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It gives us a measure of one of the components of the white blood cells , called Neutrophils. While all white blood cells help your body fight infections, neutrophils are important for fighting against bacterial infection.

Blood is made up of different types of cells which are suspended in a fluid called plasma. These include erythrocytes or red blood cells, leukocytes or white blood cells, and platelets. Blood cells are produced by the hematopoietic cells in bone marrow and are then released into circulation. RBCs carry oxygen to the tissues, platelets help in blood clotting at a site of injury, and leukocytes form an integral part of the immune system of the body.

WBCs are of five types, each having a different function and present in different numbers:

1.      Neutrophils: Under normal conditions, the number of neutrophils present is higher than any other type of WBCs.. They provide protection against pathogens, mostly bacteria and sometimes fungi. Neutrophils engulf the pathogens completely and digest them (the process is called phagocytosis). They are usually associated with acute or short-term infections.

2.      Eosinophils: Eosinophils are WBCs that are primarily responsible to fight parasitic infections. They are also involved in allergic reactions and regulation of the extent of immune response.

3.      Basophils: Basophils are WBCs which are present in the lowest numbers in circulation. They are considered to play an important role in allergic response.

[Neutrophils, eosinophils, and basophils are together classified as granulocytes. Granulocytes are the WBCs which contain granules present in their cytoplasm. These granules secrete chemicals during immune response.]

4.      Monocytes: Monocytes are WBCs which are also involved in protection against infectious pathogens by phagocytosis like neutrophils. However, monocytes are more commonly associated with chronic or long-term infections.

5.      Lymphocytes: These are specialized WBCs which are responsible for recognizing and neutralizing foreign (non-self) cells and cancer cells in the body. Lymphocytes are of three types, all of which are differentiated from a common type of lymphocyte progenitor cell:

·         T cells or T lymphocytes are produced in the bone marrow and mature in the thymus gland. They are responsible for differentiating between self and non-self cells of the body. T cells are also responsible for the initiation and extent of immune response, and targeted destruction of cancer cells and virus.

·         B cells or B lymphocytes are control acquired immunity by producing antibodies against antigens found on foreign cells and pathogens like bacteria and viruses.

·         Natural killer cells or NK cells destroy all foreign cells tagged by antibodies, cancer cells and virus-infected cells by phagocytosis.

Depending on various factors like age, gender, health condition, environmental factors, etc., varying amounts of different types of WBCs circulate in the blood. The bone marrow increases production of WBCs in response to an infection or inflammation anywhere in the body, which are then called to the site by a series of chemical signals, where they work to treat the condition. Depending on the condition, the count of one or more types of WBCs remains high in the blood. Once the condition subsides, WBC production by the bone marrow decreases and their count in circulation falls back to normal levels. Elevated amount of one or more types of leukocytes for a long time may be an indication of a chronic condition that is not resolving naturally and might need urgent attention.

Apart from an infection or inflammation, WBC count in blood can also be affected by other conditions like disorders of the immune system, autoimmune conditions, cancer, etc. One or more types of WBC count may be higher or lower than normal in these cases.

Differential Leukocyte Count Test serves as an indication of a condition affecting the body. Further tests are performed to confirm a particular condition and direct treatment.

This further contains

• Differential Neutrophil Count
• Differential Lymphocyte Count
• Differential Monocyte Count
• Differential Eosinophil Count
• Differential Basophil Count

The hemoglobin test measures the amount of hemoglobin in the blood.

Hemoglobin (Hb) is a protein found in red blood cells (RBCs) that carries oxygen from the lungs to the body tissues, and to exchange the oxygen for carbon dioxide. Hemoglobin then carries the carbon dioxide back to the lungs and where it is exchanged for oxygen. Iron is an essential part of hemoglobin. Most blood cells, including red blood cells, are produced regularly in your bone marrow (present within the cavities of many of large bones). To produce hemoglobin and red blood cells, your body needs iron, vitamin B12, folate and other nutrients from the foods you eat.

A decrease in hemoglobin concentration in blood results in anemia. Anemia is a blood disorder characterized by a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood or a lowered ability of the blood to carry oxygen to body organs and tissues. Anemia is the most common blood disorder, affecting about a third of the global population and can cause symptoms like tiredness (fatigue), weakness, shortness of breath etc.

The hemoglobin test is usually performed as a part of complete blood count (CBC) test.

The platelet count measures the number of platelets present in the blood. Platelets are also known as thrombocytes which are tiny fragments of cells. These are formed from large cells which are found in the bone marrow known as megakaryocytes. After the platelets are formed, they are released into the blood circulation.

