What is this test

TSH

A test for thyroid-stimulating hormone (TSH) is done to:

  • Find out whether the thyroid gland is working properly.
  • An underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods.
  • An overactive thyroid (hyperthyroidism) can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods.

T3/T4, FT3/FT4

The thyroid hormones Thyroxine (T4) and Triiodothyronine (T3) are produced and secreted by the thyroid gland.
Each molecule of T4 and T3 is made up of a protein and iodine (in the form of iodide). T4 contains 4 molecules of iodide and T3 contains 3 molecules of iodide – hence the names T4 and T3.

Thyroid hormones are the only compounds in the body that contain iodine. This is why dietary intake of iodine is important for thyroid health.

T4 is produced by the thyroid gland in much greater amounts than T3, around 90% more. This is because when T4 reaches organs and body tissue, it’s converted into T3.

So T4 is basically a stepping stone required for T3.

T3 is the active form of thyroid hormone in that it influences many body processes, in particular the regulation of metabolism.

Reverse T3

 RT3 is a metabolite of T4 (thyroxine). Typically, when T4 loses an atom of iodine—a process known as monodeiodination, or T4 to T3 conversion—it becomes triiodothyronine (T3), the active thyroid hormone. But in some cases, the body conserves energy by converting the T4 instead into RT3, an inactive form of T3 that is incapable of delivering oxygen and energy to the cells, as T3 does.

Thyroglobulin ab, Thyroperoxidase ab


A Thyroid Antibodies test looks for several types of antibodies which the body develops when a person has an autoimmune disorder.  This test looks for Thyroid Peroxidase and Antithyroglobulin antibodies.  These antibodies mistakenly target and damage the tissues and proteins of the thyroid gland.  The disruption of normal thyroid function this causes can lead to disorders such as Graves Disease or Hashimotos Thyroiditis.

This testing is typically ordered when someone has symptoms of a thyroid disorder or has had irregular results from other thyroid tests such as TSH, T4 and T3.  It may also be used when someone has been diagnosed with a thyroid disorder to help monitor their treatment.  Pregnant women with an autoimmune disorder often have a Thyroid Antibodies test to help determine if their infant may be at risk for thyroid dysfunction.

 

Testosterone

Testosterone is a steroid hormone that is produced by both men and women but is created in much larger quantities in men and is responsible for stimulating the development of male sexual characteristics. In a male fetus testosterone promotes the development of the penis, scrotum and other parts of a male reproductive system associated with sperm production.

Testosterone is also important for overall good health. It helps the growth of bones and muscles, and it affects mood, libido (sex drive) and certain aspects of mental ability.

Free Testosterone

Most circulating testosterone is bound to sex hormone-binding globulin (SHBG), which in men also is called testosterone-binding globulin. A lesser fraction is albumin bound and a small proportion exists as free hormone. Historically, only the free testosterone was thought to be the biologically active component. However, testosterone is weakly bound to serum albumin and dissociates freely in the capillary bed, thereby becoming readily available for tissue uptake.

All non-SHBG-bound testosterone is therefore considered bioavailable

E2

Oestradiol has several functions in the female body. Its main function is to mature and then maintain the reproductive system. During menstruation, increased oestradiol levels cause the maturation and release of the egg; as well as the thickening of the uterus lining to allow a fertilized egg to implant. The hormone is made primarily in the ovaries, so levels reduce as women age and decrease significantly during menopause.

In men, proper oestradiol levels help with bone maintenance, nitric oxide production and brain function. While men need lower levels than women, they still require this important hormone to function well.

In women, too much oestradiol has been linked to acne, constipation, loss of sex drive and depression. If the levels are extremely high they can cause uterine and breast cancer. Women with high oestradiol levels may experience weight gain and cardiovascular disease. For men, it can lead to the development of female characteristics, and loss of sexual function or muscle tone.

Progesterone

Progesterone is one of the hormones in our bodies that stimulates and regulates various functions. Progesterone plays a role in maintaining pregnancy. The hormone is produced in the ovaries, the placenta (when a woman gets pregnant) and the adrenal glands. It helps prepare your body for conception and pregnancy and regulates the monthly menstrual cycle. It also plays a role in sexual desire.

Prolactin

Prolactin is a hormone named originally after its function to promote milk production (lactation) in mammals in response to the suckling of young after birth. It has since been shown to have more than 300 functions in the body. These can be divided into a number of areas: reproductive, metabolic, regulation of fluids (osmoregulation), regulation of the immune system (immunoregulation) and behavioural functions.

IGF-1

IGF-1 is a hormone that, along with growth hormone, helps promote normal bone and tissue growth and development. An IGF-1 test is often ordered along with GH. IGF-1 mirrors GH excesses and deficiencies, but the level in the blood is stable throughout the day, making it a useful indicator of average GH levels.

