Medical Tests

C-Peptide Test

What is a C-peptide test?
This test measures the level of C-peptide in a sample of your blood or urine (pee). Measuring C-peptide is an accurate way to find out how much insulin your body is making.

Insulin is a hormone that your pancreas makes. It helps blood glucose (blood sugar) get into your cells, where it can be used for energy. This helps keep your blood glucose at healthy levels.

During the process of making insulin, your pancreas produces C-peptide. C-peptide and insulin enter your bloodstream at the same time and in equal amounts. C-peptide doesn’t affect your blood glucose levels, but it stays in your blood longer than insulin, so it’s easier to measure accurately.

A C-peptide test can provide important information to help understand, monitor, and/or treat disorders that involve how well your body makes insulin, such as hypoglycemia (low blood sugar) and diabetes.

Other names: insulin C-peptide, connecting peptide insulin, proinsulin C-peptide

What is it used for?
A C-peptide test may be used to help:

Find the cause of hypoglycemia (low blood sugar). Some types of hypoglycemia are linked to high insulin levels. A C-peptide test can tell you whether too much insulin is involved in your condition. Possible causes of hypoglycemia include:
Liver or kidney disease
Malnutrition
Drinking too much alcohol without eating
A tumor in your pancreas (uncommon)
Side effects from certain diabetes medicines, including insulin.
Manage diabetes treatment. If you have type 1 or type 2 diabetes, treatment decisions may depend on knowing how much insulin your pancreas is producing. A C-peptide test can provide an accurate measurement, even if you take insulin for diabetes. That’s because your C-peptide levels depend on how much insulin your pancreas makes. They aren’t affected by insulin that you take.
Monitor treatment for a tumor in your pancreas, called an insulinoma (uncommon). These tumors make too much insulin and cause low blood sugar. They are almost always benign (not cancer) and can usually be removed with surgery.
To find out whether you have type 1 or type 2 diabetes if your diagnosis is uncertain. Usually, your health care provider can diagnose which type of diabetes you have. But in certain cases, it can be hard to tell for sure. If your diabetes diagnosis is uncertain after 3 years, a C-peptide test may be needed.
Why do I need a C-peptide test?
You may need a C-peptide test if:

You have been diagnosed with hypoglycemia (low blood sugar) but don’t know what’s causing it.
You have diabetes and you:
Take insulin, and your provider is considering changing your treatment.
Have type 2 diabetes, and your provider wants to see if you need to start taking insulin.
Have hypoglycemia, which could be caused by taking too much diabetes medicines.
You have been diagnosed with a pancreatic tumor (insulinoma). A C-peptide test can help monitor your condition and treatment.
What happens during a C-peptide test?
A C-peptide test usually uses a sample of your blood. But the test may also be done on a sample of all your urine collected over a 24-hour period.

During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

For a 24-hour urine sample test, you will be given a special container to collect your urine and instructions on how to collect and store your samples. Your provider will tell you what time to start. The test generally includes the following steps:

To begin, urinate in the toilet as usual. Do not collect this urine. Write down the time you urinated.
For the next 24 hours, collect all your urine in the container.
During the collection period, store the urine container in a refrigerator or in a cooler with ice.
24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
Return the container with your urine to your provider’s office or the laboratory as instructed.
Will I need to do anything to prepare for the test?
For a C-peptide blood test, you may need to fast (not eat or drink) for 8–12 hours before the test. Ask your provider if there are any specific instructions you need to follow before either a blood or a urine test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. There are no known risks to a urine test.

What do the results mean?
The meaning of your results depends on your age, health, the medicines you take, and the results of other tests, such as a blood glucose test. In general:

A high level of C-peptide usually means that your body is making too much insulin. Conditions that cause high insulin levels include:
Type 2 diabetes
Cushing’s syndrome
Insulinoma, a tumor in your pancreas
Kidney failure
A low level of potassium in your blood
A low level of C-peptide may mean your body isn’t making enough insulin. Conditions that cause low insulin levels include:
Type 1 diabetes and, in some cases, type 2 diabetes
Taking too much insulin to treat diabetes (Taking more insulin than you need may block your pancreas from making insulin on its own.)
A severe infection
Addison disease
Liver disease
If you have been treated for an insulin-producing tumor in your pancreas, a decrease in your C-peptide levels means your treatment is working. An increase in your C-peptide may mean that your tumor is back.

If you have questions about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a C-peptide test?
A C-peptide test is not used to diagnose diabetes. Other tests, such as blood glucose and urine glucose, are used to screen for and diagnose diabetes.

C-Reactive Protein (CRP) Test

What is a c-reactive (CRP) protein test?
A c-reactive protein test measures the level of c-reactive protein (CRP) in a sample of your blood. CRP is a protein that your liver makes. Normally, you have low levels of c-reactive protein in your blood. Your liver releases more CRP into your bloodstream if you have inflammation in your body. High levels of CRP may mean you have a serious health condition that causes inflammation.

Inflammation is your body’s way of protecting your tissues and helping them heal from an injury, infection, or other disease. Inflammation can be acute (sudden) and temporary. This type of inflammation is usually helpful. For example, if you cut your skin, it may turn red, swell, and hurt for a few days. Those are signs of inflammation. Inflammation can also happen inside your body.

If inflammation lasts too long, it can damage healthy tissues. This is called chronic (long-term) inflammation. Chronic infections, certain autoimmune disorders, and other diseases can cause harmful chronic inflammation. Chronic inflammation can also happen if your tissues are repeatedly injured or irritated, for example from smoking or chemicals in the environment.

A CRP test can show whether you have inflammation in your body and how much. But the test can’t show what’s causing the inflammation or which part of your body is inflamed.

Other names: c-reactive protein, serum

What is it used for?
A CRP test may be used to help find or monitor inflammation in acute or chronic conditions, including:

Infections from bacteria or viruses
Inflammatory bowel disease, disorders of the intestines that include Crohn’s disease and ulcerative colitis
Autoimmune disorders, such as lupus, rheumatoid arthritis, and vasculitis
Lung diseases, such as asthma
Your health care provider may use a CRP test to see if treatments for chronic inflammation are working or to make treatment decisions if you have sepsis. Sepsis is your body’s extreme response to an infection that spreads to your blood. It’s a life-threatening medical emergency.

Why do I need a CRP test?
You may need this test if you have symptoms of a bacterial infection, such as:

Fever or chills
Rapid heart rate
Rapid breathing
Nausea and vomiting
You may also need a CRP test if your provider thinks you may have a chronic condition that causes inflammation. The symptoms will depend on the condition.

If you’ve already been diagnosed with an infection or a chronic disease that causes inflammation, you may need this test to monitor your condition and treatment. CRP levels rise and fall depending on how much inflammation is in your body. If your CRP levels fall, it’s a sign that your treatment for inflammation is working or you’re healing on your own.

What happens during a CRP test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This process usually takes less than five minutes.

Will I need to do anything to prepare for the test?
Some medicines may affect your results. So, tell your provider about any supplements or medicines that you take, including ibuprofen, aspirin, and other non-steroidal anti-inflammatory drugs (NSAIDS). Don’t stop taking any prescription medicines without talking with your provider first.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
Your CRP test results tell you how much inflammation you have in your body. But your test results can’t tell you what’s causing the inflammation. To make a diagnosis, your provider will look at your CRP results along with the results of other tests, your symptoms, and medical history.

In general, healthy people have very low amounts of CRP in their blood. Any increases above normal mean you have inflammation in your body. But labs measure CRP levels in different ways, and they define “normal” CRP ranges differently, so it’s best to ask your provider what your results mean.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CRP test?
A CRP test is sometimes confused with a high-sensitivity-(hs) CRP test. They both measure CRP, but they are used for different conditions. An hs-CRP test measures very tiny increases in your CRP levels. It is used to estimate your risk of heart disease.

C. diff Testing

What is C. diff testing?
C. diff testing checks for signs of a C. diff infection, a serious, sometimes life-threatening disease of the digestive tract. C. diff, also known as C. difficile, stands for Clostridium difficile. It is a type of bacteria found in your digestive tract.

There are many types of bacteria that live in your digestive system. Most are “healthy” or “good” bacteria, but some are harmful or “bad.” The good bacteria help with digestion and control the growth of bad bacteria. Sometimes, the balance of good and bad bacteria gets upset. This is most often caused by some types of antibiotics, which can kill both good and bad bacteria.

C. diff is not normally harmful. But when the bacteria in the digestive system get out of balance, C. diff bacteria can grow out of control. When C. diff gets overgrown, it makes toxins that are released into the digestive tract. This condition is known as a C. diff infection. A C. diff infection causes symptoms that range from mild diarrhea to life-threatening inflammation of the large intestine. It is especially dangerous to people with weakened immune systems.

C. diff infections are most often caused by the use of certain antibiotics. But C. diff can also be contagious. C. diff bacteria are passed into stool. The bacteria can spread from person to person when a someone with an infection doesn’t thoroughly wash their hands after a bowel movement. They may then spread the bacteria to food and other surfaces they touch. If you come in contact with a contaminated surface and then touch your mouth, you may get the infection.

Other names: C. difficile, Clostridium difficile, Glutamate dehydrogenase test GDH Clostridioides difficile, C. difficile toxin test

What is it used for?
C. diff testing is most often used to find out if diarrhea is being caused by C. diff bacteria.

Why do I need C. diff testing?
You may need C. diff testing if you have any of the following symptoms, especially if you’ve recently taken antibiotics.

Watery diarrhea three or more times a day, lasting for more than four days
Abdominal pain
Nausea and vomiting
Loss of appetite
Blood or mucus in the stool
Weight loss
You are more likely to need C. diff testing if you have these symptoms, along with certain risk factors. You are at higher risk for getting a C. diff infection if you:

Are aged 65 or older
Live in a nursing home or health care facility
Are a patient in a hospital
Have inflammatory bowel disease or other disorder of the digestive system
Recently had gastrointestinal surgery
Are getting chemotherapy for cancer
Have a weakened immune system
Had a previous C. diff infection
What happens during C. diff testing?
You will need to provide a sample of your stool. Testing may include tests for the C. diff toxins, bacteria, and/or genes that make the toxins. But all tests can be performed on the same sample. Your provider will give you specific instructions on how to collect and send in your sample. Your instructions may include the following:

Put on a pair of rubber or latex gloves.
Collect and store the stool in a special container given to you by your health care provider or a lab.
If you have diarrhea, you can tape a large plastic bag to the toilet seat. It may be easier to collect your stool this way. You will then put the bag into the container.
Make sure no urine, toilet water, or toilet paper mixes in with the sample.
Seal and label the container.
Remove the gloves, and wash your hands.
Return the container to your health care provider as soon as possible. C. diff toxins may be harder to find when stool is not tested quickly enough. If you are unable to get to your provider right away, you should refrigerate your sample until you are ready deliver it.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for C. diff testing.

Are there any risks to testing?
There is no known risk to having C. diff testing.

What do the results mean?
If your results were negative, it probably means your symptoms are not being caused by C. diff bacteria, or that there was a problem with testing your sample. Your health care provider may retest you for C. diff and/or order more tests to help make a diagnosis.

If your results were positive, it means your symptoms are likely being caused by C. diff bacteria. If you are diagnosed with a C. diff infection and are currently taking antibiotics, you will probably need to stop taking them. Other treatments for a C. diff infection may include:

Taking a different type of antibiotics. Your provider may prescribe antibiotics that target C. diff bacteria.
Taking probiotics, a type of supplement. Probiotics are considered “good bacteria.” They are helpful to your digestive system.
If C. diff infections keep returning after you’ve been treated, your provider may recommend a fecal microbiota transplantation (FMT). It’s also known as stool transplantation. In this procedure, stool from a healthy donor is transplanted into your colon. Research has shown that FMT is very successful in treating recurrent C. diff infections. It has not been approved by the Food and Drug Administration (FDA). So it is still considered experimental. You can talk with your provider about whether this is an option for you.

If you have questions about your results and/or treatment, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about C .diff testing?
Clostridium difficile has been renamed Clostridioides Clostridioides difficile. But the older name is still frequently used. The change does not affect the commonly used abbreviations, C. diff and C. difficile.

CA 19-9 Blood Test (Pancreatic Cancer)

What is a CA 19-9 blood test?
A CA 19-9 test measures the amount of a protein called CA 19-9 (cancer antigen 19-9) in a sample of your blood. CA 19-9 is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in your body.

Healthy people can have small amounts of CA 19-9 in their blood. High levels of CA 19-9 are often a sign of pancreatic cancer. But high levels can also be a sign of other types of cancer or certain conditions that aren’t cancer. For example, gallstones and cirrhosis of the liver can cause high CA 19-9 levels.

Because high levels of CA 19-9 can mean different things, the test is not used by itself to screen for or diagnose cancer or other diseases. But it can help monitor your cancer and check how well your treatment is working.

Other names: cancer antigen 19-9, carbohydrate antigen 19-9, CA 199 measurement, CA 19-9 radioimmunoassay (RIA)

What is it used for?
CA 19-9 blood tests may be used to:

Monitor certain types of cancer and cancer treatment. CA 19-9 levels often go up as cancer grows and go down as tumors shrink.
Help predict how cancer may behave over time.
Check whether cancer has returned after treatment.
Help diagnose certain cancers and other diseases when used with other tests.
Some people do not make CA 19-9 even when they have a cancer that usually produces high levels of CA 19-9. For these people, a CA 19-9 tumor marker test is not useful.

Why do I need a CA 19-9 test?
You may need a CA 19-9 blood test if you’ve been diagnosed with pancreatic cancer or another type of cancer that causes high CA 19-9. These include cancers of the:

Bile duct
Colon and rectum
Stomach
Ovaries
Bladder
During cancer treatment, your health care provider may test you on a regular basis to see if your treatment is working.

After your treatment is complete, you may need to have CA 19-9 tests to check whether the cancer has come back. High levels of CA 19-9 may be one of the first signs that cancer cells are growing again.

What happens during a CA 19-9 blood test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
Usually, you don’t need any special preparations for a CA 19-9 blood test. But ask your provider to be sure. If you take certain vitamins, you may need to stop them before the test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
If you’re being treated for cancer, you may be tested several times during your treatment. Your provider will look at all your test results to see how your CA 19-9 levels have changed. Your results may show:

Your levels of CA 19-9 are increasing. This may mean your tumor is growing, and/or your treatment is not working. More tests are usually needed to find out for sure.
Your levels of CA 19-9 are decreasing. This may mean your tumor is shrinking and your treatment is working.
Your levels of CA 19-9 have stayed the same. This may mean your disease is stable and hasn’t gotten better or worse.
Your CA 19-9 levels decreased after treatment, but increased later. This may mean your cancer has come back or grown. You’ll need more tests to check whether cancer is really causing the higher level of CA 19-9.
If you don’t have cancer but your test results show a high level of CA 19-9, you may not a health problem that needs treatment. Healthy people can have high CA 19-9 levels. But high levels may be a sign of a condition, such as:

Pancreatitis, inflammation of the pancreas
Gallstones
Bile duct disease, including a blockage or infection
Liver disease
Cystic fibrosis
Talk with your provider about what your results may mean.

If your provider thinks you may have one of these conditions, you will probably need other tests to find out for sure.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CA 19-9 test?
Labs use different methods to measure the amount of CA 19-9 in your blood sample. The test method can affect your results. If you’re having regular tests to monitor cancer, it’s important to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. Your test report usually says what method was used to measure your CA 19-9 levels. If you have any questions about how your tests are done, talk with your provider.

CA-125 Blood Test (Ovarian Cancer)

What is a CA-125 blood test?
This test measures the amount of a protein called CA-125 (cancer antigen 125) in a sample of your blood. CA-125 is a type of tumor marker. High levels of certain tumor markers in your blood may be a sign of cancer. If you have cancer, measuring certain tumor markers may help provide important information about how to treat your disease.

High levels of CA-125 are often found in people who have ovarian cancer. The ovaries are a pair of female reproductive glands that store ova (eggs) and make female hormones. Ovarian cancer happens when the cells in an ovary begin to grow out of control.

If you have ovarian cancer, CA-125 blood tests can help show whether your treatment is working.

Other names: cancer antigen 125, glycoprotein antigen, ovarian cancer antigen, CA-125 tumor marker

What is it used for?
A CA-125 blood test may be used:

To see if ovarian cancer treatment is working and to check for ovarian cancer that has come back. This is the most common use of CA-125 blood testing.
To learn more about a growth or lump in your pelvis (the area below your belly). If a suspicious lump shows up on imaging, such as an ultrasound, your health care provider may check your CA-125 levels along with other tests to find out whether the lump could be ovarian cancer. But a CA-125 blood test alone can’t diagnose cancer.
To screen for ovarian cancer if you’re risk is very high. If your family health history includes ovarian cancer, your provider may suggest a CA-125 blood test and other tests to look for signs of cancer. But a CA-125 test is not used as a routine screening test for people who don’t have a high risk for ovarian cancer. That’s because many common conditions that aren’t cancer can also cause high CA-125 levels, such as endometriosis or even a menstrual period.
Why do I need a CA-125 blood test?
If you’ve been diagnosed with ovarian cancer, you may have several CA-125 blood tests:

During your treatment to see if your cancer is going away. If CA-125 levels go down, it usually means your treatment is working
After your treatment, to check whether your cancer has returned
If you have a lump in your pelvis that could be ovarian cancer, you may need a CA-125 test to help find out if it could be ovarian cancer. But only a biopsy can diagnose ovarian cancer.

If you have a very high risk of getting ovarian cancer, your health care provider may suggest checking your CA-125 levels. If they’re high, you’ll probably need more tests to find out if you have cancer. You’re more likely to get ovarian cancer if you:

Have a mother or sister, or two or more other relatives who had ovarian cancer
Have family members who have had breast cancer or colorectal cancer (colon cancer)
Have inherited certain gene changes or conditions that increase your risk of ovarian cancer, such as:
Changes in your genes, including BRCA 1 or BRCA 2 genes
Lynch syndrome (also called hereditary non-polyposis colorectal cancer), an inherited disorder that increases the risk for many types of cancer
Have had breast, uterine (uterus), or colorectal cancer
If you’re concerned about getting ovarian cancer, talk with your provider about your risk.

What happens during a CA-125 blood test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CA-125 blood test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
Your provider will review your CA-125 test results along with other information about your condition. Together, you can discuss how your results affect your diagnosis, treatment, and need for more testing.

