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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.

Rheumatoid factor (RF) attacks healthy body tissues as it mistakes them for foreign body tissues. It is not found in healthy persons. The presence of RF means that the body has an autoimmune disease such as Rheumatoid arthritis. Symptoms of Rheumatoid arthritis include stiffness of joints especially in morning, pain in joints, underlying skin nodules, loss of bone and swelling of joints.   

Following tests are a part of the Comprehensive Iron deficiency profile:

Transferrin saturation test is ordered along with other iron tests when results from a routine complete blood count (CBC) show that a person's hemoglobin and hematocrit are low and their red blood cells are smaller and paler than normal. This test is ordered when a person develops signs and symptoms of anemia such as:
-Chronic fatigue/tiredness
-Dizziness
-Weakness
-Headaches
-Pale skin

Ferritin checks the levels of ferritin in the blood, which determines the levels of iron in the body and evaluates the body’s capacity to store iron. The Ferritin Test is widely performed to confirm iron deficiency anemia detected in routine check-ups. This test also determines iron overload in the body and the body’s capacity to store iron.

Total Iron binding capacity measures the level of iron available to bind with your blood cells. This test suggests iron deficiency anemia even though other clinical symptoms may not have developed yet. This test can also detect iron overload. Signs and symptoms of iron overload will vary from person to person and tend to worsen over time. They are due to iron accumulation in the blood and tissues. These may include:
-Joint pain
-Fatigue, weakness
-Weight loss
-Organ damage, such as in the heart and/or liver
-Lack of energy
-Abdominal pain
-Loss of sex drive

Unsaturated Iron binding capacity test is used in the diagnosis and treatment of anemias. Serum iron is carried by binding to the transport protein, Transferrin. the serum has considerable reserve iron-binding capacity. This is called the serum Unsaturated Iron Binding Capacity (UIBC).

Iron, serum can be ordered when results from a routine complete blood count (CBC) show that a person's hemoglobin is low or when their red blood cells are smaller and paler than normal (microcytic and hypochromic). This may indicate iron deficiency anemia even though other clinical symptoms may not have developed yet. Iron tests may also be ordered when symptoms of anemia such as fatigue, tiredness, dizziness, weakness, headaches, and pale skin are present.

Following tests are a part of the Advanced cardiac risk markers package:

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.

The Homocysteine Test measures the levels of homocysteine in the blood. Homocysteine is an amino acid which at increased levels in the body can damage the inner lining of the blood vessels that increases the chances of blood clot formation. The Homocysteine Test measures the levels of homocysteine in the blood. The Homocysteine Test is performed to screen for heart attack and stroke, especially in people with no known risk factors but with a family history of cardiovascular diseases. This test also detects and diagnoses an inherited disease called homocystinuria in newborns and infants and even detects deficiency of Vitamin B6, B12, or Folic acid.

Apolipoprotein B/ 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).

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.

Lipoprotein-A: This test measures the amount or activity of Lipoprotein in the blood. It helps in determining your risk of developing cardiovascular disease (CVD), including your risk of coronary heart disease (CHD) and ischemic stroke.

Apolipoprotein-B is ordered, when a healthcare practitioner is evaluating 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.
 

The Thyroid Profile Total test measures the levels of the following three hormones in the blood:
Thyroid Stimulating Hormone (TSH)
Thyroxine (T4) - Total
TriIodothyronine (T3) - Total

The thyroid gland (a small, butterfly-shaped gland located in front of the neck) 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 tells your thyroid gland to make and release the thyroid hormones (T3 & T4) into your blood. The thyroid gland uses the iodine gained 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 T3 and T4 hormones, you may experience symptoms like weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity to heat, etc. and 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 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 the levels of thyroid hormone decrease, the pituitary gland is stimulated to release TSH.  High TSH in turn increases the release of T3 and T4 thyroid hormones from the thyroid gland and vice-versa.

T3 and T4 circulate in the blood in two forms:

1) Bound form - It is bound to proteins present in blood and this prevents it from entering the body tissues. The three main proteins in the blood that the thyroid hormones are bound to are albumin, transthyretin and Thyroxine-binding globulin (TBG), also called Thyroid hormone Binding Globulin (THBG).

2) Free form - It enters the body tissues where it is  needed

The total T3 or total T4 includes both bound and free forms circulating in the blood. Hence, thyroid hormones can be measured as Free T3, Total T3, Free T4, and Total T4.

The total T3 and total T4 levels can be affected by the amount of protein available in the blood to bind to them.

