Check-Up Services

Our blood contains cells that carry oxygen to the tissues, inflammatory cells, and cells related to coagulation. Apart from these cells, many substances such as coagulation proteins, fibrinogen, metabolic wastes, precursors, fats, sugar, hormones, functional proteins, enzymes, minerals, molecules, protection systems of the body, many substances related to connective tissues, tumor markers, and our body fluid are available in our blood.

The amounts of these substances in the blood were determined according to the standard fasting times with previous standardized tests. These determined quantities are expressed as Normal Values.

If the cellular disruption has increased at any part of our body, meaning that tissue is defending itself against a pathological case, the cells of that tissue break down, releasing their components in blood. Hence, the increased amount of certain components show us that there is an abnormal functioning of those tissue cells. 

For instance, the level of a metabolic component in our blood might be lower than expected compared to the normal references. For example, if iron deficiency in the blood might indicate low intake, low absorbtion in the intestines, a bleeding problem or decreased capacity of its transport in blood. 

On the contrary, the level of a metabolic component in our blood might be higher than expected compared to the normal references. This may be due to an overproduction of a certain metabolite due to benign/malign tumor, or an issue with clearance from the kidneys. 

Similarly, some of our cells might increase or decrease in our blood due to various reasons. The distribution and size of our red blood cells (erythrocytes), types of white blood cells (leukocytes) or the distribution of coagulation cells (thrombocytes) give us information about many blood diseases.

In general, the following blood tests are done during the check-up process:

• Whole blood analysis and sedimentation
• Liver function tests
• Kidney function tests
• Parameters of the gallbladder
• Tests on drug use and detoxification functions
• Jaundice (Hepatitis), erythrocyte metabolism
• Blood sugar
• Blood fats (good cholesterol HDL, bad cholesterol, triglyceride, VLDL and total cholesterol, total lipid)
• Blood fats risk index
• Minerals (Calcium, phosphorus, magnesium, zinc, iron, and iron-binding capacity)
• Blood proteins
• Bilirubin panel
• Thyroid functions
• Screening for gout
• Infection and rheumatism determinants
• General tumor determinants
• Prostate tests

Detailed descriptions for each of these tests can be found in the continuation of this article.

Urine is the waste product of the kidney, which has a selective permeability that allows the removal of unwanted residues in our body and the retention of substances that we do not want to be excreted. The kidney has a kind of function that filters and cleanses the blood.

Excess of any substance in the urine indicates that the substance is more than desired in the blood. It means that there is a metabolic disorder associated with this substance. Also, some cell types call attention to problems in the bladder and urinary tract.

Imaging tests show organ pathologies with X-ray and ultrasonic sound waves. You can find details about the tests in the continuation of the article.

Tomography and MRI tests are not included in the routine check-up. These tests are challenging for the patient, are long-term, and cause exposure to unnecessary high-dose radiation and magnetic field effects.

These tests are only performed when the pathological conditions found in other tests and imaging performed within the scope of check-ups are required to be investigated in detail. It is a disturbing and inconvenient procedure that is decided to be carried out as a result of the doctor's evaluation and to be performed routinely for the patient. It is performed only for definitive diagnosis and treatment follow-up of the pathological condition when deemed necessary.

Detailed Descriptions of the Tests Performed as Part of the Check-up

Leukocytes (LEU, WBC, White Blood Cell, White Blood Cell): It is the count of inflammatory cells in the blood. It reveals whether there is an infection (caused by bacteria or virus), allergic or systemic reaction in any part of our body that we are aware of or not. In short, it is a general indicator of whether our body is fighting a disease such as rheumatism, cancer, febrile diseases, autoimmune diseases.

Erythrocyte (Erythrocyte, RBC, Red Blood Cell, Red Blood Cell): It is the count of the cells that carry the oxygen taken from the lungs with the help of the iron it contains to the tissues in the blood and carry the carbon dioxide accumulated in the tissues to the lungs to be expelled.

Thrombocyte (PLT, Platelet): These cells form the blood's coagulation proteins and are responsible for blocking the bleeding. If the amount is low, it means thrombocytopenia (where these cells are being broken down rapidly or made less). Both present the problem of non-stop bleeding. If its amount is high, it means thrombocytosis. Excess production (in cases such as benign or malignant cancer, blood diseases) causes excessive intravascular coagulation. It can result in vascular occlusions.

