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Advanced Anemia Profile

Anemia

77 parameters

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Report in 12Hrs

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At Home

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Fasting Required

Details

Extended anemia panel (iron, ferritin, B12, folate).

₹2,899₹3,999

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Parameters

  • List of Tests
    • Calcium
    • Alkaline Phosphatase
    • SGOT
    • SGPT
    • Uric Acid
    • Ferritin
    • Folic Acid
    • Vitamin B12
    • BUN
    • Creatinine
    • BUN/Creatinine
    • GGT
    • Iron
    • TIBC
    • Transferrin
    • Bilirubin - Total
    • Bilirubin - Indirect
    • Bilirubin - Direct
    • Total Cholesterol
    • HDL
    • LDL
    • VLDL
    • Triglycerides
    • Cholesterol/HDL
    • LDL/HDL
    • Non-HDL
    • Total Protein
    • Albumin
    • Globulin
    • A/G Ratio
    • Total T3
    • Total T4
    • TSH
    • HbA1c
    • Estimated Average Glucose
    • CBC - Complete Hemogram
    • Sodium
    • Potassium
    • Chloride
    • LDH Serum
    • Vitamin D 25 OH
    • Arsenic
    • Cadmium
    • Chromium
    • Cobalt
    • Lead
    • Mercury
    • Selenium
    • Barium
    • Caesium

