The Hemoglobin A1C test measures the amount of glucose that combines with hemoglobin to form glycohemoglobin during the normal lifespan of a red blood cell, which is about 120 days. The amount of glycohemoglobin formed is in direct proportion to the amount of glucose present in the bloodstream during the 120-day red blood cell lifespan. In the presence of high blood glucose levels (hyperglycemia) the amount of hemoglobin that is glycosylated to form glycohemoglobin increases and the hemoglobin A1C level will be high. Hemoglobin A1C is used primarily to monitor long-term blood glucose control and to help determine therapeutic options for treatment and management. 

Insulin is the hormone released by the pancreas in response to rising blood glucose levels and decreases blood glucose by transporting glucose into the cells. Often people lose their ability to utilise insulin to effectively drive blood glucose into energy-producing cells. This is commonly known as insulin resistance and is associated with increasing levels of insulin in the blood. Excess insulin is associated with greater risks of heart attack, stroke, metabolic syndrome, and diabetes. 

C-Peptide is used as an indicator for insulin production from the pancreas. It can help assess whether high blood glucose is due to reduced insulin output from the pancreas or due to reduced glucose uptake by the cells, a condition called insulin resistance.

Creatinine is produced primarily from the contraction of the muscle and is removed by the kidneys. 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 kidney function. Elevated levels can also indicate dysfunction in the prostate. 

This test measures the amount of creatinine in your blood and/or urine. Creatinine is a waste product produced in your muscles from the breakdown of a compound called creatine. Creatine is part of the cycle that produces energy needed to contract your muscles. Both creatine and creatinine are produced by the body at a relatively constant rate. Almost all creatinine is excreted by the kidneys, so blood levels are a good measure of how well your kidneys are working. The quantity produced depends on the sex, size or age of the person and their muscle mass. For this reason, creatinine concentrations will be slightly higher in men than in women and children

The BUN/Creatinine is a ratio between the BUN and Creatinine levels. An increased level is associated with renal dysfunction. A decreased level is associated with a diet low in protein.

The eGFR is a calculated estimate of the kidney’s Glomerular Filtration Rate. It uses 4 variables: age, race, creatinine levels and gender to estimate kidney function. Levels below 90 are an indication of a mild loss of kidney function. Levels below 60 indicate a moderate loss of kidney function and may require a visit to a renal specialist for further evaluation.

Potassium is one of the main electrolytes in the body. Due to the critical functions of potassium for human metabolism and physiology, it is essential for the body to maintain optimal serum levels even though a small concentration is found outside of the cell. Potassium levels should always be viewed in relation to the other electrolytes. Potassium concentration is greatly influenced by adrenal hormones. As such, potassium levels can be a marker for adrenal dysfunction.

Chloride plays an important role in human physiology. The amount of serum chloride is carefully regulated by the kidneys. Chloride is involved in regulating the acid-base balance in the body. Increased levels are associated with metabolic acidosis and decreased levels are associated with metabolic alkalosis. Chloride is an important molecule in the production of hydrochloric acid in the stomach so decreased levels are associated with hypochlorhydria.

Carbon Dioxide is a measure of bicarbonate in the blood. CO2, as bicarbonate, is available for acid-base balancing. Bicarbonate neutralizes metabolic acids in the body. Elevated levels of CO2 are associated with metabolic alkalosis and hypochlorhydria. Decreased levels are associated with metabolic acidosis.  

The sodium and potassium levels are under the influence of aldosterone and cortisol, both hormones produced by the adrenal glands. Aldosterone causes the body to retain sodium by causing a decreased excretion of sodium from the kidney. Aldosterone has the opposite effect on potassium causing the body to excrete potassium by increasing the excretion of potassium from the kidney.  

Lipase is an enzyme involved in fat digestion. It is produced primarily in the pancreas.Levels will increase with inflammation of the pancreas (pancreatitis) and gallbladder dysfunction. Low levels may be seen with pancreatic insufficiency, a dysfunction of the pancreas leading to a decreased output of pancreatic enzymes. 

Uric acid is produced as an end-product of purine, nucleic acid,and nucleoprotein metabolism. Levels can increase due to over-production by the body or decreased excretion by the kidneys. Increased uric acid levels are associated with gout, atherosclerosis, oxidative stress, arthritis, kidney dysfunction, circulatory disorders and intestinal permeability. Decreased levels are associated with detoxification issues, molybdenum deficiency, B12/folate anemia, and copper deficiency.

Creatine Kinase (CPK) is a group of enzymes found in skeletal muscle, the brain, and the heart muscle. Damage to one or more of these tissues will liberate CPK into the serum thus raising serum levels. Decreased levels of Creatine Kinase may be seen in the chronic stage of muscle atrophy. Increased levels of CPK are associated with muscle damage or breakdown, damage to the heart muscle as in an acute MI, heavy exercise, and brain damage or inflammation.

