Complex Wellness Panel

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CMP14 | CBC w/ Diff. | Lipid Panel | LDH | GGT | Iron & TIBC | Uric Acid | Phosphorus | TSH | Free T3 | Free T4 | Total T4 | Reverse T3 | T3 Total | T3 Uptake | Thyroglobulin Ab | Thyroid Peroxidase (TPO) Ab | C-Reactive Protein, hs | Homocysteine | Insulin | Hemoglobin A1c | Fibrinogen | Ferritin | Vitamin D-25 Hydroxy | Urinalysis

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Blood Test Panel

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C-Reactive Protein, hs (CRP, hs)

C-reactive protein (CRP) is something that the liver makes when there is inflammation.    It can be caused by a lot of different things, like arthritis, cancer, an infection, etc. .   High CRP levels can also mean that your heart’s arteries have inflammation, which can make you more likely to have a heart attack.

The CRP test is very broad, though, and does not pinpoint the cause of the inflammation; it just measures the presence of it.  

It’s important to know that a high-sensitivity C-reactive protein (hs-CRP) test is a little different from a regular C-reaction protein test.   The regular C-reactive test measures high levels of protein, which can help find diseases that cause inflammation. The hs-CRP test measures lower levels of protein, which are still high, and can show the risk of heart disease and stroke.

The Centers for Disease Control and Prevention (CDC) believes that the following are major risk factors for heart disease.

CBC w/ Diff.

A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood, especially red blood cells, white blood cells and platelets. This panel of tests looks for many illnesses, including anemia, infections, and leukemia, in your blood.


 The Comprehensive Metabolic Panel (CMP) test checks your blood for 14 different substances. It checks the balance of chemicals in your body and your metabolism, which is how your body turns food into energy. CMP is used to check how well organs are working and find diseases like diabetes, liver disease, and kidney disease. The CMP may also be ordered to keep an eye on conditions like high blood pressure and to check on people who are taking medicine for any side effects that might affect the kidneys or liver.

 A CMP checks your blood for the following things:

  •  Glucose:  Glucose is a kind of sugar that gives your body and brain energy. Blood sugar is another name for glucose. High blood glucose when you wake up is often a sign of Type 2 diabetes. Having Type 1 diabetes is usually a sign of very high glucose levels, whether you are fasting or not.
  •  Calcium: Calcium is one of your body’s most important and most common minerals. Most of the calcium in your body is in your bones, but you also need calcium in your blood. Calcium in your blood is important for the health of your nerves, muscles, and heart.
  •  Total protein: This is a measurement of the total amount of proteins in your blood, including albumin and globulins.
  •  Bilirubin: This is a waste product made when red blood cells break down. It is up to your liver to get rid of bilirubin from your body.
  •  BUN (blood urea nitrogen): This is a measurement of urea nitrogen, which is a waste product that your kidneys help get rid of from your blood.
  •  Creatinine: This is a waste product made when your muscles work. It is a waste product that your kidneys take out of your blood by filtering it.
  •  Albumin: Your liver makes this protein. It moves important things through your bloodstream and keeps your blood vessels from leaking fluid.

 A CMP also measures four electrolytes. Electrolytes are minerals that, when dissolved in a liquid, carry an electric charge. These electrolytes in your blood control how your nerves and muscles work. They also keep your blood’s acid-base balance (pH balance) and water balance in check.

  • Sodium: Most of the sodium in your body comes from the food you eat. Your kidneys help control how much sodium is in your body.
  • Potassium: You get potassium from the food you eat, and it is in all of your body’s tissues.
  • Bicarbonate: The amount of carbon dioxide (CO2) in your blood is shown by the amount of bicarbonate in your blood.
  • Chloride: Chloride works with sodium, potassium, and bicarbonate to control many of your body’s processes.

A CMP also checks for the three enzymes below in the liver. Enzymes are substances that speed up the way that some body processes work.

  • Alkaline phosphatase (ALP).
  • Alanine transaminase (ALT).
  • Aspartate aminotransferase (AST).

What does a complete metabolic panel do?

With a comprehensive metabolic panel (CMP), you can find out a lot about your health as a whole. With 14 different measurements, it can check a number of body processes and functions, such as:

  • The health of your liver and kidneys.
  • How much sugar is in your blood.
  • Your blood has the right amount of acid and base.
  • The balance of fluids and salts in your body.

Why do I need a comprehensive metabolic panel?

