA) and other autoimmune diseases. This autoimmune diagnostic test can be helpful in raising clinical awareness of an underlying or evolving autoimmune disease in patients who have mild, early or non-specific symptoms.
Optimal range: 5 - 20 mcg/L
Tacrolimus, Highly Sensitive (LC/MS/MS) is a laboratory test that measures the level of tacrolimus in the blood using a highly accurate and sensitive technique called Liquid Chromatography-Tandem Mass Spectrometry (LC/MS/MS). Tacrolimus is an immunosuppressive drug primarily used to prevent organ rejection in patients who have undergone organ transplantation, such as kidney, liver, or heart transplants. It works by inhibiting the activity of the immune system to reduce the risk of rejecting the transplanted organ.
Optimal range: 2 - 20 ng/mL
Tacrolimus, a potent immunosuppressant widely used in organ transplantation, is routinely monitored in whole blood to ensure therapeutic efficacy and minimize toxicity. Chemically known as FK506, tacrolimus binds to the immunophilin FKBP-12, forming a complex that inhibits calcineurin, a critical enzyme in T-lymphocyte signal transduction. By this mechanism, tacrolimus effectively suppresses the immune system, reducing the risk of organ rejection. Its narrow therapeutic index necessitates precise dosing, managed through regular monitoring of whole blood tacrolimus levels.
Optimal range: 0 - 0.35 IU/ml
The TB1-NIL biomarker is integral to the QuantiFERON-TB Gold Plus (QFT-Plus) assay, a diagnostic tool used to detect Mycobacterium tuberculosis infection. In this context, 'NIL' refers to the baseline interferon-gamma (IFN-γ) level measured without antigen stimulation, serving as a negative control to account for non-specific background activity. The TB1 tube contains antigens that primarily stimulate CD4+ T-cell responses. By subtracting the NIL value from the TB1-stimulated IFN-γ level (TB1-NIL), clinicians can assess the specific immune response to TB antigens. A TB1-NIL value of 0.35 IU/mL or higher typically indicates a positive result, suggesting a TB infection. This method enhances the accuracy of TB diagnosis by distinguishing specific immune responses from background noise.
Optimal range: 0 - 0.35 IU/ml
The TB2-NIL biomarker is a critical component of the QuantiFERON-TB Gold Plus (QFT-Plus) assay, which is used to detect Mycobacterium tuberculosis infection. In this context, 'NIL' refers to the baseline interferon-gamma (IFN-γ) level measured without antigen stimulation, serving as a negative control to account for non-specific background activity. The TB2 tube contains antigens designed to stimulate both CD4+ and CD8+ T-cell responses. By subtracting the NIL value from the TB2-stimulated IFN-γ level (TB2-NIL), clinicians can assess the specific immune response to TB antigens. A TB2-NIL value of 0.35 IU/mL or higher typically indicates a positive result, suggesting a TB infection. This method enhances the accuracy of TB diagnosis by distinguishing specific immune responses from background noise.
Reference range: Non-Protective (<0.1 IU/mL), Protective (equal or greater than 0.10 IU/mL)
Tetanus is a serious disease caused by the toxin from Clostridium tetani bacteria. The toxin makes its way into the nervous system and causes muscle spasms and rigid muscles.
If you have been vaccinated for tetanus in the past, this test should show that you have enough antibodies against the disease. If your levels are too low, you should receive a booster vaccine. The test will be repeated after at least a month. Several variations of the tetanus vaccine are available. The vaccine is recommended as a series in childhood. A booster vaccine is recommended every 10 years for teens and adults.
If you've never had a tetanus vaccine or been exposed to tetanus, you'll get vaccinated. You may return later to have your tetanus antibody levels checked to make sure the vaccine is working.
Optimal range: 867 - 6662 pg/mL
Transforming Growth Factor (TGF) plays a crucial role in tissue regeneration, cell differentiation, embryonic development, and regulation of the immune system. Transforming growth factor beta is found in hematopoietic (blood-forming) tissue and initiates a signaling pathway that suppresses the early development of cancer cells. It enhances the deposition of extracellular matrix and may play potential role in wound healing and cirrhosis formation. Many cells synthesize TGF-b and almost all of them have specific receptors for this peptide.
TGF Beta-1 is a protein that has important regulatory effects throughout innate immune pathways. This protein helps control the growth and division (proliferation) of cells, the process by which cells mature to carry out specific functions (differentiation), cell movement (motility), and the self-destruction of cells (apoptosis). The TGF Beta-1 protein is found throughout the body and plays a role in development before birth, the formation of blood vessels, the regulation of muscle tissue and body fat development, wound healing, and immune system function (especially regulatory T-cells).
TGF Beta-1 can impair T-regulatory cell function, which in turn contributes to the activation of autoimmunity, yet TGF Beta-1 also plays a role in suppressing autoimmunity. Neurologic, autoimmune and many other systemmic problems also are found with high TGF Beta-1.
Optimal range: 11.3 - 18.5 seconds
Thrombin is an enzyme in the blood that acts on the clotting factor fibrinogen to form fibrin, helping blood to clot. The thrombin time assesses the activity of fibrinogen.
Optimal range: 0 - 4.3 mcg/L
The Thrombin-Antithrombin Complex keeps clotting in check.
Thrombin-Antithrombin (TAT) Complex is a parameter of coagulation (= the process by which a blood clot is formed in order to stop bleeding) and fibrinolysis (= prevents blood clots that occur naturally from growing and causing problems).
Deficiencies may aid in understanding hypercoagulable states. Elevated concentrations have been associated with vascular complications associated with diabetes.
Optimal range: 0 - 156 pg/mL
TNF-beta, also called lymphotoxin-alpha, is a protein in the TNF superfamily that plays an important role in your immune system. It is primarily produced by activated T and B lymphocytes (types of white blood cells) and helps regulate inflammation, immune responses, and tumor immunity.
Optimal range: 2537 - 22306 pg/mL
Transforming Growth Factor Beta 1 (TGF-β1) is a multifunctional cytokine playing a pivotal role in regulating a wide range of cellular processes, including cell growth, differentiation, apoptosis, and immune responses. As a member of the Transforming Growth Factor Beta superfamily of cytokines, TGF-β1 is particularly noted for its dual role in both promoting and inhibiting tumor formation. In normal physiological conditions, TGF-β1 functions as a critical regulator of tissue homeostasis, exerting potent anti-inflammatory and immunosuppressive effects. It helps maintain the balance in the immune system and prevents autoimmune responses.
Optimal range: 867 - 6662 pg/mL
Transforming growth factor (TGF-beta) is a multifunctional peptide growth factor that has an important role in the regulation of cell growth, differentiation, and repair in a variety of tissues.
Optimal range: 2.2 - 13.2 ug/L
Tryptase is an enzyme that is released, along with histamine and other chemicals, from mast cells when they are activated as part of a normal immune response as well as in allergic (hypersensitivity) responses.
Optimal range: 0 - 2.2 pg/mL
Tumour Necrosis Factor alpha (TNF alpha), is an inflammatory cytokine produced by macrophages/monocytes during acute inflammation and is responsible for a diverse range of signalling events within cells, leading to necrosis or apoptosis. The protein is also important for resistance to infection and cancers.
Reference range: Negative, Equivocal, Positive
Varicella-zoster virus (VZV), a herpes virus, causes 2 distinct rash-associated diseases:
1) chickenpox (varicella) and 2) herpes zoster (shingles).
Chickenpox is a highly contagious, though typically benign, disease, usually contracted during childhood. Chickenpox is characterized by a dermal vesiculopustular rash that develops in successive crops approximately 10 to 21 days following exposure. Although primary infection with VZV results in immunity and protection from subsequent infection, VZV remains latent within sensory dorsal root ganglia and upon reactivation, manifests as herpes zoster or shingles. During reactivation, the virus migrates along neural pathways to the skin, producing a unilateral rash, usually limited to a single dermatome.
Shingles is an extremely painful condition typically occurring in older nonimmune adults or those with waning immunity to VZV and in patients with impaired cellular immunity.
Reference range: NOT DETECTED, DETECTED
Varicella-zoster virus (VZV) causes both varicella (chickenpox) and herpes zoster (shingles). VZV produces a generalized vesicular rash on the dermis (chickenpox) in normal children, usually before 10 years of age. After primary infection with VZV, the virus persists in latent form and may emerge clinically (usually in adults 50 years of age and older) to cause a unilateral vesicular eruption, generally in a dermatomal distribution (shingles).
Optimal range: 0 - 115 pg/mL
VEGF stands for Vascular Endothelial Growth Factor. VEGF is a growth factor that promotes the growth of new blood vessels. The body makes VEGF in response to low oxygen levels, also known as hypoxia. Thus, when tissues are receiving too little oxygen rich blood flow, VEGF is produced to provide a better blood supply to the tissues. VEGF also increases the permeability or leakiness of blood vessels. In fact, one form of VEGF, VEGF-A was once known as vascular permeability factor. VEGF plays a role in cell metabolism, bone formation, and blood cell creation (hematopoiesis). Unfortunately, cancer cells also produce VEGF to help improve their own blood flow. Interestingly, cancer treatments have been developed to block the action of VEGF to starve cancerous tumors of blood flow.
Optimal range: 62 - 707 pg/mL
The marker VEGF, Serum refers to a specific test that measures the levels of vascular endothelial growth factor (VEGF) in a person's blood serum. VEGF is a protein that plays a crucial role in the growth of blood vessels. This test is important because abnormal levels of VEGF can indicate various medical conditions, such as cancers, cardiovascular diseases, and eye disorders. By measuring VEGF in the serum, doctors can gain valuable insights into a patient's vascular health and the potential progression of certain diseases. This information helps in diagnosing conditions early and guiding appropriate treatment strategies to manage or improve the patient's health outcomes.
Optimal range: 50 - 200 %
A von Willebrand factor (vWF) activity – ristocetin cofactor test lets you evaluate the functioning of the protein vWF, which helps blood to clot. A clot is a lump of blood that the body produces to prevent excessive bleeding by sealing leaks from blood vessels caused by wounds, cuts, scratches, or other conditions.
The blood’s ability to clot is a complex process involving platelets (also called thrombocytes) and proteins called clotting factors. Platelets are oval-shaped cells made in the bone marrow. Most clotting factors are made in the liver. Some, like vWF, are made in blood vessel walls.
Optimal range: 50 - 217 %
What Is a Von Willebrand Factor Antigen Test?
Von Willebrand factor is involved in a few stages of blood clotting.
Proteins called clotting factors are needed for blood to clot properly and help prevent too much bleeding. A von Willebrand factor (vWF) antigen test measures the amount of a clotting factor called von Willebrand factor.
The body's clotting factors work together in a special order, almost like pieces of a puzzle. When the last piece is in place, the clot develops. But if there aren't enough of them, or any of them don't work as they should, it can take longer than normal for blood to clot.
Normally, when a blood vessel is damaged and bleeding begins, VWF forms an adhesive bridge between activated cell fragments called platelets and the injury site. This is followed by the clumping (aggregation) of platelets at the site and a series of actions referred to as activation of the coagulation cascade, resulting in the formation of a stable blood clot.
Optimal range: 0.6 - 1 Ratio
The von Willebrand Factor (VWF) Activity/VWF Antigen Ratio is a critical laboratory marker used in the diagnosis and evaluation of von Willebrand disease (VWD), a bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor, a protein essential for blood clotting. This ratio is particularly helpful in distinguishing between different types of VWD and in assessing the severity of the condition.
Optimal range: 45 - 198 % normal
The von Willebrand Factor: Collagen Binding (vWF:CB) assay is a sophisticated laboratory test that plays a crucial role in evaluating the functional capacity of von Willebrand factor (vWF), a multimeric glycoprotein essential for primary hemostasis. This test specifically assesses vWF's ability to bind to collagen, a critical step in the initial phase of blood clot formation.
Other
This category includes all markers that do not fall into any of the other categories.
Optimal range: 0 - 24 mg/g creat
3-Hydroxybutyric acid is a typical partial-degradation product of branched-chain amino acids (primarily valine) released from muscle for hepatic and renal gluconeogenesis. This acid is metabolized by 3-hydroxybutyrate dehydrogenase. The enzyme functions in nervous tissues and muscles, enabling the use of circulating hydroxybutyrate as a fuel.
Optimal range: 0 - 251 U/mL
The AntiDNAse B Titer is a test used in conjunction with ASO titer tests. It tests for poststreptococcal complications.
Optimal range: 0 - 200 IU/ml
This test can help determine whether you have had a recent strep infection with the bacteria group A Streptococcus; to help diagnose complications resulting from a strep infection such as rheumatic fever or glomerulonephritis, a form of kidney disease. This test measures the amount of ASO in the blood.
Optimal range: 0 - 0.94 index
Bordetella pertussis causes whooping cough, a worldwide infectious disease that is transmitted from person to person by droplet infection. Especially children at the age of 0-4 years are affected, and the mortality of infected infants is high.
Optimal range: 0 - 0.1 kunits/L
Testing for IgE antibodies may be useful to establish the diagnosis of an allergic disease and to define the allergens responsible for eliciting signs and symptoms.
Optimal range: 100 - 1000 U/L
CD1656 are an important NK (Natural killer) cell subset.
- NK cells are best known for killing virally infected cells, and detecting and controlling early signs of cancer. As well as protecting against disease, specialized NK cells are also found in the placenta and may play an important role in pregnancy.
- Natural killer T (NKT) cells represent a specialized T-cell population that is distinct from conventional T cells. They express an invariant T-cell receptor (TCR) that recognizes self and bacterial glycosphingolipid antigens presented by the MHC class I-like molecule, CD1d.
- Human natural killer (NK) cells can be subdivided in several subpopulations on the basis of the relative expression of the adhesion molecule CD56 and the activating receptor CD16.
- NK cells serve an important role in host defense against viral infections, as well as tumor surveillance. They are also a component of the adaptive immune response through cytokine production.
- NK cell functions are governed by a balance between activating receptors and inhibitory receptors.
Optimal range: 0.48 - 3.04 mg/L
CoQ10 is a fat-soluble, vitamin-like substance present in most cells, primarily in the mitochondria. CoQ10 plays an integral role in the generation of cellular energy through aerobic cellular respiration. In addition, CoQ10 is a powerful antioxidant at physiologic concentrations.
Optimal range: 0.37 - 2.2 ug/ml
Coenzyme Q10, also known as ubiquinone is a cofactor, electron carrier, and antioxidant. It is a critical component of the electron transport chain in mitochondria.
Optimal range: 0.1 - 0.3 IU/ml
Diphtheria is a contagious and potentially fatal disease caused by a bacterium called Corynebacterium diphtheria. Testing for the antibodies against the disease gives doctors an idea if you have immunity towards diphtheria.
Optimal range: 0 - 1.7 EV
Helicobacter pylori (H. pylori) is a type of bacteria. These germs can enter your body and live in your digestive tract. After many years, they can cause sores, called ulcers, in the lining of your stomach or the upper part of your small intestine.
Optimal range: 0 - 0.5 ng/mL
Histoplasma complement fixation is a blood test that checks for infection from a fungus called Histoplasma capsulatum (H capsulatum), which causes the disease histoplasmosis.
Optimal range: 0 - 14.9 ug/L
Mercury (Hg) is a heavy metal element. It exists in three forms: elemental, inorganic, and organic. All three of these forms of mercury can be toxic, causing several health problems.
Optimal range: 0 - 62 pg/mL , 0 - 0.29 nmol/L
Metanephrine, a metabolite of epinephrine, is at normally low levels in the plasma. Certain tumors increase the levels and will increase the levels of Metanephrine. The Metanephrine test, when normal, means these tumors are not present.
Optimal range: 0.3 - 1.5 mg/dL
Pyruvate or pyruvic acid is an intermediate in several metabolic pathways. Abnormalities in pyruvate alone are not diagnostic of any disease, but they are clinically useful when measured with lactate deform the lactate to pyruvate ratio.
Reference range: Positive (1:64), Positive (>1:64), Negative
Rocky Mountain spotted fever (RMSF) can be difficult to diagnose due to the non-specific signs and symptoms in early stages of illness. Signs and symptoms can vary from patient to patient and can resemble other, more common diseases. Nonetheless, early consideration of rickettsial disease in the differential diagnosis and empiric treatment is crucial to prevent severe illness and death.
Reference range: Positive, Negative
This test measures IgM antibodies to Rocky Mountain Spotted Fever.
IgM antibodies to RMSF are typically detectable within 1-2 weeks of infection. They will typically no longer be detectable after a few months.
Testing for RMSF is recommended for anyone who develops symptoms after being bitten by a tick or spending time outdoors in areas where ticks are prevalent. RMSF Antibody testing can sometimes show false positives due to cross-reactivity with other illnesses including Lyme Disease.
Optimal range: 0 - 0 Units
Rocky Mountain spotted fever (RMSF) is a tick-borne disease caused by the intracellular bacterium Rickettsia rickettsii.
Optimal range: 0 - 0 Units
Special Stains Test is a lab test performed on a skin sample (biopsy) to determine the pathology and confirm there is a skin disease present. It may also be used to monitor the effects of treatment of the skin disease.
Optimal range: 0 - 21 mg/g creat
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0.1 - 0.5 IU/ml
Optimal range: 176 - 323 ug/ml
Glutathione is an antioxidant, a type of chemical which helps to boost your immune system as well as prevent and reverse cellular damage. Unlike most antioxidants which come from the food you eat, glutathione is naturally produced by the body in the liver. Glutathione plays a number of roles in overall health including boosting the immune system, helping to break down nutrients in food, and protecting against chronic diseases such as Alzheimer's, Parkinsons, diabetes, some types of cancer, and heart disease.
Optimal range: 0 - 0.9 Units
Toxoplasmosis is an infection caused by a single-celled parasite called Toxoplasma gondii. While the parasite is found throughout the world, more than 40 million people in the United States may be infected with the Toxoplasma parasite. The Toxoplasma parasite can persist for long periods of time in the bodies of humans (and other animals), possibly even for a lifetime.
Optimal range: 0 - 40 IU/ml
Toxoplasma gondii is an obligate intracellular protozoan parasite that is capable of infecting a variety of intermediate hosts including humans. Infected definitive hosts (cats) shed oocysts in feces that rapidly mature in the soil and become infectious.
Optimal range: 1.1 - 10 AI
The Varicella-Zoster Antibody (IgG) test looks for antibodies in your blood that your body makes against the varicella-zoster virus. It is very contagious. Varicella-zoster virus, a herpesvirus, causes two distinct rash-associated diseases:
– chickenpox (varicella)
– shingles (herpes zoster).
Optimal range: 1.5 - 1.9 Units
Viscosity refers to the property of fluids that enables them to resist flow. Measuring the viscosity of serum, plasma, or whole blood can be valuable in diagnosing and monitoring patients with hyperviscosity syndromes, which are often associated with conditions like multiple myeloma and Waldenstrom's macroglobulinemia. These measurements are reported as a relative viscosity compared to water, where normal serum and plasma have a relative viscosity of up to 1.6. While values greater than 1.6 are considered abnormal, hyperviscosity syndromes typically do not manifest unless the relative viscosity reaches approximately 4.0 or higher.
The most common cause of serum hyperviscosity is the presence of high concentrations of IgM monoclonal proteins. Waldenstrom's macroglobulinemia is responsible for 80% to 90% of symptomatic hyperviscosity cases. Hyperviscosity syndrome can also be observed in patients with multiple myeloma, and, in rare instances, it may occur in patients with high levels of rheumatoid factors and other proteins that tend to aggregate.
Optimal range: 44 - 115 ug/dL , 6.73 - 17.59 umol/L
In healthy individuals, plasma or serum zinc are reliable markers of zinc status, mainly reflecting zinc intake. Because the effective regulation of zinc homeostasis buffers the functional response to dietary deficiency and excess, plasma zinc levels are generally considered a poor measure of marginal zinc deficiency.
Stool
In this category we look at digestion, absorbtion, gut immunology, gut metabolism, gut microbiology, beneficial bacteria and fecal fats.
Optimal range: 0 - 99 Units
Astrovirus can cause diarrheal illness (gastroenteritis). Infants and young children are most likely to have diarrhea caused by astroviruses, but the infection also occurs in the elderly and those with compromised immune systems.
Optimal range: 13.6 - 150 micromol/g
Short chain fatty acids are saturated fatty acids consisting of no more than 6 carbons. The most common forms—acetate, propionate, and butyrate—are also helpful for colon and overall health. Thus, they are called beneficial SCFAs.
Optimal range: 4 - 10 Units
Optimal range: 0.9 - 26.8 U/g
Chymotrypsin is a protein-digesting enzyme secreted by the pancreas. It is useful in monitoring if you have moderate to severe pancreatic dysfunction. When you have symptoms such as persistent diarrhea; foul-smelling, bulky, greasy stools; malnutrition; malabsorption; and vitamin deficiency and pancreatic insufficiency is suspected.
Optimal range: 0.67 - 6.76 mg/g
Deoxycholic acid (DCA) is a secondary bile acid and part of the metabolic category of the Genova test panel. Bile acids are end products of hepatic cholesterol metabolism that play an important role in fat emulsion and detoxification.
Optimal range: 0 - 99 Units
Enteroaggregative Escherichia coli (EAEC) are quite heterogeneous category of an emerging enteric pathogen associated with cases of acute or persistent diarrhea worldwide in children and adults, and over the past decade has received increasing attention as a cause of watery diarrhea, which is often persistent. EAEC infection is an important cause of diarrhea in outbreak and non-outbreak settings in developing and developed countries. Recently, EAEC has been implicated in the development of irritable bowel syndrome, but this remains to be confirmed.
Optimal range: 0 - 99 Units
Enteropathogenic Escherichia coli (EPEC) is a gram-negative bacterial pathogen that adheres to intestinal epithelial cells, causing diarrhea.
Optimal range: 0 - 99 Units
Enterotoxigenic Escherichia coli (E. coli), or ETEC, is an important cause of bacterial diarrheal illness. Infection with ETEC is the leading cause of travelers’ diarrhea and a major cause of diarrheal disease in lower-income countries, especially among children.
Optimal range: 2 - 10 Units
Optimal range: 0 - 0 Units
Optimal range: 0 - 959 ng/g
Optimal range: 2 - 10 Units
Lactobacillus species is a type of bacteria. There are lots of different species of lactobacillus.
Lactobacillus bacteria are commonly found in the human gut, mouth and vagina. They are considered generally as “good bacteria”, and in fact may contribute to good health, often being included in probiotic supplements. These bacteria are characterized by their ability to produce lactic acid as a byproduct of glucose metabolism.
Optimal range: 0.39 - 2.07 Ratio
LCA and DCA are secondary bile acids. These secondary bile acids are associated with disease. An LCA:DCA ratio greater than 1 is associated with increased risk of gallstones, breast cancer, and colorectal cancer.
Optimal range: 0.65 - 5.21 mg/g
Optimal range: 0 - 4 U/mL
Optimal range: 0 - 4999 Units
Optimal range: 200 - 1000 mcg/g
Pancreatic Elastase is an enzyme produced by exocrine tissue in the pancreas. Fecal pancreatic elastase is a non-invasive marker of exocrine pancreatic function. In the digestive tract, elastase is not broken down by other enzymes and is eventually eliminated from the body in the stool. Elastase can be detected and measured in the stool when a person's pancreas is functioning normally. The level in the stool is decreased when the exocrine tissues of the pancreas are not producing sufficient elastase and other digestive enzymes.
Optimal range: 0 - 999 Units
Plesiomonas shigelloides is a Gram-negative bacillus found in aquatic environments that has been primarily associated with sporadic cases and outbreaks of diarrheal disease.
Optimal range: 0 - 9999999 Units
Prevotella copri is a gut bacteria that may cause rheumatoid arthritis. Studies consistently find different bacterial patterns in people with inflammatory arthritis vs controls.
Optimal range: 1.3 - 8.6 micromol/g
Valerate, isovalerate and isobutyrate constitute the putrefactive short chain fatty acids (SCFAs).
Valerate, isovalerate and isobutyrate are produced exclusively by fermentation of protein. These SCFAs are putrefactive, and suggest underlying protein maldigestion, malabsorption, or BOSI.
Optimal range: 0 - 99 Units
Rotavirus affects the intestines and causes vomiting and diarrhea. This infection is especially common in young children, but it can affect adults, too. A rotavirus infection causes a condition called viral gastroenteritis.
Optimal range: 6.1 - 7.9 pH
A fecal pH test is one where a specimen of feces is tested for acidity in order to diagnose a medical condition.
Stool pH is dependent in part on fermentation of sugars. Colonic fermentation of normal amounts of carbohydrate sugars and production of fatty acids accounts for the normally slightly acidic pH.
Optimal range: 0 - 99999 Units
Vibrios are inhabitants of estuarine and fresh waters and some species are pathogenic to humans, and marine vertebrates and invertebrates. In humans, some species of vibrios can cause gastroenteritis following ingestion of contaminated food or water and septicemia when pre-existing cuts or abrasions on skin come in contact with contaminated water or seafoods.
Optimal range: 0 - 107 ng/mL
Zonulin is a protein that plays a key role in regulating the permeability of the tight junctions between cells in the lining of the small intestine. These tight junctions are like gates that control what substances can pass from the gut into the bloodstream.
When zonulin levels are balanced, the intestinal barrier remains tight and selective. However, when zonulin levels increase, the intestinal barrier becomes more "leaky," allowing larger molecules like undigested food particles, toxins, and microbes to cross into the bloodstream. This condition is commonly referred to as increased intestinal permeability, or more informally, leaky gut.
Measuring zonulin in stool offers a non-invasive way to assess the integrity of the gut barrier, particularly in the small intestine.
Gonadotropins
The gonadotropins are peptide hormones that regulate ovarian and testicular function and are essential for normal growth, sexual development and reproduction. The human gonadotropins include follicle stimulating hormone and luteinizing hormone which are made in the pituitary, and chorionic gonadotropin which is made by the placenta.
Optimal range: 1.5 - 12.4 IU/L
Follicle stimulating hormone (FSH) is a pituitary hormone that regulates growth, sexual development and reproduction, including menstruation, follicular development and ovulation.
Optimal range: 0.7 - 12.5 IU/L
Luteinizing hormone (LH) is hormone associated with reproduction and the stimulation of the release of an egg from the ovary (ovulation) in women and testosterone production in men.
Optimal range: 102 - 496 mU/L , 4.79 - 23.31 ng/mL
Prolactin is a hormone produced by the pituitary gland that causes breast development in women and milk production in pregnant women. Prolactin does not have known biological function in men.
DUTCH (male)
The DUTCH test is a urine steroid hormone test that measures hormones and hormone metabolites from a dried urine sample.
Optimal range: 0 - 1.2 ng/mg
16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol.
Optimal range: 0 - 2.8 ng/mg
The 2-Methoxy Estrogens are considered to be protective. Low levels are usually a reflection of overall low estrogens and may be improved with supplemental estrogen.
Optimal range: 0 - 5.9 ng/mg
2-Hydroxyestrone is an endogenous biomarker and major urinary metabolite of estrone and estradiol. Along with 16α-Hydroxyestrone, 2-Hydroxyestrone is used as an indicator for increased risk of cancer.
Optimal range: 0 - 0.8 ng/mg
A very carcinogenic estrogen metabolite, levels low in the reference range are desirable. Additional magnesium, liver support, and methylation support may help decrease 4-OH-E1 levels.
Optimal range: 20 - 130 ng/mg
Progesterone itself is not readily found in the urine. Instead, this test measures pregnanediol (a progesterone metabolite). Pregnanediol is well-established in research literature as a reliable marker for progesterone levels.
Optimal range: 75 - 400 ng/mg
Progesterone itself is not readily found in the urine. Instead, this test measures pregnanediol (a progesterone metabolite). Pregnanediol is well-established in research literature as a reliable marker for progesterone levels.
Optimal range: 0.5 - 2.2 ng/mg
Estradiol is the main "female" hormone. The full name is 17-beta-Estradiol.
Current research indicates that, in some people, this hormone may play a role in the loss of bone density, prevents male bodies from clearing DHT out of the prostate gland, and can stimulate estrogen-sensitive tumor growth (if estrogen-sensitive cancer cells are already present).
Optimal range: 2 - 8 ng/mg
Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Optimal range: 4 - 16 ng/mg
There are three types of estrogen: estradiol, estriol, and estrone. Estradiol is the primary female sex hormone. Estriol and estrone are minor female sex hormones. Estriol is nearly undetectable in women who aren’t pregnant.
Optimal range: 6 - 20 ng/mL
Although Progesterone is found in both males and females, it is primarily known for its role in conception, pregnancy, and the regulation of a woman’s menstrual cycle.
Optimal range: 10 - 34 ng/mg
Estrogen is known as the “female” hormone. The four major naturally occurring estrogens in women are estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4).
Although estrogen is identified with females, it is also found in men.
Endocrinology
Endocrinology is a specialized branch of medicine that focuses on the diagnosis and treatment of diseases related to hormones. It encompasses a wide array of conditions due to its systemic nature, as hormones regulate many different biological processes in the body. Endocrinologists deal with the endocrine system, which includes glands such as the thyroid, adrenal, ovaries, testes, and pancreas, among others. This field is crucial for managing complex conditions like diabetes, thyroid diseases, metabolic disorders, osteoporosis, menopause, cancers of the endocrine glands, and infertility issues. The practice of endocrinology involves a deep understanding of the biochemical mechanisms that control the body's metabolism, reproduction, growth, and development, as well as the coordinated action and communication between different organs through hormonal signals.
Optimal range: 53 - 357 ng/dL
This test serves as a valuable ancillary tool in diagnosing congenital adrenal hyperplasia (CAH), especially in cases where 21-hydroxylase and 11-hydroxylase deficiencies have already been ruled out. It is particularly instrumental in confirming a diagnosis of 3-beta-hydroxydehydrogenase (3-b-HSD) deficiency and 17-alphahydroxylase deficiency. Additionally, it is an essential component of a comprehensive battery of tests used to assess females experiencing hirsutism or infertility, both of which can be potential outcomes of adult-onset CAH.
Optimal range: 0 - 431 ng/dL
17-Hydroxyprogesterone (17-OHP) is a steroid hormone produced primarily in the adrenal glands and, to a lesser extent, in the gonads (ovaries and testes). It serves as an important intermediate in the biosynthesis of cortisol and other steroid hormones, and is a crucial biomarker for diagnosing congenital adrenal hyperplasia (CAH), a group of genetic disorders affecting adrenal gland function. CAH can lead to an imbalance of hormones, particularly cortisol.
Reference ranges:
In females, normal levels of 17-OHP vary depending on age, menstrual cycle phase, and pregnancy status. Typically, the reference range for adult women is between 20 to 100 ng/dL in the follicular phase of the menstrual cycle, and 100-500 ng/dL during the luteal phase.
Optimal range: 35 - 290 ng/dL
17-OHP is produced by the adrenal gland as part of the process of making the important hormone cortisol. The adrenal glands are two small glands. One is located on top of each kidney. Along with special enzymes, or proteins, 17-OH progesterone is converted to a hormone called cortisol.
Optimal range: 143 - 842 pg/mL
5 Alpha-Dihydrotestosterone (DHT) is a hormone that plays a crucial role in male development and health. It is derived from testosterone, the primary male sex hormone, through the action of an enzyme called 5-alpha-reductase. DHT is significantly more potent than testosterone and is involved in a variety of physiological processes. During puberty, DHT is responsible for the development of secondary sexual characteristics in males, such as facial and body hair, deepening of the voice, and growth of the genitals. It also plays a role in the growth and maintenance of the prostate gland. However, DHT is also associated with male pattern baldness and can contribute to prostate enlargement and other health issues later in life.
Optimal range: 7.2 - 63.3 pg/mL , 1.59 - 13.94 pmol/L
ACTH (Adrenocorticotropic hormone), a pituitary hormone, stimulates cortisol production from the adrenal glands. If ACTH levels are too low or too high, it can indicate that the pituitary or the adrenal glands are diseased.
Optimal range: 0 - 4.7 pg/mL
ADH stands for antidiuretic hormone also known as vasopressin. ADH primarily acts in the kidney to resorb water. Vasopressin can also be administered to raise blood pressure.
Optimal range: 0 - 30 ng/dL per ng/mL/hr , 0 - 386.1 pmol/L per ng/mL/hr
The aldosterone to renin ratio blood test measures the amount of aldosterone divided by the amount of renin in the blood plasma. The test determines whether or not primary hyperaldosteronism is present and causing high blood pressure.
Optimal range: 0 - 30 ng/dL , 0 - 1081.35 pmol/L
Aldosterone is a vital hormone for maintaining proper blood pressure and electrolyte balance. It regulates sodium and potassium levels in the body, ensuring that the correct amount of sodium is retained, and excess potassium is excreted through the kidneys. The synthesis of aldosterone is controlled by the renin-angiotensin system, which activates in response to low blood pressure or high potassium levels. Maintaining optimal aldosterone levels is crucial for overall cardiovascular health and preventing imbalances that can lead to conditions like hypertension, heart disease, or electrolyte disturbances.
Optimal range: 0.9 - 28.9 Ratio
The aldosterone-renin ratio (ARR), also known as the aldosterone plasma renin activity (PRA) ratio, is a critical diagnostic tool used in the evaluation of primary aldosteronism, a condition characterized by excessive production of the hormone aldosterone by the adrenal glands.
Optimal range: 27 - 152 ng/dL
DHEA and androstenedione are made almost exclusively by the adrenal gland (although a smaller amount is made in the ovaries). These hormones appear in urine as DHEA-S (DHEA-Sulfate), androsterone and etiocholanolone.
Optimal range: 5.5 - 37.4 pmol/L , 0.77 - 5.24 ng/mL
Anti-Müllerian Hormone (AMH) is a hormone produced by granulosa cells in ovarian follicles and plays a vital role in reproductive health. It is commonly used as a marker to assess ovarian reserve—the number of viable eggs a woman has left. This test is frequently ordered as part of fertility evaluations, to monitor ovarian function, or to predict menopause onset. In men, AMH is secreted by Sertoli cells in the testes and plays a role in early sexual differentiation, although clinical testing in adult males is rare.
AMH levels provide insight into a woman’s fertility potential because they reflect the number of small, developing follicles in the ovaries. Unlike other reproductive hormones such as FSH (follicle-stimulating hormone), AMH levels remain relatively stable throughout the menstrual cycle, making it a reliable measure of ovarian reserve at any time of the month. The test is often used in:
Evaluating fertility and guiding assisted reproductive technologies (ART), like IVF
Diagnosing or monitoring polycystic ovary syndrome (PCOS)
Assessing risk of early menopause or diminished ovarian reserve
Monitoring ovarian function in women undergoing chemotherapy or other treatments that affect fertility
Diagnosing certain ovarian tumors that may produce AMH
Optimal range: 0 - 5 mIU/L
Beta-Human Chorionic Gonadotropin (β-hCG or BHCG) is a subunit of Human Chorionic Gonadotropin (hCG), a hormone primarily produced by the placenta during pregnancy. The beta subunit is unique to hCG and serves as the basis for pregnancy tests and certain medical evaluations.
β-hCG levels are commonly assessed for:
Optimal range: 38 - 724 pg/mL
Optimal range: 0 - 8.4 pg/mL
What is Calcitonin?
Calcitonin is a hormone that plays a role in regulating the level of calcium in your blood by decreasing it.
What is a calcitonin test?
A calcitonin test measures the level of calcitonin in a sample of your blood. Calcitonin is a hormone that helps control the level of calcium in your blood. Calcitonin is made in your thyroid gland by cells called "C cells." Your thyroid is a small, butterfly-shaped gland in your neck.
Where is Calcitonin produced?
Calcitonin is a hormone that is produced in humans by the parafollicular cells (commonly known as C-cells) of the thyroid gland.
Optimal range: 2.5 - 19.5 Units
This test it performed to help diagnose primary adrenal insufficiency (Addison disease) and to detect conditions affecting the pituitary gland (secondary adrenal insufficiency). The test is performed when your cortisol level is low and/or your healthcare provider suspects that your adrenal glands are not producing enough of the hormone cortisol or that the pituitary gland is not producing enough adrenocorticotropic hormone (ACTH).
Optimal range: 6.2 - 19.4 ug/dL , 62 - 194 ng/mL , 171.03 - 535.17 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 1.5 - 9.6 ng/mL
Cortisol, often referred to as the "stress hormone," is a steroid hormone produced by the adrenal glands in response to signals from the hypothalamic-pituitary-adrenal (HPA) axis. It plays a vital role in regulating metabolism, immune responses, blood pressure, and the body's stress response. Measuring cortisol levels in saliva provides a non-invasive and accurate way to evaluate the body's cortisol production throughout the day.
Optimal range: 0.04 - 0.93 mcg/dL
Cortisol, the main glucocorticoid (representing 75%-95% of the plasma corticoids), plays a critical role in glucose metabolism and in the body's response to stress.
The majority of cortisol circulates bound to corticosteroid-binding globulin (CBG) and albumin. Normally, less than 5% of circulating cortisol is free (unbound). Only free cortisol can access the enzyme transporters in liver, kidney, and other tissues that mediate metabolic and excretory clearance.
Both hypercortisolism (Cushing disease) and hypocortisolism (Addison disease) can cause disease.
Optimal range: 2.3 - 19.4 µg/dL , 63.46 - 535.25 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli. Levels naturally peak in the morning and then reach their lowest point at night. A high blood cortisol level at night may indicate a problem with the adrenal glands; however, individuals who work at night and sleep during the day will have an inversed pattern.
Optimal range: 19 - 45 mg/L , 1.9 - 4.5 mg/dL
Corticosteroid-binding globulin (CBG), also known as transcortin, is a key plasma protein that plays a critical role in the transport and regulation of corticosteroids in the bloodstream. Produced primarily by the liver, CBG binds to glucocorticoids such as cortisol, the body’s primary stress hormone. By binding these hormones, CBG regulates their availability and helps control their biological activity. Around 80-90% of circulating cortisol is bound to CBG, ensuring that only a small fraction is free and biologically active. This intricate regulation is crucial for maintaining hormone balance and responding to stress.
CBG is not only responsible for cortisol transport, but it also acts as a reservoir that releases cortisol in response to changing physiological needs. When the body encounters stress, injury, or inflammation, enzymes like neutrophil elastase can cleave CBG, releasing bound cortisol to target tissues. This enables a rapid response to acute stress, increasing the body’s ability to cope with immediate physiological challenges. Without this mechanism, the body would struggle to meet the hormonal demands necessary to maintain homeostasis in stressful situations.
Optimal range: 71.6 - 375.4 mcg/dL , 1.94 - 10.17 umol/L
Dehydroepiandrosterone (DHEA) is a naturally occurring steroid hormone produced mainly by the adrenal glands, with smaller amounts synthesized in the gonads (ovaries and testes) and the brain. DHEA acts primarily as a precursor for the body’s major sex hormones—testosterone and estrogen—meaning it is converted into these hormones as needed. This role is crucial for reproductive function, mood regulation, metabolism, immune function, and maintaining overall hormonal balance in both men and women.
Hormone Precursor: DHEA is converted into androgens (like testosterone) and estrogens, supporting the development of secondary sexual characteristics and reproductive health.
Neurosteroid: DHEA has effects in the central nervous system, acting as a neurosteroid that can influence mood, cognitive function, and memory.
Metabolic and Immune Effects: It modulates endothelial function (essential roles in maintaining blood vessel health and regulating blood flow), reduces inflammation, improves insulin sensitivity, supports fat metabolism, and may enhance immune response.
Antioxidant Properties: DHEA may help combat oxidative stress and inflammation.
Optimal range: 200 - 1000 ng/dL
Dexamethasone is a synthetic corticosteroid commonly used in medicine for its potent anti-inflammatory and immunosuppressive properties. As a biomarker, it is often measured in blood or urine to monitor its levels during therapeutic use, evaluate compliance with prescribed regimens, or investigate suspected overuse or misuse. Dexamethasone testing is particularly relevant in diagnosing or managing conditions like adrenal insufficiency, autoimmune diseases, or certain cancers, where it is used to modulate inflammation or suppress immune responses. Elevated levels may indicate excessive dosing or prolonged exposure, which can lead to side effects like suppressed adrenal function, osteoporosis, or glucose intolerance. Conversely, low or undetectable levels in patients prescribed dexamethasone may point to non-compliance or issues with absorption or metabolism. This biomarker plays a critical role in ensuring safe and effective corticosteroid use while minimizing the risk of complications.
Optimal range: 42 - 578 pg/mL
DHEA (Dehydroepiandrosterone) is a steroid hormone produced primarily by the adrenal glands, with smaller contributions from the ovaries or testes. It serves as a precursor for other sex hormones, such as testosterone and estrogen, and plays a critical role in regulating various physiological processes. Measuring DHEA levels in saliva provides insight into adrenal gland function, hormonal balance, and overall health.
Optimal range: 147 - 1760 ng/dL
DHEA, or Dehydroepiandrosterone, Unconjugated, is a significant endogenous steroid hormone, playing a pivotal role in the human endocrine system. This hormone, produced primarily by the adrenal glands, serves as a precursor to both androgens and estrogens, which are the major male and female sex hormones, respectively. Unconjugated DHEA refers to DHEA in its free form, not bound to any other molecules, making it biologically active. The measurement of unconjugated DHEA is crucial in assessing adrenal gland function and in diagnosing various health conditions.
Optimal range: 4 - 7 :1 ratio
The DHEA-S (Dehydroepiandrosterone Sulfate) to cortisol ratio is a marker used in assessing adrenal gland function and can provide insight into the balance of hormones produced by these glands.
DHEA-S is an androgen precursor produced by the adrenal glands, which is then converted into more potent androgens or estrogens within tissues.
Cortisol, also produced by the adrenal glands, is a steroid hormone pivotal to the stress response, glucose metabolism, and inflammation control.
An optimal balance between DHEA-S and cortisol is crucial for maintaining health, as it reflects the state of adrenal function and the body’s response to stress.
Optimal range: 2.3 - 11.6 pg/mL
Free DHT is a valuable biomarker for evaluating conditions related to hair loss, prostate health, and hormonal imbalances. Understanding and monitoring free DHT levels, alongside other hormonal markers, can provide crucial insights for maintaining overall health and addressing specific medical conditions.
Optimal range: 0.54 - 2.58 %
Dihydrotestosterone (DHT), Percent Free Dialysis is a laboratory measurement used to assess the bioavailable portion of dihydrotestosterone (DHT) in the bloodstream. DHT is a potent androgen hormone derived from testosterone through the action of the enzyme 5a-reductase. This conversion primarily takes place in target tissues, such as the skin, prostate, and hair follicles, and DHT plays a crucial role in male sexual development and secondary sexual characteristics.
Optimal range: 45.4 - 1461 pmol/L , 12.37 - 397.98 pg/mL
Estradiol (Estrogen) is a female hormone, produced primarily in the ovary. The amount of estrogen produced depends on the phase of the menstrual cycle.
Men also produce estradiol, but only very small amounts.
Shortly before ovulation, estradiol levels surge and then fall immediately after ovulation. They then rise again and remain elevated until 2-3 days before menstruation.
Optimal range: 7.6 - 42.6 pg/mL , 27.9 - 156.4 pmol/L
Estradiol is the main "female" hormone. The full name is 17-beta-Estradiol.
Current research indicates that, in some people, this hormone may play a role in the loss of bone density, prevents male bodies from clearing DHT out of the prostate gland, and can stimulate estrogen-sensitive tumor growth (if estrogen-sensitive cancer cells are already present).
Men need to produce estrogen through a process involving an enzyme called aromatase that transforms testosterone into estradiol.
Aging men sometimes have too much aromatase activity, which causes their testosterone to convert to excess estradiol. This results in depletion of vital testosterone while spiking estradiol to unsafe ranges.
Optimal range: 0.4 - 3.3 pg/mL
Estradiol, a form of estrogen, is a critical hormone in the human body, primarily responsible for regulating reproductive and sexual health. The Estradiol - Saliva test measures the level of estradiol present in saliva, expressed in picograms per milliliter (pg/mL). Unlike serum tests, saliva testing reflects the bioavailable (free) fraction of estradiol, which is the active form readily used by the body.
Optimal range: 0 - 0.45 pg/mL
Optimal range: 30 - 100 pg/mL
Please check the reference ranges in the description on the main dashboard as this marker is age and gender specific.
- Estradiol is responsible for the regulation of the estrous and female menstrual reproductive cycles and for the development and maintenance of female secondary sex characteristics.
- Estradiol plays a key role in germ cell maturation and numerous other, non−gender-specific processes, including growth, bone metabolism, nervous system maturation, and endothelial responsiveness.
- Estrogens are crucial for the normal development and maintenance of the breasts and the uterus.
- Excessive estrogen levels, however, can promote cell proliferation and may increase the risk of developing breast and uterine cancers as well as uterine endometriosis.
Optimal range: 0 - 29 pg/mL
Estradiol, Ultrasensitive, LC/MS is a highly accurate test that measures very low levels of estradiol (E2)—the most potent form of estrogen—in the male body. This version uses liquid chromatography-tandem mass spectrometry (LC/MS or LC-MS/MS), a gold-standard method for hormone testing, especially when precise measurement at low concentrations is required.
In men, estradiol is mainly produced through the conversion of testosterone via the enzyme aromatase. While estrogen is often thought of as a female hormone, estradiol plays several important roles in male health, including maintaining bone density, supporting mood and cognitive function, regulating libido, and contributing to cardiovascular health.
Optimal range: 0 - 0.21 ng/mL
Estriol is one of three estrogen hormones. Estriol levels rise throughout pregnancy, helping to keep your uterus and unborn baby healthy. The levels are at their highest right before childbirth. They help prepare your body for labor and delivery.
Everyone makes estriol. But in people who aren’t pregnant, the levels are almost undetectable. Other names for estriol include oestriol and E3.
During pregnancy, estriol:
- Helps your uterus grow as the fetus gets bigger.
- Makes your body more sensitive to other pregnancy hormones.
- Prepares your body for labor and delivery and breastfeeding.
Optimal range: 50 - 170 pg/mL
Total estrogen is a reliable test for estrogen status and is used to detect hormone imbalances.
Estrogen is known as the “female” hormone. The four major naturally occurring estrogens in women are estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4).
Normal Ranges for Total Estrogen in pg/mL:
|
Adult Female (depends on the menstrual phase) |
|
|
Prepubertal <40 pg/mL Follicular Phase (1-12 days) 90-590 pg/mL Luteal Phase 130-460 pg/mL Postmenopausal 50-170 pg/mL Adult Male 60-190 pg/mL |
|
Critical Range: anything outside the limits mentioned above.
Optimal range: 60 - 190 pg/mL
Estrogen is known as the “female” hormone. The four major naturally occurring estrogens in women are estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4).
Although estrogen is identified with females, it is also found in men.
Optimal range: 10 - 373 ng/dL
Estrone Sulfate is a vital biomarker that plays a significant role in assessing hormonal health, particularly in women. Estrone sulfate is a conjugated form of estrone, one of the three main types of estrogen, and it serves as a major circulating estrogen in the bloodstream. It is primarily produced in the ovaries, placenta, and adipose tissue.
Testing of estrone sulfate levels is critical for understanding various health conditions, including menopausal status, ovarian function, and potential hormone-related disorders. In premenopausal women, estrone sulfate levels provide insights into ovarian function, whereas in postmenopausal women, these levels can help assess the risk of estrogen-related conditions such as osteoporosis or cardiovascular disease.
Optimal range: 22 - 200 pg/mL
Estrone (E1) is a steroid, a weak estrogen, and a minor female sex hormone. Estrone is one of three major endogenous estrogens, the others being estradiol and estriol. Like the other estrogens, estrone is synthesized from cholesterol and secreted mainly from the gonads, though they can also be formed from adrenal androgens in adipose tissue. Estrone is primarily derived from metabolism of androstenedione in peripheral tissues, especially adipose tissues. Estrone can be converted into estradiol and serves mainly as a precursor or metabolic intermediate of estradiol. In addition, an increase in the ratio of estrone to estradiol may be useful in assessing menopause in women.
Optimal range: 15 - 65 pg/mL
Estrone (E1) is a steroid, a weak estrogen, and a minor female sex hormone. Estrone is one of three major endogenous estrogens, the others being estradiol and estriol. Like the other estrogens, estrone is synthesized from cholesterol and secreted mainly from the gonads, though they can also be formed from adrenal androgens in adipose tissue. Estrone is primarily derived from metabolism of androstenedione in peripheral tissues, especially adipose tissues. Estrone can be converted into estradiol and serves mainly as a precursor or metabolic intermediate of estradiol. In addition, an increase in the ratio of estrone to estradiol may be useful in assessing menopause in women.
Optimal range: 0.2 - 1.8 ug/dL
This cortisol test measures the level of cortisol in your blood to see if your levels are normal.
Cortisol is made by your adrenal glands, two small glands that sit above the kidneys. A gland in your brain, called the pituitary gland, makes a hormone that tells your adrenal glands how much cortisol to make. If your cortisol levels are too high or too low, it may mean you have a disorder of your adrenal glands, a problem with your pituitary gland, or a tumor that makes cortisol.
Optimal range: 1.6 - 3.6 %
Navigating the complexities of hormonal health can be challenging, especially when it comes to understanding 'Free Estradiol, Percent'. This marker is crucial for women who are monitoring their hormonal balance, fertility, or overall health. Estradiol is a primary form of estrogen, a hormone that plays a pivotal role in female reproductive health. It influences everything from your menstrual cycle to mood regulation. What sets 'free' estradiol apart is its bioavailability. Unlike total estradiol, which includes all estradiol in your blood (both attached to proteins and unattached), free estradiol refers exclusively to the unbound portion.
Optimal range: 0.6 - 7.1 pg/mL
Free Estradiol Serum, a crucial component in evaluating hormonal balance, plays a pivotal role in both men's and women's health. Primarily known as a female hormone, estradiol is also present in men and is essential for modulating libido, erectile function, and spermatogenesis. In women, estradiol is vital for the regulation of the menstrual cycle, affecting reproductive health and fertility. It's produced by the ovaries and, in lesser amounts, by the adrenal glands and fat tissues.
Optimal range: 48 - 185 pg/mL
Free Testosterone is the bioavailable form of testosterone, a key androgen hormone responsible for regulating numerous physiological processes in both men and women. The Free Testosterone - Saliva test measures the amount of unbound testosterone in saliva, expressed in picograms per milliliter (pg/mL). Unlike total testosterone tests in blood, saliva testing specifically assesses the hormone’s biologically active fraction, which is readily available for use by the body’s tissues.
Optimal range: 11 - 78 pg/mL
Glucagon is a peptide hormone secreted from the alpha cells of the pancreatic islets of Langerhans. Hypoglycemia is physiologically the most potent secretory stimulus and the best known action of glucagon is to stimulate glucose production in the liver and thereby to maintain adequate plasma glucose concentrations. However, glucagon is also involved in hepatic lipid and amino acid metabolism and may increase resting energy expenditure. Based on satiety-inducing and food intake-lowering effects of exogenous glucagon, a role for glucagon in the regulation of appetite has also been proposed.
Optimal range: 0 - 25 pg/mL
Gonadotropin Releasing Hormone (GnRH) is a crucial peptide hormone that plays a fundamental role in regulating the reproductive system. Produced in the hypothalamus, GnRH is responsible for stimulating the pituitary gland to release two key hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are essential for the development and functioning of the ovaries in females and the testes in males, making GnRH a pivotal factor in sexual maturation, ovulation, and sperm production.
Optimal range: 0 - 6 ng/mL , 0 - 18 mIU/L
Growth Hormone and Its Functions
What is Growth Hormone? Growth hormone is essential for growth and development in children.
Where is Growth Hormone Produced? Growth hormone is produced by the pituitary gland, a small gland located at the base of the brain behind the bridge of the nose. It is normally released into the blood in pulses throughout the day and night, with peaks mostly occurring during the night. Due to this pulsatile release, a single measurement of GH level in the blood is difficult to interpret and is not usually clinically useful. The value will be higher if the sample is taken during a pulse and lower if taken between pulses.
Normal Range for Growth Hormone Levels:
→ Adult Males: 0.05 to 3 nanograms per milliliter (ng/mL)
→ Adult Females: 0.05 to 8 ng/mL
→ Children: Varies with age and gender; consult your healthcare provider for the normal range for your child.
Reference range: Positive, Negative
A qualitative HCG blood test checks if there is a hormone called human chorionic gonadotropin in your blood. HCG is a hormone produced in the body during pregnancy.
Reference range: Negative (<7.5), Positive (> or = 7.5)
Type 1 diabetes, commonly referred to as insulin-dependent diabetes (IDDM), is caused by pancreatic beta-cell destruction that leads to an absolute insulin deficiency. The clinical onset of diabetes does not occur until 80% to 90% of these cells have been destroyed. Prior to clinical onset, type 1 diabetes is often characterized by circulating autoantibodies against a variety of islet cell antigens, including glutamic acid decarboxylase (GAD), tyrosine phosphatase (IA2), and insulin. The autoimmune destruction of the insulin-producing pancreatic beta cells is thought to be the primary cause of type 1 diabetes. The presence of these autoantibodies provides early evidence of autoimmune disease activity, and their measurement can be useful in assisting the physician with the prediction, diagnosis, and management of patients with diabetes.
Optimal range: 5 - 34 ng/mL
Insulin-like growth factor-binding protein 1 is a member of the family of structurally homologous proteins (= those with a common evolutionary origin) that specifically binds and modulates the activities of IGF-1 and IGF-2.
Serum levels of IGFBP-1 exhibit considerable diurnal variation (= the variations occur in response to circadian rhythms) with levels highest early in the morning and lowest in the evening. Serum IGFBP-1 levels are controlled by insulin with the postprandial increase (= after a meal) in insulin levels producing a four- to fivefold decrease in IGFBP-1 levels relative to fasting levels.
Optimal range: 3.4 - 7 mg/L , 3400 - 7000 ng/mL
Insulin-like Growth Factor Binding Protein 3 (IGFBP-3) is an important protein in our body that helps manage growth and development. It mainly works by controlling the activity of growth factors, IGF-I and IGF-II, which are crucial for cell growth. IGFBP-3 is mostly produced in the liver and travels in the blood, often attached to these growth factors.
Apart from regulating growth factors, IGFBP-3 also has its own roles. It can influence cell growth, the process of cells dying (apoptosis), and cell transformation (differentiation). These functions make it important not just in normal body processes like growth and aging, but also in diseases like cancer and metabolic disorders such as diabetes.
Optimal range: 2571 - 5982 ug/L
IGFBP-3 is a multifunctional protein integral to regulating various physiological processes from growth to cancer progression and metabolic health. Its potential as a biomarker underscores its importance in ongoing research aimed at developing new treatments for diseases such as cancer, diabetes, and age-related disorders.
Optimal range: 0.3 - 13.4 ng/mL
What is Leptin?
Leptin is a hormone – a chemical messenger that helps different body parts work together. Leptin is anorexigenic (= causing loss of appetite), and levels are markedly decreased in women with low body weight and high in obesity. Leptin secretion follows a circadian pattern, meaning that the concentration in blood will vary throughout a 24-hour time period (higher at night than during the day).
What does Leptin do?
Leptin is an appetite suppressant. When everything works the right way, it helps you maintain a healthy weight by balancing the amount of food you eat with how much fat you have. Leptin sends a signal to your brain that helps you feel full and less interested in food. You may hear it called a satiety hormone. (Satiety means hunger feels satisfied.) It also plays a role in how your body turns fat into energy.
In a normal feedback response, a low level of leptin triggers hunger and an increase in food consumption. As the level of leptin rises from an increase in fat cells, hunger diminishes and food consumption drops off.
→ When a person eats enough food, leptin is released into the bloodstream, where it travels to the brain, signalling that they are full and that they can burn calories at a normal rate.
Leptin is produced primarily by fat cells (adipocytes) and to a lesser degree by other tissues, including the placenta in pregnant women.
Optimal range: 7.7 - 58.5 uIU/ml
Luteinizing Hormone, Human (hLH), plays a crucial role in the female reproductive system and is a key marker on a female hormone panel. This hormone, produced by the pituitary gland, is involved in regulating the menstrual cycle and ovulation. In the first half of the menstrual cycle, hLH levels gradually increase, leading to a significant surge just before ovulation. This surge is critical as it triggers the release of an egg from the ovary, making it a pivotal moment for fertility. After ovulation, if the egg is not fertilized, hLH levels decrease, and the menstrual cycle continues.
Optimal range: 2.3 - 9.5 %
Percent Free Cortisol, Serum refers to the proportion of cortisol in your blood that is not attached to proteins such as corticosteroid-binding globulin (CBG) or albumin. While about 90–95% of circulating cortisol is bound to these proteins and biologically inactive, the remaining 5–10% is “free” and able to enter cells, where it triggers important physiological effects-including the stress response, metabolism regulation, and immune system modulation.
Optimal range: 0.38 - 3.5 ng/mL
Pregnenolone, measured in nanograms per milliliter (ng/mL), is a crucial neurosteroid in males, acting as a precursor to various other steroids including progesterone, mineralocorticoids, glucocorticoids, androgens, and estrogens. It is synthesized directly from cholesterol and serves as the foundational substrate in the steroidogenesis pathway, leading to the production of these hormones.
This steroid plays a vital role in brain function, as it is involved in neurogenesis, synaptic functioning, and neural plasticity, and it also influences mood and memory.
Optimal range: 0.27 - 0.9 ng/mL , 0.86 - 2.86 nmol/L , 858.61 - 2862.05 pmol/L
Progesterone is present in men but at a much lower level than found in premenopausal women. Progesterone is not only a female hormone. Although in females it is responsible for protecting the unborn child from rejection during pregnancy, progesterone performs various other functions in both men and women. Progesterone is the precursor to other hormones, including testosterone, the sex hormone that emphasizes male characteristics.
Optimal range: 0.3 - 50.6 nmol/L , 0.09 - 15.91 ng/mL
Progesterone plays an important role in preparing the uterus for pregnancy. Levels of progesterone rise with pregnancy, and rise even higher if there are twins. Imbalances of progesterone are linked with health challenges in both men and women.
Optimal range: 3 - 30 ng/mL , 3 - 30 ug/L , 63.83 - 638.3 mUI/L
Prolactin is a hormone produced by the pituitary gland that plays a vital role in reproductive health and various physiological processes.
| Category | Prolactin Range |
|---|---|
| Adult Male | 2.0 - 18.0 |
| Adult Female (Non-Pregnant) | 3.0 - 30.0 |
| Adult Female (Pregnant) | 10.0 - 209.0 |
| Adult Female (Postmenopausal) | 2.0 - 20.0 |
| Stage | Female | Male |
|---|---|---|
| I | 3.6 - 12.0 | ≤10.0 |
| II-III | 2.6 - 18.0 | ≤6.1 |
| IV-V | 3.2 - 20.0 | 2.8 - 11.0 |
When prolactin levels exceed normal ranges, a condition called hyperprolactinemia may develop, potentially indicating underlying health conditions that require medical evaluation. Monitoring prolactin levels is crucial for diagnosing and managing hormonal imbalances that affect fertility, metabolism, and overall endocrine health.
Optimal range: 0.17 - 5.38 ng/mL/hr
Renin is an enzyme produced by the kidney that can raise blood pressure levels. The renin activity plasma test helps your doctor determine whether or not your high blood pressure is due to poor kidney health.
Optimal range: 0 - 30 pmol/L
What it is
Free testosterone is the small fraction of testosterone in the blood that is not bound to proteins like sex hormone–binding globulin (SHBG). This “free” form is biologically active and able to act directly on tissues. In women, testosterone supports bone and muscle health, libido, mood, and energy.
Why it’s measured
Free testosterone testing can help evaluate symptoms related to hormonal imbalance, including irregular periods, low libido, acne, hair changes, and unexplained fatigue. It is especially useful when total testosterone is normal but symptoms persist, as protein binding can mask hormone activity.
LifeLabs reference ranges
LifeLabs uses method-specific ranges for females, which may be reported in pg/dL or pmol/L. These ranges can differ from other labs, so always compare your result to the reference interval shown on your report.
Low levels may be linked to
Menopause or ovarian insufficiency
Pituitary or adrenal disorders
High SHBG from thyroid disorders or certain medications
Symptoms: low libido, fatigue, low muscle tone, mood changes
High levels may be linked to
Polycystic ovary syndrome (PCOS)
Low SHBG from insulin resistance or obesity
Androgen-secreting tumors (rare)
Symptoms: excess hair growth, acne, scalp hair thinning, irregular cycles
Next steps
Your result should be interpreted alongside symptoms, medical history, and other hormone tests. Management may involve addressing underlying conditions, adjusting lifestyle factors, or discussing treatment options with your healthcare provider.
Optimal range: 14 - 76 ng/mL
Total Testosterone in the context of a female hormone panel refers to the total amount of testosterone present in a woman's blood, measured in nanograms per milliliter (ng/mL). Testosterone, commonly associated with male health, is actually an important hormone in females as well, albeit in lower concentrations. It plays a critical role in muscle strength, bone density, and the functioning of the reproductive organs. Additionally, it influences libido, mood, and overall energy levels. The normal range of total testosterone in women varies depending on factors such as age and health conditions, but it generally falls between 15 to 70 ng/mL.
Optimal range: -2 - 2 SD
A Z-score compares your bone density to the average bone density of people your own age and gender.
For example, if you are a 50-year-old female, a Z-score compares your bone density to the average bone density of 50-year-old females.
Optimal range: -2 - 2 SD
A Z-score compares your bone density to the average bone density of people your own age and gender.
For example, if you are a 50-year-old female, a Z-score compares your bone density to the average bone density of 50-year-old females.
Celiac Comprehensive Panel
A Comprehensive Celiac Panel is a set of blood tests used to screen for and help diagnose celiac disease—an autoimmune disorder triggered by gluten, the protein found in wheat, barley, and rye. In people with celiac disease, the immune system mistakenly attacks the lining of the small intestine. Over time, this can cause intestinal damage, poor nutrient absorption, digestive upset, anemia, fatigue, and other health problems.
This panel combines several antibody and immune markers to improve accuracy and reduce false negatives:
Tissue Transglutaminase IgA (tTG-IgA): The most common and sensitive screening test for celiac disease. Elevated levels strongly suggest an autoimmune response to gluten.
Tissue Transglutaminase IgG (tTG-IgG): Useful for individuals with IgA deficiency, a condition that can otherwise mask celiac disease.
Deamidated Gliadin Peptide (DGP) IgA and IgG: Detect immune responses against gluten-derived proteins. Helpful in children and when tTG results are inconclusive.
Endomysial Antibody (EMA-IgA): Highly specific for celiac disease and often used to confirm a diagnosis.
Total Serum IgA: Measures overall IgA levels. Since IgA deficiency can cause false negatives, this test ensures the reliability of other antibody results.
Relying on a single test can miss cases of celiac disease. Using a combination of markers provides:
A more accurate picture of immune activity
Reduced risk of false negatives
Broader insights into gluten sensitivity and intestinal health
When celiac disease goes undiagnosed, it can lead to long-term complications such as nutrient deficiencies, osteoporosis, infertility, neurological problems, and an increased risk of certain cancers. Early detection through a comprehensive panel allows for timely treatment—most often adopting a strict gluten-free diet—to help restore gut health and prevent complications.
Note: While blood tests are powerful tools for detecting celiac disease, confirmation with an intestinal biopsy is often recommended by healthcare providers.
Optimal range: 0 - 20 units/ml
Anti-gliadin IgA is an important antibody in the context of diagnosing celiac disease, an autoimmune disorder that affects the small intestine. When individuals with celiac disease consume gluten—a protein found in wheat, barley, and rye—their immune system mistakenly targets and damages the lining of the small intestine. Anti-gliadin IgA is one of the antibodies produced by the immune system in response to the presence of gliadin, a component of gluten. This antibody is specifically of the IgA type, which is the main type of antibody found in mucous membranes, including the gut. The presence of anti-gliadin IgA in the blood is a sign that the immune system is reacting to gluten.
What does an equivocal result indicate?
An equivocal result indicates uncertainty as it falls within a borderline range that cannot be clearly classified as positive or negative. This means the levels of the antibody are not high enough to confirm the presence of a condition like celiac disease, nor low enough to rule it out. Consequently, healthcare providers may recommend retesting after some time to see if the levels change, order additional tests for more antibodies to gather more definitive information. The interpretation of an equivocal result heavily relies on the clinical context, including the patient's symptoms, medical history, and other test results. It often leads to closer monitoring of the patient's condition over time to observe any development or changes in symptoms. Essentially, an equivocal result prompts further investigation rather than providing a conclusive diagnosis, ensuring that patients receive accurate and appropriate care based on a comprehensive evaluation.
Optimal range: 0 - 25 units/ml
Anti-gliadin IgG is an antibody that the immune system produces in response to gliadin, a component of gluten found in wheat, barley, and rye. When someone with a sensitivity to gluten consumes these grains, their immune system may mistakenly identify gliadin as a harmful substance and produce Anti-gliadin IgG to attack it. This reaction is often seen in individuals with celiac disease, an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. However, Anti-gliadin IgG can also be present in non-celiac gluten sensitivity, where people experience symptoms similar to celiac disease but without the associated intestinal damage.
Optimal range: 0 - 7 U/mL
Optimal range: 0 - 7 U/mL
Optimal range: 0 - 19 Units
Deamidated gliadin peptide (DGP) antibodies, measured as IgA or IgG (anti-DGP), are blood tests used in the evaluation of suspected celiac disease. These antibodies help detect an abnormal immune response to gluten and are particularly useful in situations where standard celiac tests may be less reliable.
Optimal range: 0 - 19 Units
Detection of gliadin antibodies aids in the diagnosis and monitoring of certain gluten-sensitive enteropathies, such as celiac disease and dermatitis herpetiformis.
Optimal range: 0 - 14.9 U/mL
The Deamidated Gliadin Peptide Immunoglobulin A (DGP IGA) marker plays a pivotal role in the celiac disease diagnostic process, offering unique insights that complement other testing methods in a celiac panel. This test specifically measures the IGA antibodies against deamidated gliadin peptides, which are a form of gliadin (a key component of gluten) that has been modified during the digestive process. The presence of these antibodies indicates an immune response to gluten, characteristic of celiac disease.
What sets the DGP IGA test apart is its high sensitivity and specificity, particularly in certain patient groups. It is especially valuable in young children, under the age of two, where classic celiac disease markers like Tissue Transglutaminase Immunoglobulin A (TTG IGA) may not be as reliable. In these cases, DGP IGA can provide a more accurate reflection of the immune response to gluten. Additionally, DGP IGA testing is beneficial in cases where individuals have already started a gluten-free diet prior to testing, as it can remain positive for a longer period after gluten has been removed from the diet, unlike TTG IGA which may quickly normalize.
Optimal range: 0 - 0 Positive / Negative
Celiac disease is a chronic immune-mediated inflammatory disorder with multi-systemic manifestations, both gastrointestinal and nongastrointestinal. In genetically susceptible individuals, ingestion of gluten can cause inflammation and damage to the small intestine mucosa. Celiac disease has an incidence of 1:100 in the United States.
Optimal range: 0 - 0 Positive / Negative
Celiac disease is a chronic immune-mediated inflammatory disorder with multi-systemic manifestations, both gastrointestinal and nongastrointestinal. In genetically susceptible individuals, ingestion of gluten can cause inflammation and damage to the small intestine mucosa. Celiac disease has an incidence of 1:100 in the United States.
Optimal range: 0 - 0.1 Units
This test looks for certain antibodies in your blood that may mean you have celiac disease, an autoimmune disease.
Presence of the tissue transglutaminase (tTG) IgA antibody is associated with gluten-sensitive enteropathies such as celiac disease and dermatitis herpetiformis.
Reference range: Negative, Positive
The "Endomysial Antibody Screen (IgA) with Reflex to Titer" is a specific blood test often used to help diagnose celiac disease, an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. This test looks for antibodies against a type of tissue in your body known as endomysium, which is a layer surrounding each muscle fiber. IgA refers to Immunoglobulin A, a type of antibody found in mucous membranes and blood, playing a crucial role in the immune function of mucous membranes. If this initial screening test detects the presence of endomysial antibodies (EMA), it typically indicates an immune response triggered by gluten consumption in individuals with celiac disease. The "reflex to titer" part means that if the initial screen is positive, the laboratory will automatically perform further testing to determine the concentration of antibodies (titer). This additional step helps gauge the severity of the disease and can be useful in monitoring how well a patient is adhering to a gluten-free diet, which is the primary treatment for managing celiac disease. A higher titer indicates a higher concentration of antibodies, suggesting a more significant immune response to gluten. Understanding the results of this test can be pivotal in diagnosing celiac disease accurately, enabling individuals to adopt necessary dietary changes to improve their health and quality of life.
Reference range: <1:5 titer, 1:5 H
The Endomysial Antibody Titer is a crucial diagnostic tool in the evaluation of celiac disease and related gluten-related disorders, aiding in early diagnosis and appropriate management.
Optimal range: 0 - 3 U/mL , 0 - 100 ug/g
A tissue transglutaminase IgA (tTg-IgA) test is used to help doctors diagnose celiac disease or to see how well people with the condition are doing.
Optimal range: 0 - 5 U/mL
A tissue transglutaminase IgA (tTg-IgA) test is used to help doctors diagnose celiac disease or to see how well people with the condition are doing.
Optimal range: 0 - 14.9 U/mL
The TTG IGA marker is a crucial element in the diagnostic process for celiac disease, offering a high degree of accuracy in identifying this autoimmune disorder. Tissue Transglutaminase (TTG) is an enzyme targeted by the immune system in celiac disease, leading to the production of Immunoglobulin A (IGA) antibodies against it. This specific immune response forms the basis of the TTG IGA test, widely regarded as the first-line screening tool in diagnosing celiac disease. Its effectiveness lies in its ability to detect these antibodies, which are typically elevated in individuals with celiac disease, especially in those who have not yet started a gluten-free diet.
Lyme Testing
Let’s look at the two different ways to test for Lyme disease first:
The two most common diagnostic tests for Lyme are the enzyme-linked immunosorbent assay (ELISA) and the Western blot. Both of these blood tests measure the presence of antibodies that form in your body if you are infected with Borrelia burgdorferi, the bacterium that causes Lyme.
According to the International Lyme and Associated Diseases Society (ILADS), the tests are not always reliable to make a definitive diagnosis of Lyme. Both the ELISA and Western Blot are indirect tests, since they measure an antibody’s response to the infection, not the infection itself. However, it can take weeks to generate enough antibodies to be detected by these tests. As a result, a blood test may give false negative results even if you are infected with Lyme.
ELISA – This is the screening test used when Lyme disease is first suspected. It measures the levels of antibodies against Lyme bacteria. According to the Centers of Disease Control and Prevention, if the test proves negative for the antibodies, no further test is recommended. If the ELISA is positive or unclear, a second test is recommended to confirm the disease. However, the ELISA is falsely negative nearly 50% of the time. Sadly, many people are never tested beyond this point and are told they do not have Lyme disease when in fact they may be infected.
WESTERN BLOT – This test is run as a second-stage to confirm a positive ELISA result. It also tests for antibodies, however it reports reactivity against a panel of 10 different proteins found on the Lyme bacteria. According to the CDC, 5 of the bands must be positive for an overall positive, reportable Western blot test result.
This is generally considered the most reliable test currently available (although it is estimated to be only 80% accurate even at the best labs). Many doctors will not consider using this test unless the ELISA is positive, thus missing an important diagnostic tool.
Some Lyme specialists and scientists believe that there are five very specific bands on the Western blot test that are highly indicative of Lyme disease, band numbers 23, 31, 34, 39 and 93.
If any of these bands are positive and the patient is experiencing symptoms of Lyme disease, they may feel treatment is warranted.
What are the symptoms of Lyme disease?
Lyme disease symptoms are wide-ranging, with more than a hundred different symptoms recorded. Symptoms can also change over time, as the bacteria spreads throughout the body. To make things more confusing, Lyme disease symptoms will also vary from patient-to-patient. Lyme disease can mimic hundreds of other conditions since its symptoms mirror many medical problems such as multiple sclerosis, arthritis, chronic fatigue syndrome or lupus, and is sometimes known as “The Great Imitator” because of this.
Symptoms can play a key role in diagnosing Lyme disease. Due to the lack of an accurate diagnostic test, many patients are diagnosed based on a combination symptoms and diagnostic testing. This makes it extremely important for patients to keep track of all the symptoms they experience, to share with their healthcare provider. Lyme disease symptoms can vary based on stage of the disease (early, late, post-treatment, or chronic) and if other tick-borne infections are present and can change over time.
Symptoms in acute Lyme disease:
Acute Lyme disease (aka: early localized LD) occurs days to weeks after the initial tick bite and infection, in which the bacteria have not yet spread from the site of infection in the skin.
The most common symptoms in acute (aka: early localized) Lyme disease are the ones people are most familiar with. Because they are symptoms often shared with other illnesses, however, it’s important to recognize that they could mean Lyme and you should see a Lyme-treating physician right away.
- Erythema migrans rash or EM rash. This rash begins at the site of the tick bite about a week after the bite, and gradually expands.
Note: The center of the rash may clear, giving the rash the appearance of a “bulls-eye.” Rashes may take on many different shapes and not all rashes will have a bulls-eye appearance. There can be multiple rashes on the body. While a rash is characteristic of Lyme disease, many people will not develop a rash at all.
- Fever
- Fatigue
- Aches
- Chills
- Swollen lymph nodes
- Other flu-like symptoms
Symptoms in early disseminated Lyme disease:
Early disseminated Lyme disease occurs days to months after infection, in which the bacteria have begun to spread. There is a wide range of possible symptoms at this stage, including:
- Severe headaches and neck stiffness
- Arthritis, especially in the knees or other large joints
- Muscle aches and pains
- Heart palpitations or shortness of breath (Lyme carditis)
- Facial paralysis on one or both sides (also known as Bell’s palsy)
- Numbness or tingling in the hands or feet
- Extreme fatigue
Symptoms in late stage Lyme disease:
Late stage Lyme disease, which can include post-treatment, chronic, and neurological, occurs months to years after infection, in which the bacteria have spread throughout the body.
The symptoms of late disseminated disease are similar to those of early disseminated disease, but may be more extensive, more severe, and longer lasting. Late symptoms may also include:
- neurologic features including vertigo or dizziness,
- difficulty sleeping
- mental fogginess
- difficulty following conversations
- difficulty processing information
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 18 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 23 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 23 KD (IGM) and hence is a IgM antibody marker. IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign of an older infection.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 28 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 30 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 39 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 39 KD (IGM) and hence is a IgM antibody marker. IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign of an older infection.
Optimal range: 0 - 0 Units
The 41 KD band is often found on the Western blot. A recent study looked at the banding patterns of patients with chronic Lyme disease and healthy controls from the inner city of New York who have never had Lyme disease. They found that a large percentage of the healthy controls tested positive on the 41kd band.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 41 KD (IGM) and hence is a IgM antibody marker. IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign of an older infection.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 45 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 58 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 66 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Two types of antibodies are detected in the Western blot test.
This particular marker is called 93 KD (IGG) Band and hence is a IgG antibody marker. IgG antibodies are a sign of an older infection. In contrast, IgM antibodies reflect a relatively recent infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
Optimal range: 0 - 0 Units
Bartonella henselae Ab, IgG is a blood test that measures the level of IgG antibodies against the bacteria Bartonella henselae, which is commonly associated with cat scratch disease. IgG antibodies are produced by the immune system as a response to a past or ongoing infection, indicating that the person has been exposed to the bacteria. A positive IgG result suggests a previous infection with Bartonella henselae and that the body has developed immunity to it, although it may also indicate a chronic or persistent infection. Typically, this test is used to help diagnose cat scratch disease, which can cause symptoms like swollen lymph nodes, fever, and fatigue, particularly in people who have had contact with cats or have been scratched or bitten by one.
Optimal range: 0 - 0.01 Units
Bartonella henselae Ab, IgM is a blood test marker used to detect the presence of IgM antibodies against the Bartonella henselae bacteria, which is the cause of cat scratch disease and other Bartonella-related infections. The IgM antibodies are part of the immune system's early response to an infection, and their presence usually indicates a recent or ongoing infection with Bartonella henselae. When someone has symptoms like fever, swollen lymph nodes, or a history of being scratched or bitten by a cat, this test helps diagnose Bartonella infection by confirming that the body is actively fighting the bacteria. A positive IgM result suggests a recent infection, while a negative result might indicate either no infection or a past infection where IgM antibodies have already declined.
Optimal range: 0 - 0 Units
Optimal range: 0 - 0.01 Units
Reference range: 0-1 (negative), 2-3 (weak positive), >3 (positive)
Borrelia burgdorferi is spirochete class bacterium. B. burgdorferi sensu stricto, B. burgdorferi sensu lato, B. burgdorferi afzelii and B. burgdorferi garinii spirochetes enter the human body through tick bites.
Mixed with tick saliva, Borrelia travels through the circulation and enters different tissues. In some untreated cases, symptoms of pathogenic invasion have involved neurologic, cardiac, or joint disorders. Borrelia pathogenesis can break the blood-brain barrier, which allows invasion of the central nervous system, resulting in neuroborreliosis.
Borrelia burgdorferi sensu lato (B.b.s.l.) with the following subspecies:
- USA: Borrelia burgdorferi sensu stricto (B.b.s.s.), Borrelia andersonii, Borrelia americanum, B. carolinensis, B. bissettii, B. myamotoi
- Europe: Borrelia afzelii, Borrelia garinii, B. spielmanii, B. valaisiana, B. lusitaniae, B. bavariensis
- Asia: Borrelia japonica, B. rutdi, B. tanukii, B. sinica, B. yangtze
Reference range: 0-1 (negative), 2-3 (weak positive), >3 (positive)
Optimal range: 0 - 0.9 Units
Optimal range: 0 - 0.9 Units
Reference range: 0-1 (negative), 2-3 (weak positive), >3 (positive)
Optimal range: 0 - 0 Units
Optimal range: 60 - 360 uL
The "CD8-CD57+ Lymphocytes (Absolute)" marker on an HNK1 (CD57) panel from Labcorp represents a specific measurement of immune cells within your blood, quantified absolutely rather than as a percentage of total lymphocytes. This test focuses on a subset of natural killer (NK) cells and T lymphocytes, both critical components of your immune system's arsenal against infections and malignancies. These CD8-CD57+ cells, often referred to in the context of natural killer cell function due to their ability to directly attack and kill virus-infected cells or tumor cells without the need for prior activation, are unique. When you have a higher or lower than normal absolute count of these cells, it can be indicative of various health conditions. For example, a low absolute count of CD8-CD57+ lymphocytes is often observed in patients suffering from chronic conditions like Lyme disease, indicating a weakened immune response possibly due to the prolonged battle against the infection. On the other hand, understanding the high end of these counts is less straightforward but could suggest an active immune response to an infection or stress. This marker is particularly useful for clinicians in the context of diagnosing and managing chronic infectious diseases, as it provides insight into the state of the immune system's natural killer cell function. However, interpreting the results of this marker should always be done within the broader context of a patient's overall health, symptoms, and other laboratory findings to ensure a comprehensive understanding of their immune status.
Optimal range: 2 - 17 %
The CD57 test is offered in some clinical laboratories and is being used by some health practitioners to evaluate and follow patients diagnosed with chronic Lyme disease.
Optimal range: 0 - 0 Units
Cytomegalovirus is a common virus that usually causes no or only mild symptoms. Cytomegalovirus testing detects antibodies in the blood that the body produces in response to the infection or detects CMV directly.
Optimal range: 0 - 0 Units
EBV-VCA, IgG is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
Optimal range: 0 - 0 index
Two types of antibodies are detected in the Western blot test.
IgG antibodies are a sign of an older infection. IgM antibodies in contrast reflect a relatively recent infection.
Optimal range: 0 - 0 index
Two types of antibodies are detected in the Western blot test.
IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign of an older infection.
Optimal range: 0 - 0.8 index
Optimal range: 0 - 0.9 index
The two most common diagnostic tests for Lyme are the enzyme-linked immunosorbent assay (ELISA) and the Western blot. Both of these blood tests measure the presence of antibodies that form in your body if you are infected with Borrelia burgdorferi, the bacterium that causes Lyme. This marker is part of the ELISA assay.
Reference range: Negative, Positive
The Lyme IgG Line Blot Interp. is a marker used in the diagnosis of Lyme disease. It refers to the interpretation of the results obtained from an IgG immunoblot test used to detect antibodies against Borrelia burgdorferi, the bacterium responsible for causing Lyme disease.
Optimal range: 0 - 0.91 ISR
Reference range: Negative, Positive
The Lyme IgM Line Blot Interpretation (Interp.) marker is a diagnostic test marker used to assess the presence of specific antibodies called IgM antibodies in a patient's blood.
The IgM Line Blot Interp. marker helps in the diagnosis of Lyme disease by detecting IgM antibodies produced by the immune system in response to an infection with the bacterium Borrelia burgdorferi, which is the causative agent of Lyme disease. IgM antibodies are typically produced during the early stages of infection, usually within a few weeks after exposure to the bacteria.
Optimal range: 0 - 0.91 index
Optimal range: 0 - 0 Units
Candida IgA, IgM, IgG Blood Test
This candida test is used to screen for antibodies the body develops in response to Systemic Candidiasis or Candida. Candida is another name for yeast, a fungus which is normally found in small amounts in the body. The immune system normally keeps Candida under control but in cases where a person is sick or taking antibiotics the yeast may spread, becoming a potentially dangerous infection. This candida test looks for 3 antibody types including Iga, IgM and IgG.
Reference range: Positive, Negative, Equivocal
IgA antibodies: this type is normally found in the mucous secretions. It plays a major role in local immunity; and, constitutes 15 to 20% of all human immunoglobulins. It is the major class of antibodies found in our seromucous secretions. When the IgA levels against the candida are high, they reflect high levels of mucosal epithelial, trachea-bronchial, genital and urinary candida infections.
Blood testing for Candida (“yeast” infection) IgG, IgM, and IgA antibodies indicate past or present infection with this common fungus.
This test is used to detect systemic candidiasis. Candida normally occurs in the mouth, vagina, or gastrointestinal tract. This test is qualitative, meaning if candida antibodies are found, a candida infection is actively occurring now or has occurred in the past.
The candida antibodies test results can help you detect an ongoing candida infection and treat it as early as possible.
When you test all three antibodies, you are helping your doctor make the most accurate diagnosis.
Reference range: Positive, Negative, Equivocal
IgG Antibodies: this is the most commonly formed antibody. It is usually released upon a secondary exposure to the antigen. This type of antibody can reflect either an ongoing or a previous infection. It usually comes in a secondary stage. When the body first gets exposed to a certain antigen (primary exposure), it releases another kind of antibodies. When these decrease in number, following a secondary exposure, the body will start releasing IgG. This kind of antibody plays a major role in the phagocytic process that aims at eliminating antigens from our system.
IgG antibodies are predominant immunoglobulins; and, are found everywhere in our fluids: in both intra- and extravascular fluids. When a person becomes infected, these type of antibodies may remain in your system for many years, even after the infection is eradicated.
Reference range: Positive, Negative
IgM antibodies: this type is the first antibody released, following any first-time exposure to a certain antigen. Once formed, it activates the compliment and initiate the phagocytic system to help the body getting rid of invading antigens. IgM are specific to our intravascularly tissues. They are the most predominant immunoglobulins released upon any early infection. If the body gets re-infected with the same pathogen, the IgM levels will no longer be as elevated as in early infections. The body will then release IgG’s antibodies instead.
Optimal range: 0 - 0.9 index
Candida Immune Complexes which form in vivo are comprised of Candida Albicans antigen, anti-Candida IgG antibodies, and complement. The presence of these complexes is an indication of overgrowth of C. albicans in the gut. Candida immune complexes not only aid in diagnosing intestinal overgrowth, but that levels of complexes decrease during successful treatment of the condition
Symptoms of Candida intestinal overgrowth include bloating, itching, and skin rashes. Lehman and Reiss suggested that the presence of immune complexes to Candida is an objective means of diagnosing the condition. The results of Broughton and Lanson concluded that the marker for Candida immune complexes not only aid in diagnosing intestinal overgrowth, but that levels of complexes decrease during successful treatment.
Babesiosis
Babesiosis is a disease you can catch from certain tick bites, caused by tiny parasites that infect your red blood cells. It's a bit like malaria because these parasites also live in red blood cells and can make you feel really sick. People with babesiosis often feel very tired, have fevers, chills, sweats, headaches, body aches, loss of appetite, nausea, or even get a rash. The disease is more common in certain parts of the United States, like the Northeast and upper Midwest, especially during the warmer months when ticks are more active. Most healthy people get better without any special treatment, but it can be more serious for older people, those with weak immune systems, or other health problems. If someone needs treatment, doctors usually give them a mix of antibiotics and medications that are similar to the ones used for malaria. It's important to try to avoid tick bites by using bug spray, wearing long sleeves and pants in wooded or grassy areas, and checking your skin for ticks after being outdoors to help prevent getting babesiosis.
Optimal range: 0 - 40 titer
Optimal range: 0 - 20 titer
Babesiosis, a tick-borne illness caused by Babesia parasites, is commonly diagnosed using serological testing, where the B. duncani IFA (Indirect Fluorescent Antibody) IgM test plays a crucial role. This test specifically detects IgM antibodies against B. duncani, a Babesia species predominantly found in the western United States. IgM antibodies are among the first antibodies produced by the immune system when it encounters a pathogen. The presence of these antibodies is indicative of a recent or acute infection.
Optimal range: 0 - 40 titer
Optimal range: 0 - 20 titer
Optimal range: 0 - 40 Units
Optimal range: 0 - 20 Units
Optimal range: 0 - 0.01 Positive / Negative
Reference range: <1:64 titer, =>1:64 titer
Reference range: <1:20 titer, =>1:20 titer
Optimal range: 0 - 40 Units
Babesiosis is an infection caused by the parasite Babesia microti. The infection is acquired by contact with Ixodes ticks carrying the parasite.
Optimal range: 0 - 20 Units
Babesiosis is an infection caused by the parasite Babesia microti. The infection is acquired by contact with Ixodes ticks carrying the parasite.
Optimal range: 0 - 0 Units
WA1, also known as Babesia duncani, has been associated with symptoms similar to those caused by Babesia microti. Little, if any, crossreactivity occurs between Babesia microti and WA1.
Infectious Disease Profile
Updated: July 13, 2025 (BD)
The Infectious Disease Profile includes a range of diagnostic biomarkers used to detect and monitor infections caused by viruses, bacteria, or other pathogens. A key focus of this profile is hepatitis, an inflammation of the liver that can lead to serious health outcomes if left untreated.
Hepatitis refers to liver inflammation, which can be acute (short-term) or chronic (long-term). While some cases resolve on their own, others progress to fibrosis (liver scarring), cirrhosis (permanent liver damage), or even liver cancer.
Viral infections (the most common cause worldwide)
Toxic substances such as alcohol or certain medications
Autoimmune diseases
Other infections not directly linked to hepatitis viruses
There are five main hepatitis viruses—Hepatitis A, B, C, D, and E—each with unique modes of transmission, severity, and long-term effects:
| Type | Transmission | Risk of Chronic Disease | Common in |
|---|---|---|---|
| Hepatitis A (HAV) | Ingestion of contaminated food or water | No | Areas with poor sanitation |
| Hepatitis B (HBV) | Contact with infected blood, sexual contact, childbirth | Yes | Worldwide |
| Hepatitis C (HCV) | Blood-to-blood contact (e.g., transfusions, IV drug use) | Yes | Global |
| Hepatitis D (HDV) | Requires HBV to infect; blood and body fluids | Yes | Areas with high HBV prevalence |
| Hepatitis E (HEV) | Contaminated food/water | Rarely | Developing countries |
Hepatitis B and C are especially concerning due to their potential to cause chronic infections, which affect hundreds of millions of people globally. These infections are the leading causes of liver cirrhosis and hepatocellular carcinoma (liver cancer).
Hepatitis A & E: Fecal-oral route, typically through contaminated food or water.
Hepatitis B, C & D: Bloodborne transmission, including:
Blood transfusions or organ transplants (without proper screening)
Shared needles or non-sterile medical equipment
Sexual contact (especially with HBV)
Mother-to-child transmission during childbirth (HBV)
Early detection through lab testing is crucial to:
Diagnose active or past infections
Monitor chronic hepatitis progression
Guide treatment decisions
Prevent transmission to others
Tests may include antibody screening, antigen detection, and viral load testing, depending on the virus and suspected stage of infection.
Reference range: < 1:64, Reactive
The Anaplasma phagocytophilum Antibodies IFA (Indirect Fluorescent Antibody) Titre (IgG) marker is a critical serological assay used in the diagnosis of Anaplasmosis, a tick-borne disease caused by the bacterium Anaplasma phagocytophilum. This test specifically measures the Immunoglobulin G (IgG) antibodies in the patient's serum that are directed against A. phagocytophilum. IgG antibodies are a type of antibody that the immune system produces more slowly in response to an infection but which persists long-term, indicating either past exposure or a chronic infection.
Optimal range: 0.6 - 2.4 mg/L
Because Beta-2 Microglobulin is increased with blood cell cancers, it may be useful as a tumor marker. Though it can be used to assess kidney function as well.
Reference range: Non-reactive <= 1:20, Reactive
Reference range: Non-Reactive, Reactive
Reference range: Negative, Positive
Hepatitis B surface antigen (HBsAg) is a distinctive serological marker of acute or chronic hepatitis B infection. HBsAg is the first antigen to appear following infection with HBV and is generally detected 1-10 weeks after the onset of clinical symptoms. HBsAg assays are routinely used to diagnose suspected HBV infection and monitor the status of infected individuals to determine whether the infection has resolved or the patient has become a chronic carrier of the virus.
Reference range: Non Reactive, Reactive
HCV Antibody RFX to Quant PCR refers to a diagnostic process used in the detection and quantification of the Hepatitis C Virus (HCV). Initially, the test involves the identification of antibodies produced in response to the HCV infection.
Reference range: NOT DETECTED, <15 IU/mL mL (<1.18 log IU/mL), 15 to 100,000,000 IU/mL (1.18-8.00 log IU/mL), >100,000,000 IU/mL (>8.00 log IU/mL), Inconclusive
The viral load of hepatitis C refers to the amount of virus present in the bloodstream. The quantitative HCV RNA tests measure the amount of hepatitis C virus in the blood. The result will be an exact number, such as "1,215,422 IU/L." Many people refer to the quantitative measurement as the hepatitis C "viral load."
Reference range: Negative, Positive
What is hepatitis A?
Hepatitis A is a result of infection with the hepatitis A virus. Hepatitis A is a contagious liver disease that can range in severity from a mild illness lasting a few weeks to a severe illness causing liver failure. Most people infected with the virus get well within 6 months. However, hepatitis A can be serious for older people and people who already have liver disease such as hepatitis B or C.
Reference range: Negative, Positive
Hep A Ab, Total refers to the total antibody test for Hepatitis A virus (HAV). This test measures the overall level of antibodies, including both IgM and IgG antibodies, produced by the body in response to HAV infection or vaccination. IgM antibodies typically appear early during acute infection, while IgG antibodies persist for a longer duration, providing immunity against future infections.
Reference range: Negative, Positive
Anti-HBc IgM increases rapidly, peaks during the acute infection stage of HBV infection, and then falls to a relatively low level as the patient recovers or becomes a chronic carrier. Anti-HBc IgM is useful in the diagnosis of acute HBV infection even when HBsAg concentrations are below the sensitivity of the diagnostic assay. The presence of anti-HBc IgM and anti-HBc IgG is characteristic of acute infection, while the presence of anti-HBc IgG without anti-HBc IgM is characteristic of chronic or recovered stages of HBV infection. The use of other viral markers such as HBsAg, anti-HBs, and anti-HBc total to differentiate acute from chronic hepatitis B is inconclusive because most of these markers are alsoseen in chronic infection.
Reference range: Negative, Positive
Hep B Core Ab, Tot [aka Total antibody to hepatitis B core antigen (anti-HBc)] appears at the onset of symptoms in acute hepatitis B, is a measure of both IgM and IgG, and persists for life. The presence of total anti-HBc indicates previous or ongoing infection with hepatitis B virus in an undefined time frame. People who have immunity to hepatitis B from a vaccine do not develop anti-HBc.
Reference range: Non Reactive, Reactive
Hep B Surface Ab, Qual refers to the qualitative test for Hepatitis B Surface Antibody (HBsAb). This test determines the presence or absence of antibodies against the Hepatitis B virus on the surface of the hepatocytes. A positive result suggests that the individual has developed immunity to the Hepatitis B virus, either through prior infection or successful vaccination.
Reference range: Non Reactive, Reactive
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected. Test results can take anywhere from a few days to a few weeks to come back.
Most people who get infected with hepatitis C virus (HCV) develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. People can live without symptoms or feeling sick, so testing is the only way to know if you have hepatitis C. Getting tested is important to find out if you are infected so you can get lifesaving treatment that can cure hepatitis C.
Optimal range: 0 - 1 index
Hepatitis A is a viral infection of the liver. This tests for the presence of hepatitis A antibodies. Elevated levels reflect immunity either through previous vaccination or exposure to the illness.
Measures both IgG and IgM forms of the antibody, but does not differentiate between these two forms. Hepatitis A antibody of IgG type is indicative of old infection and is found in almost 50% of adults.
Optimal range: 0 - 0.5 index
Optimal range: 9.9 - 1000 mIU/ml
Presence of antibody to hepatitis B surface antigen (anti-HBs) is used to determine immune status to HBV or disease progression in individuals infected with HBV. Anti-HBs levels can be measured to determine if vaccination is needed, or following a vaccination regimen, to determine if protective immunity has been achieved.
- Anti-HBs usually can be detected several weeks to several months after HBsAg is no longer found, and it may persist for many years or for life after acute infection has been resolved.
- It may disappear in some patients, with only antibody to core remaining.
- People with this antibody are not overtly infectious.
- Presence of the antibody without the presence of the antigen is evidence for immunity from reinfection, with virus of the same subtype.
Optimal range: 0 - 7.5 index
The hepatitis B surface antibody test (HBsAb), looks for antibodies that your immune system makes in response to the surface protein of the hepatitis B virus.
The presence of anti-HBs is generally interpreted as indicating recovery and immunity from hepatitis B virus infection.
Anti-HBs also develops in a person who has been successfully vaccinated against hepatitis B. Among vaccine responders who completed a vaccine series, anti-HBs levels can decline over time, however the majority are still immune and will mount a response when exposed to HBV.
< 10 mIU/mL is considered nonreactive for antibodies agains Hepatitis B surface antigen.
>= 10 mIU/mL is considered reactive for antibodies against Heptitis B surface antigen
Reference range: Non-Reactive, Reactive
The hepatitis B surface antibody test (HBsAb), looks for antibodies that your immune system makes in response to the surface protein of the hepatitis B virus.
Optimal range: 0 - 1 index
This assay can be used in conjunction with other serological and clinical information to diagnose individuals with acute or chronic hepatitis B infection. This assay may also be used to screen for hepatitis B infection in pregnant women to identify neonates who are at risk of acquiring hepatitis B during the perinatal period.
Optimal range: 0 - 0.8 index
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected. Test results can take anywhere from a few days to a few weeks to come back.
Most people who get infected with hepatitis C virus (HCV) develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. People can live without symptoms or feeling sick, so testing is the only way to know if you have hepatitis C. Getting tested is important to find out if you are infected so you can get lifesaving treatment that can cure hepatitis C.
Reference range: Non Reactive, Reactive
HIV Ab/p24 Ag with Reflex is a diagnostic test used for the detection of HIV infection. It combines the identification of antibodies (Ab) and p24 antigens (Ag) associated with the HIV virus. The test is usually performed as an initial screening tool, utilizing a sensitive combination assay to detect both the presence of antibodies produced by the body in response to HIV and the p24 antigen, which is an early marker of HIV infection.
Optimal range: 0 - 1 index
This test looks for HIV infection in your blood or saliva.
HIV is the virus that causes AIDS. About 1 in 5 people who are infected with HIV don't know it because they may not have symptoms. HIV comes in 2 forms:
HIV-1. This type is found worldwide.
HIV-2. This type is mainly found in western Africa. But it has spread to the U.S.
This test is one of several tests that look for HIV infection. Some tests take a few days for results to come back. Rapid HIV tests can give your results in about 20 minutes. Getting an early diagnosis of HIV is important because you can start treatment early and also take steps to keep from spreading the virus to others.
Optimal range: 0 - 0.9 / index
HSV Type 1-Specific Ab, IgG refers to the specific antibodies produced by the immune system in response to the herpes simplex virus type 1 (HSV-1). The IgG antibodies are indicative of a past or current infection with HSV-1. This test helps in diagnosing the presence of the virus, particularly in cases of oral herpes or cold sores.
Optimal range: 0 - 0.91 / index
HSV-2 Ab, IgG refers to the antibody test for herpes simplex virus type 2 (HSV-2) using the immunoglobulin G (IgG) class of antibodies. This test is employed to detect the presence of IgG antibodies specifically related to the HSV-2 virus in the bloodstream. The presence of these antibodies typically indicates a prior exposure to the herpes simplex virus type 2, suggesting a past infection.
Reference range: Non-reactive, Reactive
Murine typhus is a disease transmitted by fleas. Endemic typhus, flea-borne typhus, and shop fever are other names used for this disease. It is caused by the bacterium, Rickettsia typhi, and possibly Rickettsia felis, found in infected fleas and their feces.
The Murine typhus IgG by IFA (Indirect Fluorescent Antibody) marker is a specific and sensitive serological test used to diagnose Murine typhus. This test is designed to detect Immunoglobulin G (IgG) antibodies in the patient's blood that are specific to R. typhi. IgG antibodies are typically produced in response to an infection several weeks after initial exposure and can persist in the bloodstream for a long time, often for the individual's lifetime.
Reference range: Non-reactive <1:16, Reactive
Reference range: Non-reactive <1:16, Reactive
Reference range: Non-reactive <1:16, Reactive
Reference range: Non-reactive <1:16, Reactive
Optimal range: 0 - 0 Units
The rapid plasma reagin (RPR) is a test used to screen for syphilis. The RPR test measures IgM and IgG antibodies to lipoidal material released from damaged host cells as well as to lipoprotein-like material, and possibly cardiolipin released from the treponemes.
Reference range: Non-reactive, Reactive 1:64
Rocky Mountain spotted fever (RMSF) is a bacterial disease spread through the bite of an infected tick.
The RMSF (Rocky Mountain Spotted Fever) IgG by IFA (Indirect Fluorescent Antibody) marker is a vital component of the serological testing for the diagnosis of Rocky Mountain Spotted Fever, a serious tick-borne illness caused by the bacterium Rickettsia rickettsii. This test is designed to detect Immunoglobulin G (IgG) antibodies that the immune system produces in response to an infection with R. rickettsii. IgG antibodies are a crucial part of the adaptive immune response, generally developing within a few weeks following the initial exposure to the pathogen and persisting in the bloodstream for a prolonged period, thereby indicating either past exposure or a chronic infection.
Reference range: Non-Reactive, Reactive
The marker RPR (DX) w/Refl Titer, along with confirmatory non-reactive testing, is an important component of the diagnostic approach to syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum. RPR, or Rapid Plasma Reagin, is a screening test used to detect antibodies produced by the body in response to a syphilis infection.
Reference range: Non Reactive, Reactive
The RPR (Rapid Plasma Reagin) test is a screening blood test used to detect syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum. It identifies the presence of antibodies in the blood that the body produces in response to the infection. A non-reactive or negative RPR result generally indicates the absence of active syphilis infection. However, it's crucial to note that a confirmatory test is often necessary to validate the RPR findings.
Reference range: Non Reactive, Reactive
Syphilis is a bacterial infection that is spread through sexual contact. The disease results in sores on or near the mouth or the genital area of the infected person. If not treated early, syphilis can lead to serious health consequences.
Syphilis is a common sexually transmitted disease. The most common symptom of syphilis is an open sore, which is generally referred to as a chancre. If you have syphilis symptoms, have had sexual contact with someone with syphilis, or are in an at-risk group for the disease, you can confirm your status with a simple blood test.
Testing is the only way to confirm a syphilis diagnosis.
Optimal range: 0 - 0 index
Reference range: Non-Reactive / Negative, Reactive / Positive, Equivocal
The venereal disease research laboratory test (VDRL) is a blood test that can identify syphilis infections. Syphilis is one of the most common sexually transmitted infections (STIs).
A VDRL test measures antibodies that are often produced within one to two weeks after an infected person develops an initial sore. VDRL testing can be performed on blood or spinal fluid.
Serologic tests provide only indirect evidence of syphilis and may be reactive in the absence of clinical, historical, or epidemiologic evidence of syphilis. The VDRL usually becomes reactive within the first few weeks after infection, peaks during the first year, and then slowly declines, so that low titers (levels) are seen in late syphilis. It can revert to negative in the absence of treatment in about 25% of cases.
Optimal range: 0 - 1.3 index
West Nile virus (WNV) is a mosquito-borne flavivirus (single-stranded RNA) that primarily infects birds but can also infect humans and horses.
Reference range: Non-Reactive, Reactive
Zika Virus
Zika virus disease is caused by a virus transmitted primarily by Aedes mosquitoes. People with Zika virus disease can have symptoms including mild fever, skin rash, conjunctivitis, muscle and joint pain, malaise or headache. These symptoms normally last for 2-7 days.
Optimal range: 0 - 0 Units
Optimal range: 0 - 0 Units
Optimal range: 0 - 0 Units
Optimal range: 0 - 0 Units
Lifestyle Dashboard
Optimal range: 0 - 1.5 drinks
Optimal range: 80 - 120 mg/dL
Optimal range: 18.5 - 25 Kg/m2
BMI Categories:
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater
Optimal range: 0 - 250 lbs , 0 - 113.4 kg
Tracking body weight over time is crucial for maintaining and improving health for several reasons.
Firstly, it allows for the early detection of unhealthy trends, such as rapid weight gain or loss, which can be indicators of underlying health issues like hormonal imbalances, metabolic disorders, or nutritional deficiencies. Regular monitoring helps in maintaining a healthy weight, a key factor in preventing chronic diseases such as diabetes, heart disease, and certain cancers.
Additionally, it enables individuals to assess the effectiveness of their dietary and exercise regimes, guiding necessary adjustments for achieving personal health goals. This tracking also provides motivational feedback, as visible changes in weight can reinforce healthy lifestyle choices.
Furthermore, it aids healthcare professionals in making informed decisions about a patient's health and in customizing treatment plans. In essence, regular weight tracking is a simple yet powerful tool for promoting long-term health and well-being.
Optimal range: 13 - 16 hrs
Optimal range: 7 - 10 scale
Optimal range: 20 - 100 min
Optimal range: 30 - 60 min
Optimal range: 70 - 99 mg/dL
Complete Blood Count Results: How to Interpret a CBC – A Comprehensive Guide
Written By: B. Dame
Updated On: July 3, 2025
The test — including platelet and white blood cell differential counts — is one of the most commonly ordered blood tests in modern healthcare. It provides essential insights into your blood health, helping detect, diagnose, and monitor a wide range of conditions such as infections, anemia, immune disorders, and blood cancers.
Doctors commonly order a Complete Blood Count (CBC) test for the following reasons:
As part of routine checkups and annual physicals
Before surgery, to evaluate overall health and readiness
To investigate unexplained symptoms such as fatigue, weakness, bruising, or bleeding
To monitor chronic conditions like anemia, infections, or blood disorders
To assess treatment effectiveness, including chemotherapy or antibiotic therapy
During pregnancy, to monitor maternal and fetal health
To identify the cause of unexplained fever or inflammation
A Complete Blood Count (CBC) is a common blood test that measures the levels of different cells in your blood. It provides important information about your overall health and helps detect a variety of medical conditions.
The CBC evaluates key blood components, including:
Red Blood Cells (RBCs): Transport oxygen throughout the body and remove carbon dioxide
White Blood Cells (WBCs): Defend against infections, inflammation, and immune challenges
Platelets: Support blood clotting and help stop bleeding
CBCs are frequently included in routine health screenings, but individual components can also be tested separately to investigate specific concerns.
Blood circulates through the heart, arteries, and veins, delivering oxygen, nutrients, and hormones throughout the body. Blood comprises:
Types of WBCs and Normal Ranges
WBCs originate from a common stem cell and differentiate in the bone marrow. Normal total WBC count: 4,500-11,000 cells/µL
| Type | Normal Range | Primary Function |
|---|---|---|
| Neutrophils | 40-60% | First responders in inflammation |
| Lymphocytes | 20-40% | Key players in immune system (T cells and B cells) |
| Monocytes | 2-8% | Mature into macrophages |
| Eosinophils | 1-4% | Fight parasites and manage allergic responses |
| Basophils | 0.5-1% | Release histamine during allergic reactions |
Normal Ranges and Parameters
| Parameter | Normal Range (Adult) | What It Measures |
|---|---|---|
| RBC Count | 4.5-5.5 million/µL (men) 4.0-5.0 million/µL (women) |
Number of RBCs |
| Hematocrit | 41-50% (men) 36-44% (women) |
Volume of RBCs in blood |
| Hemoglobin | 13.5-17.5 g/dL (men) 12.0-15.5 g/dL (women) |
Oxygen-carrying protein |
| MCV | 80-100 fL | Average RBC volume |
| MCH | 27-33 pg | Average hemoglobin mass |
| MCHC | 32-36 g/dL | Hemoglobin concentration |
| RDW | 11.5-14.5% | RBC size variation |
Normal Ranges and Clinical Significance
Pre-analytical Variables
Factors that can affect CBC results before analysis:
Medical Conditions
Medications/Treatments That Affect CBC
Recent developments have enhanced the utility and accuracy of CBC testing:
The CBC provides a comprehensive snapshot of a patient's blood health. By analyzing the individual values and overall results, healthcare providers can:
The CBC is essential in routine health evaluations and provides data on blood cells that can signal infections, anemias, and other health concerns. Healthcare providers interpret CBC results alongside the clinical picture to arrive at a diagnosis, as individual values alone may not provide the complete answer. Recent advancements in technology continue to improve the accuracy and utility of CBC testing.
What do high WBC levels mean? Elevated WBCs (>11,000/µL) may indicate infections, inflammation, or even leukemia.
What do low RBC levels signify? Low RBCs suggest anemia, potentially due to iron or vitamin B12 deficiencies.
The CBC test is a critical diagnostic tool, offering insights into your health. Regular testing and understanding your results can help you take control of your well-being.
Optimal range: 138 - 151 g/L
Hemoglobin (Hb) is the iron-containing oxygen transportation protein in red blood cells. It's rate of binding oxygen depends on the number oxygen molecules already bound.
Optimal range: 35 - 45 %
A hematocrit test (Hct) is a simple blood test that measures the percentage of red blood cells in your blood. Red blood cells are important because they carry oxygen throughout your body. Test results showing low or high hematocrit levels may be signs of blood disorders or other medical conditions.
Optimal range: 37.5 - 51 %
A hematocrit test (Hct) is a simple blood test that measures the percentage of red blood cells in your blood. Red blood cells are important because they carry oxygen throughout your body. Test results showing low or high hematocrit levels may be signs of blood disorders or other medical conditions.
Optimal range: 13 - 17.7 g/dL , 8.07 - 10.98 mmol/L , 130 - 177 g/L
What is hemoglobin?
Hemoglobin is the main component of red blood cells. Hemoglobin (abbreviation: Hb) is a red substance made of iron and protein.
What's the function of hemoglobin?
- In the blood, it carries oxygen to the cells in the body from the lungs.
- Hemoglobin also carries carbon dioxide away from the cells to the lungs, later exhaled from the body. Carbon dioxide is a colorless and odorless gas present in small amounts in the air. It is a result of metabolism in the body. Metabolism is the chemical action in cells that release energy from nutrients or use energy to create other substances.
What are normal reference ranges for hemoglobin?
Normal hemoglobin levels differ depending on several factors, including age, sex at birth, hormonal supplementation, altitude of residence as well as presence of different hemoglobin types that impact hemoglobin turnover and affinity for oxygen binding.
Like other blood values, slightly high or low levels of hemoglobin may be normal for some people. Still, suppose you are falling too far out of the normal range. In that case, your doctor will most likely order more comprehensive testing to determine the cause.
Optimal range: 11.1 - 15.9 g/dL
What is hemoglobin?
Hemoglobin is the main component of red blood cells. Hemoglobin (abbreviation: Hb) is a red substance made of iron and protein.
What's the function of hemoglobin?
- In the blood, it carries oxygen to the cells in the body from the lungs.
- Hemoglobin also carries carbon dioxide away from the cells to the lungs, later exhaled from the body. Carbon dioxide is a colorless and odorless gas present in small amounts in the air. It is a result of metabolism in the body. Metabolism is the chemical action in cells that release energy from nutrients or use energy to create other substances.
What are normal reference ranges for hemoglobin?
Normal hemoglobin levels differ depending on several factors, including age, sex at birth, hormonal supplementation, altitude of residence as well as presence of different hemoglobin types that impact hemoglobin turnover and affinity for oxygen binding.
Like other blood values, slightly high or low levels of hemoglobin may be normal for some people. Still, suppose you are falling too far out of the normal range. In that case, your doctor will most likely order more comprehensive testing to determine the cause.
Optimal range: 0 - 0.1 x10E3/µL
Immature granulocytes (IGs) are precursor white blood cells that appear in the bloodstream during heightened immune responses, particularly in severe infections or inflammatory conditions. Their presence in a complete blood count (CBC) provides valuable diagnostic information about immune system activity.
Optimal range: 0 - 0.5 %
Immature granulocytes are white blood cells that are immature. Whenever your body is fighting an infection, it will increase its white blood cell count, and more white blood cells will be immature.
Optimal range: 75 - 95 fL/red cell , 75 - 95 fl
Mean cell volume indicates the average volume of red blood cells in the body. It is often measured as a part of the red blood cell indices in a comprehensive blood count test. The results of the red blood cell indices will tell a healthcare professional whether or not anemia is present and, if so, what type it is.
Optimal range: 26.6 - 33 pg , 26.6 - 33 pg/cell , 1.65 - 2.05 fmol
Mean Corpuscular Hemoglobin (MCH) refers to the average amount of hemoglobin contained in a single red blood cell. Hemoglobin is a vital protein in the blood responsible for transporting oxygen from the lungs to the body's cells.
Optimal range: 31.5 - 35.7 g/dL , 19.59 - 22.2 mmol/L , 315 - 357 g/L
MCHC stands for mean corpuscular hemoglobin concentration. MCHC is part of the red cell indices, together with MCH and MCV. Those parameters reflect the size and hemoglobin content of red cells. They have traditionally been used to aid in the differential diagnosis of anemia.
Optimal range: 79 - 97 fl
Mean corpuscular volume indicates the average volume of red blood cells in the body. It is often measured as a part of the red blood cell indices in a comprehensive blood count test. The results of the red blood cell indices will tell a healthcare professional whether or not anemia is present and, if so, what type it is.
Optimal range: 7.5 - 11.5 fl
Mean platelet volume (MPV) is a calculation that indicates the average size of platelets in the blood. This measurement is typically done during a comprehensive blood count. An abnormal MPV is not, in it of itself, an indication of disease or disorder. MPV scores are compared against other types of blood counts to give a healthcare professional more information about a potential medical issue.
Optimal range: 27 - 33 pg
Mean RBC Iron is a specialized marker that can be found on some Complete Blood Count (CBC) panels. This marker measures the average amount of iron contained within the red blood cells (RBCs) in a given sample of blood. Iron is a crucial component of hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the rest of the body. Understanding the average iron content in red blood cells helps doctors assess whether there's an appropriate amount of iron available for hemoglobin production, which is essential for effective oxygen transport. If the Mean RBC Iron levels are unusually high or low, it might indicate an iron disorder, such as iron deficiency anemia or hemochromatosis, a condition where too much iron builds up in the body. These insights are particularly useful in diagnosing and managing conditions related to iron metabolism and anemia, thereby guiding treatment decisions to ensure the proper management of these conditions.
Optimal range: 32 - 36 g/dL
Mean RBC Iron Concentration on a Complete Blood Count (CBC) panel refers to the average concentration of iron found within the red blood cells (RBCs) circulating in your bloodstream. This measurement, often reported as part of a broader test called "Mean Corpuscular Hemoglobin Concentration" (MCHC), provides critical insights into how much hemoglobin, the oxygen-carrying component of red blood cells, is present relative to the size of these cells. A normal range of MCHC suggests that your red blood cells have a healthy amount of hemoglobin, which is essential for efficient oxygen transport throughout the body.
Optimal range: 80 - 100 fl
The marker Mean RBC Volume refers to the average volume of red blood cells (RBCs) in your blood, and it is expressed in femtoliters (fL). This measurement is also known as Mean Corpuscular Volume (MCV). It's an important diagnostic tool because it helps in the assessment of various types of anemia and other health conditions. A normal MCV falls within a specific range, but variations can indicate different issues: a higher MCV might suggest macrocytic anemia, often due to vitamin B12 or folate deficiency, whereas a lower MCV could indicate microcytic anemia, commonly due to iron deficiency. By measuring how big or small your red blood cells are on average, healthcare providers can gain insights into your overall health, particularly concerning your blood's ability to carry oxygen and nutrients. If your MCV is outside the normal range, it prompts further investigation to determine the underlying cause, which might involve looking at other markers on the CBC or additional tests.
Optimal range: 0 - 0.9 x10E3/uL
In a complete blood count (CBC) the MXD # refers to the combined count of mixed white blood cells which includes monocytes, eosinophils and basophils. This helps to understand the relative and absolute numbers of these less common white blood cells which can be important in diagnosing various conditions.
→ Monocytes: These cells fight off bacteria, viruses and fungi. They also remove dead or damaged tissues and regulate immune responses.
→ Eosinophils: These cells are involved in parasitic infections and allergic reactions and asthma.
→ Basophils: These cells are involved in inflammatory responses and allergic reactions.
Optimal range: 0 - 12 %
In a complete blood count (CBC) the MXD # refers to the combined count of mixed white blood cells which includes monocytes, eosinophils and basophils. This helps to understand the relative and absolute numbers of these less common white blood cells which can be important in diagnosing various conditions.
→ Monocytes: These cells fight off bacteria, viruses and fungi. They also remove dead or damaged tissues and regulate immune responses.
→ Eosinophils: These cells are involved in parasitic infections and allergic reactions and asthma.
→ Basophils: These cells are involved in inflammatory responses and allergic reactions.
Optimal range: 150 - 450 µl , 150 - 450 x10^9/L , 150 - 450 x10/9/l
Other names: Platelets, Thrombocyte Count
What are platelets?
Platelets (aka thrombocytes) are small, colorless cell fragments in our blood that form clots and stop or prevent bleeding.
Where are platelets made?
Platelets are made in our bone marrow, the sponge-like tissue inside our bones. Bone marrow contains stem cells that develop into red blood cells, white blood cells, and platelets.
What is the main function of platelets?
Platelets form clots when there’s damage to a blood vessel. For example, if you cut your finger, platelets mix with coagulation factors/clotting factors (proteins in the blood). Together, they form a “glue” that stops the bleeding.
Optimal range: 9.2 - 16.7 fl
This marker can give you additional information about your platelets and the cause of a high or low platelet count. Larger platelets are usually younger platelets that have been released earlier than normal from the bone marrow, while smaller platelets may be older and have been in circulation for a few days.
Optimal range: 16 - 41.3 %
Platelet-large cell ratio (P-LCR) is defined as the percentage of platelets that exceed the normal value of platelet volume of 12 fL in the total platelet count.
Platelet size has been shown to reflect platelet activity; therefore MPV (=Mean Platelet Volume) and P-LCR are a simple and easy method of indirect assessment of platelet stimulation.
Optimal range: 3.77 - 5.28 x10E3/uL
Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. Red blood cells (RBC) are made in the bone marrow and contain hemoglobin, a protein that carries oxygen to the tissues in the body. These cells are also known as erythrocytes.
Anemia is a condition that results from a decrease in the number of RBCs. Elevated RBC counts are seen in other conditions where there is low oxygen levels, certain drugs, kidney disease, or bone marrow overproduction. If your RBC count results are abnormal, additional tests are usually done to diagnose the cause of the high or low level of red blood cells.
A CBC measures two other components of your red blood cells:
- hemoglobin: oxygen-carrying protein
- hematocrit: percentage of red blood cells in your blood
Abnormal levels of red blood cells, hemoglobin, or hematocrit may be a sign of anemia, heart disease, or too little iron in your body.
Optimal range: 11 - 15 %
The RBC Distribution Width (RDW) is a crucial parameter for understanding the variation in size among your red blood cells (RBCs). When a Complete Blood Count (CBC) is performed, RDW is measured to assess how much the sizes of red blood cells differ from each other in the sample. It's expressed as a percentage and provides insight into the range of sizes: a higher RDW value indicates a greater variation in size, while a lower value suggests more uniformity. Typically, red blood cells should be fairly uniform in size; deviations can indicate several types of medical conditions. For instance, a high RDW could suggest anemia caused by a deficiency in iron, vitamin B12, or folate. It can also indicate other health issues such as chronic inflammation or liver disease. RDW is often reviewed in conjunction with other CBC parameters, like the mean corpuscular volume (MCV), which measures the average size of the red blood cells. Together, these measurements help doctors diagnose the type of anemia or other underlying conditions, providing a fuller picture of a patient’s health. Understanding RDW can therefore be a vital component in diagnosing and monitoring the progress of treatment for various medical conditions.
Optimal range: 11.7 - 15.4 %
The RDW value tells you whether enough of your red blood cells are of normal size and shape.
Why is this important?
The red blood cells are usually flat and lenticular (disc-shaped) with a diameter of around 7.5 µm (micrometer).
Blood cells must squeeze through the body’s smallest blood vessels, the above described capillaries, to do their job, but capillaries often become narrower than the cells in their normal disc shape. Capillaries can be as small as 4 µm in diameter. So the cells must deform and “curl up” to fit through those capillaries. Remember a normal red blood cell is around 7.5 µm in diameter.
Only when this process of “squeezing” through capillaries can happen, the supply of oxygen is guaranteed throughout the whole body.
Some red blood cells are however not optimally formed. To a certain extent this is normal as there are 2 million red blood cells formed per second. Usually there are around 85% to 89% of red blood cells developed properly.
Optimal range: 39 - 46 fl
Red Cell Distribution Width-Standard Deviation (RDW-SD) is a blood test parameter that measures the variability in the size of your red blood cells. It's one of the ways scientists assess the volume and size of red blood cells within a sample. A standard complete blood count (CBC) will often include RDW as it measures many different parts of your blood, including red blood cells. RDW can be reported in different ways, depending on the types of hematology analyzer instruments used, commonly as RDW-CV (Coefficient of Variation) or RDW-SD (Standard Deviation).
The RDW-SD specifically refers to the standard deviation of red blood cell volume, indicating how much the size of red blood cells varies around the average size. Normal RDW-SD levels are typically between 39-46 fL for adults. When the RDW-SD level is higher than normal, it may suggest that there is a significant variation in the size of red blood cells, which can be a symptom of various health conditions, such as anemia, liver disease, or other medical issues.
Optimal range: 4.14 - 5.8 cells/mcL , 4.14 - 5.8 x10^12/L , 4.14 - 5.8 x10/12/l
Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. Red blood cells (RBC) are made in the bone marrow and contain hemoglobin, a protein that carries oxygen to the tissues in the body. These cells are also known as erythrocytes.
Anemia is a condition that results from a decrease in the number of RBCs. Elevated RBC counts are seen in other conditions where there is low oxygen levels, certain drugs, kidney disease, or bone marrow overproduction. If your RBC count results are abnormal, additional tests are usually done to diagnose the cause of the high or low level of red blood cells.
A CBC measures two other components of your red blood cells:
- hemoglobin: oxygen-carrying protein
- hematocrit: percentage of red blood cells in your blood
Abnormal levels of red blood cells, hemoglobin, or hematocrit may be a sign of anemia, heart disease, or too little iron in your body.
Optimal range: 3.4 - 10.8 x10E3/µL , 3.4 - 10.8 x10^9/L , 3.4 - 10.8 x10/9/l
White blood cells, often called leukocytes, are three types of cells found in the blood, along with red blood cells and platelets. Specifically, the white blood cell family contains five members: monocytes, lymphocytes, basophils, neutrophils, and eosinophils. Together, these five cells act as our body’s primary immune system, responding to irritants and invaders. All blood cells are made in the bone marrow and then pass into the bloodstream. Leukocyte levels in the body are assessed through a blood differential test (also called a white blood cell differential) as a part of a complete blood count. This test can detect abnormal or immature cells and diagnose an infection, leukemia, or an autoimmune disorder. A healthcare professional may order a blood differential when someone has general signs and symptoms of infection and/or inflammation, such as:
- Fever, chills
- Body aches, pains
- Headache
Catecholamine blood test
What are Catecholamines?
Catecholamines are a group of similar hormones released into the bloodstream in response to physical or emotional stress.
Catecholamine testing measures the amounts of these hormones in the urine and/or blood. Urine testing is recommended over blood testing.
Functions of Catecholamines:
The above functions only increase during and shortly after a stressful situation and the broken down catecholamines are then eliminated from the body through the urine. However a group of rare nervous system tumors (such as pheochromocytom, paragangliomas or neuroblastoma) can produce large amounts of these catecholamines and cause havoc inside the body, such as:
Optimal range: 242 - 1125 pg/mL
Catecholamines are a group of similar hormones released into the bloodstream in response to physical or emotional stress.
The primary catecholamines are:
Optimal range: 0 - 20 pg/mL
Dopamine is widely distributed throughout the central nervous system and is involved in the control of movement.
Optimal range: 0 - 95 pg/mL
Epinephrine, often better known as adrenaline, is synthesized from norepinephrine in both the CNS and the adrenal medulla. Much like norepinephrine, this excitatory neurotransmitter helps regulate muscle contraction, heart rate, glycogen breakdown, blood pressure and more, and is heavily involved in a stress response. Elevated levels of epinephrine are often associated with hyperactivity, ADHD, anxiety, sleep issues, and low adrenal function. Over time, chronic stress and stimulation can deplete epinephrine stores leading to difficulty concentrating, fatigue, depression, insufficient cortisol production, chronic stress, poor recovery from illness, dizziness and more.
Optimal range: 217 - 1109 pg/mL
Norepinephrine (also called noradrenaline) is one of the catecholamines. Catecholamines are hormones made by the adrenal glands. The three catecholamines are epinephrine (adrenalin), norepinephrine, and dopamine.
Organic Acids, Plasma
Organic Acids, Urine assay, is the preferred test when screening for inherited disorders of metabolism. This plasma test is not as sensitive and will only detect the organic acids listed.
Optimal range: 10 - 30 umol/L
2-Hydroxy-3-methylpentanoic acid or 2-hydroxy-3-methylvaleric acid (HMVA) is an organic acid generated by L-isoleucine metabolism. It is derived from the reduction of 2-Keto-3-methylvaleric acid (KMVA), possibly through the action of a lactate dehydrogenase.
Optimal range: 20 - 75 umol/L
2-Ketoisocaproic Acid is a B-Complex Vitamin Marker (Leucine catabolism).
2-Ketoisocaproic Acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Optimal range: 3 - 20 umol/L
AKA: alpha-Ketoisovaleric acid
Alpha-Ketoisovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Optimal range: 0 - 30 umol/L
3-Oh-Butyric Acid is a metabolic marker of blood sugar utilization and insulin function.
Optimal range: 0 - 66 umol/L
Acetoacetic acid (=acetoacetate) is a ketone body and a weak Beta-keto acid produced from acetyl-CoA in the mitochondrial matrix of hepatocytes.
Optimal range: 0 - 100 umol/L
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 600 - 2600 umol/L
Formed from pyruvate in anaerobic or oxygen-starved (hypoxic) conditions to allow for ongoing production of ATP.
Optimal range: 20 - 140 umol/L
Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids. Pyruvic acid is also formed from lactic acid with O2 and zinc.
Optimal range: 16 - 25 umol/L
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Ehrlichia Ab Panel
Human ehrlichiosis is a tick-borne disease caused by rickettsial-like agents. Two forms, human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE), have been described. HME is often referred to as "spotless" or rashless Rocky Mountain spotted fever, and has been reported in various regions of the United States. The causative agent of HME has been identified as Ehrlichia chaffeensis. Infected individuals produce specific antibodies to Ehrlichia chaffeensis which can be detected by an immunofluorescent antibody (IFA) test.
Optimal range: 0 - 0.02 Units
Optimal range: 0 - 0.05 Units
Optimal range: 0 - 0.02 Units
Optimal range: 0 - 0.05 Units
H pylori, IgM, IgG, IgA Ab
Helicobacter pylori (H. pylori) is a type of bacteria that infects the digestive system. Many people with H. pylori will never have symptoms of infection. But for others, the bacteria can cause a variety of digestive disorders.
These can include:
- gastritis (inflammation of the stomach),
- peptic ulcers (sores in the stomach, small intestine, or esophagus),
- and certain types of stomach cancer.
There are different ways to test for an H. pylori infection. They include blood, stool, and breath tests. If you are having digestive symptoms, testing and treatment may help prevent serious complications.
Other names: H. pylori stool antigen, H. pylori breath tests, urea breath test, rapid urease test (RUT) for H. pylori, H. pylori culture
Optimal range: 0 - 0 Units
The H. pylori (Helicobacter pylori) breath test is a simple and safe test used to detect an active H. pylori infection.
Reference range: Negative, Positive
What is H. pylori?
Helicobacter pylori (or H. pylori) is a bacteria that can infect the stomach or duodenum (first part of the small intestine). If left untreated, H. pylori bacteria can cause gastritis (an inflammation or irritation of the stomach lining) and duodenal or gastric ulcers. In addition, infection with H. pylori increases the risk of other diseases and is also a risk factor for gastric cancer.
Accurate detection of H. pylori is the first step toward curing stomach and intestinal ulcers, and preventing the development of more serious gastrointestinal problems.
Optimal range: 0 - 9 Units
Optimal range: 0 - 0.8 U/mL
H. Pylori, IgG Abs is used to diagnose a Helicobacter Pylori infection. Helicobacter Pylori is a bacteria which is most primarily found in the gut.
Optimal range: 0 - 9 Units
Allergen Profile, Mold
Test for Mold-Related Allergies and Chronic Symptoms
The Allergen Profile, Mold test detects potential allergic responses to common environmental molds and helps evaluate conditions such as hay fever, asthma, atopic eczema, and other respiratory allergies. Mold allergens can trigger immune responses ranging from mild irritation to debilitating chronic illness.
If you've experienced water damage or mold exposure in places like your home, workplace, or school—and you're dealing with multiple unexplained symptoms—it may be time to consider testing and speak with a mold-literate or environmentally trained physician.
Mold exposure can affect nearly every system in the body. Symptoms may vary widely, but often include:
Nasal congestion
Sinusitis
Red, watery eyes
Mucus or pus in the eyes
Skin rashes or irritation
Itching and swelling
Sensitive or easily irritated skin
Chronic itching
Easy bruising
Receding gums
Tooth sensitivity (especially to hot or cold)
Brain fog or mental confusion
Memory and concentration issues
Trouble focusing or sustaining attention
Vision changes or light sensitivity
Decreased hearing
Numbness or tingling
Dizziness or balance problems
Tremors
Anxiety
Depression
Irritability
Persistent cough
Shortness of breath
Chest tightness or wheezing
Headaches or migraines
Aching joints
Muscle pain or stiffness
Bloating, nausea, or abdominal discomfort
Irritable bowel symptoms
Mucus in stool
Fatigue or chronic fatigue syndrome (CFS)
Insomnia or disrupted sleep
Laryngitis (hoarseness or voice loss)
Fibromyalgia
Vasculitis (inflammation of blood vessels)
Angioedema (swelling under the skin, especially face/throat)
Hair thinning or loss
Adrenal or thyroid dysfunction
Frequent nosebleeds
If you're experiencing several of these symptoms and have had mold exposure—especially in water-damaged or poorly ventilated environments—an Allergen Profile, Mold test may help determine whether your immune system is reacting to specific mold allergens like Aspergillus, Penicillium, Cladosporium, or Alternaria.
Diagnosing mold-related illness usually begins with a full review of symptoms and potential exposure sources. The Allergen Profile, Mold test measures IgE antibodies, which indicate an allergic immune response to mold. This is often the first step toward identifying mold as a contributing factor.
Additional diagnostic tools may include:
Environmental testing to detect mold spores or hidden moisture damage in your surroundings
Nasal swabs or sputum cultures to identify fungal overgrowth
Mycotoxin panels (often used in functional medicine) to assess systemic mold toxicity
Immune and inflammatory markers (e.g., C4a, MMP-9, TGF-beta-1, VEGF) in complex or chronic cases
Evaluation for Chronic Inflammatory Response Syndrome (CIRS) by an experienced integrative physician
Managing mold-related illness involves addressing both the immune response and the environment. A successful approach typically includes the following:
Identify and eliminate mold sources (e.g., leaks, damp areas, poor ventilation)
Hire certified mold remediation professionals to avoid spore spread
Use air purifiers with HEPA filters, dehumidifiers, and increase airflow indoors
Antihistamines, nasal sprays, or leukotriene inhibitors for allergy relief
Inhalers or asthma medications if respiratory symptoms are present
Immunotherapy (allergy shots or sublingual drops) to help reduce long-term sensitivity
Antifungal medications if fungal overgrowth is identified
Binders (e.g., cholestyramine, activated charcoal) to help eliminate mold toxins
Nutritional support with B vitamins, glutathione, and omega-3s to reduce inflammation and support detox
Low-mold diet to reduce intake of mold-containing foods like aged cheese, alcohol, and fermented items
Avoid environments with visible mold, musty odors, or poor ventilation
Use protective masks (e.g., N95) when cleaning or exposed to potential mold
Prioritize quality sleep, hydration, and stress management to aid recovery
If you’re experiencing persistent or unexplained symptoms and suspect mold exposure, consult a physician with experience in environmental medicine or mold-related illness. Early diagnosis and comprehensive treatment can significantly improve symptoms and restore long-term health.
Optimal range: 0 - 0.1 kU/L
Alternaria alternata is one of the most common fungi associated with asthma.
Optimal range: 0 - 0.1 kU/L
The fungus Aspergillus fumigatus causes allergic diseases, respiratory illnesses, and bloodstream infections.
Optimal range: 0 - 0.1 kU/L
It is a commonly encountered species in wet buildings. It is both a soil and leaf fungus.
Abnormal levels of Aureobasidi Pullulans may indicate an allergic sensitivity or hypersensitivity reaction to the fungus Aureobasidi pullulans, which is commonly found in environments such as damp areas, moldy buildings, and agricultural settings. Elevated levels suggest an overactive immune response to this fungal allergen, which may contribute to symptoms like asthma, allergic rhinitis, or other respiratory issues. Testing for this marker can help in diagnosing mold-related allergies and guide treatment strategies to manage allergic reactions.
Treatment for an allergy to Aureobasidi pullulans typically involves avoiding exposure to environments where the fungus is prevalent, such as damp or moldy areas. Medications such as antihistamines, nasal corticosteroids, or leukotriene modifiers can help manage symptoms like nasal congestion or sneezing. For more severe reactions, immunotherapy (allergy shots) may be recommended to desensitize the immune system to the allergen over time. In some cases, if asthma is present, bronchodilators or inhaled corticosteroids may be prescribed to manage respiratory symptoms.
Optimal range: 0 - 0.99 Units
Candida albicans is a dimorphic fungus that grows both as yeast and filamentous cells and one of the few species of the Candida genus that cause the infection candidiasis in humans.
Albicans is a common member of human gut flora and is detectable in the gastrointestinal tract in 40% of healthy adults. The Candida antigen tests typically monitors three specific antibodies and the Candida antigen itself: IgG antibodies, IgA antibodies, IgM antibodies.
IgA antibodies
IgA is found in mucous secretions and is important in local (mucosal) immunity.Although representing only 15-20% of our human serum immunoglobulins, are the predominant antibody class found in seromucus secretions. High levels of specific IgA antibodies against Candida species as measured in serum are thought to be associated with mucosal epithelial, tracheobronchial, and genito-urinary candida infections.
Optimal range: 0 - 0.99 Units
Candida albicans is a dimorphic fungus that grows both as yeast and filamentous cells and one of the few species of the Candida genus that cause the infection candidiasis in humans.
Optimal range: 0 - 0.99 Units
Candida albicans is a dimorphic fungus that grows both as yeast and filamentous cells and one of the few species of the Candida genus that cause the infection candidiasis in humans.
Optimal range: 0 - 0.1 kU/L
Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida. There are over 20 species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans.
Optimal range: 0 - 0.1 kU/L
Cladosporium, a well known trigger for asthmatic attacks, is one of the most widespread molds.
Cladosporium includes about 40 species naturally found in soil, on decaying plant material and as plant pathogens.
In an indoor environment, Cladosporium spp. occur as secondary wall colonizers, appearing after the primary ones such as Penicillium species, Aspergillus versicolor and Wallemia sebi. Cladosporiumis very common on wet building material (e.g., gypsum board, acrylic painted walls, wood, wallpaper, carpet and mattress dust, HVAC fans, and wet insulation in mechanical cooling units).
Optimal range: 0 - 0.1 kU/L
Epicoccum can colonize an extremely wide variety of substrates. It lives in soil all over the world and is often associated with aging or decaying plant material. It is also a phytopathogen, causing leaf spot disease in many plants. It is an agent of food spoilage and has been known to develop on apples, cantaloupes, fresh vegetables, nuts and cereals, rice, wheat, maize, pecans, peanuts, cashews, soybean and frozen or cured meats. Interestingly Epicoccum can also colonize freshwater and marine environments and has been isolated from sediment, sponges, algae and other sea plants.
Optimal range: 0 - 0.1 kU/L
Members of the genus Fusarium are ubiquitous fungi commonly found in soils and plants.
Fusarium proliferatum can be found on a wide host range as well as pathogenic on various agricultural crops. Fusarium proliferatum is a common pathogen infecting numerous crop plants and occuring in various climatic zones.
Optimal range: 0 - 0.34 kU/L
Hormodendrum IgE is a blood test that measures your immune system’s response to a specific type of mold known as Hormodendrum, a genus of fungi now often classified under Cladosporium. These molds are commonly found in outdoor and indoor environments, especially in soil, decaying plants, and damp or poorly ventilated areas of homes and buildings.
When your immune system is sensitive to Hormodendrum mold, it may produce Immunoglobulin E (IgE) antibodies in response to exposure. This immune response can trigger allergy symptoms.
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Reference range: < 0.10 (Negative), 0.10 - 0.31 (Equivocal/Low), 0.32 - 0.55 (Low), 0.56 - 1.40 (Moderate), 1.41 - 3.90 (High), 3.91 - 19.00 (Very High), 19.01 - 100.00 (Very High), >100.00 (Very High)
Optimal range: 0 - 0.1 kU/L
Normal soil inhabitant. Found around barns and barnyards where it grows on animal waste.
Optimal range: 0 - 0.1 kU/L
Penicillium Chrysogenum is a widely studied species of Penicillium that is most famous for being a source of penicillin and several other antibiotics.
Optimal range: 0 - 0.1 kU/L
Phoma is a very common soil fungus attacking weak or damaged plants. It is frequently isolated from different soils, dead plant tissues and potato. Phoma is frequently found indoors as a contaminator of humid surfaces, in connection with bio-deterioration of painted walls; producing colored spots, often pink or purple, several centimeters in diameter.
Optimal range: 0 - 0.1 kU/L
Setomelanomma/Helminthosporium almost always occurs seasonally and the spores are released on dry, hot days. Species of Helminthosporium are best known as parasites of cereals and grasses. It is frequently isolated from grains, grasses, sugar cane, soil and textiles.
- Found worldwide, most common in warm areas, especially in the southern U.S.
- Important in the Midwest as it grows on farm crops, especially corn.
- Grain thrashing operations release large quantities.
Optimal range: 0 - 0.1 kU/L
Together with Alternaria, Stemphylium is considered one of the most important mould allergens in the United States.
Herpes Testing
The IgG blood test is commonly used to diagnose herpes simplex virus (HSV) infections. Rather than detecting the virus itself, this test identifies IgG antibodies, which are immune proteins your body produces in response to the HSV infection.
Antibodies, such as IgG, are created by the immune system to target specific pathogens like viruses or bacteria. HSV IgG antibodies are produced when a herpes infection occurs and remain in the body for life, serving as markers of both current and past infections.
The HSV IgG test is most commonly used to confirm genital herpes but is not recommended as a routine screening test for the general population. It is, however, advised for pregnant women at risk of genital herpes, as treatment can reduce the risk of transmission to the baby.
Timeframe for Antibody Detection
IgG antibodies take about 3–6 weeks after the initial infection to reach detectable levels. Testing too early may result in a false-negative result.
Testing Guidelines
The Centers for Disease Control and Prevention (CDC) advises against HSV testing for asymptomatic individuals, as it does not alter sexual behavior or significantly reduce transmission rates.
Accuracy in Differentiating HSV Types
The IgG test is preferred over other antibody tests because it accurately distinguishes between HSV-1 and HSV-2 infections.
In addition to IgG testing, an IgM test is sometimes used to detect HSV. Here’s how they differ:
Note: Between 30% and 70% of people with recurrent infections may also test positive for IgM.
Your test results will generally fall into one of three categories:
False-Negative Results:
If the test is conducted too soon after exposure, IgG antibodies may not have developed yet, leading to a false-negative result.
False-Positive Results:
Occasionally, a test may incorrectly report the presence of antibodies, suggesting an infection when none exists.
If your results seem inconsistent with your symptoms or potential exposure, your healthcare provider may suggest additional testing or a repeat IgG test to confirm the diagnosis.
Treatment options vary based on whether the infection is active or recurrent. Managing HSV includes antiviral medications to reduce symptom severity, frequency of outbreaks, and the risk of transmission.
By understanding the purpose and limitations of the HSV IgG test, you can work with your healthcare provider to ensure accurate diagnosis and effective management of herpes simplex virus infections.
Reference range: Negative, Equivocal, Positive
This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.
Herpes Simplex Virus 1 and 2 (IgG), Type-Specific Antibodies - Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV Type 2 is more commonly associated with genital tract and neonatal infections, while HSV Type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment.
Reference range: Negative, Equivocal, Positive
A herpes IgM (immunoglobulin M) test is a blood test that can detect early herpes simplex virus (HSV) infection. HSV is a contagious condition that causes sores around the mouth or genitals. The IgM test does not detect herpes directly. Instead, it looks for IgM, a type of antibody. This is a protein produced by the immune system in response to a herpes infection.
Optimal range: 0 - 10 index
Human herpesvirus 6 (HHV-6) is a set of two closely related herpesviruses, HHV6-A and HHV6-B. Human Herpesvirus 6 (HHV-6) has long been suspected as one trigger for Chronic Fatigue Syndrome.
Optimal range: 0 - 20 index
The detection of IgM antibodies specific to HHV-6 is a common diagnostic tool used to assess whether an individual has recently been exposed to or is currently experiencing an active infection with this virus. IgM antibodies are produced by the immune system in response to a new or acute infection, and their presence in the blood indicates that the body is mounting an immune response to combat the virus. However, it's important to note that the presence of HHV-6 IgM antibodies does not necessarily mean that an individual is currently symptomatic, as this virus can establish latency in the body and reactivate later in life without causing obvious symptoms.
Optimal range: 0 - 0.9 index
HHV-6 IgG antibodies are specific immunoglobulins that play a pivotal role in the serological diagnosis and understanding of infections caused by the Human Herpesvirus 6 (HHV-6). HHV-6, a member of the Betaherpesvirinae subfamily, is known for its ubiquity and capability to establish lifelong latency following primary infection, often reactivating under immunocompromised conditions. The detection of HHV-6 IgG antibodies in serum is indicative of past exposure to the virus, reflecting an adaptive immune response. High titers of these antibodies suggest either a recent primary infection, typically associated with exanthem subitum (roseola infantum) in young children, or a reactivation of the virus in adults, which can lead to a range of clinical manifestations including mononucleosis-like syndromes, encephalitis, and complications in transplant recipients.
Optimal range: 0 - 0.91 index
Herpes is a common viral infection caused by the herpes simplex virus (HSV). The virus exists as two main types, HSV-1 and HSV-2.
HSV testing identifies the presence of the virus in a sample from a blister, sore or fluid to diagnose an active herpes infection or testing detects antibodies in the blood to determine previous exposure to herpes.
Both HSV-1 and HSV-2 are contagious and periodically cause small fever blisters (vesicles) that break to form open lesions.
HSV-1 primarily causes blisters or "cold sores" around the mouth (non-genital sites).
HSV-2 usually causes lesions around the genital area.
However, both HSV-1 and HSV-2 can affect either the oral or genital areas.
Optimal range: 0 - 0.1 titer
A herpes IgM (immunoglobulin M) test is a blood test that can detect early herpes simplex virus (HSV) infection. Herpes IgM is one of the first types of antibody that appears after infection, so this blood test is the earliest one that can be used to detect herpes.
HSV is a contagious condition that causes sores around the mouth or genitals.
The IgM test does not detect herpes directly. Instead, it looks for IgM, a type of antibody. This is a protein produced by the immune system in response to a herpes infection.
The herpes IgM antibodies can take up to 10 days to develop after a primary infection with the virus.
Reference range: Non-Reactive, Reactive
The marker HSV-2 IgG Inhibition, IA, refers to a specific immunological assay designed to detect IgG antibodies against Herpes Simplex Virus type 2 (HSV-2) in human serum or plasma samples. This assay is based on the principle of antibody inhibition, where specific antibodies in the patient's sample bind to antigens of HSV-2 immobilized on a solid phase, such as a microtiter plate. The presence of these antibodies is then detected through a secondary reaction that involves an enzyme-linked anti-human IgG antibody, leading to a measurable signal, typically a color change, which is indicative of the presence and quantity of HSV-2-specific IgG antibodies. The assay is highly specific due to the use of inhibition steps that minimize cross-reactivity with antibodies against other viruses, including Herpes Simplex Virus type 1 (HSV-1), thus ensuring accurate differentiation between infections caused by HSV-1 and HSV-2.
Optimal range: 0 - 0.9 Value
What is the HSV-2 IgG Screening Index? The HSV-2 IgG Screening Index is a blood test used to detect Immunoglobulin G (IgG) antibodies specific to the Herpes Simplex Virus Type 2 (HSV-2). HSV-2 is a common viral infection that primarily causes genital herpes. This test helps determine if an individual has been exposed to the virus, even if they have never experienced symptoms.
Understanding Your Results The test results are reported as an index value, which falls into one of the following categories:
Negative (≤0.90): No detectable HSV-2 IgG antibodies. This suggests no prior exposure to HSV-2.
Equivocal (0.91–1.09): The result is inconclusive. Retesting in 4 to 6 weeks is recommended to confirm status.
Positive (≥1.10): HSV-2 IgG antibodies are present, indicating past or current infection.
Optimal range: 0 - 0.91 index
Herpes is a common viral infection caused by the herpes simplex virus (HSV). The virus exists as two main types, HSV-1 and HSV-2.
HSV testing identifies the presence of the virus in a sample from a blister, sore or fluid to diagnose an active herpes infection or testing detects antibodies in the blood to determine previous exposure to herpes.
Both HSV-1 and HSV-2 are contagious and periodically cause small fever blisters (vesicles) that break to form open lesions.
HSV-1 primarily causes blisters or "cold sores" around the mouth (non-genital sites).
HSV-2 usually causes lesions around the genital area.
However, both HSV-1 and HSV-2 can affect either the oral or genital areas.
Optimal range: 0 - 0.9 Value
The marker "HSV 2 IgG, Type Specific Ab" on a herpes testing panel refers specifically to a blood test that checks for the presence of antibodies against the Herpes Simplex Virus type 2 (HSV-2). This type of virus primarily causes genital herpes, a sexually transmitted infection characterized by painful sores and blisters in the genital area. The "IgG" in the name of the test stands for Immunoglobulin G, which is a type of antibody. When someone is infected with HSV-2, their immune system responds by producing IgG antibodies specifically targeted against the virus. These antibodies usually develop within a few weeks after exposure and can remain in the body for a lifetime, providing a means of identifying past infection. A "Type Specific" test is designed to differentiate between HSV-2 antibodies and those produced in response to other herpesviruses, such as HSV-1, which commonly causes oral herpes. Detecting these antibodies through the test helps in confirming whether a person has been infected with HSV-2, even if they are not currently showing symptoms. This information is crucial for managing and preventing the spread of genital herpes.
What does an Equivocal result indicate?
"Equivocal" levels on a test like the HSV 2 IgG, Type Specific Ab mean that the results are unclear or borderline; they neither confirm nor rule out the presence of the antibodies against Herpes Simplex Virus type 2 (HSV-2) definitively. This can occur for a variety of reasons, such as the test being taken too soon after exposure, when antibody levels are not yet high enough to be definitively detected, or when there is a low level of antibodies that doesn't clearly meet the threshold for a positive result. In such cases, it's usually recommended to repeat the test after some time has passed, typically a few weeks, to see if the antibody levels have increased, which would indicate a past infection.
Optimal range: 0 - 0.1 titer
Herpes Simplex Virus is a common pathogen of humans. The clinical course of HSV in humans is extremely variable. Primary infection with HSV, either type 1 or 2, is unapparent or subclinical in a majority of cases.
When clinically apparent, HSV infections can range from minimal stomatitis to a fatal generalized infection. Some of the major clinical manifestations of HSV infections are acute gingivostomatitis, recurrent herpes labialis, keratoconjunctivitis, eczema herpeticum, encephalitis, and meningitis.
Generalized infections are normally confined to individuals with immune deficiency, immunosuppressed patients, or newborns.
There are two distinct types of HSV: Types 1 and 2.
HSV-1 and HSV-2 are closely related but they can be separated both serologically and biologically.
HSV-1 is associated with lesions above the waist (encephalitis, stomatitis, eye infections, and, in some cases, of generalized infections).
Reference range: Negative, Positive
Optimal range: 0 - 0.1 Units
Human Herpesvirus 6 (HHV-6) is a common virus that primarily infects children, causing a mild illness known as roseola, characterized by high fever and a distinctive rash. The presence of IgM antibodies against HHV-6 in the blood is a significant marker used to diagnose recent or active infection. IgM, which stands for immunoglobulin M, is the first type of antibody the immune system produces in response to an infection. When HHV-6 IgM is detected, it indicates that the body is currently fighting the virus, suggesting either a primary infection or a reactivation of the virus in individuals who were previously infected. Since HHV-6 can lie dormant and reactivate later, especially in individuals with weakened immune systems, monitoring IgM levels can be crucial in clinical settings, particularly for patients undergoing immunosuppressive treatments or organ transplants. By understanding the role of HHV-6 IgM, healthcare providers can better assess and manage the implications of HHV-6 infections, contributing to improved patient care and outcomes.
Epstein-Barr virus (EBV)
EBV antibody tests measure your immune system's response to the Epstein-Barr virus, which causes infectious mononucleosis (mono). If you've recently received lab results showing EBV antibodies, this guide will help you understand what your results mean.
Your test results will show different antibody patterns depending on when you were infected:
Sometimes test results show other patterns that require additional interpretation:
If you have an active EBV infection, treatment typically focuses on symptom relief:
Remember: This information helps explain EBV antibody test results but doesn't replace professional medical advice. Always discuss your specific results and symptoms with your healthcare provider for personalized guidance.
Prevention To reduce EBV transmission:
| VCA IgG | VCA IgM | EBNA IgG | Interpretation |
|---|---|---|---|
| Negative | Negative | Negative | No previous exposure to EBV |
| Positive | Positive | Negative | Recent infection |
| Positive | Negative | Positive | Past infection |
| Positive | Negative | Negative | Infection timing unclear (recent or past) - 5-10% of patients never develop EBNA antibodies |
| Positive | Positive | Positive | Past infection with possible reactivation |
Optimal range: 0 - 18 U/mL
The EBV (Epstein Barr) Nuclear Antigen Antibodies, IgG test looks for a type of antibody which the body typically develops in response to Epstein-Barr Virus.
EBNA antibodies usually appear 2-4 months after infection and persist for the life of the person.
This test is usually performed to establish a past infection with EBV.
Optimal range: 0 - 18 U/mL
EBV-VCA, IgG is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
Optimal range: 0 - 36 U/mL
EBV-VCA, IgM is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
EBV stands for Epstein-Barr virus.
Epstein-Barr virus is a virus that typically causes a mild to moderate illness. Blood tests for Epstein-Barr virus detect antibodies to EBV in the blood and help establish a diagnosis of EBV infection.
VCA stands for Viral capsid antigen.
– Anti-VCA IgM appears early in EBV infection and usually disappears within four to six weeks.
– Anti-VCA IgG appears in the acute phase of EBV infection, peaks at two to four weeks after onset, declines slightly then persists for the rest of a person’s life.
Optimal range: 0 - 18 U/mL
EBV CAPSID Ag.ab/IgG is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
Optimal range: 0 - 36 U/mL
EBV CAPSID Ag.Ab/IgM is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
Optimal range: 0 - 100 U/mL
If the result of the Epstein-Barr Virus Early Antigen IgG (EBV EA IgG) test falls within the reference range, it generally indicates one of the following scenarios:
No Active or Recent EBV Infection: A result within the reference range typically suggests that there is no active or recent infection by the Epstein-Barr Virus. EBV EA IgG antibodies are usually present during the acute phase of an EBV infection. Their absence or low levels within the normal range implies that the individual is likely not in the acute phase of EBV infection.
Past Infection: Individuals who have had an EBV infection in the past and have since recovered will often have EBV EA IgG levels within the reference range. After the acute phase of the infection, these antibody levels usually decline and may fall back into the reference range.
Latency: EBV can remain latent in the body after the initial infection. A reference range result for EBV EA IgG indicates that the virus is not actively replicating or causing active symptoms, consistent with a latent or dormant state of the virus.
Possible Immunity: If a person has been exposed to EBV in the past, they may have developed immunity to the virus. In such cases, other types of EBV antibodies (like VCA IgG or EBNA IgG) might be present, while EA IgG remains within the reference range, indicating a past infection and possible immunity.
Early or Very Late Stage of Infection: In very early stages of an EBV infection or in cases where a significant amount of time has passed since the infection, EA IgG levels might still be within the reference range. This is because it takes time for these antibodies to develop post-infection, and they tend to decline in later stages.
It's important to interpret these results in the context of other EBV-specific antibody tests (like VCA IgM, VCA IgG, and EBNA IgG) and the clinical presentation of the patient. The EBV antibody profile, including the EA IgG result, provides a more comprehensive understanding of the individual's infection status. A healthcare provider can best interpret what this result means in the context of an individual's symptoms, history, and overall health.
Optimal range: 0 - 9 U/mL
Aid in the diagnosis of acute EBV (infectious mononucleosis) and EBV reactivation in conjunction with other serologic tests. The appearance of IgG antibodies to Early antigen-diffuse [EA(D)] is generally associated with the primary (acute) stage of EBV infection. For most individuals these antibodies are transient and are often undetectable after 6 months.
Optimal range: 0 - 9 U/mL
The EBV Early Antigen Ab, IgG is a valuable biomarker in the diagnosis and management of Epstein-Barr virus infections. By understanding the presence and levels of these antibodies, healthcare providers can better determine the phase of EBV infection and provide appropriate treatment strategies. If you suspect an EBV infection or are experiencing prolonged symptoms, consult your healthcare provider about testing for EBV Early Antigen Ab, IgG.
Optimal range: 0 - 100 U/mL
The Epstein-Barr Virus Nuclear Antigen Antibody (EBV Nuclear Ag Ab) test is a significant component of the Epstein-Barr Virus VCA (Viral Capsid Antigen) Antibody Panel, playing a critical role in diagnosing and understanding the Epstein-Barr Virus (EBV) infection. EBV, a widespread virus, is known for causing infectious mononucleosis and is linked to several other conditions, including certain cancers and autoimmune diseases. The EBV Nuclear Ag Ab test specifically detects antibodies developed against the nuclear antigen of the Epstein-Barr Virus, which are antibodies the immune system produces in response to EBV's nuclear material.
Optimal range: 0 - 18 U/mL
The EBV (Epstein Barr) Nuclear Antigen Antibodies, IgG test looks for a type of antibody which the body typically develops in response to Epstein-Barr Virus.
EBNA antibodies usually appear 2-4 months after infection and persist for the life of the person. This test is usually performed to establish a past infection with EBV.
Optimal range: 0 - 2.7 LOG IU/mL
The marker EBV PCR Whole Blood LOG signifies the level of Epstein-Barr Virus (EBV) DNA in whole blood, measured using a quantitative PCR (polymerase chain reaction) method. The value is reported both in international units per milliliter (IU/ml) and as a logarithmic value (LOG). This measurement indicates the viral load of EBV present in the blood.
EBV is associated with various diseases, including infectious mononucleosis and certain cancers. Quantitative PCR allows precise measurement of viral DNA levels, aiding in monitoring EBV-related diseases.
The reported value helps clinicians assess the severity of infection or disease progression.
Optimal range: 0 - 500 IU/ml
This test is intended to be used for the quantitative detection of Epstein-Barr virus (EBV) DNA and as an aid in the diagnosis and management of EBV infections.
→ This test is only used as an aid in monitoring EBV-related disease.
→ It is not appropriate for the diagnosis of mononucleosis; order serological testing Epstein-Barr Viral Ab Panel instead.
Optimal range: 0 - 100 U/mL
Epstein-Barr Virus (EBV) VCA IgG is a crucial antibody tested in the Epstein-Barr Virus VCA (Viral Capsid Antigen) Antibody Panel, commonly used to diagnose and monitor EBV infections. EBV, a member of the herpesvirus family and one of the most common human viruses, is known for causing infectious mononucleosis and has been linked to various forms of cancer and autoimmune diseases. The EBV VCA IgG test specifically measures the IgG antibodies that the immune system produces in response to the viral capsid antigen of the Epstein-Barr Virus. These antibodies typically develop during the acute or recent phase of an EBV infection and can remain in the system for life, providing long-term immunity.
Optimal range: 0 - 100 U/mL
Optimal range: 0 - 0.9 index
The EBV (Epstein Barr) Nuclear Antigen Antibodies, IgG test looks for a type of antibody which the body typically develops in response to Epstein-Barr Virus.
EBNA antibodies usually appear 2-4 months after infection and persist for the life of the person.
This test is usually performed to establish a past infection with EBV.
Reference range: Non-Reactive, Reactive
The Epstein-Barr Virus (EBV) EBNA IgG MFI marker on an EBV panel is a critical serological test used for assessing infection with EBV, particularly for evaluating past or latent infections. EBNA stands for Epstein-Barr Nuclear Antigen, one of the key proteins expressed by the virus during its latent phase. The IgG (Immunoglobulin G) antibodies against EBNA are typically detected in the later stages of EBV infection and persist long-term, often for the individual's lifetime. The Mean Fluorescence Intensity (MFI) method used in this test quantifies the level of these specific antibodies by measuring the average intensity of fluorescence emitted from labeled antibodies binding to EBNA antigens.
Optimal range: 0 - 0.9 index
EBV-VCA, IgG is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
Optimal range: 0 - 0.9 index
EBV-VCA, IgM is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.
Reference range: Non-Reactive, Reactive
The Epstein-Barr Virus (EBV) VCA IgG MFI marker is a critical component in the serological assessment for Epstein-Barr virus infection, typically included in a comprehensive EBV panel. This marker specifically measures the Immunoglobulin G (IgG) antibodies against the Viral Capsid Antigen (VCA) of EBV, using a quantitative technique known as Mean Fluorescence Intensity (MFI). VCA is one of the first antigens expressed during an EBV infection, and the presence of IgG antibodies against it is indicative of a past or current infection.
Optimal range: 0 - 0 index
The mononuclear spot test or monospot test, a form of the heterophile antibody test, is a rapid test for infectious mononucleosis due to Epstein–Barr virus (EBV).
Mycoplasma
Mycoplasma refers to a group of bacteria that lack a cell wall and are known to cause respiratory, urogenital, and systemic infections in humans. The most well-known species, Mycoplasma pneumoniae, is a common cause of atypical pneumonia and other upper respiratory tract infections.
At HealthMatters.io, we help you interpret your Mycoplasma-related lab results in a clear and actionable way—so you can better understand what your body is telling you and what to do next.
Mycoplasma pneumoniae IgM
Detects early or recent infection by measuring IgM antibodies, which are typically produced at the onset of illness.
Mycoplasma pneumoniae IgG
Indicates past exposure or a later stage of infection. Helpful for confirming previous infection or tracking immune response.
Mycoplasma PCR (Polymerase Chain Reaction)
Identifies the presence of Mycoplasma pneumoniae DNA—considered one of the most accurate ways to detect active infection.
Mycoplasma hominis & Mycoplasma genitalium
Often tested via PCR in urogenital infections. These species are linked to urethritis, pelvic inflammatory disease (PID), and infertility.
Persistent dry cough
Sore throat
Mild fever
Chest discomfort
Fatigue
In urogenital infections: discharge, pelvic pain, or burning with urination
Mycoplasma infections can be subtle but persistent, often mimicking viral illnesses. Accurate testing can:
Differentiate between bacterial and viral causes
Guide appropriate treatment (e.g., antibiotics like macrolides or tetracyclines)
Help monitor recovery or identify chronic or recurrent infections
Optimal range: 0 - 0.9 Units
Mycoplasma Pneumoniae Antibody (IgG) testing plays a pivotal role in the serological diagnosis of infections caused by the bacterium Mycoplasma pneumoniae, a common agent of atypical pneumonia and other respiratory tract infections.
This antibody is a specific type of immunoglobulin G (IgG), which the human immune system produces in response to an infection with this organism.
The presence and levels of Mycoplasma pneumoniae IgG antibodies in a patient's blood are measured to determine whether they have been exposed to the pathogen, either in the recent past or as a more distant infection. Typically, the body starts producing these antibodies 1-2 weeks after the initial infection, and their levels peak around 4-6 weeks post-infection.
Optimal range: 0 - 770 U/mL
Mycoplasma Pneumoniae Antibody (IgM) testing is a crucial diagnostic tool for identifying acute infections caused by Mycoplasma pneumoniae, a common bacterium responsible for causing atypical pneumonia and other respiratory tract infections. The IgM antibodies are among the first to be produced by the immune system in response to an infection, typically appearing within the first couple of weeks after exposure to the pathogen.
In the context of Mycoplasma pneumoniae infection, the presence of IgM antibodies is indicative of a recent or ongoing infection, making this test particularly useful in the early stages of the disease. Patients infected with Mycoplasma pneumoniae often present with symptoms like cough, fever, sore throat, and sometimes more severe respiratory issues.
Optimal range: 0 - 0.8 Ratio
The "Mycoplasma pneumoniae IgA" test is a specific blood test designed to detect the presence of Immunoglobulin A (IgA) antibodies against Mycoplasma pneumoniae, a bacterium that causes respiratory infections, most notably a form of pneumonia often referred to as "walking pneumonia." Unlike typical pneumonia, walking pneumonia caused by Mycoplasma pneumoniae is generally milder and can sometimes manifest with symptoms so slight that individuals might not even realize they are ill, hence the name "walking." The body produces IgA antibodies as part of its immune response to a Mycoplasma pneumoniae infection. These antibodies are a type of protein that the immune system uses to help fight off infections, specifically at mucosal sites such as the lungs and throat in this case.
Optimal range: 0 - 100 U/mL
Mycoplasma pneumoniae is a small bacterium transmitted via organism-containing droplets.
Optimal range: 0 - 770 U/mL
Mycoplasmas are the smallest free-living microbes known.
Cytomegalovirus
Cytomegalovirus (CMV) is a member of the Herpesviridae family of viruses and usually causes asymptomatic infection after which it remains latent, primarily within bone marrow derived cells. Can be similar to primary Epstein-Barr virus infection, with fever, malaise and lymphadenopathy.
Optimal range: 0 - 1 SI
The CMV Latent marker is a laboratory test result used to determine if a person has been previously infected with cytomegalovirus (CMV) and if the virus is present in a dormant state in their body. CMV is a widespread virus that belongs to the herpesvirus family. While it can infect anyone, most healthy individuals with CMV do not show symptoms and may not even be aware they have it. Once a person is infected, the virus remains in their body for life, typically lying dormant or "latent" within certain cells.
Optimal range: 0 - 1 SI
The CMV lytic marker is a term used in medical testing to detect the active phase of cytomegalovirus (CMV) infection. CMV is a common virus that belongs to the herpesvirus family, and while it can infect anyone, it often remains dormant in the body after the initial infection.
When the virus is in its lytic phase, it means that it is actively replicating and producing new virus particles, which can potentially cause symptoms or complications, especially in individuals with weakened immune systems, such as transplant recipients, people with HIV/AIDS, or those undergoing chemotherapy.
Optimal range: 0 - 0.6 U/mL
What is the Cytomegalovirus test?
This test looks for antibodies to cytomegalovirus (CMV), a virus in the herpes family, in your blood.
CMV is so widespread that most people in the U.S. have been infected by the time they reach age 40. But many don't realize it. You can pick up the virus by handling or exchanging bodily fluids, such as saliva, blood, urine, breast milk, and semen. The virus usually causes only a mild illness. But it can do serious harm to unborn children, people with HIV/AIDS, or others with weak immune systems.
Antibodies are germ-fighting molecules that your immune system makes in response to infection. If you have CMV-specific antibodies in your blood, you may have a CMV infection.
Like other herpes family viruses, CMV hides in the body after the first infection and can flare up again. Later infections tend to be milder. In fact, in adults with a healthy immune system, the first infection may not have any symptoms.
Optimal range: 0 - 30 AU/mL
Cytomegalovirus (CMV) is a member of the Herpesviridae family of viruses and usually causes asymptomatic infection after which it remains latent in patients, primarily within bone marrow derived cells. Primary CMV infection in immunocompetent individuals may manifest as a mononucleosis-type syndrome, similar to primary Epstein-Barr virus infection, with fever, malaise and lymphadenopathy.
CMV is a significant cause of morbidity and mortality among bone marrow or solid organ transplant recipients, individuals with AIDS, and other immunosuppressed patients due to virus reactivation or from a newly acquired infection. Infection in these patient populations can affect almost any organ and lead to multiorgan failure. CMV is also responsible for congenital disease among newborns and is one of the TORCH infections (toxoplasmosis, other infections including syphilis, rubella, CMV, and herpes simplex virus).
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When your CMV IgG is positive, and your CMV IgM is negative, it typically indicates a specific scenario related to Cytomegalovirus (CMV) infection:
→ Positive CMV IgG: A positive CMV IgG result means that you have been exposed to CMV at some point in the past. It doesn't provide information about the timing of the infection but indicates past exposure.
→ Negative CMV IgM: A negative CMV IgM result suggests that you are not currently experiencing an acute or active CMV infection. CMV IgM antibodies are typically present during an active or recent infection. Their absence in the blood can indicate that the infection is not recent.
In summary, a positive CMV IgG and a negative CMV IgM result mean that you have been exposed to CMV in the past, but it is not currently an active infection. This is often seen in individuals who have had a prior CMV infection, and the virus remains dormant in their body.
It's important to discuss your test results with a healthcare provider for a more comprehensive evaluation and to understand the specific implications in your individual case. Additionally, if you have concerns about CMV or your health, consult with a medical professional for further guidance.
Optimal range: 0 - 0.89 Units
Cytomegalovirus (CMV) is a common virus that usually causes no symptoms or only mild illness. CMV testing detects antibodies in the blood that the body produces in response to the infection or detects CMV directly.
In the United States, as many as 60% of people have been exposed to CMV at some point in their life. Almost 1 out of every 3 children have been exposed to CMV by age 5 and more than half of adults are exposed to CMV by age 40.
Optimal range: 0 - 0.8 Units
Cytomegalovirus (CMV) is a common virus that usually causes no symptoms or only mild illness. CMV testing detects antibodies in the blood that the body produces in response to the infection or detects CMV directly.
In the United States, as many as 60% of people have been exposed to CMV at some point in their life. Almost 1 out of every 3 children have been exposed to CMV by age 5 and more than half of adults are exposed to CMV by age 40.
Reference range: Non-Reactive, Reactive
Parvovirus
Fifth disease is a mild rash illness caused by parvovirus B19. It is more common in children than adults. A person usually gets sick with fifth disease within four to 14 days after getting infected with parvovirus B19. This disease, also called erythema infectiosum, got its name because it was fifth in a list of historical classifications of common skin rash illnesses in children.
Signs & Symptoms
The symptoms of fifth disease are usually mild and may include
You can get a rash on your face and body
You may get a red rash on your face called “slapped cheek” rash. This rash is the most recognized feature of fifth disease. It is more common in children than adults.
Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs. The rash may be itchy, especially on the soles of the feet. It can vary in intensity and usually goes away in seven to 10 days, but it can come and go for several weeks. As it starts to go away, it may look lacy.
You may also have painful or swollen joints
People with fifth disease can also develop pain and swelling in their joints. This is called polyarthropathy syndrome. It is more common in adults, especially women. Some adults with fifth disease may only have painful joints, usually in the hands, feet, or knees, and no other symptoms. The joint pain usually lasts 1 to 3 weeks, but it can last for months or longer. It usually goes away without any long-term problems.
Optimal range: 0 - 0.89 Units
The presence of IgG antibodies only is indicative of past exposure to Parvovirus.
Optimal range: 0 - 0.89 Units
The presence of IgM class antibodies suggests recent infection.
Small Intestinal Bacterial Overgrowth (SIBO)
What is small intestinal bacterial overgrowth (SIBO)?
SIBO is the accumulation of excessive amount of gut bacteria in the small intestine (at least 100,000 bacteria per ml of fluid). While bacterium naturally exist throughout the digestive tract, with highest concentrations of bacteria in the colon, a healthy individual should have relatively low levels of bacteria present in the small intestine. Any condition which impairs the normal transit or motion of the small intestine can increase the likelihood of getting SIBO, including lack of adequate stomach acid, damage to the intestine by toxins, or a decrease in the speed at which the small intestine transfers waste to the colon. In the U.S., some research studies have demonstrated that up to 80% of the IBS population, or 36 million individuals, suffer from SIBO.
What is the small bowel?
The small bowel, also known as the small intestine, is the part of the gastrointestinal tract that connects the stomach with the colon. The main purpose of the small intestine is to digest and absorb food into the body. The small intestine is approximately 21 feet in length.
What is a hydrogen and methane breath test for small intestinal bacterial overgrowth?
The Hydrogen and Methane Breath Test for SIBO is a non-invasive diagnostic tool to identify SIBO, and can be administered in the comfort of a patient’s own home. Patients are given a substrate solution to drink, which is a mixture of water and a carbohydrate substrate (lactulose or glucose). After drinking the substrate solution, the patient will collect a series of breath samples by simply breathing into a test tube using a straw. In a healthy individual, one would not expect to see any hydrogen or methane in the breath samples for approximately 90 minutes – 2 hours, the approximate time it would take for the substrate to travel to the small intestine to the colon where, in a healthy system, the substrate would be fed upon by bacteria, thus releasing the hydrogen and methane gas. After ingesting a substrate solution, the patient collects breath samples every 15 minutes over a 2 hour and 15 minute (135 minutes) period. During the hydrogen and methane breath test for SIBO, the presence of elevated levels of hydrogen or methane gas, or both, identified within 90 minutes of ingesting the substrate solution provides evidence of bacteria in the upper region of the digestive tract, i.e. at the level of the small intestine. This excessive build up bacteria is often diagnosed as SIBO. Our SIBO breath test can be administered in-office or in the comfort of the patient’s own home.
Optimal range: 0 - 19.99 ppm
The marker “Hydrogen increase over baseline by 90 minutes” is a key diagnostic indicator, used to identify excessive hydrogen gas production caused by bacterial fermentation in the small intestine. Normally, hydrogen is produced in minimal amounts in the small bowel, but when bacteria are present in excess—typically due to SIBO—they begin fermenting ingested sugars like lactulose prematurely, releasing hydrogen that is absorbed into the bloodstream and exhaled in the breath. A rise in hydrogen levels of 20 parts per million (ppm) or more above baseline within the first 90 minutes is considered a positive result for hydrogen-dominant SIBO. This overgrowth can contribute to chronic gastrointestinal symptoms such as bloating, abdominal pain, gas, diarrhea, and nutrient malabsorption. Identifying an early hydrogen rise helps differentiate SIBO from other gut disorders and supports personalized treatment plans using targeted antimicrobials, antibiotics, or dietary interventions such as the low FODMAP diet to restore microbial balance and improve digestive health.
Optimal range: 0 - 2.99 ppm
Peak Methane (CH4) Production is a critical marker in NutriPATH’s 2-Hour SIBO Breath Test, used to detect methane-producing microbes in the small intestine, particularly methanogenic archaea such as Methanobrevibacter smithii. Unlike hydrogen, which is produced by bacteria fermenting carbohydrates, methane is formed when certain archaea consume hydrogen and convert it into methane gas. A methane level of ≥10 parts per million (ppm) at any point during the 2-hour breath test is considered a positive result for methane-dominant SIBO or Intestinal Methanogen Overgrowth (IMO).
Organix Comprehensive Profile - Urine
The Organix Comprehensive Profile is a cutting-edge nutritional test that provides a deep dive into the body's metabolic health by analyzing organic acids. This test offers a detailed look at cellular processes, helping identify potential imbalances that affect overall well-being.
Organic acids are crucial metabolic byproducts produced during processes like:
Elevated levels of specific organic acids in urine can indicate metabolic blocks or dysfunctions caused by:
Additionally, certain biomarkers in this test highlight bacterial or yeast overgrowth in the gut, offering insights into intestinal health.
With just a single urine sample, this comprehensive organic acids test delivers valuable information about your body’s unique nutritional and metabolic needs. It can help uncover:
The Organix Comprehensive Profile empowers individuals to take charge of their health by identifying underlying metabolic and nutritional imbalances. This information can guide personalized dietary, supplement, or lifestyle interventions to enhance overall wellness and vitality.
Optimal range: 0 - 0.19 mcg/mg creatinine
2-Methylhippurate is a byproduct of detoxification of the common solvent xylene. Urinary excretion of 2-methylhippurate is a sensitive and specific marker for xylene exposure which increases oxidative stress.
Optimal range: 0 - 0.05 mcg/mg creatinine
3,4-Dihydroxyphenylpropionate seems to be strongly associated with a troublesome type of bacteria called Clostridia.
Optimal range: 0 - 3.5 mmol/mol
3-Hydroxybutyric acid is a typical partial-degradation product of branched-chain amino acids (primarily valine) released from muscle for hepatic and renal gluconeogenesis. This acid is metabolized by 3-hydroxybutyrate dehydrogenase. The enzyme functions in nervous tissues and muscles, enabling the use of circulating hydroxybutyrate as a fuel.
Optimal range: 1.6 - 9.8 mcg/mg creatinine
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 7.6 ng/mg creatinine
8-hydroxy-2-deoxyguanosine measures the oxidative impact to DNA. 8-hydroxy-2-deoxyguanosine levels will be high if your total antioxidant protection is inadequate.
Optimal range: 0 - 11.1 mcg/mg creatinine
Adipate, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Optimal range: 0 - 0.9 mcg/mg creatinine
Alpha-Hydroxybutyrate is a by-product of glutathione production. Levels of alpha-hydroxybutyrate in the urine may reflect levels of glutathione production.
Optimal range: 0 - 1.1 mcg/mg creatinine
Alpha-Keto-Beta-Methylvalerate is a B-Complex Vitamin Marker. Vitamins are compounds that your body needs to be healthy. Vitamins are “essential” for proper function, which means that they are not made inside your body and must be consumed in the diet.
Optimal range: 0 - 35 mcg/mg creatinine
Alpha-Ketoglutarate is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 0.52 mcg/mg creatinine
Alpha-Ketoisocaproate is a B-Complex Vitamin Marker (Leucine catabolism).
Optimal range: 0 - 0.49 mcg/mg creatinine
Alpha-Ketoisovalerate (together with Alpha-Ketoisocaproate and Alpha-Keto-Beta-methylvalerate) requires Vitamins B1, B2, B3, B5 and lipoic acid to be metabolized.
Optimal range: 0 - 9.3 mcg/mg creatinine
Benzoate, was one of the compounds first found to be elevated in urine from patients with intestinal bacterial overgrowth of various origins.
Optimal range: 0 - 9.9 mcg/mg creatinine
ß-Hydroxybutyrate is a metabolic marker of blood sugar utilization and insulin function.
Optimal range: 0 - 11.5 mcg/mg creatinine
Beta-Hydroxyisovalerate is a sensitive indicator of biotin deficiency and is a metabolite of the amino acid isoleucine.
Optimal range: 37.3 - 153.3 mcg/mg creatinine
cis-Aconitate is involved in both energy production and removal of toxic ammonia.
Optimal range: 56 - 987 mcg/mg creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 73 mcg/mg creatinine
D-Arabinitol is a marker for intestinal yeast overgrowth.
Yeast is another class of microbes that can chronically grow in the intestinal tract and cause adverse health effects through the release of toxic metabolites. D-Arabinitol is uniquely produced by intestinal yeast, and the degree of elevation is a useful marker of their growth.
D-arabinitol is produced from dietary carbohydrates when yeasts are rapidly growing in the low oxygen environment of the small intestine.
Optimal range: 0 - 4.1 mcg/mg creatinine
D-Lactate is produced by bacteria residing in the colon when carbohydrates are not completely absorbed in the small intestine. This by-product is excreted in the urine.
Optimal range: 0 - 6.3 mcg/mg creatinine
Ethylmalonate, together with Adipate and Suberate, gives information about your ability to process fatty acids.
Optimal range: 0 - 2.2 mcg/mg creatinine
Formiminoglutamate (FIGLU) is a functional marker of insufficiency of folic acid, another B-vitamin, and is a compound made from the amino acid histidine.
Optimal range: 0 - 1.35 mcg/mg creatinine
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.
Optimal range: 0 - 10.7 mcg/mg creatinine
Glucarate helps your liver perform its important role in removing from your body many types of toxins such as pesticides, prescription drugs, food components, and intestinal bacteria.
Optimal range: 0 - 1070 mcg/mg creatinine
Microbes resident in the large intestine of the human body help to break down complex aromatic compounds in dietary plant matter (polyphenols), freeing up benzoic acid, which enters the bloodstream. The liver can add the amino acid glycine to benzoic acid to form hippuric acid, which re-enters the blood and is absorbed by the kidneys. As a result, the kidneys excrete hundreds of milligrams of hippuric acid into the urine every day.
Optimal range: 4 - 71 ug/g creat
Histamine is a compound that affects immune response and physiological function of the digestive tract, and also acts as a neurotransmitter.
Histamine helps control the sleep-wake cycle as well as energy and motivation.
Optimal range: 1.4 - 7.6 mcg/mg creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0 - 5.1 mcg/mg creatinine
Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production, and when it is elevated it may indicate that the body is trying to increase its production of CoQ10.
Optimal range: 0 - 90 mcg/mg creatinine
Indican is an indole produced when bacteria in the intestine act on the amino acid, tryptophan. Most indoles are excreted in the feces. The remainder is absorbed, metabolized by the liver, and excreted as indicanin the urine.
Optimal range: 39 - 143 mcg/mg creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 0 mcg/mg creatinine
Alpha-Ketoisovalerate requires Vitamin B1, B5, lipoic acid, B2, and B3 (in descending order of significance) to be metabolized. As your food is broken down, specific compounds are formed at steps that require B vitamin assistance. a-Ketoisovalerateis one of these compounds. If these nutrients are insufficient, the keto acids may build up in the urine.
Optimal range: 0 - 1.5 mcg/mg creatinine
Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0.6 - 16.4 mcg/mg creatinine
L-Lactate is a product of muscle use, so it is constantly produced in normal daily activity.
Optimal range: 0 - 3.1 mcg/mg creatinine
Malate is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 2.3 mcg/mg creatinine
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production.
Optimal range: 0 - 1.01 mcg/mg creatinine
Orotate is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 0 - 1.8 mcg/mg creatinine
The presence of organic compounds such as p-Hydroxybenzoate in the urine may point towards significant dysbiosis (=impaired microbiota).
Optimal range: 0 - 34 mcg/mg creatinine
Associated with small intestinal bacteria overgrowth (SIBO) due to its production by C. di cile, C. stricklandii, C. lituseburense, C. subterminale, C. putrefaciens, and C. propionicum.
Optimal range: 0 - 0.66 mcg/mg creatinine
p-hydroxyphenyllactate is a marker of cell turnover. It is also a metabolite in tyrosine degradation and may be useful for studying disorders of tyrosine metabolism.
Optimal range: 0 - 0.18 mcg/mg creatinine
Produced from bacterial degradation of unabsorbed phenylalanine.
Optimal range: 0 - 0.06 mcg/mg creatinine
Phenylpropionate is a intestinal microbial balance marker. Phenylpropionate is formed from bacterial action on phenylalanine and it should only be present at very low levels.
Optimal range: 2.8 - 13.5 mcg/mg creatinine
Picolinate is a neurotransmitter metabolism marker and is produced under inflammatory conditions.
Optimal range: 28 - 88 mcg/mg creatinine
Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Optimal range: 0 - 6.4 mcg/mg creatinine
Pyruvate feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.
Optimal range: 0 - 5.8 mcg/mg creatinine
Quinolinic acid is a neurotoxic substance produced by our own bodies and a metabolite of tryptophan.
Optimal range: 0 - 4.6 mcg/mg creatinine
Suberate, Adipate, and Ethylmalonate elevations can indicate that you may need additional carnitine and/or vitamin B2 to assist your cells in converting fats into energy efficiently.
Optimal range: 0 - 20.9 mcg/mg creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 690 - 2988 mcg/mg creatinine
Sulfate is associated with your body’s use of glutathione, an amino acid critical for removing toxins that is also a powerful antioxidant.
Optimal range: 0 - 1.41 mcg/mg creatinine
Tricarballylate is produced by a strain of aerobic bacteria. It binds to magnesium which results in magnesium deficiency.
Optimal range: 1.2 - 5.3 mcg/mg creatinine
Vanilmandelate (VMA) and Homovanillate (HVA) are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0 - 0.46 mcg/mg creatinine
Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.
Neurotransmitters
Neurotransmitters are chemical messengers used by the nervous system to relay information from one nerve to another.
Optimal neurotransmitter balance is required to maintain proper health. Imbalances can cause the brain and the body to be over- or under-stimulated, producing neurological or psychological symptoms.
Genetics, environment, chemicals and nutritional deficiencies are a few factors that can impact neurotransmitter production. Once out of balance, the nervous system begins to compensate – which, in time, can lead to neurological or psychological symptoms.
Some of the more common psychological conditions today are known to be accompanied by neurotransmitter imbalances. However, it’s also possible for individuals to present with similar symptoms yet have unique foundational imbalances. Testing helps clarify these root issues.
Common neurotransmitter-related causes of health issues often involve the following scenarios:
Anxiety & Depression
Neurotransmitter imbalances are often associated with anxiety and depression, specifically Glutamate (panic attacks), PEA, Histamine, Serotonin, as well as Epinephrine & Norepinephrine.
Chronic Fatigue
An imbalance between excitatory and inhibitory neurotransmitters can lead to persistent fatigue.
Impulsivity
GABA, Dopamine and Serotonin are three chemical messengers commonly linked to disorders like ADD, ADHD & OCD.
Insomnia
Imbalances in Glutamate, Histamine, Dopamine, GABA and Serotonin are often linked to sleep disturbances and insomnia.
PMS or PMDD
Imbalances in Serotonin, Dopamine, Norepinephrine and GABA are often involved in cases of PMDD (pre-menstrual dysphoric disorder) and severe PMS.
Optimal range: 360 - 1800 ug/g creat
Dopac (aka 3,4-Dihydroxyphenylacetic acid) is a metabolite of the neurotransmitter dopamine. Dopamine serves as the reward and pleasure center in the brain. DOPAC and HVA (Homovanillic Acid) are dopamine metabolites.
DOPAC levels, when viewed in conjunction with dopamine levels, may provide insight into how the body processes neurotransmitters.
Optimal range: 800 - 13000 ug/g creat
5-HIAA is the primary metabolite of serotonin, a chemical substance (neurotransmitter) that transmits messages between nerve cells. After it is used by the body, serotonin is broken down in the liver, and its metabolites, including 5-HIAA, are excreted in the urine.
Optimal range: 64 - 261 ug/g creat
Dopamine is a chemical found naturally in the human body. It is a neurotransmitter, meaning it sends signals from the body to the brain. Dopamine plays a part in controlling the movements a person makes, as well as their emotional responses. The right balance of dopamine is vital for both physical and mental wellbeing.
Optimal range: 4.7 - 20.8 ug/g creat
Epinephrine is commonly known as adrenaline. Your body naturally produces it during times of stress. The hormone is also necessary for maintaining a healthy cardiovascular system — it makes the heart beat more strongly, and diverts blood to tissues during times of stress.
Optimal range: 2.4 - 12.7 uMol/gCr
GABA stands for Gamma-aminobutyric acid (γ-Aminobutyric Acid) and is a nonessential protein amino acid. GABA is an inhibitory neurotransmitter in the central nervous system.
Optimal range: 6.9 - 71.8 uMol/gCr
Glutamate functions as the major excitatory neurotransmitter and metabolic fuel throughout the body. Glutamate is produced in your body, and is also found in many foods.
Optimal range: 182 - 2225 uMol/gCr
Glycine plays an important role in the body’s ability to detoxify itself as well as in wound healing. It is also important in the creation of nucleic acids and bile acids.
Optimal range: 90 - 315 mcg/24h
This test measures the amount of metanephrines in your urine that your body makes over a 24-hour period.
Metanephrines are made when your body breaks down hormones called catecholamines. These hormones are made by the adrenal glands. Catecholamines help your body respond to stress. They are sometimes called "fight or flight" hormones. They also include epinephrine, norepinephrine, and dopamine.
This test may have been ordered for you if your healthcare provider believes you have a condition called pheochromocytoma or paraganglioma. These are rare tumors that make extra amounts of catecholamines. Pheochromocytomas are found in the adrenal glands. Paragangliomas are found outside the adrenal glands.
Optimal range: 224 - 832 mcg/24h
Metanephrines are made when your body breaks down hormones called catecholamines. These hormones are made by the adrenal glands. Catecholamines help your body respond to stress. They are sometimes called "fight or flight" hormones. They also include epinephrine, norepinephrine, and dopamine.
Optimal range: 19 - 76 ug/g creat
Norepinephrine, also known as noradrenaline, is important for mental focus and emotional stability.
Norepinephrine functions as a neurotransmitter and hormone that regulates the “fight or flight” response and elevates blood pressure and heart rate, stimulates wakefulness, and reduces digestive activity.
Optimal range: 0 - 145 pg/mL , 0 - 0.64 nmol/L
Normetanephrine, a metabolite of norepinephrine, is at normally low levels in the plasma. Certain tumors increase the levels and will increase the levels of nor-metanephrine. The Normetanephrine test, when normal, means these tumors are not present.
Optimal range: 122 - 676 mcg/24h
Metanephrine and normetanephrine are breakdown products (metabolites) of the catecholamines epinephrine (adrenaline) and norepinephrine. This test measures the amounts of metanephrine and normetanephrine that are released into the urine over a 24-hour period.
Catecholamines are produced by the adrenal glands (as hormones), small triangular organs located on top of each kidney, and by cells of the sympathetic nervous system (called neurotransmitter substances or neurotransmitters). The primary catecholamines are dopamine, epinephrine (adrenaline), and norepinephrine. Catecholamines are released in response to physical or emotional stress. They help transmit nerve impulses in the brain, increase glucose and fatty acid release for energy, dilate small air passages in the lungs called bronchioles, and dilate the pupils. Norepinephrine also constricts blood vessels, which increases blood pressure, and epinephrine increases heart rate and the rate at which the body uses energy (metabolism).
Optimal range: 15 - 167 uMol/gCr
PEA stands for Beta-phenylethylamine and is an excitatory neurotransmitter made from phenylalanine and it modulates neuron voltage potentials to favor glutamate activity and neurotransmitter firing.
Optimal range: 57 - 306 ug/g creat
Serotonin plays important roles in the resolution of mood, sleep, and appetite.
Serotonin is an inhibitory neurotransmitter synthesized by enzymes that act on tryptophan and/or 5-HTP.
Neurotransmitters are divided into two basic categories:
– Excitatory neurotransmitters stimulate the brain and body.
– Inhibitory neurotransmitters calm the brain and body.
Just as levels of individual neurotransmitters are important in maintaining optimum health, so is the proper balance between your excitatory and inhibitory systems.
Optimal range: 52 - 1025 uMol/gCr
Taurine important for proper heart function, healthy sleep and promoting calmness.
Taurine is an amino sulfonic acid, but it is often referred to as an amino acid, a chemical that is a required building block of protein. Taurine is found in large amounts in the brain, retina, heart, and blood cells called platelets.
Genova Diagnostics (various)
Genova Diagnostics is a global clinical laboratory, pioneering a systems approach that supports healthcare providers in the personalized treatment and prevention of chronic disease.
Optimal range: 3.7 - 18.1 µmol/L
Eicosenoic acid has recently been reported as one of the five biomarkers for diagnosis of schizophrenia.
Optimal range: 30 - 100 ng/mL
Vitamin D is well known for the role it plays in regulating calcium and phosphorus to maintain bone health. Vitamin D insufficiency has been linked to depression and Seasonal Affective Disorder, neurological autoimmune processes, and in preventing on-going inflammation that damages tissue.
Vitamin D, frequently called the “sun vitamin,” is an essential component of the systems that our bodies use to keep bones and teeth strong. It also has important, emerging roles in immune function and cancer prevention. We have natural processes that regulate vitamin D production from the sun so extremely high levels of it are rare. Deficiency can cause a number of issues including weak bones, called osteomalacia.
Optimal range: 0 - 0.83 mmol/mol creatinine
a-hydroxybutyric acid (2-hydroxybuturic acid [2-HB]) is a marker that relates to oxidative stress.
a-hydroxybutyric acid is an organic acid produced from a-ketobutyrate via the enzymes lactate dehydrogenase (LDH) or a-hydroxybutyrate dehydrogenase (HBDH).
Optimal range: 1 - 57 Ratio
This test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. Balancing these eicosanoids in the body is an excellent way
for managing heart disease and other chronic and inflammatory processes.
Optimal range: 13 - 80 µmol/L
Alpha-linolenic acid (ALA) is plant-based essential omega-3 polyunsaturated fatty acids that must be obtained through the diet.
Optimal range: 6.8 - 31.7 mg/L
Naturally occurring vitamin E exists in eight chemical forms (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol) that have varying levels of biological activity.
Alpha- (or α-) tocopherol is the only form that is recognized to meet human requirements. Alpha-tocopherol (body’s main form of vitamin E) functions as an antioxidant, regulates cell signaling, influences immune function and inhibits coagulation.
Optimal range: 0 - 113 ppb
The major tissue sites of aluminum toxicity are the nervous system, immune system, bone, liver, and red blood cells. Aluminum may also interfere with heme (porphyrin) synthesis.
Optimal range: 1.3 - 4.7 µmol/L
Arachidic acid (also called eicosanoic acid) is a long-chain saturated fatty acid. It is the elongation product of stearic acid and can be utilized as an energy source to build membranes.
Optimal range: 158 - 521 µmol/L
Arachidonic acid is an inflammatory omega-6 fatty acid. Our bodies produce this nutrient, and its excess may lead to inflammatory diseases and mood disorders.
Optimal range: 0 - 10 ppb
Arsenic is a natural component of the earth’s crust and is widely distributed throughout the environment in the air, water and land. It is highly toxic in its inorganic form and considered a carcinogenic heavy metal.
Optimal range: 0.6 - 2.9 µmol/L
Behenic acid is a saturated fatty acids, in particular it is part of the group of very long chain fatty acids (VLCFAs).
Optimal range: 0.1 - 2.71 mg/L
Beta-Carotene is an oxidative stress marker.
– Beta-Carotene is involved in antioxidant protection.
– Beta-carotene is converted into vitamin A in the liver.
– Beta-carotene & other carotenoids are converted to vitamin A (retinol), involved in vision, antioxidant & immune function, gene expression & cell growth.
Optimal range: 0 - 1.1 ppb
The principal organs most vulnerable to cadmium toxicity are your kidney and lung. Environmental cadmium exposure is associated with renal tubular damage and high blood pressure. Cadmium toxicity impacts the kidney, where damage to proximal tubules has been described. Also, cadmium compounds are classified as carcinogenic to humans.
Cadmium, a common environmental pollutant and a major constituent of tobacco smoke, has been identified as a new class of endocrine disruptors with a wide range of detrimental effects on reproduction.
Optimal range: 24 - 65 ppm
Calcium is essential for bones and teeth, heart, nerves, muscles, and blood clotting.
Calcium is the most abundant mineral element in your body, because it is the major element in bones. Serum and red blood cell calcium, however, do not represent bone mineral content or dietary adequacy.
Although most of the body’s calcium is stored in bones, some circulates in the blood. About 40% of the calcium in blood is attached to proteins in blood, mainly albumin. Protein-bound calcium acts as a reserve source of calcium for the cells but has no active function in the body.
Optimal range: 0.8 - 6.2 µmol/L
Capric acid (also known as Decanoic acid) is a medium-chain fatty acid (=MCFA) abundant in tropical oils such as coconut oil, whereas small amounts are present in milk of goat, cow, and human. The MCFAs are virtually nonexistent in meats because animals oxidize them very rapidly from plants consumed, and do not accumulate in the tissues.
Optimal range: 0.48 - 3.04 mg/L
CoEnzyme Q10 is an essential component of the mitochondria of the energy producing unit of the cell.
Optimal range: 753 - 1920 ppb
Copper is part of enzymes, which are proteins that help biochemical reactions occur in every cell. Copper is involved in the absorption, storage and metabolism of iron.
Optimal range: 3.1 - 19.5 mmol/L
Optimal range: 27 - 140 µmol/L
Dihomogamma Linolenic Acid (DGLA) is the elongation product of Gamma-linolenic acid (GLA).
Dihomo-gamma-linolenic acid (DGLA) is a fatty acid and part of the Omega-6 fatty acids family. Those fatty acids can predominatentely be found in vegetable oils, grains, most meats and dairy.
DGLA is a strong anti-inflammatory.
Optimal range: 0 - 2 µmol/L
Docosadienoic acid is an omega-6 fatty acid. Omega-6 fatty acids are a type of polyunsaturated fat found in vegetable oils, nuts and seeds.
Optimal range: 31 - 213 µmol/L
Docosahexaenoic acid (DHA) is one of the omega-3 fatty acids.
Optimal range: 11 - 50 µmol/L
Docosapentaenoic acid, or DPA, is a lesser known member of the omega-3 family.
Optimal range: 2.6 - 18.1 µmol/L
Docosatetraenoic acid is also known as Adrenic acid / Adrenate.
Docosatetraenoic acid is a member of the class of compounds known as very long-chain fatty acids.
Fatty acids belong to one of three types or families: saturated, monounsaturated and polyunsaturated. These names describe the structure of the fatty acid in terms of whether it is fully loaded with hydrogen.
Optimal range: 5.2 - 22.5 µmol/L
Eicosadienoic acid is the elongation product of Gamma linolenic acid (GLA) and the direct precursor of Dihomogamma Linolenic (DGLA).
Optimal range: 5 - 210 µmol/L
Eicosapentaenoic Acid (EPA) is a Polyunsaturated Omega-3 Fatty Acid and is involved in the regulation of inflammatory processes and prevention of blood clots.
Optimal range: 0.07 - 5.98 Ratio
The fatty acid profile shows the balance of fats and their metabolites in plasma. Your overall balance of omega-3 and omega-6 fats is represented by the ratios of AA/EPA(arachidonic acid/eicosapentaenoic acid) and EPA/DGLA.
Optimal range: 5 - 46 µmol/L
Gamma-linolenic acid (GLA) is an omega-6 fatty acid. The body converts linoleic acid to gamma-linolenic acid and then to arachidonic acid (AA).
You can get gamma-linolenic acid from several plant-based oils, including evening primrose oil (EPO), borage oil, and black currant seed oil. Most of these oils also contain some linoleic acid.
Gamma-linolenic acid contains 18 carbons and 3 double bonds. It is synthesized from linoleic acid by adding a double bond using the delta-6-desaturase enzyme. This enzymatic reaction is very slow and further impaired in vitamin and mineral deficiencies such as zinc and cobalt. Stress, smoking, alcohol, and systemic inflammatory conditions can also slow this conversion.
Optimal range: 0.06 - 2.99 mg/L
Gamma-tocopherol is part of the Vitamin E classification group.
The term vitamin E refers to a group of eight naturally occurring compounds, all with different potencies:
– alpha-, beta-, gamma- and delta-tocopherol and
– alpha-, beta-, gamma- and delta-tocotrienol.
Optimal range: 3.5 - 16.4 mmol/mol creatinine
Glyceric acid is an organic acid that stems from the catabolism of the amino acid serine. Severe elevations in glyceric acid are an indication of a rare inborn error of metabolism known as glyceric aciduria. One form of glyceric aciduria is the result of a defect in the enzyme glycerate kinase which removes glyceric acid from the system.
Optimal range: 0 - 67 Units
Glycolic acid is another byproduct of the oxalate pathway and comes from the conversion of glyoxylic acid. Urinary levels of glycolic acid have most commonly been studied in the rare inborn error of metabolism primary hyperoxaluria type 1 (PH1). PH1 is caused by a deficiency of alanine:glyoxylate aminotransferase (AGT) which converts glyoxylic acid into glycine. When this pathway is blocked, due to inborn error, glyoxylic acid ultimately leads to higher production of glycolic acid and oxalic acid.
Optimal range: 0 - 0.74 µmol/L
Heneicosanoic acid is an odd-numbered saturated fatty acid.
Fatty acids with odd numbers of carbon atoms are produced primarily by initiating the synthetic series with the three carbon compound, propionic acid. Vitamin B12 is required for the conversion of propionate into succinate for oxidation in the central energy pathways. Deficiency of vitamin B12 results in accumulation of propionate and subsequent buildup of the odd numbered fatty acids, such as heneicosanoic acid.
Optimal range: 0 - 24.4 µmol/L
Heptadecanoic Acid is an odd chain fatty acid.
Fatty acids with odd numbers of carbon atoms are produced primarily by initiating the synthetic series with the three carbon compound, propionic acid.
Optimal range: 0 - 0.43 µmol/L
Hexacosanoic acid is a saturated fatty acid. It is a very long-chain fatty acid. Accumulation of certain very long chain fatty acids (VLCFAs) is associated with degenerative diseases of the central nervous system.
Optimal range: 11 - 46 Ratio
LA/DGLA is a fatty acid ratio.
LA/DGLA stands for linolenic acid (=LA) and dihomogammalinolenic acid (=DGLA).
The LA/DGLA ratio is a biomarker that can indicate functional zinc deficiency.
Optimal range: 2.2 - 27.3 µmol/L
Lauric acid is a saturated fat and one of the medium chain fatty acids (MCFAs) together myristic and capric acid.
Optimal range: 0 - 29 ppb
Lead toxicity causes paralysis and pain in the extremities due to effects on demyelinization, axonal degeneration, and presynaptic block.
Lead toxicity commonly affects sensory, visual, auditory, and cerebellar (coordination) functions, reflecting its impact on the nervous system. Normocytic, sideroblastic anemia is the consequence of lead’s inhibiting effects on enzymes in the heme biosynthesis pathway.
Optimal range: 0.63 - 2.45 µmol/L
Lignoceric Acid is a saturated fatty acids, in particular it is part of the group of very long chain fatty acids (VLCFAs).
Optimal range: 821 - 2032 µmol/L
Linoleic acid is by far the most abundant polyunsaturated fatty acid in most human tissues. Linoleic acid is an essential fatty acid, and low levels indicate dietary insufficiency.
Optimal range: 0 - 2.6 nmol/ML
Lipid peroxides are oxidative degradation products of lipids, generated by a free radical chain reaction. Because of their abundance of reactive hydrogens, polyunsaturated fatty acids are highly susceptible to lipid peroxidation, which compromises the integrity and function of the cell membrane in which they reside.
Optimal range: 34 - 63 ppm
Measuring mineral concentrations inside your erythrocytes (red blood cells) is one of the best ways to determine their adequacy. Minerals are important catalysts that spark many of the chemical reactions in your body. The most extensively required mineral element in your body is magnesium. Erythrocyte magnesium is a measure of magnesium adequacy.
Optimal range: 0 - 8.3 µmol/L
Mead Acid (plasma) is a marker for overall, essential fatty acid status.
Optimal range: 0 - 9.8 ppb
Mercury is an element that is found all over the earth, in soil, rocks, and water. The issue with mercury is that if humans are exposed to it, depending on the amount, route, and duration of exposure, mercury can be toxic to humans.
Optimal range: 15 - 139 µmol/L
Myristic acid is a medium chain fatty acid (=MCFA). It is present in palm kernel oil, coconut oil, butterfat, milk and to some extent in animal fats.
Optimal range: 0.8 - 9.7 µmol/L
Myristoleic acid is one of the monounsaturated fatty acids.
Optimal range: 1.1 - 2.7 µmol/L
Nervonic acid is a monounsaturated fatty acid. Nervonic acid has the longest carbon chain of all monounsaturated fatty acids. It is found in highest concentrations in nerve membranes, particularly in myelin sheaths, which are sleeves of fatty tissue that protect your nerve cells.
Optimal range: 0 - 1.89 µmol/L
Nonadecanoic Acid is an odd chain fatty acid.
Fatty acids with odd numbers of carbon atoms are produced primarily by initiating the synthetic series with the three carbon compound, propionic acid.
Optimal range: 466 - 1470 µmol/L
Oleic acid is the most common monounsaturated fatty acid in human cells.
Optimal range: 0 - 78 Units
Oxalic acid is the metabolic end-product of the glyoxylase pathway and is derived from the oxidation of glyoxylate. In the cell, the majority of glyoxylate is converted into glycine or glycolic acid. However, in some instances there may be greater oxidation of glyoxylate to oxalic acid. This leads to increased urinary excretion of oxalic acid. As 80% of kidney stones are calcium-oxalate stones, an increase in oxalic acid is strongly correlated to frequency of urolithiasis. As mentioned previously, there are inborn errors of metabolism that cause elevated oxalic acid such as primary hyperoxaluria.
Optimal range: 0 - 1.8 µmol/L
Palmitelaidic acid is a trans fat.
Trans fatty acids are prevalent in most diets because of the widespread use of hydrogenated oils used by manufacturers of margarines, bakery products, and peanut butters.
Optimal range: 667 - 2526 µmol/L
Palmitic acid is a saturated fatty acid.
Palmitic and stearic acids are significant markers for high consumption of saturated fats.
Optimal range: 30 - 256 µmol/L
Palmitoleic acid is a monounsaturated fatty acid. Palmitoleic acid is the desaturation product of palmitic acid. Since palmitic acid is predominant in human tissues where desaturase enzyme activity is present, one might expect relatively high levels of palmitoleic acid.
Optimal range: 0 - 20.6 µmol/L
Pentadecanoic acid is an odd numbered fatty acid with a 15-carbon backbone (15:0) and widely considered as one biomarker to assess dairy consumption/intake. It is not normally synthesized by humans, but is found in trace amounts in dairy products (milk fat) and ruminant meat fat.
Optimal range: 2303 - 3374 ppm
Erythrocyte potassium levels uniquely reveal your total body potassium status. Potassium is an abundant mineral that helps keep normal water balance between the cells and body fluids. Muscle contractions, nerve impulses and blood pressure rely on availability of potassium.
Optimal range: 0.13 - 0.32 ppm
Selenium is a mineral found in soil, water, and some foods. We need trace amounts for normal health, and selenium is an essential element in several metabolic pathways. It also has antioxidant properties that help prevent cellular damage from free radicals.
Optimal range: 250 - 629 µmol/L
Stearic acid is a saturated fatty acid that is two carbon atoms longer than palmitic acid.
Optimal range: 1.1 - 1.64 Ratio
The stearic acid/oleic acid ratio from red blood cells is a marker for the presence of malignant tissue, particularly with prostate cancer. In tumors, the net result of changes in fatty acid metabolism is low stearic acid and high oleic acid, causing a profound shift in the ratio of stearic to oleic acids. One likely outcome of this shift is increased fluidity of the tumor cell membrane, resulting in more rapid movement of nutrients and waste products and allowing for faster metabolic rate. The stearic/oleic ratio is used to monitor the effectiveness of cancer therapy.
Values below 1.1 are associated with malignancy.
Optimal range: 0 - 59 µmol/L
The total C18 trans isomers include elaidic acid, petroselaidic, and transvaccenic acids. The presence of these eighteen-carbon long trans fatty acids in human tissue can disrupt or impair cell membrane function. A person with high levels of total C18 trans isomers should avoid hydrogenated oils.
Optimal range: 0 - 0.78 µmol/L
Tricosanoic Acid is an odd chain fatty acid.
Fatty acids with odd numbers of carbon atoms are produced primarily by initiating the synthetic series with the three carbon compound, propionic acid.
Optimal range: 0 - 0.02 Ratio
The Triene/Tetraene (T/T) ratio is another marker for essential fatty acid status. It is calculated as the ratio of Mead acid to arachidonic acid. This ratio, combined with measurements of the essential fatty acids and Mead acid, gives a more complete picture of the degree and nature of fatty acid deficiency. An elevated ratio shows a relative excess of triene (3 double bonds) compared to tetraene (4 double bonds), which results from essential fatty acid deficiency.
Optimal range: 40 - 122 µmol/L
Vaccenic acid is a naturally occurring trans-fatty acid. Vaccenic acid is called this way as it is found in cow’s milk. The latin word vacca means cow.
Optimal range: 0.29 - 1.05 mg/L
Vitamin A is an antioxidant in the membranes of your cells where it serves a protective function. Every day you lose some vitamin A, because it is used in the replacement of old tissues.
Optimal range: 643 - 1594 ppb
Zinc plays a vital role in immunity, protein metabolism, heme synthesis, growth & development, reproduction, digestion and antioxidant function.
Amino Acids 40 Profile
This test determines essential amino acid imbalances that affect both physical and mental function
Optimal range: 0 - 9.8 µmol/L , 0 - 0.98 µmol/dL
It is a component of the dietary peptide anserine. Anserine is beta-alanyl-1-methyl-L-histidine, and it is known to come from chicken, turkey, duck, rabbit, tuna and salmon.
Optimal range: 0 - 52 µmol/L , 0 - 5.2 µmol/dL
3-Methylhistidine is an amino acid which is excreted in human urine.
The measurement of 3-methylhistidine provides an index of the rate of muscle protein breakdown. 3-Methylhistidine is a biomarker for meat consumption, especially chicken. It is also a biomarker for the consumption of soy products.
Optimal range: 230 - 681 µmol/L , 23 - 68.1 µmol/dL
Alanine is a non-essential amino acid and helps the body convert the simple sugar glucose into energy and eliminate excess toxins from the liver.
Optimal range: 0 - 39 µmol/L , 0 - 3.9 µmol/dL
Alpha-Amino-n-butyric acid (A-ANB/α-Amino-N-butyric acid) is an intermediate occurring in the catabolism of two essential amino acids, methionine and threonine.
Optimal range: 0 - 1.5 µmol/L , 0 - 0.15 µmol/dL
Alpha-aminoadipic acid (a-Aminoadipic acid) is an intermediary metabolite of lysine (primarily) and of tryptophan.
Optimal range: 0 - 0.22 Ratio
Alcohol consumption can result in elevations of the plasma Alpha-ANB/Leucine ratio. But to see this biomarker as a conclusive marker for alcoholism is not proven. The increase in the plasma Alpha-ANB/Leucine ratio does not appear to be specific for alcoholism because it was found elevated in nonalcoholic liver disease.
Optimal range: 0 - 43 µmol/L
Anserine is part of a group of Beta-Amino Acids and Derivatives. Anserine is beta-alanyl-1-methyl-L-histidine, and it is known to come from chicken, turkey, duck, rabbit, tuna and salmon.
Optimal range: 29 - 137 µmol/L , 2.9 - 13.7 µmol/dL
Arginine is a conditionally essential amino acid that is critical for your cardiovascular health and detoxification functions. The amino acid, arginine, is used to make the powerful blood vessel regulator, nitric oxide. Nitric oxide acts to lower blood pressure.
Optimal range: 31 - 90 µmol/L , 3.1 - 9 µmol/dL
Asparagine is a protein amino acid. It is non-essential in humans, meaning the body can synthesize it.
Asparagine is synthesized from aspartate and glutamine. Asparagine has three major functions:
Optimal range: 2.9 - 12.6 µmol/L , 0.29 - 1.26 µmol/dL
Aspartic acid is a nonessential protein amino acid. Aspartic Acid, also known as aspartate, is an excitatory neurotransmitter in the brainstem and spinal cord. Aspartic acid is the excitatory counterpart to glycine, an inhibitory neurotransmitter.
Optimal range: 0 - 5 µmol/L , 0 - 0.5 µmol/dL
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. Carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 0 - 3.2 µmol/L , 0 - 0.32 µmol/dL
Beta-aminoisobutyric acid (BAIB) is an amino acid end product of the pyrimidine metabolism. It is excreted in small quantities into the urine in almost all human beings. Thymine, released when RNA and DNA are degraded, enters a catabolic pathway that leads to Beta-Aminoisobutyric Acid.
Optimal range: 0 - 6.3 µmol/L
Carnosine is a dietary peptide related marker that consists of histidine and beta-alanine. Carnosine is an incompletely digested peptide that is derived primarily from beef and pork.
Optimal range: 18 - 57 µmol/L , 1.8 - 5.7 µmol/dL
The amino acid citrulline gets its name from its high concentration in the watermelon Citrullus vulgaris. In human kidneys, citrulline and aspartic acid are united by argininosuccinate synthetase (ASS) to produce arginosuccinate. The degradation of arginosuccinate to fumarate and arginine is a primary mechanism for sustaining plasma levels of arginine. The same enzyme acts in liver cells to complete the urea cycle.
Optimal range: 0 - 0.3 µmol/L , 0 - 0.03 µmol/dL
Cystathionine is an intermediary metabolite that is formed in the sequential enzymatic conversion of methionine to cysteine. Cystathionine is normally detected at very low levels in plasma. It is found between homocysteine and cysteine and is formed by the enzyme cystathionine beta-synthase (CBS).
Optimal range: 0.8 - 27.5 µmol/L
Cystine is the oxidized disulfide form of cysteine (Cys) and is the predominant form of cysteine in the blood due to its greater relative stability. Cystine is derived from dietary protein and, end formed endogenously from cysteine.
Optimal range: 0 - 11.6 µmol/L , 0 - 1.16 µmol/dL
Ethanolamine is a metabolite of the nonessential amino acid serine. In the presence of adequate levels of functional B-6 (P-5-P) serine is enzymatically converted to ethanolamine.
Optimal range: 0 - 2.9 µmol/L , 0 - 0.29 µmol/dL
GABA is a neurotransmitter that inhibits nervous system activity, producing a relaxation effect.
Optimal range: 24 - 214 µmol/L , 2.4 - 21.4 µmol/dL
Glutamic acid (or Glutamate) is a major mediator of excitatory signals in the brain and is involved in most aspects of normal brain function including cognition, memory and learning.
Optimal range: 0.06 - 0.23 Ratio
The Glutamic Acid/Glutamine Ratio is used to identify specimen handling issues that cause spontaneous degradation of glutamine to glutamate, and can reveal the origin of difficulty maintaining systemic pH balance.
Optimal range: 372 - 876 µmol/L , 37.2 - 87.6 µmol/dL
Glutamine is the most abundant amino acid in the blood and is an important source of energy for many tissues in the body. It is derived from the amino acids histidine and glutamic acid.
Optimal range: 155 - 518 µmol/L , 15.5 - 51.8 µmol/dL
Glycine is an amino acid with various important functions within your body, including detoxification, DNA formation, the synthesis of hemoglobin, and as a part of brain neurotransmission pathways. Glycine and serine are interchangeable.
Optimal range: 57 - 114 µmol/L , 5.7 - 11.4 µmol/dL
Histidine is the amino acid most necessary during stress. Amino acids are the building blocks of protein in our bodies.
Optimal range: 3 - 14 nmol/ML
Homocysteine is a sulphur-containing amino acid and is an intermediate metabolite of methionine metabolism. Homocysteine is a well-known cardiovascular disease risk factor.
Optimal range: 0 - 0.6 µmol/L
Homocystine is a common amino acid in your blood. You get it mostly from eating meat. High levels of it are linked to early development of heart disease.
Optimal range: 0 - 0.6 µmol/L
Hydroxylysine is an amino acid related to collagen.
What is collagen?
Collagen is the most abundant protein in your body. It is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin and muscles.
Optimal range: 0 - 26 µmol/L
Hydroxyproline is a collagen related amino acid. Hydroxyproline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver. Hydroxyproline is necessary for the construction of the body’s major structural protein, collagen. Hydroxyproline is present in essentially all tissues and all genetic types of collagen.
Optimal range: 0 - 0.15 Ratio
The Hydroxyproline to Proline Ratio describes the relationship between Proline and Hydroxyproline and can be looked at in relation to your collagen metabolism.
Optimal range: 35 - 104 µmol/L , 3.5 - 10.4 µmol/dL
Isoleucine is one of the three branched-chain amino acids (BCAAs) alongside both leucine and valine.
Isoleucine is a common component of proteins, peptides and hormones. Leucine is catabolized as a source of carbon for energy production during exercise in skeletal muscle.
Optimal range: 74 - 196 µmol/L , 7.4 - 19.6 µmol/dL
Leucine, together with isoleucine and valine, are essential amino acids that are referred to as branched-chain amino acids (BCAAs).
Leucine is nutritionally essential and is required for formation of body proteins, enzymes and some hormones. Leucine itself has a hormone-like activity which is stimulation of pancreatic release of insulin. The branched-chain structure of leucine makes it very important for the formation of flexible collagen tissues, particularly elastin in ligaments. Leucine is relatively abundant in all protein foods.
Optimal range: 120 - 318 µmol/L , 12 - 31.8 µmol/dL
Lysine is found in great quantities in muscle tissues, stimulates calcium absorption, carnitine synthesis, and growth and repair of muscle tissue.
Optimal range: 14 - 48 µmol/L , 1.4 - 4.8 µmol/dL
Methionine is an essential amino acid, meaning we need to get it from our diet as our body does not produce it. Methionine is a unique sulfur-containing amino acid that can be used to build proteins and produce many molecules in the body.
Optimal range: 28 - 117 µmol/L , 2.8 - 11.7 µmol/dL
Ornithine is a urea cycle metabolite.
Ornithine can stimulate the release of growth hormone. Growth hormone is necessary for tissue repair and growth. Growth hormone is often low in patients with fibromyalgia.
Optimal range: 42 - 95 µmol/L , 4.2 - 9.5 µmol/dL
Phenylalanine is a precursor for the amino acid tyrosine, which is essential for making neurotransmitters (e.g. epinephrine, norepinephrine, dopamine) and thyroid hormone. Neurotransmitters are the chemicals that communicate between nerve cells in the brain. It can relieve pain, alleviate depression, and suppress the appetite. Low levels may indicate a stressful lifestyle, leading to memory loss, fatigue, and depression.
Optimal range: 0 - 1.19 Ratio
The Phenylalanine/Tyrosine Ratio evaluates the body’s ability to convert phenylalanine to tyrosine; Conversion enzyme requires tetrahydrobiopterin (BH4), niacin (B3), and iron as cofactors.
Optimal range: 0 - 7.4 µmol/L , 0 - 0.74 µmol/dL
Phosphoethanolamine together with Ethanolamine and Phosphoserine are amino acids that are closely related structurally and they share principal roles in phospholipid metabolism.
Phospholipids are a class of lipids that are important components of cell membranes. Phospholipids are found in high concentrations in the membrane of practically every cell of the body.
Optimal range: 0 - 0.8 µmol/L , 0 - 0.08 µmol/dL
Phosphoserine is a product of glycolysis and is formed by amino group transfer from glutamic acid to phosphohydroxypyruvic acid.
Optimal range: 99 - 363 µmol/L , 9.9 - 36.3 µmol/dL
Proline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver; it does not have to be obtained directly through the diet.
Proline is the precursor to hydroxyproline, which is a major amino acid found in the connective tissue of the body – collagen.
Optimal range: 0 - 10.4 µmol/L , 0 - 1.04 µmol/dL
Sarcosine is also known as N-methylglycine. It is an intermediate and byproduct in the glycine synthesis and degradation. Sarcosine is metabolized to glycine by the enzyme sarcosine dehydrogenase, while glycine-N-methyl transferase generates sarcosine from glycine.
Optimal range: 60 - 172 µmol/L , 6 - 17.2 µmol/dL
Serine can be used as an energy source. Formed from threonine and phosphoserine (requiring B6, manganese, and magnesium), serine is necessary for the biosynthesis of acetylcholine, a neurotransmitter used in memory function.
Optimal range: 29 - 136 µmol/L , 2.9 - 13.6 µmol/dL
Taurine is a sulfur-containing amino acid required for bile formation.
Optimal range: 73 - 216 µmol/L , 7.3 - 21.6 µmol/dL
Threonine is an essential amino acid, i.e., it is vital for your health, but it cannot be synthesized by your body and therefore has to be obtained from a diet.
Optimal range: 31 - 83 µmol/L , 3.1 - 8.3 µmol/dL
Tryptophan is an essential amino acid required for the production of the neurotransmitter serotonin.
Optimal range: 0.1 - 0.11 Ratio
Tryptophan is an essential amino acid, a subunit in protein molecules and a precursor to serotonin. The brain uses tryptophan to produce serotonin, a neurotransmitter largely responsible for feelings of happiness and well-being.
Tryptophan cannot be synthesised by the body and must be obtained through diet.
Optimal range: 38 - 110 µmol/L , 3.8 - 11 µmol/dL
Tyrosin is the non-essential amino acid precursor for dopamine, norepinephrine and epinephrine. Tyrosine hydroxylase converts tyrosine into the dopamine precursor L-DOPA; BH4, Vitamin D and iron are cofactors for that enzymatic activity.
Optimal range: 146 - 370 µmol/L , 14.6 - 37 µmol/dL
Valine, together with Isoleucine and Leucine are essential amino acids and are collectively referred to as branched-chain amino acids (BCAAs).
Sjogren's Antibodies
Sjögren's Syndrome is an autoimmune disorder in which the body's immune system mistakenly reacts to the tissue in glands that produce moisture, such as tear and salivary glands. Sjögren's Syndrome can affect anyone at any age, but the majority of those afflicted are older than 40, and women are nine times more likely than men to have the disorder. It is estimated to be the second most common autoimmune disease, after lupus.
Criteria for diagnosis include, for example, signs and symptoms and positive tests for ANA, anti-SSA and anti-SSB, and/or Rheumatoid factor (RF) as well as a positive salivary gland biopsy.
anti-SSA antibodies are often found together with anti-SSB. However, anti-SSA antibodies alone are often found in lupus, particularly in limited forms of the disease. anti-SSA often appears before anti-SSB.
Specific biomarkers to look at:
SS-A (or Ro) and SS-B (or La): These are the marker antibodies for Sjögren's and the most common antibodies associated with Sjogren’s syndrome. Seventy percent of Sjögren’s patients are positive for SS-A and 40% are positive for SS-B (these may also be found in lupus patients).
ANA (Anti-Nuclear Antibody): ANAs are a group of antibodies that react against normal components of a cell nucleus. About 70% of Sjögren’s patients have a positive ANA test result. (you find this marker in our Immune system category)
RF (Rheumatoid Factor): This antibody test is indicative of a rheumatic disease, including rheumatoid arthritis (RA), lupus and Sjögren’s. It doesn’t, however, specify which rheumatic disease a person has. In Sjögren’s patients, 60-70% have a positive RF. (you find this marker in our Immune system category)
ESR (Erythrocyte Sedimentation Rate): This test measures inflammation. An elevated ESR indicates the presence of an inflammatory disorder, including Sjögren’s. (you find this marker in our Immune system category)
IGs (Immunoglobulins): These are normal blood proteins that participate in immune reactions and are usually elevated in Sjögren’s patients. (you find this marker in our Immune system category)
Optimal range: 0 - 1 AI
Anti-Ro (SS-A) is an autoantibody associated with SLE or Sjögren’s syndrome. Sjögren’s syndrome is an autoimmune disorder in which the body's immune system mistakenly reacts to the tissue in glands that produce moisture, such as tear and salivary glands.
Optimal range: 0 - 1 AI
Anti-SS-B (anti-La) is an autoantibody associated with SLE or Sjögren’s syndrome. Sjögren’s syndrome is an autoimmune disorder in which the body's immune system mistakenly reacts to the tissue in glands that produce moisture, such as tear and salivary glands.
Cortisol Awakening Response + DHEA (Saliva)
Cortisol Awakening Response (CAR):
- CAR represents the momentum of rising cortisol levels that begins several hours prior to awakening and an additional
transient increase.
- CAR reflects a person’s ability to cope with anticipated challenges and the perceptions of control around chronic stress.
Elevated levels of CAR:
- Elevated levels may be due to stress, exercise, alcohol, and specific lifestyle stressors.
- Elevated evening salivary cortisol is linked to insomnia.
- High evening cortisol levels are also associated with various diseases such as diabetes, cardiovascular disease, hormonally driven cancers, and osteoporosis.
DHEA:
DHEA levels peak at around age 25, then decline steadily through the following decades. DHEA can be converted downstream in the steroidogenic pathway to create androgens and estrogens. It has antioxidant and anti-inflammatory properties and can be protective against corticosterone’s neurotoxic effects.
- Lower levels of DHEA are seen with advancing age and have been associated with immune dysregulation, cardiovascular disease, arthritis, osteoporosis, insomnia, declining cognition, depression, fatigue, and decreased libido.
- Elevated levels of DHEA may reflect endogenous exposure and supplementation. Other considerations include Polycystic Ovarian Syndrome (PCOS,) adrenal hyperplasia and adrenal tumors.
General recommendations include overall control of the cortisol response, HPA axis support using nutrition, adaptogens, and behavioral modification.
Optimal range: 0 - 0.94 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0.75 - 2.93 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0 - 0 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0.36 - 1.88 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 2.68 - 9.3 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0 - 0 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 137 - 336 pg/mL
DHEA levels peak at around age 25, then decline steadily through the following decades. DHEA can be converted downstream in the steroidogenic pathway to create androgens and estrogens. It has antioxidant and anti-inflammatory properties and can be protective against corticosterone’s neurotoxic effects.
Optimal range: 0.25 - 2.22 nmol/L , 0.87 - 7.7 pg/mL
Proper DHEA levels contribute to the ideal metabolism of proteins, carbohydrates and fats, including efficient glycaemic control.
DHEA levels peak at around age 25, then decline steadily through the following decades. DHEA can be converted downstream in the steroidogenic pathway to create androgens and estrogens. It has antioxidant and anti-inflammatory properties and can be protective against corticosterone’s neurotoxic effects.
Optimal range: 0.05 - 0.32 Ratio
This calculation represents anabolic and catabolic balance. Since DHEA acts not only as an anabolic hormone, but appears to down-regulate the cellular effects of cortisol, this measurement can theoretically enhance the predictive value of HPA axis dysfunction.
Lipoprotein Particles and Apolipoproteins
The Lipoprotein Particles and Apolipoproteins category focuses on biomarkers related to cholesterol and fat transport in the body. These include various types of lipoproteins, like LDL and HDL, and apolipoproteins, which are protein components of lipoproteins. Analyzing these markers provides insights into cardiovascular risk, helping to assess the potential for heart disease and stroke. This category is key for understanding lipid metabolism and guiding interventions for heart health.
Optimal range: 102 - 200 mg/dL , 1.02 - 2 g/L
Apolipoprotein A is a protein carried in HDL ("good") cholesterol. It helps start the process for HDL to remove bad types of cholesterol from your body. In this way, apolipoprotein A can help to lower your risk for cardiovascular disease. Apolipoprotein A levels can be measured. But it's more common to measure the HDL and LDL ("bad") cholesterol when looking at cardiovascular risk.
This biomarker is useful for:
- Evaluating risk for atherosclerotic cardiovascular disease
- Aiding in the detection of Tangier disease
Optimal range: 0 - 90 mg/dL , 0 - 0.9 g/L
Optimal range: 0 - 0.77 Ratio
Studies have shown that the ratio of apolipoprotein A-1:apolipoprotein B may correlate better with increased risk of coronary artery disease (CAD) than total cholesterol, and LDL:HDL ratio.
Optimal range: 0 - 80 mg/dL
Apolipoprotein B100 (apoB100) is a building block of very low-density lipoproteins (VLDLs), intermediate-density lipoproteins (IDLs), and low-density lipoproteins (LDLs). These related molecules all transport fats and cholesterol in the bloodstream.
Optimal range: 6729 - 20000 nmol/L
This test identifies 5 subclasses of HDL, 1 is identified as the large HDL subclass. Decreased levels of the large HDL subclass are associated with a 1.8-fold increased risk for CVD. Large HDL particles are functionally associated with an antioxidant, paraoxanase, which may help protect the arterial wall.
Optimal range: 11906 - 26738 nmol/L
Optimal range: 9.2 - 30 nm
Reduced mean HDL size is associated with cardiovascular disease. Since HDL-C is primarily carried in the circulation by large, lipid-rich HDL particles, the inverse relationship between HDL size and cardiovascular risk can be secondary to those established for plasma levels of HDL particles, HDL-C, and large HDL.
The epidemiological data suggest that the HDL particle number may represent a more relevant therapeutic target as compared to HDL-C.
Very high mean HDL size can be paradoxically associated with elevated cardiovascular risk as observed in the EPIC-Norfolk study after multiple adjustment; this association resembles those reported between cardiovascular disease and very high levels of HDL-C as observed, for example, in the IDEAL study.
Optimal range: 10 - 100 mg/dL
HDLs comprise a family of heterogeneous particles that vary by size, density, composition, and functionality. Two distinct HDL subfractions, large buoyant HDL2 and small dense HDL3, might exert differential effects on atherosclerosis and display a promising role in CAD risk prediction.
HDL-2 is part of the larger HDL cholesterol family, which is responsible for removing excess cholesterol from the body and transporting it to the liver. HDL-2 is formed when HDL particles in the blood interact with enzymes and acquire more cholesterol.
The large HDL2 is superior to small HDL3 in the assessment of of coronary artery disease risk.
Optimal range: 30 - 100 mg/dL
HDL3-C subfractions are significantly and inversely associated with arterial stiffness, suggesting that HDL subfractions are likely more important than HDL-C in preventing cardiovascular disease.
Broadly, HDL can be distinguished into two subfractions, by density: HDL2 cholesterol (HDL2-C) and HDL3 cholesterol (HDL3-C). HDL3-C is well approximated by the sum of small and medium HDL particles (HDL-P), whereas HDL2-C correlates strongly with large HDL-P. There is no consensus, however, on the functions of HDL2-C and HDL3-C. Whereas some researchers have confirmed that large HDL-Ps have a protective effect on CHD, others recognized that the small, dense, protein-rich HDL-Ps display more potent atheroprotective properties than large, buoyant cholesterol-rich particles.
Optimal range: 30.5 - 100 umol/L
HDL-P, a measurement of total HDL particle number concentration, may be a better marker of residual risk than chemically measured high-density lipoprotein cholesterol (HDL-C, the so-called “good” cholesterol) or apolipoprotein A-1 (apoA-1, the major protein on HDL), ie, there may be a more consistent inverse association between cardiovascular endpoints and HDL-P compared with HDL-C.
Direct quantification of HDL-P concentration by NMR may be useful to refine cardiovascular risk and to evaluate novel HDL-directed therapies. Further studies are needed to clarify the role of HDL-P in clinical practice.
Optimal range: 82 - 304 nmol/L
Optimal range: 86 - 255 nmol/L
Optimal range: 4.8 - 20 umol/L
High-density lipoproteins (HDL) comprise particles of different size, density and composition and their vasoprotective functions may differ.
In the cardiovascular field, both HDL cholesterol (HDL-C) concentration and HDL particle size are independently associated with cardiovascular risk. In particular, large HDL particles appear to be protective in coronary artery disease. HDL particle (HDL-P) number has been proposed as improved inverse predictor of CVD compared to plasma HDL-C.
Optimal range: 0 - 2.7 nmol/L
What are Large VLDL Particles (Large VLDL-P)?
Large VLDL particles, also known as very-low-density lipoprotein particles, play a significant role in lipid metabolism and cardiovascular health. VLDL particles are primarily composed of triglycerides, which are a form of fat. They also contain cholesterol, fatty acids, and a protein called apolipoprotein B (apoB). High levels of apoB in the blood have been associated with an increased risk of cardiovascular disease. When there is an excessive production of VLDL particles or impaired clearance from the bloodstream, it can lead to elevated levels of VLDL cholesterol. High levels of VLDL cholesterol are considered detrimental to cardiovascular health, as they contribute to the development of atherosclerosis, which is the buildup of plaque in the arteries. Atherosclerosis can restrict blood flow and increase the risk of heart disease, heart attack, and stroke.
Optimal range: 0 - 215 nmol/L
This test measures the number of particles in each of the 8 LDL subclasses. Six of these 8 subclasses are small LDL subclass particles. These smaller particles are associated with rapid uptake into the endothelium contributing to accelerated atherosclerosis.
There is a 1.3-fold increased risk for Cardiovascular diseases associated with the small LDL trait and a 1.4-fold increased risk with the medium LDL trait.
Optimal range: 0 - 1138 nmol/L
LDL-P (LDL particle number) measures the actual number of LDL particles (particle concentration, nmol/L). It appears that LDL-P may be a stronger predictor of cardiovascular events than LDL-C.
Lipoproteins are particles that transport fats throughout the body. These particles are essential and carry a combination of proteins, vitamins, cholesterol, triglyceride, and phospholipid molecules. The composition of a lipoprotein particle changes as it circulates in the blood. Some molecules are removed and others are added, resulting in lipoprotein particles with variable amounts of cholesterol.
Optimal range: 35 - 139 nmol/L
Reference range: A Pattern, B Pattern
LDL patterns A and B refer to the size of LDL cholesterol particles in the blood. Some doctors believe that small LDL cholesterol particles in the blood may pose a greater risk for developing atherosclerosis and heart attacks than the absolute level of LDL cholesterol in the blood. The size of LDL cholesterol particles is primarily inherited. A special blood test called polyacrylamide gradient gel electrophoresis can measure particle size and determine whether a person has blood cholesterol LDL pattern A or LDL pattern B.
PATTERN A:
Persons with LDL cholesterol pattern A have large, buoyant LDL cholesterol particles. Individuals with pattern A are more likely to have normal blood levels of LDL cholesterol, HDL cholesterol, and triglycerides. Pattern A is usually not associated with an increased likelihood of atherosclerosis.
PATTERN B:
Persons with LDL cholesterol pattern B have predominantly small and dense LDL cholesterol particles. Pattern B is frequently associated with low HDL cholesterol levels, elevated triglyceride levels, and the tendency to develop high blood sugar levels and type II diabetes mellitus.
Optimal range: 222.9 - 1000 Angstrom
An average size of LDL peak subclass particles measuring less than 218 angstroms, as measured with Ion Mobility, is associated with a 1.35-fold increased risk for CVD.
Contributing factors:
Genetics/demographics:
- Genetic predisposition
- High triglyceride and low HDL-C levels
Optimal range: 20.51 - 100 nm
Small LDL-P and LDL Size are associated with CVD risk, but not after LDL-P is taken into account.
Optimal range: 0 - 142 nmol/L
Small LDL subclass particles cause plaque buildup to progress much faster because they enter the artery wall more easily than large LDL particles. A predominance of smaller LDL particles, referred to as Pattern B lipid phenotype, represents an atherogenic lipid profile that is associated with CVD.
Optimal range: 100 - 536 nmol/L
Optimal range: 75 - 360 nmol/L
Optimal range: 32 - 267 nmol/L
Optimal range: 38 - 312 nmol/L
Optimal range: 40 - 182 nmol/L
Optimal range: 0 - 1000 nmol/L
Lipoproteins are particles that transport fats throughout the body. These particles are essential and carry a combination of proteins, vitamins, cholesterol, triglyceride, and phospholipid molecules.
The composition of a lipoprotein particle changes as it circulates in the blood. Some molecules are removed and others are added, resulting in lipoprotein particles with variable amounts of cholesterol. Low-density lipoprotein particles (LDL-P) are bi-products of fat transport that remain in circulation for an extended time. While in circulation, LDL-P can penetrate the artery wall and get stuck, forming a fatty plaque. These plaques can build over time and lead to blockages, resulting in heart attacks and strokes.
Optimal range: 0 - 57 mg/dL
Optimal range: 0 - 30 mg/dL
Optimal range: 0 - 6 mg/dL
Optimal range: 0 - 0 mg/dL
Optimal range: 0 - 30 mg/dL , 0 - 63 nmol/L
Lipoprotein(a) is a unique lipoprotein that has emerged as an independent risk factor for developing vascular disease.
→ Lp(a) levels are genetically determined1 and not affected by changes in lifestyle.
→ Lp(a) is a plasma lipoprotein consisting of a cholesterolrich LDL particle attached to an additional apolipoprotein called apo(a).
→ Lipoproteins are made of protein and fat. They carry cholesterol through your blood. Lp(a) is a type of low-density lipoprotein (LDL).
→ LDL is known as “bad” cholesterol. High levels of Lp(a) can create plaque in your blood vessels. This is a buildup of cholesterol that lessens blood flow through your arteries.
Optimal range: 0 - 123 nmol/min/mL
Lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet activating factor Acetylhydrolase, is an inflammatory enzyme that circulates bound mainly to low density lipoproteins and has been found to be localized and enriched in atherosclerotic plaques.
Optimal range: 0 - 45 Units
The LP-IR Score, or Lipoprotein Insulin Resistance Score, is a clinically significant biomarker used to assess insulin resistance, a key factor in the development of type 2 diabetes and cardiovascular diseases. This score is derived from the detailed analysis of lipoprotein particle size and concentration in the blood, using advanced nuclear magnetic resonance (NMR) spectroscopy. Lipoproteins, which are complexes of lipids and proteins, play crucial roles in the transportation of cholesterol and triglycerides in the bloodstream.
The LP-IR Score is calculated based on the levels of specific lipoprotein subclasses, including very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) particles, along with their respective sizes. These lipoprotein metrics are integral in understanding the pathophysiology of insulin resistance.
For instance, an increased number of small, dense LDL particles and large VLDL particles are often indicative of insulin resistance.
Optimal range: 0 - 527 nmol/L
These particles are associated with an increased risk of heart disease; more of these small particles lead to greater risk. Your Small LDL particle score can vary widely, with a lower score being much better.
Optimal range: 15758 - 34995 nmol/L
Optimal range: 1044 - 2725 nmol/L
Optimal range: 5 - 40 mg/dL , 0.13 - 1.04 mmol/L
Very-low-density lipoprotein (VLDL) is a type of lipoprotein produced by the liver that plays a key role in transporting triglycerides, a form of fat, through the bloodstream to be used or stored by the body. VLDL is considered a type of “bad” cholesterol because high levels contribute to the formation of plaque in the arteries—a process called atherosclerosis—which increases the risk of heart disease, stroke, and other cardiovascular conditions. While similar to LDL (low-density lipoprotein), which carries mostly cholesterol, VLDL carries mostly triglycerides and is often estimated using a triglyceride measurement (typically by dividing the triglyceride level by 5). Elevated VLDL levels are associated with poor diet, obesity, sedentary lifestyle, diabetes, excessive alcohol intake, hypothyroidism, and certain medications. These particles are part of the body’s natural system for delivering fats and energy to tissues, but when present in excess, they can promote dangerous plaque buildup in the arteries. VLDL, LDL, and their remnant particles can lodge in artery walls, narrow blood vessels, and restrict oxygen-rich blood flow to the heart, brain, and other organs. High VLDL is particularly concerning when combined with other risk factors such as high LDL, low HDL (the "good" cholesterol), high blood pressure, and diabetes. Because there’s no direct test for VLDL, it’s usually assessed as part of a lipid panel, which includes total cholesterol, HDL, LDL, and triglycerides. Managing high VLDL levels often starts with lifestyle changes like reducing saturated fat and sugar intake, exercising regularly, avoiding alcohol, and addressing related conditions like obesity or insulin resistance. In some cases, medication may be necessary to help reduce cardiovascular risk. For most adults, cholesterol and lipid levels—including VLDL—should be checked every 4 to 6 years, or more often if risk factors are present.
Optimal range: 34 - 114 nmol/L
Optimal range: 0 - 46.6 nm
Special proteins, apoproteins, play an important role in moving lipoproteins around the body and facilitating their interactions with other cells. The most important of these are the apoB class, residing on VLDL, IDL, and LDL particles, and the apoA-I class, residing for the most part on the HDL particles.
VLDL are one of the major triglyceride-rich lipoproteins. They carry endogenous, hepatically synthesized triglycerides, largely derived from dietary carbohydrate or from plasma NEFA (=Non-Esterified Fatty Acids), and are of a large size (30–60 nm diameter).
Each VLDL particle has a single molecule of a larger apoB form, apoB100, with other apolipoproteins (apoE and apoCs) being acquired in plasma from HDL.
The levels of VLDL are not the only thing that matters. The size and chemical makeup of VLDL particles also contribute to health risks.
VLDL size is dependent on the triglyceride content, with large buoyant triglyceride-enriched VLDL being formed at times of triglyceride excess.
Optimal range: 3 - 33 nmol/L
Optimal range: 21 - 93 nmol/L
Optimal range: 0 - 10 mg/dL
IgG Subclass Deficiency
The IgG Subclass Deficiency Panel is a blood test that measures the levels of the four IgG (Immunoglobulin G) subclasses:
IgG1
IgG2
IgG3
IgG4
These subclasses are all part of the IgG antibody family, which plays a crucial role in your immune system's ability to recognize and fight off bacteria, viruses, and other pathogens. While total IgG may appear normal, an individual may still be deficient in one or more subclasses—this is known as an IgG subclass deficiency.
This panel is typically ordered if you:
Have frequent or recurrent infections, especially of the sinuses, lungs, or ears
Show signs of a weakened immune system
Have a normal total IgG level but suspected immune dysfunction
Are being evaluated for a primary immunodeficiency disorder (PID)
Are being monitored for certain autoimmune or inflammatory conditions
IgG1: The most abundant subclass, important for response to protein antigens (like tetanus or diphtheria).
IgG2: Plays a key role in defense against bacterial infections, especially encapsulated bacteria (e.g., Streptococcus pneumoniae).
IgG3: Effective against viral antigens; has strong pro-inflammatory properties.
IgG4: Involved in long-term or chronic antigen exposure and can be elevated in some autoimmune and allergic conditions.
A deficiency in one or more IgG subclasses may lead to increased susceptibility to infections, even if the total IgG level is within the normal range.
IgG2 Deficiency: Often associated with recurrent bacterial sinus or lung infections, especially in children.
IgG3 Deficiency: May be linked to chronic respiratory infections or viral susceptibility.
IgG1 Deficiency: Can result in broader immune dysfunction, sometimes in combination with other deficiencies.
Selective IgG4 Deficiency: Less well understood, but may co-exist with other immune abnormalities.
Frequent sinus, ear, or respiratory infections
Poor response to vaccines
Chronic cough or bronchitis
Fatigue due to repeated illnesses
In children: failure to thrive or delayed growth due to illness
If your IgG subclass levels are low, your healthcare provider may:
Review your infection history
Order pneumococcal antibody titers to assess vaccine response
Test total immunoglobulin levels (IgG, IgA, IgM)
Consider referral to an immunologist
Recommend immunoglobulin replacement therapy (IVIG or SCIG) in severe cases
The IgG Subclass Deficiency Panel evaluates whether your immune system is producing adequate levels of each IgG subclass. A deficiency can explain frequent infections and guide further testing or treatment. Even if total IgG is normal, subclass imbalances can impact immune protection. This panel plays a key role in identifying hidden immune deficiencies and improving long-term infection management.
Optimal range: 382 - 929 mg/dL
IgG is a combination of four slightly different types of IgG called IgG subclasses: IgG1, IgG2, IgG3 and IgG4. When one or more of these subclasses is persistently low and total IgG is normal, a subclass deficiency is present.
Optimal range: 241 - 700 mg/dL
IgG is a combination of four slightly different types of IgG called IgG subclasses: IgG1, IgG2, IgG3 and IgG4. When one or more of these subclasses is persistently low and total IgG is normal, a subclass deficiency is present.
Optimal range: 22 - 176 mg/dL
IgG is a combination of four slightly different types of IgG called IgG subclasses: IgG1, IgG2, IgG3 and IgG4. When one or more of these subclasses is persistently low and total IgG is normal, a subclass deficiency is present.
Optimal range: 4 - 86 mg/dL
IgG is a combination of four slightly different types of IgG called IgG subclasses: IgG1, IgG2, IgG3 and IgG4. When one or more of these subclasses is persistently low and total IgG is normal, a subclass deficiency is present.
Metabolic Analysis Markers (Urine)
The Metabolic Analysis Profile (Urine) measures four critical areas of metabolism: gastrointestinal function and dysbiosis markers, cellular and mitochondrial energy metabolites, neurotransmitter metabolites, and functionally important organic acid metabolites of amino acids.
Optimal range: 0 - 0.76 mmol/mol creatinine
Metabolite of phenylalanine via phenyl pyruvate.
Optimal range: 0 - 29 mmol/mol creatinine
Production of 3-hydroxyisovaleric acid begins with the conversion of 3-methylcrotonyl-CoA into 3-methylglutaconyl-CoA in the mitochondria by the biotin-dependent enzyme methylcrotonyl-CoA carboxylase.
Optimal range: 0 - 8.1 mmol/mol creatinine
3-Hydroxyphenylacetic acid is a rutin metabolite and an antioxidant.
Optimal range: 5 - 22 mmol/mol creatinine
Metabolite of propionic acid, precursor of methylmalonic acid via both biotin and Mg.
Optimal range: 0.02 - 0.22 mmol/mol creatinine
3-Methyl-4-OH-phenylglycol is the breakdown product from norepinephrine, but it may also be produced from epinephrine to a lesser extent.
Optimal range: 0 - 29 mmol/mol creatinine
A tyrosine metabolic product of GI bacteria.
Optimal range: 3.8 - 12.1 mmol/mol creatinine
5-OH-indoleacetic Acid is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5-OH-indoleacetic Acid are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 6.7 mmol/mol creatinine
a-Hydroxyisobutyric Acid (from MTBE) is a toxic breakdown product.
Optimal range: 0 - 2.1 mmol/mol creatinine
a-Keto-b-Methylvaleric Acid is a B-Complex Vitamin Marker. Vitamins are compounds that your body needs to be healthy. Vitamins are “essential” for proper function, which means that they are not made inside your body and must be consumed in the diet.
A metabolites of isoleucine.
Optimal range: 0 - 1.7 mmol/mol creatinine
Alpha-Ketoadipic acid (or 2-oxoadipate) is an intermediate in the metabolism of lysine.
Optimal range: 4 - 52 mmol/mol creatinine
Alpha-Ketoglutarate is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 0.89 mmol/mol creatinine
a-Ketoisocaproic Acid is a B-Complex Vitamin Marker (Leucine catabolism).
Optimal range: 0 - 0.97 mmol/mol creatinine
Alpha-Ketoisovalerate (together with Alpha-Ketoisocaproate and Alpha-Keto-Beta-methylvalerate) requires Vitamins B1, B2, B3, B5 and lipoic acid to be metabolized.
Optimal range: 0 - 0.46 mmol/mol creatinine
a-Ketophenylacetic Acid (from Styrene) is a toxic breakdown product.
Optimal range: 0 - 2.8 mmol/mol creatinine
Adipic Acid, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Optimal range: 0 - 96 mmol/mol creatinine
Breakdown product of hyaluronic acid; also found in certain foods.
Optimal range: 0 - 15 mmol/mol creatinine
Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production, and when it is elevated it may indicate that the body is trying to increase its production of CoQ10.
Optimal range: 0 - 0.05 mmol/mol creatinine
Benzoic Acid was one of the compounds first found to be elevated in urine from patients with intestinal bacterial overgrowth of various origins.
Optimal range: 0 - 2.8 mmol/mol creatinine
Ketone formed from acetyl CoA.
Optimal range: 10 - 36 mmol/mol creatinine
Cis-Aconitic Acid is involved in both energy production and removal of toxic ammonia.
Optimal range: 0 - 5.8 mmol/mol creatinine
Metabolite of yeast or anaerobic bacteria, including Clostridia.
Optimal range: 40 - 520 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 5.3 mmol/mol creatinine
Produced when Clostridia acts upon unabsorbed tryptophan, tyrosine or phenylalanine.
Optimal range: 0 - 1.5 mmol/mol creatinine
Formiminoglutamic Acid (FIGlu) is a functional marker of insufficiency of folic acid, another B-vitamin, and is a compound made from the amino acid histidine.
Optimal range: 0 - 0.51 mmol/mol creatinine
Glutaric acid is a breakdown product of lysine and/or tryptophan.
Optimal range: 0 - 603 mmol/mol creatinine
Microbes resident in the large intestine of the human body help to break down complex aromatic compounds in dietary plant matter (polyphenols), freeing up benzoic acid, which enters the bloodstream. The liver can add the amino acid glycine to benzoic acid to form hippuric acid, which re-enters the blood and is absorbed by the kidneys. As a result, the kidneys excrete hundreds of milligrams of hippuric acid into the urine every day.
Optimal range: 0 - 19 mmol/mol creatinine
Homogentisic acid is a breakdown product of 4-Hydroxyphenylpyruvic Acid (4-HPPA).
Optimal range: 1.2 - 5.3 mmol/mol creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0 - 4.2 mmol/mol creatinine
Produced from bacterial degradation of unabsorbed tryptophan.
Optimal range: 22 - 65 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 3.7 mmol/mol creatinine
Isovalerylglycine is a breakdown product of leucine.
Optimal range: 0.44 - 5 Ratio
Kynurenic acid, which is derived from the processing of tryptophan, is converted to quinolinic acid in the presence of B6 or P5P. While kynurenic is calming, quinolinic is an excitotoxin that can over stimulate nerves.
Optimal range: 0 - 7.1 mmol/mol creatinine
Kynurenic Acid is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 1.9 - 19.8 mmol/mol creatinine
Formed from pyruvate in anaerobic or oxygen-starved (hypoxic) conditions to allow for ongoing production of ATP.
Optimal range: 0 - 3 mmol/mol creatinine
Malic Acid is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 1.9 mmol/mol creatinine
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production.
Optimal range: 0.33 - 1.01 mmol/mol creatinine
Orotic Acid is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 0 - 0.12 mmol/mol creatinine
Produced from bacterial degradation of unabsorbed phenylalanine.
Optimal range: 16 - 34 mmol/mol creatinine
Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Optimal range: 7 - 32 mmol/mol creatinine
Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.
Optimal range: 0 - 9.1 mmol/mol creatinine
Quinolinic acid is a neurotoxic substance produced by our own bodies and a metabolite of tryptophan.
Optimal range: 0 - 2.1 mmol/mol creatinine
Suberic Acid, Adipate, and Ethylmalonate elevations can indicate that you may need additional carnitine and/or vitamin B2 to assist your cells in converting fats into energy efficiently.
Optimal range: 0.4 - 4.6 mmol/mol creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0 - 15 mmol/mol creatinine
Breakdown product of hyaluronic acid; also found in some foods.
Optimal range: 0.4 - 3.6 mmol/mol creatinine
Vanilmandelic Acid is a breakdown product from neurotransmitters involved in hormone and nerve impulse transmission.
Optimal range: 0 - 0.96 mmol/mol creatinine
Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.
Amino Acids Analysis
Amino acid nutritional testing aids in the identification of the following:
- dietary protein adequacy
- amino acid balance
- gastrointestinal dysfunctions
- forms of protein intolerance
- vitamin and mineral deficiencies
- renal and hepatic dysfunction
- psychiatric abnormalities
- susceptibility to inflammatory response and oxidative stress
- reduced detoxification capacity
... and many other inherent and acquired disorders in amino acid metabolism.
Plasma vs. Urine Analysis:
Plasma is traditionally used to assess the status of essential amino acids while urine analysis provides more information regarding admino acid wasting and aberrant metabolism associated with co-factor insufficiencies.
Plasma amino acid nutritional testing measures what is being transported at the time of sampling. The specimen should be collected after an overnight fast to reduce the influence of dietary protein. Abnormalities are deduced by comparison of measured levels with an established reference range.
The 24-hour urine amino acid analysis has the highest probability of detecting abnormalities if renal function is normal. The 24-hour test indicates what is high and low over the course of a day, reflects blood and tissue amino acid pools, and is not affected by circadian rhythm. Healthy kidneys efficiently conserve essential amino acids. Therefore, urine levels of amino acids decrease first and tend to give an earlier indication of inadequacy than do plasma levels.
A first morning void urine (FMV) amino acid analysis, with results normalized per gram creatinine, provides an alternative when a complete 24-hour collection is not a viable option. The FMV analysis is excellent for identification of marked abnormalities, particularly with respect to gastrointestinal health, inherited disorders in amino acid metabolism and renal function, and can be used for protein challenge testing.
Optimal range: 38 - 988 micromol/g creatinine
It is a component of the dietary peptide anserine. Anserine is beta-alanyl-1-methyl-L-histidine, and it is known to come from chicken, turkey, duck, rabbit, tuna and salmon.
Optimal range: 44 - 281 micromol/g creatinine
3-Methylhistidine is an amino acid which is excreted in human urine.
The measurement of 3-methylhistidine provides an index of the rate of muscle protein breakdown. 3-Methylhistidine is a biomarker for meat consumption, especially chicken. It is also a biomarker for the consumption of soy products.
Optimal range: 2 - 25 micromol/g creatinine
Alpha-Amino-n-butyric acid (A-ANB/α-Amino-N-butyric acid) is an intermediate occurring in the catabolism of two essential amino acids, methionine, and threonine.
Optimal range: 2 - 47 micromol/g creatinine
Alpha-aminoadipic acid (a-Aminoadipic acid) is an intermediary metabolite of lysine (primarily) and tryptophan.
Optimal range: 26 - 275 micromol/g creatinine
Alanine is a non-essential amino acid and helps the body convert the simple sugar glucose into energy and eliminate excess toxins from the liver.
Optimal range: 0.4 - 105.1 micromol/g creatinine
Anserine is part of a group of Beta-Amino Acids and Derivatives. Anserine is beta-alanyl-1-methyl-L-histidine, and it is known to come from chicken, turkey, duck, rabbit, tuna and salmon.
Optimal range: 3 - 43 micromol/g creatinine
Arginine is a conditionally essential amino acid that is critical for your cardiovascular health and detoxification functions. The amino acid, arginine, is used to make the powerful blood vessel regulator, nitric oxide. Nitric oxide acts to lower blood pressure.
Optimal range: 25 - 166 micromol/g creatinine
Asparagine is a protein amino acid. It is non-essential in humans, meaning the body can synthesize it.
Asparagine is synthesized from aspartate and glutamine.
Asparagine has three major functions:
Optimal range: 0 - 14 micromol/g creatinine
Aspartic acid is a nonessential protein amino acid. Aspartic Acid, also known as aspartate, is an excitatory neurotransmitter in the brainstem and spinal cord. Aspartic acid is the excitatory counterpart to glycine, an inhibitory neurotransmitter.
Optimal range: 0 - 22 micromol/g creatinine
Beta-alanine is a non-essential amino acid.
What are amino acids?
The body can make Non-essential amino acids, so they don’t have to be provided by food. Amino acids are the building blocks of proteins.
Optimal range: 11 - 160 micromol/g creatinine
Beta-aminoisobutyric acid (BAIB) is an amino acid end product of the pyrimidine metabolism. It is excreted in small quantities into the urine in almost all human beings. Thymine, released when RNA and DNA are degraded, enters a catabolic pathway that leads to Beta-Aminoisobutyric Acid.
Optimal range: 1 - 28 micromol/g creatinine
Carnosine is a dietary peptide related marker that consists of histidine and beta-alanine. Carnosine is an incompletely digested peptide that is derived primarily from beef and pork.
Optimal range: 0.6 - 3.9 micromol/g creatinine
The amino acid citrulline gets its name from its high concentration in the watermelon Citrullus vulgaris. In human kidneys, citrulline and aspartic acid are united by argininosuccinate synthetase (ASS) to produce arginosuccinate. The degradation of arginosuccinate to fumarate and arginine is a primary mechanism for sustaining plasma levels of arginine. The same enzyme acts in liver cells to complete the urea cycle.
Optimal range: 2 - 68 micromol/g creatinine
Cystathionine is an intermediary metabolite that is formed in the sequential enzymatic conversion of methionine (essential amino acid) to cysteine.
Optimal range: 8 - 74 micromol/g creatinine
Cysteine (FMV Urine) is part of a group of markers that indicates the balance and sufficiency of the methylation/sulfation pathway substrates and co-factors.
Optimal range: 10 - 104 micromol/g creatinine
Cystine is the oxidized disulfide form of cysteine (Cys) and is the predominant form of cysteine in the blood due to its greater relative stability. Cystine is derived from dietary protein and, end formed endogenously from cysteine.
Optimal range: 50 - 235 micromol/g creatinine
Ethanolamine is a metabolite of the nonessential amino acid serine. In the presence of adequate levels of functional B-6 (P-5-P) serine is enzymatically converted to ethanolamine.
Optimal range: 0 - 5 micromol/g creatinine
GABA is a neurotransmitter that inhibits nervous system activity, producing a relaxation effect.
Optimal range: 4 - 27 micromol/g creatinine
Glutamic acid (or Glutamate) is a major mediator of excitatory signals in the brain and is involved in most aspects of normal brain function including cognition, memory and learning.
Optimal range: 110 - 632 micromol/g creatinine
Glutamine is the most abundant amino acid in the blood and is an important source of energy for many tissues in the body. It is derived from the amino acids histidine and glutamic acid. Glutamine improves immune function, balances ammonia in the body, contributes to biosynthesis of proteins, amino acids, nucleic acids, glutathione, glutamate, and GABA.
Optimal range: 95 - 683 micromol/g creatinine
Glycine is an amino acid with various important functions within your body, including detoxification, DNA formation, the synthesis of hemoglobin, and as a part of brain neurotransmission pathways. Glycine and serine are interchangeable.
Optimal range: 124 - 894 micromol/g creatinine
Histidine is the amino acid most necessary during stress. Amino acids are the building blocks of protein in our bodies.
Histidine ameliorates fatigue, promotes clear thinking and concentration, reduces appetite, decreases anxiety, improves sleep and glucose homeostasis, and gives rise to histamine.
Optimal range: 3 - 28 micromol/g creatinine
Isoleucine is one of the three branched-chain amino acids (BCAAs) alongside both leucine and valine.
Isoleucine is a common component of proteins, peptides and hormones. Leucine is catabolized as a source of carbon for energy production during exercise in skeletal muscle.
Optimal range: 4 - 46 micromol/g creatinine
Leucine, together with isoleucine and valine, are essential amino acids that are referred to as branched-chain amino acids (BCAAs).
Leucine is nutritionally essential and is required for formation of body proteins, enzymes and some hormones. Leucine itself has a hormone-like activity which is stimulation of pancreatic release of insulin. The branched-chain structure of leucine makes it very important for the formation of flexible collagen tissues, particularly elastin in ligaments. Leucine is relatively abundant in all protein foods.
Optimal range: 11 - 175 micromol/g creatinine
Lysine is found in great quantities in muscle tissues, stimulates calcium absorption, carnitine synthesis, and growth and repair of muscle tissue.
Optimal range: 2 - 18 micromol/g creatinine
Methionine is an essential amino acid, meaning we need to get it from our diet as our body does not produce it. Methionine is a unique sulfur-containing amino acid that can be used to build proteins and produce many molecules in the body.
Optimal range: 3 - 17 micromol/g creatinine
Ornithine is a urea cycle metabolite.
Ornithine can stimulate the release of growth hormone. Growth hormone is necessary for tissue repair and growth. Growth hormone is often low in patients with fibromyalgia.
Optimal range: 8 - 71 micromol/g creatinine
Phenylalanine is a precursor for the amino acid tyrosine, which is essential for making neurotransmitters (e.g. epinephrine, norepinephrine, dopamine) and thyroid hormone. Neurotransmitters are the chemicals that communicate between nerve cells in the brain. It can relieve pain, alleviate depression, and suppress the appetite. Low levels may indicate a stressful lifestyle, leading to memory loss, fatigue, and depression.
Optimal range: 1 - 13 micromol/g creatinine
Phosphoethanolamine together with Ethanolamine and Phosphoserine are amino acids that are closely related structurally and they share principal roles in phospholipid metabolism.
Phospholipids are a class of lipids that are important components of cell membranes. Phospholipids are found in high concentrations in the membrane of practically every cell of the body.
Optimal range: 0 - 13 micromol/g creatinine
Phosphoserine is a product of glycolysis and is formed by amino group transfer from glutamic acid to phosphohydroxypyruvic acid.
Optimal range: 1 - 13 micromol/g creatinine
Proline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver; it does not have to be obtained directly through the diet.
Proline is the precursor to hydroxyproline, which is a major amino acid found in the connective tissue of the body – collagen.
Optimal range: 0 - 1.1 micromol/g creatinine
Sarcosine is also known as N-methylglycine. It is an intermediate and byproduct in the glycine synthesis and degradation. Sarcosine is metabolized to glycine by the enzyme sarcosine dehydrogenase, while glycine-N-methyl transferase generates sarcosine from glycine.
Optimal range: 40 - 163 micromol/g creatinine
Serine can be used as an energy source. Formed from threonine and phosphoserine (requiring B6, manganese, and magnesium), serine is necessary for the biosynthesis of acetylcholine, a neurotransmitter used in memory function.
Optimal range: 21 - 424 micromol/g creatinine
Taurine is a sulfur-containing amino acid required for bile formation.
Optimal range: 17 - 135 micromol/g creatinine
Threonine is an essential amino acid, i.e., it is vital for your health, but it cannot be synthesized by your body and therefore has to be obtained from a diet.
Optimal range: 5 - 53 micromol/g creatinine
Tryptophan is an essential amino acid required for the production of the neurotransmitter serotonin.
Optimal range: 11 - 135 micromol/g creatinine
Tyrosin is the non-essential amino acid precursor for dopamine, norepinephrine and epinephrine. Tyrosine hydroxylase converts tyrosine into the dopamine precursor L-DOPA; BH4, Vitamin D and iron are cofactors for that enzymatic activity.
Optimal range: 168 - 465 mmol/g creatinine
Urea is the principal nitrogenous waste product of metabolism and is generated from protein breakdown.
Optimal range: 7 - 49 micromol/g creatinine
Valine, together with Isoleucine and Leucine are essential amino acids and are collectively referred to as branched-chain amino acids (BCAAs).
Essential and Metabolic Fatty Acids Markers (RBCs)
The Essential & Metabolic Fatty Acids Analysis (EMFA) assesses the critical balance between essential Omega-6/Omega-3 fatty acids, as well as additional key fatty acids important in metabolism and cellular function. Fatty acid imbalances can be a causative factor in a variety of chronic health conditions. The Essential and Metabolic Fatty Acids Analysis can indicate the need for fatty acid supplementation and/or dietary modification.
Optimal range: 3.8 - 20 %
Essential fatty acids are classified into fat "families": omega 3 fats and omega 6 fats.
Optimal range: 30.5 - 39.7 %
When assessing fatty acids in RBCs, Genova measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total omega-6 percentage is a combined total weight percentage calculated by adding together each of the measured omega-6s.
Because some omega-6 fatty acids are less beneficial than others, each fatty acid abnormality should be addressed.
However, in general, assessing the total omega-6 percentage as it relates to the omega-3 percentage is helpful. A more balanced ratio may decrease risk of many chronic diseases. It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage, which may ultimately lower the omega-6 percentage.
Optimal range: 13.3 - 16.6 %
When assessing fatty acids in RBCs, Genova measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total omega-9 percentage is a combined total weight percentage calculated by adding up each of the measured omega-9s. In general, because the omega-9 fatty acids are beneficial, higher levels are preferred; though identifying root cause of elevations or deficiencies is important. It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage. By default, this may then lower the omega-6 percentage.
Optimal range: 39.8 - 43.6 %
When assessing fatty acids in RBCs, Genova measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total saturated fatty acid percentage is a combined total weight percentage calculated by adding up each of the measured saturated fatty acids. It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage, which then lowers the omega-6 percentage. Because some saturated fatty acids are beneficial, it is important to look at the levels of those specifically as well.
Optimal range: 0 - 15 mcg/g Creat.
8-hydroxy- 2’-deoxyguanosine (8-OHdG) is a byproduct of oxidative damage to guanine bases in DNA.
It is used as a biomarker for oxidative stress and carcinogenesis. It has been studied to estimate DNA damage after exposure to carcinogens including tobacco smoke, asbestos fibers, heavy metals, and polycyclic aromatic hydrocarbons.
Optimal range: 0.09 - 1 wt %
Alpha-linolenic acid (ALA) is plant-based essential omega-3 polyunsaturated fatty acids that must be obtained through the diet.
Optimal range: 12 - 125 Ratio
EPA (n3) and AA (n6) both compete for use of the delta-5- desaturase enzyme to be synthesized. Increased dietary intake of animal fats alters fatty acid metabolism in favor of inflammation. There are many chronic diseases associated with elevations of this ratio including cardiovascular disease, mood disorders, and cancer. Increasing dietary intake of fish oils, or omega-3 fatty acid containing foods such as flax, chia, oily fish, or walnuts, can shift delta-5-desaturase activity toward the metabolism of the more beneficial n-3 metabolites.
Decreasing intake of animal fats is also recommended.
Optimal range: 12 - 125 Ratio
This test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. Balancing these eicosanoids in the body is an excellent way
for managing heart disease and other chronic and inflammatory processes.
Optimal range: 0.22 - 0.35 wt %
Arachidic acid (also called eicosanoic acid) is a long-chain saturated fatty acid. It is the elongation product of stearic acid and can be utilized as an energy source to build membranes.
Optimal range: 15 - 21 wt %
Arachidonic acid is an inflammatory omega-6 fatty acid. Our bodies produce this nutrient, and its excess may lead to inflammatory diseases and mood disorders.
Optimal range: 0 - 13.7 mcg/L
Sources:
Found in water, air, soil, cigarettes, and cosmetics. Food grown in contaminated water sources, such as rice and vegetables, or fish, are a common source. Major sources of occupational exposureis the manufacture of pesticides, herbicides, and agricultural products.
90% of all arsenic produced is used as a preservative for wood to prevent rotting and decay. Copper chromated arsenate (CCA), also known as pressure-treated wood, wasphased out for residential use in 2003, but wood treated prior could still be in existing structures. CCA-treated wood is still used in industrial applications.
Organic arsenic found in seafood is relatively nontoxic, while the inorganic forms are toxic.
Optimal range: 0.92 - 1.68 wt %
Behenic acid is a saturated fatty acids, in particular it is part of the group of very long chain fatty acids (VLCFAs).
Optimal range: 0 - 1.22 mcg/L
SOURCES:
Found in food such as shellfish, leafy vegetables, rice, cereals, cocoa butter, dried seaweed, and legumes. Also present in nickel cadmium batteries, cigarette smoke (including second-hand smoke), insecticides, fertilizer, motor oil, emissions and exhaust. Drinking water, air, and occupational exposures are also seen.
NUTRIENT INTERACTIONS:
Iron deficiency is associated with higher cadmium burden and absorption of cadmium may increase during very early stages of iron deficiency. Zinc deficiency is associated with an increase in Cadmium, as a result of the antagonistic relationship between the elements.
Dietary cadmium inhibits GI absorption of calcium and interferes with calcium and vitamin D metabolism. Low dietary calcium stimulates synthesis of calcium- binding protein which enhances Cadmium absorption.
Optimal range: 0.43 - 1.49 mcg/mL
Coenzyme Q10 (ubiquinone, Q10 or UQ) is structurally related to vitamin E and is part of the mitochondrial respiratory chain in many organisms. It is essential for cellular energy production and also acts as an antioxidant in the body. Coenzyme Q10 is ingested with food, but it can also be produced inside the human body. Due to their high levels of energy turnover, heart, lungs and liver exhibit particularly high concentrations of Q10.
Optimal range: 75.3 - 192 mcg/dL
Copper is part of enzymes, which are proteins that help biochemical reactions occur in every cell. Copper is involved in the absorption, storage and metabolism of iron. The symptoms of a copper deficiency are similar to iron deficiency anemia. The liver makes a special protein, ceruloplasm, to transport copper and help convert iron to a form that can be used by other tissues.
Optimal range: 1.19 - 10 wt %
Dihomogamma Linolenic Acid (DGLA) is the elongation product of Gamma-linolenic acid (GLA).
Dihomo-gamma-linolenic acid (DGLA) is a fatty acid and part of the Omega-6 fatty acids family. Those fatty acids can predominatentely be found in vegetable oils, grains, most meats and dairy.
DGLA is a strong anti-inflammatory.
Optimal range: 2.1 - 10 wt %
Docosahexaenoic acid (DHA) is one of the omega-3 fatty acids.
Optimal range: 1.14 - 3 wt %
Docosapentaenoic acid, or DPA, is a lesser known member of the omega-3 family.
Optimal range: 1.5 - 4.2 wt %
Docosatetraenoic acid is also known as Adrenic acid / Adrenate.
Docosatetraenoic acid is a member of the class of compounds known as very long-chain fatty acids.
Fatty acids belong to one of three types or families: saturated, monounsaturated and polyunsaturated. These names describe the structure of the fatty acid in terms of whether it is fully loaded with hydrogen.
Optimal range: 0 - 0.26 wt %
Eicosadienoic acid is the elongation product of Gamma linolenic acid (GLA) and the direct precursor of Dihomogamma Linolenic (DGLA).
Optimal range: 0.16 - 5 wt %
Eicosapentaenoic Acid (EPA) is a Polyunsaturated Omega-3 Fatty Acid and is involved in the regulation of inflammatory processes and prevention of blood clots.
Optimal range: 0 - 0.59 wt %
Elaidic acid is the most commonly found trans fatty acid found in cell membranes.
Optimal range: 0 - 0.6 Ratio
The fatty acid profile shows the balance of fats and their metabolites in plasma. Your overall balance of omega-3 and omega-6 fats is represented by the ratios of AA/EPA(arachidonic acid/eicosapentaenoic acid) and EPA/DGLA.
Optimal range: 0.03 - 0.13 wt %
Gamma-linolenic acid (GLA) is an omega-6 fatty acid. The body converts linoleic acid to gamma-linolenic acid and then to arachidonic acid (AA).
You can get gamma-linolenic acid from several plant-based oils, including evening primrose oil (EPO), borage oil, and black currant seed oil. Most of these oils also contain some linoleic acid.
Gamma-linolenic acid contains 18 carbons and 3 double bonds. It is synthesized from linoleic acid by adding a double bond using the delta-6-desaturase enzyme. This enzymatic reaction is very slow and further impaired in vitamin and mineral deficiencies such as zinc and cobalt. Stress, smoking, alcohol, and systemic inflammatory conditions can also slow this conversion.
Optimal range: 669 - 5000 micromol/L
Glutathione (GSH) is composed of cysteine, glutamine & glycine. GSH is a source of sulfate and plays a key role in antioxidant activity and detoxification of toxins.
Optimal range: 0.22 - 0.37 wt %
Heptadecanoic Acid is an odd chain fatty acid.
Fatty acids with odd numbers of carbon atoms are produced primarily by initiating the synthetic series with the three carbon compound, propionic acid.
Optimal range: 6 - 12.3 Ratio
LA/DGLA is a fatty acid ratio.
LA/DGLA stands for linolenic acid (=LA) and dihomogammalinolenic acid (=DGLA).
The LA/DGLA ratio is a biomarker that can indicate functional zinc deficiency.
Optimal range: 0 - 2.81 mcg/dL
Lead toxicity causes paralysis and pain in the extremities due to effects on demyelinization, axonal degeneration, and presynaptic block.
Lead toxicity commonly affects sensory, visual, auditory, and cerebellar (coordination) functions, reflecting its impact on the nervous system. Normocytic, sideroblastic anemia is the consequence of lead’s inhibiting effects on enzymes in the heme biosynthesis pathway.
Optimal range: 2.1 - 3.8 wt %
Lignoceric Acid is a saturated fatty acids, in particular it is part of the group of very long chain fatty acids (VLCFAs).
Optimal range: 10.5 - 16.9 wt %
Linoleic acid is by far the most abundant polyunsaturated fatty acid in most human tissues. Linoleic acid is an essential fatty acid, and low levels indicate dietary insufficiency.
Optimal range: 6 - 12.3 Ratio
LA/DGLA is a fatty acid ratio.
LA/DGLA stands for linolenic acid (=LA) and dihomogammalinolenic acid (=DGLA).
The LA/DGLA ratio is a biomarker that can indicate functional zinc deficiency.
Optimal range: 0 - 10 micromol/g Creat.
Lipid peroxides are oxidative degradation products of lipids, generated by a free radical chain reaction. Because of their abundance of reactive hydrogens, polyunsaturated fatty acids are highly susceptible to lipid peroxidation, which compromises the integrity and function of the cell membrane in which they reside.
Optimal range: 30.1 - 56.5 mcg/g
Magnesium (RBC) - Nutreval Panel (Genova Diagnostics)
The "Magnesium (RBC)" marker on the Nutreval panel measures the concentration of magnesium within red blood cells (RBCs), providing insight into your body’s magnesium status. Magnesium is involved in hundreds of metabolic reactions, with key roles in energy production, bone density, ATP formation, muscle and nerve conduction, and cell signaling. Unlike serum magnesium levels, RBC magnesium is considered a more reliable indicator of long-term magnesium status and tissue stores.
Elevated RBC magnesium levels may suggest excessive magnesium intake, impaired kidney function, or certain metabolic or endocrine conditions. High levels can also result from supplementation or dietary intake of magnesium-rich foods. Symptoms of elevated RBC magnesium may include nausea, vomiting, low blood pressure, and muscle weakness, though clinical significance varies depending on individual health factors.
Food sources of magnesium include dark leafy greens, oatmeal, buckwheat, unpolished grains, chocolate, milk, nuts and seeds, lima beans, and molasses.
Interpreting this marker in the context of your overall health, including kidney function, medication use, and diet, is essential for understanding its implications and determining appropriate next steps.
Optimal range: 3 - 16.5 mcg/L
Manganese is a mineral that plays a key role in forming connective tissue, sex hormones, making blood clotting factors, bone health, wound healing and central nervous system function. Manganese is also essential for the absorption of calcium, as well as glucose regulation, carbohydrate, fat, cholesterol and amino acid metabolism.
Chronic exposure to manganese (as in industrial settings) may cause effects on the central nervous system.
Toxic exposure may occur from dry cells, fungicide (maneb), and in the steel or chemical industries. Manganese is present in the coloring agents for glass and soap, in paints, varnish and enamel, and in linoleum.
It is used in the manufacturing of chlorine gas and in lead-free gasoline. Industrial manganese poisoning has been recognized since 1837.
Optimal range: 0.22 - 0.37 wt %
Margaric acid is also known as heptadecanoic acid. It is a 17-carbon saturated fatty acid (17:0). Food sources mainly include milk and dairy products, though it can be endogenously made as well.
Most research in fatty acid metabolism has focused on even-chain fatty acids since they represent >99% of total human lipid concentration. For years, it had been concluded that odd chain saturated fatty acids (OCSFAs) were of little significance and used only as internal standards in laboratory methodology. However, there is now a realization that they are, in fact, relevant and important physiologically.
Optimal range: 0 - 4.35 mcg/L
Mercury is an element that is found all over the earth, in soil, rocks, and water. The issue with mercury is that if humans are exposed to it, depending on the amount, route, and duration of exposure, mercury can be toxic to humans.
Optimal range: 2.1 - 3.5 wt %
Nervonic acid is a monounsaturated fatty acid. Nervonic acid has the longest carbon chain of all monounsaturated fatty acids. It is found in highest concentrations in nerve membranes, particularly in myelin sheaths, which are sleeves of fatty tissue that protect your nerve cells.
Optimal range: 10 - 13 wt %
Oleic acid is the most common monounsaturated fatty acid in human cells.
Optimal range: 4 - 16 index
The omega-3 index is defined as the RBC percentage sum of EPA+DHA, both of which are important antiinflammatory omega-3 fatty acids. This index was first proposed in 2004 as a cardiovascular risk factor by Dr. Willian S. Harris and Dr. Clemons von Schacky as a way of assessing risk for coronary artery disease and related death. Since then, it has been repeatedly verified as an important cardiovascular biomarker, and studied in other diseases including obesity, mood disorder, and insulin resistance.
A reasonable target for the omega-3 index is >8% to decrease disease risk. Drs. Harris and von Schacky stratified risk zones as high risk (8%). These percentages have been continually verified in outcome studies and risk assessment.
Dietary intervention to increase the omega-3 index should include oily fish, flax, walnut, and chia. Fish oil supplementation can also be considered.
Optimal range: 3.4 - 10.7 Ratio
Optimal range: 4 - 20 index
The omega-3 index is defined as the RBC percentage sum of EPA+DHA, both of which are important antiinflammatory omega-3 fatty acids. This index was first proposed in 2004 as a cardiovascular risk factor by Dr. Willian S. Harris and Dr. Clemons von Schacky as a way of assessing risk for coronary artery disease and related death. Since then, it has been repeatedly verified as an important cardiovascular biomarker, and studied in other diseases including obesity, mood disorder, and insulin resistance.
A reasonable target for the omega-3 index is >8% to decrease disease risk. Drs. Harris and von Schacky stratified risk zones as high risk (8%). These percentages have been continually verified in outcome studies and risk assessment.
Dietary intervention to increase the omega-3 index should include oily fish, flax, walnut, and chia. Fish oil supplementation can also be considered.
Optimal range: 3.4 - 10.7 Ratio
Omega-6:Omega-3 ratio is calculated by dividing the sum of all the omega-6 fatty acids by the sum of all the omega-3 fatty acids.
Omega 6 and 3 are two essential fats that are categorized as polyunsaturated fatty acids, or PUFAs for short. These fats are essential since we lack the ability to make them in our bodies and must obtain them from food or supplements. Once ingested, our body uses these fats to create other types of fats with important biological and health-promoting roles.
Omega 6 and 3 have many biological roles, including cell structure as well as eye and brain development, but are probably best known for their role in inflammation. In general, omega 6 fats are considered pro-inflammatory, while omega 3 fats are considered anti-inflammatory. However, both omega 6 and omega 3 fats can promote and inhibit the body’s inflammatory response, although omega 6 appears to produce a greater inflammatory response compared to omega 3. On the other hand, DHA and EPA can turn off the body’s inflammatory response and even influence certain genes to halt the production of inflammatory molecules.
Optimal range: 18 - 23 wt %
Palmitic acid is a saturated fatty acid.
Palmitic and stearic acids are significant markers for high consumption of saturated fats.
Optimal range: 0 - 0.64 wt %
Palmitoleic acid is a monounsaturated fatty acid. Palmitoleic acid is the desaturation product of palmitic acid. Since palmitic acid is predominant in human tissues where desaturase enzyme activity is present, one might expect relatively high levels of palmitoleic acid.
Optimal range: 0.07 - 0.15 wt %
Pentadecanoic acid is an odd numbered fatty acid with a 15-carbon backbone (15:0) and widely considered as one biomarker to assess dairy consumption/intake. It is not normally synthesized by humans, but is found in trace amounts in dairy products (milk fat) and ruminant meat fat.
Optimal range: 2220 - 3626 mcg/g
Optimal range: 109 - 330 mcg/L
Selenium is an essential element. It is a cofactor required to maintain activity of glutathione peroxidase (GSH-Px), an enzyme that catalyzes the degradation of organic hydroperoxides. The absence of selenium correlates with loss of GSH-Px activity and is associated with damage to cell membranes due to accumulation of free radicals.
Optimal range: 14 - 17 µmol/L
Stearic acid is a saturated fatty acid that is two carbon atoms longer than palmitic acid.
Optimal range: 1.1 - 1.64 Ratio
The stearic acid/oleic acid ratio from red blood cells is a marker for the presence of malignant tissue, particularly with prostate cancer. In tumors, the net result of changes in fatty acid metabolism is low stearic acid and high oleic acid, causing a profound shift in the ratio of stearic to oleic acids. One likely outcome of this shift is increased fluidity of the tumor cell membrane, resulting in more rapid movement of nutrients and waste products and allowing for faster metabolic rate. The stearic/oleic ratio is used to monitor the effectiveness of cancer therapy.
Values below 1.1 are associated with malignancy.
Optimal range: 0 - 0.39 mcg/L
Sources of exposure:
Toothpastes, perfumes, soaps, food additives and dyes, plastics, food packages, plastic pipes, pesticides, paints, and pest repellents; air, water, and soil near places where naturally present in rocks.
Health Effects:
Stomach ache, anemia, liver and kidney problems, reproduction, skin and eye irritation, affects brain and nervous system
Optimal range: 0.12 - 0.18 wt %
Tricosanoic Acid is an odd chain fatty acid.
Fatty acids with odd numbers of carbon atoms are produced primarily by initiating the synthetic series with the three carbon compound, propionic acid.
Optimal range: 0 - 1.13 wt %
Vaccenic acid is a naturally occurring trans-fatty acid. Vaccenic acid is called this way as it is found in cow’s milk. The latin word vacca means cow.
Optimal range: 64.3 - 159.4 mcg/dL
Zinc is a primary nutrient that we need to thrive. It’s used in a variety of functions through the body including wound healing and creation of DNA. In North America, zinc deficiencies are rare and an unusually high level of zinc in the blood usually indicates iron deficiency or lead poisoning.
Complete Hormones (24hr)
The Complete Hormones is the most comprehensive urinary hormone test, designed to assist in the clinical management of hormone-related conditions. This hormone test assesses parent hormones, their metabolites, and key metabolic pathways.
Optimal range: 1.3 - 4.1 micromol/24 hr
11-Hydroxy-androsterone is a that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 71 - 496 nmol/dL (SG)
11-Hydroxy-androsterone is a 5β-reduced compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 0.5 - 2.6 micromol/24 hr
11-Hydroxy-etiocholanolone is a compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 64 - 363 nmol/dL (SG)
11-Hydroxy-etiocholanolone is a compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 0.3 - 1.9 micromol/24 hr
11-Keto-androsterone is a that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 37 - 236 nmol/dL (SG)
11-Keto-androsterone is a that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 0.3 - 1.6 micromol/24 hr
11-Keto-etiocholanolone is a compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 57 - 315 nmol/dL (SG)
11-Keto-etiocholanolone is a 5β-reduced compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 0 - 0 Ratio
Optimal range: 0.5 - 8.9 mcg/g Creat.
16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. It is a potent estrogen similarly to estrone, and it has been suggested that the ratio of 16α-hydroxyestrone to 2-OH-E1, the latter being much less estrogenic in comparison and even antiestrogenic in the presence of more potent estrogens like estradiol, may be involved in the pathophysiology of breast cancer. Conversely, 16α-hydroxyestrone may help to protect against osteoporosis.
Optimal range: 0 - 0 mcg/g Creat.
Optimal range: 859 - 9018 nmol/dL (SG)
An elevated 17-hydroxysteroids total and/or cortisol total may be caused by stress, strenuous exercise, inflammation, hypoglycemia, insulin resistance, hypothyroidism, or licorice ingestion.
Optimal range: 859 - 9018 micromol/24 hr
An elevated 17-hydroxysteroids total and/or cortisol total may be caused by stress, strenuous exercise, inflammation, hypoglycemia, insulin resistance, hypothyroidism, or licorice ingestion.
Optimal range: 576 - 3142 nmol/dL (SG)
ANDROGENS such as DHEA, testosterone, and androstenedione tend to be extensively metabolized into downstream androgen compounds. As a result, the levels of testosterone along with “Total 17-ketosteroids” (DHEA plus metabolites) should be used to assess androgen status and/or efficacy of androgen replacement.
Optimal range: 6 - 22.2 micromol/24 hr
Optimal range: 0 - 0 mcg/g Creat.
Optimal range: 1.3 - 36.3 mcg/g Creat.
Optimal range: 0 - 0 Ratio
Optimal range: 0 - 0 mcg/g Creat.
Optimal range: 0.2 - 8.6 mcg/g Creat.
Optimal range: 0 - 0 Ratio
Optimal range: 0.3 - 13.7 Ratio
2-hydroxyestrone and 16-hydroxyestrone are Phase I metabolites of Estrone (E1). Their ratio is of clinical significance in pre and peri-menopausal women. In post-menopausal women it does not have the same clinical significance. It is, however, hypothesized that the 2/16 ratio is important in menopausal women who are on hormone replacement therapy (HRT).
Optimal range: 1.6 - 10.7 Ratio
There is evidence that methoxylated estrogens, especially the 2-pathway methoxylated estrogens (E1 and E2), are associated with decreased breast cancer risk; 2-MeOE2, produced from 2-OHE2, has been described to have anti-proliferative, antingiogenic, and pro-apoptotic activity in multiple types of cancer.
Optimal range: 0 - 0 mcg/g Creat.
Optimal range: 0 - 5.9 mcg/g Creat.
Research focus is shifting toward 4-hydroxyesterone which is thought to have greater estrogenic and genotoxic potential than either 2-hydroxyestrone or 16a-hydroxyestrone.
Optimal range: 0 - 0 mcg/g Creat.
Optimal range: 0 - 1 mcg/g Creat.
Most recent studies find an increased breast cancer risk associated with the ratio of 4-pathway cetechols to 4-pathway methylated catechols.
Optimal range: 0.34 - 1.76 Ratio
The Etiocholanolone/Androsterone (E/A) Ratio assesses androgen metabolism by comparing the enzymatic activity of 5β-reductase/5α-reductase.
Optimal range: 0 - 0 micromol/24 hr
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 57 - 370 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 0.1 - 1.4 Ratio
This anabolic/catabolic balance – or the balance of ‘growth and healing’ versus ‘wear and tear’ in the body – can be assessed by comparing total 17-hydroxycorticosteroids with total 17-ketosteroids in the urine.
Optimal range: 0.1 - 1.4 Ratio
The Anabolic/Catabolic Balance refers to the balance between "growth and healing" (anabolic) and "wear and tear" (catabolic) activity in the body. Both anabolic and catabolic metabolism are essential to health.
Optimal range: 0 - 0.25 micromol/24 hr
The measurement of androstanediol, in addition to testosterone, is of interest for the evaluation of androgenic activity.
Optimal range: 0 - 23 nmol/dL (SG)
The measurement of androstanediol, in addition to testosterone, is of interest for the evaluation of androgenic activity.
Optimal range: 0.6 - 5.5 micromol/24 hr
Androsterone and Etiocholanolone are DHEA metabolites via Androstenedione and the 5α- and 5β-reductase pathways.
Optimal range: 117 - 939 nmol/dL (SG)
Androsterone and Etiocholanolone are DHEA metabolites via Androstenedione and the 5α- and 5β-reductase pathways.
Optimal range: 0 - 0 mcg/dL
Optimal range: 0.2 - 0.9 micromol/24 hr
DHEA is a hormone produced by both the adrenal gland and the brain. DHEA leads to the production of androgens and estrogens. DHEA levels in the body begin to decrease after age 30. Levels decrease more quickly in women.
Optimal range: 11 - 76.3 nmol/dL (SG)
DHEA is a hormone produced by both the adrenal gland and the brain. DHEA leads to the production of androgens and estrogens. DHEA levels in the body begin to decrease after age 30. Levels decrease more quickly in women.
Optimal range: 0.8 - 2.6 Ratio
The Etiocholanolone/Androsterone (E/A) Ratio assesses androgen metabolism by comparing the enzymatic activity of 5b-reductase/5a-reductase. Etiocholanolone is produced via the 5b-reductase pathway and androsterone is produced via the 5a-reductase pathway.
Optimal range: 0.34 - 1.76 Ratio
The Etiocholanolone/Androsterone (E/A) Ratio assesses androgen metabolism by comparing the enzymatic activity of 5β-reductase/5α-reductase.
Optimal range: 0.6 - 11.2 mcg/g Creat.
The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.
Optimal range: 0.6 - 11.2 mcg/g Creat.
The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.
Optimal range: 0.6 - 19.9 mcg/g Creat.
Estriol (E3) is considered to be the mildest and briefest-acting of the three estrogens.
Estrogens play a critical role in female sexual development, menstrual function, protein synthesis, cardiovascular function, bone formation and remodeling, cognitive function, emotional balance and other important health factors.
Optimal range: 0.6 - 19.9 mcg/g Creat.
Optimal range: 2 - 26.2 mcg/g Creat.
Estrone is the predominant estrogen in post-menopausal women and inter-converts with estradiol. This conversion is dependant on the bidirectional activity of 17-beta-hydroxysteroid dehydrogenase, which also converts testosterone to androstenedione (an intermediate of androsterone, etiocholanolone, and estrone).
Optimal range: 2 - 26.2 mcg/g Creat.
Estrone is the predominant estrogen in post-menopausal women and inter-converts with estradiol. This conversion is dependant on the bidirectional activity of 17-beta-hydroxysteroid dehydrogenase, which also converts testosterone to androstenedione (an intermediate of androsterone, etiocholanolone, and estrone).
Optimal range: 1.2 - 6.1 micromol/24 hr
Etiocholanolone is an androstenedione and testosterone metabolite that is excreted in the urine. It is produced from androstenedione and the 5-alpha and 5-beta-reductase metabolic pathways. It is helpful in evaluating adrenal and androgen function.
Optimal range: 121 - 1209 nmol/dL (SG)
Etiocholanolone is an androstenedione and testosterone metabolite that is excreted in the urine. It is produced from androstenedione and the 5-alpha and 5-beta-reductase metabolic pathways. It is helpful in evaluating adrenal and androgen function.
Optimal range: 0.3 - 4.2 micromol/24 hr
Progesterone rapidly metabolizes by the time it reaches the urine, and its direct metabolite, pregnanediol, is a reflection of circulating progesterone concentrations.
Optimal range: 13 - 370 nmol/dL (SG)
Progesterone rapidly metabolizes by the time it reaches the urine, and its direct metabolite, pregnanediol, is a reflection of circulating progesterone concentrations.
Optimal range: 0.6 - 2.5 micromol/24 hr
Progesterone is metabolized into numerous downstream compounds, but most immediately into pregnanediol and pregnanetriol. Urine levels of these metabolites tend to correlate with levels of serum progesterone, thus may be used to assess status of the hormone.
Optimal range: 46 - 269 nmol/dL (SG)
Progesterone is metabolized into numerous downstream compounds, but most immediately into pregnanediol and pregnanetriol. Urine levels of these metabolites tend to correlate with levels of serum progesterone, thus may be used to assess status of the hormone.
Optimal range: 0.16 - 0.65 micromol/24 hr
Optimal range: 10 - 48 nmol/dL (SG)
Testosterone is the major androgen in the body. It is converted to dihydrotestosterone by 5-alphareductase, and to estradiol by aromatase.
Optimal range: 0 - 0 micromol/24 hr
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 142 - 595 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 0 - 0 micromol/24 hr
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 522 - 6529 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 0 - 9.4 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 0 - 0 micromol/24 hr
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 0 - 0 mcg/g Creat.
Organic Acids Test (OAT) - Nutritional and Metabolic Profile
Written By: B. Dame
Updated On: January 27, 2025
Discover how the Organic Acids Test (OAT) from MosaicDX provides insights into metabolic health, gut dysbiosis, nutrient deficiencies, and chronic health conditions with 76 biomarkers in a single, easy-to-collect urine test.
The MosaicDX Organic Acids Test (formerly Great Plains Laboratory) is a powerful, non-invasive tool that evaluates 76 organic acids in a single, easy-to-collect urine sample. This test offers unparalleled insight into metabolic health, revealing imbalances in metabolic pathways and identifying nutrient deficiencies that may contribute to chronic health conditions.
The OAT test provides crucial data for individuals with neurological disorders, chronic illnesses, or symptoms like fatigue, anxiety, or digestive issues. By analyzing a wide range of metabolic markers, the OAT helps uncover underlying causes of complex symptoms and guides personalized treatment strategies.
The OAT measures over 76 biomarkers through advanced techniques like gas and liquid chromatography coupled with mass spectrometry. These biomarkers fall into several clinically meaningful categories:
Intestinal Microbial Overgrowth Markers
Oxalate Metabolites
Glycolytic Cycle and Mitochondrial Markers
Neurotransmitter Metabolites
Pyrimidine, Ketone, and Fatty Acid Oxidation Markers
Nutritional Markers
Detoxification Markers
Amino Acid Metabolites
Mineral Metabolism Markers
The OAT is particularly beneficial for individuals experiencing:
With its ability to detect nutrient deficiencies, mitochondrial dysfunction, and detoxification impairments, the OAT empowers healthcare providers to craft personalized, data-driven treatment plans.
Organic acids are natural byproducts of protein, carbohydrate, and fat digestion, which play a critical role in energy production and cellular function. However, an abnormal accumulation of organic acids in the urine may signal:
Because vitamins and minerals are essential for enzyme function, increased organic acids can indicate a functional nutrient need at the cellular level—even if bloodwork appears normal.
The OAT can help address a variety of conditions, including:
The Organic Acids Test (OAT) is a comprehensive urine test that evaluates 76 metabolic markers to assess your body’s metabolic health, nutrient status, and gut microbiome. It provides insights into energy production, detoxification, neurotransmitter balance, and more.
The OAT is ideal for individuals experiencing:
The OAT measures a wide range of markers, including:
The test requires a first-morning urine sample collected after fasting overnight. Certain foods and supplements, such as apples, grapes, cranberries, ribose, and echinacea, should be avoided 48 hours before collection.
The test identifies specific organic acids produced by yeast, bacteria, or molds in the gut. Elevated levels of these markers can signal microbial overgrowth or dysbiosis, which may cause digestive issues, fatigue, or immune dysfunction.
Yes. The OAT reveals nutrient deficiencies by identifying elevated levels of specific organic acids that indicate a functional need for vitamins or minerals, such as B vitamins, magnesium, or antioxidants.
Yes, the OAT is safe for children and can be particularly helpful in identifying metabolic imbalances or gut microbial issues in children with developmental or behavioral conditions, such as autism spectrum disorder (ASD).
Results are typically available within 1-2 weeks after the lab receives the urine sample. A detailed report categorizes findings into actionable sections for healthcare providers.
The OAT provides functional insights that traditional blood tests may not detect. It evaluates how well your body’s metabolic pathways are working, uncovering nutrient needs, detoxification issues, and mitochondrial dysfunction even when serum levels appear normal.
The Organic Acids Test can provide insights for managing:
Yes, the results can guide your healthcare provider in creating a personalized treatment plan, including recommendations for dietary changes, targeted nutrient supplementation, and strategies to address underlying imbalances.
While the OAT is highly comprehensive, its findings are best interpreted alongside clinical symptoms and under the guidance of a qualified healthcare provider. The test does not diagnose specific diseases but identifies metabolic imbalances that may contribute to symptoms.
Optimal range: 0.03 - 1.8 mmol/mol creatinine
What is 2-Hydroxybutyric acid?
2-Hydroxybutyric acid (aka α-Hydroxybutyrate) is a by-product of glutathione production. Levels of 2-Hydroxybutyric acid in the urine may reflect levels of glutathione production.
What is Glutathione?
Glutathione is an important antioxidant that can prevent damage to cellular components caused by reactive oxygen species such as free radicals, peroxides, lipid peroxides, and heavy metals.
Glutathione is constantly being used up in the removal of toxic molecules and prevention of oxidative damage.
2-Hydroxybutyric acid is a by-product from the process in which the body forms more glutathione. When that process is running at high rates, α-hydroxybutyrate excretion is increased.
Optimal range: 0 - 1.2 mmol/mol creatinine
What is 2-Hydroxybutyric acid?
2-Hydroxybutyric acid (aka α-Hydroxybutyrate) is a by-product of glutathione production. Levels of 2-Hydroxybutyric acid in the urine may reflect levels of glutathione production.
What is Glutathione?
Glutathione is an important antioxidant that can prevent damage to cellular components caused by reactive oxygen species such as free radicals, peroxides, lipid peroxides, and heavy metals.
Glutathione is constantly being used up in the removal of toxic molecules and prevention of oxidative damage.
2-Hydroxybutyric acid is a by-product from the process in which the body forms more glutathione. When that process is running at high rates, α-hydroxybutyrate excretion is increased.
Optimal range: 0.19 - 2 mmol/mol creatinine
What is 2-Hydroxybutyric acid?
2-Hydroxybutyric acid (aka α-Hydroxybutyrate) is a by-product of glutathione production. Levels of 2-Hydroxybutyric acid in the urine may reflect levels of glutathione production.
What is Glutathione?
Glutathione is an important antioxidant that can prevent damage to cellular components caused by reactive oxygen species such as free radicals, peroxides, lipid peroxides, and heavy metals.
Glutathione is constantly being used up in the removal of toxic molecules and prevention of oxidative damage.
2-Hydroxybutyric acid is a by-product from the process in which the body forms more glutathione. When that process is running at high rates, α-hydroxybutyrate excretion is increased.
Optimal range: 0 - 1.3 mmol/mol creatinine
2-Hydroxyhippuric acid is a conjugate of hydroxybenzoic acid (salicylic acid) and glycine.
Optimal range: 0 - 1.2 mmol/mol creatinine
2-Hydroxyhippuric acid is a conjugate of hydroxybenzoic acid (salicylic acid) and glycine.
Optimal range: 0 - 0.86 mmol/mol creatinine
2-Hydroxyhippuric acid is a conjugate of hydroxybenzoic acid (salicylic acid) and glycine.
Optimal range: 0 - 1.2 mmol/mol creatinine
2-Hydroxyhippuric acid is a conjugate of hydroxybenzoic acid (salicylic acid) and glycine.
Optimal range: 0 - 2 mmol/mol creatinine
2-Hydroxyisocaproic acid (aka Leucic acid / α-hydroxyisocaproic acid / HICA) is a metabolite of the branched-chain amino acid leucine.
Optimal range: 0 - 2 mmol/mol creatinine
2-Hydroxyisocaproic acid (aka Leucic acid / α-hydroxyisocaproic acid / HICA) is a metabolite of the branched-chain amino acid leucine.
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
2-Hydroxyisovaleric acid (aka 2-Hydroxy-3-methylbutyric acid) is a branched-chain amino acid metabolite.
Optimal range: 0 - 2 mmol/mol creatinine
2-Hydroxyisovaleric acid (aka 2-Hydroxy-3-methylbutyric acid) is a branched-chain amino acid metabolite.
Optimal range: 0 - 2 mmol/mol creatinine
2-Hydroxyisovaleric acid (aka 2-Hydroxy-3-methylbutyric acid) is a branched-chain amino acid metabolite.
Optimal range: 0.06 - 0.66 mmol/mol creatinine
The metabolite of phenylalanine via phenyl pyruvate.
Optimal range: 0.03 - 0.47 mmol/mol creatinine
The metabolite of phenylalanine via phenyl pyruvate.
Optimal range: 0 - 0.86 mmol/mol creatinine
The metabolite of phenylalanine via phenyl pyruvate.
Optimal range: 0 - 2 mmol/mol creatinine
2-Oxo-4-methylthiobutanoic acid, also known as 4-(methylsulfanyl)-2-oxobutanoate or 2-keto-4-methylthiobutyrate, belongs to the class of organic compounds known as thia fatty acids. Thia substituted fatty acids are saturated fatty acids which are modified by insertion of a sulfur atom at specific positions in the carbon backbone.
Optimal range: 0 - 2 mmol/mol creatinine
2-Oxo-4-methylthiobutanoic acid, also known as 4-(methylsulfanyl)-2-oxobutanoate or 2-keto-4-methylthiobutyrate, belongs to the class of organic compounds known as thia fatty acids. Thia substituted fatty acids are saturated fatty acids which are modified by insertion of a sulfur atom at specific positions in the carbon backbone.
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0 - 35 mmol/mol creatinine
2-Oxoglutaric acid is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 18 mmol/mol creatinine
2-Oxoglutaric acid is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 96 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
2-Oxoisocaproic acid (also known as Ketoleucine) is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
2-Oxoisocaproic acid is both a neurotoxin and a metabotoxin.
Optimal range: 0 - 2 mmol/mol creatinine
2-Oxoisocaproic acid (also known as Ketoleucine) is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
2-Oxoisocaproic acid is both a neurotoxin and a metabotoxin.
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0 - 2.1 mmol/mol creatinine
2-Oxoisovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids (=BCAA). 2-Oxoisovaleric acid is a neurotoxin, an acidogen, and a metabotoxin.
Optimal range: 0 - 2 mmol/mol creatinine
2-Oxoisovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids (=BCAA). 2-Oxoisovaleric acid is a neurotoxin, an acidogen, and a metabotoxin.
Optimal range: 0 - 2.5 mmol/mol creatinine
Optimal range: 0.17 - 39 mmol/mol creatinine
- A precursor in the production of cholesterol in both humans and yeast.
- Elevated levels may also indicate decreased CoQ10 synthesis.
- Moderate increases are probably due to yeast overgrowth of the GI tract and might also implicate yeast overgrowth with elevated serum cholesterol.
- Very elevated levels may be due to HMG aciduria (=3-hydroxy-3-metylglutaric aciduria)
Optimal range: 0 - 26 mmol/mol creatinine
- A precursor in the production of cholesterol in both humans and yeast.
- Elevated levels may also indicate decreased CoQ10 synthesis.
- Moderate increases are probably due to yeast overgrowth of the GI tract and might also implicate yeast overgrowth with elevated serum cholesterol.
- Very elevated levels may be due to HMG aciduria (=3-hydroxy-3-metylglutaric aciduria)
Optimal range: 0 - 88 mmol/mol creatinine
Optimal range: 0 - 3.1 mmol/mol creatinine
3-Hydroxybutyric acid is a typical partial-degradation product of branched-chain amino acids (primarily valine) released from muscle for hepatic and renal gluconeogenesis. This acid is metabolized by 3-hydroxybutyrate dehydrogenase. The enzyme functions in nervous tissues and muscles, enabling the use of circulating hydroxybutyrate as a fuel.
Optimal range: 0 - 1.9 mmol/mol creatinine
3-Hydroxybutyric acid is a typical partial-degradation product of branched-chain amino acids (primarily valine) released from muscle for hepatic and renal gluconeogenesis. This acid is metabolized by 3-hydroxybutyrate dehydrogenase. The enzyme functions in nervous tissues and muscles, enabling the use of circulating hydroxybutyrate as a fuel.
Optimal range: 0 - 4.8 mmol/mol creatinine
3-Hydroxybutyric acid is a typical partial-degradation product of branched-chain amino acids (primarily valine) released from muscle for hepatic and renal gluconeogenesis. This acid is metabolized by 3-hydroxybutyrate dehydrogenase. The enzyme functions in nervous tissues and muscles, enabling the use of circulating hydroxybutyrate as a fuel.
Optimal range: 0 - 6.2 mmol/mol creatinine
3-Hydroxyglutaric is a marker for glutaryl CoA dehydrogenase deficiency.
Optimal range: 0 - 4.6 mmol/mol creatinine
3-Hydroxyglutaric is a marker for glutaryl CoA dehydrogenase deficiency.
Optimal range: 0 - 16 mmol/mol creatinine
Optimal range: 0 - 11 mmol/mol creatinine
3-Indoleacetic is a Tryptophan byproduct of Clostria: C. stricklandii, C. litusburense, C. subterminale, and C. putrefaciens.
Optimal range: 0 - 6.8 mmol/mol creatinine
3-Indoleacetic is a Tryptophan byproduct of Clostria: C. stricklandii, C. litusburense, C. subterminale, and C. putrefaciens.
Optimal range: 0.6 - 14 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
3-Methyl-2-oxovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Moderate increase may result from lactic acidosis, episodic ketosis, or thiamine/lipoic acid deficiency. Significant elevations are associated with genetic issues, MSUD, and pyruvate dehydrogenase deficiency.
- Slight elevations may be due to deficiencies of the vitamins thiamine or lipoic acid.
- Elevated values are also associated with the genetic diseases maple syrup urine disease or pyruvate dehydrogenase deficiency.
Optimal range: 0 - 2 mmol/mol creatinine
3-Methyl-2-oxovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Moderate increase may result from lactic acidosis, episodic ketosis, or thiamine/lipoic acid deficiency. Significant elevations are associated with genetic issues, MSUD, and pyruvate dehydrogenase deficiency.
- Slight elevations may be due to deficiencies of the vitamins thiamine or lipoic acid.
- Elevated values are also associated with the genetic diseases maple syrup urine disease or pyruvate dehydrogenase deficiency.
Optimal range: 0 - 2 mmol/mol creatinine
3-Methyl-2-oxovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Moderate increase may result from lactic acidosis, episodic ketosis, or thiamine/lipoic acid deficiency. Significant elevations are associated with genetic issues, MSUD, and pyruvate dehydrogenase deficiency.
- Slight elevations may be due to deficiencies of the vitamins thiamine or lipoic acid.
- Elevated values are also associated with the genetic diseases maple syrup urine disease or pyruvate dehydrogenase deficiency.
Optimal range: 0 - 4.5 mmol/mol creatinine
The marker, 3-methylglutaconic acid in high values indicates a reduced ability to metabolize the amino acid, leucine. This abnormality is found in the genetic disease, methylglutaconic aciduria and in mitochondrial disorders.
Optimal range: 0.38 - 2 mmol/mol creatinine
The marker, 3-methylglutaconic acid in high values indicates a reduced ability to metabolize the amino acid, leucine. This abnormality is found in the genetic disease, methylglutaconic aciduria and in mitochondrial disorders.
Optimal range: 0 - 6.9 mmol/mol creatinine
Optimal range: 0 - 0.76 mmol/mol creatinine
3-methylglutaric acid is an organic acid classically associated with two distinct leucine pathway enzyme deficiencies.
Optimal range: 0.07 - 0.95 mmol/mol creatinine
3-methylglutaric acid is an organic acid classically associated with two distinct leucine pathway enzyme deficiencies.
Optimal range: 0.02 - 0.38 mmol/mol creatinine
3-methylglutaric acid is an organic acid classically associated with two distinct leucine pathway enzyme deficiencies.
