Nails, hair, skin

What’s measured

The package consists of 21 tests. This package of tests may help determine the possible causes of skin, hair, and nail problems.

Above all, you can contribute to the health of your skin, as well as your hair and nails, through regular hygiene. Excessive use or combination of a wide range of cosmetic products or beauty treatments may prevent the skin from breathing, may impair blood circulation, may shorten regeneration intervals, and may have a negative impact on its structure and, thus, health. Similarly, using chemical hair and nail treatments on a regular basis may harm the health of the hair and nails. A varied, balanced diet (in both quantity and quality), adequate exposure to fresh air, and quality sleep, when applied consistently and over time, may represent the basis for the health of your skin, hair, and nails.

Why should these tests be taken?

Prevalence

Skin diseases are on the rise partially due to environmental pollution. This is associated with an increase in acquired immune disorders and some of endocrine disorders (among others, endocrine disruptors in the environment and in food).

Symptoms

The water content and slightly acidic pH of the skin surface layer are important for both barrier function and the normal composition of the skin microbial film. Dry skin (caused, for example, by a poor drinking regimen) can lead to skin sensitization in various ways. The time required to restore the skin barrier function is approximately 4–8 weeks, during which the skin heals slowly and the patient experiences general symptoms (burning, itching).

General manifestations: e.g., burning, itching, soreness, increased sensitivity

Changes in skin appearance: e.g., pallor (e.g., in anaemia), yellow skin and mucous membranes (e.g., in liver and biliary tract diseases), grey skin tone (e.g., in kidney disease), brown skin in a Caucasian person with no history of sunburn (e.g.,), rough and doughy skin (e.g., in thyroid disease).

Changes in skin temperature: e.g., excessively warm skin (e.g., with increased thyroid function), or cool skin (e.g., with decreased thyroid function, in cardiovascular disease due to impaired blood circulation).

Local findings: e.g., skin-level or above-skin-level lesions of variable size, colour, and firmness, scaly and non-scaly findings, fissures, poorly healing wounds, moist lesions, age spots and pigment spots, warts, and skin growths.

Hair, body hair: e.g., changes in the intensity and shape of growth of hirsutism and diffuse alopecia; significant hair loss may occur in the post-covid period (approximately 1 to 12 months after recovery from Covid-19).

Nails: for instance, changes to the surface, shape, and growth rate.

We will now explain in greater detail what will be tested and why:

A blood count ("CBC with diff") determines the number of white and red blood cells, the amount of red blood cell dye (called haemoglobin), the number of platelets, and many other related parameters. It can point to anaemia, dehydration, infection, or immune system disorders, and suspect bleeding disorders and the risk of blood clots, often accompanying chronic inflammation. Nutritional disorders caused by an inappropriate composition of the consumed diet can lead to a lack of important elements and vitamins necessary for blood formation, including the production of white blood cells.

Haemoglobin HbA1c is also called glycated or glycosylated haemoglobin. The level is determined by many factors, most commonly food intake, physical exertion, a Long-term elevated glycated haemoglobin levels high level HbA1c are mainly sign of diabetes mellitus, may explain the increased susceptibility to chronic infections and poorly healing wounds.

ALT (alanine aminotransferase) is an enzyme present inside the cells (in the cytoplasm) of a number of tissues. Not only is it important for the production and degradation of amino acids and the related nitrogen metabolism, but also for glucose metabolism. A derivative of vitamin B6 helps the enzyme function properly. Increased ALT activity follows the impairment of cellular integrity, especially in the liver and red blood cells.

Proteins are among the substances responsible for a huge number of important tasks in the human body: they maintain pH, transmit various substances, inform about nutrients, provide us with immunity, participate in blood clotting, maintain the pressure in the bloodstream, promote chemical reactions through enzymes and other means, and are represented in the genes, for example in chromosomes. Proteins are mainly produced in the liver and eliminated by several organs, such as the kidneys, digestive system, respiratory system, urinary system, and reproductive system.

Interleukin 6 is a pro-inflammatory polypeptide. It has a very short activation time and reliably informs about the inflammatory process even in the early stages. In the human body, it is produced by M1 macrophages during the normal inflammatory response to infection and damage. In metabolic syndrome, M1 macrophages accumulate in adipose tissue (adipose tissue dysfunction) and increase the production of IL-6 and other cytokines, causing structural damage to vascular endothelial cells, consequently their function (dysfunction), and the development of atherosclerosis, which, as an inflammatory disease, is at the origin of many civilization diseases. Skin keratinocytes also produce interleukin 6 when under the effects of stress.