FSH, LH, and Prolactin are three key reproductive hormones which play an important role in reproduction. These tests are done to analyze any hormonal changes which may cause infertility.

Follicle-stimulating hormone (FSH): This hormone is associated with reproduction and the development of eggs in women and sperm in men. FSH is produced by the pituitary gland, and its production is controlled by a feedback system. This feedback system involving the hypothalamus in the brain, the pituitary gland, and the hormones produced by the ovaries or testicles. The Gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates the pituitary gland to release FSH and luteinizing hormone (LH; another closely-related hormone also involved in reproduction). FSH affects the growth and maturation of egg follicles in the ovaries during the follicular phase of the menstrual cycle. The menstrual cycle is divided into follicular and luteal phases, each phase lasting for 14 days. During the follicular phase, FSH triggers the production of estradiol by the follicle, and the two hormones work together in the further development of the egg follicle. Near the end of the follicular phase, the production of FSH and luteinizing hormone increases. The release of the egg from the ovary (ovulation) occurs shortly after this increased production of hormones. The hormone inhibin as well as estradiol and progesterone help in controlling the amount of FSH released by the pituitary gland. FSH also helps the ovary to respond to LH. At menopause, ovarian function decreases and eventually stops which results in increased levels of FSH and LH.

In males, the role of FSH is to stimulate the testicles to produce mature sperms and also to promote the production of androgen binding proteins. FSH levels are relatively constant in men after puberty than in women.

In infants and children, FSH levels rise shortly after birth and then fall to very low levels. Generally, in boys, these levels decrease by 6 months and in girls, they take about 1-2 years. These concentrations rise again before the beginning of puberty and the development of secondary sexual characteristics.

Disorders affecting the hypothalamus, pituitary, and/or the ovaries or testicles can cause abnormal production of FSH (too much or too little). This, as a result, can cause conditions such as infertility, abnormal menstrual cycles, or early (precocious) or delayed sexual maturation (puberty).

Luteinizing hormone (LH): This hormone is associated with reproduction and ovulation. In females, it stimulates the release of an egg from the ovary. However, in males, testosterone production is dependent on LH. This test helps in measuring the amount of LH present in the blood.

Just like FSH, LH is produced by the pituitary gland, and its production is controlled by the hypothalamus, pituitary gland, and the hormones produced by the ovaries (in women) or testicles (in men).

In premenopausal women, LH stimulates ovulation and the production of other hormones, namely, estradiol and progesterone. The menstrual cycle is divided into 2 phases, follicular and luteal phases, each of which lasts for about 14 days. Near the end of the follicular phase, there is a mid-cycle increase in follicle-stimulating hormone (FSH) and LH. This triggers ovulation. During the luteal phase, LH secretion stimulates the corpus luteum to start producing progesterone. At this point, the levels of FSH and LH get reduced, while progesterone and estradiol concentrations rise. If the egg is not fertilized, then the levels of these hormones fall after several days followed by the beginning of the next menstrual cycle. With the onset of menopause ovarian function reduces and eventually discontinues, which results in increased levels of FSH and LH.

In men, LH stimulates Leydig cells in the testicles to produce testosterone. However, the levels of LH remain relatively constant in men after puberty. Due to high levels of testosterone, the pituitary gland and the hypothalamus receives negative feedback which in turn decreases the secretion of LH hormone.

In infants and children, LH levels rise shortly after birth and then fall to very low levels, which is about 6 months in boys and 1-2 years in girls. At about 6-8 years of age, levels again rise before the beginning of puberty and secondary sexual characteristics development.

Prolactin hormone: It is produced by the pituitary gland which is located at the base of the brain. The secretion of this hormone is controlled by the hypothalamus. The primary function of this hormone is to help in the production of milk after childbirth (lactation). Prolactin levels are usually high during pregnancy and after childbirth. During pregnancy, this hormone along with other hormones like estrogen and progesterone stimulates the breasts for milk production. After the childbirth, it helps to maintain breast milk production. Suckling of the breast by the baby is important for the release of prolactin hormone. If a woman stops breastfeeding, the level of prolactin hormone will return to normal. 

Abnormally high levels of prolactin are seen in certain disease conditions like prolactinoma (non-cancerous tumor of the pituitary gland) in men and women. Prolactinomas are generally benign (non-cancerous) in nature and are seen more commonly in women. If the tumor is quite large, it can put pressure on the optic nerve and can cause headaches and visual disturbances.

