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Super Advanced Blood Package

Blood

99 parameters

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Report in 24Hrs

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At Home

fastingrequire

Fasting Required

Details

Super advanced blood package covering insulin, sugar, glucose, iron, liver, kidney, lipid, thyroid, pancreas, blood, electrolytes, inflamation markers ,cardiac markers, vitamins, blood toxicity

₹5,527₹9,877

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Parameters

  • List of Tests
    • Cardiac Markers
      • hs-CRP
      • Lipoprotein (a)
      • Apolipoprotein (A1)
      • Apolipoprotein (B)
      • Apo B: Apo A1 Ratio
      • Homocysteine
    • CBC - Complete Hemogram
    • Liver Function Test
      • Albumin
      • Alkaline Phosphatase
      • Bilirubin - Direct
      • Bilirubin - Indirect
      • Bilirubin - Total
      • AST/SGOT
      • ALT/SGPT
      • Total Protein
      • A/G Ratio
      • Gamma GT
      • Globulin
    • Kidney Profile
      • BUN
      • Calcium
      • Creatinine
      • Uric Acid
      • eGFR
      • BUN/Creatinine
      • Urea
    • Lipid Profile
      • Cholestrol/HDL
      • LDL/HDL
      • Non HDL
      • VLDL
      • Total Cholestrol
      • Triglycerides
      • HDL
      • LDL
    • Thyroid Profile
      • Total T3
      • Total T4
      • TSH
    • Pancreatic Profile
      • Amylase
      • Lipase
    • Hba1c
    • eAG
    • Vitamin Profile
      • 25 - OH Vitamin D
      • Folic Acid
      • Vitamin B12
    • Iron Studies
      • Iron
      • TIBC
      • Transferrin Saturation
    • Sodium
    • Chloride
    • Insulin Fasting
    • Testosterone
    • Zinc
    • Copper
    • Fructosamine
    • Anti CCP (ACCP)
    • ANA
    • Blood Toxic Element Profile
      • Aluminium
      • Antimony
      • Arsenic
      • Bismuth
      • Cadmium
      • Chromium
      • Cobalt
      • Lead
      • Manganese
      • Mercury
      • Nickel
      • Selenium
      • Silver
      • Thallium
      • Barium
      • Caesium
      • Uranium
      • Strontium
      • Tin
      • Molybdenum
      • Vanadium
      • Beryllium