Hemoglobin (HGB): It is the amount of a protein in the blood responsible for binding iron and oxygen. It is the most critical and first indicator of the body's energy deficiency. 

Hematocrit (HTC): It is the total volume fraction of erythrocyte cells in the blood (PCV=packed cell volume or EVF=Erythrocyte volume fraction). In anemia (anemia), the number of these cells is tried to be increased by the body, and, therefore, this fraction is seen more than usual. In other words, this test is helpful to determine anemia.

MCV (Mean Corpuscular Volume): It is the average size of oxygen-carrying cells. If the MCV is low, the erythrocytes are smaller, and if the MCV is high, they are larger. In iron deficiency anemia, erythrocytes become smaller; therefore, the MCV value is low. In vitamin B12 deficiency anemia, erythrocytes are enlarged, and MCV is high.

MCH (Mean Corpuscular Hemoglobin): While Hb gives the amount of hemoglobin in whole blood, MCH only provides the amount of hemoglobin in the erythrocyte. A low value indicates anemia.

MCHC (Mean Corpuscular Hemoglobin Concentration): It is the ratio of the MCH parameter to the total amount of erythrocytes, independent of the erythrocyte (red blood) volume. It is the amount of hemoglobin by the volume of erythrocytes, regardless of the number of erythrocytes. If there is anemia, it gives an idea about whether the cause is hemoglobin or the number of erythrocytes.

MPV (Mean Platelet Volume): It is the ratio of coagulation cells to all cells. Since young platelets are larger than others, their height indicates blood diseases, which shows that platelet production is accelerated and that there is a problem in producing or destroying coagulation cells in the environment. Its low value, on the other hand, indicates a problem with platelet production in the bone marrow. The platelet count is less than other cells.

PCT (Platelet Crit): It is the percentage of blood platelet cells to other cells. It cannot be evaluated alone. It gives information about platelet functions when evaluated with other parameters in whole blood.

PDW (Platelet Distribution Width): It shows the distribution of platelets according to the density and size of other cells in the blood. This parameter is also evaluated together with other blood parameters to investigate the relationship between coagulation disorders and cell numbers.

P-LCR (Platelet Large Cell Ratio): P-LCR represents the ratio of large platelet cells to normal platelet cells.

NEU (Neutrophil count): Neutrophils are a type of white blood cell that protect our body from infections. Neutrophils protect the organism from the invasion of microorganisms by engulfing them (phagocytosis). If we do not have enough neutrophils, our body cannot fight against bacteria.  A low level of neutrophils increases the risk of many infections. If it is high, it indicates that there is an infection in our body.

NEU% (Percentage of neutrophils): The number of neutrophils according to the general leukocyte count is an indicator of which cells are trying to eliminate the disease.

LYM (Lymphocyte count): Lymphocytes are a type of white blood cell that protect our body from infections. Lymphocytes are a cell type that secretes cytotoxic, that is, cell-killing chemicals. It is especially high in viral infections, leukemias and lymphomas. A low value, on the other hand, suggests post-operative infections. In melanoma and colorectal cancer, they accumulate in the cancer area to kill the cancer cell.

LYM% (Percentage of lymphocytes): The number of lymphocytes according to the general leukocyte count is an indicator of which cells are trying to eliminate the disease.

MON (Monocytes): Monocytes are a type of white blood cell that protect our body from infections. It is the cells that first respond to infections. A high value indicates that an infection has started in an organ or region, and the first immune response has occurred. They then turn into macrophages and eliminate the cause of the infection.

MON% (Percentage of monocytes): The number of monocytes according to the general leukocyte count is an indicator of which cells are trying to eliminate the disease.

BAS (Basophils): Basophils are a type of white blood cell that protect our body from infections. Although it is a type of cell produced in the bone marrow, they are found in many tissues in our body. When you fall and have a wound somewhere or get an infection, your cells that try to heal you are basophils. In addition to fighting infections from parasites, basophils prevent blood clotting and release histamine in allergic reactions. A low basophil value may indicate an allergic reaction. It can make an infection take longer to heal. In some cases, a basophil value that is too high can be caused by certain blood cancers.

