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Venous blood

What does the Thyroid Test TPO measure?
This thyroid test specifically measures TPO antibodies (Thyroid peroxidase). Even with normal levels of TSH, T3, and T4, a person can still have thyroid antibodies. Self-attack of the thyroid gland can lead to Hashimoto's disease.
Hashimoto's disease, an autoimmune disorder, involves the immune system attacking the thyroid cells, leading to hypothyroidism (an underactive thyroid). This condition most commonly affects women. While hypothyroidism simply refers to an underactive thyroid gland, Hashimoto's disease specifically entails an autoimmune attack on thyroid cells, causing a reduction in thyroid hormone production.
Symptoms of Hashimoto's Disease

Fatigue, tiredness
Increased sensitivity to cold
Dry skin
Constipation
Depression
Puffy face
Hair loss, brittle nails
Memory problems

Understanding the Thyroid Feedback Loop
The hypothalamic-pituitary-thyroid axis includes the thyroid gland, which operates through a negative feedback loop. Thyroid-Releasing Hormone (TRH) from the hypothalamus stimulates the pituitary to release Thyroid Stimulating Hormone (TSH). TSH then controls the production of thyroid hormones T4 and T3. Our body converts T4, the inactive form, into the active T3. However, only a third of T4 undergoes this transformation, and it requires a healthy liver, healthy gut flora, and adequate nutritional levels, including selenium and zinc. Factors such as alcohol, cigarettes, environmental toxins, heavy metals, inflammation, insulin resistance, and certain drugs can inhibit this conversion process.
How to Conduct the Thyroid Test TPO
You will conduct this test at home by pricking your finger to collect a blood sample, which you then drip onto paper strips. After sending the sample to our lab, you will receive your results digitally once the lab completes the analysis. The price includes shipping to the lab.

What does the Thyroid Test TPO measure? 
This thyroid test specifically measures TPO antibodies (Thyroid peroxidase). Even with normal levels of TSH, T3, and T4, a person can still have thyroid antibodies. Self-attack of the thyroid gland can lead to Hashimoto's disease. 
Hashimoto's disease, an autoimmune disorder, involves the immune system attacking the thyroid cells, leading to hypothyroidism (an underactive thyroid). This condition most commonly affects women. While hypothyroidism simply refers to an underactive thyroid gland, Hashimoto's disease specifically entails an autoimmune attack on thyroid cells, causing a reduction in thyroid hormone production. 
Symptoms of Hashimoto's Disease
Fatigue, tiredness 
Increased sensitivity to cold 
Dry skin 
Constipation 
Depression 
Puffy face 
Hair loss, brittle nails 
Memory problems
Understanding the Thyroid Feedback Loop 
The hypothalamic-pituitary-thyroid axis includes the thyroid gland, which operates through a negative feedback loop. Thyroid-Releasing Hormone (TRH) from the hypothalamus stimulates the pituitary to release Thyroid Stimulating Hormone (TSH). TSH then controls the production of thyroid hormones T4 and T3. Our body converts T4, the inactive form, into the active T3. However, only a third of T4 undergoes this transformation, and it requires a healthy liver, healthy gut flora, and adequate nutritional levels, including selenium and zinc. Factors such as alcohol, cigarettes, environmental toxins, heavy metals, inflammation, insulin resistance, and certain drugs can inhibit this conversion process. 
How to Conduct the Thyroid Test TPO 
You will conduct this test at home by pricking your finger to collect a blood sample, which you then drip onto paper strips. After sending the sample to our lab, you will receive your results digitally once the lab completes the analysis. The price includes shipping to the lab.

Thyroid Test TPO

Health Markers

Urine density, also known as urine specific gravity, is a measurement of the concentration of solutes in the urine. It indicates the kidney’s ability to concentrate or dilute urine and acts as a marker of hydration status and kidney function. Although normal values may vary, abnormalities can suggest dehydration, overhydration, or underlying kidney conditions.

Urine density

5-Hydroxyindoleacetate (5-HIAA) is a measurement that reflects the breakdown of serotonin, a key neurotransmitter in the body. It is primarily used as a clinical marker, especially for detecting and monitoring carcinoid tumours that may overproduce serotonin. Urinary 5-HIAA levels can also serve as an approximate indicator of the body’s overall serotonin levels.

