Description:

Free testosterone is the fraction of total testosterone that is not bound to circulating proteins. The free fraction is available to diffuse into target cells to interact with receptors or enzymes. The concentration of free testosterone is low relative to total testosterone, typically <3% of the total testosterone concentration. Total circulating testosterone is bound to sex hormone-binding globulin (SHBG) or albumin. Measurement of total and free testosterone is key in diagnosis of androgen excess or deficiency. Free testosterone is best measured by equilibrium dialysis, while total testosterone is measured by HPLC with tandem mass spectrometry.1-3 Free testosterone is estimated in this profile using these recommended techniques.

Tritiated testosterone is added to the sample and allowed to dialyze across a membrane. Once equilibrium has been achieved, the solutions on both sides of the membrane are sampled to determine the percent free testosterone. Total testosterone is measured by HPLC with tandem mass spectrometry. Serum free testosterone is then calculated by multiplying the percent free testosterone by the total testosterone concentration with unit correction.

This method is recommended for testing women, children, and hypogonadal men.

Includes:

Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis

Patient Instructions:

If using a testosterone cream please be sure you have not rubbed any into the antecubital area of your arm for the last 24 hours as it can give elevated results.

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Price: $583

Description: Testosterone testing is used to evaluate androgen excess or deficiency related to gonadal function, adrenal function, or tumor activity. Testosterone levels may be helpful in men for the diagnosis of hypogonadism, hypopituitarism, Klinefelter syndrome, and impotence (low values). Testosterone levels may be requested in women to investigate the cause of hirsutism, anovulation, amenorrhea, virilization, masculinizing tumors of the ovary, tumors of the adrenal cortices, and congenital adrenal hyperplasia (high values). Testosterone levels in children may be helpful to investigate issues related to puberty and development as well as the aforementioned.

Actual Total Testosterone levels will be provided with this test for levels up to 10,000.

Significant deviations from the normal range may require further evaluation by your physician.

Includes:
Testosterone, serum.

Patient Instructions:

If using a testosterone cream please be sure you have not rubbed any into the antecubital area of your arm for the last 24 hours as it can give elevated results.

Categories: Hormones & metabolism, Specific blood tests for men,

Price: $78

Description: Testosterone circulates almost entirely bound to transport proteins: Normally less than 1-2% is free. The principal transport protein for testosterone is known as sex hormone binding globulin (SHBG) or testosterone-estradiol binding globulin (TeBG). Testosterone measurements are used to assess erectile dysfunction, infertility, gynecomastia, and osteoporosis and to assess hormone replacement therapy.

This is a Male Only Testosterone test, it cannot be performed on a female. FEMALES needing to order this test from Quest will need to order the 'Testosterone Total LC/MS/MS'.

Use of synthetic steroids, various supplements and/or high doses of biotin may interfere with the accuracy of the standard immunoassay Testosterone Total serum test. If you are taking any of these it is recommended that you order the Testosterone Total LC/MS/MS for testing.

This testosterone test will also provide results when the total testosterone value is >1500 but <3,000. This is a Male Only test, it cannot be ordered by females. If a female orders this panel, the testosterone test will not be included on the requisition or performed at the lab.

Significant deviations from the normal range may require further evaluation by your physician.

Includes: Total Testosterone

Patient Instructions:

Due to changes in testosterone levels throughout the day, two morning (8:00-10:00 a.m.) specimens obtained on different days are recommended. If using a testosterone cream please be sure you have not rubbed any into the antecubital area of your arm for the last 24 hours as it can give elevated results. Some tests in this panel may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H or coenzyme R). Patient should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Categories: Hormones & metabolism, Specific blood tests for men,

Price: $69

Description:

Tetanus is caused by Clostridium tetani. Immunization with Tetanus Antitoxoid is effective with boosters in immunocompetent individuals. Antibody levels > or = to 0.10 IU/mL are considered protective. However, tetanus can still occur in some individuals with such antibody levels.

Alternative names:

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Price: $122

Description: Measurement of human lymphocytes' proliferative responses to various stimuli is a fundamental technique used to assess their biological status and functions. Lymphocyte proliferation response to antigens, such as candida, tetanus toxoid and tuberculin purified protein derivative (PPD), are evaluated as a function of memory in cell-mediated immunity.