Total serum protein is composed of albumin and total globulin. Conditions that affect albumin and total globulin readings will impact the total protein value. A decreased total protein can be an indication of malnutrition, digestive dysfunction due to HCl need, or liver dysfunction. Malnutrition leads to a decreased total protein level in the serum primarily from lack of available essential amino acids. An increased total protein is most often due to dehydration. 

Albumin is one of the major blood proteins. Produced primarily in the liver, Albumin plays a major role in water distribution and serves as a transport protein for hormones and various drugs. Albumin levels are affected by digestive dysfunction and a decreased albumin can be an indication of malnutrition, digestive dysfunction due to HCl need (hypochlorhydria), or liver dysfunction. Malnutrition leads to a decreased albumin level in the serum primarily from lack of available essential amino acids. Decreased albumin can also be a strong indicator of oxidative stress and excess free radical activity. Increased albumin is a strong indicator of dehydration. 

Total Globulin is composed of individual globulin fractions called alpha 1, alpha 2, beta, and gamma fractions. The total globulin level is greatly impacted by concomitant increases or decreases in one or more of these fractions. Globulins function to transport substances in the blood and constitute the antibody system, clotting proteins, and complement. Globulins are produced in the liver, the reticuloendothelial system, and other tissues.Care must be taken when making a diagnosis based upon the total globulin alone because total globulin is composed of 4 different fractions. Inflammatory, degenerative, or infectious processes are associated with increased production of antibodies.

The albumin/globulin ratio is the ratio between the albumin and total globulin levels. A decreased ratio is associated with liver dysfunction and immune activation from infectious or inflammatory processes. An increased Albumin/Globulin ratio is uncommon and is usually due to dehydration. 

AST is an enzyme present in highly metabolic tissues such as skeletal muscle, the liver, the heart, kidney and lungs. This enzyme is at times released into the bloodstream following cell damage or destruction. AST levels will be increased when liver cells and/or heart muscle cells and/or skeletal muscle cells are damaged. The cause of the damage must be investigated. Low levels are associated with a B6 deficiency.

ALT is an enzyme present in high concentrations in the liver and to a lesser extent skeletal muscle, the heart, and kidney. ALT will be liberated into the bloodstream following cell damage or destruction. Any condition or situation that causes damage to the hepatocytes will cause leakage of ALT into the bloodstream.

Gamma Glutamyl Transferase (GGT) is an enzyme that is present in highest amounts in the liver cells and to a lesser extent the kidney, prostate,and pancreas. It is also found in the epithelial cells of the biliary tract. GGT will be liberated into the bloodstream following cell damage or destruction and/or biliary obstruction. GGT is induced by alcohol and can be elevated following chronic alcohol consumption and in alcoholism. Decreased levels are associated with vitamin B6 and magnesium deficiency.

LDH represents a group of enzymes that are involved in carbohydrate metabolism. Decreased levels of LDH often correspond to hypoglycemia (especially reactive hypoglycemia), pancreatic function, and glucose metabolism. Increased levels are used to evaluate the presence of tissue damage to the cell causing a rupture in the cellular cytoplasm. LDH is found in many of the tissues of the body, especially the heart, liver, kidney, skeletal muscle, brain, red blood cells,and lungs. Damage to any of these tissues will cause an elevated serum LDH level.

The total bilirubin is composed of two forms of bilirubin: Indirect or unconjugated bilirubin, which circulates in the blood on its way to the liver and direct or conjugated bilirubin, which is the form of bilirubin made water-soluble before it is excreted in the bile. An increase in total bilirubin is associated with dysfunction or blockage in the liver, gallbladder, or biliary tree, or red blood cell hemolysis. A decrease in Total Bilirubin is associated with an increase in oxidative stress. 

Direct or conjugated bilirubin is the form of bilirubin that has been made water-soluble in the liver so it can be excreted in the bile. An increase in direct or conjugated bilirubin may be associated with a dysfunction or blockage in the liver, gallbladder, or biliary tree.

Bilirubin is formed from the breakdown of red blood cells. Indirect or unconjugated bilirubin is the protein (albumin) bound form of bilirubin that circulates in the blood on its way to the liver prior to being eliminated from the body in the bile. Elevated levels of indirect or unconjugated bilirubin are usually associated with increased red blood cell destruction. 

Ferritin is the main storage form of iron in the body. Decreased levels are strongly associated with iron deficiency where it is the most sensitive test to detect an iron deficiency. Increased levels are associated with iron overload, an increasing risk of cardiovascular disease, inflammation, and oxidative stress.

