Growth and Nutrition Checkup for Children

The Total Iron Binding Capacity test measures the ability of your blood to bind and transport iron, and therefore reflects your body's iron stores. TIBC correlates with the amount of transferrin, a protein, in your blood, that helps bind iron and facilitates its transportation in the blood. Usually, about one-third of the transferrin measured is being used to transport iron, and this is called transferrin saturation.

An Iron, Serum test determines iron levels in the blood and can help diagnose conditions like anemia, or iron overload in the body. People usually suffer from low iron levels in the blood if they prefer a diet that has low iron content, or if their body has trouble absorbing the iron from the foods or supplements they intake. Low iron levels can also occur due to intense blood loss or even during pregnancy. Similarly, an excess amount of iron in the blood can occur due to over-intake of iron supplements, blood transfusions, or if you are suffering from a condition called hemochromatosis (a rare genetic disorder that causes too much iron to build up in the body or cause problems in the body to remove excess iron). 

Therefore, doctors often suggest an Iron, Serum to help check the status of your iron level, get valuable information about your nutritional well-being, detect potential health issues (if any), and take timely preventive measures.

An Unsaturated Iron Binding Capacity test determines the reserve capacity of transferrin, i.e., the portion not yet saturated with iron. The iron-binding capacity of our body can be segregated into two parts – Total Iron Binding Capacity (TIBC) and Unsaturated Iron Binding Capacity (UIBC). UIBC refers to the capacity of transferrin, a protein that transports iron, to bind with additional iron. In easy terms, it represents the available "slots" on transferrin to carry iron molecules. Unlike iron saturation, which assesses the occupied slots, UIBC measures the unoccupied ones.

The Transferrin Saturation test determines an individual’s iron status by using the ratio of serum iron concentration and total iron binding capacity (TIBC) as a percentage. The test tells us how much iron in the blood is bound to transferrin, the main protein in the blood that binds to iron and transports it throughout the body. Under normal conditions, transferrin is one-third saturated with iron, so about two-thirds of its capacity is held in reserve. This test is often employed alongside others to evaluate iron levels and diagnose conditions like iron deficiency anemia if transferrin saturation is low or hemochromatosis (an iron overload disorder) if transferrin saturation is higher than normal.

The Bilirubin (Total, Direct and Indirect) test measures the level of three forms of bilirubin such as total bilirubin, direct (conjugated bilirubin), and indirect (unconjugated) bilirubin in the blood. Total bilirubin represents the sum of direct and indirect bilirubin. Direct bilirubin is the water-soluble form of bilirubin that has been processed by the liver via a conjugation process with glucuronic acid and is ready to be excreted into the bile ducts and ultimately into the intestines. Indirect bilirubin is the water-insoluble form of bilirubin that has not yet been processed by the liver and is bound to albumin in the blood. It is formed in the spleen and liver during the breakdown of hemoglobin from old or damaged red blood cells and cannot be excreted directly by the liver. Instead, it is transported to the liver, where it undergoes conjugation to become direct bilirubin. 

Getting tested with the Bilirubin (Total, Direct and Indirect) test provides valuable information into various aspects of liver function, bile duct health, and the body’s ability to break down and eliminate bilirubin.

Gamma-Glutamyl Transferase (GGT) is an enzyme found in various organs, with the highest concentration in the liver. Usually, this enzyme is present in low levels in the blood. However, when there is liver damage or disease, GGT is released into the bloodstream, causing an increase in GGT levels. In addition to the liver, GGT can also be elevated in conditions affecting the bile ducts or the pancreas. It is usually, the first liver enzyme to rise in the blood when there is any damage or obstruction in the bile duct, making it one of the most sensitive liver enzyme tests for detecting bile duct problems.

An SGPT (Alanine Transaminase) test measures the amount of alanine transaminase (ALT) or SGPT enzyme in your blood. ALT is most abundantly found in the liver but is also present in smaller amounts in other organs like the kidneys, heart, and muscles. Its primary function is to convert food into energy. It also speeds up chemical reactions in the body. These chemical reactions include the production of bile and substances that help your blood clot, break down food and toxins, and fight off an infection.

Elevated levels of ALT in the blood may indicate liver damage or injury. When the liver cells are damaged, they release ALT into the bloodstream, causing an increase in ALT levels. Therefore, the SGPT/ALT test is primarily used to assess the liver's health and to detect liver-related problems such as hepatitis, fatty liver disease, cirrhosis, or other liver disorders.