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Price: $717

Description: Thalassemia and hemoglobinopathies are disorders related to hemoglobin pathophysiology. Although hemoglobinopathies and thalassemias are two genetically distinct disease groups, the clinical manifestations of both include anemia of variable severity and variable pathophysiology. Thalassemias are group of autosomal recessive disorder of hemoglobin synthesis characterized by the reduction in the rate of synthesis of globin chain of one or more globin chain. The decreased synthesis of globin chain may result from gene deletion, non-sense mutation or mutation that affects the transcription or stability of mRNA products. Thalassemias are classified by the type and magnitude of decreased synthesis of the globin chain and severity of the clinical symptoms. The clinical manifestation ranges from mild anemia with microcytosis to fatal severe anemia. In the alpha-thalassemias, there is absence or decreased production of beta-globin subunits, whereas in the beta- thalassemias, there is absent or reduced production of beta globin subunits. Rare thalassemias affecting the production of delta or gamma globin subunits have also been described but are not clinically significant disorders. The beta-thalassemias can be sub-classified into those in which there is total absence of normal beta globin subunit synthesis or accumulation, the beta-zero thalassemias, and those in which some structurally normal beta globin subunits are synthesized, but in markedly decreased amounts, the beta-plus thalassemias. The alpha-thalassemia syndromes however, are usually caused by the deletion of one or more alpha globin genes and are sub-classified according to the number of alpha globin genes that are deleted (or mutated): one gene deleted (alpha-plus thalassemia); two genes deleted on the same chromosome or in cis (alpha-zero thalassemia); three genes deleted (HbH disease); or four genes deleted (hydrops fetalis with Hb Bart's). Hemoglobinopathies results from the abnormal structure of One of the globin chains of the hemoglobin molecule (mutation of alpha and/or beta globin chain resulting in a variant form of Hemoglobin A). They are inherited single- gene disorders and in most cases, they are inherited as autosomal co-dominant traits. A large number (>800) of variants of hemoglobin (Hb) have been recognized. They are identified by capital letters (eg, Hb A or Hb S), or by the city in which the variant was first discovered (eg, Hb Koln). Alpha chain variants usually form less than 25% of the total hemoglobin because the mutation typically occurs in one of the four genes that codes for alpha globin chain. For beta globin variants in the heterozygous state the variant forms more than 25% but less than 50% of the total hemoglobin. Ranked in order of relative frequency, these are: Hb S (sickle cell disease and trait), C, E, Lepore, G-Philadelphia, D-Los Angeles, Koln, Constant Spring, O-Arab, and others. Most common beta globin variants include HbS, HbC, HbD, HbE and HbG. A mutation in one beta globin subunit results in a combination of variant and normal hemoglobin and denotes carrier or trait status, also known as the heterozygote state. Mutations in both beta globin subunits result in disease based on a homozygous expression such as sickle cell anemia (HbSS). Other diseases under sickle cell disease (SCD) are HbSE, HbSC and HbS beta-thalassemia.

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Price: $883

Description: Exposure to thallium is primarily through foods and may occur in highly selected industrial environments. Urinary thallium may be used in assessing toxicity.

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Price: $349

Description: Exposure to thallium is primarily through foods and may occur in highly selected industrial environments. Blood thallium may be used in assessing chronic toxicity.

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Price: $349

• Detect toxic heavy metal exposure
• Screen for nerve damage causes
• Monitor workplace safety exposure levels

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Price: $383

Description: Exposure monitoring/investigation. Not for clinical diagnostic purposes.

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Price: $655

Description: Exposure monitoring/investigation. Not for clinical diagnostic purposes.

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Price: $655

Description: Exposure to thallium is primarily through foods and may occur in highly selected industrial environments. Urinary thallium may be used in assessing toxicity.

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Price: $352

Description: Theophylline is used in the treatment of bronchial asthma as well as in the treatment of chronic obstructive pulmonary disease and episodes of prolonged apnea in pre-term infants. Theophylline levels are monitored to assure adequate therapeutic levels are achieved and to avoid toxicity.

