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References

Cytokine Panel

This panel is used to find the source of chronic inflammation, after a high CRP reading or the persistence of any chronic inflammatory condition. This panel measures interleukin-1 beta (IL-1b), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-alpha). Each is described separately.

D-Dimer

This test is a very specific confirmatory test for disseminated intravascular coagulation (DIC). It is also used for the detection of deep vein thrombosis, acute myocardial infarction, and unstable angina. The Fragment D-Dimer assesses both thrombin and plasmin activity.

Reference Range:

0.0–0.4 µg/mL

Dehydroepiandrosterone (DHEA) Sulfate

This test is used to determine female infertility, amenorrhea, or hirsutism and to aid in the evaluation of excess androgen/adrenocortical disease, including congenital adrenal hyperplasia and adrenal tumors.

Reference Ranges:
Men:
19–29 years	280–640 µg/dL
30–39 years:	120–520 µg/dL
40–49 years:	95–530 µg/dL
50–59 years:	70–310 µg/dL
60–69 years	42–290 µg/dL
>69 years	28–175 µg/dL
LE’s Optimal Range:	500-640 µg/dL
Women:
19–29 years:	65–380 µg/dL
30–39 years:	45–270 µg/dL
40–49 years	32–240 µg/dL
50–59 years	26–200 µg/dL
60–69 years	13–130 µg/dL
>69 years	17–90 µg/dL
LE’s Optimal Range:	250-380 µg/dL

Deoxypyridinoline (Dpd) Cross Link Test

This test can be used to assess bone resorption rates in healthy individuals and in those with enhanced risk of developing metabolic bone disease. Dpd can be used to monitor antiresorptive therapies (which may include bisphosphonates) and osteoporosis.

Reference Range:

2.3–7.4 nmol Dpd/mmol creatinine

Dihydrotestosterone

This test measures serum concentrations of dihydrotestosterone, which is closely related to testosterone levels but are lower and may indicate hypergonadism or hirsutism.

Reference Ranges:
Men:	30–85 ng/dL
Women:	4–22 ng/dL
LE’s Optimal Range:
Men:	30–50 ng/dL

Epstein-Barr Virus (EBV) Acute Infection

This test is used to diagnose a suspected EBV infection (infectious mononucleosis).

EBV Interpretation	VCA-IgG	VCA-IgM	EA-IgG	EBV-NA
Susceptible	–	–	–	–
Acute infection	+	+	±	–
Convalescent phase	+	±	±	+
Chronic or reactivated	+	–	+	±
Old infection	±	–	–	+
Antibody present: +
Antibody absent: –

ESR Westergen Sedimentation Rate (ESR, Sed Rate Test)

The ESR is a nonspecific test used to detect illness associated with acute and chronic infection, inflammation (collagen-vascular diseases), advanced neoplasm, and tissue necrosis or infarction.

Reference Ranges:
Men:	0–50 years: 0–15 mm/hour
	50 years and older: 0–20 mm/hour
Women:	0–50 years: 0–20 mm/hour
	50 years and older: 0–30 mm/hour

Estradiol

This test is used to assess hypothalamic and pituitary functions, menopausal status, and sexual maturity. In males it is helpful in the assessment of gynecomastia or feminization syndromes.

Reference Ranges:		Reference Ranges:
Adult Men:	<54 pg/mL	Adult Women:
LE’s Optimal Range:	10–30 pg/mL	Follicular phase (-12):	19–83 pg/mL
		Follicular phase (-4):	64–183 pg/mL
		Midcycle peak: (-1)	150–528 pg/mL
		Luteal phase: (+2)	58–157 pg/mL
		Luteal phase: (+6)	60–211 pg/mL
		Luteal phase: (+12)	55–150 pg/mL
		Postmenopausal (untreated):	0–31 pg/mL

Estriol

This test provides an objective assessment of placental function and fetal normality in high-risk pregnancies. Estriol is the major estrogen in the pregnant female.

Reference Range:
Men or Nonpregnant Women:	<2.0 mg/dL

Estrogens Total

Estrogen measurements are used to evaluate sexual maturity, menstrual and fertility problems in females. This test is also used in the evaluation of males with gynecomastia or feminization syndromes. In pregnant women, it is used to indicate fetal-placental health. In patients with estrogen-producing tumors, it can be used as a tumor marker.

Reference Ranges:
Men:	40–115 pg/mL
LE’s Optimal Range:	40–77 pg/mL
Women:
Day 1–10:	61–394 pg/mL
Day 11–20:	122–437 pg/mL
Day 21–30:	156–350 pg/mL

Estrone

This test is used to evaluate postmenopausal bleeding due to peripheral conversion of androgenic steroids. Increased estrone levels may be associated with increased levels of circulating androgens and their subsequent peripheral conversion.