Super Advanced Blood Package - Comprehensive Medical Guide

  • Why is it done?
    • Comprehensive health screening: This package provides a complete assessment of major organ systems including cardiac, hepatic, renal, pancreatic, thyroid, and hematologic function
    • Cardiovascular risk assessment: Cardiac markers including hs-CRP, Lipoprotein(a), Apolipoprotein ratios, and homocysteine help identify individuals at risk for myocardial infarction and atherosclerotic disease
    • Metabolic syndrome evaluation: Includes glucose metabolism (HbA1c, fructosamine, insulin fasting), lipid profile, and inflammatory markers to detect pre-diabetes, diabetes, and metabolic dysfunction
    • Nutritional and micronutrient assessment: Vitamin B12, folic acid, vitamin D, iron studies, zinc, copper, and selenium levels identify deficiencies affecting metabolic function and immune competence
    • Autoimmune and inflammatory screening: Anti-CCP and ANA testing help diagnose or exclude rheumatoid arthritis and systemic autoimmune conditions
    • Toxicological screening: Blood toxic element profile detects exposure to heavy metals and trace elements that may cause chronic health effects
    • Preventive health monitoring: Ideal for annual health check-ups, baseline assessment before starting medications, or evaluation of non-specific symptoms
    • Disease surveillance: Assists in monitoring chronic conditions such as diabetes, hypertension, hyperlipidemia, thyroid disease, and autoimmune disorders
    • Hormonal assessment: Testosterone and thyroid profiles evaluate endocrine function and reproductive health
    • Electrolyte and metabolic balance: Assessment of sodium, chloride, calcium, and other minerals reflects hydration status and metabolic integrity
  • Normal Range
    • hs-CRP (high-sensitivity C-Reactive Protein): <1.0 mg/L (optimal), 1.0-3.0 mg/L (intermediate risk), >3.0 mg/L (elevated cardiovascular risk)
    • Lipoprotein(a): <30 mg/dL (optimal), 30-50 mg/dL (borderline elevated), >50 mg/dL (significantly elevated cardiovascular risk)
    • Apolipoprotein A1: Males 94-178 mg/dL, Females 101-199 mg/dL (higher values are protective for cardiovascular disease)
    • Apolipoprotein B: Males 52-109 mg/dL, Females 43-100 mg/dL (lower values are more favorable)
    • Apo B: Apo A1 Ratio: <0.9 (optimal), 0.9-1.0 (acceptable), >1.0 (increased cardiovascular risk)
    • Homocysteine: <15 μmol/L (normal), 15-30 μmol/L (intermediate risk), >30 μmol/L (elevated risk for thrombosis and atherosclerosis)
    • Complete Blood Count (CBC): Hemoglobin (Males 13.5-17.5 g/dL, Females 12.0-15.5 g/dL), Hematocrit (Males 38.8-50%, Females 35.0-45%), RBC (4.5-5.9 million/μL males, 4.1-5.1 million/μL females), WBC (4.5-11.0 thousand/μL), Platelets (150-400 thousand/μL), MCV (80-100 fL), MCH (27-33 pg), MCHC (32-36 g/dL)
    • Albumin: 3.5-5.0 g/dL (indicates protein nutrition and hepatic synthesis)
    • Alkaline Phosphatase: 44-147 IU/L (varies by age and sex)
    • Total Bilirubin: 0.1-1.2 mg/dL (normal range)
    • Direct Bilirubin: 0.0-0.3 mg/dL (conjugated bilirubin)
    • Indirect Bilirubin: 0.1-0.9 mg/dL (unconjugated bilirubin)
    • AST/SGOT: 0-40 IU/L (indicates hepatic enzyme activity)
    • ALT/SGPT: 0-44 IU/L (more liver-specific than AST)
    • Total Protein: 6.0-8.3 g/dL (total serum protein)
    • A/G Ratio (Albumin/Globulin): 1.0-2.5 (reflects protein balance)
    • Gamma GT (GGT): 9-48 IU/L (bile duct enzyme marker)
    • Globulin: 2.0-3.5 g/dL (immunoglobulin and other proteins)
    • BUN (Blood Urea Nitrogen): 7-20 mg/dL (reflects renal function and protein metabolism)
    • Calcium: 8.5-10.2 mg/dL (ionized calcium 4.5-5.3 mg/dL)
    • Creatinine: Males 0.74-1.35 mg/dL, Females 0.59-1.04 mg/dL (reflects glomerular filtration rate)
    • Uric Acid: Males 3.5-7.2 mg/dL, Females 2.6-6.0 mg/dL (indicator of purine metabolism)
    • eGFR (estimated Glomerular Filtration Rate): >90 mL/min/1.73m² (normal kidney function), 60-89 (mild decrease), 30-59 (moderate decrease), 15-29 (severe decrease), <15 (kidney failure)