Advanced Anemia Profile

  • Why is it done?
    • Comprehensive evaluation of anemia by assessing hemoglobin, hematocrit, red blood cell indices, and determining the type and severity of anemia through CBC analysis
    • Investigation of iron metabolism disorders including iron deficiency anemia through iron studies (Iron, TIBC, Transferrin, and Ferritin)
    • Detection of Vitamin B12 and Folic Acid deficiencies, which are common causes of megaloblastic anemia and neurological complications
    • Assessment of liver function (SGOT, SGPT, GGT, Bilirubin, LDH) to identify hepatic causes of anemia and hemolytic disorders
    • Evaluation of kidney function (BUN, Creatinine, BUN/Creatinine ratio) since chronic kidney disease is a major cause of anemia due to decreased erythropoietin production
    • Assessment of nutritional status and metabolic factors through Vitamin D, Thyroid Profile, and protein metabolism studies
    • Screening for toxic element exposure (Lead, Mercury, Cadmium, Arsenic, etc.) that may impair bone marrow function and cause anemia
    • Investigation of metabolic disorders including diabetes (HbA1c), thyroid dysfunction, and electrolyte imbalances that may contribute to anemia
    • Assessment of bone health and calcium metabolism which influences red blood cell production and function
    • Evaluation of lipid profile to assess cardiovascular risk in anemic patients and identify metabolic complications
    • Diagnosis of hemolytic anemia through assessment of bilirubin, LDH, and electrolyte abnormalities
    • Monitoring patients with chronic diseases, malabsorption syndromes, autoimmune conditions, and those on medications affecting hematopoiesis
  • Normal Range
    • Calcium (Total): 8.5-10.5 mg/dL (2.1-2.6 mmol/L); Ionized Calcium: 4.5-5.3 mg/dL (1.1-1.3 mmol/L)
    • Alkaline Phosphatase: 30-120 IU/L (varies by age and gender; higher in children and postmenopausal women)
    • SGOT (Aspartate Aminotransferase): 10-40 IU/L or 0.17-0.68 µkat/L
    • SGPT (Alanine Aminotransferase): 7-56 IU/L or 0.12-0.95 µkat/L
    • Uric Acid: Male 3.5-7.2 mg/dL (0.21-0.43 mmol/L); Female 2.6-6.0 mg/dL (0.16-0.36 mmol/L)
    • Ferritin: Male 24-336 ng/mL; Female 11-307 ng/mL (or 11-122 ng/mL in some labs; varies by age and menstrual status)
    • Folic Acid (Folate): 2.7-17 ng/mL or >5.4 ng/mL (>12 nmol/L considered normal)
    • Vitamin B12: 200-900 pg/mL or 150-650 pmol/L (levels >400 pg/mL considered normal; 200-400 pg/mL is borderline)
    • BUN (Blood Urea Nitrogen): 7-20 mg/dL or 2.5-7.1 mmol/L
    • Creatinine: Male 0.7-1.3 mg/dL (62-115 µmol/L); Female 0.6-1.1 mg/dL (53-97 µmol/L)
    • BUN/Creatinine Ratio: 10:1 to 20:1 (normal ratio indicates proper kidney function)
    • GGT (Gamma-Glutamyl Transferase): Male 0-65 IU/L; Female 0-45 IU/L
    • Iron (Serum): Male 60-170 µg/dL (11-30 µmol/L); Female 50-150 µg/dL (9-27 µmol/L)
    • TIBC (Total Iron Binding Capacity): 250-425 µg/dL (45-76 µmol/L)
    • Transferrin: 200-360 mg/dL (2.0-3.6 g/L)
    • Bilirubin (Total): 0.1-1.2 mg/dL (1.7-20.5 µmol/L)
    • Bilirubin (Direct/Conjugated): 0.0-0.3 mg/dL (0-5 µmol/L)
    • Bilirubin (Indirect/Unconjugated): 0.1-1.0 mg/dL (1.7-17 µmol/L)
    • Total Cholesterol: <200 mg/dL (<5.2 mmol/L) - Desirable
    • HDL (High-Density Lipoprotein): >40 mg/dL in men (>1.0 mmol/L); >50 mg/dL in women (>1.3 mmol/L) - Desirable
    • LDL (Low-Density Lipoprotein): <100 mg/dL (<2.6 mmol/L) - Optimal
    • VLDL (Very Low-Density Lipoprotein): <30 mg/dL (<0.8 mmol/L)
    • Triglycerides: <150 mg/dL (<1.7 mmol/L) - Normal
    • Total Protein: 6.0-8.3 g/dL (60-83 g/L)
    • Albumin: 3.5-5.5 g/dL (35-55 g/L)
    • Globulin: 2.3-3.5 g/dL (23-35 g/L)
    • Albumin/Globulin (A/G) Ratio: 1.0-2.5 (normal indicates proper protein metabolism)
    • Total T3 (Triiodothyronine): 80-200 ng/dL (1.2-3.1 nmol/L)
    • Total T4 (Thyroxine): 5.0-12.0 µg/dL (64-154 nmol/L)
    • TSH (Thyroid Stimulating Hormone): 0.4-4.0 mIU/L (0.4-4.0 mIU/mL)
    • HbA1c (Glycated Hemoglobin): <5.7% - Normal; 5.7-6.4% - Prediabetes; ≥6.5% - Diabetes
    • Estimated Average Glucose (eAG): <100 mg/dL - Normal; 100-125 mg/dL - Prediabetes; ≥126 mg/dL - Diabetes