5-Hydroxyindoleacetate

Bilirubin is a yellow compound that results from the breakdown of red blood cells in the body. It is transported to the liver, where it is processed and excreted into the bile. Healthy liver function ensures bilirubin is efficiently filtered from the blood and converted into a form that can be eliminated via the digestive system. Blood bilirubin levels are an important indicator of liver health, bile duct function, and red blood cell turnover.

Bilirubin

Citrate is a compound that plays a key role in the citric acid cycle, essential for energy production in aerobic organisms. It helps break down carbohydrates, fats, and proteins to produce ATP (energy). Citrate also supports the regulation of the body’s acid-base balance and contributes to kidney stone prevention by binding with calcium.

Citrate

LDL (Low-Density Lipoprotein) is a type of cholesterol often called “bad” cholesterol. It transports cholesterol particles through the bloodstream, and elevated levels can contribute to plaque buildup in the arteries. This accumulation, known as atherosclerosis, can narrow and harden the arteries, increasing the risk of heart disease and stroke.

LDL (Low-Density Lipoprotein)

Urinary leukocytes are white blood cells present in urine. They are usually absent or found in very small quantities, and elevated levels often indicate infection or inflammation in the urinary tract or kidneys. Their detection is a key marker for diagnosing urinary tract infections (UTIs) and other kidney-related disorders.

Leukocytes (urine)

Non-HDL cholesterol is a measure of all the harmful types of cholesterol, including LDL (low-density lipoprotein), VLDL (very low-density lipoprotein), and other lipid particles that contribute to plaque buildup in your arteries. It is calculated by subtracting your HDL (high-density lipoprotein) or "good" cholesterol level from your total cholesterol number. Non-HDL cholesterol is considered a more comprehensive indicator of heart disease risk than LDL cholesterol alone, as it includes all the atherogenic particles.

Non-HDL Cholesterol

Kynurenine is a key metabolite in the breakdown of the essential amino acid tryptophan. It serves as a precursor to several important compounds, including the neuroprotective kynurenic acid and the neurotoxic quinolinic acid, and plays a crucial role in a variety of physiological and pathological processes in the body.

Kynurenine

Urinary nitrates are chemical compounds usually absent or present only in small quantities in urine. Their presence can indicate a bacterial infection, such as a urinary tract infection (UTI), as certain bacteria can convert urinary nitrite into nitrate. Nitrate testing is a common diagnostic method for detecting UTIs.

Nitrates (urine)

KMO (Kynurenine 3-monooxygenase) is an enzyme that plays a key role in the kynurenine pathway, responsible for metabolising the amino acid tryptophan. It helps regulate the balance of metabolites within this pathway, influencing processes that can affect brain health. KMO activity has been linked to neurological conditions such as Alzheimer’s disease, Huntington’s disease, and schizophrenia.

KMO (enzyme)

Urobilinogen in urine is a by-product of red blood cell breakdown, formed in the intestines from bilirubin and excreted in the urine. It is normally present in low concentrations and acts as an indicator of liver function and health. Abnormally high or low levels may suggest liver disease or blood-related conditions.

Urobilinogen (urine)

Vanillylmandelic acid (VMA) is a metabolite produced from the breakdown of catecholamines such as adrenaline, noradrenaline, and dopamine. It is used as a clinical marker to evaluate catecholamine activity, with levels typically measured in urine. Various factors, including certain foods and medications, can affect VMA levels.

Vanillylmandelic acid

Creatinine is a compound produced through muscle metabolism and is an important indicator of kidney function. It is derived from creatine, a molecule vital for energy production in muscles, and is filtered from the blood by the kidneys before being excreted in the urine.

Creatinine

Anti-Thyroid Peroxidase (A-TPO) antibodies are proteins produced by the immune system that target thyroid peroxidase, an enzyme essential for thyroid hormone production. Elevated levels of A-TPO antibodies may indicate autoimmune thyroid disorders, such as Hashimoto’s thyroiditis or Graves’ disease, which can disrupt thyroid function and affect overall health.

D-dimer

EBNA IgG is a marker that reflects the presence of antibodies against the EBV (Epstein-Barr virus) nuclear antigen (EBNA), a protein produced during the later stages of infection. The presence of EBNA IgG antibodies generally indicates a past infection, as these antibodies develop several weeks to months after the initial infection and typically remain detectable for life. Testing for EBNA IgG is often used alongside VCA antibodies to differentiate between a current and past infection and to assess the stage of the infection.