Zinc (Zn) is a trace element that forms part of a large number of enzymes and coenzymes, is involved in the metabolism of sugars, proteins, DNA, RNA, haemoglobin synthesis, and CO2 transport. Plays a role in the life cycle of cells, and supports bone growth, vision, and brain function. Zinc is a strong antioxidant with a significant role in making the immune system and thyroid gland function properly, and it benefits the skin in multiple ways (wound healing, and collagen production). A lack of zinc , may cause reproductive impairment, may cause skin inflammation and hair loss and , may weaken the immune system. ,Excessive zinc amounts may influence the absorption of iron and copper, which may later cause a lack of these elements.

Sodium (Na) and potassium (K) are essential minerals necessary for normal physiological processes in the body. They form a balancing system that controls water management in the tissues and also contributes to proper kidney function. A more significant change in their levels can lead to changes in blood pressure and the occurrence of oedema.

Calcium (Ca) is a mineral and also an essential building block of bones and teeth. It supports the function of enzymes, coagulation, muscle functions (contractions and relaxation), and the release of hormones. The level of calcium together with allow a more comprehensive assessment of its action in metabolism.

Phosphorus (P) is present in the body in both inorganic and organic forms. In cells, it constitutes a component of membranes (phospholipids), present in nucleic acids, DNA, RNA , Phosphorus is associated with the formation and release of energy, and, in the form of hydrogen phosphates and dihydrogen phosphates, it contributes to the maintenance of an appropriate pH of the body's internal environment. Phosphorus metabolism disorders may be related to calcium and magnesium metabolism, and some hormones (especially parathyroid hormone, calcitonin, and vitamin D), intestines, kidneys, and bones are involved in the maintenance of Ca-P-Mg balance.

Magnesium (magnesium, Mg) is a mineral that is related to the metabolism of bones, muscles, intestines, and kidneys, and, together with other minerals, it contributes to the maintenance of the balance of the body's internal environment. It supports the proper functions of a large number of enzymes. The level of magnesium in the blood within the reference range does not rule out its overall deficiency in the body because it is the second most important intracellular cation.

Triacylglycerol and cholesterol levels represent basic indicators of fat metabolism. Their levels depend on first overall functioning of your metabolism and then diet and fysical activity.Cholesterol s a part of almost every body cell and fulfils several irreplaceable functions in the body (e.g., it is a base substance for the formation of several steroid hormones and a building component of cell membranes). It is either exogenous (taken in from outside, through food) or endogenous (produced in the body). The cholesterol pool is divided into several parts, according to its ability to change over time. Increased blood sugar levels, typically seen in patients with diabetes mellitus, may have increased lipid deposition. A certain group of the population may suffer from congenital disorders of triacylglycerols metabolism. When cholesterol or triacylglycerol levels are elevated for a long time, skin formations called xanthomas may be formed.

IgE (immunoglobulin E) is an antibody from the group of so-called reagins. Its levels in the blood are low in a healthy person. IgE distribution in the body is selective; one part is locally bound to the lymph nodes of the respiratory and digestive systems, and the rest is bound to the surface of mast cells (mastocytes) on the mucous membranes and connective tissues. A large number of granules are found in the cytoplasm of mastocytes. When IgE comes into contact with an antigen (allergen), mast cell degranulation occurs and active substances are released, such as histamine, heparin, and serotonin. Increased IgE levels in the blood are reported in cases of allergies and parasitic infections. When immune disorders are suspected, IgE values are assessed comprehensively along with other immunoglobulin groups, subgroups, and the patients' clinical conditions.

Cortisol is a steroid hormone produced mainly in the adrenal cortex. It affects the metabolism of sugars, fats and proteins, has an immunosuppressive effect, and chronic higher levels caused by some disorders may contribute to bone thinning. Cortisol is released into the bloodstream to react to mental or physical stress and thus increases the blood sugar level (sugar as an energy source to cope with stress).

TSH (thyrotropin) is a hormone produced by the cells of the anterior pituitary gland. It affects the metabolism of thyroid cells and stimulates the production and secretion of thyroid hormones. Both types of thyroid function disorders (overactive thyroid – hyperthyroidism, decreased function – hypothyroidism) may be found in some autoimmune inflammatory diseases of the thyroid gland.

