Laboratory Packages — Recommendations & Rationale

Structured by age, sex, and risk profile; aligned with available test menu and senior doctors' recommendations.

View the Complete List of Tests
Order Other Tests
How to read: Each card shows a two-column layout — Recommended Tests (left) and Rationale & Add/Drop considerations (right). Local test codes (when available) appear in monospace and map to your orderable items :contentReference[oaicite:2]{index=2}. Dr. Berry’s core annual set is incorporated across adult panels :contentReference[oaicite:3]{index=3}.

Children & Adolescents (0–18 years)

Use clinical judgment; consider local epidemiology for parasites, hepatitis, TB.

Routine / Well Child

Baseline screening for generally healthy children

Recommended tests

  • CBC with differential (1001, 1007, 1008, 1009, 1010, 1011, 1012) :contentReference[oaicite:4]{index=4}
  • Urinalysis (complete) (4101) :contentReference[oaicite:5]{index=5}
  • Stool exam (complete) (4501) — if symptoms/risk :contentReference[oaicite:6]{index=6}
  • ESR (1012) — if inflammatory symptoms :contentReference[oaicite:7]{index=7}
  • Vitamin D 25-OH (send-out if not listed) :contentReference[oaicite:8]{index=8}
  • Ferritin (add if available) :contentReference[oaicite:9]{index=9}

Rationale & considerations

  • CBC screens anemia, infection patterns; differential adds diagnostic granularity :contentReference[oaicite:10]{index=10}.
  • Urinalysis detects occult hematuria, protein, ketones, infection :contentReference[oaicite:11]{index=11}.
  • Stool exam tailored to GI symptoms and parasite exposure :contentReference[oaicite:12]{index=12}.
  • Vitamin D deficiency prevalent; supplement testing by risk/season :contentReference[oaicite:13]{index=13}.
  • Add CRP (quant/qual) for inflammatory concerns (2702/2718) :contentReference[oaicite:14]{index=14}; drop ESR if asymptomatic.
Risk Add-Ons

Overweight/Obesity, Pubertal issues, Recurrent infections

Recommended tests

  • Fasting glucose / RBS / 2-h PP (3301/3304/3302) :contentReference[oaicite:15]{index=15}; HbA1c :contentReference[oaicite:16]{index=16}
  • TSH ± Free T4/T3 (2608, 2605, 2603) :contentReference[oaicite:17]{index=17}:contentReference[oaicite:18]{index=18}
  • CRP (qual/quant) (2702/2718), ESR (1012) :contentReference[oaicite:19]{index=19}:contentReference[oaicite:20]{index=20}
  • Ferritin, Vitamin D :contentReference[oaicite:21]{index=21}

Rationale & considerations

  • Metabolic screen for pediatric insulin resistance/early dysglycemia :contentReference[oaicite:22]{index=22}.
  • Thyroid axis in growth/puberty disorders :contentReference[oaicite:23]{index=23}:contentReference[oaicite:24]{index=24}.
  • Inflammatory markers when recurrent infections/autoimmune suspicion.
  • Add lipid profile if obesity or FHx (3401–3404) :contentReference[oaicite:25]{index=25}.

Young Adults (19–39 years)

Basic Health Panel

Annual wellness with Dr. Berry core items

Recommended tests

  • CBC with differential :contentReference[oaicite:26]{index=26} (1001, 1007, 1008, 1009) :contentReference[oaicite:27]{index=27}
  • CMP (liver/renal/electrolytes) — map to:
    • Liver: AST/ALT/GGT/ALP/Bilirubin (3106,3107,3108,3109,3104/3105) :contentReference[oaicite:28]{index=28}
    • Renal: Urea/Creatinine/Uric Acid (3201,3202,3205) :contentReference[oaicite:29]{index=29}
    • Electrolytes: Na/K/Cl/Ca/Phos/Mg (3601–3605,3607) :contentReference[oaicite:30]{index=30}
  • HbA1c; Fasting glucose/RBS/2-h PP (3301/3304/3302) :contentReference[oaicite:31]{index=31}:contentReference[oaicite:32]{index=32}
  • Lipid profile (3401–3404) :contentReference[oaicite:33]{index=33}:contentReference[oaicite:34]{index=34}
  • Ferritin; Vitamin D 25-OH; hs-CRP; Homocysteine; Fasting insulin; C-peptide; TSH; Urinalysis:contentReference[oaicite:35]{index=35} (4101) :contentReference[oaicite:36]{index=36}

