Women's preventive care 40+

What’s measured

The “Women's preventive care 40+” laboratory testing package consists of 25 parameters and it is primarily intended for women over the age of 40. During this period, also known as perimenopause, women begin to exhibit the first symptoms caused by fluctuating levels of sex hormones. Despite the changes occurring, a woman can still get pregnant at this age. That is why this examination set expands the “Women's preventive care 30+” package by including selected hormone profile tests.

Prevention is one of the most important steps in taking care of one’s own health. It lies mainly in looking for risks associated with diseases and in maintaining a balanced health condition.

Parameters:

ALT

This acronym stands for Alanine Aminotransferase, which is an enzyme present in the cytoplasm of cells of certain tissues. It is crucial in the formation and breakdown of amino acids, while also playing a role in nitrogen and glucose metabolism. Increased ALT activity occurs when the integrity of cells, particularly liver cells, is compromised. As a laboratory marker, it is used in preventive screening to identify liver diseases, which occur in instances such as taking certain medications, suffering from infectious diseases, or poisoning.

Glucose

Glucose, commonly referred to as blood sugar, is a simple carbohydrate serving as the main source of energy for cells. In diabetes, glucose cannot enter the cells and the blood glucose level rises in response.

Ferritin

Ferritin is a storage protein that contains iron, mainly found in the liver, spleen, bone marrow, and intestinal mucosa. Its blood level indicates the status of iron reserves in the body. Additionally, ferritin is one of the acute phase reactants, substances the blood levels of which increase during the acute phase of inflammation.

Blood count with differential

This test can detect anaemia and the resulting impaired oxygen supply to tissues. In addition, it can rule out the risk of infection or immune system disorders, suspected blood clotting disorders, or the potential risk of blood clot formation. A blood count examination also includes a differential blood count.

Creatinine

Creatinine is a nitrogenous compound produced by the breakdown of a substance called creatine, which supplies the energy necessary for muscle contraction. It is primarily synthesised in the liver. Creatinine is excreted exclusively by the kidneys. The test measuring the level of creatinine in the blood along with glomerular filtration rate calculation therefore allow for the detection of kidney function disorders.

Uric acid

Uric acid (UA) is a nitrogenous substance formed as the end product of purine metabolism in humans. UA is a potent antioxidant (capturing free oxygen radicals) and is one of the parameters of metabolic syndrome. When its level increases in the body, it can get deposited in the form of crystals in the tissues, as it is characterised by poor water solubility.

TSH – thyroid-stimulating hormone

TSH (thyrotropin, thyroid-stimulating hormone) is a hormone produced by the cells of the anterior lobe of the pituitary gland. It affects the metabolism of thyroid cells and stimulates the production and secretion of thyroid hormones, especially thyroxine (T4) and triiodothyronine (T3).

Vitamin D

Vitamin D is a critically important fat-soluble vitamin, essential for the proper functioning of numerous metabolic processes in the body, including the proper growth and development of bones and teeth. There are two basic forms of vitamin D: vitamin D3 (cholecalciferol), which is produced in the skin following sunlight exposure and can be obtained in small amounts from animal food sources, and vitamin D2 (ergocalciferol), which comes from plant foods and is part of most vitamin supplements.

Chemical urinalysis

The basic chemical urinalysis includes a pH examination and a urine specific gravity test, along with the qualitative evidence for the presence of protein, glucose/sugar, ketone bodies, bilirubin, urobilinogen, nitrites, haemoglobin, and leukocytes. It is primarily intended for the assessment of kidney function, as well as the functioning of other organs.

Urine sediment

Urine sediment provides an overview of cellular components, i.e. erythrocytes (red blood cells), leukocytes (white blood cells), epithelial cells that line the urethra and bladder, inorganic components including crystals, and the organic presence of microorganisms.

fT4

Free T4 (fT4) is a physiologically active form of the hormone called thyroxine, which is produced by the thyroid gland. Thyroxine is one of the main hormones produced by the thyroid gland and represents a natural part of its regulatory system. It affects the overall metabolism of the body, while also serving as a prohormone for triiodothyronine (T3). Since it predominantly binds to proteins in the bloodstream, it is preferable to determine its free fraction (fT4) over the total T4, as the level of fT4 is unaffected by proteins and reflects the actual state of the thyroid gland.

Magnesium

Magnesium (Mg) is one of the main minerals in the body. It is involved in the functioning of numerous enzymes, plays a part in bone and muscle metabolism as well as intestinal and renal metabolism, and takes part in maintaining the balance of the internal environment.

HDL cholesterol

HDL cholesterol is a high-density lipoprotein and is referred to as the so-called good cholesterol. Keeping its levels within the reference range contributes to the reduction in the risk of vascular disease. Its most important function is removing excess cholesterol from tissue cells and blood vessels and transporting it to the liver, thereby maintaining the optimal amount of cholesterol and reducing the risk of cardiovascular disease.

Cholesterol

The levels of triglycerides and cholesterol (total, HDL, and LDL) are the primary indicators of lipid metabolism. Their level depends mainly on the metabolic function as a whole, but also on dietary intake and physical activity.

Lipase

Lipase is an important enzyme that is useful for diagnosing and monitoring inflammation of the pancreas (pancreatitis) and other pancreatic diseases.

Triglycerides

Triglycerides (TGs) are simple lipids which the body gets from food along with cholesterol. They function as the primary indicators of lipid metabolism and their level depends mainly on the metabolic function as a whole, but also on the food and alcohol intake and the level of physical activity.

Calcium

Calcium (Ca) is one of the most important minerals in the body. It is involved in the functioning of numerous enzymes and muscles, contributes to blood clotting and the production and secretion of hormones, and is also the primary building block of bones and teeth.

