Thyroid Panel with TSH Other names: TSH test, Thyroid profile, Thyrotropin test What is a TSH test? A TSH test is a blood test that determines thyroid-stimulating hormone (TSH) hormone in your blood. A high or a low level of TSH can lead to a thyroid problem. A thyroid is a gland of small shaped like a butterfly. It is present in front of the neck. The purpose of the thyroid is to make hormones, which move into the bloodstream. The thyroid hormones regulate different functions of the body’s metabolism. These hormones show affect every organ in the body. They help to maintain the temperature, weight, muscle strength, heart, and mood of a person. The speed of many body functions decreases if you have a low thyroid hormones in your blood. Your body’s functions speed up if you have a large quantity.  The pituitary gland in your brain controls the thyroid and makes a thyroid-stimulating hormone (TSH). The thyroid produces hormones according to the body’s needs when the TSH tells it. Your pituitary gland creates a large quantity of TSH when the levels of thyroid hormone in your blood are low. When the pituitary gland develops less or no TSH, this shows that your thyroid hormone levels are high. A TSH test gives information for maintaining the level of thyroid hormones in your body.  What is the purpose of this test? A TSH test analyzes the working conditions of a thyroid. This test shows the disease of hyperthyroidism (too high thyroid hormone) and hypothyroidism (too low thyroid hormone). The TSH test does not define the causes of a thyroid problem. When do I need a thyroid panel with a TSH test?  Your doctor may recommend this test if you experience signs of too large or small amounts of thyroid hormone in your blood. The American Association of Clinical Endocrinology, the Endocrine Society, and the American Thyroid Association routine screening for thyroid problems in adults if you do not have any symptoms. According to some experts, adults that have family history of thyroid or an autoimmune disorder need to conduct this test. You may need to perform a TSH test regularly to see the status of hormone levels due to hypothyroidism or if the case when your doctor had removed your thyroid.  Hyperthyroidism is a disease in which overactive thyroid produces high amounts of thyroid hormones in your blood. It leads to an increase in the speed of the body’s functions. It has symptoms include: Sleep trouble Fatigue Irregular or slow heartbeat Intolerance to heat or sweating The Irritating or nervous feeling Mood swings Anxiety Goiter (enlargement of the thyroid) Weight loss despite eating more Muscle weakness Increased bowel movement (frequent pooping)) Hypothyroidism is a condition of having few thyroid hormones in your blood due to an underactive thyroid. It reduces the speed of the body functions. Some causes include: Weight gain Pain in muscle and joint Skin dryness Hair thinning or dryness Constipation  Fatigue Heavy or irregular menstrual periods Fertility problems Intolerant to cold Depression Your provider may also recommend other tests to evaluate lumps or bumps on your thyroid. It may lead to thyroid cancer or thyroid nodules (solid or fluid-filled lumps that form within your thyroid) What happens during a TSH test? You may need to provide a blood sample from your veins to your healthcare provider. A small quantity of blood collects in the test tube when your provider inserts a needle into your vein. This test generally takes at least 5-10 minutes. Is there any risk to the test? A thyroid blood test contains no risk. You may feel a little pain when the needle goes in or out into your vein. Its symptoms disappear in less time.  How do I need to prepare for the test? You do not have to prepare for anything before the test. If your doctor suggests more blood tests, you may need to keep fast for at least 8-10 hours. Your healthcare provider will inform you about any specific instructions.  What does the test result mean? The results of the TSH test show how much quantity of thyroid hormone is present in your blood. Your doctor may order more thyroid blood tests to observe the reasons for a thyroid problem. The blood tests can include T4 thyroid hormone test T3 thyroid hormone test Thyroid antibodies test – It is used to diagnose autoimmune thyroid disorders, including grave’s disease and Hashimoto’s disease. These are the most common cause of hyperthyroidism and hypothyroidism, respectively.   Abnormal TSH results may show a sign of disorder for the pituitary gland in the specific case. It occurs less often.  What else do I need to know about the TSH test?  The healthy thyroid of a person may also show high or low TSH levels. A few illnesses that do not link with your thyroid can cause low TSH levels for a short time. Generally, older people aged 80 have a high value of TSH without any thyroid problems. Pregnancy also changes the level of TSH. Thyroid disease may occur during the three months of pregnancy. Sometimes thyroid disease occurs during pregnancy. Your healthcare provider observes and monitors your condition during pregnancy and after birth, if you develop thyroid disease during pregnancy. That is because of hyperthyroidism, which may process after birth. If you have ever had a thyroid disease, you need to talk with a doctor if you are pregnant or thinking about it. The screening of pregnant women for thyroid problems without symptoms if they have these conditions:   Having a family history of thyroid disease Age over 30 years Medical history of miscarriage, premature birth, or infertility  Obesity Living in an area where iodine deficiency is common   TSH test screens for hypothyroidism (congenital hypothyroidism) in newborn babies. You can order this test by visiting UmbrellaMD. You can make an appointment with the doctor to diagnose your condition. Umbrella Health Care Systems help to create an online connection between you and a doctor. You can check your test results and get treatment for your disease while sitting at home. You can register here to grab the online facility and e-consultation.  