Total Iron Binding Capacity is an approximate estimation of the serum transferrin level. Transferrin is the protein that carries most of the iron in the blood. Elevated levels are associated with iron deficiency anemia. Decreased levels of TIBC are associated with possible iron overload or a protein deficiency.

UIBC measures the unsaturated binding capacity of transferrin, the protein that carries iron in the body i.e. UIBC measures levels of transferrin that have not bound to iron. Assessment of UIBC helps to determine iron-deficiency or overload.

The % transferrin saturation index is a calculated value that tells how much serum iron is bound to the iron-carrying protein transferrin. A % transferrin saturation value of 15% means that 15% of iron-binding sites of transferrin are being occupied by iron. It is a sensitive screening test for iron deficiency anemia if it is below the optimal range. It is a sign of iron overload or too much iron in the blood if it is above the optimal range.

Serum triglycerides are composed of fatty acid molecules that enter the bloodstream either from the liver or from the diet. Clients that are optimally metabolising their fats and carbohydrates tend to have a triglyceride level about one-half of the total cholesterol level. Levels will be elevated in metabolic syndrome, fatty liver, in clients with an increased risk of cardiovascular disease, hypothyroidism, and adrenal dysfunction. Levels will be decreased in liver dysfunction, a diet deficient in fat, and inflammatory processes.

LDL functions to transport cholesterol and other fatty acids from the liver to the peripheral tissues for uptake and metabolism by the cells. It is known as bad cholesterol  because it is thought that this process of bringing cholesterol from the liver to the peripheral tissue increases the risk for atherosclerosis. An increased LDL cholesterol is just one of many independent risk factors for cardiovascular disease. It is also associated with metabolic syndrome, oxidative stress, and fatty liver.

HDL functions to transport cholesterol from the peripheral tissues and vessel walls to the liver for processing and metabolism into bile salts. It is known as “good cholesterol” because it is thought that this process of bringing cholesterol from the peripheral tissue to the liver is protective against atherosclerosis. Decreased HDL is considered atherogenic, increased HDL is considered protective. 

Non-HDL cholesterol represents the circulating cholesterol that is not carried by HDL (the protective carrier that collects cholesterol from tissues and blood vessels and transports it back to the liver). An elevated Non-HDL Cholesterol is associated with an increase risk of cardiovascular disease and related events.

The Triglyceride:HDL ratio is determined from serum triglyceride and HDL levels. Increased ratios are associated with increased cardiovascular risk and an increased risk of developing insulin resistance and Type II Diabetes. A decreased ratio is associated with decreased cardiovascular risk and a decreased risk of developing insulin resistance and Type II Diabetes.

VLDL is a lipoprotein formed in the liver to transport endogenous triglycerides, phospholipids, protein, and cholesterol. It serves, from a functional perspective, as an internal lipid transport molecule, moving triglyceride and other lipids from one area of the body to another.

Lipoprotein (a) or Lp(a) is a small dense lipoprotein that carries cholesterol in the blood.Increased blood levels of Lp(a) may be a strong indicator of early cardiovascular disease.There are no known negative effects of levels of Lp(a) at the lower end of the normal reference range. Some individuals may have no detectable Lp(a) in their blood. 

Apolipoprotein A-1 is the major component of HDL Cholesterol. Evaluation of Apo A-1 levels can help determine cardiovascular risk in those with reduced levels of HDL, increased cholesterol and increased triglycerides. Elevated levels of Apolipoprotein A1 are predictive of a lowered incidence of cardiovascular disease.

Apolipoprotein B (also called Apolipoprotein B-100) is a protein constituent of lipoproteins such as VLDL and LDL.

T-4 is the major hormone secreted by the thyroid gland. T-4 production and secretion from the thyroid gland are stimulated by the pituitary hormone TSH. Deficiencies of zinc, copper, and vitamins A, B2, B3, B6 and C will cause a decrease in production of T4 by the follicles of the thyroid gland. Most of the T4 in the blood is in the bound form, i.e. bound to proteins in the blood such as thyroid binding globulin.

Free T-4 is the unbound form of T4 in the body. Only about 0.03 – 0.05% of circulating T4 is in the free form. Free T-4 will be elevated in hyperthyroidism and decreased in hypothyroidism.

T-3 is the most active thyroid hormone and is primarily produced from the conversion of thyroxine (T-4) in the peripheral tissue. T-3 is 4 -5 times more metabolically active than T-4. Total T3 reflects the total amount of T3 present in the blood i.e. amount bound to protein and free levels.

T-3 is the most active thyroid hormone and is primarily produced from the conversion of thyroxine (T-4) in the peripheral tissue. Free T3 is the unbound form of T3 measured in the blood. Free T3 represents approximately 10% of circulating T3 in the blood. Free T-3 levels may be elevated with hyperthyroidism and decreased with hypothyroidism.