GH

 known as somatotropin it is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in human development.

GH is a stress hormone that raises the concentration of glucose and free fatty acids.It also stimulates production of IGF-1. Random growth hormones are highly variable, falling to low levels after meals and rising to high levels during fasting and with stress.

FSH/LH

FSH stimulates the follicles in the ovaries to ripen several eggs. A follicle is a balloon shaped structure which is filled with fluid and contains an egg, FSH also stimulates the ovaries to produce oestrogen.

The Pre-Ovulatory Phase is the phase between bleeding and ovulation and tends to be more variable than the second half of the menstual cycle. Although about 20 follicles begin developing each menstrual cycle due to FSH release only one follicle reaches full maturity. As the follicles develop they release estrogen, which in turn feedbacks to the brain and causes the pituitary gland to cease the production of FSH. The follicle that has matured the most - survives and continues to grow until it is ready for ovulation. The other less mature follicles stop growing (and some even die).

In men, the Follicle Stimulating Hormones initiates sperm production.

LH - Lutenising Hormone

Lutenising Hormone is secreted by the pituitary gland to stimulate ovulation that is, the release of the egg or ovum from the follicles.
LH secretion signals the remnants of the follicle to change into the corpus lunteum. The corpus luteum then begins producing progesterone and estrogens .

FSH also readies the mammary glands for milk production.

In Men, LH signals the testicle to produce Testosterone. In turn, testosterone seeps out of the testicle and into the blood stream where it circulates around the body and is put to good use doing things like growing chest hair, making muscles big and deepening  your voice. The brain monitors blood testosterone levels, if they drop too low, it will send a signal to the pituitary gland to send out more LH to kick start testosterone production.

If testosterone is chronically low (as in the case with hypogonadism or low T, the brain will respond by upping the level of LH.

If testosterone is chronically high (as in the case when using steroids or other performance enhancers) the brain will shut down production of LH. When testosterone supplementation is stopped, men can experience a “crash” as T levels plummet but the brain lags in re-starting the machinery to generate LH.

PSA (males only)

A PSA test measures the level of prostate specific antigen (PSA) in the blood and it can help to diagnose prostate disease.

Prostate specific antigen is a protein made in the prostate gland and low levels of PSA are normally present in the blood. As a man gets older, the prostate grows and the level of PSA increases.

PSA is not a test for cancer. A raised PSA level in the blood just means something is happening in the prostate which, in most instances, is not due to cancer.

The causes of raised PSA levels include the benign (non-cancerous) growth that happens with ageing (benign prostatic hyperplasia, BPH); inflammation or infection of the prostate (prostatitis); and, least commonly, prostate cancer.

Iron Studies

A serum iron test measures how much iron is in your serum. Serum is the liquid that is left over from your blood plasma when the red blood cells and the clotting elements have been removed. This test can help your doctor figure out if there is a problem with your iron levels.

The ferritin blood test measures the level of ferritin in the blood serum.

Ferritin is a protein found inside cells that stores iron so your body can use it later. A ferritin test indirectly measures the amount of iron in your blood.

Transferrin saturation, a more useful indicator of iron status than just iron or TIBC alone

Especially high or low iron levels can cause a variety of vague symptoms, such as fatigue, weakness, difficulty concentrating, and moodiness. The serum iron test can reveal both unusually low and abnormally high blood iron levels.

Early symptoms of iron deficiency (anemia) include:

  • chronic fatigue
  • dizziness
  • headaches
  • muscle weakness

Symptoms of iron overload (when your body produces too much iron) include:

  • pain in your abdomen and joints
  • bronzing/darkening of skin
  • fatigue
  • heart problems
  • lack of energy
  • lack of sex drive
  • weight loss
  • muscle weakness


Comprehensive Metabolic Profile:

Also known in Australia as a MBA20 (Multiple Biochemical analysis)

Kidney Function (UEC):
Sodium, Potassium, Chloride, Bicarbonate, Urea, Creatinine, eGFR, Calcium, Corrected Calcium, Phosphate, Uric Acid
Liver function (LFT):
Total Protein, Albumin, Alkaline Phosphatase, Total Bilirubin, Gamma GT, AST, ALT, Globulin
Lipid Studies:
Cholesterol, HDL/LDL, Non-HDL Cholesterol, Triglycerides, LDL/HDL Ratio, Chol/HDL Ratio
Glucose


Kidney Function (UEC):

Sodium, Potassium, Chloride, Bicarbonate, Urea, Creatinine, eGFR, Calcium, Corrected Calcium, Phosphate, 

 
NA: (Sodium) A sodium test checks how much sodium is in the blood. Sodium is both an electrolyte and mineral. It helps keep the water (the amount of fluid inside and outside the body's cells) and electrolyte balance of the body. Sodium is also important in how nerves and muscles work.
Most of the sodium in the body (about 85%) is found in blood and lymph fluid. Sodium levels in the body are partly controlled by a hormone called aldosterone, which is made by the adrenal glands. Aldosterone levels tell the kidneys when to hold sodium in the body instead of passing it in the urine. Small amounts of sodium are also lost through the skin when you sweat.
Most foods have sodium naturally in them or as an ingredient in cooking. Sodium is found in table salt as sodium chloride.
 