    • BUN/Creatinine Ratio: 10:1 to 20:1 (optimal ratio reflects renal function)
    • Urea: 2.5-7.1 mmol/L or 7-20 mg/dL (nitrogen waste product)
    • Total Cholesterol: <200 mg/dL (desirable), 200-239 mg/dL (borderline high), ≥240 mg/dL (high)
    • HDL Cholesterol: >40 mg/dL males (favorable), >50 mg/dL females (favorable), <40 mg/dL males (risk factor), <50 mg/dL females (risk factor)
    • LDL Cholesterol: <100 mg/dL (optimal), 100-129 mg/dL (near optimal), 130-159 mg/dL (borderline high), 160-189 mg/dL (high), ≥190 mg/dL (very high)
    • Triglycerides: <150 mg/dL (normal), 150-199 mg/dL (borderline high), 200-499 mg/dL (high), ≥500 mg/dL (very high)
    • VLDL Cholesterol: <30 mg/dL (calculated as triglycerides/5)
    • Non-HDL Cholesterol: <130 mg/dL (optimal target for cardiovascular health)
    • Cholesterol/HDL Ratio: <5.0 (desirable), >5.0 (increased cardiovascular risk)
    • LDL/HDL Ratio: <3.0 (desirable), 3.0-5.0 (moderate risk), >5.0 (high risk)
    • TSH (Thyroid Stimulating Hormone): 0.4-4.0 mIU/L (varies slightly by laboratory)
    • Total T3: 80-200 ng/dL (measures total triiodothyronine)
    • Total T4: 4.5-12.0 μg/dL (measures total thyroxine)
    • Amylase: 30-110 IU/L (pancreatic enzyme)
    • Lipase: 0-60 IU/L (pancreatic enzyme more specific than amylase)
    • HbA1c: <5.7% (normal glucose metabolism), 5.7-6.4% (prediabetes), ≥6.5% (diabetes)
    • eAG (estimated Average Glucose): <100 mg/dL (normal), 100-140 mg/dL (prediabetes), >140 mg/dL (diabetes)
    • 25-OH Vitamin D: 30-100 ng/mL (sufficient), 20-29 ng/mL (insufficient), <20 ng/mL (deficient)
    • Folic Acid: 2.7-17.0 ng/mL (serum folate, indicates current folate status)
    • Vitamin B12: 200-900 pg/mL (cobalamin levels for neurologic and hematologic function)
    • Iron: Males 60-170 μg/dL, Females 50-170 μg/dL (circulating iron bound to transferrin)
    • TIBC (Total Iron Binding Capacity): 250-425 μg/dL (iron transport capacity)
    • Transferrin Saturation: 20-45% (percentage of iron binding capacity saturated)
    • Sodium: 135-145 mEq/L (electrolyte essential for cellular function)
    • Chloride: 96-106 mEq/L (electrolyte for acid-base balance)
    • Insulin Fasting: <12 μIU/mL (optimal), 12-20 μIU/mL (borderline), >20 μIU/mL (elevated, suggesting insulin resistance)
    • Testosterone Total: Males 300-1000 ng/dL, Females 15-70 ng/dL (sex hormone for development and function)
    • Zinc: 70-150 μg/dL (trace mineral essential for immune function)
    • Copper: 70-150 μg/dL (trace mineral for metabolism and antioxidant defense)
    • Fructosamine: 170-285 μmol/L (reflects average glucose over 2-3 weeks)
    • Anti-CCP (Cyclic Citrullinated Peptide): <20 U/mL (negative for rheumatoid arthritis), ≥20 U/mL (positive)
    • ANA (Antinuclear Antibody): Negative/<1:80 (no autoimmune disease), Positive/≥1:80 (may indicate autoimmune disease)
    • Blood Toxic Elements: Aluminium <10 μg/L, Arsenic <10 μg/L, Cadmium <2 μg/L, Lead <10 μg/L, Mercury <5 μg/L (acceptable ranges vary by element; all should be at minimal detectable levels)
  • Interpretation
    • hs-CRP interpretation: Elevated levels (>3.0 mg/L) indicate increased systemic inflammation and cardiovascular risk; values between 1.0-3.0 require lifestyle modification and monitoring; persistently elevated CRP may indicate infection, chronic inflammation, or autoimmune disease
    • Lipoprotein(a) interpretation: Genetic predisposition influences levels; elevated Lipoprotein(a) (>30-50 mg/dL) significantly increases cardiovascular and thrombotic risk independent of other lipid parameters; may require aggressive lipid management
    • Apolipoprotein interpretation: Low Apo A1 reflects reduced HDL-mediated reverse cholesterol transport; elevated Apo B indicates increased atherogenic particle load; Apo B:Apo A1 ratio is a powerful cardiovascular risk predictor superior to traditional lipid ratios