EBNA (Epstein-Barr Nuclear Antigen)

Neopterin is a molecule produced by immune cells, particularly macrophages, in response to stimulation by interferon-gamma. It is regarded as a marker of immune system activation and inflammation. Elevated levels of neopterin in urine or blood can indicate increased immune activity, commonly observed in infections, autoimmune disorders, or chronic inflammatory conditions. As it reflects the cellular immune response, neopterin is sometimes used to monitor disease progression or the status of the immune system.

Neopterin

Trimethylamine N-oxide (TMAO) is a compound produced in the liver from trimethylamine (TMA), which is generated by gut bacteria during the digestion of nutrients such as choline, L-carnitine, and phosphatidylcholine. Elevated levels of TMAO have been associated with an increased risk of cardiovascular disease, kidney dysfunction, and inflammation. TMAO serves as a valuable marker for assessing metabolic health and the influence of gut microbiota on systemic disease risk. Lifestyle and diet, particularly red meat and eggs, can significantly affect TMAO levels. Monitoring TMAO may help identify hidden risks even when other conventional markers appear normal.

Trimethylamine N-oxide (TMAO)

EBV VCA is a protein component of the Epstein-Barr virus (EBV) that appears early during infection. Testing for VCA is an important marker for diagnosing both acute and chronic EBV infections.

EBV VCA (Epstein-Barr Virus Viral Capsid Antigen)

Trimethylamine (TMA) is a volatile organic compound produced in the gut through bacterial fermentation of dietary nutrients such as choline, L-carnitine, and lecithin. Typically, TMA is rapidly converted in the liver to trimethylamine N-oxide (TMAO), which is less toxic. However, elevated TMA levels can indicate imbalances in the gut microbiome or impaired liver detoxification capacity. High TMA is also linked to trimethylaminuria, a rare metabolic disorder that causes a strong body odour. Monitoring TMA provides insight into gut microbial activity, protein metabolism, and liver function.

Trimethylamine

IgG (Immunoglobulin G) is a type of antibody that indicates the body’s long-term immune response. It is the most abundant antibody in the blood and plays a crucial role in protecting against infections. In the context of Lyme disease, caused by the bacterium Borrelia burgdorferi, IgG antibodies are measured to assess past exposure or later stages of infection. Unlike IgM antibodies, which appear early on, IgG antibodies develop more slowly and can remain in the body for prolonged periods, providing lasting immunity.

IgG Antibodies

Ethyl malonate (EM) is a compound that acts as a biomarker for certain metabolic disorders. Elevated levels of ethyl malonate in the body may indicate inherited metabolic conditions, such as ethylmalonic encephalopathy, or disruptions in fatty acid oxidation.

Ethyl malonate

GOT, or Gamma-Glutamyl Transferase (GGT), is an enzyme present in various tissues throughout the body, with the highest concentrations found in the liver. It plays a crucial role in glutathione metabolism, a vital antioxidant, and is involved in the transport of amino acids across cell membranes. GOT is commonly measured in blood tests and acts as an important indicator of liver and biliary tract function.

IDO (Indoleamine 2,3-dioxygenase) is an enzyme involved in metabolising the amino acid tryptophan via the kynurenine pathway. By depleting tryptophan, it can modulate immune responses, a mechanism that some tumours may use to evade immune detection. IDO is also implicated in psychiatric and neurodegenerative disorders and is influenced by inflammation and stress.

IDO (enzyme)

Anti-Thyroid Peroxidase (A-TPO) antibodies are immune proteins that mistakenly target thyroid peroxidase, an enzyme essential for producing thyroid hormones. Elevated levels of A-TPO antibodies are often linked to autoimmune thyroid disorders such as Hashimoto’s thyroiditis and Graves’ disease, which can result in either an underactive or overactive thyroid function and impact overall health.

A-TPO

Homocysteine is a sulphur-containing amino acid produced during the metabolism of methionine, an essential amino acid. It plays a key role in methylation, detoxification, and cardiovascular function. Elevated homocysteine levels have been associated with increased risk of heart disease, stroke, cognitive decline, and pregnancy complications. Imbalances may be caused by deficiencies in B vitamins (especially B6, B12, and folate), impaired methylation, or genetic variants like MTHFR. Monitoring homocysteine levels can provide valuable insights into cardiovascular, neurological, and metabolic health.

