Ultimate Performance Blood Test
Ultimate Performance Blood Test
Ultimate Performance Blood Test
Ultimate Performance Blood Test
Ultimate Performance Blood Test, from our experts to you.
Dr Sam Rodgers MBBS, MRCGP

Chief Medical Officer meet our doctors

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What is an
Ultimate Performance Blood Test?

The Ultimate Performance Blood Test is our most comprehensive blood test yet. Ideal for sports performance or to learn as much about your body as possible, it combines a thorough health check with an advanced profile for hormone health, thyroid function, and sports nutrition.

What can I learn
from this ultimate blood test?

With tests for liver, kidney, heart health, and diabetes, you can learn more about your general health and lifestyle-related risks. Our ultimate test also gives you an advanced hormone panel, including testosterone, oestradiol, prolactin and cortisol for body composition; testosterone to cortisol ratio as a measure of recovery (most useful for men); full thyroid function for weight loss and energy; and key nutritional markers like iron, vitamin D, active B12 and folate for power and optimal performance.

When should I
take this blood test?

Take our Ultimate Performance Blood Test to establish your baseline levels and to check any personal health risks you or your trainer need to be aware of before you start your transformation programme. You can use the insights to focus on the areas of your diet and nutrition that can help you achieve your health and fitness goals, and then take it at the end of your programme to see how the transformation you've made has impacted your health. If you want, for added motivation, you can even check your progress along the way.

What's Included?