THYROID PEROXIDASE ANTIBODIES Other names: thyroid autoantibodies, thyroid-stimulating immunoglobulin, TPO, Anti-TPO, thyroid antibodies  What is a thyroid peroxidase antibodies test? The thyroid peroxidase antibodies test determines the number of thyroid antibodies in your blood. A thyroid is a gland of small shaped like a butterfly. It is present in front of the neck. The purpose of the thyroid is to make hormones, which move into the bloodstream. The thyroid hormones regulate different functions of the body’s metabolism. These hormones show affect every organ in the body. They help to maintain the temperature, weight, muscle strength, heart, and mood of a person.  The immune system develops antibodies, which are proteins to protect your body against bacteria and viruses. A condition of the autoimmune response in which antibodies mistakenly damage their own cells, tissues, and organ. It can result in chronic thyroid inflammation or damage to thyroid function.  What is the purpose of the test? The thyroid antibodies test helps to diagnose hyperthyroidism or hypothyroidism. Hyperthyroidism is a condition of an overactive thyroid gland. Hypothyroidism is due to an underactive thyroid gland. The purpose of the thyroid antibodies test is to:   Check the condition of mild hypothyroidism and whether it may develop problems over time. Diagnose an autoimmune disorder like Grave's disease and Hashimoto’s disease. Evaluate the risk of danger after the treatment for Grave's disease. Monitor if you have had treated for thyroid cancer. Prescribe the efficient course of treatment. Find the risk in the unborn child of pregnant women with thyroid disease.  Hypothyroidism occurs in Hashimoto’s thyroiditis disease, which is most common in the US. While hyperthyroidism results from Grave’s disease, which is also an autoimmune disease. The immune system attacks the healthy functions of the thyroid gland in both diseases. Despite having the thyroid antibodies test diagnoses Grave’s disease or Hashimoto's disease, it does not always mean that this test may also help in diagnosing other autoimmune disorders.  What are the different types of antibodies? The test measures the number of different thyroid antibodies in your blood. A few antibodies may destroy thyroid hormones. Some can lead to developing more amount of thyroid hormones. A thyroid peroxidase antibodies test generally gives the quantity of the following types of antibodies: Thyroid peroxidase antibodies (TPO) – The essential enzyme for producing thyroid hormones. High levels of TPO often occur in people having Hashimoto thyroiditis disease.    Thyroglobulin antibodies (Tg) – The thyroid produces thyroglobulin. It is a significant protein that produces T3 (triiodothyronine) and T4 (thyroxine) hormones. Thyroglobulin can be present when your thyroid is damaged. These antibodies also measure besides thyroglobulin tests when you receive complete treatment for thyroid cancer.   Thyrotropin receptor antibodies (TR) – These antibodies link to the receptor on thyroid cells and activate by TSH. The pituitary gland releases the hormone in the blood. This hormone is known as thyroid-stimulating hormone (TSH) or thyrotropin. In Grave’s disease, a Thyroid-stimulating immunoglobulin (TSI) connects to the TSH receptor. It also copies the action of TSH. It leads to constant stimulation of the thyroid gland and the release of a large amount of thyroid hormone.  The quantity of these hormones in the blood can play a role in diagnosing the disease for thyroid. High or low levels of T4 and TSH can indicate signs of a thyroid problem. It is the reason they are known as the best test to diagnose the conditions of the thyroid.  When do I need a thyroid peroxidase antibodies test? Your doctor may recommend the test if you experience symptoms of thyroid problems. You can order the lab test online at UmbrellaMD. Your provider may also suggest the thyroid antibodies test if you have symptoms of Hashimoto or Grave’s disease. Symptoms of Hashimoto's disease, such as Obesity Constipation Losing hair Fatigue  Pain in joint  Depression Intolerance to cold Irregular menstrual periods Symptoms of Grave’s disease:    Intolerance to heat Anxiety Weight loss Difficulty sleeping Disturbance in heartbeat Swelling in eyes Tremors Swelling in the thyroid (goiter) You may have to conduct this test if your thyroid hormone levels are too low or too high in an additional test. These include measurements of hormones such as T3, T4, and TSH (thyroid-stimulating hormone). What happens during a thyroid antibodies test? You may need to provide a blood sample. Your healthcare provider injects a needle into a vein of your arm. A small amount of blood collects in the test tube when a needle injects into your vein. Your provider applies the bandage to your vein to prevent blood leakage. This test generally takes at least 5 minutes.  How do I need to prepare for the test? You do not have to prepare for the thyroid peroxidase antibodies test.  Is there any risk to the test? There is little risk in the blood test. You may experience pain at the spot where the needle goes in. But, these symptoms do not stay for a long time.  What do the test results mean? If you have abnormal results of thyroid antibodies test, this may show the disease of autoimmune disorder. Thyroid peroxidase antibodies can indicate the following results:   Negative result – This means you have no thyroid antibodies. You do not have a disease or an autoimmune disorder. Positive result –TPO and Tg antibodies are present in your blood. These may indicate you have Hashimoto's disease. If one or both of these antibodies show high levels, people most often experience Hashimoto's disease.  Positive result – TPO and TSH receptor antibodies are present in your blood. These can indicate that you have Grave’s disease. If your results have higher thyroid antibodies, this may indicate that you are more likely to develop an autoimmune disorder. Your doctor may recommend medicines if you are diagnosed with Graves or Hashimoto disease.  What else do I need to know about a thyroid peroxidase antibodies test? The problem in the thyroid may affect pregnancy. It can lead to danger for both the mother and her unborn child. Your doctor may recommend an additional test with thyroid peroxidase antibodies if you are pregnant and have experience thyroid disease. You can register here to learn about more laboratory tests. Your provider suggests medicines during pregnancy for the treatment of thyroid disease.  Visit Umbrella Health Care Systems to make an online appointment with a doctor. It is online healthcare that provides services including e-consultation, pharmacies, laboratory tests, and medical imaging.   