    • CBC (Complete Blood Count) - Hemoglobin: Male 13.5-17.5 g/dL (135-175 g/L); Female 12.0-15.5 g/dL (120-155 g/L)
    • CBC - Hematocrit: Male 41-53% (0.41-0.53); Female 36-46% (0.36-0.46)
    • CBC - RBC (Red Blood Cells): Male 4.5-5.9 × 10^6/µL (4.5-5.9 × 10^12/L); Female 4.1-5.1 × 10^6/µL (4.1-5.1 × 10^12/L)
    • CBC - MCV (Mean Corpuscular Volume): 80-100 fL - Normocytic (indicates RBC size)
    • CBC - MCH (Mean Corpuscular Hemoglobin): 27-33 pg - Normal
    • CBC - MCHC (Mean Corpuscular Hemoglobin Concentration): 32-36 g/dL - Normal
    • CBC - WBC (White Blood Cells): 4.5-11.0 × 10^3/µL (4.5-11.0 × 10^9/L)
    • CBC - Platelet Count: 150-400 × 10^3/µL (150-400 × 10^9/L)
    • CBC - RDW (Red Cell Distribution Width): 11.5-14.5% - Normal (indicates RBC size variation)
    • CBC - Reticulocyte Count: 0.5-2.5% of total RBC - Normal
    • Sodium (Na): 136-145 mEq/L (136-145 mmol/L)
    • Potassium (K): 3.5-5.0 mEq/L (3.5-5.0 mmol/L)
    • Chloride (Cl): 98-107 mEq/L (98-107 mmol/L)
    • LDH (Lactate Dehydrogenase): 140-280 IU/L (2.4-4.8 µkat/L)
    • Vitamin D (25-OH): 30-100 ng/mL (75-250 nmol/L) - Sufficient; <20 ng/mL indicates deficiency
    • Arsenic: <50 µg/L (normal; levels vary by exposure)
    • Cadmium: <2.0 µg/L (lower in non-smokers)
    • Chromium: <10 µg/L (normal background levels)
    • Cobalt: <0.3 µg/L (normal levels)
    • Lead: <10 µg/dL in children; <15 µg/dL in adults (ideally <5 µg/dL)
    • Mercury: <1.0 µg/L (varies based on exposure source)
    • Selenium: 95-165 µg/L (normal range)
    • Barium: <10 µg/L (normal background exposure)
    • Caesium: <1.0 µg/L (minimal background levels)
  • Interpretation
    • Calcium - Elevated (>10.5 mg/dL) may indicate hyperparathyroidism, malignancy, or excessive vitamin D intake; Low (<8.5 mg/dL) suggests hypoparathyroidism, vitamin D deficiency, or chronic kidney disease
    • Alkaline Phosphatase - Elevated levels indicate bone disease, liver disease, or metabolic disorders; decreased levels are rare but may suggest hypophosphatasia
    • SGOT - Elevated levels (>40 IU/L) indicate liver damage, myocardial infarction, or muscle injury; the degree of elevation helps determine severity
    • SGPT - More specific for liver injury than SGOT; elevated levels (>56 IU/L) indicate hepatocellular damage, viral hepatitis, or cirrhosis
    • Uric Acid - Elevated (>7.2 mg/dL in males, >6.0 mg/dL in females) increases gout risk and kidney stone formation; low levels are uncommon and may indicate certain metabolic disorders
    • Ferritin - Elevated (>336 ng/mL in males, >307 ng/mL in females) indicates iron overload (hemochromatosis), inflammation, or malignancy; Low (<24 ng/mL in males, <11 ng/mL in females) suggests iron deficiency anemia
    • Folic Acid - Low levels (<2.7 ng/mL) cause megaloblastic anemia, neural tube defects in pregnancy, and neuropsychiatric symptoms; deficiency is common in alcoholics and those on certain medications
    • Vitamin B12 - Low levels (<200 pg/mL) cause pernicious anemia, neurological damage, and cognitive impairment; borderline levels (200-400 pg/mL) warrant clinical correlation; elevated levels are rare and may indicate liver disease or myeloproliferative disorders
    • BUN - Elevated (>20 mg/dL) indicates kidney dysfunction, dehydration, or increased protein catabolism; Low (<7 mg/dL) is uncommon and may suggest severe liver disease or malnutrition
    • Creatinine - Elevated levels indicate reduced glomerular filtration rate and kidney disease; progression of elevation correlates with severity of renal dysfunction
    • BUN/Creatinine Ratio >20:1 suggests prerenal azotemia (dehydration, shock); <10:1 suggests intrinsic renal disease; ratio helps differentiate cause of elevated BUN
    • GGT - Elevated levels indicate liver or biliary disease, alcohol abuse, or drug toxicity; not specific for any particular disease but highly sensitive for hepatobiliary dysfunction
    • Iron (Serum) - Low (<50-60 µg/dL) indicates iron deficiency anemia; elevated (>170 µg/dL in males, >150 µg/dL in females) suggests iron overload or hemolysis