In general:

If you are being treated for ovarian cancer, and the results of several tests show that your CA-125 levels are going down, it usually means that the treatment is helping. If your levels go up or stay the same over time, it may mean that the treatment isn’t working.
If you have finished your treatment for ovarian cancer and your CA-125 levels begin to increase over time, your cancer may be coming back.
If you have a high risk for ovarian cancer or have a suspicious pelvic lump, a high CA-125 levels could be a sign of cancer. Your provider will usually order more tests to make a diagnosis.
A high CA-125 level doesn’t always mean cancer. Other conditions may increase CA-125, including:

Endometriosis
Pelvic inflammatory disease (PID)
Uterine fibroids
Liver disease
Pregnancy
Your menstrual period, at certain times during your cycle
A normal CA-125 test result doesn’t rule out ovarian cancer. That’s because CA-125 levels may be low in the early stages of cancer. And not everyone with ovarian cancer makes high levels of CA-125.

Talk with your provider if you have questions about your results.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CA-125 blood test?
The most common type of ovarian cancer is epithelial ovarian cancer. If you have been treated for this type of cancer, you may be tested for a tumor marker called HE4 along with CA-125. Some studies show that measuring both tumor markers provides more accurate information to check whether treatment is working and to look for the return of this type of cancer.

Calcitonin Test

What is a calcitonin test?
This test measures the level of calcitonin in your blood. Calcitonin is a hormone made by your thyroid, a small, butterfly-shaped gland located near the throat. Calcitonin helps control how the body uses calcium. Calcitonin is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body.

If too much calcitonin is found in the blood, it may be a sign of a type of thyroid cancer called medullary thyroid cancer (MTC). High levels may also be a sign of other thyroid diseases that can put you at a higher risk for getting MTC. These include:

C-cell hyperplasia, a condition that causes abnormal growth of cells in the thyroid
Multiple endocrine neoplasia type 2 (MEN 2), a rare, inherited disease that causes the growth of tumors in the thyroid and other glands in the endocrine system. The endocrine system is a group of glands that control a variety of important functions, including how your body uses and burns energy (metabolism).
Other names: thyrocalcitonin, CT, human calcitonin, hCT

What is it used for?
A calcitonin test is most often used to:

Help diagnose C-cell hyperplasia and medullary thyroid cancer
Find out if treatment for medullary thyroid cancer is working
Find out if medullary thyroid cancer has returned after treatment
Screen people with a family history of multiple endocrine neoplasia type 2 (MEN 2). A family history of this disease can put you at a higher risk for developing medullary thyroid cancer.
Why do I need a calcitonin test?
You may need this test if you:

Are being treated for medullary thyroid cancer. The test can show whether the treatment is working.
Have completed treatment to see whether the cancer has come back.
Have a family history of MEN 2.
You may also need this test if you have not been diagnosed with cancer, but have symptoms of thyroid disease. These include:

A lump in the front of your neck
Swollen lymph nodes in your neck
Pain in your throat and/or neck
Trouble swallowing
Change to your voice, such as hoarseness
What happens during a calcitonin test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if you need to fast and if there are any special instructions to follow.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
If your calcitonin levels were high, it may mean you have C-cell hyperplasia or medullary thyroid cancer. If you are already being treated for this thyroid cancer, high levels may mean the treatment is not working or that cancer has returned after treatment. Other types of cancer, including cancers of the breast, lung, and pancreas, can also cause high levels of calcitonin.

If your levels were high, you will probably need more tests before your health care provider can make a diagnosis. These tests may include a thyroid scan and/or a biopsy. A thyroid scan is an imaging test that uses sound waves to look at the thyroid gland. A biopsy is a procedure where a health care provider removes a small piece of tissue or cells for testing.

If your calcitonin levels were low, it may mean your cancer treatment is working, or you are cancer free after treatment.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a calcitonin test?
If you are or have been treated for medullary thyroid cancer, you will probably be tested regularly to see if treatment was successful.

You may also get regular calcitonin tests if you have a family history of multiple endocrine neoplasia type 2. Testing can help find C-cell hyperplasia or medullary thyroid cancer as early as possible. When cancer is found early, it’s easier to treat.

Calcium Blood Test

What is a Calcium Blood Test?
A calcium blood test measures the amount of calcium in your blood. If there is too much or too little calcium in the blood, it may be a sign of a wide range of medical conditions, such as bone disease, thyroid disease, parathyroid disorders, kidney disease, and other conditions.

Calcium is one of the most important minerals in your body. About 1% of the calcium in your body is in your blood. The rest is stored in your bones and teeth. Having the right amount of calcium in your blood is necessary for your nerves, muscles, and heart to work properly. It also helps blood vessels move blood throughout your body and helps release hormones that affect many body functions.

Other names: total calcium, ionized calcium

What is it used for?
A blood calcium test is used to check your general health. It’s also used to help diagnose or monitor many types of medical conditions, including conditions that affect your bones, kidneys, digestive system, thyroid, and parathyroid glands.

There are two types of calcium blood tests that measure different forms of blood calcium:

Total calcium test measures all the calcium in your blood. You have two types of blood calcium that are normally present in about equal amounts:
“Bound calcium” is attached to proteins in your blood.
“Free calcium” is not attached to proteins. It’s also called ionized calcium. This form of blood calcium is active in many body functions.
Normally, your body tightly controls the balance of bound and ionized calcium, so a total calcium test gives a good estimate of how much ionized calcium you have.

A total calcium test is the most common test for blood calcium. It’s often part of a basic metabolic panel (BMP) and a comprehensive metabolic panel (CMP), which are both routine screening tests.

An ionized calcium test measures only the “free calcium” in your blood that isn’t attached to proteins. An ionized calcium test is more difficult to do, so it’s usually ordered if the results of a total calcium test aren’t normal. You may also have this test if you have a condition that affects your body’s ability to balance the amounts of ionized and bound calcium in your blood, or if you are seriously ill or having surgery.
Why do I need a calcium blood test?
Your health care provider may have ordered a basic or comprehensive metabolic panel, which includes a calcium blood test, as part of your regular checkup. You may also have this test to diagnose or monitor conditions that can affect your blood calcium or if you have symptoms of abnormal calcium levels.

Symptoms of high calcium levels include:

Constipation
Nausea and vomiting
Abdominal (belly) pain
Loss of appetite
More frequent urination
Increased thirst
Confusion
Symptoms of low calcium levels include:

Dry skin, coarse hair, and nails that easily break (after a long period of low levels)
Muscle cramps, spasms, or stiffness
Tingling in the lips, tongue, fingers, and feet
Arrhythmia (a problem with the rate or rhythm of your heartbeat)
Many people with high or low calcium levels don’t have any symptoms. So your provider may order a calcium test if you have a known condition that may affect your calcium levels, such as:

Kidney disease
Thyroid or parathyroid disease
Malnutrition
Problems absorbing calcium
Certain types of cancer
What happens during a calcium blood test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You usually don’t need any special preparations for a calcium blood test or a basic or comprehensive metabolic panel. Your provider may ask you to stop taking certain medicines or supplements, such as vitamin D, to make sure your test results are accurate. If your provider has ordered more tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
Results from a total calcium test that are higher than normal may be a sign of many types of conditions, such as:

Overactive parathyroid glands (hyperparathyroidism), a condition in which your parathyroid glands produce too much parathyroid hormone
Certain types of cancer, including cancer that spreads to the bone
Bone disorders, including Paget’s disease of the bone
Taking too much vitamin D over a long period of time
Results from a total calcium test that are lower than normal may be a sign of:

Low blood protein levels, which may be caused by liver disease or malnutrition
Underactive parathyroid glands (hypoparathyroidism), a condition in which your parathyroid glands produce too little parathyroid hormone
Too little calcium in your diet
Too little vitamin D or magnesium
Pancreatitis
Kidney disease
If your results from a total calcium blood test are not in the normal range, it doesn’t always mean that you have a medical condition that needs treatment. Your diet and certain medicines can affect your calcium levels. If you have questions about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a calcium blood test?
A calcium blood test does not tell you how much calcium is in your bones. Bone health can be measured with a type of x-ray called a bone density scan, or dexa scan. A dexa scan measures the mineral content, including calcium, and other aspects of your bones.

Calcium in Urine Test

What is a Calcium in Urine Test?
A calcium in urine test measures the amount of calcium in your urine (pee). If your urine calcium levels are too high or too low, it may be a sign of kidney disease, kidney stones, bone disease, a parathyroid gland disorder, or other conditions.

Calcium is one of the most important minerals in your body. Most of your calcium is stored in your bones and teeth. About 1% of the calcium in your body is in your blood. Having the right amount of calcium in your blood is necessary for your nerves, muscles, and heart to work properly. Normally, your kidneys filter out a small amount of calcium from your blood, which leaves your body in urine.

Checking the amount of calcium in urine can help diagnose kidney problems and other conditions that can affect calcium levels in your blood. If you have symptoms of any of these conditions, your health care provider may order a calcium blood test, too.

Other names: urinalysis (calcium), urinary Ca+2

What is it used for?
A calcium in urine test may be used to diagnose or monitor how well your kidney are working. It may be used if you have symptoms of kidney stones, which are more likely to form if you have too much calcium in your urine. A calcium in urine test may also help diagnose problems with the parathyroid glands in your neck. These glands help control the amount of calcium in your body.

Why do I need a calcium in urine test?
You may need a calcium in urine test if you have symptoms of a kidney stone. These symptoms include:

Sharp pain in your lower abdomen (belly), back, side, or groin
Blood in your urine
Frequent need to urinate (pee)
Pain while urinating
Inability to urinate or urinating only small amounts
Cloudy or bad-smelling urine
Nausea and vomiting
You may also need a calcium in urine test if you have symptoms of a parathyroid disorder.

Having too much parathyroid hormone doesn’t always cause symptoms. When symptoms happen, they may include:

Muscle weakness
Fatigue
Depression
Bone and joint pain
Loss of appetite
Nausea and vomiting
Constipation
Confusion
Increased thirst and urination
Symptoms of too little parathyroid hormone include:

Abdominal (belly) pain
Muscle cramps
Tingling fingers and toes
Dry skin and hair
Brittle nails
What happens during a calcium in urine test?
You’ll need to collect all your urine during a 24-hour period. This is called a 24-hour urine sample test. You will be given a special container to collect your urine and instructions on how to collect and store your samples. Your provider will tell you what time to start. The test generally includes the following steps:

To begin, urinate in the toilet as usual. Do not collect this urine. Write down the time you urinated.
For the next 24 hours, collect all your urine in the container.
During the collection period, store the urine container in a refrigerator or in a cooler with ice.
24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
Return the container with your urine to your provider’s office or the laboratory as instructed.
Will I need to do anything to prepare for the test?
You may be asked to avoid certain foods and medicines for several days before the test. Do not stop taking any medicines without talking with your provider. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?
There is no known risk to having a calcium in urine test.

What do the results mean?
Higher than normal calcium levels in urine may be a sign of:

A kidney stone
Hyperparathyroidism (too much parathyroid hormone)
Certain types of cancer, including cancer that spreads to the bones
Paget’s disease of bone
Sarcoidosis
Too much vitamin D over a long period of time, usually from supplements
Lower than normal calcium levels in urine may be a sign of:

Hypoparathyroidism (too little parathyroid hormone)
Kidney disease
Hypothyroidism (too little thyroid hormone)
Too little vitamin D or magnesium
Malabsorption disorder
Malnutrition
If your calcium levels aren’t normal, it doesn’t always mean you have a medical condition that needs treatment. Your diet and certain supplements and medicines, including antacids, can affect your urine calcium levels. If you have questions about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a calcium in urine test?
A calcium in urine test does not tell you how much calcium is in your bones. Bone health can be measured with a type of x-ray called a bone density scan, or dexa scan. A dexa scan measures the mineral content, including calcium, and other aspects of your bones.

Carbon Dioxide (CO2) in Blood

What is a Carbon Dioxide (CO2) Blood Test?
A carbon dioxide (CO2) blood test measures the amount of carbon dioxide in your blood. Carbon dioxide is an odorless, colorless gas. It is a waste product that your body makes when it uses food for energy.

Your blood carries carbon dioxide to your lungs. When you exhale, you breathe out carbon dioxide. Having too much or too little carbon dioxide in your blood can be a sign of a health problem.

Other names: carbon dioxide content, CO2 content, carbon dioxide blood test, bicarbonate blood test, bicarbonate test, total CO2; TCO2; carbon dioxide content; CO2 content; bicarb; HCO3

What is it used for?
Most of the carbon dioxide in your body is in the form of bicarbonate, which is a type of electrolyte. Electrolytes are electrically charged minerals that help control the amount of fluid and the balance of acids and bases (pH balance) in your body. A CO2 blood test is often part of a group of tests called an electrolyte panel.

An electrolyte panel may be part of a regular check-up. The test may also help diagnose or monitor conditions related to an electrolyte imbalance. These include high blood pressure and diseases of the kidneys, lungs, or liver.

Why do I need a CO2 in blood test?
Your health care provider may order a CO2 blood test as part of your regular checkup or if you have symptoms of an electrolyte imbalance. These symptoms may include:

Trouble breathing
Confusion
Weakness
Fatigue
Vomiting and/or diarrhea over a long period of time
Your provider may also order a CO2 blood test to check for side effects of certain medicines that can cause electrolyte imbalances.

What happens during a CO2 blood test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CO2 blood test or an electrolyte panel. If your provider has ordered more tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
Abnormal test results may be a sign that your body is having a hard time keeping the right acid-base balance (pH balance). This may be because your lungs or kidneys are having a problem removing carbon dioxide or because you have an electrolyte imbalance. Many different types of conditions can cause these problems.

Too much CO2 in the blood can be a sign of many conditions, including:

Lung diseases
Cushing’s syndrome
Kidney failure
Metabolic alkalosis, a condition in which your blood is not acidic enough. You may lose acid from conditions such as vomiting, dehydration, and anorexia.
Too little CO2 in the blood may be a sign of:

Addison disease, a complication of type 1 and type 2 diabetes
Diabetic ketoacidosis
Shock
Metabolic acidosis, a condition in which your blood is too acidic. It may be caused by many things, including kidney or liver disease, or long-lasting diarrhea.
Respiratory alkalosis, a condition in which your blood is not acidic enough because of lung or breathing disorders, including hyperventilation (rapid, deep breathing).
If your test results are not in the normal range, it doesn’t necessarily mean you have a medical condition that needs treatment. Other factors, including certain medicines, can affect the level of CO2 in your blood. To learn what your results mean, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CO2 blood test?
Some prescription and over-the-counter medicines can increase or decrease the amount of carbon dioxide in your blood. Be sure to tell your provider about any medicines you are taking.

Catecholamine Tests

What are catecholamine tests?
Catecholamines are hormones made by your adrenal glands, two small glands located above your kidneys. These hormones are released into the body in response to physical or emotional stress. The main types of catecholamines are dopamine, norepinephrine, and epinephrine. Epinephrine is also known as adrenaline. Catecholamine tests measure the amount of these hormones in your urine or blood. Higher than normal levels of dopamine, norepinephrine, and/or epinephrine can be a sign of a serious health condition.

Other names: dopamine, norepinephrine, epinephrine tests, free catecholamines

What are they used for?
Catecholamine tests are most often used to diagnose or rule out certain types of rare tumors, including:

Pheochromocytoma, a tumor of the adrenal glands. This type of tumor is usually benign (not cancerous). But it can be fatal if left untreated.
Neuroblastoma, a cancerous tumor that develops from nerve tissue. It mostly affects infants and children.
Paraganglioma, a type of tumor that forms near the adrenal glands. This type of tumor is sometimes cancerous, but usually grows very slowly.
The tests may also be used to see if treatments for these tumors are working.

Why do I need a catecholamine test?
You or your child may need this test if you have symptoms of a tumor that affect catecholamine levels. Symptoms in adults include:

High blood pressure, especially if it is not responding to treatment
Severe headaches
Sweating
Rapid heartbeat
Symptoms in children include:

Bone pain or tenderness
An abnormal lump in the abdomen
Weight loss
Uncontrolled eye movements
What happens during a catecholamine test?
A catecholamine test may be done in urine or blood. Urine testing is done more often because catecholamine blood levels can change quickly and may also be affected by the stress of testing.

But blood testing can be useful in helping to diagnose a pheochromocytoma tumor. If you have this tumor, certain substances will be released into the bloodstream.

For a catecholamine urine test, your health care provider will ask you to collect all urine during a 24-hour period. This is called a 24-hour urine sample test. For 24-hour urine sample test, your health care provider or a laboratory professional will give you a container to collect your urine and instructions on how to collect and store your samples. Test instructions usually include the following steps:

Empty your bladder in the morning and flush that urine away. Record the time.
For the next 24 hours, save all your urine passed in the container provided.
Store your urine container in the refrigerator or a cooler with ice.
Return the sample container to your health provider’s office or the laboratory as instructed.
During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You may be asked to avoid certain foods for two to three days before the test. These include:

Caffeinated foods and drinks, such as coffee, tea, and chocolate
Bananas
Citrus fruits
Foods that contain vanilla
You may also be asked to avoid stress and vigorous exercise before your test, as these can affect cathecholamine levels. Certain medicines may also affect levels. Be sure to tell your provider about all the medicines you are taking.

Are there any risks to the test?
There is no risk to having a urine test.

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
If your results show high levels of catecholamines in your urine or blood, it may mean you have a pheochromocytoma, neuroblastoma, or paraganglioma tumor. If you are being treated for one of these tumors, high levels may mean your treatment is not working.

High levels of these hormones does not always mean you have a tumor. Your levels of dopamine, norepinephrine, and/or epinephrine can be affected by stress, vigorous exercise, caffeine, smoking, and alcohol.

If you have questions about your results or your child’s results, talk to your health care provider.

Is there anything else I need to know about catecholamine tests?
These tests can help diagnose certain tumors, but they can’t tell whether the tumor is cancerous. Most tumors are not. If your results showed high levels of these hormones, your provider will probably order more tests. These include imaging tests such as a CT scan or an MRI, which can help your provider get more information about a suspected tumor.

CCP Antibody Test

What is a CCP antibody test?
This test looks for CCP (cyclic citrullinated peptide) antibodies in the blood. CCP antibodies, also called anti-CCP antibodies, are a type of antibody called autoantibodies. Antibodies and autoantibodies are proteins made by the immune system. Antibodies protect you from disease by fighting foreign substances like viruses and bacteria. Autoantibodies can cause disease by attacking the body’s healthy cells by mistake.