K (Potassium): The body needs a delicate balance of potassium to help the heart and other muscles work properly. But too much potassium in your blood can lead to dangerous, and possibly deadly, changes in heart rhythm.
Bicarbonate: Carbon dioxide (CO2) is a gaseous waste product from metabolism. The blood carries carbon dioxide to your lungs, where it is exhaled. More than 90% of carbon dioxide in your blood exists in the form of bicarbonate (HCO3). The rest of the carbon dioxide is either dissolved carbon dioxide gas (CO2) or carbonic acid (H2CO3). Your kidneys and lungs balance the levels of carbon dioxide, bicarbonate, and carbonic acid in the blood.
UR (Urea): A blood urea nitrogen (BUN) test checks kidney function by measuring how much urea nitrogen is in your blood. Urea nitrogen is a waste product from the breakdown of protein in the body. Normally, this waste is filtered by the kidneys and leaves the body through urine. Too much or too little urea nitrogen in the blood could signify kidney problems.
UA (Uric Acid/Urate): Higher than normal uric acid levels mean that the body is not handling the breakdown of purines well. Uric acid is a chemical created when the body breaks down substances called purines. Purines are found in some foods and drinks. These include liver, anchovies, mackerel, dried beans and peas, and beer.
Creatinine: Creatinine is a chemical waste product of creatine. Creatine is a chemical made by the body and is used to supply energy mainly to muscles.
This test is done to see how well your kidneys work. Creatinine is removed from the body entirely by the kidneys. If kidney function is not normal, creatinine level increases in your blood. This is because less creatinine is released through your urine.
The creatinine level also varies according to a person's size and muscle mass.
eGFR, the glomerular filtration rate (GFR) is a measure of the function of your kidneys. Glomeruli are tiny filters in your kidney that allow waste products to be removed from the blood, while preventing loss of important proteins and blood cells. The rate refers to the amount of blood that is filtered per minute.


Liver Function

Total Protein, Albumin, Alkaline Phosphatase, Total Bilirubin, Gamma GT, AST, ALT, Globulin

Bilirubin: Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.

TP, ALB,GLB: The total protein (TP) test measures the total amount of two classes of proteins found in the fluid portion of your blood. These are albumin and globulin.
Proteins are important parts of all cells and tissues.
•Albumin (ALB) helps prevent fluid from leaking out of blood vessels.
•Globulins (GLB) are an important part of your immune system.

Alk Phosphatase: The liver makes more ALP than the other organs or the bones. Some conditions cause large amounts of ALP in the blood. These conditions include rapid bone growth (during puberty), bone disease (such as Paget's disease or cancer that has spread to the bones), a disease that affects how much calcium is in the blood (hyperparathyroidism), vitamin D deficiency, or damaged liver cells.

GGT: Raised GGT levels indicate that something is going on with your liver but not specifically what. In general, the higher the level the greater the damage to your liver. Elevated levels may be due to liver disease, but they may also be due to congestive heart failure, drinking alcohol, and use of many prescription and non-prescription drugs including nonsteroidal anti-inflammatory drugs (NSAIDs), lipid-lowering drugs, antibiotics, histamine blockers (used to treat excess stomach acid production), antifungal agents, anticonvulsants (seizure control medications), antidepressants, and hormones such as testosterone.

ALT: Alanine transaminase (ALT) is an enzyme found in the highest amounts in the liver. Injury to the liver results in release of the substance into the blood. ALT can be non-specific. Raised levels could simply mean a heavy Gym session the day before or an indication of other problems.

AST: An AST test is requested with several other tests to help evaluate a patient who has symptoms of a liver disorder. Some of these symptoms include jaundice (yellowing of the eyes and skin), dark urine, nausea, vomiting, abdominal swelling, unusual weight gain and abdominal pain

LDH: LDH is most often measured to check for tissue damage. The protein LDH is in many body tissues, especially the heart, liver, kidney, muscles, brain, blood cells, and lungs.

Calcium: Blood calcium is tested to screen for, diagnosis, and monitor a range of conditions relating to the bones, heart, nerves, kidneys and teeth. Blood calcium levels do not directly tell how much calcium is in the bones, but rather, how much calcium is circulating in the blood.