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Price: $201

• Screen for cervical cell changes
• Detect common sexually transmitted infections
• Monitor reproductive health over time

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Price: $329

Description: When using this test, both ThinPrep Imaging Pap and HPV DNA (16, 18, Other High Risk) testing will be performed. ThinPrep Imaging Pap testing is intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by the Bethesda System for Reporting Results of Cervical Cytology. Pap smears and HPV testing algorithms are screening tests for cervical cancer. False negative and positive results occasionally occur with screening tests. Results of screening tests are most reliable when a satisfactory sample is obtained and repeat testing is performed at regular intervals recommended by patient management guidelines. Patient history and other clinical findings should be considered when interpreting results of screening assays. HPV DNA (16, 18, Other High Risk), PCR, Cervical testing is used for the detection of high-risk Human Papillomavirus in clinician-collected cervical samples. The test detects high-risk HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68, which are reported out as HPV 16, HPV 18, and other high-risk HPV types which includes, but does not differentiate, the remaining 12 high-risk types. Patients should be followed up in accordance with professional medical guidelines, results from prior screening, medical history, and other risk factors.C. trachomatis infections are the leading cause of sexually transmitted diseases in the United States. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. The consequences of Chlamydial infections can be severe if left untreated with approximately half of infections that are asymptomatic.Neisseria gonorrhoeae (gonococci) is the causative agent of gonorrhea. The disease is most often found in the cervix, but the vagina and uterus may also be infected.Trichomonas vaginalis RNA, Qualitative Transcription-Mediated Amplification, Pap Vial test is a nucleic acid amplification test that uses transcription-mediated amplification for detection of T. vaginalis RNA, using a ThinPrep Pap sample as the specimen. It is used in the screening and diagnosis of trichomoniasis.

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Price: $773

Description: When using this test, both ThinPrep Imaging Pap and HPV DNA (16, 18, Other High Risk) testing will be performed. ThinPrep Imaging Pap testing is intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by the Bethesda System for Reporting Results of Cervical Cytology. Pap smears and HPV testing algorithms are screening tests for cervical cancer. False negative and positive results occasionally occur with screening tests. Results of screening tests are most reliable when a satisfactory sample is obtained and repeat testing is performed at regular intervals recommended by patient management guidelines. Patient history and other clinical findings should be considered when interpreting results of screening assays. HPV DNA (16, 18, Other High Risk), PCR, Cervical testing is used for the detection of high-risk Human Papillomavirus in clinician-collected cervical samples. The test detects high-risk HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68, which are reported out as HPV 16, HPV 18, and other high-risk HPV types which includes, but does not differentiate, the remaining 12 high-risk types. Patients should be followed up in accordance with professional medical guidelines, results from prior screening, medical history, and other risk factors.C. trachomatis infections are the leading cause of sexually transmitted diseases in the United States. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. The consequences of Chlamydial infections are severe if left untreated with approximately half of infections that are asymptomatic.Neisseria gonorrhoeae (gonococci) is the causative agent of gonorrhea. The disease is most often found in the cervix, but the vagina and uterus may also be infected.

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Price: $524

Description: When using this test, both ThinPrep Automated Pap and HPV DNA (16, 18, Other High Risk) testing will be performed. ThinPrep Automated Pap testing is intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by the Bethesda System for Reporting Results of Cervical Cytology. Gynecologic cytology is a screening test which is subject to both false positive and false negative results. The test is most reliable when a satisfactory sample is obtained on a regular repetitive basis and must be interpreted in the context of historic and current information. HPV DNA (16, 18, Other High Risk), PCR, Cervical testing is used for the detection of high-risk Human Papillomavirus in clinician-collected cervical samples. The test detects high-risk HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68, which are reported out as HPV 16, HPV 18, and other high-risk HPV types which includes, but does not differentiate, the remaining 12 high-risk types. Patients should be followed up in accordance with professional medical guidelines, results from prior screening, medical history, and other risk factors.