BAS% (Percentage of basophils): The number of basophils according to the general leukocyte count is an indicator of which cells are trying to eliminate the disease.

EOS (Eosinophils): Eosinophils are a type of white blood cell that protects our body from infections. While eosinophils help destroy viruses, bacteria, and parasites that settle in our bodies, they also allow us to fight allergic reactions. Eosinophils are increased in allergic reactions and some parasitic infections. They also cause allergic reactions. Eosinophils play an important role in allergies, eczema, and asthma-related inflammations.

EOS% (Percentage of eosinophils): The number of eosinophils according to the general leukocyte count is an indicator of which cells are trying to eliminate the disease.

RDW-SD (Red Blood Cell Distribution Width Standard Deviation): It shows the distribution of red blood cells among other blood cells. Each of the blood cells has different sizes. Erythrocytes are 6-8 microns in diameter. Suppose there is anemia and the reason for this is a folic acid deficiency, B12 deficiency, iron deficiency, or other similar causes. In that case, the diameter of these cells gets larger, and this value becomes high.

RDW-CV (Red Blood Cell Distribution Width Coefficient of Variation): It is a calculation using the RDW-SD offset. It measures the distribution of cells by looking at the ratio of 1 SD to MCV (Mean Corpuscular Volume). It has a similar function to RDW-SD but maybe a better indicator than RDW-SD in conditions such as mild iron deficiency.

IG (Immunoglobulin): It is the measurement of certain immunoglobulins, or antibodies, in the blood. Antibodies are proteins produced by our immune system to fight antigens such as bacteria, viruses, and toxins. The body produces different immunoglobulins to fight different antigens. A high value indicates that the body is fighting an allergy or that the immune system is overactive.

IG% (Percentage of immunoglobulins): The percentage of immunoglobulins is an indicator of which antibodies any allergy is trying to eliminate.

Glucose (blood sugar) is an indicator of diabetes mellitus. It depends on factors such as diet, daily stress, nutrition. If it is high or borderline, it is hyperglycemia, if it is low, it is hypoglycemia. Both situations are related to one's energy needs. It is manifested by diseases characterized by a complete deficiency, insufficient or, on the contrary, excessive secretion of the insulin hormone, which regulates the use of sugar released from the pancreas. If insulin is not secreted or insufficient, it is called Type I diabetes. If it is secreted but still has high blood sugar, it is called insulin resistance, that is, Type II diabetes. Glucose is evaluated by standard fasting for 12-14 hours. If it is high or very low, the doctor asks for further tests and perhaps follows a clinical path to reveal hidden diabetes.

Total lipid: Lipids are fat and fat-like substances that are an essential building block and energy source for cells. The lipid panel measures the total amount of all blood fats. It is important for health that lipids remain at certain levels.

Total Cholesterol: Cholesterol is found in the blood in a protein ball called apoprotein, which also contains other types of fats. They are called differently depending on their cholesterol content and tasks. Since high total cholesterol can cause the risk of blockage of the heart vessels, this value should be below 200mg/dl. For this reason, it should be checked frequently, and its other sub-fractions should be considered with its total.

HDL Cholesterol: HDL (High-Density Lipoprotein) is the molecular structure known as good cholesterol among people and prevents its accumulation in the veins by taking the cholesterol accumulated in the veins into its body and taking it to the liver. Therefore, it is desired to be high.

LDL Cholesterol:  It is called bad cholesterol among people since it causes atherosclerosis (vascular occlusion) due to leaving the cholesterol in the vessel walls during the separation of fats called triglycerides from the molecule called VLDL (Very Low-Density Lipoprotein) made in the liver and transporting them to the tissues. It is desired to be low.

VLDL Cholesterol: It is a molecule made in the liver and contains a high percentage of a fat type called triglycerides. It transforms into LDL while transporting triglyceride from the liver to the tissues as an energy source. VLDL is the first molecule responsible for transporting triglycerides, phospholipids, and cholesterol stored and synthesized in the liver to the tissues in need.

Triglyceride: It is fats that are the body's primary source of energy after sugar. If the body does not need this energy source at the time of receipt, it stores it for later use. The higher the triglyceride in the blood, the more cholesterol the body synthesizes to balance it. Thus, high triglyceride levels become more harmful. Fats burned when doing sports are also triglycerides. Excess calories from food are also stored as triglycerides.

