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HbA1c or glycosylated hemoglobin test is an important tool in diagnosing and monitoring your diabetes. Hemoglobin, a protein found in your red blood cells, carries oxygen from the lungs to the rest of the body and glucose tends to attach to this protein. It is a reliable technique of finding your blood sugar levels as it measures the average blood glucose of the past two to three months
Average blood glucose (60-90 days) measures blood glucose of the past two to three months( the average lifespan of a red blood cell is 120 days). The higher the average blood glucose higher is your risk of diabetes. This test reveals your blood glucose level and also whether or not you are at risk of diabetes.
Iron Deficiency Profile is ordered when either deficiency of iron or excess of iron is suspected in your body. The symptoms of iron deficiency are pale skin, fatigue, headaches, weakness. This test is ordered if you have signs or symptoms of iron deficiency anemia like fatigue, weakness, headaches or your CBC shows that your hemoglobin and hematocrit are low and RBCs are smaller and paler indicating iron deficiency anemia. These tests can even be done if you have signs or symptoms of increased accumulation of iron in the body like joint pain, abdominal pain, fatigue, loss of body hair. This profile consists of three tests: Iron serum, Total Iron binding capacity, and percent transferrin saturation.
Hemogram, also known as a complete blood count (CBC) test is a group of tests that provides information about your blood group and blood cells like Red Blood Cells (RBC), White Blood Cells (WBC), and platelets. It is routinely performed to provide an overview of a patient's general health status. It is also helpful in detecting a variety of disorders including infections, anemia, diseases of the immune system, and blood cancers and is done to monitor an existing blood disorder and its treatment such as chemotherapy or radiotherapy.
Liver function test (LFT) is used to assess the function of the liver and is done when any liver disease like viral hepatitis, alcoholic hepatitis, autoimmune hepatitis, and cirrhosis (scarring of the liver)is suspected. This test is also done for monitoring of any ongoing treatment or simply as a part of a routine checkup.
Kidney Function Test (KFT) is a group of blood tests, which is used to determine how well the kidneys are working. KFT is performed either as a part of routine health checkups or to help diagnose any disease affecting the kidneys. It can also screen people at risk for the development of any kidney disease and even monitor the treatment efficacy of kidney diseases.
Cardiac Risk Markers This is a group of tests and markers that have been proven to indicate a person's chance of having a cardiovascular event such as a heart attack or stroke. This type of assessment includes 5 tests which are High Sensitive CRP, Lipoprotein A, Apolipoprotein A1 & B Apo A1/ApoB Ratio, Apolipoprotein - B, and Apolipoprotein - A1
Lipid Profile is a group of blood tests that detects the levels of different types of lipids present in the blood. A lipid profile measures cholesterol, HDL cholesterol, LDL cholesterol, very low-density lipoprotein, and triglycerides. It is done to screen for the risk of cardiovascular disease and to monitor patients who have risk factors for cardiovascular diseases.
ELEMENTS 22 (toxic and nutrients) test evaluates your toxic and nutrients profile. The toxic profile includes 14 tests Aluminium, Arsenic, Barium, Cadmium, Caesium, Mercury, Lead, Tin, Bismuth, Beryllium, Antimony, Strontium, Thallium, and Uranium, whereas nutrients profile includes 8 tests: Cobalt, Chromium, Molybdenum, Silver, Vanadium, Selenium, Nickel, and Manganese. This test is used to determine the nutrients and toxins present in your body.
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Glycosylated Hemoglobin Test measures the percentage of glycosylated hemoglobin in blood which reflects the average blood glucose over a period of past two to three months (8 - 12 weeks).