A comprehensive metabolic panel (CMP) can be helpful in a number of situations, especially if you have signs of problems with your kidneys, liver, or metabolism.  If you have a general symptom, like feeling tired, a CMP measures several important parts of your blood and can help find or rule out some causes of a common symptom.

What’s the difference between a basic metabolic panel and a full metabolic panel?

A basic metabolic panel (BMP) has eight of the 14 tests in a comprehensive metabolic panel (CMP). The liver enzyme and protein tests are not part of a BMP. Depending on your health history and needs, your doctor may have you go through a CMP or a BMP.


The ferritin test is used to evaluate an individual’s iron levels in the body. Ferritin is often paired with an iron test and also a TIBC test. Ferritin levels correlate with and are useful in evaluation of total body storage iron. From this test you will be able to identify if you are deficient or high in iron levels.


A fibrinogen test, or Factor 1 Activity test, checks how much of the protein called fibrinogen is in your blood. Your liver makes fibrinogen, which helps your blood clot.  

If you don’t have enough fibrinogen, it might be hard for your blood to clot.  If your fibrinogen levels are higher or lower than usual, it could indicate problems with how your blood clots, a fibrinogen deficiency, or uneven fibrinolysis, which is the process by which your body breaks up blood clots that shouldn’t form.

A fibrinogen test can help if you have signs like: 

  • Bleeding in your digestive system.
  • You have blood in your pee or poop.
  • Spitting blood.
  • Too many bruises.
  • Frequent nosebleeds.
  • Ruptured spleen.

* Trouble stopping bleeding or excessive bleeding when cut.

* When you’ve received unusual or abnormal results from a blood clot test, such as a Prothombin time test (PT) or Activated Partial Thromboplastin Time (APTT). 

  • Signs of problems with how the blood clots.
  • Signs of disseminated intravascular coagulation, a serious problem with blood clotting.
  • Signs of genetic diseases that make it hard for the blood to clot.
  • Recurrent pregnancy loss.

There are a few different kinds of fibrinogen shortages:

  • Afibrinogenemia, which is when your blood doesn’t have any fibrinogen. This disorder is very rare; only one person in every million has it.

Hypofibrinogenemia is when your fibrinogen levels are too low. Hypofibrinogenemia is more common than afibrinogenemia. Experts don’t know exactly how many people have it, but they do know that it’s more common.

  • Dysfibrinogenemia, which is when your fibrinogen levels are normal but fibrinogen doesn’t work right. Some people with dysfibrinogenemia don’t have any symptoms, so it’s hard to know how many people have it. However, it’s more common than afibrinogenemia.

Free T3

Free T3 (free triiodothyronine) is used to evaluate thyroid function and also in the assessment of abnormal binding protein disorders.  Measurement of Free T3 is valuable in confirming the diagnosis of hyperthyroidism, when an elevated free or total thyroxine level is found. Abnormal total and free triiodothyronine concentrations may appear in T3 toxicosis, in the presence of normal thyroxine levels. The levels of free T3 are unaffected by carrier protein variation.

Free T4

Free (Thyroxine) T4 can sometimes be indicated when binding globulin (TBG) problems are perceived, or when conventional test results appear inconsistent with clinical observations. It is common in subjects with high thyroxine-binding globulin hormone binding who are euthyroid (ie, free thyroxine should be normal in non-thyroidal diseases). It should appear normal in familial dysalbuminemic hyperthyroxinemia.


Gamma-glutamyl transferase (GGT) is used to determine why a patient would have elevated levels of alkaline phosphatase or also known as ALP. This test would be recommended for any patients with disease associated with the bile duct, and also for patients who have liver or bone disease.

Hemoglobin A1c (HgA1c )

The hemoglobin A1c test tells you how much average sugar has been in your blood over the past 2 to 3 months. It is also called HbA1c, the glycated hemoglobin test, and glycohemoglobin. 

This test is kind of like a baseball player’s batting average for the season. One game doesn’t tell you how well a player is doing over the course of their career, and one day’s test results don’t show you how well your body is working as a whole. But because this test is often used to find out if someone has diabetes, people with diabetes need to check this number often to make sure their levels stay in the normal range. It can tell you if you need to change your diabetes medicines or the way you control your blood sugar.

How the Test Works:

Red blood cells have a protein called hemoglobin. It’s what makes your blood red, and its job is to carry oxygen all over your body.

Glucose is the name for the sugar in your blood. When glucose builds up in your blood, it sticks to the hemoglobin in your red blood cells. The A1c test is used to find out how much glucose is bound.