Blood Fats Risk Index: The American Heart Association has conducted statistical studies between death from heart diseases and blood lipids worldwide and expressed the risk of catching heart diseases as a ratio according to the person's blood lipid status. It is a warning that people at high risk should monitor their blood lipids, lifestyle, and diet much more closely than those in low and moderate-risk groups. 

Calcium (Ca++): It is a vital mineral in many parts of the metabolism. Minerals are highly active due to the signaling and transport of many molecules and hormones between and within the cell, the electrical balance of nerve cells, the functioning of muscles, and their involvement in bone and tooth structure. In its deficiency, bone resorption, problems in neural activity, and disruptions in many cellular events are seen. Its deficiency results in osteomalacia. In excess, it causes calcium oxalate stones in the kidney. Therefore, the excess must be excreted in the urine. The ratio of phosphorus and calcium in the blood must be compatible.

Phosphorus (P): Phosphorus is bound to ATP (adenosine triphosphate), the primary energy molecule. Its task is to provide energy by giving the energy it has trapped in its bonds to the environment in every part of the body that needs energy. Phosphorus deficiency causes severe fatigue and disturbances in all metabolic reactions.

Iron (Fe): Iron is the molecule that carries oxygen in the body. It is bound to the erythrocyte's hemoglobin and can bind four molecules of oxygen when we breathe in the lungs. Since oxygen is the body's energy source, iron deficiency causes weakness, and metabolism slows down.

Total Iron-Binding Capacity (TIBC): Iron absorbed from the intestine cannot enter hemoglobin immediately. First, it binds to a protein called transferrin and is transported in this way until it is included in the structure of hemoglobin. If iron is low in the blood, the amount of this protein rises to bind more iron. If iron is normal or high in the blood, it falls. Its task is to maintain the level of iron in the blood. Its deficiency causes anemia, and it is thought that there is a defect in producing this protein.

Unsaturated Iron-Binding Capacity (UIBC): It indicates the remaining capacity to bind more iron in the blood. It is the expression of iron-binding capacity as saturation. It shows how many percent of transferrin, the iron-binding protein, is saturated with iron content. It should be evaluated together with the binding capacity of iron and the amount of iron.

Magnesium (Mg): Along with other minerals, it regulates nerve stimulation and muscle contractions. It also converts many enzymes involved in energy metabolism into active forms. It is found in erythrocytes in the blood. It plays a role in the energy metabolism of the cell. It is an activator of many enzymes. Without magnesium, there will be no metabolic reaction performed by this enzyme. Hypomagnesemia (magnesium deficiency) is seen in renal failure, diabetic coma, hypothyroidism, and Addison's disease. Hypermagnesemia (magnesium excess) is experienced in digestive system diseases, kidney, hormonal and metabolic diseases, and pancreatitis.

Zinc (Zn): Zinc is a mineral that takes part in many functions in the body. Protein synthesis is vital for growth and sexual development, as well as for the immune system. It performs crucial roles in situations where the body needs to heal itself and regenerate and in mental functions. It prevents premature aging of the skin and muscles. Supporting cell regeneration beautifies the skin, strengthens nails, and prevents hair loss. In zinc deficiency, the immune system weakens, and symptoms such as exhaustion, delayed healing of wounds, weakening and shedding hair are observed. In addition, growth retardation, loss of appetite, and learning and attention deficit can be observed. Moreover, zinc deficiency causes sexual growth retardation in children and low sperm count in adults. Whitening of nails is one of the symptoms of zinc deficiency. Loss of nutritional value due to improper cooking, alcohol, and stress are the main factors causing zinc deficiency. Zinc excess can cause problems such as nausea, vomiting, diarrhea, restlessness, sweating, tremble, and cholesterol imbalance. In addition, it causes weakening of the immune system and tumor formation in excessive use.

Total Protein: It is the sum of proteins in the blood. A large part of the proteins is generated in the liver cells. These proteins are immune system proteins (antibodies), metal-binding proteins, hormones and hormone-binding proteins, enzymes, proteins that regulate the body's osmotic pressure balance, and the like. Its deficiencies indicate liver failure, and its excesses indicate that one or more specific proteins in the blood are pathologically high, and the cause should be investigated.