Hemoglobin is the protein found in Red Blood Cells and is responsible for transporting oxygen. Of the different types of hemoglobin, Hemoglobin A is predominant. With the elevation of blood sugar levels, some glucose binds spontaneously to Hemoglobin A (this binding is called Glycosylation or Glycation) and remains bound for the complete lifetime of the RBC, which is 120 days normally. Higher the level of glucose in the blood, greater is the amount of it binding to Hemoglobin A. Hemoglobin A1c is the dominant form of Glycated Hemoglobin. As RBCs die and are replaced, Hemoglobin A1c is cleared and slowly replaced with non-glycosylated hemoglobin. Measurement of HbA1c level over a period of time gives an indication of the level of glucose in the blood over the specified period of time. This helps in the diagnosis of Diabetes and is useful for monitoring the effectiveness of measures taken to reduce blood sugar levels.
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Blood Stag is composed of blood cells suspended in blood plasma (yellowish-colored liquid). The blood cells include red blood cells (also called RBCs or erythrocytes), white blood cells (also called WBCs or leukocytes), and platelets (also called thrombocytes).
Red blood cells (RBCs) are the most abundant blood cells. RBCs contain hemoglobin which helps in the transportation of oxygen to the tissues. RBC count is the measurement of the number of RBCs in a given volume of blood.
Packed Cell Volume (PCV) or Hematocrit (Hct) is the measurement of the blood volume occupied by RBCs. It is expressed in percentage.
White blood cells (WBCs) are key components of the immune system and thus protect the body from various infections and cancers. Total Leucocyte count (TLC) is the measurement of the total number of leukocytes (WBCs) in a given volume of blood.
There are five types of WBCs:
Neutrophils
Basophils
Eosinophils
Lymphocytes
Monocytes
Differential Leucocyte Count (DLC) determines the percentage of different types of WBCs.
Neutrophils, Basophils, and Eosinophils are called Granulocytes because of the presence of granules inside these cells.
Absolute count of different types of WBCs is the measurement of their absolute numbers in the given volume of blood.
Platelet count - Platelets (also called thrombocytes) are disc-shaped cell fragments without a nucleus that help in blood clotting. Platelet count is the measurement of the number of platelets in a given volume of blood.
Mean Platelet Volume (MPV) is a measurement of the average size of platelets.
PDW or platelet distribution width refers to the variation of platelet size distribution
Hemoglobin (Hb) - Hemoglobin (Hb) is a protein found in red blood cells (RBCs) that carries oxygen from the lungs to the body tissues, exchanges the oxygen for carbon dioxide, and then carries the carbon dioxide back to the lungs where it is exchanged for oxygen.
Mean Corpuscular Volume (MCV) is the average volume of a red blood cell.
Mean Corpuscular Hemoglobin (MCH) is the average amount of hemoglobin in the average red blood cell.
Mean Corpuscular Hemoglobin Concentration (MCHC) is the average concentration of hemoglobin in a given volume of red cells.
Red Cell Distribution Width Coefficient of variation (RDW CV)is a measurement of the variability of the red blood distribution curve and their mean size.
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The Lipid Profile Test typically measures the levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Other results that may be reported include VLDL cholesterol, non-HDL cholesterol, and total cholesterol to HDL cholesterol ratio.
Lipids are fatty acids which store energy for the body and play essential roles in cellular structure and cell signaling. Cholesterols and triglycerides are essential lipids, carried in the blood by lipoprotein particles made up of cholesterol, triglycerides, proteins and phospholipid molecules. The lipoprotein particles are classified according to their densities into High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL), and Very Low Density Lipoproteins (VLDL).
Cholesterol is a fat-like substance formed in the liver, as well as obtained from dietary sources. It is found in all the cells and is an essential part of the structural framework of the cells apart from performing various vital body processes. However, excess cholesterol is harmful. Increased cholesterol in blood can cause it to get deposited on the inner walls of the blood vessels forming plaque.
Triglycerides are the commonest type of fat in the body. Triglycerides are obtained from dietary sources and form the stored fat in adipose tissues. Increase in triglyceride concentration can also give rise to cardiovascular diseases.
High Density Lipoproteins or HDLs are high density particles which help to reduce the chances of cardiovascular diseases by picking up and carrying lipoprotein particles of lower density to the liver for disposal.