Rationale & considerations

  • Dr. Berry’s preventive set identifies metabolic syndrome, insulin resistance, inflammation, thyroid issues early :contentReference[oaicite:37]{index=37}.
  • Add Hepatitis/HIV/Syphilis based on risk: HBsAg/Anti-HBs/Anti-HCV (2103–2121), HIV (2303), VDRL/TPHA (2301/2302) :contentReference[oaicite:38]{index=38}.
  • Drop homocysteine if low suspicion and resource-limited.
Female (Reproductive age)

Pre-conception or menstrual concerns

Recommended tests

  • β-hCG if pregnancy suspected (4120) :contentReference[oaicite:39]{index=39}
  • Iron studies + Ferritin; Vitamin D :contentReference[oaicite:40]{index=40}
  • TSH ± Free T4/T3 (2608,2605,2603) :contentReference[oaicite:41]{index=41}:contentReference[oaicite:42]{index=42}
  • LH/FSH/Prolactin for cycle disorders (2609,2610,2611) :contentReference[oaicite:43]{index=43}
  • TORCH if indicated (2401–2402) :contentReference[oaicite:44]{index=44}

Rationale & considerations

  • Thyroid and micronutrients influence fertility and outcomes :contentReference[oaicite:45]{index=45}.
  • Add hepatitis screen and HIV based on exposure risk :contentReference[oaicite:46]{index=46}.
  • Drop TORCH in low-risk, non-pregnant patients.
Male

General + fertility concerns

Recommended tests

  • Annual wellness panel above (Berry core) :contentReference[oaicite:47]{index=47}
  • Semen analysis if infertility suspected (6801) :contentReference[oaicite:48]{index=48}
  • TSH ± Free T4/T3 if symptoms (2608,2605,2603) :contentReference[oaicite:49]{index=49}

Rationale & considerations

  • Metabolic/inflammatory screening detects early risk states :contentReference[oaicite:50]{index=50}.
  • Add infectious screens by risk; drop semen analysis unless indicated.

Middle-Aged Adults (40–59 years)

Annual Preventive Panel

Comprehensive (includes Berry core set)

Recommended tests

  • CBC with differential :contentReference[oaicite:51]{index=51}
  • CMP components: liver (3106–3109,3104/3105), renal (3201,3202,3205), electrolytes (3601–3605,3607) :contentReference[oaicite:52]{index=52}
  • HbA1c; Fasting insulin; C-peptide; Fasting/2-h PP glucose (3301,3302) :contentReference[oaicite:53]{index=53}:contentReference[oaicite:54]{index=54}
  • Lipid profile (3401–3404) :contentReference[oaicite:55]{index=55}:contentReference[oaicite:56]{index=56}
  • Ferritin; Vitamin D; ESR; hs-CRP; Homocysteine; TSH; Urinalysis :contentReference[oaicite:57]{index=57} (4101,1012,2718) :contentReference[oaicite:58]{index=58}
  • GGT (3108) :contentReference[oaicite:59]{index=59}:contentReference[oaicite:60]{index=60}
  • Magnesium & Phosphorus (3607,3605) :contentReference[oaicite:61]{index=61}:contentReference[oaicite:62]{index=62}

Rationale & considerations

  • Captures metabolic syndrome, hepatic steatosis/stress, thyroid disease, systemic inflammation :contentReference[oaicite:63]{index=63}.
  • Add cardiac markers (Troponin I 3506, CK-MB 3502, LDH 3503) and ECG for symptoms/high risk :contentReference[oaicite:64]{index=64}.
  • Drop homocysteine if resource-limited and low pretest probability.