    • Homocysteine interpretation: Elevated homocysteine (>15 μmol/L) increases risk for atherosclerosis, stroke, and myocardial infarction; markedly elevated levels (>30 μmol/L) suggest genetic homocystinuria or B-vitamin deficiency; optimization through B6, B12, and folate supplementation may be beneficial
    • CBC interpretation: Low hemoglobin or hematocrit indicates anemia; elevated WBC suggests infection or leukemia; low platelets increase bleeding risk; abnormal RBC indices (MCV, MCH, MCHC) classify anemia type (microcytic, macrocytic, normocytic); differential WBC count identifies specific infections
    • Liver function tests interpretation: Elevated bilirubin (total, direct, or indirect) indicates hepatic dysfunction or biliary obstruction; elevated transaminases (AST, ALT) reflect hepatocyte damage; ALT is more liver-specific than AST; ALT>AST suggests viral hepatitis or fatty liver disease, while AST>ALT suggests cirrhosis or alcoholic liver disease; low albumin indicates chronic liver dysfunction; elevated GGT suggests bile duct disease
    • Kidney profile interpretation: Elevated creatinine and BUN indicate reduced glomerular filtration rate; eGFR categorizes chronic kidney disease stages; BUN/Creatinine ratio >20:1 suggests prerenal azotemia (dehydration), while ratio <10:1 suggests renal dysfunction; elevated uric acid increases gout and stone formation risk; abnormal calcium levels may indicate kidney disease, parathyroid dysfunction, or vitamin D deficiency
    • Lipid profile interpretation: Elevated total cholesterol and LDL indicate increased cardiovascular risk; low HDL is an independent risk factor; elevated triglycerides indicate metabolic dysfunction and may suggest metabolic syndrome; total cholesterol/HDL and LDL/HDL ratios are stronger predictors than individual values; VLDL reflects triglyceride metabolism; non-HDL cholesterol captures all atherogenic particles
    • Thyroid profile interpretation: Elevated TSH with low T4 suggests primary hypothyroidism; low TSH with elevated T3/T4 suggests hyperthyroidism; normal TSH with abnormal T3/T4 may indicate secondary thyroid dysfunction or early thyroid disease; subclinical hypothyroidism (elevated TSH, normal free T4) may warrant treatment in some patients
    • Pancreatic enzyme interpretation: Elevated amylase and lipase indicate acute pancreatitis; isolated elevated amylase may indicate salivary gland disease or macroamylasemia; lipase is more pancreas-specific; chronically elevated lipase suggests chronic pancreatitis; normal levels do not exclude pancreatitis if tested late in disease course
    • HbA1c and eAG interpretation: HbA1c reflects 3-month glucose average; <5.7% is normal; 5.7-6.4% indicates prediabetes requiring lifestyle intervention; ≥6.5% diagnostic for diabetes; eAG provides equivalent glucose reading; HbA1c may be falsely low in hemoglobinopathies or hemolysis; fructosamine measures 2-3 week glucose average for acute glucose trends
    • Vitamin D interpretation: Levels <20 ng/mL indicate deficiency with risk for rickets, osteoporosis, and immune dysfunction; 20-29 ng/mL is insufficient; 30-100 ng/mL is optimal; levels >100 ng/mL may indicate toxicity with hypercalcemia risk; seasonal variation occurs due to sun exposure; supplementation is evidence-based for deficiency
    • Vitamin B12 interpretation: Levels <200 pg/mL indicate deficiency with risk for megaloblastic anemia and neurologic complications; 200-900 pg/mL is normal but some patients with symptoms have levels in lower normal range; macrocytic anemia may indicate B12 deficiency; elevated methylmalonic acid and homocysteine confirm metabolic B12 deficiency
    • Folic acid interpretation: Low levels (<2.7 ng/mL) cause megaloblastic anemia and neural tube defects; folate status reflects recent dietary intake; RBC folate more accurately reflects long-term stores; deficiency common in alcoholism, malabsorption, and with certain medications