Low Density Lipoproteins or LDLs are lipoprotein particles of low density which carry cholesterol to the tissues. Cholesterol carried by LDLs easily comes out of blood and get deposited on the inner walls of the blood vessels, increasing the chances of cardiovascular diseases.
Very Low Density Lipoproteins or VLDLs are lipoprotein particles of very low density which carry triglycerides to the tissues. Excess triglycerides in blood causes increase in VLDL particles which in turn again increases the chance of developing cardiovascular diseases.
Plaque deposition makes the lumen of the blood vessels narrower thereby preventing proper flow of blood and may stop the flow completely. Excessive plaque deposition can also cause the arteries to harden, giving rise to a condition called Atherosclerosis. Improper flow of blood prevents the supply of nutrients and oxygen to the vital organs and may cause heart attack or stroke.
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Thyroxine (T4) Total test measures the total levels (both free and bound forms) of Thyroxine hormone (T4) in the blood.
The thyroid gland secretes the following hormones:
Triiodothyronine (T3)
Thyroxine (T4)
Thyroid Stimulating Hormone (TSH), also called Thyrotropin is a hormone secreted into the blood by the pituitary gland (a gland present in the brain). It directs the thyroid gland to produce and release the thyroid hormones (T3 & T4) into your blood. The iodine from the food stimulates the thyroid gland to make the thyroid hormones.
The thyroid hormones regulate growth and metabolism. If the thyroid gland produces very high amounts of these hormones (T3 and T4), symptoms of weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity towards heat, etc occurs. This is known as Hyperthyroidism.
The decreased production of thyroid hormones (T3 and T4) results in Hypothyroidism which may lead to weight gain, fatigue, slow heart rate, increased sensitivity towards cold, depression, dry and thin hair, etc.
There is a feedback system in the body to maintain stable amounts of the thyroid hormones (T3 and T4) in the blood. When the levels of thyroid hormones decrease, the pituitary gland is stimulated to release TSH. High TSH, in turn, increases the release of thyroid hormones (T3 & T4) from the thyroid gland and vice-versa.
T4 hormone constitutes about 90% of thyroid hormones and circulates in the blood in two forms:
1) Bound form - It is bound to the proteins present in blood and this prevents it from entering the body tissues. The three main proteins in the blood that the T4 hormone is bound to are albumin, transthyretin and Thyroxine-binding globulin (TBG). TBG is also called Thyroid hormone Binding Globulin (THBG).
2) Free form - It enters the body tissues where it is needed and this is the active form.
Hence, the T4 hormone can be measured as Free T4 or Total T4. The total T4 includes both bound and free forms circulating in the blood and can be affected by the amount of protein available in the blood to bind to them.
While the total T4 test is a useful indicator of T4 levels in the presence of normal binding proteins, it is not useful when levels of binding proteins are increased or decreased. For example, increased total T4 levels can be seen despite normal levels of free T4 levels and normal thyroid function due to an increase in thyroxine-binding proteins.
Thyroxine (T4) Total test is also done as a part of the Thyroid profile Total test which includes two more tests: Thyroid Stimulating Hormone (TSH) and Triiodothyronine (T3) Total.
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Triiodothyronine (T3) Total Test measures the total levels (both free and bound forms) of Triiodothyronine (T3) hormone in the blood.
The thyroid gland secretes the following hormones:
Triiodothyronine (T3)
Thyroxine (T4)
Thyroid Stimulating Hormone (TSH) is a hormone secreted into the blood by a gland present in the brain (Pituitary gland) and it tells your thyroid gland to make and release the thyroid hormones (T3 & T4) into your blood. The thyroid gland uses iodine from food to make the thyroid hormones.
The thyroid hormones are essential for growth and metabolism. If the thyroid gland produces very high amounts of these hormones (T3 and T4), you may experience symptoms of weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity to heat etc. and this is known as Hyperthyroidism.