The T-3 uptake test has nothing to do with actual T-3 levels, as the name might suggest. Increased levels are associated with hyperthyroidism and people on thyroid hormone. Decreased levels are associated with hypothyroidism and deficiencies of iodine and selenium.

The Free Thyroxine Index is a calculated measurement used to determine how much active thyroid hormone (thyroxine/Free T4) is available.

Reverse T-3 is formed from the thyroid hormone T-4 (thyroxine). It is thought to be an inactive form of thyroid hormone that acts as a sort of metabolic brake on the body. High stress and cortisol levels, chronic illness, inflammation, multiple vitamin deficiencies, fasting, yo-yo dieting, poor nutrition, calorie restriction, lack of exercise, and increased alcohol intake can all raise reverse T-3 levels.

The Free T3 to Reverse T3 is used to determine whether there are issues with thyroid hormone conversion. A high or optimal ratio of Free T3 to Reverse T3 isn’t considered clinically significant. A low Free T3 to Reverse T3 is a sign of Thyroid Hormone Conversion Syndrome, a situation where the peripheral conversion of T4 into the more metabolically active T3 is decreased.

Measuring Free T3 (FT3) and Free T4 (FT4) helps assess how much free and active thyroid hormone is available for use. Calculating the ratio of FT3 to FT4 can provide further information about the current thyroid status.

High Sensitivity C-Reactive Protein (Hs-CRP) is a blood marker that can help indicate the level of chronic inflammation in the body. Increased levels are associated with an increased risk of inflammation, cardiovascular disease, stroke, and diabetes.

Homocysteine is a molecule formed from the incomplete metabolism of the amino acid methionine. Deficiencies in Vitamins B6, B12, and folate cause methionine to be converted into homocysteine. Homocysteine increases the risk of cardiovascular disease by causing damage to the endothelial lining of the arteries, especially in the heart. Increased levels of homocysteine are associated with an increased risk of cardiovascular disease and stroke, as well as cancer, depression, and inflammatory bowel disease.Decreased levels of homocysteine are associated with a decrease in the body;s detoxification capacity and an increased risk of oxidative stress. 

The ESR test is based on the fact that certain blood proteins will become altered in inflammatory conditions, causing aggregation of the red blood cells and as such it is a non-specific measure for inflammation in the body. The ESR is useful for determining the level of tissue destruction, inflammation, and is an indication that a disease process is ongoing and must be investigated. 

C-Reactive Protein is a blood marker that can help indicate the level of inflammation in the body. 

Folate functions as a coenzyme in the process of methylation. Along with vitamin B12, folate is essential for DNA synthesis. Low folate intake can result in folate deficiency, which can impair methylation, DNA synthesis, and red blood cell production.

Vitamin B12 is an essential nutrient for DNA synthesis and red blood cell maturation and is also necessary for myelin sheath formation and the maintenance of nerves in the body. Decreased serum B12 levels are associated with a deficiency of B12, insufficient B12 intake in the diet, or malabsorption.

Serum calcium levels, are primarily regulated by parathyroid hormone (PTH) and vitamin D. A low calcium level indicates that calcium regulation is out of balance and not necessarily that the body is deficient of calcium and needs supplementation. Other potential imbalances would need to be investigated – ie Vitamin D, hypochlorhydria, mineral need as a few examples before supplementing. 

Phosphorous levels are regulated by parathyroid hormone (PTH). Plasma levels may be decreased after a high carbohydrate meal or in people with a diet high in refined carbohydrates. Serum phosphorous is a general marker for digestion. Decreased phosphorous levels are associated with hypochlorhydria. 

Magnesium is important for many different enzymatic reactions, including carbohydrate metabolism, protein synthesis, nucleic acid synthesis, and muscular contraction. Magnesium is also needed for energy production and is used by the body in the blood clotting mechanism. An increased serum magnesium is associated with kidney dysfunction and thyroid hypofunction. A decreased magnesium is a common finding with muscle cramps. 

Zinc is a trace mineral that participates in a significant number of metabolic functions and is found throughout the body’s tissues and fluids. Low levels of serum zinc are associated with zinc deficiency. Elevated levels of serum zinc are often seen in people supplementing with zinc. 

The Calcium:Albumin ratio is determined from serum calcium and albumin levels. Elevated levels can be a sign of protein deficiency or protein loss. Decreased levels could indicate a calcium and/or vitamin D insufficiency. 

The Calcium:Phosphorus ratio is determined from the serum calcium and serum phosphorus levels. This ratio is maintained by the parathyroid glands and is also affected by various foods. Foods high in phosphorus and low in calcium tend to disrupt the balance and shift the body toward metabolic acidity, depleting calcium and other minerals and increasing inflammation.