Your clotting cells (platelets) are produced in the bone marrow and are important for controlling bleeding. Sometimes too few platelets are produced or are destroyed too quickly resulting in a condition known as thrombocytopenia. This can be caused by immune disorders, some medication, liver disease or chronic bleeding. A high platelet count is called thrombocytosis and can be caused by a variety of conditions including bone marrow disorders, infection and inflammation.
MPV, or Mean Platelet Volume, is a measurement of the average size of your platelets. Platelets are fragmented cells within the blood that aid the process of clot formation. MPV provides an indication of platelet production in your bone marrow
Platelets or clotting cells are the smallest type of blood cell and are important in blood clotting. When bleeding occurs, the platelets swell, clump together and form a sticky plug (a clot) which helps stop the bleeding.
Red blood cells are the most common type of blood cell and have the job of delivering oxygen to your tissues via your circulatory system. Red blood cells are continuously created in your bone marrow to replace cells which are lost through bleeding or cell ageing. Your red cell count should be stable, but certain conditions can cause too few or too many cells to be created, cells to die too quickly or to be misshapen. If you are not producing enough red blood cells it affects the amount of oxygen being delivered to your tissues, resulting in anaemia and its associated symptoms of fatigue and pale skin. Overproduction of red blood cells can cause headaches, blurred vision and an enlarged spleen.
Your white blood cells are the key to your body’s immune or defence system. They fight infections and protect your body from foreign particles such as harmful germs and bacteria. White blood cells are formed from the stem cell of the bone marrow and have a lifespan of a few days. There are five major types of white blood cell and they all play a different role in protecting the body. The numbers of each one of these types of white blood cell give important information about your immune system as well as in the diagnosis of recent infection.
ESR (Erythrocyte Sedimentation Rate) is a non-specific inflammation marker. It measures the rate at which red blood cells fall to the bottom of a tube. The blood cells fall quicker during inflammation, as there are more proteins in the blood, caused by the inflammation. It is said to be nonspecific because increases do not indicate exactly where the inflammation in your body is, or what is causing it, and also because it can be affected by other conditions other than inflammation.
Urea is a waste product produced by the body when it breaks down proteins in the liver. Once the urea is made, it is transported to the kidneys, which filter it out of the blood and remove it from the body in the form of urine. Measuring the levels of urea in the blood can therefore reflect how well both the liver and the kidneys, are functioning. It is important to note that even if one kidney is severely damaged but the other is functioning perfectly, results may still return as normal.
Creatinine is a chemical waste molecule that is generated from normal muscle break down. Sportspeople can therefore have higher levels than the average person. Creatinine is cleared from the kidneys and so is also an accurate marker of kidney function, and may help in diagnosing kidney disease.
The estimated glomerular filtration rate (eGFR) assesses how well the kidneys are working by estimating the amount of blood filtered through the kidneys. The glomeruli are tiny filters in the kidneys responsible for removing waste products. If these filters do not do their job properly, kidney function can be impaired. The eGFR calculation is an estimate of actual glomerular filtration rate, calculated using your age, gender, ethnicity, and serum creatinine levels.
Potassium is essential in regulating how the heart beats. It also helps move nutrients into cells and waste products out of cells and influences how nerves and muscles communicate.
Sodium is both an electrolyte and a mineral. It helps to regulate the water and electrolyte balance of the body, and is therefore an important factor in blood pressure and pH. It also plays an important role in the function of nerves and muscles. Sodium levels in the blood are regulated by the kidneys.
Your liver is one of your body’s most important organs and has many functions including breaking down food and converting it to energy, getting rid of waste and toxins and manufacturing and regulating some hormones. Your liver can become inflamed and progressively damaged through excessive food intake, alcohol consumption and viral hepatitis. Your liver has amazing powers of regeneration, but once inflammation has led to scarring (cirrhosis) then liver disease is irreversible. Blood tests measure the level of different enzymes which, if raised, can indicate that your liver is inflamed.
The random blood glucose test measures the level of sugar in your blood and is an indicator of how well your body is metabolising sugars to store in your cells. It is most useful when analysed in conjunction with other sugar markers, such as HbA1c.
Higher levels of certain enzymes such as creatine kinase can indicate damage to heart muscle.
Calcium is the most common mineral in the body and one of the most important. The body needs it to build and repair bones and teeth, help nerves and muscles to function, blood to clot and also help the heart to work. Calcium is vital for bone strength and is kept at optimal levels through interaction with parathyroid hormone and vitamin D. If you are low in calcium you may be susceptible to poor recovery and stress fractures.
Phosphate is a chemical that contains the mineral phosphorus. Phosphates are essential for the production of energy, muscle and nerve function, and bone growth.
Uric acid is a waste product produced from the breakdown of chemical compounds called purines. Purine occurs naturally in the body, but it is also found in the food we eat – and in some foods more than others. In healthy individuals, uric acid is excreted by the kidneys in urine, however, if levels are too high to excrete, or if you have a problem metabolising purine, then uric acid can begin to accumulate and can be deposited as crystals in the bodily tissues. When this occurs in joints it causes the painful condition known as gout.