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Price: $490

• Screen for cervical cancer risk factors
• Detect high-risk HPV infection early
• Check for abnormal cervical cell changes

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Price: $464

• Screen for cervical cancer risk
• Detect common sexually transmitted infections
• Check for high-risk HPV activity

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Price: $498

• Screen for cervical cancer risk factors
• Detect high-risk HPV infections early
• Check for common sexually transmitted infections

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Price: $498

• Screen for cervical cell changes
• Detect common sexually transmitted infections
• Check high-risk HPV activity

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Price: $748

• Screen for cervical cancer risk
• Detect high-risk HPV infection
• Monitor cervical cell changes early

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Price: $464

Description: When using this test, ThinPrep Imaging Pap will be performed and will reflex to HPV DNA (16, 18, Other High Risk) testing when Pap results are Atypical Squamous Cells (ASC). ThinPrep Imaging Pap testing is intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by the Bethesda System for Reporting Results of Cervical Cytology. Pap smears and HPV testing algorithms are screening tests for cervical cancer. False negative and positive results occasionally occur with screening tests. Results of screening tests are most reliable when a satisfactory sample is obtained and repeat testing is performed at regular intervals recommended by patient management guidelines. Patient history and other clinical findings should be considered when interpreting results of screening assays. Patients should be followed up in accordance with professional medical guidelines, results from prior screening, medical history, and other risk factors.C. trachomatis infections are the leading cause of sexually transmitted diseases in the United States. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. The consequences of Chlamydial infections can be severe if left untreated with approximately half of infections that are asymptomatic.Neisseria gonorrhoeae (gonococci) is the causative agent of gonorrhea. The disease is most often found in the cervix, but the vagina and uterus may also be infected.Trichomonas vaginalis RNA, Qualitative Transcription- Mediated Amplification, Pap Vial test is a nucleic acid amplification test that uses transcription-mediated amplification for detection of T. vaginalis RNA, using a ThinPrep Pap sample as the specimen. It is used in the screening and diagnosis of trichomoniasis.

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Price: $578

Description: When using this test, ThinPrep Imaging Pap will be performed and will reflex to HPV DNA (16, 18, Other High Risk) testing when Pap results are Atypical Squamous Cells (ASC). ThinPrep Imaging Pap testing is intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by the Bethesda System for Reporting Results of Cervical Cytology. Pap smears and HPV testing algorithms are screening tests for cervical cancer. False negative and positive results occasionally occur with screening tests. Results of screening tests are most reliable when a satisfactory sample is obtained and repeat testing is performed at regular intervals recommended by patient management guidelines. Patient history and other clinical findings should be considered when interpreting results of screening assays. Patients should be followed up in accordance with professional medical guidelines, results from prior screening, medical history, and other risk factors.C. trachomatis infections are the leading cause of sexually transmitted diseases in the United States. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. The consequences of Chlamydial infections can be severe if left untreated with approximately half of infections that are asymptomatic.Neisseria gonorrhoeae (gonococci) is the causative agent of gonorrhea. The disease is most often found in the cervix, but the vagina and uterus may also be infected.

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Price: $329

• Screen for cervical cell changes
• Detect common hidden infections
• Monitor reproductive health regularly

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Price: $329

• Screen for cervical cell changes early
• Detect common reproductive infections quickly
• Check HPV status in one visit

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Price: $578

Description: Thiocyanate is used as a biomarker for exposure to cyanides or cyanide-containing chemicals. This test is a serum-based assay that is primarily used to monitor cyanide levels in individuals receiving sodium nitroprusside infusion therapy for treatment of extreme hypertension. It can also be used to determine cyanide levels in individuals who have been exposed to certain industrial chemicals, cigarettes, or thiocyanate-containing foods [1]. Thiocyanate is a principal metabolite of cyanide, which accumulates in the blood and urine in response to cyanide exposure, cigarette smoking, industrial chemicals, and sodium nitroprusside infusion. Some industrial chemicals associated with increased thiocyanate levels include acetonitrile, acrylonitrile, and amygdalin. Symptoms of thiocyanate toxicity include confusion, hyperreflexia, convulsions, and metabolic acidosis [1]. This test may be helpful for patients, with normal renal function who are receiving long-term nitroprusside therapy for 7 days or more, as well as patients with renal insufficiency who are receiving nitroprusside therapy for any length of time. Patients with renal insufficiency are especially at risk for cyanide toxicity [2]. Note that the following drugs elevate thiocyanate and could interfere with test accuracy: antipyrine, acetoacetate, and phenacetin (and their sulfoxides in large concentrations); phenacetin and acetaminophen; and salicylic acid and its complexes. References 1. Riedel K, et al. Thiocyanate in plasma and saliva (Biomonitoring Methods, 2013). In: Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area of the DFG, ed. The MAK-Collection for Occupational Health and Safety: Annual Thresholds and Classifications for the Workplace. Wiley-VHCA AG: Zurich, Switzerland; 2013;13:277-292. 2. Schulz Y. Clin Pharmacokinet.1984;9:239-251.