    • Iron studies interpretation: Low iron with high TIBC and low transferrin saturation indicates iron deficiency anemia; high iron with low TIBC and high saturation suggests hemochromatosis or secondary iron overload; ferritin should be evaluated concurrently as acute phase reactant; iron deficiency appears early with low ferritin before anemia develops
    • Sodium and chloride interpretation: Hyponatremia (<135 mEq/L) causes neurologic symptoms; hypernatremia (>145 mEq/L) indicates dehydration; chloride levels parallel sodium; abnormalities reflect volume status, renal function, and medication effects (diuretics, NSAIDs, ACE inhibitors)
    • Fasting insulin interpretation: Elevated fasting insulin (>12-20 μIU/mL) indicates insulin resistance central to metabolic syndrome; HOMA-IR (Homeostasis Model Assessment for Insulin Resistance) calculated as (fasting insulin × fasting glucose)/405; HOMA-IR >2 indicates significant insulin resistance; insulin resistance precedes type 2 diabetes development
    • Testosterone interpretation in males: Low testosterone (<300 ng/dL) indicates hypogonadism with fatigue, erectile dysfunction, and decreased muscle mass; high testosterone may indicate anabolic steroid use or rare testicular neoplasia; interpretation must consider time of day (highest morning levels) and presence of hypogonadal symptoms
    • Testosterone interpretation in females: Elevated testosterone (>70 ng/dL) may indicate PCOS, adrenal dysfunction, or androgen-secreting tumors; presents with hirsutism, acne, and menstrual irregularities; free testosterone more specific than total in diagnostic evaluation
    • Zinc interpretation: Deficiency (<70 μg/dL) impairs immunity, wound healing, and protein synthesis; low levels in alcoholics, malabsorption, and chronic diarrhea; supplementation carries risk of copper deficiency if excessive; zinc excess causes nausea and neurologic effects
    • Copper interpretation: Deficiency (<70 μg/dL) is rare but causes neutropenia and myelopathy; copper excess may indicate Wilson disease; ceruloplasmin should be measured for Wilson disease evaluation; occupational exposure risk exists
    • Fructosamine interpretation: Elevated fructosamine indicates hyperglycemia over 2-3 weeks; useful when HbA1c unreliable (hemolysis, hemoglobinopathy, pregnancy); lower upper limit than HbA1c, provides earlier detection of glucose changes; less commonly used than HbA1c
    • Anti-CCP interpretation: Positive Anti-CCP (≥20 U/mL) is highly specific for rheumatoid arthritis with ~95% specificity; predictive of erosive disease; may be positive before clinical symptoms or positive rheumatoid factor; negative Anti-CCP makes RA unlikely if negative; helps differentiate RA from other inflammatory arthropathies
    • ANA interpretation: Negative ANA (<1:80) effectively excludes systemic lupus erythematosus and related conditions; positive ANA (≥1:80) requires pattern analysis (homogeneous, speckled, centromere, nucleolar) and confirmation with specific autoantibodies; positive ANA in 3-5% healthy population; titer strength correlates with disease severity in some conditions
    • Heavy metals interpretation: Any detectable level above background warrants investigation; lead toxicity manifests at >10 μg/dL; mercury and arsenic toxicity possible at lower levels; cadmium accumulates chronically in kidneys; bismuth, thallium, antimony highly toxic even in small amounts; occupational and environmental exposure history essential; chelation therapy considered only with documented toxicity and symptoms
  • Associated Organs
    • hs-CRP, Lipoprotein(a), Apolipoproteins, Homocysteine: Heart and blood vessels - assess atherosclerosis risk, coronary artery disease, myocardial infarction, stroke, and peripheral vascular disease; inflammation in endothelium initiates atherosclerotic plaque formation
    • Complete Blood Count: Bone marrow, spleen, liver, kidneys - identifies anemia, infection, leukemia, thrombocytopenia; RBC disorders affect oxygen delivery; WBC abnormalities indicate immune dysfunction or malignancy
