Reference ranges ("normal ranges")
Because reference ranges (except for some lipid studies) are typically defined as the range of values of the median 95% of the healthy population, it is unlikely that a given specimen, even from a healthy patient, will show "normal" values for all the tests in a lengthy profile. Therefore, caution should be exercised to prevent overreaction to miscellaneous, mild abnormalities without clinical correlate.

Cardiovascular Risk Profile

Total Cholesterol
This is a test for obesity, hypertension and heart disease. Elevated cholesterol levels may lead to deposits of fat in the blood vessel resulting in narrowing and subsequent blockage of the vessel (atherosclerosis). Cholesterol levels above 6.2 MMOL/L are associated with atherosclerosis and an increased risk of coronary heart disease.

HDL Cholesterol
HDL, or good cholesterol, helps remove cholesterol from the blood and transport it to the liver for excretion. High levels of HDL are associated with a low risk of atherosclerosis and heart disease.

LDL Cholesterol
LDL, or bad cholesterol, helps deposit cholesterol in the blood vessel which leads to atherosclerosis. High levels of LDL are associated with high risk of coronary heart disease.

Total Cholesterol / HDL Cholesterol Ratio
One way to assess risk is to use the total cholesterol/HDL cholesterol ratio, with lower values indicating lower risk.

Triglycerides
Triglycerides are a type of fat found in the fat tissue of the body and are a major source of energy. Elevated levels of triglycerides may lead to coronary heart disease.

hs-CRP (high sensitivity C-reactive protein)
C-reactive protein (CRP) is a protein found in the blood. It is what we call a marker for inflammation, meaning its presence indicates a heightened state of inflammation in the body. Inflammation is a normal response to many physical states including fever, injury and infection. Inflammation is now believed to play a role in the initiation and progression of cardiovascular disease. hs-CRP has proven to be a powerful predictor of heart disease risk. Elevated hs-CRP is related to increased risk for heart attack, restenosis of coronary arteries after angioplasty, stroke, and peripheral vascular disease (PVD).

Chemistry Panel

Glucose
Elevated levels of glucose (blood sugar) may indicate diabetes mellitus. Glucose levels should always be measured while fasting; you should have nothing to eat for a minimum of eight hours before the test. A physician should always follow up an abnormal fasting glucose.

Blood Urea
Blood urea is the end product of protein metabolism. Elevated levels of blood urea are seen in persons with kidney disease. Slightly elevated levels may be seen in individuals on high protein diets.

Creatinine
Like blood urea, elevated levels of creatinine are seen in persons with kidney disease. Creatinine is a by-product of the breakdown of creatine in the muscles.

Sodium and Chloride
These elements are also known as electrolytes. Electrolyte levels are dependent on the intake of fluids and the output of waste products by the kidneys. Abnormal levels are seen in individuals with kidney disorders, hypertension (high blood pressure) and heart disease.

Calcium
Low levels of calcium are usually associated with poor dietary intake. Calcium is essential for strong bones and teeth. Milk is a very good source of calcium.

Uric Acid
High levels of uric acid can lead to gout, urinary stones, and kidney disease. Persons with elevated levels of uric acid should reduce their intake of high protein foods such as fish roe and organ meats; decreasing alcohol consumption also advisable.

Total Protein, Albumin, Globulin
Elevated levels of total protein are seen in dehydration, some cases of chronic liver disease including hepatitis, myleloma and instances of chronic infection and inflammation. Albumin and globulin are forms of protein and are part of the total protein.

Total Bilirubin
High levels of total bilirubin are seen in individuals with liver disease and haemolytic anaemias. Individual with elevated levels of bilirubin usually have jaundice (yellowness of the skin and eyes).

Alkaline Phosphatase
Alkaline phosphatase is an enzyme produced in bone and liver cells. Elevated levels of alkaline phosphatase are seen in individuals with liver or bone disorders and in rapidly growing children.

Aspartate Aminotransferase (AST)
AST is an enzyme present in many major organs such as the liver and heart, skeletal muscle and blood cells. Elevated levels are often seen in acute myocardial infarction (heart attack) and hepatitis.