CCP antibodies target healthy tissues in the joints. If CCP antibodies are found in your blood, it can be a sign of rheumatoid arthritis. Rheumatoid arthritis is a progressive, autoimmune disease that causes pain, swelling, and stiffness in the joints. CCP antibodies are found in more than 75 percent of people who have rheumatoid arthritis. They are almost never found in people who don’t have the disease.

Other names: Cyclic citrullinated peptide antibody, anticitrullinated peptide antibody, citrulline antibody, anti-cyclic citrullinated peptide, anti-CCP antibody, ACPA

What is it used for?
A CCP antibody test is used to help diagnose rheumatoid arthritis. It’s often done along with or after a rheumatoid factor (RF) test. Rheumatoid factors are another type of autoantibody. RF tests used to be the main test to help diagnose rheumatoid arthritis. But RF factors can be found in people with other autoimmune diseases and even in some healthy people. Many studies have shown that CCP antibodies provide a more accurate diagnosis of rheumatoid arthritis compared with RF testing.

Why do I need a CCP antibody test?
You may need this test if you have symptoms of rheumatoid arthritis. These include:

Joint pain
Joint stiffness, especially in the morning
Joint swelling
Fatigue
Low-grade fever
You may also need this test if other tests couldn’t confirm or rule out a diagnosis of rheumatoid arthritis.

What happens during a CCP antibody test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
Be sure to tell your health care provider about all medicines, vitamins, and dietary supplements you are taking. You may need to stop taking certain substances for 8 hours before your test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
If your CCP antibody results were positive, it means these antibodies were found in your blood. A negative result means no CCP antibodies were found. The meaning of these results may depend on the results of a rheumatoid factor (RF) test as well as a physical exam.

If you have symptoms of rheumatoid arthritis, and your results show:

Positive CCP antibodies and positive RF, it likely means that you have rheumatoid arthritis.
Positive CCP antibodies and negative RF, it may mean you are in the early stages of rheumatoid arthritis or will develop it in the future.
Negative CCP antibodies and negative RF, it means you are less likely to have rheumatoid arthritis. Your provider may need to do more tests to help find out what is causing your symptoms.
Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CCP antibody test?
Rheumatoid arthritis can be difficult to diagnose, especially in its early stages. Your provider may order one or more tests in addition to CCP antibody and RF tests. These include x-rays of your joints and the following blood tests:

Erythrocyte sedimentation rate (ESR)
Synovial fluid analysis
C-reactive protein
Antinuclear antibody
These blood tests can show signs of inflammation. Inflammation is a type of immune system response. It can be a symptom of rheumatoid arthritis.

CD4 Lymphocyte Count

What is a CD4 count?
A CD4 count is a blood test that measures the number of CD4 cells in a sample of your blood. CD4 cells are a type of white blood cell. They’re also called CD4 T lymphocytes or “helper T cells.” That’s because they help fight infection by triggering your immune system to destroy viruses, bacteria, and other germs that may make you sick.

A CD4 count is mostly used to check the health of your immune system if you are infected with HIV (human immunodeficiency virus).

HIV attacks and destroys CD4 cells. Without treatment, HIV may destroy so many CD4 cells that your immune system will have trouble fighting off infections. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome). AIDS is the most serious stage of an HIV infection. If you have AIDS, your CD4 count is so low that you may develop serious infections from viruses, bacteria, or fungi that usually don’t cause problems in healthy people. These are called “opportunistic infections,” and they can become life-threatening. AIDS increases your risk of developing certain cancers, too.

Most people with HIV don’t have AIDS. And if they take their HIV medicine as prescribed, they may never develop AIDS.

If you have HIV, a CD4 count can help your health care provider check your risk for serious infections. A CD4 count may also be used to help diagnose and monitor certain other conditions that affect your immune system.

Other names: CD4 lymphocyte count CD4+ count, T4 count, T-helper cell count, CD4 percent

What is it used for?
If you have HIV, a CD4 count may be used to:

See how HIV is affecting your immune system. CD4 counts can help monitor your risk for developing opportunistic infections or certain cancers. If your risk increases, your provider may give you treatment to help prevent infections.
Help check how well HIV treatment is working. A CD4 count is used with a test called an HIV viral load test to see if HIV medicines are working. A viral load tests measures how much HIV is in your blood.
Diagnose AIDS. Without treatment, HIV can lead to a very low CD4 count, which means you have AIDS.
A CD4 count may also be used to:

Monitor treatment after an organ transplant. If you’ve had an organ transplantation, you’ll need to take medicine to prevent your immune system from attacking the new organ. These medicines are called “anti-rejection” drugs or immunosuppressants. You may also take these medicines to treat certain autoimmune diseases. A low CD4 count means the medicine is working.
Help diagnose different types of lymphoma. A CD4 count may be used with other tests to find out which type of immune cells are causing lymphoma. The test results help choose the right treatment.
Help diagnose DiGeorge syndrome. This is an uncommon inherited disorder that often causes immune problems and other health conditions that start at birth.
Why do I need a CD4 count?
Your provider may order a CD4 count when you are first diagnosed with HIV. You will probably be tested again every few months to see if your counts have changed since your first test.

If you are taking medicine for HIV, your provider may order regular CD4 counts with an HIV viral load test to see how well your medicines are working.

What happens during a CD4 count?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CD4 count.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
CD4 results are usually given as a number of cells per cubic millimeter of blood. But labs may have different ways of describing “normal” CD4 counts. What’s normal for you depends on your age, other health conditions, and the medicines you may take. That’s why it’s important to talk with your provider about what your test results mean.

CD4 counts may change even when your health has not changed. So, your provider will usually look at a few test results over time to see if there’s a trend in your CD4 counts.

In general, ranges for CD4 counts are:

Normal CD4 count for healthy adults and teens: 500 to 1,200 cells per cubic millimeter
Low CD4 count: Below 500 cells per cubic millimeter
If you have HIV, a low CD4 count means that HIV has weakened your immune system. A CD4 count of 200 or fewer cells per cubic millimeter means that you have AIDS. With AIDS you have a high risk of developing life-threatening infections or cancers.
If you don’t have HIV, a low CD4 count may be caused by an infection. Cancer chemotherapy and medicines that weaken your immune system may also cause low CD4 counts. In certain cases, the cause of a low CD4 count is unknown, but this is uncommon.
High CD4 Count: Counts above the normal range may be sign of an infection or a blood cancer.
While there is no cure for HIV, there are different medicines that you can take to control the virus and protect your immune system. In fact, CD4 counts usually increase with these medicines, which helps keep you healthy. If you are living with HIV, it’s important to take your medicine as prescribed and get regular blood tests, including CD4 counts.

Learn more about laboratory tests, reference ranges, and understanding results.

CEA Test

What is a CEA test?
CEA stands for carcinoembryonic antigen. It is a protein found in the tissues of a developing baby. CEA levels normally become very low or disappear after birth. Healthy adults should have very little or no CEA in their body.

This test measures the amount of CEA in the blood, and sometimes in other body fluids. CEA is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body.

A high level of CEA can be a sign of certain types of cancers. These include cancers of the colon and rectum, prostate, ovary, lung, thyroid, or liver. High CEA levels may also be a sign of some noncancerous conditions, such as cirrhosis, noncancerous breast disease, and emphysema.

A CEA test can’t tell you what kind of cancer you have, or even whether you have cancer. So the test is not used for cancer screening or diagnosis. But if you’ve already been diagnosed with cancer, a CEA test can help monitor the effectiveness of your treatment and/or help find out if the disease has spread to other parts of your body.

Other names: CEA assay, CEA blood test, carcinoembryonic antigen test

What is it used for?
A CEA test may be used to:

Monitor treatment of people with certain types of cancers. These include colon cancer and cancers of the rectum, prostate, ovary, lung, thyroid, and liver.
Figure out the stage of your cancer. This means checking the size of the tumor and how far the cancer has spread.
See if cancer has returned after treatment.
Why do I need a CEA test?
You may need this test if you’ve been diagnosed with cancer. Your health care provider may test you before you start treatment, and then regularly throughout the course of your therapy. This can help your provider see how well your treatment is working. You may also get a CEA test after you’ve completed treatment. The test can help show whether the cancer has come back.

What happens during a CEA test?
CEA is usually measured in the blood. During a CEA blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Sometimes, CEA is tested in the spinal fluid or from fluid in the abdominal wall. For these tests, your provider will remove a small sample of fluid using a thin needle and/or syringe. The following fluids may be tested:

Cerebrospinal fluid (CSF), a clear, colorless liquid found in the spinal cord
Peritoneal fluid, a fluid that lines your abdominal wall
Pleural fluid, a liquid inside your chest cavity that covers the outside of each lung
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CEA blood test or a pleural fluid test.

You may be asked to empty your bladder and bowels before a CSF or peritoneal fluid test.

Are there any risks to the test?
There is very little risk to having a CEA blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

CEA tests of body fluids are usually very safe. Serious problems are rare. But you may experience one or more of the following side effects:

If you had a CSF test, you may feel some pain or tenderness in your back at the site where the needle was inserted. Some people get a headache after the test. This is called a post-lumbar headache.
If you had a peritoneal fluid test, you may feel a little dizzy or lightheaded after the procedure. There is a small risk of damage to the bowel or bladder, which may cause an infection.
If you had a pleural fluid test, there is a small risk of lung damage, infection, or blood loss.
What do the results mean?
If you were tested before you started treatment for cancer, your results may show:

A low level of CEA. This may mean your tumor is small and the cancer has not spread to other parts of your body.
A high level of CEA. This may mean you have a larger tumor and/or your cancer may have spread.
If you are being treated for cancer, you may be tested several times throughout treatment. These results may show:

Your levels of CEA started high and remained high. This may mean your cancer is not responding to treatment.
Your levels of CEA started high but then decreased. This may mean your treatment is working.
Your CEA levels decreased, but then later increased. This may mean your cancer has come back after you’ve been treated.
If you had a test on a body fluid (CSF, peritoneal, or pleural), a high level of CEA may mean the cancer has spread to that area.

If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CEA test?
Many cancers don’t produce CEA. If your CEA results were normal, you may still have cancer. Also, high levels of CEA can be sign of a noncancerous health condition. In addition, people who smoke cigarettes often have higher than normal CEA levels.

Celiac Disease Screening

What is a celiac disease blood test?
A celiac disease blood test looks for signs of celiac disease in a sample of your blood. Celiac disease is a chronic (long-term) digestive and immune disorder that damages your small intestine. The damage may prevent your body from absorbing vitamins, minerals, and other nutrients from the food you eat. This can lead to malnutrition, anemia and other serious health problems.

Celiac disease is a type of autoimmune disease. That means that your own immune system attacks healthy cells in your body. Normally, your immune system makes proteins called antibodies to fight germs. With celiac disease, problems start if you eat foods that have a protein called gluten. Your immune system “thinks” the gluten proteins are germs, so it makes antibodies that attack the lining of your small intestine.

Gluten is found in wheat, barley, rye, and some other grains. It’s also found in certain toothpastes, lipsticks, medicines, and other products. A celiac disease test looks for antibodies to gluten in your blood sample.

Other names: celiac disease antibody test, anti-tissue transglutaminase antibody (anti-tTG), deaminated gliadin peptide antibodies, anti-endometrial antibodies

What is it used for?
A celiac disease blood test is used to:

Help diagnose celiac disease if you have symptoms
Monitor celiac disease to see if treatment is helping
Screen for signs of celiac disease if the disease runs in your family (more than one person has it)
Why do I need a celiac disease blood test?
You may need a celiac disease test if you have symptoms of celiac disease. Symptoms can vary a lot, and they may come and go. Children tend to have more digestive problems than adults.

The digestive symptoms of celiac disease include:

Bloating (feeling fullness or swelling in your belly)
Chronic (long-term) diarrhea or greasy, bulky, unusually bad-smelling stool (poop)
Constipation
Gas
Lactose intolerance because of damage to the small intestine
Nausea and vomiting
Pain in the abdomen (belly)
Weight loss in adults, or not enough weight gain in children
Some people with celiac disease have symptoms that affect other parts of the body, such as:

Fatigue
Headaches
Depression and anxiety
Irritability (in children)
Itchy rash with blisters (mainly in adults)
Other conditions such as gluten sensitivity and wheat allergies may cause symptoms that are much like celiac disease. But these are different conditions. They don’t damage the small intestine, and they are diagnosed with different tests.

You may need a celiac test if you have a high risk for having the disease even if you don’t have symptoms. Celiac disease is a genetic disorder. That means it’s passed down from parents to children through genes. You are more likely to have celiac disease if you:

Have a parent, sibling or child who has the disease
Have another autoimmune disorder, such as type 1 diabetes
Most people who have genes for celiac disease don’t get the disease. But screening may still be important. That’s because you could have intestinal damage from celiac disease even if you don’t seem to notice any symptoms. This is called “silent celiac disease.” Talk with your health care provider to see if you should be tested.

What happens during a celiac disease blood test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
If the test is being used to diagnose celiac disease, you’ll need to continue to eat foods with gluten for a few weeks before testing. Your health care provider will give you specific instructions about how to prepare for the test.

If the test is being used to monitor celiac disease, you don’t need any special preparations.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
There are different types of celiac disease antibodies, so your celiac blood test results may include information on more than one type of antibody. Your results may also include other blood tests you had to look for signs of celiac disease. Your provider can explain what all your test results say about your health.

In general, results from a celiac disease blood test may be:

Negative. This means that celiac disease antibodies weren’t found in your blood. So, you probably don’t have celiac disease.
Positive. This mean that celiac disease antibodies were found in your blood. So, you’re likely to have celiac disease. To confirm the diagnosis, you will need more tests to look for damage in your intestines.
Uncertain, indeterminate, or inconclusive. These terms all mean that it’s unclear whether you have celiac disease.
Your provider may order other tests to confirm that you have celiac disease and/or to see how much damage the disease may have caused. These tests may include:

A biopsy to examine a tissue sample from your small intestine or your skin if you have a rash that could be from celiac disease. An endoscopy is used to take a sample of tissue from your small intestine.
Capsule endoscopy to look at your small intestine. For this test, you swallow a tiny camera in a capsule. As it passes through your small intestine, it records pictures. The camera leaves your body during a bowel movement (poop).
Genetic testing to see if you have a gene linked to celiac disease
Tests for other health problems that celiac disease may cause such as anemia, osteoporosis, or a lack of certain vitamins.
Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a celiac disease test?
Most people with celiac disease will feel better if they avoid foods and products with gluten. Your provider may refer you to a registered dietician (a nutrition expert) who can help you learn how to eat a healthy diet without gluten. Eating a gluten-free diet usually helps heals damage in the small intestine and prevents more damage. Many people see symptoms improve within days to weeks of starting the diet.

Cerebrospinal Fluid (CSF) Analysis

What is a Cerebrospinal Fluid (CSF) Analysis?
Cerebrospinal fluid (CSF) is a clear, colorless, watery fluid that flows in and around your brain and spinal cord. Your brain and spinal cord make up your central nervous system. It controls and coordinates everything you do, including your ability to move, breathe, see think, and more.

Cerebrospinal fluid acts like a cushion that helps protect your brain and spinal cord from sudden impact or injury. The fluid also removes waste products from the brain and helps your central nervous system work properly.

A CSF analysis is a group of tests that use a sample of your cerebrospinal fluid to help diagnose diseases of the brain and spinal cord and other conditions that affect the central nervous system.

Other names: Spinal Fluid Analysis, CSF Analysis

What is it used for?
A CSF analysis is used to measure different substances in your cerebrospinal fluid. It may include tests to diagnose:

Infectious diseases of the brain and spinal cord, including meningitis and encephalitis. CSF tests for infections look at white blood cells, bacteria, and other substances in the cerebrospinal fluid
Autoimmune disorders, such as Guillain-Barré Syndrome and multiple sclerosis (MS). CSF tests for these disorders look for high levels of certain proteins in the cerebrospinal fluid.
Bleeding in the brain
Brain tumors, including from cancers in other parts of the body that may spread to the central nervous system
Alzheimer’s disease, the most common form of dementia, which includes memory loss, confusion, and changes in behavior
Why do I need a CSF analysis?
Your health care provider may order a CSF analysis if you have:

Symptoms of an infection or bleeding in the brain or spinal cord
Symptoms of an autoimmune disorder, such as multiple sclerosis (MS)
Had a brain injury or an injury to your spinal cord
Have cancer that may have spread to your central nervous system
Symptoms that may be from another central nervous system condition, such as headaches
Symptoms of a brain or spinal cord infection include:

Fever
Severe headache
Seizures
Stiff neck
Nausea and vomiting
Sensitivity to light
Double vision
Changes in behavior
Confusion
Symptoms of MS often vary and come and go, or they may steadily get worse. They may include:

Blurred or double vision
Tingling, numbness, or pain in the arms, legs, body, or face
Painful muscle spasms
Weak muscles, often in the hands and legs
Dizziness, balance problems, or clumsy movement when walking
Bladder control problems
Fatigue
Problems thinking or learning new things
What happens during a CSF analysis?
To get a sample of cerebrospinal fluid, a provider will do a procedure called a spinal tap, also known as a lumbar puncture. A spinal tap is usually done in a hospital. During the procedure:

You will lie on your side or sit on an exam table.
A provider will clean your back and inject an anesthetic into your skin, so you won’t feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
When the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
You’ll need to stay very still while the fluid is being withdrawn.
Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CSF analysis, but you may be asked to empty your bladder (pee) and bowels (poop) before the test.

Are there any risks to the test?
There is very little risk to having a spinal tap. You may feel a little pinch or pressure when the needle is inserted. After the test, you may feel some pain or tenderness in your back at the site where the needle was inserted.

You may also have some bleeding at the site or get a headache. The headache may last for several hours or up to a week or more, but your provider may suggest treatment to help relieve the pain.

What do the results mean?
A CSF analysis may include a variety of different tests on your sample. So, the measurements on your test results will depend on which tests were done. Your provider can explain what your results mean.

In general, your CSF analysis results may show that you have an infection, an autoimmune disorder, such as multiple sclerosis (MS), or another disease or injury of the brain or spinal cord. Your provider will likely order more tests to confirm your diagnosis.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CSF analysis?
Some infections, such as meningitis caused by bacteria, are life-threatening emergencies. If your provider suspects you have bacterial meningitis or another serious infection, you may need to start medicine before you have a final diagnosis.