Testosterone (TST) is an important representative of androgens, a steroid hormone produced in men in the Leydig cells of the testes and in women in the ovaries and adrenal cortex. It is responsible for the development of primary and secondary sexual characteristics in men, including muscle and bone mass, the way fat is stored, typical male body hair, laryngeal growth (and related voice change), and sperm quality and quantity. With age, its level in the blood decreases. In women, testosterone is converted into the main female sexual hormone, oestradiol. . Clinically, hyperandrogenism in women may manifest as hirsutism, acne, seborrhea, and diffuse alopecia.

Vitamin A (axerophthol) is one of the fat-soluble vitamins. It affects the metabolism of rhodopsin (important in visual processing), influences the differentiation and growth of epithelial cells of the skin, mucous membranes, and haematopoietic cells, is important for the differentiation and maturation of sex cells, and also interferes with the metabolism of lipoproteins, proteins, and nucleic acids. Vitamin A exists in two natural forms - vitamin A1 and vitamin A2. Vitamin A has mild antioxidant properties. The stronger antioxidant is β-carotene, which is a provitamin A (precursor of vitamin A; one molecule of β-carotene produces 2 molecules of vitamin A). The active form of vitamin A is called 11-cis-retinol. The need for vitamin A during pregnancy is defined. Human malformations have also been linked to excessive vitamin A use during the first trimester.

Vitamin E (tocopherol) is one of the fat-soluble vitamins. About 30% of vitamin E is absorbed from the digestive tract. Up to 90 % of the absorbed vitamin E is transported via the ductus thoracicus into the lymph, and the remainder into the blood, where it is transported by LDL, HDL and VLDL. Vitamin E represents a group of tocopherols (alpha, beta, gamma, and delta) with antioxidant effects. When comparing the high-level toxicity among vitamins A, D, and E, vitamin E is among the least toxic.

Vitamin C is one of the water-soluble vitamins. Most animals meet their vitamin C requirements via self-synthesis. Of the foods that contain the highest amounts of vitamin C (in declining order) are peppers, blackcurrants, parsley, broccoli, horseradish, brussels sprouts, and red cabbage. As an antioxidant, it neutralizes free radicals. All organic life is essentially based on enzymatic processes and if it were not for antioxidants, free radicals, a by-product of metabolism, as well as infections and external toxins would cause the metabolism to break down. In times of stress and illness, therefore, there is an strong demand for vitamin C, and herein lies the key to its stabilising effect on the functions of metabolism. Vitamin C can be described as an integral element of metabolism. Vitamin C is thermolabile. An absolute deficiency of vitamin C may lead to scurvy, which is an uncommon disease in our environment given the abundance of a varied diet. However, manifestations of chronic mild vitamin C deficiency are common in the population and should be addressed specifically in selected population groups (women taking oral contraceptives, pregnant women, the elderly, patients on long-term salicylates and corticosteroids. Mild vitamin C deficiency is mainly manifested by increased capillary fragility with petechiae formation, dry skin and mucous membranes, frequent infections, gingivitis, prolonged wound healing and joint disorders.

Vitamin D is one of the fat-soluble vitamins. Since vitamin D is produced in the body and acts through its own receptor, it should be classified as a steroid hormone rather than a vitamin. Since there are very few foods that contain vitamin D, we consider sunlight, which enables production of the vitamin in the skin, to be an invaluable tool in obtaining balanced levels – especially in summer in our climate. In addition to its known effects on bone density and dental health, vitamin D has other positive effects. I. It strengthens the immune system through increasing the so-called cytotoxicity of macrophages and the activity of immune system cells – NK-killer cells.

Instructions before collection

We do not recommend entry of patients/clients with clinical signs of disease (temperature, cough, signs of respiratory tract infection, etc.) to undergo this test.
We recommend hand disinfection prior to entry to the clinics/collection points.

It is advised to fast for a minimum of 8 hours by refraining from eating or drinking anything expect water. Faiing to fast before the test may affect result quality. If you are currently on medications, consult your healtcare provider to determine whether you should continue taking them prior to the test.

PREPARATION FOR BLOOD COLLECTION
The recommended time to collect blood is between 7 a.m. and 9 a.m., to obtain comparable results from different blood draws. To assess the numerical test result, so-called reference intervals are used, which are based on morning fasting collections and are used for population comparison. This time interval is also recommended in light of the biological cycles that naturally take place in the body.