Alanine Aminotransferase (ALT)
ALT is an enzyme present in the liver. Elevated levels indicate destruction of liver cells and are usually seen in disorders of the liver.

Thyroxine (T4)
T4 is a hormone produced by the thyroid gland which regulates metabolic activity. Elevated levels of T4 usually indicate hyper (high) thyroidism; decrease levels usually indicate hypo (low) thyroidism.

CBC and Differential

Haemoglobin, RBC, HCT
Haemoglobin (Hb), the red pigment in Red Blood cells (RBC), is essential for the transport of oxygen to body tissue. A low haemoglobin may indicate that an individual is anaemic. An anaemic individual may appear pale and tires easily. Anaemia can be due to a decreased production of RBCs, lack of essential nutrients like iron or hereditary disorders. The haematocrit (HCT) represents the percent RBCs compared to the liquid portion of your blood.

White Blood Cells & Differential Count
White Blood Cells (WBC) help your body fight infection and removes debris. There are different types of WBC: neutrophils fight against bacteria infection; lymphocytes fight viral infection; eosinophils can indicate a parasitic infection or an allergic condition; monocytes act as scavengers to remove debris. The differential count indicates the distribution of different types of WBC.

Red Blood Cell Indices
Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH) and Mean Corpuscular Haemoglobin Concentration (MCHC) are values that refer to the volume of red blood cells and the haemoglobin content of the blood. These tests are used by your doctor to help differentiate Red blood Cell abnormalities.

Platelet Count
This is a test for bleeding disorder.

Urinalysis

The kidneys excrete urine by extracting fluid and waste from the blood flowing through them. An analysis of the urine may indicate abnormalities in the blood, kidneys and urinary tract.

Colour
Indicates physical characteristics such as impurities, blood, infection, concentration, etc.

Appearance
Urine may be clear or cloudy. Cloudy urine could indicate the presence of impurities or an infection.

pH
The pH indicates if the urine is alkaline or acidic. The pH is dependent upon the type of food eaten and the time of day the urine sample was collected.

Specific Gravity
The specific gravity is an indication of the density or concentration of the urine compared to water.

Glucose
Glucose is not normally detected in the urine of normal healthy individuals. Glucose is usually seen in the urine of patients with diabetes mellitus.

Protein
Protein is not normally detected in the urine of normal healthy individuals and its presence usually suggests a kidney disorder. Small amounts of protein may be present in normal individuals, in concentrated specimens or after a strenuous exercise.

Ketones
Ketones are not normally detected in the urine of normal healthy individuals. The presence of ketones in the urine is indicative of diabetes mellitus or acute starvation.

Bacteria/Nitrite
Urine is normally sterile. The presence of bacteria and/or nitrite in a fresh urine sample indicates a urinary tract or bladder infection.

Bilirubin
Bilirubin is not normally present in urine. The presence of bilirubin in the urine may indicate a liver disorder such as hepatitis.

Urobilinogen
Increased levels of urobilinogen can be seen in normal individuals; however, in some cases, it may indicate liver disorders or other conditions that break down red blood cells, such as Thalassemia.

White Blood Cells, Epithelial Cells, Red Blood Cells, Casts, Crystals
The function of the urinary system is to eliminate waste from the body. During this elimination process, certain cellular elements may also be passed through the urine. Small amounts of WBC, RBC and Epithelial Cells are normal. Casts and crystals in the urine should be considered abnormal.

Hepatitis Screening

Hepatitis B surface Antigen (HBsAg)
HBsAg is present in individuals with active hepatitis B virus. Hepatitis B is a life-threatening disease and very contagious. Individuals with a positive (detected) result for this test should consult a physician immediately.

Hepatitis B surface Antibodies (HBsAb)
A person who recovers completely from Hepatitis B infection or one who has been successfully immunized against hepatitis B will have the antibodies for HBsAg. However, the level of antibodies will decrease with time and there might be a need for a booster dose if the level falls below the protective range.