Optimal range: 0.01 - 0.97 mmol/mol creatinine
3-methylglutaric acid is an organic acid classically associated with two distinct leucine pathway enzyme deficiencies.
Optimal range: 0 - 0.33 mmol/mol creatinine
3-Oxoglutaric indicates yeast overgrowth in the gastrointestinal tract.
Optimal range: 0 - 0.11 mmol/mol creatinine
3-Oxoglutaric indicates yeast overgrowth in the gastrointestinal tract.
Optimal range: 0 - 0.46 mmol/mol creatinine
3-Oxoglutaric indicates yeast overgrowth in the gastrointestinal tract.
Optimal range: 0 - 75 mmol/mol creatinine
4-Cresol has been used as a specific marker for Clostridium difficile.
Optimal range: 0 - 39 mmol/mol creatinine
4-Cresol has been used as a specific marker for Clostridium difficile.
Optimal range: 0 - 84 mmol/mol creatinine
Optimal range: 0 - 1.3 mmol/mol creatinine
4-Hydroxybenzoic Acid is a marker for intestinal dysbiosis.
Optimal range: 0 - 0.73 mmol/mol creatinine
4-Hydroxybenzoic Acid is a marker for intestinal dysbiosis.
Optimal range: 0 - 3 mmol/mol creatinine
4-Hydroxybenzoic Acid is a marker for intestinal dysbiosis.
Optimal range: 0 - 4.8 mmol/mol creatinine
A moderate urinary increase in 4-hydroxybutyric acid may be due to intake of dietary supplements containing 4-hydroxybutyric acid, also known as gamma-hydroxybutyric acid. Very high levels may indicate the genetic disorder 3-methylglutaconic aciduria involving succinic semialdehyde dehydrogenase deficiency.
Optimal range: 0 - 3.4 mmol/mol creatinine
A moderate urinary increase in 4-hydroxybutyric acid may be due to intake of dietary supplements containing 4-hydroxybutyric acid, also known as gamma-hydroxybutyric acid. Very high levels may indicate the genetic disorder 3-methylglutaconic aciduria involving succinic semialdehyde dehydrogenase deficiency.
Optimal range: 0 - 4.3 mmol/mol creatinine
A moderate urinary increase in 4-hydroxybutyric acid may be due to intake of dietary supplements containing 4-hydroxybutyric acid, also known as gamma-hydroxybutyric acid. Very high levels may indicate the genetic disorder 3-methylglutaconic aciduria involving succinic semialdehyde dehydrogenase deficiency.
Optimal range: 0 - 4.7 mmol/mol creatinine
A moderate urinary increase in 4-hydroxybutyric acid may be due to intake of dietary supplements containing 4-hydroxybutyric acid, also known as gamma-hydroxybutyric acid. Very high levels may indicate the genetic disorder 3-methylglutaconic aciduria involving succinic semialdehyde dehydrogenase deficiency.
Optimal range: 0.79 - 17 mmol/mol creatinine
4-Hydroxyhippuric is a glycine conjugate of 4-hydroxybenzoic acid, the paraben metabolite.
Optimal range: 0 - 14 mmol/mol creatinine
4-Hydroxyhippuric is a glycine conjugate of 4-hydroxybenzoic acid, the paraben metabolite.
Optimal range: 0 - 30 mmol/mol creatinine
4-Hydroxyhippuric is a glycine conjugate of 4-hydroxybenzoic acid, the paraben metabolite.
Optimal range: 0 - 19 mmol/mol creatinine
A tyrosine metabolic product of GI bacteria.
Optimal range: 0 - 30 mmol/mol creatinine
A tyrosine metabolic product of GI bacteria.
Optimal range: 0 - 18 mmol/mol creatinine
A tyrosine metabolic product of GI bacteria.
Optimal range: 2 - 32 mmol/mol creatinine
A tyrosine metabolic product of GI bacteria.
Optimal range: 0 - 2 mmol/mol creatinine
4-hydroxyphenyllactate is present in relatively higher concentrations in the cerebrospinal fluid and urine of patients with phenylketonuria (PKU) and tyrosinemia.
Optimal range: 0 - 2 mmol/mol creatinine
4-hydroxyphenyllactate is present in relatively higher concentrations in the cerebrospinal fluid and urine of patients with phenylketonuria (PKU) and tyrosinemia.
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0 - 4.3 mmol/mol creatinine
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 2.9 mmol/mol creatinine
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 11 mmol/mol creatinine
Optimal range: 0 - 14 mmol/mol creatinine
A metabolite produced by Aspergillus and possibly other fungal species in the GI tract.
Optimal range: 0 - 18 mmol/mol creatinine
A metabolite produced by Aspergillus and possibly other fungal species in the GI tract.
Optimal range: 0 - 28 mmol/mol creatinine
A metabolite produced by Aspergillus and possibly other fungal species in the GI tract. Prescription or natural antifungals, along with high-potency, multi-strain probiotics, may reduce overgrowth levels.
Optimal range: 0 - 10 mmol/mol creatinine
Acetoacetic acid (=acetoacetate) is a ketone body and a weak Beta-keto acid produced from acetyl-CoA in the mitochondrial matrix of hepatocytes.
Optimal range: 0 - 10 mmol/mol creatinine
Acetoacetic acid (=acetoacetate) is a ketone body and a weak Beta-keto acid produced from acetyl-CoA in the mitochondrial matrix of hepatocytes.
Optimal range: 0 - 10 mmol/mol creatinine
Acetoacetic acid (=acetoacetate) is a ketone body and a weak Beta-keto acid produced from acetyl-CoA in the mitochondrial matrix of hepatocytes.
Optimal range: 6.8 - 28 mmol/mol creatinine
Elevated in mitochrondrial disorders. Aconitase metabolizes citric and aconitic acids, and is dependent on glutathione.
Optimal range: 4.1 - 23 mmol/mol creatinine
Elevated in mitochrondrial disorders. Aconitase metabolizes citric and aconitic acids, and is dependent on glutathione.
Optimal range: 9.8 - 39 mmol/mol creatinine
Elevated in mitochrondrial disorders. Aconitase metabolizes citric and aconitic acids, and is dependent on glutathione.
Optimal range: 0.04 - 3.8 mmol/mol creatinine
Adipic Acid, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Optimal range: 0 - 2.9 mmol/mol creatinine
Adipic Acid, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Optimal range: 0.19 - 6.5 mmol/mol creatinine
Adipic Acid, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Optimal range: 0 - 29 mmol/mol creatinine
Breakdown product of hyaluronic acid; also found in certain foods.
Optimal range: 0 - 56 mmol/mol creatinine
Produced by action of Candida hyaluronidase on the intercellular cement, hyaluronic acid. Oxidation of the hyaluronic acid breakdown by white blood cell hypochlorite produces tartaric acid and arabinose. Antifungal treatment and high-potency, multi-strain probiotics may help rebalance GI flora.
Optimal range: 0 - 20 mmol/mol creatinine
Breakdown product of hyaluronic acid; also found in certain foods.
Optimal range: 0 - 50 mmol/mol creatinine
Produced by action of Candida hyaluronidase on the intercellular cement, hyaluronic acid. Oxidation of the hyaluronic acid breakdown by white blood cell hypochlorite produces tartaric acid and arabinose. Antifungal treatment and high-potency, multi-strain probiotics may help rebalance GI flora.
Optimal range: 10 - 200 mmol/mol creatinine
Ascorbic Acid is a natural water-soluble vitamin (Vitamin C). Ascorbic acid is a potent reducing and antioxidant agent that functions in fighting bacterial infections, in detoxifying reactions, and in the formation of collagen in fibrous tissue, teeth, bones, connective tissue, skin, and capillaries.
Optimal range: 10 - 200 mmol/mol creatinine
Ascorbic Acid is a natural water-soluble vitamin (Vitamin C). Ascorbic acid is a potent reducing and antioxidant agent that functions in fighting bacterial infections, in detoxifying reactions, and in the formation of collagen in fibrous tissue, teeth, bones, connective tissue, skin, and capillaries.
Optimal range: 10 - 200 mmol/mol creatinine
Ascorbic Acid is a natural water-soluble vitamin (Vitamin C). Ascorbic acid is a potent reducing and antioxidant agent that functions in fighting bacterial infections, in detoxifying reactions, and in the formation of collagen in fibrous tissue, teeth, bones, connective tissue, skin, and capillaries.
Optimal range: 0 - 29 mmol/mol creatinine
Carboxycitric is a metabolite of yeast/fungi and general indicator of gastrointestinal dysbiosis. Elevated yeast/fungal metabolites indicate overgrowth in the GI tract.
Optimal range: 0 - 20 mmol/mol creatinine
Carboxycitric is a metabolite of yeast/fungi and general indicator of gastrointestinal dysbiosis. Elevated yeast/fungal metabolites indicate overgrowth in the GI tract.
Optimal range: 0 - 25 mmol/mol creatinine
Optimal range: 0 - 3.6 mmol/mol creatinine
Metabolite of yeast or anaerobic bacteria, including Clostridia.
Optimal range: 0.11 - 2 mmol/mol creatinine
Metabolite of yeast or anaerobic bacteria, including Clostridia.
Optimal range: 0 - 5 mmol/mol creatinine
Optimal range: 0 - 507 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 2.2 - 260 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 597 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 0.38 mmol/mol creatinine
Produced when Clostridia acts upon unabsorbed tryptophan, tyrosine or phenylalanine.
Optimal range: 0 - 0.23 mmol/mol creatinine
Produced when Clostridia acts upon unabsorbed tryptophan, tyrosine or phenylalanine.
Optimal range: 0 - 0.59 mmol/mol creatinine
Produced when Clostridia acts upon unabsorbed tryptophan, tyrosine or phenylalanine.
Optimal range: 0 - 3.5 mmol/mol creatinine
HVA and DOPAC are the major metabolites of dopamine.
Optimal range: 0.07 - 4 mmol/mol creatinine
HVA and DOPAC are the major metabolites of dopamine.
Optimal range: 0.27 - 1.9 mmol/mol creatinine
HVA and DOPAC are the major metabolites of dopamine.
Optimal range: 0.13 - 4.9 mmol/mol creatinine
HVA and DOPAC are the major metabolites of dopamine.
Optimal range: 0.44 - 2.8 mmol/mol creatinine
Ethylmalonate, together with Adipate and Suberate, gives information about your ability to process fatty acids.
Optimal range: 0.13 - 2.7 mmol/mol creatinine
Optimal range: 0.06 - 4.8 mmol/mol creatinine
Optimal range: 0 - 0.94 mmol/mol creatinine
Fumaric acid, measured on the Organic Acids Test (OAT), is a key marker of your body’s energy production and detoxification pathways. It plays a vital role in the Citric Acid Cycle, which generates cellular energy, and the urea cycle, which eliminates excess nitrogen. Balanced levels support organ function, brain health, and overall vitality, while imbalances may indicate issues like mitochondrial dysfunction, nutrient deficiencies, or oxidative stress. Fumaric acid is also influenced by sunlight exposure, much like vitamin D. Abnormal levels can guide interventions such as optimizing nutrient intake, improving energy metabolism, and addressing underlying health concerns.
Optimal range: 0 - 0.49 mmol/mol creatinine
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.
Optimal range: 0 - 1.8 mmol/mol creatinine
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.
Optimal range: 0 - 16 mmol/mol creatinine
Furan 2,5-dicarboxylic is a byproduct of Aspergillus and other fungal species.
Optimal range: 0 - 13 mmol/mol creatinine
Furan 2,5-dicarboxylic is a byproduct of Aspergillus and other fungal species.
Optimal range: 0 - 18 mmol/mol creatinine
Optimal range: 0 - 1.9 mmol/mol creatinine
Furancarbonylglycine is a metabolite produced by Aspergillus and possibly other fungal species in the GI tract.
Optimal range: 0 - 3.6 mmol/mol creatinine
A metabolite produced by Aspergillus and possibly other fungal species in the GI tract. Prescription or natural antifungals, along with high-potency, multi-strain probiotics, may reduce overgrowth.
Optimal range: 0 - 2.3 mmol/mol creatinine
Furancarbonylglycine is a metabolite produced by Aspergillus and possibly other fungal species in the GI tract.
Optimal range: 0 - 3.1 mmol/mol creatinine
A metabolite produced by Aspergillus and possibly other fungal species in the GI tract. Prescription or natural antifungals, along with high-potency, multi-strain probiotics, may reduce overgrowth.
Optimal range: 0.04 - 0.36 mmol/mol creatinine
Glutaric acid is made from lysine & tryptophan via alphaketo-adipic acid.
- Elevated in the genetic diseases glutaric academia types I and II.
- Moderate increases may be due to deficiencies in riboflavin and coenzyme Q10, or celiac disease.
- Moderate increases are common in autism possibly due to defective vitamin absorption or microbial production in the GI tract.
Optimal range: 0 - 1.1 mmol/mol creatinine
Glutaric acid is made from lysine & tryptophan via alphaketo-adipic acid.
- Elevated in the genetic diseases glutaric academia types I and II.
- Moderate increases may be due to deficiencies in riboflavin and coenzyme Q10, or celiac disease.
- Moderate increases are common in autism possibly due to defective vitamin absorption or microbial production in the GI tract.
Optimal range: 0 - 0.43 mmol/mol creatinine
Glutaric acid is made from lysine & tryptophan via alphaketo-adipic acid.
- Elevated in the genetic diseases glutaric academia types I and II.
- Moderate increases may be due to deficiencies in riboflavin and coenzyme Q10, or celiac disease.
- Moderate increases are common in autism possibly due to defective vitamin absorption or microbial production in the GI tract.
Optimal range: 0 - 1.4 mmol/mol creatinine
Glutaric acid is made from lysine & tryptophan via alphaketo-adipic acid.
- Elevated in the genetic diseases glutaric academia types I and II.
- Moderate increases may be due to deficiencies in riboflavin and coenzyme Q10, or celiac disease.
- Moderate increases are common in autism possibly due to defective vitamin absorption or microbial production in the GI tract.
Optimal range: 0.77 - 7 mmol/mol creatinine
The organic acids test by Great Plains Laboratory measures a few oxalate metabolites which can determine if someone has high oxalate levels. These include oxalic, glycolic, and glyceric.
In humans and in yeast, glyoxalate is the parent compound that can be converted into the three metabolites measured on the Organic Acids Test (OAT): glyceric, glycolic, and oxalic acid.
Normal values rule out genetic causes of significantly elevated urinary oxalic acid.
Optimal range: 0.21 - 4.9 mmol/mol creatinine
Normal values rule out genetic causes of significantly elevated urinary oxalic acid.
Optimal range: 0.74 - 13 mmol/mol creatinine
Normal values rule out genetic causes of significantly elevated urinary oxalic acid.
Optimal range: 16 - 117 mmol/mol creatinine
Indicator of genetic disease of oxalate metabolism called Hyperoxaluria type I due to a deficiency in the enzyme activity of alanine glyoxylate amino transferase (AGT).
Optimal range: 18 - 81 mmol/mol creatinine
Indicator of genetic disease of oxalate metabolism called Hyperoxaluria type I due to a deficiency in the enzyme activity of alanine glyoxylate amino transferase (AGT).
Optimal range: 27 - 221 mmol/mol creatinine
Optimal range: 0 - 613 mmol/mol creatinine
Hippuric acid is a conjugate (=a compound formed by the joining of two or more compounds) of glycine and benzoic acid formed in the liver.
Most hippuric acid in urine is derived from microbial breakdown of chlorogenic acid to benzoic acid.
Optimal range: 0 - 717 mmol/mol creatinine
Hippuric acid is a conjugate (=a compound formed by the joining of two or more compounds) of glycine and benzoic acid formed in the liver.
Most hippuric acid in urine is derived from microbial breakdown of chlorogenic acid to benzoic acid.
Optimal range: 0 - 241 mmol/mol creatinine
Hippuric acid is a conjugate (=a compound formed by the joining of two or more compounds) of glycine and benzoic acid formed in the liver.
Most hippuric acid in urine is derived from microbial breakdown of chlorogenic acid to benzoic acid.
Optimal range: 0 - 680 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
Homogentisic acid is a breakdown product of 4-Hydroxyphenylpyruvic Acid (4-HPPA).
Elevated in the genetic disease homogentisic aciduria (alkaptonuria).
Optimal range: 0 - 2 mmol/mol creatinine
Homogentisic acid is a breakdown product of 4-Hydroxyphenylpyruvic Acid (4-HPPA).
Elevated in the genetic disease homogentisic aciduria (alkaptonuria).
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0.8 - 3.6 mmol/mol creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0.39 - 2.2 mmol/mol creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0.49 - 13 mmol/mol creatinine
Optimal range: 0 - 208 mmol/g creatinine
HPHPA is a clostridia metabolite and dysbiosis marker and stands for 3-(3-hydroxyphenyl)-3-hydroxypropionic acid.
Optimal range: 0 - 102 mmol/mol creatinine
HPHPA is a clostridia metabolite and dysbiosis marker and stands for 3-(3-hydroxyphenyl)-3-hydroxypropionic acid.
Optimal range: 0 - 220 mmol/mol creatinine
HPHPA is a clostridia metabolite and dysbiosis marker and stands for 3-(3-hydroxyphenyl)-3-hydroxypropionic acid.
Optimal range: 0.16 - 1.8 Ratio
The Organic Acids Test measures levels of HVA (homovanillic acid) and VMA (vanillylmandelic acid), the metabolites of the neurotransmitters, dopamine and epinephrine/norepinephrine. It also measures the ratio of the two metabolites.
Optimal range: 0.32 - 1.4 Ratio
The Organic Acids Test measures levels of HVA (homovanillic acid) and VMA (vanillylmandelic acid), the metabolites of the neurotransmitters, dopamine and epinephrine/norepinephrine. It also measures the ratio of the two metabolites.
Optimal range: 0.23 - 2.8 mmol/mol creatinine
The Organic Acids Test measures levels of HVA (homovanillic acid) and VMA (vanillylmandelic acid), the metabolites of the neurotransmitters, dopamine and epinephrine/norepinephrine. It also measures the ratio of the two metabolites.
Optimal range: 0.1 - 1.8 Ratio
HVA and DOPAC are the major metabolites of dopamine. HVA stands for Homovanillic acid and DOPAC stands for Dihydroxyphenylacetic.
Optimal range: 0.17 - 1.6 mmol/mol creatinine
HVA and DOPAC are the major metabolites of dopamine. HVA stands for Homovanillic acid and DOPAC stands for Dihydroxyphenylacetic.
Optimal range: 0.37 - 3.3 mmol/mol creatinine
Optimal range: 0 - 2.2 mmol/mol creatinine
Kynurenic Acid is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0 - 1.8 mmol/mol creatinine
Kynurenic Acid is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0 - 4.2 mmol/mol creatinine
Optimal range: 0 - 48 mmol/mol creatinine
Formed from pyruvate in anaerobic or oxygen-starved (hypoxic) conditions to allow for ongoing production of ATP.
Optimal range: 0.74 - 19 mmol/mol creatinine
Formed from pyruvate in anaerobic or oxygen-starved (hypoxic) conditions to allow for ongoing production of ATP.
Optimal range: 2.6 - 48 mmol/mol creatinine
Formed from pyruvate in anaerobic or oxygen-starved (hypoxic) conditions to allow for ongoing production of ATP.
Optimal range: 0.06 - 1.8 mmol/mol creatinine
Malic Acid is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 1.1 mmol/mol creatinine
Malic Acid is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 2.3 mmol/mol creatinine
Malic Acid is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 9.7 mmol/mol creatinine
Malonic acid is found to be associated with malonyl-CoA decarboxylase deficiency, which is an inborn error of metabolism. The name “Malonic” originates from Latin malum, meaning apple. Malonic acid is the archetypal example of a competitive inhibitor: it acts against succinate dehydrogenase (complex II) in the respiratory electron transport chain.
Optimal range: 0 - 9.9 mmol/mol creatinine
Malonic acid is found to be associated with malonyl-CoA decarboxylase deficiency, which is an inborn error of metabolism. The name “Malonic” originates from Latin malum, meaning apple. Malonic acid is the archetypal example of a competitive inhibitor: it acts against succinate dehydrogenase (complex II) in the respiratory electron transport chain.
Optimal range: 0 - 18 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
Mandelic acid is the major metabolite of styrene. Styrene (vinylbenzene) is used as an intermediate in plastic synthesis. Values less than 5 mg/L are due to normal metabolism of phenylalanine or tyrosine.
Optimal range: 0 - 2 mmol/mol creatinine
Mandelic acid is the major metabolite of styrene. Styrene (vinylbenzene) is used as an intermediate in plastic synthesis. Values less than 5 mg/L are due to normal metabolism of phenylalanine or tyrosine.
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0.19 - 2.7 mmol/mol creatinine
Methylcitric is an organic acids that reflects decreased activity of the biotin-dependent enzyme propionyl-CoA carboxylase.
Optimal range: 0.15 - 1.7 mmol/mol creatinine
Methylcitric is an organic acids that reflects decreased activity of the biotin-dependent enzyme propionyl-CoA carboxylase.
Optimal range: 0 - 5.7 mmol/mol creatinine
Optimal range: 0 - 2.3 mmol/mol creatinine
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production.
Optimal range: 0 - 2.3 mmol/mol creatinine
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production.
Optimal range: 0 - 5.2 mmol/mol creatinine
Optimal range: 0.1 - 2.2 mmol/mol creatinine
Methylsuccinic acid is a normal metabolite found in human fluids and is an intermediate metabolite in the breakdown of fatty acids.
Optimal range: 0 - 2.3 mmol/mol creatinine
Methylsuccinic acid is a normal metabolite found in human fluids and is an intermediate metabolite in the breakdown of fatty acids.
Optimal range: 0 - 4 mmol/mol creatinine
Methylsuccinic acid is a normal metabolite found in human fluids and is an intermediate metabolite in the breakdown of fatty acids.
Optimal range: 0 - 38 mmol/mol creatinine
Elevated N-acetylaspartic acid is due to the genetic disorder Carnavan’s disease, a potentially fatal disease causing spongy degeneration of the brain.
What is Carnavan’s disease?
Canavan disease is a rare inherited disorder that damages the ability of nerve cells (neurons) in the brain to send and receive messages. This disease is one of a group of genetic disorders called leukodystrophies. Leukodystrophies disrupt the growth or maintenance of the myelin sheath, which is the covering that protects nerves and promotes the efficient transmission of nerve impulses.
Optimal range: 0 - 38 mmol/mol creatinine
Elevated N-acetylaspartic acid is due to the genetic disorder Carnavan’s disease, a potentially fatal disease causing spongy degeneration of the brain.
What is Carnavan’s disease?
Canavan disease is a rare inherited disorder that damages the ability of nerve cells (neurons) in the brain to send and receive messages. This disease is one of a group of genetic disorders called leukodystrophies. Leukodystrophies disrupt the growth or maintenance of the myelin sheath, which is the covering that protects nerves and promotes the efficient transmission of nerve impulses.
Optimal range: 0 - 38 mmol/mol creatinine
Optimal range: 0 - 0.28 mmol/mol creatinine
N-Acetylcysteine (NAC) is a powerful antioxidant that increases the glutathione reserves in the body.
Together with glutathione, N-Acetylcysteine (NAC) directly binds to toxic metabolites. Although N-Acetylcysteine (NAC) may be beneficial under certain conditions, excessive use of the supplement could be harmful.
Optimal range: 0 - 0.13 mmol/mol creatinine
N-Acetylcysteine (NAC) is a powerful antioxidant that increases the glutathione reserves in the body.
Together with glutathione, N-Acetylcysteine (NAC) directly binds to toxic metabolites. Although N-Acetylcysteine (NAC) may be beneficial under certain conditions, excessive use of the supplement could be harmful.
Optimal range: 0 - 0.34 mmol/mol creatinine
Optimal range: 0.06 - 0.54 mmol/mol creatinine
Orotic Acid is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 0 - 0.88 mmol/mol creatinine
Orotic Acid is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 0 - 0.46 mmol/mol creatinine
Orotic Acid is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 0.04 - 0.8 mmol/mol creatinine
Optimal range: 6.8 - 101 mmol/mol creatinine
Oxalic acid may be associated with dysbiosis from Aspergillus, Penicillium, Candida, or high dose vitamin C. If yeast or fungal markers are elevated, antifungal therapy may reduces oxalates. Also associated with anti-freeze (ethylene glycol) poisoning.
Optimal range: 15 - 174 mmol/mol creatinine
Oxalic acid may be associated with dysbiosis from Aspergillus, Penicillium, Candida, or high dose vitamin C. If yeast or fungal markers are elevated, antifungal therapy may reduces oxalates. Also associated with anti-freeze (ethylene glycol) poisoning.
Optimal range: 8.9 - 67 mmol/mol creatinine
Oxalic acid may be associated with dysbiosis from Aspergillus, Penicillium, Candida, or high dose vitamin C. If yeast or fungal markers are elevated, antifungal therapy may reduces oxalates. Also associated with anti-freeze (ethylene glycol) poisoning.
Optimal range: 35 - 185 mmol/mol creatinine
Oxalic acid may be associated with dysbiosis from Aspergillus, Penicillium, Candida, or high dose vitamin C. If yeast or fungal markers are elevated, antifungal therapy may reduces oxalates. Also associated with anti-freeze (ethylene glycol) poisoning.
Optimal range: 0 - 10 mmol/mol creatinine
Pantothenic acid is an essential B vitamin (=Vitamin B5) that is converted to coenzyme A (unrelated to vitamin A). Coenzyme A is needed for the synthesis of fatty acids, cholesterol, and acetyl choline and is also needed for the Krebs cycle and fatty acid catabolism.
Optimal range: 0 - 5.4 mmol/mol creatinine
Pantothenic acid is an essential B vitamin (=Vitamin B5) that is converted to coenzyme A (unrelated to vitamin A). Coenzyme A is needed for the synthesis of fatty acids, cholesterol, and acetyl choline and is also needed for the Krebs cycle and fatty acid catabolism.
Optimal range: 0 - 14 mmol/mol creatinine
Pantothenic acid is an essential B vitamin (=Vitamin B5) that is converted to coenzyme A (unrelated to vitamin A). Coenzyme A is needed for the synthesis of fatty acids, cholesterol, and acetyl choline and is also needed for the Krebs cycle and fatty acid catabolism.
Optimal range: 0 - 2 mmol/mol creatinine
Phenyllactic acid is a metabolite of phenylalanine.
Optimal range: 0 - 2 mmol/mol creatinine
Phenyllactic acid is a metabolite of phenylalanine.
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
Phenylpyruvic acid is a keto-acid that is an intermediate or catabolic byproduct of phenylalanine metabolism. It has a slight honey-like odor.
Optimal range: 0 - 2 mmol/mol creatinine
Phenylpyruvic acid is a keto-acid that is an intermediate or catabolic byproduct of phenylalanine metabolism. It has a slight honey-like odor.
Optimal range: 0 - 4 mmol/mol creatinine
Optimal range: 1000 - 5000 mmol/mol creatinine
Phosphoric acid is a marker of vitamin D and calcium. This marker indicates whether vitamin D receptors are activated. If phosphoric acid is low, then the person is likely vitamin D and/or calcium deficient. Low levels can be due to low phosphate consumption, low digestive juice production, or deficiencies in vitamin D, vitamin K2, or magnesium.
Optimal range: 1000 - 4900 mmol/mol creatinine
Phosphoric acid is a marker of vitamin D and calcium. This marker indicates whether vitamin D receptors are activated. If phosphoric acid is low, then the person is likely vitamin D and/or calcium deficient. Low levels can be due to low phosphate consumption, low digestive juice production, or deficiencies in vitamin D, vitamin K2, or magnesium.
Optimal range: 1000 - 7300 mmol/mol creatinine
Optimal range: 0 - 34 mmol/mol creatinine
A major metabolite of vitamin B6. High pyridoxic acid indicates high recent intake of vitamin B6. Because some individuals may require very high doses of vitamin B6, high values do not necessarily indicate the need to reduce vitamin B6 intake. Low values are associated with low B6 status, high oxalates, and/or low neurotransmitters.
Optimal range: 0 - 26 mmol/mol creatinine
The main urinary metabolite of pyridoxine (Vitamin B6) and is a measure of recent dietary intake.
Low values of pyridoxic acid in the urine indicate low recent intake while high values indicate high recent dietary intake.
Optimal range: 0 - 53 mmol/mol creatinine
Optimal range: 10 - 33 mmol/mol creatinine
Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Optimal range: 5.7 - 25 mmol/mol creatinine
Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Optimal range: 13 - 62 mmol/mol creatinine
Optimal range: 0 - 9.1 mmol/mol creatinine
Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.
Optimal range: 0.88 - 9.1 mmol/mol creatinine
Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.
Optimal range: 0.28 - 6.7 mmol/mol creatinine
Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.
Optimal range: 0.32 - 8.8 mmol/mol creatinine
Optimal range: 0.85 - 3.9 mmol/mol creatinine
Quinolinic acid is a neurotoxic substance produced by our own bodies and a metabolite of tryptophan.
Optimal range: 0.52 - 2.4 mmol/mol creatinine
Quinolinic acid is a neurotoxic substance produced by our own bodies and a metabolite of tryptophan.
Optimal range: 0.48 - 8.8 mmol/mol creatinine
Optimal range: 0.42 - 2 Ratio
A high ratio of quinolinic acid to the tryptophan metabolite, 5-hydroxyindoleacetic acid, indicates excessive inflammation due to recurrent infections, excessive tryptophan intake, immune overstimulation, excessive adrenal production of cortisol, or excessive exposure to phthalates.
Optimal range: 0 - 0.24 mmol/mol creatinine
Increased urinary products of the omega fatty acid metabolism pathway may be due to carnitine deficiency, fasting, or increased intake of triglycerides from coconut oil, or some infant formulas.
Optimal range: 0 - 0.14 mmol/mol creatinine
Increased urinary products of the omega fatty acid metabolism pathway may be due to carnitine deficiency, fasting, or increased intake of triglycerides from coconut oil, or some infant formulas.
Optimal range: 0 - 0.61 mmol/mol creatinine
Optimal range: 0.18 - 2.2 mmol/mol creatinine
Suberic Acid, Adipate, and Ethylmalonate elevations can indicate that you may need additional carnitine and/or vitamin B2 to assist your cells in converting fats into energy efficiently.
Optimal range: 0 - 1.9 mmol/mol creatinine
Suberic Acid, Adipate, and Ethylmalonate elevations can indicate that you may need additional carnitine and/or vitamin B2 to assist your cells in converting fats into energy efficiently.
Optimal range: 0 - 7 mmol/mol creatinine
Suberic Acid, Adipate, and Ethylmalonate elevations can indicate that you may need additional carnitine and/or vitamin B2 to assist your cells in converting fats into energy efficiently.
Optimal range: 0 - 9.3 mmol/mol creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0 - 15 mmol/mol creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0 - 5.3 mmol/mol creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0 - 23 mmol/mol creatinine
Optimal range: 0 - 4.5 mmol/mol creatinine
Breakdown product of hyaluronic acid; also found in some foods.
Optimal range: 0 - 5.3 mmol/mol creatinine
Breakdown product of hyaluronic acid; also found in some foods.
Optimal range: 0 - 6.5 mmol/mol creatinine
Breakdown product of hyaluronic acid; also found in some foods.
Optimal range: 0 - 0.56 mmol/mol creatinine
A pyrimidine (DNA building block) that is elevated in the genetic disease dihydropyrimidine dehydrogenase deficiency. In this genetic disease, the pyrimidine uracil is also elevated.
- Thymine is one of the five bases used to build nucleic acids.
- It is also known as 5-methyluracil or by the abbreviations T or Thy.
- Thymine is found in DNA, where it pairs with adenine via two hydrogen bonds. In RNA, thymine is replaced by uracil.
Optimal range: 0 - 0.36 mmol/mol creatinine
A pyrimidine (DNA building block) that is elevated in the genetic disease dihydropyrimidine dehydrogenase deficiency. In this genetic disease, the pyrimidine uracil is also elevated.
- Thymine is one of the five bases used to build nucleic acids.
- It is also known as 5-methyluracil or by the abbreviations T or Thy.
- Thymine is found in DNA, where it pairs with adenine via two hydrogen bonds. In RNA, thymine is replaced by uracil.
Optimal range: 0 - 0.91 mmol/mol creatinine
Optimal range: 0 - 0.44 mmol/mol creatinine
A chemical byproduct released from fumonisins during passage through the gastrointestinal tract. Fumonisins are fungal toxins produced primarily by F. verticillioides. Elevated levels can be caused by the intake of corn or corn-based food contaminated with fumonisins.
Optimal range: 0 - 0.86 mmol/mol creatinine
A chemical byproduct released from fumonisins during passage through the gastrointestinal tract. Fumonisins are fungal toxins produced primarily by F. verticillioides. Elevated levels can be caused by the intake of corn or corn-based food contaminated with fumonisins.
Optimal range: 0 - 0.58 mmol/mol creatinine
A chemical byproduct released from fumonisins during passage through the gastrointestinal tract. Fumonisins are fungal toxins produced primarily by F. verticillioides. Elevated levels can be caused by the intake of corn or corn-based food contaminated with fumonisins.
Optimal range: 0 - 1.3 mmol/mol creatinine
A chemical byproduct released from fumonisins during passage through the gastrointestinal tract. Fumonisins are fungal toxins produced primarily by F. verticillioides. Elevated levels can be caused by the intake of corn or corn-based food contaminated with fumonisins.
Optimal range: 0 - 9.7 mmol/mol creatinine
The pyrimidine metabolites are markers of folate metabolism. The two markers are uracil and thymine. Folate acts as a methyl donor in converting uracil to thymine.
Elevated values of uracil suggest folic acid deficiency. Folate is needed to convert uracil to thymine by methylation.
Optimal range: 0 - 6.9 mmol/mol creatinine
The pyrimidine metabolites are markers of folate metabolism. The two markers are uracil and thymine. Folate acts as a methyl donor in converting uracil to thymine.
Elevated values of uracil suggest folic acid deficiency. Folate is needed to convert uracil to thymine by methylation.
Optimal range: 0 - 16 mmol/mol creatinine
The pyrimidine metabolites are markers of folate metabolism. The two markers are uracil and thymine. Folate acts as a methyl donor in converting uracil to thymine.
Elevated values of uracil suggest folic acid deficiency. Folate is needed to convert uracil to thymine by methylation.
Optimal range: 0.46 - 3.7 mmol/mol creatinine
Metabolite of epinephrine and norepinephrine. Often elevated due to stress induced catecholamine output or lead toxicity.
Optimal range: 0.53 - 2.2 mmol/mol creatinine
Metabolite of epinephrine and norepinephrine. Often elevated due to stress induced catecholamine output or lead toxicity.
Optimal range: 0.72 - 6.4 mmol/mol creatinine
Antidiuretic Hormone Profile
ADH is a hormone that is produced in a part of the brain called the hypothalamus. It is then stored and released from the pituitary, a small gland at the base of the brain. ADH acts on the kidneys to control the amount of water excreted in the urine.
ADH blood test is ordered when your provider suspects you have a disorder that affects your ADH level such as:
- Buildup of fluids in your body that are causing swelling or puffiness
- Excessive amounts of urine
- Low sodium (salt) level in your blood
- Thirst that is intense or uncontrollable
Certain diseases affect the normal release of ADH. The blood level of ADH must be tested to determine the cause of the disease. ADH may be measured as part of a water restriction test to find the cause of a disease.
Optimal range: 0 - 4.7 pg/mL
The Vasopressin test measures the level of antidiuretic hormone (ADH) in blood.
Toxic Non-Metal Chemical Profile
Every day, we are exposed to hundreds of toxic chemicals through products like pharmaceuticals, pesticides, packaged foods, household products, and environmental pollution. As we have become more exposed to chemical-laden products and to toxic chemicals in food, air, and water, we have been confronted with an accelerating rate of chronic illnesses like cancer, heart disease, chronic fatigue syndrome, chemical sensitivity, autism spectrum disorders, ADD/AD(H)D, autoimmune disorders, Parkinson’s disease, and Alzheimer’s disease.
Because exposure to environmental pollutants has been linked to many chronic diseases, The Great Plains Laboratory has created GPL-TOX, a toxic non-metal chemical profile that screens for the presence of 172 different toxic chemicals including organophosphate pesticides, phthalates, benzene, xylene, vinyl chloride, pyrethroid insecticides, acrylamide, perchlorate, diphenyl phosphate, ethylene oxide, acrylonitrile, and more. This profile also includes Tiglylglycine (TG), a marker for mitochondrial disorders resulting from mutations of mitochondrial DNA. These mutations can be caused by exposure to toxic chemicals, infections, inflammation, and nutritional deficiencies.
Optimal range: 0 - 0.2 µg/g creatinine
2,4-Dichlorophenoxyacetic Acid (2,4-D) is a very common herbicide that was a part of Agent Orange, which was used by the U.S. in the Vietnam War. It is most commonly used in agriculture on genetically modified foods, and as a weed killer for lawns. Exposure to 2, 4-D via skin or oral ingestion is associated with neuritis, weakness, nausea, abdominal pain, headache, dizziness, peripheral neuropathy, stupor, seizures, brain damage, and impaired reflexes. 2, 4-D is a known endocrine disruptor, and can block hormone distribution and cause glandular breakdown.
Optimal range: 0 - 10 µg/g creatinine
2-Methylhippuric Acid (2MHA), 3-Methylhippuric Acid (3MHA), 4-Methylhippuric Acid (4MHA)
These are metabolites of xylenes, solvents found in paints, lacquers, cleaning agents, pesticides, and gasoline. Exposure to xylenes generates methylhippuric acid isomers.
Optimal range: 0 - 0.8 µg/g creatinine
HEMA is a metabolite of ethylene oxide, which is used in the production of agrochemicals, detergents, pharmaceuticals, and personal care products.
Chronic exposure to ethylene oxide has been determined to be mutagenic to humans.
Optimal range: 0 - 200 µg/g creatinine
2-Hydroxyisobutyric acid is formed endogenously as a product of branched-chain amino acid degradation and ketogenesis. This compound is also the major metabolite of gasoline octane enhancers such as MTBE and ETBE.
Optimal range: 0 - 8 ug/g creat
3-HPMA is the main urinary metabolite of acrolein. Acrolein is an environmental pollutant, commonly used as an herbicide and in many different chemical industries. Acrolein is also present in the burning of cigarettes, gasoline, and oil. Certain bacteria produce acrolein, such as Clostridium. Acrolein metabolites are associated with diabetes and insulin resistance.
Optimal range: 0 - 0.3 µg/g creatinine
Pyrethrins are widely used as insecticides. Exposure during pregnancy doubles the likelihood of autism. Pyrethrins may affect neurological development, disrupt hormones, induce cancer, and suppress the immune system.
Optimal range: 0 - 0.6 µg/g creatinine
Organophosphates are one of the most toxic groups of substances in the world, primarily found in pesticide formulations. They are inhibitors of cholinesterase enzymes, leading to overstimulation of nerve cells, causing sweating, salivation, diarrhea, abnormal behavior, including aggression and depression. Children exposed to organophosphates have more than twice the risk of developing pervasive developmental disorder (PDD), an autism spectrum disorder. Maternal organophosphate exposure has been associated with various adverse outcomes including having shorter pregnancies and children with impaired reflexes.
Optimal range: 0 - 4 µg/g creatinine
Organophosphates are one of the most toxic groups of substances in the world, primarily found in pesticide formulations. They are inhibitors of cholinesterase enzymes, leading to overstimulation of nerve cells, causing sweating, salivation, diarrhea, abnormal behavior, including aggression and depression. Children exposed to organophosphates have more than twice the risk of developing pervasive developmental disorder (PDD), an autism spectrum disorder. Maternal organophosphate exposure has been associated with various adverse outcomes including having shorter pregnancies and children with impaired reflexes.
Optimal range: 0 - 1 µg/g creatinine
This is a metabolite of the organophosphate flame retardant triphenyl phosphate (TPHP), which is used in plastics, electronic equipment, nail polish, and resins. TPHP can cause endocrine disruption. Studies have also linked TPHP to reproductive and developmental problems.
Optimal range: 0 - 0.38 ug/g creat
Glyphosate is the world's most widely produced herbicide. It is a broad-spectrum herbicide that is used in more than 700 different products for agriculture and forestry to home use.
Possible treatment options if in higher ranges:
Treatment of glyphosate toxicity should be centered on determining the route of introduction and avoiding future exposure. Glyphosate is readily metabolized in the body. However, a recent study found that glyphosate accumulates in mammalian bones. Another study found glyphosate to be detectable in mammalian intestine, spleen, liver, muscle, and kidney. Kidney impairment is common in regions where glyphosate may accumulate in ground water as metal chelates. The most effective way to reduce glyphosate exposure is to avoid living in areas where glyphosate is applied and to avoid eating GMO foods or animal products such as milk or meat for which GMO foods were used to feed the animals. Since glyphosate is now commonly combined with the weed killer 2,4-dichlorophenoxyacetic acid (2,4-D), testing for this chemical with the GPL-TOX test may wish to be considered also.
Optimal range: 0 - 5 µg/g creatinine
Monoethyl Phthalate (or Monoethylphthalate) (MEP) from diethyl phthalate is the most abundant phthalate metabolite found in urine. Diethyl phthalate is used in plastic products. Elevated values indicate exposure from various possible sources. Elimination of phthalates may be accelerated by sauna treatment.
Optimal range: 0 - 0.2 µg/g creatinine
N-acetyl phenyl cysteine (NAP) is a metabolite of benzene.
Benzene is an organic solvent that is widespread in the environment. Benzene is a by-product of all types of industrial processes and combustion, including motor vehicle exhaust and cigarette smoke, and is released by outgassing from synthetic materials. Benzene is an extremely toxic chemical that is mutagenic and carcinogenic. High exposures to benzene cause symptoms of nausea, vomiting, dizziness, lack of coordination, central nervous system depression, and death. It can also cause hematological abnormalities.
Optimal range: 0 - 5.8 µg/g creatinine
NACE is a metabolite of acrylonitrile, which is used in the production of acrylic fibers, resins, and rubber.
Acrylonitrile is metabolized by the cytochrome P450s and then conjugated to glutathione. Supplementation with glutathione should assist in the detoxification of acrylonitrile.
Optimal range: 0 - 4 µg/g creatinine
N-acetyl(2-hydroxypropyl)cysteine (NAHP) is used in the production of plastics and is used as a fumigant (=gaseous pesticides).
This chemical is a metabolite of propylene oxide. Propylene oxide is used to make polyester resins for textile and construction industries. It is also used in the preparation of lubricants, surfactants, and oil demulsifiers. It has also been used as a food additive, an herbicide, a microbicide, an insecticide, a fungicide, and a miticide. Propylene oxide is a probable human carcinogen.
Optimal range: 0 - 4 µg/g creatinine
NADB is a metabolite of 1,3 butadiene, which is evident of exposure to synthetic rubber such as tires. 1,3 butadiene is a known carcinogen and has been linked to increased risk of cardiovascular disease. Individuals that come into contact with rubber, such as car tires, could absorb 1,3 butadiene through the skin.
Optimal range: 0 - 4 µg/g creatinine
NAPR is a metabolite of 1-bromopropane. Chronic exposure can lead to decreased cognitive function and impairment of the central nervous system. Acute exposure can lead to headaches.
1-bromopropane is an organic solvent used for metal cleaning, foam gluing, and dry cleaning. Studies have shown that 1-BP is a neurotoxin as well as a reproductive toxin. Research indicates that exposure to 1-BP can cause sensory and motor deficits. Chronic exposure can lead to decreased cognitive function and impairment of the central nervous system. Acute exposure can lead to headaches.
Optimal range: 0 - 4 µg/g creatinine
N-acetyl-S-(2-carbamoylethyl)cysteine (NAE) is a metabolite of acrylamide, which is detoxified through a two-step process.
First acrylamide is metabolized by the cytochrome P450s.
Second it is conjugated to glutathione in order to make it more water soluble.
Optimal range: 0 - 2 µg/g creatinine
The chemical Perchlorate (PERC) is used in the production of rocket fuel, missiles, fireworks, flares, explosives, fertilizers, and bleach. Studies show that perchlorate is often found in water supplies. Many food sources are also contaminated with percholate. Percholate can disrupt the thyroid’s ability to produce hormones. The EPA has also labeled perchlorate a likely human carcinogen.
Optimal range: 0 - 5 µg/g creatinine
Styrene is used in the manufacturing of plastics, in building materials, and is found in car exhaust fumes. Polystyrene and its copolymers are widely used as food-packaging materials. The ability of styrene monomer to leach from polystyrene packaging to food has been reported. Occupational exposure due to inhalation of large amounts of styrene adversely impacts the central nervous system, causes concentration problems, muscle weakness, fatigue, and nausea, and irritates the mucous membranes of the eyes, nose, and throat.
Optimal range: 0 - 0.04 µg/g creatinine
Tiglylglycine is a marker for mitochondrial dysfunction. Mutations of mitochondria DNA may result from exposure to toxic chemicals, infections, inflammation, and nutritional deficiencies.
MycoTOX Profile (Mold Exposure)
Mycotoxins are some of the most prevalent toxins in the environment. Mycotoxins are metabolites produced by fungi like mold, which can infest buildings, vehicles, and foodstuffs. A majority of mycotoxin exposures are through food ingestion or airborne exposure. In the European Union, 20% of all grains harvested have been found to be contaminated with mycotoxins. Unfortunately, mycotoxins are resistant to heat and many processing procedures. Fungi are able to grow on almost any surface, especially if the environment is warm and wet. Inner wall materials of buildings, wall paper, fiber glass insulation, ceiling tiles, and gypsum support are all good surfaces for fungi to colonize. These fungi then release mycotoxins into the environment causing symptoms of many different chronic diseases. Diseases and symptoms linked to mycotoxin exposure include fever, pneumonia-like symptoms, heart disease, rheumatic disease, asthma, sinusitis, cancer, memory loss, vision loss, chronic fatigue, skin rashes, depression, ADHD, anxiety, and liver damage.
Recommendations for Treatment of Mycotoxins
If you or a patient has done a MycoTOX Profile and the results show moderate to high levels of mycotoxins there are things you can do to help the body eliminate the toxins and prevent future exposures.
The first step is to eliminate or reduce exposure to mold. The majority of exposures result from contaminated food, skin contact, and inhalation of spore-borne toxins, which is often caused by water-damaged buildings. Inhalation of spore-borne toxins can be limited by detecting and eliminating damp and moldy environments, both indoor and outdoor. Mold can enter homes through open windows, vents, doorways, and heating and air conditioning systems. Mold grows well on organic products such as paper, wood, cardboard, and ceiling tiles. Mold can also grow on insulation, drywall, wallpaper, carpet, fabric, and upholstery. Mold can be controlled by cleaning and drying after water intrusion; having proper ventilation for showers, laundry, and cooking areas; making sure that windows, roofs, and pipes are free of leaks; and by controlling humidity levels. After moisture problems are alleviated it is recommended that mold removal be performed by a licensed contractor. Attempts to remove mold may cause mold spores to scatter and spread to other areas. In addition, treating mold without proper ventilation could result in health problems caused by the release of mycotoxins from the mold spores. Treatment for mold exposure should include fluid support to prevent dehydration. The drug Oltipraz can increase glutathione conjugation of mold toxins while inhibiting the toxic effect of P450 oxidation, reducing liver toxicity and promoting safer elimination. A diet of carrots, parsnips, celery, and parsley may reduce the carcinogenic effects of mold. Bentonite clay and zeolite clay are reported to reduce the absorption of mold found in food. Supplementation with chlorophyllin, zinc, A, E, C, NAC, rosmarinic acid, and liposomal glutathione alone or in combination have been shown to mitigate the oxidative effects of mold toxins.
Optimal range: 0 - 0.5 ng/g creatinine
Aflatoxin M1 (AFM1) is the main metabolite of aflatoxin B1, which is a mycotoxin produced by the mold species Aspergillus. Aflatoxins are some of the most carcinogenic substances in the environment. Aflatoxin susceptibility is dependent on multiple different factors such as age, sex, and diet.
Optimal range: 0 - 10 ng/g creatinine
Chaetoglobosin A (CHA) is produced by the mold Chaetomium globosum (CG).
Optimal range: 0 - 25 ng/g creatinine
Dihydrocitrinone (DHC) is a metabolite of Citrinin (CTN), which is a mycotoxin that is produced by the mold genera Aspergillus, Penicillium, and Monascus.
Optimal range: 0 - 0.3 ng/g creatinine
Enniatin B is a fungal metabolite categorized as cyclohexa depsipeptides toxin produced by the fungus Fusarium. This strain of fungus is one of the most common cereal contaminants.
Optimal range: 0 - 200 ng/g creatinine
Gliotoxin (GTX) is produced by the mold genus Aspergillus. Aspergillus spreads in the environment by releasing conidia which are capable of infiltrating the small alveolar airways of individuals.
Optimal range: 0 - 200 ng/g creatinine
Gliotoxin (GTX) is produced by the mold genus Aspergillus. Aspergillus spreads in the environment by releasing conidia which are capable of infiltrating the small alveolar airways of individuals. In order to evade the body’s defenses Aspergillus releases Gliotoxin to inhibit the immune system. One of the targets of Gliotoxin is PtdIns (3,4,5) P3. This results in the downregulation of phagocytic immune defense, which can lead to the exacerbation of polymicrobial infections. Gliotoxin impairs the activation of T-cells and induces apoptosis in monocytes and in monocyte-derived dendritic cells. These impairments can lead to multiple neurological syndromes.
Optimal range: 0 - 37.4 ng/g creatinine
Mycophenolic Acid is an antifungal, antibacterial, and antiviral mycotoxin acid. It is produced by the Penicillium fungus.
Mycophenolic Acid is an immunosuppressant which inhibits the proliferation of B and T lymphocytes. Mycophenolic Acid exposure can increase the risk of opportunistic infections such as clostridia and Candida.
Mycophenolic Acid is associated with miscarriage and congenital malformations when the woman is exposed in pregnancy.
Optimal range: 0 - 37.4 ng/g creatinine
Mycophenolic Acid is an antifungal, antibacterial, and antiviral mycotoxin acid. It is produced by the Penicillium fungus.
Mycophenolic Acid is an immunosuppressant which inhibits the proliferation of B and T lymphocytes. Mycophenolic Acid exposure can increase the risk of opportunistic infections such as clostridia and Candida.
Mycophenolic Acid is associated with miscarriage and congenital malformations when the woman is exposed in pregnancy.
Optimal range: 0 - 7.5 ng/g creatinine
Ochratoxin A (OTA) is a nephrotoxic, immunotoxic, and carcinogenic mycotoxin. This chemical is produced by molds in the Aspergillus and Penicillium families.
Optimal range: 0 - 0.2 ng/g creatinine
Roridin E is a macrocyclic trichothecene produced by the mold species Fusarium, Myrothecium, and Stachybotrys (i.e. black mold). Trichothecenes are frequently found in buildings with water damage but can also be found in contaminated grain.
Optimal range: 0 - 0.4 ng/g creatinine
Sterigmatocystin (STG) is a mycotoxin that is closely related to aflatoxin. STG is produced from several species of mold such as Aspergillus, Penicillium, and Bipolaris. It is considered to be carcinogenic, particularly in the cells of the GI tract and liver. STG has been found in the dust from damp carpets.
Optimal range: 0 - 0.4 ng/g creatinine
Optimal range: 0 - 1.3 ng/g creatinine
Verrucarin A (VRA) is a macrocyclic trichothecene mycotoxin produced from Stachybotrys, Fusarium, and Myrothecium. Trichothecenes are frequently found in buildings with water damage but can also be found in contaminated grain. VRA is a small, amphipathic molecule that can move passively across cell membranes.
Optimal range: 0 - 3.2 ng/g creatinine
Zearalenone (ZEA) is a mycotoxin that is produced by the mold species Fusarium, and has been shown to be hepatotoxic, haematotoxic, immunotoxic, and genotoxic. ZEA is commonly found in several foods in the US, Europe, Asia, and Africa including wheat, barley, rice, and maize.
Semen analysis
A semen analysis measures the quantity and quality of both the liquid portion, called semen, and the microscopic moving cells called sperm. Semen is the turbid, whitish substance that is released from the penis during ejaculation. Sperm are the cells in semen with a head and a tail that enables them to travel to the egg. A typical semen analysis could measure:
- the volume of semen
- the macroscopic appearance
- the semen viscosity (thickness)
- sperm concentration,
- total number of sperm
- sperm motility (the percentage that are able to move, as well as how vigorously and straight the sperm move)
- the number of normal and abnormal (defective) sperm
- coagulation and liquefaction (the time it takes the semen to go from a gel to a liquid state)
- fructose level (a sugar in semen)
- pH (acidity)
- the number of immature sperm, and
- the number of white blood cells (cells that indicate infection).
Optimal range: 3 - 21 days
Optimal range: 0 - 0 Units
In a semen analysis, "active sperm" typically refers to sperm motility. Active sperm are those that are capable of moving, and sperm motility is an important parameter in assessing male fertility.
Optimal range: 0 - 0 10e6/ml
Reference range: Absent, Present
Agglutination morphology in a semen analysis refers to the clumping or sticking together of sperm cells, which can affect their ability to swim freely and reach the egg for fertilization. This is an important biomarker in male fertility assessments because agglutination can reduce the chances of conception.
What Causes Sperm Agglutination?
Optimal range: 0 - 0 qm
Reference range: Milk white, Yellow, Green, Pinkish-red, Black
Semen is typically whitish-gray with a jelly-like texture, but it can fluctuate with different lifestyle changes. Unless you’re experiencing other symptoms, temporary changes in the color of your semen usually aren’t a cause for concern.
If your semen is a different color than usual, take a few moments to scan your body for other changes.
Semen that’s tinged with yellow, green, pink, red, orange, or brown isn’t ideal, but it may not be cause for concern unless it’s accompanied by other unusual symptoms.
Genital soreness, itching, or burning could point to an underlying infection or other condition. When it comes to consistency, semen that’s thicker than usual could be a sign of dehydration.
Optimal range: 0 - 0 degree
Optimal range: 25 - 100 %
The term motility refers to the movement of a man’s sperm. The analysis assesses whether or not the sperm are swimming properly and in a straight line. Sperm receive a letter grade from A to D, with an A given to the fastest, straightest swimmers and a D given to those that don’t move at all.
Class A - They are fast progressive sperms that swim quickly in a straightforward direction.
Optimal range: 0 - 0 %
Optimal range: 0 - 0 %
Optimal range: 0 - 0 %
Optimal range: 0 - 96 %
The deformity rate in a semen analysis refers to the percentage of sperm with abnormal morphology or shape within a semen sample. The deformity rate is an essential factor in assessing male fertility because sperm with abnormal morphology may have difficulty fertilizing an egg.
The World Health Organization (WHO) provides reference values for normal sperm morphology in a semen analysis. According to the WHO criteria, a semen sample is considered normal when at least 4% of sperm exhibit normal morphology. Sperm with abnormal shapes can include those with misshapen heads, tails, or other structural abnormalities.
Optimal range: 20 - 200 10e6/ml
In a semen analysis, density typically refers to sperm concentration, which is a crucial parameter used to assess male fertility. Sperm density signifies the number of sperm present per milliliter (ml) of semen. It quantifies the concentration of sperm in the ejaculate and is an essential factor in evaluating a man's reproductive health.
Optimal range: 0 - 0 10e6/ml
Reference range: Completely liquefaction, Incomplete liquefaction
The Liquefaction status in a semen analysis is an important aspect of semen analysis that assesses how semen changes from a coagulated to a more liquid state, with deviations from the norm potentially indicating fertility issues.
Optimal range: 20 - 30 min
Liquefaction time in a semen analysis is a crucial parameter that indicates the time it takes for semen to transition from a gel-like consistency to a liquid state. It is essential for sperm mobility and is used as a diagnostic indicator to assess sperm health and potential fertility issues.
Optimal range: 0 - 49.9 %
The acronym MAR stands for mixed antiglobulin reaction. The test is used to diagnose imunological infertility, which means that antisperm antibodies are present that prevent conception from taking place. Antibodies in blood, semen or cervical mucous coat the surface of the sperm, which impairs sperm transport and ultimately fertilisation of the ovum.
Optimal range: 0 - 49.9 %
The acronym MAR stands for mixed antiglobulin reaction. The test is used to diagnose imunological infertility, which means that antisperm antibodies are present that prevent conception from taking place. Antibodies in blood, semen or cervical mucous coat the surface of the sperm, which impairs sperm transport and ultimately fertilisation of the ovum.
Optimal range: 0 - 1 mill/ml
Optimal range: 0 - 0 mill/ml
Optimal range: 40 - 81 %
Motility in a semen analysis is a critical parameter that signifies the ability of sperm to move, which is essential for fertilization. It provides valuable information about sperm health, fertility potential, and the quality of sperm in a semen sample.
Optimal range: 0 - 0 %
Optimal range: 0 - 0 %
Optimal range: 31 - 34 %
Motility - Progressive, Fast refers to how well and how quickly sperm move forward in a straight line. Sperm motility is one of the key factors that determines a man's fertility because the sperm need to swim efficiently to reach and fertilize the egg. Here’s a breakdown of this term:
- Motility refers to the sperm’s ability to move. Healthy sperm must be able to swim to reach the egg.
- Progressive motility means the sperm are moving forward in a purposeful, straight line or large circles. This is important because only sperm that move forward can make the journey to fertilize the egg.
- Fast describes the speed of movement. In a healthy semen sample, fast-progressive sperm are the ones moving quickly and efficiently toward the egg, which improves the chances of fertilization.
Optimal range: 0 - 0 %
Optimal range: 0 - 0 %
Optimal range: 0 - 0 %
Optimal range: 50 - 100 %
The percentage of A+B motility in semen analysis is a crucial indicator of sperm's ability to effectively move and play a role in natural conception. Higher percentages are generally associated with better fertility outcomes.
Optimal range: 7.2 - 8 pH
Normal semen pH is in the range of 7.2 to 8 and it tends to increase with time after ejaculation. Changes are usually due to inflammation of the prostate or seminal vesicles.
Optimal range: 7.2 - 9 pH
Semen pH is an important biomarker assessed during a semen analysis, as it indicates the acidity or alkalinity of the semen, which plays a key role in the health and functionality of sperm. The normal pH range for semen is typically between 7.2 and 8.0, which is slightly alkaline. This alkalinity helps protect sperm as they pass through the acidic environment of the female reproductive tract.
Optimal range: 13 - 20 qmol/ejac.
percent able to move as well as how vigorously and straight the sperm move
Optimal range: 20 - 40 mU/ejac.
Optimal range: 2.4 - 5 qmol/ejac.
Optimal range: 14 - 50 mill/ml
Optimal range: 15 - 50 mill
Sperm count is a key biomarker measured in a semen analysis to evaluate male fertility. It refers to the number of sperm present in a milliliter (mL) of semen. A normal sperm count is typically considered to be 15 million or more sperm per milliliter. A higher sperm count increases the chances of fertilization, as more sperm are available to reach and fertilize the egg.
What Does Sperm Count Mean?
- Normal sperm count: A healthy sperm count is important because it increases the likelihood that sperm will reach the egg for fertilization. A count of 15 million sperm per mL or higher is considered normal by the World Health Organization (WHO).
- Low sperm count: If the sperm count is less than 15 million sperm per mL, it is called oligospermia, which may reduce the chances of conceiving naturally. However, even with a lower sperm count, pregnancy is still possible, though it might be more challenging.
- No sperm count: If there is no sperm found in the semen, this condition is called azoospermia, which can be caused by blockages, genetic factors, or issues with sperm production in the testicles.
Optimal range: 0 - 0 10e6/ml
Optimal range: 0 - 0 10e6/ml
Optimal range: 3 - 4 %
Optimal range: 40 - 100 %
Optimal range: 0 - 0 Units
Optimal range: 0 - 0 Units
Optimal range: 0 - 0 mill
Optimal range: 39 - 928 Units
The "total number" in a semen analysis typically refers to the total sperm count, which is a crucial parameter in assessing male fertility. The total sperm count represents the total number of sperm present in one ejaculate of semen.
Normal Range: A normal total sperm count is typically considered to be 39 million sperm per ejaculate or more. This count takes into account the total number of sperm, regardless of their motility (ability to move) or morphology (shape).
Optimal range: 0 - 0 um/s
Optimal range: 40 - 100 um/s
Quantitative Assessment:
VCL is a quantitative parameter used to assess sperm motility. It is one of the factors evaluated during a semen analysis to determine the quality and functionality of sperm.
Optimal range: 25 - 100 um/s
Velocity of Straight Line (VSL) is an important parameter measured in semen analysis to assess sperm motility. VSL refers to the time-average velocity of a sperm head as it moves along a straight line between its first and last detected positions. It is a crucial aspect of sperm motility evaluation and provides insights into the ability of sperm to move efficiently in a forward direction.
In terms of what is considered a good VSL value in semen analysis, the specific threshold can vary depending on laboratory standards and reference values. However, generally, a VSL value above 25-30 micrometers per second (μm/s) is often considered indicative of healthy sperm motility. Higher VSL values suggest that sperm are capable of progressive, forward movement, which is essential for successful fertilization.
Reference range: Normal, Abnormal
Viscosity is an important biomarker assessed in a semen analysis that measures the thickness or fluidity of the semen. It plays a key role in determining the semen's ability to effectively transport sperm through the male reproductive system and into the female reproductive tract during fertilization. Normal viscosity allows semen to liquefy within 15 to 30 minutes after ejaculation, which facilitates sperm movement.
Optimal range: 2 - 5 ml
Semen volume refers to the amount of seminal fluid ejaculated during a male's orgasm. On average, the volume of semen in a single ejaculation typically ranges between 2 to 5 milliliters, equivalent to approximately 0.12 to 0.31 cubic inches in volume for human males. However, this volume can vary among individuals and may be influenced by factors such as age, sexual activity, and overall health.
Semen volume is an essential aspect of male reproductive health, as it plays a role in delivering sperm to the female reproductive tract for fertilization. It is commonly analyzed in semen analysis tests to assess male fertility and reproductive function, as deviations from the normal volume may indicate underlying issues. It's important to note that the idea of increasing semen volume through products or methods is largely a myth, as it is primarily determined by individual biology and health factors, not external interventions.
Optimal range: 1.5 - 5.5 ml
CORTISOL, LC/MS, SALIVA, 4 SAMPLES
Salivary cortisol level, particularly late-night salivary cortisol (LNSC) level, is useful in screening for endogenous Cushing syndrome. Two or more positive results of LNSC tests may be used to confirm Cushing syndrome. LNSC measurement may also be used to monitor for recurrence of Cushing disease.
Normally, the secretion of cortisol has a circadian rhythm. Patients with Cushing syndrome often lose the late-night circadian nadir (= low point). Therefore, an elevated LNSC level may provide initial evidence for Cushing syndrome. Two or more positive results of LNSC tests may establish the diagnosis of Cushing syndrome if non-neoplastic hypercortisolism (pseudo-Cushing syndrome) is excluded. Because saliva is convenient to collect, LNSC testing is especially useful for individuals who need to provide multiple specimens over time for the evaluation of cyclic Cushing syndrome.
Annual LNSC testing is recommended to monitor for the recurrence of Cushing disease after pituitary surgery. LNSC testing may also be used in assessing treatment outcomes in patients receiving medical therapy for Cushing disease.
Non-neoplastic hypercortisolism caused by obesity, psychiatric disorders, alcohol use disorder, and polycystic ovary syndrome may increase LNSC levels. LNSC testing should not be used to screen for Cushing syndrome in individuals without normal day and night cycles. LNSC testing has low sensitivity in patients with adrenal tumors.
Other tests, such as urinary free cortisol and dexamethasone suppression test, may also be used to screen for Cushing syndrome.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
Optimal range: 0.04 - 0.56 mcg/dL
What is cortisol?
Cortisol is a crucial steroid hormone produced by the adrenal glands, involved in various vital functions including the regulation of metabolism, blood sugar levels, anti-inflammatory actions, and the body's response to stress. To gauge an individual's physiological stress levels or diurnal rhythm, saliva is often used as a non-invasive medium for measuring cortisol.
What is LC/MS?
The liquid chromatography-mass spectrometry (LC/MS) method is a preferred analytical technique for these assessments due to its high specificity and sensitivity in detecting and quantifying cortisol in saliva.
Optimal range: 0 - 0.21 mcg/dL
What is cortisol?
Cortisol is a crucial steroid hormone produced by the adrenal glands, involved in various vital functions including the regulation of metabolism, blood sugar levels, anti-inflammatory actions, and the body's response to stress. To gauge an individual's physiological stress levels or diurnal rhythm, saliva is often used as a non-invasive medium for measuring cortisol.
What is LC/MS?
The liquid chromatography-mass spectrometry (LC/MS) method is a preferred analytical technique for these assessments due to its high specificity and sensitivity in detecting and quantifying cortisol in saliva.
Optimal range: 0 - 0.15 mcg/dL
What is cortisol?
Cortisol is a crucial steroid hormone produced by the adrenal glands, involved in various vital functions including the regulation of metabolism, blood sugar levels, anti-inflammatory actions, and the body's response to stress. To gauge an individual's physiological stress levels or diurnal rhythm, saliva is often used as a non-invasive medium for measuring cortisol.
What is LC/MS?
The liquid chromatography-mass spectrometry (LC/MS) method is a preferred analytical technique for these assessments due to its high specificity and sensitivity in detecting and quantifying cortisol in saliva.
Optimal range: 0 - 0.09 mcg/dL
Quest Diagnostics Urine Markers
Quest Diagnostics provides essential urine marker tests, which are vital for diagnosing and monitoring a range of health conditions. These non-invasive tests detect substances in urine that indicate diseases such as diabetes, kidney disease, and infections, as well as drug use. They are a key component of routine health screenings, aiding in early disease detection and treatment efficacy monitoring. The accuracy and reliability of these tests play a significant role in advancing personalized medicine, ensuring tailored and effective patient care.
Optimal range: 0 - 5205 pg/mg Cr
Optimal range: 15 - 60 mcg/24h
Investigation of Wilson disease and obstructive liver disease using a 24-hour urine specimen
Optimal range: 3.1 - 42.3 mcg/L
Cortisol is a steroid hormone synthesized from cholesterol by a multienzyme cascade in the adrenal glands. It is the main glucocorticoid in humans and acts as a gene transcription factor influencing a multitude of cellular responses in virtually all tissues. Cortisol plays a critical role in glucose metabolism, maintenance of vascular tone, immune response regulation, and in the body's response to stress. Its production is under hypothalamic-pituitary feedback control
Optimal range: 2 - 130 mg/dL
Creatinine is the endproduct of creatine metabolism. Creatine is present primarily in muscle and the amount of creatinine produced is related to total skeletal muscle mass. Daily creatinine production is fairly constant except when there is massive injury to muscle. The kidneys excrete creatinine very efficiently and blood levels and daily urinary excretion of creatinine fluctuates very little in healthy normal people. Since blood and daily urine excretion of creatinine shows minimal fluctuation, creatinine excretion is useful in determining whether 24-hour urine specimens for other analytes (e.g., protein) have been completely and accurately collected.
Optimal range: 0.5 - 2.15 g/24 h
Creatinine, a key urine marker tested by Quest Diagnostics, is an important indicator of kidney function and overall renal health. It is a waste product produced by the normal metabolism of muscle tissue and is usually filtered out of the blood by the kidneys and excreted in urine.
The measurement of creatinine levels in urine is a critical component of various health assessments, particularly in evaluating kidney function. Urine creatinine helps in diagnosing kidney diseases and monitoring the effectiveness of treatment for renal disorders. The concentration of creatinine in urine can reveal how well the kidneys are functioning; unusually high or low levels can indicate renal impairment or disease. This test is often used in conjunction with other tests, such as blood creatinine levels and the calculation of creatinine clearance, to provide a more comprehensive view of kidney health.
Additionally, urine creatinine levels are used to normalize the levels of other substances in urine, providing more accurate results for tests such as urine protein. This is particularly important in drug testing, where creatinine levels are measured to ensure that urine samples have not been diluted, which could mask the presence of drugs.
Optimal range: 2.1 - 23 mg/g creat
Optimal range: 0 - 104 pg/mg Cr
Leukotriene E4 is a critical molecule in the field of immunology and inflammation. Its role in asthma, allergies, and potentially in other serious health conditions, underscores the importance of ongoing research in this area. Understanding the mechanisms of LTE4 not only contributes to better management of inflammatory diseases but also opens avenues for new therapeutic interventions in a variety of health disorders.
Optimal range: 30 - 200 mcg/g Creat.
N-methylhistamine in urine is a significant biomarker with growing interest in the medical community, particularly in the diagnosis and monitoring of mast cell activation disorders. This compound, a metabolite of histamine, provides crucial insights into the activity of mast cells within the body. Mast cells, known for their role in allergic responses, release histamine among other mediators during activation. Elevated levels of N-methylhistamine in urine can indicate increased mast cell activity, which is a characteristic feature of conditions like mastocytosis or mast cell activation syndrome (MCAS).
Optimal range: 1.7 - 6.5 mg/g Cr
Vanillylmandelic Acid (VMA) is a metabolic breakdown product of certain catecholamines, including epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine. VMA is excreted in the urine, and its measurement in a random urine sample is used in medical tests to assess the levels of these catecholamines.
Quest Diagnostics
The "Quest Diagnostics" category encompasses a wide array of medical laboratory tests and markers typically performed by Quest Diagnostics, a leading laboratory services provider. This category includes tests ranging from routine blood and urine analyses to more specialized diagnostic tests. These tests are crucial for detecting and monitoring various health conditions, including metabolic disorders, infectious diseases, cancer, and hormonal imbalances. Quest Diagnostics is known for utilizing advanced testing technologies and methodologies, ensuring accuracy and reliability in their results. This category serves as a comprehensive resource for individuals and healthcare providers looking to understand the various tests offered by Quest Diagnostics, aiding in early diagnosis, treatment planning, and ongoing health management.
Reference range: Negative, Positive
This result is a qualitative determination of autoantibodies to 21-Hydroxylase (21-OH Abs) in patient serum. 21-OH Abs occur in autoimmune Addison's disease, whether isolated or part of type I or type II autoimmune polyglandular syndrome. This result should be used in conjunction with other clinical and laboratory findings and is not a substitute for functional testing required to diagnose adrenal insufficiency.
Optimal range: 5 - 30 mcg/mL
The biomarker Acetoacetate, measured in serum or plasma (S/P) is a key component in the evaluation of ketone body levels within the human body. Acetoacetate is one of the three primary ketone bodies, alongside beta-hydroxybutyrate and acetone, produced during the process of ketogenesis, which occurs primarily in the mitochondria of liver cells. This metabolic process is triggered under conditions where glucose availability is insufficient to meet the body's energy demands, such as during prolonged fasting, carbohydrate-restricted diets, or uncontrolled diabetes mellitus.
Optimal range: 0 - 53 pmol/L
Acetylcholine receptor (AChR) antibodies are autoantibodies produced by the immune system that mistakenly target proteins called acetylcholine receptors that are located on muscles that you can consciously or voluntarily control (known as skeletal muscle fibers). This test detects and measures AChR antibodies in the blood.
Optimal range: 0.68 - 1.63 IU/ml
The ADAMTS13 activity and inhibitor assays are useful for the diagnosis of congenital or acquired form of TTP.
ADAMTS13 is a plasma protein responsible for regulating the interaction of platelets with von Willebrand factor (VWF) and physiologic proteolytic cleavage of ultra large (UL) VWF multimers at the Tyr(1605)- Met(1606) bond in the A2 domain of VWF. Reduced or absent ADAMTS13 activity can retain UL VWF that can trigger intravascular platelet aggregation and microthrombi causing clinical symptoms or signs of thrombotic thrombocytopenic purpura (TTP).
Measurement of ADAMTS13 activity and its inhibitor is crucial in the diagnosis of TTP, potentially fatal thrombotic microangiopathy (TMA) syndrome and further differentiation of congenital (Upshaw-Schulman syndrome) versus acquired (e.g. autoimmune-related disorder) etiology.
Optimal range: 85 - 156 %
This test is used for the chromogenic determination of plasmin inhibitor (alpha 2-antiplasmin) activity in human plasma. Alpha 2-antiplasmin is the major fast-acting inhibitor of the fibrinolytic enzyme plasmin and an important regulator of the fibrinolytic system.
Measurement of A2-antiplasmin provides a more complete assessment of disseminated intravascular coagulation, intravascular coagulation, fibrinolysis, and hyperfibrinolysis (primary fibrinolysis), when measured in combination with fibrinogen, D-dimers, and fibrinolysis products.
Reference range: Nuclear, membrane, Nuclear, centromere, Nuclear, homogenous, Nuclear, nucleolar, Nuclear, proliferating cell nuclear antigen (PCNA), speckled, Nuclear dots (1-6 per cell), Nuclear dots (6-20 per cell), Cytoplasmic, cytoskeletal, Cytoplasmic, golgi apparatus, Cytoplasmic, lysosomal, Cytoplasmic, mitochondrial, Cytoplasmic, ribosomal, Nuclear, Dense Fine Speckled, Cytoplasmic, Discrete Dots/GW body, Mitotic, Spindle Fibers, Nuclear, Speckled
Usually, the results of the ANA test are reported in titers and patterns. The titer gives information about how many times the lab technician diluted the blood plasma to get a sample of ANAs.
The pattern of the ANA test can give information about the type of autoimmune disease present and the appropriate treatment program
Reference range: Negative, Positive
The ANAchoice Screen is a diagnostic test The ANAchoice Screen is a diagnostic test used to detect the presence of antinuclear antibodies (ANA) in the blood. ANAs are a group of antibodies that bind to certain contents of the nucleus of the cell and are often found in patients with certain autoimmune diseases, such as systemic lupus erythematosus (SLE), Sjögren's syndrome, and rheumatoid arthritis, among others. (ANA) in the blood. ANAs are a group of antibodies that bind to certain contents of the nucleus of the cell and are often found in patients with certain autoimmune diseases, such as systemic lupus erythematosus (SLE), Sjögren's syndrome, and rheumatoid arthritis, among others.
Optimal range: 5.2 - 12.9 %
Arachidonic acid (AA) is a key omega-6 fatty acid measured in the OmegaCheck test offered by Cleveland HeartLab, which assesses cardiovascular risk based on polyunsaturated fatty acid (PUFA) status.
Optimal range: 0 - 20 SAU
Beta-2 glycoprotein 1 antibody is an autoantibody that is associated with inappropriate blood clotting. This test detects and measures one class (IgA) of beta-2 glycoprotein 1 antibodies.
Optimal range: 0 - 20 SGU
The antiphospholipid antibody syndrome (APS) is a clinical-pathologic correlation that includes a clinical event (e.g. thrombosis, pregnancy loss, thrombocytopenia) and persistent positive antiphospholipid antibodies (IgM or IgG ACA >40 MPL/GPL,IgM or IgG anti-b2GPI antibodies or a lupus anticoagulant).
Optimal range: 0 - 20 SMU
The assay contributes to the diagnosis of antiphospholipid syndrome (APS). The clinical symptoms of APS alone are not sufficiently specific to make a definitive diagnosis. Laboratory tests thus play an important role in the diagnosis of the disease. In patients with APS, autoantibodies are formed that bind to phospholipids like cardiolipin or to phospholipid-binding proteins like beta-2-glycoprotein.
Detection of these autoantibodies is an integral part of the classification criteria issued by the International Society on Thrombosis and Hemostasis.
Beta-2-glycoprotein I is a 50 KD protein cofactor required by anti-cardiolipin antibodies (ACA) to bind to cardiolipin and other phospholipid molecules.
Reference range: Not Detected, Detected
The diagnosis of cerebrospinal fluid (CSF) rhinorrhea or otorrhea (leakage of CSF into the nose or ear canal, usually as a result of head trauma, tumor, congenital malformation, or surgery) is often difficult to confirm. Traditional chemical analyses (eg, glucose, protein, specific gravity) are unreliable. Radiographic studies, especially those involving the injection of dyes or radiographic compounds, are costly and may introduce additional risks to the patient.
Optimal range: 0 - 0.28 mmol/L
Beta-Hydroxybutyrate (BHB) is a ketone body extensively measured in clinical diagnostics to assess and monitor ketosis and ketogenic states. BHB is produced in the liver from fatty acids during periods of low carbohydrate intake, fasting, prolonged exercise, or in pathological states such as diabetes mellitus. As a water-soluble molecule, BHB circulates throughout the body and can be utilized by various tissues, including the brain, as an alternative energy source when glucose availability is limited.
Optimal range: 90 - 100 %CD15s
CD15s expression (LAD 2), as part of a Leukocyte Adhesion Deficiency (CD15s, CD18) panel from Quest Diagnostics, plays a critical role in diagnosing Leukocyte Adhesion Deficiency Type II (LAD II). This condition is a rare genetic disorder that affects the immune system's ability to function properly. In healthy individuals, CD15s (also known as sialyl-Lewis X) is a specialized molecule present on the surface of white blood cells (leukocytes) that facilitates their adhesion, or sticking, to blood vessel walls during inflammation or infection. This process is essential for the immune response, as it allows leukocytes to exit the bloodstream and enter affected tissues to combat pathogens.
Optimal range: 90 - 100 %CD18
The marker "CD18 Expression (LAD 1)" on a Leukocyte Adhesion Deficiency (CD15s, CD18) panel from Quest Diagnostics is a crucial test for diagnosing Leukocyte Adhesion Deficiency Type 1 (LAD-1), a rare genetic disorder. In this condition, CD18, a protein that is part of a complex necessary for white blood cells (leukocytes) to adhere to and migrate through blood vessel walls during an immune response, is either missing or malfunctioning. CD18 expression is vital because it facilitates the process by which white blood cells exit the bloodstream to reach sites of infection, inflammation, or injury.
Optimal range: 0 - 14 pmol/L
The copeptin test is a helpful tool used by doctors to check on a specific part of our body's hormone system. Copeptin is a piece of a larger hormone called pre-provasopressin, which breaks down into three parts, including vasopressin. Vasopressin is important because it helps control how much water our bodies keep and how much we pee out. It's hard to measure vasopressin directly because it doesn't last long in our blood and is present in tiny amounts. That's where copeptin comes in – it's easier to measure and tells us how much vasopressin our body is making.
Reference range: Negative, Positive
Confirmation testing for dsDNA IgG antibodies in patients with clinical features of systemic lupus erythematosus or at-risk for disease.
Optimal range: 0 - 0.2 Ratio
The EPA (Eicosapentaenoic Acid) to Arachidonic Acid ratio is a measure often used to gauge the balance of anti-inflammatory and pro-inflammatory fatty acids in the body.
Eicosapentaenoic Acid (EPA) is an omega-3 fatty acid primarily found in fatty fish and fish oil supplements, known for its anti-inflammatory properties.
In contrast, Arachidonic Acid is an omega-6 fatty acid found in animal products and some vegetable oils, which can give rise to pro-inflammatory eicosanoids when metabolized.
Optimal range: 0 - 357 pg/mL
Optimal range: 0 - 60 pg/mL
Fungitell®, an FDA cleared and CE marked diagnostic test, is used for the detection of (1→3)-β-D-Glucan, which is frequently associated with the presence of fungal pathogens. The majority of these are Candida and Aspergillus species.
Optimal range: 7 - 20.5 U/g Hgb
Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme essential for energy production and found in all cells, including red blood cells (RBCs), where it safeguards them from toxic by-products of metabolism. A G6PD deficiency, a genetic disorder affecting over 400 million people worldwide, can lead to RBCs becoming susceptible to breaking apart (hemolysis), particularly when triggered by factors like stress, infections, drugs, or certain substances, like fava beans.
Optimal range: 7 - 20.5 U/g Hgb
GLUCOSE-6-PHOSPHATE DEHYDROGENASE helps red blood cells (RBCs) function normally. It also protects them from potentially harmful byproducts that can accumulate when your body is fighting infection or as the result of certain medications. A lack of GLUCOSE-6-PHOSPHATE DEHYDROGENASE may make RBCs more vulnerable to breaking down in a process called hemolysis.
Optimal range: 0 - 5 IU/ml
This test is intended for the semiquantitative determination of glutamic acid decarboxylase (GAD) antibody in human serum; it is useful as an aid in the diagnosis of type 1 diabetes mellitus (autoimmune mediated diabetes).
Optimal range: 0 - 2 mcg/mL
Gluten (F79) IgG is a specific immunoglobulin G antibody marker used in the immunological assessment of gluten sensitivity and related disorders. This antibody targets a fraction of gluten proteins, primarily found in wheat and related grains, and its presence in the bloodstream can be indicative of an immune response to gluten ingestion.
Reference range: Not Detected, Detected
The Helicobacter Pylori Ag, EIA, STOOL test by Quest Diagnostics is a non-invasive diagnostic tool used to detect H. pylori antigens in stool samples. H. pylori is a bacteria linked to peptic ulcers, chronic gastritis, and stomach cancer. The test involves analyzing a stool sample using enzyme immunoassay (EIA) to identify the presence of the bacteria. A positive result indicates an active infection, necessitating antibiotic treatment, while a negative result suggests no current infection. This test is highly sensitive, specific, and suitable for all age groups, providing critical information for early detection and treatment of H. pylori infections.
Reference range: Not detected, Detected
The urea breath test can be used to aid in the diagnosis of H pylori infection. The test can also be used to assess therapy when it is administered more than a month after completion of therapy.
Reference range: Negative, Positive
The Hexagonal Phase Confirm test is a specific laboratory test used to detect lupus anticoagulant (LA), which is a type of antibody associated with antiphospholipid syndrome and other autoimmune disorders. The term "Hexagonal Phase" refers to a particular method of confirming the presence of LA. This test is part of a broader Lupus Anticoagulant Evaluation which may include various other tests to assess for the presence of these antibodies because they show a great deal of heterogeneity.
Optimal range: 0 - 1.8 ng/mL
Useful for evaluating for diseases of immediate hypersensitivity or mast cell proliferation (mastocytosis). Histamine is one of the major mediators of allergic reactions. Some carcinoid tumors, particularly of gastric origin, produce and release excessive histamine. Symptoms of flushing, itching, urticaria, vomiting, syncope or shock assumed to be due to histamine release, which coincides with increased urine of plasma levels. Systemic mastocytosis or basophilia can produce persistent elevations in plasma or urine histamine concentrations.
Optimal range: 50 - 300 mg/dL
Immunoglobulin M (IgM), which is found mainly in the blood and lymph fluid, is the first antibody to be made by the body to fight a new infection. Expressed on the surface of B cells (monomer) and in a secreted form (pentamer) with very high avidity (forms multiple binding sites with antigen). Eliminates pathogens in the early stages of B-cell mediated (humoral) immunity before there is sufficient IgG.
Optimal range: 4 - 86 mg/dL
IgG immunoglobulins are composed of four subtypes named IgG1, IgG2, IgG3 and IgG4. Each subclass is present in the serum in different concentrations, varies with age, and has different roles for immune response. Abnormal levels of one or more subclasses may be associated with certain conditions.
This marker helps to evaluate sinopulmonary infections, asthma; immunotherapy hyposensitization; and allergies.
Optimal range: 0.4 - 1.8 mmol/L
Lactic acid is a metabolite produced during anaerobic metabolism in muscle cells, especially during intense physical activity. It serves as an energy source, helps maintain blood sugar levels, and plays a critical role in various metabolic processes. Monitoring lactic acid levels in plasma is a vital tool in diagnosing and managing various medical conditions, providing valuable insights into a patient's overall health and metabolic status.
Optimal range: 0.5 - 76.3 mIU/ml
Optimal range: 0.6 - 1.2 mmol/L
The lithium blood test measures the amount of lithium in your bloodstream to ensure levels stay within a safe and effective range. Lithium is a mood stabilizer commonly used to treat bipolar disorder and mania, but it has a narrow therapeutic window—meaning too little may be ineffective, while too much can be toxic. Regular monitoring helps adjust the dose, prevent side effects, and guide treatment decisions. Lithium is processed by the kidneys and affected by factors like hydration, sodium levels, and overall kidney function. Symptoms such as fatigue, tremors, nausea, or confusion may signal levels that are too high or too low, making this test essential for safe and successful long-term treatment.
Optimal range: 0 - 20 u
Liver Kidney Microsomal (LKM-1) Antibody (IgG)
The presence of LKM-1 antibodies can be used in conjunction with clinical findings and other laboratory tests to aid in the diagnosis of autoimmune liver diseases such as autoimmune hepatitis (AIH-2).
Optimal range: 0 - 0.01 Units
Optimal range: 0 - 57 pg/mL , 0 - 0.34 nmol/L
To help diagnose or rule out a rare tumor of the adrenal gland called a pheochromocytoma or a rare tumor occurring outside the adrenal glands called a paraganglioma; these tumors (PPGL) produce excess hormones called catecholamines, which are broken down to metanephrines.
Optimal range: 0 - 20 U/mL
Mutated citrullinated vimentin (MCV) antibody is a specific type of autoantibody that has gained attention in the context of rheumatology, particularly in the diagnosis and management of rheumatoid arthritis (RA). Citrullination is a post-translational modification of proteins, which is a normal process in cell death and differentiation.
Optimal range: 0 - 10.8 ng/mL
Neuron-specific enolase (NSE) is an enzyme that is found in the cytoplasm of neurons and neuroendocrine cells. The production of NSE occurs late in neural differentiation, thus making NSE an index of neural maturation.
Reference range: NONE DETECTED, DETECTED
Neutrophil Antibody, Flow Cytometry - Neutrophil Antibody has been observed with neonatal alloimmune neutropenia, autoimmune neutropenia, transfusion reactions, and drug-induced neutropenia.
The "Neutrophil Antibody, Flow Cytometry - Neutrophil Antibody" test on a panel from Quest Diagnostics is a specialized diagnostic tool used to detect antibodies that target neutrophils, which are a type of white blood cell crucial for our immune defense against infections. Neutrophil antibodies can lead to various conditions, including autoimmune neutropenia—where the immune system mistakenly attacks and destroys neutrophils, reducing the body's ability to fight off infections. This test is particularly useful in diagnosing immune-related neutropenia, monitoring the severity of the autoimmune response, and guiding treatment decisions in conditions where neutrophil antibodies may be involved.
Optimal range: 0 - 148 pg/mL , 0 - 0.87 nmol/L
Normetanephrine is an important metabolite of norepinephrine and serves as a marker for the activity of the sympathetic nervous system. Measuring normetanephrine levels can provide valuable information for diagnosing and managing certain medical conditions associated with sympathetic nervous system dysfunction.
Optimal range: 0 - 253 pg/mL
NT-proBNP is a diagnostic screening tool to differentiate between people with normal and reduced left ventricular systolic function.
- N-terminal (NT)-pro hormone BNP (NT-proBNP) is a non-active prohormone that is released from the same molecule that produces BNP.
- B-type natriuretic peptide (BNP) is a hormone produced by your heart.
- Both BNP and NT-proBNP are released in response to changes in pressure inside the heart. These changes can be related to heart failure and other cardiac problems.
Levels goes up when heart failure develops or gets worse, and levels goes down when heart failure is stable. In most cases, BNP and NT-proBNP levels are higher in patients with heart failure than people who have normal heart function.
Optimal range: 0 - 0 nmol/ML
Reference range: Optimal, Moderate, High
Risk: Optimal > 3.2%; Moderate 2.2-3.2%; High < 2.2%
The Omega-3 Index test by Quest Diagnostics measures the levels of omega-3 fatty acids in the serum, with a focus on eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are expressed as a percentage of phospholipid fatty acids. A diet rich in these omega-3 fatty acids is linked to a reduced risk of cardiovascular events, including sudden cardiac death. The Omega-3 Index is used as an indicator of risk for such events and as a therapeutic target. Additionally, a higher EPA/Arachidonic Acid ratio, which is also measured in this test, is associated with a lower risk of cardiac issues.
Optimal range: 1.4 - 4.9 %
The Omega-3 Index is a crucial biomarker that measures the levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), two essential omega-3 fatty acids, in your red blood cell membranes. Expressed as a percentage, this index helps assess your overall omega-3 status and its potential impact on your health.
Optimal range: 5.7 - 21.3 Ratio
Omega-6:Omega-3 ratio is calculated by dividing the sum of all the omega-6 fatty acids by the sum of all the omega-3 fatty acids.
Omega 6 and 3 are two essential fats that are categorized as polyunsaturated fatty acids, or PUFAs for short. These fats are essential since we lack the ability to make them in our bodies and must obtain them from food or supplements. Once ingested, our body uses these fats to create other types of fats with important biological and health-promoting roles.
Omega 6 and 3 have many biological roles, including cell structure as well as eye and brain development, but are probably best known for their role in inflammation. In general, omega 6 fats are considered pro-inflammatory, while omega 3 fats are considered anti-inflammatory. However, both omega 6 and omega 3 fats can promote and inhibit the body’s inflammatory response, although omega 6 appears to produce a greater inflammatory response compared to omega 3. On the other hand, DHA and EPA can turn off the body’s inflammatory response and even influence certain genes to halt the production of inflammatory molecules.
Optimal range: 16 - 77 pg/mL , 1.68 - 8.11 pmol/L
Parathyroid Hormone (PTH), Intact, plays a crucial role in maintaining a delicate balance in our body's calcium and phosphorus levels, directly impacting bone health. This hormone, produced by the parathyroid glands located behind the thyroid gland in the neck, regulates calcium levels in the blood by influencing bone remodeling, the process where old bone tissue is replaced by new. When calcium levels drop, PTH is secreted, increasing calcium absorption in the intestines, reducing its excretion by the kidneys, and stimulating the release of calcium from bones. This function is vital as calcium is essential for many bodily functions, including nerve signaling, muscle contraction, and blood clotting.
Optimal range: 22 - 34 seconds
Optimal range: 0 - 22 mcg/mL
The Penicillium Chrysogenum/Notatum IgG Test provides valuable insights into mold exposure and its potential health impacts. However, results should be interpreted cautiously and in conjunction with clinical symptoms and environmental assessments. This test is one tool among many in diagnosing and managing mold-related health conditions, helping healthcare providers make informed decisions about patient care and environmental safety.
Optimal range: 22 - 237 ng/dL
Pregnenolone is a chemical substance that is a precursor to all steroid hormones.
Optimal range: 0 - 0.3 ng/mL
Optimal range: 0 - 175 ng/g creatinine
Prostaglandin D2 (PGD2) is a bioactive lipid compound that plays a significant role in various physiological and pathological processes within the human body. It belongs to the family of prostaglandins, which are a group of physiologically active lipid compounds having diverse hormone-like effects in animals. PGD2 itself is produced primarily by mast cells, which are cells involved in the immune response, and it is derived from arachidonic acid through the action of the enzyme prostaglandin D synthase. This compound has several important roles, including the mediation of allergic responses and inflammation. In the context of allergies, PGD2 can cause symptoms such as bronchoconstriction and vasodilation. It's also involved in the regulation of sleep-wake cycles and acts as a neuromodulator in the brain.
Optimal range: 200 - 400 pg/mL
Prostaglandins are lipid autacoids derived from arachidonic acid. They both sustain homeostatic functions and mediate pathogenic mechanisms, including the inflammatory response.
Optimal range: 35 - 115 pg/mL
Optimal range: 80 - 240 pg/mL
Optimal range: 0 - 20 G units
Reference range: Optimal, Moderate, High
Optimal range: 63 - 160 mcg/dL
Selenium, a trace element essential for human health, plays a critical role in various physiological processes and is commonly assessed through its concentration in serum. As an integral component of selenoproteins, selenium is pivotal in antioxidant defense systems, thyroid hormone metabolism, and immune function. The primary dietary sources of selenium include nuts, cereals, meat, fish, and eggs, with its bioavailability influenced by soil composition and dietary factors. Serum selenium levels are reflective of both short-term and long-term selenium status, offering a reliable biomarker for nutritional assessment. The typical reference range for serum selenium varies, but is generally considered to be between 70 and 150 ng/mL.
Optimal range: 0 - 20.1 u
Anti-soluble liver antigen antibodies are detected in 10% - 30% of patients with type 1 autoimmune hepatitis (AIH), but not in patients with type 2 AIH, primary sclerosing cholangitis or primary biliary cirrhosis.
Optimal range: 8 - 25 ng/dL
T3 Reverse, measured through the highly accurate LC/MS/MS (Liquid Chromatography with Tandem Mass Spectrometry) method, is an essential test in the realm of endocrinology, particularly for evaluating thyroid function and metabolic disorders. Reverse T3 (rT3) is a specific form of the thyroid hormone that is often checked in patients with suspected thyroid dysfunction, especially in the context of non-thyroidal illness syndrome or euthyroid sick syndrome.
Optimal range: 2.3 - 4.2 pg/mL
Optimal range: 373 - 838 uM
Glutathione is an antioxidant, a type of chemical which helps to boost your immune system as well as prevent and reverse cellular damage. Unlike most antioxidants which come from the food you eat, glutathione is naturally produced by the body in the liver. Glutathione plays a number of roles in overall health including boosting the immune system, helping to break down nutrients in food, and protecting against chronic diseases such as Alzheimer's, Parkinsons, diabetes, some types of cancer, and heart disease.
Optimal range: 0 - 205 pg/mL
The marker "Total, Free (MN+NMN)" typically refers to the measurement of both metanephrine (MN) and normetanephrine (NMN) levels in a biological sample, such as blood or urine. These two compounds, metanephrine and normetanephrine, are metabolites of catecholamines, specifically epinephrine and norepinephrine. Measuring their levels can provide important diagnostic information related to the functioning of the sympathetic nervous system and the presence of certain medical conditions.
Optimal range: 0 - 10.99 mcg/L
Tryptase is an enzyme that is released, along with histamine and other chemicals, from mast cells when they are activated as part of a normal immune response as well as in allergic (hypersensitivity) responses.
Optimal range: 0 - 140 %
TSI stands for thyroid stimulating immunoglobulin. TSIs are antibodies that tell the thyroid gland to become more active and release excess amounts of thyroid hormone into the blood. A TSI test measures the amount of thyroid stimulating immunoglobulin in your blood.
Optimal range: 31.01 - 86 pg/mL
What is the VEGF test?
This test measures the amount of vascular endothelial growth factor (VEGF) in your blood. VEGF is a substance that helps encourage the growth of new blood vessels. Your body makes more VEGF in certain cases. For instance, if your tissues aren't getting enough oxygen, they may make more VEGF so that new blood vessels grow to bring in more oxygen. Your lungs contain VEGF because good blood flow is vital there.
But VEGF also plays a role in cancer growth. Cancers need an ample blood supply. As a tumor grows larger, its cells need more oxygen from the blood. The cancer encourages new blood vessels to grow to supply it with more blood and oxygen. Most tumors show higher levels of VEGF. Sometimes higher levels mean a lower chance of survival. In addition, VEGF may be important in the spread of cancer to other places within your body. Certain cancer treatments target VEGF. This test may be used to tell how well the treatments are working.
VEGF can also promote "leakiness" of blood vessels. This can lead to swelling in surrounding areas. This can be especially harmful during brain cancer because it can increase pressure within the skull and may lead to brain damage. Leaking blood vessels in the eye causing problems is also seen in age-related macular degeneration and eye changes from diabetes.
Normal concentrations of VEGF do not exclude the diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome.
Early Sjogrens Syndrome Profile
Sjögren syndrome is an autoimmune disease characterized by lymphocyte infiltration of exocrine glands, which manifests as dry eyes and mouth. The syndrome is estimated to be between 9 and 20 times more common in women than in men and typically presents in the 4th or 5th decade of life. The disease can present by itself (primary) or in association with another underlying autoimmune condition (secondary), commonly rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). Sjögren syndrome may occur as part of a triad that includes primary biliary cirrhosis (PBC) and autoimmune thyroid disease. Patients with Sjögren's syndrome also have an overall increased risk for malignancies, specifically non-Hodgkin lymphoma and thyroid cancer.
Sjogren's syndrome (SS) is a systemic disease in which loss of salivary gland and lachrymal gland function is associated with hypergammaglobulinemia, autoantibody production, mild kidney and lung disease and eventually lymphoma. SS involves dry eyes and dry mouth without systemic features that may be either primary or secondary to another autoimmune disease, such as SLE. Patients with SS and picked up at a late stage in their disease, after the salivary glands and lachrymal glands are already destroyed, because they are asymptomatic until that time. At this point, only symptomatic treatment can be offered for abnormal lachrymal and salivary gland function. The diagnosis for SS is currently at a crossroad with the American College of Rheumatology providing which requires characteristic autoantibodies (SS-A/SS-B) or minor salivary gland biopsy. Since lip biopsies are not frequently performed in clinical practice, there is increased emphasis placed on autoantibodies in diagnosis. The current Ro and La antibodies can delay the diagnosis by over 6 years. Recently novel antibodies have been identified: salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA6) and parotid secretory protein (PSP) using western blot methodology. Further studies have shown that the isotype differentiation of the markers adds to the sensitivity of diagnosis of SS. These autoantibodies occurred earlier in the course of the disease than antibodies to Ro or La. In addition antibodies to SP-1, CA-6 and PSP were found in patients meeting the criteria for SS who lacked antibodies to Ro or La. Furthermore, in patients with idiopathic xerostomia and xerophthalmia for less than 2 years, 76% had antibodies to SP-1 and/or CA6 while only 31% had antibodies to Ro or La.
Antibodies to different isotypes (IgG, IgM & IgA of SP-1, CA6 and PSP are useful markers for identifying patients with SS at early stages of the disease or those that lack antibodies to either Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
Optimal range: 0 - 20 EU/ml
The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La.
BORRELIOSIS - Lyme Disease
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 40 titer
The Lyme Immunoflourescence Assay (IFA) detects antibodies (IgG IgM, IgA) against B. burgdorferi in a patient's serum. Therefore, it is useful as a screening test at all stages of the disease.
IgM-specific antibodies are usually high during the early (or active) stage of the disease; and in some patients IgM may persist for a long time. Antibody levels tends to rise above background levels within 2-3 weeks after an infection. IgG appears later in the disease, but may remain present in low levels long after the disease is cured.
Borrelia burgdorferi is a pathogenic spirochete responsible for Lyme disease via a tick vector. This spirochete causes a characteristic annular rash, arthritis, carditis, and in late stages, encephalopathy.
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
BORRELIOSIS- Relapsing Fever Borrelia
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
Optimal range: 0 - 0.01 Positive / Negative
ANAPLASMOSIS
Anaplasmosis is a disease caused by the bacterium Anaplasma phagocytophilum. These bacteria are spread to people by tick bites primarily from the blacklegged tick (Ixodes scapularis) and the western blacklegged tick (Ixodes pacificus).
People with anaplasmosis will often have fever, headache, chills, and muscle aches. Doxycycline is the drug of choice for adults and children of all ages with anaplasmosis.
Optimal range: 0 - 40 titer
Anaplasmosis is a tick-borne infection that can sometimes be severe or fatal. Anaplasmosis is caused by the bacteria, Anaplasma phagocytophilum. It cannot be spread from person-to-person. You may develop anaplasmosis if you are bitten by an infected blacklegged tick.
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An "Indeterminate" result (where result falls in the "orange" reference range) on an HGA IFA - IgG test, suggests that the detected levels of IgG antibodies are neither clearly positive nor negative. This ambiguous result can occur in various scenarios, such as during the early stages of infection when antibody levels are rising, during the resolution phase of a past infection when antibody levels are declining, or due to cross-reactivity with antibodies from similar infections. It poses interpretation challenges and often necessitates further evaluation considering the clinical context, including symptoms and history of tick exposure. In some cases, repeat testing after a period may be required to monitor changes in antibody levels, thereby aiding in clarifying the diagnosis. This indeterminate result highlights the complexity of diagnosing anaplasmosis solely based on serological testing and underscores the need for a comprehensive clinical assessment.
Optimal range: 0 - 20 titer
The HGA (Human Granulocytic Anaplasmosis) IFA (Indirect Fluorescent Antibody) - IgM test on an Anaplasmosis panel is a crucial diagnostic tool for the detection of acute Human Granulocytic Anaplasmosis, a tick-borne disease caused by the bacterium Anaplasma phagocytophilum. This test specifically measures the presence of Immunoglobulin M (IgM) antibodies, which are the first type of antibody produced by the immune system in response to an infection. The presence of IgM antibodies specific to A. phagocytophilum indicates a recent or acute infection, as these antibodies typically become detectable within the first few weeks after exposure and generally peak within a month before gradually declining.
Bartonellosis
Bartonellosis is a term for diseases caused by Bartonella, a type of bacteria that can infect both humans and animals. One of the most common forms of Bartonellosis is Cat Scratch Disease, which you can get from the scratch or bite of an infected cat. It often causes swollen lymph nodes, fever, and sometimes a blister or a small bump at the site of the scratch or bite.
Another type is Trench Fever, spread by body lice, and can cause fever, headaches, and pain in the legs. There's also Carrion's disease, found mainly in the Andes mountains, which can cause severe anemia and fever.
These diseases usually aren't serious and can get better on their own, but sometimes, especially in people with weak immune systems, they can be more severe and need treatment with antibiotics. It's important to avoid getting bitten or scratched by animals and to keep good hygiene to lower the risk of getting Bartonellosis.
Optimal range: 0 - 40 titer
Optimal range: 0 - 20 titer
Reference range: Negative, Indeterminate, Positive
Reference range: Negative, IND, Positive
Reference range: Negative, Indeterminate, Positive
Reference range: Negative, IND, Positive
Reference range: Negative, Positive
The Bartonella henselae antibody (IgG) screen is a serological test used to detect the presence of IgG antibodies against Bartonella henselae, the bacterium responsible for Cat Scratch Disease (CSD).
This screening test is essential in the diagnostic workup of patients presenting with symptoms suggestive of CSD, such as prolonged fever, lymphadenopathy, and in some cases, more severe complications like bacillary angiomatosis or neuroretinitis. The IgG antibodies typically develop a few weeks after the initial infection and can persist in the body for a long time, potentially indicating either a past or an ongoing infection.
Reference range: <1:64, =>1:64
Bartonella henselae antibody (IgG) testing is a critical diagnostic tool for identifying past or chronic infection with Bartonella henselae, the bacterium primarily responsible for causing Cat Scratch Disease (CSD).
This test measures the level of immunoglobulin G (IgG) antibodies specific to B. henselae in a patient's blood.
IgG antibodies against this pathogen typically develop several weeks after the initial infection and can persist in the body for a long period, sometimes even for years.
Reference range: Negative, Positive
Bartonella henselae antibody (IgM) testing plays a crucial role in the serological diagnosis of acute infections caused by Bartonella henselae, the bacterium responsible for Cat Scratch Disease (CSD) and other associated conditions. IgM antibodies are the first type of antibodies produced by the immune system in response to an infection. In the context of B. henselae exposure, the detection of IgM antibodies is particularly significant as it often indicates a recent or ongoing infection. The IgM response typically develops within a few days to weeks following the initial exposure to the pathogen and can provide early diagnostic clues before the appearance of IgG antibodies.
Reference range: Negative, Indeterminate, Positive
Bartonella quintana (IgG) is an antibody marker that indicates past exposure or infection with the bacterium Bartonella quintana, which is the cause of trench fever. This disease is primarily transmitted to humans through body lice. The presence of IgG antibodies against B. quintana in the blood suggests that the individual has been exposed to the bacteria at some point in the past, leading the immune system to produce these specific antibodies. However, IgG antibodies usually appear several weeks after infection and can remain in the blood for months to years, indicating that the infection might not be active. Symptoms of B. quintana infection can include recurrent fever, headache, rash, and bone pain. Diagnosing B. quintana typically involves a combination of clinical evaluation, serological tests (like detecting IgG), and sometimes PCR testing to detect the bacteria's DNA. Treatment generally includes antibiotics, such as doxycycline, to effectively manage the infection.
Reference range: Negative, IND, Positive
Bartonella quintana (IgM) is a specific antibody marker that indicates a recent or active infection with the bacteria Bartonella quintana, which is responsible for diseases such as trench fever. The presence of IgM (immunoglobulin M) antibodies in the blood signifies that the immune system has recently encountered the bacteria, suggesting an early stage or acute infection. Bartonella quintana is typically transmitted through body lice, and infections can lead to symptoms like fever, headaches, muscle pain, and, in some cases, more severe conditions like endocarditis or chronic bacteremia. Detecting B. quintana (IgM) helps healthcare providers diagnose the infection early and start appropriate antibiotic treatments to manage and resolve the infection effectively.
Reference range: Negative, Positive
The Bartonella quintana antibody (IgG) screen is a serological test designed to detect the presence of immunoglobulin G (IgG) antibodies specific to Bartonella quintana, a bacterium known for causing trench fever, bacillary angiomatosis, and endocarditis, particularly in immunocompromised individuals.
This test plays a critical role in the diagnostic process, especially in patients presenting with symptoms consistent with these conditions, such as prolonged fever, body aches, and in more severe cases, vascular lesions or heart valve infection.
The presence of B. quintana IgG antibodies indicates that the individual has been exposed to the bacterium, with their immune system generating a response.
Reference range: Negative, Positive
Bartonella quintana antibody (IgM) testing is an important diagnostic tool used to detect acute infections caused by Bartonella quintana, a bacterium associated with several serious conditions, including trench fever, bacillary angiomatosis, and endocarditis. The presence of IgM antibodies against B. quintana in a patient's blood is a key indicator of recent or ongoing infection. IgM is the first class of antibodies the body produces in response to an infection.
Reference range: Negative, Indeterminate, Positive
Reference range: Negative, IND, Positive
Optimal range: 0 - 0.01 Positive / Negative
Reference range: Negative, Indeterminate, Positive
The Bartonella genus (IgG) marker test is an integral component of the diagnostic panel for Bartonellosis, a group of infectious diseases caused by various species within the Bartonella genus, such as Bartonella henselae and Bartonella quintana. This serological assay is specifically designed to detect Immunoglobulin G (IgG) antibodies directed against Bartonella antigens in the patient's serum. IgG antibodies are the most abundant type of antibody found in blood circulation and are primarily responsible for long-term immunity and pathogen neutralization. The presence of IgG antibodies to Bartonella typically indicates either a past infection or a chronic, ongoing infection, as these antibodies generally develop several weeks post-infection and can persist for months or years.
Reference range: Negative, Indeterminate, Positive
Bartonellosis, a group of infectious diseases caused by bacteria of the Bartonella genus, can be diagnosed using serological panels that include the Bartonella genus (IgM) marker test. This test is designed to detect Immunoglobulin M (IgM) antibodies in the blood, which are produced by the immune system as an early response to a Bartonella infection. Bartonella species, including Bartonella henselae and Bartonella quintana, are known to cause diseases such as cat scratch disease, trench fever, and bacillary angiomatosis.
Reference range: Negative, IND, Positive
Reference range: Negative, Indeterminate, Positive
Reference range: Negative, Indeterminate, Positive
The Bartonella species (IgG) marker on a Bartonellosis panel plays a pivotal role in the serological diagnosis of infections caused by various Bartonella species, which include notable pathogens like Bartonella henselae and Bartonella quintana. This test specifically targets Immunoglobulin G (IgG) antibodies, which are produced by the immune system as a later response to an infection. IgG antibodies typically develop within a few weeks post-exposure and can persist for months or years, providing long-term immunity and indicating either past exposure or a chronic infection.
Reference range: Negative, Indeterminate, Positive
The Bartonella species (IgM) marker, a crucial element in the diagnostic panel for Bartonellosis, is designed to detect specific Immunoglobulin M (IgM) antibodies in the bloodstream, targeting various Bartonella species, including common pathogens like Bartonella henselae and Bartonella quintana. IgM antibodies are the initial type of antibody that the immune system produces in response to an infection. Their presence in the blood usually indicates a recent or acute infection with Bartonella, as these antibodies typically appear within a few days to a week following exposure and can remain detectable for several months thereafter.
Rickettsiosis
Rickettsiosis is a term for a group of diseases caused by a type of bacteria called Rickettsia, which are often spread by ticks, fleas, and lice. The most well-known of these diseases is Rocky Mountain spotted fever, which is transmitted by tick bites and can cause symptoms like a high fever, headache, and a rash that starts on the wrists and ankles and then spreads. Another common rickettsial disease is typhus, which can be spread by fleas or lice and often causes high fever, headache, and a rash that typically starts on the body and spreads outwards. These diseases can be serious, but they can usually be treated effectively with antibiotics if they're caught early. It's important to prevent rickettsiosis by avoiding tick and flea bites, using insect repellent, and staying away from areas where these insects live. If you think you might have been bitten by a tick and start to feel sick, it's important to see a doctor right away, especially if you develop a fever or rash.
Optimal range: 0 - 40 titer
The R. rickettsii IFA - IgG marker on a Rickettsiosis panel is a crucial diagnostic tool for identifying infection with Rickettsia rickettsii, the bacterium responsible for Rocky Mountain spotted fever (RMSF), a potentially severe tick-borne illness. This serological test detects Immunoglobulin G (IgG) antibodies that the immune system produces specifically in response to an R. rickettsii infection. IgG antibodies are part of the body's later immune response, typically developing a few weeks after initial exposure to the pathogen and potentially persisting for years, thus indicating either past exposure or chronic infection.
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An "Indeterminate" result (if result falls in orange reference range) in the R. rickettsii IFA - IgG test indicates that the detected levels of IgG antibodies against Rickettsia rickettsii, the causative agent of Rocky Mountain spotted fever (RMSF), are unclear and do not conclusively fall within the defined positive or negative ranges. This ambiguous result can be due to several reasons. It might suggest that the antibody levels are at a borderline range, possibly indicating an early immune response where the antibodies are just starting to develop and have not reached a level high enough to be considered positive. Alternatively, it could be a sign of declining antibody levels from a past infection that is resolving or has already resolved, where the antibodies are present but at diminishing levels. An indeterminate result can also arise from technical issues in the test procedure or cross-reactivity with antibodies from other similar infections. In such cases, further evaluation is necessary, often including a clinical assessment of symptoms, patient history, and possibly additional diagnostic tests, such as a repeat IgG test after some time or other serological tests like IgM testing. This indeterminate outcome highlights the complexity of diagnosing RMSF based solely on serological testing and underscores the importance of a comprehensive clinical assessment to accurately determine the infection status.
Optimal range: 0 - 40 titer
The R. typhi IFA - IgG marker on a Rickettsiosis panel is a specialized diagnostic tool used for the detection of IgG antibodies against Rickettsia typhi, the causative agent of murine typhus. This serological assay plays a critical role in the diagnosis of the disease, particularly in epidemiological settings where murine typhus is prevalent. IgG antibodies are a key component of the adaptive immune response, typically developing within a few weeks following exposure to a pathogen and persisting for an extended period, thereby indicating past exposure or a possible chronic infection.
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An "Indeterminate" result (a result that falls within the orange reference range) in the R. typhi IFA - IgG test signifies that the levels of IgG antibodies against Rickettsia typhi, the bacterium responsible for murine typhus, are ambiguous and do not clearly fall into the positive or negative categories. This uncertain result can occur for several reasons. It may indicate that the antibody levels are at a borderline, possibly suggesting an early stage of the immune response where antibodies are just starting to develop but haven't reached a definitive positive level. Alternatively, it could be a sign of declining antibody levels from a past infection that is resolving or has already resolved, where the antibodies are present but at diminishing levels. Technical factors within the test itself or cross-reactivity with antibodies from other similar pathogens can also contribute to an indeterminate result. In such cases, further evaluation is often necessary, including a clinical assessment of symptoms, patient history, and possibly additional diagnostic tests, such as a repeat IgG test after some time or IgM testing. This indeterminate outcome emphasizes the need for a comprehensive approach in diagnosing murine typhus, considering serological results alongside the broader clinical picture to accurately determine the infection status.
Corona Virus COVID-19
Coronavirus Disease 2019 or COVID-19 (formally known as 2019-nCoV) is the name for the respiratory syndrome caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Reference range: Positive, Negative
Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China.
Optimal range: 0 - 0.99 index
The SARS-CoV-2 IgG assay is intended for qualitative and semi-quantitative detection of IgG antibodies to the S1 receptor binding domain (RBD) of the SARS-CoV-2 spike protein. The measurement of IgG levels can provide insight to an individual's adaptive immune response to a SARS-CoV-2 infection or vaccination. Although the assay is designed to assess the level of an individual's immune response, studies are still needed to determine the index level threshold that confers protective immunity as well as how long the adaptive immune response may last post-infection or via vaccination.
Optimal range: 0 - 0.8 ug/ml
Qualitative and semi-quantitative detection of antibodies to SARS-CoV-2 spike protein receptor binding domain (RBD). Aid in identifying individuals with an adaptive immune response to SARS-CoV-2, indicating recent or prior infection. to SARS-CoV-2 spike protein receptor binding domain (RBD). Aid in identifying individuals with an adaptive immune response to SARS-CoV-2, indicating recent or prior infection.
Estrogens and Metabolites (Urine) - DUTCH
Estrogen is a key anabolic hormone, meaning it promotes growth and development in the body.
There are three primary forms of estrogen:
Estrone (E1) – weaker, but still biologically active
Estradiol (E2) – the most potent and biologically active form, responsible for most estrogen effects
Estriol (E3) – weaker, plays a bigger role in vaginal and urinary tract health
In Women:
In premenopausal women, most estrogen is produced in the ovaries.
Smaller amounts are created by converting testosterone into estrogen through a process called aromatization.
After menopause, estrogen production shifts almost entirely to aromatization.
The enzyme responsible for aromatization is found in fat tissue, the brain, gonads, blood vessels, skin, and bone.
In Men:
Men produce estrogen mainly through aromatization of testosterone.
Men’s estrogen levels are much lower than those of cycling women—but interestingly, men often have higher estrogen levels than postmenopausal women.
Estrogen plays a role in multiple systems of the body:
Reproductive health:
Supports the growth of female secondary sex characteristics
Thickens the uterine lining for implantation
Increases vaginal acidity (protects against infection)
Maintains vaginal lubrication (E3 is especially important here)
Bone health: Maintains bone density and strength
Brain function:
Helps regulate body temperature
Protects against memory decline
Increases serotonin and serotonin receptors
Skin and connective tissue:
Supports collagen production
Maintains skin thickness
Improves blood flow to the skin
Cardiovascular protection: Helps protect against atherosclerosis
When your body makes estrogen, it eventually needs to break it down and eliminate it.
This happens in the liver through phase 1 and phase 2 detoxification, producing intermediate forms called metabolites.
In phase 1, estrone (E1) and estradiol (E2) are converted into three main metabolites:
2-OH-E1 – considered the “safer” metabolite; weakly stimulates cell growth and may even help inhibit it
4-OH-E1 – can damage DNA; linked to higher cancer risk
16-OH-E1 – more estrogenic; can contribute to symptoms of estrogen dominance
Typical healthy distribution of phase 1 metabolites:
70% → 2-OH-E1
10% → 4-OH-E1
20% → 16-OH-E1
Unbalanced ratios—especially high 4-OH-E1—may increase health risks in both men and women.
After phase 1, metabolites move into phase 2 detoxification, specifically methylation.
Methylation neutralizes the potentially harmful phase 1 metabolites, preparing them for safe elimination instead of allowing them to recirculate in the body.
Only 2-OH and 4-OH metabolites can be methylated.
16-OH-E1 is not methylated and is eliminated through other pathways.
By measuring estrogens and their metabolites, the DUTCH test can:
Assess overall estrogen production
Determine how your body is processing estrogen through phase 1 and phase 2 detoxification
Identify unfavorable metabolism patterns that may contribute to symptoms or long-term health risks
Guide targeted support for liver detoxification and hormone balance
Optimal range: 0.7 - 2.6 ng/mg
16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. It is a potent estrogen similarly to estrone, and it has been suggested that the ratio of 16α-hydroxyestrone to 2-OH-E1, the latter being much less estrogenic in comparison and even antiestrogenic in the presence of more potent estrogens like estradiol, may be involved in the pathophysiology of breast cancer. Conversely, 16α-hydroxyestrone may help to protect against osteoporosis.
Optimal range: 0.2 - 0.6 ng/mg
16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. It is a potent estrogen similarly to estrone, and it has been suggested that the ratio of 16α-hydroxyestrone to 2-OH-E1, the latter being much less estrogenic in comparison and even antiestrogenic in the presence of more potent estrogens like estradiol, may be involved in the pathophysiology of breast cancer. Conversely, 16α-hydroxyestrone may help to protect against osteoporosis.
Optimal range: 2.5 - 6.5 ng/mg
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1.
2-Methoxy-E1 has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy-E1 levels were lower in breast cancer patients than controls.
Optimal range: 0.3 - 1.4 ng/mg
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1.
2-Methoxy-E1 has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy-E1 levels were lower in breast cancer patients than controls.
Optimal range: 0 - 0.7 ng/mg
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy estrogens are produced from 2-OH estrogens through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH estrogens and particularly 2-Methoxy estrogens.
2-Methoxy estrogens has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy estrogen levels were lower in breast cancer patients than controls.
Optimal range: 0 - 0.4 ng/mg
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy estrogens are produced from 2-OH estrogens through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH estrogens and particularly 2-Methoxy estrogens.
2-Methoxy estrogens has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy estrogen levels were lower in breast cancer patients than controls.
Optimal range: 5.1 - 13.1 ng/mg
Most consider 2-OH-E1 favorable
Estrogen is metabolized (primarily by the liver) down three phase I pathways. The 2-OH pathway is considered the safest because of the anti-cancer properties of 2-OH metabolites. Conversely, the 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA. The third pathway, 16-OH creates the most estrogenic of the metabolites (although still considerably less estrogenic than estradiol) - 16-OH-E1.
Optimal range: 0.3 - 2 ng/mg
Most consider 2-OH-E1 favorable
Estrogen is metabolized (primarily by the liver) down three phase I pathways. The 2-OH pathway is considered the safest because of the anti-cancer properties of 2-OH metabolites. Conversely, the 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA. The third pathway, 16-OH creates the most estrogenic of the metabolites (although still considerably less estrogenic than estradiol) - 16-OH-E1.
Optimal range: 0 - 1.2 ng/mg
Research and clinical studies show that the 2-hydroxylated estrogens (2-OH E2 and 2-OH E1) are a safer pathway of hydroxylation than the 4-hydroxyestrogens (4-OH E2 and 4-OH E1), which bind to and damage DNA, leading to mutations that are associated with increased breast cancer risk.
Optimal range: 0 - 0.3 ng/mg
Research and clinical studies show that the 2-hydroxylated estrogens (2-OH E2 and 2-OH E1) are a safer pathway of hydroxylation than the 4-hydroxyestrogens (4-OH E2 and 4-OH E1), which bind to and damage DNA, leading to mutations that are associated with increased breast cancer risk.
Optimal range: 0 - 1.8 ng/mg
- The 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA.
- Estrone is hydroxylated through Phase 1 detox to form 4-OH-E1. In Phase 2 it is methylation to form 4-MeE1. When 4-OH-E1 is properly methylated to 4-MeE1 it is relatively benign as the 4-MeE1 is easily eliminated and risks are low.
- When it is not methylated 4-OH-E1 builds up. Then it converts to 3,4-Quinones which are carcinogenic similarly to the 16 pathway. Women with uterine fibroids may have increased levels of 4-OH-E1. High levels of estrogen across the board are associated with heavy cycles.
Optimal range: 0 - 0.3 ng/mg
- The 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA.
- Estrone is hydroxylated through Phase 1 detox to form 4-OH-E1. In Phase 2 it is methylation to form 4-MeE1. When 4-OH-E1 is properly methylated to 4-MeE1 it is relatively benign as the 4-MeE1 is easily eliminated and risks are low.
- When it is not methylated 4-OH-E1 builds up. Then it converts to 3,4-Quinones which are carcinogenic similarly to the 16 pathway. Women with uterine fibroids may have increased levels of 4-OH-E1. High levels of estrogen across the board are associated with heavy cycles.
Optimal range: 0 - 0.5 ng/mg
4 hydroxy estrone (4-OH-E1) and estradiol (4-OH-E2) are metabolites of estrone and estradiol and are very reactive estrogens. They are highly prone to the formation of catechol estrogen-derived 3,4 semi-quinones, which are potent, electrophilic, free radical-generating molecules that have been shown to lead to DNA mutagenesis. Indeed, 4 hydroxy E1 and E2 are the most potent and potentially carcinogenic estrogens.
Optimal range: 0 - 0.1 ng/mg
4 hydroxy estrone (4-OH-E1) and estradiol (4-OH-E2) are metabolites of estrone and estradiol and are very reactive estrogens. They are highly prone to the formation of catechol estrogen-derived 3,4 semi-quinones, which are potent, electrophilic, free radical-generating molecules that have been shown to lead to DNA mutagenesis. Indeed, 4 hydroxy E1 and E2 are the most potent and potentially carcinogenic estrogens.
Optimal range: 1.8 - 4.5 ng/mg
The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.
Optimal range: 0.2 - 0.7 ng/mg
The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.
Optimal range: 5 - 18 ng/mg
Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Optimal range: 0.6 - 4 ng/mg
Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Optimal range: 12 - 26 ng/mg
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, since it is the least powerful of the three estrogen types, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers and estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 1 - 7 ng/mg
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, largely due to the fact that it is the least powerful of the three types of estrogen, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers as well as estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 35 - 70 ng/mg
Total Estrogen measures the combined levels of estradiol (E2), estrone (E1), and estriol (E3). These hormones support reproductive function, bone strength, brain health, and cardiovascular protection. Abnormal levels may indicate menopause, pregnancy, or hormone imbalances. While levels are lower in men, estrogen balance remains important for overall health.
Optimal range: 4 - 15 ng/mg
Total estrogen is a reliable test for estrogen status and is used to detect hormone imbalances.
Estrogen is known as the “female” hormone. The four major naturally occurring estrogens in women are estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4).
Progesterone Metabolites (Urine) - DUTCH
Progesterone is a key reproductive hormone that plays a central role in menstrual cycle health, fertility, and hormonal balance.
In women, progesterone is secreted in significant amounts only after ovulation during the luteal phase.
One of its main roles is to balance the effects of estrogen—helping support a healthy uterine lining, stabilizing mood, and promoting overall well-being.
Adequate luteal-phase progesterone levels are essential for successful implantation and pregnancy.
Only a very small amount of parent progesterone appears in urine.
Instead, the DUTCH test measures progesterone metabolites, which are breakdown products of progesterone in the body.
These metabolites provide a reliable estimate of circulating progesterone.
Advantages of urinary metabolites over single-time blood or saliva tests:
A serum or saliva test shows progesterone at a single moment.
A urinary metabolite result reflects an average production since the last urination, offering a broader view of hormone activity.
Progesterone is metabolized primarily through two pathways:
5α-pregnanediol – the “alpha” pathway
5β-pregnanediol – the “beta” pathway
Key points:
In most women, each pathway accounts for about half of progesterone metabolism.
Some women show a pathway preference, favoring alpha or beta more strongly.
Hormonal patterns can influence this preference:
PCOS: Women often push testosterone toward the alpha pathway (making more potent DHT) and tend to also push progesterone toward 5α-pregnanediol.
Hypothyroidism: Often associated with a heavier preference for the 5β-pregnanediol pathway.
Both progesterone metabolites measured by the DUTCH test have been shown to correlate well with serum progesterone values, making them a reliable reflection of luteal-phase hormone production.
Knowing your progesterone metabolite levels helps determine:
Whether ovulation has occurred
If luteal-phase progesterone levels are sufficient to support fertility
How your body’s metabolism may be influencing hormone balance
This information is especially important when evaluating menstrual irregularities, fertility concerns, perimenopause changes, or hormone therapy outcomes.
Optimal range: 200 - 740 ng/mg
This test measures pregnanediol, a metabolite of progesterone. It is used in the evaluation and decision making in women who are having difficulty becoming pregnant or maintaining a pregnancy. It is also used to monitor “high-risk” pregnancies.
Optimal range: 580 - 3000 ng/mg
This test measures pregnanediol, a metabolite of progesterone. It is used in the evaluation and decision making in women who are having difficulty becoming pregnant or maintaining a pregnancy. It is also used to monitor “high-risk” pregnancies.
Optimal range: 15 - 50 ng/mg
This test measures pregnanediol, a metabolite of progesterone. It is used in the evaluation and decision making in women who are having difficulty becoming pregnant or maintaining a pregnancy. It is also used to monitor “high-risk” pregnancies.
Optimal range: 600 - 2000 ng/mg
Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.
Optimal range: 2000 - 9000 ng/mg
Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.
Optimal range: 60 - 200 ng/mg
Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.
Optimal range: 50 - 150 %
Normally, cortisol levels rise within 10 to 30 minutes of waking to help boost energy levels and then drop throughout the day. This is known as the cortisol awakening response (CAR).
Androgens and Metabolites (Urine) - DUTCH
The Androgens and Metabolites section of the DUTCH test by Precision Analytical evaluates how your body produces and processes key sex hormones, particularly DHEA, testosterone, and their metabolites.
It focuses on three main areas:
Total DHEA production
Testosterone levels
Metabolic pathway preference – whether your body favors 5α (alpha) or 5β (beta) metabolism
DHEA (Dehydroepiandrosterone) is a precursor hormone produced by the adrenal glands and is essential for making both testosterone and estrogen.
To assess total DHEA output, the DUTCH test adds up three primary urinary metabolites:
DHEA-S (DHEA sulfate – the storage form of DHEA)
Etiocholanolone (a 5β metabolite)
Androsterone (a 5α metabolite)
Looking at all three together provides a more complete picture of daily DHEA production than measuring a single marker.
Example: If total DHEA output is high but DHEA-S is low, it may indicate that inflammation or other factors are blocking the sulfation process (the conversion of DHEA into its storage form, DHEA-S). This highlights why multiple DHEA markers are evaluated rather than relying on just one.
The DUTCH test measures testosterone directly in urine and also looks at three downstream metabolites:
5α-DHT (dihydrotestosterone – a highly potent androgen)
5α-Androstanediol
5β-Androstanediol
These metabolites help determine how your body is processing testosterone and whether more of it is being converted into the powerful androgen DHT.
Your body breaks down androgens through two main pathways:
5α pathway (alpha) → Produces androsterone and leads toward DHT formation. These metabolites are more androgenic (stronger effects).
5β pathway (beta) → Produces etiocholanolone, which is less androgenic (weaker effects).
If androsterone is high and etiocholanolone is low, it suggests a 5α-dominant metabolism, meaning your body favors making DHT.
This can occur even if overall androgen levels are normal or low. For example, in women with PCOS, elevated insulin can push testosterone metabolism toward the 5α pathway, increasing DHT production. Because DHT is about three times more potent than testosterone, symptoms like thinning scalp hair, facial hair growth, and acne can develop.
DHEA output is assessed by adding DHEA-S, androsterone, and etiocholanolone.
Testosterone metabolism is tracked by measuring testosterone and its 5α and 5β metabolites.
5α dominance means your body is more likely to produce potent androgens like DHT, which can cause stronger hormonal effects and symptoms.
Even low overall androgen levels can result in high DHT activity if the 5α pathway is favored.
Optimal range: 6 - 30 ng/mg
5a-Androstanediol is a testosterone metabolite that is more androgenic than b-Androstanediol. It is metabolized via the 5-alpha metabolic pathway (= increased 5α-reductase activity). In contrast, the 5-beta metabolism makes androgens less potent.
Increased 5a-reductase activity may be accompanied by clinical signs of androgenicity (excess facial hair growth, scalp hair loss, acne, irritability, oily skin, prostate issues in men...etc).
Optimal range: 30 - 250 ng/mg
Optimal range: 0 - 6.6 ng/mg
5a-DHT is a testosterone metabolite.
5a-DHT is essential for the development of the male sex characteristics before birth, particularly the formation of the external genitalia. In the adult, 5a-DHT is needed to develop and maintain male gender characteristics, such as facial hair, deep voice, and muscle growth. In women, 5a-DHT may induce the onset of puberty and causes the body and pubic hair growth.
Increased 5a-DHT levels are found in about 40% of patients with idiopathic hirsutism and 35% of patients with polycystic ovarian syndrome (=PCOS).
Optimal range: 5 - 25 ng/mg
5a-DHT is a testosterone metabolite.
5a-DHT is essential for the development of the male sex characteristics before birth, particularly the formation of the external genitalia. In the adult, 5a-DHT is needed to develop and maintain male gender characteristics, such as facial hair, deep voice, and muscle growth. In women, 5a-DHT may induce the onset of puberty and causes the body and pubic hair growth.
Increased 5a-DHT levels are found in about 40% of patients with idiopathic hirsutism and 35% of patients with polycystic ovarian syndrome (=PCOS).
Optimal range: 20 - 75 ng/mg
5b-Androstanediol is a testosterone metabolite that is less androgenic than 5a-DHT and 5a-Androstanediol. It is metabolized via the 5-beta metabolic pathway. In contrast, the 5-alpha metabolism makes androgens more potent (= increased 5α-reductase activity).
Optimal range: 40 - 250 ng/mg
5b-Androstanediol is a testosterone metabolite that is less androgenic than 5a-DHT and 5a-Androstanediol. It is metabolized via the 5-beta metabolic pathway. In contrast, the 5-alpha metabolism makes androgens more potent (= increased 5α-reductase activity).
Optimal range: 200 - 1650 ng/mg
Androsterone is a DHEA metabolite via the 5-alpha-reductase pathway. The 5-alpha pathway is more androgenic.
Optimal range: 500 - 3000 ng/mg
Androsterone and Etiocholanolone are DHEA metabolites via Androstenedione and the 5α- and 5β-reductase pathways.
Optimal range: 20 - 750 ng/mg
DHEA-S is the sulfate ester of DHEA and only a part of DHEA testing. If this marker was low it would mean that there is potential inflammation blocking DHEA being converted to DHEA-S.
Optimal range: 30 - 1500 ng/mg
DHEA is produced in the adrenal glands and is a precursor to both testosterone and estrogen.
Optimal range: 2.3 - 14 ng/mg
Epi-Testosterone is one of several naturally-occurring testosterone compounds in the body that act as steroids.
Optimal range: 25 - 115 ng/mg
Epi-Testosterone is one of several naturally-occurring testosterone compounds in the body that act as steroids.
Optimal range: 200 - 1000 ng/mg
Etiocholanolone is a DHEA metabolite that is excreted in the urine. It is produced from androstenedione and the 5-beta-reductase metabolic pathway. It is helpful in evaluating adrenal and androgen function.
Optimal range: 400 - 1500 ng/mg
Etiocholanolone is an androstenedione and testosterone metabolite that is excreted in the urine. It is produced from androstenedione and the 5-alpha and 5-beta-reductase metabolic pathways. It is helpful in evaluating adrenal and androgen function.
Optimal range: 2.3 - 14 ng/mg
Testosterone is the major androgen in the body. It is converted to dihydrotestosterone by 5-alphareductase, and to estradiol by aromatase.
Optimal range: 25 - 115 ng/mg
Testosterone is the major androgen in the body. It is converted to dihydrotestosterone by 5-alphareductase, and to estradiol by aromatase.
Optimal range: 400 - 3000 ng/mg
DHEA is often called the anti-aging hormone. It’s made in the adrenal glands naturally and levels hit their peak in your 20s. They start to dwindle after you hit 30. Estrogen and testosterone are created from DHEA.
Creatinine (Urine) - DUTCH
In this section of the DUTCH test, you’ll see your creatinine values from all four urine samples collected throughout the day.
Creatinine is measured for one important reason: to correct hormone results for urine dilution.
The concentration of hormones in urine can vary depending on how diluted your sample is.
If you are well-hydrated, your urine is more diluted, and hormone concentrations appear lower.
If you are dehydrated, your urine is more concentrated, and hormone levels may appear higher.
Creatinine correction adjusts for these differences. Because creatinine is excreted at a relatively steady, predictable rate in healthy individuals, it serves as a reliable reference point to “normalize” your results, regardless of hydration.
The DUTCH test uses creatinine correction to make its spot urine samples comparable to the gold standard: a 24-hour urine collection.
A 24-hour urine test captures hormone excretion over an entire day but can be difficult for patients to complete correctly.
Research shows that when a 24-hour urine collection is done properly, creatinine-corrected DUTCH values match closely with 24-hour urine hormone results. This correlation supports the accuracy and validity of creatinine correction in the DUTCH method.
Abnormal kidney function (such as impaired creatinine clearance or low glomerular filtration rate – GFR) can affect creatinine levels and, therefore, the accuracy of correction.
Any urine hormone test (DUTCH or 24-hour) should not be used to assess free cortisol in patients with significantly reduced kidney function, as results may appear artificially low.
Proper hydration and following collection instructions closely help ensure more accurate results.
Creatinine correction accounts for urine dilution, making hormone measurements more reliable.
It allows spot urine samples from the DUTCH test to be compared to 24-hour urine results.
Kidney health plays a role in creatinine accuracy—results may be skewed if creatinine clearance or GFR is abnormal.
Optimal range: 0.2 - 2 mg/ml
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Optimal range: 0.2 - 2 mg/ml
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Optimal range: 0.2 - 2 mg/ml
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Optimal range: 0.2 - 2 mg/ml
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Daily Free Cortisol and Cortisone + Metabolites (Urine) - DUTCH
This section of the DUTCH test evaluates your body’s daily stress hormone patterns by measuring free cortisol, free cortisone, and their metabolites.
It answers five key questions:
What is the overall free cortisol pattern across the day?
What is the total free cortisol for the day?
What is your Cortisol Awakening Response (CAR)?
What is the total amount of cortisol metabolites?
Does your body prefer to produce active cortisol or inactive cortisone?
The Cortisol Awakening Response reflects how sharply cortisol rises in the first 30–40 minutes after waking.
Normal pattern: Cortisol peaks shortly after waking, then gradually declines through the day, reaching its lowest point at night.
CAR calculation: The difference between your waking cortisol sample and the one collected 30–40 minutes later.
Why it matters:
Low or flat CAR may suggest low HPA axis activity (underactive stress response) and can be linked to fatigue, burnout, sleep disorders, PTSD, and certain chronic illnesses.
High CAR can indicate an overactive HPA axis, often associated with stress, inflammation, pain, or blood sugar instability.
You can view your CAR visually in the cortisol chart in your DUTCH report.
Free cortisol – the biologically active stress hormone circulating in your system (~1% of total cortisol).
Free cortisone – the inactive form of cortisol.
Cortisol metabolites – breakdown products representing over 70% of total cortisol output. These are often the best indicators of overall adrenal gland activity.
The DUTCH test not only measures totals but also determines metabolic preference:
Cortisol preference → more active hormone in circulation
Cortisone preference → more hormone is converted into the inactive form for excretion
1. Low free cortisol + low metabolites
→ Suggests low overall cortisol production (possible adrenal insufficiency or suppressed HPA axis).
2. Low free cortisol + high metabolites
→ Indicates increased cortisol clearance (seen in obesity or hyperthyroidism, including overtreatment with thyroid medication).
3. High cortisol all day
→ May require evaluation for Cushing’s disease or adrenal/pituitary tumors.
4. High morning cortisol + high metabolites, but normal evening levels
→ HPA axis is overactive early in the day, not necessarily due to tumors. Often linked to chronic stress.
5. High evening cortisol
→ Suggests disrupted HPA axis rhythm and may require lifestyle or therapeutic interventions to support healthy cortisol decline.
6. Low free cortisol + flat pattern + high metabolites with cortisone preference
→ Your body produces cortisol but quickly deactivates it into cortisone. Seen in obesity or hyperthyroidism.
7. High-normal free cortisol + high CAR + cortisol metabolite preference
→ May occur in inflammation, low thyroid function, or certain adrenal conditions. The body produces cortisol but struggles to deactivate it.
THF (tetrahydrocortisol) = active cortisol metabolite
THE (tetrahydrocortisone) = inactive cortisone metabolite
In general:
If cortisol is low → better to lean toward cortisol preference
If cortisol is high → better to lean toward cortisone preference to avoid excessive active hormone effects
If topical hydrocortisone cream is applied (especially at night), it can artificially elevate evening cortisol results.
If cortisone levels rise along with cortisol: This is likely true physiological production.
If cortisone stays low: The spike in cortisol may be due to topical cream contamination.
The DUTCH test evaluates both free and metabolized cortisol to give a full picture of stress hormone production and clearance.
The Cortisol Awakening Response offers insights into your HPA axis health and stress resilience.
Metabolic preference (cortisol vs cortisone) helps explain whether your body is activating or deactivating cortisol more aggressively.
Results must be interpreted in context, especially if kidney function, topical steroid use, or other medical conditions are factors.
Optimal range: 65 - 200 ug
Cortisol is a steroid produced and secreted by the adrenal glands.
A very small percentage of cortisol is free and unbound, while the remaining is in transition. The human body produces cortisol first, and then different glands have the ability to keep it as cortisol or convert it into cortisone, which is biologically inactive.
The biomarker 24hr Free Cortisol is the sum of your free cortisol measurements throughout one day. In the DUTCH test those individual measurements are labeled as:
- Cortisol (Waking)
- Cortisol B (Morning)
- Cortisol C (Afternoon)
- Cortisol D (Night)
If you add those four readings together you get your 24hr Free Cortisol reading.
Optimal range: 220 - 450 ug
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Optimal range: 75 - 370 ng/mg
This is one of the three cortisol metabolites. The total some of the three cortisol metabolites gives us a good indication of the overall cortisol production in your body.
Two of the 3 metabolites are the active form of cortisol (THF). The other metabolite is in the inactive form cortisone.
This particular marker (a-THF) hence is an active cortisol metabolite.
Optimal range: 175 - 700 ng/mg
Metabolized cortisol is the sum of a-tetrahydrocortisol (a-THF), b-tetrahydrocortisol (b-THF), and b-tetrahydrocortisone (b-THE). They are a good indication of the total cortisol output from the adrenal gland or clearance out the body.
Optimal range: 1050 - 2500 ng/mg
B-Tetrahydrocortisol [aka 5-beta-Tetrahydrocortisol (5b-THF)] is a metabolite of cortisol.
Tetrahydrocortisone, Tetrahydrocortisol and Allo-Tetrahydrocortisol are cortisol metabolites that reflect approximately 50% of daily cortisone synthesis. These will often reflect a chronic adrenal picture if levels are out of normal limits.
Urine contains free cortisol, but it also contains many cortisol metabolites, like cortisone or 5-alpha- tetrahydrocortisol, 5-beta-tetrahydrocortisol, tetrahydrocortisone, etc.
Optimal range: 1750 - 4000 ng/mg
B-Tetrahydrocortisol [aka 5-beta-Tetrahydrocortisol (5b-THF)] is a metabolite of cortisol.
Tetrahydrocortisone, Tetrahydrocortisol and Allo-Tetrahydrocortisol are cortisol metabolites that reflect approximately 50% of daily cortisone synthesis. These will often reflect a chronic adrenal picture if levels are out of normal limits.
Urine contains free cortisol, but it also contains many cortisol metabolites, like cortisone or 5-alpha- tetrahydrocortisol, 5-beta-tetrahydrocortisol, tetrahydrocortisone, etc.
Optimal range: 1550 - 3800 ng/mg
This is one of the three cortisol metabolites. The total some of the three cortisol metabolites gives us a good indication of the overall cortisol production in your body.
Two of the 3 metabolites are the active form of cortisol (THF). The other metabolite is in the inactive form cortisone.
This particular marker (b-THE) hence is an inactive cortisol metabolite.
Optimal range: 2350 - 5800 ng/mg
This is one of the three cortisol metabolites. The total some of the three cortisol metabolites gives us a good indication of the overall cortisol production in your body.
Two of the 3 metabolites are the active form of cortisol (THF). The other metabolite is in the inactive form cortisone.
This particular marker (b-THE) hence is an inactive cortisol metabolite.
Optimal range: 10 - 50 ng/mg
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Dutch test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Cortisol A (Waking)
- Cortisol B (Morning)
- Cortisol C (Afternoon)
- Cortisol D (Night)
When you are looking at Cortisol A (Waking) it is essential to also look at Cortisol B (Morning). The difference between those 2 cortisol samples is called the cortisol awakening response (or CAR).
An elevated CAR would mean that the difference between those 2 markers is really big.
Different possible reasons for an elevated CAR:
- an overactive HPA axis (=plays an important role in the stress response), ongoing job-related stress (anticipatory stress for the day)
- blood sugar dysregulation
- pain (i.e. waking with painful joints or a migraine),
- and general depression (not Seasonal affective disorder/”winter depression”)
Neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) does. So this means that if your morning free cortisol reading spikes up high first thing in the morning, there is something to look at. Is there an overactivity to stress? Are you anticipating a stressful day at work? If your morning free cortisol levels are high, this can be due to stress or anticipating stress.
Optimal range: 30 - 130 ng/mg
This is the 2nd cortisol sample of the day. Usually measured 30 to 60 minutes after waking.
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Dutch test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Cortisol A (Waking)
- Cortisol B (Morning)
- Cortisol C (Afternoon)
- Cortisol D (Night)
When you are looking at Cortisol B (Morning) it is essential to also look at Cortisol A (Waking). The difference between those 2 cortisol samples is called the cortisol awakening response (or CAR).
An elevated CAR would mean that the difference between those 2 markers is really big.
Different possible reasons for an elevated CAR:
- an overactive HPA axis (=plays an important role in the stress response), ongoing job-related stress (anticipatory stress for the day)
- blood sugar dysregulation
- pain (i.e. waking with painful joints or a migraine),
- and general depression (not Seasonal affective disorder/”winter depression”)
Neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) does. So this means that if your morning free cortisol reading spikes up high first thing in the morning, there is something to look at. Is there an overactivity to stress? Are you anticipating a stressful day at work? If your morning free cortisol levels are high, this can be due to stress or anticipating stress.
Optimal range: 7 - 30 ng/mg
This is the 3rd cortisol sample of the day. Usually measured in the afternoon.
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Dutch test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Cortisol A (Waking)
- Cortisol B (Morning)
- Cortisol C (Afternoon)
- Cortisol D (Night)
Optimal range: 6 - 12.5 Rate
Optimal range: 0 - 14 ng/mg
This is the 4th cortisol sample of the day (=evening/night).
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Dutch test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Cortisol A (Waking)
- Cortisol B (Morning)
- Cortisol C (Afternoon)
- Cortisol D (Night)
Optimal range: 40 - 120 ng/mg
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Cortisone A (Waking) can help to confirm the marker Cortisol A (Waking).
Optimal range: 90 - 230 ng/mg
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Cortisone B (Morning) can help to confirm the marker Cortisol B (Morning).
Optimal range: 32 - 95 ng/mg
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Cortisone C (Afternoon) can help to confirm the marker Cortisol C (Afternoon).
Optimal range: 0 - 55 ng/mg
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Cortisone D (Night) can help to confirm the marker Cortisol D (Night).
Optimal range: 2750 - 6500 ng/mg
Metabolized Cortisol is the sum of a-THF, b-THF and b-THE (the most abundant cortisol metabolites).
While free cortisol is the best assessment for tissue levels of cortisol, it only represents 1-3% of the total produced. The majority of cortisol results in a urine metabolite and the total of these metabolites best represents the total glandular output (=from glands) of cortisol for the day.
Optimal range: 4550 - 10000 ng/mg
Metabolized cortisol best reflects total cortisol production.
Optimal range: 0.4 - 1.5 ng/mL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0 - 0.9 ng/mL
The test also offers an optional Insomnia Cortisol measurement, which is particularly relevant for individuals experiencing sleep disturbances. This additional salivary sample, known as the "Insomnia Sample," is collected in the middle of the night when the patient is struggling to sleep. It's designed to determine cortisol’s potential role in sleep disturbances.
Elevated cortisol levels during this period can suggest that cortisol imbalances may be contributing to insomnia. This measurement provides valuable additional information about cortisol’s potential causal role in sleep disturbances.
Optimal range: 0 - 0.9 ng/mL
This measurement offers valuable additional information about cortisol’s potential causal role in sleep disturbances.
When people suffer from insomnia, the 5 salivary cortisol measurements on the DUTCH Plus may not be enough to assess cortisol’s potential role in the sleep disturbances. This additional marker can give you insight into cortisol levels during the night.
Optimal range: 0 - 0.9 ng/mL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 3.7 - 8.2 ng/mL
This is the 2nd cortisol sample of the day. Usually measured 30 to 60 minutes after waking.
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Dutch test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Cortisol A (Waking)
- Cortisol B (Morning)
- Cortisol C (Afternoon)
- Cortisol D (Night)
When you are looking at Cortisol B (Morning) it is essential to also look at Cortisol A (Waking). The difference between those 2 cortisol samples is called the cortisol awakening response (or CAR).
An elevated CAR would mean that the difference between those 2 markers is really big.
Different possible reasons for an elevated CAR:
- an overactive HPA axis (=plays an important role in the stress response), ongoing job-related stress (anticipatory stress for the day)
- blood sugar dysregulation
- pain (i.e. waking with painful joints or a migraine),
- and general depression (not Seasonal affective disorder/”winter depression”)
Neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) does. So this means that if your morning free cortisol reading spikes up high first thing in the morning, there is something to look at. Is there an overactivity to stress? Are you anticipating a stressful day at work? If your morning free cortisol levels are high, this can be due to stress or anticipating stress.
Optimal range: 2.3 - 5.3 ng/mL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 1.6 - 4.6 ng/mL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 9.6 - 19.3 ng/mL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 2 - 7.1 ng/mL
Optimal range: 0 - 4.8 ng/mL
The Saliva Cortisone - Extra 1 marker on the DUTCH Plus panel from Precision Analytical is a specific test that measures the level of cortisone in saliva. Cortisone is a hormone produced by the body as a metabolite of cortisol, which is often referred to as the "stress hormone." Cortisol plays a crucial role in helping the body respond to stress, regulate metabolism, reduce inflammation, and assist with memory formulation. It is produced by the adrenal glands, which are small glands located above each kidney. In the body, cortisol is converted into cortisone by an enzyme called 11β-Hydroxysteroid dehydrogenase. By measuring cortisone levels in the saliva, the test provides insights into the functioning of this enzyme and the adrenal glands' activity.
Optimal range: 0 - 4.8 ng/mL
The marker "Saliva Cortisone - Insomnia" provides a unique and insightful perspective into the complex relationship between cortisol metabolism and sleep disorders, such as insomnia. Cortisone, measured through saliva in this context, is a less active metabolite of cortisol, the primary stress hormone produced by the adrenal glands. Cortisol is crucial for various bodily functions, including the regulation of sleep-wake cycles, blood sugar levels, inflammation, and the body’s response to stress. In individuals with insomnia, cortisol levels can be dysregulated, leading to an imbalance that affects sleep quality and duration.
Optimal range: 0 - 4.8 ng/mL
Optimal range: 12.4 - 19.4 ng/mL
Optimal range: 9.4 - 15.3 ng/mL
Optimal range: 6.8 - 14.5 ng/mL
Optimal range: 36 - 55 ng/mL
Saliva Cortisone Total on a DUTCH (Dried Urine Test for Comprehensive Hormones) test measures the overall amount of cortisone present in saliva over a specified period, usually a day. Cortisone is a metabolite of cortisol, the body's primary stress hormone, produced by the adrenal glands. This measurement is crucial in assessing adrenal gland function and the body's stress response. Unlike single-point measurements, the total cortisone level provides a broader view of how cortisone levels fluctuate and are maintained throughout the day, offering insights into the health of the hypothalamic-pituitary-adrenal (HPA) axis and the body’s circadian rhythm.
Nutritional Organic Acids (Urine) - DUTCH
The Nutritional Organic Acids section of the DUTCH test measures organic acids in urine that act as functional indicators of nutrient status.
When the body is low in certain vitamins, amino acids, or antioxidants at the cellular level, related organic acids can build up and be excreted in urine.
In some cases, these functional markers are more reliable than measuring the nutrient directly in blood, because they reflect how well your body is actually using the nutrient—not just how much is circulating.
Methylmalonate (MMA)
Marker for vitamin B12 status.
High levels may indicate a cellular B12 deficiency, even if blood B12 appears normal.
B12 is essential for nerve health, DNA synthesis, and red blood cell formation.
Xanthurenate
Linked to vitamin B6 status.
Elevated levels suggest impaired B6-dependent enzyme function, often related to inflammation or poor amino acid metabolism.
B6 is needed for neurotransmitter production and hormone balance.
Kynurenate
Also influenced by vitamin B6 status and tryptophan metabolism.
Imbalances in kynurenate may reflect inflammation, immune activation, or mood-related changes.
β-Hydroxyisovalerate
Functional marker for biotin (vitamin B7) deficiency.
Biotin supports energy metabolism, hair/skin health, and gene regulation.
Pyroglutamate
Associated with glutathione status.
Low or high levels may indicate depletion of glutathione—the body’s “master antioxidant” important for detoxification, immune defense, and reducing oxidative stress.
Indican
Marker of gut microbial activity.
Elevated levels can signal protein putrefaction in the gut, often due to dysbiosis or poor protein digestion.
By measuring these organic acids, the DUTCH test can:
Detect hidden nutrient deficiencies before they show up on standard blood tests.
Identify metabolic imbalances linked to inflammation, poor detoxification, or gut dysbiosis.
Provide actionable guidance for targeted dietary, supplement, and lifestyle interventions.
Optimal range: 0 - 8.8 ng/mg
8-OHdG measures the effect of endogenous oxidative damage to DNA. The marker is used to estimate the risk for various cancers and degenerative diseases. Adjusting treatments and lifestyle to minimize the presence of 8-OHdG is a productive step toward health and longevity.
Optimal range: 0 - 12.5 ug/mg
Elevated b-hydroxyisovalerate is found as a result of biotin insufficiency. This issue often presents in patients as skin problems as well as hair loss. Look for this DUTCH test marker to assess biotin status and determine if intervention is required. Adequate biotin supply will yield a lower level of b-hydroxyisovalerate.
Optimal range: 0 - 18 ug/mg
b-Hydroxyisovalerate is made when the body is deficient in biotin. This marker has an inverse relationship with biotin, therefore elevated levels represent deficiencies in biotin. Biotin is an important cofactor in mitochondrial function, metabolism of fatty acids, glucose, and protein, as well as ROS production. Reactive oxygen species (= ROS) are generated during mitochondrial oxidative metabolism as well as in cellular response to xenobiotics, cytokines, and bacterial invasion. Oxidative stress refers to the imbalance due to excess ROS or oxidants over the capability of the cell to mount an effective antioxidant response.
Biotin deficiency has similar symptoms as other B-vitamin deficiencies but is most often associated with hair loss. Factors that influence biotin levels include inadequate dietary intake, long-term and high-dose B5 supplementation, dysbiosis/gut health, antibiotic use, medications, and biotinidase deficiency.
Optimal range: 4 - 16 ug/mg
Homovanillate (HVA) is the primary metabolite of dopamine, a brain and adrenal neurotransmitter that comes from tyrosine (with BH4 and iron as co-factors). Dopamine goes on to create norepinephrine and epinephrine (= adrenaline).
Low levels of dopamine are associated with depression, addictions, cravings, apathy, pleasure seeking behaviors, increased sleepiness, impulsivity, tremors, low motivation fatigue and low mood.
High levels of dopamine are associated with agitation, insomnia, mania, hyperactivity, hyper-focus, high stress, anxiety and addictions/ cravings/ pleasure seeking (to maintain high levels).
High Homovanillate (HVA) can be caused by the use of the following supplements, foods or medications within 72 hours of collecting urine samples: tyrosine, phenylalanine, mucuna, quercetin, bananas, avocados as well as parkinson's medications.
If these are being used, the HVA on the DUTCH test may not accurately reflect circulating dopamine levels and should be disregarded.
Optimal range: 0 - 100 ug/mg
Indican is an indole produced when bacteria in the intestine act on the amino acid, tryptophan. Most indoles are excreted in the feces.
The remainder is absorbed, metabolized by the liver, and excreted as indicanin the urine.
Accumulated levels of Indican in the urine may suggest gastrointestinal dysbiosis or malabsorption.
Optimal range: 0 - 131 ug/mg
Indican is a byproduct of tryptophan putrefaction by microbes in the gut. Accumulated levels of indican in the urine suggest higher levels of tryptophan putrefaction from gastrointestinal dysbiosis or malabsorption.
Production of indican occurs when tryptophan creates indoles in the colon. No other endogenous indoles are metabolized in this way, so when we see indican in the urine, it is directly related to gut production and a direct reflection of gut health. When there is concern of dysbiosis, there may be poor metabolism of sex hormones (including estrogen) along with chronic low-grade inflammation that can impact cortisol production and metabolism.
Optimal range: 0.8 - 4.5 ug/mg
Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 1 - 6.6 ug/mg
Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine. These products of amino acid breakdown cannot be further metabolized in the absence of vitamin B6.
Optimal range: 0 - 2.5 ug/mg
The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.
Optimal range: 0 - 3.5 ug/mg
The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.
Optimal range: 28 - 58 ug/mg
Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Optimal range: 38 - 83 ug/mg
Pyroglutamate is an intermediate in glutathione recycling and production. Glutathione requires the amino acids cysteine, glycine and glutamate for production. If the body cannot convert pyroglutamate forward to glutathione, it will show up elevated in the urine. High pyroglutamate is an established marker for glutathione deficiency. Remember that glutathione is one of the most potent antioxidants in the human body and is especially important in getting rid of toxins including the reactive quinone species formed by 4-OH-E1 and 4-OH-E2. This reactive species can damage DNA if not detoxified by either methylation or glutathione.
Optimal range: 0 - 12.5 ug/mg
Quinolinate is a neurotoxin derived from tryptophan. Elevated quinolinate is seen in brain and nerve tissue damage, especially in disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, motor neuron diseases, multiple sclerosis, epilepsy, amyotrophic lateral sclerosis, and major depressive disorder. We can also see elevated quinolinate due to low serotonin and need for vitamin B3 (niacin). The causes of elevated quinolinate include neuroinflammation, general inflammation, infection, phthalate exposure, and/or oral tryptophan use.
Optimal range: 2.5 - 7.5 ug/mg
Vanilmandelate (VMA) is the primary metabolite of norepinephrine and epinephrine (adrenaline). The adrenal gland makes cortisol and DHEA (from the adrenal cortex) as well as norepinephrine and epinephrine (from the adrenal medulla).
→ When adrenal hormone output is low, Vanilmandelate (VMA) levels may be low.
→ If Homovanillate (HVA) levels are significantly higher than Vanilmandelate (VMA), there may be a conversion problem from dopamine to norepinephrine. This case can be caused by a copper or vitamin C deficiency.
→ The enzymes COMT (methylation of catechols) and MAO are needed to make HVA and VMA from dopamine and norepinephrine respectively. If these enzymes are not working properly, HVA and/or VMA may be low in urine, when circulating levels of dopamine and/or norepinephrine/epinephrine may not be low.
→ Low levels of norepinephrine/epinephrine are associated with addictions, cravings, fatigue, low blood pressure, low muscle tone, intolerance to exercise, depression, and loss of alertness.
→ High levels of norepinephrine and epinephrine are associated with feelings of stress, aggression, violence, impatience, anxiety, panic, excess worry/hypervigilance, insomnia, paranoia, increasing tingling/burning, loss of memory, pain sensitivity, high blood pressure and heart palpitations.
Optimal range: 0.12 - 1.2 ug/mg
Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.
Optimal range: 0.2 - 1.9 ug/mg
Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.
Neurotransmitter Metabolites (Urine) - DUTCH
The Neurotransmitter Metabolites section of the DUTCH test measures organic acids that are the breakdown products (metabolites) of important brain chemicals.
These markers provide insight into how your body is producing and processing dopamine, norepinephrine, and serotonin-related pathways.
The DUTCH test reports three main urinary metabolites:
Homovanillate (HVA) – The primary metabolite of dopamine.
Dopamine supports motivation, focus, mood stability, and motor control.
Low HVA may suggest reduced dopamine production or turnover.
High HVA may be linked to increased dopamine metabolism, stress, or certain metabolic states.
Vanilmandelate (VMA) – The main metabolite of norepinephrine and epinephrine.
These neurotransmitters regulate alertness, energy, blood pressure, and the body’s stress response.
Low VMA may indicate low catecholamine output.
High VMA can occur with chronic stress or in certain adrenal conditions.
Quinolinate – A metabolite from the kynurenine pathway of tryptophan metabolism.
Elevated levels are considered neurotoxic and may reflect inflammation, oxidative stress, or overactivation of immune pathways.
High quinolinate can disrupt normal brain signaling and has been linked to mood disorders and neurodegeneration risk.
Neurotransmitter balance is closely tied to hormone health. Cortisol, estrogen, and other hormones can directly influence dopamine, norepinephrine, and serotonin metabolism.
By measuring these metabolites alongside hormone patterns, the DUTCH test gives a more complete picture of how stress, hormones, and brain chemistry interact.
While urinary neurotransmitter metabolites are not a perfect reflection of brain neurotransmitter levels, research supports their use as a reliable marker of whole-body neurotransmitter activity.
They help practitioners:
Identify whether low or high neurotransmitter activity may be contributing to symptoms
Understand whether hormone imbalances are affecting brain chemistry
Guide targeted nutritional, lifestyle, and therapeutic support for both hormonal and neurological health
Optimal range: 2.5 - 7.5 ug/mg
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 5.2 ng/mg
8-OHdG measures the effect of endogenous oxidative damage to DNA. The marker is used to estimate the risk for various cancers and degenerative diseases. Adjusting treatments and lifestyle to minimize the presence of 8-OHdG is a productive step toward health and longevity.
Optimal range: 3 - 11 ug/mg
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 10 - 85 ng/mg
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH). A low MSH is associated with insomnia, an increased perception of pain, and mold exposure. Pineal melatonin (melatonin is also made in significant quantities in the gut) is associated with the circadian rhythm of all hormones (including female hormone release). It is also made in small amounts in the bone marrow, lymphocytes, epithelial cells and mast cells. Studies have shown that a urine sample collected upon waking has levels of 6-Hydroxymelatonin-sulfate (6-OHMS) that correlate well to the total levels of melatonin in blood samples taken continuously throughout the night. The DUTCH test uses the waking sample only to test levels of melatonin production. Low melatonin levels may be associated with insomnia, poor immune response, constipation, weight gain or increased appetite. Elevated melatonin is usually caused by ingestion of melatonin through melatonin supplementation or eating melatonin-containing foods. Elevated melatonin production that is problematic is rare, but levels can be higher in patients with Chronic Fatigue Syndrome and may be phase shifted (peaking later) in some forms of depression.
Optimal range: 0 - 9.6 ug/mg
Quinolinate is a neurotoxin derived from tryptophan. Elevated quinolinate is seen in brain and nerve tissue damage, especially in disorders such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, motor neuron diseases, multiple sclerosis, epilepsy, amyotrophic lateral sclerosis, and major depressive disorder. We can also see elevated quinolinate due to low serotonin and need for vitamin B3 (niacin). The causes of elevated quinolinate include neuroinflammation, general inflammation, infection, phthalate exposure, and/or oral tryptophan use.
Optimal range: 2.2 - 5.5 ug/mg
Vanilmandelate is a metabolite of epinephrine and norepinephrine (also known as adrenaline and noradrenaline).
Toxic & Essential Elements (Hair)
Hair is an excretory tissue for essential, nonessential and potentially toxic elements. In general, the amount of an element that is irreversibly incorporated into growing hair is proportional to the level of the element in other body tissues. Therefore, hair elements analysis provides an indirect screening test for physiological excess, deficiency or maldistribution of elements in the body. Clinical research indicates that hair levels of specific elements, particularly potentially toxic elements such as cadmium, mercury, lead and arsenic, are highly correlated with pathological disorders. For such elements, levels in hair may be more indicative of body stores than the levels in blood and urine.
All screening tests have limitations that must be taken into consideration. The correlation between hair element levels and physiological disorders is determined by numerous factors. Individual variability and compensatory mechanisms are major factors that affect the relationship between the distribution of elements in hair and symptoms and pathological conditions. It is also very important to keep in mind that scalp hair is vulnerable to external contamination of elements by exposure to hair treatments and products. Likewise, some hair treatments (e.g. permanent solutions, dyes, and bleach) can strip hair of endogenously acquired elements and result in false low values. Careful consideration of the limitations must be made in the interpretation of results of hair analysis. The data provided should be considered in conjunction with symptomology, diet analysis, occupation and lifestyle, physical examination and the results of other analytical laboratory tests.
Caution: The contents of this report are not intended to be diagnostic and the physician using this information is cautioned against treatment based solely on the results of this screening test. For example, copper supplementation based upon a result of low hair copper is contraindicated in patients afflicted with Wilson’s Disease.
Optimal range: 0 - 7 µg/g
Optimal range: 0 - 0.05 µg/g
Possible sources of antimony:
- Food and smoking are the usual sources of antimony. Thus cigarette smoke can externally contaminate hair, as well as contribute to uptake via inhalation.
- Gunpowder (ammunition) often contains antimony. Firearm enthusiasts often have elevated levels of antimony in hair.
Other possible sources are:
- textile industry,
- metal alloys,
- and some anti-helminthic and anti-protozoal drugs.
- Antimony is also used in the manufacture of paints, glass, ceramics, solder, batteries, bearing metals and semiconductors.
Optimal range: 0 - 0.06 µg/g
Elemental analysis provides a good estimate of exposure to inorganic arsenic (As). However, hair can be contaminated externally with As from air, water, dust, shampoos and soap. Inorganic As, and some organic As compounds, can cause toxicity. Some research suggests that As may beessential at extremely low levels but its function is not understood. Inorganic As accumulates inhair, nails, skin, thyroid gland, bone and the gastrointestinal tract. Organic As is rapidly excreted in the urine.
Optimal range: 0 - 2 µg/g
Hair may be used to evaluate exposure to barium (Ba). Exogenous contamination has been observed from bath water containing Ba. Elevated levels of hair Ba are often observed as a result of exposure to Ba for diagnostic medical tests.
Optimal range: 0 - 0.02 µg/g
Beryllium ores are used to make speciality ceramics for electrical and high-technology applications, also used in nuclear weapons and reactors, aircraft and space vehicle structures, instruments, x-ray machines, and mirrors.
Beryllium alloys are used in automobiles, computers, sports equipment (golf clubs and bicycle frames), and dental bridges. Lung damage has been observed in people exposed to high levels of beryllium in the air. Beryllium blocks several hepatic enzyme systems. Marcotte and Witschi (l972) suggested that this element binds to chromatin and interferes with DNA synthesis. Preventive measures such as avoiding skin contact with beryllium to prevent sensitization are most important. Careful irrigation and debridement are recommended for wounds.
Optimal range: 0 - 2 µg/g
Bismuth is found in alloys, catalysts, cosmetics, paints, magnets, ceramics, pharmaceuticals, x-ray contrast media,
and semiconductors. Bismuth is generally non-toxic, although very high levels may cause nausea, vomiting, and diarrhea.
Renal, neurological, and hematological problems have been associated with bismuth toxicity. Hair is not a sensitive
specimen for bismuth toxicity; blood and urine are most commonly used.
Optimal range: 0.25 - 1.5 µg/g
Optimal range: 0 - 0.05 µg/g
Hair cadmium (Cd) levels provide an indication of mild to moderate exposure to the nephrotoxic metal. Very high exposure and assimilation of Cd destroys the hair follicle. Cd is a toxic heavy metal that has no metabolic function in the body. Moderately high Cd exposure may be associated with hypertension, while very severe Cd toxicity may cause hypotension. Cd adversely affects the kidneys, lungs, testes, arterial walls, and bones and interferes with many enzymatic reactions. Chronic Cd excess can lead to microcytic, hypochromic anemia and proteinuria with excretion of beta-2-microglobin, and functional zinc deficiency. Cd excess is also commonly associated with fatigue, hypertension, kidney disease, weight loss, osteomalacia, and lumbar pain.
Optimal range: 300 - 1200 µg/g
Optimal range: 0.4 - 0.65 µg/g
A high hair chromium (Cr) level is likely to indicate excess exposure to Cr. Hair Cr levels do not appear to be affected by permanent solutions, dyes, or bleaches, but external contamination is possible. Trivalent Cr is considered to be an essential trace element with a low order of toxicity. Cr toxicity via oral ingestion is not likely. However, it is noteworthy that excessive self-supplementation has been reported to be associated with insomnia and increased unpleasant dream activity in some individuals (J. Nutr. Med.; 3(43), 1992).
Phytates decrease oral assimilation of Cr+3, whereas nicotinic acid and vitamin C increase absorption of Cr+3, zinc, vanadium and iron compete with Cr for absorption. In contrast, hexavalent Cr compounds are considerably more toxic and are primarily absorbed via inhalation as a result of industrial exposure. Industrial exposure to high amounts of Cr has been reported to be associated with allergic dermatitis, skin ulcers, bronchitis, and lung and nasal carcinoma. Elevated hair Cr levels have also been observed in patients with cerebral thrombosis and cerebral hemorrhage.
Optimal range: 0.01 - 0.04 µg/g
Hair may be used for monitoring excess exposure to cobalt (Co). However, hair is occasionally contaminated by external Co from some hair treatments. If an individual’s hair has been treated with permanent solutions, dyes, or bleach, the Co levels may not be indicative of body Co accumulation.
Humans absorb Co both as inorganic Co and as vitamin B-12; the body pools of each fluctuate independently. Humans cannot convert inorganic Co to vitamin B-12, and vitamin B-12 provides the only documented function of Co in humans. Thus, a high hair Co level does not mean that vitamin B-12 levels are high or even adequate.
Optimal range: 11 - 37 µg/g
Optimal range: 0.03 - 0.04 µg/g
The relationship between the levels of Germanium in hair and other tissues has not been established and there is currently no published documentation linking elevated hair Germanium levels to Germanium toxicity. However, recent observations indicate that hair Germanium levels are increased by supplementation/therapeutic use of Germanium compounds.
Optimal range: 0.25 - 1.8 µg/g
Iodine is an essential mineral that plays a crucial role in thyroid function. The thyroid gland uses iodine to produce thyroid hormones, which are responsible for controlling growth, repairing damaged cells, and supporting a healthy metabolism.
Optimal range: 7 - 16 µg/g
Iron is required in hemoglobin for transporting oxygen in the blood, for detoxification and for energy production in the cells. Iron is found in lean meats, organ meats, shellfish, molasses, beans, whole-grain cereals, and dark green vegetables
Optimal range: 0 - 0.6 µg/g
Generally, hair provides a good indication of exposure to lead (Pb). However, elevated levels of Pb in head hair are occasionally an artifact of hair darkening agents, e.g. lead acetate. Although such products can cause exogenous contamination, transdermal absorption may be clinically significant. When scalp hair is contaminated with such products, hair Pb levels are typically extremely high
Optimal range: 0.01 - 0.02 µg/g
Lithium (Li) is normally found in hair at very low levels. Hair Li correlates with high dosage of Li carbonate in patients treated for Affective Disorders. However, the clinical significance of low hair Li levels is not certain at this time. Thus, hair Li is measured primarily for research purposes. Anecdotally, clinical feedback to DDI consultants suggests that low level Li supplementation may have some beneficial effects in patients with behavioral/emotional disorders. Li occurs almost universally in water and in the diet; excess Li is rapidly excreted in urine.
Optimal range: 35 - 120 µg/g
Optimal range: 0.08 - 0.6 µg/g
Manganese (Mn) is an essential element which is involved in the activation of many important enzymes. However, Mn excess is postulated to result in glutathionyl radical formation, reduction of the free glutathione pool, and increased exposure of adrenal catecholamines (e.g. dopamine) to free radical damage.
Hair Manganese (Mn) levels generally reflect actual body stores, and external contamination can influence hair Mn. Since particulate manganese-containing dust is the most common source of Mn toxicity, hair is considered to be an excellent tissue for the assessment of Mn exposure.
Optimal range: 0 - 0.8 µg/g
Hair mercury (Hg) is an excellent indiator of exposure to methylmercury from fish. Mercury is toxic to humans and animals. Individuals vary greatly in sensitivity and tolerance to Hg burden.
Optimal range: 0.02 - 0.05 µg/g
Optimal range: 0 - 0.3 µg/g
Hair is a reasonable tissue for monitoring accumulated body stores of Nickel (Ni). However, hair is OFTEN contaminated with Ni from hair treatments, dyes, and hair products. There is substantial evidence that Ni is an essential element which is required in extremely low amounts. However, excess Ni has been well established to be nephrotoxic, and carcinogenic. Elevated Ni is often found in individuals who work in the electronic and plating, mining, and steel manufacture industries. A cigarette typically contains from 2 to 6 mcg of Ni; Ni is absorbed more efficiently in the lungs (~35%) than in the gastrointestinal tract (~5%).
Optimal range: 150 - 220 µg/g
Optimal range: 0 - 0.01 µg/g
Platinum (Pt) is a nonessential element that is sometimes detected in hair. However, the clinical significance of hair Pt has not been well studied. Hair treatments may contribute to artifactual contamination of scalp hair.
Pt is poorly absorbed in the gut but may be absorbed via inhalation. Since it is a relatively rare element, most Pt exposures are of occupational origin.
Optimal range: 8 - 75 µg/g
The level of Potassium (K) in hair does not reflect nutritional status or dietary intake. However, hair K levels may provide clinically relevant information pertaining to adrenal function and/or electrolyte balance
Optimal range: 0.01 - 0.1 µg/g
Rubidium is a relatively benign element that typically parallels the potassium level. It varies according to levels found in water supplies.
Optimal range: 0.55 - 1.1 µg/g
Selenium is normally found in hair at very low levels, and several studies provide evidence that low hair Selenium is reflective of dietary intake and associated with cardiovascular disorders. Utilization of hair Selenium levels to assess nutritional status, however, is complicated by the fact that use of Selenium- or sulfur-containing shampoo markedly increases hair Selenium (externally) and can give a false high value.
Optimal range: 0 - 0.15 µg/g
Hair silver (Ag) levels have been found to reflect environmental exposure to the element. However, hair may be contaminated with Ag from hair treatments such as permanents, dyes, and bleaches.
Ag is not an essential element and is of relatively low toxicity. However, some Ag salts are very toxic. Sources of Ag include modern hot tubs, seafood, metal and chemical processing industries, photographic processes, jewelry making (especially soldering), effluents from coal fired power plants and colloidal silver products.
Optimal range: 20 - 250 µg/g
Optimal range: 0.5 - 7.6 µg/g
Strontium in a hair analysis can provide valuable information about an individual's body burden of strontium and its correlation with calcium levels in body tissues. Strontium levels in hair can be influenced by both endogenous (internal) and exogenous (external) sources. Endogenous sources of strontium in hair originate from the body's strontium pools within blood and bones, while exogenous sources represent external environmental influences from aerosols, particulates, and environmental waters.
Optimal range: 44000 - 50000 µg/g
Optimal range: 0 - 0 µg/g
Thallium (Tl) is a highly toxic element which, like lead and mercury, accumulates in many body tissues. Hair levels reflect chronic accumulation of Tl, but alopecia occurs about two weeks after ACUTE Tl poisoning. Thallium occurs naturally in some minerals, and magmatic and sedimentary rock, consequently in soil, water, and air. Industrially, Tl is used in lenses and prisms, as an alloy with mercury in low temperature thermometers, and in the preparation of high density liquids.
Optimal range: 0 - 0 µg/g
Optimal range: 0 - 0.3 µg/g
Hair Tin (Sn) levels have been found to correlate with environmental exposure. Depending on chemical form, Sn is a potentially toxic element. Inorganic Sn has a low degree of toxicity, while organic Sn has appreciable toxicity. Inorganic Sn is used as flame-proofing treatment in textiles, as a wood preservative, and has various uses in the glass industry. Sn is also used in tin plate electrolysis for Sn alloy coatings.
Optimal range: 0 - 0.7 µg/g
Titanium (Ti) is measured in hair to assist in the identification of external contamination of hair by treatments and products. Shampoos, dyes, and “highlighting” are the primary sources of Ti, which binds tenaciously to hair. Ti dioxide is the most common form of Ti used as a whitening agent (toothpaste, conditioners, shampoos, etc.).
Optimal range: 0 - 0.06 µg/g
The levels of uranium (U) in hair usually reflect levels of U in other tissues. However, hair may be externally contaminated by shampoos or hair products that contain U.
U is a nonessential element that is very abundant in rock, particularly granite, lignite, monazite sands, and phosphate rocks. U is present at widely varying levels in drinking water, root vegetables, and present in high phosphate fertilizers. Other sources of U include: ceramics, some colored glass, many household products and tailings from U mines. Spent U rods have been milled into armor piercing bullets and missile heads.
Optimal range: 0.02 - 0.07 µg/g
Optimal range: 140 - 220 µg/g
A high level of zinc (Zn) in hair may be indicative of low Zn in cells, and functional Zn deficiency. Zn can be displaced from proteins such as intracellular metallothionein by other metals, particularly cadmium, lead, copper, and mercury (Toxicology of Metals, 1994), resulting in paradoxically elevated hair Zn. Zn may also be high in hair as a result of the use of Zn- containing anti-dandruff shampoo. Rough or dry, flaky skin is a symptom of Zn deficiency, so it is not uncommon for Zn deficient patients to use an anti-dandruff shampoo.
Optimal range: 0.02 - 0.42 µg/g
Zirconium is one of the elements measured in hair element testing offered by Doctor's Data.
This test is designed to assess the levels of various elements, including both toxic and essential ones, in a person's hair.
Zirconium testing can be valuable for several purposes, such as evaluating toxic element exposure, assessing the effects of excessive fish consumption, and investigating conditions like alopecia, depression, fatigue, malabsorption, hypertension, and impaired health.
GI-MAP Interpretive Guide by Diagnostic Solutions
Written By: B. Dame
Updated On: July 3, 2025
Discover how the GI-MAP stool test from Diagnostic Solutions Laboratory evaluates your microbiome, digestion, pathogens, and intestinal health. Understand your results and how they relate to your symptoms.
The GI-MAP (Gastrointestinal Microbial Assay Plus) is an advanced stool analysis test developed by Diagnostic Solutions Laboratory. It uses cutting-edge quantitative PCR (qPCR) technology to detect and measure the DNA of microbes in your gut with high precision.
Unlike traditional stool tests, GI-MAP provides:
Quantitative data on gut bacteria, viruses, parasites, and fungi
Clinical relevance through pathogen virulence factors
Actionable insights for gut health, digestion, and immune response
The GI-MAP is often recommended by integrative and functional medicine practitioners to investigate chronic GI symptoms, autoimmune disorders, and systemic inflammation.
The GI-MAP evaluates a wide range of gastrointestinal biomarkers across these key categories:
Detects harmful bacteria like Clostridium difficile, Salmonella, Shigella, and E. coli (including shiga-toxin producing strains)
Identifies protozoa (e.g., Giardia, Cryptosporidium, Entamoeba histolytica) and helminths (worms)
Screens for viruses such as Norovirus and Rotavirus
Measures overgrowth of Candida species and Geotrichum
Assesses beneficial bacteria (e.g., Lactobacillus, Bifidobacterium, Faecalibacterium prausnitzii) and dysbiosis patterns
Evaluates potential overgrowth of normally harmless bacteria that may contribute to inflammation or SIBO
Secretory IgA – Immune response in the gut lining
Calprotectin – Inflammation in the intestines
Beta-glucuronidase – Enzyme linked to detox and estrogen metabolism
Anti-gliadin IgA – Marker for gluten reactivity
Steatocrit – Fat malabsorption
Elastase-1 – Pancreatic enzyme output
The GI-MAP stands out from other stool tests because it’s:
DNA-based: More accurate than microscopy or culture
Quantitative: Measures how much of each microbe is present
Clinically actionable: Includes virulence factors and immune markers
Comprehensive: Covers gut ecology, digestion, inflammation, and infection
It’s especially useful for investigating:
IBS, IBD, and chronic bloating
Food sensitivities or intolerances
Fatigue, skin issues, and autoimmune disorders
Mood and cognitive symptoms linked to the gut-brain axis
GI-MAP reports display:
Detected organisms, their concentration, and reference ranges
Color-coded flags for high or low levels
Clinical notes from the lab on virulence and clinical significance
Note: Not all “positive” results are bad. The presence of some microbes at low levels is normal. Focus on:
Overgrowth of pathogens
Disrupted microbiome balance
Signs of gut inflammation or poor digestion
Use HealthMatters.io to upload your GI-MAP results and get plain-language explanations of each marker and what it means for your gut health.
Inflammatory Bowel Disease (Crohn’s, Ulcerative colitis (UC))
Leaky gut / intestinal permeability
Chronic constipation or diarrhea
Autoimmune diseases
Brain fog, fatigue, skin conditions
Nutrient malabsorption
Hormonal imbalances (via gut-liver axis)
Yes. It uses qPCR DNA technology, which is highly sensitive and specific compared to traditional stool tests.
Yes. It’s typically recommended to stop antimicrobials, probiotics, and digestive aids for at least 2–4 weeks unless otherwise advised by your practitioner.
The test kit includes simple instructions and a return mailer. You’ll collect a small stool sample at home.
Results are typically available within 7–10 business days after the sample reaches the lab.
While you’ll get valuable insights, some findings require clinical context. Use HealthMatters.io to bridge the gap with plain-language explanations and then review with your provider.
Many practitioners recommend retesting every 3–6 months if you’re addressing infections, dysbiosis, or gut inflammation.
Upload your GI-MAP report to:
Decode each biomarker in easy-to-understand terms
Track progress over time
Share organized insights with your integrative or functional medicine practitioner
Make confident decisions about your gut health
The GI-MAP test by Diagnostic Solutions offers one of the most complete snapshots of gut health available today. Whether you’re struggling with unresolved digestive issues or exploring the root causes of systemic symptoms, the GI-MAP provides clear, clinically relevant answers.
Reference range: Absent, Present
Genes associated with clarithromycin resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with clarithromycin resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with clarithromycin resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with tetracycline resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 0 - 10000000000 Units
Adenovirus serotypes 40 and 41 cause acute gastroenteritis (inflammation of the stomach and intestines) primarily in children.
Reference range: Absent, Present
Genes associated with tetracycline resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 10 - 8200000 Units
Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.
Reference range: Negative, Positive
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 0 - 0 Units
The distribution of hookworm (Necator americanus and Ancylostoma duodenale) is worldwide, with particular prevalence in rural areas of the moist tropics where there is inadequate sanitation and people walk barefoot. The two species produce indistinguishable thin-walled eggs that hatch in soil. Infection is usually acquired by walking barefoot in soil contaminated with human faeces. The larvae undergo several moults before infective larvae are produced.
Optimal range: 0 - 175 U/L
Antigliadin antibodies (AGAs) are antibodies of the IgA and IgG classes found in the serum of celiac disease patients. These antibodies mainly target gliadin-derived peptides, which are the main proteins of gluten. AGAs are not specific for celiac disease as they are also found in patients with other gastrointestinal diseases such as gastritis, gastroenteritis, and IBD.
Optimal range: 0 - 0 Units
Ascaris lumbricoides, an intestinal roundworm, is one of the most common helminthic human infections worldwide.
Ascaris lumbricoides is the largest intestinal nematode of man. The female worms are larger than the males and can measure 40 cm in length and 6 mm in diameter. They are white or pink and are tapered at both ends.
Optimal range: 0 - 2486 U/mL
Beta-glucuronidase is an enzyme that breaks the tight bond between glucuronic acid and toxins in the intestines. The liver and intestine bind toxins, steroid hormones and some dietary components to glucuronic acid. That is a protective process that limits absorption and enterohepatic reabsorption of toxins, and enhances excretion. A high level of activity of Beta-glucuronidase in the gut is not desirable. A low level of Beta-glucuronidase activity is not known to be of any direct clinical consequence.
Optimal range: 0 - 1760000 Units
Bacillus spp. are spore forming bacteria, ubiquitous in the environment. B. cereus in particular is a frequently recognized cause of toxin-induced acute gastroenteritis.
Other infections caused by this genus include:
- sepsis
- pneumonia
- endocarditis
- central nervous system (CNS) and ocular infections
Optimal range: 1600000000 - 250000000000 Units
Gram-negative species of the Bacteroidetes phylum. Immune-modulating normal gut species. Believed to be involved in microbial balance, barrier integrity, and neuroimmune health (Hsiao 2013). High levels may result from reduced digestive capacity or constipation. Low levels may contribute to reduced anti-inflammatory activity in the intestine.
Optimal range: 860000000000 - 3300000000000 Units
Bacteroidetes are the most prominent gut microbes in much of the world. They are thought to help protect against obesity because they do not digest fat well.
Optimal range: 67000000 - 100000000000000 Units
Gram-positive genus in the Actinobacteria phylum. Present in breast milk. Colonizes the human GI tract at birth. Common in probiotics. Thrives on a wide variety of prebiotic fibers.
Optimal range: 0 - 2000 Units
Blastocystis hominis is found throughout the world in both people with and without symptoms. It is a non-pathogenic parasite. Non-pathogenic parasites are present in the gastrointestinal tract and generally are self-limiting and do not cause illness. However, some research shows an association between non-pathogenic parasites and gastrointestinal symptoms.
Optimal range: 0 - 999 Units
C. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use).
C. difficile produces two toxins:
- Toxin A is a tissuedamaging enterotoxin,
- while toxin B is referred to as a cytotoxin.
Optimal range: 0 - 999 Units
C. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use).
C. difficile produces two toxins:
- Toxin A is a tissuedamaging enterotoxin,
- while toxin B is referred to as a cytotoxin.
Optimal range: 0 - 173 ug/g
Calprotectin is a calcium-binding protein with antimicrobial properties. It accounts for 60% of neutrophil cytosolic content and is also found in monocytes and macrophages. Calprotectin is released from the intestinal mucosa into the stool in intestinal inflammation.
Optimal range: 0 - 999 Units
When people worry about eating undercooked chicken, they usually focus on getting sick from salmonella bacteria. But another common type of bacteria called campylobacter can also make you ill if you eat poultry that isn’t fully cooked.
Optimal range: 0 - 500 Units
Commensal fungi that can be pathogenic to immunocompromised patients. Causes vaginal yeast infections and can be fatal in systemic infections. May cause diarrhea. Has been suggested to cause a cluster of symptoms including GI complaints, fatigue, and muscle or joint pain but evidence is weak.
Optimal range: 0 - 5000 Units
Commensal fungi that can be pathogenic to immunocompromised patients. Causes vaginal yeast infections and can be fatal in systemic infections. May cause diarrhea. Has been suggested to cause a cluster of symptoms including GI complaints, fatigue, and muscle or joint pain but evidence is weak.
Optimal range: 0 - 100000 Units
Chilomastix mesnili is a nonpathogenic flagellate that is often described as a commensal organism in the human gastrointestinal tract.
Optimal range: 0 - 500000 Units
Gram-negative bacteria in the Proteobacteria phylum.
Optimal range: 0 - 5000000 Units
Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity.
Autoimmune Association: Rheumatoid arthritis
Reference range: Negative, Positive
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 5000000 - 50000000 Units
Markers in this class are important producers of short-chain fatty acids, and have many well-documented roles in promoting a healthy intestinal barrier, immune balance, and protection against pathogens.
Optimal range: 0 - 999999 Units
Cryptosporidium is notorious for being spread by swimming pools. A number of Cryptosporidium outbreaks have occurred after contamination of public swimming facilities. Cryptosporidium can cause gas, bloating, diarrhea, and abdominal pain. In a healthy, immune-competent person, this is a selflimiting infection and can be cleared within 2-3 weeks.
Optimal range: 0 - 50000 Units
This parasite causes an intestinal infection called cyclosporiasis.
Optimal range: 0 - 100000 Units
Epidemiology:
- Herpes virus that has infected 60% of the US population
- One in three children have contracted CMV by five years old
- Passed around in child daycare centers
Optimal range: 0 - 798000000 Units
Desulfovibrio is a genus of gram-negative sulphate-reducing bacteria. This genus has been positively correlated to IBD, colorectal cancer (in animal model), ulcerative colitis, liver disease and autism.
Desulfovibrio spp. is predominant member of Sulfate-reducing bacteria in human gut microbiota. Sulfate-reducing bacteria (SRB) are anaerobic microorganisms that conduct dissimilatory sulfate reduction to obtain energy, resulting in the release of a great quantity of sulfide. They are commonly isolated from environmental sources, but are also present in the digestive tract of animals and humans.
Different species of Desulfovibrio: Desulfovibrio desulfuricans, Desulfovibrio piger, Desulfovibrio fairfieldensis Desulfovibrio legallii
The bacteria produce hydrogen sulfide (H2S), a metabolite which can influence cell signaling and reduce oxidative stress at low concentrations and pose toxicity at higher concentrations.
Optimal range: 0 - 100000 Units
Dientamoeba fragilis is a parasite that lives in the large intestine of people. This protozoan parasite produces trophozoites; cysts have not been identified. The intestinal infection may be either asymptomatic or symptomatic.
Optimal range: 0 - 999 Units
Optimal range: 200 - 2000 ug/g
Pancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.
Optimal range: 0 - 10000 Units
Epidemiology:
- Fecal contamination of food or water
Clinical Implications:
- Considered non-pathogenic; individuals may be asymptomatic
- May be indicative of dysbiosis, conservative treatment may be indicated if clinical presentation is consistent with enteroparasitosis.
Optimal range: 0 - 5000000 Units
Entamoeba coli are intestinal amebae that are found in the large intestine. They generally are not considered pathogenic. However, when these amebae are found in stool samples it can indicate the presence of other potentially pathogenic organisms.
Optimal range: 0 - 9999 Units
Entamoeba histolytica is a disease-causing parasite that can affect anyone, although it is more common in those who lived or travelled in tropical areas with poor sanitary conditions. Diagnosis can be difficult since, under a microscope, it looks similar to other parasites such as Entamoeba dispar and Entamoeba hartmanii. The latter two parasites generally do not cause illness.
Optimal range: 1000000 - 50000000 Units
Gram-negative genus in the Proteobacteria phylum. Closely related to E. coli (in the same taxonomic family). High levels may indicate increased intestinal inflammatory activity. Low levels may indicate reduced mucosal health.
Optimal range: 0 - 10000 Units
Gram-positive species in the Firmicutes phylum. High levels may result from reduced stomach acid, PPI use, compromised digestive function, SIBO or constipation. High natural resistance to some antibiotics, which may result in overgrowth.
Optimal range: 0 - 10000 Units
Gram-positive species in the Firmicutes phylum. High levels may result from reduced stomach acid, PPI use, compromised digestive function, SIBO or constipation. High natural resistance to some antibiotics, which may result in overgrowth.
Optimal range: 190000 - 200000000 Units
Enterococcus is a genus of Gram-positive bacteria that lives in the human gut as part of the normal microbiome. Common species include E. faecalis and E. faecium. In healthy amounts, they coexist with other microbes; when present in excess, Enterococcus can behave opportunistically, forming biofilms, irritating the gut lining, and—if it translocates—contributing to infections outside the gut (e.g., urinary tract).
Optimal range: 0 - 999 Units
What is enterohemorrhagic E. coli?
Escherichia coli (or simply E. coli) is one of the many groups of bacteria that normally live in the intestines of healthy humans and most warm-blooded animals. E. coli bacteria help maintain the balance of normal intestinal bacteria against harmful bacteria.
However, there are hundreds of types or strains of E. coli bacteria. Different strains of E. coli have different characteristics.
One E. coli strain that causes a severe intestinal infection in humans is known as enterohemorrhagic E. coli (EHEC). It’s the most common strain to cause illness in people. It’s different from other E. coli because it produces a potent toxin called Shiga toxin. This toxin damages the lining of the intestinal wall, causing bloody diarrhea.
Optimal range: 0 - 999 Units
Optimal range: 0 - 999 Units
Optimal range: 0 - 2.34 ug/g
Eosinophil Activation Protein (EDN/EPX) is a protein released by activated eosinophils which has strong cytotoxic characteristics.
Cytotoxic means that a substance or process can damage cells or cause them to die. "Cyto" means cell and "toxic" means poison.
The protein plays a significant role in a variety of inflammatory and mast-cell mediated pathologies in addition to fighting pathogens, particularly viral infections.
Optimal range: 0 - 10000000 Units
- One of the most common viruses worldwide; infects 90–95% of the population
- Commonly contracted in childhood and causes mild symptoms
Optimal range: 3700000 - 3800000000 Units
- Gram-negative genus in the Proteobacteria phylum.
- Normal gut flora.
- Escherichia coli (E. coli) is the primary species in this genus.
- Most E. coli are nonpathogenic (pathogenic E. coli strains are measured separately).
Optimal range: 1000 - 500000000 Units
Faecalibacterium prausnitzii is one of the most important bacteria in the human gut flora and makes up to 5-10% of the total number of bacteria detected in stool samples from healthy humans. Faecalibacterium prausnitzii has a crucial role in maintaining gut physiology and host wellbeing.
Optimal range: 57000000000 - 300000000000 Units
Gram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth, nose, throat, and colon.2 An abnormal result in one or both of these phylum suggest imbalanced normal microbes in the GI tract. Further, high Firmicutes and low Bacteroidetes (resulting in a high F/B ratio) suggest microbial imbalance which may be related to increased caloric extraction from food, fat deposition and lipogenesis, impaired insulin sensitivity, and increased inflammation.
Optimal range: 0 - 1 Ratio
An abnormal result in one or both of these phylum suggest imbalanced normal microbes in the GI tract.
Gram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth, nose, throat, and colon.
Reference range: Negative, Positive
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 0 - 100000000 Units
Autoimmune Association: Systemic sclerosis or inflammatory bowel disease.
Optimal range: 0 - 300 Units
May cause disease in immunosuppressed patients. Low levels may be a dietary artefact; certain strains are used to make soft cheeses.
Optimal range: 0 - 5000 Units
Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States.
Optimal range: 0 - 5 ng/g
Fecal gluten monitoring is an important tool to:
- Quantitively evaluate amount of gluten peptide in stool for accurate assessment of potential exposure
- Monitor adherence to gluten-free diet for anyone aiming to follow a GF lifestyle
- Monitor accidental (unintentional) consumption of gluten for both the celiac and non-celiac gluten sensitive patient, even if they are not experiencing symptoms
- Assist in the assessment of refractory celiac (failure to heal despite going GF)
Reference range: Absent, Present
Genes associated with fluoroquinolone resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with fluoroquinolone resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with fluoroquinolone resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with fluoroquinolone resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with fluoroquinolone resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 0 - 999 Units
Helicobacter pylori (H. pylori) infection occurs when H. pylori bacteria infect your stomach. Helicobacter pylori has been evolving with human beings for well over 50,000 years, since they migrated out of Africa. H. pylori colonization has been implicated in a variety of gastroduodenal diseases.
Optimal range: 0 - 50000 Units
Gram-negative bacteria in the Proteobacteria phylum. Common residents of the oral cavity and respiratory tract. May cause diarrhea, gas, abdominal pain, and bloating; Common after long-term antibiotic use; May release histamine in the gut; High levels may indicate increased intestinal inflammatory activity.
Optimal range: 0 - 5000 Units
Klebsiella species are gram-negative bacteria normally found in the intestinal tract that are associated with a wide range of small intestinal disorders including:
- alterations of motility,
- diarrhea,
- gas,
- abdominal pain,
- and bloating.
Optimal range: 860000 - 620000000 Units
Gram-positive genus of lactate-producing bacteria in the Firmicutes phylum. Many strains used as probiotics.
Optimal range: 0 - 5000 Units
Bacterial species in the Actinobacteria phylum. Higher levels have been associated with Crohn’s disease and rheumatoid arthritis.
Optimal range: 0 - 338000000 Units
Family of bacteria-like microbes that produce methane. Facilitates carbohydrate fermentation and short-chain fatty acid production by beneficial bacteria. High levels linked to chronic constipation, as well as some types of SIBO and IBS. Low levels may indicate reduced production of short-chain fatty acids and may be associated with inflammation.
Optimal range: 0 - 5000 Units
Optimal range: 0 - 1000 Units
Gram-negative group in the Proteobacteria phylum. May produce histamine. High levels may indicate increased intestinal inflammatory activity. High levels may cause diarrhea, and may also be associated with SIBO.
Optimal range: 0 - 0 Units
Hookworms are soil-transmitted nematode parasites that can reside for many years in the small intestine of their human hosts; Necator americanus is the predominant infecting species.
Optimal range: 0 - 10000000 Units
Norovirus GI & GII, or Norwalk virus, is the most common cause of non-bacterial gastroenteritis in the world. It is widely known for causing the stomach flu on cruise ships. Three genotypes of this diverse virus, GI, GII, and GIV, can infect humans.
Optimal range: 0 - 10 ug/g
The fecal occult blood test (=FOBT) looks for blood in your feces. “Occult” (=hidden) means that the blood amount is so small that it cannot be seen with the naked eye. The bleeding does not change the color of the stool or result in visible bright red blood. Therefore, the blood is found only by testing the stool for blood in the laboratory.
Reference range: Absent, Present
Genes associated with amoxicillin resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with amoxicillin resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Reference range: Absent, Present
Genes associated with amoxicillin resistance.
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 0 - 100 Units
Epidemiology:
Fecal contamination of food or water
Clinical Implications:
- Considered harmless, a non-pathogen
- Infected individuals are usually asymptomatic
- May contribute to dysbiosis
- Also colonizes dogs, cats, and other animals
Optimal range: 0 - 100000000 Units
Prevotella spp. is known for its ability to degrade complex plant polysaccharides (carbohydrates) and fiber.
Optimal range: 0 - 1000 Units
Opportunistic Bacteria associated with Autoimmunity.
Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals can be a source
Optimal range: 0 - 50000 Units
Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals can be a source.
Optimal range: 0 - 500 Units
- Gram-negative bacteria in the Proteobacteria phylum.
- Pseudomonas aeruginosa are normal flora in the human gastrointestinal (GI) tract, which on occasion cause GI tract infection.
Optimal range: 0 - 10000 Units
Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity and may cause abdominal cramping and loose stools. Some strains of P. aeroginosa may produce toxins that can damage cells.
Optimal range: 0 - 1000 Units
- Common in soil, plants, bathrooms, and in beverages like milk, juice, and water.
- May be a commensal (=living in a relationship in which one organism derives food or other benefits from another organism without hurting or helping it).
- Can cause disease in immunosuppressed patients.
Optimal range: 0 - 1000 Units
Optimal range: 50000000 - 20000000000 Units
A genus of Gram-positive anaerobic bacteria in the Clostridia class that inhabit the human colon. The Roseburia genus has five well-characterized species, all of which produce short-chain fatty acids (SCFAs), such as acetate, propionate, and butyrate. Roseburia can also produce butyrate from acetate promoting balance in energy homeostasis. The genus is widely recognized to influence colonic motility, support immunity, and suppress inflammation.
Optimal range: 0 - 9999 Units
Epidemiology
- Fecal contamination of ingested foods (eggs, poultry, meat, unpasteurized milk, raw fruits, and vegetables)
- Exposure to pets (reptiles, amphibians, baby chicks)
Clinical Implications
- May be asymptomatic
- Symptoms include fever, vomiting, and severe diarrhea
- Typically self limiting within seven days
- GI infection can cause reactive arthritis and may be involved in ankylosing spondylitis
- Systemic infections may require treatment with antibiotics
Optimal range: 510 - 2010 ug/g
As the most abundant class of antibody found in the human intestinal lumen, secretory IgA (sIgA) is recognized as a first line of defense in protecting the intestinal epithelium from enteric pathogens and toxins. It is used to assess gastrointestinal barrier function.
Optimal range: 0 - 999 Units
Epidemiology
- Fecal contamination of ingested foods (undercooked meat, unpasteurized milk, juice, and water)
Clinical Implications
- Symptoms may include severe abdominal cramps and diarrhea
- Toxins may elicit strong inflammatory response
Optimal range: 0 - 999 Units
Optimal range: 0 - 500 Units
Gram-positive bacteria in the Firmicutes phylum. High levels may result from reduced digestive capacity, and intestinal inflammatory activity. Some strains may produce toxins and contribute to loose stools or diarrhea.
Optimal range: 0 - 10000 Units
Gram-positive bacteria in the Firmicutes phylum. High levels may result from reduced digestive capacity, and intestinal inflammatory activity. Some strains may produce toxins and contribute to loose stools or diarrhea.
Optimal range: 0 - 15 %
The steatocrit is a measure of the amount of fat in stool.
Optimal range: 0 - 1000 Units
Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.
Optimal range: 0 - 0 Units
Taeniasis in humans is a parasitic infection caused by the tapeworm species Taenia saginata (beef tapeworm), Taenia solium (pork tapeworm), and Taenia asiatica (Asian tapeworm).
Humans can become infected with these tapeworms by eating raw or undercooked beef (T. saginata) or pork (T. solium and T. asiatica). People with taeniasis may not know they have a tapeworm infection because symptoms are usually mild or nonexistent.
Taenia solium tapeworm infections can lead to cysticercosis, which is a disease that can cause seizures, so it is important to seek treatment.
Reference range: Negative, Positive
The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol. Since microbes can rapidly share DNA under stress, the presence of antibiotic resistance is reason enough to avoid that drug class.
Optimal range: 0 - 0 Units
Epidemiology:
- Fecal contamination of produce or person-to-person contact
- Prevalent in Asia, Africa, South America, and rural southeastern United States
Optimal range: 0 - 99999 Units
Optimal range: 0 - 0 Units
Helicobacter pylori BabA Adhesin: A Key Virulence Factor in Gastric Disease
Helicobacter pylori is a gram-negative, spiral-shaped bacterium that colonizes the human stomach, affecting approximately 50% of the global population. While many infections remain asymptomatic, H. pylori can cause a spectrum of gastric diseases, ranging from chronic gastritis to peptic ulcers and gastric cancer. The bacterium's ability to persist in the harsh gastric environment is largely attributed to its virulence factors, with BabA (blood group antigen-binding adhesin) playing a crucial role in pathogenesis.
Optimal range: 0 - 0 Units
cagA (cytotoxin-associated gene A) is a virulence factor produced by certain strains of Helicobacter pylori (H. pylori), a bacterium that can colonize the human stomach lining. Not all H. pylori strains carry this gene. When present, cagA significantly increases the bacterium's ability to cause inflammation and damage to the stomach lining.
Optimal range: 0 - 0 Units
Duodenal ulcer promoting gene a (dupA) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer.
Optimal range: 0 - 0 Units
The iceA gene is recognized as a significant virulence factor in the genome of Helicobacter pylori, a Gram-negative, spiral-shaped bacterium implicated in the pathogenesis of various gastrointestinal diseases, including gastritis, peptic ulcers, and is associated with the development of gastric cancer. This gene exists in two main allelic variants: iceA1 and iceA2, each displaying different epidemiological distributions and potential roles in the bacterium's pathogenicity.
Optimal range: 0 - 0 Units
H. pylori virulence factor OipA (Outer Inflammatory Protein A) - associated with gastric cancer and peptic ulcer.
Optimal range: 0 - 0 Units
Optimal range: 0 - 0 Units
The virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori.
These genes code for proteins that will predispose one to more serious H. pylori infections.
Helicobacter pylori (H. pylori):
Recent studies have shown that nearly 50% of the world’s population may harbor H. pylori. And, although many carriers are asymptomatic, H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer.
Additionally, in early phases of colonization, patients may experience hypochlorhydria followed by a change to hyper aciduria. Over time, additional H. pylori strains may colonize, including those with Virulence Factors and increased disease potential.
Optimal range: 0 - 0 Units
The virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori. These genes code for proteins that will predispose one to more serious H. pylori infections.
Recent studies have shown that nearly 50% of the world’s population may harbor H. pylori. And, although many carriers are asymptomatic, H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer. Additionally, in early phases of colonization, patients may experience hypochlorhydria followed by a change to hyper aciduria. Over time, additional H. pylori strains may colonize, including those with Virulence Factors and increased disease potential.
Optimal range: 0 - 99999 Units
Optimal range: 0 - 175 ng/g
Zonulin is a protein that opens intercellular tight junctions in the gut lining (the connections between epithelial cells that make up the gastrointestinal lining). Zonulin increases intestinal permeability in the jejunum and ileum and is considered a biomarker for barrier permeability.
Toxic Metals (Urine)
Analysis of the levels of toxic metals in urine after the administration of a metal detoxification agent is an objective way to evaluate the accumulation of toxic metals. Acute metal poisoning is rare. More common, however, is a chronic, low-level exposure to toxic metals that can result in significant retention in the body that can be associated with a vast array of adverse health effects and chronic disease.
One cannot draw valid conclusions about adverse health effects of metals without assessing net retention. For an individual, toxicity occurs when net retention exceeds physiological tolerance. Net retention is determined by the difference between the rates of assimilation and excretion of metals. To evaluate net retention, one compares the levels of metals in urine before and after the administration of a pharmaceutical metal detoxification agent such as EDTA, DMSA or DMPS. Different compounds have different affinities for specific metals, but all function by sequestering "hidden" metals from deep tissue stores and mobilizing the metals to the kidneys for excretion in the urine.
It is important to perform both pre- and post-provocation urinalysis to permit distinction between ongoing exposures to metals (pre-) and net bodily retention. The pre-provocation urine collection can also be utilized to assess the rate of creatinine clearance if a serum specimen is also submitted.
Many clinicians also request the analysis of essential elements in urine specimens to evaluate nutritional status and the efficacy of mineral supplementation during metal detoxification therapy. Metal detoxification agents can significantly increase the excretion of specific nutrient elements such as zinc, copper, manganese and molybdenum.
Chromium metabolism authorities suggest that 24-hour chromium excretion likely provides the best assessment of chromium status. Early indication of renal dysfunction can be gleaned from urinary wasting of essential elements such as magnesium, calcium, potassium and sodium in an unprovoked specimen.
Variability in urine volume can drastically affect the concentration of elements. To compensate for urine dilution variation, elements are expressed per unit creatinine for timed collections. For 24-hour collections, elements are reported as both units per 24 hours and units per creatinine.
Optimal range: 0 - 25 µg/g creatinine
Urinary aluminum (Al) provides an indication of very recent or ongoing exposure to the potentially toxic metal. Urine accounts for greater than 95% of Al excretion from the body. Compromised renal function increases the risk of Al retention in the very young, elderly and patients with renal disease.
Optimal range: 0 - 0.18 µg/g creatinine
Possible sources of antimony:
- Food and smoking are the usual sources of antimony. Thus cigarette smoke can externally contaminate hair, as well as contribute to uptake via inhalation.
- Gunpowder (ammunition) often contains antimony. Firearm enthusiasts often have elevated levels of antimony in hair.
Other possible sources are:
- textile industry,
- metal alloys,
- and some anti-helminthic and anti-protozoal drugs.
- Antimony is also used in the manufacture of paints, glass, ceramics, solder, batteries, bearing metals and semiconductors.
Optimal range: 0 - 50 µg/g creatinine
Urinary arsenic (As) provides an indication of recent or ongoing exposure to various forms of the metalloid. Urine As may also indicate, to a lesser extent, endogenous detoxification of inorganic As. The less toxic organic forms of As from seafood have a circulating half-life of about 48 hours, and are rapidly excreted from the body. Consider very recent shellfish consumption with a finding of high urinary As.
Food, well water, and air are common sources of exposure for As. The predominant dietary source of As is seafood, followed by rice/rice-based products, mushrooms, and poultry (antiparasitics in feed). While fish/shellfish contain the highest levels of As, most abundant are the much less harmful organic As species arsenobetaine and arsenocholine; they are rapidly and efficiently excreted.
Optimal range: 0 - 5 µg/g creatinine
Urinary barium (Ba) provides an indication of recent or ongoing exposure to the toxic metal, and endogenous detoxification to a lesser extent. The main dietary sources of Ba include milk, flour, potatoes and some nuts and nut butters. Brazil nuts naturally contain high concentrations of Ba (e.g. 1,500 μg/g), and their recent consumption may be transiently associated with clinically insignificant elevations of urinary Ba.
Other sources of exposure to Ba include contaminated water, air or soil. Ba has been used in rodenticides and insecticides, and is used for medical testing (barium “swallow” for imaging). Mining, refining and combustion of coal and oil emit Ba. Mine-tailings and masonry products made from such can be a significant source of Ba to individuals producing or working with them (e.g. reconstruction, demolition).
Optimal range: 0 - 0.1 µg/g creatinine
Urinary beryllium (Be) provides an estimate of a recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. After assimilation Be is slowly excreted in urine and may be found elevated many months after high level exposure.
Be is poorly absorbed in the gastrointestinal tract, but is readily absorbed across the lungs and skin. Inhalation is the primary route of significant exposure to Be, and may be associated with dyspnea, cough and pulmonary distress (berylliosis). Berylliosis, is an occupationally acquired lung disease that is associated with primary production, metal machining, and reclaiming scrap alloys. Other high-exposure occupations are in the nuclear power, aerospace, and electronics industries.
Optimal range: 0 - 1 µg/g creatinine
Bismuth is found in alloys, catalysts, cosmetics, paints, magnets, ceramics, pharmaceuticals, x-ray contrast media,
and semiconductors. Bismuth is generally non-toxic, although very high levels may cause nausea, vomiting, and diarrhea.
Renal, neurological, and hematological problems have been associated with bismuth toxicity. Hair is not a sensitive
specimen for bismuth toxicity; blood and urine are most commonly used.
Optimal range: 0 - 0.9 µg/g creatinine
Urinary cadmium (Cd) provides an indication of recent or ongoing exposure to the toxic metal, and endogenous detoxification to a lesser extent. Most of absorbed Cd is retained in the liver and kidneys for many years. A small portion of assimilated Cd body leaves slowly in urine and bile/feces. Absorption, systemic transport and cellular uptake of Cd are mediated by metal transporters that the body uses for the essential elements iron, zinc and calcium.
Optimal range: 0 - 10 µg/g creatinine
Optimal range: 0 - 0.8 µg/g creatinine
Urinary gadolinium (Gd) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. Urinary Gd would be expected to be variably high if urine was collected within a week of medicinal Gd administration for imaging purposes.
Gd is found in the environment in geographically variable amounts, and usually at very low levels. It is widely used in industrial and household applications such as radar technologies, compact discs, and microwaves; direct exposure from such sources is not a concern. However disposal of Gd-containing devices contributes to greater potential for human exposure. The single greatest direct source of exposure to Gd is Gd-based contrast agents (GBCAs) that are widely used with magnetic resonance imaging (MRI).
Optimal range: 0 - 1.2 µg/g creatinine
A percentage of assimilated Lead is excreted in urine. Therefore the urine Lead level reflects recent or ongoing exposure to Lead and the degree of excretion or endogenous detoxification processes.
Sources of Lead include:
- old lead-based paints,
- batteries,
- industrial smelting and alloying,
- some types of solders,
- Ayruvedic herbs,
- some toys and products from China and Mexico,
- glazes on (foreign) ceramics,
- leaded (anti-knock compound) fuels,
- bullets and fishing sinkers,
- artist paints with Pb pigments,
- and leaded joints in municipal water systems.
Optimal range: 0 - 1.3 µg/g creatinine
Mercury is often abbreviated Hg. It may be breathed in, ingested or absorbed through the skin and is toxic. As a vapor, mercury is odorless.
Urinary mercury testing is considered a very accurate way to assess whether or not you have been exposed to the inorganic form of the heavy metal. There is also an organic form of mercury, which can become toxic in the body but this form of mercury is best detected in a blood test sample.
A urine mercury test measures mercury excretion from the body over 24 hours, both before and after a “provocation” or “detox” compound is ingested. A provocation compound increases the excretion of a substance such as toxic metals. EDTA, DMSA, and DMPS are examples of provocation compounds.
Optimal range: 0 - 5 µg/g creatinine
Urinary nickel (Ni) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. There is substantial evidence that Ni is an essential trace element.
However, excessive assimilation of Ni has been established to be nephrotoxic, and carcinogenic. The general population may be exposed to Ni from ambient air, water and food. With the exception of specific occupational exposures, most absorbed Ni comes from food and beverages, and intakes can vary depending upon geographical location and water supply. Extensive Ni exposure may occur with cigarette
smoking.
Optimal range: 0 - 0.3 µg/g creatinine
Urinary palladium (Pd) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent.
As one of the rarest elements in the earth’s crust, Pd is a precious metal associated with the platinum-group metals. The chemical and physical properties of Pd account for its widespread use in catalytic and automobile related industrial applications, electronic devices, dental applications, and fine jewelry (white gold). Currently Pd is used in the manufacture of the tiny multi-layer ceramic capacitors used in wide-screen television screens, computers and mobile phones.
Optimal range: 0 - 0.1 µg/g creatinine
Urinary platinum (Pt) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. Significant exposure to this non-essential, precious metal is unusual except in association with chemotherapy. Pt–containing, high-gold alloys have been used in dentistry for many decades. Platinum is poorly absorbed in the gut and high-level oral exposure is unlikely. Jewelers who make high-end jewelry may be exposed to Pt.
Optimal range: 0 - 0.5 µg/g creatinine
Urinary tellurium (Te) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. The metal has no physiological function in the body, and urinary excretion is predominant.
Te is a very rare element that is a byproduct of milled copper. The use of Te in industrial applications has increased in scope and scale. Te may be used as an additive in steel and it is often alloyed to aluminum, copper, lead and tin. It is also used in the manufacture of solar panels (cadmium-telluride), cast iron, ceramics, vulcanized rubber, blasting caps, and glass production.
Optimal range: 0 - 0.5 µg/g creatinine
Sources:
Fish, shellfish, plants, cigarettes, soil, air, water, electronic devices, switches and closures for the semiconductor industry, glass for medical procedures.
Nutrient interactions:
Some of its toxic effects results from interference with biological functions of potassium.
Optimal range: 0 - 0.02 µg/g creatinine
Urinary thorium (Th) provides an indication of recent or ongoing exposure to the radioactive metal, and endogenous detoxification to a lesser extent. This test measures Th232 which is the most abundant, naturally occurring radioactive isotope of Th.
Th is found almost everywhere in the earth’s crust, so exposure to small amounts of Th from air, food and water is unavoidable. Th is a naturally occurring radioactive metal that is found at low levels in soil, rocks, water, plants, and animals. Th is almost as abundant in the earth’s crust as lead, and three times more abundant than uranium (U238).
Optimal range: 0 - 5 µg/g creatinine
Urinary tin (Sn) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. Sn has no known physiological function in the body. Inorganic Sn has a low potential for toxicity, while organic Sn may have appreciable toxic effects.
Metallic Sn and inorganic Sn compounds are normally found in small amounts in soil, food and air. Exposure to Sn compounds may be much higher in close proximity to hazardous waste sites. Inorganic Sn is poorly absorbed from the gut. The main source of Sn is food. Canned tomatoes, tomato products, pineapple, pears and similar fruits contain the highest concentrations of Sn. The Sn concentrations of food increase with storage in opened cans.
Optimal range: 0 - 0.4 µg/g creatinine
Urinary tungsten (W) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. W doesn’t have physiological functions in the body, and has low toxic potential with oral exposure.
About 50% of W appears to be rapidly absorbed from gastrointestinal tract, and excretion from the body is primarily via the urinary route. W is highly absorbed via inhalation of dust and fumes. In the body W is antagonistic to the essential element molybdenum which is important for the conversion of sulfite to essential sulfate, and for the production of uric acid. Thereby, excess W may impair physiological reactions and be associated with sulfite sensitivity (wine, eggs, etc.) and/or low levels of uric acid in blood.
Low uric acid is not necessarily consequential, but rather may be an indicator of functional molybdenum insufficiency.
Optimal range: 0 - 0.03 µg/g creatinine
Urinary uranium (U) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. This test measures U238 which is the most abundant, naturally occurring U isotope.
All ten isotopes of U are radioactive; U-238 is the most abundant naturally occurring isotope and lowest energy emitter. It is important to note that the measured U-238 represents naturally occurring U, and does not indicate or imply exposure to highly enriched U-235 which is used in nuclear power and weaponry.
Essential Elements (Urine)
Many clinicians request the analysis of essential elements in urine specimens to evaluate nutritional status and the efficacy of mineral supplementation during metal detoxification therapy. Metal detoxification agents can significantly increase the excretion of specific nutrient elements such as zinc, copper, manganese and molybdenum.
Chromium metabolism authorities suggest that 24-hour chromium excretion likely provides the best assessment of chromium status. Early indication of renal dysfunction can be gleaned from urinary wasting of essential elements such as magnesium, calcium, potassium and sodium in an unprovoked specimen.
Variability in urine volume can drastically affect the concentration of elements. To compensate for urine dilution variation, elements are expressed per unit creatinine for timed collections. For 24-hour collections, elements are reported as both units per 24 hours and units per creatinine.
Optimal range: 0.6 - 4 mEq/g creat
Optimal range: 30 - 350 mEq/g creat
Optimal range: 0 - 2 mEq/g creat
Chromium (Cr) is essential for proper metabolism of glucose in humans. It potentiates the action of insulin via glucose tolerance factor (GTF) which is Cr+3 bound in a dinicotinic acid-glutathione complex. Other functions of Cr include aiding in lipid metabolism and assisting with HDL/LDL cholesterol balance.
Optimal range: 0 - 1.7 mEq/g creat
The Cobalt (Urine) biomarker helps assess your body’s cobalt levels and whether you may have been exposed to an unhealthy amount of this metal. While cobalt is essential in small amounts, elevated levels can signal an underlying issue that requires further evaluation. If you have concerns about your test results, it’s best to consult with your healthcare provider to determine the next steps.
Optimal range: 0.01 - 0.03 mEq/g creat
Optimal range: 0 - 50 mEq/g creat
Optimal range: 0.01 - 0.2 mEq/g creat
Lithium is a naturally occurring trace element found in soil, groundwater, and various plant-based foods. It is best known for its pharmaceutical form—lithium carbonate or lithium citrate—used at high doses to treat mood disorders such as bipolar disorder. However, in trace amounts, lithium may play a beneficial biological role, supporting brain health, mood regulation, cognitive function, and neuroprotection.
The "Essential Elements; urine" panel by Mosaic Diagnostics measures urinary excretion of lithium to assess short-term intake, environmental exposure, or supplementation. While lithium is not officially classified as an “essential nutrient” for humans, emerging research suggests that low-dose lithium intake may contribute to overall mental and neurological well-being.
Optimal range: 25 - 230 mEq/g creat
Optimal range: 0 - 0.6 mEq/g creat
Optimal range: 0.01 - 0.13 mEq/g creat
Molybdenum is an essential activator of some important enzymes in the body: sulfite oxidase (catalyzes formation of sulfate from sulfite), xanthine oxidase (formation of uric acid and superoxide ion from xanthine), and aldehyde oxidase (processes aldehydes). Over 50% of absorbed Mo is normally excreted in urine; the remainder is excreted via bile to the feces or is excreted in sweat.
Optimal range: 180 - 1100 mEq/g creat
Optimal range: 20 - 110 µg/mg creat
Optimal range: 0.03 - 0.25 mEq/g creat
Optimal range: 45 - 200 mEq/g creat
Optimal range: 0.04 - 0.3 mEq/g creat
Optimal range: 250 - 1050 mEq/g creat
Optimal range: 0 - 0.8 mEq/g creat
Dietary vanadium is found in black pepper, mushrooms, dill seed, parsley, soy, corn, olive oil, radishes and other root vegetables, lettuces, nuts and strawberries. A balanced diet may provide 10 to 30 mcg of Vanadium per day. This trace element is important in cellular metabolism, bone and tooth formation, reproduction and growth. Also, Vanadium appears to be involved in glucose metabolism.
Optimal range: 0.1 - 1.5 mEq/g creat
ZRT Laboratory (Urinary Neurotransmitters)
Neurotransmitters are chemical messengers used by the nervous system to relay information from one nerve to another.
Optimal neurotransmitter balance is required to maintain proper health. Imbalances can cause the brain and the body to be over- or under-stimulated, producing neurological or psychological symptoms.
Genetics, environment, chemicals and nutritional deficiencies are a few factors that can impact neurotransmitter production. Once out of balance, the nervous system begins to compensate – which, in time, can lead to neurological or psychological symptoms.
Some of the more common psychological conditions today are known to be accompanied by neurotransmitter imbalances. However, it’s also possible for individuals to present with similar symptoms yet have unique foundational imbalances. Testing helps clarify these root issues.
Common neurotransmitter-related causes of health issues often involve the following scenarios:
Anxiety & Depression
Neurotransmitter imbalances are often associated with anxiety and depression, specifically Glutamate (panic attacks), PEA, Histamine, Serotonin, as well as Epinephrine & Norepinephrine.
Chronic Fatigue
An imbalance between excitatory and inhibitory neurotransmitters can lead to persistent fatigue.
Impulsivity
GABA, Dopamine and Serotonin are three chemical messengers commonly linked to disorders like ADD, ADHD & OCD.
Insomnia
Imbalances in Glutamate, Histamine, Dopamine, GABA and Serotonin are often linked to sleep disturbances and insomnia.
PMS or PMDD
Imbalances in Serotonin, Dopamine, Norepinephrine and GABA are often involved in cases of PMDD (pre-menstrual dysphoric disorder) and severe PMS.
Optimal range: 147 - 467 µg/g creatinine
3-Hydroxykynurenine is a metabolic intermediate of the kynurenine pathway that elicits neurotoxic effects.
Optimal range: 2988 - 5850 µg/g creatinine
5-HIAA is the primary metabolite of serotonin, a chemical substance (neurotransmitter) that transmits messages between nerve cells. After it is used by the body, serotonin is broken down in the liver, and its metabolites, including 5-HIAA, are excreted in the urine.
Optimal range: 9.48 - 24.96 ug/g Cr
5a,3a-Androstanediol, a metabolite of the potent androgen 5a-Dihydrotestosterone (5a-DHT), is a significant marker in the ZRT Laboratory Urinary Neurotransmitters panel, emphasizing its role in male health and hormonal balance. This metabolite provides insight into the body's androgen metabolism, particularly reflecting the activity of 5a-DHT, a key hormone in male physiology.
In men, 5a,3a-Androstanediol is involved in several critical functions, including the development and maintenance of male characteristics, regulation of mood and libido, and influence on hair growth patterns. Abnormal levels of this metabolite can indicate issues in androgen metabolism, which might manifest in conditions such as male pattern baldness, prostate health concerns, and potential mood disorders.
Optimal range: 0.71 - 2.46 ug/g Cr
5a-Dihydrotestosterone (5a-DHT), a potent androgen, is a crucial marker in the ZRT Laboratory Urinary Neurotransmitters panel, underscoring its significance in male health and hormonal research. 5a-DHT, derived from testosterone via the enzyme 5-alpha reductase, plays a key role in male physiology, including the development of male characteristics, maintenance of prostate health, and regulation of hair growth.
Optimal range: 0.32 - 1.2 ug/g Cr
Allopregnanolone, a neurosteroid of growing interest in male health. This metabolite of progesterone plays a crucial role in modulating brain function, particularly influencing mood, stress response, and cognitive processes. In men, allopregnanolone levels are essential for maintaining neurological and psychological well-being. Abnormal levels of allopregnanolone can be indicative of various health issues, ranging from mood disorders to neurodegenerative diseases. The inclusion of allopregnanolone in ZRT's urinary neurotransmitter panel allows for a more comprehensive assessment of a patient's neuroendocrine status, contributing to a deeper understanding of the complex interplay between hormones and neurotransmitters in men's health.
Optimal range: 2.12 - 9.51 ug/g Cr
Androstenedione, a crucial androgenic steroid, is a notable marker in the ZRT Laboratory Urinary Neurotransmitters panel, reflecting its significant role in male health and endocrinology. In men, androstenedione serves as a vital precursor in the biosynthesis of testosterone and estrogen, hormones pivotal for maintaining various physiological functions. Produced primarily in the adrenal glands and testes, optimal levels of androstenedione are essential for supporting male sexual development, muscle mass, bone density, and overall energy levels.
Optimal range: 0.3 - 2 mg/ml
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Optimal range: 9.01 - 93.8 ug/g Cr
DHEA (Dehydroepiandrosterone), a pivotal adrenal hormone, features prominently in the ZRT Laboratory Urinary Neurotransmitters panel, underscoring its importance in male health and wellness. As one of the most abundant circulating steroids in humans, DHEA serves as a precursor to both androgens and estrogens, hormones that are essential in male physiology. In men, optimal DHEA levels are critical for maintaining muscle mass, bone density, mood stability, and overall energy levels. Low DHEA levels in males can be a marker of adrenal insufficiency, aging, or other health conditions, and are often associated with symptoms like fatigue, depression, a decrease in sexual function, and an increased risk for chronic diseases.
Optimal range: 658 - 1449 µg/g creatinine
Dopac (aka 3,4-Dihydroxyphenylacetic acid) is a metabolite of the neurotransmitter dopamine. Dopamine serves as the reward and pleasure center in the brain. DOPAC and HVA (Homovanillic Acid) are dopamine metabolites.
DOPAC levels, when viewed in conjunction with dopamine levels, may provide insight into how the body processes neurotransmitters.
Optimal range: 144 - 240 µg/g creatinine
Dopamine is a chemical found naturally in the human body. It is a neurotransmitter, meaning it sends signals from the body to the brain. Dopamine plays a part in controlling the movements a person makes, as well as their emotional responses. The right balance of dopamine is vital for both physical and mental wellbeing.
Optimal range: 3.15 - 8.85 ug/g Cr
Epi-Testosterone, an often-overlooked yet significant steroid hormone, is a critical marker in the ZRT Laboratory Urinary Neurotransmitters panel, underlining its relevance in the realm of male health diagnostics. Although chemically similar to testosterone, epi-testosterone functions differently and does not possess the same androgenic properties. In males, epi-testosterone is primarily known as a natural counterbalance to testosterone, maintaining a crucial hormonal equilibrium. Its ratio to testosterone is of particular interest in clinical assessments, as significant deviations from the normal balance can indicate various health issues, including endocrine disorders or potential doping in athletes.
Optimal range: 1.4 - 4.2 µg/g creatinine
Epinephrine is commonly known as adrenaline. Your body naturally produces it during times of stress. The hormone is also necessary for maintaining a healthy cardiovascular system — it makes the heart beat more strongly, and diverts blood to tissues during times of stress.
Optimal range: 0.18 - 0.49 ug/g Cr
Estradiol is vital in male health and is measured in the ZRT Laboratory Urinary Neurotransmitters panel. Originating from testosterone, it influences male libido, erectile function, and spermatogenesis. Imbalances can lead to health issues; high estradiol can cause gynecomastia and emotional changes, while low levels may decrease bone density and libido. The ZRT panel helps diagnose hormonal imbalances, assisting healthcare professionals in managing these conditions. Understanding estradiol levels is crucial for treating hormonal issues in males, leading to improved health outcomes.
Optimal range: 193 - 367 µg/g creatinine
GABA stands for Gamma-aminobutyric acid (γ-Aminobutyric Acid) and is a nonessential protein amino acid. GABA is an inhibitory neurotransmitter in the central nervous system.
Optimal range: 1515 - 2710 µg/g creatinine
Glutamate functions as the major excitatory neurotransmitter and metabolic fuel throughout the body. Glutamate is produced in your body, and is also found in many foods.
The brain's major excitatory neurotransmitter glutamate (also known as glutamic acid) functions as the "on" switch in the brain. Glutamate regulates appetite, thinking (cognition), increases gut motility, optimizes learning, modulates memory, mood and perception of pain, improves libido, and decreases sleep. The brain is the major contributor of glutamate in the body.
Optimal range: 37 - 71 µg/g creatinine
Glutamine improves immune function, balances ammonia in the body, contributes to biosynthesis of proteins, amino acids, nucleic acids, glutathione, glutamate, and GABA.
Optimal range: 61 - 159 mcg/g Creat.
Glycine is a simple, nonessential (can be made in the body) amino acid that plays a role in the production of DNA, phospholipids, collagen, creatine, heme and glutathione. Glycine serves as a neurotransmitter that modulates excitatory signals in the brain, and as an anti-inflammatory agent that calms aggression, improves sleep quality, stabilizes blood sugar, and improves metabolic parameters.
Optimal range: 5.2 - 15.3 µg/g creatinine
Histamine is a compound that affects immune response and physiological function of the digestive tract, and also acts as a neurotransmitter.
Histamine helps control the sleep-wake cycle as well as energy and motivation.
Histamine plays a dual role in the body as a neurotransmitter and a modulator of the immune system. Histamine has anti-pain properties, plays a neuroprotective role in the brain, and contributes to optimal maintenance of cognition and memory. Histamine stimulates wakefulness and decreases sleep, stimulates gastric acid production, increases metabolism, suppresses appetite, and prevents weight gain. Histamine is a potent vasodilator and a pro-inflammatory agent.
Optimal range: 19.7 - 58.4 µg/g creatinine
Histidine ameliorates fatigue, promotes clear thinking and concentration, reduces appetite, decreases anxiety, improves sleep and glucose homeostasis, and gives rise to histamine.
Optimal range: 3737 - 7048 µg/g creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 639 - 1200 µg/g creatinine
Kynurenic acid, a neuroactive metabolite produced from kynurenine, is regarded to be neuroprotective unless in excess amounts.
Optimal range: 257 - 960 µg/g creatinine
Kynurenine is a central metabolite of the amino acid tryptophan with vasodilatory properties.
Optimal range: 10.1 - 26 ug/g Cr
Melatonin (1st Morning), a crucial marker of sleep-wake cycle regulation and overall well-being, is a key component of the ZRT Laboratory Urinary Neurotransmitters panel, highlighting its significance in both sleep medicine and general health monitoring. Melatonin, often referred to as the "sleep hormone," is produced by the pineal gland in the brain and plays a vital role in regulating the body's circadian rhythm. The measurement of first morning melatonin levels provides invaluable insights into an individual’s sleep quality and circadian rhythm health.
Optimal range: 6 - 17 ug/g Cr
Melatonin (2nd Morning), a pivotal marker in the ZRT Laboratory Urinary Neurotransmitters panel, offers essential insights into an individual’s sleep-wake cycle and overall neuroendocrine health. This hormone, predominantly secreted by the pineal gland during darkness, is crucial for regulating circadian rhythms and promoting restful sleep. The measurement of melatonin levels on the second morning provides a unique perspective on the body's ability to maintain stable melatonin production across multiple sleep cycles.
Optimal range: 0.5 - 3.6 ug/g Cr
Melatonin (Evening), a critical biomarker in the ZRT Laboratory Urinary Neurotransmitters panel, plays an instrumental role in assessing nocturnal melatonin production and understanding sleep-wake cycle disturbances in individuals. Melatonin, often called the 'darkness hormone', is naturally produced by the pineal gland in response to darkness, peaking during the night to regulate sleep patterns and circadian rhythms. The measurement of evening melatonin levels provides valuable insights into the body’s readiness for sleep and its ability to enter a restful state.
Optimal range: 1.3 - 8.4 ug/g Cr
Melatonin (Night), a key indicator of sleep health and circadian rhythm, is a prominent marker in the ZRT Laboratory Urinary Neurotransmitters panel, underscoring its crucial role in evaluating nocturnal melatonin activity and overall well-being. Melatonin, known as the "sleep hormone," is produced by the pineal gland and is critical for regulating the sleep-wake cycle and maintaining the body's internal clock. Nighttime measurements of melatonin provide essential insights into an individual's natural sleep patterns and the effectiveness of their circadian rhythms.
Optimal range: 79 - 140 µg/g creatinine
N-methylhistamine is a major metabolite of the neurotransmitter histamine.
Optimal range: 15 - 28.1 µg/g creatinine
Norepinephrine, also known as noradrenaline, is important for mental focus and emotional stability.
Norepinephrine functions as a neurotransmitter and hormone that regulates the “fight or flight” response and elevates blood pressure and heart rate, stimulates wakefulness, and reduces digestive activity.
Optimal range: 17.9 - 31.7 µg/g creatinine
Normetanephrine, a metabolite of norepinephrine, is at normally low levels in the plasma. Certain tumors increase the levels and will increase the levels of nor-metanephrine. The Normetanephrine test, when normal, means these tumors are not present.
Optimal range: 5.3 - 16.1 µg/g creatinine
PEA stands for Beta-phenylethylamine and is an excitatory neurotransmitter made from phenylalanine and it modulates neuron voltage potentials to favor glutamate activity and neurotransmitter firing.
Optimal range: 47 - 140 ug/g Cr
Pregnanediol, a key marker in male health, is prominently featured in the ZRT Laboratory Urinary Neurotransmitters panel. Pregnanediol is a metabolite of progesterone, a hormone often associated with female reproductive health but equally important in males. In men, progesterone, and consequently pregnanediol, play roles in regulating the central nervous system, influencing mood, and contributing to the synthesis of other crucial steroids like testosterone.
Abnormal levels of pregnanediol in men can indicate various health concerns, including adrenal issues, hormonal imbalances, and even potential impacts on prostate health.
Optimal range: 5.2 - 13.7 µg/g creatinine
Norepinephrine and epinephrine are catecholamine messengers that play important roles in the regulation of diverse physiological systems by acting through adrenergic receptors.
Optimal range: 61 - 103.2 µg/g creatinine
Serotonin plays important roles in the resolution of mood, sleep, and appetite.
Serotonin is an inhibitory neurotransmitter synthesized by enzymes that act on tryptophan and/or 5-HTP.
Optimal range: 0.5 - 3 Ratio
The Testosterone to Epi-Testosterone ratio (T/Epi-T), a critical metric in male hormonal assessment, is a pivotal component of the ZRT Laboratory Urinary Neurotransmitters panel, emphasizing its importance in the field of men's health and endocrinology. This ratio, which compares the levels of testosterone (the primary male sex hormone) to epi-testosterone (a non-androgenic counterpart), is essential in evaluating hormonal balance and health in men. In clinical practice, the T/Epi-T ratio is particularly insightful, as it helps in identifying abnormalities in steroid metabolism and potential hormonal imbalances.
Optimal range: 24.5 - 134.1 µg/g creatinine
Taurine improves sleep, relieves anxiety, and has neuroprotective properties.
Optimal range: 3.81 - 14.21 ug/g Cr
Testosterone, the primary male sex hormone, is a key focus in the ZRT Laboratory Urinary Neurotransmitters panel, highlighting its paramount importance in men's health and endocrinology. This hormone plays a central role in male physiology, influencing muscle mass, bone density, fat distribution, and red blood cell production. Beyond physical attributes, testosterone is critical for libido, sexual function, mood regulation, and cognitive abilities. In men, optimal testosterone levels are essential for overall health and well-being.
Optimal range: 3970 - 8450 µg/g creatinine
Tryptophan is an amino acid that generates serotonin, melatonin, and kynurenine derivatives.
Optimal range: 279 - 588 µg/g creatinine
Tyramine is a trace amine derived from tyrosine, found naturally in food. Tyramine has vasoconstrictive properties and can increase blood pressure and trigger migraines.
Optimal range: 4790 - 10278 µg/g creatinine
Tyrosine enhances cognitive performance, energy, and alertness, and improves memory after sleep deprivation.
Optimal range: 2580 - 4766 µg/g creatinine
Vanilmandelate is a metabolite of epinephrine and norepinephrine (also known as adrenaline and noradrenaline).
Optimal range: 694 - 1510 µg/g creatinine
Xanthurenic acid is a metabolite of the kynurenine pathway, formed from 3-Hydroxykynurenine and serves as an indirect marker of vitamin B6 status.
Array 5 Multiple Autoimmune Reactivity Screen
This test measures predictive autoantibodies, including some that may appear up to 10 years before clinical symptoms. It provides a cost-effective and efficient evaluation of potential tissue damage across multiple organs, empowering early diagnosis and intervention for autoimmune and related conditions.
By offering predictive autoantibody testing alongside targeted antigen panels, this test empowers individuals and healthcare providers to take a proactive approach to autoimmune health and organ function.
Optimal range: 0.6 - 1.9 ELISA Index
ANTIBODIES ASSOCIATED WITH*:
*This test by itself is not diagnostic for any condition or disease
- Addison’s Disease
- Adrenal Autoimmunity
- Adrenal Insufficiency
- Atrophic Gastritis
- Autoimmune Endocrine Disorders
- Diabetes Insipidus
- Graves’ Disease
- Hashimoto’s Thyroiditis
- Vitiligo
Optimal range: 0 - 2.7 ELISA Index
ANTIBODIES ASSOCIATED WITH:
This test by itself is not diagnostic for any condition or disease
Alcoholic Liver Disease
Demyelinating Disease
Graves’ Disease
Hashimoto’s Thyroiditis
Infectious agent exposure
PANDAS / ANDAS / OCD
Rheumatoid Arthritis
Recent Onset Type 1 Diabetes Toxin Exposure
Known Cross-Reactions: Streptococcal Protein
----------------------------
Function: Tubulin is a building block protein and a major component of a cell’s internal cytoskeleton, called microtubules. These structures play key roles in many cellular functions including, interaction with guanine, lateral contacts, interaction with beta and gamma phosphates of nucleotides, interaction with gamma phosphate, longitudinal contacts, backbone interactions with α and β phosphates, hydrophobic contact of conserved residues, nucleotide contacts, MAP-binding domain and acetylation site.
Optimal range: 0 - 1.3 ELISA Index
ANTIBODIES ASSOCIATED WITH:
This test by itself is not diagnostic for any condition or disease
Alcoholic Liver Disease
Demyelinating Disease
Graves’ Disease
Hashimoto’s Thyroiditis
Infectious agent exposure
PANDAS / ANDAS / OCD
Rheumatoid Arthritis
Recent Onset Type 1 Diabetes Toxin Exposure
Known Cross-Reactions: Streptococcal Protein
----------------------------
Function: Tubulin is a building block protein and a major component of a cell’s internal cytoskeleton, called microtubules. These structures play key roles in many cellular functions including, interaction with guanine, lateral contacts, interaction with beta and gamma phosphates of nucleotides, interaction with gamma phosphate, longitudinal contacts, backbone interactions with α and β phosphates, hydrophobic contact of conserved residues, nucleotide contacts, MAP-binding domain and acetylation site.
Optimal range: 0.6 - 2 ELISA Index
Function:
Myosin, the major contractile protein, converts chemical energy into mechanical force through hydrolysis of ATP. a-Myosin is almost exclusively expressed in cardiac tissue.
Antibodies Appear:
- Autoimmune Myocarditis [3]
- Dilated Cardiomyopathy [3]
- Myasthenia Gravis [5]
- Rheumatic Heart Disease [2]
Optimal range: 0 - 1.7 ELISA Index
Function:
Arthritic peptide, glucose-6-phosphate isomerase, is an endogenous molecule associated with joints. This cytoplasmic enzyme catalyzes the second step of glycolysis and is found at low levels in serum. Arthritic peptide can stimulate KRN T cells when processed and presented by antigen presenting cells.
Antibodies Appear:
Mixed Connective Tissue Disease [1]
Osteoarthritis [2]
Rheumatoid Arthritis [1, 2, 3]
Known Cross-Reactions:
gliadin, dairy proteins, pork [4]
Optimal range: 0.4 - 1.6 ELISA Index
Function:
Saccharomyces cerevisae, baker’s yeast, contains Chl1p, a putative helicase with human homologs (antiSaccharamyces cerevisae antibody – ASCA), which is required for DNA repair, recombination, transcriptional silencing and aging. Anti-neutrophil cytoplasmic antibodies (ANCAs) are a group of autoantibodies against antigens in the cytoplasm of neutrophil granulocytes and monocytes.
Antibodies Appear:
Behçet’s Syndrome with GI Involvement
Crohn’s Disease
Long-term use of Anti-Thyroid Medication
Ulcerative Colitis5 Vasculitis
Optimal range: 0.6 - 1.6 ELISA Index
GM1 is exposed at the surface of spinal motor neurons, and in the peripheral nerves, it is limited to the node and paranodal region. Low levels of antibodies can be found in normal individuals and in patients with certain autoimmune disorders, however, high titers may be helpful in the diagnosis of multifocal motor neuropathy with conduction block (MMNCB), and paraproteinenia including motor neuron disease and multifocal motor neuropathy.
Optimal range: 0.1 - 1.4 ELISA Index
Asialoganglioside is exposed at the surface of spinal motor neurons, and in the peripheral nerves, it is limited to the node and paranodal region. Low levels of antibodies can be found in normal individuals and in patients with certain autoimmune disorders, however, high titers may be helpful in the diagnosis of multifocal motor neuropathy with conduction block (MMNCB), and paraproteinenia including motor neuron disease and multifocal motor neuropathy.
Optimal range: 0.4 - 1.5 ELISA Index
Function:
Cerebellum is the part of the brain controlling movement and balance. Inside the cerebellar cortex there are large neurons called Purkinje’s cells. The Cerebellar antibodies test measures antibodies against the cerebellum Purkinje’s Cell Antigens.
Antibodies Appear:
- Autism
- Celiac Disease
- Gluten Ataxia
- Paraneoplastic Cerebellar Degeneration Syndrome
- Opsoclonus-Myoclonus Syndrome
Known Cross-Reactions:
gliadin, tumor cells, Milk butyrophilin
Optimal range: 0 - 1.3 ELISA Index
Function:
Cerebellum is the part of the brain controlling movement and balance. Inside the cerebellar cortex there are large neurons called Purkinje’s cells. The Cerebellar antibodies test measures antibodies against the cerebellum Purkinje’s Cell Antigens.
Antibodies Appear:
- Autism
- Celiac Disease
- Gluten Ataxia
- Paraneoplastic Cerebellar Degeneration Syndrome
- Opsoclonus-Myoclonus Syndrome
Known Cross-Reactions:
gliadin, tumor cells, Milk butyrophilin
Optimal range: 0.2 - 1.5 ELISA Index
Function:
Collagen is a group of proteins found in the flesh and connective tissues. The most abundant protein of the human body, Collagen is the main component of connective tissue. Collagen is found in tissues such as tendon, ligament and skin, and is also abundant in cornea, cartilage, bone, blood vessels, the gut, and intervertebral disc. The fibroblast is the most common cell which creates collagen. In muscle tissue, collagen serves as a major component of the endomysium.
Antibodies Appear:
Arthritis [4]
Goodpasture’s Syndrome (*rat study) [1]
Type 1 Bullous SLE [3]
Known Cross-Reactions:
Clostridium botulinum, RNA polymerase 20–32, Streptococcus pyogenes; [1] Porphyromonas gingivalis; [5,6] Klebsiella; [7] Chicken collagen; [8] Cow, Pig, Goat and Dog collagen; [9] Cow gelatin [10]
Optimal range: 0.2 - 2.3 ELISA Index
Function:
The cytochrome P450 (CYP) superfamily is a large and diverse group of enzymes, most of which catalyze the oxidation of organic substances. A hepatocyte is a cell of the main tissue of the liver. Hepatocytes make up 70-80% of the liver’s cytoplasmic mass. These cells play a role in: protein synthesis; protein storage; transformation of carbohydrates; synthesis of cholesterol, bile salts and phospholipids; detoxification; modification, and excretion of exogenous and endogenous substances; and initiates formation and secretion of bile.
Antibodies Appear:
Autoimmune Hepatitis Type 2 [4]
Chronic Hepatitis C [4]
Heptocellular Carcinoma [3]
Liver/Mycrosomal Autoimmunities [1, 2]
Known Cross-Reactions:
asialoglycoprotein receptor, [2]
gliadin [5]
Optimal range: 0.4 - 1.3 ELISA Index
ANTIBODIES ASSOCIATED WITH:
This test by itself is not diagnostic for any condition or disease
Atherosclerotic Lesions
Osteoarthritis
BODY TISSUE:
Joint
Optimal range: 0.4 - 1.9 ELISA Index
Function:
Glutamic Acid Decarboxylase (GAD), a neuronal protein, is an enzyme responsible for the conversion of the excitatory neurotransmitter glutamate to the inhibitory neurotransmitter g-aminobutyric acid (GABA). GAD is also expressed by pancreatic beta cells.
Antibodies Appear:
- Battan disease [6]
- Celiac disease [3]
- Cerebellar ataxia [4]
- Gluten sensitivity [3]
- Polyendocrine autoimmune syndrome [2]
- Stiff-person syndrome [2]
- Type 1 Diabetes [2, 4, 7]
Known Cross-Reactions:
- Casein; [1]
- Coxsackievirus; [5]
- Gliadin; [7]
- Rotavirus; [9]
- Cytomegalovirus; [10, 11]
- Rubella; [12]
- Buckwheat, Amaranth, Rice, Corn, Yeast, Potato, Quinoa, Oats [13]
Optimal range: 0 - 5 U/mL
ANTIBODIES ASSOCIATED WITH*:
*This test by itself is not diagnostic for any condition or disease
Battan Disease
Celiac Disease
Cerebellar Ataxia
Non-Celiac Gluten Sensitivity
Polyendocrine Autoimmune Syndrome
Stiff-Person Syndrome
Type 1 Diabetes
Optimal range: 0 - 7.49 U/mL
Identification of individuals at risk of type 1 diabetes (including high-risk relatives of patients with diabetes).
Optimal range: 0.5 - 1.9 ELISA Index
Associated with:
- Insulinoma
- Type 1 Diabetes
- Unexplained Hypoglycemia
- Latent Autoimmune Diabetes of Adults
Optimal range: 0 - 2.5 ELISA Index
Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. It is necessary for the absorption of vitamin B12 within distal ileum.
Clinical Significance:
Autoantibodies against Intrinsic Factor are considered highly specific to patients with Pernicious Anemia. Intrinsic Factor antibodies are rarely found in the absence of Pernicious Anemia. Less commonly, Intrinsic Factor antibodies may also be found in patients with Graves’ disease and in relatives of patients with Pernicious Anemia.
Optimal range: 0.6 - 1.7 ELISA Index
Function:
Myelin is the protective sheath surrounding nerves. Myelin basic protein (MBP) is believed to be important in the process of myelination, the building of myelin sheaths. Thus, MBP is often a target in the demyelination process in various neuroimmune disorders.
Optimal range: 0.3 - 2 ELISA Index
Function:
Myelin is the protective sheath surrounding nerves. Myelin basic protein (MBP) is believed to be important in the process of myelination, the building of myelin sheaths. Thus, MBP is often a target in the demyelination process in various neuroimmune disorders.
Optimal range: 0 - 1.9 ELISA Index
Function:
Myocardial Peptides make up heart structure tissues.
Antibodies Appear:
- Acute Rheumatic Fever [6]
- Autoimmune Myocarditis [1, 2]
- Heart Disease [1, 2, 3]
- Heart Trauma [3, 4, 6]
- Rheumatic Heart Disease [6]
Optimal range: 0.7 - 2 ELISA Index
Function:
A star-shaped cell, an osteocyte is an abundant cell found in compact bone. Cytoplasmic extensions, which occupy canals called canaliculi, network osteocytes. Canaliculi are used by osteocytes for the exchange of nutrients and waste through gap junctions. Osteocytes are actively involved in the routine turnover of bony matrix, through various mechanisms. Through a mechanism called osteocytic osteolysis, osteocytes can destroy bone.
Antibodies Appear:
Osteoclastogenesis [4]
Osteopenia [3]
Osteoporosis [3]
Known Cross-Reactions:
Phosphatase I, [1] gliadin [5]
Clinical Significance:
Optimal range: 0 - 1.8 ELISA Index
ANTIBODIES ASSOCIATED WITH:
This test by itself is not diagnostic for any condition or disease
Autoimmune Endocrine Disorders
Autoimmune Polyendocrine Syndrome Type 1
Hypogonadism
Premature Menopause
Premature Ovarian Failure
BODY TISSUE:
Reproductive
Optimal range: 0 - 2.2 ELISA Index
Associated with:
- Gastric Autoimmunity
- Chronic Atrophic Gastritis
- Pernicious Anemia
Optimal range: 0.4 - 1.7 ELISA Index
Function:
Phospholipids are a class of lipids that are a major component of all cell membranes. They play a role in the formation of lipid bilayers. Most phospholipids contain a diglyceride, a phosphate group, and a simple organic molecule such as choline.
Antibodies Appear:
- Antiphospholipid Syndrome[1, 4]
- NIDDM [7]
- Systemic Lupus Erythematosus [3, 6]
Known Cross-Reactions:
- Anti-ribosomal P protein antibodies [1]
- DNA [2]
- Cardiolipin [2]
Optimal range: 0.6 - 1.8 ELISA Index
ANTIBODIES ASSOCIATED WITH:
This test by itself is not diagnostic for any condition or disease
Arterial Thrombosis
Autoimmune Thrombocytopenia
Cardiovascular Disease
Coronary Artery Disease
Systemic Lupus Erythematosus (SLE)
BODY TISSUE:
Cardiovascular and Endocrine
Optimal range: 0 - 2.1 ELISA Index
Function:
Synapsin I, also known as phosphosynaspin I, is a major immunoreactive protein found in most neurons of the central and peripheral nervous systems. It is a member of a group of neuronal phosphoproteins involved in the regulation of neurotransmitter release. Synapsin I is present in the nerve terminal of axons, specifically in the membranes of synaptic vesicles.
Antibodies Appear:
- Demyelinating Diseases
- Inhibited Neurotransmitter Release
- Lupus
- Multiple Sclerosis
Known Cross-Reactions:
Gliadin (a protein of wheat)
Optimal range: 0.1 - 1.5 ELISA Index
Function:
Synapsin I, also known as phosphosynaspin I, is a major immunoreactive protein found in most neurons of the central and peripheral nervous systems. It is a member of a group of neuronal phosphoproteins involved in the regulation of neurotransmitter release. Synapsin I is present in the nerve terminal of axons, specifically in the membranes of synaptic vesicles.
Antibodies Appear:
- Demyelinating Diseases
- Inhibited Neurotransmitter Release
- Lupus
- Multiple Sclerosis
Known Cross-Reactions:
Gliadin (a protein of wheat)
Optimal range: 0.5 - 2 ELISA Index
Optimal range: 0 - 200 WHO units
Function:
Thyroglobulin (Tg) is a glycoprotein formed by two identical subunits. Tg is synthesized in thyrocytes and released into thyroid follicles where it is most abundant. Tg plays the main role in coupling of iodinized tyrosine residues to form hormones, triiodothyronine (T3) and thyroxine (T4), through its specific sites. In order to release these hormones, the thyroid gland has to reabsorb the Tg droplets from the follicular lumen into folicular cells. A small fraction of Tg (around 100 mcg) is released from thyroid on a daily basis.
Antibodies Appear:
Autoimmune Thyroid Disease [1, 2, 3]
Hashimoto’s Thyroiditis [1, 2, 3]
Graves’ Disease [1, 2]
Known Cross-Reactions:
Thyroid peroxidase, [4] heat shock protein, [5] Latex hevein [6]
Optimal range: 0 - 2.1 ELISA Index
Function:
Thyroid peroxidase (TPO) is an enzyme expressed mainly in the thyroid that frees iodine for its addition onto thyroglobulin tyrosine residues for the production of thyroxine (T4) or triiodothyronine (T3), thyroid hormones.
Some TPO antibodies may lyse thyroid cells or inhibit TPO enzyme activity, in vitro [2, 7] but in general it is considered an antibody response to thyroid damage inflicted by T-Cells.
Antibodies Appear:
Autoimmune Thyroid Disease [1, 3, 5, 6]
Graves’ Disease [3]
Hashimoto’s Thyroiditis [2]
Vitiligo [3, 4]
Known Cross-Reactions:
Thyroglobulin, [9]
Gliadin, [10]
Helicobacter pylori, [11]
heat shock protein [12]
Optimal range: 0 - 100 WHO units
Function:
Thyroid peroxidase (TPO) is an enzyme expressed mainly in the thyroid that frees iodine for its addition onto thyroglobulin tyrosine residues for the production of thyroxine (T4) or triiodothyronine (T3), thyroid hormones. Some TPO antibodies may lyse thyroid cells or inhibit TPO enzyme activity, in vitro [2, 7] but in general it is considered an antibody response to thyroid damage inflicted by T-Cells.
Antibodies Appear:
Autoimmune Thyroid Disease [1, 3, 5, 6]
Graves’ Disease (an immune system disorder that results in the overproduction of thyroid hormones) [3]
Hashimoto’s Thyroiditis (can cause your thyroid to not make enough thyroid hormone.)[2]
Vitiligo [a chronic (long-lasting) autoimmune disorder that causes patches of skin to lose pigment or color.] [3, 4]
Known Cross-Reactions:
- Thyroglobulin, [9]
- gliadin, [10]
- Helicobacter pylori, [11]
- heat shock protein [12]
Optimal range: 0 - 3 ELISA Index
Associated with:
• Ulcerative Colitis
• Colon Autoimmunity
• Inflammatory Bowel Disease
Tropomyosin is a cytoskeletal microfilamental protein that regulates actin mechanics. Tropomyosin plays an important role in muscle contraction. Tropomyosin, along with the troponin complex, works with actin in muscle fibers and manages muscle contraction by regulating the binding of myosin. Tropomyosin isoforms are involved in the stabilization of actin filaments, intracellular organelle movement, cell-shape maintenance and cytokinesis.
Array 3X - Wheat/Gluten Proteome Reactivity & Autoimmunity Screen
Inclusion of the specific antigens comprising Antibody Array 3, or Comprehensive Gluten Reactivity and Autoimmunity is based on recent medical research studies. Comprehensive quantitative mapping of T-cell epitopes was determined in CD. Results demonstrated that people respond to a heterogeneous array of peptides; some recognized many peptides from single or multiple gliadin families, while others reacted to only one peptide. These results confirmed that a large number of gluten epitopes may be implicated in the development of CD and associated diseases. Indeed, a T-cell line from one Celiac patient failed to recognize any of the 21 tested peptides, which confirmed that a large number of gluten and other wheat protein epitopes are implicated in development of CD and associated disorders. This suggests that other gliadin peptides and proteins are involved in the pathogenesis of Gluten-Reactivity and CD. Cyrex extended this heterogeneity in T-cell responses to gluten and other peptides originated from wheat to humoral immune responses by measuring IgG and IgA antibodies against nine different wheat antigens and peptides as well as enzymes associated with autoimmunities. Heterogeneity in IgG and IgA antibodies against these twelve antigens was confirmed by variation in antibody response against various wheat associated antigens on individual bases.
Measuring a patient’s immune response to an array of wheat antigens increases the sensitivity and specificity, and will provide greater confidence in formulation of a diagnosis that allows for better patient compliance with a gluten-free diet.
Assessing wheat/gluten reactivity and intestinal autoimmunity is recommended for people who:
- Have gut dysbiosis, which appears to be resistant to standard therapy
- Are suspected of having intestinal mucosal damage
- Complain of food allergy and intolerance
- Complain of chemical hypersensitivity
- Present multiple-symptom complaints (including Chronic Fatigue Syndrome and Fibromyalgia)
- Suffer from abnormal immune cell count and function
- May suffer from blood-brain barrier permeability, depression, or neuroautoimmunity
- Neuroautoimmune patients to consider:
- Thyroiditis
- Arthritis
- Myocarditis
- Dermatitis
- Endocrinopathy
- Polyendocrinopathy
- Osteoarthritis
- Pernicious Anemia
- Other
Clinical Use:
- Identify possible Celiac disease, non-celiac gluten sensitivity, dermatitis herpetiformis, gluten ataxia or other wheat/gluten-related disorder.
- Assess autoimmune reactivity associated with wheat proteins and peptides.
What is celiac disease?
Celiac disease is a well-recognized medical condition in which gliadins (gluten proteins found in wheat, barley and rye) cause an immune reaction in sensitive individuals which destroys the lining of the small intestine. This can lead to severe digestive symptoms and malabsorption of nutrients However, some celiac patients have no gut symptoms, even though their body is still being damaged, while others experience neurological and psychiatric symptoms instead of the classic digestive distress.
It is now recognized that many people have reactions to either wheat or gluten that don’t qualify as a celiac disease but still impact on their health. This includes wheat sensitivity and non-celiac gluten-sensitivity. Previously it was thought that the effects of gluten were limited to celiac disease, and strictly gut-oriented, such as bloating, gas, and abdominal pain.
What are common symptoms of celiac disease, wheat sensitivity and non-celiac gluten sensitivity?
The symptoms of celiac disease, wheat sensitivity and NCGS are very diverse. This can make it difficult to diagnose and it is not possible to distinguish between different gluten-related complaints on the basis of symptoms alone.
Common symptoms include:
- Bloating
- Abdominal pain
- Fatigue
- Diarrhoea or constipation
- Headaches
- Anxiety
- Depression
- Nausea
- Brain fog
- Heartburn
- Numbness in arms and legs
- Ataxia (lack of coordination, gait abnormality, speech changes or abnormalities in eye movements)
- Mouth ulcers
- Joint and muscle pain
- Dermatitis/rashes
- Anaemia
Older tests for celiac disease and gluten sensitivity focus on just one protein – alpha gliadin.
It has been discovered wheat is made up of more than 100 different components that can cause a reaction, not just one. The problem is, a person can react to only one of the many proteins in wheat, or a combination of proteins, peptides, and enzymes associated with wheat.
The full range of antigens tested includes:
- Wheat IgG
- Wheat IgA
- Wheat Germ Agglutinin IgG
- Wheat Germ Agglutinin IgA
- Non-Gluten Proteins-A IgG*
- Non-Gluten Proteins-A IgA*
- Non-Gluten Proteins-B IgG*
- Non-Gluten Proteins-B IgA*
- Gliadin Toxic Peptides IgG*
- Gliadin Toxic Peptides IgA*
- Native + Deamidated Alpha-Gliadin-33-mer IgG
- Native + Deamidated Alpha-Gliadin-33-mer IgA
- Alpha-Gliadin-17-mer IgG
- Alpha-Gliadin-17-mer IgA
- Gamma-Gliadin-15-mer IgG
- Gamma-Gliadin-15-mer IgA
- Omega-Gliadin-17-mer IgG
- Omega-Gliadin-17-mer IgA
- Glutenin-21-mer IgG
- Glutenin-21-mer IgA
- Gluteomorphin+Prodynorphin IgG
- Gluteomorphin+Prodynorphin IgA
- Gliadin-Transglutaminase Complex IgG
- Gliadin-Transglutaminase Complex IgA
- Microbial Transglutaminase IgG*
- Microbial Transglutaminase IgA*
- Transglutaminase-2 IgG
- Transglutaminase-2 IgA
- Transglutaminase-3 IgG
- Transglutaminase-3 IgA
- Transglutaminase-6 IgG
- Transglutaminase-6 IgA
The test is able to identify possible celiac disease, non-celiac gluten sensitivity, dermatitis herpetiformis, gluten ataxia or other wheat/gluten-related disorders. It can also be useful for assessing autoimmune reactivity associated with wheat proteins and peptides.
How to interpret your test results?
When IgA reactions are predominant, it is an indication of possible Celiac disease and other autoimmunities.
When IgG reactions are predominant, it is an indication of wheat/gluten immune response and possible autoimmunity due to lack of digestive enzymes and/or other factors.When both IgA and IgG reactions occur, it is an indication of wheat/gluten immune response and its progression to Celiac disease and/or other autoimmune disorders.
For an interpretive chart, please visit out blog: https://blog.healthmatters.io/2023/07/03/cyrex-3-interpretation-chart/
Optimal range: 0.2 - 1.5 ELISA Index
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0 - 1.2 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.2 - 1.6 ELISA Index
The wheat tested is the full kernel containing the protein constituents of wheat. This includes what may be on or in the wheat kernel. These are gluten proteins, and non-gluten proteins (non-gluten proteins A and B and Wheat Germ Agglutinins). A positive result to wheat means that your digestive system is not absorbing these proteins well, therefore your immune system starts producing antibodies to gluten or non-gluten part(s) of wheat.
Optimal range: 0 - 1.3 ELISA Index
The wheat tested is the full kernel containing the protein constituents of wheat. This includes what may be on or in the wheat kernel. These are gluten proteins, and non-gluten proteins (non-gluten proteins A and B and Wheat Germ Agglutinins). A positive result to wheat means that your digestive system is not absorbing these proteins well, therefore your immune system starts producing antibodies to gluten or non-gluten part(s) of wheat.
Optimal range: 0 - 1.1 ELISA Index
Optimal range: 0.2 - 1.5 ELISA Index
Optimal range: 0.3 - 2.4 ELISA Index
Optimal range: 0 - 2.2 ELISA Index
Optimal range: 0 - 2.1 ELISA Index
Microbial Transglutaminase is not made by the human body, it is made by bacteria and is used in the food and drug industry. It is capable of cross reacting with the Gliadin-Transglutaminase complex. Those antibodies may trigger autoimmune reactivity.
Optimal range: 0.1 - 2 ELISA Index
Microbial Transglutaminase IgG is a specific marker tested in the Array 3X - Wheat/Gluten Proteome Reactivity & Autoimmunity panel developed by Cyrex Laboratories, designed to detect immune responses to a unique enzyme, microbial transglutaminase. This enzyme, commonly used in food processing to improve protein texture, is structurally similar to the tissue transglutaminase (tTG) enzyme in the human body, which plays a role in the development of celiac disease and other gluten-related disorders.
Optimal range: 0.2 - 1.4 ELISA Index
Optimal range: 0.3 - 1.8 ELISA Index
Optimal range: 0 - 1.8 ELISA Index
Alpha-amylase and serpin can escape digestion and activate toll-like receptor-4 (TLR4). Immune reactivity and clinical manifestations of non-gluten proteins are most often associated with hypersensitivities/allergies. IgG and IgA antibodies to non-gluten proteins may be present due to cross-reactivity between non-gluten and gluten proteins. Homology between g-gliadin and non-gluten proteins has been shown. Furthermore, wheat, barley, rye and corn belong to the same family of a-amylase inhibitors.
Optimal range: 0 - 1.3 ELISA Index
Optimal range: 0.3 - 1.3 ELISA Index
Optimal range: 0 - 3 ELISA Index
The "Non-Gluten Proteins-B IgG" marker is designed to detect immune system reactions to a variety of proteins in wheat that are not classified as gluten. While gluten often gets the most attention due to its association with celiac disease and gluten sensitivity, wheat contains a broad array of other proteins that can also trigger immune responses in some individuals. These non-gluten proteins can provoke IgG antibodies, which are a type of antibody that the immune system produces in response to what it perceives as foreign invaders.
Optimal range: 0.2 - 1.7 ELISA Index
The Omega-Gliadin-17-mer peptide is a highly immunogenic fragment of gliadin, a component of gluten, and measuring IgA antibodies against it can help identify mucosal immune responses, especially in the gut. Elevated levels of Omega-Gliadin-17-mer IgA may indicate non-celiac gluten sensitivity, early-stage celiac disease, or other forms of gluten-related disorders, even in individuals who test negative for traditional celiac markers. Because IgA is the primary immunoglobulin found in mucosal areas like the intestines, this test is particularly useful for uncovering immune activation in the gut lining due to gluten exposure.
Optimal range: 0 - 1.4 ELISA Index
Optimal range: 0.1 - 1.6 ELISA Index
Optimal range: 0 - 1.4 ELISA Index
Tissue Transglutaminase-2 (tTG2) -- Transglutaminases are enzymes with multiple functions. One of the key functions is to build tissue structures. tTG2 is found throughout the body, but is the predominant enzyme in the intestinal villi. This makes it a preferred biomarker for possible Celiac disease.
Optimal range: 0.1 - 1.8 ELISA Index
Tissue Transglutaminase-3 (tTG3) -- The transglutaminase found in skin and hair shaft follicles is tTG3. In some individuals, the ingestion of gluten causes eruptions on the skin known as dermatitis herpetiformis. Adherence to the gluten-free diet can clear the skin of these eruptions.
Optimal range: 0 - 1.4 ELISA Index
Tissue Transglutaminase-3 (tTG3) -- The transglutaminase found in skin and hair shaft follicles is tTG3. In some individuals, the ingestion of gluten causes eruptions on the skin known as dermatitis herpetiformis. Adherence to the gluten-free diet can clear the skin of these eruptions.
Optimal range: 0.4 - 2 ELISA Index
Tissue Transglutaminase-6 (tTG6) -- The transglutaminase found in the brain and nervous system is tTG6. In some individuals, the ingestion of gluten causes neurological manifestations, such as gluten ataxia (walking or balance disorder) or peripheral neuropathy (tingling in the legs or feet). Adherence to the gluten-free diet can improve these neurological conditions.
Optimal range: 0 - 1.2 ELISA Index
Tissue Transglutaminase-6 (tTG6) -- The transglutaminase found in the brain and nervous system is tTG6. In some individuals, the ingestion of gluten causes neurological manifestations, such as gluten ataxia (walking or balance disorder) or peripheral neuropathy (tingling in the legs or feet). Adherence to the gluten-free diet can improve these neurological conditions.
Optimal range: 0 - 1.6 ELISA Index
Wheat Germ Agglutinin is not gluten, but is found in whole grain wheat. If your test results are positive (higher than normal levels of antibodies) the most logical suggestion is to not eat whole grain wheat and to be certain other wheat derived foods are not Wheat Germ Agglutinin contaminated.
Optimal range: 0 - 1 ELISA Index
Wheat Germ Agglutinin is not gluten, but is found in whole grain wheat. If your test results are positive (higher than normal levels of antibodies) the most logical suggestion is to not eat whole grain wheat and to be certain other wheat derived foods are not Wheat Germ Agglutinin contaminated.
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0 - 1.8 ELISA Index
Array 10 - Multiple Food Immune Reactivity Screen
Written By: B. Dame
Updated On: January 27, 2025
This test is a comprehensive food immune reactivity assessment, evaluating 180 foods in the form they are typically consumed—whether raw, cooked, or both. By measuring Immunoglobulin G (IgG) antibody responses to these foods, the test provides actionable insights into potential food sensitivities and immune reactions.
Elevated IgG antibody levels can trigger an inflammatory response, which may lead to tissue damage and a range of symptoms. While the antibodies themselves do not cause harm, their role in initiating inflammation can contribute to:
It’s important to note that IgG reactivity does not always correlate directly with symptoms. However, elimination of reactive foods has been shown to reduce these symptoms significantly in many cases.
IgG food testing is a valuable tool for individuals with chronic conditions, including:
The test helps guide elimination diets, which have been clinically proven to alleviate symptoms associated with food sensitivities. For example:
Food-related immune reactions are broadly categorized into IgG-mediated sensitivities and IgE-mediated allergies:
IgE Food Allergies:
IgG Food Sensitivities:
Elimination diets based on IgG test results have demonstrated success in improving conditions such as:
Elimination diets guided by IgG food test results can help pinpoint specific food triggers and improve overall well-being. Research has shown these diets to:
Clinical studies have consistently demonstrated the effectiveness of IgG-guided elimination diets:
1. What does an elevated IgG level mean?
Elevated IgG levels suggest an immune response to specific foods but don’t necessarily indicate intolerance. It’s a marker of potential sensitivity, and elimination diets can help determine if symptoms improve by avoiding those foods.
2. How long do IgG food antibodies stay in the body?
IgG antibodies can remain in the body for several weeks, which is why symptoms of IgG food sensitivities may appear hours to days after consuming the triggering food.
3. What conditions can IgG food testing help with?
IgG food testing has been shown to benefit conditions like IBS, migraines, autism spectrum disorders, ADHD, rheumatoid arthritis, and epilepsy.
4. How is IgG different from IgE testing?
IgE testing identifies immediate food allergies, while IgG testing identifies delayed food sensitivities that cause symptoms over time. Both play distinct roles in understanding immune reactions to food.
5. Can IgG food testing help with weight loss?
While not directly designed for weight loss, identifying and removing IgG-reactive foods may help reduce inflammation and improve energy levels, supporting overall health and weight management.
6. How accurate is IgG food sensitivity testing?
IgG food testing is supported by research and clinical evidence, but results should always be interpreted by a qualified healthcare provider. Combining test results with elimination diets often yields the best outcomes.
Find out more about the Elimination diet here >>
Optimal range: 0.2 - 1.8 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.2 - 2 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0 - 1.8 ELISA Index
Optimal range: 0.2 - 1.5 ELISA Index
Optimal range: 0.3 - 1.3 ELISA Index
Optimal range: 0.2 - 2.8 ELISA Index
Optimal range: 0.1 - 2.7 ELISA Index
Optimal range: 0.3 - 2.1 ELISA Index
Optimal range: 0.1 - 2.2 ELISA Index
Optimal range: 0.2 - 1.1 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.1 - 2.3 ELISA Index
Optimal range: 0.2 - 2.8 ELISA Index
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0.3 - 1.9 ELISA Index
Optimal range: 0.3 - 1.9 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 1.8 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.3 - 2.1 ELISA Index
Optimal range: 0.3 - 1.6 ELISA Index
Optimal range: 0.1 - 1.6 ELISA Index
Optimal range: 0.1 - 1.8 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 2 ELISA Index
Optimal range: 0.1 - 3 ELISA Index
Optimal range: 0.1 - 2.5 ELISA Index
Optimal range: 0.1 - 2.5 ELISA Index
Optimal range: 0.1 - 1.9 ELISA Index
Optimal range: 0.1 - 1.2 ELISA Index
Optimal range: 0.1 - 1.1 ELISA Index
Carrageenan gum is a substance extracted from red and purple seaweeds, consisting of a mixture of polysaccharides. It is used as a thickening or emulsifying agent in food products. You will often find this ingredient in nut milks, meat products, and yogurt.
Most food-related gums are composed of complex and variable mixtures of oligosaccharides, polysaccharides and glycoproteins with an extremely high molecular weight polysaccharide attached to a hydroxyproline-rich polypeptide backbone.
Gum reactivity can be a serious problem especially for people on a gluten-free diet. Gluten-free products often use gums as a substitute for gluten to hold ingredients together.
Optimal range: 0.1 - 2.7 ELISA Index
Optimal range: 0.1 - 2.2 ELISA Index
Optimal range: 0.2 - 1.5 ELISA Index
Optimal range: 0.3 - 1.7 ELISA Index
Optimal range: 0.2 - 2.3 ELISA Index
The cashew tree, belonging to the plant family Anacardiaceae, grows in the tropical climate and produces cashew apples and cashew seeds. The cashew seed, which is mostly just referred to as cashew, is widely consumed either on its own, raw or roasted, or used in a variety of recipes.
Optimal range: 0.1 - 2.2 ELISA Index
Optimal range: 0.1 - 2.3 ELISA Index
Optimal range: 0.2 - 1.4 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.2 - 1.7 ELISA Index
Chia seeds (Salvia hispanica), also called Salba chia or Mexican chia, are the edible seeds of a flowering plant from the mint family. Native to Mexico and Guatemala, the seeds have a long history. They were a vital crop in ancient Aztec and Mesoamerican cultures. The seeds had medicinal applications and made up an important part of the peoples’ diets.
Today, chia grows commercially in many countries including Mexico, Guatemala, Peru, Argentina, Australia, and the United States. The seeds are widely recognized as a nutrient-dense addition to healthy diets.
Optimal range: 0 - 1.3 ELISA Index
Optimal range: 0.1 - 1.9 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Cilantro and Coriander come from the same plant, but the tastes are very different. If you find you are allergic to cilantro, you are very likely to be allergic to Coriander as well. Cilantro is the leaves and stems, while Coriander is the seeds from the plant flowers. Cilantro is found in many Asian and Mexican dishes such as sauces, salsa, and pesto.
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.3 - 1.7 ELISA Index
Optimal range: 0.1 - 1.9 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.4 - 1.8 ELISA Index
Optimal range: 0.2 - 2 ELISA Index
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0.1 - 1.8 ELISA Index
What are Aquaporins?
Aquaporins, also known as ‘water channels,’ are integral membrane proteins that conduct water molecules in and out of cells in the human body. Aquaporins from food sources are highly stable in food preparation and therefore may reach the gastrointestinal as intact proteins or peptides. In cases of breakdown in immunological tolerance, aquaporins from foods may become antigenic, and the immune reaction against them could result in antibody production. Aquaporins from food sources show similarity to human aquaporin, and thus they have high potential for triggering autoimmunity to nervous system tissues.
Optimal range: 0.1 - 1.4 ELISA Index
Optimal range: 0.2 - 2.1 ELISA Index
Optimal range: 0.3 - 2.4 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.1 - 2.6 ELISA Index
Optimal range: 0.2 - 2.3 ELISA Index
Optimal range: 0.2 - 1.2 ELISA Index
Optimal range: 0.2 - 1.4 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.3 - 1.7 ELISA Index
Optimal range: 0.1 - 1.6 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.1 - 2.1 ELISA Index
Optimal range: 0.3 - 1.5 ELISA Index
Optimal range: 0.2 - 2.2 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.5 - 1.1 ELISA Index
Artificial food colorings are used extensively in foods, and humans are regularly exposed to them by ingestion. These chemical colorants form adducts (bonds or “bridges”) with proteins in humans; therefore, measuring the antibodies to these colorants will indicate whether or not they are responsible for a person's immune or autoimmune reaction. A person may not react to a particular food; however, they may react to the food once its protein is bound with an artificial colorant. It is important to note that we are talking about food proteins binding to artificial food colorants, and vice-versa. The binding of artificial colorants to a food protein may increase the food’s antigenicity and ability to cause an enhanced immune reaction in patients.
Optimal range: 0.2 - 1.8 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0 - 1.2 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.1 - 1.9 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.1 - 2.5 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.1 - 1.9 ELISA Index
Optimal range: 0.2 - 1 ELISA Index
Optimal range: 0.3 - 1.2 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.3 - 1.8 ELISA Index
Optimal range: 0.2 - 2.4 ELISA Index
Optimal range: 0.1 - 1.4 ELISA Index
Gum tragacanth is one of the most widely used natural emulsifiers and thickeners available to the food, drug, and allied industries. The high viscosity imparted to water by the gum makes it useful for preparing aqueous suspensions of insoluble substances. Gum tragacanth has the food additive E number E413. Gum tragacanth is the dried gummy exudation of several species of Astragalus (family Leguminosae).
Optimal range: 0.1 - 1.6 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.3 - 1.5 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.2 - 1.7 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.3 - 2 ELISA Index
Optimal range: 0.2 - 1.3 ELISA Index
Optimal range: 0.2 - 1.9 ELISA Index
Optimal range: 0.3 - 2 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 1.8 ELISA Index
Optimal range: 0 - 0.8 ELISA Index
Locust bean gum, also known as carob bean gum, comes from the carob seeds of the carob tree, grown in the Mediterranean. It is a hydrocolloid used in food as a thickener, stabilizer and emulsifier.
Locust bean gum is used as a stabilizer, thickener, and fat replacer in foods, and also as an adjunct gelling agent and texturizer to other hydrocolloids such as carrageenan.
Optimal range: 0.3 - 2.3 ELISA Index
Optimal range: 0.2 - 2 ELISA Index
Optimal range: 0.2 - 1.5 ELISA Index
Optimal range: 0 - 1.3 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Meat-glue, a combination of transglutaminase with other ingredients, is used to turn small pieces of meat into larger pieces of meat.
Optimal range: 0.3 - 2.1 ELISA Index
Optimal range: 0.1 - 1.6 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.4 - 1.5 ELISA Index
Optimal range: 0.2 - 1.9 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.2 - 1.7 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0.4 - 2.6 ELISA Index
Optimal range: 0.1 - 1.6 ELISA Index
Optimal range: 0.2 - 1.7 ELISA Index
Optimal range: 0.2 - 2.1 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.1 - 2.3 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.2 - 2 ELISA Index
Optimal range: 0.3 - 1.9 ELISA Index
Optimal range: 0.2 - 1.9 ELISA Index
Optimal range: 0.3 - 1.8 ELISA Index
Optimal range: 0.2 - 1.4 ELISA Index
Optimal range: 0.2 - 2.6 ELISA Index
Optimal range: 0.3 - 1.5 ELISA Index
Optimal range: 0.1 - 1.9 ELISA Index
Oral ingestion of pineapple (in any form) may induce IgE-mediated allergic reactions, such as OAS or even severe reactions like anaphylaxis.
Optimal range: 0.2 - 2.6 ELISA Index
Bromelain is a specific pineapple antigen. When assessed alone it is more sensitive than measuring antibodies against many pineapple proteins.
Optimal range: 0.4 - 2.4 ELISA Index
Optimal range: 0.4 - 2 ELISA Index
Optimal range: 0.3 - 2.2 ELISA Index
Optimal range: 0.3 - 1.9 ELISA Index
Optimal range: 0.1 - 1.9 ELISA Index
Optimal range: 0.1 - 2.2 ELISA Index
Optimal range: 0.1 - 1.8 ELISA Index
Optimal range: 0.1 - 1.6 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.2 - 1.6 ELISA Index
Optimal range: 0.5 - 1.5 ELISA Index
People who are new to the GFD encounter new foods and/or over-consume old favorites to compensate for the lack of wheat in the diet. Gluten-free cookies, crackers, breads and cakes often contain copious amounts of rice, amaranth, sorghum and other substitutes. Some of these new-to-the-patient foods may illicit an adverse reaction. Other foods that are often introduced to the patient on the GFD are quinoa, buckwheat and hemp. Some People may turn to the “ancient” grains (Polish wheat, spelt, barley, rye), not knowing that these contain gluten. Another problem patients often face on the GFD is the over-consumption of another starch to make up for the loss of wheat. They turn to potato, rice or corn as a substitute. This can lead to the development of a new sensitivity or the enhancement of old sensitivities.
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 2.3 ELISA Index
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0.2 - 1.7 ELISA Index
Optimal range: 0.2 - 1.7 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.3 - 2.2 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.2 - 2.3 ELISA Index
Optimal range: 0.2 - 2.4 ELISA Index
Optimal range: 0.3 - 2.9 ELISA Index
Optimal range: 0.1 - 2 ELISA Index
Optimal range: 0.2 - 2.8 ELISA Index
Optimal range: 0.1 - 1.2 ELISA Index
Optimal range: 0.2 - 1.3 ELISA Index
Optimal range: 0.2 - 1.6 ELISA Index
Optimal range: 0.1 - 1.6 ELISA Index
Optimal range: 0.1 - 2.1 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.2 - 1.9 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Optimal range: 0.1 - 1.7 ELISA Index
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 2 ELISA Index
Optimal range: 0.3 - 2.3 ELISA Index
Optimal range: 0.2 - 1.5 ELISA Index
Optimal range: 0.4 - 1.8 ELISA Index
Optimal range: 0.1 - 1.8 ELISA Index
Optimal range: 0.2 - 1.4 ELISA Index
Optimal range: 0.2 - 2.2 ELISA Index
Aquaporins from food sources show similarity to human aquaporin, and thus they have high potential for triggering autoimmunity to nervous system tissues.
Optimal range: 0.2 - 2.1 ELISA Index
Optimal range: 0.1 - 2.4 ELISA Index
Optimal range: 0.1 - 2.7 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.2 - 1.3 ELISA Index
Optimal range: 0.1 - 2.4 ELISA Index
Optimal range: 0.3 - 2 ELISA Index
Optimal range: 0.2 - 1 ELISA Index
Optimal range: 0.2 - 1.9 ELISA Index
Optimal range: 0.1 - 2.6 ELISA Index
Optimal range: 0.1 - 1.4 ELISA Index
Optimal range: 0.1 - 1.3 ELISA Index
Optimal range: 0.1 - 1.7 ELISA Index
Xanthan gum is a food thickener made from bacteria that infect numerous plants. It is an ingredient in a wide variety of foods, as well as products such as toothpaste. Though it may offer some health benefits, it is used primarily to change the texture of food, not for any specific health need.
- Xanthan gum thickens food and other products, and also prevents ingredients from separating.
- Non-food products, such as oil and cosmetics, also contain xanthan gum.
- Xanthan gum may help lower or stabilize blood sugar.
- As with any food or food additive, some people may not tolerate it.
Optimal range: 0.3 - 1.9 ELISA Index
Optimal range: 0.1 - 2 ELISA Index
Optimal range: 0.2 - 0.8 ELISA Index
Elevated antibody levels can be clinically significant — while the antibodies themselves don’t destroy anything, they do trigger an inflammatory response that can cause significant destruction of tissue and resulting symptoms. This response is not necessarily dependent on antibody levels. However, an equivocal result may mean you are just beginning to exhibit an immune reaction, so this is an important time to take measures to support the body in damping immune reactivity.
Complete Heavy Metals Test (Blood)
A heavy metal blood test is a group of tests that measure the levels of potentially harmful metals in the blood.
The most common metals tested for are lead, mercury, arsenic, and cadmium.
Metals that are less commonly tested for include copper, zinc, aluminum, and thallium. Heavy metals are found naturally in the environment, certain foods, medicines, and even in water.
Heavy metals can get in your system in different ways. You might breathe them in, eat them, or absorb them through your skin. If too much metal gets into your body, it can cause heavy metal poisoning. Heavy metal poisoning can lead to serious health problems. These include organ damage, behavioral changes, and difficulties with thinking and memory. The specific symptoms and how it will affect you, depend on the type of metal and how much of it is in your system.
Optimal range: 0 - 5 ug/L
The major tissue sites of aluminum toxicity are the nervous system, immune system, bone, liver, and red blood cells. Aluminum may also interfere with heme (porphyrin) synthesis.
Optimal range: 0 - 20 mcg/L
The major tissue sites of aluminum toxicity are the nervous system, immune system, bone, liver, and red blood cells. Aluminum may also interfere with heme (porphyrin) synthesis.
Optimal range: 0 - 10 ug/L
Possible sources of antimony:
- Food and smoking are the usual sources of antimony. Thus cigarette smoke can externally contaminate hair, as well as contribute to uptake via inhalation.
- Gunpowder (ammunition) often contains antimony. Firearm enthusiasts often have elevated levels of antimony in hair.
Other possible sources are:
- textile industry,
- metal alloys,
- and some anti-helminthic and anti-protozoal drugs.
- Antimony is also used in the manufacture of paints, glass, ceramics, solder, batteries, bearing metals and semiconductors.
Optimal range: 0 - 23 ug/L
Arsenic is a natural component of the earth’s crust and is widely distributed throughout the environment in the air, water and land. It is highly toxic in its inorganic form and considered a carcinogenic heavy metal.
Sources:
Found in water, air, soil, cigarettes, and cosmetics. Food grown in contaminated water sources, such as rice and vegetables, or fish, are a common source. Major sources of occupational exposureis the manufacture of pesticides, herbicides, and agricultural products.
90% of all arsenic produced is used as a preservative for wood to prevent rotting and decay. Copper chromated arsenate (CCA), also known as pressure-treated wood, wasphased out for residential use in 2003, but wood treated prior could still be in existing structures. CCA-treated wood is still used in industrial applications.
Organic arsenic found in seafood is relatively nontoxic, while the inorganic forms are toxic.
Optimal range: 0 - 1 ug/L
Barium is a silvery-white metal found in nature. Barium compounds are used to make paint, bricks, tiles, glass, and rubber; used by the oil and gas industries in drilling muds; and sometimes used by doctors to perform medical tests.
Optimal range: 0 - 0.42 ug/L
Optimal range: 0 - 4 ug/L
Optimal range: 0 - 20 ug/L
Optimal range: 0 - 0.4 ug/L
Optimal range: 0 - 1400 ug/L
Optimal range: 0 - 250 ug/L
Optimal range: 0 - 0.83 ug/L
Lithium is a mood stabilizer that can be helpful with bipolar disorder and other conditions but is well known for causing side effects and toxicity. That said, properly monitored, lithium can be safe as well as effective in controlling moods.
Optimal range: 0 - 1 ug/L
Manganese is a mineral that plays a key role in forming connective tissue, sex hormones, making blood clotting factors, bone health, wound healing and central nervous system function. Manganese is also essential for the absorption of calcium, as well as glucose regulation, carbohydrate, fat, cholesterol and amino acid metabolism.
Chronic exposure to manganese (as in industrial settings) may cause effects on the central nervous system.
Toxic exposure may occur from dry cells, fungicide (maneb), and in the steel or chemical industries. Manganese is present in the coloring agents for glass and soap, in paints, varnish and enamel, and in linoleum.
It is used in the manufacturing of chlorine gas and in lead-free gasoline. Industrial manganese poisoning has been recognized since 1837.
Optimal range: 0 - 35 ug/L
Optimal range: 0 - 28 ug/L
Food is the major source of exposure to Ni.
Foods naturally high in Nickel include chocolate, soybeans, nuts, and oatmeal. Individuals may also be exposed to nickel by breathing air, drinking water, or smoking tobacco containing Nickel. Stainless steel and coins contain Nickel. Some jewelry is plated with Nickel or made from Nickel alloys. Patients may be exposed to Nickel in artificial body parts made from Nickel-containing alloys.
The most common harmful health effect of Nickel in humans is an allergic reaction. Approximately 10% to 20% of the population is sensitive to Nickel. The most serious harmful health effects from exposure to Nickel, such as chronic bronchitis, reduced lung function, and cancer of the lung and nasal sinus, have occurred in people who have breathed dust containing certain Nickel compounds while working in Nickel refineries or nickel-processing plants.
Optimal range: 0 - 0 ug/L
Optimal range: 0 - 200 ug/L
Selenium is an essential element. It is a cofactor required to maintain activity of glutathione peroxidase (GSH-Px), an enzyme that catalyzes the degradation of organic hydroperoxides. The absence of selenium correlates with loss of GSH-Px activity and is associated with damage to cell membranes due to accumulation of free radicals.
Optimal range: 0 - 2 ug/L
Optimal range: 0 - 0 ug/L
Optimal range: 0 - 2 ug/L
Optimal range: 0 - 0 ug/L
Optimal range: 0 - 8600 ug/L
OmegaCheck
Omega-3 and omega-6 fatty acids are polyunsaturated long chain fatty acids (PUFA) required by the body for proper functioning, normal growth and the formation of neural synapses and cellular membranes. Omega-3 and -6 fatty acids are considered “essential” and obtained primarily from dietary sources.
Three of the most important omega-3 fatty acids are eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA). Omega-3 fatty acids are primarily obtained from food sources. They have antioxidant, anti-inflammatory and anti-thrombotic effects, and can help to reduce triglyceride levels. Two of the most important omega-6 fatty acids are arachidonic acid (AA) and linoleic acid (LA). Omega-6 fatty acids are obtained from animal sources and plant oils, and have pro-inflammatory and pro-thrombotic properties at high levels.
- Consumption of omega-3 fatty acids reduces the occurrence of major acute cardiac events in healthy individuals or patients with cardiovascular risk factors or who have cardiovascular disease.
- Consumption of omega-3 fatty acids leads to a reduction in triglycerides and non-HDL, as well as Lp-PLA2 levels.
- A high intake of omega-6 fatty acid precursors can interfere with the absorption of omega-3 fatty acids. The mean omega-6:omega-3 ratio of the standard American diet is approximately 10:1. A diet with an omega-6:omega-3 fatty acid ratio of 4:1 or less may reduce total mortality up to 70% over 2 years.
Optimal range: 8.6 - 15.6 % by wt
Arachidonic acid is an inflammatory omega-6 fatty acid. Our bodies produce this nutrient, and its excess may lead to inflammatory diseases and mood disorders.
Optimal range: 3.7 - 40.7 Ratio
This test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. Balancing these eicosanoids in the body is an excellent way
for managing heart disease and other chronic and inflammatory processes.
Optimal range: 1.2 - 3.9 % by wt
Docosahexaenoic acid (DHA) is one of the omega-3 fatty acids.
Omega-3 fatty acids (omega-3s) have a carbon–carbon double bond located three carbons from the methyl end of the chain. Omega-3s, sometimes referred to as “n-3s,” are present in certain foods such as flaxseed and fish, as well as dietary supplements such as fish oil. Several different omega-3s exist, but the majority of scientific research focuses on three: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA contains 18 carbon atoms, whereas EPA and DHA are considered “long-chain” (LC) omega-3s because EPA contains 20 carbons and DHA contains 22.
Optimal range: 0.8 - 1.8 % by wt
Docosapentaenoic acid (DPA) is an omega-3 fatty acid with 22 carbons and five double bonds (22:5n3). It is formed from its precursor, EPA, by way of the elongase enzyme which adds two carbons. It can be supplemented or obtained in the diet from foods such as marine oily fish.
Not only is DPA found in most fish and marine foods but it is also present in lean red meat from ruminant animals.
Optimal range: 0.2 - 2.3 % by wt
Eicosapentaenoic Acid (EPA) is a Polyunsaturated Omega-3 Fatty Acid and is involved in the regulation of inflammatory processes and prevention of blood clots.
Omega-3 fatty acids (omega-3s) have a carbon–carbon double bond located three carbons from the methyl end of the chain. Omega-3s, sometimes referred to as “n-3s,” are present in certain foods such as flaxseed and fish, as well as dietary supplements such as fish oil. Several different omega-3s exist, but the majority of scientific research focuses on three: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA contains 18 carbon atoms, whereas EPA and DHA are considered “long-chain” (LC) omega-3s because EPA contains 20 carbons and DHA contains 22.
Optimal range: 5.4 - 50 % by wt
Three of the most important omega-3 fatty acids are eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA). Omega-3 fatty acids are primarily obtained from food sources, such as oily fish. They have antioxidant, anti-inflammatory, and antithrombotic effects, and can help to reduce triglyceride levels.
Optimal range: 18.6 - 29.5 % by wt
Linoleic acid is by far the most abundant polyunsaturated fatty acid in most human tissues. Linoleic acid is an essential fatty acid, and low levels indicate dietary insufficiency.
Optimal range: 5.4 - 10 % by wt
Essential fatty acids are classified into fat "families": omega 3 fats and omega 6 fats.
Non-essential fat "families" include omega-9 fats, saturated fats, omega-7 fats, and trans-fats.
Optimal health depends on the proper balance of all fats - both essential and non-essential fats - in the diet. Proper balance means adequate amounts of each individual fat, without having too much, and maintaining proper balance between the various "families" of fats.
Optimal range: 11 - 43 % by wt
The laboratory does not provide a specific reference range for this marker. Please refer to the Omega-6/Omega-3 Ratio for detailed information and interpretive guidance. This ratio is essential for assessing various health markers related to fatty acids and their balance in the body.
Omega-6 fatty acids are a type of polyunsaturated fat found in vegetable oils, nuts and seeds. When eaten in moderation and in place of the saturated fats found in meats and dairy products, omega-6 fatty acids can be good for your heart.
Your body needs fatty acids and can make all but two of them, which is why they are called essential fatty acids. Linoleic and linolenic acids are derived from foods containing omega-6 and omega-3 fatty acids, respectively, which serve different functions in the body. Some of these fatty acids appear to cause inflammation, but others seem to have anti-inflammatory properties. More research is needed to fully understand how these apparently opposing effects interact with each other and with other nutrients.
Optimal range: 3.7 - 14.4 Ratio
Omega-6:Omega-3 ratio is calculated by dividing the sum of all the omega-6 fatty acids by the sum of all the omega-3 fatty acids.
Omega 6 and 3 are two essential fats that are categorized as polyunsaturated fatty acids, or PUFAs for short. These fats are essential since we lack the ability to make them in our bodies and must obtain them from food or supplements. Once ingested, our body uses these fats to create other types of fats with important biological and health-promoting roles.
Omega 6 and 3 have many biological roles, including cell structure as well as eye and brain development, but are probably best known for their role in inflammation. In general, omega 6 fats are considered pro-inflammatory, while omega 3 fats are considered anti-inflammatory. However, both omega 6 and omega 3 fats can promote and inhibit the body’s inflammatory response, although omega 6 appears to produce a greater inflammatory response compared to omega 3. On the other hand, DHA and EPA can turn off the body’s inflammatory response and even influence certain genes to halt the production of inflammatory molecules.
Optimal range: 5.4 - 15 % by wt
This marker determines fatty acid-associated risk for cardiovascular events.
OmegaCheck = [(EPA + DPA + DHA) ÷ total PLFA] x 100
Diet is a modifiable risk factor for cardiovascular disease. For example, diets rich in polyunsaturated fatty acids (PUFAs) are generally thought to be beneficial for heart health. Omega-3 PUFAs, also called n-3 PUFAs, are involved in multiple biological pathways. These pathways include coagulation, muscle function, cellular transport, and cell division and growth, all of which affect heart health.
The 3 major omega-3 PUFAs are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA). Another omega-3 PUFA, docosapentaenoic acid (DPA), is an intermediate metabolite formed during the interconversion of EPA and DHA. Fish oil and fatty fish such as salmon, mackerel, herring, and tuna are the primary dietary sources of EPA and DHA. ALA is found in plant-based foods such as green leafy vegetables, beans, and vegetable oils; after ingestion, ALA is metabolized to EPA and then, though very inefficiently, to DHA.
While there is no specific upper limit defined in the context of OmegaCheck, it is generally considered prudent not to exceed 12% - 15% of total fatty acids from omega-3s without medical supervision. It's essential to discuss your omega-3 intake and any test results with your healthcare provider to ensure they are appropriate for your health needs.
Genetics
Reference range: Negative, Positive
Reduced methylenetetrahydrofolate reductase (MTHFR) enzyme activity is a genetic risk factor for hyperhomocysteinemia, especially when present with low serum folate levels. Two common variants in the MTHFR gene result in reduced enzyme activity. The "thermolabile" variant C677T [NM 005957.3: c.665C>T (p.A222V)] and A1298C [c. 1286A>C (p.E429A)] occur frequently in the general population.
Optimal range: 0 - 0 Units
Reference range: (-/-) No clinical abnormality, (+/-) Heterozygous, (+/+) Homozygous
Tree Nut Allergen Panel
The Tree Nut Allergy Test Panel measures the levels of specific IgE antibodies in your blood to specific peanut and tree nut allergens. This panel measures responses to almond, Brazil nut, cashew nut, hazelnut, macadamia nut, peanut, pecan nut, pistachio, and walnut.
This test reports the presence of lgE(s) antibodies to peanut and tree nut allergens, but the result by itself cannot confirm the presence of the allergy.
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.35 kUA/L
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 0.1 kU/L
- Walnut is one of the most common causes of allergic reactions to tree nuts.
- Walnut allergy is potentially life-threatening, increasing in prevalence, and rarely outgrown.
- The estimated prevalence of walnut allergy in the general population is as high as 0.5% and in food allergic children as high as 4%.
ANA Comprehensive Panel
This test helps to detect and helps diagnose certain autoimmune disorders, such as lupus and Sjögren syndrome, among other types.
Antinuclear antibodies (ANA) are a group of autoantibodies produced by a person's immune system when it fails to adequately distinguish between "self" and "nonself." The ANA test detects these autoantibodies in the blood.
ANA react with components of the body's own healthy cells and cause signs and symptoms such as tissue and organ inflammation, joint and muscle pain, and fatigue. ANA specifically target substances found in the nucleus of a cell, hence the name "antinuclear." They probably do not damage living cells because they cannot access their nuclei. However, ANA can cause damage to tissue by reacting with nuclear substances when they are released from injured or dying cells.
The ANA test is one of the primary tests for helping to diagnose a suspected autoimmune disorder or rule out other conditions with similar signs and symptoms. The ANA test may be positive with several autoimmune disorders. Patients with the autoimmune disorder systemic lupus erythematosus (SLE) are almost always positive for ANA, but the percentage of patients with other autoimmune disorders who have positive ANA results varies. Also, a significant number of patients with a variety of other types of disorders (and even some heathy people) may be positive for ANA, especially at low levels.
Reference range: <1:40, >1:40
Anti-Centromere Antibodies (Anti-Centromere Ab) detected by Indirect Immunofluorescence Assay (IFA) at RDL (Reference Diagnostic Laboratories) are essential diagnostic markers associated with autoimmune disorders, particularly limited cutaneous scleroderma and CREST syndrome.
Optimal range: 0 - 0.9 AI
Centromere B Antibody is diagnostic for the form of scleroderma known as CREST (calcinosis, Raynaud's phenomenon, esophageal immotility, sclerodactyly, and telangiectasia).
With a high specificity and a prevalence of 80 to 95%, antibodies against centromeres are pathognomonic for the limited form of progressive systemic sclerosis and can be detected even before the onset of the disease. If the corresponding clinical indication is given, the quantitative determination of antibodies with a monospecific test system, e.g. the Anti-Centromeres ELISA, is recommended.
Optimal range: 0 - 4 IU/ml
The anti-dsDNA test identifies the presence of these autoantibodies in the blood.
The test for anti-dsDNA, along with other autoantibody tests, may be used to help establish a diagnosis of lupus and distinguish it from other autoimmune disorders.
The anti-double-stranded DNA antibody (anti-dsDNA) is a specific type of ANA antibody found in about 30% of people with systemic lupus. Less than 1% of healthy individuals have this antibody, making it helpful in confirming a diagnosis of systemic lupus. The absence of anti-dsDNA, however, does not exclude a diagnosis of lupus.
The presence of anti-dsDNA antibodies often suggests more serious lupus, such as lupus nephritis (kidney lupus). When the disease is active, especially in the kidneys, high amounts of anti-DNA antibodies are usually present. However, the anti-dsDNA test cannot be used to monitor lupus activity, because anti-dsDNA can be present without any clinical activity. Three tests are currently used to detect anti-dsDNA antibodies, namely enzyme-linked immunosorbent assay (ELISA), the Crithidia luciliae immunofluorescence test, and a test called radioimmunoassay.
Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren syndrome and mixed connective tissue disease (MCTD).
Optimal range: 0 - 1 AI
Presence of Jo-1 (antihistidyl transfer RNA [t-RNA] synthetase) antibody is associated with polymyositis and may also be seen in patients with dermatomyositis.
Polymyositis is one of a group of rare diseases called the inflammatory myopathies that involve chronic (long-standing) muscle inflammation and weakness, and in some cases, pain. Myopathy is a general term used to describe a number of conditions affecting the muscles. All myopathies can cause muscle weakness.
Jo-1 antibody is also associated with pulmonary involvement (interstitial lung disease), Raynaud phenomenon, arthritis, and mechanic's hands (implicated in antisynthetase syndrome).
Optimal range: 0 - 0.9 AI
Help to diagnose drug-induced lupus (DIL) and systemic lupus erythematosus (SLE). Antibodies to both chromatin and histones have been found in patients with procainamide-induced lupus; however, patients with lupus induced by drugs such as quinidine, penicillamine, methyldopa, and acebutolol have antibodies to chromatin but not antihistone. Antichromatin antibodies are found in 50% to 90% of SLE patients and have been linked with proteinuria in SLE patients.
Antichromatin antibodies are more sensitive than anti-dsDNA antibodies in detecting active SLE.
Optimal range: 0 - 0.9 AI
Scl-70 antibody is seen in 20% of people with scleroderma (also known as systemic sclerosis), and in some people with CREST syndrome (calcinosis, Raynaud, esophageal dysfunction, sclerodactyly, telangiectasia).
Optimal range: 0 - 1 NEG AI
Anti-ribosomal P proteins antibody (anti-rib P) is a highly specific marker for systemic lupus erythematosus (SLE) and it is associated with liver involvement in this disease.
Optimal range: 0 - 1 Units
A positive result for RNP antibodies is consistent with a connective tissue disease. Although strongly associated with connective tissue diseases, RNP antibodies are not considered a "marker" for any particular disease except in the following situation: when found in isolation (ie, dsDNA antibodies and Sm antibodies are not detectable), a positive result for RNP antibodies is consistent with the diagnosis of mixed connective tissue disease.
Optimal range: 0 - 0.9 AI
Smith antigens, along with RNP antigens, are part of small nuclear RNAs. Levels of antibodies to these two antigens are often elevated in SLE. The Smith antigen is composed of the B1, D, and E proteins.
Anti-Smith antibody has low sensitivity but high specificity for systemic lupus erythematosus (SLE). It is occasional present in mixed connective-tissue disease (MCTD).
Anti-Smith antibody levels are elevated in up to 30% of SLE cases and 8% of MCTD cases.
Array 2 - Intestinal Antigenic Permeability Screen
This test measures intestinal permeability to large molecules, which inflame the immune system.
Gluten can cause silent inflammation in the gut, which can eventually lead to intestinal permeability, or “leaky gut.”
Also, NSAID medications, chronic stress, excess alcohol, proton pump inhibitors and other factors can also contribute to “leaky gut” which allows undigested food particles, bacteria, and other antigens to escape into the bloodstream where they can trigger allergies, sensitivities, and inflammation in various parts of the body. This test helps to determine if leaky gut is present and can be used to monitor complete healing of the gut lining.
For an interpretative chart, please visit our blog entry called "Guide to Intestinal antigenic permeability screen (Cyrex Screen 2)".
Optimal range: 0 - 20.1 ELISA Index
Actomyosin is a smooth muscle protein found throughout the body. In the intestinal barrier's epithelial cells, actomyosin proteins form cables called the Actin Network.
Optimal range: 0 - 1.8 ELISA Index
Lipopolysaccharides (LPS) are endotoxins from gram-negative bacteria in the gut. The LPS protects gram-negative bacteria from gram-positive bacteria. When gram-negative bacterium dies it releases its LPS, which travels through the epithelial cells of the intestinal barrier and finds its way into the blood stream.
Optimal range: 0 - 2.6 ELISA Index
Lipopolysaccharides (LPS) are endotoxins from gram-negative bacteria in the gut. The LPS protects gram-negative bacteria from gram-positive bacteria. When gram-negative bacterium dies it releases its LPS, which travels through the epithelial cells of the intestinal barrier and finds its way into the blood stream.
Optimal range: 0 - 2.1 ELISA Index
Lipopolysaccharides (LPS) are endotoxins from gram-negative bacteria in the gut. The LPS protects gram-negative bacteria from gram-positive bacteria. When gram-negative bacterium dies it releases its LPS, which travels through the epithelial cells of the intestinal barrier and finds its way into the blood stream.
Optimal range: 0.1 - 1.6 ELISA Index
Occludin and Zonulin are proteins of the tight junctions found between epithelial cells of the intestinal barrier. These proteins are gate keepers of the body, allowing only small amino acid nutrients to pass into the blood stream.
Optimal range: 0.3 - 1.6 ELISA Index
Occludin and Zonulin are proteins of the tight junctions found between epithelial cells of the intestinal barrier. These proteins are gate keepers of the body, allowing only small amino acid nutrients to pass into the blood stream.
Optimal range: 0 - 1.8 ELISA Index
Occludin and Zonulin are proteins of the tight junctions found between epithelial cells of the intestinal barrier. These proteins are gate keepers of the body, allowing only small amino acid nutrients to pass into the blood stream.
Adrenal Stress Profile with Cortisol Awakening Response
The Adrenocortex Stress Profile (ASP) provides an assessment of the Hypothalamic-Pituitary-Adrenal (HPA) axis using timed salivary samples of the hormones cortisol and DHEA. Salivary testing is an easy, non-invasive option to measure unbound, biologically active parent hormone levels.