Albumin: It makes up most of the total proteins in the blood. It is generated in the liver. Its most important task is to prevent fluid flow out of the vessel by maintaining the blood pressure inside the vessel (oncotic pressure). In other words, it provides a balance between blood and tissue fluids. It is the primary protein of body secretions (such as saliva, tears, bile secretion). Moreover, some molecules are carried by albumin in the blood. Fatty acids and steroid hormones are some examples of these. In its deficiency, the transport of these substances and the balance of body fluids are disturbed. Edema occurs.

Globulin: It is a group of proteins belonging to the body's defense system. It is also called immunoglobulins. If the body is fighting a disease for some reason, the globulin fraction generally increases. According to the type of the disease, the clinic is directed to investigate its subtypes. In case of an increase, detailed studies are carried out for cancer diseases, autoimmune diseases, infectious diseases and allergic reactions.

Total Bilirubin:  This protein, which is responsible for the transport of oxygen in the red blood cells (erythrocyte, red blood cell), passes into the blood when the life of the erythrocyte is depleted and broken down. It is converted to the form to be excreted in the urine in the liver and excreted. In liver failure, the amount of it in the blood rises. In addition, in the case of lysis of erythrocytes more than usual, which also causes some erythrocyte diseases (such as anemias and similar disorders), it increases in the blood. Its amount is also high in diseases that affect the liver, such as hepatitis (jaundice).

Direct Bilirubin: It is the form of total bilirubin that is excreted in the urine by changing its structure in the liver. This parameter is an indicator that the liver is able to perform the excretion process adequately. In other words, if there is an increase in bilirubin, but the direct bilirubin is normal, this indicates that the increase is due to blood disease, not the liver disease. It is the type of bilirubin seen in the urine. It is increased in the blood when there is an obstruction in the bile ducts or other gallbladder diseases.

Indirect Bilirubin: It is the part of total bilirubin that has not yet reached the liver after the erythrocytes have been broken down and have not been made ready to be excreted in the urine in the liver. This parameter indicates whether the liver is able to adequately absorb the bilirubin and completely excrete it in the urine. For this reason, when evaluated with total bilirubin to understand a deficiency in the liver, it provides information about the cause of bilirubin increase.

ALT (Alanine Transaminase, SGPT): It is an enzyme related to protein metabolism found in the liver, heart, and, less specifically, in other organs. However, since it is mainly found in the liver cell membrane, it is the first enzyme that provides a response and therefore gives the first information in case the liver cell is worn out by any disease factor.

AST (Aspartate Transaminase, SGOT): It is an enzyme related to protein metabolism found in the liver, heart, and, less specifically, in other organs. However, since it is mainly found in the liver cells, if the liver is fighting viruses, diseases, or toxic substances, the wear of the cells increases when the liver gets tired, and this substance rises in the blood. When it decreases, the liver's ability to produce this enzyme becomes exhausted.

GGT (Gamma Glutamyl Transferase): It is the enzyme that has the task of detoxification (detoxication) between the liver and bile ducts. It is responsible for removing any chemicals, alcohol, drugs, or toxic metabolic wastes from the liver through the bile and excreting them through the urinary tract. If it is high, it is understood that there are metabolic problems in the liver and that the person is in touch with toxic substances. Excessive consumption of alcohol, caffeine, drugs, and similar substances also causes an increase in this enzyme.

ALP (Alkaline Phosphatase): It is an enzyme found in the bile ducts and gallbladder. While any dysfunction in the liver increases the activity of this enzyme, gallbladder diseases and obstructions in the bile ducts for various reasons also increase this enzyme.

HBsAg (Hepatitis B Virus Antigen): Hepatitis B is a virus that wears down the liver too much compared to other types of hepatitis, is very difficult to treat, and has a lasting effect. It is effortless to transmit, and the virus can be easily removed from an active person through blood and blood products. It can be transmitted by various factors such as hairdressers and barber salons, manicure procedures, injectors, and sexual intercourse. In other words, it is possible to be transmitted in any way that comes into contact with the blood of someone with hepatitis B virus and causes it to mix with one's own blood. Hepatitis B is protected by the immune system, sometimes without being felt by the person. Therefore, there are many people in the community who have the DNA of this virus as carriers, even if they are not active. Therefore, getting the virus is a very close possibility. For this reason, every individual should take this test in order not to harm their environment and themselves.