Whenever there is an injury to a tissue or blood vessel, bleeding starts. At this point, platelets help in stopping the bleeding in three ways:

• The platelets will adhere to the injury site

• The platelets will accumulate at the injury site 

• The platelets will release chemical compounds which stimulate gathering of other platelets

With these steps, a loose platelet connection forms at the site of injury. This process is known as primary hemostasis. The activated platelets start to support the coagulation cascade which involves a series of steps that includes the sequential activation of clotting factors. This process is known as secondary hemostasis which results in the formation of fibrin strands that knit through the loose platelet connection to form a fibrin net. After that, the connection is compressed to form a stable clot so that it remains in place until the injury heals. Once the injury is healed, other factors come into play and break it down so that it gets removed. 

In case the platelets are not sufficient in number or are not functioning properly, a stable clot might not form. These unstable clots can result in an increased risk of excessive bleeding. 

Blood is made up of different types of cells suspended in a fluid called plasma. These include erythrocytes or red blood cells, leukocytes or white blood cells, and platelets. Blood cells are produced by the hematopoietic cells in bone marrow and are then released into circulation. RBCs carry oxygen to the tissues, platelets help in blood clotting at a site of injury, and leukocytes form a part of the immune system of the body. WBCs are of five primary types: neutrophils, basophils, eosinophils, monocytes, and lymphocytes. Lymphocytes are further of three types: B-Lymphocytes, T-Lymphocytes, and natural killer (NK) cells. Neutrophils, basophils, eosinophils are collectively called granulocytes since they contain granules in cytoplasm.

Depending on various factors like age, gender, health condition, environmental factors, etc., varying amounts of different types of WBCs circulate in the blood. The bone marrow increases the production of WBCs in response to an infection or inflammation anywhere in the body. These WBCs are called to the site by a series of chemical signals, where they work to treat the condition. During this time, the total leukocyte count remains high in blood. Once the infection or inflammation subsides, WBC production by bone marrow decreases and WBC count in circulation falls back to normal levels. A continuously elevated WBC count may thus be an indication of a chronic condition that is not resolving naturally and might need urgent attention.

Apart from an infection or inflammation, WBC count in blood can also be affected by other conditions like disorders of the immune system, autoimmune conditions, cancer, etc. WBC count may be higher or lower than normal in these cases.

WBC count test serves as an indication of a condition affecting the body. Further tests are performed to confirm a particular condition and direct treatment.

The absolute eosinophil count measures the number of eosinophils present in the blood. Eosinophils, a  type of white blood cells, helps in fighting the disease. These come into action for are said to be linked with certain infections and allergic diseases. The eosinophils are produced and mature in the bone marrow. They usually take about 8 days to mature and then are moved to blood vessels.

The eosinophils have varied functions which include the physiological role in organ formation such as the development of post-gestational mammary gland. Other functions include its movement to the areas of inflammation, trapping substances, killing cells, bactericidal and anti-parasitic activity. It also helps the treatment of immediate allergic reactions and modulation of inflammatory responses.

Human blood is made up of erythrocytes or red blood cells, leukocytes or white blood cells, and platelets suspended in a fluid called plasma. Each of the component of blood performs a specific function. The packed cell volume or hematocrit is a ratio of the volume occupied by the RBCs to the total volume occupied by all the blood components or whole blood.

The RBCs transport inhaled oxygen from the lungs to all the cells of the body, and also a small amount of carbon dioxide from the cells to the lungs to be exhaled. The majority of carbon dioxide is transported in solution in plasma as bicarbonate ions. They contain a protein called hemoglobin which binds to oxygen for transport.

RBCs are produced in the erythropoietic cells of the bone marrow in response to the hormone Erythropoietin secreted by the kidneys when oxygen saturation of blood is detected to be low (hypoxia). The average lifespan of RBCs in circulation is 120 days. Hence, the bone marrows continuously produce RBCs to maintain a steady concentration in blood. The Packed Cell Volume Test depends on the count as well as the average size of the RBCs (Mean Corpuscular Volume or MCV). Higher than normal amount of RBCs produced by the bone marrow can cause the hematocrit to increase, leading to increased blood density and slow blood flow. Lower than normal hematocrit can be caused by low production of RBCs, reduced lifespan of RBC in circulation, or excessive bleeding, leading to reduced amount of oxygen reaching the cells.