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Alternative Names Celiac Disease,tTG Antibody,Transglutaminase, Tissue Antibody IgA,Dermatitis Herpetiformis,tTG IgA Tissue Transglutaminase (tTG) Antibody (IgA) - Tissue Transglutaminase Antibody, IgA, is useful in diagnosing gluten-sensitive enteropathies, such as Celiac Sprue Disease, and an associated skin condition, dermatitis herpetiformis. Methodology Immunoassay (IA) Reference Range(s) <15.0 U/mL    Antibody not detected ≥15.0 U/mL    Antibody detected Preferred Specimen(s) 1 mL serum Minimum Volume 0.5 mL Transport Container Transport tube Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 14 days Frozen: 30 days Reject Criteria Gross hemolysis • Grossly lipemic

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

TRANSFERRIN What are the other names for the test? TIBC, Total iron-binding capacity, Transferrin saturation, Serum Iron-Binding Capacity, Siderophilin, UIBC, IBC What is a transferrin test? A transferrin test determines the amount of transferrin in your blood. Transferrin is an essential protein in the blood that helps to bind iron and transfer it throughout your body. Iron is a significant mineral that helps your red blood cells to carry oxygen to your cells in the body. Your liver develops transferrin. When you have a low iron level, your liver creates additional transferrin to deposit recommended iron into your blood. In general, your body keeps track of the iron level and prevents it from going too high or too low. Your healthcare provider using this test can get more detailed information about medical issues, such as anemia that may affect the level of iron in your body. What is the purpose of the test? A transferrin test may be used besides other iron tests to evaluate the quantity of iron flowing in your blood, the total capacity of the blood to transfer iron, and the iron levels in your body. In most cases, the iron tests may order simultaneously. The results of each test may help to find the deficiency of iron, anemia, or large amounts of iron in the body. When do I need to take this test? Your healthcare provider may recommend this test if you experience specific forms of anemia. It is a disease in which you have low red blood cells. Iron deficiency is one type of anemia that indicates you don’t possess recommended iron to develop hemoglobin. Hemoglobin is the element that provides support to the red blood cells to carry oxygen. If you see the following signs and symptoms of anemia, you may need to take this test. Symptoms of anemia   Severe weakness Headaches Pale skin Dizziness Extreme fatigue/tiredness Breath problems Increased heartbeat during physical activity Irritability In general, anemia occurs due to blood loss or when you cannot absorb iron from food. Pregnant women have more chances of anemia. You may need to conduct this test when your provider suspects a high iron level in your blood. Symptoms of excess iron deposition depend from person to person and become complicated with time. These can include   Pain in the joint Losing weight Abdominal pain Low energy Decreased sex drive A damaged organ like the heart or/and liver Weakness Fatigue Your provider also suggests the test to detect iron poisoning, which is most common in children. They may get vitamins or supplements that possess iron in large amounts. What is the procedure of the transferrin test? You need to provide a blood sample to your provider for a transferrin test. A small needle inserts in a vein in your arm to collect a blood sample in a test tube. A bandage applies to your vein. The test does not take time greater than 5 minutes. How do I need to prepare for the test? You may need to stop taking certain medicines that can affect your test results. Your provider will inform you about any specific instructions for a transferrin test until you do not need to prepare for the test. If you may need to order additional blood tests, you have to keep fast for at least 12 hours before the test.   