Cerebrospinal Fluid (CSF) Analysis

What is a Cerebrospinal Fluid (CSF) Analysis?
Cerebrospinal fluid (CSF) is a clear, colorless, watery fluid that flows in and around your brain and spinal cord. Your brain and spinal cord make up your central nervous system. It controls and coordinates everything you do, including your ability to move, breathe, see think, and more.

Cerebrospinal fluid acts like a cushion that helps protect your brain and spinal cord from sudden impact or injury. The fluid also removes waste products from the brain and helps your central nervous system work properly.

A CSF analysis is a group of tests that use a sample of your cerebrospinal fluid to help diagnose diseases of the brain and spinal cord and other conditions that affect the central nervous system.

Other names: Spinal Fluid Analysis, CSF Analysis

What is it used for?
A CSF analysis is used to measure different substances in your cerebrospinal fluid. It may include tests to diagnose:

Infectious diseases of the brain and spinal cord, including meningitis and encephalitis. CSF tests for infections look at white blood cells, bacteria, and other substances in the cerebrospinal fluid
Autoimmune disorders, such as Guillain-Barré Syndrome and multiple sclerosis (MS). CSF tests for these disorders look for high levels of certain proteins in the cerebrospinal fluid.
Bleeding in the brain
Brain tumors, including from cancers in other parts of the body that may spread to the central nervous system
Alzheimer’s disease, the most common form of dementia, which includes memory loss, confusion, and changes in behavior
Why do I need a CSF analysis?
Your health care provider may order a CSF analysis if you have:

Symptoms of an infection or bleeding in the brain or spinal cord
Symptoms of an autoimmune disorder, such as multiple sclerosis (MS)
Had a brain injury or an injury to your spinal cord
Have cancer that may have spread to your central nervous system
Symptoms that may be from another central nervous system condition, such as headaches
Symptoms of a brain or spinal cord infection include:

Fever
Severe headache
Seizures
Stiff neck
Nausea and vomiting
Sensitivity to light
Double vision
Changes in behavior
Confusion
Symptoms of MS often vary and come and go, or they may steadily get worse. They may include:

Blurred or double vision
Tingling, numbness, or pain in the arms, legs, body, or face
Painful muscle spasms
Weak muscles, often in the hands and legs
Dizziness, balance problems, or clumsy movement when walking
Bladder control problems
Fatigue
Problems thinking or learning new things
What happens during a CSF analysis?
To get a sample of cerebrospinal fluid, a provider will do a procedure called a spinal tap, also known as a lumbar puncture. A spinal tap is usually done in a hospital. During the procedure:

You will lie on your side or sit on an exam table.
A provider will clean your back and inject an anesthetic into your skin, so you won’t feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
When the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
You’ll need to stay very still while the fluid is being withdrawn.
Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CSF analysis, but you may be asked to empty your bladder (pee) and bowels (poop) before the test.

Are there any risks to the test?
There is very little risk to having a spinal tap. You may feel a little pinch or pressure when the needle is inserted. After the test, you may feel some pain or tenderness in your back at the site where the needle was inserted.

You may also have some bleeding at the site or get a headache. The headache may last for several hours or up to a week or more, but your provider may suggest treatment to help relieve the pain.

What do the results mean?
A CSF analysis may include a variety of different tests on your sample. So, the measurements on your test results will depend on which tests were done. Your provider can explain what your results mean.

In general, your CSF analysis results may show that you have an infection, an autoimmune disorder, such as multiple sclerosis (MS), or another disease or injury of the brain or spinal cord. Your provider will likely order more tests to confirm your diagnosis.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CSF analysis?
Some infections, such as meningitis caused by bacteria, are life-threatening emergencies. If your provider suspects you have bacterial meningitis or another serious infection, you may need to start medicine before you have a final diagnosis.

Ceruloplasmin Test

What is a ceruloplasmin test?
This test measures the amount of ceruloplasmin in your blood. Ceruloplasmin is a protein that is made in the liver. It stores and carries copper from the liver into the bloodstream and to the parts of your body that need it.

Copper is a mineral that is found in several foods, including nuts, chocolate, mushrooms, shellfish, and liver. It is important to many body functions, including building strong bones, producing energy, and making melanin (the substance that gives skin its color). But if you have too much or too little copper in your blood, it can be a sign of a serious health problem.

Other names: CP, ceruloplasmin blood test, ceruloplasmin, serum

What is it used for?
A ceruloplasmin test is most often used, along with copper testing, to help diagnose Wilson disease. Wilson disease is a rare genetic disorder that prevents the body from removing excess copper. It can cause a dangerous buildup of copper in the liver, brain, and other organs.

It may also be used to diagnose disorders that cause a copper deficiency (too little copper). These include:

Malnutrition, a condition where you are not getting enough nutrients in your diet
Malabsorption, a condition that makes it hard for your body to absorb and use the nutrients you eat
Menkes syndrome, a rare, incurable genetic disease
In addition, the test is sometimes used to diagnose liver disease.

Why do I need a ceruloplasmin test?
Your health care provider may order a ceruloplasmin test if you have symptoms of Wilson disease. These include:

Anemia
Jaundice (yellowing of the skin and eyes)
Nausea
Abdominal pain
Trouble swallowing and/or speaking
Tremors
Trouble walking
Changes in behavior
You may also need this test if you have a family history of Wilson disease, even if you don’t have symptoms. Symptoms usually appear between the ages of 5 and 35, but can show up earlier or later in life.

You may also have this test if you have symptoms of a copper deficiency (too little copper). These include:

Pale skin
Abnormally low levels of white blood cells
Osteoporosis, a condition that causes weakening of bones and makes them prone to fractures
Fatigue
Tingling in hands and feet
Your baby may need this test if he or she has symptoms of Menkes syndrome. Symptoms usually show up in infancy and include:

Hair that is brittle, sparse, and/or tangled
Feeding difficulties
Failure to grow
Developmental delays
Lack of muscle tone
Seizures
Most children with this syndrome die within the first few years of life, but treatment given in early infancy (within about 28 days after birth) may help some children live longer.

What happens during a ceruloplasmin test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a ceruloplasmin test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
A lower than normal level of ceruloplasmin may mean your body is not able to use or eliminate copper properly. It can be a sign of:

Wilson disease
Menkes syndrome
Liver disease
Malnutrition
Malabsorption
Kidney disease
If your ceruloplasmin levels were higher than normal, it may be a sign of:

A serious infection
Heart disease
Rheumatoid arthritis
Leukemia
Hodgkin lymphoma
But high levels of ceruloplasmin may also be due to conditions that don’t need medical treatment. These include pregnancy and the use of birth control pills.

If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a ceruloplasmin test?
Ceruloplasmin tests are often done along with other tests. These include copper tests in blood and/or urine and liver function tests.

Chickenpox and Shingles Tests

What are chickenpox and shingles tests?
These tests check to see if you are or have ever been infected with the varicella zoster virus (VZV). This virus causes chickenpox and shingles. When you are first infected with VZV, you get chickenpox. Once you get chickenpox, you can’t get it again. The virus remains in your nervous system but is dormant (inactive). Later in life, VZV can become active and can cause shingles. Unlike chicken pox, you can get shingles more than once, but it is rare.

Both chickenpox and shingles cause blistering skin rashes. Chickenpox is a highly contagious disease that causes red, itchy sores (pox) all over the body. It used to be a very common childhood disease, infecting nearly all children in the United States. But since a chickenpox vaccine was introduced in 1995, there have been far fewer cases. Chickenpox may be uncomfortable, but it’s usually a mild illness in healthy children. But it can be serious for adults, pregnant women, newborns, and people with weakened immune systems.

Shingles is a disease that only affects people who once had chickenpox. It causes a painful, burning rash that may stay in one part of the body or spread to many parts of the body. Nearly one-third of people in the United States will get shingles at some point in their lifetime, most often after the age of 50. Most people who develop shingles recover in three to five weeks, but it sometimes causes long-term pain and other health problems.

Other names: varicella zoster virus antibody, serum varicella immunoglobulin G antibody level, VZV antibodies IgG and IgM, herpes zoster

What are they used for?
Health care providers can usually diagnose chickenpox or shingles with a visual examination. Tests are sometimes ordered to check for immunity to the varicella zoster virus (VZV). You have immunity if you’ve had chickenpox before or have had the chickenpox vaccine. If you have immunity it means you can’t get chickenpox, but you can still get shingles later in life.

Tests may be done on people who don’t have or are unsure about immunity and are at higher risk of complications from VZV. These include:

Pregnant women
Newborns, if the mother is infected
Teen and adults with symptoms of chickenpox
People with HIV/AIDS or another condition that weakens the immune system
Why do I need a chickenpox or shingles test?
You may need a chickenpox or shingles test if you are at risk for complications, are not immune to VZV, and/or have symptoms of infection. Symptoms of the two diseases are similar and include:

Red, blistering rash. Chickenpox rashes often appear all over the body and are usually very itchy. Shingles sometimes appear in just one area and are often painful.
Fever
Headache
Sore throat
You may also need this test if you are in a high-risk group and were recently exposed to chickenpox or shingles. You can’t catch shingles from another person. But the shingles virus (VZV) can be spread and cause chickenpox in someone who doesn’t have immunity.

What happens during chickenpox and shingles testing?
You will need to provide a sample of blood from your vein or from the fluid in one of your blisters. Blood tests check for antibodies to the VZV. Blister tests check for the virus itself.

For a blood test from a vein, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out.

For a blister test, a health care provider will gently press a cotton swab on a blister to collect a sample of fluid for testing.

Both types of tests are quick, usually taking less than five minutes.

Will I need to do anything to prepare for the test?
You don’t any special preparations for a blood or blister test.

Are there any risks to the test?
After a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. There is no risk to having a blister test.

What do the results mean?
If you have symptoms and results show VZV antibodies or the virus itself, it’s likely you have chickenpox or shingles. Your diagnosis of either chickenpox or shingles will depend on your age and specific symptoms. If your results show antibodies or the virus itself and you don’t have symptoms, you either once had chickenpox or received the chickenpox vaccine.

If you are diagnosed with an infection and are in a high-risk group, your health care provider may prescribe antiviral medicines. Early treatment can prevent serious and painful complications.

Most healthy children and adults with chickenpox will recover from chickenpox within a week or two. Home treatment can help relieve symptoms. More serious cases may be treated with antiviral medicines. Shingles may also be treated with antiviral medicines as well as pain relievers.

If you have questions about your results or your child’s results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about chickenpox and shingles tests?
The Centers for Disease Control and Prevention (CDC) recommends the chickenpox vaccine for children, teens, and adults who never had chickenpox or the chickenpox vaccine. Some schools require this vaccine for admittance. Check with your child’s school and your child’s health care provider for more information.

The CDC also recommends that healthy adults age 50 and older get two doses of the shingles vaccine called Shingrix, separated by 2 to 6 months. The vaccine provides strong protection against shingles and complications from the disease. You should get the vaccine even if you’ve already had shingles, as it may prevent future outbreaks.

A different shingles vaccine called Zostavax is no longer available in the United States. If you had a Zostavax vaccine in the past, you should still get vaccinated with Shingrix. Talk to your health care provider about the best time get Shingrix.

Chlamydia Test

What is a Chlamydia Test?
Chlamydia is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection spread through vaginal, oral, or anal sex with someone who has the infection.

A chlamydia test looks for chlamydia bacteria in a sample of fluid from your body. The sample may be:

Urine (pee)
Fluid that’s usually swabbed from the:
Urethra (the tube that carries urine out of your body)
Vagina
Rectum (the last part of your intestine that connects to the anus).
Chlamydia often has no symptoms, so you may spread the disease without even knowing you have the infection. If a pregnant person has chlamydia, they can give the infection to their baby during childbirth.

The disease is easily treated with antibiotic medicine. But if it’s not treated, it can cause serious complications. The infection can spread in the female reproductive system and cause infertility. It can also lead to reactive arthritis (uncommon).

A chlamydia test can diagnose the disease so you can get treatment before you develop lasting health problems or spread the disease to others.

Other names: Chlamydia NAAT or NAT, Chlamydia/GC STD Panel

What is it used for?
A chlamydia test is used to find out whether or not you have a chlamydia infection. The test is also done three months after treatment for chlamydia to check for re-infection.

Why do I need a chlamydia test?
Chlamydia is a very common STD, especially in sexually active people ages 15 to 24. But chlamydia usually doesn’t cause symptoms, so the Centers for Disease Control and Prevention (CDC) and other health organizations recommend regular screening tests if your risk of getting chlamydia is high.

If you are a woman or a transgender or gender diverse person with a cervix (lower part of the uterus), you should:

Get tested for chlamydia at least once a year if you are:
Younger than 25 and having sex
Age 25 or older and have a higher risk of getting chlamydia because you:
Have a new sex partner or more than one partner
Have a sex partner who is having sex with others
Have a sex partner with an STD
Don’t use condoms correctly every time
Get tested for chlamydia if you are pregnant.
Regular chlamydia testing at least once a year is also recommended if you:

Have HIV.
Are a man who has sex with men (MSM) or a transgender diverse person with a penis who has sex with men. Test every 3 to 6 months if you or your partner have sex with more than one person, or if you have other sexual behaviors that may increase your risk for getting chlamydia.
The best testing schedule for you may be different than the recommendations. Ask your provider how often you should get tested.

Your provider will order a test if your sex partner has been diagnosed with chlamydia or if you have symptoms. Symptoms of chlamydia may include:

An unusual discharge (fluid) from your genitals (penis or vagina) or rectum
Irritation or itching around your genitals
Pain or burning when you urinate (pee)
Rectal pain or bleeding if chlamydia infects the rectum
What happens during a chlamydia test?
To do a chlamydia test, you will need to provide a sample of fluid from the part of your body that may be infected. There are two ways to gather the sample:

A first-catch urine sample. You use a sterile cup to a collect urine from the very first part of your urine stream. To get an accurate test result, you will need to stop urinating for two hours before the test.
A swab sample. Your provider will use a special swab or brush to gather cells, usually from the genital area (the urethra or the vagina). This may cause some brief discomfort. In certain cases, the rectum, cervix, throat, or eyes may be swabbed. Your provider may give you the option to swab yourself following special instructions.
Test results are usually ready in a day. There are some rapid chlamydia tests that can provide results in 90 minutes or less.

You can also buy at-home collection kits to test for chlamydia and other STDs. With these kits, you collect a swab or urine sample at home and send it to a lab for testing. It’s important to follow all the instructions carefully.

You should not use an at-home test if you have symptoms of chlamydia or if your partner has chlamydia. In that case, it’s important to talk with your provider right away so you don’t delay treatment.

Ask your provider whether at-home chlamydia testing is right for you.

Will I need to do anything to prepare for the test?
Preparations for a chlamydia test depend on the type of sample you will be providing. You may need to avoid antibiotic medicines and vaginal douches or creams for 24 hours before your test. Ask your provider if there are any special instructions for your test.

Are there any risks to the test?
There are no known risks to having a chlamydia test.

What do the results mean?
A negative test result means that you did not have a chlamydia infection when the sample was collected.
A positive test result means you have been infected with chlamydia.
If your test result is positive, you will need antibiotics to treat your infection. Your provider will give you instructions on how to take your medicine. To make sure your infection is cured, follow the instructions carefully and finish all the medicine.

You will also need to let your sexual partner/s know you tested positive for chlamydia so that they can be tested and treated if necessary. Three months after you finish treatment, you will need to be tested for chlamydia again to check for a new infection. That’s because repeat infections are very common. Ask your provider to tell you how often to get tested after that.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a chlamydia test?
Chlamydia testing can help you avoid lasting health problems and stop the spread of this disease. You can also take steps to protect yourself from getting chlamydia.

The most reliable way to prevent chlamydia or any STD is to not have vaginal, oral, or anal sex. If you are sexually active, you can reduce your risk of infection by:

Having sex with only one partner who has tested negative for STDs and who has sex only with you (mutual monogamy)
Using condoms correctly every time you have sex

Chloride Blood Test

What is a Chloride Blood Test?
A chloride blood test measures the amount of chloride in your blood. Chloride is a type of electrolyte. Electrolytes are electrically charged minerals that help control the amount of fluids and the balance of acids and bases (pH balance) in your body. Chloride is often measured with other electrolytes to diagnose or monitor conditions, such as kidney disease, heart failure, liver disease, and high blood pressure.

Other names: CI, Serum chloride

What is it used for?
You usually get a chloride test as part of a routine blood screening to check your general health. It’s also used to help diagnose conditions related to an imbalance of acids or fluids in your body.

Why do I need a chloride blood test?
Your health care provider may have ordered a chloride blood test as part of an electrolyte panel, which is a routine blood test. An electrolyte panel is a test that measures chloride and other electrolytes, such as potassium, sodium, and bicarbonate. You may also need a chloride blood test if you have symptoms of an acid or fluid imbalance, including:

Vomiting over a long period of time
Diarrhea
Fatigue
Weakness
Dehydration
Trouble breathing
What happens during a chloride blood test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a chloride blood test or an electrolyte panel. If your provider has ordered other blood tests, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
There are many reasons why your chloride levels may not be in the normal range.

High levels of chloride may be a sign of:

Dehydration
Kidney disease
Metabolic acidosis, a condition in which you have too much acid in your blood. It can cause nausea, vomiting, and fatigue.
Low levels of chloride may be a sign of:

Heart failure
Lung disease
Addison disease, a condition in which your body’s adrenal glands don’t produce enough of certain types of hormones. It can cause a variety of symptoms, including weakness, dizziness, weight loss, and dehydration.
Metabolic alkalosis, a condition in which you have too much base in your blood. It can cause irritability, muscle twitching, and tingling in the fingers and toes.
If your chloride levels are not in the normal range, it doesn’t always mean you have a medical problem that needs treatment. Many things can affect your chloride levels, such as drinking too much fluid or losing fluid because of vomiting or diarrhea. Also, certain medicines such as antacids can cause abnormal results. To learn what your results mean, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a chloride blood test?
Urine also contains some chloride. Your provider may also recommend a urine chloride test to get more information about your chloride levels.

Cholesterol Levels

What is a Cholesterol Test?
A cholesterol test is a blood test that measures the amount of cholesterol and certain fats in your blood. Cholesterol is a waxy, fat-like substance that’s found in your blood and every cell of your body. You need some cholesterol to keep your cells and organs healthy.