    • TIBC - Elevated (>425 µg/dL) indicates iron deficiency as the body increases iron-binding capacity to capture available iron; Low (<250 µg/dL) suggests iron overload or chronic liver disease
    • Transferrin - Elevated indicates iron deficiency; decreased suggests iron overload or acute phase response
    • Bilirubin (Total) - Elevated (>1.2 mg/dL) indicates jaundice from hemolysis, liver disease, or biliary obstruction; clinical significance varies with indirect vs. direct ratio
    • Bilirubin (Direct) - Elevated indicates cholestasis (bile duct obstruction or liver disease); direct hyperbilirubinemia with normal alkaline phosphatase and aminotransferases suggests Dubin-Johnson or Rotor syndrome
    • Bilirubin (Indirect) - Elevated indicates hemolysis, ineffective erythropoiesis, or impaired conjugation; high indirect bilirubin with normal direct bilirubin suggests Gilbert's syndrome if <3 mg/dL
    • Total Cholesterol - >240 mg/dL is high risk for cardiovascular disease; 200-239 mg/dL is borderline; <200 mg/dL is desirable
    • HDL - High levels are protective against cardiovascular disease; low levels (<40 mg/dL in men, <50 mg/dL in women) increase cardiovascular risk
    • LDL - High levels (>130 mg/dL) increase cardiovascular risk; <100 mg/dL is optimal, especially in patients with existing coronary artery disease
    • Triglycerides - High levels (>200 mg/dL) increase cardiovascular risk and risk of acute pancreatitis; very high (>500 mg/dL) significantly increases pancreatitis risk
    • Total Protein - Low (<6.0 g/dL) indicates malnutrition, liver disease, or nephrotic syndrome; elevated (>8.3 g/dL) suggests dehydration or immunoproliferative disorders
    • Albumin - Low (<3.5 g/dL) indicates malnutrition, liver disease, nephrotic syndrome, or chronic inflammation; affects drug binding and colloid osmotic pressure
    • Globulin - Elevated suggests chronic infection, autoimmune disease, or malignancy; low levels are less clinically significant
    • A/G Ratio - Low (<1.0) indicates relatively elevated globulins suggesting chronic disease; high (>2.5) is less significant but may indicate severe liver disease
    • Total T3 - Low (<80 ng/dL) indicates hypothyroidism or sick euthyroid syndrome; elevated (>200 ng/dL) suggests hyperthyroidism or T3 toxicosis
    • Total T4 - Low (<5.0 µg/dL) indicates primary hypothyroidism if TSH is elevated; elevated (>12.0 µg/dL) suggests hyperthyroidism
    • TSH - Elevated (>4.0 mIU/L) indicates primary hypothyroidism; low (<0.4 mIU/L) suggests hyperthyroidism or secondary hypothyroidism; TSH is most sensitive screening test for thyroid dysfunction
    • HbA1c - Reflects average blood glucose over 2-3 months; values of 5.7-6.4% indicate prediabetes requiring intervention; ≥6.5% diagnoses diabetes
    • eAG - Provides glucose equivalent of HbA1c; helps patients understand average daily glucose; useful for monitoring glycemic control
    • Hemoglobin - Low (<13.5 g/dL in males, <12.0 g/dL in females) indicates anemia; elevated (>17.5 g/dL in males, >15.5 g/dL in females) suggests polycythemia or dehydration
    • Hematocrit - Low indicates anemia; elevated suggests polycythemia or hemoconcentration; proportional to hemoglobin
    • RBC Count - Low (<4.1 × 10^6/µL in females, <4.5 × 10^6/µL in males) indicates anemia; elevated suggests polycythemia or dehydration
    • MCV - <80 fL indicates microcytic anemia (iron deficiency, thalassemia); >100 fL indicates macrocytic anemia (B12/folate deficiency, reticulocytosis)
    • MCH - <27 pg indicates hypochromic (low hemoglobin per RBC); >33 pg indicates hyperchromic (rarely seen); helps classify anemia type
    • MCHC - <32 g/dL indicates hypochromic RBCs (iron deficiency); >36 g/dL is rare but may indicate cold agglutinins artifact
    • WBC - Low (<4.5 × 10^3/µL) indicates leukopenia (bone marrow disease, infections, medications); elevated (>11.0 × 10^3/µL) indicates leukocytosis (infection, leukemia, stress)
    • Platelets - Low (<150 × 10^3/µL) indicates thrombocytopenia (bleeding risk); elevated (>400 × 10^3/µL) indicates thrombocytosis (thrombotic risk)