Daily hassles, chronic pain, blood sugar dysregulation, work stressors, and poor relationship quality can alter the HPA axis. Imbalances in adrenal hormones can have a wide range of negative consequences that can adversely impact overall quality of life. The symptoms of HPA axis dysfunction can be vague and are highly variable but may include: fatigue, insomnia, weight gain, depression, GI complaints, and chronic pain. HPA axis dysfunction is associated with many conditions including:
- hypertension
- cardiovascular disease
- gastrointestinal and immune dysregulation
- diabetes and metabolic syndrome
- depression
- chronic fatigue
- persistent pain
- neurodegenerative disease and cognitive decline
Micronutrient (Vibrant America)
This test provides a comprehensive extracellular and intracellular assessment of the levels of the most important vitamins, minerals, antioxidants, fatty acids, and amino acids to help you make healthy lifesstyle choices in consultation with your healthcare provider.
Optimal range: 5.5 - 19.01 %
The AA (Arachidonic Acid) test in red blood cells (RBC), a critical component of the Micronutrient panel by Vibrant America, provides an essential analysis of arachidonic acid levels, a prominent omega-6 fatty acid. AA plays a significant role in inflammatory and immune responses and is a key component of cell membranes, impacting cellular signaling and function. Measuring AA in RBCs offers a more accurate and long-term view of the body's fatty acid profile than serum levels, reflecting true cellular uptake and utilization. This test is particularly crucial in evaluating the balance between omega-6 and omega-3 fatty acids, which is vital for maintaining optimal health and preventing chronic diseases.
Optimal range: 2.5 - 10.9 Ratio
This test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. Balancing these eicosanoids in the body is an excellent way
for managing heart disease and other chronic and inflammatory processes.
Optimal range: 81.6 - 249 nmol/ML
Physiological Function:
L-Arginine is a conditionally essential amino acid found in the diet. It is a dietary supplement used mostly by athletes because it is the amino acid that directly produces nitric oxide via the nitric oxide synthase enzymes.
Arginine helps heal injuries, aids kidneys in removing waste, and boosts immune system function.
Optimal range: 39.2 - 89.8 nmol/ML
Optimal range: 0.5 - 2.8 ng/MM WBC
Asparagine is a non-essential amino acid required for development and function of the brain. Asparagine can be synthesized from glutamine and aspartate. Asparagine is also required for DNA and RNA synthesis and removal of the cellular waste product ammonia.
Optimal range: 8.9 - 10.6 mg/dL
Optimal range: 15 - 120 ng/MM WBC
Optimal range: 11.6 - 43.4 nmol/ML
Optimal range: 0.3 - 1.5 ng/MM WBC
Optimal range: 6.8 - 31 nmol/ML
Physiological Function:
Choline is metabolized within cellular mitochondria resulting in production of trimethylglycine; TMG plays a role in supporting methyl donation processes either directly (methylating homocysteine) or indirectly through supporting production of S-adenosyl methionine (SAMe). Choline is converted into acetylcholine (ACh).
Common food sources:
Beef liver, eggs, soybeans, scallops, chicken breast
Optimal range: 0.2 - 1.5 ng/MM WBC
Optimal range: 0.1 - 0.7 ng/mL
Chromium occurs in primarily two states, trivalent chromium (chromium 3) typically found in foods and hexavalent chromium (chromium 6) typically found in industrial sources and pollutants. Chromium 3 is much less toxic than chromium 6. The body can detoxify some amount of chromium 6 to chromium 3 using glutathione, hydrogen peroxide, glutathione reductase, and ascorbic acid. Few serious adverse effects have been linked to high intakes of chromium 3, so no UL (= upper limit) has been established for chromium 3. Overexposure to chromium 6 can occur in welders and other workers in the metallurgical industry, use of chromium-containing paints and primers, individuals with metallic surgical implants, individuals who ingest chromium salts. Chromium toxicity can occur via oral, inhaled, or dermal absorption. Chromium toxicity, depending upon route of exposure, can cause nausea, vomiting, diarrhea, muscle cramps, skin lesions, sinus, nasal and lung cancer, renal failure, liver damage, circulatory collapse, coma and death.
Optimal range: 18.7 - 47.5 nmol/ML
Citrulline is an amino acid that is not one of the essential amino acids nor a common dietary amino acid (named after its only good natural source, watermelons), but is interconverted in the body and serves roles similar to L-arginine and L-ornithine.
Common food sources:
Food sources of L-citrulline include watermelon, muskmelons, bitter melons, squashes, gourds, cucumbers, and pumpkins.
Optimal range: 0.56 - 2.78 ug/ml
Optimal range: 39.6 - 225.3 pg/MM WBC
CoQ10 is a fat-soluble compound primarily synthesized by the body and also consumed in the diet. It is found in virtually all cell membranes and participates in the mitochondria to convert carbohydrates and fatty acids into ATP. CoQ10 also supports cell signaling, gene expression, stimulation of cell growth, inhibition of apoptosis, control of thiol groups, formation of hydrogen peroxide, and control of membrane channels.
Food sources of CoQ10 are considered poor sources of the nutrient. Foods that contain more CoQ10 than others include organ meats from red meat sources. Nuts are considered a moderate source but would have to be eaten in extreme amounts to get the daily requirement.
Optimal range: 0.6 - 1.8 mcg/mL
Optimal range: 2 - 15 ng/MM WBC
Optimal range: 3.4 - 37 nmol/ML
Optimal range: 60 - 565 pg/MM WBC
Common food sources:
Soybeans, beef, lamb, sunflower seeds, chicken, oats
Physiological Function:
→ Cysteine has antioxidant properties itself, but is also a precursor molecule to glutathione production, the master antioxidant.
→ Cysteine is also an important source of sulfide for iron-sulfide metabolism.
→ Cysteine will bind metals easily to its thiol group, such as iron, nickel, copper, zinc, and heavy metals such as mercury and lead, which may confer some chelation benefits.
→ Cysteine counteracts acetaldehyde effects from consumption of alcohol and can reduce hangovers.
Optimal range: 2.42 - 10.52 %
The DHA (Docosahexaenoic Acid) test within red blood cells (RBC), featured in the Micronutrient panel by Vibrant America, is a crucial assessment tool for evaluating levels of DHA, an essential omega-3 fatty acid. DHA is paramount for brain health, visual function, and maintaining the integrity of the nervous system. By measuring DHA in RBCs, this test offers a more accurate and long-term representation of omega-3 fatty acid status than serum measurements, reflecting the body's true DHA utilization. This is particularly important for brain development in infants and children, cognitive function in adults, and in the management of cardiovascular health.
Optimal range: 0.45 - 1.8 %
The DPA (Docosapentaenoic Acid) test in red blood cells (RBC) offers a comprehensive assessment of DPA levels, a key omega-3 fatty acid. DPA, found in fish oils and marine life, plays a critical role in cardiovascular health, brain function, and inflammation regulation. Measuring DPA levels in RBCs provides a more accurate and long-term indicator of omega-3 status than serum tests, reflecting the body's actual omega-3 fatty acid utilization over time. This is particularly vital for individuals at risk of heart disease, cognitive disorders, or inflammatory conditions.
Optimal range: 0.15 - 2.26 %
→ Eicosapentanoic acid (EPA) is an omega-3 fatty acid that participates in the health of cellular membranes, mediates lipid actions, and reduces inflammatory responses in the body.
→ EPA and DHA influence the types of inflammatory response mediators made in favor of anti-inflammatory eicosanoids such as leukotrienes, prostaglandins, and thromboxanes. EPA and DHA are also noted for moderate to strong anti-depressant effects.
→ Specific to EPA, it has been shown to suppress signaling of TNF-α in adipocytes.
→ EPA also increases cerebral oxygenation.
→ EPA appears to have some beneficial influence on regulating levels of leptin and increasing adiponectin.
→ EPA may enhance adaptive immunity by stimulating B cell responsiveness.
Optimal range: 0 - 10 Units
The EBV (Epstein Barr) Nuclear Antigen Antibodies, IgG test looks for a type of antibody which the body typically develops in response to Epstein-Barr Virus.
EBNA antibodies usually appear 2-4 months after infection and persist for the life of the person.
This test is usually performed to establish a past infection with EBV.
Optimal range: 0 - 10 Units
The Epstein–Barr virus, also called human herpesvirus 4 (HHV-4), is one of the causes of infectious mononucleosis (glandular fever). It is a double-stranded, enveloped, linear DNA virus. Lyme disease and infectious mononucleosis are common illnesses that share similar clinical presentations and hence its useful to test together.
Optimal range: 0 - 10 Units
The Epstein–Barr virus (EBV), also called human herpesvirus 4 (HHV-4), is a virus of the herpes family, which includes herpes simplex virus 1 and 2, and is one of the most common viruses in humans. It is best known as the cause of infectious mononucleosis. It is also associated with particular forms of cancer, particularly Hodgkin's lymphoma, Burkitt's lymphoma, nasopharyngeal carcinoma, and central nervous system lymphomas associated with HIV. Finally, there is evidence that infection with the virus is associated with a higher risk of certain autoimmune diseases, especially dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis and multiple sclerosis.
Optimal range: 95.5 - 1000 ng/mL
Folate is the naturally occurring form found in foods; folic acid is the supplement/synthetic form. Folate is more bioavailable.
Once in circulation, folate gets methylated.
Methyl-tetrahydrofolate is the most abundant folate in circulation and it functions with vitamin B12 in methylation reactions to reduce
homocysteine, but is also involved in DNA synthesis, and red blood cell synthesis.
Optimal range: 4.6 - 100 ng/mL
Optimal range: 393.5 - 699.3 nmol/ML
- Glutamine is a conditionally essential amino acid (conditional mainly during times of disease or muscle wasting, such HIV/AIDS, cancer, or severe infections).
- In the intestinal lining, glutamine is the preferred source of fuel for intestinal epithelial cells and the main energy source for leukocytes (immune cells).
- Other important functions of glutamine include: transporting nitrogen between cells, acting as a precursor to glutathione production, acting as a precursor to nucleotides (for DNA and RNA synthesis), participating in gluconeogenesis in the absence of adequate carbohydrate intake, blunting the rise of blood glucose after consuming carbohydrate-rich meals, and regulating intestinal tight junctions.
Very good sources of glutamine include: whey, casein, milk, white rice, corn, and tofu.
Good sources of glutamine include: meat and eggs.
Optimal range: 1.4 - 7 ng/MM WBC
- Glutamine is a conditionally essential amino acid (conditional mainly during times of disease or muscle wasting, such HIV/AIDS, cancer, or severe infections).
- In the intestinal lining, glutamine is the preferred source of fuel for intestinal epithelial cells and the main energy source for leukocytes (immune cells).
- Other important functions of glutamine include: transporting nitrogen between cells, acting as a precursor to glutathione production, acting as a precursor to nucleotides (for DNA and RNA synthesis), participating in gluconeogenesis in the absence of adequate carbohydrate intake, blunting the rise of blood glucose after consuming carbohydrate-rich meals, and regulating intestinal tight junctions.
Very good sources of glutamine include: whey, casein, milk, white rice, corn, and tofu.
Good sources of glutamine include: meat and eggs.
Optimal range: 98.7 - 1163 pg/MM WBC
Optimal range: 20.5 - 60.7 nmol/ML
Optimal range: 0.1 - 2.5 ng/MM WBC
Optimal range: 88.9 - 117 mg/dL
Optimal range: 37 - 145 ug/dL
Iron is required for the production of red blood cells (a process known as hematopoiesis), but it's also part of hemoglobin (that is the pigment of the red blood cells) binding to the oxygen and thus facilitating its transport from the lungs via the arteries to all cells throughout the body. Once the oxygen is delivered, the iron (as part of hemoglobin) binds the carbon dioxide which is then transported back to the lung, from where it gets exhaled. Iron is also involved in the conversion of blood sugar to energy.
Optimal range: 25.5 - 158.9 nmol/ML
Optimal range: 3.22 - 10.49 %
The LA (Linoleic Acid) test within red blood cells (RBC) offers an in-depth analysis of linoleic acid levels, a crucial omega-6 fatty acid. As a primary component of cell membranes, LA plays a significant role in maintaining skin health, supporting the immune system, and promoting overall cellular function. The RBC measurement of LA provides a more accurate reflection of the body's cellular health and fatty acid balance over time compared to serum tests. This is particularly important for assessing inflammatory conditions, skin disorders, and cardiovascular health.
Optimal range: 101.2 - 249.3 nmol/ML
Optimal range: 1.18 - 3.74 x10E3/uL
The "Lymphocyte Count" is an important marker on the Micronutrient panel from VibrantAmerica. Lymphocytes are a type of white blood cell crucial for the body's immune system. They play a significant role in defending the body against infections, viruses, and other harmful invaders. The lymphocyte count measures the number of lymphocytes present in your blood. A healthy lymphocyte count indicates a well-functioning immune system, capable of effectively fighting off infections and diseases. Conversely, an abnormal lymphocyte count, whether too high or too low, can signal underlying health issues. For example, a low lymphocyte count might indicate a compromised immune system, making the body more susceptible to infections and illnesses, while a high count could suggest the presence of an ongoing infection or an autoimmune disorder where the body mistakenly attacks its own tissues. Regular monitoring of your lymphocyte count through panels like the Micronutrient panel from VibrantAmerica helps in early detection and management of potential health problems, ensuring that your immune system remains robust and effective in protecting your overall health.
Optimal range: 3.6 - 7.7 mg/dL
Magnesium (RBC) testing, a key component of the Micronutrient panel by Vibrant America, offers critical insights into the body's magnesium levels within red blood cells (RBCs). Unlike serum magnesium tests, the Magnesium (RBC) test provides a more accurate reflection of the body's magnesium stores, as red blood cells contain magnesium that is actively used in bodily functions. Magnesium is essential for over 300 enzymatic reactions and plays a pivotal role in nerve function, muscle contraction, heartbeat regulation, and bone health.
Optimal range: 1.6 - 2.6 mg/dL
Optimal range: 0.3 - 2 ng/mL
Optimal range: 2 - 75 pg/MM WBC
Optimal range: 0.1 - 0.5 nmol/ML
Optimal range: 1.56 - 6.13 x10E3/uL
Optimal range: 8 - 12.65 %
Omega-3 Index is the sum of EPA % and DHA % as measured in whole blood, and derived by validated calculations to yield the equivalent sum of EPA % and DHA % in red blood cell membranes. Please note this value is a percentage, with the denominator being the sum of all Fatty Acids measured in the blood and thus the index can vary based on fatty acid composition of the diet.
The index can be used as an indicator of risk for sudden cardiac death and nonfatal cardiovascular events and as a therapeutic target.It can also be used to assess adherence to omega-3 therapy and/or success or failure of such therapy. Optimal omega-3 index positively impacts heart rate, blood pressure, triglyceride levels, myocardial efficiency, inflammatory responses, and endothelial function while also improving cognitive function.
Optimal range: 8 - 12.65 %
Omega-3 Index is the sum of EPA % and DHA % as measured in whole blood, and derived by validated calculations to yield the equivalent sum of EPA % and DHA % in red blood cell membranes. Please note this value is a percentage, with the denominator being the sum of all Fatty Acids measured in the blood and thus the index can vary based on fatty acid composition of the diet.
The index can be used as an indicator of risk for sudden cardiac death and nonfatal cardiovascular events and as a therapeutic target.It can also be used to assess adherence to omega-3 therapy and/or success or failure of such therapy. Optimal omega-3 index positively impacts heart rate, blood pressure, triglyceride levels, myocardial efficiency, inflammatory responses, and endothelial function while also improving cognitive function.
Optimal range: 3.5 - 5.1 mmol/L
Optimal range: 109.8 - 218.4 ng/mL
Optimal range: 234 - 1050 pg/MM WBC
Optimal range: 94.2 - 246.8 nmol/ML
D-serine is a neuromodulator, produced in glial cells of the brain, and modulates the functions of neurons. Serine can be considered a nootropic nutrient.
Serine enhances binding of other compounds at NMDA (N-methyl-D-aspartate) receptors.
Optimal range: 1.8 - 19.8 ng/MM WBC
D-serine is a neuromodulator, produced in glial cells of the brain, and modulates the functions of neurons. Serine can be considered a nootropic nutrient.
Serine enhances binding of other compounds at NMDA (N-methyl-D-aspartate) receptors.
Optimal range: 136 - 145 mmol/L
Optimal range: 0 - 10 Units
IgG antibodies to Streptococcal A refer to the specific IgG antibodies produced by the immune system in response to infection with Streptococcus bacteria, particularly Group A Streptococcus (Strep A). These antibodies play a crucial role in protecting against Streptococcal infections. Streptococcus pyogenes, also known as Group A Streptococcus, is a pathogenic bacterium that causes a range of infections, including pharyngitis (strep throat), impetigo, invasive infections, and immune-mediated sequelae such as acute rheumatic fever and rheumatic heart disease.
IgG antibodies can show up in your test for weeks, months or years after an infection.
Optimal range: 3.25 - 13.99 %
The Total Omega-3 (RBC) test, a vital component of the Micronutrient panel by Vibrant America, offers a comprehensive assessment of omega-3 fatty acids in red blood cells (RBCs), crucial for a wide range of bodily functions. This test measures the total amount of omega-3 fatty acids, including EPA (Eicosapentaenoic Acid), DHA (Docosahexaenoic Acid), and DPA (Docosapentaenoic Acid), providing an accurate indicator of long-term omega-3 status, as opposed to transient serum levels. Omega-3 fatty acids are essential for cardiovascular health, brain function, and anti-inflammatory processes. Adequate levels are associated with reduced risk of heart disease, improved cognitive function, and lower inflammation.
Optimal range: 11.03 - 34.96 %
The Total Omega-6 (RBC) test, a pivotal component of the Micronutrient panel by Vibrant America, provides an in-depth analysis of the total omega-6 fatty acids present in red blood cells (RBCs). Omega-6 fatty acids, including key types like linoleic acid (LA) and arachidonic acid (AA), play vital roles in cellular health, inflammation regulation, and overall bodily functions. By measuring omega-6 levels in RBCs, this test offers a more precise and long-term assessment of the body's fatty acid profile compared to transient serum levels, reflecting true cellular integration and utilization over time.
Optimal range: 155.9 - 368 nmol/ML
Valine is a branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway. As a glycogenic amino acid, valine maintains mental vigor, muscle coordination, and emotional calm.
Optimal range: 40.8 - 154.5 mcg/dL
Vitamin A is a group of fat-soluble vitamins which includes retinol, retinal, retinoic acid, and several provitamin A carotenoids, among which beta-carotene is the most important.
Vitamin A has multiple functions including: growth and development in infants, children and adolescents, maintenance of the immune system, and healthy vision.
Vitamin A is needed by the retina of the eye for both low-light and color vision.
Vitamin A also functions as retinoic acid, an important hormone-like growth factor for epithelial and other cells.
Other important roles that vitamin A plays in the body include: gene transcription, haematopoiesis, and antioxidant activity.
Optimal range: 0.9 - 17.3 pg/MM WBC
Optimal range: 1.4 - 71.3 nmol/L
Optimal range: 0.1 - 7 pg/MM WBC
Optimal range: 232 - 1245 pg/mL
- Vitamin B12 is an important coenzyme when in its active form of methylcobalamin.
- B12 facilitates the metabolism of folic acid through its primary role as a methyl donor.
- B12 requires intrinsic factor for absorption, which is calcium dependent.
- The role of vitamin B12 in the production of some neurotransmitters may also be evidenced by mood imbalance in susceptible individuals.
Optimal range: 2 - 11.99 pg/MM WBC
Optimal range: 5.6 - 126.1 mcg/L
Common food resources:
Beef, fortified tofu, dairy, salmon, mushrooms, pork, spinach
Physiological Function:
Two very important coenzymes involved in energy metabolism are derived from riboflavin to participate in oxidation/reduction reactions.
Riboflavin is also essential for NOS enzyme (nitric oxide synthase) and glutathione reductase which regenerates glutathione, and which is very important for antioxidation/detoxification.
Optimal range: 0.2 - 3.6 pg/MM WBC
Two very important coenzymes involved in energy metabolism are derived from riboflavin to participate in oxidation/reduction reactions.
Riboflavin is also essential for NOS enzyme (nitric oxide synthase) and glutathione reductase which regenerates glutathione, and which is very important for antioxidation/detoxification.
Optimal range: 2.6 - 36.1 ng/mL
Optimal range: 39.6 - 303.5 pg/MM WBC
Food Sources:
The most concentrated sources of niacin are in animal products (pork), peanuts/peanut butter, tofu, and eggs.
Also consider food sources high in tryptophan *Enriched grains provide supplemental niacin.
Physiological Function:
Niacin is extensively involved in metabolic reduction reactions through NAD-NADPH pathways. Over 200 enzymes in the human body require niacin.
Other important major functions of niacin B include: fatty acid synthesis, ATP synthesis, DNA repair, lower cholesterol/LDL, aids in
circulation.
Optimal range: 22.7 - 429.2 mcg/L
Vitamin B5 is part of the structural component of coenzyme A. It is also important for synthesis of red blood cells, sex hormones, adrenal hormones, and vitamin D. Another significant function of B5 is to work with carnitine and CoQ10 for fatty acid oxidation/metabolism.
Optimal range: 2.5 - 32.8 pg/MM WBC
Vitamin B5 is part of the structural component of coenzyme A. It is also important for synthesis of red blood cells, sex hormones, adrenal hormones, and vitamin D. Another significant function of B5 is to work with carnitine and CoQ10 for fatty acid oxidation/metabolism.
Optimal range: 2.8 - 76.2 ng/mL
Optimal range: 0.5 - 9.7 pg/MM WBC
Optimal range: 0.2 - 1.1 mg/dL
Vitamin C has a major function of being an antioxidant. It boosts immunity through increasing white blood cells, in addition to supporting regeneration of vitamin E. Vitamin C can also reduce atherosclerosis, stroke and high blood pressure, and inflammation. Because of its role in the generation of connective tissue, it is necessary for optimal collagen production. Vitamin C is also an important component of l-carnitine, which is necessary for breakdown of fats into energy.
Optimal range: 0.5 - 9.7 ng/MM WBC
Vitamin C has a major function of being an antioxidant. It boosts immunity through increasing white blood cells, in addition to supporting regeneration of vitamin E. Vitamin C can also reduce atherosclerosis, stroke and high blood pressure, and inflammation. Because of its role in the generation of connective tissue, it is necessary for optimal collagen production. Vitamin C is also an important component of l-carnitine, which is necessary for breakdown of fats into energy.
Optimal range: 30 - 108 ng/mL
25-hydroxyvitamin D is a standard lab test which measures the inactive precursor to 1,25-OHD, which is a combination of two forms of vitamin D in the body: vitamin D2 and vitamin D3.
25-OHD has a longer half-life in the blood than 1,25-OHD, and, therefore, levels may differ from levels of active 1,25-OHD3.
Because 25-OHD is a precursor to active forms of vitamin D, it is important to note that it is not reflective of overall active D3 levels, but rather what is available for conversion if cofactors are sufficient.
The conversion of 25-OHD to 1,25-OHD is performed in the kidneys and regulated by parathyroid hormone (PTH). When blood calcium levels fall, PTH signals the kidneys to convert more 25-OHD to 1,25-OHD, which increases intestinal absorption of calcium, and reduces bone demineralization of calcium.
Optimal range: 0.4 - 1.8 ng/mL
Vitamin D3 is also referred to as 1,25-hydroxyvitamin D3 (1,25-OHD3).
1,25-OHD3 has a shorter half-life in the blood than 25-OHD (what most standard labs run, and what is most commonly used to assess total vitamin D status), and, therefore, levels may differ from what is measured as 25-OHD.
The conversion of 25-OHD to 1,25-OHD is performed in D the kidneys and regulated by parathyroid hormone (PTH).
When blood calcium levels fall, PTH signals the kidneys to convert more 25-OHD to 1,25-OHD, which increases intestinal absorption of calcium, and reduces bone demineralization of calcium.
Vitamin D3 also regulates the function of hundreds of genes, supports the immune system, supports production and function of endocrine hormones, is important for normal growth and development of bones and teeth, tightly regulates the levels of calcium and phosphorus being absorbed intestinally as well as released from bone, regulates cell differentiation and growth, and may play an important role in regulating mood.
Patients who present with hypercalcemia, hyperphosphatemia, and low PTH may suffer from unregulated conversion of 25-OHD to 1,25-OHD.
Optimal range: 25.9 - 246.6 pg/MM WBC
Vitamin D3 is also referred to as 1,25-hydroxyvitamin D3 (1,25-OHD3).
1,25-OHD3 has a shorter half-life in the blood than 25-OHD (what most standard labs run, and what is most commonly used to assess total vitamin D status), and, therefore, levels may differ from what is measured as 25-OHD.
The conversion of 25-OHD to 1,25-OHD is performed in D the kidneys and regulated by parathyroid hormone (PTH).
When blood calcium levels fall, PTH signals the kidneys to convert more 25-OHD to 1,25-OHD, which increases intestinal absorption of calcium, and reduces bone demineralization of calcium.
Vitamin D3 also regulates the function of hundreds of genes, supports the immune system, supports production and function of endocrine hormones, is important for normal growth and development of bones and teeth, tightly regulates the levels of calcium and phosphorus being absorbed intestinally as well as released from bone, regulates cell differentiation and growth, and may play an important role in regulating mood.
Patients who present with hypercalcemia, hyperphosphatemia, and low PTH may suffer from unregulated conversion of 25-OHD to 1,25-OHD.
Optimal range: 7.4 - 30.6 mg/L
Vitamin E is an important antioxidant that reduces the formation of reactive oxygen species (ROS) that result from fat oxidation.
Vitamin E also regulates cell signaling, influences immune function, and inhibits coagulation.
Optimal range: 18.4 - 1031.1 pg/MM WBC
Vitamin E is an important antioxidant that reduces the formation of reactive oxygen species (ROS) that result from fat oxidation.
Vitamin E also regulates cell signaling, influences immune function, and inhibits coagulation.
Optimal range: 0.1 - 8.1 ng/mL
Optimal range: 0.1 - 0.71 pg/MM WBC
Vitamin K is a group of fat-soluble vitamins. This group of vitamins includes two natural vitamins: vitamin K1 and vitamin K2. These Vitamins are structurally similar and their name comes from the German word “klotting”.
Vitamin K1, is also known as phylloquinone.
Vitamin K assists with blood clotting, supports the K formation of bone and bone matrix, and aids in
glucose to glycogen conversion for storage in the
liver.
Optimal range: 0.1 - 5.19 ng/mL
Vitamin K is a group of fat-soluble vitamins. This group of vitamins includes two natural vitamins: vitamin K1 and vitamin K2.
Vitamin K2 is the main storage form of Vitamin K in animals. It has several forms, referred to as menaquinones.
The nomenclature denoting vitamin K2 types will include an‘MK’to specify this is a menaquinone and the number following this denotes how many isoprenyl units are on the side chain of the molecule. The most common forms are MK-4 and MK-7.
Bacteria in the colon can convert K1 (from K plant-based foods) into vitamin K2.
Vitamin K2 is necessary to prevent arterial 2 calcification, which it does by activating matrix GLA
protein (MGP). This matrix GLA protein is present in blood vessels and inhibits soft tissue calcification.
Matrix GLA protein needs to be carboxylated to work properly and Vitamin K2-MK7 plays a major role in this carboxylation.
Optimal range: 0.1 - 0.89 pg/MM WBC
Vitamin K is a group of fat-soluble vitamins. This group of vitamins includes two natural vitamins: vitamin K1 and vitamin K2.
Vitamin K2 is the main storage form of Vitamin K in animals. It has several forms, referred to as menaquinones.
The nomenclature denoting vitamin K2 types will include an‘MK’to specify this is a menaquinone and the number following this denotes how many isoprenyl units are on the side chain of the molecule. The most common forms are MK-4 and MK-7.
Bacteria in the colon can convert K1 (from K plant-based foods) into vitamin K2.
Vitamin K2 is necessary to prevent arterial 2 calcification, which it does by activating matrix GLA
protein (MGP). This matrix GLA protein is present in blood vessels and inhibits soft tissue calcification.
Matrix GLA protein needs to be carboxylated to work properly and Vitamin K2-MK7 plays a major role in this carboxylation.
Optimal range: 3.98 - 10.04 x10E3/uL
Optimal range: 0.5 - 1 mcg/mL
Optimal range: 4 - 15 ng/MM WBC
One Day Hormone Check
The One Day Hormone Check is a non-invasive salivary hormone test designed to assess bioavailable, unbound hormone levels over a 24-hour period. This test provides insights into key hormones, including:
- Estrogen markers – Estradiol, Estrone, Estriol
- Progesterone & the P/E2 ratio (Progesterone-to-Estradiol)
- Testosterone
- Cortisol (stress hormone)
- DHEA (precursor to sex hormones)
- Melatonin (sleep-regulating hormone)
This test helps identify hormonal imbalances that impact both men and women. It is particularly useful for:
By analyzing hormone interactions—such as sex hormones, adrenal function (DHEA & cortisol), and sleep-wake cycles (melatonin)—clinicians can personalize hormone replacement therapy (HRT), nutritional interventions, and lifestyle recommendations.
People with hormonal imbalances may experience:
The therapeutic reference ranges provided are based on a cohort of perimenopausal and menopausal women (ages 37-62) who were treated with bioidentical hormone therapy (HT). This therapy included combinations of:
Note: These ranges are for informational purposes only. Individual hormone levels should be interpreted in the context of personal health history and clinical symptoms.
Optimal range: 50 - 150 %
The "Cortisol Awakening Response, Percent Increase" (CAR) is a crucial marker measured in the 4300 Adrenocortex Stress Profile - Saliva test by Genova Diagnostics. This test assesses how your cortisol levels change shortly after you wake up in the morning. Cortisol is a hormone produced by the adrenal glands that plays a vital role in managing stress, maintaining energy levels, and regulating various body functions. Normally, cortisol levels rise sharply within the first 30 to 45 minutes after waking up, a phenomenon known as the cortisol awakening response. The CAR, expressed as a percent increase, helps to gauge the responsiveness of your adrenal glands and their ability to produce cortisol in response to the anticipation of the day's demands.
Optimal range: 71 - 640 pg/mL
DHEA is a hormone produced by both the adrenal gland and the brain. DHEA leads to the production of androgens and estrogens. DHEA levels in the body begin to decrease after age 30. Levels decrease more quickly in women.
Optimal range: 358 - 2538 Ratio
The DHEA: Cortisol Ratio is an important marker that helps assess the balance between two crucial hormones produced by the adrenal glands: dehydroepiandrosterone (DHEA) and cortisol.
DHEA is often referred to as a "youth hormone" because it supports immune function, mood, energy levels, and overall well-being. On the other hand, cortisol is known as the "stress hormone" because it plays a key role in the body's response to stress, affecting metabolism, immune response, and energy levels.
The ratio between these two hormones is significant because it provides insight into how well the adrenal glands are functioning. A balanced ratio indicates that the body is managing stress well and maintaining overall hormonal balance. However, an imbalance, such as a high cortisol level with low DHEA, can indicate chronic stress, adrenal fatigue, or other health issues.
Optimal range: 358 - 2538 Ratio
This calculation represents anabolic and catabolic balance. Since DHEA acts not only as an anabolic hormone, but appears to down-regulate the cellular effects of cortisol, this measurement can theoretically enhance the predictive value of HPA axis dysfunction.
An optimal ratio indicates proper HPA axis homeostasis.
Optimal range: 2.9 - 13.7 pmol/L
Estrogens play a critical role in female sexual development, menstrual function, protein synthesis, cardiovascular function, bone formation and remodeling, cognitive function, emotional balance and other important health factors. The estrogenic potency of estradiol is 12 times that of estrone and 80 times that of estriol. Estradiol is the primary estrogen in premenopausal women. Estrone is the second most potent estrogen compared to estradiol.
Optimal range: 0 - 135 pmol/L
Estriol is considered to be the mildest and briefest-acting of the three estrogens.
Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Optimal range: 36.6 - 253.2 pmol/L
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, largely due to the fact that it is the least powerful of the three types of estrogen, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers as well as estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 10 - 106 Ratio
The P/E2 ratio describes the relationship between progesterone and estradiol levels, and is used clinically to ascertain dominance of one hormone compared to the other.
Optimal range: 52 - 850 pmol/L
Progesterone is important for normal reproductive and menstrual function, and influences the health of bone, blood vessels, heart, brain, skin, and many other tissues and organs. As a precursor, progesterone is used by the body to make other steroid hormones, including DHEA, cortisol, estrogen and testosterone. In addition, progesterone plays an important role in mood, blood sugar balance, libido, and thyroid function, as well as adrenal gland health.
Optimal range: 0 - 0.03 mcg/dL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0.03 - 0.11 mcg/dL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0.01 - 0.07 mcg/dL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0.1 - 0.34 mcg/dL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 3.71 - 33.38 pg/mL
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH).
Optimal range: 0 - 1.97 pg/mL
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH).
Optimal range: 0 - 12.12 pg/mL
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH).
Optimal range: 34 - 183 pmol/L
Testosterone is an androgenic sex steroid/hormone that helps maintain libido, influences muscle mass and weight loss, and plays a role in the production of several other hormones. During the aging process, testosterone levels gradually decline in both sexes, which can lead to loss of bone density. Testosterone concentrations tend to be higher in men versus women.
Optimal range: 66 - 304 pmol/L
In the adult male, testosterone maintains the structure and function of the prostate, testes, seminal vesicles, and external male genitalia. In addition, testosterone affects lean body mass, bone density, hematopoiesis, libido and mood.
Optimal range: 52 - 239 pmol/L
In the adult male, testosterone maintains the structure and function of the prostate, testes, seminal vesicles, and external male genitalia. In addition, testosterone affects lean body mass, bone density, hematopoiesis, libido and mood.
Optimal range: 110 - 513 pmol/L
In the adult male, testosterone maintains the structure and function of the prostate, testes, seminal vesicles, and external male genitalia. In addition, testosterone affects lean body mass, bone density, hematopoiesis, libido and mood.
Optimal range: 89 - 362 pmol/L
In the adult male, testosterone maintains the structure and function of the prostate, testes, seminal vesicles, and external male genitalia. In addition, testosterone affects lean body mass, bone density, hematopoiesis, libido and mood.
LabCorp (various)
LabCorp operates one of the largest clinical laboratory networks in the world. Labcorp is a leading global life sciences company. With a mission to improve health and improve lives, Labcorp delivers world-class diagnostic solutions, brings innovative medicines to patients faster and uses technology to improve the delivery of care.
Optimal range: 50 - 145 nmol/L
3-O-Methyldopa (3-OMD) is a compound that emerges in the context of diagnosing and monitoring various medical conditions, particularly those related to neurological disorders such as Parkinson's disease. It's essential to understand that 3-OMD is closely related to L-DOPA, a medication widely used in the treatment of Parkinson's disease. In patients receiving L-DOPA therapy, 3-OMD is produced as a metabolite - a substance created during the breakdown and conversion of the drug within the body.
If the concentraton of 3-O-methyldopa in plasma is within the reference range, it demonstrates that the individual does not have aromatc L-amino acid decarboxylase (AADC) defciency.
Optimal range: 14 - 82 U/L
The ACE (Angiotensin-converting enzyme) test is a blood test that measures the amount of ACE, an enzyme that plays a role in blood pressure regulation. Higher levels of ACE can be an indicator of sarcoidosis, a complex disease with an unclear cause that typically impacts the lungs and can also involve various organs such as the eyes, skin, nerves, liver, and heart.
Sarcoidosis is characterized by the formation of granulomas—clustered masses of immune cells, inflammatory cells, and fibrous tissue. These granulomas can alter the normal structure of tissues, potentially leading to organ damage and inflammation if they are numerous enough. The presence of these granulomas, especially around their outer edges, can lead to elevated ACE levels in the blood.
Optimal range: 0 - 0.01 g/dL
Volatile substances in the blood include ethanol, methanol, isopropanol, and acetone. Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis. Methanol and isopropanol are highly toxic and result from exogenous ingestion.
The presence of acetone may indicate exposure to acetone; it is also a metabolite of isopropanol and may be detected during ketoacidosis.
Optimal range: 2.2 - 3.5 Ratio
Screening test for the factor V Leiden gene mutation and other causes of activated protein C resistance
Optimal range: 0 - 9 ug/L
The "Aluminum, Plasma/Serum" test measures the level of aluminum in your blood, specifically in the plasma or serum component. Aluminum is the third most abundant element in the Earth's crust and is commonly found in our environment, including water, food, and some consumer products. While it's generally considered non-toxic at low levels, exposure to high levels of aluminum can lead to health issues, especially in individuals with compromised kidney function or those exposed to the metal through occupational hazards, medical treatments, or excessive use of aluminum-containing products.
Optimal range: 36 - 136 ug/dL
Ammonia measurements are mainly of use in the diagnosis of urea cycle deficiencies (any neonate with unexplained nausea, vomiting, or neurological deterioration appearing after first feeding), and they play an important part in the detection of Reye syndrome.
In Reye syndrome threefold increases in AST, ALT and plasma ammonia are required for diagnosis with/or the diagnostic liver biopsy findings. Ammonia levels increase characteristically early; plasma ammonia ≥100 μg/dL reflects severe hepatic changes.
Reference range: Negative, Borderline, Positive
The ANA (Antinuclear Antibody) by IFA (Indirect Fluorescent Antibody) test with reflex to titer and pattern is a laboratory analysis used in the diagnosis of autoimmune disorders.
This test detects antibodies that react against components within the nucleus of the body's cells. It's often one of the first tests ordered when a patient shows symptoms that may suggest an autoimmune condition like lupus, rheumatoid arthritis, or scleroderma.
Reference range: Negative, Positive (Abnormal)
An ANA test detects antinuclear antibodies (ANA) in your blood. Your immune system normally makes antibodies to help you fight infection. In contrast, antinuclear antibodies often attack your body's own tissues — specifically targeting each cell's nucleus.
Reference range: Homogeneous, Speckled, Nucleolar, Centromere, Nuclear Dot, Nuclear Membrane, Cytoplasmic
Usually, the results of the ANA test are reported in titers and patterns. The titer gives information about how many times the lab technician diluted the blood plasma to get a sample of ANAs.
The pattern of the ANA test can give information about the type of autoimmune disease present and the appropriate treatment program
Reference range: Negative (<5.0), Positive (> or = 5.0)
This test allows for the detection of the presence of antibodies to glutamic acid decarboxylase, which provides early evidence of autoimmune disease activity; its measurement has been shown to be useful in assisting the physician in the prediction, diagnosis, and management of patients with diabetes.
Optimal range: 0 - 301 U/mL
Anti-DNase B is a blood test to look for antibodies to a substance (protein) produced by group A streptococcus. This is the bacteria that cause strep throat.
Negative anti-DNase B and ASO tests or very low titers means that it is unlikely you had a recent strep infection. This is especially true if a sample taken 10 to 14 days later is also negative. Your signs and symptoms are likely due to a cause other than a recent strep infection.
Optimal range: 0 - 1 Units
Histone antibodies are autoantibodies. These are antibodies produced by a person’s own immune system that target his or her own histones. Histones are proteins that are a part of chromatin, the genetic material present in the nucleus of almost all cells within the body. Because histones are found inside cells, this attack on “self” can cause symptoms throughout the body. This test detects the presence of histone antibodies in the blood.
Reference range: Negative, Positive
Anti-intermyofibrillar is a Antimyocardial Antibody (= AMA). AMAs are a sign of heart damage. Higher levels are linked to several forms of heart disease. They can be found in the blood before you have any symptoms of heart disease.
Having these antibodies can be a sign of swelling of the membrane around your heart (pericarditis). Some people also develop AMAs after heart surgery or a heart attack. After a heart attack, your body may make antibodies against the heart protein troponin. This can slow healing. Research is currently being done on how to prevent this.
You might also have an AMA test done if your healthcare provider thinks you have rheumatic heart disease. This disease can develop as a complication of rheumatic fever.
Optimal range: 0 - 20 Units
Optimal range: 0 - 20 Units
Optimal range: 0 - 20 Units
Reference range: Negative, Positive
Anti-sarcolemma antibodies are a type of antibodies that can be found in certain medical conditions. They are specifically associated with cardiac muscle disorders and are often detected in patients with conditions such as Dressler's syndrome after myocardial infarction, cardiomyopathy, myocarditis, rheumatic fever, and those who have undergone cardiac surgery. These antibodies can target various antigens, including adenine nucleotide translocator protein, cardiac myosin, and tropomyosin.
Antisarcolemmal (ASAs) are a serologic hallmark of inflammatory heart muscle disease (= Myocarditis) and its sequelae (= any complication or condition that results from a pre-existing illness, injury, or medical intervention).
Myocarditis is inflammation of the heart muscle (myocardium). The inflammation can reduce the heart's ability to pump blood. Myocarditis can cause chest pain, shortness of breath, and rapid or irregular heart rhythms (arrhythmias).
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Borderline, Positive
Autoimmune rheumatic diseases are conditions in which the immune system attacks the joints and certain systems. They are often difficult to diagnose, as their symptoms can be vague, vary from patient to patient, and often overlap. Laboratory testing can provide useful information, but no single test provides a definitive diagnosis for any one rheumatic disease. Diagnosis is most often based on a compilation of symptoms and signs, including clinical information and laboratory test results.
Testing for antinuclear antibodies (ANAs) using an immunofluorescence assay (IFA) is a good first approach for laboratory evaluation of patients suspected of having certain autoimmune rheumatic diseases. ANAs, a group of autoantibodies directed against diverse nuclear and cytoplasmic antigens, are associated with several autoimmune rheumatic diseases.
These include:
- systemic lupus erythematosus (SLE),
- systemic sclerosis (SSc),
- and mixed connective tissue disease (MCTD).
Optimal range: 0 - 200 IU/ml
The ASO test is primarily used to help determine whether a recent strep infection with group A Streptococcus:
Optimal range: 23.8 - 42.9 pmol/min/ml
Aromatic L-amino acid decarboxylase (AADC) enzyme plays a crucial role in the human body's ability to process certain amino acids into neurotransmitters, which are chemical messengers that transmit signals in the brain and other areas of the nervous system.
AADC acts on L-amino acids, particularly those with an aromatic side chain, such as L-dopa (levodopa), converting them into dopamine, and 5-hydroxytryptophan into serotonin. These neurotransmitters are essential for regulating mood, movement, and autonomic functions within the body.
The assessment of AADC enzyme activity can help diagnose AADC deficiency—a rare but serious condition that affects neurotransmitter synthesis, leading to developmental delays, movement disorders, and autonomic dysfunction. By evaluating this marker, healthcare providers can gain insights into a patient's neurotransmitter production capabilities, guiding diagnosis and treatment strategies for conditions influenced by neurotransmitter levels. This makes the Aromatic L-amino acid decarboxylase enzyme a significant point of interest for researchers and clinicians alike, offering a window into the complex interplay of genetics, enzyme activity, and neurological health.
Optimal range: 0 - 0.49 index
Aspergillus Ag, BAL (Bronchoalveolar Lavage) is a vital test for diagnosing pulmonary aspergillosis, caused by the Aspergillus fungus. It's especially crucial for patients with weakened immune systems. This minimally invasive procedure involves analyzing lavage fluid from the lungs for Aspergillus antigens, providing a rapid and accurate diagnosis. Early detection through Aspergillus Ag, BAL enables prompt antifungal treatment, significantly improving patient outcomes.
Optimal range: 0 - 100 pg/mL
This test measures the levels of a certain type of hormone in your blood called a B-type natriuretic peptide. This test gives you information about your heart.
Providers use a BNP test to diagnose heart failure. If you already know you have heart failure, your provider may order this test to check the severity (seriousness) of your condition. They may also use this test to monitor how heart failure treatments are working. In some cases, your provider may also order it if they think you may be at higher risk of developing heart failure.
Reference range: Normal (<1:256), Abnormal (> or = 1:1024))
The Babesia duncani WA1 IgG assay is used to detect antibodies due to infection of the tick-borne protozoa Babesia duncani in cases of diagnostic uncertainty or suspected chronic infection. The assay is performed by indirect fluorescent antibody (IFA) method. Titer values above the reference intervals are considered evidence of current infection or past infection (e.g. within the last year).
Reference range: Negative, Positive
Doctors often suspect C. difficile in anyone who has diarrhea and who has other risk factors for C. difficile.
Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), also known as Clostridioides difficile and often referred to as C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.
Optimal range: 0 - 3.6 %
Determine the extent of carbon monoxide poisoning, toxicity; check on the effect of smoking on the patient; work up headache, irritability, nausea, vomiting, vertigo, dyspnea, collapse, coma, convulsions; work up persons exposed to fires and smoke inhalation.
Carbon monoxide levels are of limited value in testing for smoking, since it is cleared rapidly. The half-life of carboxyhemoglobin in individuals with normal cardiopulmonary function is one to two hours. Urinary cotinine, if available, is preferable as a test for tobacco use. Arterial blood gases may be of limited value in treatment decisions for carbon monoxide poisoning.
Carboxyhemoglobin is useful in judging the extent of carbon monoxide toxicity and in considering the effect of smoking on the patient. A direct correlation has been claimed between CO level and symptoms of atherosclerotic diseases, intermittent claudication, angina, and myocardial infarction. Exposure may occur not only from smoking but also from garage exposure, and from various motors.
Reference range: Negative, Positive
A cold agglutinin test may be used to help detect cold agglutinin disease and determine the cause of a person’s hemolytic anemia. It may be used as a follow-up test after a complete blood count (CBC) shows a decrease in a person’s red blood cell (RBC) count and hemoglobin, especially if these findings are linked to an exposure to cold temperatures.
Cold agglutinin disease is a rare autoimmune disorder in which autoantibodies produced by a person’s immune system mistakenly target and destroy RBCs, causing hemolytic anemia. These autoantibodies are cold-reacting and can cause signs and symptoms related to anemia after an affected person is exposed to cold temperatures. This disease may be classified as either primary or secondary, triggered by an infection or other condition.
Optimal range: 0.5 - 1 ug/ml
Copper is part of enzymes, which are proteins that help biochemical reactions occur in every cell. Copper is involved in the absorption, storage and metabolism of iron. The symptoms of a copper deficiency are similar to iron deficiency anemia. The liver makes a special protein, ceruloplasm, to transport copper and help convert iron to a form that can be used by other tissues.
Reference range: Negative, Present
Optimal range: 31 - 701 ng/dL
Dehydroepiandrosterone (DHEA) is a steroid that is produced by both the adrenal cortex and the testis. The levels of this steroid increase before the onset of puberty (adrenarche) and decrease significantly with age.
DHEA and DHEA-S are the major precursors of 17-ketosteroids.
Optimal range: 0 - 0.25 umol/L
Deoxyuridine is a nucleoside, a building block of DNA, but unlike its close relative thymidine, it is not commonly found in DNA. In the context of a Thymidine and Deoxyuridine Analytes panel from Labcorp, testing for deoxyuridine alongside thymidine offers valuable insights into a person's metabolic and DNA synthesis processes. When cells make DNA, they preferentially use thymidine. However, the presence of deoxyuridine in significant amounts can indicate a metabolic issue or a disorder related to DNA synthesis. One of the most critical conditions associated with elevated levels of deoxyuridine is thymidine phosphorylase deficiency, which can lead to mitochondrial DNA depletion syndromes, characterized by a range of symptoms from muscle weakness to neurological impairment. Additionally, abnormal levels of deoxyuridine and thymidine can suggest issues with the salvage pathway, a cellular recycling process crucial for DNA repair and replication. By analyzing the levels of these nucleosides, the panel can help diagnose these rare but significant conditions. The test's results, therefore, offer a window into the complex interplay of the body's nucleoside metabolism and DNA repair systems, providing crucial information that can guide diagnosis and treatment.
Optimal range: 0 - 0.01 g/dL
Quantitation of alcohol level for medical or legal purposes; test unconscious patients; used to diagnose alcohol intoxication and determine appropriate therapy; detect alcoholism and to monitor ethanol treatment for methanol intoxication. Must be tested as possible cause of coma of unknown etiology since alcohol intoxication may mimic diabetic coma, cerebral trauma, and drug overdose.
Reference range: Class 0 (Negative), Class 0/I (Equivocal/Low), Class I (Low), Class II (Moderate), Class III (High), Class IV (Very High), Class V (Very High), Class VI (Very High)
F078-IgE Casein is an allergy test that measures IgE antibodies specific to casein, a protein found in cow’s milk. This test helps identify whether your immune system is triggering an IgE-mediated allergic reaction to casein, which can cause symptoms ranging from mild discomfort to severe allergic responses.
Optimal range: 0 - 2 ug/ml
Casein is a major allergen in milk and the main protein constituent in cheese. Milk protein or casein intolerance occurs when the body has a food-specific IgG antibody response to the protein found in milk. This is not to be confused with lactose intolerance, which occurs wheninsufficient amounts of lactase are produced by cells in the small intestine.
Immunoglobulin G (IgG) antibodies to specific allergens have not been proved to be involved in pathogenesis of disease. The presence of IgG against otherwise innocuous antigens (such as foods) in serum simply indicates that the individual has been exposed to antigens that are recognized as foreign entities by the immune system. The presence of food-specific IgG alone cannot be taken as evidence of allergy or autoimmune disease and only indicates immunologic sensitization by the food in question. Consequently, the quantitative IgG test should only be ordered by specialists who recognize the limitations of the test.
Reference range: Class 0 (Negative), Class 0/I (Equivocal/Low), Class I (Low), Class II (Moderate), Class III (High), Class IV (Very High), Class V (Very High), Class VI (Very High)
F079-IgE Gluten is an allergy test that measures IgE antibodies specific to gluten, a protein found in wheat, barley, and rye. This test helps determine whether your immune system is producing an IgE-mediated allergic response to gluten, which can lead to symptoms of wheat allergy rather than non-IgE gluten-related conditions like celiac disease or gluten sensitivity.
Optimal range: 0 - 2 ug/ml
Immunoglobulin G (IgG) antibodies to specific allergens have not been proved to be involved in pathogenesis of disease. The presence of IgG against otherwise innocuous antigens (such as foods) in serum simply indicates that the individual has been exposed to antigens that are recognized as foreign entities by the immune system. The presence of food-specific IgG alone cannot be taken as evidence of allergy or autoimmune disease and only indicates immunologicsensitization by the food in question. Consequently, thequantitative IgG test should only be ordered by specialists who recognize the limitations of the test.
Optimal range: 0 - 0.86 ng/mg
The F2-Isoprostane/Creatinine Ratio is considered the gold standard for assessing oxidative stress, a biological process that can damage cells and tissues and is closely linked to the development of chronic diseases like cardiovascular disease. This test is particularly useful for individuals with lifestyle risk factors such as poor diet, smoking, a family history of heart disease, or elevated cholesterol levels. F2-isoprostanes (F2-IsoPs) are compounds formed when arachidonic acid—a fatty acid essential for muscle function and cellular processes—is oxidized in the body. While the body can produce arachidonic acid naturally or obtain it from foods like red meat and egg yolks, excessive levels can lead to increased production of F2-IsoPs, which in turn may promote blood vessel constriction, elevate blood pressure, and increase blood clotting, all of which raise the risk for heart attacks and strokes. Elevated F2-IsoP levels have also been associated with early plaque formation in arteries, and studies have shown that individuals with high levels of F2-IsoPs may be up to 30 times more likely to develop heart disease. The test is performed using a high-precision Liquid Chromatography-Tandem Mass Spectrometry (LC/MS/MS) method developed by Cleveland HeartLab, Inc., and although it has not been FDA-cleared, it is CLIA-certified for clinical use and provides critical insight into a patient’s oxidative stress and cardiovascular risk.
Optimal range: 0 - 60 Droplets/HPF
Increases in neutral fat are commonly associated with pancreatic exocrine insufficiency.
Optimal range: 0 - 100 Droplets/HPF
Increase in stool total fats (neutral fats, soaps, and fatty acids) is likely to be associated with small bowel disease.
Optimal range: 0 - 1000 ng/mL
Folate is a water-soluble vitamin essential for cell growth and division. RBC folate determination is obtained by measuring the folate concentration in a whole blood (WB) hemolysate solution and dividing it by the patient’s hematocrit (Hct; %).
This is an intermediary biomarker that is used to calculate Folate, RBC. There is no reference range provided by the laboratory, hence please refer to the actual "Folate, RBC" marker instead.
Optimal range: 499 - 1504 ng/mL
Folates are compounds of pteroylglutamic acid (PGA) that function as coenzymes in metabolic reactions involving the transfer of single-carbon units from a donor to a recipient compound. Folate, with vitamin B12, is essential for DNA synthesis, which is required for normal red blood cell maturation. Humans obtain folate from dietary sources including fruits, green and leafy vegetables, yeast, and organ meats. Folate is absorbed through the small intestine and stored in the liver.
Optimal range: 127 - 427 U/10E12 RBC
This test measures the amount of G6PD in red blood cells to help diagnose a G6PD deficiency.
G6PD deficiency is an inherited condition. It is when the body doesn’t have enough of an enzyme called G6PD (glucose-6-phosphate dehydrogenase).
This enzyme helps red blood cells work correctly. A lack of this enzyme can cause hemolytic anemia. This is when the red blood cells break down faster than they are made.
Optimal range: 4.8 - 15.7 U/g Hb
This test measures the amount of G6PD in red blood cells to help diagnose a G6PD deficiency.
G6PD deficiency is an inherited condition. It is when the body doesn’t have enough of an enzyme called G6PD (glucose-6-phosphate dehydrogenase).
This enzyme helps red blood cells work correctly. A lack of this enzyme can cause hemolytic anemia. This is when the red blood cells break down faster than they are made.
Optimal range: 0 - 22.2 ng/mL
- Aiding in the prognosis for people diagnosed with heart failure
- Risk-stratification of heart failure people
- An early indication of treatment failure and as a therapeutic target
Galectin-3 can be used in conjunction with clinical evaluation as an aid in assessing the prognosis of people with chronic heart failure.
Galectin-3 levels >17.8 ng/mL are present in a proportion of people with NYHA class II-IV. Such elevated levels are associated with a more progressive form of heart failure resulting in an increased hazard for death or hospitalization.
Optimal range: 0 - 11 seconds
The Hexagonal Phospholipid Neutralization test is a laboratory test used to detect lupus anticoagulants, which are antibodies that can lead to blood clotting problems. It is highly sensitive but may require additional tests for confirmation in the clinical assessment of antiphospholipid syndrome and related disorders.
Optimal range: 12 - 127 ng/mL
This test measures the amount of histamine in the blood.
Histamine is a substance that is released from specialized cells called mast cells when they are activated, often as part of an allergic immune response.
Optimal range: 0 - 4.4 ug Eq/mL
Anti-C1q autoantibodies are indicative for lupus nephritis, but can also be found in other conditions and inflammatory diseases.
Circulating immune complexes can be demonstrated in rheumatic, infectious, and neoplastic diseases, as well as most immunologically mediated illnesses (inflammatory bowel disease, thrombotic thrombocytopenic purpura). Complement is part of the innate immune system. Its major function is recognition and elimination of pathogens. Complement activity plays also an important role in the pathogenesis of systemic autoimmune diseases.
Optimal range: 0 - 66.1 pg/mL
Interleukin 8 (IL-8) is a promising marker for many clinical conditions and currently being applied by various subspecialties of medicine either for the purpose of rapid diagnosis or as a predictor of prognosis. Nevertheless, IL-8 level increased as a result of many inflammatory conditions, so careful interpretation of IL-8 level is required to make correlation with desired clinical condition's diagnosis or prognosis.
Optimal range: 0 - 0.01 g/dL
Volatile substances in the blood include ethanol, methanol, isopropanol, and acetone. Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis. Methanol and isopropanol are highly toxic and result from exogenous ingestion.
The presence of isopropanol indicates exposure which may result in intoxication and CNS depression. Ingestion of isopropanol can be fatal if patients do not receive immediate medical treatment.
Optimal range: 0 - 0.1 kU/L
Detect possible allergic responses to various substances in the environment such as animals, antibiotics, foods, grasses, house dust, mites, insects, insulin, molds, smuts, trees, and weeds; evaluate hay fever, asthma, atopic eczema, and respiratory allergy.
Optimal range: 4.8 - 25.7 mg/dL , 0.53 - 2.85 mmol/L
This test measures the level of lactic acid, also known as lactate, in your blood. Lactic acid is a substance made by muscle tissue and by red blood cells, which carry oxygen from your lungs to other parts of your body. Normally, the level of lactic acid in the blood is low.
Lactic acid levels rise when oxygen levels decrease.
Low oxygen levels may be caused by:
- Strenuous exercise
- Heart failure
- Severe infection
- Shock, a dangerous condition that limits blood flow to your organs and tissues
If lactic acid levels get too high, it can lead to a life-threatening condition known as lactic acidosis. A lactic acid test can help diagnose lactic acidosis before it causes serious complications.
Optimal range: 2 - 20 ug/ml
Lamotrigine (Lamictal) is an anticonvulsant medication commonly used for the treatment of epilepsy and bipolar disorder. Measuring the serum concentration of Lamotrigine is crucial for ensuring therapeutic efficacy and safety. Labcorp's Lamotrigine (Lamictal), Serum test helps to monitor the drug levels in patients to ensure they are within the therapeutic range, thereby optimizing treatment and minimizing the risk of adverse effects.
Optimal range: 0 - 0 g/dL
M-protein is an abnormal protein produced by myeloma cells that accumulates in and damages bone and bone marrow.
Optimal range: 0 - 2 ng/mL
Toxic exposure may occur from dry cells, fungicide (maneb), and in the steel industry or chemical industry. Manganese is present in the coloring agents for glass and soap, in paints, varnish, enamel, and in linoleum. It is used in the manufacture of chlorine gas and now in lead-free gasoline. Industrial manganese poisoning has been recognized since 1837. Some water supplies are sufficiently contaminated by manganese that endemic psychiatric and neurological disease is presen
Optimal range: 11 - 23 ng/mL
The Manganese (Mn) content in the adult human is 11.0 to 23 ng/mL. About 25% is stored in the skeleton. Within each cell, Manganese is concentrated in the mitochondria. Bone, liver, and pancreas tend to have the highest concentrations.
Mn is an important part of the anti-oxidant enzyme super oxidase dismutase.
Optimal range: 0 - 40 pg/mL
Melanocyte-Stimulating hormone (MSH) characterizes a group of hormones made by the pituitary gland, hypothalamus, and skin cells. MSH is essential for preserving the skin from ultraviolet rays, the development of pigmentation, and controlling appetite.
Optimal range: 0 - 0.01 g/dL
Detecting methanol in cases of accidental ingestion, or intentional ingestion by potential suicide victims or alcoholics.
The presence of methanol indicates exposure which may result in intoxication, central nervous system (CNS) depression, and metabolic acidosis. Ingestion of methanol can be fatal if patients do not receive immediate medical treatment.
Reference range: Negative, Positive
Reference range: Negative, Positive
Infectious mononucleosis, or mono, is a disease most frequently caused by infection with the Epstein-Barr virus (EBV). The viruses that cause mono are commonly spread through bodily fluids, especially saliva. While less common, transmission may also occur through blood and semen during sexual contact, blood transfusions, and organ transplantations.
Optimal range: 0 - 2.5 ng/mL
Reference range: Negative, Positive
Optimal range: 0 - 3 U/mL
Optimal range: 0 - 3 seconds
A Platelet Neutralization test in a blood test is a specialized laboratory test used to detect the presence of lupus anticoagulants (LAs), which are autoantibodies associated with blood clotting disorders such as antiphospholipid syndrome (APS). It is an essential component of the diagnostic process, but its interpretation requires consideration of other clinical and laboratory information.
Optimal range: 19 - 83 ug/L
Procollagen I intact N-terminal propeptide (PINP) values should not be used as a screening test for osteoporosis in the general population. PINP is used to monitor bone formation and antiresorptive therapies. PINP should be measured prior to the start of therapy to determine a baseline value and again at 3 to 6 months after initiation of therapy. Therapeutic response is evaluated by comparing pre and post-treatment values.
Optimal range: 73 - 180 %
Protein C is a vitamin K-dependent plasma protein.
Protein C helps control blood clotting. A lack of this protein or a problem with the function of this protein may cause blood clots to form in veins. The test is also used to screen relatives of people who are known to have protein C deficiency. It may also be done to find the reason for repeated miscarriages.
Optimal range: 60 - 140 %
Protein S is a critical component of the body's anticoagulation system, playing a pivotal role in regulating blood clot formation. It is a glycoprotein that circulates in the bloodstream and acts as a cofactor for protein C, another important anticoagulant protein. The primary function of protein S is to enhance the activity of activated protein C (APC) in breaking down coagulation factors Va and VIIIa, thus inhibiting the formation of excessive blood clots.
Optimal range: 0 - 0.9 AI
Antibodies to ribonucleoprotein, RNP, are found often in very high levels in patients with a variety of systemic rheumatic diseases, including SLE, progressive systemic sclerosis and Mixed Connective Tissue Disease, a distinct disease entity with overlapping clinical features of SLE, scleroderma, polymyositis and rheumatoid arthritis.
These autoantibodies usually give a strong speckled pattern of nuclear staining in immunofluorescence. The structure of the antigens recognised by anti-RNP antibodies is complex. The commonest determinants and ones which are most widely detected are those called RNP or U1RNP. Anti-RNP antibodies can be detected alone (usually in MCTD) or together with anti-Sm (lupus). Anti-Sm is seldom found alone.
Optimal range: 31 - 207 ng/mL
Serotonin plays important roles in the resolution of mood, sleep, and appetite.
Serotonin is an inhibitory neurotransmitter synthesized by enzymes that act on tryptophan and/or 5-HTP.
Neurotransmitters are divided into two basic categories:
– Excitatory neurotransmitters stimulate the brain and body.
– Inhibitory neurotransmitters calm the brain and body.
Just as levels of individual neurotransmitters are important in maintaining optimum health, so is the proper balance between your excitatory and inhibitory systems.
Optimal range: 3 - 20 ng/mL
Sirolimus is often referred to by the brand name Rapamune.
Sirolimus is an immunosuppressant drug used in the prophylaxis of organ rejection in patients receiving transplants.
Sirolimus can be used in combination with ciclosporin, tacrolimus or mycophenolate.
Sirolimus levels are measured in order to establish the correct dose, maintain therapeutic levels and ensure that toxic levels are avoided.
Reference range: Negative, Positive
S stercoralis has a complex lifecycle that begins with maturation to the infective filariform larva in warm, moist soil. The larvae subsequently penetrate exposed skin and migrate hematogenously to the lungs, from where they ascend the bronchial tree and are swallowed. Once in the small intestine, filariform larva matures into the adult worms that burrow into the mucosa. Gravid female worms produce eggs that develop into noninfectious rhabditiform larvae in the gastrointestinal tract and are eventually released in the stool. The time from dermal penetration to appearance of Strongyloides in stool samples is approximately 3 to 4 weeks.
Optimal range: 40 - 250 ng/dL
The marker “Testost., F+W Bound” stands for Testosterone Free and Weakly Bound. Free and weakly bound testosterone, also referred to as bioavailable testosterone, is thought to reflect an individual’s biologically active, circulating testosterone. It includes free testosterone and testosterone that is bound to albumin. It does not include sex hormone binding globulin-bound testosterone.
Optimal range: 0 - 0.25 umol/L
Thymidine is one of the nucleosides that forms part of DNA, essentially a building block of our genetic material. It consists of a thymine base attached to a sugar molecule (deoxyribose); together, these components are crucial for DNA replication and repair processes. In the context of the Thymidine and Deoxyuridine Analytes panel, measuring thymidine levels can provide insight into certain disorders. For instance, elevated levels of thymidine (and deoxyuridine, its counterpart in the panel) can indicate issues with DNA synthesis and repair mechanisms, potentially pointing to mitochondrial diseases or disorders related to pyrimidine metabolism, such as "thymidine phosphorylase defciency (MNGIE)". These conditions can have a wide range of implications, from neurological disorders to myopathy and beyond. Thus, the Thymidine and Deoxyuridine Analytes panel is a diagnostic tool that helps in the detection and management of these conditions by measuring the concentration of these nucleosides in the blood. By understanding the levels of thymidine, healthcare providers can make more informed decisions about diagnosis, treatment, and management of patients with suspected metabolic or genetic abnormalities.
Optimal range: 414 - 1020 nmol/mg/hr
Thymidine Phosphorylase Activity refers to the measurement of the enzyme's activity in the body, which plays a significant role in nucleotide metabolism—the process by which cells manage their energy and the synthesis of the building blocks of DNA and RNA. Thymidine Phosphorylase (TP) is involved in the breakdown of thymidine, a nucleoside that is a component of DNA, into thymine and deoxyribose-1-phosphate. This process is crucial for the proper recycling of nucleotides and maintaining the balance of DNA synthesis and repair mechanisms within cells.
Optimal range: 13 - 39 ug/ml
Thyroid-binding globulin (TBG) is produced in the liver and is the primary circulating (transport) protein that binds thyroid hormones3,5,3’-triiodothyronine (T3) and thyroxine (T4) and carries them in the bloodstream.
Optimal range: 0 - 7.2 IU/ml
Toxoplasma gondii is an obligate intracellular protozoan parasite that is capable of infecting a variety of intermediate hosts including humans. Infected definitive hosts (cats) shed oocysts in feces that rapidly mature in the soil and become infectious.
Reference range: Non Reactive, Reactive
Treponema pallidum antibodies are specific antibodies produced by the immune system in response to infection with Treponema pallidum, the bacterium responsible for causing syphilis. These antibodies play a crucial role in the diagnosis and monitoring of syphilis.
There are various treponemal tests, including the Treponema pallidum particle agglutination (TP-PA) test, fluorescent treponemal antibody absorption (FTA-ABS) test, and enzyme immunoassays (EIAs). These tests detect different types of Treponema pallidum antibodies.
Optimal range: 50 - 100 ug/ml
Valproate is an alternative drug in the treatment of complex partial seizures but may be considered for initial therapy in patients with partial and secondarily generalized seizures.
Valproic acid is used as an anticonvulsant to treat certain types of seizures, to prevent migraine headaches and to treat various psychiatric illnesses such as bipolar disorder and aggression. Drugs that compete for protein-binding sites with valproic acid can increase the concentration of valproic acid. Therapeutic drug monitoring is useful to optimize dose. Measurement of the free concentration is useful if toxicity is suspected.
Optimal range: 0 - 18.8 mg/g creat
Vanillylmandelic Acid (VMA) is a key metabolic byproduct found in urine, derived from the breakdown of catecholamines such as adrenaline (epinephrine) and noradrenaline (norepinephrine), which are vital hormones produced by the adrenal glands. The measurement of VMA in a random urine sample is a significant diagnostic tool used to assess and monitor certain medical conditions, particularly those involving the adrenal glands and nervous system.
Optimal range: 0 - 58.8 pg/mL
Vasoactive intestinal peptide (= VIP) is a neurotransmitter, widely distributed through the central and peripheral nervous system with the highest concentration occurring in the submucosal postganglionic intrinsic nerves of the intestinal tract.
Normally VIP has a low blood concentration and does not change with meals.
What are the functions of Vasoactive intestinal peptide?
VIP is considered a hormone and is found in the pancreas, intestine, and central nervous system. It has many functions in the body, such as:
→ functions as a neuromodulator and neurotransmitter
→ helping to control the secretion of water, salts, enzymes, and gastric acid during digestion.
→ regulates smooth muscle activity, epithelial cell secretion, and blood flow in the gastrointestinal tract
→ being a potent vasodilator [open (dilate) blood vessels]
→ has effects on the immune system and the central nervous system.
→ it functions as a neurohormone and paracrine mediator, being released from nerve terminals and acting locally on receptor-bearing cells.
Optimal range: 0 - 36 ug/dL
What is Zinc protoporphyrin (ZPP)?
Zinc protoporphyrin (ZPP) is a normal metabolite that accumulates in trace amounts in erythrocytes (Red blood cells) during hemoglobin (=a protein in red blood cells that carries oxygen) synthesis (=the production of hemoglobin).
The final step in the heme pathway involves the enzyme ferrochelatase, which binds ferrous iron with protoporphyrin IX through a process called chelation. This reaction is crucial for the synthesis of heme, a compound that plays a vital role in various biological functions such as oxygen transport. However, in cases of iron deficiency or impaired iron utilization, an alternative metal substrate, zinc, can be used by ferrochelatase. On the other hand, lead toxicity can interfere with the transfer of iron within cells, leading to a condition similar to iron deficiency. Essentially, lead toxicity mimics the effects of iron deficiency by disrupting the normal functioning of intracellular iron transfer.
Reference range: Negative, Positive
Zinc Transporter 8 Autoantibodies
- ZnT8 antibody distinguishes type 1 and type 2 diabetes mellitus.
- ZnT8 antibody identifies relatives of diabetic patients at most risk for developing diabetes.
- ZnT8 antibody predicts the future need for insulin treatment in adult-onset diabetic patients.
- ZnT8 antibody predicts the future development of diabetes mellitus in women with gestational diabetes.
Detects zinc transporter 8 autoantibodies (ZnT8), an autoimmune diabetes marker that is instrumental in the diagnosis of new-onset type 1 diabetes
Optimal range: 10 - 40 ug/ml
Zonisamide is an anticonvulsant medication primarily used to treat epilepsy and sometimes prescribed off-label for migraine prevention, neuropathic pain, and weight management. It works by stabilizing neuronal activity through sodium and calcium channel modulation, as well as by influencing GABAergic and dopaminergic systems.
Adrenal Function Profile (Labrix, Doctor's Data)
This profile provides a comprehensive view of HPA axis/adrenal function and includes 4 cortisol levels collected over the course of the day, plus DHEA.
Cortisol levels should be at their highest level 30 minutes after waking up in the morning, decreasing gradually over the course of the day, reaching their lowest point at bedtime. The resulting curve or pattern allows health care providers to pinpoint issues with adrenal gland function. Alterations in this pattern can result in symptoms related to stress, fatigue and insomnia.
DHEA levels naturally decline with age, although alterations can be seen as part of the stres response.
Optimal range: 14 - 25 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 2 - 5 nmol/L
This is the 3rd cortisol sample of the day. Usually measured in the evening.
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
Optimal range: 1 - 4 nmol/L
This is the 4th cortisol sample of the day (=night).
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
Optimal range: 5 - 10 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 106 - 300 pg/mL
DHEA levels peak at around age 25, then decline steadily through the following decades. DHEA can be converted downstream in the steroidogenic pathway to create androgens and estrogens. It has antioxidant and anti-inflammatory properties and can be protective against corticosterone’s neurotoxic effects.
Optimal range: 75 - 330 ug/ml
Every mucosal membrane surface such as the eyes, nose, throat, and gastrointestinal system represent a large portal of entry for pathogenic bacteria, viruses, and yeasts. Secretory IgA (sIgA) is the predominant antibody found on these mucosal membranes, and represents the body’s first line of defense. SIgA levels change in response to stress.
Hormone Report (Labrix, Doctor's Data)
The Comprehensive Hormone Profile reports hormone levels, and also calculates the Progesterone (Pg)/Estradiol (E2) ratio, which assesses the relationship between estradiol, which can drive cellular proliferation, and progesterone, which mitigates that growth and potentiates cellular differentiation.
Hormones are powerful molecules essential for maintaining physical and mental health. We frequently think of estrogen as being a female hormone, and testosterone as being a male hormone. But men AND women make both, plus several more that need to be in balance for optimum health. An imbalance of any one hormone can throw your physical and mental health out of balance, causing aggravating and even serious health problems.
One size does not fit all when it comes to hormones. For decades western medicine has prescribed hormone replacement therapy as if everyone needed the same thing and the same amount. Nothing could be further from the truth. Your hormones are like your fingerprints and in order to achieve optimal health, you need to know what your specific imbalances are. Female and male hormone tests can help identify these imbalances.
There are several ways to test for hormones (saliva, serum and urine). Saliva is the best method to test the active/bioavailable portion of hormones, which are reflective of tissue levels. In addition, if using a topical (transdermal) hormone preparation for treatment, saliva testing is the most accurate tool to measure and monitor hormone status.
Optimal range: 1 - 10 Ratio
The Estrogen Quotient is a simple ratio of the cancer protective E3 relative to the proliferative estrogens E1 and E2, to assess breast cancer risk.
The higher your E3 is compared to your E1 and E2 levels, the lower your cancer risks may be.
Optimal range: 0.6 - 4.5 pg/mL
Estradiol (E2) is produced in women mainly in the ovary. The testes and adrenal glands are the principal source of estradiol in men. In women, normal levels of estradiol provide for proper ovulation, conception, and pregnancy, while also promoting healthy bone structure and regulating cholesterol levels.
Optimal range: 7.5 - 66 pg/mL
Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Optimal range: 0 - 35 pg/mL
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, largely due to the fact that it is the least powerful of the three types of estrogen, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers as well as estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 200 - 1000 Ratio
This ratio is helpful when both E2 and Pg are within range, yet the patient continues to have symptoms. It is not expected to be normal or used clinically when either E2 and/or Pg are outside of their expected ranges or if the patient does not have clinical symptoms.
Optimal range: 127 - 446 pg/mL
Progesterone is a female sex hormone of primary importance in ovulation, fertility and menopause. It is particularly important in preparing the endometrium for the implantation of the blastocyte and in maintaining pregnancy. In the follicular phase of menstrual cycle progesterone is produced in low levels. It increases to the LH peak and then sharply rises to high levels. Next there is a sharp decline to low levels of follicular phase. In non-pregnant women progesterone is mainly secreted by the corpus luteum whereas in pregnancy the placenta becomes the major source. Minor sources for progesterone are the adrenal cortex for both sexes and the testes for males.
Optimal range: 6 - 49 pg/mL
Testosterone is an anabolic hormone produced predominately by the ovaries in women and the testes in men, and to a lesser extent in the adrenal glands. It is essential for creating energy, maintaining optimal brain function (memory), regulating the immune
system, and building and maintaining the integrity of structural tissues such as skin, muscles, and bone. Premenopausal testosterone levels usually fall within the high-normal range and postmenopausal levels at low-normal range. In men testosterone levels peak in the teens and then fall throughout adulthood.
Neuro Basic Profile (Labrix, Doctor's Data)
Neurotransmitters are chemical messengers that play a crucial role in communication within the nervous system. They enable signals to pass between neurons across synapses, influencing and regulating vital processes such as:
While neurotransmitters primarily function within the Central Nervous System (CNS), they also interact with the body’s glands, organs, and muscles, making them essential for overall health.
Urinary neurotransmitter testing provides an overall assessment of the body’s ability to produce, regulate, and break down neurotransmitters. Since the same enzymes, cofactors, and precursors influence neurotransmitter metabolism in both the central and peripheral nervous systems, urinary levels offer valuable clinical insights into whole-body neurotransmitter activity.
Alterations in urinary neurotransmitter levels are associated with numerous symptoms and conditions, including:
Research shows that neurotransmitter imbalances profoundly affect overall well-being. These imbalances are linked to many common symptoms and conditions, including mood disorders, hormonal issues, and cognitive decline. Factors contributing to neurotransmitter depletion or dysfunction include:
These influences disrupt natural neurotransmission, potentially leading to chronic health issues and diminished quality of life.
The neurotransmission system relies on a balance between two types of neurotransmitters:
This natural system of checks and balances ensures optimal nervous system function. When disrupted, it can result in symptoms such as anxiety, fatigue, and cognitive dysfunction.
Urinary neurotransmitter testing is a practical, non-invasive method for assessing neurotransmitter balance. By analyzing neurotransmitter levels, healthcare practitioners can identify potential imbalances and develop personalized treatment plans.
To optimize neurotransmitter function and support overall health:
Take Control of Your Neurotransmitter Health
Understanding your body’s neurotransmitter balance is essential for improving mood, cognition, and overall well-being. Speak with your healthcare provider about urinary neurotransmitter testing today to unlock the key to better mental and physical health.
Optimal range: 390 - 1500 ug/g
Optimal range: 90 - 210 nmol/g
Optimal range: 2000 - 8000 ug/g
Optimal range: 30 - 225 mg/dL
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Optimal range: 125 - 250 µg/g
Dopamine is largely responsible for regulating the pleasure reward pathway, memory and motor control. Its function creates both inhibitory and excitatory action depending on the dopaminergic receptor it binds to. Memory issues are common with both elevations and depressions in dopamine levels. Caffeine and other stimulants, such as medications for ADD/ADHD, often improve focus by increasing dopamine release, although continual stimulation of this release can deplete dopamine over time.
Optimal range: 1.6 - 8.3 µg/g
Epinephrine, often better known as adrenaline, is synthesized from norepinephrine in both the CNS and the adrenal medulla. Much like norepinephrine, this excitatory neurotransmitter helps regulate muscle contraction, heart rate, glycogen breakdown, blood pressure and more, and is heavily involved in a stress response. Elevated levels of epinephrine are often associated with hyperactivity, ADHD, anxiety, sleep issues, and low adrenal function. Over time, chronic stress and stimulation can deplete epinephrine stores leading to difficulty concentrating, fatigue, depression, insufficient cortisol production, chronic stress, poor recovery from illness, dizziness and more.
Optimal range: 2 - 5.6 qmol/g
Gamma-aminobutyrate (GABA) is the major inhibitory neurotransmitter found in the CNS and, as such, is important for balancing excitatory action of other neurotransmitters.
Optimal range: 12 - 45 qmol/g
Glutamate is an excitatory neurotransmitter and is considered to be the most abundant neurotransmitter in the nervous system. Glutamate is involved in most aspects of normal brain function including cognition, memory and learning, although high levels of glutamate can cause excitotoxicity, a process where nerve cells are damaged by excessive stimulation.
Optimal range: 450 - 2200 qmol/g
Glycine is inhibitory and plays dual roles as both a neurotransmitter and an amino acid that serves as a building block of proteins. Glycine improves sleep quality, calms aggression, and serves as an anti-inflammatory agent. Glycine has been shown to boost mental performance and memory.
Optimal range: 14 - 44 qg/g
Histamine is an excitatory neurotransmitter involved in the sleep/wake cycle and inflammatory response. Histamine plays a dual role in the body as both a neurotransmitter and immunomodulator increasing metabolism, promoting wakefulness, attention, circadian rhythms, learning, and memory.
Optimal range: 45 - 119 ug/g
Optimal range: 22 - 50 µg/g
Norepinephrine, also called noradrenaline, is an excitatory neurotransmitter produced in the CNS, as well as a stress hormone produced in the adrenal medulla. Norepinephrine is involved in a wide variety of actions including attention, focus, regulating heart rate, affecting blood flow, and suppressing inflammation. Involved in arousal, it prepares the body for action by relaying messages in the sympathetic nervous system as part of the autonomic nervous system’s fight-or-flight response.
Optimal range: 0 - 13 Ratio
The Norepinephrine / Epinephrine ratio is an indicator of epinephrine (adrenaline) conversion (epinephrine is synthesized from norepinephrine). Anxiety, burnout, and poor blood sugar control are associated with a relative epinephrine depletion, and thus an elevated Norepi:Epi ratio.
Optimal range: 85 - 300 ug/g
Optimal range: 32 - 84 nmol/g
Phenethylamine (PEA) promotes energy, elevates mood, regulates attention and aggression, and serves as a biomarker for ADHD. Elevated PEA may contribute to anxiety, with very high levels having amphetamine-like effects. Elevated PEA levels may be associated with higher cortisol levels. Low PEA may be associated with ADHD, depression, Parkinson’s disease and bipolar disorder.
Optimal range: 60 - 125 µg/g
Serotonin is a key neurotransmitter that is involved in the regulation of sleep, appetite and aggression. Serotonin imbalance is a common contributor to mood problems, and pharmacologic agents that alter serotonin levels are among the most commonly used class of drugs prescribed for anxiety and depression.
Optimal range: 320 - 1000 umol/g
Optimal range: 0.2 - 0.9 umol/g
Optimal range: 2 - 4 umol/g
Optimal range: 32 - 80 umol/g
2200 GI Effects Comprehensive Profile - Stool
Written By: B. Dame
Updated On: January 28, 2025
The GI Effects Comprehensive Profile (Test Code 2200) is a powerful diagnostic tool designed to uncover the root causes of common gastrointestinal (GI) symptoms and support overall health. By analyzing stool biomarkers like fecal calprotectin, this test differentiates between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS) and evaluates potential gastrointestinal infections or dysbiosis.
Genova’s GI Effects Stool Profiles leverage advanced technologies and biomarkers to provide actionable insights into gut health, offering a comprehensive view of:
These profiles help healthcare providers develop personalized strategies to manage GI health and address broader health concerns.
The GI Effects Stool Profiles go beyond traditional diagnostics to identify underlying causes of a variety of GI and systemic conditions. Common symptoms and conditions addressed include:
Your gut microbiome—the ecosystem of trillions of microbes in your digestive tract—plays a vital role in overall health. Research links a dysbiotic microbiome (imbalanced gut flora) to a wide range of conditions, from GI disorders to autoimmune diseases and mental health challenges.
A healthy gut microbiome supports key metabolic activities, which in turn influence systemic health. Conversely, poor lifestyle choices or chronic health conditions can disrupt the microbiome, creating a vicious cycle of poor health.
Understanding your gut health is the first step toward resolving chronic symptoms and optimizing overall well-being. The GI Effects Comprehensive Profile empowers individuals and healthcare providers with the insights needed to create a healthier future.
Optimize your health—starting with your gut. Speak to your healthcare provider about the GI Effects Comprehensive Profile today and unlock the key to better digestive and systemic health.
Optimal range: 48.1 - 69.2 %
Acetate is the most abundant SCFA in the colon and makes up more than half of the total SCFA detected in feces. These beneficial SCFA have anti-inflammatory properties, provide energy to nourish the colonic epithelial cells and intestinal microbiota, and exert numerous positive effects on gut homeostasis.
Reference range: -50%, -25%, 0%, +25%
Optimal range: 8500 - 100000000000 CFU/g stool
Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
Human microflora is influenced by environmental factors and the competitive ecosystem of the organisms in the GI tract. Pathogenic significance should be based upon clinical symptoms.
Alpha-hemolytic Streptococcus refers to a group of gram-positive cocci bacteria within the Streptococcus genus. These bacteria exhibit alpha-hemolysis, a partial or "greening" hemolysis on blood agar.
Alpha-hemolytic Streptococcus can cause various infections in humans and animals, including streptococcal infections transmitted through coughs and sneezes. The viridans streptococci, another subgroup, are commensal bacteria that produce alpha-hemolysis.
Optimal range: 0 - 20000000 CFU/g stool
Anaerotruncus colihomonis (pronounced “an-AERO-trunk-us colly-HOM-in-iss”) is a newly described bacterial genus and species isolated from the stool specimens of children. Its clinical significance, however, is unknown.
The species is found only relatively infrequently in the human gut. It comes from the genus Anaerotruncus, which contains just this one species. The genus name comes from the Greek words “an” and “aero”, meaning respectively “without” and “air”, and the Latin word “truncus”, which means “stick”—making the overall name “a stick that lives without air”, since the cells of this bacterial genus are rod-like in shape and live in the absence of oxygen. The species name “colihominis” means “of the gut of man”.
Optimal range: 0 - 20000000 CFU/g stool
The genus Anaerotruncus includes species Anaerotruncus colihominis and Anaerotruncus massiliensis.
A. colihominis hominis is a butyrate and acetate producer.
Abundance is associated with higher bacterial gene richness in the gut a.
A. colihominis is increased in healthy individuals and presumed to be anti-inflammatory.
There is an inverse correlation with high BMI and elevated serum triglycerides in older Amish adults.
There is an inverse relationship with A. colihominis abundance and cognitive function scores in patients with Alzheimer's disease.
Anaerotruncus massiliensis is a newly identified strain similar to A. colihominis. They both ferment amino acids and carbohydrates and are mucin degraders.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0 - 950000000 CFU/g stool
Bacteroides uniformis is a fiber-degrading bacteria. It colonizes the gut in early infancy and is promoted by breast feeding.
Thought to enhance the gut barrier through the production of butyrate and GABA. Also produces beta glucuronidase, degrades mucin, and produces folate.
Studied in preclinical trials as a potential probiotic for use in inflammatory and metabolic disorders.
B. uniformis was found to be decreased in obese patients as compared to healthy or lean groups. It was higher in healthy controls as compared to patients with ulcerative colitis.
Enriched in healthy individuals versus colorectal cancer patients.
Associated with degradation of the isoflavone genistein, which then becomes less bioavailable to the human.
Optimal range: 0 - 830000000 CFU/g stool
Bacteroides vulgatus is among the most commonly isolated microbes from the human gastrointestinal tract, and it has been found to constitute part of the core gut microbiota in healthy humans.
Optimal range: 3400000 - 1500000000 CFU/g stool
The predominant genera in the human colonic microbiota are Bacteroides and Prevotella, which belong to the major phyla Bacteroidetes.
Reference range: -50%, -25%, 0%, +25%
Optimal range: 3000000 - 290000000 CFU/g stool
Barnesiella ssp. is a small group of two species of bacteria that are usually only found at reasonably low levels in the gut.
Optimal range: 368 - 6266 U/g
Beta-glucuronidase is an enzyme which is produced by colonocytes and by some intestinal bacteria (particularly E. coli, but also Ruminococcus, Bacteroides, Eubacterium, Peptostreptococcus, Staphylococcus, and Clostridium).
Beta-glucuronidase breaks down complex carbohydrates and increases the bioavailability and reabsorption of plant polyphenols (lignans, flavonoids, ceramides, and glycyrrhetinic acid).
Beta-glucuronidase deconjugates glucuronide molecules from a variety of toxins, carcinogens, hormones (i.e. estrogens) and drugs.
Deconjugation permits reabsorption via enterohepatic circulation, with the potential to elevate systemic levels of potentially harmful compounds and hormones.
Optimal range: 0 - 130000000 CFU/g stool
Bifidobacterium longum is a specific species of microscopic non-pathogenic bacteria found naturally in the gastrointestinal tracts of humans as well as in most other animals.
Optimal range: 0 - 130000000 CFU/g stool
Bifidobacterium longum is comprised of multiple subspecies that beneficially modulate the immune system. It is found in probiotic supplements and fermented foods. Lactate producer; acetate producer.
Utilizes diet-derived carbohydrates.
Optimal range: 460000 - 260000000 Units
A common component of the microbiota of the human gastrointestinal tract and in particular are amongst the first bacterial colonizers of the intestine.
Reference range: Not Detected, Detected
What is Blastocystis spp.?
Blastocystis is a common microscopic organism that inhabits the intestine and is found throughout the world. A full understanding of the biology of Blastocystis and its relationship to other organisms is not clear, but is an active area of research. Infection with Blastocystis is called blastocystosis.
What are the symptoms of infection with Blastocystis?
Watery or loose stools, diarrhea, abdominal pain, anal itching, weight loss, constipation, and excess gas have all been reported in persons with Blastocystis infection. Many people have no symptoms at all. The organism can be found in both well and sick persons.
How long will I be infected?
Blastocystis can remain in the intestine for weeks, months, or years.
Reference range: Not Detected, Rare Detected
Optimal range: 0 - 33000000 CFU/g stool
‘Butyrivibrio‘ is a genus of bacteria in Class Clostridia. Butyrivibrio crossotus are often found in the human gut and inversely associated with obesity.
Optimal range: 0 - 50 mcg/g
Calprotectin is a protein that binds to both calcium and zinc. Fecal calprotectin levels are abnormally increased in people with intestinal inflammation, thus it is useful for distinguishing between inflammatory and non-inflammatory diarrhea.
Reference range: Negative, Positive
Campylobacter spp. is a foodborne pathogen responsible for causing gastroenteritis. Infection typically occurs after consuming contaminated food, especially poultry, unpasteurized milk, and water. Patients infected with Campylobacter may experience symptoms such as acute watery or bloody diarrhea, abdominal cramping, and weight loss. In some cases, the infection can lead to more severe health issues, such as the autoimmune condition Guillain-Barré syndrome, which can cause muscle weakness and paralysis.
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
Candida spp. have commonly been identified as part of the healthy human mycobiome. Host defense interruption, or immunocompromise, is required for them to act as pathogens.
Candida albicans is the most prevalent among the Candida spp.
Fungi, including Candida, are ubiquitous in our environment and are part of natural foods and industrial processes, including antibiotic production, bread, cheese, alcoholic beverages, decomposing natural debris, fruits, and soil nutrients.
Candida is present in the gut of up to 70% of healthy adults, but certain factors, including diabetes, antibiotics, antacid, and steroid inhaleruse, promote overgrowth.
Reference range: Not Detected, Detected
Optimal range: 0.4 - 4.8 mg/g
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
- Citrobacter are Gram-negative, nonspore-forming, facultatively anerobic bacilli.
- Citrobacter fall within the Enterobacteriaceae family.
- Citrobacter is considered a commensal bacteria; however, depending on the clinical picture, it is also known to be an opportunistic pathogen.
- Citrobacter species are found in water, soil, food, and commonly in the human intestinal tract.
- Citrobacter infections can also be nosocomial.
- Although considered a commensal, some Citrobacter isolates have virulent toxins, such as Shiga-like toxins, heat-stable toxins, and cholera B toxin B subunit homologs.
- Citrobacter is most often asymptomatic but can cause diarrhea.
Reference range: Negative, Positive
Clostridium difficile is an anaerobic, spore-forming gram-positive bacterium that can be part of the normal intestinal flora. After a disturbance of the gut flora (usually with antibiotics), colonization with toxin producing Clostridium difficile can take place. Not all colonized patients develop symptoms. When present, symptoms include bloody and non-bloody diarrhea, fever, abdominal pain and vomiting.
Optimal range: 0 - 15000000 CFU/g stool
Clostridium spp. is a genus belonging to the phylum Firmicutes. While interpreting the literature, careful attention should be paid to the phylogenetic classification of this group due to minor spelling differences between the taxonomic levels. Beyond the phylum level, it is broken down as follows: Class: Clostridia, Order: Clostridiales, Family: Clostridiaceae, and finally, Genus: Clostridium.
The Clostridium genus contains more than 100 species, most of which are commensal, however it does include pathogens. The literature discusses Clostridial clusters, which may include other species belonging to Eubacterium, Ruminococcus, Roseburia, Butyrivibrio, Faecalibacterium and other genera. These clusters exist due to historic issues with classification, where unclassified species would be moved into the Clostridium category.
Optimal range: 0 - 130000000 CFU/g stool
- Possibly proinflammatory, may play a role in altering intestinal barrier integrity.
- Produces H2, ethanol, short-chain fatty acids including butyrate, and lactate and is a major utilizer of lactose.
- Contains bile salt hydrolases to metabolize bile, and along with Bifidobacterium, can modify bile acids to modulate the virulence and pathogenicity of enteric pathogens.
- Consumes oligosaccharides and simple sugars
Optimal range: 0 - 120000000 CFU/g stool
The abundance of Coprococcus eutactus is associated with greater bacterial gene richness in the gut.
Coprococcus is a genus of anaerobic cocci which are all part of the human faecal flora. Coprococcus includes those gram-positive, anaerobic cocci that actively ferment carbohydrates, producing butyric and acetic acids with formic or propionic and/or lactic acids. Fermentable carbohydrates are either required or are highly stimulatory for growth and continued subculture. The genus is bio-chemically closely related to Ruminococcus.
Reference range: Not Detected, Detected
Cryptosporidiosis is a disease that causes watery diarrhea. Crypto is caused by a microscopic parasite called Cryptosporidium. Anyone can get sick with Crypto, but people with weakened immune systems are more likely to have severe and potentially life-threatening symptoms. This includes people who have health problems or take medicines that lower their body’s ability to fight germs and sickness—such as people whose immune systems are weakened because of cancer, an organ transplant or have cancer, or HIV.
Reference range: Not Detected, Detected
Cyclospora cayetanensis is a coccidian (= intestinal) parasite that causes a diarrheal disease known as cyclosporiasis in humans and possibly in other primates.
It belongs to the phylum Apicomplexa and the genus Cyclospora. The species name, "cayetanensis," refers to the Cayetano Heredia University in Lima, Peru, where early epidemiological and taxonomic work on this parasite was conducted.
Symptoms of cyclosporiasis include watery diarrhea, loss of appetite, weight loss, abdominal cramps, nausea, and sometimes low-grade fever. The severity of the illness can vary based on factors such as age, the condition of the host, and the size of the infectious dose.
Infection with Cyclospora cayetanensis occurs when individuals consume food or water contaminated with the parasite. People living or traveling in countries where cyclosporiasis is endemic may be at an increased risk of infection. The oocysts are shed in the stool of infected individuals and need favorable laboratory conditions to sporulate and become infective. Cyclosporiasis can also be acquired from contaminated produce, leading to outbreaks in developed countries.
How is Cyclospora infection treated?
The recommended treatment is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People who have diarrhea should also rest and drink plenty of fluids.
Optimal range: 0 - 54000000 CFU/g stool
Desulfovibrio piger is part of a group called Sulfate-reducing bacteria (=SRB). SRBs are normal inhabitants of the intestine in humans. This group of bacteria can “breathe” sulfate rather than oxygen. SRBs have been suspected to contribute to gastrointestinal disease due to the production of hydrogen sulfide, which can be considered toxic to the gut epithelium.
Reference range: Not Detected, Detected
Dientamoeba fragilis is a parasite that lives in the large intestine of people. This protozoan parasite produces trophozoites; cysts have not been identified. The intestinal infection may be either asymptomatic or symptomatic.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0 - 2 Score
Biomarkers:
- IAD/Methane Score
- PP Bacteria/Yeast
- Reference Variance
- Total Abundance
Therapeutic Support Options:
Therapeutic support options are static to serve as potential treatment ideas. Clinician discretion is advised when selecting appropriate therapeutics for individual patients.
- Pre-/Probiotics
- Increase Dietary Fiber Intake
- Consider SIBO Testing
- Increase Resistant Starches
- Increase Fermented Foods
- Meal Timing
Reference range: Zone 1, Zone 2, Zone 3, Zone 4
Genova’s data analysis has led to the development of unique dysbiosis patterns, related to key physiologic disruptions, such as immunosuppression and inflammation. These patterns may represent dysbiotic changes that could pose clinical significance.
Reference range: Not Detected, Detected
Epidemiology:
→ Fecal contamination of ingested foods or water
→ Pets may be a source of exposure
→ Sexual contact may be a source of exposure
Clinical Implications:
→ Symptoms include diarrhea, fulminating colitis (resembling ulcerative colitis), and dysentery
→ Extreme cases may invade liver and lung tissues
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
E. cloaceae is a Gram-negative, nonspore-forming, enteric bacilli belonging to the Enterobacteriaceaefamily. Enterobacteriaceae are not considered primary human pathogens, but are capable of causing opportunistic infections.
Enterobacter have a ubiquitous environmental distribution (trees, plants, crops, soil, water, and foods). They are also part of the normal flora of the GI tract. It can also be a common nosocomial infection.
Enterobacter’s ability to form biofilms and to secrete various cytotoxins, such as enterotoxins and hemolysins, contribute to its pathogenicity.
Most patients with an E. cloaceae infection are asymptomatic. However, when present, symptoms can include nausea, vomiting, diarrhea, and abdominal cramps.
Reference range: Not Detected, Detected
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
Optimal range: 0 - 4.6 mcg/g
Eosinophil Protein X is a water-soluble protein that is found in eosinophils. Fecal Eosinophil Protein X levels are abnormally increased in people with intestinal inflammation where high concentrations of eosinophils may be found.
Optimal range: 0 - 7500000 CFU/g stool
Escherichia coli (E. coli) is a type of bacteria that normally live in the intestines of people and animals.
Reference range: -50%, -25%, 0%, +25%
Optimal range: 1100000 - 1100000000 CFU/g stool
Faecalibacterium prausnitzii is one of the most important bacteria in the human gut flora and makes up to 5-10% of the total number of bacteria detected in stool samples from healthy humans. Faecalibacterium prausnitzii has a crucial role in maintaining gut physiology and host wellbeing.
Reference range: Light Brown, Brown, Not Given
Fecal color analysis on a GI Effects panel is a significant component in the evaluation of gastrointestinal health. The color of stool can provide meaningful insights into digestive processes and potential issues within the gastrointestinal tract. Stool normally ranges in color from various shades of brown, influenced by the breakdown of bilirubin and the presence of bile in the digestive system.
However, deviations from this typical brown hue can indicate various conditions and factors. For instance, clay-colored or pale stools may suggest a problem with the liver, gallbladder, or bile ducts, potentially indicating issues with bile production or flow. Dark, tar-like stools can be indicative of gastrointestinal bleeding, often resulting from conditions like ulcers or hemorrhoids. Green stools might be related to the transit time of food through the intestines or the consumption of certain foods, like leafy green vegetables. Red or black stools may be alarming, potentially pointing to blood in the stool, which could result from gastrointestinal bleeding. Yellow or greasy stools may signal malabsorption, where the body struggles to digest and absorb fats.
Reference range: Formed/Normal, Not Given, Loose, Hard/Constip.
Fecal consistency analysis on a GI Effects panel is a crucial aspect of assessing an individual's gastrointestinal health. The appearance and texture of stool can provide valuable insights into the functioning of the digestive system and may indicate various underlying issues.
Loose fecal consistency, as identified through this testing, can signify a range of potential concerns. It may point to malabsorption, where the body struggles to absorb essential nutrients from ingested food, potentially leading to nutritional deficiencies. Additionally, loose stools can be indicative of inflammation within the gastrointestinal tract, which can be associated with conditions like inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS).
Optimal range: 3.2 - 38.6 mg/g
When you eat fat, a small amount of the fat passes out the body through the colon. Some of the different types of fats in the feces include phospholipids, sterols, sphingolipids, cholesteryl esters, glycolipids, soaps and glycerides.
A fecal fat test helps your doctor identify pancreatic or intestinal disorders. It can indicate your body isn’t creating enough enzymes or there is malabsorption.
Reference range: Negative, Positive
Fecal lactoferrin is a valuable biomarker measured in GI tests to assess inflammation in the gastrointestinal tract. It is a protein released by neutrophils, a type of white blood cell, during inflammation, making its presence in stool indicative of inflammatory processes within the gut. Elevated levels of fecal lactoferrin are often associated with conditions such as inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, and can help differentiate these from non-inflammatory conditions like irritable bowel syndrome (IBS).
Optimal range: 0 - 0 Units
The fecal occult blood test (=FOBT) looks for blood in your feces. “Occult” (=hidden) means that the blood amount is so small that it cannot be seen with the naked eye. The bleeding does not change the color of the stool or result in visible bright red blood. Therefore, the blood is found only by testing the stool for blood in the laboratory.
Reference range: Negative, Positive
The fecal occult blood test (=FOBT) looks for blood in your feces. “Occult” (=hidden) means that the blood amount is so small that it cannot be seen with the naked eye. The bleeding does not change the color of the stool or result in visible bright red blood. Therefore, the blood is found only by testing the stool for blood in the laboratory.
Blood in the stool means there is likely some kind of bleeding in the digestive tract. It can be a sign of a problem in your digestive system, such as a growth, or polyp, or cancer in the colon or rectum.
– This test is a screening that may help find colorectal cancer early, when treatment is most effective.
– Occult blood means that you can’t see it with the naked eye.
– Identifies microscopic amounts of blood in the stool
Optimal range: 0 - 680 mcg/g
Fecal Secretory IgA is a marker of gut secretory immunity and barrier function.
Reference range: -50%, -25%, 0%, +25%
Optimal range: 12 - 620 Ratio
The F/B ratio provides an estimate of the predominance of two major phyla of commensal organisms, which has been associated with a number of metabolic disorders.
Reference range: -50%, -25%, 0%, +25%
Optimal range: 0 - 180000 CFU/g stool
Fusobacterium spp. present in the oral and gut flora is carcinogenic and is associated with the risk of pancreatic and colorectal cancers. Fusobacterium spp. is also implicated in a broad spectrum of human pathologies, including Crohn’s disease and ulcerative colitis (UC).
Fusobacterium is very rarely found among the usual gut bugs, but it appears to flourish in colon cancer cells.
Reference range: Not Detected, Detected
Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States.
Reference range: Negative, Positive
Helicobacter pylori is a bacterium that causes peptic ulcer disease and plays a role in the development of gastric cancer. Direct stool testing of the antigen (HpSA) is highly accurate and is appropriate for diagnosis and follow-up of infection.
Optimal range: 0 - 2 Score
Biomarkers:
- Parasitic Infection Pathogenic and potentially pathogenic parasites i.e., Cryptosporidium, Giardia, Entamoeba histolytica, all others)
- Pathogenic Bacteria (Clostridium difficile toxin, Helicobacter pylori, Campylobacter spp., Shiga toxin E. coli)
- PP Bacteria/Yeast (Known Pathogen i.e., Salmonella, Aeromonas, all others)
- Total Abundance: The total commensal abundance is a sum-total of the reported commensal bacteria compared to a healthy cohort. Low levels of commensal bacteria are often observed after antimicrobial therapy, or in diets lacking fiber and/or prebiotic-rich foods and may indicate the need for microbiome support. Conversely, higher total commensal abundance may indicate potential bacteria overgrowth or probiotic supplementation.
Infection Score:
This is where common infectious microorganisms are reported and includes pathogenic bacteria and intestinal parasites.
Therapeutic Support Options:
Therapeutic support options are static to serve as potential treatment ideas. Clinician discretion is advised when selecting appropriate therapeutics for individual patients.
- Antibiotics (if warranted)
- Antimicrobial Herbal Therapy
- Antiparasitic Herbal Therapy (if warranted)
- Saccharomyces boulardii
Optimal range: 0 - 2 Score
Biomarkers:
- Calprotectin is a marker of neutrophil-driven inflammation. Produced in abundance at sites of inflammation, this biomarker has been proven clinically useful in differentiating between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS). [1,2]
- Eosinophil Protein X is a marker of eosinophil-driven inflammation and allergic response.
- Fecal Secretory IgA is a marker of gut secretory immunity and barrier function.
- Fecal Occult Blood Test detects hidden blood; fecal immunochemical testing (FIT) has been recommended by the American College of Gastroenterology as the preferred noninvasive test for colorectal cancer screening/detection.
Score explanation:
The functional imbalance scores are generated using weighted algorithms that incorporate biomarkers belonging to each functional category.
0 to 2: This represents a low need for support.
2 to 3: This represents an optional need for support.
4 to 6: This represents moderate need for support.
7 to 10: This represents high need for support.
Therapeutic Support Options:
Therapeutic support options are static to serve as potential treatment ideas. Clinician discretion is advised when selecting appropriate therapeutics for individual patients.
- Elimination Diet/ Food Sensitivity Testing
- Mucosa Support: Slippery Elm, Althea, Aloe, DGL, etc.
- Zinc Carnosine
- L-Glutamine
- Quercetin
- Turmeric
- Omega-3's
Optimal range: 0 - 60 Level
The Inflammation-Associated Dysbiosis (IAD) score serves as a crucial metric for evaluating the interplay between gut inflammation and microbiota composition. This score holds significance as it illuminates how inflammation within the gastrointestinal tract impacts the delicate balance between beneficial and harmful gut bacteria.
Derived from a pattern-based algorithm, the Inflammation-Associated Dysbiosis score categorizes patients based on their scores, revealing a negative correlation between mean IAD score and commensal bacteria abundance, alongside positive associations with fecal calprotectin, EPX, and sIgA levels. Validation studies, encompassing Genova’s database of IBD patients and an independent UCLA study with IBD cohorts, underscore its reliability.
The causal relationship between inflammation-associated dysbiosis and inflammation remains uncertain. A low IAD score coupled with elevated inflammatory markers suggests that the gut microbiome might not be a contributing factor to the inflammatory condition, warranting exploration of alternative etiologies. Longitudinal investigations are imperative to unravel the implications of a high IAD score in the absence of elevated inflammatory markers. It's plausible that an inflammatory microbiome pattern may precede the onset of elevated inflammatory markers, underscoring the need for further research.
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
Klebsiella are non-motile, Gramnegative rods that belong to the Enterobacteriaceae family.
Klebsiella bacteria are considered commensal but act as opportunistic bacteria in the GI tract.
Klebsiellais a leading cause of hospital-acquired infections.
Klebsiella is part of the normal intestinal flora.
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
Klebsiella are non-motile, Gramnegative rods that belong to the Enterobacteriaceae family. Klebsiella bacteria are considered commensal but act as opportunistic bacteria in the GI tract. Klebsiellais a leading cause of hospital-acquired infections.
Klebsiella is part of the normal intestinal flora. The environment likely acts as a reservoir for human acquisition, either as colonization or infection. It is frequently found in water, sewage, soil, and plant surfaces.
Optimal range: 0 - 1600000 Units
Lactobacillus species is a type of bacteria. There are lots of different species of lactobacillus.
Lactobacillus bacteria are commonly found in the human gut, mouth and vagina. They are considered generally as “good bacteria”, and in fact may contribute to good health, often being included in probiotic supplements. These bacteria are characterized by their ability to produce lactic acid as a byproduct of glucose metabolism.
Optimal range: 1.2 - 29.1 mg/g
Long chain fatty acids are a fecal fat. Fecal fats also include triglycerides, cholesterol and phospholipids. They are derived predominately from the dietary ingestion of fat, and provide important clues about digestion and absorption.
Optimal range: 0 - 2 Score
Biomarkers:
Products of Protein Breakdown - Products of Protein Breakdown are markers of undigested protein reaching the colon.
Pancreatic Elastase - Pancreatic Elastase-1 is a marker of exocrine pancreatic function.
Fecal Fats - Fecal Fat is a marker of fat breakdown and absorption.
Score explanation:
The functional imbalance scores are generated using weighted algorithms that incorporate biomarkers belonging to each functional category.
0 to 2: This represents a low need for support.
2 to 3: This represents an optional need for support.
4 to 6: This represents moderate need for support.
7 to 10: This represents high need for support.
Therapeutic Support Options:
Therapeutic support options are static to serve as potential treatment ideas. Clinician discretion is advised when selecting appropriate therapeutics for individual patients.
- Digestive Enzymes
- Betaine HCl
- Bile Salts
- Apple Cider Vinegar
- Mindful Eating Habits
- Digestive Bitters
Optimal range: 0 - 2 Score
Biomarkers:
- SCFA (%)
- Total SCFA's
- n-Butyrate Conc.
- Beta-glucuronidase
Score explanation:
The functional imbalance scores are generated using weighted algorithms that incorporate biomarkers belonging to each functional category.
0 to 2: This represents a low need for support.
2 to 3: This represents an optional need for support.
4 to 6: This represents moderate need for support.
7 to 10: This represents high need for support.
Therapeutic Support Options:
Therapeutic support options are static to serve as potential treatment ideas. Clinician discretion is advised when selecting appropriate therapeutics for individual patients.
- Pre-/Probiotics
- Increased Dietary Fiber Intake
- Increase Resistant Starches
- Increase Fermented Foods
- Calcium D-Glucarate (for high beta-glucuronidase)
Optimal range: 5 - 16 Score
The Methane Dysbiosis Score on a GI Effects panel is an assessment of the likelihood of methane-dominant dysbiosis in the gastrointestinal tract. Methane production in the gut is primarily attributed to methanogenic archaea, particularly Methanobrevibacter smithii. These organisms thrive in an anaerobic environment and use hydrogen, a byproduct of bacterial fermentation, to produce methane. Elevated methane levels are often associated with a slower transit time in the intestines, contributing to symptoms such as constipation and bloating, as well as potential disruptions in gut motility.
Optimal range: 0 - 20000000 CFU/g stool
Methanobrevibacter smithii is highly prevalent in the human gut. Lower counts have been associated with obesity while higher amounts have been associated with anorexia.
Optimal range: 11.8 - 33.3 %
N-Butyrate is one of the short-chain fatty acids produced by Lactobacillus and Bifidobacteria in the colon. It becomes a food supply capable of providing up to 30% of the energy needed by colon cells. N-butyrate improves colon health.
Optimal range: 3.6 - 100 micromol/g
This short-chain fatty acid (SCFA) is produced as a result of the fermentation of dietary fiber, particularly gums and pectins, by certain bacteria that inhabit the intestines (particularly probiotic bacteria such as Lactobacilli and Bifodobacteria species).
An n-butyrate level within the reference range is first and foremost then, an indicator that such health promoting bacteria are present in sufficient amounts.
Optimal range: 0 - 95000000 CFU/g stool
The bacteria are found in the human gut where they are considered “commensal”, which means “eating from the same dish”. They exist in the human body without either helping or hindering us.
Optimal range: 0 - 11000000 CFU/g stool
Oxalobacter formigenes is a bacterium that colonizes the colon of a substantial proportion of the normal population and metabolizes dietary and endogenous oxalate and hence reducing the incidence of kidney stones.
Optimal range: 200 - 1000 mcg/g
Pancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.
Optimal range: 0 - 830000000 CFU/g stool
Generally considered a beneficial gut commensal, although is capable of attaching to and invading colonic epithelial cells and inducing pro-inflammatory cytokines.
- Produces beta-glucuronidase, succinate, lactate, acetate, formate, and propionate.
- Associated with insulin resistance.
- Contains bile salt hydrolases to metabolize bile.
- Formerly named Bacteroides vulgatus.
Optimal range: 0.2 - 6.9 mg/g
The enzyme LCAT transesterifies cholesterol in the blood with fats from lecithin. When this happens as it should, HDL, VLDL and LDL lipoprotein particles are remodeled and cholesterol is moved out of the blood. The Phospholipid test looks for LCAT deficiency.
Optimal range: 66000000 - 3800000000 CFU/g stool
Prevotella spp. is known for its ability to degrade complex plant polysaccharides (carbohydrates) and fiber.
Optimal range: 1.8 - 9.9 micromol/g
Products of Protein Breakdown, which includes isovalerate, valerate and isobutyrate are produced by bacterial fermentation of proteinaceous material (polypeptides and amino acids) in the distal colon.
Products of Protein Breakdown (Total) is a set of markers of undigested protein reaching the colon.
Optimal range: 0 - 29.3 %
Propionate is among the most common short-chain fatty acids produced in the human gut in response to indigestible carbohydrates (fiber) in the diet.
Reference range: -50%, -25%, 0%, +25%
Reference range: NG - No Growth, NP - Non-Pathogen, PP - Potential Pathogen, P - Pathogen
Optimal range: 13000 - 29000000 CFU/g stool
Pseudoflavonifractor spp. has been positively associated with weight loss.
Optimal range: 360000 - 460000000 CFU/g stool
Roseburia is a genus (=group) of 5 species of bacteria named in the 1980s after American microbiologist Theodor Rosebury. Bacteria in this genus are notable for breaking down sugar, and producing a short-chain fatty acid called butyrate which is important as a food for the cells lining the colon.
Optimal range: 0 - 1500000000 CFU/g stool
Ruminococcus bromii is a keystone species, playing a large role in the digestion of resistant starches. It has been proposed that the primary role played by R. bromii is to release energy from resistant starch to other members of the microbial community, giving it an important role for maintaining microbial community balance. R. gnavus can efficiently cross-feed on starch degradation products released by R. bromii, even though it is normally a mucin degrading bacteria.
Optimal range: 95000000 - 1600000000 CFU/g stool
The Ruminococcus bacteria in our gut microbiomes play a major role in helping us digest resistant starches - the complex carbohydrates found in high fiber foods such as lentils, beans, and unprocessed whole grains.
Reference range: Negative, Positive
Shiga toxin-producing Escherichia coli (STEC) is a significant pathogen detected in GI tests that can cause severe gastrointestinal illness. STEC infection often occurs through the consumption of contaminated food or water, particularly undercooked beef, raw milk, and fresh produce. Patients infected with STEC may experience symptoms such as severe abdominal cramps, diarrhea (often bloody), vomiting, and occasionally fever. The presence of Shiga toxin in E. coli is particularly concerning because it can lead to serious complications like hemolytic uremic syndrome (HUS), a condition that can cause kidney failure, especially in young children and the elderly.
Optimal range: 23.3 - 200 micromol/g
SCFAs are produced from the fermentation of fibre and protein by certain components of the gut microflora. The SCFAs produced from the fermentation of fibre by probiotic bacteria such as Bifidobacteria and Lactobacilli have a range of beneficial effects from serving as a fuel for cells lining the intestine (and the rest of the body) to creating an acidic intestinal environment that is unfavourable to potential pathogens.
Reference range: Not Detected, Detected
Optimal range: 90 - 110 %
The total commensal abundance is a sum-total of the reported commensal bacteria compared to a healthy cohort. Low levels of commensal bacteria are often observed after antimicrobial therapy, or in diets lacking fiber and/or prebiotic-rich foods and may indicate the need for microbiome support. Conversely, higher total commensal abundance may indicate potential bacteria overgrowth or probiotic supplementation.
Reference range: Not Detected, Detected
Optimal range: 0.3 - 2.8 mg/g
Fecal fats include triglycerides, long-chain fatty acids, cholesterol, and phospholipids, and are derived primarily from the dietary ingestion of fat.
Most of the fats in our diet are in the form of triglycerides. These are broken down by an efficient digestive system into smaller fragments that can then be absorbed from the small intestine.
Optimal range: 0 - 4100000 CFU/g stool
Veillonella are anaerobic, gram-negative cocci, part of the normal flora of the mouth, gastrointestinal tract, and vaginal tract.
Reference range: -50%, -25%, 0%, +25%
Reference range: No Growth, Non-Pathogen, Potential Pathogen, Pathogen
Y. enterocolitica is a gram-negative, bacillus-shaped bacterium. Y. entrocolitica can be short-lived as an infection. However, even if the infection is treated successfully, due to the action of various bacterial toxins and mimicry with human tissue, continued immune responses against these toxins may result in various inflammatory and autoimmune disorders, such as inflammatory bowel disease, autoimmune thyroid disease, uveitis, Lyme-associated disorders and even reactive arthritis.
Optimal range: 22.3 - 161.1 ng/mL
Zonulin is a protein modulator of intestinal tight junctions and is used to assess intestinal permeability. It can be used for assessing impaired gut barrier function for several autoimmune and metabolic conditions including celiac disease, type 1 diabetes and insulin resistance.
Comprehensive Stool Analysis / Parasitology
The Comprehensive Stool Analysis detects the presence of pathogenic microorganisms such as yeast, parasites, and bacteria that contribute to chronic illness and neurological dysfunction. It provides helpful information about prescription and natural products effective against specific strains detected in the sample. The test also evaluates beneficial bacteria levels, intestinal immune function, overall intestinal health, and inflammation markers.
Many chronic disorders come from digestive problems and inadequate nutrient absorption. Proper gastrointestinal function is needed to eliminate toxic substances, pathogenic microbes, and undigested food particles from the body to prevent health problems. Nutrients require a specific internal environment to be properly digested and transported throughout the body.
Abnormal intestinal microorganisms in the GI tract are widely known to cause disease. Research shows a relationship between the GI tract and the neurological, hepatic, and immune systems. For example, excessive yeast produces toxic substances that can pass through the blood-brain barrier and alter neurological functioning causing “brain fog,” behavior problems, and learning difficulties.
Why Conduct a Comprehensive Stool Analysis?
The Comprehensive Stool Analysis + Parasitology (CSAP) is an essential diagnostic tool that enables practitioners to assess the status of beneficial and imbalanced commensal bacteria, pathogenic bacteria, yeast/fungus, and parasites. The identification of pathogenic species and susceptibility testing assists in the selection of the most suitable pharmaceutical or natural treatment agents.
The Comprehensive Stool Analysis test measures:
Efficient remediation of GI dysfunctions involves a comprehensive approach that includes elimination of pathogens and irritants, supplementation of hydrochloric acid, pancreatic enzymes, and pre- and probiotics, and repair of the mucosal barrier.
Optimal range: 50 - 72 %
Acetate is the most abundant SCFA in the colon and makes up more than half of the total SCFA detected in feces. These beneficial SCFA have anti-inflammatory properties, provide energy to nourish the colonic epithelial cells and intestinal microbiota, and exert numerous positive effects on gut homeostasis.
Optimal range: 11 - 32 %
N-Butyrate is one of the short-chain fatty acids produced by Lactobacillus and Bifidobacteria in the colon. It becomes a food supply capable of providing up to 30% of the energy needed by colon cells. N-butyrate improves colon health.
Optimal range: 0.8 - 4 mg/ml
This short-chain fatty acid (SCFA) is produced as a result of the fermentation of dietary fiber, particularly gums and pectins, by certain bacteria that inhabit the intestines (particularly probiotic bacteria such as Lactobacilli and Bifodobacteria species).
An n-butyrate level within the reference range is first and foremost then, an indicator that such health promoting bacteria are present in sufficient amounts.
Optimal range: 0 - 50 µg/g
Calprotectin is a protein that binds to both calcium and zinc. Fecal calprotectin levels are abnormally increased in people with intestinal inflammation, thus it is useful for distinguishing between inflammatory and non-inflammatory diarrhea.
Optimal range: 200 - 1000 µg/mL
Pancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.
Optimal range: 0 - 7.3 µg/mL
Lactoferrin and Calprotectin are reliable markers for differentiating organic inflammation (IBD) from function symptoms (IBS) and for management of IBD. Monitoring levels of fecal lactoferrin and calprotectin can play an essential role in determining the effectiveness of therapy, are good predictors of IBD remission, and can indicate a low risk of relapse.
Optimal range: 0 - 500 ng/mL
Lysozyme is an enzyme that catalyzes the hydrolysis of specific glycosidic bonds in mucopolysaccharides that constitute the cell wall of gram-positive bacteria. Lysozyme is an antibacterial defense present in the G.I. tract and is secreted by granulocytes, macrophages, Paneth cells, and Brunner's Glands as well as normal colonic crypt cells. The main source for fecal lysozyme is the intestinal granulocytes.
Optimal range: 5.8 - 7 pH
Fecal pH is largely dependent on the fermentation of fiber by the beneficial flora of the gut.
Optimal range: 11 - 25 %
Propionate is among the most common short-chain fatty acids produced in the human gut in response to indigestible carbohydrates (fiber) in the diet.
Optimal range: 30 - 275 mg/dL
As the most abundant class of antibody found in the human intestinal lumen, secretory IgA (sIgA) is recognized as a first line of defense in protecting the intestinal epithelium from enteric pathogens and toxins. It is used to assess gastrointestinal barrier function.
Optimal range: 5 - 16 mg/ml
SCFAs are produced from the fermentation of fibre and protein by certain components of the gut microflora. The SCFAs produced from the fermentation of fibre by probiotic bacteria such as Bifidobacteria and Lactobacilli have a range of beneficial effects from serving as a fuel for cells lining the intestine (and the rest of the body) to creating an acidic intestinal environment that is unfavourable to potential pathogens.
Optimal range: 0.8 - 5 %
Valerate is a Short Chain Fatty Acid (SCFA). It is derived from bacterial fermentation of protein in the distal colon.
SCFAs are the end product of the bacterial fermentation process of dietary fiber by beneficial flora in the gut and play an important role in the health of the GI as well as protecting against intestinal dysbiosis.
Reference range: Not Detected, Many
Yeast identification on a Comprehensive Stool Analysis is a critical aspect of gastrointestinal health assessments, offering valuable insights into the microbial balance within the digestive system. This analysis plays a pivotal role in identifying the presence and overgrowth of yeast species, such as Candida, which can significantly impact gut health and overall well-being. In a balanced gut microbiome, yeast exists harmlessly along with various beneficial bacteria, but factors like antibiotic use, diet, and stress can disrupt this balance, leading to yeast overgrowth. Symptoms of yeast overgrowth can include gastrointestinal discomfort, bloating, fatigue, and can even affect mental health.
IgG Yeasts Allergy Test
Immunoglobulin G (IgG) food testing is a useful guide for structuring elimination diets for patients with many chronic conditions. Individuals with neurological, gastrointestinal, movement, and behavioral disorders often suffer from IgG food sensitivities. People may continue to eat offending foods unaware of their potential adverse effects. Symptoms associated with food sensitivities may occur hours or days after the offending food was eaten because IgG food antibodies remain for a much longer time than traditional IgE antibodies. As immunological reactions, IgE food allergy causes the release of histamine, producing an immediate hypersensitivity reaction, in which symptoms appear within minutes or hours. In contrast, food sensitivity is a non-IgE allergy characterized by the measurement of IgG antibodies specific to antigenic food proteins. This IgG food allergy is a delayed hypersensitivity reaction in which symptoms appear anywhere from hours to days after eating the offending food. Elimination of IgG-positive foods may improve symptoms of irritable bowel syndrome, autism, AD(H)D, cystic fibrosis, rheumatoid arthritis, and epilepsy, according to numerous clinical studies.
Optimal range: 0 - 3.49 Units
A separate test for IgG antibody to Candida (serum and DBS) is included because of Candida’s importance to overall health. IgG antibodies to Candida may be due to current or past infection or intestinal overgrowth. An elevated Candida IgG indicates the immune system has interacted with Candida. Although Candida and related fungal species are normal constituents of GI flora, use of antibiotics, oral contraceptives, chemotherapy, or anti-inflammatory steroids increases the possibility of fungal overgrowth and imbalance of GI flora. Dietary improvements and/or antifungal therapy may lower Candida antibodies and reduce symptoms.
Optimal range: 1 - 3.49 Units
Heavy Metals
The Vibrant Heavy Metals test is a urine-based test to screen for 20 of the most common heavy metals known to accumulate and cause adverse health effects in the human body. This test can be taken either provoked or non-provoked.
- Heavy metal toxicity is under-represented as a root cause of illness and disease in humans, is thought to affect over 1 million individuals annually, and can affect virtually all biological systems within the human body
- Heavy metals may be the root cause of common neurological disorders, gastrointestinal disorders, autoimmune diseases, and disorders associated with increased oxidative stress and cellular dysfunction
- Due to the ability of many heavy metals to deplete critical nutrients such as antioxidants and minerals, the Vibrant Heavy Metals test should be run alongside a Vibrant Micronutrient panel, to assess both intra- and extracellular levels of commonly affected nutrients
- Populations at greater risk of heavy metal toxicity include developing fetuses, children, and the immunocompromised, as well as individuals with impaired liver function and reduced antioxidant activity
- Heavy metals are present in all regions of the United States, and can accumulate in air, soil, and drinking or ground water sources in and around concentrated sources of heavy metals from industrial production or pollution
- Some professions and hobbies are at greater risk of heavy metal toxicity, including fuel, munitions, painting, rubber manufacturing, industrial smelting, mining, photographic processing, agriculture, semiconductors, welding, and waste or radioactive waste disposal sites
- The World Health Organization (WHO) considers 13 heavy metals of significance to human and environmental health: arsenic, cadmium, cobalt, chromium, copper, mercury, manganese, nickel, lead, tin, and titanium, however, there are other metals and metalloids that may be significant causes of health problems in humans.
Optimal range: 0 - 54 ug/g
The major tissue sites of aluminum toxicity are the nervous system, immune system, bone, liver, and red blood cells. Aluminum may also interfere with heme (porphyrin) synthesis.
Optimal range: 0 - 0.78 ug/g
Possible sources of antimony:
- Food and smoking are the usual sources of antimony. Thus cigarette smoke can externally contaminate hair, as well as contribute to uptake via inhalation.
- Gunpowder (ammunition) often contains antimony. Firearm enthusiasts often have elevated levels of antimony in hair.
Other possible sources are:
- textile industry,
- metal alloys,
- and some anti-helminthic and anti-protozoal drugs.
- Antimony is also used in the manufacture of paints, glass, ceramics, solder, batteries, bearing metals and semiconductors.
Optimal range: 0 - 116 ug/g
Arsenic is a natural component of the earth’s crust and is widely distributed throughout the environment in the air, water and land. It is highly toxic in its inorganic form and considered a carcinogenic heavy metal.
Optimal range: 0 - 6.9 ug/g
Barium is a silvery-white metal found in nature. Barium compounds are used to make paint, bricks, tiles, glass, and rubber; used by the oil and gas industries in drilling muds; and sometimes used by doctors to perform medical tests.
Optimal range: 0 - 0.9 ug/g
Optimal range: 0 - 14.9 ug/g
Optimal range: 0 - 1.5 ug/g
Optimal range: 0 - 9.9 ug/g
Optimal range: 0 - 0.39 ug/g
Optimal range: 0 - 4.4 ug/g
Optimal range: 0 - 3.9 ug/g
Optimal range: 0 - 0.2 ug/g
Optimal range: 0 - 0.99 ug/g
Optimal range: 0 - 0.79 ug/g
Optimal range: 0 - 0.8 ug/g
Optimal range: 0 - 0.5 ug/g
Optimal range: 0 - 9.9 ug/g
Optimal range: 0 - 0.99 ug/g
Optimal range: 0 - 0.13 ug/g
Uranium is a naturally occurring radioactive element found on earth found in nearly all rocks and soils. It is used as fuel for nuclear power plants and the nuclear reactors that run naval ships and submarines. It can also be used in nuclear weapons. Depleted uranium is used in military applications, including as a shield to protect against ionizing radiation, as armor in military vehicles, in munitions to help them penetrate enemy armored vehicles, and as a counterbalance on helicopter rotors. Uranium can be ingested through the lungs, and gastrointestinal (GI) tract, and can be absorbed through the skin. Uranium can stick to plant roots so unwashed root vegetables are a primary source of uranium in the diet. However, Brazil nuts are also found to have high levels. The majority of uranium that is inhaled through the lungs or ingested through the GI tract is not absorbed and leaves the body through the feces.
Mycotoxins (Vibrant America)
The Vibrant Mycotoxins test is a urine-based assay for 31 of the most common mycotoxins produced by molds to which humans are exposed.
Individuals most at risk for mycotoxin exposure include those who live or work in older buildings, those who have known exposure to water-damaged buildings, and those with impaired immune responses or higher levels of oxidative stress.
Mycotoxins complicate human health in a number of ways and their presence in the human body can lead to a number of serious health concerns, including autoimmune disease and cancer.
There may be higher incidence of autoimmune or neurological symptoms in your patients with mycotoxin toxicity. Consider screening for Hashimoto’s thyroiditis, connective tissue disorders, celiac disease, and neurological autoimmunity along with mycotoxin testing.
Treatment of mycotoxin exposure should include a holistic approach to eradicate the mold from the individual, thorough and professional removal of mold from environmental sources, and continued testing to monitor reductions in mycotoxin levels post-intervention.
Due to the common co-occurrence of Lyme and mycotoxin exposure from depressed immunity in affected individuals, as well as symptom overlap between tickborne diseases and mycotoxins, consider running the Vibrant Tickborne Diseases panel along with the Vibrant Mycotoxins test.
Optimal range: 0 - 5.2 ng/g
- Aflatoxin B1 (AFB1) is produced by many strains of Aspergillus fungi.
- Aflatoxin B1 is the most potent natural carcinogen known and is usually the major aflatoxin produced by toxigenic strains.
- Aflatoxin B1 is one of the most potent liver carcinogens known and has been associated as a cocarcinogen with hepatitis B in the high incidence of human liver cancer.
- AFB1 is a potent toxin, mutagen, and carcinogen, and is implicated in the etiology of hepatocarcinoma.
Optimal range: 0 - 6.1 ng/g
Aatoxin B2 (AFB2) is a mycotoxin produced by several Aspergillus spp. and found in contaminated foods or hay exposed to water or humid conditions. Exposure routes are primarily ingestion or inhalation. Ingestion can either occur directly from food such as grains, tree nuts, and oilseeds or can also occur from ingestion of milk or meat from animals fed contaminated feed. Toxicity of aatoxins can be categorized as follows, in descending order of known toxic effects: aatoxin B1, aatoxin G1, aatoxin B2, and aatoxin G2. Animal studies have indicated that AFB2 has hepatotoxic, teratogenic, and carcinogenic effects.
Optimal range: 0 - 8.1 ng/g
Optimal range: 0 - 4.8 ng/g
Aflatoxin M1 (AFM1) is the main metabolite of aflatoxin B1, which is a mycotoxin produced by the mold species Aspergillus. Aflatoxins are some of the most carcinogenic substances in the environment. Aflatoxin susceptibility is dependent on multiple different factors such as age, sex, and diet.
Optimal range: 0 - 3.2 mcg/g
BPA is one of the highest volume of chemicals produced worldwide. It is a starting material for the synthesis of plastics. BPA-based plastic is clear and tough, and is made into plastic bottles including water bottles, sports equipment, CDs, and DVDs. Epoxy resins containing BPA are used to line water pipes, as coatings on the inside of many food and beverage cans and in making thermal paper such as that used in sales receipts.
Optimal range: 0 - 9.4 ng/g
Dihydrocitrinone (DHC) is a metabolite of Citrinin (CTN), which is a mycotoxin that is produced by the mold genera Aspergillus, Penicillium, and Monascus.
Optimal range: 0 - 50.6 Units
Deoxynivalenol (DON), also known as Deoxynivalenol, a tricothecene mycotoxin, is produced by several species of Fusarium. DON has been associated with outbreaks of acute gastrointestinal illness in humans. The FDA advisory level for DON for human consumption is 1 ppm.
Optimal range: 0 - 3.2 ng/g
Diacetoxyscirpenol (DAS), also known as anguidine, is a type A trichothecene mycotoxin primarily produced by Fusarium fungi. Trichothecenes are known as major contaminants of cereals and cereal-containing foods.
Optimal range: 0 - 12.4 ng/g
Dihydrocitrinone is a metabolite of Citrinin (CTN), which is a mycotoxin that is produced by mold species of the genera Aspergillus, Penicillium, and Monascus.
CTN exposure can lead to nephropathy, because of its ability to increase permeability of mitochondrial membranes in the kidneys. The three most common exposure routes are through ingestion, inhalation, and skin contact.
CTN has been shown to be carcinogenic in rat studies. Multiple studies have linked CTN exposure to a suppression of the immune response.
Optimal range: 0 - 1.3 mcg/g
DPP is a metabolite of triphenyl phosphate (TPHP), which is used as plasticizer and a fire retardant for a variety of materials including electronic equipment, PVC, hydraulic fluids, glues, nail polishes, and casting resins. TPHP exhibits low acute toxicity by dermal or oral contact. Long-term exposure to TPHP has been linked with reproductive and developmental toxicity, neurotoxicity, metabolic disruption, endocrine effects, and genotoxicity.
Optimal range: 0 - 0.22 ng/g
Optimal range: 0 - 5.4 ng/g
Fumonisin B2 is a mycotoxin produced by Fusarium growing on moldy corn (maize) grain. FB2 and Fumonisin B3 (FB3) occur in lower concentrations than FB1. FB1 and FB2 are approximately equal in structure and toxicity but naturally occur in a ratio of about 3: 1 for FB1/FB2, thus has less toxicity than FB1.
Optimal range: 0 - 8.1 ng/g
Fumonisin B3 (FB3), a less commonly studied but significant mycotoxin, is an important marker in Total Tox Burden panels, reflecting potential exposure to toxins produced by Fusarium species, predominantly found in maize and its by-products. Structurally, FB3 is similar to other fumonisins like B1 and B2, but it is often present at lower concentrations in contaminated foods. Its inclusion in tox burden assessments is crucial due to its potential health implications. Although FB3's toxicity is generally considered to be lower than that of fumonisin B1, it still poses health risks, particularly hepatotoxic and nephrotoxic effects, and it may play a role in esophageal cancer and neural tube defects.
Optimal range: 0 - 155.9 ng/g
Gliotoxin is produced by the mold genus Aspergillus. Aspergillus spreads in the environment by releasing conidia which are capable of infiltrating the small alveolar airways of individuals.
Optimal range: 0 - 0.75 mcg/g
Glyphosate is the world's most widely produced herbicide. It is a broad-spectrum herbicide that is used in more than 700 different products for agriculture and forestry to home use.
Possible treatment options if in higher ranges:
Treatment of glyphosate toxicity should be centered on determining the route of introduction and avoiding future exposure. Glyphosate is readily metabolized in the body. However, a recent study found that glyphosate accumulates in mammalian bones. Another study found glyphosate to be detectable in mammalian intestine, spleen, liver, muscle, and kidney. Kidney impairment is common in regions where glyphosate may accumulate in ground water as metal chelates. The most effective way to reduce glyphosate exposure is to avoid living in areas where glyphosate is applied and to avoid eating GMO foods or animal products such as milk or meat for which GMO foods were used to feed the animals. Since glyphosate is now commonly combined with the weed killer 2,4-dichlorophenoxyacetic acid (2,4-D), testing for this chemical with the GPL-TOX test may wish to be considered also.
Optimal range: 0 - 0.1 ng/g
Isosatratoxin F is another trichothecene produced by Stachybotrys chartarum. Several animal studies have shown that isosatratoxin F can cause nasal and pulmonary toxicity when administered intranasally or intratracheally. They showed that pulmonary alveolus cells were injured following intratracheal instillation of isosatratoxin F with marked changes in surfactant synthesis and secretion.
Optimal range: 0 - 20 mcg/g
MEOHP is a metabolite of mono(2-ethylhexyl) phthalate (MEHP), which belongs to the most common environmental toxin phthalates.
Phthalates, often known as plasticizers, are a group of chemicals used to make plastics more flexible and harder to break. They are widely used in cosmetics, adhesives, detergents, lubricating oils, automotive plastics, and plastic clothes. People are exposed to phthalates by eating or drinking contaminated foods but also by breathing in air that contains phthalate vapors or dusts.
Optimal range: 0 - 305 mcg/g
Mono-ethyl phthalate (MEtP) is a metabolite of DEP (diethyl phthalate).
Mono-ethyl phthalate (MEtP) is found in personal care products such as perfume, cologne, aftershaves, deodorants, shampoo, and hand lotion.
Optimal range: 0 - 2.4 Units
Produced by the mold genus Fusarium, the type B trichothecenes, nivalenol (NIV) and their acetylated precursors are often contaminating cereal staples, posing a potential threat to public health that is still incompletely understood.
Trichothecenes are very resistant to milling and processing, they can enter human food products easily. NIV is not found in food as commonly as DON; however, it demonstrates higher toxicity in animal studies. The toxicity of NIV is often compared to the toxicity of DON; however, the amount of toxicological data on NIV impact is much lower compared to DON.
Optimal range: 0 - 8.7 ng/g
Patulin is a mycotoxin associated with the spoilage of grains, fruits, cheeses, and breads. It is considered the most significant mycotoxin in fruit and fruit juices; important because high-risk populations such as infants, children and the elderly consume these products.
Optimal range: 0 - 6.3 ng/g
Roridin H is produced mainly by Stachybotrys and categorized as a trichothecene mycotoxin. There are reports showing the involvement of these trichothecene in the development of 'sick building syndrome'. These trichothecenes were found in air samples in the ventilation systems of private houses and office buildings, and on the walls of houses with high humidity. The symptoms of airborne toxicosis disappeared when the buildings and ventilation systems were thoroughly cleaned.
Optimal range: 0 - 5.1 ng/g
Optimal range: 0 - 1.33 ng/g
Optimal range: 0 - 6.9 ng/g
Verrucarin J is a trichothecene produced by Stachybotrys chartarum. They can grow in damp indoor environments and may contribute to health problems among building occupants. These Trichothecenes are lipophilic and thus the route of exposure can easily be through the skin, gut, and pulmonary mucosa.
IBD Expanded Panel (Inflammatory Bowel Disease)
Five-marker IBD profile identifies and differentiates patients with ulcerative colitis (UC) and Crohn’s disease (CD).
Novel serological markers for inflammatory bowel disease (IBD) improve sensitivity and specificity to aid in differential diagnosis and provide valuable prognostic information about disease behavior.
Inflammatory bowel disease is a chronic disorder of the lower gastrointestinal tract that may occur in three forms:
- Crohn's disease (CD)
- ulcerative colitis (UC)
- indeterminate colitis (IC).
Its prevalence in the adult population approaches 0.3%. The differential diagnosis of the different forms of IBD is often difficult, time-consuming, and invasive.
The gold standard for diagnosis is endoscopy with biopsies for histologic examination. In recent years, however, a number of serological markers have been introduced. The most commonly employed serological markers of IBD are anti-Saccharomyces cerevisiae antibody (ASCA) and atypical perinuclear antineutrophil cytoplasmic antibody (pANCA). ASCA positivity is found predominantly in patients with CD, while pANCA positivity is found predominantly in patients with UC. A combination of ASCA and pANCA has a specificity of as high as 99% for differentiation of CD from UC. Nevertheless, there are a substantial number of patients with IBD who are negative for both. The addition of novel serological markers improves the sensitivity of the conventional ASCA/pANCA combination.
| Five-marker Profile | Ulcerative Colitis | Crohn’s Disease | Crohn’s with High Risk of Aggressive Disease | Crohn’s with Very High Risk of Aggressive Disease |
| pANCA | Positive (+) Up to 70% sensitivity | Negative (-) | Negative (-) or positive (+) | Negative (-) or positive (+) |
| gASCA IgG | Negative (-) | Positive (+) 66.1% sensitivity |
Two positive (+) markers High risk |
Three or more positive (+) markers Very high risk |
| ALCA IgG | Negative (-) | Positive (+) 85.5% sensitivity | ||
| ACCA IgA | ||||
| AMCA IgG |
Optimal range: 0 - 80 Units
The IBD Expanded Panel test offers three novel markers:
- antichitobioside IgA (ACCA),
- antilaminaribioside IgG (ALCA),
- antimannobioside IgG (AMCA),
together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.
Optimal range: 0 - 55 Units
The IBD Expanded Panel test offers three novel markers:
- antichitobioside IgA (ACCA),
- antilaminaribioside IgG (ALCA),
- antimannobioside IgG (AMCA),
together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.
Optimal range: 0 - 90 Units
The IBD Expanded Panel test offers three novel markers:
- antichitobioside IgA (ACCA),
- antilaminaribioside IgG (ALCA),
- antimannobioside IgG (AMCA),
together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.
Optimal range: 0 - 19 Units
Antigliadin IgG (native) is an antibody test that detects immune system reactivity to gliadin, a key protein found in gluten (wheat, barley, and rye). This test measures IgG antibodies, which are associated with delayed immune responses rather than the immediate reactions seen with IgE-mediated allergies.
Reference range: Negative, Positive
Atypical perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) occur in most patients with ulcerative colitis but only in a minority of those with Crohn's disease.
Optimal range: 0 - 45 Units
This marker is usually part of a test called IBD Expanded Panel (IBD = Inflammatory Bowel Disease) and aids in the diagnosis of inflammatory bowel disease and the differential diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC); it is also a prognostic aid for clinical management of patients with CD.
Optimal range: 0 - 20 Units
Anti-Saccharomyces cerevisiae antibodies (ASCA) are immune proteins found in people with inflammatory bowel disease (IBD), which is a chronic condition characterized by swollen and damaged tissues in the intestinal tract. The ASCA test detects these antibodies in the blood. ASCA can help distinguish between Crohn disease (CD) and ulcerative colitis (UC), the two most common types of inflammatory bowel disease (IBD).
IgA and IgG antibody testing for S. cerevisiae is useful adjunct testing for differentiating Crohn's disease and ulcerative colitis. Close to 80% of Crohn's disease patients are positive for either IgA or IgG. In ulcerative colitis, less than 15% are positive for IgG and less than 2% are positive for IgA. Fewer than 5% are positive for either IgG or IgA antibody, and no healthy controls had antibody for both.
Optimal range: 0 - 20 Units
Anti-Saccharomyces cerevisiae antibodies (ASCA) are immune proteins found in people with inflammatory bowel disease (IBD), which is a chronic condition characterized by swollen and damaged tissues in the intestinal tract. The ASCA test detects these antibodies in the blood. ASCA can help distinguish between Crohn disease (CD) and ulcerative colitis (UC), the two most common types of inflammatory bowel disease (IBD).
Sensory Motor Neuropathy Complete Antibody Panel
Sensory-motor neuropathies may occur by various mechanisms. These include development of autoantibodies to neuronal structures such as myelin associated glycoprotein (MAG) antibody, Hu antibody, and the ganglioside antibodies.
Sensory-motor neuropathies may also occur via antibody cross-reactivity or local immune complex deposition as seen in autoimmune disease with primarily non-neuronal targets including Sjogren's syndrome (SSA/SSB), systemic lupus erythematosus and related conditions (ANA IFA), celiac disease (tTG antibody), vasculitis (ANCA), and immune complex deposition (cryoglobulins, rheumatoid factor). Motor-sensory neuropathy may be associated with monoclonal gammopathy (serum immunofixation and serum immunoglobulins).
Reference range: POSITIVE, NEGATIVE
ANCA Screen includes evaluation for p-ANCA, c-ANCA and atypical p-ANCA. A positive ANCA screen reflexes to titer and pattern(s), e.g., cytoplasmic pattern (c-ANCA), perinuclear pattern (p-ANCA), or atypical p-ANCA pattern. c-ANCA and p-ANCA are observed in vasculitis, whereas atypical p-ANCA is observed in IBD (Inflammatory Bowel Disease). Atypical p-ANCA is detected in about 55% to 80% of patients with ulcerative colitis but only 5% to 25% of patients with Crohn's disease.
Reference range: POSITIVE, NEGATIVE
Cryoglobulins are circulating proteins, specifically immunoglobulins (i.e., IgG, IgM, IgA or light chains), that clump together (precipitate) when they are exposed to cold and dissolve when warmed. They may be present in small quantities in the blood of some healthy people but are most frequently associated with abnormal protein production and a variety of diseases and conditions. This test detects and measures the relative quantity of cryoglobulins in the blood.
Reference range: POSITIVE, NEGATIVE
Neuronal nuclear (Hu) antibody is present in patients with various neurological symptoms including two paraneoplastic syndromes: sensory neuropathy (PSN) and encephalomyelitis (PEM). The presence of Hu antibody strongly suggests underlying small cell lung carcinoma (SCLC). Hu antibody is identified by IFA and confirmed by Western Blot. A negative result does not exclude the possibility of a SCLC or other malignant tumor.
Reference range: POSITIVE, NEGATIVE
MAG, Western Blot with reflexes is useful in detecting antibodies associated with autoimmune peripheral neuropathy.
MAG stands for Myelin Associated Glycoprotein.
Optimal range: 0 - 1 AI
Autoantibodies to myeloperoxidase (MPO) are commonly associated with the following small-vessel vasculitides:
- microscopic polyangiitis,
- polyarteritis nodosa,
- Churg-Strauss syndrome,
- necrotizing and crescentic glomerulonephritis
- and occasionally granulomatosis with polyangiitis (GPA, Wegener's).
The perinuclear IFA pattern, (p-ANCA) is based largely on autoantibody to myeloperoxidase which serves as the primary antigen. These autoantibodies are present in active disease.
Optimal range: 0 - 1 AI
Autoantibodies to proteinase-3 (PR-3) are accepted as characteristic for granulomatosis with polyangiitis (GPA, Wegener's), and are detectable in 95% of the histologically proven cases. The cytoplasmic IFA pattern, (c-ANCA), is based largely on autoantibody to PR-3 which serves as the primary antigen. These autoantibodies are present in active disease.
Optimal range: 0 - 4 U/mL
A tissue transglutaminase (tTG) IgA and/or IgG test is used as part of an evaluation for certain autoimmune conditions, most notably celiac disease.
An autoimmune disease can occur when the body’s immune system mistakenly perceives a nonthreatening substance. In the case of people with celiac disease, gluten (a protein found in wheat, barley, rye, and oats) is seen as a foreign invader and is attacked by the immune system. This immune system response in celiac disease also involves the production of antibodies directed against an enzyme normally present in the intestines called tissue transglutaminase (tTG).
Reference range: <15.0 Antibody not detected, > or = 15.0 Antibody detected
Tissue transglutaminase has been identified as the major autoantigen in celiac disease. IgA antibodies against tTG are highly disease specific serological markers for celiac disease and dermatitis herpetiformis. tTG IgG antibodies are less specific for these diseases but are helpful markers in patients with IgA deficiency.
A negative tTG IgG test alone does not rule out gluten-sensitive enteropathy.
Celiac disease is a life-long condition in which ingestion of gluten, the water insoluble wheat-gliadin and the prolamins in rye and barley, leads to chronic inflammation and damage of the small intestinal mucosa. Also useful in monitoring adherence to gluten-free diet in patients with IgA deficiency.
Interpretation:
TTGA and TTGG both >10 U/mL: Suggestive of Celiac disease
TTG-IgG may be used to follow patients with Celiac disease who are IgA deficient. However, TTG-IgG alone is not sufficient to diagnose Celiac Disease.
Micronutrient Test, Spectracell Laboratories
SpectraCell Laboratories is a CLIA-certified clinical laboratory headquartered in Houston, Texas, specializing in advanced diagnostic testing for nutritional and metabolic health. As a trusted leader in functional medicine, SpectraCell provides in-depth laboratory analysis of micronutrients, vitamins, minerals, antioxidants, amino acids, and metabolites to help uncover hidden deficiencies and guide personalized treatment plans.
SpectraCell’s Micronutrient Test is a comprehensive blood panel that evaluates the intracellular levels of 31 essential micronutrients—measuring how effectively your body uses these nutrients at the cellular level. This test goes beyond conventional serum testing to identify long-term nutrient imbalances that may contribute to fatigue, immune dysfunction, mood disorders, and chronic health conditions.
The test includes assessment of:
Vitamins: A, B1, B2, B3, B6, B12, C, D, E, K, and Folate
Minerals: Magnesium, Zinc, Copper, Calcium
Amino Acids: Glutamine, Serine, Asparagine
Antioxidants: Glutathione, CoQ10, Selenium, Alpha-lipoic acid
Metabolic Compounds: Carnitine, Inositol, Choline
This test is recommended for individuals with:
Chronic fatigue or low energy
Brain fog, anxiety, or depression
Frequent illness or immune challenges
Digestive issues such as IBS or malabsorption
Hormonal imbalances
Inflammatory or autoimmune conditions
A proactive interest in optimizing nutrition and long-term health
SpectraCell Laboratories uses proprietary functional testing technology to measure nutrient levels inside white blood cells—where long-term micronutrient status is best assessed. This method reflects how well nutrients are actually being utilized by the body, making it more clinically relevant than serum-only tests.
SpectraCell also pioneered telomere length testing, offering insight into biological aging and cellular function—available to clinicians and patients outside of a research setting.
The SpectraCell Micronutrient Test includes a detailed, easy-to-understand report that categorizes your nutrient levels as:
Adequate: Your cells show optimal nutrient function
Borderline: Nutrient levels may be suboptimal, requiring closer monitoring or dietary adjustments
Deficient: A clear functional deficiency that may be contributing to symptoms or long-term health risks
The report also includes:
Personalized nutrient repletion suggestions
Functional commentary on how each deficiency could affect energy, immunity, mood, or metabolism
A visual chart summarizing your cellular nutrient status at a glance
Tools for healthcare providers to design targeted supplement and lifestyle plans
Your healthcare provider can review the results with you to prioritize which deficiencies are most relevant to your symptoms and goals.
Test type: Blood draw (requires a licensed phlebotomist or clinic visit)
Turnaround time: Approximately 10 to 14 business days
Laboratory: SpectraCell Laboratories, Houston, TX (CLIA-certified)
Optional panels: Telomere testing, cardiometabolic risk profile, hormone testing
Get Clear, Personalized Insight into Your Nutritional Health
The Micronutrient Test from SpectraCell Laboratories provides an evidence-based foundation for targeted nutrition. Whether you're struggling with persistent symptoms or seeking optimal wellness, this advanced diagnostic test reveals what your cells truly need to function at their best.
Optimal range: 85 - 100 %
Lipoic Acid is a sulfur-containing vitamin-like substance that is an important cofactor in energyproducing reactions in the production of cellular energy (ATP). Lipoic acid has been referred to as a “universal antioxidant” because it is soluble in both fat and water. It is capable of regenerating several other antioxidants back to their active reduced states, including vitamin C, vitamin E, glutathione and coenzyme Q10. Alpha lipoic acid has several potential actions for the type 2 (non-insulin-dependent) diabetic. It reduces glycosylation reactions (attachment of sugar moieties to protein) and facilitates healing of diabetic nerve damage. Biochemical reactions utilizing lipoic acid occur within the mitochondria, where it functions critically in its antioxidant capacity.
Optimal range: 39 - 100 %
Asparagine is a dietarily dispensable amino acid synthesized from aspartate and glutamine. Asparagine has three major functions:
1) incorporation into amino acid sequences of proteins;
2) storage form for aspartate (is a required precursor for synthesis of DNA, RNA and ATP); and
3) source of amino groups for production of other dispensable amino acids via trasaminases.
Optimal range: 34 - 100 %
Biotin is required for proper metabolism of fats and carbohydrates. Biotin-dependent enzymes catalyze the addition of carboxyl groups (COO-) from bicarbonate, for use in fatty acid biosynthesis, gluconeogenesis, lipogenesis, propionate metabolism, and leucine catabolism.
Optimal range: 38.1 - 100 %
Calcium is the most abundant mineral in the body, with 99% residing in bones and teeth. As a component of hard tissues, Calcium fulfills a structural role to maintain body size and act as attachments for musculoskeletal tissues.
Optimal range: 46 - 100 %
L-carnitine is an amino acid derivitive of the essential amino acids L-lysine and methonine. The conversion to carnitine requires niacin (B3), vitamins B6 and C, and iron. It is found in nearly all cells of the body but chiefly in the liver and kidney. Carnitine is essential for the transportation of long-chain fatty acids across the inner mitochondrial membranes in the mitochondria, where they are metabolized by beta-oxidation to produce biological energy in the form of adenosine triphosphate (ATP). L-Carnitine also is required to remove short- and medium-chain fatty acids from the mitochondria. This removal optimizes energy production by maintaining coenzyme A at optimal levels for normal metabolism and energy production.
Optimal range: 20 - 100 %
Choline is an essential nutrient that is part of cell membranes and is used by nerves to send impulses. Choline is known to be essential for mammals, and is essential for human cell growth. A dietary requirement for choline in humans has not been proven, although recent data on infants and dietary choline depletion in adults suggests that choline is an essential nutrient. Historically, choline is considered as a lipotrope and member of the B vitamin complex.
Choline has several distinct functions. First, choline serves as a source of one-carbon units (methyl groups) for biosynthesis of other compounds. Interactions with methionine, Vitamin B12, folate, ethanolamine, and betaine allow choline to partially replace, or be replaced by other constituents in one-carbon metabolism. Second, choline is a component of phosphatidyl choline, the major component of cell membranes. Lecithin is a commercial name for phospholipids containing 10-35% phosphatidyl choline. Phosphatidyl choline has interactions with cholesterol and lipoprotein metabolism.
Optimal range: 40 - 100 %
Chromium is an essential trace mineral that plays an important role in optimizing insulin function and the regulation of blood glucose levels. Chromium may also be anti-atherogenic and assist in lowering cholesterol.
Optimal range: 86 - 100 %
Coenzyme Q-10 belongs to a family of substances called ubiquinones. These compounds are lipophilic, water-insoluble substances involved in electron transport and energy production within the mitochondria. In this capacity, coenzyme Q-10 facilitates the conversion of the energy released through glycolysis into ATP (adenosine triphospate).
Optimal range: 42 - 100 %
Like most trace minerals, copper acts as an enzyme cofactor in several key metabolic processes in the body. Among its many functions, copper aids in the formation of bone, hemoglobin and red blood cells, therefore enabling the efficient transport of oxygen throughout the body. In addition, copper works in balance with vitamin C and zinc to manufacture elastin (skin protein) as well as collagen and other structural proteins in cartilage and tendons. It is also involved in the healing process, energy production, hair and skin coloring (production of melanin) and taste sensitivity. Copper stimulates the absorption of iron through the copper transport protein ceruloplasmin. Copper also aids in the metabolism of several fatty acids and helps prevent oxidative damage by serving as a cofactor to superoxide dismutase. In addition, copper is needed for proper insulation (mylination) of nerve cells and serves as a cofactor for the synthesis of the neurotransmitter norepinephrine.
Optimal range: 41 - 100 %
Cysteine is a sulfur-containing, conditionally-essential amino acid. The sulfur group (thiol or sulfhydryl group) in cysteine accounts for most of cysteine’s functions. Cysteine can be oxidized with itself to form cystine.
Cysteine has six major functions:
1) incorporation into amino acid sequences of proteins, where cysteine promotes protein structure by sulfhydryl bonding;
2) ratelimiting precursor for glutathione synthesis;
3) precursor for taurine (used in bile formation and nerve function);
4) source of sulfate for connective tissue synthesis;
5) source of pyruvate for energy or glucose production;
6) neurotransmitter. As a component of glutathione, cysteine functions include being a powerful antioxidant, detoxification agent, component of some prostaglandins, and an amino acid transporter across membranes. Formation of cysteine from homocysteine is one pathway to reduce homocysteine levels.
Optimal range: 38 - 100 %
Folate (Folic Acid) is needed to produce blood cells and other new tissue cells. Folate is a generic term for a group of pteridine compounds essential for one-carbon unit metabolism. Folates are involved in the synthesis of DNA, RNA, and tRNA necessary for cell growth. Folates are required for metabolism of methionine, histidine, tryptophan, glycine, serine, and formate. Interactions with Vitamin B6 and B12 also occur from common metabolic pathways. Folate function is necessary to prevent accumulation of homocystine. Deficient folate status of pregnant females is also directly linked to incidence of birth defects, especially neural tube defects such as spina bifida.
Optimal range: 34 - 100 %
Humans have a limited ability to metabolize fructose (fruit sugar). Fructose is metabolized differently from other sugars. A fructose load leads to accumulation of fructose-1-phosphate in cells which may partially deplete intracellular ATP levels in susceptible individuals.
Since fructose intolerance is a cellular event, rather than a single nutrient deficiency, symptoms may vary widely among persons. Preliminary evidence suggests clinical symptoms of fructose intolerance may include fatigue, headaches, weakness, dizziness, behavioral changes, and depressed immune function. Medical literature suggests that certain individuals with fructose intolerance may show hypertriglyceridemia, elevation of uric acid, and interference with copper metabolism.
Dietary sources of fructose are numerous; however, an excess intake of fructose should be avoided, rather than absolute removal of dietary fructose. In this manner, whole foods containing fructose (fruits and some vegetables) may be consumed, in order to benefit from their overall nutritional value.
Foods very rich in fructose include table sugar (sucrose), high fructose corn syrup, corn syrup, fruit juice concentrates and a large list of prepared foods containing sucrose and/or corn syrup. Reduction of excess dietary fructose intake by avoidance of foods very rich in fructose is suggested when fructose intolerance is exhibited.
Optimal range: 38 - 100 %
The patient’s cells are challenged with glucose and their ability to grow in the presence or absence of insulin is determined. A significant decrease of cell growth is indicative of reduced ability to metabolize glucose.
Preliminary evidence suggests that persons with abnormal Glucose-Insulin Interaction exhibit hypoglycemia or hyperglycemia based on glucose tolerance testing. Morbidly obese persons with abnormal Glucose-Insulin Interaction may indicate insulin resistance. Thus, deficiency symptoms include fatigue, headaches, nausea, disorientation, dizziness, cold hands and feet, glucose intolerance.
Dietary suggestions are to replace, as much as possible, refined carbohydrates (table sugar, corn syrup, white flour, products made predominantly with white flour and/or sugar) with wholefood, unrefined carbohydrates (whole grain products, legumes, fruits). Reduce intake of foods with a high glycemic index. If clinically indicated, it is suggested that further laboratory testing of glucose and insulin metabolism be conducted (glucose tolerance test, glycosylated hemoglobin). Since chromium status is closely linked with insulin function and glucose tolerance, a chromium deficiency is one possible reason for abnormal Glucose-Insulin Interaction.
Optimal range: 37 - 100 %
Glutamine is used for energy, for synthesis of other essential building blocks, (protein, DNA, and RNA), and for removal of toxic substances.
Glutamine is a dispensable amino acid present in greater amounts than any other amino acid in the body fluid and cells.
Optimal range: 42 - 100 %
Glutathione is implicated in many cellular functions including antioxidant protection and detoxification. It is also essential for the maintenance of cell membrane integrity in red blood cells.
Optimal range: 64 - 100 %
Function: An essential nutrient, inositol is found in cell membranes and is needed for proper function of hormones. Inositol, similar to choline, is a component of phospholipids (phosphatidyl inositols). Phosphatidyl inositols function as cell membrane components and as regulators of cell membrane transport by acting as a calcium-mobilizing system (the “PI effect”). Thus, inositol status interacts with a wide variety of hormonal and regulatory events in cells. Lipotropic activity (reduction of blood or tissue lipid levels) of inositol centers around the role of phosphatidyl inositol in lipoproteins. Since inositol is widely available from dietary sources, endogenous synthesis and gut microfloral synthesis, inositol is not classified as a vitamin. Nevertheless, inositol has been considered as a component of the B vitamin complex.
Optimal range: 37 - 100 %
Magnesium is predominantly found intracellularly, where it is vital for proper cell functions. Magnesium is the second most prevalent intracellular cation (after potassium). Magnesium functions are numerous and essential, including enzyme activation (over 300 types), neuromuscular activity, membrane transport and interactions, energy metabolism (carbohydrates, fats, proteins), and roles in calcium and phosphorus metabolism.
Optimal range: 50 - 100 %
Manganese is a mineral element that is both nutritionally essential and has the potential to be very toxic. This fact is further complicated by the small range of dosage for clinical benefit and toxicity with serious consequences. Manganese is an important factor in many critical biochemical processes including antioxidant function. The principle antioxidant enzyme within our mitochondria (energy) is superoxide dismutase and the enzymes requires manganese for optimal performance. Manganese is also required for normal skeletal development and cartilage synthesis. Wound healing is also impacted by manganese, as the synthesis of collagen in skin cells is dependent on the presence of adequate manganese. Manganese is also important functioning as a co-factor in the metabolism of carbohydrates, amino acids and cholesterol. Manganese is considered anti-osteoporotic and anti-arthritic.
Optimal range: 65 - 100 %
Oleic acid is the most common monounsaturated fatty acid in human cells. Oleic acid is incorporated into cell membrane phospholipids, where it is important for proper membrane fluidity. Hormone responsiveness, infectivity of pathogens, mineral transport and immune competence are affected by membrane fluidity.
Optimal range: 13 - 100 %
Pantothenic acid plays vital roles in energy production from foodstuffs. Pantothenate is a component of coenzyme A, which is indispensable for two-carbon unit metabolism (acetyl groups). Acetyl groups are involved in the release of energy from carbohydrates, fats, proteins, and other compounds, as well as synthesis of fats, cholesterol, steroid hormones, porphyrin and phospholipids.
Optimal range: 74 - 100 %
The trace mineral selenium functions primarily as a component of the antioxidant enzyme, glutathione peroxidase. Glutathione peroxidase activity, which requires selenium for activity, facilitates the recycling of vitamins C and E, in optimizing the performance of the antioxidant system.
Optimal range: 30 - 100 %
Serine is used to manufacture proteins, energy, cell membrane structure and synthesis of other cell components (DNA and RNA). Serine is a dispensable amino acid obtained from the diet and synthesized from other amino acids and metabolites of glucose.
Serine participates in protein synthesis, energy production, phospholipid synthesis (phosphatidyl serine and ethanolamine) and one-carbon unit metabolism (necessary for DNA and RNA synthesis). Quantitatively, serine supplies more one-carbon units than any other nutrient. Serine is an attachment point for carbohydrates on protein chains.
Repletion Information: Since serine is a dispensable amino acid, no dietary RDA exists. Serine is present in foods that are rich in protein. Doses of 1-2 grams daily of pure serine appear safe.
Optimal range: 70 - 100 %
Vitamin A is a family of fat soluble compounds (carotinoids) that play an important role in vision, bone growth, reproduction and cell differentiation. It also helps regulate the immune system, promoting optimal lymphocyte function in defending against bacterial and viral infections. Retinol (Vitamin A) promotes healthy surface linings of the eyes and respiratory, urinary and instestinal tracts. Vitamin A also promotes healthy skin function and integrity. Retinol is the most active form of Vitmain A and is synthesized in the body by conversion of provitamin A, primarily beta-carotene, into retinol. Lycopene, lutein and zeaxathin are carotiniods that do not have Vitamin A activity, but have other helath promoting properties. Studies are inconclusive in identifying vitamin A’s rols as an antioxidant.
Optimal range: 78 - 100 %
Vitamin B1 (Thiamin) is used by cells to help make energy from foodstuffs. Thiamin pyrophosphate is a cofactor for dehydrogenase enzymes with key roles in cellular energy production.
Dietary sources richest in B1 (per serving) include:
- Nutritional supplements
- Rice Bran
- Nutritional Yeasts
- Wheat Germ
- Legumes (beans, peas, soybeans, lentils)
Optimal range: 18 - 100 %
Vitamin B12 is needed to form blood and immune cells, and support a healthy nervous system. A series of closely-related compounds known collectively as cobalamins or vitamin B12 are converted into active forms methylcobalamin or 5’-deoxyadenosylcobalamin. Methylcobalamin interacts with folate metabolism, preventing folate derivatives from being trapped in unusable states. Adenosylcobalamin is involved in the metabolism of odd-chain fatty acids and branchedchain amino acids.
Optimal range: 53 - 100 %
Riboflavin helps to metabolize foodstuffs into energy. Riboflavin is converted into its active forms, flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN). FAD and FMN are primarily involved as cofactors in oxidation-reduction reactions for flavoproteins, essential for cellular energy production and respiration. Riboflavin has a role in antioxidant status by activating glutathione reductase, which regenerates reduced glutathione.
Optimal range: 85 - 100 %
Niacinamide is needed to metabolize foodstuffs into energy. Niacinamide is converted into the coenzymes nicotinamide adenine dinucleotide (NAD) and NADP, which function in oxidationreduction reactions essential for release of energy from carbohydrates, fats, and proteins. Niacin can also be synthesized by the body from tryptophan, although with low efficiency
Optimal range: 60 - 100 %
Vitamin B6 is needed to metabolize proteins and is important for a healthy immune system, nerves, bones and arteries. Vitamin B6 is a complex of three similar molecules: Pyridoxine, Pyridoxal and Pyridoxamine. All are present in foods and converted into to pyridoxal-5- phosphate, the most active coenzyme form. The primary functions of vitamin B6 are in protein metabolism, transferring amino acid and sulfur groups. Roles in synthesis of heme (for hemoglobin), niacin, neurotransmitters, connective tissues, eicosanoids, and sphingolipids in nerve sheaths are also essential. Vitamin B6 also participates in the utilization of glycogen and immune function.
Optimal range: 40 - 100 %
Vitamin C is required for several metabolic functions in the body. One of its major roles is in the synthesis of collagen and elastin, the main structural proteins of skin, cartilage and blood vessels.
It is also necessary in the production of several stress response hormones including adrenalin, noradrenalin, cortisol and histamine, and it is required in the synthesis of carnitine, an amino acid that facilitates the conversion of fatty acids into energy within the mitochondria.
Optimal range: 50 - 100 %
Vitamin D is the principle regulator of calcium homeostasis in the body. It is essential for skeletal development and bone mineralization. Vitamin D is a prohormone with no hormone activity. It is converted to a molecule that has biological activity. The active form of the vitamin is 1,25-dihydroxyvitamin D, usually referred to as vitamin D3. It is synthesized in the skin from 7-dehydrocholesterol via photochemical reactions requiring UV light (sunlight). Inadequate exposure to sunlight contributes to vitamin D deficiency. Vitamin D deficiency in adults can lead to osteoporosis. This results from a compensatory increase in the production of parathyroid hormone resulting in bone resorption. Increasing evidence is accumulating that vitamin D may also contribute to antioxidant function by inhibiting lipid peroxidation. The mechanism of the antioxidant effect is unknown. Vitamin D is also needed for adequate blood levels of insulin. Vitamin D receptors have been identified in the pancreas.
Optimal range: 84 - 100 %
Vitamin E is an antioxidant that protects cell membranes and other fat-soluble compounds from oxidative damage by free radicals.
Optimal range: 30 - 100 %
The primary function of vitamin K is to aid in the formation of clotting factors and bone proteins. It serves as a cofactor in the production of six proteins that regulate blood clotting, including prothrombin. In addition, it helps to form osteocalcin, a protein necessary for the mineralization of bone.
Vitamin K also aids in the formation of glucose into glycogen for storage in the liver. In addition, it promotes the prevention and reversal of arterial calcification, plague progression and lipid peroxidation. Deficiency may increase the risk of calcification of arterial walls, particularly in individuals on vitamin D supplementation (Vitamin D promotes calcium absorption). Vitamin K exists in three forms: K1, a natural form found in plants (phylloquinone); K2, which is synthesized in the intestine (menaquinone); and K3, a synthetic form that must be activated in the liver (menadione).
Vitamin K is absorbed in the upper small intestines and transported throughout the body in chylomicrons.
Optimal range: 37 - 100 %
The primary role of zinc is to activate almost 200 enzymes with vital roles in cell regulation, immune function, acid/base balance, DNA, RNA, and protein synthesis, lipid metabolism, eicosanoid production, and digestion. Zinc also is a component of insulin (energy metabolism), thymic hormones (immune function) and gustin (taste acuity).
Tumor / Cancer screening tests
This category includes tumor markers, sometimes called cancer markers, in the blood, urine, or body tissues. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body. Some tumor markers are specific to one type of cancer. Others can be found in several types of cancers.
Tumor marker tests are most often used to:
- Plan your treatment. If tumor marker levels go down, it usually means the treatment is working.
- Help find out if a cancer has spread to other tissues
- Help predict the likely outcome or course of your disease
- Check to see if your cancer has come back after successful treatment
- Screen people at high risk for cancer.
Risk factors can include family history and previous diagnosis of another type of cancer.
Cancer screening tests also aim to find cancer early, before it causes symptoms and when it may be easier to treat successfully.
Effective screening tests are those that:
- Find cancer early
- Reduce the chance that someone who is screened regularly will die from the cancer
- Have more potential benefits than harms. (Possible harms of screening tests include bleeding or other physical damage, inaccurate test results, and overdiagnosis—the diagnosis of cancers that would not have caused problems and did not need treatment.)
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Note: Can tumor markers be used in cancer screening?
Because tumor markers can be used to predict the response of a tumor to treatment and for prognosis, researchers have hoped that they might also be useful in screening tests that aim to detect cancer early, before there are any symptoms.
However, although tumor markers are extremely useful for determining whether a tumor is responding to treatment or assessing whether it has recurred, no tumor marker identified to date is sufficiently sensitive (that is, able to correctly identify people who have the disease) or specific (that is, able to correctly identify people who do not have the disease) to screen for cancer.
For example, until recently, the prostate-specific antigen (PSA) test, which measures the level of PSA in the blood, was used routinely to screen men for prostate cancer. However, an increased PSA level can be caused by benign prostate conditions as well as by prostate cancer, and most men with an elevated PSA level do not have prostate cancer. Because results from clinical trials showed that PSA testing leads at best to only a small reduction in the number of prostate cancer deaths and can lead to overdiagnosis and overtreatment, the PSA test is no longer recommended for routine screening. Now it is often used to monitor men with a history of prostate cancer to see if their cancer has come back. See the PSA Test fact sheet for more information.
Optimal range: 0 - 9.9 %
AFP-L3% (Alpha-Fetoprotein-L3 Percent) is a specialized blood test that measures the percentage of a specific subtype of alpha-fetoprotein (AFP) in the bloodstream. AFP is a protein normally produced by the liver and yolk sac during fetal development. In adults, elevated AFP levels can be a sign of liver disease or cancer, particularly hepatocellular carcinoma (HCC), the most common type of primary liver cancer.
AFP exists in different forms, and AFP-L3 is a glycosylated variant that is more specifically associated with malignant liver tumors. The AFP-L3% refers to the proportion of total AFP that is the L3 subtype, offering more precise insight into the risk or presence of liver cancer.
Optimal range: 0 - 8.3 U/mL
Other names: total AFP, alpha-fetoprotein-L3 Percent
Healthy adults should have very low levels of AFP.
AFP stands for alpha-fetoprotein. It is a protein made in the liver of a developing baby. AFP levels are usually high when a baby is born, but fall to very low levels by the age of 1. An AFP tumor marker test is a blood test that measures the levels of AFP in adults. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body.
What is it used for?
An AFP tumor marker test may be used to:
- Help confirm or rule out a diagnosis of liver cancer or cancer of the ovaries or testicles.
- Monitor cancer treatment. AFP levels often go up if cancer is spreading and go down when treatment is working.
- See if cancer has returned after treatment.
- Monitor the health of people with cirrhosis or hepatitis.
Why do I need an AFP tumor marker test?
You may need an AFP tumor marker test if a physical exam and/or other tests show there is a chance you have liver cancer or cancer of the ovaries or testicles. Your provider may order an AFP test to help confirm or rule out the results of other tests.
You may also need this test if you are currently being treated for one of these cancers, or recently completed treatment. The test can help your provider see if your treatment is working or if your cancer has come back after treatment.
In addition, you may need this test if you have a noncancerous liver disease. Certain liver diseases can put you at a higher risk of getting liver cancer.
Optimal range: 0 - 45.9 U/mL
A CA 125 test may be used to monitor certain cancers during and after treatment. In some cases, a CA 125 test may be used to look for early signs of ovarian cancer in people with a very high risk of the disease.
Optimal range: 0 - 31 U/mL
Cancer antigen 15-3 (CA 15-3) is used to monitor response to breast cancer treatment and disease recurrence.
The reference range of serum CA 15-3 is less than 30 U/mL. The upper limit of the range varies depending on the laboratory and kit used for the test. Values obtained with different assay kits, methods, or laboratories cannot be used interchangeably.
CA 15-3 levels are most commonly used to monitor metastatic breast cancer during active therapy. Tumor marker levels must be used in conjunction with the history, physical examination, and diagnostic imaging. A decrease in marker levels during treatment can indicate tumor response, whereas stable or increasing levels despite adequate treatment can indicate that the tumor is not responding to treatment or that the tumor is recurring.
CA 15-3 measurement can also be used to survey disease recurrence after treatment of metastatic breast cancer. In the absence of measurable disease, an increase in CA 15-3 levels could indicate treatment failure. However, CA 15-3 levels can rise during the initial 4-6 weeks of starting therapy. This transient rise does not usually correlate with disease progression.
Optimal range: 0 - 35 U/mL
A CA 19-9 test measures the amount of a protein called CA 19-9 (cancer antigen 19-9) in a sample of your blood. CA 19-9 is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in your body.
Healthy people can have small amounts of CA 19-9 in their blood.
Optimal range: 0 - 38 U/mL
The cancer antigen 27.29 test (CA 27.29) is a blood test that measures the levels of glycoprotein produced by the mucin-1 (MUC1) gene.
The level of CA 27.29, also known as 27.29, is used as a tumor marker to measure the activity of the disease in patients with breast cancer. It’s one of several types of tumor markers used for breast cancer and is most commonly used in advanced breast cancer, as opposed to early-stage breast cancer.
Optimal range: 0 - 6.9 U/mL
Elevated CA72-4 levels in serum and plasma are seen in the pancreas, gallbladder, colon, cervix, and endometrium carcinomas.
CA 72-4, also known as cancer antigen 72-4, is a protein that is commonly found in high levels in the blood of individuals with certain types of cancer, most notably gastrointestinal and ovarian cancers. This marker is used primarily in the medical field as a tumor marker, which means it helps doctors monitor the presence and progression of cancer in the body. The CA 72-4 marker can be measured through a blood test, and elevated levels might indicate the presence of cancer or that cancer treatment is not fully effective. However, it is important to note that elevated CA 72-4 levels are not exclusive to cancer and can sometimes be seen in benign conditions. Therefore, while CA 72-4 is a useful tool for monitoring cancer, it is usually used in conjunction with other diagnostic tests and markers to provide a more accurate picture of a patient's health status. This marker can help in early detection, monitoring treatment response, and detecting potential recurrence of cancer, making it a valuable component in oncology.
Optimal range: 0 - 3.9 ng/mL
Carcinoembryonic antigen (CEA) is a glycoprotein, which is present in normal mucosal cells but increased amounts are associated with adenocarcinoma, especially colorectal cancer. CEA therefore has a role as a tumour marker. Sensitivity and specificity are low, however, so it is of more use for monitoring than for screening or diagnosis.
Nonsmokers: <3.9 ng/mL
Smokers: <5.6 ng/mL
Optimal range: 200 - 2100 U/L
The CD19 antigen (aka B-lymphocyte antigen CD19 or Cluster of Differentiation 19) plays an important role in clinical oncology. It’s a protein found on the surface of B-cells, a type of white blood cell.
Optimal range: 0 - 311 ng/mL
Chromogranin-A (CgA) is an acidic glycoprotein expressed in the secretory granules of most normal and neoplastic neuroendocrine (NE) cell types, where it is released together with peptide hormones and biogenic amines. Neuroendocrine tumors (NETs) are a form of cancer that differ from other neoplasia in that they synthesize, store, and secrete peptides, e.g., CgA and amines. CgA is secreted from neuroendocrine-derived tumors including foregut, midgut and hindgut gastrointestinal NETs, pheochromocytomas, neuroblastomas, medullary thyroid carcinomas, some pituitary tumors, functioning and non-functioning pancreatic NETs.
Optimal range: 0 - 2.08 ug/L
The CYFRA 21-1 is well known as tumor maker of lung cancer and is not influenced by environmental factors.
CYRFA 21-1 (cytokeratin 19 fragment) has been demonstrated as clinically useful in the prognostication and monitoring of non-small cell lung cancer (NSCLC). Elevated pre-treatment levels may be associated with unfavorable prognosis, and decreasing levels during therapy predict an objective response to treatment. However, the level of CYFRA 21-1 cannot be used as absolute evidence for the presence or absence of disease and results must be viewed in context with other clinical evidence.
Cytokeratins are epithelial markers whose expression is not lost during malignant transformation. CYFRA 21-1 is a cytokeratin-19 fragment that is soluble in serum and can be used as circulating tumor marker. Although expressed in all body tissues, its major occurrence is in the lung, particularly in lung cancer tissues.
Reference range: No evidence of monoclonal B cell population, Evidence of monoclonal B-cell population
The Leukemia/Lymphoma/Myeloma Panel by Flow Cytometry is a specialized diagnostic test used in the field of hematology (=the study of blood and blood disorders) to analyze and classify various blood and bone marrow disorders, including:
→ Leukemia (Leukemia is a broad term for cancers of the blood cells)
→ Lymphoma (a broad term for cancer that begins in cells of the lymph system)
→ and Myeloma (a cancer of the plasma cells).
Optimal range: 0 - 900 ng/mL
Matrix Metalloproteinase 9 (MMP-9), also known as gelatinase B, is a critical enzyme in the human body that plays a vital role in remodeling the extracellular matrix, the network of proteins and other substances surrounding cells. It belongs to a larger family of enzymes known as matrix metalloproteinases, which are responsible for breaking down various components of the extracellular matrix.
MMP-9 specifically targets collagen and gelatin, important structural proteins in tissues. By breaking down these proteins, MMP-9 aids in processes like wound healing, tissue repair, and angiogenesis (the formation of new blood vessels). This makes it an essential player in normal physiological processes. However, MMP-9's activity isn't always beneficial; its overactivity or dysregulation is linked to various diseases.
Optimal range: 0 - 984 ng/mL
MMP-9 is a marker of inflammation, tissue remodeling, wound healing, and mobilization of tissue-bound growth factors and cytokines.
Matrix metalloproteinases (MMPs) play an important role in the progression of tumour cells and the invasion of inflammatory cells by degrading the extracellular matrix. In the MMP family, MMP-9 gelatinase is thought to contribute to the pathogenesis of inflammatory arteritis by disrupting the elastic lamina.
MMP-9 contributes to the pathogenesis of numerous clinical disease states, including rheumatic arthritis, coronary artery disease, chronic obstructive pulmonary disease, multiple sclerosis, asthma, and cancer. Current research is exploring the role of this enzyme as a potential drug target.
Optimal range: 0 - 17.6 ng/mL
Neuron-specific enolase (NSE) is a key biomarker predominantly found in neurons and neuroendocrine cells, making it highly valuable for clinical diagnostics and monitoring neurological and neuroendocrine disorders. NSE is a glycolytic enzyme that plays a crucial role in the process of glycolysis, helping to convert glucose into energy. Due to its specificity, elevated levels of NSE in the blood or cerebrospinal fluid (CSF) are often indicative of neuronal damage or neuroendocrine tumors. Clinically, NSE is extensively used as a tumor marker for small cell lung cancer (SCLC) and neuroblastoma, where its elevated levels correlate with tumor burden, disease progression, and patient prognosis.
Optimal range: 0 - 16.3 ug/L
Optimal range: 0 - 0.05 Score
Total Prostate Specific Antigen (TPSA) is a serine protease produced by prostate cells, primarily used as a biomarker for the screening and monitoring of prostate cancer. While elevated TPSA levels can indicate the presence of prostate cancer, they can also arise from benign conditions such as benign prostatic hyperplasia (BPH) and prostatitis. The TPSA test measures the total amount of PSA in the blood, which includes both free and protein-bound forms. Although TPSA is a valuable tool in early detection and management of prostate cancer, its specificity is limited, as elevated levels can occur in non-cancerous conditions. Therefore, healthcare providers often use additional tests, such as the free-to-total PSA ratio, to improve diagnostic accuracy and differentiate between benign and malignant prostate conditions.
Optimal range: 0 - 4 ng/mL
The Prostate-specific antigen (PSA) test measures the amount of prostate specific antigen proteins made by the prostate gland and prostate cancers. It is used as a screen for prostate cancer, or a way to monitor progress of prostate cancer patients.
Optimal range: 25 - 50 %
The free prostate-specific antigen test, known as the free PSA test, is used to help detect signs of prostate cancer. The test measures the level of unbound prostate-specific antigen in the blood, which can help doctors to diagnose issues like inflammation of the prostate or cancer.
Free PSA tests are often used alongside other PSA tests to confirm a diagnosis or test results. Free PSA tests can also be used instead of a biopsy if the doctor suspects prostate cancer, but a biopsy may still be needed.
Optimal range: 0 - 0.1 ug/L
Optimal range: 0 - 2.3 ng/mL
Optimal range: 0 - 1.4 ug/L
Total Prostate Specific Antigen (TPSA) is a serine protease produced by prostate cells, primarily used as a biomarker for the screening and monitoring of prostate cancer. While elevated TPSA levels can indicate the presence of prostate cancer, they can also arise from benign conditions such as benign prostatic hyperplasia (BPH) and prostatitis. The TPSA test measures the total amount of PSA in the blood, which includes both free and protein-bound forms. Although TPSA is a valuable tool in early detection and management of prostate cancer, its specificity is limited, as elevated levels can occur in non-cancerous conditions. Therefore, healthcare providers often use additional tests, such as the free-to-total PSA ratio, to improve diagnostic accuracy and differentiate between benign and malignant prostate conditions.
Optimal range: 0.56 - 1.4 pg/mL
Tumor Necrosis Factor-Alpha (TNF-α) is a critical biomarker used in medical diagnostics and research, known for its role in regulating inflammation and the immune system. A highly sensitive TNF-α test provides accurate detection of this cytokine, aiding in the diagnosis and management of various health conditions.
TNF-α is a cytokine primarily produced by activated macrophages, though other cells can also secrete it. It plays a central role in:
Optimal range: 0 - 33 ug/L
RealTime Laboratories
RealTime Lab is known for its mycotoxin test panel where they are testing for the presence of 16 of the most common and toxic mycotoxins produced by indoor mold contaminants.
Methylation Panel
Methylation is a biochemical process in which methyl groups (CH3) are transferred or donated between molecules, thereby changing their structure and function. This happens billions of times per second in every cell throughout the body. The methylation cycle is dependent on amino acids, vitamin cofactors, and minerals obtained from the diet to ensure adequate function of this biochemical pathway.
The incredibly vast processes in the body that depend upon methylation are what ultimately make functional testing for methylation impairment a valuable clinical tool. Some of these processes include, but are not limited to:
- creatine production for skeletal muscle contraction
- DNA and RNA synthesis
- gene regulation (epigenetics)
- hormone regulation and detoxification
- energy production
- cell membrane repair
- fat metabolism
- myelination
- immune function
- neurotransmitter production and metabolism
- vascular endothelial function and nitric oxide production
To keep these processes functioning optimally, there is a necessary balance between many different biochemical pathways. What is termed the “methylation cycle” involves an interplay between folate metabolism, methionine metabolism, and homocysteine transsulfuration.
The body continually adapts these interconnected pathways in order to maintain homeostasis.
However, key amino acid deficiencies, a lack of vitamin and mineral cofactors, genetic enzymatic predispositions, and a wide array
of oxidative stressors can impact multiple enzymes leading to a disruption in a patient’s overall methylation status.
Optimal range: 21 - 71 micromol/L
- Betaine (trimethylglycine) can be used to turn homocysteine back into methionine
- Betaine is derived from dietary choline (Meats, eggs, and beets)
- Betaine is used for: Methylation / Osmolyte, under cell stress (mainly in kidneys)
Optimal range: 2.6 - 7.7 Ratio
Betaine and choline can be obtained from the diet or synthesized de novo.
Betaine is derived from dietary choline – nuts, cauliflower and broccoli, beets, meats, and eggs.
Choline is a lipotrope, in that it helps to mobilize fat from the liver. Phosphatidylcholine, a derivative, is required for the production of hepatic very-low-density lipoprotein and the mobilization of fat from the liver. Therefore, choline deficiency can result in fatty liver and liver abnormalities.
Optimal range: 5.2 - 13 micromol/L
Choline is a nutrient that supports various bodily functions, including cellular growth and metabolism. The body makes some choline, but the majority comes from dietary sources.
Optimal range: 271 - 392 micromol/L
Cysteine is a nonessential sulfur-containing amino acid. It is obtained from the diet and is also endogenously made from cystathionine. Dietary cysteine sources include poultry, eggs, beef, and whole grains. [L]
Optimal range: 74 - 369 nanomol/L
Because cystathionine is an intermediate of the transsulfuration pathway, elevation of this biomarker may indicate a backup of the transsulfuration pathway. Conversion of cystathionine to glutathione requires necessary cofactors, such as vitamin B6, zinc, glycine, and magnesium. Therefore, transient elevations of this metabolite may indicate increased need for these cofactors.
Optimal range: 1.6 - 5 micromol/L
The amino acid derivative dimethylglycine (DMG) is produced when betaine (trimethylglycine) donates a methyl group to homocysteine for re-methylation back to methionine. This methyl donation is mediated by the enzyme betaine homocysteine methyltransferase (BHMT). Elevations in DMG act as a negative feedback by inhibiting this enzymatic conversion. [L]
Optimal range: 669 - 5000 micromol/L
Glutathione (GSH) is a tripeptide comprised of three amino acids (cysteine, glycine, and glutamic acid). Glutathione is the body’s most potent intracellular antioxidant. It exists intracellularly in either an oxidized or reduced state.
GSH acts as an antioxidant, free radical scavenger, and detoxifying agent. Excessive formation of reactive oxygen species (ROS), including hydrogen peroxide (H2O2), is toxic to the cell. Hence, the metabolism of these free radicals are critical, and they are tightly controlled. [L]
Optimal range: 181 - 440 micromol/L
Glycine is a nonessential amino acid with many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins.
Glycine is a major collagen and elastin component, which are the most abundant proteins in the body. Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption. [L] Glycine is the precursor to various important metabolites such as porphyrins, purines, heme, and creatine. It acts both as an inhibitory neurotransmitter in the CNS (via its interaction with strychnine-sensitive glycine receptors), and as an excitatory neurotransmitter on N-methyl-D-aspartate (NMDA) receptors. [L]
Optimal range: 3.7 - 10.4 micromol/L
- Homocysteine is often used as an indicator of methylation status
- Clinicians aim for optimal: 2-10μmol/L
- Homocysteine must be recycled back into methionine
Optimal range: 0.55 - 0.64 Ratio
This calculated ratio is called the ‘Met/Sulf Balance’ and it compares analytes between the methylation pathway and transsulfuration pathways.
Biomarker levels are compared proportionately allowing potential insight into which of the pathways is being favored.
The four analytes from the main methylation pathway that are used in the Met/Sulf Balance are SAM, SAH, methionine, and homocysteine. The four analytes from the transsulfuration pathway are cystathionine, cysteine, taurine, and glutathione.
Optimal range: 23 - 38 micromol/L
Methionine is an essential amino acid that plays an important role in the methylation cycle.
Optimal range: 1.03 - 1.2 Ratio
Compares 8 different biomarkers
– 4 biomarkers with a methyl group to give
– 4 biomarkers that have had a methyl group removed
The clinical utility of the Methylation Balance Ratio is that it represents a potential way to detect subtle methylation imbalance prior to alterations in the SAM/SAH ratio.
Methylated Metabolites are:
- SAM
- Methionine
- Betaine
- Serine
Un-Methylated Metabolites are:
- SAH
- Homocysteine
- DMG
- Sarcosine
Optimal range: 2.2 - 6.4 micromol/L
The SAM/SAH ratio is commonly referred to as the “Methylation Index” in the literature and has well- documented clinical associations.
Global methylation is dependent on two key factors: adequate SAM supply and SAH removal.
The SAM/SAH ratio has been proposed to indicate the likelihood of hyper- or hypo-methylation.
Overall, the SAM/SAH ratio is under tight homeostatic control. SAM levels remain fairly stable due to denovo synthesis and feedback mechanisms. Given this, alterations in the methylation index are more likely a result of SAH fluctuations.
Optimal range: 16 - 41 nanomol/L
S-adenosylhomocysteine (SAH) is the end-product of methylation reactions in the body. SAM ultimately donates a methyl group for methylation (DNA, detoxification, etc.) resulting in SAH formation. SAH is also the metabolic precursor of all the homocysteine (Hcy) produced in the body. In literature, SAH is sometimes referred to as AdoHcy.
Optimal range: 65 - 150 nanomol/L
- The methylation cycle is all about making sure there is adequate SAM (S-adenosylmethionine)
- SAM is overwhelmingly the body’s main methyl donor
- Think of SAM as the body’s methylation currency
- SAM can donate a methyl group wherever it is needed
Optimal range: 3670 - 6743 nanomol/L
Sarcosine is an amino acid made when SAM is conjugated with glycine by the glycine-N- methyltransferase (GNMT) enzyme. It can also be made by catabolism of DMG. There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats. [L]
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents. [L]
In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess. Disposal of excess SAM is seen in excess methyl donor supplementation, or SAM elevation due to adiposity/ obesity. Some clinicians use sarcosine elevation as a marker of ‘excess methyl supplementation’ or ‘over- methylation.’ Currently, there is no literature to support this hypothesis, but rather it is based on physiology. [L]
Optimal range: 91 - 161 micromol/L
Serine is a nonessential amino acid used in protein biosynthesis. In the folate cycle, glycine and serine are interconverted by the enzyme serine hydroxymethyltransferase (SHMT). Glycine accepts a methyl donor from 5-10 MTHF and becomes serine; therefore, serine is methylated glycine. [L] These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. [L]
Optimal range: 50 - 139 micromol/L
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the non-essential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid. Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine). [L], [L]
Small Intestinal Bacterial Overgrowth (SIBO) 3 Hour
Small intestinal bacterial overgrowth (SIBO) is an increase in the number of bacteria and/or the presence of atypical microbiota in the small intestine.
Gram-positive flora might be present due to failure of the gastric acid barrier, whereas the presence of colonic bacteria may be due to failure of intestinal clearance and small intestinal anatomical alterations.
The bacteria in SIBO are mainly colonic type bacteria, and it is hypothesized that it is the retrograde bacterial migration from the large intestine into the small intestine that leads to symptoms. These organisms produce gases, including hydrogen (H2), methane (CH4), and hydrogen sulfide (H2 S).
The bacteria commonly found in SIBO include Escherichia coli, Enterococcus spp., Klebsiella pneumonia, and Proteus mirabilis.
The common methaneproducing organisms include archaea, such as Methanobrevibacter smithii, as well as bacteria, including certain Clostridium and Bacteroides species. There are many natural defense mechanisms against SIBO. These include, but are not limited to:
- Antegrade peristalsis and the migrating motor complex (MMC)
- Bacteriostatic action of gastric acid, pancreatic enzymes, and bile; bile is an important suppressor of methanogenesis
- Intestinal mucus layer (traps bacteria)
- Ileocecal valve inhibits retrograde translocation of bacteria from the colon to the small intestine
- Immune system, specifically sIgA, prevents bacterial proliferation.
SIBO symptoms are non-specific, including abdominal pain/distention, flatulence, nausea, dyspepsia, constipation, and diarrhea. Post-prandial bloating is a common SIBO symptom due to the bacteria fermenting carbohydrates that produces gas, distension, and bloating. The mechanisms by which diarrhea may occur include bacterial de-conjugation of bile salts, enterotoxic effects of bacterial metabolites, increased small intestinal permeability, decreased vitamin B12, and low grade inflammation resulting from immune activation in the small intestinal mucosa.
Immune activation involves an increased number of intraepithelial lymphocytes, mast cells, and enterochromaffin cells. The mediators of the host immune response trigger the enteric nervous system, which can alter GI motility and visceral hypersensitivity.
Additionally, lipopolysaccharide (LPS), a gram-negative bacterial endotoxin, can accelerate intestinal transit. Methane (CH4) production has been associated with the pathogenesis of common clinical conditions, such as obesity, irritable bowel syndrome (IBS), and constipation. Methane gas itself may slow intestinal transit, and patients with CH4-predominant bacterial overgrowth have been found to be five times more likely to have constipation compared to individuals with H2-predominant overgrowth. Moreover, the severity of constipation has been found to directly correlate with the CH4 level.
-------------------------------------
SIBO Pathophysiology and Symptoms:
Small intestinal bacterial overgrowth (SIBO) is an increase in the number of bacteria and/or the presence of atypical microbiota in the small intestine. Gram-positive flora might be present due to failure of the gastric acid barrier, whereas the presence of colonic bacteria may be due to failure of intestinal clearance and small intestinal anatomical alterations. The bacteria in SIBO are mainly colonic type bacteria, and it is hypothesized that it is the retrograde bacterial migration from the large intestine into the small intestine that leads to symptoms. These organisms produce gases, including hydrogen (H2), methane (CH4), and hydrogen sulfide (H2S). The bacteria commonly found in SIBO include Escherichia coli, Enterococcus spp., Klebsiella pneumonia, and Proteus mirabilis. The common methane- producing organisms include archaea, such as Methanobrevibacter smithii, as well as bacteria, including certain Clostridium and Bacteroides species.
There are many natural defense mechanisms against SIBO. These include, but are not limited to:
- Antegrade peristalsis and the migrating motor complex (MMC)
- Bacteriostatic action of gastric acid, pancreatic enzymes, and bile; bile is an important suppressor of methanogenesis
- Intestinal mucus layer (traps bacteria)
- Ileocecal valve inhibits retrograde translocation of bacteria from the colon to the small intestine
- Immune system, specifically sIgA, prevents bacterial proliferation.
SIBO symptoms are non-specific, including abdominal pain/distention, flatulence, nausea, dyspepsia, constipation, and diarrhea. Post-prandial bloating is a common SIBO symptom due to the bacteria fermenting carbohydrates that produces gas, distension, and bloating.
The mechanisms by which diarrhea may occur include bacterial de-conjugation of bile salts, enterotoxic effects of bacterial metabolites, increased small intestinal permeability, decreased vitamin B12, and low grade inflammation resulting from immune activation in the small intestinal mucosa. Immune activation involves an increased number of intraepithelial lymphocytes, mast cells, and enterochromaffin cells. The mediators of the host immune response trigger the enteric nervous system, which can alter GI motility and visceral hypersensitivity. Additionally, lipopolysaccharide (LPS), a gram-negative bacterial endotoxin, can accelerate intestinal transit.
Methane (CH4) production has been associated with the pathogenesis of common clinical conditions, such as obesity, irritable bowel syndrome (IBS), and constipation. Methane gas itself may slow intestinal transit, and patients with CH4-predominant bacterial overgrowth have been found to be five times more likely to have constipation compared to individuals with H2-predominant overgrowth.
Moreover, the severity of constipation has been found to directly correlate with the CH4 level.
Associated Conditions:
Conditions in which a high prevalence of overgrowth are commonly observed include, but are not limited to:
- Functional GI disorders (such as irritable bowel syndrome and gastroparesis)
- Hypothyroidism15
- Neuromuscular diseases (such as restless leg syndrome)
- Inflammatory bowel disease (IBD)
- Pancreatic disease
- Celiac disease
- Liver disease
- Diabetes
- Fibromyalgia
- Rosacea
- Parkinson’s disease
- Obesity
- Interstitial cystitis
Risk Factors:
Decreased intestinal motility is a key factor in the development of SIBO and its recurrence. Out of all the diseases and disorders associated with SIBO, 90% of cases involve either small intestinal motility disorders and/or chronic pancreatitis.
The migrating motor complex (MMC) describes the waves of electromechanical activity that sweep through the intestines in regular cycles between meals. The MMC triggers waves that move non-digestible substances through the gastrointestinal tract from the stomach distally to the terminal ileum.
In addition, the MMC is responsible for moving bacteria from the small intestine to the large intestine, as well as inhibiting the migration of colonic bacteria into the terminal ileum.
Any disorder that impairs MMC function can be a risk factor for SIBO. Gastroenteritis that leads to post-infectious IBS-D is thought to be a risk factor for SIBO. Campylobacter jejuni, Salmonella, E. coli, and Shigella produce cytolethal distending toxin (CDT), and the host can produce an autoimmune response that damages the pacemaker cells for the MMC, resulting in decreased MMC activity.
Other key SIBO risk factors include conditions that result in immunocompromise, decreased bacteriostatic digestive secretions (HCl, pancreatic enzymes, bile acids), and ileocecal valve dysfunction.
Complications of SIBO:
Because SIBO is not consistently characterized by the same species, different symptoms or complications may result, depending on the organisms that are present and their specific function in the GI tract. SIBO can result in damage to the small intestinal mucosa leading to malabsorption and intestinal permeability. Microscopic inflammatory changes in the lamina propria and villous atrophy are common.
Destruction of the intestinal mucosa can result in reduced disaccharidase function and increased intraluminal bacterial carbohydrate degradation, causing SIBO symptoms. The bacteria themselves can consume nutrients, leading to micronutrient deficiencies, and deconjugate bile acids, leading to fat and fat-soluble vitamin malabsorption. Bacteria can produce toxic substances resulting in increased serum endotoxin, stimulating inflammatory cytokine production.
SIBO complications include:
- Weight loss
- Steatorrhea
- Vitamin/mineral deficiency
- Fat-soluble vitamins (A,D,E,K)
- Vitamin B12
- Iron
- Hypoproteinemia/hypoalbuminemia
- Bile acid deficiency
- Anemia
- Osteoporosis
- Neuropathies
Treatment Considerations:
Antibiotics are commonly used to treat SIBO, and studies show normalized breath tests as well as symptomatic relief. The underlying causes of SIBO must be treated properly. Otherwise, the likelihood of SIBO recurrence is very high, even after antibiotic therapy. In general, clinical management of the SIBO patient involves antibiotics and/or natural antimicrobial agents, promotility/prokinetic agents, nutrient supplementation for depleted nutrients and/ or for brush border healing, dietary interventions, meal spacing, and treatment of comorbid conditions.
Treat the Overgrowth:
Antibiotics:
- Rifaximin is a non-absorbable antibiotic that has been FDA-approved for IBS-D, traveler’s diarrhea, and hepatic encephalopathy. It has been extensively studied in functional bowel disorders. It is efficacious against Gram- positive and Gram-negative aerobic and anaerobic bacteria. It can target common SIBO organisms including E. coli, Klebsiella spp., Enterobacter spp., and E. faecalis. In addition to its direct antibiotic effects, rifaximin may also modulate the host inflammatory response with its anti-inflammatory effect. It is best used for hydrogen- predominant SIBO.
- While rifaximin can be used as an individual agent in patients with methane positive breath-testing, an additional agent may be a more effective treatment in instances of constipation-predominant symptomology or when both H2 and CH4 are present. Rifaximin plus neomycin, both non-absorbable antibiotics, have been described as an effective treatment for constipation-predominant cases.
- A variety of other antibiotics have been studied for SIBO with varying efficacy. These include metronidazole, ciprofloxacin, norfloxacin, amoxicillin-clavulanic acid, cefoxitin, and doxycycline.
Natural Agents:
- In addition to pharmaceutical agents, limited evidence suggests a possible role for natural anti-microbial agents such as berberine, allicin (a component of garlic), oregano oil, and/or neem. One study showed that herbal therapies are at least as effective as rifaximin for SIBO resolution confirmed by lactulose breath test. The herbal products used in this study were a combination of Dysbiocide and FC Cidal (Biotics Research Laboratories) or Candibactin-AR and Candibactin-BR (Metagenics, Inc.).
Elemental Diet:
- Elemental formulas are medical foods that provide nutrition that is absorbed in the proximal small intestine, thus limiting the delivery to the bacteria residing in the distal small intestine.
- This diet may be an alternative to antibiotics in patients with allergies to antibiotics or who cannot tolerate antibiotics.8
Provide Nutritional Support:
Numerous nutritional consequences have been associated with SIBO including: weight loss, fat soluble vitamin deficiency, vitamin B12 deficiency, iron deficiency, hypoproteinemia, and low serum bile acids. Any patient with such secondary consequences may warrant nutraceutical support until SIBO has been addressed. Dietary adjustments to support the management of bacterial overgrowth are also commonly utilized in SIBO. Because no dietary approach has been found to be uniformly effective for the management of symptoms, ongoing dietary modifications, based on patient feedback, is imperative.
Common dietary SIBO interventions include the Specific Carbohydrate Diet (SCD), Low FODMAPs, SIBO Specific Diet (a combination of low FODMAPs and SCD designed by Allison Siebecker, ND), SIBO Bi-Phasic Diet (designed by Australian clinician Nirala Jacobi, ND), a liquid elemental diet, GAPS Diet, the Cedars-Sinai Medical Center’s Low Fermentation/SIBO Diet (Mark Pimentel, MD), and the Fast Tract Diet (designed by Norman Robillard, PhD).
Probiotics may be beneficial, but further studies are needed to determine the dose and strain. Prebiotics, often added to probiotic supplements, are fermentable foods for bacteria and can encourage overgrowth; these should be avoided during treatment. Other supplements used by functional medicine key opinion leaders include hydrochloric acid, digestive enzymes, and brush border healing supplements, including mucilaginous herbs (licorice, slippery elm, aloe vera, marshmallow), colostrum, L-glutamine, zinc carnosine, vitamins A and D, curcumin, resveratrol, glutathione, and N-acetylcysteine.
Correct the Underlying Cause:
While it may not always be possible, depending on the condition, treatment should include strategies to minimize any risk factors or comorbid conditions for SIBO. Patients with impaired GI motility that affects the migrating motor complex (MMC), or anatomical abnormalities of the digestive tract, are particularly susceptible to SIBO.
Optimal functioning of the MMC may be supported in the following ways:
- Meal spacing every 4 – 5 hours and an overnight fast. The MMC is active during fasting states and is stopped by feedings.
- Use of prokinetic/promotility agents:
- Pharmaceutical agents include low-dose erythromycin, low-dose naltrexone (LDN), and others. Erythromycin is a motilin agonist and can increase the frequency of phase III of the MMC. LDN is an opioid antagonist and can stimulate peristalsis and increase transit.
- Natural agents include the botanical product Iberogast, ginger, and others. Iberogast consists of 9 herbs and, when compared with the prokinetics metoclopramide and cisapride, there was comparable effectiveness in the treatment of dyspepsia. Ginger increases motility during phase III of the MMC.
Retesting:
In a patient treated for SIBO, many variables affect the decision of when to retest, including the patient’s underlying condition and its severity, and the length and type of treatment. The North American consensus group suggests that breath tests may be performed shortly after cessation of antibiotic therapy to confirm eradication.
References:
- Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterol Hepatol (N Y). 2007;3(2):112-122.
- Martins CP, Chaves CHA, Castro MGB, Gomes IC, Passos M. Prevalence of Small Intestine Bacterial Overgrowth in Patients with Gastrointestinal Symptoms. Arq Gastroenterol. 2017;54(2):91-95.
- Quigley EM. Small intestinal bacterial overgrowth: what it is and what it is not. Current opinion in gastroenterology. 2014;30(2):141-146.
- Ghoshal UC, Shukla R, Ghoshal U. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut and liver. 2017;11(2):196-208.
- Sachdev AH, Pimentel M. Gastrointestinal bacterial overgrowth: pathogenesis and clinical significance. Therapeutic advances in chronic disease. 2013;4(5):223-231.
- Triantafyllou K, Chang C, Pimentel M. Methanogens, methane and gastrointestinal motility. J Neurogastroenterol Motil. 2014;20(1):31-40.
- Bures J, Cyrany J, Kohoutova D, et al. Small intestinal bacterial overgrowth syndrome. World JGastroenterol. 2010;16(24):2978-2990.
- Rezaie A, Pimentel M, Rao SS. How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Curr Gastroenterol Rep. 2016;18(2):8.
- Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA. 2004;292(7):852-858.
- Pimentel M, Funsalus R, Rao S, Zhang H. Methanogens in human health and disease. Am J Gastroenterol Suppl. 2012;1:28-33.
- de Lacy Costello BP, Ledochowski M, Ratcliffe NM. The importance of methane breath testing: a review. J Breath Res. 2013;7(2):024001.
- Kunkel D, Basseri RJ, Makhani MD, Chong K, Chang C, Pimentel M. Methane on breath testing is associated with constipation: a systematic review and meta-analysis. Digestive diseases and sciences. 2011;56(6):1612-1618.
- Rezaie A, Buresi M, Lembo A, et al. Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus. The American journal of gastroenterology. 2017;112(5):775-784.
- Costa MB, Azeredo Jr IL, Marciano RD, Caldeira LM, Bafutto M. Evaluation of small intestine bacterial overgrowth in patients with functional dyspepsia through H2 breath test. Arq Gastroenterol. 2012;49(4):279-283.
- Patil AD. Link between hypothyroidism and small intestinal bacterial overgrowth. Indian J Endocrinol Metab. 2014;18(3):307-309.
- Pimentel M, Wallace D, Hallegua D, et al. A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing. AnnRheumDis.2004;63(4):450-452.
- Chedid V, Dhalla S, Clarke JO, et al. Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Global advances in health and medicine: improving healthcare outcomes worldwide. 2014;3(3):16-24.
- Vantrappen G, Janssens J, Hellemans J, Ghoos Y. The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. The Journal of clinical investigation. 1977;59(6):1158-1166.
- Pimentel M, Morales W, Rezaie A, et al. Development and validation of a biomarker for diarrhea-predominant irritable bowel syndrome in human subjects. PloS one. 2015;10(5):e0126438.
- Grace E, Shaw C, Whelan K, Andreyev HJ. Review article: small intestinal bacterial overgrowth--prevalence, clinical features, current and developing diagnostic tests, and treatment. Alimentary pharmacology & therapeutics. 2013;38(7):674-688.
- Pimentel M, Chang C, Chua KS, et al. Antibiotic treatment of constipation-predominant irritable bowel syndrome. Digestive diseases and sciences. 2014;59(6):1278-1285.
- Pimentel M, Chatterjee S, Chow EJ, Park S, Kong Y. Neomycin improves constipation-predominant irritable bowel syndrome in a fashion that is dependent on the presence of methane gas: subanalysis of a double-blind randomized controlled study. Digestive diseases and sciences. 2006;51(8):1297-1301.
- Pimentel M, Lembo A, Chey WD, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. The New England journal of medicine. 2011;364(1):22- 32.
- Pimentel M, Morales W, Lezcano S, Sun-Chuan D, Low K, Yang J. Low-dose nocturnal tegaserod or erythromycin delays symptom recurrence after treatment of irritable bowel syndrome based on presumed bacterial overgrowth. Gastroenterol Hepatol (N Y). 2009;5(6):435-442.
- Ploesser J, Weinstock LB, Thomas E. Low dose naltrexone: side effects and efficacy in gastrointestinal disorders. International journal of pharmaceutical compounding. 2010;14(2):171-173.
- Cook S. Small Intestinal Bacterial Overgrowth: A clinician's guide to evaluation and treatment. 2017; http://www.naturalmedicinejournal.com/research-guide-library, 2017.
- Sandberg-Lewis S, Siebecker A. SIBO: Dysbiosis Has A New Name. Townsend Letter. 2015(February/March).
- Pimentel M. Review article: potential mechanisms of action of rifaximin in the management of irritable bowel syndrome with diarrhoea. Alimentary pharmacology & therapeutics. 2016;43 Suppl 1:37-49.
- Foxx-Orenstein AE, Camilleri M, Szarka LA, et al. Does co-administration of a non-selective opiate antagonist enhance acceleration of transit by a 5-HT4 agonist in constipation- predominant irritable bowel syndrome? A randomized controlled trial. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2007;19(10):821-830.
- Saller R, Pfister-Hotz G, Iten F, Melzer J, Reichling J. [Iberogast: a modern phytotherapeutic combined herbal drug for the treatment of functional disorders of the gastrointestinal tract (dyspepsia, irritable bowel syndrome)--from phytomedicine to "evidence based phytotherapy." A systematic review]. Forschende Komplementarmedizin und klassische Naturheilkunde = Research in complementary and natural classical medicine. 2002;9 Suppl 1:1-20.
- Malfertheiner P. STW 5 (Iberogast) Therapy in Gastrointestinal Functional Disorders. Digestive diseases. 2017;35 Suppl 1:25-29.
- Micklefield GH, Redeker Y, Meister V, Jung O, Greving I, May B. Effects of ginger on gastroduodenal motility. International journal of clinical pharmacology and therapeutics.
1999;37(7):341-346.
Optimal range: 0 - 20 ppm
Hydrogen increase over baseline by 90 minutes.
A rise of ≥ 20 ppm from baseline in hydrogen by 90 min should be considered a positive test to suggest the presence of SIBO
Optimal range: 0 - 10 ppm
Utilization of breath methane levels for SIBO assessment is controversial largely due to a lack of validation related to diagnostic specifics such as timing and magnitude of increase; however, CH4 measurements are increasingly obtained to address other clinical questions. Recent evidence has associated CH4 production with the pathogenesis of common clinical conditions, such as obesity, irritable bowel syndrome (IBS), and constipation.
Optimal range: 0 - 19.99 ppm
A combined H2 + CH4 increase of 12 ppm or more may be suggestive of small intestinal bacterial overgrowth.
Breath analysis standards for abnormal tests are suggested if an increase of 12ppm for Hydrogen (H2), 12ppm for Methane (CH4), or a combined 12ppm for Hydrogen (H2) & Methane (CH4) is detected. Only the treating clinician is able to determine if there are additional factors that could have a material impact on the results of this analysis.
A diagnosis can only be obtained from a medical professional that combines clinical information with the results of this breath analysis.
The results of this Hydrogen (H2) & Methane (CH4) breath test should be utilized as a guideline only.
Gut Zoomer by Vibrant Wellness
The Gut Zoomer by Vibrant Wellness is an advanced gut microbiome test designed to provide an in-depth analysis of bacteria, yeast, viruses, and parasites, along with key digestive and inflammatory markers. This test stands out for its ability to detect over 300 microbial species, making it one of the most comprehensive digestive health assessments available today.
If you struggle with leaky gut, gut dysbiosis, digestive issues, or inflammatory conditions, the Gut Zoomer can help identify microbial imbalances and guide personalized treatment strategies.
Your gut microbiome, located in the large intestine, consists of over 1,000 species of bacteria that play crucial roles in:
- Immune system regulation
- Nutrient metabolism
- Intestinal barrier integrity (gut lining protection)
An imbalanced gut microbiome (dysbiosis) has been linked to gastrointestinal disorders, skin conditions, autoimmune diseases, immune dysfunction, and chronic inflammation. Understanding your gut microbial composition is essential for maintaining optimal health and digestion.
Using proprietary microarray hybridization technology, the Gut Zoomer assesses:
- Microbial Diversity: Detects bacteria, fungi (Candida spp.), viruses, and parasites
- Inflammation & Gut Health Markers: Evaluates gut permeability (leaky gut), immune response, and intestinal inflammation
- Short-Chain Fatty Acid Metabolism: Measures SCFAs, which impact gut and metabolic health
- Digestive & Absorption Function: Analyzes enzyme activity and nutrient breakdown
This test goes beyond generic microbiome reports by categorizing findings into specific health-related groups (e.g., Gut Bacteria & Autoimmune Health), helping you pinpoint potential triggers of digestive and systemic conditions.
Additionally, the Gut Zoomer provides personalized probiotic recommendations, tailoring 35 probiotic strains based on your unique microbiome profile.
This test is beneficial for individuals experiencing:
- Chronic digestive symptoms (bloating, diarrhea, constipation, acid reflux)
- Leaky gut (intestinal permeability)
- Food intolerances & nutrient malabsorption
- Autoimmune conditions (IBD, Hashimoto’s, rheumatoid arthritis)
- Skin disorders (eczema, psoriasis, acne)
- Brain fog, fatigue, mood imbalances
- Frequent infections or weakened immunity
- One of the most comprehensive gut microbiome tests available
- Simultaneously detects over 300 microorganisms with advanced technology
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Optimal range: 60.2 - 72.7 %
Acetic Acid can inhibit the accumulation of body fat and hepatic lipids without altering food consumption. It suppresses body fat accumulation by upregulating genes necessary for fatty-acid oxidation and mitochondrial processing. It has been found to have an inhibitory effect on the conversion of glucose to fatty acids in the liver. It has also been suggested as a promising compound for improving obesity and obesity-linked type 2 diabetes.
Optimal range: 0 - 20 Units
Optimal range: 10 - 5000 Units
Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.
Optimal range: 0 - 20 Units
Atopobium is a genus of bacteria that resides in the human body, most notably in the gut, oral cavity, and urogenital tract. It is classified as a Gram-positive anaerobic bacterium, meaning it thrives in low-oxygen environments like the gastrointestinal tract. In small, balanced amounts, Atopobium plays a relatively neutral role in the gut microbiome. However, when levels become too high or too low, it can be a signal of microbial imbalance—also known as dysbiosis—that may contribute to various health issues.
On the Vibrant Wellness Gut Zoomer panel, Atopobium is measured to help assess your gut’s microbial composition and overall digestive health. This marker is part of a larger picture that helps determine if your gut is in balance—or if certain bacteria are overgrowing or missing.
Optimal range: 0 - 20 Units
The marker "β-glucuronidase producing bacteria" is a significant indicator of the bacterial enzyme activity within the gut microbiome. β-glucuronidase is an enzyme produced by certain bacteria that plays a crucial role in the metabolism of complex carbohydrates and the processing of various substances within the intestines. This enzyme helps to break down glucuronides, which are compounds that the body uses to detoxify and eliminate waste, including hormones, toxins, and pharmaceuticals, by attaching glucuronic acid to them, making them more water-soluble and easier to excrete through the bile or urine.
The presence and level of β-glucuronidase producing bacteria in your gut can provide valuable insights into your intestinal health and function. Elevated levels of this enzyme can lead to the reactivation of potentially harmful substances that were meant to be excreted, contributing to various health issues, including hormone imbalance, increased risk of certain cancers, and impaired detoxification processes. Conversely, too low levels may indicate a compromised ability to break down and eliminate waste properly. Understanding the balance and activity of β-glucuronidase producing bacteria through the Gut Zoomer panel allows healthcare providers to tailor specific dietary, lifestyle, and possibly supplementation interventions aimed at optimizing gut health, supporting detoxification processes, and ultimately contributing to overall well-being.
Optimal range: 0 - 20 Units
Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism.
Optimal range: 0 - 20 Units
The marker "Bacteroides vulgatus" is an indicator of the presence and balance of a specific type of bacteria within your gut microbiome. Bacteroides vulgatus is a species of bacteria that resides in the human intestine and plays a critical role in the digestive process. It's involved in breaking down complex carbohydrates, fiber, and proteins, assisting in the absorption of nutrients, and contributing to the body's immune response. In a balanced gut microbiome, Bacteroides vulgatus helps to maintain intestinal health, protect against harmful pathogens, and even regulate inflammation. However, an imbalance, where levels of Bacteroides vulgatus are either too high or too low, can be associated with various health issues, including digestive disorders, immune system dysfunctions, and increased risk of certain chronic diseases. The Gut Zoomer panel from Vibrant Wellness is a comprehensive test that provides detailed insights into the composition of your gut microbiome, including the levels of Bacteroides vulgatus. By understanding the balance of such bacteria in your gut, healthcare providers can offer targeted dietary recommendations, probiotics, or other interventions to help restore gut health and improve overall wellness.
Optimal range: 0 - 34.9 ng/mL
Beta defensin 2 is an antibiotic peptide locally regulated by inflammation in humans. It is produced by a number of epithelial cells and exhibits potent antimicrobial activity against Gram-negative bacteria and Candida, but not Gram-positive bacteria. It has been speculated that beta-defensin 2 may contribute to the infrequency of Gram-negative infections on skin and lung tissue.
Optimal range: 10 - 1000 Units
A common component of the microbiota of the human gastrointestinal tract and in particular are amongst the first bacterial colonizers of the intestine.
Optimal range: 10 - 100 Units
Optimal range: 10 - 100 Units
The marker "Bifidobacterium animalis" is an indicator of the presence and concentration of a particular strain of beneficial bacteria within the digestive system. Bifidobacterium animalis is a type of probiotic, which means it's a good microorganism that supports gut health and contributes to a balanced intestinal flora. It plays a crucial role in the digestion of dietary fibers, the production of important vitamins like vitamin K, and the support of the immune system. In a Gut Zoomer panel, which is a comprehensive test designed to provide a detailed look at the microbial landscape of the gut, the levels of Bifidobacterium animalis can provide insight into the overall health and balance of the gut microbiome. High levels of this bacterium are generally associated with a healthy gut, indicating good digestion, efficient nutrient absorption, and a strong barrier against pathogens. Conversely, low levels might suggest an imbalance, which could be linked to various digestive issues and may warrant dietary changes, probiotic supplementation, or further investigation. Essentially, this marker is a valuable piece of the puzzle in understanding gut health and can guide personalized nutrition and treatment plans aimed at optimizing gut function and overall well-being.
Optimal range: 10 - 100 Units
Bifidobacterium animalis subsp. lactis is a key probiotic marker in the realm of gut microbiome analysis. This bacterium is a member of the Bifidobacterium genus, which is highly regarded for its beneficial effects on gut health. B. animalis subsp. lactis is a Gram-positive, anaerobic, rod-shaped bacterium that is naturally present in the human gastrointestinal tract. It plays a crucial role in maintaining gut homeostasis, enhancing immune function, and potentially contributing to the prevention of gastrointestinal infections. This subspecies is particularly known for its ability to tolerate harsh gastrointestinal conditions, such as low pH and high bile salt concentrations, making it effective in colonizing and exerting its beneficial effects in the gut.
Optimal range: 10 - 100 Units
Bifidobacterium catenulatum is a beneficial bacterium that belongs to the Bifidobacterium genus—one of the most important and well-studied groups of microbes in the human gut. It is considered a commensal species, meaning it naturally coexists within your gastrointestinal tract and contributes positively to your health when present in balanced amounts.
Although it is more abundant in infants and children, B. catenulatum is also commonly found in the adult colon. It plays a key role in digesting complex carbohydrates, producing short-chain fatty acids, and supporting immune balance.
This bacterium is commonly included in stool microbiome tests like the Vibrant Wellness Gut Zoomer to evaluate the presence of protective microbes and the overall diversity of your gut microbiota.
Optimal range: 10 - 100 Units
Bifidobacterium dentium is a notable species within the Bifidobacterium genus, a key component of the human gut microbiome. This anaerobic, Gram-positive bacterium is particularly recognized for its role in the oral cavity, where it's often associated with dental caries (tooth decay), but it also inhabits the gastrointestinal tract. In the gut, Bifidobacterium dentium contributes to the fermentation of dietary fibers, producing beneficial metabolites such as short-chain fatty acids (SCFAs), which are crucial for maintaining gut barrier integrity, modulating the immune system, and potentially impacting mood and behavior through the gut-brain axis.
Optimal range: 10 - 100 Units
Bifidobacterium infantis is a highly specialized microbe ("beneficial bacteria") that resides in the gut microbiome.
Unlike most other bacteria in the gut microbiome, Bifidobacterium infantis (also known as "b infantis") is an inherited microbe, often being passed down from mother to child during child birth.
Once it takes up residence in the gut microbiome, Bifidobacterium infantis flourishes and helps to cultivate an environment where other beneficial bacteria can grow.
Optimal range: 10 - 100 Units
Bifidobacterium longum is a specific species of microscopic non-pathogenic bacteria found naturally in the gastrointestinal tracts of humans as well as in most other animals.
Optimal range: 0 - 20 Units
Blautia is a genus of bacteria that resides in the human gut and is involved in various important processes, including the fermentation of carbohydrates and the production of short-chain fatty acids like butyrate. Butyrate is especially vital as it serves as a primary energy source for colon cells, supports the integrity of the gut barrier, and modulates the immune response, thereby playing a crucial role in maintaining the overall health of the gastrointestinal tract.
Blautia has been linked to several health outcomes. For instance, a balanced presence of Blautia can contribute to a healthy gut environment, potentially protecting against certain diseases. Conversely, imbalances in Blautia levels have been associated with various conditions, including obesity, diabetes, and inflammatory bowel diseases like Crohn's disease and ulcerative colitis.
Optimal range: 0 - 20 Units
The Bradyrhizobiaceae is a family of bacteria within the order Rhizobiales, known primarily for their role in nitrogen fixation in soil. However, their presence in the human gut microbiome, although less commonly discussed, is gaining attention for potential health implications. These bacteria are Gram-negative and possess unique metabolic capabilities that could influence gut health. In the context of the gut microbiome, the role of Bradyrhizobiaceae is not as extensively studied as other bacterial families, yet emerging research suggests they might contribute to the metabolic diversity of the gut flora.
Optimal range: 5.1 - 12.4 %
N-Butyrate is one of the short-chain fatty acids produced by Lactobacillus and Bifidobacteria in the colon. It becomes a food supply capable of providing up to 30% of the energy needed by colon cells. N-butyrate improves colon health.
Optimal range: 10 - 100 Units
Butyricimonas represents a genus of bacteria within the gut microbiome that plays a pivotal role in intestinal health through its metabolic activities. These bacteria are anaerobic, Gram-negative, and belong to the phylum Bacteroidetes. They are notable for their ability to ferment polysaccharides, complex carbohydrates, and fibers, leading to the production of butyrate - a short-chain fatty acid (SCFA) crucial for maintaining colonic health. Butyrate serves several key functions: it is the primary energy source for colonocytes (cells lining the colon), helps in maintaining the integrity of the gut barrier, possesses anti-inflammatory properties, and plays a role in modulating immune responses.
Optimal range: 10 - 100 Units
‘Butyrivibrio‘ is a genus of bacteria in Class Clostridia. Butyrivibrio crossotus are often found in the human gut and inversely associated with obesity.
Optimal range: 0 - 50 mcg/g
Calprotectin is a marker of inflammation in the gut. Although it is not diagnostic of inflammatory bowel disease, calprotectin can indicate the possibility of Crohn’s disease, chronic ulcerative colitis, and/or the overuse of NSAID medication.
Optimal range: 0 - 110 Units
What is Candida spp.?
Candida is a genus of yeast that naturally resides in the human body, particularly in the gastrointestinal (GI) tract, mouth, skin, and vaginal flora. In small amounts, Candida plays a role in digestion and immune function. However, an overgrowth can lead to various symptoms and health concerns.
Optimal range: 10 - 100 Units
Catenibacterium, a lesser-known but significant genus of bacteria in the gut microbiome, is gaining attention in gut health assessments, including comprehensive gut tests. These bacteria are part of the natural flora of the human gastrointestinal tract and play a role in the complex ecosystem of the gut. While not as extensively studied as other genera like Lactobacillus or Bifidobacterium, Catenibacterium has been implicated in various functions that are crucial for maintaining gut health and overall well-being.
Optimal range: 0 - 1.25 %
Chenodeoxycholic acid (CDCA), also known as chenodiol, usually conjugates with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones.
Optimal range: 0 - 0.36 %
Cholic acid (CA), Chenodeoxycholic acid (CDCA), Deoxycholic acid (DCA), Lithocholic acid (LCA) are the major bile acids related to gut microbiome.
Bile Acids are natural products of cholesterol synthesis that aid in the emulsification and absorption of dietary fats in the small intestine. Elevated total fecal bile acid is indicative of a diagnosis of bile acid malabsorption. Quantification of fecal bile acids aids in diagnosis for IBS and identification of patients with chronic diarrhea who may benefit from bile acid sequestrant therapy. There is a connection between the liver health, fecal bile acid concentrations, and gut microbiota composition. Bile acids have both direct antimicrobial effects on gut microbes and indirect effects through FXR-induced antimicrobial peptides.
Optimal range: 0 - 20 Units
Optimal range: 10 - 100 Units
Clostridia clusters XIVa represent a significant component of the human gut microbiome, particularly within the Firmicutes phylum. This cluster is predominantly composed of anaerobic, Gram-positive bacteria. These organisms are known for their diverse metabolic capabilities, which play a crucial role in the fermentation of dietary fibers and the production of short-chain fatty acids (SCFAs) like butyrate, propionate, and acetate. Butyrate, in particular, is vital for maintaining colonic health, as it serves as the primary energy source for colonocytes, aids in the maintenance of the gut barrier function, and exhibits anti-inflammatory properties. The presence and abundance of Clostridia clusters XIVa, as measured in such panels, can provide valuable insights into gut health, with deviations from normal levels being potentially indicative of dysbiosis or altered gut function.
Optimal range: 10 - 100 %
The marker "Clostridiales Family XIV Incertae Sedis" pertains to a specific, yet not fully classified, group within the Clostridiales order, underlining the complexity and ongoing exploration in the realm of gut microbiota research. This group, labeled "Incertae Sedis," meaning "of uncertain placement," comprises bacteria that have not yet been definitively categorized into a known family due to the current limitations in bacterial taxonomy and the rapid evolution of genomic sequencing technologies. These microorganisms, residing in the human gastrointestinal tract, are anaerobic and predominantly Gram-positive. They play a pivotal role in the gut ecosystem, primarily involved in the fermentation of dietary fibers and the resultant production of short-chain fatty acids (SCFAs), like butyrate, propionate, and acetate.
Optimal range: 0 - 20 Units
Clostridium spp. is part of the intestinal indigenous microbiota and they can produce several endogenous infections.
- Clostridia are one of the most commonly studied anaerobes that cause disease in humans.
- The Clostridium genus contains more than 100 species.
- Clostridia spp are vegetative cells that are rod shaped and arranged in pairs or short chains.
- Clostridium genus bacteria are often described as a biological threat but many of them have positive properties and are used in cosmetic and medicine manufacturing.
- Clostridia typically live in dust, soil, water and in human and animal intestines.
- When the environment is hostile, Clostridia produce spores which are resistant to many disinfectants, including some with antimicrobial properties.
- The odour produced by the Clostridia metabolism can be likened to that of mud, manure and the decay of plant materials.
Optimal range: 0 - 20 Units
Clostridium hathewayi is a notable marker in the study of the human gut microbiome. This bacterium, belonging to the Clostridiaceae family, is an anaerobic, spore-forming, Gram-positive microorganism. It has garnered attention in scientific circles due to its association with various gastrointestinal disorders and conditions. Clostridium hathewayi is known for its role in the fermentation processes within the gut, contributing to the breakdown of proteins and amino acids. This process can lead to the production of biologically active compounds, some of which may have detrimental effects, such as increased gut permeability and inflammation.
Optimal range: 0 - 20 Units
Clostridium ramosum is a type of bacteria that can be found in the human gut, and its levels can be analyzed through a Gut Zoomer panel by Vibrant Wellness. This panel is a comprehensive test designed to give a detailed look into the microbial ecosystem residing in your gut. It helps to understand how the balance of bacteria and other organisms in the gut can influence your overall health. Specifically, "Clostridium ramosum" is part of a larger family of bacteria, some of which are known to play roles in both health and disease. In a healthy gut, "Clostridium ramosum" exists in balance with other microbes, contributing to the digestion of food, the synthesis of essential vitamins, and the strengthening of the immune system. However, if its levels become too high or too low, it might indicate a disturbance in the gut microbiome, which could be linked to various health issues, including digestive disorders, nutrient absorption problems, and even impacts on mental health.
Optimal range: 0 - 20 Units
Optimal range: 0 - 20 Units
Optimal range: 0 - 20 Units
Optimal range: 10 - 100 Units
Coprococcus, a genus of bacteria within the gut microbiome, is often analyzed in gut health tests to assess its levels and overall contribution to intestinal health. Belonging to the Firmicutes phylum, Coprococcus plays a significant role in the complex ecosystem of the gut. It is known for its involvement in the fermentation of dietary fibers and the production of important metabolic byproducts, such as short-chain fatty acids (SCFAs). SCFAs, including butyrate, are vital for maintaining the health of the intestinal lining, providing energy to colon cells, and regulating inflammation and immune function.
The presence and abundance of Coprococcus in the gut can be influenced by various factors. Diet, particularly the intake of fiber-rich foods like vegetables, fruits, whole grains, and legumes, significantly impacts the levels of Coprococcus, as these bacteria thrive on the fibers found in these foods. A diet lacking in such fibers can lead to a decrease in Coprococcus, affecting the overall balance and health of the gut microbiome. Additionally, lifestyle factors like stress, sleep patterns, and physical activity, as well as the use of medications like antibiotics, can also influence the levels of these bacteria.
Optimal range: 24.25 - 75.84 %
Deoxycholic acid (DCA) is a bile acid which emulsifies and solubilizes dietary fats in the intestine, and when injected subcutaneously, it disrupts cell membranes in adipocytes and destroys fat cells in that tissue.
Optimal range: 0 - 20 Units
Desulfovibrio, a genus of bacteria in the human gut identified through microbiome testing, plays a role in reducing sulfate to hydrogen sulfide. These anaerobic bacteria are influenced by diet, particularly sulfur-rich foods, and the overall health of the gut microbiota. While Desulfovibrio contributes to the gut's sulfur cycle under normal conditions, an overgrowth is associated with health issues like inflammatory bowel diseases, attributed to excessive hydrogen sulfide production. Managing their levels typically involves dietary modifications to reduce sulfur intake and increase fiber, alongside probiotics and prebiotics to promote a balanced gut microbiota. In cases where elevated Desulfovibrio is linked to gastrointestinal conditions, healthcare professionals may recommend further diagnostics and tailored medical interventions to restore microbial balance and address individual health needs.
Optimal range: 0 - 20 Units
Desulfovibrio piger, detected in a gut microbiome test, is a significant bacterium of interest due to its unique characteristics and potential implications for gut health. It is a species of sulfate-reducing bacteria, meaning it uses sulfate as a terminal electron acceptor in its metabolic processes. This bacterium is anaerobic, thriving in environments without oxygen. In the context of the human gut, its presence and abundance can be noteworthy. Desulfovibrio piger is known to play a role in the sulfur cycle within the gut ecosystem, converting sulfate to hydrogen sulfide, a gas that, in high concentrations, can have detrimental effects on the gut lining and overall intestinal health.
Optimal range: 0 - 20 Units
Dorea is a genus of bacteria that resides in the human gut as part of the normal intestinal microbiome. It is a Gram-positive, anaerobic bacterium from the Lachnospiraceae family, a group known for producing short-chain fatty acids and fermenting dietary fiber.
Although Dorea is considered a commensal organism (not inherently harmful), its presence and abundance in the gut can offer clues about your digestive efficiency, gas production, inflammation levels, and overall microbial balance.
Optimal range: 0 - 20 Units
Eggerthella lenta is a normal human microflora that is anaerobic, non-sporulating, and Gram positive. However, an increasing number of studies have shown that it could also be an important pathogen for humans, even causing life-threatening infection under certain conditions. However, understanding its pathogenic mechanism and treatment options still need to be improved; more clinical data are needed to explore it further. The frequency of E. lenta bacteremia is increased in patients with hematologic or solid organ cancer, diabetes mellitus and also in those with appendicitis.
Optimal range: 0 - 20 Units
Enterobacteriaceae plays a pivotal role in gut dysbiosis associated with IBD pathogenesis and progression.
Optimal range: 0 - 20 Units
Enterococcus species, when detected in a gastrointestinal (GI) test, can provide important insights into the health and balance of the gut microbiome. These bacteria are part of the normal intestinal flora in humans and animals and typically coexist harmlessly within the gut ecosystem. The most commonly identified species in clinical settings are Enterococcus faecalis and Enterococcus faecium. In a balanced gut environment, Enterococcus species contribute to digestive processes and can even play a role in protecting against harmful pathogens. However, their significance in a GI test must be interpreted with caution, as these species can also act as opportunistic pathogens, especially in individuals with a weakened immune system or in hospital settings.
Optimal range: 0 - 2000 Units
Enterotoxigenic Escherichia coli (ETEC) LT is a significant marker for gastrointestinal health analysis. ETEC is a leading cause of traveler's diarrhea and is also a common contributor to diarrheal illnesses in developing countries, particularly affecting children. The "LT" in ETEC LT refers to the heat-labile enterotoxin produced by these bacteria. This toxin, similar in structure and function to cholera toxin, disrupts normal intestinal function by increasing the secretion of water and electrolytes in the small intestine, leading to diarrhea. The presence of ETEC LT in the gut microbiome is an indicator of an active or recent infection.
Optimal range: 0 - 20 Units
Optimal range: 10 - 1000 Units
Eubacterium spp. are of only minor clinical importance. They are normal flora of the intestinal tract and cause infection under opportunistic conditions.
Optimal range: 10 - 100 Units
Eubacterium rectale (E. rectale), which accounts for up to 13% of the gut microbiota in total feces in the human colon and thus, is one of the most prevalent bacterial species, is a major contributor to the production of butyrate. People with Crohn’s disease, rheumatoid arthritis (RA), and ulcerative colitis have significantly reduced amounts of Eubacterium rectale, and these people have lower butyrate concentrations in their feces than healthy individuals.
Optimal range: 10 - 100 Units
Faecalibacterium prausnitzii is one of the most important bacteria in the human gut flora and makes up to 5-10% of the total number of bacteria detected in stool samples from healthy humans. Faecalibacterium prausnitzii has a crucial role in maintaining gut physiology and host wellbeing.
Optimal range: 0 - 148 U/L
Antigliadin antibodies (AGAs) are antibodies of the IgA and IgG classes found in the serum of celiac disease patients. These antibodies mainly target gliadin-derived peptides, which are the main proteins of gluten. AGAs are not specific for celiac disease as they are also found in patients with other gastrointestinal diseases such as gastritis, gastroenteritis, and IBD.
Optimal range: 0 - 4.8 mcg/g
Eosinophil Protein X (EPX) is a water-soluble protein that is found in eosinophils.
EPX levels in stool are a marker of eosinophil activity in the gastrointestinal system. Fecal EPX abnormality is suggestive of food allergy, eosinophil-driven inflammation (caused by parasites). The test has been shown to have higher specificity and positive predictive value for detecting disease activity in inflammatory bowel disease compared to fecal calprotectin.
Optimal range: 0 - 6.4 mcg/mL
Lactoferrin is a glycoprotein released by a type of white blood cell called neutrophil.
Fecal lactoferrin levels are helpful in monitoring disease activity and efficacy of treatment for IBD.
Optimal range: 0 - 10 mcg/g
Fecal occult blood testing (FOBT) checks stool samples for hidden (occult) blood loss from the mouth to the colon.
Optimal range: 6.1 - 7.8 pH
A fecal pH test is one where a specimen of feces is tested for acidity in order to diagnose a medical condition.
- Human feces is normally acidic.
- The average pH for a healthy person is a pH of 6.6.
Fecal pH is dependent in part on fermentation of sugars. Colonic fermentation of normal amounts of carbohydrate sugars and production of fatty acids accounts for the normally slightly acidic pH.
Optimal range: 25.1 - 160.8 ng/mL
Fecal zonulin is a biomarker of intestinal permeability, often referred to as “leaky gut.” Zonulin is a protein that regulates the tight junctions between intestinal cells. When zonulin levels rise, these junctions loosen, allowing larger molecules — such as food proteins, toxins, or microbes — to pass into the bloodstream, which can trigger inflammation and immune responses.
Measuring zonulin in stool is considered more gut-specific than serum testing, since blood levels can also be influenced by production in other organs like the liver, heart, and brain. Elevated fecal zonulin has been associated with conditions such as celiac disease, non-celiac gluten sensitivity, Crohn’s disease, ulcerative colitis, IBS-D, metabolic syndrome, obesity, type 1 diabetes, and autoimmune disorders. Lifestyle factors like smoking, stress, and processed food intake can also affect zonulin release.
Fecal zonulin is most informative when used alongside other stool markers (such as calprotectin, secretory IgA, or anti-gliadin IgA) to help assess gut barrier integrity and distinguish between inflammatory bowel disease and other gastrointestinal disorders.
Optimal range: 0 - 20 Units
Genus of gram-negative bacteria in the Fusobacteria phylum. Commonly found in the oral cavity, and may also be found in the intestine. Associated with inflammatory processes, as well as autoimmune conditions such as systemic sclerosis.
Autoimmune Association: Systemic sclerosis or inflammatory bowel disease
Fusobacterium in the gut microbiome is noteworthy due to its association with various gastrointestinal conditions. Its balance is influenced by factors like diet, oral health, and gut microbiota composition. Managing its levels involves dietary and oral hygiene interventions, and potentially probiotic supplementation and medical treatments, all aimed at maintaining a healthy and diverse gut microbiome.
Optimal range: 0 - 400 Units
Giardia lamblia—also known as Giardia intestinalis or Giardia duodenalis—is a microscopic protozoan parasite that infects the small intestine. It is one of the most common causes of parasitic gastrointestinal infections worldwide, affecting both children and adults.
Giardia spreads through contaminated water, food, or surfaces, and is especially common in areas with poor sanitation or in people who travel, camp, or drink untreated water.
On stool testing panels like the Vibrant Wellness Gut Zoomer, Giardia lamblia is included to detect active parasitic infections that may be causing symptoms like diarrhea, fatigue, or malabsorption.
Optimal range: 0 - 20 Units
Optimal range: 10 - 100 Units
Lactobacillus species is a type of bacteria. There are lots of different species of lactobacillus.
Lactobacillus bacteria are commonly found in the human gut, mouth and vagina. They are considered generally as “good bacteria”, and in fact may contribute to good health, often being included in probiotic supplements. These bacteria are characterized by their ability to produce lactic acid as a byproduct of glucose metabolism.
Optimal range: 10 - 100 Units
L. acidophilus is a probiotic bacteria that naturally occurs in the human gut and other parts of the body. This bacteria helps the digestive system break down sugars, such as lactose, into lactic acid.
Optimal range: 10 - 100 Relative Abundance
Lactobacillus animalis is a key marker of gut health, reflecting the composition and functional state of the gastrointestinal microbiome. This bacterium is a member of the Lactobacillus genus, which is well-known for its role in promoting gut health and forming part of the natural microbiota of the human gastrointestinal tract. Lactobacillus animalis is a lactic acid-producing bacterium, characterized by its ability to ferment sugars into lactic acid, thereby contributing to the acidic environment in the gut that inhibits the growth of harmful bacteria.
Optimal range: 10 - 100 Units
"Lactobacillus brevis" serves as a fascinating marker of your gut health, offering a glimpse into the complex ecosystem of bacteria residing in your digestive system. This specific bacterium is part of the Lactobacillus genus, a group of bacteria known for their role in promoting a healthy gut. They achieve this by producing lactic acid, which helps to maintain an acidic environment in the gut, inhibiting the growth of harmful bacteria. Lactobacillus brevis, in particular, is noteworthy for its potential benefits, which include supporting the immune system, enhancing the absorption of nutrients, and possibly even contributing to mental well-being through the gut-brain axis. However, it's also important to have a balanced amount of Lactobacillus brevis, as an overabundance can sometimes lead to issues, depending on an individual's unique gut flora composition and overall health.
Optimal range: 10 - 100 Units
Lactobacillus d. bulgaricus (L. d. bulgaricus) is a beneficial bacteria found in the digestive tract. Intestinal bacteria is referred to as gut flora or microbes. This strain of bacteria may also be found in foods or supplements. When it’s consumed, it’s referred to as probiotics.
Optimal range: 10 - 100 Units
Optimal range: 10 - 100 Units
Optimal range: 10 - 100 Units
Lactobacillus Plantarum have been shown to:
- Alleviate the symptoms of IBS
- Help treat Small Intestinal Bacterial Overgrowth.
- Accelerate the healing of intestines after illness.
- Mitigate allergic reactions to foods such as soy flour.
There is also evidence that Lactobacillus Plantarum may help in the treatment and prevention of depression and dementia.
Optimal range: 10 - 100 Units
Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation.
Optimal range: 10 - 100 Units
Lactobacillus rhamnosus, a probiotic with good survival capacity in the human gut, has well-documented adhesion properties and health effects.
Optimal range: 0 - 20 Units
Optimal range: 10 - 100 Units
Lactococcus is a genus of Gram-positive, lactic acid-producing bacteria that plays a prominent role in food fermentation and, to a lesser extent, in the human microbiome. You’ll often find Lactococcus species like Lactococcus lactis in fermented dairy products, including cheese, buttermilk, and yogurt.
While Lactococcus is not a dominant member of the gut microbiota, it is sometimes present in small amounts, especially in people who consume a lot of fermented foods or probiotic-rich diets. It is considered a non-pathogenic, commensal bacterium—meaning it generally coexists peacefully in the gut without causing harm.
On microbiome panels like the Vibrant Wellness Gut Zoomer, Lactococcus is measured to assess the presence of less-common, fermentation-associated microbes and to help identify patterns of microbial imbalance or overgrowth.
Optimal range: 0.32 - 3.38 Ratio
LCA and DCA are secondary bile acids. These secondary bile acids are associated with disease. An LCA:DCA ratio greater than 1 is associated with increased risk of gallstones, breast cancer, and colorectal cancer.
Optimal range: 10 - 100 Units
The marker "Leuconostoc" is designed to provide insight into the presence and levels of Leuconostoc bacteria in your gut microbiome.
Leuconostoc is a genus of bacteria that is often associated with the fermentation process of various foods and beverages, such as sauerkraut, kimchi, and some dairy products. In the context of gut health, Leuconostoc can play a beneficial role by contributing to the fermentation process within the intestine, which can help in the production of certain vitamins and the improvement of digestive health.
However, like many aspects of the gut microbiome, balance is key. An overabundance or deficiency of Leuconostoc can indicate an imbalance in the gut flora, which might be associated with various health issues, including digestive disorders or impaired immune function.
Optimal range: 24.16 - 75.75 %
Lithocholic acid (LCA) is a bile acid formed from chenodeoxycholate by bacterial action, usually conjugated with glycine or taurine. It acts as a detergent to solubilize fats for absorption and is itself absorbed.
Optimal range: 0.9 - 28.1 mg/g
Long chain fatty acids are a fecal fat. Fecal fats also include triglycerides, cholesterol and phospholipids. They are derived predominately from the dietary ingestion of fat, and provide important clues about digestion and absorption.
Optimal range: 0 - 575 ng/mL
Lysozyme is an enzyme that catalyzes the hydrolysis of specific glycosidic bonds in mucopolysaccharides that constitute the cell wall of gram-positive bacteria. Lysozyme is an antibacterial defense present in the G.I. tract and is secreted by granulocytes, macrophages, Paneth cells, and Brunner's Glands as well as normal colonic crypt cells. The main source for fecal lysozyme is the intestinal granulocytes.
Reference range: Detected, Not Detected
Presence of meat fibers is indicative of improper chewing or digestive insufficiency.
Optimal range: 0 - 20 Relative Abundance
Optimal range: 0 - 20 Units
Methanobrevibacter smithii, a prominent archaeon (=a microorganism) in the human gut microbiome, is frequently identified in comprehensive gut health tests and plays a pivotal role in the intricate ecosystem of our digestive system. This microorganism is renowned for its ability to process hydrogen and carbon dioxide, producing methane as a byproduct, and thus, it significantly impacts the overall efficiency of the gut's fermentation processes.
Optimal range: 0 - 20 Units
Micrococcus is a genus of bacteria commonly found in various environments, including soil, water, and human skin. While typically harmless, the presence of Micrococcus in the gut can provide valuable insights into an individual's gut health. These bacteria are generally considered part of the normal flora of the human body, playing a role in maintaining the balance of microbial communities. However, an overgrowth or imbalance of Micrococcus in the gut may indicate underlying issues such as dysbiosis, which is an imbalance in the microbial ecosystem that can lead to various health problems.
Optimal range: 0 - 0.2 ng/mL
MMP-9 is an important marker of intestinal inflammation. It has been shown to be significantly increased in the stool of UC patients compared with healthy controls and patients with IBS, and was found to correlate with the clinical and endoscopic activity of UC.
Optimal range: 200 - 1000 mcg/g
Pancreatic Elastase is an enzyme produced by exocrine tissue in the pancreas. Fecal pancreatic elastase is a non-invasive marker of exocrine pancreatic function. In the digestive tract, elastase is not broken down by other enzymes and is eventually eliminated from the body in the stool. Elastase can be detected and measured in the stool when a person's pancreas is functioning normally. The level in the stool is decreased when the exocrine tissues of the pancreas are not producing sufficient elastase and other digestive enzymes.
Optimal range: 0 - 20 Units
Peptostreptococcus is a type of bacteria that is part of the normal flora in the human gut but can become noteworthy under certain conditions. The Gut Zoomer panel is a comprehensive test designed to provide a detailed look at the microbial environment within the gastrointestinal tract, offering insights into the balance of beneficial and potentially harmful bacteria. Peptostreptococcus, in this context, is highlighted because its levels can have implications for an individual's health. When in balance, Peptostreptococcus plays a role in the normal processes of the gut, such as helping in the breakdown of proteins and other substances. However, if its levels become too high, it may indicate an imbalance in the gut microbiota, which can be associated with various health issues, including inflammatory conditions and infections. The presence and concentration of Peptostreptococcus, as identified by the Gut Zoomer panel, can therefore provide valuable information for diagnosing gut health issues and guiding treatment decisions. It's essential to interpret these results within the broader context of an individual's health, symptoms, and other test outcomes, ideally under the guidance of healthcare professionals familiar with gut health and the microbiome.
Optimal range: 0 - 20 Units
Optimal range: 10 - 100 Units
Prevotella spp. is known for its ability to degrade complex plant polysaccharides (carbohydrates) and fiber.
The "Prevotella" marker is a critical component for understanding the microbial landscape of the human gut. Prevotella is a genus of bacteria that is of particular interest in these analyses because it is commonly found in the human gastrointestinal tract. Its presence and abundance can tell us a lot about a person's diet, health status, and risk for certain diseases.
Prevotella species are known to thrive on a carbohydrate-rich diet, particularly those high in fibers such as fruits, vegetables, and whole grains. Thus, higher levels of Prevotella in the gut microbiome can indicate a diet rich in these foods. Some studies [L, L] suggest a correlation between Prevotella and improved gut health and lower inflammation, while others have noted its association with certain inflammatory diseases and conditions such as rheumatoid arthritis, indicating its dual role in health and disease.
Optimal range: 10 - 100 Units
Prevotella copri is a gut bacteria that may cause rheumatoid arthritis. Studies consistently find different bacterial patterns in people with inflammatory arthritis vs controls.
Optimal range: 15.4 - 30.3 %
Propionate is among the most common short-chain fatty acids produced in the human gut in response to indigestible carbohydrates (fiber) in the diet.
Optimal range: 10 - 1000 Units
Propionibacterium is a genus capable of producing SCFAs, predominantly acetate and propionic acid.
The genus Propionibacterium consists of two principal groups, cutaneous and classical or dairy. Cutaneous species are predominant members of the microbial population of human skin and have also been isolated from the feces of humans and other vertebrate animals. They are often considered opportunistic organisms and have been occasionally associated with infections in humans.
Optimal range: 10 - 100 Units
Propionibacterium freudenreichii, identified in a gut microbiome test, is a significant bacterium that offers intriguing insights into the health and balance of the gut ecosystem. This species is part of the Propionibacterium genus, known for its unique metabolic properties, particularly in the production of propionic acid – a beneficial short-chain fatty acid (SCFA) with several important roles in gut health. SCFAs, like propionic acid, are crucial for maintaining the health of the colon, regulating the immune system, and ensuring the integrity of the gut barrier.
Optimal range: 0 - 20 Units
Opportunistic Bacteria associated with Autoimmunity.
Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals can be a source.
Optimal range: 10 - 100 Units
Roseburia is a genus (=group) of 5 species of bacteria named in the 1980s after American microbiologist Theodor Rosebury. Bacteria in this genus are notable for breaking down sugar, and producing a short-chain fatty acid called butyrate which is important as a food for the cells lining the colon.
Optimal range: 0 - 20 Units
Ruminococcus obeum, identified in a gut microbiome test, is a bacterium of considerable interest due to its role in the complex ecosystem of the human gut. As a member of the Ruminococcaceae family, it is part of a group of bacteria that are key players in the breakdown of complex carbohydrates and fibers, contributing significantly to the fermentative processes in the gut. This fermentative activity is crucial for the production of short-chain fatty acids (SCFAs), like butyrate, which are vital for maintaining colon health, regulating the immune system, and ensuring the integrity of the gut barrier.
Optimal range: 0 - 4.8 mcg/g , 0 - 48 mcg/mL
Fecal S100A12 is a novel noninvasive marker that distinguishes children with active IBD from healthy control subjects. Anti-inflammatory diet along with supplements such as fish oils, and N-acetyl glucosamine should be considered.
Optimal range: 0 - 210 Units
Sapovirus I, detected in a gut test, is a significant indicator of gastrointestinal health, particularly in the context of viral infections. Sapovirus, a member of the Caliciviridae family, is known for causing acute gastroenteritis, primarily in children and infants, but it can also affect adults. These viruses are typically transmitted through the fecal-oral route, often due to contaminated food or water, or close contact with infected individuals. The presence of Sapovirus I in a gut test indicates a recent or ongoing infection, which can be responsible for symptoms such as diarrhea, vomiting, abdominal pain, and sometimes fever and dehydration.
Optimal range: 0 - 210 Units
Optimal range: 426 - 1450 mcg/g
SIGA (Secretory IgA) is the primary antibody that is protecting us from pathogens and toxins from penetrating mucosal surfaces. Its role is crucial in protecting the integrity of the intestinal epithelium. The antibody blocks the access to the epithelial receptors and traps pathogens and toxins in the mucus which are then excreated by peristaltic movements.
Optimal range: 0 - 20 Units
Solobacterium moorei is an intriguing and less commonly known marker in the analysis of gut microbiota. This bacterium belongs to the Clostridia class and is a Gram-positive, anaerobic species. It has been relatively recently identified and characterized in the context of human gut flora. Solobacterium moorei is noteworthy for its association with oral and gastrointestinal malodor, as it is known to produce volatile sulfur compounds (VSCs) which are often linked to conditions such as halitosis.
Optimal range: 0 - 20 Units
Staphylococcaceae, a family of bacteria that includes the well-known genus Staphylococcus, is sometimes detected in gut microbiome tests. These tests analyze the diverse array of microorganisms present in the gastrointestinal tract, providing insights into the health and balance of the gut microbiome. Staphylococcaceae are more commonly associated with skin flora, but they can also be found in the gut, where their presence and levels can have various implications.
In a healthy individual, Staphylococcaceae in the gut usually exist in small numbers as part of the normal microbiota. However, their overgrowth or presence in higher-than-normal concentrations can be indicative of an imbalance or dysbiosis in the gut microbiome. Such an imbalance can be influenced by several factors, including dietary habits, antibiotic usage, and overall gut health. For instance, a diet high in processed foods and sugars, low in fiber, or a course of broad-spectrum antibiotics can disrupt the delicate balance of gut flora, potentially leading to an increase in Staphylococcaceae.
Optimal range: 0 - 20 Units
Staphylococcus epidermidis is a crucial microbial marker in the context of human gut health and overall microbiome analysis. As a member of the Staphylococcus genus, S. epidermidis is a Gram-positive, facultative anaerobe that is part of the normal human flora, predominantly residing on the skin but also found in the gut. Traditionally regarded as a benign commensal organism, S. epidermidis plays a significant role in the maintenance of skin barrier function and has been shown to possess probiotic properties that benefit gut health. It contributes to the inhibition of pathogenic bacterial colonization by competing for nutrients and space, and through the production of antimicrobial peptides.
Optimal range: 0 - 20 Units
Staphylococcus pasteuri is a species of bacteria from the Staphylococcus genus, a group that includes both harmless skin microbes and some well-known pathogens like Staphylococcus aureus. S. pasteuri is considered a coagulase-negative staphylococcus (CoNS)—generally less aggressive than its more pathogenic relatives.
Originally isolated from dairy products and human skin, Staphylococcus pasteuri is not a dominant member of the human gut microbiome. Its presence in stool or gut microbiome tests, such as the Vibrant Wellness Gut Zoomer, may signal environmental contamination, translocation, or microbial imbalance (dysbiosis), especially if found in elevated amounts.
Optimal range: 0 - 20 Units
The marker "Staphylococcus species" on a Gut Zoomer panel by Vibrant Wellness refers to a group of bacteria included in the extensive testing to assess the health and diversity of an individual's gut microbiome. Staphylococcus is a genus of bacteria, some species of which are harmless and naturally reside in the human body, including the skin and nasal passages, while others can be pathogenic and cause infections. In the context of the Gut Zoomer panel, the presence, absence, or abundance of Staphylococcus species helps provide insights into the microbial balance within the gut. A balanced gut microbiome is crucial for digestive health, immune function, and overall well-being. An overgrowth of pathogenic Staphylococcus species could potentially lead to undesirable symptoms and may indicate an imbalance in gut flora or an increased risk for certain health conditions. Conversely, the normal presence of non-pathogenic Staphylococcus species can be a part of a healthy gut microbiome.
Optimal range: 0 - 20 Units
Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.
Optimal range: 10 - 100 Units
Streptococcus thermophilus belongs to a group of bacteria called lactic acid bacteria.
Lactic acid bacteria are found in fermented foods such as yogurt and cheese. Streptococcus thermophilus are used as so-called "probiotics," the opposite of antibiotics. "Friendly" bacteria such as Streptococcus thermophilus can help us break down food, absorb nutrients, and fight off "unfriendly" organisms that might cause diseases such as diarrhea.
Optimal range: 0.5 - 5.3 mg/g
Total Cholesterol represents the combined level of cholesterol in the blood, encompassing low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and very low-density lipoprotein (VLDL) cholesterol. Cholesterol is a type of lipid essential for various bodily functions, including the formation of cell membranes, production of hormones, and synthesis of vitamin D.
Optimal range: 0.5 - 5.3 mg/g
Elevated levels of Cholesterol in the stool may indicate inadequate absorption.
Optimal range: 2.9 - 37.5 mg/g
The Fecal Fat test helps your doctor identify if you have pancreatic or intestinal disorders. It can also show that enzymes, which are prescribed are working in the case of known malabsorption disorders.
Optimal range: 0.3 - 2.5 mg/g
Since most of the dietary fat is composed of triglycerides, excess fecal triglyceride levels indicate incomplete fat hydrolysis (maldigestion). This is possibly due to inadequate pancreatic secretion or activation of pancreatic lipase, which can cause excessive, unhydrolyzed triglycerides to be excreted in the feces.
Optimal range: 0.3 - 6.4 mg/g
About one-third of the total fats in blood serum is composed of phospholipids, a fat containing phosphorus. A big proportion of these phospholipids is lecithin, which contains choline phosphate plus glycerol combined together on one part of the molecule.
There’s an enzyme called lecithin-cholesterol acyltransferase (LCAT) that is responsible for transesterifying free cholesterol with fats derived from lecithin. The LCAT is important for lipoprotein particle remodeling; for example, converting HDL, LDL, and VLDL to other lipoprotein particles.
Optimal range: 0.3 - 6.4 mg/g
Optimal range: 45.4 - 210.1 micromol/g
Short Chain Fatty Acids (SCFA) are the products of fermentation of insoluble fiber from diet (e.g., cellulose, resistant starch) by the bacteria in the gut. These fatty acids have been shown to play an important role in regulating metabolism in the gut and are closely associated with gastrointestinal diseases. Acetic acid, propionic acid, and butyric acid are the most abundant, representing 90-95% of the SCFA present in the colon. A total of 13 SCFAs are quantified in stool to assist assessment of the gut health and inflammation.
Optimal range: 0 - 20 Units
Tyzzerella, a genus of bacteria identified in comprehensive gut tests, is part of the intricate ecosystem of the human gut microbiome. Though not as widely recognized as some other bacterial genera, Tyzzerella plays its own unique role in gut health and functionality. The presence and levels of Tyzzerella, along with other bacterial species, are analyzed in gut tests to provide a deeper understanding of the microbiome's composition and health.
The specific role of Tyzzerella in the gut is an area of ongoing research, but like many gut bacteria, it's believed to be involved in the breakdown and fermentation of dietary components, contributing to overall gut function. The bacteria in the Tyzzerella group may participate in the metabolism of certain carbohydrates and fibers, aiding in the digestive process and the production of beneficial metabolites. These metabolites, including short-chain fatty acids (SCFAs), are crucial for maintaining gut barrier integrity, modulating the immune system, and providing energy to colon cells.
Optimal range: 0 - 20 Units
Shows inverse associations with diet quality. [L]
The marker Tyzzerella 4 is a fascinating and important component when it comes to understanding gut health. This marker is part of a comprehensive test offered by Vibrant Wellness that evaluates the microbiome, or the community of bacteria and other microorganisms, living in the human gut. Tyzzerella 4 refers to a specific type of bacteria that has been identified and included in the panel for its potential significance in the digestive system's health and overall wellbeing.
In the context of the Gut Zoomer panel, the presence, absence, or abundance of Tyzzerella 4 can provide valuable insights. For instance, certain levels of this bacterium might be associated with health conditions, digestive function, or the effectiveness of the gut barrier. The Gut Zoomer panel aims to give a detailed snapshot of the gut's microbial landscape, enabling healthcare providers to tailor recommendations for diet, lifestyle, or treatment to improve gut health and, by extension, general health.
Optimal range: 0.8 - 3.5 %
Valerate is a Short Chain Fatty Acid (SCFA). It is derived from bacterial fermentation of protein in the distal colon.
SCFAs are the end product of the bacterial fermentation process of dietary fiber by beneficial flora in the gut and play an important role in the health of the GI as well as protecting against intestinal dysbiosis.
Reference range: Not Detected, Detected
Presence of vegetable fibers is indicative of improper chewing or digestive insufficiency.
Optimal range: 0 - 20 Relative Abundance
Optimal range: 10 - 100 Relative Abundance
Optimal range: 0 - 2300 U/mL
Beta-glucuronidase is an enzyme induced by anaerobic bacteria. Many toxins, hormones, and drugs are excreted from the body after conjugation to a glucuronide molecule. Beta-glucuronidase can uncouple these conjugates, freeing these potential carcinogens in the bowel and increase cancer risk.
Amino Acids test [Great Plains Laboratory / Doctor's Data]
Amino acids are the basic structural units that comprise proteins and are found throughout the body. Many inborn errors of amino acid metabolism that affect amino acid transport or metabolism have been identified, such as phenylketonuria and tyrosinemia. Amino acid disorders can manifest at any age, but most become evident in infancy or early childhood. These disorders result in the accumulation or the deficiency of 1 or more amino acids in biological fluids, which leads to the clinical signs and symptoms of the particular amino acid disorder.
The clinical presentation is dependent upon the specific amino acid disorder. In general, affected patients may experience failure to thrive, neurologic symptoms, digestive problems, dermatologic findings, and physical and cognitive delays. If not diagnosed and treated promptly, amino acid disorders can result in intellectual disabilities and possibly death.
In addition, amino acid analysis may have clinical importance in the evaluation of several acquired conditions including endocrine disorders, liver diseases, muscle diseases, neoplastic diseases, neurological disorders, nutritional disturbances, kidney failure, and burns. General elevations in urine amino acid levels, called aminoaciduria, can be seen in disorders with amino acid transport defects such as lysinuric protein intolerance and Hartnup disease, as well as in conditions with renal tubular dysfunction including Lowe syndrome and Dent disease.
Optimal range: 60 - 300 qM/g creatinine
It is a component of the dietary peptide anserine. Anserine is beta-alanyl-1-methyl-L-histidine, and it is known to come from chicken, turkey, duck, rabbit, tuna and salmon.
Optimal range: 55 - 700 qM/g creatinine
Both 1-methylhistidine and 3-methylhistidine are histidine metabolites which have been proposed as markers of meat intake. Note that some confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
3-methylhistidine is a constituent of actin and myosin, the contractile proteins of skeletal muscles. Urinary excretion of 3-methylhistidine may be a result of muscle breakdown or consumption of meat fibers. Unlike 1-methylhistidine, 3-methylhistidine has been shown to increase in fasting states indicating catabolism of muscle tissue. Therefore, this marker is more variable with regards to animal protein consumption.
Optimal range: 140 - 650 qM/g creatinine
Optimal range: 5 - 60 qM/g creatinine
Alpha amniobutyric acid (AABA), also known as Alpha-amino-N-butyric acid (A-ANB), is an intermediate formed during the catabolism of methionine and threonine. Increases in AABA occur secondary to elevations of either methionine or threonine. AABA becomes propionic acid via alpha-ketobutyric acid in the presence of adequate amounts of thiamin, vitamin B2(as FAD), vitamin B3(as NAD), lipoic acid and magnesium. Deficiencies of any of these, or vitamin B6, could cause increases in AABA. Elevated or decreased levels of the amino acid may indicate a congenital enzyme defect.
Optimal range: 7 - 60 qM/g creatinine
Alpha-aminoadipic acid (a-Aminoadipic acid) is an intermediary metabolite of lysine (primarily) and of tryptophan.
Optimal range: 10000 - 48000 qM/g creatinine
Optimal range: 12000 - 49000 qM/g creatinine
Ammonia is a waste product naturally produced in the body. It primarily comes from the digestion of protein by bacteria in the intestines.
Optimal range: 0 - 90 qM/g creatinine
Anserine (beta-alanyl-3-methyl-histidine) is a urinary biomarker from the consumption of poultry and fish. It is a dipeptide consisting of the amino acids 1-methylhistidine and beta-alanine. The enzyme carnosineN-methyl transferase catalyzes the transfer of a methyl group of S-adenosylmethionine (SAM) on carnosine to form anserine. Anserine acts as an antioxidant, free radical scavenger, and pH buffer. It can reduce blood sugar and affect renal sympathetic nerve activity and blood pressure. Anserine is measured in FMV urine only.
Optimal range: 6 - 45 qM/g creatinine
Optimal range: 40 - 200 qM/g creatinine
Optimal range: 6 - 30 qM/g creatinine
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 0 - 15 qM/g creatinine
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. And, as previously mentioned, carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 0 - 160 qM/g creatinine
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA. Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys. β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 0 - 75 qM/g creatinine
Carnosine (beta-alanyl-L-histidine) is a urinary biomarker which comes from the consumption of beef, pork, and to a lesser extent, poultry.
It is a dipeptide consisting of the amino acids histidine and beta-alanine and is concentrated in skeletal and heart muscle, brain, and kidneys. Carnosine has antioxidant properties, antiglycation effects, enhanced calcium sensitivity, and pH buffering activity during highintensity exercise.
It also has neuroprotective properties and may play an important role in Alzheimer’s disease and other neurodegenerative diseases.
Carnosine is also protective against secondary diabetic renal complications.
Optimal range: 1 - 26 qM/g creatinine
Optimal range: 30 - 225 mg/dL
The urinary creatinine concentration (CC) represents the actual creatinine concentration in the specimen that was submitted.
Under normal conditions, the rate of excretion of creatinine is quite constant and highly correlated with lean body mass (muscle). However, the CC can vary significantly as a function of urine volume.
Optimal range: 7 - 40 qM/g creatinine
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 20 - 65 qM/g creatinine
Cysteine is a nonessential sulfur-containing amino acid. It is obtained from the diet and is also endogenously made from the intermediate amino acid cystathionine. Dietary cysteine sources include poultry, eggs, beef, and whole grains.
This amino acid should not be confused with the oxidized derivative of cysteine called cystine. Cystine is formed by combining two cysteine molecules within a redox reaction. The urinary FMV amino acid test reports cysteine and cystine separately. The plasma amino acid test combines both cysteine and cystine as one biomarker -cyst(e)ine.
Optimal range: 25 - 90 qM/g creatinine
Cystine is formed from the oxidation of cysteine, or from the degradation of glutathione oxidation products. It is two cysteines linked together with a disulfide bond.
The urine FMV amino acid test reports cysteine and cystine separately. The plasma amino acid test combines both cysteine and cystine as one biomarker.
Optimal range: 100 - 425 qM/g creatinine
Optimal range: 0 - 7 qM/g creatinine
Gamma-aminobutyrate (GABA) is the major inhibitory neurotransmitter found in the CNS and, as such, is important for balancing excitatory action of other neurotransmitters.
Optimal range: 10 - 60 qM/g creatinine
Optimal range: 155 - 650 qM/g creatinine
Optimal range: 3 - 120 Ratio
Optimal range: 340 - 3500 qM/g creatinine
Glycine is an amino acid with various important functions within your body, including detoxification, DNA formation, the synthesis of hemoglobin, and as a part of brain neurotransmission pathways. Glycine and serine are interchangeable.
Optimal range: 370 - 1600 qM/g creatinine
Optimal range: 0 - 1 qM/g creatinine
Optimal range: 0 - 40 qM/g creatinine
Hydroxyproline is a collagen related amino acid. Hydroxyproline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver. Hydroxyproline is necessary for the construction of the body’s major structural protein, collagen. Hydroxyproline is present in essentially all tissues and all genetic types of collagen.
Optimal range: 5 - 30 qM/g creatinine
Optimal range: 15 - 80 qM/g creatinine
Optimal range: 32 - 300 qM/g creatinine
Optimal range: 8 - 55 qM/g creatinine
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 0 - 10 qM/g creatinine
Optimal range: 3 - 27 qM/g creatinine
Optimal range: 25 - 100 qM/g creatinine
Optimal range: 24 - 85 qM/g creatinine
Optimal range: 0.05 - 0.8 qM/g creatinine
Optimal range: 1 - 50 qM/g creatinine
Optimal range: 0 - 7 qM/g creatinine
Optimal range: 135 - 540 qM/g creatinine
Optimal range: 200 - 1400 qM/g creatinine
Optimal range: 56 - 300 qM/g creatinine
Optimal range: 20 - 93 qM/g creatinine
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 28 - 150 qM/g creatinine
Tyrosin is the non-essential amino acid precursor for dopamine, norepinephrine and epinephrine. Tyrosine hydroxylase converts tyrosine into the dopamine precursor L-DOPA; BH4, Vitamin D and iron are cofactors for that enzymatic activity.
Tyrosine enhances cognitive performance, energy, and alertness, and improves memory after sleep deprivation.
Optimal range: 100 - 550 mM/g
Urea is the final excretory product of nitrogen (protein) metabolism in the body.
Optimal range: 16 - 58 qM/g creatinine
Amino Acid Profile, Qn (Plasma)
Diagnosis and monitoring of inherited aminoacidurias, organic acidurias, and urea cycle defects. May be used as a follow-up confirmatory test to some abnormal newborn screen results.
False-negative results can occur, especially when a patient is affected with a mild or intermittent variant of a disorder or when clinical condition or dietary treatment causes secondary changes to the profile. Results of amino acid profiling should be interpreted in the context of clinical presentation, as well as other laboratory tests. Frozen serum may be diagnostic, however, certain amino acids may be falsely elevated or low.
Optimal range: 209.2 - 515.5 umol/L
Alanine is a non-essential amino acid and helps the body convert the simple sugar glucose into energy and eliminate excess toxins from the liver.
Optimal range: 0 - 3.2 umol/L
Allo-isoleucine is nearly undetectable in individuals not affected by maple-syrup urine disease (MSUD). Accordingly, its presence is diagnostic for MSUD, and its absence is sufficient to rule-out MSUD.
Optimal range: 0 - 1.9 umol/L
Alpha-aminoadipic acid (a-Aminoadipic acid) is an intermediary metabolite of lysine (primarily) and of tryptophan.
Optimal range: 5.4 - 34.5 umol/L
Alpha amniobutyric acid (AABA), also known as Alpha-amino-N-butyric acid (A-ANB), is an intermediate formed during the catabolism of methionine and threonine. Increases in AABA occur secondary to elevations of either methionine or threonine. AABA becomes propionic acid via alpha-ketobutyric acid in the presence of adequate amounts of thiamin, vitamin B2(as FAD), vitamin B3(as NAD), lipoic acid and magnesium. Deficiencies of any of these, or vitamin B6, could cause increases in AABA. Elevated or decreased levels of the amino acid may indicate a congenital enzyme defect.
Optimal range: 36.3 - 119.2 umol/L
Arginine is a conditionally essential amino acid that is critical for your cardiovascular health and detoxification functions. The amino acid, arginine, is used to make the powerful blood vessel regulator, nitric oxide. Nitric oxide acts to lower blood pressure.
Optimal range: 0 - 3 umol/L
Argininosuccinate (aka Arginosuccinic acid) is a basic amino acid. Some cells synthesize it from citrulline, aspartic acid and use it as a precursor for arginine in the urea cycle or Citrulline-NO cycle. The enzyme that catalyzes the reaction is argininosuccinate synthetase. Argininosuccinic acid is a precursor to fumarate in the citric acid cycle via argininosuccinate lyase. Defects in the argininosuccinate lyase enzyme can lead to argininosuccinate lyase deficiency, which is an inborn error of metabolism.
Optimal range: 29.5 - 84.5 umol/L
Asparagine is a protein amino acid. It is non-essential in humans, meaning the body can synthesize it.
Asparagine is synthesized from aspartate and glutamine. Asparagine has three major functions:
Optimal range: 0 - 7.4 umol/L
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 1.1 - 9 umol/L
Beta-alanine is is a non-essential amino acid.
What are amino acids?
Non-essential amino acids can be made by the body, so they don’t have to be provided by food. Amino acids are the building blocks of proteins.
Optimal range: 0 - 4.3 umol/L
Beta-aminoisobutyric acid (BAIB) is an amino acid end product of the pyrimidine metabolism. It is excreted in small quantities into the urine in almost all human beings. Thymine, released when RNA and DNA are degraded, enters a catabolic pathway that leads to Beta-Aminoisobutyric Acid.
Optimal range: 15.6 - 46.9 umol/L
The amino acid citrulline gets its name from its high concentration in the watermelon Citrullus vulgaris. In human kidneys, citrulline and aspartic acid are united by argininosuccinate synthetase (ASS) to produce arginosuccinate. The degradation of arginosuccinate to fumarate and arginine is a primary mechanism for sustaining plasma levels of arginine. The same enzyme acts in liver cells to complete the urea cycle.
Optimal range: 0 - 0.7 umol/L
Cystathionine is an intermediary metabolite that is formed in the sequential enzymatic conversion of methionine to cysteine. Cystathionine is normally detected at very low levels in plasma. It is found between homocysteine and cysteine and is formed by the enzyme cystathionine beta-synthase (CBS).
Optimal range: 15.8 - 47.3 umol/L
Cystine is the oxidized disulfide form of cysteine (Cys) and is the predominant form of cysteine in the blood due to its greater relative stability. Cystine is derived from dietary protein and, end formed endogenously from cysteine.
Optimal range: 0 - 50 umol/L
Ethanolamine, Plasma is a marker measured in an Amino Acid Profile, Quantitative (Plasma) panel, which plays an important role in various bodily functions. Ethanolamine is a key component of phospholipids, which are essential building blocks of cell membranes. This compound is involved in the synthesis of phosphatidylethanolamine, a crucial phospholipid that helps maintain the structural integrity and fluidity of cell membranes. Beyond its structural role, ethanolamine is also involved in cell signaling and neurotransmission, particularly in the central nervous system. It serves as a precursor for the synthesis of acetylcholine, a vital neurotransmitter that affects muscle contraction, memory, and learning. Normal levels of ethanolamine in the plasma indicate proper cellular function and membrane stability.
Optimal range: 0 - 0.6 umol/L
Gamma-aminobutyrate (GABA) is the major inhibitory neurotransmitter found in the CNS and, as such, is important for balancing excitatory action of other neurotransmitters.
Optimal range: 18.1 - 155.9 umol/L
Glutamate functions as the major excitatory neurotransmitter and metabolic fuel throughout the body. Glutamate is produced in your body, and is also found in many foods.
Optimal range: 372.8 - 701.4 umol/L
Glutamine is the most abundant amino acid in the blood and is an important source of energy for many tissues in the body. It is derived from the amino acids histidine and glutamic acid.
Optimal range: 144 - 411 umol/L
Glycine is an amino acid with various important functions within your body, including detoxification, DNA formation, the synthesis of hemoglobin, and as a part of brain neurotransmission pathways. Glycine and serine are interchangeable.
Optimal range: 47.2 - 98.5 umol/L
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine. Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
Optimal range: 0 - 1.7 umol/L
The amino acid homocitrulline is a metabolite of ornithine in human metabolism.
The amino acid can be detected in larger amounts in the urine of individuals with urea cycle disorders. Both amino acids can be detected in urine. Amino acid analysis allows for the quantitative analysis of these amino acid metabolites in biological fluids such as urine, blood, plasma or proteins.
Optimal range: 0 - 0.2 umol/L
Homocystine is a common amino acid in your blood. You get it mostly from eating meat. High levels of it are linked to early development of heart disease.
Optimal range: 0.1 - 0.8 umol/L
Hydroxylysine is an amino acid related to collagen.
What is collagen?
Collagen is the most abundant protein in your body. It is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin and muscles.
Optimal range: 4.7 - 35.2 umol/L
Hydroxyproline is a collagen related amino acid. Hydroxyproline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver. Hydroxyproline is necessary for the construction of the body’s major structural protein, collagen. Hydroxyproline is present in essentially all tissues and all genetic types of collagen.
Optimal range: 32.8 - 88.3 umol/L
Isoleucine is one of the three branched-chain amino acids (BCAAs) alongside both leucine and valine.
Isoleucine is a common component of proteins, peptides and hormones. Leucine is catabolized as a source of carbon for energy production during exercise in skeletal muscle.
Optimal range: 66.7 - 165.7 umol/L
Leucine, together with isoleucine and valine, are essential amino acids that are referred to as branched-chain amino acids (BCAAs).
Leucine is nutritionally essential and is required for formation of body proteins, enzymes and some hormones. Leucine itself has a hormone-like activity which is stimulation of pancreatic release of insulin. The branched-chain structure of leucine makes it very important for the formation of flexible collagen tissues, particularly elastin in ligaments. Leucine is relatively abundant in all protein foods.
Optimal range: 94 - 278 umol/L
Lysine is found in great quantities in muscle tissues, stimulates calcium absorption, carnitine synthesis, and growth and repair of muscle tissue.
Optimal range: 14.7 - 35.2 umol/L
Methionine is an essential amino acid, meaning we need to get it from our diet as our body does not produce it. Methionine is a unique sulfur-containing amino acid that can be used to build proteins and produce many molecules in the body.
Optimal range: 30.1 - 101.3 umol/L
Ornithine is a urea cycle metabolite.
Ornithine can stimulate the release of growth hormone. Growth hormone is necessary for tissue repair and growth. Growth hormone is often low in patients with fibromyalgia.
Optimal range: 0 - 20 umol/L
P-Ethanolamine, Plasma is short for Phosphoethanolamine (PEA). Phosphoethanolamine (PEA) is a marker measured in the plasma as part of an Amino Acid Profile, Quantitative (Qn) panel. This compound is a derivative of the amino acid serine and plays a critical role in the biosynthesis of phospholipids, which are essential components of cell membranes. In the body, PEA serves as a precursor to phosphatidylethanolamine, one of the most abundant phospholipids in cell membranes, and is involved in various cellular processes, including membrane signaling and repair. Elevated levels of phosphoethanolamine in the plasma can indicate metabolic disruptions or inherited metabolic disorders such as phosphoethanolaminuria, where there is an abnormal accumulation of PEA due to enzyme deficiencies.
Optimal range: 35.8 - 76.9 umol/L
Phenylalanine is a precursor for the amino acid tyrosine, which is essential for making neurotransmitters (e.g. epinephrine, norepinephrine, dopamine) and thyroid hormone. Neurotransmitters are the chemicals that communicate between nerve cells in the brain. It can relieve pain, alleviate depression, and suppress the appetite. Low levels may indicate a stressful lifestyle, leading to memory loss, fatigue, and depression.
Optimal range: 84.8 - 352.5 umol/L
Proline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver; it does not have to be obtained directly through the diet.
Proline is the precursor to hydroxyproline, which is a major amino acid found in the connective tissue of the body – collagen.
Optimal range: 0 - 4 umol/L
Sarcosine is also known as N-methylglycine. It is an intermediate and byproduct in the glycine synthesis and degradation. Sarcosine is metabolized to glycine by the enzyme sarcosine dehydrogenase, while glycine-N-methyl transferase generates sarcosine from glycine.
Optimal range: 48.7 - 145.2 umol/L
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 29.2 - 132.3 umol/L
Taurine is a sulfur-containing amino acid required for bile formation.
Optimal range: 67.8 - 211.6 umol/L
Threonine is an essential amino acid, i.e., it is vital for your health, but it cannot be synthesized by your body and therefore has to be obtained from a diet.
Optimal range: 23.5 - 93 umol/L
Tryptophan is an essential amino acid required for the production of the neurotransmitter serotonin.
Optimal range: 27.8 - 83.3 umol/L
Tyrosin is the non-essential amino acid precursor for dopamine, norepinephrine and epinephrine. Tyrosine hydroxylase converts tyrosine into the dopamine precursor L-DOPA; BH4, Vitamin D and iron are cofactors for that enzymatic activity.
Optimal range: 133 - 317.1 umol/L
Valine, together with Isoleucine and Leucine are essential amino acids and are collectively referred to as branched-chain amino acids (BCAAs).
Hemoglobin Fractionation Profile
The Hemoglobinopathy Evaluation Profile Blood Test, or Hemoglobin Fractionation, aids in the diagnosis of hemoglobinopathy, an inherited blood disorder characterized by the presence of an abnormal form of hemoglobin (known as a variant) or decreased hemoglobin production (known as thalassemia).
Hemoglobin (Hb) is a protein found in red blood cells (RBCs) that binds to oxygen and helps transport it throughout the body. The shape, size and function of RBCs may be altered when hemoglobin variants are present, which could result in inefficient oxygen transportation and premature destruction of the cells, leading to hemolytic anemia. Symptoms of hemolytic anemia include weakness, fatigue, jaundice and pale skin. Severe hemoglobinopathies, such as homozygous Hb S (Sickle Cell Anemia), can result in symptoms such as episodes of acute pain, shortness of breath and an enlarged spleen.
Normal hemoglobin types include:
- Hemoglobin A: makes up about 95%-98% of Hb found in adults; it contains two alpha and two beta protein chains.
- Hemoglobin A2: makes up about 2%-3% of Hb in adults; it has two alpha and two delta protein chains.
- Hemoglobin F (fetal hemoglobin): makes up to 1%-2% of Hb found in adults; it has two alpha and two gamma protein chains. This is the primary hemoglobin produced by the fetus during pregnancy; its production usually falls shortly after birth and reaches adult levels by 1-2 years.
Hemoglobinopathies occur when changes (variants) in the genes that provide information for making the globin chains cause changes in the proteins. These genetic variants may result in a reduced production of one of the normal globin chains or in the production of structurally altered globin chains. Approximately 7% of the world’s population carry at least one copy of a genetic variant in one of the hemoglobin chains (carrier), and the rate can vary dramatically based on ethnicity. Genetic variants may affect the structure of the hemoglobin, its behavior, its production rate, and/or its stability. The presence of abnormal hemoglobin within RBCs can alter the appearance (size and shape) and function of the red blood cells.
Red blood cells containing abnormal hemoglobin (hemoglobin variants) may not carry oxygen efficiently and may be broken down by the body sooner than usual (a shortened survival), resulting in hemolytic anemia.
While there are more than 1,000 hemoglobinopathies currently described and novel forms are still being discovered, some of the most common hemoglobin variants include:
- Hemoglobin S, the primary hemoglobin in people with sickle cell disease that causes the RBC to become misshapen (sickle), decreasing the cell’s survival
- Hemoglobin C, which can cause a minor amount of hemolytic anemia
- Hemoglobin E, which may cause no symptoms or generally mild symptoms
Thalassemia is a condition in which a gene variant results in reduced production of one of the globin chains. This can upset the balance of alpha to beta chains, leading to decrease in hemoglobin A, causing abnormal forms of hemoglobin to form (alpha thalassemia) or causing an increase of minor hemoglobin components, such as Hb A2 or Hb F (beta thalassemia).
Hemoglobinopathies can be thought of as an alteration of quality of the hemoglobin molecule (how well it functions), while thalassemias are an alteration of quantity.
Many other less common hemoglobin variants exist. Some are silent – causing no signs or symptoms – while others affect the function and/or stability of the hemoglobin molecule.
Optimal range: 96.4 - 98.8 %
Hemoglobin A makes up about 95%-98% of Hb found in adults; it contains two alpha and two beta protein chains.
Optimal range: 1.8 - 3.2 %
Hemoglobin A2 makes up about 2%-3% of Hb in adults; it has two alpha and two delta protein chains.
Optimal range: 0 - 0 %
Hemoglobin C can cause a minor amount of hemolytic anemia.
Optimal range: 0 - 2 %
Hemoglobin F (fetal hemoglobin) makes up to 1%-2% of Hb found in adults; it has two alpha and two gamma protein chains. This is the primary hemoglobin produced by the fetus during pregnancy; its production usually falls shortly after birth and reaches adult levels by 1-2 years.
Optimal range: 0 - 0 %
Hemoglobin S, the primary hemoglobin in people with sickle cell disease that causes the RBC to become misshapen (sickle), decreasing the cell's survival.
Reference range: Negative, Positive
The Hemoglobin Solubility test is used to help identify the presence of Hemoglobin S. The test may also detect sickling hemoglobins, and evaluate hemolytic anemia.
Optimal range: 0 - 0 %
Array 12 – Pathogen-Associated Immune Reactivity Screen
Array 12 – Pathogen-Associated Immune Reactivity Screen assesses IgG immune reactivity to pathogens that are documented triggers or exacerbators of autoimmunity. Array 12 contains a variety of pathogens including oral pathogens, gastrointestinal pathogens, gastrointestinal parasites, bacterial and stealth pathogens, environmental molds, viral pathogens and tick-borne pathogens.
- Tick-borne pathogens are obvious triggers of Lyme disease, however there are additional pathogens that haven’t been in the limelight.
- One example is the opportunistic bacterium Acinetobacter, which, due to cross-reactivity with neurological tissues, has been shown to play a role in multiple sclerosis.
- Giardia lamblia is well known as a cause of watery diarrhea, but less known for persisting in asymptomatic patients where the pathogen destroys intestinal villa thereby preventing nutrient absorption. Giardia can then cross-react with structural proteins such as tubulin and actin, which then triggers autoimmunity of the joints.
Optimal range: 0.3 - 2.2 ELISA Index
Acinetobacter is a non-motile, gram-negative bacterium. Acinetobacter may cause infections of the lung, urinary tract, bloodstream or surgical wounds. Due to cross-reactivity with major neurological tissues, Acinetobacter has been shown to play a role in multiple sclerosis.
If the Acinetobacter level is equivocal, it means that the test results are unclear or borderline, not definitively indicating either a positive or negative result for the presence of Acinetobacter. This uncertainty could be due to various factors, such as low levels of antibodies, cross-reactivity with other pathogens, or technical variations in the test.
In this situation, the following steps are generally recommended:
Consult with Your Healthcare Provider: Discuss the equivocal result with your doctor, who can interpret the findings in the context of your overall health and symptoms.
Repeat the Test: Your doctor may suggest repeating the test after a certain period to see if the results become clearer. Sometimes, immune reactivity levels can change over time.
Additional Testing: Further diagnostic tests may be recommended to get a more definitive understanding. This could include blood tests, cultures, or imaging studies.
Review Symptoms and History: Your healthcare provider will consider your medical history, any current symptoms, and potential risk factors for Acinetobacter infection. This information can help determine the likelihood of an infection and guide further action.
Monitor Health: In the absence of symptoms, your doctor may recommend monitoring your health and watching for any signs of infection. If symptoms develop, prompt medical evaluation will be necessary.
Consider Possible Contamination or Technical Issues: Sometimes, an equivocal result may be due to technical issues or contamination. Ensuring the quality and accuracy of the testing process is important.
By taking these steps, you and your healthcare provider can work towards a clearer diagnosis and appropriate management plan.
Optimal range: 0.2 - 1.1 ELISA Index
Aspergillus is the genus of asexual spore-forming mold species common in many climates. It is found in soil, water and air. Aspergillus fumigatus, Aspergillus niger and Aspergillus flavus are common molds to which humans are exposed. Due to the increased use of immunosuppressant medications, the development of more intensive chemotherapies and the advent of AIDS, there has been in increase in the number of patients at risk of developing invasive aspergillosis. Aspergillus grows slowly, and can manifest in a variety of ways including chronic sinusitis and brain lesions.
What if your test result is "equivocal"?
An "equivocal" result on a Pathogen-Associated Immune Reactivity Screen (like when testing for Aspergillus) generally indicates that the test detected the presence of antibodies or immune markers at a level that is not clearly positive but higher than the typical negative range. Here's what this might mean and some steps you could consider:
→ Uncertain Diagnosis: Equivocal results are often inconclusive, meaning they don't provide a definitive answer as to whether you have an active infection or immune response to Aspergillus. This can be due to a variety of reasons including early infection, low-level exposure, or cross-reactivity with other substances.
→ Follow-up Testing: Usually, when results are equivocal, doctors recommend re-testing after a period of time. This could help determine if the levels of antibodies or immune markers are changing, which might indicate an active or resolving infection.
→ Clinical Context: It's important to consider these results in the broader context of your symptoms and medical history. If you are showing symptoms consistent with an Aspergillus infection (such as respiratory issues, if Aspergillus is suspected in the lungs), further diagnostic testing might be necessary.
→ Consultation with a Specialist: In cases where Aspergillus is a serious concern (for instance, in immunocompromised individuals), consulting a specialist in infectious diseases or a pulmonologist might be advisable. They can offer more specific tests and interpret the results in the context of your overall health status.
→ Monitor Symptoms: Keep an eye on any symptoms that might be related to Aspergillus exposure, such as coughing, wheezing, or other respiratory problems, and report these to your healthcare provider.
If your test result is equivocal, it's best to discuss these steps with your healthcare provider, who can offer guidance tailored to your specific situation.
Optimal range: 0.1 - 0.9 ELISA Index
Babesia is a tick-borne intraerythrocytic protozoan parasite, which can result in subclinical or mild illness in most cases, but occasionally, in immunocompromised individuals, the reaction can be severe.
Optimal range: 0.1 - 1.6 ELISA Index
Blastocystis hominis (B. hominis) is a unicellular protozoan found in the large intestine of humans. B. hominis is the most prevalent single-celled eukaryotic organism found in humans. It is a causative pathogen in irritable bowel disorders and the toxins released by B. hominis can contribute to fibromyalgia. This presence of B. hominis-specific immunoglobulins in the serum samples suggests that the immune action against this parasite is not limited to the intestinal level. Antibodies to the pathogen can be found in both symptomatic and asymptomatic individuals, therefore, it is still unclear whether B. hominis is a truly pathogenic organism, or a commensal, or perhaps, is capable of being a pathogen in specific circumstances.
Optimal range: 0.2 - 1 ELISA Index
Borrelia burgdorferi is spirochete class bacterium. B. burgdorferi sensu stricto, B. burgdorferi sensu lato, B. burgdorferi afzelii and B. burgdorferi garinii spirochetes enter the human body through tick bites.
Optimal range: 0 - 2.4 ELISA Index
C. jejuni is a gram-negative bacterium that causes severe gastroenteritis. Due to C. jejuni’s ability to produce lipoligosaccharides, the bacteria are able to invade intestinal epithelial cells. Beyond the gut wall, C. jejuni has been implicated in disorders such as arthritis and Guillain-Barré syndrome. The severity of these disorders makes C. jejuni an important environmental trigger to assess while working up certain autoimmune patients.
Optimal range: 0.2 - 1.8 ELISA Index
C. albicans is a human commensal yeast. By penetrating the intestinal barrier this pathogen is able to thrive in the human host. Its inflammatory effect in the gastrointestinal tract opens the intestinal barrier, putting tissue and organs at risk for autoimmunity. Candida has been shown to crossreact with a variety of human tissues and thus, when Candida or its antigens reach the blood stream, the antibodies produced against it may turn on self-tissue proteins. The end result can be autoimmunity.
Optimal range: 0 - 1.8 ELISA Index
Chlamydias are obligate intracellular pathogens. Chlamydia pneumoniae (C. pneumoniae) is a human pathogen that infects the respiratory tract and is responsible for some cases of communityacquired pneumonia.
Optimal range: 0.3 - 1.1 ELISA Index
Epstein-Barr virus (EBV), or herpes type IV, is a DNA virus composed of linear double stranded DNA genome enclosed by a capsid and membrane derived envelope made from a variety of glycoproteins.
Optimal range: 0.2 - 1.3 ELISA Index
C. difficile is the leading cause of antibiotic-associated nosocomial diarrhea and colitis in the industrialized world. This gram-positive bacterium can reside in the human host without triggering serious clinical conditions, however, when the colonized bacteria produce toxin A and toxin B, the resulting changes in gastrointestinal pH and cytoskeletal structures of the barrier, serious disorders can occur. Pathogenic C. difficile has been linked to colitis, irritable bowel disease and liver disorders.
Optimal range: 0.4 - 2.6 ELISA Index
C. parvum is a protozoan parasite that can cause gastrointestinal illness with diarrhea in humans. Through various mechanisms the parasite can manipulate the host cytoskeleton proteins, including rearranging tropomyosin-5 protein, actinin, villin, ezrin, at the site of infection. This restructuring of proteins allows the parasite to infiltrate intestinal cells. Due to antigenic similarity between C. parvum, actin and tropomyosin structures, these antibodies may cross-react with human tissues resulting in autoimmunity associated with parasitic infections.
Optimal range: 0.2 - 2.4 ELISA Index
Hepatitis C virus (HCV) is an enveloped, positive-sense single-stranded RNA virus of the Flaviviridae family.
Optimal range: 0.2 - 1.2 ELISA Index
Cytomegalovirus (CMV) is an opportunistic herpesvirus belonging to the Betaherpesvirinae subfamily, which is classified as herpes type-5. After primary infection, CMV can infect a variety of cell types such as epithelial cells of salivary glands, large intestine, lungs, smooth muscle, endothelial cells, liver, kidney, fibroblasts, neuronal cells and various myeloid cells.
Optimal range: 0.2 - 1.9 ELISA Index
E. histolytica invasion may contribute to T-helper-2 bias and antibody production particularly against E. histolytica lectins and their association with tissue antigens such as phospholipids, actin and ANCA. By penetrating the intestinal tissues, E. histolytica is able to disturb tight junction assemblies, thereby opening the intestinal tight junctions and putting the body at risk for autoimmunity. Once in the bloodstream, E. histolytica may trigger autoimmunity against neurological or bone tissues, due to its homology with gangliosides and skeletal actin.
Optimal range: 0.2 - 1.6 ELISA Index
G. lamblia is a flagellated protozoan parasite that colonizes and reproduces in the small intestine. G. lamblia causes giardiasis. Giardiasis does not spread via the bloodstream, nor does it spread to other parts of the gastrointestinal tract. Giardiasis remains in the lumen of the small intestine. Chronic infection with Giardia may abate and the patient could become asymptomatic. Asymptomatic individuals may become reservoirs for spreading the infection. Antibodies against G. lamblia may cross-react with human tissue antigens such as tubulin, actin, actinin, tropomyosin and others. The end result may be autoimmunity against those tissues.
Optimal range: 0.5 - 1.9 ELISA Index
H. pylori, a gram-negative bacterium colonizes the gastrointestinal system, where is interferes with intestinal barrier functions, induces inflammatory responses and can contribute to autoimmunity. Mechanisms of autoimmunity include molecular mimicry, polyclonal activation, epitope spreading, bystander activation and super antigen release. H. pylori has been implicated in disorders of the thyroid, liver, joints and nervous system.
Optimal range: 1 - 2.6 ELISA Index
Heat shock protein 60 (HSP60) is a mitochondrial chaperonin that plays a role in the transportation and refolding of proteins from the cytoplasm into the mitochondrial matrix.
Optimal range: 0.2 - 1.4 ELISA Index
Human Herpesvirus-6 (HHV-6), belonging to the beta-herpesvirus subfamily, is a lymphotropic virus, which infects mainly T cells in vitro, causes acute and latent infections.
Optimal range: 0 - 1.3 ELISA Index
Klebsiella are gram-negative, facultative anaerobic, non-motile, rod-shaped bacteria. Array 12 assesses immune reactivity to Klebsiella pneumoniae, Klebsiella oxytoca and Klebsiella pneumoniae uti.
Optimal range: 0.2 - 1.5 ELISA Index
Mycobacterium avium (M. avium) is a gram-positive, slow-growing bacteria with high guanine and cytosine content. It is present mainly in cattle and transmitted to humans by drinking unpasteurized animal milk. M. avium, M. bovis and M. tuberculosis are the most common human acquired mycobacteria.
Optimal range: 0.2 - 1.8 ELISA Index
Mycoplasma refers to a genus of bacteria that lack a cell wall, which makes them immune to common antibiotics such as penicillin. Mycoplasma pneumoniae, Mycoplasma arthritidis and ureaplasma are common human pathogens.
Optimal range: 0 - 1.9 ELISA Index
Penicillium is a genus of fungi, which commonly grows on many foodstuffs such as cocoa beans, coffee beans, cassava flour, cereals, fish, peanuts, dried fruits, wine, poultry eggs and milk.
Optimal range: 0.4 - 1.4 ELISA Index
Oral bacterium P. gingivalis has been well-documented as a mediator of periodontal disease. Furthermore, hosts harboring this pathogen have been shown to have greater risk for rheumatoid arthritis. Researchers are elucidating the mechanisms by which P. gingivalis contributes to the pathogenesis of arthritic and their related disorders. Upregulation of intestinal lipopolysaccharides and subsequent inflammation, as well as citrullination of alpha-enolase, which shares homology with human tissue α-enolase, are described mechanisms of autoimmunity.
Optimal range: 0 - 3 ELISA Index
Rotavirus is a double-stranded RNA virus that is commonly associated with gastroenteritis in children. Repeated infections with rotavirus can lead to viral replication in intestinal cells. Changes in intestinal cells leads to intestinal barrier dysfunction, increased intestinal permeability and the easy translocation of environmental immunogens into circulation. Pathogenic rotavirus has been linked to various disorders such as Celiac disease and type 1 diabetes.
What if your result is "EQUIVOCAL"?
An "equivocal" result means that the test results are uncertain or inconclusive. This can happen for several reasons, such as the amount of antibodies being at the threshold level where it's difficult to clearly determine if it's a positive or negative result. Here’s what you might consider doing next:
→ Repeat the Test: Often, an equivocal result leads to a recommendation to repeat the test after some time. This allows your body more time to develop a clearer immune response that can be more easily measured.
→ Consult Your Healthcare Provider: Discuss the results with your healthcare provider. They can provide guidance on the implications of your test results in the context of your symptoms and medical history.
→ Monitor Symptoms: If you are experiencing symptoms that led to the testing, keep track of them and inform your healthcare provider. This can help in determining the next steps in your medical care.
→ Consider Additional Testing: Your doctor might suggest additional tests to rule out or confirm the presence of Rotavirus or other pathogens, especially if you show symptoms consistent with an infection.
Understanding the context and the implications of an equivocal result is best handled by healthcare professionals who can provide personalized advice based on your overall health condition.
Optimal range: 0.4 - 2.7 ELISA Index
Stachybotrys chartarum (S. chartarum) is a black mold that produces asexual spores. S. chartarum is the usual perpetrator involved in water/moisture/wet-damaged building illnesses.
Optimal range: 0.1 - 1.4 ELISA Index
M Protein is an extracellular product of Streptococcus that contributes to the pathogenicity of the gram-positive bacterium. Antibody response against streptococcal M protein and its reaction with myosin may result in endothelial cell damage and the release of inner valve proteins. This results in antibody production against collagen, vimentin, elastin and laminin, which may contribute to the pathogenesis of streptococcal-associated disorders.
What if your result is "equivocal"?
An "equivocal" result on a test like the Streptococcal M Protein on a Pathogen-Associated Immune Reactivity Screen panel means that the test did not clearly indicate whether the specific antibodies or antigens being tested for were absent or present in your sample. Here's what you can consider in this situation:
→ Repeat Testing: Sometimes an equivocal result may suggest that the levels of the target protein or antibody are near the threshold of detection. Your doctor might recommend repeating the test to confirm the result.
→ Additional Testing: To get a clearer picture of your health, additional tests might be needed. This could include more specific tests for streptococcal infection or other related conditions.
→ Clinical Assessment: Your healthcare provider will likely consider these test results in conjunction with your symptoms and medical history. Equivocal results might need to be interpreted differently based on individual health conditions and symptoms.
→ Monitoring Symptoms: If you are currently experiencing symptoms that might be related to a streptococcal infection or other immune responses, your healthcare provider might monitor your symptoms over time to see if they progress or resolve.
It's important to discuss your test results with your healthcare provider, who can give you specific advice based on your overall health context and guide you on the next steps.
Optimal range: 0.4 - 1.9 ELISA Index
S. mutans is a gram positive bacterium commonly found in the human oral cavity. It is known to promote dental caries. S. mutans has been shown to elicit inflammation by stimulating cytokine production in the dental pulp below caries. When this inflammation reaches the intestines, it can contribute to dysbiosis, breakdown of intestinal barrier structures and the infiltration of S. mutans immunogens into circulation. Antibodies against S. mutans have long been recognized as cross-reactive to human heart tissues and thus, suspected of playing a role in heart disorders.
Optimal range: 0 - 2.4 ELISA Index
Streptozymes (NADase, DNase, streptokinase, streptolysin O, and hyaluronidase) are extracellular products, or exoantigens, of the streptococcus bacteria.
Optimal range: 0.2 - 1.8 ELISA Index
Y. enterocolitica is a gram-negative, bacillus-shaped bacterium. Y. entrocolitica can be short-lived as an infection. However, even if the infection is treated successfully, due to the action of various bacterial toxins and mimicry with human tissue, continued immune responses against these toxins may result in various inflammatory and autoimmune disorders, such as inflammatory bowel disease, autoimmune thyroid disease, uveitis, Lyme-associated disorders and even reactive arthritis.
Heart and Muscle Health
Blood and urine lab tests are used to find out your risk of heart and blood vessel disease. The results, along with your health history, help your health care team create the best plan of care for you.
Keeping your muscles healthy will help you to be able to walk, run, jump, lift things, play ... Healthy muscles let you move freely and keep your body strong.
Optimal range: 0 - 100 ng/mL
ADMA/SDMA may be measured in individuals with multiple risk factors for the development of CVD.
One of the earliest manifestations of endothelial dysfunction is nitric oxide (NO) deficiency, which promotes atherosclerosis. Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), its structural isomer, are metabolites of L-arginine, an amino acid that is catalyzed to L-citrulline and NO by nitric oxide synthase (NOS).
Both ADMA and SDMA have distinct pathophysiologies and manifestations. ADMA is a competitive inhibitor of NOS thereby reducing NO production and promoting endothelial dysfunction. SDMA also interferes with NO production, but does so indirectly by reducing the cellular availability of arginine. ADMA is primarily cleared through enzymatic degradation in the bloodstream and its presence identifies subclinical cardiovascular disease (CVD). Conversely, SDMA is primarily excreted in the urine and identifies reduced renal function.
Optimal range: 3.3 - 10.3 ug/L
Aldolase is an enzyme that participates in glycolysis, which is the pathway for metabolizing glucose into energy. Elevated levels of aldolase in the blood occur in diseases of muscle including Duchenne muscular dystrophy, dermatomyositis, and polymyositis.
Optimal range: 0 - 0 %
There are three types of Creatine Kinase enzymes:
CK-MM, found mostly in skeletal muscles
CK-MB, found mostly in the heart muscle
CK-BB, found mostly in your brain. It's also found in smooth muscles such as the intestine or uterus.
A small amount of CK in the blood is normal. Higher amounts can mean a health problem. Depending on the type and level of CK found, it can mean you have damage or disease of the skeletal muscles, heart, or brain.
Optimal range: 0 - 3 %
Creatine Kinase is a type of protein that is mostly found in the skeletal muscle (CK-MM). 97 to 100% of Creatine Kinase are usually found in skeletal muscle. The other two types of Creatine Kinase are CK-MB (Creatine Kinase found in the heart muscle) and CK-BB (Creatine Kinase found in brain tissue).
There are three types of Creatine Kinase enzymes:
CK-MM, found mostly in skeletal muscles
CK-MB, found mostly in the heart muscle
CK-BB, found mostly in brain tissue
CK-MB isoenzymes level helps quantify the degree of myocardial infarction and the timing of onset of infarction.
This enzyme is also used to determine the effectiveness of thrombolytic therapy used for myocardial infarction.
This is found in cardiac and skeletal muscles. The cardiac muscle has 30%, and the skeletal muscle has 1% MB.
Optimal range: 97 - 100 %
Creatine Kinase is a type of protein that is mostly found in the skeletal muscle (CK-MM). 97 to 100% of Creatine Kinase are usually found in skeletal muscle. The other two types of Creatine Kinase are CK-MB (Creatine Kinase found in the heart muscle) and CK-BB (Creatine Kinase found in brain tissue).
There are three types of Creatine Kinase enzymes:
CK-MM, found mostly in skeletal muscles
CK-MB, found mostly in the heart muscle
CK-BB, found mostly in brain tissue
A small amount of CK in the blood is normal. Higher amounts can mean a health problem. Depending on the type and level of CK found, it can mean you have damage or disease of the skeletal muscles, heart, or brain
Optimal range: 24 - 204 U/L , 0.41 - 3.47 µkat/L , 24 - 204 IU/L
Creatine kinase (CK) is an enzyme found primarily in the brain, skeletal muscles, and heart. Conditions that cause damage to any of these three areas produce an elevated level of CK. For this reason, CK tests are often run to detect muscle damage, especially if someone is taking a drug such as a statin, using cocaine, or has been exposed to a toxin. If you’re experiencing chest pain or weakness your doctor may order a CK test to determine if you’ve had a heart attack. It is also common for doctors to use this test to evaluate the extent of sports injuries. Creatine kinase levels reflect the amount of muscle in the body, and as such men typically have higher levels than women. Finally, a CK test may be used to diagnose rhabdomyolysis, a condition characterized by the rapid breakdown of muscle tissue. It is worth noting that a normal level of CK does not necessarily mean that there is no muscle damage. It could mean that the damage occurred long enough ago for levels to return to normal. Frequently, a succession of CK tests are run as changes in CK levels due to muscle damage can take hours to present.