Homocysteine

SDMA is a methylated derivative of the amino acid arginine and is primarily excreted by the kidneys. Unlike ADMA, SDMA does not directly inhibit nitric oxide synthase but reflects similar metabolic and renal processes. Elevated SDMA levels can indicate reduced kidney clearance or altered amino acid metabolism. Stable or optimal SDMA values suggest efficient renal function and normal arginine turnover.

SDMA (Symmetric Dimethylarginine)

ADMA is an endogenous inhibitor of nitric oxide synthase (NOS), the enzyme responsible for producing nitric oxide (NO), a key molecule for vascular tone and endothelial function.  
Elevated ADMA levels can reduce nitric oxide availability, potentially affecting blood vessel dilation and circulation.  
Increased concentrations have been associated with endothelial dysfunction and impaired blood flow regulation.  
Low or balanced ADMA levels generally indicate healthy nitric oxide production and vascular function.

ADMA (Asymmetric Dimethylarginine)

Histamine is a bioactive compound derived from the amino acid histidine and plays key roles in immune defence, stomach acid secretion, and inflammatory responses.  
In the bloodstream, histamine reflects both mast cell activity and the body’s ability to break down histamine via enzymes such as DAO and HNMT.  
Elevated histamine levels may indicate immune activation, allergic response, or reduced capacity to degrade histamine.  
Low or balanced histamine concentrations suggest normal regulation of histamine metabolism and immune function.

Histamine

Amylase is an enzyme involved in digestion, produced by the pancreas and salivary glands. Its primary function is to break down complex carbohydrates — such as starches and glycogen — into simpler sugars like maltose and glucose, which the body can easily absorb.

Amylase

Primary bile acids – cholic acid (CA) and chenodeoxycholic acid (CDCA) – are produced in the liver and constitute the initial stage of bile acid metabolism. They are vital for emulsifying dietary fats and aiding the absorption of fat-soluble vitamins. Elevated levels may indicate altered bile acid synthesis or cholestasis, whereas low levels could suggest reduced liver production or bile flow. Balanced concentrations indicate normal liver function and bile acid turnover.

Primary Bile Acids (CA, CDCA)

Tertiary bile acids are secondary bile acids that have undergone further modification in the liver, such as ursodeoxycholic acid (UDCA). They are generally considered less cytotoxic and may have protective, anti-inflammatory effects on the liver and bile ducts. Elevated tertiary bile acids can indicate adaptive responses to oxidative or metabolic stress. Adequate levels reflect efficient bile acid recycling and hepatobiliary balance.

Tertiary Bile Acids

This ratio reflects the conversion of primary bile acids by intestinal bacteria into secondary bile acids.  
A higher ratio may indicate increased microbial conversion or slowed bile acid turnover, while a lower ratio can reflect reduced bacterial activity or impaired bile flow.  
Maintaining balance is important for gut–liver communication, lipid metabolism, and overall digestive health.

Secondary / Primary Bile Acids (Ratio)

This ratio represents the relationship between more cytotoxic bile acids (e.g., lithocholic and deoxycholic acid) and protective bile acids such as ursodeoxycholic acid (UDCA).  
An elevated ratio may suggest increased oxidative or inflammatory stress in the liver or gut environment.  
A lower ratio, with higher levels of neuroprotective bile acids, indicates better bile acid homeostasis and reduced cellular stress.  
Balanced values support optimal liver detoxification and metabolic resilience.

Cytotoxic / Neuroprotective Bile Acids (Ratio)

Suberic acid, also known as octanedioic acid, is a dicarboxylic acid that functions as a metabolic marker in the body. In biological and physiological contexts, it is primarily linked to fatty acid metabolism. Elevated levels of suberic acid may indicate metabolic disorders, particularly those involving fatty acid oxidation, such as medium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency.

Suberic acid

Lactate, also known as lactic acid, is a byproduct of anaerobic metabolism — the process of breaking down glucose for energy without adequate oxygen, often during intense exercise. It is associated with muscle fatigue and the familiar “burn” sensation experienced during strenuous activity. Lactate also plays a role in the Cori cycle, where it is converted back into glucose in the liver.

Lactate

Kynurenic acid is a metabolite produced in the kynurenine pathway during the breakdown of the amino acid tryptophan. It acts in the nervous system as a neuroprotective agent and is of interest in neurological and psychiatric research. Imbalances in kynurenic acid levels have been linked to conditions such as schizophrenia and depression.