Also, the decreased production of thyroid hormones (T3 and T4) results in Hypothyroidism which may cause symptoms like weight gain, fatigue, slow heart rate, increased sensitivity to cold, depression, dry and thin hair etc.
There is a feedback system in the body to maintain stable amounts of the thyroid hormones (T3 and T4) in the blood. When thyroid hormone levels decrease, the pituitary gland is stimulated to release TSH. This high TSH in turn leads to the release of more thyroid hormones (T3 & T4) from the thyroid gland and vice-versa.
Majority of the T3 hormone is formed from T4 hormone and a smaller fraction is produced directly by the thyroid gland. T3 hormone circulates in the blood in two forms:
1) Bound form - It is bound to proteins present in blood and this prevents it from entering body tissues. The two main proteins in the blood that the T3 hormone is bound to are albumin and Thyroxine-binding globulin (TBG), also called Thyroid hormone Binding Globulin (THBG).
2) Free form - It enters the body tissues where it is needed and this is the active form. Free Triiodothyronine (FT3) constitutes only 0.3% of the total T3 hormone.
The total T3 includes both bound and free forms circulating in the blood and can be affected by the amount of protein available in the blood to bind to them. The T3 hormone can be measured as Free T3 or Total T3. Triiodothyronine (T3) Total Test measures the total levels (both free and bound forms) of Triiodothyronine (T3) hormone in the blood and is usually done as a part of the Thyroid Profile Total test which includes two more tests: Thyroid Stimulating Hormone (TSH) and Thyroxine Total (T4) hormone.
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Thyroid Stimulating Hormone (TSH) test measures the amount of TSH in your blood which helps to find out if the thyroid gland is working normally or not. Low TSH levels indicate hyperthyroidism and high TSH levels indicate hypothyroidism.
In case of hyperthyroidism, the thyroid gland produces very high amounts of thyroid hormones (T3 and T4) and you may experience symptoms of weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity towards heat, etc. In case of Hypothyroidism, there is a decrease in the production of thyroid hormones (T3 and T4) which may cause weight gain, fatigue, slow heart rate, increased sensitivity towards cold, depression, dry and thin hair, etc.
There is a feedback system in the body to maintain stable amounts of the thyroid hormones (T3 and T4) in the blood. TSH signals the thyroid gland to make and release the thyroid hormones (T3 & T4) into the blood when the level of thyroid hormones is low and can also signal the thyroid gland to lower the production of thyroid hormones when the level of thyroid hormones is very high. So, when the thyroid hormone (T3 and T4) levels decrease, the pituitary gland is stimulated to release TSH and this high TSH level, in turn, stimulates thyroid gland to release more thyroid hormone (T3 & T4) from the thyroid gland and the vice-versa happens when the thyroid hormone levels are very high.
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Apolipoprotein A-I (apo A-I) is a protein that plays an important role in the transportation and metabolism of lipids and is the main protein component in high-density lipoprotein. Apo A-I is ordered in someone who has a personal or family history of abnormal lipid levels and/or premature cardiovascular disease. It may be ordered when your doctor is trying to determine the cause of a person's high cholesterol.
High sensitive CRP: High sensitive C reactive protein is a test that measures the amount of C reactive protein in the blood. The level of this marker is elevated in cases of inflammation in the body. This test can evaluate your risk of heart diseases such as coronary artery disease.
Apolipoprotein B/ Apolipoprotein A1 Ratio helps in evaluating your risk of developing cardiovascular disease (CVD); It is also used to monitor treatment for high cholesterol. This test is not widely used for a screening test but may be ordered if a person has a family history of heart disease and/or high cholesterol and triglycerides (hyperlipidemia).
Lipoprotein B is a marker that has been proven to indicate a person's chance of having a cardiovascular event such as a heart attack or stroke.
Apolipoprotein B is ordered along with an apo A-I or other lipid tests, when a healthcare practitioner is trying to evaluate someone's risk of developing CVD and when a person has a personal or family history of heart disease and/or abnormal lipid levels, especially when the person has significantly elevated triglyceride levels.