Triglycerides are a type of fat (lipid) that circulate in the blood. They are carried in the bloodstream by lipoproteins called chylomicrons and VLDLs (very low density lipoproteins). After you eat, your body converts excess calories into triglycerides which are then transported to cells to be stored as fat. Your body then releases triglycerides when required for energy.
Cholesterol is a fatty substance found in the blood that plays an essential role in how the cells in the body work. However, too much cholesterol in the blood can have a serious effect on your health as it increases your risk of having a heart attack or stroke. There are many factors which raise the risk of cardiovascular disease and we are learning more all the time about the complex biological processes which lead to a heart attack. High levels of cholesterol have long been known to increase your risk but, even then, it is not that simple – there are different types of cholesterol and some are more dangerous than others. Cholesterol is manufactured in the liver and also comes from the food we eat. Diet, family history, obesity and lack of exercise can all adversely impact cholesterol levels.
HDL:
HDL cholesterol, or High Density Lipoprotein is a molecule in the body which removes cholesterol from the bloodstream and transports it to the liver where it is broken down and removed from the body in bile. HDL cholesterol is commonly known as ‘good cholesterol’. You can make dramatic changes to your cholesterol levels through diet and training. And just like with the diabetes checks, if you can improve your levels you can hopefully prevent getting serious, possibly even fatal conditions down the line. You can use HDL and LDL (and non-HDL) results as markers and targets for improvement. Regular exercise will help get the LDL down and the HDL up, in particular cardio and resistance training exercises. A Mediterranean diet which is high in vegetables and oily fish, and low in meat and dairy, will also help to optimise cholesterol levels.
LDL:
LDL cholesterol (low density lipoprotein) is a molecule made of lipids and proteins which transports cholesterol, triglycerides and other fats to various tissues throughout the body. Too much LDL cholesterol, commonly called ‘bad cholesterol’, can cause fatty deposits to accumulate inside artery walls, potentially leading to atherosclerosis and heart disease. You can make dramatic changes to your cholesterol levels through diet and training. And just like with the diabetes checks, if you can improve your levels you can hopefully prevent getting serious, possibly even fatal conditions down the line. You can use HDL and LDL (and non-HDL) results as markers and targets for improvement. Regular exercise will help get the LDL down and the HDL up, in particular cardio and resistance training exercises. A Mediterranean diet which is high in vegetables and oily fish, and low in meat and dairy, will also help to optimise cholesterol levels.
Non-HDL:
Non-HDL cholesterol includes all the cholesterol molecules which are not HDL (or ‘good’ cholesterol). It therefore includes all the non-protective and potentially harmful cholesterol in your blood. As such, it is considered to be a better marker for cardiovascular risk than total cholesterol and LDL cholesterol. The recommended level of non-HDL cholesterol is below 4 mmol/L. You can make dramatic changes to your cholesterol levels through diet and training. And just like with the diabetes checks, if you can improve your levels you can hopefully prevent getting serious, possibly even fatal conditions down the line. You can use HDL and LDL (and non-HDL) results as markers and targets for improvement. Regular exercise will help get the LDL down and the HDL up, in particular cardio and resistance training exercises. A Mediterranean diet which is high in vegetables and oily fish, and low in meat and dairy, will also help to optimise cholesterol levels.
Iron is a vital component of oxygen transport, DNA synthesis and oxidative phosphorylation, which are fundamental processes for life.
Total iron-binding capacity (TIBC) is a measure of the ability of your body to efficiently carry iron through the blood.
Haemoglobin A1c (HbA1c), also known as glycated haemoglobin, is a longer term measure of glucose levels in your blood than a simple blood glucose test. Glucose attaches itself to the haemoglobin in your red blood cells, and as your cells live for around 12-16 weeks, it gives us a good indication of the average level of sugar in your blood over a 3 month period.
The thyroid is a gland at the base of your neck responsible for a number of metabolic processes, including energy expenditure, cardiac function, muscle physiology and substrate turnover. Disturbances in your thyroid function can lead to excess hormone levels (overactive) or diminished levels (underactive).
Thyroid Stimulating Hormone (TSH) is produced by the pituitary gland and stimulates the thyroid gland to produce the two thyroid hormones thyroxine (T4) and triiodothyronine (T3). Thyroid hormone production is part of a neuroendocrine cascade. It starts in the hypothalamus with the release of thyrotropin releasing hormone (TRH), which triggers the pituitary gland to produce thyroid stimulating hormone (TSH). This binds to cells in the thyroid gland to release the hormones T3 and T4 (thyroxine). T4 is also converted into T3 (the more active thyroid hormone) at peripheral tissues.
It is these hormones which essentially control the metabolism around your body. All these levels are normally held in tight balance through negative feedback loops. Abnormal thyroid function can manifest by over-secretion or under-secreting the thyroid hormones. Very often there is an autoimmune component to these conditions and we can often see this by looking at your thyroid antibodies in more advanced thyroid tests.
Thyroxine (T4) is one of two hormones produced by the thyroid gland. It works to speed up the rate of your metabolism. Most T4 is bound to carrier proteins in the blood, but it is only the free, or unbound T4 that is active in the body, which is measured in this test.