Is there any risk in this test? A transferrin test is a blood test that does not have a high risk. You may experience a little pain at the point in your vein from where the blood collects. A chance of bleeding or bruising may also occur, but generally, these signs do not last long. What do transferrin test results indicate? The test results depend on the person’s age, gender, medical history, and other factors. Each lab may use different measurement methods. You can make an online appointment here with a doctor to understand your test results. Many medical conditions can lead to high or low levels of transferrin. Your provider may use a transferrin test and additional iron tests to find the reason for your symptoms. What is the recommended range for this test? The test results expressed in milligrams per deciliter (mg/dL). The ideal range for transferrin is 215 to 380 mg/dL. Your provider may also measure the transferrin levels by total iron-binding capacity (TIBC). Its results report in the unit of micrograms per deciliter (mcg/dL). The recommended values are 250 to 450 mcg/dL. Transferrin saturation is another method to observe which positions on your transferrin that may bind iron are working. Its ideal values are 15% to 50%. The test value lies below 10%, indicating iron deficiency and anemia. What else do I need to know about this test? Your provider may recommend these tests as well, such as   TIBC - This test determines the total amount of iron that may combine with transferrin protein in your blood. This test is the indirect measurement of transferrin available to link with iron.   Serum-iron- This test calculates the total quantity of iron in the liquid portion of your blood that is bound to transferrin.   UIBC - This test depicts the reserve capacity of transferrin, which does not combine with iron.   Transferrin saturation - It shows the percentage of transferrin-iron binding capacities. This test represents the percentage by dividing the amount of iron by the TIBC.   Ferritin - This test determines the amount of transferrin developed by all cells when the level of iron increases in your body. It shows the total amount of iron in the body. What factors may affect the test results? You can avoid the usage of aspirin, antibiotics, and birth control pills. These may alter your test results. Visit Umbrella Health Care Systems to place an online order for this test if you don’t have a prescription. For information about more laboratory tests, medical imaging, and e-consultation service, you can register here.  

Includes Maple (Box Elder) (t1) Birch (t3) Mountain Cedar (t6) Oak (t7) Cottonwood (t14) "Preferred Specimen(s) 1.5 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Immunoassay Reference Range(s) See individual analytes Alternative Name(s) ImmunoCAP®

Preferred Specimen(s) 2 mL serum Minimum Volume 1.5 mL Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Includes IgE allergy testing for: Almond (f20) Brazil Nut (f18) Cashew Nut (f202) Hazelnut (f17) Macadamia Nut (rf345) Peanut (f13) Pecan Nut (f201) Pistachio (f203) Walnut (f256) Methodology Immunoassay (IA) Assay Category Reference Range(s) See Laboratory Report Alternative Name(s) Mixed Nut Allergen Panel,ImmunoCAP®,Nut Mix