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Price: $364

Description: 6-Mercaptopurine (Purinethol) and its imidazolyl derivative, Azathioprine (Imuran), are immunosuppressive drugs. 6-Mercaptopurine (6-MP) is indicated for remission induction and maintenance therapy of acute lymphoblastic leukemia (ALL). Azathioprine is indicated as an adjunct for the prevention of rejection in renal allograft (kidney transplant) patients, for the management of rheumatoid arthritis, and for the management of inflammatory bowel disease. Azathioprine is cleaved to 6-MP. 6-MP is metabolized via a series of enzymatic steps to 6-thioguanine nucleotides (6-TGNs), to 6-methyl-mercaptopurine (6-MMPNs) by the enzyme thiopurine methyltransferase (TPMT), and to 6-thiouric acid by the enzyme xanthine oxidase (XO). TPMT enzyme activity has large inter-individual variations which affect the efficacy, toxicity and variability of the treatment. Therapeutic drug monitoring of 6-MP metabolites (6-TGNs and 6-MMPNs) in erythrocytes is recommended to assist therapy, particularly in combination with TPMT enzyme activity or mutation analysis.

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Price: $319

Description: Thiopurine S-methyltransferase (TPMT; S-adenosyl-L-methionine:thiopurine S-methyltransferase) catalyzes thiopurine S-methylation, an important metabolic pathway for antineoplastic and immunosuppressive drugs. In the US, 11% of the population show intermediate TPMT activity, and approximately 1 in 300 have TPMT deficiency. Given potentially fatal nature of hematopoietic toxicity when full doses of mercaptopurine or azathioprine are given to TPMT deficient patients, and the difficulty to measure TPMT activity accurately when patients have been given red cell transfusions, the molecular method to determine TPMT genotype permits prospective identification of patients at risk.

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Price: $897

• Check radioactive metal exposure levels
• Screen for industrial toxin buildup
• Monitor workplace safety risks

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Price: $374

Description: Thrombin-Antithrombin (TAT) Complex is a parameter of coagulation and fibrinolysis. The Thrombin-Antithrombin Complex keeps clotting in check. Deficiencies may aid in understanding hypercoagulable states. Elevated concentrations have been associated with vascular complications associated with diabetes.

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Price: $345

Description: This test, also known as thrombin time, is useful for evaluating the presence of heparin and other direct thrombin inhibitor anticoagulants in specimens with prolonged coagulation studies. It is also used to aid in the diagnosis of congenital and acquired disorders of fibrinogen.Anticoagulant interference: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Vitamin K antagonists (eg. warfarin): no effect; Heparin (UFH or LMWH): prolonged; Dabigatran or Argatroban (Direct Thrombin Inhibitors): prolonged; Rivaroxaban, Apixaban, Edoxaban (Factor Xa Inhibitors): no effect.

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Price: $205

Description: Thrombin Clotting Time - This test, also known as thrombin time, is useful for evaluating the presence of heparin and other direct thrombin inhibitor anticoagulants in specimens with prolonged coagulation studies. It is also used to aid in the diagnosis of congenital and acquired disorders of fibrinogen. Anticoagulant interference: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Vitamin K antagonists (eg. warfarin): no effect; Heparin (UFH or LMWH): prolonged; Dabigatran or Argatroban (Direct Thrombin Inhibitors): prolonged; Rivaroxaban, Apixaban, Edoxaban (Factor Xa Inhibitors): no effect.