Adrenal hormones
Autoimmunity
Cholesterol status
Clotting status
Diabetes
Gout risk
Hormones
Inflammation
Iron status
Kidney health
Liver health
Proteins
Red blood cells
Thyroid hormones
Vitamins
White blood cells
Select profile for more information
DHEA sulphate DHEAS is the sulphated form of DHEA, a hormone which is produced by the adrenal glands and is responsible for male characteristics in both men and women. DHEAS gradually declines from the age of 30 onwards.
Cortisol Cortisol is a stress hormone produced by the adrenal glands. It is vital to survival given its role in functions such as immunity, regulating blood pressure and releasing insulin for blood sugar maintenance.
Thyroglobulin antibodies This test looks for antibodies to thyroglobulin, a protein which is specific to the thyroid gland. Under normal circumstances it does not enter the bloodstream, but if your thyroid is inflamed or under attack from the body's own immune system, then thyroglobulin can be secreted and antibodies detected. Most cases of thyroid disease are caused by an autoimmune condition where the thyroid gland is attacked by the body's own immune system. This can cause the thyroid gland to produce more thyroid hormone (as in the case of Graves' disease) or to produce less as the cells in the thyroid gland are gradually destroyed (as in the case of Hashimoto's thyroiditis).
Thyroid peroxidase antibodies Thyroid peroxidase (TPO) is an enzyme important in the production of thyroid hormones. This test looks for antibodies against TPO which are often raised in cases of autoimmune thyroid conditions and occasionally in healthy individuals.
Total cholesterol Cholesterol is an essential fat (lipid) in the body. Although it has a bad reputation it has some important functions, including building cell membranes and producing a number of essential hormones including testosterone and oestradiol. Cholesterol is manufactured in the liver and also comes from the food we eat. Although there are a number of different types of cholesterol, the two main components of total cholesterol are HDL (high density lipoprotein) which is protective against heart disease and LDL (low density lipoprotein) which, in high levels, can contribute to cardiovascular disease. Your total cholesterol result on its own is of limited value in understanding your risk of heart disease; high levels of HDL cholesterol can cause a raised total cholesterol result but may actually be protective against heart disease. Equally, you can have a normal total cholesterol level but have low levels of protective HDL cholesterol. The most important factors are how much HDL and LDL cholesterol you have, and what proportion of your total cholesterol is made up of protective HDL cholesterol. We give a detailed breakdown of the components of your total cholesterol in the rest of this cholesterol profile.
LDL cholesterol LDL cholesterol (low-density lipoprotein) is a molecule made of lipids and proteins which transports cholesterol, triglycerides and other fats to various tissues throughout the body. Too much LDL cholesterol, commonly called 'bad cholesterol', can cause fatty deposits to accumulate inside artery walls, potentially leading to atherosclerosis and heart disease.
Non - HDL cholesterol Your total cholesterol is broken down into 2 main components; HDL (good) cholesterol and LDL (bad). There are more types of harmful cholesterol in your blood than just LDL - these include VLDL (very low-density lipoproteins) and other lipoproteins which are thought to be even more harmful than LDL cholesterol. Non-HDL cholesterol is calculated by subtracting your HDL cholesterol value from your total cholesterol. It therefore includes all the non-protective and potentially harmful cholesterol in your blood, not just LDL. As such, it is considered to be a better marker for cardiovascular risk than total cholesterol and LDL cholesterol. The recommended level of non-HDL cholesterol is below 4 mmol/L.
HDL cholesterol HDL cholesterol (high-density lipoprotein) is a molecule in the body which removes cholesterol from the bloodstream and transports it to the liver where it is broken down and removed from the body in bile. HDL cholesterol is commonly known as 'good cholesterol'.
Total cholesterol : HDL The cholesterol/HDL ratio is calculated by dividing your total cholesterol value by your HDL cholesterol level. It is used as a measure of cardiovascular risk because it gives a good insight into the proportion of your total cholesterol which is good (i.e. high-density lipoprotein HDL). Heart disease risk tools (such as QRisk) use the cholesterol/HDL ratio to calculate your risk of having a heart attack.
Triglycerides Triglycerides are a type of fat (lipid) that circulate in the blood. After you eat, your body converts excess calories (whether from fat or carbohydrates) into triglycerides which are then transported to cells to be stored as fat. Your body then releases triglycerides when required for energy.
Platelet count Platelets or clotting cells are the smallest type of blood cell. They are formed in the bone marrow and are important in blood clotting. When bleeding occurs, the platelets swell, clump together and form a sticky plug (a clot) which helps stop the bleeding.
MPV MPV, or Mean Platelet Volume, is a measurement of the average size of your platelets. Platelets are fragmented cells within the blood that aid the process of clot formation. MPV provides an indication of platelet production in your bone marrow.
HbA1c Haemoglobin A1c (HbA1c), also known as glycated haemoglobin, is a longer term measure of glucose levels in your blood than a simple blood glucose test. Glucose attaches itself to the haemoglobin in your red blood cells, and as your cells live for around 12-16 weeks, it gives us a good indication of the average level of sugar in your blood over a 3 month period.
Uric acid Uric acid is a waste product produced from the breakdown of chemical compounds called purines. Purine occurs naturally in the body, but it is also found in the food we eat - and in some foods more than others. In healthy individuals, uric acid is excreted by the kidneys in urine, however, if levels are too high to excrete, or if you have a problem metabolising purine, then uric acid can begin to accumulate and can be deposited as crystals in the bodily tissues. When this occurs in joints it causes the painful condition known as gout.