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Alternative Names Trichomoniasis,T.vaginalis,T vaginalis,Vaginitis,Trichomonas Vaginalis RNA,Urine Trichomonas. Trichomonas vaginalis RNA, Qualitative, TMA - Trichomonas vaginalis RNA, Qualitative Transcription-Mediated Amplification (TMA) assay is a nucleic acid amplification test that uses TMA for detection of T. vaginalis RNA in vaginal swabs (preferred), female or male urine, or endocervical swabs. It is used in the screening and diagnosis of trichomoniasis. When the clinical performance of this assay was evaluated, sensitivity was 100% in vaginal swab, endocervical swab, and PreservCyt® Solution liquid PAP specimens. Specificity was 98.2% in vaginal swab specimens and 98.1% in endocervical swab specimens [1,2]. Trichomoniasis is one of the most common sexually transmitted infections (STIs) in the United States, with an estimated 1.1 million new cases each year [3]. It is curable. About 70% of people infected with T. vaginalis are asymptomatic, though symptoms may show up after the infection has been present for some time. In women, symptoms include vaginal and/or urethral discharge, painful urination and genital burning and discomfort [4]. Patient Preparation Urine: Patient should not have urinated within one hour prior to collection. Female patients should not cleanse the labial area prior to providing the specimen. Methodology Transcription-Mediated Amplification (TMA) Preferred Specimen(s) 1 vaginal swab in Aptima® Transport Tube or 1 endocervical swab in Aptima® Transport Tube or 2 mL female or male urine in Aptima® Transport Tube Alternative Specimen(s) Female or male urine (no preservatives): 2 mL of urine, specimen must be transferred into the Aptima® Urine Transport Medium within 24 hours of collection and before being assayed Minimum Volume 1 vaginal swab • 1 endocervical swab • 2 mL urine Collection Instructions Vaginal swab: Follow instructions in the Aptima® Vaginal Swab Collection or Multitest Collection Kit (orange label). Endocervical swab: Follow instructions in the Aptima® Unisex Swab Specimen Collection Kit (white label). Excess mucus should be removed prior to sampling. Urine: Direct patient to provide a first-catch urine (a maximum of 20-30 mL of the initial urine stream) into a urine collection cup free of any preservatives. 2 mL of urine specimen must be transferred into the Aptima® Specimen Transport within 24 hours of collection and before being assayed. Use the tube provided in the urine specimen collection kit. The fluid (urine plus transport media) level in the urine transport tube must fall within the clear pane of the tube label.