    • Liver function tests: Liver - evaluates hepatic synthetic function, cholestasis, hepatocellular injury; abnormalities indicate viral hepatitis, cirrhosis, fatty liver disease, alcoholic liver disease, drug toxicity, autoimmune hepatitis, hemolysis (elevated bilirubin)
    • Kidney profile: Kidneys - assesses glomerular filtration rate, kidney dysfunction, chronic kidney disease stages; detects acute kidney injury, nephrotic syndrome, uremia; calcium abnormalities indicate renal osteodystrophy
    • Lipid profile: Liver, cardiovascular system - evaluates lipid metabolism and cardiovascular risk; abnormalities associated with atherosclerosis, metabolic syndrome, and pancreatitis (hypertriglyceridemia)
    • Thyroid profile: Thyroid gland, pituitary gland (TSH) - evaluates hypothyroidism, hyperthyroidism, subclinical thyroid disease; TSH sensitive indicator of thyroid dysfunction; affects metabolism, growth, development, and mood
    • Pancreatic enzymes: Pancreas - detects acute pancreatitis, chronic pancreatitis, pancreatic cancer; enzyme elevation indicates pancreatic inflammation or necrosis
    • HbA1c, eAG, fructosamine: Pancreas (islet beta cells), kidneys - evaluates glucose metabolism and diabetes control; reflects glycemic trends and complication risk; kidneys affected by diabetic complications
    • Vitamin D: Small intestine (absorption), skin (synthesis), kidneys (metabolism) - essential for calcium absorption, bone health, immune function; deficiency risks rickets (children), osteomalacia (adults), osteoporosis, immune dysfunction
    • Vitamin B12, Folic acid: Stomach (intrinsic factor), small intestine (absorption) - required for DNA synthesis, neurologic function; deficiency causes megaloblastic anemia and neurologic complications (paresthesias, ataxia, dementia)
    • Iron studies: Small intestine (absorption), bone marrow (RBC production), liver (storage), spleen (hemolysis) - iron deficiency anemia affects oxygen-carrying capacity; iron overload damages heart, liver, endocrine organs
    • Sodium and chloride: Kidneys, adrenal glands, cardiovascular system - maintains fluid balance, nerve conduction, cardiac function; abnormalities cause hypertension, arrhythmias, neurologic symptoms
    • Fasting insulin: Pancreatic islet cells, liver, skeletal muscle - insulin resistance central to metabolic syndrome and type 2 diabetes development; peripheral insulin resistance increases liver and muscle dysfunction
    • Testosterone: Testes (males), ovaries and adrenal glands (females), pituitary - essential for sexual development, reproductive function, muscle mass, bone density, mood; abnormalities cause sexual dysfunction, infertility, mood disorders
    • Zinc and copper: Small intestine (absorption), liver (metabolism and storage), immune cells - zinc essential for immunity, wound healing, protein synthesis; copper required for ceruloplasmin synthesis, iron metabolism, antioxidant defense
    • Anti-CCP and ANA: Immune system, various organs - detect autoimmune antibodies; Anti-CCP specific for rheumatoid arthritis affecting joints; ANA detects systemic autoimmune diseases affecting multiple organs (SLE, Sjögren's, systemic sclerosis)
    • Heavy metals: Multiple organs depending on element - lead affects kidneys, nervous system, bone marrow; mercury damages kidneys, nervous system; arsenic affects skin, kidneys, cardiovascular system; cadmium accumulates in kidneys causing damage
  • Follow-up Tests
    • If hs-CRP elevated: Repeat testing after 2-4 weeks to confirm elevation; consider inflammatory markers (ESR, fibrinogen); imaging (echocardiography, carotid ultrasound) if cardiovascular risk; consider infection workup if markedly elevated
    • If Lipoprotein(a) elevated: Genetic counseling and family screening; aggressive lipid management with statin and ezetimibe; consider PCSK9 inhibitors; lipoprotein apheresis in very high-risk patients; MTHFR analysis for hyperhomocysteinemia
    • If homocysteine elevated: Vitamin B6, B12, and folate supplementation; renal function assessment; check for hypothyroidism; repeat testing after 8-12 weeks of supplementation