FBC / CBC

Otherwise known as a ‘Full Blood Count’ (FBC or CBC)

The main component of blood (60 per cent) is the liquid called plasma. Blood cells make up the other 40 per cent and include:
Red blood cells – known as erythrocytes. Every red blood cell contains haemoglobin, a complicated protein that carries oxygen. Haemoglobin contains iron, which is important for carrying oxygen around the body.

White blood cells – known collectively as leukocytes. These are cells of the immune system that fight infection. The different types of white blood cells include lymphocytes, eosinophils, monocytes, neutrophils and basophils.

Platelets –help to clot the blood to stop bleeding.

A LOW Haemoglobin (Hb) is called anaemia, and has a variety of causes, including chronic (over a long time) blood loss, destruction of red cells, decreased blood cell formation in the bone marrow, defective production of haemoglobin, or chronic illness.
A HIGH Haemoglobin (Hb) is called polycythaemia and may be caused by smoking, chronic lung disease or a blood condition called polycythaemia rubra vera (PRV).

White Cell Count:A VERY LOW White Cell Count would raise concern that the immune system is overwhelmed by infection and may not have enough white blood cells to fight the infection effectively. This is particularly true in the setting of recent chemotherapy.

A LOW White Cell Count (WCC) may occur early on in any infective illness, or may be normal.

A HIGH White Cell Count is often due to an infection, which may or may not be severe. Other causes include a seizure, steroid medications such as prednisolone, or as a non-specific "stress response" to pain or illness.

A VERY HIGH White Cell Count may be due to severe infection, or less commonly due an acute or chronic form of leukaemia.


Diabetes

Diabetes is a chronic condition.This means that it lasts for a long time, often for someone's whole life.
For our bodies to work properly we need to convert glucose (sugar) from food into energy. A hormone called insulin is essential for the conversion of glucose into energy.

In people with diabetes, insulin is no longer produced or not produced in sufficient amounts by the body.
So when people with diabetes eat glucose, which is in foods such as breads, cereals, fruit and starchy vegetables, legumes, milk, yoghurt and sweets, it can’t be converted into energy.Instead of being turned into energy the glucose stays in the blood. This is why blood glucose levels are higher in people with diabetes.

Glucose is carried around your body in your blood. Your blood glucose level is called glycaemia.
In diabetes, either the pancreas can’t make insulin (type 1 diabetes), or the cells don’t respond to the insulin properly (insulin resistance) and the pancreas produces inadequate insulin for the body’s increased needs (type 2 diabetes).

If the insulin cannot do its job, the glucose channels cannot open properly. Glucose builds up in the blood instead of getting into cells for energy. High blood glucose levels cause the health problems linked to diabetes often referred to as complications. These include kidney damage, eye disease, heart disease and persistent infections.

A fasting blood glucose test is initially done to help with diagnosis of diabetes and/or glucose intolerance. Progressing to a glucose tolerance test if required.

CHOLESTEROL

Cholesterol is a fatty substance produced naturally by your body and found in your blood. You can also get cholesterol from some foods. It is used for many different things in the body, but causes health problems when there is too much of it in the blood.

Too much cholesterol in the blood causes fatty deposits to gradually build up in blood vessels. This makes it harder for blood to flow through, which can cause a heart attack or stroke.

There are several types of cholesterol found in your body.

Low density lipoprotein (LDL) is also known as ‘bad’ cholesterol because it can add to the build-up of plaque in your arteries and increase your risk of Coronary Heart Disease (CHD).

High density lipoprotein (HDL) is also known as ‘good’ cholesterol because it helps to protect you against CHD. Triglycerides are another type of fat in the blood. There is evidence to suggest that some people with higher levels of blood triglycerides are at increased risk of CHD,

Making lifestyle changes, in particular changing some of the foods you eat, is very important to help to reduce your cholesterol and improve your heart health. You may also need to take cholesterol-lowering medicines to help you manage your cholesterol and reduce your risk of having a heart attack or stroke.

Suggested reference ranges for good health:

  • Total cholesterol: < 5.5
  • Triglycerides: < 2.0
  • HDL: > 1.0
  • LDL: <2.0

AMINO ACIDS: Plasma/Serum

Amino acids are the basic building blocks of the body. They are also sources of energy, like fats and carbohydrates. However, amino acids are structurally characterized by the fact that they contain nitrogen (N), whereas fats and carbohydrates do not.

Therefore, only amino acids are capable of forming tissues, organs, muscles, skin and hair.

Alanine,  Arginine, Asparagine, Aspartic acid, Citrulline, Cysteine, Glutamic acid/Glutamate, Glycine ,Histidine, Homocysteine, Isoleucine, Leucine, Lysine, Methionine, Ornithine, Phenylalanine

Serine, Taurine, Threonine, Tyrosine, Tryptophan, Valine