Kynurenic acid

Cholesterol is a waxy, fat-like substance found in all cells of the body and is essential for producing hormones, vitamin D, and digestive substances. While the body produces all the cholesterol it needs, it is also present in animal-based foods such as meat and dairy. There are two main types: low-density lipoprotein (LDL), or “bad” cholesterol, which can contribute to plaque buildup in arteries, and high-density lipoprotein (HDL), or “good” cholesterol, which helps remove excess cholesterol from the bloodstream.

Total Cholesterol

ALT (Alanine Aminotransferase): ALT is an enzyme predominantly found in the liver, where it assists in protein metabolism. When liver cells are damaged or inflamed, ALT is released into the bloodstream, causing its levels to rise. Measuring ALT is a common method to assess liver health, as elevated levels may indicate liver injury or disease, while normal levels generally signify normal liver function.

ALT (Alanine Aminotransferase)

Pyruvate is a key compound in cellular metabolism formed as the end product of glycolysis when glucose is broken down. It plays a central role in energy production by entering the citric acid cycle under oxygen-rich conditions. When oxygen is scarce, such as during intense exercise, pyruvate is converted into lactate to support continued ATP (energy) production. Additionally, pyruvate is involved in gluconeogenesis and serves as a precursor for amino acid synthesis.

Pyruvate

The SAMe/SAH ratio is a measure that reflects the balance between two important compounds in the body — S-Adenosylmethionine (SAMe) and S-Adenosylhomocysteine (SAH). SAMe acts as a key methyl donor in many biochemical processes, while SAH is produced after SAMe donates a methyl group. A higher SAMe/SAH ratio indicates a strong methylation capacity, which supports healthy cellular function and overall well-being.

SAMe-SAH ratio

The measurement of histamine in stool is a diagnostic test used to evaluate gastrointestinal conditions. Histamine is a compound involved in immune responses and inflammation. Elevated levels of histamine in stool may indicate allergic reactions, infections, or disorders affecting the gut’s immune system. Monitoring histamine in stool can help assess digestive health and inform treatment strategies.

LDL-HDL Ratio

Albumin is the most abundant protein in human blood plasma and plays a key role in maintaining oncotic pressure, helping to keep fluid within blood vessels. It also binds to and transports various substances in the blood, such as hormones, vitamins, and medications. Produced by the liver, albumin levels in the blood serve as important indicators of liver function and nutritional status.

Albumin

Methylmalonic acid (MMA) is a substance produced in the body during the metabolism of certain fats and proteins. It is a by-product of methionine breakdown and is influenced by vitamin B12 levels. Elevated MMA levels can serve as an indicator of vitamin B12 deficiency.

Methylmalonic acid (MMA)

Betaine is a compound found in foods such as beetroot and spinach. It plays key roles in the body by acting as a methyl donor in methylation processes, helping regulate cellular fluid balance, supporting liver health by preventing fat accumulation, and lowering homocysteine levels, which contributes to cardiovascular health.

Betaine

Urea is a waste product produced in the liver through the breakdown of proteins. Once formed, it is transported to the kidneys and ultimately expelled in the urine. Measuring urea levels in the blood, commonly referred to as blood urea nitrogen (BUN), is a routine test used to assess kidney function. Raised blood urea levels may indicate impaired kidney function or other problems affecting waste processing and elimination.

Urea

Creatine Kinase (CK) is an enzyme found in the heart, brain, skeletal muscles, and other tissues. Raised CK levels in the blood indicate muscle damage, as the enzyme is released when muscle cells are harmed. There are different types of CK, including CK-MM found in skeletal muscle, CK-MB mainly in the heart, and CK-BB typically in the brain. Measuring CK levels is useful for diagnosing and monitoring muscle damage, such as that caused by a heart attack (myocardial infarction).

CK (Creatine Kinase)

PSA, or Prostate-Specific Antigen, is a protein produced by the prostate gland. Measuring PSA levels in the blood helps screen for prostate health, as elevated levels may indicate prostate cancer. However, higher PSA can also result from non-cancerous conditions such as benign prostatic hyperplasia or prostatitis.