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The cholesterol LDL test measures the levels of cholesterol LDL in the blood. LDL also known as low-density lipoprotein carries cholesterol in the blood. It consists mainly of cholesterol, similar other substances, and a small amount of protein. 

 It is very important to monitor and maintain healthy levels of lipids for staying healthy. Intake of foods that are high in saturated fats and trans unsaturated fats can raise the levels of cholesterol in the blood. The extra cholesterol gets deposited in plaques on the walls of blood vessels. This may result in atherosclerosis  (hardening of the arteries). It can also increase the risk of various other health problems such as heart disease and stroke.

The cholesterol LDL is known as “bad cholesterol” as it gets deposited in the vessels as plaque, giving rise to cardiovascular diseases. The cholesterol HDL which is the high-density lipoproteins cholesterol is known as “good cholesterol” as its role is to transport cholesterol from the arteries to the liver and thus protects the body against heart diseases.

The cholesterol LDL test helps in determining the risk of heart disease in an individual. It also helps in planning out the treatment considering other known risk factors as well. The treatment can involve changes in lifestyle such as diet and exercise or lipid-lowering medications such as statins.

Triglycerides test measures the levels of triglycerides in the blood.

Triglycerides are a type of body fat (lipid). Chemically, triglycerides consist of three ("tri-") molecules of fatty acid combined with a molecule of the alcohol glycerol ("-glyceride").

High levels of triglycerides in the blood have been linked to atherosclerosis which increases the risk of heart disease (Coronary Artery Disease), peripheral artery disease, stroke and kidney disease. Atherosclerosis is a disease in which plaque (made up of fat, cholesterol, calcium, and other substances) builds up inside the arteries (blood vessels) resulting in narrowing of the lumen. This restricts the flow of blood to the organs and other parts of the body. Signs and symptoms of atherosclerosis usually do not appear until severe or total blockage of the artery (blood vessel). Therefore, most people are not aware of atherosclerosis until they have a medical emergency, such as a heart attack or stroke.

Increased levels of triglycerides may also be seen in Metabolic syndrome (cluster of metabolic risk factors for cardiovascular disease, type 2 diabetes and stroke). Very high triglyceride levels can also cause inflammation of the pancreas (pancreatitis).

Triglycerides test is usually done as a part of lipid profile which includes other tests like cholesterol, HDL (High-density lipoprotein), LDL (Low-density lipoprotein), VLDL (Very low-density lipoprotein) also.

Cholesterol is essential for life, as it is required by the body to work properly. It plays a role in the formation of cell membranes in all organs and tissues in the body. It is associated with the formation of hormones which are important for development, growth, and reproduction. It forms bile acids, which help to absorb nutrients from food. 

In the blood, a small amount of cholesterol circulates in the form of lipoproteins which contains protein, cholesterol, triglyceride, and phospholipid molecules. These are classified according to their density into HDL (high-density lipoproteins), LDL (low-density lipoproteins), and VLDL (very low-density lipoproteins). HDL cholesterol is also known as good cholesterol, as it carries excess cholesterol away for disposal while LDL cholesterol is also known as bad cholesterol, as it deposits cholesterol in tissues and organs. 

It is important to maintain and monitor the levels of cholesterol for a healthy lifestyle. The source of cholesterol is diet as well. If a person is taking too much of cholesterol-rich foods, it can cause a rise in levels of cholesterol in the blood. The amount of cholesterol which is not required by the body starts to deposit in the form of plaques on the walls of blood vessels. These plaques can narrow or block the blood vessels opening which can lead to the hardening of arteries known as atherosclerosis. Also, with an increase in cholesterol levels, there is an increased risk of various conditions such as heart disease and stroke. 

The Glucose - fasting urine test measures the levels of glucose in urine during the period of fasting. The most common cause of high levels of glucose in the urine is diabetes. In diabetes, the way the body processes the glucose gets affected. The insulin hormone is responsible for controlling the metabolism of glucose in the blood. In diabetic patients, the body is either not able to make enough insulin or the body is not able to utilize the insulin produced. Due to this, the glucose starts to build up in the blood and the kidneys are not able to control it to release it into the urine.

The presence of glucose in the urine is termed as glycosuria or glucosuria. This could be due to side effects caused by certain medicines or problems in the kidney, such as renal glycosuria. 

The Protein, Urine measures the excessive protein excreted in the urine. The urine protein tests measure the protein which is released into the urine. Normally, the urine protein elimination is less than 150 mg/day and less than 30 mg of albumin/day. Temporarily raised levels may be seen in conditions such as stress, infections, pregnancy, cold exposure, diet, or heavy exercise. 