Your liver makes all the cholesterol your body needs. But you can also get cholesterol from the foods you eat, especially meat, eggs, poultry, and dairy products. Foods that are high in dietary fat can also make your liver produce more cholesterol.

There are two main types of cholesterol: low-density lipoprotein (LDL), or “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol.

Too much LDL cholesterol in your blood increases your risk for coronary artery disease and other heart diseases. High LDL levels can cause the buildup of a sticky substance called plaque in your arteries. Over time, plaque can narrow your arteries or fully block them. When this happens, parts of your body don’t get enough blood:

If the blood flow to the heart is blocked, it can cause a heart attack.
If the blood flow to the brain is blocked, it can cause a stroke.
If the blood flow to the arms or legs is blocked, it can cause peripheral artery disease.
Other names for a cholesterol test: Lipid profile, Lipid panel

What is it used for?
A cholesterol test gives you and your health care provider important information about your risk of developing heart disease. If your test shows you have high cholesterol, you can take steps to lower it. This may decrease your risk of developing heart problems in the future. A cholesterol test measures:

LDL levels. Also known as the “bad” cholesterol, LDL is the main source of blockages in the arteries.
HDL levels. Considered the “good” cholesterol, HDL helps get rid of “bad” LDL cholesterol.
Total cholesterol. The combined amount of LDL cholesterol and HDL cholesterol in your blood.
Triglyceride levels. Triglycerides are a type of fat found in your blood. Some studies show that high levels of triglycerides may increase the risk of heart disease, especially in women.
VLDL levels. Very low-density lipoprotein (VLDL) is another type of “bad” cholesterol. High VLDL levels have been linked to plaque buildup in the arteries. VLDL isn’t usually included in routine cholesterol tests because it’s difficult to measure. About half of VLDL is triglycerides, so your VLDL level can be estimated as a percentage of your triglyceride level.
Why do I need a cholesterol test?
Your provider may order a cholesterol test as part of a routine exam. You may also have a cholesterol test if you have a family history of heart disease or if your risk for heart problems is high because of:

High blood pressure
Type 2 diabetes
Smoking
Excess weight or obesity
Lack of physical activity
A diet high in saturated fat
Your age may also be a factor, because your risk for heart disease increases as you get older.

What happens during a cholesterol test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

You may be able to use an at-home kit to check your cholesterol levels. Your kit will include a device to prick your finger to collect a drop of blood for testing. Be sure to follow the kit instructions carefully. Also, be sure to tell your provider if your at-home test shows that your total cholesterol level is higher than 200 mg/dl.

Will I need to do anything to prepare for the test?
You may need to fast (not eat or drink) for 9 to 12 hours before your blood cholesterol test. That’s why the tests are often done in the morning. Your provider will let you know if you need to fast and if there are any other special instructions.

Are there any risks to the test?
There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
Cholesterol is usually measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. The information below will help you understand what your test results mean. In general, low LDL levels and high HDL cholesterol levels are good for heart health.

The LDL listed on your results may say “calculated.” This means that your LDL level is an estimate based on your total cholesterol, HDL, and triglycerides. Your LDL level may also be measured “directly” from your blood sample. Either way, you want your LDL number to be low.

A healthy cholesterol level for you may depend on your age, family history, lifestyle, and other risk factors for heart disease, such as high triglyceride levels. Your provider can explain what’s right for you.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about my cholesterol levels?
High cholesterol can lead to heart disease, the number one cause of death in the United States. You can’t change some risk factors for high cholesterol, such as age and your genes. But there are actions you can take to lower your LDL levels and reduce your risk, including:

Eating a healthy diet. Reducing or avoiding foods high in saturated fat and cholesterol can help reduce the cholesterol levels in your blood.
Losing weight. Being overweight can increase your cholesterol and risk for heart disease.
Staying active. Regular exercise may help lower your LDL (bad) cholesterol levels and raise your HDL (good) cholesterol levels. It may also help you lose weight.
Talk to your provider before making any major change in your diet or exercise routine.

Chorionic Villus Sampling (CVS)

What is chorionic villus sampling (CVS)?
Chorionic villus sampling (CVS) is test for pregnant women that checks chorionic villi, tiny finger-like growths found in the placenta. The placenta is the organ that nourishes an unborn baby in the uterus. The test looks for abnormalities in the baby’s chromosomes. Chromosomes are parts of cells that contain your genes. Genes are parts of DNA passed down from your mother and father. Normally, people have a total of 46 chromosomes.

Chorionic villi contain the same chromosomes as an unborn baby. So, a CVS test can show if a baby has an extra chromosome or a missing or damaged chromosome. These chromosome differences can cause serious health problems.

CVS is a prenatal diagnostic test, which means it can almost always tell for sure whether an unborn baby has a chromosome disorder. This is different than a prenatal screening test, which only shows whether a baby has an increased risk of a serious health problem.

Other names: CVS test

What is it used for?
CVS testing is used to diagnose chromosome problems or other genetic diseases in an unborn baby. These include:

Down syndrome, a disorder that causes intellectual disabilities, certain physical features, and various health problems.
Cystic fibrosis, a disease that causes mucus buildup in the lungs and other organs, making it hard to breathe.
Sickle cell disease, a disorder of the red blood cells. It can cause pain, infections, organ damage, and strokes.
Tay-Sachs disease, a disorder that causes fatty proteins to build up in the brain. It affects sight, hearing, and mental development. Most children with Tay-Sachs die by the age of 5.
CVS testing is very accurate and can be done early in pregnancy, between the 10th and 13th week. But it can only diagnose certain genetic diseases. A CVS test does not diagnose or screen for birth defects such as neural tube defects, conditions that cause abnormal development of a developing baby’s brain and/or spine. Different tests, including an alpha-fetoprotein (AFP) blood test, are used to screen for or diagnose these and other birth defects.

Why do I need a CVS test?
You may need CVS testing if you are at higher risk for having a baby with a chromosome disorder. Risk factors include:

Age. Women age 35 and older have a higher risk of having a baby with Down syndrome or another genetic disorder.
Family history of a genetic disorder
Having another child with a genetic disorder
You may also need CVS testing if you had abnormal results on a prenatal screening test.

What happens during a CVS test?
There are two types of CVS tests:

Transabdominal The sample is taken through the abdomen.
Transcervical. The sample is taken through the cervix. The cervix is the lower, narrow end of the uterus that opens into the vagina.
Your provider will use an ultrasound to check your baby’s position and guide the procedure (transabdominal or transcervical). Ultrasound is an imaging test that uses sound waves to create pictures.

During a transabdominal CVS, your provider will:

Clean your abdomen with an antiseptic.
Apply a numbing medicine to your abdomen.
Insert a long, thin needle through your abdomen and uterus and into the placenta. You may feel a cramping or stinging sensation as the needle enters the uterus.
Use the needle to withdraw a sample of tissue from the placenta.
Remove the needle.
During a transcervical CVS, your provider will:

Clean your vagina and cervix with an antiseptic
Use an instrument called a speculum to gently spread apart the sides of your vagina.
Insert a thin tube through your vagina and cervix and up to the placenta. You may feel a slight twinge or cramping as this is done.
Use the tube to gently suck in a sample of tissue from the placenta.
Remove the tube.
Will I need to do anything to prepare for the test?
On the morning of the test, you may be asked to drink extra fluids and not urinate. This will fill your bladder, which may help move the uterus into a better position for the procedure.

Are there any risks to the test?
CVS is generally considered to be a safe procedure, but it does have some risks. These include:

Miscarriage, which happens in about one in every hundred procedures
Infection
Bleeding
Rh sensitization. This is a condition in which your body makes antibodies (proteins made by the immune system) that attack your baby’s red blood cells. If diagnosed during pregnancy, it is easily treatable.
Limb defects in the baby (this is very rare)
What do the results mean?
CVS test results are usually available within two weeks.

If your results were not normal, it may mean your baby has a chromosome or genetic disorder, such as Down syndrome or cystic fibrosis. Occasionally, CVS test results are unclear, and your provider may recommend amniocentesis. Amniocentesis is another prenatal diagnostic test. It is performed between the 15th and 20th week of pregnancy.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about CVS testing?
Some chromosome and genetic disorders require your baby to have extensive medical treatments. Other disorders may not be treatable. If your CVS test results were not normal, you should talk with your health care provider about your options and the decisions you may need to make. It may also help to speak to a genetic counselor both before and after you get your results. A genetic counselor is a specially trained professional in genetics and can help you understand what your results mean.

Chymotrypsin in Stool

What is a chymotrypsin in stool test?
This test measures the amount of chymotrypsin in a stool sample. Chymotrypsin is an enzyme released by the pancreas during digestion. If lower than normal amounts are released, it may mean your pancreas isn’t making enough enzymes to digest your food properly. This is known as pancreatic insufficiency.

Pancreatic insufficiency is most often caused by chronic pancreatitis, a swelling of the pancreas. It may also be caused by cystic fibrosis (CF), a genetic disorder that causes mucus to build up in the lungs and other organs, including the pancreas. People with CF often have trouble absorbing nutrients from food.

Your sample may also be tested for trypsin, an enzyme released by the pancreas along with chymotrypsin.

Other names: fecal chymotrypsin, trypsin and chymotrypsin stool test

What is it used for?
A chymotrypsin in stool test is used to help diagnose conditions that affect the pancreas, such as:

Pancreatitis
Cystic fibrosis
Malnutrition, a condition in which your body does not get the calories, vitamins, and/or minerals needed for good health
Why do I need a chymotrypsin in stool test?
You may need this test if you have symptoms of a pancreatic disorder. These include:

Chronic diarrhea
Abdominal pain
Foul-smelling, greasy stools
Weight loss
Frequent sinus infections
What happens during a chymotrypsin in stool test?
You will need to provide a stool sample. Your health care provider will give you specific instructions on how to collect and send in your sample. Your instructions may include the following:

Put on a pair of rubber or latex gloves.
Collect and store the stool in a special container given to you by your health care provider or a lab. You may get a device or applicator to help you collect the sample.
Make sure no urine, toilet water, or toilet paper mixes in with the sample.
Seal and label the container.
Remove the gloves, and wash your hands.
Return the container to your health care provider or the lab by mail or in person.
Will I need to do anything to prepare for this test?
You don’t need any special preparations for a chymotrypsin in stool test.

Are there any risks to this test?
There is no known risk to having a stool test.

What do the results mean?
Your results will show whether the amount of chymotrypsin in your stool is normal or below normal. Your results may also include the amount of trypsin found.

If the amount of chymotrypsin and/or trypsin is below normal, it may mean your pancreas isn’t making enough enzymes to digest your food properly. But the test can’t diagnose any specific disorders by itself. Your health care provider will need to order more tests. These may include the following, which measure different pancreatic enzymes:

Stool elastase
Lipase blood test
Amylase blood test
If you have questions about your results, talk to your health care provider.

Coagulation Factor Tests

What are Coagulation Factor Tests?
Coagulation factors are proteins in your blood. They help form blood clots to stop bleeding when you have an injury. These proteins are also called clotting factors. You have several different types of clotting factors that are all important for making blood clots.

Coagulation factor tests are blood tests that check one or more of your clotting factors to see if you:

Have too much or too little of a clotting factor
Are missing a clotting factor
Have a clotting factor that isn’t working properly
Your liver makes most of your clotting factors. But normally, clotting factors are turned off, so you don’t form abnormal blood clots. When you have an injury that causes bleeding, blood cells called platelets begin to make a soft blood clot to stop the bleeding.

The platelets release molecules into your blood that begin to turn on the clotting factors. The clotting factors work together in a chain reaction to form a harder blood clot that will stay firmly in place.

Problems with any one of your clotting factors may mean that:

Your blood clots too easily, even without an injury. This condition may lead to clots that block your blood flow and cause serious conditions, such as heart attack, stroke, or clots in the lungs.
Your blood doesn’t clot enough after an injury or surgery. If this happens, you have a bleeding disorder. Bleeding disorders can lead to serious blood loss after an injury.
Clotting factors have names, such as fibrinogen and prothrombin. Each clotting factor also has a Roman numeral name, such as “clotting factor II.”

Other names: blood clotting factors, factor assays, factor assay by number (Factor I, Factor II, Factor VIII, etc.) or by name (fibrinogen, prothrombin, hemophilia A, hemophilia B, etc.), coagulation panel

What is it used for?
A coagulation factor test is used to find out if you have a problem with any of your clotting factors that may cause too little or too much blood clotting.

Coagulation factor tests are also used to monitor people who have a known problem with clotting factors or who take medicine called blood thinners to lower the risk of blood clots.

You may have tests for one or more factors at a time.

Why do I need a coagulation factor test?
You may need this test if you have:

An abnormal result on a blood test that checks how long it takes your blood to clot. These tests include a prothrombin time test and INR (PT/INR) and/or a partial thromboplastin time test (PTT).
A family health history of problems with clotting factors. Some conditions that affect clotting factors, such hemophilia, are inherited. That means that your parents passed the gene for the disease to you. These conditions are not common.
A health condition that may affect clotting factors in your blood:

Conditions that may cause a bleeding disorder include:

Severe liver disease
A lack of vitamin K
Blood transfusions
Cancer
Immune disorders
Conditions that may cause a problem with blood clots include:

Autoimmune diseases, such as lupus
Cancer
Obesity
Certain infections, such as sepsis and COVID-19
Not moving for long periods of time, such as after surgery
Lack of vitamins B6, B12, and folate
Symptoms that may be from a problem with clotting factors:

Symptoms of bleeding disorders may include:

Heavy bleeding that doesn’t stop with pressure after an injury, dental procedure, or surgery
Frequent nosebleeds that start on their own
Blood in urine (pee) or stool (poop)
Frequent, large bruises or tiny red or brown spots under the skin
Redness, swelling, pain, or stiffness from bleeding into muscles or joints
Heavy menstrual periods
Symptoms of too much blood clotting may include:

Swelling, redness, warmth, and pain in your arms or legs which may be from a clot
Trouble breathing from a clot that’s traveled to your lung
Nausea
What happens during a coagulation factor test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a coagulation factor test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
Your provider may need to order other tests to diagnose the cause of a problem with your clotting factors.

Lower than normal levels of one or more clotting factors or a missing clotting factor may mean you have a bleeding disorder. Depending on which clotting factors were tested, your results may show the type of bleeding disorder you have and how serious it is.

Bleeding disorders that you inherit usually involve only one clotting factor. There is no cure for inherited bleeding disorders, but treatment can help manage your condition.
Bleeding disorders caused by other conditions usually involve low levels of two or more clotting factors. Treatment depends on the cause of your bleeding disorder.
Higher than normal levels of one or more clotting factors may mean you have a disorder that makes your blood clot more than it should. Your provider may recommend medicine and heart-healthy lifestyle changes to help prevent clots. You may also need to avoid hormone replacement therapy for menopause and birth control pills with estrogen, because they may increase the risk of blood clots.

Talk with your provider to find out what your tests results mean and what treatment is best for you.

Cognitive Testing

What is cognitive testing?
Cognitive testing checks for problems with cognition. Cognition is a combination of processes in your brain that’s involved in almost every aspect of your life. It includes thinking, memory, language, judgment, and the ability to learn new things. A problem with cognition is called cognitive impairment. The condition ranges from mild to severe.

There are many causes of cognitive impairment. They include side effects of medicines, blood vessel disorders, depression, and dementia. Dementia is a term used for a severe loss of mental functioning. Alzheimer’s disease is the most common type of dementia.

Cognitive testing can’t show the specific cause of impairment. But testing can help your provider find out if you need more tests and/or take steps to address the problem.

There are different types of cognitive tests. The most common tests are:

Montreal Cognitive Assessment (MoCA)
Mini-Mental State Exam (MMSE)
Mini-Cog
All three tests measure mental functions through a series of questions and/or simple tasks.

Other names: cognitive assessment, Montreal Cognitive Assessment, MoCA test, Mini-Mental State Exam (MMSE), and Mini-Cog

What is it used for?
Cognitive testing is often used to screen for mild cognitive impairment (MCI). People with MCI may notice changes in their memory and other mental functions. The changes aren’t severe enough to have a major effect on your daily life or usual activities. But MCI can be a risk factor for more serious impairment. If you have MCI, your provider may give you several tests over time to check for a decline in mental function.

Why do I need cognitive testing?
You may need cognitive testing if you show signs of cognitive impairment. These include:

Forgetting appointments and important events
Losing things often
Having trouble coming up with words that you usually know
Losing your train of thought in conversations, movies, or books
Increased irritability and/or anxiety
Your family or friends may suggest testing if they notice any of these symptoms.

What happens during a cognitive test?
There are different types of cognitive tests. Each involves answering a series of questions and/or performing simple tasks. They are designed to help measure mental functions, such as memory, language, and the ability to recognize objects. The most common types of tests are:

Montreal Cognitive Assessment (MoCA) test. A 10-15 minute test that includes memorizing a short list of words, identifying a picture of an animal, and copying a drawing of a shape or object.
Mini-Mental State Exam (MMSE). A 7-10 minute test that includes naming the current date, counting backward, and identifying everyday objects like a pencil or watch.
Mini-Cog. A 3-5 minute test that includes recalling a three-word list of objects and drawing a clock.
Will I need to do anything to prepare for cognitive testing?
You don’t need any special preparations for a cognitive test.

Are there any risks to testing?
There is no risk to having cognitive testing.

What do the results mean?
If your test results were not normal, it means you have some problem with memory or other mental function. But it won’t diagnose the cause. Your health care provider may need to do more tests to find out the reason. Some types of cognitive impairment are caused by treatable medical conditions. These include:

Thyroid disease
Side effects of medicines
Vitamin deficiencies
In these cases, cognition problems may improve or even clear up entirely after treatment.

Other types of cognitive impairment are not curable. But medicines and healthy lifestyle changes may help slow mental decline in some cases. A diagnosis of dementia may also help patients and their families prepare for future health needs.

If you have questions or are concerned about your results, talk to your health care provider.

Is there anything else I need to know about cognitive testing?
The MoCA test is usually better at finding mild cognitive impairment. The MMSE is better at finding more serious cognitive problems. The Mini-Cog is often used because it is quick, easy-to-use, and widely available. Your health care provider may do one or more of these tests, depending on your condition.

Cold Stimulation Test

What is a cold stimulation test?
A cold stimulation test involves placing your fingers in an ice water bath to find out if you have Raynaud’s syndrome. Raynaud’s syndrome, also known as Raynaud’s disease or Raynaud’s phenomenon, is a condition that causes brief episodes where little or no blood flows to certain parts of your body after exposure to cold or sometimes stress. It mostly affects fingers and/or toes.