Since red blood cells only live for about 3 months, the test shows how much glucose has been in your blood on average over the past 3 months.

If your glucose levels have been high for the past few weeks, your hemoglobin A1c test will be higher.

Your levels can go down with a combination of diet, exercise, getting rid of toxins, and medicine.

Every 3 months, people with diabetes should get an A1c test to make sure their blood sugar is in the right range. If you have good control of your diabetes, you may be able to go longer between blood tests, but experts say you should still check at least twice a year.

If you have a disease that affects your hemoglobin, like anemia, this test may give you misleading information. Some supplements, high cholesterol, kidney disease, and liver disease are other things that can impact the results of the hemoglobin A1c test.


Homocysteine is an amino acid that is produced by the body by chemically altering adenosine. It may be used to evaluate heart function, vitamin B levels, folate levels, renal (kidney) function or enzyme activities, and those with a history of heart disease or stroke.
High homocysteine levels can directly damage the delicate endothelial cells that line the inside of arteries, resulting in vascular inflammation, arterial plaque rupture, and blood clot formation.
Symptoms that qualify a patient to have a homocysteine test include but are not limited to:

  • Fatigue
  • Weakness
  • Diarrhea
  • Dizziness
  • Rapid heart rate
  • Sore mouth/tongue
  • Discomfort in the arms, feet, hands, or legs
  • Loss of appetite

Individuals who have recently experienced a stroke or heart attack may want this test to assess risk of cardiovascular disease, inflammation, or disorder.


Insulin is used to diagnose an insulin-producing tumor and verify that the removal of the tumor has been successful.  It can also be used to diagnose hypoglycemia, insulin resistance, and can be paired with a C-peptides test to determine levels of insulin being produced in the body, and levels of insulin coming from an outside source such as insulin injections.

Iron & TIBC

Iron & TIBC is used to aid in the evaluation of a number of conditions involved with red cell production and destruction, iron transport, or iron metabolism.


The LDH test is used to evaluate and monitor a number of different diseases and conditions including acute or chronic tissue damage, and different forms of anemia or severe infection. The LDH test can also help stage and monitor treatment such as chemotherapy for several different forms of cancers and germ cell tumors.

Lipid Panel

The lipid panel is used to guide practitioners regarding what treatment is best for patients who have borderline or high risk of heart disease. HDL particles are involved in the process of removing excess cholesterol and transporting it to the liver for removal. LDL particles deposits extra cholesterol in the walls of blood vessels. Because of this, HDL particles are known as “good cholesterol” and LDL particles are known as “bad cholesterol”.


Primary hyperparathyroidism and other causes of calcium elevation, including ectopic hyperparathyroidism (pseudohyperparathyroidism).
The signs and symptoms of phosphate depletion may include neuromuscular, neuropsychiatric, gastrointestinal, skeletal, and cardiopulmonary systems. Manifestations usually are accompanied by serum levels <1.0 mg/dL.

Reverse T3

Reverse T3 is a biologically inactive form of T3. When T4 is converted to T3 in the body, a certain percentage of the T3 is in the form of RT3. When the body is under stress, thyroid hormone levels may be outside of normal ranges even though there is no thyroid disease present. RT3 may be elevated in non-thyroidal conditions, particularly the stress of illness.

T3 Total

T3 Total (Triiodothyronine) is needed in patients who have clinical evidence for hyperthyroidism, in whom the usual thyroid profile result is reported as normal or borderline. The T3 Total test is recommended for patients with supraventricular tachycardia, for patients with fatigue and weight loss not otherwise explained, or for patients with proximal myopathy who also have T4 levels that are not elevated.

T3 Uptake

T3 Uptake is a thyroid function test for the diagnosis of hypothyroidism or hyperthyroidism, used with thyroxine (T4) or equivalent to provide free T4 index, (FTI). An indirect measure of binding protein, the T3 uptake shows available binding sites (ie, reflects TBG). T3 uptake is not a measurement of T3 serum. T3 Uptake should never be used alone due to the fact that its usual application is use with thyroxine (T4).

Thyroglobulin Ab

Thyroglobulin Ab is primarily used to detect and confirm autoimmune thyroiditis, Hashimoto thyroiditis.

Total T4

Total T4 is a thyroid function test. Total T4 is decreased in hypothyroidism and in the third stage of (painful) subacute thyroiditis. It is increased with hyperthyroidism, with subacute thyroiditis in its first stage and with thyrotoxicosis caused by Hashimoto disease.  Total T4 is also used to diagnose T4 toxicosis.