PSA free

IgM (Immunoglobulin M) is a type of antibody that acts as the body’s initial defence against infections. It plays a crucial role in the immune system’s early response by rapidly recognising and targeting invading pathogens. In diagnostic testing, IgM levels are measured to identify recent infections, such as Lyme disease caused by Borrelia burgdorferi. The presence of IgM antibodies in the blood usually indicates recent exposure or an active infection, providing valuable information about the early phases of the immune response.

IgM Antibodies

Alkaline phosphatase (ALP) is an enzyme found in various tissues throughout the body, particularly in the liver, bones, kidneys, and digestive system. ALP plays a crucial role in breaking down proteins and in dephosphorylation processes. In the liver, it is associated with the bile ducts and is frequently used to assist in diagnosing liver and bone conditions. Raised ALP levels may indicate bile duct obstruction or bone disorders, while low levels can be associated with certain genetic conditions and malnutrition.

ALP (Alkaline phosphatase)

3-Hydroxykynurenine (3-OH-kynurenine) is a metabolite in the kynurenine pathway, which reflects the breakdown of the amino acid tryptophan. It serves as an intermediate compound during the conversion of tryptophan into important molecules, including the essential coenzyme NAD+ (nicotinamide adenine dinucleotide).

3-Hydroxykynurenine

Alpha-ketoglutarate (AKG) is a key compound in the Krebs cycle, an essential metabolic pathway for energy production in cells. It plays a crucial role in converting nutrients into energy, amino acid metabolism, and nitrogen transport. Additionally, Alpha-ketoglutarate is involved in various cellular processes, including signaling and regulation....

Alpha-ketoglutarate

The cholesterol-to-HDL (Chol:HDL) ratio is a measure that reflects the balance between total cholesterol and high-density lipoprotein (HDL) cholesterol in the blood. This ratio is used to assess the risk of heart disease, with a lower ratio indicating a healthier balance and a reduced risk. It is often considered a more accurate indicator of cardiovascular health than total cholesterol levels alone.

Cholesterol:HDL Ratio

Total bile acids represent the combined concentration of all bile acids circulating in the bloodstream. They are synthesised in the liver from cholesterol and have a central role in the digestion of fats, nutrient absorption, and detoxification. Elevated total bile acid levels may indicate reduced bile flow, liver dysfunction, or impaired reabsorption in the intestine. Normal concentrations suggest balanced bile acid synthesis and efficient hepatic and intestinal function.

Total Bile Acids

Urinary protein, also known as proteinuria, refers to the presence of an abnormal amount of protein in the urine. Proteins, such as albumin, are vital components of blood, but they are not normally found in urine in significant amounts. The presence of protein in urine can indicate kidney damage or disease, as healthy kidneys typically prevent significant protein loss through urine.

Protein (urine)

Malate, or malic acid, is a key compound involved in cellular metabolism, particularly within the Krebs cycle in the mitochondria. It plays a crucial role in energy production by being converted into oxaloacetate, a process that generates NADH, which is then utilised to produce ATP, the cell's primary energy currency.

Malate

Choline is an essential nutrient that plays a key role in many vital bodily functions. It helps maintain the structure of cell membranes, supports the production of the neurotransmitter acetylcholine for muscle control, memory, and mood, and aids in fat metabolism and liver health. Choline is also important for brain development, neural tube formation during pregnancy, DNA synthesis, and healthy nervous system function.

Choline

Cystathionine is a non-protein amino acid that acts as an important intermediate in the metabolism of the essential amino acids methionine and cysteine. It plays a crucial role in the transsulfuration pathway, where homocysteine is converted into cystathionine by the enzyme cystathionine β-synthase (CBS), and cystathionine is subsequently broken down into cysteine by the enzyme cystathionine γ-lyase (CSE).

Cystathionine

Glucose is a simple sugar and the primary source of energy for the body’s cells. It plays a vital role in metabolism, supporting brain function, muscle activity, and overall energy production. Blood glucose levels are carefully regulated by hormones such as insulin and glucagon. Imbalances in glucose levels can lead to conditions like diabetes, hypoglycaemia, and hyperglycaemia, impacting overall health and requiring proper management.

Glucose

Gamma-glutamyl transferase (GGT) is an enzyme present throughout the body, with the highest concentrations in the liver. GGT plays a crucial role in glutathione metabolism, which is essential for antioxidant defence. It facilitates the transfer of amino acids and peptides across cell membranes. Raised GGT levels are commonly used as a marker to detect liver damage, particularly bile duct obstruction and liver conditions associated with alcohol consumption.