Optimal range: 0 - 5.3 ng/mg
The CK-MB test measures levels of a specific enzyme, Creatine kinase-MB, primarily found in heart muscle cells, to diagnose heart damage. CK-MB is one of three forms of the creatine kinase enzyme, with the others being CK-MM and CK-BB, found in different muscles and organs. Elevated CK-MB levels, especially with a high ratio to total creatine kinase, indicate heart damage, which could be due to various causes such as physical trauma, surgery, or a heart attack. While historically crucial for diagnosing heart attacks, the CK-MB test has been largely replaced by more specific cardiac troponin tests. The test is performed mainly in emergency settings, with results varying based on individual health factors and laboratory standards.
Optimal range: 29 - 168 U/L
Creatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal muscle.
This test may be used to:
- Diagnose heart attack
- Evaluate cause of chest pain
- Determine if or how badly a muscle is damaged
- Detect dermatomyositis, polymyositis, and other muscle diseases
- Tell the difference between malignant hyperthermia and postoperative infection
Reference range: Not Observed, Observed
Reference range: Not Observed, Observed
Optimal range: 0 - 3 index
The relative index represents the ratio of CKMB to the CK, total. Relative index = CK-MB, in ng/mL ÷ CK, total, U/L x 100. Due to the different units measured (ng/mL for CK-MB vs. U/L for CK, total), this does not represent a true percentage and is, therefore, called a “relative index.” Currently, a relative index of ≥5.0% suggests the MB may be myocardial in origin. The relative index may be of particular value in patients who have an elevated CK, total due to trauma or surgery.
Both an elevated CK-MB and Relative Index are suggestive of Myocardial Infarction.
Optimal range: 0 - 210 pg/mL
NT-proBNP (N-terminal pro B-type natriuretic peptide) is a protein released by the heart when it is under strain, often due to conditions like heart failure. Normally, only small amounts are found in the blood, but levels rise when the heart struggles to pump effectively, making NT-proBNP a valuable marker for diagnosing and monitoring heart failure. Doctors may order this test if you have symptoms such as shortness of breath, swelling in the legs, fatigue, or unexplained coughing. It can also help assess the severity of heart failure, guide treatment decisions, and track how well therapies are working.
NT-proBNP results vary with age and kidney function. In general, values below 300 pg/mL make heart failure unlikely, while higher levels suggest the heart may not be pumping properly (cutoffs are 450 pg/mL for people under 50, 900 pg/mL for ages 50–75, and 1,800 pg/mL for those over 75). Levels can also be influenced by obesity, kidney disease, and certain medications. Unlike BNP, NT-proBNP is more stable in the blood, making it a reliable test for evaluating heart function. If elevated, your doctor may order additional tests, such as an echocardiogram or ECG, to confirm the diagnosis and guide treatment.
Optimal range: 73 - 135 ng/mL
ADMA/SDMA may be measured in individuals with multiple risk factors for the development of CVD.
SDMA is primarily excreted in the urine and identifies reduced renal function.
One of the earliest manifestations of endothelial dysfunction is nitric oxide (NO) deficiency, which promotes atherosclerosis. Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), its structural isomer, are metabolites of L-arginine, an amino acid that is catalyzed to L-citrulline and NO by nitric oxide synthase (NOS).
Both ADMA and SDMA have distinct pathophysiologies and manifestations. ADMA is a competitive inhibitor of NOS thereby reducing NO production and promoting endothelial dysfunction. SDMA also interferes with NO production, but does so indirectly by reducing the cellular availability of arginine. ADMA is primarily cleared through enzymatic degradation in the bloodstream and its presence identifies subclinical cardiovascular disease (CVD). Conversely, SDMA is primarily excreted in the urine and identifies reduced renal function.
Optimal range: 0 - 0.06 ng/mL , 0 - 60 ng/L
Troponin proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.
Optimal range: 0 - 13 ng/liter
Troponin T, High Sensitivity (hs-TnT) is an independent prognostic marker that aids in the diagnosis of myocardial infarction (MI) in an acute setting (>22 ng/L for males and >14 ng/L for females), and there is literature supporting its use to assess relative risk for cardiovascular disease (CVD) and adverse cardiovascular events (≥6 ng/L for males and females).
Complete Hormones FMV - Menopause Female
Complete Hormones is Genova's most comprehensive urinary hormone profile, and is designed to assist with the clinical management of hormone-related symptoms in both male and females. This profile assesses parent hormones and their metabolites as well as key metabolic pathways, provides insight into the contribution that sex hormones may have in patients presenting with hormone-related complaints, and helps assess disease risk associated with elevated estrogen metabolites.
Urine measures the most metabolites, providing more insight into associated disease risk.
The Complete Hormones profile evaluates:
- Progesterone (via pregnanediol)
- Glucocorticoids, including cortisol
- Androgens, including DHEA and testosterone, and their metabolites
- Estrogens (E1 Estrone, E2 Estradiol, E3 Estriol) and metabolites, including hydroxylated and methoxylated estrogens
- Methylation capacity
- 5α-reductase activity
- Anabolic/Catabolic Balance
When should the Complete Hormones test be considered?
The Complete Hormones test is designed to assist in the management of hormone-related symptoms in both males and females.
The Complete Hormones test is ideal for establishing a baseline assessment of parent hormones and their metabolites ahead of clinical intervention with hormone therapy (HT) as well as subsequent monitoring if needed in both female and male patients.
The Complete Hormones test provides insight into the impact that shifting hormone levels may play in men (andropause or male menopause) and women (peri/menopause). Symptoms include the following:
Optimal range: 43 - 391 nmol/dL (SG)
11-Hydroxy-androsterone is a 5β-reduced compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 49 - 336 nmol/dL (SG)
11-Hydroxy-etiocholanolone is a compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 46 - 258 nmol/dL (SG)
11-Keto-androsterone is a that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 0 - 0 nmol/dL (SG)
11-Keto-etiocholanolone is a 5β-reduced compound that is an end product of androgen catabolism.
In the Genova complete hormone test this marker is part of the "Total 17-ketosteroids" group.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 0.4 - 7.7 mcg/g Creat.
16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. It is a potent estrogen similarly to estrone, and it has been suggested that the ratio of 16α-hydroxyestrone to 2-OH-E1, the latter being much less estrogenic in comparison and even antiestrogenic in the presence of more potent estrogens like estradiol, may be involved in the pathophysiology of breast cancer. Conversely, 16α-hydroxyestrone may help to protect against osteoporosis.
Optimal range: 973 - 8177 nmol/dL (SG)
An elevated 17-hydroxysteroids total and/or cortisol total may be caused by stress, strenuous exercise, inflammation, hypoglycemia, insulin resistance, hypothyroidism, or licorice ingestion.
Optimal range: 303 - 2184 nmol/dL (SG)
ANDROGENS such as DHEA, testosterone, and androstenedione tend to be extensively metabolized into downstream androgen compounds. As a result, the levels of testosterone along with “Total 17-ketosteroids” (DHEA plus metabolites) should be used to assess androgen status and/or efficacy of androgen replacement.
Optimal range: 973 - 8177 nmol/dL (SG)
An elevated 17-hydroxysteroids total and/or cortisol total may be caused by stress, strenuous exercise, inflammation, hypoglycemia, insulin resistance, hypothyroidism, or licorice ingestion.
Optimal range: 303 - 2184 nmol/dL (SG)
Testosterone and DHEA are metabolized into what are collectively known as the 17-ketosteroids.
Optimal range: 0.9 - 43.8 mcg/g Creat.
Optimal range: 0.3 - 5.9 mcg/g Creat.
Optimal range: 0 - 0 Ratio
Optimal range: 0.4 - 11.6 Ratio
There is evidence that methoxylated estrogens, especially the 2-pathway methoxylated estrogens (E1 and E2), are associated with decreased breast cancer risk; 2-MeOE2, produced from 2-OHE2, has been described to have anti-proliferative, antingiogenic, and pro-apoptotic activity in multiple types of cancer.
Optimal range: 0 - 8.8 mcg/g Creat.
Research focus is shifting toward 4-hydroxyesterone which is thought to have greater estrogenic and genotoxic potential than either 2-hydroxyestrone or 16a-hydroxyestrone.
Optimal range: 0 - 1 mcg/g Creat.
Most recent studies find an increased breast cancer risk associated with the ratio of 4-pathway cetechols to 4-pathway methylated catechols.
Optimal range: 38 - 331 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 0 - 0 Ratio
Optimal range: 0.1 - 1.4 Ratio
The Anabolic/Catabolic Balance refers to the balance between "growth and healing" (anabolic) and "wear and tear" (catabolic) activity in the body. Both anabolic and catabolic metabolism are essential to health.
Optimal range: 0 - 20 nmol/dL (SG)
The measurement of androstanediol, in addition to testosterone, is of interest for the evaluation of androgenic activity.
Optimal range: 43 - 580 nmol/dL (SG)
Androsterone and Etiocholanolone are DHEA metabolites via Androstenedione and the 5α- and 5β-reductase pathways.
Optimal range: 2.8 - 33 nmol/dL (SG)
DHEA is a hormone produced by both the adrenal gland and the brain. DHEA leads to the production of androgens and estrogens. DHEA levels in the body begin to decrease after age 30. Levels decrease more quickly in women.
Optimal range: 0.55 - 2.45 Ratio
The Etiocholanolone/Androsterone (E/A) Ratio assesses androgen metabolism by comparing the enzymatic activity of 5β-reductase/5α-reductase.
Optimal range: 0.6 - 15.4 mcg/g Creat.
The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.
Optimal range: 0.7 - 30.8 mcg/g Creat.
Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Optimal range: 1.1 - 26.2 mcg/g Creat.
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, since it is the least powerful of the three estrogen types, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers and estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 82 - 765 nmol/dL (SG)
Etiocholanolone is an androstenedione and testosterone metabolite that is excreted in the urine. It is produced from androstenedione and the 5-alpha and 5-beta-reductase metabolic pathways. It is helpful in evaluating adrenal and androgen function.
Optimal range: 8 - 196 nmol/dL (SG)
Progesterone rapidly metabolizes by the time it reaches the urine, and its direct metabolite, pregnanediol, is a reflection of circulating progesterone concentrations.
Optimal range: 23 - 176 nmol/dL (SG)
Progesterone is metabolized into numerous downstream compounds, but most immediately into pregnanediol and pregnanetriol. Urine levels of these metabolites tend to correlate with levels of serum progesterone, thus may be used to assess status of the hormone.
Optimal range: 8 - 48 nmol/dL (SG)
Testosterone is the major androgen in the body. It is converted to dihydrotestosterone by 5-alphareductase, and to estradiol by aromatase.
Optimal range: 126 - 559 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 627 - 6568 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Optimal range: 0 - 7.7 nmol/dL (SG)
This marker is part of the "17-Hydroxysteroids" group. Please refer to the "17-Hydroxysteroids, Total" marker.
Advanced Dried Urine Hormone Profile
The Advanced Dried Urine Hormone Profile provides a comprehensive evaluation of key hormone levels and their metabolites, offering deeper insights into hormonal balance and function. This test assesses a range of sex hormones, adrenal hormones, and their metabolites, helping to identify imbalances that may contribute to various symptoms and health conditions.
Hormone fluctuations are a natural part of life, especially in women, where levels shift throughout the menstrual cycle and different life stages. However, disruptions in this balance can lead to issues such as PMS, menopause, infertility, and complex conditions like PCOS and endometriosis. By analyzing dried urine samples, this test delivers a detailed view of hormone metabolism, guiding targeted treatment strategies for hormonal health.
This test is ideal for individuals experiencing symptoms of hormonal imbalance or those seeking a proactive approach to hormonal health. It provides actionable insights for personalized treatment plans, whether addressing reproductive health, adrenal function, or overall hormone metabolism.
Optimal range: 0.35 - 1.07 µg/g
16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. It is a potent estrogen similarly to estrone, and it has been suggested that the ratio of 16α-hydroxyestrone to 2-OH-E1, the latter being much less estrogenic in comparison and even antiestrogenic in the presence of more potent estrogens like estradiol, may be involved in the pathophysiology of breast cancer. Conversely, 16α-hydroxyestrone may help to protect against osteoporosis.
Optimal range: 0.21 - 0.38 Ratio
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1.
2-Methoxy-E1 has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy-E1 levels were lower in breast cancer patients than controls.
Optimal range: 0.03 - 0.08 µg/g
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy estrogens are produced from 2-OH estrogens through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH estrogens and particularly 2-Methoxy estrogens.
2-Methoxy estrogens has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy estrogen levels were lower in breast cancer patients than controls.
Optimal range: 0.26 - 0.68 µg/g
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1.
2-Methoxy-E1 has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy-E1 levels were lower in breast cancer patients than controls.
Optimal range: 1.29 - 5.49 Ratio
2-hydroxyestrone and 16-hydroxyestrone are Phase I metabolites of Estrone (E1). Their ratio is of clinical significance in pre and peri-menopausal women. In post-menopausal women it does not have the same clinical significance. It is, however, hypothesized that the 2/16 ratio is important in menopausal women who are on hormone replacement therapy (HRT).
Optimal range: 0.17 - 0.7 µg/g
Research and clinical studies show that the 2-hydroxylated estrogens (2-OH E2 and 2-OH E1) are a safer pathway of hydroxylation than the 4-hydroxyestrogens (4-OH E2 and 4-OH E1), which bind to and damage DNA, leading to mutations that are associated with increased breast cancer risk.
Optimal range: 0.7 - 2.54 µg/g
Most consider 2-OH-E1 favorable
Estrogen is metabolized (primarily by the liver) down three phase I pathways. The 2-OH pathway is considered the safest because of the anti-cancer properties of 2-OH metabolites. Conversely, the 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA. The third pathway, 16-OH creates the most estrogenic of the metabolites (although still considerably less estrogenic than estradiol) - 16-OH-E1.
Optimal range: 3.93 - 11.62 µg/g creatinine
20a-Dihydroprogesterone (20a-DHP), also known as 20a-hydroxyprogesterone (20a-OHP), is a naturally occurring, endogenous progestogen. It is a metabolite of progesterone, formed by the 20a-hydroxysteroid dehydrogenases (20a-HSDs). 20a-DHP can be transformed back into progesterone by 20a-HSDs. 20a-DHP has very low affinity for the progesterone receptor and is much less potent as a progestogen in comparison to progesterone.
3a- and 20a- dihydroprogesterone, have tumor-inhibitory properties in breast cancer.
Optimal range: 0.67 - 2.03 µg/g creatinine
3a-Dihydroprogesterone (3a-DHP), also known as 3a-hydroxyprogesterone, is an endogenous neurosteroid. It is biosynthesized by 3a-hydroxysteroid dehydrogenase from progesterone. 3a-DHP has been found to act as a positive allosteric modulator of the GABAA receptor and is described as being as active as allopregnanolone in regard to this action. In accordance, it has anxiolytic effects in animals. 3a-DHP has also been found to inhibit the secretion of follicle-stimulating hormone (FSH) from the rat pituitary gland, demonstrating possible antigonadotrophic properties.
Optimal range: 0.19 - 0.77 ug/g
3a-Dihydroprogesterone (3a-DHP), also known as 3a-hydroxyprogesterone, is an endogenous neurosteroid. It is biosynthesized by 3a-hydroxysteroid dehydrogenase from progesterone. 3a-DHP has been found to act as a positive allosteric modulator of the GABAA receptor and is described as being as active as allopregnanolone in regard to this action. In accordance, it has anxiolytic effects in animals. 3a-DHP has also been found to inhibit the secretion of follicle-stimulating hormone (FSH) from the rat pituitary gland, demonstrating possible antigonadotrophic properties.
Optimal range: 0.05 - 0.13 Ratio
Healthy Phase II metabolism methylates 2-hydroxy (2-OH) estrogens to the more cancer-protective 2-methoxy (2-MeO) forms, and neutralizes the potentially carcinogenic 4-OH estrogens to their 4-MeO forms.
Optimal range: 0.1 - 0.29 Ratio
Healthy Phase II metabolism methylates 2-hydroxy (2-OH) estrogens to the more cancer-protective 2-methoxy (2-MeO) forms, and neutralizes the potentially carcinogenic 4-OH estrogens to their 4-MeO forms.
Optimal range: 0 - 0.04 µg/g
4-Methoxyestradiol (4-ME2) is an endogenous, naturally occurring methoxylated catechol estrogen and metabolite of estradiol that is formed by catechol O-methyltransferase via the intermediate 4-hydroxyestradiol.
Optimal range: 0 - 0.04 µg/g
Neutralized version of carcinogenic 4-OH-E1
Optimal range: 0.1 - 0.18 µg/g
4-OHE1and 4-OH-E2 are referred to as the “bad” estrogens, along with 16a-OHE1. They are primarily produced by CYP1B1 and CYP34A, respectively, enzymes localized in tissues, including breast and prostate as well as liver. Some have suggested that increased expression of CYP1B1 and 4-hydroxylation of estradiol are biomarkers of tumorigenesis.
Human breast cancer tissue produces much higher levels of 4-OH than 2-OH, while normal breast tissue produces approximately equal amounts of the two metabolites. Women taking hormone therapy with a polymorphism in CYP1B1 had twice the risk of developing breast cancer compared to other HRT users.
Optimal range: 0.17 - 0.47 µg/g
- The 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA.
- Estrone is hydroxylated through Phase 1 detox to form 4-OH-E1. In Phase 2 it is methylation to form 4-MeE1. When 4-OH-E1 is properly methylated to 4-MeE1 it is relatively benign as the 4-MeE1 is easily eliminated and risks are low.
- When it is not methylated 4-OH-E1 builds up. Then it converts to 3,4-Quinones which are carcinogenic similarly to the 16 pathway. Women with uterine fibroids may have increased levels of 4-OH-E1. High levels of estrogen across the board are associated with heavy cycles.
Optimal range: 2.98 - 13.1 µg/g creatinine
5a,3a–androstanediol is a neuroactive steroid that enhances dopamine activity, important for mood elevation.
Optimal range: 2.32 - 8.17 ug/g Cr
5a,3a–androstanediol is a neuroactive steroid that enhances dopamine activity, important for mood elevation.
3a-Androstanediol (often abbreviated as 3a-diol), also known as 5a-androstane-3a,17b-diol, is an endogenous inhibitory androstane neurosteroid and a weak androgen, and a major metabolite of dihydrotestosterone (DHT). As a neurosteroid, it acts as a potent positive allosteric modulator of the GABAA receptor, and has been found to have rewarding, anxiolytic, pro-sexual, and anticonvulsant effects. Relative to its isomer 3b-androstanediol, which is a potent estrogen, 3a-androstanediol has substantially lower, though still significant affinity for the estrogen receptors.
Optimal range: 0.28 - 1.52 µg/g creatinine
5a-DHT is a testosterone metabolite.
5a-DHT is essential for the development of the male sex characteristics before birth, particularly the formation of the external genitalia. In the adult, 5a-DHT is needed to develop and maintain male gender characteristics, such as facial hair, deep voice, and muscle growth. In women, 5a-DHT may induce the onset of puberty and causes the body and pubic hair growth.
Increased 5a-DHT levels are found in about 40% of patients with idiopathic hirsutism and 35% of patients with polycystic ovarian syndrome (=PCOS).
Optimal range: 0.26 - 0.98 ug/g Cr
Optimal range: 14.65 - 76.71 µg/g creatinine
Allopregnanediol, or 5a-pregnane-3a,20a-diol, is an endogenous metabolite of progesterone and allopregnanolone and an isomer of pregnanediol.
Optimal range: 1.38 - 6.75 ug/g Cr
Allopregnanediol, or 5a-pregnane-3a,20a-diol, is an endogenous metabolite of progesterone and allopregnanolone and an isomer of pregnanediol. Progesterone is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans. It belongs to a group of steroid hormones called the progestogens and is the major progestogen in the body. Progesterone has a variety of important functions in the body. It is also a crucial metabolic intermediate in the production of other endogenous steroids, including the sex hormones and the corticosteroids, and plays an important role in brain function as a neurosteroid. In addition to its role as a natural hormone, progesterone is used as a medication, for instance in menopausal hormone therapy.
Optimal range: 2.23 - 14.87 µg/g creatinine
Allopregnanolone, also known as brexanolone, is a medication and a naturally produced steroid that acts on the brain. Allopregnanolone possesses a wide variety of effects, including, in no particular order, antidepressant, anxiolytic, stress-reducing, rewarding, prosocial, antiaggressive, prosexual, sedative, pro-sleep, cognitive, memory-impairment, analgesic, anesthetic, anticonvulsant, neuroprotective, and neurogenic effects.
Optimal range: 0.3 - 1.31 ug/g Cr
Allopregnanolone is a neurosteroid hormone that plays a significant role in the context of postmenopausal women. During the menopausal transition, there is a notable reduction in allopregnanolone levels, primarily due to decreased ovarian synthesis of progesterone. This hormonal change can have implications for mood and cognition.
Optimal range: 3.93 - 13.53 µg/g creatinine
DHEA and androstenedione are made almost exclusively by the adrenal gland (although a smaller amount is made in the ovaries). These hormones appear in urine as DHEA-S (DHEA-Sulfate), androsterone and etiocholanolone.
Optimal range: 248 - 937 µg/g creatinine
Androsterone is a DHEA metabolite via the 5-alpha-reductase pathway. The 5-alpha pathway is more androgenic.
Optimal range: 152 - 482 ug/g Cr
Androsterone is the product of androgens metabolized by 5-alpha reductase. It acts as a neurosteroid and a weak potentiator of GABA-A receptor activity.
Optimal range: 1.11 - 3.74 µg/g creatinine
Bisphenol A (BPA) is a xenoestrogen, exhibiting estrogen-mimicking, hormone-like properties that raise concern about its suitability in some consumer products and food containers. Bisphenol A (BPA) is an organic synthetic compound and it is a starting material for the synthesis of plastics, primarily certain polycarbonates and epoxy resins, as well as some polysulfones and certain niche materials. BPA is an endocrine-disrupting chemical that has been found to bind to both of the nuclear estrogen receptors. A recent exposure to plastic that released excessive amounts of BPA into a food or a beverage could be identified by high levels of urinary BPA.
Optimal range: 1.5 - 4.5 ug/g Cr
Optimal range: 3.19 - 9.59 µg/g creatinine
Corticosterone, also known as 17-deoxycortisol, is a steroid hormone of the corticosteroid type produced in the cortex of the adrenal glands. Corticosterone has multiple effects on memory. The main effects are seen through the impact of stress on emotional memories as well as long term memory. With emotional memories, corticosterone is largely associated with fear memory recognition. Not only does corticosterone have effects on emotional memories but memory recognition and consolidation as well.
Optimal range: 0.5 - 0.7 Ratio
Cortisol is a steroid hormone synthesized from cholesterol by a multienzyme cascade in the adrenal glands. It is the main glucocorticoid in humans and acts as a gene transcription factor influencing a multitude of cellular responses in virtually all tissues. Cortisol plays a critical role in glucose metabolism, maintenance of vascular tone, immune response regulation, and in the body's response to stress. Its production is under hypothalamic-pituitary feedback control.
Cortisone, a downstream metabolite of cortisol, provides an additional variable to assist in the diagnosis of various adrenal disorders, including abnormalities of 11-beta-hydroxy steroid dehydrogenase (11-beta HSD), the enzyme that converts cortisol to cortisone. Deficiency of 11-beta HSD results in a state of mineralocorticoid excess because cortisol (but not cortisone) acts as a mineralocorticoid receptor agonist. Licorice (active component glycyrrhetinic acid) inhibits 11-beta HSD and excess consumption can result in similar changes.
Optimal range: 0.3 - 2 mg/ml
The evaluation of the creatinine concentration in the urine does only serve as an admeasurement of the individual efficiency of the kidney. High values point to an urine concentration, low values to a strong dilution. Only the consideration of these circumstances allowes to evaluate the requested analyte correctly.
Optimal range: 0.3 - 2 mg/ml
The evaluation of the creatinine concentration in the urine does only serve as an admeasurement of the individual efficiency of the kidney. High values point to an urine concentration, low values to a strong dilution. Only the consideration of these circumstances allowes to evaluate the requested analyte correctly.
Optimal range: 0.3 - 2 mg/ml
The evaluation of the creatinine concentration in the urine does only serve as an admeasurement of the individual efficiency of the kidney. High values point to an urine concentration, low values to a strong dilution. Only the consideration of these circumstances allowes to evaluate the requested analyte correctly.
Optimal range: 0.3 - 2 mg/ml
The evaluation of the creatinine concentration in the urine does only serve as an admeasurement of the individual efficiency of the kidney. High values point to an urine concentration, low values to a strong dilution. Only the consideration of these circumstances allowes to evaluate the requested analyte correctly.
Optimal range: 0.3 - 2 mg/ml
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Optimal range: 0.69 - 2.23 µg/g creatinine
Deoxycorticosterone (DOC) is a steroid hormone synthesized in the adrenal gland and is a precursor for the synthesis of cortisol and aldosterone. The levels of DOC of pregnant women are extraordinarily high compared with those in men and nonpregnant women. The major diagnostic utility of measurement of steroid synthesis intermediates such as Deoxycorticosterone is in diagnosing disorders of steroid synthesis.
Optimal range: 15.82 - 129.17 µg/g creatinine
DHEA-S is the sulfate ester of DHEA and only a part of DHEA testing. If this marker was low it would mean that there is potential inflammation blocking DHEA being converted to DHEA-S.
Optimal range: 0.3 - 2 Ratio
The ratio of potentially toxic urinary estrogens (i.e. 2- and 4-catechols of estradiol and estrone) to inert estriol has been used for many years as an index of breast cancer risk.
Optimal range: 2.01 - 4.66 µg/g creatinine
Epitestosterone, or isotestosterone is an endogenous steroid and an epimer of the androgen sex hormone testosterone. It is a weak competitive antagonist of the androgen receptor (AR). Structurally, epitestosterone differs from testosterone only in the configuration at the hydroxy-bearing carbon, C17. Epitestosterone is believed to form in a similar way to testosterone; studies found that around 50% of epitestosterone production in human males can be ascribed to the testis, although the exact pathway of its formation is still the subject of research. It has been shown to accumulate in mammary cyst fluid and in the prostate. Epitestosterone levels are typically highest in young males; however, by adulthood, most healthy males exhibit a testosterone to epitestosterone ratio (T/E ratio) of about 1:1
Optimal range: 0.78 - 1.79 µg/g creatinine
The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.
Optimal range: 0.78 - 1.98 µg/g
Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Optimal range: 2.27 - 5.22 µg/g
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, since it is the least powerful of the three estrogen types, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers and estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 330 - 960 µg/g creatinine
Etiocholanolone is a DHEA metabolite that is excreted in the urine. It is produced from androstenedione and the 5-beta-reductase metabolic pathway. It is helpful in evaluating adrenal and androgen function.
Optimal range: 7.8 - 29.5 µg/g creatinine
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Advanced Dried Urine Hormone Profile (NutriPATH) test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Free Cortisol (1st Morning)
- Free Cortisol (2nd Morning)
- Free Cortisol (Evening)
- Free Cortisol (Night)
When you are looking at Free Cortisol (1st Morning) it is essential to also look at Free Cortisol (2nd Morning). The difference between those 2 cortisol samples is called the cortisol awakening response (or CAR).
An elevated CAR would mean that the difference between those 2 markers is really big.
Different possible reasons for an elevated CAR:
- an overactive HPA axis (=plays an important role in the stress response), ongoing job-related stress (anticipatory stress for the day)
- blood sugar dysregulation
- pain (i.e. waking with painful joints or a migraine),
- and general depression (not Seasonal affective disorder/”winter depression”)
Neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) does. So this means that if your morning free cortisol reading spikes up high first thing in the morning, there is something to look at. Is there an overactivity to stress? Are you anticipating a stressful day at work? If your morning free cortisol levels are high, this can be due to stress or anticipating stress.
Optimal range: 23.4 - 68.9 µg/g creatinine
This is the 2nd cortisol sample of the day. Usually measured 30 to 60 minutes after waking.
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Advanced Dried Urine Hormone Profile (NutriPATH) test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Free Cortisol (1st Morning)
- Free Cortisol (2nd Morning)
- Free Cortisol (Evening)
- Free Cortisol (Night)
When you are looking at Free Cortisol (2nd Morning) it is essential to also look at Free Cortisol (1st Morning). The difference between those 2 cortisol samples is called the cortisol awakening response (or CAR).
An elevated CAR would mean that the difference between those 2 markers is really big.
Different possible reasons for an elevated CAR:
- an overactive HPA axis (=plays an important role in the stress response), ongoing job-related stress (anticipatory stress for the day)
- blood sugar dysregulation
- pain (i.e. waking with painful joints or a migraine),
- and general depression (not Seasonal affective disorder/”winter depression”)
Neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) does. So this means that if your morning free cortisol reading spikes up high first thing in the morning, there is something to look at. Is there an overactivity to stress? Are you anticipating a stressful day at work? If your morning free cortisol levels are high, this can be due to stress or anticipating stress.
Optimal range: 6 - 19.2 µg/g creatinine
This is the 3rd cortisol sample of the day. Usually measured in the afternoon/evening.
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Advanced Dried Urine Hormone Profile (NutriPATH) test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Free Cortisol (1st Morning)
- Free Cortisol (2nd Morning)
- Free Cortisol (Evening)
- Free Cortisol (Night)
Optimal range: 2.6 - 8.4 µg/g creatinine
This is the 4th cortisol sample of the day (=evening/night).
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
In the Advanced Dried Urine Hormone Profile (NutriPATH) test there are 4 individual free cortisol readings that were measured at different times throughout one day:
- Free Cortisol (1st Morning)
- Free Cortisol (2nd Morning)
- Free Cortisol (Evening)
- Free Cortisol (Night)
Optimal range: 31.6 - 91.6 µg/g creatinine
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Free Cortisone (1st Morning) can help to confirm the marker Free Cortisol (1st Morning).
Optimal range: 63.3 - 175.8 µg/g creatinine
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Free Cortisone (2nd Morning) can help to confirm the marker Free Cortisol (2nd Morning).
Optimal range: 30.6 - 88.5 µg/g creatinine
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Free Cortisone (Evening) can help to confirm the marker Free Cortisol (Evening).
Optimal range: 15.5 - 44.7 µg/g creatinine
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Free Cortisone (Night) can help to confirm the marker Free Cortisol (Night).
Optimal range: 18 - 40.9 µg/g creatinine
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH).
Optimal range: 7.3 - 31.9 µg/g creatinine
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH).
Optimal range: 0.7 - 2.2 µg/g creatinine
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH).
Optimal range: 1.7 - 11.1 µg/g creatinine
Melatonin is not technically an adrenal or sex hormone however it is highly involved in the entire endocrine system. It is made in small amounts in the pineal gland in response to darkness and stimulated by Melanocyte Stimulating Hormone (MSH).
Optimal range: 1000 - 1500 µg/g creatinine
Based on the optimal luteal levels of urinary Pgdiol (about 1300-2000 µg/g creatinine) an optimal working range for the ratio of this progesterone metabolite to estradiol was established based on the median level of urinary estradiol (1.37 µg/g creatinine). Thus the optimal working ratio of urinary Pgdiol to estradiol in the premenopausal woman during the peak luteal phase should be in the neighborhood of about 1000 to 1500.
Optimal range: 465 - 1609 µg/g creatinine
Progesterone itself is not readily found in the urine. Instead, this test measures pregnanediol (a progesterone metabolite). Pregnanediol is well-established in research literature as a reliable marker for progesterone levels.
Optimal range: 0.5 - 3 µg/g creatinine
Optimal range: 1.22 - 3.97 µg/g creatinine
Testosterone is the major androgen in the body. It is converted to dihydrotestosterone by 5-alphareductase, and to estradiol by aromatase.
Optimal range: 214 - 546 µg/g creatinine
This is one of the three cortisol metabolites. The total some of the three cortisol metabolites gives us a good indication of the overall cortisol production in your body.
Two of the 3 metabolites are the active form of cortisol (THF). The other metabolite is in the inactive form cortisone.
This particular marker (a-THF) hence is an active cortisol metabolite.
Optimal range: 437 - 1184 µg/g creatinine
This is one of the three cortisol metabolites. The total some of the three cortisol metabolites gives us a good indication of the overall cortisol production in your body.
Two of the 3 metabolites are the active form of cortisol (THF). The other metabolite is in the inactive form cortisone.
This particular marker (b-THE) hence is an inactive cortisone metabolite.
Optimal range: 12.26 - 33.12 µg/g creatinine
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 23.27 - 50.88 µg/g creatinine
The inactive or “storage form” of adrenal glucocorticoid. Can be reversibly transformed to cortisol. Clinically, cortisone may reflect a measure of adrenal reserve when compared to cortisol. Ideally, cortisone will be about 30% higher than cortisol when both are at optimal levels. Values at the high end or low end of the reference range are generally not optimal.
OMX Organic Metabolomics / Diagnostic Solutions
The OMX™ Organic Metabolomics Test is an advanced functional health assessment that analyzes organic acids, amino acids, and other key metabolites to provide a detailed view of your body’s metabolic function and nutrient needs. Developed by Diagnostic Solutions Laboratory, this test offers insights into how well your body processes food, generates energy, detoxifies, and responds to environmental stressors.
The OMX™ test evaluates biomarkers related to:
Metabolic pathway efficiency
Mitochondrial energy production
Amino acid balance and utilization
Nutrient and vitamin cofactor levels
Detoxification and oxidative stress
Gut microbial metabolites and dysbiosis
Mood and neurotransmitter metabolism
This test is ideal for individuals experiencing:
Chronic fatigue or low energy
Nutrient deficiencies despite supplementation
Cognitive or mood changes
Digestive issues or bloating
Hormonal or metabolic imbalances
Suspected exposure to toxins or oxidative stress
Comprehensive metabolic health overview
Early detection of functional imbalances
Supports personalized nutrition and treatment plans
Useful in chronic conditions, functional medicine, and integrative care
Urine or plasma (easy sample collection options available)
Gain a deeper understanding of your body's unique biochemistry and take the guesswork out of nutrition, detox, and lifestyle decisions with the OMX™ Organic Metabolomics Test.
Optimal range: 88 - 394.4 nmol/mg Creatinine
It is a component of the dietary peptide anserine. Anserine is beta-alanyl-1-methyl-L-histidine, and it is known to come from chicken, turkey, duck, rabbit, tuna and salmon.
Optimal range: 0 - 16 nmol/ML
1-methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 0 - 0.6 nmol/mg Creatinine
2-Methylhippuric Acid (2MHA), 3-Methylhippuric Acid (3MHA), 4-Methylhippuric Acid (4MHA) -- These are metabolites of xylenes, solvents found in paints, lacquers, cleaning agents, pesticides, and gasoline. Exposure to xylenes generates methylhippuric acid isomers.
Optimal range: 0 - 2.1 nmol/mg Creatinine
Optimal range: 3.7 - 36 nmol/mg Creatinine
Methylsuccinic acid is a normal metabolite found in human fluids. Increased urinary levels of methylsuccinic acid (together with ethylmalonic acid) are the main biochemical measurable features in ethylmalonic encephalopathy, a rare metabolic disorder with an autosomal recessive mode of inheritance that is clinically characterized by neuromotor delay, hyperlactic acidemia, recurrent petechiae, orthostatic acrocyanosis, and chronic diarrhea. The underlying biochemical defect involves isoleucine catabolism.
Moreover, methylsuccinic acid is found to be associated with ethylmalonic encephalopathy, isovaleric acidemia, and medium-chain acyl-CoA dehydrogenase deficiency, which are also inborn errors of metabolism.
Note: These tests are used to check for rare metabolic disorders, usually in infants. There is no apparent reason nor benefit to checking ethylmalonic and methylsuccinic acid levels in adults who aren’t suspected to have rare genetic disorders.
Optimal range: 0 - 4.4 nmol/mg Creatinine
- 3,4-dihydroxyphenylpropionic acid is found in red beetroot, common beet, olives, and correlated with coffee intake.
- One of the most abundant phenolates, formed by microbial transformation of dietary polyphenols and endogenous metabolites such as dopamine, phenylalanine, tyrosine, and tryptophan. 3,4-dihydroxyphenylpropionic acid is highly correlated with homovanillic acid (HVA).
- 3,4-dihydroxyphenylpropionic acid has antioxidant properties and significantly inhibited the secretion of pro-inflammatory cytokines
Optimal range: 0 - 521.8 nmol/mg Creatinine
3,5-Dihydroxybenzoic acid was highly correlated with intake of whole-grain bread and breakfast cereals, and a primary metabolite of alkylresorcinols, a biomarker for whole-grain intake.
Alkylresorcinols are a naturally occurring type of phenolic lipid found in high concentrations in the outer layer and bran of cereal grain, primarily wheat and rye.
Optimal range: 28.2 - 2371.9 nmol/mg Creatinine
Optimal range: 0 - 26.9 nmol/ML
3-Methylhistidine is an amino acid which is excreted in human urine.
The measurement of 3-methylhistidine provides an index of the rate of muscle protein breakdown. 3-Methylhistidine is a biomarker for meat consumption, especially chicken. It is also a biomarker for the consumption of soy products.
Optimal range: 0 - 0.5 nmol/mg Creatinine
Phenylpropionylglycine is an acyl glycine. Acyl glycines are normally minor metabolites of fatty acids. However, the excretion of certain acyl glycines is increased in several inborn errors of metabolism. In certain cases the measurement of these metabolites in body fluids can be used to diagnose disorders associated with mitochondrial fatty acid beta-oxidation. Acyl glycines are produced through the action of glycine N-acyltransferase, which is an enzyme that catalyzes the chemical reaction: acyl-CoA + glycine < -- > CoA + N-acylglycine.
Optimal range: 1.4 - 15.7 nmol/mg Creatinine
(p-Hydroxybenzoate or 4-HB)
- One of the most abundant phenolates formed by the microbiota. It is a product of microbial transformation of dietary polyphenols and endogenous metabolites such as dopamine, phenylalanine, tyrosine, and tryptophan.
- It is found in red huckleberry, coriander, blueberry, Swiss chard, carrots, olive, and sour cherries.
- Coenzyme Q10 is synthesized in multiple steps from the precursor 4-hydroxybenzoic acid. CoQ10 is composed of a benzoquinone ring.
- 4-hydroxybenzoic acid increased on a low FODMAP diet and is positively associated with Firmicutes, Verrucomicrobia, and A. muciniphilia, and negatively with Actinobacteria.
- 4-hydroxybenzoic acid is the common metabolite of all parabens, structurally related benzoic acid (without the OH group) and has potential endocrine activity.
Optimal range: 43.1 - 528.1 nmol/mg Creatinine
4-Hydroxyphenylacetate is a tyrosine metabolic product of certain Clostridia bacteria. Elevated levels are associated with Clostridia overgrowth, small intestinal bowel overgrowth (SIBO), or small bowel disease. May also indicate celiac disease.
For individuals with normal, healthy intestinal function, the compound p-Hydroxyphenylacetate should not appear as more than background concentrations in urine.
Measurement of 4-hydroxyphenylacetic acid excretion in urine is useful in screening for diseases of the small intestine associated with bacterial overgrowth.
Optimal range: 0 - 355.9 nmol/mg Creatinine
AKA: 4-Hydroxyphenylpyruvate, 4-HPPA
4-hydroxyphenylpyruvic acid is an intermediate in the breakdown of phenylalanine.
4-hydroxyphenylpyruvic acid is converted to homogentisate; a blockage at this step results in increased homogentisate, which can be diagnostic of alkaptonuria.
If the pathway is not blocked, 4-HPPA ends up in the Krebs cycle converted into fumaric acid.
Optimal range: 0 - 23.3 nmol/mg Creatinine
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 6.4 nmol/mg Creatinine
8-hydroxy-2-deoxyguanosine measures the oxidative impact to DNA. 8-hydroxy-2-deoxyguanosine levels will be high if your total antioxidant protection is inadequate.
Optimal range: 15.4 - 95.6 nmol/mg Creatinine
a-hydroxybutyric acid (2-hydroxybuturic acid [2-HB]) is a marker that relates to oxidative stress.
a-hydroxybutyric acid is an organic acid produced from a-ketobutyrate via the enzymes lactate dehydrogenase (LDH) or a-hydroxybutyrate dehydrogenase (HBDH).
Optimal range: 0 - 83.5 nmol/mg Creatinine
a-Keto-b-Methylvaleric Acid is a B-Complex Vitamin Marker. Vitamins are compounds that your body needs to be healthy. Vitamins are “essential” for proper function, which means that they are not made inside your body and must be consumed in the diet.
A metabolites of isoleucine.
Optimal range: 0 - 12.6 nmol/mg Creatinine
- Alpha-ketobutyric acid results from the breakdown of threonine or methionine during glutathione production.
- Specifically, cystathionine is metabolized to alpha-ketobutyric acid and cysteine.
- a- ketobutyric acid enters the mitochondrial matrix and get converted to propionyl-CoA by the branched chain keto-acid dehydrogenase complex (BCKDHC) and enters the Krebs cycle at succinyl-CoA.
- Evaluate lactate and the branched chain keto acids
- Evaluate alpha-hydroxybutyric acid
- Associated Nutrients: Vitamin B3
- a -Ketobutyric acid is produced from cystine, along with hydrogen sulfide (H2S) as a by-product.
- a- Ketobutyric acid is reversibly converted to a- hydroxybutyric acid.
Optimal range: 0 - 169.6 nmol/mg Creatinine
Alpha-Ketoglutarate is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 20.4 nmol/mg Creatinine
2-Ketoisocaproic Acid is a B-Complex Vitamin Marker (Leucine catabolism).
2-Ketoisocaproic Acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Optimal range: 0 - 6.1 nmol/mg Creatinine
Alpha-Ketoisovalerate (together with Alpha-Ketoisocaproate and Alpha-Keto-Beta-methylvalerate) requires Vitamins B1, B2, B3, B5 and lipoic acid to be metabolized.
Optimal range: 7.4 - 63.2 nmol/mg Creatinine
Optimal range: 0 - 4.8 nmol/ML
- An intermediate metabolite of lysine metabolism, produced primarily under oxidative stress (metal-catalyzed oxidation).
- In adolescents, α-aminoadipic acid was associated with adipogenesis and insulin resistance.
- Higher plasma α-aminoadipic acid was associated with a 4-fold risk of future diabetes and identified risk up to 12 years before the onset of overt disease.
- BCAAs, cystine, α-aminoadipic acid, phenylalanine, and leucine + lysine were significantly increased in obesity, T2D, and with worsening health.
Alpha-aminoadipic acid (also known as 2-aminoadipic acid) is an intermediary biomarker of lysine and tryptophan metabolism. The further metabolism of alpha-aminoadipic acid to alpha-ketoadipic acid requires vitamin B6.
Plasma alpha-aminoadipic acid is strongly associated with the risk of developing diabetes as seen in an assessment of the Framingham Heart Study data. Circulating levels were found to be elevated for many years prior to the onset of diabetes. Preclinical data shows it may also play a role in oxidation and atherosclerotic plaque formation.
Optimal range: 4.3 - 55.6 nmol/mg Creatinine
Adipic Acid, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Optimal range: 47.2 - 439 nmol/mg Creatinine
Optimal range: 271.5 - 730 nmol/ML
- In a review of 46 studies higher plasma alanine was a potential predictor of insulin resistance and diabetes.
- In a review of baseline urine markers and conventional metabolic assessments, with a 5-year follow up, elevated baseline urine alanine was found to correlate with elevated levels of A1C (effect size >.8) and insulin resistance, independent of weight.
- Plasma alanine and asparagine were reduced in B6 deficiencies in animal studies.
- Plasma alanine and glutamic acid both positively correlated with depression.
- Branched-chain amino acids (BCAA) are the primary nitrogen source for glutamine and alanine synthesis; BCAA are associated with metabolic disease.
- Blood alanine was lower in IBD compared to controls.
Optimal range: 0 - 2.1 mcg/g Creat.
Aldosterone is a mineralcoritcoid and a hormone. It allows the transport of sodium across the cell membrane. Aldosterone is important in blood pressure regulation and also for the volume of blood found in the blood vessels.
Optimal range: 0 - 224.5 nmol/mg Creatinine
Anserine is a dipeptide composed of beta-alanine and histidine, and it is included in the OMX Organic Metabolomics test panel by Diagnostic Solutions Laboratory. Elevated levels of anserine in the test results can indicate increased muscle metabolism or oxidative stress, as anserine acts as a buffer in muscle tissue, helping to maintain pH levels during intense physical activity. This marker is particularly relevant for athletes or individuals engaged in high levels of physical exertion, as it may reflect adaptations to training or muscle recovery processes. Additionally, anserine levels can provide insights into dietary habits, particularly protein intake, and may also be associated with certain metabolic conditions. Monitoring anserine alongside other metabolites allows practitioners to gain a comprehensive understanding of a patient's metabolic health and tailor interventions accordingly.
Optimal range: 0 - 18.4 nmol/ML
Anserine is part of a group of Beta-Amino Acids and Derivatives. Anserine is beta-alanyl-1-methyl-L-histidine, and it is known to come from chicken, turkey, duck, rabbit, tuna and salmon.
Optimal range: 0 - 11.9 nmol/mg Creatinine
Other names: Anthranilate
- Several clinical studies have reported increased excretion of anthranilic acid and other metabolites in bladder cancer patients.
- Anthranilic acid was one of nine markers that positively correlated with proteinuria.
- Anthranilic acid comes from the kynurenine pathway, which is B6 dependent; Anthranilic acid activity may be reduced during vitamin B6 restriction.
- In a mathematical model without a tryptophan load, a moderate B6 deficiency resulted in slight decreases in kynurenic and anthranilic acids.
- Patients with acute intermittent porphyria had significantly increased urinary excretion of kynurenine and anthranilic acid.
Optimal range: 0 - 9 nmol/mg Creatinine
- Evaluate for consumption of foods and pharmaceuticals that contain arabinitol.
- Because a common substrate for the production of arabinitol in the body is glucose, reduced intake of dietary sugars is a key therapeutic area for elevated arabinitol.
- Urinary arabinitol has been noted as a marker for invasive candidiasis or infection by Candida fungal species, though other genera are capable of production.
- Microbiome analysis is a reasonable next step if high levels of arabinitol are found in the urine. Treatment of an imbalanced microbiome can help reduce the overgrowth of pathogenic species that have been found to produce arabinitol.
Optimal range: 0 - 26.4 nmol/mg Creatinine
→ Arginine is a precursor of urea, nitric oxide, polyamines (putrescine, spermidine, spermine and agmatine), proline, glutamate, and creatine.
→ Levels may drop with increased need, or in renal or small intestine dysfunction.
→ Synthesis of arginine depends on citrulline levels and is less regulated by dietary arginine. Supplementation with citrulline increases plasma arginine and the production of nitric oxide (NO).
→ Arginine supplementation may lower blood pressure.
→ Metabolism of elevated arginine levels is dependent on glycine availability.
→ Plasma arginine and ornithine increased, while citrulline remained stable, following watermelon juice intake, a rich source of citrulline.
Optimal range: 36.9 - 112.2 nmol/ML
Optimal range: 0 - 29.5 nmol/mg Creatinine
It is not normally detectable in healthy adults. Adult argininosuccinate lyase insufficiencies are typically treated with a lower protein/higher carbohydrate diet, arginine supplementation, and avoidance of fasting.
Optimal range: 0 - 14.2 nmol/ML
Optimal range: 14 - 159.7 nmol/mg Creatinine
Optimal range: 15.6 - 62.7 nmol/ML
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 0 - 47.5 nmol/mg Creatinine
Asparagine is converted to aspartic acid, then to glutamic acid.
Asparagine is a nontoxic carrier of residual ammonia. A byproduct of asparagine metabolism is oxaloacetate.
Higher levels of asparagine were associated with lower rates of diabetes, insulin, and HOMA.
Plasma asparagine and the tyrosine/phenylalanine ratio were found to be protective against depression.
Higher asparagine, aspartic acid, and citrulline were associated with higher rates of physical frailty and sarcopenia.
Plasma glutamine, cysteine, and asparagine were significantly downregulated in psoriasis patients.
Optimal range: 5.4 - 21.5 nmol/ML
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 3.2 - 116.4 nmol/mg Creatinine
b-hydroxybutyrate is one of the ketone bodies.
The term ketone body describes any of 3 molecules: acetoacetate, b-hydroxybutyrate, or acetone. Acetoacetate is produced by acetyl-CoA metabolism, b-hydroxybutyrate is the result of acetoacetate reduction, and acetone is produced by the spontaneous decarboxylation of acetoacetate.
Ketone bodies are fundamental for metabolic homeostasis during periods of prolonged starvation. The brain cannot use fatty acids for energy production and usually depends on glucose to meet its metabolic needs. In cases of fasting or starvation, ketone bodies become a major fuel for brain cells, sparing amino acids from being catabolized to gluconeogenesis precursors to be used to supply the brain with energy. After prolonged starvation, ketone bodies can provide as much as two thirds of the brain's energy needs.
Ketone bodies are strong organic acids that fully dissociate in blood. When ketone body production becomes uncontrollable, the buffering systems are saturated, and blood pH drops; this is a condition known as ketoacidosis.
The two common clinical scenarios for ketoacidosis are diabetic ketoacidosis and alcoholic ketoacidosis.
Optimal range: 0 - 102.8 nmol/mg Creatinine
b-Hydroxyisovaleric Acid [aka 3-Hydroxyisovaleric Acid (3-HIA)] is formed from the metabolism of the branched-chain amino acid leucine. Methylcrotonyl-CoA carboxylase catalyzes an essential step in this pathway and is biotin dependent. Reduced activity of this enzyme leads to an alternate pathway of metabolism resulting in 3-hydroxyisovaleric acid.
Optimal range: 0 - 9.2 nmol/mg Creatinine
Optimal range: 0 - 0.7 nmol/ML
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. Carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 0 - 621.4 nmol/mg Creatinine
→ Benzoic acid is primarily made endogenously by gut bacteria acting upon dietary polyphenols.
→ Benzoic acid acts as an acidifier and can inhibit pathogenic microorganisms.
→ Benzoic acid is found in broccoli, pepper (C. annuum), fruits, corn. It is also an additive.
→ Hippuric acid is the main metabolite of benzoate.
→ Benzoic acid + butyrate-CoA ligase = butyryl-CoA + glycine + glycine N-benzoyltransferase (GLYAT) → hippuric acid
→ Phenylacetic acid and benzoic acid have been proposed as a way to modulate release of glycine, glutamine/glutamic acid, and taurine, as a neuroregulatory process.
→ Phenylacetic acid and benzoic acid have both been used clinically to scavenge glycine and glutamine for the purpose of excess nitrogen excretion in urea cycle defects.
Optimal range: 0 - 3.6 nmol/mg Creatinine
Benzoylform is also known as Phenylglyoxylic Acid and a marker for Styrene exposure. Styrene is a chemical used to make latex, synthetic rubber, and polystyrene resins. These resins are used to make plastic packaging, disposable cups and containers, insulation, and other products. Styrene is also produced naturally in some plants.
Breathing high levels of styrene may cause changes in color vision, tiredness, feeling drunk, slowed reaction time, concentration problems, or balance problems. Hearing loss has been observed in animals exposed to very high concentrations of styrene.
Styrene used in insulation, fiberglass, plastic pipes, automobile parts, shoes, drinking cups and other food containers, and carpet backing.
Some examples of workers at risk of being exposed to styrene include the following:
→ Benzoylformate has been associated with metabolism of adrenaline and noradrenaline, and phenylketonuria.
→ In a review of 2005–2006 and 2011–2012 NHANES data (N=4690), smokers had 2-fold and 1.6-fold higher levels.
→ Eating more vegetables and fruit was associated with decreased levels.
Optimal range: 2.2 - 91.9 nmol/mg Creatinine
- Each of the BCAAs is catabolized by a dehydrogenase enzyme forming branched-chain keto acids (BDKA), or 2-oxo acids. The dehydrogenase enzyme is heavily dependent on B-complex vitamins, the lack of which may decrease pathway function, possibly leading to an elevation of the BCKA.
- Early research found a vitamin B1 (thiamin)-responsive form of maple syrup urine disease (MSUD).
- Higher urinary BCKA was found to decrease with B-complex vitamins supplementation.
- Evaluate intake of B-complex, primarily thiamin (B1).
- Evaluate dietary intake or supplementation with branched-chain amino acids.
Optimal range: 3.9 - 70 nmol/mg Creatinine
Optimal range: 0 - 2.7 nmol/ML
Carnosine (beta-alanyl-L-histidine) is a urinary biomarker which comes from the consumption of beef, pork, and to a lesser extent, poultry.
It is a dipeptide consisting of the amino acids histidine and beta-alanine and is concentrated in skeletal and heart muscle, brain, and kidneys. Carnosine has antioxidant properties, antiglycation effects, enhanced calcium sensitivity, and pH buffering activity during highintensity exercise.
It also has neuroprotective properties and may play an important role in Alzheimer’s disease and other neurodegenerative diseases.
Carnosine is also protective against secondary diabetic renal complications.
Optimal range: 126.3 - 668.9 nmol/mg Creatinine
Cis-Aconitic Acid is involved in both energy production and removal of toxic ammonia.
Optimal range: 203 - 3208.6 nmol/mg Creatinine
- Diet has a significant impact on citric acid levels:
» Increased acid load due to diets high in animal-based proteins, carbonated drinks, and in severe carbohydrate restriction can lead to mild metabolic acidosis, hypercalciuria, and reduced citric-acid excretion.
» Plant-based diets are associated with increased citric acid. Alkalinization of urine through consumption of citrus foods, alkaline mineral water, fruits and vegetables, or citrate supplements (such as mag-citrate) increase citric acid levels.
- Low urine citric acid has been associated with insulin resistance, metabolic acidosis, bonedensity, hypokalemia, the development of kidney stones, kidney disease, and chronic kidney disease, and immune-mediated inflammatory diseases, including rheumatoid arthritis, psoriasis, psoriatic arthritis, systemic lupus erythematosus, Crohn’s disease, and ulcerative colitis.
Optimal range: 0 - 12.6 nmol/mg Creatinine
→ Citrulline comes from dietary sources and plasma amino acid precursors such as arginine, ornithine, glutamine, glutamate, or proline.
→ Enterocytes are the main site of citrulline production, making small intestine function a key determinant of plasma citrulline levels.
→ Decreased blood citrulline was associated with impaired enterocyte function and small bowel absorptive capacity, increased risk of diabetes, a marker of physical frailty and sarcopenia, and multiple sclerosis.
Optimal range: 13.8 - 59.7 nmol/ML
Optimal range: 0 - 82 nmol/mg Creatinine
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli. Levels naturally peak in the morning and then reach their lowest point at night. A high blood cortisol level at night may indicate a problem with the adrenal glands; however, individuals who work at night and sleep during the day will have an inversed pattern.
Optimal range: 0 - 250 mcg/g Creat.
Cortisone is the inactive form of cortisol. Cortisone shows minimal biological activity per se, reflecting negligible affinity for the glucocorticoid and aldosterone receptors. The kidney, colon and saliva gland have lots of activity for changing cortisol to cortisone (active to inactive) to keep cortisol off the aldosterone receptor. Cortisone is converted back in the liver, fat, etc. (inactive to active).
Optimal range: 29.3 - 296.8 mg/dL
As a waste product, creatinine is filtered out of the blood by the kidneys and removed from the body in urine. The amount of creatinine formed daily is based on muscle mass, which varies with age, gender, and ethnicity. It is usually produced at a fairly constant rate in each person. Elevated creatinine can indicate kidney issues and should be evaluated with additional kidney-function testing; however, it is not an early marker for diagnosis of early disease and estimated GFR has become a more useful measurement.
Optimal range: 2.5 - 57.5 nmol/mg Creatinine
Optimal range: 0 - 0.3 nmol/ML
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 0 - 48.5 nmol/mg Creatinine
Cystine is rate limiting for glutathione production. Cystine is the oxidized form of cysteine.
→ Low cystine may be reflective of reduced glutathione levels and has also been noted in those with celiac disease and lower BMD.
→ Cysteine can be imported into cells either directly or as cystine, within the cell, cystine is immediately reduced to cysteine.
→ Higher plasma cystine has been associated with older age, female, higher BMI, lower GFR, diabetes mellitus, metabolic syndrome, hypertension, lower total cholesterol levels, statin use, lower ejection fraction, and higher hsCRP.
→ Higher urine cystine may be indicative of impaired amino acid reabsorption defects and has been associated with recurrent cystine kidney stones.
→ Cystine from foods sources is considered nutritionally equivalent to cysteine (egg, beef, and whole grains, fish, lentils, and oatmeal).
Optimal range: 13.4 - 51.9 nmol/ML
Cystine is rate limiting for glutathione production. Cystine is the oxidized form of cysteine.
Cystine is formed from the oxidation of cysteine, or from the degradation of glutathione oxidation products. It is two cysteines linked together with a disulfide bond.
Optimal range: 0.6 - 29.9 nmol/mg Creatinine
- Only elevated is of concern. D-lactic acid is generally produced in minimal quantities by human cells. It comes from three sources,
1. from human methylglyoxal (MGO) pathway (assumed to be the sole source of blood D-lactate in healthy people),
2. production by gut bacteria (mostly in patients with short bowel syndrome (SBS)), and
3. ingestion of preformed D-lactate.
- The source of D-lactic acid is dependent on the situation. MGO is a precursor of glycation of proteins and DNA, resulting in advanced glycation end products (AGEs), which is associated with increased oxidative stress. MGO is predominantly detoxified by the glyoxalase system (requires glutathione), with the majority going to D-lactate.
Optimal range: 0 - 15.4 nmol/mg Creatinine
- Equol is a bacterial-derived metabolite with estrogenic and antioxidant activity. Reductase enzymes secreted by the gut microbiota convert daidzein into equol. Daidzein is an isoflavone from soy, tofu, soy milk, tempeh, miso.
- The ability to produce equol varies among individuals because only people who possess the intestinal bacteria capable of producing equol are regarded as equol producers. Vegetarians reported significantly higher rates of equol production.
- Spot-urine equol levels have been found to correlate strongly with serum concentrations.
- Women with PMS had a significantly higher risk of being an equol nonproducer. Intake of daidzein from soy has been associated with reductions of estrogen-dependent and aging-associated disorders. Isoflavonoid-rich herbal supplement (included daidzein) improved intima-media thickness of carotid arteries (CIMT) and inhibited growth of existing atherosclerotic plaques of postmenopausal women.
Optimal range: 108.8 - 492.4 nmol/mg Creatinine
Ethanolamine is an intermediary metabolite in the serine-to-choline sequence. It can be used to synthesize phosphatidylethanolamine (PE), a very important membrane phospholipid. Ethanolamine is not only a precursor, but also a breakdown product of PE. Ethanolamine is abundant in both intestinal and bacterial cell membranes. It plays a significant role in the renewal and proliferation of intestinal cells and intestinal inflammation. Also, since ethanolamine plays a structural role in skeletal muscle cell membranes, some evidence suggests it may be a marker of skeletal muscle turnover.
Optimal range: 0 - 16.9 nmol/ML
Ethanolamine is an intermediary metabolite in the serine-to-choline sequence. It can be used to synthesize phosphatidylethanolamine (PE), a very important membrane phospholipid. Ethanolamine is not only a precursor, but also a breakdown product of PE. Ethanolamine is abundant in both intestinal and bacterial cell membranes. It plays a significant role in the renewal and proliferation of intestinal cells and intestinal inflammation. Also, since ethanolamine plays a structural role in skeletal muscle cell membranes, some evidence suggests it may be a marker of skeletal muscle turnover.
Optimal range: 9.9 - 65.6 nmol/mg Creatinine
Ethylmalonate, together with Adipate and Suberate, gives information about your ability to process fatty acids.
Note: These tests are used to check for rare metabolic disorders, usually in infants. There is no apparent reason nor benefit to checking ethylmalonic and methylsuccinic acid levels in adults who aren’t suspected to have rare genetic disorders.
Optimal range: 0 - 2.7 nmol/mg Creatinine
Formiminoglutamic Acid (FIGlu) is an intermediary organic acid in the conversion of the amino acid histidine to glutamic acid. This enzymatic conversion requires tetrahydrofolic acid.
Optimal range: 0.1 - 9.2 nmol/mg Creatinine
Emerging research seems to show a relationship between the rise in metabolic diseases and the increased consumption of fructose—particularly consumption of non-natural sources of fructose found in sugar-sweetened beverages and other processed foods.
Elevated fructose levels should be further investigated. Dietary fructose intake should be determined, modified if excessive, and monitored for metabolic changes.
Optimal range: 0 - 16.1 nmol/mg Creatinine
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.
Optimal range: 0 - 9.5 nmol/mg Creatinine
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania.
Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution. Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production.
Optimal range: 0 - 1.5 nmol/ML
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania.
Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution. Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production.
Optimal range: 0 - 31.5 nmol/mg Creatinine
AKA: Glucarate / D-Glucaric Acid
- Urinary glucaric acid has been used as an indicator of induced hepatic drug metabolization and elevated with exposure to xenobiotics.
- Levels may indirectly represent P-450 activity or an end-product of the glucuronidation pathway.
- Calcium-D-glucarate is the calcium salt of D-Glucarate.
- Dietary glucaric acid and supplementation with calcium-D-glucarate may suppress cell proliferation and inflammation, induce apoptosis, and have anticancer properties. Glucaric acid from dietary plants may act as a nontoxic β-glucuronidase inhibitor. Glucaric acid is normally in equilibrium with D-glucaro-1,4- lactone, and an increase in dietary glucaric acid increased D-glucaro-1,4- lactone, which suppresses blood and tissue beta-glucuronidase activity. Vegetarians may have higher levels.
- It has been found increased with increased PCBs, toxins, and medications.
Optimal range: 0 - 15.2 mg/dL
- Glucose identifies processing of overall diet. Small amounts of glucose may be found in the urine of healthy individuals.
- Researchers found that those with a high waist-to-hip ratio (WHR), but no history of diabetes, had significantly lower urine glucose excretion.
- Metabolism of glucose – glycolysis – is heavily dependent on magnesium.
Optimal range: 7.2 - 129.2 nmol/mg Creatinine
Glutamic acid is a nonessential amino acid is derived from the diet and from the breakdown of gut proteins. Glutamate is a major excitatory neurotransmitter in the brain. It plays a role in neuronal differentiation, migration, and survival in the developing brain. It is also involved in synaptic maintenance, neuroplasticity, learning, and memory.
Optimal range: 38.3 - 251.2 nmol/ML
Optimal range: 11.8 - 538.4 nmol/mg Creatinine
Optimal range: 352.4 - 1017.1 nmol/ML
Glutamine is the most abundant amino acid in the blood and is an important source of energy for many tissues in the body. It is derived from the amino acids histidine and glutamic acid.
Optimal range: 0.1 - 30.5 Ratio
- Glutamic acid has been associated with higher BMI, blood pressure, and insulin resistance, while glutamine levels were inversely associated.
- A high plasma glutamine-to-glutamic acid ratio was associated with lower risk of diabetes in the Framingham Heart Study (n=1015).
- Higher glutamine-to-glutamic acid ratio was associated with a better cardiometabolic-risk profile over 10 years in the PRIMED study (n=1879).
Optimal range: 2.1 - 21.7 nmol/ML
- Glutamic acid has been associated with higher BMI, blood pressure, and insulin resistance, while glutamine levels were inversely associated.
- A high plasma glutamine-to-glutamic acid ratio was associated with lower risk of diabetes in the Framingham Heart Study (n=1015).
- Higher glutamine-to-glutamic acid ratio was associated with a better cardiometabolic-risk profile over 10 years in the PRIMED study (n=1879).
Optimal range: 0 - 8.5 nmol/mg Creatinine
Glutaric Acid (Glutarate) is endogenously produced in the catabolism of lysine and tryptophan.
- Increased Glutaric acid is associated with secondary carnitine deficiency.
- Glutaryl-CoA (from lysine or tryptophan) normally enters the Krebs cycle via transition to acetyl-CoA.
» Glutaryl-CoA dehydrogenase (GCDH) + glutaryl-CoA + B2 → acetyl-CoA.
» If GCDH is blocked, glutaryl-CoA + carnitine → elevated glutaric acid.
Optimal range: 231.3 - 3103.3 nmol/mg Creatinine
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine. It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins. Glycine is a major collagen and elastin component, which are the most abundant proteins in the body. Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Optimal range: 154.2 - 582.7 nmol/ML
Optimal range: 0 - 18.9 nmol/mg Creatinine
Glycylproline is a compound that provides insights into collagen breakdown and metabolism. Collagen is a vital protein found in connective tissues like skin, tendons, and bones. Elevated levels of Glycylproline on the OMX panel may indicate increased collagen turnover or degradation, which can be associated with conditions affecting connective tissues, joint health, or skin elasticity. Monitoring Glycylproline levels through metabolomics testing helps practitioners understand the body's collagen metabolism and overall connective tissue health, guiding personalized interventions to support collagen synthesis and tissue integrity based on the patient's metabolic profile and health history.
→ Patients with pressure sores had significantly increased glycylproline, finding positive predictive value for pressure sores of 70%.
→ In an older (1964) review of bone markers of patients with bone disease, researchers found glycylproline only in patients with severe active rickets.
→ Urine glycylproline and hydroxylysine patients with pressure sores, compared to controls.
Optimal range: 0 - 2.6 nmol/ML
- Patients with pressure sores had significantly increased glycylproline, finding positive predictive value for pressure sores of 70%.
- In an older (1964) review of bone markers of patients with bone disease, researchers found glycylproline only in patients with severe active rickets.
- Urine glycylproline and hydroxylysine patients with pressure sores, compared to controls.
Optimal range: 0.01 - 0.09 index
Glutamate/ [Serine + Glycine] GSG Index
The GSG index was higher in NAFLD (Nonalcoholic fatty liver disease (NAFLD), positively correlating with intrahepatic fat content and liver enzymes.
Weight loss is linked to reduction in the GSG Index and a correlated reduction in homeostasis model assessment (HOMA) of insulin and aspartate aminotransferase (AST).
Optimal range: 0.7 - 9.6 nmol/mg Creatinine
Urinary hexanoylglycine is a specific marker for the diagnosis of Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency.
Optimal range: 198.7 - 3104.6 nmol/mg Creatinine
→ Benzoic acid is metabolized to hippuric acid and excreted.
→ Hippuric acid is a normal urinary metabolite associated with microbial degradation of certain dietary components.
→ Levels of hippuric acid rise with the consumption of fruit juice, tea, and wine, which are converted to benzoic acid.
→ Though a defect in the enzymatic conjugation of benzoic to hippuric acid has been noted in Crohn’s disease patients, research implicates altered gut microbial metabolism as the cause of decreased hippuric acid.
→ Other research has found a positive association between Clostridia spp. and hippuric acid levels.
→ Hippuric acid has been positively associated with gut diversity.
→ If elevated, evaluate benzoic acid and glycine levels. Support with glycine if needed.
Optimal range: 106.9 - 1235.7 nmol/mg Creatinine
Optimal range: 61.2 - 104.7 nmol/ML
Histidine is involved in one-carbon units for conversion of formiminoglutamic acid (FIGLU) to glutamic acid.
- High plasma histidine has been associated with increased plasma glutamic acid, alanine and glutamine, and decreased branched-chain amino acids.
- Elevated urine histidine means it is not available for hemoglobin production. Hemoglobin is 10% histidine.
- High levels have been associated with progression of type 2 diabetes after gestational diabetes (= a type of diabetes that can develop during pregnancy in women who don't already have diabetes.)
- Decreased plasma histidine was associated with increased risk of ulcerative colitis relapse; a higher serum CRP in Crohn’s disease; chronic kidney disease; increased inflammation; and atopic dermatitis.
Optimal range: 0 - 42.2 nmol/mg Creatinine
Homocitrulline is a marker that may indicate how much protein carbamoylation is happening in the body. Protein carbamoylation is a process where isocyanate reacts with the amino acid lysine, resulting in the formation of homocitrulline. This modification is thought to contribute to molecular aging and is linked to various health issues, including atherosclerosis (a condition where arteries become narrowed) and problems with the immune system.
Research has shown that patients with chronic kidney disease tend to have higher levels of homocitrulline, and these levels are positively related to urea concentration, which is a waste product that builds up when the kidneys are not functioning properly.
Additionally, individuals with coronary artery disease also exhibit significantly elevated serum homocitrulline levels. This suggests that measuring homocitrulline can provide valuable insights into certain health conditions and the overall metabolic state of a person.
Optimal range: 0 - 3.4 nmol/ML
Optimal range: 0 - 2.6 nmol/mg Creatinine
→ Plasma homocystine is higher in those with cystathionine-beta-synthase deficiency.
→ Plasma homocystine, as well as taurine, were significantly lower in insufficient methotrexate therapy responders.
→ Homocystine is an oxidized disulfide form of homocysteine, which gets readily converted to cystathionine.
Optimal range: 0 - 2.2 nmol/ML
Homocystine is a common amino acid in your blood. You get it mostly from eating meat. High levels of it are linked to early development of heart disease.
Optimal range: 0 - 153.7 nmol/mg Creatinine
Homogentisic acid is a breakdown product of 4-Hydroxyphenylpyruvic Acid (4-HPPA).
Elevated in the genetic disease homogentisic aciduria (alkaptonuria).
Optimal range: 0 - 42.1 nmol/mg Creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0 - 18 nmol/mg Creatinine
3-Hydroxykynurenine is a metabolic intermediate of the kynurenine pathway that elicits neurotoxic effects.
Optimal range: 0 - 25.3 nmol/mg Creatinine
- Hydroxyproline is the key factor in stabilizing collagens.
- Hydroxyproline is abundant in meat and low in plant-based foods. Meat intake increases levels of proline and hydroxyproline.
- Increased hydroxyproline has been found in collagen catabolism (bone resorption, increased reactive oxygen species [ROS]), tissue degradation, muscle damage, or other conditions such as Paget's disease or Alzheimer's disease.
- Proline and hydroxyproline both negatively correlated with a higher likelihood of anxiety, depression, and psychoses.
Optimal range: 0 - 30.6 nmol/ML
Hydroxyproline is the key factor in stabilizing collagens.
- Hydroxyproline is abundant in meat and low in plant-based foods. Meat intake increases levels of proline and hydroxyproline.
- Increased hydroxyproline has been found in collagen catabolism (bone resorption, increased reactive oxygen species [ROS]), tissue degradation, muscle damage, or other conditions such as Paget’s disease or Alzheimer’s disease.
- Proline and hydroxyproline both negatively correlated with a higher likelihood of anxiety, depression, and psychoses.
- Plasma hydroxylproline may be reduced with fatigue (caused by deprivation of rest and sleep; a physical stress condition) or oxidative stress.
Optimal range: 3 - 55.5 nmol/mg Creatinine
- A product of tryptophan fermentation. If elevated, decrease protein intake and address digestion and GI issues. Bacteroides, Clostridia, and E. coli ferment tryptophan to produced indoleacetic acid.
- It has been found elevated in liver disease, ASD, and cancer, and has been noted as a marker of microbial activity.
- Indoleacetic acid can be degraded by Bacillus subtilis, or Pseudomonas aeruginosa.
- Indoleacetic acid has been found in many foods, such as lettuce, cherry tomato, Chinese bayberry, and okra.
Optimal range: 137.1 - 794.9 nmol/mg Creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 18.3 nmol/mg Creatinine
Optimal range: 35.5 - 112.4 nmol/ML
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Branched-Chain Amino Acids (BCAAs) are required for protein synthesis and are metabolized outside hepatic tissues, unlike most other essential amino acids. They are converted to branched-chain keto acids which require B-complex vitamins. BCAAs have been associated with obesity, weight loss, insulin resistance, and nonalcoholic fatty liver disease (NAFLD).
BCAA’s are nitrogen donors, facilitate glucose uptake by liver and skeletal muscle, and enhance glycogen synthesis.
- BMI was positively associated with urine 2-hydroxyisobutyrate, isoleucine, valine, tryptophan, and tyrosine.
- Elevated urine levels were associated with higher colorectal cancer.
Optimal range: 0 - 0.31 Ratio
KT Ratio stands for Kynurenine/Tryptophan Ratio (KTR).
What is Tryptophan?
Tryptophan is involved in serotonin production and is the least abundant amino acid.
What is Kynurenine?
Kynurenine is primary breakdown product of tryptophan.
Optimal range: 0.02 - 0.1 Ratio
KT Ratio stands for Kynurenine/Tryptophan Ratio (KTR).
What is Tryptophan?
Tryptophan is involved in serotonin production and is the least abundant amino acid.
What is Kynurenine?
Kynurenine is primary breakdown product of tryptophan.
Optimal range: 7.8 - 54 nmol/mg Creatinine
Kynurenic Acid is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0 - 11.6 nmol/mg Creatinine
Kynurenine is the primary breakdown product of tryptophan.
- Kynurenine blood levels have been found higher in type 2 diabetes, obesity, CVD, ADHD in children, HOMA-IR.
- Higher kynurenine increases Treg cell differentiation via the AhR (aryl hydrocarbon receptor) pathway.
- Blood levels were lower in acute ischemic stroke patients, older age, adults with ADHD.
- Upregulation of other tryptophan breakdown enzymes KMO (Kynurenine monooxygenase) and KYNU (Kynureninase) may decrease kynurenine.
Optimal range: 0 - 4.4 nmol/ML
Kynurenine is the primary breakdown product of tryptophan.
- Kynurenine blood levels have been found higher in type 2 diabetes, obesity, CVD, ADHD in children, HOMA-IR.
- Higher kynurenine increases Treg cell differentiation via the AhR (aryl hydrocarbon receptor) pathway.
- Blood levels were lower in acute ischemic stroke patients, older age, adults with ADHD.
- Upregulation of other tryptophan breakdown enzymes KMO (Kynurenine monooxygenase) and KYNU (Kynureninase) may decrease kynurenine.
Optimal range: 12.2 - 458.2 nmol/mg Creatinine
- Lactic acid is produced endogenously under anaerobic conditions.
- Main route of lactic acid disposal is conversion to pyruvic acid or excretion via urine.
- Higher urine lactic acid levels have been associated with diabetes, fasting glucose, HOMAIR, IBD, chronic kidney disease, Fanconi syndrome, and age-related macular degeneration.
» Both L- and D-lactic acids were elevated in diabetes
- Nutrient deficiencies of B1, CoQ10, and/or lipoic acid, have been associated with elevated lactic acid levels in both urine and blood.
- Limited research noting a higher decline of T4 was associated with a low lactic acid, alanine and glycine.
Optimal range: 0 - 44.8 nmol/mg Creatinine
Optimal range: 57.1 - 187.5 nmol/ML
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
- Activator of mTOR
- 3-hydroxymethylglutaric acid (HMG) is an “off-product” intermediate in leucine degradation
- Has an anabolic effect on cell signaling and protein synthesis; an activator of the mammalian target of rapamycin (mTOR).
- Elevated urine levels have been associated with higher colorectal cancer rates and a possible biomarker of rheumatoid arthritis (along with phenylalanine).
- Leucine supplementation has been shown to increase plasma ammonia concentrations.
Optimal range: 13.7 - 329.3 nmol/mg Creatinine
Optimal range: 210.6 - 498.2 nmol/ML
Lysine catabolism leads to collagen and carnitine production.
- Higher plasma valine, lysine, and tyrosine were independently and positively associated with gestational diabetes mellitus and insulin activity.
- Increased urinary lysine was associated with a lower risk of chronic kidney disease (0.73 [0.50-0.90].
- Low lysine has been associated with increased anxiety in human and animal studies.
- Lysine and arginine supplementation were found to reduce anxiety and basal salivary cortisol levels in adults.
- Lower plasma lysine and glutamine levels, and higher glutamic acid, were significantly associated with ADHD.
Optimal range: 1 - 27.1 nmol/mg Creatinine
Malic Acid is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 16.9 nmol/mg Creatinine
→ Mandelic acid and benzoylformate are major metabolites of styrene and ethylbenzene exposure.
→ Styrene is a key component in consumer products. Occupational exposure has been associated with increased rates of pulmonary, neurological, genetic, ocular, and reproductive complications, plus leukemia.
→ Styrene can be found in polystyrene packaging and can migrate into packaged food.
→ Benzoylformate has been associated with metabolism of adrenaline and noradrenaline, and phenylketonuria.
→ In a review of 2005–2006 and 2011–2012 NHANES data (N=4690), smokers had 2-fold and 1.6-fold higher levels of both markers.
→ Eating more vegetables and fruit was associated with decreased levels.
Optimal range: 0 - 9.1 nmol/mg Creatinine
Optimal range: 12.1 - 38.5 nmol/ML
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 0 - 24.9 nmol/mg Creatinine
Methylmalonic Acid (MMA) is formed from propionylCoA via methylmalonyl-CoA. Major dietary sources of propionyl-CoA include valine, isoleucine, methionine, threonine, and odd chain fatty acids. MethylmalonylCoA is converted to succinyl-CoA to feed the Citric Acid Cycle via the enzyme methylmalonyl-CoA mutase. This enzyme is very vitamin B2 dependent. In B12 deficiency, methylmalonyl-CoA is hydrolyzed to methylmalonic acid.
Optimal range: 0 - 130.4 nmol/mg Creatinine
Albumin is not normally found in urine. Temporary dysfunction of the filtration barrier can occur under certain conditions, including fever, dehydration, a urinary tract infection (UTI), and after vigorous exercise, allowing small amounts of albumin through the barrier.
Recommendations for follow-up include three measurements one month apart. Although microalbuminuria does have relatively benign causes, its presence in urine should be further evaluated for serious and chronic conditions.
Many factors affect levels, including gender, race, blood pressure, time of day, exercise, dehydration, smoking, hypertension, diabetes, muscle mass, and amount of food, water, and salt intake, producing up to a 40% daily variation.
Endothelial dysfunction is likely to be involved in the initiation and development of microalbuminuria, initially reversible but becoming fixed with increasing vascular structural changes.
Optimal range: 0 - 26.8 nmol/mg Creatinine
Optimal range: 0 - 26.8 nmol/mg Creatinine
→ It is a key substrate for the synthesis of proline, polyamines, and citrulline.
→ Higher ornithine blood levels were associated with lower breast cancer risk; also found higher in those with Alzheimer’s and Parkinson’s disease.
→ Ornithine supplements have been utilized for NH3 detoxification in liver disease.
Optimal range: 39 - 132.1 nmol/ML
Optimal range: 1.2 - 13.1 nmol/mg Creatinine
Orotic Acid is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 144.9 - 1749.5 nmol/mg Creatinine
Oxalic acid may be associated with dysbiosis from Aspergillus, Penicillium, Candida, or high dose vitamin C. If yeast or fungal markers are elevated, antifungal therapy may reduces oxalates. Also associated with anti-freeze (ethylene glycol) poisoning.
Optimal range: 5.5 - 7.7 Units
Optimal range: 0 - 8.7 nmol/mg Creatinine
Produced from bacterial degradation of unabsorbed phenylalanine.
Optimal range: 7.4 - 69.6 nmol/mg Creatinine
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy. Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 31.7 - 71 nmol/ML
Final products include: DOPA, dopamine, norepinephrine, epinephrine, thyroid hormones, melanin, in TCA cycle, or 4-hydroxyphenylacetic acid.
Optimal range: 11.2 - 192.4 nmol/mg Creatinine
Optimal range: 0 - 55 nmol/mg Creatinine
Phosphoethanolamine is an intermediate in the serine-to-choline sequence. It is both a precursor and byproduct of phospholipid biosynthesis and breakdown. As a precursor to the phospholipid phosphatidylethanolamine, phosphoethanolamine plays a key role in myelination. Elevated phosphoethanolamine reflects brain phospholipid turnover, an indicator of neural membrane synthesis and signal transduction. Research into neurologic conditions like Alzheimer’s disease and Huntington’s disease suggests that depletions of both phosphoethanolamine and ethanolamine accompany neuronal death. Phosphoethanolamine is also important in cartilage structure and function, especially in bone and teeth.
Optimal range: 0 - 6.3 nmol/ML
Phosphoethanolamine is an intermediate in the serine-to-choline sequence. It is both a precursor and byproduct of phospholipid biosynthesis and breakdown. As a precursor to the phospholipid phosphatidylethanolamine, phosphoethanolamine plays a key role in myelination. Elevated phosphoethanolamine reflects brain phospholipid turnover, an indicator of neural membrane synthesis and signal transduction. Research into neurologic conditions like Alzheimer’s disease and Huntington’s disease suggests that depletions of both phosphoethanolamine and ethanolamine accompany neuronal death. Phosphoethanolamine is also important in cartilage structure and function, especially in bone and teeth.
Optimal range: 0 - 4 nmol/mg Creatinine
Other names: Picolinate
From the breakdown of hydroxykynurenine via ACMS decarboxylase
- Decreased picolinic acid and increased quinolinic acid blood levels noted in suicidal subjects.
- A tryptophan metabolite produced through non-enzymatic conversion.
Optimal range: 1.5 - 24.8 nmol/mg Creatinine
Pimelic acids are excreted in elevated amounts in urine in disorders of mitochondrial beta-oxidation and disorders of peroxisomal beta-oxidation, for which they are of significant diagnostic value.
Pimelic acid originating from fatty acid synthesis pathway is a bona fide precursor of biotin in B. subtilis.
Optimal range: 0 - 27.9 nmol/mg Creatinine
Collagen Catabolism: Collagen contains proline, hydroxyproline, and glycine.
→ Sarcopenia (low muscle mass) was associated with higher plasma proline.
→ Proline was significantly lower in esophageal cancer patients compared to the healthy controls.
→ Hydroxyproline and proline together constitute around 25% of residues and allow for stability and twisting of collagen.
→ Dietary intake increases levels of proline and hydroxyproline.
→ Proline and hydroxyproline both negatively correlated with a higher likelihood of anxiety, depression, and psychoses.
Optimal range: 117.2 - 411.9 nmol/ML
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid. Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage. Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn. In addition to dietary sources, proline can be synthesized from glutamate/glutamine, arginine, and ornithine. It can also be synthesized within enterocytes from degradation of small peptides.
Optimal range: 0 - 98.3 nmol/mg Creatinine
- Pyridoxic acid (4-Pyridoxate) is a catabolic product of vitamin B6 that is excreted in the urine. Pyridoxic acid represents > 90% of vitamin B6 species excreted in the urine, and 40-60% of dietary vitamin B6 intake. Urine 4-pyridoxic acid correlated with plasma PLP and RBC PLP.
- 4-Pyridoxic acid level varies according to vitamin B6 intake and responds within 1–2 weeks to vitamin B6 depletion and repletion. Very low levels (<dl on the report) may indicate B6 need, and very high levels may identify excess intake.
- Increased xanthurenic acid after a tryptophan load may occur in vitamin B6-deficient individuals.
- In a mathematical model without a tryptophan load, xanthurenic acid and kynurenine increased at a more pronounced deficiency. Kynurenic acid may be more sensitive but may also result in a slight decrease.
Optimal range: 75.8 - 543.8 nmol/mg Creatinine
Pyroglutamic acid (5-oxoproline) is produced and utilized in the gamma-glutamyl cycle. This cycle is needed to assist in the production and recycling of glutathione (GSH), a powerful antioxidant.
Glutathione is a tripeptide, consisting of glutamate, cysteine, and glycine. Using the gamma-glutamyl cycle, GSH is divided into cysteinyl glycine and a gammaglutamyl molecule which attaches to another amino acid for transport across a membrane or into a cell. Gammaglutamyl transferase then splits off that attached amino acid, and the glutamate becomes pyroglutamic acid (5-oxoproline).
Cysteinyl glycine is also broken down and transported into the cell as cysteine and glycine. The entire GSH molecule needs to be reformed intracellularly from pyroglutamic acid by recombining cysteine, glycine, and glutamic acid using GSH synthetase.
This enzymatic reformation requires cofactors such as ATP and magnesium.
Optimal range: 0 - 67.4 nmol/mg Creatinine
Pyruvic Acid feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.
Optimal range: 0 - 14.9 nmol/mg Creatinine
Research has noted antidiabetic, anti-inflammatory, antioxidant, antimicrobial, anti-Alzheimer's, antiarthritic, cardiovascular, and wound-healing effects.
Optimal range: 29.4 - 178.5 nmol/mg Creatinine
Kynurenic acid and Quinolinic acid are tryptophan metabolites formed through the kynurenine pathway. Tryptophan is the amino acid precursor to serotonin; its major route for catabolism is the kynurenine pathway. Important products of the kynurenine pathway include xanthurenic acid and kynurenic acid, which can further metabolize into quinolinic acid. The historical importance of this pathway has mainly been as a source of the coenzyme NAD+, which is important for all redox reactions in the mitochondria.
However, it is now understood that kynurenic and quinolinic acid have physiologic implications. This alternate pathway is upregulated in response to inflammation and stress, which can lead to deficient serotonin production. Kynurenic acid has shown some neuroprotective properties in the brain, since it can stimulate NMDA receptors. However, its importance on the periphery is still not fully elucidated. Some studies outline antiinflammatory, analgesic, antiatherogenic, antioxidative, and hepatoprotective properties to peripheral kynurenic acid.
The correlation to levels of urinary excretion needs further study. Quinolinic acid, in and of itself, can be inflammatory and neurotoxic.
Optimal range: 0 - 118.1 nmol/mg Creatinine
Optimal range: 0 - 10.4 nmol/ML
Sarcosine is also known as N-methylglycine. It is an intermediate and byproduct in the glycine synthesis and degradation. Sarcosine is metabolized to glycine by the enzyme sarcosine dehydrogenase, while glycine-N-methyl transferase generates sarcosine from glycine.
Optimal range: 1.5 - 21 nmol/mg Creatinine
Increased urinary products of the omega fatty acid metabolism pathway may be due to carnitine deficiency, fasting, or increased intake of triglycerides from coconut oil, or some infant formulas.
Optimal range: 6.3 - 554.2 nmol/mg Creatinine
Optimal range: 54.2 - 207.4 nmol/ML
- Plasma serine was found higher in depression, and psychoses including schizophrenia.
- Methionine supplementation significantly increased plasma serine.
- Serine is involved in cysteine and methionine metabolism.
- Blood serine was lower in patients with hypertension.
- Blood serine was lower in patients with greater liver fat fractions, higher alanine transaminase (ALT) and triglyceride, in patients with fatty liver disease.
Optimal range: 0.7 - 9.3 nmol/mg Creatinine
- Suberic acid is present in the urine of people with fatty acid oxidation disorders.
- A metabolic breakdown product derived from oleic acid.
- Elevated levels of this unsaturated dicarboxylic acid are found in individuals with medium-chain acyl-CoA dehydrogenase deficiency (MCAD).
- Elevated in Schizophrenics
- People with metabolic syndrome or diabetes had significantly elevated adipic acid, suberic acid, lactic acid, and fumaric acid.
- Ketosis is sometimes accompanied by excessive excretion of adipic and suberic acid.
Optimal range: 0 - 0.4 nmol/mg Creatinine
Suberylglycine is an acyl glycine. Acyl glycines are normally minor metabolites of fatty acids. However, the excretion of certain acyl glycines is increased in several inborn errors of metabolism. In certain cases the measurement of these metabolites in body fluids can be used to diagnose disorders associated with mitochondrial fatty acid beta-oxidation.
Optimal range: 12.3 - 260.4 nmol/mg Creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0 - 12.1 nmol/mg Creatinine
Sulfocysteine is the product of sulfite-dependent cleavage of cystine. In the pathway, cysteine becomes sulfite, which converts to sulfate via sulfite oxidase + Mo. If the pathway is blocked, sulfocysteine builds up.
Optimal range: 0 - 1.4 nmol/ML
Sulfocysteine is the product of sulfite-dependent cleavage of cystine. In the pathway, cysteine becomes sulfite, which converts to sulfate via sulfite oxidase + Mo. If the pathway is blocked, sulfocysteine builds up.
Optimal range: 9.9 - 408.4 nmol/mg Creatinine
- Tartaric acid is a compound found in plant foods. It has been identified as a biomarker of grape intake, though it has also been identified in other foods. Tartaric acid levels peak at 4–8 hours after intake. Levels in foods vary significantly between types of foods and within individual foods.
- Tartaric acid cannot be processed by humans and is either excreted or utilized by gut bacteria as a carbon source. Some bacteria have genes for tartaric metabolizing enzymes, so levels can be impacted by gut microbiome. The process starts once tartaric acid is released (i.e., grapes are crushed or are invaded by pathogens), making it susceptible to catabolic enzymes from microorganisms, which may reduce it to oxaloacetate, glyceric acid, and pyruvic acid.
Optimal range: 39.2 - 2436.6 nmol/mg Creatinine
Optimal range: 25.9 - 107.2 nmol/ML
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid.
Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
It has been proposed that taurine acts as an antioxidant, intracellular osmolyte, membrane stabilizer, and a neurotransmitter.
Optimal range: 4.2 - 224.1 nmol/mg Creatinine
Optimal range: 51.4 - 184.9 nmol/ML
Optimal range: 0 - 107.4 nmol/mg Creatinine
Optimal range: 211.9 - 577.3 nmol/ML
- BCAAs are key nitrogen donors in the form of glutamic acid, glutamine, and alanine.
- Elevated total BCAAs have been associated with obesity, weight loss, insulin resistance, and NAFLD.
- Elevated plasma BCAAs were associated with an increased risk of hypertension, cardiovascular disease.
- BCAAs are higher in a “Western” diet. Check B6 need.
- Lower levels seen in liver cirrhosis and urea cycle disorders.
- Decreased amino acids are seen with decreased protein and calorie intake; increased tissue uptake, and body losses (urine, sweat, etc.).
Optimal range: 10.1 - 74.3 nmol/mg Creatinine
Three pathways:
- Kynurenine Pathway (primary pathway) – leading to niacin production
- Serotonin/Melatonin
- Indoles
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 36.9 - 87.1 nmol/ML
Three pathways:
- Kynurenine Pathway (primary pathway) – leading to niacin production
- Serotonin/Melatonin
- Indoles
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 0 - 99 mcg/mg creatinine
- A higher protein intake or supplementation results in increased levels.
- Low protein intake or inflammation can lead to lower levels.
- Nutrient cofactors of tyrosine pathways include BH4, non-heme iron, vitamins B6 and B3, copper, niacin, vitamin C, magnesium, and SAMe.
- Elevated tyrosine is associated with a higher risk of type 2 diabetes and gestational diabetes and a higher body mass index.
- Tyrosine-supplementation effects on cognition vary – unfavorable effects were noted on working-memory performance in older adults.
- Higher tyrosine was related to better cognitive skills in younger adults.
- Urine and blood tyrosine were noted to be lower in depression.
Optimal range: 27.8 - 84.5 nmol/ML
- A higher protein intake or supplementation results in increased levels.
- Low protein intake or inflammation can lead to lower levels.
- Nutrient cofactors of tyrosine pathways include BH4, non-heme iron, vitamins B6 and B3, copper, niacin, vitamin C, magnesium, and SAMe.
- Elevated tyrosine is associated with a higher risk of type 2 diabetes and gestational diabetes and a higher body mass index.
- Tyrosine-supplementation effects on cognition vary – unfavorable effects were noted on working-memory performance in older adults.
- Higher tyrosine was related to better cognitive skills in younger adults.
- Urine and blood tyrosine were noted to be lower in depression.
Optimal range: 0 - 51.1 nmol/mg Creatinine
Optimal range: 109.3 - 283 nmol/ML
Valine is a branched-chain amino acid (BCAA).
BCAA’s are nitrogen donors, facilitate glucose uptake by liver and skeletal muscle, and enhance glycogen synthesis.
Branched-Chain Amino Acids (BCAAs) are required for protein synthesis and are metabolized outside hepatic tissues, unlike most other essential amino acids. They are converted to branched-chain keto acids which require B-complex vitamins. BCAAs have been associated with obesity, weight loss, insulin resistance, and nonalcoholic fatty liver disease (NAFLD).
- BMI was positively associated with urine 2-hydroxyisobutyrate, isoleucine, valine, tryptophan, and tyrosine.
- Plasma valine, lysine, and tyrosine positively associated with gestational diabetes mellitus (= a type of diabetes that can develop during pregnancy in women who don't already have diabetes.) and insulin activity.
- Elevated urine levels have been associated in higher colorectal cancer.
Optimal range: 5.3 - 36.1 nmol/mg Creatinine
Metabolite of epinephrine and norepinephrine. Often elevated due to stress induced catecholamine output or lead toxicity.
Optimal range: 0.6 - 10.2 nmol/mg Creatinine
Xanthurenic acid is produced as part of the kynurenine pathway of tryptophan catabolism, along with kynurenic and quinolinic acid.
From the breakdown of hydroxykynurenine via kynurenine aminotransferases (KAT) +B6
- Elevated xanthurenic acid has been noted with B6 deficiency.
- Elevated levels have been noted as more significant in oral contraceptive users in studies using a tryptophan load.
- In a mathematical model without a tryptophan load, a moderate vitamin B6 deficiency resulted in a slight increase in xanthurenic acid and a slight decrease in kynurenic acid and anthranilate.
- Without a tryptophan load, urine kynurenine and xanthurenic acid both increase in a pronounced B6 deficiency.
- Animal studies found a low urinary excretion ratio of xanthurenic acid/ kynurenic acid as a possible marker of niacin need, proposing that levels may increase with repletion.
- Niacin (vitamin B3) is a product of tryptophan degradation. In alcoholic pellagra patients, the tryptophanniacin pathway is inhibited after the 3-hydroxyanthranilate oxidase step, which can result in increased kynurenic acid, and decreased xanthurenic acid and quinolinic acid.
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Reference range: -3, -2, -1, 0, +1, +2, +3
Acinetobacter junii is rarely a cause of disease in humans. A. junii has mainly been associated with bacteremia in preterm infants and pediatric oncologic patients.
Acinetobacter junii is one of more than 50 different species belonging to the genus Acinetobacter, most of which are nonpathogenic environmental organisms. They may cause opportunistic infections only in people with compromised immune status or with an indwelling device (such as urinary catheters, vascular access devices, endotracheal tubes, tracheostomies, enteral feeding tubes and wound drains), or both.
Acinetobacter species are ubiquitous and can be isolated from many sources including soil, water, sewage, and food. Acinetobacter species can colonize skin, wounds, the oral mucosa, and respiratory and gastrointestinal tracts.
Reference range: -3, -2, -1, 0, +1, +2, +3
Actinobacteria is one of the largest bacterial phyla, comprised of Gram-positive bacteria.
Reference range: -3, -2, -1, 0, +1, +2, +3
Actinomycetales are considered low abundance colonizers of the gastrointestinal tract with primary residence on the skin.
Reference range: Positive, Negative
Adenoviruses are non-enveloped DNA viruses.
Adenovirus is a cause of acute gastroenteritis in infants, young children, the elderly and immuno-compromised patients. The Adenovirus serotypes most frequently associated with gastroenteritis are Adenovirus 40 and 41.
Adenovirus gastroenteritis generally causes watery diarrhea lasting one to two weeks.
Reference range: NG, 1+, 2+, 3+, 4+
Reference range: -3, -2, -1, 0, 1, 2, 3
Reference range: -3, -2, -1, 0, +1, +2, +3
Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.
Reference range: -3, -2, -1, 0, +1, +2, +3
- Alistipes does not contribute significantly to short chain fatty acid production.
- A diet rich in animal protein and fat increases the abundance of Alistipes.
- High abundance of Alistipes was identified as a possible predictor of successful weight loss.
- Alistipes may positively correlate with depression.
Reference range: -3, -2, -1, 0, +1, +2, +3
Alistipes does not contribute significantly to short chain fatty acid production. A diet rich in animal protein and fat increases the abundance of Alistipes. High abundance of Alistipes was identified as a possible predictor of successful weight loss. Increased abundance of Alistipes has been correlated with a greater frequency of pain in pediatric irritable bowel syndrome patients.
Reference range: -3, -2, -1, 0, 1, 2, 3
Reference range: Not Detected, Detected
Ascaris is a worm that infects the small intestine, but its life cycle includes migration through the circulation to the heart and lungs, and into the oropharynx. Infection is acquired through the ingestion of embryonated eggs in contaminated soil or water. Ascariasis is the most prevalent intestinal helminth infection in the world; current estimates suggest that more than 1 billion persons are infected. In the US, infection is more common in rural parts of the southeast.
Most individuals have no noticeable symptoms. Migrating larvae may produce “verminous pneumonia”. However, heavy infection, especially in children, may produce abdominal cramps, and a mass of tangled worms may cause intestinal obstruction. Aberrant migration of individual adult worms occasionally leads to obstructions resulting in cholangitis, cholecystitis, liver abscess, pancreatitis, appendicitis, or peritonitis.
Reference range: -3, -2, -1, 0, +1, +2, +3
The phylum Firmicutes constitutes the most diverse and abundant group of gastrointestinal microbiota which are grouped into four classes, Bacilli, Clostridia, Erysipelotrichi, and Negativicutes. They make up approximately 39% of the gut microbiota, on average, in healthy adults, but can comprise as much as 80% of the community.
Reference range: No Growth, 1+, 2+, 3+, 4+
Imbalanced bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficient levels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher levels.
Reference range: -3, -2, -1, 0, +1, +2, +3
Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism.
Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood.
Bacteroides fragilis plays an important role in the prevention of intestinal inflammation. An energy-restricted diet has been shown to increase B. fragilis in overweight adolescents. An increase in B. stercoris has been associated with higher risk of colon cancer. Decreased levels of Bacteroides spp. have been reported in association with multiple sclerosis, rheumatoid arthritis and Parkinson’s disease.
Reference range: -3, -2, -1, 0, +1, +2, +3
Bacteroides pectinophilus contributes to breakdown of dietary pectins which are prebiotics. Pectins are complex, plantderived carbohydrates that are indigestible by human enzymes, but can be easily degraded by certain commensal bacteria in the gut.
Reference range: -3, -2, -1, 0, +1, +2, +3
Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism.
Reference range: -3, -2, -1, 0, +1, +2, +3
The predominant genera in the human colonic microbiota are Bacteroides and Prevotella, which belong to the major phyla Bacteroidetes.
Reference range: -3, -2, -1, 0, +1, +2, +3
Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism. Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood.
Reference range: -3, -2, -1, 0, +1, +2, +3
Bacteroides zoogleoformans is part of the Bacteroides genus. Species in the genus Bacteroides carry out broad metabolic functions, including:
- degradation of complex plant polysaccharides,
- proteolytic activities (=the breakdown of proteins into smaller polypeptides or amino acids),
- de-conjugation of bile acids,
- mucosal barrier integrity,
- short chain fatty acid production,
- fatty acid storage and glucose metabolism.
Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood. Bacteroides fragilis plays an important role in the prevention of intestinal inflammation. An energy-restricted diet has been shown to increase B. fragilis in overweight adolescents. An increase in B. stercoris has been associated with higher risk of colon cancer. Decreased levels of Bacteroides spp. have been reported in association with multiple sclerosis, rheumatoid arthritis and Parkinson’s disease.
Reference range: Not Detected, Detected
Reference range: -3, -2, -1, 0, +1, +2, +3
Considered amongst the most beneficial commensal bacteria in the human gut, Bifidobacterium spp. are able to degrade monosaccharides, galacto-, manno-, and fructo-oligosaccharides, as well as some complex carbohydrates. Many of the non-digestible oligosaccharides, found as natural components in mother’s milk, select for colonization of these species which dominate the infant gut shortly after birth.
Bifidobacteria may provide health benefits directly through interactions with the host, and indirectly through interactions with other microorganisms. Bifidobacterium spp. take part in production and adsorption of vitamins, such as vitamins K and B12, biotin, folate, thiamine, riboflavin, and pyridoxine.
Reference range: Not Detected, Detected
Reference range: Negative, Positive
Most Campylobacter infections in industrialized countries are caused by C. jejuni, C. coli, and C. lari with an estimated 1.5 million cases of foodborne illness due to Campylobacter per year in the US. Campylobacter spp. are responsible for approximately 15% of hospitalizations resulting from foodborne infections.
Generally, campylobacteriosis presents as one to three days of fever, vomiting, and headaches followed by three to seven days of watery or bloody diarrhea and may include abdominal pain, cramping, nausea, headache, and/ or muscle pain within 2-5 days of infection.
Contaminated water, pets, food, unpasteurized milk and undercooked poultry, are sources of infection. Use of antibiotics is controversial but may benefit children whom have had symptoms for less than 7 days, and immunocompromised individuals.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Negative, Intermediate, Positive
Simple sugars are absorbed in the small intestine and should not be appreciably present in the colon because they are a primary energy source for pathogenic or dysbiotic bacteria and yeast.
Reference range: -3, -2, -1, 0, +1, +2, +3
Consumption of a Western diet has been shown to increase Catenibacterium mitsuokai in the human gut microbiota.
Catenibacterium mitsuokai ferments glucose, mannose, galactose, fructose, sucrose, maltose, cellobiose, lactose and salicin in the production of lactic acid, acetic acid as well as iso-butyric acid.
The presence of Catenibacterium mitsuokai has been positively associated with obesity-related insulin resistance.
Reference range: Not Detected, Detected
Charcot-Leyden crystals are formed from the breakdown of immune cells, especially eosinophils, and may be seen in the stool of patients with parasitic diseases. The crystals are indicative of immune response and can sometimes be seen in association with non-parasitic infection or inflammation.
Reference range: Not Detected, Detected, Few Trophs
Chilomastix mesnili is a flagellated protozoan included in the Comprehensive Stool Analysis + Parasitology (CSAP) panel by Doctor's Data, which screens for a wide range of gastrointestinal pathogens. While typically considered a non-pathogenic commensal organism, its presence may indicate exposure to contaminated food or water and serves as a marker of fecal-oral transmission. Detection is reported using microscopy and may require multi-day stool collection due to intermittent shedding. Although it generally doesn't cause symptoms or require treatment, its presence should be interpreted in the context of other findings and patient symptoms to rule out co-infections or underlying GI issues.
Reference range: No Growth, 1+, 2+, 3+, 4+
Citrobacter spp., a gram-negative bacterium and member of the Enterobacteriaceae family, is considered dysbiotic at 3+ or greater. Citrobacter freundii complex (including C. freundii, C. braakii, C. gullenii, C. murliniae, rodentium, C. wermanii, C. youngae, C. koseri and C. farmeri) can cause diarrheal disease.
Reference range: No Growth, 1+, 2+, 3+, 4+
Citrobacter spp., a gram-negative bacterium and member of the Enterobacteriaceae family, is considered dysbiotic at 3+ or greater.
Citrobacter freundii complex (including C. freundii, C. braakii, C. gullenii, C. murliniae, rodentium, C. wermanii, C. youngae, C. koseri and C. farmeri, can cause diarrheal disease.
Symptoms are the result of an E. coli-like heat-stable enterotoxin and hydrogen sulfide.
Citrobacter freundii complex has been implicated as a cause of gastrointestinal infection and inflammation, acute dysentery, and dyspepsia.
Reference range: Not Detected, Detected
This trematode infects the bile ducts. Infection occurs through consumption of encysted metacercariae in raw, dried, or pickled fish imported from endemic areas, which include Japan, Korea, China, Taiwan, and Vietnam.
Light infection is usually asymptomatic. Most pathologic manifestations result from inflammation and intermittent obstruction of the biliary ducts. In the acute phase, abdominal pain, nausea, diarrhea, and eosinophilia can occur. In long-standing infections cholangitis, cholelithiasis, pancreatitis, biliary obstruction, portal fibrosis, and cholangiocarcinoma can develop.
Praziquantel (25 mg/kg tid x 1 day, adult dose) is considered the most effective drug. Natural agents include elecampane, costus, and quassia.
Reference range: -3, -2, -1, 0, +1, +2, +3
Markers in this class are important producers of short-chain fatty acids, and have many well-documented roles in promoting a healthy intestinal barrier, immune balance, and protection against pathogens.
Reference range: Negative, Positive
C. difficile may cause diarrhea following the production of two toxins, enterotoxin A and cytotoxin B.
C. difficile is the most common cause of nosocomial infectious diarrhea in developed countries and is the major cause of antibiotic-associated pseudo-membranous colitis. C. difficile infection (CDI) symptoms vary from asymptomatic carriage (30% of young children) to mild/moderate watery diarrhea with fever and malaise to pseudomembranous colitis with bloody diarrhea, severe abdominal pain and fever. CDI occurs almost exclusively after broad-spectrum antibiotic use. No treatment is necessary for asymptomatic carriers. Anti-motility agents are contraindicated. CDI can be treated with vancomycin 125 mg given 4 times daily for 10 days, administered orally, and fidaxomicin 200 mg given twice daily for 10 days, as first-line options for both non-severe and severe initial CDI. Patients with fulminant CDI should receive vancomycin 500 mg 4 times per day in combination with IV metronidazole. In second or subsequent recurrences, patients can be treated with oral vancomycin, fidaxomicin, or a fecal transplant. Co-administration of Saccharomyces boulardii and Lactobacillus rhamnosus during antibiotic therapy may reduce the risk of infection relapse. Oral rehydration therapy is recommended to prevent dehydration.
Reference range: -3, -2, -1, 0, +1, +2, +3
Reference range: -3, -2, -1, 0, +1, +2, +3
Appropriate digestion and metabolism of complex dietary carbohydrates from plants drives healthy diversity in the gut microbiota. Clostridium methylpentosum ferments the naturally occurring sugar L-rhamnose that is released by microbial breakdown of plant-derived pectin.
Reference range: Brown, Other
Stool is normally brown because of pigments formed by bacteria acting on bile introduced into the digestive system from the liver. While certain conditions can cause changes in stool color, many changes are harmless and are caused by pigments in foods or dietary supplements.
Reference range: Soft, Other
Stool normally contains about 75% water and ideally should be formed and soft. Stool consistency can vary based upon transit time and water absorption.
Reference range: -3, -2, -1, 0, +1, +2, +3
Coprobacillus cateniformis ferment glucose and other common sugars primarily to acetic and lactic acid, and to a lesser extent butyrate and valerate.
Reference range: Negative, Positive
The Cryptosporidium parasite causes disease in humans through ingestion of infectious oocysts in contaminated water or food, and by direct contact with fecal material from individuals or animals actively shedding oocysts. Two species of Cryptosporidium cause disease in humans, Cryptosporidium hominis and Cryptosporidium parvum. C. hominis is more prevalent in the US, South America, Australia, and Africa, while C. parvum accounts for most cases in Europe. Along with Giardia, Cryptosporidium is the most common parasitic cause of diarrheal illness in the US and other developed nations.
Reference range: -3, -2, -1, 0, +1, +2, +3
Dialister invisus is generally considered an endodontic pathogen (Endo is the Greek word for inside and odont is Greek for tooth). Dialister invisus is often associated with periodontitis, caries, halitosis, and endodontic infections.
Dialister invisus (D. invisus) is capable of generating both acetate and propionate, and the abundance of this bacterium is reduced in patients with CD.
Reference range: -3, -2, -1, 0, +1, +2, +3
Dialister invisus is generally considered an endodontic pathogen (Endo is the Greek word for inside and odont is Greek for tooth). Dialister invisus is often associated with periodontitis, caries, halitosis, and endodontic infections.
Dialister invisus (D. invisus) is capable of generating both acetate and propionate, and the abundance of this bacterium is reduced in patients with CD.
Reference range: Not Detected, Detected
D. fragilis infects the large intestine. This parasite does not have a cyst stage, and cannot survive long outside the body alone. It may be spread in pinworm (Enterobius vermicularis) eggs. Infection is common worldwide, including in the United States. D. fragilis is known to cause non-invasive diarrheal illness in humans. 90% of children are symptomatic, whereas only 15-20% of adults are. The most common symptoms include diarrhea, stomach pain, and stomach cramping. Loss of appetite and weight, nausea, and fatigue are also common.
Recommended treatment is iodoquinol (650 mg tid x 20 days, adult dose). Alternatives include tetracycline (500 mg qid x 10 days, adult dose) and metronidazole (500-750 mg tid x 10 days, adult dose). Natural agents include berberine, wormwood, black walnut, grapefruit seed extract, and oil of oregano.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: -3, -2, -1, 0, +1, +2, +3
Dorea is a genus within the Lachnospiraceae family that is in the Firmicutes phylum. Dorea species are known to produce hydrogen and carbon dioxide as end-products of glucose fermentation and may be associated with bloating.
Optimal range: 200 - 1000 µg/mL
Elastase is a pancreatic enzyme that digests and degrades a number of proteins. A finding of low elastase in a formed stool specimen is an indicator of pancreatic exocrine insufficiency. Moderate pancreatic insufficiency is defined at 100-200 μg/mL, and severe pancreatic insufficiency as <100 μg/mL. Fecal elastase can be artefactually low due to fluid dilution effects in a loose/watery stool sample. Check the
reported consistency of the stool specimen.
Fecal elastase measured by a sensitive immunoassay is a specific marker for pancreatic function and maintains a high diagnostic accuracy among patients with small intestinal diseases. This elastase marker allows for the diagnosis or exclusion of pancreatic exocrine insufficiency and degree of severity, which can be caused by chronic pancreatitis, cystic fibrosis, pancreatic tumor, cholelithiasis or diabetes mellitus.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Negative, Positive
Entamoeba histolytica is a protozoan parasite that infects an estimated 34 to 50 million people per year worldwide, and kills 100,000 individuals annually. The disease caused by E. histolytica, amebiasis, is common in tropical areas with poor sanitary conditions but is also endemic in the US with the prevalence of E. histolytica infection estimated to be 4%. The most common clinical manifestation of infection with E. histolytica is amoebic diarrhea without dysentery; however, more severe cases can result in amoebic dysentery, which is diarrhea with mucous and visible or microscopic blood, severe abdominal pain, fever, and elevated fecal lysozyme. Occasional asymptomatic carriage is possible.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: No Growth, 1+, 2+, 3+, 4+
Enterobacter cloacae complex is part of the Enterobacteriaceae family. E cloacae complex is a group of six closely related species with similar resistance patterns:
E. cloacae, E. asburiae, E. hormaechei, E. kobei, E. ludwigii, and E. nimipressuralis.
Reference range: -3, -2, -1, 0, +1, +2, +3
Enterobacteriaceae is a large family of bacteria within the Proteobacteria phyla. Enterobacteriaceae is inclusive of normal commensal species, harmless opportunists, and many of the more familiar pathogens, such as Salmonella, Escherichia coli, Klebsiella, Shigella and Proteus.
Other potential disease-causing bacteria in this family include Enterobacter and Citrobacter species.
Overall, Enterobacteriaceae were found at higher levels in patients with NAFLD and PD. Diets rich in in complex carbohydrates are associated with lower levels of Enterobacteriaceae, in comparison to diets rich in fat and/or protein.
Reference range: Not Detected, Detected
This nematode inhabits the large intestine and migrates to the anus at night, where it deposits eggs on the perianal surface. Pinworm is the most common worm infection in the United States. School-age children, followed by preschoolers, have the highest rates of infection. Perianal pruritus, especially at night, is a characteristic symptom. Disturbed sleep, loss of appetite, restlessness and irritability may be experienced with heavy infection. Very rarely, E. vermicularis will migrate to the urinary bladder, vagina, or peritoneal cavity.
Reference range: Not Detected, Detected
Reference range: Negative, Positive
ETEC is a major cause of traveler’s diarrhea in adults in industrialized countries and a leading cause of infant diarrhea in developing countries. ETEC is estimated to cause 200 million episodes of diarrhea and approximately 380,000 deaths in children in the developing world and travelers to those areas. In the US, ETEC is estimated to cause approximately 17,800 foodborne illnesses annually. Enterotoxins produced by ETEC strains include heat-labile LT toxin and heat-stable ST toxin. ETEC illnesses are usually associated with acute watery diarrhea and sometimes nausea, headache, vomiting, or fever.
Reference range: Negative, Positive
E. coli O157 is a member of the pathogenic enterohemorrhagic E. coli strains (also known as verocytotoxin producing or Shiga-toxin producing E. coli (STEC)), and is an uncommon but serious cause of gastroenteritis. Infection with E. coli O157 often causes hemorrhagic colitis which involves severe abdominal cramps with watery non-hemorrhagic diarrhea which can become grossly bloody after two or three days.
Reference range: -3, -2, -1, 0, +1, +2, +3
Reference range: -3, -2, -1, 0, +1, +2, +3
Reference range: -3, -2, -1, 0, +1, +2, +3
Eubacterium hallii and Eubacterium rectale are both part of the Lachnospiraceae family that is in the Firmicutes phylum.
Reference range: -3, -2, -1, 0, +1, +2, +3
Reference range: -3, -2, -1, 0, +1, +2, +3
Reference range: -3, -2, -1, 0, +1, +2, +3
Faecalibacterium prausnitzii is one of the most abundant butyrate producing bacteria in a healthy gastrointestinal tract.
Reference range: Not Detected, Detected
Reference range: None, Moderate, High
Individuals who have pancreatic insufficiency secondary to pancreatic or biliary tract disease may be unable to efficiently digest and absorb fat normally. The microscopic fecal fat test is a reliable marker for fat malabsorption, and evaluation enzyme therapy in patients with pancreatic exocrine insufficiency. When assessing the root cause of fat malabsorption the following should be considered: dietary fat intake, gastric surgery, pancreatic disease, biliary obstruction, liver disease, mucosal integrity, and problems with chylomicron formation.
Supplementation with pancreatic enzymes, HCL, and/or bile salts may be indicated. Steatorrhea is associated with a particularly foul odor of the stool.
Reference range: -3, -2, -1, 0, +1, +2, +3
Gram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth, nose, throat, and colon.2 An abnormal result in one or both of these phylum suggest imbalanced normal microbes in the GI tract. Further, high Firmicutes and low Bacteroidetes (resulting in a high F/B ratio) suggest microbial imbalance which may be related to increased caloric extraction from food, fat deposition and lipogenesis, impaired insulin sensitivity, and increased inflammation.
Reference range: Not Detected, Detected
Reference range: Negative, Positive
G. duodenalis, a single celled protozoa, is the most frequent cause of non-bacterial diarrhea in the United States. The Centers for Disease Control and Prevention (CDC) estimates as many as 2.5 million cases of Giardia infection occur annually in the U.S. Symptomatic individuals may experience diarrhea, abdominal cramps, dehydration, malabsorption, loss of appetite, anemia, and weight loss 1-2 weeks following the ingestion of cysts. Typically symptoms will last 1-2 weeks and infections are self-limiting. Most individuals will be completely asymptomatic. Prevalence of giardiasis in adults has been estimated to be 4-7%. Higher prevalence rates have been reported in children.
Reference range: Not Detected, Detected
Reference range: -3, -2, -1, 0, 1, 2, 3
Reference range: Not Detected, Detected
The adult nematodes attach to the wall of the small intestine and suck blood. The hookworm life cycle also includes migration through the circulation to the heart and lungs, and into the oropharynx. Infection occurs when larvae from fecally-contaminated soil penetrate human skin. A. duodenale is widely distributed in the Mediterranean basin, India, China, Japan, and the Pacific coastal areas of South America
but is rare in the USA and equatorial Africa. N. americanus is the predominant hookworm of Central and South Africa, southern Asia, Melanesia, and Polynesia. It is widely distributed in the southern USA, on islands of the Caribbean, and on the Atlantic side of Central and South America. About 25% of the world’s population is infected with hookworms.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Iodamoeba buetschlii is considered nonpathogenic or commensal. Infection occurs via fecal-oral route, and indicates increased risk of
exposure to potential pathogens.
Reference range: Not Detected, Detected
Reference range: No Growth, 1+, 2+, 3+, 4+
Klebsiella spp. are gram-negative bacilli belonging to the Enterobacteriaceae family and closely related to the genera Enterobacter and Serratia. Klebsiella spp. are considered dysbiotic in the amount of 3 - 4 +. Klebsiella spp. are widely distributed in nature and in the gastrointestinal tract of humans. In humans, they may colonize the skin, oral cavity, pharynx, or gastrointestinal tract. Regarded as normal flora in many parts of the colon, intestinal tract and biliary tract, the gut is the main reservoir of opportunistic strains.
This bacteria has the potential to cause intestinal, lung, urinary tract, and wound infections, but overgrowth of Klebsiella spp. is commonly asymptomatic.
Reference range: No Growth, 1+, 2+, 3+, 4+
Klebsiella spp. are gram-negative bacilli belonging to the Enterobacteriaceae family and closely related to the genera Enterobacter and Serratia. Klebsiella spp. are widely distributed in nature and in the gastrointestinal tract of humans. In humans, they may colonize the skin, oral cavity, pharynx, or gastrointestinal tract.
Reference range: -3, -2, -1, 0, +1, +2, +3
The Lachnospiraceae family is a diverse group of butyric acid producers, which have been associated with beneficial microbial and epithelial cell growth. Consumption of a Mediterranean diet decreased levels of species belonging to Lachnospiraceae.
Lachnospiraceae are known to increase with intake of cruciferous vegetables and wheat bran, and decrease with a resistant starch diet.
Reference range: -3, -2, -1, 0, +1, +2, +3
Reference range: -3, -2, -1, 0, +1, +2, +3
Decreased and normal levels of Lactobacillus spp. have been reported in patients with irritable bowel syndrome. Lactobacillus spp. abundance was shown to be lower in the active phase of ulcerative colitis. Lactobacillus levels were shown to be increased after inulin consumption, but decreased after consumption of maltodextrin. Polyphenols derived from chocolate, green tea, blackcurrant, red wine
and grape seed extracts have been shown to increase Lactobacillus species. The increased abundance of Lactobacillus species has been associated with amelioration (=improvement) of inflammation.
Reference range: -3, -2, -1, 0, +1, +2, +3
Lactobacillus species is a type of bacteria. There are lots of different species of lactobacillus.
Lactobacillus bacteria are commonly found in the human gut, mouth and vagina. They are considered generally as “good bacteria”, and in fact may contribute to good health, often being included in probiotic supplements. These bacteria are characterized by their ability to produce lactic acid as a byproduct of glucose metabolism.
Reference range: No Growth, 1+, 2+, 3+, 4+
Reference range: -3, -2, -1, 0, 1, 2, 3
Reference range: Negative, Positive
The presence of mucus in the stool may be due to prolonged irritation to the intestinal mucosa and may be secondary to a proliferation of gastrointestinal enteropathogens such as bacteria, yeast, or parasites. It can also be associated with an inflammatory bowel condition. Mucus is also secreted by the intestinal mucosa in response to parasympathetic excitability such as spastic constipation, mucus colitis, neoplasm of the rectum, or villous adenoma of the colon. A positive mucus result requires treatment of the cause of inflammation and possibly anti-inflammatory therapy. Microbial analysis, including PCR and culture along with microscopic studies of the stool are useful in the detection of dysbiotic bacteria, viruses, yeast, or parasites. Localized abscesses and inflammatory disorders should also be ruled out.
Reference range: Not Detected, Rare, Detected
Muscle fibers in the stool are an indicator of incomplete digestion. Bloating, flatulence, feelings of “fullness” may be associated with increase in muscle fibers.
The presence of muscle fibers in the stool is an indicator of incomplete digestion. This may be due to a number of factors including excessive meat intake and insufficient mastication. Other factors may include insufficient hydrochloric acid secretion within the stomach and/or insufficient output of pancreatic enzymes. Bloating and flatulence often accommodate hypochlorhydria and insufficient pancreatic enzyme output.
Reference range: -3, -2, -2, 0, +1, +2, +3
Mycoplasma hominis is from the Tenericutes phylum.
Tenericutes are cell wall-less bacteria that do not synthesize precursors of peptidoglycan. Tenericutes consist of four main clades designated as the Acholeplasma, Spiroplasma, Pneumoniae and Hominis clusters. Tenericutes are typically parasites or commensals of eukaryotic hosts.
Mycoplasma hominis is a fastidious bacterium, which usually colonizes the lower urogenital tract and may cause systemic infections in neonates and genital infections in adults. It can also be the cause of serious extra-genital infections, mainly in immunosuppressed or predisposed subjects.
Reference range: Positive, Negative
Norovirus affects people of all ages causing 19 to 21 million illnesses in the US per year. It is the leading contributor to acute gastroenteritis (AGE) across all age groups. While infections can occur year-round, Norovirus outbreaks tend to peak in cold weather. Norovirus infection symptoms include vomiting with watery, non-bloody diarrhea and abdominal cramps; occasionally fever, headache, muscle aches, or fatigue.
Reference range: Negative, Positive
In many cases, a positive occult blood results from gastrointestinal bleeding from the upper small intestine or higher. Gastric ulceration could, for example, result in a finding of occult blood rather than blood in the feces. However, a positive finding of occult blood may also be associated with colon cancer, ulcerative colitis (check fecal calprotectin and lactoferrin levels), ulceration of the esophagus, stomach or duodenum, diverticulitis, and gastric carcinoma.
Reference range: -3, -2, -1, 0, +1, +2, +3
The abundance of Parabacteroides spp., major anaerobic producers of acetate and succinate is increased with a high fat diet and is positively correlated with body weight. Parabacteroides spp., along with certain Bacteroides spp., have been shown to distinguish healthy adults from patients with irritable bowel syndrome or ulcerative colitis. Reduced abundance of this group of bacteria has also been linked to Crohn’s disease in children. Parabacteroides spp. has been found to be less abundant in patients with multiple sclerosis.
Reference range: -3, 2, -1, 0, +1, +2, +3
The abundance of Parabacteroides spp., major anaerobic producers of acetate and succinate is increased with a high fat diet and is positively correlated with body weight. Parabacteroides spp., along with certain Bacteroides spp., have been shown to distinguish healthy adults from patients with irritable bowel syndrome or ulcerative colitis. Reduced abundance of this group of bacteria has also been linked to Crohn’s disease in children. Parabacteroides spp. has been found to be less abundant in patients with multiple sclerosis.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
P. hominis is considered nonpathogenic or commensal. It lives in the large intestine. Exposure occurs via fecal-oral route, and indicates increased risk of exposure to potential pathogens.
Reference range: -3, -2, -1, 0, +1, +2, +3
Phascolarctobacterium faecium can produce short-chain fatty acids, including acetate and propionate, and may be associated with metabolic effects and mental state of the host.
Reference range: Not Detected, Detected
Reference range: -3, -2, -1, 0, +1, +2, +3
Proteobacteria (phylum)
Proteobacteria include a wide variety of pathogens, including species within the Escherichia, Shigella Salmonella, Vibrio, and Helicobacter genera. The phylum includes a number of species that are permanent residents of the microbiota and capable of inducing nonspecific inflammation and diarrhea when their presence is increased. Proteobacteria make up approximately 2% of the gut microbiota in healthy adults.
A high-fat diet is positively associated with an abundance of Proteobacteria. Slightly increased abundance of Proteobacteria may be associated with low-grade inflammation. Proteobacteria are increased in inflammatory bowel disease and irritable bowel syndrome. Higher abundance of Proteobacteria has been associated with a moderate to severe disease course in newly discovered ulcerative colitis patients. They are associated with diarrhea in IBS.
Reference range: Not Detected, Few, Moderate
Red Blood Cells (RBC) in the stool may be associated with a parasitic or bacterial infection, or an inflammatory bowel condition such as ulcerative colitis. Colorectal cancer, anal fistulas, and hemorrhoids should also be ruled out.
Reference range: Not Detected, Detected
Reference range: Negative, Positive
Rotaviruses are classified into seven serogroups (A-G); however, only groups A, B, and C are human pathogens.
The Group A Rotaviruses are responsible for the majority of infections.
Globally, Rotavirus is estimated to cause more than 125 million cases of gastroenteritis in children each year. Rotavirus symptoms can include non-bloody watery diarrhea, loss of appetite, low-grade fever, vomiting and abdominal cramping. Symptoms may be severe in infants, young children and virus may shed after resolution. While Rotavirus predominately infects children, it can also affect adults, and produces a more severe disease in immuno-compromised hosts. Transmission is via direct contact or fecal-oral via contaminated objects, food or water (drinking or recreational). Incubation period is typically two days and virus may shed prior to symptom presentation. Anti-emetics may be considered for children > 6 months old. Studies indicate that zinc may reduce severity of illness. The scientific literature does not currently support any specific herbal or nutritional antiviral therapies for this virus type. Lactobacillus casei GG and Saccharomyces boulardii may provide moderate clinical benefit in the treatment of watery diarrhea.
Reference range: No Growth, 1+, 2+, 3+, 4+
Imbalanced bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficient levels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher levels.
Reference range: No Growth, 1+, 2+, 3+, 4+
Reference range: -3, -2, -1, 0, +1, +2, +3
Members of Ruminococcus sensu produce acetate, but not butyrate. Ruminococcus gnavus, like Akkermansia muciniphila is a mucin degrading specialist.
HIGHER LEVELS:
- Higher levels of Ruminococcus spp. were associated with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.
- Increased abundance of Ruminococcus spp. has been reported in irritable bowel syndrome (IBS)
- Ruminococcus gnavus has been found to be in higher abundance in diarrhea predominant IBS.
- Intake of resistant starch has been associated with increased levels of R. bromii.
LOWER LEVELS:
- Reduced levels of R. bromii were observed in patients with primary biliary cirrhosis.
- Ruminococcus spp. are reportedly decreased in abundance with Crohn’s disease and ulcerative colitis.
- A diet rich in animal protein and fat was found to reduce the abundance of this species in human gut.
Reference range: -3, -2, -1, 0, +1, +2, +3
Members of Ruminococcus sensu produce acetate, but not butyrate.
Ruminococcus gnavus, like Akkermanisia muciniphila is a mucin degrading specialist.
Reference range: Negative, Positive
Salmonella are facultative anaerobic bacteria in the family of Enterobacteriaceae. There are two species of Salmonella, Salmonella enterica and Salmonella bongori that include over 2,600 different serotypes. The majority of the pathogenic serotypes of Salmonella that affect humans are within the species of Salmonella enterica (S. enterica). Worldwide, Salmonella spp. causes an estimated 93.8 million cases of gastroenteritis each year.
Optimal range: 30 - 275 mg/dL
Fecal Secretory IgA is a marker of gut secretory immunity and barrier function.
Immunoglobulin A (IgA) is an antibody playing a critical role in mucosal immunity and is produced in greater quantities than all other types of antibody combined.
In its secretory form, Secretory IgA is the main immunoglobulin found in mucous secretions and provides protection against potentially pathogenic microbes, due to its ability to resist degradation by enzymes and survive in harsh environments such as GI and respiratory tracts.
Reference range: Negative, Positive
E. coli are a diverse group of bacteria that normally live in the intestines of humans and animals. Although most strains of these bacteria are harmless, some produce toxins that can make you sick and cause diarrhea (loose stool/poop) such as Shiga toxin-producing E. coli (STEC).
Anyone can get STEC infection. Young children and the elderly are more susceptible to develop serious infection, but healthy older children and young adults can also become seriously ill.
Reference range: Negative, Positive
Shigella spp. are non-sporulating bacteria that belong to the family Enterobacteriaceae. Shigella infections account for 5% to 20% of all diarrheal episodes throughout the world, and although these infections are commonly seen in children younger than five years old, they can be found in adults of all ages. Shigellosis often begins with fever, watery diarrhea, and abdominal cramps, and can progress to bloody diarrhea.
Reference range: -3, -2, -1, 0, +1, +2, +3
Streptococcus agalactiae, also known as Lancefield’s group B streptococcus (GBS), is a gram-positive facultative anaerobe. Found in around 30% of healthy adult gastrointestinal tracts and vaginas, it can cause severe infections. The bacterium is the leading cause of septicaemia, pneumonia and meningitis in neonates. Additionally, a recent study showed that neonates of GBS+ women have a different microbiota composition compared to GBS-, possibly leading to disease development later in life.
Eubacterium is a genus of gram-positive bacteria. They are one of the most abundant species in healthy colons and use lactate and acetate to produce butyrate, and 1,2 propanediol to produce propionate.
Depletion of Eubacterium rectale has been associated with high fat diets, colorectal cancer and ulcerative colitis. Species belonging to this genus are also involved in the metabolism of polyphenols - health-promoting metabolites, which can reduce incidence of carcinogenesis. Eubacterium rely on sources of resistant starches for survival.
Reference range: No Growth, 1+, 2+, 3+, 4+
Imbalanced bacteria are usually neither pathogenic nor beneficial to the host GI tract. Imbalances can occur when there are insufficient levels of beneficial bacteria and increased levels of commensal bacteria. Certain commensal bacteria are reported as dysbiotic at higher levels.
Reference range: No Growth, 1+, 2+, 3+, 4+
Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.
Reference range: No Growth, 1+, 2+, 3+, 4+
Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients.
These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls. Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.
Reference range: -3, -2, -1, 0, +1, +2, +3
Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients.
Reference range: -3, -2, -1, 0, +1, +2, +3
Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients. These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls.
Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.
Reference range: -3, -2, -1, 0, +1, +2, +3
Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients. These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls.
Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.
Reference range: -3, -2, -1, 0, +1, +2, +3
Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients. These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls. Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.
Reference range: Not Detected, Detected
Strongyloides infects the duodenum and jejunum, but its life cycle also includes migration through the lungs. Infection occurs when larvae
penetrate the skin of humans or are passed via the fecal-oral route. Strongyloidiasis is endemic throughout the tropics and subtropics, including rural areas of the southern USA. More than half of infected persons are asymptomatic. Acute symptoms of strongyloidiasis may include epigastric pain and tenderness, diarrhea, nausea, vomiting, constipation, and weight loss. Chronic infection may lead to glucose malabsorption and protein-losing enteropathy.
Reference range: Not Detected, Detected
These cestodes usually infect the intestinal tract, but Taenia solium may also invade the CNS. Transmission is by ingesting cysts in raw or undercooked meat. Taenia solium transmission may also occur via the fecal-oral route, which increases chance of CNS involvement. T. saginata is prevalent in Ethiopia, Kenya, the Middle East, Yugoslavia, Mexico, and parts of South America and Eastern Europe. T. solium is found in Europe, Latin America, India, and China. Infection in the USA is rare. Taeniasis is usually asymptomatic. Mild abdominal symptoms may include epigastric discomfort, increased hunger, diarrhea, nausea, and weight loss. Death of cysts can elicit an intense inflammatory tissue response, with symptoms appearing 4 to 5 years after infection. Infection of the brain or CNS (neurocysticercosis) can cause severe symptoms including seizures, altered mental status, focal neurological signs, and aseptic meningitis.
Reference range: Not Detected, Detected
T. trichiura is a nematode that infects the large intestine. Infection is spread via the fecal-oral route. The parasite is found principally in the tropics and subtropics. Mild asymptomatic infections are common in rural parts of the southeastern USA. Light infections are often asymptomatic. Heavy infections cause abdominal pain, anorexia, and diarrhea and may retard growth. Very heavy infections may cause weight loss, anemia, and rectal prolapse in children and parturient women.
No drug treatment is required for asymptomatic or light infections. Mebendazole (100 mg bid x 3 days, adult dose) or albendazole (400 mg qd x 3 days, adult dose) are used for more severe infections. These drugs should not be used during pregnancy. Natural agents include quassia and black walnut.
Reference range: Not Detected, Rare, Few, Detected
Vegetable fibers in the stool may be indicative of inadequate chewing, or eating “on the run”.
Reference range: -3, -2, -1, 0, +1, +2, +3
Veillonella are anaerobic, gram-negative cocci, part of the normal flora of the mouth, gastrointestinal tract, and vaginal tract.
Reference range: Negative, Positive
Vibrio cholerae is one of the most common causes of diarrhea worldwide. While diarrhea associated with V. cholerae is predominately seen in the Indian subcontinent, South East Asia, Africa, and South America, sporadic cases of V. cholerae-induced diarrhea have been reported in the United States. Gastrointestinal disease caused by V. cholerae is due to production of the cholera toxin. Two types of infection occur; cholera, which is a severe illness presents with profuse, “rice-water” diarrhea, vomiting, tachycardia, dehydration, muscle cramps, restlessness or irritability, and vibriosis, which is characterized by abdominal cramps, nausea, vomiting, fever and chills which is a self-limited illness of 3-4 days.
Reference range: Not Detected, Rare, Detected
White Blood Cells (WBC) and Mucus in the stool can occur with bacterial and parasitic infections, with mucosal irritation, and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.
Elevated levels of WBCs in the stool are an indication of an inflammatory process resulting in the infiltration of leukocytes within the intestinal lumen. This could be the result of an inflammatory bowel conditions including ulcerative colitis (UC) or Crohn’s disease (check fecal calprotectin and lactoferrin). Enteroinvasive bacteria such as Campylobacter, Shigella, Salmonella, and Enteropathogenic parasites such as Giardia, Blastocystis, Cryptosporidium, and Entamoeba can be a cause of inflammation to the mucosal lining. WBCs are often accompanied by mucus in the stool (macroscopic examination). Other conditions that may be associated with WBCs in the stool include localized abscesses and anal fistulas. A positive WBC result may warrant identification and eradication of the cause of inflammation and possible anti-inflammatory therapy.
Reference range: Not Detected, Moderate, Many, Rare, Few
Yeast may normally be present in small quantities on the skin, in the mouth and intestine. While small quantities of yeast may be normal, yeast observed in higher quantities is considered abnormal.
Amino Acid Analysis, LC/MS
Amino acid analysis is necessary for the diagnosis of a variety of inborn errors of metabolism. These include, but are not limited to:
- phenylketonuria,
tyrosinemia,
citrullinemia,
non-ketotic hyperglycinemia,
maple syrup urine disease,
and homocystinuria.
The assay is also key for the continued monitoring of treatment plans for these disorders and useful for assessing nutritional status of patients.
Optimal range: 0 - 237 mmol/mol creatinine
1-Methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 12 - 41 mmol/mol creatinine
Both 1-methylhistidine and 3-methylhistidine are histidine metabolites which have been proposed as markers of meat intake. Note that some confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
3-methylhistidine is a constituent of actin and myosin, the contractile proteins of skeletal muscles. Urinary excretion of 3-methylhistidine may be a result of muscle breakdown or consumption of meat fibers. Unlike 1-methylhistidine, 3-methylhistidine has been shown to increase in fasting states indicating catabolism of muscle tissue. Therefore, this marker is more variable with regards to animal protein consumption.
Optimal range: 10 - 78 mmol/mol creatinine
Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine. It is found in many foods including eggs, meat, lentils, and fish. Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.
Optimal range: 0 - 13 mmol/mol creatinine
Alpha-aminoadipic acid (a-Aminoadipic acid) is an intermediary metabolite of lysine (primarily) and of tryptophan.
Optimal range: 0 - 2 mmol/mol creatinine
Alpha-Amino-N-butyric acid (α-ANB), also known as alpha-aminobutyric acid, is a nonessential amino acid derived from the catabolism of methionine, threonine, and serine.
α-ANB is both formed and metabolized by reactions which require vitamin B6 as a cofactor.
Optimal range: 0 - 6 mmol/mol creatinine
Arginine is found in all protein foods and is very abundant in seeds and nuts. It is considered a semi-essential amino acid during early development, infection/inflammation, or renal and/or intestinal impairment. It has many functions in the body including:
- ammonia disposal in the urea cycle
- immune function
- stimulation of insulin release
- muscle metabolism (creatine/creatinine precursor)
- nitric oxide (NO) formation
- glutamic acid and proline formation
- glucose/glycogen conversion
- stimulation of the release of growth hormone, vasopressin, and prolactin
- wound healing
Because arginine is a precursor for nitric oxide synthesis, it is often used therapeutically in cardiovascular disease for its vasodilatory effects.
Optimal range: 2 - 43 mmol/mol creatinine
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 0 - 2 mmol/mol creatinine
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 0 - 12 mmol/mol creatinine
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. And, as previously mentioned, carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 0 - 102 mmol/mol creatinine
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA. Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys. β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 0 - 2 mmol/mol creatinine
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified.
It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins.
Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine.
Optimal range: 1.77 - 23.31 mmol/L
Creatinine is the endproduct of creatine metabolism. Creatine is present primarily in muscle and the amount of creatinine produced is related to total skeletal muscle mass. Daily creatinine production is fairly constant except when there is massive injury to muscle. The kidneys excrete creatinine very efficiently and blood levels and daily urinary excretion of creatinine fluctuates very little in healthy normal people. Since blood and daily urine excretion of creatinine shows minimal fluctuation, creatinine excretion is useful in determining whether 24-hour urine specimens for other analytes (e.g., protein) have been completely and accurately collected.
Optimal range: 0 - 10 mmol/mol creatinine
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 4 - 15 mmol/mol creatinine
Cystine is formed from the oxidation of cysteine, or from the degradation of glutathione oxidation products. It is two cysteines linked together with a disulfide bond.
Optimal range: 24 - 75 mmol/mol creatinine
Ethanolamine is an intermediary metabolite in the serine-to-choline sequence. It can be used to synthesize phosphatidylethanolamine (PE), a very important membrane phospholipid. Ethanolamine is not only a precursor, but also a breakdown product of PE. Ethanolamine is abundant in both intestinal and bacterial cell membranes. It plays a significant role in the renewal and proliferation of intestinal cells and intestinal inflammation. Also, since ethanolamine plays a structural role in skeletal muscle cell membranes, some evidence suggests it may be a marker of skeletal muscle turnover.
Optimal range: 0 - 2 mmol/mol creatinine
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania. Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution.
Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production. Endogenous GABA is produced by the decarboxylation of the excitatory neurotransmitter glutamic acid.
Optimal range: 0 - 4 mmol/mol creatinine
Glutamic acid is a nonessential amino acid is derived from the diet and from the breakdown of gut proteins. Glutamate is a major excitatory neurotransmitter in the brain. It plays a role in neuronal differentiation, migration, and survival in the developing brain. It is also involved in synaptic maintenance, neuroplasticity, learning, and memory.
Optimal range: 24 - 211 mmol/mol creatinine
Glutamine is a nonessential amino acid and is the most abundant amino acid in the body. It is formed from glutamate using the enzyme glutamine synthetase.
Approximately 80% of glutamine is found in the skeletal muscle, and this concentration is 30 times higher than the amount of glutamine found in human plasma. Although glucose is used as fuel for many tissues in the body, glutamine is the main fuel source for a large number of cells including lymphocytes, neutrophils, macrophages, and enterocytes.
Optimal range: 0 - 383 mmol/mol creatinine
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine. It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins. Glycine is a major collagen and elastin component, which are the most abundant proteins in the body. Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Optimal range: 20 - 309 mmol/mol creatinine
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine.
Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
With this, decreased amounts of histidine and insufficient vitamin B6 can subsequently lead to a decrease in histamine concentration. This may impair digestion, since histamine binds to H2 receptors located on the surface of parietal cells to stimulate gastric acid secretion, necessary for protein breakdown.
Histidine also inhibits the production of proinflammatory cytokines by monocytes and is therefore anti-inflammatory and antioxidant.
With these beneficial effects, histidine supplementation has been shown to improve insulin resistance, reduce BMI, suppress inflammation, and lower oxidative stress in obese women with metabolic syndrome.
Interestingly, histadine can also be broken down to form urocanic acid in the liver and skin. Urocanic acid absorbs UV light and is thought to act as a natural sunscreen.
Optimal range: 0 - 1 mmol/mol creatinine
Homocystine is the oxidized form of homocysteine. A substance is oxidized when it undergoes the process of oxidation. I.e the addition of oxygen or any electronegative elements or the removal of hydrogen or any electropositive element.
Homocystine is a dipeptide consisting of two homocysteine molecules joined by a disulfide bond. A dipeptide is a molecule that consists of two amino acids joined together by a peptide bond.
Homocystine occurs only transiently before being reduced to homocysteine and converted to the harmless cystathionine via a vitamin B6-dependent enzyme. Homocystine and homocysteine-cysteine mixed disulfides account for >98% of total homocysteine in plasma from healthy individuals.
Optimal range: 0 - 9 mmol/mol creatinine
Hydroxylysine is an amino acid related to collagen.
What is collagen?
Collagen is the most abundant protein in your body. It is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin and muscles.
Optimal range: 0 - 2 mmol/mol creatinine
- Hydroxyproline is the key factor in stabilizing collagens.
- Hydroxyproline is abundant in meat and low in plant-based foods. Meat intake increases levels of proline and hydroxyproline.
- Increased hydroxyproline has been found in collagen catabolism (bone resorption, increased reactive oxygen species [ROS]), tissue degradation, muscle damage, or other conditions such as Paget's disease or Alzheimer's disease.
- Proline and hydroxyproline both negatively correlated with a higher likelihood of anxiety, depression, and psychoses.
Optimal range: 0 - 4 mmol/mol creatinine
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0 - 7 mmol/mol creatinine
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 4 - 69 mmol/mol creatinine
Lysine is a nutritionally essential amino acid abundant in meat, fish, fowl, and legumes and is needed for formation of body proteins and enzymes.
Lysine can be methylated using S-adenosylmethionine (SAM) to synthesize carnitine, which is needed for fatty acid oxidation. Lysine also generates Acetyl CoA for use in the citric acid cycle. Lysine, proline, hydroxyproline, and vitamin C are important in the synthesis of collagen for skin, bones, tendons and cartilage.
L-lysine supplementation has also been studied for herpes simplex treatment and prophylaxis and may be beneficial.
Optimal range: 0 - 2 mmol/mol creatinine
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 0 - 5 mmol/mol creatinine
Ornithine is an intermediate nonprotein-forming amino acid of the urea cycle. Arginine is converted to ornithine via the arginase enzyme, with urea as a byproduct. Ornithine combined with carbamoyl phosphate is then converted into citrulline via the ornithine transcarbamylase (OTC) enzyme. The contribution of carbamoyl phosphate results from the metabolism of ammonia by the enzyme carbamoyl phosphate synthase, and if this magnesium-dependent process is impaired, ammonia buildup, or hyperammonemia can occur.
Optimal range: 2 - 10 mmol/mol creatinine
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy. Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 0 - 2 mmol/mol creatinine
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid.
Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage.
Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn.
Optimal range: 0 - 80 mmol/mol creatinine
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine. It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents. In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess.
Optimal range: 12 - 82 mmol/mol creatinine
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 0 - 269 mmol/mol creatinine
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid.
Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
It has been proposed that taurine acts as an antioxidant, intracellular osmolyte, membrane stabilizer, and a neurotransmitter.
Optimal range: 5 - 53 mmol/mol creatinine
Threonine is an essential amino acid, i.e., it is vital for your health, but it cannot be synthesized by your body and therefore has to be obtained from a diet.
Optimal range: 2 - 16 mmol/mol creatinine
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 4 - 22 mmol/mol creatinine
Tyrosine is a conditionally essential amino acid which can come directly from the digestion of dietary protein. Common food sources include dairy, beans, whole grains, meat, and nuts.
If intake is insufficient, tyrosine can be formed from the essential amino acid phenylalanine using a tetrahydrobiopterin reaction. Tyrosine itself is a precursor to several neurotransmitters including dopamine, epinephrine and norepinephrine. It is also needed to create thyroid hormone and melanin skin pigments.
Within the metabolism of tyrosine to form neurotransmitters and other hormones, there are several important nutrient cofactors involved including vitamin B1, vitamin B6, tetrahydrobiopterin, copper, vitamin C, among others.
Optimal range: 2 - 6 mmol/mol creatinine
Valine, together with Isoleucine and Leucine are essential amino acids and are collectively referred to as branched-chain amino acids (BCAAs).
Array 11 – Chemical Immune Reactivity Screen
Array 11 measures an expanded range of environmental chemical toxins that bind to human tissues versus other laboratory tests that only identify chemical exposure.
Clinical Use:
- Identify the loss of immune tolerance associated with chemical exposure, which may lead to autoimmune reactivity
- Assist in setting guidelines for the avoidance of specific chemicals to reduce the risk of igniting the autoimmune process
- Monitor the effectiveness of the clinical management of patients
Optimal range: 0.9 - 3.2 ELISA Index
Aflatoxins are organic chemical compounds produced by a polyketide pathway by many strains of the mold, Aspergillus.
Aspergillus flavus is a particular strain common contaminant in agricultural products such as peanuts, rice, figs and corn.
Aflatoxin B1 is the most potent natural carcinogen known and is usually the major aflatoxin produced by toxigenic strains. The Curse of the Mummy has been a popular theme for literature, films and folklore.
Optimal range: 0.4 - 2.3 ELISA Index
Aflatoxins are organic chemical compounds produced by a polyketide pathway by many strains of the mold, Aspergillus.
Aspergillus flavus is a particular strain common contaminant in agricultural products such as peanuts, rice, figs and corn.
Aflatoxin B1 is the most potent natural carcinogen known and is usually the major aflatoxin produced by toxigenic strains. The Curse of the Mummy has been a popular theme for literature, films and folklore.
Optimal range: 0.4 - 1.6 ELISA Index
Classified as a hydrocarbon, Benzene [C6H6] is an organic chemical compound composed of 6 carbon atoms forming a hexagonal ring arrangement. Benzene is a solvent found in crude oil; because it has a high octane number, it is utilized in gasoline. Benzene is also used as a precursor to heavy chemicals (i.e. ethylbenzene, cumene from which acetone and phenols are derived). Most solvents are neurotoxic and many are carcinogenic.
Acute inhalation exposure to high concentrations of benzene can cause drowsiness, fatigue, nausea, vertigo, narcosis, and other symptoms of central nervous system (CNS) depression; however, the most damaging health effects associated with benzene exposure are chronic effects due to repeated exposure to low concentrations over many years.
Optimal range: 0.3 - 2.1 ELISA Index
Benzene Ring Compounds: Benzene, Pheno, Toluene, Xylene
Classified as a hydrocarbon, Benzene [C6H6] is an organic chemical compound composed of 6 carbon atoms forming a hexagonal ring arrangement. Benzene is a solvent found in crude oil. Because it has a high octane number, it is utilized in gasoline. Benzene is also used as a precursor to heavy chemicals (i.e. ethylbenzene, cumene from which acetone and phenols are derived).
Most solvents are neurotoxic and many are carcinogenic.
Optimal range: 0.1 - 1.8 ELISA Index
Optimal range: 0.1 - 2 ELISA Index
Optimal range: 0.4 - 1.5 ELISA Index
Optimal range: 0.2 - 1.2 ELISA Index
Optimal range: 0.6 - 2.4 ELISA Index
Formaldehyde is an organic compound. Formaldehyde-based materials are common to the manufacture of automobiles. Formaldehyde-containing resins – melamine formaldehyde, ureaformaldehyde, phenolformaldehyde, carbamide formaldehyde – are used as a binder in plywood and particleboard production, home furnishings, household cleaners, paints, textiles, landscape and yard products, medicinal and personal care products, pesticides, fire retardation, increased water repellency, stiffness, carpeting made with synthetic fibers, and wrinkle-resistance in fabric finishing; paper products treated with formaldehyde include paper bags, waxed paper, paper towels, and disposable sanitary products; in the health care industry, formaldehyde is used in disinfectants, preservatives, and embalming fluid. Thus, formaldehyde exposure occurs in multiple home and work environments. Formaldehyde has been classified as a known human carcinogen by the International Agency for Research on Cancer.
Optimal range: 0.4 - 2.7 ELISA Index
Formaldehyde is an organic compound. Formaldehyde-based materials are common to the manufacture of automobiles. Formaldehyde-containing resins – melamine formaldehyde, ureaformaldehyde, phenolformaldehyde, carbamide formaldehyde – are used as a binder in plywood and particleboard production, home furnishings, household cleaners, paints, textiles, landscape and yard products, medicinal and personal care products, pesticides, fire retardation, increased water repellency, stiffness, carpeting made with synthetic fibers, and wrinkle-resistance in fabric finishing; paper products treated with formaldehyde include paper bags, waxed paper, paper towels, and disposable sanitary products; in the health care industry, formaldehyde is used in disinfectants, preservatives, and embalming fluid. Thus, formaldehyde exposure occurs in multiple home and work environments. Formaldehyde has been classified as a known human carcinogen by the International Agency for Research on Cancer.
Optimal range: 0.2 - 1.5 ELISA Index
Isocyanates are a family of highly reactive, low molecular weight chemicals.
Exposure to toluene diisocyanate (TDI) and other isocyanates can cause irritation of the mucous membranes, eyes, upper respiratory tract, and skin.
Optimal range: 0.2 - 2.1 ELISA Index
Isocyanates are a family of highly reactive, low molecular weight chemicals.
Exposure to toluene diisocyanate (TDI) and other isocyanates can cause irritation of the mucous membranes, eyes, upper respiratory tract, and skin.
Optimal range: 0.2 - 1.3 ELISA Index
Chemical Found In: Mercury (Hg) is a heavy chemical element that is emitted to the air by human activities, such as manufacturing or burning coal for fuel, and from natural sources, such as volcanoes. It is deposited, via ecosystem transport, into lakes and oceans, where it bioaccumulates in fish. According to the US EPA, "nearly all methylmercury exposures in the U.S. occur through eating fish and shellfish." In addition, mercury is used in thermometers, barometers, float valves, mercury switches, and other devices where exposure can occur with device breakage. It is also found in amalgam material for dental restorations, energyefficient light bulbs, and is used in scientific research applications.
Optimal range: 0.1 - 2.2 ELISA Index
Optimal range: 0.2 - 1.8 ELISA Index
Optimal range: 0 - 2.1 ELISA Index
Optimal range: 0.2 - 1.5 ELISA Index
Parabens are a class of chemical used as preservatives and have bactericidal and fungicidal properties. Parabens are used in many personal care and beauty products, and pharmaceuticals.
Parabens are man-made chemicals often used in small amounts as preservatives in cosmetics, pharmaceuticals, foods, and beverages. Common parabens are methylparaben, ethylparaben, propylparaben, and butylparaben. Often more than one paraben is used in a single product.
Optimal range: 0 - 1.2 ELISA Index
Optimal range: 0.3 - 1.4 ELISA Index
Optimal range: 0 - 2.5 ELISA Index
Optimal range: 0.1 - 1.5 ELISA Index
Optimal range: 0.1 - 2.1 ELISA Index
Tetrachloroethylene (PCE) is a chemical widely used in the dry cleaning of clothes and fabrics and in metal degreasing. It is also a prevalent drinking water contaminant.
Optimal range: 0.3 - 1.5 ELISA Index
Optimal range: 0.4 - 2.6 ELISA Index
ANCA Panel
For diagnosis and monitoring inflammatory activity in primary systemic small vessel vasculitides. The anti-PR3-ANCA EIA is useful for confirming positive ANCA results by IFA, particularly with the cANCA pattern. Presence of anti-PR3 antibodies is highly specific for Wegener granulomatous (WG) disease, for which the sensitivity is reported to be 98%. Levels of anti-PR3 are elevated during active phases of disease and lower during remission. Monitoring anti-PR3 levels, therefore, can aid in disease management.
The anti-MPO-ANCA EIA is useful for confirming positive ANCA results by IFA, particularly with the P-ANCA pattern. Presence of anti-MPO antibodies is highly specific for idiopathic and vasculitis-associated crescentic glomerulonephritis, classic polyarteritis nodosa, Churg-Strauss syndrome, and polyangiitis overlap syndrome without renal involvement. Levels of anti-MPO are elevated during active phases of disease and lower during remission. Therefore, monitoring anti-MPO levels can aid in disease management.
Optimal range: 0 - 0.9 Units
For diagnosis and monitoring inflammatory activity in primary systemic small vessel vasculitides. The anti-MPO-ANCA EIA is useful for confirming positive ANCA results by IFA, particularly with the pANCA pattern.
Optimal range: 0 - 0.9 Units
Antibodies against proteinase 3 (PR3) are referred to as c-ANCA fluorescent subtype, namely cytoplasmic antibodies (granular cytoplasmic fluorescence). PR3 is a neutral serine proteinase 3, also known as Wegener's autoantigen. Antibodies against PR3 are a highly specific marker in diagnosing Wegener's granulomatosis.
Optimal range: 0 - 9 U/mL
For diagnosis and monitoring inflammatory activity in primary systemic small vessel vasculitides. The anti-MPO-ANCA EIA is useful for confirming positive ANCA results by IFA, particularly with the pANCA pattern.
Optimal range: 0 - 3.5 U/mL
For diagnosis and monitoring inflammatory activity in primary systemic small vessel vasculitides. Antineutrophil antibodies are best demonstrated in these diseases by using a combination of IFA and EIAs that detect ANCA specific for PR3-ANCA or MPO-ANCA. Presence of anti-MPO antibodies are highly specific for idiopathic and vasculitis associated crescentic glomerulonephritis, classic polyarteritis nodosa, Churg-Strauss syndrome, and polyangiitis overlap syndrome without renal involvement.
Reference range: Negative, Positive
Reference range: Negative, Positive
Atypical perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) occur in most patients with ulcerative colitis but only in a minority of those with Crohn's disease.
Organic Acids
Organic acids panels are used to test for the organic acids present in urine, which are byproducts of daily cellular metabolism. These organic acid markers offer valuable insights into identifying the underlying causes of chronic symptoms. By following known metabolic pathways and enzyme-cofactor requirements, healthcare providers can use these markers to detect imbalances, toxicity, and inflammation in chronically or acutely ill patients with complex illnesses. The comprehensive information provided by organic acids testing, in conjunction with other diagnostic tests, allows practitioners to form a complete clinical picture of the root causes of a patient's condition. This, in turn, guides the development of personalized and effective interventions.
Optimal range: 0.06 - 1.58 mmol/mol
What is 2-Hydroxybutyric acid?
2-Hydroxybutyric acid (aka α-Hydroxybutyrate) is a by-product of glutathione production. Levels of 2-Hydroxybutyric acid in the urine may reflect levels of glutathione production.
What is Glutathione?
Glutathione is an important antioxidant that can prevent damage to cellular components caused by reactive oxygen species such as free radicals, peroxides, lipid peroxides, and heavy metals.
Glutathione is constantly being used up in the removal of toxic molecules and prevention of oxidative damage.
2-Hydroxybutyric acid is a by-product from the process in which the body forms more glutathione. When that process is running at high rates, α-hydroxybutyrate excretion is increased.
Optimal range: 0 - 1.42 mmol/mol
2-Hydroxyhippuric acid is a conjugate of hydroxybenzoic acid (salicylic acid) and glycine.
Optimal range: 0 - 0.88 mmol/mol
2-Hydroxyisocaproic acid (aka Leucic acid / α-hydroxyisocaproic acid / HICA) is a metabolite of the branched-chain amino acid leucine.
Optimal range: 0 - 0.4 mmol/mol
2-Hydroxyisovaleric acid (aka 2-Hydroxy-3-methylbutyric acid) is a branched-chain amino acid metabolite.
2-hydroxy-3-methylbutyric acid is a valine derivative that is valine in which the amino group has been replaced by a ‘hydroxy’ group.
A moderate increase of branched-chain amino acid metabolites in urine may result from lactic acidosis, episodic ketosis, or de ficiencies of the vitamins, thiamine or lipoic acid. A signi ficant increase of branched-chain amino acid metabolites is associated with the genetic disorders, maple syrup urine disease (MSUD) and pyruvate dehydrogenase de ficiency. Patients with slight to moderate elevations may use dietary supplements containing thiamine to improve clinical symptoms.
Optimal range: 0.05 - 0.69 mmol/mol
The metabolite of phenylalanine via phenyl pyruvate.
Optimal range: 0 - 0.18 mmol/mol
2-Oxo-4-methylthiobutanoic acid, also known as 4-(methylsulfanyl)-2-oxobutanoate or 2-keto-4-methylthiobutyrate, belongs to the class of organic compounds known as thia fatty acids. Thia substituted fatty acids are saturated fatty acids which are modified by insertion of a sulfur atom at specific positions in the carbon backbone.
Elevated in an inborn error of methionine metabolism. Con firmation of the genetic disorder requires testing of plasma amino acids.
Optimal range: 0 - 34.77 mmol/mol
2-Oxoglutaric acid is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 0.41 mmol/mol
2-Oxoisocaproic acid (also known as Ketoleucine) is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
2-Oxoisocaproic acid is both a neurotoxin and a metabotoxin.
A moderate increase of branched-chain amino acid metabolites in urine may result from lactic acidosis, episodic ketosis, or de ficiencies of the vitamins, thiamine or lipoic acid. A signi ficant increase of branched-chain amino acid metabolites is associated with the genetic disorders, maple syrup urine disease (MSUD) and pyruvate dehydrogenase de ficiency. Patients with slight to moderate elevations may use dietary supplements containing thiamine to improve clinical symptoms.
Optimal range: 0 - 2 mmol/mol
Optimal range: 0.14 - 38.95 mmol/mol
- A precursor in the production of cholesterol in both humans and yeast.
- Elevated levels may also indicate decreased CoQ10 synthesis.
- Moderate increases are probably due to yeast overgrowth of the GI tract and might also implicate yeast overgrowth with elevated serum cholesterol.
- Very elevated levels may be due to HMG aciduria (=3-hydroxy-3-metylglutaric aciduria)
Optimal range: 0 - 4.9 mmol/mol
3-Hydroxyglutaric is a marker for glutaryl CoA dehydrogenase deficiency.
Optimal range: 0 - 12.67 mmol/mol
Optimal range: 0 - 2.6 mmol/mol
3-Methyl-2-oxovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Moderate increase may result from lactic acidosis, episodic ketosis, or thiamine/lipoic acid deficiency. Significant elevations are associated with genetic issues, MSUD, and pyruvate dehydrogenase deficiency.
- Slight elevations may be due to deficiencies of the vitamins thiamine or lipoic acid.
- Elevated values are also associated with the genetic diseases maple syrup urine disease or pyruvate dehydrogenase deficiency.
Optimal range: 0 - 6.2 mmol/mol
The marker, 3-methylglutaconic acid in high values indicates a reduced ability to metabolize the amino acid, leucine. This abnormality is found in the genetic disease, methylglutaconic aciduria and in mitochondrial disorders.
Optimal range: 0 - 0.75 mmol/mol
3-methylglutaric acid is an organic acid classically associated with two distinct leucine pathway enzyme deficiencies.
Optimal range: 0 - 0.31 mmol/mol
3-Oxoglutaric acid is a simple carboxylic acid and a key intermediate in the Krebs cycle, which has also been identified as a microbial metabolite. Its presence is often linked to the overgrowth of harmful or dysbiotic gut flora, such as Candida albicans. Research has shown that children with autism tend to have lower levels of 3-oxoglutaric acid, potentially due to increased uptake of this compound across the blood-brain barrier. Elevated levels of 3-oxoglutaric acid may suggest a yeast overgrowth in the gastrointestinal (GI) tract. It may be beneficial to consider further testing, such as a Gut Zoomer panel and fungal antibodies test, to assess the extent of dysbiosis and identify the root cause. A gut restorative protocol, which could include high-potency multi-strain probiotics, prescription or natural antifungals, and other targeted gut support, may be recommended to help restore microbial balance and improve overall gut health.
Optimal range: 0 - 74.88 mmol/mol
4-Cresol has been used as a specific marker for Clostridium difficile.
Optimal range: 0 - 1.3 mmol/mol
Optimal range: 0 - 4.57 mmol/mol
A moderate urinary increase in 4-hydroxybutyric acid may be due to intake of dietary supplements containing 4-hydroxybutyric acid, also known as gamma-hydroxybutyric acid. Very high levels may indicate the genetic disorder 3-methylglutaconic aciduria involving succinic semialdehyde dehydrogenase deficiency.
Optimal range: 0.74 - 16.98 mmol/mol
Optimal range: 0 - 20.1 mmol/mol
Optimal range: 0 - 0.84 mmol/mol
Optimal range: 1711 - 9788 mcg/g
Optimal range: 0 - 13.4 mmol/mol
5-Hydroxymethyl-furoic Acid is a naturally occurring human urinary metabolite, a nematicide, a bacterial xenobiotic metabolite and a fungal metabolite. It is a metabolite produced by Aspergillus and possibly other fungal species in the GI tract. Consider a Gut zoomer or fungal antibodies test in order to determine the root cause. It was first identified in the urine of a leukemic patient who was excreting an abnormal amount of its glycine derivative. Multi-strain probiotics can be supplemented to improve the condition.
Optimal range: 0 - 9.6 mmol/mol
Acetoacetic acid (=acetoacetate) is a ketone body and a weak Beta-keto acid produced from acetyl-CoA in the mitochondrial matrix of hepatocytes.
Optimal range: 6.1 - 27.9 mmol/mol
Elevated in mitochrondrial disorders. Aconitase metabolizes citric and aconitic acids, and is dependent on glutathione.
Optimal range: 0.04 - 3.9 mmol/mol
Adipic Acid, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Optimal range: 0 - 30 mmol/mol
Breakdown product of hyaluronic acid; also found in certain foods.
Optimal range: 12.2 - 179.25 mmol/mol
Ascorbic Acid is a natural water-soluble vitamin (Vitamin C). Ascorbic acid is a potent reducing and antioxidant agent that functions in fighting bacterial infections, in detoxifying reactions, and in the formation of collagen in fibrous tissue, teeth, bones, connective tissue, skin, and capillaries.
Optimal range: 0 - 30 mmol/mol
Carboxycitric acid, an analogue of the Krebs/citric acid cycle, serves as a marker for intestinal microbial overgrowth, particularly involving yeast and fungi. As a byproduct of the Krebs cycle, elevated levels may also point to energy metabolism disorders. Research has shown that children with autism tend to have lower levels of 3-oxoglutaric acid, which is thought to result from increased uptake of these compounds across the blood-brain barrier. Urinary levels of carboxycitric acid have been observed to decrease following nystatin therapy. To identify the root cause, consider testing with a Gut Zoomer, fungal antibodies, or a mycotoxin panel. Implementing multi-strain probiotics and comprehensive gastrointestinal support can help improve this condition.
Optimal range: 0 - 0 mmol/mol
Optimal range: 0 - 498.8 mmol/mol
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 0 mg/ml
Optimal range: 0 - 0.44 mmol/mol
3,4-Dihydroxyphenylpropionic acid (DHPPA) is a marker for beneficial and commensal bacteria. It is produced when specific bacteria metabolize chlorogenic acid, a polyphenol found in various foods, including apples, pears, peas, coffee, sunflower seeds, carrots, blueberries, cherries, potatoes, tomatoes, eggplants, sweet potatoes, peaches, wine polyphenols, and catechins. The primary bacteria responsible for this process include Lactobacilli, Bifidobacteria, and E. coli. DHPPA acts as an antioxidant, helping to lower cholesterol, reduce pro-inflammatory cytokines, and protect against harmful bacteria. Elevated DHPPA levels may reflect a high dietary intake of polyphenols or an overgrowth of bacteria leading to increased polyphenol conversion.
Optimal range: 577.3 - 1655.5 mcg/g
Optimal range: 0.47 - 2.74 mmol/mol
Ethylmalonate, together with Adipate and Suberate, gives information about your ability to process fatty acids.
Optimal range: 0 - 0.91 mmol/mol
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.
Optimal range: 0 - 16.7 mmol/mol
Optimal range: 0 - 1.82 mmol/mol
Furancarbonylglycine is a metabolite produced by Aspergillus and possibly other fungal species in the GI tract.
Optimal range: 250.2 - 599.2 mcg/g
γ-amino butyric acid (GABA) is the major inhibitory neurotransmitter of the brain. Its major precursor is L-glutamate, which is converted to GABA via the enzyme glutamate decarboxylase (GAD).
GABA has also been detected in other peripheral tissues including intestines, stomach, Fallopian tubes, uterus, ovaries, testes, kidneys, urinary bladder, the lungs and liver, albeit at much lower levels than in neurons or insulin- producing β-cells.
GABA's principial role:
GABA's principal role is reducing neuronal excitability throughout the nervous system. In humans, GABA is also directly responsible for the regulation of muscle tone. In addition, GABA controls the mood, sleep, blood pressure while preventing anxiety.
GABA is sold as a dietary supplement. GABA is found ubiquitously among plants. GABA is prevalent in foods such as Adzuki bean, barley, broccoli, buckwheat, chestnut, common bean, kale, lupin, maypop, mouse-ear hawkweed, oat, pea, pokeroot, potato, rice, shiitake, soya bean, spinach, St John’s wort, sweet potato, tea, tomato, valerian, wheat, wild celery.
Optimal range: 0.03 - 0.38 mmol/mol
Glutaric Acid is formed from the essential amino acids lysine and tryptophan through the intermediaries of alpha ketoadipic acid and glutaryl-CoA. Glutaryl-CoA is further metabolized to glutaconyl- and crotonyl-CoA by an enzyme called glutaryl-CoA dehydrogenase. This enzyme requires riboflavin (vitamin B2) as a cofactor.
Optimal range: 0.74 - 7.4 mmol/mol
Glyceric acid is an organic acid that stems from the catabolism of the amino acid serine. Severe elevations in glyceric acid are an indication of a rare inborn error of metabolism known as glyceric aciduria. One form of glyceric aciduria is the result of a defect in the enzyme glycerate kinase which removes glyceric acid from the system.
Optimal range: 0 - 0 mmol/mol
Optimal range: 0 - 607 mmol/mol
Benzoic acid and hippuric acid are formed from the bacterial metabolism of polyphenols. Urinary benzoic acid may also come from ingestion of food preservatives such as sodium benzoate. Hippuric acid is made when sodium benzoate is conjugated with glycine.
Optimal range: 0 - 0.35 mmol/mol
Optimal range: 3535 - 8455 mcg/g
Homovanillic acid (HVA) is a major catecholamine metabolite that is produced by a consecutive action of monoamine oxidase and catechol-Omethyltransferase on dopamine. HVA is associated with dopamine levels in the brain. Dopamine (3,4-dihydroxyphenethylamine) is a major excitatory neurotransmitter that functions both as a hormone and a neurotransmitter and plays several important roles in the brain and body. It is synthesized in the brain and kidneys. In the brain, dopamine functions as a neurotransmitter that acts on several distinct dopamine pathways, one of which plays a major role in the motivational component of reward-motivated behavior.
Optimal range: 0 - 227 mmol/mol
HPHPA is a clostridia metabolite and dysbiosis marker and stands for 3-(3-hydroxyphenyl)-3-hydroxypropionic acid.
HPHPA is an indicator for dysbiosis due to overgrowth of Clostridia bacteria (e.g., C. sporogenes, C. caloritolerans, and C. botulinum) in the GI tract. This metabolite was found in higher concentrations in urine samples of children with autism compared to age and sex appropriate controls. This metabolite inhibits the enzyme dopamine-beta-hydroxylase, leading to a derangement of neurotransmitter balance. Consider testing the complete neurotransmitter cascade to observe all marker levels.
Optimal range: 2.6 - 8.3 Ratio
HVA and DOPAC are the major metabolites of dopamine. HVA stands for Homovanillic acid and DOPAC stands for Dihydroxyphenylacetic.
Optimal range: 2.6 - 8.3 Ratio
Optimal range: 125.6 - 991.3 mcg/g
Optimal range: 0 - 50.4 mmol/mol
Lactic acid is a microbial metabolite, urinary lactic acid is produced by Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Enterobacter, Acinetobacter, Proteus mirabilis, Citrobacter frundii, Enterococcus faecalis, Streptococcus group B, Staphylococcus saprophyticus, Bacillus, Corynebacterium, Rhizopus and Saccharomyces cerevisiae. Lactic acid is a good marker distinguishing lower urinary tract infection (cystitis) from upper urinary tract urinary tract infections (pyelonephritis). Excess of exercise, bacterial overgrowth in the GI tract, B-vitamin deficiency have been shown to be contributing factors. The possibility of an inborn error of metabolism increases when the lactic acid value exceeds 300 mmol/mol creatinine. There are many inborn errors of metabolism that are present with elevated lactic acid, including disorders of sugar metabolism, pyruvate dehydrogenase deficiency, and mitochondrial disorders.
Optimal range: 0.08 - 1.74 mmol/mol
Fumaric acid uses the fumarase enzyme to become malic acid. Malate dehydrogenase catalyzes the conversion of malic acid into oxaloacetate. Two forms of this enzyme exist in eukaryotes. One operates within the mitochondria to contribute to the Citric Acid Cycle; the other is in the cytosol where it participates in the malate/ aspartate shuttle.
Riboflavin is an important cofactor for this enzyme and overall mitochondrial energy production and cellular function. Riboflavin (also known as vitamin B2) is one of the B vitamins, which are all water soluble.
At the end of each Citric Acid Cycle, the four-carbon oxaloacetate has been regenerated, and the cycle continues.
Optimal range: 0 - 9.8 mmol/mol
Optimal range: 0 - 0.24 mmol/mol
Optimal range: 0.15 - 2.96 mmol/mol
Methylcitric is an organic acids that reflects decreased activity of the biotin-dependent enzyme propionyl-CoA carboxylase.
Optimal range: 0 - 2.21 mmol/mol
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production.
Optimal range: 0.13 - 2.14 mmol/mol
Methylsuccinic acid is a normal metabolite found in human fluids and is an intermediate metabolite in the breakdown of fatty acids.
Optimal range: 0 - 3.9 mmol/mol
Elevated N-acetylaspartic acid is due to the genetic disorder Carnavan’s disease, a potentially fatal disease causing spongy degeneration of the brain.
What is Carnavan’s disease?
Canavan disease is a rare inherited disorder that damages the ability of nerve cells (neurons) in the brain to send and receive messages. This disease is one of a group of genetic disorders called leukodystrophies. Leukodystrophies disrupt the growth or maintenance of the myelin sheath, which is the covering that protects nerves and promotes the efficient transmission of nerve impulses.
Optimal range: 0 - 0.26 mmol/mol
N-Acetylcysteine (NAC) is a powerful antioxidant that increases the glutathione reserves in the body.
Together with glutathione, N-Acetylcysteine (NAC) directly binds to toxic metabolites. Although N-Acetylcysteine (NAC) may be beneficial under certain conditions, excessive use of the supplement could be harmful.
Optimal range: 0 - 0 mmol/mol
Optimal range: 0 - 0 mmol/mol
Optimal range: 0 - 9.91 mmol/mol
Pantothenic acid is an essential B vitamin (=Vitamin B5) that is converted to coenzyme A (unrelated to vitamin A). Coenzyme A is needed for the synthesis of fatty acids, cholesterol, and acetyl choline and is also needed for the Krebs cycle and fatty acid catabolism.
Optimal range: 0 - 0.21 mmol/mol
Phenyllactic acid is a metabolite of phenylalanine.
Optimal range: 0.23 - 2.2 mmol/mol
Optimal range: 1000 - 5000 mmol/mol
Phosphoric acid is a marker of vitamin D and calcium. This marker indicates whether vitamin D receptors are activated. If phosphoric acid is low, then the person is likely vitamin D and/or calcium deficient. Low levels can be due to low phosphate consumption, low digestive juice production, or deficiencies in vitamin D, vitamin K2, or magnesium.
Optimal range: 0 - 34 mmol/mol
A major metabolite of vitamin B6. High pyridoxic acid indicates high recent intake of vitamin B6. Because some individuals may require very high doses of vitamin B6, high values do not necessarily indicate the need to reduce vitamin B6 intake. Low values are associated with low B6 status, high oxalates, and/or low neurotransmitters.
Optimal range: 10.14 - 32.45 mmol/mol
Pyroglutamic acid (5-oxoproline) is produced and utilized in the gamma-glutamyl cycle. This cycle is needed to assist in the production and recycling of glutathione (GSH), a powerful antioxidant.
Glutathione is a tripeptide, consisting of glutamate, cysteine, and glycine. Using the gamma-glutamyl cycle, GSH is divided into cysteinyl glycine and a gammaglutamyl molecule which attaches to another amino acid for transport across a membrane or into a cell. Gammaglutamyl transferase then splits off that attached amino acid, and the glutamate becomes pyroglutamic acid (5-oxoproline).
Cysteinyl glycine is also broken down and transported into the cell as cysteine and glycine. The entire GSH molecule needs to be reformed intracellularly from pyroglutamic acid by recombining cysteine, glycine, and glutamic acid using GSH synthetase.
This enzymatic reformation requires cofactors such as ATP and magnesium.
Optimal range: 0 - 9.4 mmol/mol
Pyruvic acid is an intermediate compound in the metabolism of carbohydrates, proteins, and fats. Pyruvic acid is found to be associated with Fumarase deficiency, which is an inborn error of metabolism. It is also a metabolite of Corynebacterium. Elevated levels of pyruvic acid are associated with vigorous exercise, bacterial overgrowth of the GI tract, shock, poor perfusion, B-vitamin deficiency, mitochondrial dysfunction or damage, and anemia, among others. High pyruvic acid indicates the possibility of an inborn error of metabolism when the value exceeds 100 mmol/mol creatinine.
Optimal range: 610.3 - 2432.9 mcg/g
Optimal range: 0.32 - 1.1 Ratio
A high ratio of quinolinic acid to the tryptophan metabolite, 5-hydroxyindoleacetic acid, indicates excessive inflammation due to recurrent infections, excessive tryptophan intake, immune overstimulation, excessive adrenal production of cortisol, or excessive exposure to phthalates.
Optimal range: 0 - 0.23 mmol/mol
Increased urinary products of the omega fatty acid metabolism pathway may be due to carnitine deficiency, fasting, or increased intake of triglycerides from coconut oil, or some infant formulas.
Optimal range: 0.16 - 2.18 mmol/mol
- Suberic acid is present in the urine of people with fatty acid oxidation disorders.
- A metabolic breakdown product derived from oleic acid.
- Elevated levels of this unsaturated dicarboxylic acid are found in individuals with medium-chain acyl-CoA dehydrogenase deficiency (MCAD).
- Elevated in Schizophrenics
- People with metabolic syndrome or diabetes had significantly elevated adipic acid, suberic acid, lactic acid, and fumaric acid.
- Ketosis is sometimes accompanied by excessive excretion of adipic and suberic acid.
Optimal range: 0 - 9.4 mmol/mol
Succinyl CoA becomes succinic acid using succinyl CoA synthetase. This reaction produces NADH which directly provides electrons for the electron transport chain or respiratory chain. Succinic acid requires the enzyme succinate dehydrogenase to become fumarate. This enzyme is ironbased and requires vitamin B2 to support flavin adenine dinucleotide (FAD) as a redox coenzyme. Succinate dehydrogenase plays a critical role in mitochondrial metabolism. Impairment of this enzyme’s activity has been linked to a variety of diseases such as cancer and neurodegenerative diseases.
Optimal range: 0 - 4.47 mmol/mol
Optimal range: 0 - 0.63 mmol/mol
A pyrimidine (DNA building block) that is elevated in the genetic disease dihydropyrimidine dehydrogenase deficiency. In this genetic disease, the pyrimidine uracil is also elevated.
- Thymine is one of the five bases used to build nucleic acids.
- It is also known as 5-methyluracil or by the abbreviations T or Thy.
- Thymine is found in DNA, where it pairs with adenine via two hydrogen bonds. In RNA, thymine is replaced by uracil.
Optimal range: 0 - 0.5 mmol/mol
Optimal range: 0 - 9.4 mmol/mol
The pyrimidine metabolites are markers of folate metabolism. The two markers are uracil and thymine. Folate acts as a methyl donor in converting uracil to thymine.
Elevated values of uracil suggest folic acid deficiency. Folate is needed to convert uracil to thymine by methylation.
Cytokine Panel 13, Serum
Primarily for research and to support attempts to understand the pathogenesis of immune, infectious, allergic, or inflammatory disorders.
Optimal range: 0 - 4.2 pg/mL
IFN-γ is a helper T-cell 1 (Th1)-derived cytokine and plays a critical role for both innate and adaptive immunity against viral and intracellular bacterial infections and tumor control.
Optimal range: 0 - 6.5 pg/mL
Interleukin-1-beta, one form of interleukin-1, is made mainly by one type of white blood cell, the macrophage, and helps another type of white blood cell, the lymphocyte, fight infections. It also helps leukocytes pass through blood vessel walls to sites of infection and causes fever by affecting areas of the brain that control body temperature. The other form of interleukin-1, interleukin-1-alpha, acts the same as interleukin-1-beta.
Optimal range: 0 - 2.8 pg/mL
Interleukin-10 is an important suppressor of immune responses.
In vitro studies indicate that Interleukin-10 directly inhibits IL-2 and IL-5 production by TH1 and TH2 cells. Interleukin-10 acts as an immunosuppressor of antigen presenting cells (APC). Interleukin-10 suppresses epidermal Langerhans cell APC function, monocyte chemokines expression, and the bactericidal responses of macrophages. A number of studies suggest that IL-10 plays a role in controlling inflammation, autoimmunity, and angiogenesis.
Optimal range: 0 - 1.9 pg/mL
This family of cytokines plays crucial roles in shaping immune responses during antigen presentation and influence cell-fate decisions of differentiating naïve T cells. They also play essential roles in regulating functions of a variety of effector cells, making IL-12 family cytokines important therapeutic targets or agents in a number of inflammatory diseases, such as the CNS autoimmune diseases, uveitis and multiple sclerosis.
One of a group of related proteins made by leukocytes (white blood cells) and other cells in the body. Interleukin-12 is made mainly by B lymphocytes and macrophages. It causes other immune cells to make cytokines and increases the growth of T lymphocytes. It may also block the growth of new blood vessels. Interleukin-12 made in the laboratory is used as a biological response modifier to boost the immune system in cancer therapy. Interleukin-12 is a type of cytokine. Also called IL-12.
Optimal range: 0 - 2.3 pg/mL
Interleukin 13 is a mediator of allergic inflammation and different diseases including asthma.
IL-13 is implicated in numerous processes, including a) recruitment of eosinophils and M2 macrophages to the lung, b) induction of mucus secretion into the airways and goblet cell metaplasia, c) proliferation of smooth muscle cells, and d) fibrosis via fibroblast activation and subsequent collagen deposition.
Optimal range: 0 - 1.4 pg/mL
IL-17A, commonly referred to as IL-17, is involved in normal physiological processes and is also a leading pathogenic cytokine in a wide range of pathologic conditions, including cancer and autoimmune disorders, due to its strong proinflammatory effects. Besides IL-17A, there are five other members structurally related to IL-17A in the IL-17 family, which are IL-17B, IL-17C, IL-17D, IL-17E (IL-25), and IL-17F.
Optimal range: 175.3 - 858.2 pg/mL
Soluble Interleukin 2 receptor concentration reflects the immune activation in autoimmune diseases, neoplasms (notably lymphoproliferations), and infections.
Optimal range: 0 - 2.1 pg/mL
Interleukin 2 is a pleiotropic cytokine produced primarily by mitogen- or antigen- activated T lymphocytes.
Interleukin 2 plays a role in promoting the clonal expansion of antigen-specific cytotoxic and suppressor T cells. In vitro studies suggest that Interleukin 2 may also be produced by dendritic cells and certain lymphoma cell lines.
In addition, Interleukin 2 has been shown to mediate multiple immune responses on a variety of cell types.
Optimal range: 0 - 2.2 pg/mL
Interleukin 4 is a pleiotropic cytokine produced by activated T lymphocytes, CD3+ cells, NK-T cells, mast cells, eosinophils, and basophils.
Interleukin 4 has multiple immune response modulation functions on a variety of cell types. It is an important regulator of isotype switching, inducing IgE production in B lymphocytes. It is an important modulator of the differentiation of precursor T helper cells to the TH2 subset that mediates humoral immunity and modulates antibody production. In addition, Interleukin 4 has also been shown to have antitumor activity both in vivo and in vitro.
Optimal range: 0 - 2.1 pg/mL
Interleukin 5 plays a critical role in the host immune response to helminthic infections and has been implicated in the pathology of certain allergic diseases, asthma, and vasculitis.
Optimal range: 0 - 2 pg/mL
Interleukin-6 is involved in inflammation and infection responses and also in the regulation of metabolic, regenerative, and neural processes.
Optimal range: 0 - 3 pg/mL
Interleukin 8 (IL-8) is a promising marker for many clinical conditions and currently being applied by various subspecialties of medicine either for the purpose of rapid diagnosis or as a predictor of prognosis. Nevertheless, IL-8 level increased as a result of many inflammatory conditions, so careful interpretation of IL-8 level is required to make correlation with desired clinical condition's diagnosis or prognosis.
Optimal range: 532 - 1891 pg/mL
Interleukin-2 Receptor Alpha Chain (IL-2Ra), also known as CD25, is a protein expressed on the surface of immune cells, such as activated T-cells, B-cells, and natural killer (NK) cells. When it is shed from the surface of these cells, it circulates in the blood as soluble IL-2 receptor alpha (sIL-2Ra). Measuring sIL-2Ra levels provides insights into immune system activity and inflammation.
sIL-2Ra plays a critical role in the regulation of the immune response. It binds to interleukin-2 (IL-2), a key cytokine for T-cell growth and immune function. Elevated levels of sIL-2Ra are associated with immune system activation and are often seen in various inflammatory and autoimmune conditions, cancers, and infectious diseases.
Optimal range: 0 - 7.2 pg/mL
Results are used to understand the pathophysiology of immune, infectious, or inflammatory disorders, or may be used for research purposes.
Tumor necrosis factor-α (cachectin) and tumor necrosis factor-β (lymphotoxin) are two closely related proteins that share sequence homology of 34% in their amino acid sequence. Both mediators act on their target cells via the same receptors and, therefore, show similar, but not identical, biological effects. Under denaturing conditions TNF-α is a 17-kilodalton, nonglycosylated protein. The biologically active form of TNF-α is a trimer. Besides this soluble form of TNF-α, a 28-kilodalton membrane-bound form occurs on cell surfaces of TNF-producing cells, which may serve as a pool for soluble TNF-α and can be proteolytically cleaved from the cell surface.
Organic Acids Metabolomic Mapping
The Organic Acids Metabolomic Profile is a nutritional test providing insights into organic acids and a view into the body’s cellular metabolic processes. Additionally, children’s reference ranges are designed to provide more accurate paediatric nutritional evaluations. Identifying metabolic blocks that can be treated nutritionally allows individual tailoring of interventions that maximise patient responses and lead to improved patient outcomes.
The Organic Acids Metabolomic profile provides vital patient information from a single urine specimen. This organic acids nutritional test is valuable for determining:
- Functional vitamin and mineral status
- Amino acid insufficiencies like carnitine and NAC
- Oxidative damage and antioxidant need
- Phase I & Phase II detoxification capacity
- Functional B-complex vitamin need
- Neurotransmitter metabolites
- Mitochondrial energy production
- Methylation sufficiency
- Lipoic acid and CoQ10 status
- Markers for bacterial and yeast overgrowth
- Oxalate markers
- Nutritional markers
Optimal range: 10 - 200 mmol/molCr
Ascorbic Acid is a natural water-soluble vitamin (Vitamin C). Ascorbic acid is a potent reducing and antioxidant agent that functions in fighting bacterial infections, in detoxifying reactions, and in the formation of collagen in fibrous tissue, teeth, bones, connective tissue, skin, and capillaries.
Optimal range: 166 - 507 nmol/L
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 5 - 13 mmol/L
Creatinine values are measured to correct results for urine dilution.
Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine.
The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.
Optimal range: 35 - 143 ug/mgCR
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 1.5 ug/mgCR
Kynurenic Acid is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0 - 1.47 ug/mgCR
p-hydroxyphenyllactate is a marker of cell turnover. It is also a metabolite in tyrosine degradation and may be useful for studying disorders of tyrosine metabolism, including inborn errors of metabolism, and liver disease. High levels of p-hydroxyphenyllactate may respond to high intakes of vitamin C, which aids in restoration of normal metabolism and cell control.
Optimal range: 2.8 - 13.5 ug/mgCR
Picolinate is a neurotransmitter metabolism marker and is produced under inflammatory conditions.
Optimal range: 0 - 7 ug/mgCR
Breakdown product of hyaluronic acid; also found in some foods.
Tickborne
Tickborne diseases (TBDs) are a growing concern across the United States, with various tick species transmitting harmful microorganisms to humans and animals. These diseases can be difficult to diagnose because their symptoms often overlap with other conditions, making early detection crucial for effective treatment and prevention.
Ticks, which carry a range of pathogens, need anywhere from 24 to 72 hours to transmit diseases to a host. If detected in time, ticks can often be removed before they pass on harmful microorganisms, helping reduce the risk of infection. However, many tickborne diseases remain undiagnosed for months due to nonspecific symptoms, leading to increased suffering and disease progression.
The symptoms of tickborne diseases can vary, but common signs include:
Fever and/or chills
Headache
Bell’s palsy
Neck stiffness
Fatigue
Muscle or joint aches/pains
Gastrointestinal symptoms (nausea, vomiting, diarrhea)
Rash
Loss of appetite and weight loss
Cognitive or psychological changes
Anemia
Enlarged, tender lymph nodes
Painful abdomen
Dizziness or shortness of breath
Numbness or weakness in limbs
Tickborne diseases have more than doubled in the past 13 years and now account for 77% of all vector-borne disease reports in the United States. Among these, Lyme disease remains the most common, accounting for 82% of all tickborne disease cases. Other prevalent tickborne diseases include:
Anaplasmosis
Babesiosis
Bartonella infections
Ehrlichiosis
Rickettsiosis
Rocky Mountain spotted fever (RMSF)
Because the symptoms of tickborne diseases can mimic those of other illnesses, they are often overlooked or misdiagnosed, especially in their early stages. This delayed diagnosis can lead to worsening symptoms and complications. Prompt recognition and treatment are essential for preventing severe outcomes, particularly for vulnerable populations such as the elderly and immunocompromised individuals.
The CDC/IDSA Lyme disease criteria require the following to report Lyme IgM as positive:
One positive test for VlsE1, C6 peptide, or Whole Cell Sonicate (WCS), AND
At least two of the following three antigens must be positive:
23-25 kDa
39 kDa
41 kDa
In the Alternative Lyme Criteria, IgM is reported positive if VlsE1, C6 peptide, or WCS is borderline or positive, and at least two of the following antigens are borderline or positive:
23-25 kDa
31 kDa
34 kDa
39 kDa
41 kDa
83-93 kDa
For Lyme IgG, the CDC criteria require:
A positive result for VlsE1, C6 peptide, or WCS, AND
Positive results for any five of the following ten antigens:
18 kDa
23-25 kDa
28 kDa
30 kDa
39 kDa
41 kDa
45 kDa
58 kDa
66 kDa
83-93 kDa
According to Alternative Lyme Criteria, IgG is reported positive if VlsE1, C6 peptide, or WCS is borderline or positive, and at least two of the following antigens are borderline or positive:
18 kDa
23-25 kDa
28 kDa
30 kDa
39 kDa
41 kDa
45 kDa
58 kDa
66 kDa
83-93 kDa
Tickborne diseases, including Lyme disease, present a significant health risk across the United States. Early and accurate diagnosis is crucial for managing these conditions effectively, as symptoms often overlap with other illnesses. By understanding the signs of tickborne diseases and utilizing diagnostic tests, individuals and healthcare providers can take the necessary steps to ensure prompt treatment, particularly for those who may be more vulnerable. Regular tick prevention measures and swift action upon finding a tick can also help reduce the risks associated with these potentially debilitating diseases.
Reference range: Negative, Positive
Reference range: Negative, Positive
Optimal range: 0 - 10 Units
Anaplasma phagocytophilum causes human granulocytic anaplasmosis (HGA).
Human granulocytic anaplasmosis (HGA) is a tick-borne infection caused by the bacterium Anaplasma phagocytophilum, a small bacterium infecting typically neutrophils transmitted by Ixodes ticks. Granulocytic anaplasmosis is the most widespread tick-borne infection in animals in Europe and both its geographic distribution and that of its tick vector, Ixodes ricinus complex (mainly Ixodes ricinus and Ixodes persulcatus in Europe) are increasing in latitude and altitude. Individuals are at greatest risk when ticks are active during the spring through to autumn period.
Despite the increasing prevalence of Anaplasma phagocytophilum in animal hosts, human cases are not frequent, though probably they are underestimated due to the nonspecific clinical signs (flu-like symptoms). The USA strains have shown higher morbidity and mortality (< 1%) and until now no fatal case has been reported in humans in Europe.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Babesia microti is a microscopic parasite that infects red blood cells and causes babesiosis, a malaria-like illness transmitted primarily by Ixodes scapularis ticks (also known as black-legged or deer ticks). This is the same tick species that spreads Lyme disease and anaplasmosis.
The p32 – IgM test detects early immune response to a specific protein (p32) found on Babesia microti. IgM antibodies are typically the first antibodies your immune system produces after exposure to an infection, usually appearing within the first 1 to 2 weeks. Therefore, a positive or elevated result suggests a recent or active Babesia infection.
A medium IgM result for Babesia microti p32 indicates a moderate level of early antibodies, which may reflect:
An early infection in which the immune response is still developing
A resolving infection, with IgM levels beginning to decline
A nonspecific or borderline immune signal that may require further confirmation
Medium results are not conclusive on their own and should be interpreted alongside symptoms, exposure history, and other lab markers such as IgG antibodies or PCR testing (to detect Babesia DNA).
Optimal range: 0 - 10 Units
Babesia microti is a microscopic parasite that infects red blood cells and causes babesiosis, a tick-borne illness often compared to malaria due to its similar symptoms. It is primarily transmitted by the Ixodes scapularis tick (also known as the deer tick), which also carries Lyme disease and other co-infections.
The p41 – IgM test detects early immune activity against a specific protein (p41) expressed by Babesia microti. IgM antibodies are the first type of antibodies produced by the immune system following infection. The presence of IgM typically indicates a recent or active infection, particularly during the early stages when symptoms first appear.
A medium IgM result for Babesia microti p41 reflects a moderate level of early antibodies, which may indicate:
An early or developing immune response
A resolving infection, where IgM is declining as IgG antibodies begin to rise
A borderline or nonspecific result, which may need confirmation with additional tests
Medium results are not definitive on their own and should be interpreted alongside your symptoms, exposure history (e.g., recent tick bites), and other test results, such as Babesia microti IgG or PCR testing to detect the parasite’s DNA.
Optimal range: 0 - 10 Units
Babesia microti, the primary agent of human babesiosis in the United States.
The B. microti life cycle involves two hosts, which includes a rodent, primarily the white-footed mouse, Peromyscus leucopus, and a tick in the genus, Ixodes, the same tick species that vectors Lyme disease. Cases of babesiosis caused by B. microti occur in southern New England and the northern Midwest. Early clinical manifestations are intermittent fevers accompanied by fatigue and malaise, headache, chills, and myalgias. Nausea, vomiting, reduced appetite, and depression can also occur. Coinfection with Lyme disease or anaplasmosis may complicate the clinical presentation and predispose the patient to more severe disease.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Bartonella henselae, a species within the Bartonella genus, is a proteobacterium responsible for bartonellosis, which includes conditions such as Cat Scratch Disease (CSD) and Bacillary Angiomatosis (BA). Human infection is most commonly transmitted through scratches or bites from companion animals, particularly cats and dogs. Symptoms of B. henselae infection typically appear within ten days of exposure, beginning with a papule (a small raised bump) at the site of entry. This is usually followed by swollen lymph nodes, most often in the armpit (axillary) region. About half of infected individuals also experience general symptoms such as body aches, nausea, abdominal pain, and overall malaise.
Optimal range: 0 - 10 Units
Bartonella henselae is a bacterial species known for causing Cat Scratch Disease (CSD) as well as other systemic or chronic infections in certain individuals. It is primarily transmitted through scratches or bites from cats, but it may also be spread via fleas or ticks.
The 26 kDa – IgG test detects the presence of IgG antibodies to a 26-kilodalton (kDa) protein expressed by Bartonella henselae. IgG antibodies generally appear weeks after infection and can remain in the body for months or even years, indicating a long-term immune response.
Optimal range: 0 - 10 Units
Bartonella henselae is a bacterial species best known for causing Cat Scratch Disease (CSD) and can also lead to more serious or chronic infections in some individuals. It is most commonly transmitted through scratches or bites from cats, but it can also be spread through fleas or ticks.
The 26 kDa – IgM test detects IgM antibodies directed against a 26-kilodalton protein produced by Bartonella henselae. IgM is the first type of antibody the body produces in response to infection, usually appearing within 1–2 weeks after initial exposure. Because of this, a positive result may signal a recent or active infection.
A medium IgM result indicates a moderate level of early antibodies, which may reflect:
An early-stage infection, where the immune response is still developing
A waning infection, with IgM levels beginning to decline
A borderline or nonspecific reaction, which should be interpreted carefully
Medium results are not diagnostic by themselves and should be considered alongside clinical symptoms, IgG antibody levels, and other relevant testing such as PCR (which detects bacterial DNA).
Optimal range: 0 - 10 Units
Several species of Bartonella bacteria cause disease in people. Infection with any one of these bacteria is referred to broadly as bartonellosis, although some forms of infection also have common names (for example, cat scratch disease).
Bartonella bacteria are spread to humans by fleas, body lice, sand flies, or contact with flea-infested animals. There is no evidence that ticks spread Bartonella infection to people. In the United States, the most common form of bartonellosis is caused by Bartonella henselae.
Optimal range: 0 - 10 Units
Bartonella vinsonii, a member of the genus Bartonella, is a proteobacterium that is the causative agent of Bartonellosis. The pathogen has been isolated in immunocompetent patients with endocarditis, arthritis, neurological disease and neoplasia . From animal studies it appears that Bartonella henselae is well adapted to felines or cats while Bartonella vinsonii is well adapted to canines or dogs though each species can infect both.
Optimal range: 0 - 10 Units
Borrelia afzelii is a species of Borrelia, a bacterium that can infect various species of vertebrates and invertebrates.
B. afzelii and B. garinii are the primary causes of Lyme disease in Europe and Asia. Coinfection by this Borrelia species with one or more pathogens can occur, carried by the vector, which appears to be in most cases the tick.
Optimal range: 0 - 10 Units
Borrelia afzelii is a species of Borrelia, a bacterium that can infect various species of vertebrates and invertebrates. B. afzelii and B. garinii are the primary causes of Lyme disease in Europe and Asia.
Coinfection by this Borrelia species with one or more pathogens can occur, carried by the vector, which appears to be in most cases the tick. In Europe the related genospecies Borrelia afzelii is associated with both EM and acrodermatitis chronica atrophicans (ACA), and several European studies have found compelling evidence for B. afzelii infection in patients with morphea.
Optimal range: 0 - 10 Units
Borrelia afzelii is a species of Borrelia, a bacterium that can infect various species of vertebrates and invertebrates. B. afzelii and B. garinii are the primary causes of Lyme disease in Europe and Asia. Coinfection by this Borrelia species with one or more pathogens can occur, carried by the vector, which appears to be in most cases the tick. In Europe the related genospecies Borrelia afzelii is associated with both EM and acrodermatitis chronica atrophicans (ACA), and several European studies have found compelling evidence for B. afzelii infection in patients with morphea.
Optimal range: 0 - 10 Units
Borrelia andersonii is a species of Borrelia, a genus of spiral-shaped bacteria that includes several species known to cause tickborne illnesses such as Lyme disease and relapsing fever. While Borrelia andersonii has not been definitively linked to human disease, it has been isolated from Ixodes ticks (the same ticks that transmit Lyme disease) and from wild animals in parts of North America, suggesting it may play a role in the broader ecology of tickborne infections.
The IgG antibody test for Borrelia andersonii measures the body’s long-term immune response to this bacterium. IgG antibodies typically appear weeks after exposure and can remain in the bloodstream for months or even years, indicating past exposure or infection.
A medium IgG result indicates a moderate level of antibodies, which may reflect:
A recent or past exposure to Borrelia andersonii
A low-level or cross-reactive immune response, possibly due to exposure to a related Borrelia species
A borderline finding, which may or may not be clinically significant
Follow-up testing and clinical evaluation can help determine whether additional investigation or treatment is necessary.
Optimal range: 0 - 10 Units
Borrelia andersonii is a species within the Borrelia genus, a group of spiral-shaped bacteria that includes known causes of Lyme disease and relapsing fever. Borrelia andersonii has been found in Ixodes ticks and certain wild animals in North America, but it is not currently recognized as a confirmed human pathogen. However, its presence on testing panels may indicate exposure to Borrelia bacteria or potential cross-reactivity with related species.
The IgM antibody test for Borrelia andersonii detects early immune response—specifically IgM antibodies, which typically appear within 1–2 weeks of infection or exposure. This makes IgM testing useful for identifying recent or possible current exposure to Borrelia species.
A medium IgM result indicates a moderate level of early antibodies, which could reflect:
An early or low-level immune response to a Borrelia species
A resolving immune reaction, if exposure occurred recently
A borderline or nonspecific result, which should be interpreted with caution
In the absence of symptoms or supporting test results, a medium IgM result is typically not diagnostic and may not require treatment.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
The p30 – IgM marker measures early immune system activity against the p30 protein of Borrelia burgdorferi, the bacterium responsible for Lyme disease. The "p30" refers to a 30-kilodalton protein expressed by the bacterium, which serves as one of several antigens used in serologic testing to detect the body’s immune response.
IgM antibodies are produced during the early stages of infection—typically within the first 1 to 2 weeks following exposure. Therefore, the presence of IgM antibodies to the p30 protein may indicate that your immune system is actively responding to a recent or ongoing Borrelia infection.
A medium result for Borrelia burgdorferi p30 – IgM indicates a moderate level of IgM antibodies to the p30 protein. This may represent an early immune response, a waning infection, or a nonspecific antibody reaction. While not strongly positive, it suggests some level of immune activity and should be interpreted alongside your symptoms, exposure risk (such as tick bites in a Lyme-endemic area), and results from other Lyme-related markers.
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
Outer surface protein A (OspA) is one of the major proteins in the outer membrane of this B. burgdorferi. A vaccine based OspA was approved by the FDA in 1998. Individuals vaccinated subcutaneously showed approximately 76% protection agains B. burgdorferi infection after receiving three vaccine doses; however, the human vaccine was removed from the market later.
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
Outer surface protein A (OspA) is one of the major proteins in the outer membrane of this B. burgdorferi. A vaccine based OspA was approved by the FDA in 1998. Individuals vaccinated subcutaneously showed approximately 76% protection agains B. burgdorferi infection after receiving three vaccine doses; however, the human vaccine was removed from the market later.
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
Outer surface protein B (OspB) is one of the major proteins in the outer membrane of this B. burgdorferi. OspB was found to be critical for B. burgdorferi adherence and survival within Ixodes ticks.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
B. burgdorferi p66 is an outer membrane spanning protein Oms66. It is proven to be an integral membrane porin because liposome-reconstituted P66 displayed channel-forming activity in planar lipid bilayer assays. P66 has also been shown to function as an adhesin that binds the mammalian cell receptors, B3 chain and B1 chain integrins.
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
B. burgdorferi p66 is an outer membrane spanning protein Oms66. It is proven to be an integral membrane porin because liposome-reconstituted P66 displayed channel-forming activity in planar lipid bilayer assays. P66 has also been shown to function as an adhesin that binds the mammalian cell receptors, B3 chain and B1 chain integrins.
Optimal range: 0 - 10 Units
The Borrelia burgdorferi p83-93 IgG marker detects the presence of IgG antibodies against a specific protein (p83-93) found in Borrelia burgdorferi, the bacterium that causes Lyme disease. This protein is associated with the late stages of Lyme disease and is considered highly specific to Borrelia.
What does p83-93 mean?
The numbers “p83-93” refer to a protein with a molecular weight of 83 to 93 kilodaltons, which is strongly immunogenic. It is typically expressed during later phases of infection, and the body produces IgG antibodies in response.
Why is this marker important?
A positive p83-93 IgG result may indicate a long-standing or late-stage infection with Borrelia burgdorferi. IgG antibodies generally take weeks to develop, so this marker is not used to detect early infection but rather to assess chronic or past exposure.
Optimal range: 0 - 10 Units
The Borrelia burgdorferi p83-93 (IgM) marker tests for IgM antibodies against the p83-93 protein of Borrelia burgdorferi, the bacterium responsible for Lyme disease. IgM antibodies typically appear early in an infection and signal an active or recent immune response.
What does p83-93 mean?
The p83-93 protein is a high molecular weight antigen (83 to 93 kilodaltons) found on Borrelia burgdorferi. It is most often associated with late-stage Lyme disease, although detection of IgM against this protein can occasionally appear in early stages if the immune response is robust.
Optimal range: 0 - 10 Units
Borreliella burgdorferi is one of the pathogens of the Borreliella burgdorferi sensu lato complex causing Lyme disease. Lyme disease is a zoonotic, vector-borne disease transmitted by the Ixodes tick. Clinical presentation of Lyme disease is known for the characteristic bull's-eye rash (also known as erythema migrans) but can also include myocarditis, cardiomyopathy, arrythmia, arthritis, arthralgia, meningitis, neuropathies, and facial nerve palsy depending on the stage of infection.
Optimal range: 0 - 10 Units
The VlsE1 – IgM marker detects early immune system activity against Borrelia burgdorferi, the bacterium that causes Lyme disease. VlsE1 (Variable major protein-like sequence Expressed 1) is a highly specific surface protein used by the bacterium to evade the immune system through antigenic variation. Because of this, VlsE1 is a key target in serological testing for Lyme disease.
IgM antibodies are typically the first type of antibody produced by the immune system in response to an infection. Therefore, a positive or elevated IgM result for Borrelia burgdorferi VlsE1 may indicate recent or current infection.
A medium result for Borrelia burgdorferi VlsE1 – IgM indicates a moderate level of IgM antibodies targeting the VlsE1 protein of the Lyme disease bacterium. This suggests that the immune system has recently encountered the pathogen and is mounting a response, but the antibody levels are not high enough to be considered strongly positive. A medium IgM result may reflect an early or evolving immune response, a past exposure with lingering antibodies, or potentially nonspecific reactivity. On its own, this result does not confirm active Lyme disease and should be interpreted alongside symptoms, exposure history, and other diagnostic markers such as IgG or PCR.
Optimal range: 0 - 10 Units
Borrelia garinii is one of several Borrelia species that can cause Lyme borreliosis, primarily found in Europe and parts of Asia. It is closely related to Borrelia burgdorferi, the main species responsible for Lyme disease in North America. B. garinii is especially associated with neurological symptoms, such as meningitis or nerve pain.
The OspC (Outer surface protein C) is a major surface protein expressed by Borrelia during the early stages of infection, and it plays a key role in the immune system's recognition of the bacterium. The IgG antibody test for Borrelia garinii OspC measures your body’s longer-term immune response to this specific protein, indicating prior exposure or ongoing immune activity.
A medium result for Borrelia garinii OspC – IgG* indicates a moderate level of long-term antibodies. This can reflect:
Past infection with partial immune clearance
Low-grade or waning immune response
A nonspecific immune signal that may need further testing to confirm clinical significance
Medium results are considered indeterminate or equivocal and should be evaluated in the broader context of symptoms, exposure history, and other lab markers such as IgM antibodies or PCR.
Optimal range: 0 - 10 Units
Borrelia hermsii is a bacterial species that causes tick-borne relapsing fever (TBRF), a disease characterized by recurring episodes of fever and other flu-like symptoms. It is transmitted to humans by soft-bodied ticks of the Ornithodoros genus, which typically feed quickly and are often found in rodent-infested cabins, campsites, or rustic buildings in the western United States and parts of Canada.
The IgG antibody test for Borrelia hermsii measures your body's longer-term immune response to this pathogen. IgG antibodies typically appear weeks after infection and can remain in the bloodstream for months or years after exposure.
A medium IgG result for Borrelia hermsii indicates a moderate level of antibodies, which may reflect:
Previous exposure to the bacterium
An early IgG response in the transition from active to resolved infection
A nonspecific or borderline immune signal, particularly if no symptoms are present
Medium results should be interpreted in the context of your symptoms, risk factors, and other test results, such as IgM antibodies or PCR testing.
Optimal range: 0 - 10 Units
Borrelia maritima is a lesser-known species within the Borrelia genus—a group of bacteria that includes species responsible for Lyme disease and relapsing fever. B. maritima has been identified in ticks and marine or coastal wildlife, but it is not currently recognized as a confirmed cause of human illness. Its presence on testing panels is typically used to explore environmental exposure to Borrelia species or potential cross-reactivity with more well-studied pathogens, such as Borrelia burgdorferi.
The IgG antibody test for Borrelia maritima detects long-term antibodies that the immune system produces weeks after exposure to the bacterium. IgG antibodies can remain in the blood for months or even years, indicating prior immune system recognition of the organism.
A medium IgG result indicates a moderate antibody level, which may reflect:
Recent or remote past exposure to B. maritima or a related species
A low-grade or nonspecific immune response
A borderline result that may not be clinically significant unless accompanied by symptoms or other positive markers
Optimal range: 0 - 10 Units
Borrelia mayonii is a recently identified species of bacteria in the Borrelia burgdorferi sensu lato complex and is known to cause a form of Lyme disease in the Upper Midwest region of the United States. Unlike Borrelia burgdorferi, B. mayonii may lead to more severe or unusual symptoms such as higher fevers, nausea, vomiting, and diffuse rashes rather than the classic bull's-eye rash.
The IgG antibody test for Borrelia mayonii detects the body’s longer-term immune response to this bacterium. IgG antibodies typically appear several weeks after infection and can persist for months or even years.
A medium result for Borrelia mayonii – IgG indicates a moderate level of antibodies, which may reflect:
Past exposure with lingering antibodies
Early-stage IgG response, before levels reach a strong positive
Low-level reactivity that may or may not be clinically significant
This result should be interpreted alongside other laboratory markers, especially IgM results, symptom history, and any potential tick exposure.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Borrelia spielmanii is one of several Borrelia species known to cause Lyme borreliosis, primarily in Europe. While it is less well-known than Borrelia burgdorferi or Borrelia garinii, B. spielmanii has been identified in patients with skin-related Lyme symptoms, such as erythema migrans (the classic Lyme rash). It is transmitted by Ixodes ticks, the same genus responsible for spreading other Lyme-causing Borrelia species.
The OspC (Outer Surface Protein C) is an early-expressed protein by Borrelia during infection. The IgM antibody test for B. spielmanii OspC measures your body’s initial immune response to this protein. Since IgM is the first class of antibody produced, it often indicates a recent or active infection.
A medium result for Borrelia spielmanii OspC – IgM indicates a moderate level of early immune response. This may reflect:
An early infection that is still developing
A recent but resolving infection
A nonspecific or borderline immune reaction that may require follow-up testing to clarify
Medium results are not diagnostic on their own and should be reviewed in the context of symptoms, exposure history, and additional biomarkers.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Understanding Borrelia turicatae and Your Tickborne Disease Test Result
Borrelia turicatae is a significant cause of tick-borne relapsing fever (TBRF) in the southwestern United States. It is transmitted by Ornithodoros turicata, a soft-bodied tick notable for its extremely rapid feeding—often completing a blood meal in minutes. This brief feeding period makes transmission events difficult to detect. These ticks are commonly found in caves and in the burrows of ground squirrels and prairie dogs throughout the Plains and desert regions of the Southwest.
Strong epidemiological evidence links B. turicatae to human infection. While recurrent fever is a hallmark of relapsing fever, infected individuals may also experience a broad range of nonspecific symptoms. Clinical features can include chills, nausea, headache, muscle and joint pain, vomiting, fatigue, and thrombocytopenia (low platelet count), among others. These symptoms can mimic those of many other illnesses, which often makes diagnosis challenging.
If your Vibrant America Tickborne Disease panel shows a "medium" IgG result for Borrelia turicatae, this indicates a moderate level of antibodies in your blood. This level is higher than what’s considered normal (or negative), but it does not reach the threshold for a strong positive.
A medium IgG result can suggest:
Past exposure to Borrelia turicatae, with antibodies lingering from a previous infection.
Early or resolving infection, where IgG levels are still rising or beginning to decline.
Low-level or nonspecific immune response, which may not indicate an active or clinically significant infection.
It’s important to understand that this result alone is not diagnostic of an active infection. It should always be considered in the context of your symptoms, known or possible tick exposure, and other lab findings such as IgM antibody levels or PCR testing.
Speak with your healthcare provider. They can evaluate your clinical history, symptoms, and risk factors to determine the relevance of this result.
Consider repeat testing. A follow-up IgG test in 2 to 4 weeks may help assess whether antibody levels are increasing, which would suggest a recent or ongoing infection.
Review complementary test results. The Vibrant America panel often includes IgM testing, PCR, and screening for other tick-borne infections. These additional markers can provide a more complete picture of your immune status and infection history.
A medium IgG result for Borrelia turicatae suggests moderate antibody levels, which may reflect prior exposure, an early immune response, or a nonspecific finding. While this result is not definitive for active disease, it warrants further review with your healthcare provider, especially if symptoms are present. Clinical correlation and follow-up testing are essential for accurate diagnosis and appropriate care.
If you have results for IgM or PCR testing from the same panel, those can offer valuable context and may help clarify the stage or presence of infection. Let me know if you’d like help interpreting those results as well.
Optimal range: 0 - 10 Units
Borrelia turicatae is a species of bacteria that causes tick-borne relapsing fever (TBRF), an illness marked by recurring episodes of fever and flu-like symptoms. This bacterium is transmitted to humans by soft-bodied ticks—specifically Ornithodoros turicata—which feed quickly and are commonly found in caves, animal burrows, and rustic shelters in the southern and southwestern United States.
The IgM antibody test for Borrelia turicatae measures your body’s early immune response to infection. IgM is the first type of antibody produced after exposure to a pathogen, usually appearing within 1–2 weeks of infection.
A medium IgM result for Borrelia turicatae indicates a moderate level of early antibodies, which may reflect:
An early or developing immune response following recent exposure
A waning IgM response, as the body transitions to producing IgG antibodies
A nonspecific or borderline signal, especially if symptoms are mild or absent
Medium results are not diagnostic on their own and should be interpreted alongside your symptoms, exposure history, and additional markers like IgG or PCR.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
From ticks and small rodents
Optimal range: 0 - 10 Units
Reference range: Negative, Positive
Reference range: Negative, Positive
Optimal range: 0 - 10 Units
Chlamydophila pneumoniae is a type of bacteria that commonly causes respiratory infections, including bronchitis, sinusitis, and atypical pneumonia. In most cases, infections are mild and self-limiting, but in some individuals—especially older adults or those with weakened immune systems—it can contribute to more persistent or chronic respiratory conditions.
The IgG antibody test for Chlamydophila pneumoniae measures the body’s long-term immune response to this bacterium. IgG antibodies usually appear several weeks after infection and can remain in the bloodstream for months or even years. This means an elevated IgG result indicates past exposure or a previous infection.
A medium IgG result reflects a moderate level of antibodies, which may indicate:
A past infection that your body has responded to and is no longer fighting
A waning or borderline immune response, depending on timing and overall health
In some cases, cross-reactivity or residual antibodies from a remote infection
This result should be interpreted in the context of symptoms and additional lab findings.
Optimal range: 0 - 10 Units
Coxsackie viruses are a group of enteroviruses that can cause a variety of illnesses, ranging from mild to serious. These viruses are divided into Group A and Group B, each associated with different clinical conditions. Group A viruses often cause hand, foot, and mouth disease, while Group B viruses can lead to viral myocarditis, pericarditis, or aseptic meningitis.
The IgG antibody test for Coxsackie virus detects long-term immune response to the virus. IgG antibodies typically develop several weeks after infection and remain in the bloodstream for months or even years, indicating past exposure or infection.
A medium IgG result indicates a moderate level of antibodies, which may reflect:
A recent past infection with declining antibody levels
An incomplete or borderline immune response
A nonspecific or cross-reactive finding, particularly in the absence of symptoms
This result should be interpreted alongside your clinical history, symptoms, and any corresponding IgM antibody results, which reflect current or recent infection.
Optimal range: 0 - 10 Units
Human herpesvirus 7 is a herpes family virus that can stay in your body for life usually in a dormant state. It is ubiquitous worldwide and nearly 70% of all children will be exposed to the virus by the age of 4. DNA of the virus has been found in the CD4+ T cells of healthy adults which is indicative of the latency.
Optimal range: 0 - 10 Units
Mycoplasma pneumoniae is a type of bacteria that commonly causes respiratory infections, especially atypical pneumonia—a milder, slower-developing form of pneumonia often referred to as "walking pneumonia." It is also associated with sore throat, prolonged cough, sinusitis, and bronchitis. In some cases, it can contribute to more serious complications such as asthma exacerbations, ear infections, or skin rashes.
The IgG antibody test detects long-term immune response to Mycoplasma pneumoniae. IgG antibodies typically appear several weeks after infection and may remain in the bloodstream for months or even years, indicating past exposure or infection.
A medium IgG result reflects a moderate level of antibodies, which may suggest:
A recent past infection, with IgG levels still stabilizing
A waning immune response from an older infection
Borderline reactivity, possibly requiring repeat testing or further evaluation
A medium result alone does not indicate whether the infection is active—it should be considered alongside symptoms and other lab markers, especially IgM.
Optimal range: 0 - 10 Units
Lyme disease and Parovirus B19 infections produce arthritis, rashes, and a systemic illness that may be thought to represent a chronic rheumatic disease. Cases of co infections have also been reported in literature. Additionally, it has been shown to be a good candidate for differential diagnosis in cases of arthopathy where Lyme disease has been suspected.
Optimal range: 0 - 10 Units
Parvovirus B19 is a common human virus that causes fifth disease (also known as erythema infectiosum), especially in children. It typically presents with a “slapped cheek” facial rash and mild flu-like symptoms. In adults, it can cause joint pain or arthritis-like symptoms, and in vulnerable individuals—such as pregnant women, immunocompromised patients, or those with chronic anemia—it can lead to more serious complications, including fetal infection or severe anemia.
The VP1/VP2 Co-Capsid IgG test detects IgG antibodies to the virus-like particle (VLP) capsid proteins VP1 and VP2 of Parvovirus B19. These are the major structural proteins that form the virus’s outer shell. When your immune system recognizes these proteins, it produces IgG antibodies that typically remain in the bloodstream for many months or years—indicating past infection and likely immunity.
A medium IgG result suggests a moderate level of antibodies, which may reflect:
A resolving infection where IgG is still building
A recent past exposure
A borderline immune response that may need further testing in some cases
If there are clinical concerns (e.g., during pregnancy or in the presence of anemia), additional tests—such as Parvovirus B19 IgM or PCR—may be used to determine whether an active infection is present.
Optimal range: 0 - 10 Units
Parvovirus B19 is a common virus that causes fifth disease (also known as erythema infectiosum), particularly in children. It often presents with a red rash on the cheeks (“slapped cheek” appearance) and mild flu-like symptoms. In adults, it may cause joint pain or fatigue. In certain cases—especially among pregnant women, people with weakened immune systems, or those with chronic anemia—Parvovirus B19 infection can lead to more serious complications, such as fetal infection or severe anemia.
The VP1/VP2 Co-Capsid – IgM test detects IgM antibodies to the virus-like particle (VLP) capsid proteins VP1 and VP2, which are structural proteins of the virus. IgM antibodies are the first type of antibodies the immune system produces after an infection and typically appear within 1 to 2 weeks of exposure. This test helps identify recent or current infection with Parvovirus B19.
A medium IgM result suggests a moderate level of early antibodies, which may indicate:
An early-stage infection with IgM levels still rising
A resolving infection, with IgM beginning to decline
A borderline or nonspecific response, which may need follow-up testing for confirmation
In these cases, your healthcare provider may recommend additional tests such as IgG (to assess longer-term immunity) or PCR (to detect viral DNA).
Optimal range: 0 - 10 Units
Parvovirus B19 is a common virus that causes a mild childhood illness known as fifth disease or erythema infectiosum, which typically presents with a “slapped cheek” rash and low-grade fever. In adults, infection may lead to joint pain or flu-like symptoms. In some cases—particularly in people with weakened immune systems, certain blood disorders, or during pregnancy—Parvovirus B19 can lead to more serious complications, such as anemia or fetal infection.
The VLP VP2 – IgG test detects IgG antibodies against the virus-like particle (VLP) of the VP2 protein, one of the main structural proteins of Parvovirus B19. IgG antibodies usually develop a few weeks after infection and remain in the bloodstream long-term, indicating past exposure and likely immunity.
A medium IgG result reflects a moderate level of antibodies, which may indicate:
A recent past infection that is resolving
An early developing immune response
A borderline or nonspecific result, especially in the absence of symptoms or recent illness
Further testing (e.g., IgM antibodies) may be recommended if symptoms are present or if there is clinical concern about current infection.
Optimal range: 0 - 10 Units
Rickettsia typhi is the etiological agent of murine typhus. R. typhi is transmitted primarily by the rat flea, Xenopsylla cheopis. Lice and mites can be potential vectors and rodents, shrews, opossums, cats can be reservoir. The clinical manifestations of murine typhus are usually less severe than those of epidemic typhus and includes persistent headache, a high-grade fever, and a cutaneous rash predominating on the trunk. Murine typhus usually takes a prolonged incubation period and the characteristic rash is occasionally absent. An antibody response is usually detected only after 10 days from the onset of systemic symptoms, and antibody titers reach a peak after 3 to 4 weeks or later if an antibiotic therapy has been administered.
Optimal range: 0 - 10 Units
Rickettsia typhi is the bacterium that causes murine typhus, a flea-borne illness most commonly found in warm, coastal regions of the world, including parts of the southern United States (e.g., Texas and California). It is primarily transmitted to humans by the bite of fleas infected from rodents or, occasionally, opossums or other small mammals.
The Surface Antigen – IgM test detects IgM antibodies produced by your immune system in response to proteins on the surface of Rickettsia typhi. IgM antibodies are typically the first to appear during an infection, usually within the first 1 to 2 weeks of exposure. A positive result generally suggests a recent or active infection.
Optimal range: 0 - 10 Units
Tickborne Encephalitis Virus (TBEV) is a virus that causes tickborne encephalitis (TBE)—a serious infection affecting the brain and central nervous system. TBEV is transmitted through the bite of infected Ixodes ticks, and is most commonly found in parts of Central and Eastern Europe, Russia, and Northern and Eastern Asia.
The IgG antibody test for TBEV detects long-term immune response to the virus. IgG antibodies typically develop several weeks after infection or vaccination and can remain in the bloodstream for months or years, indicating past exposure, recovery from infection, or prior vaccination.
Optimal range: 0 - 10 Units
Tickborne Encephalitis Virus (TBEV) is a virus that causes tickborne encephalitis (TBE), a potentially serious illness affecting the brain and central nervous system. TBEV is spread through the bite of infected Ixodes ticks and is most common in parts of Central and Eastern Europe, Russia, and northern and eastern Asia.
The IgM antibody test detects the body’s initial immune response to the virus. IgM antibodies are the first type produced by the immune system after exposure to an infection—usually appearing within 1 to 2 weeks. Because of this, an elevated IgM level typically indicates a recent or active infection with TBEV.
A medium IgM result indicates a moderate level of early antibodies, which may reflect:
An early stage of infection, where the immune response is still increasing
A declining IgM response, as the body transitions to producing longer-term IgG antibodies
A borderline or nonspecific response, which may require confirmation with additional testing
Medium results should be interpreted alongside clinical symptoms, travel or exposure history, and other tests such as TBEV IgG or PCR.
Optimal range: 0 - 10 Units
Toxoplasma gondii is a protozoan parasite that infects most species of warm-blooded animals, including humans, and causes the disease toxoplasmosis. Tick based transmission has been increasingly considered and evidence indicates that T. gondii could be a potentially unrecognized tick-borne pathogen spreading toxoplasmosis . The parasite forms cysts that can affect almost any part of the body often your brain and muscle tissue of different organs, including the heart. The immune system keeps the parasites in check in an inactive state however, if it is weakened by disease or certain medications, the infection can be reactivated, leading to serious complications.
Optimal range: 0 - 10 Units
Toxoplasma gondii is a microscopic parasite that causes toxoplasmosis, a common infection that often goes unnoticed in healthy individuals but can pose serious risks during pregnancy or in people with weakened immune systems. It is typically transmitted through undercooked meat, contaminated water or soil, or contact with cat feces.
The MIC3 – IgM test detects IgM antibodies against the MIC3 protein, which is one of the parasite’s microneme proteins involved in host cell invasion. IgM antibodies are the first antibodies produced by your immune system in response to infection and generally appear within 1–2 weeks after initial exposure. Therefore, this test helps identify a recent or current infection with Toxoplasma gondii.
A medium IgM result indicates a moderate level of early antibodies, which may reflect:
An early or developing infection, with IgM levels not yet at their peak
A resolving infection, with IgM levels on the decline
A nonspecific or borderline immune response that may need further evaluation
This result should be interpreted in combination with clinical symptoms, risk factors, and other laboratory markers such as IgG and avidity testing.
Optimal range: 0 - 10 Units
Toxoplasma gondii is a microscopic parasite that causes toxoplasmosis, a common infection that is often mild or asymptomatic in healthy people but can be serious in pregnant individuals, newborns, or people with weakened immune systems. The parasite is usually transmitted through undercooked meat, contaminated food or water, or exposure to infected cat feces.
The p29 – IgM test detects IgM antibodies targeting the p29 protein, a specific surface antigen expressed by Toxoplasma gondii. IgM antibodies are the first antibodies produced by the immune system in response to infection, typically appearing within 1 to 2 weeks of exposure. This test helps identify recent or active infection.
A medium IgM result suggests a moderate immune response, which could reflect:
An early-stage infection, where IgM levels are still increasing
A declining immune response as the body transitions to longer-lasting IgG antibodies
A borderline or nonspecific immune signal, especially in the absence of symptoms
Follow-up testing is often recommended to determine whether the infection is truly active or resolving.
Optimal range: 0 - 10 Units
Toxoplasma gondii is a microscopic parasite that causes toxoplasmosis, a common infection that is often mild in healthy individuals but can cause serious complications in pregnant women, newborns, and immunocompromised individuals. People typically become infected by eating undercooked meat, drinking contaminated water, or coming into contact with cat feces that contain the parasite.
The p30 – IgG test detects IgG antibodies against the p30 protein, also known as SAG1 (surface antigen 1), which is one of the most abundant and immunologically important proteins on the surface of T. gondii. IgG antibodies usually appear 1 to 2 weeks after infection and can remain in the body for years or even a lifetime, indicating past exposure and likely immunity.
A medium IgG result reflects a moderate level of long-term antibodies, which may indicate:
A recent past infection with antibody levels still stabilizing
A residual or waning immune response from an older exposure
A borderline result, which may require further evaluation with IgM testing or IgG avidity to determine timing
Optimal range: 0 - 10 Units
Toxoplasma gondii is a common parasite that causes toxoplasmosis, an infection often mild or unnoticed in healthy individuals but potentially serious in pregnant women, newborns, or people with weakened immune systems. It is usually spread through undercooked meat, contaminated food or water, or contact with infected cat feces.
The p30 – IgM test measures IgM antibodies directed against the p30 protein (also known as SAG1, a major surface antigen) of Toxoplasma gondii. IgM antibodies are produced early in an infection—typically within 1 to 2 weeks of exposure—and serve as a marker for recent or active infection.
A medium IgM result indicates a moderate early immune response, which could reflect:
An early-stage infection, before peak antibody production
A declining or resolving infection
A borderline immune reaction, which might require confirmation with additional testing
Your provider may recommend follow-up tests to clarify whether the infection is recent or resolved, including IgG testing, IgG avidity, or PCR.
Lymphocyte Subset Panel 2
The Lymphocyte Subset Panel 2 is an advanced diagnostic tool that plays a pivotal role in immunological profiling, offering invaluable insights into the body's immune system. This comprehensive panel is designed to analyze specific subsets of lymphocytes, including T cells, B cells, Natural Killer (NK) cells, and their various subpopulations, providing a detailed overview of immune function. Crucial for diagnosing and monitoring a range of immune-related conditions, this panel is particularly relevant in the context of autoimmune diseases, immunodeficiencies, and in the management of patients with cancer, especially those undergoing immunotherapy. By quantifying subsets like CD4+ and CD8+ T cells, B cells, and NK cells (characterized by CD16 and CD56 markers), the Lymphocyte Subset Panel 2 enables clinicians to assess the immune system's balance and responsiveness. This test is indispensable in clinical settings for evaluating the immune status of patients with recurrent infections, autoimmune disorders, or as part of the pre- and post-treatment assessment in cancer therapy. The precision and depth of information provided by the Lymphocyte Subset Panel 2 make it a cornerstone in modern immunological diagnostics, guiding therapeutic decisions and offering a clearer path towards personalized medical care.
Optimal range: 6 - 29 %
The CD19 antigen (aka B-lymphocyte antigen CD19 or Cluster of Differentiation 19) plays an important role in clinical oncology. It’s a protein found on the surface of B-cells, a type of white blood cell.
Optimal range: 57 - 85 %
The percentage of CD3+ T cells, often referred to as mature T cells, is a crucial component of the immune system and plays a central role in defending the body against infections and other foreign invaders. These cells are characterized by the presence of the CD3 surface marker, which is involved in T cell receptor signaling. CD3+ T cells can be further divided into two main subsets: CD4+ T cells (helper T cells) and CD8+ T cells (cytotoxic T cells). CD4+ T cells assist in orchestrating immune responses by coordinating various immune cells and directing them to combat specific pathogens. On the other hand, CD8+ T cells are responsible for directly identifying and destroying infected or abnormal cells, such as virus-infected cells and cancer cells. An optimal balance and functionality of these T cell subsets are critical for a healthy immune response.
Optimal range: 4.9 - 25.9 %
This test is used to detect soluble IL-2Rα in human plasma or serum produced in response to increased activation of B and T cells and immune system activation. Studies show elevated levels of sIL-2Rα in serum with the onset of rejection episodes in allograft recipients, autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus (SLE), hemophagocytic lymphohistiocytosis (HLH) and in the course of some leukemias and lymphomas. This test may be of diagnostic and/or prognostic value in HLH, granulomatous, autoimmune, and malignant diseases.
Optimal range: 30 - 61 %
The CD4 percentage (CD4%) is the percentage of white blood cells (lymphocytes) that are CD4 cells.
Optimal range: 12 - 42 %
The proportion of all T cells that are CD8 cells.
CD8 cells are also called cytotoxic T-lymphocytes. They help fight cancer and germs that live inside your cells (intracellular pathogens).
The CD8 percentage is sometimes more reliable than the absolute count of CD8 because it tends to vary less.
Optimal range: 79 - 535 uL
Optimal range: 110 - 660 cells/uL
The CD19 antigen (aka B-lymphocyte antigen CD19 or Cluster of Differentiation 19) plays an important role in clinical oncology. It’s a protein found on the surface of B-cells, a type of white blood cell.
Optimal range: 840 - 3060 cells/uL
CD3+ cells are all T-lymphocytes, which includes both CD4+ and CD8+ lymphocyte cells.
This figure is rarely used for making treatment decisions.
Optimal range: 490 - 1740 cells/uL
The CD4 cells are Helper T-cells expressing both CD3 and CD4.
CD4 T-cells levels are a criterion for categorizing HIV-related clinical conditions by CDC's classification system for HIV infection. The measurement of CD4 T-cell levels has been used to establish decision points for initiating P. jirovecii prophylaxis, antiviral therapy and to monitor the efficacy of treatment. The Public Health Service (PHS) has recommended that CD4 T-cell levels be monitored every 3 to 6 months in all HIV-infected persons.
During HIV infection, antiviral therapy is often initiated when the absolute CD4 count drops below 500 cells/µL. When the absolute CD4 count drops below 200 cells/µL, therapeutic prophylaxis against PCP and other opportunistic infections may be initiated. When the absolute CD4 count drops below 100 cells/µL, prophylaxis against Mycobacterium avium complex is recommended.
Optimal range: 0.99 - 3.15 thou/mcL
Reference Ranges:
18-55 years: 0.99-3.15 thou/mcL
>55 years: 1.00-3.33 thou/mcL
The absolute CD45 count is a measurement of the total number of lymphocytes in a blood sample. CD45 is a surface marker expressed on all white blood cells, including lymphocytes, monocytes, and granulocytes.
The absolute CD45 count provides information about the overall quantity of lymphocytes present, which can be clinically relevant in evaluating various immune system disorders or conditions that affect lymphocyte levels.
For example, low absolute CD45 counts may be seen in immunodeficiency disorders, while elevated counts can occur in certain infections, autoimmune diseases, or blood cancers.
Optimal range: 180 - 1170 cells/uL
This figure is rarely used for making treatment decisions.
CD4 and CD8 are two types of white blood cells in your blood. CD4 cells are also called T-helper cells, T-suppressor cells, and cytotoxic T-cells. They help the body fight infections. CD8 cells are also called cytotoxic T-lymphocytes. They help fight cancer and germs that live inside your cells (intracellular pathogens).
The absolute number of all CD8 cells, which include both killer and suppressor T cells. The normal range for an HIV-negative person is 150 to 1,000. It is usually higher in a person with HIV.
Optimal range: 850 - 3900 cells/uL
Lymphocytes are a type of white blood cell found in the body. They serve in several major roles in our immune system including identification of and response to invading organism. Your healthcare professional may assess lymphocyte levels when a white blood cell count came back as abnormal.
Optimal range: 109 - 897 cells/mcL
The Absolute T-Suppressor Cells marker is an important measurement that gives doctors a closer look at a specific part of your immune system. T-suppressor cells, also known as CD8+ cells, play a critical role in managing and regulating your body's immune response. These cells are like the body's own regulatory officials, working to calm the immune system down and prevent it from overreacting, which can be just as harmful as underreacting. The "absolute" part of the marker's name refers to the actual count of these T-suppressor cells in a sample of your blood, giving a clear picture of how many are present to perform their crucial function.
Optimal range: 1.2 - 9 % of CD19
The Activated CD21low CD38- % biomarker measures the proportion of B cells with low CD21 expression and absent CD38 expression, representing a subset of atypical or activated B cells linked to immune dysregulation. These cells are associated with chronic immune activation (e.g., in HIV or hepatitis), autoimmune diseases (e.g., lupus, rheumatoid arthritis), and primary immunodeficiencies (e.g., CVID). They are often indicative of B cell exhaustion caused by prolonged antigen exposure. Elevated levels may signal chronic activation or autoimmune pathology, while interpretation requires clinical context, additional immune markers, and other laboratory findings to assess immune status effectively.
Optimal range: 3 - 26 cells/mcL
Activated CD21low CD38- B cells are a distinct subset of B lymphocytes associated with chronic immune activation and immune dysregulation. These cells exhibit low CD21 expression, absence of CD38, elevated activation markers like CD80 and CD86, and increased inhibitory receptors such as PD-1 and FCRL4. They produce class-switched antibodies, predominantly IgG and IgA, which often include autoreactive antibodies and those targeting persistent antigens. These cells play a role in chronic inflammation, autoantibody production, and disrupted immune tolerance, commonly linked to autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis, as well as chronic infections like HIV and hepatitis C. Reduced responsiveness to signaling pathways and cytokine secretion, including IL-6 and TNF-α, highlight their contribution to immune dysfunction. Monitoring these cells and their antibodies provides insights into chronic immune activation, autoimmune processes, and the efficacy of immunomodulatory therapies, making them valuable markers in diagnostics and disease management.
Optimal range: 96 - 100 % of CD19
CD20 is a critical surface marker predominantly expressed on B lymphocytes from the late pre-B cell stage to memory B cells, absent on pro-B cells and plasma cells. The CD20+ % marker measures the proportion of B cells expressing CD20, aiding in disease monitoring, treatment assessment, and immune status evaluation. Abnormal levels can indicate conditions like chronic lymphocytic leukemia, non-Hodgkin lymphoma, or immunodeficiencies and are pivotal in tracking the efficacy of anti-CD20 therapies such as rituximab. Normal CD20+ % ranges vary, typically 5-15% of total lymphocytes or 95-100% when expressed as a percentage of CD19+ B cells. Deviations should be interpreted alongside other markers (e.g., CD19, CD22) and clinical context to guide diagnosis and treatment.
Optimal range: 110 - 450 cells/mcL
CD20 is a cell surface protein primarily expressed on the surface of B-cells, a type of white blood cell involved in the immune response. The CD20 molecule plays a critical role in the development, differentiation, and function of B-cells, which are responsible for producing antibodies. It acts as a calcium channel, helping regulate the flow of calcium ions into the cell, a process essential for B-cell activation and immune function. CD20 is not expressed on early B-cell precursors or on plasma cells, which means its expression is limited to specific stages in B-cell maturation.
Because CD20 is highly expressed on the surface of mature B-cells, it has become an important biomarker in diagnosing and treating various B-cell-related diseases, particularly B-cell non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL). These cancers are characterized by an abnormal proliferation of B-cells, and CD20 serves as a target for therapies designed to eliminate these malignant cells. Rituximab, an anti-CD20 monoclonal antibody, was one of the first therapeutic agents to target this protein, marking a significant advance in cancer treatment.
Optimal range: 28 - 57 %
CD3+/CD4+ % refers to the percentage of T-helper cells (a subtype of white blood cells) among all T-lymphocytes (T cells) in your blood. This marker is often measured as part of an immune panel using flow cytometry, especially in contexts involving immune system monitoring, such as HIV, autoimmune conditions, or immunodeficiency assessments.
CD3+ T cells: Represent all mature T lymphocytes, a key part of the adaptive immune system.
CD4+ T cells: A subset of CD3+ cells, often called T-helper cells, which coordinate immune responses by signaling other immune cells.
CD3+/CD4+ %: The percentage of total T cells that are CD4+. This gives insight into the relative balance of helper T cells within the T cell population.
Optimal range: 300 - 1400 /uL
CD3+/CD4+, Abs stands for the absolute count of CD4+ T-helper cells within the total population of CD3+ T cells in the blood. This marker measures the exact number of helper T cells per microliter (μL) of blood, rather than just their percentage. It is a key indicator of immune system function, especially in the context of infections like HIV, immune deficiencies, and chronic inflammatory conditions.
Optimal range: 10 - 39 %
CD3+/CD8+ % refers to the percentage of cytotoxic T cells (CD8+) among all T-lymphocytes (CD3+ cells) in your blood. This immune marker is measured using flow cytometry and is commonly included in T-cell subset panels to evaluate immune system status.
CD3+ T cells: Represent all mature T lymphocytes, which are essential for adaptive immunity.
CD8+ T cells: A subset of CD3+ cells, often called cytotoxic T cells, that directly kill infected or abnormal cells (like virus-infected cells or cancer cells).
CD3+/CD8+ %: Indicates the proportion of cytotoxic T cells among total T cells, helping assess immune activation, suppression, or imbalance.
Optimal range: 200 - 900 /uL
CD3+/CD8+, Abs refers to the absolute count of cytotoxic T cells (CD8+) within the population of total T cells (CD3+) in your blood. This test measures the number of CD8+ T cells per microliter (μL) of blood and is a critical marker for evaluating immune function, especially in viral infections, immune disorders, and after immune-modulating treatments.
CD3+ T cells: Represent all mature T lymphocytes—key players in the adaptive immune system.
CD8+ T cells: A subset of CD3+ T cells, known as cytotoxic T cells, that target and destroy virus-infected, cancerous, or otherwise abnormal cells.
“Abs” (Absolute): Indicates the actual number of CD3+/CD8+ cells per microliter (μL) of blood, not just the percentage.
The CD8+ absolute count provides important insight into:
Immune activation during viral infections (e.g., HIV, CMV, EBV)
T-cell immune surveillance and response
Immune suppression or recovery following chemotherapy, transplant, or immunodeficiency
Chronic inflammation or autoimmune disease activity
Optimal range: 4 - 25 %
The CD3-/CD16+CD56+ (%) test is a sophisticated diagnostic assay crucial in the field of immunology, offering invaluable insights into the functioning of the body’s immune system. This test specifically measures the percentage of natural killer (NK) cells, identified by the absence of CD3 and the presence of CD16 and CD56 markers, in the total lymphocyte population. NK cells are a vital component of the innate immune system, playing a key role in the body’s first line of defense against tumors, virally infected cells, and in modulating immune responses. The CD3-/CD16+CD56+ (%) test is pivotal in evaluating various immune conditions, including autoimmune diseases, chronic viral infections, and certain cancers.
Optimal range: 70 - 760 cells/mcL
The "CD3-/CD16+CD56+ (Absolute)" marker is a crucial measure for evaluating the absolute count of Natural Killer (NK) cells in your blood. NK cells are a vital type of lymphocyte, which is a category of white blood cells that play a key role in your body's first line of defense in its immune response. These cells are unique because they lack the CD3 marker, a characteristic typically found on T cells, and instead, are identified by the presence of CD16 and CD56 markers.
Understanding the absolute count of NK cells, rather than just their percentage among lymphocytes, provides a clearer picture of how equipped your immune system is to combat infections and potentially cancerous cells. NK cells are essentially the body’s natural surveillance system, capable of destroying cells that have become infected or have undergone malignant transformation, without the need for prior activation.
Optimal range: 0.86 - 5 Ratio
This test looks at the ratio of two important types of white blood cells in your blood.
Lymphocytes are a type of white blood cell in your immune system. This test looks at two of them, CD4 and CD8.
CD4 cells lead the fight against infections. CD8 cells can kill cancer cells and other invaders.
Optimal range: 1 - 3.6 Ratio
The CD4/CD8 ratio (CD3+) is an important marker that reflects the balance between two major subsets of T lymphocytes—CD4+ helper T cells and CD8+ cytotoxic T cells—within the total T-cell population (CD3+). This ratio is a key indicator of immune system health, especially in conditions involving immune deficiency, chronic infections, inflammation, and immune reconstitution.
CD3+ T cells: Represent all mature T lymphocytes. Both CD4+ and CD8+ T cells fall under this category.
CD4+ T cells: Also known as helper T cells, they coordinate immune responses by signaling other immune cells.
CD8+ T cells: Also known as cytotoxic T cells, they destroy infected, damaged, or cancerous cells.
CD4/CD8 Ratio (CD3+): The ratio of helper T cells to cytotoxic T cells within the CD3+ T-cell population.
Optimal range: 2 - 77 %
The CD57 test is offered in some clinical laboratories and is being used by some health practitioners to evaluate and follow patients diagnosed with chronic Lyme disease.
Optimal range: 100 - 360 uL
The CD57 test is offered in some clinical laboratories and is being used by some health practitioners to evaluate and follow patients diagnosed with chronic Lyme disease.
Optimal range: 5.1 - 22 % of CD19
Class-switched CD27+IgD-IgM- B cells represent a subset of memory B cells that have undergone immunoglobulin class switching, a process in which B cells switch from producing IgM and IgD to producing other immunoglobulin isotypes such as IgG, IgA, or IgE. These cells are defined by the expression of CD27, a marker of memory B cells, and the absence of IgD and IgM on their surface. Class-switched memory B cells play a vital role in adaptive immunity, enabling the production of high-affinity antibodies in response to antigens encountered during prior infections or vaccinations. Alterations in the percentage of class-switched memory B cells can indicate disruptions in immune function. For instance, reduced levels are associated with immunodeficiencies, chronic infections, and certain autoimmune diseases, whereas elevated levels may occur in hyperactive immune states. Evaluating the proportion of these cells provides valuable insights into the immune system’s ability to mount an effective and targeted response to pathogens and immunological challenges.
Optimal range: 11 - 61 cells/mcL
Class-switched CD27+IgD-IgM- antibodies refer to immunoglobulins produced by class-switched memory B cells that express CD27 but lack surface IgD and IgM. These antibodies result from immunoglobulin class switch recombination (CSR), a process enabling B cells to produce IgG, IgA, or IgE isotypes instead of IgM and IgD, thereby enhancing immune specificity and functionality. Class-switched antibodies are pivotal in adaptive immunity, offering high-affinity responses tailored to neutralize specific pathogens or toxins encountered during prior infections or vaccinations. Dysregulation in the production or function of these antibodies can indicate immune dysfunction. Reduced levels are often associated with conditions such as common variable immunodeficiency (CVID) or chronic infections, while aberrant production may occur in autoimmune diseases or allergic responses. Evaluating class-switched antibodies provides crucial insights into the immune system’s ability to mount targeted, long-term defenses and adapt to immunological challenges.
Optimal range: 7 - 14 %
CD1656 are an important NK (Natural killer) cell subset.
- NK cells are best known for killing virally infected cells, and detecting and controlling early signs of cancer. As well as protecting against disease, specialized NK cells are also found in the placenta and may play an important role in pregnancy.
- Natural killer T (NKT) cells represent a specialized T-cell population that is distinct from conventional T cells. They express an invariant T-cell receptor (TCR) that recognizes self and bacterial glycosphingolipid antigens presented by the MHC class I-like molecule, CD1d.
- Human natural killer (NK) cells can be subdivided in several subpopulations on the basis of the relative expression of the adhesion molecule CD56 and the activating receptor CD16.
- NK cells serve an important role in host defense against viral infections, as well as tumor surveillance. They are also a component of the adaptive immune response through cytokine production.
- NK cell functions are governed by a balance between activating receptors and inhibitory receptors.
Optimal range: 50 - 375 #/cumm
CD1656 are an important NK (Natural killer) cell subset.
- NK cells are best known for killing virally infected cells, and detecting and controlling early signs of cancer. As well as protecting against disease, specialized NK cells are also found in the placenta and may play an important role in pregnancy.
- Natural killer T (NKT) cells represent a specialized T-cell population that is distinct from conventional T cells. They express an invariant T-cell receptor (TCR) that recognizes self and bacterial glycosphingolipid antigens presented by the MHC class I-like molecule, CD1d.
- Human natural killer (NK) cells can be subdivided in several subpopulations on the basis of the relative expression of the adhesion molecule CD56 and the activating receptor CD16.
- NK cells serve an important role in host defense against viral infections, as well as tumor surveillance. They are also a component of the adaptive immune response through cytokine production.
- NK cell functions are governed by a balance between activating receptors and inhibitory receptors.
Optimal range: 70 - 760 cells/uL
The Natural Killer Cells CD3-CD16+CD56+ (ABS) test is an advanced diagnostic tool with significant implications in the fields of immunology, oncology, and reproductive medicine. Natural Killer (NK) cells, a critical component of the innate immune system, play a vital role in the body’s first line of defense against tumors and virally infected cells. This test quantifies the absolute number of NK cells in the blood, specifically identifying the subset characterized by the absence of CD3 and the presence of CD16 and CD56 markers. High or abnormal levels of these cells can be indicative of various health conditions.
Optimal range: 5 - 30 %
Natural Killer (NK) cells, identified by their CD16 and CD56 markers, are an integral component of the lymphocyte panel in immunological testing. These cells are a type of lymphocyte, distinct from B and T cells, and form a crucial part of the innate immune system. The lymphocyte panel, often used in immunological assessments, typically includes the analysis of various subsets of lymphocytes, such as T cells, B cells, and NK cells, to evaluate the immune system's status and function.
Evaluating NK cells in a lymphocyte panel can provide critical insights into the immune system's functioning, particularly in diagnosing and monitoring immune disorders, certain infections, and cancers. Abnormal levels or functionality of NK cells can indicate underlying immunological issues. For instance, reduced NK cell activity might be observed in some viral infections or immune deficiencies, while certain autoimmune diseases might show altered NK cell numbers or function.
Optimal range: 2.4 - 15 % of CD19
The marker "Non switched CD27+IgD+IgM+ %" on a Lymphocyte Subset Panel refers to a specific type of cell found within the immune system. This marker is used to identify a subset of B cells, which are crucial components of the immune response. In particular, CD27+IgD+IgM+ denotes B cells that have not undergone a process called class switching. Class switching is a biological mechanism where a B cell changes the type of antibody it produces. However, the cells identified by this marker still produce IgM antibodies, which are among the first types of antibodies generated in response to an infection. These B cells also express CD27, a protein that indicates a certain level of maturity and capability to respond to pathogens. The presence and percentage of these non-switched B cells can provide valuable insights into the body's immune status and its ability to respond to infections or immunological disorders. Therefore, analyzing this marker can help clinicians understand various conditions related to immune function and potentially guide treatment options.
Optimal range: 5 - 46 cells/mcL
Non-switched CD27+IgD+IgM+ Abs are a subset of B cells characterized by the expression of CD27, IgD, and IgM on their surface. These cells are primarily involved in T-cell-independent immune responses and are thought to play a key role in the early defense against pathogens, particularly in mucosal immunity. Unlike class-switched memory B cells, non-switched memory B cells retain IgM as their predominant antibody isotype, enabling rapid responses to previously encountered antigens. Their presence and function are crucial in maintaining immunological memory and have been associated with conditions like autoimmune diseases, chronic infections, and immunodeficiencies. Abnormal levels of these cells may indicate disruptions in immune regulation, prompting further evaluation in clinical and research settings.
Optimal range: 0.4 - 4.1 % of CD19
Plasmablasts CD38+IgM- are short-lived, antibody-secreting cells that emerge from activated B cells during early immune responses. Characterized by high CD38 expression, absence of surface IgM, and variable CD138 expression, these cells are crucial for rapid production of antibodies such as IgG, IgA, or IgE, depending on prior class-switching. Plasmablasts originate from extrafollicular or early germinal center responses and serve as a bridge between early and late humoral immunity. Elevated levels are seen in acute infections, recent vaccinations, and autoimmune conditions like systemic lupus erythematosus (SLE), while reduced levels are associated with primary or secondary immunodeficiencies and impaired B cell function. With their short lifespan and high antibody secretion rate, plasmablasts are key indicators of ongoing immune activity, making their assessment valuable for monitoring infections, autoimmune activity, and the effectiveness of B cell-targeted therapies.
Optimal range: 1 - 8 cells/mcL
Plasmablasts CD38+IgM- antibodies are immunoglobulins secreted by plasmablasts, a short-lived subset of antibody-secreting cells characterized by high CD38 expression and the absence of surface IgM. These antibodies, predominantly of the IgG, IgA, or IgE isotypes, are produced through class-switch recombination and play a critical role in the early phases of adaptive immunity, providing rapid defense against pathogens. Plasmablasts arise from extrafollicular responses or early germinal center reactions and serve as a bridge between innate immune responses and long-term humoral immunity established by plasma cells. Elevated levels of plasmablast-derived antibodies are associated with acute infections, recent vaccinations, autoimmune diseases such as systemic lupus erythematosus (SLE), and inflammatory conditions, while reduced levels may indicate immunodeficiencies or immunosuppression. These antibodies are also key contributors to mucosal immunity, particularly through IgA production. Measuring plasmablasts CD38+IgM- antibodies offers valuable insights into immune activation, antigen exposure, vaccination efficacy, and autoimmune processes, making them critical markers for immunological assessments and disease monitoring.
Optimal range: 0.9 - 3.7 Ratio
Optimal range: 10 - 33 % of CD19
Total Memory CD27+ % is a key measurement in B cell subset analysis that indicates the proportion of memory B cells within the B cell population. CD27, a tumor necrosis factor receptor family member, serves as a reliable marker for memory B cells and signifies previous antigen exposure and successful immune responses. When measured as a percentage of CD19+ B cells, the typical range in healthy adults is 25-45%. The analysis includes both switched (IgD-CD27+) and non-switched (IgD+CD27+) memory B cells. This marker is clinically significant for assessing various immunological conditions such as Common Variable Immunodeficiency (CVID), autoimmune diseases, and immunosenescence, as well as monitoring treatment responses and immune reconstitution. The percentage typically varies with age, with older adults showing higher values due to accumulated antigen exposure, while younger individuals generally have lower percentages as they are still developing their immunological memory.
Optimal range: 23 - 110 cells/mcL
The Total Memory CD27+ Absolute Count (Abs) measures the number of CD27+ memory T cells in the bloodstream, critical for adaptive immunity and rapid responses to previously encountered pathogens. CD27, a co-stimulatory receptor, is expressed on naive and memory T cells but absent in terminal effector T cells. This marker is significant for assessing immune competence, diagnosing immunodeficiencies (e.g., CVID, HIV/AIDS), monitoring chronic infections (e.g., hepatitis, CMV), autoimmune diseases, and immune recovery after treatments like chemotherapy or transplantation. Abnormal levels may indicate immune dysfunction, active infections, or chronic immune activation. Interpretation should consider clinical context, other immune markers, and additional testing to guide diagnosis and treatment.
Optimal range: 108 - 680 /cumm
In a lymphocyte panel, which is a key tool for evaluating the immune system, Total NK (Natural Killer) cells identified by CD16 and CD56 surface markers play a significant role. NK cells are a distinct subset of lymphocytes, essential for innate immune responses, especially in the early defense against viral infections and tumor cells. These cells are unique as they do not require prior sensitization to recognize and attack abnormal cells. The lymphocyte panel typically measures various lymphocyte populations, including T cells, B cells, and NK cells, to assess immune function and identify potential disorders.
In clinical and diagnostic settings, assessing Total NK cells is important for understanding a patient's immune status. Abnormalities in NK cell numbers or function can be indicative of various conditions, such as immune deficiencies, autoimmune diseases, certain cancers, and responses to viral infections. Therefore, the lymphocyte panel, including the analysis of Total NK cells, is a vital diagnostic tool, helping in the diagnosis, monitoring, and management of a range of immune-related disorders. It also plays a role in the assessment of patients undergoing treatments that affect the immune system, such as chemotherapy, radiation therapy, or immunotherapy, providing crucial information for optimizing treatment strategies.
Optimal range: 0.7 - 5.9 % of CD19
The marker "Transitional CD38+IgM+ %" on a Lymphocyte Subset Panel is an important parameter used in the evaluation of immune system health, specifically focusing on a particular subset of B lymphocytes. This marker identifies transitional B cells, which are a stage of B cell development occurring after they leave the bone marrow and before they become fully mature. CD38 and IgM are both molecules found on the surface of these cells. CD38 is a glycoprotein involved in cell activation and signaling, while IgM is a type of antibody that these cells produce in early stages. The percentage of these transitional CD38+IgM+ B cells among the total lymphocytes provides valuable information about the immune system's status and its ability to respond to infections or other immune challenges. In clinical settings, assessing the proportion of these cells helps in diagnosing and monitoring immune disorders, including certain types of immunodeficiencies and autoimmune diseases. This measurement is especially crucial in evaluating the immune system's maturity and functional capacity in young individuals or in patients undergoing immune restoration therapies.
Optimal range: 1 - 17 cells/mcL
Transitional CD38+IgM+ B cells are an intermediate stage in B cell development, bridging immature B cells in the bone marrow to mature B cells in peripheral lymphoid tissues. Defined by high CD38 expression and surface IgM as their predominant immunoglobulin isotype, these cells play a key role in establishing the initial B cell repertoire, maintaining central tolerance by eliminating autoreactive clones, and contributing to early immune responses. They are subdivided into T1, T2, and T3 subsets, with T1 being the most immature. Dysregulation of transitional B cells is associated with immune imbalances: elevated levels are linked to autoimmune diseases like SLE and rheumatoid arthritis, while reduced levels suggest primary immunodeficiencies such as CVID or XLA. Monitoring transitional CD38+IgM+ B cells provides valuable insights into B cell development, immune reconstitution, and the pathogenesis of immune disorders.
Lyme Disease Serology
Aid in the diagnosis of Lyme disease in individuals with clinical signs and symptoms consistent with Lyme disease. Lyme disease should be considered based on the presence of typical signs and symptoms of infection in patients with a history of possible exposure to infected ticks. This panel utilizes FDA-cleared assays following the modified two-tiered testing (MTTT) algorithm.
Reference range: Non-Reactive, Reactive
Reference range: Positive, Negative
This test measures the level of Borrelia antibodies in your blood. Borrelia burgdorferi bacteria cause Lyme disease.
The bacteria are spread to humans through the bite of an infected tick.
Lyme disease is the most common tick-borne illness in the U.S. If not treated, Lyme disease can cause an infection of the tissues covering the brain and spinal cord (meningitis).
Reference range: Positive, Negative
Two types of antibodies are detected in the Western blot test.
IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign of an older infection.
IgM antibodies usually disappear after eight weeks post-exposure.
IgG remains in the serum for a very long time.
In the Western blot test there are three bands for IgM and 10 bands for IgG.
Reference range: Non-Reactive, Reactive
Reference range: Positive, Negative
The Lyme disease blood test looks for antibodies in the blood to the bacteria that causes Lyme disease. The test is used to help diagnose Lyme disease.
Lyme disease is caused by bacteria called Borrelia burgdorferi. Blacklegged ticks carry these bacteria. The ticks pick up the bacteria when they bite mice or deer that are infected with Lyme disease. You can get the disease if you are bitten by an infected tick, mostly in northeastern states and on the West Coast. The good news is that usually a tick has to be attached to your body for 24 to 36 hours to infect you. The bad news is that blacklegged ticks are so small they're almost impossible to see.
ZRT Laboratory (Salivary Steroids)
Steroid hormones in the bloodstream are 95-99% bound to carrier proteins, and in this form are unavailable to target tissues. Saliva testing measures the amount of hormone available to target tissues – the bioavailable amount. For this reason, saliva testing better relates to specific symptoms of excess or deficiency, and is a good option for monitoring hormone therapy.
Optimal range: 12 - 48 pg/mL
11-deoxycortisol is an adrenal hormone. It is the end product of 17-hydroxyprogesterone (17OHPg) through 21-hydroxylase synthesis and is the immediate precursor of cortisol.
Levels of these cortisol precursors and the enzymes that stimulate cortisol synthesis from them are typically increased when ACTH levels are increased, which can occur with Cushing syndrome, adrenal carcinoma, ACTH-producing tumors, or 11β-hydroxylase deficiency, a more rare form of CAH34 than seen with 21-hydroxylase deficiency, which constitutes > 95% of all CAH cases
Optimal range: 6 - 28 pg/mL
The hormone 17-hydroxyprogesterone is produced by the adrenal glands. 17-OHPg is converted to cortisol, which is released in varying amounts, but at particularly high levels during times of physical or emotional stress. A cortisol deficiency can occur in certain people which can lead to an increase in 17-OH progesterone in the blood. LCMS saliva testing has allowed accurate determination of 17-OH progesterone along with other androgens, correlating with serum levels and allowing useful steroid profiling in disorders of steroid metabolism19. High levels of 17-OHPg can indicate CAH. CAH is a glandular disorder that results in the adrenal glands being unable to create enough cortisol, which may consequently increase the production of DHEA and testosterone.
Optimal range: 41 - 130 pg/mL
7-keto DHEA (also known as 7-oxo DHEA) is a steroid produced by metabolism of DHEA.
It is not directly converted to testosterone or estrogen.
7-keto DHEA is rapidly absorbed when given as a supplement and converted to its sulfate derivative. It is commonly used to produce the metabolic effects of DHEA while avoiding metabolism into estrogens or androgens, and clinical research supports its role in benefiting metabolism and weight management. Endogenous 7-keto DHEA may have some anticortisol activity through enzyme competition which in the case of hypercortisolism may be beneficial to the adverse effects of cortisol on metabolic syndrome. Most studies on 7-keto DHEA are on improving the metabolic rate where there appears to be improvement in metabolism despite being on a low caloric diet. There is also limited information that 7-keto DHEA may act to increase levels of T3 while patients are on a caloric restricted diet.
Optimal range: 16 - 63 pg/mL
Aldosterone is a mineralcoritcoid and a hormone. It allows the transport of sodium across the cell membrane. This is especially important in the kidney (distal tubule). Because of its function, aldosterone is important in blood pressure regulation and also for the volume of blood found in the blood vessels. Potassium is an antagonist to sodium. If potassium is high, sodium levels will be low. When potassium is found high in the plasma of the blood, the adrenals step in and synthesize aldosterone. The synthesis of aldosterone is taken care of in the body primarily by the renin-angiotensin system.
Optimal range: 0 - 111.5 pg/mL
Allopregnanolone, also known as brexanolone, is a medication and a naturally produced steroid that acts on the brain. Allopregnanolone possesses a wide variety of effects, including, in no particular order, antidepressant, anxiolytic, stress-reducing, rewarding, prosocial, antiaggressive, prosexual, sedative, pro-sleep, cognitive, memory-impairment, analgesic, anesthetic, anticonvulsant, neuroprotective, and neurogenic effects.
Optimal range: 0 - 5 pg/mL
Anastrozole is a medication that inhibits the enzyme aromatase to suppress testosterone conversion to estrogens.
Anastrozole is used in combination with other treatments for suppressing testosterone conversion to estrogens. It can be used in combination with other treatments, typically men using testosterone therapy to prevent conversion to estrogens; and in breast cancer and prostate cancer patients to inhibit endogenous estrogen production that could stimulate estrogen-sensitive tumor growth. It is most often used for hormone-receptive breast cancer.
It works by binding to the aromatase enzyme and blocking the conversion of androgens to estrogens in peripheral tissues. Off-label it is commonly used to decrease the production of estrogen in men and is also used as part of a treatment plan for women with endometriosis.
Optimal range: 36 - 93 pg/mL
Androstenedione is secreted predominantly by the adrenal gland and production is controlled, in part, by adrenocorticotropic hormone (ACTH). It is also produced in the testes and ovaries from DHEA-S. It is a weak androgen and an intermediate in the biosynthesis of testosterone and estrone from DHEA. It has been found to have some estrogenic activity.
Androstenedione is converted to estrone by the action of aromatase in fat tissue.
Optimal range: 11 - 66 pg/mL
Corticosterone, also known as 17-deoxycortisol, is a steroid hormone of the corticosteroid type produced in the cortex of the adrenal glands. Corticosterone has multiple effects on memory. The main effects are seen through the impact of stress on emotional memories as well as long term memory. With emotional memories, corticosterone is largely associated with fear memory recognition. Not only does corticosterone have effects on emotional memories but memory recognition and consolidation as well.
Optimal range: 0.6 - 1.9 ng/mL
Cortisol is produced by the adrenal glands in response to stressors, both daily (e.g. waking up, low blood sugar) and unusual (e.g. emotional upset, infections, injury, surgery). Cortisol levels are highest in the morning, and then drop steadily throughout the day to their lowest point during sleep.
Cortisol is essential in regulating and mobilizing the immune system against infections and reducing inflammation. It helps to mobilize glucose, the primary energy source for the brain, and maintain normal blood sugar levels. While normal levels of cortisol are essential for life and optimal functioning of other hormones, particularly thyroid hormone, chronically elevated levels can be detrimental to health. Stress and persistently elevated cortisol levels can contribute to premature aging and chronic illness.
Optimal range: 2.5 - 6.2 ng/mL
Under the direction of the hypothalamus and pituitary, and controlled by a negative feedback loop, the zona fasciculata of the adrenal cortex is stimulated to produce cortisol in response to circadian peaks and troughs in ACTH synthesis in addition to various types of stressors such as emotional/psychological, physical (injury, exercise), chemical, pathological (viruses, bacteria, etc.).
The feedback loop is commonly referred to as the hypothalamic-pituitary-adrenal (HPA) axis.
In a normal nonstressed state cortisol production is at its highest upon waking and declines steadily during the day, reaching its lowest point at bedtime.
Optimal range: 0.4 - 1 ng/mL
Cortisol is produced by the adrenal glands in response to stressors, both daily (e.g. waking up, low blood sugar) and unusual (e.g. emotional upset, infections, injury, surgery). Cortisol levels are highest in the morning, and then drop steadily throughout the day to their lowest point during sleep.
Cortisol is essential in regulating and mobilizing the immune system against infections and reducing inflammation. It helps to mobilize glucose, the primary energy source for the brain, and maintain normal blood sugar levels. While normal levels of cortisol are essential for life and optimal functioning of other hormones, particularly thyroid hormone, chronically elevated levels can be detrimental to health. Stress and persistently elevated cortisol levels can contribute to premature aging and chronic illness.
Optimal range: 1.2 - 3 ng/mL
Cortisol is produced by the adrenal glands in response to stressors, both daily (e.g. waking up, low blood sugar) and unusual (e.g. emotional upset, infections, injury, surgery). Cortisol levels are highest in the morning, and then drop steadily throughout the day to their lowest point during sleep.
Cortisol is essential in regulating and mobilizing the immune system against infections and reducing inflammation. It helps to mobilize glucose, the primary energy source for the brain, and maintain normal blood sugar levels. While normal levels of cortisol are essential for life and optimal functioning of other hormones, particularly thyroid hormone, chronically elevated levels can be detrimental to health. Stress and persistently elevated cortisol levels can contribute to premature aging and chronic illness.
Optimal range: 10 - 23.3 ng/mL
Salivary cortisone is an inert form of cortisol, as is estrone to estradiol.
Simultaneous testing for cortisol and cortisone assists in diagnosing acquired or inherited abnormalities of 11β-hydroxy steroid dehydrogenase, affecting the cortisol to cortisone ratio.
Deficiency of 11β-HSD results in a state of mineralocorticoid excess because cortisol, not cortisone, acts as a mineralocorticoid receptor agonist.
Optimal range: 77 - 287 pg/mL
Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is the precursor for estrogens and testosterone, and is therefore normally present in significantly greater quantities than all the other steroid hormones. It is mostly found in the circulation in the form of its sulfate ester, DHEA sulfate (DHEA-S), levels of which in saliva are higher and more stable than those of DHEA. Its production is highest in the late teens to early 20s and declines gradually with age in both men and women.
Optimal range: 0.8 - 8 ng/mL
Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is the precursor for estrogens and testosterone, and is therefore normally present in significantly greater quantities than all the other steroid hormones. It is mostly found in the circulation in the form of its sulfate ester, DHEA sulfate (DHEA-S), levels of which in saliva are higher and more stable than those of DHEA. Its production is highest in the late teens to early 20s and declines gradually with age in both men and women.
Optimal range: 2 - 23 ng/mL
Levels of DHEA-S reflect adrenal gland function.
Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is the precursor for estrogens and testosterone, and is therefore normally present in significantly greater quantities than all the other steroid hormones.
Optimal range: 0 - 7 pg/mL
Dihydrotestosterone is an endogenous androgen that is formed from testosterone via 5α-reductase activity in certain tissues including the prostate gland, seminal vesicles, epididymis, skin, hair follicles, liver, and brain.
DHT, relative to testosterone, is more potent as an agonist of the androgen receptor. Inhibition of 5α-reductase activity to reduce prostatic DHT levels is used to treat benign prostatic hyperplasia (BPH).
DHT has been used clinically as treatment for low testosterone levels in men. DHT is biologically important for sexual differentiation of the male genitalia during embryogenesis.
Circulating levels of DHT are low in relation to testosterone. Deficiency in 5α-reductase results in incompletely virilized males which is clinically supported by an elevated ratio of testosterone to DHT.
Optimal range: 0.5 - 1.7 pg/mL
Estradiol, the most potent of the three primary estrogens (estradiol, estrone, and estriol), plays an essential role in maintaining the health of nearly every tissue in the body, in particular the reproductive tissues, brain, skin, bone, liver, and cardiovascular system. Physiological levels of estradiol formed cyclically with natural progesterone throughout a woman’s premenopausal years maintain the health and youthfulness of these tissues.
Menopause results in the loss of ovarian estrogen production and a consequent drop in circulating levels of estradiol. If, during menopause, estradiol drops well below the lower end seen in premenopausal women, this can be associated with adverse effects in the reproductive tissues (incontinence, vaginal dryness), brain (lowered neurotransmitters, increased hot flashes and night sweats), skin (more rapid aging), bone (accelerated loss and greater risk for osteoporosis and fracture), liver (compromised hormone metabolism and reduced synthesis of hormone binding globulins, reducing the circulating half-lives of hormones that are bound to them), and cardiovascular system (increased risk for insulin resistance, diabetes, and cardiovascular disease).
Optimal range: 1.3 - 3.3 pg/mL
Estradiol is the predominant, and the most potent, circulating estrogen. Bioavailable estradiol, which represents about 2% of the total protein-bound estradiol in the bloodstream , exits the bloodstream in capillary beds and enters target cells such as the brain, breasts, uterus, bone and heart.
Optimal range: 0 - 1.9 pg/mL
Estriol is the weakest of the three major naturally-occurring estrogens in women. It is a product of the metabolism of estrone and estradiol and is excreted in the urine in greater amounts than estradiol. Because of its weak estrogenic activity, estriol is sometimes preferred for intravaginal use as an alternative to systemic estrogen therapy for the treatment of urogenital atrophy in postmenopausal women. It is also used in anti-aging skin creams as a form of topical estrogen replacement to counteract the effects of age-related estrogen loss on skin.
Estriol is the major estrogen found in the maternal circulation during pregnancy; 90% of this circulating estriol is the product of metabolism of DHEA from the fetal adrenals, and so maternal estriol levels are used as an indicator of fetal health. In non-pregnant women, estriol levels are similar in both pre– and post-menopause, and are also similar to levels in men. The saliva test for estriol has been found to be predictive of increased risk of preterm labor in pregnant women. In non-pregnant women it is most commonly used for monitoring of levels in women using estriolcontaining supplements as part of hormone replacement therapy.
Optimal range: 0 - 3 pg/mL
Estriol is the weakest of the three major naturally-occurring estrogens in women.
Estriol is a product of the metabolism of estrone and estradiol. Because of its weak estrogenic activity, estriol is sometimes preferred for intravaginal use as an alternative to systemic estrogen therapy for the treatment of urogenital atrophy in postmenopausal women.
It is also used in anti-aging skin creams as a form of topical estrogen replacement to counteract the effects of age-related estrogen loss on skin. Estriol is the major estrogen found in the maternal circulation during pregnancy; 90% of this circulating estriol is the product of metabolism of DHEA from the fetal adrenals, and so maternal estriol levels are used as an indicator of fetal health.
In non-pregnant women, estriol levels are similar in both pre- and post-menopause and are also similar to levels in men. Salivary estriol has been found to be predictive of increased risk of preterm labor in pregnant women. In nonpregnant women, it is most commonly used for monitoring of levels in women using estriol-containing supplements as part of hormone replacement therapy.
Optimal range: 0.9 - 3.1 pg/mL
Estrone is one of three main circulating estrogens in humans. Like estradiol, estrone is secreted by the ovaries, but it is also predominantly produced in peripheral tissues by the action of aromatase on its precursor androstenedione. Its estrogenic activity is intermediate to that of estriol, the weakest estrogen, and estradiol, the strongest. Estrone is converted to the more potent estradiol in tissues by the action of 17β-hydroxysteroid dehydrogenase, and through this conversion it represents the main source of circulating estradiol in postmenopausal women and in men.
Estrone is the predominant circulating estrogen in postmenopausal women, compared to estradiol which predominates in premenopausal women. This is because ovarian estradiol production declines significantly post-menopause while estrone production from androstenedione changes minimally compared to premenopause. The aromatization of androstenedione to estrone increases with increased body weight, since aromatase is prevalent in fat tissue. This increased availability of estrone contributes to the rise in circulating estradiol with increasing body mass index in obese postmenopausal women.
Optimal range: 3.2 - 7.9 pg/mL
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, since it is the least powerful of the three estrogen types, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers and estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 0 - 0.4 pg/mL
Ethinyl estradiol is an estrogen receptor agonist commonly used in combined oral contraceptives. It is a synthetic derivative of estradiol. In the liver it stimulates the synthesis of SHBG, increasing SHBG levels by 2- to 4-fold in women, which has the effect of binding more circulating testosterone and reducing free testosterone concentrations by 40-80%. The suppression of free testosterone levels may impact female sexual desire.
Optimal range: 0 - 5 pg/mL
Finasteride is a 5α-reductase inhibitor used to block the formation of the potent androgen DHT from its precursor, testosterone. It is used to treat benign prostatic hyperplasia as well as male pattern baldness in men and women, and excessive facial or body hair growth in women.
Serum testosterone levels increase as a result of the reduced conversion to DHT, but the increase is not usually outside the normal range
. Treatment with finasteride has been linked with sexual side effects.
Optimal range: 0 - 5 pg/mL
Letrozole is an aromatase inhibitor used as an adjuvant treatment for hormone-dependent breast cancer. It inhibits peripheral estrogen production in fat tissues, where it prevents the conversion of testosterone into estradiol. It has similar safety and efficacy to anastrozole.
Optimal range: 3 - 22 pg/mL
Melatonin is a hormone that is produced from the pineal gland in a circadian pattern and plays a role in the initiation of sleep.
The production and release of this hormone is connected to the time of day, ideally increasing when it is dark and decreasing when it is light. Melatonin and cortisol follow opposite circadian patterns but are not cross-regulated in a negative feedback manner.
The production of melatonin decreases with age.
Treatment with melatonin may be useful in people with circadian rhythm sleep disorders, such as delayed sleep phase disorder, jet lag, shift worker disorder, and the non-24-hour sleep-wake disorder most commonly found in totally blind individuals.
Optimal range: 1 - 23 pg/mL
Pregnenolone sulfate is a neurosteroid that enhances the glutamate N-methyl-D-aspartate (NMDA)-receptor function and inhibits receptors for glycine, GABA, thereby regulating the excitation-inhibition balance in the CNS.
It enhances learning and memory and promotes nerve cell survival. Along with other endogenous neurosteroids, it has been implicated in the development of neuropsychiatric disorders such as schizophrenia, depression, and anxiety. Trials of the therapeutic use of pregnenolone, the precursor of pregnenolone sulfate, in schizophrenia have shown some success. Low plasma levels of pregnenolone sulfate have been observed in people with generalized social phobia.
Optimal range: 12 - 100 pg/mL
Progesterone is manufactured in the ovaries at about 10-30 mg of progesterone each day during the latter half of the menstrual cycle (luteal phase). Younger women with regular cycles generally make adequate progesterone, consistent with their having fewer symptoms of estrogen excess. Progesterone is important in normal menstrual cycles, breast development, maintaining pregnancy, relaxing blood vessels and influencing neurotransmitters in the brain.
Optimal range: 75 - 270 pg/mL
Progesterone’s primary function during the menstrual cycle is to induce a secretory endometrium ready for implantation of a fertilized egg. Levels therefore increase during the luteal phase of the cycle after ovulation. If no implantation occurs, progesterone returns to follicular phase levels.
Optimal range: 126 - 2265 pg/mL
Progesterone’s primary function during the menstrual cycle is to induce a secretory endometrium ready for implantation of a fertilized egg.
Levels therefore increase during the luteal phase of the cycle after ovulation.
If no implantation occurs, progesterone returns to follicular phase levels. If a pregnancy results, progesterone continues to rise to very high levels and carries out a variety of functions necessary to sustain the pregnancy.
In some patients with infertility, ovulation may occur but luteal phase levels of progesterone are inadequate. Luteal phase deficiency is a result of inadequate progesterone production by the corpus luteum.
During menopause, ovarian progesterone production dwindles, resulting in postmenopausal levels similar to those seen in men.
Progesterone has wide-ranging physiological effects, including neuroprotection, maintenance of skin elasticity, and development of bone tissue. Progesterone also counteracts the proliferative effects of estrogen on the endometrium. When samples are collected after transdermal application of progesterone, saliva progesterone levels are higher than serum, indicating distribution of progesterone to tissues.
Optimal range: 0.5 - 2 Ratio
Optimal range: 100 - 500 Ratio
Optimal: 100-500 when E2 1.3-3.3 pg/mL
Optimal range: 23 - 196 Ratio
This ratio is helpful when both E2 and Pg are within range, yet the patient continues to have symptoms. It is not expected to be normal or used clinically when either E2 and/or Pg are outside of their expected ranges or if the patient does not have clinical symptoms.
Is the ratio relevant in women using hormone therapy?
With some types of hormone therapy such as topical progesterone, Pg levels in saliva are much higher than endogenous luteal phase levels, ranging from 200-3000 pg/mL at 12-24 hours after dosing, and so the ratio can appear high. However, because symptoms of both estrogen dominance and progesterone dominance can look the same, testing and assessing the ratio along with clinical symptoms can help determine the next step for treatment.
Optimal range: 7 - 22 pg/mL
In men, levels of testosterone begin to decline with age, usually beginning around the mid-40s. The decline in testosterone production by the testes can be more precipitous in some men than others.
Excessive weight gain, stress, lack of exercise, and many medications can further reduce testosterone levels, leading to symptoms that include low libido, irritability, depression, loss of muscle mass and strength, weight gain, erectile dysfunction, osteoporosis, and adverse changes in the blood lipid profile.
Testosterone levels in saliva are an accepted method for assessment of hypogonadism in men.
In women, high testosterone, often caused by ovarian cysts, leads to conditions such as excessive facial and body hair, acne, and oily skin and hair.
Low testosterone in postmenopausal women, seen particularly after surgical removal of the ovaries, leads to female symptoms of androgen deficiency including loss of libido, thinning skin, vaginal dryness, and loss of bone and muscle mass.
Optimal range: 16 - 55 pg/mL
Testosterone levels in saliva are an accepted method for assessment of hypogonadism in men. In women, high testosterone, often caused by ovarian cysts, leads to conditions such as excessive facial and body hair, acne, and oily skin and hair. Low testosterone in postmenopausal women, seen particularly after surgical removal of the ovaries, leads to female symptoms of androgen deficiency including loss of libido, thinning skin, vaginal dryness, and loss of bone and muscle mass.
NutrEval Plasma - Urine and Blood
The NutrEval Profile is a cutting-edge diagnostic tool designed to uncover the root causes of dysfunction in the body. It offers health practitioners unparalleled insights into nutritional deficiencies, biochemical imbalances, and metabolic dysfunctions, enabling targeted interventions that promote optimal health and prevent chronic conditions. Recognized as one of the most comprehensive nutritional evaluations available, NutrEval empowers patients and clinicians alike with actionable information for long-term wellness.
The NutrEval test examines a wide range of biomarkers to evaluate key aspects of health, including macronutrient and micronutrient status, digestion, energy production, detoxification, and oxidative stress. Key areas assessed include:
Indicators of metabolic and digestive function, revealing insights into energy production and gut health.
Measures essential and nonessential amino acids, assessing protein metabolism and absorption critical for muscle, brain, and immune function.
Evaluates essential fatty acid intake and metabolism, highlighting inflammation balance and cellular health.
Identifies imbalances between free radicals and antioxidants, which play a role in aging, chronic disease, and cellular damage.
Assesses essential minerals (e.g., magnesium, zinc) and exposure to heavy metals (e.g., mercury, lead), offering a complete picture of nutrient status and potential toxicity.
The NutrEval Profile uses an integrative, systems-based approach to assess over 125 biomarkers from a simple blood and urine sample. This comprehensive data supports clinicians in creating personalized treatment plans for various health concerns.
The NutrEval test is ideal for individuals experiencing health challenges related to nutrient imbalances or metabolic dysfunction. It’s especially beneficial for patients with:
For patients not requiring a full evaluation, the NutrEval Profile offers subpanels for targeted assessments, including:
These subpanels allow for focused insights into specific areas of concern, making it easier to design precise treatment strategies.
The NutrEval Profile combines intracellular, extracellular, direct, and functional measurements to provide a holistic view of nutritional health. Unlike standard nutrient tests, NutrEval synthesizes data from multiple biomarkers to create a detailed picture of biochemical and metabolic imbalances. Its proprietary algorithm generates personalized nutrient recommendations based on your unique results, ensuring precision in treatment.
The ultimate goal of the NutrEval Profile is to empower individuals to achieve optimal health by addressing the underlying nutritional and biochemical imbalances hindering their wellness. With tailored interventions, healthcare providers can help patients improve digestion, energy production, detoxification, and overall vitality.
For those seeking a comprehensive and individualized nutritional assessment, the NutrEval test is an indispensable resource for promoting long-term health and preventing chronic disease.
Take control of your well-being by identifying and addressing nutritional imbalances. Speak with your healthcare provider about how the NutrEval Profile can help you achieve better health and vitality.
Optimal range: 0 - 3.85 Units
1-methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 0 - 0.78 Units
Both 1-methylhistidine and 3-methylhistidine are histidine metabolites which have been proposed as markers of meat intake.
Note that some confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
3-methylhistidine is a constituent of actin and myosin, the contractile proteins of skeletal muscles. Urinary excretion of 3-methylhistidine may be a result of muscle breakdown or consumption of meat fibers. Unlike 1-methylhistidine, 3-methylhistidine has been shown to increase in fasting states indicating catabolism of muscle tissue. Therefore, this marker is more variable with regards to animal protein consumption.
Optimal range: 1.76 - 9.99 Units
Alpha-Amino-N-butyric acid (α-ANB), also known as alphaaminobutyric acid, is a nonessential amino acid derived from the catabolism of methionine, threonine, and serine.
α-ANB is both formed and metabolized by reactions which require vitamin B6 as a cofactor.
Optimal range: 0 - 0.28 Units
Alpha-aminoadipic acid (also known as 2-aminoadipic acid) is an intermediary biomarker of lysine and tryptophan metabolism. The further metabolism of alpha-aminoadipic acid to alpha-ketoadipic acid requires vitamin B6.
Plasma alpha-aminoadipic acid is strongly associated with the risk of developing diabetes as seen in an assessment of the Framingham Heart Study data. Circulating levels were found to be elevated for many years prior to the onset of diabetes.
Preclinical data shows it may also play a role in oxidation and atherosclerotic plaque formation.
Optimal range: 19 - 62 Units
Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine.
It is found in many foods including eggs, meat, lentils, and fish.
Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.
Optimal range: 4.1 - 17.5 Units
Arginine is found in all protein foods and is very abundant in seeds and nuts. It is considered a semi-essential amino acid during early development, infection/inflammation, or renal and/or intestinal impairment. It has many functions in the body including:
- ammonia disposal in the urea cycle
- immune function
- stimulation of insulin release
- muscle metabolism (creatine/creatinine precursor)
- nitric oxide (NO) formation
- glutamic acid and proline formation
- glucose/glycogen conversion
- stimulation of the release of growth hormone, vasopressin, and prolactin
- wound healing
Because arginine is a precursor for nitric oxide synthesis, it is often used therapeutically in cardiovascular disease for its vasodilatory effects.
Optimal range: 3.5 - 11.6 Units
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name.
Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body.
Optimal range: 0 - 0.67 Units
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets.
It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 0 - 0.7 Units
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. And carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors. For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance.
Optimal range: 0 - 0.72 Units
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA.
Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys.
β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 1.6 - 5.7 Units
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified.
It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins.
Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine.
Optimal range: 5.9 - 19.9 Units
Cysteine is a nonessential sulfur-containing amino acid. It is obtained from the diet and is also endogenously made from the intermediate amino acid cystathionine.
Dietary cysteine sources include poultry, eggs, beef, and whole grains.
This amino acid should not be confused with the oxidized derivative of cysteine called cystine. Cystine is formed by combining two cysteine molecules within a redox reaction.
The urinary FMV amino acid test reports cysteine and cystine separately.
The plasma amino acid test combines both cysteine and cystine as one biomarker called "Cyst(e)ine".
Optimal range: 0 - 0.09 Units
Cystathionine is an intermediate dipeptide within the process of transsulfuration.
Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle.
Optimal range: 0.19 - 0.78 Units
Ethanolamine is an intermediary metabolite in the serine-to-choline sequence. It can be used to synthesize phosphatidylethanolamine (PE), a very important membrane phospholipid. Ethanolamine is not only a precursor, but also a breakdown product of PE. Ethanolamine is abundant in both intestinal and bacterial cell membranes. It plays a significant role in the renewal and proliferation of intestinal cells and intestinal inflammation.
Also, since ethanolamine plays a structural role in skeletal muscle cell membranes, some evidence suggests it may be a marker of skeletal muscle turnover.
Optimal range: 0 - 0.06 Units
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania.
Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution.
Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production. Endogenous GABA is produced by the decarboxylation of the excitatory neurotransmitter glutamic acid. It can also be produced from the diamine putrescine using diamine oxidase (DAO).
Optimal range: 2 - 14.5 Units
Glutamic acid is a nonessential amino acid is derived from the diet and from the breakdown of gut proteins. Glutamate is a major excitatory neurotransmitter in the brain.
It plays a role in neuronal differentiation, migration, and survival in the developing brain. It is also involved in synaptic maintenance, neuroplasticity, learning, and memory.
Glutamate is present in many foods including cheese, seafood, meat, and spinach.
In spite of intake, the total pool of glutamic acid in the blood is small, due to its rapid uptake and utilization by tissues including muscle and the liver (which uses it to form glucose and lactate).
Optimal range: 41 - 111 Units
Glutamine is a nonessential amino acid and is the most abundant amino acid in the body. It is formed from glutamate using the enzyme glutamine synthetase.
Approximately 80% of glutamine is found in the skeletal muscle, and this concentration is 30 times higher than the amount of glutamine found in human plasma. Although glucose is used as fuel for many tissues in the body, glutamine is the main fuel source for a large number of cells including lymphocytes, neutrophils, macrophages, and enterocytes.
Optimal range: 5 - 23 Units
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine.
It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins.
Glycine is a major collagen and elastin component, which are the most abundant proteins in the body.
Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Glycine is the precursor to various important metabolites such as porphyrins, purines, heme, and creatine. It acts both as an inhibitory neurotransmitter in the CNS and as an excitatory neurotransmitter on N-methyl-D-aspartate (NMDA) receptors.
Optimal range: 6.5 - 13.3 Units
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine.
Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
With this, decreased amounts of histidine and insufficient vitamin B6 can subsequently lead to a decrease in histamine concentration. This may impair digestion, since histamine binds to H2 receptors located on the surface of parietal cells to stimulate gastric acid secretion, necessary for protein breakdown.
Histidine also inhibits the production of proinflammatory cytokines by monocytes and is therefore anti-inflammatory and antioxidant.
With these beneficial effects, histidine supplementation has been shown to improve insulin resistance, reduce BMI, suppress inflammation, and lower oxidative stress in obese women with metabolic syndrome.
Interestingly, histadine can also be broken down to form urocanic acid in the liver and skin. Urocanic acid absorbs UV light and is thought to act as a natural sunscreen.
Optimal range: 4.09 - 17.43 Units
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs).
Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Not only do the BCAAs account for almost 50% of muscle protein, but they have many metabolic functions.
BCAAs act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, and the immune response. They are also involved in stimulation of albumin and glycogen synthesis, improvement of insulin resistance, inhibition of free radical production, and hepatocyte apoptosis with liver regeneration.
Optimal range: 9 - 25.3 Units
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs).
Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Not only do the BCAAs account for almost 50% of muscle protein, but they have many metabolic functions.
BCAAs act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, and the immune response. They are also involved in stimulation of albumin and glycogen synthesis, improvement of insulin resistance, inhibition of free radical production, and hepatocyte apoptosis with liver regeneration.
Optimal range: 13.7 - 34.7 Units
Lysine is a nutritionally essential amino acid abundant in meat, fish, fowl, and legumes and is needed for formation of body proteins and enzymes.
Lysine can be methylated using S-adenosylmethionine (SAM) to synthesize carnitine, which is needed for fatty acid oxidation. Lysine also generates Acetyl CoA for use in the citric acid cycle. Lysine, proline, hydroxyproline, and vitamin C are important in the synthesis of collagen for skin, bones, tendons and cartilage.
L-lysine supplementation has also been studied for herpes simplex treatment and prophylaxis and may be beneficial.
Optimal range: 2.3 - 6.5 Units
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds.
Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 4.38 - 15.42 Units
Ornithine is an intermediate nonprotein-forming amino acid of the urea cycle.
Arginine is converted to ornithine via the arginase enzyme, with urea as a byproduct. Ornithine combined with carbamoyl phosphate is then converted into citrulline via the ornithine transcarbamylase (OTC) enzyme. The contribution of carbamoyl phosphate results from the metabolism of ammonia by the enzyme carbamoyl phosphate synthase, and if this magnesium-dependent process is impaired, ammonia buildup, or hyperammonemia can occur.
Ornithine can also form polyamines including putrescine via the ornithine decarboxylase (ODC) enzyme, which requires pyridoxal-5-phosphate (vitamin B6) as a cofactor.
Putrescine and other polyamines are crucial to the growth and proliferation of cells.
Optimal range: 6.07 - 17.46 Units
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy.
Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 0.09 - 0.57 Units
Phosphoethanolamine is an intermediate in the serineto-choline sequence. It is both a precursor and byproduct of phospholipid biosynthesis and breakdown. As a precursor to the phospholipid phosphatidylethanolamine, phosphoethanolamine plays a key role in myelination.
Optimal range: 0 - 0.39 Units
Phosphoserine is the phosphorylated ester of the amino acid serine. The addition of a phosphoryl group to an amino acid, or its removal, plays a role in cell signaling and metabolism. Phosphoserine is a byproduct of glycolysis and subsequent intermediate to then become serine. The enzyme that catalyzes this step, phosphoserine phosphatase, is magnesium dependent.
This metabolite is not to be confused with a similar-sounding metabolite, phosphatidylserine; this is a common CNS supplement and essential for neuronal cell membranes.
Optimal range: 11 - 57 Units
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid.
Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage.
Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn.
Optimal range: 0 - 0.15 Units
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine. It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents. In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess.
Optimal range: 2.1 - 7 Units
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats.
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons.
In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 4.41 - 10.99 Units
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins.
In most tissues, it remains a free amino acid. Taurine’s highest concentration is in muscle, platelets, and the central nervous system.
Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
Optimal range: 6.42 - 16.32 Units
Threonine is a large neutral amino acid and a precursor for the amino acid glycine.
Foods that contain relatively high amounts of threonine include cheeses (especially Swiss), meat, fish, poultry, seeds, walnuts, cashews, almonds and peanuts. Threonine gets converted to glycine using a two-step biochemical pathway involving the enzymes threonine dehydrogenase and the vitamin B6-dependent glycine C-acetyltransferase.
Threonine has been studied clinically as a supplement to increase cerebrospinal fluid levels of glycine in patients with spasticity related to neurological conditions such as multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS). Threonine may also play a role in tissue healing and liver health.
Optimal range: 2.65 - 6.67 Units
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP). 5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways.
Serotonin is further metabolized to melatonin via methylation.
Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 4.8 - 17.3 Units
Tyrosine is a conditionally essential amino acid which can come directly from the digestion of dietary protein.
Common food sources include dairy, beans, whole grains, meat, and nuts.
If intake is insufficient, tyrosine can be formed from the essential amino acid phenylalanine using a tetrahydrobiopterin reaction. Tyrosine itself is a precursor to several neurotransmitters including dopamine, epinephrine and norepinephrine. It is also needed to create thyroid hormone and melanin skin pigments.
Optimal range: 216 - 1156 Units
Urea is a nontoxic byproduct of nitrogen (ammonia) detoxification. It is formed in the liver via the urea cycle and is the end product of protein metabolism. It is essentially a waste product with no physiological function.
Optimal range: 18.3 - 42.6 Units
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs).
Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Not only do the BCAAs account for almost 50% of muscle protein, but they have many metabolic functions.
BCAAs act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, and the immune response. They are also involved in stimulation of albumin and glycogen synthesis, improvement of insulin resistance, inhibition of free radical production, and hepatocyte apoptosis with liver regeneration.
OmegaQuant
OmegaQuant is an independent, CLIA-certified lab that offers Omega-3 Index, Vitamin D, Prenatal DHA and Mother’s Milk DHA testing to researchers, clinicians and the public.
Optimal range: 2.5 - 11 Units
Only one omega-6 fatty acid, arachidonic acid (AA), and one omega-3 fatty acid, eicosapentaenoic acid (EPA), make up the AA:EPA ratio. The desirable range for the AA:EPA ratio is 2.5:1 – 11:1. The desirable ranges for the ratio were calculated to correspond to the desirable range for the Omega-3 Index due to the strong relationship among these metrics.
Optimal range: 3.1 - 5.1 Units
Omega-6:Omega-3 (n6:n3) ratio is calculated by dividing the sum of seven omega-6 fatty acids by the sum of four omega-3 fatty acids in whole blood. Only one omega-6 fatty acid, arachidonic acid (AA), and one omega-3 fatty acid, eicosapentaenoic acid (EPA), make up the AA:EPA ratio. The desirable range for the Omega-6:Omega-3 ratio is 3:1 to 5:1, and the desirable range for the AA:EPA ratio is 2.5:1 – 11:1. The desirable ranges for the ratios were calculated to correspond to the desirable range for the Omega-3 Index due to the strong relationship among these metrics.
Optimal range: 8 - 12 %
The Omega-3 Index is the proportion of long-chain omega-3s, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), of all fatty acids in your red blood cell membranes. It reflects the omega-3 status of your body over the last 4 months, similar to how hemoglobin A1C reflects long-term glucose blood levels. As a part of an overall healthy lifestyle, an Omega-3 Index in the 8-12% range may help to maintain heart, brain, eye and joint health.
Optimal range: 0 - 1 %
The Trans Fat Index is the percent of 18:1 and 18:2 trans fatty acids of total fatty acids in red blood cell membranes, and the desirable range is <1%.
Trans fatty acids (or trans fats) in our blood come only from the food we eat because our bodies cannot make them.
Trans fats in the diet come from two sources:
1) industrial production by the "partial hydrogenation" of vegetable oils, in which liquid oils are converted into solid fats to be used in processed foods,
2) meat and milk products of ruminant animals, like cows and goats.
The fattyacids that make up the Trans Fat Index were chosen because they were typically found in processed foods, but a small amount may come from ruminant sources.
Environmental Toxins
Environmental toxins, technically called toxicants, are substances produced endogenously from the human body and which, when absorbed, inhaled, or ingested, can cause acute or chronic toxic overload, which may manifest in a variety of biological organ, tissue, and cellular-level systems.
Environmental toxins are cancer-causing chemicals and endocrine disruptors, both human-made and naturally occurring.
Susceptibility to toxic overload varies person-to-person, and can be affected by a variety of factors including:
Optimal range: 0 - 1005 mcg/g
2-Hydroxyisobutyric acid is formed endogenously as a product of branched-chain amino acid degradation and ketogenesis. This compound is also the major metabolite of gasoline octane enhancers such as MTBE and ETBE.
Optimal range: 0 - 74 mcg/g
Methylhippuric Acids (MHAs) are metabolites of xylene (dimethylbenzenes).
Xylenes are widely used as solvents in products including paints, detergents, pesticides, fuel, perfumes, and exhaust fumes.
The main effect of inhaling xylene vapor is depression of the central nervous system (CNS), with symptoms such as headache, dizziness, nausea, and vomiting.
Long-term exposure may lead to irritability, depression, insomnia, agitation, extreme tiredness, tremors, hearing loss, impaired concentration, and short-term memory loss.
A condition called chronic solvent-induced encephalopathy, commonly known as "organic solvent syndrome" has been associated with xylene exposure.
Optimal range: 0 - 74 mcg/g
Since 4-methylhippuric acid (4-MHA) is a metabolite of p-xylene, the measurement of 4-MHA in urine may be correlated to a subject's level of xylene exposure.
Optimal range: 0 - 5.2 mcg/g
Organophosphates are one of the most toxic groups of substances in the world, primarily found in pesticide formulations. They are inhibitors of cholinesterase enzymes, leading to overstimulation of nerve cells, causing sweating, salivation, diarrhea, abnormal behavior, including aggression and depression. Children exposed to organophosphates have more than twice the risk of developing pervasive developmental disorder (PDD), an autism spectrum disorder. Maternal organophosphate exposure has been associated with various adverse outcomes including having shorter pregnancies and children with impaired reflexes.
Optimal range: 0 - 6.1 mcg/g
Ethylparaben belongs to the paraben family and is an anti-fungal agent often used in a variety of cosmetics and personal-care products. It is also used as a food preservative. Although parabens are generally considered safe when used in low percentages, a study claimed to have found a link between parabens and breast cancer.
Optimal range: 0 - 5 mcg/g
MEHP is a metabolite of Bis(2-ethylhexyl)phthalate (DEHP) which belongs to the most common environmental toxin phthalates.
Phthalates, often known as plasticizers, are a group of chemicals used to make plastics more flexible and harder to break. They are widely used in:
- cosmetics,
- adhesives,
- detergents,
- lubricating oils,
- automotive plastics,
- and plastic clothes.
Optimal range: 0 - 11.8 mcg/g
NACE is a metabolite of acrylonitrile, which is used in the production of acrylic fibers, resins, and rubber.
Acrylonitrile is metabolized by the cytochrome P450s and then conjugated to glutathione. Supplementation with glutathione should assist in the detoxification of acrylonitrile.
Optimal range: 0 - 5 mcg/g
NAPR is a metabolite of 1-bromopropane. Chronic exposure can lead to decreased cognitive function and impairment of the central nervous system. Acute exposure can lead to headaches.
1-bromopropane is an organic solvent used for metal cleaning, foam gluing, and dry cleaning. Studies have shown that 1-BP is a neurotoxin as well as a reproductive toxin. Research indicates that exposure to 1-BP can cause sensory and motor deficits. Chronic exposure can lead to decreased cognitive function and impairment of the central nervous system. Acute exposure can lead to headaches.
Optimal range: 0 - 105.6 mcg/g
Styrene is used in the manufacturing of plastics, in building materials, and is found in car exhaust fumes. Polystyrene and its copolymers are widely used as food-packaging materials. The ability of styrene monomer to leach from polystyrene packaging to food has been reported. Occupational exposure due to inhalation of large amounts of styrene adversely impacts the central nervous system, causes concentration problems, muscle weakness, fatigue, and nausea, and irritates the mucous membranes of the eyes, nose, and throat.
Reduce exposure by eliminating plastic and styrofoam containers for cooking, reheating, eating or drinking (especially warm or hot) food or beverages. Replace these containers with glass, paper, or stainless steel whenever possible. Elimination of styrene can be accelerated by sauna treatment, reduced glutathione supplementation (oral, intravenous, transdermal, precursors such as N-acetyl cysteine [NAC]).
Optimal range: 0 - 45 mcg/g
Triclosan is an antibacterial and antifungal agent present in some consumer products, including toothpaste, soaps, detergents, toys, and surgical cleaning treatments.
Humans are exposed to triclosan through skin absorption when washing hands or in the shower, brushing teeth, using mouthwash or doing dishes, and through ingestion when swallowed.
Additional exposure is possible through ingesting plants grown in soil treated with sewage sludge, or eating fish exposed to it. Triclosan has been associated with a higher risk of food allergy. Triclosan has also been found to be a weak endocrine disruptor. Prenatal triclosan exposure was associated with increased cord testosterone levels in the infants.
VibrantAmerica (various)
Vibrant America is a leading science and technology company delivering laboratory services.
Optimal range: 2.5 - 10.9 Ratio
This test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. Balancing these eicosanoids in the body is an excellent way
for managing heart disease and other chronic and inflammatory processes.
Optimal range: 10 - 100 Relative Abundance
Optimal range: 10 - 100 Relative Abundance
Optimal range: 0 - 0.9 Units
Gliadin constitutes a class of proteins that are present in wheat and other cereal which give it the ability to rise properly when baked. The main types of gliadin are alpha, beta, gamma and omega gliadins. Research has suggested that antibody reactivity against all the above mentioned forms of gliadin are found in individuals with ‘Wheat related disorders.’
Optimal range: 0 - 0.9 Units
Alpha-Beta Gliadin IgG is a type of antibody that is produced by the immune system in response to gliadin, a protein found in gluten. Gliadin is commonly found in wheat, barley, and rye and is known to trigger an immune response in individuals with celiac disease or non-celiac gluten sensitivity.
When the immune system detects gliadin in the body, it produces antibodies, including Alpha-Beta Gliadin IgG, to target and neutralize it. Elevated levels of Alpha-Beta Gliadin IgG antibodies in the blood can indicate the presence of an immune response to gliadin and may suggest the presence of celiac disease or non-celiac gluten sensitivity.
Optimal range: 0 - 0.9 Units
Non-gluten proteins constitute about 25% of the total protein content of wheat cereal. Recently it has been shown that these non-gluten proteins are immune-reactive in individuals with wheat sensitivity. The 5 groups of non-gluten proteins which are distinctly different from the gluten proteins that are responsible for inflammation in patients with wheat sensitivity are serpins, purinins, farinins, amylase/protease inhibitors and globulins.
Optimal range: 0 - 0.9 Units
Actin is responsible for regulating paracellular flow across the intestinal epithelium. However, increased levels of actin suggest epithelial cell damage leading to increased intestinal permeability and decreased barrier function.
Optimal range: 0 - 281 U/mL
High levels of lipopolysaccharides (LPS) antibodies are indicative of penetration of LPS into the bloodstream. LPS binds to cells lining the gut and increases synthesis of pro-inflammatory substances.
Optimal range: 0 - 30 Units
High levels of lipopolysaccharides (LPS) antibodies are indicative of penetration of LPS into the bloodstream. LPS binds to cells lining the gut and increases synthesis of pro-inflammatory substances.
Optimal range: 0 - 0.9 Units
Zonulin acts as the gate-keeper between the cells of the intestinal lining in order for nutrients and other essential molecules to be transported in and out of the intestine. However, when leaky gut is present, the intestinal lining is compromised allowing larger protein molecules to get into the bloodstream thereby causing an immune response.
Optimal range: 5.5 - 19.01 %
Arachidonic acid (AA) is a 20-carbon polyunsaturated n-6 fatty acid with 4 double bonds (20:4n6). Its double bonds contribute to cell membrane fluidity and predispose it to oxygenation. This can lead to several important metabolites which ensure a properly functioning immune system as well as regulate inflammation, brain activity, and other signaling cascades. AA’s metabolites are called eicosanoids which are signaling molecules.
Optimal range: 10 - 100 Relative Abundance
Bacillus coagulans (B. coagulans) is a type of probiotic ("good" bacteria). It isn't naturally found in the body, but it produces lactic acid in the gut.
Because B. coagulans produces lactic acid, it's often misclassified as lactobacillus. Unlike lactobacillus, B. coagulans forms spores. Spores are important for telling B. coagulans apart from other lactic acid bacteria.
People take B. coagulans for constipation and irritable bowel syndrome (IBS). It is also used for diarrhea, gas, indigestion, and many other conditions, but there is no good scientific evidence to support these other uses.
Optimal range: 0 - 20 Relative Abundance
Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism.
Optimal range: 10 - 100 Relative Abundance
Optimal range: 10 - 100 Relative Abundance
Bifidobacterium infantis is a highly specialized microbe ("beneficial bacteria") that resides in the gut microbiome.
Unlike most other bacteria in the gut microbiome, Bifidobacterium infantis (also known as "b infantis") is an inherited microbe, often being passed down from mother to child during child birth.
Once it takes up residence in the gut microbiome, Bifidobacterium infantis flourishes and helps to cultivate an environment where other beneficial bacteria can grow.
Optimal range: 10 - 100 Relative Abundance
Bifidobacterium lactis is also known as Bifidobacterium animalis subsp. lactis;
They are typically gram-positive, anaerobic, rod-shaped bacterium which can be found in the large intestines of most mammals, including humans.
Bifidobacterium lactis is the species of Bifidobacterium most commonly used in food products, as it is more robust than other species of Bifidobacterium genus. Amongst other characteristics, B. animalis subsp. lactis exhibits elevated oxygen tolerance, enabling it to survive in a wider range of environments. This probiotic species has also been shown to inhibit the toxic effects induced by the wheat protein gliadin, a component of wheat gluten. Wheat intolerance is becoming far more prevalent in modern society, but wheat products are staple foods in many cultures, so the potential of this bacterial species to help minimise some of the negative side effects of gluten consumption is attracting some interest.