TSH (thyroid stimulating hormone) is the most common test used to evaluate thyroid function and symptoms related to a thyroid disorder such as hyperthyroidism, or hypothyroidism.  Produced by the pituitary gland, the primary role of TSH in the body is to stabilize amounts of T4 (thyroxine) and T3 (triiodothyronine) in the blood.  This process controls how much energy the body burns.
The TSH test is often ordered to:

  • Diagnose thyroid disorders
  • Check for under active thyroid in newborn children
  • Evaluate thyroid replacement therapy
  • Evaluate anti-thyroid treatment
  • Screen adults for thyroid disorders

The TSH test is often ordered with a free T4 test, free T3 test, and/or thyroid antibodies.  These tests can be ordered together in a panel called a thyroid panel.
Symptoms related to hyperthyroidism include anxiety, weight loss, shaking, weakness, sensitivity to light, or eye problems (swollen eyes, irritation/dryness).
Symptoms related to hypothyroidism include swollen skin, tiredness/fatigue, hair loss, weight gain, dry skin, or irregularity with menstruation in women.
Individuals who are being treated for a thyroid disorder often have the TSH test ordered at regular intervals. It is also ordered when an individual has an adjustment in their thyroid medication.  The American Thyroid Association recommends that patients wait 6-8 weeks after adjusting medication before they retest thyroid stimulating hormone levels.

Uric Acid

The uric acid blood test is used to detect high levels of this compound in the blood in order to help diagnose gout. The test is also used to monitor uric acid levels in people undergoing chemotherapy or radiation treatment for cancer. Rapid cell turnover from such treatment can result in an increased uric acid level. The uric acid blood test is ordered when a health care provider suspects that someone has a high uric acid level. Some people with high levels of uric acid have a disease called gout, which is a common form of arthritis. People with gout suffer from joint pain, most often in their toes, but in other joints as well. The test is also ordered to monitor cancer patients undergoing chemotherapy or radiation therapy, to ensure that uric acid levels do not get dangerously high.


How does a urinalysis work?

A urinalysis, which is also called a urine test, looks at the color, smell, and microscopic structure of your urine (pee). It can include a number of tests that use a single sample of urine to find and measure different chemicals in your urine.

Urinalysis is often used to check for or keep an eye on liver disease, kidney disease, diabetes, and urinary tract infections, as well as to diagnose urinary tract infections (UTIs).

What kinds of tests are done on a urine sample?

In general, a doctor or lab worker can look at a urinalysis urine sample for the following general things:

  • Color and appearance 
  • Findings in chemistry
  • Results via a microscope

First, a health care provider will look at how a sample of urine looks to the “naked eye.” They look to see if it’s clear or cloudy and if it’s light yellow, dark yellow, or a different color.   Normal urine is usually some shade of yellow. It can be clear or pale yellow, or it can be a deep amber color, depending on how concentrated or watery your urine is.

Some medicines and supplements you take, as well as some foods you eat, like beets, can change the color of your urine. But a disease can also be shown by urine that is a strange color. For example, if there is blood in your urine, it will be red. This can be a sign of a disease or damage to a part of your urinary system.

Cloudy urine doesn’t always mean that the urine isn’t healthy. For instance, sperm and skin cells don’t hurt you, but they can make your urine look cloudy. Other things, like red blood cells, white blood cells, and bacteria, can also make your urine cloudy. This could be a sign of a number of health problems, such as:

  • Dehydration.
  • Infection of the urinary tract (UTI).
  • Diseases and infections spread through sexual contact (STDs and STIs).
  • Uterine stones.
  • Diabetes.
  • In a urinalysis, a dipstick is often used for the following types of tests:

Protein urine test: A protein urine test looks for proteins in your urine, like albumin. Higher-than-normal protein levels in the urine could be a sign of heart failure, kidney problems, or even being dehydrated.

The acid-base (pH) level in your urine is measured by a urine pH test. A high urine pH could mean that you have kidney problems or a urinary tract infection (UTI). A low urine pH could be a sign of ketoacidosis or diarrhea, both of which can be caused by diabetes.

Ketones are found in your urine when your body breaks down fats and fatty acids to use as fuel. This is most likely to happen if your body doesn’t get enough sugar or carbs to use as fuel.