A Raynaud’s episode can be triggered by very mild and limited exposure to cold, such as taking food out of the freezer or holding a cold drink. When an episode happens, your skin may feel cold and numb. It may also make your skin turn white or blue. As blood flow returns, your skin may tingle, throb, or turn red. It usually takes about 15 minutes for normal blood flow to return.

There are two forms of Raynaud’s syndrome:

Primary Raynaud’s, a fairly common and mild condition. It is not associated with any other health problem. Symptoms usually start between the ages of 15 and 25. Most people with primary Raynaud’s syndrome can manage their symptoms without medical treatment.
Secondary Raynaud’s, often referred to as Raynaud’s phenomenon, is less common than primary Raynaud’s but more serious. Symptoms may include skin ulcers (open sores caused by poor blood flow) or skin infections. Symptoms usually start between the ages of 35 and 40. Secondary Raynaud’s is most often caused by another medical condition. These include immune system disorders and connective tissue diseases. Connective tissue diseases affect blood flow to tissues and organs.
Other names: cold challenge test

What is it used for?
A cold stimulation test is used to diagnose Raynaud’s syndrome.

Why do I need a cold stimulation test?
You may need this test if you have symptoms of Raynaud’s syndrome. Symptoms usually show up after exposure to cold. They mostly affect fingers and toes and include:

Skin that turns white or blue
Skin that is numb and painful
Skin that takes a long time to warm up after exposure
What happens during a cold stimulation test?
A small device that measures temperature will be taped to your fingers.
Your provider will record the temperature.
You will then place your hands into an ice water bath for 20 seconds.
You will remove your hands from the ice water.
Your provider will record your finger temperature every five minutes for up to 20 minutes, or until your temperature returns to the same as it was before the ice water bath.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a cold stimulation test.

Are there any risks to the test?
You may feel some discomfort while your hands are in the ice water.

What do the results mean?
If it takes 20 minutes or more for your finger temperature to return to normal after the ice water bath, it probably means you have Raynaud’s syndrome. If your symptoms are severe and/or you are age 35 or older, you may have secondary Raynaud’s syndrome. Secondary Raynaud’s can be caused by several disorders, including:

Scleroderma, a disease that causes hardening of the skin and other body tissues
Sjögren’s syndrome, a disorder that causes dryness of the eyes and mouth
Lupus, an autoimmune disorder that affects multiple parts of the body, including the joints, blood vessels, kidneys, and brain
Rheumatoid arthritis, an autoimmune disorder that causes pain, swelling, and stiffness of the joints
A blood disorder, such as polycythemia vera, a disease that causes your body to make too many red blood cells
Pulmonary hypertension, a type of high blood pressure that affects arteries in your lungs and heart
If your provider thinks you have secondary Raynaud’s syndrome, he or she may order more tests to help diagnose the disorder that is causing it. These tests include:

Nailfold capillaroscopy. For this test, your provider will place a drop of oil on the base of one of your fingernails. The nail area is then examined under a microscope. If abnormal arteries are seen, it can be a sign of scleroderma or other connective tissue disease.
Blood tests to check for immune system disorders. These include an antinuclear antibody (ANA) test, erythrocyte sedimentation rate (ESR), and C-reactive protein.
If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a cold stimulation test?
There are steps you can take that may help you avoid or reduce the symptoms of Raynaud’s syndrome, including:

Dressing extra warmly for cold weather. This includes wearing a hat, mittens, scarf, and heavy socks.
Using battery- or chemical-operated hand and/or foot warmers
Turning down air conditioning and wearing a sweater or jacket when in an air-conditioned space
Getting regular exercise, which increases blood flow
Limiting caffeine and alcohol
Avoiding stress
These changes should be enough to manage the symptoms of primary Raynaud’s syndrome. If your symptoms are causing too much discomfort, or if you have secondary Raynaud’s syndrome, your provider may also prescribe medicines that can help open your blood vessels.

Colorectal Cancer Screening Tests

What are colorectal cancer screening tests?
Colorectal cancer screening tests check for signs of colorectal cancer. Colorectal cancer is a type of cancer that affects the colon or rectum. The colon makes up most of the large intestine. The rectum is at the end of the large intestine and connects to the anus.

Colorectal cancer is a leading cause of cancer deaths in the United States. Screening can help find colorectal cancer early, when treatment is most effective. Colorectal cancer screening can sometimes prevent cancer from even developing. That’s because some types of screening tests let a health care provider find and remove abnormal growths, known as colorectal polyps. Most of these polyps are benign (not cancerous) but do have a risk of becoming cancerous if not removed.

Other names: colon cancer screening

What are they used for?
Colorectal cancer screening tests are used to check for signs of colorectal cancer and/or to remove colorectal polyps.

Why do I need a colorectal cancer screening test?
The National Cancer Institute and other expert medical groups recommend people get regular screenings for colorectal cancer, starting at age 50. The American Cancer Society recommends that people begin screening at age 45. You should talk with your health care provider about when you should start and about the different types of screening tests.

You may need to be screened at a younger age, or more often, if you have certain risk factors including:

A family history of colorectal cancer
Previously had colorectal polyps
A family history of, or having had, ovarian cancer
Inflammatory bowel disease such as ulcerative colitis or Crohn’s disease
What happens during a colorectal cancer screening?
There are two main types of colorectal cancer screening tests: visual exams and stool tests. There are different options for both types of tests.

Visual exams are procedures that allow a provider to look inside the colon and rectum. They are done either using a thin tube with a camera attached or with a special imaging device. Types of visual exams include:

Colonoscopy. This test allows a provider to view your entire colon and rectum. It is often done in an outpatient department of a hospital or medical center. Before the test, you will need to empty out your colon (large bowel) in a procedure called bowel prep. During the test:

You will lie on an exam table.
You will be given medicine called a sedative to help you relax. It also prevents you from feeling pain during the procedure. You may be awake for the test, but you probably won’t remember anything.
A colonoscope, a thin, lighted tube with a camera attached, will be inserted into your rectum and up into your colon.
Your provider will look for colorectal polyps or other abnormal areas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
The sedative you are given may make you drowsy for several hours. You should arrange for someone to drive you home.

Sigmoidoscopy. This test allows your provider to look at the lower part of the colon. During the test:

You will lie on an exam table with your knees drawn up to your chest.
A sigmoidoscope, a flexible, lighted tube with a camera, will be inserted into the rectum and up into the lower part of the colon.
Air will be pumped through the sigmoidoscope to make the colon bigger and easier to see.
The air may make you feel like you need to have a bowel movement or pass gas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
Virtual Colonoscopy. This is a type of x-ray that uses a CT scan (computed tomography) to take detailed, 3-dimensional pictures of the entire colon and rectum. It is usually done in a radiology department of a hospital or medical center. This procedure also requires bowel prep beforehand. During the test:

You will lie on a narrow table.
You may be asked to drink a liquid containing contrast dye. Contrast dye is a substance that makes parts of your body show up more clearly on an x-ray.
A provider will insert a small tube into the rectum.
Air will be pumped through the tube to make the colon bigger and easier to see.
The table will slide into the CT machine.
A series of images will be taken.
Stool tests look at stool samples for signs of cancer. For these tests, you take a stool sample at home and send it to a lab. Types of stool tests:

Fecal occult blood tests. These tests look for hidden (known as occult) blood in the stool. Blood in the stool may be a sign of polyps, cancer, or other conditions. Your health care provider will give you a kit that includes instructions on how to do the test.

There are two types of fecal occult blood tests: the fecal immunochemical test (FIT) and the guaiac smear method (gFOBT). Below are typical instructions for each test. Your instructions may vary slightly depending on the manufacturer of the test kit.

For a fecal immunochemical test (FIT), you will most likely need to:

Collect samples from two or three separate bowel movements.
Collect the sample from the toilet using the special brush or other device included in your kit.
For each sample, use the brush or device to take the sample from the surface of the stool.
Brush the sample onto a test card.
Label and seal all your samples as directed.
Mail the samples to your health care provider or lab.
For a guaiac smear test (gFOBT), you will most likely need to:

Collect samples from three separate bowel movements.
For each sample, collect the stool and store it in a clean container. Make sure the sample does not mix in with urine or water from the toilet.
Use the applicator from your test kit to smear some of the stool on the test card or slide, also included in your kit.
Label and seal all your samples as directed.
Mail the samples to your health care provider or lab.
Stool DNA test. This test checks for genetic changes in the stool that may be signs of colorectal polyps or cancer. Your provider will let you know to get a test kit. The kit will include instructions on how to do the test. The instructions will likely include the following steps:

Put a special container inside your toilet.
Collect an entire bowel movement.
Close and seal the container.
Mail the container with the stool sample to a lab for testing.
Will I need to do anything to prepare for the test?
There are no special preparations needed for a FIT or stool DNA test. The typical preparations for other colorectal cancer screening tests are below.

For a colonoscopy and virtual colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:

Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.

For a sigmoidoscopy, before the test, you may need to:

Follow a clear liquid diet one or more days before the procedure. This isn’t always required, so be sure to talk to your provider before the test.
You may be asked to fast (not eat or drink) on the morning of the procedure.
Use an enema to empty your bowels about one hour before the procedure. A second enema is sometimes needed.
For a g(FOBT) test, you may need to avoid the following foods and medicines for several days before your test:

Nonsteroidal, anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or aspirin
More than 250 mg of vitamin C daily from supplements, fruit juices, or fruit
Red meat, such as beef, lamb, or pork
Your health care provider will give you full instructions on how to prepare for your screening test.

Are there any risks to the test?
There are no risks to having a fecal occult blood test or a stool DNA test.

Serious risks of colonoscopy are rare but can include:

Tears in the colon or rectum wall
Bleeding
Reaction to the sedative
There are fewer risks to sigmoidoscopy than with a colonoscopy. Tears in the colon and bleeding can happen, but they are even less common than with a colonoscopy.

In a virtual colonoscopy, risks include:

Exposure to a small dose of radiation from the scan.
Rarely, a tear in the colon or rectum can happen when it is inflated with air.
What do the results mean?
If your fecal occult blood test or stool DNA test had abnormal results, it doesn’t necessarily mean you have cancer. But your provider will probably order more tests, such as a colonoscopy, to help make a diagnosis.

Abnormal results for the other types of screening tests may include the following:

Colonoscopy

Colorectal polyps or abnormal tissue were found and removed.
Samples were sent to a lab for testing.
Most polyps aren’t cancerous but can turn into cancer if not removed. Depending on the size and number of polyps, your provider may recommend more frequent colonoscopies.

Sigmoidoscopy

Colorectal polyps or abnormal tissue were found. They may or may not be removed depending on their location.
Whether or not your polyps were removed, you will probably need a colonoscopy so your provider can view your entire colon and rectum.
Virtual colonoscopy

Colorectal polyps or abnormal tissue were seen on the CT scan.
You will probably need a traditional colonoscopy so your provider can get a tissue sample. Sometimes this procedure can be done on the same day as your virtual colonoscopy.
If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a colorectal cancer screening?
Each type of screening test has advantages and disadvantages. You and your provider should discuss the benefits and risks of each option. The following may help guide your decision

Colposcopy

What is a colposcopy?
A colposcopy is a procedure that allows a health care provider to closely examine a woman’s cervix, vagina, and vulva. It uses a lighted, magnifying device called a colposcope. The device is placed at the opening of the vagina. It magnifies the normal view, allowing your provider to see problems that can’t be seen by the eyes alone.

If your provider sees a problem, he or she may take a sample of tissue for testing (biopsy). The sample is most often taken from the cervix. This procedure is known as a cervical biopsy. Biopsies may also be taken from the vagina or vulva. A cervical, vaginal, or vulvar biopsy can show if you have cells that are at risk for becoming cancer. These are called precancerous cells. Finding and treating precancerous cells may prevent cancer from forming.

Other names: colposcopy with directed biopsy

What is it used for?
A colposcopy is most often used to find abnormal cells in the cervix, vagina, or vulva. It may also be used to:

Check for genital warts, which may be a sign of an HPV (human papillomavirus) infection. Having HPV may put you at higher risk for developing cervical, vaginal, or vulvar cancer.
Look for noncancerous growths called polyps
Check for irritation or inflammation of the cervix
If you’ve already been diagnosed and treated for HPV, the test may be used to monitor cell changes in the cervix. Sometimes abnormal cells return after treatment.

Why do I need a colposcopy?
You may need this test if you had abnormal results on your Pap smear. A Pap smear is a test that involves getting a sample of cells from the cervix. It can show if there are abnormal cells, but it can’t provide a diagnosis. A colposcopy provides a more detailed look at the cells, which may help your provider confirm a diagnosis and/or find other potential problems.

You may also need this test if:

You have been diagnosed with HPV
Your provider sees abnormal areas on your cervix during a routine pelvic exam
You have bleeding after sex
What happens during a colposcopy?
A colposcopy may be done by your primary care provider or by a gynecologist, a doctor who specializes in diagnosing and treating diseases of the female reproductive system. The test is usually done in the provider’s office. If abnormal tissue is found, you may also get a biopsy.

During a colposcopy:

You will remove your clothing and put on a hospital gown.
You will lie on your back on an exam table with your feet in stirrups.
Your provider will insert a tool called a speculum into your vagina. It is used to spread open your vaginal walls.
Your provider will gently swab your cervix and vagina with a vinegar or iodine solution. This makes abnormal tissues easier to see.
Your provider will place the colposcope near your vagina. But the device will not touch your body.
Your provider will look through the colposcope, which provides a magnified view of the cervix, vagina, and vulva. If any areas of tissue look abnormal, your provider may perform a cervical, vaginal, or vulvar biopsy.
During a biopsy:

A vaginal biopsy can be painful, so your provider may first give you a medicine to numb the area.
Once the area is numb, your provider will use a small tool to remove a sample of tissue for testing. Sometimes many samples are taken.
Your provider may also do a procedure called an endocervical curettage (ECC) to take a sample from the inside of the opening of the cervix. This area can’t be seen during a colposcopy. An ECC is done with a special tool called a curette. You may feel a slight pinch or cramp as the tissue is removed.
Your provider may apply a topical medicine to the biopsy site to treat any bleeding you may have.
After a biopsy, you should not douche, use tampons, or have sex for a week after your procedure, or for as long as your health care provider advises.

Will I need to do anything to prepare for the test?
Do not douche, use tampons or vaginal medicines, or have sex for at least 24 hours before the test. Also, it’s best to schedule your colposcopy when you are not having your menstrual period. And be sure to tell your provider if you are pregnant or think you may be pregnant. Colposcopy is generally safe during pregnancy, but if a biopsy is needed, it can cause extra bleeding.

Are there any risks to the test?
There is very little risk to having a colposcopy. You may have some discomfort when the speculum is inserted into the vagina, and the vinegar or iodine solution may sting.

A biopsy is also a safe procedure. You may feel a pinch when the tissue sample is taken. After the procedure, your vagina may be sore for a day or two. You may have some cramping and slight bleeding. It’s normal to have a little bleeding and discharge for up to a week after the biopsy.

Serious complications from a biopsy are rare, but call your provider if you have any of the following symptoms:

Heavy bleeding
Abdominal pain
Signs of infection, such as fever, chills and/or bad smelling vaginal discharge
What do the results mean?
During your colposcopy, your provider may find one or more of the following conditions:

Genital warts
Polyps
Swelling or irritation of the cervix
Abnormal tissue
If your provider also performed a biopsy, your results may show you have:

Precancerous cells in the cervix, vagina, or vulva
An HPV infection
Cancer of the cervix, vagina, or vulva
If your biopsy results were normal, it’s unlikely that you have cells in your cervix, vagina, or vulva that are at risk for turning into cancer. But that can change. So your provider may want to monitor you for cell changes with more frequent Pap smears and/or additional colposcopies.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a colposcopy?
If your results showed you have precancerous cells, your provider may schedule another procedure to remove them. This may prevent cancer from developing. If cancer was found, you may be referred to a gynecologic oncologist, a provider who specializes in treating cancers of the female reproductive system.

Complement Blood Test

What is a complement blood test?
A complement blood test measures the amount or activity of complement proteins in the blood. Complement proteins are part of the complement system. This system is made up of a group of proteins that work with the immune system to identify and fight disease-causing substances like viruses and bacteria.

There are nine major complement proteins. They are labeled C1 through C9. Complement proteins may be measured individually or together. C3 and C4 proteins are the most commonly tested individual complement proteins. A CH50 test (sometimes called CH100) measures the amount and activity of all the major complement proteins.

If the test shows that your complement protein levels are not normal or that the proteins aren’t working with the immune system as well as they should, it can be a sign of an autoimmune disease or other serious health problem.

Other names: complement antigen, compliment activity C3, C4, CH50, CH100, C1 C1q, C2

What is it used for?
A complement blood test is most often used to diagnose or monitor autoimmune disorders such as:

Lupus, a chronic disease affecting multiple parts of the body, including the joints, blood vessels, kidneys, and brain
Rheumatoid arthritis, a condition that causes pain and swelling of the joints, mostly in the hands and feet
It may also be used to help diagnose certain bacterial, viral, or fungal infections.

Why do I need a complement blood test?
You may need a complement blood test if you have symptoms of an autoimmune disorder, especially lupus. Symptoms of lupus include:

A butterfly-shaped rash across your nose and cheeks
Fatigue
Mouth sores
Hair loss
Sensitivity to sunlight
Swollen lymph nodes
Chest pain when breathing deeply
Joint pain
Fever
You may also need this test if you are being treated for lupus or other autoimmune disorder. The test can show how well the treatment is working.

What happens during a complement blood test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a complement blood test.

Are there any risks to a complement blood test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
If your results show lower than normal amounts or decreased activity of complement proteins, it may mean you have one of the following conditions:

Lupus
Rheumatoid arthritis
Cirrhosis
Certain types of kidney disease
Hereditary angioedema, a rare but serious disorder of the immune system. It can cause swelling of the face and airways.
Malnutrition
A recurrent infection (usually bacterial)
If your results show higher than normal amounts or increased activity of complement proteins, it may mean you have one of the following conditions:

Certain types of cancer, such as leukemia or non-Hodgkin lymphoma
Ulcerative colitis, a condition in which the lining of the large intestine and rectum become inflamed
If you are being treated for lupus or another autoimmune disease, increased amounts or activity of complement proteins may mean your treatment is working.

If you have questions about your results, talk to your health care provider.