An Alkaline Phosphatase (ALP) test measures the quantity of ALP enzyme present throughout the body. The main sources of this enzyme are the liver and bones. It exists in different forms depending on where it originates, such as liver ALP, bone ALP, and intestinal ALP. In the liver, it is found on the edges of the cells that join together to form bile ducts. 

ALP levels can be increased during pregnancy as it is found in the placenta of pregnant women. It is also higher in children because their bones are in the growth phase. ALP is often high during growth spurts (a short period when an individual experiences quick physical growth in height and body weight).

An SGOT (Aspartate Aminotransferase) test measures the levels of serum glutamic-oxaloacetic transaminase (SGOT), also known as aspartate aminotransferase (AST), an enzyme produced by the liver. SGOT is present in most body cells, most abundantly in the liver and heart. The primary function of this enzyme is to convert food into glycogen (a form of glucose), which is stored in the cells, primarily the liver. The body uses this glycogen to generate energy for various body functions.

The Protein Total, Serum test measures the amount of proteins in the body. Proteins are known as the building blocks of all cells and tissues. They play a crucial role in the growth and development of most of your organs and in making enzymes and hormones. There are two types of proteins found in the body, namely albumin and globulin. About 60% of the total protein is made up of albumin, which is produced by the liver. It helps to carry small molecules such as hormones, minerals, and medicines throughout the body. It also serves as a source of amino acids for tissue metabolism. On the other hand, globulin is a group of proteins that are made by the liver and the immune system. They play an important role in liver functioning, blood clotting, and fighting off infections.

There are five types of WBCs: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. A Differential Leukocyte Count test measures the percentage of each type of WBC in the blood. Leukocytes or WBCs are produced in the bone marrow and defend the body against infections and diseases. Each type of WBC plays a unique role to protect against infections and is present in different numbers.

The Red Blood Cell Count test measures the total number of red blood cells in your blood. RBCs are the most abundant cells in the blood with an average lifespan of 120 days. These cells are produced in the bone marrow and destroyed in the spleen or liver. Their primary function is to help carry oxygen from the lungs to different body parts. The normal range of RBC count can vary depending on age, gender, and the equipment and methods used for testing.

The Hb (Hemoglobin) test measures the concentration of hemoglobin in your blood. Hemoglobin binds oxygen molecules and carries them to body tissues while removing carbon dioxide. Low hemoglobin suggests reduced oxygen-carrying capacity. It can be due to anemia, bleeding, nutritional deficiencies (iron, vitamin B12, folate), or chronic disease. High hemoglobin may occur in dehydration, living at high altitudes, smoking, or diseases like polycythemia vera.

The Platelet Count test measures the average number of platelets in the blood. Platelets are disk-shaped tiny cells originating from large cells known as megakaryocytes, which are found in the bone marrow. After the platelets are formed, they are released into the blood circulation. Their average life span is 7-10 days. 

Platelets help stop the bleeding, whenever there is an injury or trauma to a tissue or blood vessel, by adhering and accumulating at the injury site and releasing chemical compounds that stimulate the gathering of more platelets. A loose platelet plug is formed at the site of injury and this process is known as primary hemostasis. These activated platelets support the coagulation pathway that involves a series of steps, including the sequential activation of clotting factors; this process is known as secondary hemostasis. After this step, there is a formation of fibrin strands that form a mesh incorporated into and around the platelet plug. This mesh strengthens and stabilizes the blood clot so that it remains in place until the injury heals. After healing, other factors come into play and break the clot down so that it gets removed. In case the platelets are not sufficient in number or not functioning properly, a stable clot might not form. These unstable clots can result in an increased risk of excessive bleeding. 

The Total Leukocyte Count test measures the numbers of all types of leukocytes, namely neutrophil, lymphocyte, monocyte, eosinophil, and basophil, in your blood. Leukocytes or WBCs are an essential part of our immune system. These cells are produced in the bone marrow and defend the body against infections and diseases. Each type of WBC plays a unique role to protect against infections and is present in different numbers.

The Hematocrit test measures the proportion of red blood cells (RBCs) in your blood as a percentage of the total blood volume. It is a crucial part of a complete blood count (CBC) and helps in assessing your blood health. RBCs are responsible for carrying oxygen from the lungs to different parts of the body. The hematocrit test provides valuable information about your blood's oxygen-carrying capacity.

Higher-than-normal amounts of RBCs produced by the bone marrow can cause the hematocrit to increase, leading to increased blood density and slow blood flow. On the other hand, lower-than-normal hematocrit can be caused by low production of RBCs, reduced lifespan of RBCs in circulation, or excessive bleeding, leading to a reduced amount of oxygen being transported by RBCs. Monitoring your hematocrit levels is essential for diagnosing and managing various blood-related disorders.