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The kidneys are a pair of bean-shaped organs located on either side of the spinal column in the abdomen towards the back. The kidneys perform a number of important functions. The most important of these is that they filter the blood and separate the waste products generated out of regular metabolic activities of the body, primarily urea. Following the separation, the kidneys excrete the waste products out of the body through urine. They help in maintaining the normal pH level and water balance of the body. The kidneys also play essential roles in the synthesis of Vitamin D and Red Blood Cells (RBCs).
The Kidney Function Test includes the following tests to monitor kidney function:
· Blood Urea Nitrogen (BUN)/ Urea:
Blood Urea Nitrogen is a test to measure the amount of urea nitrogen present in the blood. Urea is a nitrogenous by-product of the metabolism of protein, and its level in blood serves as an indication of the amount of nitrogen present in blood as urea. In simpler terms, BUN is the measure of the amount of nitrogen present in blood in the form of urea. High BUN levels in the blood can be caused as a result of kidney diseases, dehydration and obstruction in the urinary tract due to kidney stones, prostate gland enlargement, etc.
Urea test measures the level of urea in the blood. Urea is a final waste product formed from the breakdown of proteins. Urea is filtered out of the blood by the kidneys to excrete excess nitrogen present in the blood through urine. Excess of urea in blood is called uremia and can be caused by a number of conditions including kidney diseases.
· Uric Acid:
This test measures the level of uric acid in the blood. Uric acid is a waste product formed from the breakdown of purines, which are essential building blocks of DNA. It is also produced by the metabolism of proteinaceous food, especially red meat. Uric acid is excreted from the body by the kidneys through urine and a small portion through stool. The uric acid test indicates the level of uric acid in the blood and serves as an indirect estimation of the proper functioning of the kidneys.
The presence of excess amounts of uric acid in the blood is called hyperuricemia, and causes gout due to the accumulation of uric acid crystals in the synovial fluid between joints. Hyperuricemia also causes the formation of hard lumps of uric acid crystals called tophi under the skin and at the top of the ears. Uric acid crystals can also accumulate in the kidneys and cause kidney stones.
· Creatinine:
This test measures the level of Creatinine in blood. Creatinine is a waste product formed from the normal breakdown of muscles in the body. Creatinine is almost completely excreted by the kidneys, so their levels in the blood serve as an indication of kidney function.
Excess creatinine in the blood can be found due to decreased elimination from the kidneys as well as due to increased creatinine production by muscular breakdown, eating cooked meat, protein supplements, etc.
· BUN/Creatinine Ratio:
BUN/Creatinine Ratio compares the levels of nitrogen as urea in blood to the levels of creatinine in the blood. This ratio serves as a more accurate representation of kidney function. It is also used to check for dehydration since the BUN level increases in dehydration while creatinine levels remain the same. Low BUN to creatinine ratio can be caused due to a low protein diet, liver cirrhosis, rhabdomyolysis (muscle disease), syndrome of inappropriate antidiuretic hormone secretion (SIADH) as well as during pregnancy.
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LFT measures the level of liver enzymes, proteins, and bilirubin in the blood.
The liver is a wedge-shaped organ located in the right upper part of the abdomen. The liver helps in the synthesis of certain proteins, produces bile (an alkaline compound which helps in the breakdown of fat), process the bilirubin (a yellowish substance produced from the breakdown of hemoglobin) and helps in removing ammonia and other toxins (harmful substances) from the body. It plays an important role in the metabolism of fats, protein, and carbohydrates. It stores glycogen, vitamins, and minerals as well as helps in the metabolism (breakdown) of certain drugs.
Many diseases affect the health of the liver like hepatitis A, hepatitis B, hepatitis C, alcoholic hepatitis, autoimmune hepatitis, cirrhosis, non-alcoholic fatty liver disease (NAFLD), bile duct obstruction, liver or bile duct cancer and many others. Liver function can also be affected by various risk factors like alcohol abuse, certain drugs, sedentary lifestyle, and obesity. Regular monitoring of liver function is essential for early detection of any liver abnormality.