    • If anemia detected on CBC: Iron studies, vitamin B12, folic acid levels; peripheral blood smear; reticulocyte count; if microcytic consider iron deficiency workup; if macrocytic consider B12/folate deficiency or hypothyroidism; bone marrow biopsy if diagnosis unclear
    • If abnormal liver function: Viral hepatitis serology (Hepatitis A, B, C); autoimmune markers (ANA, anti-smooth muscle antibody); ceruloplasmin if suspecting Wilson disease; ultrasound or CT imaging; consider liver biopsy if cirrhosis suspected
    • If eGFR <60 mL/min/1.73m²: Repeat testing to confirm chronic kidney disease; urinalysis and urine protein/creatinine ratio; blood pressure monitoring; renal ultrasound; consider nephrology referral if stage 3b-5 CKD; monitor annually for progression
    • If lipid profile abnormal: Repeat fasting lipid panel; lipoprotein analysis; apolipoprotein subclass measurement if high triglycerides; genetic testing if familial hypercholesterolemia suspected; cardiac risk assessment (Framingham, ASCVD risk calculator)
    • If TSH abnormal: Free T4 measurement; anti-TPO and anti-thyroglobulin antibodies if autoimmune suspected; thyroid ultrasound if palpable nodule; repeat testing 6-8 weeks after dose adjustment if hypothyroidism diagnosed
    • If pancreatic enzymes elevated: Abdominal ultrasound or CT; assess for gallstones, alcohol use; triglycerides measurement; calcium level; repeat enzymes in 24-48 hours; consider MRCP if biliary obstruction suspected
    • If HbA1c in prediabetic range (5.7-6.4%): Fasting glucose and 2-hour oral glucose tolerance test; repeat HbA1c annually; implement lifestyle modification; repeat testing every 3-6 months if borderline
    • If HbA1c ≥6.5%: Repeat confirmation testing; fasting glucose, random glucose; comprehensive metabolic panel; urinalysis; renal function; ophthalmology referral for diabetic retinopathy screening; initiate antidiabetic therapy; monitor HbA1c every 3 months until controlled
    • If vitamin D deficient: Vitamin D supplementation (1000-4000 IU daily); recheck levels in 2-3 months; assess for malabsorption, renal disease, or liver dysfunction if severe deficiency; monitor calcium and phosphorus
    • If vitamin B12 low: Intrinsic factor and parietal cell antibodies if pernicious anemia suspected; methylmalonic acid and homocysteine for metabolic confirmation; B12 supplementation (oral or intramuscular); recheck levels 2-3 months after treatment initiation
    • If folic acid low: Assess for malabsorption (celiac serology, tissue transglutaminase); folate supplementation; dietary counseling; recheck in 2-3 months; exclude B12 deficiency before treating folate deficiency (prevents masking neurologic complications)
    • If iron deficiency anemia: Assess for blood loss (colonoscopy if age appropriate); celiac serology; H. pylori testing; iron supplementation with recheck CBC in 6-8 weeks; ferritin monitoring; if not responsive consider malabsorption workup
    • If elevated fasting insulin: Oral glucose tolerance test; HbA1c; weight loss intervention; metformin consideration; lifestyle modification emphasis; repeat testing after 3 months
    • If testosterone low in males: LH and FSH measurement; prolactin level; repeat testing (testosterone varies with time of day); consider sleep apnea screening; testicular ultrasound if pituitary dysfunction suspected
    • If testosterone elevated in females: 17-hydroxyprogesterone; DHEA-S; pelvic ultrasound; ACTH stimulation test if adrenal hyperplasia suspected; pituitary MRI if pituitary androgen excess suspected
    • If zinc or copper abnormal: Dietary assessment; check for malabsorption disorders; copper/zinc ratio evaluation; assess for Wilson disease if copper elevated; supplementation with monitoring
    • If Anti-CCP positive: Rheumatology referral; disease-modifying antirheumatic drug (DMARD) initiation; baseline X-rays of affected joints; rheumatoid factor and ESR for confirmation; joint examination and imaging monitoring