PSA (Prostate-Specific Antigen) is a protein produced by the prostate gland and commonly measured in the blood as a marker of prostate health. Elevated PSA levels may indicate prostate cancer but can also result from non-cancerous conditions such as benign prostatic hyperplasia or prostatitis.

Transferrin is a blood protein responsible for binding and transporting iron throughout the body. It plays a key role in maintaining iron balance by delivering iron to tissues and storing excess iron in a safe form. Levels of transferrin typically rise when iron stores are low and decrease when iron stores are high or in cases of chronic illness. Measuring transferrin helps provide important insights into iron metabolism and related disorders.

Transferrin

eGFR (Estimated Glomerular Filtration Rate) is a measure that estimates how well the kidneys filter waste from the blood. It is calculated using serum creatinine levels along with factors such as age, body size and sex. eGFR is a key indicator of kidney function, helping to determine how effectively the kidneys are working. A lower eGFR suggests reduced kidney function, which may indicate kidney disease or damage.

eGFR (Estimated Glomerular Filtration Rate)

Total Iron Binding Capacity (TIBC) is a blood test that indicates the blood’s ability to bind and transport iron via transferrin — the primary iron-carrying protein. It offers an indirect measure of available transferrin and is frequently used alongside other iron tests to help evaluate iron deficiency, anaemia, or iron overload conditions.

Total Iron Binding Capacity (TIBC)

Globulin is a group of blood proteins that play important roles in the body, including transporting hormones, lipids, vitamins, and minerals. They are also key components of the immune system, with some globulins functioning as antibodies that help defend against infections. Produced by the liver and immune system, globulin levels can provide insight into immune health, liver function, and nutritional status.

Globulin

Succinate is a key metabolic intermediate that plays an essential role in the Krebs cycle, the process by which cells produce energy. It helps convert nutrients into ATP, the primary energy source for cellular functions. Beyond energy production, succinate also participates in amino acid and fatty acid synthesis and acts as a signalling molecule that influences inflammation and the body’s response to low oxygen levels.

Succinate

Homovanillic acid (HVA) is a metabolite that reflects the breakdown of dopamine, a key neurotransmitter in the body. HVA levels serve as an important marker for assessing dopamine activity. Variations in HVA can indicate changes in dopamine function and are used to monitor the effectiveness of treatments targeting dopamine metabolism.

Homovanillic acid

Hydroxymethylglutarate (HMG), particularly as β-hydroxy β-methylglutaryl-CoA (HMG-CoA), is a compound that fulfils two crucial functions in the body. It is a key intermediate in cholesterol synthesis, essential for producing cell membranes, steroid hormones, and bile acids. Furthermore, in the liver, HMG-CoA aids in the production of ketone bodies, which act as an alternative energy source during fasting, low-carbohydrate diets, or vigorous exercise when glucose levels are diminished.

Hydroxymethylglutarate

HbA1c (Glycated Haemoglobin) is a biomarker that reflects the average blood glucose levels over the past two to three months. It forms when glucose binds to haemoglobin in red blood cells and serves as a key indicator for long-term blood sugar control. Elevated HbA1c levels suggest poor glucose regulation and are commonly used to diagnose and manage diabetes.

HbA1c

Triglycerides are a type of fat (lipid) found in the bloodstream and act as a primary form of energy storage. Excess calories from food are converted into triglycerides and stored in fat cells, which are then released by hormones to provide energy between meals. Elevated triglyceride levels, particularly when combined with high LDL or low HDL cholesterol, are associated with an increased risk of atherosclerosis, heart attack, and stroke.

Triglycerides

Ketones are substances produced when the body breaks down fats for energy, especially during low carbohydrate intake such as fasting or following a ketogenic diet. This process, called ketosis, primarily occurs in the liver and produces key ketones like beta-hydroxybutyrate, acetoacetate, and acetone. Ketones act as an alternative energy source, particularly for the brain, but elevated levels can indicate serious conditions such as diabetic ketoacidosis (DKA) in people with diabetes.

Ketones

Transglutaminase IgG (tTG-IgG) is a blood test that detects IgG antibodies against tissue transglutaminase, an enzyme found in the lining of the intestines. It is primarily used to assist in diagnosing coeliac disease, particularly in individuals with IgA deficiency or inconclusive tTG-IgA results, by indicating an immune response to gluten.