The appearance of persistent protein discharge in the urine suggests possible kidney damage or the requirement of additional tests to know the cause.

In a normal functioning kidney, the filtered proteins are retained or reabsorbed and sent back to the blood. Whereas, if any damage is caused to the kidneys then it may affect their functioning which may cause detectable amounts of protein extracted into the urine.

The Bilirubin Total measures the amount of bilirubin present in the blood of a person. Bilirubin is an orange-yellow waste pigment produced by the normal breakdown of heme. The heme is a component of hemoglobin and is found in red blood cells. The liver processes the bilirubin and eliminates it from the body. 

The life span of red blood cells is about 120 days. The heme which is released from the hemoglobin is converted into bilirubin which is called unconjugated bilirubin. It is then carried to the liver by proteins, where it gets attached to sugars and becomes conjugated bilirubin. This conjugated bilirubin enters the bile from the liver and passes to the small intestine. Here, it gets broken down by the bacteria and further gets eliminated in the stool. These breakdown products of bilirubin are responsible for giving the characteristic brown color to the stool.

A healthy adult body produces approximately 250 - 350 mg of bilirubin daily. About 85% of bilirubin comes from damaged or degraded RBCs while the remaining amount comes from the bone marrow or liver.

Small amount of unconjugated bilirubin is released in the blood normally, but there is no virtual presence of conjugated bilirubin in the blood. 

Both the forms of bilirubin can be measured or evaluated by the laboratory tests, and total bilirubin (sum of conjugated or unconjugated bilirubin) may be reported. In case there is an increase in levels of bilirubin, there will be yellowing of the skin and white of the eyes, giving the appearance of jaundice.  

Alanine Transaminase test measures the levels of alanine transaminase in the blood.  Alanine Transaminase is an enzyme which is found in liver and kidney cells. However, this enzyme, in less quantity, can be found in the muscles and the heart. Its function is to convert alanine (an amino acid found in proteins) to pyruvate (intermediate in cellular energy production). 

Generally, these levels of alanine transaminase in the blood remain low in healthy individuals. However, if there is any damage to the liver, alanine transaminase is released in the blood. This process helps in early detection of any damage to the liver. 

The function of the liver is to process the nutrients of the body. It also produces bile which helps in digesting fats along with the production of other important proteins such as blood clotting factors and albumin. The liver breaks the potentially toxic substances into harmless products which can be used or eliminated by the body. 

This test is done with another liver enzyme, aspartate aminotransferase (AST) as a part of the liver panel. In case of damage to the liver, there is a sudden rise in levels of both enzymes. However, alanine transaminase is more specific for the liver. In some cases, it is possible that only one of them is increased. The AST/ALT ratio can be calculated to differentiate between various causes and severity of the liver injury. This can also help to distinguish whether the injury is from damage to the liver or heart or muscles.

The alkaline phosphatase, serum test measures the alkaline phosphatase levels in the blood. Alkaline phosphatase (ALP) is an enzyme which is found in various tissues throughout the body. The maximum concentrations of ALP are present in cells of bone and liver. Usually, raised levels of ALP are caused due to liver disease or bone disorders.

ALP is found in the liver on the cell edges that join to form bile ducts. The bile ducts are the tiny tubes which drain bile from the liver to the bowels. The bile juice formed is required by the small intestine to help digest fat in the diet.

ALP is produced by osteoblasts cells in the bone which are involved in bone formation. The various tissue types produce distinct forms of ALP which are known as isoenzymes.

The levels of ALP generally increase to a great extent if one or more bile ducts get blocked. The reason could be inflammation of the gallbladder which is known as cholecystitis or the presence of gallstones. The small amount of increase of ALP in the blood can be seen in liver cancer and cirrhosis. These high levels can also be observed if there is intake of medications toxic to the liver and hepatitis.

In conditions, where there is formation of excessive bones such as Paget’s disease one can also have increased levels of ALP. Along with that, higher blood ALP levels can be seen in children and adolescents, as they are in the growing stage and so are their bones.

Aspartate aminotransferase (AST) is an enzyme which is found in most of the body cells but mainly in the heart and liver. It is also present in kidneys and muscles but in smaller amounts. Normally, the levels of AST are low, but the levels rise when there is an injury to cells of the liver or muscle. 

The function of the liver is to process the nutrients of the body. It also produces bile which helps in digesting fats along with the production of other important proteins such as blood clotting factors and albumin. The liver breaks the potentially toxic substances into harmless products which can be used or eliminated by the body. 