Optimal range: 0 - 20 Relative Abundance
Clostridium spp. is part of the intestinal indigenous microbiota and they can produce several endogenous infections.
Optimal range: 0 - 20 Relative Abundance
Linked to Parkinson’s disease
Optimal range: 0.9 - 2.6 Units
The copper to zinc ratio refers to the relative proportion of copper to zinc in the body, and it is an important indicator of overall health. Both copper and zinc are essential trace minerals that play crucial roles in various physiological processes. An optimal balance between the two is vital for several functions, including immune system efficiency, antioxidant defense, and neurological function. Imbalances in this ratio, whether skewed towards an excess of copper or a deficiency of zinc, can be associated with a range of health concerns.
Optimal range: 0 - 20 Relative Abundance
Eggerthella lenta is a normal human microflora that is anaerobic, non-sporulating, and Gram positive. However, an increasing number of studies have shown that it could also be an important pathogen for humans, even causing life-threatening infection under certain conditions. However, understanding its pathogenic mechanism and treatment options still need to be improved; more clinical data are needed to explore it further. The frequency of E. lenta bacteremia is increased in patients with hematologic or solid organ cancer, diabetes mellitus and also in those with appendicitis.
Optimal range: 10 - 100 Relative Abundance
Escherichia coli Nissle is a Gram-negative strain with many prominent probiotic properties in the treatment of intestinal diseases such as diarrhea and inflammatory bowel disease (IBD), in particular ulcerative colitis.
Escherichia coli Nissle not only exhibits antagonistic effects on a variety of intestinal pathogenic bacteria, but also regulates the secretion of immune factors in vivo and enhances the ability of host immunity.
Optimal range: 10 - 100 Relative Abundance
Possibly related to IBD
Faecalibacterium and Roseburia are major producers of butyrate in the intestine. A reduced abundance of the organisms and a concurrent reduction in butyrate levels are associated with inflammatory bowel disease.
Optimal range: 0 - 0.9 Units
Non-gluten proteins constitute about 25% of the total protein content of wheat cereal. Recently it has been shown that these non-gluten proteins are immune-reactive in individuals with wheat sensitivity. The 5 groups of non-gluten proteins which are distinctly different from the gluten proteins that are responsible for inflammation in patients with wheat sensitivity are serpins, purinins, farinins, amylase/protease inhibitors and globulins.
Optimal range: 0 - 0.9 Units
Gliadin constitutes a class of proteins that are present in wheat and other cereal which give it the ability to rise properly when baked. The main types of gliadin are alpha, beta, gamma and omega gliadins. Research has suggested that antibody reactivity against all the above mentioned forms of gliadin are found in individuals with ‘Wheat related disorders.’
Optimal range: 0 - 0.9 Units
Non-gluten proteins constitute about 25% of the total protein content of wheat cereal. Recently it has been shown that these non-gluten proteins are immune-reactive in individuals with wheat sensitivity. The 5 groups of non-gluten proteins which are distinctly different from the gluten proteins that are responsible for inflammation in patients with wheat sensitivity are serpins, purinins, farinins, amylase/protease inhibitors and globulins.
Optimal range: 0 - 0.9 Units
Gluteomorphin, also known as gliadorphin, is a peptide that is derived from the digestion of gluten in the gastrointestinal tract. Specifically, gluteomorphin is produced when the digestive enzymes break down a protein in gluten called gliadin.
Gluteomorphin has been found to have opioid-like effects, meaning that it can bind to the opioid receptors in the brain and produce feelings of euphoria and relaxation. Some researchers have suggested that this may be one reason why people with gluten sensitivity or celiac disease may experience cravings or addiction-like behaviors when consuming gluten-containing foods.
Optimal range: 0 - 0.9 Units
HMW (high molecular weight) glutenin is a protein component found in wheat gluten. Gluten is a mixture of proteins found in wheat, barley, and rye that provides the elasticity and texture in dough and other baked goods.
The gluten proteins can be divided into two main groups: the gliadins and the glutenins. The glutenins can be further divided into the low molecular weight (LMW) glutenins and the high molecular weight (HMW) glutenins.
Optimal range: 10 - 100 Relative Abundance
Optimal range: 3.22 - 10.49 %
Linoleic acid (LA) is the only essential omega-6 fatty acid and must be obtained from the diet. From LA, other omega-6s can be created using elongase and desaturase enzymes. LA contains 18 carbons, with 2 double bonds, the first of which is at the 6th carbon position (18:2n6). LA is found in nuts and vegetable oils (corn, soybean, canola, sunflower, etc.) as well as most meats. When the double bonds of LA are arranged differently, the term conjugated LA (CLA) is used.
Optimal range: 0 - 0.9 Units
Glutenin is a major protein found in wheat and constitutes about 47% of its protein content. Glutenin is responsible for the strength and elasticity of dough. The main types of glutenin are the LMW (low molecular weight) and the HMW (high molecular weight) glutenin.
HMW glutenin has been associated with Celiac disease, asthma and Atopic dermatitis.
LMW Glutenin has been associated with Celiac disease, asthma, Atopic dermatitis, Urticaria and Anaphylaxis.
Optimal range: 0 - 0.9 Units
Gliadin constitutes a class of proteins that are present in wheat and other cereal which give it the ability to rise properly when baked. The main types of gliadin are alpha, beta, gamma and omega gliadins. Research has suggested that antibody reactivity against all the above mentioned forms of gliadin are found in individuals with ‘Wheat related disorders.’
Optimal range: 0 - 20 Relative Abundance
Oscillospira is a common yet rarely cultivated gut bacterial genus. Recently human gut microbiota studies have demonstrated its underlying significance for host health.
Optimal range: 0 - 20 Relative Abundance
Oral bacterium P. gingivalis has been well-documented as a mediator of periodontal disease. Furthermore, hosts harboring this pathogen have been shown to have greater risk for rheumatoid arthritis. Researchers are elucidating the mechanisms by which P. gingivalis contributes to the pathogenesis of arthritic and their related disorders. Upregulation of intestinal lipopolysaccharides and subsequent inflammation, as well as citrullination of alpha-enolase, which shares homology with human tissue α-enolase, are described mechanisms of autoimmunity.
Optimal range: 0 - 0.9 Units
Prodynorphin is an opioid that is a basic building block of endorphins.
Optimal range: 10 - 100 Relative Abundance
Optimal range: 0 - 0.9 Units
Non-gluten proteins constitute about 25% of the total protein content of wheat cereal. Recently it has been shown that these non-gluten proteins are immune-reactive in individuals with wheat sensitivity. The 5 groups of non-gluten proteins which are distinctly different from the gluten proteins that are responsible for inflammation in patients with wheat sensitivity are serpins, purinins, farinins, amylase/protease inhibitors and globulins.
Optimal range: 0 - 0.9 Units
Serpins, also known as serine protease inhibitors, are a family of proteins that play a crucial role in regulating the activity of enzymes called serine proteases. Serine proteases are enzymes that cleave peptide bonds in proteins and play important roles in a variety of biological processes, including blood clotting, inflammation, and immune defense.
Serpins work by inhibiting the activity of serine proteases, which helps to prevent excessive proteolytic activity and maintain the proper balance of proteases in the body. Serpins achieve this inhibition by forming a complex with the serine protease, which then irreversibly inactivates the protease.
Optimal range: 10 - 100 Relative Abundance
Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.
Optimal range: 11.03 - 34.96 %
Optimal range: 0 - 20 Relative Abundance
Array 22 - Irritable Bowel/SIBO Screen
-- Identify the overgrowth of large intestinal bacteria in the small intestine and the release of bacterial cytotoxins
-- Evaluate a breach of intestinal barrier by bacterial cytotoxins and their entry into circulation
-- Assist in setting guidelines for treatment of irritable bowels/SIBO and reduce risk of igniting the autoimmune process
Recommended for Patients Who:
-- Have irritable bowels
-- Exhibit symptoms of malabsorption, including weight loss, anemia or fatty stools
-- Have associated conditions such as fatigue, reflux, skin disorders, obesity or food intolerances
Optimal range: 0.1 - 0.71 ELISA Index
Optimal range: 0 - 2.11 ELISA Index
Optimal range: 0 - 2.3 ELISA Index
Bacterial Cytotoxins refer to the cytolethal distending toxin, subunit B (CdtB) that is released by Escherichia coli, Salmonella, Shigella and Campylobacter jejuni. Utilizing subunits A and C, gram-negative bacteria can bind to human cells, allowing CdtB to infiltrate the cell. Inside the cell, CdtB contributes to cytoskeletal damage, which may induce apoptosis (cell death). CdtB is the first bacterial toxin known to act in the nucleus of a target cell.
Associated With:
- Irritable bowels
- SIBO
- Gut dysbiosis
- Chronic functional bowel changes
- Localized aggressive periodontitis
Optimal range: 0.4 - 1.61 ELISA Index
What is being measured
This marker tests for IgA antibodies against specific cytoskeletal proteins in the intestinal lining, including proteins like vinculin, talin, and alpha-actinin. These proteins are essential for maintaining the structure and function of the intestinal barrier.
Why this matters
When harmful bacteria such as Campylobacter, E. coli, or Salmonella damage the gut lining, they may release toxins that disrupt intestinal cells. In response, the immune system may start producing IgA antibodies against the body’s own structural proteins. An elevated level of Cytoskeletal Proteins IgA indicates that the immune system is actively targeting these proteins, which can be a sign of damage to the intestinal barrier.
Clinical significance
Elevated Cytoskeletal Proteins IgA is often associated with post-infectious IBS or small intestinal bacterial overgrowth (SIBO).
It may indicate that bacteria or their toxins have breached the gut lining and triggered an immune reaction.
This immune activation may also contribute to symptoms outside the gut, such as fatigue or brain fog, through a mechanism often described as "leaky gut" or intestinal permeability.
What to consider if your result is elevated
An elevated result supports the need for further evaluation of SIBO or post-infectious irritable bowel symptoms.
Your healthcare provider may recommend treatments to reduce bacterial overgrowth, repair the gut lining, and calm immune activation.
Addressing elevated IgA responses early may help prevent more systemic or autoimmune responses later.
Summary
Cytoskeletal Proteins IgA is a marker of immune reactivity to your own intestinal lining. If elevated, it points to structural damage in the gut, often caused by bacterial overgrowth or prior gastrointestinal infections. Intervening early can help restore gut integrity and reduce ongoing immune stress.
Let me know if you’d like a version tailored for clinicians or want to add references or citations.
Optimal range: 0.2 - 2.11 ELISA Index
Optimal range: 0.2 - 2.3 ELISA Index
Cytoskeletal Proteins is the collective name given to intercellular adherent junctions that are involved in the integrity and functionality of the epithelial barrier. The major cytoskeletal proteins assessed in Array 22 are a-actinin, talin and vinculin. Alpha-actinin forms a lattice-like structure and stabilizes the muscle contractile, additionally a-actinin associates with signaling molecules. Talin is found in focal adhesions where it links the transmembrane receptors, integrins, to the actomyosin network and either directly or indirectly interacts with a-actinin and vinculin. Vinculin is a cytoskeletal protein associated with cell-cell and cell-matrix junctions.
Known Cross-Reactions: Alpha-actinin with anti-ssDNA
NxGen MDx Vaginosis Test
The NxGen MDx Vaginosis Test looks for 99% of the causes of community-acquired vaginal infections, helping your doctor distinguish between different types of infections without relying on symptoms alone.
Bacterial vaginosis, or BV, is a common vaginal infection in women. It is the most common vaginal infection in women of childbearing age, including pregnant women.
While it is not a sexually transmitted disease (STD), some sexual behaviors increase the chances for BV. Women who have never had sex can also have BV.
How is it spread?
The vagina contains many different types of bacteria. Normally, there are large numbers of "good" bacteria that keep the number of "harmful" bacteria very low. Bacterial vaginosis occurs when this balance is upset and there are more "harmful" bacteria than "good" bacteria. The cause of BV is not fully understood.
The risk of BV is higher if you:
Have a new sex partner or multiple sex partners
Do not use condoms
Have a female sexual partner with BV
BV is more common in lesbian and bisexual women than in other women. The reason for this is unknown.
What are signs of BV in women?
Women with BV may have few or no signs of infection. Some women with BV have:
Increased vaginal discharge:
Often watery
Gray or white in color
Sometimes has an unpleasant, fish-like odor, especially after sex
Itching or irritation in the vaginal area
Burning during urination
How do you know if you have BV?
BV can be diagnosed during a medical exam. To check for BV, your health care provider looks for signs of infection and collects a sample of vaginal fluid for lab tests.
How is it treated?
BV is treated with antibiotics. These can be in pill form, creams, gels, or ovules. Sometimes BV goes away without treatment.
Female partners of women with BV may need treatment. Male sexual partners do not need treatment
What can happen if you have BV for a long time?
Most often, BV does not cause other health problems. However, if left untreated, BV may increase your risk for:
Sexually transmitted diseases (STDs) like herpes, chlamydia, gonorrhea, and HIV
Pelvic inflammatory disease where BV bacteria infect the uterus or fallopian tubes. Pelvic inflammatory disease can cause infertility and increase the risk of ectopic (tubal) pregnancy.
An infection after a procedure on the female organs. This includes cesarean section, abortion, and surgery on the cervix or uterus.
Early labor or birth, if pregnant
If you have BV:
Always finish antibiotic treatment, even if the signs of BV go away
Talk to female sex partners about getting BV treatment
How can you avoid BV?
Protect the normal balance of bacteria in the vagina by:
Not douching
Asking your sex partners to be examined for BV
Having sex with only one person who only has sex with you
Using condoms during sex
Reducing the number of sex partners
Washing the genital area daily with mild soap and water
For more information, see Safer Sex.
What about pregnancy?
BV is common in pregnant women. Treatment is very important. BV can increase the risk for:
Low birth weight babies
Early labor and birth
If you are pregnant and have BV, see your health care provider one month after finishing treatment.
Reference range: Not detected, Detected
Optimal range: 0 - 2000 Copies/ul eq.
Prevotella bivia (P. bivia) is an anaerobic, non-pigmented, gramnegative bacillus which is naturally present in the human female vaginal tract, and it is also occasionally seen in the oral cavity. It has a high proliferative potential in the presence of estrogen. Therefore, its involvement in, vaginal tract infections such as endometritis and pelvic inflammatory disease, has been well described in the literature. If left untreated, it may cause more serious conditions, such as cuff abscess, abdominal wall empyema, or septic arthritis.
Optimal range: 0 - 2000 Copies/ul eq.
Group B strep (streptococcus) is a common bacterium often carried in the intestines or lower genital tract. The bacterium is usually harmless in healthy adults. In newborns, however, it can cause a serious illness known as group B strep disease.
Group B strep can also cause dangerous infections in adults with certain chronic medical conditions, such as diabetes or liver disease. Older adults are at increased risk of illness due to group B strep, too.
If you're a healthy adult, there's nothing you need to do about group B strep. If you're pregnant, get a group B strep screening test during your third trimester. If you have group B strep, antibiotic treatment during labor can protect your baby.
Metabolimix+
The Metabolomix+® is a comprehensive, non-invasive nutrition and metabolism test that identifies functional nutrient deficiencies, metabolic imbalances, and related health risks.
Developed by Genova Diagnostics, this test uses a first-morning urine sample, with optional bloodspot and buccal swab collections, to deliver a highly detailed picture of your biochemical health.
The Metabolomix+ provides personalized insights into your body’s needs for vitamins, minerals, amino acids, fatty acids, antioxidants, and more—helping uncover root causes of symptoms and guiding targeted interventions.
Your results are organized into key functional health categories, making it easier for your healthcare provider to pinpoint areas needing attention.
Organic acids are biochemical byproducts that reflect how well your metabolism is functioning.
The Metabolomix+ measures:
Malabsorption & Dysbiosis Markers – Identify imbalances in gut bacteria and yeast that can affect nutrient absorption.
Mitochondrial & Cellular Energy Metabolites – Assess how efficiently your cells produce energy through the Krebs cycle.
Neurotransmitter Metabolites – Evaluate the breakdown products of serotonin, dopamine, norepinephrine, and epinephrine.
Vitamin Markers – Detect functional needs for B vitamins and other essential nutrients.
Detoxification & Toxin Markers – Assess your body’s detox capacity and possible toxin exposure.
Oxalate Markers – Screen for risk factors linked to kidney stones, oxidative stress, and metabolic disorders.
Amino acids are the building blocks of proteins and vital for nearly every body system. This panel evaluates:
Essential & Nonessential Amino Acids – Determine dietary sufficiency and metabolic balance.
B Vitamin-Dependent Pathways – Identify where vitamin-dependent enzymes may be underperforming.
Urea Cycle Markers – Assess nitrogen balance and ammonia detoxification.
Glycine/Serine Pathways – Linked to methylation and neurotransmitter synthesis.
Dietary Peptide Markers – Reveal protein digestion quality and meat intake.
Measures damage from oxidative stress and the body’s antioxidant defense:
Lipid Peroxides – Indicate oxidative damage to cell membranes.
8-OHdG (8-hydroxy-2'-deoxyguanosine) – Reflects DNA damage risk from free radicals.
Fatty acids influence inflammation, brain function, and cardiovascular health. This profile includes:
Omega-3s (EPA, DHA) – Support heart, brain, and anti-inflammatory pathways.
Omega-6s – Influence immune function and inflammation.
Omega-9s & Saturated Fats – Affect nerve health and fat metabolism.
Trans Fats & Omega-7s – Monitored for cardiovascular risk.
Enzyme Function (Delta-6 Desaturase) – Determines fatty acid conversion efficiency.
Omega-3 Index & Ratios – Provide cardiovascular risk insights.
Screens for:
15 essential minerals (e.g., magnesium, zinc, selenium) for metabolic and immune support
20 toxic elements (e.g., lead, mercury, arsenic) that may burden detox pathways and health
Identifies SNPs (single nucleotide polymorphisms) that influence metabolism, detox, and inflammation:
MTHFR – Affects folate metabolism and methylation.
COMT – Influences neurotransmitter breakdown.
TNF-α – Linked to chronic inflammation.
APOE – Associated with cardiovascular and brain health risk.
The Metabolomix+ offers a systems-based approach to understanding your nutrition and metabolism, ideal for people seeking proactive, functional health insights.
Key Benefits:
Detects early nutrient deficiencies before symptoms become severe
Supports prevention of chronic diseases through targeted nutrition
Tracks biochemical response to diet, supplements, and lifestyle changes
Provides valuable insights for fatigue, brain fog, digestive issues, mood changes, and inflammation
The Metabolomix+ is especially valuable for individuals who:
Have chronic fatigue, mood disorders, digestive symptoms, or inflammation
Want to optimize their nutrition for long-term health
Need a personalized supplement and diet plan based on functional lab data
Are working with an integrative or functional medicine practitioner to address complex health concerns
Bottom line:
The Metabolomix+ test provides a comprehensive nutritional and metabolic health blueprint, helping you and your provider make precise, evidence-based decisions to restore balance, improve function, and protect long-term wellness.
Optimal range: 1.6 - 5 %
When assessing fatty acids in RBCs, Genova measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total omega-3 percentage is a combined total weight percentage. It is calculated by adding up each of the measured omega-3s. Higher total percentages of omega-3 fatty acids are anti-inflammatory, cardioprotective, and considered beneficial.
It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage. By default, this may then lower the omega-6 percentage.
Optimal range: 30.5 - 39.7 %
When assessing fatty acids in RBCs, Genova measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total omega-6 percentage is a combined total weight percentage calculated by adding together each of the measured omega-6s.
Because some omega-6 fatty acids are less beneficial than others, each fatty acid abnormality should be addressed.
However, in general, assessing the total omega-6 percentage as it relates to the omega-3 percentage is helpful. A more balanced ratio may decrease risk of many chronic diseases. It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage, which may ultimately lower the omega-6 percentage.
Optimal range: 17.3 - 22.5 %
When assessing fatty acids in RBCs, Genova measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total omega-9 percentage is a combined total weight percentage calculated by adding up each of the measured omega-9s. In general, because the omega-9 fatty acids are beneficial, higher levels are preferred; though identifying root cause of elevations or deficiencies is important. It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage. By default, this may then lower the omega-6 percentage.
Optimal range: 39.8 - 43.6 %
When assessing fatty acids in RBCs, Genova measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total saturated fatty acid percentage is a combined total weight percentage calculated by adding up each of the measured saturated fatty acids. It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage, which then lowers the omega-6 percentage. Because some saturated fatty acids are beneficial, it is important to look at the levels of those specifically as well.
Optimal range: 18 - 887 micromol/g creatinine
1-methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 0 - 29 mmol/mol creatinine
3-Hydroxyisovaleric Acid (3-HIA) is formed from the metabolism of the branched-chain amino acid leucine. Methylcrotonyl-CoA carboxylase catalyzes an essential step in this pathway and is biotin dependent. Reduced activity of this enzyme leads to an alternate pathway of metabolism resulting in 3-hydroxyisovaleric acid.
Optimal range: 0 - 8.1 mmol/mol creatinine
3-Hydroxyphenylacetic acid and 4-hydroxyphenylacetic acid are produced by the bacterial fermentation of amino acids, much like Indoleacetic acid (IAA).
Optimal range: 5 - 22 mmol/mol creatinine
3-Hydroxypropionic Acid (3-HPA) is a major urinary metabolite of propionic acid. Propionic acid is derived from dietary branched-chain amino acids, oddchain fatty acids, and can be produced in the gut by bacterial fermentation of fiber. The biotin-dependent enzyme propionyl CoA carboxylase is responsible for metabolizing propionic acid to methylmalonyl CoA, which is subsequently isomerized to succinyl CoA. Decreased activity of this enzyme shunts propionyl CoA into alternative pathways which form 3-HPA.
Optimal range: 0.02 - 0.22 mmol/mol creatinine
3-Methyl-4-OH-Phenylglycol (MHPG) is a byproduct of the central nervous system’s norepinephrine (NE) metabolism. MHPG metabolizes to vanilmandelic acid (VMA) in the liver using the enzymes alcohol dehydrogenase and aldehyde dehydrogenase. Urinary MHPG was originally thought to represent CNS sympathetic output, but is now known to be principally derived from peripheral neuronal NE metabolism.
MHPG has been widely studied as a marker to predict response to medications used in mood disorders or as a biomarker to monitor pharmacotherapies.
Optimal range: 47 - 232 micromol/g creatinine
Both 1-methylhistidine and 3-methylhistidine are histidine metabolites which have been proposed as markers of meat intake. Note that some confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
3-methylhistidine is a constituent of actin and myosin, the contractile proteins of skeletal muscles. Urinary excretion of 3-methylhistidine may be a result of muscle breakdown or consumption of meat fibers. Unlike 1-methylhistidine, 3-methylhistidine has been shown to increase in fasting states indicating catabolism of muscle tissue. Therefore, this marker is more variable with regards to animal protein consumption.
Optimal range: 0 - 29 mmol/mol creatinine
3-Hydroxyphenylacetic acid and 4-hydroxyphenylacetic acid are produced by the bacterial fermentation of amino acids, much like Indoleacetic acid (IAA).
Optimal range: 3.8 - 12.1 mmol/mol creatinine
5-OH-indoleacetic Acid (5-HIAA) is a downstream metabolite of serotonin, which is formed from the essential amino acid tryptophan. Most blood serotonin and urinary 5-HIAA comes from serotonin formation outside of the CNS, primarily the liver and enterochromaffin cells in the gastrointestinal tract. Serotonin is further metabolized by monoamine oxidase to become 5-HIAA.
Optimal range: 0 - 15 mcg/g Creat.
8-hydroxy- 2’-deoxyguanosine (8-OHdG) is a byproduct of oxidative damage to guanine bases in DNA. It is used as a biomarker for oxidative stress and carcinogenesis.
It has been studied to estimate DNA damage after exposure to carcinogens including tobacco smoke, asbestos fibers, heavy metals, and polycyclic aromatic hydrocarbons.
8-OHdG levels are positively associated with markers of inflammation and evening cortisol, indicating that increased physiological or psychosocial stress is associated with increased oxidative damage.
Optimal range: 2 - 21 micromol/g creatinine
Alpha-Amino-N-butyric acid (α-ANB), also known as alphaaminobutyric acid, is a nonessential amino acid derived from the catabolism of methionine, threonine, and serine. α-ANB is both formed and metabolized by reactions which require vitamin B6 as a cofactor.
Optimal range: 6 - 56 micromol/g creatinine
Alpha-aminoadipic acid (also known as 2-aminoadipic acid) is an intermediary biomarker of lysine and tryptophan metabolism. The further metabolism of alpha-aminoadipic acid to alpha-ketoadipic acid requires vitamin B6.
Plasma alpha-aminoadipic acid is strongly associated with the risk of developing diabetes as seen in an assessment of the Framingham Heart Study data. Circulating levels were found to be elevated for many years prior to the onset of diabetes. Preclinical data shows it may also play a role in oxidation and atherosclerotic plaque formation.
Optimal range: 0 - 0.83 mmol/mol creatinine
α-hydroxybutyric acid (2-hydroxybuturic acid [2-HB]) is a marker that relates to oxidative stress. 2-HB is an organic acid produced from α-ketobutyrate via the enzymes lactate dehydrogenase (LDH) or α-hydroxybutyrate dehydrogenase (HBDH). These enzymes are catalyzed by NADH. Oxidative stress creates an imbalance in NADH/NAD ratios, which leads directly to the production of 2-HB. Being that 2-HB’s precursor α-ketobutyrate is a byproduct in the glutathione (GSH) synthesis pathway, an increased demand for GSH may ultimately result in increased 2-HB. Increased oxidative stress associated with insulin resistance increases the rate of hepatic glutathione synthesis. Plasma 2-HB is highly associated with insulin resistance and may be an effective biomarker for prediabetes. A study on type 2 diabetics showed that GSH infusion restored the NADH/NAD balance and resulted in improvement of insulin sensitivity and beta cell function.
Optimal range: 0 - 6.7 mmol/mol creatinine
α-Hydroxyisobutyric Acid is a major urinary metabolite of the industrial solvent methyl tert-butyl ether (MTBE).
MTBE was a gasoline additive discontinued in the early 2000’s used to reduce automobile emissions. Due to significant ground water leakage from storage tanks, ongoing exposure to MTBE exists in ground water. There is also data available on levels of MTBE in ambient air.
Urinary α-hydroxyisobutryic acid is a marker of recent MTBE exposure. Although, MTBE was initially designated as “noncarcinogenic”, recent studies suggest some interesting clinical associations. Exposure to MTBE has been linked to type 2 diabetes as a result of disrupted zinc homeostasis and glucose tolerance. There are also clinical associations with autism, DNA oxidative damage, and methylation defects. Studies on cancer, reproductive abnormalities, nonalcoholic fatty liver, and neurotoxicity have been either negative or inconclusive thus far.
Optimal range: 0 - 2.1 mmol/mol creatinine
Of the essential amino acids, there are three branchedchain amino acids (leucine, isoleucine, and valine).
Unlike most amino acids, the initial step of branchedchain amino acid (BCAA) metabolism does not take place in the liver. They increase rapidly in systemic circulation after protein intake and are readily available for use. Skeletal muscle is where most of the initial catabolism of BCAA takes place using branched-chain aminotransferase enzymes to form α-ketoacids, which are then released from muscles back into the blood to be further metabolized, mainly in the liver.
BCAA act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, immune response, and many other beneficial metabolic processes.
α-Ketoisovaleric Acid (AKIV) is produced from the essential amino acid valine. It then metabolizes to become succinyl Co-A. AKIV is glucogenic.
α-Ketoisocaproic Acid (AKIC) is produced from leucine and further metabolizes to form acetyl-CoA and acetoacetate. AKIC is ketogenic.
α-Keto-β-Methylvaleric Acid (AKBM) comes from isoleucine, and further metabolizes to form acetylCoA and succinyl-CoA. AKBM is therefore both glycogenic and ketogenic.
These α-ketoacids then require an enzyme complex called branched-chain α-keto acid dehydrogenase (BCKD) for further metabolism.
This enzyme complex requires multiple vitamin cofactors, such as vitamin B1, B2, B3, B5, and lipoic acid.
Optimal range: 0 - 1.7 mmol/mol creatinine
α-Ketoadipic Acid (AKAA; 2-Oxoadipic acid, 2-Ketoadipic acid) is an organic acid formed from α-aminoadipic acid (which originates with lysine) and also from α-aminomuconic acid (derived from tryptophan).
AKAA metabolizes to form glutaryl-CoA via oxidative decarboxylation. The cofactors needed in this step are Coenzyme A, NAD, thiamine pyrophosphate (vitamin B1), lipoic acid, and vitamin B2.
Optimal range: 4 - 52 mmol/mol creatinine
Isocitric Acid is converted to α-ketoglutaric acid using the enzyme isocitrate dehydrogenase. Alphaketoglutarate is a rate-determining intermediate in the Citric Acid Cycle and provides an important source of glutamine and glutamate that stimulates protein synthesis and bone tissue formation, inhibits protein degradation in muscle, and constitutes an important metabolic fuel for cells of the gastrointestinal tract. Alpha-ketoglutaric acid is then converted to Succinyl CoA using the enzyme alpha-ketoglutarate dehydrogenase. This enzyme complex is very similar to the pyruvate dehydrogenase complex with similar nutrient cofactor needs.
Optimal range: 0 - 0.89 mmol/mol creatinine
Of the essential amino acids, there are three branchedchain amino acids (leucine, isoleucine, and valine).
Unlike most amino acids, the initial step of branchedchain amino acid (BCAA) metabolism does not take place in the liver. They increase rapidly in systemic circulation after protein intake and are readily available for use. Skeletal muscle is where most of the initial catabolism of BCAA takes place using branched-chain aminotransferase enzymes to form α-ketoacids, which are then released from muscles back into the blood to be further metabolized, mainly in the liver.
BCAA act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, immune response, and many other beneficial metabolic processes.
α-Ketoisovaleric Acid (AKIV) is produced from the essential amino acid valine. It then metabolizes to become succinyl Co-A. AKIV is glucogenic.
α-Ketoisocaproic Acid (AKIC) is produced from leucine and further metabolizes to form acetyl-CoA and acetoacetate. AKIC is ketogenic.
α-Keto-β-Methylvaleric Acid (AKBM) comes from isoleucine, and further metabolizes to form acetylCoA and succinyl-CoA. AKBM is therefore both glycogenic and ketogenic.
These α-ketoacids then require an enzyme complex called branched-chain α-keto acid dehydrogenase (BCKD) for further metabolism.
This enzyme complex requires multiple vitamin cofactors, such as vitamin B1, B2, B3, B5, and lipoic acid.
Optimal range: 0 - 0.97 mmol/mol creatinine
Of the essential amino acids, there are three branchedchain amino acids (leucine, isoleucine, and valine).
Unlike most amino acids, the initial step of branchedchain amino acid (BCAA) metabolism does not take place in the liver. They increase rapidly in systemic circulation after protein intake and are readily available for use. Skeletal muscle is where most of the initial catabolism of BCAA takes place using branched-chain aminotransferase enzymes to form α-ketoacids, which are then released from muscles back into the blood to be further metabolized, mainly in the liver.
BCAA act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, immune response, and many other beneficial metabolic processes.
α-Ketoisovaleric Acid (AKIV) is produced from the essential amino acid valine. It then metabolizes to become succinyl Co-A. AKIV is glucogenic.
α-Ketoisocaproic Acid (AKIC) is produced from leucine and further metabolizes to form acetyl-CoA and acetoacetate. AKIC is ketogenic.
α-Keto-β-Methylvaleric Acid (AKBM) comes from isoleucine, and further metabolizes to form acetylCoA and succinyl-CoA. AKBM is therefore both glycogenic and ketogenic.
These α-ketoacids then require an enzyme complex called branched-chain α-keto acid dehydrogenase (BCKD) for further metabolism.
This enzyme complex requires multiple vitamin cofactors, such as vitamin B1, B2, B3, B5, and lipoic acid.
Optimal range: 0 - 0.46 mmol/mol creatinine
α-Ketophenylacetic Acid, also known as phenylglyoxylic acid (PGA), is a urinary metabolite of styrene, toluene, xylenes, and ethylbenzene.
It acts as a urinary marker of recent exposure via inhalation, contact, oral, and others.
The biologic half-life of styrene in humans is fairly short and corresponds with the disappearance of PGA from the urine. Styrene is widely used for synthesis of polymers such as plastics, rubbers, and surface coating. It is also used in the pharmaceutical industry. Styrene is commonly applied in the manufacturing of paints, pigments, and glues. Coexposure to other solvents, like toluene and ethyl acetate is common in workplaces where styrene is a concern. Since toluene and xylene are components of unleaded gasoline, workers at gas stations are at potential risk of exposure, as well as the general population.
Styrene exposure may interfere with peripheral metabolism of thyroid hormones by inhibiting conversion of T4 to T3.
It may also affect DNA repair capacity and damage. There are also clinical associations with insulin resistance, oxidative stress, and inflammation.
Optimal range: 0.28 - 5 wt %
Alpha-linolenic acid (ALA) is an essential n-3 fatty acid and must be obtained in the diet. Sources include green leafy vegetables, oily fish, flaxseed, soybean oil, canola oil, walnuts, and chia seeds. ALA has an 18-carbon backbone with 3 double bonds starting at the third carbon molecule (18:3n3). It is an important precursor to make eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), though these can also be obtained in the diet. Most dietary ALA is used to generate energy and only a small portion is converted to EPA and DHA.
Optimal range: 10 - 86 Ratio
EPA (n3) and AA (n6) both compete for use of the delta-5- desaturase enzyme to be synthesized. Increased dietary intake of animal fats alters fatty acid metabolism in favor of inflammation. There are many chronic diseases associated with elevations of this ratio including cardiovascular disease, mood disorders, and cancer. Increasing dietary intake of fish oils, or omega-3 fatty acid containing foods such as flax, chia, oily fish, or walnuts, can shift delta-5-desaturase activity toward the metabolism of the more beneficial n-3 metabolites.
Decreasing intake of animal fats is also recommended.
Optimal range: 0 - 2.8 mmol/mol creatinine
Dietary fatty acids are metabolized into fuel sources using beta-oxidation. Fatty acid conversion into Acetyl-CoA requires transport across the mitochondrial membrane via the carnitine shuttle. When beta-oxidation is impaired, fats are metabolized using an alternate pathway called omega-oxidation. Omega-oxidation results in elevated levels of dicarboxylic acids such as adipic acid and suberic acid. Impaired beta-oxidation occurs in carnitine deficiency or enzymatic dysfunction due to lack of nutrient cofactors. Vitamin B2 and magnesium play a role in optimizing beta-oxidation.
Optimal range: 26 - 275 micromol/g creatinine
Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine. It is found in many foods including eggs, meat, lentils, and fish. Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.
Optimal range: 0 - 22.3 ug/g creat
SOURCES:
Found in virtually all food and food additives, water, air, and soil. Also found in antacids, antiperspirants, cosmetics, astringents, cans, pots, pans, siding, roofing, and foil.
Optimal range: 0.7 - 76.1 micromol/g creatinine
Anserine (beta-alanyl-3-methyl-histidine) is a urinary biomarker from the consumption of poultry and fish. It is a dipeptide consisting of the amino acids 1-methylhistidine and beta-alanine. The enzyme carnosineN-methyl transferase catalyzes the transfer of a methyl group of S-adenosylmethionine (SAM) on carnosine to form anserine. Anserine acts as an antioxidant, free radical scavenger, and pH buffer. It can reduce blood sugar and affect renal sympathetic nerve activity and blood pressure. Anserine is measured in FMV urine only.
Optimal range: 0 - 0.15 ug/g creat
SOURCES:
Found naturally in the environment, air, soil, water.
Found in lead storage batteries, solder, sheet and pipe metal, pewter, bearings and castings, paints, ceramics, fireworks, plastic enamels, metal and glass.
Sometimes used medically to treat parasites.
Optimal range: 0.24 - 0.4 wt %
Arachidic acid is very long, 20-carbon backbone saturated fatty acid (20:0). It is found in various nuts, soybeans, peanut oil, corn oil, and cocoa butter. In addition to dietary sources, it can be synthesized by the hydrogenation of the omega-6 fatty acid arachidonic acid or the elongation of stearic acid.
Optimal range: 7 - 12 wt %
Arachidonic acid (AA) is a 20-carbon polyunsaturated n-6 fatty acid with 4 double bonds (20:4n6). Its double bonds contribute to cell membrane fluidity and predispose it to oxygenation. This can lead to several important metabolites which ensure a properly functioning immune system as well as regulate inflammation, brain activity, and other signaling cascades. AA’s metabolites are called eicosanoids which are signaling molecules. They can be produced via cyclooxygenases, lipoxygenase, cytochrome P450, and oxygen species-triggered reactions. These pathways yield molecules like prostaglandins, isoprostanes, thromboxane, leukotrienes, lipoxins, and epoxyeicosatrienoic acids. AA can be obtained in the diet from eggs, fish, and animal meats and fats – or produced directly from DGLA using the delta-5-desaturase enzyme. Although often vilified, adequate AA intake is needed to achieve an equilibrium between its inflammatory and resolution effects to support a healthy immune system. It is also fortified in infant formulas due to its importance in growth and development.
Optimal range: 3 - 43 micromol/g creatinine
Arginine is found in all protein foods and is very abundant in seeds and nuts. It is considered a semi-essential amino acid during early development, infection/inflammation, or renal and/or intestinal impairment.
Optimal range: 0 - 50 ug/g creat
Sources:
Found in water, air, soil, cigarettes, and cosmetics. Food grown in contaminated water sources, such as rice and vegetables, or fish, are a common source. Major sources of occupational exposureis the manufacture of pesticides, herbicides, and agricultural products.
90% of all arsenic produced is used as a preservative for wood to prevent rotting and decay. Copper chromated arsenate (CCA), also known as pressure-treated wood, wasphased out for residential use in 2003, but wood treated prior could still be in existing structures. CCA-treated wood is still used in industrial applications.
Organic arsenic found in seafood is relatively nontoxic, while the inorganic forms are toxic.
Optimal range: 12 - 115 micromol/g creatinine
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 0 - 9 micromol/g creatinine
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 0 - 18 micromol/g creatinine
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. Carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 4 - 194 micromol/g creatinine
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA. Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys. β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 0 - 15 mmol/mol creatinine
β-hydroxy-β-methylglutaric acid (HMG) is a precursor to cholesterol and coenzyme Q10 (CoQ10) synthesis. It is a product of hydroxymethylglutaryl-coenzyme A (HMGCoA). HMGCoA- reductase is a rate limiting enzyme in cholesterol production. Medications that interfere with this enzyme may result in elevated HMG and subsequent low levels of cholesterol and CoQ10. CoQ10 is important for cellular energy production in the mitochondrial respiratory chain.
Optimal range: 0 - 2.8 mmol/mol creatinine
β-hydroxybutyrate is a ketone body. During periods of fasting, exercise, and metabolic disease, ketone bodies are generated in the liver and become an energy source instead of glucose.
Optimal range: 0 - 6.7 ug/g creat
BARIUM SOURCES:
Radiologic testing contrast, paint, bricks, ceramics, glass and rubber. Air, water, and food. Fish and aquatic organisms can accumulate barium.
BARIUM NUTRIENT INTERACTIONS:
Barium toxicity can induce severe hypokalemia.
Optimal range: 0.88 - 1.61 wt %
Behenic acid is a VLSFA which contains 22 carbons (22:0). Its name is derived from Ben oil (behen oil) from the Moringa oleifera tree. Commercially, products containing Moringa oil have high amounts of behenic acid in them such as hair conditioners, topical moisturizers, and other cosmetic oils. It can also be obtained through the diet in canola (rapeseed) oil and peanut oil. Using the elongase enzyme, it can be synthesized from arachidic acid.
Optimal range: 0 - 0.05 mmol/mol creatinine
Benzoic acid and hippuric acid are formed from the bacterial metabolism of polyphenols. Urinary benzoic acid may also come from ingestion of food preservatives such as sodium benzoate. Hippuric acid is made when sodium benzoate is conjugated with glycine.
Optimal range: 0 - 2.28 ug/g creat
Used in alloys, electronics, batteries, crystal ware, cosmetics, flame retardants,and in antimicrobial therapy (H. pylori), antiseptic dressings, paraffin paste. Bismuth medical therapies exhibit high therapeutic effects and little side effects, though over-dosage can cause toxicity.
Very limited absorption in the GI tract. When absorbed, it binds mainly to transferrin and lactoferrin, interacts with enzymes due to a high affinity to cysteine residues, blocking the active site. Can accumulate in the kidney, lung, spleen, liver, brain, and muscles, while being eliminated in urine and feces via bile and intestinal secretions.
Optimal range: 0 - 0.64 ug/g creat
SOURCES:
Found in food such as shellfish, leafy vegetables, rice, cereals, cocoa butter, dried seaweed, and legumes. Also present in nickel cadmium batteries, cigarette smoke (including second-hand smoke), insecticides, fertilizer, motor oil, emissions and exhaust. Drinking water, air, and occupational exposures are also seen.
NUTRIENT INTERACTIONS:
Iron deficiency is associated with higher cadmium burden and absorption of cadmium may increase during very early stages of iron deficiency. Zinc deficiency is associated with an increase in Cadmium, as a result of the antagonistic relationship between the elements.
Dietary cadmium inhibits GI absorption of calcium and interferes with calcium and vitamin D metabolism. Low dietary calcium stimulates synthesis of calcium- binding protein which enhances Cadmium absorption.
Optimal range: 37 - 313 mg/g creat
Optimal range: 1 - 32 micromol/g creatinine
Carnosine (beta-alanyl-L-histidine) is a urinary biomarker which comes from the consumption of beef, pork, and to a lesser extent, poultry.
It is a dipeptide consisting of the amino acids histidine and beta-alanine and is concentrated in skeletal and heart muscle, brain, and kidneys. Carnosine has antioxidant properties, antiglycation effects, enhanced calcium sensitivity, and pH buffering activity during highintensity exercise.
It also has neuroprotective properties and may play an important role in Alzheimer’s disease and other neurodegenerative diseases.
Carnosine is also protective against secondary diabetic renal complications.
Optimal range: 0 - 10.5 ug/g creat
Naturally occurring Cs can be found in a stable form. Radioactive Cs is produced by the fission of uranium in fuel elements, usually near nuclear power plants. These are unstable but eventually become stable through radioactive decay. Some Cs can be found in air, water, and soil (and thereby food) based on location near nuclear plants.
Higher levels of vitamin D (25(OH)D3) have been linked to enhanced absorption of radioactive isotopes like cesium. Cs and potassium compete for uptake and cell membrane potential.
Optimal range: 0.6 - 9.4 ug/g creat
Chromium is ubiquitous in foods at low low concentrations. Derived from processing of food with stainless steel equipment. Also present in tobacco smoke, chrome, plating, dyes and pigments, leather tanning, and wood preserving and is deposited into air, water, and soil.
Blood distribution of chromium appears to be equally divided between plasma and RBCs, whole blood chromium the sample type for total chromium measurement. Chromium (VI) is more concentrated in the RBCs, while chromium (III) does not enter the RBCs. Therefore, it is possible to distinguish sources and types of exposure to indicate toxic (Cr VI) exposure versus benign (Cr III) by measuring RBC chromium. Chromium rapidly clears from the blood and measurements relate to recent exposure. Urinary chromium excretion reflects absorption of the previous one to two days.
Optimal range: 10 - 36 mmol/mol creatinine
A two-carbon group from Acetyl-CoA is transferred to oxaloacetate to form citric acid. Citric acid is then converted to isocitric acid through a cis-aconitic intermediate using the enzyme aconitase. Aconitase is an iron-sulfate protein that controls iron homeostasis.
Optimal range: 0 - 5.8 mmol/mol creatinine
Citramalic acid and tartaric acid are yeast metabolites that are also influenced by dietary intake of fruits, wine, and sugars.
Optimal range: 40 - 520 mmol/mol creatinine
A two-carbon group from Acetyl-CoA is transferred to oxaloacetate to form citric acid. Citric acid is then converted to isocitric acid through a cis-aconitic intermediate using the enzyme aconitase. Aconitase is an iron-sulfate protein that controls iron homeostasis.
Optimal range: 0.7 - 3.4 mmol/g creatinine
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified. It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins. Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine. Because citrulline is produced in enterocytes, it has been proposed as a marker of enterocyte mass in conditions of villous atrophy.
Optimal range: 0.01 - 2.6 ug/g creat
Optimal range: 4 - 11.4 ug/g creat
Sources:
Legumes, mushrooms, chocolate, nuts and seeds, shellfish and liver are high in copper all greater than 2.4 µg per gram.
Food, water and air (via combustion and fossil fuels and agriculture) are sources of copper.
Copper pipes and fixtures in household plumbing may allow copper to leak into water.
Optimal range: 3.1 - 19.5 mmol/L
Urinary creatinine is commonly used as a laboratory standardization when evaluating urinary analytes. Creatinine excretion is influenced by muscle mass and body habitus since creatinine formation occurs in muscle.
Dietary intake of proteins containing arginine and glycine (precursors of creatine) and creatine supplementation can elevate levels.
Hydration status may also play a role in urinary creatinine levels.
Optimal range: 3.1 - 19.5 mmol/L
A urine creatinine concentration is part of every FMV analysis. All urinary biomarkers are ratioed to the creatinine concentration for standardization.
Urinary creatinine is commonly used as a laboratory standardization when evaluating urinary analytes. Creatinine excretion is influenced by muscle mass and body habitus since creatinine formation occurs in muscle. Dietary intake of proteins containing arginine and glycine (precursors of creatine) and creatine supplementation can elevate levels. Hydration status may also play a role in urinary creatinine levels.
Optimal range: 4 - 48 micromol/g creatinine
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 9 - 60 micromol/g creatinine
Cysteine is a nonessential sulfur-containing amino acid. It is obtained from the diet and is also endogenously made from the intermediate amino acid cystathionine. Dietary cysteine sources include poultry, eggs, beef, and whole grains.
This amino acid should not be confused with the oxidized derivative of cysteine called cystine. Cystine is formed by combining two cysteine molecules within a redox reaction. The urinary FMV amino acid test reports cysteine and cystine separately. The plasma amino acid test combines both cysteine and cystine as one biomarker -cyst(e)ine.
Optimal range: 10 - 116 micromol/g creatinine
Cystine is formed from the oxidation of cysteine, or from the degradation of glutathione oxidation products. It is two cysteines linked together with a disulfide bond.
The urine FMV amino acid test reports cysteine and cystine separately. The plasma amino acid test combines both cysteine and cystine as one biomarker.
Optimal range: 0 - 36 mmol/mol creatinine
D-arabinitol is a sugar alcohol produced specifically by Candida spp. The majority of the published literature shows a correlation between serum or urinary D-arabinitol levels and systemic invasive candidiasis in immunocompromised individuals. Several articles have suggested that D-arabinitol is a useful marker for diagnosis of candidiasis in this patient population as well as potentially be a prognostic indicator in a broad range of conditions.
Optimal range: 1.02 - 5 wt %
Dihomo-gamma-linolenic acid (DGLA) is a 20-carbon omega-6 with 3 double bonds (20:3n6) derived from the essential linolenic acid. LA is metabolized to GLA, which is rapidly elongated to DGLA. There are only trace amounts of DGLA found in organ meats, otherwise it must be synthesized from GLA. The inability to convert precursor fatty acids to DGLA is associated with various pathologic and physiologic conditions such as aging, diabetes, alcoholism, atopic dermatitis, rheumatoid arthritis, cancer, and cardiovascular disease.
Optimal range: 0 - 5.3 mmol/mol creatinine
Dihydroxyphenylpropionic Acid (DHPPA), also known as 3,4 dihydroxyphenylpropionic acid, is a byproduct of the fermentation of dietary phenols by several bacteria, including some Clostridia spp. and others. Although once thought to identify the presence of specific dysbiotic bacteria, ongoing research suggests there are several bacterial species potentially involved.
Optimal range: 0.8 - 5 wt %
Docosahexaenoic acid (DHA) is an omega-3 fatty acid with 22 carbons and 6 double bonds (22:6n3). It can be obtained from the diet, supplemented, or created by conversion from DPA using elongase and desaturase enzymes. DHA is present in fatty fish such as salmon, tuna, and mackerel, and low levels of DHA can be found in meat and eggs. Both individually or in combination with EPA, DHA is widely supplemented due to the enormous amount of research available regarding its anti-inflammatory role in many clinical conditions such as cardiovascular disease, cognitive decline, autoimmune disease, fetal development, visual disturbances, cancer, and metabolic syndrome.
Optimal range: 0.34 - 5 wt %
Docosapentaenoic acid (DPA) is an omega-3 fatty acid with 22 carbons and five double bonds (22:5n3). It is formed from its precursor, EPA, by way of the elongase enzyme which adds two carbons. It can be supplemented or obtained in the diet from foods such as marine oily fish.
Not only is DPA found in most fish and marine foods but it is also present in lean red meat from ruminant animals.
Optimal range: 0.45 - 1.25 wt %
Docosatetraenoic acid (DTA) is a very long chain omega-6 fatty acid with 22 carbons and 4 double bonds (22:4n6).
It is synthesized by adding 2 carbons atoms to the backbone of arachidonic acid using the elongase enzyme. It is sometimes referred to by its common name adrenic acid and is one of the most abundant fatty acids in the early human brain and the adrenal gland. DTA has not been well studied, though it has recently been shown to have important physiologic functions. It is now believed to be a pro-resolving mediator in inflammation by blocking neutrophilic metabolites and dampening the inflammation response. For example, in osteoarthritis DTA enhances phagocytosis by macrophages which clears products of cartilage breakdown in the joint space. Supplementation of DTA is being studied as a promising intervention in osteoarthritis to dampen inflammation and prevent structural damage.
Optimal range: 0 - 0.26 wt %
Eicosadienoic acid (EDA) is a rare, omega-6 fatty acid with a 20-carbon backbone and two double bonds (20:2n6). It is mainly formed through the downstream metabolism of omega-6s by elongating LA. EDA can be metabolized to form DGLA and AA. Literature is sparse regarding its role in the inflammatory cascade though it is known to modulate the metabolism of other PUFAs and to alter the responsiveness of macrophages to stimulate inflammation.
Optimal range: 0.12 - 5 wt %
Eicosapentaenoic acid (EPA) is an omega-3 fatty acid with 20 carbons and 5 double bonds (20:5n3).
EPA can either be made from the downstream metabolism of ALA or it can be obtained in the diet. Food sources include oily fish such as salmon, mackerel, cod, and sardines. In addition to diet and ALA desaturation, EPA is also available as a fish oil supplement. The desaturation of ALA to EPA is not a very efficient process, therefore dietary intake or supplementation is important.
Optimal range: 0 - 0.59 wt %
Elaidic acid (EA) is an 18-carbon chained fatty acid with one double bond in the trans formation at the 9th carbon (18:1n9t). It is the trans isomer of oleic acid. EA is the principal and most abundant trans fatty acid in the Western diet. It is found in partially hydrogenated vegetable oil and margarine. There are trace amounts of EA in the meat and dairy products from ruminant animals. EA has been shown to induce oxidative stress and alter mitochondrial signaling. It is quickly incorporated into triglycerides and cholesterol esters. Once incorporated into plasma membranes, it activates nuclear factorkB to induce adhesion molecules and become proinflammatory leading to endothelial dysfunction.
Optimal range: 40 - 226 micromol/g creatinine
Ethanolamine is an intermediary metabolite in the serine-to-choline sequence. It can be used to synthesize phosphatidylethanolamine (PE), a very important membrane phospholipid. Ethanolamine is not only a precursor, but also a breakdown product of PE. Ethanolamine is abundant in both intestinal and bacterial cell membranes. It plays a significant role in the renewal and proliferation of intestinal cells and intestinal inflammation. Also, since ethanolamine plays a structural role in skeletal muscle cell membranes, some evidence suggests it may be a marker of skeletal muscle turnover.
Optimal range: 0 - 1.5 mmol/mol creatinine
Formiminoglutamic Acid (FIGlu) is an intermediary organic acid in the conversion of the amino acid histidine to glutamic acid. This enzymatic conversion requires tetrahydrofolic acid.
Optimal range: 0 - 3 micromol/g creatinine
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania.
Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution. Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production.
Optimal range: 0.15 - 0.54 wt %
γ-linolenic acid (GLA) is an omega-6 fatty acid containing 18 carbons and 3 double bonds (18:3n6).
It is synthesized from LA by adding a double bond using the delta-6-desaturase enzyme. This enzymatic reaction is very slow and further impaired in vitamin and mineral deficiencies such as zinc and cobalt.
Stress, smoking, alcohol, and systemic inflammatory conditions can also slow this conversion.
Optimal range: 0 - 0.02 ug/g creat
Used as a nuclear MRI contrast agent (usually in its chelated form). Also used in magnets, compact discs, superconductors, magnets, and fluorescent materials.Can also be found in ground and drinking water.
Gdions in chelates can be exchanged with cations like zinc, copper, calcium, or iron. Zinc is a major contributor, therefore adequatezinc levels improve Gd excretion.
Gdcan accumulatein tissue, bone, and brain. Usually removed via kidney. Chelated Gd can dissociate under certain metabolic conditions and inhibit intracellular calcium signalingand disrupt the action of thyroid hormone. Gd targets iron recycling macrophages, induces cellular iron import/export, and labile iron release, which participates in systemic fibrosis.
Optimal range: 0 - 0.03 ug/g creat
Used in integrated circuits, LED’s, solar cells, laser diodes. It is also used in medicine, where the radioisotopes are used as imaging agents,and stable compounds are used in chemotherapy. Ga can be a antimicrobial agent, and used to treat life-threatening, malignancyrelated hypercalcemia. Can be found in ground water near mining, manufacturingand coal combustion plants. Most commonly seen in occupationalexposures, while thereis less data on consumer electronic exposures.
Ga competes with iron for transferrin binding and inhibits receptor-mediated iron uptake by cells, renderingcells irondeficient. Iron replacement has been shown to restore hemoglobin production in Ga exposed cells. It was also found to interact with bone metabolism and to lower calcium levels in the blood.
Optimal range: 2 - 16 micromol/g creatinine
Glutamic acid is a nonessential amino acid is derived from the diet and from the breakdown of gut proteins. Glutamate is a major excitatory neurotransmitter in the brain. It plays a role in neuronal differentiation, migration, and survival in the developing brain. It is also involved in synaptic maintenance, neuroplasticity, learning, and memory.
Optimal range: 85 - 518 micromol/g creatinine
Glutamine is a nonessential amino acid and is the most abundant amino acid in the body. It is formed from glutamate using the enzyme glutamine synthetase. Approximately 80% of glutamine is found in the skeletal muscle, and this concentration is 30 times higher than the amount of glutamine found in human plasma. Although glucose is used as fuel for many tissues in the body, glutamine is the main fuel source for a large number of cells including lymphocytes, neutrophils, macrophages, and enterocytes.
Optimal range: 0 - 0.51 mmol/mol creatinine
Glutaric Acid is formed from the essential amino acids lysine and tryptophan through the intermediaries of alpha ketoadipic acid and glutaryl-CoA. Glutaryl-CoA is further metabolized to glutaconyl- and crotonyl-CoA by an enzyme called glutaryl-CoA dehydrogenase. This enzyme requires riboflavin (vitamin B2) as a cofactor.
Optimal range: 3.5 - 16.4 mmol/mol creatinine
Glyceric acid is an organic acid that stems from the catabolism of the amino acid serine. Severe elevations in glyceric acid are an indication of a rare inborn error of metabolism known as glyceric aciduria. One form of glyceric aciduria is the result of a defect in the enzyme glycerate kinase which removes glyceric acid from the system. While many case studies have linked this disorder with severe developmental abnormalities, there is some debate as to whether glycerate kinase deficiency is the cause or rather a confounding variable. Another glyceric aciduria is referred to as primary hyperoxaluria type 2 (PH2). This rare genetic condition results in excessive production of oxalates in the system in the form of oxalic acid. Over time, systemic deposition of oxalates in body tissues can occur which is a process known as oxalosis. This disease is characterized by urolithiasis, nephrocalcinosis, and deposition of oxalates in other body tissues.
Optimal range: 47 - 435 micromol/g creatinine
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine. It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins. Glycine is a major collagen and elastin component, which are the most abundant proteins in the body. Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Optimal range: 0 - 67 mmol/mol creatinine
Glycolic acid is another byproduct of the oxalate pathway and comes from the conversion of glyoxylic acid. Urinary levels of glycolic acid have most commonly been studied in the rare inborn error of metabolism primary hyperoxaluria type 1 (PH1). PH1 is caused by a deficiency of alanine:glyoxylate aminotransferase (AGT) which converts glyoxylic acid into glycine.
Optimal range: 0 - 603 mmol/mol
Benzoic acid and hippuric acid are formed from the bacterial metabolism of polyphenols. Urinary benzoic acid may also come from ingestion of food preservatives such as sodium benzoate. Hippuric acid is made when sodium benzoate is conjugated with glycine.
Optimal range: 102 - 763 micromol/g creatinine
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine. Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
Optimal range: 1.2 - 5.3 mmol/mol creatinine
Homovanillic acid (HVA), or 3-methoxy-4- hydroxyphenylacetic acid, is a metabolite of dopamine. Although dopamine is an important brain neurotransmitter, a substantial amount of dopamine is produced in the GI tract.
In neurotransmitter production, dopamine is formed from phenylalanine and tyrosine using several enzymes which require nutrient cofactors such as iron, tetrahydrobiopterin, and pyridoxal phosphate.
Optimal range: 0 - 4.2 mmol/mol creatinine
Indoleacetic acid (IAA), or indole-3-acetate, is produced by the bacterial fermentation of the amino acid tryptophan.
IAA can be formed from several common gut microbes such as Clostridia species, Escherichia coli, and Saccharomyces species.
Optimal range: 5 - 64 ug/g creat
Iron measurement on a FMV Urine test provides valuable insights into the body's iron status. This test assesses the presence of iron in the urine, which can indicate various aspects of iron metabolism. Low levels of iron in the urine may suggest a deficiency of this essential mineral, potentially leading to conditions like iron-deficiency anemia. High levels of iron in the urine could be indicative of excessive iron intake, absorption issues, or underlying medical conditions like hemochromatosis, a disorder characterized by iron overload. Monitoring iron levels through FMV urine testing can assist healthcare providers in diagnosing and managing iron-related disorders, guiding interventions such as dietary modifications, iron supplementation, or further investigations to optimize iron balance and overall health.
Optimal range: 22 - 65 mmol/mol creatinine
A two-carbon group from Acetyl-CoA is transferred to oxaloacetate to form citric acid. Citric acid is then converted to isocitric acid through a cis-aconitic intermediate using the enzyme aconitase. Aconitase is an iron-sulfate protein that controls iron homeostasis.
Optimal range: 3 - 25 micromol/g creatinine
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0 - 3.7 mmol/mol creatinine
Isovalerylglycine is produced from leucine catabolism. It is further metabolized via isovaleryl-CoA dehydrogenase. This enzyme requires vitamin B2 as a cofactor.
Optimal range: 0.44 - 5 Ratio
Because of the specific inflammatory component of quinolinic acid, as well as the potentially protective role of kynurenic acid peripherally, laboratories measure the ratio of kynurenic acid to quinolinic acid. This ratio can act as a measure of disturbed kynurenine pathway metabolism. It suggests that tryptophan is catabolized via the kynurenine pathway, rather than the serotonin pathway.
Optimal range: 0 - 7.1 mmol/mol creatinine
Kynurenic acid and Quinolinic acid are tryptophan metabolites formed through the kynurenine pathway. Tryptophan is the amino acid precursor to serotonin; its major route for catabolism is the kynurenine pathway. Important products of the kynurenine pathway include xanthurenic acid and kynurenic acid, which can further metabolize into quinolinic acid. The historical importance of this pathway has mainly been as a source of the coenzyme NAD+, which is important for all redox reactions in the mitochondria.
However, it is now understood that kynurenic and quinolinic acid have physiologic implications. This alternate pathway is upregulated in response to inflammation and stress, which can lead to deficient serotonin production. Kynurenic acid has shown some neuroprotective properties in the brain, since it can stimulate NMDA receptors. However, its importance on the periphery is still not fully elucidated. Some studies outline antiinflammatory, analgesic, antiatherogenic, antioxidative, and hepatoprotective properties to peripheral kynurenic acid.
The correlation to levels of urinary excretion needs further study. Quinolinic acid, in and of itself, can be inflammatory and neurotoxic.
Optimal range: 1.9 - 19.8 mmol/mol creatinine
Lactic Acid and Pyruvic Acid are byproducts of glycolysis. Carbohydrates, which contain glucose, are broken down through glycolysis to form pyruvate and two ATP molecules. Pyruvate can also be generated through the catabolism of various amino acids, including alanine, serine, cysteine, glycine, tryptophan and threonine. Magnesium is an important cofactor for a number of glycolytic enzymes necessary to produce pyruvate. Optimally, pyruvic acid is oxidized to form Acetyl-CoA to be used aerobically via the Citric Acid Cycle to produce energy. In an anaerobic state, lactic acid is formed instead.
Optimal range: 0 - 1.4 ug/g creat
Found naturally in soil. More often found in fossil fuels, gasoline/exhaust, manufacturing, lead-acid batteries, ammunitions, metal solder and pipes, X-ray shields, paint, glass, pigments, and sheet lead.
Optimal range: 6 - 61 micromol/g creatinine
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 1.1 - 1.9 wt %
Lignoceric acid has 24 carbons and no double bonds (24:0). It can be formed from behenic acid using the elongase enzyme. It is found in peanuts, nut and seed oils. It can also be found in wood tar. Lignoceric acid is one of many fatty acids which compose brain tissue and myelin.
Optimal range: 18.8 - 28.3 wt %
Linoleic acid (LA) is the only essential omega-6 fatty acid and must be obtained from the diet.
From LA, other omega-6s can be created using elongase and desaturase enzymes. LA contains 18 carbons, with 2 double bonds, the first of which is at the 6th carbon position (18:2n6).
LA is found in nuts and vegetable oils (corn, soybean, canola, sunflower, etc.) as well as most meats. When the double bonds of LA are arranged differently, the term conjugated LA (CLA) is used. Although technically CLA can be termed a trans-fat, a natural type of CLA can be obtained in the dietary intake of meat and milk from ruminant animals. There are many isomers of CLA – some beneficial and others are not as well defined. There is some controversy regarding how much LA is needed from the diet for adequacy. Although LA is needed to synthesize downstream fatty acids, it may lead to increased inflammatory fatty acid production.
Optimal range: 12.6 - 31.5 Ratio
LA/DGLA is a fatty acid ratio.
LA/DGLA stands for linolenic acid (=LA) and dihomogammalinolenic acid (=DGLA).
The LA/DGLA ratio is a biomarker that can indicate functional zinc deficiency.
Optimal range: 0 - 10 micromol/g Creat.
Lipid peroxides are a class of reactive oxygen species (ROS) that preferentially oxidize polyunsaturated fatty acids (PUFAs) linoleic, arachidonic, and docosahexaenoic acids (omega-6 PUFAs).
Lipid peroxides exert their toxic effects via two mechanisms. One is by altering the assembly, composition, structure and dynamics of cell membrane lipid bilayers. The second is by producing more reactive oxygen species or by degrading into reactive compounds capable of damaging DNA and proteins.
The central nervous system is particularly prone to lipid peroxidation due to the high quantity of ROS as a byproduct of ATP synthesis in a lipid-enriched environment.16 Circulating LDLs can be affected by lipid peroxidation and are implicated in diseases including atherosclerosis, metabolic syndrome, and diabetes.
Optimal range: 9 - 129 ug/g creat
Optimal range: 15 - 231 micromol/g creatinine
Lysine is a nutritionally essential amino acid abundant in meat, fish, fowl, and legumes and is needed for formation of body proteins and enzymes.
Lysine can be methylated using S-adenosylmethionine (SAM) to synthesize carnitine, which is needed for fatty acid oxidation. Lysine also generates Acetyl CoA for use in the citric acid cycle. Lysine, proline, hydroxyproline, and vitamin C are important in the synthesis of collagen for skin, bones, tendons and cartilage.
Optimal range: 41 - 267 mg/g creat
Sources:
Green leafy vegetables, legumes, nuts, seeds, whole grains, medicines (e.g., Milk of Magnesia), Epsom salt. Over the last 60 years, the Mg content in fruits and vegetables has decreased by 20-30%,and 80-90% of Mg is lost during food processing.
Absorption factors:
The intestine, bone and kidney maintain magnesium homeostasis. Unlike other minerals, Mg can be absorbed along the entire length of the GI tract. Soft drinks, low protein diets, foods containing phytates, polyphenols and oxalic acid, fluoride, antibiotics, and oral contraceptives bind to magnesium and produce insoluble precipitatesor complexes, negatively impacting Mg availability and absorption. Caffeine, alcohol and diuretics (e.g., furosemide, bumetanide) increase renal excretion of Mg. Antacids (e.g., omeprazole) affect Mg absorption due to the increase in GI pH.
Optimal range: 0 - 3 mmol/mol creatinine
Fumaric acid uses the fumarase enzyme to become malic acid. Malate dehydrogenase catalyzes the conversion of malic acid into oxaloacetate. Two forms of this enzyme exist in eukaryotes. One operates within the mitochondria to contribute to the Citric Acid Cycle; the other is in the cytosol where it participates in the malate/ aspartate shuttle. Riboflavin is an important cofactor for this enzyme and overall mitochondrial energy production and cellular function. At the end of each Citric Acid Cycle, the four-carbon oxaloacetate has been regenerated, and the cycle continues.
Optimal range: 0.03 - 1.16 ug/g creat
Optimal range: 0.24 - 0.45 %
Margaric acid is also known as heptadecanoic acid. It is a 17-carbon saturated fatty acid (17:0). Food sources mainly include milk and dairy products, though it can be endogenously made as well.
Most research in fatty acid metabolism has focused on even-chain fatty acids since they represent >99% of total human lipid concentration. For years, it had been concluded that odd chain saturated fatty acids (OCSFAs) were of little significance and used only as internal standards in laboratory methodology. However, there is now a realization that they are, in fact, relevant and important physiologically.
Optimal range: 0 - 2.19 ug/g creat
SOURCES:
Mercury (Hg) has three forms:
Elemental (metallic)- older glass thermometers, fluorescent light bulbs, dental amalgams, folk remedies, combustion, electrical industry (switches, batteries, thermostats), solvents, wood processing
Organic (methyl mercury)- seafood, thimerosal (preservative), fungicides
Inorganic- skin lightening compounds, industrial exposure, folk medicine, lamps, photography, disinfectants
Optimal range: 2 - 16 micromol/g creatinine
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 0 - 1.9 mmol/mol creatinine
Methylmalonic Acid (MMA) is formed from propionylCoA via methylmalonyl-CoA. Major dietary sources of propionyl-CoA include valine, isoleucine, methionine, threonine, and odd chain fatty acids. MethylmalonylCoA is converted to succinyl-CoA to feed the Citric Acid Cycle via the enzyme methylmalonyl-CoA mutase. This enzyme is very vitamin B2 dependent. In B12 deficiency, methylmalonyl-CoA is hydrolyzed to methylmalonic acid.
Optimal range: 15 - 175 ug/g creat
Sources of Molybdenum:
- Beans (lima, white, red, green, pinto, peas),
- grains (wheat, oat, rice),
- nuts,
- vegetables (asparagus, dark leafy, Brassicas),
- milk, cheese.
Absorption factors:
- Molybdenum absorption is passive in the intestines.
- Urinary excretion is a direct reflection of dietary Molybdenum intake, not necessarily Molybdenum status.
- Increased Mo intake may elevate urinary copper excretion.
Optimal range: 1.1 - 1.8 wt %
Nervonic acid (NA) is an omega-9 MUFA with a 24-carbon backbone and one double bond (24:1n9). It is a very important fatty acid in the white matter of the brain and is responsible for nerve cell myelin biosynthesis. There are small amounts of NA in cooking fats, vegetable oils and borage oil. It can also be synthesized in the body by elongating oleic acid (which is essentially desaturated stearic acid). NA is essential for the growth and maintenance of the brain and peripheral nervous tissue enriched with sphingomyelin.
Optimal range: 0 - 3.88 ug/g creat
Used in making metal coins and jewelry, valves and heat exchangers, and stainless steel. Also used for nickel plating, color ceramics, cosmetics, tobacco, and batteries. Can be found in the soil, air, and water. There are also nickel containing foods such as almonds, chick peas, cocoa, tomato, lentils, oats, peanuts, and walnuts.
NUTRIENT INTERACTIONS:
Iron is a competitive inhibitor of nickel absorption, therefore absorption is enhanced with iron deficiency. Vitamin C works as an antioxidant to counter ROS from nickel, and may also inhibit nickel absorption.
Optimal range: 0 - 0.08 ug/g creat
Sources:
Niobiumis sometimes found in jewelry, and is used with other alloys, like titanium, to make surgical implants and dental applications. It is also a component of superconducting magnets and nuclear reactor cores.
Physiologic effects:
Niobium is poorly absorbed from the GI tract.
Clinical significance:
It is a moderate eye and skin irritant. Due to poor GI absorption, it has a low order of toxicity. Lethargy and respiratory depression have only been seen with parenteral administration.
Optimal range: 14 - 21 wt %
Oleic acid (OA) has an 18-carbon backbone with one double bond at the 9th position (18:1n9). Oleic acid’s main dietary source is olive oil, and it is also available as a supplement. OA can also be synthesized in the body by adding a double bond to stearic acid using the enzyme delta-9-desaturase. Oleic acid is important in cell membrane fluidity and has attracted a lot of positive attention due the amount of olive oil found in the ‘Mediterranean diet.’
Optimal range: 4 - 15 index
The omega-3 index is defined as the RBC percentage sum of EPA+DHA, both of which are important antiinflammatory omega-3 fatty acids. This index was first proposed in 2004 as a cardiovascular risk factor by Dr. Willian S. Harris and Dr. Clemons von Schacky as a way of assessing risk for coronary artery disease and related death. Since then, it has been repeatedly verified as an important cardiovascular biomarker, and studied in other diseases including obesity, mood disorder, and insulin resistance.
A reasonable target for the omega-3 index is >8% to decrease disease risk. Drs. Harris and von Schacky stratified risk zones as high risk (8%). These percentages have been continually verified in outcome studies and risk assessment.
Dietary intervention to increase the omega-3 index should include oily fish, flax, walnut, and chia. Fish oil supplementation can also be considered.
Optimal range: 8.5 - 27.4 Ratio
There has been a significant change in the balance of Omega-6s to Omega-3s with the evolution of the Western diet. Close to a 1:1 balance existed throughout history. However, rapid dietary changes and food industry advances have altered this to now be vastly in favor of Omega-6s by upwards of 20:1. This change correlates with many chronic diseases such as cardiovascular disease, cancer, metabolic syndrome, obesity, mood disorders, autoimmunity, and neurogenerative disease.
Dietary interventions which favor omega-3, in lieu of omega-6s, is recommended with elevations in this ratio to achieve a closer balance between the two.
Optimal range: 3 - 17 mmol/g creatinine
Ornithine is an intermediate nonprotein-forming amino acid of the urea cycle. Arginine is converted to ornithine via the arginase enzyme, with urea as a byproduct. Ornithine combined with carbamoyl phosphate is then converted into citrulline via the ornithine transcarbamylase (OTC) enzyme. The contribution of carbamoyl phosphate results from the metabolism of ammonia by the enzyme carbamoyl phosphate synthase, and if this magnesium-dependent process is impaired, ammonia buildup, or hyperammonemia can occur.
Optimal range: 0.33 - 1.01 mmol/mol creatinine
Orotic Acid is an organic acid which serves as an intermediate in nucleotide synthesis and is linked to arginine metabolism as a urea cycle marker for nitrogen balance.
It is formed from aspartic acid and carbamoyl phosphate. Carbamoyl phosphate plays an important role in the body because it brings nitrogen into the urea cycle for detoxification and disposal. Carbamoyl phosphate enters the urea cycle to react with ornithine to form citrulline. When ammonia levels significantly increase or the liver’s capacity for detoxifying ammonia into urea decreases, carbamoyl phosphate leaves the mitochondria and instead enters the pyrimidine pathway. This stimulates orotic acid biosynthesis and subsequent urinary excretion. Orotic acid can also be found in the diet. The richest dietary sources include cow’s milk and dairy products.
Optimal range: 0 - 78 mmol/mol creatinine
Oxalic acid is the metabolic end-product of the glyoxylase pathway and is derived from the oxidation of glyoxylate.
In the cell, the majority of glyoxylate is converted into glycine or glycolic acid. However, in some instances there may be greater oxidation of glyoxylate to oxalic acid. This leads to increased urinary excretion of oxalic acid.
As 80% of kidney stones are calcium-oxalate stones, an increase in oxalic acid is strongly correlated to frequency of urolithiasis.
Optimal range: 19 - 27 wt %
Palmitic acid (PA) is a 16-carbon saturated fatty acid (16:0) and the most common fatty acid in the human body. It can be obtained via diet or synthesized from carbohydrates, other fatty acids, and amino acids. As the name suggests, it is a major component of palm oil, but can also be found in meat, dairy, cocoa butter, coconut oil, and olive oil.
Palm oil and palmitic acid are also found in many products ranging from skincare products, margarine, cereals, and baked goods.
Optimal range: 0 - 2.58 wt %
Palmitoleic acid (POA) is a monounsaturated omega-7 fatty acid (16:1n7).
The main dietary sources of palmitoleic acid include dairy products, avocado oils, oily fish, and macadamia nuts. Macadamia nuts contain the cis- isomer of POA, while dairy products mainly contain the trans- isomer. Like many fatty acids, POA can also be endogenously made from the breakdown of triglycerides, the desaturation of palmitic acid, or de novo synthesis from carbohydrates. POA is an important signaling lipokine, produced mainly by white adipose tissue, that regulates important metabolic processes such as skeletal muscle glucose disposal, insulin sensitivity, and hepatic lipid deposition. It is also a modulator of adipocyte lipolysis, however, studies are mixed as to POA’s specific role in obesity. Epidemiologic studies show that circulating POA levels are involved in cholesterol metabolism and hemostasis, though the results are mixed as to their specific cardiovascular outcomes.
Optimal range: 0.14 - 0.3 wt %
Pentadecanoic acid is a 15-carbon saturated fatty acid (15:0) and hence an Odd-Chain Saturated Fatty Acids (OCS-FAs).
Its major dietary source is the butterfat in cow’s milk. It can also be synthesized from propionate.
Most research in fatty acid metabolism has focused on even-chain fatty acids since they represent >99% of total human lipid concentration. For years, it had been concluded that odd chain saturated fatty acids (OCSFAs) were of little significance and used only as internal standards in laboratory methodology. However, there is now a realization that they are, in fact, relevant and important physiologically.
Optimal range: 0 - 0.12 mmol/mol creatinine
Phenylacetic acid (PAA) is produced by the bacterial metabolism of phenylalanine. Several bacterial strains are known to produce PAA, including Bacteroidetes and Clostridium species. Dietary polyphenols may also contribute to PAA elevation.
Optimal range: 7 - 92 micromol/g creatinine
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy. Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 1 - 9 micromol/g creatinine
Phosphoethanolamine is an intermediate in the serine-to-choline sequence. It is both a precursor and byproduct of phospholipid biosynthesis and breakdown. As a precursor to the phospholipid phosphatidylethanolamine, phosphoethanolamine plays a key role in myelination. Elevated phosphoethanolamine reflects brain phospholipid turnover, an indicator of neural membrane synthesis and signal transduction. Research into neurologic conditions like Alzheimer’s disease and Huntington’s disease suggests that depletions of both phosphoethanolamine and ethanolamine accompany neuronal death. Phosphoethanolamine is also important in cartilage structure and function, especially in bone and teeth.
Optimal range: 0 - 13 micromol/g creatinine
Phosphoserine is the phosphorylated ester of the amino acid serine. The addition of a phosphoryl group to an amino acid, or its removal, plays a role in cell signaling and metabolism. Phosphoserine is a byproduct of glycolysis and subsequent intermediate to then become serine. The enzyme that catalyzes this step, phosphoserine phosphatase, is magnesium dependent. This metabolite is not to be confused with a similar-sounding metabolite, phosphatidylserine; this is a common CNS supplement and essential for neuronal cell membranes.
Optimal range: 0 - 0.03 ug/g creat
SOURCES:
Can be found in soil and river sediments, air, and jewelry. Used as a catalyst in the automotive, chemical, and pharmaceutical industries. It’s resistance to oxidation makes it important in the manufacturing of laboratory equipment. It is also used as a chemotherapeutic agent.
PHYSIOLOGIC EFFECTS:
Platinum binds to DNA and interferes with transcription and replication resulting in apoptosis.
CLINICAL SIGNIFICANCE:
Metallic forms are inert, but the complex salts can produce conjunctivitis, urticaria, dermatitis, and eczema with dermal exposure. Nephrotoxicity and thrombocytopenia are seen with platinum chemotherapeutic agents. Respiratory exposures can produce wheezing and shortness of breath.
Optimal range: 759 - 4653 mg/g creat
Optimal range: 1 - 9 micromol/g creatinine
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid. Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage. Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn. In addition to dietary sources, proline can be synthesized from glutamate/glutamine, arginine, and ornithine. It can also be synthesized within enterocytes from degradation of small peptides.
Optimal range: 16 - 34 mmol/mol creatinine
Pyroglutamic acid (5-oxoproline) is produced and utilized in the gamma-glutamyl cycle. This cycle is needed to assist in the production and recycling of glutathione (GSH), a powerful antioxidant.
Glutathione is a tripeptide, consisting of glutamate, cysteine, and glycine. Using the gamma-glutamyl cycle, GSH is divided into cysteinyl glycine and a gammaglutamyl molecule which attaches to another amino acid for transport across a membrane or into a cell. Gammaglutamyl transferase then splits off that attached amino acid, and the glutamate becomes pyroglutamic acid (5-oxoproline).
Cysteinyl glycine is also broken down and transported into the cell as cysteine and glycine. The entire GSH molecule needs to be reformed intracellularly from pyroglutamic acid by recombining cysteine, glycine, and glutamic acid using GSH synthetase.
This enzymatic reformation requires cofactors such as ATP and magnesium.
Optimal range: 7 - 32 mmol/mol creatinine
Lactic Acid and Pyruvic Acid are byproducts of glycolysis. Carbohydrates, which contain glucose, are broken down through glycolysis to form pyruvate and two ATP molecules. Pyruvate can also be generated through the catabolism of various amino acids, including alanine, serine, cysteine, glycine, tryptophan and threonine. Magnesium is an important cofactor for a number of glycolytic enzymes necessary to produce pyruvate. Optimally, pyruvic acid is oxidized to form Acetyl-CoA to be used aerobically via the Citric Acid Cycle to produce energy. In an anaerobic state, lactic acid is formed instead.
Optimal range: 0 - 9.1 mmol/mol creatinine
Kynurenic acid and Quinolinic acid are tryptophan metabolites formed through the kynurenine pathway. Tryptophan is the amino acid precursor to serotonin; its major route for catabolism is the kynurenine pathway. Important products of the kynurenine pathway include xanthurenic acid and kynurenic acid, which can further metabolize into quinolinic acid. The historical importance of this pathway has mainly been as a source of the coenzyme NAD+, which is important for all redox reactions in the mitochondria.
However, it is now understood that kynurenic and quinolinic acid have physiologic implications. This alternate pathway is upregulated in response to inflammation and stress, which can lead to deficient serotonin production. Kynurenic acid has shown some neuroprotective properties in the brain, since it can stimulate NMDA receptors. However, its importance on the periphery is still not fully elucidated. Some studies outline antiinflammatory, analgesic, antiatherogenic, antioxidative, and hepatoprotective properties to peripheral kynurenic acid.
The correlation to levels of urinary excretion needs further study. Quinolinic acid, in and of itself, can be inflammatory and neurotoxic.
Optimal range: 0 - 2263 ug/g creat
SOURCES:
Soil, rocks, vegetation, water, contrast agent for PET scans, atomic clocks, photoelectric cells, magnetometers, GPS systems, fireworks.
NUTRIENT INTERACTIONS:
Rubidium resembles potassium, and these two elements are metabolically interchangeable.
PHYSIOLOGIC EFFECTS:
Rb is rapidly and completely absorbed by the GI tract when ingested and is excreted mainly through the kidneys. Urinary excretion is consistent with a 50-day half-life. Physiologically, rubidium most resembles potassium, and these two elements are metabolically interchangeable. In the myocardium it is an active participant in the NA/K pump. Rubidium and lithium are often studied for CNS dysfunctions including mania and depression, and may work through the NMDA/nitrergic pathways.
CLINICAL SIGNIFICANCE:
Rb chloride was used historically to treat cardiac issues, syphilis, epilepsy and more recently has been studied for depression. Excess rubidium chloride was associated with weight gain, diarrhea, nausea/vomiting, polyuria, confusion, excitement/agitation and dermatitis. In rats, rubidium chloride administration led to hypokalemia.
Optimal range: 0 - 1 micromol/g creatinine
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine.
It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents.
In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess. Some clinicians use sarcosine elevation as a marker of ‘excess methyl supplementation’ or ‘over-methylation.’ Currently, there is no literature to support this hypothesis, but rather it is based on physiology.
Optimal range: 32 - 333 ug/g creat
Optimal range: 24 - 140 micromol/g creatinine
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 9 - 12 wt %
Stearic acid (SA) is a saturated fatty acid with an 18-carbon backbone (18:0). Although it is mainly abundant in animal fat, cocoa butter and shea butter are also very high in SA. It is also commonly used in detergents, soaps, cosmetics, shampoos, and shaving cream. Additionally, it can be synthesized in the body from palmitic acid. SA is not a strong substrate to make triglycerides compared to other saturated fatty acids and it generates a lower lipemic response.
Optimal range: 47 - 346 ug/g creat
Strontium is found in fish, grains, leafy vegetables, dairy, soil, water, air, and isalso used in the manufacturingof televisions, fireworks, paints, glass, ceramics, fluorescent lights, medicines, magnets.
Vitamin D, calcium, and protein reduces the absorption of Strontium. It is eliminated mainly through urine.
Strontium is considered a trace mineral that is similar to calcium, accumulates in bone and is involved in bone metabolism. Stronitum promotes calcium uptake into the bone and has been used as a prescription drug in the treatment of osteoporosis.
Optimal range: 0 - 2.1 mmol/mol creatinine
Dietary fatty acids are metabolized into fuel sources using beta-oxidation. Fatty acid conversion into Acetyl-CoA requires transport across the mitochondrial membrane via the carnitine shuttle. When beta-oxidation is impaired, fats are metabolized using an alternate pathway called omega-oxidation. Omega-oxidation results in elevated levels of dicarboxylic acids such as adipic acid and suberic acid. Impaired beta-oxidation occurs in carnitine deficiency or enzymatic dysfunction due to lack of nutrient cofactors. Vitamin B2 and magnesium play a role in optimizing beta-oxidation.
Optimal range: 0.4 - 4.6 mmol/mol creatinine
Succinyl CoA becomes succinic acid using succinyl CoA synthetase. This reaction produces NADH which directly provides electrons for the electron transport chain or respiratory chain. Succinic acid requires the enzyme succinate dehydrogenase to become fumarate. This enzyme is ironbased and requires vitamin B2 to support flavin adenine dinucleotide (FAD) as a redox coenzyme. Succinate dehydrogenase plays a critical role in mitochondrial metabolism. Impairment of this enzyme’s activity has been linked to a variety of diseases such as cancer and neurodegenerative diseases.
Optimal range: 367 - 1328 mg/g creat
Sulfur, an essential mineral, plays a pivotal role in various metabolic processes, including the synthesis of amino acids like methionine and cysteine, and in the production of glutathione, a critical antioxidant that protects cells from damage caused by free radicals and heavy metals. Elevated levels of sulfur in urine can indicate a high intake of sulfur-rich foods, such as cruciferous vegetables, garlic, and onions, or supplements containing sulfur amino acids. Conversely, low sulfur levels may suggest dietary deficiencies or impaired sulfur metabolism, potentially linked to conditions like reduced glutathione synthesis, impaired detoxification pathways, and metabolic dysregulation. Additionally, sulfur is involved in the methylation process, a critical biochemical pathway essential for DNA synthesis and repair, neurotransmitter production, and the regulation of gene expression.
Optimal range: 0 - 15 mmol/mol creatinine
- Tartaric acid is a compound found in plant foods. It has been identified as a biomarker of grape intake, though it has also been identified in other foods. Tartaric acid levels peak at 4–8 hours after intake. Levels in foods vary significantly between types of foods and within individual foods.
- Tartaric acid cannot be processed by humans and is either excreted or utilized by gut bacteria as a carbon source. Some bacteria have genes for tartaric metabolizing enzymes, so levels can be impacted by gut microbiome. The process starts once tartaric acid is released (i.e., grapes are crushed or are invaded by pathogens), making it susceptible to catabolic enzymes from microorganisms, which may reduce it to oxaloacetate, glyceric acid, and pyruvic acid.
Common Dietary Sources:
Wine/grapes, chocolate, food additive/preservative
Optimal range: 39 - 568 micromol/g creatinine
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid.
Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
It has been proposed that taurine acts as an antioxidant, intracellular osmolyte, membrane stabilizer, and a neurotransmitter.
Optimal range: 0 - 0.3 ug/g creat
SOURCES:
Fish, shellfish, plants, cigarettes, soil, air, water, electronic devices, switches and closures for the semi-conductor industry, glass for medical procedures.
NUTRIENT INTERACTIONS:
Some of its toxic effects results from interference with biological functions of potassium.
Optimal range: 0 - 4.19 ug/g creat
Thorium is a naturally occurring element found at very low levels in the air, food and drinking water. It is not easily taken up by your body. It is unlikely that health effects will occur in the general population.
Sources:
Rocks, soil, water, plants, ceramics, gas lantern mantles, metals in the aerospace industry and nuclear reactors reactions, fuel for nuclear energy and mining.
Nutrient interactions:
unknown
Physiological effects:
Th can damage chromosomes.
Clinical significance:
Exposure may lead to increased risk of certain cancers including gallbladder, liver, and leukemia, as well as cirrhosis. Inhaled Th (mainly among workers exposed to Th dus) can cause lung damage many years after being exposed
Optimal range: 9 - 97 micromol/g creatinine
Threonine is a large neutral amino acid and a precursor for the amino acid glycine. Foods that contain relatively high amounts of threonine include cheeses (especially Swiss), meat, fish, poultry, seeds, walnuts, cashews, almonds and peanuts. Threonine gets converted to glycine using a two-step biochemical pathway involving the enzymes threonine dehydrogenase and the vitamin B6-dependent glycine C-acetyltransferase.
Optimal range: 0 - 2.04 ug/g creat
SOURCES:
Found in manufacturing, food, packaging, solder, bronzing, dyeing textiles, plastics, PVC pipes, fungicides, toothpaste, perfume, soap, food additives, electronic, cigarette aerosol, and dyes. Naturally present and rocks and nearby air, water, and soil. Seafood is the primary route of human exposure to tin compounds. Tin is found in both organic and inorganic forms. Inorganic tin is generally regarded as safe by the FDA as a food additive for human consumption.
Nutrient interactions:
Tin disturbs copper, zinc, and iron metabolism.
Optimal range: 0.19 - 0.26 wt %
Tricosanoic acid is an 23-carbon, odd-chain saturated fat (23:0) synthesized initially from propionic acid and can be derived in the diet from sesame, sunflower, and hempseed oils. It can furthermore be found in milk and dairy products, as well as some wild mushroom species. It can also be endogenously made.
Most research in fatty acid metabolism has focused on even-chain fatty acids since they represent >99% of total human lipid concentration. For years, it had been concluded that odd chain saturated fatty acids (OCSFAs) were of little significance and used only as internal standards in laboratory methodology. However, there is now a realization that they are, in fact, relevant and important physiologically.
Optimal range: 8 - 58 micromol/g creatinine
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 0 - 0.21 ug/g creat
Optimal range: 19 - 135 micromol/g creatinine
Tyrosine is a conditionally essential amino acid which can come directly from the digestion of dietary protein. Common food sources include dairy, beans, whole grains, meat, and nuts. If intake is insufficient, tyrosine can be formed from the essential amino acid phenylalanine using a tetrahydrobiopterin reaction. Tyrosine itself is a precursor to several neurotransmitters including dopamine, epinephrine and norepinephrine. It is also needed to create thyroid hormone and melanin skin pigments. Within the metabolism of tyrosine to form neurotransmitters and other hormones, there are several important nutrient cofactors involved including vitamin B1, vitamin B6, tetrahydrobiopterin, copper, vitamin C, among others.
Optimal range: 0 - 0.03 ug/g creat
Sources:
Largely limited to use as a nuclear fuel. Present naturally in air, water, food, and soil. The uranyl ion forms water-soluble compounds and is an important component in body fluids. Three different kinds are defined: natural, enriched, and depleted uranium(DU). The radiological and chemical propertiesof natural and DU have similar chemotoxicity, though natural is 60% more radiotoxic.
Nutrient Interactions:
U is reactive. It can combine with and affect the metabolism of lactate, citrate, pyruvate, carbonate,and phosphate, causing mitochondrialdamage. It replaces calciumin bone.
Optimal range: 150 - 380 mmol/g creatinine
Urea is a nontoxic byproduct of nitrogen (ammonia) detoxification. It is formed in the liver via the urea cycle and is the end product of protein metabolism. It is essentially a waste product with no physiological function.
Optimal range: 0 - 0 mmol/L
Optimal range: 0 - 1.65 wt %
Vaccenic acid (VA) is a monounsaturated omega-7 fatty acid (18:1n7).
VA is a naturally occurring trans-fat unlike those produced industrially. The trans-configuration occurs around carbon 11, therefore VA is sometimes denoted as trans11-18:1n7. Ruminant animals produce vaccenic acid in a fermentation process in their microbiome. The dairy products (cheese, milk, butter) or meat obtained from these animals contain VA. There is also a cis-configuration of vaccenic acid created by de novo lipogenesis.
Optimal range: 5 - 43 micromol/g creatinine
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0.1 - 3.2 ug/g creat
Sources:
Mushrooms, shellfish, black pepper, parsley, dill seed, beer, wine, grains, sweeteners, infant cereals.
Fossil fuels, welding, catalysts, steel alloys, batteries, photographic developer, drying agent in paints/varnishes, reducing agent, pesticides, black dyes/inks/pigments in ceramics, printing and textile industries.
Optimal range: 0.4 - 3.6 mmol/mol creatinine
Vanilmandelic acid (VMA) is formed in the liver by the oxidation of 3-methoxy-4-hydroxyphenylglycol.
As a downstream metabolite of tyrosine-derived catecholamines, levels of VMA can reflect the overall synthesis and metabolism of catecholamines.
Whether norepinephrine or epinephrine are metabolized into VMA or 3-methoxy-4-OH-phenylglycol (MHPG) depends on the presence and specificity of various available aldehyde reductase and dehydrogenase enzymes.
Optimal range: 0 - 0.96 mmol/mol creatinine
Xanthurenic acid is produced as part of the kynurenine pathway of tryptophan catabolism, along with kynurenic and quinolinic acid.
Optimal range: 63 - 688 ug/g creat
The marker Zinc on a Comprehensive Urine Element Profile panel from Genova Diagnostics is used to assess the amount of zinc that is being excreted in an individual's urine. Zinc is an essential trace mineral that plays crucial roles in various bodily functions, including immune response, DNA synthesis, and protein production.
Fatty Acids Profile, Essential (Serum/Plasma)
Aids in identification of patients with essential fatty acid deficiency, evaluation of nutritional status, and diet monitoring.
Optimal range: 0 - 5.88 Ratio
This test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. Balancing these eicosanoids in the body is an excellent way
for managing heart disease and other chronic and inflammatory processes.
Optimal range: 30 - 100 qg/mL
Alpha-linolenic acid (ALA) is an essential n-3 fatty acid and must be obtained in the diet. Sources include green leafy vegetables, oily fish, flaxseed, soybean oil, canola oil, walnuts, and chia seeds. ALA has an 18-carbon backbone with 3 double bonds starting at the third carbon molecule (18:3n3). It is an important precursor to make eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), though these can also be obtained in the diet. Most dietary ALA is used to generate energy and only a small portion is converted to EPA and DHA.
Optimal range: 0 - 250 qg/mL
Arachidonic acid is an inflammatory omega-6 fatty acid. Our bodies produce this nutrient, and its excess may lead to inflammatory diseases and mood disorders.
Optimal range: 100 - 200 qg/mL
Docosahexaenoic acid (DHA) is an omega-3 fatty acid with 22 carbons and 6 double bonds (22:6n3). It can be obtained from the diet, supplemented, or created by conversion from DPA using elongase and desaturase enzymes. DHA is present in fatty fish such as salmon, tuna, and mackerel, and low levels of DHA can be found in meat and eggs. Both individually or in combination with EPA, DHA is widely supplemented due to the enormous amount of research available regarding its anti-inflammatory role in many clinical conditions such as cardiovascular disease, cognitive decline, autoimmune disease, fetal development, visual disturbances, cancer, and metabolic syndrome.
Optimal range: 50 - 100 qg/mL
Eicosapentaenoic Acid (EPA) is a Polyunsaturated Omega-3 Fatty Acid and is involved in the regulation of inflammatory processes and prevention of blood clots.
Omega-3 fatty acids (omega-3s) have a carbon–carbon double bond located three carbons from the methyl end of the chain. Omega-3s, sometimes referred to as “n-3s,” are present in certain foods such as flaxseed and fish, as well as dietary supplements such as fish oil. Several different omega-3s exist, but the majority of scientific research focuses on three: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA contains 18 carbon atoms, whereas EPA and DHA are considered “long-chain” (LC) omega-3s because EPA contains 20 carbons and DHA contains 22.
Optimal range: 0.17 - 1 Ratio
The EPA:AA ratio is a valuable predictor of cardiovascular risk.
The EPA:AA ratio may be a marker of chronic inflammation, with a lower ratio corresponding to higher levels of inflammation. It is now well established that inflammation plays an important role in cardiovascular disease.
Optimal range: 0 - 930 qg/mL
Linoleic acid is by far the most abundant polyunsaturated fatty acid in most human tissues. Linoleic acid is an essential fatty acid, and low levels indicate dietary insufficiency.
Optimal range: 0 - 20 index
Monounsaturated Fatty Acid Index Includes:
Optimal range: 35 - 145 nmol/ML
Nervonic acid (NA) is an omega-9 MUFA with a 24-carbon backbone and one double bond (24:1n9). It is a very important fatty acid in the white matter of the brain and is responsible for nerve cell myelin biosynthesis. There are small amounts of NA in cooking fats, vegetable oils and borage oil. It can also be synthesized in the body by elongating oleic acid (which is essentially desaturated stearic acid). NA is essential for the growth and maintenance of the brain and peripheral nervous tissue enriched with sphingomyelin.
Optimal range: 4.5 - 30 index
The omega-3 index is defined as the RBC percentage sum of EPA+DHA, both of which are important anti-inflammatory omega-3 fatty acids. This index was first proposed in 2004 as a cardiovascular risk factor by Dr. Willian S. Harris and Dr. Clemons von Schacky as a way of assessing risk for coronary artery disease and related death. Since then, it has been repeatedly verified as an important cardiovascular biomarker, and studied in other diseases including obesity, mood disorder, and insulin resistance.
Low values of the index over a prolonged period of time indicate an increased risk of developing cardiovascular diseases.
Dietary intervention to increase the omega-3 index should include oily fish, flax, walnut, and chia. Fish oil supplementation can also be considered.
Optimal range: 0 - 0.07 Ratio
The Omega-3/Omega-6 ratio signifies the balance between omega-3 and omega-6 fatty acids in one's diet. Omega-3 and omega-6 are essential fatty acids with distinct roles in the body. A balanced ratio is important for overall health. An imbalanced ratio, often seen in modern diets rich in processed foods, can contribute to inflammation and various chronic diseases. The ratio's importance lies in its impact on inflammation levels, cardiovascular health, and other bodily processes. Monitoring and maintaining an appropriate Omega-3/Omega-6 ratio can support optimal health and well-being.
Optimal range: 0 - 39 index
Optimal range: 0 - 30 %
When assessing fatty acids in RBCs, this marker measures a weighted percentage of fatty acids taken up into the erythrocyte wall. The total saturated fatty acid percentage is a combined total weight percentage calculated by adding up each of the measured saturated fatty acids. It should be noted that when dealing with percentages, the amount of each fatty acid can influence the others. For example, fish oil supplementation may increase the overall omega-3 percentage, which then lowers the omega-6 percentage. Because some saturated fatty acids are beneficial, it is important to look at the levels of those specifically as well.
Fatty acids are essential to heart health. Balancing fatty acids can improve cholesterol and triglyceride levels, improve immune system function as well as reduce inflammation and rate of heart disease.
Saturated Fatty Acid Index Includes:
Myristic (14:0)
Palmitic (16:0)
Stearic (18:0)
- May raise levels of LDL-C and increases heart disease risk.
Optimal range: 0.12 - 0.55 mmol/L
Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been linked to healthy aging throughout our lifespan - from fetal development to prevention of Alzheimer’s disease. Omega-3 fatty acids are anti-inflammatory and used in cell membrane production, function, and overall gene expression. Most standard American diets are deficient in common n-3 food sources such as flax, oily fish, nuts, and green leafy vegetables. Deficiencies in n-3 have been correlated with many clinical conditions such as neurodevelopmental and behavioral disorders, cardiovascular disease, cognitive decline, mood disorders, skin abnormalities, visual changes, and cancer.
Optimal range: 0 - 0.5 %
Trans Fatty Acid Index Includes:
- Palmitelaidic (16:1n9t)
- Elaidic (18:1n9t)
- Linoelaidic (18:2n9t)
Optimal range: 2.25 - 10 Ratio
Unsaturated/Saturated Ratio Index Includes:
- Omega 3 FA (EPA, DHA, ALA)
- Omega 6 FA (LA, AA, DA)
- Saturated FA (Myristic, Palmitic, Stearic)
-- Increasing polyunsaturated (PUFA) intake lowers LDL-C and decreases heart disease risk.
-- Increased intake of PUFA lowers LDL-C by increasing LDL receptor activity.
Optimal range: 50 - 250 nmol/ML
Vaccenic acid (VA) is a monounsaturated omega-7 fatty acid (18:1n7). VA is a naturally occurring trans-fat unlike those produced industrially. The trans-configuration occurs around carbon 11, therefore VA is sometimes denoted as trans11-18:1n7. Ruminant animals produce vaccenic acid in a fermentation process in their microbiome. The dairy products (cheese, milk, butter) or meat obtained from these animals contain VA.
3301 Organix Comprehensive Profile - Urine (mmol/mol creatinine)
The Organix Comprehensive Profile is a nutritional test providing insights into organic acids and a view into the body's cellular metabolic processes. Identifying metabolic blocks that can be treated nutritionally allows individual tailoring of interventions that maximize responses and lead to improved outcomes.
Optimal range: 0 - 5.3 mmol/mol creatinine
3,4-Dihydroxyphenylpropionate seems to be strongly associated with a troublesome type of bacteria called Clostridia.
Optimal range: 0.02 - 0.22 mmol/mol creatinine
3-Methyl-4-OH-Phenylglycol (MHPG) is a byproduct of the central nervous system’s norepinephrine (NE) metabolism. MHPG metabolizes to vanilmandelic acid (VMA) in the liver using the enzymes alcohol dehydrogenase and aldehyde dehydrogenase. Urinary MHPG was originally thought to represent CNS sympathetic output, but is now known to be principally derived from peripheral neuronal NE metabolism.
MHPG has been widely studied as a marker to predict response to medications used in mood disorders or as a biomarker to monitor pharmacotherapies.
Optimal range: 3.8 - 12.1 mmol/mol creatinine
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 15 mmol/mol creatinine
8-hydroxy-2-deoxyguanosine measures the oxidative impact to DNA. 8-hydroxy-2-deoxyguanosine levels will be high if your total antioxidant protection is inadequate.
Optimal range: 0 - 0.83 mmol/mol creatinine
Alpha-Hydroxybutyrate is a by-product of glutathione production. Levels of alpha-hydroxybutyrate in the urine may reflect levels of glutathione production.
Optimal range: 0 - 6.7 mmol/mol creatinine
α-Hydroxyisobutyric Acid is a major urinary metabolite of the industrial solvent methyl tert-butyl ether (MTBE).
MTBE was a gasoline additive discontinued in the early 2000’s used to reduce automobile emissions. Due to significant ground water leakage from storage tanks, ongoing exposure to MTBE exists in ground water. There is also data available on levels of MTBE in ambient air.
Urinary α-hydroxyisobutryic acid is a marker of recent MTBE exposure. Although, MTBE was initially designated as “noncarcinogenic”, recent studies suggest some interesting clinical associations. Exposure to MTBE has been linked to type 2 diabetes as a result of disrupted zinc homeostasis and glucose tolerance. There are also clinical associations with autism, DNA oxidative damage, and methylation defects. Studies on cancer, reproductive abnormalities, nonalcoholic fatty liver, and neurotoxicity have been either negative or inconclusive thus far.
Optimal range: 0 - 2.1 mmol/mol creatinine
Alpha-Keto-Beta-Methylvalerate is a B-Complex Vitamin Marker. Vitamins are compounds that your body needs to be healthy. Vitamins are “essential” for proper function, which means that they are not made inside your body and must be consumed in the diet.
Optimal range: 0 - 1.7 mmol/mol creatinine
α-Ketoadipic Acid (AKAA; 2-Oxoadipic acid, 2-Ketoadipic acid) is an organic acid formed from α-aminoadipic acid (which originates with lysine) and also from α-aminomuconic acid (derived from tryptophan).
AKAA metabolizes to form glutaryl-CoA via oxidative decarboxylation. The cofactors needed in this step are Coenzyme A, NAD, thiamine pyrophosphate (vitamin B1), lipoic acid, and vitamin B2.
Optimal range: 4 - 52 mmol/mol creatinine
Alpha-Ketoglutarate is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 0.89 mmol/mol creatinine
Alpha-Ketoisocaproate is a B-Complex Vitamin Marker (Leucine catabolism).
Optimal range: 0 - 0.97 mmol/mol creatinine
Alpha-Ketoisovalerate (together with Alpha-Ketoisocaproate and Alpha-Keto-Beta-methylvalerate) requires Vitamins B1, B2, B3, B5 and lipoic acid to be metabolized.
Optimal range: 0 - 0.46 mmol/mol creatinine
α-Ketophenylacetic Acid, also known as phenylglyoxylic acid (PGA), is a urinary metabolite of styrene, toluene, xylenes, and ethylbenzene.
It acts as a urinary marker of recent exposure via inhalation, contact, oral, and others.
The biologic half-life of styrene in humans is fairly short and corresponds with the disappearance of PGA from the urine. Styrene is widely used for synthesis of polymers such as plastics, rubbers, and surface coating. It is also used in the pharmaceutical industry. Styrene is commonly applied in the manufacturing of paints, pigments, and glues. Coexposure to other solvents, like toluene and ethyl acetate is common in workplaces where styrene is a concern. Since toluene and xylene are components of unleaded gasoline, workers at gas stations are at potential risk of exposure, as well as the general population.
Styrene exposure may interfere with peripheral metabolism of thyroid hormones by inhibiting conversion of T4 to T3.
It may also affect DNA repair capacity and damage. There are also clinical associations with insulin resistance, oxidative stress, and inflammation.
Optimal range: 0 - 2.8 mmol/mol creatinine
Adipate, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Carnitine is needed to move fatty acids into the mitochondria where they are converted to energy using vitamin B2.
If carnitine is sufficient long-chain fatty acids go through beta-oxidation in the mitochondria.
When insufficient levels of carnitine or vitamin B2 slow down this process, other parts of the cellular machinery take over and make adipate and suberate.
A similar block in another pathway causes high ethylmalonate. Since most of our bodies’ energy is produced from the burning of fatty acids, our muscles and brain suffer when this cellular energy pathway is blocked. Anything that interferes with the normal fatty acid oxidation may reveal high levels of these metabolites.
Optimal range: 0 - 2.8 mmol/mol creatinine
ß-Hydroxybutyrate is a metabolic marker of blood sugar utilization and insulin function.
Optimal range: 0 - 29 mmol/mol creatinine
Elevated b-hydroxyisovalerate is found as a result of biotin insufficiency. This issue often presents in patients as skin problems as well as hair loss. Adequate biotin supply will yield a lower level of b-hydroxyisovalerate.
Until recently, biotin deficiency was very difficult to determine in humans because this vitamin deficiency affects health in ways that mimic many other conditions. Doctors were likely to overlook biotin deficiency until this test was discovered. Beta(ß)-hydroxyisovalerate is a specific and sensitive metabolic marker for functional biotin deficiency. As your biotin intake decreases, your ß-hydroxyisovalerate excretion increases.
Optimal range: 5 - 22 mmol/mol creatinine
b-Hydroxypropionate (aka 3-Hydroxypropionic Acid, 3-HPA) is a major urinary metabolite of propionic acid. Propionic acid is derived from dietary branched-chain amino acids, oddchain fatty acids, and can be produced in the gut by bacterial fermentation of fiber. The biotin-dependent enzyme propionyl CoA carboxylase is responsible for metabolizing propionic acid to methylmalonyl CoA, which is subsequently isomerized to succinyl CoA. Decreased activity of this enzyme shunts propionyl CoA into alternative pathways which form 3-HPA.
Optimal range: 0 - 0.05 mmol/mol creatinine
Benzoate, was one of the compounds first found to be elevated in urine from patients with intestinal bacterial overgrowth of various origins.
Optimal range: 10 - 36 mmol/mol creatinine
cis-Aconitate is involved in both energy production and removal of toxic ammonia.
Optimal range: 0 - 5.8 mmol/mol creatinine
Citramalic acid and tartaric acid are yeast metabolites that are also influenced by dietary intake of fruits, wine, and sugars.
Optimal range: 40 - 520 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 3.1 - 19.5 mmol/L
Urinary creatinine is commonly used as a laboratory standardization when evaluating urinary analytes. Creatinine excretion is influenced by muscle mass and body habitus since creatinine formation occurs in muscle.
Dietary intake of proteins containing arginine and glycine (precursors of creatine) and creatine supplementation can elevate levels.
Hydration status may also play a role in urinary creatinine levels.
Optimal range: 0 - 36 mmol/mol creatinine
D-arabinitol is a sugar alcohol produced specifically by Candida spp. The majority of the published literature shows a correlation between serum or urinary D-arabinitol levels and systemic invasive candidiasis in immunocompromised individuals. Several articles have suggested that D-arabinitol is a useful marker for diagnosis of candidiasis in this patient population as well as potentially be a prognostic indicator in a broad range of conditions.
Optimal range: 0 - 1.5 mmol/mol creatinine
Formiminoglutamate (FIGLU) is a functional marker of insufficiency of folic acid, another B-vitamin, and is a compound made from the amino acid histidine.
Optimal range: 0 - 0.51 mmol/mol creatinine
Glutarate (Glutaric Acid) is formed from the essential amino acids lysine and tryptophan through the intermediaries of alpha ketoadipic acid and glutaryl-CoA. Glutaryl-CoA is further metabolized to glutaconyl- and crotonyl-CoA by an enzyme called glutaryl-CoA dehydrogenase. This enzyme requires riboflavin (vitamin B2) as a cofactor.
Optimal range: 3.5 - 16.4 mmol/mol creatinine
Glyceric acid is an organic acid that stems from the catabolism of the amino acid serine. Severe elevations in glyceric acid are an indication of a rare inborn error of metabolism known as glyceric aciduria. One form of glyceric aciduria is the result of a defect in the enzyme glycerate kinase which removes glyceric acid from the system. While many case studies have linked this disorder with severe developmental abnormalities, there is some debate as to whether glycerate kinase deficiency is the cause or rather a confounding variable. Another glyceric aciduria is referred to as primary hyperoxaluria type 2 (PH2). This rare genetic condition results in excessive production of oxalates in the system in the form of oxalic acid. Over time, systemic deposition of oxalates in body tissues can occur which is a process known as oxalosis. This disease is characterized by urolithiasis, nephrocalcinosis, and deposition of oxalates in other body tissues.
Optimal range: 0 - 67 mmol/mol creatinine
Glycolate is one of the oxalate markers.
Glycolic acid (glycolate) is an indicator of genetic disease of oxalate metabolism called Hyperoxaluria type I due to a deficiency in the enzyme activity of alanine glyoxylate amino transferase (AGT).
Oxalate (and its acid form, oxalic acid), is an organic acid that is primarily derived from three sources: the diet, fungus (such as Aspergillus and Penicillium), possibly Candida, and also human metabolism.
Oxalic acid is the most acidic organic acid in body fluids and is used commercially to remove rust from car radiators. Antifreeze (ethylene glycol) is toxic primarily because it is converted to oxalate in the body. Two different types of genetic diseases are known in which oxalates are high in the urine, hyperoxalurias type I and type II.
In the genetic disease hyperoxaluria type I and in vitamin B-6 deficiency, there is a deficiency in the enzyme activity of alanine glyoxylate amino transferase (AGT), leading to the accumulation of glyoxylic acid. The high glyoxylic acid can then be converted to glycolate by the enzyme GRHPR or to oxalate by the enzyme LDH. Thus, glycolate, glyoxylate, and oxalate are the metabolites that are then elevated in the Organic Acids Test in hyperoxaluria type I and in vitamin B-6 deficiency.
Optimal range: 0 - 603 mmol/mol creatinine
Microbes resident in the large intestine of the human body help to break down complex aromatic compounds in dietary plant matter (polyphenols), freeing up benzoic acid, which enters the bloodstream. The liver can add the amino acid glycine to benzoic acid to form hippuric acid, which re-enters the blood and is absorbed by the kidneys. As a result, the kidneys excrete hundreds of milligrams of hippuric acid into the urine every day.
Optimal range: 1.2 - 5.3 mmol/mol creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0 - 15 mmol/mol creatinine
Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production, and when it is elevated it may indicate that the body is trying to increase its production of CoQ10.
Optimal range: 0 - 4.2 mmol/mol creatinine
Indoleacetic acid (IAA), or indole-3-acetate, is produced by the bacterial fermentation of the amino acid tryptophan.
IAA can be formed from several common gut microbes such as Clostridia species, Escherichia coli, and Saccharomyces species.
Optimal range: 22 - 65 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 3.7 mmol/mol creatinine
Isovalerylglycine is produced from leucine catabolism. It is further metabolized via isovaleryl-CoA dehydrogenase. This enzyme requires vitamin B2 as a cofactor.
Optimal range: 0 - 7.1 mmol/mol creatinine
Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0.44 - 5 mmol/mol creatinine
Optimal range: 1.9 - 19.8 mmol/mol creatinine
L-Lactate is a product of muscle use, so it is constantly produced in normal daily activity.
Optimal range: 0 - 8.1 mmol/mol creatinine
m-Hydroxyphenylacetate (3-Hydroxyphenylacetic acid) and 4-hydroxyphenylacetic acid are produced by the bacterial fermentation of amino acids, much like Indoleacetic acid (IAA).
Optimal range: 0 - 3 mmol/mol creatinine
Malate is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 1.9 mmol/mol creatinine
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production.
Optimal range: 0.33 - 1.01 mmol/mol creatinine
Orotate is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 0 - 78 mmol/mol creatinine
Oxalic acid is the metabolic end-product of the glyoxylase pathway and is derived from the oxidation of glyoxylate.
In the cell, the majority of glyoxylate is converted into glycine or glycolic acid. However, in some instances there may be greater oxidation of glyoxylate to oxalic acid. This leads to increased urinary excretion of oxalic acid.
As 80% of kidney stones are calcium-oxalate stones, an increase in oxalic acid is strongly correlated to frequency of urolithiasis.
Optimal range: 0 - 29 mmol/mol creatinine
Associated with small intestinal bacteria overgrowth (SIBO) due to its production by C. di cile, C. stricklandii, C. lituseburense, C. subterminale, C. putrefaciens, and C. propionicum.
Optimal range: 0 - 0.12 mmol/mol creatinine
Produced from bacterial degradation of unabsorbed phenylalanine.
Optimal range: 16 - 34 mmol/mol creatinine
Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Optimal range: 7 - 32 mmol/mol creatinine
Pyruvate feeds into the citric acid cycle & converts into acetyl CoA. Pyruvate is formed from carbohydrate via glucose or glycogen & secondarily from fats (glycerol) & glycogenic amino acids.
Optimal range: 0 - 9.1 mmol/mol creatinine
Quinolinic acid is a neurotoxic substance produced by our own bodies and a metabolite of tryptophan.
Optimal range: 0 - 2.1 mmol/mol creatinine
Suberate, Adipate, and Ethylmalonate elevations can indicate that you may need additional carnitine and/or vitamin B2 to assist your cells in converting fats into energy efficiently.
Optimal range: 0.4 - 4.6 mmol/mol creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0 - 15 mmol/mol creatinine
- Tartaric acid is a compound found in plant foods. It has been identified as a biomarker of grape intake, though it has also been identified in other foods. Tartaric acid levels peak at 4–8 hours after intake. Levels in foods vary significantly between types of foods and within individual foods.
- Tartaric acid cannot be processed by humans and is either excreted or utilized by gut bacteria as a carbon source. Some bacteria have genes for tartaric metabolizing enzymes, so levels can be impacted by gut microbiome. The process starts once tartaric acid is released (i.e., grapes are crushed or are invaded by pathogens), making it susceptible to catabolic enzymes from microorganisms, which may reduce it to oxaloacetate, glyceric acid, and pyruvic acid.
Common Dietary Sources:
Wine/grapes, chocolate, food additive/preservative
Optimal range: 0.4 - 3.6 mmol/mol creatinine
Vanilmandelate (VMA) and Homovanillate (HVA) are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0 - 0.96 mmol/mol creatinine
Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.
Urinalysis, complete
Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various disease states. Microscopic examination helps to detect the presence of cells and other formed elements.
Reference range: NONE SEEN
Reference range: NEGATIVE, POSITIVE
Reference range: NEGATIVE, POSITIVE
Reference range: NONE SEEN, DETECTED
Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called urinalysis. Hyaline casts can be present in low numbers (0-1/LPF) in concentrated urine of otherwise normal patients and are not always associated with renal disease.
Reference range: NEGATIVE, POSITIVE
Reference range: NEGATIVE, POSITIVE
Reference range: NEGATIVE, POSITIVE
Reference range: NEGATIVE, POSITIVE
Optimal range: 5 - 8 pH
Reference range: NEGATIVE, TRACE, POSITIVE
Urine protein tests detect and/or measure protein being released into the urine. If the kidneys are damaged or compromised due to other conditions, they become less effective at filtering, causing detectable amounts of protein to spill over into the urine.
Reference range: NONE SEEN
Optimal range: 1 - 1.03 specific gravity
Reference range: NONE SEEN, > 5 HPF
>10 x 106/L squamous epithelial cells indicate skin/mucosal contamination of the sample.
What are epithelial cells?
Epithelial cells are the cells on the body's surface, such as the skin, urinary tract, blood vessels, and organs. They act as a protective barrier, stopping viruses from entering the body. Besides the protective function, epithelial cells perform other functions as well, such as:
→ Help with sensory detection of taste, smell or sight as they transfer signals through the sensory nerve endings
→ Secrete hormones, enzymes, hormones, and fluids
→ Absorb certain substances, such as nutrients from the food
→ Epithelial cells in the kidney excrete waste, and epithelial cells in the sweat glands excrete sweat
→ Filter blood, dirt, and particles
→ Allow selective diffusion of materials to pass through
In general, epithelial cells act as a barrier between the outside and inside of your body, and help protect your body from viruses.
Reference range: NONE SEEN, HIGH
Urine is a generally thought of as a sterile body fluid, therefore, evidence of white blood cells or bacteria in the urine is considered abnormal and may suggest a urinary tract infection such as, bladder infection (cystitis), infection of kidney (pyelonephritis).
Systemic Sclerosis
Systemic sclerosis (SSc) is a chronic, multisystem, heterogeneous autoimmune disease. Individuals with SSc have a mortality rate approximately 2.8 times that of the general population. In the United States, the incidence is approximately 15 cases per 100,000 person-years.
The disease is characterized by inflammation, vasculopathy, and progressive fibrosis of the skin and internal organs.
SSc is frequently referred to as scleroderma; however, scleroderma includes SSc and localized forms of scleroderma that affect only the skin.
The 2 main types of SSc are defined according to the pattern of skin involvement:
limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc).
In lcSSc, skin thickening is present distal to the elbows and knees, and facial skin thickening may or may not be present.
In contrast, dcSSc is characterized by thickening of the skin of the whole extremity, as well as that of the anterior chest, abdomen, and back, with or without facial skin involvement.
Multiple organs, including the heart, lungs, gastrointestinal tract, and kidneys, can be affected in both forms, though organ involvement is generally less severe in lcSSc.
CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) occurs frequently in lcSSC but can also occur in longstanding dcSSc.
Of patients with SSc, approximately 55% have lcSSc and 35% have dcSSc. The remaining 10% of patients with SSc have sine scleroderma or an overlap syndrome.
Sine scleroderma is a form of SSc that has characteristic clinical features but spares the skin. Overlap syndromes occur when features of another autoimmune disease are present along with SSc.
Early treatment of SSc can improve outcomes, so prompt diagnosis is important. However, diagnosis can be challenging because many patients present with nonspecific symptoms such as Raynaud phenomenon, gastroesophageal reflux, puffy fingers, and fatigue.
In addition, patients with other autoimmune disorders may present with symptoms suggestive of SSc. Testing for autoantibodies that are associated with SSc assists diagnosis and can help predict organ involvement and severity of disease.
References:
Lee YH. Overall and sex- and disease subtype-specific mortality in patients with systemic sclerosis: an updated meta-analysis. Z Rheumatol. 2019;78(2):195-201. doi:10.1007/s00393-018-0492-8
Fan Y, Bender S, Shi W, et al. Incidence and prevalence of systemic sclerosis and systemic sclerosis with interstitial lung disease in the United States. J Manag Care Spec Pharm. 2020;26(12):1539-1547. doi:10.18553/jmcp.2020.20136
Lee JJ, Pope JE. Diagnosis and management of systemic sclerosis: a practical approach. Drugs. 2016;76(2):203-213. doi:10.1007/s40265-015-0491-x
Young A, Khanna D. Systemic sclerosis: commonly asked questions by rheumatologists. J Clin Rheumatol. 2015;21(3):149-155. doi:10.1097/RHU.0000000000000232
Denton CP, Khanna D. Systemic sclerosis. Lancet. 2017;390(10103):1685-1699. doi:10.1016/s0140-6736(17)30933-9
Optimal range: 0 - 11 SI
CENP-A stands for centromere proteins A.
Centromere antibodies can be directed against a number of centromere proteins (CENP), including CENP-A, -B, and -C, though CENP-B is thought to be the main target.
These antibodies are found in 20% to 40% of patients with SSc and are associated with the lcSSc subtype.
Furthermore, centromere antibodies are included in the 2013 ACR-EULAR classification criteria. However, these antibodies can occur in other connective tissue diseases, including:
- systemic lupus erythematosus (SLE),
- primary biliary cholangitis,
- rheumatoid arthritis,
- and Sjögren syndrome.
Optimal range: 0 - 11 SI
CENP-B stands for centromere proteins B.
Centromere antibodies can be directed against a number of centromere proteins (CENP), including CENP-A, -B, and -C, though CENP-B is thought to be the main target.
These antibodies are found in 20% to 40% of patients with SSc and are associated with the lcSSc subtype.
Furthermore, centromere antibodies are included in the 2013 ACR-EULAR classification criteria. However, these antibodies can occur in other connective tissue diseases, including:
- systemic lupus erythematosus (SLE),
- primary biliary cholangitis,
- rheumatoid arthritis,
- and Sjögren syndrome.
Optimal range: 0 - 11 SI
U3-RNP antibodies target the U3 small nucleolar ribonucleoprotein (U3-RNP) complex, which consists of the protein fibrillarin and U3 RNA. These antibodies are found in about 4% to 10% of patients with SSc, and are especially common in African American SSc patients (approximately 30%). U3-RNP antibodies are rarely found in patients with other autoimmune disorders; thus, the presence of these antibodies supports a SSc diagnosis.
These antibodies occur most often in dcSSc, but they can also occur in lcSSc.
U3-RNP antibodies are associated with multiorgan involvement, including the heart, kidneys, muscle, lungs, and gastrointestinal system. Their presence is an independent risk factor for the development of PAH, and PAH is the most common cause of death in U3-RNP–positive patients. Therefore, their presence indicates a poorer prognosis.
Optimal range: 0 - 11 SI
PM/Scl antibodies target the PM/Scl exosome complex, and most reactivity is against 2 proteins, PM/Scl-75 and PM/Scl-100. They are present in 2% to 11% of SSc patients and are associated with SSc-myositis overlap syndrome and lcSSc. PM/Scl antibodies also occur in other autoimmune diseases such as polymyositis and dermatomyositis.
The presence of either PM/Scl-75 or PM/Scl-100 antibody is associated with calcinosis, and the co-occurrence of both antibodies is associated with inflammatory myositis.
However, each antibody may be associated with a distinct clinical phenotype; gastrointestinal symptoms and ILD are common in patients with PM/Scl-75 antibodies but less so in those with PM/Scl-100 antibodies. Internal organ involvement generally remains mild in patients with any PM/Scl antibodies, and the presence of these antibodies is associated with an overall favorable prognosis.
Optimal range: 0 - 11 SI
PM/Scl antibodies target the PM/Scl exosome complex, and most reactivity is against 2 proteins, PM/Scl-75 and PM/Scl-100. They are present in 2% to 11% of SSc patients and are associated with SSc-myositis overlap syndrome and lcSSc. PM/Scl antibodies also occur in other autoimmune diseases such as polymyositis and dermatomyositis.
The presence of either PM/Scl-75 or PM/Scl-100 antibody is associated with calcinosis, and the co-occurrence of both antibodies is associated with inflammatory myositis.
However, each antibody may be associated with a distinct clinical phenotype; gastrointestinal symptoms and ILD are common in patients with PM/Scl-75 antibodies but less so in those with PM/Scl-100 antibodies. Internal organ involvement generally remains mild in patients with any PM/Scl antibodies, and the presence of these antibodies is associated with an overall favorable prognosis.
Optimal range: 0 - 11 SI
RNA polymerase III antibodies target RNA polymerase epitopes 11 and 155 and are thus also known as anti-RP11 and anti-RP155.
These antibodies are found in 7% to 41% of patients with SSc and occur most often in dcSSc.
They are diagnostic for SSc, as they are rarely found in other autoimmune diseases, and are included in the 2013 ACR-EULAR classification criteria.
The presence of RNA polymerase III antibodies is associated with progressive skin thickening, gastric antral vascular ectasia (GAVE), and renal crisis.
In addition, these antibodies are associated with onset of cancer within a 2-year timeframe before or after onset of SSc skin changes. Historically, RNA polymerase III antibodies indicated a poor prognosis, but mortality rates improved after the introduction of ACE inhibitors to treat renal crisis; the prognosis for patients with RNA polymerase III antibodies is now better than for those with Scl-70 or U3-RNP antibodies.
Optimal range: 0 - 11 SI
RNA polymerase III antibodies target RNA polymerase epitopes 11 and 155 and are thus also known as anti-RP11 and anti-RP155.
These antibodies are found in 7% to 41% of patients with SSc and occur most often in dcSSc.
They are diagnostic for SSc, as they are rarely found in other autoimmune diseases, and are included in the 2013 ACR-EULAR classification criteria.
The presence of RNA polymerase III antibodies is associated with progressive skin thickening, gastric antral vascular ectasia (GAVE), and renal crisis.
In addition, these antibodies are associated with onset of cancer within a 2-year timeframe before or after onset of SSc skin changes. Historically, RNA polymerase III antibodies indicated a poor prognosis, but mortality rates improved after the introduction of ACE inhibitors to treat renal crisis; the prognosis for patients with RNA polymerase III antibodies is now better than for those with Scl-70 or U3-RNP antibodies.
Optimal range: 0 - 1 NEG AI
Scl-70 is also known as Topoisomerase I Antibody.
Topoisomerase I antibodies were initially named Scl-70 based on immunoblot detection of a 70-kDa protein.
The prevalence of Scl-70 antibodies in SSc varies widely across geographies and ethnicities, ranging from 9% to 71%.
These antibodies are strongly associated with dcSSc but also occur in lcSSc.
The 2 main types of SSc are defined according to the pattern of skin involvement: limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc). In lcSSc, skin thickening is present distal to the elbows and knees, and facial skin thickening may or may not be present. In contrast, dcSSc is characterized by thickening of the skin of the whole extremity, as well as that of the anterior chest, abdomen, and back, with or without facial skin involvement. Multiple organs, including the heart, lungs, gastrointestinal tract, and kidneys, can be affected in both forms, though organ involvement is generally less severe in lcSSc. CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) occurs frequently in lcSSc but can also occur in longstanding dcSSc.
Optimal range: 0 - 11 SI
Scl-70 is also known as Topoisomerase I Antibody.
Topoisomerase I antibodies were initially named Scl-70 based on immunoblot detection of a 70-kDa protein.
The prevalence of Scl-70 antibodies in SSc varies widely across geographies and ethnicities, ranging from 9% to 71%.
These antibodies are strongly associated with dcSSc but also occur in lcSSc.
The 2 main types of SSc are defined according to the pattern of skin involvement: limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc). In lcSSc, skin thickening is present distal to the elbows and knees, and facial skin thickening may or may not be present. In contrast, dcSSc is characterized by thickening of the skin of the whole extremity, as well as that of the anterior chest, abdomen, and back, with or without facial skin involvement. Multiple organs, including the heart, lungs, gastrointestinal tract, and kidneys, can be affected in both forms, though organ involvement is generally less severe in lcSSc. CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) occurs frequently in lcSSc but can also occur in longstanding dcSSc.
Optimal range: 0 - 1 NEG AI
The SCL-70 antibody test is a blood test used to detect antibodies against topoisomerase I, an enzyme found in the nucleus of cells. These antibodies are part of the antinuclear antibody (ANA) family and are often associated with certain autoimmune conditions—most notably systemic sclerosis (scleroderma).
This test helps doctors evaluate symptoms such as skin thickening, joint pain, fatigue, or shortness of breath that may be related to autoimmune diseases.
Optimal range: 0 - 11 SI
Th/To antibodies target RNase P and mitochondrial RNase ribonucleoprotein complexes. These antibodies are found in 2% to 5% of SSc patients and are primarily associated with lcSSc. Th/To antibodies are rarely found in other autoimmune diseases but can occur in patients with localized scleroderma.
Patients with Th/To antibodies often develop both ILD and PAH and thus have a poorer prognosis than other patients with lcSSc.
Optimal range: 0 - 11 SI
U1-snRNP antibodies, also referred to as U1-RNP and Smith (Sm)/RNP, target 3 components of the U1 small nuclear ribonucleoprotein complex: U1-snRNP RNP A, U1-snRNP RNP C, and U1-snRNP RNP-70kd.
These antibodies, found in 2% to 14% of SSc patients, are more frequent in lcSSc than in dcSSc.
The 2 main types of SSc are defined according to the pattern of skin involvement: limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc).
In lcSSc, skin thickening is present distal to the elbows and knees, and facial skin thickening may or may not be present. In contrast, dcSSc is characterized by thickening of the skin of the whole extremity, as well as that of the anterior chest, abdomen, and back, with or without facial skin involvement. Multiple organs, including the heart, lungs, gastrointestinal tract, and kidneys, can be affected in both forms, though organ involvement is generally less severe in lcSSc.
CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) occurs frequently in lcSSC but can also occur in longstanding dcSSc.
The antibodies are also found in patients with other autoimmune diseases, including approximately 90% of patients with mixed connective tissue disease.
Optimal range: 0 - 11 SI
U1-snRNP antibodies, also referred to as U1-RNP and Smith (Sm)/RNP, target 3 components of the U1 small nuclear ribonucleoprotein complex: U1-snRNP RNP A, U1-snRNP RNP C, and U1-snRNP RNP-70kd.
These antibodies, found in 2% to 14% of SSc patients, are more frequent in lcSSc than in dcSSc.
The 2 main types of SSc are defined according to the pattern of skin involvement: limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc).
In lcSSc, skin thickening is present distal to the elbows and knees, and facial skin thickening may or may not be present. In contrast, dcSSc is characterized by thickening of the skin of the whole extremity, as well as that of the anterior chest, abdomen, and back, with or without facial skin involvement. Multiple organs, including the heart, lungs, gastrointestinal tract, and kidneys, can be affected in both forms, though organ involvement is generally less severe in lcSSc.
CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) occurs frequently in lcSSC but can also occur in longstanding dcSSc.
The antibodies are also found in patients with other autoimmune diseases, including approximately 90% of patients with mixed connective tissue disease.
Optimal range: 0 - 11 SI
U1-snRNP antibodies, also referred to as U1-RNP and Smith (Sm)/RNP, target 3 components of the U1 small nuclear ribonucleoprotein complex: U1-snRNP RNP A, U1-snRNP RNP C, and U1-snRNP RNP-70kd.
These antibodies, found in 2% to 14% of SSc patients, are more frequent in lcSSc than in dcSSc.
The 2 main types of SSc are defined according to the pattern of skin involvement: limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc).
In lcSSc, skin thickening is present distal to the elbows and knees, and facial skin thickening may or may not be present. In contrast, dcSSc is characterized by thickening of the skin of the whole extremity, as well as that of the anterior chest, abdomen, and back, with or without facial skin involvement. Multiple organs, including the heart, lungs, gastrointestinal tract, and kidneys, can be affected in both forms, though organ involvement is generally less severe in lcSSc.
CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) occurs frequently in lcSSC but can also occur in longstanding dcSSc.
The antibodies are also found in patients with other autoimmune diseases, including approximately 90% of patients with mixed connective tissue disease.
Amino Acid Analysis
Amino Acid analysis is necessary for the diagnosis of a variety of inborn errors of metabolism. These include, but are not limited to:
- phenylketonuria
- tyrosinemia
- citrullinemia
- non-ketotic hyperglycinemia
- maple syrup urine disease
- and homocystinuria.
The assay is also key for the continued monitoring of treatment plans for these disorders and useful for assessing nutritional status of patients.
Interpretive Information:
Elevation of 1 or more amino acids may be diagnostic of an aminoacidopathy. Elevated amino acid levels are also associated with noninherited diseases such as severe liver disease and renal tubular disorders (eg, Fanconi syndrome).
Decreased levels of amino acids are associated with malnutrition as seen in the elderly or those with poor protein intake or gastrointestinal disease.
Additional laboratory testing is required to diagnose other inherited disorders (ie, lactic acidosis, organic aciduria, and some urea cycle defects). Results should be evaluated in the context of clinical findings and/or additional test results.
Infant formulas that are supplemented with amino acids (particularly methionine and homocitrulline) and parenteral nutrition may affect the clinical accuracy of this test. Bacterial contamination of specimens and certain medications, such as valproic acid, can also affect the levels of specific amino acids. In addition, the absence of a protein-containing diet in newborns may preclude detection of selected aminoacidopathies.
References:
Part 8. Amino Acids. In: Scriver CR, Beaudet AL, Valle D, Sly WS, Childs B, Kinzler KW, Vogelstein B, eds. The Metabolic and Molecular Bases of Inherited Disease. 8th ed. New York, NY: McGraw-Hill, Inc; 2001;1665-2105.
Part IV. Disorders of amino acid metabolism and transport. Fernandes J, Saudubray J-M, Van den Berghe G, eds. Inborn Metabolic Diseases Diagnosis and Treatment. 3rd ed. New York, NY: Springer; 2000;169-273.
Part 2. Disorders of amino acid metabolism. Nyhan WL, Barshop BA, Ozand PT, eds. Atlas of Metabolic Diseases. 2nd ed. New York, NY: Oxford University Press Inc; 2005;109-189.
Blau N, Duran M, Blaskovics ME, Gibson KM, eds. Physician's Guide to the Laboratory Diagnosis of Metabolic Diseases. 2nd ed. New York, NY: Springer; 2003.
Heiblim DI, Evans HE, Glass L, et al. Child neurology: amino acid concentrations in cerebrospinal fluid. Arch Neurol. 1978;35:765-768.
Goldsmith RF, Earl JW, Cunningham AM. Determination of delta-aminobutyric acid and other amino acids in cerebrospinal fluid of pediatric patients by reversed-phase liquid chromatography. Clin Chem. 1987;33:1736-1740.
Optimal range: 0 - 47 umol/L
Optimal range: 2 - 9 umol/L
Optimal range: 200 - 483 umol/L
Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine. It is found in many foods including eggs, meat, lentils, and fish. Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.
Optimal range: 0 - 2 umol/L
Amino Acid Analysis, Plasma - Amino Acid analysis is necessary for the diagnosis of a variety of inborn errors of metabolism. These include, but are not limited to, phenylketonuria, tyrosinemia, citrullinemia, non-ketotic hyperglycinemia, maple syrup urine disease, and homocystinuria. The assay is also key for the continued monitoring of treatment plans for these disorders and useful for assessing nutritional status of patients.
Optimal range: 7 - 32 umol/L
Alpha amniobutyric acid (AABA), also known as Alpha-amino-N-butyric acid (A-ANB), is an intermediate formed during the catabolism of methionine and threonine. Increases in AABA occur secondary to elevations of either methionine or threonine. AABA becomes propionic acid via alpha-ketobutyric acid in the presence of adequate amounts of thiamin, vitamin B2(as FAD), vitamin B3(as NAD), lipoic acid and magnesium. Deficiencies of any of these, or vitamin B6, could cause increases in AABA. Elevated or decreased levels of the amino acid may indicate a congenital enzyme defect.
Optimal range: 43 - 107 umol/L
Arginine is found in all protein foods and is very abundant in seeds and nuts. It is considered a semi-essential amino acid during early development, infection/inflammation, or renal and/or intestinal impairment.
Optimal range: 31 - 64 umol/L
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 1 - 4 umol/L
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 0 - 3 umol/L
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA. Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys. β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 0 - 5 umol/L
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. And, as previously mentioned, carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 16 - 51 umol/L
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified. It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins. Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine. Because citrulline is produced in enterocytes, it has been proposed as a marker of enterocyte mass in conditions of villous atrophy.
Optimal range: 0 - 1 umol/L
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 5 - 13 umol/L
Ethanolamine is an intermediary metabolite in the serine-to-choline sequence. It can be used to synthesize phosphatidylethanolamine (PE), a very important membrane phospholipid. Ethanolamine is not only a precursor, but also a breakdown product of PE. Ethanolamine is abundant in both intestinal and bacterial cell membranes. It plays a significant role in the renewal and proliferation of intestinal cells and intestinal inflammation. Also, since ethanolamine plays a structural role in skeletal muscle cell membranes, some evidence suggests it may be a marker of skeletal muscle turnover.
Optimal range: 0 - 3 umol/L
Optimal range: 10 - 97 umol/L
Glutamic acid is a nonessential amino acid is derived from the diet and from the breakdown of gut proteins. Glutamate is a major excitatory neurotransmitter in the brain. It plays a role in neuronal differentiation, migration, and survival in the developing brain. It is also involved in synaptic maintenance, neuroplasticity, learning, and memory.
Optimal range: 428 - 747 umol/L
Glutamine is a nonessential amino acid and is the most abundant amino acid in the body. It is formed from glutamate using the enzyme glutamine synthetase. Approximately 80% of glutamine is found in the skeletal muscle, and this concentration is 30 times higher than the amount of glutamine found in human plasma. Although glucose is used as fuel for many tissues in the body, glutamine is the main fuel source for a large number of cells including lymphocytes, neutrophils, macrophages, and enterocytes.
Optimal range: 122 - 322 umol/L
Glycine is an amino acid with various important functions within your body, including detoxification, DNA formation, the synthesis of hemoglobin, and as a part of brain neurotransmission pathways. Glycine and serine are interchangeable.
Optimal range: 0 - 0 umol/L
Optimal range: 60 - 109 umol/L
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine. Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
Optimal range: 0 - 1 umol/L
Optimal range: 4 - 27 umol/L
Hydroxyproline is a collagen related amino acid. Hydroxyproline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver. Hydroxyproline is necessary for the construction of the body’s major structural protein, collagen. Hydroxyproline is present in essentially all tissues and all genetic types of collagen.
Optimal range: 34 - 98 umol/L
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 73 - 182 umol/L
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 119 - 233 umol/L
Lysine is a nutritionally essential amino acid abundant in meat, fish, fowl, and legumes and is needed for formation of body proteins and enzymes.
Lysine can be methylated using S-adenosylmethionine (SAM) to synthesize carnitine, which is needed for fatty acid oxidation. Lysine also generates Acetyl CoA for use in the citric acid cycle. Lysine, proline, hydroxyproline, and vitamin C are important in the synthesis of collagen for skin, bones, tendons and cartilage.
Optimal range: 16 - 34 umol/L
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 27 - 83 umol/L
Ornithine is an intermediate nonprotein-forming amino acid of the urea cycle. Arginine is converted to ornithine via the arginase enzyme, with urea as a byproduct. Ornithine combined with carbamoyl phosphate is then converted into citrulline via the ornithine transcarbamylase (OTC) enzyme. The contribution of carbamoyl phosphate results from the metabolism of ammonia by the enzyme carbamoyl phosphate synthase, and if this magnesium-dependent process is impaired, ammonia buildup, or hyperammonemia can occur.
Optimal range: 40 - 74 umol/L
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy. Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 104 - 383 umol/L
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid. Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage. Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn. In addition to dietary sources, proline can be synthesized from glutamate/glutamine, arginine, and ornithine. It can also be synthesized within enterocytes from degradation of small peptides.
Optimal range: 0 - 4 umol/L
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine. It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents. In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess.
Optimal range: 65 - 138 umol/L
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 31 - 102 umol/L
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid.
Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
It has been proposed that taurine acts as an antioxidant, intracellular osmolyte, membrane stabilizer, and a neurotransmitter.
Optimal range: 67 - 198 umol/L
Threonine is a large neutral amino acid and a precursor for the amino acid glycine. Foods that contain relatively high amounts of threonine include cheeses (especially Swiss), meat, fish, poultry, seeds, walnuts, cashews, almonds and peanuts. Threonine gets converted to glycine using a two-step biochemical pathway involving the enzymes threonine dehydrogenase and the vitamin B6-dependent glycine C-acetyltransferase.
Optimal range: 40 - 91 umol/L
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 38 - 96 umol/L
Tyrosine is a conditionally essential amino acid which can come directly from the digestion of dietary protein. Common food sources include dairy, beans, whole grains, meat, and nuts. If intake is insufficient, tyrosine can be formed from the essential amino acid phenylalanine using a tetrahydrobiopterin reaction. Tyrosine itself is a precursor to several neurotransmitters including dopamine, epinephrine and norepinephrine. It is also needed to create thyroid hormone and melanin skin pigments. Within the metabolism of tyrosine to form neurotransmitters and other hormones, there are several important nutrient cofactors involved including vitamin B1, vitamin B6, tetrahydrobiopterin, copper, vitamin C, among others.
Optimal range: 132 - 313 umol/L
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Acylcarnitine Profile, Plasma
An acylcarnitine profile is a diagnostic tool used to evaluate the various forms of carnitine present in the blood. This assessment can provide critical insights into metabolic disorders, particularly those affecting fatty acid oxidation and organic acid metabolism. The interpretation of this profile involves analyzing the concentrations of different acylcarnitines to identify abnormalities that may indicate specific metabolic conditions.
The first step in interpreting an acylcarnitine profile is to examine the overall levels of free carnitine and acylcarnitines. Free carnitine levels offer a baseline understanding of carnitine availability in the body. Elevated levels of certain acylcarnitines can suggest a blockade in metabolic pathways, where intermediate products accumulate due to enzyme deficiencies or transport defects. For example, elevated levels of C8 and C10:1 acylcarnitines are indicative of medium-chain acyl-CoA dehydrogenase deficiency (MCADD), a common fatty acid oxidation disorder.
The next step involves analyzing the ratios of different acylcarnitines to pinpoint more specific metabolic issues. Ratios such as C16/C2 (palmitoylcarnitine/free carnitine) or C14:1/C14 (tetradecenoylcarnitine/tetradecanoylcarnitine) are particularly useful in diagnosing disorders like carnitine palmitoyltransferase II deficiency and very-long-chain acyl-CoA dehydrogenase deficiency (VLCADD). These ratios help differentiate between conditions that might present similarly in initial screenings but have different underlying causes and treatment protocols.
It is essential to consider the clinical context and symptoms presented by the patient. An acylcarnitine profile should be interpreted alongside other diagnostic tests and clinical evaluations to provide a comprehensive diagnosis. For instance, elevated levels of C3 (propionylcarnitine) might be associated with propionic acidemia, but similar elevations could also indicate methylmalonic acidemia or other disorders of propionate metabolism. Therefore, corroborating these findings with additional tests, such as urine organic acids analysis or genetic testing, is crucial for an accurate diagnosis.
An acylcarnitine profile is used to screen for genetic disorders related to fatty acid oxidation and several organic acidurias. This profile is especially useful in various clinical situations, including the evaluation of symptomatic patients, screening asymptomatic (at-risk) siblings of known patients, newborn screening and follow-up testing, prenatal diagnosis, and postmortem screening.
Overall, interpreting an acylcarnitine profile requires a thorough understanding of metabolic pathways and the specific patterns of acylcarnitine elevations associated with various metabolic disorders. Health professionals must integrate these biochemical findings with clinical symptoms and other diagnostic data to ensure precise and effective diagnosis and treatment planning. This comprehensive approach allows for the accurate identification and management of metabolic disorders, improving patient outcomes.
If all your values in an acylcarnitine panel are within the normal reference ranges, it generally indicates that there are no detectable abnormalities in your fatty acid oxidation or organic acid metabolism. Here are a few key points to understand what this result means:
Efficient Fatty Acid Oxidation: Your body appears to be effectively breaking down fatty acids for energy. This process is crucial for maintaining energy levels, especially during periods of fasting or prolonged exercise.
No Significant Enzyme Deficiencies: The absence of elevated or decreased acylcarnitine levels suggests that the enzymes involved in fatty acid oxidation and organic acid metabolism are functioning properly. This includes enzymes like acyl-CoA dehydrogenases and carnitine palmitoyltransferases.
No Fatty Acid Oxidation Disorders (FAODs): Disorders such as medium-chain acyl-CoA dehydrogenase deficiency (MCADD) or very-long-chain acyl-CoA dehydrogenase deficiency (VLCADD) typically cause elevated levels of specific acylcarnitines. Normal results suggest that you do not have these conditions.
No Organic Acidurias: Conditions like propionic acidemia or methylmalonic acidemia often result in abnormal acylcarnitine levels. Normal values indicate that these disorders are unlikely.
Stable Energy Production: Your body’s ability to produce energy from fatty acids is likely stable, contributing to overall metabolic health and preventing symptoms like fatigue, muscle weakness, or hypoglycemia during fasting.
Balanced Nutritional Status: Normal acylcarnitine levels can also suggest that your diet and nutritional intake are adequate to support proper metabolic function.
While normal acylcarnitine levels are reassuring, it's important to interpret these results within the broader context of your health and any symptoms you may have. Here are a few considerations:
Normal acylcarnitine panel results are indicative of a well-functioning metabolic system, with no apparent disruptions in fatty acid oxidation or organic acid metabolism. However, always discuss your results with your healthcare provider to ensure a comprehensive understanding and to determine if any additional testing or follow-up is necessary.
Optimal range: 0 - 33 mmol/mol creatinine
Optimal range: 0 - 0.08 umol/L
Optimal range: 0 - 0.05 umol/L
Optimal range: 0 - 0.06 umol/L
Optimal range: 0 - 0.04 umol/L
Optimal range: 0 - 0.05 umol/L
Optimal range: 3.23 - 10.29 umol/L
Optimal range: 0 - 0.1 umol/L
Optimal range: 0 - 0.02 nmol/ML
Optimal range: 0 - 0.02 umol/L
Optimal range: 0 - 0.02 umol/L
Optimal range: 0 - 0.05 umol/L
Optimal range: 0 - 0.38 umol/L
Optimal range: 0.01 - 0.32 umol/L
Optimal range: 0 - 0.2 umol/L
Optimal range: 0 - 0.15 umol/L
Optimal range: 0 - 0.6 umol/L
Optimal range: 0 - 0.19 nmol/ML
Optimal range: 19 - 48 umol/L
Optimal range: 0 - 0.1 umol/L , 0 - 0.05 nmol/ML
Optimal range: 0 - 0.02 umol/L
Optimal range: 0 - 0.03 umol/L
Optimal range: 0.03 - 0.13 umol/L
Optimal range: 0 - 0.04 umol/L
Optimal range: 0 - 0.1 umol/L
Optimal range: 0.08 - 0.38 umol/L
Optimal range: 0.01 - 0.21 umol/L
Optimal range: 0 - 0.11 umol/L
Optimal range: 0.02 - 0.12 umol/L
Optimal range: 0.01 - 0.07 umol/L
Optimal range: 0 - 0.11 umol/L
Optimal range: 0 - 0.27 umol/L
Optimal range: 0 - 0.7 umol/L
Optimal range: 0 - 1.26 nmol/ML
Optimal range: 0 - 0.09 umol/L
Optimal range: 0 - 0.02 nmol/ML
Optimal range: 0 - 0.02 umol/L
Optimal range: 0 - 0.02 umol/L
Optimal range: 0 - 0.06 umol/L
Optimal range: 0 - 0.05 nmol/ML
Optimal range: 0 - 0.02 nmol/ML
Optimal range: 0 - 0.02 umol/L
Optimal range: 0 - 0.02 umol/L
Optimal range: 0 - 0.02 nmol/ML
Optimal range: 0 - 0.02 nmol/ML
Optimal range: 0.04 - 0.17 umol/L
Optimal range: 0 - 0.03 umol/L
Optimal range: 0 - 1 umol/L
Optimal range: 0.16 - 0.62 umol/L
Optimal range: 0 - 0.07 umol/L
Optimal range: 0 - 0.08 umol/L
Optimal range: 0 - 0.03 nmol/ML
Optimal range: 0 - 0.11 umol/L
Optimal range: 0 - 0.03 umol/L
Optimal range: 0 - 0.17 umol/L
Optimal range: 0 - 0.02 umol/L
Organic Acids, Comprehensive, Quantitative
This test is intended for the diagnosis and monitoring of inherited disorders affecting multiple metabolic pathways.
Organic acidurias are inherited disorders resulting from a deficient enzyme or transport protein. Although most are autosomal recessive disorders (= two copies of an abnormal gene must be present in order for the disease or trait to develop), several are X-linked. The more than 60 described organic acidurias affect many metabolic pathways including amino acid metabolism, lipid metabolism, purine and pyrimidine metabolism, the urea cycle, the Krebs cycle and fatty acid oxidation. These disorders are characterized by a wide variety of symptoms such as lethargy, coma, hypotonia, seizures, ataxia, vomiting, failure to thrive, developmental delay, liver disease, neutropenia, thrombocytopenia, osteomalacia and osteoporosis. Severity of presentation is highly variable as is age of onset, and patients may not present with the most characteristic features. Laboratory results commonly indicate metabolic acidosis, increased anion gap, hyperammonemia, hypoglycemia, lactic acidemia, ketosis, or abnormal lipid patterns. Treatment may be based on dietary restrictions and/or supplementation with cofactors (e.g., riboflavin or cobalamin) or conjugating agents (e.g., carnitine or sodium benzoate); however, there is no effective therapy for some of the disorders.
Elevation of one or more organic acids is diagnostic for an organic aciduria; however, elevations should be interpreted in context with clinical findings and/or additional test results. Since many organic acidurias are episodic, the diagnostic efficacy is maximized when the patient is expressing symptoms at the time of specimen collection.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 8 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 1 - 14 mmol/mol creatinine
2-Hydroxyglutaric acid is identifiable in urine by routine organic acid analysis.
What is 2-hydroxyglutaric aciduria?
2-hydroxyglutaric aciduria is a rare neurometabolic disorder characterized by the significantly elevated levels of hydroxyglutaric acid in one's urine. It is either autosomal recessive or autosomal dominant.
2-hydroxyglutaric aciduria is a condition that causes progressive damage to the brain. The major types of this disorder are called D-2-hydroxyglutaric aciduria (D-2-HGA), L-2-hydroxyglutaric aciduria (L-2-HGA), and combined D,L-2-hydroxyglutaric aciduria (D,L-2-HGA).
Optimal range: 0 - 0 mmol/mol creatinine
2-Hydroxyisocaproic acid (aka Leucic acid / α-hydroxyisocaproic acid / HICA) is a metabolite of the branched-chain amino acid leucine.
Optimal range: 0 - 1 mmol/mol creatinine
2-Hydroxyisovaleric acid (aka 2-Hydroxy-3-methylbutyric acid) is a branched-chain amino acid metabolite.
Optimal range: 0 - 4 mmol/mol creatinine
2-Methyl-3-hydroxybutyric acid, which is also known as 3-Hydroxy-2-methyl-butanoic acid (HMBA) is a normal urinary metabolite involved in the isoleucine catabolism, as well as presumably beta-oxidation of fatty acids and ketogenesis, excreted in abnormally high amounts in beta-ketothiolase deficiency.
Beta-ketothiolase deficiency is an inherited disorder in which the body cannot effectively process a protein building block (amino acid) called isoleucine. This disorder also impairs the body's ability to process ketones, which are molecules produced during the breakdown of fats.
Optimal range: 0 - 0 mmol/mol creatinine
2-Methylacetoacetic acid is a metabolite that has an increased excretion in patients with acetoacetyl-CoA thiolase deficiency. Thiolases are ubiquitous and important enzymes. Several isoenzymes are known, which can occur in the cytosol, the mitochondria, or the peroxisomes. Thiolases are CoA-dependent enzymes which catalyze the formation of a carbon-carbon bond in a Claisen condensation step and its reverse reaction via a thiolytic degradation mechanism. Mitochondrial acetoacetyl-coenzyme A (CoA) thiolase (T2) is important in the pathways for the synthesis and degradation of ketone bodies as well as for the degradation of 2-methylacetoacetyl-CoA. Moreover, 2-methylacetoacetic acid is found to be associated with beta-ketothiolase deficiency, which is also an inborn error of metabolism. 2-Methylacetoacetic acid is found in urine and can be used as a biomarker for the diagnosis of beta-ketothiolase deficiency.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 10 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
2-OH-3ME-Valeric (aka 3-Methyl-2-oxovaleric acid) is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Moderate increase may result from lactic acidosis, episodic ketosis, or thiamine/lipoic acid deficiency. Significant elevations are associated with genetic issues, MSUD, and pyruvate dehydrogenase deficiency.
- Slight elevations may be due to deficiencies of the vitamins thiamine or lipoic acid.
- Elevated values are also associated with the genetic diseases maple syrup urine disease or pyruvate dehydrogenase deficiency.
Optimal range: 0 - 3 mmol/mol creatinine
3-Methyl-2-oxovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
Moderate increase may result from lactic acidosis, episodic ketosis, or thiamine/lipoic acid deficiency. Significant elevations are associated with genetic issues, MSUD, and pyruvate dehydrogenase deficiency.
- Slight elevations may be due to deficiencies of the vitamins thiamine or lipoic acid.
- Elevated values are also associated with the genetic diseases maple syrup urine disease or pyruvate dehydrogenase deficiency.
Optimal range: 0 - 0 mmol/mol creatinine
2-OXO-Butyric Acid is also known as Alpha-ketobutyric acid.
- Alpha-ketobutyric acid results from the breakdown of threonine or methionine during glutathione production.
- Specifically, cystathionine is metabolized to alpha-ketobutyric acid and cysteine.
- a- ketobutyric acid enters the mitochondrial matrix and get converted to propionyl-CoA by the branched chain keto-acid dehydrogenase complex (BCKDHC) and enters the Krebs cycle at succinyl-CoA.
- Evaluate lactate and the branched chain keto acids
- Evaluate alpha-hydroxybutyric acid
- Associated Nutrients: Vitamin B3
- a -Ketobutyric acid is produced from cystine, along with hydrogen sulfide (H2S) as a by-product.
- a- Ketobutyric acid is reversibly converted to a- hydroxybutyric acid.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 33 mmol/mol creatinine
2-Oxoglutaric acid is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 4 mmol/mol creatinine
2-Oxoisocaproic acid (also known as Ketoleucine) is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids.
2-Oxoisocaproic acid is both a neurotoxin and a metabotoxin.
Optimal range: 0 - 0 mmol/mol creatinine
2-Oxoisovaleric acid is an abnormal metabolite that arises from the incomplete breakdown of branched-chain amino acids (=BCAA). 2-Oxoisovaleric acid is a neurotoxin, an acidogen, and a metabotoxin.
Optimal range: 0 - 0 mmol/mol creatinine
Metabolite of phenylalanine via phenyl pyruvate.
Optimal range: 0 - 7 mmol/mol creatinine
Optimal range: 0 - 21 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0 - 97 mmol/mol creatinine
Optimal range: 0 - 72 mmol/mol creatinine
3-Hydroxyisovaleric Acid (3-HIA) is formed from the metabolism of the branched-chain amino acid leucine. Methylcrotonyl-CoA carboxylase catalyzes an essential step in this pathway and is biotin dependent. Reduced activity of this enzyme leads to an alternate pathway of metabolism resulting in 3-hydroxyisovaleric acid.
Optimal range: 0 - 8 mmol/mol creatinine
3-Hydroxypropionic acid (3-HPA) is a major urinary metabolite of propionic acid. Propionic acid is derived from dietary branched-chain amino acids, odd-chain fatty acids, and can be produced in the gut by bacterial fermentation of fiber. The biotindependent enzyme propionyl CoA carboxylase is responsible for metabolizing propionic acid to methylmalonyl CoA, which is subsequently isomerized to succinyl CoA. Decreased activity of this enzyme shunts propionyl CoA into alternative pathways which form 3-HPA.
Optimal range: 0 - 3 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
3-Hydroxyvaleric acid may be products of the condensation of propionyl-CoA with acetyl-CoA catalyzed by 3-oxoacyl-CoA thiolases. An increase amount of 3-hydroxyvaleric acid can be found in methylmalonic acidemia and propionic acidemia.
Optimal range: 0 - 7 mmol/mol creatinine
Optimal range: 3 - 17 mmol/mol creatinine
The marker, 3-methylglutaconic acid in high values indicates a reduced ability to metabolize the amino acid, leucine. This abnormality is found in the genetic disease, methylglutaconic aciduria and in mitochondrial disorders.
Optimal range: 0 - 3 mmol/mol creatinine
Optimal range: 0 - 4 mmol/mol creatinine
Optimal range: 8 - 88 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 1 mmol/mol creatinine
Optimal range: 0 - 3 mmol/mol creatinine
4-hydroxyphenyllactate is present in relatively higher concentrations in the cerebrospinal fluid and urine of patients with phenylketonuria (PKU) and tyrosinemia.
Optimal range: 0 - 0 mmol/mol creatinine
A moderate urinary increase in 4-hydroxybutyric acid may be due to intake of dietary supplements containing 4-hydroxybutyric acid, also known as gamma-hydroxybutyric acid. Very high levels may indicate the genetic disorder 3-methylglutaconic aciduria involving succinic semialdehyde dehydrogenase deficiency.
Optimal range: 1 - 27 mmol/mol creatinine
3-Hydroxyphenylacetic acid and 4-hydroxyphenylacetic acid are produced by the bacterial fermentation of amino acids, much like Indoleacetic acid (IAA).
Optimal range: 0 - 6 mmol/mol creatinine
AKA: 4-Hydroxyphenylpyruvate, 4-HPPA
4-hydroxyphenylpyruvic acid is an intermediate in the breakdown of phenylalanine.
4-hydroxyphenylpyruvic acid is converted to homogentisate; a blockage at this step results in increased homogentisate, which can be diagnostic of alkaptonuria.
If the pathway is not blocked, 4-HPPA ends up in the Krebs cycle converted into fumaric acid.
Optimal range: 1 - 30 mmol/mol creatinine
Phenylacetic acid (PAA) and phenylpropionic acid (PPA) are products of phenylalanine metabolism caused by intestinal bacteria. High levels of PAA or PPA in urine may result from the dysbiosis of intestinal flora or the decreased metabolism of phenylalanine, such as phenylketonuria (PKU). PAA is also a metabolite of 2-phenylethylamine, and low levels of PAA in urine are considered as a marker of depression. Urinary 4-hydroxybenzoic acid (4-HBA) and 4-hydroxyphenylacetic acid (4-HPAA) represent a considerable percentage of tyrosine intake. 4-HBA is one of the major catechin metabolites after the intake of green tea infusions. In addition, 4-HPAA has been found to be useful in screening for small bowel diseases associated with anaerobic bacterial overgrowth.
Optimal range: 0 - 5 mmol/mol creatinine
Optimal range: 8 - 69 mmol/mol creatinine
Pyroglutamate (or 5-Oxoproline) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Acetoacetic acid (=acetoacetate) is a ketone body and a weak Beta-keto acid produced from acetyl-CoA in the mitochondrial matrix of hepatocytes.
Optimal range: 8 - 143 mmol/mol creatinine
Elevated in mitochrondrial disorders. Aconitase metabolizes citric and aconitic acids, and is dependent on glutathione.
Optimal range: 0 - 4 mmol/mol creatinine
Dietary fatty acids are metabolized into fuel sources using beta-oxidation. Fatty acid conversion into Acetyl-CoA requires transport across the mitochondrial membrane via the carnitine shuttle. When beta-oxidation is impaired, fats are metabolized using an alternate pathway called omega-oxidation. Omega-oxidation results in elevated levels of dicarboxylic acids such as adipic acid and suberic acid. Impaired beta-oxidation occurs in carnitine deficiency or enzymatic dysfunction due to lack of nutrient cofactors. Vitamin B2 and magnesium play a role in optimizing beta-oxidation.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 24 - 1174 mmol/mol creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 6 mmol/mol creatinine
Optimal range: 0 - 1 mmol/mol creatinine
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 1 mmol/mol creatinine
Optimal range: 0 - 21 mmol/mol creatinine
Glyceric acid is an organic acid that stems from the catabolism of the amino acid serine. Severe elevations in glyceric acid are an indication of a rare inborn error of metabolism known as glyceric aciduria. One form of glyceric aciduria is the result of a defect in the enzyme glycerate kinase which removes glyceric acid from the system. While many case studies have linked this disorder with severe developmental abnormalities, there is some debate as to whether glycerate kinase deficiency is the cause or rather a confounding variable. Another glyceric aciduria is referred to as primary hyperoxaluria type 2 (PH2). This rare genetic condition results in excessive production of oxalates in the system in the form of oxalic acid. Over time, systemic deposition of oxalates in body tissues can occur which is a process known as oxalosis. This disease is characterized by urolithiasis, nephrocalcinosis, and deposition of oxalates in other body tissues.
Optimal range: 0 - 0 mmol/mol creatinine
Urinary hexanoylglycine is a specific marker for the diagnosis of Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 11 mmol/mol creatinine
Optimal range: 0 - 3 mmol/mol creatinine
Isobutyrylglycine is an acyl glycine. Acyl glycines are normally minor metabolites of fatty acids. However, the excretion of certain acyl glycines is increased in several inborn errors of metabolism.
In certain cases the measurement of these metabolites in body fluids can be used to diagnose disorders associated with mitochondrial fatty acid beta-oxidation.
Optimal range: 10 - 131 mmol/mol creatinine
A two-carbon group from Acetyl-CoA is transferred to oxaloacetate to form citric acid. Citric acid is then converted to isocitric acid through a cis-aconitic intermediate using the enzyme aconitase. Aconitase is an iron-sulfate protein that controls iron homeostasis.
Optimal range: 0 - 3 mmol/mol creatinine
Optimal range: 1 - 41 mmol/mol creatinine
Lactic acid (Lactate) and pyruvic acid are byproducts of glycolysis. Carbohydrates, which contain glucose, are broken down through glycolysis to form pyruvate and two ATP molecules. Pyruvate can also be generated through the catabolism of various amino acids, including alanine, serine, cysteine, glycine, tryptophan and threonine. Magnesium is an important cofactor for a number of glycolytic enzymes necessary to produce pyruvate. Optimally, pyruvic acid is oxidized to form Acetyl-Co-A to be used aerobically via the Krebs Cycle to produce energy. In an anaerobic state, lactic acid is formed instead.
Optimal range: 0.4 - 1.8 mmol/L
This test measures the level of lactic acid (also known as lactate) in your blood. Lactic acid is the endproduct of the anaerobic metabolism of glucose. The blood lactic acid concentration is affected by its production in muscle cells and erythrocytes and its rate of metabolism in the liver.
Optimal range: 0 - 3 mmol/mol creatinine
Fumaric acid uses the fumarase enzyme to become malic acid. Malate dehydrogenase catalyzes the conversion of malic acid into oxaloacetate. Two forms of this enzyme exist in eukaryotes. One operates within the mitochondria to contribute to the Citric Acid Cycle; the other is in the cytosol where it participates in the malate/ aspartate shuttle. Riboflavin is an important cofactor for this enzyme and overall mitochondrial energy production and cellular function. At the end of each Citric Acid Cycle, the four-carbon oxaloacetate has been regenerated, and the cycle continues.
Optimal range: 0 - 0 mmol/mol creatinine
Malonic acid is found to be associated with malonyl-CoA decarboxylase deficiency, which is an inborn error of metabolism. The name “Malonic” originates from Latin malum, meaning apple. Malonic acid is the archetypal example of a competitive inhibitor: it acts against succinate dehydrogenase (complex II) in the respiratory electron transport chain.
Optimal range: 0 - 14 mmol/mol creatinine
Methylcitric is an organic acids that reflects decreased activity of the biotin-dependent enzyme propionyl-CoA carboxylase.
Optimal range: 0 - 2 mmol/mol creatinine
Other names: Methylmalonic Acid or MMA
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production. In one step of metabolism, vitamin B12 promotes the conversion of methylmalonyl CoA (a form of MMA) to succinyl Coenzyme A. If there is not enough B12 available, then the MMA concentration begins to rise, resulting in an increase of MMA in the blood and urine. The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.
Optimal range: 0 - 3 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 41 mmol/mol creatinine
Optimal range: 0 - 4 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
N-Valerylglycine (also known as N-Pentanoylglycine) is an acyl derivative of Glycine. The presence of N-Valerylglycine (among other metabolites) in urine is used in medicine to diagnose inborn errors of metabolism (such as mitochondrial fatty acid b-oxidation defects) through the use of liquid chromatography coupled with tandem mass spectrometry.
Optimal range: 0 - 19 mmol/mol creatinine
Optimal range: 0 - 2 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Phenylacetic acid (PAA) is produced by the bacterial metabolism of phenylalanine. Several bacterial strains are known to produce PAA, including Bacteroidetes and Clostridium species. Dietary polyphenols may also contribute to PAA elevation.
Optimal range: 0 - 0 mmol/mol creatinine
Phenyllactic acid is a metabolite of phenylalanine.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Phenylpyruvic acid is a keto-acid that is an intermediate or catabolic byproduct of phenylalanine metabolism. It has a slight honey-like odor.
Optimal range: 0 - 0 mmol/mol creatinine
Propionylglycine is a N-acylglycine obtained by formal condensation of the carboxy group of propionic acid with the amino group of glycine. It has a role as a human urinary metabolite. It is functionally related to a propionic acid. It is a conjugate acid of a propionylglycinate.
Optimal range: 0 - 14 mmol/mol creatinine
Lactic acid and pyruvic acid are byproducts of glycolysis. Carbohydrates, which contain glucose, are broken down through glycolysis to form pyruvate and two ATP molecules. Pyruvate can also be generated through the catabolism of various amino acids, including alanine, serine, cysteine, glycine, tryptophan and threonine.92 Magnesium is an important cofactor for a number of glycolytic enzymes necessary to produce pyruvate.93 Optimally, pyruvic acid is oxidized to form Acetyl-Co-A to be used aerobically via the Krebs Cycle to produce energy. In an anaerobic state, lactic acid is formed instead.
Optimal range: 0 - 0 mmol/mol creatinine
Increased urinary products of the omega fatty acid metabolism pathway may be due to carnitine deficiency, fasting, or increased intake of triglycerides from coconut oil, or some infant formulas.
Optimal range: 0 - 2 mmol/mol creatinine
Dietary fatty acids are metabolized into fuel sources using beta-oxidation. Fatty acid conversion into Acetyl-CoA requires transport across the mitochondrial membrane via the carnitine shuttle.80 When beta-oxidation is impaired, fats are metabolized using an alternate pathway called omega-oxidation. Omega-oxidation results in elevated levels of dicarboxylic acids such as adipic acid and suberic acid. Impaired beta-oxidation occurs in carnitine deficiency or enzymatic dysfunction due to lack of nutrient cofactors. Vitamin B2 and magnesium play a role in optimizing beta-oxidation.
Optimal range: 0 - 3 mmol/mol creatinine
Optimal range: 0 - 16 mmol/mol creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body.
Optimal range: 0 - 0 mmol/mol creatinine
Succinylacetone (SA) is used for the diagnosis and monitoring of patients with tyrosinemia type I (Tyr I). Succinylacetone is exclusively elevated in blood and urine of patients with tyrosinemia type I . As urinary Succinylacetone concentration is much higher than blood, Succinylacetone is usually tested in urine samples.
Optimal range: 0 - 0 mmol/mol creatinine
A pyrimidine (DNA building block) that is elevated in the genetic disease dihydropyrimidine dehydrogenase deficiency. In this genetic disease, the pyrimidine uracil is also elevated.
- Thymine is one of the five bases used to build nucleic acids.
- It is also known as 5-methyluracil or by the abbreviations T or Thy.
- Thymine is found in DNA, where it pairs with adenine via two hydrogen bonds. In RNA, thymine is replaced by uracil.
Optimal range: 0 - 7 mmol/mol creatinine
Optimal range: 0 - 48 mmol/mol creatinine
Trans-Cinnamoylglycine is one component of the Acylglycines panel.
Acylglycines are an important class of metabolites that are used in the diagnosis of several organic acidurias and mitochondrial fatty acid oxidation disorders.
Optimal range: 0 - 9 mmol/mol creatinine
The pyrimidine metabolites are markers of folate metabolism. The two markers are uracil and thymine. Folate acts as a methyl donor in converting uracil to thymine.
Elevated values of uracil suggest folic acid deficiency. Folate is needed to convert uracil to thymine by methylation.
Optimal range: 0 - 5 mmol/mol creatinine
Hair Tissue Analysis [ARL (Analytical Research Labs)]
Providing a mineral blueprint of one's biochemistry, a hair tissue mineral analysis can provide pertinent information about one's metabolic rate, energy levels, and stage of stress.
A hair tissue mineral analysis performed by Analytical Research Labs, Inc., is a screening test for the level of 20 minerals and toxic metals in a sample of hair. It is a tissue mineral biopsy that is non-invasive, relatively inexpensive and extremely accurate. Our laboratory uses only the most advanced and sophisticated instrumentation available today, the Perkin Elmer ICP-MS nexION 2000B Mass Spectrometer to assess mineral levels in parts per million or parts per billion.
A hair tissue mineral analysis is considered a standard test used around the world for the biological monitoring of trace elements and toxic metals in humans and animals species. The same technology is used for soil testing and testing of rock samples to detect mineral levels.
Hair, like all other body tissues, contains minerals that are deposited as the hair grows. Although the hair is dead, the minerals remain as the hair continues to grow out. A sample of hair cut close to the scalp provides information about the mineral activity in the hair that took place over the past three to four months, depending on the rate of hair growth.
Optimal range: 0.05 - 0.3 Units
Boron is normally found in hair but the correlations among Boron absorption, and tissue and hair levels of Boron have yet to be determined. Boron has a low order of toxicity, but excessive intake induces riboflavinuria. Boron is frequently high in hair in association with high levels of potentially toxic elements (i.e. lead, mercury, and cadmium) and exposure to toxic chemicals. Exogenous contamination of hair with B is possible since B is present in some soap. Boron is also present in some cleaners, cements, ceramics and glass.
Optimal range: 32 - 64 Units
Calcium is found in every cell throughout the body. Over ninety percent is found stored in the bones and teeth.
- Calcium is regulated by the thyroid, parathyroid, adrenal and pituitary gland. It’s use in the body is involved in maintaining the acid alkaline balance.
- It is necessary for normal blood clotting, nerve conduction, muscle contraction and relaxation, cell division, heart rate, and maintenance of the bones and teeth.
- It is a primary extra-cellular element.
- Excellent quality bioavailable calcium is lacking in the diets of most people. The main food sources are raw and organic dairy products, carrots and carrot juice and a few other vegetable sources such as nuts and seeds. However, when cows milk is pasteurized and homogenized, calcium availability declines greatly. As a result, most people are not benefitting enough from the calcium in the milk, cheese and yogurt they are consuming.
Optimal range: 0.09 - 0.15 Units
Chromium enhances utilization of insulin, resulting in improved burning of glucose. Chromium is involved in maintaining blood sugar levels and energy levels. It is also associated with cholesterol regulation.
Hair Chromium is a good indicator of tissue levels and may provide a better indication of status than do urine or blood/serum.
Chromium is generally accepted as an essential trace element that is required for maintenance of normal glucose and cholesterol levels; it potentiates insulin fucnction.
Deficiency conditions may include hyperglycemia, transient hyper/hypoglycemia, fatigue, accelerated atherosclerogenesis, elevated LDL cholesterol, increased need for insulin and diabetes-like symptoms, and impaired stress responses.
Optimal range: 0.03 - 0.06 Units
Cobalt is an alkaline-forming and somewhat toxic element. It is widely distributed in foods. It is required for the formation of vitamin B12, also called cyanocobalamin or methylcobalamin.
Sources Of Cobalt
Meats (as vitamin B12)
Roles In The Body
Needed for the formation of vitamin B12 - blood formation, nervous system
FOOD SOURCES OF COBALT
Seafood - sardines, salmon, herring
Meat/Organs - liver, kidney
Nuts/seeds - peanuts
Vegetables - peas, okra
Dairy - butter
Grains - buckwheat, wheat bran, wheat germ
Miscellaneous - molasses, raw sugar, cornstarch, cornmeal, some artificial prosthetic hips
Optimal range: 1.5 - 3 Units
Copper is an essential mineral in the body and directly or indirectly affects virtually every bodily system function. Copper is required for energy production, cardiovascular health, neurotransmitter activity, female reproductive system, skin health, blood formation and the immune system.
Optimal range: 2.1 - 4.2 Units
Iron is required in hemoglobin for transporting oxygen in the blood, for detoxification and for energy production in the cells. Iron is found in lean meats, organ meats, shellfish, molasses, beans, whole-grain cereals, and dark green vegetables
Optimal range: 0.1 - 0.3 Units
Lithium (Li) is normally found in hair at very low levels. Hair Li correlates with high dosage of Li carbonate in patients treated for Affective Disorders. However, the clinical significance of low hair Li levels is not certain at this time. Thus, hair Li is measured primarily for research purposes. Anecdotally, clinical feedback to DDI consultants suggests that low level Li supplementation may have some beneficial effects in patients with behavioral/emotional disorders. Li occurs almost universally in water and in the diet; excess Li is rapidly excreted in urine.
Optimal range: 4 - 10 Units
Magnesium is extremely important in keeping calcium in a bio-available form. In other words, magnesium is necessary for the utilization of calcium. Magnesium tends to follow calcium up and down. Magnesium is required for the bones and nervous system. It is also essential for over 600 vital enzymatic reactions in the body. It is a primary intra-cellular element.
Optimal range: 0.02 - 0.06 Units
Manganese (Mn) is an essential element which is involved in the activation of many important enzymes. However, Mn excess is postulated to result in glutathionyl radical formation, reduction of the free glutathione pool, and increased exposure of adrenal catecholamines (e.g. dopamine) to free radical damage.
Hair Manganese (Mn) levels generally reflect actual body stores, and external contamination can influence hair Mn. Since particulate manganese-containing dust is the most common source of Mn toxicity, hair is considered to be an excellent tissue for the assessment of Mn exposure.
Optimal range: 0.06 - 0.14 Units
Molybdenum (Mo) is an essential trace element that is an activator of specific enzymes such as: xanthine oxidase (catalyses formation of uric acid), sulphite oxidase (catalyses oxidation of sulphite to sulphate), and aldehyde dehydrogenase (catalyses oxidation of aldehydes).
Possible effects or symptoms consistent with Mo deficiency are: subnormal uric acid in blood and urine, sensitivity or reactivity to sulphites, protein intolerance (specifically to sulphur-bearing amino acids), and sensitivity or reactivity to aldehydes.
Molybdenum (Mo) deficiency has been linked to gout. Low levels in heavy meat eaters reflect digestive disorder, the need for digestive enzymes and dietary changes. Such patients should avoid pork, beef, wholegrain and rather eat poultry, fish and other lighter proteins.
Optimal range: 0 - 0.1 Units
Hair is a reasonable tissue for monitoring accumulated body stores of Nickel (Ni). However, hair is OFTEN contaminated with Ni from hair treatments, dyes, and hair products. There is substantial evidence that Ni is an essential element which is required in extremely low amounts. However, excess Ni has been well established to be nephrotoxic, and carcinogenic. Elevated Ni is often found in individuals who work in the electronic and plating, mining, and steel manufacture industries. A cigarette typically contains from 2 to 6 mcg of Ni; Ni is absorbed more efficiently in the lungs (~35%) than in the gastrointestinal tract (~5%).
Optimal range: 13 - 20.8 Units
Phosphorus levels are highly indicative of one's ability to synthesize protein. The inability to synthesize protein frequently results in impaired digestion.
Phosphorus is an essential mineral that is involved in protein synthesis and energy production within the cells. All proteins contain phosphorus and thus are a significant source of organic phosphorus. The hair tissue mineral level of phosphorus is often associated with the adequacy of protein synthesis in the body. This depends on the diet, lifestyle, condition of the intestinal tract and liver and the levels of other nutritional minerals such as zinc and copper.
Optimal range: 5 - 15 Units
Potassium is a primary intra-cellular element required for fluid balance, nerve activity and muscle activity.
Optimal range: 0.12 - 0.21 Units
Selenium is required for thyroid function. Selenium is an essential component of the enzymes that convert Thyroxine (T4) to Triodothyronine (T3). Selenium is also important in heavy metal detoxification and is also important in enhancing immune system function.
Selenium (Se) is normally found in hair at very low levels, and several studies provide evidence that low hair Se is reflective of dietary intake and associated with cardiovascular disorders. Utilization of hair Se levels to assess nutritional status, however, is complicated by the fact that use of Se- or sulfur-containing shampoo markedly increases hair Se (externally) and can give a false high value.
Optimal range: 17 - 35 Units
Sodium is an essential mineral for maintaining water balance and blood pressure in the body and is a primary extra-cellular element
Optimal range: 16 - 24 Units
Zinc is found in small quantities in the body (about two grams) and is essential for over 50 functions including all protein synthesis, growth and development, male reproductive system, insulin production and secretion, vision, digestion, prostate health, skin, hair and nail health, and immune system activity.
HPA (NeuroLab)
NeuroLab is a leading specialist in the research, analysis, and development of biomarkers associated with hypothalamic-pituitary-adrenal (HPA) axis function. Optimal HPA function is foundational to peak performance of the body’s neuroendocrine communication system.
Optimal range: 2.3 - 5.3 nm
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
Optimal range: 1 - 6 ng/mL
It stands for Dehydroepiandrosterone and is a building block of steroid hormones that is produced predominantly in the adrenal glands.
Considered the body’s anti-aging hormone, DHEA-S levels tend to fall with age.
Optimal range: 0.25 - 2.16 mg/dL
Creatinine is used to calculate results and is not to be used diagnostically.
Optimal range: 250 - 400 ug/g Cr
Dopamine is a neurotransmitter that activates the brain’s reward center during pleasurable activities.
Optimal dopamine function is involved in many aspects of health, including memory, movement, motivation, mood, attention, sleep, arousal, learning, and lactation.
What is dopamine and what are its functions?
Dopamine is a neurotransmitter (= chemical messenger) that is produced in large concentrations during pleasurable activities such as when eating sugar or junk food, having sex, or participating in fun and enjoyable down-time activities like spending time in nature or engaging in a favorite hobby. Dopamine is released during these times as a reward for engaging in the activities necessary for survival and reproduction such as eating, drinking, and competing.
Optimal range: 10 - 15 ug/g Cr
Epinephrine, also known as adrenaline, is a monoamine that serves as both a stress hormone and an excitatory neurotransmitter. It is produced by chromaffin cells within the adrenal medulla of the adrenal gland and is secreted into the bloodstream during acute stress. Epinephrine rapidly provides the body with the energy and alertness necessary to produce an appropriate response to stressors. It does this by binding to alpha and beta adrenergic receptors throughout the body and changing how various organs function, including the heart, blood vessels, lungs, liver, eyes, and digestive system. Most of the body's epinephrine acts as a hormone, and only a small amount acts as a neurotransmitter. The catecholamine synthesis pathway begins with the uptake of the amino acid tyrosine into the cytoplasm and ends with the production of epinephrine through a series of enzymatic reactions.
Optimal range: 1 - 2.4 nm
Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.
Optimal range: 600 - 1100 ug/g Cr
GABA is a neurotransmitter that occurs naturally and is known for its calming effects on the body. It is also associated with regulating the sleep/wake cycle. If we experience feelings of anxiety or hyperactivity, it could indicate an imbalance in GABA levels. This imbalance could also lead to sleep disturbances, ranging from difficulty sleeping to excessive drowsiness, depending on the severity of the imbalance. Testing for GABA levels can help identify the extent of the imbalance and the best approach to correcting it. A diet rich in GABA-containing foods, its precursor, and cofactors can help correct high or low levels of GABA.
What Does GABA Do?
GABA is an inhibitory neurotransmitter produced in the brain. GABA is also produced and functions in the periphery. As an inhibitory neurotransmitter, GABA blocks excitatory neurotransmitters by decreasing stimulation of nerve cells. This blocking action by GABA leads to the calming effect that GABA is known to produce, which helps reduce anxiousness, regulate sleep, and make us feel calmer.
What Happens When You Have a GABA Imbalance?
Imbalanced GABA levels are associated with a number of health concerns that impact quality of life. For example:
How Does GABA Become Imbalanced?
A number of factors can disrupt GABA levels or associated hormones and neurotransmitters. These factors include:
How Can We Naturally Support GABA?
It is possible to encourage healthy levels of GABA through lifestyle measures, including:
Optimal range: 5 - 10 mg/g Cr
Glutamate is a vital neurotransmitter in the central nervous system, involved in almost all significant excitatory brain functions. It is the primary and most abundant excitatory neurotransmitter, and it's estimated that over half of all neural synapses release glutamate, making it a critical player in neural circuit communication.
Glutamic acid and glutamate are essentially interchangeable terms. The two molecules are almost identical, except that glutamic acid has an additional proton, or hydrogen atom. In physiological conditions, glutamic acid sheds this extra proton and becomes glutamate, the abundant form of the amino acid in the human body.
Glutamate is a crucial excitatory neurotransmitter that plays a vital role in maintaining healthy brain and nervous system function. It enables us to learn, remember, feel, sense, and coordinate our movements effectively.
Optimal range: 5.1 - 11.6 nm
Morning cortisol is a crucial marker on a cortisol panel offered by Neurolab, providing valuable insights into an individual's adrenal gland function and overall hormonal health. Cortisol, often referred to as the "stress hormone," follows a diurnal rhythm, meaning its levels fluctuate throughout the day, typically peaking in the early morning and gradually declining towards the evening. Measuring morning cortisol levels, ideally between 6 and 8 AM, is essential because this is when cortisol should naturally be at its highest. Elevated morning cortisol can indicate a variety of conditions, such as Cushing's syndrome, chronic stress, or an overactive adrenal gland. Conversely, abnormally low levels may suggest adrenal insufficiency or Addison's disease.
Optimal range: 1 - 6 ng/mL
Optimal range: 0.4 - 2.1 nm
The "Night Cortisol" marker on a Cortisol panel by Neurolab is a crucial measure that helps understand the functioning of the body's stress response system, specifically during nighttime. Cortisol, often called the stress hormone, is produced by the adrenal glands and follows a diurnal rhythm, meaning its levels fluctuate throughout the day. Typically, cortisol levels peak in the early morning and gradually decline throughout the day, reaching their lowest point at night. The "Night Cortisol" marker measures the amount of cortisol present in the body during the nighttime, usually collected through a saliva sample before bedtime. Monitoring nighttime cortisol is essential because elevated levels during this period can indicate various health issues, such as chronic stress, insomnia, or adrenal disorders.
Optimal range: 0 - 13 Ratio
Optimal range: 30 - 50 ug/g Cr
Norepinephrine, also known as noradrenaline, is important for mental focus and emotional stability.
Norepinephrine functions as a neurotransmitter and hormone that regulates the “fight or flight” response and elevates blood pressure and heart rate, stimulates wakefulness, and reduces digestive activity.
Optimal range: 1.64 - 7.27 mcg/g Cr
PEA stands for Beta-phenylethylamine and is an excitatory neurotransmitter made from phenylalanine and it modulates neuron voltage potentials to favor glutamate activity and neurotransmitter firing.
Optimal range: 125 - 260 ug/g Cr
Serotonin is one of our happiness neurotransmitters that makes us feel good. When we are feeling anxious it can be a sign of serotonin imbalance. In addition to mood concerns, serotonin imbalance may also show up as sleep disruptions, gut issues, or cravings and urges; among many other complaints. Because it plays a role in regulating several physiological processes, serotonin testing is helpful to identify serotonin imbalances. Low or high serotonin levels can be corrected with diet and lifestyle.
How does Serotonin become imbalanced?
A number of factors can disrupt serotonin levels or associated hormones or neurotransmitters. These factors include:
How can we naturally support Serotonin?
It is possible to encourage healthy levels of serotonin through lifestyle measures, including:
Lactate Dehydrogenase (LDH) Isoenzymes Test
The Lactate Dehydrogenase (LDH) Isoenzymes test measures the level of the different lactate dehydrogenase (LDH) isoenzymes in the blood. LDH, also known as lactic acid dehydrogenase, is a type of protein, known as an enzyme. LDH plays an important role in making your body's energy. It is found in almost all the body's tissues.
When tissues are damaged or diseased, they release LDH isoenzymes into the bloodstream. The type of LDH isoenzyme released depends on which tissues are damaged. This test can help your provider find out the location and cause of your tissue damage.
The five isoenzymes are found in different amounts in tissues throughout the body:
Optimal range: 17 - 32 %
When illness or injury damages your cells, LDH may be released into the bloodstream, causing the level of LDH in your blood to rise.
LDH-1: heart and red blood cells
Optimal range: 25 - 40 %
When illness or injury damages your cells, LDH may be released into the bloodstream, causing the level of LDH in your blood to rise.
LDH-2: heart and red blood cells
Optimal range: 17 - 27 %
When illness or injury damages your cells, LDH may be released into the bloodstream, causing the level of LDH in your blood to rise.
LDH-3: lymph tissue, lungs, platelets, pancreas
Optimal range: 5 - 13 %
When illness or injury damages your cells, LDH may be released into the bloodstream, causing the level of LDH in your blood to rise.
LDH-4: liver and skeletal muscle
Optimal range: 4 - 20 %
When illness or injury damages your cells, LDH may be released into the bloodstream, causing the level of LDH in your blood to rise.
LDH-5: liver and skeletal muscle
Sexually transmitted disease
Sexually transmitted diseases (STDs) are infections transmitted from an infected person to an uninfected person through sexual contact. STDs can be caused by bacteria, viruses, or parasites. Examples include gonorrhea, genital herpes, human papillomavirus infection, HIV/AIDS, chlamydia, and syphilis.
Some STDs can be passed from a pregnant person to the baby, either during pregnancy or when giving birth. Other ways that STDs may be spread include during breastfeeding, through blood transfusions, or by sharing needles.
STDs don't always cause symptoms or may only cause mild symptoms. So it is possible to have an infection and not know it. And even without symptoms, STDs can still be harmful and may be passed on during sex.
If there are symptoms, they could include:
Diagnosis:
Early and rapid diagnosis of STDs increases the chance to limit effects of the disease. Left untreated, STDs, such as gonorrhea, syphilis, chlamydia, genital herpes, and human papillomavirus (HPV), can lead to devastating and sometimes long-term complications. These complications include blindness, bone deformities, brain damage, cancer, heart disease, infertility, birth defects, mental retardation, and even death.
Treatments:
There are many different kinds of STDs, and the types of treatment are as varied as their symptoms. No STD is harmless. Even the curable ones can cause serious consequences if left untreated. HIV is of particular concern as biological evidence demonstrates the increased likelihood of acquiring and transmitting HIV when STDs are present.
Reference range: Negative, Positive
Chlamydia trachomatis is the most common cause of curable bacterial sexually transmitted infection (STI) worldwide. It manifests primarily as urethritis in males and endocervicitis in females.
Untreated chlamydial infection in man can cause epididymitis and proctitis. Though most women with Chlamydia infection are asymptomatic or have minimal symptoms, some develop salpingitis, endometritis, pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility. It is associated with an increased risk for the transmission or acquisition of HIV and is also attributed to be a risk factor for the development of cervical carcinoma.
Reference range: Negative, Positive
Gardnerella vaginalis is a type of bacteria that is commonly found in the vaginal flora of some women. While it can be present in the vagina without causing any issues, it is often associated with bacterial vaginosis (BV), a condition that occurs when the natural balance of bacteria in the vagina is disrupted. BV can lead to symptoms such as unusual discharge, a fishy odor, and vaginal irritation, although some women may not experience any symptoms. Gardnerella vaginalis plays a key role in this imbalance because its overgrowth can reduce the number of "good" bacteria like lactobacilli, which normally help maintain a healthy vaginal environment. BV is not considered a sexually transmitted infection (STI), but it is more common in sexually active women. It is usually treated with antibiotics to restore the normal bacterial balance.
Reference range: Non Reactive, Reactive
AIDS is caused by 2 known types of HIV. HIV type 1 (HIV-1) is found in patients with AIDS or AIDS-related complex and in asymptomatic infected individuals at high risk for AIDS. The virus is transmitted by sexual contact, by exposure to infected blood or blood products, or from an infected mother to her fetus or infant. HIV type 2 (HIV-2) infection is endemic only in West Africa, and it has been identified in individuals who had sexual relations with individuals from that geographic region. HIV-2 is similar to HIV-1 in viral morphology, overall genomic structure, and its ability to cause AIDS.
Reference range: NEGATIVE, POSITIVE
AIDS is caused by 2 known types of HIV. HIV type 1 (HIV-1) is found in patients with AIDS or AIDS-related complex and in asymptomatic infected individuals at high risk for AIDS. The virus is transmitted by sexual contact, by exposure to infected blood or blood products, or from an infected mother to her fetus or infant. HIV type 2 (HIV-2) infection is endemic only in West Africa, and it has been identified in individuals who had sexual relations with individuals from that geographic region. HIV-2 is similar to HIV-1 in viral morphology, overall genomic structure, and its ability to cause AIDS.
Reference range: Non Reactive, Reactive
AIDS is caused by 2 known types of HIV. HIV type 1 (HIV-1) is found in patients with AIDS or AIDS-related complex and in asymptomatic infected individuals at high risk for AIDS. The virus is transmitted by sexual contact, by exposure to infected blood or blood products, or from an infected mother to her fetus or infant. HIV type 2 (HIV-2) infection is endemic only in West Africa, and it has been identified in individuals who had sexual relations with individuals from that geographic region. HIV-2 is similar to HIV-1 in viral morphology, overall genomic structure, and its ability to cause AIDS.
Reference range: NEGATIVE, POSITIVE
AIDS is caused by 2 known types of HIV. HIV type 1 (HIV-1) is found in patients with AIDS or AIDS-related complex and in asymptomatic infected individuals at high risk for AIDS. The virus is transmitted by sexual contact, by exposure to infected blood or blood products, or from an infected mother to her fetus or infant. HIV type 2 (HIV-2) infection is endemic only in West Africa, and it has been identified in individuals who had sexual relations with individuals from that geographic region. HIV-2 is similar to HIV-1 in viral morphology, overall genomic structure, and its ability to cause AIDS.
Reference range: NON-REACTIVE, REACTIVE, REPEATEDLY REACTIVE
The fourth generation tests can identify both HIV-specific antigen p24 and HIV antibodies with a blood sample.
The fourth generation HIV test, also called an enzyme-linked immunosorbent assay (ELISA) test, is a more complete screening that can identify acute HIV. This is the time when the virus is multiplying rapidly and you’re more likely to pass the infection.
In the first few weeks after exposure to HIV, your body produces an antigen known as p24. This protein is only present in people who have acute HIV infection. It triggers your immune system to respond.
The fourth generation tests require a blood sample that’s sent to a lab for testing. Blood testing done by a lab is the most accurate type of test.
Reference range: Negative, Positive
Mycoplasma hominis is a type of bacteria that naturally lives in the urogenital tract of some healthy people. It’s part of the Mycoplasma family, which are unique bacteria that lack a cell wall—making them harder to detect and treat with standard antibiotics like penicillin.
In many individuals, Mycoplasma hominis is harmless. But in others, especially when it grows out of balance or spreads, it can contribute to urogenital infections, reproductive health issues, and even complications in pregnancy.
Reference range: Negative, Positive
What is gonorrhea?
Gonorrhea is a sexually transmitted disease (STD) caused by infection with the Neisseria gonorrhoeae bacterium. N. gonorrhoeae infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in women and men. N. gonorrhoeae can also infect the mucous membranes of the mouth, throat, eyes, and rectum.
How do people get gonorrhea?
Gonorrhea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread perinatally from mother to baby during childbirth.
People who have had gonorrhea and received treatment may be reinfected if they have sexual contact with a person infected with gonorrhea.
Reference range: Negative, Positive
What is trichomoniasis?
Trichomoniasis (or “trich”) is a very common STD caused by infection with Trichomonas vaginalis (a protozoan parasite). Although symptoms vary, most people who have trich cannot tell they have it.
How common is trichomoniasis?
In the United States, CDC estimates that there were more than two million trichomoniasis infections in 2018. However, only about 30% develop any symptoms of trich. Infection is more common in women than in men. Older women are more likely than younger women to have the infection.
How is trichomoniasis spread?
Sexually active people can get trich by having sex without a condom with a partner who has trich.
In women, the infection is most commonly found in the lower genital tract (vulva, vagina, cervix, or urethra). In men, the infection is most commonly found inside the penis (urethra). During sex, the parasite usually spreads from a penis to a vagina, or from a vagina to a penis. It can also spread from a vagina to another vagina.
It is not common for the parasite to infect other body parts, like the hands, mouth, or anus. It is unclear why some people with the infection get symptoms while others do not. It probably depends on factors like a person’s age and overall health. People with trich can pass the infection to others, even if they do not have symptoms.
Reference range: Negative, Positive
Neural Zoomer Plus
The Neural Zoomer Plus is an array of neurological autoantibodies which offers very specific antibody-to-antigen recognition. The Vibrant Neural Zoomer Plus is designed to assess an individual’s reactivity to 48 neurological antigens, which may have connections to a variety of neurologically related diseases.
With a panel of 48 of the most well-studied neurological autoantibodies, the Neural Zoomer Plus is able to guide providers in treatment protocols by pinpointing the mechanisms behind disease progression and providing a roadmap to solutions and improved health outcomes in this challenging arena of disease.
The test also has optional additional genetic testing for the ApoE genotype, which has been shown to influence risk for certain neurological conditions.
The Vibrant Neural Zoomer Plus aims to reduce the prevalence of neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention.
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Autoimmunity is a main component in nervous system diseases where a misguided immune response attacks the body's own organs and tissues. Autoimmune disorders affect 5-10% of the general population and can target virtually any structure within the central or peripheral nervous system in a highly specific way, targeting a very specific cell population (e.g., Purkinje cells of the cerebellum). Depending on the cell type that is targeted in different central nervous system (CNS) structures (e.g., the astrocyte in neuromyelitis optica), the syndromes that result may be diverse, such as those associated with optic neuritis, myelitis, and attacks of brain edema in neuromyelitis optica.
Understanding these specific disorders requires an analysis of how the target antigen molecules affect immune cellular interactions both to generate the autoimmune reaction and to produce the immune–mediated injury of the nervous system. Autoantibodies are a novel emerging entity that is useful in providing such information in early stages of the disease with a simple blood sample. The Vibrant neurological autoimmune panel, “Neural Zoomer,” includes a comprehensive spectrum of autoimmune markers responsible for a diverse range of neural autoimmune diseases that has the potential to provide the details of the specific type of autoimmune neural disease (eg: demyelination, blood brain barrier disruption, optical/peripheral neuropathy, neuromuscular disorders, brain inflammation and autoimmunity) and the degree of severity to implement the most effective treatment plan possible.
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Neurological autoimmunity is a misguided immune response to virtually any structure within the central nervous system (CNS) or peripheral nervous system (PNS).
Studies show that neurological antibodies may have connections with a variety of neurologically related diseases that can progress slowly over decades if lifestyle modifications and medical interventions are not implemented.
Common symptoms associated with autoimmunity in the nervous system include:
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Lifestyle Choices:
→ Treatments that rebuild and fortify a hyperpermeable intestinal barrier can aid in reversing or reducing autoimmune disease symptoms. Intestinal permeability syndrome is associated with autoimmune diseases and reversing symptoms of autoimmune diseases is accelerated with healing the lining of the gastrointestinal tract. Vibrant’s Wheat Zoomer can accurately detect the presence of intestinal permeability syndrome.
→ Avoid exposure to heavy metals: Neurotoxicity of metals has been demonstrated widely. The CNS is particularly vulnerable to accumulation of these metals. The brain readily accumulates metals, which, under physiologic conditions, are incorporated into essential metalloproteins required for neuronal health and energy homeostasis. Severe consequences can arise from circumstances of excess essential metals or exposure to toxic nonessential metal.
→ Avoid exposure to mold or high mold/water-damaged environments: Mold neurotoxicity is an increasingly common occurrence that can cause memory deficits, difficulty concentrating, problems with language and reasoning, mental fatigue, depression, and anxiety.
→ Treat infections immediately: Herpes simplex virus type 2 (HSV-2) infection, for example, is responsible for significant neurological morbidity, perhaps more than any other virus. Research indicates that as many as 45 million people in the United States have been infected with HSV-2, and the estimated incidence of new infection is 1 million annually.
Consider following programs that may help prevent and reverse the cognitive and physiological effects of neurological disorders, including but not limited to:
→ Consider regular sauna bathing, as studies show high frequency of sauna use lowers the risk of dementia and Alzheimer's disease.
→ Maintain a healthy lifestyle (healthy fat-rich and vegetable-heavy diet, omega-3-fatty acids, low sugar intake, quit smoking, regular exercise)
→ Consider taking supplements: Research indicates inflammation and free radical oxidative stress play major roles in the propagation of neurodegenerative diseases. A few supplements in particular have been found to mitigate damage caused by oxidative stress and/or reduce the activity of TNF and other inflammatory cytokine pathways:
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0.1 - 10 Units
Acetylcholine receptors are responsible for binding acetylcholine, a neurotransmitter for signal transduction in CNS. They are localized in neuromuscular junctions. Antibodies against acetylcholine receptor are found in myasthenia gravis disease, which destroys the receptor function, leading to a neuromuscular transmission defect, which then causes hypofunction, fatigue, and inflammation of skeletal muscles and produces serum antibodies against muscle antigens.
Optimal range: 0.1 - 10 Units
Acetylcholine receptors are responsible for binding acetylcholine, a neurotransmitter for signal transduction in CNS. They are localized in neuromuscular junctions. Antibodies against acetylcholine receptor are found in myasthenia gravis disease, which destroys the receptor function, leading to a neuromuscular transmission defect, which then causes hypofunction, fatigue, and inflammation of skeletal muscles and produces serum antibodies against muscle antigens.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Relative Abundance
AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) is a compound that is a specific agonist for the AMPA receptor, where it mimics the effects of the neurotransmitter glutamate. In some epilepsies, antibodies to AMPA receptors leads to neuron damage. The same is true for ischemia, where oxygen deprivation leads to excitotoxicity. Conversely, Alzheimer's disease is characterized by decreased AMPA activation and synapse loss.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0.1 - 10 Units
Antibodies against Amphiphysin occur in patients with paraneoplastic variant Stiff person syndrome but can also be seen in autoimmune encephalitis. Antibodies against Amphiphysin are associated with breast cancer and small cell lung cancer. Neurological symptoms may precede the diagnosis of cancer with up to five years.
Antibodies against Amphiphysin are graded as High-risk antibodies with a frequency of 80% of underlying cancer and a positive result yield 3 points PNS score, according to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes.
Optimal range: 0.1 - 10 Units
Antibodies against Amphiphysin occur in patients with paraneoplastic variant Stiff person syndrome but can also be seen in autoimmune encephalitis. Antibodies against Amphiphysin are associated with breast cancer and small cell lung cancer. Neurological symptoms may precede the diagnosis of cancer with up to five years.
Antibodies against Amphiphysin are graded as High-risk antibodies with a frequency of 80% of underlying cancer and a positive result yield 3 points PNS score, according to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0.1 - 10 Units
Antibodies to aquaporin 4 constitute a sensitive and highly specific serum marker of neuromyelitis optica (NMO) that can facilitate the differential diagnosis of NMO and classic multiple sclerosis.
Neuromyelitis optica is an inflammatory demyelinating disorder of the central nervous system (CNS). The discovery of circulating IgG antibodies against the astrocyte water channel protein aquaporin 4 (AQP4) and the evidence that AQP4 IgG is involved in the development of neuromyelitis optica revolutionized the understanding of the disease. Anti aquaporin 4 antibodies have also been shown in patients with peripheral demyelination. In addition, human aquaporin 4 shows cross-reactivity with corn and soybean aquaporins.
Optimal range: 0.1 - 10 Units
Antibodies to aquaporin 4 constitute a sensitive and highly specific serum marker of neuromyelitis optica (NMO) that can facilitate the differential diagnosis of NMO and classic multiple sclerosis.
Neuromyelitis optica is an inflammatory demyelinating disorder of the central nervous system (CNS). The discovery of circulating IgG antibodies against the astrocyte water channel protein aquaporin 4 (AQP4) and the evidence that AQP4 IgG is involved in the development of neuromyelitis optica revolutionized the understanding of the disease. Anti aquaporin 4 antibodies have also been shown in patients with peripheral demyelination. In addition, human aquaporin 4 shows cross-reactivity with corn and soybean aquaporins.
Optimal range: 0 - 10 Units
The "Anti-Cerebellum" marker is a crucial test component designed to detect autoantibodies targeting the cerebellum, which is a part of the brain responsible for coordinating voluntary movements, including posture, balance, coordination, and speech. The presence of these autoantibodies can indicate an autoimmune response against the cerebellum, potentially leading to neurological disorders such as cerebellar ataxia. This condition is characterized by difficulties in balance, movement, and possibly affecting speech and eye movements, profoundly impacting an individual's quality of life.
Optimal range: 0 - 10 Units
Anti-Contactin-associated protein-like 2 (CASPR2) antibodies, including both IgG and IgA classes, are autoantibodies targeting the CASPR2 protein, a component of the voltage-gated potassium channel complex located in the nervous system. The presence of these antibodies is associated with a spectrum of neurological conditions, often termed CASPR2-antibody associated syndromes, which include neuromyotonia (also known as Isaac's syndrome), Morvan syndrome, and autoimmune forms of limbic encephalitis.
Patients with anti-CASPR2 antibodies can present with various symptoms depending on the affected region of the nervous system. In neuromyotonia, symptoms may include muscle twitching, cramps, and stiffness, whereas limbic encephalitis is characterized by memory loss, confusion, seizures, and sometimes psychiatric symptoms. Morvan syndrome is distinguished by a combination of neuromyotonia and encephalitis symptoms, along with autonomic dysfunction like sleep disturbances, sweating, and cardiac irregularities.
Optimal range: 0 - 10 Units
Anti-Contactin-associated protein-like 2 (CASPR2) antibodies of the IgM class are less commonly reported compared to their IgG counterparts but represent an important aspect of the immune response in certain autoimmune neurological disorders. CASPR2 is a cell adhesion molecule that plays a significant role in the proper functioning of the nervous system, particularly in the juxtaparanodal regions of myelinated axons, where it helps to cluster potassium channels. These potassium channels are crucial for maintaining the electrical excitability of nerve cells. When anti-CASPR2 IgM antibodies target this protein, they can disrupt normal neuronal function, leading to a range of clinical manifestations.
Optimal range: 0.1 - 10 Units
Anti-CV2 antibodies, encompassing both IgG and IgA immunoglobulin classes, target a neuronal protein known as CRMP-5 (Collapsin Response Mediator Protein 5). These antibodies are typically associated with paraneoplastic neurological syndromes (PNS), a group of disorders that arise from the immune system's response to certain cancers. The presence of anti-CV2 antibodies can lead to a variety of neurological manifestations, ranging from cerebellar ataxia, limbic encephalitis, to peripheral neuropathies, and less frequently, myelopathies.
Optimal range: 0.1 - 10 Units
Anti CV2 antibodies are a group of antibodies that react with a 66 kd brain protein belonging to the family of CRMP proteins. The manifestations associated with anti CV2 antibodies include cerebellar degeneration, uveitis, and peripheral neuropathy, and mixed axonal and demyelinating peripheral neuropathy.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Relative Abundance
The Anti-Dopamine Receptor 1 (D1R) antibodies test measures IgG and IgA antibodies against dopamine receptor 1 (D1R), a key receptor in the brain involved in cognitive function, movement, and motivation. The presence of these antibodies may indicate immune system activity against dopamine receptors, potentially affecting neurological function.
A mildly elevated result for Anti-Dopamine Receptor 1 (IgG + IgA) on the Neural Zoomer Plus panel by Vibrant America suggests a low to moderate immune response targeting dopamine receptor 1 (D1R) in the brain. While not as concerning as a highly elevated result, it may still indicate underlying neuroinflammation, immune dysregulation, or an early-stage autoimmune response.
Early or Low-Grade Autoimmune Activity
Transient Immune Activation
Subclinical Neurological Impact
Blood-Brain Barrier Permeability ("Leaky Brain")
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
The Anti-Dopamine Receptor 2 (DRD2) antibodies test measures immune reactivity to dopamine receptor 2 (DRD2) in the brain. Dopamine receptors play a crucial role in neurotransmission, regulating movement, cognition, mood, and behavior. The presence of IgG and IgA antibodies against DRD2 may indicate an autoimmune reaction targeting these receptors.
A mildly elevated Anti-Dopamine Receptor 2 (IgG + IgA) result on the Neural Zoomer Plus panel by Vibrant America may indicate low-grade neuroimmune activation without necessarily pointing to an active or severe autoimmune condition. This can suggest:
Early or Low-Grade Neuroinflammation:
Past Exposure or Immune Memory:
Gut-Brain Axis Imbalance:
Molecular Mimicry & Post-Infectious Effects:
Subclinical or Early Autoimmune Activity:
Neurological & Psychiatric Symptoms Without Diagnosis:
A mildly elevated Anti-Dopamine Receptor 2 (IgG + IgA) result does not necessarily indicate disease, but it suggests low-level immune reactivity that could be linked to past infections, gut-brain axis issues, or early neuroimmune dysregulation. Evaluating other biomarkers, symptoms, and potential triggers can provide more context for managing overall neurological and immune health.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
The "Anti-Endothelin A Receptor" marker plays a critical role in the NeuralZoomer panel. Endothelin A receptor is a protein found on the surface of certain cells within the body and is involved in regulating various functions, including blood pressure and inflammation. When the immune system mistakenly targets and produces antibodies against the endothelin A receptor, it can lead to vascular issues and contribute to the development of autoimmune diseases.
Endothelin peptides modulate the development of distinct neural cell types, including Schwann cells, astrocytes, and neural crest cells, as well as physiologic growth and development. The endothelin A receptor has a greater affinity for ET-1, one of the peptides of endothelin.
The endothelin A receptor auto-antibodies are found in vascular dementia.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0.1 - 10 Units
Glial fibrillary acidic protein (GFAP) is the major structural protein of the glial intermediate filament of astrocytes that forms part of the cytoskeleton of mature astrocytes and other glial cells, but is not found outside the CNS. Anti-GFAP is produced when the protein enters the bloodstream after a rupture of the blood brain barrier, thus serves as a blood based diagnostic marker of brain injury.
Optimal range: 0.1 - 10 Units
Glial fibrillary acidic protein (GFAP) is the major structural protein of the glial intermediate filament of astrocytes that forms part of the cytoskeleton of mature astrocytes and other glial cells, but is not found outside the CNS. Anti-GFAP is produced when the protein enters the bloodstream after a rupture of the blood brain barrier, thus serves as a blood based diagnostic marker of brain injury.
Optimal range: 0.1 - 10 Units
Glucose-regulating protein 78 (GRP78) is a molecular chaperone in the endoplasmic reticulum (ER) that promotes folding and assembly of proteins, controls the quality of proteins, and regulates ER stress signaling through Ca2+ binding to the ER. In tumors, GRP78 is often upregulated, acting as a central stress sensor that senses and adapts to changes in the tumor microenvironment, mediating ER stress of cancer cells under various stimulations of the microenvironment to trigger the folding protein response.
Increasing evidence has shown that GRP78 is closely associated with the progression and poor prognosis of lung cancer, and plays an important role in the treatment of lung cancer.
Optimal range: 0.1 - 10 Units
Glucose-regulating protein 78 (GRP78) is a molecular chaperone in the endoplasmic reticulum (ER) that promotes folding and assembly of proteins, controls the quality of proteins, and regulates ER stress signaling through Ca2+ binding to the ER. In tumors, GRP78 is often upregulated, acting as a central stress sensor that senses and adapts to changes in the tumor microenvironment, mediating ER stress of cancer cells under various stimulations of the microenvironment to trigger the folding protein response.
Increasing evidence has shown that GRP78 is closely associated with the progression and poor prognosis of lung cancer, and plays an important role in the treatment of lung cancer.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Anti-glycine receptor (GlyR) antibodies, including IgG and IgA classes, are autoantibodies directed against the glycine receptor, a key inhibitory neurotransmitter receptor in the central nervous system. The presence of these antibodies is most commonly associated with autoimmune disorders such as stiff-person syndrome (SPS) and its variants, including progressive encephalomyelitis with rigidity and myoclonus (PERM). These conditions are characterized by severe muscle stiffness, spasms, and functional impairment due to disrupted inhibitory signaling in the spinal cord and brainstem. The detection of anti-GlyR antibodies, especially of the IgG type, supports the diagnosis of these neurological disorders and can guide immunotherapy treatments. The IgA class of anti-GlyR antibodies may also have clinical relevance, although less is known about their exact role compared to IgG. The measurement of these antibodies is done through specialized laboratory tests, which can be critical for both diagnosis and management of affected individuals.
Optimal range: 0 - 10 Units
Anti-glycine receptor (Anti-GlyR) antibodies of the IgM class are a type of autoantibody directed against glycine receptors in the central nervous system. Glycine receptors are crucial for the regulation of motor and sensory pathways due to their inhibitory function in neurotransmission. When IgM antibodies bind to these receptors, they can disrupt normal inhibitory signaling, leading to a range of neurological symptoms.
The presence of anti-GlyR IgM is particularly significant because IgM is usually the first antibody class to rise in response to an antigen and can indicate an acute phase of an immune response. While less commonly discussed than IgG anti-GlyR antibodies, which are associated with conditions like stiff-person syndrome (SPS) and PERM (progressive encephalomyelitis with rigidity and myoclonus), IgM antibodies may also be implicated in similar disorders or suggest a different aspect of the immune response.
Optimal range: 0.1 - 10 Units
Detection of ganglioside M1 (GM1) antibodies, usually of the IgM isotype, is associated with multi-focal motor neuropathy and lower motor neuropathy, characterized by muscle weakness and atrophy. Multi-focal motor neuropathy may occur with or without high serum titers of anti-GM1 antibodies. GM1 antibodies are detected in approximately 50 % of persons with multi-focal motor neuropathy.
Optimal range: 0.1 - 10 Units
Detection of ganglioside M1 (GM1) antibodies, usually of the IgM isotype, is associated with multi-focal motor neuropathy and lower motor neuropathy, characterized by muscle weakness and atrophy. Multi-focal motor neuropathy may occur with or without high serum titers of anti-GM1 antibodies. GM1 antibodies are detected in approximately 50 % of persons with multi-focal motor neuropathy.
Optimal range: 0.1 - 10 Units
GM2 ganglioside is a potential peripheral nerve antigen for neuropathy-associated autoantibodies. Anti-GM2 IgM antibodies have been reported in some patients with dysimmune neuropathy or lower motor neuron syndrome, in whom they were often associated with a concomitant reactivity with GM1.
Optimal range: 0.1 - 10 Units
GM2 ganglioside is a potential peripheral nerve antigen for neuropathy-associated autoantibodies. Anti-GM2 IgM antibodies have been reported in some patients with dysimmune neuropathy or lower motor neuron syndrome, in whom they were often associated with a concomitant reactivity with GM1.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Herpes simplex virus 1 (HSV-1) is a member of the herpesvirus family, Herpesviridae, that infect humans. HSV-1 (which produces most cold sores) is ubiquitous and contagious. As a neurotropic and neuroinvasive virus, HSV-1 persists in the body by becoming latent and hiding from the immune system in the cell bodies of neurons. HSV-1 has been reported to have a pathogenesis role in Herpes simplex encephalitis (HSE) and seropositivity to HSV-1 antibodies has been correlated with increased risk of Alzheimer's disease.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0.1 - 10 Units
The anti-Hu antibody is the most frequent manifestation of sensory neuropathy with frequent autonomic involvement. The clinical patterns of the neuropathies is in keeping with accordance with the cellular distribution of the HuD antigen.
→ Antibodies to Hu, Ri and Yo antigens are present in patients with paraneoplastic neurologic syndrome such as encephalomyelitis.
→ Hu antibodies are frequently associated with small cell lung cancer and neuroblastoma.
→ Hu antibodies are rarely associated with non-small cell lung cancer, prostate cancer or seminoma.
Optimal range: 0.1 - 10 Units
The anti-Hu antibody is the most frequent manifestation of sensory neuropathy with frequent autonomic involvement. The clinical patterns of the neuropathies is in keeping with accordance with the cellular distribution of the HuD antigen.
→ Antibodies to Hu, Ri and Yo antigens are present in patients with paraneoplastic neurologic syndrome such as encephalomyelitis.
→ Hu antibodies are frequently associated with small cell lung cancer and neuroblastoma.
→ Hu antibodies are rarely associated with non-small cell lung cancer, prostate cancer or seminoma.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
The "Anti-Hydroxytryptamine" marker is an important indicator used to assess the potential for neurological disorders. Hydroxytryptamine, more commonly known as serotonin, is a crucial neurotransmitter in the human brain, playing a pivotal role in regulating mood, sleep, and digestion, among other vital functions. When the immune system produces antibodies against serotonin, indicated by the "Anti-Hydroxytryptamine" marker, it can signify an abnormal immune response that might affect neurological health. The presence of these antibodies could potentially lead to a variety of neurological conditions, as serotonin's normal function is disrupted, affecting the brain's communication pathways.
These autoantibodies are found mainly in autoimmune encephalitis.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
The Anti-Ma (IgG + IgA) biomarker is a diagnostic marker used to detect autoantibodies against Ma antigens, which are proteins found in the brain, particularly in the Purkinje cells of the cerebellum. These antibodies are typically associated with autoimmune responses that target the central nervous system (CNS). The Anti-Ma test, often part of a broader neurological autoantibody panel like Vibrant America’s Neural Zoomer Plus, is crucial for identifying potential paraneoplastic syndromes and other neurological autoimmune disorders.
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If Anti-Ma (IgG + IgA) is mildly elevated, it may suggest an autoimmune response targeting Ma antigens, which are primarily found in neurons, particularly in the Purkinje cells of the cerebellum. These antibodies are often associated with paraneoplastic syndromes (neurological conditions triggered by an underlying malignancy) and other autoimmune neurological disorders.
Paraneoplastic Cerebellar Degeneration (PCD):
Anti-Ma (IgG + IgA) antibodies are commonly found in paraneoplastic cerebellar degeneration, a condition where the immune system attacks the cerebellum in response to cancer, particularly ovarian, breast, and small-cell lung cancer.
Mild elevation may still be indicative of a paraneoplastic syndrome, even if the patient does not have overt symptoms or a diagnosed malignancy. Further cancer screening (e.g., imaging, PET scans) may be warranted to rule out an underlying tumor.
Autoimmune Neurological Disorders:
In some cases, Anti-Ma antibodies can be present in autoimmune cerebellar ataxia, a condition where the immune system attacks the cerebellum without the presence of cancer. Mildly elevated levels may indicate an autoimmune process affecting the central nervous system (CNS).
Early or Subclinical Autoimmune Response:
A mildly elevated Anti-Ma (IgG + IgA) level could represent an early-stage autoimmune reaction that has not yet developed into a more severe condition. This could be indicative of a developing autoimmune neurological disorder, which may progress if not addressed.
Monitoring levels over time, along with the appearance of symptoms, can help track the progression of the autoimmune response.
Non-specific or False Positive:
A mildly elevated Anti-Ma (IgG + IgA) could also be due to non-specific immune activation or cross-reactivity with other antigens. In such cases, further testing, such as CSF analysis or additional autoimmune panels, may help clarify the cause.
It’s important to correlate the antibody results with the patient's clinical history and symptoms.
Clinical Correlation: The elevation should be interpreted in light of any symptoms the patient may be experiencing, such as motor coordination difficulties (e.g., ataxia), dysarthria (difficulty speaking), or nystagmus (involuntary eye movements). These symptoms may suggest a neurological condition, possibly linked to paraneoplastic syndrome or an autoimmune disorder.
Cancer Screening:
If Anti-Ma (IgG + IgA) levels are mildly elevated, it’s crucial to rule out an underlying malignancy. This could involve:
Imaging (e.g., CT scans, MRI, PET scans) to detect tumors, especially ovarian, breast, or lung cancers.
Tumor marker tests to identify cancer-related autoimmunity.
Additional Autoimmune Testing:
Further tests, such as CSF analysis (looking for intrathecal antibody production), Anti-Yo, Anti-Hu, or Anti-Ri antibodies, may help confirm a diagnosis of paraneoplastic cerebellar degeneration or another neurological autoimmune condition.
A mildly elevated Anti-Ma (IgG + IgA) level suggests that there may be an autoimmune response affecting the nervous system, possibly related to paraneoplastic cerebellar degeneration or another autoimmune condition. The next steps typically involve further testing, such as cancer screening and additional autoimmune panels, to clarify the cause and guide appropriate treatment. Monitoring symptoms and antibody levels over time is important for detecting any progression of the condition.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0.1 - 10 Units
Myelin-associated glycoprotein (MAG) is a trans-membrane protein of both the central nervous system (CNS) and peripheral nervous system (PNS) myelin (= an insulating layer, or sheath that forms around nerves), involved in the process of myelination (= the formation of a myelin sheath).
Optimal range: 0.1 - 10 Units
Myelin-associated glycoprotein (MAG) is a trans-membrane protein of both the central nervous system (CNS) and peripheral nervous system (PNS) myelin (= an insulating layer, or sheath that forms around nerves), involved in the process of myelination (= the formation of a myelin sheath).
Optimal range: 0.1 - 10 Units
Microglia are a type of macrophage located throughout the brain and spinal cord that act as the first and main form of active immune defense in the CNS. These markers indicate a destruction of the blood brain barrier and are found to play a role in tissue destruction of Alzheimer’s disease.
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Mildly elevated levels of Anti-Microglia (IgG + IgA) antibodies suggest that the immune system may be reacting against microglial cells, which are the resident immune cells of the central nervous system (CNS). Microglia play a crucial role in maintaining homeostasis in the brain and spinal cord by removing dead cells, modulating inflammation, and responding to injury or infection. These cells are involved in both immune defense and neuroprotection.
Mild elevation of Anti-Microglia antibodies typically indicates an immune-mediated process that may be affecting the CNS. This could be linked to various neuroinflammatory or neurodegenerative conditions.
Neuroinflammatory Diseases:
Anti-Microglia antibodies can be present in a range of neuroinflammatory conditions where the immune system is abnormally activated within the brain or spinal cord. These antibodies may indicate that the immune system is targeting microglial cells, potentially contributing to neuroinflammation and neuronal damage.
Multiple Sclerosis (MS):
Mild elevations in Anti-Microglia antibodies could indicate early-stage MS or a subclinical relapse, where there is inflammation in the CNS. Microglial cells are often activated in MS to clear myelin debris, and the presence of these antibodies might be an early sign of immune system activation.
Neurodegenerative Disorders:
In some neurodegenerative diseases (e.g., Alzheimer's disease, Parkinson's disease, or frontotemporal dementia), there is an accumulation of misfolded proteins or other cellular damage that leads to microglial activation. Mildly elevated Anti-Microglia antibodies may reflect an immune-mediated inflammatory response in the CNS, which could contribute to disease progression by exacerbating neuronal damage.
Autoimmune Neuroinflammatory Disorders:
Anti-Microglia antibodies may also be present in autoimmune conditions that affect the CNS, such as autoimmune encephalitis or paraneoplastic syndromes. In these conditions, the body’s immune system attacks its own brain tissue, and microglia can become activated as part of this immune response. A mild elevation could be an early sign of these conditions, suggesting immune involvement in the brain.
Microglial Activation in Response to Injury or Infection:
Mild elevations in Anti-Microglia antibodies can sometimes indicate that microglial activation is occurring in response to trauma (such as brain injury), infection, or chronic inflammation. This could be due to conditions such as traumatic brain injury (TBI), infection-induced encephalitis, or chronic neuroinflammatory processes.
Potential for Chronic Neuroinflammation:
Microglial activation, especially if chronic, can contribute to neurodegeneration. Even a mild elevation in these antibodies might suggest an ongoing low-level immune response in the CNS, potentially leading to neuronal damage over time if left unchecked.
Clinical Correlation:
Symptoms such as cognitive dysfunction, motor deficits, seizures, mood changes, or sensory disturbances should be carefully evaluated. If the patient presents with neurological symptoms, these antibody levels should be considered alongside other tests and clinical findings to help identify the underlying cause.
A comprehensive neurological exam will help assess the extent and nature of the symptoms and guide further testing.
Further Testing: To better understand the significance of Anti-Microglia (IgG + IgA) elevation, additional tests may be required:
MRI scans of the brain and spinal cord to detect signs of demyelination or other structural changes in the CNS that could suggest conditions like multiple sclerosis or neurodegenerative diseases.
CSF (Cerebrospinal Fluid) analysis: This can assess for signs of neuroinflammation and the presence of other biomarkers, such as oligoclonal bands, which are indicative of MS or other autoimmune neurological diseases.
Other autoimmune panels: Testing for other antibodies (e.g., Anti-NMDA, Anti-Yo, or Anti-Ri) may help identify autoimmune encephalitis or paraneoplastic syndromes.
Monitoring:
Anti-Microglia antibodies may be mildly elevated during early-stage disease or in response to neuroinflammation. If the patient is asymptomatic or only mildly symptomatic, monitoring Anti-Microglia levels over time could help detect disease progression.
Regular follow-up and repeat testing may be necessary to track changes in the immune response and assess the development of more pronounced symptoms.
Mildly elevated levels of Anti-Microglia (IgG + IgA) suggest an immune response targeting the microglial cells in the CNS, which could be associated with a variety of neuroinflammatory or neurodegenerative conditions, such as multiple sclerosis, autoimmune encephalitis, or neurodegenerative diseases like Alzheimer’s or Parkinson’s. The presence of these antibodies may indicate an early-stage immune-mediated process in the brain, but their significance must be interpreted in the context of the patient’s clinical symptoms, history, and additional diagnostic tests. Monitoring and follow-up evaluations are key to understanding whether this mild elevation is part of a larger autoimmune or neurodegenerative disorder.
Optimal range: 0.1 - 10 Units
Microglia are a type of macrophage located throughout the brain and spinal cord that act as the first and main form of active immune defense in the CNS. These markers indicate a destruction of the blood brain barrier and are found to play a role in tissue destruction of Alzheimer’s disease.
Optimal range: 0.1 - 10 Units
Muscle-specific kinase (MuSK) is a single-pass transmembrane protein that has a critical role in signaling between motor neurons and skeletal muscle. Anti-MuSK is an important marker in patients without anti-acetylcholine receptor antibodies in myasthenia gravis disease.
Optimal range: 0.1 - 10 Units
Muscle-specific kinase (MuSK) is a single-pass transmembrane protein that has a critical role in signaling between motor neurons and skeletal muscle. Anti-MuSK is an important marker in patients without anti-acetylcholine receptor antibodies in myasthenia gravis disease.
Optimal range: 0.1 - 10 Units
Myelin basic protein (MBP) is a protein believed to be important in the process of myelination of nerves in the nervous system. Anti-Myelin basic protein is related to the risk for multiple sclerosis, autism, PANDAS/ANDAS/OCD, and systemic lupus erythematosus (SLE).
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Mildly elevated levels of Anti-Myelin Basic Protein (MBP) (IgG + IgA) suggest an immune response directed against myelin basic protein, which is a key structural protein found in myelin (the fatty sheath that insulates nerve fibers in the central nervous system). This test is typically used to help diagnose demyelinating diseases, where the immune system attacks and damages the myelin.
Demyelinating Diseases: Anti-MBP antibodies are often associated with demyelinating conditions such as multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), and other autoimmune neurological disorders. These conditions involve the immune system attacking the myelin, leading to neurological deficits.
Multiple Sclerosis (MS):
In MS, Anti-MBP antibodies are sometimes elevated, particularly during relapses or flare-ups of the disease. Mild elevation in Anti-MBP (IgG + IgA) could indicate a subclinical or early stage of MS, especially if the individual has symptoms like neurological deficits, muscle weakness, or visual disturbances.
Acute Disseminated Encephalomyelitis (ADEM):
ADEM is a rare, autoimmune condition often triggered by infections or vaccinations, which results in widespread inflammation and demyelination in the brain and spinal cord. Mildly elevated Anti-MBP levels could be seen in cases of ADEM, especially in the early stages.
Subclinical Disease or Early Immune Response:
A mild increase in Anti-MBP (IgG + IgA) could suggest early immune activation in conditions like MS or other autoimmune neuroinflammatory diseases. These antibodies might appear before more severe clinical symptoms manifest, indicating that the immune system is beginning to target myelin, but clinical signs may not yet be apparent. In such cases, monitoring of the patient’s neurological status over time may be necessary.
Recent Demyelinating Events:
Elevated Anti-MBP levels can sometimes be a reflection of a recent demyelinating event, such as a mild relapse in MS or a recent episode of ADEM. If the individual has a known history of demyelination, mild elevation in Anti-MBP could be a marker of ongoing immune activity against the myelin, even if the person is currently experiencing mild or no symptoms.
Cross-Reactivity or False Positives:
Mildly elevated Anti-MBP levels can also occur due to cross-reactivity with other autoimmune conditions or infections. These antibodies may be present in the blood without a specific diagnosis of demyelinating disease, so further testing is needed to determine if this elevation is related to an underlying neurological condition. Some infections or inflammatory processes could lead to temporary elevations in Anti-MBP antibodies.
Clinical Correlation:
The mild elevation of Anti-MBP antibodies should always be interpreted in the context of the patient's clinical presentation. Symptoms such as muscle weakness, visual disturbances, balance problems, numbness, or cognitive dysfunction may indicate a neurological condition like MS or ADEM. A thorough clinical evaluation is needed to assess the likelihood of an ongoing demyelinating process.
Further Testing: To confirm the diagnosis and determine the underlying cause of the elevation, additional tests may be needed:
MRI (Magnetic Resonance Imaging) of the brain and spinal cord: MRI is a key tool in detecting areas of demyelination, which is characteristic of conditions like MS and ADEM.
Lumbar Puncture (CSF Analysis): Examining cerebrospinal fluid for the presence of oligoclonal bands (a marker of inflammation in the CNS) and other abnormalities can help confirm a diagnosis of multiple sclerosis or other inflammatory CNS disorders.
Other Autoimmune Panels: Testing for additional antibodies such as Anti-Aquaporin-4 (AQP4) or Anti-Myelin Oligodendrocyte Glycoprotein (MOG) antibodies may help differentiate between similar neurological conditions.
Monitoring: If the individual is asymptomatic or has mild symptoms, monitoring Anti-MBP levels over time may be appropriate. A repeat test can help track changes in antibody levels and assist in detecting the progression of the autoimmune response. In some cases, immunosuppressive treatments or disease-modifying therapies may be considered if a demyelinating disease is diagnosed.
Mildly elevated levels of Anti-Myelin Basic Protein (MBP) (IgG + IgA) suggest an immune response against the myelin in the central nervous system. This could be indicative of an early stage or subclinical form of a demyelinating disease such as multiple sclerosis or acute disseminated encephalomyelitis (ADEM). However, it is essential to interpret the results in conjunction with the patient's symptoms, clinical history, and further diagnostic tests, as there are several conditions that can cause mild elevations in Anti-MBP antibodies. Regular monitoring and follow-up are critical for tracking disease progression and determining the appropriate course of action.
Optimal range: 0.1 - 10 Units
Myelin basic protein (MBP) is a protein believed to be important in the process of myelination of nerves in the nervous system. Anti-Myelin basic protein is related to the risk for multiple sclerosis, autism, PANDAS/ANDAS/OCD, and systemic lupus erythematosus (SLE).
Optimal range: 0.1 - 10 Units
Myelin oligodendrocyte glycoprotein (MOG) is a glycoprotein associated with the myelination of nerves in the central nervous system (CNS).
MOG is found in the myelin that insulates the nerves of the central nervous system (CNS), which consists of the brain, spinal cord and optic nerves. Damage to myelin causes disruption in the transmission of nerve signals in the body and a variety of symptoms.
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Mildly elevated levels of Anti-Myelin Oligodendrocyte Glycoprotein (MOG) (IgG + IgA) typically suggest an autoimmune response directed against MOG, a protein located on the surface of oligodendrocytes, which are cells in the central nervous system (CNS) responsible for the formation and maintenance of myelin. Myelin is the protective sheath surrounding nerve fibers, essential for proper nerve signal transmission.
MOG-Associated Disorders:
Anti-MOG antibodies are most commonly associated with MOG antibody-associated disease (MOGAD), a condition that can lead to demyelination (damage to myelin) in the CNS, particularly affecting the optic nerves (optic neuritis), the spinal cord (transverse myelitis), and the brain.
Mildly elevated levels of Anti-MOG IgG + IgA could suggest a subclinical form of MOGAD where the immune system is targeting myelin but the symptoms are not yet prominent or the condition is in its early stages.
MOGAD can sometimes be mistaken for multiple sclerosis (MS), but it often presents with different clinical features and patterns of demyelination. MOGAD tends to have a more favorable prognosis compared to MS, especially in pediatric patients.
Acute Demyelinating Conditions:
Mild elevation in Anti-MOG levels could also indicate an ongoing acute demyelinating event in the CNS. These events can present as optic neuritis, transverse myelitis, or even acute disseminated encephalomyelitis (ADEM), especially in children. The elevation of Anti-MOG antibodies is more commonly seen during or after such events.
Possible Relapse or Early Immune Response:
If a person has had a prior demyelinating episode or has a known diagnosis of MOGAD, a mild elevation in Anti-MOG antibodies may signal a relapse or an ongoing immune response that is not yet causing clear clinical symptoms. It may indicate the need for closer monitoring or a change in treatment, especially in the context of autoimmune therapies like immunosuppressive drugs or monoclonal antibodies.
Cross-Reactivity or False Positive:
A mild elevation in Anti-MOG antibodies can also be seen in non-specific autoimmune responses or as a result of cross-reactivity with other immune responses. IgA levels are less commonly associated with MOGAD than IgG, and some individuals might have elevated levels due to other infections or inflammatory processes. Thus, a mild elevation may require further clarification and should be interpreted alongside clinical symptoms and other diagnostic findings.
Clinical Correlation:
The mildly elevated Anti-MOG IgG + IgA levels should be interpreted in the context of the patient’s neurological symptoms. Common symptoms of MOGAD or other demyelinating disorders include:
Visual disturbances or optic neuritis (painful vision loss)
Spinal cord involvement (limb weakness, sensory changes, bowel/bladder dysfunction)
Encephalitis or encephalopathy (confusion, cognitive disturbances)
Further Testing:
Additional tests may be necessary to confirm whether the elevation of Anti-MOG antibodies is related to MOGAD or another demyelinating disorder. These might include:
MRI scans of the brain and spine to detect areas of demyelination.
Lumbar puncture (CSF analysis) to assess for any inflammatory changes or oligoclonal bands.
Other autoimmune panels (e.g., testing for Anti-Aquaporin-4 antibodies associated with Neuromyelitis Optica (NMO)) to differentiate between similar conditions.
Monitoring and Follow-Up:
If Anti-MOG antibodies are mildly elevated but the patient is asymptomatic or has mild symptoms, the doctor may choose to monitor the levels over time. Regular follow-ups and repeat testing may help detect any progression of symptoms or changes in antibody levels, which could prompt earlier intervention if necessary.
Mildly elevated levels of Anti-Myelin Oligodendrocyte Glycoprotein (MOG) IgG + IgA may indicate an autoimmune response affecting the CNS, potentially linked to MOG-associated disease (MOGAD) or other demyelinating conditions. It is important to correlate these antibody levels with clinical symptoms and additional tests to accurately diagnose the underlying cause and guide appropriate management. Early detection and intervention can help manage symptoms and reduce the risk of progression.
Optimal range: 0.1 - 10 Units
Myelin oligodendrocyte glycoprotein (MOG) is a glycoprotein associated with the myelination of nerves in the central nervous system (CNS).
MOG is found in the myelin that insulates the nerves of the central nervous system (CNS), which consists of the brain, spinal cord and optic nerves. Damage to myelin causes disruption in the transmission of nerve signals in the body and a variety of symptoms.
Optimal range: 0.1 - 10 Units
Myelin proteolipid protein (= PLP) is the major membrane protein of central nervous system (CNS) myelin sheath that surrounds and protects nerve fibers and its expression is largely limited to oligodendrocytes (myelinating cells of the central nervous system).
Anti-myelin proteolipid protein antibodies (anti-PLP antibodies) are produced by the immune system and can attack the myelin sheath, leading to damage and destruction of nerve fibers.
Anti-myelin proteolipid protein antibodies are a useful marker in patients with seronegative anti-myelin basic protein, the frequent marker in active multiple sclerosis and optic neuritis.
Optimal range: 0.1 - 10 Units
Myelin proteolipid protein (= PLP) is the major membrane protein of central nervous system (CNS) myelin sheath that surrounds and protects nerve fibers and its expression is largely limited to oligodendrocytes (myelinating cells of the central nervous system).
Anti-myelin proteolipid protein antibodies (anti-PLP antibodies) are produced by the immune system and can attack the myelin sheath, leading to damage and destruction of nerve fibers.
Anti-myelin proteolipid protein antibodies are a useful marker in patients with seronegative anti-myelin basic protein, the frequent marker in active multiple sclerosis and optic neuritis.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0.1 - 10 Units
Neurofascin (NF) is a cell adhesion molecule (= cell adhesion molecules are transmembrane glycoproteins that enable cells to bind together and attach to the extracellular matrix).
NF is expressed in both the CNS and the peripheral nervous system (PNS) and plays important roles in developing and maintaining neural structures.
Anti-neurofascin autoantibodies are found mainly in combined central and peripheral demyelination (CCPD), a rare demyelinating condition affecting both CNS and peripheral nervous system (PNS) tissues, and also in chronic inflammatory demyelinating polyneuropathy (CIDP) and axonal injury in patients with multiple sclerosis (MS). Recognition of this antibody may be important in treatment management, becauseanti-neurofascin seropositive CCPD patients respond well to Intravenous Immunoglobulin or plasma exchange treatments.
Optimal range: 0.1 - 10 Units
Neurofascin (NF) is a cell adhesion molecule (= cell adhesion molecules are transmembrane glycoproteins that enable cells to bind together and attach to the extracellular matrix).
NF is expressed in both the CNS and the peripheral nervous system (PNS) and plays important roles in developing and maintaining neural structures.
Anti-neurofascin autoantibodies are found mainly in combined central and peripheral demyelination (CCPD), a rare demyelinating condition affecting both CNS and peripheral nervous system (PNS) tissues, and also in chronic inflammatory demyelinating polyneuropathy (CIDP) and axonal injury in patients with multiple sclerosis (MS). Recognition of this antibody may be important in treatment management, becauseanti-neurofascin seropositive CCPD patients respond well to Intravenous Immunoglobulin or plasma exchange treatments.
Optimal range: 0.1 - 10 Units
Neuron specific enolase is a protein enzyme that is encoded by the ENO2 gene. It is found in mature neurons and cells of neuronal origin. Antibodies against neuron specific enolase are found in patients with optical neuropathies (= damage inflicted on the optic nerve in your eye).
Optimal range: 0.1 - 10 Units
Neuron specific enolase is a protein enzyme that is encoded by the ENO2 gene. It is found in mature neurons and cells of neuronal origin. Antibodies against neuron specific enolase are found in patients with optical neuropathies (= damage inflicted on the optic nerve in your eye).
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0.1 - 10 Units
Purkinje cells, or Purkinje neurons, are a class of GABAergic neurons located in the cerebellum. Purkinje cells are aligned like dominos stacked one in front of the other. Their large dendritic arbors form nearly two-dimensional layers through which parallel fibers from the deeper-layers pass.
Optimal range: 0 - 10 Units
The test detects IgG and IgA antibodies targeting Purkinje cells, the primary inhibitory neurons in the cerebellum, responsible for motor coordination and cognitive processing. These antibodies may bind to intracellular or membrane-associated proteins, such as ARHGAP26 (linked to cerebellar ataxia) or Yo antigens (e.g., CDR2/CDR2L in paraneoplastic syndromes).
Anti-Purkinje cell antibodies are associated with:
Paraneoplastic Cerebellar Degeneration (PCD):
Strongly linked to underlying cancers (e.g., breast, ovarian, or lung malignancies), with 90-98% of anti-Yo-positive cases having neoplasms.
Symptoms include subacute cerebellar ataxia, dysarthria, and diplopia.
Autoimmune Cerebellar Ataxia:
Non-paraneoplastic cases often target antigens like ARHGAP26 or RGS8, causing inflammatory cerebellar damage.
Psychiatric and Neurodevelopmental Disorders:
Anti-Purkinje antibodies (IgG) are reported in schizophrenia, bipolar disorder, and ADHD, correlating with acute psychopathology and positive symptoms.
May disrupt cerebellar-limbic circuits involved in emotion and cognition.
Optimal range: 0 - 10 Units
The Anti-Purkinje cell (IgM) marker on Vibrant America’s Neural Zoomer Plus panel detects IgM-class autoantibodies targeting Purkinje cells, specialized neurons in the cerebellum that are critical for motor coordination. This test is part of a broader evaluation for neurological autoimmunity, helping identify immune-mediated damage linked to conditions like cerebellar ataxia, paraneoplastic syndromes, or neurodegenerative disorders.
Optimal range: 0 - 10 Units
The Anti-RAGE peptide (IgG + IgA) marker measures the presence of antibodies against the Receptor for Advanced Glycation End Products (RAGE) in the blood. This receptor plays a crucial role in inflammation, immune system regulation, and neural function. RAGE is highly expressed in the brain, particularly in neurons, microglia, and endothelial cells of the blood-brain barrier.
A moderate elevation in Anti-RAGE Peptide (IgG + IgA) on the Neural Zoomer Plus panel suggests an ongoing but not severe immune response against the Receptor for Advanced Glycation End Products (RAGE). This may indicate low-grade neuroinflammation, early-stage neurological dysfunction, or an autoimmune process that is not yet fully developed.
Early or Mild Neuroinflammation
Blood-Brain Barrier Disruption (Mild to Moderate)
Metabolic & Glycation-Related Stress
Autoimmune Activity – Subclinical or Developing
Chronic Low-Grade Infection or Environmental Trigger
A moderately elevated Anti-RAGE Peptide (IgG + IgA) result is not necessarily pathological but may indicate early neuroinflammatory activity, metabolic stress, or mild blood-brain barrier disruption. It is important to monitor changes, manage inflammation, and identify possible contributing factors to prevent progression toward neurodegeneration or autoimmune disease.
Optimal range: 0 - 10 Units
Optimal range: 0.1 - 10 Units
Anti recoverin antibodies are one of the key components of antibody disorders of the central nervous system (CNS). They have also been shown to be associated with retinopathy, which is characterized by impaired vision and photosensitivity.
Optimal range: 0.1 - 10 Units
Anti recoverin antibodies are one of the key components of antibody disorders of the central nervous system (CNS). They have also been shown to be associated with retinopathy, which is characterized by impaired vision and photosensitivity.
Optimal range: 0.1 - 10 Units
The presence of anti-Ri antibody identifies a subset of patients with paraneoplastic ataxia and eye movement disorders (opsoclonus) who usually suffer from breast or other gynecological cancer; the antibody when present is a useful marker for an underlying malignancy.
Optimal range: 0.1 - 10 Units
The presence of anti-Ri antibody identifies a subset of patients with paraneoplastic ataxia and eye movement disorders (opsoclonus) who usually suffer from breast or other gynecological cancer; the antibody when present is a useful marker for an underlying malignancy.
Optimal range: 0.1 - 10 Units
The S100B is a calcium-binding peptide and is used as a parameter of glial activation and/or death in many disorders of the central nervous system (CNS). It plays important roles in normal CNS development and recovery after injury.
Although S100B is mainly found in astroglial and Schwann cells, it also has extracerebral sources.
S100B is a useful neurobiochemical marker of brain damage such as in circulatory arrest, stroke and traumatic brain injury.
S100B is also associated with neurodegenerative diseases like Alzheimer's disease or other chronic neurological diseases.
Optimal range: 0.1 - 10 Units
The S100B is a calcium-binding peptide and is used as a parameter of glial activation and/or death in many disorders of the central nervous system (CNS). It plays important roles in normal CNS development and recovery after injury.
Although S100B is mainly found in astroglial and Schwann cells, it also has extracerebral sources.
S100B is a useful neurobiochemical marker of brain damage such as in circulatory arrest, stroke and traumatic brain injury.
S100B is also associated with neurodegenerative diseases like Alzheimer's disease or other chronic neurological diseases.
Optimal range: 0.1 - 10 Units
The marker "Anti-Streptococcal A (IgG)" is a specialized test designed to detect the presence of IgG antibodies against Streptococcus A bacteria in the blood. Streptococcus A is a type of bacteria that can cause various infections, ranging from mild throat infections (like strep throat) to m
If Anti-Streptococcal A (IgG) is mildly elevated, it suggests that there may have been a recent or past streptococcal infection. Anti-Streptococcal A antibodies are typically produced in response to Group A Streptococcus (GAS) infection, such as strep throat, scarlet fever, or skin infections.
Recent or Past Infection:
A mildly elevated Anti-Streptococcal A (IgG) can indicate that the body has encountered Group A Streptococcus in the past, but it might not necessarily reflect an active infection. IgG antibodies appear after the acute phase of infection and can remain elevated for weeks to months following recovery.
Post-Infection Immunity:
A mild increase in Anti-Streptococcal A IgG may simply represent a normal immune response as the body has developed immunity to Group A Streptococcus after a previous infection. This suggests that your immune system has successfully responded to the bacteria, and you may have protection against future infections by the same pathogen.
Risk for Post-Streptococcal Sequelae:
While IgG antibodies typically indicate past exposure, elevated levels may also be seen in cases of post-streptococcal sequelae such as rheumatic fever or post-streptococcal glomerulonephritis. These are conditions that can develop weeks after an untreated or inadequately treated streptococcal infection. In such cases, the elevation is usually accompanied by other clinical symptoms (such as joint pain, heart inflammation, or kidney issues) and may require further diagnostic investigation.
Chronic or Recurrent Infections:
In rare cases, mildly elevated IgG levels can occur if there have been chronic or recurrent infections with Group A Streptococcus, possibly due to incomplete treatment or recurrent throat infections. This may necessitate additional investigation or a more thorough assessment of infection history and treatment.
Clinical Correlation: A mildly elevated Anti-Streptococcal A IgG should always be interpreted in the context of clinical symptoms and history. If you have recently had a strep infection or symptoms like sore throat, fever, or skin infections, it may be a sign that your immune system is responding appropriately.
Follow-Up Tests: If there are concerns about post-streptococcal sequelae (such as rheumatic fever or glomerulonephritis), further tests may be needed, such as:
Anti-Streptolysin O (ASO) titers: A more direct marker of recent streptococcal infection.
Echocardiogram or urine tests: To rule out any complications like heart damage or kidney involvement.
Reassessment: If no recent strep infection is evident and symptoms persist, it may be necessary to revisit the diagnosis and consider other causes for the antibody elevation.
A mildly elevated Anti-Streptococcal A IgG level is often not cause for immediate concern and may reflect prior exposure or past infection with Group A Streptococcus. However, if there are concerns about recent symptoms, unresolved infections, or complications like rheumatic fever or glomerulonephritis, further clinical evaluation and testing are warranted to ensure appropriate management.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
The Anti-Titin (IgG + IgA) biomarker, measured in Vibrant Wellness' Neural Zoomer Plus panel, assesses immune reactivity to titin, a giant protein critical for muscle elasticity and contraction. This test helps identify autoimmune responses targeting neuromuscular tissues, which may underlie conditions like myasthenia gravis and thymoma-associated syndromes.
The test detects IgG and IgA antibodies against titin, a structural protein in skeletal and cardiac muscle. Titin stabilizes sarcomeres during muscle contraction, and autoantibodies against it are often linked to neuromuscular junction dysfunction.
Anti-Titin antibodies are associated with:
Myasthenia Gravis (MG):
Found in approximately 30% of generalized MG cases, particularly in patients with thymoma (a tumor of the thymus).
Associated with severe disease phenotypes and poorer response to acetylcholinesterase inhibitors.
Thymoma Screening:
The presence of Anti-Titin antibodies may prompt imaging (e.g., chest CT) to rule out thymic tumors.
Late-Onset MG:
More common in patients over 50, often without thymoma, but with higher rates of muscle-specific kinase (MuSK) antibodies.
Optimal range: 0 - 10 Units
Optimal range: 0.1 - 10 Units
ANTIBODIES ASSOCIATED WITH:
This test by itself is not diagnostic for any condition or disease
Alcoholic Liver Disease
Demyelinating Disease
Graves’ Disease
Hashimoto’s Thyroiditis
Infectious agent exposure
PANDAS / ANDAS / OCD
Rheumatoid Arthritis
Recent Onset Type 1 Diabetes Toxin Exposure
Known Cross-Reactions: Streptococcal Protein
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Function: Tubulin is a building block protein and a major component of a cell’s internal cytoskeleton, called microtubules. These structures play key roles in many cellular functions including, interaction with guanine, lateral contacts, interaction with beta and gamma phosphates of nucleotides, interaction with gamma phosphate, longitudinal contacts, backbone interactions with α and β phosphates, hydrophobic contact of conserved residues, nucleotide contacts, MAP-binding domain and acetylation site.
Optimal range: 0.1 - 10 Units
ANTIBODIES ASSOCIATED WITH:
This test by itself is not diagnostic for any condition or disease
Alcoholic Liver Disease
Demyelinating Disease
Graves’ Disease
Hashimoto’s Thyroiditis
Infectious agent exposure
PANDAS / ANDAS / OCD
Rheumatoid Arthritis
Recent Onset Type 1 Diabetes Toxin Exposure
Known Cross-Reactions: Streptococcal Protein
----------------------------
Function: Tubulin is a building block protein and a major component of a cell’s internal cytoskeleton, called microtubules. These structures play key roles in many cellular functions including, interaction with guanine, lateral contacts, interaction with beta and gamma phosphates of nucleotides, interaction with gamma phosphate, longitudinal contacts, backbone interactions with α and β phosphates, hydrophobic contact of conserved residues, nucleotide contacts, MAP-binding domain and acetylation site.
Optimal range: 0 - 10 Units
Voltage-gated calcium channels (VGCCs) are a group of voltage-gated ion channels found in the membrane of excitable cells such as muscle, glial cells, and neurons. They are key transducers of membrane potential changes into intracellular Ca2+ transients that initiate many physiological events. In neurons, voltage-gated Ca2+ channels initiate synaptic transmission. Anti-voltage-gated calcium channel autoantibodies are responsible for Lambert-Eaton myasthenic syndrome (LEMS), a rare autoimmune disorder of the neuromuscular junction.
Optimal range: 0 - 10 Units
The Anti-Voltage Gated Calcium Channels (VGCC) IgM biomarker is a specialized test used to detect antibodies against the voltage-gated calcium channels in the nervous system. These calcium channels play a crucial role in the function of neurons, helping to regulate the flow of calcium ions in and out of nerve cells, which is essential for the proper transmission of electrical signals in the brain and throughout the nervous system.
What It Measures: This test specifically measures IgM antibodies directed against these voltage-gated calcium channels. IgM is a type of antibody that typically appears early in immune responses. The presence of Anti-VGCC IgM antibodies can suggest an autoimmune response, where the immune system mistakenly targets these calcium channels, potentially disrupting normal nerve cell function.
Clinical Relevance: The presence of Anti-VGCC IgM antibodies has been linked to several neurological conditions, most notably paraneoplastic neurologic syndromes (PNS). In PNS, the immune system targets components of the nervous system in response to an underlying malignancy. These conditions may lead to symptoms such as muscle weakness, vision disturbances, memory issues, or even severe conditions like Lambert-Eaton Myasthenic Syndrome (LEMS), a disorder that impairs communication between nerves and muscles.
Optimal range: 0 - 10 Units
The Anti-Voltage Gated Potassium Channels (VGKC) test, measuring IgG and IgA antibodies, is part of specialized diagnostic panels such as the Neural Zoomer panel by Vibrant America. This test is used to detect antibodies against voltage-gated potassium channels, which are essential proteins located on the surface of neurons. These channels regulate the flow of potassium ions in and out of nerve cells, playing a critical role in the electrical activity that drives neural communication.
The Anti-VGKC IgG + IgA test specifically measures two types of antibodies (IgG and IgA) that target the voltage-gated potassium channels. IgG antibodies are the most common type of antibody in the bloodstream and often appear later in immune responses, while IgA antibodies are found in mucosal areas, such as the respiratory and gastrointestinal tracts. The presence of these antibodies can indicate an autoimmune response, where the body's immune system mistakenly attacks its own nerve cells, interfering with normal nervous system function.
Optimal range: 0 - 10 Units
The Anti-Voltage Gated Potassium Channels (VGKC) IgM test is a diagnostic assay aimed at detecting IgM antibodies targeting components of the VGKC complex. These channels are essential for regulating potassium ion flow in neurons, contributing to nerve signaling and maintaining the electrical activity of the nervous system.
This test specifically identifies IgM antibodies directed against VGKC-complex proteins. While IgG antibodies are more commonly associated with autoimmune neurological conditions, the presence of IgM antibodies may indicate an early immune response targeting these channels. The VGKC complex includes proteins such as leucine-rich glioma-inactivated 1 (LGI1) and contactin-associated protein 2 (CASPR2), which are crucial for synaptic function and neuronal communication.
Anti-VGKC IgM antibodies are less frequently studied compared to their IgG counterparts, but their detection could still provide insights into autoimmune mechanisms affecting the nervous system. VGKC-complex antibodies have been implicated in conditions such as:
Limbic Encephalitis: Characterized by cognitive impairment, seizures, and psychiatric symptoms, often associated with LGI1 antibodies.
Neuromyotonia: A peripheral nerve hyperexcitability syndrome linked to CASPR2 antibodies.
Morvan Syndrome: A rare disorder featuring neuromyotonia, autonomic dysfunction, and insomnia.
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Units
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
The marker "EBNA1 (IgG)" is a crucial indicator for assessing neurological health and potential autoimmune conditions affecting the nervous system. EBNA1 stands for Epstein-Barr Nuclear Antigen 1, and the IgG designation refers to Immunoglobulin G, a type of antibody. This particular marker is significant because it helps detect past infections with the Epstein-Barr virus (EBV), which is known to be associated with a variety of neurological disorders. EBV is a common virus, and while it often causes mild symptoms or goes unnoticed in many people, its connection to neurological conditions can be significant in a subset of individuals. The presence of IgG antibodies against EBNA1 indicates that a person has been infected with EBV at some point in their life, and their immune system has produced antibodies to fight off the virus. In the context of the NeuralZoomer Plus panel, testing for EBNA1 (IgG) antibodies helps healthcare providers understand whether a past EBV infection might be contributing to neurological symptoms or conditions. This information is valuable for developing a comprehensive picture of a patient's neurological health and tailoring treatment approaches to address any identified autoimmune or viral-related issues.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
The CMV EIA Antigen (IgG) marker on the Neural Zoomer Plus panel measures IgG antibodies against Cytomegalovirus, a common herpesvirus that infects most people at some point in their lives.
EIA (Enzyme Immunoassay) is the method used to detect IgG levels.
The IgG class of antibodies indicates past exposure to CMV and the formation of long-term immune memory.
CMV is usually dormant in healthy individuals but can cause neurological issues in some cases—especially in the context of autoimmunity, immune dysfunction, or reactivation.
You have been exposed to Cytomegalovirus in the past.
Your immune system has produced a moderately high level of IgG antibodies against CMV.
This may suggest either:
Recent past infection (especially if IgM is negative but IgG is rising), or
Ongoing immune system activation or reactivation, particularly relevant if symptoms are present.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
The Epstein-Barr Virus (EBV) p18 IgG marker is a vital component of the NeuralZoomer Plus panel from Vibrant Wellness, designed to assess neurological health and the risk of autoimmunity. EBV, a widespread herpesvirus, infects most people at some point in their lives, potentially leading to infectious mononucleosis. However, many individuals carry the virus asymptomatically. The p18 IgG marker specifically indicates the body's immune response to EBV, focusing on the production of Immunoglobulin G (IgG) antibodies against the virus's p18 protein—a component of the viral capsid antigen (VCA), essential for the virus's infection and replication processes.
The presence of IgG antibodies against EBV's p18 suggests a past or chronic infection, offering significant insights into a patient's immune system status and potential neurological or autoimmune disease risk factors. This testing is crucial, as chronic EBV infection is linked to various neurological conditions and autoimmune diseases. The NeuralZoomer Plus panel facilitates early detection and intervention, providing a personalized approach to prevent and manage neurological health issues. By including the EBV p18 marker, the panel offers a comprehensive view of the body's immune activity against EBV, essential for diagnosing and treating conditions with a potential viral cause.
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
Optimal range: 0 - 10 Relative Abundance
The marker "VCA gp125 (IgG)" is an important component of a comprehensive test that aims to detect potential neural autoimmunity, which can affect the nervous system and brain health. "VCA" stands for Viral Capsid Antigen, and "gp125" refers to a specific glycoprotein component of the Epstein-Barr Virus (EBV) that this test targets. The "IgG" in the name signifies Immunoglobulin G, a type of antibody. In the context of this test, the presence of IgG antibodies against the VCA gp125 indicates a past or ongoing immune response to the EBV.
The Epstein-Barr Virus is known for its association with various conditions, including but not limited to, mononucleosis, certain cancers, and potentially contributing to autoimmune diseases and neurological conditions. The NeuralZoomer Plus panel, offered by Vibrant Wellness, includes this marker as part of its broader effort to identify autoantibodies that could signal the presence of neurological conditions, aiding healthcare providers in diagnosing and managing potential autoimmune-related neurological disorders. This tool is particularly valuable for identifying silent or subclinical conditions that may otherwise go unnoticed, enabling early intervention strategies to prevent or mitigate long-term health issues related to neural autoimmunity.
Optimal range: 0 - 10 Relative Abundance
Serum Antibody Testing for Mycotoxins
MyMycoLab is a laboratory specializing in blood serum antibody testing for mycotoxins. They offer testing for 12 different mycotoxins, measuring both IgG and IgE antibodies. This provides a comprehensive look at how the body is reacting to mycotoxins, either through a toxicological or allergic response.
Mycotoxins and molds are often referred to as "The Great Masquerader" by the World Health Organization, as they mimic a wide range of illnesses and conditions, making them difficult to diagnose and treat.
The first step in understanding whether you are affected by mycotoxins and molds is through testing. Molds are biological organisms, while mycotoxins are toxic substances, which are far more dangerous. A blood serum test is the most precise and accurate method for detecting your body’s reaction to mycotoxins, whether from toxicity or allergy.
Toxin-producing molds are always present in water-damaged homes or workplaces. There is a significant body of accepted, non-controversial evidence in medical science linking mycotoxin exposure to immune dysregulation, neurological disorders, cancer, and various other health issues. It is important to discuss these concerns with your clinicians.
According to the National Institute for Occupational Safety and Health (NIOSH), very low levels of mycotoxins are present in many foods. For example, Vomitoxin (Deoxynivalenol) from Fusarium mold is found in grains, but a person would need to consume a massive amount (e.g., over 14 pounds of oatmeal or 20 slices of bread daily) to reach harmful levels.
Mycotoxins are routinely detected in the urine of healthy individuals, but this does not necessarily indicate disease or mold-related health problems. The levels found in food and beverages are typically in parts per billion and do not pose a risk to health.
IgG is the most abundant antibody in human serum, responsible for long-term immunity. It can cross the placenta and protect the newborn. IgG antibodies to mycotoxins indicate an ongoing immune reaction, often due to current environmental exposure or past colonization, especially in the sinuses or lungs.
IgE antibodies are associated with allergies. They trigger the release of histamine, heparin, and cytokines from mast cells, which causes inflammation and can lead to mast cell activation. Mast cells are involved in various inflammatory diseases, including arthritis, psoriasis, and multiple sclerosis.
Here is a brief overview of common mycotoxins:
Satratoxin: A potent trichothecene mycotoxin primarily produced by Stachybotrys (black mold). It is known for its neurotoxic effects, causing brain inflammation, and triggering apoptosis in olfactory sensory neurons. Symptoms of exposure include fatigue, headaches, nosebleeds, chest pain, pulmonary hemorrhage, moist dermatitis, and fever. Prolonged exposure can lead to chronic immune responses, brain and nerve cell damage.
Verrucarin and Verrucarol: Produced by Fusarium and Aspergillus species, these trichothecene mycotoxins are known for causing tremors, immune toxicity, inflammation, and protein synthesis inhibition.
Ochratoxin: This mycotoxin affects the immune system, kidneys, liver, and lungs, and is carcinogenic. It impacts DNA and inhibits protein synthesis. Ochratoxin has been shown to cause leaky gut syndrome and disrupt nutrient absorption. It cannot be excreted in urine, and its highest levels are found in breast milk. Key target organs include the liver, kidney, brain, skeletal muscle, and fat tissue. It can cross the placenta.
T2 Toxin: A trichothecene mycotoxin, it has been used in biological warfare. It can cause gastrointestinal issues like diarrhea and vomiting, as well as reproductive cycle changes and infertility. It is known to lower testosterone levels.
Vomitoxin (Deoxynivalenol): Another trichothecene mycotoxin, it damages the intestinal barrier, leading to conditions like inflammatory bowel disease and celiac disease. It also disrupts hormone levels, impacting both estrogen and testosterone.
Cladosporium Toxin (Cladosporium HSP 70): This airborne mold spore is a significant allergen, especially for individuals with asthma or respiratory conditions. It also produces volatile organic compounds (VOCs), which are neurotoxic. Symptoms include severe headaches, seizures, and sleepiness.
Alternaria Toxin (Alternariol): Known for its cytotoxic, mutagenic, and genotoxic properties, it can cause immune suppression, inflammation, and lower testosterone levels.
Aspergillus Toxin (Aspergillus Hemolysin): This mycotoxin is cytotoxic, especially to neutrophils and macrophages, and is carcinogenic. It is hemolytic, meaning it destroys red blood cells.
Aspergillus Auto-Toxin (Sterigmatocystin): This carcinogenic, mutagenic, and teratogenic mycotoxin can cause autoimmune diseases and liver toxicity.
Penicillium Toxin (Mycophenolic Acid): Known to cause immune suppression.
Asp/Pen Neuro Auto-Toxin (Gliotoxin): A neurotoxic mycotoxin linked to conditions like multiple sclerosis, it also suppresses the immune system and is cytotoxic to white blood cells.
Stachybotrys Toxin (Trichothecene): This potent mycotoxin can affect multiple systems in the body:
Vascular: Increased fragility, pulmonary hemorrhage.
Nervous: Tremors, headaches, seizures, sleep disturbances, incoordination, depression, and nerve demyelination (CIDP).
Digestive: Vomiting, diarrhea, liver toxicity, anorexia, and intestinal hemorrhage.
Cutaneous: Rash, photosensitization, skin sloughing, and burning sensations.
Endocrine: Reduced testosterone and estrogen levels.
Fumonisin B1: Produced by Fusarium molds, this mycotoxin is hepatotoxic, nephrotoxic, and linked to esophageal cancer. It can disrupt brain function and cause depression resistant to treatment. It also affects mitochondrial function.
Zearalenone: This estrogenic mycotoxin impacts reproduction in both men and women. It can cause reduced embryo survival, fetal weight reduction, premature breast development in girls, and lower testosterone in men. It is hepatotoxic, immunotoxic, and affects mitochondrial function.
Optimal range: 0 - 0.15 Units
Alternaria alternata is one of the most common fungi associated with asthma.
Optimal range: 0 - 0.15 Units
Alternaria alternata is one of the most common fungi associated with asthma.
Optimal range: 0 - 0.15 Units
Aspergillus Auto-Toxin (Sterigmatocystin) carcinogenic (causes cancer), mutagenic (causes mutations), andteratogenic (causes malformations of the fetus), hepatotoxic (liver); can cause autoimmune diseases.
Sterigmatocystin (STG) is a mycotoxin that is closely related to aflatoxin. STG is produced from several species of mold such as Aspergillus, Penicillium, and Bipolaris. It is considered to be carcinogenic, particularly in the cells of the GI tract and liver. STG has been found in the dust from damp carpets.
Optimal range: 0 - 0.15 Units
Aspergillus Auto-Toxin (Sterigmatocystin) carcinogenic (causes cancer), mutagenic (causes mutations), andteratogenic (causes malformations of the fetus), hepatotoxic (liver); can cause autoimmune diseases.
Sterigmatocystin (STG) is a mycotoxin that is closely related to aflatoxin. STG is produced from several species of mold such as Aspergillus, Penicillium, and Bipolaris. It is considered to be carcinogenic, particularly in the cells of the GI tract and liver. STG has been found in the dust from damp carpets.
Optimal range: 0 - 0.15 Units
Aspergillus Hemolysis can cause immune suppression and is carcinogenic.
Aspergillus is the genus of asexual spore-forming mold species common in many climates. It is found in soil, water and air. Aspergillus fumigatus, Aspergillus niger and Aspergillus flavus are common molds to which humans are exposed.
Optimal range: 0 - 0.15 Units
Aspergillus Hemolysis can cause immune suppression and is carcinogenic.
Aspergillus is the genus of asexual spore-forming mold species common in many climates. It is found in soil, water and air. Aspergillus fumigatus, Aspergillus niger and Aspergillus flavus are common molds to which humans are exposed.
Optimal range: 0 - 0.15 Units
Aspergillus/Penicillium Neuro Auto-Toxin (Gliotoxin) can cause immune suppression, neurotoxicity (has been linked to multiple sclerosis and others), immune toxicity.
Gliotoxin is produced by the mold genus Aspergillus. Aspergillus spreads in the environment by releasing conidia which are capable of infiltrating the small alveolar airways of individuals. In order to evade the body’s defenses Aspergillus releases Gliotoxin to inhibit the immune system. One of the targets of Gliotoxin is PtdIns (3,4,5) P3. This result in the downregulation of phagocytic immune defense, which can lead to the exacerbation of polymicrobial infections. Gliotoxin impairs the activation of T-cells and induces apoptosis in monocytes and in monocyte-derived dendritic cells. These impairments to dendritic cells can lead to multiple neurological syndromes. Retesting is recommended after 3-6 months of treatment.
Gliotoxin is produced by the common indoor mold genus Aspergillus and is immunosuppressive (=it can dampen the body's ability to ward off disease and infection).
Optimal range: 0 - 0.15 Units
Aspergillus/Penicillium Neuro Auto-Toxin (Gliotoxin) can cause immune suppression, neurotoxicity (has been linked to multiple sclerosis and others), immune toxicity.
Gliotoxin is produced by the mold genus Aspergillus. Aspergillus spreads in the environment by releasing conidia which are capable of infiltrating the small alveolar airways of individuals. In order to evade the body’s defenses Aspergillus releases Gliotoxin to inhibit the immune system. One of the targets of Gliotoxin is PtdIns (3,4,5) P3. This result in the downregulation of phagocytic immune defense, which can lead to the exacerbation of polymicrobial infections. Gliotoxin impairs the activation of T-cells and induces apoptosis in monocytes and in monocyte-derived dendritic cells. These impairments to dendritic cells can lead to multiple neurological syndromes. Retesting is recommended after 3-6 months of treatment.
Gliotoxin is produced by the common indoor mold genus Aspergillus and is immunosuppressive (=it can dampen the body's ability to ward off disease and infection).
Optimal range: 0 - 0.15 Units
Cladosporium, a well known trigger for asthmatic attacks, is one of the most widespread molds.
Cladosporium includes about 40 species naturally found in soil, on decaying plant material and as plant pathogens.
In an indoor environment, Cladosporium spp. occur as secondary wall colonizers, appearing after the primary ones such as Penicillium species, Aspergillus versicolor and Wallemia sebi. Cladosporiumis very common on wet building material (e.g., gypsum board, acrylic painted walls, wood, wallpaper, carpet and mattress dust, HVAC fans, and wet insulation in mechanical cooling units).
Optimal range: 0 - 0.15 Units
Cladosporium, a well known trigger for asthmatic attacks, is one of the most widespread molds.
Cladosporium includes about 40 species naturally found in soil, on decaying plant material and as plant pathogens.
In an indoor environment, Cladosporium spp. occur as secondary wall colonizers, appearing after the primary ones such as Penicillium species, Aspergillus versicolor and Wallemia sebi. Cladosporiumis very common on wet building material (e.g., gypsum board, acrylic painted walls, wood, wallpaper, carpet and mattress dust, HVAC fans, and wet insulation in mechanical cooling units).
Optimal range: 0 - 0.15 Units
Fumonisin B1 (FB1) is a type of mycotoxin produced by certain species of Fusarium, a group of molds that commonly contaminate crops like corn, maize, and other grains. Fumonisins, particularly FB1, are among the most toxic members of this group. When consumed by humans or animals through contaminated food, these toxins can pose various health risks.
Optimal range: 0 - 0.15 Units
Fumonisin B1 (FB1) is a type of mycotoxin produced by certain species of Fusarium, a group of molds that commonly contaminate crops like corn, maize, and other grains. Fumonisins, particularly FB1, are among the most toxic members of this group. When consumed by humans or animals through contaminated food, these toxins can pose various health risks.
Optimal range: 0 - 0.15 Units
Ochratoxin is a nephrotoxic, immunotoxic, and carcinogenic mycotoxin. This chemical is produced by molds in the Aspergillus and Penicillium families.
Exposure:
Exposure is done primarily through water damaged buildings. Minimal exposure can occur through contaminated foods such as cereals, grape juices, dairy, spices, wine, dried vine fruit, and coffee. Exposure to Ochratoxin can also come from inhalation exposure in water-damaged buildings.
Ochratoxin can cause immune suppression, lung disease, urinary tract tumors, and is nephrotoxic (kidneys), hepatotoxic (liver), genotoxic (genes), and carcinogenic (causes cancer). This is due to its ability to form DNA adducts and inhibit protein synthesis. Ochratoxin can potentiate the effects of IL-1 Bon IL-8 secretion with a range of 35% to 138% increase and augments the transepithelial passage of commensal bacteria with a 12- to 1522-fold increase. Studies have shown it causes leaky gut syndrome and changes the nutrients that are absorbed from foods.
Optimal range: 0 - 0.15 Units
Ochratoxin is a nephrotoxic, immunotoxic, and carcinogenic mycotoxin. This chemical is produced by molds in the Aspergillus and Penicillium families.
Exposure:
Exposure is done primarily through water damaged buildings. Minimal exposure can occur through contaminated foods such as cereals, grape juices, dairy, spices, wine, dried vine fruit, and coffee. Exposure to Ochratoxin can also come from inhalation exposure in water-damaged buildings.
Ochratoxin can cause immune suppression, lung disease, urinary tract tumors, and is nephrotoxic (kidneys), hepatotoxic (liver), genotoxic (genes), and carcinogenic (causes cancer). This is due to its ability to form DNA adducts and inhibit protein synthesis. Ochratoxin can potentiate the effects of IL-1 Bon IL-8 secretion with a range of 35% to 138% increase and augments the transepithelial passage of commensal bacteria with a 12- to 1522-fold increase. Studies have shown it causes leaky gut syndrome and changes the nutrients that are absorbed from foods.
Optimal range: 0 - 0.15 Units
Penicillium is a genus of fungi, which commonly grows on many foodstuffs such as cocoa beans, coffee beans, cassava flour, cereals, fish, peanuts, dried fruits, wine, poultry eggs and milk.
Optimal range: 0 - 0.15 Units
Penicillium is a genus of fungi, which commonly grows on many foodstuffs such as cocoa beans, coffee beans, cassava flour, cereals, fish, peanuts, dried fruits, wine, poultry eggs and milk.
Optimal range: 0 - 0.15 Units
These water-soluble mycotoxins could produce airborne particles which could facilitate entry and release into respiratory airway tissue that may selectively induce apoptosis in olfactory sensory neurons in the nose (rhinitis) and brain(mild focal encephalitis).
Although epidemiological studies that specifically examine exposure to mycotoxins in indoor residential environments are relatively limited, there is substantial evidence of a relationship between mycotoxin exposure (via ingestion and inhalation) and adverse health effects in occupational (agricultural and food processing) settings and animal studies.
Optimal range: 0 - 0.15 Units
These water-soluble mycotoxins could produce airborne particles which could facilitate entry and release into respiratory airway tissue that may selectively induce apoptosis in olfactory sensory neurons in the nose (rhinitis) and brain(mild focal encephalitis).
Although epidemiological studies that specifically examine exposure to mycotoxins in indoor residential environments are relatively limited, there is substantial evidence of a relationship between mycotoxin exposure (via ingestion and inhalation) and adverse health effects in occupational (agricultural and food processing) settings and animal studies.
Optimal range: 0 - 0.15 Units
Stachybotrys chartarum (S. chartarum) is a black mold that produces asexual spores. S. chartarum is the usual perpetrator involved in water/moisture/wet-damaged building illnesses.
Optimal range: 0 - 0.15 Units
Stachybotrys chartarum (S. chartarum) is a black mold that produces asexual spores. S. chartarum is the usual perpetrator involved in water/moisture/wet-damaged building illnesses.
Optimal range: 0 - 0.15 Units
T2 Toxin are trichothecene mycotoxins and are the only mycotoxins that have been used in biological warfare. They can cause diarrhea, vomiting, and intestinal hemorrhage, as well as changes in reproductive cycles and infertility. This mycotoxin is known to decrease testosterone.
Optimal range: 0 - 0.15 Units
T2 Toxin are trichothecene mycotoxins and are the only mycotoxins that have been used in biological warfare. They can cause diarrhea, vomiting, and intestinal hemorrhage, as well as changes in reproductive cycles and infertility. This mycotoxin is known to decrease testosterone.
Optimal range: 0 - 0.15 Units
Verrucarin and Verrucarol are trichothecene mycotoxins mainly produced by Fusarium and Aspergillus species and are known to cause tremors, immune toxicity, inflammation, are cytotoxic (= can damage cells or cause them to die), and are potent protein synthesis inhibitors (= stops or slows the growth or proliferation of cells by disrupting the processes that lead directly to the generation of new proteins).
Optimal range: 0 - 0.15 Units
Verrucarin and Verrucarol are trichothecene mycotoxins mainly produced by Fusarium and Aspergillus species and are known to cause tremors, immune toxicity, inflammation, are cytotoxic (= can damage cells or cause them to die), and are potent protein synthesis inhibitors (= stops or slows the growth or proliferation of cells by disrupting the processes that lead directly to the generation of new proteins).
Optimal range: 0 - 0.15 Units
Vomitoxin (aka Deoxynivalenol or DON), a tricothecene mycotoxin, is produced by several species of Fusarium. DON has been associated with outbreaks of acute gastrointestinal illness in humans. The FDA advisory level for DON for human consumption is 1 ppm.
Optimal range: 0 - 0.15 Units
Vomitoxin (aka Deoxynivalenol or DON), a tricothecene mycotoxin, is produced by several species of Fusarium. DON has been associated with outbreaks of acute gastrointestinal illness in humans. The FDA advisory level for DON for human consumption is 1 ppm.
Optimal range: 0 - 0.15 Units
Zearalenone (ZEN) is a mycotoxin produced by several species of Fusarium fungi, commonly found in cereals like maize, wheat, barley, and other crops. ZEN is known for its estrogenic activity because it structurally resembles estrogen and can mimic its effects in animals and humans. This mycotoxin can enter the food chain through contaminated grain-based products, and humans can be exposed to it by consuming contaminated food or animal products.
Optimal range: 0 - 0.15 Units
Zearalenone (ZEN) is a mycotoxin produced by several species of Fusarium fungi, commonly found in cereals like maize, wheat, barley, and other crops. ZEN is known for its estrogenic activity because it structurally resembles estrogen and can mimic its effects in animals and humans. This mycotoxin can enter the food chain through contaminated grain-based products, and humans can be exposed to it by consuming contaminated food or animal products.
Hormone & Urinary Metabolites Assessment Profile
The Hormone and Urinary Metabolites Assessment Profile (HuMap) provides a comprehensive overview of hormones and their metabolites, as well as efficiency of enzymes involved in their metabolism.
The Hormone and Urinary Metabolites Assessment Profile (HuMap) provides a comprehensive overview of steroid hormones, their metabolites, and the efficiency of the enzymes that metabolize these hormones. This non-invasive test requires only 4 or 5 separate urine collections. Because the breakdown of hormones relies so heavily on processes within the liver, this test can also help reveal patterns of liver metabolism and conjugation. Additionally, testing urinary hormone metabolites can contribute to further understanding of endogenous hormone secretion, supplemental hormone utilization, enzyme activity, oxidative stress, and insight into how your body metabolizes hormones.
Optimal range: 0 - 0 ng/mg Creat/Day
Optimal range: 0.3 - 1.2 ng/mg Creat/Day
Optimal range: 0.35 - 1.8 ng/mg Creat/Day
11-Deoxycortisol has very little glucocorticoid activity yet its role as an intermediate in cortisol creation may assist in understanding of impairment along this pathway. CYP21A (21-hydroxylase) is responsible for the conversion of 17-hydroxyprogesterone to 11-deoxycortisol.
Optimal range: 0.35 - 1.8 ng/mg Creat/Day
Optimal range: 210 - 920 ng/mg Creat/Day
11-Hydroxy-Androsterone (OHAN) is a urinary metabolite of cortisol metabolism as well as 11-oxygenated androgens production from the adrenal glands. While research is limited in the significance of elevations of this metabolite, it may be associated with certain conditions like 21-hydroxylase deficiency and castration- resistant prostate cancer.
Optimal range: 180 - 800 ng/mg Creat/Day
OHAN is a urinary metabolite of cortisol metabolism as well as 11-oxygenated androgens production from the adrenal glands.
Optimal range: 250 - 1000 ng/mg Creat/Day
Optimal range: 35 - 380 ng/mg Creat
Optimal range: 40 - 470 ng/mg Creat/Day
OHET is the product of cortisol metabolism as well as 11-oxygenated androgens produced from the adrenal gland. Levels tend to reflect levels of etiocholanolone.
Optimal range: 20 - 710 ng/mg Creat/Day
Optimal range: 10 - 50 %
Optimal range: 10 - 50 ng/mg Creat/Day
Percentages of 2-OH-E1, 4-OH-E1, and 16-OH-E1
When evaluating phase I metabolism, it can be helpful to compare the percentages of 2, 4, and 16 OH-E1 metabolites. Most individuals metabolize the majority of their estrogens down the 2-OH-E1 pathway which is generally considered the “safer pathway”. This is followed by 16-OH-E1 and 4-OH-E1 respectively, both of which are deemed more reactive and potentially genotoxic.
Optimal range: 15 - 50 %
In a Hormone Metabolite Assessment Panel (HUMAP) for pre-menopausal women, the percentage of 16-Hydroxyestrone (16-OH-E1) is a critical marker for evaluating estrogen metabolism and its implications for health.
16-OH-E1 is a metabolite of estrogen, produced through the 16α-hydroxylation pathway, and is known for its strong estrogenic properties. In contrast to other estrogen metabolites that are less active, 16-OH-E1 has been linked to an increased risk of estrogen-sensitive conditions, such as certain types of breast and uterine cancers. It promotes the growth of estrogen-responsive tissues and can contribute to conditions associated with estrogen dominance.
Optimal range: 0.47 - 4.9 ng/mg Creat/Day
Optimal range: 0.5 - 5.3 ng/mg Creat/Day
Optimal range: 4.2 - 15 ng/mg Creat/Day
16a-Hydroxyestrone, particularly in the context of a pre-menopausal Hormone Metabolite Assessment Panel (HUMAP), is a significant marker in understanding estrogen metabolism. Estrogens are a group of hormones critical for sexual and reproductive development, primarily in women. In a pre-menopausal woman, the levels and balance of these hormones are crucial for regular menstrual cycles, fertility, and overall health. The HUMAP test assesses various metabolites of estrogen, among other hormones, to provide a comprehensive view of hormonal balance and metabolism.
16a-Hydroxyestrone is one of the metabolites of estrone, a form of estrogen. It's formed in the body through the hydroxylation of estrone at the 16th carbon position. This particular metabolite is known for its strong estrogenic activity. High levels of 16a-Hydroxyestrone are often associated with an increased risk of estrogen-sensitive conditions like certain types of breast cancer and other estrogen-related disorders. This is due to its potential to stimulate estrogen receptor-positive cells more potently than other estrogen metabolites.
Optimal range: 0.19 - 0.85 ng/mg Creat/Day
17-OH Progesterone is the product of progesterone hydroxylation.
Optimal range: 0.12 - 0.65 ng/mg Creat/Day
17-OH Progesterone is the product of progesterone hydroxylation.
Optimal range: 0.17 - 0.55 ng/mg Creat/Day
17-Hydroxyprogesterone (17-OHP) is a steroid hormone produced by the adrenal glands and ovaries. On a Sex Hormones Profile; Urine (female) panel by Doctor's Data, the 17-Hydroxyprogesterone (Pre-menopausal) marker measures the levels of this hormone in urine.
In pre-menopausal women, 17-OHP plays a crucial role in the production of other hormones, including cortisol and estrogen. It is involved in the progesterone synthesis pathway and can help in assessing adrenal and ovarian function. Elevated or abnormal levels of 17-OHP may indicate a variety of conditions, including polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia (CAH), or adrenal gland disorders.
Optimal range: 0.02 - 0.55 ng/mg Creat/Day
Optimal range: 0.03 - 0.29 ng/mg Creat/Day
Optimal range: 0.8 - 3.9 ng/mg Creat/Day
Optimal range: 2.68 - 8.6 ng/mg Creat/Day
Optimal range: 1.6 - 6.5 ng/mg Creat/Day
Optimal range: 13.4 - 33.7 ng/mg Creat/Day
Optimal range: 0.06 - 0.32 Ratio
Optimal range: 0.08 - 0.5 Ratio
Optimal range: 0.1 - 0.36 Ratio
Optimal range: 0.03 - 0.26 Ratio
Optimal range: 0.07 - 0.86 Ratio
Optimal range: 0.07 - 0.37 Ratio
In a Hormone & Urinary Metabolite Assessment Panel (HUMAP) for pre-menopausal women, the ratio of 2-Methoxyestradiol (2-M-E2) to 2-Hydroxyestrone (2-OH-E2) (2-M-E2:2-OH-E2) is an important marker of estrogen metabolism. Estrogens are metabolized in the body through different pathways, and the 2-hydroxylation pathway, leading to the formation of 2-Hydroxyestrone, is often considered a more favorable route due to its relatively weaker estrogenic activity compared to other pathways. The 2-Hydroxyestrone can further be metabolized into 2-Methoxyestradiol, a metabolite known for its anti-angiogenic and apoptotic properties, which may have protective roles against estrogen-related cancers.
Optimal range: 0.01 - 0.08 ng/mg Creat/Day
Optimal range: 0.01 - 0.08 ng/mg Creat/Day
Optimal range: 0.17 - 0.5 ng/mg Creat/Day
Optimal range: 0.5 - 1.6 ng/mg Creat/Day
Optimal range: 0.4 - 2.2 ng/mg Creat/Day
Optimal range: 2 - 5.9 ng/mg Creat/Day
Optimal range: 40 - 88 %
Optimal range: 40 - 88 %
Percentages of 2-OH-E1, 4-OH-E1, and 16-OH-E1
When evaluating phase I metabolism, it can be helpful to compare the percentages of 2, 4, and 16 OH-E1 metabolites. Most individuals metabolize the majority of their estrogens down the 2-OH-E1 pathway which is generally considered the “safer pathway”. This is followed by 16-OH-E1 and 4-OH-E1 respectively, both of which are deemed more reactive and potentially genotoxic.
Optimal range: 50 - 85 %
Optimal range: 1.5 - 7.9 Ratio
Optimal range: 0.6 - 50 Ratio
Optimal range: 1.6 - 5.1 Ratio
In a Hormone Metabolite Assessment Panel (HUMAP) for pre-menopausal women, the ratio of 2-Hydroxyestrone (2-OH-E1) to 16-Hydroxyestrone (16-OH-E1) is a critical metric for assessing estrogen metabolism and its implications for health. This ratio reflects the balance between two major pathways of estrogen metabolism: the 2-hydroxylation pathway, leading to 2-OH-E1, and the 16α-hydroxylation pathway, resulting in 16-OH-E1.
2-OH-E1 is generally considered a safer estrogen metabolite due to its weaker estrogenic activity, and it has been associated with a reduced risk of estrogen-related conditions, such as certain breast cancers.
On the other hand, 16-OH-E1 is known for its potent estrogenic effects and has been linked to an increased risk of estrogen-sensitive conditions.
Optimal range: 0.6 - 3 ng/mg Creat/Day
21-Hydroxyprogesterone is a steroid hormone with mineralocorticoid properties produced in the adrenal gland which serves as a precursor hormone to aldosterone.
Optimal range: 0.3 - 1.4 ng/mg Creat/Day
21-Hydroxyprogesterone is a steroid hormone with mineralocorticoid properties produced in the adrenal gland which serves as a precursor hormone to aldosterone.
Optimal range: 0.4 - 5.6 ng/mg Creat/Day
Optimal range: 0 - 0.5 ng/mg Creat/Day
4-OH-E2 is associated with a higher risk of certain cancers and other negative markers for breast health in females. Due to the lack of research in this area, it may be postulated that males carry a similar risk.
Optimal range: 0 - 0.45 ng/mg Creat/Day
Optimal range: 0.14 - 0.93 ng/mg Creat/Day
Optimal range: 0 - 0.5 ng/mg Creat/Day
Higher levels indicate slowed COMT activity (methylation) and are associated with a higher risk for breast cancer in females. Due to the lack of research in this area, it may be postulated that men carry a similar risk. Elevation may also be due to an overactive CYP1B1 enzyme or sluggish CYP1A1 or CYP34A. Additional support for the COMT enzyme can help with the conversion toward the inactive
metabolite, 4-M-E1.
Optimal range: 0 - 0.3 ng/mg Creat/Day
Optimal range: 0 - 2.85 ng/mg Creat/Day
Optimal range: 0.04 - 0.5 Ratio
Optimal range: 0.09 - 1 Ratio
Optimal range: 0.09 - 0.54 Ratio
Optimal range: 0.01 - 0.5 Ratio
Optimal range: 0.02 - 0.5 Ratio
4-M-E2 (4-Methoxyestradiol) and 4-OH-E2 (4-Hydroxyestradiol) are two important estrogen metabolites whose levels are of particular interest in post-menopausal women, especially when assessed through a Hormone and Urinary Metabolites Assessment Profile. This profile is designed to evaluate the balance and metabolism of hormones, providing valuable insights into a woman's health status after menopause.
Optimal range: 0.04 - 0.54 Ratio
Optimal range: 0.01 - 0.03 ng/mg Creat/Day
Methyl metabolites are considered inactive and are correlated with antiproliferative effects. Proper elimination of 4-M-E2 requires optimal excretion via GI tract optimization. To fully understand this value, it may be beneficial to examine the 4-M-E2 / 4-OH-E2 ratio.
Optimal range: 0 - 0 ng/mg Creat/Day
4-Methoxyestradiol is a metabolite of estradiol. 4-Methoxyestradiol is analyzed for its concentration and metabolic behavior in the human body. This analysis is vital for understanding its biological role and implications in various physiological and pathological processes. As an endogenous non-steroidal estrogen metabolite, 4-Methoxyestradiol possesses distinct properties, differing from its parent compound estradiol in terms of receptor affinity and biological activity.
Optimal range: 0.05 - 0.11 ng/mg Creat/Day
Optimal range: 0.03 - 0.17 ng/mg Creat/Day
Optimal range: 0.02 - 0.14 ng/mg Creat/Day
Optimal range: 0.05 - 0.28 ng/mg Creat/Day
4-Methoxyestrone is a metabolite of estrone, a form of estrogen, and is produced through the methoxylation process. This metabolite is considered to be a less active form of estrogen, having weaker estrogenic effects compared to other metabolites like 16a-Hydroxyestrone. The presence and levels of 4-Methoxyestrone in a pre-menopausal woman can offer insights into her estrogen detoxification pathways, specifically indicating the activity of methylation processes in the body. Efficient methylation is important for the neutralization and elimination of estrogen and its metabolites, reducing the risk of estrogen-dominant conditions.
Optimal range: 2 - 10 %
Optimal range: 2 - 10 %
Percentages of 2-OH-E1, 4-OH-E1, and 16-OH-E1
When evaluating phase I metabolism, it can be helpful to compare the percentages of 2, 4, and 16 OH-E1 metabolites. Most individuals metabolize the majority of their estrogens down the 2-OH-E1 pathway which is generally considered the “safer pathway”. This is followed by 16-OH-E1 and 4-OH-E1 respectively, both of which are deemed more reactive and potentially genotoxic.
Optimal range: 2 - 7 %
In a Hormone Metabolite Assessment Panel (HUMAP) designed for pre-menopausal women, the percentage of 4-Hydroxyestrone (4-OH-E1) plays a crucial role in understanding estrogen metabolism and its associated risks. 4-OH-E1 is one of the metabolites of estrogen produced through the 4-hydroxylation pathway, which is significant due to its potent biological activity. This metabolite is known for its strong estrogenic effects and has been linked to an increased risk of estrogen-related cancers, particularly breast cancer.
In the body, 4-OH-E1 can be further metabolized to form catechol estrogen quinones, which have the potential to damage DNA and cause mutations. The percentage of 4-OH-E1 in the overall estrogen metabolite profile is a critical marker; higher percentages can indicate a greater reliance on the 4-hydroxylation pathway, suggesting a potential increase in the risk for estrogen-driven conditions. Factors influencing the proportion of 4-OH-E1 include genetics, liver health, diet, lifestyle, and exposure to environmental toxins.
Optimal range: 0 - 0.14 Ratio
Optimal range: 0 - 0.17 Ratio
Optimal range: 0.03 - 0.17 Ratio
Optimal range: 35 - 105 ng/mg Creat/Day
Pregnenetriol is a metabolite of 17a-pregnenolone, an intermediary resulting from the hydroxylation of pregnenolone by CYP17A1 enzyme.
Optimal range: 35 - 120 ng/mg Creat/Day
Optimal range: 70 - 245 ng/mg Creat/Day
Optimal range: 10 - 108 ng/mg Creat/Day
Optimal range: 2.5 - 15 ng/mg Creat/Day
5A-AD is a metabolite of 5αDHT.
Research suggests:
- that postmenopausal women may experience low levels of this metabolite.
- elevations of this pathway in females maybe due to PCOS and hirsutism.
Optimal range: 5 - 48 ng/mg Creat/Day
Optimal range: 0.7 - 6.3 ng/mg Creat/Day
Optimal range: 0.4 - 4 ng/mg Creat/Day
5A-DHT is converted from testosterone by 5-α reductase in the ovaries and peripherally in fat tissue.
Optimal range: 0.2 - 6 ng/mg Creat/Day
Optimal range: 0.06 - 0.24 Ratio
The metabolic prioritization for alpha or beta reductase activity within the progesterone pathway may be confirmatory of a general preference of metabolism. Comparing these results with the metabolic preference of androgens and corticoids may provide additional insight.
Optimal range: 0.06 - 0.24 Ratio
The metabolic prioritization for alpha or beta reductase activity within the progesterone pathway may be confirmatory of a general preference of metabolism. Comparing these results with the metabolic preference of androgens and corticoids may provide additional insight.
Optimal range: 0.1 - 0.5 Ratio
Optimal range: 9 - 50 ng/mg Creat/Day
The most important progesterone metabolite, pregnanediol (PDL), can serve as a urinary marker for endogenous progesterone levels and as an indicator of ovulation. PDL exists as two isomers, 5α-pregnanediol and 5β-pregnanediol. 5β-pregnanediol represents the majority end point of endogenous progesterone metabolism and appears to have little activity within the body, while 5α-pregnanediol, the lesser metabolite of PDL, can cross the blood brain barrier and may partially agonize GABA-A receptors.
Optimal range: 5 - 25 ng/mg Creat/Day
Metabolites of progesterone are measured in urine, including 5b-pregnanediol and 5a-pregnanediol. 5b-pregnanediol is inactive in the body but is the major metabolite of progesterone. 5a-pregnanediol is often a metabolite of more interest, as it can cross the blood brain barrier and up-regulate GABA activity and is considered neuroprotective to the brain. Both taken together represent the major metabolic end points for progesterone and can be used to represent total progesterone production.
Optimal range: 50 - 505 ng/mg Creat/Day
Optimal range: 90 - 380 ng/mg Creat/Day
5B-THB is a terminal metabolite of corticosterone. This metabolite in combination with other terminal metabolites can be used to estimate metabolism of corticosterone. While research in elevations or low levels of single terminal metabolites is limited, assessing metabolism may provide valuable information about enzyme activity.
Optimal range: 160 - 430 ng/mg Creat/Day
5a-Tetrahydrocorticosterone (5a-THB) is a lesser-known metabolite of cortisol, and its measurement on a HUMAP panel can provide valuable insights, particularly for pre-menopausal females.
5a-THB is a part of the complex hormonal interplay within the body and serves as an indicator of not just adrenal function but also of the body's overall response to stress and metabolic processes.
Optimal range: 420 - 1060 ng/mg Creat/Day
Optimal range: 150 - 860 ng/mg Creat/Day
5A-THF is a terminal metabolite of cortisol metabolized via 5-alpha reductase. This metabolite along with the other terminal metabolites can be used to determine metabolized cortisol.
Optimal range: 200 - 1300 ng/mg Creat/Day
Optimal range: 0.6 - 1.2 Ratio
Optimal range: 0.6 - 1.2 Ratio
The relationship of the cortisol metabolites (5-alpha THF + THF) to cortisone metabolite (THE) is another tool in the assessment of the dominance of active cortisol or inactive cortisone.
Optimal range: 0.7 - 1.4 Ratio
Optimal range: 0.15 - 0.65 Ratio
Optimal range: 0.15 - 0.65 Ratio
The 5A-THF/5B-THF ratio is a calculation used to show the preference of 5-alpha reductase activity to 5-beta reductase activity. While research is limited in the significance of 5-alpha or 5-beta reductase activity in the glucocorticoids, it can serve as an additional screening tool for overall preference for 5-alpha or 5-beta reductase activity within the androgen and progesterone pathways.
Optimal range: 0.4 - 1.4 Ratio
Optimal range: 18 - 200 ng/mg Creat/Day
Optimal range: 7 - 87 ng/mg Creat/Day
5B-AD is the result of 5-beta reduction of DHT as well as a metabolite of etiocholanolone.
Optimal range: 14 - 124 ng/mg Creat/Day
Optimal range: 55 - 250 ng/mg Creat/Day
The most important progesterone metabolite, pregnanediol (PDL), can serve as a urinary marker for endogenous progesterone levels and as an indicator of ovulation. PDL exists as two isomers, 5α-pregnanediol and 5β-pregnanediol. 5β-pregnanediol represents the majority end point of endogenous progesterone metabolism and appears to have little activity within the body, while 5α-pregnanediol, the lesser metabolite of PDL, can cross the blood brain barrier and may partially agonize GABA-A receptors.
Optimal range: 70 - 320 ng/mg Creat/Day
5B-PD is the major progesterone metabolite.
Progesterone is produced by the corpus luteum following ovulation and to a lesser extent by the adrenal glands in both sexes. While found in the urine in small amounts, progesterone can be seen as a clinical marker of luteul activity and theraputic oral progesterone administration.
The most important progesterone metabolite, pregnanediol (PDL), can serve as a urinary marker for endogenous progesterone levels and as an indicator of ovulation. PDL exists as two isomers, 5α-pregnanediol and 5β-pregnanediol. 5β-pregnanediol represents the majority end point of endogenous progesterone metabolism and appears to have little activity within the body, while 5α-pregnanediol, the lesser metabolite of PDL, can cross the blood brain barrier and may partially agonize GABA-A receptors.
Optimal range: 375 - 2210 ng/mg Creat/Day
Optimal range: 58 - 240 ng/mg Creat/Day
5B-THB is a terminal metabolite of corticosterone. This metabolite in combination with other terminal metabolites can be used to estimate metabolism of corticosterone. While research in elevations or low levels of single terminal metabolites is limited, assessing metabolism may provide valuable information about enzyme activity.
Optimal range: 65 - 240 ng/mg Creat/Day
Optimal range: 690 - 2240 ng/mg Creat/Day
Optimal range: 720 - 2050 ng/mg Creat/Day
5B-THF is a terminal metabolite of cortisol metabolized via 5-beta reductase. This metabolite along with the other terminal metabolites can be used to determine metabolized cortisol.
Optimal range: 900 - 2600 ng/mg Creat/Day
Optimal range: 0 - 7.5 ng/mg Creat/Day
Optimal range: 0 - 7.7 ng/mg Creat/Day
Optimal range: 0 - 7.5 ng/mg Creat/Day
8-hydroxy-2’-deoxyguanosine is marker resulting from DNA damage due to oxidative stress.
Optimal range: 0.8 - 6.4 ng/mg Creat/Day
Allopregnanolone is a potent neuroactive steroid capable of binding the GABA-A receptor often leading to sedative and anxiolytic action. The calming action of allopregnanolone is often seen with orally supplemented progesterone, as the liver metabolizes a large portion of oral progesterone to the neuroactive steroid allopregnanolone.
Optimal range: 1.4 - 4.8 ng/mg Creat/Day
Allopregnanolone is a downstream metabolite of progesterone considered a neurosteroid due to its ability to influence the GABA-A receptor, creating anxiolytic effects.
Progesterone is produced by the corpus luteum following ovulation and to a lesser extent by the adrenal glands in both sexes. While found in the urine in small amounts, progesterone can be seen as a clinical marker of luteul activity and theraputic oral progesterone administration. The most important progesterone metabolite, pregnanediol (PDL), can serve as a urinary marker for endogenous progesterone levels and as an indicator of ovulation. PDL exists as two isomers, 5α-pregnanediol and 5β-pregnanediol.
5β-pregnanediol represents the majority end point of endogenous progesterone metabolism and appears to have little activity within the body, while 5α-pregnanediol, the lesser metabolite of PDL, can cross the blood brain barrier and may partially agonize GABA-A receptors.
This action is possibly due to its role as an immediate precursor to allopregnanolone. Allopregnanolone is a potent neuroactive steroid capable of binding the GABA-A receptor often leading to sedative and anxiolytic action. The calming action of allopregnanolone is often seen with orally supplemented progesterone, as the liver metabolizes a large portion of oral progesterone to the neuroactive steroid allopregnanolone.
Optimal range: 3.3 - 130 ng/mg Creat/Day
Optimal range: 0.8 - 7.7 ng/mg Creat/Day
Optimal range: 0.2 - 5.3 ng/mg Creat/Day
Androstenedione is a weak androgen secreted by adrenal glands, testes, and ovaries that is converted to testosterone or estrone in the periphery.
Optimal range: 0.5 - 9.2 ng/mg Creat/Day
Optimal range: 0.5 - 1.4 Ratio
Optimal range: 0.5 - 1.4 Ratio
Optimal range: 0.8 - 2.6 Ratio
The ratio of Androsterone (5a) to Etiocholanolone (5b) in a Human Urinary Metabolic Profile (HUMAP) panel is a critical marker for assessing the balance of androgen metabolism in the body. Androsterone and Etiocholanolone are both metabolites of testosterone and other androgens, but they differ in their origins and physiological impacts. Androsterone, derived predominantly from the metabolism of testosterone, is associated with androgenic properties, playing a role in male characteristics and anabolic functions. In contrast, Etiocholanolone, though also a testosterone metabolite, does not possess androgenic activity and is a product of the 5β-reductase pathway.
Optimal range: 470 - 2400 ng/mg Creat/Day
Optimal range: 250 - 1600 ng/mg Creat/Day
Androsterone is the product of androgens metabolized by 5-alpha reductase. It acts as a neurosteroid and a weak potentiator of GABA-A receptor activity.
Optimal range: 610 - 2050 ng/mg Creat/Day
Optimal range: 6 - 34 ng/mg Creat/Day
Corticosterone is a precursor hormone to aldosterone. Research is limited in the clinical significance of both elevated or low corticosterone and may be due to levels of precursor hormones.
Optimal range: 10 - 47 ng/mg Creat/Day
Optimal range: 2 - 10 ng/mg Creat
Cortisol is the main glucocorticoid released from the adrenal gland in response to stress. High levels of cortisol have been reported in cases of Cushing’s disease, malnutrition, early life stress, hypothyroidism, depression, alcoholism, obesity, and critical illness. Additionally, exogenous exposure to glucocorticoids prior to testing may be a source of cortisol elevations.
Optimal range: 3 - 12 ng/mgCreat
The Cortisol Bedtime marker is a critical indicator in endocrinology, representing the level of cortisol in the body at bedtime. Cortisol, a hormone produced by the adrenal glands, is central to various physiological processes, including stress response, metabolism, and immune system regulation. In a healthy individual, cortisol levels exhibit a diurnal rhythm: they peak in the early morning and gradually decline throughout the day, reaching their lowest point at night. This natural rhythm is essential for numerous bodily functions, such as regulating the sleep-wake cycle, managing blood sugar levels, and maintaining overall energy balance.
Optimal range: 3 - 18 ng/mg Creat
Cortisol is the main glucocorticoid released from the adrenal gland in response to stress. High levels of cortisol have been reported in cases of Cushing’s disease, malnutrition, early life stress, hypothyroidism, depression, alcoholism, obesity, and critical illness. Additionally, exogenous exposure to glucocorticoids prior to testing may be a source of cortisol elevations.
Optimal range: 5 - 27 ng/mgCreat
Cortisol, often referred to as the "stress hormone," plays a crucial role in various bodily functions, including metabolism, immune response, and the body's response to stress. The Cortisol Dinnertime marker, a specific measure of cortisol levels in the body during the evening, is an important indicator in understanding the body's endocrine function and stress response. Typically, cortisol levels follow a diurnal rhythm, peaking in the early morning shortly after waking and gradually declining throughout the day to reach their lowest point during the late evening or night. This pattern is essential for regulating various physiological processes, including the sleep-wake cycle, blood sugar levels, and energy metabolism.
Optimal range: 6 - 40 ng/mg Creat
Cortisol is the main glucocorticoid released from the adrenal gland in response to stress. High levels of cortisol have been reported in cases of Cushing’s disease, malnutrition, early life stress, hypothyroidism, depression, alcoholism, obesity, and critical illness. Additionally, exogenous exposure to glucocorticoids prior to testing may be a source of cortisol elevations.
Optimal range: 5 - 47 ng/mgCreat
Optimal range: 14 - 110 ng/mg Creat
Cortisol is the main glucocorticoid released from the adrenal gland in response to stress. High levels of cortisol have been reported in cases of Cushing’s disease, malnutrition, early life stress, hypothyroidism, depression, alcoholism, obesity, and critical illness. Additionally, exogenous exposure to glucocorticoids prior to testing may be a source of cortisol elevations.
Optimal range: 13 - 80 ng/mgCreat
Optimal range: 0.18 - 0.6 Ratio
Cortisol / cortisone ratio indicates activity of HSD11B2 activity and assessment of tissue specific concentrations of cortisol, which normally cannot be measured without a biopsy.
Optimal range: 0.24 - 0.45 Ratio
Optimal range: 9 - 35 ng/mg Creat/Day
Cortisol is the main glucocorticoid released from the adrenal gland in response to stress. High levels of cortisol have been reported in cases of Cushing’s disease, malnutrition, early life stress, hypothyroidism, depression, alcoholism, obesity, and critical illness. Additionally, exogenous exposure to glucocorticoids prior to testing may be a source of cortisol elevations.
Optimal range: 8 - 27 ng/mg Creat/Day
The Cortisol/day measurement on a HUMAP panel is a crucial indicator of cortisol levels throughout a typical day, reflecting the hormone's diurnal pattern and its overall balance in the body. Cortisol, produced by the adrenal glands, is integral to many bodily functions, such as regulating metabolism, immune response, and the body's stress response. Normally, cortisol levels exhibit a diurnal rhythm: they are highest in the early morning, aiding in waking up and providing energy for the day ahead, and gradually decrease as the day progresses, reaching their lowest levels late in the evening and during early night. This pattern ensures optimal functioning of various physiological processes, including the sleep-wake cycle and blood sugar regulation.
Optimal range: 10 - 55 ng/mg Creat
Cortisone is the inactive form of cortisol. Elevations of cortisone may reflect high cortisol production, excessive 11BHSD2 activity, or insufficient conversion by 11BHSD1.