LDL cholesterol

LDL cholesterol is a low-density lipoprotein referred to as the so-called bad cholesterol. The small, dense LDL particles (sd-LDL) play a key role in the development and progression of atherosclerosis. They form in the liver as VLDL, where they get converted following the delivery of triglycerides, and apolipoprotein B-100 binds to their surface. The main function of LDL is to transport cholesterol into cells, where it is utilised in the building of tissue cell membranes and in the metabolism of hormones.

Oestradiol

Oestradiol is the main female sex hormone produced in the ovaries. This hormone is important for the proper course of the menstrual cycle and pregnancy, being produced by the placenta in the latter. During menopause, it is produced in small quantities by the adrenal cortex, and with the decrease in its blood levels, its physiological preventive function against osteoporosis and cardiovascular disease is also diminished.

Potassium

Potassium is an important cation found inside cells. It plays an irreplaceable role in cellular metabolism; together with sodium and chlorides, it maintains intracellular osmotic pressure and acid-base balance, and regulates muscle and nerve function. Its imbalance causes heart rhythm disturbances and general fatigue.

FSH – Follicle-stimulating hormone

FSH (Follicle-stimulating hormone) is produced in the anterior lobe of the pituitary gland. It stimulates the growth and maturation of ovarian follicles in women. At menopause, ovarian function ceases and FSH levels subsequently increase.

HbA1c

HbA1c stands for glycated haemoglobin, which provides indirect information about the average blood sugar level (glycaemia) over the last 2-3 months.

Sodium

Sodium is the most abundant mineral in the human body. Together with other electrolytes, it ensures normal cellular function and regulates the amount of water in the body. Its blood level assessment is also used when dealing with non-specific health problems such as dehydration or oedemas.

Chlorides

Chlorides (Cl) are the main anions and together with sodium and potassium are classified as electrolytes. They are involved in maintaining a constant internal environment, including osmotic pressure or acid-base balance.

LH – Luteinising hormone

LH (Luteinising hormone) is produced in the cells of the anterior lobe of the pituitary gland. In women, it stimulates the synthesis of steroid sex hormones in the ovaries. During menopause, when the ovaries stop functioning, its serum level increases.

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.

PREPARATION FOR URINALYSIS

If you have chosen a chemical analysis of urine and urine sediment based on the first morning urine sample, do not forget to obtain a collection tube, either at the pharmacy or at any of our sampling points. If urine culture is tested, this tube must be sterile.
 

INSTRUCTIONS TO FOLLOW
It is recommended to follow the standard drinking regime prior to urine collection, to avoid coffee and alcohol (in the case of adult clients) that are diuretic and could dilute the urine as a result of its increased production. 24 hours prior to urine collection, sexual intercourse is not appropriate because the number of cellular particles and protein in the urine will increase.
Girls and women undergo this test outside their menstrual cycle, it is not recommended to collect urine samples 3 days before or 3 days after the cycle, when red blood cells that are not produced in the urinary tract may be present. The results can be evaluated as false positives.
 

HYGIENE
Immediately before the urine collection, it is important to thoroughly clean the genitourinary tract so that urine is not contaminated with mucus, bacteria or soap. When urinating, women and girls will separate their labia and wash their external genital organs with lukewarm water. Men and boys will pull back their foreskin and wash their penis. Your hands must be clean when doing so.
 

PROCEDURE
The medium (released after one third of the urine has been emptied) morning urine should be collected. Allow the first part of the urine to end in the toilet to ensure that bacteria from the outer urinary tract have been removed and cells peeled from the urethral meatus have been eliminated. The second (medium) part of the urine shows the actual state of the urinary tract. Urine should be collected directly into a 10 ml collection tube. The remaining urine is drained back into the toilet. Close the tube tightly and rinse with water. Carefully close with the test tube cap. Do not touch the bottom of the cap with your hands, and do not place its inner side on washbasins or bathtubs. Hold the cap of the test tube only around its outer perimeter to prevent any contamination of the collected urine by bacteria on your hands or furniture. Do not pour the urine from other containers, as it may get contaminated by bacteria or fibres attached to such containers. Always collect urine samples directly into the tube.
 

STORAGE AND TRANSPORT
The sample should be delivered for analysis within 4 hours after its collection and should be maintained at 4-8 °C to avoid the decomposition of cellular elements in the urine or the bacterial proliferation at higher temperatures. Biochemical quantitative urine assay A sample of spontaneous urination is collected for examination. A urine collection tube should be prepared in the evening before the test date. If you do not have an original urine collection tube, a 3dcl jar is sufficient. The jar must be clean, rinsed with boiling water and left to dry. Collect all of the urine in the jar after performing morning genitourinary tract hygiene, then pour approximately 10 ml of urine into the collection tube. You will obtain a mixed representative sample needed to determine creatinine, total protein, albumin levels or urine electrophoresis.
One common, clean urine collection tube, usually with a yellow cap, is sufficient for the chemical analysis of urine and urinary sediment. For culture testing, urine should be collected in a sterile tube, usually with a red cap. The use of empty bottles and other household urine collection containers is not appropriate due to the presence of bacteria and other components. One common, clean urine collection tube, usually with a yellow cap, is required for a quantitative biochemical assay. Proper preparation prior to the urine collection is a must for a correct result. A correct result is one of the conditions to reach the correct diagnosis.
 

SPECIFIC SITUATIONS
In order to obtain relevant answers to your questions through laboratory tests, it is important to accurately inform about the following facts before your blood test:
•    regularly used medicines and supplements (ideally present a written list right before the blood test)
•    infectious diseases you suffer from (HIV, hepatitis, mononucleosis...)
•    contact with an infected person or presence in an infectious environment