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

TRIGLYCERIDES (REFL)   Any other name for this test?    Triglyceride lab tests are known by the terms TG, TRIG, lipid panel, and fasting lipoprotein panel.    What are TRIGLYCERIDES?    Triglycerides are the most common fat(lipid) found in the blood. They are also the body's primary source of energy.     What is the purpose of triglycerides in the blood?   Triglycerides provide energy for your body. They are created when you consume more calories than you require and are then stored in your fat cells for future use. Triglycerides are released from your cells into your bloodstream when your body requires energy so that your muscles have the fuel to function.   You may have high triglycerides if you consistently consume more calories than you burn, especially from foods heavy in carbohydrates (hypertriglyceridemia).      What is a Triglycerides Lab Test?     A triglyceride lab test counts the number of triglycerides in the blood. The lab test screens for heart conditions and also checks for high triglyceride levels. A Triglycerides Lab Test evaluates your risk of heart disease. This test is frequently done as part of a lipid panel.   Why does the doctor order triglycerides lab tests?   Doctors ask for Triglycerides Lab Test as part of a lipid panel test to understand deeply your risk for heart disease and other heart conditions. They will monitor your risk for heart attack and high lipid. Treatment will be according to the test results.     Why do I need this test?  During your regular checkup, the doctor might ask you to undergo a triglycerides lab test. If you have recovered from a heart attack or you are being treated for high cholesterol. To monitor how well your heart is functioning.      What are the risk factors that lead to a Triglycerides Lab Test?  Smoking cigarettes  Having a weight problem   Consuming a poor diet   Not working out enough   Age (45 years or older men or 55 years or older women)   Suffering from high blood pressure   Heart disease runs in the family   Being diabetic or having prediabetes   Having heart disease or having experienced a heart attack in the past.    When to consider a Triglycerides Lab Test?  Consider it,  As a part of your regular lipid profile checkup. Adults should consider it every once four to six years.  Kids should have their lipid profile monitoring done between the age of nine and eleven and afterward again between seventeen and twenty-one.     Do we need to fast for this test?  Yes, fasting is considered for this test means you cannot eat or drink anything for nine to twelve hours before the test is done. Healthcare professionals will guide you more about the process of a Triglycerides Lab Test.    How does a triglycerides test work?  A tiny needle is used to take a blood sample from a vein in your hand. Blood is collected and placed into a test container. Due to the needle's in and out motion, there may be slight discomfort and pain.    Is there any risk linked to this test?  There is no serious risk to this test. You could have minor pain or bruise around the area where the needle went. These symptoms will go away in 2-3 days.    What will happen after the test? After the test is completed, your healthcare professional will bandage the area from where the blood is drawn to stop the bleeding.    What do the results mean? The standard unit of measurement for triglycerides is milligrams (mg) of triglycerides per deciliter (dL) of blood. The treatment will be under the Standard guidelines for normal or higher levels of triglycerides. The following are the Normal adult guidelines: Normal (preferred): not more than 150 mg/dL High-risk: 150 to 199 mg/dL High: 200 to 499 mg/dL Extremely high (500 mg/dL and above) The outcomes for teenagers and children differ.   What does a low triglyceride test result mean? A low triglyceride lab test result means you have a lower risk of developing heart disease.   What does a high-test result for triglycerides mean?  You increase the risk of developing heart disease if the results of your triglyceride lab test are high. Results show that you have too much blood fat. The use of foods high in carbohydrates or genetic factors is the cause of high triglycerides. High triglycerides can cause arteriosclerosis, which thickens the artery walls and increases the risk of stroke, heart attack, and heart disease. Extremely high triglycerides can also result in acute pancreatic inflammation (pancreatitis). The doctors will make notable changes in your lifestyle and diet to control the level of triglycerides. Are any other tests that need to complete besides the triglyceride lab test? A triglyceride lab test is usually done in a group as a part of the lipid panel test. This test aid medical specialist in analyzing your heart status, all of these tests are merged for further process. These test results will guide how your medical care will be offered.   Anything else I need to know regarding the triglyceride test? Some medicines can raise the level of blood triglycerides. Ask your healthcare provider if there is any medicine in your prescription which might affect the test results. Some medical conditions may also contribute to high triglyceride levels in the blood. These conditions are listed below: Liver illness  Failure of the kidney Thyroid disorder  Obesity  Diabetes  Alcohol Use Disorder (AUD) If you have one of the conditions listed above, you are at a high risk of developing heart disease.

Clinical Significance Triglycerides (REFL) - Serum triglyceride analysis has proven useful in the diagnosis and treatment of patients with diabetes mellitus, nephrosis, liver obstruction, other diseases involving lipid metabolism, and various endocrine disorders. In conjunction with high density lipoprotein and total serum cholesterol, a triglyceride determination provides valuable information for the assessment of coronary heart disease risk. Preferred Specimen(s) 1 mL serum Alternative Specimen(s) Sodium heparin (green-top) tube • Lithium heparin (green-top) tube Minimum Volume 0.5 mL Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Serum and plasma Room temperature: 5 days Refrigerated: 7 days Frozen: 28 days Reject Criteria Anticoagulants other than heparin Includes This is a client specific reflex test. Reflex criteria has been pre-defined by the ordering physician. Additional testing will be performed at an additional charge. Patient Preparation Triglyceride test only: Patient should fast 9-12 hours prior to collection. As part of lipid panel testing: A fasting sample is not required. Methodology Spectrophotometry (SP) Reference Range(s) ≤9 Years      <75 mg/dL     10-19 Years    <90 mg/dL    ≥20 Years    <150 mg/dL    