Optimal range: 11 - 40 ng/mgCreat
Cortisone Bedtime as measured on a HUMAP panel is a significant indicator of cortisone levels in the body at bedtime. Cortisone, a metabolite of cortisol, plays a key role in various physiological functions, including the regulation of inflammation, stress response, and metabolic processes. In a healthy individual, cortisone, much like cortisol, follows a diurnal rhythm, with levels typically peaking in the morning and gradually declining throughout the day, reaching their lowest at night. This pattern is critical for maintaining several bodily functions, including the sleep-wake cycle and the body’s ability to recover and rejuvenate during sleep.
Optimal range: 15 - 100 ng/mg Creat
Cortisone is the inactive form of cortisol. Elevations of cortisone may reflect high cortisol production, excessive 11BHSD2 activity, or insufficient conversion by 11BHSD1.
Optimal range: 18 - 70 ng/mg Creat
Cortisone Dinnertime on a HUMAP panel represents the measurement of cortisone levels in the body during the evening. Cortisone is a steroid hormone and is closely related to cortisol, often referred to as the "stress hormone." While cortisol is the active form, cortisone is considered an inactive metabolite, and the balance between these two hormones is crucial for maintaining various bodily functions. The conversion of cortisol to cortisone is an essential process, helping regulate the body's response to stress, inflammation, and metabolism. In a typical diurnal pattern, like cortisol, cortisone levels are expected to decline towards the evening and night, facilitating restful sleep and recovery processes.
Optimal range: 25 - 95 ng/mg Creat
Cortisone is the inactive form of cortisol. Elevations of cortisone may reflect high cortisol production, excessive 11BHSD2 activity, or insufficient conversion by 11BHSD1.
Optimal range: 20 - 80 ng/mgCreat
Optimal range: 45 - 280 ng/mg Creat
Cortisone is the inactive form of cortisol. Elevations of cortisone may reflect high cortisol production, excessive 11BHSD2 activity, or insufficient conversion by 11BHSD1.
Optimal range: 30 - 110 ng/mgCreat
Optimal range: 30 - 95 ng/mg Creat/Day
Cortisone is the inactive form of cortisol. Elevations of cortisone may reflect high cortisol production, excessive 11BHSD2 activity, or insufficient conversion by 11BHSD1.
Optimal range: 24 - 65 ng/mg Creat/Day
Optimal range: 35 - 240 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 35 - 240 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 35 - 240 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 35 - 240 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 30 - 225 mg/dL
Optimal range: 35 - 240 mg/dL/Day
Optimal range: 30 - 225 mg/dL/Day
Optimal range: 30 - 225 mg/dL/Day
Optimal range: 18 - 170 ng/mg Creat/Day
Dehydroepiandrosterone (DHEA) is predominantly produced in the adrenal glands and serves as a precursor hormone for androstenedione and eventually estrone and testosterone. High levels of DHEA may be due to DHEA or pregnenolone supplementation. Additional research suggests DHEA elevations may also be due to such conditions as adult-onset adrenal hyperplasia, congenital adrenal hyperplasia, and very rarely, adrenal carcinoma. SULT2A1 catalyzes the sulfate conjugation of DHEA, and research suggests dopamine can induce this enzyme.
Optimal range: 10 - 120 ng/mg Creat/Day
Dehydroepiandrosterone (DHEA) is a hormone predominantly produced in the adrenal glands which serves as precursor hormone for androstenedione and eventually estrone and testosterone.
Optimal range: 40 - 500 ng/mg Creat/Day
Optimal range: 25 - 660 ng/mg Creat/Day
Dehydroepiandrosterone sulfate or DHEA-S is the sulfated form of dehydroepiandrosterone (DHEA) and the major steroid precursor in humans. This sulfation is reversibly catalyzed by sulfotransferase 2A1 (SULT2A1) primarily in the adrenals, the liver, and the small intestine.
Optimal range: 15 - 320 ng/mg Creat/Day
Dehydroepiandrosterone sulfate or DHEA-S is the sulfated form of dehydroepiandrosterone (DHEA) and the major steroid precursor in humans. This sulfation is reversibly catalyzed by sulfotransferase 2A1 (SULT2A1) primarily in the adrenals, the liver, and the small intestine.
Optimal range: 30 - 1180 ng/mg Creat/Day
Optimal range: 39 - 762 ng/mg Creat/Day
DHEA and DHEAs are produced in the adrenal gland and serve as precursors to androgens and estrogens. Due to the interconversion between DHEA and DHEAS via SULT2A1 and/or STS, the sum of these maybe a better representation of total DHEA synthesis.
Optimal range: 25 - 370 ng/mg Creat/Day
DHEA and DHEAs are produced in the adrenal gland and serve as precursors to androgens and estrogens. Due to the interconversion between DHEA and DHEAS via SULT2A1 and/or STS, the sum of these may be a better representation of total DHEA synthesis.
Optimal range: 106 - 1502 ng/mg Creat/Day
Optimal range: 0 - 40 ng/mg Creat/Day
Optimal range: 0 - 5 ng/mg Creat/Day
Optimal range: 0 - 15 ng/mg Creat/Day
Optimal range: 0.4 - 2 ng/mg Creat/Day
Estradiol level is most consistent with exogenous exposure, supplementation, or aromatization of testosterone to estradiol. CYP19, also known as aromatase, can be upregulated raising intracellular estrogens in men which can contribute to increased adiposity, metabolic syndrome, and prostate pathology. CYP19 enzyme is induced during times of stress, exposure to xeno-estrogens, high glycemic diet, excessive adipose tissue, and alcohol consumption.
Optimal range: 0.2 - 1.5 ng/mg Creat/Day
Optimal range: 2.58 - 13.9 ng/mg Creat/Day
In a Hormone Metabolite Assessment Panel (HUMAP) for pre-menopausal women, estradiol plays a pivotal role as a primary estrogen hormone. Estradiol is not just a crucial marker for assessing overall estrogenic activity but also for understanding a woman's reproductive health, menstrual cycle regularity, and general well-being.
In pre-menopausal women, estradiol levels fluctuate throughout the menstrual cycle, peaking during ovulation, which signifies the body's readiness for potential conception. These fluctuations are normal and critical for the proper functioning of the reproductive system.
Optimal range: 1.2 - 4.1 ng/mg Creat/Day
Optimal range: 1 - 5.4 ng/mg Creat/Day
Evaluation of the estrogen metabolism pathway relies on understanding several key steps of metabolism: the amount of unconjugated estrogens, hydroxylation of E1 and E2, methylation of hydroxy estrogens, and the function of key enzymes.
Evaluation of the estrogen metabolism pathway relies on understanding several key steps of metabolism: the amount of unconjugated estrogens, hydroxylation of E1 and E2, methylation of hydroxy estrogens, and the function of key enzymes.
Optimal range: 8.57 - 17.8 ng/mg Creat/Day
In the context of a Hormone Metabolite Assessment Panel (HUMAP) for pre-menopausal women, Estriol plays a unique and informative role in the spectrum of estrogen metabolites. Estriol, a weaker estrogen compared to estradiol and estrone, is predominantly known for its significance during pregnancy, where its levels rise markedly. However, in non-pregnant, pre-menopausal women, estriol is present in much lower amounts and is a product of the metabolism of other estrogens. Its levels in a HUMAP panel provide insights into the body's estrogen metabolism pathways and overall hormonal balance.
Optimal range: 1.8 - 5 ng/mg Creat/Day
A component of the estrone level may be due to aromatization of androstenedione and testosterone by CYP19 (aromatase) enzyme in adipose tissue, and/or conversion from estradiol due to HSD17B activity. Aromatase up-regulation and increased intracellular estrogens in men may contribute to increased adiposity, metabolic syndrome, and prostate pathology. CYP19 enzyme is induced during times of stress, exposure to xeno-estrogens, high glycemic diet, excessive adipose tissue, and alcohol consumption.
Optimal range: 1.5 - 4.4 ng/mg Creat/Day
Optimal range: 9.41 - 34.73 ng/mg Creat/Day
Estrone is one of the three major naturally occurring estrogens, alongside estradiol and estriol.
Estrone, as a marker in a Human Urinary Metabolic Profile (HUMAP) panel for pre-menopausal women, offers valuable insights into estrogen metabolism and overall hormonal balance.
In pre-menopausal women, it plays a pivotal role in the menstrual cycle and overall reproductive health. Unlike estradiol, which is the predominant form of estrogen during the reproductive years, estrone becomes more significant after menopause. However, its levels and balance in pre-menopausal women are still crucial.
Optimal range: 490 - 2100 ng/mg Creat/Day
Optimal range: 290 - 1700 ng/mg Creat/Day
Etiocholanolone is a 5-beta reduced isomer of androsterone, and a major metabolite of testosterone and androstenedione, however it is not active as an androgen.
Optimal range: 620 - 2440 ng/mg Creat/Day
Optimal range: 0 - 0.34 ng/mg Creat/Day
Progesterone is produced by the corpus luteum following ovulation and to a lesser extent by the adrenal glands in both sexes. While found in the urine in small amounts, progesterone can be seen as a clinical marker of luteal activity and theraputic oral progesterone administration.
Optimal range: 0 - 0.22 ng/mg Creat/Day
Progesterone is produced by the corpus luteum following ovulation and to a lesser extent by the adrenal glands in both sexes. While found in the urine in small amounts, progesterone can be seen as a clinical marker of luteul activity and theraputic oral progesterone administration. The most important progesterone metabolite, pregnanediol (PDL), can serve as a urinary marker for endogenous progesterone levels and as an indicator of ovulation.
Optimal range: 0.29 - 1.6 ng/mg Creat/Day
Optimal range: 12 - 63 ng/mg Creat/Day
Optimal range: 1 - 12 ng/mg Creat/Day
Testosterone is the major anabolic androgen found in females. Because urinary testosterone levels are independent of circadian rhythm fluctuation, urine may be a better medium than serum to indicate androgen production.
Optimal range: 0.25 - 10.9 ng/mg Creat/Day
Optimal range: 0.6 - 2.4 Ratio
Optimal range: 0.1 - 2 Ratio
Optimal range: 0.7 - 3 Ratio
The ratio of Testosterone to Epi-Testosterone in pre-menopausal women, as part of a Human Urinary Metabolic Profile (HUMAP) panel, is a significant indicator of hormonal balance and metabolic function. Testosterone, although primarily considered a male hormone, plays a vital role in women's health too, influencing muscle mass, bone density, libido, and overall well-being. Epi-Testosterone, while not an active androgen itself, serves as an important reference point in evaluating the balance of androgenic activity. In pre-menopausal women, this ratio is crucial as it can reveal insights into various physiological and pathological states. A balanced Testosterone/Epi-Testosterone ratio is expected in healthy individuals, maintaining the delicate interplay of hormonal activities crucial for physical health, emotional well-being, and reproductive function.
Optimal range: 1200 - 3000 ng/mg Creat/Day
Tetrahydrocortisone is a terminal metabolite of cortisone. This metabolite along with the other terminal metabolites can be used to determine metabolized cortisol. Research in elevations or low levels of single terminal metabolites is limited, assessing metabolized cortisol and daily output may provide more clinically more relevant information.
Optimal range: 1000 - 3000 ng/mg Creat/Day
THE is a terminal metabolite of cortisone. This metabolite along with the other terminal metabolites can be used to determine metabolized cortisol. Research in elevations or low levels of single terminal metabolites is limited, assessing metabolized cortisol and daily output may provide more clinically relevant information.
Optimal range: 1180 - 4000 ng/mg Creat/Day
Optimal range: 44 - 150 ng/mg Creat/Day
5B-THA is a terminal metabolite of corticosterone. This metabolite in combination with other terminal metabolites can be used to estimate metabolism of corticosterone. While research in elevations or low levels of single terminal metabolites is limited, assessing metabolism may provide valuable information about enzyme activity.
Optimal range: 46 - 220 ng/mg Creat/Day
Optimal range: 2000 - 6000 ng/mg Creat/Day
This calculation includes the daily metabolites of cortisol (5-alpha THF, THF) and cortisone (THE) which maybe a better representation of daily cortisol output than measuring cortisol and cortisone alone due to metabolism differences in the liver (with thyroid hormone) and fatty tissues.
Optimal range: 2000 - 6000 ng/mg Creat/Day
This calculation includes the daily metabolites of cortisol (5-alpha THF, THF) and cortisone (THE) which maybe a better representation of daily cortisol output than measuring cortisol and cortisone alone due to metabolism differences in the liver (with thyroid hormone) and fatty tissues.
High levels can indicate increased cortisol secretion or hyperthyroidism.
Low levels may indicate decreased cortisol secretion or hypothyroidism.
Optimal range: 2500 - 7900 ng/mg Creat/Day
Toxic Metals (Stool)
Fecal elemental analysis provides a direct indication of dietary exposure to toxic metals and indirect information about the potential for toxic metal burden. Chronic, low-level assimilation of toxic metals can result in accumulation in the body. For many toxic metals, fecal (biliary) excretion is the primary natural route of elimination from the body. Specimen collection is convenient for the patient and only requires a single-step procedure. Elements are measured by ICP-MS and expressed on a dry weight basis to eliminate variability related to water content of the specimen.
Optimal range: 0 - 0.05 mg/kg Dry Wt
Fecal antimony (Sb) provides an indication of recent oral exposure to the element, and to a much lesser extent Sb that has been excreted from the body in bile. Sb is a nonessential element that is chemically similar to but less toxic than inorganic arsenic. Like arsenic, Sb is conjugated with glutathione and excreted in urine and feces.
Optimal range: 0 - 0.2 mg/kg Dry Wt
Fecal Arsenic (As) provides an estimate of a very recent oral exposure to the element, and to a much lesser extent, As that has been excreted from the body in bile. Inorganic As accumulates in hair, nails, skin, thyroid gland, bone and the gastrointestinal tract. Non-toxic organic As (shellfish) is rapidly excreted, primarily in the urine and to a lesser extent in the feces.
Optimal range: 0 - 0.01 mg/kg Dry Wt
Fecal beryllium (Be) provides an estimate of a recent oral exposure to the element. Be is poorly absorbed in the gastrointestinal tract, but is readily absorbed across the lungs and skin. Inhalation is the primary route of significant exposure to Be, and may be associated with dyspnea, cough and pulmonary distress (berylliosis). Berylliosis, is an occupationally acquired lung disease that is associated with primary production, metal machining, and reclaiming scrap alloys. Other high-exposure occupations are in the nuclear power, aerospace, and electronics industries. Fecal Be is not diagnostic for berylliosis.
Optimal range: 0 - 0.1 mg/kg Dry Wt
Fecal bismuth (Bi) provides an estimate of a recent oral exposure to the element. Bi is a non-essential element of relatively low toxicity. Absorption is dependent upon solubility of the Bi compound, with insoluble Bi excreted in the feces while soluble forms are excreted primarily in the urine. Sources of Bi include: cosmetics (lipstick), Bi containing medications such as ranitidine Bi-citrate, antacids (Pepto-
Bismol), pigments used in colored glass and ceramics, dental cement, and dry cell battery electrodes.
Several organometallic Bi compounds are used for bactericidal and fungicidal applications.
Symptoms of moderate Bi toxicity include constipation or bowel irregularity, foul breath, blue/black gum line, and malaise. Unusually high levels of Bi retention in the body may result in nephrotoxicity (nephrosis, proteinurea) and neurotoxicity (tremor, memory loss, monoclonic jerks, dysarthria, dementia). Urine elements analysis may be used to corroborate Bi absorption for a period of days or a few weeks after
the exposure.
Optimal range: 0 - 0.5 mg/kg Dry Wt
Fecal cadmium (Cd) provides an estimate of very recent oral exposure to the element, and to a much lesser extent the biliary excretion of Cd from the body. Cd absorption is suppressed to some extent with appropriate intake of zinc, calcium, and selenium. Cd is found in varying amounts in foods, from very low for some fruits to high in some shellfish (oysters, anchovies) and organ meats. Root vegetables tend to have higher Cd content than other vegetables. Refined carbohydrates have very little zinc in relation to the Cd. Other sources of Cd include human biosolids, pigments and paints, batteries (Ni-Cd), plastics and synthetic rubber (tires).
Optimal range: 0 - 0.1 mg/kg Dry Wt
Fecal cesium (CS) provides an indication of recent oral exposure to the element, and to a much lesser extent Cs that has been excreted from the body in bile. Naturally occurring Cs is not radioactive and is referred to as stable Cs (Cs133). Cesium is a naturally occurring element found combined with other elements in rocks, soil, and dust in low amounts. Humans may be exposed to Cs at relatively low levels from air and diet. Cesium-chloride is used as a lubricant to facilitate drilling for oil and natural gas. As such Cs may contaminate surface and ground water, and certain crops in close proximity to drilling sites.
Optimal range: 0 - 60 mg/kg Dry Wt
Fecal copper (Cu) provides an estimate of very recent exposure to Cu, and to some extent biliary Cu excretion. The biliary / fecal route is the main route of excretion for Cu from the body.
Optimal range: 0 - 0.03 mg/kg Dry Wt
Fecal gadolinium (Gd) provides an indication of Gd that has been excreted from the body in bile, and to a lesser extent oral exposure. Gadolinium can be found in the environment in geographically variable amounts, and usually at very low levels. Gadolinium is widely used in industrial and household applications such as radar technologies, compact discs, and microwaves; direct exposure from such sources is not a concern. However disposal of Gd-containing devices contributes to greater potential for human exposure.
Optimal range: 0 - 0.3 mg/kg Dry Wt
Fecal lead (Pb) provides an indication of recent oral exposure to the element, and to a much lesser extent Pb that has been excreted from the body in bile. Absorbed Pb is excreted primarily in urine (76%) and bile (16%). Lead remains the most common clinically problematic toxic metal despite long past termination of its use in gasoline and paint. However, high levels of Pb have been found in soil under older bridges and overpasses due to sand blasting and refurbishing.
Optimal range: 0 - 200 mg/kg Dry Wt
Fecal manganese (Mn) provides an indication of recent oral exposure to the element, and to a much lesser extent Mn that has been excreted from the body in bile. Manganese is an essential trace element that is naturally present in many foods and available as a dietary supplement. Oral absorption is very low (< 3%), so the vast majority of fecal Mn represents unabsorbed Mn from foods and beverages. Low oral absorption is protective because excessive retention of Mn in the body may have neurological consequences.
Optimal range: 0 - 0.05 mg/kg Dry Wt
Fecal mercury (Hg) provides a good indication of recent or ongoing exposure to elemental Hg, and to a much lesser extent Hg that has been excreted from the body in bile. Data collected at Doctor’s Data indicates a linear association between fecal Hg concentration and the number of amalgams currently in the mouth. Fecal Hg for subjects with 9 to 11 dental amalgams in place was 20-times greater than that
of subjects without any dental amalgams in place (0.60 and 0.03 g/gram dry weight, respectively). Dental amalgams typically contain about 50% elemental Hg, and constant abrasion associated with chewing and bruxism releases very small particles of Hg which are poorly absorbed (about 5%) in the gastrointestinal tract. A direct association between fecal Hg levels and health has not been established, but a land mark study of amalgam placement in monkeys indicated there was an associated induction of co-resistance to both Hg and antibiotics by pathogenic bacteria in the gastrointestinal tract, particularly for species in the Enterobacteriaceae family. Such was also reported for miners exposed to elemental Hg while working in gold mines.
Optimal range: 0 - 8 mg/kg Dry Wt
Fecal nickel (Ni) provides an estimate of very recent or ongoing oral exposure to the element. One to 10% of dietary Ni is be absorbed from the gastrointestinal tract into the blood; that which is not absorbed is excreted in the feces. Nickel is present to a minor extent in most dietary items and food is considered to be a major source of nickel exposure for the general population.
There is substantial evidence that Ni is an essential trace element which may be required in extremely low amounts. However, excessive assimilation of Ni has been well established to be nephrotoxic, and carcinogenic. With the exception of specific occupational exposures, most absorbed nickel comes from food and beverages, and intakes can vary due to a multitude of factors depending upon geographical
location and water supply.
Optimal range: 0 - 0 mg/kg Dry Wt
Platinum (Pt) is a nonessential element that is sometimes detected in feces. However, the clinical significance of high levels of Pt in feces has not been well studied. Platinum is poorly absorbed in the gut and high level of oral exposure is unusual. Since it is a relatively rare element, most Pt exposures are of occupational origin. There may have been a slight increase in environmental Pt due to the use of Pt in automobile catalytic converters. Pt is a byproduct of copper refining and used as an alloy in some dental and orthopedic materials.
Optimal range: 0 - 0.02 mg/kg Dry Wt
Fecal thallium (Tl) provides an indication of Tl that has been excreted from the body in bile, and to a lesser extent recent oral exposure to the element. The biliary fecal route is the primary route of Tl excretion from the body, although about 35% is excreted in urine. Tl is rapidly and near completely absorbed when ingested, inhaled or brought into contact with skin.
Thallium is a highly toxic heavy metal which is generally tasteless and odorless, and doesn’t have physiological functions in the body.
Optimal range: 0 - 0.13 mg/kg Dry Wt
Fecal tungsten (W) provides an indication of recent oral exposure to the element, and to a much lesser extent W that has been excreted from the body in bile. About 50% of W appears to be rapidly absorbed from gastrointestinal tract, and excretion from the body is primarily via the urinary route.
Tungsten is highly absorbed via inhalation. W doesn’t have physiological functions in the body. In the body W is antagonistic to the essential element molybdenum which is important for the conversion of sulfite to essential sulfate, and for the production of uric acid.
Thereby, excess W may impair physiological reactions and be associated with sulfite sensitivity (wine, eggs, etc.) and/or low levels of uric acid in blood. Low uric acid is not necessarily consequential, but rather may be an indicator of functional molybdenum insufficiency.
Optimal range: 0 - 0.1 mg/kg Dry Wt
Fecal uranium (U) provides an indication of recent oral exposure to the element, and to a much lesser extent U that has been excreted from the body in bile. The levels of U in feces has been used to estimate total daily intake of U. Most U passes through the intestine unabsorbed. Excretion of U from the body occurs via bile and urine.
Amino Acid Profile, Qn (Urine)
Amino acids are organic compounds that play an important role in properly digesting food, creating usable energy, maintaining health and functioning normally. This panel can help discover deficiencies in amino acids by testing for amino acids.
Urine represents a convenient biofluid for metabolomic studies due to its noninvasive collection and richness in metabolites. Here, amino acids are valuable biomarkers for their ability to reflect imbalances of different biochemical pathways.
Amino acid analysis aids in the identification of dietary protein adequacy and amino acid balance, gastrointestinal dysfunctions, forms of protein intolerance, vitamin and mineral deficiencies, renal and hepatic dysfunction, psychiatric abnormalities, susceptibility to inflammatory response and oxidative stress, reduced detoxification capacity and many other inherent and acquired disorders in AA metabolism. Plasma is traditionally used to assess the status of essential AA while urine analysis provides more information regarding AA wasting and aberrant metabolism associated with co-factor insufficiencies.
Useful for:
Many individuals have "hidden" impairments in amino acid metabolism that are problematic and often go undiagnosed. These impairments may or may not be expressed as specific symptoms. They may silently increase susceptibility to a degenerative disease or they may be associated with, but not causative for, a disease. Because of the wealth of information provided, it is suggested that a complete amino acid analysis be performed whenever thorough nutritional testing and a metabolic workup is called for.
Amino acid analysis provides fundamental information about nutrient adequacy, including the quality and quantity of dietary protein, digestive disorders, and vitamin and mineral deficiencies - particularly folic acid, B12, B6 metabolism, zinc and magnesium. In addition, amino acid analysis provides important diagnostic information about hepatic and renal function, availability of precursors of neurotransmitters, detoxification capacity, susceptibility to occlusive arterial disease (homocystine), and many inherent disorders in amino acid metabolism.
Plasma vs. Urine Analysis:
Plasma is traditionally used to assess the status of essential AA while urine analysis provides more information regarding AA wasting and aberrant metabolism associated with co-factor insufficiencies. Plasma amino acid nutritional testing measures what is being transported at the time of sampling. The specimen should be collected after an overnight fast to reduce the influence of dietary protein. Abnormalities are deduced by comparison of measured levels with an established reference range.
Optimal range: 0 - 1889 umol/g creatinine
1-Methyl-Histidine is a compound found in urine that is measured as part of an Amino Acid Profile, Quantitative (Qn) test. This marker is particularly important because it can provide valuable insights into muscle metabolism and dietary protein intake. 1-Methyl-Histidine is a breakdown product of an amino acid called histidine, which is found in significant amounts in muscle tissue and certain proteins, particularly those from animal sources like meat. When you consume these proteins, your body metabolizes them, and one of the by-products is 1-Methyl-Histidine, which is then excreted in the urine. Elevated levels of 1-Methyl-Histidine in urine can indicate increased muscle turnover or high dietary intake of meat, reflecting how much protein your body is processing and breaking down. This can be particularly useful in various clinical settings, such as monitoring protein metabolism in athletes, assessing nutritional status, and diagnosing or managing conditions that affect muscle health. Conversely, low levels might suggest inadequate protein intake or impaired muscle metabolism. Thus, measuring 1-Methyl-Histidine in urine helps clinicians understand more about a person's dietary habits, muscle health, and overall metabolic state, making it a valuable tool in nutritional and medical assessments.
Optimal range: 77.9 - 1337 umol/g Cr
Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine. It is found in many foods including eggs, meat, lentils, and fish. Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.
Optimal range: 0.1 - 13.5 umol/g Cr
Allo-isoleucine is nearly undetectable in individuals not affected by maple-syrup urine disease (MSUD). Accordingly, its presence is diagnostic for MSUD, and its absence is sufficient to rule-out MSUD.
Optimal range: 0.5 - 146.7 umol/g Cr
Alpha-aminoadipic acid (a-Aminoadipic acid) is an intermediary metabolite of lysine (primarily) and of tryptophan.
Optimal range: 1 - 34.6 umol/g Cr
Alpha amniobutyric acid (AABA), also known as Alpha-amino-N-butyric acid (A-ANB), is an intermediate formed during the catabolism of methionine and threonine. Increases in AABA occur secondary to elevations of either methionine or threonine. AABA becomes propionic acid via alpha-ketobutyric acid in the presence of adequate amounts of thiamin, vitamin B2(as FAD), vitamin B3(as NAD), lipoic acid and magnesium. Deficiencies of any of these, or vitamin B6, could cause increases in AABA. Elevated or decreased levels of the amino acid may indicate a congenital enzyme defect.
Optimal range: 0 - 90 umol/g creatinine
Anserine is a dipeptide, a small molecule composed of two amino acids, specifically beta-alanine and histidine. It is commonly found in the skeletal muscles and brain of mammals and is particularly abundant in poultry and fish. The presence and concentration of anserine in urine can provide valuable insights into various physiological and pathological conditions. For instance, elevated levels of anserine in urine may indicate increased muscle breakdown or protein catabolism, which can occur during intense physical activity, muscle wasting diseases, or certain metabolic disorders. Conversely, low levels might suggest issues with protein intake or absorption. Monitoring anserine levels can be crucial for diagnosing and managing conditions related to muscle metabolism and overall protein utilization in the body. By evaluating the urinary excretion of anserine, healthcare providers can gain a better understanding of an individual's metabolic state and potentially identify underlying health issues that require further investigation or intervention.
Optimal range: 5 - 69.6 umol/g Cr
Arginine is found in all protein foods and is very abundant in seeds and nuts. It is considered a semi-essential amino acid during early development, infection/inflammation, or renal and/or intestinal impairment. It has many functions in the body including:
- ammonia disposal in the urea cycle
- immune function
- stimulation of insulin release
- muscle metabolism (creatine/creatinine precursor)
- nitric oxide (NO) formation
- glutamic acid and proline formation
- glucose/glycogen conversion
- stimulation of the release of growth hormone, vasopressin, and prolactin
- wound healing
Because arginine is a precursor for nitric oxide synthesis, it is often used therapeutically in cardiovascular disease for its vasodilatory effects.
Optimal range: 0.1 - 51.2 umol/g Cr
Argininosuccinate (aka Arginosuccinic acid) is a basic amino acid. Some cells synthesize it from citrulline, aspartic acid and use it as a precursor for arginine in the urea cycle or Citrulline-NO cycle. The enzyme that catalyzes the reaction is argininosuccinate synthetase. Argininosuccinic acid is a precursor to fumarate in the citric acid cycle via argininosuccinate lyase. Defects in the argininosuccinate lyase enzyme can lead to argininosuccinate lyase deficiency, which is an inborn error of metabolism.
Optimal range: 25.4 - 454.2 umol/g Cr
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 1 - 86.7 umol/g Cr
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 1 - 869.8 umol/g Cr
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. And, as previously mentioned, carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 0.5 - 807.9 umol/g Cr
Beta-aminoisobutyric acid (BAIB) is an amino acid end product of the pyrimidine metabolism. It is excreted in small quantities into the urine in almost all human beings. Thymine, released when RNA and DNA are degraded, enters a catabolic pathway that leads to Beta-Aminoisobutyric Acid.
Optimal range: 10 - 200 umol/g creatinine
Carnosine is a dipeptide molecule composed of the amino acids beta-alanine and histidine, and it is found primarily in muscle and brain tissues. When measured in urine, carnosine levels can provide valuable insights into an individual's muscle metabolism and overall health.
Elevated levels of carnosine in the urine may indicate increased muscle breakdown or high dietary intake of carnosine-rich foods, such as meat and fish. Conversely, low levels could suggest issues with muscle synthesis or insufficient dietary intake. Carnosine is known for its antioxidant properties and its role in buffering lactic acid in muscles during intense physical activity, which helps reduce muscle fatigue and improve performance. By analyzing the carnosine levels in urine, healthcare providers can gain insights into a person's nutritional status, muscle health, and potential metabolic issues, allowing for more personalized and effective health and nutrition interventions.
Optimal range: 1 - 27.4 umol/g Cr
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified.
It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins.
Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine.
Optimal range: 0.5 - 80.8 umol/g Cr
Cystathionine is an intermediate dipeptide within the process of transsulfuration.
Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle.
Optimal range: 0.3 - 223.8 umol/g Cr
Cystine is formed from the oxidation of cysteine, or from the degradation of glutathione oxidation products. It is two cysteines linked together with a disulfide bond.
Optimal range: 0.5 - 13.1 umol/g Cr
Gamma-aminobutyrate (GABA) is the major inhibitory neurotransmitter found in the CNS and, as such, is important for balancing excitatory action of other neurotransmitters.
Optimal range: 5 - 92.4 umol/g Cr
Glutamate is a vital neurotransmitter in the central nervous system, involved in almost all significant excitatory brain functions. It is the primary and most abundant excitatory neurotransmitter, and it's estimated that over half of all neural synapses release glutamate, making it a critical player in neural circuit communication.
Glutamic acid and glutamate are essentially interchangeable terms. The two molecules are almost identical, except that glutamic acid has an additional proton, or hydrogen atom. In physiological conditions, glutamic acid sheds this extra proton and becomes glutamate, the abundant form of the amino acid in the human body.
Glutamate is a crucial excitatory neurotransmitter that plays a vital role in maintaining healthy brain and nervous system function. It enables us to learn, remember, feel, sense, and coordinate our movements effectively.
Optimal range: 5 - 1756.2 umol/g Cr
Glutamine is a nonessential amino acid and is the most abundant amino acid in the body. It is formed from glutamate using the enzyme glutamine synthetase.
Approximately 80% of glutamine is found in the skeletal muscle, and this concentration is 30 times higher than the amount of glutamine found in human plasma. Although glucose is used as fuel for many tissues in the body, glutamine is the main fuel source for a large number of cells including lymphocytes, neutrophils, macrophages, and enterocytes.
Optimal range: 277.3 - 7996.9 umol/g Cr
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine.
It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins.
Glycine is a major collagen and elastin component, which are the most abundant proteins in the body.
Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Glycine is the precursor to various important metabolites such as porphyrins, purines, heme, and creatine. It acts both as an inhibitory neurotransmitter in the CNS and as an excitatory neurotransmitter on N-methyl-D-aspartate (NMDA) receptors.
Optimal range: 106.4 - 2534.2 umol/g Cr
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine.
Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
With this, decreased amounts of histidine and insufficient vitamin B6 can subsequently lead to a decrease in histamine concentration. This may impair digestion, since histamine binds to H2 receptors located on the surface of parietal cells to stimulate gastric acid secretion, necessary for protein breakdown.
Histidine also inhibits the production of proinflammatory cytokines by monocytes and is therefore anti-inflammatory and antioxidant.
With these beneficial effects, histidine supplementation has been shown to improve insulin resistance, reduce BMI, suppress inflammation, and lower oxidative stress in obese women with metabolic syndrome.
Interestingly, histadine can also be broken down to form urocanic acid in the liver and skin. Urocanic acid absorbs UV light and is thought to act as a natural sunscreen.
Optimal range: 0.5 - 80 umol/g Cr
The amino acid homocitrulline is a metabolite of ornithine in human metabolism.
The amino acid can be detected in larger amounts in the urine of individuals with urea cycle disorders. Both amino acids can be detected in urine. Amino acid analysis allows for the quantitative analysis of these amino acid metabolites in biological fluids such as urine, blood, plasma or proteins.
Optimal range: 0.3 - 1.4 umol/g Cr
Homocystine is the oxidized form of homocysteine. A substance is oxidized when it undergoes the process of oxidation. I.e the addition of oxygen or any electronegative elements or the removal of hydrogen or any electropositive element.
Homocystine is a dipeptide consisting of two homocysteine molecules joined by a disulfide bond. A dipeptide is a molecule that consists of two amino acids joined together by a peptide bond.
Homocystine occurs only transiently before being reduced to homocysteine and converted to the harmless cystathionine via a vitamin B6-dependent enzyme. Homocystine and homocysteine-cysteine mixed disulfides account for >98% of total homocysteine in plasma from healthy individuals.
Optimal range: 0.1 - 37.3 umol/g Cr
Hydroxylysine is an amino acid related to collagen.
What is collagen?
Collagen is the most abundant protein in your body. It is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin and muscles.
Optimal range: 0.5 - 87.9 umol/g Cr
- Hydroxyproline is the key factor in stabilizing collagens.
- Hydroxyproline is abundant in meat and low in plant-based foods. Meat intake increases levels of proline and hydroxyproline.
- Increased hydroxyproline has been found in collagen catabolism (bone resorption, increased reactive oxygen species [ROS]), tissue degradation, muscle damage, or other conditions such as Paget's disease or Alzheimer's disease.
- Proline and hydroxyproline both negatively correlated with a higher likelihood of anxiety, depression, and psychoses.
Optimal range: 5 - 48.1 umol/g Cr
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs).
Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Not only do the BCAAs account for almost 50% of muscle protein, but they have many metabolic functions.
BCAAs act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, and the immune response. They are also involved in stimulation of albumin and glycogen synthesis, improvement of insulin resistance, inhibition of free radical production, and hepatocyte apoptosis with liver regeneration.
Optimal range: 5 - 129.1 umol/g Cr
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 15.3 - 1020.6 umol/g Cr
Lysine is a nutritionally essential amino acid abundant in meat, fish, fowl, and legumes and is needed for formation of body proteins and enzymes.
Lysine can be methylated using S-adenosylmethionine (SAM) to synthesize carnitine, which is needed for fatty acid oxidation. Lysine also generates Acetyl CoA for use in the citric acid cycle. Lysine, proline, hydroxyproline, and vitamin C are important in the synthesis of collagen for skin, bones, tendons and cartilage.
L-lysine supplementation has also been studied for herpes simplex treatment and prophylaxis and may be beneficial.
Optimal range: 1 - 37.1 umol/g Cr
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds.
Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 5 - 76.3 umol/g Cr
Ornithine is an intermediate nonprotein-forming amino acid of the urea cycle.
Arginine is converted to ornithine via the arginase enzyme, with urea as a byproduct. Ornithine combined with carbamoyl phosphate is then converted into citrulline via the ornithine transcarbamylase (OTC) enzyme. The contribution of carbamoyl phosphate results from the metabolism of ammonia by the enzyme carbamoyl phosphate synthase, and if this magnesium-dependent process is impaired, ammonia buildup, or hyperammonemia can occur.
Ornithine can also form polyamines including putrescine via the ornithine decarboxylase (ODC) enzyme, which requires pyridoxal-5-phosphate (vitamin B6) as a cofactor.
Putrescine and other polyamines are crucial to the growth and proliferation of cells.
Optimal range: 0 - 150 umol/g creatinine
P-Ethanolamine stands for Phosphoethanolamine. Phosphoethanolamine is a compound involved in the metabolism of phospholipids, which are essential components of cell membranes. Elevated levels of phosphoethanolamine in urine can indicate metabolic disorders or conditions related to phospholipid metabolism. For instance, abnormal levels may be associated with certain types of metabolic diseases, vitamin B6 deficiency, or issues with kidney function. Monitoring phosphoethanolamine levels can help healthcare providers diagnose these conditions, assess the effectiveness of treatments, and understand more about a patient's metabolic health. It's an important marker because it provides information that can lead to early detection and management of metabolic abnormalities, ultimately contributing to better health outcomes.
Optimal range: 5 - 239 umol/g Cr
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy.
Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 5 - 168.6 umol/g Cr
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid.
Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage.
Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn.
Optimal range: 0.5 - 27.3 umol/g Cr
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine. It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents. In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess.
Optimal range: 98.4 - 1052.8 umol/g Cr
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 24.2 - 5335.7 umol/g Cr
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid.
Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
It has been proposed that taurine acts as an antioxidant, intracellular osmolyte, membrane stabilizer, and a neurotransmitter.
Optimal range: 5 - 714.9 umol/g Cr
Threonine is an essential amino acid, i.e., it is vital for your health, but it cannot be synthesized by your body and therefore has to be obtained from a diet.
Optimal range: 1 - 207.5 umol/g Cr
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP). 5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways.
Serotonin is further metabolized to melatonin via methylation.
Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 5 - 388.9 umol/g Cr
Tyrosine is a conditionally essential amino acid which can come directly from the digestion of dietary protein.
Common food sources include dairy, beans, whole grains, meat, and nuts.
If intake is insufficient, tyrosine can be formed from the essential amino acid phenylalanine using a tetrahydrobiopterin reaction. Tyrosine itself is a precursor to several neurotransmitters including dopamine, epinephrine and norepinephrine. It is also needed to create thyroid hormone and melanin skin pigments.
Optimal range: 5 - 147.4 umol/g Cr
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Urinary Hormones
The Vibrant Wellness Urinary Hormones is a test to measure urinary hormones including estrogens, androgens, progesterogens, glucocorticoids and oxidative stress. The panel is designed to give a complete picture of an individual’s levels of hormones and their metabolites in urine. Hormones are essential chemical messengers which regulate routine processes in the body.
Hormones, especially adrenal hormones and sex hormones, are interconnected with neurotransmitters. An imbalance of adrenal and sex hormones could lead to neurotransmitter imbalances which could revert back to cause hormonal imbalances.
Hormone imbalances can affect a wide range of body functions including:
Metabolism and appetite, heart rate, sleep cycles, reproductive cycles and sexual function, general growth and development, mood and stress levels, body temperature.
Conditions or symptoms associated with hormonal imbalances such as:
Hot flashes, night sweats, headaches, hair loss, poor sleep, anxiety, depression, stress, low libido, memory lapse, sugar cravings, weight gain, dry/dull appearance of skin, poor stamina, decreased muscle mass/strength, neck/back pain, decreased urinary flow (men), thinning hair, eyebrows, or eyelashes, erectile dysfunction, apathy/mood changes, poor cognition, brain fog, fatigue, chronic irritability, increased facial hair/acne, irregular menstrual cycles.
Optimal range: 1.2 - 5.7 Ratio
2-hydroxyestrone and 16-hydroxyestrone are Phase I metabolites of Estrone (E1). Their ratio is of clinical significance in pre and peri-menopausal women. In post-menopausal women it does not have the same clinical significance. It is, however, hypothesized that the 2/16 ratio is important in menopausal women who are on hormone replacement therapy (HRT).
Optimal range: 0.08 - 0.29 mcg/g
The hydroxylation of estradiol is one of the major routes of metabolism of the estrogen steroid hormone estradiol. It is hydroxylated into the catechol estrogens 2-hydroxyestradiol and 4-hydroxyestradiol and into estriol (16a-hydroxyestradiol). 2-hydroxyestradiol metabolite has several physiological consequences: the ability to influence intracellular signaling, adenohypophyseal hormone secretion, radical and quinone formation and inhibition of tumor formation.
Optimal range: 0.25 - 0.42 Ratio
Healthy Phase II metabolism methylates 2-hydroxy (2-OH) estrogens to the more cancer-protective 2-methoxy (2-MeO) forms, and neutralizes the potentially carcinogenic 4-OH estrogens to their 4-MeO forms.
Optimal range: 0.03 - 0.15 mcg/g
The hydroxylation of estradiol is one of the major routes of metabolism of the estrogen steroid hormone estradiol. It is hydroxylated into the catechol estrogens 2-hydroxyestradiol and 4-hydroxyestradiol and into estriol (16α-hydroxyestradiol). 4-hydroxyestradiol (4-OH-E2), like 2-OH-E2, can be physiologically active as well as tumorigenic. 4-OH-E2 is capable of binding estrogen receptors with a reduced dissociation rate and prolonged activation, thereby inducing cellular growth and proliferation, adenohypophyseal hormone secretion, and prostaglandin production.
Optimal range: 0 - 4.77 mcg/g
8-hydroxy-2’-deoxyguanosine (8-OHdG, or 8-oxodG) is a marker of oxidative stress. Urinary 8-OHdG, in particular, has been measured most frequently to indicate the extent of oxidative damage. guanine is most prone to oxidation. Guanine molecule, one of the four main nucleobases found in the nucleic acids DNA, oxidizes to produce the modified 8-OHdG which acts as one of the predominant forms of free radical-induced lesions of DNA. Oxidative modified DNA in the form of 8-OHdG can be quantified to indicate the extent of DNA damage
Optimal range: 18.12 - 79.22 mcg/g
This is one of the three cortisol metabolites. The total some of the three cortisol metabolites gives us a good indication of the overall cortisol production in your body.
Two of the 3 metabolites are the active form of cortisol (THF). The other metabolite is in the inactive form cortisone.
This particular marker (a-THF) hence is an active cortisol metabolite.
Optimal range: 40.8 - 224.7 mcg/g
b-Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone. Low progesterone symptoms include hot flashes, vaginal dryness, mood instability, low sex drive, sleep problems, brain fog, hair loss, loss of muscle mass and strength, weight gain and anxiety.
Optimal range: 226.67 - 277.41 Ratio
This ratio is helpful when both E2 and Pg are within range, yet the patient continues to have symptoms. It is not expected to be normal or used clinically when either E2 and/or Pg are outside of their expected ranges or if the patient does not have clinical symptoms.
Optimal range: 598.36 - 1511.23 mcg/g
b-Tetrahydrocortisone (b-THE) is an adrenal steroid and a cortisol metabolite. Tetrahydrocortison (THE) is a down-stream metabolite of cortisol and cortisone.
Cortisone is a pregnane steroid hormone closely related to cortisol. It is one of the main hormones released by the adrenal gland in response to stress. Cortisone suppresses the immune system, thus reducing inflammation and attendant pain and swelling at the site of the injury.
Optimal range: 0 - 3.2 mcg/g
Bisphenol A (BPA) is a xenoestrogen, exhibiting estrogen-mimicking, hormone-like properties that raise concern about its suitability in some consumer products and food containers. Bisphenol A (BPA) is an organic synthetic compound and it is a starting material for the synthesis of plastics, primarily certain polycarbonates and epoxy resins, as well as some polysulfones and certain niche materials. BPA is an endocrine- disrupting chemical that has been found to bind to both of the nuclear estrogen receptors. A recent exposure to plastic that released excessive amounts of BPA into a food or a beverage could be identified by high levels of urinary BPA.
Optimal range: 2.18 - 9.47 mcg/g
Corticosterone, also known as 17-deoxycortisol, is a steroid hormone of the corticosteroid type produced in the cortex of the adrenal glands. Corticosterone has multiple effects on memory. The main effects are seen through the impact of stress on emotional memories as well as long term memory. With emotional memories, corticosterone is largely associated with fear memory recognition. Not only does corticosterone have effects on emotional memories but memory recognition and consolidation as well.
Optimal range: 881.68 - 2319.75 mcg/g
Metabolized cortisol reflects the total cortisol produced and clearing through the liver, while free-cortisol results tell us how much cortisol is free to bind to receptors and allows for assessment of the circadian rhythm.
Cortisol is a steroid hormone, in the glucocorticoid class of hormones. It is increased in response to stress and low blood-glucose concentration. It functions to increase blood glucose levels through gluconeogenesis, to suppress the immune system, and to aid in the metabolism of fat, protein, and carbohydrates. It also decreases bone formation. Cortisol prevents the release of substances in the body that cause inflammation.
Optimal range: 5.42 - 16.13 mcg/g
Estrogen is the primary female sex hormone. It is responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens in females that have estrogenic hormonal activity: estrone, estradiol, and estriol. The estrane steroid estradiol is the most potent and prevalent of these. In addition to their role as natural hormones, estrogens are used as medications, for instance in menopausal hormone therapy and hormonal birth control.
Allergy Mold Panel, Complete
Detect possible allergic responses to various substances in the environment and evaluate for hay fever, asthma, atopic eczema, and respiratory allergy.
The quantitative allergen-specific IgE test is indicated:
(1) to determine whether an individual has elevated allergen-specific IgE antibodies;
(2) if specific allergic sensitivity is needed to allow immunotherapy to be initiated;
(3) when testing individuals for agents that may potentially cause anaphylaxis;
(4) when evaluating individuals who are taking medication (eg, long-acting antihistamines) that may interfere with other testing modalities (eg, skin testing);
(5) if immunotherapy or other therapeutic measures based on skin testing results have not led to a satisfactory remission of symptoms;
(6) when an individual is unresponsive to medical management where identification of offending allergens may be beneficial.
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
Alternaria alternata is one of the most common fungi associated with asthma. Not only the presence of asthma but also persistence and severity of asthma have been strongly associated with sensitization and exposure to A alternata. Although exposure to Alternaria is an important risk factor for asthma, few studies have assessed exposure to this fungus in indoor environments.
A alternata, a cosmopolitan saprophyte commonly found in soil and plants, is usually considered an outdoor allergen.
Although most intense exposure is likely to occur outdoors, Alternariaand other allergenic fungi are also found in indoor environments.
Reference range: Negative, Positive
What is Aspergillus?
Aspergillus, the mold (a type of fungus) that causes aspergillosis, is very common both indoors and outdoors, so most people breathe in fungal spores every day. It’s probably impossible to completely avoid breathing in some Aspergillus spores. For people with healthy immune systems, breathing in Aspergillus isn’t harmful. However, for people who have weakened immune systems, breathing in Aspergillus spores can cause an infection in the lungs or sinuses which can spread to other parts of the body.
There are approximately 180 species of Aspergillus, but fewer than 40 of them are known to cause infections in humans. Aspergillus fumigatus is the most common cause of human Aspergillus infections. Other common species include A. flavus, A. terreus, and A. niger.
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
Found worldwide, Aspergillus fumigatus can colonize in the bronchial tracts of asthmatics, causing severe asthma and low lung functions and sometimes leading to severe conditions.
Within the larger Aspergillus genus, Aspergillus fumigatus is typically blue-green to gray in color with a woolly or cotton-like texture. Although Aspergillus is considered a seasonal outdoor mold that's often found on decaying vegetation, it can also colonize indoor environments such as air-conditioning systems, and it's one of the three most common indoor airborne fungi (along with Penicillium and Cladosporium).
Aspergillus requires minimal moisture, and some species tolerate very dry conditions. As such, Aspergillus can grow rapidly in areas that can't support other molds. It produces small, dry, and easily aerosolized spores, which make them a significant indoor air contaminant. If you're allergic to Aspergillus fumigatus, you may experience symptoms after inhaling its spores.
Optimal range: 0 - 0.1 kU/L
Chaetomium globosum is a globally distributed hydrophilic mold commonly found in water-damaged buildings and various organic materials. It is recognized as a significant allergen linked to respiratory diseases, with studies showing sensitization rates of around 7% among atopic patients in regions like West Virginia and Poland. While it infrequently causes infections, particularly in immunocompromised individuals, its potential for producing mycotoxins raises health concerns. The mold's presence in damp environments contributes to poor indoor air quality and an increased risk of respiratory symptoms, including asthma. Preventing moisture accumulation and addressing water damage are essential strategies for minimizing exposure to this mold and its associated health risks.
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
Cladosporium, a well known trigger for asthmatic attacks, is one of the most widespread molds.
Cladosporium includes about 40 species naturally found in soil, on decaying plant material and as plant pathogens.
In an indoor environment, Cladosporium spp. occur as secondary wall colonizers, appearing after the primary ones such as Penicillium species, Aspergillus versicolor and Wallemia sebi. Cladosporiumis very common on wet building material (e.g., gypsum board, acrylic painted walls, wood, wallpaper, carpet and mattress dust, HVAC fans, and wet insulation in mechanical cooling units).
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
Mucor racemosus (M. racemosus) is an outdoor as well as an indoor mold.
Mucor racemosus' presence has been reported in homes, schools, hospitals, and water damaged buildings.
Mucor is a saprotrophic (= organism that feeds on nonliving organic matter), ubiquitous (= found everywhere) microorganism found in the dung, plants or animal dead tissue/material, and employed as a food additive in some traditional cultures.
→ M. racemosus thrives in environments with limited ventilation or sheltered from wind, high humidity, and poor light.
→ Inhalation of fungal spores is the primary route of exposure to the allergens, while ingestion of Mucor contaminated food may be the secondary route of exposure.
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
Penicillium is a genus of fungi, which commonly grows on many foodstuffs such as cocoa beans, coffee beans, cassava flour, cereals, fish, peanuts, dried fruits, wine, poultry eggs and milk.
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
Penicillium is a genus of fungi, which commonly grows on many foodstuffs such as cocoa beans, coffee beans, cassava flour, cereals, fish, peanuts, dried fruits, wine, poultry eggs and milk.
Reference range: Class 0 (<0.1 kU/L), Class 0/1 (0.10-0.34 kU/L), Class 1 (0.35-0.69 kU/L), Class 2 (0.70-3.49 kU/L), Class 3 (3.50-17.4 kU/L), Class 4 (17.5-49.9 kU/L), Class 5 (50-100 kU/L), Class 6 (>100 kU/L)
This mold is a well-known plant pathogen, and may be found growing on a wide range of vegetables including tomato, lettuce, beans, pea, etc.
The Allergen Stemphylium Botryosum (m10) IgE test is a laboratory test used to detect the presence of specific immunoglobulin E (IgE) antibodies to the mold Stemphylium botryosum. IgE antibodies are produced by the immune system in response to exposure to allergens, including molds.
Hepatic Detox Profile
The body continually attempts to eliminate chemical toxins through enzymatic processes in the liver. Urinary D-glucaric acid, a byproduct of Phase I detoxification, is an indicator of chemical exposure to over 200 chemicals. Urinary mercapturic acids are excreted end products of Phase II detoxification. Together, assessment of these two analytes provides valuable information about exposure to xenobiotics, liver disease and the ability of the liver to eliminate toxins. This non-invasive test requires a single, first morning void (= FMV) urine collection.
Optimal range: 40 - 400 nM/mg
The human body attempts to eliminate xenobiotics (foreign organic chemicals) through a concerted effort of enzymatic “functionalization” (phase I) and conjugation (phase II).
Functionalization involves chemical modification of the xenobiotic by the cytochrome P-450 or the “mixed function oxidase” enzyme systems. Once functionalized, the altered xenobiotic can then be conjugated and excreted.
Urinary D-glucaric acid, a hepatic byproduct of enzymatic response to chemical toxins (phase I), is a reliable indicator of exposure to xenobiotics.
Optimal range: 40 - 95 qM/mM
The urinary level of mercapturic acids indicates quantitatively the degree of activity or capability of phase II detoxification. Mercapturic acids are the final excretory products of detoxification and include a variety of functionalized xenobiotics that have been conjugated with glutathione or L-cysteine prior to excretion. When the rate of formation of functionalized xenobiotics (phase I) exceeds the capacity of phase II detoxification, more potent toxins accumulate.
Comprehensive Metabolic Panel (CMP): Biomarkers, Benefits, and Results Explained
Written By: B. Dame
Updated On: Aug 12, 2025
Other names: Comp. Metabolic Panel (12)
Learn about the Comprehensive Metabolic Panel (CMP), a key diagnostic blood test that evaluates 14 biomarkers for liver, kidney, and overall health. Understand results, biomarkers, and how CMP aids early detection.
Also known as the Comp. Metabolic Panel (14), the Comprehensive Metabolic Panel (CMP) is a vital blood test that measures 14 key biomarkers in your blood. This test provides critical insights into your body’s chemical balance, metabolism, and the health of major organs, including the liver and kidneys.
The CMP is a routine blood test that evaluates 14 essential markers in your blood, offering a comprehensive view of your overall health. It assesses processes like:
Healthcare providers use Comprehensive Metabolic Panels (CMPs) for diagnosis, screening, and monitoring of various conditions, helping identify potential health issues early and track the effectiveness of treatments.
A CMP is widely used in routine checkups and provides valuable data for diagnosing, screening, and monitoring health conditions.
The CMP helps healthcare providers diagnose a variety of conditions, including liver disease, kidney disease, diabetes, and high blood pressure.
As part of a routine health checkup, the CMP can identify potential health issues before symptoms appear, ensuring early intervention.
For those with chronic conditions or on medications, the CMP tracks treatment progress and monitors potential side effects, especially on the liver and kidneys.
The Comprehensive Metabolic Panel includes the following tests:
Measures blood sugar levels, crucial for diagnosing and monitoring diabetes. Elevated levels often indicate Type 2 diabetes, while very high levels suggest Type 1 diabetes.
A waste product filtered by the kidneys, BUN levels indicate kidney function.
A byproduct of muscle activity, creatinine levels help evaluate kidney performance.
Determines how well your kidneys filter waste from your blood.
Helps differentiate between acute and chronic kidney conditions.
Essential for nerve function, muscle contractions, and fluid balance.
Regulates heart function, nerve signals, and muscle contractions.
Works with sodium and potassium to maintain fluid balance and blood pressure.
Indicates your blood’s acid-base balance.
Essential for bone health, muscle function, and nerve signaling.
Measures albumin and globulin levels, proteins crucial for bodily functions.
Produced by the liver, albumin maintains fluid balance and transports nutrients.
High levels may indicate infections or autoimmune diseases, while low levels could signal liver or kidney disease.
A waste product from the breakdown of red blood cells, bilirubin levels assess liver function.
An enzyme linked to bone and liver health. High levels often indicate liver or bone disorders.
An enzyme that signals liver or muscle damage.
High ALT levels suggest liver damage or disease.
CMP results include the measurement of each biomarker, along with normal reference ranges.
Abnormal results don’t always mean you have a health condition. Factors like diet, medications, or errors in sample collection can influence results.
The CMP is a versatile diagnostic tool that helps identify a variety of conditions, including:
The CMP is a simple, non-invasive test that offers a detailed snapshot of your health. Its ability to detect early signs of chronic conditions and monitor ongoing health issues makes it an essential part of routine healthcare.
Ask your healthcare provider about adding a Comprehensive Metabolic Panel (CMP) to your routine health checkup. Early detection and monitoring can lead to better health outcomes and peace of mind.
A Comprehensive Metabolic Panel (CMP) is a blood test that measures 14 key biomarkers to evaluate overall health, including liver function, kidney function, electrolyte balance, and blood sugar levels. It provides a comprehensive view of your body’s metabolic processes and organ health.
A CMP is essential for diagnosing, screening, and monitoring various health conditions. It helps:
The CMP evaluates 14 biomarkers, including:
The CMP can identify and monitor a range of conditions, such as:
Yes, fasting for 8-12 hours before the test is typically required to ensure accurate glucose and other metabolic marker results. During the fasting period, you should avoid eating or drinking anything except water.
A Basic Metabolic Panel (BMP) includes 8 tests focusing on kidney function, blood sugar, and electrolytes. The CMP expands on this by adding liver function markers and protein levels, providing a more comprehensive assessment of overall health.
A CMP is recommended for:
Abnormal results may indicate potential health issues, such as:
Abnormal results should be discussed with your healthcare provider, as factors like diet, medications, or temporary illnesses can also influence outcomes.
Most CMP results are available within 1-2 business days after the blood sample is collected. Your healthcare provider will interpret the results and explain their significance.
While a CMP cannot diagnose a condition on its own, it provides critical data that helps healthcare providers identify potential health concerns. Additional tests or imaging may be needed for a definitive diagnosis.
The frequency of CMP testing depends on your health status and needs:
The CMP is a standard blood test with minimal risks. Some people may experience slight bruising or discomfort at the blood draw site, but these effects are temporary.
Yes, staying hydrated by drinking water is encouraged before a CMP test, as it helps make the blood draw easier and does not affect the test results.
The CMP tracks changes in metabolic markers over time, helping your doctor:
Optimal range: 8.6 - 10.2 mg/dL , 2.15 - 2.55 mmol/L
Adjusted calcium is useful in the interpretation of calcium levels when albumin levels are low.
Adjusted calcium, also known as corrected calcium, is a critical marker on a Comprehensive Metabolic Panel (CMP), which is a blood test used to assess your overall health and detect various medical conditions. Calcium is an essential mineral in the body, crucial for bone health, muscle function, nerve signaling, and blood clotting. The CMP measures the total calcium in your blood, but this value can be influenced by the levels of albumin, a protein that binds calcium. Since only the unbound or "free" calcium is biologically active, it's important to adjust the total calcium level for the albumin level to get a more accurate understanding of your calcium status. This is particularly important for people with abnormal albumin levels, such as those with liver disease, kidney disease, or severe malnutrition. The adjusted calcium value helps doctors make better-informed decisions about diagnosing and treating conditions related to calcium imbalances, such as hypercalcemia (high calcium levels) or hypocalcemia (low calcium levels). By providing a clearer picture of the physiologically active calcium, the adjusted calcium marker is an invaluable tool for ensuring appropriate medical care.
Optimal range: 6 - 46 U/L , 6 - 46 IU/L
Alanine-aminotransferase (ALT) is an enzyme produced by the liver and is used to facilitate chemical reactions in the body. A high level of ALT in the blood is typically an indication of liver damage. ALT tests are frequently run along side other tests (such as an alkaline phosphatase test) to determine the source of liver damage.
Alanine-aminotransferase (ALT) is found in highest concentrations in the liver but also in smaller amounts in heart, muscle and kidney. May be elevated due to hepatocellular disease, biliary issues, pancreatitis.
Optimal range: 3.8 - 4.8 g/dL , 38 - 48 g/L
What is a serum Albumin test?
You need a proper balance of albumin to keep fluid from leaking out of blood vessels (= oncotic pressure). It also carries vital nutrients and hormones. Albumin also gives your body the proteins it needs to keep growing and repairing tissue.
A serum albumin test is a simple blood test that measures the amount of albumin in your blood. Having surgery, getting burned, or having an open wound raises your chances of having a low albumin level.
What Is Albumin?
Albumin is the most common protein found in the blood. It represents half (~50%) of the total protein content (reference range: 3.8 g/dL to 4.8 g/dL) of plasma in healthy human patients.
Albumin is synthesized (= produced) by liver hepatocytes (= the major cells in the liver). Very little albumin is stored in the liver, and most of it gets rapidly excreted into the bloodstream.
Albumin has two main functions:
1. Maintenance (modulation) of appropriate oncotic pressure in the vascular system.
Albumin is responsible for much of the colloidal osmotic pressure of the blood, and hence is a very important factor in regulating the exchange of water between the plasma and the interstitial compartment, which is the space between the cells. Due to the hydrostatic pressure, water is forced through the walls of the capillaries in the tissue space. This flow of water is continuous until the osmotic pull of protein, in this case albumin molecules, causes it to stop. An abnormal deficiency of albumin can lead to water passing from the bloodstream into the tissues (edema).
2. Transporter of endogenous and exogenous (i.e. drugs) ligands.
Albumin serves as a transport protein carrying large organic anions, those such as fatty acids, hormones (cortisol and thyroxine when their specific binding globulins are saturated), bilirubin and many drugs. Severe liver disease can result in hypoalbuminemia (hypo = below, beneath), which leads to fewer available binding sites for exogenous drugs. This results in larger amounts of unbound exogenous drugs, which can lead to increased drug sensitivity. This sensitivity manifests when patients have serum albumin concentrations lower than 2.5 g/dL.
Optimal range: 1.2 - 2.2 Ratio
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 albumin/globulin ratio is used to try to identify causes of change in total serum protein. It will go out of the normal range if one component increases or decreases relative to the other. Hence it is important to look at changes in the individual components (albumin and globulins) as well as the ratio.
Optimal range: 44 - 121 U/L , 44 - 121 IU/L
What is Alkaline phosphatase (ALP)?
Alkaline phosphatase (ALP) is an enzyme (= enzymes are proteins that act as biological catalysts by accelerating chemical reactions) found in the blood that helps break down proteins and that plays a role in numerous processes in the human body. Any abnormalities in blood concentrations (either high or low) may be indicative of diseases ranging from gallstones and thyroid disease to hepatitis and cancer.
ALP is found in all tissues of the body but, not surprisingly, is found in its highest concentration in the liver, bones, kidneys, and intestines as well as the bile ducts (that drain bile from the liver) and gallbladder (that stores bile).
Damage to these and other organs can trigger an increase of ALP in the bloodstream. By contrast, certain diseases or conditions can impair ALP synthesis and lead to a drop in the blood concentration.
Optimal range: 0 - 40 U/L , 0 - 40 IU/L
Aspartate-aminotransferase (AST) and alanine-aminotransferase (ALT) are both produced by the liver and serve in functions throughout the human body. Aspartate-aminotransferase is most commonly related to liver health. Blood tests for AST and ALT are often ordered together to identify the source of damage in our organs.
AST is an intracellular enzyme that is usually elevated due to active tissue and cellular destruction. May be elevated due to hepatitis, liver cirrhosis or alcoholism, hypothyroidism. May be decreased due to Vit B6 deficiency, elevated serum nitrogen.
Optimal range: 0.7 - 1.2 Ratio
The AST/ALT ratio, also known as the De Ritis ratio, is a calculated value from two liver enzymes: aspartate aminotransferase (AST) and alanine aminotransferase (ALT). These enzymes are found primarily in the liver and play a key role in amino acid metabolism. The ratio helps doctors assess liver health and identify potential liver diseases or other underlying conditions.
Optimal range: 0 - 1.2 mg/dL , 0 - 20.52 µmol/L
What is Bilirubin
Bilirubin is a yellowish substance. Bilirubin is made in the body when the hemoglobin protein in old red blood cells is broken down. The breakdown of old cells is a normal, healthy process. Bilirubin is found in bile, a fluid your liver makes that helps you digest food. Bilirubin is stored in the gallbladder and is involved in digesting food. Most bilirubin is eliminated in the feces or urine. Elevated bilirubin levels may indicate certain diseases. It is responsible for the yellow color of bruises and the yellow discoloration in jaundice. Its subsequent breakdown products, such as stercobilin, cause the brown color of feces. A different breakdown product, urobilin, is the main component of the straw-yellow color in urine. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak out of your liver and into your blood. When too much bilirubin gets into the bloodstream, it can cause jaundice, a condition that causes your skin and eyes to turn yellow. Signs of jaundice, along with a bilirubin blood test, can help your health care provider find out if you have liver disease.
Optimal range: 6 - 24 mg/dL , 2.14 - 8.57 mmol/L
BUN, or blood urea nitrogen, is used predominantly to measure kidney function. BUN reflects the ratio between the production and clearance of urea in the body. Urea is formed almost entirely by the liver from both protein metabolism and protein digestion. The amount of urea excreted as BUN varies with the amount of dietary protein intake.
Increased BUN levels are a sign of kidney dysfunction. An increased BUN level may be due to increased production of urea by the liver or decreased excretion by the kidney. Increased BUN levels are also associated with dehydration and hypochlorhydria.
Decreased BUN levels are associated with malabsorption and a diet low in protein.
Optimal range: 28 - 66 %
Bone isoenzymes, specifically bone-specific alkaline phosphatase (BSAP), are important biomarkers used to assess bone metabolism and turnover. These enzymes play a crucial role in bone formation and mineralization processes.
Bone isoenzymes are a subset of alkaline phosphatases (ALP), which are hydrolytic enzymes that function in an alkaline environment. They are primarily produced by osteoblasts, the cells responsible for bone formation, and are present in the plasma membrane of these cells. The main function of bone isoenzymes is to hydrolyze phosphates, which are then used in the formation of proteins, nucleotides, and the mineralization of bone.
Optimal range: 10 - 24 :1 ratio
What Is the BUN/Creatinine Ratio?
The Blood Urea Nitrogen (BUN) to Creatinine ratio — also called the BUN/Creatinine ratio — is an important indicator of kidney function. It is commonly used to help diagnose acute or chronic kidney disease or damage.
BUN and creatinine are both waste products from normal metabolism:
BUN represents the amount of nitrogen in the blood from the breakdown of protein.
Creatinine is a byproduct of muscle metabolism.
When both a BUN test and a creatinine test are performed, the results can be combined to calculate the BUN/Creatinine ratio. This gives healthcare providers a more complete picture of kidney health than either test alone, helping them identify potential kidney issues and guide treatment decisions.
While creatinine is often considered a more specific measure of glomerular filtration rate (GFR) than BUN, the BUN/Creatinine ratio is still a useful indirect estimate of kidney function and can provide valuable diagnostic insight.
Note: If results for both BUN and creatinine are within their normal ranges, the ratio may not be reported.
Optimal range: 8.6 - 10.2 mg/dL , 2.15 - 2.55 mmol/L
Calcium is the most abundant mineral in the body and one of the most important. Our bodies use calcium to build and fix bones and teeth, help nerves work, make muscles contract, aid in blood clotting, and to help our heart beat. That being said, almost all of the calcium in our bodies is stored in the bones (99%). Typically, our bodies carefully regulate the amount of calcium in the bloodstream. When levels are low, our bones release calcium. When levels are too high, our bones absorb the excess calcium or it is excreted through stool and urine. Factors that determine the amount of calcium in your body include: diet, phosphate levels, how much calcium and vitamin D your intestines absorb, and certain hormones (parathyroid hormone, calcitonin, and estrogen). It is critical to get the right amount of calcium in your diet because the human body loses calcium everyday. This is particularly true for pregnant women. The process of creating a baby requires a large amount of calcium. Frequently, the needed calcium will be taken from the mother’s bones during fetal development. This can put mothers at an increased risk for conditions like osteoporosis (brittle bones) in their older age.
Optimal range: 0 - 2.3 mg/dL
Calcium, Total (RBCs) measures the level of calcium inside red blood cells (RBCs), providing insight into long-term calcium status at the cellular level. This test differs from a standard serum calcium test, which reflects extracellular calcium levels that are tightly regulated by hormones such as parathyroid hormone (PTH) and vitamin D.
Calcium is a crucial mineral for:
Optimal range: 0 - 2.7 Ratio
The Calcium/Albumin Ratio is a calculated value derived from total calcium and albumin levels on a Comprehensive Metabolic Panel (CMP). It provides insights into the balance between calcium, a critical mineral for bone health and cellular function, and albumin, a protein that affects calcium availability in the bloodstream.
Optimal range: 1.9 - 4.2 Ratio
The Calcium/Phosphorus Ratio is a calculated value used to evaluate the balance between calcium and phosphorus, two essential minerals that play critical roles in bone health, cellular function, and metabolic processes. This ratio provides insights into how these minerals interact and whether they are in proper balance for optimal physiological function.
Optimal range: 20 - 29 mEq/L , 20 - 29 mmol/L
Carbon Dioxide is a naturally occurring gas in the body, produced as a byproduct of metabolism. Most of the CO2 in the blood exists in the form of bicarbonate, which plays a vital role in maintaining the body’s acid-base (pH) balance. This balance is essential for proper cell function and overall metabolic stability. A CO2 blood test, often part of a basic metabolic panel (BMP) or comprehensive metabolic panel (CMP), measures the level of bicarbonate in your blood and helps evaluate the body’s acid-base status and electrolyte balance. Elevated or decreased CO2 levels can signal underlying health issues. Low CO2 levels may be linked to conditions like metabolic acidosis, kidney disease, severe diarrhea, or uncontrolled diabetes, while high CO2 levels may be caused by dehydration, lung diseases like COPD, or metabolic alkalosis. Other factors such as medications, diet, and even pregnancy can influence test results. Common symptoms that may prompt CO2 testing include nausea, vomiting, shortness of breath, and confusion, especially if an acid-base imbalance is suspected. In some cases, more specific testing—like an arterial blood gas (ABG) test—is needed to accurately measure carbon dioxide and blood pH directly. It’s important to understand that CO2 test results are usually interpreted alongside other markers such as sodium, potassium, chloride, and blood pH to get a complete picture of your health. The normal reference range for adult CO2 levels is typically 20–29 mEq/L, but this can vary slightly depending on the lab. Abnormal results do not automatically indicate a serious health condition, as temporary changes can occur due to factors like medications, dietary habits, or temporary illnesses. Your healthcare provider will use your CO2 level in combination with other test results and your medical history to make an accurate diagnosis and determine if treatment or further testing is needed.
Optimal range: 32 - 290 mmol/L
Chloride, as measured in a random urine sample is essential for evaluating the body's electrolyte balance and acid-base status, as chloride is a major anion (negatively charged ion) found in the blood and urine. In this test, chloride levels are assessed alongside creatinine, a waste product produced by muscle metabolism, which serves as a reference to help interpret the chloride results more accurately. By comparing the amount of chloride to creatinine in the urine, healthcare providers can gain insights into the kidney's ability to filter and reabsorb essential minerals. This is particularly important in diagnosing and managing conditions related to electrolyte imbalances, dehydration, and kidney function.
Optimal range: 96 - 106 mEq/L , 96 - 106 mmol/L
Chloride is a molecule found in the body and belongs to the electrolyte group, indicating that it possesses an electrical charge. Electrolytes work to maintain the pH of our body fluids, help our cells to keep the amount of fluid inside and outside the cell balanced, and aid in the maintenance of proper blood volume / blood pressure. Tests for chloride, sodium, potassium, and bicarbonate are typically done together as part of an electrolyte panel, a basic metabolic panel, or a comprehensive metabolic panel. A healthcare professional may order an electrolyte panel when symptoms such as prolonged vomiting, diarrhea, weakness, and difficulty breathing are present. An electrolyte panel can also be used to determine the cause of a pH level in the blood that is too acidic or too alkaline. Additionally, electrolyte panels may be done routinely to monitor medications or diseases that are known to cause electrolyte imbalance. Chloride can be measured through blood or urine.
Optimal range: 38 - 318 mmol/g creatinine
Optimal range: 97 - 137 ml/min
The primary goal of a creatinine clearance test is to measure the estimated glomerular filtration rate (eGFR), providing insight into kidney filtration efficiency. It is instrumental in diagnosing, screening, and tracking the progression of kidney disease.
The test involves measuring creatinine levels in a blood sample and a 24-hour urine collection. Creatinine is a byproduct of the breakdown of creatine, which provides energy to muscles. The kidneys filter creatinine from the blood, and it is excreted in urine. By using a specific formula that considers creatinine levels in both the blood and urine, adjusted for body size, the test estimates the glomerular filtration rate (GFR).
A creatinine clearance test is performed to evaluate kidney function by analyzing both blood and urine samples. Creatinine is a waste product generated by normal muscle activity, which the kidneys filter from the blood and eliminate through urine. This test compares the levels of creatinine in the blood and urine to determine how effectively the kidneys are filtering blood, a key indicator for diagnosing and monitoring kidney health.
Optimal range: 0.57 - 1 mg/dL , 50.39 - 88.4 µmol/L , 50.39 - 88.4 umol/L
Creatinine is formed by the breakdown of creatine, a key molecule in muscular metabolism. Our kidneys are responsible for removing creatinine from the blood and expelling it in urine. Therefore, blood creatinine levels are a good indicator of how well the kidneys are working. A disorder of the kidney and/or urinary tract will reduce the excretion of creatinine and thus raise blood serum levels. Creatinine is traditionally used with BUN to assess for impaired renal function.
- Increased creatinine levels are associated with kidney dysfunction, kidney disease and a possible dysfunction in the prostate.
- Decreased creatinine levels are associated with muscle atrophy due to creatinine’s connection to muscle metabolism.
Optimal range: 60 - 150 mL/min per 1.73 m2
eGFR stands for estimated glomerular filtration rate. Your eGFR score is a reflection of your blood test for creatinine, a waste product formed in muscular metabolism. It estimates how well your kidneys are working.
Optimal range: 60 - 150 mL/min per 1.73 m2
Alternative Names: GFR; Estimated GFR; eGFR
What is GFR?
GFR is a blood test that measures how much blood your kidneys filter each minute, which is known as your glomerular filtration rate (GFR). You have two kidneys. Their main job is to filter wastes and extra water out of your blood to make urine. eGFR is a measure of how well your kidneys are working. Measuring serum creatinine along with an estimated glomerular filtration rate (eGFR) is recommended as the first step in GFR evaluation by current clinical practice guidelines. Your eGFR is an estimated number based on a blood test and your age, sex, body type and race. eGFR is considered a mostly reliable test for doctors to know how well your kidneys are working. However, the eGFR may not be accurate if you are younger than 18, pregnant, very overweight or very muscular. In addition, other tests such as an ultrasound or a kidney biopsy may be ordered to find a cause of your kidney disease.
Optimal range: 60 - 150 mL/min /1.73m2
The eGFR (estimated Glomerular Filtration Rate) / Cystatin C Ratio is a significant marker offering vital insights into kidney function and health. Glomerular filtration rate (GFR) is a test that measures the flow rate of filtered fluid through the kidneys, serving as a critical indicator of kidney health. eGFR is an estimated value derived from blood creatinine levels, age, sex, and race, providing a non-invasive assessment of kidney function. Cystatin C, on the other hand, is a protein produced by all nucleated cells in the body, and its level in the blood inversely correlates with kidney function. Unlike creatinine, Cystatin C levels are less influenced by muscle mass, age, or diet, making it a potentially more accurate marker of kidney function for certain populations.
Optimal range: 0 - 1.33 Score
Noninvasive estimate of liver scarring in HCV and HBV patients, to assess need for biopsy.
Optimal range: 1.5 - 4.5 g/dL , 15 - 45 g/L
What is globulin?
Globulin is a protein and is made in the liver. High levels may indicate autoimmune disease, infections or cancer. A low globulin reading may be a sign of liver or kidney disease.
About 40% of the proteins in your blood are alpha, beta and gamma globulins. Albumin is the other common blood protein.
Globulin forms the main transport system for various substances as well as a constituant of the antibody system (“immunoglobulins”) that fights infections and viruses. Globulins are also needed to form blood clots and keep the liver and kidneys functioning.
The globulin value on the chemistry panel is not measured, but is calculated by the equation: Globulins = Total protein – Albumin.
There are four groups of globulins. Serum protein electrophoresis is the test used to distinguish one from another and establish levels of each within the bloodstream.
Optimal range: 65 - 99 mg/dL , 3.61 - 5.49 mmol/L
What is Glucose?
A blood sugar test measures the amount of a sugar called glucose in a sample of your blood. Glucose (also known as blood sugar) is a major source of energy for most cells of the body, including brain cells. Glucose is a building block for carbohydrates. Carbohydrates are found in fruit, cereal, bread, pasta, and rice. Carbohydrates are quickly turned into glucose in your body. This can raise your blood glucose level. A hormone called insulin helps move glucose from your bloodstream into your cells. Elevated fasting blood glucose is often a sign of Type 2 diabetes. Very high glucose levels, whether fasting or not, usually indicate Type 1 diabetes.
Glucose is often part of a regular blood test called the comprehensive metabolic panel (CMP).
Optimal range: 65 - 125 mg/dL
Glucose Non-Fasting tests are an essential tool in the ongoing monitoring and management of blood sugar levels, crucial for individuals with diabetes or those at risk. Unlike traditional glucose tests that require fasting, these non-fasting tests offer a convenient and immediate assessment of blood glucose levels at any time of day, regardless of when you last ate.
Optimal range: 1 - 24 %
Intestinal isoenzymes of alkaline phosphatase are biomarkers that indicate the presence of specific forms of the alkaline phosphatase enzyme within the intestine. This biomarker is significant in assessing the health and function of the intestinal system, as alkaline phosphatase is involved in various physiological processes, including the absorption of nutrients and the maintenance of gut health.
Optimal range: 25 - 69 %
Optimal range: 0 - 0 %
Macrohepatic isoenzymes are a unique form of alkaline phosphatase (ALP) that can be found in some individuals' blood.
Macrohepatic isoenzymes are larger-than-normal versions of liver alkaline phosphatase. They're called "macro" because they're bigger than typical ALP enzymes.
The presence of macrohepatic isoenzymes can be important for several reasons:
Optimal range: 0 - 0 %
Placental alkaline phosphatase (PLAP) is a unique biomarker among the alkaline phosphatase isozymes, with significant clinical and research implications. This enzyme is primarily produced by the placenta during pregnancy and has distinctive characteristics that set it apart from other ALP isozymes.
PLAP is encoded by the ALPP gene and is a membrane-associated sialoglycoprotein enzyme. It is expressed at high concentrations in syncytiotrophoblasts of the placenta, particularly during the third trimester of gestation. PLAP exists as a homodimer anchored to the apical and basal plasma membranes of syncytiotrophoblasts.
Optimal range: 12 - 129 mmol/L
Potassium is a vital mineral and electrolyte in the body, playing key roles in several critical body functions, such as regulating heartbeat, muscle function, and nerve signaling. In the context of medical testing the measurement of potassium in a random urine sample is significant. This test does not require any special preparation such as fasting and can be performed at any time, making it a convenient option for patients. In this panel, potassium levels are often analyzed alongside creatinine, a byproduct of muscle metabolism, to evaluate the potassium excretion relative to creatinine excretion. This ratio can help assess kidney function and the balance of electrolytes. High levels of potassium in the urine might indicate conditions like hyperaldosteronism (where the adrenal gland releases too much hormone), whereas low levels could suggest issues such as acute or chronic kidney disease, or excessive use of diuretics. The combined measurement with creatinine helps to adjust for variations in urine concentration, providing a more accurate picture of the body’s potassium release and retention, crucial for diagnosing and managing potential health concerns effectively.
Optimal range: 3.5 - 5.2 mmol/L
Potassium (chemical symbol K+) is an essential mineral and electrolyte found in every cell of your body. It plays a key role in:
Helping nerves send signals
Supporting muscle contractions, including the heartbeat
Moving nutrients into cells and waste products out
Maintaining a healthy fluid and electrolyte balance
As an electrolyte, potassium conducts electrical impulses when dissolved in body fluids. This electrical activity is vital for normal muscle, nerve, and heart function.
Optimal range: 17 - 121 mmol/g creatinine
The "Potassium/Creatinine Ratio" marker is a crucial diagnostic tool used to evaluate the balance of potassium in your urine relative to creatinine. Potassium, an essential mineral, is vital for proper cell function, including maintaining normal heart function and regulating fluid balance. Creatinine, a waste product generated from muscle metabolism, is typically used as a reference marker because its excretion rate in urine is relatively stable. The ratio between potassium and creatinine helps to normalize potassium levels against urine concentration variations, providing a more accurate assessment of potassium excretion from the body. This measurement is particularly important in diagnosing and monitoring conditions related to electrolyte imbalance, kidney function, and certain hormonal disorders. It helps doctors understand how well the kidneys are processing potassium and whether there might be excessive loss or retention of potassium, which can have significant health implications. Thus, this test is a vital part of understanding overall kidney health and managing conditions that affect electrolyte balance.
Optimal range: 120 - 300 mcg/L
Selenium, RBC (Red Blood Cells) measures intracellular selenium levels, providing a better reflection of long-term selenium status compared to a standard serum selenium test. Selenium is a trace mineral essential for antioxidant defense, thyroid function, immune health, and detoxification.
Selenium is crucial for:
- Antioxidant protection – A key component of glutathione peroxidase, which neutralizes harmful free radicals.
- Thyroid hormone production – Necessary for converting T4 (thyroxine) into T3 (triiodothyronine), the active thyroid hormone.
- Immune function – Supports immune cell activity and reduces inflammation.
- Heavy metal detoxification – Helps eliminate toxic metals like mercury.
- Cognitive and cardiovascular health – Supports brain function and prevents oxidative stress in the heart.
RBC selenium levels provide a longer-term view (about 3–4 months) of selenium status, unlike serum selenium, which can fluctuate with recent dietary intake.
Optimal range: 28 - 272 mmol/L
Optimal range: 134 - 144 mmol/L
What is a Sodium test?
This test measures the levels of sodium in your blood and is usually done as part of an electrolyte or basic metabolic panel blood test.
The sodium test may also be ordered separately if you have:
You may also receive this test to monitor medications that affect your sodium levels. These include diuretics and certain hormones.
Elevated or decreased amounts of sodium in your body can have many adverse health effects ranging from as minor as thirst to as serious as a coma in incredibly severe cases. Monitoring the healthy level of this essential mineral is incredibly important to your overall health.
A sodium blood test is used to detect an abnormal sodium level, including low sodium (hyponatremia) and high sodium (hypernatremia). It is often used as part of an electrolyte panel or basic metabolic panel for a routine health exam.
Optimal range: 28 - 280 mmol/g creatinine
The "Sodium/Creatinine Ratio" marker is an important test used to assess the concentration of sodium in relation to creatinine in urine. This ratio is crucial for determining how well the kidneys are managing sodium and water balance in the body. Sodium, a key electrolyte, helps regulate blood pressure, blood volume, and cellular function, while creatinine, a waste product produced by muscle metabolism, serves as a marker for kidney function. By measuring the amount of sodium per unit of creatinine, this test provides a normalized value that isn't affected by urine concentration, which can vary greatly. This makes the Sodium/Creatinine Ratio a reliable indicator for evaluating kidney health, particularly in diagnosing conditions related to abnormal sodium handling such as dehydration or conditions that cause excessive sodium loss. Understanding this ratio can help healthcare providers manage and diagnose various renal and systemic disorders effectively.
Optimal range: 30 - 35 Ratio
The Sodium/Potassium (Na/K) ratio is a key metric derived from sodium and potassium levels measured on a comprehensive metabolic panel (CMP). This ratio reflects the balance between these two essential electrolytes in the body, both of which play crucial roles in maintaining cellular function, fluid balance, and overall health.
Optimal range: 6 - 8.5 g/dL , 60 - 85 g/L
What is the total protein marker?
Total protein is the sum concentration of all individual serum proteins (g/dL). There are many hundreds of different protein species in serum, including straight polypeptides as well as glycosylated and lipid-associated forms.
Since total protein consists mainly of a composite of albumin and globulins, the result is not interpreted in isolation, but rather is interpreted in context of the changes in albumin and globulins (independently and in relation to each other). Albumin generally accounts for about half (~50%) of the total protein concentration in plasma.
Optimal range: 17 - 48 mg/dL , 2.83 - 7.99 mmol/L
→ Waste Product: Urea is a waste product formed in the liver from the breakdown of proteins.
→ Excretion Pathway: It is transported via the bloodstream to the kidneys, where it is filtered out and excreted in urine.
→ Health Indicator: Urea levels are measured to assess kidney function; high levels may indicate kidney dysfunction.
→ Protein Metabolism: It helps remove excess nitrogen from the body, a byproduct of protein metabolism.
→ CMP Component: Urea (or BUN) is a key marker on a Comprehensive Metabolic Panel (CMP) used to monitor overall metabolic and renal health.
Chl. pneumoniae (IgG/IgM/IgA)
Chl. pneumoniae (IgG/IgM/IgA)
Chlamydia pneumoniae IgG
Chlamydia pneumoniae IgM
Chlamydia pneumoniae IgA
Reference range: Negative (<1:16), Positive
The bacteria Chlamydia pneumoniae is spread by airborne droplets and infects the mucous membranes of the respiratory tract. These infections can be the cause of pharyngitis, laryngitis and sinusitis. A dry, hacking cough is the most common symptom of these infections. Not everyone who has mycoplasma and chlamydia in their nasopharynx gets sick - it depends on the body's resistance, but they can still infect others.
Reference range: Negative (<1:16), Positive
The bacteria Chlamydia pneumoniae is spread by airborne droplets and infects the mucous membranes of the respiratory tract. These infections can be the cause of pharyngitis, laryngitis and sinusitis. A dry, hacking cough is the most common symptom of these infections. Not everyone who has mycoplasma and chlamydia in their nasopharynx gets sick - it depends on the body's resistance, but they can still infect others.
Reference range: Negative (<1:16), Positive
The bacteria Chlamydia pneumoniae is spread by airborne droplets and infects the mucous membranes of the respiratory tract. These infections can be the cause of pharyngitis, laryngitis and sinusitis. A dry, hacking cough is the most common symptom of these infections. Not everyone who has mycoplasma and chlamydia in their nasopharynx gets sick - it depends on the body's resistance, but they can still infect others.
Lymphocyte Activity Profile
Also known as: Lymphocyte Act. Profile; T cell count; CD4 count; lymphocyte subsets; TBNK; CD4/CD8 count; B cell count; CD19 count; CD20 count
This test measures percentages and absolute numbers of lymphocytes, CD3 T cells, CD4 T cells and CD8 T cells and in lymphocyte subsets also B cells and NK cells.
Lymphocytes in peripheral blood (circulation) are heterogeneous and can be broadly classified into T cells, B cells, and natural killer (NK) cells. There are various subsets of each of these individual populations with specific cell-surface markers and function. This assay provides absolute and relative quantitation for the main categories of T cells, B cells, and NK cells.
Each of these lymphocyte subpopulations have distinct effector and regulatory functions and are maintained in homeostasis under normal physiological conditions. Each of these lymphocyte subsets can be identified by a combination of one or more cell surface markers.
The CD3 antigen is a pan-T-cell marker, and T cells can be further divided into 2 broad categories, based on the expression of CD4 or CD8 coreceptors.
B cells can be identified by expression of CD19, while NK cells are typically identified by the coexpression of CD16 and CD56.
The absolute counts of lymphocyte subsets are known to be influenced by a variety of biological factors, including hormones, the environment, and temperature.
Abnormalities in the number and percent of T (CD3, CD4, CD8), B (CD19), and NK (CD16+CD56) lymphocytes have been described in a number of different disease conditions. In patients who are infected with HIV, the CD4 count is measured for AIDS diagnosis and for initiation of antiviral therapy. The progressive loss of CD4 T lymphocytes in patients infected with HIV is associated with increased infections and complications. The Public Health Service has recommended that all patients who are HIV-positive be tested every 3 to 6 months for the level of CD4 T lymphocytes.
Lymphocyte subset quantitation is also very useful in the evaluation of patients with primary immunodeficiencies of all ages, including follow-up for newborn screening for severe combined immunodeficiency and immune monitoring following immunosuppressive therapy for transplantation, autoimmunity, or any other relevant clinical condition where immunomodulatory treatment is used.
It is also helpful as a preliminary screening assay for gross quantitative anomalies in any lymphocyte subset, whether related to malignancies or infection.
Optimal range: 57.5 - 86.2 %
The proportion of all immune cells that are T cells. This figure is rarely used for making treatment decisions.
Optimal range: 30.8 - 58.5 %
The CD4 percentage (CD4%) is the percentage of white blood cells (lymphocytes) that are CD4 cells.
The immune system contains lots of different cells. The two main types of lymphocytes are T cells and B cells. CD4 cells are a type of T cell. So the CD4% looks at the CD4 count in relation to other immune cells.
CD4% is sometimes a more stable indication of whether there has been a change in the immune system. If the percentage hasn’t changed the change in the absolute count is not important.
Optimal range: 12 - 35.5 %
The proportion of all T cells that are CD8 cells.
CD8 cells are also called cytotoxic T-lymphocytes. They help fight cancer and germs that live inside your cells (intracellular pathogens).
The CD8 percentage is sometimes more reliable than the absolute count of CD8 because it tends to vary less.
Optimal range: 4.9 - 25.9 %
This test is used to detect soluble IL-2Rα in human plasma or serum produced in response to increased activation of B and T cells and immune system activation. Studies show elevated levels of sIL-2Rα in serum with the onset of rejection episodes in allograft recipients, autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus (SLE), hemophagocytic lymphohistiocytosis (HLH) and in the course of some leukemias and lymphomas. This test may be of diagnostic and/or prognostic value in HLH, granulomatous, autoimmune, and malignant diseases.
Optimal range: 0 - 11.3 %
The CD57 test is offered in some clinical laboratories and is being used by some health practitioners to evaluate and follow patients diagnosed with chronic Lyme disease.
Optimal range: 1.4 - 19.4 %
The percentage of natural killer (NK) cells expressing CD56 and CD16, also known as % NK (CD56/16), is a significant parameter in the characterization of different subsets of human NK cells. CD56 is a marker for NK cells, and its expression can vary between different subtypes.
Optimal range: 24 - 406 /uL
Ab NK (CD56/16) refers to the antibody staining of natural killer (NK) cells to detect the presence of specific surface markers, CD56 and CD16. CD56 is a neural cell adhesion molecule, and CD16 is an Fc receptor. Ab NK (CD56/16) analysis is crucial in identifying and characterizing different subsets of NK cells, including the CD56bright and CD56dim populations, each with distinct functional roles in the immune system.
Optimal range: 79 - 535 uL
CD25 is the receptor for IL2 and is expressed on activated T cells, B cells, and macrophages. CD25 is expressed in certain types of B-cell lymphoma (hairy cell leukemia) and T-cell lymphoma (adult T-cell lymphoma/leukemia [ATLL]).
Optimal range: 0 - 254 uL
Why use the CD57 test?
The CD57 test is offered in some clinical laboratories and is being used by some health practitioners to evaluate and follow patients diagnosed with chronic Lyme disease.
What is Lyme disease?
Lyme disease, the most common vector-borne illness in the United States, is caused by Borrelia burgdorferi and transmitted by the bite of the Ixodes sp. tick (the deer tick).
The disease usually begins with erythema migrans, an expanding skin lesion at the site of the tick bite. Within several days or weeks, there is hematogenous dissemination of the spirochetes, and patients may present with dermatologic, neurological, cardiac, and rheumatologic involvement.
Optimal range: 622 - 2402 uL
CD3+ cells are all T-lymphocytes, which includes both CD4+ and CD8+ lymphocyte cells.
This figure is rarely used for making treatment decisions.
Optimal range: 359 - 1519 uL
The CD4 cells are Helper T-cells expressing both CD3 and CD4.
CD4 T-cells levels are a criterion for categorizing HIV-related clinical conditions by CDC's classification system for HIV infection. The measurement of CD4 T-cell levels has been used to establish decision points for initiating P. jirovecii prophylaxis, antiviral therapy and to monitor the efficacy of treatment. The Public Health Service (PHS) has recommended that CD4 T-cell levels be monitored every 3 to 6 months in all HIV-infected persons.
During HIV infection, antiviral therapy is often initiated when the absolute CD4 count drops below 500 cells/µL. When the absolute CD4 count drops below 200 cells/µL, therapeutic prophylaxis against PCP and other opportunistic infections may be initiated. When the absolute CD4 count drops below 100 cells/µL, prophylaxis against Mycobacterium avium complex is recommended.
Optimal range: 109 - 897 uL
This figure is rarely used for making treatment decisions.
CD4 and CD8 are two types of white blood cells in your blood. CD4 cells are also called T-helper cells, T-suppressor cells, and cytotoxic T-cells. They help the body fight infections. CD8 cells are also called cytotoxic T-lymphocytes. They help fight cancer and germs that live inside your cells (intracellular pathogens).
The absolute number of all CD8 cells, which include both killer and suppressor T cells. The normal range for an HIV-negative person is 150 to 1,000. It is usually higher in a person with HIV.
Optimal range: 5 - 20 %
CD19 is a protein that serves as a cell surface marker found on B-lymphocytes (B-cells), which are a type of white blood cell crucial to the adaptive immune system. As part of the B-cell receptor complex, CD19 functions as a co-receptor that enhances the sensitivity and response of B-cells to antigens. This protein plays a vital role in B-cell development, activation, proliferation, and differentiation.
Optimal range: 71 - 91 %
CD2 is a type I transmembrane glycoprotein that is expressed on the surface of T cells, natural killer cells, thymocytes, and dendritic cells. The CD2 protein is also a costimulatory receptor that plays a role in T cell activation and signaling.
Optimal range: 5 - 20 %
CD20 is a cell surface protein primarily found on B-lymphocytes (B-cells), which are essential white blood cells in the adaptive immune system. CD20 plays a crucial role in regulating B-cell activation, growth, and differentiation, particularly in the immune response to pathogens.
Optimal range: 57 - 89 %
The proportion of all immune cells that are T cells. This figure is rarely used for making treatment decisions.
Optimal range: 31 - 58 %
The CD4 percentage (CD4%) is the percentage of white blood cells (lymphocytes) that are CD4 cells.
The immune system contains lots of different cells. The two main types of lymphocytes are T cells and B cells. CD4 cells are a type of T cell. So the CD4% looks at the CD4 count in relation to other immune cells.
CD4% is sometimes a more stable indication of whether there has been a change in the immune system. If the percentage hasn’t changed the change in the absolute count is not important.
Optimal range: 0.92 - 3.72 Ratio
This test looks at the ratio of two important types of white blood cells in your blood.
Lymphocytes are a type of white blood cell in your immune system. This test looks at two of them, CD4 and CD8.
CD4 cells lead the fight against infections. CD8 cells can kill cancer cells and other invaders.
Optimal range: 58 - 85 %
Cell surface antigen CD5 is a marker for activated human B cells.
CD5 is a T-cell associated marker that is also expressed by two B-cell neoplasms; lymphocytic leukemia and mantle cell lymphoma. CD5 antigen is expressed in 95% of thymocytes and 72% of peripheral blood lymphocytes. In lymph nodes, CD5 is mainly reactive with Tcells. It has been shown to react with thymic carcinomas, but rarely in thymomas. It has also been observed in a subset of intravascular large B-cell lymphomas and marks some anaplastic large cell lymphomas. CD5 has proven very useful in marking mantle cell lymphoma when used in tandem with CD23, cyclin D1, and CD10 (CD10 is negative; CD5, cyclin D1 are positive for mantle cell lymphoma).
Optimal range: 70 - 89 %
CD7 is a transmembrane protein highly expressed in acute T-cell leukemia (T-ALL) and in a subset of peripheral T-cell lymphomas. Normal expression of CD7 is largely confined to T cells and natural killer (NK) cells, reducing the risk of off-target-organ toxicity.
Optimal range: 19 - 43 %
The proportion of all T cells that are CD8 cells.
CD8 cells are also called cytotoxic T-lymphocytes. They help fight cancer and germs that live inside your cells (intracellular pathogens).
The CD8 percentage is sometimes more reliable than the absolute count of CD8 because it tends to vary less.
Optimal range: 3 - 22 %
CD16, also known as FcγRIII, refers to a cluster of differentiation molecule found on the surface of various immune cells, including natural killer cells, neutrophils, monocytes, macrophages, and certain T cells. CD16 has been identified as two different receptors: FcγRIIIa (CD16a) and FcγRIIIb (CD16b). These receptors participate in signal transduction and are involved in antibody-dependent cellular cytotoxicity (ADCC), which is a process where immune cells target and destroy cells coated with specific antibodies.
Optimal range: 0 - 0 x10/9/l
CD16, also known as FcγRIII, refers to a cluster of differentiation molecule found on the surface of various immune cells, including natural killer cells, neutrophils, monocytes, macrophages, and certain T cells. CD16 has been identified as two different receptors: FcγRIIIa (CD16a) and FcγRIIIb (CD16b). These receptors participate in signal transduction and are involved in antibody-dependent cellular cytotoxicity (ADCC), which is a process where immune cells target and destroy cells coated with specific antibodies.
Optimal range: 0.06 - 0.6 x10/9/l
The CD19 antigen (aka B-lymphocyte antigen CD19 or Cluster of Differentiation 19) plays an important role in clinical oncology. It’s a protein found on the surface of B-cells, a type of white blood cell.
Optimal range: 0.8 - 2.4 x10/9/l
CD3+ cells are all T-lymphocytes, which includes both CD4+ and CD8+ lymphocyte cells.
This figure is rarely used for making treatment decisions.
Optimal range: 0.5 - 1.6 x10/9/l
The CD4 cells are Helper T-cells expressing both CD3 and CD4.
CD4 T-cells levels are a criterion for categorizing HIV-related clinical conditions by CDC's classification system for HIV infection. The measurement of CD4 T-cell levels has been used to establish decision points for initiating P. jirovecii prophylaxis, antiviral therapy and to monitor the efficacy of treatment. The Public Health Service (PHS) has recommended that CD4 T-cell levels be monitored every 3 to 6 months in all HIV-infected persons.
During HIV infection, antiviral therapy is often initiated when the absolute CD4 count drops below 500 cells/µL. When the absolute CD4 count drops below 200 cells/µL, therapeutic prophylaxis against PCP and other opportunistic infections may be initiated. When the absolute CD4 count drops below 100 cells/µL, prophylaxis against Mycobacterium avium complex is recommended.
Optimal range: 0.92 - 3.72 Ratio
This test looks at the ratio of two important types of white blood cells in your blood.
Lymphocytes are a type of white blood cell in your immune system. This test looks at two of them, CD4 and CD8.
CD4 cells lead the fight against infections. CD8 cells can kill cancer cells and other invaders.
Optimal range: 5 - 24 %
CD56 is an adhesion molecule mediating homophilic and heterophilic adhesion in neurons, natural killer cells, and a small subset of CD4- and CD8-positive T cells. It is expressed in tumors with neuroendocrine differentiation (small cell lung carcinoma and neural-derived tumors) or natural killer cell lineage (subset of lymphomas). In normal small intestine, the ganglion cells in the muscle wall and nerves will show strong staining. Scattered lymphocytes may also be positive.
Optimal range: 0.07 - 0.6 x10/9/l
CD56 is an adhesion molecule mediating homophilic and heterophilic adhesion in neurons, natural killer cells, and a small subset of CD4- and CD8-positive T cells. It is expressed in tumors with neuroendocrine differentiation (small cell lung carcinoma and neural-derived tumors) or natural killer cell lineage (subset of lymphomas). In normal small intestine, the ganglion cells in the muscle wall and nerves will show strong staining. Scattered lymphocytes may also be positive.
Optimal range: 5 - 27 %
CD56+CD3- % is a key immunological marker identifying natural killer (NK) cells, essential in innate immunity. Elevated levels can indicate an active immune response or certain malignancies, while decreased levels may suggest impaired immunity, as seen in HIV/AIDS or post-chemotherapy. This parameter is crucial in transplant immunology for monitoring immune reconstitution and in assessing the effectiveness of immunotherapies, particularly in cancer treatments. CD56+CD3- % thus plays a significant role in diagnosing, monitoring, and treating immune and hematological disorders.
Optimal range: 77 - 427 uL
CD56+CD3- (absolute) cells are crucial in the immune system, primarily acting as natural killer (NK) cells. Their unique combination of CD56 positivity and CD3 negativity makes them essential for defending against pathogens and cancer cells. These cells are pivotal in diagnosing and managing immune-related conditions and cancers, highlighting their role in personalized medicine.
Optimal range: 0.2 - 1 x10/9/l
This figure is rarely used for making treatment decisions.
CD4 and CD8 are two types of white blood cells in your blood. CD4 cells are also called T-helper cells, T-suppressor cells, and cytotoxic T-cells. They help the body fight infections. CD8 cells are also called cytotoxic T-lymphocytes. They help fight cancer and germs that live inside your cells (intracellular pathogens).
The absolute number of all CD8 cells, which include both killer and suppressor T cells. The normal range for an HIV-negative person is 150 to 1,000. It is usually higher in a person with HIV.
Optimal range: 0 - 0 %
Optimal range: 0 - 0 %
IgG Allergens (14), Molds
The Allergen Profile, Mold (LabCorp) detects possible allergic responses to various substances in the environment and evaluates for hay fever, asthma, atopic eczema, and respiratory allergy.
Optimal range: 0 - 2 ug/ml
The "F001-IgG Egg White" marker is a blood test that measures the level of immunoglobulin G (IgG) antibodies specific to egg white proteins. IgG antibodies are produced by the immune system in response to exposure to allergens, such as egg white. When a person is sensitive or allergic to egg white, their immune system may react by producing IgG antibodies, which can be detected through this test.
Egg white allergy is one of the most common food allergies, especially in children. However, many individuals with an egg allergy will show IgE antibodies, which are associated with immediate allergic reactions. IgG antibodies, on the other hand, are often linked to delayed food sensitivities or intolerances, which may not cause immediate symptoms but can lead to chronic issues over time, such as gastrointestinal discomfort, headaches, or skin rashes.
Optimal range: 0 - 2 ug/ml
Optimal range: 0 - 2 ug/ml
The "F082-IgG Cheese, Mold Type" marker is a blood test that measures the presence of immunoglobulin G (IgG) antibodies against proteins found in moldy cheeses. Mold-type cheeses, such as blue cheese, Roquefort, Camembert, and Brie, are made by introducing specific types of mold during the aging process. For individuals with sensitivities or intolerances to these molds, the immune system may produce IgG antibodies as a response to these foreign substances.
IgG antibodies are associated with delayed immune reactions, meaning symptoms linked to mold-type cheeses may take hours or even days to appear after consumption. Elevated levels of the F082-IgG Cheese, Mold Type marker may indicate a sensitivity to molds found in certain cheeses, leading to symptoms like digestive discomfort, bloating, headaches, skin rashes, or fatigue.
Optimal range: 0 - 2 ug/ml
The "F236-IgG Whey" marker is a blood test that measures the presence of immunoglobulin G (IgG) antibodies directed against whey proteins. Whey is a protein found in milk and is commonly used in various food products, including protein powders, dairy products, and infant formulas. For individuals with a sensitivity or intolerance to whey, the immune system may produce IgG antibodies in response to these proteins.
IgG antibodies are associated with delayed-type immune reactions, meaning that symptoms caused by whey sensitivity may take several hours or even days to appear after consumption. Elevated levels of the F236-IgG Whey marker suggest that the immune system is reacting to whey proteins, which may indicate an intolerance or sensitivity to whey. Symptoms of whey sensitivity can include digestive issues like bloating, gas, and stomach discomfort, as well as headaches, fatigue, skin rashes, or other chronic symptoms.
Optimal range: 0 - 1.9 ug/ml
Penicillium Chrysogenum is a widely studied species of Penicillium that is most famous for being a source of penicillin and several other antibiotics.
Optimal range: 0 - 2 ug/ml
The "M001-IgG Penicillium chrysogenum" marker is a blood test that measures the presence of immunoglobulin G (IgG) antibodies against Penicillium chrysogenum, a type of mold commonly found in indoor environments, including on decaying organic matter, building materials, and even certain foods like cheese. Penicillium chrysogenum is also known for being the source of penicillin, an antibiotic.
When an individual is exposed to Penicillium chrysogenum, their immune system may produce IgG antibodies, particularly if they have a sensitivity or intolerance to this mold. IgG antibodies are typically associated with delayed-type immune responses, meaning symptoms related to mold exposure may not appear immediately but could take hours or days to manifest. Elevated levels of the M001-IgG Penicillium chrysogenum marker suggest an immune response to this mold, which could potentially contribute to various symptoms.
Optimal range: 0 - 1.9 ug/ml
Cladosporium, a well known trigger for asthmatic attacks, is one of the most widespread molds.
Cladosporium includes about 40 species naturally found in soil, on decaying plant material and as plant pathogens.
In an indoor environment, Cladosporium spp. occur as secondary wall colonizers, appearing after the primary ones such as Penicillium species, Aspergillus versicolor and Wallemia sebi. Cladosporiumis very common on wet building material (e.g., gypsum board, acrylic painted walls, wood, wallpaper, carpet and mattress dust, HVAC fans, and wet insulation in mechanical cooling units).
Optimal range: 0 - 2 ug/ml
The "M002-IgG Cladosporium herbarum" marker is a blood test that measures the presence of immunoglobulin G (IgG) antibodies against Cladosporium herbarum, a common mold species. This mold is typically found in both indoor and outdoor environments, especially in damp or decaying organic materials, such as soil, plants, and wood. Cladosporium herbarum is one of the most prevalent outdoor molds and is frequently found in areas with high humidity, as well as in poorly ventilated indoor spaces.
When an individual is exposed to Cladosporium herbarum, their immune system may produce IgG antibodies in response. Elevated levels of these antibodies suggest that the person may have a sensitivity or intolerance to this mold, which could lead to various health symptoms.
Optimal range: 0 - 1.9 ug/ml
The fungus Aspergillus fumigatus causes allergic diseases, respiratory illnesses, and bloodstream infections.
Optimal range: 0 - 1.9 ug/ml
Normal soil inhabitant. Found around barns and barnyards where it grows on animal waste.
Optimal range: 0 - 0.1 kU/L
Optimal range: 0 - 1.9 ug/ml
Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida. There are over 20 species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans.
Optimal range: 0 - 1.9 ug/ml
Alternaria alternata is one of the most common fungi associated with asthma.
Not only the presence of asthma but also persistence and severity of asthma have been strongly associated with sensitization and exposure to A alternata. Although exposure to Alternaria is an important risk factor for asthma, few studies have assessed exposure to this fungus in indoor environments.
Optimal range: 0 - 1.9 ug/ml
Botrytis cinerea is called the grey mold, as it covers the decayed tissues with conidiophores.
B. cinerea is found regularly in the soil, though its proportion of the total fungus population is not high. It can be parasitic on a wide range of plants, causing blight or rot of leaves, flowers and fruits. It is called the grey mold, as it covers the decayed tissues with conidiophores, e.g. grey mold of cabbage or lettuce, tomato. It is especially seen in connection with soft fruits, e.g. strawberries and grapes.
Individuals exposed to B. cinerea may be sensitised to this fungus without experiencing any clinical symptoms, or may experience exacerbation of symptoms of asthma, hayfever or sinusitis, or may develop hypersensitivity pneumonitis (also known as 'winegrower's lung'). IgE- binding components from B. cinerea appear to have both early- and late-phase antigens.
Optimal range: 0 - 1.9 ug/ml
Setomelanomma/Helminthosporium almost always occurs seasonally and the spores are released on dry, hot days. Species of Helminthosporium are best known as parasites of cereals and grasses. It is frequently isolated from grains, grasses, sugar cane, soil and textiles.
- Found worldwide, most common in warm areas, especially in the southern U.S.
- Important in the Midwest as it grows on farm crops, especially corn.
- Grain thrashing operations release large quantities.
Optimal range: 0 - 1.9 ug/ml
Members of the genus Fusarium are ubiquitous fungi commonly found in soils and plants.
Fusarium proliferatum can be found on a wide host range as well as pathogenic on various agricultural crops. Fusarium proliferatum is a common pathogen infecting numerous crop plants and occuring in various climatic zones.
Optimal range: 0 - 1.9 ug/ml
Together with Alternaria, Stemphylium is considered one of the most important mould allergens in the United States.
Optimal range: 0 - 1.9 ug/ml
Rhizopus nigricans is a fungus commonly known as bread mold and is the most common species of Rhizopus. It is found on old food and in soils and even in children's sandboxes. The genus contains some 50 species and bread mold is sometimes confused with species of Mucor or other species of Rhizopus like Rhizopus oryzae. The spores, dispersed in hot dry weather, contain allergenic proteins with 31 distinct allergens, which can produce respiratory and nasal symptoms in concentration (chronic cough, dyspnea, chest tightness, chronic phlegm, snuffle, snizzle and allergic rhinitis). Food handling workers are particularly at risk if they are mold allergic.
Optimal range: 0 - 1.9 ug/ml
It is a commonly encountered species in wet buildings. It is both a soil and leaf fungus.
Optimal range: 0 - 1.9 ug/ml
Epicoccum can colonize an extremely wide variety of substrates. It lives in soil all over the world and is often associated with aging or decaying plant material. It is also a phytopathogen, causing leaf spot disease in many plants. It is an agent of food spoilage and has been known to develop on apples, cantaloupes, fresh vegetables, nuts and cereals, rice, wheat, maize, pecans, peanuts, cashews, soybean and frozen or cured meats. Interestingly Epicoccum can also colonize freshwater and marine environments and has been isolated from sediment, sponges, algae and other sea plants.
Optimal range: 0 - 1.9 ug/ml
Aspergillus species are ubiquitous environmental molds that grow on organic matter and aerosolized conidia (conidia is a spore produced by various fungi at the tip of a specialized hypha).
Aspergillus is a genus of molds that includes several hundred species that grow in nutrient-depleted environments.
Humans inhale hundreds of conidia per day without adverse consequences, except for a small minority of people for whom infection with Aspergillus causes significant morbidity (the condition of suffering from a disease or medical condition).
The clinical manifestations of aspergillosis are determined by the host immune response to exposure with the spectrum ranging from a simple allergic response to local lung disease with mycelial balls to catastrophic systemic Aspergillus infection.
Porphyrins, Quantitative, Random Urine
Urine porphyrins are useful for the evaluation of cutaneous (=relating to or affecting the skin) photosensitivity to exclude porphyria cutanea tarda (PCT).
Porphyria cutanea tarda (PCT) is a part of a spectrum of diseases that arise as a result of abnormal enzymes in the biosynthesis of heme. It is caused by the deficiency of the uroporphyrinogen III decarboxylase (UROD) enzyme and should be differentiated from other porphyrias.
Evaluation of neurologic and/or psychiatric symptoms associated with acute porphyrias (=a group of rare disorders characterized by an enzymatic defect in the heme biosynthetic pathway), such as acute intermittent porphyria (AIP), requires urine porphobilinogen (PBG) testing.
Optimal range: 0.7 - 3.6 mg/g creat
Optimal range: 0 - 15 ug/L
Coproporphyrin I is a porphyrin metabolite arising from heme synthesis.
Optimal range: 0 - 49 ug/L
Coproporphyrin III is a porphyrin derivative.
Small amounts of porphyrins (coproporphyrin) are excreted in normal human urine. Coproporphyrin also is present in bile and feces.
Optimal range: 0 - 2 ug/L
Heptacarboxyporphyrin is a Porphyrin.
Porphyrins are precursors of heme and usually only occur in urine in negligible amounts.
Optimal range: 0 - 1 ug/L
Hexacarboxyporphyrin is a Porphyrin. Porphyrins are precursors of heme and usually only occur in urine in negligible amounts.
Optimal range: 0.2 - 2.2 mg/g Creat.
The "PBG/Creatinine Ratio" marker found on a Porphobilinogen, Quantitative, Random Urine panel by LabCorp is a crucial test for evaluating the presence and concentration of porphobilinogen (PBG) in urine in relation to creatinine levels. This test is significant for diagnosing and monitoring conditions related to abnormal porphyrin metabolism, such as acute intermittent porphyria, among others. Porphyria refers to a group of disorders that result from a buildup of natural chemicals that produce porphyrin in your body.
Porphobilinogen is a precursor in the biosynthesis of heme, the iron-containing prosthetic group found in hemoglobin. Normally, the body regulates the production of porphobilinogen and other intermediates in the heme production pathway. However, genetic conditions can disrupt this balance, leading to the accumulation of toxic precursors like PBG.
Optimal range: 0 - 2 ug/L
Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low levels in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Optimal range: 0 - 0 mg/L
Optimal range: 0 - 20 ug/L
Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low levels in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Coxsackie A IgG Antibody
The Coxsackie Antibody, IgG test is used to detect antibodies against the Coxsackie virus in the blood. This condition is most common in children under the age of five, and it can cause Hand, Foot, and Mouth disease.
Coxsackieviruses are part of the enterovirus family of viruses (which also includes polioviruses and hepatitis A virus) that can live in the human digestive tract. In most cases, coxsackievirus infections cause mild flu-like symptoms and go away without treatment. But in some cases, they can lead to more serious infections. The viruses can spread from person to person, usually on unwashed hands and surfaces contaminated by feces, where they can live for several days.
Reference range: Negative, High
Coxsackie viruses are enteroviruses belonging to the Picornavirus family, which is comprised of strains A and B as well as various serotypes A1-22, 24, and B1-6. Following incubation, a variety of well known diseases can manifest themselves within the host. Coxsackie A is commonly associated with hand, foot, and mouth disease, which primarily affects children younger than 10 years of age. In rare cases, Coxsackie infections may produce mild or subclinical symptoms, yet most infections trigger the onset of flu-like ailments but may include symptoms of other diseases along the lines of pneumonia, hepatitis, and meningitis.
Reference range: Negative, High
Coxsackie viruses are enteroviruses belonging to the Picornavirus family, which is comprised of strains A and B as well as various serotypes A1-22, 24, and B1-6. Following incubation, a variety of well known diseases can manifest themselves within the host. Coxsackie A is commonly associated with hand, foot, and mouth disease, which primarily affects children younger than 10 years of age. In rare cases, Coxsackie infections may produce mild or subclinical symptoms, yet most infections trigger the onset of flu-like ailments but may include symptoms of other diseases along the lines of pneumonia, hepatitis, and meningitis.
Reference range: Negative, High
Coxsackievirus A7 (CVA7) is a rarely detected and poorly characterized virus that belongs to the Enterovirus A species and has three strains: Parker, USSR, and 275/58. Despite a difference in pathogenicity among the three strains, they can all be typed by CVA7-specific neutralizing antibodies. CVA7 is most closely related to CVA14, CVA16, and Enterovirus 71 (EV71), and is associated with hand, foot and mouth disease (HFMD). CVA7 is neurotropic and can cause paralytic poliomyelitis. CVA7 was widely detected in the 1950s and 1960s during paralytic epidemics.
Reference range: Negative, High
Coxsackie viruses are enteroviruses belonging to the Picornavirus family, which is comprised of strains A and B as well as various serotypes A1-22, 24, and B1-6. Following incubation, a variety of well known diseases can manifest themselves within the host. Coxsackie A is commonly associated with hand, foot, and mouth disease, which primarily affects children younger than 10 years of age. In rare cases, Coxsackie infections may produce mild or subclinical symptoms, yet most infections trigger the onset of flu-like ailments but may include symptoms of other diseases along the lines of pneumonia, hepatitis, and meningitis.
3102 ION (Blood/Urine) Amino Acids 40
Amino Acids 40 Profile - Plasma
The ION (Individual Optimal Nutrition) Profile with 40 Amino Acids nutritional analysis can help identify nutrient deficiencies that may be a root cause of complex chronic conditions. The ION with 40 Amino Acids is ideal for establishing a baseline assessment ahead of clinical intervention with nutraceuticals as well as subsequent monitoring as needed.
By evaluating 150 key biomarkers and ratios, the ION Profile with 40 Amino Acids evaluates organic acids, fat-soluble vitamins, Coenzyme Q10, homocysteine, oxidative stress markers, nutrient and toxic elements, fatty acids, and amino acids.
The ION Profile with 40 Amino Acids provides an expanded amino acid panel for enhanced clinical insight. Results can be used to personalize treatment plans to improve nutritional status, augment other treatments, and increase the resolution of complex chronic conditions.
Optimal range: 0 - 3.85 qmol/dL
1-methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 30 - 100 ng/mL
Vitamin D is well known for the role it plays in regulating calcium and phosphorus to maintain bone health. Vitamin D insufficiency has been linked to depression and Seasonal Affective Disorder, neurological autoimmune processes, and in preventing on-going inflammation that damages tissue.
Vitamin D, frequently called the “sun vitamin,” is an essential component of the systems that our bodies use to keep bones and teeth strong. It also has important, emerging roles in immune function and cancer prevention. We have natural processes that regulate vitamin D production from the sun so extremely high levels of it are rare. Deficiency can cause a number of issues including weak bones, called osteomalacia.
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There is no consensus in the literature regarding optimal levels of 25-Hydroxyvitamin D. Higher levels of 25-Hydroxyvitamin D may be concerning in patients with renal failure. Levels below 30 ng/mL are considered insufficient by most medical associations.
Optimal range: 0 - 0.78 qmol/dL
Both 1-methylhistidine and 3-methylhistidine are histidine metabolites which have been proposed as markers of meat intake. Note that some confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
3-methylhistidine is a constituent of actin and myosin, the contractile proteins of skeletal muscles. Urinary excretion of 3-methylhistidine may be a result of muscle breakdown or consumption of meat fibers. Unlike 1-methylhistidine, 3-methylhistidine has been shown to increase in fasting states indicating catabolism of muscle tissue. Therefore, this marker is more variable with regards to animal protein consumption.
Optimal range: 0 - 15 mcg/mg creatinine
8-hydroxy-2-deoxyguanosine measures the oxidative impact to DNA. 8-hydroxy-2-deoxyguanosine levels will be high if your total antioxidant protection is inadequate.
Optimal range: 1.76 - 9.99 qmol/dL
Alpha-Amino-N-butyric acid (α-ANB), also known as alphaaminobutyric acid, is a nonessential amino acid derived from the catabolism of methionine, threonine, and serine. α-ANB is both formed and metabolized by reactions which require vitamin B6 as a cofactor.
Optimal range: 0 - 0.28 qmol/dL
Alpha-aminoadipic acid (also known as 2-aminoadipic acid) is an intermediary biomarker of lysine and tryptophan metabolism. The further metabolism of alpha-aminoadipic acid to alpha-ketoadipic acid requires vitamin B6.
Plasma alpha-aminoadipic acid is strongly associated with the risk of developing diabetes as seen in an assessment of the Framingham Heart Study data. Circulating levels were found to be elevated for many years prior to the onset of diabetes. Preclinical data shows it may also play a role in oxidation and atherosclerotic plaque formation.
Optimal range: 0.07 - 0.54 Ratio
Alcohol consumption can result in elevations of the plasma Alpha-ANB/Leucine ratio. But to see this biomarker as a conclusive marker for alcoholism is not proven. The increase in the plasma Alpha-ANB/Leucine ratio does not appear to be specific for alcoholism because it was found elevated in nonalcoholic liver disease.
Optimal range: 19 - 62 qmol/dL
Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine. It is found in many foods including eggs, meat, lentils, and fish. Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.
Optimal range: 5.9 - 19.4 mg/L
Naturally occurring vitamin E exists in eight chemical forms (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol) that have varying levels of biological activity.
Alpha- (or α-) tocopherol is the only form that is recognized to meet human requirements. Alpha-tocopherol (body’s main form of vitamin E) functions as an antioxidant, regulates cell signaling, influences immune function and inhibits coagulation.
Optimal range: 4.1 - 17.5 qmol/dL
Arginine is found in all protein foods and is very abundant in seeds and nuts. It is considered a semi-essential amino acid during early development, infection/inflammation, or renal and/or intestinal impairment.
Optimal range: 0 - 13.7 mcg/L
Optimal range: 3.5 - 11.6 qmol/dL
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 0 - 0.67 qmol/dL
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 0 - 0.7 qmol/dL
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. Carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 0 - 0.72 qmol/dL
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA. Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys. β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 3 - 91 mcg/dL
Beta-Carotene is an oxidative stress marker.
– Beta-Carotene is involved in antioxidant protection.
– Beta-carotene is converted into vitamin A in the liver.
– Beta-carotene & other carotenoids are converted to vitamin A (retinol), involved in vision, antioxidant & immune function, gene expression & cell growth.
Optimal range: 0 - 1.22 mcg/L
Optimal range: 1.6 - 5.7 qmol/dL
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified. It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins. Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine. Because citrulline is produced in enterocytes, it has been proposed as a marker of enterocyte mass in conditions of villous atrophy.
Optimal range: 0.43 - 1.49 mcg/mL
- CoEnzyme Q10 acts as an antioxidant.
- CoEnzyme Q10 is needed for basic cell functions in energy production.
CoEnzyme Q10’s primary function is to transfer electrons through the electron transport chain in the mitochondrial inner membrane. The electrons are received directly from succinate, or indirectly from several other substrates such as pyruvate, acyl-CoA, and alpha–ketoglutarate in the form of NADH (=Nicotinamide adenine dinucleotide). CoEnzyme Q10 moves from one electron carrier complex to the next, ultimately delivering electrons, one at a time. While the electrons are delivered one at a time, they leave in pairs to form ATP and H20.
Optimal range: 75.3 - 192 mcg/dL
Optimal range: 5.9 - 19.9 qmol/dL
Cysteine is a nonessential sulfur-containing amino acid. It is obtained from the diet and is also endogenously made from the intermediate amino acid cystathionine.
Dietary cysteine sources include poultry, eggs, beef, and whole grains.
This amino acid should not be confused with the oxidized derivative of cysteine called cystine. Cystine is formed by combining two cysteine molecules within a redox reaction.
The urinary FMV amino acid test reports cysteine and cystine separately.
The plasma amino acid test combines both cysteine and cystine as one biomarker called "Cyst(e)ine".
Optimal range: 0 - 0.09 qmol/dL
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 0.19 - 0.78 qmol/dL
Ethanolamine is an intermediary metabolite in the serine-to-choline sequence. It can be used to synthesize phosphatidylethanolamine (PE), a very important membrane phospholipid. Ethanolamine is not only a precursor, but also a breakdown product of PE. Ethanolamine is abundant in both intestinal and bacterial cell membranes. It plays a significant role in the renewal and proliferation of intestinal cells and intestinal inflammation. Also, since ethanolamine plays a structural role in skeletal muscle cell membranes, some evidence suggests it may be a marker of skeletal muscle turnover.
Optimal range: 0 - 0.06 qmol/dL
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania.
Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution. Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production.
Optimal range: 0.7 - 4.9 mg/L
Gamma-tocopherol is part of the Vitamin E classification group.
The term vitamin E refers to a group of eight naturally occurring compounds, all with different potencies:
– alpha-, beta-, gamma- and delta-tocopherol and
– alpha-, beta-, gamma- and delta-tocotrienol.
Optimal range: 2 - 14.5 qmol/dL
Glutamic acid is a nonessential amino acid is derived from the diet and from the breakdown of gut proteins. Glutamate is a major excitatory neurotransmitter in the brain. It plays a role in neuronal differentiation, migration, and survival in the developing brain. It is also involved in synaptic maintenance, neuroplasticity, learning, and memory.
Optimal range: 0 - 0.31 Ratio
The Glutamic Acid/Glutamine Ratio is used to identify specimen handling issues that cause spontaneous degradation of glutamine to glutamate, and can reveal the origin of difficulty maintaining systemic pH balance.
Optimal range: 41 - 111 qmol/dL
Glutamine is a nonessential amino acid and is the most abundant amino acid in the body. It is formed from glutamate using the enzyme glutamine synthetase. Approximately 80% of glutamine is found in the skeletal muscle, and this concentration is 30 times higher than the amount of glutamine found in human plasma. Although glucose is used as fuel for many tissues in the body, glutamine is the main fuel source for a large number of cells including lymphocytes, neutrophils, macrophages, and enterocytes.
Optimal range: 669 - 5000 umol/L
Optimal range: 5 - 23 qmol/dL
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine. It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins. Glycine is a major collagen and elastin component, which are the most abundant proteins in the body. Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Optimal range: 6.5 - 13.3 qmol/dL
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine. Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
Optimal range: 3.7 - 10.4 umol/L
- Homocysteine is often used as an indicator of methylation status
- Clinicians aim for optimal: 2-10μmol/L
- Homocysteine must be recycled back into methionine
Optimal range: 4.09 - 17.43 qmol/dL
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0 - 2.81 mcg/dL
Optimal range: 9 - 25.3 qmol/dL
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0 - 10 umol/g creatinine
Lipid peroxides are a class of reactive oxygen species (ROS) that preferentially oxidize polyunsaturated fatty acids (PUFAs) linoleic, arachidonic, and docosahexaenoic acids (omega-6 PUFAs).
Lipid peroxides exert their toxic effects via two mechanisms. One is by altering the assembly, composition, structure and dynamics of cell membrane lipid bilayers. The second is by producing more reactive oxygen species or by degrading into reactive compounds capable of damaging DNA and proteins.
The central nervous system is particularly prone to lipid peroxidation due to the high quantity of ROS as a byproduct of ATP synthesis in a lipid-enriched environment.16 Circulating LDLs can be affected by lipid peroxidation and are implicated in diseases including atherosclerosis, metabolic syndrome, and diabetes.
Optimal range: 13.7 - 34.7 qmol/dL
Lysine is a nutritionally essential amino acid abundant in meat, fish, fowl, and legumes and is needed for formation of body proteins and enzymes.
Lysine can be methylated using S-adenosylmethionine (SAM) to synthesize carnitine, which is needed for fatty acid oxidation. Lysine also generates Acetyl CoA for use in the citric acid cycle. Lysine, proline, hydroxyproline, and vitamin C are important in the synthesis of collagen for skin, bones, tendons and cartilage.
Optimal range: 30.1 - 56.5 mcg/g
Optimal range: 3 - 16.5 mcg/L
Optimal range: 0 - 4.35 mcg/L
Optimal range: 2.3 - 6.5 qmol/dL
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 4.38 - 15.42 qmol/dL
Ornithine is an intermediate nonprotein-forming amino acid of the urea cycle. Arginine is converted to ornithine via the arginase enzyme, with urea as a byproduct. Ornithine combined with carbamoyl phosphate is then converted into citrulline via the ornithine transcarbamylase (OTC) enzyme. The contribution of carbamoyl phosphate results from the metabolism of ammonia by the enzyme carbamoyl phosphate synthase, and if this magnesium-dependent process is impaired, ammonia buildup, or hyperammonemia can occur.
Optimal range: 6.07 - 17.46 qmol/dL
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy. Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 0.53 - 1.46 Ratio
The Phenylalanine/Tyrosine Ratio evaluates the body’s ability to convert phenylalanine to tyrosine; Conversion enzyme requires tetrahydrobiopterin (BH4), niacin (B3), and iron as cofactors.
Optimal range: 0.09 - 0.57 qmol/dL
Phosphoethanolamine is an intermediate in the serine-to-choline sequence. It is both a precursor and byproduct of phospholipid biosynthesis and breakdown. As a precursor to the phospholipid phosphatidylethanolamine, phosphoethanolamine plays a key role in myelination. Elevated phosphoethanolamine reflects brain phospholipid turnover, an indicator of neural membrane synthesis and signal transduction. Research into neurologic conditions like Alzheimer’s disease and Huntington’s disease suggests that depletions of both phosphoethanolamine and ethanolamine accompany neuronal death. Phosphoethanolamine is also important in cartilage structure and function, especially in bone and teeth.
Optimal range: 0 - 0.39 qmol/dL
Phosphoserine is the phosphorylated ester of the amino acid serine. The addition of a phosphoryl group to an amino acid, or its removal, plays a role in cell signaling and metabolism. Phosphoserine is a byproduct of glycolysis and subsequent intermediate to then become serine. The enzyme that catalyzes this step, phosphoserine phosphatase, is magnesium dependent. This metabolite is not to be confused with a similar-sounding metabolite, phosphatidylserine; this is a common CNS supplement and essential for neuronal cell membranes.
Optimal range: 2220 - 3626 mcg/g
Optimal range: 11 - 57 qmol/dL
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid. Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage. Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn. In addition to dietary sources, proline can be synthesized from glutamate/glutamine, arginine, and ornithine. It can also be synthesized within enterocytes from degradation of small peptides.
Optimal range: 0 - 0.15 qmol/dL
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine.
It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents.
In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess. Some clinicians use sarcosine elevation as a marker of ‘excess methyl supplementation’ or ‘over-methylation.’ Currently, there is no literature to support this hypothesis, but rather it is based on physiology.
Optimal range: 109 - 330 mcg/L
Optimal range: 2.1 - 7 qmol/dL
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 4.41 - 10.99 qmol/dL
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid.
Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
It has been proposed that taurine acts as an antioxidant, intracellular osmolyte, membrane stabilizer, and a neurotransmitter.
Optimal range: 6.42 - 16.32 qmol/dL
Threonine is a large neutral amino acid and a precursor for the amino acid glycine. Foods that contain relatively high amounts of threonine include cheeses (especially Swiss), meat, fish, poultry, seeds, walnuts, cashews, almonds and peanuts. Threonine gets converted to glycine using a two-step biochemical pathway involving the enzymes threonine dehydrogenase and the vitamin B6-dependent glycine C-acetyltransferase.
Optimal range: 2.65 - 6.67 qmol/dL
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 0.04 - 0.09 Ratio
Tryptophan is an essential amino acid, a subunit in protein molecules and a precursor to serotonin. The brain uses tryptophan to produce serotonin, a neurotransmitter largely responsible for feelings of happiness and well-being.
Tryptophan cannot be synthesised by the body and must be obtained through diet.
Optimal range: 4.8 - 17.3 qmol/dL
Tyrosine is a conditionally essential amino acid which can come directly from the digestion of dietary protein. Common food sources include dairy, beans, whole grains, meat, and nuts. If intake is insufficient, tyrosine can be formed from the essential amino acid phenylalanine using a tetrahydrobiopterin reaction. Tyrosine itself is a precursor to several neurotransmitters including dopamine, epinephrine and norepinephrine. It is also needed to create thyroid hormone and melanin skin pigments. Within the metabolism of tyrosine to form neurotransmitters and other hormones, there are several important nutrient cofactors involved including vitamin B1, vitamin B6, tetrahydrobiopterin, copper, vitamin C, among others.
Optimal range: 216 - 1156 qmol/dL
Urea is a nontoxic byproduct of nitrogen (ammonia) detoxification. It is formed in the liver via the urea cycle and is the end product of protein metabolism. It is essentially a waste product with no physiological function.
Optimal range: 18.3 - 42.6 qmol/dL
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 18.9 - 57.3 mcg/dL
Required by the eye for vision and to protect the rest of your body from damaging effects of infection and stress.
Vitamin A is an antioxidant in the membranes of your cells where it serves a protective function. Every day you lose some vitamin A, because it is used in the replacement of old tissues.
Optimal range: 64.3 - 159.4 mcg/dL
Toxic & Essential Elements (Whole Blood)
Blood elemental analysis should be performed prior to the initiation of, and intermittently during, metal detoxification. Toxic metals disrupt essential element metabolism and are antagonistic to some elements such as cadmium to zinc and lead to calcium. Further, commonly utilized metal detoxification agents can cause significantly increased urinary wasting of some essential elements.
Analysis of toxic elements/metals in whole blood is useful for assessment of recent or ongoing exposure to the toxins, but does not provide accurate information about net retention of toxic metals in the body. For example, blood lead levels peak about five hours after acute exposure and then decrease exponentially with a half-life in blood of about one month. Evaluation and elimination of ongoing exposure to toxic metals is another important component of efficient metal detoxification.
Accurate assessment of essential element status in the most appropriate compartment is highly recommended for determination of appropriate supplementation. The absorption, transport and metabolism of essential elements is highly integrated and regulated. Inappropriate supplementation or dietary imbalance of elements can have significant adverse health effects. For example, excess intake of zinc or molybdenum can result in copper deficiency and excess assimilation of manganese can have serious neurotoxic effects that are expressed as Parkinson's-like disease.
Whole blood analysis is an excellent test for measuring the levels of both intracellular and extracellular circulating elements. Extracellular elements have functions in serum/plasma or are transported to tissues in serum/plasma associated with specific proteins or albumen. Intracellular elements have very specific functions as obligatory constituents of metalloproteins/enzymes in red blood cells and lymphocytes. The red and white blood cells serve as surrogate cells representative of peripheral cells in general. Some essential elements, such as selenium, are portioned in and have important physiological roles in both the intracellular and extracellular compartments. Likewise, the toxic metal lead is transported in both the fluid and cellular (red blood cells) compartments of blood. Therefore, measurement of elements in both blood compartments permits a more complete evaluation of total blood element levels.
Optimal range: 0 - 9 ug/L
Exposure to arsenic-laden drinking water can induce symptoms of gastroenteritis and lead to cancer, diabetes, and neurological and vascular dysfunction. Long-term arsenic exposure in drinking water shows a dose-response relationship to carotid atherosclerosis. The mechanism involves the induction of expression of genes coding inflammatory mediators. Arsenic has also been linked to dermatosis and cancers of the skin, bladder, and lung. Dietary arsenic is contributed by various foods including cereals and breads, 18.1%; starchy vegetables, 14.9%; and meats and fish, 32.1% of total average daily intake.
Optimal range: 0 - 4 ug/L
Barium is used in X-ray contrast media and in some salts for enemas. Many foods contain small concentrations of barium, and it responds somewhat like calcium, magnesium, and strontium to physiological controls. Symptoms of high barium include gastrointestinal complaints, muscle weakness, facial numbness, and hypotension. Treatments for high barium include oral sodium sulfate. Serum potassium levels should also be checked and treat hypokalemia, if present.
Optimal range: 0 - 1 ug/L
The principal organs most vulnerable to cadmium toxicity are kidney and lung. Environmental cadmium exposure is associated with renal tubular damage and high blood pressure. Cadmium toxicity impacts the kidney, where damage to proximal tubules has been described. Also, cadmium compounds are classified as carcinogenic to humans.
Associated conditions include:
→ Renal: hypertension, kidney failure
→ Neurological: loss of coordination, numbness of limbs, loss of hearing
Whole blood cadmium is indicative of recent exposure, and is therefore not reflective of total-body burden. Normal concentration of whole blood cadmium is up to 1 μg/L for nonsmokers, and up to 4 μg/L for smokers. Whole blood levels of 10 μg/L have been associated with renal dysfunction.
Optimal range: 4.8 - 7.1 mg/dL
Calcium is essential for bones and teeth, heart, nerves, muscles, and blood clotting. Calcium’s actions are as wide ranging as neuronal excitation, neurotransmitter release, innate immunity, hormonal secretion, and tone of smooth muscle cells in the vasculature, airways, uterus, gastrointestinal (GI) tract, and urinary bladder. Calcium deficiency can lead to osteoporosis. Other symptoms include musculoskeletal pain, muscle cramps, and tetany. Optimum calcium status can help prevent lead toxicity. Because calcium is high outside of the cell, calcium levels in erythrocytes are not a measurement of total body calcium status, but instead are a measure of cell membrane permeability. Erythrocyte calcium is a useful marker in the management of patients with hypertension and arrhythmias, renal failure, and even pre-menstrual syndrome. Treatment for high intracellular calcium includes magnesium, antioxidants, and fatty acids (to improve the integrity of the cell membrane).
Optimal range: 0.2 - 0.8 ug/L
Chromium, when measured in whole blood as part of a Toxic and Essential Elements panel, provides valuable insights into the body's chromium status, which is pivotal for various physiological functions. Chromium is a trace element essential for human health, primarily recognized for its role in enhancing the action of insulin, a hormone critical to the metabolism and storage of carbohydrate, fat, and protein. Its presence in whole blood reflects both recent dietary intake and the body's stores of the mineral. Chromium exists in several forms, but the trivalent chromium (Cr3+) is the biologically active form, considered safe and necessary for human health, while hexavalent chromium (Cr6+) is toxic and carcinogenic. The measurement of chromium in whole blood can be crucial for evaluating nutritional status, particularly in populations at risk of chromium deficiency, such as those with unbalanced diets, the elderly, and individuals with impaired glucose tolerance.
Optimal range: 0 - 0.8 ug/L
Cobalt (Co) is an essential trace element due to its well-known role in vitamin B12, important in hematopoiesis and thyroid function. The consequences of B12 deficiency are well known, including central nervous system complaints, pernicious anemia, and potentially fatal macrocytic anemia. Ingested cobalt is largely excreted in urine. Whole-blood cobalt was detected at approximately 0.17 μg/L in patients awaiting surgery. Toxicity may occur at cobalt intakes above 300 mg/d, although even therapeutic doses at 29.5 mg/d have been associated with toxicity, including goiter, hypothyroidism, and heart failure.
Optimal range: 70 - 140 ug/dL
Copper, a trace element, is a crucial component on a Toxic and Essential Elements panel when assessed in whole blood. It plays a vital role in numerous physiological processes, acting as a key cofactor in various enzymatic reactions. Copper is integral in the formation of red blood cells, the maintenance of healthy nerves and bones, and the absorption and utilization of iron. It also contributes to the synthesis of ATP, the body's primary energy currency, and is involved in the formation of connective tissue and the functioning of the immune system.
Optimal range: 0 - 3 ug/dL
Lead toxicity causes paralysis and pain in the extremities due to effects on demyelinization, axonal degeneration, and presynaptic block. Lead toxicity commonly affects sensory, visual, auditory, and cerebellar (coordination) functions, reflecting its impact on the nervous system. Normocytic, sideroblastic anemia is the consequence of lead’s inhibiting effects on enzymes in the heme biosynthesis pathway. Other clinical signs associated with lead toxicity are kidney damage, epigastric pain and nausea, and male and female reproductive failure. Hyperactivity, anorexia, decreased play activity, low intelligence quotient and poor school performance have been observed in children with high lead levels. Sources of lead include lead pipes, painted toys, some red lipsticks, lead paint or its dust, soil around old cars, old homes, or highways (past leaded gasoline contamination).
Optimal range: 0.4 - 20 ug/L
Lithium, a chemical element represented by the symbol Li, is both a therapeutic agent and a potential toxicant, prominently featured in Toxic and Essential Elements panels for whole blood testing. Medically, lithium is primarily used in the treatment of bipolar disorder, effectively stabilizing mood and reducing the extremes of mania and depression. In such therapeutic use, monitoring lithium levels in whole blood is crucial, as the therapeutic range is relatively narrow and closely borders on toxicity. Symptoms of lithium toxicity include nausea, tremors, confusion, and in severe cases, renal impairment and neurotoxicity. In a Toxic and Essential Elements panel, the concentration of lithium in the blood is measured to ensure it remains within a safe and effective range for patients undergoing lithium therapy.
Optimal range: 3 - 4.2 mg/dL
Magnesium, when measured in whole blood, is an essential element of the Toxic and Essential Elements panel, offering significant insights into a person's metabolic and physiological status. As an essential mineral, magnesium plays a pivotal role in over 300 enzymatic reactions within the human body, crucial for processes such as protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation. It also contributes to the structural development of bone and is required for the synthesis of DNA, RNA, and the antioxidant glutathione. The measurement of magnesium in whole blood provides a more comprehensive understanding of the body's magnesium status compared to serum magnesium levels, as it includes both intracellular and extracellular magnesium.
Optimal range: 4 - 22 ug/L
Manganese, a trace element found in whole blood, plays a pivotal role in human health and is measured in a Toxic and Essential Elements panel. As an essential nutrient, manganese is crucial for several biological processes, including bone formation, blood clotting, and immune response. It acts as a cofactor for various enzymes, notably those involved in metabolism and antioxidant defenses, such as superoxide dismutase, which protects cells from damage caused by free radicals. Despite its essentiality, manganese levels must be tightly regulated, as both deficiency and excess can lead to health issues.
Optimal range: 0 - 4.5 ug/L
Mercury intoxication is associated with a triad of symptoms: (1) mental changes, (2) spontaneous tremor and deficits in psychomotor performance, and (3) stomatitis and gingivitis. The toxic effects of mercury have been associated with neurological dysfunction, dementia, and autoimmune diseases. Although research suggests that the etiology of autism is multifactorial, numerous reports demonstrate that aspects of mercury toxicity appear similar to autism symptomatology.
According to the CDC, mercury released from amalgams may comprise up to 75% of an individual’s mercury exposure. Methylmercury from seafood is considered to be the most important source of non-occupational human mercury exposure. Blood mercury has revealed low level chronic and acute exposure from work environments. Significant exposure is evident when whole blood alkyl mercury is greater than 50 μg/L, or when inorganic mercury (Hg2+) exposure is greater than 200 μg/L. Children’s reference values for whole blood mercury from 1.5 to 1.0 μg/L have been proposed. Risk of Attention Deficit Hyperactivity Disorder (ADHD) was found to be nearly 10 times higher when blood mercury was above 29 nmol/L. The quantity of mercury assayed in blood and hair, but not urine, correlates with the severity of toxicity symptoms.
Optimal range: 0.3 - 2.5 ug/L
Molybdenum supplementation has been shown to reduce sulfite sensitivity, a condition marked by asthma, shortness of breath, edema, dermatitis, and possible anaphylaxis by increasing sulfite oxidase activity, in patients with low blood molybdenum. Frank molybdenum deficiency states are largely relegated to those on total parenteral nutrition, with symptoms including mental disturbance and coma. Blood and urine specimens have been used for direct molybdenum measurement, but they are mainly reflective of intake and have not been adequately evaluated.
Optimal range: 0 - 3 ug/L
Deficiency of nickel is associated with poor growth and reproductive dysfunction. Nickel has been shown to work in a cooperative way with calcium, iron, and zinc. Chronic exposure to some forms of nickel via inhalation is carcinogenic. Mucosal tissue irritation associated with nickel can manifest as asthma, rhinitis and sinusitis. Pulmonary inflammation may arise after breathing in nickel in the form of dust or smoke. Nickel toxicity may result in liver necrosis or carcinoma. Hypersensitivity reactions may occur with chronic nickel exposure.
Dermatitis is also associated with nickel worn as jewelry. Other sources of nickel include stainless steel, tobacco smoke, industrial exhaust fumes, batteries, as well as electronic and plating and mining industries. Urine and plasma have been used for assessing nickel exposure, although only acute exposure is revealed because nickel is rapidly cleared from blood.
Optimal range: 0 - 0.1 ug/L
Platinum and platinum alloys are used in surgical tools, laboratory utensils, dentistry, jewelry, silicone breast implants, electrical resistance wires, automobile catalytic converters, optical fibers, and liquid crystal display glass, especially for laptops. It is believed that automotive catalytic converters release platinum to the roadside environment. Platinum is used in some chemotherapy drugs, such as cisplatin, which is used to treat ovarian cancer. Workers in the following areas show the highest platinum levels: roadside maintenance, refineries, oncology wards, electronics plants, chemical plants, and jewelry production. Women with silicone breast implants have platinum exposure. One study showed a significant uptake of platinum from platinum-containing dental alloy restorations. The general population is at increasing risk of exposure to platinum because of the widespread use of catalytic converters and growing applications for platinum in various sectors of the economy.
Optimal range: 140 - 350 ug/L
Selenium, a trace element found in the whole blood, is a significant component of the Toxic and Essential Elements panel, offering vital insights into an individual's nutritional status and potential toxic exposure. As an essential micronutrient, selenium is crucial for various bodily functions, most notably its role in the synthesis of selenoproteins, which includes important antioxidant enzymes like glutathione peroxidases and thioredoxin reductases. These enzymes play a critical role in protecting cells from oxidative damage caused by free radicals, thereby contributing to immune system function and thyroid hormone metabolism. Selenium's optimal range in the body is narrow: both deficiency and excess can lead to health issues.
Optimal range: 10 - 45 ug/L
Strontium incorporates into hydroxyl crystal lattice of bone, stimulates new cortical and cancellous bone formation, and decreases bone resorption by inhibiting osteoclastic activity. There are a number of stable isotopes of strontium, including 84Sr, 86Sr, 87Sr, and 88Sr. Radioactive strontium, 90Sr, is a nuclear waste product and a human carcinogen. Serum strontium levels have been evaluated during therapy to establish GI absorption. Strontium has been shown to concentrate in hair with increased environmental exposure. Like calcium and magnesium, strontium is deposited in bone. Conversely, it is mobilized from bone when blood calcium levels fall.
Optimal range: 0 - 0.5 ug/L
Severe, painful neurological and gastrointestinal symptoms occur from thallium poisoning; alopecia is the most characteristic sign, as it is coupled with a black pigment at the hair root. Nausea, vomiting, and diarrhea have been reported. Thallium exposure may occur due to soil contamination with thallium-containing pesticides although they have been banned since 1972. Specimens used for thallium detection include urine, which is the main route of excretion, and hair. Blood levels have been measured, but thallium is rapidly cleared, so exposure must be acute to achieve accurate results. Treatment for high thallium levels include Prussian blue, DMSA, or activated charcoal for ingested thallium. BAL, D-penicillamine and EDTA are contraindicated.
Optimal range: 0 - 0.1 ug/L
Tungsten is found in electric lamps, television tubes, car distributors, electrical furnaces, and x-ray targets. It is used in metal evaporation work. Inhaled tungsten has been associated with pulmonary fibrosis, lung cancer, and neurosensory and cognitive deficits. Oral exposure is suspected to cause reproductive, neurological, and developmental effects.
Sources:
- Filaments for electric lamps, electron and television tubes, and for metal evaporation work.
- Electrical contact points for car distributors
- X-ray targets
- Windings and heating elements for electrical furnaces
- Missile and high-temperature applications
Optimal range: 0 - 0.1 ug/L
Uranium (U) is an abundant element on earth. Its widespread use in military and industry, including nuclear power, has increased human exposure. Uranium can be ingested or inhaled and is cleared in urine rapidly, although some will pool in bone and kidney tissues. Uranium toxicity in humans leads to renal damage. Lung cancer is commonly associated with inhaled uranium. Urine can be a sensitive specimen for uranium exposure, but assessment should be undertaken promptly. Intravenous sodium bicarbonate 1.4% has been used to treat uranium toxicity and inositol hexaphosphate has been used in animal studies.
Optimal range: 0.04 - 0.3 ug/L
Some studies suggest vanadium has a role in glucose and lipid metabolism, red blood cell formation, and thyroid function. Vanadium assessment and treatment may be indicated in cases of metabolic syndrome or non-insulindependent diabetes mellitus due to vanadium’s role in insulin sensitization. Symptoms that appear to be associated with excessive vanadium are hypertension, decreased coenzymes A and Q10, bipolar disorder, and disruption of energy metabolism. Exposure to vanadium in air or water is of concern for those exposed to vanadium industrial plants. Symptoms may include respiratory disorders, green tongue, high urinary excretion of vanadium, and reduced neurobehavioral abilities. Urine vanadium is traditionally used to assess occupational exposure. Whole blood vanadium has been shown to significantly differentiate children with vanadium exposure from non-exposed children but authors stated that hair levels of vanadium did not significantly correlate with vanadium exposure. This may have to do with distinction of acute versus chronic exposure.
Optimal range: 480 - 780 ug/dL
Zinc, a trace element found in nearly every cell of the human body, is an essential component measured in the Toxic and Essential Elements panel using a whole blood sample. This panel assesses the levels of various elements that are vital for health, as well as those that could be harmful in excess. Zinc's role in the body is multifaceted; it acts as a catalytic agent in over 300 enzymes, plays a critical role in protein synthesis, wound healing, DNA synthesis, and cell division. It is also crucial for proper immune system function and has a significant impact on the body's metabolic rate.
Essential Elements (Serum)
Serum elements are used to assess the status of key elements and electrolytes such as calcium, sodium, potassium and iron that have important functions in the extracellular fluid compartment of blood.
Useful for:
- Anemia
- Bone Density
- Cardiovascular Disease
- Dermatitis or Poor Wound Healing
- Fatigue
- Hypertension
- Impaired Glucose Tolerance
- Inflammation
- Kidney Function
- Nutritional Deficiencies
- Sexual Impotence or Decreased Testosterone Production
- Vision Problems
Optimal range: 8.9 - 10.3 mg/dL
Although 99% of calcium exists in bones and teeth, serum calcium (Ca) is of greatest clinical concern. Ca regulates transmission of nerve impulses, muscle contraction, coagulation, and numerous enzymatic reactions. The uptake and release of Ca from bone is regulated by parathyroid hormone, and serum Ca levels are inversely proportional to phosphorus levels. Low serum Ca results in muscle tetany while high Ca levels result in lowered neuromuscular excitability, muscle weakness, and other more complex symptoms. Marked variations in serum Ca may result from parathyroid gland or bone disease, poor diet/intestinal absorption of calcium (vitamin D), kidney disease, and other abnormalities.
Optimal range: 50 - 170 ug/dL
Measurements of non-heme, serum iron (Fe) are used in the diagnosis and treatment of diseases such as Fe deficiency anemia, Fe toxicity and acute or chronic hemochromatosis. The most comprehensive assessment of Fe status includes transferrin saturation and ferritin.
Optimal range: 1.7 - 2.5 mg/dL
Magnesium (Mg) is a major intracellular cation that is involved in over three hundred enzymatic reactions in the body. Little is known about the factors affecting serum Mg, but the parathyroid gland appears to be involved. Low serum Mg levels may be associated with poor diet/malabsorption, diabetes, hyperthyroidism, hypoparathyroidism, myocardial infarction, congestive heart failure, liver cirrhosis, alcoholism and diuresis. Increased serum Mg levels may be associated with renal failure, dehydration, severe diabetic acidosis, and Addison’s disease.
Optimal range: 2.5 - 4.5 mg/dL
Measurements of serum inorganic phosphorus (phosphate or PO4) are used in the diagnosis and treatment of disorders including parathyroid gland and kidney diseases, and vitamin D status. Serum PO4 is regulated by coordinated efforts of vitamin D and parathyroid hormone, and PO4 levels are inversely proportional to Ca levels. Low PO4 may be associated with fatigue, paresthesias and muscle weakness, while elevated PO4 may be associated with hypoparathyroidism, hyperthyroidism, hypocalcemia and tetany.
Optimal range: 3.5 - 5 mEq/L
Sodium (Na+) and potassium (K+) are electrolytes that affect most metabolic functions. They serve to maintain osmotic pressure and hydration of various body fluid compartments, body pH and regulation of heart and muscle functions. Electrolytes are also involved in oxidation-reduction reactions and participate in essential enzymatic reactions. Electrolytes can be affected by state of hydration. Hemolysis can result in falsely elevated K+.
Optimal range: 135 - 145 mEq/L
Sodium (Na+) and potassium (K+) are electrolytes that affect most metabolic functions. They serve to maintain osmotic pressure and hydration of various body fluid compartments, body pH and regulation of heart and muscle functions. Electrolytes are also involved in oxidation-reduction reactions and participate in essential enzymatic reactions. Electrolytes can be affected by state of hydration. Hemolysis can result in falsely elevated K+.
Cytokine Response Profile (CytoDx), Diagnostic Solutions
Alterations in the immune system that result in chronic inflammation and autoimmunity have been linked to a wide range of health conditions and diseases. Cytokines are important mediators of many immune responses, and imbalances in cytokines have been shown to play key roles in chronic inflammation and autoimmunity. Most cytokines can be generally characterized as pro-inflammatory or anti-inflammatory, depending on their primary effects on immune responses. Immune responses are often further characterized by the type of T helper (Th) cell involved.
Optimal range: 0 - 3 Units
GM-CSF stands for Granulocyte-Macrophage Colony-Stimulating Factor. It is one of the cytokines evaluated in the CytoDx Cytokine Response Profile test offered by Diagnostic Solutions Laboratory.
Cytokines are critical mediators of immune responses, and their imbalances have been linked to chronic inflammation and autoimmunity, which can play key roles in various health conditions and diseases.
GM-CSF is classified as a pro-inflammatory cytokine. It is involved in stimulating the production of granulocytes and macrophages from precursor cells, promoting their proliferation, differentiation, and activation. GM-CSF plays a crucial role in various immune responses and has implications in inflammation and autoimmune conditions.
Optimal range: 0 - 5 Units
IFN gamma refers to Interferon-gamma. Interferon-gamma is one of the cytokines assessed in the CytoDx Cytokine Response Profile offered by Diagnostic Solutions Laboratory. Cytokines are important mediators of immune responses, and their imbalances have been linked to chronic inflammation and autoimmune diseases.
IFN gamma is categorized as a pro-inflammatory cytokine and is associated with Th1 cell responses. Th1 cells are involved in cellular immunity and play a critical role in defense against intracellular pathogens, such as viruses and certain bacteria. Interferon-gamma is a key cytokine produced by Th1 cells and is essential for activating immune responses against these intracellular pathogens.
Optimal range: 0 - 4.9 Units
IL-1 beta refers to Interleukin-1 beta. Interleukin-1 beta is one of the cytokines assessed in the CytoDx Cytokine Response Profile offered by Diagnostic Solutions Laboratory. Cytokines are critical mediators of immune responses, and their imbalances have been linked to chronic inflammation and autoimmune diseases.
Optimal range: 0 - 2 Units
Optimal range: 0 - 3 Units
Optimal range: 0 - 5 Units
Optimal range: 0 - 2 Units
Optimal range: 0 - 1.9 Units
Optimal range: 0 - 19 Units
Optimal range: 0 - 12 Units
Optimal range: 0 - 2 Units
Optimal range: 0 - 1 Units
Optimal range: 0 - 1.8 Units
Optimal range: 0 - 8.2 Units
Optimal range: 0 - 27.8 Units
Optimal range: 0 - 35.2 Units
Optimal range: 26460.9 - 96117.3 Units
T-Cell-Specific Protein RANTES is chemotactic for T-cells, human eosinophils and basophils and plays an active role in recruiting leukocytes into inflammatory sites. It also activates the release of proteins from eosinophils such as eosinophilic cationic protein. It changes the density of eosinophils and makes them hypodense, which is thought to represent a state of generalized cell activation and is associated most often with diseases such as asthma and allergic rhinitis.
Optimal range: 0 - 22 Units
TNF-alpha is an important protein in your immune system that plays a big role in inflammation and overall health. It's part of a CYTOKINES Panel and helps your body respond to injuries, infections, and other issues.
TNF-alpha is made by immune cells like macrophages and T-cells when your body is fighting something, such as an infection or inflammation. It helps:
240 Food Panel: IgA, IgG, IgG4 (US BioTek)
Food sensitivities are recognized to be correlated with many chronic health conditions, such as IBS, eczema, fatigue, and others - but with proper identification and elimination of offending foods, many experience relief from their symptoms.
Food sensitivities are inflammatory responses of the immune system triggered by food allergens. Unlike food allergies, the symptoms of a food sensitivity often occur hours or even days after exposure, making it difficult to pinpoint the specific offending food(s). This delayed reaction is what causes the majority of the 12 million people estimated to suffer from food sensitivities unaware and blame things like aging for their chronic symptoms.
Testing for food sensitivities streamlines the process of identifying triggering foods, providing clear evidence and guidance to begin the healing process and start improving symptoms.
IgG is an antibody that can activate the pro-inflammatory complement system (complement cascade) associated with chronic inflammatory conditions. High levels of IgG (class II or higher) overload receptors and drive the inflammatory reaction while low levels of IgG (class 0/I) indicate tolerance.
IgG4 is an antibody which in most people does not activate the complement system, but instead is a blocking antibody for IgE. The presence of IgG4 is protective, not inflammatory, as IgG4/IgE binding tends to decrease IgE hypersensitivity (true allergy). If IgG4 is high, testing for IgE reactivity is advised and it may be best to remove the food from the diet permanently.
Independent increases in IgG4 only can be associated with certain autoimmune conditions such as eosinophilic esophagitis.
IgA is an antibody that can activate the pro-inflammatory complement system. Unlike Secretory IgA (sIgA) in stool, which is two IgA molecules bound together and secreted into the gut, serum IgA levels are associated with allergies and asthma. A Serum IgA reaction to food triggers can indicate foods that are irritating the lining of the gut.
Conditions and symptoms commonly associated with food sensitivity:
Brain Fog, Bloating, Weight Gain, Mood Swings, Joint Pain/Inflammation, Constipation, Diarrhea, Bronchitis, Crohn’s disease, Eczema, Migraines, GI distress, Stomach pain, Acne, ADD/ADHD, Autism, Sinus issues, Depression.
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
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Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
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Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
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Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
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Reference range: Very Low, Low, Moderate, High, Very High
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Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Reference range: Very Low, Low, Moderate, High, Very High
Allergens w/ Total IgE Area 2
Detect possible allergic responses to various substances in the environment and evaluate for hay fever, asthma, atopic eczema, and respiratory allergy. The quantitative allergen-specific IgE test is indicated
(1) to determine whether an individual has elevated allergen-specific IgE antibodies;
(2) if specific allergic sensitivity is needed to allow immunotherapy to be initiated;
(3) when testing individuals for agents that may potentially cause anaphylaxis;
(4) when evaluating individuals who are taking medication (eg, long-acting antihistamines) that may interfere with other testing modalities (eg, skin testing);
(5) if immunotherapy or other therapeutic measures based on skin testing results have not led to a satisfactory remission of symptoms;
(6) when an individual is unresponsive to medical management where identification of offending allergens may be beneficial.
Optimal range: 6 - 495 IU/ml
In the blood of healthy people, IgE antibodies make up less than 0.001% of all immunoglobulins. These IgE antibodies are key in triggering allergic responses when people sensitive to allergens come into contact with them.
Structurally, IgE resembles other antibodies, having two light chains and two heavy chains. The heavy chains have a special region that determines the antibody's specificity to antigens. Measuring IgE levels is clinically significant mainly because of its role in allergic reactions, even though IgE myeloma is a very rare condition.
Reference range: Class 0 (0-0.10 kU/L), Class 0/I (0.10-0.31 kU/L), Class I (0.32-0.55 kU/L), Class II (0.56-1.40 kU/L), Class III (1.41-3.90 kU/L), Class IV (3.91-19.00 kU/L), Class V (19.01-100 kU/L), Class VI (>100 kU/L)
Alternaria alternata is one of the most common fungi associated with asthma. Not only the presence of asthma but also persistence and severity of asthma have been strongly associated with sensitization and exposure to A alternata. Although exposure to Alternaria is an important risk factor for asthma, few studies have assessed exposure to this fungus in indoor environments.
A alternata, a cosmopolitan saprophyte commonly found in soil and plants, is usually considered an outdoor allergen.
Although most intense exposure is likely to occur outdoors, Alternariaand other allergenic fungi are also found in indoor environments.
Reference range: Class 0 (0-0.10 kU/L), Class 0/I (0.10-0.31 kU/L), Class I (0.32-0.55 kU/L), Class II (0.56-1.40 kU/L), Class III (1.41-3.90 kU/L), Class IV (3.91-19.00 kU/L), Class V (19.01-100 kU/L), Class VI (>100 kU/L)
The marker "M010-IgE Stemphylium herbarum" refers to a specific immunoglobulin E (IgE) test used to detect sensitivity or allergic reactions to the mold Stemphylium herbarum. Stemphylium herbarum is a common fungus found in various environments, including outdoor locations such as soil, decaying plant material, and dead leaves. This mold species is prevalent during late summer and fall, particularly in temperate and humid climates. It can release spores into the air, which can be inhaled by individuals, potentially triggering an allergic response in susceptible people. The M010-IgE test measures the level of specific IgE antibodies in the blood that are directed against Stemphylium herbarum. Elevated levels of these antibodies indicate that the immune system is sensitized to this particular mold, meaning that exposure to it may cause allergic symptoms. Symptoms can range from mild to severe and may include sneezing, runny or stuffy nose, itchy eyes, coughing, wheezing, and other respiratory issues. In some cases, exposure can also aggravate asthma or other chronic respiratory conditions.
Reference range: Class 0 (0-0.10 kU/L), Class 0/I (0.10-0.31 kU/L), Class I (0.32-0.55 kU/L), Class II (0.56-1.40 kU/L), Class III (1.41-3.90 kU/L), Class IV (3.91-19.00 kU/L), Class V (19.01-100 kU/L), Class VI (>100 kU/L)
Oak (genus Quercus) comprises roughly 450 different species of ornamental and timber trees and shrubs. Shedding substantial amounts of pollen that spreads via wind, oaks are commonly allergenic and may cause severe reactions. Widely distributed throughout the Northern Hemisphere, oaks produce pollen that is a major cause of hay fever (i.e., allergic rhinitis) symptoms.
Residing in urban, residential, and forest areas, oak trees are scattered across North America, the West Indies, Central America, Eurasia, and portions of Africa and South America.
NutriStat
The NutriStat Profile is a cutting-edge diagnostic test designed to optimize your nutritional and metabolic health through a simple blood and urine sample. This comprehensive test evaluates a wide range of biomarkers, offering valuable insights into areas such as metabolic health, thyroid function, cardiovascular health, and hormonal balance. By identifying functional nutritional needs, the NutriStat profile empowers individuals to take proactive steps toward better health and disease prevention.
The NutriStat Profile analyzes key biochemical markers to provide a detailed overview of your body’s nutritional and functional status. It covers:
The NutriStat Profile is ideal for individuals with a variety of health concerns or those seeking to optimize their overall wellness. It is especially beneficial for:
The NutriStat Profile goes beyond standard testing by integrating a diverse range of biomarkers, enabling a holistic understanding of your health. Key benefits include:
This versatile test is highly applicable for individuals with diverse health conditions, including:
Using a simple blood and urine sample, the NutriStat Profile evaluates multiple biomarkers across key health domains. By combining advanced testing methods, this profile identifies imbalances that may not be evident through standard tests, empowering individuals to take control of their health.
The NutriStat Profile is more than just a test—it’s a pathway to better health. Whether you’re addressing specific health concerns or seeking to enhance your overall wellness, this comprehensive assessment provides the tools needed to make informed, proactive health decisions.
Take the first step toward better health today by consulting your healthcare provider about the NutriStat Profile.
Optimal range: 5 - 25 %
The marker % Free Copper on a Nutristat test signifies the proportion of unbound or available copper in the bloodstream. This measurement helps assess the balance between free copper and the copper bound to proteins like ceruloplasmin.
Abnormalities in % Free Copper levels can indicate imbalances in copper metabolism and potential health issues, such as Wilson's disease or other copper-related disorders. Nutristat tests, which assess copper, zinc, and related ratios, aid in evaluating nutritional and metabolic aspects related to these essential minerals.
Optimal range: 50 - 200 nmol/L
Optimal range: 37.5 - 188 pmol/L
Activated Vitamin B12, also known as holotranscobalamin (holo-TC), is a significant biomarker for Vitamin B12 status in the body. Unlike total B12, which measures both active and inactive forms, holo-TC specifically indicates the amount of Vitamin B12 that is available for cellular uptake and use. This makes it a more precise marker for assessing B12 deficiency, especially in clinical situations where accurate diagnosis is crucial.
Optimal range: 0 - 4.07 ug/mgCR
Dietary fatty acids are metabolized into fuel sources using beta-oxidation. Fatty acid conversion into Acetyl-CoA requires transport across the mitochondrial membrane via the carnitine shuttle. When beta-oxidation is impaired, fats are metabolized using an alternate pathway called omega-oxidation. Omega-oxidation results in elevated levels of dicarboxylic acids such as adipic acid and suberic acid. Impaired beta-oxidation occurs in carnitine deficiency or enzymatic dysfunction due to lack of nutrient cofactors. Vitamin B2 and magnesium play a role in optimizing beta-oxidation.
Optimal range: 33 - 48 g/L
Optimal range: 30 - 110 units/L
Optimal range: 10 - 50 units/L
Optimal range: 8 - 16 mmol/L
Optimal range: 0 - 115 IU/ml
Optimal range: 1.1 - 1.8 g/L
Apolipoprotein A is a protein carried in HDL ("good") cholesterol. It helps start the process for HDL to remove bad types of cholesterol from your body. In this way, apolipoprotein A can help to lower your risk for cardiovascular disease. Apolipoprotein A levels can be measured. But it's more common to measure the HDL and LDL ("bad") cholesterol when looking at cardiovascular risk.
This biomarker is useful for:
- Evaluating risk for atherosclerotic cardiovascular disease
- Aiding in the detection of Tangier disease
Optimal range: 0.7 - 1.2 g/L
Optimal range: 0.9 - 135 ug/mgCR
Ascorbic Acid is a natural water-soluble vitamin (Vitamin C). Ascorbic acid is a potent reducing and antioxidant agent that functions in fighting bacterial infections, in detoxifying reactions, and in the formation of collagen in fibrous tissue, teeth, bones, connective tissue, skin, and capillaries.
Optimal range: 10 - 50 units/L
Optimal range: 2.1 - 12.2 umol/L
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA. Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys. β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 20 - 32 mmol/L
Optimal range: 0 - 20 umol/L
Optimal range: 260 - 740 pmol/L
Optimal range: 95 - 110 mmol/L
Optimal range: 0 - 5.5 mmol/L
Your total cholesterol score is calculated using the following equation: HDL + LDL + 20 percent of your triglyceride level.
With HDL cholesterol, higher levels are better. Low HDL cholesterol puts you at a higher risk for heart disease. With LDL cholesterol, lower levels are better. High LDL cholesterol puts you at a higher risk for heart disease.
Optimal range: 0.8 - 1 Ratio
Optimal range: 5 - 65 ng/mL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 60 - 110 umol/L
Optimal range: 0.06 - 0.13 mmol/L
Optimal range: 2.7 - 9.2 umol/L
Optimal range: 0 - 0 pmol/L
Optimal range: 0 - 2.83 ug/mgCR
Ethylmalonate, together with Adipate and Suberate, gives information about your ability to process fatty acids.
Optimal range: 30 - 400 ug/L
Protein that stores iron. Red blood cells need iron to carry oxygen around the body such as the liver, bone marrow, and muscles. An indirect marker of the total amount of iron stored in the body; hence, serum ferritin is used as a diagnostic test for iron- deficiency anemia.
Optimal range: 2 - 4.5 g/L
Optimal range: 3.1 - 6.8 pmol/L
Optimal range: 12 - 22 pmol/L
T4 (thyroxine) is the predominant hormone produced by the thyroid gland. It is an inactive hormone and is converted into its active form, T3 within cells. Free T4 is the non-bound fraction of the total T4 circulating in the blood.
Optimal range: 1.2 - 2.2 Ratio
The FT3 (Free Triiodothyronine) to Reverse T3 (rT3) ratio is a crucial biomarker for assessing thyroid function, particularly in the context of thyroid hormone metabolism and the body’s overall metabolic state. Triiodothyronine (T3) is the active form of thyroid hormone, essential for regulating metabolism, energy production, and numerous physiological processes. In contrast, Reverse T3 (rT3) is an inactive form produced when the body converts thyroxine (T4) into a metabolically inactive state. The FT3 to rT3 ratio provides insight into how effectively the body is converting T4 into its active form (T3) versus its inactive form (rT3), serving as an indicator of various health conditions and metabolic states.
Optimal range: 5 - 50 units/L
Optimal range: 26 - 39 g/L
Optimal range: 3 - 5.4 mmol/L
What is Glucose?
A blood sugar test measures the amount of a sugar called glucose in a sample of your blood. Glucose (also known as blood sugar) is a major source of energy for most cells of the body, including brain cells. Glucose is a building block for carbohydrates. Carbohydrates are found in fruit, cereal, bread, pasta, and rice. Carbohydrates are quickly turned into glucose in your body. This can raise your blood glucose level. A hormone called insulin helps move glucose from your bloodstream into your cells. Elevated fasting blood glucose is often a sign of Type 2 diabetes. Very high glucose levels, whether fasting or not, usually indicate Type 1 diabetes.
Glucose is often part of a regular blood test called the comprehensive metabolic panel (CMP).
Optimal range: 0.3 - 1.2 ug/mgCR
Glutaric Acid is formed from the essential amino acids lysine and tryptophan through the intermediaries of alpha ketoadipic acid and glutaryl-CoA. Glutaryl-CoA is further metabolized to glutaconyl- and crotonyl-CoA by an enzyme called glutaryl-CoA dehydrogenase. This enzyme requires riboflavin (vitamin B2) as a cofactor.
Optimal range: 207 - 617 umol/L
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine. It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins. Glycine is a major collagen and elastin component, which are the most abundant proteins in the body. Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Optimal range: 0.9 - 2 mmol/L
Optimal range: 0 - 5 mg/L
Optimal range: 0 - 237 ug/mgCR
Microbes resident in the large intestine of the human body help to break down complex aromatic compounds in dietary plant matter (polyphenols), freeing up benzoic acid, which enters the bloodstream. The liver can add the amino acid glycine to benzoic acid to form hippuric acid, which re-enters the blood and is absorbed by the kidneys. As a result, the kidneys excrete hundreds of milligrams of hippuric acid into the urine every day.
Optimal range: 5 - 15 umol/L
Optimal range: 0.2 - 0.4 umol/L
Hydroxylysine is an amino acid related to collagen.
What is collagen?
Collagen is the most abundant protein in your body. It is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin and muscles.
Optimal range: 10.3 - 39 umol/L
- Hydroxyproline is the key factor in stabilizing collagens.
- Hydroxyproline is abundant in meat and low in plant-based foods. Meat intake increases levels of proline and hydroxyproline.
- Increased hydroxyproline has been found in collagen catabolism (bone resorption, increased reactive oxygen species [ROS]), tissue degradation, muscle damage, or other conditions such as Paget's disease or Alzheimer's disease.
- Proline and hydroxyproline both negatively correlated with a higher likelihood of anxiety, depression, and psychoses.
Optimal range: 0.1 - 0.6 mmol/L
IDL Cholesterol is a plasma lipoprotein. Cholesterol and triglycerides are insoluble in water and therefore these lipids must be transported in association with proteins. Lipoproteins are complex particles with a central core containing cholesterol esters and triglycerides surrounded by free cholesterol, phospholipids, and apolipoproteins, which facilitate lipoprotein formation and function.
Optimal range: 0.1 - 0.4 mmol/L
IDL Cholesterol is a plasma lipoprotein. Cholesterol and triglycerides are insoluble in water and therefore these lipids must be transported in association with proteins. Lipoproteins are complex particles with a central core containing cholesterol esters and triglycerides surrounded by free cholesterol, phospholipids, and apolipoproteins, which facilitate lipoprotein formation and function.
Optimal range: 0.1 - 0.6 mmol/L
IDL Cholesterol is a plasma lipoprotein. Cholesterol and triglycerides are insoluble in water and therefore these lipids must be transported in association with proteins. Lipoproteins are complex particles with a central core containing cholesterol esters and triglycerides surrounded by free cholesterol, phospholipids, and apolipoproteins, which facilitate lipoprotein formation and function.
Optimal range: 15 - 160 ug/L
Iodine is an essential mineral that plays a crucial role in thyroid function. The thyroid gland uses iodine to produce thyroid hormones, which are responsible for controlling growth, repairing damaged cells, and supporting a healthy metabolism.
Optimal range: 5 - 30 umol/L
Reference range: TYPE A, TYPE B
Optimal range: 0 - 3.4 mmol/L
Low-density lipoprotein cholesterol (LDL-C), or “bad” cholesterol, is known to increase risk of heart attack and stroke when levels become elevated in the blood. LDL-C is measured as a part of a lipid profile, which is used to determine your risk for developing cardiovascular disease. LDL-C can usually be controlled through a combination of lifestyle changes.
Optimal range: 0 - 3.6 Ratio
Optimal range: 0 - 75 nmol/L
Optimal range: 0.1 - 1.5 mmol/L
Optimal range: 0.1 - 0.8 mmol/L
Optimal range: 0 - 0.2 mmol/L
Optimal range: 0 - 0.01 mmol/L
Optimal range: 0 - 0.01 mmol/L
Optimal range: 0 - 0.01 mmol/L
Optimal range: 0 - 0.01 mmol/L
Optimal range: 268 - 500 Angstrom
The mean particle size in a lipid or metabolic profile provides important information about the type of lipoprotein particles present in the blood, which has implications for cardiovascular risk and overall metabolic health. This marker is increasingly being recognized as a crucial component in comprehensive cardiovascular risk assessment.
Optimal range: 0 - 2 ug/L
SOURCES:
Mercury (Hg) has three forms:
Elemental (metallic)- older glass thermometers, fluorescent light bulbs, dental amalgams, folk remedies, combustion, electrical industry (switches, batteries, thermostats), solvents, wood processing
Organic (methyl mercury)- seafood, thimerosal (preservative), fungicides
Inorganic- skin lightening compounds, industrial exposure, folk medicine, lamps, photography, disinfectants
Optimal range: 0 - 4 mmol/L
Your non-HDL cholesterol result refers to your total cholesterol value minus your HDL cholesterol. Your lipid panel results normally include four numbers:
- low-density lipoprotein (LDL) cholesterol;
- high-density lipoprotein (HDL) cholesterol;
- triglycerides; and
- total cholesterol.
Optimal range: 0.4 - 0.5 Ratio
The Omega-3/Omega-6 ratio signifies the balance between omega-3 and omega-6 fatty acids in one's diet. Omega-3 and omega-6 are essential fatty acids with distinct roles in the body. A balanced ratio is important for overall health. An imbalanced ratio, often seen in modern diets rich in processed foods, can contribute to inflammation and various chronic diseases. The ratio's importance lies in its impact on inflammation levels, cardiovascular health, and other bodily processes. Monitoring and maintaining an appropriate Omega-3/Omega-6 ratio can support optimal health and well-being.
Optimal range: 3.5 - 5.2 mmol/L
Optimal range: 0.2 - 0.5 nmol/L
Progesterone – NutriStat Hormone Health Panel
Progesterone is a key hormone that helps regulate the menstrual cycle, supports fertility, and balances estrogen levels—especially in women. It's primarily produced by the ovaries after ovulation and in smaller amounts by the adrenal glands in both sexes. In pregnancy, progesterone levels naturally rise to support fetal development.
On the NutriStat Hormone Health Panel, progesterone is measured to assess overall hormone balance.
In Women (non-pregnant):
Slightly high progesterone levels may occur during the luteal phase of the menstrual cycle, after ovulation, or if you're taking hormone therapy or certain supplements. In rare cases, elevations may be linked to ovarian cysts or adrenal gland issues.
In Men:
Men produce low levels of progesterone to support sperm development and testosterone regulation. Slight elevations can result from adrenal overactivity, testicular conditions, or use of progesterone creams/supplements.
While low progesterone is more commonly associated with symptoms like irregular periods or mood changes, slightly elevated levels aren’t always cause for concern. Context matters—such as where you are in your cycle (for women), medication use, or overall hormone patterns. Always review your results with a healthcare provider to determine what’s normal for your body and whether further evaluation is needed.
Optimal range: 60 - 80 g/L
Optimal range: 0.45 - 1.25 Ratio
Optimal range: 230 - 540 pmol/L
Optimal range: 190 - 500 ug/L
Selenium is an essential element. It is a cofactor required to maintain activity of glutathione peroxidase (GSH-Px), an enzyme that catalyzes the degradation of organic hydroperoxides. The absence of selenium correlates with loss of GSH-Px activity and is associated with damage to cell membranes due to accumulation of free radicals.
Optimal range: 6 - 45 nmol/L
Optimal range: 18 - 54 nmol/L
Optimal range: 135 - 145 mmol/L
Optimal range: 0 - 2.9 ug/mgCR
Dietary fatty acids are metabolized into fuel sources using beta-oxidation. Fatty acid conversion into Acetyl-CoA requires transport across the mitochondrial membrane via the carnitine shuttle. When beta-oxidation is impaired, fats are metabolized using an alternate pathway called omega-oxidation. Omega-oxidation results in elevated levels of dicarboxylic acids such as adipic acid and suberic acid. Impaired beta-oxidation occurs in carnitine deficiency or enzymatic dysfunction due to lack of nutrient cofactors. Vitamin B2 and magnesium play a role in optimizing beta-oxidation.
Optimal range: 8.6 - 29 nmol/L
Optimal range: 0 - 35 IU/ml
Optimal range: 16 - 20.6 %
Having high levels of Total Omega 9 Fatty Acids is generally considered beneficial for health. Omega-9 fatty acids are monounsaturated fats that are nonessential, meaning your body can produce them. They are often found in foods like olive oil, avocados, and nuts. Omega-9 fatty acids have been associated with potential roles in reducing inflammation and promoting heart health. While they are nonessential, incorporating sources of omega-9 fats into your diet can be advantageous, especially when replacing saturated fats. High levels of omega-9s are generally preferred as they are considered beneficial for overall well-being, particularly heart health. However, it's important to maintain a balanced diet and consider factors such as overall fat intake and the types of fats consumed.
Optimal range: 0.1 - 2.45 %
Palmitoleic acid (POA) is a monounsaturated omega-7 fatty acid (16:1n7).
The main dietary sources of palmitoleic acid include dairy products, avocado oils, oily fish, and macadamia nuts. Macadamia nuts contain the cis- isomer of POA, while dairy products mainly contain the trans- isomer. Like many fatty acids, POA can also be endogenously made from the breakdown of triglycerides, the desaturation of palmitic acid, or de novo synthesis from carbohydrates. POA is an important signaling lipokine, produced mainly by white adipose tissue, that regulates important metabolic processes such as skeletal muscle glucose disposal, insulin sensitivity, and hepatic lipid deposition. It is also a modulator of adipocyte lipolysis, however, studies are mixed as to POA’s specific role in obesity. Epidemiologic studies show that circulating POA levels are involved in cholesterol metabolism and hemostasis, though the results are mixed as to their specific cardiovascular outcomes.
Optimal range: 1.8 - 3.5 g/L
Optimal range: 15 - 45 %
Optimal range: 0 - 2 mmol/L
Optimal range: 0.5 - 5 mIU/L
Optimal range: 0 - 1.8 IU/L
Optimal range: 3.5 - 8 mmol/L
Optimal range: 0.1 - 0.6 mmol/L
What is VLDL?
VLDL stands for very-low-density lipoprotein. Your liver makes VLDL and releases it into your bloodstream. The VLDL particles mainly carry triglycerides, another type of fat, to your tissues. VLDL is similar to LDL cholesterol, but LDL mainly carries cholesterol to your tissues instead of triglycerides.
VLDL and LDL are sometimes called "bad" cholesterols because they can contribute to the buildup of plaque in your arteries. This buildup is called atherosclerosis. The plaque that builds up is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, the plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your body. It can lead to coronary artery disease and other heart diseases.
A normal VLDL level is below 30 mg/dL. Your healthcare provider can measure your VLDL cholesterol through a simple blood test. If your VLDL is high, lifestyle changes and medication can help.
AVISE CTD
Accurate and Early Diagnosis for Lupus and Connective Tissue Disease.
Connective tissue diseases (CTDs) can be very hard to diagnose early because symptoms can be vague, inconsistent and/or attributed to other illnesses.
AVISE CTD combines AVISE Lupus, a 10-marker diagnostic test designed to help rule-in or rule-out lupus, with an expanded connective tissue disease panel to aid in the differential diagnosis of other connective tissue diseases.
When combined with your provider's clinical assessment, AVISE CTD can provide the information necessary to help make the right diagnosis. If you're ready to start dealing with the real cause of your symptoms don't wait. Request your AVISE CTD conversation guide to help you speak to your provider about the AVISE CTD test.
Reference range: Negative, Positive
Antinuclear antibody (ANA) testing is used in the diagnostic evaluation of various autoimmune diseases, including connective tissue diseases such as systemic lupus erythematosus (SLE), Sjögren syndrome, and systemic sclerosis (SSc).
Initial testing for autoimmune connective tissue diseases (also referred to as systemic autoimmune rheumatic diseases, or SARDs) should include tests for C-reactive protein (CRP), ANAs, rheumatoid factor, and cyclic citrullinated peptide antibodies.
If ANA results are positive, follow-up or confirmatory testing may be guided by the pattern(s) observed and/or the patient’s clinical presentation.
Reference range: Negative, Positive, Strong Positive
ANA IFA is a first line screen for detecting the presence of up to approximately 150 autoantibodies in various autoimmune diseases. A positive ANA IFA result is suggestive of autoimmune disease and reflexes to titer and pattern. Further laboratory testing may be considered if clinically indicated.
Reference range: Negative, Equivocal, Positive
Associated Disease: Hashimoto’s Thyroiditis & Graves’ Disease
Sensitivity: 60-85%
Interpretation: Anti-thyroglobulin antibodies are found in 60-85% of patients with Hashimoto’s thyroiditis and 30-80% of patients with Graves’ disease.
Total Tox-Burden
The Total Tox Burden panel is a comprehensive test that screens for three major categories of toxins that can affect health: environmental toxins, mycotoxins (mold toxins), and heavy metals. By combining these into one test, it gives a broader picture of your body’s toxic load.
Mycotoxins: Detects 31 mold toxins that can come from water-damaged buildings, contaminated food, or environmental exposure. Mycotoxins can affect the immune system, energy levels, and overall health.
Heavy Metals: Screens for 20 common heavy metals such as mercury, lead, and arsenic. These metals can accumulate in the body over time and may contribute to fatigue, cognitive changes, or organ stress. This test can be done with or without a provocation method.
Environmental Toxins: Looks for chemicals from plastics, pesticides, and industrial pollutants that are often encountered in daily life. These toxins may disrupt hormones, metabolism, and cellular health.
Everyday exposures—from food and water to household products and the environment—can build up in the body. High toxin levels may be linked to fatigue, brain fog, immune issues, and chronic health conditions. The Total Tox Burden test helps you and your healthcare provider identify whether toxins may be contributing to your symptoms and guide strategies for detoxification and prevention.
Optimal range: 0 - 7.9 ug/g
DDT, a persistent organic pollutant once commonly used as a pesticide for controlling malaria and typhus, metabolizes in humans to produce 2,2-bis (4-chlorophenyl) acetic acid (DDA), the primary urinary metabolite and potential exposure biomarker. DDT readily adsorbs to soils and sediments, which can serve as both sinks and long-term sources of exposure. As an endocrine disruptor, DDT poses significant health risks, potentially disrupting semen quality, menstruation, gestational length, and lactation duration, and accumulating in lipid-rich areas of the body, affecting reproductive capabilities and fetal development. It is also likely a human carcinogen, particularly linked to breast cancer. DDE, another DDT metabolite, is excreted as DDA in the urine. Humans can absorb DDT through inhalation of gaseous and particulate phases, direct dermal contact, ingestion of contaminated substances, and exposure to contaminated soil or products. To detoxify, sweating induced by infrared and steam sauna sessions can help eliminate DDT from the body by excreting it through the skin.
Optimal range: 0 - 0.5 ug/g
2,4-Dichlorophenoxyacetic Acid (2,4-D) is one of the most widely used herbicides globally, commonly applied in agriculture and landscaping. Exposure to this chemical—especially at chronic low levels—has been linked to potential health concerns, including endocrine disruption, reproductive and developmental effects, and an increased risk of non-Hodgkin lymphoma.
While the metabolism of 2,4-D in humans is not well-characterized, studies in animals show that it undergoes conjugation processes such as glucuronidation and sulfation. These metabolic pathways help transform 2,4-D into more water-soluble forms that are ultimately excreted in the urine.
Optimal range: 0 - 208 Units
2,3,4-Methylhippuric Acid (2,3,4-MHA) is a metabolite of xylene, a solvent commonly used in industrial and commercial products like paints, varnishes, adhesives, and gasoline. Elevated levels of 2,3,4-MHA in urine typically indicate significant exposure to xylene, especially in occupational settings such as paint manufacturing, chemical production, and printing. Environmental exposure can also occur in areas with high vehicular emissions or nearby industrial activities, while consumer product exposure may happen through the use of xylene-containing products like solvents and cleaning supplies. Chronic or prolonged exposure to xylene, reflected by elevated 2,3,4-MHA levels, can lead to neurotoxic effects, including headaches, dizziness, and memory issues, as well as respiratory symptoms like coughing and shortness of breath. Long-term exposure can also result in liver and kidney damage, and may affect cardiovascular health, potentially causing changes in heart rate and blood pressure. Additionally, xylene exposure has been linked to reproductive health concerns, including potential birth defects or developmental delays in infants. Monitoring 2,3,4-MHA levels is crucial for identifying individuals at risk and taking preventive measures to reduce exposure in both occupational and environmental contexts.
Optimal range: 0 - 1.7 ug/g
Optimal range: 0 - 795 ug/g
2-Hydroxyisobutyric acid is formed endogenously as a product of branched-chain amino acid degradation and ketogenesis. This compound is also the major metabolite of gasoline octane enhancers such as MTBE and ETBE.
MTBE and ETBE are gasoline additives used to improve octane ratings. Exposure to these compounds is most likely due to groundwater contamination, inhalation or skin exposure to gasoline or its vapors, and exhaust fumes. MTBE has been demonstrated to cause hepatic, kidney, and central nervous system toxicity, peripheral neurotoxicity, and cancer in animals. Very high values have been reported in genetic disorders. Because the metabolites of these compounds are the same, ETBE may be similarly toxic.
Optimal range: 0 - 77.9 ug/g
2-Methylhippuric Acid (2MHA) is a substance your body makes when it breaks down xylene, a chemical solvent commonly found in paints, glues, cleaning products, pesticides, perfumes, and fuels. Testing urine for 2MHA is a simple way to check for recent xylene exposure.
A “Moderate” result for 2-Methylhippuric Acid (2MHA) in urine suggests xylene exposure above baseline but not in the high or critical range. This usually reflects recent or ongoing contact with products containing xylene—such as paints, solvents, fuel, or industrial fumes—rather than severe or acute poisoning.
Levels are above the optimal or expected range but below those linked with high risk or acute toxicity.
May indicate regular or occupational exposure rather than accidental overexposure.
Shows that the body is actively processing and excreting xylene.
Review possible exposure sources at work, home, or in your environment.
Take steps to minimize unnecessary contact, such as improving ventilation, using protective gear, or switching to safer products.
If you experience symptoms (headaches, dizziness, fatigue, brain fog), discuss results with your healthcare provider for evaluation and possible repeat testing.
A “Moderate” 2MHA result is a signal to pay attention, but not a cause for alarm. It highlights that your body has processed some xylene and that reducing exposure can support long-term neurological, immune, and overall health.
Optimal range: 0 - 64.8 ug/g
3-Methylhippuric Acid (3MHA) is a substance your body makes when breaking down m-xylene, a solvent found in everyday products like paints, varnishes, adhesives, cleaning agents, pesticides, and fuels. Testing urine for 3MHA provides a clear measure of recent xylene exposure.
For 3-Methylhippuric Acid (3MHA), a moderate level in urine indicates:
Above baseline exposure to m-xylene (higher than expected background levels), but not in the high or toxic range.
Likely reflects recent or regular contact with products containing xylene (paints, varnishes, adhesives, fuels, industrial solvents).
Suggests the body is actively metabolizing and excreting xylene, meaning your detox pathways are working, but exposure is enough to be measurable and noteworthy.
Often tied to occupational or environmental exposure, rather than accidental overexposure or acute poisoning.
Not alarming on its own — it doesn’t necessarily mean severe toxicity.
Worth paying attention to — ongoing moderate exposure can contribute to cumulative toxic burden, especially affecting the nervous system, mood, sleep, and energy.
Action point — review likely sources of xylene, reduce exposure where possible, and support detoxification (hydration, nutrition, clean air/ventilation).
A moderate 3MHA result is a signal of meaningful xylene exposure, but not a red-flag level. It’s an opportunity to identify where xylene is entering your environment and take steps to minimize contact, preventing progression toward higher, more concerning levels.
Optimal range: 0 - 1.01 ug/g
3-Phenoxybenzoic Acid (3PBA) is a metabolite formed as a result of exposure to pyrethroids, a class of insecticides widely used in both household and agricultural settings. Pyrethroids account for approximately 30% of the insecticide market worldwide and are designed based on the natural insecticidal compounds found in chrysanthemum flowers, known as pyrethrins. These chemicals are commonly used in agriculture, household pest control, and veterinary medicine.
Pyrethroids work by targeting the nervous system of insects, causing hyperexcitation and paralysis. While they are effective in controlling pests, exposure to pyrethroids can lead to various health concerns. Potential health impacts include neurobehavioral and neurodevelopmental effects, as well as endocrine disruption. Long-term exposure has also been associated with an increased risk of all-cause mortality and cardiovascular disease.
Optimal range: 0 - 65.51 ug/g
4-Methylhippuric Acid (4MHA) is a marker your body produces when it breaks down p-xylene, a chemical solvent found in many common products, including paints, varnishes, adhesives, cleaning agents, pesticides, and fuels.
Measuring 4MHA in urine provides a direct assessment of recent p-xylene exposure. It is often included in environmental toxin panels such as the Total Tox Burden test.
A moderate 4-Methylhippuric Acid (4MHA) result in urine suggests recent or ongoing exposure to p-xylene at levels above background, but not in the high or toxic range. This often reflects regular contact with products such as paints, solvents, adhesives, or fuels—either at work, during home projects, or from environmental fumes. While not immediately dangerous, moderate levels indicate that your body is actively processing and excreting p-xylene, and that your toxic burden may be increasing. Reducing exposure sources, ensuring good ventilation, and using protective measures can help bring levels down and protect long-term neurological and overall health.
Optimal range: 0 - 0.42 ug/g
4-Nonylphenols are used in manufacturing antioxidants, lubricating oil additives, laundry and dish detergents, emulsiers, and solubilizers. These compounds are also precursors used to produce paints, pesticides, cosmetics, and plastics. Nonylphenol persists in aquatic environments and is moderately bioaccumulative. It is not readily biodegradable, and it can take months or longer to degrade in surface waters, soils, and sediments. It has a potential role as an endocrine disruptor and xenoestrogen due to its ability to act with estrogen-like activity. Nonylphenol exposure has also been associated with breast cancer.
Optimal range: 0 - 3.9 ng/g
Aflatoxin B1 (AFB1) is a mycotoxin produced by several strains of the fungus Aspergillus flavus. It is found in foods, specifically cereals such as corn and rice, tree nuts, oilseeds (peanut, cottonseed, etc.) and spices, notably those grown in tropical and sub-tropical regions. There is substantial evidence that aflatoxins cause hepatic carcinoma and AFB1, the most toxic aflatoxin, is classified as carcinogenic (Group 1) by the International Agency for Research on Cancer (IARC). Aflatoxins such as AFB1 can cause additive effects in individuals affected by hepatitis B. Wasting and weight loss, stunted growth and development in children, liver cirrhosis and aflatoxicosis are other conditions associated with aflatoxin ingestion.
Optimal range: 0 - 4.58 ng/g
Aatoxin B2 (AFB2) is a mycotoxin produced by several Aspergillus spp. and found in contaminated foods or hay exposed to water or humid conditions. Exposure routes are primarily ingestion or inhalation. Ingestion can either occur directly from food such as grains, tree nuts, and oilseeds or can also occur from ingestion of milk or meat from animals fed contaminated feed. Toxicity of aatoxins can be categorized as follows, in descending order of known toxic effects: aatoxin B1, aatoxin G1, aatoxin B2, and aatoxin G2. Animal studies have indicated that AFB2 has hepatotoxic, teratogenic, and carcinogenic effects.
Optimal range: 0 - 3.68 ng/g
Aflatoxins are naturally occurring Mycotoxins that are produced by Aspergillus species of fungi. Aflatoxin G1 (AFG1) is one of the four major naturally known aflatoxins produced by the Aspergillus species.
Optimal range: 0 - 6.08 ng/g
Aflatoxin G2 is a mycotoxin produced by certain species of molds, particularly Aspergillus flavus and Aspergillus parasiticus. This toxin is a member of the aflatoxin family, known for its potent carcinogenic and toxic effects on humans and animals. Aflatoxin G2 is one of several structurally related compounds, including Aflatoxin B1, B2, G1, and others, but it is considered less toxic than Aflatoxin B1. It can contaminate various food crops, including peanuts, corn, rice, and tree nuts, particularly in warm and humid regions where mold growth is more prevalent. Aflatoxin G2, like other aflatoxins, poses significant health risks when ingested or inhaled, as it can cause liver damage, suppress the immune system, and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC). It is essential to monitor and limit exposure to aflatoxin-contaminated foods, as they pose a severe threat to food safety and public health.
Optimal range: 0 - 3.6 ng/g
Optimal range: 0 - 17.83 ug/g
Optimal range: 0 - 0.07 ug/g
SOURCES:
Found naturally in the environment, air, soil, water.
Found in lead storage batteries, solder, sheet and pipe metal, pewter, bearings and castings, paints, ceramics, fireworks, plastic enamels, metal and glass.
Sometimes used medically to treat parasites.
Optimal range: 0 - 11.9 ug/g
Arsenic is a naturally occurring element found in soil, water, and food, with exposure most often coming from contaminated groundwater, rice, grains, seafood, or certain workplaces. While small amounts are common in daily life, elevated arsenic in urine suggests recent or ongoing exposure at a level that may increase health risks. Long-term exposure is linked to skin changes, digestive upset, fatigue, immune suppression, kidney and liver stress, cardiovascular problems, and higher cancer risk, especially from inorganic arsenic in water or food. Testing for arsenic helps identify hidden sources of exposure so you can take steps to reduce risk—such as using filtered water, limiting high-arsenic foods, and avoiding older pesticides or arsenic-treated wood. If results are elevated, working with a healthcare provider familiar with environmental medicine can help guide safe detox and long-term protection.
Optimal range: 0 - 0.02 mcg/g
Atrazine one of the most widely used herbicides in US to prevent pre- and postemergence broadleaf weeds in crops such as maize (corn) and sugarcane and on turf, such as golf courses and residential lawns. It used to be the most commonly detected pesticide contaminating drinking water and studies suggest it is an endocrine disruptor, an agent that can alter the natural hormonal system. The implications for children’s health are related to effects during pregnancy and during sexual development.
Optimal range: 0 - 0.02 ug/g
Atrazine is a common herbicide used in agriculture to control weeds. When it's used, it can break down in the environment into different forms, one of which is atrazine mercapturate. Atrazine and its breakdown products have been linked to potential health concerns, including disruptions to hormone systems and possibly increased risks of certain health issues. Testing for atrazine mercapturate can give insight into whether someone has been exposed to atrazine and its metabolites, which could be helpful in understanding potential health impacts or guiding strategies for reducing exposure.
Optimal range: 0 - 5.59 ug/g
Optimal range: 0 - 0.2 ug/g
Beryllium is a silvery-white metal that is lighter than aluminum but stronger than steel. Its strength-to-weight ratio, reflectivity, transparency to X-rays, thermal stability and conductivity, and high melting point makes it an essential material in the defense, nuclear, aerospace, medical, information technology, and telecommunications industries.
Beryllium is toxic as both a skin irritant and an inhaled substance and can result in dermatitis, acute pneumonitis, and chronic pulmonary disease. The first signs of serious or life-threatening acute beryllium exposure may involve difficulty breathing, chest pain, or shortness of breath. Despite increasing governmental regulations limiting exposure to beryllium in high-risk occupations, any amount of beryllium can cause short-term and long-term diseases.
Optimal range: 0 - 0.58 ug/g
Optimal range: 0 - 2.12 ug/g
Bisphenol A (BPA) is a xenoestrogen, exhibiting estrogen-mimicking, hormone-like properties that raise concern about its suitability in some consumer products and food containers. Bisphenol A (BPA) is an organic synthetic compound and it is a starting material for the synthesis of plastics, primarily certain polycarbonates and epoxy resins, as well as some polysulfones and certain niche materials. BPA is an endocrine-disrupting chemical that has been found to bind to both of the nuclear estrogen receptors. A recent exposure to plastic that released excessive amounts of BPA into a food or a beverage could be identified by high levels of urinary BPA.
Optimal range: 0 - 0.92 Units
Bisphenol S (BPS) is a synthetic compound used in the manufacturing of plastics and resins, commonly found in a wide range of consumer products, such as food and drink containers, water bottles, thermal receipt papers, dental sealants, toys, cosmetics, and the lining of canned goods. Like its predecessor, Bisphenol A (BPA), BPS is known to be an endocrine disruptor, raising concerns about its potential effects on health.
BPS has been linked to several health risks similar to those associated with BPA, including reproductive and developmental issues, as well as an increased risk of obesity, diabetes, cardiovascular disease, and certain cancers. In response to growing concerns about BPA, many companies have switched to producing "BPA-Free" products. However, emerging evidence suggests that alternatives like BPS may also pose similar health risks, prompting ongoing research into their safety.
Optimal range: 0 - 0.25 ug/g
Butylparaben belongs to the paraben family and is one of the most common antimicrobial preservatives in cosmetics such as such as makeup, moisturizers, hair-care products, and shaving creams. It is also used in medication suspensions, and as a avoring additive in food. When exposed to high levels of butylparaben via inhalation, irritation to the respiratory tract results; symptoms include coughing and shortness of breath. Ingestion of large doses of butylparaben may cause irritation to the gastrointestinal (GI) tract. Butylparaben is an endocrine disruptor.
Optimal range: 0 - 0.29 ug/g
SOURCES:
Found in food such as shellfish, leafy vegetables, rice, cereals, cocoa butter, dried seaweed, and legumes. Also present in nickel cadmium batteries, cigarette smoke (including second-hand smoke), insecticides, fertilizer, motor oil, emissions and exhaust. Drinking water, air, and occupational exposures are also seen.
NUTRIENT INTERACTIONS:
Iron deficiency is associated with higher cadmium burden and absorption of cadmium may increase during very early stages of iron deficiency. Zinc deficiency is associated with an increase in Cadmium, as a result of the antagonistic relationship between the elements.
Dietary cadmium inhibits GI absorption of calcium and interferes with calcium and vitamin D metabolism. Low dietary calcium stimulates synthesis of calcium- binding protein which enhances Cadmium absorption.
Optimal range: 0 - 6.37 ug/g
Cesium is a naturally occurring element found combined with other elements in rocks, soil, and dust in low amounts. It is used to make atomic clocks, optical glass, and vacuum tubes. Nuclear explosions or the breakdown of uranium in fuel elements can produce radioactive forms of cesium. Exposure to stable or radioactive cesium occurs from ingesting contaminated food or drinking water or breathing contaminated air. In muscle cells, cesium competes with, and displaces, potassium. Such exposures may cause nausea, vomiting, diarrhea, bleeding, fatigue, muscle weakness, and palpitations. In severe conditions, it can cause cardiac arrhythmia, coma, and even death. Cesium can cause DNA damage which can affect genomic stability. Altered in genomic stability is a hallmark of aging. Thus, cesium toxicity may accelerate aging owing to its contribution to genomic instability.
Optimal range: 0 - 17.9 ng/g
Chaetoglobosin A (CHA) is one of the chaetoglobosin mycotoxins produced from the fungus Chaetomium globosum. Chaetomium globosum is the third most common indoor fungal contaminant of damp buildings. It has been isolated from several places such as soil, dung, feeds, foods, textiles, plywood, carpet, wallpaper and wet walls.
Inhalation of airborne spores and CHA from this fungus is known to produce respiratory as well as systemic infection in human beings. Case reports of infections include mild to severe illness, from sinusitis, onychomycosis, and cutaneous infections to disseminated cerebral disease, pneumonia and keratitis. Relatively low levels of CHA have been shown to be lethal to various tissue culture cell lines and it is thought that CHA is highly toxigenic, even at minimal doses.
Optimal range: 0 - 7.05 ng/g
Citrinin (CTN) is a mycotoxin that can be detected in a urine test, and its presence often signifies potential exposure to this fungal toxin. Citrinin is primarily produced by various species of molds, particularly Penicillium and Aspergillus, commonly found in food products, such as grains, cereals, and fermented foods like cheese and soy sauce.
Optimal range: 0 - 37.95 ng/g
Optimal range: 0 - 2.4 ng/g
Optimal range: 0 - 3.2 ug/g
Optimal range: 0 - 0.17 ug/g
Diethyldithiophosphate (DEDTP) is a metabolite of organophosphates, which are one of the most common causes of poisoning worldwide and are frequently intentionally used as pesticides. They can enter the body through the lungs or skin, or by eating contaminated food. Even at low levels, organophosphates may be hazardous to the nervous system, especially for foetuses and young children. Repeated or prolonged exposure may induce impaired memory and concentration, disorientation, severe depression, irritability, confusion, headache, speech diculties, delayed reaction times, nightmares, sleepwalking, drowsiness, or insomnia. Organophosphates function by inhibiting the action of cholinesterase enzymes in nerve cells. An inuenza-like condition with headache, nausea, weakness, loss of appetite, and malaise.
Optimal range: 0 - 4.61 Units
Diethylphosphate (DEP) is a metabolite of organophosphate pesticides, which are commonly used in agriculture to control pests and in residential environments to manage insects and rodents. Organophosphates exert their effects by inhibiting acetylcholinesterase, an enzyme crucial for proper nerve function. This inhibition disrupts nerve signaling, which can lead to a range of health issues.
Exposure to organophosphate pesticides, and consequently to DEP, has been associated with several health concerns, including neurological deficits, neurodegenerative diseases, and peripheral nerve damage. Furthermore, long-term exposure may contribute to neurodevelopmental issues, oxidative stress, psychological effects, and liver function abnormalities.
Monitoring DEP levels through panels like ToxDetect helps assess exposure to organophosphates and their potential impacts on health. Understanding DEP concentrations can guide preventive measures to reduce the risks associated with these toxic chemicals.
Optimal range: 0 - 1.24 ug/g
Optimal range: 0 - 9.3 ng/g
Dihydrocitrinone (DHC) is a metabolite of Citrinin (CTN), which is a mycotoxin produced by several fungal strains in the Penicillium, Aspergillus and Monascus genera and found in stored grains and other food products. Citrinin has nephrotoxic and genotoxic effects, and often occurs in combination with ochratoxin A. Studies show that dihydrocitrinone (DHC) has a signicantly reduced cytotoxic and genotoxic potential as compared to CTN. Thus, DHC is considered a detoxication related step of CIT metabolism.
Optimal range: 0 - 9.1 ug/g
Organophosphates are one of the most toxic groups of substances in the world, primarily found in pesticide formulations. They are inhibitors of cholinesterase enzymes, leading to overstimulation of nerve cells, causing sweating, salivation, diarrhea, abnormal behavior, including aggression and depression. Children exposed to organophosphates have more than twice the risk of developing pervasive developmental disorder (PDD), an autism spectrum disorder. Maternal organophosphate exposure has been associated with various adverse outcomes including having shorter pregnancies and children with impaired reflexes.
Optimal range: 0 - 0.67 ug/g
Dimethyldithiophosphate (DMDTP) is a urinary metabolite that forms when the body breaks down certain organophosphate pesticides, such as malathion, dimethoate, and methyl parathion—chemicals commonly used in agriculture and among the most frequent causes of poisoning worldwide. Testing for DMDTP, as done on the Environmental Toxins panel by Vibrant Wellness, helps identify recent exposure to these pesticides, which can enter the body through inhalation, skin contact, or ingestion of contaminated food and water. Even at low levels, organophosphates may be harmful to the nervous system, particularly in fetuses, infants, and young children, due to their ability to inhibit cholinesterase enzymes that regulate nerve function. Chronic or repeated exposure has been associated with a wide range of symptoms, including headaches, confusion, memory problems, depression, speech difficulties, delayed reaction times, and sleep disturbances like insomnia and nightmares. Some individuals may also experience flu-like symptoms such as nausea, weakness, fatigue, and loss of appetite. Elevated levels of DMDTP do not always signal acute toxicity but can reflect an environmental toxic burden that may require lifestyle changes or detoxification support. To reduce exposure, individuals are encouraged to eat organic produce when possible, thoroughly wash fruits and vegetables, avoid the use of chemical pesticides at home, ensure proper ventilation in agricultural or treated environments, use protective equipment when handling pesticides, and support detox pathways with nutrients such as glutathione, folate, and B vitamins.
Optimal range: 0 - 5.91 ug/g
Dimethylthiophosphate (DMTP) is a metabolite of organophosphates, which are among the most common causes of poisoning worldwide. Organophosphates are frequently used as pesticides and can enter the body through the lungs, skin, or by consuming contaminated food.
Even at low exposure levels, organophosphates may pose a serious risk to the nervous system, especially for foetuses and young children. Repeated or prolonged exposure may lead to a range of neurological symptoms, including:
Optimal range: 0 - 1.1 ug/g
Diphenyl Phosphate (DPP) is a urinary metabolite that forms when the body breaks down organophosphate flame retardants such as triphenyl phosphate (TPHP), trixylenyl phosphate, and other aryl phosphate esters (APEs). These chemicals are used not only in consumer products like electronics, furniture, and cosmetics but also industrially as catalysts, paint additives, and protective agents in organic synthesis. DPP is measured to assess recent exposure, typically within the past 1–2 days, and elevated levels may indicate absorption through inhalation, skin contact, or ingestion. While originally used to reduce fire risk, these compounds are now linked to concerning health effects. Research shows that DPP may disrupt endocrine signaling, impair cardiac development, and contribute to mitochondrial dysfunction. In addition, DPP has been associated with renal toxicity, liver damage (hepatotoxicity), and blood-related effects (hemotoxicity). Monitoring DPP is especially important for vulnerable populations such as children, pregnant individuals, and those with frequent chemical exposure. Reducing contact with flame-retardant-treated products, improving indoor air quality, and supporting detoxification pathways are key strategies to lower your body burden.
Optimal range: 0 - 0.13 ng/g
Enniatin B1 (ENN B1) is a type of mycotoxin—a toxic compound produced by certain molds, most often species of Fusarium. These molds can contaminate grains, cereals, and other plant-based foods, especially when crops are stored in warm or humid conditions. ENN B1 belongs to a group of related toxins called enniatins, which are considered “emerging mycotoxins” because they are not yet routinely regulated but are increasingly recognized for their potential health effects.
A moderate level of Enniatin B1 (ENN B1) in urine indicates recent dietary or environmental exposure to Fusarium mold toxins at levels above normal background, but not in the high or concerning range. This often reflects regular intake of contaminated grains or cereals, or exposure to foods stored in warm, humid, or poorly ventilated conditions. While moderate levels are not usually linked to acute toxicity, they may contribute to your overall toxic burden and could play a role in digestive issues, fatigue, or lowered immunity, especially when combined with other mycotoxins. Reducing consumption of suspect foods, improving storage practices, and supporting detoxification pathways may help bring levels down and protect long-term health.
Optimal range: 0 - 5.41 ug/g
Optimal range: 0 - 3.45 ng/g
Fusarium is one of the most prevalent fungi associated with contamination of corn and other agricultural products throughout the world.
Many different fumonisins have so far been reported, and they have been grouped into four main categories (A, B, C, and P).
The most abundant of the fumonisins is fumonisin B1 (FB1).
They can also be found in moisture-damaged buildings, and, therefore, exposure of humans to Fusarium mycotoxins including FB1 may take place.
FB1 bears a clear structural similarity to the cellular sphingolipids, and this similarity has been shown to disturb the metabolism of sphingolipids by inhibiting a key enzyme in sphingolipid biosynthesis.
FB1 is neurotoxic, hepatotoxic, and nephrotoxic in animals, and it has been classified as a possible carcinogen to humans. The cellular mechanisms behind FB1-induced toxicity include the induction of oxidative stress, apoptosis, and cytotoxicity, as well as alterations in cytokine expression.
References:
Peraica M, Radic B, Lucic A, Pavlovic M. Toxic effects of mycotoxins in humans. Bull World Health Organ. 1999;77(9):754-66. PMID: 10534900; PMCID: PMC2557730. [L]
Optimal range: 0 - 4.05 ng/g
Optimal range: 0 - 6.08 ng/g
Optimal range: 0 - 0.17 ug/g
Urinary gadolinium (Gd) provides an indication of recent or ongoing exposure to the metal, and endogenous detoxification to a lesser extent. Urinary Gd would be expected to be variably high if urine was collected within a week of medicinal Gd administration for imaging purposes.
Gd is found in the environment in geographically variable amounts, and usually at very low levels. It is widely used in industrial and household applications such as radar technologies, compact discs, and microwaves; direct exposure from such sources is not a concern. However disposal of Gd-containing devices contributes to greater potential for human exposure. The single greatest direct source of exposure to Gd is Gd-based contrast agents (GBCAs) that are widely used with magnetic resonance imaging (MRI).
Optimal range: 0 - 6.69 ug/g
Optimal range: 0 - 116.93 ng/g
Gliotoxin is a mycotoxin (toxic substance made by mold), most commonly produced by Aspergillus fumigatus and related mold species. These molds often grow in water-damaged buildings, damp indoor spaces, soil, compost, and decaying plant matter, making gliotoxin exposure possible in homes, workplaces, and agricultural environments.
Gliotoxin belongs to a group of compounds called epipolythiodioxopiperazines (ETPs), which are known for their ability to suppress the immune system and increase oxidative stress in human cells.
Optimal range: 0 - 1.65 ug/g
Glyphosate is the world's most widely produced herbicide. It is a broad-spectrum herbicide that is used in more than 700 different products for agriculture and forestry to home use.
Possible treatment options if in higher ranges:
Treatment of glyphosate toxicity should be centered on determining the route of introduction and avoiding future exposure. Glyphosate is readily metabolized in the body. However, a recent study found that glyphosate accumulates in mammalian bones. Another study found glyphosate to be detectable in mammalian intestine, spleen, liver, muscle, and kidney. Kidney impairment is common in regions where glyphosate may accumulate in ground water as metal chelates. The most effective way to reduce glyphosate exposure is to avoid living in areas where glyphosate is applied and to avoid eating GMO foods or animal products such as milk or meat for which GMO foods were used to feed the animals. Since glyphosate is now commonly combined with the weed killer 2,4-dichlorophenoxyacetic acid (2,4-D), testing for this chemical with the GPL-TOX test may wish to be considered also.
Optimal range: 0 - 0.52 ug/g
Optimal range: 0 - 0.57 ug/g
The fungicide/pesticide use of mercury has declined due to environmental concerns, but mercury residues persist in the environment. Emissions from coalfired power plants and hospital/municipal incinerators are significant sources of mercury pollution.
Methylmercury, the most common, organic form of mercury, occurs by methylation of inorganic Hg in aquatic biota or sediments (both freshwater and ocean sediments).
Methylmercury accumulates in aquatic animals and fish and is concentrated up the food chain reaching highest concentrations in large fish and predatory birds.
Except for fish, the human intake of dietary mercury is negligible unless the food is contaminated with one of the previously listed forms/sources. Daily ingestion of fish can result in the assimilation of 1 to 10 micrograms of mercury/day.
Depending upon the extent of cumulative mercury exposure, elevated levels of urine mercury may occur after administration of DMPS, DMSA or D-penicillamine. Blood and especially red blood cell elemental analyses are useful for assessing recent or ongoing exposure to organic (methyl) mercury.
Optimal range: 0 - 180 ug/g
Methylparaben belongs to the paraben family and is an anti-fungal agent often used in a variety of cosmetics and personal-care products. It is also used as a food preservative. Methylparaben is generally recognized as safe for food and cosmetic antibacterial preservation. Methylparaben is readily absorbed from the gastrointestinal tract or through the skin. Studies indicate that methylparaben applied on the skin may react with UVB (Ultraviolet type B), leading to increased skin aging and DNA damage. Methylparaben was responsible for disrupting estrogenic and androgenic receptors too.
Some research has suggested that parabens may have endocrine-disrupting properties and could be associated with certain health issues, such as hormone imbalances. However, the specific health effects of parabens on humans are not well understood, and results from studies have been inconclusive.
Optimal range: 0 - 14.1 ug/g
Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) is a metabolite of mono(2-ethylhexyl) phthalate (MEHP), which is part of the common environmental toxins known as phthalates. Phthalates, often referred to as plasticizers, are a group of chemicals used to make plastics more flexible and durable. They are widely used in various products, including:
People are exposed to phthalates through several routes:
Optimal range: 0 - 5.19 Units
Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) is a metabolite of di-2-ethylhexyl phthalate (DEHP), a commonly used plasticizer in the manufacturing of flexible plastics. DEHP is widely found in products like PVC flooring, medical devices, and children's toys. MEOHP is detected in urine samples as part of environmental and exposure monitoring, particularly in a ToxDetect panel, which tests for chemicals that may have harmful effects on human health.
MEOHP is often used as an indicator of DEHP exposure, as the body metabolizes DEHP into MEOHP and other related compounds. Elevated levels of MEOHP in urine may suggest higher exposure to DEHP, which has been linked to various health concerns. These include potential effects on the endocrine system, reproductive health, and developmental processes.
Optimal range: 0 - 8.99 ug/g
Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) is a metabolite of mono(2-ethylhexyl) phthalate (MEHP), which belongs to a group of common environmental toxins known as phthalates. Phthalates, also referred to as plasticizers, are chemicals used to make plastics more flexible and durable. They are widely used in a variety of products, including:
Routes of Exposure:
Optimal range: 0 - 2.73 ug/g
Optimal range: 0 - 1.92 Units
Mono-2ethylhexyl phthalate (MEHP) is a metabolite of di(2-ethylhexyl) phthalate (DEHP), a common plasticizer used in a variety of consumer products, such as vinyl flooring, medical devices, and personal care items. MEHP is primarily detected through specialized testing, such as a ToxDetect panel, to assess potential exposure to phthalates, which are known endocrine disruptors.
MEHP is used in environmental and health assessments to evaluate the extent of exposure to DEHP, as it is the active compound released when DEHP breaks down in the body. Research has suggested that MEHP and other phthalate metabolites can influence hormone regulation, particularly affecting the reproductive system. Studies have linked elevated levels of MEHP with developmental and hormonal disruptions, including potential risks for fertility, thyroid function, and metabolism.
Optimal range: 0 - 94.2 ug/g
Optimal range: 0 - 14.1 Units
Monobutyl phthalate (MBP) is a metabolite of butyl phthalate, which is commonly used as a plasticizer in various consumer products, including plastics, cosmetics, and personal care items. When ingested or absorbed into the body, butyl phthalate breaks down into MBP, making it an important marker for assessing exposure to phthalates.
In a ToxDetect panel, the detection of MBP helps to evaluate an individual's level of exposure to phthalates, which are known endocrine disruptors. Phthalates can interfere with hormone function and may contribute to health issues, particularly affecting reproductive health and development. Elevated levels of MBP can indicate recent or ongoing exposure to phthalates, potentially leading to adverse health effects over time.
Optimal range: 0 - 51.5 Units
Monoethylphthalate (MEP) is a metabolite of the widely used chemical compound diethylphthalate (DEP), which is found in many consumer products, including personal care items, plastic products, and fragrances. As a breakdown product of DEP, MEP is commonly detected in human urine and is often measured as an indicator of exposure to phthalates, a group of chemicals used to make plastics more flexible and durable.
Optimal range: 0 - 11.5 Units
Monoisobutyl phthalate (MiBP) is a metabolite of dibutyl phthalate (DBP), a widely used plasticizer found in various consumer products. MiBP is often measured in toxicology panels, such as the ToxDetect panel, to assess potential exposure to phthalates and their metabolites. Phthalates, including DBP, are used in the production of flexible plastics and are commonly found in products such as toys, cosmetics, and medical devices.
MiBP is detected in urine as a marker of DBP exposure and can be indicative of recent exposure to phthalates. The presence of MiBP in urine suggests that the body has metabolized DBP, which can enter the body through ingestion, inhalation, or dermal absorption. Although phthalates are widely used, they have raised health concerns due to their potential endocrine-disrupting effects. Studies have shown that phthalates may interfere with hormone regulation, potentially affecting reproductive health, fetal development, and other physiological functions.
Optimal range: 0 - 3.6 ng/g
Mycophenolic Acid is an antifungal, antibacterial, and antiviral mycotoxin acid. It is produced by the Penicillium fungus.
Mycophenolic Acid is an immunosuppressant which inhibits the proliferation of B and T lymphocytes. Mycophenolic Acid exposure can increase the risk of opportunistic infections such as clostridia and Candida.
Mycophenolic Acid is associated with miscarriage and congenital malformations when the woman is exposed in pregnancy.
Optimal range: 0 - 101 ug/g
N-Acetyl (2, hydroxypropyl) Cysteine (NAHP) is a metabolite of propylene oxide, which is majorly used to produce polyurethane plastics and fumigant. These materials are used in polyester resins for the textile and construction industries as well as for lubricants, surfactants, and oil demulsifiers. Propylene oxide has been classified as a possible human carcinogen. Frequent exposure may lead to an increased risk of cancer.
Optimal range: 0 - 5.28 ug/g
N-Acetyl (2-Cyanoethyl) Cysteine (NACE) is a metabolite formed as a result of exposure to acrylonitrile, a chemical found in a variety of products, including acrylic fiber clothing, carpeting, acrylonitrile-based plastics, and plastic food containers. Acrylonitrile can also leach into foods from these materials, and it is present in cigarette smoke.
Acute exposure to high levels of acrylonitrile, especially through inhalation, can lead to respiratory irritation, difficulty breathing, dizziness, cyanosis (bluish skin), limb weakness, and convulsions. Long-term exposure may cause symptoms such as headaches, fatigue, and general malaise. Acrylonitrile is primarily metabolized by the liver, where it is conjugated with glutathione by glutathione transferases. This process leads to the formation of N-Acetyl (2-Cyanoethyl) Cysteine, which is then excreted in the urine.
Optimal range: 0 - 374 ug/g
N-Acetyl (3,4-Dihydroxybutyl) Cysteine (NADB) is a metabolite produced as a result of exposure to 1,3-butadiene, a petrochemical primarily used in the production of synthetic rubber, including materials for car and truck tires. It is also an environmental pollutant found in car exhaust, fuel combustion for energy or heating, and cigarette smoke.
Exposure to 1,3-butadiene has been linked to significant health risks, including cancer and cardiovascular disease. The International Agency for Research on Cancer (IARC) has classified 1,3-butadiene as a human carcinogen. While the exact metabolic process of 1,3-butadiene in humans is not fully understood, it is known that the primary route of exposure is inhalation. Around half of inhaled 1,3-butadiene is exhaled directly, while the remainder is metabolized in the liver and excreted in the urine.
Optimal range: 0 - 1.35 Units
N-Acetyl (Carbomethyl) Cysteine is a metabolite formed as a result of exposure to acrylamide, a chemical that is produced when starchy foods like potatoes, grains, and coffee beans are cooked at high temperatures. Other sources of acrylamide exposure include cigarette smoke, as it is generated during the combustion of tobacco, and certain cosmetic products where acrylamide may be present as a contaminant.
Acrylamide exposure has been linked to an increased risk of cancer, particularly affecting organs such as the kidneys, ovaries, and uterus. It has also been associated with neurotoxicity, which can lead to cognitive and motor impairments. Other potential health risks include genotoxicity, reproductive toxicity, hepatotoxicity, immunotoxicity, and an elevated risk of cardiovascular disease.
Optimal range: 0 - 11.3 ug/g
NAPR is a metabolite of 1-bromopropane. Chronic exposure can lead to decreased cognitive function and impairment of the central nervous system. Acute exposure can lead to headaches.
1-bromopropane is an organic solvent used for metal cleaning, foam gluing, and dry cleaning. Studies have shown that 1-BP is a neurotoxin as well as a reproductive toxin. Research indicates that exposure to 1-BP can cause sensory and motor deficits. Chronic exposure can lead to decreased cognitive function and impairment of the central nervous system. Acute exposure can lead to headaches.
Optimal range: 0 - 1.29 ug/g
N-acetyl phenyl cysteine (NAP) is a metabolite derived from benzene, a chemical that has been widely used in the past as an industrial solvent. Due to its toxicity and associated health risks, the use of benzene has been significantly reduced. However, exposure to benzene can still occur in occupational settings, as well as in the general environment and at home, due to the widespread use of benzene-containing petroleum products such as motor fuels and solvents.
Benzene exposure has been linked to a range of health issues, including respiratory, hepatic (liver), cardiovascular, immune, nervous, and endocrine system dysfunctions. Monitoring NAP levels can help assess an individual’s exposure to benzene and provide insights into potential health risks associated with this toxic compound.
Optimal range: 0 - 82 ug/g
Optimal range: 0 - 6.37 ug/g
Nickel is a naturally occurring metal found in air, water, soil, and many everyday items—including stainless steel, batteries, coins, pigments, jewelry, cosmetics, kitchenware, and certain foods such as chocolate, nuts, seeds, legumes, and grains. It is also present in cigarette smoke and industrial products.
The body requires only trace amounts of nickel for enzyme activity, but excess exposure can be toxic and may accumulate in tissues over time. A urine nickel test measures recent or ongoing exposure to this heavy metal.
A moderate level of nickel in urine suggests recent or ongoing exposure above background levels, but not in the high or toxic range. This may reflect regular contact with nickel-containing items (such as jewelry, coins, stainless steel cookware, or cosmetics), dietary intake from foods naturally higher in nickel (like chocolate, nuts, or legumes), or environmental/workplace exposure from welding, batteries, or metal production.
While moderate results are not usually a cause for alarm, they indicate that nickel is contributing to your toxic burden and could play a role in symptoms such as skin rashes, fatigue, headaches, or mild respiratory irritation. Over time, continued moderate exposure may increase the risk of allergic reactions, organ stress, or chronic health effects.
Key takeaway: A moderate result signals that your body is processing more nickel than usual. Identifying and reducing everyday or occupational sources—while supporting detoxification through hydration, a balanced diet, and avoiding unnecessary contact—can help bring levels back toward the optimal range.
Optimal range: 0 - 1.8 ng/g
Nivalenol (NIV) is a type B trichothecene mycotoxin produced by Fusarium molds, which often contaminate staple grains such as wheat, barley, corn, and oats—particularly in humid or temperate climates. Unlike many contaminants that break down during processing, NIV can persist in food even after cooking or baking, meaning exposure may occur through everyday products like bread, pasta, cereals, and baked goods.
Structurally, NIV is similar to deoxynivalenol (DON, or “vomitoxin”), but studies suggest that NIV causes greater oxidative stress and toxicity than DON.
A moderate level of Nivalenol (NIV) in urine suggests recent dietary exposure to Fusarium mold toxins from grains such as wheat, corn, barley, or oats at levels above background but not in the high or toxic range. This typically reflects regular intake of contaminated grain-based foods rather than acute poisoning. While not immediately dangerous, moderate results signal that NIV may be contributing to your toxic burden, with potential effects on digestion, immune strength, and long-term cellular health. Reducing consumption of lower-quality or mold-prone grains, improving food storage, and supporting detoxification can help bring levels back toward the optimal range.
Optimal range: 0 - 3.83 ng/g
Ochratoxin A (OTA), a renal toxin, is produced majorly by Aspergillus and Penicillium fungal species. Ochratoxin A has been found in barley, oats, rye, wheat, coffee beans, and other plant products, with barley having a particularly high likelihood of contamination. It is also frequently found in pork intended for human consumption.
Optimal range: 0 - 0.15 ug/g
Optimal range: 0 - 6.53 ng/g
Optimal range: 0 - 4.89 ug/g
Perchlorate (PERC) is a naturally occurring and man-made anion and is a powerful oxidizing agent. It is mainly used for propellants in rocket fuel as well as control static electricity in food packaging. Perchlorate may be accumulated into vegetables through water cycle and other parts in the environment. Perchlorate contamination in food and water has been found to be harmful for human health. Perchlorate is classified as a possible carcinogen. It may disrupt the thyroid’s ability to produce hormones. It has also been linked with lung toxicity and aplastic anemia.
Optimal range: 0 - 0.14 ug/g
Optimal range: 0 - 0.19 ug/g
Peruoropentanoate (PFPeA) is a short chain peruoroalkyl acid and used to make various products resistant to oil, stains, grease, and water. PFPeA is ubiquitous in the environment and is spread through water, food, and vehicles. Extensive public health data is not available regarding the health effects of PFPeA, however pre-clinical studies highlight potential concerns regarding cancer, endocrine disruption, accelerated puberty, liver dysfunction, immune system damage, and thyroid changes.
Optimal range: 0 - 1.27 ug/g
Optimal range: 0 - 285 ug/g
Styrene is used in the manufacturing of plastics, in building materials, and is found in car exhaust fumes. Polystyrene and its copolymers are widely used as food-packaging materials. The ability of styrene monomer to leach from polystyrene packaging to food has been reported. Occupational exposure due to inhalation of large amounts of styrene adversely impacts the central nervous system, causes concentration problems, muscle weakness, fatigue, and nausea, and irritates the mucous membranes of the eyes, nose, and throat.
Reduce exposure by eliminating plastic and styrofoam containers for cooking, reheating, eating or drinking (especially warm or hot) food or beverages. Replace these containers with glass, paper, or stainless steel whenever possible. Elimination of styrene can be accelerated by sauna treatment, reduced glutathione supplementation (oral, intravenous, transdermal, precursors such as N-acetyl cysteine [NAC]).
Optimal range: 0 - 0.1 ug/g
Optimal range: 0 - 36.7 ug/g
Optimal range: 0 - 4.28 ng/g
Roridin A is a macrocyclic trichothecene mycotoxin produced by Stachybotrys chartarum, commonly known as “black mold.” This mold thrives in damp, water-damaged buildings and can also contaminate grains, straw, and other plant materials.
Among trichothecenes, Roridin A is considered one of the most toxic, with powerful effects on human cells.
A moderate level of Roridin A in urine suggests recent exposure to black mold (Stachybotrys chartarum), most often from spending time in a water-damaged building or handling contaminated grains or straw. This level indicates your body is processing more of this toxin than expected, but not at the highest or most concerning range. Moderate results do not usually signal acute poisoning, but they do mean ongoing exposure may be adding to your toxic burden. Over time, this can contribute to respiratory irritation, fatigue, brain fog, or immune suppression. Reducing mold exposure in your environment and supporting detox pathways can help bring levels back toward the optimal range and protect long-term health.
Optimal range: 0 - 0.75 ng/g
Roridin E is a macrocyclic trichothecene mycotoxin produced by several fungi, including Fusarium, Myrothecium, Trichoderma, Trichothecium, Cephalosporium, Verticimonosporium, and especially Stachybotrys chartarum—better known as “black mold.”
These toxic molds often contaminate grains such as wheat, oats, and maize, but Stachybotrys also thrives indoors in damp, water-damaged buildings, making indoor exposure a major concern. Roridin E and other trichothecenes are considered among the most potent mold toxins—so harmful that some have been studied as potential biological warfare agents.
A moderate level of Roridin E in urine suggests recent exposure to trichothecene-producing molds, most often from contaminated grains or from indoor black mold (Stachybotrys) in a damp or water-damaged building. This result indicates your body is processing more of this toxin than expected, though not at the highest or most dangerous range. While moderate levels don’t usually point to acute poisoning, they may still contribute to your overall toxic burden and can be linked to symptoms such as digestive upset, fatigue, headaches, brain fog, or immune weakness. Reducing exposure to moldy environments and contaminated food sources, while supporting detox pathways, can help bring levels back toward the optimal range and protect long-term health.
Optimal range: 0 - 3.83 ng/g
Optimal range: 0 - 0.1 ng/g
Satratoxin G is a macrocyclic trichothecene mycotoxin produced by commonly called black mold or Stachybotrys chartarum, that contribute to disorders associated with water-damaged buildings.
Optimal range: 0 - 0.1 ng/g
Optimal range: 0 - 0.3 ng/g
Optimal range: 0 - 0.1 ng/g
T-2 Toxin is a tricothecene produced by species of Fusarium and is one of the rare and deadlier toxins. If ingested in sufficient quantity, T-2 toxin can severely damage the entire digestive tract and cause rapid death due to internal hemorrhage. T-2 has been implicated in the human diseases alimentary toxic aleukia and pulmonary hemosiderosis. Damage caused by T-2 toxin is often permanent.
Optimal range: 0 - 0.42 ug/g
Optimal range: 0 - 0.24 ug/g
SOURCES:
Fish, shellfish, plants, cigarettes, soil, air, water, electronic devices, switches and closures for the semi-conductor industry, glass for medical procedures.
NUTRIENT INTERACTIONS:
Some of its toxic effects results from interference with biological functions of potassium.
Optimal range: 0 - 0.02 ug/g
Optimal range: 0 - 0.09 ug/g
Tiglylglycine (TG) is an organic acid and a biomarker of mitochondrial function. It is produced when the body metabolizes the amino acid isoleucine. In healthy individuals, mitochondria—the “power plants” of our cells—process it efficiently, keeping TG levels very low.
When TG levels are elevated in urine, it may indicate mitochondrial dysfunction or, in rare cases, an inherited metabolic disorder. For this reason, TG is often included in organic acids tests as part of evaluating cellular energy health.
A moderate level of Tiglylglycine (TG) in urine suggests your mitochondria—the parts of your cells that produce energy—may not be working at full efficiency. This level is above the expected range but not as high as those seen in severe mitochondrial dysfunction or rare genetic disorders. Moderate results often reflect stress on the mitochondria from triggers such as toxin exposure, inflammation, chronic infection, or nutritional deficiencies. While not immediately dangerous, this finding means your body may be struggling with energy metabolism, which can contribute to symptoms like fatigue, muscle weakness, or brain fog. Supporting mitochondrial health through better nutrition, detoxification strategies, and lifestyle changes can help bring levels back toward the optimal range.
Optimal range: 0 - 1 ug/g
Optimal range: 0 - 29.9 ug/g
Triclosan (TCS) is an antibacterial and antifungal agent found in various consumer products, such as toothpaste, soaps, detergents, toys, and surgical cleaning treatments. Humans are exposed to triclosan through skin absorption during activities like handwashing, showering, brushing teeth, or using mouthwash. Ingestion can also occur when triclosan is swallowed during these activities, or through eating food from plants grown in soil treated with sewage sludge.
Triclosan is considered a weak endocrine disruptor, and prenatal exposure has been linked to increased testosterone levels in infants' umbilical cord blood.
Optimal range: 0 - 0.12 ug/g
Tungsten (atomic number 74) is a naturally occurring metal found in rocks and minerals. It is famous for having the highest melting point of all metals and for maintaining exceptional strength at high temperatures.
Because of these unique properties, tungsten is used in both industry and consumer goods, including:
Light bulb filaments and X-ray tubes
Catalysts in chemical production
Steel alloys for tools, turbine blades, and heavy machinery
Sporting equipment such as darts and golf clubs
Military applications, including projectiles, armor, and rotors, often as a substitute for lead and depleted uranium
A moderate level of tungsten in urine suggests recent exposure above normal background levels, but not in the high or toxic range. This often reflects environmental or occupational contact—such as working with tungsten alloys, breathing in dust from industrial settings, or consuming water or food from contaminated sources. While moderate results are not usually linked to immediate health risks, they may still contribute to your overall toxic burden and could play a role in symptoms like fatigue, mild breathing irritation, or digestive upset. Reducing unnecessary exposure and supporting detoxification through hydration and healthy nutrition can help bring levels back toward the optimal range.
Optimal range: 0 - 0.02 ug/g
Optimal range: 0.24 - 2.16 mg/ml
Urine creatinine is a crucial marker on an Organic Acids panel, primarily used to assess kidney function and the overall adequacy of urine concentration. Creatinine is a waste product formed from the normal breakdown of muscle tissue and is excreted through the kidneys. Its levels in urine are often evaluated to ensure proper kidney filtration and are used as a baseline to interpret other metabolites on the Organic Acids panel. When urine creatinine is low, it may indicate diluted urine, potentially affecting the accuracy of other metabolite readings. Conversely, high urine creatinine levels might suggest dehydration or impaired kidney function. Monitoring urine creatinine is essential for accurate assessment of metabolic processes and to help rule out issues related to kidney health.
Optimal range: 0 - 0.75 ng/g
Optimal range: 0 - 5.18 ng/g
Optimal range: 0 - 0.38 ng/g
Zearalenone (ZEN), a potent mycotoxin commonly found in contaminated crops, is increasingly recognized as a critical marker in Total Tox Burden panels due to its significant impact on health. Produced primarily by Fusarium species of fungi, ZEN is often detected in a variety of agricultural products, including cereals, maize, and other grains, especially under conditions favoring fungal growth, such as high humidity and temperature. Structurally similar to natural estrogenic compounds, ZEN exhibits strong estrogenic activity, leading to potential endocrine disruption in both humans and animals. This mycotoxin binds competitively to estrogen receptors, potentially causing reproductive disorders, immunological effects, and even carcinogenic outcomes.
Neurotransmitters (VibrantWellness)
The Neurotransmitters test is a test to measure inhibitory, excitatory, and other neurotransmitters, their precursors, and their derivatives to determine imbalances.
Neurotransmitters are chemical molecules that our bodies can't function without. They facilitate chemical signals or messages from one neuron to the next target cell, which can be another nerve cell, a muscle cell, or a gland.
Neurotransmitters are critical to determining mental performance, emotions, pain response, and energy levels.
Because hormones are interconnected with neurotransmitters, an imbalance in adrenal and sex hormones may lead to neurotransmitter imbalances which could feedback negatively and cause hormonal imbalances. Thus, a combination of testing hormone and neurotransmitter levels is recommended to provide the physician with a comprehensive assessment of the hormonal and neurotransmitter dysfunctions, supporting the identification of underlying causes of symptoms.
Optimal range: 0.7 - 6 mcg/g
Epinephrine, also known as adrenaline, is a monoamine that serves as both a stress hormone and an excitatory neurotransmitter. It is produced by chromaffin cells within the adrenal medulla of the adrenal gland and is secreted into the bloodstream during acute stress. Epinephrine rapidly provides the body with the energy and alertness necessary to produce an appropriate response to stressors. It does this by binding to alpha and beta adrenergic receptors throughout the body and changing how various organs function, including the heart, blood vessels, lungs, liver, eyes, and digestive system. Most of the body's epinephrine acts as a hormone, and only a small amount acts as a neurotransmitter. The catecholamine synthesis pathway begins with the uptake of the amino acid tyrosine into the cytoplasm and ends with the production of epinephrine through a series of enzymatic reactions.
Optimal range: 0.74 - 1.88 Ratio
The Organic Acids Test measures levels of HVA (homovanillic acid) and VMA (vanillylmandelic acid), the metabolites of the neurotransmitters, dopamine and epinephrine/norepinephrine. It also measures the ratio of the two metabolites.
Optimal range: 6.7 - 12.8 mcg/g
The Norepinephrine / Epinephrine ratio is an indicator of epinephrine (adrenaline) conversion (epinephrine is synthesized from norepinephrine). Anxiety, burnout, and poor blood sugar control are associated with a relative epinephrine depletion, and thus an elevated Norepi:Epi ratio.
Optimal range: 0.32 - 1.1 Ratio
A high ratio of quinolinic acid to the tryptophan metabolite, 5-hydroxyindoleacetic acid, indicates excessive inflammation due to recurrent infections, excessive tryptophan intake, immune overstimulation, excessive adrenal production of cortisol, or excessive exposure to phthalates.
Optimal range: 51.2 - 127.9 mcg/g
Serotonin plays important roles in the resolution of mood, sleep, and appetite.
Serotonin is an inhibitory neurotransmitter synthesized by enzymes that act on tryptophan and/or 5-HTP.
Neurotransmitters are divided into two basic categories:
– Excitatory neurotransmitters stimulate the brain and body.
– Inhibitory neurotransmitters calm the brain and body.
Just as levels of individual neurotransmitters are important in maintaining optimum health, so is the proper balance between your excitatory and inhibitory systems.
Optimal range: 2411.2 - 5047.8 mcg/g
Vanillylmandelic acid (VMA) is an end-stage metabolite of the catecholamines dopamine, epinephrine, and norepinephrine formed via the actions of monoamine oxidase, catechol-O-methyl transferase (COMT), and aldehyde dehydrogenase. VMA is found in the urine, along with other catecholamine metabolites, including homovanillic acid (HVA), metanephrine, and normetanephrine.
Array 14 - Mucosal Immune Reactivity Screen
Array 14 - Multiple Mucosal Immune Reactivity Screen (Cyrex Laboratories) is a cost-effective, easy, and non-invasive method for measuring mucosal immune reaction to a range of exogenous and endogenous antigens.
The production of IgA and IgM antibodies against antigens in saliva may be an early stage in the induction of inflammation and autoimmunity. If the immune reactivity is not addressed and it may result in a breach of the intestinal barrier, followed by a systemic immune reaction. The inflammation of systemic autoantibodies contributes to the progression of autoimmune and neuroautoimmune reactivity.
Array 14 was developed based on the immunological occurrence that exposure to an antigen via the mouth and intestinal tract results first in the production of IgA antibodies in secretions. Repeated exposure to the same antigen(s) results in the production of IgG, IgM and IgA antibodies in the blood. The biomarkers in Array 14 were selected to give an invaluable picture of both likely antigens which may cause immune reactions and the areas they may effect. These include the following:
Optimal range: 0.1 - 2.1 ELISA Index
Gastrointestinal microfilaments of the Actomyosin Network are critical for apical junctional complex biogenesis and function. The apical junctional complex, made up in part by tight junction proteins zonulin and occludin, is responsible for preventing antigen invasion and preservation of the biochemical homeostasis within the gastrointestinal tract. The Actomyosin Network can signal tight junction contractions and give structure to their assembly.
Optimal range: 0 - 1.9 ELISA Index
Aflatoxins are organic chemical compounds produced by a polyketide pathway by many strains of the mold Aspergillus, Aspergillus flavus is a particular strain common contaminant in agricultural products such as wheat, peanuts and corn.
Optimal range: 0 - 2.6 ELISA Index
Known Cross-Reactions: A5-B3 glycinin of soy, cerebellar, gliadin
The presence of salivary antibodies to a-Casein + b-Casein combined is an indication of loss of oral tolerance and onset of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Cow’s Milk is the most common cause of food immune reactivity in the first years of life and contributes to maladies such as gastrointestinal upset, skin problems, respiratory manifestations and anaphylaxis, for some the sensitivity persists throughout one’s lifetime and may contribute to autoimmunity later in life. Infants have been shown to produce salivary IgA to casein, but tend to outgrow the immune reactivity.
Elevated salivary antibodies to casein in infants have been shown to reflect atopic risk for developing an allergy during the first three years of life. Particular autoimmunities associated with Casein include diabetes, Celiac disease and autoimmune uveitis.
Cow’s Milk plays a role in the gastrointestinal symptoms in 50% of patients with Gluten Reactivity and Celiac disease.
Optimal range: 0.2 - 2 ELISA Index
Gliadin is a glycoprotein. It is an alcohol-soluble protein present in wheat and occurring in various forms (a-, g-, and w-gliadins). a-Gliadin-33-mer is produced by natural digestion processes. It is resistant to proteolytic degradation and stimulates T cells.
Known Cross-Reactions: 21 Hydroxylase, Asialoganglioside, Corn, Cytochrome P450, Dairy proteins, Glutamic Acid Decarboxylase, Myelin Basic Protein, Millet, Myocardial Peptide, Oats, Osteocyte, Ovary, Rice, Synapsin, Thyroid Peroxidase, Yeast; Cerebellar
Optimal range: 0 - 2.4 ELISA Index
Saccharomyces cerevisae, baker’s yeast, contains Chl1p, a putative helicase with human homologs (antiSaccharamyces cerevisae antibody – ASCA). It is required for DNA repair, recombination, transcriptional silencing and aging. Anti-neutrophil cytoplasmic antibodies (ANCAs) are a group of autoantibodies produced against antigens in the cytoplasm of neutrophil granulocytes and monocytes.
Known Cross-Reactions: Mannan, enteric bacterial antigens
Antibodies Appear: Crohn’s disease, Sjögren’s syndrome
Optimal range: 0.2 - 2.2 ELISA Index
Bisphenol A (BPA) is used to make polycarbonate polymers and epoxy resins, along with other materials used to make plastics, including water bottles and other food and beverage containers. Paper products, most notably thermal receipt paper, have now been shown to also contain significant amounts of BPA.
Optimal range: 0 - 2.6 ELISA Index
The blood brain barrier (BBB) is a physical barrier formed by the arrangement of endothelial cells and tight junctions that line the capillaries which supply blood to the brain. The tissue proteins of the BBB are also present in the enteric nervous system (ENS). The complex ENS network resides in the wall of the gastrointestinal tract, the myenteric plexus and the submucosal plexus.
The ENS controls aspects of gut function, including motility, microvascular circulation, epithelial secretion of fluid, ions and bioactive peptides and intestinal barrier function.
Associated With: Individuals training for professional sports (saliva), Inflammatory bowel disease (saliva), Traumatic brain injury (serum)
Optimal range: 0.1 - 2.1 ELISA Index
Calprotectin is an abundant neutrophil protein. It belongs to the family of S100 calcium binding proteins. Calprotectin is released from activated leukocytes during activation or cell death leading to increased concentrations in plasma, serum, spinal fluid, synovial fluid, urine, saliva or stools. As an antimicrobial, Calprotectin is increased during bacterial infections or inflammation in relevant organs.
Optimal range: 0 - 2.5 ELISA Index
Known Cross-Reactions: Cerebellar, Gliadin
The presence of salivary antibodies to Casomorphin is an indication of loss of mucosal tolerance and the onset of food immune reactivity. The production of antibodies to Casomorphin may be indicative of a lack of the enzyme dipeptidyl peptidase (DPPIV). The offending food and its known cross-reactive foods should be eliminated from the diet. Casomorphin is known to modulate the mucosa of the intestinal lining. If the mucosa is damaged, Casomorphin and other ingested peptides can more easily penetrate the intestinal barrier. As an opioid peptide, Casomorphin, once in the blood stream, is capable of disrupting the blood-brain barrier and interfering with the neurotransmitter messaging system. Antibodies against Casomorphin can identify a cause of behavioral and cognitive problems.
Optimal range: 0.2 - 2.3 ELISA Index
The presence of salivary antibodies to Corn is an indication of loss of mucosal tolerance and the onset of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to Corn have been reported.
Corn gluten activates mucosal neutrophils and eosinophils, which enhance mucosal nitric oxide produce and thus exacerbates the gastrointestinal inflammatory conditions found in Celiac disease and other inflammatory bowel disorders.
Optimal range: 0 - 2 ELISA Index
The presence of salivary antibodies to Egg is an indication of loss of mucosal tolerance and the onset of food immune reactivity. Egg antigen assessed consists of egg white, egg yolk both raw and cooked. The offending food and its known cross-reactive foods should be eliminated from the diet. Egg immune reactivity is more common in children than in adults.
Since many children eventually develop immune tolerance, they may outgrow immune reactivity to Egg.
Cooked egg introduced at 4 to 6 months of age may protect against egg allergy/sensitivity. Adult onset of Egg allergy has been reported.
Optimal range: 0.1 - 2.1 ELISA Index
Gliadin is a glycoprotein. It is an alcohol-soluble protein present in wheat and occurring in various forms (a-, g-, and w-gliadins). g-Gliadins-15-mer are considered to be the most ancient of the gluten family. This group of gliadins works with gluten proteins to determine the functional properties of wheat flour.
Known Cross-Reactions: Cerebellar
Optimal range: 0 - 2.6 ELISA Index
Glutenin or Glutenine is a wheat protein that together with gliadin produces gluten. Glutenin gives firmness to bread dough during the kneading process by increasing the stability through a 3-dimensional network.
Optimal range: 0 - 2.5 ELISA Index
Gluteomorphin, also known as, Gliadorphin, is an opioid peptide formed from undigested Gliadin from gluten protein.
Optimal range: 0 - 2.9 ELISA Index
An immune complex is formed from the binding of an antibody to a soluble antigen. The bound antigen and antibody act as a specific antigen. Immune complexes can be subject to any of a number of responses, which can lead to autoimmune reactivity.
Antibodies Appear: IgA-related renal disease, Mucosal infection, Sjogren’s syndrome
Optimal range: 0 - 2.6 ELISA Index
Lipopolysaccharide (LPS) is a molecule made up of a lipid and a polysaccharide. LPS is a component of the surface membrane of gram-negative bacteria found in the gastrointestinal tract. Gram-negative bacteria include: Escherichia coli, Salmonella, Shigella, Pseudomonus, Helicobactor, Legionella, Wolbachia. As an endotoxin, LPS increases the negative charge of the bacterial membrane and promotes the upregulation of pro-inflammatory cytokines.
Optimal range: 0 - 1.8 ELISA Index
Mercury (Hg) is a heavy chemical element that is emitted to the air by human activities, such as manufacturing or burning coal for fuel, and from natural sources, such as volcanoes. It is deposited, via ecosystem transport, into lakes and oceans, where it bioaccumulates in fish. According to the US EPA, “nearly all methylmercury exposures in the U.S. occur through eating fish and shellfish.” In addition, mercury is used in thermometers, barometers, float valves, mercury switches, and other devices where exposure can occur with device breakage. It is also found in dental amalgams, energy-efficient light bulbs, and is used in scientific research applications.
Optimal range: 0 - 1.9 ELISA Index
Mixed Heavy Metals (Nickel, Cobalt, Cadmium, Lead, Arsenic) are ubiquitous compounds found in soil, drinking water and food supply, and are not fully avoidable. However, certain exposures can be limited or controlled. These include the exposure of Heavy Metals from manufactured goods, cigarette smoke, paints, gasoline, and some food containers and cookware. Arsenic is absorbed by all plants, but is more concentrated in leafy vegetables, rice, apple and grape juice, and seafood.
Optimal range: 0 - 3.2 ELISA Index
Myelin is the protective sheath surrounding nerves. Myelin basic protein (MBP) is believed to be important in the process of myelination, the building of myelin sheaths. Thus, MBP is often a target in the demyelination process in various neuroimmune disorders.
Known Cross-Reactions:
Chlamydia pneumonia, herpes – streptococcal protein; gliadin
Optimal range: 0 - 2.3 ELISA Index
Occludin and Zonulin are proteins of the tight junctions found between epithelial cells of the intestinal barrier. These proteins are gate keepers of the body, allowing only small amino acid nutrients to pass into the blood stream. When tight junction proteins are functioning properly, they prevent large molecules from crossing the intestinal barrier into the blood stream, where they can elicit an immune response.
Optimal range: 0.1 - 1.9 ELISA Index
Human rotaviruses belong to the family of Reoviridae. Rotavirus is a double-stranded RNA virus that is commonly associated with gastroenteritis in children.
Known Cross-Reactions: Pollen allergen of Parietaria
Optimal range: 0.2 - 2 ELISA Index
The presence of salivary antibodies to Soy is an indication of loss of mucosal tolerance and the onset of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Soy allergy/intolerance is becoming more common as more people begin to seek a healthy protein-rich food. Additionally, patients with immediate or delayed sensitivities should not only avoid ingesting the food, but should also abstain from using topical products that contain Soy.
Optimal range: 0 - 1.2 ELISA Index
SIgA is the main immunoglobulin found in mucous secretions, including tears, saliva, sweat, colostrum, and secretions from the genitourinary tract, GI tract, prostate and respiratory epithelium. It is the most abundant class of antibodies found in the intestine. It promotes clearance of microbial pathogens and antigens from intestinal lumen through a process of entrapment called “immune exclusion.” SIgA uses this process to prevent the binding of these invaders to the epithelial cell receptors and entrapping them in the upper and lower layers of mucus, thus facilitating their removal through agglutination and GI secretion.
Optimal range: 0 - 3.1 ELISA Index
Transglutaminases are a family of enzymes. They form protein polymers, like scaffolding, which are vital in the formation of barriers and stable structures. The Transglutaminase found in the gastrointestinal tract is responsible for the conversion of glutamine to glutamic acid.
Commercial food industry uses transglutaminase to bind proteins together in the making of processed meats, including fish and imitation meats.
Known Cross-Reactions: Fibrinogen, Transglutaminase-3 and -6
Optimal range: 0 - 3.6 ELISA Index
The biological function of Wheat Germ Agglutinin (WGA) in wheat is unknown, however, its suggested function is to protect against fungal infection due to its ability to bind to chitin-containing cell walls. WGA is a lectin protein that binds to N-acetylglucosamine (GlcNAc) and is a binder of gram-positive bacteria via GlcNAc moies in the peptidoglycan layer of the cell wall.
Known Cross-Reactions: Lysozyme aka muramidase or N-acetylmurmamide glycanhydrolase
GI EcologiX (Invivo Healthcare)
Gastrointestinal Health & Microbiome Profile
GI EcologiX is a gut health and microbiome stool test using qPCR & ELISA technology and encompassing key microbial targets and health markers to inform and assess the individual’s microbial ecosystem and health status. The information gathered from this test can be used to guide changes in a person’s lifestyle, nutrition or other self-care interventions to protect and promote their health and well-being.
Included:
– 7 x health markers
– 62 x microbial markers
Optimal range: 3.5 - 9.2 Units
Bacteroides ovatus had been shown to elicit the largest IgG and IgA responses in Crohn’s patients of the commensal bacteria.
Why Bacteroides ovatus induces such as response is not totally known, but it does produce esterase and lipase which can be potentially hazardous to the intestinal tissue, especially if initial damage has been created by a bacterial toxin such as Enterotoxigenic Bacteroides fragilis (ETBF). Bacteriodes ovatus plays an important role of degrading inulin, which the metabolites of in turn feeds Bacteroides vulgatus and supports the colony, so they have a syntrophic relationship
Optimal range: 7.3 - 16.3 Units
Bifidobacterium is a genus of gram-positive, anaerobic bacteria. Species of this genus are highly abundant in infants, especially in breastfed ones. Reduced levels of Bifidobacteria, with a consequent depletion of acetate production, in early life have been correlated to the insurgence of atopic diseases later in life, such as asthma and eczema. Several strains are now used as probiotics in order to prevent the development of these diseases and ameliorate symptoms. For example, they have been used to treat or prevent colorectal cancer, treat antibiotic-associated diarrhoea, decrease incidence of necrotising enterocolitis, reduce symptoms of IBD, improve colon regularity and decrease pathogen colonisation in the gut.
Optimal range: 2.4 - 9.5 Units
Bilophila Wadsworthia is a gram negative, anaerobic, sulfidogenic bacterium resistant to β-lactam antibiotics. This pathobiont is commonly found in patients with appendicitis and it has been associated to the Western diet (high in fats and animal proteins), as well as severe malnutrition. A recent study in animals showed that a high fat diet stimulates the growth of B. Wadsworthia, which causes inflammation, dysfunction in the intestinal barrier and bile acid metabolism, hepatic steatosis and dysfunctional glucose metabolism. Interestingly, the co-administration of a probiotic strain (Lactobacillus rhamnoses) reduces the generated inflammation and limits the metabolic impairment.
Optimal range: 0 - 0.6 Units
Candida albicans is a filamentous yeast that colonises the mouth and gastrointestinal tract of more than 60% of healthy adults. In immunocompromised subjects (cancer, organ transplants, AIDS) it often causes the infection candidiasis. Superficial infections commonly affect the mouth and vagina, while systemic infections, often together with S. aureus, have a 40-60% mortality rate. C. albicans is associated with small intestinal fungal overgrowth (SIFO), causing bloating, diarrhoea and nausea. C. albicans is also associated with Crohn’s disease.
Optimal range: 10.4 - 16.5 Units
The abundance of Coprococcus eutactus is associated with greater bacterial gene richness in the gut.
Coprococcus is a genus of anaerobic cocci which are all part of the human faecal flora. Coprococcus includes those gram-positive, anaerobic cocci that actively ferment carbohydrates, producing butyric and acetic acids with formic or propionic and/or lactic acids. Fermentable carbohydrates are either required or are highly stimulatory for growth and continued subculture. The genus is bio-chemically closely related to Ruminococcus.
Optimal range: 4.5 - 12 Units
Escherichia coli (E. coli) is a type of bacteria that normally live in the intestines of people and animals.
Optimal range: 7.7 - 14.8 Units
Eubacterium rectale is part of the Lachnospiraceae family and produces butyrate. Eubacterium rectale was found to be in lower abundance in patients with type 2 diabetes, colorectal cancer, and chronic idiopathic diarrhea. There is a negative correlation between Eubacterium rectale levels and the symptomatology of irritable bowel syndrome (IBS). Decreased levels of Eubacterium spp. have been associated with very high protein diets.
Optimal range: 0.8 - 9 Units
Hafnia alvei plays an active role in fermented foods, such as cheeses, kimchi and other traditional fermented dishes. Increased serum IgA and IgM have been found in chronic fatigue patients with increased intestinal permeability to Hafnia alvei, Pseudomonas aeruginosa, Morganella morganii, Proteus mirabilis, Pseudomonas putida, Citrobacter koseri, and Klebsiella pneumoniae. Hafnia alvei has the potential to decarboxylate histidine to histamine.
Optimal range: 0 - 2.5 Units
Gram-negative bacteria in the Proteobacteria phylum. Common residents of the oral cavity and respiratory tract. May cause diarrhea, gas, abdominal pain, and bloating; Common after long-term antibiotic use; May release histamine in the gut; High levels may indicate increased intestinal inflammatory activity.
Optimal range: 2.7 - 8.9 Units
Lactobacillus is a genus of gram-positive, facultative anaerobes. Species belonging to this genus normally colonise the mouth, gastrointestinal- and vaginal- tract of humans. They are also known as lactic acid bacteria since the main product of their metabolism is lactate and acetate. Lactobacillus reduce pathogen colonisation in the GI tract by lowering the pH and by producing antimicrobial compounds like reuterin. Species belonging to this genus are mostly considered beneficial for the organism, helping maintain homeostasis, and are considered probiotics. They help to reduce inflammation through immunomodulation; act on the nervous system and on gut permeability. They are also protective from early-life disorders such as autoimmune diseases, allergies and obesity.
Optimal range: 5.7 - 10.2 Units
Roseburia homini is a gram-negative or gram-variable, anaerobic bacterium. Being a butyrate-producing bacterium, the derived anti-inflammatory proprieties have been inversely associated to the active status of Crohn’s disease. Decreased abundance of R. hominis has been also associated to IBS and colorectal carcinogenesis. Roseburia negatively correlates with plasma glucose in T2D patients, suggesting a possible role in glucose homeostasis. Lower levels of Roseburia have been detected in subjects affected by Parkinson’s diseases and gallstones.
Optimal range: 14.2 - 17.7 Units
Ruminococcus bromii is a keystone species, playing a large role in the digestion of resistant starches. It has been proposed that the primary role played by R. bromii is to release energy from resistant starch to other members of the microbial community, giving it an important role for maintaining microbial community balance. R. gnavus can efficiently cross-feed on starch degradation products released by R. bromii, even though it is normally a mucin degrading bacteria.
Optimal range: 6.3 - 12.5 Units
Male Comprehensive Metabolic Performance Profile (Urine) Physicians Lab
Physicians Lab offers a variety of urine testing to support wellness and integrative medicine professionals. They have designed their comprehensive Urine Hormone Panel to offer some of the most precise results available for total and free hormones, as well as metabolites in the body.
Optimal range: 56.8 - 132.8 ug/mg CR
1-methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 706.3 - 1562.8 ng/mg CR
Optimal range: 3.4 - 17.7 ug/mg CR
Beta-aminoisobutyric acid (also known as 3-aminoisobutyric acid) is a non-protein amino acid formed by the catabolism of valine and the nucleotide thymine. It is further catabolized to methylmalonic acid semialdehyde and propionyl-CoA. Levels are controlled by a vitamin B6-dependent reaction in the liver and kidneys. β-aminoisobutyric acid can also be produced by skeletal muscle during physical activity.
Optimal range: 0 - 0 ug/mg CR
Optimal range: 4.3 - 9.6 ug/mg CR
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 0 - 4.4 ug/mg CR
Optimal range: 12.6 - 38.8 ug/mg CR
Optimal range: 220.1 - 595.3 ng/mg CR
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified. It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins. Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine. Because citrulline is produced in enterocytes, it has been proposed as a marker of enterocyte mass in conditions of villous atrophy.
Optimal range: 0 - 264.5 ng/mg CR
GABA stands for Gamma-aminobutyric acid (γ-Aminobutyric Acid) and is a nonessential protein amino acid. GABA is an inhibitory neurotransmitter in the central nervous system.
Optimal range: 1374.2 - 2960.5 ng/mg CR
Homovanillic acid (HVA), or 3-methoxy-4- hydroxyphenylacetic acid, is a metabolite of dopamine. Although dopamine is an important brain neurotransmitter, a substantial amount of dopamine is produced in the GI tract.
In neurotransmitter production, dopamine is formed from phenylalanine and tyrosine using several enzymes which require nutrient cofactors such as iron, tetrahydrobiopterin, and pyridoxal phosphate.
Optimal range: 447.7 - 1211.3 ng/mg CR
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 3.7 - 39.2 ug/mg CR
Lactic Acid and Pyruvic Acid are byproducts of glycolysis. Carbohydrates, which contain glucose, are broken down through glycolysis to form pyruvate and two ATP molecules. Pyruvate can also be generated through the catabolism of various amino acids, including alanine, serine, cysteine, glycine, tryptophan and threonine. Magnesium is an important cofactor for a number of glycolytic enzymes necessary to produce pyruvate. Optimally, pyruvic acid is oxidized to form Acetyl-CoA to be used aerobically via the Citric Acid Cycle to produce energy. In an anaerobic state, lactic acid is formed instead.
Optimal range: 1148.6 - 2711.6 ng/mg CR
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 466.9 - 1569.5 ng/mg CR
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 299.7 - 809.7 ng/mg CR
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid. Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage. Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn. In addition to dietary sources, proline can be synthesized from glutamate/glutamine, arginine, and ornithine. It can also be synthesized within enterocytes from degradation of small peptides.
Optimal range: 0 - 0 ng/mg CR
Optimal range: 12.2 - 25.2 ug/mg CR
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 2.5 - 11.5 ug/mg CR
Succinyl CoA becomes succinic acid using succinyl CoA synthetase. This reaction produces NADH which directly provides electrons for the electron transport chain or respiratory chain. Succinic acid requires the enzyme succinate dehydrogenase to become fumarate. This enzyme is ironbased and requires vitamin B2 to support flavin adenine dinucleotide (FAD) as a redox coenzyme. Succinate dehydrogenase plays a critical role in mitochondrial metabolism. Impairment of this enzyme’s activity has been linked to a variety of diseases such as cancer and neurodegenerative diseases.
Optimal range: 4.3 - 10.6 ug/mg CR
Threonine is a large neutral amino acid and a precursor for the amino acid glycine. Foods that contain relatively high amounts of threonine include cheeses (especially Swiss), meat, fish, poultry, seeds, walnuts, cashews, almonds and peanuts. Threonine gets converted to glycine using a two-step biochemical pathway involving the enzymes threonine dehydrogenase and the vitamin B6-dependent glycine C-acetyltransferase.
Optimal range: 3.2 - 8.1 ug/mg CR
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 1653.4 - 3284.8 ng/mg CR
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 1236.1 - 3430.7 ng/mg CR
Vanillylmandelic acid (VMA) is an end-stage metabolite of the catecholamines dopamine, epinephrine, and norepinephrine formed via the actions of monoamine oxidase, catechol-O-methyl transferase (COMT), and aldehyde dehydrogenase. VMA is found in the urine, along with other catecholamine metabolites, including homovanillic acid (HVA), metanephrine, and normetanephrine.
MALE: First AM Comp - Urine Profile + Metabolites (Physicians Lab)
Physicians Lab offers a variety of urine testing to support wellness and integrative medicine professionals. They have designed their comprehensive Urine Hormone Panel to offer some of the most precise results available for total and free hormones, as well as metabolites in the body.
Optimal range: 34 - 118 ng/mg CR
11-Hydroxy-Androsterone (OHAN) is a urinary metabolite of cortisol metabolism as well as 11-oxygenated androgens production from the adrenal glands. While research is limited in the significance of elevations of this metabolite, it may be associated with certain conditions like 21-hydroxylase deficiency and castration- resistant prostate cancer.
Optimal range: 39 - 164 ng/mg CR
11-Hydroxy-etiocholanolone is a compound that is an end product of androgen catabolism.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 2.7 - 14 ng/mg CR
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1.
2-Methoxy-E1 has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy-E1 levels were lower in breast cancer patients than controls.
Optimal range: 12.3 - 50.1 ng/mg CR
5a-Androstanediol is a testosterone metabolite that is more androgenic than b-Androstanediol. It is metabolized via the 5-alpha metabolic pathway (= increased 5α-reductase activity). In contrast, the 5-beta metabolism makes androgens less potent.
Increased 5a-reductase activity may be accompanied by clinical signs of androgenicity (excess facial hair growth, scalp hair loss, acne, irritability, oily skin, prostate issues in men...etc).
Optimal range: 73 - 192 ng/mg CR
Metabolized cortisol is the sum of a-tetrahydrocortisol (a-THF), b-tetrahydrocortisol (b-THF), and b-tetrahydrocortisone (b-THE). They are a good indication of the total cortisol output from the adrenal gland or clearance out the body.
Optimal range: 23 - 78 ng/mg CR
Alpha-Pregnanediol in men's urine is a significant metabolite of progesterone, and its levels can provide valuable insights into hormonal balance and potential health concerns related to progesterone and androgen metabolism.
Optimal range: 0.5 - 1.5 Ratio
Alpha-Pregnanediol and Beta-Pregnanediol are metabolites of progesterone, and they are used as surrogate markers because they are the most abundant metabolites. The ratio between these two metabolites can provide insights into the relative activity of specific steroidogenic enzymes or pathways involved in progesterone metabolism.
Optimal range: 97 - 279 ng/mg CR
Optimal range: 0.4 - 1.2 Ratio
Cortisol / cortisone ratio indicates activity of HSD11B2 activity and assessment of tissue specific concentrations of cortisol, which normally cannot be measured without a biopsy.
Optimal range: 0.5 - 1.5 Ratio
Optimal range: 1 - 10 Ratio
Optimal range: 9.6 - 30.2 ng/mg CR
Dehydroepiandrosterone is a 17-Ketosteroid produced primarily by the adrenal gland by side chain cleavage of 17-Hydroxy Pregnenolone. It is reversibly converted to Dehydroepiandrosterone-Sulfate and Androstenediol. It is also converted to Androstenedione. It is excreted in the urine as Sulfate and Glucuronide conjugates and unconjugated (Free) forms.
Free DHEA urine is excreted into the urine primarily from Free (unbound) blood DHEA. DHEA urine is one of the first androgens to increase significantly at the onset of adrenache. Levels increase throughout puberty until adulthood. In females, levels drop off sharply after menopause. DHEA may distinguish adrenal causes of overandrogenization from gonadal causes.
Optimal range: 35 - 90 ng/mg CR
Tetrahydrodeoxycortisol (THS) is a mineralocorticoid, the main urinary metabolite of 11-deoxycortisol. THS excretion is significantly associated with tetrahydroaldosterone excretion, total androgen excretion, and cortisol metabolites.
Profile 1, Trace Elements (Hair)
The Profile 1, Trace Elements (Hair) test panel, offered by Trace Elements Inc., is a comprehensive diagnostic tool designed to assess the levels of various trace elements and heavy metals in the body through hair analysis. This test measures the concentrations of both essential and toxic elements, providing a valuable insight into an individual's nutritional status and potential exposure to toxic elements. Elements commonly analyzed include calcium, magnesium, zinc, copper, selenium, and toxic metals like lead, mercury, and arsenic. Hair is an excellent medium for this analysis because it accumulates trace elements over time, offering a unique long-term view of mineral status and exposure to toxic substances. The results from this test can aid healthcare professionals in identifying potential deficiencies or excesses of essential minerals, as well as exposure to toxic elements, which can be critical in diagnosing various health conditions and developing tailored treatment plans. The Profile 1 test is widely used due to its non-invasive nature and the ability to reflect long-term metabolic activity, making it a valuable tool in preventive health care and the management of nutritional and environmental factors affecting health.
Optimal range: 0 - 2 Units
Optimal range: 0 - 0.01 Units
Optimal range: 0 - 0.01 Units
Arsenic circulating in the blood will bind to protein by formation of a covalent complex with sulfhydryl groups of the amino acid cysteine. Keratin, the major structural protein in hair and nails, contains many cysteine residues and, therefore, is one of the major sites for accumulation of arsenic. Since arsenic has a high affinity for keratin, the concentration of arsenic in hair is higher than in other tissues. Arsenic binds to keratin at the time of exposure, "trapping" the arsenic in hair. Therefore, hair analysis for arsenic is not only used to document that an exposure occurred, but when it occurred. Hair collected from the nape of the neck can be used to document recent exposure. Axillary or pubic hair is used to document long-term (6 months-1 year) exposure.
Optimal range: 0 - 0.27 Units
Optimal range: 0 - 0 Units
Beryllium ores are used to make speciality ceramics for electrical and high-technology applications, also used in nuclear weapons and reactors, aircraft and space vehicle structures, instruments, x-ray machines, and mirrors.
Beryllium alloys are used in automobiles, computers, sports equipment (golf clubs and bicycle frames), and dental bridges. Lung damage has been observed in people exposed to high levels of beryllium in the air. Beryllium blocks several hepatic enzyme systems. Marcotte and Witschi (l972) suggested that this element binds to chromatin and interferes with DNA synthesis. Preventive measures such as avoiding skin contact with beryllium to prevent sensitization are most important. Careful irrigation and debridement are recommended for wounds.
Optimal range: 0 - 0.04 Units
Bismuth is a heavy, brittle metal with a white, silver-pink hue, typically found in small amounts in the earth's crust and often used in various industrial, cosmetic, and pharmaceutical applications, such as in the manufacturing of low-melting alloys, cosmetics, and some medications, particularly those used for gastrointestinal issues. In the context of a hair test, the presence of bismuth can indicate exposure to these products or environmental sources. While trace amounts of bismuth are generally considered non-toxic to humans, elevated levels can be a cause for concern.
Optimal range: 0 - 0.83 Units
Optimal range: 2.2 - 6.2 Ratio
Ideal ratio of 4.2:1 with an acceptable ideal range of 2.2 to 6.2.
Calcium is affected by several hormones and is considered to be under parasympathetic control. Therefore, the hormone cascade that affects the retention of calcium also affects thyroid expression.
Elevation of the Ca/K ratio can be indicative of reduced thyroid expression. The opposite, a low Ca/K ratio would indicate an elevation of thyroid expression. This ratio would also be associated with adrenal activity.
The Ca/K ratio can also be affected by iron, zinc, copper, selenium, lithium, cobalt, molybdenum and others.
Optimal range: 3 - 11 Ratio
Ideal ratio of 7:1 with an acceptable range from 3 to 11. Calcium and magnesium are regulated by the parathyroid, thyroid and estrogen, as well as through renal function. A markedly elevated Ca/Mg ratio reflects the potential for parathyroid hormone dominance. This
is also associated with increased insulin levels as well. A low Ca/Mg ratio reflects the potential for low insulin levels and elevated adrenal cortical hormone production.
Optimal range: 1.6 - 3.6 Ratio
The ratio of Ca/P in hair refers to the ratio of calcium (Ca) to phosphorus (P) concentrations in a sample of hair. Calcium and phosphorus are both essential minerals in the human body, and they play various roles in maintaining healthy bones, teeth, and other bodily functions.
Hair mineral analysis, including the measurement of Ca/P ratio, is sometimes used as a diagnostic tool in alternative or complementary medicine practices. Proponents of hair mineral analysis claim that imbalances in mineral ratios can provide insights into a person's nutritional status, metabolic function, and potential health issues. However, it's important to note that the scientific validity and reliability of hair mineral analysis for diagnostic purposes are still debated within the medical and scientific communities.
Traditional medical diagnostic practices generally rely on more established methods, such as blood tests and clinical assessments, to determine mineral imbalances and other health-related issues. If you have concerns about your mineral levels or overall health, it's recommended to consult with a qualified medical professional who can provide evidence-based guidance and appropriate testing.
Optimal range: 84 - 300 Ratio
The Ca/Pb ratio in hair refers to the ratio of calcium (Ca) to lead (Pb) concentrations in a hair sample. This ratio can be used as an indicator of potential lead exposure or lead toxicity in an individual. Lead is a toxic heavy metal that can have harmful effects on various body systems, especially the nervous system.
Optimal range: 0 - 0.01 Units
Cadmium is a heavy metal that can accumulate in the body over time and may cause harmful effects at elevated levels. When measured through hair analysis, cadmium reflects long-term exposure to this toxic element, offering insight into environmental or occupational sources of contamination.
Cadmium is a naturally occurring metal found in the earth’s crust. It’s commonly used in:
Batteries (especially nickel-cadmium batteries)
Pigments and coatings
Cigarette smoke
Industrial processes like metal plating, mining, and smelting
Humans can absorb cadmium through inhalation, contaminated food, water, or tobacco smoke.
Optimal range: 22 - 104 Units
Optimal range: 0.02 - 0.08 Units
A high hair chromium (Cr) level is likely to indicate excess exposure to Cr. Hair Cr levels do not appear to be affected by permanent solutions, dyes, or bleaches, but external contamination is possible. Trivalent Cr is considered to be an essential trace element with a low order of toxicity. Cr toxicity via oral ingestion is not likely. However, it is noteworthy that excessive self-supplementation has been reported to be associated with insomnia and increased unpleasant dream activity in some individuals (J. Nutr. Med.; 3(43), 1992).
Phytates decrease oral assimilation of Cr+3, whereas nicotinic acid and vitamin C increase absorption of Cr+3, zinc, vanadium and iron compete with Cr for absorption. In contrast, hexavalent Cr compounds are considerably more toxic and are primarily absorbed via inhalation as a result of industrial exposure. Industrial exposure to high amounts of Cr has been reported to be associated with allergic dermatitis, skin ulcers, bronchitis, and lung and nasal carcinoma. Elevated hair Cr levels have also been observed in patients with cerebral thrombosis and cerebral hemorrhage.
Optimal range: 0 - 0.01 Units
Hair may be used for monitoring excess exposure to cobalt (Co). However, hair is occasionally contaminated by external Co from some hair treatments. If an individual’s hair has been treated with permanent solutions, dyes, or bleach, the Co levels may not be indicative of body Co accumulation.
Humans absorb Co both as inorganic Co and as vitamin B-12; the body pools of each fluctuate independently. Humans cannot convert inorganic Co to vitamin B-12, and vitamin B-12 provides the only documented function of Co in humans. Thus, a high hair Co level does not mean that vitamin B-12 levels are high or even adequate.
Optimal range: 0.9 - 3.2 Units
Hair Copper (Cu) levels are usually indicative of body status, except that exogenous contamination may occur giving a false normal (or false high). Common sources of contamination include: permanent solutions, dyes, bleaches, and swimming pools/hot tubs in which Cu compounds have been used as algaecides.
Cu is an essential element that activates specific enzymes. Erythrocyte superoxide dismutase (SOD) is a Cu (and zinc) dependent enzyme; lysyl oxidase which catalyzes crosslinking of collagen is another Cu dependent enzyme. Adrenal catecholamine synthesis is Cu dependent, because the enzyme dopamine beta-hydroxylase, which catalyzes formation of norepinephrine from dopamine, requires Cu.
If hair Cu is in the normal range, this usually means tissue levels are in the normal range. However, under circumstances of contamination, a real Cu deficit could appear as a (false) normal. If symptoms of Cu deficiency are present, a whole blood or red blood cell elements analysis can be performed for confirmation of Cu status.
Optimal range: 0.2 - 1.6 Ratio
Optimal range: 10 - 40 Ratio
Optimal range: 4.4 - 20 Ratio
Optimal range: 0 - 0 Units
Optimal range: 0.5 - 2 Units
Optimal range: 0 - 0.2 Units
Optimal range: 0 - 0.01 Units
Lithium, when detected on a Profile 1, Trace Elements (Hair) test panel, plays a critical role in understanding one's exposure to this element and its potential impact on health. Primarily known for its use in psychiatric medication, particularly for bipolar disorder, lithium in trace amounts is naturally present in water and soil, and consequently in the human body. This test, which analyzes hair samples, offers a unique window into the body's long-term accumulation of lithium. Unlike blood tests that reflect recent exposure, hair analysis can reveal exposure over weeks to months. Lithium levels in hair can indicate either dietary intake or environmental exposure.
Optimal range: 1.3 - 9.4 Units
Magnesium (Hair) refers to the measurement of magnesium levels in a small sample of hair. This type of testing is part of a hair tissue mineral analysis (HTMA), which assesses the long-term balance of essential and toxic elements in the body. Unlike blood tests that reflect short-term changes, hair provides a longer-term view of mineral status—typically over a period of several weeks to months.
Why magnesium matters:
Magnesium is an essential mineral involved in over 300 enzymatic reactions in the body. It plays a critical role in:
Energy production (ATP synthesis)
Muscle and nerve function
Blood sugar regulation
Bone development
Stress response and mood regulation
Cardiovascular health
Optimal range: 0.01 - 0.11 Units
Manganese (Mn) is an essential element which is involved in the activation of many important enzymes. However, Mn excess is postulated to result in glutathionyl radical formation, reduction of the free glutathione pool, and increased exposure of adrenal catecholamines (e.g. dopamine) to free radical damage.
Hair Manganese (Mn) levels generally reflect actual body stores, and external contamination can influence hair Mn. Since particulate manganese-containing dust is the most common source of Mn toxicity, hair is considered to be an excellent tissue for the assessment of Mn exposure.
Optimal range: 0 - 0.15 Units
Mercury is a heavy metal that can be toxic to the body at elevated levels. Hair analysis for mercury, as seen on the Profile 1, Trace Elements (Hair) test panel, offers insight into chronic or past exposure to mercury, especially over the previous weeks to months.
Hair tissue mineral analysis (HTMA) is commonly used to assess long-term exposure to heavy metals like mercury. Unlike blood or urine, which reflect recent exposure, hair provides a timeline of accumulation, giving a broader view of how much mercury your body has been exposed to over time.
Optimal range: 0 - 0.01 Units
Optimal range: 1.4 - 3.4 Ratio
The Sodium to Potassium ratio (Na/K) is a crucial indicator of stress on the adrenal glands, and its proper regulation is essential for maintaining overall health. Aldosterone and cortisol play key roles in controlling sodium and potassium levels in the body, influencing blood pressure and stress response. Proper management of this ratio is vital for maintaining physiological balance and well-being.
Optimal range: 2 - 6 Ratio
The Na/Mg ratio in a Profile 1, Trace Elements (Hair) panel is crucial for assessing health and nutrition. This ratio, comparing Sodium (Na) and Magnesium (Mg), helps identify imbalances that may indicate conditions like hypertension or adrenal insufficiency. Sodium is essential for fluid balance and nerve function, while Magnesium is key for enzymatic reactions and muscle function. A balanced Na/Mg ratio is vital for cellular health and metabolic efficiency. Deviations can guide dietary and lifestyle adjustments, with significant implications in nutritional therapy and holistic health care. This analysis provides non-invasive, long-term metabolic insights, aiding in tailored health strategies.
Optimal range: 0 - 0.08 Units
Optimal range: 10 - 21 Units
Optimal range: 0 - 0 Units
Optimal range: 2 - 23 Units
Potassium is a primary intra-cellular element required for fluid balance, nerve activity and muscle activity.
Optimal range: 0 - 0.02 Units
Rubidium is a relatively benign element that typically parallels the potassium level. It varies according to levels found in water supplies.
Optimal range: 71126 - 5000000 Ratio
Optimal range: 28450 - 50000 Ratio
Optimal range: 5690 - 50000 Ratio
Optimal range: 0.8 - 2 Ratio
Optimal range: 0.04 - 0.12 Units
Selenium is normally found in hair at very low levels, and several studies provide evidence that low hair Selenium is reflective of dietary intake and associated with cardiovascular disorders. Utilization of hair Selenium levels to assess nutritional status, however, is complicated by the fact that use of Selenium- or sulfur-containing shampoo markedly increases hair Selenium (externally) and can give a false high value.
Optimal range: 3 - 34 Units
Optimal range: 0 - 0.58 Units
Strontium in a hair analysis can provide valuable information about an individual's body burden of strontium and its correlation with calcium levels in body tissues. Strontium levels in hair can be influenced by both endogenous (internal) and exogenous (external) sources. Endogenous sources of strontium in hair originate from the body's strontium pools within blood and bones, while exogenous sources represent external environmental influences from aerosols, particulates, and environmental waters.
Optimal range: 3915 - 5528 Units
Sulfur levels in hair analysis can provide valuable insights into an individual's health and nutritional status. Here's what sulfur signifies in hair analysis:
→ Dietary Sulfur Intake: Sulfur is an essential mineral that is obtained through the diet, primarily from sulfur-containing amino acids like cysteine and methionine. Hair analysis can indicate the individual's dietary sulfur intake.
→ Protein and Keratin Formation: Sulfur is a critical component of proteins, including the protein keratin found in hair. Adequate sulfur levels are necessary for the formation of strong and healthy hair.
→ Detoxification Processes: Sulfur is also involved in the body's detoxification processes. Sulfur-containing compounds help the body eliminate toxins and heavy metals, and hair analysis can reveal how effectively these processes are functioning.
→ Hair Health: Low sulfur levels in hair may suggest potential issues with hair health and growth. It can be associated with conditions like brittle or thinning hair.
→ Nutritional Status: Sulfur levels in hair can reflect an individual's overall nutritional status. Low sulfur levels may indicate a deficiency in sulfur-containing amino acids or other nutrients in the diet.
→ Toxic Exposure: On the other hand, excessively high sulfur levels in hair may be a sign of exposure to environmental pollutants or sulfur-containing compounds.
It's important to note that interpreting hair analysis results, including sulfur levels, should be done by healthcare professionals or experts in the field. The significance of sulfur levels can vary from person to person, and a comprehensive assessment of the individual's health, diet, and environmental factors is necessary for a more accurate understanding of the implications.
Optimal range: 0 - 0 Units
Optimal range: 0 - 0.07 Units
Optimal range: 0 - 0.24 Units
Optimal range: 0 - 0 Units
Optimal range: 0 - 0.01 Units
Uranium is a naturally occurring radioactive heavy metal found in soil, rocks, water, and certain foods. While small environmental exposures are common, elevated uranium levels in the body can be a health concern due to its chemical toxicity and potential for radiation exposure.
Optimal range: 0 - 0.01 Units
Optimal range: 9 - 22 Units
A high level of zinc (Zn) in hair may be indicative of low Zn in cells, and functional Zn deficiency. Zn can be displaced from proteins such as intracellular metallothionein by other metals, particularly cadmium, lead, copper, and mercury (Toxicology of Metals, 1994), resulting in paradoxically elevated hair Zn. Zn may also be high in hair as a result of the use of Zn- containing anti-dandruff shampoo. Rough or dry, flaky skin is a symptom of Zn deficiency, so it is not uncommon for Zn deficient patients to use an anti-dandruff shampoo.
Optimal range: 0 - 0.06 Units
Optimal range: 500 - 20000 Ratio
Optimal range: 4 - 12 Ratio
The ideal ratio between zinc and copper is 8:1 with an acceptable range from 4 to 12.
The minerals zinc and copper are influenced by several physiological factors, as well as hormonal factors, including estrogen, progesterone and testosterone.
Zinc is necessary for the production of progesterone and testosterone, while copper is influenced by estrogen.
Zinc and copper are also related to the antioxidant activity of superoxide dismutase (SOD). Their balance would reflect the activity of zinc and copper activated SOD. This ratio is affected by physiological conditions such as pregnancy, growth and development. Virus and bacterial infections can also influence the Zn/Cu ratio.
Optimal range: 200 - 2000 Ratio
Pneumococcal Ab (23 Serotype)
This test measures IgG antibody levels to Streptococcus pneumoniae to evaluate how well a person has responded to pneumococcal vaccination. Streptococcus pneumoniae is a bacteria responsible for most cases of pneumonia, as well as other serious conditions like bronchitis, septicemia, and meningitis. Pneumonia is especially dangerous for young children, adults over 65, and individuals with weakened immune systems.
There are several pneumococcal vaccines available, with the two most common being Prevnar13 (PCV13) and Pneumovax23 (PPSV23). PCV13 provides protection against 13 pneumococcal serotypes, while PPSV23 covers 23 serotypes. Depending on age and risk factors, a person may be recommended to receive one or both vaccines. After vaccination, this blood test helps verify if sufficient IgG antibody levels have been developed to protect against infection.
This test specifically measures antibodies to the 23 serotypes included in the PPSV23 vaccine, which are classified as: 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A, 19F, 20, 22F, 23F, and 33F. It typically takes 3–4 weeks after vaccination for IgG antibodies to fully develop.
Testing is usually ordered after vaccination to confirm adequate antibody levels for protection. It's important to review test results with a healthcare provider, as low antibody levels may not always be flagged on the report but could indicate insufficient immunity.
While the presence of antibodies suggests some level of immunity, the exact serologic correlates of protection against pneumococcal disease have not been rigorously established for all patient populations. Published data and expert consensus, including recommendations from the World Health Organization (WHO), suggest the following:
In addition to the quantity of antibodies, other factors such as antibody avidity (strength of binding to the antigen) and opsonophagocytic activity (ability of antibodies to promote bacterial clearance) contribute to protection.
After vaccination, a 4–6 week period is typically needed to assess the immune response. A normal post-vaccine serologic response is often defined as either:
This test plays a vital role in ensuring the effectiveness of pneumococcal vaccination, especially for at-risk individuals, by identifying whether adequate protection has been achieved.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 50 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 50 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 50 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 50 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 10 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 50 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
Optimal range: 1.3 - 50 ug/ml
The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination.
LRA (Lymphocyte Response Assay)
Conventional therapies for autoimmune conditions involve some combination of immune suppressive therapies. In contrast, the LRA (Lymphocyte Response Assay) by ELISA/ACT is a way of determining for each individual what items are burdening the immune system and a system for restoring immune competence.
By looking directly at lymphocytes, the LRA detects all 3 types of delayed food and chemical hypersensitivities to as many as 512 items.
Reactive items are an adverse load on your body’s immune defenses. This means a reduced ability to respond to new or chronic infections. Reactive items also decrease immune activities needed to repair your body. This can provoke inflammation and self-attack ("autoimmunity").
Avoid strong reactors for six (6) months and moderate reactors for three (3) months to reduce the burden on the immune system and restore your body’s ability to repair. Avoiding reactive items can break the cycle of impaired defense and repair, allowing your body to start the recovery and repair process.
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Reference range: Strong reaction, Moderate reaction, No reaction
Cytokine assay panel for immune profile
Cytokines are a large group of secreted proteins with diverse structures and functions, which regulate and coordinate many cells activities of innate and adaptive immune systems. Therefore, these molecules are involved in multiple processes: acute inflammations such as infectious or post-vaccinal conditions, chronic inflammations such as autoimmune diseases, chronic infections or tumors.
Optimal range: 0 - 26.5 pg/mL
CCL3, also known as Macrophage Inflammatory Protein-1 alpha (MIP-1α), is a chemokine protein that plays a critical role in the immune response and inflammation. Chemokines are small proteins that act as signaling molecules, attracting and directing immune cells to sites of infection, injury, or inflammation within the body.
CCL3 is produced by various cell types, including macrophages, monocytes, and dendritic cells. It is part of the CC (or beta) chemokine family, which indicates the presence of two adjacent cysteine residues near the amino terminus of the protein. CCL3 interacts with specific receptors on the surface of target cells, primarily the CCR1, CCR4, and CCR5 receptors.
Optimal range: 0 - 8.63 pg/mL
CCL4 is a chemoattractant for critical immune regulatory cells such as monocytes/macrophages, T-lymphocytes, natural killer cells and dendritic cells.
CCL4 is produced by monocytes, T/B lymphocytes, neutrophils, fibroblasts and endothelial/epithelial cells. CCL4 expression by neutrophils contributes to inflammation by recruiting other leukocytes at site(s) of inflammation which results in resolution of inflammation by macrophage-mediated efferocytosis or development of chronic inflammation.
Optimal range: 0 - 10318.2 pg/mL
T-Cell-Specific Protein RANTES is chemotactic for T-cells, human eosinophils and basophils and plays an active role in recruiting leukocytes into inflammatory sites. It also activates the release of proteins from eosinophils such as eosinophilic cationic protein. It changes the density of eosinophils and makes them hypodense, which is thought to represent a state of generalized cell activation and is associated most often with diseases such as asthma and allergic rhinitis.
Optimal range: 0 - 8.41 pg/mL
IFN-γ is a helper T-cell 1 (Th1)-derived cytokine and plays a critical role for both innate and adaptive immunity against viral and intracellular bacterial infections and tumor control.
Optimal range: 0 - 12.22 pg/mL
GM-CSF stands for Granulocyte-Macrophage Colony-Stimulating Factor. It is a protein that functions as a growth factor and cytokine in the immune system. GM-CSF is produced by various cells, including immune cells like T cells, macrophages, and endothelial cells, as well as some non-immune cells.
Its main role is to stimulate the production and differentiation of a type of white blood cell called granulocytes (including neutrophils, eosinophils, and basophils) and macrophages from their precursor cells in the bone marrow. These cells play critical roles in the immune response, including defense against infections and regulation of inflammatory processes.
Optimal range: 0 - 5.76 pg/mL
Interleukin-10 is an important suppressor of immune responses.
In vitro studies indicate that Interleukin-10 directly inhibits IL-2 and IL-5 production by TH1 and TH2 cells. Interleukin-10 acts as an immunosuppressor of antigen presenting cells (APC). Interleukin-10 suppresses epidermal Langerhans cell APC function, monocyte chemokines expression, and the bactericidal responses of macrophages. A number of studies suggest that IL-10 plays a role in controlling inflammation, autoimmunity, and angiogenesis.
Optimal range: 0 - 4.78 pg/mL
Interleukin 13 is a mediator of allergic inflammation and different diseases including asthma.
IL-13 is implicated in numerous processes, including a) recruitment of eosinophils and M2 macrophages to the lung, b) induction of mucus secretion into the airways and goblet cell metaplasia, c) proliferation of smooth muscle cells, and d) fibrosis via fibroblast activation and subsequent collagen deposition.
Optimal range: 0 - 8.89 pg/mL
Interleukin 2 is a pleiotropic cytokine produced primarily by mitogen- or antigen- activated T lymphocytes.
Interleukin 2 plays a role in promoting the clonal expansion of antigen-specific cytotoxic and suppressor T cells. In vitro studies suggest that Interleukin 2 may also be produced by dendritic cells and certain lymphoma cell lines.
In addition, Interleukin 2 has been shown to mediate multiple immune responses on a variety of cell types.
Optimal range: 0 - 12.19 pg/mL
Interleukin 4 is a pleiotropic cytokine produced by activated T lymphocytes, CD3+ cells, NK-T cells, mast cells, eosinophils, and basophils.
Interleukin 4 has multiple immune response modulation functions on a variety of cell types. It is an important regulator of isotype switching, inducing IgE production in B lymphocytes. It is an important modulator of the differentiation of precursor T helper cells to the TH2 subset that mediates humoral immunity and modulates antibody production. In addition, Interleukin 4 has also been shown to have antitumor activity both in vivo and in vitro.
Optimal range: 0 - 8 pg/mL
Interleukin-6 is involved in inflammation and infection responses and also in the regulation of metabolic, regenerative, and neural processes.
Optimal range: 0 - 13.87 pg/mL
Interleukin 8 (IL-8) is a promising marker for many clinical conditions and currently being applied by various subspecialties of medicine either for the purpose of rapid diagnosis or as a predictor of prognosis. Nevertheless, IL-8 level increased as a result of many inflammatory conditions, so careful interpretation of IL-8 level is required to make correlation with desired clinical condition's diagnosis or prognosis.
Optimal range: 0 - 2068.22 pg/mL
CD40 ligand (CD40L), also known as CD154, is a protein that is primarily expressed on the surface of activated T cells and belongs to a member of the tumor necrosis factor superfamily. Lack of CD40L results in an inability to undergo immunoglobulin class switch and only class IgM antibodies can be generated. CD40L exists as a membrane-bound form with a molecular weight of 33 kDa and as a soluble form with a molecular weight of 18 kDa. Soluble CD40L (sCD40L) is stored in platelet granules and thus its presence in the blood is a biomarker of platelet activation. sCD40L expression is known to be upregulated in atheroma-associated cells.
Optimal range: 0 - 16.1 pg/mL
Results are used to understand the pathophysiology of immune, infectious, or inflammatory disorders, or may be used for research purposes.
Tumor necrosis factor-α (cachectin) and tumor necrosis factor-β (lymphotoxin) are two closely related proteins that share sequence homology of 34% in their amino acid sequence. Both mediators act on their target cells via the same receptors and, therefore, show similar, but not identical, biological effects. Under denaturing conditions TNF-α is a 17-kilodalton, nonglycosylated protein. The biologically active form of TNF-α is a trimer. Besides this soluble form of TNF-α, a 28-kilodalton membrane-bound form occurs on cell surfaces of TNF-producing cells, which may serve as a pool for soluble TNF-α and can be proteolytically cleaved from the cell surface.
Optimal range: 0 - 8.43 pg/mL
What is the VEGF test?
This test measures the amount of vascular endothelial growth factor (VEGF) in your blood. VEGF is a substance that helps encourage the growth of new blood vessels. Your body makes more VEGF in certain cases. For instance, if your tissues aren't getting enough oxygen, they may make more VEGF so that new blood vessels grow to bring in more oxygen. Your lungs contain VEGF because good blood flow is vital there.
But VEGF also plays a role in cancer growth. Cancers need an ample blood supply. As a tumor grows larger, its cells need more oxygen from the blood. The cancer encourages new blood vessels to grow to supply it with more blood and oxygen. Most tumors show higher levels of VEGF. Sometimes higher levels mean a lower chance of survival. In addition, VEGF may be important in the spread of cancer to other places within your body. Certain cancer treatments target VEGF. This test may be used to tell how well the treatments are working.
VEGF can also promote "leakiness" of blood vessels. This can lead to swelling in surrounding areas. This can be especially harmful during brain cancer because it can increase pressure within the skull and may lead to brain damage. Leaking blood vessels in the eye causing problems is also seen in age-related macular degeneration and eye changes from diabetes.
Normal concentrations of VEGF do not exclude the diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome.
Body Temperature Measurements
Tracking body temperature is crucial for various reasons:
Health Monitoring: A higher temperature (fever) often indicates an underlying infection or illness, allowing for timely medical intervention and treatment.
Disease Detection: Changes in body temperature can be indicative of certain diseases and conditions, aiding in early detection and diagnosis.
Medical Diagnosis: Hospitals and healthcare professionals rely on temperature measurement as a diagnostic tool for assessing patient health and guiding treatment decisions.
Treatment Monitoring: Tracking temperature helps monitor the effectiveness of treatments and interventions, ensuring progress or necessitating adjustments.
Daily Health: Regular temperature measurement can provide insights into overall health trends and help individuals identify anomalies or potential health issues.
In summary, body temperature tracking is a fundamental aspect of healthcare, aiding in the identification of illnesses, guiding medical decisions, and promoting overall well-being.
Optimal range: 97 - 99 F
The Daily Average Temperature by Dr. Rind refers to a concept related to metabolic health. According to information from Dr. Rind's Center for Health, the average daytime temperature of an individual is influenced by the thyroid mechanism and metabolic health. Typically, an adult with a healthy thyroid and metabolism has an average mid-afternoon temperature around 98.6 degrees Fahrenheit (37.0°C).
Dr. Rind's Metabolic Temperature Graph is used to record and track daily average temperatures, often associated with monitoring metabolic health and thyroid function. It's worth noting that Dr. Rind's methods are utilized in contexts like addressing chronic fatigue syndrome.
Optimal range: 97 - 99 F
Dr. Barnes' Basal Temperature Test (BBTT) is a method used to assess thyroid function. It involves measuring the body's basal temperature upon waking. The test is based on the idea that low thyroid function can result in a lower body temperature. According to Dr. Broda Otto Barnes, who developed and promoted the test, a normal reading upon waking is around 97.8 °F (36.6 °C). If the basal temperature consistently deviates from this range, it might indicate an underactive thyroid.
The BBTT is performed by placing a thermometer in the armpit for 10 minutes immediately upon waking. While this test can provide indications of thyroid issues, it's not a definitive diagnostic tool and should be used alongside other assessments. If the test suggests thyroid dysfunction, consult a medical professional for further evaluation and treatment options.
B Cell Panel
A B cell panel, also known as a B-cell screen or B cell subset analysis, is a laboratory test that measures and analyzes B cells (B lymphocytes) in the blood. B cells are a type of white blood cell that plays a crucial role in the immune system. They are responsible for producing antibodies that help the body fight infections and diseases.
The B cell panel is used to assess the quantity and function of B cells in the blood. It can provide valuable information for diagnosing and monitoring various medical conditions, including B-cell leukemia, lymphoma, immunodeficiency disorders, and autoimmune diseases. The test helps healthcare professionals understand how B cells are functioning and whether there are any abnormalities in their numbers or activity.
Different B cell panels may focus on specific aspects of B cell function, such as immunophenotyping, which identifies specific markers on B cells to characterize their subtype. Overall, a B cell panel is an essential tool in the diagnosis and management of conditions related to the immune system and hematological disorders, providing valuable insights into a patient's health.
Optimal range: 42 - 72 %
CD19+CD27+IgM+IgD+ refers to a specific subset of B cells characterized by the expression of the cell surface markers CD19, CD27, IgM, and IgD. These markers help categorize B cells into different subsets based on their developmental stage and function.
In this context, the percentage of CD19+CD27+IgM+IgD+ cells (% of CD27+) likely refers to the proportion of B cells with this specific phenotype within the total CD27+ B cell population. It represents a subset of memory B cells with unique characteristics.
Optimal range: 0.5 - 2.9 %
Naive B cells CD19+CD27-CD21-CD38- are a specific subset of B cells with distinct surface marker characteristics:
CD19+: This marker indicates that these cells express the CD19 antigen, which is commonly found on B cells.
CD27-: The absence of CD27 expression suggests that these B cells are not memory B cells. CD27 is typically expressed on memory B cells.
CD21-: The absence of CD21 expression may indicate that these B cells have reduced levels of complement receptor 2 (CR2), which can affect their ability to respond to complement-mediated signals.
CD38-: The absence of CD38 expression suggests that these B cells have lower levels of CD38, which is involved in various B cell functions, including activation and differentiation.
Optimal range: 58 - 78 %
Naive B cells, characterized as CD19+CD27-IGM+IGD+, are a subset of B cells that have not yet encountered an antigen. Here's a breakdown of their characteristics:
CD19+: This marker signifies that these cells express the CD19 antigen, which is a common B cell marker.
CD27-: Naive B cells lack CD27 expression. CD27 is a marker used to distinguish between memory B cells and naive B cells. The absence of CD27 indicates that these B cells have not undergone the differentiation and class-switching that typically occurs in memory B cells.
IGM+ and IGD+: Naive B cells express both IgM and IgD immunoglobulin isotypes on their surface. IgM and IgD are B cell receptors and are important for antigen recognition. Naive B cells carry both to allow them to respond to a wide range of antigens effectively.
Cerebrospinal Fluid (CSF) Analysis
A CSF analysis, also known as spinal fluid analysis or CSF testing, comprises a set of tests that utilize a sample of cerebrospinal fluid to diagnose various conditions affecting the brain, spinal cord, and the central nervous system. These tests are valuable for identifying neurological diseases, infections, and other health issues that may impact CNS function.
CSF plays a crucial role as a protective cushion for the brain and spinal cord, guarding them against sudden impacts and injuries. Additionally, it serves as a waste disposal system, aiding in the removal of metabolic waste products from the brain. This function is essential for maintaining the optimal functioning of the central nervous system.
Optimal range: 0.16 - 1 Ratio
Optimal range: 7 - 29 mg/dL
Albumin, CSF refers to the measurement of albumin levels in cerebrospinal fluid (CSF). Albumin is a protein made by the liver that normally circulates in the blood. In healthy individuals, only very small amounts of albumin pass from the blood into the CSF due to the protective blood-brain barrier (BBB).
Measuring albumin in the CSF helps assess the integrity of the blood-brain barrier. The blood-brain barrier is a selective membrane that controls which substances can enter the brain from the bloodstream.
This test is commonly used to evaluate:
Suspected central nervous system (CNS) infections or inflammation
Neurological conditions such as multiple sclerosis
Trauma, stroke, or tumors that may disrupt the BBB
Conditions causing increased CSF protein levels
Reference range: Clear, Yellow, Orange, Pink
Cerebrospinal fluid (CSF) is a clear, watery liquid that flows around the brain and spinal cord, surrounding and protecting them. CSF testing is performed to evaluate the level or concentration of different substances and cells in CSF in order to diagnose conditions affecting the brain and spinal cord (central nervous system).
The appearance of the sample of CSF is usually compared to a sample of water.
Optimal range: 0 - 0 %
Crenated erythrocytes are red blood cells (RBCs) with an irregular, spiked appearance caused by cellular dehydration or exposure to hypertonic environments. In cerebrospinal fluid (CSF), their presence typically reflects structural damage or mechanical disruption to blood vessels, leading to RBC breakdown or abnormal morphology.
Optimal range: 50 - 80 mg/dL , 2.78 - 4.44 mmol/L
CSF glucose, also known as cerebrospinal fluid glucose or glycorrhachia, is a measurement used to determine the concentration of glucose in cerebrospinal fluid. The normal reference range for CSF glucose is typically between 50-80 mg/dL.
If the levels are lower than this range, it may indicate an infection or other medical conditions.
The CSF glucose test is an important diagnostic tool used to assess various neurological and infectious diseases. It helps doctors evaluate conditions like meningitis, encephalitis, and other central nervous system disorders.
Abnormal results, such as high CSF glucose levels, can be indicative of conditions like hyperglycemia, infection (bacterial or fungal), or inflammation of the central nervous system.
Optimal range: 0 - 0.7 index
The CSF IgG Index is a valuable marker for detecting immune activity within the brain or spinal cord, often helping diagnose or monitor diseases like multiple sclerosis. Results should always be interpreted alongside other tests (e.g., oligoclonal bands, MRI) and clinical findings by a healthcare provider.
Optimal range: 0 - 0 MM3
Normally no red blood cells are present in the CSF. The presence of red blood cells may indicate bleeding into the CSF or may indicate a “traumatic tap” – blood that leaked into the CSF sample during collection.
Optimal range: 5 - 40 mg/dL , 50 - 400 mg/L
Protein appears in nearly all body tissues, along with your enzymes, blood, and cerebrospinal fluid (CSF). Healthy CSF has a low amount of protein.
- Protein level, opening pressure, and CSF-to-serum glucose ratio vary with age.
- CSF protein concentration is one of the most sensitive indicators of pathology within the CNS.
- The spinal fluid normally contains very little protein since serum proteins are large molecules that do not cross the blood-brain barrier. Most of the protein that is normally present is albumin.
- CSF protein concentration may rise due to 2 factors: either an increased permeability of the blood brain barrier allowing more protein and higher molecular weight proteins to enter the CSF or proteins may be synthezised within the cerebrospinal canal by inflammatory or other invading cells.
Optimal range: 0 - 5 MM3
Normally very few white blood cells are present in CSF. A significant increase in white blood cells in the CSF can be caused by infection or inflammation of the central nervous system.
Optimal range: 0 - 8 index
The CSF/Serum Albumin Index is a key diagnostic tool used to assess the integrity of the blood-brain barrier (BBB). It compares albumin concentrations in the cerebrospinal fluid (CSF) and serum. Since albumin is produced exclusively in the liver and not within the central nervous system (CNS), its presence in the CSF indicates passive diffusion across the BBB. An elevated index suggests increased permeability or disruption of the barrier, making it a reliable marker for BBB dysfunction.
Optimal range: 0 - 0 cells/uL
Erythrocytes (red blood cells) are typically absent in cerebrospinal fluid (CSF) under normal conditions. Their presence can indicate a subarachnoid hemorrhage (bleeding in the brain), traumatic lumbar puncture (blood contamination during CSF collection), or other conditions such as CNS trauma, severe infections, or tumors causing blood vessel damage. Differentiating between true hemorrhage and a traumatic puncture often involves testing for xanthochromia (a yellow discoloration from hemoglobin breakdown) and analyzing sequential CSF samples for a decreasing erythrocyte count. Elevated erythrocytes in CSF require further evaluation with imaging or additional tests to determine the underlying cause and guide appropriate treatment.