LFT is a group of tests that measure the levels of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), Total protein, Bilirubin and Gamma Glutamyltransferase (GGT) in blood. Each component has its own significance and helps to understand a particular aspect of the liver function.
Alanine Aminotransferase (ALT)
Alanine Aminotransferase (ALT) is an enzyme and this test measures the level of this enzyme in the blood. ALT is also known as serum glutamic-pyruvic transaminase (SGPT) and is mainly found in the liver, but also in smaller amounts in the kidneys, heart, pancreas and muscles. This enzyme is released into the bloodstream in case of liver disease or damage leading to increased ALT blood levels, a specific indicator of liver injury. However, this test cannot determine the extent or severity of the liver damage.
Aspartate Aminotransferase (AST)
This test measures the level of the enzyme AST in your blood. It is also known as serum glutamic-oxaloacetic transaminase (SGOT). AST is found in the liver and is released in the blood in large amounts in case of any liver injury. AST levels are usually measured along with ALT as AST is not specific for liver (also found in the heart, skeletal muscle and other organs). Your doctor may also recommend an ALT/AST ratio to help in the diagnosis.
Alkaline phosphatase (ALP)
This test measures the blood levels of the enzyme ALP which is found in the liver (one of the main source), bile ducts, bones, intestine, pancreas and kidney. ALP helps to break down proteins in the body. Diseases that mainly harm or damage the cells of the liver and bile duct, leading to overproduction and release of this enzyme into the bloodstream. This causes increased blood ALP levels.
Total Serum Protein
This test measures the total amount of protein in the blood, which includes two major types of proteins: albumin and globulin. The test report mentions separate results for total protein, albumin, globulin and albumin/globulin ratio (A/G ratio).
The level of proteins in the blood indicates the biosynthetic capacity of the liver. Hepatocytes (liver cells) are unable to synthesize this protein in certain liver diseases leading to a fall in protein levels in the blood.
Albumin is synthesized only in the liver. It helps to transports minerals, enzymes, hormones, bilirubin and some medicines throughout your body. It prevents the fluid from leaking out of your blood vessels into the tissues.
Globulin is synthesized in the liver and by the cells of the immune system. It plays a key role in fighting infections and transports many enzymes, hormones, minerals and some medicines in the body.
Bilirubin
This test measures the amount of bilirubin in the blood. Bilirubin is a waste product formed by the breakdown of red blood cells and is processed by the liver.
Bilirubin blood test report includes separate values for direct (conjugated) bilirubin, indirect (unconjugated) bilirubin, and total bilirubin.
When heme is released from the hemoglobin, it is converted to bilirubin. This is called unconjugated (indirect) bilirubin which is carried to the liver by some proteins.
In the liver, bilirubin gets attached (conjugated) to modified sugars (glucuronic acid) and form conjugated (direct) bilirubin.
Both these forms can be measured or estimated by laboratory tests, and a total bilirubin result (includes both direct and indirect bilirubin) is also measured.
A damaged liver can’t properly process bilirubin, leading to abnormally high levels of bilirubin in the blood. Increased unconjugated bilirubin in the blood results due to its overproduction or improper uptake by the liver. Increased conjugated bilirubin results can be seen in diseases that reduce the rate of secretion of conjugated bilirubin into the bile or the flow of bile into the intestine resulting in a backward flow of conjugated bilirubin into the blood.
Gamma-glutamyltransferase (GGT)
This test measures the level of the enzyme GGT in your blood which is present in large amounts in the liver. It is a transport molecule and it helps the liver to metabolize many drugs and toxins. GGT is a very sensitive test for detecting any liver disease especially due to alcohol abuse and is also one of the first enzymes to rise in patients with bile duct obstruction like tumor or stones.
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