Complete Blood Count (CBC)

What is a Complete Blood Count?
A complete blood count, or CBC, is a blood test that measures many different parts and features of your blood, including:

Red blood cells, which carry oxygen from your lungs to the rest of your body.
White blood cells, which fight infections and other diseases. There are five major types of white blood cells. A CBC test measures the total number of white cells in your blood. A different test called a CBC with differential measures the number of each type of these white blood cells.
Platelets, which stop bleeding by helping your blood to clot.
Hemoglobin, a protein in red blood cells that carries oxygen from your lungs to the rest of your body.
Hematocrit, a measurement of how much of your blood is made up of red blood cells.
Mean corpuscular volume (MCV), a measure of the average size of your red blood cells.
Other names for a complete blood count: CBC, full blood count, blood cell count

What is it used for?
A complete blood count is a common blood test that is often part of a routine checkup. Complete blood counts can help detect a variety of disorders including infections, anemia, diseases of the immune system, and blood cancers.

Why do I need a complete blood count?
Your health care provider may have ordered a complete blood count as part of your checkup or to monitor your overall health. The test may also be used to:

Help diagnose blood diseases, infection, immune system disorders, or other medical conditions
Check for changes in an existing blood disorder
What happens during a complete blood count?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
Usually there is no special preparation necessary for a complete blood count. But if your provider ordered other tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?
There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle went in, but most symptoms go away quickly.

What do the results mean?
A CBC counts the cells in your blood. There are many reasons your levels may not be in the normal range. For example:

Abnormal levels of red blood cells, hemoglobin, or hematocrit may be a sign of anemia, heart disease, or too little iron in your body.
Low white cell count may be a sign of an autoimmune disorder, bone marrow disorder, or cancer.
High white cell count may be a sign of an infection or a reaction to medicine.
If any of your levels are abnormal, it doesn’t always mean you have a medical condition that needs treatment. Diet, activity level, medicines, a menstrual period, not drinking enough water, and other factors can affect the results. Talk with your provider to learn what your results mean.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a complete blood count?
A complete blood count is only one tool your health care provider uses to learn about your health. Your provider will consider your medical history, symptoms, and other factors to make a diagnosis. You may also need additional tests.

Comprehensive Metabolic Panel (CMP)

What is a comprehensive metabolic panel (CMP)?
A comprehensive metabolic panel (CMP) is a test that measures 14 different substances in your blood. It provides important information about your body’s chemical balance and metabolism. Metabolism is the process of how the body uses food and energy. A CMP includes tests for the following:

Glucose, a type of sugar and your body’s main source of energy.
Calcium, one of the body’s most important minerals. Calcium is essential for proper functioning of your nerves, muscles, and heart.
Sodium, potassium, carbon dioxide, and chloride. These are electrolytes, electrically charged minerals that help control the amount of fluids and the balance of acids and bases in your body.
Albumin, a protein made in the liver.
Total protein, which measures the total amount of protein in the blood.
ALP (alkaline phosphatase), ALT (alanine transaminase), and AST (aspartate aminotransferase). These are different enzymes made by the liver.
Bilirubin, a waste product made by the liver.
BUN (blood urea nitrogen) and creatinine, waste products removed from your blood by your kidneys.
Abnormal levels of any of these substances or combination of them can be a sign of a serious health problem.

Other names: chem 14, chemistry panel, chemistry screen, metabolic panel

What is it used for?
A CMP is used to check several body functions and processes, including:

Liver and kidney health
Blood sugar levels
Blood protein levels
Acid and base balance
Fluid and electrolyte balance
Metabolism
A CMP may also be used to monitor the side effects of certain medicines.

Why do I need a CMP?
A CMP is often done as part of a regular checkup. You may also need this test if your health care provider thinks you have liver or kidney disease.

What happens during a CMP?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You may need to fast (not eat or drink) for at least 8 hours before the test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
If any one result or combination of CMP results were not normal, it can indicate a number of different conditions. These include liver disease, kidney failure, or diabetes. You will likely need more tests to confirm or rule out a specific diagnosis.

If you have questions about your results, talk to your health care provider.

Concussion Tests

What are concussion tests?
Concussion tests can help find out if you or your child has suffered a concussion. A concussion is a type of brain injury caused by a bump, blow, or jolt to the head. Young children are at a higher risk of concussions because they are more active and because their brains are still developing.

Concussions are often described as mild traumatic brain injuries. When you get a concussion, your brain shakes or bounces inside your skull. It causes chemical changes in the brain and affects brain function. After a concussion, you may have headaches, mood changes, and problems with memory and concentration. The effects are usually temporary, and most people make a full recovery after treatment. The main treatment for a concussion is rest, both physical and mental. Left untreated, a concussion can cause long-term brain damage.

Other names: concussion assessment

What are they used for?
Concussion tests are used to assess brain function after a head injury. A type of concussion test, called a baseline test, is often used for athletes who play contact sports, a common cause of concussion. A baseline concussion test is used on non-injured athletes before the start of a sports season. It measures normal brain function. If a player gets injured, the baseline results are compared with the concussion tests performed after the injury. This helps the health care provider see if the concussion has caused any problems with brain function.

Why do I need concussion testing?
You or your child may need concussion testing after a head injury, even if you think the injury is not serious. Most people don’t lose consciousness from a concussion. Some people get concussions and don’t even know it. It’s important to watch for concussion symptoms so you or your child can get treated promptly. Early treatment can help you recover faster and prevent further injury.

Concussion symptoms include:

Headache
Nausea and vomiting
Fatigue
Confusion
Dizziness
Sensitivity to light
Changes in sleep patterns
Mood changes
Difficulty concentrating
Memory problems
Some of these concussion symptoms show up right away. Others may not show up for weeks or months after the injury.

Certain symptoms may mean a more serious brain injury than a concussion. Call 911 or seek immediate medical attention if you or your child has any of the following symptoms:

Inability to be woken up after injury
Severe headache
Seizures
Slurred speech
Excessive vomiting
What happens during concussion testing?
Testing usually includes questions about concussion symptoms and a physical exam. You or your child may also be checked for changes in:

Vision
Hearing
Balance
Coordination
Reflexes
Memory
Concentration
Athletes may get concussion baseline testing before the start of a season. A baseline concussion test usually involves taking an online questionnaire. The questionnaire measures attention, memory, speed of answers, and other abilities.

Testing sometimes includes one of the following types of imaging tests:

CT (computerized tomography) scan, a type of x-ray that takes a series of pictures as it rotates around you
MRI (magnetic resonance imaging), which uses powerful magnets and radio waves to create an image. It does not use radiation.
In the near future, a blood test may also be used to help diagnose a concussion. The FDA recently approved a test, called the Brain Trauma Indicator, for adults with concussions. The test measures certain proteins that are released into the bloodstream within 12 hours of a head injury. The test may be able to show how serious the injury is. Your provider may use the test to decide whether or not you need a CT scan.

Will I need to do anything to prepare for a concussion test?
You don’t need any special preparations for concussion testing.

Are there any risks to the tests?
There is little risk to having concussion testing. CT scans and MRIs are painless, but can be a little uncomfortable. Some people feel claustrophobic in an MRI scanning machine.

What do the results mean?
If your results show that you or your child has a concussion, rest will be the first and most important step in your recovery. This includes getting plenty of sleep and not doing any strenuous activities.

You’ll also need to rest your mind too. This is known as cognitive rest. It means limiting schoolwork or other mentally challenging activities, watching TV, using the computer, and reading. As your symptoms improve, you can gradually increase your level of physical and mental activities. Talk to your health care provider or your child’s provider for specific recommendations. Taking enough time to recover can help ensure a full recovery.

For athletes, there may be specified steps, called a concussion protocol, that are recommended in addition to the steps listed above. These include:

Not returning to the sport for seven or more days
Working with coaches, trainers, and medical professionals to assess the athlete’s condition
Comparing baseline and after-injury concussion results
Is there anything else I need to know about concussion testing?
There are steps you can take to prevent concussions. These include:

Wearing helmets while biking, skiing, and doing other sports
Regularly checking sports equipment for proper fit and function
Wearing seatbelts
Keeping the home safe with well-lit rooms and removing objects from floors that might cause someone to trip. Falls in the home are a leading cause of head injury.
Preventing concussions is important for everyone, but it’s especially crucial for people who have had a concussion in the past. Having a second concussion close to the time of the first injury can cause additional health problems and lengthen recovery time. Having more than one concussion in your lifetime may also cause some long-term health problems.

Cord Blood Testing and Banking

What are cord blood testing and cord blood banking?
Cord blood is the blood left in the umbilical cord after a baby is born. The umbilical cord is the rope-like structure that connects a mother to her unborn baby during pregnancy. It contains blood vessels that bring nourishment to the baby and remove waste products. After a baby is born, the cord is cut with a small piece remaining. This piece will heal and form the baby’s belly button.

Cord blood testing

Once the umbilical cord has been cut, a health care provider may take a sample of blood from the cord for testing. These tests may measure a variety of substances and check for infections or other disorders.

Cord blood banking

Some people want to bank (save and store) blood from their baby’s umbilical cord for future use in treating diseases. The umbilical cord is full of special cells called stem cells. Unlike other cells, stem cells have the ability to grow into many different types of cells. These include bone marrow, blood cells, and brain cells. Stem cells in cord blood can be used to treat certain blood disorders, including leukemia, Hodgkin disease, and some types of anemia. Researchers are studying whether stem cells can also treat other types of diseases.

What is cord blood testing used for?
Cord blood testing may be used to:

Measure blood gases. This helps to see if a baby’s blood has a healthy level of oxygen and other substances.
Measure bilirubin levels. Bilirubin is a waste product made by the liver. High bilirubin levels can be a sign of a liver disease.
Perform a blood culture. This test may be done if a provider thinks a baby has an infection.
Measure different parts of the blood with a complete blood count. This is done more often on premature babies.
Check for signs of a baby’s exposure to illegal or misused prescription drugs a mother may have taken during pregnancy. Umbilical cord blood can show signs of a variety of drugs, including opiates; such as heroin and fentanyl; cocaine; marijuana; and sedatives. If any of these drugs are found in cord blood, a health care provider can take steps to treat the baby and help avoid complications such as developmental delays.
What is cord blood banking used for?
You may want to consider banking your baby’s cord blood if you:

Have a family history of a blood disorder or certain cancers. Your baby’s stem cells will be a close genetic match to his or her sibling or other family member. The blood may be helpful in treatment.
Want to protect your child from a future illness, although it’s unlikely that a child can be treated with his or her own stem cells. That’s because a child’s own stem cells may have the same problem that led to the disease in the first place.
Want to help others. You can donate your baby’s cord blood to a facility that provides lifesaving stem cells to patients in need.
How is cord blood collected?
Soon after your baby is born, the umbilical cord will be cut to separate the baby from your body. The cord used to be routinely cut right after birth, but leading health organizations now recommend waiting at least one minute before cutting. This helps improve blood flow to the baby, which may have long-term health benefits.

After the cord is cut, a health care provider will use a tool called a clamp to stop the cord from bleeding. The provider will then use a needle to withdraw blood from the cord. The cord blood will be packaged and either sent to a lab for testing or to a cord blood bank for long-term storage.

How is cord blood banked?
There are two types of umbilical cord blood banks.

Private banks. These facilities save your baby’s cord blood for your family’s personal use. These facilities charge a fee for collection and storage. However, there is no guarantee the cord blood will be useful to treat your baby or a member of your family in the future.
Public banks. These facilities use cord blood to help others and to do research. Cord blood in public banks may be used by anyone who needs it.
Is there any preparation needed for cord blood testing or banking?
There are no special preparations needed for cord blood testing. If you want to bank your baby’s cord blood, talk to your health care provider early in your pregnancy. This will give you time to get more information and review your options.

Are there any risks to cord blood testing or banking?
There is no risk to cord blood testing. Cord blood banking at a private facility can be very expensive. The cost is usually not covered by insurance.

What do cord blood test results mean?
Cord blood test results will depend on what substances were measured. If results were not normal, talk to your health care provider to see if your baby needs treatment.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about cord blood testing or banking?
Unless you have a family history of certain blood disorders or cancers, it’s unlikely your baby’s cord blood will help your baby or your family. But research is ongoing and the future of using stem cells for treatment looks promising. Also, if you save your baby’s cord blood at a public cord bank, you may be able to help patients right now.

Cortisol Test

What is a Cortisol Test?
A cortisol test measures the level of cortisol in your blood, urine, or saliva to see if your levels are normal. Cortisol is a hormone that affects almost every organ and tissue in your body. It helps your body:

Respond to stress (cortisol is sometimes called the “stress hormone”)
Reduce inflammation
Regulate blood sugar and metabolism (how your body uses food for energy)
Control blood pressure
Cortisol is made by your adrenal glands, two small glands that sit above the kidneys. A gland in your brain, called the pituitary gland, makes a hormone that tells your adrenal glands how much cortisol to make. If your cortisol levels are too high or too low, it may mean you have a disorder of your adrenal glands, a problem with your pituitary gland, or a tumor that makes cortisol.

High levels of cortisol may also happen if you take large doses of certain steroid medicines, such as prednisone, for a long time. And low levels may happen if you stop the medicine suddenly.

Without treatment, cortisol levels that are too high or too low can be very serious.

Other names: urinary cortisol, salivary cortisol, free cortisol, blood cortisol, plasma cortisol

What is it used for?
A cortisol test is used to help diagnose medical conditions that cause too much or too little cortisol. These conditions include disorders that affect the adrenal glands:

Cushing’s syndrome is a disorder that happens when your body has too much cortisol over a long period of time.
Addison disease is a condition in which your adrenal glands are damaged and can’t make enough cortisol.
Secondary adrenal insufficiency is a condition in which your adrenal glands don’t make enough cortisol because your pituitary gland isn’t working properly.
Cortisol testing is also used to monitor treatment for these conditions.

Why do I need a cortisol test?
You may need a cortisol test if you have symptoms of a condition that affects cortisol levels.

Symptoms of Cushing’s syndrome (too much cortisol) may include:
Weight gain
Thin arms and legs
Round face
Increased fat around the base of the neck or between the shoulder blades
Easy bruising
Wide purple streaks on the stomach, breasts, hips, and under the arms
Muscle weakness
Common symptoms of Addison disease and adrenal insufficiency (not enough cortisol) may include:
Long-lasting fatigue
Muscle weakness
Loss of appetite
Weight loss
Abdominal (belly) pain
What happens during a cortisol test?
A cortisol test often uses a sample of blood drawn at a lab. But the test may also be done on urine or saliva collected at home. Normally, cortisol levels vary during the day, so your provider may order more than one type of test to get more information about your cortisol levels.

For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Blood samples are usually taken twice during the day–once in the morning when cortisol levels are at their highest, and again around 4 p.m., when levels are much lower.

For a cortisol urine test, your provider may ask you to collect all your urine during a 24-hour period. This is called a “24-hour urine sample test.” For this test, you’ll be given a special container and instructions for how to collect and store your urine sample. Your provider will tell you what time to start. The test usually includes the following steps:

To begin, urinate in the toilet as usual. Do not collect this urine. Write down the time you urinated.
For the next 24 hours, collect all your urine in the container.
Store the urine container in a refrigerator or in a cooler with ice during the collection period.
24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
Return the container with your urine to your provider’s office or the laboratory as instructed.
In certain cases, a urine test for cortisol may be done on one sample of urine collected in the morning.

A cortisol saliva test is usually done at home with a kit to collect a saliva sample. Your provider will tell you what time to collect your sample. It’s often done at night before you go to bed when cortisol levels are normally lower.

Most kits include a swab and a container to store it. Be careful to follow the instructions that come with your kit. They usually include these general steps:

Do not eat, drink, brush, or floss your teeth for 30 minutes before the test.
Wash and dry your hands.
Open the tube that holds the swab and let the swab fall into your mouth without touching it with your hands.
Roll the swab in your mouth or hold it under your tongue for about 2 minutes until it is soaked with saliva.
Spit the swab back into the tube without touching it and close the tube.
Label the tube with the time you collected the sample.
Take your saliva sample to your doctor’s office or the lab the next day as instructed.
Will I need to do anything to prepare for the test?
The preparations will depend on the type of test you are having. Be sure to follow all the instructions that your provider gives you.

Stress can raise your cortisol levels, so you may need to rest before your test. A blood test will require you to schedule two appointments at different times of the day. Before a saliva test, you may need to stop using certain medicines. Let your provider know about all medicines you use, including skin creams. But don’t stop using any medicines without talking with your provider first.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

There are no known risks to a urine or saliva test.

What do the results mean?
A cortisol test alone can’t diagnose the cause of abnormal cortisol levels. If your cortisol level isn’t normal, you will usually have more tests to find out what is causing the problem.

High levels of cortisol may be a sign that you have Cushing’s syndrome. It may be caused by:

Taking high doses of certain steroid medicines for a long time to treat conditions, such as asthma, rheumatoid arthritis, and lupus
Tumors in your pituitary gland or other parts of your body that make too much of the hormone that tells your adrenal glands to make cortisol
Tumors in your adrenal glands that make extra cortisol
Low levels of cortisol may mean you have Addison disease or secondary adrenal insufficiency:

Common causes of Addison’s disease include damage to the adrenal glands from conditions, such as:
Autoimmune diseases
Certain infections, such as tuberculosis (TB) and HIV/AIDS
Common causes of secondary adrenal insufficiency include:
Autoimmune diseases
Problems with the pituitary gland
Traumatic brain injury
The most common cause of low cortisol levels is suddenly stopping steroid medicines after using them for a long time.

If your cortisol results aren’t normal, it doesn’t always mean you have a medical condition that needs treatment. Cortisol levels can be affected by:

Stress
Pregnancy
Exercise
Serious illness
Hot and cold temperatures
Certain thyroid diseases
Obesity
Certain medicines, such as birth control pills
To learn what your test results mean, talk with your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a cortisol test?
A cortisol test is one of the tests that may be used to help diagnose congenital adrenal hyperplasia (CAH). CAH is a group of inherited disorders in which the adrenal glands don’t make enough cortisol.

Creatine Kinase

What is a creatine kinase (CK) test?
This test measures the amount of creatine kinase (CK) in the blood. CK is a type of protein, known as an enzyme. It is mostly found in your skeletal muscles and heart, with lesser amounts in the brain. Skeletal muscles are the muscles attached to your skeleton. They work with your bones to help you move and give your body power and strength. Heart muscles pump blood in and out of the heart.