    • RDW - Elevated (>14.5%) indicates increased RBC size variation suggesting anemia or hemolysis; normal RDW with anemia suggests acute bleeding or hemolysis
    • Reticulocyte Count - Elevated (>2.5%) indicates appropriate bone marrow response to anemia or hemolysis; low (<0.5%) with anemia suggests bone marrow failure
    • Sodium - Low (<136 mEq/L) indicates hyponatremia causing neurological symptoms; elevated (>145 mEq/L) indicates hypernatremia causing dehydration and altered mental status
    • Potassium - Low (<3.5 mEq/L) indicates hypokalemia causing muscle weakness and cardiac arrhythmias; elevated (>5.0 mEq/L) indicates hyperkalemia causing cardiac conduction abnormalities
    • Chloride - Low (<98 mEq/L) indicates hypochloremia; elevated (>107 mEq/L) indicates hyperchloremia; usually moves in parallel with sodium
    • LDH - Elevated indicates tissue damage (hemolysis, myocardial infarction, muscle injury, liver disease); LDH5 elevation suggests liver or muscle disease
    • Vitamin D - <20 ng/mL indicates deficiency causing rickets, osteomalacia, and impaired calcium absorption; 20-29 ng/mL is insufficient; 30-100 ng/mL is sufficient
    • Arsenic - Elevated levels (>50 µg/L) indicate toxic exposure causing peripheral neuropathy, skin changes, and increased cancer risk
    • Cadmium - Elevated levels (>2.0 µg/L) indicate toxic exposure causing kidney damage, bone disease, and anemia; smokers have higher levels
    • Chromium - Elevated levels indicate occupational or environmental exposure; can cause dermatitis and respiratory issues
    • Cobalt - Elevated levels indicate exposure from industrial sources, implants, or contaminated water; may cause cardiomyopathy
    • Lead - Elevated (>10 µg/dL in children, >15 µg/dL in adults) causes neurotoxicity, anemia, kidney damage, and developmental delays in children
    • Mercury - Elevated levels (>1.0 µg/L) indicate toxic exposure causing neurological damage, tremor, and cognitive impairment
    • Selenium - Low levels (<95 µg/L) may impair immune function and thyroid metabolism; very high levels (>165 µg/L) indicate toxic exposure
    • Barium - Elevated levels indicate environmental exposure; high levels may cause hypokalemia and gastrointestinal symptoms
    • Caesium - Elevated levels indicate exposure from radioactive contamination or environmental sources; rare toxic element requiring investigation
  • Associated Organs
    • Calcium - Bone tissue, parathyroid glands, kidneys, intestines; regulates muscle contraction, nerve transmission, blood clotting; abnormalities lead to osteoporosis, hypocalcemic tetany, arrhythmias
    • Alkaline Phosphatase - Bone, liver, biliary system; elevated in bone disorders (Paget's disease, rickets), liver disease, and during growth periods
    • SGOT/SGPT - Primarily liver; also muscle, heart, kidneys, red blood cells; elevated indicates hepatocellular injury, cirrhosis, hepatitis, or myocardial infarction
    • Uric Acid - Kidneys, joints, purine metabolism; elevated levels form crystals in joints (gout) and kidneys (nephrolithiasis)
    • Ferritin - Iron storage in liver, spleen, bone marrow; elevated indicates hemochromatosis (iron overload affecting liver, heart, pancreas) or inflammation; low indicates anemia risk
    • Folic Acid - Gastrointestinal system, liver, bone marrow; deficiency impairs DNA synthesis affecting rapidly dividing cells (RBCs, WBCs, GI cells)
    • Vitamin B12 - Gastrointestinal system, liver, nervous system, bone marrow; deficiency causes pernicious anemia and peripheral neuropathy
    • BUN/Creatinine - Kidneys; reflects glomerular filtration rate; abnormalities indicate acute or chronic kidney disease affecting all body systems
    • GGT - Liver and biliary system; most sensitive indicator of hepatobiliary disease; elevated in alcoholic liver disease and cholestasis
    • Iron/TIBC/Transferrin - Gastrointestinal system (absorption), liver (storage), bone marrow (utilization); abnormalities cause iron deficiency or overload anemia
    • Bilirubin - Liver, gallbladder, blood; elevated indicates hepatic dysfunction, hemolysis, or biliary obstruction affecting multiple organ systems