High levels of prolactin are also seen in patients with diseases of the hypothalamus (located in the brain), other pituitary gland disorders and tumors, kidney disease, liver disease, hypothyroidism, polycystic ovary syndrome (PCOD) and conditions like anorexia nervosa (eating disorder).

Low levels of prolactin are seen in patients with pseudohypoparathyroidism, patients taking bromocriptine and in conditions of pituitary deficiency like necrosis or infarction of the pituitary gland.

Amylase is an enzyme that helps in the breakdown of complex dietary carbohydrates into simple carbohydrates for absorption. Digestion of carbohydrates begins in the mouth since amylase is secreted by the salivary glands. However, most of the amylase is produced by the pancreas and secreted into the duodenum of the small intestine. Amylase is also found in small quantities in blood, urine and peritoneal fluid.

The levels of amylase in blood rise either due to its increased secretion into the blood or decreased clearance by the kidneys or due to both these reasons. High levels are commonly seen in acute pancreatitis (inflammation of the pancreas) where the amylase levels rise rapidly (in 6 to 48 hours). In mild cases of pancreatitis, amylase levels slowly return to normal within a few days. Higher levels for longer periods indicate other complications.

IgE test measures the amount of IgE (immunoglobulin E) in the blood. It is an antibody produced by the immune system in response to danger. Normally, it is present in very small amounts in the blood. It belongs to the class of immunoglobulins which include five types of immunoglobulins:  IgA, IgG, IgM, IgD, and IgE. 

Immunoglobulins are produced by plasma cells (specific immune cells) when the body recognizes bacteria, viruses, other microorganisms or any other unknown substances as harmful foreign antigens to the immune system. 

The production of IgE is seen in cases of response to allergens such as asthma and response to parasitic infections. Other allergens can include plant pollen, eggs, peanuts, bee venom, strawberries, and other allergens substances. 

These IgE antibodies, once produced, bind to white blood cells and lead to the release of substances like histamine. This further causes constriction of bronchi in the lungs in allergic or asthmatic persons. Other signs and symptoms which can develop in these patients include running nose, skin itching, itchy eyes. 

The severity of the reaction depends upon the body’s exposure to allergens which can be observed from mild reddening and itching of skin to problems in breathing (respiratory distress) to vomiting and diarrhea to conditions of shock. 

Calcium (Ca) Test measures the levels of calcium in blood. Calcium is essential for body processes including cell signaling, blood clotting, contraction of muscles, and functioning of nerves. It plays a crucial role in the formation and maintenance of healthy bones. Deficiency of calcium results in Osteoporosis, a disease in which the bones lose their density and become soft and fragile, causing them to fracture very easily.

About 99% of the total amount of calcium received by the body is bound as calcium complex in bones, and the remaining 1% lies in blood circulation. Of the amount of calcium circulating in the blood, about half remains bound to albumin protein or other ions and are metabolically inactive, while the remaining half remains free and metabolically active. Blood Calcium tests can be of two types: Total Calcium Test used to measure the total calcium concentration in blood including both the free and bound forms, and Ionized Calcium Test used to measure the concentration of only the metabolically active form.

Calcium levels in the blood are maintained within a very narrow range by a number of mechanisms. Deviation from the normal range of calcium concentration causes Hypocalcemia (low levels of calcium), or Hypercalcemia (excess of calcium). Both these conditions impact normal body processes in the short term and may give rise to other conditions in the long term.

A blood calcium test cannot be used to check for a lack of calcium in your diet or for osteoporosis (loss of calcium from bones) as the body can have normal calcium levels even in case of dietary deficiency of Calcium. The body can augment mild calcium deficiency by releasing the calcium stored in bones.

Lipase is an enzyme, which helps in the breakdown and digestion of dietary triglycerides (fats) into simple fatty acids for absorption. Lipase is secreted primarily by the pancreas, and in small amounts by the stomach, intestines, and the liver. The pancreas secretes lipase into the pancreatic duct, which flows into the duodenum (anterior portion of the small intestine). Normally only a small amount of lipase is secreted into the blood and is maintained at this low level. However, in the case of conditions like pancreatitis, blockage of the pancreatic duct, pancreatic cysts or tumors, etc., the levels of lipase in the blood get increased.

The Lipase Test may be performed together with Amylase Test to help in the diagnosis of pancreatitis or other conditions. Amylase levels also increase in case of pancreatitis. In Pancreatitis, Lipase rises almost at the same time as amylase (4-8 hrs) but the elevation lasts much longer (7-14 days) as compared to amylase.