Urea: It is the final product of protein breakdown. It is excreted through the urine. It is toxic when it is high in the blood. If there is a problem in the kidneys that will prevent urea excretion, it rises in the blood. Its increase indicates that the production and destruction of any protein in the body has increased enough to exceed the excretion capacity of the kidney or the presence of a problem such as kidney inflammation (glomerulonephritis), tumor, kidney stone that prevents the kidney from excretion of urea. Urea increase should be intervened immediately.

BUN (Blood Urea Nitrogen): It is the expression of the height of urea in the blood as nitrogen on the urea molecule. Some clinics and clinicians use this test as a different reference in diagnosis and treatment.

Creatinine: It is a protein synthesized in the kidneys, liver, and pancreas. Its task is to provide phosphorus to the muscles during energy synthesis, which is the body's source of life, by keeping phosphorus bound. Once energy is obtained, it is reused to bind new phosphorus molecules. The daily excretion of creatinine in the kidney is about 2 g/day. The rest is kept. Creatinine is an important end product of muscle metabolism and is excreted from the kidneys with urine. If kidney function is impaired, this excretion slows down, and creatinine rises in the blood. There is no clinical significance if the creatinine level is lower than normal. If creatinine is high in the blood, it is necessary to re-conduct the test with creatinine in the urine for 24 hours to understand kidney function. This test is called creatinine clearance.

Uric Acid: Uric acid is the product of the destruction of ATP, the body's energy-providing molecule, and DNA fragments in cells that have lost their lives. When these breakdowns increase, uric acid rises in the blood. If it cannot be excreted by the kidney for any reason, it crystallizes by accumulating in the joint fluids and surrounding tissues since it has acid properties. It causes gout. Consuming foods containing uric acid and young animal meat in particular increases the level of uric acid in the blood. 

Urine Analysis: Urine can be defined as a filtrate produced by the kidneys, which acts as the sieve system of the blood. While the metabolic residues (toxins) in the body are thrown out with the help of water, some molecules, minerals, and vitamins that are not wanted to be removed are separated and kept. Their excretion in the urine is directly related to their blood values. When these substances rise above a specific value in the blood, the kidney's filtering capacity becomes insufficient, and the filtering tubes (glomeruli) are blocked. Seeing these obstruction-causing substances in the urine with a microscope indicates that the kidney tubules have begun to be damaged. Although a substance that rises above a specific rate in the blood is excreted from the kidney, there is a speed and capacity at which each substance can be excreted. This is called the threshold value of the kidney for this substance. For instance, this is 180 mg/dl for glucose. In other words, when glucose rises above 180 mg/dl in the blood, abnormal glucose begins to appear, and abnormal glucose values are observed in the urine. It is also acceptable for urobilinogen, which is the bile form of bilirubin in the urine, and bilirubin and albumin (protein), which are its different forms in the blood. During prolonged hunger or pregnancy, when the baby uses sugar, the body tries to obtain its energy from fats. And consequently, ketone bodies (acetone in the urine) are formed in the blood, which is acidic and toxic. It should not be too high in the blood. The appearance of it in the urine indicates that this level has increased.

If there is a bacterial infection in the urinary tract or bladder, it is detected by nitrite produced from bacteria. The color and density of the urine may alter due to the substances excreted in the urine and the presence of more or less water in the body. For instance, if there is the protein in the urine, the urine becomes a cloudy and dense liquid. If there is bilirubin in the urine, the color of urine becomes dark yellow. Also, the color of urine becomes dark yellow when taking vitamins A and B. The presence of sugar, albumin, and other metabolites in the urine thickens the urine.

The shaped elements (cells and crystals) in the urine settle to the bottom when centrifuged (swirled rapidly at 5000 rpm) in the tube. This precipitation is examined under a microscope. Based on the structures of the cells, it can be reported whether there is a blockage in the kidney tubulins, inflammation and bleeding in the bladder and urinary tract, and damage in the urinary tract and bladder. Certain shaped elements in the urine, which should be in an above-normal number of cells or not, indicate certain diseases.