Other General Screening Tests

Blood Group & Rh Type
There are four major blood groups, A, B, AB and O. These major blood groups can be either Rhesus (Rh) negative or positive. It is important to know your blood group prior to a blood transfusion. With very few exceptions, an individual must always be transfused with his or her own blood type and Rh.

Rapid Plasma Reagin (RPR)
RPR is a very sensitive test used to screen for syphilis. A positive (detected) result does not necessarily indicate that a person has syphilis. Because the test is set to detect abnormals at very low levels, there is some chance of a false-positive result. However, a physician should follow up all positive results.

Tumour Markers

Measurements of tumour marker levels can be useful – when used along with x-rays or other tests – in the detection and diagnosis of some types of cancer. However, measurements of tumour marker levels alone are not sufficient to diagnose cancer for the following reasons:

Tumour marker levels can be elevated in people with benign conditions.
Tumour marker levels are not elevated in every person with cancer – especially in the early stages of the disease.
Many tumour markers are not specific to a particular type of cancer; the level of a tumour marker can be raised by more than one type of cancer.
Conclusions based on tumor marker tests are seldom based on one test result but on a series of test results, called serial measurements. A series of increasing or decreasing values is more significant than a single value.

Alpha-Fetoprotein (AFP)
A tumor marker associated with liver, testicular, and ovarian cancer. Non-cancerous conditions that can cause elevated AFP levels include benign liver conditions, such as cirrhosis or hepatitis; ataxia telangiectasia; Wiscott-Aldrich syndrome; and pregnancy.

Carcinoembryonic Antigen (CEA)
CEA is normally found in small amounts in the blood of most healthy people, but may become elevated in people who have cancer or some benign conditions. The primary use of CEA is in monitoring colorectal cancer, especially when the disease has spread. CEA is also used after treatment to check for recurrence of colorectal cancer. However, a wide variety of other cancers can produce elevated levels of this tumour marker, including melanoma, lymphoma, and cancers of the breast, lung, pancreas, stomach, cervix, bladder, kidney, thyroid, liver and ovary.
Elevated CEA levels can also occur in patients with non-cancerous conditions, including inflammatory bowel disease, pancreatitis, and liver disease. Tobacco use can also contribute to higher-than-normal levels of CEA.

CA 19-9
Initially found in colorectal cancer patients, CA 19-9 has also been identified in patients with pancreatic, stomach, and bile duct cancer. Researchers have discovered that, in those who have pancreatic cancer, higher levels of CA 19-9 tend to be associated with more advanced disease. Non-cancerous conditions that may elevate CA 19-9 levels include gallstones, pancreatitis, cirrhosis of the liver, and cholecystitis.

CA 15-3
CA 15-3 levels are most useful in following the course of treatment in women diagnosed with breast cancer, especially advanced breast cancer. CA 15-3 levels are rarely elevated in women with early stage breast cancer. Cancers of the ovary, lung, and prostate may also raise CA 15-3 levels. Elevated levels of CA 15-3 may be associated with non-cancerous conditions, such as benign breast or ovarian disease, endometriosis, pelvic inflammatory disease, and hepatitis. Pregnancy and lactation can also cause CA 15-3 levels to rise.

CA 125
CA 125 is produced by a variety of cells, but particularly by ovarian cancer cells. Studies have shown that many women with ovarian cancer have elevated CA 125 levels. CA 125 is recommended as a screening test for ovarian cancer when there is a history of hereditary cancer syndrome (a pattern of clusters of ovarian cancer within two or more generations).

Not all women with elevated CA 125 levels have ovarian cancer. CA 125 levels may also be elevated by cancer of the uterus, cervix, pancreas, liver, colon, breast, lung, and digestive tract. Non-cancerous conditions that can cause elevated CA 125 levels include endometriosis, pelvic inflammatory disease, peritonitis, pancreatitis, liver disease, and any condition that inflames the pleura (the tissue that surrounds the lungs and lines the chest cavity). Menstruation and pregnancy can also cause an increase in CA 125.