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance TSH - For differential diagnosis of primary, secondary, and tertiary hypothyroidism. Also useful in screening for hyperthyroidism. This assay allows adjustment of exogenous thyroxine dosage in hypothyroid patients and in patients on suppressive thyroxine therapy for thyroid neoplasia. Preferred Specimen(s) 1 mL serum Minimum Volume 0.7 mL Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Reject Criteria Plasma Patient Preparation Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay." Methodology Immunoassay (IA) Reference Range(s) Premature Infants (28-36 Weeks)        1st Week of Life    0.20-27.90 mIU/L Term Infants (>37 Weeks)        Serum or Cord Blood    1.00-39.00 mIU/L   1-2 Days    3.20-34.60 mIU/L   3-4 Days    0.70-15.40 mIU/L   5 Days-4 Weeks    1.70-9.10 mIU/L   1-11 Months    0.80-8.20 mIU/L   1-19 Years    0.50-4.30 mIU/L   ≥20 Years    0.40-4.50 mIU/L Pregnancy        First Trimester    0.26-2.66 mIU/L   Second Trimester    0.55-2.73 mIU/L   Third Trimester    0.43-2.91 mIU/LTSH levels decline rapidly during the first week of life in most children, but may remain transiently elevated in a few individuals despite normal free T4 levels. For proper interpretation of an abnormal TSH from a newborn thyroid screen, a Free T4 by Dialysis (test code 35167) or Total T4 (test code 867) should be considered. Alternative Name(s) Thyrotropin,Thyroid Stimulating Hormone

Clinical Significance TSH (REFL) - For differential diagnosis of primary, secondary, and tertiary hypothyroidism. Also useful in screening for hyperthyroidism. This assay allows adjustment of exogenous thyroxine dosage in hypothyroid patients and in patients on suppressive thyroxine therapy for thyroid neoplasia. Preferred Specimen(s) 1 mL serum Minimum Volume 0.7 mL Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Reject Criteria Plasma Includes This is a client specific reflex test. Reflex criteria has been pre-defined by the ordering physician. Additional testing will be performed at an additional charge. Patient Preparation Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay. " Methodology Immunoassay (IA) Reference Range(s) Premature Infants (28-36 Weeks)        1st Week of Life    0.20-27.90 mIU/L Term Infants (>37 Weeks)        Serum or Cord Blood    1.00-39.00 mIU/L   1-2 Days    3.20-34.60 mIU/L   3-4 Days    0.70-15.40 mIU/L   5 Days-4 Weeks    1.70-9.10 mIU/L   1-11 Months    0.80-8.20 mIU/L   1-19 Years    0.50-4.30 mIU/L   ≥20 Years    0.40-4.50 mIU/L Pregnancy        First Trimester    0.26-2.66 mIU/L   Second Trimester    0.55-2.73 mIU/L   Third Trimester    0.43-2.91 mIU/LTSH levels decline rapidly during the first week of life in most children, but may remain transiently elevated in a few individuals despite normal free T4 levels. For proper interpretation of an abnormal TSH from a newborn thyroid screen, a Free T4 by Dialysis (test code 35167) or Total T4 (test code 867) should be considered.

Clinical Significance TSH with Reflex to Free T4 - For differential diagnosis of primary, secondary, and tertiary hypothyroidism. Also useful in screening for hyperthyroidism. This assay allows adjustment of exogenous thyroxine dosage in hypothyroid patients and in patients on suppressive thyroxine therapy for thyroid neoplasia. Preferred Specimen(s) 1 mL serum Minimum Volume 0.7 mL Collection Instructions This assay should only be ordered on patients 1 year of age or older. Orders on patients younger than 1 year will have a TSH only performed. Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Includes For patients 1 year of age or older, Free T4 will be performed at an additional charge (CPT code(s): 84439) when TSH result exceeds age/gender specific reference range. Patient Preparation Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay." Methodology Immunoassay (IA) Reference Range(s) Premature Infants (28-36 Weeks)        1st Week of Life    0.20-27.90 mIU/L Term Infants (>37 Weeks)        Serum or Cord Blood    1.00-39.00 mIU/L   1-2 Days    3.20-34.60 mIU/L   3-4 Days    0.70-15.40 mIU/L   5 Days-4 Weeks    1.70-9.10 mIU/L   1-11 Months    0.80-8.20 mIU/L   1-19 Years    0.50-4.30 mIU/L   ≥20 Years    0.40-4.50 mIU/L Pregnancy        First Trimester    0.26-2.66 mIU/L   Second Trimester    0.55-2.73 mIU/L   Third Trimester    0.43-2.91 mIU/LTSH levels decline rapidly during the first week of life in most children, but may remain transiently elevated in a few individuals despite normal free T4 levels. For proper interpretation of an abnormal TSH from a newborn thyroid screen, a Free T4 by Dialysis (test code 35167) or Total T4 (test code 867) should be considered. Alternative Name(s) Thyroid Stimulating Hormone with Reflex