Older Adults (60+ years)

Comprehensive Geriatric

Annual baseline + organ reserve & bone health

Recommended tests

  • All Middle-Age panel (Berry core) :contentReference[oaicite:65]{index=65}
  • Renal: Urea/Creatinine/Uric Acid (3201,3202,3205) :contentReference[oaicite:66]{index=66}
  • Bone/Metabolic: Calcium/Phosphorus/Vitamin D/ALP (3604,3605,3109) :contentReference[oaicite:67]{index=67}:contentReference[oaicite:68]{index=68}
  • Thyroid: TSH + Free T4/T3 (2608,2605,2603) :contentReference[oaicite:69]{index=69}
  • Inflammation: ESR (1012), hs-CRP (2718) :contentReference[oaicite:70]{index=70}:contentReference[oaicite:71]{index=71}
  • Liver profile: AST/ALT/GGT/Bilirubin (3106,3107,3108,3104/3105) :contentReference[oaicite:72]{index=72}
  • ECG; consider Chest X-ray baseline (10000, 20010) :contentReference[oaicite:73]{index=73}

Rationale & considerations

  • Age amplifies cardiometabolic, renal, hepatic, thyroid, and osteometabolic risks; periodic surveillance is prudent :contentReference[oaicite:74]{index=74}.
  • Add B12 and homocysteine for cognitive symptoms; drop imaging if asymptomatic and low risk.

Special Risk Packages

Diabetes / Metabolic Syndrome

Detection & monitoring

Recommended tests

  • HbA1c; Fasting glucose / 2-h PP (3301,3302) :contentReference[oaicite:75]{index=75}:contentReference[oaicite:76]{index=76}
  • Fasting insulin; C-peptide :contentReference[oaicite:77]{index=77}
  • Lipid profile (3401–3404) :contentReference[oaicite:78]{index=78}:contentReference[oaicite:79]{index=79}
  • CMP (renal/electrolytes; liver including GGT 3108) :contentReference[oaicite:80]{index=80}:contentReference[oaicite:81]{index=81}
  • Ferritin; hs-CRP; Urinalysis :contentReference[oaicite:82]{index=82} (4101) :contentReference[oaicite:83]{index=83}

Rationale & considerations

  • Insulin + C-peptide identify insulin resistance years before A1c rises :contentReference[oaicite:84]{index=84}.
  • Ferritin & hs-CRP signal inflammatory/metabolic stress :contentReference[oaicite:85]{index=85}.
  • Add magnesium/phosphorus if ketosis/diuretic use; drop 2-h PP once control established.
Cardiovascular Risk

Primary prevention & symptomatic workup

Recommended tests

  • Lipid profile (3401–3404) :contentReference[oaicite:86]{index=86}
  • hs-CRP; Homocysteine :contentReference[oaicite:87]{index=87}
  • Electrolytes (3601–3603,3604,3607) :contentReference[oaicite:88]{index=88}
  • Cardiac enzymes (symptoms/high risk): Troponin I 3506, CK-MB 3502, LDH 3503 :contentReference[oaicite:89]{index=89}
  • ECG (10000) :contentReference[oaicite:90]{index=90}

Rationale & considerations

  • Lipids + inflammation refine ASCVD risk beyond LDL alone :contentReference[oaicite:91]{index=91}.
  • Add fasting insulin/C-peptide if metabolic syndrome suspected; drop enzymes if purely screening/asymptomatic.
Thyroid / Hormonal

Hypo/Hyperthyroid symptoms, cycle disorders

Recommended tests

  • TSH (first-line) :contentReference[oaicite:92]{index=92} + Free T4/T3 (2608,2605,2603) :contentReference[oaicite:93]{index=93}
  • Women with cycle issues: LH/FSH/Prolactin (2609,2610,2611) :contentReference[oaicite:94]{index=94}
  • DHEA-S (adrenal insight) :contentReference[oaicite:95]{index=95}

Rationale & considerations

  • TSH is an efficient gatekeeper; expand to Free hormones if abnormal or symptomatic :contentReference[oaicite:96]{index=96}.
  • Add anti-TPO if available/autoimmune suspicion; drop Free T3 in straightforward euthyroid states.
Infectious Disease Risk

Epidemiology-guided screening

Recommended tests

  • Hepatitis: HBsAg/Anti-HBs/Anti-HCV (2103–2121) :contentReference[oaicite:97]{index=97}
  • HIV (2303); Syphilis VDRL/TPHA (2301/2302) :contentReference[oaicite:98]{index=98}
  • Tuberculosis: Mantoux (30010) :contentReference[oaicite:99]{index=99}
  • Dengue rapid (epidemic/fever) (2554); Malaria (6301) :contentReference[oaicite:100]{index=100}

Rationale & considerations

  • Targeted screening per exposure and prevalence improves yield.
  • Add LFTs (AST/ALT/GGT) when hepatitis markers positive; drop TORCH outside pregnancy planning.