The prostate profile measures the levels of free PSA (Prostate Specific Antigen) and total PSA as well as the calculated ratio. PSA is a protein made only by the prostate gland. Some of it leaks into your blood, but how much depends on your age and the health of your prostate.
Ferritin is a complex globular protein which stores iron in an inactive form. As your iron stores deplete, the ferritin releases its iron for use. If your ferritin depletes then you will run out of iron and if your iron runs out your ability to produce red blood cells in your bone marrow decreases. Ferritin therefore gives a good measure of your iron stores. Ferritin is also an acute phase protein, so can increase during periods of infection, inflammation or trauma.
Vitamin D is vital for bone maintenance in conjunction with calcium. It also plays important roles in muscle function and protein synthesis. More recent research has highlighted other non-musculoskeletal benefits too, including immune modulation, protection against chronic diseases and increased athletic performance. Your skin can make vitamin D when it is exposed to sunlight. However, in the UK this is difficult, especially in winter. It is very common for people living in the UK to be low in vitamin D, even if they exercise outside.
Folate is a B vitamin which acts as a coenzyme in the metabolism of amino acids. It is also vital for the synthesis of purines and pyrimidines which are essential for DNA synthesis and red cell formation. Folate is also especially important during the first trimester of pregnancy so if you are thinking of becoming pregnant it is important to make sure your folate levels are normal.
Follicle Stimulating Hormone (FSH) is produced in the pituitary gland and is important for women in the production of eggs by the ovaries and for men for men in the production of sperm. In the first half of the menstrual cycle in women, FSH stimulates the enlargement of follicles within the ovaries. Each of these follicles will help to increase oestradiol levels. One follicle will become dominant and will be released by the ovary (ovulation), after which follicle stimulating hormone levels drop during the second half of the menstrual cycle. In men, FSH acts on the seminiferous tubules of the testicles where they stimulate immature sperm cells to develop into mature sperm.
Oestradiol is a female steroid hormone, produced in the ovaries of women and to a much lesser extent in the testes of men. It is the strongest of three oestrogens and is responsible for the female reproductive system as well as the growth of breast tissue and bone thickness. In pre-menopausal women, oestradiol levels vary throughout the monthly cycle, peaking at ovulation. In women, oestradiol levels decline with age, culminating with the menopause when the ovaries stop producing eggs. Low oestradiol can cause many symptoms associated with the menopause, including hot flushes, night sweats and mood swings. Low oestradiol can also cause osteoporosis.
Progesterone is a steroid hormone produced in the corpus luteum and the adrenal glands. Its main role is to prepare the body for and support a pregnancy. It is produced in increasing amounts in the second half of the menstrual cycle. Progesterone is normally tested on day 21 of your menstrual cycle to assess whether ovulation has taken place. Although progesterone is considered a female hormone, men also produce progesterone in the adrenal glands and the testes. Progesterone in men plays a role in testosterone production.
Luteinising Hormone (LH) is produced by the pituitary gland and is important for male and female fertility. In women it governs the menstrual cycle, peaking before ovulation. In men it stimulates the production of testosterone.
Testosterone is a hormone that causes male characteristics. For men, it helps to regulate sex drive and has a role in controlling bone mass, fat distribution, muscle mass, strength and the production of red blood cells and sperm. Testosterone is produced in the testicles of men and, in much smaller amounts, in the ovaries of women. Testosterone levels in men naturally decline after the age of 30, although lower than normal levels can occur at any age and can cause low libido, erectile dysfunction, difficulty in gaining and maintaining muscle mass and lack of energy. Although women have much lower amounts of testosterone than men, it is important for much the same reasons, playing a role in libido, the distribution of muscle and fat and the formation of red blood cells.
Cortisol is known as the “stress hormone”, though it does a lot more than just being released during stress. Cortisol is produced in the adrenal gland and works on the majority of cells in your body. It can help to control blood sugar levels, blood pressure, regulate metabolism, reduce inflammation and assists with memory.
Insulin is an important metabolic hormone. Made in your pancreas, insulin is produced after eating in order to move the sugar from your blood into your cells for future energy use. If we eat too much, especially sugar and starchy foods, our bodies are flooded with insulin and over time our cells become resistant to the effects of insulin, leaving high levels of sugar and insulin in the bloodstream.
The B vitamins are a group of 8 all water-soluble vitamins, all crucial for cell metabolism, converting food into energy, the normal functioning of the central nervous system and the formation of red blood cells.
Vitamin B1 (thiamine): Thiamine (B1) is a water-soluble vitamin required to form adenosine triphosphate which all cells in the body need.
Vitamin B2 (Riboflavin)
Vitamin B3 (Niacin)
Vitamin B6 (Pyridoxine)
Vitamin B9 (red cell)
Vitamin B12 (active)
Growth hormone (hGH), or somatotropin, is a hormone responsible for normal body growth and development. This test measures the level of growth hormone in your blood.
C-Reactive Protein (CRP) is an inflammation marker used to assess whether there is inflammation in the body – it does not identify where the inflammation is located.