Clinical Significance TSH, 2 Specimens - For differential diagnosis of primary, secondary, and tertiary hypothyroidism. Also useful in screening for hyperthyroidism. This assay allows adjustment of exogenous thyroxine dosage in hypothyroid patients and in patients on suppressive thyroxine therapy for thyroid neoplasia. Preferred Specimen(s) 1 mL serum per specimen Minimum Volume 0.7 mL per specimen Transport Container Serum Separator Tubes (SST®s) Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Reject Criteria Plasma Patient Preparation Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay. " Methodology Immunoassay (IA) Reference Range(s) 1-2 Days    3.20-34.60 mIU/L 3-4 Days    0.70-15.40 mIU/L 5 Days-4 Weeks    1.70-9.10 mIU/L 1-11 Months    0.80-8.20 mIU/L 1-19 Years    0.50-4.30 mIU/L ≥20 Years    0.40-4.50 mIU/L Pregnancy        First Trimester    0.26-2.66 mIU/L   Second Trimester    0.55-2.73 mIU/L   Third Trimester    0.43-2.91 mIU/L

Clinical Significance TSH, 4 Specimens - For differential diagnosis of primary, secondary, and tertiary hypothyroidism. Also useful in screening for hyperthyroidism. This assay allows adjustment of exogenous thyroxine dosage in hypothyroid patients and in patients on suppressive thyroxine therapy for thyroid neoplasia. Preferred Specimen(s) 1 mL serum per specimen Minimum Volume 0.7 mL per specimen Transport Container Serum Separator Tubes (SST®s) Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Reject Criteria Plasma Patient Preparation Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay. " Methodology Immunoassay (IA) Reference Range(s) 1-2 Days    3.20-34.60 mIU/L 3-4 Days    0.70-15.40 mIU/L 5 Days-4 Weeks    1.70-9.10 mIU/L 1-11 Months    0.80-8.20 mIU/L 1-19 Years    0.50-4.30 mIU/L ≥20 Years    0.40-4.50 mIU/L Pregnancy        First Trimester    0.26-2.66 mIU/L   Second Trimester    0.55-2.73 mIU/L   Third Trimester    0.43-2.91 mIU/L

Clinical Significance TSH, 5 Specimens - For differential diagnosis of primary, secondary and tertiary hypothyroidism. Also useful in screening for hyperthyroidism. This assay allows adjustment of exogenous thyroxine dosage in hypothyroid patients and in patients on suppressive thyroxine therapy for thyroid neoplasia. Preferred Specimen(s) 1 mL per specimen Minimum Volume 0.7 mL per specimen Transport Container Serum Separator Tubes (SST®s) Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Reject Criteria Plasma Patient Preparation Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay. " Methodology Immunoassay (IA) Reference Range(s) 1-2 Days    3.20-34.60 mIU/L 3-4 Days    0.70-15.40 mIU/L 5 Days-4 Weeks    1.70-9.10 mIU/L 1-11 Months    0.80-8.20 mIU/L 1-19 Years    0.50-4.30 mIU/L ≥20 Years    0.40-4.50 mIU/L Pregnancy        First Trimester    0.26-2.66 mIU/L   Second Trimester    0.55-2.73 mIU/L   Third Trimester    0.43-2.91 mIU/L

Clinical Significance TSH, Pregnancy - TSH levels are lower during pregnancy, especially during the 1st trimester. Based on recent clinical studies which have shown that even mildly elevated TSH during pregnancy is associated with adverse pregnancy outcomes, the American Thyroid Association has released clinical guidelines which recommend the use of assay-specific and trimester-specific reference intervals. Preferred Specimen(s) 1 mL serum Minimum Volume 0.7 mL Transport Container Serum Separator Tube (SST®) Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Patient Preparation Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks. According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay." Methodology Immunoassay (IA) Reference Range(s) First Trimester    0.26-2.66 mIU/L Second Trimester    0.55-2.73 mIU/L Third Trimester    0.43-2.91 mIU/LResults are flagged based on the first trimester assay-specific reference interval. For later stages of pregnancy, interpret results based on the trimester-specific reference intervals provided. Alternative Name(s) Pregnancy TSH

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Turkey Feathers (e89) IgE - This test quantifies an individual’s IgE response to turkey feathers. It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare professional after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days