Sedimentation: It shows the difference in density between the liquid part of the blood with cells and other substances. If any cell or molecule (sugar, fats, proteins, defense systems, etc.) rises in the blood, the density of the blood increases, and the blood elements rapidly collapse according to the ratio of these elements. The higher this precipitation is at a specific time, it is understood that one or more substances above normal are found incorrectly in the blood. More detailed research is required to find this substance. It is the first sign of disease (infection, cancer, autoimmune diseases, febrile illnesses, etc.)

ASO (Antistreptolysin Antibody): Streptolysin is the name of the toxin secreted by bacteria called "Hemolytic streptococcus." An examination to determine the presence of this toxin is called ASO. ASO is elevated in some Hemolytic Streptococcal infections such as rheumatism. Therefore, ASO values are important in diagnosis. An ASO above 300 indicates that the patient is carrying bacteria called streptococcus. A Group A streptococcal infection causes these values to increase, especially if there is an infection focus such as tonsillitis or dental abscess since these areas are not cleaned after an acute infection attack and continue to contain streptococci for anatomical reasons. ASO rises approximately 1-3 weeks after exposure to streptococcus. Sometimes it can stay as high as six months or even one year. It may increase in joint, kidney, or heart diseases. However, the high level of ASO does not indicate that these diseases exist for sure. It only shows that the streptococcal bacterium has entered the body.

CRP (C-Reactive Protein): C-reactive protein, commonly used abbreviation CRP, is one of the proteins called acute phase reactants, the amount of which increases in the blood during inflammatory reactions and is produced by the liver and fat cells. High CRP levels indicate an acute inflammatory reaction or infection in the body, and decreased levels of CRP indicate that the inflammatory reaction or infection has begun to fall.

RF (Rheumatoid Factor): It is a blood test that shows rheumatoid factor antibodies in the patient. Usually, antibodies are substances produced by the body's immune system that defend against bacteria and viruses that cause disease. RF antibody, on the other hand, causes damage by attaching to normal body tissue and is found to be elevated in 80% of patients with rheumatoid arthritis.

CEA (Carcinoembryonic Antigen): Tumor Marker is a special protein that is released from the tumor cell and belongs only to the structure of that tumor. Although there are proteins in the blood that have a similar reaction under ordinary conditions, a tumor marker can be elevated in the blood, often specific to benign or malignant cancer tissue. CEA is a group of glycoproteins that allow cells to stick together (for recognition). Healthy people have very small amounts in their blood. However, due to increased cell proliferation in various types of cancer, it rises in the blood due to tumor formation and tissue thickening (hyperplasia). CEA is also elevated in heavy smokers. It can be elevated in all types of cancer; however, it reaches its highest value in colon cancer. Tumor markers are very diverse. However, since CEA rises in all cancer types, it is a good screening indicator to draw attention to cancer.

Tumor markers specific to women:

• CA 125: Benign or malignant tumor marker that can be elevated in the ovarian, endometrial, and fallopian cancer tubes
• CA 15-3: The type of marker that can be elevated, especially in breast cancers
• CA 19-9: The type of marker that can be elevated, especially in ovarian and gastrointestinal system cancers.

Tumor markers specific to men:

• PSA (Prostate-Specific Antigen): It increases in the blood as a determinant in the enlargement of the prostate gland, benign or malignant prostate tumors. When it is high in the blood, the subject should be investigated by a urology specialist, and it should be determined whether there is cancer with tests such as fPSA and biopsy.

Ultrasonography: Ultrasonography is the imaging of organs with the help of sound waves sent to the tissue, their impact, reflection, and received signals in the tissue. It is based on examining and reporting abnormal shapes (tumors, wall thicknesses, cysts) by a radiologist. The pathological images seen are evaluated, and after the general evaluation, the person is directed to the relevant specialist doctor.

• Thyroid ultrasonography: It is the imaging of the structure, size, and masses of the thyroid glands (benign or malignant tumors, simple cysts, etc.) with ultrasonographic sound waves.
• Pelvic ultrasonography:  It is the ultrasonographic examination of the prostate, seminal vesicles, and urinary bladder.
• Upper abdominal ultrasonography: It is the ultrasonographic examination of the liver, gall bladder, both kidneys, spleen, and pancreas.
• Breast ultrasound (only in women): It is the examination of breast masses with the help of ultrasonic sound waves.