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Price: $205

Description: This test detects the factor V Leiden and prothrombin (factor II c.*97G>A) gene variants, the most common causes of inherited thrombophilia; it may be used to evaluate individuals with a strong personal or family history of venous thromboembolism (VTE) and inform treatment or preventive decisions [1].Factor V Leiden refers to the c.1691G>A variant in the FV gene, which encodes coagulation factor V. This variant results in resistance to factor V protein degradation by activated protein C and increases the risk of VTE 6 to 8 fold in heterozygous carriers and 80 fold in homozygous carriers [1]. The mean age of symptom onset is 31 to 44 years, but some heterozygous carriers can be asymptomatic [2]. In the United States, Factor V Leiden is most prevalent in White individuals, with an estimated frequency of 5% [1].The prothrombin gene variant (factor II c.*97G>A) is a variant in the F2 gene, which encodes coagulation factor II. This variant increases the risk of venous thrombosis 2 to 4 fold in heterozygous carriers [1] and 20 fold in coinherence of factor V Leiden and factor II c.*97G>A [2]. Factor II c.*97G>A is most prevalent in White Americans with an estimated frequency of 1% to 3% [1].Factor V Leiden and factor II c.*97G>A testing may be indicated in clinical scenarios where results can help guide clinical decisions for the patient and family members. These clinical scenarios include first VTE developed under 50 years of age, VTE at an unusual site (eg, cerebral veins), recurrent VTE, a strong family history of VTE, and low activated protein C resistance activity [1].Routine testing for factor V Leiden and factor II c.*97G>A is not recommended for prenatal carrier screening, newborn screening, or individuals taking oral contraceptive [2]. Approximately 50% to 60% of familial thrombophilia is associated with variants in the FV or F2 gene; variants in the genes that encode protein C, protein S, and antithrombin can also cause inherited thrombophilia.The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.References1. Zhang S, et al. Genet Med. 2018;20(12):1489-1498.2. Vnencak-Jones CL, et al. Genetics. In: Rifai R, et al, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier Inc; 2022.

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Price: $940

Description: This test detects the factor V Leiden and prothrombin (factor II c.*97G>A) gene variants, the most common causes of inherited thrombophilia; it may be used to evaluate individuals with a strong personal or family history of venous thromboembolism (VTE) and inform treatment or preventive decisions [1]. Testing the factor V R2 in factor V Leiden heterozygous patients helps assess the additional risk of VTE.Factor V Leiden refers to the c.1691G>A variant in the FV gene, which encodes coagulation factor V. This variant results in resistance to factor V protein degradation by activated protein C and increases the risk of VTE 6 to 8 fold in heterozygous carriers and 80 fold in homozygous carriers [1]. The mean age of symptom onset is 31 to 44 years, but some heterozygous carriers can be asymptomatic [2]. In the United States, Factor V Leiden is most prevalent in White individuals, with an estimated frequency of 5% [1].The prothrombin gene variant (factor II c.*97G>A) is a variant in the F2 gene, which encodes coagulation factor II. This variant increases the risk of venous thrombosis 2 to 4 fold in heterozygous carriers [1] and 20 fold in coinherence of factor V Leiden and factor II c.*97G>A [2]. Factor II c.*97G>A is most prevalent in White Americans with an estimated frequency of 1% to 3% [1].Factor V Leiden and factor II c. *97G>A testing may be indicated in clinical scenarios where results can help guide clinical decisions for the patient and family members. These clinical scenarios include first VTE developed under 50 years of age, VTE at an unusual site (eg, cerebral veins), recurrent VTE, a strong family history of VTE, and low activated protein C resistance activity [1].Routine testing for factor V Leiden and factor II c.*97G>A is not recommended for prenatal carrier screening, newborn screening, or individuals taking an oral contraceptive [2]. Approximately 50% to 60% of familial thrombophilia is associated with variants in the FV or F2 gene; variants in the genes that encode protein C, protein S, and antithrombin can also cause inherited thrombophilia.If the factor V Leiden result is heterozygous, the R2 variant (c.3980A>G) in the FV gene will be tested. Although the R2 allele alone does not increase the risk of VTE, coinheritance of factor V R2 and factor V Leiden is associated with a 3- to 4-fold increase in risk of VTE [3].The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.References1. Zhang S, et al. Genet Med. 2018;20(12):1489-1498.2. Vnencak-Jones CL, et al. Genetics. In: Rifai R, et al, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier Inc; 2022.3. Faioni EM, et al. Blood. 1999;94(9):3062-3066.