Transglutaminase IgG

Anti-Thyroglobulin (A-TG) antibodies are immune system proteins that target thyroglobulin, an essential protein in the thyroid gland involved in the production of thyroid hormones. Elevated A-TG levels often indicate autoimmune thyroid disorders such as Hashimoto’s thyroiditis or Graves’ disease. These conditions can affect thyroid function and overall health, making A-TG monitoring important for diagnosis and management.

A-TG

Cis-aconitate is an intermediate in the Krebs cycle, a central metabolic pathway involved in cellular energy production. It is formed during the conversion of citrate to isocitrate, a reaction catalysed by the enzyme aconitase. The Krebs cycle plays a vital role in oxidising nutrients to produce ATP, the main energy source for cells, and also supplies key building blocks for the synthesis of amino acids, nucleotides, and fatty acids.

Cis-aconitate

Xanthurenate is a metabolite produced during the breakdown of the amino acid tryptophan via the kynurenine pathway. Its levels can indicate vitamin B6 (pyridoxine) status, as this vitamin serves as an essential cofactor in the process. Elevated xanthurenate may suggest a deficiency in vitamin B6.

Xanthurenate

High-sensitivity C-reactive protein (hs-CRP) is a blood test that measures low levels of C-reactive protein (CRP), a key marker of inflammation in the body. Unlike standard CRP tests, hs-CRP can detect subtle inflammation, making it particularly useful for assessing the risk of cardiovascular diseases such as heart attacks and strokes. Raised hs-CRP levels may indicate a higher risk of heart disease, even when other risk factors are absent.

hs-CRP

HDL (High-Density Lipoprotein) is a type of cholesterol commonly known as “good” cholesterol. It helps protect heart health by transporting excess cholesterol from the bloodstream to the liver, where it can be eliminated from the body. Higher HDL levels are linked to a reduced risk of heart disease and stroke.

HDL (High-Density Lipoprotein)

Transferrin saturation is a measure that reflects the percentage of transferrin — a blood protein that transports iron — that is actually bound to iron. It helps assess how effectively iron is being carried and utilised in the body. This marker is useful for identifying iron deficiency or iron overload, and is typically calculated using serum iron and total iron-binding capacity (TIBC). Low levels may suggest iron deficiency, while high levels can indicate conditions such as haemochromatosis.

Transferrin Saturation

Quinolinic acid is a metabolite in the kynurenine pathway, which is involved in the metabolism of the amino acid tryptophan. It plays a key role as an excitotoxin in the central nervous system. Elevated levels of quinolinic acid have been linked to neurological conditions such as Alzheimer’s disease, Huntington’s disease, epilepsy, and certain psychiatric disorders including depression.

Quinolinic acid

Haematuria, or blood in the urine, is a finding that indicates the presence of red blood cells in the urine. It may be visible, giving the urine a pink, red, or cola-like colour, or microscopic, detectable only through laboratory testing. This condition can arise from a wide range of causes, from minor issues to serious underlying diseases.

Blood (urine)

Total protein is a measurement that reflects the combined levels of two major blood proteins — albumin and globulin. Albumin, the most abundant protein in blood plasma, helps maintain oncotic pressure and transports various substances, while globulins play key roles in immune response, blood clotting, and other functions. Total protein levels provide important insights into nutritional status as well as liver and kidney health.

Total Protein

Citramalate, also referred to as citramalic acid, is a compound that can be measured as a urinary biomarker to evaluate metabolic health. It is produced as a metabolic by-product and may indicate a bacterial imbalance or overgrowth in the gut. Elevated levels can also suggest potential disruptions in normal metabolic functions.

Citramalate

Alanine aminotransferase (ALT) is an enzyme found predominantly in the liver that plays a crucial role in protein metabolism and other vital metabolic processes. Elevated ALT levels in the blood may indicate liver cell damage or inflammation, making it a significant marker for evaluating liver health.

ALT (SGPT)

Nicotinamide adenine dinucleotide (NAD) is an essential coenzyme found in all living cells. It plays a crucial role in cellular metabolism, particularly in redox reactions, by cycling between its oxidised form (NAD⁺) and reduced form (NADH). Beyond energy production, NAD⁺ is vital for cell signalling, DNA repair, and regulating gene expression, making it indispensable for maintaining cellular health and function.

A-TPO

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