    • Lipid Profile - Heart, blood vessels, liver, adipose tissue; abnormalities increase cardiovascular disease, stroke, and metabolic syndrome risk
    • Total Protein/Albumin/Globulin - Liver (synthesis), kidneys (loss), GI tract (absorption); reflects nutritional status and synthetic liver function
    • Thyroid Profile - Thyroid gland, anterior pituitary; abnormalities affect metabolism, energy, weight, and heart function
    • HbA1c/eAG - Pancreas (insulin production), blood glucose regulation; abnormalities indicate diabetes with complications in kidneys, eyes, heart, nerves
    • CBC - Bone marrow (production), spleen (storage/destruction), cardiovascular system (transport); comprehensive assessment of hematopoietic and immune function
    • Electrolytes (Na/K/Cl) - Kidneys, adrenal glands, cardiovascular system; regulate fluid balance, nerve transmission, muscle contraction, acid-base balance
    • LDH - Widely distributed: heart, liver, kidneys, muscles, RBCs; elevated indicates tissue damage in multiple organs
    • Vitamin D - Bone, intestines, kidneys, parathyroid glands; deficiency causes rickets, osteomalacia, increased fracture risk, and impaired calcium homeostasis
    • Toxic Elements - Bone (lead storage), nervous system (neurotoxicity), liver (detoxification), kidneys (excretion); chronic exposure causes multisystem damage
  • Follow-up Tests
    • Calcium - If abnormal: Ionized calcium, phosphate, parathyroid hormone (PTH), 25-hydroxyvitamin D, alkaline phosphatase for bone disease assessment; DEXA scan for osteoporosis
    • Alkaline Phosphatase - If elevated: GGT to differentiate hepatic from bone origin; bone-specific alkaline phosphatase, PTH, vitamin D for bone disease
    • SGOT/SGPT - If elevated: Complete liver panel, PT/INR, albumin, bilirubin; ultrasound or CT of liver; viral hepatitis serology (HAV, HBV, HCV); autoimmune hepatitis antibodies
    • Uric Acid - If elevated: 24-hour urine uric acid, renal function tests; imaging for kidney stones if symptoms present; initiate gout prophylaxis if recurrent attacks
    • Ferritin - If elevated: Serum iron, TIBC, iron saturation, liver imaging, HFE gene testing for hemochromatosis; if low: iron studies, bone marrow biopsy if indicated
    • Folic Acid - If low: Vitamin B12 level, peripheral blood smear for megaloblastic changes, methylmalonic acid, homocysteine; dietary assessment; consider methotrexate or anticonvulsant review
    • Vitamin B12 - If low: Folate level, methylmalonic acid, homocysteine, intrinsic factor antibodies, parietal cell antibodies; peripheral smear, bone marrow if needed
    • BUN/Creatinine - If abnormal: Calculated eGFR, urinalysis, renal ultrasound; if elevated: assess for chronic kidney disease staging; monitor blood pressure, electrolytes; referral to nephrology if progressive
    • GGT - If elevated: Liver ultrasound, hepatitis serology, consider abdominal imaging; if isolated elevation with normal transaminases, may indicate alcohol use
    • Iron Studies - If abnormal: Serum ferritin (high suggests iron overload, low suggests deficiency), transferrin saturation >45% suggests hemochromatosis; consider HFE mutation testing; bone marrow biopsy if diagnosis unclear
    • Bilirubin - If elevated: Fractionated bilirubin, liver function tests, hepatitis serology, imaging; if indirect predominates investigate hemolysis; if direct predominates investigate cholestasis
    • Lipid Profile - If abnormal: Assess cardiovascular risk using Framingham or ASCVD calculator; consider LDL particle testing; initiate statin if high risk; repeat in 4-12 weeks after lifestyle modifications
    • Total Protein/Albumin - If low: Assess for malnutrition, liver disease, or nephrotic syndrome; urinalysis for proteinuria, 24-hour urine protein if nephrotic syndrome suspected
    • Thyroid Profile - If TSH abnormal: Free T3/T4 levels; thyroid antibodies (TPO, thyroglobulin); thyroid ultrasound if nodules suspected; initiate replacement or antithyroid therapy as indicated