Reference Ranges:
Men:	12–72 pg/mL
Women:
Follicular phase:	37–138 pg/mL
Midcycle peak:	60–229 pg/mL
Luteal phase:	50–114 pg/mL

Factor VIII Activity

This test is used to evaluate levels of coagulant factor VIII. A deficiency in factor VIII is known as hemophilia A. Elevated levels are associated with a significantly increased risk of ischemic heart disease and with the development of the geriatric syndrome of frailty.

Fasting Glucose and Insulin

These two tests are used to determine elevated levels of glucose and insulin. Excess glucose and insulin are implicated in many age-related diseases, such as type 2 diabetes, hypertension, heart disease, and stroke, and are a hallmark of mammalian aging. Please note: These tests require a fasting blood level, meaning that a 12-hour fast is required before the collection of a blood sample. Each of these tests is described separately.

Glucose: This test is used to detect diabetes mellitus and evaluate carbohydrate metabolism disorders including alcoholism. It is also used to evaluate acidosis, ketoacidosis, dehydration, coma, hypoglycemia, insulinoma, and neuroglycopenia.
Insulin: This test is primarily used to measure insulin evaluation in individuals with fasting hypoglycemia. Insulin levels tend to be inappropriately elevated in individuals with insulin-secreting tumors. Fasting hypoglycemia in association with markedly elevated serum insulin levels is considered the determining factor for insulinoma. Insulin levels can be useful in predicting susceptibility to the development of type II diabetes, although C-peptide has largely supplanted insulin measurement for this role.

Female Panel

The Female panel consists of a Chemistry Panel, CBC, Free Testosterone, DHEA-S, Estradiol, Progesterone, Homocysteine, and Cardiac CRP. Each of these tests is described separately.

Ferritin

This test is used to evaluate iron reserves in the body and to determine iron deficiency anemia or iron overload.

Reference Ranges:
Men:	22–322 ng/mL
Women:	10–291 ng/mL
LE’s Optimal Range:	50–150 ng/mL

Fibrinogen, Antigen

This test is used primarily for detecting suspected bleeding disorders or excessive amounts that could contribute to abnormal clotting.

Reference Range Adult:	180–350 mg/dL
LE’s Optimal Range:	180–250mg/dL
Critical Value:	Values <100 mg/dL can be associated with spontaneous bleeding.
High Value:	Values >400 mg/dL can cause spontaneous clotting.

Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH)

This test is used in the determination of menopause and is integral in the evaluation of suspected gonadal failure.

FSH	Reference Ranges:	LH	Reference Ranges:
Adult Men:		Adult Men:
		20–70 years:	1.5–9.3 mIU/mL
> 15 years:	1.4–18.1 mIU/mL	> 70 years:	3.1–34.6 mIU/mL
LE’s Optimal Range:	1.4–14 mIU/mL	LE’s Optimal Range:	0.5–9.3 mIU/mL
Women:		Women:
Follicular phase:	2.5–10.2 mIU/mL	Follicular phase:	1.9–12.5 mIU/mL
Ovulatory peak:	3.4–33.4 mIU/mL	Ovulatory peak:	8.7–76.3 mIU/mL
Luteal phase:	1.5–9.1 mIU/mL	Luteal phase:	0.5–16.9 mIU/mL
Postmenopausal phase:	23.0–116.3 mIU/mL	Postmenopausal phase:	5.0–52.3 mIU/mL
		Contraceptives	0.7–5.6 mIU/mL

Fructosamine

This test is used to evaluate diabetic control. Fructosamine, rather than glucose level, is an index of longer-term control.

Gamma Glutamyl Transpeptidase

This test is a sensitive indicator of hepatobiliary disease (obstructive jaundice, intrahepatic cholestasis, or pancreatitis). It is also used as an indicator of chronic and heavy alcohol abuse.

Reference Range:

0–65 IU/L

Glucose (Serum)

This test is used to detect diabetes mellitus. It is used to evaluate carbohydrate metabolism disorders including alcoholism. It is also used to evaluate acidosis, ketoacidosis, dehydration, coma, hypoglycemia, insulinoma, and neuroglycopenia. Please note: These tests require a fasting blood level, meaning that a 12-hour fast is required before the collection of a blood sample.

Reference Range:	65–99 mg/dL
LE’s Optimal Range:	70–85 mg/dL

Human Chorionic Gonadotropin (HCG) Beta Subunit, Pregnancy

This test is used to detect the beta subunit of HCG, providing a sensitive, specific test for the detection of early pregnancy, ectopic pregnancy, or threatened abortion.