There are three types of CK enzymes:

CK-MM, found mostly in skeletal muscles
CK-MB, found mostly in the heart muscle
CK-BB, found mostly in brain tissue
A small amount of CK in the blood is normal. Higher amounts can mean a health problem. Depending on the type and level of CK found, it can mean you have damage or disease of the skeletal muscles, heart, or brain.

Other names: CK, total CK, creatine phosphokinase, CPK

What is it used for?
A CK test is most often used to diagnose and monitor muscular injuries and diseases. These diseases include:

Muscular dystrophy, a rare inherited disease that causes weakness, breakdown, and loss of function of skeletal muscles. It mostly occurs in males.
Rhabdomyolis, a rapid breakdown of muscle tissue. It can be caused by a serious injury, muscle disease, or other disorder.
The test can be used to help diagnose a heart attack, though not very often. CK testing used to be a common test for heart attacks. But another test, called troponin, has been found to be better at detecting heart damage.

Why do I need a CK test?
You may need a CK test if you have symptoms of a muscular disorder. These include:

Muscle pain and/or cramps
Muscle weakness
Balance problems
Numbness or tingling
You may also need this test if you had a muscle injury or stroke. CK levels may not peak until up to two days after certain injuries, so you may need to be tested a few times. This test can help show if you have damage to your heart or other muscles.

What happens during a CK test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CK test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?
If your results show you have a higher than normal level of CK, it may mean you have an injury or disease of the muscles, heart, or brain. To get more information, your provider may order tests to check the levels of specific CK enzymes:

If you have higher than normal CK-MM enzymes, it may mean you have a muscle injury or disease, such as muscular dystrophy or rhabdomyolis.
If you have higher than normal CK-MB enzymes, it may mean you have an inflammation of the heart muscle or are having or recently had a heart attack.
If you have higher than normal CK-BB enzymes, it may mean you have had a stroke or brain injury.
Other conditions that can cause higher than normal CK levels include:

Blood clots
Infections
Hormonal disorders, including disorders of the thyroid and adrenal glands
Lengthy surgery
Certain medicines
Strenuous exercise
If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CK test?
Other blood tests, such as an electrolyte panel and kidney function tests, may be ordered along with a CK test.

Creatinine Test

What is a creatinine test?
This test measures creatinine levels in blood and/or urine. Creatinine is a waste product made by your muscles as part of regular, everyday activity. Normally, your kidneys filter creatinine from your blood and send it out of the body in your urine. If there is a problem with your kidneys, creatinine can build up in the blood and less will be released in urine. If blood and/or urine creatinine levels are not normal, it can be a sign of kidney disease.

Other names: blood creatinine, serum creatinine, urine creatinine

What is it used for?
A creatinine test is used to see if your kidneys are working normally. It’s often ordered along with another kidney test called blood urea nitrogen (BUN) or as part of a comprehensive metabolic panel (CMP). A CMP is a group of tests that provide information about different organs and systems in the body. A CMP is frequently included in a routine checkup.

Why do I need a creatinine test?
You may need this test if you have symptoms of kidney disease. These include:

Fatigue
Puffiness around the eyes
Swelling in your feet and/or ankles
Decreased appetite
Frequent and painful urination
Urine that is foamy or bloody
You may also need this test if you have certain risk factors for kidney disease. You may be at higher risk for kidney disease if you have:

Type 1 or type 2 diabetes
High blood pressure
A family history of kidney disease
What happens during a creatinine test?
Creatinine can be tested in blood or urine.

For a creatinine blood test:

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

For a creatinine urine test:

Your health care provider will ask you to collect all urine during a 24-hour period. Your health care provider or a laboratory professional will give you a container to collect your urine and instructions on how to collect and store your samples. A 24-hour urine sample test generally includes the following steps:

Empty your bladder in the morning and flush that urine away. Record the time.
For the next 24 hours, save all your urine passed in the container provided.
Store your urine container in the refrigerator or a cooler with ice.
Return the sample container to your health provider’s office or the laboratory as instructed.
Will I need to do anything to prepare for the test?
You may be told to not eat cooked meat for 24 hours before your test. Studies have shown that cooked meat can temporarily raise creatinine levels.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

There is no risk to having a urine test.

What do the results mean?
In general, high levels of creatinine in blood and low levels in urine indicate kidney disease or another condition that affects kidney function. These include:

Autoimmune diseases
Bacterial infection of the kidneys
Blocked urinary tract
Heart failure
Complications of diabetes
But abnormal results don’t always mean kidney disease. The following conditions can temporarily raise creatinine levels:

Pregnancy
Intense exercise
A diet high in red meat
Certain medicines. Some medicines have side effects that raise creatinine levels.
If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a creatinine test?
Your health care provider may also order a creatinine clearance test. A creatinine clearance test compares the level of creatinine in blood with the level of creatinine in urine. A creatinine clearance test may provide more accurate information on kidney function than a blood or urine test alone.

Crystals in Urine

What is a Crystals in Urine Test?
A crystals in urine test checks a sample of your urine (pee) for crystals. It shows what the crystals are made of, how large they are, and how many are in your urine.

Your urine contains many dissolved substances, including minerals. If you have too many minerals in your urine, certain minerals may clump together with other substances and form solid crystals.

It’s normal to have a few small crystals in your urine. But certain types of crystals may stick together and become kidney stones, which are hard, pebble-like pieces of material that form in the kidneys. Kidney stones can be as small as a grain of sand or as big as a pea or even larger. The acidity of your urine and can affect how stones form.

Small kidney stones may pass out of your body through your urine with little or no pain. A large kidney stone may get stuck and block your urine flow. This can cause pain or bleeding. But with treatment, kidney stones rarely cause serious damage.

Other names: urinalysis (crystals) microscopic urine analysis, microscopic examination of urine

What is it used for?
A crystals in urine test is often part of a urinalysis, a test that measures different substances in your urine. A urinalysis is used to check your general health, including the health of your urinary tract and kidneys. It may include a visual check of your urine sample, tests for certain chemicals, and an examination under a microscope to look for certain types of cells.

A crystals in urine test is part of a microscopic exam of urine. It may be used to help diagnose kidney stones. A crystals in urine test may also help diagnose a problem with your metabolism, the process of how your body uses food and energy. Problems with metabolism can affect both the amount of minerals in your urine and the amount of substances that prevent minerals from forming crystals.

Why do I need a crystals in urine test?
A urinalysis is often part of a routine checkup. Your health care provider may include a crystals in urine test in your urinalysis if you have symptoms of a kidney stone. These include:

Sharp pains in your lower abdomen (belly), side, groin, or back
Blood in your urine
Frequent need to urinate
Not being able to urinate at all or only urinating a little bit
Pain when urinating
Cloudy or bad-smelling urine
Nausea and vomiting
Fever and chills
What happens during a crystals in urine test?
You will need to give a urine sample for the test. This test may use the clean catch method or could be a 24-hour urine test.

Clean Catch

A health care professional may give you a cleansing wipe, a small container, and instructions for how to use the “clean catch” method to collect your urine sample. It’s important to follow these instructions so that germs from your skin don’t get into the sample:

Wash your hands with soap and water and dry them.
Open the container without touching the inside.
Clean your genital area with the cleansing wipe:
For a penis, wipe the entire head (end) of the penis. If you have a foreskin, pull it back first.
For a vagina, separate the labia (the folds of skin around the vagina) and wipe the inner sides from front to back.
Urinate into the toilet for a few seconds and then stop the flow. Start urinating again, this time into the container. Don’t let the container touch your body.
Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.
Finish urinating into the toilet.
Put the cap on the container and return it as instructed.
24-hour Urine Test

Your provider may also request that you collect all your urine during a 24-hour period. This is called a “24-hour urine sample test.” It may provide more complete results because the amount of crystals and other substances in urine can vary throughout the day.

If you need to have a 24-hour urine sample test, you’ll be given a special container and instructions for how to collect and store your urine sample. Your provider will tell you what time to start. The test usually includes the following steps:

To begin, urinate in the toilet as usual. Do not collect this urine. Write down the time you urinated.
For the next 24 hours, collect all your urine in the container.
Store the urine container in a refrigerator or in a cooler with ice.
24 hours after starting the test, try to urinate if you can. This is your last urine collection.
Return the container with your urine to your provider’s office or the laboratory as instructed.
If you have hemorrhoids that bleed or are having your menstrual period, tell your provider before your test.

Will I need to do anything to prepare for the test?
You don’t need any special preparations for a crystals in urine test. To make sure your test results are accurate, be sure to carefully follow all the instructions for providing your urine sample.

Are there any risks to the test?
There is no known risk to having a crystals in urine test.

What do the results mean?
If your test results show that you have many crystals, large crystals, or certain types of crystals in your urine, it may be a sign that you have:

One or more kidney stones
Have a high risk of developing kidney stones
A problem with your metabolism that affects the amount of minerals in your urine and/or the amount of substances that prevent crystals from forming
A urinary tract infection (UTI)
A genetic condition that causes kidney stones, such as cystinuria (uncommon)
Your provider may need to order other tests to make a diagnosis.

Having crystals in your urine doesn’t always mean that you have a medical condition that needs treatment. If you have a small kidney stone, it may pass through your urine on its own with little or no pain. Also, certain medicines, your diet, not drinking enough fluids, and other things can lead to crystals in urine. If you have questions about your test results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a crystals in urine test?
Different minerals and other substances form different types of crystals in urine. A crystals in urine test can tell what type of crystals are in your urine. This information helps your provider understand why the crystals are forming and what would help reduce your risk for developing kidney stones in the future, such as:

Drinking more water
Making changes in your diet
Taking or avoiding certain medicines

CSF Immunoglobulin G (IgG) Index

What is a CSF IgG index?
CSF stands for cerebrospinal fluid. It is a clear, colorless fluid that flows in and around your brain and spinal cord. Your brain and spinal cord make up your central nervous system. Cerebrospinal fluid cushions your central nervous system from impact or injury. It also removes waste products from the brain and helps your central nervous system work properly.

IgG stands for immunoglobulin G. It is a type of antibody. Antibodies are proteins that your immune system makes to fight germs.

A CSF IgG index measures the levels of IgG in your cerebrospinal fluid. Normally you have a tiny amount of IgG in your cerebrospinal fluid. High levels of IgG may mean you have an infection or an inflammatory or autoimmune disease that involves your central nervous system. An autoimmune disorder causes your immune system to attack your own healthy cells by mistake, which can lead to serious health problems.

Other names: cerebrospinal fluid IgG level, cerebrospinal fluid IgG measurement, CSF IgG level, IgG (Immunoglobulin G) spinal fluid, IgG synthesis rate

What is it used for?
A CSF IgG index is used to check for diseases of the central nervous system. It is often used to help diagnose multiple sclerosis (MS). MS is a chronic (long-lasting) autoimmune disorder that attacks the outside covering of your nerves.

Most people with MS have higher than normal levels of IgG. But a CSF IgG test alone can’t diagnose MS.

Why do I need a CSF IgG index?
You may need a CSF IgG index if you have symptoms of a central nervous system disorder, especially multiple sclerosis (MS). The symptoms of MS often vary. They may come and go or steadily get worse. They include:

Blurred or double vision
Tingling, numbness, or pain in the arms, legs, body, or face
Painful muscle spasms
Weak muscles, often in the hands and legs
Dizziness
Problems with balance and walking
Bladder control problems
Fatigue
Problems with thinking or memory
What happens during a CSF IgG index?
To get a sample of cerebrospinal fluid, a provider will do a procedure called a spinal tap, also known as a lumbar puncture. A spinal tap is usually done in a hospital. During the procedure:

You will lie on your side or sit on an exam table.
A provider will clean your back and inject an anesthetic into your skin, so you won’t feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
When the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
You’ll need to stay very still while the fluid is being withdrawn.
Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a CSF IgG index, but you may be asked to empty your bladder (pee) and bowels (poop) before the test.

Are there any risks to the test?
There is very little risk to having a spinal tap. You may feel a little pinch or pressure when the needle is inserted. After the test, you may feel some pain or tenderness in your back at the site where the needle was inserted.

You may also have some bleeding at the site or get a headache. The headache may last for several hours or up to a week or more, but your provider may suggest treatment to help relieve the pain.

What do the results mean?
A CSF IgG index that’s higher than normal may be a sign of an infection or an inflammatory or autoimmune condition that affects your central nervous system, such as:

Multiple sclerosis
Transverse myelitis (TM)
Syphilis that infects your nervous system (neurosyphilis)
Connective tissue disorders
Guillain-Barre syndrome
Encephalitis caused by herpes simplex
You may need more tests before your provider can diagnose your condition.

A CSF IgG index that’s lower than normal may be a sign that your body is unable to make enough IgG antibodies, and you are likely to get sick with infections. Experts don’t know what causes this problem. Normally, a test of IgG levels in blood is used to check whether you may lack IgG antibodies.

If you have questions about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CSF IgG index?
The CSF IgG index is often used to help diagnose multiple sclerosis (MS), but there is no specific test for MS. If your provider thinks you have MS, you will probably have other tests to help diagnose or rule out the disease.

While there is no cure for MS, there are many treatments available that can relieve symptoms and help keep it from getting worse.

Cytomegalovirus (CMV) Tests

What are cytomegalovirus (CMV) tests?
Cytomegalovirus (CMV) is a virus in the herpes family. Other types of herpes viruses include chickenpox and mononucleosis (mono). CMV infections are very common. In the United States, over half of adults have been exposed to CMV at some point in their lives, often during childhood or early adulthood. After initial infection, the virus remains in the body for the rest of your life. Most of the time, the virus stays dormant (inactive). However, it can become active again (reactivated) in certain situations such as stress or an immune system problem.

In healthy people, CMV infections usually cause mild, flu-like illnesses or no symptoms at all. Most people with CMV don’t even know they have it. But CMV can be dangerous to people with weakened immune systems due to conditions such as HIV or cancer. It can also cause significant health problems in infants. A pregnant woman with an active CMV infection can pass the virus to her unborn baby. CMV can cause deafness, vision problems, intellectual disabilities, and other serious disorders in babies who are infected before birth.

CMV tests check for signs of the virus in the blood, sputum, or other body fluids. CMV testing can help those at risk for complications get the treatment they need. While there is no cure for CMV, antiviral medicines and other treatments may reduce symptoms and improve outcomes.

Other names: CMV IgG and IgM, cytomegalovirus antibody

What are they used for?
CMV tests are used to help diagnose a current, reactivated, or past CMV infection in people at risk for health complications. Risk groups include:

People with weakened immune systems due to certain infections or diseases
People who have recently received an organ transplant
Pregnant women with symptoms of a CMV infection
Newborns with symptoms of infection
Why do I need a CMV test?
You may need testing if you have a weakened immune system or are pregnant and have the following symptoms:

Swollen lymph nodes
Sore throat
Fever
Fatigue
Weakness
Muscle aches
Headache
Your baby may need this test if he or she has the following symptoms:

Jaundice, a condition that causes the skin and eyes to turn yellow
Low birth weight
Small head
Hearing and/or vision problems
Seizures
What happens during a CMV test?
There are several types of CMV tests, including:

Blood tests

This is the most common way to test adults for CMV.
During the test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial.
CSF test

A sample of cerebrospinal fluid (CSF) will be collected through a procedure called a spinal tap, also known as a lumbar puncture.
During the test, a provider will inject a numbing medicine (anesthetic) into your back and insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small bones that make up your spine.
Your provider will then withdraw a small amount of fluid for testing.
Sputum test

Sputum is a thick mucus that settles in your lungs when you have an infection or chronic illness.
During the test, your health care provider will ask you to breathe deeply and then cough deeply into a special cup.
Your provider may tap you on the chest to help loosen sputum from your lungs.
Biopsy

During the test, your provider will remove a small sample of tissue for testing.
Biopsies can be done with a needle or a special type of surgical instrument.
Amniocentesis

This procedure is done on pregnant women to see if an unborn baby has been infected with CMV.
During the procedure, you’ll lie on your back on an exam table.
Your provider will move an ultrasound device over your abdomen. Ultrasound uses sound waves to check the position of your uterus, placenta, and baby.
Your provider will insert a thin needle into your abdomen and withdraw a small amount of amniotic fluid.
Newborns are usually given a saliva or urine test.

During an infant saliva test:

A provider will insert a sterile swab into your baby’s cheek and swirl for several seconds.
The swab will be placed in a special solution for testing.
During an infant urine test:

You will be given a special plastic bag that will fit over your baby’s genital area.
You will place a diaper over the bag.
After your baby has urinated, you will remove the bag from the diaper and empty the urine into a container given to you by your provider.
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a blood or sputum test. There are also no preparations needed for an infant saliva or urine test.

You may need to empty your bladder before a lumbar puncture.

You may be asked to fast (not eat or drink) for several hours before a biopsy.

For an amniocentesis, you may be asked to keep a full bladder or empty your bladder right before the procedure, depending on your stage of pregnancy.

Your provider or your child’s provider will let you know if you need to make any other preparations.

Are there any risks to the test?
There are no known risks to having a sputum test, infant saliva test, or infant urine test.

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

If you had a lumbar puncture, you may have pain or tenderness in your back when the needle is inserted. You may also get a headache after the procedure. The headache can last for several hours or up to a week or more.

If you had a biopsy, you may have a little bruising, bleeding, or soreness at the biopsy site. This usually goes away after a few days.

If you had an amniocentesis, you may have some mild discomfort and/or cramping during and/or after the procedure, but serious complications are rare. The procedure does have a slight risk (less than 1 percent) of causing a miscarriage.

What do the results mean?
The test result can show whether you have been infected with CMV. But it can’t show if it’s a current, past, or reactivated infection. If you have symptoms and/or risk factors such as an immune system disorder, your provider may do additional tests to help make a diagnosis and create a treatment plan. If you are pregnant and your amniocentesis shows your baby has CMV, your child’s provider may test and treat your baby soon after birth to help prevent complications.

If you have questions about your results, talk to your health care provider or your child’s provider.

Learn more about laboratory tests, references ranges, understanding results.

Is there anything else I need to know about CMV testing?
CMV tests are included as part of a TORCH panel, a group of blood tests used to screen newborns and sometimes pregnant woman for the following infections:

TOxoplasmosis
Rubella
Cytomegalovirus
Herpes simplex virus
These infections can cause birth defects if a mother gets infected during pregnancy. Early diagnosis and treatment may help prevent a baby from getting a serious health problem.