    • HbA1c - If elevated: Fasting glucose, 2-hour post-meal glucose, C-peptide for beta-cell function; retinal exam, urine albumin-to-creatinine ratio for complications; initiate diabetes management
    • CBC Abnormalities - If Hgb low: Iron studies, B12, folate, reticulocyte count, peripheral smear, bone marrow biopsy if indicated; if WBC low: bone marrow exam, flow cytometry; if platelets low: bleeding time, coagulation studies
    • Electrolytes - If abnormal: Assess fluid status, determine cause (medication-induced, renal, adrenal); repeat levels after 4-6 hours if severe abnormality; monitor carefully in hospitalized patients
    • LDH - If elevated: Identify source through clinical history and other lab abnormalities; LDH isoenzymes if needed; LD-1/LD-2 ratio (inverted in myocardial infarction)
    • Vitamin D - If deficient: Begin vitamin D supplementation, recheck in 8-12 weeks; assess for malabsorption if levels do not improve; dietary counseling
    • Toxic Elements - If elevated lead: Repeat testing to confirm; source identification and removal; consider chelation therapy if symptomatic or very elevated; occupational/environmental assessment
    • General Anemia Follow-up - Repeat CBC in 4-6 weeks after intervention to assess response; monitor symptoms; investigate if anemia worsens despite treatment; refer to hematology if complex or refractory
  • Fasting Required?
    • Yes - Fasting for 9-12 hours is required for this comprehensive test package to obtain accurate results
    • Fasting Duration: 9-12 hours overnight fasting is ideal (e.g., blood draw in morning after fasting since prior evening)
    • Water Intake: Patients may drink plain water during the fasting period to maintain hydration; this does not affect test results
    • Food Restrictions: No food intake 9-12 hours before collection; avoid all beverages except water including coffee, tea, juice, milk, and alcohol
    • Medications - Continue all regularly scheduled medications unless specifically instructed otherwise by the ordering physician; some medications affecting lipid levels may need temporary discontinuation but should not be stopped without medical advice
    • Vitamin/Supplement Restrictions: Discontinue iron supplements, vitamin B12, folic acid, and other relevant supplements 24 hours before testing if possible (consult with physician); however, do not stop medications like B12 injections without guidance
    • Exercise: Avoid strenuous exercise 24 hours before testing as it can affect LDH, CK, and other enzyme levels; light physical activity is acceptable
    • Stress Reduction: Avoid emotional stress or trauma before testing as stress can affect cortisol, glucose, and electrolyte levels; try to arrive 5-10 minutes early to relax
    • Positioning: Sit quietly for at least 5 minutes before blood draw; remain seated during collection to prevent syncope
    • Smoking: Avoid smoking for at least 30 minutes before collection as nicotine can affect various lab parameters
    • Alcohol: Do not consume any alcohol 24 hours before testing as it can affect lipid profiles, liver enzymes, glucose, and other parameters
    • Specific Note on Lipid Profile: The lipid profile component requires fasting as food intake, especially fatty foods, elevates triglycerides and can affect total cholesterol and LDL measurements
    • Specific Note on HbA1c: Fasting not required for HbA1c specifically, as it reflects long-term glucose control; however, fasting is required for other components of this package
    • Specimen Collection: Blood draw typically uses multiple tubes (EDTA for CBC, SST for serum tests); collection usually takes 5-10 minutes
    • Documentation: Bring photo identification, insurance card, and list of current medications; inform phlebotomist of any allergies to collection tube materials
    • Sample Stability: Samples should be processed within 1-2 hours of collection; some elements require special handling to prevent contamination or degradation
    • Timing of Results: Most results available within 24-48 hours; complex tests like toxic element profile may take 3-5 business days

How our test process works!

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