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Price: $940

Description: Factor V Leiden (R506Q) is the most common genetic determinant for hereditary venous thrombosis. Another DNA variant, the HR2 allele, has been associated with a 3-4 fold increased risk to venous thrombosis when it occurs in the presence of the Factor V Leiden mutation.

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Price: $1940

Description: This test will be used to measure serum TPO level in patients with thrombocytopenia of unknown cause. ITP (Idiopathic Thrombocytopenia purpura) is a common cause of thrombocytopenia. The diagnosis is based on exclusion criteria. Serum TPO levels are normal or only slightly elevated in ITP so that if TPO level is markedly elevated the diagnosis of ITP is strongly in doubt. Markedly elevated TPO levels may occur in individuals with genetic mutations of CD110. New Drugs, non peptide thrombopoietin receptor agonist (CD110) are becoming increasingly used in patients with thrombocytopenia of ITP. The cost of these new drugs is very high. That is why it is important to know levels of TPO. Patients with elevated TPO levels do not respond to treatment with thrombopoietin receptor agonist. Knowing levels of TPO may help in predicting efficacy of response to an extremely expensive stimulating drug used in a wide variety of hematologic disorders. May reduce the need for platelet transfusions with all known complications and reduced cost of blood products by hospital.

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Price: $370

Description: This panel is useful to determine the etiology of various hypercoagulability states.

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Price: $1321

Description: When intravascular thrombosis is suspected in the absence of overt clinical symptoms, elevation in D-dimer, fibrin monomer, prothrombin fragment 1.2, or thrombin-antithrombin complex may be the only indicator of intravascular clot formation and generation of activated factor X. Marked elevation in only 1 or 2 of these markers should lead to further investigation of the site of the thrombosis (eg, early dissecting aortic aneurysm, anomalous arterial/venous fistula).

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Price: $844

Description: This test detects the presence of specific IgE against thyme. A positive test only indicates that a person is sensitized and potentially allergic to this allergen. A diagnosis of allergy requires clinical signs and symptoms that appear to be associated with exposure to the allergen in addition to the detection of markers of IgE sensitization [1].More specific information about this allergen can be found on the following website: https://www.thermofisher.com/phadia/us/en/resources/allergen-encyclopedia.htmlReference1. Bernstein IL, et al. Ann Allergy Asthma Immunol. 2008;100(3 Suppl 3):S1-S148.

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Price: $49

Description: Measurement of thyroglobulin antibodies is useful in the diagnosis and management of a variety of thyroid disorders including Hashimoto's thyroiditis, Graves's disease and certain types of goiter.

Significant deviations from the normal range may require further evaluation by your physician.

Includes:
Thyroglobulin Antibody (TAA or TgAb)
This test is also known as:
Antithyroglobulin Antibody

Estimated turnaround for results is 5 business days. If confirmation testing is required

Patient Instructions: No fasting needed.

Categories: Thyroid diseases,

Price: $57

• Confirm tissue origin before diagnosis
• Detect thyroid-related tumor markers
• Support pathology review with clarity

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Price: $440

Description: Thyroglobulin is elevated in three types of thyroid disorders: goiter and thyroid hyperfunction, inflammation or physical injury to the thyroid, and differential thyroid tumors.

Significant deviations from the normal range may require further evaluation by your physician.

Includes: Thyroglobulin, LC/MS/MS

Categories: Thyroid diseases,

Price: $233

Description: Thyroglobulin (TG) is a secretory product only of the thyroid gland. The major clinical use of serum TG measurement is to monitor, but not to diagnose, patients with well-differentiated thyroid cancers. The measurement of thyroglobulin, after thyroidectomy and ablation of the thyroid gland, is useful to determine metastasis. Deficient TG synthesis is observed in infants with goitrous hypo-thyroidism. Most patients with thyroid autoimmune disease have thyroglobulin antibody. With immunometric assays (sandwich assays), TGAB interference typically produces inappropriately low TG results, most likely caused by endogenous TG immune complexes that block one or more of the reagent antibodies from binding endogenous TG.