Glucose urine test: This test checks how much sugar (glucose) is in your urine. Glucose shouldn’t be in your urine under normal circumstances, so if it is, it could be a sign of diabetes or gestational diabetes.

Bilirubin is a yellowish pigment that is found in bile, a fluid made by your liver. It can be found in your urine. If you have bilirubin in your urine, it could mean that something is wrong with your liver or bile ducts.

Nitrite urine test: A urinary tract infection can be shown by a positive result on a nitrite test (UTI). But not all bacteria can change nitrate (a normal part of urine) into nitrite, so you can still have a UTI even if a nitrite test comes back negative.

Leukocyte esterase urine test: Most white blood cells have an enzyme called leukocyte esterase. If this test comes back positive, it could mean that there is inflammation in your kidneys or urinary tract. Most of the time, white blood cells in urine are caused by a bacterial infection in the urinary tract (UTI).

A specific gravity test for urine: A specific gravity test shows how much of each chemical in your urine there is. Abnormal results could mean a number of different health problems.

Urine microscopic findings

A lab worker may look at a sample of urine through a microscope to find tiny things in the urine, such as:

  • Cells.
  • Cell fragments.
  • Casts of urine
  • Mucus.
  • Bacteria and other germs.
  • Crystals.

Red blood cell (RBC) urine test: If you have a lot of RBCs in your urine, that means you have blood in it. But this test can’t find out where the blood came from. For example, blood from hemorrhoids or bleeding in the vaginal area can’t be told apart from a bleed in the urinary system. Red blood cells in your urine that are higher than normal may be a sign of problems with your bladder, kidneys, or urinary tract.

Urine test for white blood cells (WBC): If you have a lot of WBCs or a positive test for leukocyte esterase, it could mean that you have an infection or inflammation in your urinary tract.

Epithelial cells are the cells that cover the inside and outside of your body, as well as the inside of body cavities and hollow organs. Epithelial cells line your urinary tract. Some epithelial cells in your urine are normal, but if there are a lot of them, it could mean you have an infection, inflammation, or cancer in your urinary tract.

Bacteria, yeast, and parasites: Bacteria can sometimes get into your urethra and urinary tract and cause an infection (UTI). Bacteria, yeast, and parasites can also get into the urine sample, especially if the person has a vagina. People with a yeast infection in their vaginal area may have yeast in their sample. Trichomonas vaginalis is a parasite that can sometimes be found in the urine of women. It’s what causes trichomoniasis, an STD.

Casts of urine: Casts are small pieces that look like tubes and can sometimes be found in your urine. They are made from the protein that your kidney cells give off. Some types of casts may be a sign of a problem with the kidneys, while others are perfectly normal.

How are urinalysis and a urine culture different?

In order to diagnose urinary tract infections and other infections, bacteria from a urine sample are grown in a lab. Normal urinalysis tests don’t look at urine cultures. Like a urinalysis, a urine culture sample must be taken using the clean catch method or by putting a catheter through the urethra into the bladder.

If your urinalysis shows that you may have a UTI, your doctor may order a urine culture, which is a test that a lab will run on the urine sample you gave for the first urinalysis. With a urine culture, the type of bacteria that caused the UTI can be found out.

Vitamin D-25 Hydroxy

Vitamin D-25 Hydroxy is ordered when an individual has low calcium and/or symptoms of vitamin D deficiency. This can appear as bone weakness/softness, or fractures in adults, or as rickets (bone malformation) in children.
The vitamin D test is for individuals at high risk of deficiency. It is used to monitor diseases that interfere with fat absorption. These diseases include cystic fibrosis or Crohn disease. This test also monitors the effectiveness of Vitamin D-25 Hydroxy, calcium, magnesium or phosphorus supplementation.
Individuals at risk of vitamin D deficiency include: older adults, individuals who have limited exposure to sunlight, individuals who are obese, or who have fat malabsorption.
Low levels of D-25 hydroxy are one of the earliest changes that show in individuals with early kidney failure.  People with kidney disease also show low levels.

High levels of D-25 hydroxy show due to diseases that can make Vitamin D-25 Hydroxy outside of the kidneys. The two primary diseases related to this are sarcoidosis or certain lymphomas.

Long term high levels of vitamin D can eventually lead to the damage of certain organs such as the kidneys and blood vessels via calcification.  If magnesium levels are low, a physician may supplement both magnesium and calcium in order to eliminate a low calcium level that is resistant to Vitamin D-25 Hydroxy.

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