Optimal range: 0 - 6.7 mg/dL
IgG, Quant, CSF stands for Immunoglobulin G, Quantitative, Cerebrospinal Fluid. This test measures the concentration of IgG, a type of antibody, in your cerebrospinal fluid (CSF)—the clear fluid that surrounds your brain and spinal cord.
Immunoglobulin G (IgG) is the most abundant antibody in the body. It plays a critical role in immune defense by identifying and neutralizing viruses, bacteria, and other foreign substances. IgG is normally found in the blood but can also be present in small amounts in the CSF.
Optimal range: -9.9 - 3.3 mg/day
The IgG Synthesis Rate (CSF) measures how much immunoglobulin G (IgG) is being actively produced within the central nervous system (CNS)—specifically the brain and spinal cord. It helps determine whether the immune system is generating antibodies inside the CNS, which can signal inflammation, infection, or autoimmune activity affecting the brain or spinal cord.
Why it matters:
While some IgG naturally crosses from the blood into the cerebrospinal fluid (CSF), an elevated IgG synthesis rate means the immune system is producing extra IgG locally within the CNS. This is a hallmark of conditions like multiple sclerosis (MS), chronic CNS infections, or autoimmune neuroinflammatory diseases.
Optimal range: 0 - 0.25 Ratio
The IgG/Alb Ratio, CSF helps distinguish whether elevated IgG in the cerebrospinal fluid is due to local immune activity or simply leakage through a damaged blood-brain barrier. A high ratio often points to neurological conditions like multiple sclerosis or chronic CNS infections. A normal or low ratio suggests stable immune activity and barrier integrity.
Optimal range: 0 - 25 U/L
Lactate dehydrogenase (LDH) in cerebrospinal fluid (CSF) serves as a significant biomarker for evaluating various central nervous system (CNS) conditions. Elevated CSF LDH levels are linked to trauma, infections, neoplastic disorders, and autoimmune diseases, reflecting underlying pathologies affecting the brain and CNS. LDH plays a crucial role in cellular metabolism by catalyzing the interconversion of pyruvate and lactate.
CSF LDH analysis is particularly valuable in distinguishing structural from metabolic causes of altered mental status in children, with higher levels often indicating structural brain injuries. In meningitis, CSF LDH levels are markedly elevated in pyogenic and tubercular meningitis compared to viral meningitis, aiding in diagnosis and differentiation. Furthermore, CSF LDH isoenzyme analysis has shown potential in identifying CNS involvement in hematologic malignancies, enhancing the sensitivity of CSF cytology.
Optimal range: 0 - 5 cells/uL
Optimal range: 40 - 80 %
Lymphocytes (Lymphs) in cerebrospinal fluid (CSF) are an important marker often assessed during lab tests to evaluate the health of the central nervous system. Lymphocytes are a type of white blood cell that plays a critical role in the immune response. In the CSF, elevated levels of lymphs can indicate inflammation or infection, such as viral meningitis, autoimmune diseases, or certain cancers like lymphoma. Normal lymphocyte levels in the CSF typically suggest a healthy central nervous system. However, deviations from normal ranges may prompt further investigation to determine the underlying cause of the immune response within the brain and spinal cord.
Optimal range: 0 - 0 %
Non-Crenated Erythrocytes (CSF) refer to red blood cells (RBCs) in cerebrospinal fluid (CSF) that maintain their normal, smooth, biconcave shape. Their presence typically indicates a more recent or acute introduction of blood into the CSF, such as from a traumatic injury, subarachnoid hemorrhage, or traumatic lumbar puncture. Unlike crenated erythrocytes, which form after prolonged exposure to CSF or osmotic stress, non-crenated erythrocytes suggest fresh bleeding or damage. Elevated levels of non-crenated erythrocytes often accompany other markers of acute trauma or hemorrhage and require further evaluation with imaging studies and additional CSF analysis to identify the source and extent of the underlying issue.
Optimal range: 0 - 4 uL
The nucleated cell count in CSF is a vital marker of immune system activity within the brain and spinal cord. Elevated levels often point to infection, inflammation, malignancy, or other CNS pathology, and always require interpretation in the context of other laboratory findings and clinical symptoms. A normal count generally suggests no active CNS inflammation or infection, but results must be considered alongside the patient’s overall clinical picture.
Reference range: Absent, Present
Oligoclonal bands (OCBs) are special types of proteins (called immunoglobulin G or IgG) that show up in cerebrospinal fluid (CSF), the fluid that surrounds your brain and spinal cord. These bands form when the immune system produces antibodies in the central nervous system (CNS). Finding these bands in the CSF can help doctors diagnose certain diseases affecting the brain and spinal cord, especially those involving inflammation.
Optimal range: 0 - 61 pg/mL
Phosphorylated Tau 181 (pTau181) is a biomarker measured in cerebrospinal fluid (CSF) to assess the presence of abnormal tau protein associated with neurodegenerative diseases, particularly Alzheimer’s disease. Tau is a protein involved in stabilizing microtubules within neurons, but when abnormally phosphorylated at specific sites, such as threonine 181, it becomes dysfunctional and contributes to the formation of neurofibrillary tangles—a hallmark of Alzheimer’s pathology. Elevated pTau181 levels in CSF are strongly indicative of tau-related neurodegeneration and help distinguish Alzheimer’s disease from other types of dementia or neurodegenerative conditions. When analyzed alongside total tau and amyloid-beta (Aβ42) levels, pTau181 improves diagnostic accuracy for early Alzheimer’s, aiding in the differentiation of Alzheimer’s from other disorders like frontotemporal dementia. Elevated pTau181 levels reflect not only neuronal damage but also ongoing tau hyperphosphorylation, making it a critical tool for both diagnosis and monitoring disease progression.
Optimal range: 0 - 0 %
Polymorphonuclear cells (PMNs), primarily neutrophils, are white blood cells that play a crucial role in the immune response to bacterial infections. In cerebrospinal fluid (CSF), the presence of elevated PMNs, known as neutrophilic pleocytosis, typically indicates acute inflammation or infection in the central nervous system (CNS). Normal CSF contains 0-5 PMNs/µL, and significant increases are often associated with conditions such as bacterial meningitis, where PMNs can exceed 80% of the total white blood cell count, as well as early viral meningitis, CNS abscesses, trauma, and subarachnoid hemorrhage. The detection of elevated PMNs is a key diagnostic indicator for distinguishing bacterial infections from viral or other causes, necessitating further tests like CSF glucose and protein levels to determine the underlying issue. Prompt evaluation and treatment are critical, particularly in life-threatening situations like bacterial meningitis.
Optimal range: 0 - 6 %
Segmented Neutrophils (CSF) refer to mature white blood cells found in the cerebrospinal fluid (CSF), which play a key role in the body’s immune response. Normally, neutrophils are present in low or undetectable levels in the CSF. Elevated levels of segmented neutrophils in a lab report may indicate an infection, particularly bacterial meningitis, or other inflammatory conditions affecting the central nervous system (CNS). It is important to interpret these results in conjunction with other CSF markers and clinical symptoms to accurately diagnose underlying conditions.
Reference range: Clear, Yellow, Pink, Green, Brown
Normal CSF is crystal clear. However, as few as 200 white blood cells (WBCs) per mm3 or 400 red blood cells (RBCs) per mm3 will cause CSF to appear turbid (=cloudy).
Xanthochromia is a yellow, orange, or pink discoloration of the CSF, most often caused by the lysis of RBCs resulting in hemoglobin breakdown to oxyhemoglobin, methemoglobin, and bilirubin.
Optimal range: 0.5 - 3 Ratio
Tau/Tau-P Ratio is a cerebrospinal fluid (CSF) biomarker used to evaluate the relationship between total tau and phosphorylated tau (pTau), providing critical insights into the underlying pathology of neurodegenerative diseases, particularly Alzheimer’s disease. This ratio reflects both the extent of neuronal damage (indicated by total tau) and the degree of tau protein hyperphosphorylation (indicated by pTau).
The Tau/Tau-P ratio enhances the diagnostic specificity of Alzheimer’s disease when interpreted alongside amyloid-beta (Aβ42) levels and other CSF biomarkers. It helps differentiate Alzheimer’s from other dementias or neurodegenerative conditions, making it a valuable tool in early diagnosis, treatment planning, and monitoring disease progression.
Optimal range: 0 - 290 pg/mL
Total Tau in CSF is a biomarker used to assess neuronal damage and degeneration, particularly in the context of neurodegenerative diseases. Tau is a protein primarily found in neurons, where it stabilizes microtubules essential for cellular transport. Elevated levels of total tau in cerebrospinal fluid (CSF) are often associated with conditions such as Alzheimer’s disease, where neuronal damage leads to the release of tau into the CSF. Increased tau can also indicate acute brain injuries, such as stroke, traumatic brain injury, or other neurodegenerative disorders. In Alzheimer’s disease, total tau is typically elevated alongside phosphorylated tau (pTau), which reflects pathological tau phosphorylation processes, distinguishing it from other neurodegenerative diseases. The measurement of total tau in CSF, combined with other markers like amyloid-beta (Aβ) peptides and pTau, provides valuable insights into the underlying pathology, aiding in early diagnosis, prognosis, and differentiation of dementia-related conditions.
Optimal range: 620 - 1000 pg/mL
Mycotoxin Panel (RealTime Laboratories)
RealTime Lab’s Total Mycotoxin Panel detects 16 of the most toxigenic mycotoxins, including 9 macrocyclic trichothecenes linked to Stachybotrys—commonly referred to as “Black Mold.” This advanced test employs competitive ELISA, a highly sensitive detection method that utilizes antibodies tailored to target mycotoxins.
The Total Mycotoxin Panel delivers results in a clear, numeric format, measuring toxin levels in parts-per-billion (ppb) as standardized by the FDA, WHO, CDC, and food industry for clinical use.
This user-friendly reporting ensures both patients and healthcare providers can interpret results with ease.
Mycotoxins are harmful toxic metabolites produced by molds. Research published in peer-reviewed scientific journals highlights their significant impact on human health.
RealTime Lab’s expert team of doctors and scientists has identified 16 clinically significant mycotoxins and their secondary metabolites for testing. By leveraging their semi-quantitative competitive ELISA platform, the lab ensures highly accurate detection of these dangerous compounds.
Exposure to mycotoxins is linked to a wide array of health conditions, ranging from acute to chronic.
Early detection is crucial to mitigating these risks and supporting effective treatment.
RealTime Lab combines state-of-the-art technology with scientific expertise to deliver reliable, actionable results for mold-related health concerns.
Take control of your health by scheduling your mycotoxin test today.
Optimal range: 0 - 0.8 ppb
Aflatoxins can contaminate corn, cereals, sorghum, peanuts and other oil-seed crops. Thus, food contamination by this group of mycotoxins has been implicated in both animal and human Aflatoxicosis.
Optimal range: 0 - 0.5 ppb
What is gliotoxin?
Gliotoxin is a toxic secondary metabolite (mycotoxin) produced by several fungal species, including Aspergillus, Candida, Eurotium, Trichoderma, Neosartorya, Penicillium, and Acremonium. It is most commonly associated with Aspergillus fumigatus, A. flavus, and A. niger—fungi known for causing invasive infections, particularly in individuals with weakened immune systems.
Inhalation or environmental exposure: Mold-contaminated indoor environments can release airborne spores that contain gliotoxin.
Ingestion: Gliotoxin may be present in contaminated food, especially in poorly stored grains, nuts, and spices.
Fungal infection: Gliotoxin is produced internally during active fungal infections, particularly in immunocompromised individuals.
Gliotoxin is harmful due to its:
Immunosuppressive properties, weakening the body’s ability to fight infections
Genotoxicity, meaning it can damage DNA
Role in fungal pathogenicity, helping fungi evade immune responses and spread within the host
In clinical settings, gliotoxin-producing fungi have been detected in the bloodstream of patients with compromised immunity, such as those undergoing chemotherapy, organ transplants, or living with HIV/AIDS.
An equivocal result means the level of gliotoxin detected is inconclusive—neither clearly positive nor negative. This result typically indicates that the gliotoxin concentration is near the test's threshold for detection and may be influenced by:
Mild or transient exposure
Early-stage fungal colonization
Laboratory variability or sample quality issues
Retest: A follow-up test can help determine whether the exposure is increasing, decreasing, or resolving.
Evaluate symptoms and risk: Discuss any signs of fungal infection or immune compromise with your healthcare provider.
Environmental assessment: Consider testing your home or workplace for mold if environmental exposure is suspected.
Support detoxification: Some approaches to support clearance of mycotoxins include optimizing liver function, ensuring proper hydration, and using binders or antioxidants under clinical guidance.
Optimal range: 0 - 1.8 ppb
A toxin produced by different Aspergillus and Penicillium species — is one of the most-abundant food-contaminating mycotoxins. It is also a frequent contaminant of water-damaged houses and of heating ducts. Exposure can also come from inhalation in water-damaged buildings.
Optimal range: 0 - 0.07 ppb
The trichothecenes are a large family of metabolites produced by several species of molds including Fusarium, Myrothecium, Trichoderma, Trichothecium, Cephalosporium, Verticimonosporium and Stachybotrys.
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An equivocal result means that the level of the Trichothecene Group toxins detected in your sample falls within a range that is not definitively positive or negative. It suggests that the concentration of the toxins is close to the threshold used by the lab to determine whether the result is considered clinically significant.
Here’s a breakdown of what it typically means:
Equivocal result: The result is not conclusive. It could mean the level detected is close to the cutoff but not high enough to be clearly categorized as "positive" for significant exposure or contamination.
Next steps: Depending on your symptoms and health concerns, your healthcare provider might recommend a follow-up test to confirm the result or further evaluate your health in relation to potential mycotoxin exposure.
It’s essential to consult with your healthcare provider to interpret the result in the context of your symptoms and medical history. They may advise further testing or steps to minimize potential exposure to molds.
Optimal range: 0 - 0.5 ppb
Zearalenone (ZEA) is a mycotoxin that is produced by the mold species Fusarium, and has been shown to be hepatotoxic, haematotoxic, immunotoxic, and genotoxic. ZEA is commonly found in several foods in the US, Europe, Asia, and Africa including wheat, barley, rice, and maize.
Cell Count and Differential, Synovial Fluid
What Is Synovial Fluid?
Synovial fluid is the thick liquid that lubricates your joints and keeps them moving smoothly. It’s on all of your joints, including in your knees, shoulders, hips, hands, and feet.
What Is a Synovial Fluid Analysis?
A synovial joint fluid analysis is a group of tests your doctor can use to diagnose problems with your joints.
Joint conditions like arthritis, gout, infections, and bleeding disorders can change how your synovial fluid looks and feels. A sample of this fluid taken during a procedure called an arthrocentesis can help your doctor figure out what’s causing your symptoms.
What’s The Purpose of a Synovial Fluid Analysis?
If you have joint symptoms like:
→ Pain
→ Redness
→ Swelling
→ Fluid buildup
Synovial fluid analysis can also help your doctor figure out if you have:
→ A condition that inflames your joints, like gout, rheumatoid arthritis, and lupus
→ An infection like septic arthritis
→ Bleeding disorders like hemophilia or von Willebrand disease
→ A disease that break down joints over time, like osteoarthritis
Your doctor might also use this test to see if your treatment for your joint condition is working.
A synovial fluid analysis may be ordered to diagnose or rule out the following conditions:
→ Autoimmune disorders:
Autoimmune disorders are conditions in which a person’s immune system mistakenly attacks healthy tissue. In some autoimmune disorders, including rheumatoid arthritis, lupus, and psoriatic arthritis, the immune system damages healthy tissues of the joints.
→ Septic arthritis:
Septic arthritis is an infection caused by microbes such as bacteria or fungi that lead to acute inflammation in one or more joints.
→ Gout or pseudogout:
Gout and pseudogout are painful forms of arthritis, caused by the accumulation of uric acid or calcium crystals in the joint.
→ Bleeding in the joint:
Also called hemarthrosis, an accumulation of blood in the joint can be caused by an injury to the joint, cancer, hemophilia, and other health conditions.
Synovial fluid analysis is helpful for determining the underlying cause of arthritis, particularly for septic or crystal-induced arthritis. The white cell count, differential count, cultures, Gram stain, and crystal search using polarized light microscopy are the most useful studies.
Arthrocentesis with synovial fluid analysis should be attempted in all patients who have a joint effusion or signs suggestive of inflammation within the joint, without a known cause. The most important reason to perform a synovial fluid analysis may be to evaluate for septic arthritis in a patient presenting with an acutely swollen joint that is painful and warm even in patients with a known arthritic disease.
Synovial fluid analysis is also helpful in narrowing the differential diagnosis by distinguishing between categories of joint effusions (ie, inflammatory versus noninflammatory), and to diagnose hemarthrosis.
Reference range: Clear, Hazy, Cloudy
Normal joints contain a small volume of synovial fluid that is highly viscous, clear, and essentially acellular.
Clarity: Increased opacity of the fluid is usually due to abnormally large numbers of nucleated or red blood cells (RBCs). However, translucent or even opaque fluid may be the result of acellular material. Examples include lipids in fat necrosis, chyle droplets, or innumerable monosodium urate (MSU) crystals aspirated from gouty tophi.
Optimal range: 0 - 0 %
Basophils are not a primary focus in synovial fluid analysis, and their presence in synovial fluid is typically not a key diagnostic marker for joint-related conditions. Instead, the analysis primarily concentrates on more common white blood cell types to assess joint health and inflammation.
Reference range: Straw/Yellow, Colorless
Color and clarity may vary. Normal synovial fluid is clear and colorless or straw-colored. Abnormal fluid may look cloudy, opaque, and/or differently colored. For example, cloudy fluid may indicate an infection, and pink or reddish fluid may indicate the presence of blood.
Reference range: No crystals found, Crystals found
The presence and identification of crystals in synovial fluid analysis are essential for diagnosing specific joint-related conditions, particularly gout and CPPD disease. This diagnostic information informs appropriate treatment strategies to manage these conditions effectively.
Optimal range: 0 - 2 %
The percentage of eosinophils in synovial fluid analysis is a valuable diagnostic marker that can indicate various joint conditions, particularly eosinophilic synovitis. It serves as a crucial piece of information for healthcare providers to determine the appropriate treatment and management strategies.
Optimal range: 0 - 74 %
Lymphocytes are a type of white blood cell that plays a key role in the immune system. They are responsible for recognizing and combating infections, including viral and autoimmune diseases.
Optimal range: 40 - 80 %
Cerebrospinal fluid (CSF) is a clear liquid that cushions and surrounds the brain and spinal cord. It helps support the venous structures around the brain, and it’s important in brain homeostasis and metabolism. This fluid is continually replenished by the choroid plexus in the brain and absorbed into the bloodstream. The body completely replaces CSF every few hours.
The WBC count seen in normal adult CSF is comprised of approximately 70 percent lymphocytes and 30 percent monocytes. There are two forms of lymphocytes: B cells, which make antibodies, and T cells, which recognize and remove foreign substances.
Lymphocytes, when found in cerebrospinal fluid (CSF) as part of a Cell Count and Differential panel, provide critical insights into the immunological and pathological status of the central nervous system (CNS). The presence and concentration of lymphocytes in CSF are indicative of the immune response within the CNS and can be a marker for various conditions, including infections, autoimmune disorders, and malignancies.
Optimal range: 0 - 69 %
The percentage of monocytes and macrophages in synovial fluid analysis serves as an important indicator of joint inflammation and immune response. It aids in the diagnosis and management of various joint conditions, particularly those characterized by inflammation.
Optimal range: 15 - 45 %
Optimal range: 15 - 45 %
In the context of cerebrospinal fluid (CSF) analysis the evaluation of monocytes, often referred to as "Monos," is of considerable diagnostic significance. Monocytes in CSF are a type of white blood cell that play a key role in the immune response, particularly in phagocytosis and antigen presentation. Normally, the CSF, which bathes the central nervous system (CNS), contains a very low number of monocytes, reflecting the CNS's status as an immune-privileged site with restricted access to peripheral immune cells.
Optimal range: 0 - 24 %
Synovial fluid analysis includes a differential cell count, which identifies and quantifies the different types of white blood cells present in the fluid. Neutrophils are one of the cell types counted in this differential analysis. It is a critical parameter that aids in the assessment of joint health.
An elevated percentage can signal inflammation or infection within the joint, helping guide diagnosis and treatment decisions.
Optimal range: 0 - 6 %
The CSF PMN % biomarker refers to the percentage of polymorphonuclear leukocytes (PMNs), commonly known as neutrophils, found in cerebrospinal fluid (CSF). PMNs are a type of white blood cell involved in the immune response, and their presence in CSF can indicate inflammation or infection within the central nervous system. Typically, CSF contains very few white blood cells, and a low PMN percentage is considered normal.
Optimal range: 0 - 0 MM3
In the analysis of cerebrospinal fluid (CSF), the presence and count of red blood cells (RBCs) is a crucial diagnostic marker, particularly when assessed as part of a cell count with differential. Normally, CSF is devoid of RBCs, as it is a clear fluid that cushions the brain and spinal cord within the central nervous system (CNS).
Optimal range: 0 - 15 %
Synoviocytes are essential for joint health and the production of synovial fluid, but their percentage is not a standard component of synovial fluid analysis. Instead, the focus of this analysis is on the presence and percentages of white blood cells to diagnose joint-related conditions.
Optimal range: 0 - 150 cells/uL
The Total Nucleated Cell Count (TNCC) in a synovial fluid analysis helps to assess joint health by quantifying the number of white blood cells in the synovial fluid. An elevated TNCC can indicate joint inflammation, infection, or crystal-induced arthritis, aiding in the diagnosis and appropriate management of joint-related conditions.
Optimal range: 0 - 5 MM3
The measurement of Total Nucleated Cells (TNC) in cerebrospinal fluid (CSF), as part of a cell count with differential, is a critical parameter in the diagnostic evaluation of neurological conditions. Total Nucleated Cells in CSF encompass all cells with a nucleus – primarily lymphocytes, monocytes, and, in certain pathological conditions, neutrophils, eosinophils, and sometimes abnormal cells like tumor cells or immature blood cells. Normally, the CSF contains a very low number of nucleated cells, reflecting the immune-privileged status of the central nervous system (CNS). The normal range typically falls between 0 to 5 cells per microliter, although this can vary slightly based on laboratory standards.
Reference range: Negative, Positive
Xanthochromia, in the context of cerebrospinal fluid (CSF) analysis, is a diagnostic marker of significant clinical importance, particularly when evaluated alongside a cell count with differential. Xanthochromia refers to the yellowish discoloration of the CSF, typically caused by the presence of bilirubin, a breakdown product of hemoglobin. This discoloration is not immediately apparent after a hemorrhagic event but develops several hours post-bleed as red blood cells (RBCs) degrade. The most critical clinical relevance of xanthochromia is its role in diagnosing subarachnoid hemorrhage (SAH). In SAH, bleeding occurs into the subarachnoid space (between the brain and the arachnoid membrane), often due to a ruptured cerebral aneurysm. Xanthochromia can reliably distinguish SAH from a traumatic lumbar puncture (LP), a procedure-related occurrence where RBCs are accidentally introduced into the CSF sample, as xanthochromia does not occur immediately after blood enters the CSF.
Comprehensive Gut Biome & Health Test (Verisana)
With the Comprehensive Gut Biome & Health Test, you receive an extensive examination of your intestine based on your stool sample:
1.) Candida and mold
2.) Bacterial imbalance of the intestinal flora
3.) Secretory IgA (gut mucosal immunology)
4.) Helicobacter pylori
The intestinal mucosa forms a mechanical barrier in healthy people: it is permeable to nutrients and liquids, but impermeable to harmful substances.
Beyond that, the gut and its bacteria are of great importance for the immune system – nearly 80% of all immune cells are located there. However, the intestinal mucosa can fulfill its task only with an intact gut flora.
The test analyzes the values of the following analytes:
Proteus sp., Klebsiella sp., Enterobacter sp., Citrobacter sp., Pseudomonas sp., Other aerobic bacteria, Bifidobacterium sp., Bacteroides sp., Lactobacillus sp., Clostridium sp., Candida albicans, Candida sp., Geotrichum sp., Mold, Secretory IgA, Helicobacter pylori.
Verisana's Comprehensive Gut Biome & Health Test helps you to get a comprehensive picture of your gut health as the state of your gastrointestinal system is extremely important for your overall well-being.
Optimal range: 0 - 0 mg/dL
Reference range: Not Detected, Detected
Optimal range: 0 - 0 cfu/ml
Optimal range: 0 - 0 cfu/ml
Reference range: Not Detected, Detected
Blastocystis hominis (B. hominis) is a unicellular protozoan found in the large intestine of humans. B. hominis is the most prevalent single-celled eukaryotic organism found in humans. It is a causative pathogen in irritable bowel disorders and the toxins released by B. hominis can contribute to fibromyalgia. This presence of B. hominis-specific immunoglobulins in the serum samples suggests that the immune action against this parasite is not limited to the intestinal level. Antibodies to the pathogen can be found in both symptomatic and asymptomatic individuals, therefore, it is still unclear whether B. hominis is a truly pathogenic organism, or a commensal, or perhaps, is capable of being a pathogen in specific circumstances.
Optimal range: 0 - 0 cfu/ml
Optimal range: 0 - 0 cfu/ml
Optimal range: 0 - 0 cfu/ml
Reference range: Not Detected, Detected
Optimal range: 0 - 0 cfu/ml
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Dientamoeba fragilis is a parasite that lives in the large intestine of people. This protozoan parasite produces trophozoites; cysts have not been identified. The intestinal infection may be either asymptomatic or symptomatic.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 10000000 - 100000000 cfu/ml
Gram-positive genus of lactate-producing bacteria in the Firmicutes phylum. High levels may be due to reduced digestive capacity, constipation or small intestinal bacterial overgrowth. Low levels may indicate insufficiency of beneficial bacteria.
Optimal range: 10000000 - 100000000 cfu/ml
Escherichia coli (E. coli) is a type of bacteria that normally live in the intestines of people and animals.
Reference range: Not Detected, Detected
Optimal range: 0 - 1000 cfu/ml
This fungus has garnered scientific interest due to its presence in the human microbiome and its widespread occurrence in the environment. It plays a role in various biological processes and can have both positive and negative effects on human health, depending on its context and interaction with the host.
Reference range: Not Detected, Detected
Reference range: Negative, Positive
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0 - 0 cfu/ml
Optimal range: 0 - 0 cfu/ml
Reference range: Negative, Positive
Optimal range: 0 - 0 cfu/ml
Optimal range: 0 - 0 cfu/ml
Reference range: Not Detected, Detected
Optimal range: 0 - 0 ug/g
Optimal range: 6.2 - 6.8 Units
Fecal pH is largely dependent on the fermentation of fiber by the beneficial flora of the gut.
Optimal range: 0 - 0 cfu/ml
Optimal range: 0 - 0 cfu/ml
Reference range: Not Detected, Detected
Optimal range: 510 - 2040 ug/ml
SIGA (Secretory IgA) is the primary antibody that is protecting us from pathogens and toxins from penetrating mucosal surfaces. Its role is crucial in protecting the integrity of the intestinal epithelium. The antibody blocks the access to the epithelial receptors and traps pathogens and toxins in the mucus which are then excreated by peristaltic movements.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Catecholamines, Fractionated, Random Urine
Catecholamines, Fractionated, Random Urine is a test that measures the levels of certain hormones called catecholamines in a random urine sample. Catecholamines are a group of hormones and neurotransmitters that include substances like epinephrine (adrenaline), norepinephrine, and dopamine. These chemicals play essential roles in the body's "fight or flight" response, regulating blood pressure, heart rate, and other physiological responses to stress.
The test is typically used to diagnose and monitor certain medical conditions, such as:
Pheochromocytoma: This is a rare tumor that can develop in the adrenal glands (located on top of the kidneys) and can produce excessive amounts of catecholamines. Elevated levels of catecholamines in urine can be a sign of pheochromocytoma.
Paraganglioma: Similar to pheochromocytoma, paragangliomas are rare tumors that can develop in other parts of the body and also produce excess catecholamines.
Neuroblastoma: This is a type of cancer that commonly occurs in children and can also produce high levels of catecholamines.
A random urine sample is collected for this test, which means that it can be taken at any time during the day without any specific preparation. The levels of catecholamines in the urine are measured to determine if they fall within the normal range or if there is an excess, which may suggest an underlying medical condition.
It's important to note that the interpretation of catecholamine levels in urine can be influenced by various factors, including:
- medications,
- diet,
- and stress.
Therefore, healthcare providers may consider additional tests and clinical information when making a diagnosis. If your healthcare provider has recommended this test, they will provide specific instructions on how to collect the urine sample and any other necessary preparations.
Optimal range: 30 - 130 mcg/g Cr
In a Catecholamines, Fractionated, Random Urine test, "Calculated Total (E+NE)" typically refers to the calculated total concentration of epinephrine (E) and norepinephrine (NE) in the urine sample.
Epinephrine (also known as adrenaline) and norepinephrine (noradrenaline) are two of the main catecholamines measured in this type of test. These hormones are produced by the adrenal glands and play essential roles in the body's response to stress and the "fight or flight" response.
Optimal range: 295 - 1123 mcg/g Cr
In a Catecholamines, Fractionated, Random Urine test, dopamine is one of the catecholamines measured. Catecholamines are a group of hormones and neurotransmitters that include substances like epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine. These chemicals play essential roles in the body's nervous system and its response to stress.
Optimal range: 0 - 20 mcg/g Cr
In a Catecholamines, Fractionated, Random Urine test, epinephrine (also known as adrenaline) is one of the catecholamines measured. Epinephrine is a hormone and neurotransmitter produced by the adrenal glands, which are located on top of the kidneys. It is also released by certain nerve cells in the sympathetic nervous system.
Epinephrine plays a vital role in the body's "fight or flight" response to stress or danger. When released into the bloodstream, it can have several effects, including increasing heart rate, dilating the airways, and redirecting blood flow to essential organs like the muscles and the brain. These responses prepare the body for quick action in response to a perceived threat.
Optimal range: 20 - 108 mcg/g Cr
Norepinephrine is one of the catecholamines measured in the Catecholamines, Fractionated, Random Urine test.
Norepinephrine, also known as noradrenaline, is a hormone and neurotransmitter produced by the adrenal glands, as well as certain nerve cells (neurons) in the sympathetic nervous system. It plays a crucial role in the body's "fight or flight" response, helping to prepare the body for action by increasing heart rate, constricting blood vessels, and raising blood pressure.
StoneRisk Diagnostic Profile
A stone risk profile is a panel of tests that assess the risk of kidney stone formation. The tests measure the levels of substances in the body that form and prevent stones.
Kidney stones are small, pebble-like pieces of material that form in one or both of your kidneys. Kidney stones form when you have high levels of certain minerals or salts in your urine.
Kidney stones can be as small as a grain of sand or as large as a pea, and sometimes even larger. Very small stones may pass out of your body when you urinate. Larger or odd-shaped stones can get stuck inside your urinary tract and block the flow of urine. This may cause severe pain or bleeding, and you may need treatment to get rid of the stones. But with treatment, kidney stones usually don't cause permanent damage.
Optimal range: 0 - 0 mEq/24 hr
Optimal range: 0 - 3 Ratio
Optimal range: 0 - 6 Ratio
Calcium oxalate crystals are the most common cause of kidney stones — hard clumps of minerals and other substances that form in the kidneys. These crystals are made from oxalate — a substance found in foods like green, leafy vegetables — combined with calcium. Having too much oxalate or too little urine can cause the oxalate to crystalize and clump together into stones.
Kidney stones can be very painful. They can also cause complications like urinary tract infections. But they are often preventable with a few dietary changes.
Optimal range: 0 - 320 mg/24 hr
Optimal range: 38 - 210 mmol/24 hr
Optimal range: 320 - 1240 mg/24 hr
Citric acid helps prevent stone formation by binding calcium.
Citrate is a powerful force against calcium stones. It binds calcium in a soluble complex. It interferes with calcium crystal formation and growth. Low urine citrate is a risk factor for new stone onset. Above 400 mg daily there is no extra risk of stones in men or women, so ‘hypocitraturia’ means a urine citrate below 400 mg daily.
Optimal range: 800 - 1800 mg/24 hr
Blood and urine creatinine concentrations reflect kidney function; they may be used for comparing to other substances as the level of creatinine in blood is normally stable and, in urine, it reflects how dilute or concentrated the urine is.
Optimal range: 2.1 - 58 mg/24 hr
Optimal range: 12 - 293 mg/24 hr
Optimal range: 0 - 4 Ratio
Optimal range: 300 - 900 mOsmol/kg
Optimal range: 4 - 31 mg/24 hr
Optimal range: 4.5 - 8 pH
Optimal range: 261 - 1078 mg/24 hr
Optimal range: 14 - 95 mmol/24 hr
Optimal range: 39 - 258 mmol/24 hr
Optimal range: 0 - 1 Ratio
Struvite is the crystal name for stones that form only in the presence of urease-producing bacteria (eg, Proteus mirabilis, Klebsiella pneumoniae, Corynebacterium species, Ureaplasma urealyticum) in the upper urinary tract.
Other names for this crystal type include "triple phosphate" and magnesium ammonium phosphate carbonate apatite. Struvite is found in approximately 1 percent of stones and is much more common in females than in males (due to the higher risk of urinary tract infections in females).
Optimal range: 0 - 30 mEq/24 hr
Optimal range: 0 - 1.2 Ratio
Likely to form uric acid stones; some people who have increased uric acid also have gout
Optimal range: 174 - 902 mg/24 hr
Uric acid, a key biomarker assessed through a 24-hour urine test, holds significant clinical relevance in diagnosing and managing various metabolic and renal disorders. Chemically, uric acid is the end product of purine metabolism in humans, arising predominantly from the dietary breakdown of nucleic acids and, to a lesser extent, endogenous purine synthesis. Normally, it is soluble in the blood, filtered by the kidneys, and excreted in urine. However, deviations in its urinary concentration can be indicative of pathological states. Elevated urinary uric acid levels, or hyperuricosuria, can signal conditions such as gout, a form of arthritis characterized by the deposition of monosodium urate crystals in joints due to hyperuricemia.
Optimal range: 600 - 1600 mL/24 hr
Optimal range: 600 - 1600 mL/24 hr
Drinking more fluids can help lower your risk of kidney stones. The goal is to increase the amount of urine that flows through your kidneys and also to lower the concentrations of substances that promote stone formation. While you can vary the types of beverages you drink, sugar-sweetened beverages (such as soda and sports drinks) actually seem to increase the risk of kidney stones; they have other negative health effects as well and should therefore be avoided.
Tuberculosis Testing
What is tuberculosis (TB)?
Tuberculosis, or TB, is an infectious disease caused by the bacterium Mycobacterium tuberculosis. Tuberculosis was once the leading cause of death in the United States, but it can now be successfully treated if discovered in time.
Microscopic droplets suspended in the air pass the TB organism from person to person. Infection can occur when an uninfected person comes in contact with someone who has active tuberculosis.
People who are exposed to TB may never get sick. They develop what is called latent TB infection. A person with latent TB is not contagious and does not show any signs or symptoms of being sick. The immune system controls the infection. Latent TB may develop into active TB if the immune system becomes weakened. A person with active TB disease is sick and shows signs and symptoms of the disease (e.g., persistent cough, weight loss). People with active TB are infectious and can spread the TB bacterium to others.
How can I be screened for TB?
There are two types of tests that screen for TB infection: the tuberculin skin test (TST or PPD) and blood tests such as the T-SPOT.TB test. The tuberculin skin test has been around for over 100 years. The T-SPOT.TB test is a blood test that was approved by the FDA in 2008. This test is particularly important for those who have had the TB vaccination, also known as the BCG vaccination, or for those who are immunocompromised.
What happens if my test result is positive?
A positive test may mean that you have either latent or active TB. Your doctor will advise you on whether any additional testing, such as a chest x-ray, is needed.
Reference range: Negative, Positive
The T-Spot TB test is a unique, single-visit blood test for tuberculosis (TB) that offers the opportunity to detect latent TB before it activates. The test is effective with immunocompromised and BCG-vaccinated patient populations and is the only IGRA without a warning or limitation for screening immunocompromised individuals.
Protein Electrophoresis and Total Protein, Random Urine
This test is used to analyze the protein content in urine. The proteins are separated into 5 major components: albumin, alpha-1, alpha-2, beta, and gamma. Interpretation of elevations, decreases, or visual changes in different components and/or associated patterns can provide information on various disease states, including inflammatory diseases, autoimmune diseases, different types of kidney injury, plasma cell disorders, and cancers.
This panel is used to evaluate an individual with symptoms associated with potential monoclonal gammopathy, or when an individual has abnormally high total protein, albumin, or immunoglobulin levels. This test can help with initial diagnosis, as well as monitoring disease progression and treatment effectiveness.
Although a 24-hour UPEP is recommended for diagnosis and monitoring, sometimes a random UPEP is ordered at the discretion of the clinician to help guide the diagnostic process in the right direction. One advantage of a UPEP is that no special handling is required, which may be an important factor depending on clinical conditions.
Note: The results of this test should not be used in isolation; these results alone are not enough to make a diagnosis or for monitoring. UPEP results should be evaluated along with other laboratory, clinical, and imaging findings as appropriate. Additional testing, such as bone marrow studies, serum protein electrophoresis (SPEP), and immunofixation (IFE), may be required for comprehensive evaluation.
Optimal range: 20 - 275 mg/dL
A random urine creatinine test measures the level of creatinine in a urine sample collected at a random time during the day. Creatinine is a waste product generated by the breakdown of creatine, a substance found in muscles. This test is often used to assess kidney function and muscle health.
Optimal range: 5 - 24 mg/dL
Total protein in random urine samples is often used in conjunction with other tests and clinical assessments to diagnose and monitor kidney diseases, such as glomerulonephritis, nephrotic syndrome, or diabetic nephropathy.
Optimal range: 24 - 184 mg/g creat , 0.02 - 0.18 mg/mg creat
The spot (random) urine protein to creatinine ratio (P/C ratio) is an alternative, fast and simple method of detecting and estimating the quantitative assessment of proteinuria.
Balance Hormone Profile (Dried Urine)
The Balance profile is Meridian Valley Lab's most popular dried urine profile. It provides a broad and in-depth evaluation of hormone balance, function and circadian cortisol pattern. This panel measures estrogens and clinically relevant estrogen metabolites, which allow for assessment of cancer risk factors and detoxification pathways. Pregnanediol assays progesterone activity in the body. DHEA, testosterone and their metabolites provide a detailed assessment of androgen function. Cortisol, cortisone, and their metabolites, combined with 4-point cortisol and cortisone curves, provide an industry-leading evaluation of adrenal health.
Optimal range: 46 - 231 ug/g Creatinine
Optimal range: 251 - 1013 ug/g Creatinine
Optimal range: 47 - 481 ug/g Creatinine
11-Hydroxy-etiocholanolone is a compound that is an end product of androgen catabolism.
Androgens are important hormones in the health of both men and women. Testosterone and DHEA are metabolized into what is collectively known as the 17-ketosteroids (DHEA is formally included as a 17-ketosteroid). Together, these markers provide a comprehensive assessment of androgen sufficiency, as well as evaluating the need for, and monitoring of, androgen hormone therapy.
Optimal range: 1.2 - 7.1 ug/g Creatinine
16α-OH E1 is a metabolite of estrone with dual roles: it has been linked to carcinogenic activity while also playing a crucial role in bone formation. Extremely high or low levels can be problematic. Elevated levels may indicate impaired estrogen detoxification and the need for interventions to enhance this process. Conversely, very low levels may increase the risk of osteopenia and suggest the need for supplemental estradiol, particularly in women with additional risk factors for osteoporosis.
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 mg/dL
Optimal range: 0.1 - 0.53 ug/g Creatinine
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy estrogens are produced from 2-OH estrogens through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH estrogens and particularly 2-Methoxy estrogens.
2-Methoxy estrogens has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy estrogen levels were lower in breast cancer patients than controls.
Optimal range: 1 - 6.8 ug/g Creatinine
The 2-Methoxy Estrogens are considered to be protective.
2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1.
2-Methoxy-E1 has shown antiproliferative effects in both hormone-dependent and hormone-independent breast cancer cells. These studies have shown that urinary 2-Methoxy-E1 levels were lower in breast cancer patients than controls.
Optimal range: 3.2 - 22.2 ug/g Creatinine
Optimal range: 1.6 - 7.7 Ratio
An optimal 2/16α ratio falls between 2 and 4. Ratios below 2 may suggest an increased risk of breast cancer, though this concern is less significant when overall estrogen levels are low. Supporting estrogen metabolism toward 2-OH E1 with targeted nutrients may be beneficial in such cases. Ratios above 4, particularly when 16α-OH E1 levels are low, may indicate an elevated risk of osteopenia.
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 mg/dL
Optimal range: 0.32 - 2.26 ug/g Creatinine
Optimal range: 4 - 33 ug/g Creatinine
Optimal range: 0.6 - 1.6 Ratio
Optimal range: 8 - 122 ug/g Creatinine
5β-Androstanediol is a metabolite of testosterone formed through the 5β-DHT pathway. It plays a role in assessing androgen metabolism and provides insights into 5β-reductase activity. Measuring this metabolite, along with others like 5α-Androstanediol, Androsterone, and Etiocholanolone, helps evaluate overall androgen status, especially in individuals with low DHEA or testosterone levels, where direct hormone measurements might be less informative.
Low or low-normal levels of 5β-Androstanediol may indicate insufficient androgen production, while elevated levels are commonly associated with conditions such as polycystic ovary syndrome (PCOS) or excessive androgen supplementation. Understanding these levels can guide the management of hormonal imbalances and related health conditions.
Optimal range: 689 - 3871 ug/g Creatinine
Optimal range: 17.7 - 84.4 ug/g Creatinine
Urinary 6-Sulfatoxymelatonin (MT6s) is the main metabolite of melatonin.
Melatonin assists in the body’s sleep/wake cycle and is also a very powerful antioxidant. Primary production is in the pineal gland. The GI mucosa is a significant source secondary production, with retina, bone marrow, platelets, skin, and lymphocytes all producing smaller amounts. GI-produced melatonin has paracrine effects (=affects adjacent cells) and does not enter general circulation. MT6s itself has no physiologic activity, but is a good indicator of whole body melatonin production. Low urinary MT6s is an indication for melatonin supplementation. It is normal to see elevated urinary values with supplemented doses higher than 1mg.
Optimal range: 2908 - 5535 ug/g Creatinine
Adrenal reserve, represented by the marker THE+5α-THF+THF (tetrahydrocortisone, 5-alpha-tetrahydrocortisol, and tetrahydrocortisol) on a dried urine essential hormone profile, is a critical indicator of adrenal gland function, particularly in women during the luteal phase of their menstrual cycle. This phase, which occurs after ovulation and before menstruation, is characterized by significant hormonal fluctuations that can influence adrenal function. The adrenal reserve marker provides valuable insights into the body's ability to produce and metabolize cortisol, a vital stress hormone.
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 mg/dL
Optimal range: 105 - 412 ug/g Creatinine
Allo-Tetrahydrocorticosterone (5α-THB) is a significant biomarker in dried urine panel analysis, offering vital insights into the body's hormonal balance and stress response. As a metabolite of cortisol, 5α-THB is crucial in understanding the body's glucocorticoid activity, a fundamental aspect of the stress response mechanism. Cortisol, produced by the adrenal glands, is known as the "stress hormone," playing a pivotal role in various physiological processes including metabolism regulation, immune response modulation, and stress adaptation. In the metabolic pathway, cortisol is reduced to tetrahydrocortisol (THF) and subsequently transformed into 5α-THB. This conversion is catalyzed by the enzyme 5α-reductase, which also participates in other critical physiological processes such as androgen metabolism.
Optimal range: 443 - 1651 ug/g Creatinine
Optimal range: 0.6 - 2.2 Ratio
The Andro/Etio ratio compares the levels of two key androgen metabolites, androsterone (Andro) and etiocholanolone (Etio), which are produced from DHEA and androstenedione through the 5α- and 5β-reductase pathways, respectively. This ratio provides insights into the balance of androgen metabolism and the activity of these two reductase enzymes.
A higher Andro/Etio ratio reflects increased 5α-reductase activity, favoring the conversion of androgens into androsterone. Elevated 5α-reductase activity is often associated with conditions like polycystic ovary syndrome (PCOS), androgen dominance, or metabolic syndrome.
A lower Andro/Etio ratio suggests increased 5β-reductase activity, favoring the production of etiocholanolone. This may occur in conditions with altered androgen metabolism or impaired 5α-reductase function.
Evaluating the Andro/Etio ratio helps clinicians assess the enzymatic balance of androgen metabolism, identify potential hormonal imbalances, and tailor interventions to optimize androgen-related health outcomes.
Optimal range: 636 - 2327 ug/g Creatinine
Androsterone is a DHEA metabolite via the 5-alpha-reductase pathway. The 5-alpha pathway is more androgenic.
Optimal range: 32 - 121 ug/g Creatinine
Optimal range: 0.5 - 1.2 Ratio
Optimal range: 39 - 143 ug/g Creatinine
Optimal range: 100 - 1333 ug/g Creatinine
DHEA is produced in the adrenal glands and is a precursor to both testosterone and estrogen. DHEA also affects bone density, response to stress, mood and cognitive function, improves insulin sensitivity, and is associated with decreased cardiovascular and cancer risk. It peaks in the mid-20s and begins to decline after 30. Longevity is associated with higher than age-normal levels of DHEA.
Optimal range: 0.3 - 2.9 ug/g Creatinine
Optimal range: 1.6 - 6.6 ug/g Creatinine
The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.
Optimal range: 5.4 - 23.2 ug/g Creatinine
Optimal range: 1 - 10 Ratio
Patients with an EQ>1 have a higher survival rate after breast cancer, and may be at decreased risk for developing breast cancer. EQ often declines as women enter menopause.
Optimal range: 4.1 - 21.6 ug/g Creatinine
Produced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, since it is the least powerful of the three estrogen types, women should still understand this hormone and its known effects on the body.
- Weaker compared to Estradiol (Research says the estrogenic activity is about 4% of estradiol’s activity)
- Most abundant in menopause
- Made via aromatization in several tissues like fat and muscle
- Converts into estradiol (E2)
Estrone (E1) is also made by the ovary but in fat tissue in lesser quantities. While not as abundant in circulation as estradiol, estrone excess can still increase the risk for estrogen dominant cancers and estrogen dominant symptoms such as breast tenderness, heavy menstrual cycles, headaches, and erectile dysfunction and breast development in men just like estradiol. Estrone is commonly thought to be more abundant during menopause.
Estradiol and estrone can interconvert into each other.
Optimal range: 630 - 3006 ug/g Creatinine
Etiocholanolone is a DHEA metabolite that is excreted in the urine. It is produced from androstenedione and the 5-beta-reductase metabolic pathway. It is helpful in evaluating adrenal and androgen function.
Optimal range: 266 - 938 ng/g creatinine
A T3 (=triiodothyronine) test is a blood test that helps diagnose thyroid conditions, specifically hyperthyroidism (overactive thyroid). Healthcare providers typically order this test alongside other thyroid function tests.
High or low T3 levels may indicate an overactive or underactive thyroid.
According to the American Thyroid Association (ATA), T3 tests are most useful for diagnosing hyperthyroidism. They are less helpful in diagnosing hypothyroidism.
Healthcare providers test T3 levels using blood tests.
The tests for free T3 are generally less accurate than for total T3.
Free T3 or total T3 blood tests may be ordered to evaluate thyroid function if a thyroid disorder is suspected. They may also be used to evaluate pituitary gland problems, assess the severity and type of thyroid disease, and monitor treatment for a thyroid condition.
Optimal range: 341 - 1524 ng/g creatinine
Free T4, or free thyroxine, is an essential thyroid hormone that plays a crucial role in regulating metabolism and overall health. While conventional thyroid function tests typically measure Free T4 in blood samples, it's less common to assess Free T4 in dried urine tests. Dried urine tests are more commonly used to measure certain other hormones and metabolites.
Optimal range: 0.75 - 2.06 mg/g creat
Kynurenic Acid is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0.2 - 0.65 Ratio
A comparison of 2-Methoxyestrone with 2OHE1 allows insight into methylation pathways. If the methylation ratio is on the low end of the reference range, consider adding supplements to improve methylation. If needed, consider further testing for methylation defects.
Optimal range: 1.2 - 4.8 Ratio
The Na+/K+ (sodium-to-potassium) ratio is a critical marker of mineral balance and is closely linked to kidney and adrenal function. Sodium and potassium are essential electrolytes involved in blood pressure regulation, muscle contraction, and cell-to-cell communication, and their balance significantly impacts overall health.
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 ug/g
Optimal range: 0 - 0 mg/dL
Optimal range: 25 - 150 mmol/24 hr
Optimal range: 140 - 1293 ug/g Creatinine
Optimal range: 40 - 220 mmol/24 hr
Optimal range: 3 - 12.2 ug/g Creatinine
Testing testosterone levels in women through dried urine tests is an effective and convenient method for assessing hormonal balance.
Testosterone is typically associated with men, but women also produce this hormone in smaller quantities. It plays a crucial role in women's health, affecting mood, energy, libido, and muscle mass.
Optimal range: 32 - 166 ug/g Creatinine
Optimal range: 585 - 1631 ug/g Creatinine
Optimal range: 1112 - 3475 ug/g Creatinine
Optimal range: 12.6 - 47.8 ug/g Creatinine
Optimal range: 0.17 - 0.86 mg/g creat
Xanthurenic acid is a metabolite in the tryptophan degradation pathway, produced during the metabolism of tryptophan to niacin (vitamin B3) via the kynurenine pathway. Its levels are influenced by vitamin B6 status, as adequate B6 is required for the proper enzymatic conversion of kynurenine into downstream metabolites.
Complete Microbiome Mapping (NutriPATH)
The Complete Microbiome Mapping Test was designed to assess a patient’s microbiome from a single stool sample, with particular attention to microbes that cause disease or that disrupt normal microbial balance and contribute to perturbations in the GI flora and contribute to illness.
The panel is a comprehensive collection of microbial targets as well as immune and digestive markers. It screens for pathogenic bacteria, commensal bacteria, opportunistic pathogens, fungi, viruses, and parasites.
Common Conditions:
Optimal range: 0 - 100 units/L
Optimal range: 44.5 - 72.4 %
Acetate is the most abundant SCFA in the colon and makes up more than half of the total SCFA detected in feces. These beneficial SCFA have anti-inflammatory properties, provide energy to nourish the colonic epithelial cells and intestinal microbiota, and exert numerous positive effects on gut homeostasis.
Optimal range: 0 - 4.82 %
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^3 CFU/g
Optimal range: 1 - 50 x10^7 CFU/g
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 1.6 - 250 x10^5 CFU/g
Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism.
Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood.
Bacteroides fragilis plays an important role in the prevention of intestinal inflammation. An energy-restricted diet has been shown to increase B. fragilis in overweight adolescents. An increase in B. stercoris has been associated with higher risk of colon cancer. Decreased levels of Bacteroides spp. have been reported in association with multiple sclerosis, rheumatoid arthritis and Parkinson’s disease.
Optimal range: 50 - 95 %
Optimal range: 368 - 6266 U/g
Optimal range: 5.2 - 1000 x10^5 CFU/g
Bifidobacterium longum is a specific species of microscopic non-pathogenic bacteria found naturally in the gastrointestinal tracts of humans as well as in most other animals.
Optimal range: 6.7 - 1000 x10^5 CFU/g
A common component of the microbiota of the human gastrointestinal tract and in particular are amongst the first bacterial colonizers of the intestine.
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 10.8 - 33.5 %
Butyrate is a short-chain fatty acid (SCFA) produced in the colon by the bacterial fermentation of undigested carbohydrates, primarily dietary fiber. It serves as a primary energy source for colonocytes (cells of the colon) and has several important roles in maintaining gut health and overall well-being.
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 50 ug/g
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 0 - 5 x10^4 CFU/g
Optimal range: 0 - 5 x10^5 CFU/g
Optimal range: 0 - 5 x10^4 CFU/g
Optimal range: 0 - 5 x10^4 CFU/g
Optimal range: 5 - 50 x10^7 CFU/g
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 18 x10^7 CFU/g
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 5 x10^5 org/g
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 5 x10^5 CFU/g
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 1.9 - 2000 x10^3 CFU/g
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 0 - 1 x10^3 CFU/g
Optimal range: 0 - 0 x10^5 CFU/g
Optimal range: 3.7 - 3800 x10^4 CFU/g
Escherichia species, prominently Escherichia coli (E. coli), are a significant aspect of gastrointestinal (GI) test results due to their diverse roles within the human gut and potential implications for health. E. coli is a common and typically harmless resident of the human intestinal tract, playing a crucial role in maintaining the gut's microbial balance. However, certain strains of E. coli can be pathogenic, leading to various gastrointestinal and extraintestinal diseases. When a GI test indicates elevated or abnormal levels of E. coli, it may signal an infection or a disruption in the gut microbiome's equilibrium.
Optimal range: 0 - 0.02 %
Optimal range: 200 - 3500 x10^6 CFU/g
Optimal range: 3.5 - 40 %
Optimal range: 0 - 10 x10^4 CFU/g
Optimal range: 0 - 3 x10^2 CFU/g
Optimal range: 0 - 1 x10^5 org/g
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^3 CFU/g
Reference range: Not Detected, Detected
Optimal range: 0 - 5 x10^5 CFU/g
Optimal range: 0 - 5 x10^3 CFU/g
Klebsiella are non-motile, Gramnegative rods that belong to the Enterobacteriaceae family. Klebsiella bacteria are considered commensal but act as opportunistic bacteria in the GI tract. Klebsiellais a leading cause of hospital-acquired infections.
Klebsiella is part of the normal intestinal flora. The environment likely acts as a reservoir for human acquisition, either as colonization or infection. It is frequently found in water, sewage, soil, and plant surfaces.
Optimal range: 8.3 - 885 x10^3 CFU/g
Lactobacillus rhamnosus, a probiotic with good survival capacity in the human gut, has well-documented adhesion properties and health effects.
Optimal range: 8.6 - 6200 x10^3 CFU/g
Lactobacillus species is a type of bacteria. There are lots of different species of lactobacillus.
Lactobacillus bacteria are commonly found in the human gut, mouth and vagina. They are considered generally as “good bacteria”, and in fact may contribute to good health, often being included in probiotic supplements. These bacteria are characterized by their ability to produce lactic acid as a byproduct of glucose metabolism.
Optimal range: 0 - 3.5 x10^5 CFU/g
Optimal range: 0 - 1 x10^5 CFU/g
Reference range: Not Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Negative, Positive
Optimal range: 5 - 500 x10^6 CFU/g
Oxalobacter formigenes is a bacterium that colonizes the colon of a substantial proportion of the normal population and metabolizes dietary and endogenous oxalate and hence reducing the incidence of kidney stones.
Optimal range: 200 - 1000 ug/g
Pancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 1 x10^9 CFU/g
Optimal range: 0 - 32 %
Optimal range: 0.5 - 12.5 %
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 5 x10^5 CFU/g
Optimal range: 0 - 3 x10^4 CFU/g
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^3 CFU/g
Reference range: Not Detected, Detected
Optimal range: 0 - 3 x10^3 CFU/g
Optimal range: 0 - 1 x10^5 CFU/g
Reference range: Not Detected, Detected
Optimal range: 510 - 2040 ng/mL
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 13.6 - 500 umol/g
Optimal range: 0 - 5 x10^3 CFU/g
Optimal range: 0 - 1 x10^3 CFU/g
Optimal range: 0 - 15 %
Reference range: Brown
Reference range: Formed
Optimal range: 0 - 3 x10^6 CFU/g
Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0.5 - 7 %
Optimal range: 0 - 2.4 %
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 0 - 107 ng/mL
Breath test (Trio-Smart)
Trio-smart is an advanced breath testing method used for diagnosing various conditions such as small intestinal bacterial overgrowth (SIBO), intestinal methanogen overgrowth (IMO), and excessive hydrogen production. This comprehensive breath test assesses the levels of hydrogen, methane, and hydrogen sulfide in a patient's breath, aiding healthcare providers in making accurate diagnoses and determining appropriate treatment plans. Trio-smart's precise measurements of these gases provide valuable insights into gastrointestinal health, allowing for targeted and effective management strategies tailored to the patient's specific needs.
Optimal range: 0 - 10 ppm
Utilization of breath methane levels for SIBO assessment is controversial largely due to a lack of validation related to diagnostic specifics such as timing and magnitude of increase; however, CH4 measurements are increasingly obtained to address other clinical questions. Recent evidence has associated CH4 production with the pathogenesis of common clinical conditions, such as obesity, irritable bowel syndrome (IBS), and constipation.
Optimal range: 0 - 29.46 ppm
Hydrogen is produced when certain bacteria in the small intestine consume sugars and produce hydrogen gas as a byproduct.
Hydrogen levels are considered abnormal when they rise greater than ≥20 ppm (parts per million) from the baseline within 90 minutes.
In healthy humans, hydrogen gas is exclusively produced by intestinal bacteria - primarily a result of carbohydrate fermentation by anaerobic bacteria in the colon. In SIBO, fermentation of the malabsorbed lactulose substrate by bacteria residing in the small intestine results in elevated concentration of exhaled hydrogen (H2).
Optimal range: 0 - 3 ppm
Trio-smart measures a third fermented gas, hydrogen sulfide (H2S). Which is produced by sulfate-reducing bacteria utilizing H2 to produce H2S. Clinical trials have noted that H2S is associated with diarrhea in patients. In a 2021 study, it was found that healthy subjects had H2S levels of <3.00 ppm. Levels of hydrogen sulfide ≥3.00 ppm are associated with diarrhea and indicative of excess hydrogen sulfide. Higher levels of hydrogen sulfide predict more severe diarrhea.
ANA 12 Plus Profile (RDL)
ANA 12 Plus Profile is reflexive and consists of the following:
Anti-Nuclear Ab (ANA)
If positive, reflexes to following 14 components:
- Anti-Cardiolipin Ab (IgG, IgA and IgM Isotypes)
- Anti-Centromere Ab
- Anti-Chromatin Ab
- Anti-dsDNA Ab by Farr
- Anti-La (SS-B) Ab
- Anti-Ro (SS-A) Ab
- Anti-Scl-70 Ab
- Anti-Sm
- Anti-TPO (Thyroid Microsomal Peroxidase) Ab
- Anti-U1 RNP
- C3 Complement
- C4 Complement
- Rheumatoid Factor by Turb
- Anti-CCP (Cyclic Citrullinated Peptide) Ab.
If ANA is positive, all tests listed are performed. If ANA is negative, an Anti-Ro (SS-A) Ab test is performed to catch the small percentage of ANA false negative results. ANA includes titer and pattern.
Optimal range: 0 - 12 APL U/mL
Anti-Cardiolipin antibodies (aCL) of the IgA class are autoantibodies that target cardiolipin, a phospholipid found in cell membranes. While less commonly discussed than their IgG and IgM counterparts, IgA anti-cardiolipin antibodies also play a role in autoimmune conditions, particularly antiphospholipid syndrome (APS).
APS is an autoimmune disorder characterized by an increased risk of blood clots (thrombosis) and pregnancy complications, including recurrent miscarriages. The presence of IgA anti-cardiolipin antibodies can contribute to the diagnostic criteria for APS, especially in patients who test negative for the more common IgG and IgM types but have clinical symptoms suggestive of APS.
Optimal range: 0 - 15 GPL U/mL
Anti-Cardiolipin antibodies (aCL) of the IgG class are a type of autoantibody directed against cardiolipin, a phospholipid present in cell membranes. These antibodies are significant in the diagnosis and management of autoimmune disorders, particularly in the context of antiphospholipid syndrome (APS).
APS is characterized by thrombosis (blood clots) and pregnancy complications, including recurrent miscarriages. The presence of anti-cardiolipin antibodies, especially the IgG subtype, is one of the laboratory criteria for diagnosing APS. Elevated levels of these antibodies can increase the risk of blood clot formation in veins and arteries, leading to complications like deep vein thrombosis, stroke, or heart attack.
Optimal range: 0 - 13 MPL U/mL
Anti-Cardiolipin antibodies (aCL) of the IgM class are autoantibodies directed against cardiolipin, a specific phospholipid in cell membranes. These antibodies are clinically significant, especially in the context of antiphospholipid syndrome (APS), an autoimmune disorder characterized by an increased tendency for blood clot formation (thrombosis) and complications in pregnancy. The IgM class of aCL is one of the key markers tested for the diagnosis of APS.
Optimal range: 0 - 20 Units
Anti-CCP antibodies, or anti-cyclic citrullinated peptide antibodies, are autoantibodies frequently found in the blood of individuals with rheumatoid arthritis (RA). These antibodies target proteins that have been altered by a process called citrullination; this alteration changes the structure of the protein, causing the immune system to recognize them as foreign.
Reference range: Negative, Positive
The Anti-Centromere Antibody (ACA) test is an indirect immunofluorescence assay (IFA) used to detect autoantibodies that target centromere proteins. These antibodies are primarily associated with autoimmune connective tissue diseases, particularly limited cutaneous systemic sclerosis. The test is available at various clinical laboratories and plays a crucial role in diagnosing and monitoring certain autoimmune conditions.
Optimal range: 0 - 20 Units
The marker "Anti-Chromatin Ab, IgG (RDL)" refers to a specific type of blood test that detects antibodies called immunoglobulin G (IgG) that are directed against chromatin. Chromatin is a complex of DNA and proteins found in the nucleus of our cells, and it plays a critical role in packaging DNA into a compact, manageable form, and in regulating gene expression. The presence of anti-chromatin antibodies, like those detected by this test, is significant because they are commonly associated with certain autoimmune disorders, particularly systemic lupus erythematosus (SLE).
Optimal range: 0 - 8 IU/ml
The anti-double stranded DNA (anti-dsDNA) tests are used to help diagnose and monitor lupus, also called systemic lupus erythematosus or SLE, a chronic inflammatory autoimmune disorder in which the immune system mistakenly targets the body’s own cells and tissues.
Your doctor may order an anti-dsDNA if you have a positive antinuclear antibody (ANA) test and symptoms associated with lupus, such as persistent fatigue, pain in your joints, and a red rash resembling a butterfly across the nose and cheeks. Anti-dsDNA tests are also periodically used to assess disease activity in people who have already been diagnosed with lupus.
Optimal range: 0 - 20 Units
The Anti-La (SS-B) Antibody test is an important diagnostic tool for autoimmune disorders. This test specifically detects antibodies against the La (or SS-B) antigen, which is another key protein target in certain autoimmune diseases. The presence of Anti-La (SS-B) antibodies is closely associated with Sjögren's syndrome, a condition characterized by dry eyes and mouth due to immune-mediated damage to moisture-secreting glands.
Reference range: Negative, Positive
Anti-Nuclear Antibody by IFA (RDL) refers to a diagnostic test that detects antinuclear antibodies (ANAs) in the blood. ANAs are a group of autoantibodies that target substances found in the nucleus of cells, and their presence is often associated with various autoimmune disorders.
The IFA, or Indirect Fluorescent Antibody method, is a common technique used for this test. It involves adding a patient's serum to a substrate containing cells, and then, if ANAs are present, they bind to the nuclei in the cells. After washing away unbound antibodies, a fluorescent-labeled secondary antibody is added, which attaches to any bound ANAs. Under a fluorescence microscope, the presence of ANAs is indicated by a specific pattern of fluorescence in the cells' nuclei.
This test is particularly important in diagnosing conditions like systemic lupus erythematosus, Sjögren's syndrome, scleroderma, and mixed connective tissue disease.
Optimal range: 0 - 20 Units
The Anti-Ro (SS-A) Antibody test is a critical diagnostic tool in the assessment of autoimmune diseases. This test detects antibodies against the Ro/SS-A antigen, a protein implicated in the development of certain autoimmune conditions. The presence of Anti-Ro (SS-A) antibodies is notably associated with Sjögren's syndrome, a disorder characterized by dry eyes and mouth, and systemic lupus erythematosus (SLE).
Optimal range: 0 - 20 Units
Anti-Scl-70 antibodies, also known as Anti-Topoisomerase I antibodies, are a specific type of autoantibody primarily associated with systemic sclerosis (scleroderma), a chronic autoimmune disease. These antibodies target the enzyme topoisomerase I, which is involved in DNA replication and repair. The presence of Anti-Scl-70 antibodies is clinically significant as they are found in approximately 20-40% of patients with systemic sclerosis, particularly in those with the diffuse cutaneous form of the disease.
Optimal range: 0 - 20 Units
Anti-Sm antibodies (Anti-Smith antibodies) are autoantibodies that are strongly associated with systemic lupus erythematosus (SLE), a chronic autoimmune disease. The presence of Anti-Sm antibodies is considered a specific marker for SLE, as these antibodies are rarely found in individuals without the disease. It is reported that approximately 99% of individuals without SLE lack Anti-Sm antibodies, but they are present in only about 20% of people with SLE, indicating that while their presence is highly specific to SLE, they are not found in all cases of the disease.
Optimal range: 0 - 9 IU/ml
Anti-TPO antibodies (Anti-Thyroid Peroxidase antibodies) are autoantibodies directed against thyroid peroxidase, an enzyme crucial for the production of thyroid hormones. These antibodies are a key marker in autoimmune thyroid diseases, particularly Hashimoto's thyroiditis and, to a lesser extent, Graves' disease. In Hashimoto's thyroiditis, which is the most common cause of hypothyroidism, the presence of Anti-TPO antibodies signifies an immune system attack on the thyroid gland, leading to inflammation, damage, and eventually reduced thyroid function. Patients with elevated levels of Anti-TPO antibodies are at an increased risk of developing hypothyroidism, even if their thyroid function is normal at the time of testing. In Graves' disease, which is characterized by hyperthyroidism, Anti-TPO antibodies are less commonly present but can coexist with other types of thyroid autoantibodies.
Optimal range: 0 - 20 Units
The Anti-U1 RNP (Ribonucleoprotein) Antibody test is a specific diagnostic tool used in the evaluation of connective tissue diseases. This test detects antibodies against the U1 RNP, a component of a small nuclear ribonucleoprotein complex involved in RNA processing. The presence of anti-U1 RNP antibodies is particularly significant in the diagnosis of mixed connective tissue disease (MCTD), a disorder that exhibits features of several connective tissue diseases like systemic lupus erythematosus, scleroderma, and polymyositis.
Optimal range: 82 - 167 mg/dL
C3 Complement, often simply referred to as C3, is a crucial protein component of the immune system's complement system. The complement system is a part of the innate immune response and plays a significant role in inflammation and defending against infections. C3, in particular, is central to the activation of the complement system. It gets activated through one of the three complement pathways (classical, lectin, or alternative) and subsequently participates in opsonization (marking pathogens for destruction), chemotaxis (attracting immune cells to the site of infection), and cell lysis (breaking down of cells).
Optimal range: 14 - 44 mg/dL
C4 Complement, an essential component of the immune system's complement pathway, plays a pivotal role in both innate and adaptive immunity. Similar to C3, C4 is involved in the activation of the complement system, particularly in the classical and lectin pathways. Activation of C4 leads to its cleavage into C4a and C4b, with the latter playing a key role in opsonization (coating pathogens to promote phagocytosis) and in the formation of the C3/C5 convertase, crucial for further complement activation. Measuring the levels of C4 in the blood is an important diagnostic tool, especially in autoimmune and inflammatory conditions.
Reference range: Low, High, Borderline
The Homogeneous pattern observed in an Antinuclear Antibody (ANA) test is a specific type of result that indicates the presence of antibodies in the blood that are reacting against components in the cell nucleus. This pattern is termed 'homogeneous' because the antibodies produce a uniform, diffuse staining of the entire nucleus in a cell. The ANA test is commonly used in the diagnosis and management of autoimmune diseases, where the body's immune system mistakenly attacks its own cells. A homogeneous pattern is often associated with systemic lupus erythematosus (SLE), a complex autoimmune disorder, but it can also be seen in other conditions such as rheumatoid arthritis, Sjogren's syndrome, and mixed connective tissue disease. However, it's important to note that ANA patterns, including the homogeneous pattern, are not exclusive to any single disease. The presence of this pattern requires careful interpretation by a healthcare professional in the context of the patient's symptoms, clinical history, and other laboratory findings. Additionally, a small percentage of healthy individuals can have a positive ANA test, including a homogeneous pattern, without any underlying autoimmune disease. Therefore, while the homogeneous pattern provides valuable diagnostic clues, it is part of a larger puzzle in understanding and managing autoimmune disorders.
Reference range: Low, High
The Nuclear Dot Pattern, observed in Antinuclear Antibody (ANA) testing, is a distinctive immunofluorescence pattern characterized by discrete speckles or dots within the cell nucleus. This pattern emerges when specific autoantibodies in the patient's serum react with nuclear proteins, most notably Sp100 and promyelocytic leukemia (PML) protein. The presence of a Nuclear Dot Pattern is of clinical significance as it is often associated with certain autoimmune conditions.
Optimal range: 0 - 14 IU/ml
Rheumatoid Factor (RF) is an autoantibody often found in individuals with autoimmune diseases, most notably rheumatoid arthritis (RA). It targets the Fc region of immunoglobulin G (IgG), forming immune complexes that contribute to inflammation and tissue damage. Detecting RF is crucial for diagnosing and monitoring autoimmune disorders.
One of the methods for measuring RF is Turbidimetric Rheumatoid Factor Detection (Turb RDL). This technique uses turbidimetry, a method that measures the cloudiness or turbidity in a solution caused by antigen-antibody complexes. When RF is present in the serum sample, it reacts with specific antigens, creating immune complexes. These complexes scatter light, and the degree of scattering is directly proportional to the concentration of RF in the sample. The higher the RF levels, the more turbid the solution becomes.
Reference range: Low, High
The speckled pattern in ANA (Antinuclear Antibody) testing is one of the most common and diagnostically significant patterns, characterized by its distinctive, fine or coarse speckled appearance under a fluorescence microscope. This pattern indicates the presence of antibodies targeting various extractable nuclear antigens (ENAs), including but not limited to Smith (Sm) antigen, ribonucleoprotein (RNP), SS-A (Ro), and SS-B (La). The diversity of these antigens means that the speckled pattern is associated with a range of autoimmune disorders, most notably systemic lupus erythematosus (SLE), Sjögren's syndrome, mixed connective tissue disease (MCTD), and systemic sclerosis.
Array 4 - Gluten-Associated Cross-Reactive Foods and Foods Sensitivity
Many times, gluten-free foods, which are supposed to be safe, can be offensive to some individuals. This can be due to sensitivity or a phenomenon called Cross-Reactivity.
Once a patient is diagnosed as Celiac Disease (CD) or having Gluten Reactivity, he/she is instructed to adhere to a gluten-free diet. Brochures, books and websites help the patient with this seemingly difficult process. However, a significant percentage of these patients will continue to have gluten-like complaints even after being on a gluten-free diet (GFD) for months. Most countries define “gluten-free” products based on the recommendation of the Food and Agricultural Organization of the United Nations and World Health Organization.
This codex alimentarius allows the inclusion of up to 0.3% protein from gluten containing grains in foods labeled “gluten-free.” If the sensitive body is exposed to 0.3% protein, the immune system will recognize and react to the protein.
Testing for Gluten-Associated Cross-Reactive Foods and Foods Sensitivity in this array can assist the clinician in revealing the possible cause of this continued gluten-like reaction in the patient.
Recommended for patients who:
- Have Non-Celiac Gluten Sensitivity or Celiac disease.
- Are experiencing limited improvements or are non-responsive on a gluten-free diet.
- Have gut dysbiosis, which appears to be resistant to standard therapy
Optimal range: 0.1 - 1.7 ELISA Index
The presence of antibodies to a-Casein + b-Casein combined is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Cow’s Milk is the most common cause of food allergy in the first years of life and contributes to maladies such as gastrointestinal upset, skin problems, respiratory manifestations and anaphylaxis. For some the sensitivity persists throughout one’s lifetime and may contribute to autoimmunity later in life. Particular autoimmunities associated with Casein include Celiac disease and autoimmune uveitis. Cow’s Milk plays a role in the gastrointestinal symptoms in 50% of patients with non-celiac gluten sensitivity and Celiac disease.
Optimal range: 0 - 1.8 ELISA Index
The presence of antibodies to Amaranth is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Amaranth is considered a beneficial food, especially for patients with cardiovascular disease and hypertension, due to its ability to reduce blood pressure and cholesterol.
Amaranth is also an excellent anti-oxidant. Amaranth labeled by the scientific community as a non-allergenic food, however, allergy to Amaranth has been reported. If a recently diagnosed gluten-reactive patient exhibits high levels of antibodies to Amaranth, it may be
due to the late introduction of Amaranth into the diet.
Optimal range: 0 - 0.8 ELISA Index
The presence of antibodies to Buckwheat is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Although a gluten-free grain, Buckwheat has been shown to be antigenic in celiac and non-celiac gluten-sensitive patients.
Inhalation of Buckwheat flour has also been reported to trigger occupational asthma and childhood nocturnal asthma.
Special consideration should be made for patients who work in the baking industry. Due to cross-reactions, patients with elevated antibodies against Buckwheat should not have contact with latex products.
Optimal range: 0 - 1.8 ELISA Index
The presence of antibodies to Casomorphin is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Casomorphin is known to modulate the mucosa of the intestinal lining. If the mucosa is damaged, Casomorphin and other ingested peptides can more easily penetrate the intestinal barrier. As an opioid peptide, Casomorphin, once in the blood stream, is capable of disrupting the blood-brain barrier and interfering with the neurotransmitter messaging system.
Antibodies against Casomorphin can identify a cause of behavioral and cognitive problems.
Optimal range: 0 - 2.7 ELISA Index
The presence of antibodies to Corn is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to Corn have been reported. Corn gluten activates mucosal neutrophils and eosinophils, which enhance mucosal nitric oxide produce and thus exacerbates the gastrointestinal inflammatory conditions found in Celiac disease and other inflammatory bowel disorders.
Optimal range: 0 - 2 ELISA Index
The presence of antibodies to Cow’s Milk is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Bellioni et al. found that 92% of subjects with an allergy to cow’s milk showed reactivity to goat’s milk.
Cow’s Milk is the most common cause of food allergy in the first years of life; although most children outgrow the allergy by age 3 or 4.
For some, the immune reactivity persists throughout one’s lifetime and may contribute to autoimmunity later in life. Particular autoimmunities associated with Cow’s Milk include Type 1 Diabetes, Behçet’s disease and Systemic Lupus Erythematosus.
Cow’s Milk plays a role in the gastrointestinal symptoms in 50% of patients with non-celiac gluten sensitivity and Celiac disease.
Optimal range: 0 - 0.6 ELISA Index
The presence of antibodies to Egg is an indication of food immune reactivity. Egg antigen assessed consists of egg white, egg yolk both raw. The offending food and its known cross-reactive foods should be eliminated from the diet. Egg immune reactivity is more common in children than in adults.
Since many children eventually develop immune tolerance, they may outgrow immune reactivity to Egg. Cooked egg introduced at 4 to 6 months of age may protect against egg immune reactivity. Adult onset of Egg allergy has been reported. Bird-egg syndrome, more common in adults than children, is the association between respiratory allergy to bird antigens and food allergy to eggs, and in some cases, meat from the same or different bird species.
Optimal range: 0 - 2.3 ELISA Index
The presence of antibodies to Hemp is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Hemp is emerging as a popular alternative food source, especially for vegetarians. Very few studies have been done on Hemp as a food source, although some cases of sensitization and allergy to the plant have been reported.
Optimal range: 0 - 1.5 ELISA Index
The presence of antibodies to Instant Coffee is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to Coffee plant, inhaled grounds and consumed food products have been reported.
Optimal range: 0 - 1.4 ELISA Index
The presence of antibodies to Milk Butyrophilin is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Milk Butyrophilin has a far reaching effect on the body. It can stimulate antigen-specific immune responses in both gut-associated lymphoid tissue (GALT) and peripheral immune organs, and it exacerbates central nervous system inflammation.
Milk Butyrophilin shares a similar homology to myelin and has been shown to degrade myelin tissues through molecular mimicry and cross-reactivity. Patients exhibiting neurological disorders should therefore abstain from consuming milk products.
Optimal range: 0 - 1.2 ELISA Index
The presence of antibodies to Milk Chocolate is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Dark chocolate, in moderation, has many health benefits. It is filled with antioxidants, improves endothelial function, improves gut microbiota, exhibits chemopreventive effects, and activates Factor XII. Pure cacao, dark chocolate and milk chocolate are known to elicit adverse reactions in the form of IgE allergy and delayed intolerance.
Optimal range: 0 - 1.5 ELISA Index
The presence of antibodies to Millet is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Millet is primarily consumed in Asian countries, where it is a food crop. In the US, millet is primarily grown for fodder however it is becoming popular as a health food. Patients with known thyroid disorders should abstain from ingesting Millet as it is a goitrogen.
Optimal range: 0 - 1.4 ELISA Index
The presence of antibodies to Oats is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to Oat have been reported. Genetically speaking, Oats do not contain gluten and thereby should be safe to eat for the celiac or non-celiac gluten-sensitive patient. However, due to cross-contamination of Oats during transportation and food processing, they may become harmful to the gluten-reactive population. Some varieties of Oats have been shown to cross-react with gliadin.
Optimal range: 0 - 1.8 ELISA Index
The presence of antibodies to Potato is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to Potato have been reported. Immune reactivity to Potato is rare and occurs more often in children, who usually out-grow it, than in adults.
Optimal range: 0 - 1.5 ELISA Index
The presence of antibodies to Quinoa is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Quinoa is considered a beneficial food, especially for celiac patients and vegetarians. Quinoa is labeled by the scientific community as a nonallergenic food, however, severe allergic reaction to Quinoa has been reported. If a recently diagnosed gluten-reactive patient exhibits high levels of antibodies to Quinoa, it may be due to the late introduction of Quinoa into the diet.
Optimal range: 0 - 1.2 ELISA Index
The presence of antibodies to Rice is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to Rice have been reported.
Despite its cross-reactivity to wheat, Rice is often over-consumed in a gluten-free diet, which can result in the patient developing an immune reactivity to Rice.
Optimal range: 0 - 1.1 ELISA Index
The presence of antibodies to Rye is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. The antigenic properties of Rye produce inflammatory injury in the absorptive surface of the small intestine. Thus, it is associated with gastrointestinal disorders. Special consideration for patients who work in the baking industry must be taken, as flour hypersensitivity and baker’s asthma associated with Rye have been reported. Due to the cross-reactive nature of Rye and w-gliadin, patients who test positive should be educated on exercise-induced anaphylaxis triggered by w-gliadin.
Optimal range: 0.1 - 1.3 ELISA Index
The presence of antibodies to Sesame is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Sesame allergy/intolerance is becoming more common as more people begin to seek a healthy protein-rich food. Special precaution must be taken by those in the baking industry, as occupational asthma stemming from the inhalation of Sesame flour has been reported.
Additionally, patients with immediate or delayed immune reactivities should not only avoid ingesting the food, but should also abstain from using topical products that contain Sesame.
What if your test result is "equivocal"?
An equivocal result on a test for sesame sensitivity in the context of gluten-associated cross-reactive foods means that the test result is uncertain or borderline. This could indicate a low level of sensitivity to sesame, but it's not definitive enough to confirm a true sensitivity or allergy.
Here’s what to consider or do next:
→ Consultation with a Healthcare Provider: It’s important to discuss the results with a healthcare professional who can provide guidance based on your overall health, symptoms, and medical history.
→ Further Testing: Your healthcare provider may recommend additional testing to clarify the results. This could include more specific allergy tests or a different type of sensitivity test.
→ Dietary Monitoring: You might be advised to monitor your symptoms when consuming sesame products. Keeping a food diary that tracks what you eat and any symptoms that follow can be helpful.
→ Elimination Diet: In some cases, an elimination diet might be suggested, where sesame is removed from your diet for a period to see if symptoms improve. This can be followed by a reintroduction phase to see if symptoms reoccur when sesame is added back.
→ Consider Other Factors: Since cross-reactivity can be complex, it’s also wise to consider other factors that might affect your symptoms, such as other food sensitivities or gastrointestinal conditions.
An equivocal result can be frustrating, but with careful management and professional guidance, you can determine the best approach for your health.
Optimal range: 0 - 1.2 ELISA Index
The presence of antibodies to Sorghum is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Sorghum flour, although difficult to process, is becoming a popular alternative flour to use in gluten-free baking. A study on the effects of Sorghum in celiac patients showed that the flour was not antigenic. If a recently diagnosed gluten-reactive patient results with high levels of antibodies against Sorghum, it is most likely due to the late introduction of the food to the patient’s diet, rather than a gluten-associated reaction.
Optimal range: 0.2 - 1.2 ELISA Index
The presence of antibodies to Soy is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Soy allergy/intolerance is becoming more common as more people begin to seek a healthy protein-rich food. Additionally, patients with immediate or delayed immune reactivities should not only avoid ingesting the food, but should also abstain from using topical products that contain Soy.
Optimal range: 0 - 1.4 ELISA Index
The presence of antibodies to Tapioca is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to Tapioca have been reported, especially in patients with known latex allergies.
With the globalization of the food market, Tapioca is now being sold and consumed in new markets of North American and European countries, where an increase in reported adverse reactions have been seen.
Optimal range: 0 - 1.3 ELISA Index
The presence of antibodies to Teff is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Little work has been published on this food product. Due to the prevalence of its consumption by, and low incidence of diabetes, in Ethiopians, it can be postulated that Teff may be a healthy alternative grain for patients needing to consume a
low-glycemic diet. Teff has also been considered to be safe for Celiac patients, as it does not contain alpha-gliadin and has no cross-reactivity to the alpha-gliadin of wheat. If a recently diagnosed non-celiac gluten-sensitive patient exhibits high levels of antibodies to Teff, it may be due to the late introduction of Teff into the diet.
Optimal range: 0.1 - 1.3 ELISA Index
Elevated levels of antibodies to Whey Protein indicate dairy protein immune reactivity. Although Whey supplementation has been proven to have healthful benefits such as the improvement of blood pressure and vascular function in obese patients and stimulation of beneficial gut microflora in infants, patients with cow’s milk intolerance should avoid consuming whey.
The casein: Whey protein ratio in native cow’s milk is 80:20. Because whey contains lactose, it should be avoided by those who are lactose intolerant. Dried whey, used as a food additive, contains more than 70% lactose.
Optimal range: 0 - 1.5 ELISA Index
The presence of antibodies to Yeast is an indication of food immune reactivity. The offending food and its known cross-reactive foods should be eliminated from the diet. Adverse reactions to yeast manifest as inflammatory bowel disorders. Due to the inflammatory effects of Yeast, patients who exhibit high levels of antibodies to Yeast, should be assessed for increased intestinal permeability.
Antinuclear Ab 9 by Multiplex
The Antinuclear Ab 9 by Multiplex Test includes:
Anticentromere B antibodies; anti-dsDNA; antichromatin antibodies; anti-Jo-1; RNP antibodies; antiscleroderma 70 antibodies; Smith antibodies; Sjögren anti-SS-A; Sjögren anti-SS-B
This panel is to detect antibodies associated with SLE and mixed connective tissue disease. Anti-Sm is highly specific for SLE. Anti-RNP is found with a variety of rheumatoid diseases. RNP, Sm, SS-A, SS-B, Scl-70, and Jo-1 are extractable nucleoprotein complexes found in the nucleus and/or cytoplasm of substrate cells.
Optimal range: 0 - 0.9 AI
Anti-Ro (SS-A) is an autoantibody associated with SLE or Sjögren’s syndrome. Sjögren’s syndrome is an autoimmune disorder in which the body's immune system mistakenly reacts to the tissue in glands that produce moisture, such as tear and salivary glands.
Optimal range: 0 - 0.9 AI
Anti-SS-B (anti-La) is an autoantibody associated with SLE or Sjögren’s syndrome. Sjögren’s syndrome is an autoimmune disorder in which the body's immune system mistakenly reacts to the tissue in glands that produce moisture, such as tear and salivary glands.
Arterial Blood Gas Analysis (ABG)
Blood gas analysis allows the assessment of oxygenation, ventilation, acid-base balance and metabolic status.
Arterial Blood Gas (ABG) Analysis is a critical diagnostic test that measures the amounts of oxygen and carbon dioxide in the arterial blood. This test is essential for assessing respiratory function and the acid-base balance within the body. By drawing blood from an artery, usually at the wrist where the radial artery is accessible, the ABG analysis provides information on parameters such as pH, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), bicarbonate (HCO3-), and oxygen saturation (O2 Sat). The pH indicates the acidity or alkalinity of the blood, with normal levels typically ranging from 7.35 to 7.45. PaO2 and PaCO2 levels assess the effectiveness of the lungs in exchanging oxygen and carbon dioxide, while bicarbonate levels help gauge the metabolic component of the acid-base balance. An ABG test is particularly useful in managing respiratory diseases, monitoring patients on mechanical ventilation, and evaluating the effectiveness of therapeutic interventions in critically ill patients. It's a direct reflection of the gas exchange and metabolic processes in the body, providing vital information that can guide acute and chronic patient management.
Optimal range: 0 - 0 mmHg
In an Arterial Blood Gas (ABG) analysis, the term A-a O2 refers to the alveolar-arterial oxygen gradient. It measures the difference between the oxygen concentration in the alveoli of the lungs and the arterial system. Alveoli are tiny, balloon-shaped air sacs in the lungs that perform gas exchange between inhaled air and the blood.
This gradient is important because it can help to identify how well oxygen is being transferred from the lungs to the blood. A larger-than-normal gradient suggests that there may be a problem with oxygen transfer, which could be due to various reasons such as lung diseases or issues with the pulmonary circulation.
Optimal range: -2.5 - 2.5 mmol/L
Optimal range: -2.5 - 2.5 mmol/L
The Base Excess (ECF) - Arterial marker on Labcorp's Arterial Blood Gas (ABG) Panel quantifies the amount of acid or base required to restore a liter of arterial blood to a normal pH of 7.40 at a PaCO2 of 40 mmHg and a temperature of 37°C. This value reflects the metabolic component of acid-base balance, independent of respiratory influences.
Clinical Significance
Positive Base Excess: Indicates metabolic alkalosis, where there is an excess of base or a deficit of acid in the blood.
Negative Base Excess: Suggests metabolic acidosis, characterized by an excess of acid or a loss of base.
Optimal range: 19 - 25 mmol/L
Optimal range: 0 - 2 %
Optimal range: 65 - 110 mg/dL
The Glucose - Arterial marker on Labcorp's Arterial Blood Gas (ABG) Panel measures the concentration of glucose in arterial blood. Glucose is a primary energy source for the body's cells and is tightly regulated by hormones such as insulin and glucagon. Monitoring glucose levels is essential for assessing metabolic status and diagnosing conditions like diabetes mellitus and hypoglycemia.
Optimal range: 19 - 25 mmol/L
The HCO3- - Arterial marker on Labcorp's Arterial Blood Gas (ABG) Panel measures the concentration of bicarbonate ions (HCO3-) in the arterial blood. Bicarbonate plays a crucial role in maintaining the acid-base balance of the body, functioning as a buffer to regulate the pH of blood. It helps neutralize excess acids or bases, thus stabilizing the body’s pH levels. HCO3- is closely linked with the respiratory system's ability to excrete CO2 and the kidneys' ability to excrete or retain bicarbonate, making it a key indicator of both metabolic and respiratory health.
Optimal range: 0 - 0 %
Optimal range: 40.1 - 52.5 %
Optimal range: 13 - 17 g/dL
Optimal range: 1.11 - 1.3 mmol/L
Ionized Calcium – Arterial measures the active, unbound form of calcium in the bloodstream, providing a real-time assessment of calcium available for critical functions like muscle contraction, nerve signaling, and heart rhythm. Unlike total calcium, it’s unaffected by protein levels and is especially useful in intensive care, surgical, or emergency settings. Abnormal levels may indicate serious conditions such as kidney disease, sepsis, parathyroid disorders, or acid-base imbalances. Because ionized calcium is sensitive to changes in blood pH and must be carefully measured, it’s a key marker in monitoring critically ill patients.
Optimal range: 0.7 - 2.1 mmol/L
The Lactate - Arterial marker on Labcorp's Arterial Blood Gas (ABG) Panel measures the concentration of lactate in arterial blood. Lactate is a byproduct of anaerobic metabolism, which occurs when cells rely on processes that do not require oxygen to produce energy, often due to insufficient oxygen supply or impaired oxygen utilization. Elevated lactate levels are commonly associated with tissue hypoxia or poor perfusion, where tissues do not receive enough oxygen to meet their metabolic demands. High lactate levels can indicate a variety of conditions, including shock, sepsis, severe hypoxia, or organ failure. In some cases, elevated lactate can also result from metabolic disorders or certain medications. Monitoring lactate levels is crucial in critically ill patients to assess the severity of acidosis, identify underlying conditions, and guide appropriate treatment strategies.
Optimal range: 0 - 1 %
Optimal range: 17 - 24 %
Optimal range: 75 - 100 %
Optimal range: 92 - 100 %
Optimal range: 35 - 39 mmHg
Optimal range: 35 - 39 mm/Hg
The pCO2 - Arterial marker on Labcorp's Arterial Blood Gas (ABG) Panel measures the partial pressure of carbon dioxide (CO2) in arterial blood. pCO2 is an important indicator of lung function and the body’s ability to remove CO2, a byproduct of metabolism. It plays a key role in regulating blood pH through the bicarbonate buffer system. Abnormal levels of pCO2 can indicate respiratory or metabolic issues: elevated levels (hypercapnia) suggest hypoventilation or respiratory failure, while decreased levels (hypocapnia) may indicate hyperventilation or respiratory alkalosis. Monitoring pCO2 levels helps clinicians assess respiratory efficiency, acid-base balance, and potential underlying conditions such as chronic obstructive pulmonary disease (COPD), asthma, or kidney dysfunction.
Optimal range: 7.35 - 7.45 pH
Optimal range: 7.35 - 7.45 pH
Optimal range: 61 - 82 mmHg
Optimal range: 65 - 85 mm/Hg
Optimal range: 61 - 82 mmHg
Optimal range: 3.5 - 5 mmol/L
The Potassium - Arterial marker on Labcorp's Arterial Blood Gas (ABG) Panel measures the concentration of potassium ions (K+) in the arterial blood. Potassium is a critical electrolyte that plays a key role in maintaining cell function, nerve transmission, and muscle contraction. It is also essential in regulating the body's acid-base balance and controlling the electrical activity of the heart. Abnormal potassium levels can indicate a range of conditions: elevated levels (hyperkalemia) may suggest kidney dysfunction, acidosis, or cellular injury, while low levels (hypokalemia) can occur due to conditions like excessive diuretic use, alkalosis, or gastrointestinal losses (e.g., vomiting, diarrhea). Monitoring arterial potassium levels is crucial for assessing overall electrolyte balance, cardiac health, and metabolic function.
Optimal range: 136 - 144 mmol/L
Heavy Metal Basic Panel (5520) (Access Medical Labs)
A heavy metal blood test or urine test is a panel of tests that help measure the amount of heavy metal toxicity in your blood, urine or other body tissue or fluid. While “heavy metals” is a broad term, some of the most common metals that are tested for include lead, mercury, arsenic, cadmium, copper, zinc, aluminum and thallium. Sometimes, these tests are also known as heavy metal toxicity tests.
So how do heavy metals get into your system?
You can breathe them in, eat them or absorb them through your skin. Some small quantities of essential element metals are needed in order to survive and regulate bodily functions – like chromium, iron and zinc. These metals can be incorporated in safe levels with supplements. However, overexposure to metals can be toxic to humans and can cause heavy metal poisoning. This heavy metal concentration in your body can cause harmful health effects like organ damage and dysfunction, neurological and muscular degeneration, cancer, allergies and even death.
Getting a heavy metal test is useful to determine the levels of heavy metals in your system. A heavy metal test measures the type of heavy metals in your system and how much of that toxic metal may be present.
Your healthcare provider may order a heavy metals panel if you have any signs or symptoms of heavy metal poisoning and/or your healthcare provider suspects you’ve dealt with heavy metal exposure.
Taking a heavy metal toxicity test can also be useful in guiding the management and treatment of any heavy metal poisoning. Retaking a test after treatment can provide confirmation that the treatment methods are working. For instance, a heavy metal test can help monitor the effectiveness of chelation therapy, which is a treatment to help rid the body of high amounts of heavy metals. A known recent exposure to heavy metals may also be a reason for getting a heavy metal test.
Have I been exposed to heavy metals?
There are many sources of heavy metal exposure. Here are some common ways you can be exposed to heavy metals:
- Smoking
- Working in a factory that uses or processes heavy metals
- Breathing in lead paint as a result of fixing up your older home
- Soil erosion, sewage discharge, and breathing in pesticides
- Eating fish that was caught in an area with high mercury levels
- Drinking water contaminated by heavy metals
What are the signs and symptoms of heavy metal poisoning?
Unfortunately, many signs and symptoms of heavy metal poisoning overlap with other conditions and can be confused with other conditions. The symptoms of heavy metal poisoning may also depend on the exact metal you’ve been exposed to. Some metals are much more toxic than others, and the exposure method can also influence the severity of the poisoning. For instance, a metal that’s inhaled may be more dangerous than the same metal being held in your hand. Lead exposure and lead poisoning, for instance, is much more harmful to young children since their brains are still developing.
So although the signs and symptoms can vary drastically, your healthcare provider may recommend a heavy metal test if you have any of the following symptoms:
- Abdominal pain
- Anemia
- Chills
- Diarrhea
- Muscle weakness
- Nausea or vomiting
- Shortness of breath
- Nervous system symptoms like tingling in your hands or feet
Optimal range: 0 - 30 ug/g
The major tissue sites of aluminum toxicity are the nervous system, immune system, bone, liver, and red blood cells. Aluminum may also interfere with heme (porphyrin) synthesis. Consequences of aluminum toxicity are encephalopathy and abnormal speech, myoclonic jerks, convulsions, and a predisposition to osteomalacic fractures.
Exposure to aluminum is ubiquitous via food, water, air and soil. Aluminum is used to produce beverage cans, cooking pots, siding, roofing, aluminum foil and airplanes. Further, it is found in antacids, buffered aspirin, food additives (especially in grains and cheeses), astringents, vaccinations, cat litter, antiperspirants, infant formula, and baking soda.
Optimal range: 0 - 0.9 ug/g
Optimal range: 0 - 100 ug/g
Optimal range: 0 - 6 ug/g
Optimal range: 0 - 10 ug/g
Optimal range: 0 - 2 ug/g
Optimal range: 0 - 12 ug/g
Optimal range: 0 - 0 mg/dL
Optimal range: 0 - 0.9 ug/g
Optimal range: 0 - 2 ug/g
Optimal range: 0 - 10 ug/g
Optimal range: 0 - 10 ug/g
Optimal range: 0 - 7 ug/g
Optimal range: 0 - 1 ug/g
Optimal range: 0 - 1 ug/g
Optimal range: 0 - 4000 ug/g
Optimal range: 0 - 0.7 ug/g
Optimal range: 0 - 0.1 ug/g
Optimal range: 0 - 10 ug/g
Optimal range: 0 - 6 ug/g
Titanium in the urine can be indicative of exposure to the metal, which is found in a variety of consumer products, medical devices, pharmaceuticals, and in the workplace environment. However, it's important to note that the presence of titanium in urine doesn't necessarily indicate a health risk. Titanium is generally considered to be of low toxicity to humans, but elevated levels could suggest excessive exposure, which might warrant further investigation to understand the source and potential health implications. Medical evaluation and additional tests would be necessary to assess the significance of titanium levels in urine and to determine if there is any health risk associated with the exposure.
Optimal range: 0 - 1 ug/g
Optimal range: 0 - 0.05 ug/g
Uranium (U) is an abundant element on earth. Its widespread use in military and industry, including nuclear power, has increased human exposure. Uranium can be ingested or inhaled and is cleared in urine rapidly, although some will pool in bone and kidney tissues. Uranium toxicity in humans leads to renal damage. Lung cancer is commonly associated with inhaled uranium. Urine can be a sensitive specimen for uranium exposure, but assessment should be undertaken promptly. Intravenous sodium bicarbonate 1.4% has been used to treat uranium toxicity and inositol hexaphosphate has been used in animal studies.
The GI – Advanced Profile (US BioTek)
The GI – Advanced Profile is the most comprehensive stool test by US BioTek, building upon the Basic and Standard GI Microbiome profiles to offer 98 markers from 15 different testing categories.
The profile combines different testing methodologies to offer highly sensitive results with industry-leading accuracy and reproducibility:
PCR
US BioTek uses real-time polymerase chain reaction (RT-PCR) tests to qualitatively detect nucleic acid from various parasites, bacteria, and viruses. The RT-PCR platform is FDA-authorized and requires specialized equipment and personnel to identify DNA within cells. Polymerase chain reaction (PCR) is a relatively simple and widely used molecular biology technique to amplify and detect DNA and RNA sequences. The use of PCR testing allows US BioTek to more precisely identify even the smallest amounts of markers within the stool providing accurate, reliable, and reproducible results.
ELISA
An established immunological technique, ELISA is widely used to detect the presence of specific antibodies or antigens in a patient’s blood. It is a basic testing platform in a fully-automated protocol utilizing advanced robotics and barcoding to identify each specimen throughout the testing procedure. Antigen-specific antibodies, bound to the antigen, are detected through spectrophotometric analysis.
Macroscopy
Stool macroscopy is a method of visually examining stool samples to detect abnormalities such as blood, mucus, parasites, and other foreign materials. The stool is first inspected for color, consistency, and any unusual features.
Culture
Stool culture is a laboratory test that identifies bacteria in stool specimens. A small amount of stool is placed on a growth medium and incubated at a warm temperature. If bacteria are present, they will grow and form colonies. The colonies can then be identified by their appearance and by biochemical tests.
Optimal range: 0 - 100 units/L
Optimal range: 44.5 - 72.4 %
Acetate is the most abundant SCFA in the colon and makes up more than half of the total SCFA detected in feces. These beneficial SCFA have anti-inflammatory properties, provide energy to nourish the colonic epithelial cells and intestinal microbiota, and exert numerous positive effects on gut homeostasis.
Optimal range: 0 - 4.82 %
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^3 CFU/g
Optimal range: 1 - 50 x10^7 CFU/g
Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.
Reference range: Sensitive, Not Tested, Resistant
Reference range: Sensitive, Not Tested, Resistant
Ampicillin, a broad-spectrum beta-lactam antibiotic, is part of the penicillin class and is commonly used to treat a variety of bacterial infections. Its mechanism of action involves inhibiting bacterial cell wall synthesis, which is crucial for bacterial growth and survival. Ampicillin is effective against a range of Gram-positive and some Gram-negative bacteria, making it a valuable tool in combating infections like pneumonia, bronchitis, and urinary tract infections.
However, the concept of antibiotic sensitivities is critical when considering ampicillin's effectiveness. Antibiotic sensitivity refers to the susceptibility of bacteria to specific antibiotics, determined through laboratory testing. This testing is vital in guiding appropriate antibiotic therapy, ensuring that the prescribed antibiotic is effective against the bacteria causing the infection. Over time, many bacteria have developed resistance to ampicillin, primarily through the production of beta-lactamase enzymes that deactivate the antibiotic. This resistance has led to the need for antibiotic stewardship—careful and responsible management of antibiotic use to prevent the development of resistance.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Sensitive, Not Tested, Resistant
Augmentin, a widely used antibiotic, is a combination of two active ingredients: amoxicillin, a penicillin-type antibiotic, and clavulanic acid, a beta-lactamase inhibitor. This combination is designed to enhance the effectiveness of amoxicillin by overcoming certain types of antibiotic resistance. Amoxicillin works by inhibiting bacterial cell wall synthesis, effectively killing or stopping the growth of bacteria. However, many bacteria have developed resistance to amoxicillin through the production of beta-lactamase enzymes, which break down the antibiotic before it can act. Clavulanic acid in Augmentin inhibits these enzymes, thereby protecting amoxicillin from degradation and expanding its spectrum of activity. This makes Augmentin effective against a broader range of bacteria compared to amoxicillin alone, including many that are resistant to other penicillins.
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 1.6 - 250 x10^5 CFU/g
Species in the genus Bacteroides carry out broad metabolic functions, including degradation of complex plant polysaccharides, proteolytic activities, de-conjugation of bile acids, mucosal barrier integrity, short chain fatty acid production, fatty acid storage and glucose metabolism.
Bacteroides spp. are maintained at a higher abundance in breastfed individuals into adulthood.
Bacteroides fragilis plays an important role in the prevention of intestinal inflammation. An energy-restricted diet has been shown to increase B. fragilis in overweight adolescents. An increase in B. stercoris has been associated with higher risk of colon cancer. Decreased levels of Bacteroides spp. have been reported in association with multiple sclerosis, rheumatoid arthritis and Parkinson’s disease.
Optimal range: 50 - 95 %
The Bacteroidetes Phylum marker refers to a group of bacteria commonly found in the human gut, playing a crucial role in the digestive process. This phylum includes various species that are essential for breaking down complex molecules like carbohydrates and fibers, helping in the absorption of nutrients and the production of short-chain fatty acids which are vital for gut health. The presence and balance of Bacteroidetes can be an indicator of gut flora health; for instance, a healthy balance between Bacteroidetes and another major gut bacteria group, Firmicutes, is often associated with good digestive health.
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Optimal range: 368 - 6266 U/g
Optimal range: 4.6 - 1000 x10^5 CFU/g
Bifidobacterium adolescentis is a beneficial bacterium commonly found in the human gastrointestinal (GI) tract, particularly in the intestines. The presence and quantity of Bifidobacterium adolescentis are significant because it plays a crucial role in maintaining a healthy digestive system. This bacterium helps in breaking down complex carbohydrates, producing essential vitamins like B12, and supporting the immune system by inhibiting harmful pathogens. An optimal level of Bifidobacterium adolescentis indicates a balanced gut microbiome, which is vital for overall digestive health, nutrient absorption, and immune function.
Optimal range: 4.6 - 1000 x10^6 CFU/g
Bifidobacterium bifidum is a significant bacterium to evaluate gut health. This specific bacterium is a member of the Bifidobacterium genus, known for its beneficial effects on the digestive system. It naturally inhabits the intestines and plays a crucial role in maintaining a healthy balance of gut flora. Bifidobacterium bifidum helps in the digestion of dietary fiber, producing short-chain fatty acids like acetate, propionate, and butyrate, which are essential for colon health. Moreover, it enhances the immune response by inhibiting harmful pathogens and reducing inflammation. This bacterium is also involved in the production of vitamins, such as B-complex vitamins, and assists in the absorption of minerals like calcium and magnesium.
Optimal range: 4.6 - 1000 x10^6 CFU/g
Bifidobacterium breve is a beneficial probiotic bacterium naturally found in the human gut, particularly in infants and breastfed babies. It plays a crucial role in digestion, immune function, and protecting against harmful microbes. This strain is known for its ability to ferment a variety of carbohydrates, break down dietary fiber, and produce short-chain fatty acids (SCFAs), which support gut health.
Optimal range: 5.2 - 1000 x10^5 CFU/g
Bifidobacterium longum is a specific species of microscopic non-pathogenic bacteria found naturally in the gastrointestinal tracts of humans as well as in most other animals.
Optimal range: 6.7 - 1000 x10^5 CFU/g
A common component of the microbiota of the human gastrointestinal tract and in particular are amongst the first bacterial colonizers of the intestine.
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Optimal range: 0 - 1 x10^5 org/g
Blastocystis hominis is found throughout the world in both people with and without symptoms. It is a non-pathogenic parasite. Non-pathogenic parasites are present in the gastrointestinal tract and generally are self-limiting and do not cause illness. However, some research shows an association between non-pathogenic parasites and gastrointestinal symptoms.
Optimal range: 10.8 - 33.5 %
Butyrate is a short-chain fatty acid (SCFA) produced in the colon by the bacterial fermentation of undigested carbohydrates, primarily dietary fiber. It serves as a primary energy source for colonocytes (cells of the colon) and has several important roles in maintaining gut health and overall well-being.
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 50 ug/g
Calprotectin is a calcium-binding protein with antimicrobial properties. It accounts for 60% of neutrophil cytosolic content and is also found in monocytes and macrophages. Calprotectin is released from the intestinal mucosa into the stool in intestinal inflammation.
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 0 - 5 x10^4 CFU/g
The Candida albicans marker in a gastrointestinal (GI) panel is a crucial indicator of the presence and concentration of Candida albicans, a yeast-like fungus, in the gut microbiome. Candida albicans is a common commensal organism in the human body, residing in the oral cavity, gastrointestinal tract, and vaginal mucosa without causing harm under normal circumstances. However, an overgrowth of this fungus, as suggested by elevated levels in a GI panel, can lead to candidiasis, a condition that manifests in various forms depending on the affected area. In the context of the gastrointestinal tract, an overgrowth can disrupt the delicate balance of the gut microbiome, leading to symptoms like bloating, gas, diarrhea, and in some cases, systemic symptoms if the fungus enters the bloodstream.
Optimal range: 0 - 5 x10^5 CFU/g
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Reference range: Sensitive, Not Tested, Resistant
Reference range: Sensitive, Not Tested, Resistant
Optimal range: 0 - 5 x10^4 CFU/g
Citrobacter spp., a gram-negative bacterium and member of the Enterobacteriaceae family, is considered dysbiotic at 3+ or greater.
Citrobacter freundii complex (including C. freundii, C. braakii, C. gullenii, C. murliniae, rodentium, C. wermanii, C. youngae, C. koseri and C. farmeri, can cause diarrheal disease.
Symptoms are the result of an E. coli-like heat-stable enterotoxin and hydrogen sulfide.
Citrobacter freundii complex has been implicated as a cause of gastrointestinal infection and inflammation, acute dysentery, and dyspepsia.
Optimal range: 0 - 5 x10^4 CFU/g
Optimal range: 0 - 5 x10^4 CFU/g
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Optimal range: 5 - 50 x10^7 CFU/g
Clostridium species, when identified in a gastrointestinal (GI) test, can be of significant clinical interest due to their diverse roles in human health and disease. Members of the Clostridium genus are a part of the normal gut flora in humans and animals, but certain species can become pathogenic under specific conditions. Clostridium difficile (C. difficile) is particularly noteworthy; it's known for causing infections in the GI tract, especially after the use of broad-spectrum antibiotics that disrupt the normal gut microbiota. C. difficile infections (CDI) are a major concern in healthcare settings, as they can lead to conditions ranging from mild diarrhea to life-threatening colitis.
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Coptis, often referred to in the context of traditional Chinese medicine, is a genus of plants known for their potent medicinal properties, particularly their natural inhibitory effects against various pathogens and health conditions. The most well-known species within this genus is Coptis chinensis, commonly called Chinese goldthread. The primary active component of Coptis is berberine, an alkaloid that imparts the distinct yellow color to the roots of these plants and is responsible for many of their therapeutic effects.
Berberine, extracted from Coptis, has been studied for its broad-spectrum antimicrobial properties. It has shown inhibitory effects against bacteria, viruses, fungi, and parasites. This makes it a potential natural alternative or complement to conventional antibiotics, especially in the face of increasing antibiotic resistance. Berberine's mechanism of action is believed to involve the disruption of microbial cell function, although the exact processes vary depending on the type of pathogen.
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 18 x10^7 CFU/g
Desulfovibrio piger is a type of sulfate-reducing bacterium (SRB) commonly found in the human gut microbiome. It plays a role in the breakdown of dietary sulfate, producing hydrogen sulfide (H2S) as a byproduct. While hydrogen sulfide serves essential roles in small amounts—such as maintaining gut lining integrity—excessive levels can contribute to gut dysbiosis and inflammatory conditions.
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 5 x10^5 org/g
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 5 x10^5 CFU/g
Enterobacter is a genus of common Gram-negative, facultatively anaerobic, rod-shaped bacteria, commonly found in the environment as well as the gastrointestinal tract. There are many species, however, not all species are known to cause human disease.
Usually considered a commensal organism; however, strains of E.b cloacae have been shown to produce a heat-stable toxin similar to that produced by E.coli.
Reference range: Non-Pathogen (< 4+), Possible Pathogen (4+)
Enterobacter ludwigii is a notable species within the Enterobacter genus, a part of the larger family of Enterobacteriaceae. This species, like others in its genus, is a Gram-negative, facultatively anaerobic bacterium, typically found in various environments, including water, soil, and the human gastrointestinal tract. While Enterobacter ludwigii shares many characteristics with other members of its genus, it also possesses unique features and behaviors that are of interest in clinical and environmental microbiology.
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^5 CFU/g
Enterococcus faecalis, a key indicator often identified in gut health assessments like the comprehensive GI tests, plays a significant role in understanding the complex ecosystem of the human gastrointestinal tract. As a bacterium that is naturally present in the gut, Enterococcus faecalis can provide critical insights into the microbiome's balance and overall health. It's important for health enthusiasts, medical professionals, and patients alike to recognize the dual nature of this bacterium: while it is a normal resident of a healthy gut, its overgrowth can be a marker of dysbiosis or an imbalance in the gut flora. This makes monitoring its levels crucial in comprehensive gut health tests.
Optimal range: 0 - 1 x10^5 CFU/g
Gram-positive species in the Firmicutes phylum. High levels may result from reduced stomach acid, PPI use, compromised digestive function, SIBO or constipation. High natural resistance to some antibiotics, which may result in overgrowth.
Reference range: Non-Pathogen (< 4+), Possible Pathogen (4+)
Optimal range: 1.9 - 2000 x10^3 CFU/g
Enterococcus species, when detected in a gastrointestinal (GI) test, can provide important insights into the health and balance of the gut microbiome. These bacteria are part of the normal intestinal flora in humans and animals and typically coexist harmlessly within the gut ecosystem. The most commonly identified species in clinical settings are Enterococcus faecalis and Enterococcus faecium. In a balanced gut environment, Enterococcus species contribute to digestive processes and can even play a role in protecting against harmful pathogens. However, their significance in a GI test must be interpreted with caution, as these species can also act as opportunistic pathogens, especially in individuals with a weakened immune system or in hospital settings.
Reference range: Not Detected , Detected
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 0 - 1 x10^3 CFU/g
Optimal range: 0 - 1 x10^5 CFU/g
Reference range: N/A
Optimal range: 3.7 - 3800 x10^4 CFU/g
Enterococcus species, commonly detected in gastrointestinal (GI) tests, represent a significant group of bacteria naturally inhabiting the human gut. These species, particularly Enterococcus faecalis and Enterococcus faecium, are noteworthy for their dual nature: while being normal constituents of the intestinal microbiota, they can also act as opportunistic pathogens. Their presence in GI tests can sometimes be indicative of a healthy, balanced gut flora, but their overgrowth or presence in certain clinical contexts can signal an imbalance or an infection.
Optimal range: 0 - 0.02 %
The Euryarchaeota phylum, a key player in the realm of gut microbiome analysis, stands out in gut health panels for its unique and diverse archaeal species. This phylum, part of the broader Archaea domain, includes various organisms that play crucial roles in the gut ecosystem, notably the methane-producing Methanobrevibacter smithii. The presence and levels of Euryarchaeota in the gastrointestinal tract are indicative of the gut's metabolic state and overall health. These archaea are particularly known for their role in methane production, which can significantly impact gut motility and the digestive process.
Optimal range: 200 - 3500 x10^6 CFU/g
Faecalibacterium prausnitzii is one of the most important bacteria in the human gut flora and makes up to 5-10% of the total number of bacteria detected in stool samples from healthy humans. Faecalibacterium prausnitzii has a crucial role in maintaining gut physiology and host wellbeing.
Optimal range: 3.5 - 40 %
The marker "Firmicutes Phylum" refers to a significant group of bacteria commonly found in the human gut. Firmicutes are one of the most abundant types of bacteria in the human digestive tract, playing a crucial role in the body's ability to digest and absorb nutrients. They are also involved in the synthesis of certain vitamins and the regulation of our immune system. A GI panel often measures the levels of Firmicutes to assess the balance of microbial populations in the gut. An imbalance in these bacteria can be linked to various health conditions, including digestive disorders, obesity, and metabolic issues. When analyzing GI panel results, high or low levels of Firmicutes can provide insights into the individual's gut health, pointing towards potential dysbiosis (microbial imbalance) and guiding appropriate dietary or medical interventions to restore balance and support overall health.
Optimal range: 0 - 1 Ratio
The "Firmicutes:Bacteroidetes Ratio" is an important marker that provides insights into the composition of gut microbiota. Firmicutes and Bacteroidetes are two major groups of bacteria commonly found in the human gut. Each plays a critical role in digestion and overall health. The ratio between these two types of bacteria can indicate different states of gut health and has been linked to various conditions. For instance, an imbalance, often reflected in a higher Firmicutes to Bacteroidetes ratio, has been associated with obesity and other metabolic disorders. Conversely, a lower ratio might be observed in leaner individuals. This marker helps healthcare providers understand the bacterial balance within a patient’s gastrointestinal tract, offering clues about the patient's metabolic health and potential digestive issues. Analyzing this ratio allows practitioners to recommend specific dietary or therapeutic interventions aimed at restoring a healthy balance of gut microbiota, thereby improving the patient's overall health.
Optimal range: 0 - 10 x10^4 CFU/g
The marker Fusobacterium species refers to a group of bacteria that are part of the normal flora in the human gut but can also act as pathogens under certain conditions. Fusobacterium species are anaerobic bacteria, meaning they thrive in environments with little to no oxygen, such as the deeper layers of the mucous membrane lining the gut. In a healthy individual, these bacteria coexist peacefully with other microorganisms and contribute to the gut's ecological balance. However, if the balance is disrupted, Fusobacterium can become opportunistic pathogens, leading to infections. The presence of these bacteria in elevated levels on a GI panel can indicate an infection or dysbiosis (an imbalance in the microbial community), which may be associated with various gastrointestinal disorders, including inflammatory bowel disease and colon cancer. Therefore, the detection of Fusobacterium species on a GI panel is crucial for diagnosing potential infections or imbalances, guiding effective treatment plans to restore gut health.
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Reference range: Sensitive, Not Tested, Resistant
Optimal range: 0 - 3 x10^2 CFU/g
The Geotrichum species marker on a gastrointestinal (GI) panel is indicative of the presence and relative abundance of Geotrichum, a genus of fungi, in the gut microbiome. Geotrichum species are commonly found in soil, water, air, and various food products; they are also a part of the normal flora of the skin, respiratory system, and gastrointestinal tract in humans. In a balanced gut microbiome, the presence of Geotrichum species is typically harmless and may even play a role in the complex ecosystem of the gut. However, an overgrowth or significant presence indicated by a GI panel can have clinical implications.
Optimal range: 0 - 1 x10^5 org/g
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Golden seal, or Hydrastis canadensis, is a North American herb known for its natural inhibitory properties, mainly due to alkaloids like berberine and hydrastine. It's traditionally used for its antimicrobial activity against bacteria, fungi, and parasites, making it a popular remedy for gastrointestinal and respiratory infections. Goldenseal also has anti-inflammatory properties, beneficial in treating conditions like gastritis and ulcerative colitis, and is thought to support the immune system, often used for colds and flu.
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Reference range: Not Detected, Detected
Optimal range: 0 - 1 x10^3 CFU/g
Reference range: Not Detected, Detected
Optimal range: 0 - 5 x10^5 CFU/g
Klebsiella spp. are gram-negative bacilli belonging to the Enterobacteriaceae family and closely related to the genera Enterobacter and Serratia. Klebsiella spp. are considered dysbiotic in the amount of 3 - 4 +. Klebsiella spp. are widely distributed in nature and in the gastrointestinal tract of humans. In humans, they may colonize the skin, oral cavity, pharynx, or gastrointestinal tract. Regarded as normal flora in many parts of the colon, intestinal tract and biliary tract, the gut is the main reservoir of opportunistic strains.
This bacteria has the potential to cause intestinal, lung, urinary tract, and wound infections, but overgrowth of Klebsiella spp. is commonly asymptomatic.
Optimal range: 0 - 5 x10^3 CFU/g
Klebsiella are non-motile, Gramnegative rods that belong to the Enterobacteriaceae family. Klebsiella bacteria are considered commensal but act as opportunistic bacteria in the GI tract. Klebsiellais a leading cause of hospital-acquired infections.
Klebsiella is part of the normal intestinal flora. The environment likely acts as a reservoir for human acquisition, either as colonization or infection. It is frequently found in water, sewage, soil, and plant surfaces.
Optimal range: 1.7 - 500 x10^3 CFU/g
Lactobacillus acidophilus, measured in CFU/g (Colony Forming Units per gram), is a key biomarker included in the GI Standard Test Panel by US BioTek. This gram-positive, rod-shaped bacterium is a vital member of the gut microbiome, primarily residing in the small intestine. It is one of the most well-studied probiotic species and plays a critical role in maintaining gut and overall health.
Optimal range: 1.7 - 500 x10^3 CFU/g
Lactobacillus delbrueckii is a member of the Lactobacillus genus, known for its beneficial role in the gut microbiome. It is commonly found in fermented dairy products like yogurt and plays a crucial role in maintaining a balanced gut environment. On the GI – Advanced Profile panel, the presence and levels of Lactobacillus delbrueckii are important because this bacterium helps in the digestion process by producing lactic acid, which in turn lowers the pH of the gut. This acidic environment is essential for inhibiting the growth of harmful bacteria, supporting the integrity of the gut lining, and enhancing nutrient absorption. A healthy level of Lactobacillus delbrueckii is indicative of a well-functioning digestive system, while low levels might suggest a disruption in the gut microbiome, potentially leading to issues like poor digestion, inflammation, or an overgrowth of pathogenic bacteria.
Optimal range: 1.7 - 500 x10^3 CFU/g
Lactobacillus Plantarum have been shown to:
- Alleviate the symptoms of IBS
- Help treat Small Intestinal Bacterial Overgrowth.
- Accelerate the healing of intestines after illness.
- Mitigate allergic reactions to foods such as soy flour.
There is also evidence that Lactobacillus Plantarum may help in the treatment and prevention of depression and dementia.
Optimal range: 8.3 - 885 x10^3 CFU/g
Lactobacillus rhamnosus was first isolated in 1983 and is known to have a strong avidity for human intestinal cells and can survive acid and bile environments. It is considered one of the most studied probiotics, with research showing that it could do the following:
- alleviate rotavirus diarrhea in children,
- prevent atopic dermatitis,
- protect against urinary tract infections,
- and improve symptoms of irritable bowel syndrome.
Lactobacillus rhamnosus appears to be safe and effective in prolonging remission in UC patients. LGG has also been studied in CD, but found to be no better than placebo.
Optimal range: 1.7 - 500 x10^3 CFU/g
Lactobacillus salivarius is a type of probiotic bacteria that plays a significant role in maintaining a healthy gastrointestinal (GI) tract. Lactobacillus salivarius is used to assess the levels of this beneficial bacterium in the digestive system. Lactobacillus salivarius is known for its ability to produce lactic acid, which helps to lower the pH in the gut and creates an environment that is less favorable for harmful bacteria and pathogens. This probiotic also contributes to the overall balance of the gut microbiome, which is crucial for proper digestion, nutrient absorption, and immune function. Additionally, Lactobacillus salivarius has been associated with anti-inflammatory properties and may help in alleviating symptoms of certain gastrointestinal disorders such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).
Optimal range: 8.6 - 6200 x10^3 CFU/g
Lactobacillus species is a type of bacteria. There are lots of different species of lactobacillus.
Lactobacillus bacteria are commonly found in the human gut, mouth and vagina. They are considered generally as “good bacteria”, and in fact may contribute to good health, often being included in probiotic supplements. These bacteria are characterized by their ability to produce lactic acid as a byproduct of glucose metabolism.
Reference range: Sensitive, Not Tested, Resistant
Optimal range: 0 - 3.5 x10^5 CFU/g
Methanobrevibacter smithii, a prominent archaeon (=a microorganism) in the human gut microbiome, is frequently identified in comprehensive gut health tests and plays a pivotal role in the intricate ecosystem of our digestive system. This microorganism is renowned for its ability to process hydrogen and carbon dioxide, producing methane as a byproduct, and thus, it significantly impacts the overall efficiency of the gut's fermentation processes.
Optimal range: 0 - 1 x10^5 CFU/g
Reference range: Not Detected, Detected
The GI – Advanced Profile by US BioTek features a comprehensive marker known as "Mucuous," which plays a pivotal role in assessing gastrointestinal health. This marker is crucial for understanding the mucosal integrity within the GI tract. A balanced mucous level is essential for proper digestion, nutrient absorption, and barrier function against pathogens. When discussing the GI – Advanced Profile, highlighting the Mucuous marker is key, as it provides invaluable insights into gut health, potentially indicating issues such as inflammation or infections.
Reference range: Not Detected, Detected
Reference range: Sensitive, Not Tested, Resistant
Reference range: Not Detected, Detected
Reference range: Negative, Positive
Reference range: 100% Inhibition, 80% Inhibition, 60% Inhibition, 40% Inhibition, 20% Inhibition, 0% Inhibition
Optimal range: 5 - 500 x10^6 CFU/g
Oxalobacter formigenes is a bacterium that colonizes the colon of a substantial proportion of the normal population and metabolizes dietary and endogenous oxalate and hence reducing the incidence of kidney stones.
Optimal range: 200 - 1000 ug/g
Pancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.
Reference range: Sensitive, Not Tested, Resistant
Optimal range: 0 - 1 x10^5 org/g
Optimal range: 0 - 1 x10^9 CFU/g
Optimal range: 0 - 32 %
Propionate is among the most common short-chain fatty acids produced in the human gut in response to indigestible carbohydrates (fiber) in the diet.
Optimal range: 0.5 - 12.5 %
Proteobacteria are a diverse phylum, comprised with several subclasses: Alphaproteobacteria, Betaproteobacteria, Gammaproteobacteria, Deltaproteobacteria, Epsilonproteobacteria, and Zetaproteobacteria.
The Proteobacteria are commonly occurring in healthy mammalian GI microbiomes and include common human pathogens. Proteobacteria contribute to homeostasis of the anaerobic environment of the gastrointestinal tract. It has a role in protein and sugar degradation and maintaining oxygen homeostasis within the gut.
Optimal range: 0 - 1 x10^4 CFU/g
Opportunistic Bacteria associated with Autoimmunity.
Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals can be a source
Optimal range: 0 - 5 x10^5 CFU/g
Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals can be a source.
Optimal range: 0 - 3 x10^4 CFU/g
- Gram-negative bacteria in the Proteobacteria phylum.
- Pseudomonas aeruginosa are normal flora in the human gastrointestinal (GI) tract, which on occasion cause GI tract infection.
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^3 CFU/g
Reference range: Not Detected, Detected
Optimal range: 0 - 3 x10^3 CFU/g
Optimal range: 0 - 1 x10^5 CFU/g
Reference range: Not Detected, Detected
Optimal range: 510 - 2040 ng/mL
Fecal Secretory IgA is a marker of gut secretory immunity and barrier function.
Immunoglobulin A (IgA) is an antibody playing a critical role in mucosal immunity and is produced in greater quantities than all other types of antibody combined.
In its secretory form, Secretory IgA is the main immunoglobulin found in mucous secretions and provides protection against potentially pathogenic microbes, due to its ability to resist degradation by enzymes and survive in harsh environments such as GI and respiratory tracts.
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 13.6 - 500 umol/g
Optimal range: 0 - 5 x10^3 CFU/g
Optimal range: 0 - 1 x10^3 CFU/g
Staphylococcus species, commonly found in the gastrointestinal tract, are a diverse group of bacteria. Some species are harmless and part of the normal gut flora, while others, like Staphylococcus aureus, can be pathogenic. The presence of Staphylococcus in the gut microbiome is a natural occurrence, but an overgrowth may indicate an imbalance or potential infection. Scientifically, their role in the GI tract is complex, as they can interact with the immune system and impact gut health. Elevated levels of pathogenic Staphylococcus species in the GI tract require careful clinical evaluation, as they might be linked to various health conditions, including food poisoning and intestinal infections. Treatment approaches depend on the specific Staphylococcus species identified and the overall health context.
Optimal range: 0 - 15 %
Steatocrit is a diagnostic test specifically designed to measure the fat content in feces, offering a non-invasive method to evaluate fat malabsorption. This condition, where fats are not properly absorbed by the intestines, can lead to various gastrointestinal disorders, including steatorrhea (the excretion of abnormal quantities of fat with the feces), which is indicative of issues such as pancreatic insufficiency, celiac disease, Crohn's disease, or other conditions affecting the bile ducts or small intestine.
Reference range: Brown
Reference range: Formed, Unformed, Semi-Formed
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^6 CFU/g
Optimal range: 0 - 5 x10^6 CFU/g
Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients.
These findings are in accordance with a study that showed that UC patients have significantly increased Streptococcus spp. and depletion of Bifidobacterium spp. Higher levels of Streptococcus spp. were also observed in patients with colorectal cancer compared to healthy controls. Administration of S. salivarius together with Bifidobacterium bifidum was shown to reduce the incidence of acute diarrhea and rotavirus shedding in infants. S. salivarius and S. thermophilus are also widely used in dairy products like yogurt and cheese.
Optimal range: 0 - 3 x10^6 CFU/g
Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts.
Reference range: Not Detected , Detected
Strongyloides spp refers to a genus of roundworms responsible for strongyloidiasis, a parasitic infection that can range from asymptomatic to severe, particularly in immunocompromised individuals. This parasite primarily infects humans through skin contact with soil contaminated by infective larvae.
Once inside the body, the larvae migrate to the intestines, where they mature into adults and reproduce. The unique lifecycle of Strongyloides allows it to replicate within the host, potentially causing chronic infections that can last for decades. In mild cases, the infection may cause abdominal discomfort, diarrhea, and rash at the site of entry. However, in immunocompromised patients or when the parasite load is high, it can lead to serious complications, including malabsorption, severe GI symptoms, and in rare cases, hyperinfection syndrome, which is potentially fatal. The detection of Strongyloides spp. in a GI panel is crucial for the timely initiation of appropriate antiparasitic treatment, typically involving medications to eradicate the infection and prevent complications. This marker's identification also underscores the importance of hygiene and sanitation measures in preventing soil-transmitted helminth infections.
Reference range: Not Detected, Detected
Optimal range: 5 - 2000 x10^6 CFU/g
Total Bifidobacteria refers to the overall population of beneficial Bifidobacterium species in the gut. These probiotic bacteria play a crucial role in digestive health, immune function, and maintaining a balanced gut microbiome. They help break down dietary fiber, produce short-chain fatty acids (SCFAs) like acetate and butyrate, and support the production of essential vitamins such as B vitamins.
Optimal range: 1.7 - 3000 x10^3 CFU/g
Total Lactobacilli measured in x10^3 CFU/g (Colony Forming Units per gram) is a critical biomarker indicating the presence and abundance of beneficial Lactobacillus bacteria in the gastrointestinal tract. These gram-positive bacteria are key contributors to the gut microbiome, supporting both digestive and overall health.
Clinicians use Total Lactobacilli levels to assess the state of beneficial bacteria in the gut ecosystem. Healthy levels are associated with improved digestive function and immune health, while low levels may signal an imbalance in the gut microbiome, also known as dysbiosis.
Reference range: Not Detected, Detected
Reference range: Sensitive, Not Tested, Resistant
Optimal range: 0.5 - 7 %
Valerate is a Short Chain Fatty Acid (SCFA). It is derived from bacterial fermentation of protein in the distal colon.
SCFAs are the end product of the bacterial fermentation process of dietary fiber by beneficial flora in the gut and play an important role in the health of the GI as well as protecting against intestinal dysbiosis.
Optimal range: 0 - 2.4 %
The marker "Verrucomicrobia Phylum" refers to a group of bacteria belonging to the phylum Verrucomicrobia, which is often evaluated during stool tests to understand gut health. Verrucomicrobia are a less common but interesting group of bacteria that reside in various environments, including soil, freshwater, and marine ecosystems, but they are also present in the human gut, particularly in the large intestine. In the context of a GI Panel, the presence and levels of Verrucomicrobia can provide insights into the microbial diversity of the gut, which is crucial for maintaining digestive health and immune function. These bacteria are particularly noted for their role in breaking down complex polysaccharides (large sugar molecules), which is an important process in the human digestive system. An imbalance in the levels of Verrucomicrobia, either too high or too low, can indicate disturbances in the gut microbiome, which might be associated with various health conditions such as inflammatory bowel disease or obesity. Therefore, monitoring this phylum can help healthcare providers assess gut health and contribute to the diagnosis and management of gastrointestinal disorders.
Optimal range: 0 - 1 x10^4 CFU/g
Optimal range: 0 - 1 x10^5 CFU/g
Optimal range: 0 - 107 ng/mL
Zonulin is a protein that opens intercellular tight junctions in the gut lining (the connections between epithelial cells that make up the gastrointestinal lining). Zonulin increases intestinal permeability in the jejunum and ileum and is considered a biomarker for barrier permeability.
Urinary Amino Acids (Synlab)
Amino Acids build and repair tissues, cause chemical reactions, transport nutrients, hormone and neurotransmitter synthesis, immune and detoxification functions, and more. Their critical role in human health makes them important in numerous clinical presentations.
A urinary Amino Acids Test can provide valuable insights into your body’s amino acid metabolism.
Amino Acid imbalances have been associated with:
- ADD/ADHD
- Autism Spectrum Disorders
- Cardiovascular Disease
- Depression/Anxiety
- Diabetes
- Digestive Distorders
- Epilepsy
- Fatigue
- Hypertension
- Infertility
- Insomnia
- Kidney Disease and Impaired Function
- Low Dietary Protein Intake or Malnutrition
- Maldigestion/Malabsorption
- Nutritional Deficiencies
- Rheumatoid Arthritis
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 0 - 4 mmol/mol creatinine
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. And, as previously mentioned, carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 0 - 1 mmol/mol creatinine
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 4 - 12 mmol/mol creatinine
Cystine is formed from the oxidation of cysteine, or from the degradation of glutathione oxidation products. It is two cysteines linked together with a disulfide bond.
The urine FMV amino acid test reports cysteine and cystine separately. The plasma amino acid test combines both cysteine and cystine as one biomarker.
Optimal range: 0 - 1 mmol/mol creatinine
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania.
Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution. Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production.
Optimal range: 0 - 0 mmol/mol creatinine
Optimal range: 5 - 20 mmol/mol creatinine
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy. Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 0 - 3 mmol/mol creatinine
Phosphoethanolamine is an intermediate in the serine-to-choline sequence. It is both a precursor and byproduct of phospholipid biosynthesis and breakdown. As a precursor to the phospholipid phosphatidylethanolamine, phosphoethanolamine plays a key role in myelination. Elevated phosphoethanolamine reflects brain phospholipid turnover, an indicator of neural membrane synthesis and signal transduction. Research into neurologic conditions like Alzheimer’s disease and Huntington’s disease suggests that depletions of both phosphoethanolamine and ethanolamine accompany neuronal death. Phosphoethanolamine is also important in cartilage structure and function, especially in bone and teeth.
Optimal range: 0 - 5 mmol/mol creatinine
Tryptophan is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Anaplasma Phagocytophilum and Ehrlichia Chaffeensi Antibody Panel
The Anaplasma phagocytophilum and Ehrlichia chaffeensis Antibody Panel is a comprehensive serological test used to diagnose infections caused by these two tick-borne pathogens. Anaplasma phagocytophilum is responsible for anaplasmosis, while Ehrlichia chaffeensis causes human monocytic ehrlichiosis (HME). Both diseases can present with similar clinical symptoms, including fever, headache, muscle aches, and in some cases, more severe complications like thrombocytopenia and elevated liver enzymes. The antibody panel typically includes tests for both IgM and IgG antibodies to each pathogen, providing information about recent and past infections. The presence of IgM antibodies suggests a recent or acute infection, while IgG antibodies indicate past exposure or a longer-term response to the infection. This panel is particularly valuable in areas where ticks are prevalent and in patients with a history of tick exposure, as it helps differentiate between these two infections, which, despite their similarities, may require different approaches to treatment. A positive result for either pathogen can guide appropriate antibiotic therapy and management. However, results should be interpreted with caution, as cross-reactivity between antibodies to different pathogens can occur, and the presence of antibodies alone does not always indicate an active infection. Clinicians often consider these test results alongside the patient's clinical presentation, history, and other laboratory findings for an accurate diagnosis.
Reference range: <1:64, =>1:64
Anaplasma phagocytophilum Ab (IgG) testing is a serological method used to detect antibodies, specifically Immunoglobulin G (IgG), against Anaplasma phagocytophilum, the bacterium responsible for the tick-borne disease known as anaplasmosis. The presence of IgG antibodies typically indicates past exposure or a more chronic immune response to this pathogen. IgG antibodies against A. phagocytophilum usually develop a few weeks after the initial infection and can persist in the bloodstream for a prolonged period, making them useful markers for past infection.
Reference range: <1:20, =>1:20
Anaplasma phagocytophilum Ab (IgM) testing is a crucial diagnostic tool for detecting acute infections caused by Anaplasma phagocytophilum, the bacterium responsible for anaplasmosis, a tick-borne disease. The IgM antibodies are the first type of antibodies produced by the immune system in response to an infection. Their presence in a patient's blood is an important indicator of a recent or ongoing infection.
Typically, IgM antibodies against A. phagocytophilum appear within the first few weeks following exposure to the bacterium. This makes the IgM test particularly valuable in the early diagnosis of anaplasmosis, especially in patients presenting with initial symptoms such as fever, muscle aches, and fatigue, which are often nonspecific and can be mistaken for other illnesses. A positive IgM test result provides strong evidence for a recent Anaplasma infection, guiding prompt treatment and management strategies. However, it's important to interpret these results carefully.
Reference range: <1:64, =>1:64
Ehrlichia chaffeensis antibody (IgG) testing is a critical diagnostic tool used to detect previous or ongoing infections with Ehrlichia chaffeensis, the bacterium responsible for human monocytic ehrlichiosis (HME), a potentially severe tick-borne disease.
The presence of IgG antibodies against E. chaffeensis in a patient's blood suggests an immune response to this specific pathogen. IgG antibodies are typically produced later in the course of an infection and can persist for a long period, often indicating past exposure or a more chronic form of the infection. In clinical settings, testing for E. chaffeensis IgG is particularly important for patients presenting with symptoms suggestive of HME, which include fever, headache, malaise, and sometimes more severe manifestations like thrombocytopenia, leukopenia, and elevated liver enzymes.
Reference range: <1:20, =>1:20
Ehrlichia chaffeensis Ab (IgM) testing plays a critical role in the early diagnosis of human monocytic ehrlichiosis (HME), a tick-borne illness caused by the bacterium Ehrlichia chaffeensis. This test specifically looks for IgM antibodies, which are among the first antibodies produced by the immune system in response to an infection. The presence of IgM antibodies against E. chaffeensis typically indicates a recent or ongoing infection, as these antibodies usually develop within the first week or two after exposure to the bacterium and can be detected before the IgG antibodies.
Chlamydia/Chlamydophila Ab PNL 3 (IgG, IgA, IgM)
The Chlamydia/Chlamydophila Antibody Panel 3 (IgG, IgA, IgM) is a comprehensive serological test used to detect antibodies against Chlamydia and Chlamydophila species in a patient's blood. This panel tests for three types of antibodies: Immunoglobulin G (IgG), Immunoglobulin A (IgA), and Immunoglobulin M (IgM), each providing different information about the timing and stage of the infection. IgG antibodies are usually indicative of a past infection or a later stage of an ongoing infection, as they develop over a longer period and can persist for years. IgA antibodies are often associated with mucosal infections and can indicate a more recent or ongoing infection, especially in the respiratory or genital tracts. IgM antibodies are the first to appear in response to an infection and suggest a recent or acute infection. The Chlamydia/Chlamydophila Ab PNL 3 is particularly useful in diagnosing infections like Chlamydia pneumoniae, which can cause respiratory illnesses, and Chlamydia trachomatis, known for causing sexually transmitted infections and trachoma. A comprehensive analysis of IgG, IgA, and IgM levels provides a more complete picture of the infection's status, helping clinicians to determine whether the infection is recent, ongoing, or past, and to guide appropriate treatment. However, results should be interpreted carefully in the context of clinical symptoms and other diagnostic tests due to the potential for cross-reactivity and the varying persistence of antibody types.
Reference range: <1:16 titer, =>1:16 titer
Reference range: <1:64 titer, =>1:64 titer
Reference range: <1:10 titer, =>1:10 titer
Reference range: <1:16, =>1:16
Reference range: <1:64 titer, =>1:64 titer
Reference range: <1:10 titer, =>1:10 titer
Reference range: <1:16 titer, =>1:16 titer
Reference range: less than 1:64 titer, equal or greater than 1:64 titer
Reference range: <1:10 titer, =>1:10 titer
Protein, Total and Protein Electrophoresis, 24 Hour Urine and Immunofixation
The test panel comprising Protein, Total and Protein Electrophoresis, 24 Hour Urine, and Immunofixation is an important diagnostic tool used in medical laboratories to assess and monitor various health conditions. The Total Protein test measures the total amount of protein in the urine over a 24-hour period and is crucial in evaluating kidney function and diagnosing kidney disorders. High levels of protein in urine, known as proteinuria, can indicate kidney damage or disease, as the kidneys are normally responsible for preventing excessive protein loss.
Protein Electrophoresis, specifically in a 24-hour urine sample, separates proteins based on their size and charge. This test is vital for identifying the specific types of proteins being excreted, which can provide valuable insights into underlying health issues. For example, the presence of abnormal proteins, like Bence Jones protein, can be an indicator of multiple myeloma, a type of blood cancer.
Immunofixation is another critical component of this panel. It is used to identify specific proteins, particularly immunoglobulins, in the urine. This test is particularly important in diagnosing and monitoring monoclonal gammopathies, conditions where a type of immune cell produces an abnormal amount of a single type of antibody. Immunofixation helps in differentiating between various types of monoclonal gammopathies, including multiple myeloma, Waldenström's macroglobulinemia, and others.
Together, these tests provide a comprehensive overview of protein levels and types in the urine, assisting healthcare professionals in diagnosing and managing a range of disorders, especially those related to the kidneys and immune system. Abnormal results from these tests often necessitate further investigation to pinpoint the exact cause and determine the appropriate course of treatment. The synergy of these tests lies in their ability to offer both a broad and detailed view of protein metabolism and excretion, making them indispensable in modern clinical diagnostics.
Optimal range: 0 - 100 %
In the context of a Protein Electrophoresis test, particularly for urine, the albumin percentage is an important indicator. This test typically involves separating different proteins found in the urine based on their physical properties, and then quantifying them. The albumin percentage refers to the proportion of albumin in relation to the total amount of proteins detected in the urine sample.
Optimal range: 0 - 100 %
In a urine protein electrophoresis test, which is part of the panel including Total Protein and Protein Electrophoresis, 24 Hour Urine, the Alpha-1-Globulins percentage is an important parameter to consider. Alpha-1-globulins are a group of plasma proteins that include several important components, such as alpha-1-antitrypsin, alpha-1-acid glycoprotein, and others.
Optimal range: 0 - 100 %
Alpha-2 globulins is a class of proteins that has many functions in the body and is involved in inflammation.
Optimal range: 0 - 100 %
Beta globulins are a group of proteins in the blood plasma that include transferrin, hemopexin, complement proteins, and low-density lipoproteins (LDL).
The beta globulins percentage provides insight into the composition of proteins excreted in the urine. A deviation from the normal range can indicate an abnormality in protein synthesis, degradation, or loss.
Some beta globulins, like transferrin, are produced in the liver. Altered levels in the urine can indicate liver dysfunction, as the liver plays a critical role in synthesizing various plasma proteins.
The presence and levels of beta globulins in urine can help assess kidney function. Healthy kidneys typically prevent large proteins like globulins from being excreted in significant amounts. Therefore, elevated levels of beta globulins in the urine may indicate kidney damage or disease.
Optimal range: 0.5 - 2.15 g/24 h
Creatinine is a waste product produced by muscles and is typically filtered out of the blood by the kidneys. By measuring the amount of creatinine excreted in the urine over a 24-hour period, this test helps assess kidney function. Consistent levels of creatinine excretion indicate stable kidney function, whereas abnormal levels can point to kidney impairment. Furthermore, the 24-hour urine creatinine measurement is often used to validate the completeness of the 24-hour urine collection, ensuring that the collected sample is representative of the patient's typical urine output. This aspect is crucial for accurately interpreting other results from the urine analysis, such as protein levels.
Reference range: Normal Pattern, Abnormal Pattern
In a Protein Electrophoresis test, part of panels like Total Protein and Protein Electrophoresis, 24 Hour Urine, the "pattern" refers to the arrangement and distribution of protein fractions (such as albumin, alpha-1, alpha-2, beta, and gamma globulins) as revealed in the test results. This pattern, which is identified through the separation of proteins based on size and electrical charge, shows the different protein groups and their relative proportions. A normal pattern typically has albumin as the most abundant protein, followed by various globulins. Abnormalities in this pattern can indicate medical conditions such as liver disease, immune disorders, or kidney issues. The pattern is crucial for diagnosing and monitoring these conditions, providing insight into the body's protein composition and any deviations from normal levels.
Optimal range: 0 - 150 mg/24 hr
The "Protein, Total, 24 HR Urine" marker in this panel is a critical measure for evaluating kidney function and detecting kidney disorders. It quantifies the total amount of protein excreted in urine over a 24-hour period. Normally, healthy kidneys filter blood and retain most proteins, preventing significant protein loss in urine. Therefore, an elevated total protein level in a 24-hour urine collection can be a sign of proteinuria, indicating kidney damage or disease. Conditions such as glomerulonephritis, diabetic nephropathy, or hypertension-related kidney damage can lead to increased urinary protein excretion. This marker is essential for diagnosing and monitoring these conditions, providing insights into the severity of kidney impairment and the effectiveness of treatment strategies. Accurate 24-hour urine collection is crucial for this measurement, as it reflects the total protein excretion more reliably than a single or random urine sample.
Optimal range: 0 - 100 mg/g creat , 0 - 0.1 mg/mg creat
The Protein/Creatinine Ratio in a test panel that includes Total Protein and Protein Electrophoresis, 24 Hour Urine, is a significant indicator of kidney function and health. This ratio compares the amount of protein to the amount of creatinine in a urine sample, providing a more accurate assessment of protein excretion than measuring protein alone. In healthy kidneys, protein is retained in the bloodstream, and only small amounts are excreted in urine, whereas creatinine, a waste product, is consistently excreted. An elevated Protein/Creatinine Ratio can indicate abnormal protein loss through the kidneys, a condition known as proteinuria, which is often a sign of kidney damage or disease. By normalizing the protein level to the creatinine level, this ratio helps account for variations in urine concentration and provides a more reliable assessment of proteinuria, particularly important for early detection and monitoring of kidney disease.
Heavy Metals Profile I, Blood
The "Heavy Metals Profile I, Blood" panel offered by LabCorp is a comprehensive diagnostic tool designed to assess exposure to several significant heavy metals. This test typically includes the analysis of blood levels of metals such as lead, mercury, cadmium, and arsenic. These metals are known for their potential toxicity and adverse health effects when they accumulate in the body. Lead exposure, for instance, can affect the nervous system, kidneys, and reproductive system and is especially harmful to children, causing developmental delays and learning difficulties. Mercury exposure can lead to neurological and behavioral disorders and is particularly dangerous for pregnant women due to its potential effects on fetal development. Cadmium, often found in industrial workplaces, can cause kidney damage and is a known carcinogen, while arsenic exposure, which can occur through contaminated water, food, or industrial processes, is linked to skin lesions, cancer, and cardiovascular diseases. This test is crucial for individuals who might have been exposed to these metals through their occupation, environmental factors, or lifestyle choices. It aids healthcare providers in diagnosing potential heavy metal poisoning, monitoring exposure levels, and devising appropriate treatment strategies, including chelation therapy in severe cases. The "Heavy Metals Profile I, Blood" is an essential tool in occupational and environmental health, helping to safeguard individuals from the detrimental effects of these toxic substances and ensuring timely intervention to prevent long-term health consequences.
Optimal range: 0 - 9 ug/L
The "Arsenic, Blood" marker on the "Heavy Metals Profile I, Blood" panel from LabCorp is a crucial test for assessing exposure to arsenic, a toxic heavy metal with significant health implications. Arsenic exposure can occur through various means, including contaminated water, certain foods, industrial processes, and occupational exposure in industries like mining and smelting.
Measuring arsenic levels in blood is essential for detecting recent exposure, as arsenic is rapidly cleared from the bloodstream and redistributed to organs and tissues. Elevated blood arsenic levels can lead to acute symptoms like gastrointestinal distress, cardiac problems, and severe skin manifestations. Chronic exposure, even at lower levels, is particularly concerning, as it can result in long-term health issues like skin lesions, increased risk of cancers (especially skin, bladder, and lung), cardiovascular diseases, and neurotoxicity. For certain forms of organic arsenic, such as those found in seafood, the toxicity is much lower, and these forms are rapidly eliminated from the body; however, inorganic arsenic, found in contaminated water and certain foods, is highly toxic.
Optimal range: 0 - 1.2 ug/L
Exposure to inorganic cadmium fumes in industrial settings can cause various health issues such as fatigue, coughing, chest pain, a burning sensation in the throat, and kidney damage. People with cadmium-induced kidney problems generally have a poor prognosis, with urinary β-microglobulin and urinary protein being critical indicators. Inhalation of cadmium fumes can result in pneumonia with acute exposure and emphysema with prolonged exposure.
Optimal range: 0 - 3.4 ug/dL
The "Lead, Blood" marker on the "Heavy Metals Profile I, Blood" panel from LabCorp is a critical test for detecting and monitoring lead exposure in the body. Lead, a toxic heavy metal, can have severe health implications, particularly when exposure occurs over extended periods. This marker measures the concentration of lead in the blood, which is the most reliable indicator of recent or ongoing lead exposure. Elevated blood lead levels can have detrimental effects on various bodily systems, especially in children, where even low levels of exposure can lead to significant developmental delays, learning difficulties, and behavioral issues.
Optimal range: 0 - 14.9 ug/L
The "Mercury, Blood" marker on LabCorp's "Heavy Metals Profile I, Blood" panel is a critical diagnostic tool for assessing exposure to mercury, a heavy metal known for its toxicity. Mercury exposure can occur through various sources, such as consumption of certain types of fish and shellfish, dental amalgam fillings, industrial emissions, and occupational hazards in industries like mining or manufacturing. The blood test for mercury is particularly effective in detecting recent exposure to organic mercury, including methylmercury, the form most commonly associated with fish consumption.
Toxic Element Exposure Profile; Hair (Doctor's Data)
Hair Elements analysis provides information regarding recent and ongoing exposure to potentially toxic metals, especially methylmercury and arsenic, and time-averaged status of specific nutrient elements. This noninvasive screening test requires only .25 grams of hair. Doctor's Data offers a Hair Elements profile containing essential and toxic elements and a Hair Toxic Element Exposure profile containing an expanded lineup of toxic metals.
Useful for:
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With respect to its contained elements, hair is essentially an excretory tissue rather than a functional tissue. Hair element analysis provides important information which, in conjunction with symptoms and other laboratory values, can assist the physician with an early diagnosis of physiological disorders associated with aberrations in essential and toxic element metabolism.
As protein is synthesized in the hair follicle, elements are incorporated permanently into the hair with no further exchange or equilibration with other tissues. Scalp hair is easy to sample, and because it grows an average of one to two cm per month, it contains a "temporal record" of element metabolism and exposure to toxic elements.
Nutrient elements including magnesium, chromium, zinc, copper and selenium are obligatory co-factors for hundreds of important enzymes and also are essential for the normal functions of vitamins. The levels of these elements in hair are correlated with levels in organs and other tissues.
Toxic elements may be 200 to 300 times more highly concentrated in hair than in blood or urine. Therefore, hair is the tissue of choice for detection of recent exposure to elements such as arsenic, aluminum, cadmium, lead, antimony and mercury. The CDC acknowledges the value of hair mercury levels as a maternal and infant marker for exposure to neurotoxic methylmercury from fish.
Through recent vast improvements in technology, instrumentation and application of scientific protocols, hair element analysis has become a valuable tool for providing dependable and useful data for physicians and their patients. The U.S. Environmental Protection Agency stated in a recent report that "...if hair samples are properly collected and cleaned, and analyzed by the best analytic methods, using standards and blanks as required, in a clean and reliable laboratory by experienced personnel, the data are reliable." (U.S.E.P.A. 600/4-79-049)
Hair, however, is vulnerable to external elemental contamination by means of certain shampoos, bleaches, dyes, and curing or straightening treatments. Therefore, the first step in the interpretation of a hair element report is to rule out sources of external contamination.
Hair element analysis is a valuable and inexpensive screen for physiological excess, deficiency or maldistribution of elements. It should not be considered a stand-alone diagnostic test for essential element function, and should be used in conjunction with patient symptoms and other laboratory tests. Doctor's Data offers a Hair Toxic and Essential Elements profile and a Hair Toxic Element Exposure profile containing an expanded lineup of toxic metals.
Optimal range: 0 - 19 ug/g
Optimal range: 0 - 0.15 ug/g
Optimal range: 0 - 0.2 ug/g
Optimal range: 0 - 3 ug/g
Optimal range: 0 - 0.05 ug/g
Optimal range: 0 - 5 ug/g
Optimal range: 0 - 0.3 ug/g
Optimal range: 0 - 0.01 ug/g
Optimal range: 0 - 0.95 ug/g
Optimal range: 0 - 0.08 ug/g
Optimal range: 0 - 60 ug/g
Optimal range: 0 - 0.01 ug/g
Optimal range: 0 - 0.04 ug/g
Optimal range: 0 - 0.3 ug/g
Optimal range: 0 - 5 ug/g
Optimal range: 0 - 1.3 ug/g
Optimal range: 0 - 3 ug/g
Optimal range: 0 - 0.6 ug/g
Optimal range: 0 - 0.01 ug/g
Optimal range: 0 - 0.01 ug/g
Optimal range: 0 - 2.1 ug/g
Optimal range: 0 - 0.5 ug/g
Hair silver (Ag) levels have been found to reflect environmental exposure to the element. However, hair may be contaminated with Ag from hair treatments such as permanents, dyes, and bleaches. Ag is not an essential element and is of relatively low toxicity. However, some Ag salts are very toxic.
Sources of Ag include modern hot tubs, seafood, metal and chemical processing industries, photographic processes, jewelry making (especially soldering), effluents from coal fired power plants and colloidal silver products.
Optimal range: 0 - 0.05 ug/g
Optimal range: 0 - 0.01 ug/g
Optimal range: 0 - 0.01 ug/g
Optimal range: 0 - 0.8 ug/g
Optimal range: 0 - 1 ug/g
Optimal range: 0 - 0.01 ug/g
Optimal range: 0 - 0.2 ug/g
Optimal range: 0 - 0.2 ug/g
Optimal range: 0 - 270 ug/g
Organic Acids Profile (US BioTek)
The Organic Acids Profile (OAP) offered by US BioTek Laboratories provides an excellent overview of mitochondrial and primary biochemical functions. The analytes on the OAP can detect problems with the body’s processing of dietary macronutrients (carbohydrates, fats, and proteins) or problems with the Citric Acid Cycle (CAC), one of the primary pathways in the mitochondria.
The OAP also provides an overview of bacterial metabolism in the gastrointestinal microbiome, which can have profound effects on the health, and on biochemical and detoxification functions of the human host.
Recent scientific advances illuminate the importance of inheritance (genetic and epigenetic), environment and nutrition for human health and wellness. Pollution, malnutrition, or other physical or psychological stress can dysregulate or inhibit primary biochemical pathways, mitochondria, the gut microbiome, and detoxification functions. If an individual has inherited low-activity enzyme variants, such stressors may be enough to shift them from health to disease. Chronic inflammatory diseases such as type II diabetes, cardiovascular disease, fatty liver, immune system dysregulation, premature ageing, etc. have been associated with mitochondrial dysfunction and/or the dysregulation of primary biochemical pathways. The OAP is a reliable tool for screening and monitoring individuals with inherited or acquired biochemical or mitochondrial dysregulations.
US BioTek’s Organic Acids Profile is designed to screen the general population for metabolic problems associated with aging, chronic inflammation, environment-induced mitochondrial dysfunction, and low-activity enzyme variants requiring additional nutritional support. The test is not designed to diagnose inborn errors of metabolism (IEMs); the majority of IEMs result in significant functional and intellectual challenges and are diagnosed in infancy. Please note that, as with all urine tests, adequate kidney function is required for accurate results.
References:
- Cani PD. Interactions between gut microbes and host cells control gut barrier and metabolism. Int J Obes Suppl. 2016;6(Suppl 1):S28-S31.
- Dela Cruz CS, Kang MJ. Mitochondrial dysfunction and damage associated molecular patterns (DAMPs) in chronic inflammatory diseases. Mitochondrion. 2018;41:37-44.
- Hollman AL, Tchounwou PB, Huang HC. The Association between Gene-Environment Interactions and Diseases Involving the Human GST Superfamily with SNP Variants. Int J Environ Res Public Health. 2016;13(4):379.
- Jain A, Li XH, Chen WN. An untargeted fecal and urine metabolomics analysis of the interplay between the gut microbiome, diet and human metabolism in Indian and Chinese adults. Sci Rep. 2019;9:9191. https://doi.org/10.1038/s41598-019-45640-y
- Johannsen DL, Ravussin E. The role of mitochondria in health and disease. Curr Opin Pharmacol. 2009;9(6):780-786.
- Picard M, McEwen BS. Psychological Stress and Mitochondria: A Systematic Review. Psychosom Med. 2018;80(2):141-153.
- Tsoukalas D, Alegakis A, Fragkiadaki P, et al. Application of metabolomics: Focus on the quantification of organic acids in healthy adults. Int J Mol Med. 2017;40(1):112-120.
Optimal range: 0 - 1.24 ug/mg creatinine
2-Hydroxyphenylacetate is a key intermediary in the metabolism of phenylalanine, an essential amino acid, and tyrosine, a conditionally essential amino acid. Elevated levels of 2-Hydroxyphenylacetate can signal underlying metabolic disturbances or genetic abnormalities in phenylalanine and tyrosine metabolism, such as phenylketonuria (PKU) or tyrosinemia. Monitoring 2-Hydroxyphenylacetate levels as part of the Organic Acids Profile can be instrumental in diagnosing and managing these metabolic disorders, facilitating early intervention and personalized treatment strategies for affected individuals.
Optimal range: 0 - 0.06 ug/mg creatinine
2-Methylhippurate is a byproduct of detoxification of the common solvent xylene. Urinary excretion of 2-methylhippurate is a sensitive and specific marker for xylene exposure which increases oxidative stress.
Optimal range: 0 - 0.01 ug/mg creatinine
Sources of Exposure:
- Mainly by inhalation of vapors.
- Production occurs during petroleum refining.
- Primary use is as a motor fuel additive.
- Automotive emissions, poor emission-control devices on older vehicles, poor maintenance practices, diesel engine exhaust.
- Solvent in coatings, paint thinners, wood preservatives, cleaners, dry cleaners, degreasers, aerosols, pesticides, printing and inks.
- Component of white spirit, the most widely used solvent in the paint and coating industry.
Optimal range: 0.46 - 9.21 ug/mg creatinine
Indoleacetic acid (IAA), or indole-3-acetate, is produced by the bacterial fermentation of the amino acid tryptophan.
IAA can be formed from several common gut microbes such as Clostridia species, Escherichia coli, and Saccharomyces species.
Optimal range: 0 - 0.18 ug/mg creatinine
3-Methylhippurate is a Xylene Metabolite.
Xylene is found in many solvents (paints, perfumes, etc.). Used in insecticide\pesticide application. Metabolized to Methylhippurate, which is measured in urine.
Optimal range: 1.17 - 8.06 ug/mg creatinine
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 4.42 ug/mg creatinine
Adipate, together with Suberate and Ethylmalonate are all functional markers for deficiency of carnitine.
Carnitine is needed to move fatty acids into the mitochondria where they are converted to energy using vitamin B2.
If carnitine is sufficient long-chain fatty acids go through beta-oxidation in the mitochondria.
When insufficient levels of carnitine or vitamin B2 slow down this process, other parts of the cellular machinery take over and make adipate and suberate.
A similar block in another pathway causes high ethylmalonate. Since most of our bodies’ energy is produced from the burning of fatty acids, our muscles and brain suffer when this cellular energy pathway is blocked. Anything that interferes with the normal fatty acid oxidation may reveal high levels of these metabolites.
Optimal range: 0 - 1.24 ug/mg creatinine
What is α-Hydroxybutyrate?
α-Hydroxybutyrate is a by-product of glutathione production. Levels of alpha-hydroxybutyrate in the urine may reflect levels of glutathione production.
What is Glutathione?
Glutathione is an important antioxidant that can prevent damage to cellular components caused by reactive oxygen species such as free radicals, peroxides, lipid peroxides, and heavy metals.
Glutathione is constantly being used up in the removal of toxic molecules and prevention of oxidative damage.
α-Hydroxybutyrate is a by-product from the process in which the body forms more glutathione. When that process is running at high rates, α-hydroxybutyrate excretion is increased.
Optimal range: 0 - 6.35 ug/mg creatinine
α-Hydroxyisobutyric Acid is a major urinary metabolite of the industrial solvent methyl tert-butyl ether (MTBE).
MTBE was a gasoline additive discontinued in the early 2000’s used to reduce automobile emissions. Due to significant ground water leakage from storage tanks, ongoing exposure to MTBE exists in ground water. There is also data available on levels of MTBE in ambient air.
Urinary α-hydroxyisobutryic acid is a marker of recent MTBE exposure. Although, MTBE was initially designated as “noncarcinogenic”, recent studies suggest some interesting clinical associations. Exposure to MTBE has been linked to type 2 diabetes as a result of disrupted zinc homeostasis and glucose tolerance. There are also clinical associations with autism, DNA oxidative damage, and methylation defects. Studies on cancer, reproductive abnormalities, nonalcoholic fatty liver, and neurotoxicity have been either negative or inconclusive thus far.
Optimal range: 0 - 1.29 ug/mg creatinine
Alpha-Keto-Beta-Methylvalerate is a B-Complex Vitamin Marker. Vitamins are compounds that your body needs to be healthy. Vitamins are “essential” for proper function, which means that they are not made inside your body and must be consumed in the diet.
Optimal range: 0 - 18.94 ug/mg creatinine
Alpha-Ketoglutarate is an organic acid that is important for the proper metabolism of all essential amino acids. It is formed in the Krebs cycle, the energy-producing process that occurs in most body cells.
Optimal range: 0 - 1.09 ug/mg creatinine
Alpha-Ketoisocaproate is a B-Complex Vitamin Marker (Leucine catabolism).
Vitamins are compounds that your body needs to be healthy. Vitamins are “essential” for proper function, which means that they are not made inside your body and must be consumed in the diet. The B-complex vitamins are necessary for many enzymes in your body to function properly.
Many B vitamins are used as co-factors in the breakdown of amino acids. A deficiency of any of these B vitamins may lead to a block in one or more of these pathways resulting in elevations of the markers.
Vitamins B1 (thiamin), B3 (niacin), and B5 (pantothenic acid) are necessary for energy pathways of all of the cells in your body. As your food is broken down, specific compounds are formed at steps that require B vitamin assistance. Alpha-Ketoisocaproate is one some these compounds. The production of this metabolite requires vitamins B1, B3, B5 and lipoic acid.
Optimal range: 0 - 0.49 ug/mg creatinine
Alpha-Ketoisovalerate (together with Alpha-Ketoisocaproate and Alpha-Keto-Beta-methylvalerate) requires Vitamins B1, B2, B3, B5 and lipoic acid to be metabolized.
Optimal range: 0 - 6.87 ug/mg creatinine
Benzoate, was one of the compounds first found to be elevated in urine from patients with intestinal bacterial overgrowth of various origins.
Optimal range: 0 - 8.09 ug/mg creatinine
ß-Hydroxybutyrate is a metabolic marker of blood sugar utilization and insulin function.
Beta-hydroxybutyrate is 1 of 3 sources of ketone bodies. Its relative proportion in the blood (78%) is greater than the other 2 ketone bodies, acetoacetate (20%) and acetone (2%). During carbohydrate deprivation (starvation, digestive disturbances, frequent vomiting), decreased carbohydrate utilization (diabetes mellitus), glycogen storage diseases, and alkalosis, acetoacetate production increases.
Optimal range: 0 - 8.86 ug/mg creatinine
Beta-Hydroxyisovalerate is a sensitive indicator of biotin deficiency and is a metabolite of the amino acid isoleucine.
Until recently, biotin deficiency was very difficult to determine in humans because this vitamin deficiency affects health in ways that mimic many other conditions. Doctors were likely to overlook biotin deficiency until this test was discovered.
Optimal range: 0 - 40.54 ug/mg creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Citrate, cis-Aconitate (and Isocitrate) are involved in both energy production and removal of toxic ammonia.
High levels can indicate ammonia toxicity. Chronic loss of these valuable compounds can contribute to loss of organ reserve and disturbances in neurological function. If they are low they can indicate a need for essential amino acids, especially arginine.
Nutrient association: Arginine, Iron
Optimal range: 71.3 - 772.63 ug/mg creatinine
Citrate holds significant importance in metabolic assessments and clinical evaluations. This molecule plays a central role in energy metabolism as it is an essential component of the Citric Acid Cycle (CAC), also known as the Krebs cycle, which is a crucial process in cellular respiration. Citrate serves as the starting point in the CAC, where it undergoes a series of enzymatic reactions to generate ATP, the cell's primary energy currency.
Optimal range: 0 - 3.88 ug/mg creatinine
Ethylmalonate, together with Adipate and Suberate, gives information about your ability to process fatty acids.
Ethylmalonate, which comes from the breakdown of butyrate, has a carnitine-dependent pathway and can accumulate with an insufficient amount of carnitine. Dietary fat, carbohydrate, and protein are all broken down to produce energy using pathways that require vitamin B2 (riboflavin).
Optimal range: 0 - 1.13 ug/mg creatinine
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle. This cycle critically supports organ maintenance and neurological function. Fumarate is also a product of the urea cycle. Much like vitamin D, fumaric acid is formed by the body, in the skin, during exposure to sunlight.
Optimal range: 17.13 - 768.53 ug/mg creatinine
Microbes resident in the large intestine of the human body help to break down complex aromatic compounds in dietary plant matter (polyphenols), freeing up benzoic acid, which enters the bloodstream. The liver can add the amino acid glycine to benzoic acid to form hippuric acid, which re-enters the blood and is absorbed by the kidneys. As a result, the kidneys excrete hundreds of milligrams of hippuric acid into the urine every day.
Optimal range: 0 - 6.66 ug/mg creatinine
Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.
Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Optimal range: 0 - 7.2 ug/mg creatinine
Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production, and when it is elevated it may indicate that the body is trying to increase its production of CoQ10.
Optimal range: 19.94 - 74.88 ug/mg creatinine
Citric acid, cis-aconitic acid, and isocitric acid are the first three metabolites in the Krebs Citric Acid energy production cycle, which operates in the mitochondria of your cells.
Citrate, cis-Aconitate (and Isocitrate) are involved in both energy production and removal of toxic ammonia.
High levels can indicate ammonia toxicity. Chronic loss of these valuable compounds can contribute to loss of organ reserve and disturbances in neurological function. If they are low they can indicate a need for essential amino acids, especially arginine.
Optimal range: 0 - 2.49 ug/mg creatinine
Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.
Optimal range: 0 - 23.35 ug/mg creatinine
Lactate serves as a valuable metabolic marker that provides insights into various physiological processes within the body. Elevated levels of lactate can signify multiple underlying factors, including impaired mitochondrial function, nutrient deficiencies, or metabolic disorders. Monitoring lactate levels on the panel aids healthcare practitioners in assessing energy metabolism, identifying potential issues with oxygen delivery and utilization, and recognizing conditions like lactic acidosis.
Optimal range: 0 - 2.62 ug/mg creatinine
Malate is involved in the citric acid cycle (aka. Krebs cycle). The citric acid cycle is a series of reactions that occur in the mitochondrion to generate chemical energy that fuels the metabolism.
Optimal range: 0 - 0.34 ug/mg creatinine
Mandelate is a Styrene metabolite.
Sources of exposure:
- Raw materials (benzene and ethylene) for the manufacture of styrene are supplied primarily from the petroleum industry.
- Used in the manufacture of synthetic rubbers, synthetic latex, polyesters, and plastic products.
- Automotive emissions, tobacco smoke, released from building materials, carpet backing. Low-level exposure may occure through ingestion of food products packaged in polystyrene containers.
- Packaging materials, toys, hobbies, crafts, house wares and appliances, electrical and thermal insulation, fiberglass, pipes, automobile parts, foam cups.
- Emissions from styrene production and disposal procedures - chemical spills, landfill sites and industrial discharges.
- Occupational Exposure: industries and operations concerned with the fabrication and application of plastics - styrene/polystyrene manufacturing plants, resin manufacturers, synthetic rubber plants, boats and automobile plants, laminators.
Optimal range: 0 - 0.61 ug/mg creatinine
Mandelate + Phenylglyoxylate are Styrene metabolites.
Sources of exposure:
- Raw materials (benzene and ethylene) for the manufacture of styrene are supplied primarily from the petroleum industry.
- Used in the manufacture of synthetic rubbers, synthetic latex, polyesters, and plastic products.
- Automotive emissions, tobacco smoke, released from building materials, carpet backing. Low-level exposure may occure through ingestion of food products packaged in polystyrene containers.
- Packaging materials, toys, hobbies, crafts, house wares and appliances, electrical and thermal insulation, fiberglass, pipes, automobile parts, foam cups.
Optimal range: 0 - 1.64 ug/mg creatinine
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production. In one step of metabolism, vitamin B12 promotes the conversion of methylmalonyl CoA (a form of MMA) to succinyl Coenzyme A. If there is not enough B12 available, then the MMA concentration begins to rise, resulting in an increase of MMA in the blood and urine. The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.
Optimal range: 0 - 2.2 ug/mg creatinine
Methylsuccinate is a metabolite in the body's biochemical pathways and is primarily associated with the catabolism of certain amino acids, including methionine and threonine. Elevated levels of methylsuccinate can be indicative of metabolic disturbances related to amino acid metabolism. High methylsuccinate levels may stem from various factors, including enzyme deficiencies or genetic mutations in the pathways involved in methionine and threonine metabolism. Such elevations could be associated with conditions like methylmalonic acidemia, which is a group of rare genetic disorders affecting organic acid metabolism.
Optimal range: 0 - 0.1 ug/mg creatinine
MEOHP is a metabolite of mono(2-ethylhexyl) phthalate (MEHP), which belongs to the most common environmental toxin phthalates.
Phthalates, often known as plasticizers, are a group of chemicals used to make plastics more flexible and harder to break. They are widely used in cosmetics, adhesives, detergents, lubricating oils, automotive plastics, and plastic clothes. People are exposed to phthalates by eating or drinking contaminated foods but also by breathing in air that contains phthalate vapors or dusts.
Optimal range: 0 - 1.04 ug/mg creatinine
Orotate is a sensitive marker of your liver’s capacity to convert toxic ammonia to non-toxic urea that you can excrete. That capacity can be increased by additional arginine. Ammonia toxicity can also be reduced by supplementation with α-ketoglutarate, magnesium, aspartic acid, and glutamic acid. Ammonia impairs brain function, causing difficulty with thinking, fatigue, headaches, and increased food sensitivities.
Optimal range: 0 - 1.43 ug/mg creatinine
The presence of organic compounds such as p-Hydroxybenzoate in the urine may point towards significant dysbiosis (=impaired microbiota). p-Hydroxybenzoat may reflect intestsinal overgrowth, usually accomanied by microbal hyperpermeability.
Optimal range: 0 - 26.39 ug/mg creatinine
Para-hydroxyphenylacetate, often referred to as P-Hydroxyphenylacetate or PARA, is a metabolite that plays a crucial role in the US BioTek Organic Acids panel, a diagnostic tool used in functional medicine and clinical assessments. PARA is a key intermediate in the degradation pathway of the amino acid tyrosine and is produced during the breakdown of tyrosine in the body. Elevated levels of PARA on the panel can provide valuable insights into various metabolic and enzymatic processes. An abnormal PARA level can be indicative of issues related to tyrosine metabolism, such as deficiencies in enzymes like phenylalanine hydroxylase or tyrosine aminotransferase. It can also suggest disruptions in gut microbiota, as some bacteria produce PARA as a metabolic byproduct.
Optimal range: 0 - 1.55 ug/mg creatinine
p-hydroxyphenyllactate is a marker of cell turnover. It is also a metabolite in tyrosine degradation and may be useful for studying disorders of tyrosine metabolism.
Optimal range: 0 - 0.3 ug/mg creatinine
Phenylglyoxylate is a Styrene metabolite.
Sources of exposure:
- Raw materials (benzene and ethylene) for the manufacture of styrene are supplied primarily from the petroleum industry.
- Used in the manufacture of synthetic rubbers, synthetic latex, polyesters, and plastic products.
- Automotive emissions, tobacco smoke, released from building materials, carpet backing. Low-level exposure may occure through ingestion of food products packaged in polystyrene containers.
- Packaging materials, toys, hobbies, crafts, house wares and appliances, electrical and thermal insulation, fiberglass, pipes, automobile parts, foam cups.
Optimal range: 0 - 0.17 ug/mg creatinine
Phthalates, often known as plasticizers, are a group of chemicals used to make plastics more flexible and harder to break. They are widely used in cosmetics, adhesives, detergents, lubricating oils, automotive plastics, and plastic clothes. People are exposed to phthalates by eating or drinking contaminated foods but also by breathing in air that contains phthalate vapors or dusts.
Optimal range: 14.58 - 37.47 ug/mg creatinine
Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.
Pyroglutamate is a step in the production/recycling of glutathione. Glutathione is one of the most potent anti-oxidants in the human body. It is especially important in getting rid of toxins, including the harmful metabolites of estrogen detoxification 4-OH-E1 and 4-OH-E2.
In healthy individuals, a very modest amount of Pyroglutamate is spilled in the urine.
Optimal range: 0 - 1.9 ug/mg creatinine
Pyruvate is a key player in energy metabolism, serving as a critical intermediate in the glycolytic pathway, where glucose is converted into pyruvate, and subsequently, pyruvate plays a central role in the Citric Acid Cycle (CAC), also known as the Krebs cycle. Elevated pyruvate levels on the panel can indicate a range of metabolic challenges and disruptions. High pyruvate levels may arise due to factors such as nutritional inhibitions affecting enzymes involved in pyruvate breakdown, the presence of low-activity enzyme variants inherited genetically, an abundance of precursor molecules like glucose and amino acids, or elevated levels of downstream products like lactate and citrate.
Optimal range: 0 - 5.37 ug/mg creatinine
Quinolinic acid is a neurotoxic substance produced by our own bodies and a metabolite of tryptophan.
Tryptophan and its different pathways:
The management of tryptophan converting to serotonin within the brain has some complex moving parts. Tryptophan gets converted into serotonin. High levels of stress of any type and acute/chronic infections can change this process by provoking an immune system response. Instead of serotonin being made from tryptophan in this process, two other compounds are eventually made: They are kynurenic acid which is neuroprotective and quinolinic acid which is neurodegenerative.The quinolinic acid is a NMDA-agonist, i.e. quinolinic acid, NMDA, and inflammation are best friends and like to wreak havoc when kynurenic acid is lacking. Recent research showed that patients suffering from severe depression and suicidality were found to have very high levels of inflammation and elevated NMDA activity as a result of long-term dysregulation of this pathway. The researchers’ recommended goal was to find ways to dampen the NMDA receptors and quinolinic acid in the brain.
Optimal range: 0 - 2.64 ug/mg creatinine
Suberate, Adipate, and Ethylmalonate elevations can indicate that you may need additional carnitine and/or vitamin B2 to assist your cells in converting fats into energy efficiently.
Optimal range: 0 - 20.99 ug/mg creatinine
Succinate (or succinic acid) is an important metabolite that is involved in several chemical processes in the body. Succinic acid is a key intermediate of both the Kreb’s cycle and the electron transport chain that generates adenosine triphosphate (ATP), the currency for most of the body’s energy transactions.
Succinate is produced from bacterial degradation of unabsorbed glutamine and is a metabolite of alpha-ketogluturate, as well as methionine, valine & leucine; precursor of fumaric acid; also formed from bacterial action on glutamine.
Optimal range: 0 - 0.15 ug/mg creatinine
t,t-Muconic Acid (Trans, trans-muconic acid) is a Benzene Metabolite.
Sources of Exposure:
Natural component of crude and refined petroleum. Automotive emissions, poor emission-control devices on older vehicles, poor maintenance practices, automotive-refueling operations and industrial emissions. Discharge of industrial wastewater from chemical plants, chemical manufacturing sites, and petrochemical and petroleum industries.
Seepage from underground petroleum storage tanks, waste streams. By-product of various combustion processes - wood burning, organic wastes, tobacco smoke. First and second-hand smoke accounts for the largest source of benzene expsorue of the general public. The amount of benzene in a single cigarette may vary from 5.9-90 micrograms.
Optimal range: 0 - 1.06 ug/mg creatinine
Tricarballylate (tricarb) is derived from dietary carbohydrates. It binds magnesium very tightly and prevents absorption, leading to magnesium deficiency.
Tricarballylate (tricarb) is produced by a strain of aerobic bacteria that quickly repopulates in the gut. As its name implies, tricarb contains three carboxylic acid groups.
This organic acid binds very tightly to magnesium, possibly zinc and calcium and may induce a deficiency in these important minerals. The bacterium that produces this element is also very fast growing and may cause numerous vitamin and mineral deficiencies. As it may interfere with carbohydrate absorption, a diet low in carbohydrates is suggested.
Optimal range: 0 - 3.64 ug/mg creatinine
Vanilmandelate is a noradrenalin metabolite.
Nutrient association: Essential amino acids
Vanilmandelate (VMA) and Homovanillate (HVA) are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.
Treatments to improve digestion, along with supplementation of tyrosine or phenylalanine, can help improve the ability to keep up with demand for these neurotransmitters.
Methionine Metabolism Profile (NutriPATH)
Methylation is a process where certain nutrients called ‘methyl donors’ are added to specific elements of DNA, our gene markers and proteins that keep them physiologically active. Methylation is a major pathway to focus on in understanding autoimmune and neurological diseases such as multiple sclerosis, seizure disorders, dementia, chronic fatigue syndrome, lupus, depression, anxiety and autism spectrum disorders. Methylation is responsible for making, maintaining and repairing DNA.
The methylation cycle is a biochemical pathway that manages or contributes to a wide range of biochemical functions: detoxification, supporting DNA (turning genes on and off), producing energy, reducing inflammation, synthesising neurotransmitters, homocysteine metabolism, protein methylation, phase 2 liver detoxification and supporting immune function. Inadequate methylation capacity can lead to birth defects, depression, cognitive decline, and cancer. Impaired methylation has even been associated with autism. Support of methylation markers has been associated with rapid return of speech, improvement of behaviour in ADD and ADHD spectrums.
Methionine is an amino acid necessary for utilisation of methyl groups from the folate cycle and balance homocysteine levels. Methionine synthase (MTR) requires vitamin B12 and an enzyme, methionine synthase reductase, which is produced from the MTRR gene. Homocysteine, a sulphur-containing amino acid, is a metabolite of the essential amino acid methionine, and exists at a critical biochemical intersection in the methionine cycle between (Sadenosylmethionine), the indispensable ubiquitous methyl donor, and vitamins B12 and folic acid. High blood levels of homocysteine signal a breakdown in this vital process, resulting in far-reaching biochemical consequences. The Methylation Cycle is a biochemical pathway that manages or contributes to a wide range of biochemical functions: detoxification, supporting DNA (turning genes on and off), producing energy, reducing inflammation, synthesising neurotransmitters, homocysteine metabolism, protein methylation, phase 2 liver detoxification and supporting immune function. Inadequate methylation capacity can lead to birth defects, depression, cognitive decline, and cancer. Impaired methylation has even been associated with autism. Support of methylation markers has been associated with rapid return of speech, improvement of behaviour in ADD and ADHD spectrums.
Conditions associated with impaired methionine and methylation defects:
Allergies, Diabetes, Autism, High folate supplementation, Cancer, Infertility, Pre-conception care, Chronic Fatigue Syndrome, Mental health disorders, Cognitive decline, Estrogen dominance, Cardiovascular disease, Schizophrenia.
Significant markers of methionine metabolism assessment:
SAMe (S-adenosylmethionine) - a synthetic form of a compound formed naturally in the body from the essential amino acid methionine and adenosine triphosphate (ATP), the energyproducing compound found in all cells in the body.
SAH (S-adenosyl Homocysteine) - amino acid derivative and modulator of the activated methyl cycle and cysteine biosynthesis and product of SAMe-dependant methylation of biological molecules, including DNA, RNA, histones and other proteins.
Vitamin B12 - essential for recycling homocysteine and the formation of methyl donors involved in cardiovascular function, sleep, blood cell formation, and nerve function.
Folate - a substrate and vitamin B12 is a coenzyme for the formation of MTHF that depends on the regeneration of THF, the parent compound in the homocysteine-to-methionine conversion.
Homocysteine - an amino acid associated with atherosclerosis that can become elevated when there is need for folate, vitamin B6 and/or vitamin B12.
Methionine - an amino acid necessary for utilisation of methyl-groups from the folate cycle and balance homocysteine levels.
Optimal range: 37.5 - 188 pmol/L
Activated Vitamin B12, also known as holotranscobalamin (holo-TC), is a significant biomarker for Vitamin B12 status in the body. Unlike total B12, which measures both active and inactive forms, holo-TC specifically indicates the amount of Vitamin B12 that is available for cellular uptake and use. This makes it a more precise marker for assessing B12 deficiency, especially in clinical situations where accurate diagnosis is crucial.
Optimal range: 0 - 0 umol/L
Optimal range: 0 - 0 umol/L
Optimal range: 10 - 22 nmol/L
S-Adenosyl Homocysteine, often referred to as SAH, is a metabolite that plays a crucial role in various biochemical processes within the human body. SAH is a key intermediate in the methylation cycle, which is essential for the methylation of DNA, RNA, proteins, and other molecules. Methylation is a fundamental cellular process that regulates gene expression, supports the synthesis of neurotransmitters, and influences various biochemical reactions. SAH is formed when S-Adenosyl Methionine (SAMe), a methyl donor, transfers its methyl group to various substrates.
Optimal range: 86 - 145 nmol/L
S-Adenosyl Methionine, commonly known as SAMe, is a naturally occurring compound found in the human body and also available as a dietary supplement. SAMe plays a fundamental role in numerous biochemical reactions, particularly in the methylation process, where it donates methyl groups to various substrates, thereby participating in essential cellular processes. SAMe is considered a critical methyl donor in biological methylation reactions, which are involved in the synthesis of neurotransmitters, DNA, RNA, and the regulation of gene expression.
Optimal range: 4 - 20 Ratio
The SAM/SAH ratio is commonly referred to as the “Methylation Index” in the literature and has well- documented clinical associations.
Global methylation is dependent on two key factors: adequate SAM supply and SAH removal.
The SAM/SAH ratio has been proposed to indicate the likelihood of hyper- or hypo-methylation.
Overall, the SAM/SAH ratio is under tight homeostatic control. SAM levels remain fairly stable due to denovo synthesis and feedback mechanisms. Given this, alterations in the methylation index are more likely a result of SAH fluctuations.
Optimal range: 0 - 0 nmol/L
Folate Metabolism Profile (NutriPATH)
Folate is a water soluble B vitamin (B9), which humans cannot synthesise and is thus a dietary requirement. The primary function of folate is the transfer of methyl and formyl groups. It is essential for cell growth and reproduction, the formation of certain amino acids (methionine, serine, glycine and histidine), the breakdown of proteins (e.g. homocysteine), the formation of DNA and RNA, red blood cell maturation and serotonin, noradrenaline (norepinephrine) and dopamine formation.
Active and Inactive Forms of Folate Dihydrofolate (DHF) is the dietary form of folate, whilst folic acid is the synthetic form of folate used in supplements and to fortify the food supply. These forms of folate are not biologically active; they must undergo enzymatic transformation to L-methylfolate in order to be used by cells.
L-methylfolate, unlike the other folates, is able to cross the blood-brain barrier for use in the CNS. The conversion of dihydrofolate (DHF) and folic acid to L-methylfolate occurs through a three or four step process:
• Folic acid is converted to DHF by the dihydrofolate reductase enzyme (DHFR)
• DHF is then converted to tetrahydrofolate (THF)
• THF is converted to 5,10-methyleneTHF
• 5,10-methyleneTHF is converted to L-methylfolate by the methyltetrahydrofolate reductase enzyme (MTHFR).
L-MethylFolate Deficiencies:
For many people, their DHF from the diet leads to adequate L-methylfolate levels, however, malabsorption, digestive and liver disease, as well as certain genetic enzyme polymorphisms, can result in an impaired ability to activate folic acid. This L-methylfolate deficiency results in symptoms and conditions including mental health disorders, cardiovascular disease, increased adiposity, reduced lean body mass, birth defects and an increased risk for certain cancers.
Folate metabolism is required for optimal methylation. Methylation is a major pathway to focus on in understanding autoimmune and neurological diseases such as multiple sclerosis, seizure disorders, dementia, chronic fatigue syndrome, lupus, depression, anxiety and autism spectrum disorders.
Methylation is responsible for making, maintaining and repairing DNA. The Methylation Cycle is a biochemical pathway that manages or contributes to a wide range of biochemical functions: detoxification, supporting DNA (turning genes on and off), producing energy, reducing inflammation, synthesising neurotransmitters, homocysteine metabolism, protein methylation, phase 2 liver detoxification and supporting immune function. Inadequate methylation capacity can lead to birth defects, depression, cognitive decline and cancer.
Impaired methylation has even been associated with autism. Support of methylation markers has been associated with rapid return of speech, improvement of behaviour in ADD and ADHD spectrums.
Conditions associated with impaired folate and methylation defects:
Allergies, Diabetes, Autism, High folate supplementation, Cancer, Infertility, Pre-conception care, Chronic Fatigue Syndrome, Mental health disorders, Cognitive decline, Estrogen dominance, Cardiovascular disease, Schizophrenia.
Analytes:
Optimal range: 6.6 - 39.9 nmol/L
Folates function as cofactors in the transfer and utilization of one carbon groups. These reactions are essential for the production of purines and pyrimidines for DNA synthesis. Folates also play a major role in the regeneration of methionine from homocysteine. In pregnancy, poor body stores of folates may lead to neural tube defects, such as spina bifida.
Optimal range: 9 - 35.5 nmol/L
Folinic Acid (5-formyl THF), is an active and reduced form of folate. In the body, folinic acid may be converted into any of the other active forms of folate. Supplying the body with folinic acid bypasses many of the required metabolic steps, and it is rapidly converted to 5MTHF.
Optimal range: 0.6 - 6.8 nmol/L
Tetrahydrofolate is the basic, reduced form of folate from which other forms of reduced folate are made.
Active and Inactive Forms of Folate:
Dihydrofolate (DHF) is the dietary form of folate, whilst folic acid is the synthetic form of folate used in supplements and to fortify the food supply. These forms of folate are not biologically active; they must undergo enzymatic transformation to L-methylfolate in order to be used by cells. L-methylfolate, unlike the other folates, is able to cross the blood-brain barrier for use in the CNS. The conversion of dihydrofolate (DHF) and folic acid to L-methylfolate occurs through a three or four step process:
1. Folic acid is converted to DHF by the dihydrofolate reductase enzyme (DHFR)
2. DHF is then converted to tetrahydrofolate (THF)
3. THF is converted to 5,10-methyleneTHF
4. 5,10-methyleneTHF is converted to L-methylfolate by the methyltetrahydrofolate reductase enzyme (MTHFR).
Sputum Culture, Bacterial
A sputum culture test is a laboratory analysis used to detect and identify bacteria or fungi that may be causing a respiratory tract infection. The test involves collecting a sample of sputum (mucus coughed up from the respiratory tract) and cultivating it in a lab to see what types of microorganisms grow. This helps in diagnosing infections like pneumonia, bronchitis, or tuberculosis. The results guide healthcare providers in choosing the most effective treatment, particularly in selecting the right antibiotics if a bacterial infection is identified. The test is essential for accurate diagnosis and effective treatment of respiratory infections.
Reference range: Few, Moderate, Many
The term "Mixed Respiratory Flora" on a sputum test refers to the presence of a diverse range of microorganisms that are normally found in the upper respiratory tract. This includes a variety of bacteria, both harmless (commensal) and potentially pathogenic. In a healthy individual, these organisms exist in balance and are not typically a cause for concern. However, in certain circumstances, such as a weakened immune system or other underlying conditions, some of these organisms can become opportunistic and lead to infections.
Reference range: Few (1-9/LPF), Moderate (10-24/LPF), Many (>25/LPF)
Polymorphonuclear leukocytes (PMNs), commonly known as neutrophils, are a critical component of the body's immune response, especially in fighting bacterial infections. When a sputum culture test reveals a significant presence of PMNs ("Many Polys"), it typically indicates an active respiratory infection. These cells are quickly mobilized to infection sites, where they engulf and destroy pathogens. Their presence in a sputum sample helps clinicians determine the nature of a respiratory problem. High levels of PMNs can suggest a bacterial infection, prompting further investigation and possibly the prescription of antibiotics. However, the interpretation of these results should always be done alongside clinical assessments and other diagnostic tests to ensure accurate diagnosis and appropriate treatment.
Urine Microalbumin
The Urine Microalbumin test panel is a critical diagnostic tool used primarily for early detection of kidney damage, particularly in patients with diabetes, hypertension, or other risk factors for chronic kidney disease. This panel typically includes the measurement of microalbumin, a small protein that should be minimally present in urine, and creatinine, a waste product from muscle metabolism. The key parameter often assessed is the Microalbumin/Creatinine Ratio (ACR), which provides a more accurate indication of kidney function by normalizing the amount of albumin to the creatinine level. This adjustment is essential as it accounts for variations in urine concentration, offering a reliable assessment of albumin excretion. Elevated levels of microalbumin in the urine, or an increased ACR, are early indicators of kidney dysfunction, signaling that the kidneys' filtering system is allowing albumin to leak into the urine. This test panel is an essential aspect of managing patients with conditions that affect kidney health, enabling early detection of kidney damage. Regular monitoring with the Urine Microalbumin test can lead to timely intervention, potentially slowing the progression of kidney disease and improving patient outcomes. Additionally, this test is useful for assessing cardiovascular risk, as microalbuminuria has been linked to an increased risk of heart disease and stroke in both diabetic and non-diabetic populations.
Optimal range: 47 - 110 mg/dL
Optimal range: 0.51 - 29 mg/dL
The Microalbumin urine test, often abbreviated as "Microalb, Ur," is a crucial diagnostic tool used to detect early signs of kidney damage, particularly in individuals at risk for kidney disease, such as those with diabetes or hypertension. This test measures the level of albumin, a type of protein, in the urine. Normally, albumin is present in low levels in the urine, as healthy kidneys filter it out of the bloodstream and reabsorb it. However, when the kidneys are damaged, they become less efficient at filtration, leading to an increased leakage of albumin into the urine, a condition known as microalbuminuria.
Optimal range: 1 - 30 mg/g
The Microalbumin/Creatinine Ratio (ACR) is a critical diagnostic marker used primarily for evaluating kidney function, particularly in individuals at risk for kidney disease, such as those with diabetes or hypertension. This ratio is calculated by measuring the amount of albumin (a type of protein) and creatinine (a waste product) in a urine sample. Albumin is typically present in the blood and should be filtered and retained by healthy kidneys; however, when the kidneys are damaged, small amounts of albumin can leak into the urine, a condition known as microalbuminuria. Creatinine, produced at a relatively constant rate by muscle metabolism and excreted in the urine, serves as a benchmark for normalizing the amount of albumin excretion.
ImmunoCAP Specific IgE Blood Test (Allergy Testing by Quest Diagnostics)
The ImmunoCAP Specific IgE blood test, offered by Quest Diagnostics, is a highly specialized diagnostic tool used to detect specific IgE antibodies in the blood, which are associated with allergic reactions. This test is pivotal in the accurate identification of allergies to substances such as foods, pollens, molds, animal dander, and insect stings. Utilizing cutting-edge technology, the ImmunoCAP® system is renowned for its precision and sensitivity, making it a preferred choice among healthcare professionals for allergy testing. By measuring the concentration of specific IgE antibodies, the test provides valuable information that can assist in the diagnosis and management of allergic conditions, leading to personalized treatment plans and improved patient care. This detailed approach to allergy testing is integral in understanding individual allergic responses and in devising strategies for effective management and mitigation of allergy symptoms.
Reference range: 0 (<0.10 kU/L), 0/1 (0.10-0.34 kU/L), 1 (0.35-0.69 kU/L), 2 (0.70-3.49 kU/L), 3 (3.50-17.4 kU/L), 4 (17.5-49.9 kU/L), 5 (50-100 kU/L), 6 (>100 kU/L)
The allergen-specific IgE antibody test is a key diagnostic method for identifying gluten allergies, measuring an individual's IgE response to gluten. It is used alongside clinical evaluations for a comprehensive allergy diagnosis. While sensitive, this test indicates only IgE sensitization, not necessarily an allergy, as many sensitized individuals don't exhibit symptoms. Wheat, containing gluten, is a common allergen with varied symptoms and affects a small percentage of the global population. Management of wheat allergy primarily involves dietary avoidance and, in some cases, oral immunotherapy, with epinephrine auto-injectors prescribed for severe reactions. The prevalence and severity of wheat allergy vary globally, often associated with other atopic disorders in children.
Glucose Tolerance Test
A glucose tolerance test (GTT) is an important diagnostic tool used to assess how well your body processes sugar (glucose), playing a crucial role in diagnosing diabetes and other related health conditions. This test involves measuring your body’s response to sugar. Initially, a fasting blood sugar level is taken after you’ve fasted overnight. Then, you’re given a sweet liquid containing a specific amount of glucose, and subsequent blood sugar tests are conducted at intervals to track how your body deals with the sugar influx. The results of a GTT can reveal different conditions: if your blood sugar levels rise and then quickly return to normal, you likely have a healthy glucose metabolism. However, if your blood sugar levels rise higher than normal and take a longer time to come back down, it may indicate a pre-diabetic condition or gestational diabetes (in pregnant women). GTT is especially important for monitoring pregnant women's health, as gestational diabetes can pose risks to both the mother and baby. It's a simple yet effective test that provides invaluable insights into your body's metabolic health, guiding both diagnosis and treatment strategies for conditions related to impaired glucose handling.
Interpreting the results of a glucose tolerance test (GTT) requires an understanding of the blood sugar level benchmarks. Typically, blood sugar levels are measured at fasting, and then at intervals of 30 minutes, 1 hour, 2 hours, and sometimes 3 hours after consuming the glucose drink. Normal fasting blood sugar levels should be less than 100 mg/dL. If your fasting level is between 100 to 125 mg/dL, it indicates a pre-diabetic condition, known as impaired fasting glucose. A fasting level of 126 mg/dL or higher on two separate tests suggests diabetes. Post-glucose consumption, a normal blood sugar level should return to less than 140 mg/dL within 2 hours. Levels between 140 and 199 mg/dL after 2 hours indicate pre-diabetes, known as impaired glucose tolerance. A level of 200 mg/dL or higher at the 2-hour point suggests diabetes. It's important to note that these ranges can vary slightly depending on the lab and the specific test used. Therefore, it's crucial to discuss the results with a healthcare provider, who can interpret them in the context of your overall health and medical history.
Optimal range: 70 - 140 mg/dL
The 2-hour blood sugar level in a glucose tolerance test (GTT) is a critical marker for assessing glucose metabolism and diagnosing conditions like diabetes and pre-diabetes. This test is a cornerstone in diabetes management and is especially vital during pregnancy to screen for gestational diabetes. After fasting overnight, your initial blood sugar level is measured. Then, you consume a glucose-rich drink, and your blood sugar levels are tested again at various intervals, with the 2-hour mark being particularly significant. Under normal circumstances, the body efficiently processes the glucose, and blood sugar levels should fall back to less than 140 mg/dL within 2 hours.
If the 2-hour blood sugar level in a glucose tolerance test (GTT) is significantly low, it may indicate a condition called reactive hypoglycemia. This condition occurs when your blood sugar drops excessively after eating. Normally, the body regulates blood glucose levels efficiently, but in reactive hypoglycemia, this regulation is disrupted, leading to a rapid decline in blood sugar levels after carbohydrate intake.
Optimal range: 65 - 99 mg/dL
The fasting specimen in a Glucose Tolerance Test (GTT) is a critical component in diagnosing and managing diabetes and other glucose-related disorders. This initial blood sample is taken after an individual has fasted for at least 8 to 12 hours, ensuring that food intake does not influence the blood glucose levels. The accuracy and reliability of the fasting specimen are essential for the GTT, as it establishes a baseline glucose level against which subsequent readings (taken after the intake of a glucose-rich drink) are compared. A normal fasting blood glucose level typically falls below 100 mg/dL. Levels between 100 to 125 mg/dL indicate a pre-diabetic condition, known as impaired fasting glucose, while a level of 126 mg/dL or higher can suggest diabetes, warranting further tests for confirmation.
Gut Barrier Panel
KBMO has created a unique Gut Barrier Panel which in recognition that leaky gut occurs across a spectrum we have included the following gatekeeper markers: Candida, Zonulin and Occludin and LPS. For each marker, we measure IgG 1-4 /C3d in addition to IgA 1 and 2.
Reference range: Negative, Positive
The Occludin IgG1-4+C3d test on a gut barrier panel detects immune responses against occludin, a key protein in gut lining integrity. Positive results indicate autoimmune reactions, potentially leading to "leaky gut" and related gastrointestinal issues. A negative result suggests a healthy gut barrier. This test is vital for assessing and managing gut health conditions.
Reference range: Negative, Positive
Zonulin is a marker of intestinal permeability, otherwise known as leaky gut. If a person has elevated Zonulin levels, the normal regulation of the tight junctions is compromised.
Zonulin is a protein that is synthesized in intestinal cells and liver cells. It is a key biomarker for intestinal permeability and is the only regulator of intestinal permeability that is reversible.
What is intestinal permeability?
Intestinal permeability, often referred to as "leaky gut," is a condition where the lining of the small intestine becomes damaged, causing undigested food particles, toxins, and bacteria to leak through the intestinal wall into the bloodstream. Normally, the gut lining acts as a barrier, selectively allowing nutrients to pass through while keeping harmful substances out. When this barrier is compromised, it can lead to inflammation and trigger immune responses, potentially contributing to various health issues such as food sensitivities, digestive problems, and even autoimmune diseases.
Kappa/Lambda Light Chain, Free w/Ratio,Rand Urine
The Kappa/Lambda Light Chain, Free w/Ratio, Random Urine panel from Quest Diagnostics is a crucial diagnostic test for detecting and monitoring multiple myeloma and other disorders related to abnormal or excessive production of immunoglobulin light chains. This test measures the levels of kappa and lambda free light chains, along with their ratio, in urine. The precise quantification of these light chains and their ratio is essential for diagnosing conditions like light chain multiple myeloma or primary systemic amyloidosis. Quest Diagnostics, renowned for their advanced diagnostic technology and accuracy, ensures reliable results for this test, making it an invaluable tool for healthcare professionals in the early detection and management of these complex conditions. This test is also instrumental in monitoring the effectiveness of treatment regimens for patients with plasma cell dyscrasias, contributing significantly to patient care and outcomes.
Optimal range: 5.71 - 26.3 mg/L
Light chains are proteins produced by immune cells called plasma cells. Also called “Free Lambda Light Chains” they link together with other proteins (heavy chains) to form immunoglobulins (= antibodies) that target and neutralize specific threats to the body (= bacteria & viruses).
Optimal range: 170 - 370 mg/dL
Kappa is a type of immunoglobulin light chain measured on the Immunofixation, Serum (NMH/LFH) panel to help identify abnormal monoclonal protein production, often associated with plasma cell or B-cell disorders. In healthy individuals, kappa and lambda light chains are produced in a balanced ratio, but an excess of kappa may indicate a monoclonal gammopathy such as multiple myeloma, MGUS (monoclonal gammopathy of undetermined significance), or related conditions. Immunofixation helps pinpoint the presence and type of monoclonal antibody by detecting kappa or lambda light chains linked to specific heavy chains like IgG, IgA, or IgM. An abnormal kappa result—especially if it appears as a monoclonal band or significantly alters the kappa/lambda ratio—can suggest a clonal proliferation of plasma cells. This marker is commonly used alongside other tests like serum free light chain assays, protein electrophoresis, and bone marrow evaluation to confirm diagnosis and guide management of monoclonal plasma cell disorders.
Optimal range: 0 - 32.9 mg/L
The Kappa Light Chain, Free, Urine test is a highly specialized diagnostic tool used extensively in the field of medical diagnostics to detect and monitor a range of hematological disorders, particularly multiple myeloma and other plasma cell dyscrasias. This test specifically measures the level of free kappa light chains present in the urine, which are small protein fragments produced by plasma cells, a type of white blood cell. Elevated levels of kappa light chains in urine can be an indicator of multiple myeloma, a cancer of plasma cells, or other related disorders. The test is crucial in both the initial diagnostic process and the ongoing monitoring of these conditions, playing a vital role in the early detection and effective management of diseases characterized by abnormal plasma cell growth.
Optimal range: 1.4 - 2.7 Ratio
The Kappa/Lambda ratio measures the balance between free kappa and lambda light chains in the blood and helps detect abnormal plasma cell activity. A high ratio suggests excess kappa light chain production, while a low ratio indicates excess lambda—both can signal monoclonal gammopathies like multiple myeloma or MGUS. This ratio is a key marker used alongside other tests to diagnose and monitor plasma cell disorders.
Optimal range: 0 - 8.69 Ratio
The Kappa/Lambda Free Ratio (Urine) test is a sophisticated diagnostic assessment extensively utilized in the field of medical diagnostics, particularly in hematology and oncology. This test plays a pivotal role in the detection and management of multiple myeloma and other plasma cell disorders. It measures the ratio of kappa to lambda free light chains in urine. Free light chains are small protein segments produced by plasma cells in the bone marrow. In a healthy individual, kappa and lambda light chains are produced in a relatively balanced ratio. However, an imbalance in this ratio, as indicated by the Kappa/Lambda Free Ratio (Urine) test, can be a significant marker for various hematological conditions.
Optimal range: 90 - 210 mg/dL
The Lambda marker on a Serum Immunofixation (IFE) panel helps detect abnormal lambda light chain production by plasma cells, which may indicate disorders such as multiple myeloma, MGUS, or light chain amyloidosis. Normally, the immune system produces a balanced mix of kappa and lambda light chains, but a sharp monoclonal lambda band suggests a clonal plasma cell disorder. This test is used alongside kappa and heavy chain markers to identify and characterize monoclonal proteins (M-proteins) in the blood, guiding diagnosis and further evaluation of possible blood cancers or related conditions.
Optimal range: 0 - 3.79 mg/L
The Lambda Light Chain, Free, Urine test is a critical diagnostic tool, prominently used in the field of medical diagnostics to identify and monitor various hematologic disorders, with a particular focus on multiple myeloma and other conditions related to plasma cell dyscrasias. This test specifically measures the concentration of free lambda light chains in the urine. Lambda light chains are protein fragments produced by plasma cells, a type of white blood cell integral to the immune system. An abnormal increase in the levels of lambda light chains in urine can be a key indicator of multiple myeloma, a cancer of plasma cells, or other related disorders such as light chain amyloidosis, where abnormal proteins accumulate in tissues.
YO AB Screen w/Reflex to Titer and WB, Serum
The YO AB Screen with Reflex to Titer and Western Blot (WB), Serum, is a specialized diagnostic panel primarily used for detecting paraneoplastic neurological syndromes, particularly in the context of suspected ovarian or breast cancer. This test screens for anti-Yo antibodies, which are associated with paraneoplastic cerebellar degeneration (PCD), a condition where the immune system, in response to a cancer, mistakenly attacks the central nervous system. If the initial screening is positive, the test reflexively proceeds to a titer to quantify the antibody levels and a Western Blot for further confirmation. The presence and level of anti-Yo antibodies can assist in diagnosing PCD and may also indicate an underlying malignancy, often before the cancer is clinically detectable. This makes the test a valuable tool for early cancer detection and managing associated neurological complications. The YO AB Screen with Reflex to Titer and WB is crucial for providing comprehensive care in oncology and neurology, reflecting the importance of integrated diagnostics in early detection and intervention for cancer-related neurological disorders.
Reference range: Negative, Positive, Fluorescence noted
The YO Ab Screen, IFA (Immunofluorescence Assay), Serum test is a crucial diagnostic marker used primarily in neurology and oncology to detect paraneoplastic neurological syndromes, especially paraneoplastic cerebellar degeneration (PCD) associated with ovarian and breast cancers. This test identifies anti-Yo antibodies, indicative of an autoimmune response where the body's immune system mistakenly targets its own central nervous system tissues in reaction to cancer. The use of IFA, a highly sensitive technique, allows for the precise detection of these antibodies. A positive result can be an early indicator of an underlying malignancy, often before the cancer is clinically identifiable. This test is instrumental in guiding the diagnosis and management of PCD and aids in the early detection and treatment of associated cancers. The YO Ab Screen, IFA, Serum test exemplifies the intersection of neurology and oncology in modern diagnostics, emphasizing the significance of specialized testing in early cancer detection and the management of its neurological complications.
HU Antibody Screen w/Refl to Titer and WB
The Hu Antibody Screen with Reflex to Titer and Western Blot (WB) panel is a specialized diagnostic test crucial for detecting paraneoplastic neurological syndromes, particularly small cell lung cancer-related disorders. This test is designed to identify Hu antibodies, which are indicative of an immune response where the body's immune system mistakenly attacks its own nervous system in reaction to a cancer. If initial screening is positive, the test reflexively proceeds to a titer to quantify the antibody levels and a Western Blot for confirmation. The presence of Hu antibodies is often associated with encephalomyelitis and sensory neuronopathy, making this test a vital tool in early cancer detection and managing complex neurological conditions.
Reference range: Negative, Positive, Fluorescence noted
The Hu Ab Screen, IFA (Immunofluorescence Assay), Serum test is a pivotal diagnostic tool in neurology and oncology, primarily utilized for the detection of paraneoplastic neurological syndromes associated with cancers like small cell lung cancer. This test identifies Hu antibodies, markers of an autoimmune response where the immune system targets the nervous system, often in response to an underlying malignancy. The application of IFA, known for its sensitivity and specificity, ensures accurate detection of these antibodies. A positive result can be a critical early indicator of cancer, even before it is clinically evident, and aids in diagnosing associated neurological conditions such as encephalomyelitis and sensory neuronopathy.
Ehrlichia Chaffeensis (IgG, IgM)
The Ehrlichia Chaffeensis (IgG, IgM) panel is a critical diagnostic tool used for detecting Ehrlichiosis, a bacterial illness transmitted by ticks. This panel tests for both IgG and IgM antibodies against Ehrlichia chaffeensis, the bacterium responsible for the disease. The presence of IgM antibodies typically indicates a recent or acute infection, as these are the first antibodies to be produced in response to an infection. IgG antibodies, on the other hand, develop more slowly and can indicate a past infection or a more chronic stage of the disease. This dual testing approach allows for a comprehensive assessment of the infection's timeline, aiding in the accurate diagnosis and appropriate treatment planning. Ehrlichiosis can cause flu-like symptoms and, if left untreated, may lead to severe complications. Therefore, the Ehrlichia Chaffeensis (IgG, IgM) panel is essential for timely identification and management of the infection, particularly in areas where tick-borne diseases are prevalent. The test plays a significant role in enhancing patient care by facilitating early detection and intervention, underscoring the importance of accurate diagnostic tools in infectious disease management.
Reference range: <1:64, >1:64
The E. Chaffeensis Ab IgG test is a specialized diagnostic tool pivotal in the field of infectious diseases, particularly in the context of tick-borne illnesses. Ehrlichia chaffeensis is the bacterium responsible for Ehrlichiosis, a condition transmitted through tick bites, primarily in regions where ticks are endemic. The IgG antibody test for E. chaffeensis plays a crucial role in the diagnosis and management of this infection.
Reference range: <1:20, >1:20
The E. Chaffeensis Ab IgM test is a crucial diagnostic tool in the realm of infectious diseases, specifically for the timely detection of Ehrlichiosis, a tick-borne illness caused by the Ehrlichia chaffeensis bacterium. This test detects IgM antibodies, which are among the first antibodies produced by the immune system in response to an infection.
Gallbladder
Optimal range: 0 - 10 mm
The gallbladder is a small organ located under the liver that stores bile, a substance that helps to break down fats. Sometimes polyps (small growths, usually with a stalk) form along the mucosal surface of the gallbladder; it is unclear what causes this to happen. Gallbladder polyps can cause symptoms similar to gallstones - pain in the right upper abdominal area after eating, especially with fatty meals. Appropriate management and follow-up of gallbladder polyps depends on the size of the polyp. Gallbladder polyps equal to or smaller than 5 mm are usually benign (non-cancerous). These should be evaluated with a baseline ultrasound and a repeat ultrasound in 12 months. Follow-up examinations are not necessary if the polyp is stable with the repeat ultrasound.
Discuss this finding with your primary care provider for further evaluation and management.
Comprehensive 24-Hour Urine Steroid Hormone Profile Test
The Comprehensive 24-Hour Urine Steroid Hormone Profile Test by Rhein Labs is an advanced diagnostic tool designed to provide an in-depth analysis of an individual's hormonal status. This test evaluates a wide array of steroid hormones and their metabolites over a 24-hour period, using urine samples to offer a thorough and dynamic picture of the body's hormonal functioning. Unlike single-point blood tests, this method captures the fluctuations and rhythms of hormone production within a full day, providing valuable insights into conditions such as adrenal fatigue, hormonal imbalances, and metabolic disorders. It includes the assessment of key hormones like cortisol, estrogen, testosterone, and their metabolites, making it an invaluable resource for healthcare professionals in diagnosing and managing various endocrine-related conditions. By offering a comprehensive snapshot of hormonal activity, the Rhein Labs test aids in personalized treatment planning and helps in the optimization of overall health and well-being.
Optimal range: 796 - 2456 ug/24hrs
5α-Tetrahydrocortisol (5α-THF), a crucial adrenal metabolite, is an essential marker in the Comprehensive 24-Hour Urine Steroid Hormone Profile Test, particularly for evaluating male adrenal function and stress response. 5α-THF, a metabolite derived from cortisol, the body's primary stress hormone, provides a key insight into cortisol metabolism and adrenal gland health in men. The 24-hour urine collection method for assessing 5α-THF levels offers a comprehensive overview of daily cortisol activity, which is vital for understanding the body’s response to stress and overall adrenal function.
Optimal range: 42 - 710 ug/24hrs
Androstenetriol (5-AT), a metabolite of the hormone dehydroepiandrosterone (DHEA), is a noteworthy marker in the Comprehensive 24-Hour Urine Steroid Hormone Profile Test, emphasizing its relevance in evaluating adrenal function and overall health status in men. As an indicator of adrenal gland activity, 5-AT plays a significant role in the body's response to stress and immune system regulation. The measurement of 5-AT levels in a 24-hour urine sample offers a comprehensive overview of adrenal function over an extended period, providing deeper insights than single-point blood tests. This marker is particularly valuable in assessing conditions such as adrenal fatigue or insufficiency, where 5-AT levels may be diminished.
Optimal range: 3 - 12 ug/24hrs
Estrone (E1), a key estrogen hormone, is a crucial marker in the Comprehensive 24-Hour Urine Steroid Hormone Profile Test, emphasizing its importance in assessing male hormonal balance and health. In men, while estrogen is typically associated with female physiology, estrone plays a significant yet often underestimated role. It is involved in bone metabolism, brain function, and cardiovascular health. Estrone is produced primarily from the conversion of androstenedione, a steroid hormone. The measurement of estrone levels in a 24-hour urine sample provides a comprehensive overview of its daily production and metabolism, offering valuable insights into the endocrine system's functioning.
Optimal range: 45 - 85 ug/24hrs
Testosterone, the primary male sex hormone, is a vital marker in the Comprehensive 24-Hour Urine Steroid Hormone Profile Test, signifying its paramount importance in assessing male health and hormonal function. Testosterone plays a crucial role in developing and maintaining male characteristics, influencing muscle mass, bone density, libido, and overall energy levels. In the context of a 24-hour urine test, the measurement of testosterone offers an extensive view of its daily production and metabolism, providing a more accurate reflection of the hormone's activity than a single blood test. This method captures the fluctuations in testosterone levels throughout the day, offering crucial insights into the endocrine system's functioning.
Thyroid Panel
A Thyroid Panel is an essential health category for assessing thyroid function, a key aspect of metabolic health and well-being. This panel typically includes tests for Thyroid Stimulating Hormone (TSH), Free Thyroxine (T4), Free Triiodothyronine (T3), and sometimes Thyroid Peroxidase Antibodies (TPO Antibodies), providing a comprehensive view of thyroid health. The thyroid gland, located in the neck, plays a crucial role in regulating metabolism, energy levels, and body temperature. Abnormalities in thyroid function can lead to conditions such as hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid), each with distinct symptoms and health implications. Hypothyroidism can cause fatigue, weight gain, and depression, while hyperthyroidism may lead to weight loss, anxiety, and heart palpitations. The Thyroid Panel is vital for diagnosing these conditions and is especially important for individuals experiencing symptoms of thyroid dysfunction, pregnant women, or those with a family history of thyroid disorders. Regular monitoring through a Thyroid Panel can aid in the early detection and effective management of thyroid-related health issues. This test is a cornerstone in preventive healthcare, ensuring thyroid-related problems are identified and treated promptly, thereby enhancing overall health and quality of life. For anyone concerned about their metabolic health, a Thyroid Panel is an invaluable tool for maintaining optimal wellness.
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TSH (Thyroid Stimulating Hormone): Measures TSH levels to differentiate among primary, secondary, and tertiary hypothyroidism. It's also crucial for hyperthyroidism screening, providing a foundational understanding of thyroid function.
T4 (Thyroxine), Total: This test evaluates total T4 levels, aiding in the diagnosis of both hypothyroidism and hyperthyroidism, reflecting the thyroid's overall hormone production.
T3 Uptake: This assessment, used alongside thyroxine (T4) measurements, helps calculate the free T4 index. It's a key tool in evaluating various thyroid disorders.
T4 Free (FT4): Specifically targets the measurement of free T4, playing a vital role in diagnosing both hypothyroidism and hyperthyroidism, indicating the active portion of thyroxine.
Thyroid Peroxidase and Thyroglobulin Antibodies: These tests are instrumental in diagnosing and managing thyroid conditions, including autoimmune thyroiditis, Hashimoto's disease, Graves’ Disease, and some types of goiter.
Thyroglobulin, LC/MS/MS: Utilized primarily in the detection and monitoring of residual or recurrent thyroid cancer, providing critical information for ongoing cancer management.
TSI (Thyroid Stimulating Immunoglobulin): Essential for identifying Graves’ disease and helpful in predicting the likelihood of neonatal hyperthyroidism.
Thyroxine-binding globulin, TBG: This test is used in the diagnosis and management of various thyroid conditions, including Graves’ disease, neonatal hypothyroidism, and postpartum thyroid dysfunctions, assessing the protein that transports thyroid hormones.
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For more information on how to screen for Hypo- and hyper-thyroidism, please read our blog article "Hypo- and hyper-thyroidism: algorithm for screening and diagnosis"
Optimal range: 0 - 39 Units
Thyroglobulin antibodies are antibodies that recognize and bind to thyroglobulin, interfering with its function. Thyroglobulin is critical for thyroid hormone production, so thyroglobulin antibodies usually indicate thyroid disease.
Optimal range: 0 - 60 U/mL
Antithyroid antibodies are crucial biomarkers for diagnosing and managing autoimmune thyroid diseases like Hashimoto's thyroiditis and Graves' disease. Detecting these antibodies early can lead to better treatment outcomes, helping to prevent long-term complications related to thyroid dysfunction. If you have symptoms of thyroid imbalance or a family history of autoimmune disorders, testing for antithyroid antibodies is a key step in protecting your thyroid health.
Optimal range: 0.6 - 1.2 ng/dL , 7.72 - 15.45 pmol/L
Thyroxine is a hormone produced by the thyroid gland. The term “free thyroxine” means the measured thyroxine that is not bound to proteins in the blood.
Optimal range: 1.2 - 4.9 Units
The free T4 index (FTI) is a blood test used to diagnose thyroid disorders. T4, also called thyroxine, is a thyroid hormone. The test measures how much of it is in your blood to help determine whether your thyroid gland is underactive (hypothyroidism) or overactive (hyperthyroidism).
Optimal range: 15 - 65 pg/mL
Parathyroid hormone (PTH) helps the body maintain stable levels of calcium in the blood. It is part of a feedback loop that includes calcium, PTH, vitamin D, and, to some extent, phosphorus (phosphate) and magnesium. Conditions and diseases that disrupt this feedback loop can cause inappropriate elevations or decreases in calcium and PTH levels and lead to symptoms of hypercalcemia or hypocalcemia.
Elevated Calcium and (upper-)normal PTH Levels: Potential indicators of Parathyroid and other health conditions:
If intact parathyroid hormone (PTH) levels are in the (upper-)normal range and calcium levels are slightly elevated, it could indicate primary hyperparathyroidism, where one or more parathyroid glands are overactive, although other conditions like Familial Hypocalciuric Hypercalcemia (FHH), medication or supplement effects, and certain medical conditions may also be responsible. These findings should be interpreted in the context of the patient's overall health and symptoms, with further diagnostic tests and consultation with a healthcare provider necessary for an accurate diagnosis and appropriate treatment plan.
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Interpretive Guide |
Intact PTH |
Calcium |
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Normal Parathyroid |
Normal |
Normal |
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Hypoparathyroidism |
Low or Low Normal |
Low |
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Hyperparathyroidism
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|
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Non-Parathyroid
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Reference range: Negative, Positive
Parathyroid hormone (PTH) antibodies are specialized monoclonal or polyclonal antibodies engineered to specifically bind to parathyroid hormone—a critical regulator of calcium and phosphorus balance in the human body. These antibodies are widely utilized in both biomedical research and clinical diagnostics to detect, measure, and study PTH levels in biological samples.
Parathyroid hormone is an 84-amino acid polypeptide secreted by the parathyroid glands. It plays a vital role in calcium and phosphate homeostasis through three main mechanisms:
Stimulating bone resorption to release calcium into the bloodstream
Enhancing renal calcium reabsorption to reduce urinary calcium loss
Promoting activation of vitamin D, which boosts intestinal calcium absorption
Disruptions in PTH production or action can lead to:
Hypoparathyroidism – low PTH levels, leading to hypocalcemia and hyperphosphatemia
Hyperparathyroidism – elevated PTH levels, often resulting in hypercalcemia and hypophosphatemia
Optimal range: 9.2 - 24.1 ng/dL , 141.32 - 370.2 pmol/L
Reverse T3 is a biologically inactive thyroid hormone; however, it does block the conversion of thyroxine (T4) to triiodothyronine (T3). Higher levels of reverse T3 can decrease the effect of thyroid hormone.
Optimal range: 0.8 - 2 ng/mL
T3, or Triiodothyronine, is a vital hormone in a thyroid panel, measured in nanograms per milliliter (ng/mL). It is essential for diagnosing and monitoring thyroid disorders like hyperthyroidism and hypothyroidism. High T3 levels may indicate hyperthyroidism, causing symptoms like weight loss and increased heart rate. Low levels suggest hypothyroidism, leading to weight gain and fatigue. Monitoring T3 is crucial for effective thyroid disorder management and treatment.
Optimal range: 2 - 4.4 pg/mL , 3.07 - 6.76 pmol/L
A T3 (=triiodothyronine) test is a blood test that helps diagnose thyroid conditions, specifically hyperthyroidism (overactive thyroid). Healthcare providers typically order this test alongside other thyroid function tests.
High or low T3 levels may indicate an overactive or underactive thyroid.
According to the American Thyroid Association (ATA), T3 tests are most useful for diagnosing hyperthyroidism. They are less helpful in diagnosing hypothyroidism.
Healthcare providers test T3 levels using blood tests.
The tests for free T3 are generally less accurate than for total T3.
Free T3 or total T3 blood tests may be ordered to evaluate thyroid function if a thyroid disorder is suspected. They may also be used to evaluate pituitary gland problems, assess the severity and type of thyroid disease, and monitor treatment for a thyroid condition.
Optimal range: 0.82 - 1.77 ng/dL , 10.55 - 22.78 pmol/L
Thyroxine or T4 is a hormone produced by the thyroid gland. The term “free T4” means measured T4 that is not bound to proteins in the blood.
Optimal range: 4.5 - 12 ug/dL , 45 - 120 ng/mL , 57.92 - 154.46 nmol/L
Thyroxine (T4) is a hormone produced by the thyroid gland. It is sometimes called total thyroxine because it includes both free T4 and T4 bound to proteins.
Optimal range: 0 - 34 IU/ml
Thyroid peroxidase (TPO) is an enzyme that is critical for to thyroid hormone synthesis in the thyroid gland. Thyroid peroxidase (TPO) antibodies bind to and block the action of TPO, resulting in decreases in thyroid hormone levels. The presence of TPO antibodies in the blood is abnormal and usually indicates thyroid disease. The thyroid peroxidase (TPO) antibodies test is usually ordered after thyroid abnormalities have been detected with some other type of testing, such as TSH and free T4. It is usually ordered with thyroglobulin antibody testing.
Optimal range: 0 - 0.55 IU/L
The measurement of thyroid stimulating autoantibodies, in conjunction with other clinical and laboratory findings, is used as an aid in the diagnosis of patients suspected of having Graves' disease.
Optimal range: 0.45 - 4.5 mIU/L , 0.45 - 4.5 IU/L
Thyroid stimulating hormone (TSH) is one of the most important hormones currently used to diagnose thyroid abnormalities. This glycoprotein is secreted by the pituitary and stimulates release of thyroxine (T4) and triiodothyronine (T3) from the thyroid gland.
TSH release from the pituitary is controlled by thyrotropin releasing hormone (TRH) stimulation and negative feedback from free T3 and free T4.
Optimal range: 71 - 180 ng/mL , 7100 - 18000 ng/dL , 1.09 - 2.77 nmol/L
The T3 test measures triiodothyronine in blood to help doctors diagnose hyperthyroidism. The total triiodothyronine (T3) test is one of several tests used to diagnose thyroid disorders. T3 is an active thyroid hormone that your body creates by converting thyroxine (T4) into triiodothyronine. The 3 and 4 in the names represent the number of iodine atoms it has.
T3 helps maintain muscle control, brain function and development, heart and digestive functions. High or low T3 levels may indicate an overactive or underactive thyroid.
The thyroid gland is located in front of your neck. It has right and left lobes that resemble a butterfly. This gland produces hormones that help control your metabolism, which is how your body uses energy. Disorders that affect thyroid function can either speed up or slow down metabolic processes.
Optimal range: 0 - 2 IU/L
TRAb (TSH Receptor Binding Antibody) is a biomarker used primarily to diagnose and manage thyroid-related disorders. It is especially useful for identifying Graves' disease, which is an autoimmune condition where the body's immune system attacks the thyroid, causing it to become overactive. TRAb testing can also help diagnose neonatal hypothyroidism, a condition in newborns where the thyroid is underactive, and postpartum thyroid dysfunction, which can occur in some women after childbirth and involves temporary thyroid problems.
Optimal range: 24 - 39 %
T3 Uptake - T3 Uptake (T3U) is used with measurement of Thyroxine (T4) to calculate the Free T4 Index. The calculated Free T4 is useful in the assessment of thyroid diseases. Elevations are associated with Hyperthyroidism or Thyroid Hormone Resistance whereas low concentrations are associated with Hypothyroidism.
T + B-Lymphocyte Differential
The "T + B-Lymphocyte Differential" panel by Labcorp is a comprehensive test that involves flow cytometry methodology to evaluate different subsets of lymphocytes in the blood. This test includes the analysis of various lymphocyte types such as T cells (CD3+), B cells (CD19+), and natural killer (NK) cells (CD3^{-}CD56+). It provides detailed measurements like the percentage and absolute counts of these cells, as well as the CD4:CD8 ratio, which is crucial in assessing immune system health.
Specifically, the test measures the percentages and absolute counts of CD3+ T cells, CD3+CD4+ helper/inducer cells, CD3+CD8+ suppressor/cytotoxic cells, CD19+ B cells, and CD3^{-}CD56+ NK cells. Additionally, it includes a complete blood count (CBC) with differential and platelet count. This panel is particularly useful in the classification and diagnosis of primary immunodeficiency diseases and in monitoring patients with AIDS.
The test requires a whole blood specimen, collected in specific types of tubes, and it's important that the specimen is handled correctly to maintain its viability. The expected turnaround time for test results is generally between 1 to 3 days. However, additional time may be needed for confirmatory or reflex tests.
The "T + B-Lymphocyte Differential" panel is significant for its role in understanding various conditions affecting the immune system, including evaluating and monitoring HIV infection. In HIV-1 infected patients, for instance, the test can provide valuable information about the progression of the disease and the effectiveness of antiretroviral therapy, as it typically shows a decrease in CD4 T cells and an increase in CD8 T cells, along with a decrease in the CD4:CD8 ratio.
This comprehensive approach to lymphocyte profiling is essential in contemporary clinical immunology, providing clinicians with detailed insights into the status and functioning of a patient's immune system.
Optimal range: 57.5 - 86.2 %
The biomarker "% CD 3 Pos. Lymph." in a T + B-Lymphocyte Differential panel from Labcorp refers to the percentage of lymphocytes in the blood that are CD3 positive. CD3 is a protein complex and a T-cell co-receptor that defines T-lymphocytes, which are crucial components of the immune system.
This marker is used to evaluate the immune system's health, particularly in diagnosing and monitoring conditions affecting T-cell function, such as immunodeficiency disorders or certain types of leukemia. The measurement of CD3 positive lymphocytes helps in understanding the proportion of T cells in the overall lymphocyte population, providing insight into the body's adaptive immune response.
Optimal range: 30.8 - 58.5 %
The CD4 percentage (CD4%) is the percentage of white blood cells (lymphocytes) that are CD4 cells.
The immune system contains lots of different cells. The two main types of lymphocytes are T cells and B cells. CD4 cells are a type of T cell. So the CD4% looks at the CD4 count in relation to other immune cells.
CD4% is sometimes a more stable indication of whether there has been a change in the immune system. If the percentage hasn’t changed the change in the absolute count is not important.
Optimal range: 12 - 35.5 %
The proportion of all T cells that are CD8 cells.
CD8 cells are also called cytotoxic T-lymphocytes. They help fight cancer and germs that live inside your cells (intracellular pathogens).
The CD8 percentage is sometimes more reliable than the absolute count of CD8 because it tends to vary less.
Optimal range: 3.3 - 25.4 %
The biomarker "% CD19+ Lymphs" in a T + B-Lymphocyte Differential panel from Labcorp quantifies the percentage of lymphocytes in the blood that are B cells, identified by the presence of the CD19 protein on their surface. CD19 is a critical component of the B cell receptor complex and plays a vital role in the development and function of B cells. B cells are essential for the adaptive immune response, primarily responsible for antibody production.
Optimal range: 109 - 897 /uL
The "Abs. CD 8 Suppressor" biomarker in a T + B-Lymphocyte Differential panel from Labcorp measures the absolute count of CD8 positive suppressor T-cells in the blood. CD8 cells, also known as cytotoxic T cells, play a critical role in the immune system's defense against pathogens and cancer cells by directly destroying infected or malignant cells. The absolute count provides a specific numeric value of these cells, unlike percentage values which only give a proportion relative to other cells.
Optimal range: 12 - 645 /uL
The biomarker "Abs.CD19+ Lymphs" in the T + B-Lymphocyte Differential panel from Labcorp measures the absolute count of CD19 positive lymphocytes, which are primarily B cells. CD19 is a marker indicating B cell presence, crucial for the adaptive immune response, especially in antibody production. This absolute count provides a specific numerical value rather than a percentage, offering a direct measure of the B cell population in the blood. It's instrumental in diagnosing and monitoring conditions affecting B cell function, such as immunodeficiency disorders, certain types of leukemia, and autoimmune diseases. Understanding variations in these counts is vital for evaluating the immune system's health and function.
Optimal range: 622 - 2402 /uL
CD3+ cells are all T-lymphocytes, which includes both CD4+ and CD8+ lymphocyte cells.
This figure is rarely used for making treatment decisions.
Absolute CD3 cells, also known as CD3+ cells, refer to a subset of T-lymphocytes that express the CD3 marker on their surface. CD3 is a protein complex and T cell co-receptor involved in activating both cytotoxic T cells (CD8+ naive T cells) and T helper cells (CD4+ naive T cells).
Absolute CD3 cell count represents the total number of CD3+ cells in a given blood sample. It includes both CD4+ and CD8+ T-lymphocytes, which are subtypes of T cells with different functions.
Optimal range: 359 - 1519 /uL
The CD4 cells are Helper T-cells expressing both CD3 and CD4.
CD4 T-cells levels are a criterion for categorizing HIV-related clinical conditions by CDC's classification system for HIV infection. The measurement of CD4 T-cell levels has been used to establish decision points for initiating P. jirovecii prophylaxis, antiviral therapy and to monitor the efficacy of treatment. The Public Health Service (PHS) has recommended that CD4 T-cell levels be monitored every 3 to 6 months in all HIV-infected persons.
During HIV infection, antiviral therapy is often initiated when the absolute CD4 count drops below 500 cells/µL. When the absolute CD4 count drops below 200 cells/µL, therapeutic prophylaxis against PCP and other opportunistic infections may be initiated. When the absolute CD4 count drops below 100 cells/µL, prophylaxis against Mycobacterium avium complex is recommended.
Optimal range: 0.92 - 3.72 Ratio
This test looks at the ratio of two important types of white blood cells in your blood.
Lymphocytes are a type of white blood cell in your immune system. This test looks at two of them, CD4 and CD8.
CD4 cells lead the fight against infections. CD8 cells can kill cancer cells and other invaders.
Sexually Transmitted Disease (STD) panel
Clinical Pathology Laboratories (CPL) offers a comprehensive Sexually Transmitted Disease (STD) panel, designed to detect various infections commonly transmitted through sexual contact. This panel typically includes tests for several key STDs such as Human Immunodeficiency Virus (HIV), Hepatitis B and C, Syphilis, Chlamydia, and Gonorrhea. The tests used in the panel employ a combination of methodologies, including nucleic acid amplification tests (NAATs), enzyme immunoassays (EIAs), and rapid plasma reagin (RPR) tests, among others, to accurately identify the presence of these infections.
HIV testing usually involves antibody/antigen tests to detect the virus itself or the body's response to it. Hepatitis B and C tests look for markers of these viruses in the blood, including antigens and antibodies, to indicate current or past infections. Syphilis is generally tested through serological assays to detect antibodies produced in response to the Treponema pallidum bacterium. Chlamydia and Gonorrhea, both caused by bacteria, are often detected using NAATs from urine samples or swabs from the genital area, throat, or rectum.
The STD panel is crucial for early detection and treatment of these infections, which can sometimes be asymptomatic. Early detection not only helps in initiating timely treatment for the infected individual but also plays a vital role in preventing the spread of these diseases to others. Regular testing is recommended for sexually active individuals, particularly those with multiple partners or those who engage in unprotected sex. CPL's STD panel is an essential tool in public health for managing and controlling sexually transmitted infections. It reflects the laboratory's commitment to providing accurate, sensitive, and specific diagnostic services to assist in the effective treatment and management of STDs.
Reference range: Negative, Positive
Chlamydia, caused by the bacterium Chlamydia trachomatis, is one of the most prevalent sexually transmitted infections (STIs) worldwide. It primarily affects the genital tract, but can also impact the rectum, throat, and eyes. One of the key challenges in controlling Chlamydia is its often asymptomatic nature; a significant proportion of infected individuals exhibit no noticeable symptoms, thereby unknowingly facilitating its spread. When symptoms do occur, they can include genital discharge, burning during urination, lower abdominal pain, painful sexual intercourse for women, and testicular pain in men.
Reference range: Negative, Positive
Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It is one of the most common STIs, affecting millions of individuals worldwide annually. Gonorrhea primarily infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in both men and women. It can also affect the mouth, throat, eyes, and rectum.
The transmission of gonorrhea typically occurs during vaginal, anal, or oral sex with an infected partner. A significant concern with gonorrhea is its capacity to be asymptomatic, particularly in women. When symptoms are present, they can vary. In men, common symptoms include a burning sensation during urination and a white, yellow, or green discharge from the penis. Women may experience increased vaginal discharge, painful urination, vaginal bleeding between periods, and abdominal or pelvic pain. If left untreated, gonorrhea can lead to serious health complications. In women, it can cause pelvic inflammatory disease (PID), which can result in infertility, ectopic pregnancy, and chronic pelvic pain. In men, gonorrhea can lead to painful inflammation of the ducts in the testicles, which can also result in infertility.
Reference range: Non-Reactive, Reactive
The marker "Herpes Simplex 1 Ab, IgG" on a sexually transmitted disease (STD) test panel refers to the detection of Immunoglobulin G (IgG) antibodies specific to Herpes Simplex Virus Type 1 (HSV-1) in an individual's blood. HSV-1 is primarily known for causing oral herpes, which manifests as cold sores or fever blisters, but it can also cause genital herpes. The presence of IgG antibodies is indicative of a past or current HSV-1 infection, as these antibodies are produced by the immune system in response to the virus and remain in the body for life, providing long-term immunity.
The IgG antibodies for HSV-1 typically develop within a few weeks to months after initial exposure to the virus and are detectable through serological testing. These antibodies play a critical role in controlling and containing herpes outbreaks but do not eradicate the virus. The virus resides latently in the nerve cells and can reactivate, leading to recurrent infections. Unlike IgM antibodies, which are produced first and indicate recent infection, IgG antibodies suggest a longer-term or past infection.
Reference range: Non-Reactive, Reactive
The marker "Herpes Simplex 2 Ab, IgG" on a sexually transmitted disease (STD) test panel is indicative of a serological test for detecting Immunoglobulin G (IgG) antibodies specific to Herpes Simplex Virus Type 2 (HSV-2). HSV-2 is predominantly associated with genital herpes, a viral infection characterized by periodic outbreaks of painful sores or blisters in the genital area. The presence of IgG antibodies against HSV-2 generally signifies past exposure to the virus, either through symptomatic infections or asymptomatic viral shedding. Unlike IgM antibodies, which appear soon after infection and then wane, IgG antibodies develop within weeks to months post-exposure and persist for life, offering long-term immune response.
Reference range: Non-Reactive, Reactive
Human Immunodeficiency Virus (HIV) is categorized into two distinct types: HIV-1 and HIV-2. Both are retroviruses that attack the body's immune system, but they have differences in their geographical prevalence, transmission rates, and progression to Acquired Immunodeficiency Syndrome (AIDS).
HIV-1: This is the most common type of HIV and is found worldwide. It's responsible for the vast majority of HIV infections globally. HIV-1 is characterized by its rapid transmission and progression. It is more aggressive and infects cells faster than HIV-2, leading to a quicker decline in immune function if left untreated. HIV-1 is divided into four groups: M (Main), O (Outlier), N (Non-M, Non-O), and P, with Group M responsible for the majority of infections worldwide. Further, Group M is divided into multiple subtypes and circulating recombinant forms (CRFs).
HIV-2: This type is less common and is predominantly found in West Africa, with some cases in India and Europe. Compared to HIV-1, HIV-2 is transmitted less efficiently, particularly from mother to child and through heterosexual contact. The progression of HIV-2 to AIDS is generally slower, and it may have a longer asymptomatic stage. HIV-2 is also less responsive to certain antiretroviral therapies, requiring specific treatment regimens.
Reference range: Non-Reactive, Reactive
The marker "RPR (Rapid Plasma Reagin) Result" on a sexually transmitted disease (STD) test panel is a critical diagnostic tool for syphilis, a bacterial infection caused by Treponema pallidum. The RPR test is a non-treponemal serological screening used to detect the presence of reagin, an antibody-like substance produced in response to the cellular damage caused by the syphilis bacteria. The test measures the levels of these antibodies in the plasma by assessing the agglutination (clumping) of certain cardiolipin-lecithin-cholesterol particles mixed with the patient's serum or plasma.
The RPR test is particularly valued for its ability to screen for active syphilis infections, monitor the effectiveness of treatment, and in some cases, suggest re-infection or treatment failure. A positive RPR result often indicates an active syphilis infection but must be confirmed with specific treponemal tests, like the Fluorescent Treponemal Antibody Absorption (FTA-ABS) test or the Treponema pallidum Particle Agglutination (TP-PA) test, to differentiate it from other conditions that can cause a positive RPR, such as certain autoimmune diseases or other infections.
Reference range: NOT INDIC.
The marker "RPR (Rapid Plasma Reagin) Titer" on a sexually transmitted disease (STD) test panel is an essential diagnostic tool in the assessment and management of syphilis, a bacterial infection caused by Treponema pallidum. The RPR test is a non-treponemal serological test that quantitatively measures the concentration of reagin antibodies in the blood. These antibodies are produced as an immune response to components released from damaged cells caused by the syphilis bacterium.
The titer, or concentration, of these antibodies is reported as a ratio, which is determined by serially diluting the blood sample and noting the highest dilution at which agglutination (clumping) of test antigens still occurs.
Neutrophil Cytoplasmic Antibodies
The Neutrophil Cytoplasmic Antibodies (ANCA) panel is a critical diagnostic tool in the field of immunology, particularly for identifying a group of autoimmune diseases known as ANCA-associated vasculitides. These diseases, including Granulomatosis with Polyangiitis (GPA), Microscopic Polyangiitis (MPA), and Eosinophilic Granulomatosis with Polyangiitis (EGPA), are characterized by inflammation and damage to blood vessels throughout the body. The ANCA panel primarily tests for two types of antibodies: Anti-Proteinase 3 (PR3-ANCA) and Anti-Myeloperoxidase (MPO-ANCA), which target enzymes found in neutrophils, a type of white blood cell.
The presence and pattern of these antibodies, identified through methods such as indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA), provide valuable information for diagnosis. In IIF, PR3-ANCA typically shows a cytoplasmic staining pattern (c-ANCA), while MPO-ANCA exhibits a perinuclear pattern (p-ANCA), although ELISA provides a more specific detection. The type and level of ANCA antibodies can not only help in diagnosing the specific type of vasculitis but also in assessing disease activity and guiding treatment strategies.
Elevated PR3-ANCA is often associated with GPA, and high levels of MPO-ANCA are commonly seen in MPA and EGPA. The presence of these antibodies suggests an autoimmune process where the body's immune system erroneously attacks its own cells and tissues, leading to inflammation and damage, particularly in the blood vessels. This can result in a range of symptoms, from skin rashes and joint pain to severe organ damage, depending on the vessels and organs affected.
The ANCA panel is a cornerstone in the diagnosis of vasculitides but must be interpreted in the context of clinical findings and other laboratory results. Its role extends beyond diagnosis; it's also vital in monitoring disease progression and response to therapy. Understanding the nuances of the ANCA panel and the diseases it helps diagnose is crucial for clinicians in providing accurate diagnoses and effective treatments. Ongoing research and advancements in the understanding of ANCA-associated diseases continue to refine the use and interpretation of this panel, making it an evolving and indispensable tool in clinical immunology.
Optimal range: 0 - 10 CU
Anti-myeloperoxidase (MPO) antibodies, detected through the Neutrophil Cytoplasmic Antibodies (ANCA) panel, are crucial in diagnosing autoimmune diseases like Microscopic Polyangiitis (MPA) and Eosinophilic Granulomatosis with Polyangiitis (EGPA). These conditions, part of autoimmune vasculitides, involve the immune system mistakenly attacking blood vessels, leading to inflammation and potential organ damage.
MPA is a rare autoimmune disorder causing inflammation in small and medium-sized vessels, affecting organs like kidneys and lungs, with symptoms like fatigue and joint pain. EGPA, formerly known as Churg-Strauss Syndrome, also targets small to medium vessels but is marked by high eosinophil counts, affecting organs including lungs and heart, and presenting symptoms like asthma and skin rashes.
Myeloperoxidase is an enzyme in white blood cells aiding infection defense. Anti-MPO antibodies, indicating an immune attack on this enzyme, are significant in diagnosing and managing these vasculitides. High anti-MPO levels in MPA signify active disease and potential relapse. In EGPA, their presence aids in diagnosis and prognosis. These antibodies can trigger damaging immune responses in blood vessels, leading to inflammation. Continuous research on anti-MPO antibodies is pivotal in understanding and treating autoimmune vasculitides.
Optimal range: 0 - 20 CU
Anti-Proteinase 3 antibodies (PR3-ANCA) are key in diagnosing Granulomatosis with Polyangiitis (GPA), an autoimmune disease where the immune system attacks blood vessels, mainly affecting the respiratory system and kidneys. Proteinase 3, an enzyme in neutrophils, is targeted by these antibodies, leading to vessel inflammation and damage. High levels of anti-PR3 antibodies indicate active GPA, aiding in its management and treatment decisions. This understanding is vital for developing targeted therapies to control the disease.
Coronary calcium scan
Other names for this test are: Coronary artery calcium (CAC) test, Coronary calcium CT scan, Heart CT calcium scan.
A coronary calcium scan, also known as a coronary artery calcium (CAC) scan, is a specialized type of computed tomography (CT) scan that measures the amount of calcium in the walls of the coronary arteries, which supply blood to the heart muscle. This non-invasive imaging test is used to evaluate the risk of coronary artery disease (CAD), a leading cause of heart attacks. Calcium in the coronary arteries is an early sign of CAD, as it's a component of plaque that can narrow or block these arteries, leading to heart disease. The scan produces a calcium score, which reflects the extent of calcification in the coronary arteries. A score of zero indicates no detectable plaque and a low risk of a coronary event in the near future, while a higher score suggests a greater risk. This score helps in stratifying patients into different risk categories for heart disease and can guide physicians in making decisions about preventive measures and treatment strategies. The scan is particularly valuable for individuals with intermediate risk factors for heart disease, such as family history, high cholesterol, hypertension, smoking, or diabetes, where traditional risk assessment methods may be inconclusive. It's important to note that while a coronary calcium scan can indicate the presence and extent of calcification, it does not provide information on the severity of blockages or the presence of non-calcified plaque. The scan is a useful tool in preventive cardiology, allowing for early intervention and lifestyle modifications to reduce the risk of heart disease.
Reference range: O - No evidence of CAD, 1-10 - Minimal evidence of CAD, 11-100 - Mild evidence of CAD, 101-400 - Moderate evidence of CAD, Over 400 - Extensive evidence of CAD
Reference range: 0, 1 - 10, 11 - 100, 101 - 400, Over 400
The Left Anterior Descending (LAD) artery, often visualized in a Coronary Calcium Scan, is a crucial blood vessel in the heart's circulatory system, renowned for its role in supplying blood to a large portion of the heart muscle. In the context of a Coronary Calcium Scan, which utilizes computed tomography (CT) technology to detect calcium deposits in the coronary arteries, the LAD artery is scrutinized for signs of calcification. Calcification in the LAD is of particular clinical importance due to the artery's extensive coverage and significant role in myocardial perfusion. Calcium deposits in the LAD are indicative of atherosclerotic plaque buildup, a hallmark of coronary artery disease (CAD).
Reference range: 0, 1 - 10, 11 - 100, 101 - 400, Over 400
The Left Circumflex (LCX) artery is an essential component of the heart's arterial system, and its assessment in a Coronary Calcium Scan provides significant insights into cardiovascular health. The LCX branches off from the left coronary artery and encircles the heart muscle, primarily supplying blood to the lateral and posterior walls of the left ventricle. In the context of a Coronary Calcium Scan, which employs computed tomography (CT) to detect calcifications in the coronary arteries, the LCX is meticulously examined for signs of atherosclerotic plaque.
Reference range: 0, 1 - 10, 11 - 100, 101 - 400, Over 400
In a Coronary Calcium Scan, the Left Main (LM) coronary artery represents a critical focus of assessment due to its primary role in the heart's blood supply. The LM artery is a short but crucial vessel that branches from the aorta and bifurcates into the Left Anterior Descending (LAD) and the Left Circumflex (LCX) arteries, supplying a significant portion of the heart muscle with oxygen-rich blood. During the scan, which employs computed tomography (CT) technology, the LM is evaluated for the presence of calcification – a key indicator of coronary artery disease (CAD). Calcifications in the LM are particularly concerning because of the artery's strategic location and the extensive area of myocardium it supplies.
Reference range: 0, 1 - 10, 11 - 100, 101 - 400, Over 400
The Right Coronary Artery (RCA) is a pivotal vessel in the cardiovascular system, playing a central role in the assessment of heart health during a Coronary Calcium Scan. This scan, utilizing computed tomography (CT) technology, is designed to detect the presence of calcium deposits within the coronary arteries, indicative of atherosclerotic plaque. The RCA originates from the right aortic sinus and courses along the right atrioventricular groove, supplying blood to the right atrium, right ventricle, part of the left ventricle, the sinoatrial (SA) node in most individuals, and the atrioventricular (AV) node. The presence of calcification in the RCA, as revealed in the scan, signifies the extent of coronary artery disease (CAD) in this vessel.
Reference range: 0, 1 - 10, 11 - 100, 101 - 400, Over 400
The Total Coronary Score, often referred to as the Agatston score, in a Coronary Calcium Scan is a critical quantitative measure that encapsulates the cumulative burden of calcified plaque within the coronary arteries. This score is derived from a computed tomography (CT) scan, specifically designed to detect calcium deposits in the coronary arteries, which are a hallmark of atherosclerotic coronary artery disease (CAD). The Agatston method, named after its inventor, Dr. Arthur Agatston, assigns a density factor to each segment of detectable calcification, and this factor is multiplied by the area of the calcification to generate a score for each lesion. These individual lesion scores are then summed to obtain the total coronary calcium score. The higher the score, the greater the extent of calcification and, consequently, the higher the risk of future cardiac events such as myocardial infarction.
Urinary Tract Infection Panel (RealTime Laboratories)
The Urinary Tract Infection Panel offered by RealTime Laboratories is a comprehensive diagnostic test that employs PCR (Polymerase Chain Reaction) technology. This advanced method is used to accurately detect the presence of 18 different bacteria and 1 yeast known to cause urinary tract infections (UTIs). Furthermore, the panel is capable of identifying seven genes that are associated with resistance to antibiotics.
One of the key advantages of this test is its precision in diagnosing UTIs, which can eliminate the guesswork often involved in treatment decisions. By identifying the specific bacteria or yeast causing the infection, and also detecting genes that indicate antibiotic resistance, the test enables healthcare providers to select the most effective treatment.
The test is suitable for adults, as it is not available for patients under 18 years of age. The results from the RealTime Labs UTI Panel can significantly aid in antibiotic stewardship, an effort to improve how antibiotics are prescribed and used. This approach not only helps in providing the correct treatment but also plays a crucial role in preventing the misuse of antibiotics, which is essential to combat the growing issue of antibiotic resistance.
Reference range: Absent, Present
The blaSHV gene, detected in the Urinary Tract Infection Panel by RealTime Laboratories, is a significant marker for antibiotic resistance, particularly in urinary tract infections (UTIs). This gene encodes the SHV type beta-lactamase, an enzyme that confers resistance to beta-lactam antibiotics, a class that includes penicillins and cephalosporins. The presence of the blaSHV gene in UTI-causing bacteria is a critical factor in determining the appropriate antibiotic treatment, as it indicates that the bacteria may be resistant to commonly used antibiotics in this class.
Reference range: Absent, Present
Enterococcus faecalis, a notable marker in urinary tract infection (UTI) panels, such as those offered by RealTime Laboratories, is a significant bacterium due to its role in various infections. As a gram-positive, facultative anaerobic organism, E. faecalis is commonly found as part of the normal intestinal flora but can cause a variety of infections including urinary tract infections, endocarditis, and bacteremia.
Urinary tract infections caused by E. faecalis are particularly noteworthy. These infections often occur in chronically ill patients, especially in nosocomial settings, and can be associated with factors like urinary catheterization or obstruction. E. faecalis is capable of causing complicated UTIs, such as pyelonephritis, perinephric abscesses, and chronic prostatitis, which can also lead to bacteremia.
Reference range: Absent, Present
The ermB gene, included in the Urinary Tract Infection Panel by RealTime Laboratories, is a significant marker for antibiotic resistance, particularly relevant in the context of urinary tract infections (UTIs). This gene is responsible for conferring resistance to macrolide antibiotics, which include erythromycin, clarithromycin, and azithromycin, through a mechanism known as ribosomal methylation. The presence of the ermB gene in urinary pathogens is a critical factor in determining the appropriate antibiotic therapy, as it indicates the potential ineffectiveness of macrolide antibiotics.
Coxsackie A IgM Antibody
The Coxsackie A gM Antibody panel is a diagnostic tool used to detect the presence of antibodies against the Coxsackie A virus, a significant member of the Enterovirus family. This panel differentiates between IgG and IgM antibodies, providing crucial insights into the timing and stage of the infection.
IgM antibodies typically indicate a recent or ongoing infection, as they are the first antibodies produced by the immune system in response to an infection.
In contrast, IgG antibodies develop later and can indicate a past infection or a more mature immune response.
This test is especially important in diagnosing conditions caused by Coxsackie A virus, such as hand, foot, and mouth disease, herpangina, and various other systemic illnesses. Accurate identification through this antibody panel aids in appropriate clinical management and understanding of the patient's immune status regarding Coxsackie A virus exposure.
Reference range: Negative, High
Reference range: Negative, High
Reference range: Negative, High
Reference range: Negative, High
Coxsackie B Virus Antibodies
This test is used to aid in diagnosing Coxsackie virus infection. Coxsackie B viruses cause a wide variety of illnesses, including pleurodynia (Bornholm disease), meningitis, rash, pulmonary infection and a generalized systemic infection.
The Coxsackie B Virus Antibodies panel is a critical diagnostic tool used for detecting antibodies against the Coxsackie B virus, a key pathogen within the Enterovirus genus. This panel specifically tests for the presence of antibodies to several serotypes of the Coxsackie B virus, typically Coxsackie B1 through B6. The presence of these antibodies in a patient's blood can indicate either a current or past infection. Coxsackie B viruses are known to cause a variety of illnesses, ranging from mild syndromes like fever, pleurodynia, and herpangina, to more severe conditions such as myocarditis, pericarditis, and meningitis. In some cases, they are also implicated in the development of chronic diseases, including dilated cardiomyopathy and diabetes. The Coxsackie B Virus Antibodies panel is essential for diagnosing these infections accurately, guiding appropriate clinical treatment, and understanding the epidemiology of these viruses. This panel plays a crucial role in public health monitoring and individual patient care, especially in cases of unexplained cardiac or neurological symptoms.
Reference range: Negative, High
Coxsackie B-1 Antibody (Ab) is a specific immunological marker used in the detection of previous or ongoing infections caused by the Coxsackie B-1 virus, a member of the Enterovirus genus within the Picornaviridae family. This virus is known for its role in a variety of clinical syndromes, ranging from mild febrile illnesses to more severe conditions such as myocarditis, pericarditis, and aseptic meningitis. The presence of Coxsackie B-1 Ab, particularly IgM and IgG classes, in serum samples is indicative of the immune response triggered by the body against this pathogen. IgM antibodies usually suggest a recent acute infection, appearing early in the course of the disease and declining as the infection resolves. In contrast, IgG antibodies develop later and can persist for years, indicating past exposure and possibly conferring immunity. The detection of these antibodies is crucial for epidemiological surveillance, diagnosis, and understanding the immunopathology of Coxsackie B-1 virus infections. Advanced serological assays, including enzyme-linked immunosorbent assay (ELISA) and neutralization tests, are employed for accurate and sensitive detection of Coxsackie B-1 Ab, playing a significant role in clinical diagnosis and in differentiating this infection from other enteroviral diseases with similar clinical presentations.
Reference range: Negative, High
Coxsackie B-2 Antibody (Coxsackie B-2 Ab) is a specific immunoglobulin marker indicative of exposure to the Coxsackie B-2 virus, a member of the enterovirus family and one of the distinct serotypes within the Coxsackie B virus group. This serotype is known for its role in various clinical manifestations ranging from mild, flu-like symptoms to more severe conditions like myocarditis, pericarditis, and pancreatitis. The presence of Coxsackie B-2 antibodies, detectable through serological assays, is crucial in the diagnosis and epidemiological tracking of these infections.
Reference range: Negative, High
Coxsackie B-3 antibody (Coxsackie B-3 Ab) plays a pivotal role in the immunological response to Coxsackie B-3 virus, a significant member of the Enterovirus genus within the Picornaviridae family. This virus is known for its involvement in various clinical syndromes, ranging from mild gastrointestinal and respiratory illnesses to more severe conditions like myocarditis, pericarditis, and pancreatitis. The Coxsackie B-3 Ab is a specific antibody formed in response to infection by the Coxsackie B-3 virus, and its detection is crucial for the accurate diagnosis and epidemiological study of the virus.
Reference range: Negative, High
Coxsackie B-4 antibody (Coxsackie B-4 Ab) is a specific immunoglobulin marker indicative of exposure to the Coxsackie B-4 virus, a member of the Enterovirus genus within the Picornaviridae family. This virus is known for its role in various human diseases, ranging from mild febrile illnesses to more severe conditions such as myocarditis, pancreatitis, and aseptic meningitis. The presence of Coxsackie B-4 Ab is particularly significant in the context of research into the etiology of type 1 diabetes mellitus; there is accumulating evidence suggesting that Coxsackie B-4 may act as a trigger in genetically predisposed individuals, potentially initiating or accelerating pancreatic beta-cell destruction.
Reference range: Negative, High
Coxsackie B-5 Antibody (Coxsackie B-5 Ab) is a specific marker used in the serological diagnosis of infections caused by the Coxsackie B-5 virus, one of the several serotypes of the Coxsackie B viruses belonging to the Enterovirus genus. The presence of Coxsackie B-5 Ab in a patient's serum is indicative of an immune response to this particular serotype, which is known for its role in a range of acute and chronic illnesses.
Reference range: Negative, High
Coxsackie B-6 Ab, or Coxsackie B-6 antibody, is a significant marker in the medical diagnosis and study of infections caused by the Coxsackie B-6 virus, a member of the Enterovirus genus within the Picornaviridae family. This specific antibody is part of the immune response to the Coxsackie B-6 virus, which is known for causing a spectrum of diseases, ranging from mild gastrointestinal distress to more severe conditions like myocarditis, pericarditis, and even pancreatitis. The presence of Coxsackie B-6 Ab in a patient's blood is indicative of either a current or past infection with this virus.
Autoimmune Neuromuscular Profile
The Autoimmune Neuromuscular Profile offered by LabCorp is a comprehensive diagnostic panel designed to detect autoantibodies associated with various autoimmune neuromuscular disorders and to evaluate the presence of four markers related to autoimmune neuromuscular disorders, the test includes Anti-cN-1A Ab for Inclusion Body Myositis (IBM), Anti-HMGCR Ab, Anti-Jo-1 Ab, and Anti-SRP Ab.
Reference range: Negative, Weak Positive, Moderate Positive, Strong Positive
Anti-cN-1A (NT5c1A) antibodies are a specific biomarker crucial in the diagnosis and understanding of Inclusion Body Myositis (IBM), a progressive and chronic inflammatory muscle disorder. These antibodies target the protein 5'-nucleotidase 1A (NT5c1A), which plays a role in purine metabolism. The presence of Anti-cN-1A (NT5c1A) antibodies is increasingly recognized as a distinctive serological marker for IBM, distinguishing it from other inflammatory myopathies. IBM is characterized by progressive muscle weakness and atrophy, primarily affecting the quadriceps and forearm muscles. Unlike other myositis forms, IBM is generally resistant to conventional immunosuppressive therapies, making its early and accurate diagnosis through biomarkers like Anti-cN-1A (NT5c1A) particularly important for patient management.
Reference range: Negative, Weak Positive, Moderate Positive, Strong Positive
Anti-HMGCR antibodies, also known as Anti-3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase antibodies, are a specific type of autoantibody targeting the HMGCR enzyme, a key component in the cholesterol synthesis pathway. These antibodies have gained significant attention in the field of rheumatology and autoimmunity, particularly in their association with statin-associated autoimmune myopathy, a condition characterized by progressive muscle weakness and elevated serum creatine kinase levels. Patients who develop this condition, often in the context of statin therapy, produce Anti-HMGCR antibodies that are believed to mediate an autoimmune response against muscle fibers.
Reference range: Negative, Weak Positive, Moderate Positive, Strong Positive
Anti-Jo-1 Ab (RDL), or Anti-Histidyl-tRNA Synthetase Antibody, is a pivotal serological marker extensively used in the diagnosis and management of autoimmune disorders, particularly Idiopathic Inflammatory Myopathies (IIM), including Polymyositis (PM) and Dermatomyositis (DM). This autoantibody targets the histidyl-tRNA synthetase enzyme, which is crucial in protein synthesis. The presence of Anti-Jo-1 Ab is considered a hallmark feature of the Anti-Synthetase Syndrome, a subtype of IIM characterized by a unique clinical triad: myositis, interstitial lung disease, and polyarthritis. Patients positive for Anti-Jo-1 Ab often exhibit more severe symptoms, with a pronounced pulmonary involvement and a higher risk of developing interstitial lung disease, which can be a major determinant of prognosis.
Reference range: Negative, Positive
Anti-SRP Ab (Signal Recognition Particle Antibody), as measured by reference laboratories such as RDL (Reference Diagnostics Laboratory), is a highly specific serological marker crucial in the diagnosis and management of autoimmune myopathies, particularly Polymyositis and Dermatomyositis. The signal recognition particle (SRP) is a cytoplasmic ribonucleoprotein involved in the translocation of secretory and membrane proteins. In autoimmune contexts, the immune system aberrantly produces antibodies against SRP, leading to muscle inflammation and damage.
Connective Tissue Disease Cascade
The Connective Tissue Disease Cascade panel is an advanced diagnostic tool used for the detection and evaluation of autoimmune connective tissue diseases. This comprehensive panel includes a series of tests that identify specific antibodies commonly associated with these disorders, such as systemic lupus erythematosus, Sjögren's syndrome, scleroderma, polymyositis, and rheumatoid arthritis. By analyzing antibodies like ANA (Antinuclear Antibody), dsDNA, Smith antibodies, and others, the panel provides crucial information about the presence and type of autoimmune connective tissue disease a patient may have. This aids in early diagnosis, which is essential for effective management and treatment. The panel is particularly useful in cases where symptoms are unclear or overlap with multiple conditions, offering a detailed immunological profile that guides clinicians in their diagnostic and therapeutic decision-making. The Connective Tissue Disease Cascade panel is thus a vital resource in the field of rheumatology and autoimmune diagnostics, helping to tailor patient care more effectively.
Optimal range: 0 - 21 SGU
Anti-Beta2 Glycoprotein I IgG is a specific class of autoantibodies directed against beta-2 glycoprotein I (β2GPI), a plasma protein that plays a critical role in the regulation of coagulation. The presence of these autoantibodies is clinically significant, particularly in autoimmune disorders such as Antiphospholipid Syndrome (APS), where they contribute to a hypercoagulable state. APS, characterized by thrombosis and pregnancy morbidity, is often associated with the presence of anti-β2GPI IgG, along with other antiphospholipid antibodies like lupus anticoagulant and anti-cardiolipin antibodies.
Optimal range: 0 - 33 SMU
Anti-Beta2 Glycoprotein I IgM antibodies are a critical serological marker in the field of immunology and hematology, particularly in the diagnosis and management of antiphospholipid syndrome (APS). Beta2 Glycoprotein I, a phospholipid-binding plasma protein, plays a pivotal role in the coagulation process. The presence of IgM autoantibodies against Beta2 Glycoprotein I indicates an autoimmune response that can interfere with the normal coagulation pathway, leading to an increased risk of thrombosis. These autoantibodies are a subset of antiphospholipid antibodies, which also include anti-cardiolipin antibodies and lupus anticoagulant. In the clinical context, the detection of Anti-Beta2 Glycoprotein I IgM is significant for the diagnosis of APS, particularly in patients presenting with unexplained blood clots (thrombosis) or recurrent pregnancy loss, both of which are hallmark features of APS.
FU Female FMV Urine Comprehensive Hormone
The "FU Female FMV Urine Comprehensive Hormone" test by Physicians Lab is a specialized diagnostic tool designed for comprehensive hormone analysis in women. This test evaluates a wide range of hormonal levels through a female morning void (FMV) urine sample, offering a detailed insight into a woman's hormonal balance. It measures key hormones such as estrogen, progesterone, testosterone, cortisol, and their metabolites, which are crucial in understanding various aspects of women's health. This test is particularly beneficial for diagnosing and managing conditions like hormonal imbalances, menopause, premenstrual syndrome (PMS), and fertility issues. By providing an extensive profile of hormone levels, the test aids healthcare providers in developing personalized treatment plans, including hormone replacement therapy or other interventions tailored to the patient's specific hormonal needs. The convenience of using a urine sample makes this test a non-invasive option for patients, offering a comprehensive hormonal assessment with ease and comfort.
Optimal range: 0 - 1.43 ng/mg CR
16α-Hydroxyestrone serves as an important indicator of estrogen metabolism pathways in the body. This compound is a metabolite of estrone (E1), formed through the hydroxylation process at the 16th carbon of the steroid structure. The balance of 16α-Hydroxyestrone, relative to other estrogen metabolites, is particularly significant in assessing hormonal health and the risk of estrogen-related disorders.
Elevated levels of this metabolite are often linked to an increased risk of estrogen-sensitive conditions, such as certain types of breast and endometrial cancers. This is because 16α-Hydroxyestrone is a potent estrogen metabolite that can bind to estrogen receptors, potentially stimulating cellular proliferation in estrogen-sensitive tissues.
Optimal range: 2 - 8.4 ng/mg CR
2-Hydroxyestrone is a metabolite of estrogen and is often referred to as a "good" estrogen due to its relatively benign nature compared to other estrogen metabolites. The significance of 2-Hydroxyestrone lies in its role in the 2-hydroxylation pathway, one of the primary routes through which the body metabolizes estrogens. This metabolite is considered to have weaker estrogenic activity and is associated with a reduced risk of estrogen-related cancers, such as breast cancer, in contrast to other pathways that produce more potent and potentially harmful estrogen metabolites.
Optimal range: 3.1 - 15.8 ng/mg CR
2-Methoxyestrone is a key marker in the "FU Female FMV Urine Comprehensive Hormone" panel by Physicians Lab, playing a pivotal role in the assessment of estrogen metabolism and overall hormonal balance in women. It is a metabolite of estrone, one of the primary forms of estrogen in the body. The significance of 2-Methoxyestrone lies in its role as an indicator of how estrogen is being processed and metabolized within the body. This metabolite is often considered a "good" estrogen metabolite because it's associated with a lower risk of estrogen-related pathologies, including certain types of breast cancer.
Optimal range: 0 - 1.2 ng/mg CR
4-Hydroxyestrone is a crucial estrogen metabolite measured in the "FU Female FMV Urine Comprehensive Hormone" panel, offering significant insights into estrogen metabolism and women's health. This metabolite is one of the three primary pathways through which estrone, a form of estrogen, is metabolized in the body. The significance of 4-Hydroxyestrone lies in its biological activity and potential implications for health risks, particularly in relation to estrogen-sensitive conditions such as breast cancer.
Optimal range: 26 - 338 ng/mg CR
Alpha-Pregnanediol, a key biomarker in the FU Female FMV Urine Comprehensive Hormone panel, is a metabolite of progesterone, an essential hormone in female reproductive health. Scientifically, alpha-pregnanediol is a progestogen, a substance that plays a crucial role in the menstrual cycle, pregnancy, and embryogenesis. In the context of the urine hormone panel, the measurement of alpha-pregnanediol provides vital insights into the body's progesterone levels, as it is a direct byproduct of progesterone metabolism.
Optimal range: 0.5 - 1.5 ng/mg CR
The Anabolic/Catabolic Ratio is a critical marker that offers insight into the overall balance between anabolic (building and repairing) and catabolic (breaking down) metabolic processes in the body. This ratio is determined by comparing the levels of specific hormones and metabolites that are indicative of anabolism, such as DHEA (Dehydroepiandrosterone) and growth hormone metabolites, against those indicative of catabolism, like cortisol and its metabolites. An optimal balance between anabolic and catabolic processes is crucial for maintaining health, as it influences muscle strength, bone density, recovery from exercise, and overall energy levels.
An imbalance in this ratio, skewed towards catabolism, can signify a state of increased breakdown, often associated with stress, overtraining, poor nutrition, or illness. This state can lead to symptoms such as fatigue, muscle weakness, slow recovery from exercise, and poor general health. On the other hand, a shift towards anabolism, although necessary for growth and repair, when excessive, can indicate conditions like insulin resistance or abnormal growth hormone levels.
Optimal range: 147 - 593 ng/mg CR
Androsterone is a metabolite of androgens, crucial for evaluating hormonal balance in women. Chemically classified as a 17-ketosteroid, androsterone is primarily a breakdown product of testosterone, but it can also be derived from other androgens. In women, the measurement of androsterone in a morning void urine sample offers valuable insights into androgenic activity, which plays a vital role in various physiological processes, including libido, energy levels, and overall well-being.
Optimal range: 38 - 507 ng/mg CR
The marker "Average DHEA-S" (Dehydroepiandrosterone Sulfate) is a critical indicator of adrenal gland function and overall androgen status in women. DHEA-S, a sulfated form of DHEA, is one of the most abundant circulating steroids in the human body and serves as a precursor for both androgens and estrogens. It is predominantly produced in the adrenal glands, with its levels reflecting adrenal function.
Elevated levels of DHEA-S can be associated with conditions like polycystic ovary syndrome (PCOS), adrenal hyperplasia, or adrenal tumors, and can lead to symptoms such as hirsutism, acne, and menstrual irregularities. On the other hand, low levels of DHEA-S might indicate adrenal insufficiency, aging, or chronic stress, which can manifest in fatigue, weakness, and decreased libido.
Optimal range: 201 - 1669 ng/mg CR
Beta-Pregnanediol is a crucial metabolic byproduct of progesterone, one of the primary female sex hormones. Scientifically, Beta-Pregnanediol is a progesterone metabolite, which means it is formed when the body breaks down progesterone. Its measurement in urine provides valuable insights into the body's progesterone levels. Progesterone plays a vital role in the menstrual cycle, pregnancy, and overall reproductive health.
Optimal range: 1600 - 12474 ng/mg CR
Beta-Pregnanediol, when measured in conjunction with oral progesterone supplementation serves as a critical marker for assessing the efficacy and metabolic impact of progesterone therapy. This particular metabolite of progesterone, excreted predominantly in urine, provides insight into the body's utilization and processing of administered progesterone. In the context of hormone replacement therapy or treatment for menstrual irregularities, fertility issues, or menopausal symptoms, monitoring Beta-Pregnanediol levels can be instrumental in determining the appropriate dosing and effectiveness of oral progesterone.
Optimal range: 0 - 3.2 ng/mg CR
Dihydrotestosterone (DHT) is a key androgenic marker providing critical insights into androgen metabolism and its implications in female health. DHT, a biologically active metabolite of testosterone, is formed primarily in peripheral tissues through the action of the enzyme 5-alpha-reductase. Despite being commonly associated with male physiology, DHT plays a significant role in women, particularly in hair follicle health, skin condition, and overall hormonal balance. Elevated levels of DHT in women can lead to androgenic effects such as hirsutism (excessive hair growth in areas typical for males), acne, and in some cases, androgenic alopecia (pattern hair loss). These symptoms are often observed in conditions like polycystic ovary syndrome (PCOS), which is characterized by an overproduction of androgens.
Optimal range: 0.8 - 3.3 ng/mg CR
Estradiol (E2) is critical for assessing the estrogenic activity and hormonal balance in women. Estradiol, the most potent of the three major estrogens (which also include estrone and estriol), plays a pivotal role in female reproductive health, influencing the menstrual cycle, fertility, and secondary sexual characteristics.
Estradiol is primarily produced by the ovaries in premenopausal women and, to a lesser extent, by adipose tissue and the adrenal glands. Its production is stimulated by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In postmenopausal women, estradiol levels significantly decrease due to diminished ovarian function, with a relative increase in the importance of peripheral sources like adipose tissue for its production.
Optimal range: 0 - 0 ng/mg CR
Optimal range: 1.7 - 8.5 ng/mg CR
Estrone (E1) is a significant estrogenic marker providing crucial insights into a woman's estrogen metabolism and overall hormonal balance. Estrone, primarily a product of peripheral aromatization of androstenedione, is one of the three major naturally occurring estrogens, alongside estradiol (E2) and estriol (E3).
In premenopausal women, estrone levels typically fluctuate with the menstrual cycle, whereas in postmenopausal women, it becomes the predominant form of estrogen, primarily produced in adipose tissue.
Optimal range: 6.1 - 17.3 ng/mg CR
The marker Free Dehydroepiandrosterone (Free DHEA) is a crucial indicator of adrenal gland function and overall androgen status in women. DHEA, a naturally occurring steroid hormone, is primarily produced by the adrenal glands and is a precursor to both estrogens and androgens, including testosterone. In the context of the comprehensive hormone panel, measuring Free DHEA in urine provides valuable insights into the body's unbound and bioavailable DHEA, as opposed to total DHEA levels which include both bound and free forms. This distinction is important because it is the free form of DHEA that is biologically active and capable of influencing physiological processes.
Elevated levels of Free DHEA can be indicative of adrenal hyperactivity or an adrenal tumor, and they are often associated with conditions such as polycystic ovary syndrome (PCOS), where there is an excess of androgens. Symptoms of high DHEA levels include acne, hirsutism (excessive hair growth in areas where hair is normally minimal or absent), and irregular menstrual cycles. On the other hand, low levels of Free DHEA might suggest adrenal insufficiency, which can lead to symptoms such as fatigue, muscle weakness, and mood disturbances.
Optimal range: 2.3 - 7.8 ng/mg CR
Testosterone, a key androgen hormone typically associated with male physiology, plays a significant role in female health. In women, testosterone is produced in the ovaries, adrenal glands, and peripheral tissues, and it contributes to muscle strength, bone density, and sexual function. The urinary measurement of testosterone offers insights into the body's hormonal balance. Elevated levels of testosterone in females can be indicative of conditions such as polycystic ovary syndrome (PCOS), adrenal hyperplasia, or ovarian tumors. Conversely, low levels may be associated with reduced libido, fatigue, muscle weakness, and osteoporosis. It's important to interpret urinary testosterone levels in conjunction with other hormones, particularly estrogen and progesterone, to accurately assess overall hormonal health and diagnose any underlying conditions. This comprehensive approach allows for a more nuanced understanding of a woman's endocrine function and helps in tailoring specific treatment strategies in functional medicine.
Optimal range: 0 - 0 ng/mg CR
Optimal range: 30 - 130 ng/mg CR
The marker "Total Estrogen Load" in a FU Female FMV Urine Comprehensive Hormone Panel is a critical measure for assessing the overall estrogenic activity in a woman's body. This comprehensive assessment quantifies the cumulative levels of estrogens, including estrone (E1), estradiol (E2), and estriol (E3), over an entire menstrual cycle.
Estrogens are key hormones in female reproductive health, influencing menstrual cycle regulation, fertility, and secondary sexual characteristics. In a clinical setting, analyzing the total estrogen load is vital for diagnosing and managing conditions such as estrogen dominance, where there is an imbalance between estrogen and progesterone levels, often leading to symptoms like irregular menstrual cycles, fibrocystic breasts, mood swings, and weight gain.
Optimal range: 7 - 31 ng/mg CR
The marker "Waking Cortisol" is an essential indicator of adrenal gland function and stress response. Cortisol, often referred to as the "stress hormone," is produced by the adrenal cortex and plays a pivotal role in numerous physiological processes, including metabolism regulation, immune response modulation, and maintenance of blood pressure. Normally, cortisol levels follow a diurnal rhythm, peaking in the early morning shortly after waking (which is why the measurement of "Waking Cortisol" is significant) and gradually declining throughout the day. This peak is part of the body's natural preparation for the day ahead, known as the cortisol awakening response (CAR).
The Lymphocyte MAP
FEATURES
Unique Immunotypes for Comprehensive Insights
Advanced Th1/Th2 Balance Analysis (Immunotypes 6 & 7)
Regulatory T Cells (Tregs, Immunotype 8)
Th17 Dominance (Immunotype 9)
Natural Killer (NK) Cell Patterns (Immunotypes 12 & 13)
CD57+ NK Cells and Their Role (Immunotype 14)
CLINICAL USES
Why Choose the Lymphocyte MAP™ by Cyrex Laboratories?
The Lymphocyte MAP™ is an advanced, comprehensive diagnostic panel designed to assess the immune system's functionality and integrity at the cellular level. By analyzing 29 key lymphocyte biomarkers, including Th1, Th2, Treg, Th17, and various NK cell types, this test provides a detailed overview of immune health.
Key features include:
This test is ideal for:
By providing healthcare practitioners with actionable insights, the Lymphocyte MAP™ supports tailored treatment strategies to restore immune balance and improve patient outcomes.
Maximize your immune health with the Lymphocyte MAP™ by Cyrex Laboratories—the gold standard in immune system evaluation.
Optimal range: 6 - 18 %
B cells, also known as B lymphocytes, are a crucial component of the adaptive immune system. They function primarily by producing antibodies against antigens, which are substances recognized as foreign by the immune system. These antibodies are specific proteins that can directly neutralize invaders or tag them for destruction by other parts of the immune system. The "% B Cell" marker is thus an important indicator of the body's ability to mount an effective humoral immune response.
Optimal range: 1.6 - 6.2 %
Optimal range: 1.5 - 9.2 %
The % CD57+ CD16+ NK marker represents the proportion of Natural Killer (NK) cells in the blood that express the CD57 and CD16 surface proteins. These proteins are associated with the maturation and functionality of NK cells, making this marker an important indicator of immune health and activity.
These cells play a critical role in the immune system by:
Optimal range: 2.5 - 15.8 %
The marker % CD57+ CD8+ T cells provides insightful data into an individual's immune status, specifically reflecting the subset of natural killer T cells (NKT-like cells) that exhibit both CD57 and CD8 markers.
CD57, a marker for terminal differentiation, is expressed on a subset of T cells that have undergone extensive proliferation and are associated with senescence and a high degree of cytotoxic potential.
CD8+ T cells, on the other hand, are crucial components of the adaptive immune system, responsible for directly killing infected or cancerous cells.
The co-expression of CD57 on CD8+ T cells marks a highly differentiated cell population with potent cytotoxic function but reduced proliferative capacity.
Optimal range: 10 - 30 %
The % Cytotoxic (CD8) T Cell marker reflects the proportion of CD8+ T cells among total lymphocytes or T-helper cells. CD8+ T cells, also known as cytotoxic T lymphocytes (CTLs), are a critical component of the adaptive immune system. Their primary role is to directly attack and destroy infected, cancerous, or damaged cells, particularly those harboring intracellular pathogens like viruses.
CD8+ T cells are activated upon recognizing antigens presented by MHC Class I molecules on the surface of target cells. Once activated, they release cytotoxic granules containing perforin and granzymes, which induce apoptosis in the target cells.
Optimal range: 2 - 10 %
The percentage of Cytotoxic NK (Natural Killer) cells expressing CD16+. CD16+, also known as FcγRIII, is a low affinity receptor for the Fc region of immunoglobulins G (IgG), found on the surface of NK cells, and plays a pivotal role in antibody-dependent cellular cytotoxicity (ADCC). This mechanism is crucial for the immune system's ability to target and eliminate cells that are infected by pathogens or transformed malignantly.
Optimal range: 20 - 40 %
The % Lymphocyte marker reflects the proportion of lymphocytes within the total white blood cell (WBC) count. Lymphocytes are a key component of the immune system and play a vital role in protecting the body from infections, cancer, and other immune challenges. They are categorized into three main types:
T Lymphocytes (T cells):
B Lymphocytes (B cells):
Natural Killer (NK) Cells:
Optimal range: 3 - 15 %
The marker "% NK Cell (CD56+)" signifies the percentage of natural killer (NK) cells that express the CD56 antigen, a pivotal component in the assessment of immune health and functionality. NK cells, a critical subset of lymphocytes in the innate immune system, play a crucial role in the body's first line of defense against tumors and various infections.
Optimal range: 1 - 6 %
The % NKT (CD56+ CD16+ T Cell) marker measures the proportion of natural killer T (NKT) cells within the total lymphocyte population. NKT cells are a unique subset of immune cells that share characteristics of both T lymphocytes and natural killer (NK) cells. They express markers typically associated with NK cells (CD56 and CD16) and play a pivotal role in bridging the innate and adaptive immune systems.
These cells are involved in:
Optimal range: 1.8 - 3.3 %
The % Regulatory T Cell (Treg) marker on the Lymphocyte MAP™ panel represents the proportion of Tregs within the total lymphocyte population. Regulatory T cells (Tregs) are a specialized subset of CD4+ T-helper cells critical for maintaining immune system balance and preventing autoimmune reactions. They achieve this by suppressing excessive immune responses and promoting tolerance to self-antigens.
Optimal range: 46 - 82 %
The "% T Cell" marker refers to the percentage of T cells in the lymphocyte population of the blood. T cells, a type of white blood cell, are central to the adaptive immune response, playing a pivotal role in immune regulation and response to pathogens.
If the T cell percentage is high with normal or low B cells, or if there are normal T cell levels with low B cell counts, it may indicate a T cell dominance (Immunotype 2). This condition can be associated with immune dysregulation, including hypersensitivities, allergies, and certain autoimmune disorders. Conversely, a low % T Cell could suggest issues with bone marrow, lymph nodes, and other lymphoid organs, and is observed in conditions like viral infections, including HIV and COVID-19.
Optimal range: 28 - 55 %
The marker % T-Helper (CD4) Cell is a critical parameter for assessing immune system health and functionality. T-Helper cells, also known as CD4+ cells, are a subset of lymphocytes that play a vital role in the immune response by activating and directing other immune cells. They are essential for both the cell-mediated and humoral branches of the adaptive immune system.
The percentage of T-Helper cells is particularly significant as it reflects the body's capacity to mount an effective immune response against pathogens, support the production of antibodies by B cells, and regulate the activity of cytotoxic T cells and other immune cells. An imbalance in the % T-Helper (CD4) Cell count, whether elevated or decreased, can indicate immune dysregulation, which may manifest in autoimmune diseases, immunodeficiency disorders, or an increased susceptibility to infections.
Optimal range: 18 - 34 %
The % T-Helper-1 (TH1) Cell marker measures the proportion of TH1 cells among total lymphocytes or T-helper cells (CD4+). TH1 cells are a subset of CD4+ T-helper cells that drive cell-mediated immunity, crucial for defending against intracellular pathogens (e.g., viruses, certain bacteria) and for orchestrating the immune system's response to cancer cells.
TH1 cells primarily produce pro-inflammatory cytokines, such as interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), and interleukin-2 (IL-2). These cytokines activate macrophages, cytotoxic T cells, and natural killer (NK) cells, enhancing the immune system's ability to destroy infected or abnormal cells.
Optimal range: 2.5 - 6.2 %
The % T-Helper-17 (Th17) marker plays an important role in the evaluation of the immune system's state, particularly in the context of inflammation and autoimmunity. Th17 cells, a subset of T-helper cells, are primarily known for their involvement in inflammatory responses and their role in autoimmune diseases. They function by producing interleukin-17 (IL-17) and other pro-inflammatory cytokines, which are critical in the body's defense against certain pathogens, especially at mucosal barriers. However, dysregulation or overactivity of Th17 cells can contribute to the pathogenesis of various autoimmune and inflammatory conditions.
Elevated levels of Th17 cells can indicate a predisposition towards certain autoimmune conditions, such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease, among others. Conversely, a reduction in Th17 levels might be indicative of compromised mucosal immunity.
Optimal range: 3.2 - 6.6 %
The % T-Helper-2 Cell marker is a critical component in evaluating immune system functionality, particularly in the context of immune system balance and potential disorders. T-Helper-2 cells, often denoted as Th2 cells, are a subtype of T cells that play a significant role in the immune system's humoral immunity response. These cells are primarily involved in stimulating B cells to produce antibodies, especially in response to extracellular pathogens such as parasites and bacteria.
The % T-Helper-2 Cell marker is used to assess the balance between Th1 and Th2 cells, which is essential for maintaining immune system homeostasis. A disproportionate increase in Th2 cells, often indicated by a higher percentage in the panel, is associated with certain immunological conditions. Specifically, Th2 dominance may result in heightened responses to allergens, contributing to allergic reactions, asthma, and other atopic disorders. It can also be implicated in certain autoimmune diseases where an overactive humoral response is observed.
Optimal range: 1 - 4 Ratio
The CD4/CD8 ratio is a critical marker of immune system health. It measures the balance between CD4+ T-helper cells and CD8+ cytotoxic T cells, two major subtypes of T lymphocytes. These cells play complementary roles in immune defense:
The ratio is calculated by dividing the absolute count of CD4+ cells by that of CD8+ cells, and it provides insight into the state of immune regulation, activation, and balance.
Optimal range: 4 - 11 Ratio
The T Cell/B Cell Ratio is a sophisticated biomarker indicative of the adaptive immune system's balance and functionality. This ratio compares the quantity of T cells, which are primarily responsible for cell-mediated immunity, to B cells, which are central to humoral immunity through antibody production.
Optimal range: 1 - 5 Ratio
The TH1/TH2 ratio measures the balance between T-helper type 1 (TH1) and T-helper type 2 (TH2) cells. These are subsets of CD4+ T-helper cells that regulate the immune system by driving different types of immune responses:
The TH1/TH2 ratio reflects the overall immune system balance:
Optimal range: 1 - 3 Ratio
The Th17/Treg ratio is a critical marker offering significant insights into the immune system's regulatory mechanisms. Th17 cells (T-helper 17) and Treg cells (regulatory T cells) represent two distinct subsets of CD4+ T cells with opposing functions in the immune response.
Th17 cells are pro-inflammatory and play a crucial role in the body's defense against pathogens and in the pathogenesis of various autoimmune and inflammatory diseases. They are characterized by the production of interleukin-17 (IL-17) and other inflammatory cytokines.
On the other hand, Treg cells are responsible for maintaining immune tolerance and preventing autoimmune responses by suppressing the activity of effector T cells, including Th17 cells.
Optimal range: 90 - 400 cells/uL
The Total B Cell marker is a critical indicator used to assess the status of B cells within the immune system.
B cells, also known as B lymphocytes, play a pivotal role in the adaptive immune response, primarily responsible for the production of antibodies that neutralize pathogens and facilitate their removal by other immune cells. The Total B Cell marker quantifies the overall population of B cells, providing insights into the body's capability to mount an effective humoral immune response.
In the context of autoimmune conditions, an altered level of B cells can indicate dysregulation in the immune system, potentially leading to or exacerbating autoimmune reactivity. By evaluating this marker within the comprehensive Lymphocyte MAP panel, clinicians can gain a nuanced understanding of the patient's immune landscape, including potential autoimmune triggers and the balance between different lymphocyte populations.
Optimal range: 45 - 144 cells/uL
The Total CD3- CD57+ Lymphocyte marker is offering insights into the immune system's state, particularly in the context of chronic infections and certain health conditions. This marker focuses on a subset of lymphocytes that are characterized by the absence of the CD3 marker and the presence of the CD57 marker. These lymphocytes are significant in immunophenotyping, a process that categorizes lymphocytes based on their surface markers, which in turn helps in understanding the immune system's response to various conditions.
Optimal range: 25 - 162 cells/uL
Natural Killer (NK) cells are a type of immune cell critical for identifying and destroying virus-infected cells and cancerous cells. The subset of NK cells marked as CD57+ CD16+ is involved in regulating immune responses and maintaining long-term immune surveillance.
These cells are often associated with the maturation and functionality of NK cells. CD57 is a marker of late-stage, terminally differentiated NK cells, while CD16 contributes to the activation of NK cells, allowing them to destroy target cells effectively.
This test measures the total number of CD57+ CD16+ NK cells in your blood. These cells are key players in:
Optimal range: 30 - 317 cells/uL
The Total CD57+ CD8+ T Cell marker plays a crucial role in immunological assessments. This marker is particularly significant because CD57+ CD8+ T cells are a subset of natural killer T cells (NKT cells) and cytotoxic T cells, which are integral components of the body's immune response. These cells are characterized by the expression of the CD57 and CD8 markers on their surface.
CD57 is a marker often associated with terminal differentiation, senescence, and memory in various immune cells, including NK cells and T cells. In the context of CD8+ T cells, CD57 expression signifies a highly differentiated state. These cells are known for their potent effector functions, especially in cytotoxic responses, which are essential in controlling viral infections and tumor surveillance.
Optimal range: 200 - 500 cells/uL
Optimal range: 30 - 200 cells/uL
Total Cytotoxic NK (Natural Killer) cells, identified by the CD16+ marker, represent a crucial component in the innate immune system, playing a significant role in the body's first line of defense against tumors and virally infected cells.
NK cells, characterized by their expression of the CD16 surface marker, are involved in the direct killing of target cells without the need for prior sensitization, distinguishing them from other lymphocytes that require antigen presentation. They are pivotal in controlling early responses to infection and malignancy through the release of cytolytic granules that induce apoptosis in target cells.
Optimal range: 1000 - 4000 cells/uL
Optimal range: 60 - 220 cells/uL
Total NK cells (CD56+) represent a critical subset of lymphocytes pivotal for innate immunity, providing the first line of defense against tumors and a variety of pathogens. Natural Killer (NK) cells are characterized by their expression of the CD56 surface marker, distinguishing them from other lymphocyte subsets. The significance of measuring Total NK cells (CD56+) in this panel lies in their role in immune surveillance and early immune responses.
Optimal range: 10 - 120 cells/uL
The Total NKT (CD56+ CD16+ T Cell) marker measures the absolute count of natural killer T (NKT) cells in the blood. NKT cells are a specialized group of immune cells that share characteristics of both T lymphocytes (adaptive immunity) and natural killer (NK) cells (innate immunity). They play a crucial role in immune defense, inflammation regulation, and the body’s response to infections and tumors.
NKT cells express CD56 and CD16, markers typically associated with NK cells, along with T-cell receptors (TCRs). They are involved in:
Optimal range: 15 - 45 cells/uL
Total Regulatory T cells (Treg) serve as a crucial marker for understanding immune regulation and potential autoimmune dysregulation within the body. Tregs, a subset of T cells characterized by the expression of CD4, CD25, and the transcription factor FoxP3, play an essential role in maintaining immune tolerance by suppressing the activation and proliferation of effector T cells that could otherwise attack self-antigens and cause autoimmune disease.
Optimal range: 440 - 1600 cells/uL
Optimal range: 500 - 1100 cells/uL
Optimal range: 150 - 530 cells/uL
The Total T-Helper-1 Cell marker serves as a critical component in the evaluation of immune system functionality, particularly in the adaptive immune response. T-Helper-1 (Th1) cells are a subset of CD4+ T cells, which are pivotal in orchestrating the body's defense against intracellular pathogens, such as viruses and certain bacteria, by producing a specific profile of cytokines, including interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), and interleukin-2 (IL-2).
These cytokines not only help in the activation of macrophages and the enhancement of their phagocytic activity but also play a crucial role in promoting the differentiation of CD8+ T cells into cytotoxic T lymphocytes, thereby aiding in the clearance of infected cells.
Optimal range: 35 - 80 cells/uL
The Total T-Helper-17 (Th17) marker is a critical component in evaluating immune system functionality, particularly in the context of immune response regulation. T-Helper 17 (Th17) cells, a subset of pro-inflammatory T-helper cells, play a pivotal role in the immune system, primarily involved in the defense against pathogens and in the pathogenesis of various autoimmune and inflammatory diseases.
The Th17 marker is crucial for understanding the dynamics of immune responses, especially in conditions where the immune system may be overactive or imbalanced. Th17 cells produce interleukin-17 (IL-17), a cytokine that triggers inflammation and has been linked to the pathogenesis of several autoimmune and inflammatory conditions, including psoriasis, rheumatoid arthritis, and inflammatory bowel disease. Elevated levels of Th17 cells can signify a heightened inflammatory state, suggesting a predisposition or existing condition of autoimmunity or chronic inflammation.
Optimal range: 39 - 120 cells/uL
Total T-Helper-2 (Th2) cells are a subset of the CD4+ T cells, playing a pivotal role in the adaptive immune response. They are characterized by their function in helping B cells to produce antibodies and are crucial in the defense against extracellular pathogens, such as bacteria and parasites. This evaluation is particularly relevant in the context of allergic responses, autoimmune disorders, and chronic inflammatory conditions, where a shift towards a Th2-dominant response can indicate an imbalance in immune regulation.
The measurement of Th2 cells within this panel provides insights into the Th1/Th2 balance, an essential aspect for understanding various pathological conditions and guiding therapeutic strategies. By monitoring Th2 levels, healthcare providers can gain valuable information about an individual's immune status, facilitating personalized medical interventions aimed at restoring immune equilibrium and mitigating disease progression.
Optimal range: 4000 - 11000 cells/uL
The Total WBC (White Blood Cell) count measures the total number of white blood cells present in the blood, which are essential components of the immune system. White blood cells are responsible for defending the body against both infectious disease and foreign materials.
In the context of the Lymphocyte MAP panel, the Total WBC count serves as a foundational assessment of the immune system's overall state. A normal range of WBC indicates a balanced immune response, whereas deviations from this range can signal various health conditions. For instance, a higher than normal WBC count (leukocytosis) can indicate an inflammatory response, infection, stress, or more serious conditions like leukemia. Conversely, a lower than normal count (leukopenia) can suggest a compromised immune system, potentially due to bone marrow deficiencies, autoimmune disorders, or the effects of certain medications.
Cortisol Awakening Response (CAR)
The Cortisol Awakening Response (CAR) test is a non-invasive saliva test that serves as a reliable marker of stress response and a critical tool for revealing adrenal imbalances. Lifestyle, physical and psychological stresses put constant demands on the adrenal glands. If they become depleted adrenal fatigue or insufficiency may be experienced.
The Cortisol Awakening Response (CAR) test is a unique assessment measuring the predictable rise and fall in cortisol within the first hour of awakening. The test is essential in evaluating the overall function of the HPA axis. In this particular test we measure cortisol immediately on rising, 30 minutes post waking, 60 minutes post waking, 12:00 (noon), 4:00pm and 8:00pm.
The CAR test allows your physician to determine how healthy your HPA axis is which useful in assessing the HPA-axis.
The CAR test is an appropriate tool in practice for most of your patients as it provides an easy assessment of their ability to deal with stressors and is also reflective of how well they have dealt with stressors in the past.
Analytes:
- Cortisol (on waking)
- Cortisol +30 mins
- Cortisol +60mins
- Cortisol 12:00noon
- Cortisol 4:00pm
- Cortisol 8:00pm
- DHEAs
CORTISOL AWAKENING RESPONSE:
The cortisol awakening response (CAR) test is a transient, immediate rise in cortisol upon awakening and is distinct from the diurnal rhythm. In a normal individual without significant stressors, cortisol is highest in the morning shortly after awakening, rises by up to 60% roughly 30 minutes after awakening, then steadily drops throughout the day, reaching the lowest level during sleep in the very early morning about 2 am. A loss of the expected curve with its characteristic morning peak and steady decline towards evening may suggest HPA axis dysfunction.
CAR RISE RESPONSE WITHIN NORMAL RANGE:
The rise in Cortisol from waking to 30 minutes post-waking is within normal range. This indicates normal Cortisol production/metabolism.
CAR DECLINE RESPONSE WITHIN NORMAL RANGE:
The decline in Cortisol from waking to 60 minutes post-waking is within normal range.
This is consistent with normal Cortisol production/metabolism.
LOW/LOW NORMAL MIDDAY CORTISOL LEVEL:
Midday Cortisol level is below mean range and suggestive of adrenal insufficiency. This suggests suboptimal adrenal functioning, and if accompanied by low evening cortisol and low DHEA, suspect adrenal fatigue. Suggest supplementation with DHEA and standard adrenal support.
LOW/LOW NORMAL LATE AFTERNOON:
Late afternoon cortisol level insufficiency. This suggests by low evening cortisol and low DHEA, suspect adrenal fatigue. Suggest supplementation with DHEA and standard adrenal support.
EVENING CORTISOL LEVEL WITHIN RANGE:
Saliva evening cortisol level is normal and within range.
References:
Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res. 2002 Oct;53(4):865-71. doi: 10.1016/s0022-3999(02)00429-4. PMID: 12377295. [L]
Fries E, Dettenborn L, Kirschbaum C. The cortisol awakening response (CAR): facts and future directions. Int J Psychophysiol. 2009 Apr;72(1):67-73. doi: 10.1016/j.ijpsycho.2008.03.014. Epub 2008 Sep 30. PMID: 18854200. [L]
Clow A, Hucklebridge F, Stalder T, Evans P, Thorn L. The cortisol awakening response: more than a measure of HPA axis function. Neurosci Biobehav Rev. 2010 Sep;35(1):97-103. doi: 10.1016/j.neubiorev.2009.12.011. Epub 2009 Dec 22. PMID: 20026350. [L]
Hackett RA, Kivimäki M, Kumari M, Steptoe A. Diurnal Cortisol Patterns, Future Diabetes, and Impaired Glucose Metabolism in the Whitehall II Cohort Study. J Clin Endocrinol Metab. 2016 Feb;101(2):619-25. doi: 10.1210/jc.2015-2853. Epub 2015 Dec 8. PMID: 26647151; PMCID: PMC4880118. [L]
Hammer F, Deutschbein T, Marx A, Güder G, Michalski R, Ertl G, Allolio B, Angermann CE, Störk S, Fassnacht M. High evening salivary cortisol is an independent predictor of increased mortality risk in patients with systolic heart failure. Int J Cardiol. 2016 Jan 15;203:69-73. doi: 10.1016/j.ijcard.2015.10.084. Epub 2015 Oct 20. PMID: 26492313. [L]
Optimal range: 0 - 33 %
The CAR Decline Response is a significant indicator of the hypothalamic-pituitary-adrenal (HPA) axis functionality and reflects the body's response to stress. Cortisol, a glucocorticoid hormone produced by the adrenal cortex, plays a crucial role in various physiological processes, including metabolism regulation, immune response modulation, and stress response. Upon waking, cortisol levels typically surge, peaking within the first 30 to 45 minutes, and then gradually decline throughout the day, following a diurnal rhythm. This initial spike, or the CAR, is thought to be associated with the anticipation of the upcoming day's challenges and is influenced by various factors such as sleep quality, psychosocial stressors, and underlying health conditions.
Optimal range: 35 - 60 %
The "CAR (Cortisol Awakening Response) Rise Response" is a physiological phenomenon observed in the hypothalamic-pituitary-adrenal (HPA) axis, reflecting the body's reaction to stress and its regulatory mechanisms of stress hormones, primarily cortisol.
Upon awakening, a marked increase in cortisol levels is typically observed, peaking within the first 30 to 45 minutes after waking. This response is thought to be an adaptive mechanism that prepares the body for the anticipated demands of the day, enhancing alertness and mobilizing energy resources. The magnitude and pattern of the CAR can be influenced by various factors, including sleep quality, psychosocial stressors, and underlying health conditions. Scientific studies have utilized the CAR as a biomarker for assessing HPA axis function and its dysregulation in stress-related disorders, such as chronic fatigue syndrome, depression, and post-traumatic stress disorder (PTSD).
Optimal range: 2 - 11 nmol/L
Cortisol, a glucocorticoid hormone synthesized from cholesterol in the adrenal cortex, plays a pivotal role in the human body's response to stress, metabolism regulation, immune response modulation, and maintenance of homeostasis. The "Cortisol Profile, Afternoon" specifically refers to the measurement of cortisol levels during the afternoon hours, a critical time point given cortisol's diurnal variation. Typically, cortisol levels peak in the early morning, shortly after waking, and decline throughout the day to reach their lowest levels at midnight. However, the afternoon cortisol levels are not merely an intermediate point in this daily cycle; they provide valuable insights into an individual's adrenal function and stress response.
Optimal range: 1 - 8 nmol/L
The marker "Cortisol Profile, Evening" refers to the measurement of cortisol levels in the body during the evening hours, typically reflecting the end-of-day physiological status of an individual's hypothalamic-pituitary-adrenal (HPA) axis function. Cortisol is a glucocorticoid hormone produced by the adrenal cortex, playing a pivotal role in stress response, metabolism regulation, immune response modulation, and circadian rhythm maintenance. In a healthy individual, cortisol levels exhibit diurnal variation—peaking in the early morning shortly after awakening and declining throughout the day to reach its lowest level at night.
Optimal range: 4 - 14 nmol/L
The cortisol profile, particularly measurements taken at midday, provides significant insights into the diurnal pattern of cortisol secretion, which is critical for assessing adrenal gland function and the body's response to stress. Cortisol, a glucocorticoid hormone produced by the adrenal cortex, plays a pivotal role in glucose metabolism, immune response regulation, and stress response. The hypothalamic-pituitary-adrenal (HPA) axis governs its production, with cortisol levels exhibiting a diurnal rhythm—peaking in the early morning hours shortly after awakening and declining throughout the day to reach their lowest levels at night. Midday cortisol levels, therefore, offer a snapshot of the descending limb of this diurnal curve and can be indicative of alterations in HPA axis activity.
Optimal range: 19 - 81 nmol/L
The cortisol profile, specifically Total Cortisol Awakening Response (CAR), is a critical marker in the scientific understanding of stress response and adrenal function in humans. Cortisol, a glucocorticoid hormone produced by the adrenal cortex, plays a pivotal role in various physiological processes, including metabolism regulation, immune response modulation, and stress response. The Total CAR refers to the overall increase in cortisol concentration within the first 30 to 45 minutes after awakening. This response is a dynamic indicator of the hypothalamic-pituitary-adrenal (HPA) axis functionality, providing insights into an individual's stress reactivity and resilience.
Optimal range: 12 - 48 nmol/L
The Cortisol Profile, Waking marker refers to the pattern of cortisol secretion within the first hour after waking up. Cortisol is a glucocorticoid hormone produced by the adrenal cortex, playing a pivotal role in the human body's response to stress, metabolism regulation, immune response modulation, and maintenance of homeostasis. The waking cortisol profile is characterized by a sharp increase in cortisol levels upon awakening, known as the cortisol awakening response (CAR). This response is a part of the circadian rhythm of cortisol secretion, which generally follows a diurnal pattern, peaking in the early morning hours and gradually declining throughout the day to reach its lowest point at night.
Optimal range: 12 - 48 nmol/L
The cortisol profile, specifically the measurement of cortisol levels at waking and again 30 minutes later, is a critical marker in the study of the hypothalamic-pituitary-adrenal (HPA) axis function and its response to stress. Cortisol, a glucocorticoid hormone produced by the adrenal cortex, plays a pivotal role in the body's response to stress, regulating a wide range of processes including metabolism, immune response, and the circadian rhythm. The typical pattern observed in healthy individuals is a peak in cortisol levels within the first 30 to 45 minutes after waking, known as the cortisol awakening response (CAR), followed by a gradual decline throughout the day, reaching its lowest levels at night. This diurnal variation is thought to be a result of the central circadian clock in the suprachiasmatic nucleus (SCN) of the hypothalamus, which modulates the secretion of corticotropin-releasing hormone (CRH) and subsequently adrenocorticotropic hormone (ACTH), leading to cortisol release.
Optimal range: 12 - 48 nmol/L
The cortisol profile, particularly the "Cortisol Awakening Response (CAR)" measured at waking and 60 minutes thereafter, represents a critical biomarker in psychoneuroendocrinology, offering insights into the hypothalamic-pituitary-adrenal (HPA) axis functionality. This dynamic measure of cortisol secretion is pivotal for understanding an individual's stress response and adaptability. Upon awakening, cortisol levels sharply increase, peaking within the first 30 to 45 minutes, a phenomenon attributed to the anticipation of the upcoming day's challenges and activities. This surge, quantified by sampling salivary cortisol at waking and again 60 minutes later, encapsulates the reactivity of the HPA axis to natural circadian rhythms and psychosocial stressors.
Optimal range: 4 - 6 Ratio
The Cortisol/DHEA-Sulfate (DHEAS) Ratio in the context of the Cortisol Awakening Response (CAR) represents a crucial biomarker in psychoneuroendocrinology, providing valuable insights into the dynamic interplay between the hypothalamic-pituitary-adrenal (HPA) axis and adrenal steroidogenesis under conditions of stress and physiological arousal.
Cortisol, a glucocorticoid hormone, plays a pivotal role in the body's response to stress, influencing various physiological processes, including metabolism, immune function, and circadian rhythm regulation.
DHEAS, an adrenal androgen, serves as a counter-regulatory hormone, often associated with anabolic functions and resilience against stress.
Optimal range: 5 - 30 nmol/L
The marker DHEAS Profile, Waking+30min refers to the measurement of dehydroepiandrosterone sulfate (DHEAS) levels in the body at 30 minutes after waking up. DHEAS is an endogenous steroid hormone produced predominantly by the adrenal cortex, and to a lesser extent by the ovaries and testes. It serves as a precursor to sex steroids, including androgens and estrogens, and is the most abundant circulating steroid hormone in humans. The significance of measuring DHEAS levels at this time lies in the assessment of adrenal gland function, stress response, and potential endocrine disorders. Upon waking, the hypothalamic-pituitary-adrenal (HPA) axis is activated, leading to a surge in cortisol levels known as the cortisol awakening response (CAR). DHEAS, being partly regulated by adrenocorticotropic hormone (ACTH) similarly to cortisol, also exhibits a diurnal rhythm and potentially a waking response, although its dynamics can be less pronounced and more variable among individuals.