    • If ANA positive: Pattern analysis with reflex panels; specific antibodies (anti-dsDNA, anti-Smith, anti-Ro/SSA, anti-La/SSB) depending on pattern; rheumatology referral; ESR, C3, C4 complement levels
    • If heavy metals detected: Identify source of exposure; occupational/environmental history; assess for toxicity symptoms; consultation with toxicology specialist; urinary heavy metal levels; consideration of chelation therapy only with clinical toxicity; long-term follow-up monitoring
    • General follow-up: Repeat comprehensive package annually for asymptomatic individuals; more frequent monitoring (every 3-6 months) for identified abnormalities being treated; imaging studies (ultrasound, CT, MRI) as clinically indicated; specialist referrals based on abnormal findings
  • Fasting Required?
    • YES - Fasting is required for this comprehensive package
    • Fasting duration: 8-12 hours is recommended (overnight fast typically 10-12 hours)
    • Rationale for fasting: Triglycerides and fasting insulin/glucose require fasting state for accurate interpretation; non-fasting triglycerides are falsely elevated by recent food intake; lipid panel interpretation standardized on fasting measurements; glucose values affected by carbohydrate absorption
    • What permitted while fasting: Water intake is permitted and encouraged; plain black tea or coffee without cream/milk/sugar is generally acceptable; medications should not be taken with food unless specifically indicated
    • What not permitted while fasting: No food of any kind; no beverages except water and plain black tea/coffee; no juice, milk, or beverages with sugar; no chewing gum; no candy; no nutritional supplements
    • Medications and fasting: Most routine medications can be taken with water on morning of blood draw; ACE inhibitors, beta-blockers, antithyroid medications are typically taken as scheduled; statins can be taken prior to fasting blood draw (preferably noted for interpretation); confirm with your physician about specific medications
    • Timing of draw: Morning blood draw (7-9 AM) is preferred to standardize hormone levels (testosterone highest in morning); consistent timing between serial tests improves comparability
    • Pre-test dietary preparation: Resume normal diet day before testing; avoid excessive alcohol 24-48 hours before testing (alcohol affects lipids, glucose, liver enzymes); avoid high-fat meals in the 24 hours before testing; remain well-hydrated
    • Activity before testing: Light activity is acceptable; avoid strenuous exercise 24 hours before testing (can affect muscle enzymes and metabolic markers); rest for 5-10 minutes before blood draw for most accurate readings
    • Special considerations for women: For testosterone testing, timing in menstrual cycle should be documented (typically early follicular phase day 3-5); hormonal contraceptive use affects testosterone levels; menopausal status should be noted
    • Stress management: Minimize stress during fasting period as stress hormones can affect metabolic markers; arrive early to testing facility to allow relaxation before draw; deep breathing exercises recommended before blood draw
    • After blood draw: No specific restrictions after testing; resume normal diet and activities immediately; stay well-hydrated; if feeling lightheaded, sit for 5-10 minutes before standing
    • Documentation requirements: Note exact fasting duration for report; document time of blood draw; inform laboratory of any acute illnesses, fever, or infections as these affect markers; list current medications as some may affect results
    • Non-compliance with fasting: Results may be invalid if fasting instructions not followed; non-fasting triglycerides especially unreliable for clinical decision-making; lipid panel interpretation compromised; may require repeat testing with proper fasting

How our test process works!

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