The Mean Corpuscular Volume test measures the average size of your red blood cells, which carry oxygen through your body. This test tells whether your RBCs are of average size and volume or whether they are bigger or smaller.

An MCH test measures the average amount of hemoglobin in a single red blood cell (RBC). Hemoglobin is an iron-containing protein in RBCs, and its major function is to transport oxygen from the lungs to all body parts. This test provides information about how much oxygen is being delivered to the body by a certain number of RBCs.

An MCHC test measures the average amount of hemoglobin in a given volume of RBCs. MCHC is calculated by dividing the amount of hemoglobin by hematocrit (volume of blood made up of RBCs) and then multiplying it by 100. 

The Absolute Leucocyte Count test measures the total number of white blood cells (leucocytes) in the given volume of blood. It examines different types of white blood cells such as neutrophils, lymphocytes, monocytes, basophils and eosinophils. These cells tell about the status of the immune system and its ability to fight off infections and other conditions like inflammation, allergies, bone marrow disorders etc.

An MPV test measures the average size of the platelets in your blood. Platelets are disk-shaped tiny cells originating from large cells known as megakaryocytes, which are found in the bone marrow. After the platelets are formed, they are released into the blood circulation. Their average life span is 7-10 days. 

Platelets help stop bleeding whenever there is an injury or trauma to a tissue or blood vessel by adhering and accumulating at the injury site, and by releasing chemical compounds that stimulate the gathering of more platelets. After these steps, a loose platelet plug is formed at the site of injury, and this process is known as primary hemostasis. These activated platelets support the coagulation pathway that involves a series of steps including the sequential activation of clotting factors; this process is known as secondary hemostasis. After this, there is a formation of fibrin strands that form a mesh incorporated into and around the platelet plug. This mesh strengthens and stabilizes the blood clot so that it remains in place until the injury heals. After healing, other factors come into play and break the clot down so that it gets removed. In case the platelets are not sufficient in number or are not functioning properly, a stable clot might not form. These unstable clots can result in an increased risk of excessive bleeding. 

The PDW test reflects variability in platelet size, and is considered a marker of platelet function and activation (clot formation in case of an injury). This marker can give you additional information about your platelets and the cause of a high or low platelet count. Larger platelets are usually younger platelets that have been recently released from the bone marrow, while smaller platelets may be older and have been in circulation for a few days. Higher PDW values reflect a larger range of platelet size, which may result from increased activation, destruction and consumption of platelets.

The RDW CV test which is part of red cell indices, helps identify characteristics of red blood cells. RDW (red cell distribution width) measures the variations in the sizes of red blood cells, indicating how much they differ from each other in a blood sample. RDW is expressed as RDW-CV, a coefficient of variation. A higher RDW may suggest more variation in red cell sizes, while a lower RDW indicates more uniform red cell sizes.

The Vitamin B12 test measures the amount of vitamin B12 in your blood. Vitamin B12 is important for a healthy nervous system, making red blood cells, and helping in DNA formation. Low B12 levels are common in older adults, children, vegans or vegetarians, people with diabetes, those who had gastric bypass surgery, breastfeeding women, and people with conditions like Crohn’s disease that affect vitamin absorption. High B12 levels can occur in liver diseases, certain blood disorders, or from taking vitamin supplements. Usually, high levels from supplements are not harmful, as extra B12 is removed through urine.

The Vitamin B9 (Folic Acid) test analyzes the levels of vitamin B9 in the blood. Vitamin B9 is a part of the B complex of vitamins and is an essential nutrient, meaning the body cannot produce it and has to be taken into the diet. Folate is the naturally occurring form of vitamin B9, whereas folic acid refers to a supplement that is added to food and drinks. The deficiency of vitamin B9 (folic acid) can also lead to macrocytic anemia in which the size of the RBCs becomes larger than normal.

The Vitamin D (25-Hydroxy) test measures the levels of vitamin D in the body. Vitamin D is an essential nutrient that can be synthesized in the body upon healthy exposure to sunlight or absorbed from dietary sources. It exists in two forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D2 is present in plants, such as yeast or mushrooms, and is available as a supplement in fortified foods. Vitamin D3 is found in foods like cheese, mushrooms, egg yolks, and fatty fish.

Both forms of vitamin D need to be converted in the liver and kidneys before the body can use them effectively. This test shows the total level of vitamin D (D2 + D3) circulating in the body and guides your doctor in recommending the right treatment or lifestyle changes if needed.