Electrocardiography (ECG): The rhythmic movements and contractions that occur as the heart pumps blood in and out are examined. These contractions are displayed by electrical changes in the muscles. Information about heart function is obtained by detecting images that deviate from the rhythmic pattern in the contraction and relaxation pattern.

Echocardiography: The cardiologist reports the ultrasonography of the heart in terms of the flow of clean and dirty blood, the movement and efficiency of the heart muscles, the function and physiological structure of the heart valves, the flow, and pumping speed of the blood. This test examines the anatomy, physiology, and related problems of the heart. If necessary, the pathologies can go to further examinations and treatments with the guidance of a cardiologist, and the possible risk of heart diseases is detected early, and precautions are taken.

Chest X-Ray: It is to view the findings such as infection, thickness, alveolar image blurring, cancer risk in the lung with low-dose x-rays. It is reported by a radiologist. If a suspicious image is found, the person is directed to the relevant doctor by the internist. Challenging procedures such as further tomography, MRI, biopsy are requested, and a definitive diagnosis is made. The greatest risk today is lung cancer. Since lung cancer develops insidiously and quickly, this procedure should be carried out often.

Imaging examinations specific to women:

• Breast ultrasound: It is the examination of breast masses with the help of ultrasonic sound waves.
• Mammography: It is the examination of the breast in terms of cysts with the help of low-dose x-rays, with a different beam than sound waves. In this way, breast cancer can be diagnosed even two years before tumor formation.
• Bone Density (40 years and older):It is the examination of bone density by giving low-dose x-rays. As a result of this process, analysis is made according to specific density criteria. The weakening of the bone tissue, which the person does not realize until the fracture stage, is determined and reported as the T Score. After the treatment is done by the relevant specialist, the preservation of bone density can be achieved.
  • Lumbar: It is an indicator of regeneration destruction and deformation of lumbar vertebra bone cells.
  • Hip: It is the regeneration and destruction of hip bone cells.

TSH (Thyroid Stimulating Hormone): T3 and T4 hormones are secretory hormones of the thyroid gland. However, the release of these hormones is stimulated or slowed down by TSH, a regulatory hormone from the pituitary gland. Depending on the adequacy or excess of thyroid hormones in the blood, it rises and forces the thyroid gland to secrete more hormones, or it falls, preventing the thyroid gland from secreting more hormones. When it rises, it should be mutually evaluated with the state of other hormones.

FT3 (Free T3, Free T3): T3 (Triiodothyronine) is a hormone secreted by the thyroid glands. Together with the hormone T4 (Tetraiodothyroxine), it regulates many metabolic functions of the body, such as binding proteins, other proteins, enzymes, mineral and vitamin metabolism, hormonal signals, growth. After the T3 hormone is secreted from the thyroid gland, it is separated from the albumin it binds to and returns to its free state, which is active in the blood. Therefore, it is more accurate to test its active state. Its deficiency is hypothyroidism, its excess is hyperthyroidism. Hypothyroid patients are sluggish, overweight, and have a slow metabolism. Hyperthyroid patients, on the other hand, cannot gain weight; they sweat, are irritable, and are hypertensive. Thyroid disease can be seen genetically; however, there are also immunological types related to toxic and iodine intake. If it is noticed and treated without the occurrence of apparent symptoms, a life without problem can be maintained with treatment.

FT4 (Free T4, Free T4): Like T3, it is a hormone secreted by the thyroid glands. Together with the T3 hormone, it regulates many metabolic functions of the body, such as binding proteins, other proteins, enzymes, mineral and vitamin metabolism, hormonal signals, growth. After the T4 hormone is secreted from the thyroid gland, it is separated from the albumin it binds to and returns to its free state, which is active in the blood. Therefore, it is more accurate to test its active state. Its deficiency is hypothyroidism, its excess is hyperthyroidism. Hypothyroid patients are sluggish, overweight, and have a slow metabolism. Hyperthyroid patients, on the other hand, cannot gain weight; they sweat, are irritable, and are hypertensive. Thyroid disease can be seen genetically; however, there are also immunological types related to toxic and iodine intake. If it is noticed and treated without the occurrence of apparent symptoms, a life without problem can be maintained with treatment.