FSH Follicle Stimulating Hormone (FSH) is produced in the pituitary gland and is important for women in the production of eggs by the ovaries and for men for men in the production of sperm. In the first half of the menstrual cycle in women, FSH stimulates the enlargement of follicles within the ovaries. Each of these follicles will help to increase oestradiol levels. One follicle will become dominant and will be released by the ovary (ovulation), after which follicle stimulating hormone levels drop during the second half of the menstrual cycle. In men, FSH acts on the seminiferous tubules of the testicles where they stimulate immature sperm cells to develop into mature sperm.
LH Luteinising Hormone (LH) is produced by the pituitary gland and is important for male and female fertility. In women it governs the menstrual cycle, peaking before ovulation. In men it stimulates the production of testosterone.
Oestradiol Oestradiol is a female steroid hormone, produced in the ovaries of women and to a much lesser extent in the testes of men. It is the strongest of three oestrogens and is responsible for the female reproductive system as well as the growth of breast tissue and bone thickness. In pre-menopausal women, oestradiol levels vary throughout the monthly cycle, peaking at ovulation. In women, oestradiol levels decline with age, culminating with the menopause when the ovaries stop producing eggs. Low oestradiol can cause many symptoms associated with the menopause, including hot flushes, night sweats and mood swings. Low oestradiol can also cause osteoporosis.
Testosterone Testosterone is a hormone that causes male characteristics. For men, it helps to regulate sex drive and has a role in controlling bone mass, fat distribution, muscle mass, strength and the production of red blood cells and sperm. Testosterone is produced in the testicles of men and, in much smaller amounts, in the ovaries of women. Testosterone levels in men naturally decline after the age of 30, although lower than normal levels can occur at any age and can cause low libido, erectile dysfunction, difficulty in gaining and maintaining muscle mass and lack of energy. Although women have much lower amounts of testosterone than men, it is important for much the same reasons, playing a role in libido, the distribution of muscle and fat and the formation of red blood cells. All laboratories will slightly differ in the reference ranges they apply because they are based on the population they are testing. The normal range is set so that 95% of men will fall into it. For greater consistency, we use the guidance from the British Society for Sexual Medicine (BSSM) which advises that low testosterone can be diagnosed when testosterone is consistently below the reference range, and that levels below 12 nmol/L could also be considered low, especially in men who also report symptoms of low testosterone or who have low levels of free testosterone.
Free testosterone - calc Most testosterone circulating in the blood is bound to proteins, in particular SHBG and albumin; only 2-3 % of testosterone is free and available to cells. This test uses an algorithm to calculate the level of free or unbound testosterone in relation to total testosterone, SHBG and albumin.
Testosterone : cortisol The Testosterone/Cortisol (T:C) ratio is a marker which shows promise in assessing whether athletes are recovering well after intense training. Testosterone is an anabolic hormone which helps to build muscle, produce red blood cells and increase aerobic metabolism in muscles. Cortisol is a catabolic hormone working antagonistically with testosterone, inhibiting protein synthesis and blocking anabolic signalling. The T:C ratio is more sensitive to the stresses of training than either measure alone. Over time it can be trended to see how well you are recovering.
Prolactin Prolactin is a hormone which is produced in the pituitary gland and plays a role in reproductive health. Its primary purpose is to stimulate milk production after childbirth, and in pregnant and breastfeeding women prolactin levels can soar.
hs - CRP C-Reactive Protein (CRP) is an inflammation marker used to assess whether there is inflammation in the body - it does not identify where the inflammation is located. High Sensitivity CRP (CRP-hs) is a test used to detect low-level inflammation thought to damage blood vessels which can lead to a heart attack or stroke. When you suffer a serious injury or infection you experience significant inflammation around the site of injury - such as the swelling around a twisted ankle. Any injury like this will cause your CRP-hs to rise.
Iron Iron is a mineral that is essential for life. It is a component of haemoglobin, a protein in our red blood cells that is responsible for transporting oxygen around our body. If we don't have enough iron, our haemoglobin levels fall and we can't get sufficient oxygen to our cells. This can cause symptoms which include fatigue, dizziness, and shortness of breath. Serum iron is a very transient reading and can be influenced by the amount of iron-rich food in your diet in the days before your blood test. For this reason, iron is rarely looked at on its own, and is interpreted alongside other markers in an iron status test.
TIBC Total iron-binding capacity (TIBC) is a measure of the ability of your body to efficiently carry iron through the blood.
Transferrin saturation Transferrin is made in the liver and is the major protein in the blood which binds to iron and transports it round the body. This test measures how much this protein is 'saturated' by iron.
Ferritin Ferritin is a protein which stores iron in your cells and tissues. Usually, the body incorporates iron into haemoglobin to be transported around the body, but when it has a surplus, it stores the remaining iron in ferritin for later use. Measuring ferritin levels gives us a good indication of the amount of iron stored in your body.
Urea Urea is a waste product produced by the body when it breaks down proteins in the liver. Once the urea is made, it is transported to the kidneys, which filter it out of the blood and remove it from the body in the form of urine. Measuring the levels of urea in the blood can therefore reflect how well both the liver and the kidneys, are functioning. It is important to note that even if one kidney is severely damaged but the other is functioning perfectly, results may still return as normal.