The rise in levels of AST can be due to conditions causing liver damage such as hepatitis, drugs which are toxic to liver, cirrhosis, or alcoholism. The AST test is not specific for the liver. Its levels may also rise in conditions which affect other parts of the body.

This test is done with alanine aminotransferase (ALT) test. Both the enzymes are found in the liver and their levels rise in case of liver damage. The ratio of AST/ALT helps in differentiating between the causes of liver damage in case of injury to heart or muscle. 

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.

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.

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.

Creatinine is a waste product which is produced by the muscles due to the breakdown of a compound called Creatine. During the cycle of energy production which is required to contract muscles, creatine is produced. Kidneys remove creatinine from the body by filtering it from the blood and then releasing it into the urine. This test measures the amount of creatinine in the blood.

The body produces creatine and creatinine at a relatively same rate. Since kidneys filter most of the creatinine from the blood and release it into the urine, the blood levels can be used as an indicator to know how well the kidneys are functioning. The amount of creatinine produced depends upon the size of the person as well as their muscle mass. That is why levels of creatinine are higher in men as compared to women and children.

The Uric acid test measures the levels of uric acid in the blood. Uric acid is a nitrogenous compound produced by the metabolic breakdown of purine. Purines are nitrogenous bases in DNA forming parts of the structural framework of the cells. Breakdown of purines occurs when cells become old and die, forming uric acid. Uric acid is also formed from the metabolic breakdown of some types of food like red meat, seafood, beans, etc.

Most of the uric acid in the blood is filtered and eliminated by the kidneys and a small remaining amount in the stool. The concentration of uric acid in the blood can increase due to overproduction of uric acid or improper elimination of uric acid, and this condition is called Hyperuricemia. Hyperuricemia can also be caused due to cancer treatment by chemotherapy or radiotherapy. These treatment methods kill the cancer cells, which may leak the uric acid into the blood.

Excess uric acid can form crystals in the synovial fluid between the joints causing inflammation and pain. This condition is called gout and can severely damage the joints if left untreated. The Uric Acid Test can indicate the presence of gout, or risk of formation of gout. However, it is not a definitive test for gout. Confirmatory test for gout is performed by analysis of synovial fluid (joint fluid) for monosodium urate crystals. Chronic Hyperuricemia can cause the formation of tophi, which are hard lumpy deposits of uric acid crystals formed under the skin, in the joints, and at the top of the ears. Tophi cause severe damage to the joints and may compress nerves causing chronic pain and disfigurement. The excess uric acid may also deposit and crystallize in the kidneys causing kidney stones and acute renal failure.

Urea is a byproduct of protein metabolism. Proteins consumed in the diet are digested and converted into amino acids, which are utilized by the body. This metabolic process creates toxic byproduct ammonia. This byproduct is rapidly converted by the liver to form urea, which is less toxic and is transported relatively safely in blood. Following this, urea is transported by the blood to the kidneys. The kidneys then filter it out of the blood and excrete it out of the body in a solution called urine. This process continues and the body keeps producing and excreting urea, hence maintaining a low and steady level of urea in the blood.

The BUN test measures the amount of urea present in the urea. The levels of BUN test in the blood are affected due to impairment of kidney function, or due to large scale liver conditions. Primarily, BUN Test results are used to evaluate kidney functioning. Results are often interpreted together with results of Creatinine Tests that measure the levels of another metabolic waste (creatinine), which is also excreted in the urine.

The Blood Urea Nitrogen test measures the amount of urea nitrogen in the blood. Urea is a waste product which is formed in the liver. It is formed when protein is metabolized into amino acids. This leads to the production of ammonia which is further converted into urea which is a less toxic waste product. 

Both ammonia and urea have nitrogen as their component. The liver releases urea into the blood which is then carried out to the kidneys. Here, it is filtered out of the blood and then released into the urine. Since this is a continuous process, a small and stable amount of urea nitrogen always remains in the blood.

In the case of kidney or liver diseases, there is a change in the amount of urea present in the blood. If the liver produces urea in increased amounts or if there is any problem in the functioning of the kidneys, there can be difficulty in filtering out wastes of the blood which will lead to rising in urea concentrations in the blood. If due to liver damage or disease there is less production of urea, the concentration of BUN will fall.

The BUN test is done along with creatinine test to evaluate kidney function to diagnose kidney disease and to monitor patients undergoing treatment of kidney disease.