Lactate/Pyruvate, Filtrate
Optimal range: 10 - 20 Ratio
The lactate:pyruvate (L:P) ratio is considered a helpful (not diagnostic) tool in the evaluation of patients with possible disorders of mitochondrial metabolism, especially in patients with neurologic dysfunction and either elevated or normal blood lactate levels. Pyruvic acid levels alone have little clinical utility.
The blood lactate to pyruvate ratio is used to distinguish between pyruvate dehydrogenase deficiency and other causes of congenital lactic acidosis. In conjunction with an elevated lactate, an L:P ratio greater than 30 suggests inherited disorders of the respiratory chain complex or tricarboxylic acid cycle disorders. In conjunction with an elevated lactate, an L:P ratio less than 25 suggests a defect in pyruvate metabolism. An artificially high L:P ratio can be observed in acutely ill individuals. Abnormal concentrations of lactate, pyruvate, and the L:P ratio are not diagnostic for any single disorder and must be interpreted in the context of the individual's clinical presentation and other laboratory studies.
Optimal range: 9 - 16 mg/dL
Lactic Acid, measured as part of the "LACTATE/PYRUVATE, FILTRATE" panel by Quest Diagnostics, is a critical biomarker in assessing the metabolic status of an individual, particularly in the context of cellular respiration and energy production.
Lactic acid is produced in the muscles and red blood cells as a byproduct of anaerobic metabolism, a process that occurs when oxygen levels are too low to meet the energy demands of the body through aerobic respiration. Under normal physiological conditions, lactic acid is continuously converted to pyruvate, which then enters the Krebs cycle for further energy production in the presence of adequate oxygen.
Optimal range: 0.3 - 1.5 mg/dL
Pyruvic acid, an intermediate metabolite, plays an important role in linking carbohydrate and amino acid metabolism to the tricarboxylic acid cycle, the fatty acid beta-oxidation pathway, and the mitochondrial respiratory chain complex. Though isolated elevated pyruvate is not diagnostic of any inborn error of metabolism, analysis with lactate may suggest an inborn error of metabolism as some present with lactic acidosis or a high lactate-to-pyruvate (L:P) ratio.
Allergen Panel
An allergy panel is a comprehensive test designed to detect hypersensitivity to a variety of allergens, including environmental and pet-related factors. This panel often encompasses specific IgE (Immunoglobulin E) tests for common triggers such as dust mites, which are microscopic organisms that thrive in household dust, and elm tree pollen, a seasonal allergen prevalent in many regions. Mugwort weed IgE testing is also included to identify reactions to this common herb that can provoke symptoms in sensitive individuals. Additionally, the panel tests for cockroach IgE, due to the allergenic potential of cockroach droppings, and cat dander IgE, recognizing that proteins found in the skin flakes, saliva, and urine of cats can lead to allergic reactions. By covering these and many more markers, an allergy panel offers a detailed overview of an individual's allergic sensitivities, enabling tailored management strategies to alleviate symptoms and improve quality of life.
Optimal range: 0 - 0.34 kUA/L
Alternaria alternata mold IgE is a specific marker included in allergy panels that helps identify if an individual has an allergic sensitivity to a common type of fungus known as Alternaria alternata. This mold is widely found in the environment, thriving outdoors in soil, plants, and rotting vegetation, and can also make its way indoors through open doors, windows, and ventilation systems. People who are sensitive to this mold may experience allergic reactions when they inhale its spores, leading to symptoms such as sneezing, runny nose, itchy eyes, and asthma exacerbations.
Optimal range: 0 - 0.34 kUA/L
Optimal range: 0 - 0.34 kUA/L
Reference range: Class 0 (< 0.34), Class 1 (0.35 – 0.69), Class 2 (0.70 – 3.49), Class 3 (3.50 – 17.49), Class 4 (17.50 – 49.99), Class 5 (50.0 – 100.0), Class 6 (100+)
Optimal range: 0 - 0.34 kUA/L
Optimal range: 0 - 0.34 kUA/L
Optimal range: 0 - 0.34 kUA/L
Reference range: Class 0 (< 0.34), Class 1 (0.35 – 0.69), Class 2 (0.70 – 3.49), Class 3 (3.50 – 17.49), Class 4 (17.50 – 49.99), Class 5 (50.0 – 100.0), Class 6 (100+)
This biomarker measures Immunoglobulin E (IgE) antibodies specific to Dermatophagoides farinae, also known as the American house dust mite. Elevated levels of D. farinae-specific IgE suggest that your immune system has developed a sensitivity to proteins from this mite, which can trigger allergic reactions.
Optimal range: 0 - 0.34 kUA/L
The Dog Dander IgE test measures the specific immune response to proteins found in dog skin flakes, saliva, and urine, collectively known as "dander." IgE, or Immunoglobulin E, is an antibody that your immune system releases when it detects allergens, like dog dander, in sensitive individuals. High levels of Dog Dander IgE suggest that your immune system reacts to these proteins, often causing symptoms like sneezing, itching, or wheezing.
If you experience allergy-like symptoms around dogs, a high Dog Dander IgE result can confirm a sensitivity. Knowing this can guide you in managing exposure and exploring options to reduce symptoms, such as allergy medications or specialized treatments.
Optimal range: 0 - 0.34 kUA/L
The "Dust Mite (Dermatophagoides pteronyssinus) IgE" test measures your body's immune response to a common allergen found in household dust mites. Dust mites, tiny creatures invisible to the naked eye, thrive in warm, humid environments like bedding, carpets, and furniture. When you inhale or come into contact with dust containing these mites, your immune system may react by producing specific antibodies called IgE (Immunoglobulin E) if you’re sensitive to them.
Optimal range: 0 - 0.34 kUA/L
Reference range: Class 0 (< 0.34), Class 1 (0.35 – 0.69), Class 2 (0.70 – 3.49), Class 3 (3.50 – 17.49), Class 4 (17.50 – 49.99), Class 5 (50.0 – 100.0), Class 6 (100+)
Optimal range: 0 - 0.34 kUA/L
Reference range: Class 0 (< 0.34), Class 1 (0.35 – 0.69), Class 2 (0.70 – 3.49), Class 3 (3.50 – 17.49), Class 4 (17.50 – 49.99), Class 5 (50.0 – 100.0), Class 6 (100+)
Optimal range: 0 - 0.34 kUA/L
Optimal range: 0 - 0.34 kUA/L
Optimal range: 0 - 0.34 kUA/L
Optimal range: 0 - 0.34 kU/L
The "Stachybotrys chartarum/atra IgE" on an allergy panel is a specific test used to detect an allergic response to Stachybotrys chartarum (also known as Stachybotrys atra), a type of mold often associated with damp and water-damaged buildings. This mold is commonly referred to as "black mold" due to its dark appearance and is known for producing mycotoxins that can be harmful to human health. When people are exposed to Stachybotrys chartarum, either by inhaling spores or through direct contact, their immune system may identify the mold as a threat and produce Immunoglobulin E (IgE) antibodies as a defense mechanism. IgE antibodies are specialized proteins that play a key role in the body's allergic response.
Optimal range: 0 - 20.4 mcg/mL
The "Stachybotrys chartarum/atra IgG" marker on an allergy panel is a specific test that measures the Immunoglobulin G (IgG) antibodies in your blood that react against Stachybotrys chartarum (also known as Stachybotrys atra), a type of mold commonly referred to as "black mold." This mold is notorious for its potential health risks and is often found in buildings with water damage or high humidity levels. Stachybotrys chartarum produces mycotoxins that can cause various health problems when inhaled or ingested, ranging from mild allergic reactions to more severe conditions like respiratory issues and immune system suppression.
Reference range: Class 0 (< 0.34), Class 1 (0.35 – 0.69), Class 2 (0.70 – 3.49), Class 3 (3.50 – 17.49), Class 4 (17.50 – 49.99), Class 5 (50.0 – 100.0), Class 6 (100+)
Ri Antibody Screen with Reflex to Titer and Western Blot
The Ri Antibody Screen with Reflex to Titer and Western Blot is a diagnostic panel offered by Quest Diagnostics, designed to detect the presence of Ri antibodies in the blood. Ri antibodies are autoantibodies, meaning they are produced by the body's immune system against its own tissues, specifically targeting neuronal (nerve cell) proteins. The presence of these antibodies is associated with a group of conditions known as paraneoplastic neurological syndromes (PNS), which are rare disorders that can affect various parts of the nervous system. These syndromes often develop in people who have cancer, as the immune system's response to the tumor mistakenly attacks neurons, leading to neurological symptoms. The initial part of the test, the Ri Antibody Screen, uses an immunofluorescence assay (IFA) technique to detect antibodies. If this screening test is positive, indicating the potential presence of Ri antibodies, the test reflexes, or automatically proceeds, to additional testing methods, such as a titer and possibly a Western Blot. The titer quantifies the amount of antibodies present, providing an indication of the immune response's intensity, while the Western Blot confirms the specificity of the antibodies for the Ri antigen. This panel is particularly important for diagnosing PNS early, which can then prompt further investigation for an underlying cancer, if not already known. It helps in the management of the neurological symptoms and the underlying cause, aiming to improve the patient's quality of life and outcome. A comprehensive approach, involving this panel, allows healthcare providers to make informed decisions regarding diagnosis, monitoring, and treatment strategies for affected individuals.
Reference range: Negative, Positive, Fluorescence Noted
Ri Antibody Screen with Reflex to Titer and Western Blot - Anti-Ri can be detected in patients with the paraneoplastic opsoclonus/myoclonus syndrome. Neoplasms most often associated with Anti-Ri include breast cancer, gynecological cancers, and small cell lung cancer.
Chemistry Tests
A Chemistry Tests panel, often referred to as a Chemistry Panel or Chem Panel, is a comprehensive set of tests used to evaluate the general health status of an individual and diagnose a wide range of conditions. This panel typically measures various substances in the blood, including electrolytes (like sodium, potassium, and chloride), enzymes, fats, proteins, glucose, and metabolic waste products. The specific tests included can vary, but common ones are the Comprehensive Metabolic Panel (CMP) and Basic Metabolic Panel (BMP), which assess kidney function, liver function, blood sugar levels, and acid/base balance, among other vital functions. The results can help in detecting abnormalities that may indicate diseases such as diabetes, kidney disease, liver disease, and hypertension. It's also used to monitor the effectiveness of medications and the impact of chronic diseases on the body. Doctors often order a Chemistry Tests panel during routine check-ups or when diagnosing symptoms to get a broad picture of a patient's metabolic health and to guide further diagnostic testing or treatment plans.
Optimal range: 0 - 15 mg/24 hr
5-Hydroxyindolacetic acid (5-HIAA) is an important chemical compound in the medical and biochemical fields, acting as a primary interest for its role as a metabolite in the human body. Essentially, it's what remains after serotonin, a key neurotransmitter responsible for regulating mood, appetite, and sleep among other functions, is broken down. The body converts serotonin into 5-HIAA, which is then excreted in the urine.
Amino Acids; Urine 24-hour (Doctor's Data)
Amino acid analysis is a powerful diagnostic tool that plays a critical role in evaluating the balance and adequacy of dietary proteins, gastrointestinal health, and various metabolic functions. This analysis is crucial for identifying conditions such as protein intolerance, deficiencies in vitamins and minerals, and disorders in liver and kidney functions. It also provides insights into psychiatric conditions, susceptibility to inflammation, oxidative stress, and issues with the body’s detoxification processes.
Key Applications of Amino Acid Testing:
- Mental Health Disorders: Useful in managing ADD/ADHD, autism spectrum disorders, depression, and anxiety.
- Chronic Conditions: Helps monitor cardiovascular diseases, epilepsy, fatigue, hypertension, and rheumatoid arthritis.
- Digestive Health: Essential for diagnosing digestive disorders and nutritional deficiencies.
- Reproductive Health: Can aid in addressing issues related to infertility and insomnia.
- Kidney and Liver Function: Critical for assessing kidney function and potential impairments in amino acid metabolism.
Many individuals exhibit subtle amino acid metabolism impairments that often remain unnoticed but can predispose them to chronic degenerative diseases. A comprehensive amino acid analysis is recommended as part of a detailed nutritional and metabolic assessment to uncover these hidden issues.
Benefits of Amino Acid Testing:
- Nutritional Adequacy: Provides essential data on the quality and quantity of dietary proteins.
- Diagnostic Capabilities: Offers insights into liver and kidney health, neurotransmitter precursors, and detoxification capabilities.
- Risk Assessment: Identifies risk factors for arterial occlusive diseases and profiles various inherited metabolic disorders.
Plasma vs. Urine Analysis for Amino Acids:
- Plasma Analysis: Traditionally used to assess essential amino acids. It is best conducted after an overnight fast to minimize dietary influences, providing a snapshot of amino acid transport at the time of sampling.
- Urine Analysis: Offers deeper insights into amino acid wasting and abnormal metabolism due to cofactor deficiencies. A 24-hour urine test is highly effective in detecting abnormalities, reflecting the amino acid levels over an entire day and providing an early indication of deficiencies.
For individuals unable to complete a 24-hour urine collection, a first morning void (FMV) test can be a practical alternative, especially useful for detecting significant abnormalities in gastrointestinal health, renal function, and inherited amino acid disorders.
Optimal range: 80 - 450 qmol/24 hours
1-methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 600 - 2500 mL/24 hr
The "24 Hour Volume" marker on a Urine 24-hour Amino Acids panel from Doctor's Data is a crucial measurement that indicates the total volume of urine collected over a 24-hour period.
This measurement is essential because it helps ensure the accuracy of the test results. Amino acids are small molecules in the body that play key roles in building proteins, supporting metabolism, and performing other vital functions.
By collecting urine for 24 hours, the lab can accurately determine the concentration of amino acids excreted in the urine throughout the day. This comprehensive snapshot helps identify any abnormalities or imbalances in amino acid levels, which can be indicative of various health conditions. It's important for patients to follow the collection instructions carefully, ensuring all urine is collected within the specified time frame to provide a complete and accurate sample for analysis. This helps healthcare providers diagnose potential health issues more effectively and tailor appropriate treatments.
Optimal range: 60 - 1500 qmol/24 hours
Both 1-methylhistidine and 3-methylhistidine are histidine metabolites which have been proposed as markers of meat intake. Note that some confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
3-methylhistidine is a constituent of actin and myosin, the contractile proteins of skeletal muscles. Urinary excretion of 3-methylhistidine may be a result of muscle breakdown or consumption of meat fibers. Unlike 1-methylhistidine, 3-methylhistidine has been shown to increase in fasting states indicating catabolism of muscle tissue. Therefore, this marker is more variable with regards to animal protein consumption.
Optimal range: 120 - 690 qmol/24 hours
Optimal range: 8 - 90 qmol/24 hours
Optimal range: 8 - 90 qmol/24 hours
Optimal range: 12000 - 65000 qmol/24 hours
Optimal range: 0 - 110 qmol/24 hours
Anserine (beta-alanyl-3-methyl-histidine) is a urinary biomarker from the consumption of poultry and fish. It is a dipeptide consisting of the amino acids 1-methylhistidine and beta-alanine. The enzyme carnosineN-methyl transferase catalyzes the transfer of a methyl group of S-adenosylmethionine (SAM) on carnosine to form anserine. Anserine acts as an antioxidant, free radical scavenger, and pH buffer. It can reduce blood sugar and affect renal sympathetic nerve activity and blood pressure. Anserine is measured in FMV urine only.
Optimal range: 10 - 70 qmol/24 hours
Optimal range: 45 - 260 qmol/24 hours
Optimal range: 7 - 38 qmol/24 hours
Optimal range: 0 - 35 qmol/24 hours
Beta-alanine is a non-essential amino acid involved in various metabolic processes in the body. It's not typically required from the diet because the body can produce it. In medical testing, the levels of beta-alanine in urine are measured to assess its concentration in the body.
Under normal conditions, beta-alanine is efficiently converted into other substances, including alpha-ketoglutarate, through a process that depends on vitamin B-6.
Optimal range: 0 - 400 qmol/24 hours
Optimal range: 0 - 60 qmol/24 hours
Optimal range: 1 - 40 qmol/24 hours
Optimal range: 900 - 3000 mg/24 hr
Optimal range: 9 - 65 qmol/24 hours
Optimal range: 31 - 90 qmol/24 hours
Optimal range: 32 - 130 qmol/24 hours
Optimal range: 125 - 600 qmol/24 hours
Optimal range: 0 - 7 qmol/24 hours
Optimal range: 10 - 65 qmol/24 hours
Glutamate is an important marker included on the Amino Acids; Urine 24-hour panel provided by Doctor's Data. This amino acid plays a crucial role in the body, primarily as a neurotransmitter in the brain, where it helps in sending signals between nerve cells. It's one of the most abundant neurotransmitters and is essential for learning and memory. When measured in a urine test, the levels of glutamate can give valuable insights into a person's metabolic processes. Abnormal levels of glutamate in the urine can indicate various health issues. For example, elevated glutamate can suggest problems with neurological functions or an imbalance in amino acid metabolism. On the other hand, low levels might point to issues like inadequate protein intake or specific metabolic disorders. The 24-hour urine collection method used in this test helps to provide a comprehensive view of the glutamate levels over a full day, giving a more accurate assessment than a single snapshot might. This detailed information can be crucial for doctors to diagnose potential health issues and to recommend appropriate dietary adjustments or treatments to balance glutamate levels in the body.
Optimal range: 190 - 725 qmol/24 hours
Optimal range: 380 - 3500 qmol/24 hours
Optimal range: 390 - 1900 qmol/24 hours
Optimal range: 0 - 1.2 qmol/24 hours
Optimal range: 0 - 55 qmol/24 hours
Optimal range: 6 - 32 qmol/24 hours
Optimal range: 12 - 95 qmol/24 hours
Optimal range: 45 - 700 qmol/24 hours
Optimal range: 9 - 56 qmol/24 hours
Optimal range: 0 - 10 qmol/24 hours
Optimal range: 3 - 55 qmol/24 hours
Optimal range: 30 - 130 qmol/24 hours
Optimal range: 20 - 100 qmol/24 hours
Optimal range: 0.06 - 0.8 qmol/24 hours
Phosphoserine is the phosphorylated ester of the amino acid serine. The addition of a phosphoryl group to an amino acid, or its removal, plays a role in cell signaling and metabolism. Phosphoserine is a byproduct of glycolysis and subsequent intermediate to then become serine. The enzyme that catalyzes this step, phosphoserine phosphatase, is magnesium dependent. This metabolite is not to be confused with a similar-sounding metabolite, phosphatidylserine; this is a common CNS supplement and essential for neuronal cell membranes.
Optimal range: 1 - 70 qmol/24 hours
Optimal range: 0 - 10 qmol/24 hours
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine. It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents. In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess.
Optimal range: 140 - 568 qmol/24 hours
Optimal range: 350 - 1850 qmol/24 hours
Taurine is a crucial amino acid that serves multiple roles in the body:
(1) It acts as a powerful antioxidant, helping to protect cells from damage caused by harmful molecules known as free radicals.
(2) Taurine also aids in the regulation of minerals such as calcium within cells
(3) and supports the healthy function of the heart and blood vessels.
(4) Additionally, it is vital for the proper functioning of the brain and eyes.
Optimal range: 60 - 340 qmol/24 hours
Optimal range: 25 - 140 qmol/24 hours
Optimal range: 30 - 188 qmol/24 hours
Optimal range: 180 - 900 mmol/24 hr
Optimal range: 18 - 85 qmol/24 hours
Metabolite Ratios (Urine) - DUTCH
The Metabolite Ratios section of the DUTCH test evaluates how your body is processing and detoxifying estrogens.
These ratios compare different estrogen metabolites to help identify whether your estrogen metabolism is protective, balanced, or potentially risky.
The DUTCH test reports three key ratios:
2-OH / 16-OH-E1 Balance
2-OH / 4-OH-E1 Balance
2-Methoxy / 2-OH Balance
This ratio compares two major estrogen metabolites:
2-OH-E1 → Often considered the safer pathway; weakly estrogenic and may help block cell overgrowth.
16-OH-E1 → More estrogenic; can promote tissue growth and may contribute to estrogen-dominant symptoms.
Why it matters:
A higher ratio (more 2-OH compared to 16-OH) is generally considered more favorable for long-term hormone balance.
A lower ratio may suggest that estrogen is being metabolized in a way that could increase stimulation of estrogen-sensitive tissues.
This ratio evaluates:
2-OH-E1 → Protective, as above.
4-OH-E1 → Can be more harmful, as it may damage DNA and has been linked to a higher risk of certain hormone-related cancers.
Why it matters:
A higher 2-OH to 4-OH ratio is generally better, indicating your body favors the less risky pathway.
A lower ratio means a greater share of estrogen is moving through the potentially DNA-damaging 4-OH pathway, which may require support for safe detoxification.
This ratio reflects phase 2 estrogen metabolism (methylation):
2-OH-E1 → A phase 1 metabolite that needs to be neutralized.
2-Methoxy-E1 → The methylated (neutralized) form of 2-OH-E1, created in phase 2 detoxification.
Why it matters:
A higher ratio suggests efficient methylation, meaning your body is converting potentially reactive estrogen metabolites into safer, excretable forms.
A low ratio may indicate sluggish methylation, which can allow reactive metabolites to remain active longer in the body.
By looking at these three ratios together, practitioners can see:
Whether your estrogen metabolism favors protective or more risky pathways
How efficiently your body neutralizes potentially harmful estrogen metabolites
Whether additional nutritional or lifestyle support may help improve hormone detoxification
Balanced ratios are important for both women and men, as estrogen metabolism impacts reproductive health, breast and prostate health, and overall hormonal balance.
Optimal range: 0.39 - 0.67 Ratio
The 2-Methoxy / 2-OH Balance is a measure used to assess the balance between two important forms of estrogen metabolites in the body. Estrogen, a hormone crucial for various bodily functions, undergoes a process called metabolism, where it is broken down into different metabolites. Among these metabolites, 2-methoxyestrone (2-Methoxy) and 2-hydroxyestrone (2-OH) are significant. The balance between these two metabolites is essential for overall health, as an imbalance can potentially indicate increased risk for certain health conditions, including hormone-related cancers and cardiovascular diseases. Specifically, a higher ratio of 2-Methoxy to 2-OH is generally considered favorable, as it suggests a more favorable estrogen metabolism pattern associated with lower cancer risk. However, the interpretation of this ratio should be done in the context of individual health and other factors.
Important Note: If Estrogen metabolite levels are very low, the reproducibility of the test is not as ideal, so calculated ratios (for the methylation-activity index and phase I estrogen metabolism ratios) are more approximate, less certain, and may not be reported.
Optimal range: 0.4 - 0.7 Ratio
Optimal range: 2.69 - 11.83 Ratio
The 2-OH / 16-OH-E1 Balance is a measure of the ratio between two types of estrogen metabolites in the body: 2-hydroxyestrone (2-OH) and 16-alpha-hydroxyestrone (16-OH-E1).
Estrogen, a hormone primarily produced in the ovaries, plays a crucial role in various bodily functions, including:
(1) regulating the menstrual cycle,
(2) supporting reproductive health,
and (3) maintaining bone density.
However, when estrogen is broken down (metabolized) in the body, it forms different metabolites, some of which may have different effects on health. The 2-OH metabolite is considered to have more favorable properties, potentially exerting protective effects against certain health risks, such as cancer, whereas the 16-OH-E1 metabolite is associated with higher estrogenic activity and may be linked to an increased risk of estrogen-related health issues.
Therefore, assessing the balance between these two metabolites can provide valuable insights into estrogen metabolism and overall health status, helping healthcare providers tailor interventions to promote hormonal balance and reduce health risks.
Optimal range: 2.85 - 9.88 Ratio
The 2-OH / 16-OH-E1 Balance is an important marker that helps assess how your body processes estrogen, which is a hormone present in both men and women. While estrogen is often associated with female health, men also produce and rely on it for various bodily functions, including maintaining bone density, cardiovascular health, and proper brain function.
Optimal range: 5.4 - 12.62 Ratio
The 2-OH / 4-OH-E1 Balance refers to the balance between two different forms of estrogen metabolites in the body, specifically 2-hydroxyestrone (2-OH) and 4-hydroxyestrone (4-OH-E1). Estrogen is a hormone that plays a crucial role in various bodily functions, including reproductive health and bone density. When estrogen is metabolized or broken down in the body, it forms different metabolites, and the balance between these metabolites can provide important insights into overall health.
The 2-OH form is often considered less harmful, with potential protective effects against certain health issues, while the 4-OH-E1 form is associated with increased risk for conditions like cancer. Therefore, analyzing the ratio of these two metabolites can help assess estrogen metabolism and provide valuable information for optimizing health and preventing potential risks.
Important Note: If Estrogen metabolite levels are very low, the reproducibility of the test is not as ideal, so calculated ratios (for the methylation-activity index and phase I estrogen metabolism ratios) are more approximate, less certain, and may not be reported.
Optimal range: 6.44 - 12.6 Ratio
Cardiovascular & Stroke Screenings
Life Line Screening offers a suite of Cardiovascular & Stroke Screenings aimed at detecting potential risk factors and underlying conditions that could lead to serious health issues in the future. These screenings primarily focus on identifying signs of carotid artery disease, atrial fibrillation, and peripheral arterial disease, as well as assessing the risk of stroke and abdominal aortic aneurysm. Utilizing non-invasive technologies such as ultrasound and electrocardiograms (EKGs), Life Line Screening provides these services in community-based settings like churches, community centers, and offices. The goal is to facilitate early detection of cardiovascular conditions, which can be crucial for timely intervention and management, potentially preventing the progression of these conditions into more severe complications. This approach is particularly targeted towards older adults and those with risk factors for cardiovascular disease, aiming to reduce future health risks and medical costs through preventive care.
Reference range: Normal, Abnormal, Critical
Reference range: Normal, Abnormal
Reference range: Normal, Mild, Moderate, Significant, Critical, Possible Occlusion
Reference range: Normal, Mild, Moderate, Significant, Critical, Possible Occlusion
Reference range: Low Probability of Osteoporosis, Additional Investigation, High Probability of Osteoporosis
Reference range: Abnormal < 0.3, Abnormal 0.31-0.89, Normal 0.9 - 1.4, Abnormal > 1.4
Reference range: Abnormal < 0.3, Abnormal 0.31-0.89, Normal 0.9-1.4, Abnormal >1.40
NutriStat Basic Profile
The NutriStat Basic Profile by US BioTek Laboratories is a comprehensive nutritional assessment tool designed to provide valuable insights into an individual's nutritional status and potential deficiencies. This panel includes an array of tests that measure various biomarkers related to nutrient levels, metabolic function, and overall health. Typically, the NutriStat Basic Profile assesses levels of essential vitamins such as B12, D, and folate, along with key minerals like magnesium, zinc, and selenium. Additionally, it evaluates amino acids, fatty acids, and other critical compounds necessary for optimal body function. By analyzing these biomarkers, healthcare practitioners can identify specific nutrient deficiencies or imbalances that may be contributing to health issues such as fatigue, weakened immune function, or chronic diseases. The results from this panel enable personalized nutritional interventions, allowing for tailored dietary recommendations and supplement regimens to address specific needs. Moreover, the NutriStat Basic Profile can be instrumental in monitoring the effectiveness of ongoing nutritional therapies, providing a dynamic view of a patient's nutritional health over time. This tool is particularly valuable for individuals with dietary restrictions, those recovering from illness, or anyone seeking to optimize their overall wellness through targeted nutrition. US BioTek Laboratories, known for its commitment to high-quality, reliable testing methods, ensures that the NutriStat Basic Profile delivers precise and actionable data, empowering both healthcare providers and patients to make informed decisions for better health outcomes.
Optimal range: 0 - 20 %
The marker % Free Copper on a Nutristat test signifies the proportion of unbound or available copper in the bloodstream. This measurement helps assess the balance between free copper and the copper bound to proteins like ceruloplasmin.
Abnormalities in % Free Copper levels can indicate imbalances in copper metabolism and potential health issues, such as Wilson's disease or other copper-related disorders. Nutristat tests, which assess copper, zinc, and related ratios, aid in evaluating nutritional and metabolic aspects related to these essential minerals.
Optimal range: 2.4 - 8.9 umol/L
1-methylhistidine is derived from the dipeptide anserine (which consists of the amino acids 1-methylhistidine and beta-alanine). Anserine and its derivatives are associated with the consumption of poultry and fish. Both 1-methylhistidine and 3-methylhistidine have been proposed as markers of meat intake. Note that confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
Optimal range: 0 - 0.05 ug/mgCR
Optimal range: 1.7 - 47.1 umol/L
Both 1-methylhistidine and 3-methylhistidine are histidine metabolites which have been proposed as markers of meat intake. Note that some confusion exists in the literature regarding the numbering of atoms in the imidazole ring of histidine – 1 versus 3 – and thus, there is caution with interpretation and clinical significance of these two markers.
3-methylhistidine is a constituent of actin and myosin, the contractile proteins of skeletal muscles. Urinary excretion of 3-methylhistidine may be a result of muscle breakdown or consumption of meat fibers. Unlike 1-methylhistidine, 3-methylhistidine has been shown to increase in fasting states indicating catabolism of muscle tissue. Therefore, this marker is more variable with regards to animal protein consumption.
Optimal range: 0 - 6.1 ug/mgCR
Optimal range: 0 - 1.7 ug/mgCR
Optimal range: 0.34 - 3.98 ug/mgCR
5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
Optimal range: 0 - 12 ng/gCR
Optimal range: 0 - 0.62 Ratio
Alcohol consumption can result in elevations of the plasma Alpha-ANB/Leucine ratio. But to see this biomarker as a conclusive marker for alcoholism is not proven. The increase in the plasma Alpha-ANB/Leucine ratio does not appear to be specific for alcoholism because it was found elevated in nonalcoholic liver disease.
Optimal range: 0 - 1.52 ug/mgCR
Of the essential amino acids, there are three branchedchain amino acids (leucine, isoleucine, and valine).
Unlike most amino acids, the initial step of branchedchain amino acid (BCAA) metabolism does not take place in the liver. They increase rapidly in systemic circulation after protein intake and are readily available for use. Skeletal muscle is where most of the initial catabolism of BCAA takes place using branched-chain aminotransferase enzymes to form α-ketoacids, which are then released from muscles back into the blood to be further metabolized, mainly in the liver.
BCAA act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, immune response, and many other beneficial metabolic processes.
α-Ketoisovaleric Acid (AKIV) is produced from the essential amino acid valine. It then metabolizes to become succinyl Co-A. AKIV is glucogenic.
α-Ketoisocaproic Acid (AKIC) is produced from leucine and further metabolizes to form acetyl-CoA and acetoacetate. AKIC is ketogenic.
α-Keto-β-Methylvaleric Acid (AKBM) comes from isoleucine, and further metabolizes to form acetylCoA and succinyl-CoA. AKBM is therefore both glycogenic and ketogenic.
These α-ketoacids then require an enzyme complex called branched-chain α-keto acid dehydrogenase (BCKD) for further metabolism.
This enzyme complex requires multiple vitamin cofactors, such as vitamin B1, B2, B3, B5, and lipoic acid.
Optimal range: 0 - 21.72 ug/mgCR
Isocitric Acid is converted to α-ketoglutaric acid using the enzyme isocitrate dehydrogenase. Alphaketoglutarate is a rate-determining intermediate in the Citric Acid Cycle and provides an important source of glutamine and glutamate that stimulates protein synthesis and bone tissue formation, inhibits protein degradation in muscle, and constitutes an important metabolic fuel for cells of the gastrointestinal tract. Alpha-ketoglutaric acid is then converted to Succinyl CoA using the enzyme alpha-ketoglutarate dehydrogenase. This enzyme complex is very similar to the pyruvate dehydrogenase complex with similar nutrient cofactor needs.
Optimal range: 0 - 0.34 ug/mgCR
Of the essential amino acids, there are three branchedchain amino acids (leucine, isoleucine, and valine).
Unlike most amino acids, the initial step of branchedchain amino acid (BCAA) metabolism does not take place in the liver. They increase rapidly in systemic circulation after protein intake and are readily available for use. Skeletal muscle is where most of the initial catabolism of BCAA takes place using branched-chain aminotransferase enzymes to form α-ketoacids, which are then released from muscles back into the blood to be further metabolized, mainly in the liver.
BCAA act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, immune response, and many other beneficial metabolic processes.
α-Ketoisovaleric Acid (AKIV) is produced from the essential amino acid valine. It then metabolizes to become succinyl Co-A. AKIV is glucogenic.
α-Ketoisocaproic Acid (AKIC) is produced from leucine and further metabolizes to form acetyl-CoA and acetoacetate. AKIC is ketogenic.
α-Keto-β-Methylvaleric Acid (AKBM) comes from isoleucine, and further metabolizes to form acetylCoA and succinyl-CoA. AKBM is therefore both glycogenic and ketogenic.
These α-ketoacids then require an enzyme complex called branched-chain α-keto acid dehydrogenase (BCKD) for further metabolism.
This enzyme complex requires multiple vitamin cofactors, such as vitamin B1, B2, B3, B5, and lipoic acid.
Optimal range: 0 - 1.15 ug/mgCR
Of the essential amino acids, there are three branchedchain amino acids (leucine, isoleucine, and valine).
Unlike most amino acids, the initial step of branchedchain amino acid (BCAA) metabolism does not take place in the liver. They increase rapidly in systemic circulation after protein intake and are readily available for use. Skeletal muscle is where most of the initial catabolism of BCAA takes place using branched-chain aminotransferase enzymes to form α-ketoacids, which are then released from muscles back into the blood to be further metabolized, mainly in the liver.
BCAA act as substrates for protein synthesis, energy production, neurotransmitter production, glucose metabolism, immune response, and many other beneficial metabolic processes.
α-Ketoisovaleric Acid (AKIV) is produced from the essential amino acid valine. It then metabolizes to become succinyl Co-A. AKIV is glucogenic.
α-Ketoisocaproic Acid (AKIC) is produced from leucine and further metabolizes to form acetyl-CoA and acetoacetate. AKIC is ketogenic.
α-Keto-β-Methylvaleric Acid (AKBM) comes from isoleucine, and further metabolizes to form acetylCoA and succinyl-CoA. AKBM is therefore both glycogenic and ketogenic.
These α-ketoacids then require an enzyme complex called branched-chain α-keto acid dehydrogenase (BCKD) for further metabolism.
This enzyme complex requires multiple vitamin cofactors, such as vitamin B1, B2, B3, B5, and lipoic acid.
Optimal range: 0 - 4.16 ug/mgCR
Optimal range: 1.1 - 69.2 Ratio
This test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. Balancing these eicosanoids in the body is an excellent way
for managing heart disease and other chronic and inflammatory processes.
Optimal range: 0 - 4.07 ug/mgCR
Adipic acid is an organic compound commonly found in a variety of foods, especially those containing artificial flavors and additives. It is a significant component in the production of nylon and other synthetic fibers but is also present in small amounts in our bodies as a byproduct of fatty acid metabolism. In a nutritional context, the measurement of adipic acid levels can provide valuable insights into an individual's metabolic health. Elevated levels of adipic acid in the body may indicate issues related to the breakdown of fats, which could be influenced by dietary habits, metabolic disorders, or the overconsumption of processed foods. Monitoring adipic acid can help in identifying imbalances in fatty acid metabolism, guiding dietary adjustments, and potentially improving overall metabolic function. This marker is particularly useful for assessing how well the body is managing the breakdown and utilization of fats, which is crucial for maintaining energy balance and preventing the accumulation of harmful substances in the bloodstream. Understanding adipic acid levels can thus play a critical role in optimizing nutritional health and preventing metabolic complications.
Optimal range: 272 - 756 umol/L
Alanine is a nonessential amino acid. It is the second most abundant amino acid in circulation, after glutamine. It is found in many foods including eggs, meat, lentils, and fish. Alanine is involved in sugar metabolism for energy and is important in immune system function, specifically T lymphocyte activation. Interestingly, alanine is an agonist that binds to the glycine site of N-methyl-d-aspartate (NMDA) receptors in the brain and improves the positive and cognitive symptoms of patients with schizophrenia.
Optimal range: 0.1 - 1.9 %
Alpha-linolenic acid (ALA) is plant-based essential omega-3 polyunsaturated fatty acids that must be obtained through the diet.
Optimal range: 0.4 - 1.3 umol/L
Alpha-aminoadipic acid (a-Aminoadipic acid) is an intermediary metabolite of lysine (primarily) and of tryptophan.
Optimal range: 21.4 - 95.6 umol/L
Alpha amniobutyric acid (AABA), also known as Alpha-amino-N-butyric acid (A-ANB), is an intermediate formed during the catabolism of methionine and threonine. Increases in AABA occur secondary to elevations of either methionine or threonine. AABA becomes propionic acid via alpha-ketobutyric acid in the presence of adequate amounts of thiamin, vitamin B2(as FAD), vitamin B3(as NAD), lipoic acid and magnesium. Deficiencies of any of these, or vitamin B6, could cause increases in AABA. Elevated or decreased levels of the amino acid may indicate a congenital enzyme defect.
Optimal range: 0 - 30 ug/L
SOURCES:
Found in virtually all foodand food additives, water, air, and soil. Also found in antacids, antiperspirants, cosmetics, astringents, cans, pots, pans, siding, roofing, and foil.
NUTRIENT INTERACTIONS:
Calcium deficiency, citric acid, and low gut pH causes increased Al absorption. Low iron intake increases Al absorption (rat study). Selenium may be protective against Al. Al reduces phosphorus and fluoride absorption. Al disrupts lipid membrane fluidity, altering Fe, magnesium, and calcium homeostasis, causing oxidative stress.
Optimal range: 0 - 0.4 umol/L
Anserine (beta-alanyl-3-methyl-histidine) is a urinary biomarker from the consumption of poultry and fish. It is a dipeptide consisting of the amino acids 1-methylhistidine and beta-alanine. The enzyme carnosineN-methyl transferase catalyzes the transfer of a methyl group of S-adenosylmethionine (SAM) on carnosine to form anserine. Anserine acts as an antioxidant, free radical scavenger, and pH buffer. It can reduce blood sugar and affect renal sympathetic nerve activity and blood pressure. Anserine is measured in FMV urine only.
Optimal range: 0 - 5 ug/L
SOURCES:
Found naturally in the environment, air, soil, water.
Found in lead storage batteries, solder, sheet and pipe metal, pewter, bearings and castings, paints, ceramics, fireworks, plastic enamels, metal and glass.
Sometimes used medically to treat parasites.
Optimal range: 0 - 79.5 ug/mgCR
Optimal range: 0.1 - 0.53 %
Arachidic acid (also called eicosanoic acid) is a long-chain saturated fatty acid. It is the elongation product of stearic acid and can be utilized as an energy source to build membranes.
Optimal range: 5 - 14.8 %
Arachidonic acid is an inflammatory omega-6 fatty acid. Our bodies produce this nutrient, and its excess may lead to inflammatory diseases and mood disorders.
Optimal range: 1.9 - 55.3 umol/L
Arginine is found in all protein foods and is very abundant in seeds and nuts. It is considered a semi-essential amino acid during early development, infection/inflammation, or renal and/or intestinal impairment.
Optimal range: 0 - 10 ug/L
Sources:
Found in water, air, soil, cigarettes, and cosmetics. Food grown in contaminated water sources, such as rice and vegetables, or fish, are a common source. Major sources of occupational exposureis the manufacture of pesticides, herbicides, and agricultural products.
90% of all arsenic produced is used as a preservative for wood to prevent rotting and decay. Copper chromated arsenate (CCA), also known as pressure-treated wood, wasphased out for residential use in 2003, but wood treated prior could still be in existing structures. CCA-treated wood is still used in industrial applications.
Organic arsenic found in seafood is relatively nontoxic, while the inorganic forms are toxic.
Optimal range: 0.9 - 135 ug/mgCR
Optimal range: 29 - 82.6 umol/L
Asparagine is a non-essential protein amino acid that is present in many fruits and vegetables including asparagus, from which it gets its name. Other dietary sources include meat, potatoes, eggs, nuts, and dairy. It can also be formed from aspartic acid and glutamine using the enzyme asparagine synthetase.
In addition to being a structural component of many proteins, asparagine is also useful to the urea cycle. It acts as a nontoxic carrier of residual ammonia to be eliminated from the body. Asparagine is rapidly converted to aspartic acid by the enzyme asparaginase. Interestingly, L-asparaginase has been successfully used as a chemotherapeutic agent for decades.
It causes extracellular depletion of asparagine which seems to play a critical role in cellular adaptations to glutamine and apoptosis.
Optimal range: 5.9 - 26.4 umol/L
Aspartic acid is a nonessential amino acid that plays roles in many important metabolic processes, such as energy production (citric acid cycle), hormone metabolism, CNS activation, and the urea cycle. It is found in many protein sources such as oysters, meats, seeds, avocado, asparagus, and beets. It is also an ingredient in artificial sweeteners.
Aspartic acid is a precursor to many amino acids and other molecules like asparagine, arginine, isoleucine, lysine, methionine, isoleucine, threonine, nucleotides, NAD, and pantothenate. Aspartate, like glutamine, can also be considered a neuroexcitatory neurotransmitter since it activates the N-methyl-D-aspartate receptor in the brain.
Optimal range: 0 - 4.29 ug/mgCR
Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production, and when it is elevated it may indicate that the body is trying to increase its production of CoQ10.
Optimal range: 0 - 10.79 ug/mgCR
β-hydroxybutyrate is a ketone body. During periods of fasting, exercise, and metabolic disease, ketone bodies are generated in the liver and become an energy source instead of glucose.
Optimal range: 0.2 - 1.59 %
Behenic acid is a saturated fatty acids, in particular it is part of the group of very long chain fatty acids (VLCFAs).
Optimal range: 0 - 7 ug/mgCR
Optimal range: 0 - 4 ug/L
Beryllium is a silvery-white metal that is lighter than aluminum but stronger than steel. Its strength-to-weight ratio, reflectivity, transparency to X-rays, thermal stability and conductivity, and high melting point makes it an essential material in the defense, nuclear, aerospace, medical, information technology, and telecommunications industries.
Beryllium is toxic as both a skin irritant and an inhaled substance and can result in dermatitis, acute pneumonitis, and chronic pulmonary disease. The first signs of serious or life-threatening acute beryllium exposure may involve difficulty breathing, chest pain, or shortness of breath. Despite increasing governmental regulations limiting exposure to beryllium in high-risk occupations, any amount of beryllium can cause short-term and long-term diseases.
Optimal range: 3 - 15.4 umol/L
β-alanine is a breakdown product of carnosine and anserine, which are dipeptides from meat consumption. Although β-alanine’s properties are limited, its relationship to carnosine makes it important. Both have antioxidant properties. And, as previously mentioned, carnosine is critical for pH buffering in skeletal muscle during exercise, but its formation can be limited by enzymatic factors.
For this reason, supplementation with β-alanine is sometimes used to enhance carnitine and therefore improve athletic performance. In addition to diet and supplementation, β-alanine can also be endogenously produced. This occurs via degradation of uracil in the liver but it can also be made by intestinal bacteria such as E. coli.
Optimal range: 2.1 - 12.2 umol/L
Optimal range: 0 - 9.16 ug/mgCR
b-Hydroxyisovaleric Acid [aka 3-Hydroxyisovaleric Acid (3-HIA)] is formed from the metabolism of the branched-chain amino acid leucine. Methylcrotonyl-CoA carboxylase catalyzes an essential step in this pathway and is biotin dependent. Reduced activity of this enzyme leads to an alternate pathway of metabolism resulting in 3-hydroxyisovaleric acid.
Optimal range: 1.06 - 6.66 ug/mgCR
Optimal range: 0 - 1 ug/L
Used in alloys, electronics, batteries, crystal ware, cosmetics, flame retardants,and in antimicrobial therapy (H. pylori), antiseptic dressings, paraffin paste. Bismuth medical therapies exhibit high therapeutic effects and little side effects, though over-dosage can cause toxicity.
Very limited absorption in the GI tract. When absorbed, it binds mainly to transferrin and lactoferrin, interacts with enzymes due to a high affinity to cysteine residues, blocking the active site. Can accumulate in the kidney, lung, spleen, liver, brain, and muscles, while being eliminated in urine and feces via bile and intestinal secretions.
Optimal range: 0 - 1.1 ug/L
SOURCES:
Found in food such as shellfish, leafy vegetables, rice, cereals, cocoa butter, dried seaweed, and legumes. Also present in nickel cadmium batteries, cigarette smoke (including second-hand smoke), insecticides, fertilizer, motor oil, emissions and exhaust. Drinking water, air, and occupational exposures are also seen.
NUTRIENT INTERACTIONS:
Iron deficiency is associated with higher cadmium burden and absorption of cadmium may increase during very early stages of iron deficiency. Zinc deficiency is associated with an increase in Cadmium, as a result of the antagonistic relationship between the elements.
Dietary cadmium inhibits GI absorption of calcium and interferes with calcium and vitamin D metabolism. Low dietary calcium stimulates synthesis of calcium- binding protein which enhances Cadmium absorption.
Optimal range: 0.1 - 1.1 umol/L
Carnosine (beta-alanyl-L-histidine) is a urinary biomarker which comes from the consumption of beef, pork, and to a lesser extent, poultry.
It is a dipeptide consisting of the amino acids histidine and beta-alanine and is concentrated in skeletal and heart muscle, brain, and kidneys. Carnosine has antioxidant properties, antiglycation effects, enhanced calcium sensitivity, and pH buffering activity during highintensity exercise.
It also has neuroprotective properties and may play an important role in Alzheimer’s disease and other neurodegenerative diseases.
Carnosine is also protective against secondary diabetic renal complications.
Optimal range: 16 - 45 mg/dL
Ceruloplasmin is a copper-containing enzyme that plays a role in the body's iron metabolism. This test measures the amount of ceruloplasmin in the blood.
Optimal range: 1 - 2 ug/L
Chromium is ubiquitous in foods at low low concentrations. Derived from processing of food with stainless steel equipment. Also present in tobacco smoke, chrome, plating, dyes and pigments, leather tanning, and wood preserving and is deposited into air, water, and soil.
Blood distribution of chromium appears to be equally divided between plasma and RBCs, whole blood chromium the sample type for total chromium measurement. Chromium (VI) is more concentrated in the RBCs, while chromium (III) does not enter the RBCs. Therefore, it is possible to distinguish sources and types of exposure to indicate toxic (Cr VI) exposure versus benign (Cr III) by measuring RBC chromium. Chromium rapidly clears from the blood and measurements relate to recent exposure. Urinary chromium excretion reflects absorption of the previous one to two days.
Optimal range: 18 - 78 ug/mgCR
Cis-Aconitic Acid is involved in both energy production and removal of toxic ammonia.
Optimal range: 0 - 8.4 ug/mgCR
Optimal range: 132.5 - 645.6 ug/mgCR
A two-carbon group from Acetyl-CoA is transferred to oxaloacetate to form citric acid. Citric acid is then converted to isocitric acid through a cis-aconitic intermediate using the enzyme aconitase. Aconitase is an iron-sulfate protein that controls iron homeostasis.
Optimal range: 19.3 - 57.1 umol/L
Citrulline is an intermediate, nonprotein-forming amino acid in the urea cycle serving as a precursor to arginine. It derives its name from the watermelon (Citrullus vulgaris), where it was first isolated and identified. It is easily absorbed by the gut and bypasses the liver, making it an effective method for repleting arginine.
Other food sources of citrulline include muskmelons, bitter melons, squashes, gourds, cucumbers and pumpkins. Citrulline can also be synthesized from arginine and glutamine in enterocytes, which can then be metabolized by the kidneys back into arginine. Because citrulline is produced in enterocytes, it has been proposed as a marker of enterocyte mass in conditions of villous atrophy.
Optimal range: 0.13 - 1.7 ug/L
Cobalt is an essential trace element that is part of the NutriStat Basic Profile by US BioTek, and it plays a crucial role in our overall health. Cobalt is a component of vitamin B12 (cobalamin), which is vital for red blood cell production, nerve function, and DNA synthesis. When you see cobalt levels measured in your profile, it’s usually reflecting your body's intake and utilization of vitamin B12.
Optimal range: 1.27 - 4.29 ug/mgCR
Optimal range: 0.52 - 0.8 mg/L
Sources:
Legumes, mushrooms, chocolate, nuts and seeds, shellfish and liver are high in copper all greater than 2.4 µg per gram.
Food, water and air (via combustion and fossil fuels and agriculture) are sources of copper.
Copper pipes and fixtures in household plumbing may allow copper to leak into water.
Optimal range: 70 - 140 ug/dL
Copper serum is one of the diagnostic methods of ascertaining whether a patient is suffering from some kind of liver problem or from a genetic disease called Wilson’s disease.
Optimal range: 0.8 - 1 Ratio
The Copper/Zinc Ratio on a NutriSTAT panel represents a significant biomarker in nutritional and health assessments, offering insights into the balance between two essential trace elements: copper and zinc. Copper and zinc are pivotal for numerous physiological processes.
Copper plays a crucial role in:
→ the formation of red blood cells,
→ the maintenance of nerve cells,
→ and the immune system.
Optimal range: 5 - 65 ng/mL
Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.
Optimal range: 0.1 - 0.6 umol/L
Cystathionine is an intermediate dipeptide within the process of transsulfuration. Transsulfuration is the main route for irreversible homocysteine disposal, glutathione production, and energy. The initial step involves the enzyme cystathionine β-synthase enzyme (CBS). This reaction requires nutrient cofactors such as vitamin B6 and iron. Cystathionine is then converted to cysteine, and eventually goes on to either make glutathione or feed the Kreb’s cycle. Currently, there is no known source or physiologic function for cystathionine other than serving as a transsulfuration intermediate. Some literature suggests that cystathionine may exert protection against endoplasmic reticulum stress-induced tissue damage and cell death, but studies are sparse.
Optimal range: 5.2 - 41.8 umol/L
Optimal range: 31 - 50 umol/L
Cystine is formed from the oxidation of cysteine, or from the degradation of glutathione oxidation products. It is two cysteines linked together with a disulfide bond.
The urine FMV amino acid test reports cysteine and cystine separately. The plasma amino acid test combines both cysteine and cystine as one biomarker.
Optimal range: 0 - 7.7 ug/mgCR
Optimal range: 7.8 - 22.3 Ratio
Delta 6 Desaturase is an essential enzyme involved in the metabolism of fatty acids, which are vital components of our cells and play critical roles in maintaining overall health. Specifically, Delta 6 Desaturase helps convert dietary fats into essential fatty acids like gamma-linolenic acid (GLA) and eicosapentaenoic acid (EPA), which are crucial for producing anti-inflammatory molecules and supporting brain function, heart health, and immune response. The Nutristat Basic Profile from US Biotek measures the activity of this enzyme to provide insights into an individual's fatty acid metabolism.
Optimal range: 0.5 - 2.5 %
Dihomogamma Linolenic Acid (DGLA) is the elongation product of Gamma-linolenic acid (GLA).
Dihomo-gamma-linolenic acid (DGLA) is a fatty acid and part of the Omega-6 fatty acids family. Those fatty acids can predominatentely be found in vegetable oils, grains, most meats and dairy.
DGLA is a strong anti-inflammatory.
Optimal range: 0 - 0 ug/mgCR
Optimal range: 1 - 6.5 %
Docosahexaenoic acid (DHA) is an omega-3 fatty acid with 22 carbons and 6 double bonds (22:6n3). It can be obtained from the diet, supplemented, or created by conversion from DPA using elongase and desaturase enzymes. DHA is present in fatty fish such as salmon, tuna, and mackerel, and low levels of DHA can be found in meat and eggs. Both individually or in combination with EPA, DHA is widely supplemented due to the enormous amount of research available regarding its anti-inflammatory role in many clinical conditions such as cardiovascular disease, cognitive decline, autoimmune disease, fetal development, visual disturbances, cancer, and metabolic syndrome.
Optimal range: 0.08 - 0.83 %
Docosapentaenoic acid (DPA) is an omega-3 fatty acid with 22 carbons and five double bonds (22:5n3). It is formed from its precursor, EPA, by way of the elongase enzyme which adds two carbons. It can be supplemented or obtained in the diet from foods such as marine oily fish.
Not only is DPA found in most fish and marine foods but it is also present in lean red meat from ruminant animals.
Optimal range: 0.53 - 2.81 %
Docosapentaenoic acid (DPA) is an omega-3 fatty acid with 22 carbons and five double bonds (22:5n3). It is formed from its precursor, EPA, by way of the elongase enzyme which adds two carbons. It can be supplemented or obtained in the diet from foods such as marine oily fish.
Not only is DPA found in most fish and marine foods but it is also present in lean red meat from ruminant animals.
Optimal range: 0.3 - 2.5 %
Docosatetraenoic acid is also known as Adrenic acid / Adrenate.
Docosatetraenoic acid is a member of the class of compounds known as very long-chain fatty acids.
Fatty acids belong to one of three types or families: saturated, monounsaturated and polyunsaturated. These names describe the structure of the fatty acid in terms of whether it is fully loaded with hydrogen.
Optimal range: 0.1 - 0.43 %
Eicosadienoic acid is the elongation product of Gamma linolenic acid (GLA) and the direct precursor of Dihomogamma Linolenic (DGLA).
Optimal range: 0.14 - 6.92 %
Eicosapentaenoic acid (EPA) is an omega-3 fatty acid with 20 carbons and 5 double bonds (20:5n3).
EPA can either be made from the downstream metabolism of ALA or it can be obtained in the diet. Food sources include oily fish such as salmon, mackerel, cod, and sardines. In addition to diet and ALA desaturation, EPA is also available as a fish oil supplement. The desaturation of ALA to EPA is not a very efficient process, therefore dietary intake or supplementation is important.
Optimal range: 0 - 2.83 ug/mgCR
Ethylmalonic acid is a significant marker often evaluated in clinical settings to provide insights into metabolic processes within the body. Elevated levels of this compound can indicate a variety of metabolic disturbances, particularly those involving fatty acid oxidation and mitochondrial function.
Optimal range: 0 - 5.1 ug/mgCR
Formiminoglutamic Acid (FIGlu) is an intermediary organic acid in the conversion of the amino acid histidine to glutamic acid. This enzymatic conversion requires tetrahydrofolic acid.
Optimal range: 0.18 - 2.07 ug/mgCR
Fumarate (together with Succinate and Malate) is used in the body’s metabolic pathway that generates cellular energy – the Citric Acid Cycle.
Optimal range: 0.3 - 0.9 umol/L
Gamma-aminobutyric acid (GABA) is an amino acid that functions as an inhibitory neurotransmitter. It serves one-third of brain neurons and is involved in depression and mania.
Although there are some dietary supplement and food sources for GABA (cruciferous vegetables, spinach, tomatoes, beans, and rice), the primary source may be endogenous prodution. Nervous tissue, the gut microbiome, the liver, pancreas, and endothelial cells are important sources for production.
Optimal range: 0.05 - 0.72 %
Gamma-linolenic acid (GLA) is an omega-6 fatty acid. The body converts linoleic acid to gamma-linolenic acid and then to arachidonic acid (AA).
You can get gamma-linolenic acid from several plant-based oils, including evening primrose oil (EPO), borage oil, and black currant seed oil. Most of these oils also contain some linoleic acid.
Gamma-linolenic acid contains 18 carbons and 3 double bonds. It is synthesized from linoleic acid by adding a double bond using the delta-6-desaturase enzyme. This enzymatic reaction is very slow and further impaired in vitamin and mineral deficiencies such as zinc and cobalt. Stress, smoking, alcohol, and systemic inflammatory conditions can also slow this conversion.
Optimal range: 0 - 15.18 ug/mgCR
Optimal range: 0.1 - 1.1 mmol/L
The marker Glucose (OA) (Urine) is used to assess the level of glucose in urine, which can provide important insights into an individual's metabolic health. Glucose is a type of sugar that is a primary source of energy for the body's cells. Under normal circumstances, glucose is reabsorbed by the kidneys and does not appear in urine. However, when blood glucose levels are excessively high, as can occur in conditions like diabetes, the kidneys may not be able to reabsorb all of the glucose, leading to its presence in the urine. This condition is known as glycosuria. Monitoring glucose in urine can help detect issues with blood sugar regulation, which may be indicative of diabetes or other metabolic disorders. In addition, the presence of glucose in urine can sometimes signal kidney damage or dysfunction, as the kidneys are not effectively filtering blood. Regularly testing urine for glucose is a non-invasive method that can aid in early detection and management of metabolic conditions, helping individuals maintain better overall health through timely intervention and lifestyle adjustments.
Optimal range: 0.1 - 0.38 Ratio
The Glutamic Acid/Glutamine Ratio is used to identify specimen handling issues that cause spontaneous degradation of glutamine to glutamate, and can reveal the origin of difficulty maintaining systemic pH balance.
Optimal range: 63.9 - 237 umol/L
Glutamic acid is a nonessential amino acid is derived from the diet and from the breakdown of gut proteins. Glutamate is a major excitatory neurotransmitter in the brain. It plays a role in neuronal differentiation, migration, and survival in the developing brain. It is also involved in synaptic maintenance, neuroplasticity, learning, and memory.
Optimal range: 289 - 615 umol/L
Glutamine is a nonessential amino acid and is the most abundant amino acid in the body. It is formed from glutamate using the enzyme glutamine synthetase. Approximately 80% of glutamine is found in the skeletal muscle, and this concentration is 30 times higher than the amount of glutamine found in human plasma. Although glucose is used as fuel for many tissues in the body, glutamine is the main fuel source for a large number of cells including lymphocytes, neutrophils, macrophages, and enterocytes.
Optimal range: 0.3 - 1.2 ug/mgCR
Optimal range: 0.2 - 0.9 ug/mgCR
Optimal range: 207 - 617 umol/L
Glycine is a nonessential amino acid that is synthesized from choline, serine, hydroxyproline, and threonine. It has many important physiologic functions. It is one of three amino acids that make up glutathione. Glycine’s dietary sources include meat, fish, legumes, and gelatins. Glycine is a major collagen and elastin component, which are the most abundant proteins in the body. Like taurine, it is an amino acid necessary for bile acid conjugation; therefore, it plays a key role in lipid digestion and absorption.
Optimal range: 13.5 - 85.9 ug/mgCR
Optimal range: 0.1 - 0.77 %
Optimal range: 0 - 237 ug/mgCR
Optimal range: 71.3 - 206 umol/L
Histidine is a semi-essential amino acid which is formed in the breakdown of carnosine. Red meat is a common source of carnosine, and therefore histadine. Other food sources include poultry, fish, nuts, seeds, and grains. Histidine and histamine have a unique relationship. The amino acid histadine becomes histamine via a vitamin B6- dependent enzyme called histidine decarboxylase.
Optimal range: 2.39 - 14.92 ug/mgCR
Homovanillic acid (HVA) is a major catecholamine metabolite that is produced by a consecutive action of monoamine oxidase and catechol-Omethyltransferase on dopamine. HVA is associated with dopamine levels in the brain. Dopamine (3,4-dihydroxyphenethylamine) is a major excitatory neurotransmitter that functions both as a hormone and a neurotransmitter and plays several important roles in the brain and body. It is synthesized in the brain and kidneys. In the brain, dopamine functions as a neurotransmitter that acts on several distinct dopamine pathways, one of which plays a major role in the motivational component of reward-motivated behavior.
Optimal range: 0.2 - 0.4 umol/L
Hydroxylysine is an amino acid related to collagen.
What is collagen?
Collagen is the most abundant protein in your body. It is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin and muscles.
Optimal range: 10.3 - 39 umol/L
Hydroxyproline is a collagen related amino acid. Hydroxyproline is a nonessential amino acid, which means that it is manufactured from other amino acids in the liver. Hydroxyproline is necessary for the construction of the body’s major structural protein, collagen. Hydroxyproline is present in essentially all tissues and all genetic types of collagen.
Optimal range: 0 - 0.27 Ratio
The Hydroxyproline to Proline Ratio describes the relationship between Proline and Hydroxyproline and can be looked at in relation to your collagen metabolism.
Optimal range: 0 - 6.8 ug/mgCR
Optimal range: 0 - 160 ug/L
Iodine is an essential mineral that plays a crucial role in thyroid function. The thyroid gland uses iodine to produce thyroid hormones, which are responsible for controlling growth, repairing damaged cells, and supporting a healthy metabolism.
Optimal range: 19 - 79.2 ug/mgCR
A two-carbon group from Acetyl-CoA is transferred to oxaloacetate to form citric acid. Citric acid is then converted to isocitric acid through a cis-aconitic intermediate using the enzyme aconitase. Aconitase is an iron-sulfate protein that controls iron homeostasis.
Optimal range: 53.3 - 143 umol/L
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0 - 1.51 ug/mgCR
Kynurenic acid and Quinolinic acid are tryptophan metabolites formed through the kynurenine pathway. Tryptophan is the amino acid precursor to serotonin; its major route for catabolism is the kynurenine pathway. Important products of the kynurenine pathway include xanthurenic acid and kynurenic acid, which can further metabolize into quinolinic acid. The historical importance of this pathway has mainly been as a source of the coenzyme NAD+, which is important for all redox reactions in the mitochondria.
However, it is now understood that kynurenic and quinolinic acid have physiologic implications. This alternate pathway is upregulated in response to inflammation and stress, which can lead to deficient serotonin production. Kynurenic acid has shown some neuroprotective properties in the brain, since it can stimulate NMDA receptors. However, its importance on the periphery is still not fully elucidated. Some studies outline antiinflammatory, analgesic, antiatherogenic, antioxidative, and hepatoprotective properties to peripheral kynurenic acid.
The correlation to levels of urinary excretion needs further study. Quinolinic acid, in and of itself, can be inflammatory and neurotoxic.
Optimal range: 0 - 23.08 ug/mg CR
Lactic Acid and Pyruvic Acid are byproducts of glycolysis. Carbohydrates, which contain glucose, are broken down through glycolysis to form pyruvate and two ATP molecules. Pyruvate can also be generated through the catabolism of various amino acids, including alanine, serine, cysteine, glycine, tryptophan and threonine. Magnesium is an important cofactor for a number of glycolytic enzymes necessary to produce pyruvate. Optimally, pyruvic acid is oxidized to form Acetyl-CoA to be used aerobically via the Citric Acid Cycle to produce energy. In an anaerobic state, lactic acid is formed instead.
Optimal range: 469 - 899 umol/L
Optimal range: 0 - 90 ug/L
Found naturally in soil. More often found in fossil fuels, gasoline/exhaust, manufacturing, lead-acid batteries, ammunitions, metal solder and pipes, X-ray shields, paint, glass, pigments, and sheet lead.
Optimal range: 121 - 254 umol/L
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0.2 - 1.92 %
Lignoceric Acid is a saturated fatty acids, in particular it is part of the group of very long chain fatty acids (VLCFAs).
Optimal range: 14 - 31.3 %
Linoleic acid is by far the most abundant polyunsaturated fatty acid in most human tissues. Linoleic acid is an essential fatty acid, and low levels indicate dietary insufficiency.
Optimal range: 139 - 437 umol/L
Lysine is a nutritionally essential amino acid abundant in meat, fish, fowl, and legumes and is needed for formation of body proteins and enzymes.
Lysine can be methylated using S-adenosylmethionine (SAM) to synthesize carnitine, which is needed for fatty acid oxidation. Lysine also generates Acetyl CoA for use in the citric acid cycle. Lysine, proline, hydroxyproline, and vitamin C are important in the synthesis of collagen for skin, bones, tendons and cartilage.
Optimal range: 39 - 58 mg/L
Sources:
Green leafy vegetables, legumes, nuts, seeds, whole grains, medicines (e.g., Milk of Magnesia), Epsom salt. Over the last 60 years, the Mg content in fruits and vegetables has decreased by 20-30%,and 80-90% of Mg is lost during food processing.
Absorption factors:
The intestine, bone and kidney maintain magnesium homeostasis. Unlike other minerals, Mg can be absorbed along the entire length of the GI tract. Soft drinks, low protein diets, foods containing phytates, polyphenols and oxalic acid, fluoride, antibiotics, and oral contraceptives bind to magnesium and produce insoluble precipitatesor complexes, negatively impacting Mg availability and absorption. Caffeine, alcohol and diuretics (e.g., furosemide, bumetanide) increase renal excretion of Mg. Antacids (e.g., omeprazole) affect Mg absorption due to the increase in GI pH.
Optimal range: 0 - 3.59 ug/mgCR
Fumaric acid uses the fumarase enzyme to become malic acid. Malate dehydrogenase catalyzes the conversion of malic acid into oxaloacetate. Two forms of this enzyme exist in eukaryotes. One operates within the mitochondria to contribute to the Citric Acid Cycle; the other is in the cytosol where it participates in the malate/ aspartate shuttle. Riboflavin is an important cofactor for this enzyme and overall mitochondrial energy production and cellular function. At the end of each Citric Acid Cycle, the four-carbon oxaloacetate has been regenerated, and the cycle continues.
Optimal range: 9 - 33 ug/L
Whole grains (wheat germs, oats anda bran), rice, and nuts (hazelnuts, almonds, and pecans) contain the highest amount of Manganese.
Other food sources include chocolate, tea, mussels, clams, legumes, fruit, leafy vegetables (spinach), seeds (flax, sesame, pumpkin, sunflower, and pine nuts) and spices (chili powder, cloves and saffron).
Airborne exposure can occur through automobile exhaust, unleaded gasoline and occupational exposire (mining, welding, ferroalloy and steel industry, battery manufacturing).
It is also present in fungicides, textile bleaching, manufacturing of glass and ceramics, paint, matches and fireworks, leather tanning, hydroquinone, potassium permanganate and other chemical production. Soil manganese concentrations can contaminate well water.
Optimal range: 0 - 2 ug/L
SOURCES:
Mercury (Hg) has three forms:
Elemental (metallic)- older glass thermometers, fluorescent light bulbs, dental amalgams, folk remedies, combustion, electrical industry (switches, batteries, thermostats), solvents, wood processing
Organic (methyl mercury)- seafood, thimerosal (preservative), fungicides
Inorganic- skin lightening compounds, industrial exposure, folk medicine, lamps, photography, disinfectants
Optimal range: 8.5 - 34.8 umol/L
Methionine is an essential amino acid that plays an important role in the methylation cycle. Methionine is obtained from dietary intake or through homocysteine remethylation. Methionine’s dietary sources include eggs, fish, meats, Brazil nuts, and other plant seeds. Methionine is converted to the body’s main methyl donor, S-adenosylmethionine (SAM). This conversion requires the enzyme methionine adenosyltransferase (MAT).
Optimal range: 0 - 4.92 ug/mgCR
Methyl-Succinic Acid is a compound measured in urine that provides valuable insights into the metabolic processes occurring within the body. It is a key biomarker for evaluating mitochondrial function, which is crucial for energy production in cells. Specifically, elevated levels of Methyl-Succinic Acid can indicate issues with the body's ability to break down certain types of fats. This can be related to a deficiency in specific enzymes involved in the Krebs cycle, an essential energy-producing pathway.
Optimal range: 0 - 1.85 ug/mgCR
Methylmalonic Acid (MMA) is formed from propionylCoA via methylmalonyl-CoA. Major dietary sources of propionyl-CoA include valine, isoleucine, methionine, threonine, and odd chain fatty acids. MethylmalonylCoA is converted to succinyl-CoA to feed the Citric Acid Cycle via the enzyme methylmalonyl-CoA mutase. This enzyme is very vitamin B2 dependent. In B12 deficiency, methylmalonyl-CoA is hydrolyzed to methylmalonic acid.
Optimal range: 0.6 - 2 ug/L
Sources of Molybdenum:
- Beans (lima, white, red, green, pinto, peas),
- grains (wheat, oat, rice),
- nuts,
- vegetables (asparagus, dark leafy, Brassicas),
- milk, cheese.
Absorption factors:
- Molybdenum absorption is passive in the intestines.
- Urinary excretion is a direct reflection of dietary Molybdenum intake, not necessarily Molybdenum status.
- Increased Mo intake may elevate urinary copper excretion.
Optimal range: 15.65 - 31.82 %
The Monounsaturated Fats, Total marker provides valuable information about the level of monounsaturated fats in your body. Monounsaturated fats are a type of healthy fat found in various foods, including olive oil, avocados, nuts, and seeds. These fats are known for their beneficial effects on heart health, as they can help reduce bad cholesterol levels and lower the risk of heart disease.
Optimal range: 0.1 - 2.45 %
Myristic acid is a medium chain fatty acid (=MCFA). It is present in palm kernel oil, coconut oil, butterfat, milk and to some extent in animal fats.
Optimal range: 0.15 - 0.83 ug/mgCR
Optimal range: 0.13 - 1.96 %
Nervonic acid is a monounsaturated fatty acid. Nervonic acid has the longest carbon chain of all monounsaturated fatty acids. It is found in highest concentrations in nerve membranes, particularly in myelin sheaths, which are sleeves of fatty tissue that protect your nerve cells.
Optimal range: 0 - 2 ug/L
Used in making metal coins and jewelry, valves and heat exchangers, and stainless steel. Also used for nickel plating, color ceramics, cosmetics, tobacco, and batteries. Can be found in the soil, air, and water. There are also nickel containing foods such as almonds, chick peas, cocoa, tomato, lentils, oats, peanuts, and walnuts.
NUTRIENT INTERACTIONS:
Iron is a competitive inhibitor of nickel absorption, therefore absorption is enhanced with iron deficiency. Vitamin C works as an antioxidant to counter ROS from nickel, and may also inhibit nickel absorption.
Optimal range: 14.2 - 25.5 %
Oleic acid is the most common monounsaturated fatty acid in human cells.
Optimal range: 2.9 - 12.9 %
The laboratory does not provide a specific reference range for this marker.
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The omega-3 index is defined as the RBC percentage sum of EPA+DHA, both of which are important antiinflammatory omega-3 fatty acids. This index was first proposed in 2004 as a cardiovascular risk factor by Dr. Willian S. Harris and Dr. Clemons von Schacky as a way of assessing risk for coronary artery disease and related death. Since then, it has been repeatedly verified as an important cardiovascular biomarker, and studied in other diseases including obesity, mood disorder, and insulin resistance.
A reasonable target for the omega-3 index is >8% to decrease disease risk. Drs. Harris and von Schacky stratified risk zones as high risk (8%). These percentages have been continually verified in outcome studies and risk assessment.
Dietary intervention to increase the omega-3 index should include oily fish, flax, walnut, and chia. Fish oil supplementation can also be considered.
Optimal range: 2.57 - 15.15 %
The marker Omega 3, Total represents the combined levels of various omega-3 fatty acids in your blood. Omega-3 fatty acids are essential fats that the body cannot produce on its own, meaning they must be obtained through diet or supplements. They are known for their numerous health benefits, including supporting heart health, reducing inflammation, and aiding in brain function. The "Omega 3, Total" measurement typically includes important omega-3s like EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid), and ALA (alpha-linolenic acid). A sufficient level of omega-3s in your blood is crucial because these fats help to maintain cell membranes, regulate blood clotting, and reduce the risk of chronic diseases such as heart disease and arthritis.
Optimal range: 0.1 - 0.46 Ratio
The Omega-3/Omega-6 ratio is an important marker that provides valuable insight into your overall health and dietary balance. Omega-3 and Omega-6 are essential fatty acids, meaning they are crucial for your body's functions but must be obtained through your diet since your body cannot produce them. Omega-3 fatty acids, commonly found in fish, flaxseeds, and walnuts, are known for their anti-inflammatory properties and benefits for heart health, brain function, and overall well-being. In contrast, Omega-6 fatty acids, found in vegetable oils, nuts, and seeds, while also necessary for health, tend to promote inflammation when consumed in excess. The balance between these two types of fatty acids is crucial; a proper ratio helps maintain cellular health, supports immune function, and reduces the risk of chronic diseases.
Optimal range: 24.85 - 44.15 %
The marker Omega 6, Total measures the overall amount of omega-6 fatty acids in your body. Omega-6 fatty acids are a type of polyunsaturated fat found in many common foods, such as vegetable oils (like corn oil, soybean oil, and sunflower oil), nuts, seeds, and some meats. These fats are essential for human health because they play a crucial role in brain function, skin and hair growth, bone health, and the regulation of metabolism. However, it's important to maintain a proper balance between omega-6 and omega-3 fatty acids, another type of essential fat, to avoid potential health issues.
Optimal range: 1.9 - 14.6 Ratio
Omega-6:Omega-3 ratio is calculated by dividing the sum of all the omega-6 fatty acids by the sum of all the omega-3 fatty acids.
Omega 6 and 3 are two essential fats that are categorized as polyunsaturated fatty acids, or PUFAs for short. These fats are essential since we lack the ability to make them in our bodies and must obtain them from food or supplements. Once ingested, our body uses these fats to create other types of fats with important biological and health-promoting roles.
Omega 6 and 3 have many biological roles, including cell structure as well as eye and brain development, but are probably best known for their role in inflammation. In general, omega 6 fats are considered pro-inflammatory, while omega 3 fats are considered anti-inflammatory. However, both omega 6 and omega 3 fats can promote and inhibit the body’s inflammatory response, although omega 6 appears to produce a greater inflammatory response compared to omega 3. On the other hand, DHA and EPA can turn off the body’s inflammatory response and even influence certain genes to halt the production of inflammatory molecules.
Optimal range: 101 - 407 umol/L
Ornithine is an intermediate nonprotein-forming amino acid of the urea cycle. Arginine is converted to ornithine via the arginase enzyme, with urea as a byproduct. Ornithine combined with carbamoyl phosphate is then converted into citrulline via the ornithine transcarbamylase (OTC) enzyme. The contribution of carbamoyl phosphate results from the metabolism of ammonia by the enzyme carbamoyl phosphate synthase, and if this magnesium-dependent process is impaired, ammonia buildup, or hyperammonemia can occur.
Optimal range: 0 - 1.09 ug/mgCR
Optimal range: 3.15 - 41.69 ug/mgCR
Optimal range: 0 - 1.5 ug/mgCR
Optimal range: 17.5 - 27.1 %
Palmitic acid is a saturated fatty acid.
Palmitic and stearic acids are significant markers for high consumption of saturated fats.
Optimal range: 0.13 - 2.9 %
Palmitoleic acid, a key component of the Nutristat Basic Profile by US BioTek, provides valuable insights into your health status. This monounsaturated omega-7 fatty acid is naturally present in foods like macadamia nuts, sea buckthorn oil, and certain fish. Known for its anti-inflammatory properties, palmitoleic acid aids in enhancing insulin sensitivity, regulating blood sugar levels, and supporting heart health by lowering LDL cholesterol and boosting HDL cholesterol. Moreover, it contributes to skin health by promoting hydration and elasticity, leading to a more youthful appearance. Monitoring and optimizing palmitoleic acid levels can significantly impact overall health, improving cardiovascular function, metabolic control, and skin condition. Utilizing this marker can be instrumental in effectively managing and understanding your health.
Optimal range: 0.5 - 7.4 ug/mgCR
Optimal range: 0 - 2 ug/mgCR
Optimal range: 0 - 1.47 ug/mgCR
p-hydroxyphenyllactate is a marker of cell turnover. It is also a metabolite in tyrosine degradation and may be useful for studying disorders of tyrosine metabolism, including inborn errors of metabolism, and liver disease. High levels of p-hydroxyphenyllactate may respond to high intakes of vitamin C, which aids in restoration of normal metabolism and cell control.
Optimal range: 0 - 0.4 ug/mgCR
Optimal range: 51.2 - 121 umol/L
Phenylalanine is an essential amino acid found in most foods which contain protein such as meat, fish, lentils, vegetables, and dairy. Phenylalanine is the precursor to another amino acid, tyrosine. Because tyrosine is needed to form several neurotransmitters (dopamine, epinephrine, and norepinephrine), as well as thyroid hormone and melanin, phenylalanine intake is important.
Optimal range: 0 - 2.01 Ratio
The Phenylalanine/Tyrosine Ratio evaluates the body’s ability to convert phenylalanine to tyrosine; Conversion enzyme requires tetrahydrobiopterin (BH4), niacin (B3), and iron as cofactors.
Optimal range: 0 - 0.2 ug/mgCR
Optimal range: 14.1 - 102 umol/L
Phosphoserine is the phosphorylated ester of the amino acid serine. The addition of a phosphoryl group to an amino acid, or its removal, plays a role in cell signaling and metabolism. Phosphoserine is a byproduct of glycolysis and subsequent intermediate to then become serine. The enzyme that catalyzes this step, phosphoserine phosphatase, is magnesium dependent. This metabolite is not to be confused with a similar-sounding metabolite, phosphatidylserine; this is a common CNS supplement and essential for neuronal cell membranes.
Optimal range: 0 - 1.5 ug/mgCR
Picolinate is a neurotransmitter metabolism marker and is produced under inflammatory conditions.
Optimal range: 0 - 3 ug/mgCR
Pimelic acid, found in urine, is a significant metabolic marker that provides insights into various biochemical processes within the body. This compound is a dicarboxylic acid that plays a crucial role in the biosynthesis of biotin, an essential B-vitamin necessary for numerous metabolic functions, including the metabolism of fats, carbohydrates, and proteins.
Optimal range: 0 - 0.4 ug/L
SOURCES:
Can be found in soil and river sediments, air, and jewelry. Used as a catalyst in the automotive, chemical, and pharmaceutical industries. It’s resistance to oxidation makes it important in the manufacturing of laboratory equipment. It is also used as a chemotherapeutic agent.
PHYSIOLOGIC EFFECTS:
Platinum binds to DNA and interferes with transcription and replication resulting in apoptosis.
CLINICAL SIGNIFICANCE:
Metallic forms are inert, but the complex salts can produce conjunctivitis, urticaria, dermatitis, and eczema with dermal exposure. Nephrotoxicity and thrombocytopenia are seen with platinum chemotherapeutic agents. Respiratory exposures can produce wheezing and shortness of breath.
Optimal range: 108 - 223 umol/L
Proline is a nonessential amino acid. It contains a secondary α-imino group and is sometimes called an α-imino acid. Proline, and its metabolite hydroxyproline, constitute a third of the total amino acids found in collagen. Lysine, proline, hydroxyproline, and vitamin C are all important in the synthesis of collagen for skin, bones, tendons, and cartilage. Proline is abundant in meat, bone meal, poultry, salmon, wheat, barley, and corn. In addition to dietary sources, proline can be synthesized from glutamate/glutamine, arginine, and ornithine. It can also be synthesized within enterocytes from degradation of small peptides.
Optimal range: 0.7 - 20.3 ug/mgCR
Optimal range: 5.3 - 15.7 ug/mgCR
Optimal range: 0 - 8.11 ug/mgCR
Pyruvic acid, also known as pyruvate, is a key intermediate in several metabolic pathways throughout the body. Its presence in urine can provide valuable insights into a person's metabolic health and energy production processes. Pyruvic acid is a product of glycolysis, the process by which glucose is broken down to produce energy. After glycolysis, pyruvate can follow several pathways: it can be converted into acetyl-CoA and enter the Krebs cycle for further energy production, or it can be transformed into lactate under anaerobic conditions. Elevated levels of pyruvic acid in urine might indicate issues with carbohydrate metabolism, potential enzyme deficiencies, or problems in the Krebs cycle.
Optimal range: 0 - 9.74 ug/mgCR
Kynurenic acid and Quinolinic acid are tryptophan metabolites formed through the kynurenine pathway. Tryptophan is the amino acid precursor to serotonin; its major route for catabolism is the kynurenine pathway. Important products of the kynurenine pathway include xanthurenic acid and kynurenic acid, which can further metabolize into quinolinic acid. The historical importance of this pathway has mainly been as a source of the coenzyme NAD+, which is important for all redox reactions in the mitochondria.
However, it is now understood that kynurenic and quinolinic acid have physiologic implications. This alternate pathway is upregulated in response to inflammation and stress, which can lead to deficient serotonin production. Kynurenic acid has shown some neuroprotective properties in the brain, since it can stimulate NMDA receptors. However, its importance on the periphery is still not fully elucidated. Some studies outline antiinflammatory, analgesic, antiatherogenic, antioxidative, and hepatoprotective properties to peripheral kynurenic acid.
The correlation to levels of urinary excretion needs further study. Quinolinic acid, in and of itself, can be inflammatory and neurotoxic.
Optimal range: 3.9 - 9.7 umol/L
Sarcosine is an amino acid made within the methylation cycle when S-adenosylmethionine (SAM) is conjugated with glycine.
It can also be made by catabolism of dimethylglycine (DMG).
There are many dietary sources of sarcosine including eggs, legumes, nuts, and meats.
Sarcosine is also available as an over-the-counter supplement, and it is widely used in cosmetic formulations (toothpaste, creams, and soaps) and detergents.
In the methylation cycle, sarcosine is created by the GNMT enzyme, which functions to control SAM excess. Some clinicians use sarcosine elevation as a marker of ‘excess methyl supplementation’ or ‘over-methylation.’ Currently, there is no literature to support this hypothesis, but rather it is based on physiology.
Optimal range: 29.89 - 42.1 %
Saturated Fats, Total is a key marker providing important information about the levels of saturated fats in your diet. Saturated fats are a type of fat found in various foods, including animal products like meat and dairy, as well as some plant-based oils like coconut and palm oil and peanut butter. These fats are typically solid at room temperature. Monitoring the total amount of saturated fats in your diet is crucial because high intake is linked to an increased risk of developing heart disease and other health issues. When you consume too many saturated fats, it can lead to higher levels of LDL (low-density lipoprotein) cholesterol, often referred to as "bad" cholesterol, in your blood.
Optimal range: 190 - 500 ug/L
Sources:
The selenium content of grains and vegetables depends on the selenium content of the soil. In meats, selenium content is dependent on the diet of the animals. Foods with higher selenium content include Brazil nuts, seafood (especially tuna), chicken, beef, pork, lamb. Also present in air, water, soil, metallurgy, airborne coal/oil emissions, dandruff shampoo, paints, photo cells, drums, photocopiers, glass, ceramics, rubber, pharmaceuticals.
Absorption factors:
Selenium tends to be well absorbed, and the bioavailability of selenium in the form of selenomethionine is greater than 90%. Sulfur, lead, arsenic, calcium and iron reduced the absorption of selenium. Urine is the main route of excretion and reflects recent dietary intake. Plasma is useful for assessing nutritional selenium status.
Optimal range: 43.8 - 94.3 umol/L
Serine is a nonessential amino acid used in protein biosynthesis and can be derived from four possible sources: dietary intake, degradation of protein and phospholipids, biosynthesis from glycolysis intermediate 3-phosphoglycerate, or from glycine.
Serine is found in soybeans, nuts, eggs, lentils, shellfish, and meats. Serine is used to synthesize ethanolamine and choline for phospholipids. Serine is essential for the synthesis of sphingolipids and phosphatidylserine in CNS neurons. In the folate cycle, glycine and serine are interconverted. These methyltransferase reactions and interconversions are readily reversible depending on the needs of the folate cycle. Dietary serine is not fully converted to glycine; therefore, serine supplementation has little value, though is not harmful.
Optimal range: 0 - 2 ug/L
Silver is a marker on the NutriStat Basic Profile by US BioTek that helps assess the level of this metal in your body. While silver is not an essential nutrient for human health, it can be present in the body due to various sources, including dietary intake, environmental exposure, and the use of silver-containing products. In medical contexts, silver is sometimes used for its antibacterial properties in wound dressings and certain medical devices. However, elevated levels of silver in the body can be concerning. High silver levels may indicate exposure to silver from industrial settings, contaminated food or water, or overuse of silver supplements or colloidal silver products, which some people use for purported health benefits.
Optimal range: 8.4 - 15 %
Stearic acid is a saturated fatty acid that is two carbon atoms longer than palmitic acid.
Optimal range: 0 - 2.9 ug/mgCR
Suberic acid is an important organic compound that can be measured to gain insights into metabolic processes within the body. It is a dicarboxylic acid, meaning it has two carboxyl groups (-COOH) at each end of its molecular structure. This compound is naturally produced during the breakdown of fatty acids, specifically through a process called beta-oxidation. Elevated levels of suberic acid in the body can indicate issues with fatty acid metabolism, which may be due to a deficiency in specific nutrients like carnitine, necessary for transporting fatty acids into the mitochondria where they are broken down for energy. Additionally, high suberic acid levels might suggest mitochondrial dysfunction, where the energy-producing organelles in cells are not working efficiently. This can result from various factors, including genetic conditions, nutrient deficiencies, or environmental toxins. Monitoring suberic acid levels can thus be a valuable tool for identifying metabolic imbalances and guiding nutritional and therapeutic interventions to restore optimal metabolic function.
Optimal range: 1.88 - 27.59 ug/mgCR
Succinyl CoA becomes succinic acid using succinyl CoA synthetase. This reaction produces NADH which directly provides electrons for the electron transport chain or respiratory chain. Succinic acid requires the enzyme succinate dehydrogenase to become fumarate. This enzyme is ironbased and requires vitamin B2 to support flavin adenine dinucleotide (FAD) as a redox coenzyme. Succinate dehydrogenase plays a critical role in mitochondrial metabolism. Impairment of this enzyme’s activity has been linked to a variety of diseases such as cancer and neurodegenerative diseases.
Optimal range: 0 - 16.5 ug/mgCR
Optimal range: 89.9 - 301 umol/L
Taurine differs from other amino acids because a sulfur group replaces the carboxyl group of what would be the nonessential amino acid, β-alanine. It takes part in biochemical reactions and is not fully incorporated into proteins. In most tissues, it remains a free amino acid.
Taurine’s highest concentration is in muscle, platelets, and the central nervous system. Taurine is mainly obtained via dietary sources (dairy, shellfish, turkey, energy drinks), but can also come from sulfur amino acid metabolism (methionine and cysteine).
It has been proposed that taurine acts as an antioxidant, intracellular osmolyte, membrane stabilizer, and a neurotransmitter.
Optimal range: 0 - 0.6 ug/L
SOURCES:
Fish, shellfish, plants, cigarettes, soil, air, water, electronic devices, switches and closures for the semi-conductor industry, glass for medical procedures.
NUTRIENT INTERACTIONS:
Some of its toxic effects results from interference with biological functions of potassium.
Optimal range: 59 - 206 umol/L
Threonine is a large neutral amino acid and a precursor for the amino acid glycine. Foods that contain relatively high amounts of threonine include cheeses (especially Swiss), meat, fish, poultry, seeds, walnuts, cashews, almonds and peanuts. Threonine gets converted to glycine using a two-step biochemical pathway involving the enzymes threonine dehydrogenase and the vitamin B6-dependent glycine C-acetyltransferase.
Optimal range: 0 - 1.3 ug/L
SOURCES:
Found in manufacturing, food, packaging, solder, bronzing, dyeing textiles, plastics, PVC pipes, fungicides, toothpaste, perfume, soap, food additives, electronic, cigarette aerosol, and dyes. Naturally present and rocks and nearby air, water, and soil. Seafood is the primary route of human exposure to tin compounds. Tin is found in both organic and inorganic forms. Inorganic tin is generally regarded as safe by the FDA as a food additive for human consumption.
Nutrient interactions:
Tin disturbs copper, zinc, and iron metabolism.
Optimal range: 368 - 724 umol/L
- BCAAs are key nitrogen donors in the form of glutamic acid, glutamine, and alanine.
- Elevated total BCAAs have been associated with obesity, weight loss, insulin resistance, and NAFLD.
- Elevated plasma BCAAs were associated with an increased risk of hypertension, cardiovascular disease.
- BCAAs are higher in a “Western” diet. Check B6 need.
- Lower levels seen in liver cirrhosis and urea cycle disorders.
- Decreased amino acids are seen with decreased protein and calorie intake; increased tissue uptake, and body losses (urine, sweat, etc.).
Optimal range: 15.65 - 31.82 %
The Total Monounsaturated Fats marker provides valuable information about the level of monounsaturated fats in your body. Monounsaturated fats are a type of healthy fat found in various foods, including olive oil, avocados, nuts, and seeds. These fats are known for their beneficial effects on heart health, as they can help reduce bad cholesterol levels and lower the risk of heart disease.
Optimal range: 2.57 - 15.15 %
The marker Total Omega 3 Fatty acids represents the combined levels of various omega-3 fatty acids in your blood. Omega-3 fatty acids are essential fats that the body cannot produce on its own, meaning they must be obtained through diet or supplements. They are known for their numerous health benefits, including supporting heart health, reducing inflammation, and aiding in brain function. The "Omega 3, Total" measurement typically includes important omega-3s like EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid), and ALA (alpha-linolenic acid). A sufficient level of omega-3s in your blood is crucial because these fats help to maintain cell membranes, regulate blood clotting, and reduce the risk of chronic diseases such as heart disease and arthritis.
Optimal range: 24.85 - 44.15 %
Omega-6 fatty acids are a type of polyunsaturated fat found in vegetable oils, nuts and seeds. When eaten in moderation and in place of the saturated fats found in meats and dairy products, omega-6 fatty acids can be good for your heart.
Your body needs fatty acids and can make all but two of them, which is why they are called essential fatty acids. Linoleic and linolenic acids are derived from foods containing omega-6 and omega-3 fatty acids, respectively, which serve different functions in the body. Some of these fatty acids appear to cause inflammation, but others seem to have anti-inflammatory properties. More research is needed to fully understand how these apparently opposing effects interact with each other and with other nutrients.
Optimal range: 16 - 27 %
Having high levels of Total Omega 9 Fatty Acids is generally considered beneficial for health. Omega-9 fatty acids are monounsaturated fats that are nonessential, meaning your body can produce them. They are often found in foods like olive oil, avocados, and nuts. Omega-9 fatty acids have been associated with potential roles in reducing inflammation and promoting heart health. While they are nonessential, incorporating sources of omega-9 fats into your diet can be advantageous, especially when replacing saturated fats. High levels of omega-9s are generally preferred as they are considered beneficial for overall well-being, particularly heart health. However, it's important to maintain a balanced diet and consider factors such as overall fat intake and the types of fats consumed.
Optimal range: 29.89 - 42.1 %
Total Saturated Fats is a key marker providing important information about the levels of saturated fats in your diet. Saturated fats are a type of fat found in various foods, including animal products like meat and dairy, as well as some plant-based oils like coconut and palm oil and peanut butter. These fats are typically solid at room temperature. Monitoring the total amount of saturated fats in your diet is crucial because high intake is linked to an increased risk of developing heart disease and other health issues. When you consume too many saturated fats, it can lead to higher levels of LDL (low-density lipoprotein) cholesterol, often referred to as "bad" cholesterol, in your blood.
Optimal range: 0.22 - 1.99 %
Trans fats are a type of unsaturated fat that have been chemically altered through a process called hydrogenation, which is commonly used to extend the shelf life of processed foods. These fats are found in many packaged snacks, baked goods, and fried foods. High levels of trans fats in the blood are associated with an increased risk of heart disease, inflammation, and other health issues. The Trans Fat Index provides a snapshot of your trans fat intake over time, offering valuable insight into your dietary habits.
Optimal range: 0.3 - 2.02 %
The marker "Trans Fatty Acids, Total" on a Nutristat Basic Profile from US Biotek measures the total amount of trans fats in a person's blood. Trans fats are a type of unsaturated fat that can be harmful to health. They are often found in processed and fried foods, as well as in baked goods made with partially hydrogenated oils.
Risks Associated with High Trans Fatty Acid Levels
High levels of trans fatty acids in the blood are associated with an increased risk of heart disease, as they can raise LDL (bad) cholesterol levels while lowering HDL (good) cholesterol levels. This imbalance can lead to the build-up of fatty deposits in the arteries, increasing the risk of atherosclerosis, heart attacks, and strokes. Additionally, trans fats can cause inflammation and negatively affect insulin sensitivity, contributing to the risk of diabetes.
Optimal range: 0.07 - 0.92 %
Trans Linoleic Fatty Acid is a specific type of trans fat that is measured in the Nutristat Basic Profile by US Biotek. Trans fats, including Trans Linoleic Fatty Acid, are unsaturated fats that have been chemically altered to improve shelf life and stability in foods, but they can have negative health effects.
Measuring Trans Linoleic Fatty Acid Levels
On the Nutristat Basic Profile, measuring Trans Linoleic Fatty Acid levels helps assess an individual's intake of trans fats, which are commonly found in processed and fried foods. High levels of Trans Linoleic Fatty Acid in the body are a concern because they are linked to increased risks of heart disease, inflammation, and other chronic health conditions.
Optimal range: 0 - 0.51 %
Optimal range: 0.1 - 2.45 %
Palmitoleic acid (POA) is a monounsaturated omega-7 fatty acid (16:1n7).
The main dietary sources of palmitoleic acid include dairy products, avocado oils, oily fish, and macadamia nuts. Macadamia nuts contain the cis- isomer of POA, while dairy products mainly contain the trans- isomer. Like many fatty acids, POA can also be endogenously made from the breakdown of triglycerides, the desaturation of palmitic acid, or de novo synthesis from carbohydrates. POA is an important signaling lipokine, produced mainly by white adipose tissue, that regulates important metabolic processes such as skeletal muscle glucose disposal, insulin sensitivity, and hepatic lipid deposition. It is also a modulator of adipocyte lipolysis, however, studies are mixed as to POA’s specific role in obesity. Epidemiologic studies show that circulating POA levels are involved in cholesterol metabolism and hemostasis, though the results are mixed as to their specific cardiovascular outcomes.
Optimal range: 0 - 1.97 ug/mgCR
Optimal range: 0.12 - 0.35 Ratio
Tryptophan is an essential amino acid, a subunit in protein molecules and a precursor to serotonin. The brain uses tryptophan to produce serotonin, a neurotransmitter largely responsible for feelings of happiness and well-being.
Tryptophan cannot be synthesised by the body and must be obtained through diet.
Optimal range: 61.1 - 211 umol/L
Tryptophane is involved in serotonin production via vitamin B6-dependent pathways resulting in the intermediate 5-hydroxytryptophan (5-HTP).
5-HTP is often used as a supplement for serotonin formation instead of tryptophan, which can be quickly metabolized in other pathways. Serotonin is further metabolized to melatonin via methylation. Because of these downstream conversions, therapeutic administration of 5-HTP has been shown to be effective for depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
Optimal range: 30.2 - 76 umol/L
Tyrosine is a conditionally essential amino acid which can come directly from the digestion of dietary protein. Common food sources include dairy, beans, whole grains, meat, and nuts. If intake is insufficient, tyrosine can be formed from the essential amino acid phenylalanine using a tetrahydrobiopterin reaction. Tyrosine itself is a precursor to several neurotransmitters including dopamine, epinephrine and norepinephrine. It is also needed to create thyroid hormone and melanin skin pigments. Within the metabolism of tyrosine to form neurotransmitters and other hormones, there are several important nutrient cofactors involved including vitamin B1, vitamin B6, tetrahydrobiopterin, copper, vitamin C, among others.
Optimal range: 0 - 0.1 ug/L
Sources:
Largely limited to use as a nuclear fuel. Present naturally in air, water, food, and soil. The uranyl ion forms water-soluble compounds and is an important component in body fluids. Three different kinds are defined: natural, enriched, and depleted uranium(DU). The radiological and chemical propertiesof natural and DU have similar chemotoxicity, though natural is 60% more radiotoxic.
Nutrient Interactions:
U is reactive. It can combine with and affect the metabolism of lactate, citrate, pyruvate, carbonate,and phosphate, causing mitochondrialdamage. It replaces calciumin bone.
Optimal range: 2.8 - 8.1 mmol/L
Urea is a nontoxic byproduct of nitrogen (ammonia) detoxification. It is formed in the liver via the urea cycle and is the end product of protein metabolism. It is essentially a waste product with no physiological function.
Optimal range: 178 - 377 umol/L
Branched Chain Amino Acids (Isoleucine, Leucine, Valine) Isoleucine, leucine and valine are the three branched chain amino acids (BCAAs). Branched chain amino acids (BCAA) are essential amino acids and must be obtained from the diet (mainly meat, grains, and dairy).
Optimal range: 0.1 - 0.5 ug/L
Sources:
Mushrooms, shellfish, black pepper, parsley, dill seed, beer, wine, grains, sweeteners, infant cereals.
Fossil fuels, welding, catalysts, steel alloys, batteries, photographic developer, drying agent in paints/varnishes, reducing agent, pesticides, black dyes/inks/pigments in ceramics, printing and textile industries.
Optimal range: 1.4 - 5.09 ug/mgCR
Vanillylmandelic acid (VMA) is an end-stage metabolite of the catecholamines dopamine, epinephrine, and norepinephrine formed via the actions of monoamine oxidase, catechol-O-methyl transferase (COMT), and aldehyde dehydrogenase. VMA is found in the urine, along with other catecholamine metabolites, including homovanillic acid (HVA), metanephrine, and normetanephrine.
Optimal range: 0 - 0.93 ug/mgCR
Xanthurenic acid is a metabolite that is measured in urine to assess the body's metabolism of tryptophan, an essential amino acid involved in numerous biological processes, including the synthesis of serotonin and niacin. Elevated levels of xanthurenic acid in the urine can indicate a deficiency in vitamin B6, which is a crucial cofactor in the proper metabolism of tryptophan. When vitamin B6 is insufficient, the body’s ability to convert tryptophan into its beneficial end products is impaired, leading to an accumulation of intermediate metabolites like xanthurenic acid. This marker can also provide insights into potential disruptions in glucose metabolism and immune function, as abnormal levels have been associated with conditions such as diabetes and autoimmune diseases. Monitoring xanthurenic acid levels can thus be an important aspect of understanding overall health, particularly in relation to nutritional status and metabolic functions.
Optimal range: 8.6 - 14.5 mg/L
Optimal range: 58 - 124 ug/dL
In healthy individuals, plasma or serum zinc are reliable markers of zinc status, mainly reflecting zinc intake. Because the effective regulation of zinc homeostasis buffers the functional response to dietary deficiency and excess, plasma zinc levels are generally considered a poor measure of marginal zinc deficiency.
Optimal range: 0 - 3 ug/L
Zirconium is a trace element that appears on the NutriStat Basic Profile by US BioTek, typically measured to assess environmental exposure and potential health impacts. Zirconium is not known to play any essential biological role in the human body, and its presence is generally attributed to external sources rather than dietary intake.
PLATELET AUTOANTIBODIES
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
PLATELET ANTIBODIES
Reference range: NEGATIVE, POSITIVE
Reference range: NEGATIVE, POSITIVE
Reference range: NEGATIVE, POSITIVE
DetoxiGenomic Profile and a la carte SNPs
The DetoxiGenomic® Profile and a la carte SNPs are designed to assess genetic risks for chronic diseases. According to the CDC, precision medicine, also known as personalized medicine, tailors patient care based on genetics, lifestyle, and environmental factors. Single Nucleotide Polymorphisms (SNPs) are genetic variants that can predispose patients to various chronic diseases. By testing for these SNPs, clinicians can identify genetic predispositions and customize treatments. Everyone has SNPs, which are common and generally not as severe as genetic mutations. SNPs subtly reduce cellular functions, impacting overall quality of life. Genomic testing helps identify hidden gene polymorphisms that may lead to chronic diseases. Many people mistakenly believe that having a SNP means they will develop the associated disease. However, most genes can be influenced by environmental, dietary, and lifestyle factors. Genotypic SNP testing can prompt monitoring of associated biomarkers, such as closely watching homocysteine levels in patients with MTHFR polymorphisms. SNP testing is beneficial for patients with chronic conditions that resist treatment, a family history of cardiovascular disease, mood disorders, Alzheimer’s, cancer, autoimmune diseases, inflammatory conditions, cardiovascular disease, mood disorders, osteoporosis, metabolic disorders, chemical sensitivity, asthma, lung problems, and cognitive decline.
The DetoxiGenomic Profile evaluates over 20 SNPs related to phase 1 and phase 2 detoxification pathways, highlighting risks of impaired detoxification capacity and susceptibility to adverse drug reactions. Specific SNPs available include:
These SNPs can be added to other profiles like NutrEval, Metabolomix+, Methylation Panel, and Essential Estrogens for comprehensive genetic risk assessment.
Reference range: Present, Absent
The health implications of Glutathione S-Transferase (GST) are significant, as GST is crucial for Phase II detoxification of xenobiotics, carcinogens, and oxidative stress products. GSTM1, a specific variant of GST, is primarily located in the liver. The GSTM1 gene can be either present or absent (null). When at least one copy of the gene is present, it is classified as present; when both copies are absent, it is classified as absent. Polymorphisms in Glutathione S-Transferase are linked to a reduced ability to detoxify a wide range of substances, leading to increased oxidative stress and a higher risk of chronic diseases. This decreased detoxification capacity can impair the body's ability to handle environmental toxins, potentially resulting in long-term health consequences.
Boston Heart HDL Map Test
OVERVIEW OF THE HDL MAP
Standard HDL-C tests only measure the total amount of HDL-C contained by all HDL particles. Boston Heart’s exclusive HDL Map test measures the amount of apoA-I in the five most significant subpopulations, resulting in a deeper understanding of a patient’s CVD risk.
This exclusive method provides an accurate and consistent indication of reverse cholesterol transport by separating the larger, cardioprotective particles (α-1) most associated with decreased CVD risk from the smaller HDL particles which have been associated with increased risk.
The Boston Heart HDL Map® test assesses the five key HDL subpopulations linked to cardiovascular disease (CVD) risk through a unique gel electrophoresis technique. This method measures the amount of apoA-I protein in each of the five HDL subclasses, offering precise insights to identify patients at higher risk of CVD.
A low α-1 level is a critical indicator of recurrent CVD events. Studies have shown that low levels of α-1 HDL and high levels of pre ß-1 HDL are predictive of recurrent CVD events, particularly in men with low HDL-C (<40 mg/dL) and existing CVD. Notably, low α-1 HDL levels are the most significant predictor of CVD recurrence (p<0.001).
Treatment options include:
Optimal range: 45 - 100 mg/dL
Low a-1 level is a significant predictor of recurrent CVD events.
The marker α-1 from the Boston Heart HDL Map test is a key player in understanding cardiovascular health. HDL, or high-density lipoprotein, often called "good cholesterol," helps carry cholesterol away from the arteries to the liver, where it can be removed from the body. Among the different types of HDL, α-1 is the most mature and efficient at clearing cholesterol from the bloodstream. When levels of α-1 HDL are low, it’s a red flag because it significantly increases the risk of recurring heart problems.
Optimal range: 65 - 100 mg/dL
The α-2 marker, one of the key HDL subpopulations measured by the Boston Heart HDL Map® test, plays an important role in assessing cardiovascular health. HDL, or high-density lipoprotein, is commonly known as "good cholesterol" because it helps remove bad cholesterol from the bloodstream. The α-2 HDL subclass is a specific type of HDL particle that carries cholesterol away from the arteries and back to the liver, where it can be processed and removed from the body. Measuring the levels of α-2 HDL can provide valuable insights into an individual's risk for cardiovascular disease (CVD).
Optimal range: 0 - 20 mg/dL
The marker α-3 in the Boston Heart HDL Map Test is one of the specific subpopulations of high-density lipoprotein (HDL) particles measured to assess cardiovascular disease (CVD) risk. HDL particles, often referred to as "good cholesterol," play a crucial role in transporting cholesterol from the arteries to the liver for removal from the body. Among the various HDL subpopulations, α-3 HDL is particularly significant because it is involved in reverse cholesterol transport, a process that helps reduce cholesterol buildup in the arteries and thus lowers the risk of atherosclerosis and heart disease.
What does it mean if the α-3 is "Borderline"?
A borderline elevated result for the α-3 marker in the Boston Heart HDL Map Test indicates that while the levels of this HDL subpopulation are higher than average, they are not significantly high enough to guarantee optimal cardiovascular protection. This means the patient may have some capacity for effective reverse cholesterol transport, which helps remove cholesterol from the arteries and transport it to the liver for excretion, but this capacity is not at its peak.
Borderline elevated α-3 levels suggest that while the risk of cardiovascular disease (CVD) is potentially lower than in individuals with low α-3 levels, it is not as low as in those with markedly high α-3 levels. This intermediate status can be due to various factors, including diet, physical activity, genetics, and overall health conditions such as obesity, diabetes, or smoking habits.
From a diagnostic perspective, a borderline elevated result serves as a warning to reassess and possibly enhance lifestyle habits and medical treatments. The causes can range from partially healthy habits that need improvement to underlying health issues that impact cholesterol metabolism. There are usually no symptoms directly associated with borderline elevated α-3 levels, but the individual may be at a slightly increased risk for CVD compared to those with higher α-3 levels.
Treatment options to improve α-3 HDL levels and overall cardiovascular health include adopting a heart-healthy diet low in saturated fats and cholesterol, increasing physical activity, losing weight if necessary, quitting smoking, and managing stress. In some cases, medications such as statins or niacin might be recommended to improve HDL functionality and overall lipid profile. Regular follow-ups and monitoring of HDL subpopulations can help adjust these interventions effectively to reduce CVD risk.
Optimal range: 0 - 20 mg/dL
Alpha-4 High-Density Lipoprotein (α-4 HDL) is a specific subtype of HDL, commonly referred to as "good cholesterol." HDL, or High-Density Lipoprotein, is a type of protein in your blood that carries fats. The "alpha-4" designation identifies a particular size and density category within the HDL group. This α-4 HDL plays a vital role in regulating your body's cholesterol levels. It acts like a specialized waste management team, moving through your bloodstream to collect excess cholesterol from your cells and tissues, then transporting it back to your liver for disposal. This process is crucial for maintaining cell health and preventing the buildup of harmful cholesterol in your arteries.
Optimal range: 0 - 20 mg/dL
What is Pre-Beta-1 HDL?
Pre-Beta-1 HDL, often referred to as Pre-b-1 HDL, is a distinct form of High-Density Lipoprotein (HDL), commonly known as "good cholesterol." This specific type of HDL is unique because it is the smallest and most compact form, serving as the starting point in the development of HDL particles. Pre-b-1 HDL plays a vital role in the reverse cholesterol transport process, where it collects excess cholesterol from your body's tissues and transports it back to the liver for removal. This process is crucial for maintaining the health of your heart and blood vessels. Essentially, Pre-b-1 HDL functions like a diligent cleaner, continually picking up and eliminating unwanted cholesterol from your body. Understanding the importance of Pre-b-1 HDL can help in managing cholesterol levels and promoting cardiovascular health.
Full GI Panel
The Full GI Panel offered by Parasitology Center, Inc. (PCI) is a comprehensive screening option that combines the Comprehensive Stool Analysis (CSA) and Swab Culture tests. This panel is highly recommended for individuals experiencing gastrointestinal (GI) symptoms.
This detailed analysis investigates a wide range of intestinal parasites, including protozoa, trematodes, tapeworms, and nematodes, collected from all seven continents. It also examines other intestinal organisms such as Candida, yeast, and various fungi. The thorough assessment includes essential bio-indicators like red and white blood cells, mucus, fatty acid crystals, starch granules, undigested tissue, beneficial bacteria, epithelial cells, pollen, and Charcot-Leyden crystals, providing invaluable insights into digestive health.
The Swab Culture test offers comprehensive culturing and analysis of bacterial and fungal infections, delivering precise sensitivity and resistance results. It quantifies positive findings to accurately determine the infection's intensity. This versatile test allows for culturing samples from various sources, including stool, skin, urine, and other body parts or secretions (excluding blood).
For individuals with GI symptoms who have previously received negative stool tests for parasites, this test is highly recommended due to the similarity of symptoms between pathogenic bacteria and parasitic infections. The testing package is inclusive, and it is important to note that both the swab and CSA components must be sent together to avoid individual test pricing.
Reference range: 0 (No Presence), 1 (Low Presence), 2 (Moderate Presence), 3 (High Presence), 4 (Heavy Presence)
Reference range: 0 (No Presence), 1 (Low Presence), 2 (Moderate Presence), 3 (High Presence), 4 (Heavy Presence)
Reference range: 0 (No Presence), 1 (Low Presence), 2 (Moderate Presence), 3 (High Presence), 4 (Heavy Presence)
Reference range: 0 (No Presence), 1 (Low Presence), 2 (Moderate Presence), 3 (High Presence), 4 (Heavy Presence)
Reference range: 0 (No Presence), 1 (Low Presence), 2 (Moderate Presence), 3 (High Presence), 4 (Heavy Presence)
Reference range: 0 (No Presence), 1 (Low Presence), 2 (Moderate Presence), 3 (High Presence), 4 (Heavy Presence)
Boston Heart Cholesterol Balance Test
The Boston Heart Cholesterol Balance® test directly measures key cholesterol production and absorption markers associated with circulating total cholesterol (TC) by analyzing lathosterol, desmosterol, beta-sitosterol, campesterol, and cholestanol.
In vivo, approximately 80% of cholesterol production occurs through a major pathway measured by the precursor lathosterol, while the remaining 20% is measured via desmosterol. Additionally, over 90% of beta-sitosterol and campesterol (plant sterols) are absorbed into intestinal cells, making them excellent indicators of cholesterol absorption. These markers of cholesterol production and absorption can be directly measured in plasma or serum and are predictive of low-density lipoprotein cholesterol (LDL-C) response to statins and ezetimibe. A third absorption marker, cholestanol, is also measured, indicating the conversion of cholesterol to the bile acid chenodoxycholate.
Cholesterol production and absorption marker values are reported in relative terms as µmol x 100/mmol of TC, with very high values also reported in absolute concentrations (mg/L). A visual representation of the Cholesterol Balance Score (the ratio of cholesterol production to cholesterol absorption) facilitates the assessment of the patient’s cholesterol balance status.
Compared to standard and advanced lipid testing by other laboratories, the Cholesterol Balance test offers a more comprehensive characterization of cardiovascular disease (CVD), aiding in the selection of the most effective treatment options to achieve LDL-C goals.
Reference range: LOW, MEDIUM, HIGH
Absorption markers on the Boston Heart Cholesterol Balance® test provide crucial insights into how effectively cholesterol is being absorbed in the body. These markers include beta-sitosterol, campesterol, and cholestanol, which are key indicators of cholesterol absorption from the intestine. Beta-sitosterol and campesterol, both plant sterols, are absorbed into intestinal cells and serve as excellent indicators of cholesterol absorption efficiency. Cholestanol, another absorption marker, reflects the conversion of cholesterol into bile acid chenodoxycholate. By measuring these markers in plasma or serum, the test can predict a patient's response to cholesterol-lowering treatments such as statins and ezetimibe. This information helps healthcare providers tailor treatment plans to optimize cholesterol management and improve cardiovascular health outcomes.
Optimal range: 0 - 115 umol x 100/mmol of Total Cholesterol
Optimal range: 0 - 170 umol x 100/mmol of Total Cholesterol
Campesterol is a critical marker on the Boston Heart Cholesterol Balance® test, providing valuable insights into cholesterol absorption. As a plant sterol, campesterol is absorbed into intestinal cells and serves as an excellent indicator of how much cholesterol is being absorbed from the diet. Elevated levels of campesterol in the bloodstream suggest increased cholesterol absorption, which can influence the effectiveness of certain cholesterol-lowering treatments. By measuring campesterol, alongside other markers like lathosterol and beta-sitosterol, the Boston Heart Cholesterol Balance® test offers a comprehensive assessment of a patient's cholesterol metabolism, enabling healthcare providers to tailor treatment strategies more effectively to manage and reduce cardiovascular disease risk.
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If your levels are moderately elevated:
Moderately elevated levels of campesterol indicate an increased absorption of cholesterol from dietary sources. This can suggest that the body is taking in more cholesterol than it is producing internally. Elevated campesterol levels are significant because they can impact the effectiveness of cholesterol-lowering medications, such as statins, which primarily reduce cholesterol production rather than absorption. In such cases, alternative or additional treatments, like ezetimibe, which specifically targets cholesterol absorption, may be considered. Monitoring campesterol levels provides valuable information for tailoring patient treatment plans to more effectively manage cholesterol levels and reduce the risk of cardiovascular disease.
Optimal range: 0.5 - 1.1 Score
The Cholesterol Balance Score, a key marker on the Boston Heart Cholesterol Balance® test, provides a comprehensive assessment of an individual's cholesterol metabolism by evaluating the ratio of cholesterol production to absorption. This score is derived from the direct measurement of lathosterol and desmosterol (cholesterol production markers) and beta-sitosterol, campesterol, and cholestanol (cholesterol absorption markers). By offering insights into both production and absorption pathways, the Cholesterol Balance Score helps clinicians understand the underlying causes of dyslipidemia and tailor treatment strategies more effectively. This personalized approach can enhance the management of cardiovascular disease risk and improve patient outcomes by precisely targeting LDL-C lowering therapies.
Optimal range: 0 - 65 umol x 100/mmol of Total Cholesterol
Desmosterol is a critical marker on the Boston Heart Cholesterol Balance® test, playing a vital role in assessing cholesterol synthesis within the body. As one of the primary precursors in cholesterol production, desmosterol represents the alternative pathway that accounts for approximately 20% of in vivo cholesterol synthesis. Measuring desmosterol levels provides valuable insight into an individual's cholesterol biosynthesis, complementing the primary pathway marker, lathosterol. Elevated desmosterol levels can indicate increased endogenous cholesterol production, which may influence treatment strategies aimed at lowering low-density lipoprotein cholesterol (LDL-C) levels. By incorporating desmosterol measurements, the Boston Heart Cholesterol Balance test delivers a more nuanced understanding of cholesterol metabolism, enhancing the precision of cardiovascular disease risk assessment and management.
Optimal range: 0 - 85 umol x 100/mmol of Total Cholesterol
Lathosterol is a crucial marker measured in the Boston Heart Cholesterol Balance® test, providing valuable insights into cholesterol production within the body. As a precursor in the biosynthesis of cholesterol, lathosterol levels directly reflect the rate of endogenous cholesterol synthesis. Elevated levels of lathosterol indicate increased cholesterol production, which can be a critical factor in assessing cardiovascular disease risk. By quantifying lathosterol, the Boston Heart Cholesterol Balance® test offers a detailed understanding of an individual's cholesterol metabolism, enabling healthcare providers to tailor treatment strategies more effectively. This marker is instrumental in guiding decisions on therapeutic interventions such as statins, aimed at lowering cholesterol levels and improving overall cardiovascular health.
Reference range: LOW, MEDIUM, HIGH
The "Production Markers" on the Boston Heart Cholesterol Balance® test provide crucial insights into the body's cholesterol synthesis. This test measures key precursors such as lathosterol and desmosterol, which are indicative of the primary pathways through which cholesterol is produced. Approximately 80% of in vivo cholesterol production occurs via the major pathway involving lathosterol, while the remaining 20% utilizes the pathway associated with desmosterol. By evaluating these markers, the test offers a detailed view of cholesterol biosynthesis, allowing healthcare providers to understand better and manage patients' cholesterol levels. This information is pivotal in tailoring treatment strategies, particularly in predicting and optimizing responses to lipid-lowering therapies such as statins and ezetimibe.
Endo+
What is Endo+?
Endo+ is a unique profile that combines multiple hormonal assessments and synthesizes the information so the clinician can quickly identify imbalances.
Hormones are chemical messengers released by a cell, gland, or organ into the blood that elicit a cascade of physiologic responses by acting on specific target tissues. Over 50 hormones have been identified. They can be synthesized from cholesterol or peptides and amino acids.
Genova offers a variety of endocrine assessments to meet the testing needs of each patient. Their endocrine products assist the clinician in identifying hormone imbalances, hormone metabolism issues, and disease risk.
Reference ranges are based on healthy adult populations. Pediatric reference ranges are not available.
Clinicians can build an individualized hormone assessment for each patient choosing from six component profiles.
What is included on the Endo+ profile?
→ Sex hormones (saliva): progesterone, estrone, estradiol, estriol, testosterone
→ Sex hormones (serum): progesterone, estrone, estradiol, estriol, testosterone, SHBG, DHEA-S
→ Estrogen metabolism (urine): estrone, estradiol, estriol, 2-hydroxyestradiol, 2-hydroxyestrone, 16a-hydroxyestrone, 4-hydroxyestradiol, 4-hydroxyestrone, 2-methoxyestradiol, 2-methyoxyestrone, 4-methyoxyestradiol, 4-methoxyestrone
→ Adrenocortex Stress Profile: cortisol x4, DHEA
→ Thyroid Assessment: TSH, fT3, fT4, rT3, anti-TG, anti-TPO
→ Melatonin: melatonin x3
→ Add-ons:
These smaller component profiles are also available individually.
Hormone Feedback and Regulation:
Many hormones have a self-regulating system that involves a negative feedback loop, meaning once the hypothalamus senses that enough of the target hormone is circulating, production shuts down. If levels are too low, the hypothalamus will resume the production cascade. Genova’s hormone assays detect endogenous or bioidentical hormones versus non-bioidentical hormones. If a patient is taking non-bioidentical hormones, the negative feedback loop may result in lower levels of endogenous hormones. For this reason, Genova does not recommend testing in patients taking non-bioidentical hormones. Genova’s profiles assess target gland hormones (i.e., cortisol, sex hormones, thyroid hormones), and pituitary hormones (i.e., TSH, LH, FSH). Measuring both levels of the feedback loop helps to distinguish between primary and secondary causes of imbalance.
Patient Population:
Hormone imbalances can result in numerous symptoms and conditions. However, many of the clinical manifestations are nonspecific and are also present in non-endocrine disorders. The endocrine system is interconnected to many other organ systems in the body, making it difficult to differentiate the root cause of symptoms. For example, hallmark symptoms of cardiovascular disease may overlap with hormonal imbalances. Testing is important to determine if a hormonal imbalance is contributing to a patient’s symptoms. There are many reasons clinicians test hormones including:
→ Hormonal symptoms
→ Hormone supplementation
→ Risk assessment for cancers, CVD, etc.
Hormone Balancing Considerations:
Every person is unique and treating hormone imbalances must be tailored. Numerous modifiable and nonmodifiable factors influence hormone levels:
→ Age
→ Detoxification capacity and metabolism
→ Toxic exposures/endocrine disruptors
→ Physical activity
→ Medications
→ Diet and nutrient status
→ Stress
→ Infection
BiomeFx
BiomeFx by Microbiome Labs is a cutting-edge stool test designed to deliver an in-depth analysis of the gut microbiome, empowering practitioners with actionable insights for improving overall health. This advanced diagnostic tool leverages state-of-the-art DNA sequencing technology to evaluate the balance of beneficial microbes and harmful pathogens, while uncovering their functional roles and potential health impacts.
With BiomeFx, practitioners gain access to a unique, data-rich reporting system that reveals key functional aspects of the gut microbiome. The test evaluates 14 essential keystone species, 29+ pathogens, and provides insights into microbial cross-feeding dynamics and over 20 critical microbiome functions. It also identifies dysbiosis ratios and highlights imbalances in microbial metabolite production.
Armed with this comprehensive data, healthcare providers can create personalized strategies tailored to individual needs, including customized nutrition plans, lifestyle adjustments, and targeted supplementation. By addressing microbiome imbalances, BiomeFx supports optimal digestive health and helps tackle a wide range of health concerns.
Unlock the potential of gut health with BiomeFx—your path to a healthier, balanced microbiome.
Optimal range: 15.85 - 34.16 Healthy Relative Abundance IQR (%)
Acetate is another SCFA produced by gut bacteria through the fermentation of prebiotic fibers like inulin and GOS or unabsorbed peptides and fats. Gut-derived acetate production is tightly regulated within the microbiome and determined by the presence of prebiotic fiber and the balance between saccharolytic and proteolytic fermentation. Acetate is used for cholesterol synthesis and lipogenesis but can also be utilized by muscle tissue. Additionally, some gut bacteria like Roseburia spp and Faecalibacterium prausnitzii can convert acetate into butyrate. Excessive acetate production combined with insufficient butyrate production can lead to fat gain, particularly around the liver.
Optimal range: 0.08 - 1.51 Healthy Relative Abundance IQR (%)
Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.
Optimal range: 0 - 10 index
In ecology, Alpha Diversity describes a particular ecosystem by combining information about the number of species observed and their abundance. This marker evaluates your gut microbiome by looking at your own personal species diversity, which can be negatively affected by antibiotics, environmental toxins, stress, diet, or other factors. This can lead to the microbiome being dominated by only a few species. A high Alpha Diversity indicates that the ecosystem has many species and their abundance is balanced, which is typically associated with a healthy microbiome.
Optimal range: 19.85 - 27.41 Healthy Relative Abundance IQR (%)
Ammonia is a normal by-product of the microbial fermentation of amino acids, particularly glutamine. This process is carried out by various commensal bacteria, including Clostridia, Enterobacteria, Bacillus spp., E. coli, Staphylococcus, and Fusobacterium. In Gram-negative gut bacteria, ammonia plays a crucial role in nitrogen anabolism, which is necessary for producing essential compounds such as amino acids, NAD, pyrimidines, purines, and amino sugars. The production of ammonia by these bacteria is associated with three key enzymes: glutamine synthetase (GS), glutamate synthase (GOGAT), and glutamate dehydrogenase (GDH).
Optimal range: 0 - 10 index
Beta Diversity is the variation of species when comparing the composition of two separate ecosystems. This marker compares the composition of your gut microbiome to healthy populations in order to illustrate notable differences. A higher Beta Diversity is preferred.
Optimal range: 0.1 - 1.72 Healthy Relative Abundance IQR (%)
Bifidobacterium adolescentis is a beneficial bacterium commonly found in the human gastrointestinal (GI) tract, particularly in the intestines. The presence and quantity of Bifidobacterium adolescentis are significant because it plays a crucial role in maintaining a healthy digestive system. This bacterium helps in breaking down complex carbohydrates, producing essential vitamins like B12, and supporting the immune system by inhibiting harmful pathogens. An optimal level of Bifidobacterium adolescentis indicates a balanced gut microbiome, which is vital for overall digestive health, nutrient absorption, and immune function.
Optimal range: 0.06 - 0.75 Healthy Relative Abundance IQR (%)
Bifidobacterium longum is a specific species of microscopic non-pathogenic bacteria found naturally in the gastrointestinal tracts of humans as well as in most other animals.
Optimal range: 0.03 - 0.46 Healthy Relative Abundance IQR (%)
Optimal range: 0 - 0.13 IQR in Reference (%)
Bilophila wadsworthia is a sulfate-reducing bacterium that naturally occurs in the human gut microbiome, typically in small quantities. This anaerobic, gram-negative bacillus was first isolated in 1989 and is known for its ability to thrive in bile-rich environments. While B. wadsworthia is present in 50-60% of healthy individuals, an overgrowth of this species has been associated with various health concerns. It produces hydrogen sulfide, which in excess can contribute to gut inflammation and has been linked to conditions such as inflammatory bowel disease, irritable bowel syndrome, and colorectal cancer. B. wadsworthia's growth is particularly stimulated by diets high in saturated fats and taurine-rich foods like meat and dairy products. In controlled studies, this bacterium has been shown to exacerbate metabolic dysfunctions in mice fed a high-fat diet, leading to increased inflammation, intestinal barrier dysfunction, and glucose dysregulation. The presence and abundance of B. wadsworthia in a BiomeFX report may provide insights into potential gut dysbiosis and associated health risks, especially in the context of dietary habits and metabolic health.
Optimal range: 4.84 - 21.88 Healthy Relative Abundance IQR (%)
Butyrate is arguably the most important SCFA, yet it comprises only 15-20% of total SCFA production. Butyrate enhances intestinal barrier function, acts as a fuel source for enterocytes, scavenges ammonia, regulates the immune system, reduces oxidative stress, and much more. Butyrate production is mostly associated with microbial fermentation of fibers such as bran, oligosaccharides, arabinoxylan, resistant starches, and others. Furthermore, butyrate production requires an acidic environment in the gut.
Optimal range: 0 - 0.05 Healthy Relative Abundance IQR (%)
Clostridium scindens is a bacterium found in the human gut microbiome, known for its ability to convert primary bile acids into secondary bile acids, such as deoxycholic acid. This conversion can have significant effects on gut health and the overall microbial environment.
Clostridium scindens Role in the Gut:
Optimal range: 0 - 0.14 %
Escherichia coli, commonly known as E. coli, is a diverse group of bacteria that typically live in the intestines of humans and animals. Most strains of E. coli are harmless and play an important role in maintaining a healthy gut microbiome. However, some pathogenic strains can cause serious infections, particularly in the urinary tract, gastrointestinal system, and bloodstream. These pathogenic strains can be acquired through contaminated food or water and may result in symptoms such as diarrhea, abdominal pain, and, in severe cases, kidney failure.
Optimal range: 2.6 - 21.05 Healthy Relative Abundance IQR (%)
The estrobolome is a network of over 60 genera of bacteria that can recycle or deconjugate inactivated estrogens for reabsorption into circulation by producing very powerful enzymes. This recycling process is handled by gut bacteria with beta-glucuronidase and beta-glucosidase activity. When the estrobolome is too abundant, the body is unable to efficiently eliminate estrogen, causing estrogens to build up and ultimately leading to estrogen dominance. On the other hand, if estrogen recycling (estrobolome) is too low, then this may lead to insufficient levels of estrogen in circulation.
Optimal range: 0.46 - 4.2 Healthy Relative Abundance IQR (%)
Eubacterium rectale is part of the Lachnospiraceae family and produces butyrate. Eubacterium rectale was found to be in lower abundance in patients with type 2 diabetes, colorectal cancer, and chronic idiopathic diarrhea. There is a negative correlation between Eubacterium rectale levels and the symptomatology of irritable bowel syndrome (IBS). Decreased levels of Eubacterium spp. have been associated with very high protein diets.
Optimal range: 1.29 - 4.79 Healthy Relative Abundance IQR (%)
Faecalibacterium prausnitzii is a key indicator of gut health on a microbiome test panel. As a major butyrate-producing bacterium, it plays a critical role in maintaining the intestinal barrier, regulating the immune system, and exerting anti-inflammatory effects. Low levels of Faecalibacterium prausnitzii are often associated with conditions such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), obesity, type 2 diabetes, and various mental health disorders. This bacterium is sensitive to diet, antibiotics, and lifestyle factors, making its presence a valuable marker for assessing gut health and the overall balance of the gut microbiota. Addressing deficiencies in Faecalibacterium prausnitzii through dietary adjustments, probiotics, and prebiotics can significantly contribute to restoring and maintaining gut health.
Optimal range: 0.68 - 2.91 Ratio
In adults, Firmicutes and Bacteroidetes are the most abundant bacterial phyla in the gut. The Firmicutes to Bacteroidetes (F/B) abundance ratio was shown to increase from infancy to adulthood and subsequently to decrease again in the elderly. Elevated F/B ratios have been linked to obesity though the evidence is not conclusive.
Optimal range: 0 - 3.58 Healthy Relative Abundance IQR (%)
Gamma-aminobutyric acid (GABA) is a neurotransmitter, or chemical messenger, in the brain that blocks specific signals in the central nervous system in order to slow down the brain. This provides a protective and calming effect on the brain and body. High fat diets are shown to reduce GABA levels in the prefrontal cortex by 40% which can result in various mood imbalances and difficulty sleeping.
Optimal range: 15.81 - 34.81 Healthy Relative Abundance IQR (%)
Glutathione is the most powerful antioxidant in the human body. It is found in nearly every cell in the body and is the primary agent of detoxification in the liver. Glutathione can also act as a hormone, regulating the release of GABA and dopamine. Glutathione is produced from three amino acids glutamate, cysteine, and glycine which are obtained from food or supplementation. Deficiency in glutathione may lead to production of free radicals and oxidative damage throughout the body. Recent evidence suggests that the gut microbiome determines levels of glutathione throughout the body.
Optimal range: 30 - 40 index
The Gut Microbiome Index (GMI) is an overall score for gut microbiome health. A score above 30 is considered excellent. It is calculated by assessing four key indicators of your gut microbiome's health and comparing them to those of a typical healthy gut microbiome. The four key indicators include Alpha Diversity (species richness), Beta Diversity (composition), Pathogen Occurrence (population of pathogens) and Resistome Occurrence (population of antibiotic resistance genes).
Optimal range: 0 - 0 Healthy Relative Abundance IQR (%)
Histamine can be produced in the gut and travel to distant areas of the body, where it may induce unfavorable symptoms. Patients with an overabundance of histamine-producing bacteria should focus on strengthening intestinal barrier function, as a leaky gut can allow gut derived histamines to enter circulation and promote dietary intolerances or disruption in healthy allergic responses. High levels of gut derived histamine are associated with high abundance of Proteobacteria, Roseburia, Morganii morganii, and Klebsiella pneumoniae and decreased abundance of Bifidobacterium.
Optimal range: 2.23 - 12.41 Healthy Relative Abundance IQR (%)
Sulfate-reducing bacteria convert dietary sulfur and taurine to H2S, a toxic compound that impairs intestinal detoxification pathways and can cause gas that smells like rotten eggs. H2S production is associated with high-protein, low-fiber diets. Sulfate-reducing bacteria compete with methane-producers and acetate-producers for the same H2 substrate; and as a result, it is important to maintain a delicate balance among all three.
Optimal range: 2.45 - 13.43 Healthy Relative Abundance IQR (%)
Indole is a byproduct of the microbial degradation of tryptophan that can be utilized in a variety of ways in the gut microbiome. Indole can bind to serotonin receptors in order to regulate behavior, gut motility, and food intake, and it can support immune and intestinal health by interacting with gut microbes, scavenging free radicals, and increasing the expression of xenobiotic-metabolizing enzymes like cytochrome P450. Indole also functions as a signaling molecule that may be increased during latent infections. Indole production must be balanced, as too much indole may produce unwanted changes in mood or cognition, yet insufficient indole production may damage the gut barrier.
Optimal range: 18.16 - 33.45 Healthy Relative Abundance IQR (%)
Lactate is an intermediate of carbohydrate metabolism, produced from pyruvate during lactic acid fermentation. Lactate also plays important roles in immunomodulation and inflammation modulation. These species use lactate as a substrate for SCFA production. However, if there is an overabundance of lactate producers paired with low abundance of lactate utilizers (SCFA producers) this will cause a surge of lactate in the gut which can be toxic and harmful to host tissues.
Optimal range: 0 - 0.2 Healthy Relative Abundance IQR (%)
Limosilactobacillus reuteri is a lactic acid bacterium that naturally resides in the gastrointestinal tract of humans and other animals. It is considered a probiotic due to its potential health benefits, particularly in gastrointestinal health. In the context of a GI test, the presence of Limosilactobacillus reuteri can indicate its role in maintaining gut health and its potential therapeutic effects.
Optimal range: 0 - 0.04 Healthy Relative Abundance IQR (%)
Methanogens convert acetate, ammonia, hydrogen gas, and trimethylamines (TMA) to methane gas. Methane gas also slows the intestinal transit and affects gut motility, which may also allow increased time for nutrient absorption. Furthermore, methane producers compete with acetate producers for substrate utilization, which may explain why methanogens are indirectly associated with digestive issues.
Optimal range: 0.01 - 0.07 Healthy Relative Abundance IQR (%)
Oxalobacter formigenes is a bacterium that colonizes the colon of a substantial proportion of the normal population and metabolizes dietary and endogenous oxalate and hence reducing the incidence of kidney stones.
Optimal range: 5.84 - 19.71 Healthy Relative Abundance IQR (%)
Phenols, including phenol and p-cresol, are aromatic compounds that result from the microbial fermentation of aromatic amino acids, such as tryptophan and tyrosine. These compounds are cytotoxic and may cause damage to the gut, skin, vascular system, kidneys, and more.
Tyrosine tends to be metabolized to phenol by Escherichia coli, Proteus spp., and Streptococcus faecalis, whereas it tends to be metabolized to p-cresol by strictly anaerobic gut bacteria such as Bacteroides fragilis, Fusobacterium spp., and Clostridium spp.
Tryptophan is abundant in foods such as cheese, poultry, red meat, egg whites, and seeds; and therefore, these foods can increase phenol production in the gut. Similarly, tyrosine is also present in protein-rich foods including beef, pork, chicken, fish, chicken, tofu, milk, cheese, beans, seeds, nuts, and whole grains. When paired with a diet low in fermentable fibers, these foods have the potential to dramatically increase phenol and p-cresol production, as gut microbes are forced to use amino acids for energy. Increasing gut acidity through the intake of resistant starches, galactooligosaccharides, and fructooligosaccharides may reduce the production of these toxic metabolites.
Optimal range: 0.01 - 0.11 Healthy Relative Abundance IQR (%)
Parabacteroides goldsteinii is a species of anaerobic bacteria commonly found in the human gastrointestinal tract. Known for its potential health benefits, it's considered a next-generation probiotic. This bacterium often shows up in results from a BiomeFX panel, a sophisticated test used to analyze the gut microbiome's composition. As part of the Bacteroidetes group, it's crucial for maintaining a healthy gut environment. Parabacteroides goldsteinii plays a significant role in breaking down complex carbohydrates, aiding digestion, and producing short-chain fatty acids that are essential for gut health and provide energy to colon cells. Additionally, this bacterium helps maintain a balanced immune system by interacting with the gut-associated lymphoid tissue, which is vital for immune responses.
Optimal range: 0.15 - 1 Healthy Relative Abundance IQR (%)
Parabacteroides merdae is a prominent bacterium in the human gut microbiota, often assessed in gut health panels due to its significant role in maintaining digestive health and contributing to the gut’s metabolic activities. This anaerobic bacterium is known for its involvement in the fermentation of dietary fibers, leading to the production of beneficial short-chain fatty acids (SCFAs) such as acetate and propionate, which are crucial for colon health. Parabacteroides merdae also plays a part in modulating the immune system and protecting against pathogenic bacteria. Its presence in balanced levels is often considered a marker of a healthy and diverse microbiota. Alterations in its abundance can be associated with various gastrointestinal conditions, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and metabolic disorders. Monitoring Parabacteroides merdae on a gut test panel provides valuable insights into an individual’s gut health and can guide dietary and therapeutic interventions to restore and maintain a balanced gut ecosystem.
Optimal range: 0 - 10 index
Low levels of pathogens can be normal and characteristic of a healthy, diverse gut microbiome. Increased levels of pathogens, however, could indicate that a pathogen is playing a role in symptoms you are experiencing. The Pathogen Control Index compares the relative abundances (RA) of specific pathogens to normal levels present in the healthy gut.
Note: BiomeFx is NOT a diagnostic test. If your Pathogen Control Index is low, consult your physician who can make a diagnosis and provide treatment if needed.
Optimal range: 0.3 - 6.34 Healthy Relative Abundance IQR (%)
Generally considered a beneficial gut commensal, although is capable of attaching to and invading colonic epithelial cells and inducing pro-inflammatory cytokines.
- Produces beta-glucuronidase, succinate, lactate, acetate, formate, and propionate.
- Associated with insulin resistance.
- Contains bile salt hydrolases to metabolize bile.
- Formerly named Bacteroides vulgatus.
Optimal range: 7.08 - 17.93 Healthy Relative Abundance IQR (%)
Polyamines like putrescine, spermidine, and cadaverine are metabolites of arginine and tyrosine that have many important roles in the gut like stabilizing RNA and DNA structures, supporting protein synthesis, and scavenging free radicals. However, high amounts of polyamines can be toxic to the gut microbiome. Gut bacteria primarily synthesize amines from amino acids. Generally speaking, Gram-positive bacteria tend to reduce the concentration of amines, while Gram-negative species produce amines and increase their concentration.
Optimal range: 0 - 11.3 Ratio
High Prevotella:Bacteroides ratios are associated with lower BMI and reduced incidence of chronic, inflammatory disease. Low Prevotella:Bacteroides ratios are associated with metabolic imbalances and are positively correlated with high intake of protein and animal fat as typical for a Western diet. Higher abundance of Prevotella is observed in individuals that consume diets rich in carbohydrates and fiber. Bacteroides is increased by sugar and saturated fat intake, while Prevotella generally thrives on fiber rich foods, like fruit, vegetables, beans, and whole grains. Levels of Prevotella tend to decrease with age.
Optimal range: 6.86 - 16.91 Healthy Relative Abundance IQR (%)
Propionate is a SCFA that can be produced by gut bacteria through the fermentation of key fibers or the metabolism of lactate. Propionate supports a healthy immune system by encouraging regulatory T cell differentiation in gut associated lymphoid tissues (GALT), and it also promotes gluconeogenesis in the liver, supports insulin sensitivity, and improves gut hormone production. Propionate and butyrate both work together to support healthy inflammatory responses by inhibiting histone deacetylases (HDACs) in macrophages and dendritic cells.
Optimal range: 0.37 - 7.99 Ratio
Gram-negative Proteobacteria are a source of lipopolysaccharide associated with metabolic endotoxemia. Bifidobacterium species within Actinobacteria produce health-promoting metabolites like IL-10, SCFA, and GABA. Consuming a balanced diet with a wide variety of fibers, polyphenols, and a healthy level of fat can help balance this ratio.
Optimal range: 0 - 10 index
This section explores the presence and abundance of a panel of antibiotic resistance genes in the gut microbiome, and compares that to healthy population. The resistome is the sum of antimicrobial resistance genes in your gut. High number of resistance functions in your gut will make pathogens less likely to be sensitive to antibiotics and may be an indication that virulent strains are flourishing.
Optimal range: 0.04 - 0.5 Healthy Relative Abundance IQR (%)
Roseburia intestinalis is a bacterium commonly found in the human gut and is known for its role in producing butyrate, a short-chain fatty acid that has beneficial effects on gut health. In a gastrointestinal (GI) test, the presence and levels of Roseburia intestinalis can provide insights into the health of the gut microbiome.
Optimal range: 0.16 - 2.61 Healthy Relative Abundance IQR (%)
Ruminococcus bromii is a keystone species, playing a large role in the digestion of resistant starches. It has been proposed that the primary role played by R. bromii is to release energy from resistant starch to other members of the microbial community, giving it an important role for maintaining microbial community balance. R. gnavus can efficiently cross-feed on starch degradation products released by R. bromii, even though it is normally a mucin degrading bacteria.
Optimal range: 0 - 0.39 IQR in Reference (%)
Sutterella wadsworthensis is a fascinating microbe that's part of the normal gut flora in many people. This gram-negative, non-spore-forming bacterium is known for its ability to thrive in bile-rich environments, which explains its presence in the intestines and bile ducts. While S. wadsworthensis is found in about 50-60% of healthy individuals, its role in gut health is still being explored. On a BiomeFX report, elevated levels of S. wadsworthensis might catch your attention. This could indicate potential changes in your gut microbiome balance, possibly linked to dietary factors like high consumption of saturated fats or taurine-rich foods. Some studies have associated higher levels of S. wadsworthensis with conditions like inflammatory bowel disease and autism spectrum disorders, though the exact relationship is still under investigation. It's important to note that while its presence isn't inherently harmful, an overgrowth might be worth discussing with your healthcare provider, especially if you're experiencing any digestive issues or have concerns about your metabolic health.
Optimal range: 37.32 - 50.4 Healthy Relative Abundance IQR (%)
Thiamin is a vitamin that plays a critical role in energy metabolism, especially in the brain and nervous system. Thiamin also plays an important role in muscle contraction and nerve conduction. Faecalibacterium spp utilize thiamine but do not produce it, indicating that there is a competition for vitamins within the gut microbiome.
Optimal range: 16.18 - 38.67 Healthy Relative Abundance IQR (%)
Vitamin B12 (cobalamin) is crucial for healthy red blood cells, brain and nervous system function, DNA regulation, and metabolism. Production of B12 by gut bacteria contribute up to 31% of the daily recommended intake for this nutrient.
Optimal range: 36.18 - 52.52 Healthy Relative Abundance IQR (%)
Vitamin B2 (riboflavin) is a cofactor needed for energy production and fat metabolism that also plays an important role in immune cell function.
Optimal range: 31.76 - 42.42 Healthy Relative Abundance IQR (%)
Vitamin B5 (pantothenic acid) is essential for energy production and fat metabolism. Bacteroides fragilis, Prevotella copri, Ruminococcus spp, Salmonella enterica, and Helicobacter pylori can all produce vitamin B5 in the gut. However, there are many species that rely on vitamin B5 for growth but cannot synthesize it, like most Fusobacterium, Bifidobacterium spp, Faecalibacterium spp, Lactobacillus spp, and some strains of Clostridium difficile, suggesting that these bacteria may compete with the host for vitamin B5.
Optimal range: 7.9 - 25.47 Healthy Relative Abundance IQR (%)
Vitamin B6 is an incredibly versatile nutrient that supports immunity, brain function, and protein metabolism. It is also a necessary, rate limiting cofactor for neurotransmitter production, including dopamine, serotonin, gamma-aminobutyric acid (GABA), noradrenaline, and the hormone melatonin.
This nutrient is found abundantly in foods, particularly fish, chicken, tofu, sweet potato, and avocado.
B6 can also be produced by commensal gut species including Bacteroides fragilis, Prevotella copri, Bacillus clausii, Corynebacterium glutamicum, Listeria monocytogenes, Streptococcus mutans, Bifidobacterium longum, Collinsella aerofaciens, and Helicobacter pylori.
Human gut microflora contribute up to 86% of the daily recommended intake of B6.
Optimal range: 10.51 - 29.69 Healthy Relative Abundance IQR (%)
Biotin (also known as Vitamin H, Vitamin B7, or Vitamin B8) is a water soluble vitamin necessary for growth, development, and cellular energy production that can support healthy hair, skin, and nails and support healthy immune responses. Biotin is synthesized from tryptophan by intestinal bacteria like Bacteroides fragilis, Prevotella copri, Ruminococcus lactaris, Clostridium difficile, Bifidobacterium infantis, Helicobacter pylori, and Fusobacterium varium. In contrast, some species of Prevotella, Bifidobacterium, Clostridium, Ruminococcus, Faecalibacterium, and Lactobacillus may steal biotin from the host as they need it for survival.
Optimal range: 0 - 10.79 Healthy Relative Abundance IQR (%)
Vitamin B9 (folate or tetrahydrafolate), is essential for healthy blood cells. Gut-derived folate is directly absorbed into the colon, contributing up to 37% of the daily recommended intake. If vitamin B9 producers are low, there could be low levels of this nutrient available to the body.
Optimal range: 0 - 6.35 Healthy Relative Abundance IQR (%)
Vitamin K2 is a fat-soluble vitamin necessary for calcium metabolism and critical for the health of teeth, bones, nerves, and the cardiovascular system. Most K2 comes from dietary sources, however, gut bacteria including Escherichia coli, Bacteroides vulgatus, Bacillus subtilis and Bacteroides fragilis can also produce K2 endogenously. However, microbially derived K2 has protective role against oxidative tissue damage in the gut.
Vaccination Tracker
Online Vaccination Tracker
The Online Vaccination Tracker at HealthMatters.io is your comprehensive solution for managing and tracking all your vaccinations in one convenient place. With this tool, users can easily keep a detailed record of their immunizations, including common vaccines, immunization dates, and reminders for when to redo vaccines. This ensures that your vaccination status is always up-to-date, whether for personal health, travel requirements, or medical consultations.
Features:
Vaccine Records: Log and track all your common vaccines, including:
Immunization Dates: Keep a precise record of all your immunization dates, ensuring you always know when you received each vaccine.
Renewal Reminders: Set reminders for when vaccines need to be redone, ensuring you never miss a crucial booster shot or renewal.
Travel Requirements: Check and update your vaccination status based on the requirements of the country you plan to visit. This feature is essential for international travelers who need to comply with specific health regulations.
Health Check-ups: Easily access your vaccination history during medical check-ups or emergencies, providing healthcare professionals with essential information for better care.
Benefits:
The Online Vaccination Tracker at HealthMatters.io is an indispensable tool for anyone looking to maintain optimal health and stay prepared for travel and medical needs. Keep your vaccinations up-to-date and manage your health efficiently with HealthMatters.io.
Reference range: Vaccinated, Not Vaccinated
Doctors recommend two doses of the chickenpox vaccine for children and unvaccinated individuals as the best protection against chickenpox, with most vaccinated people being protected for life. The vaccine is highly effective, preventing nearly all severe cases and resulting in milder symptoms for breakthrough cases. Children should receive doses at 12-15 months and 4-6 years, while older individuals should get two doses 28 days apart. Post-exposure vaccination can prevent or lessen the severity of the disease. Vaccination is crucial for at-risk groups like healthcare professionals, caregivers, and those in communal settings. Some individuals, such as those with immune system issues or who are pregnant, should consult a healthcare provider before getting vaccinated. The chickenpox vaccine is safe, effective, and has significantly reduced chickenpox cases, hospitalizations, and deaths since its introduction.
Reference range: Vaccinated, Not vaccinated
Reference range: Vaccinated, Not Vaccinated
Influenza, commonly known as the flu, is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can range from mild to severe, potentially leading to hospitalization and, in some cases, death.
Reference range: Vaccinated, Not vaccinated
Reference range: Vaccinated, Not vaccinated
Reference range: Vaccinated, Not vaccinated
Human Papillomavirus, or HPV, is a common virus that spreads through skin-to-skin contact, usually during sexual activity. While most HPV infections clear up on their own, some can lead to serious health problems, including certain types of cancer and genital warts.The good news is that there's a safe and effective vaccine to protect against the most harmful types of HPV. This vaccine is recommended for both boys and girls, typically starting around age 11 or 12, but it can be given as early as age 9.
Reference range: Vaccinated, Not Vaccinated
Japanese encephalitis virus (JEV) is a flavivirus related to dengue, yellow fever and West Nile viruses, and is spread by mosquitoes (especially Culex tritaeniorhynchus).
JEV is the main cause of viral encephalitis in many countries of Asia with an estimated 100 000 clinical cases every year.
Although symptomatic Japanese encephalitis (JE) is rare, the case-fatality rate among those with encephalitis can be as high as 30%. Permanent neurologic, cognitive and behavioural sequelae occur in 30–50% of those with encephalitis.
Reference range: Vaccinated, Not vaccinated
Reference range: Vaccinated, Not vaccinated
Reference range: Vaccinated, Not vaccinated
Reference range: Vaccinated, Not vaccinated
Reference range: Vaccinated, Not Vaccinated
Pneumonia is a severe respiratory infection that inflames the air sacs in one or both lungs, potentially filling them with fluid or pus. Symptoms include cough, fever, chills, and difficulty breathing. Pneumonia can be caused by bacteria, viruses, or fungi, with pneumococcal pneumonia, caused by Streptococcus pneumoniae, being particularly dangerous. The pneumococcal vaccination is crucial in preventing this infection. There are two main types of vaccines: pneumococcal conjugate vaccines (PCV15, PCV20) and the pneumococcal polysaccharide vaccine (PPSV23). These vaccines are recommended for children under five, adults over 65, and individuals aged 19-64 with specific risk factors. Vaccination not only protects individuals from serious illness but also reduces the spread of the infection within the community. Regular vaccination tracking and consultation with healthcare providers are essential to ensure timely and appropriate vaccination, thereby enhancing individual and public health.
Reference range: Vaccinated, Not vaccinated
Polio is a serious disease caused by a virus that targets the nervous system. It’s typically transmitted through contact with the stool (poop) of an infected person or, less commonly, through droplets from a sneeze or cough. Polio can spread in the following ways:
Reference range: Vaccinated, Not vaccinated
Stay Protected with Tetanus Vaccines: Essential Information
Tetanus is a serious infection caused by Clostridium tetani bacteria, but the good news is that vaccines are available to prevent it. In the United States, three types of vaccines provide protection against tetanus, along with other diseases:
Who Should Get Which Vaccine?
Reference range: Vaccinated, Not vaccinated
The Typhoid vaccine is an important immunization that protects against typhoid fever, a serious bacterial infection caused by Salmonella Typhi. Typhoid is transmitted through contaminated food and water, and it poses a significant health risk, especially in regions with poor sanitation. The vaccine is highly recommended for travelers to areas where typhoid is common, such as parts of Asia, Africa, and Latin America. There are two main types of typhoid vaccines: an inactivated injectable vaccine and a live, attenuated oral vaccine. Both are effective, but protection is not lifelong, so booster doses may be necessary. Staying up-to-date with your typhoid vaccination is crucial for preventing this potentially life-threatening illness.
Reference range: Vaccinated, Not vaccinated
GlycoCheck
GlycoCheck is a non-invasive test, using a video microscope camera placed under the tongue. It evaluates your micro- vascular system down to the smallest capillaries and reflects your entire body’s health. The video microscope shows live movement of your red blood cells as they travel through your microvessels.
Research confirms that under- the-tongue measurements are indicative of the health of the entire vascular system which supplies nutrients and oxygen to organs such as the brain, eyes, heart, kidneys, and all others.
Reference range: >=10 - Very High, 9 - Very High, 8 - High, 7 - High, 6 - High Average, 5 - Average, 4 - Average, 3 - Low Average, 2 - Low, 1 - Low, 0.0 - Very Low
Understanding your MicroVascular Health Score™ (MVHS) is essential because a healthy microvascular system is critical for delivering nutrients and oxygen to cells and removing waste products from organs. The GlycoCheck® system measures microvessel health, including capillary density, blood volume, flow, red cell velocity, and endothelial glycocalyx function. A healthy microvascular system, protected by the glycocalyx, ensures efficient nutrient exchange. MVHS is calculated from capillary blood volume, recruitment capacity, and PBR. The microcirculation system constitutes 99% of the vascular surface area, crucial for nutrient and waste exchange, unlike macrocirculation. Poor microcirculation can lead to serious health issues like diabetes, hypertension, heart disease, and more. Early signs include high blood pressure, diabetes, skin problems, fatigue, and memory loss. Maintaining microvascular health through a balanced diet, exercise, and medical consultation can significantly improve overall well-being and reduce health risks.
GutIQ
The Gut IQ Profile is a revolutionary stool analysis that offers a complete overview of your gut health. By leveraging advanced PCR and metagenomic sequencing technologies, it provides detailed insights into the gut microbiome and biochemical markers essential for digestive health.
Metagenomic sequencing, also known as shotgun sequencing, is a cutting-edge technique used to analyze the genetic material of entire microbial communities within a stool sample. This method sequences all genetic material in a random, unbiased manner, offering a more comprehensive understanding of your gut microbiome compared to traditional, targeted approaches.
Broad Microbial Coverage
Identifies over 28,000 microbial species, including unculturable and previously unknown microorganisms.
Unbiased Approach
Random sequencing ensures an extensive and detailed overview of microbial diversity.
Comprehensive Results
Delivers insights into the complete microbial community, rather than focusing on a predefined subset.
Using a simple stool sample, the Gut IQ Profile provides detailed information on:
Microbiome Composition
Understand the balance of beneficial and harmful microbes in your gut.
Biochemical Markers
Analyze digestion, inflammation, and intestinal permeability for a deeper understanding of gut function.
With its combination of PCR and metagenomic sequencing technologies, the Gut IQ Profile goes beyond traditional stool tests, delivering actionable insights for improved gut health and overall well-being. Whether you're addressing digestive issues, managing inflammation, or optimizing your gut health, this comprehensive analysis offers the clarity you need to make informed decisions.
Lymph Monitoring
Optimal range: 0.3 - 7.9 %
Optimal range: 3 - 146 abs
Optimal range: 0.4 - 5 %
The biomarker CD3+/CD4-/CD8- identifies a unique subset of T lymphocytes that express the CD3 surface protein but lack both CD4 and CD8 co-receptors. These cells are often referred to as double-negative T cells (DN T cells) due to their absence of CD4 and CD8 expression. DN T cells represent a small fraction of the total T cell population in peripheral blood, typically accounting for less than 5% of T cells.
Optimal range: 4 - 104 abs
The biomarker CD3+/CD4-/CD8- identifies a unique subset of T lymphocytes that express the CD3 surface protein but lack both CD4 and CD8 co-receptors. These cells are often referred to as double-negative T cells (DN T cells) due to their absence of CD4 and CD8 expression. DN T cells represent a small fraction of the total T cell population in peripheral blood, typically accounting for less than 5% of T cells.
T Cell monitoring & Activation
Optimal range: 0.2 - 5.8 %
The marker "CD3/gamma-delta" on a T Cell Monitoring & Activation panel refers to a unique subset of T cells known as gamma-delta T cells. These cells are characterized by their T-cell receptor (TCR) composition, which includes a gamma chain and a delta chain, distinguishing them from the more common alpha-beta T cells, which have alpha and beta chains in their TCRs. Gamma-delta T cells are a critical component of the immune system, bridging the gap between innate and adaptive immunity. Unlike conventional alpha-beta T cells, gamma-delta T cells can recognize antigens without the need for presentation by major histocompatibility complex (MHC) molecules, allowing for a rapid response to a wide range of pathogens, including bacteria, viruses, and tumors.
Optimal range: 0.2 - 4.3 %
Memory T Cells
Optimal range: 1 - 8.3 %
The marker "CD3/CD8/CD45RO" is used in immunological studies to identify and characterize a specific subset of T cells known as memory T cells. CD3 is a marker found on all T cells, indicating their role in the immune system, while CD8 is present on cytotoxic T cells, which are responsible for directly killing infected or cancerous cells. CD45RO is a marker that distinguishes memory T cells from naive T cells; it indicates that these cells have previously encountered an antigen and are primed for a faster and more efficient response upon re-exposure.
Optimal range: 0.2 - 3.29 %
Toxic Metals; stool
If you're concerned about the possibility of heavy metal accumulation in your body, the Toxic Metals Panel Fecal Test measures fecal levels of antimony, arsenic, beryllium, bismuth, cadmium, copper, lead, mercury, nickel, platinum, thallium, tungsten and uranium.
If you're concerned about the possibility of heavy metal accumulation in your body, this Toxic Metals Panel is an important step to measure the following analytes:
Antimony, Arsenic, Beryllium, Bismuth, Cadmium, Cesium, Copper, Gadolinium, Lead, Manganese, Mercury (best for dental amalgam exposure), Nickel, Platinum, Thallium, Tungsten, Uranium
Analysis of elements in feces provides a means to assess oral exposure, and to a lesser extent endogenous detoxification of potentially toxic metals. For several toxic elements such as mercury, cadmium, lead, antimony and uranium, biliary excretion of metals into feces is a primary natural route of elimination from the body. Studies performed at Doctor’s Data demonstrate that the fecal mercury content and number of amalgam surfaces are highly correlated. Therefore people with several amalgams in place will typically have higher concentrations of fecal mercury than people without amalgams. Results are reported as mg/kg dry weight of feces to eliminate the influence of variability in water content of fecal specimens. Since this test reflects both oral exposure and biliary excretion of metals, overt clinical associations are not directly implied.
Optimal range: 0 - 0.05 mg/kg Dry Wt
Optimal range: 0 - 0.2 mg/kg Dry Wt
Optimal range: 0 - 0.01 mg/kg Dry Wt
Optimal range: 0 - 0.1 mg/kg Dry Wt
Optimal range: 0 - 0.5 mg/kg Dry Wt
Optimal range: 0 - 0.1 mg/kg Dry Wt
Optimal range: 0 - 60 mg/kg Dry Wt
Optimal range: 0 - 0.03 mg/kg Dry Wt
Optimal range: 0 - 0.3 mg/kg Dry Wt
Optimal range: 0 - 200 mg/kg Dry Wt
Optimal range: 0 - 0.05 mg/kg Dry Wt
Optimal range: 0 - 8 mg/kg Dry Wt
Optimal range: 0 - 0 mg/kg Dry Wt
Optimal range: 0 - 0.02 mg/kg Dry Wt
Optimal range: 0 - 0.13 mg/kg Dry Wt
Optimal range: 0 - 0.1 mg/kg Dry Wt
Optimal range: 66.3 - 78.8 mg/kg Dry Wt
Adult Gut Health Test
The Adult Gut Health Test provides detailed insights into the balance of beneficial and harmful microorganisms in your microbiome, including their relative abundances. With advanced shotgun metagenomics technology, this test delivers strain-level precision and offers valuable information about the functional capacity of your gut, from digestion efficiency to potential signs of inflammation. Designed specifically for adults, this test helps you better understand your gut health and its impact on overall well-being.
Optimal range: 0 - 620 rpkm
Acetate is the most abundant SCFA in the colon and makes up more than half of the total SCFA detected in feces. These beneficial SCFA have anti-inflammatory properties, provide energy to nourish the colonic epithelial cells and intestinal microbiota, and exert numerous positive effects on gut homeostasis.
Optimal range: 0 - 0.5 %
Actinobacteriota, formerly known as Actinobacteria, is a significant phylum within the gut microbiota that plays a crucial role in human health. On an adult gut health test, Actinobacteriota serves as a marker for assessing various aspects of gut function, including digestion, immune regulation, and the production of beneficial metabolites. This phylum is well known for containing bacterial genera such as Bifidobacterium, which are associated with positive health outcomes, including the production of short-chain fatty acids (SCFAs), modulation of inflammation, and inhibition of harmful pathogens.
One of the primary functions of Actinobacteriota in the gut is its involvement in carbohydrate metabolism. Many species within this group are adept at breaking down complex carbohydrates and fibers, which are not digestible by human enzymes, into SCFAs like acetate and butyrate. These metabolites serve as an energy source for colon cells, help maintain the integrity of the gut lining, and contribute to a balanced inflammatory response. Therefore, a healthy level of Actinobacteriota on a gut health test is often seen as indicative of a diet rich in fiber and prebiotics, which supports overall gut health.
However, an imbalance in Actinobacteriota levels can be a marker of gut dysbiosis, a condition where the microbial community in the gut is disturbed. Low levels of beneficial bacteria like Bifidobacterium may indicate poor digestion of fiber, reduced SCFA production, and a higher risk of inflammatory conditions such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). Conversely, an overgrowth of certain Actinobacteriota species, particularly pathogenic strains, could be associated with conditions like small intestinal bacterial overgrowth (SIBO) or contribute to metabolic disorders.
Optimal range: 4000 - 9400 U/h*g
Beta-glucuronidase is an enzyme produced by various types of bacteria in the gut and plays a key role in gut health. It is involved in the process of deconjugation of glucuronides, which are compounds formed in the liver to help detoxify substances like hormones, toxins, and drugs. Once these glucuronides reach the gut, beta-glucuronidase can break them down, leading to the reabsorption of the substances that were previously detoxified, which can have both beneficial and harmful effects depending on the compounds involved.
Optimal range: 10 - 100 %
Bifidobacterium is a genus of bacteria that plays a critical role in the health of the adult gut microbiome. It is often highlighted as a key marker in gut health tests due to its beneficial effects on digestion, immune function, and overall well-being. Bifidobacteria are among the first microbes to colonize the human gut during infancy, but their presence in the gut typically decreases with age, diet changes, and other factors. In an adult gut health test, the presence or absence of Bifidobacterium can indicate important insights into the balance of the microbiome and its potential impact on overall health.
Optimal range: 0 - 800 rpkm
Butyrate is a short-chain fatty acid (SCFA) that plays a critical role in maintaining gut health, and its measurement can be an important marker on adult gut health tests. Produced by the fermentation of dietary fibers by beneficial gut bacteria, butyrate is primarily generated in the colon and acts as a key energy source for colonocytes, the cells lining the colon. By providing fuel for these cells, butyrate helps maintain the integrity of the gut barrier, preventing harmful substances from passing into the bloodstream and triggering inflammation. Low levels of butyrate on a gut health test could suggest a disruption in the balance of gut bacteria, often referred to as dysbiosis, which can contribute to various gastrointestinal disorders like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD).
Slightly elevated levels of butyrate in a gut health test may indicate an overabundance of butyrate-producing bacteria or an imbalance in the gut microbiota, potentially linked to certain dietary or health factors. While butyrate is generally considered beneficial for gut health due to its anti-inflammatory and colon-protective properties, excessively high levels could suggest that the fermentation of dietary fibers is occurring too rapidly or that there is an excessive intake of fermentable fibers. This can lead to issues like bloating, gas, or other gastrointestinal discomforts.
Additionally, elevated butyrate levels might reflect a temporary increase in fiber consumption, such as after introducing a fiber-rich diet, which can cause a surge in short-chain fatty acid production as the gut bacteria adjust. However, persistently high levels might point to underlying conditions such as small intestinal bacterial overgrowth (SIBO) or imbalances in the gut ecosystem that could lead to digestive issues over time.
Though slightly elevated levels are not usually cause for immediate concern, they may indicate the need for a closer look at dietary patterns or gut health, especially if accompanied by symptoms like bloating, discomfort, or irregular bowel movements. Adjusting fiber intake or investigating other markers of gut health may help normalize butyrate levels and ensure a healthy balance in the gut microbiome.
Optimal range: 0 - 500 rpkm
Propionate is among the most common short-chain fatty acids produced in the human gut in response to indigestible carbohydrates (fiber) in the diet.
Optimal range: 351 - 500 rpkm
Vitamin B7, also known as biotin, is a crucial water-soluble vitamin that plays a significant role in various metabolic processes, particularly in supporting skin, hair, and nail health. In the context of an adult gut health test, Vitamin B7 serves as a marker that can offer insights into digestive health, nutrient absorption, and microbial balance in the gastrointestinal (GI) tract.
Optimal range: 0 - 150 rpkm
Xylooligosaccharides (XOS) are prebiotics, a type of non-digestible carbohydrate that is fermented by gut bacteria to promote the growth of beneficial microorganisms, such as Bifidobacterium and Lactobacillus. These compounds are derived from plant-based sources, including fruits, vegetables, and wood, and are considered highly effective in supporting a healthy gut microbiome.
In a gut health test, measuring levels of Xylooligosaccharides could indicate the abundance of certain bacteria that are capable of breaking them down and producing beneficial byproducts like short-chain fatty acids (SCFAs). SCFAs, such as butyrate and acetate, play a crucial role in maintaining gut lining integrity, modulating immune function, and promoting anti-inflammatory processes. A healthy balance of XOS and the bacteria that thrive on them is often associated with improved digestive health, reduced bloating, and enhanced nutrient absorption.
Elevated Xylooligosaccharide breakdown could be a sign of overactivity in certain gut bacteria, which might be associated with excessive fermentation, leading to gas, bloating, or other digestive discomforts. Therefore, tracking this marker helps tailor dietary and probiotic recommendations for optimal gut health.
In some cases, elevated levels of XOS fermentation may also reflect a diet that is too high in fermentable prebiotics or fiber-rich foods, overwhelming the gut's capacity to process them efficiently. While prebiotics like XOS are beneficial for gut health, an excess can sometimes disturb the microbial balance, leading to discomfort for certain individuals, especially those with conditions like small intestinal bacterial overgrowth (SIBO) or irritable bowel syndrome (IBS).
Galleri test
Galleri by GRAIL is a multi-cancer early detection blood test designed to screen for many of the deadliest cancers, including those that currently have no recommended screening methods. The test can identify cancerous DNA fragments, which act like a "fingerprint" of cancer, often before symptoms appear or traditional diagnostic methods can detect it.
As cancers grow, they shed DNA into the bloodstream. The Galleri test detects these DNA fragments, providing an early indication of cancer, known as a "Cancer Signal." In individuals aged 50-79, approximately 1% are expected to receive a positive result, which includes a prediction of the tissue or organ of origin, called the Cancer Signal Origin (CSO). Among those who test positive, around 40% are expected to have a confirmed cancer diagnosis after further diagnostic evaluation.
In clinical studies, the Galleri test accurately identified the correct CSO 88% of the time for participants with a confirmed cancer diagnosis. This prediction helps doctors pinpoint the likely location of the cancer and guides further diagnostic steps.
The Galleri test has been rigorously evaluated in clinical studies with over 20,000 participants and is backed by certifications from the International Organization for Standardization (ISO 15189), Clinical Laboratory Improvement Amendments (CLIA), and accreditation by the College of American Pathologists (CAP).
When tested, you will receive one of two possible results within about two weeks:
For nearly 99% of people, no cancer signal will be detected. If a signal is found, the test also predicts the tissue or organ associated with the cancer, providing vital information to guide the next steps in your care.
Reference range: No Cancer Signal Detected, Cancer Signal Detected
The Galleri multi-cancer early detection test screens for multiple cancers with a single blood test. In a clinical study, the Galleri test was able to detect a signal shared by more than 50 types of cancer.
Galleri is a screening test and does not diagnose cancer. Diagnostic testing is needed to confirm cancer.
The Galleri test looks for active cancer and does not predict your future genetic risk for cancer.
The Galleri test does not detect a signal for all cancers and not all cancers can be detected in the blood.
False positives and false negative results do occur.
If Galleri detects a cancer signal, your result will include one or two Cancer Signal Origins which predict the tissue type or organ associated with the cancer signal.
Urinary Toxic & Essential Elements
Analyzing elements can provide insight into why you may not synthesize or convert thyroid hormones and can help determine the cause of thyroid related symptoms. The thyroid gland regulates cellular energy metabolism, as well as controls heart rate and protein synthesis for proper growth and development. This profile includes Dried Urine tests for: Iodine, Bromine, Lithium, Selenium, Arsenic, Cadmium, Mercury and Creatinine.
Optimal range: 0 - 0 ug/g Cr
Optimal range: 0 - 0 ug/g Cr
Optimal range: 0 - 0 ug/g Cr
Optimal range: 0.3 - 2 mg/ml
Optimal range: 100 - 380 ug/g Cr
Optimal range: 0 - 0 ug/g Cr
Optimal range: 0 - 0 ug/g Cr
Optimal range: 0 - 0 ug/g Cr
Blood Spot Toxic & Essential Elements
Dried Blood Spot (DBS) testing is a simple, convenient method for measuring essential and toxic elements using a small sample of whole blood collected on filter paper. It's an excellent alternative to traditional liquid blood draws and offers several advantages—especially when testing elements that are stored primarily inside red blood cells, such as lead, zinc, and magnesium.
Most standard blood tests analyze serum (the clear liquid part of blood), but this isn’t always the best way to detect nutrient deficiencies—especially for minerals that are mostly found inside red blood cells.
Zinc and Lead: These elements are concentrated in red blood cells, making whole blood testing (like DBS) more accurate than serum tests.
Magnesium: Serum magnesium levels are tightly controlled by the body’s homeostasis, often staying "normal" even when your intracellular magnesium is low. DBS provides a better view of your true magnesium status.
Copper and Zinc: DBS testing captures both intracellular and extracellular levels, helping detect imbalances or deficiencies earlier than standard serum or plasma tests.
Arsenic is not measured using DBS, because it is rapidly cleared from the bloodstream. Instead, urine testing is the best way to assess recent arsenic exposure.
It's important to note that DBS reference ranges are different from those used in serum testing. Because whole blood contains both plasma and red blood cells, levels measured in DBS are not directly comparable to serum results. For accurate interpretation, element-specific DBS reference ranges should always be used.
Convenient: Requires only a small finger-prick sample
Accurate: Better reflects intracellular mineral levels
Early detection: Identifies deficiencies that serum tests may miss
Useful for at-home testing: Easy sample collection and shipping
Dried Blood Spot testing is an effective tool for monitoring nutritional status and toxic element exposure, offering a clearer picture of your health—especially when traditional blood tests fall short.
Optimal range: 0 - 0.75 ug/L
Whole blood cadmium is within the normal reference range, which is a favorable finding indicating low recent exposure to this toxic metal. However, if cadmium levels are at the high end of the normal range, it is important to also measure urinary cadmium, which better reflects long-term body burden.
Cadmium bioaccumulates in the body over time. At birth, cadmium levels are minimal, but by age 30, accumulated levels may reach a point where they begin to negatively affect health. Cadmium has a biological half-life of 15–30 years in the kidneys, making urine testing the preferred method for assessing cumulative, lifetime exposure.
Cadmium is a non-essential, highly toxic element. It is:
A known kidney toxin
A neurotoxin affecting peripheral nerves
An estrogen mimic that can disrupt hormonal balance
A Group 1 carcinogen (classified by the IARC)
Optimal range: 0.64 - 1.1 mg/L
Copper is an essential trace element involved in antioxidant defense, immune response, nerve cell development, and iron metabolism. It also serves as a cofactor for numerous vital enzymes and proteins. The human body contains approximately 100 mg of copper, with the highest concentrations found in the brain and liver.
Copper is primarily absorbed in the stomach and small intestine, where higher pH levels help release it from dietary macromolecules. Once absorbed, copper is transported in the blood by albumin and transcuperin to the liver, where it binds to ceruloplasmin, a copper-carrying protein. Ceruloplasmin production is stimulated by adrenal hormones, so dysfunction in the liver or adrenal glands can disrupt copper balance, potentially leading to copper buildup in tissues. Under normal conditions, the body maintains copper homeostasis through biliary excretion, preventing toxicity.
Optimal range: 29 - 51 mg/L
Magnesium is a vital mineral and cofactor involved in approximately 600 enzymatic reactions. It plays a key role in:
Protein synthesis
DNA and RNA production
Reproductive health
Cellular energy generation and storage (ATP)
Muscle and nerve function
Blood glucose regulation
Blood pressure control
Magnesium is also known to reduce the risk of stroke, according to substantial clinical evidence.
Optimal range: 0 - 6.98 ug/L
Whole blood mercury levels are within the normal reference range, which suggests no recent excessive exposure. However, values in the high-normal range may still warrant investigation to identify and reduce possible sources of mercury exposure.
Mercury is a potent neurotoxin that exists in three primary forms in the body:
Elemental mercury
Inorganic mercury
Organic mercury (primarily methylmercury, MeHg)
Exposure to high levels of mercury can result in symptoms such as:
Impaired balance and coordination
Hearing loss
Speech difficulties
Tingling or numbness due to peripheral nerve damage
When selenium or zinc levels are low in the presence of elevated mercury, it's important to increase these nutrients to support the body's antioxidant defense systems. Mercury strongly binds to sulfur and selenium-containing proteins, particularly in the brain, where its half-life may exceed 20 years.
Optimal range: 6.16 - 10.3 Ratio
The zinc-to-copper ratio (Zn/Cu ratio) is a key indicator of trace mineral balance in the body. Both zinc and copper are essential nutrients that support numerous physiological functions, but they also act in opposition in several biological processes. Maintaining the right ratio between them is more important than the absolute level of either mineral alone.
Zinc supports immune function, wound healing, DNA synthesis, antioxidant activity, and enzyme function.
Copper plays a role in energy production, nervous system health, iron metabolism, and connective tissue formation.
When the Zn/Cu ratio is balanced, these minerals complement each other. However, an imbalance—whether due to excess copper, low zinc, or both—can disrupt enzyme activity and contribute to oxidative stress, inflammation, and immune dysfunction.
Optimal range: 130 - 362 ug/L
Whole blood selenium levels are within the normal reference range. This measurement reflects long-term selenium status, while urinary selenium levels are better indicators of recent intake.
Selenium is an essential trace element with critical roles in:
Thyroid hormone metabolism
Antioxidant defense (especially via glutathione peroxidase)
Maintaining cellular redox balance
Low selenium levels are linked to thyroid dysfunction, particularly Hashimoto’s thyroiditis, and reduced conversion of thyroxine (T4) to triiodothyronine (T3).
Optimal range: 5.06 - 8.57 mg/L
Zinc is an essential trace element that serves as a co-factor for over 300 enzymes and plays a critical role in numerous biological functions. It is necessary for cell growth and division, DNA synthesis, wound healing, taste perception, immune and thyroid function, blood clotting, reproduction, tissue repair, and protection against oxidative stress. Zinc also contributes to important structural and regulatory processes in the body.
Adequate zinc intake helps reduce the absorption of toxic metals like lead and protects the kidneys from cadmium-induced damage. Zinc is absorbed more efficiently when the diet includes animal proteins such as eggs, beef, and cheese—these release amino acids that help keep zinc soluble and bioavailable. Conversely, phytates found in legumes and whole grains can bind zinc and inhibit its absorption. As a result, vegetarians and vegans—who typically consume higher levels of phytates and lower levels of animal protein—are at greater risk for zinc deficiency and may require higher levels of supplementation. Alcohol consumption can also impair zinc status by reducing absorption and increasing urinary losses.
Blood Spot Thyroids
The thyroid is a small, butterfly-shaped gland located just below the Adam's apple, playing a crucial role in regulating metabolism, energy, and overall hormonal balance. However, various factors, such as hormone imbalances, mineral deficiencies, and environmental pollutants, can disrupt thyroid function, leading to significant health issues.
Thyroid Dysfunction is Often Under-Diagnosed
According to the American Thyroid Association, up to 60% of people with thyroid disorders may be unaware of their condition. Thyroid problems disproportionately affect women, who are seven times more likely than men to experience thyroid dysfunction, with up to a one-in-five chance of developing issues, especially during perimenopause when hormone levels fluctuate.
Thyroid dysfunction can manifest through a wide range of symptoms. Do any of these sound familiar?
Signs of Hypothyroidism:
Signs of Hyperthyroidism:
What Does the Blood Spot Thyroid Testing Panel Measure?
This comprehensive panel assesses levels of key thyroid hormones to determine if there’s an imbalance:
TSH (Thyroid-Stimulating Hormone): Produced by the pituitary gland, TSH stimulates the thyroid to produce thyroxine (T4).
Free T4 (Thyroxine): The main hormone produced by the thyroid, T4 is converted to its active form, T3, in the body’s cells.
Total T4: This includes both free T4 and protein-bound T4, offering insight into the thyroid's ability to produce and release T4 into the bloodstream.
Free T3 (Triiodothyronine): T3 is the active hormone responsible for regulating the metabolic activity of cells.
TPOab (Thyroid Peroxidase Antibodies): These antibodies, produced in autoimmune conditions like Hashimoto’s, target the thyroid gland. Measuring TPOab levels helps diagnose autoimmune thyroid diseases.
By using a blood spot sample, this testing panel provides a convenient way to evaluate thyroid function, helping identify imbalances that could be affecting your overall health and well-being.
Thyroid health can be compromised by nutritional deficiencies, particularly in iodine and selenium, as well as by overexposure to harmful elements like bromine, arsenic, cadmium, and mercury. These substances are prevalent in our environment, found in the food we eat, the water we drink, the materials we come into contact with, and the air we breathe.
Elements That Affect Thyroid Function:
Iodine: Iodine is crucial for the production of key thyroid hormones, T4 and T3. A deficiency in iodine can hinder hormone production, leading to hypothyroidism, goiter, and cognitive decline. Iodine deficiency has also been linked to an increased risk of breast cancer. Common sources of iodine include dairy products, seafood, iodized salt, and grains.
Bromine: This element is often found in flame retardants, fumigants, medications, and pool/spa sanitizers. High environmental exposure to bromine can lead to excessive accumulation in the body, disrupting thyroid function.
Selenium: Selenium is essential for thyroid hormone production, neutralizing free radicals, DNA synthesis, and cancer prevention. While too much selenium can be toxic, insufficient selenium levels impair the conversion of T4 to T3, affecting thyroid health. Common dietary sources of selenium include Brazil nuts, seafood, eggs, and grains.
Arsenic: An environmental heavy metal, arsenic has multiple toxic effects on the body and can interfere with selenium function, leading to deficiency. It is found in shellfish, seaweed, rice, fruit, and well water.
Mercury: Mercury is a highly toxic heavy metal that can damage the brain and nervous system. It impacts thyroid function by inhibiting selenium and mimicking the effects of arsenic exposure. High mercury levels can accumulate from sources like dental amalgams, seafood, and certain vaccinations.
Cadmium: Chronic exposure to cadmium can cause the accumulation of this metal in the thyroid gland, resulting in tissue damage. Smoking is a major source of cadmium exposure, with smokers having about twice the levels of non-smokers.
Maintaining optimal levels of these elements, while avoiding excessive exposure to toxins, is crucial for supporting healthy thyroid function.
Optimal range: 2.4 - 4.2 pg/mL
Optimal range: 0.7 - 2.5 ng/dL
Optimal range: 0 - 150 IU/ml
Optimal range: 0.5 - 3 uU/mL
Advanced Intestinal Barrier Assessment (Plasma)
Precision Point Diagnostics: Advanced IBA Profile for Intestinal Barrier Assessment
The Advanced Intestinal Barrier Assessment (IBA) profile from Precision Point Diagnostics offers an in-depth evaluation of intestinal barrier function. By utilizing a collection of innovative biomarkers, this test helps clinicians determine if their patients are experiencing intestinal permeability, commonly known as "leaky gut." Intestinal permeability is often linked to autoimmune diseases, systemic inflammation, and food sensitivities. Addressing gut barrier health is critical for resolving chronic diseases—without proper gut healing, other treatments may have limited effectiveness.
Key Biomarkers in the Advanced IBA Profile
The Advanced IBA profile features unique and clinically relevant markers that provide a comprehensive view of gut barrier health:
This test is beneficial for patients suffering from allergies, food sensitivities, digestive issues, headaches, cognitive decline, depression, and other related conditions (refer to the Table of Associated Symptoms and Conditions for more details).
Personalized Treatment Plans Based on IBA Results
The Advanced IBA profile enables clinicians to develop tailored treatment plans based on each patient's specific test results, ensuring more effective and targeted interventions. Since no two patients are the same, protocols to improve intestinal permeability must be individualized. The Advanced IBA profile helps identify the root cause of barrier dysfunction, making treatment more efficient, cost-effective, and successful.
Some patients may need to focus on balancing DAO and histamine levels, while others may need to address the underlying causes of Zonulin elevation or high LPS antibodies. With this precise approach, clinicians can effectively address the root causes of intestinal permeability and guide their patients back to health.
By using the Advanced IBA profile, practitioners can pinpoint and treat intestinal permeability issues, ultimately helping their patients achieve long-term wellness.
Optimal range: 0 - 34 ng/mL
The DAO:Histamine ratio helps identify subtle imbalances between histamine levels and DAO enzyme activity. Even if DAO levels are within the normal range, symptoms may still occur if histamine levels are elevated. A low ratio indicates that the amount of DAO is insufficient to manage the histamine present in the body. Treatments aimed at regulating either DAO or histamine levels can help restore balance and improve this ratio.
Optimal range: 42.9 - 200 ng/mL
Diamine Oxidase (DAO) and Histamine Regulation
Diamine Oxidase (DAO) is a crucial enzyme responsible for regulating histamine levels by breaking down extracellular histamine, primarily in the microvilli of the small intestine. When DAO levels are low, the body struggles to effectively degrade histamine, leading to an accumulation of histamine and related symptoms. Histamine-N-methyltransferase (HNMT) is another enzyme that assists in histamine breakdown, though it plays a secondary role compared to DAO.
Optimal range: 0 - 1.2 ng/mL
Maintaining a proper balance of histamine is crucial for individuals with allergic and gastrointestinal symptoms. Both excessively high and low levels of histamine can lead to health issues. Histamine was initially identified for its role in anaphylactic allergies, where exposure to specific allergens triggers mast cell degranulation and the release of histamine. This can result in severe, life-threatening reactions.
When the gut barrier is compromised, it increases vulnerability to food antigens, toxins, and harmful microbes. This condition, often referred to as "leaky gut," weakens the body's defenses and leads to inflammation. Common symptoms of elevated histamine include rapid heart rate (tachycardia), headaches, flushing, hives (urticaria), itching (pruritis), low blood pressure (hypotension), bronchospasm, and in severe cases, cardiac arrest.
Optimal range: 0.83 - 4.47 ug/ml
Optimal range: 9.09 - 31.5 ug/ml
Optimal range: 2.5 - 9.4 ug/ml
Optimal range: 0 - 3.19 ng/mL
Zonulin, a protein that regulates the permeability of the intestinal lining, plays a key role in maintaining the gut barrier. It breaks down tight junctions between the cells in the gastrointestinal (GI) tract, which are essential for protecting the body from external threats. When these tight junctions are compromised, it results in increased intestinal permeability, often referred to as "leaky gut." This weakened barrier makes the body more susceptible to food antigens, toxins, and harmful microbes, leading to elevated inflammation.
High plasma zonulin levels have been associated with a variety of health conditions, including celiac disease, autoimmune disorders, type 1 diabetes, multiple sclerosis, and rheumatoid arthritis. Studies have shown that patients with active celiac disease have higher zonulin levels compared to those without the condition. Additionally, elevated zonulin levels may appear 2 to 5 years before the onset of autoimmune diseases, diabetes, or allergies, suggesting zonulin could serve as an early marker for these disease processes.
Borreliosis
Understanding the Borreliosis Biomarker Category: Insights into Lyme Disease and Related Tick-Borne Infections
The biomarker category "Borreliosis" encompasses a range of biomarkers used in diagnosing Lyme disease and other infections caused by Borrelia species. Lyme disease, the most common form of borreliosis, is caused by Borrelia burgdorferi, transmitted through tick bites. Due to the complexity of Borrelia infections, clinicians use multiple biomarkers—including Borrelia WB IgM, Borrelia WB IgG, and P100—to identify the presence and stage of the disease. Together, these biomarkers provide a layered view of the immune response to Borrelia infection, helping determine whether an infection is recent, persistent, or past.
Key Borreliosis Biomarkers: Borrelia WB IgM, Borrelia WB IgG, and P100
In the borreliosis category, Borrelia WB IgM, Borrelia WB IgG, and P100 are essential markers. Each reflects different stages and characteristics of the immune response to Borrelia infection:
These three markers together create a comprehensive profile, allowing clinicians to assess the infection stage and duration more accurately.
Interpretive Matrix for Borreliosis Biomarkers
The following matrix provides an overview of possible interpretations based on combinations of results for Borrelia WB IgM, Borrelia WB IgG, and P100. Each result combination reflects different infection stages or diagnostic implications.
| Borrelia WB IgM | Borrelia WB IgG | P100 | Interpretation |
|---|---|---|---|
| Positive | Negative | Negative | Early-Stage Infection: Suggests recent exposure with early IgM response. IgG and P100 may not have developed yet. |
| Positive | Positive | Negative | Intermediate Infection: Infection is progressing, with early IgG response accompanying IgM, but P100 has not appeared. |
| Positive | Positive | Positive | Advanced or Chronic Infection: Prolonged infection suggested by ongoing IgM and IgG responses and later-stage P100 reactivity. |
| Negative | Positive | Negative | Past or Resolved Infection: IgG alone indicates prior exposure, with no current IgM or chronic markers present. |
| Negative | Positive | Positive | Chronic or Persistent Infection: IgG and P100 together indicate ongoing immune response and possible chronic infection. |
| Negative | Negative | Positive | Atypical or Persistent Immune Response: P100 reactivity without IgM or IgG is unusual; further investigation is recommended to rule out other causes. |
| Negative | Negative | Negative | No Evidence of Infection: Absence of all markers suggests no current or past infection or that testing occurred too early for antibody detection. |
Clinical Significance of Each Biomarker Combination
This matrix serves as a diagnostic guide, offering insights into each result pattern:
Early Infection: Positive IgM with negative IgG and P100 results typically indicates an early-stage infection. This combination suggests the immune system has recently encountered Borrelia burgdorferi and has begun producing IgM antibodies. Early treatment is essential to prevent progression.
Intermediate Stage: When both IgM and IgG are positive but P100 is still negative, the infection may be progressing from early to intermediate stages. This indicates the body’s immune response is developing further, as IgG begins to appear.
Chronic Infection: Positive IgG and P100 with negative IgM usually indicate a chronic or persistent infection, where IgG and P100 reactivity reflect a prolonged immune response. If symptoms are consistent with late-stage Lyme disease, further clinical management may be necessary.
Atypical Response: In cases where only P100 is positive and IgM and IgG are negative, the interpretation is more complex. P100 positivity alone might suggest an atypical immune response to Borrelia burgdorferi, prompting further investigation through additional testing, such as PCR or testing for other tick-borne infections.
Challenges and Limitations of Borreliosis Biomarkers
Although these biomarkers are valuable, interpreting them can be challenging due to variability in immune responses. For example, not all patients develop detectable antibodies at the same rate, and Borrelia’s ability to evade the immune system can result in delayed or absent IgM and IgG responses. False positives may also occur, particularly with IgM, due to cross-reactivity with other infections or autoimmune conditions. Consequently, these markers are most effective when used alongside clinical findings, history of exposure, and other tests as needed.
Additional Testing and Follow-up
If the biomarker results are inconclusive, additional testing may be beneficial. PCR (Polymerase Chain Reaction) testing, which detects Borrelia DNA directly, can confirm an active infection when standard antibody markers are negative. Retesting after a few weeks may also capture changes in antibody levels as the infection progresses. Testing for other co-infections, such as Babesia or Ehrlichia, may also be necessary, as co-infections can mimic Lyme disease symptoms and influence test results.
Conclusion
The Borreliosis biomarker category, consisting of Borrelia WB IgM, Borrelia WB IgG, and P100, provides a comprehensive approach to diagnosing Lyme disease and assessing its stage. By examining these markers together, healthcare providers gain a clearer understanding of the immune response to Borrelia burgdorferi, helping to differentiate early, chronic, and past infections. While these biomarkers are powerful diagnostic tools, they are most effective when used in conjunction with clinical evaluation, patient history, and, if needed, additional testing. This integrated approach enhances diagnostic accuracy and informs treatment strategies, supporting better patient outcomes in managing Lyme disease and related infections.
Reference range: Negative, Positive
The Borrelia Western Blot IgG (Immunoglobulin G) is a vital component in the diagnostic process for Lyme disease, an infection caused by the bacterium Borrelia burgdorferi. IgG antibodies are part of the body’s adaptive immune response and typically develop weeks to months after initial infection, indicating either past exposure or a current, longer-term immune response. Because Lyme disease is a complex, multi-stage illness with varying symptomatology depending on the stage, the IgG Western Blot test provides valuable insights, especially in patients with symptoms that suggest chronic or late-stage infection.
Reference range: Negative, Positive
The Borrelia Western Blot (WB) IgM test is a significant tool in the diagnosis of Lyme disease, an infection caused by the Borrelia burgdorferi bacteria, transmitted primarily through tick bites. The IgM test specifically detects early immune responses to the bacteria and is a valuable marker during the initial weeks following exposure. The presence of IgM antibodies, which are the first line of defense, provides insight into whether an infection is recent, as IgM antibodies typically appear within one to two weeks of exposure and may decline after a few months. Given that Lyme disease can present with a range of symptoms that mimic other illnesses, accurately interpreting IgM and other biomarkers is essential for both timely treatment and effective management of the disease.
Reference range: Negative, Positive
When it comes to diagnosing Lyme disease, a condition caused by the Borrelia burgdorferi bacteria, healthcare providers often rely on a combination of clinical evaluation, patient symptoms, and specific laboratory tests. One of the components sometimes found on a Borrelia test panel is the P100 biomarker. Understanding what this biomarker signifies and how it fits into Lyme disease diagnostics can shed light on the often-complex process of diagnosing this tick-borne illness.
What is the P100 Biomarker?
P100 is a protein antigen found in the Borrelia burgdorferi bacterium. This protein, along with others like P41, OspC, and others, is used to detect the presence of an immune response to Lyme disease. The P100 antigen, sometimes referred to as the 100 kDa protein, gets its name from its molecular weight. This protein becomes relevant in Lyme disease testing because it is associated with the immune response to the infection; when the immune system encounters Borrelia burgdorferi, it generates antibodies that specifically target bacterial antigens, including P100. Detecting antibodies against P100 can provide insight into a patient’s exposure to the Lyme-causing bacteria.
Minerals & Metals Test
The Minerals & Metals Test by EquiLife is an at-home hair analysis designed to assess long-term mineral levels and detect toxic heavy metal exposure in the body. This test provides a comprehensive view of how your body metabolizes essential minerals and its burden of harmful metals, offering valuable insights into your overall health.
What the Test Measures
Why This Test Is Important
How the Test Works
Benefits of the Minerals & Metals Test
Who Can Benefit
The test is ideal for individuals experiencing:
How to Take Action
After receiving your results, you’ll be equipped with actionable steps to:
Optimal range: 0 - 0.15 Units
The Minerals & Metals Test by Equi.Life measures aluminum levels in hair, offering insight into the body’s exposure to and excretion of this metal. Aluminum is not naturally required by the human body, and excessive exposure or accumulation can be toxic. Measuring aluminum levels in hair provides a reflection of long-term exposure.
Optimal range: 0 - 0.01 Units
Optimal range: 3.68 - 4.3 Ratio
The Calcium-to-Potassium (Ca/K) ratio is a key marker on a hair mineral analysis test that provides insight into your metabolic health, adrenal function, and overall vitality. Calcium (Ca) and potassium (K) are essential minerals that play important roles in cellular function, energy production, and stress response.
This ratio reflects the balance between these two minerals in your body and can indicate underlying health patterns.
Optimal range: 6 - 7 Ratio
Optimal range: 2.3 - 2.7 Units
Optimal range: 0 - 0.01 Units
Optimal range: 32 - 65 Units
Optimal range: 0.09 - 0.15 Units
Chromium is an essential trace mineral crucial for carbohydrate metabolism and insulin sensitivity. It plays a role in stabilizing blood sugar levels and is involved in lipid and protein metabolism. Hair analysis offers a long-term view of chromium status, reflecting dietary intake, environmental exposure, and overall mineral balance.
Optimal range: 0 - 0.06 Units
Optimal range: 1.5 - 3 Units
Optimal range: 2.2 - 4.3 Units
Iron is an essential trace mineral that plays a critical role in oxygen transport, energy production, and immune function. Measured in a hair mineral analysis, iron levels can reflect long-term trends in the body’s mineral status and potential imbalances. Abnormal iron levels—either elevated or decreased—may indicate underlying health concerns.
Optimal range: 0 - 0.09 Units
Optimal range: 0 - 0.3 Units
Optimal range: 5 - 11 Units
Magnesium is an essential mineral that plays a pivotal role in over 300 enzymatic processes, including energy production, nerve function, muscle contraction, and bone health.
Magnesium levels in hair analysis provide valuable insights into long-term mineral status. Understanding whether levels are elevated or decreased can help pinpoint potential health concerns and guide dietary, lifestyle, and supplementation strategies for restoring balance. Always consult with a qualified practitioner to interpret results and tailor treatment plans.
Optimal range: 0.03 - 0.06 Units
Manganese is an essential trace mineral involved in various biological functions, including enzyme activation, antioxidant defense, bone health, and carbohydrate metabolism. Hair analysis can provide insights into long-term manganese exposure and its role in your body's metabolic balance.
Optimal range: 0 - 0 Units
Mercury is a heavy metal that can accumulate in the body through environmental exposure, diet (such as fish and shellfish), dental fillings, or industrial contact. Hair testing for mercury offers insights into long-term exposure and potential retention in tissues. Detecting abnormal levels of mercury in hair can guide detoxification strategies and address symptoms linked to mercury toxicity or deficiency.
Optimal range: 0 - 0.15 Units
Optimal range: 2.3 - 2.7 Units
Optimal range: 3.9 - 4.5 Ratio
Optimal range: 0 - 0.15 Units
Optimal range: 12.8 - 19.2 Units
Optimal range: 7 - 16 Units
Potassium is an essential mineral and electrolyte crucial for maintaining cellular function, nerve signaling, muscle contractions, and fluid balance. In a hair mineral analysis, potassium levels provide insight into adrenal activity, metabolic health, and overall electrolyte balance. Unlike serum potassium, hair potassium reflects longer-term trends in mineral retention and utilization.
Optimal range: 0.12 - 0.21 Units
Optimal range: 19 - 36 Units
Optimal range: 16 - 24 Units
Optimal range: 7.5 - 8.5 Units
The Zn/Cu ratio (zinc to copper ratio) on a hair test panel is an important indicator of the body’s mineral balance. Zinc and copper are essential trace minerals that work together to support various biological processes, including immune function, energy production, and brain health. However, maintaining the right balance between these two is key to optimal health.
Hair Mineral Analysis Level 1- Hair
Hair Metal and Mineral Analysis: Understanding Nutrient and Toxic Metal Levels
Hair metal and mineral analysis evaluates the nutrient and toxic metal content in hair, offering insights into the body’s mineral status and exposure to harmful substances. Hair serves as an excellent medium for such analysis because it reflects both external environmental exposure and internal absorption through the bloodstream. Over time, minerals and metals accumulate in hair, providing a stable record of metabolic and cellular activity.
This test can measure a wide range of metals and minerals in a single sample, giving valuable information about nutrient metabolism and cellular function. Since minerals are essential catalysts for every physiological process in the body, their levels in hair can reveal imbalances that impact overall health. The structure of hair remains unchanged after growth, meaning mineral levels in each section remain fixed, accurately reflecting accumulation over the hair growth period, typically 1–3 months.
Toxic heavy metals, absorbed from pollution, chemicals, and environmental poisons, pose a growing threat to health. These metals accumulate in body tissues and can cause significant developmental, neurological, and systemic damage. Heavy metal toxicity has been linked to a wide range of health issues, including those affecting the cardiovascular, endocrine, immune, musculoskeletal, skin, and nervous systems.
Hair analysis provides a non-invasive method to identify such exposures and guide interventions for better health.
Optimal range: 0 - 8 ppm
Optimal range: 0 - 0.2 ppm
Optimal range: 0 - 0.2 ppm
Optimal range: 220 - 1600 ppm
Optimal range: 5.5 - 292 Ratio
The Calcium/Copper (Ca/Cu) ratio in hair mineral analysis provides valuable insights into your mineral balance and overall metabolic function. This ratio reflects the dynamic interaction between calcium, a structural and regulatory mineral, and copper, an essential trace element crucial for enzymatic and metabolic processes.
Optimal range: 16.1 - 293 Rate
Optimal range: 4.9 - 26.1 Rate
Optimal range: 0.9 - 11.3 Ratio
Optimal range: 0.02 - 0.21 ppm
A high hair chromium (Cr) level is likely to indicate excess exposure to Cr. Hair Cr levels do not appear to be affected by permanent solutions, dyes, or bleaches, but external contamination is possible. Trivalent Cr is considered to be an essential trace element with a low order of toxicity. Cr toxicity via oral ingestion is not likely. However, it is noteworthy that excessive self-supplementation has been reported to be associated with insomnia and increased unpleasant dream activity in some individuals (J. Nutr. Med.; 3(43), 1992).
Phytates decrease oral assimilation of Cr+3, whereas nicotinic acid and vitamin C increase absorption of Cr+3, zinc, vanadium and iron compete with Cr for absorption. In contrast, hexavalent Cr compounds are considerably more toxic and are primarily absorbed via inhalation as a result of industrial exposure. Industrial exposure to high amounts of Cr has been reported to be associated with allergic dermatitis, skin ulcers, bronchitis, and lung and nasal carcinoma. Elevated hair Cr levels have also been observed in patients with cerebral thrombosis and cerebral hemorrhage.
Optimal range: 10 - 41 ppm
Optimal range: 4.6 - 17.7 ppm
Optimal range: 0.1 - 2.5 Ratio
Optimal range: 5.5 - 195 Ratio
Optimal range: 0 - 3 ppm
Optimal range: 20 - 130 ppm
Optimal range: 0.05 - 0.92 ppm
Optimal range: 0 - 0.6 ppm
Optimal range: 0 - 1 ppm
Optimal range: 0.4 - 1.7 ppm
Optimal range: 0 - 1 ppm
Optimal range: 0 - 0.7 ppm
Optimal range: 150 - 272 ppm
Optimal range: 383 - 2254 Ratio
Optimal range: 8.2 - 13.2 Ratio
Optimal range: 10.4 - 45.4 Ratio
Optimal range: 1.09 - 12.4 Ratio
Optimal range: 142 - 3542 Ratio
1018 Celiac Profile - Serum
The "1018 Celiac Profile - Serum" by Genova Diagnostics is a comprehensive blood test designed to identify celiac disease and gluten sensitivity. This panel measures critical biomarkers that indicate immune reactions to gluten, helping pinpoint potential celiac disease, gluten intolerance, or related autoimmune issues.
Celiac disease is an autoimmune disorder where the ingestion of gluten—found in wheat, barley, and rye—triggers an immune response that damages the small intestine lining. Untreated, it can lead to malabsorption, nutrient deficiencies, and other health complications.
Genova Diagnostics is a trusted name in functional testing, delivering accurate, clinically actionable results to help individuals take control of their health.
If your results suggest celiac disease or gluten sensitivity, working with a healthcare provider to adopt a gluten-free diet can alleviate symptoms and improve your quality of life. Further testing, such as intestinal biopsies or genetic testing, may be recommended for confirmation.
If IgA is low, rely on IgG-based tests:
Optimal range: 0 - 6.9 U/mL
Anti-Deamidated Gliadin IgA (DGP IgA) is a key marker for detecting celiac disease by measuring IgA antibodies against gluten fragments (deamidated gliadin peptides). It’s especially useful for identifying early-stage disease or confirming unclear results from other tests like tTG IgA. Elevated DGP IgA indicates an immune response to gluten, suggesting potential intestinal damage. If levels are high, further testing, such as an intestinal biopsy, may be needed to confirm the diagnosis and guide treatment with a gluten-free diet.
Optimal range: 0 - 6.9 U/mL
Anti-Deamidated Gliadin IgG (DGP IgG) is a key marker for detecting celiac disease and gluten sensitivity, especially in individuals with IgA deficiency or unclear test results. Elevated DGP IgG levels suggest an immune reaction to gluten, indicating possible celiac disease or non-celiac gluten sensitivity. It’s a reliable alternative when standard IgA-based tests are inconclusive. If your DGP IgG is high, consult your healthcare provider for further evaluation, such as additional antibody tests or a biopsy, to confirm the diagnosis and determine if a gluten-free diet is needed.
Optimal range: 0 - 6.9 U/mL
Anti-Tissue Transglutaminase IgA (tTG IgA) is the primary and most reliable test for detecting celiac disease, measuring IgA antibodies produced in response to gluten. Elevated levels strongly suggest celiac disease, as they indicate immune-driven damage to the intestinal lining. However, in individuals with IgA deficiency, results may appear normal, requiring alternative tests like tTG IgG. If tTG IgA is elevated, further evaluation, such as an intestinal biopsy, is often recommended to confirm the diagnosis and guide treatment with a gluten-free diet.
Optimal range: 0 - 6.9 U/mL
Anti-Tissue Transglutaminase IgG (tTG IgG) is a key marker used in celiac disease testing, particularly for individuals with IgA deficiency, where standard tTG IgA results may be unreliable. Elevated tTG IgG levels suggest the immune system is reacting to gluten, which can indicate celiac disease or, in some cases, non-celiac gluten sensitivity. However, tTG IgG can occasionally be elevated due to other conditions, such as liver disease or autoimmune disorders. If your tTG IgG is high, it’s important to consult with your healthcare provider, who may recommend additional tests, like a biopsy or further antibody screening, to confirm celiac disease and guide the next steps for managing gluten-related symptoms.
Optimal range: 69 - 446 mg/dL
The Total IgA biomarker on the 1018 Celiac Profile - Serum by Genova Diagnostics measures the overall levels of Immunoglobulin A (IgA), an essential antibody that plays a crucial role in the immune system, particularly at mucosal surfaces like the gastrointestinal tract. IgA protects against pathogens and dietary antigens, such as gluten, which are processed in the gut. In the context of celiac disease testing, Total IgA is measured to ensure the accuracy of IgA-dependent biomarkers, such as anti-tissue transglutaminase (tTG IgA) and deamidated gliadin peptide (DGP IgA).
IMMUNODEF.PANEL(T/B/NK)
Brazilian Biomarkers
This category hosts a comprehensive collection of biomarkers commonly used in medical diagnostics in Brazil and Portuguese-speaking regions. It includes tests for metabolic health, hormonal balance, cardiovascular risk, inflammatory markers, and thyroid function, among others.
Designed to cater to the unique needs of healthcare practitioners and patients in Brazil, the listed biomarkers provide essential insights into health conditions such as diabetes, thyroid disorders, autoimmune diseases, hormonal imbalances, and cardiovascular risks.
Whether you're analyzing fasting glucose, vitamin D levels, hormone profiles, or advanced autoimmune panels, this category serves as a centralized resource for interpreting these key tests. Perfect for doctors, health enthusiasts, and individuals seeking to better understand their lab results in a regional and culturally relevant context.
Esta categoria reúne uma coleção abrangente de biomarcadores comumente utilizados em diagnósticos médicos no Brasil e em regiões de língua portuguesa. Inclui exames para saúde metabólica, equilíbrio hormonal, risco cardiovascular, marcadores inflamatórios e função tireoidiana, entre outros.
Desenvolvida para atender às necessidades específicas de profissionais de saúde e pacientes no Brasil, os biomarcadores listados fornecem insights essenciais sobre condições de saúde, como diabetes, distúrbios da tireoide, doenças autoimunes, desequilíbrios hormonais e riscos cardiovasculares.
Seja para analisar glicose em jejum, níveis de vitamina D, perfis hormonais ou painéis autoimunes avançados, esta categoria funciona como um recurso centralizado para interpretar esses exames-chave. Ideal para médicos, entusiastas da saúde e indivíduos que buscam compreender melhor seus resultados laboratoriais em um contexto regional e culturalmente relevante.
Optimal range: 3.8 - 8.4 mg/dL
Optimal range: 6 - 46 U/L
Optimal range: 0 - 4 IU/ml
Optimal range: 0 - 7 U/mL
Optimal range: 0 - 39 Units
Optimal range: 0 - 34 IU/ml
Optimal range: 0 - 1 AI
Optimal range: 0 - 1 AI
Reference range: Negativo, Positivo
Optimal range: 0 - 40 U/L
Optimal range: 0 - 0.2 x10E3/µL
Os basófilos são um tipo de glóbulo branco que ajuda a defender o organismo contra alérgenos, patógenos e parasitas. Eles têm uma vida curta de um a dois dias e desempenham um papel fundamental na resposta imunológica.
Como granulócitos, os basófilos contêm histamina e heparina, que regulam a inflamação. A histamina dilata os vasos sanguíneos, desencadeando sintomas alérgicos como espirros e coriza, enquanto a heparina previne a coagulação excessiva do sangue.
Os basófilos também interagem com a imunoglobulina E (IgE), trabalhando junto com os mastócitos para liberar histamina e serotonina, amplificando as respostas alérgicas e inflamatórias.
Embora sejam poucos em número, os basófilos são essenciais para a defesa imunológica e reações alérgicas.
Optimal range: 0 - 1 %
Os basófilos são um tipo de glóbulo branco (leucócito) que desempenha um papel essencial no seu sistema imunológico, especialmente na defesa do corpo contra alérgenos, patógenos e parasitas. Apesar de representarem menos de 1% dos seus glóbulos brancos, os basófilos são fundamentais para gerenciar reações alérgicas e respostas inflamatórias.
Características dos Basófilos
Optimal range: 3.4 - 10.8 x10E3/µL
A contagem de células brancas do sangue (WBC) mede a quantidade de leucócitos no sangue, essencial para identificar infecções, inflamações e condições médicas como doenças autoimunes e distúrbios sanguíneos. Essas células desempenham um papel crucial no sistema imunológico, sendo divididas em neutrófilos, linfócitos, monócitos, eosinófilos e basófilos. O exame é frequentemente incluído no hemograma completo (CBC) e auxilia no diagnóstico e monitoramento de tratamentos médicos. Valores normais variam entre 3.800 e 10.800 células/µL, dependendo do laboratório, e devem ser interpretados com a orientação de um médico.
Optimal range: 4.14 - 5.8 cells/mcL
As células vermelhas do sangue transportam oxigênio dos pulmões para o resto do corpo. Elas também levam dióxido de carbono de volta aos pulmões para ser exalado. As células vermelhas do sangue (hemácias) são produzidas na medula óssea e contêm hemoglobina, uma proteína que transporta oxigênio para os tecidos do corpo. Essas células também são conhecidas como eritrócitos.
A anemia é uma condição resultante da diminuição no número de hemácias. Contagens elevadas de hemácias são observadas em outras condições, como baixos níveis de oxigênio, uso de certos medicamentos, doenças renais ou superprodução na medula óssea. Se os resultados da contagem de hemácias forem anormais, geralmente são realizados testes adicionais para diagnosticar a causa dos níveis elevados ou reduzidos de células vermelhas do sangue.
Um hemograma completo (HC) mede dois outros componentes das células vermelhas do sangue:
hemoglobina: proteína que transporta oxigênio
hematócrito: porcentagem de células vermelhas no sangue
Níveis anormais de células vermelhas do sangue, hemoglobina ou hematócrito podem ser um sinal de anemia, doença cardíaca ou deficiência de ferro no corpo.
Optimal range: 39 - 80 mg/dL
Optimal range: 0 - 99.1 mg/dL
Optimal range: 0 - 199 mg/dL
Optimal range: 31.5 - 35.7 g/dL
MCHC significa concentração de hemoglobina corpuscular média. O MCHC faz parte dos índices dos glóbulos vermelhos, juntamente com o MCH e o MCV. Esses parâmetros refletem o tamanho e o conteúdo de hemoglobina das hemácias. Tradicionalmente, eles são utilizados para auxiliar no diagnóstico diferencial de anemias.
Optimal range: 150 - 450 µl
Outros nomes: Plaquetas, Contagem de Trombócitos
O que são as plaquetas?
As plaquetas (também conhecidas como trombócitos) são pequenos fragmentos celulares incolores presentes no sangue que formam coágulos e ajudam a interromper ou prevenir sangramentos.
Onde as plaquetas são produzidas?
As plaquetas são produzidas na medula óssea, o tecido esponjoso dentro dos ossos. A medula óssea contém células-tronco que se desenvolvem em glóbulos vermelhos, glóbulos brancos e plaquetas.
Qual é a principal função das plaquetas?
As plaquetas formam coágulos quando há danos a um vaso sanguíneo. Por exemplo, se você cortar o dedo, as plaquetas se misturam com os fatores de coagulação (proteínas presentes no sangue). Juntas, elas formam uma espécie de "cola" que interrompe o sangramento.
Optimal range: 2.3 - 19.4 ug/dL
Optimal range: 0.57 - 1 mg/dL
Optimal range: 4 - 22 ng/dL
Optimal range: 0 - 0.4 x10E6/µL
Os eosinófilos são um tipo de glóbulo branco que ajuda a defender o organismo contra parasitas, alérgenos, bactérias e vírus. Embora representem menos de 5% dos glóbulos brancos, desempenham um papel fundamental na resposta imunológica.
Um nível elevado de eosinófilos pode indicar infecção ou reação alérgica, enquanto níveis muito altos podem ser um sinal de uma condição de saúde subjacente.
Os eosinófilos destroem patógenos invasores e contribuem para a inflamação, especialmente em alergias, asma e eczema. Embora a inflamação ajude a controlar infecções, também pode causar danos aos tecidos, tornando os eosinófilos tanto protetores quanto agentes em doenças alérgicas.
Optimal range: 0 - 6 %
Os eosinófilos estão no centro da resposta inflamatória do corpo, especialmente em casos de alergias. Quando o sistema imunológico identifica uma ameaça, como um parasita ou alérgeno, os eosinófilos liberam substâncias químicas para atacar o invasor. Esse processo desencadeia a inflamação, que ajuda a isolar e controlar a resposta imunológica no local da infecção ou irritação.
Embora a inflamação seja um mecanismo de proteção, ela também pode causar danos aos tecidos ao redor. A inflamação crônica, como a observada em alergias, asma ou eczema, pode levar a desconforto e outros efeitos de saúde a longo prazo.
Optimal range: 30 - 400 pg/mL
Optimal range: 0 - 14 IU/ml
Optimal range: 30 - 400 ug/dL
Optimal range: 1.5 - 12.4 IU/L
Optimal range: 0 - 65 U/L
Optimal range: 65 - 99 mg/dL
Optimal range: 37.5 - 51 %
Um teste de hematócrito (Hct) é um exame de sangue simples que mede a porcentagem de glóbulos vermelhos no seu sangue. Os glóbulos vermelhos são importantes porque transportam oxigênio por todo o corpo. Resultados que mostram níveis baixos ou altos de hematócrito podem ser sinais de distúrbios sanguíneos ou outras condições médicas.
Optimal range: 13 - 17.7 g/dL
O que é hemoglobina?
A hemoglobina é o principal componente das células vermelhas do sangue. Hemoglobina (abreviação: Hb) é uma substância vermelha composta de ferro e proteína.
Qual é a função da hemoglobina?
No sangue, a hemoglobina transporta oxigênio dos pulmões para as células do corpo.
A hemoglobina também transporta dióxido de carbono das células para os pulmões, sendo posteriormente eliminado do corpo através da expiração. O dióxido de carbono é um gás incolor e inodoro presente em pequenas quantidades no ar. Ele é um subproduto do metabolismo no corpo. Metabolismo é o processo químico nas células que libera energia dos nutrientes ou utiliza energia para criar outras substâncias.
Quais são os valores de referência normais para a hemoglobina?
Os níveis normais de hemoglobina variam dependendo de vários fatores, incluindo idade, sexo ao nascimento, uso de suplementação hormonal, altitude de residência, bem como a presença de diferentes tipos de hemoglobina que afetam a renovação e a afinidade da hemoglobina para ligação com o oxigênio.
Assim como outros valores sanguíneos, níveis ligeiramente altos ou baixos de hemoglobina podem ser normais para algumas pessoas. No entanto, se os seus níveis estiverem muito fora da faixa normal, é provável que seu médico solicite exames mais abrangentes para determinar a causa.
Optimal range: 26.6 - 33 pg
Hemoglobina Corpuscular Média (MCH) refere-se à quantidade média de hemoglobina contida em uma única célula vermelha do sangue. A hemoglobina é uma proteína vital no sangue, responsável por transportar oxigênio dos pulmões para as células do corpo.
Optimal range: 4.8 - 5.6 %
Optimal range: 0 - 14.5 umol/L
Optimal range: 0.45 - 4.5 mIU/L
Optimal range: 2.6 - 24.9 uIU/ml
Optimal range: 0.3 - 13.4 ng/mL
Optimal range: 0.7 - 12.5 IU/L
Optimal range: 0.7 - 3.1 x10E3/µL
Os linfócitos são um tipo de glóbulo branco essencial para a defesa imunológica. Eles ajudam o corpo a combater infecções, doenças e invasores estranhos. Como parte do sistema imunológico, os linfócitos trabalham em conjunto com gânglios linfáticos, tecidos e órgãos linfáticos para proteger contra ameaças.
Os linfócitos identificam e lembram antígenos (substâncias estranhas como bactérias, vírus e toxinas). Após o primeiro contato com um antígeno, alguns linfócitos se tornam células de memória, permitindo uma resposta mais rápida e eficaz em exposições futuras. Esse mecanismo é a base das vacinações.
Os linfócitos monitoram continuamente o corpo, interagindo com fagócitos (monócitos, macrófagos) e células dendríticas para coordenar a resposta imunológica.
Optimal range: 20 - 40 %
Os linfócitos são um tipo de glóbulo branco que desempenha um papel essencial no seu sistema imunológico. Eles ajudam o corpo a combater doenças e infecções, identificando e atacando invasores nocivos como bactérias, vírus e toxinas. Como parte de uma rede complexa de células imunológicas, linfonodos, tecidos linfáticos e órgãos, os linfócitos são fundamentais para manter o sistema de defesa do corpo.
As células T regulam a resposta do sistema imunológico e atacam diretamente células infectadas ou cancerígenas.
As células B produzem anticorpos—proteínas que especificamente identificam e neutralizam vírus, bactérias e outras substâncias estranhas.
Diferentemente das células T, as células NK podem destruir células tumorais e infectadas sem a necessidade de ativação prévia, proporcionando uma resposta imune rápida.
Os linfócitos têm a capacidade única de memorizar antígenos, que são substâncias estranhas que desencadeiam uma reação imunológica. Após encontrar um antígeno, alguns linfócitos se transformam em células de memória. Essas células permitem que o sistema imunológico responda de forma mais rápida e eficaz quando exposto ao mesmo antígeno novamente. Este mecanismo é a base de como as vacinas protegem contra certas doenças.
Os linfócitos estão constantemente monitorando o corpo em busca de antígenos—desde um resfriado comum até células cancerígenas. Eles interagem com outras células imunológicas, como fagócitos (por exemplo, monócitos e macrófagos) e células especializadas, como as dendríticas, para coordenar uma resposta imune direcionada.
Os linfócitos são elementos-chave do sistema imunológico, trabalhando para detectar, responder e memorizar invasores nocivos. Eles garantem proteção de longo prazo e fortalecem a imunidade do corpo contra ameaças futuras.
Optimal range: 0.1 - 0.9 x10E3/µL
Os monócitos são um tipo de glóbulo branco (leucócito) que desempenha um papel fundamental na defesa imunológica. Eles circulam no sangue e nos tecidos, identificando e eliminando vírus, bactérias, fungos e células infectadas.
Quando um patógeno entra no corpo, os monócitos se transformam em macrófagos ou células dendríticas. Os macrófagos destroem invasores, enquanto as células dendríticas alertam outras células imunológicas para responder à ameaça.
Os monócitos são os maiores glóbulos brancos, cerca de duas vezes o tamanho dos glóbulos vermelhos. Embora sejam poucos em número, são essenciais para proteger o organismo contra infecções.
Optimal range: 4 - 8 %
Os monócitos são um tipo de glóbulo branco (leucócito) que desempenha um papel crucial no sistema imunológico. Eles ajudam a proteger o corpo ao identificar e eliminar invasores nocivos, como vírus, bactérias, fungos e protozoários, além de remover células infectadas ou danificadas.
Os monócitos circulam na corrente sanguínea e entram nos tecidos quando necessário. Ao encontrar um invasor ou detectar danos celulares, eles podem:
Quando germes ou bactérias invadem o corpo, os monócitos se transformam em:
Os monócitos são o maior tipo de glóbulo branco, sendo aproximadamente duas vezes maiores que os glóbulos vermelhos. Embora sejam menos numerosos do que outros glóbulos brancos, sua versatilidade e capacidade de coordenar respostas imunológicas os tornam essenciais para proteger o corpo contra infecções e manter a saúde imunológica.
Os monócitos desempenham um papel duplo:
Embora menos abundantes do que outros glóbulos brancos, os monócitos se destacam pelo seu tamanho, adaptabilidade e papel crucial no sistema imunológico. Eles são fundamentais para reconhecer ameaças, coordenar respostas e manter o corpo saudável.
Optimal range: 1.4 - 7 x10E3/µL
Os neutrófilos são os glóbulos brancos mais abundantes e essenciais para a defesa imunológica. Eles são produzidos na medula óssea e circulam pelo sangue e tecidos para combater infecções.
Como células fagocíticas, os neutrófilos engolfam e destroem bactérias, vírus e outros invasores nos locais de infecção. Eles também desempenham um papel na resposta inflamatória, ajudando o corpo a reagir a alérgenos e lesões.
Os neutrófilos são transparentes e geralmente esféricos em repouso, mas mudam de forma para combater infecções de maneira eficaz.
Optimal range: 50 - 70 %
Os neutrófilos são o tipo mais abundante de glóbulo branco (leucócito) no corpo humano e desempenham um papel crucial no funcionamento do sistema imunológico. Como células fagocíticas, sua principal função é englobar e destruir invasores nocivos, como bactérias e vírus, especialmente no local de uma lesão ou infecção.
Além de combater infecções, os neutrófilos também estão envolvidos na resposta inflamatória do corpo. Eles reagem a alérgenos, lesões ou infecções, liberando enzimas e sinalizando outras células imunológicas, contribuindo para a inflamação — um processo natural que ajuda a proteger e curar o corpo.
Com seu papel duplo na imunidade e na inflamação, os neutrófilos são indispensáveis para a manutenção da saúde geral e para a defesa contra uma ampla gama de patógenos.
Optimal range: 0 - 1 mg/L
Optimal range: 2 - 25 ng/mL
Optimal range: 3 - 30 ng/mL
Optimal range: 11.7 - 15.4 %
O valor do RDW indica se uma quantidade suficiente de suas hemácias possui tamanho e forma normais.
As hemácias normalmente têm uma forma discóide e achatada, com um diâmetro médio de cerca de 7,5 µm (micrômetros).
Para desempenharem sua função, as hemácias precisam atravessar os menores vasos sanguíneos do corpo, os capilares. Muitas vezes, os capilares são ainda mais estreitos do que as próprias hemácias, podendo ter um diâmetro de apenas 4 µm. Isso significa que as hemácias devem se deformar e “enrolar” para conseguir passar por esses capilares.
A deformação das hemácias é essencial para garantir que o oxigênio seja adequadamente distribuído por todo o corpo.
Entretanto, nem todas as hemácias são formadas de maneira ideal. Isso é normal até certo ponto, considerando que cerca de 2 milhões de hemácias são produzidas por segundo. Geralmente, entre 85% e 89% das hemácias são desenvolvidas corretamente. Hemácias malformadas podem prejudicar esse processo, impactando a eficiência no transporte de oxigênio.
Optimal range: 24.6 - 122 nmol/L
Optimal range: 71.6 - 375.4 mcg/dL
Optimal range: 2 - 4.4 pg/mL
Optimal range: 0.82 - 1.77 ng/dL
Optimal range: 264 - 916 ng/dL
Optimal range: 0 - 149 mg/dL
Optimal range: 0 - 40 mm/h
Optimal range: 232 - 1245 pg/mL
Optimal range: 30 - 100 ng/mL
Optimal range: 79 - 97 fl
O volume corpuscular médio (VCM) indica o volume médio das células vermelhas do sangue no corpo. Ele é frequentemente medido como parte dos índices de glóbulos vermelhos em um exame de hemograma completo. Os resultados dos índices de glóbulos vermelhos ajudam o profissional de saúde a determinar se há anemia e, em caso afirmativo, qual é o tipo de anemia.
Optimal range: 7.5 - 11.5 fl
O Volume Plaquetário Médio (MPV) é um cálculo que indica o tamanho médio das plaquetas no sangue. Essa medição é geralmente realizada como parte de um hemograma completo. Um MPV anormal, por si só, não é um indicativo de doença ou distúrbio. Os valores do MPV são comparados com outros tipos de contagens sanguíneas para fornecer ao profissional de saúde mais informações sobre possíveis condições médicas.
PFAS (FOREVER CHEMICALS) 9 PANEL
The PFAS (Forever Chemicals) 9 Panel by Quest Diagnostics is a comprehensive blood test designed to measure the levels of 9 specific PFAS chemicals in the body. PFAS, also known as "forever chemicals," are human-made substances that have been used in a variety of products since the 1940s. These chemicals are persistent in the environment and the human body due to their strong carbon-fluorine bonds, which makes them durable and resistant to heat, water, oil, and dirt. However, this same durability raises concerns as PFAS can accumulate in the environment and in human bodies over time.
PFAS (pronounced "pea-fass") have been used in a range of products, including nonstick cookware, water-repellent clothing, firefighting foams, stain-resistant fabrics, and more. While these chemicals provide benefits such as durability and resistance, their persistent nature means they do not naturally break down and can accumulate in water, air, soil, and human blood.
PFAS have been found in the blood of nearly everyone globally, and their widespread presence has raised concerns about their potential health risks. Research has linked elevated PFAS levels with an increased risk for several health conditions, including:
Decreased immune system response
Higher than normal cholesterol and lipid levels (dyslipidemia)
Decreased growth in unborn babies and infants
Increased risk of kidney cancer in adults
While more research is needed to fully understand the long-term effects of PFAS exposure, studies from government agencies, including the National Academies of Sciences, Engineering, and Medicine (NASEM), have concluded there is sufficient evidence linking PFAS to these health risks.
Purpose:
The PFAS 9 Panel measures the levels of 9 common PFAS chemicals in the blood, providing insight into your overall PFAS exposure.
Health Implications:
Elevated PFAS levels may indicate long-term exposure and may be associated with an increased risk of health conditions, such as immune system dysfunction, dyslipidemia, growth issues in infants, and kidney cancer.
Test Use:
The test helps assess past exposure to PFAS but does not predict future health outcomes or identify specific exposure sources.
CDC Recognition:
The Centers for Disease Control and Prevention (CDC) acknowledges the value of PFAS blood testing conducted by CLIA-certified laboratories, such as Quest Diagnostics.
What Will the Test Results Show?
The PFAS 9 Panel will provide detailed results showing both the overall level of PFAS in your blood and the individual levels of each of the 9 PFAS chemicals tested. However, it is important to note that the test does not identify the source of exposure or predict future health conditions.
This test is particularly recommended for individuals who have had significant exposure to PFAS, such as:
Workers exposed to PFAS-containing materials (e.g., firefighters using firefighting foam)
People living near manufacturing plants, military bases, or other sites with known PFAS contamination
Individuals with a history of using products containing PFAS, like nonstick cookware or water-repellent fabrics
If you have elevated levels of PFAS, it is essential to discuss your results with a physician, as only a healthcare provider can diagnose any potential health conditions.
There are no immediate signs or symptoms of PFAS presence in the blood, and PFAS testing cannot predict future health impacts. While high levels of PFAS have been associated with certain health conditions, further studies are necessary to understand the full range of health implications.
If your PFAS levels are higher than normal, it’s crucial to consult with a doctor. Only a physician can diagnose any health conditions that may arise from elevated PFAS exposure and recommend steps to reduce exposure.
The PFAS (Forever Chemicals) 9 Panel offers valuable information about the presence of PFAS chemicals in the body. By understanding your exposure levels, you can make informed decisions about managing health risks related to these persistent chemicals. Talk to your healthcare provider for further guidance based on your test results.
This panel is not intended for use in diagnosing or treating diseases or conditions and should not be used for forensic purposes.
Optimal range: 0 - 0.1 ng/mL
Optimal range: 0 - 0.1 ng/mL
Optimal range: 0 - 0.1 ng/mL
Optimal range: 0 - 0.1 ng/mL
Optimal range: 0 - 0.1 ng/mL
MeFOSAA (Methylperfluorooctane sulfonamidoacetic acid) is one of the 9 specific PFAS (Forever Chemicals) measured in the PFAS (Forever Chemicals) 9 Panel by Quest Diagnostics. It is a chemical compound that belongs to the family of perfluorinated alkyl substances (PFAS), which are synthetic chemicals known for their resistance to heat, water, oil, and stains. These unique properties make PFAS useful in a wide range of consumer products, but their persistence in the environment and human body has raised concerns about potential health risks.
Optimal range: 0 - 2 ng/mL
The NASEM Recommended Summation is a key component in interpreting the results of the PFAS (Forever Chemicals) 9 Panel by Quest Diagnostics. It represents a cumulative measure of the levels of the 9 PFAS chemicals tested in the blood. This summation provides an overall indication of a person’s exposure to PFAS, which are known for their persistence in the environment and human body due to their strong carbon-fluorine bonds.
If the result of the NASEM Recommended Summation is categorized as "intermediate," it indicates that the levels of PFAS in your blood are neither low nor high, but fall somewhere in between. This means that your overall exposure to PFAS, as measured by the test, is moderate.
An "intermediate" result suggests that while you may not have a very high level of PFAS in your body, there is still a noteworthy presence of these chemicals. It could indicate that you have been exposed to PFAS at a level that is higher than typical background exposure, but not to the extent that would trigger concerns for significant health risks, as seen with higher levels.
If your NASEM Recommended Summation result is "intermediate," it’s important to discuss the result with your healthcare provider. They can provide guidance on whether further monitoring or steps to reduce PFAS exposure are necessary. While this result does not indicate an urgent risk, it could be a signal to evaluate lifestyle factors, such as reducing exposure to PFAS-containing products (e.g., nonstick cookware, water-repellent clothing, or certain foods) or reviewing water quality if you live near potential contamination sources.
Your doctor may recommend periodic testing or other actions to minimize future exposure to PFAS.
An "intermediate" result on the NASEM Recommended Summation scale indicates moderate PFAS exposure. While this is not typically cause for immediate concern, it is an opportunity to monitor and assess your exposure levels and take preventive steps if necessary. Always consult with your healthcare provider to better understand your results and any appropriate next steps.
Optimal range: 0 - 0.1 ng/mL
Optimal range: 0 - 0.1 ng/mL
Optimal range: 0 - 0.1 ng/mL
Optimal range: 0 - 0.1 ng/mL
Food Allergy Panel
The Food Allergy Panel test measures immunoglobulin E (IgE) antibodies in the blood, which are produced in response to specific food allergens. This panel evaluates immune responses to the following foods: almond, cashew nut, codfish, cow's milk, egg white, hazelnut, peanut, salmon, scallop, sesame seed, shrimp, soybean, tuna, walnut, and wheat.
If your antibody levels for peanut, milk, or egg are abnormal, additional component panels will be performed on the same sample to provide detailed protein information to share with your allergist. Food allergy reactions can range from mild discomfort to severe symptoms, often developing within minutes to hours of exposure. Identifying which allergens trigger these reactions is important. This panel may help determine whether you've had or currently have an allergic response to any of these food allergens. If you are experiencing any of the signs and symptoms listed below, this test may be beneficial for you.
PLEASE NOTE
This test reports the presence of IgE antibodies, but the results alone cannot confirm a diagnosis of food allergies. It’s important to follow up with your healthcare provider, who will evaluate your results in the context of your medical history, symptoms, medications, and other tests. Only a healthcare provider can diagnose an allergy and prescribe necessary treatment.
You can buy this food allergy panel online through Quest without needing a doctor’s visit. Simply purchase the test, visit a nearby Quest location for sample collection, and receive your results quickly. This panel measures IgE antibody levels in response to common food allergens:
Almond
Cashew nut
Codfish
Cow's milk
Egg white
Hazelnut
Peanut
Salmon
Scallop
Sesame seed
Shrimp
Soybean
Tuna
Walnut
Wheat
IgE antibodies are normally found in small amounts in the blood, but larger amounts may indicate an overreaction to allergens, triggering the release of histamine and causing an allergic response. Certain foods are known to cause serious allergic reactions, including milk, egg, fish, shellfish, peanut, tree nuts, sesame seed, soybean, and wheat. Allergies may cause the following signs and symptoms, which should be discussed with your doctor for confirmation:
Abdominal pain/cramps, diarrhea, nausea, or vomiting
Rash, welts, hives, or eczema
History of mild allergic reaction to a specific food
Nasal congestion, wheezing, or mild difficulty breathing
Runny nose
Tingling, swelling, or itchiness of the mouth, throat, eyes, skin, lips, tongue, face, or other areas of the body
This test may not be appropriate if you experience more severe symptoms. SEEK IMMEDIATE MEDICAL ATTENTION during your reaction. See a specialist for appropriate evaluation if you experience:
Chest tightness
Shortness of breath or constriction and tightening of the airways
Swollen throat or the sensation of a lump in the throat making it hard to breathe or swallow
Severe drop in blood pressure
Rapid pulse
Feeling faint, dizziness, or lightheaded
Loss of consciousness
Anaphylaxis (a potentially life-threatening reaction that can cause itching, hives, skin rash, swelling of the throat, lips, or tongue, and difficulty breathing, potentially leading to shock)
Most allergic reactions occur within minutes, but some may develop hours after exposure. Reactions to allergens can vary from a stuffy nose to anaphylaxis. Anaphylactic shock occurs when blood pressure drops so severely that tissues and cells do not receive enough oxygen. Due to the potential severity of allergic reactions, it is essential to work with your healthcare provider to develop an optimal treatment and prevention plan.
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Mold Allergy Panel
The Mold Allergy Panel detects immunoglobulin E (IgE) antibodies in the blood, which are produced in response to specific mold allergens. This test evaluates immune responses to five common molds associated with allergies: Alternaria alternata, Aspergillus fumigatus, Candida albicans, Cladosporium herbarum, and Mucor racemosus.
An allergic reaction to mold allergens can range from uncomfortable to severe. Mold exposure symptoms usually develop within a few minutes to a few hours. It is important to identify which allergens may trigger an allergic response. This panel can help determine whether you have had or currently have an allergic reaction to mold allergens. If you are experiencing any of the signs and symptoms listed in the "Signs & Symptoms" section below, this test may be for you.
The test requires a blood sample to measure IgE antibody levels made by your immune system in response to common indoor and outdoor mold allergens, offering a quick and convenient way to test for multiple allergens simultaneously. There is no need to discontinue any allergy medications you're currently taking, and because it’s a blood test, there’s no exposure to allergens, thus eliminating the risk of severe allergic reactions—unlike with skin testing.
The following molds are measured by this panel:
Alternaria alternata: The most prevalent mold in dry, warm climates, Alternaria alternata has air spores that peak in the afternoon and typically disseminate in warm, dry air. It is often found in soil and on plants, cereal grains, grass, corn silage, rotten wood, bricks, canvas, iron, compost, and bird nests.
Aspergillus fumigatus: This mold can grow both indoors and outdoors. Outdoors, it thrives in soil, decomposing leaves, bird droppings, compost, wood chips, hay, stored grains, and sweet potatoes. Indoors, it can be found on surfaces such as ventilation ducts, floors, walls, potted plants, household dust, and starchy foods like rice, cereal, and bread.
Candida albicans: Known for causing fungal infections, Candida is often referred to as a yeast but is actually a type of fungus (mold). It can live in soil and organic debris but commonly resides on the skin, in the mouth, intestinal tract, and other moist areas of the body. Yeast can also be found in many foods.
Cladosporium herbarum: Predominant in temperate climates, Cladosporium herbarum can grow both indoors and outdoors. Outdoors, it is found on plants, in soil, and on food. Indoors, it can be found in bathrooms, basements, and on surfaces such as window panes, insulation, fabrics, wood, wallpaper, carpets, upholstered furniture, faucets, and curtains.
Mucor racemosus: Found in soil, plant debris, and dung, Mucor racemosus also grows indoors in house dust, mattresses, carpets, and ventilation ducts.
IgE antibodies are normally present in small amounts in the blood, but larger quantities can indicate that the body is overreacting to allergens, causing it to produce histamine and trigger allergic reactions. Allergies may cause the following signs and symptoms:
Sneezing
Irritated eyes (swelling, redness, watering, scratchiness, itching, puffiness)
Congestion
Runny nose
Itchy nose, ears, or mouth
Headache
Fatigue
Increased asthma symptoms (coughing, wheezing, difficulty breathing)
Rash, welts, hives, or eczema
Nasal congestion, wheezing, shortness of breath, or slight trouble breathing
This test may not be right for you if you experience more severe symptoms. SEEK IMMEDIATE MEDICAL ATTENTION during your reaction. See a specialist for further evaluation if you experience:
Chest tightness
Shortness of breath or constriction and tightening of the airways
A swollen throat or the sensation of a lump in your throat that makes it difficult to breathe
A severe drop in blood pressure
Rapid pulse
Feeling faint, dizzy, or lightheaded
Loss of consciousness
Please Note:
While this test identifies IgE antibodies to mold allergens, the results alone do not confirm an allergy diagnosis. It’s essential to follow up with your healthcare provider, who will assess your results in the context of your medical history, symptoms, medications, and any other tests. Only a healthcare provider can diagnose an allergy and prescribe the necessary treatment.
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
Optimal range: 0 - 0.35 kU/L
The Metals Acute Poisoning Panel, Blood (CSA) offered by Quest Diagnostics is a laboratory test designed to detect and measure the presence of various heavy metals in the blood, which can indicate acute poisoning. This panel includes the analysis of the following elements:
Antimony
Arsenic
Bismuth
Cadmium
Chromium
Cobalt
Copper
Mercury
Molybdenum
Nickel
Selenium
Thallium
These elements are analyzed to assess potential exposure to toxic metals.
The test is particularly useful for individuals who have been exposed to environments or substances containing these metals, as acute poisoning can lead to serious health issues. Symptoms of heavy metal poisoning vary depending on the specific metal involved but may include gastrointestinal distress, neurological symptoms, and organ dysfunction.
If you suspect exposure to any of these metals, consulting a healthcare professional is essential. They can provide guidance on appropriate testing, interpretation of results, and potential treatment options.
Optimal range: 0 - 5 mcg/L
Optimal range: 0 - 10 mcg/L
Optimal range: 0 - 1 mcg/L
Optimal range: 0 - 5 mcg/L
Optimal range: 0 - 1 mcg/L
Optimal range: 0 - 1 mcg/L
Optimal range: 80 - 180 mcg/dL
Optimal range: 0 - 10 mcg/L
Optimal range: 0 - 10 mcg/L
Optimal range: 0 - 5 mcg/L
Optimal range: 60 - 230 mcg/L
Optimal range: 0 - 1 mcg/L
Optimal range: 440 - 860 mcg/dL
This test is used for evaluating Interstitial Lung Disease (ILD) associated with various autoimmune disorders such as Systemic Sclerosis (SS), Sjögren's Syndrome (SjS), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), Idiopathic Inflammatory Myopathies (IIM), and ANCA-Associated Vasculitis (AAV). Identifying an underlying autoimmune condition in ILD patients is crucial for guiding therapeutic decisions and significantly influences prognosis.
Reference range: Negative, Positive
Reference range: Negative, Positive
Optimal range: 0 - 20 Units
Optimal range: 0 - 20 Units
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Optimal range: 0 - 20 Units
Optimal range: 0 - 0 Units
Optimal range: 0 - 20 Units
This profile helps differentiate between Autoimmune Hepatitis type 1 and 2.
Reference range: Negative, Positive
Optimal range: 0 - 20 Units
Optimal range: 0 - 20 Units
Reference range: <1:20, 1:40
Optimal range: 0 - 20 Units
Reference range: <1:20, 1:40
Smooth muscle antibodies (SMA) are the standard diagnostic marker of autoimmune hepatitis (AH).
Optimal range: 0 - 20 Units
Optimal range: 0 - 20 Units
The Bile Acids, Fractionated LC-MS test offered by Labcorp is a specialized diagnostic assay that utilizes liquid chromatography-mass spectrometry (LC-MS) to measure and profile various bile acids in a patient's biological sample, typically serum or plasma. This test is primarily used to assess liver function, diagnose cholestasis, and monitor metabolic disorders related to bile acid synthesis and transport.
Advanced Analytical Technique: LC-MS provides high specificity and sensitivity, enabling the detection of both primary and secondary bile acids, as well as conjugated and unconjugated forms.
Comprehensive Profiling: The test measures a broad spectrum of bile acids, including but not limited to cholic acid, chenodeoxycholic acid, deoxycholic acid, lithocholic acid, and ursodeoxycholic acid.
Clinical Applications:
Evaluation of cholestatic liver diseases such as primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC).
Assessment of inborn errors of bile acid synthesis.
Monitoring of patients undergoing bile acid sequestrant therapy.
Investigation of unexplained liver enzyme elevations.
Interpretation of Results: The test results are typically interpreted by healthcare providers in conjunction with clinical findings and other laboratory tests to provide a comprehensive understanding of the patient's condition.
Optimal range: 0 - 5.8 umol/L
Chenodeoxycholic Acid on Labcorp's Bile Acids, Fractionated LC/MS-MS Panel
Chenodeoxycholic acid is a primary bile acid synthesized in the liver from cholesterol, playing a crucial role in the digestion and absorption of fats and fat-soluble vitamins. On Labcorp’s Bile Acids, Fractionated LC/MS-MS Panel, chenodeoxycholic acid is measured alongside other bile acids to evaluate liver function and bile acid metabolism. Elevated levels of chenodeoxycholic acid can indicate conditions such as cholestasis or bile acid synthesis disorders. This test utilizes liquid chromatography coupled with tandem mass spectrometry (LC/MS-MS) to provide accurate quantification of chenodeoxycholic acid in the serum or plasma. The ability to precisely measure this bile acid helps clinicians diagnose and manage liver diseases, metabolic disorders, and biliary dysfunctions, ensuring targeted treatment strategies.
Optimal range: 0 - 2.2 umol/L
Cholic acid is a primary bile acid synthesized in the liver from cholesterol. It plays a crucial role in the emulsification and absorption of dietary fats and fat-soluble vitamins in the small intestine. Cholic acid is also involved in regulating cholesterol levels and maintaining the integrity of the intestinal mucosa.
Optimal range: 0 - 3.3 umol/L
Deoxycholic Acid on Labcorp's Bile Acids, Fractionated LC/MS-MS Panel
Deoxycholic acid is a secondary bile acid formed in the colon by the bacterial metabolism of primary bile acids, such as cholic acid. On Labcorp's Bile Acids, Fractionated LC/MS-MS Panel, deoxycholic acid is measured to help assess bile acid metabolism and liver function. Elevated levels of deoxycholic acid can be associated with various gastrointestinal and liver conditions, including cholestasis, inflammatory bowel diseases, or liver dysfunction. The LC/MS-MS technology used in this panel offers high sensitivity and precision, enabling accurate quantification of deoxycholic acid and other bile acids in serum or plasma samples. By analyzing these bile acid profiles, healthcare providers can better understand and manage disorders related to bile secretion, absorption, and liver function.
Optimal range: 0 - 9.2 umol/L
Total bile acids refer to the sum of all bile acids present in the bloodstream, including both primary and secondary bile acids. On Labcorp's Bile Acids, Fractionated LC/MS-MS Panel, the measurement of total bile acids provides a comprehensive assessment of bile acid metabolism and liver function. Elevated levels of total bile acids can indicate liver dysfunction, cholestasis, or bile acid synthesis disorders. The LC/MS-MS method used in this test offers high accuracy and sensitivity, enabling precise quantification of total bile acids in serum or plasma samples. By evaluating total bile acid levels, healthcare providers can diagnose conditions such as liver disease, biliary obstructions, and metabolic disorders, ensuring timely and effective management of these conditions.
Optimal range: 0 - 1.9 umol/L
Ursodeoxycholic acid (UDCA) is a naturally occurring bile acid that has been extensively studied and utilized in the treatment of various liver and gallbladder conditions. It is particularly effective in managing cholestatic liver diseases, where bile flow is impaired, leading to the accumulation of bile acids in the liver.
The Alkaline Phosphatase Isoenzymes test offered by Labcorp is a diagnostic assay used to measure and differentiate the sources of elevated alkaline phosphatase (ALP) levels in the blood. This test is essential for identifying whether the elevation is due to liver, bone, or intestinal conditions.
Methodology: Electrophoresis
Specimen Required: Serum (1.6 mL; minimum 0.8 mL)
Collection Container: Red-top or gel-barrier tube
Stability:
Room temperature: 7 days
Refrigerated: 7 days
Frozen: 3 months
Turnaround Time: 3–5 days
Patient Preparation: Fasting overnight is recommended, as eating, especially a fatty meal, may elevate intestinal ALP levels.
The test measures three ALP isoenzymes:
Liver Isoenzyme
Males: 13% to 88% (depending on age)
Females: 18% to 85% (depending on age)
Bone Isoenzyme
Males: 12% to 68% (depending on age)
Females: 14% to 68% (depending on age)
Intestinal Isoenzyme
Males and Females: 0% to 18% (depending on age)
Liver Disorders: Elevated liver ALP may suggest conditions such as hepatitis, cirrhosis, or bile duct obstruction.
Bone Diseases: Increased bone ALP levels are linked to diseases like Paget's disease, osteomalacia, or bone metastases.
Intestinal Conditions: Elevated intestinal ALP can occur after a fatty meal, especially in individuals with specific blood types.
Specimen Requirements: Only serum samples are accepted; plasma or samples collected in EDTA, oxalate, or citrate tubes are unsuitable.
Test Interpretation: The results should be evaluated alongside other clinical data to determine the cause of elevated ALP levels.
Optimal range: 14 - 68 %
The Bone Fraction on Labcorp's Alkaline Phosphatase (ALP) Isoenzyme Panel represents the portion of alkaline phosphatase originating from bone tissue. Elevated levels of the bone fraction may indicate conditions such as Paget's disease, osteomalacia, or bone metastases, which involve increased bone turnover. This isoenzyme is specifically measured to differentiate the source of elevated ALP levels, allowing healthcare providers to pinpoint bone-related disorders. The ALP isoenzyme panel utilizes electrophoresis or other advanced techniques to separate and identify different ALP isoenzymes, providing valuable insights into bone health. By evaluating the bone fraction, clinicians can accurately diagnose bone diseases and guide appropriate treatment.
Optimal range: 0 - 18 %
The Intestinal Fraction on Labcorp's Alkaline Phosphatase (ALP) Isoenzyme Panel represents the portion of alkaline phosphatase derived from the intestines. Elevated levels of the intestinal fraction may be observed after meals, especially in individuals with blood types B or O who are secretors, as they tend to have higher levels of intestinal ALP following food intake. This isoenzyme is measured to help determine the source of elevated ALP levels and to assess gastrointestinal health. By differentiating the intestinal fraction from other sources of ALP, such as the liver or bone, healthcare providers can better understand the cause of elevated enzyme levels and investigate potential gastrointestinal disorders or other related conditions. The ALP isoenzyme panel's precise measurement of this fraction can guide clinicians in diagnosing conditions related to the intestinal system.
Optimal range: 18 - 85 %
The Liver Fraction on Labcorp's Alkaline Phosphatase (ALP) Isoenzyme Panel refers to the specific portion of alkaline phosphatase that originates from the liver. This isoenzyme is measured to help assess liver function and diagnose liver-related disorders. Elevated levels of the liver fraction may indicate conditions such as liver disease, bile duct obstruction, or cholestasis. The ALP isoenzyme panel uses electrophoresis or other specialized techniques to differentiate between the liver, bone, and intestinal isoenzymes of alkaline phosphatase, providing critical insight into the source of elevated ALP levels. By accurately identifying the liver fraction, healthcare providers can better understand the underlying cause of liver dysfunction and determine appropriate treatment strategies.
This panel evaluates the levels of four key antibody types—IgG, IgA, IgM, and IgE—providing a comprehensive overview of immune system function. It aids in identifying immune deficiencies, chronic infections, autoimmune conditions, and allergic responses. Monitoring these immunoglobulins is particularly beneficial for individuals experiencing recurrent infections, unexplained inflammation, or undergoing immunosuppressive therapy.
What it measures:
IgG is the most abundant antibody in the body and plays a key role in long-term immunity. It is produced during later stages of an infection and remains in circulation to provide lasting protection.
High IgG levels may indicate:
Chronic infections (e.g., hepatitis, HIV)
Autoimmune diseases (e.g., lupus, rheumatoid arthritis)
Multiple myeloma or other gammopathies
Low IgG levels may indicate:
Immunodeficiency disorders (e.g., Common Variable Immunodeficiency)
Poor immune function or malnutrition
Protein-losing conditions (e.g., nephrotic syndrome)
Why it matters:
Low IgG can lead to frequent infections, while high IgG may point to chronic immune activation or malignancy.
What it measures:
IgA is primarily found in mucosal areas such as the respiratory and gastrointestinal tracts. It helps protect against pathogens that enter through mucosal surfaces.
High IgA levels may indicate:
Chronic liver disease (e.g., cirrhosis)
Inflammatory bowel disease (e.g., ulcerative colitis, Crohn’s disease)
Autoimmune disorders (e.g., celiac disease, lupus)
Low IgA levels may indicate:
Selective IgA deficiency (a common immunodeficiency)
Increased susceptibility to respiratory and digestive infections
Why it matters:
Abnormal IgA levels can impact your ability to fight off infections and may signal gut or autoimmune disorders.
What it measures:
IgM is the first antibody produced in response to an infection. It acts as a front-line defense during the initial immune response.
High IgM levels may indicate:
Acute or recent infections
Waldenström’s macroglobulinemia
Certain autoimmune diseases (e.g., primary biliary cholangitis)
Low IgM levels may indicate:
Immunodeficiencies
Bone marrow suppression or genetic disorders
Why it matters:
IgM levels help differentiate between early-stage and long-term immune responses, offering insight into how your body is responding to infections.
What it measures:
IgE is involved in allergic responses and defense against parasites. It binds to allergens and triggers the release of histamine from mast cells.
High IgE levels may indicate:
Allergies (e.g., pollen, food, dust mites)
Asthma or eczema
Parasitic infections
Atopic dermatitis
Low IgE levels are usually not clinically significant, but may be evaluated in conjunction with other immune markers.
Why it matters:
Elevated IgE is a key marker for allergic disease and may help guide treatment strategies for asthma, eczema, or food sensitivities.
Optimal range: 61 - 356 mg/dL
Total IgA measures the concentration of Immunoglobulin A in the blood, an antibody that plays a crucial role in immune defense—particularly in the mucous membranes of the respiratory, gastrointestinal, and urogenital tracts. It is the body’s first line of defense against inhaled, ingested, and sexually transmitted pathogens.
IgA provides immune protection by neutralizing viruses and bacteria before they penetrate deeper into the body. It is also involved in maintaining a healthy balance of immune tolerance in the gut. Abnormal IgA levels can signal underlying immune disorders or chronic inflammatory conditions.
Optimal range: 0 - 87 IU/ml
Optimal range: 767 - 1590 mg/dL
Total IgG measures the concentration of Immunoglobulin G, the most abundant antibody in the bloodstream. IgG plays a central role in long-term immune protection by recognizing and neutralizing viruses, bacteria, and other foreign invaders. It also helps the immune system "remember" past infections, providing immunity over time.
Why is Total IgG important?
IgG is essential for fighting infections and for the effectiveness of vaccinations. It circulates in the blood and tissues, identifying pathogens and helping to trigger a broader immune response. Total IgG measurement provides insight into the strength and status of your adaptive immune system.
Optimal range: 45 - 281 mg/dL
Gynecological health refers to the well-being of the female reproductive system, including the uterus, cervix, ovaries, fallopian tubes, vagina, and breasts. This category encompasses preventive care, routine screenings, hormonal balance, menstrual health, fertility, and the detection of infections or gynecologic cancers.
Maintaining good gynecological health is essential at every stage of life — from adolescence through menopause and beyond. Regular check-ups and testing can help identify potential issues early, when they are most treatable.
Pap Smear: Screens for abnormal cervical cells that could lead to cervical cancer.
HPV Testing: Detects high-risk human papillomavirus strains associated with cervical cancer.
Pelvic Exams: Assess the health of reproductive organs.
Menstrual Health: Monitoring irregularities, pain, or symptoms of conditions like PCOS or endometriosis.
Fertility Assessments: Tests related to ovulation, ovarian reserve, and cycle tracking.
STI Screening: Identifies sexually transmitted infections such as chlamydia, gonorrhea, or trichomoniasis.
Ultrasounds & Imaging: Used to assess ovaries, uterus, or detect fibroids, cysts, and other abnormalities.
Gynecological health is about more than just reproductive function — it plays a key role in your overall physical, hormonal, and emotional health. Tracking changes in test results over time can help guide treatment, support fertility planning, and catch problems early.
Anyone with a cervix or female reproductive organs can benefit from regular gynecological health monitoring — regardless of gender identity. It’s especially important during:
Annual wellness visits
Contraceptive planning
Pre-pregnancy or fertility planning
Perimenopause and menopause
Reference range: Negative, Positive
Reference range: Negative, Positive
HPV Genotype 16 is one of the most common and high-risk types of human papillomavirus (HPV). It is considered the most aggressive strain in terms of its potential to cause cervical cancer and other HPV-related cancers, including anal, throat, and penile cancers.
When tested, a positive result for HPV 16 means that this specific high-risk virus is present in your cervical cells. HPV 16 is responsible for about 50% of all cervical cancer cases worldwide. Because of its strong link to cancer, identifying this genotype is important for guiding follow-up care and treatment decisions.
Reference range: Negative, Positive
Reference range: Negative (NIL), Positive (abnormal)
A Pap smear, also called a Pap test, is a simple and important screening procedure used to detect abnormal cells in the cervix — the lower part of the uterus that opens into the vagina. It helps identify changes that may lead to cervical cancer, often before any symptoms appear.
During the test, a healthcare provider gently collects a small sample of cells from the cervix using a soft brush or swab. These cells are then examined under a microscope or analyzed in a lab to check for precancerous changes, infections, or other abnormalities.
Reference range: Negative, Positive
PapIG, HPV, Rfx 16/18, refers to a series of tests used in cervical cancer screening.
The Pap test, or Pap smear, is a procedure that collects cells from the cervix to detect precancerous or cancerous cell changes.
HPV refers to the human papillomavirus, a sexually transmitted infection that can cause cervical cancer. Specific strains of HPV, particularly types 16 and 18, are known to be high-risk for developing cervical cancer.
The term "Rfx" stands for "reflex," suggesting a testing protocol where, if an initial test (like an HPV test) is positive, it is followed by a reflex test specifically for the high-risk types 16 and 18. When the results for these tests come back negative, it indicates that no high-risk HPV types are present and that there are no abnormal cell changes on the cervix at the time of testing. This outcome is reassuring, but regular screening is recommended to monitor for any future changes that could develop into cervical cancer.
Paraneoplastic antibodies are a group of autoantibodies produced by the immune system in response to certain types of cancer (neoplasms). Instead of only attacking cancer cells, these antibodies may mistakenly target healthy nerve or brain tissue, leading to a set of conditions known as paraneoplastic neurological syndromes (PNS).
These antibodies serve as biomarkers—helping doctors detect the presence of an underlying tumor and explaining unexplained neurological symptoms.
Paraneoplastic antibodies can help:
Identify a hidden (occult) cancer before it causes obvious symptoms
Explain neurological symptoms that do not have a clear cause
Support a diagnosis of autoimmune encephalitis, neuropathy, cerebellar degeneration, or myelopathy
Guide cancer screening and neurologic workup
Anti-Hu (ANNA-1) – often linked to small cell lung cancer
Anti-Yo (PCA-1) – associated with breast or gynecologic cancers
Anti-Ri (ANNA-2) – seen in breast and lung cancer
CRMP5 (CV2), Ma2, Amphiphysin, and others
Each antibody is associated with specific cancer types and neurological symptoms, and their detection helps narrow down the underlying cause.
Your doctor may order a paraneoplastic antibody panel if you experience:
Sudden or unexplained neurological symptoms (memory loss, seizures, balance problems)
Progressive weakness or numbness
Autoimmune encephalitis
Neurological symptoms with a history or suspicion of cancer
A positive result suggests that your symptoms may be related to an autoimmune response to an underlying cancer.
It does not confirm cancer, but it raises the suspicion and typically prompts additional testing (e.g., imaging, oncology referral).
Some people with a positive result may not have cancer but still experience autoimmune neurologic symptoms.
A negative result means no known paraneoplastic antibodies were detected.
However, this does not rule out all autoimmune conditions. If symptoms persist, more targeted antibody testing may be needed based on your clinical presentation.
The Paraneoplastic Antibodies category includes important tests that can help uncover hidden cancers and explain neurological symptoms caused by autoimmune reactions. These markers play a critical role in early diagnosis, guiding treatment, and improving outcomes for individuals with paraneoplastic neurological syndromes.
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Reference range: Negative, Positive
Optimal range: 0 - 30 pmol/L
The VGCC (Voltage-Gated Calcium Channel) antibody is an autoantibody that targets calcium channels found on the surface of nerve cells. These channels play a critical role in transmitting nerve signals, especially in muscles and the brain. When the immune system mistakenly produces VGCC antibodies, it can interfere with normal nerve function and may be linked to certain neurological and autoimmune disorders.
The Myasthenia Gravis (MG) Profile is a blood test panel used to help diagnose myasthenia gravis, a chronic autoimmune disorder that affects the connection between nerves and muscles. This condition causes muscle weakness, especially in the eyes, face, throat, and limbs, and symptoms often get worse with activity and improve with rest.
The MG Profile looks for specific autoantibodies that interfere with normal muscle activation, helping doctors confirm or rule out the diagnosis.
Myasthenia gravis can sometimes be difficult to diagnose based on symptoms alone, especially in its early stages. The MG Profile detects antibodies that are highly specific to this disease, enabling a more accurate diagnosis and helping guide treatment decisions.
The panel may include testing for one or more of the following antibodies:
Acetylcholine Receptor (AChR) Antibodies
The most common antibodies in MG, targeting receptors that help muscles receive nerve signals.
Muscle-Specific Kinase (MuSK) Antibodies
Found in a smaller subset of patients, particularly those who are AChR antibody-negative but still have MG symptoms.
LRP4 Antibodies (optional or separate in some panels)
Seen in some cases of MG not explained by AChR or MuSK antibodies.
Your healthcare provider may order the MG Profile if you have symptoms such as:
Drooping eyelids (ptosis)
Double vision (diplopia)
Slurred speech
Difficulty swallowing
Weakness in the arms, legs, or neck
Muscle fatigue that worsens with activity
Positive for AChR, MuSK, or LRP4 antibodies:
This supports a diagnosis of autoimmune myasthenia gravis. Treatment with medications that improve nerve-muscle communication or suppress the immune system may be recommended.
Negative result:
A negative test does not completely rule out MG. Some individuals with classic symptoms may not have detectable antibodies. In such cases, your doctor may perform additional testing, such as EMG (electromyography) or a single-fiber EMG to assess nerve and muscle function directly.
It’s a simple blood draw, usually done at a laboratory or medical office. No special preparation is needed.
The Myasthenia Gravis Profile is a crucial tool for diagnosing this rare autoimmune neuromuscular disease. By detecting antibodies that disrupt communication between nerves and muscles, it helps doctors identify MG early and begin appropriate treatment—potentially improving symptoms and quality of life.
Optimal range: 0 - 0.24 nmol/L
The AChR Binding Antibodies, Serum test measures the presence of autoantibodies against acetylcholine receptors (AChRs) in the blood. These antibodies interfere with the normal communication between nerves and muscles and are commonly associated with myasthenia gravis (MG) — a chronic autoimmune disorder that causes muscle weakness and fatigue.
This test specifically looks for binding antibodies, the most common type found in people with MG.
Optimal range: 0 - 25 %
AChR Blocking Antibodies are a type of autoantibody that interfere with how acetylcholine receptors (AChRs) work at the neuromuscular junction—the place where nerves signal muscles to contract. These antibodies block the receptors, preventing proper nerve-to-muscle communication.
This test measures the blocking antibodies specifically, which are one subset of acetylcholine receptor antibodies commonly involved in myasthenia gravis (MG)—a chronic autoimmune neuromuscular disorder that causes weakness in voluntary muscles.
AChR Blocking Antibodies are found in a significant number of people with myasthenia gravis, especially those with generalized symptoms affecting the face, limbs, and respiratory muscles. This test helps confirm a diagnosis and can be especially helpful when other types of AChR antibodies (like binding or modulating) are also being evaluated.
Optimal range: 0 - 45 %
The AChR-Modulating Antibody test detects autoantibodies that disrupt communication between nerves and muscles by targeting and altering acetylcholine receptors (AChRs) on muscle cells. These antibodies are commonly found in people with myasthenia gravis (MG), a chronic autoimmune neuromuscular disorder.
The term “modulating” refers to the antibody’s ability to change the number or function of acetylcholine receptors, making it harder for muscles to respond to nerve signals, which leads to muscle weakness and fatigue.
This test is part of a broader diagnostic panel for myasthenia gravis. While other AChR antibody tests (such as binding or blocking antibodies) show whether antibodies are present, the modulating antibody test specifically shows whether those antibodies are actively interfering with receptor function on the surface of muscle cells.
Optimal range: 0 - 1 U/mL
The MuSK Abs, Serum test detects antibodies against Muscle-Specific Kinase (MuSK) in your blood. These antibodies are associated with a type of autoimmune myasthenia gravis (MG)—a condition that causes muscle weakness due to a breakdown in communication between nerves and muscles.
MuSK is a protein that plays a key role in forming and maintaining the connection between nerve endings and muscle fibers. When the immune system creates antibodies that attack MuSK, it can lead to impaired nerve-muscle signaling and muscle fatigue.
This test is especially helpful in diagnosing seronegative myasthenia gravis—cases where patients have MG symptoms but test negative for acetylcholine receptor (AChR) antibodies. MuSK antibodies are found in about 5–8% of MG patients, particularly in those with:
Facial, throat, and respiratory muscle weakness
Rapid symptom progression
Less eye-related symptoms compared to AChR-positive MG
The Adrenocorticotropic Hormone (ACTH) Stimulation Test—also known as the Cosyntropin Stimulation Test—is a diagnostic blood test used to evaluate how well your adrenal glands are functioning. Specifically, it measures your body’s ability to produce cortisol, a vital hormone that helps regulate blood pressure, blood sugar, metabolism, and your body’s response to stress.
Doctors may order the ACTH stimulation test to:
Diagnose adrenal insufficiency (such as Addison’s disease)
Evaluate pituitary gland disorders (secondary adrenal insufficiency)
Investigate low cortisol levels found on routine lab work
Monitor adrenal gland function in people using long-term corticosteroids
Assess unexplained symptoms like fatigue, weakness, low blood pressure, or weight loss
The test involves measuring your blood cortisol levels at specific times after receiving an injection of Cosyntropin (a synthetic form of ACTH):
Baseline: A blood sample is taken to measure your initial cortisol level.
Injection: Cosyntropin is given by intramuscular (IM) or intravenous (IV) injection.
Follow-up measurements: Blood samples are drawn again at 30 minutes and 60 minutes after the injection.
These timed samples help determine how well your adrenal glands respond to ACTH stimulation.
Cortisol reference ranges can vary by laboratory and the specific test used. Typical values are:
Baseline (pre-injection): 6–18 µg/dL (may vary by lab and time of day)
30 minutes post-injection: ≥18 µg/dL
60 minutes post-injection: ≥20 µg/dL
A normal response is an increase in cortisol levels to at least 18–20 µg/dL at either the 30-minute or 60-minute mark. Always interpret results using your laboratory’s reference ranges.
| Result Pattern | Possible Interpretation |
|---|---|
| Low baseline + low response | Primary adrenal insufficiency (Addison’s disease) |
| Low baseline + delayed/partial response | Secondary adrenal insufficiency (pituitary dysfunction) |
| Normal baseline + blunted response | Subclinical adrenal suppression (often due to recent corticosteroid use) |
Abnormal or borderline results may require further testing, such as an insulin tolerance test or additional hormone studies, for a definitive diagnosis.
To ensure accurate results:
Follow your doctor’s instructions about medications, especially corticosteroids or hormone therapies.
Fast or avoid strenuous activity, if advised.
Inform your healthcare provider about any recent illness or long-term medication use.
The ACTH stimulation test is generally safe. Rarely, you may experience mild discomfort at the injection site, lightheadedness, or temporary changes in blood pressure.
The ACTH (Cosyntropin) Stimulation Test is a reliable and widely used tool for evaluating adrenal gland health. It helps detect conditions like Addison’s disease or pituitary-related hormone imbalances, guiding appropriate treatment and long-term care. If you're experiencing unexplained fatigue, low cortisol levels, or suspect adrenal issues, this test can provide essential answers. Always discuss your results and next steps with your healthcare provider.
Optimal range: 5 - 52 pg/mL
Adrenocorticotropic Hormone (ACTH) is a critical hormone produced by the pituitary gland in the brain. Its main job is to signal your adrenal glands, located on top of the kidneys, to release cortisol — the body’s key stress hormone.
ACTH plays a central role in your body's hypothalamic-pituitary-adrenal (HPA) axis, which regulates your response to stress, blood sugar levels, metabolism, immune response, and more.
An ACTH blood test is commonly ordered when:
Cortisol levels are abnormal
Symptoms suggest adrenal insufficiency or Cushing’s syndrome
You're being evaluated for pituitary gland function
You’re undergoing an ACTH stimulation test (Cosyntropin test) and a baseline ACTH is needed
Optimal range: 6 - 18 ug/dL
Cortisol Baseline (pre-injection) refers to the initial cortisol level measured in the blood before administering synthetic ACTH (Cosyntropin) as part of the ACTH stimulation test, which evaluates adrenal gland function. Cortisol is a vital hormone produced by the adrenal glands that helps regulate stress response, blood sugar, inflammation, metabolism, and blood pressure. Measuring the baseline cortisol level provides a reference point to assess how well the adrenal glands are functioning at rest and to compare with cortisol levels after stimulation. A low baseline cortisol level may indicate primary adrenal insufficiency (such as Addison’s disease), secondary adrenal insufficiency due to pituitary dysfunction, or recent corticosteroid use that suppresses natural cortisol production. Conversely, a high baseline cortisol level may suggest Cushing’s syndrome, acute stress, chronic illness, or excessive use of corticosteroid medications. The test is typically performed in the morning when cortisol is naturally at its peak, using a serum blood sample collected before the Cosyntropin injection. This baseline measurement is critical for identifying hormone imbalances and determining whether further endocrine evaluation or treatment is needed.
Optimal range: 18 - 100 ug/dL
Cortisol, 30 minutes post-injection is a key measurement taken during the ACTH (Cosyntropin) Stimulation Test to evaluate how well your adrenal glands respond to stimulation. It reflects the level of cortisol in the blood 30 minutes after an injection of synthetic ACTH, which normally prompts the adrenal glands to release cortisol. In healthy individuals, cortisol levels should rise significantly from baseline, typically reaching at least 18 µg/dL or higher. A normal increase suggests proper adrenal function, while a low or blunted response may indicate primary adrenal insufficiency (such as Addison’s disease), secondary adrenal insufficiency due to pituitary dysfunction, or adrenal suppression from corticosteroid use. This serum sample is collected using a standard blood draw 30 minutes after injection and is interpreted alongside baseline and 60-minute cortisol values to determine whether the hypothalamic-pituitary-adrenal (HPA) axis is functioning normally.
Optimal range: 18 - 100 ug/dL
Cortisol, 60 minutes post-injection measures the level of cortisol in the blood one hour after an injection of synthetic ACTH (Cosyntropin) during the ACTH stimulation test. This measurement helps evaluate how well the adrenal glands sustain cortisol production in response to hormonal stimulation over time.
A normal cortisol response at 60 minutes is typically defined as a level of 18–20 µg/dL or higher, although exact thresholds may vary depending on the laboratory and the specific assay method used (for example, immunoassay vs. LC-MS/MS). In healthy individuals, cortisol levels often continue to rise between 30 and 60 minutes, with median values generally ranging from 20 to 30 µg/dL.
A cortisol level below 18 µg/dL at 60 minutes may indicate adrenal insufficiency—either primary (due to adrenal gland dysfunction, such as Addison’s disease) or secondary (due to pituitary disorders or recent corticosteroid use). Some individuals may show a delayed but ultimately adequate cortisol response that appears only at the 60-minute mark.
It is important to interpret the 60-minute cortisol value in conjunction with baseline and 30-minute results, as well as the patient’s clinical presentation. This comprehensive approach provides a more accurate assessment of adrenal function and helps guide further diagnostic or treatment decisions.
Effectively assessing and treating mood disorders requires more than just observation—it demands objective clinical data. Traditional care often relies on a trial-and-error approach to psychiatric medications, guided by patient self-reports and clinician evaluations. While this can work for some, it may also lead to delays in finding the right treatment and increases the risk of side effects or worsening symptoms during interim failures.
The Neurotransmitter-Intermediate Profile provides an evidence-based alternative by offering a four-point urine analysis that measures nine key neurotransmitters involved in emotional, cognitive, and metabolic regulation. These neurotransmitters influence a wide range of physiological and psychological functions, including mood, hormone balance, sleep, stress response, pain perception, appetite, memory, and focus.
Serotonin
GABA
Dopamine
Noradrenaline (Norepinephrine)
Adrenaline (Epinephrine)
Glutamate
Phenylethylamine (PEA)
Glycine
Histamine
Neurotransmitter Ratios for clinical insight
Each report includes a correlation analysis, prepared by NutriPATH’s clinical team, aligning the patient's reported symptoms with their specific neurotransmitter levels. This gives practitioners a powerful tool to:
Identify biochemical imbalances contributing to mood disorders
Tailor personalized treatment plans
Monitor therapeutic effectiveness objectively over time
Mental & Emotional Health:
Anxiety and depression
Mood swings
Aggression
Poor motivation, concentration, and memory
Other Related Health Issues:
Hormonal imbalances
Thyroid dysfunction
Gut-brain axis disorders (e.g., GIT issues)
ADHD or hyperactivity
Test Type: Four-point urine collection
Technology: LC-MS/MS (Liquid Chromatography–Tandem Mass Spectrometry)
Turnaround Time: Fast, accurate results with detailed interpretation
By objectively measuring neurotransmitter levels, the Neurotransmitter-Intermediate Profile offers healthcare practitioners a clinical edge—helping them move beyond subjective assessments to develop truly personalized, data-driven treatment strategies.
Optimal range: 0.8 - 6.2 ug/gCR
Optimal range: 103 - 282 ug/gCR
Optimal range: 167 - 463 ug/gCR
Optimal range: 1213 - 4246 ug/gCR
Optimal range: 41 - 295 ug/gCR
Optimal range: 3.6 - 44.3 ug/gCR
Optimal range: 10 - 35.7 ug/gCR
Optimal range: 2.9 - 25.2 Ratio
Optimal range: 3.6 - 38.8 ug/gCR
Optimal range: 47.6 - 140.3 ug/gCR
CDSA Level 1 – Comprehensive Digestive Stool Analysis (NutriPATH)
NutriPATH offers a broad range of gastrointestinal test panels designed to give healthcare practitioners the flexibility to choose the most appropriate analyses for each patient’s needs.
The CDSA Level 1 test provides a detailed assessment of the gut’s microbiological environment. It includes:
Macroscopic and microscopic evaluation
Bacteriology
Mycology (yeast detection)
Parasitology
This test helps identify imbalanced colonizing organisms and potential pathogens, while also measuring levels of beneficial flora. It is a valuable tool for detecting gut infections or confirming/excluding dysbiosis.
The CDSA can support earlier, more targeted interventions, improve treatment precision, and help reduce the risk of relapse—especially in patients with chronic or recurrent gastrointestinal symptoms. It also supports clinical decision-making when evaluating the necessity of more invasive procedures such as colonoscopy.
The Level 1 assessment is a cost-effective option and can be particularly useful in cases where infection or microbiome imbalance is suspected. For enhanced parasite detection, it is recommended to add the DNA Multiplex PCR (Test Code 2002) to any CDSA level.
Optimal range: 2 - 4 Value
Optimal range: 2 - 4 Value
Optimal range: 2 - 4 Value
Optimal range: 2 - 4 Value
Optimal range: 2 - 4 Value
The Brain Health category includes biomarkers that evaluate cognitive function, neurological integrity, and the risk of neurodegenerative conditions such as Alzheimer’s disease, Parkinson’s disease, and other forms of dementia. These tests provide valuable insights into the health and resilience of the central nervous system (CNS), allowing for early detection of brain-related disorders, monitoring of disease progression, and guidance for personalized interventions.
Whether you're noticing changes in memory or mental clarity, managing a known neurological condition, or proactively tracking your brain function over time, these biomarkers help you understand key aspects of brain performance, neuronal health, and long-term cognitive risk. They support targeted strategies for cognitive preservation, mental performance optimization, and early intervention when needed.
Optimal range: 0.17 - 10 Ratio
The Aβ42/40 Ratio (Amyloid Beta 42/40 Ratio) is a biomarker that helps detect early signs of Alzheimer’s disease by measuring the balance between two key amyloid beta proteins in the blood or cerebrospinal fluid. A lower ratio indicates a buildup of amyloid plaques in the brain, one of the earliest and most specific signs of Alzheimer’s pathology—even before symptoms appear. This test is particularly useful for individuals experiencing memory loss or at risk of cognitive decline, and it is often used alongside tau protein markers to improve diagnostic accuracy and guide early intervention.
Optimal range: 0 - 2.13 pg/mL
Neurofilament proteins are vital structural components of nerve cells, helping to maintain their shape and function. Of these, neurofilament light chain (NfL) has emerged as a clinically important biomarker. When neurons are damaged or undergoing degeneration, NfL is released into the cerebrospinal fluid (CSF) and blood, where it can be measured. Elevated NfL levels are a highly sensitive indicator of neuroaxonal injury, though it is important to note that NfL is not specific to any single disease—it reflects neuronal damage from a variety of causes.
Optimal range: 0 - 0.15 pg/mL
This test measures levels of phosphorylated tau217 (p-tau217) in the blood—a protein strongly linked to the development of Alzheimer’s disease and other neurodegenerative conditions. Tau proteins normally help stabilize nerve cells in the brain. However, when they become abnormally phosphorylated, as seen in Alzheimer’s, they can form toxic tangles that interfere with memory and thinking.
Why it matters:
The presence of elevated p-tau217 in plasma is a highly specific early indicator of Alzheimer's pathology, even before major symptoms appear. This biomarker is clinically validated to distinguish Alzheimer’s disease from other forms of dementia with greater accuracy than previous tau tests.
Optimal range: 0.1 - 1.71 ELISA Index
What does this marker measure?
The Blood-Brain Barrier Protein IgG + IgA marker assesses whether your immune system is producing antibodies (IgG and IgA) against specific structural proteins that make up the blood-brain barrier.
IgG antibodies reflect systemic or long-term immune responses.
IgA antibodies reflect mucosal or surface-level immune activity, often originating in barrier tissues such as the gut, lung, or brain lining.
Elevated levels of these antibodies suggest that the immune system has been exposed to and is reacting against blood-brain barrier proteins, which typically should be hidden from immune surveillance. This is a strong indication of BBB disruption, either past or ongoing.
Optimal range: 0.2 - 1.31 ELISA Index
What Does This Marker Measure?
The Blood-Brain Barrier Protein IgM marker detects IgM-class antibodies against structural proteins of the blood-brain barrier. This test specifically measures the immune system’s early-stage response to damage or dysfunction in the BBB.
IgM is the first antibody type produced in an immune response.
It typically reflects acute or recent immune activation, often in response to new or ongoing tissue damage.
In the context of the BBB, IgM antibodies suggest that the immune system has been recently exposed to normally hidden proteins from the brain’s protective lining—indicating a possible breach or compromise in the barrier.
Optimal range: 1.69 - 1.78 %
Optimal range: 1.03 - 1.06 %
Optimal range: 1 - 4 Ratio
Optimal range: 0 - 1 Biological years per year
Optimal range: 0.38 - 0.42 %
Optimal range: 8.01 - 14.29 Ratio
Optimal range: 5.14 - 5.28 %
Optimal range: 6.52 - 6.69 %
Optimal range: 4.45 - 4.57 %
Optimal range: 2.21 - 2.31 %
Optimal range: 7.2 - 7.35 %
Optimal range: 1.09 - 1.16 %
Optimal range: 3.35 - 3.46 %
Optimal range: 1 - 2.4 Ratio
Optimal range: 62.9 - 62.95 %
Optimal range: 0 - 0 Age
Optimal range: 0 - 0 Age
Optimal range: 0.6 - 6.41 %
Optimal range: 83 - 100 %
Optimal range: 5 - 15 kb
Optimal range: 6 - 22.7 ug/L
Bone-specific alkaline phosphatase (BAP or BSAP) is an enzyme produced primarily by osteoblasts, the cells responsible for building new bone. It is a specific isoenzyme of the broader alkaline phosphatase (ALP) family, which includes enzymes from the liver, intestines, kidneys, and placenta.
Unlike total ALP, which reflects contributions from various organs, BAP directly reflects bone metabolism. Measuring BAP levels in the blood provides a more accurate picture of bone turnover, which is critical in diagnosing and monitoring bone-related conditions.
Optimal range: 44 - 215 RU/mL
FGF-23, or fibroblast growth factor 23, is a hormone-like protein that plays a critical role in phosphate and vitamin D metabolism. It is primarily produced by bone cells (osteocytes and osteoblasts) and acts mainly on the kidneys to regulate:
Phosphate excretion in urine
Vitamin D activation
Calcium-phosphate balance
FGF-23 is part of a feedback system that helps maintain normal blood phosphate levels. When phosphate levels rise, FGF-23 secretion increases to help eliminate excess phosphate through the urine and reduce vitamin D activation.
Optimal range: 5.2 - 22.4 ng/mL
Osteocalcin is a protein hormone produced almost exclusively by osteoblasts, the specialized bone-forming cells. It plays a critical role in bone formation, mineralization, and calcium regulation. Osteocalcin is considered one of the most specific markers of bone-building activity and is often used to assess bone metabolism and bone turnover.
After being synthesized by osteoblasts, osteocalcin becomes incorporated into the bone matrix or is released into the bloodstream. Measuring serum osteocalcin helps evaluate the rate at which new bone is being formed — making it a valuable marker in diagnosing and monitoring osteoporosis, metabolic bone diseases, and certain hormonal disorders.
The Lupus Anticoagulant Comp (Comprehensive) panel is a specialized blood test used to detect lupus anticoagulants—a type of autoantibody that interferes with the body’s normal blood clotting process. Despite the name, lupus anticoagulants are not related to lupus exclusively and do not prevent clotting—in fact, they can increase the risk of abnormal blood clots (thrombosis).
Your doctor may order this panel if you have experienced:
Unexplained blood clots (deep vein thrombosis or pulmonary embolism)
Multiple miscarriages or pregnancy complications
Prolonged PTT (partial thromboplastin time) on routine labs
Suspected antiphospholipid syndrome (APS)
Autoimmune conditions like systemic lupus erythematosus (SLE)
Labcorp’s Lupus Anticoagulant Comp panel typically includes:
dRVVT Screen and Confirm (Dilute Russell Viper Venom Test)
PTT-LA (Partial Thromboplastin Time with LA-sensitive reagent)
Hexagonal Phase Phospholipid Neutralization Test
Each component is designed to detect the presence and activity of lupus anticoagulant antibodies by evaluating how your blood clots under different conditions.
Positive or Elevated Results: May indicate the presence of lupus anticoagulants and support a diagnosis of antiphospholipid syndrome. This raises your risk of developing blood clots or pregnancy complications.
Negative or Normal Results: Suggest lupus anticoagulants are not present or are below the detectable threshold.
Sometimes results may be equivocal, requiring repeat testing—especially if you’re ill or taking blood thinners, which can affect accuracy.
If your results are abnormal, your healthcare provider may:
Repeat the test in 12 weeks to confirm persistence (required for APS diagnosis)
Order additional antibody tests (like anti-cardiolipin or beta-2 glycoprotein I)
Assess your personal and family history of clotting or autoimmune disease
Adjust medications or recommend lifestyle changes to reduce clotting risk
The Lupus Anticoagulant Comp panel is an essential diagnostic tool for identifying clotting risks linked to autoimmunity. It plays a critical role in managing conditions like antiphospholipid syndrome and ensuring appropriate preventative care.
Optimal range: 0 - 47.6 sec
Optimal range: 0 - 1.34 Ratio
Optimal range: 0 - 47 sec
Optimal range: 0 - 43.5 sec
Optimal range: 0 - 23 sec
The myDNA Comprehensive Health Report is an advanced DNA methylation and genetic testing panel designed to give a deep, personalized understanding of your genetic blueprint. By analyzing key genetic markers, this test helps uncover how your DNA influences digestion, hormones, energy, stress, inflammation, detoxification, and overall health.
Unlike standard health tests, this report goes beyond surface-level results, providing actionable insights for both patients and practitioners. With a focus on preventative health and wellness, it identifies genetic strengths and potential weaknesses, guiding tailored nutrition, lifestyle, and treatment strategies.
The report examines 92 genes and 113 SNPs (single nucleotide polymorphisms) across major areas of health, including:
Digestion – insights into nutrient absorption, gut health, and food sensitivities.
Energy – how your body converts food into usable energy.
Hormones – genetic markers affecting hormone balance and metabolism.
Stress & Cognitive Performance – resilience, mood regulation, and focus.
Inflammation – predisposition to chronic inflammation and recovery speed.
Athletic Performance – genetic traits linked to strength, endurance, and recovery.
DNA Protection & Repair – markers influencing healthy aging and cellular repair.
Detoxification – genetic capacity to clear toxins and support liver function.
Each category comes with a genetic strengths and weaknesses summary, making it easy to see where your body may be performing well and where extra support may be needed.
Personalized shopping list – tailored food and nutrient recommendations to support your genetic profile.
Suggested follow-up blood tests – helping practitioners validate findings and build a more complete health picture.
Holistic guidance – empowering long-term health, wellness, and prevention strategies.
The myDNA Comprehensive Health Report is ideal for individuals who want to:
Take a proactive approach to long-term health and wellness.
Understand their genetic risk factors for common health concerns.
Optimize diet, fitness, stress resilience, and lifestyle choices.
Work with their practitioner to create a personalized, DNA-driven health plan.
Reference range: Wild Type , Heterozygous, Homozygous
The 5-HT2A-rs6314 marker is a single nucleotide polymorphism (SNP) in the HTR2A gene, which encodes the 5-HT2A serotonin receptor. This receptor plays a key role in regulating mood, cognition, sleep, appetite, and how the brain responds to serotonin — one of the most important neurotransmitters for mental health and emotional balance.
The rs6314 SNP involves a C to T substitution at a specific point in the gene, leading to a change in the receptor’s structure and function. Because serotonin receptors influence both the central nervous system and peripheral systems (including gut function and cardiovascular health), variations in this gene may affect both mental and physical health outcomes.
The Immunoserology of Lyme panel is a serum-based test that uses advanced ELISA methodology to detect both active and chronic Lyme disease, including complications such as Lyme arthritis and neuroborreliosis.
This panel measures IgM and IgG antibodies against Borrelia burgdorferi and its subspecies (B. afzelii, B. garinii, B. miyamotoi), as well as potential tick-borne co-infections like Babesia, Bartonella, and Ehrlichia. By analyzing antibodies to multiple Borrelia antigens—such as Outer Surface Proteins (OspA, OspB, OspC, OspE), Variable Major Protein (VMP), and Leukocyte Function Associated Antigen (LFA)—the test provides a more precise and reliable diagnosis than standard Lyme assays.
Lyme disease often mimics autoimmune or neurological conditions, making misdiagnosis common.
False positives can lead to unnecessary treatment and side effects.
False negatives may delay care, increasing the risk of arthritis, meningitis, or long-term neurological complications.
By combining cultured Borrelia antigens with proteins expressed in vivo, this immunoserology panel improves diagnostic accuracy and helps distinguish Lyme disease from other inflammatory conditions.
This test may be considered for patients with:
History of a tick bite or erythema migrans (rash)
Unexplained autoimmune-like symptoms (lupus, rheumatoid arthritis, psoriatic arthritis)
Neurological issues (cranial neuritis, meningitis, memory problems, nerve pain)
Chronic joint pain or arthritis (Lyme arthritis, chronic synovitis)
Immune dysfunction or chronic fatigue
Lyme borreliosis is an inflammatory disease affecting multiple organ systems—including the skin, joints, nervous system, heart, and immune system. The Immunoserology of Lyme panel offers a comprehensive and patented ELISA approach to detecting Borrelia infections and related co-infections, guiding earlier and more effective treatment decisions.
Optimal range: 0 - 0.81 index
The IgG Borrelia afzelii test measures antibodies against Borrelia afzelii, one of the main bacterial species that cause Lyme disease in Europe and Asia. Unlike Borrelia burgdorferi (more common in North America), B. afzelii is especially associated with chronic skin forms of Lyme disease, such as acrodermatitis chronica atrophicans (ACA).
Optimal range: 0 - 0.81 index
The IgG Borrelia burgdorferi sensu stricto (s.s.) test measures antibodies against the primary species of Borrelia that causes Lyme disease in North America and parts of Europe. This species is strongly linked to arthritis, neurological symptoms, and late-stage Lyme manifestations.
Optimal range: 0 - 0.81 index
The IgG Borrelia burgdorferi Antigen (Ag) test measures long-term antibodies against antigens of Borrelia burgdorferi, the main bacterium responsible for Lyme disease, particularly in North America. Unlike species-specific tests that focus on one strain, antigen-based assays detect immune responses to a broader range of Borrelia proteins, offering insight into both past exposure and potential later-stage infection.
Optimal range: 0 - 0.81 index
The IgG Borrelia garinii test detects antibodies against Borrelia garinii, one of the main bacterial species in the Borrelia burgdorferi sensu lato complex that causes Lyme disease, particularly in Europe and Asia. This strain is strongly linked with neurological forms of Lyme disease (neuroborreliosis), including meningitis, radiculitis, and cranial nerve involvement.
Optimal range: 0 - 0.81 index
The IgG Borrelia miyamotoi test detects antibodies against Borrelia miyamotoi, a tick-borne bacterium closely related to Lyme disease pathogens but classified as a relapsing fever Borrelia species. Unlike Borrelia burgdorferi sensu lato (which causes classical Lyme disease), B. miyamotoi is associated with hard-tick relapsing fever (HTRF) and can cause recurring fever episodes, flu-like symptoms, and in some cases, neurological complications.
Optimal range: 0 - 0.81 index
The IgG Babesia test measures antibodies against Babesia species, a group of parasites transmitted by ticks that can cause babesiosis, a malaria-like illness. Babesia microti is the most common species in North America, while Babesia divergens and others are more frequently found in Europe and Asia.
IgG antibodies typically develop several weeks after infection and may remain detectable for months or years, even after treatment.
A positive IgG result usually indicates past exposure or immune memory, not necessarily an active infection.
IgM antibodies are more reflective of recent or acute babesiosis, while IgG testing provides a view of longer-term immune response.
Optimal range: 0 - 0.81 index
The IgG Bartonella test measures antibodies against Bartonella species, a group of bacteria transmitted by ticks, fleas, or scratches from infected animals (especially cats). Bartonella henselae and Bartonella quintana are the most common human pathogens. Infection can lead to cat scratch disease, trench fever, or tick-borne bartonellosis, which may cause persistent systemic or neurological symptoms.
Optimal range: 0 - 0.81 index
The IgG Ehrlichia test measures antibodies against Ehrlichia species, bacteria transmitted by ticks that cause ehrlichiosis, a potentially serious tick-borne illness. The two main human pathogens are Ehrlichia chaffeensis (human monocytic ehrlichiosis, HME) and Ehrlichia ewingii. Infections can lead to fever, chills, muscle aches, headache, and sometimes severe complications if untreated.
Optimal range: 0 - 0.81 index
The IgG Immunodominant Peptide C6 (P. C6) test detects antibodies against a highly conserved region of the VlsE protein from Borrelia burgdorferi, the main bacterium that causes Lyme disease. The C6 peptide is considered an immunodominant epitope—a portion of the protein that triggers a strong and reliable immune response across different strains of Borrelia.
Optimal range: 0 - 0.81 index
The IgG LFA Antigen + CK10 test evaluates long-term antibody responses to both Borrelia antigens (using a lateral flow assay, or LFA) and Cytokeratin 10 (CK10), a structural protein found in epithelial tissues such as the skin. This combined test helps clinicians explore the connection between infection-driven immune responses and autoimmune reactivity.
Optimal range: 0 - 0.81 index
The IgG Outer Surface Proteins A and C (OspA & OspC) test is a blood test that measures your immune system’s production of IgG antibodies against specific proteins on the surface of Borrelia burgdorferi, the bacteria that causes Lyme disease.
Outer Surface Proteins (Osp) are molecules the bacteria use to survive and infect humans:
OspA helps the bacteria persist in ticks.
OspC plays a key role in establishing infection in people.
When your immune system encounters Borrelia burgdorferi, it may produce IgG antibodies targeting these proteins. Detecting these antibodies can help provide clues about whether your body has mounted a response to Lyme disease.
Optimal range: 0 - 0.81 index
The IgG OspE test measures antibodies against Outer Surface Protein E (OspE) of Borrelia burgdorferi, one of the proteins that help the bacterium evade the immune system and persist in the body. OspE belongs to the Erp (OspE-related proteins) family, which plays a key role in protecting Borrelia from complement-mediated killing by binding to host factor H.
Optimal range: 0 - 0.81 index
The IgG VmpE test measures antibodies against Variable Major Protein E (VmpE), a surface protein produced by Borrelia burgdorferi, the bacterium that causes Lyme disease. VmpE belongs to a family of variable major proteins (Vmps) that the bacteria can change through a process called antigenic variation. This ability allows Borrelia to evade immune detection and sometimes persist in the body.
Optimal range: 0 - 0.81 index
IgM B. afzelii measures early antibodies against Borrelia afzelii, a major cause of Lyme disease in Europe and Asia. Unlike B. burgdorferi sensu stricto, which dominates in North America, B. afzelii is strongly linked to skin-related forms of Lyme borreliosis, including erythema migrans and acrodermatitis chronica atrophicans (ACA). IgM antibodies typically appear within the first weeks of infection, making this marker useful for detecting recent or early exposure, especially in patients with skin or joint symptoms after tick bites. Because low-level or isolated IgM responses can reflect cross-reactivity or false positives, results should always be interpreted with other Borrelia markers, clinical history, and follow-up testing.
What it means: Borderline levels of IgM antibodies were detected against Borrelia afzelii. This may represent an early or low-level immune response, or it may reflect non-specific reactivity rather than true Lyme infection. Results in this range require careful interpretation, particularly if you have Lyme-like symptoms or known tick exposure.
Next steps: Your doctor may recommend repeat testing after a few weeks, reviewing other Lyme antibody markers (including B. burgdorferi and B. garinii), or confirming with an immunoblot. Clinical history and symptoms are essential to determine whether this finding represents Lyme disease.
Repeat testing: Because IgM antibodies may rise in the early weeks after infection, repeating the test in 2–4 weeks can help clarify whether the immune response is increasing (suggesting infection) or fading (suggesting no infection).
Additional Lyme tests: Your doctor may order IgG antibody testing, immunoblots, or a broader Lyme panel (including other Borrelia subspecies and Osp proteins) to confirm the result.
Consider co-infections: If exposure risk is high, testing for tick-borne co-infections (e.g., Babesia, Bartonella, Ehrlichia) may also be recommended.
Clinical evaluation: Symptoms and history of tick exposure are critical. Even borderline results can be significant if you have classic Lyme signs such as erythema migrans, joint pain, neurological changes, or unexplained fatigue.
Ongoing monitoring: If symptoms persist but results remain unclear, your provider may recommend ongoing monitoring and possibly other diagnostic methods such as PCR.
Optimal range: 0 - 0.81 index
The IgM B. burgdorferi sensu stricto test helps detect early Lyme disease by measuring IgM antibodies, which the body produces soon after a tick bite. A positive result may point to a recent infection, but it isn’t always proof of active disease because false positives and lingering IgM can occur. Doctors use this test along with symptoms (such as rash, fever, tiredness, joint or nerve problems) and exposure history to make an accurate diagnosis. Finding Lyme disease early is important, since timely treatment can prevent serious complications affecting the joints, nervous system, or heart.
Optimal range: 0 - 0.81 index
The IgM B. burgdorferi Antigen (AG) test measures early antibodies against a broad set of Borrelia burgdorferi proteins, making it a sensitive marker for detecting early Lyme disease. IgM antibodies typically appear within 1–2 weeks after a tick bite and peak in the first month, so a positive result may indicate a recent or active infection. However, IgM alone is not diagnostic: results can persist after treatment or arise from cross-reactions with other infections or autoimmune conditions. Therefore, this marker is most valuable when interpreted with symptoms, exposure history, IgG results, and confirmatory tests. As part of a comprehensive Lyme serology panel, the IgM AG test supports early recognition and management of Lyme disease, helping to prevent progression to later complications affecting joints, the nervous system, or the heart.
An equivocal result means your IgM antibody level is right at the borderline — not clearly negative, but not strongly positive either. This does not confirm Lyme disease. Sometimes this happens if the test is done very soon after a tick bite, before antibodies fully develop, or because of background signals in the immune system. Your doctor may suggest repeating the test after a few weeks, checking for other antibodies, and reviewing your symptoms and history before making any diagnosis.
Optimal range: 0 - 0.81 index
The IgM B. garinii test detects early antibodies against Borrelia garinii, a subspecies within the Borrelia burgdorferi sensu lato complex that is especially common in Europe and Asia and strongly associated with neurological forms of Lyme disease (neuroborreliosis). IgM antibodies typically appear 1–3 weeks after infection, making this marker useful for identifying recent immune responses in patients with early neurological symptoms such as meningitis, facial nerve palsy, radiculoneuritis, or cognitive issues. While a positive result may support an early diagnosis, interpretation depends on clinical context, timing, and geography, since false positives and persistent IgM without IgG conversion can occur. The test is most informative when combined with other Lyme markers (e.g., B. burgdorferi sensu stricto, B. afzelii, or Osp proteins), helping clinicians recognize neurological Lyme disease earlier and guide appropriate management.
An equivocal result means the test is in the borderline range — not clearly negative, but not fully positive either. This can happen if testing is done very early after a tick bite, before antibodies have built up, or if the signal comes from the immune system reacting to something else. On its own, this result does not confirm or rule out Lyme disease. Your doctor may recommend repeating the test, checking other Lyme markers, and reviewing your symptoms and travel or exposure history to get a clearer answer.
Optimal range: 0 - 0.81 index
The IgM B. miyamotoi test detects early antibodies against Borrelia miyamotoi, a relapsing fever–type spirochete transmitted by the same Ixodes ticks that spread Lyme disease. Unlike classical Lyme borreliosis, B. miyamotoi causes Borrelia miyamotoi disease (BMD), which typically presents with acute, flu-like illness and recurring episodes of fever, and in some cases, neurological complications such as meningoencephalitis, particularly in immunocompromised patients. Importantly, BMD rarely produces the bull’s-eye rash seen in Lyme disease, making antibody testing critical for recognition. A positive IgM result generally indicates recent or active infection, but interpretation should take clinical symptoms, geographic exposure, and confirmatory testing into account, since cross-reactivity with Lyme Borrelia is possible.
An equivocal result means the antibody level is close to the test’s cut-off, and may reflect very early infection, low-level cross-reactivity, or a nonspecific finding; in such cases, repeat testing or additional confirmatory assays are often needed for clarity.
Optimal range: 0 - 0.81 index
The IgM Babesia test measures early antibodies against Babesia species, tick-borne protozoan parasites that invade red blood cells and can cause babesiosis, a malaria-like illness. In North America, Babesia microti is most common, while B. divergens and B. venatorum predominate in Europe, often leading to more severe disease. IgM antibodies typically appear within 1–2 weeks of infection, making this marker useful for identifying recent or acute cases before IgG antibodies or confirmatory findings emerge. Clinically, babesiosis can range from flu-like symptoms (fever, chills, sweats, fatigue) to hemolytic anemia, splenomegaly, and multi-organ complications, especially in elderly or immunocompromised patients, or those without a spleen. Because the same ticks can also transmit Lyme disease (Borrelia) and Anaplasma, co-infections are common and can complicate the illness.
An equivocal IgM Babesia result means antibody levels are near the cut-off, making the finding uncertain; this may reflect very early infection, low-level reactivity, or nonspecific response, and repeat or confirmatory testing is often needed for clarification.
Optimal range: 0 - 0.81 index
The IgM Bartonella test detects early antibodies against Bartonella species, a group of bacteria transmitted by ticks, fleas, lice, or scratches from infected animals (especially cats). The most common human pathogens are Bartonella henselae and Bartonella quintana, which can cause cat scratch disease, trench fever, or tick-borne bartonellosis. In some cases, Bartonella infections may contribute to chronic fatigue, neurological issues, or joint pain, especially when co-infections with Lyme disease or Babesia are present.
Optimal range: 0 - 0.81 index
The IgM Ehrlichia test detects early antibodies to Ehrlichia species, tick-borne bacteria that invade white blood cells and cause ehrlichiosis, most often due to E. chaffeensis (human monocytic ehrlichiosis) or E. ewingii. IgM antibodies usually appear within 1–2 weeks of illness, making this marker useful for identifying recent or acute infection, particularly in patients presenting with fever, severe headache, fatigue, muscle aches, gastrointestinal upset, or neurological changes. Laboratory findings commonly include low white blood cells, low platelets, and elevated liver enzymes. Because ehrlichiosis can progress rapidly to severe complications in older adults, immunocompromised patients, or those with delayed treatment, timely recognition and empiric doxycycline therapy are critical. However, IgM alone is not definitive since early levels can be low and false positives may occur.
An equivocal IgM Ehrlichia result means the antibody level is near the cut-off, leaving the test uncertain; this may reflect very early infection, a nonspecific immune response, or cross-reactivity, and repeat or confirmatory testing (PCR or IgG serology) is often needed.
Optimal range: 0 - 0.81 index
The IgM Immunodominant C6 test measures early antibodies against the conserved C6 peptide of VlsE, a key surface protein of Borrelia burgdorferi sensu lato. Because the IR6 region of VlsE is highly conserved across major Lyme-causing subspecies (B. burgdorferi sensu stricto, B. afzelii, B. garinii), C6-based assays serve as valuable pan-Borrelia markers in Lyme serology. IgM to C6 typically appears within 1–3 weeks of infection, making it especially useful for detecting recent exposure, particularly in patients with early localized symptoms, neurological manifestations, or evolving musculoskeletal involvement. While C6 ELISAs show strong sensitivity and specificity, IgM alone is not diagnostic—isolated IgM after 6–8 weeks or cross-reactivity with other pathogens (including Borrelia miyamotoi) can lead to nonspecific results.
An equivocal IgM C6 result means antibody levels are near the cut-off, leaving interpretation uncertain; this may reflect very early infection, low-level reactivity, or a nonspecific immune response, so repeat or confirmatory testing is often required.
Optimal range: 0 - 0.81 index
The IgM LFA Antigen + CK10 test measures two important parts of the immune system. The IgM portion looks for the body’s early-response antibodies, which usually appear soon after an infection begins, such as from a virus, bacteria, or parasite. Detecting IgM often suggests a recent or ongoing infection, while unusually persistent IgM levels may also point to chronic immune activity. The CK10 portion of the test checks for antibodies against cytokeratin 10, a protein found in skin and epithelial cells. Antibodies to CK10 can be a clue that the immune system is mistakenly targeting the body’s own tissues, as seen in certain autoimmune skin or inflammatory conditions. Together, these markers can help distinguish whether symptoms are more likely due to infection, autoimmunity, or both.
If results are reported as equivocal, antibody levels are near the cut-off, meaning the test is uncertain; in these cases, repeat or confirmatory testing is often recommended.
Optimal range: 0 - 0.81 index
The IgM OspA + OspC test helps detect an early immune response to Borrelia burgdorferi, the bacteria that cause Lyme disease. It looks for IgM antibodies against two important surface proteins:
OspC (Outer Surface Protein C): Typically produced within the first 2–3 weeks after infection, making it a strong marker for early Lyme disease.
OspA (Outer Surface Protein A): More often linked with later or persistent infection, and sometimes associated with chronic or autoimmune-like Lyme symptoms.
By measuring IgM antibodies against both proteins, this test provides a broader view of where a person may be along the Lyme disease timeline.
The IgM OspA + OspC test can be useful for people who have:
Early Lyme symptoms such as rash, fever, fatigue, or muscle pain
Neurological signs including facial palsy or nerve discomfort
Joint pain or swelling that appears weeks to months after infection
A history of tick exposure in areas where Lyme disease is common
IgM antibodies are most reliable in the early weeks of infection. On their own, they cannot confirm Lyme disease. False positives are possible, which is why doctors often order additional testing (such as IgG antibodies, VlsE/C6 peptide, or multi-antigen panels) to confirm results.
A positive IgM OspA + OspC test suggests that your immune system is reacting to Borrelia and may indicate a recent or active infection. However, your healthcare provider will always consider your symptoms, exposure history, and other test results before making a diagnosis.
If your result is reported as equivocal (borderline), it means the antibody level is close to the cutoff and not clearly positive or negative. In this case, repeat testing or confirmatory panels are often recommended to clarify the result.
Optimal range: 0 - 0.81 index
The IgM OspE test detects early antibodies against Outer Surface Protein E (OspE) of Borrelia burgdorferi, the bacterium responsible for Lyme disease. OspE belongs to the Erp (OspE-related proteins) family, which helps Borrelia survive in the human bloodstream by binding to factor H, a host protein that protects the bacteria from complement-mediated killing.
Optimal range: 0 - 0.81 index
The IgM Variable Major Protein E (VmpE) test detects early antibodies against a surface protein that Borrelia burgdorferi—the bacteria responsible for Lyme disease—uses to survive through antigenic variation. VmpE can repeatedly alter its structure, enabling Borrelia to evade immune detection and, in some cases, contribute to persistent or relapsing infection.
IgM antibodies to VmpE usually appear within the first 1–3 weeks after infection, making this test valuable for identifying recent exposure to Lyme disease. In some cases, IgM reactivity may also remain detectable in ongoing immune activation, offering insights into possible bacterial persistence.
Clinically, IgM VmpE provides complementary information to markers such as OspC and VlsE, helping clinicians assess both early immune recognition and potential long-term Borrelia activity.
As with all IgM-based assays, results must be interpreted alongside patient history, symptoms, and additional confirmatory markers.
An equivocal IgM VmpE result means antibody levels are near the test cut-off, leaving the finding uncertain. This may reflect very early infection, a nonspecific immune response, or cross-reactivity. In such cases, repeat or follow-up testing is usually recommended to clarify the result.
The HDL Function Panel with HDLfx pCAD Score is a blood test that looks beyond “HDL cholesterol” (HDL-C) quantity to assess how well your HDL particles work. It measures a set of apolipoproteins carried on HDL-like particles and uses them to estimate HDL’s cholesterol efflux capacity (CEC)—the process by which HDL helps remove cholesterol from artery walls. The panel then reports a composite HDLfx pCAD Score that classifies relative risk for coronary atherosclerosis.
While low HDL-C is linked to higher cardiovascular risk, raising HDL-C with drugs hasn’t consistently reduced events. That’s why researchers and clinicians focus on HDL function—especially CEC—as a more meaningful indicator of cardiovascular protection.
ApoA1-associated lipoprotein (AALP) apolipoproteins: ApoA1, ApoC1, ApoC2, ApoC3, ApoC4 (nmol/L), isolated using an ApoA-1 affinity method and quantified by LC-MS/MS.
HDLfx pCEC: a predicted CEC derived from those proteins that correlates strongly with cell-based CEC (r = 0.86).
HDLfx pCAD Score: a risk-classification algorithm reweighted from the pCEC model to improve CAD case identification.
HDLfx pCAD Score
≤ 71: lower relative risk classification
> 71: higher relative risk classification (in the reference study, sensitivity ~76% and specificity ~75% for detecting coronary atherosclerosis defined as ≥50% stenosis).
This score does not diagnose disease; it refines risk assessment and should be interpreted with your overall clinical picture.
HDLfx pCEC (%)
Sex-specific reference intervals are provided on the report (men ~8.9–14.2 % efflux/4 hr; women ~9.1–15.6 % efflux/4 hr). Higher CEC generally indicates better HDL function.
AALP apolipoproteins (ApoA1, C1, C2, C3, C4)
Reported with male/female reference ranges to help identify patterns associated with less favorable HDL functionality. Your clinician will interpret these in context of lipids, inflammation, diabetes status, medications, and family history.
People with discordant lipid profiles (e.g., normal or high HDL-C but residual risk).
Premature CAD in the family or personal history of atherosclerosis.
Metabolic syndrome, insulin resistance, type 2 diabetes, chronic inflammatory conditions, or persistent risk despite statin therapy.
(Clinical use should always be individualized.)
HDL-C is not the whole story; HDL function provides added insight.
A higher pCAD Score (>71) suggests higher relative risk and may prompt more aggressive risk-factor management (lifestyle, LDL-lowering, glycemic control, blood pressure, inflammation).
Use this panel to fine-tune prevention strategies alongside standard lipids, ApoB/LDL-C, inflammation markers, diabetes metrics, imaging, and clinical judgment.
Optimal range: 181.36 - 359.23 nmol/L
Optimal range: 23.11 - 57.57 nmol/L
Optimal range: 3.67 - 14.55 nmol/L
Optimal range: 11.34 - 40.54 nmol/L
Optimal range: 0.29 - 1.1 nmol/L
Optimal range: 0 - 71 Score
Optimal range: 8.9 - 14.2 %