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Price: $168

Description: Thyroglobulin (TG) is a secretory product only of the thyroid gland. The major clinical use of serum TG measurement is to monitor, but not to diagnose, patients with well-differentiated thyroid cancers. The measurement of thyroglobulin, after thyroidectomy and ablation of the thyroid gland, is useful to determine metastasis. Deficient TG synthesis is observed in infants with goitrous hypothyroidism.

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Price: $293

• Pinpoint the cause of unexplained fatigue
• Reveal hidden thyroid issues effortlessly
• Confirm your health status with certainty

Includes:

Comprehensive Metabolic Profile ( includes eGFR ): Albumin, Albumin/Globulin Ratio (calculated), Alkaline Phosphatase, ALT, AST, BUN/Creatinine Ratio (calculated), Calcium, Carbon Dioxide, Chloride, Creatinine with GFR Estimated, Globulin (calculated), Glucose, Potassium, Sodium, Total Bilirubin, Total Protein, Urea Nitrogen

Thyroglobulin, LC/MS/MS

T3 Uptake; T4 (Thyroxine), Total; Free T4 Index (T7); Thyroid-Stimulating Hormone (TSH)

Patient Instructions:

You should fast for 12 hours before collection of the specimen. Fasting is defined as no consumption of food or beverage other than water for at least 12 hours before testing.

Estimated turnaround for results is 3 business days. If confirmation testing is required, the estimated time may be extended.

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Price: $308

Description: The thyroid mutation panel assesses for all 8 of the most common mutations or rearrangements associated with thyroid neoplasia. The BRAF codon 600 mutation, and RET/PTC1 and RET/PTC3 rearrangements are highly associated with papillary thyroid cancer, the PAX8-PPAR{gamma} with follicular carcinomas and RAS mutations (in either HRAS, KRAS and NRAS) usually with follicular neoplasms. See test codes 90477 (BRAF), 90473 (RET/PTC), 90474 (PPAR/PAX8), and 90479 (RAS panel) for individual components. A thyroid cytology diagnosis code with reflex to molecular, as appropriate, is also available.

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Price: $5279

Description: Thyroglobulin measurements are most useful in the postoperative monitoring of patients with papillary, follicular, and Hurthle cell carcinomas. However, approximately 20% of individuals develop autoantibodies to thyroglobulin. Since these antibodies interfere with immunoassay measurement of thyroglobulin, it is necessary to determine the presence or absence of antibodies before measuring thyroglobulin. This panel provides a sensitive method for determination of thyroglobulin autoantibodies, with subsequent measurement of thyroglobulin by either a sensitive immunoassay (Tg Ab negative samples) or LCMSMS (Tg Ab positive samples). The mass spectrometry assay has no interference from autoantibodies.

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Price: $325

Description: The Thyroid Cascading Reflex order code that will act as an aid to physicians in the diagnosis of common adult thyroid disorders. The initial results of a TSH will determine further reflex orders of T4, Free, TPO Antibodies and T3, Free orders and provided an interpretation based upon the results of the reflexed tests.

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Price: $49

Description: The Thyroid Check Deluxe panel is designed to provide an overall view of the thyroid function.

A significant deviation from the normal range may require further evaluation by your physician

Includes:
Reverse T3, LC/MS/MS
Thyroid Peroxidase (TPO)
Thyroglobulin Antibodies (TAA)
Thyroid Profile w/ TSH: T3 Uptake; T4 (Thyroxine), Total; Free T4 Index (T7); Thyroid-Stimulating Hormone (TSH)
Thyroxine Free, Direct Dialysis (FT4)
Tri-iodothyronine (T3) Total
Tri-iodothyronine Free (FT3)

Estimated turnaround for results is 8 business days.

Categories: Thyroid diseases,

Price: $270