GENERAL PRE-SAMPLING INSTRUCTIONS
• It is necessary to come to the testing site earlier, so that you can rest in the waiting room for approximately 20 minutes to have a relatively relaxed body and mind.
• It is not advisable to draw blood before collection.
• It is necessary to arrive on an empty stomach for the collection itself, in the case of collections at a later time in the day, at least three hours on an empty stomach. At home, it is desirable to drink a sufficient amount of pure water (at least up to half a liter) - this is important for a successful blood collection. Mineral water, juice, coffee and tea are not recommended.
Herbs included in tea may contain substances affecting the blood count. Coffee and black tea increase gastric acid production and release insulin from the pancreas, thereby affecting glucose metabolism. Since everything in the body is interrelated, they can impact other tests. Another extreme is when your body is running out of fluids. In this case, the number of red blood cells, the level of protein and lipids bound to the protein increase and the level of urea in the blood can also increase. It is therefore advisable to drink pure water when you wake up.


Generally, it is recommended to:
• around 6 p.m. eat only light meals, do not eat fatty food (cheese, butter, cream, meat, smoked meat, bacon) and sweet meals,
• fast for 10-12 hours (Attention: it is not advisable to starve for more than 16 hours!), in the case of later collection (after 9:30 a.m.), a lighter breakfast is allowed, no later than 3 hours before collection,
• drink non-alcoholic beverages and drinks without sugar in the usual quantity, in the case of adult clients 24 hours before blood collection (Alcohol in the blood changes lipid levels, the level of glucose is reduced, uric acid levels increase and liver enzymes are released into the blood),
• take only prescribed medicines in the evening,
• avoid increased physical activity, and strength and endurance exercise the day before blood collection (Lipid, glucose, some enzyme levels in the blood and other parameters may change during physical activity. The recovery of normal values to maintain the accuracy of laboratory results may take a longer time, depending on the duration of the exercise, your physical fitness in general and other factors. We recommend maintaining normal daily physical activity such as light stretching, short cycling to work, gardening, etc.),
• avoid psychological stress, which raises blood glucose levels and causes the release of stress hormones in particular,
• avoid smoking for at least 6 hours prior to blood collection because it increases the level of carbonylhemoglobin produced by the reaction of the blood dye with carbon monoxide and alters the permeability and elasticity of the vessels, affecting the ratios of blood analytes,
• do not chew gum for at least 6 hours before blood collection, as this may affect glucose and enzyme levels,
• do not undergo stressful diagnostic or therapeutic interventions for at least 24 hours prior to blood collection.
If any of the tests you have selected require special preparation, you will be informed of the fact by email with the order and blood collection instructions attached. These specific instructions have priority over the general recommendations for preparation.


MEDICINES
It is recommended to have blood collected before the planned doses of medicines. If it is not possible to take the medicine later, you should inform the nurse during blood collection and specify what medication you have taken.
Take the medicines prescribed by your doctor in the morning or bring them with you to take them after blood collection (thyroid medicines, antihypertensive medicines, blood thinners, contraceptives, etc.) In the case of later collection (after 9:30 a.m.), you can take the prescribed medication in the morning.
Do not take iron, vitamin, nutritional supplements or other supplements, including homeopathics, for at least three (3) days prior to blood collection.


SPECIFIC SITUATIONS
In order to obtain the appropriate answers to your questions with regard to the laboratory tests, it is important to accurately notify the nurse at the healthcare provider about the following facts prior to your blood test:
• regularly used medicines and supplements (ideally come with a written list to the blood collection site),
• infectious diseases you suffer from (e.g., HIV, hepatitis, mononucleosis...),
• contact with an infected person or presence in an infectious environment,
• if you have received an infusion within the last 5 days, specify into which limb,
• intramuscular injections within 3 days prior to the blood collection date,
• long-term immobilisation, lost ability to move,
• activities at higher altitudes,
• allergy to common band-aids,
• if you feel unwell when looking at blood or needles, please also notify our blood collection staff of the fact.


OTHER FACTORS
Please note that prolonged use of medication or other important factors may affect the values measured by the tests you have selected. For more information, please see the description of the specific test. To obtain objective test results, take the time to properly prepare for your blood collection.