Creatinine Creatinine is a chemical waste molecule that is generated from normal muscle metabolism. Measurement of this is an indicator of the levels of other waste products in the body. Creatinine is also an accurate marker of kidney function, and may help in diagnosing kidney disease.
eGFR The estimated glomerular filtration rate (eGFR) assesses how well the kidneys are working by estimating the amount of blood filtered through the kidneys. The glomeruli are tiny filters in the kidneys responsible for removing waste products. If these filters do not do their job properly, kidney function can be impaired. The eGFR calculation is an estimate of actual glomerular filtration rate, calculated using your age, gender, ethnicity, and serum creatinine levels.
Bilirubin Bilirubin is a product of the breakdown of haemoglobin from red blood cells. It is removed from the body via the liver, stored and concentrated in the gallbladder and secreted into the bowel. It is removed from your body through urine and faeces. Bilirubin causes the yellowish colour you sometimes see in bruises, due to red blood cells breaking down underneath the skin.
ALP Alkaline phosphatase (ALP) is an enzyme found mainly in the liver and bones. Measuring it can indicate ongoing liver, gallbladder or bone disease.
ALT Alanine transferase (ALT) is an enzyme which is mostly found in the liver, but is also found in smaller amounts in the heart, muscles and the kidneys. If the liver is damaged, ALT is leaked into to bloodstream. As ALT is predominantly found in the liver, it is usually an accurate marker for liver inflammation and can indicate liver damage caused by alcohol, fatty liver, drugs or viruses (hepatitis).
Gamma GT Gamma GT, also known as gamma-glutamyl transferase (GGT), is a liver enzyme which is raised in liver and bile duct diseases. It is used in conjunction with ALP to distinguish between bone or liver disease. Gamma GT is also used to diagnose alcohol abuse as it is raised in 75% of long term drinkers.
Total protein Total Protein represents the sum of the proteins albumin and globulin in your blood. Albumin and globulin have a range of functions including keeping blood within vessels, transporting nutrients and fighting infection. Abnormal levels can indicate malnutrition as well as a liver or kidney disorder.
Albumin Albumin is a protein which is made mainly in the liver. It helps to exert the osmotic pressure which holds water within the blood. It also helps carry nutrients and medications and other substances through the blood and is important for tissue growth and healing. Albumin also carries hormones around the body, therefore measuring the amount of albumin in the blood can help us calculate how much hormone is available to your tissues.
Globulin Globulin is an umbrella term for a set of different proteins that the immune system and the liver produce. Certain globulins bind with haemoglobin while others transport metals, such as iron, in the blood. Additionally, there is a certain type of globulin known as an immunoglobulin, (another name for an antibody) which helps to fight infection in the body.
SHBG SHBG (sex hormone binding globulin) is a protein which transports the sex hormones (testosterone, oestrogen and dihydrotestosterone (DHT)) in the blood.Hormones which are bound to SHBG are inactive which means that they are unavailable to your cells. Measuring the level of SHBG in your blood gives important information about your levels of free or unbound hormones which are biologically active and available for use.
Haemoglobin Haemoglobin is a protein in red blood cells which carries oxygen around the body and gives the blood its red colour. This test measures the amount of haemoglobin in the blood and is a good measure of the blood's ability to carry oxygen around the body.
Haematocrit HCT (haematocrit) measures the amount of space (volume) within the blood that is taken up by red blood cells.
Red cell count Red Blood Cell (RBC) Count analyses the number of red blood cells in the blood. Red blood cells carry oxygen from the lungs to the rest of the body, where it can be used to fuel energy processes such as movement and respiration. They also carry carbon dioxide produced from cells back to the lungs so that it can be exhaled.
MCV MCV (mean corpuscular volume) reflects the average size of your red blood cells. This is important to measure, as it can indicate how much oxygen your cells are likely to be transporting around the body.
MCH MCH (mean corpuscular haemoglobin) measures the average amount of haemoglobin contained in one of your red blood cells.
MCHC MCHC (mean corpuscular haemoglobin concentration) is the average concentration of haemoglobin in your red blood cells. Haemoglobin is a molecule which allows red blood cells to transport oxygen around the body.
RDW Red blood cell distribution width (RDW) indicates whether your red blood cells are all the same size, or different sizes or shapes. Normally cells are fairly uniform both in size and in shape, but some blood disorders may cause your red blood cells to form in abnormal sizes. This test measures the difference between the largest and the smallest red blood cell.
TSH Thyroid stimulating hormone (TSH) is produced in the pituitary gland in order to regulate the production of thyroid hormones thyroxine (T4) and triiodothyronine (T3) by the thyroid gland. If thyroid hormones in the blood are low, then more TSH is produced to stimulate the thyroid gland to produce more of them. If thyroid hormone levels are high, then the pituitary produces less TSH to slow the production of thyroid hormones. If TSH is too high or too low, it normally signifies that there is a problem with the thyroid gland which is causing it to under or over produce thyroid hormones. Sometimes a disorder of the pituitary gland can also cause abnormal TSH levels.
Free T3 Triiodothyronine (T3) is the more active of the two thyroid hormones produced by the thyroid gland. Most T3 is bound to protein in the blood. Free T3 measures the level of T3 that is free, or unbound to protein, and is available to regulate metabolism.
Free thyroxine Thyroxine (T4) is one of two hormones produced by the thyroid gland. It works to speed up the rate of your metabolism. Most T4 is bound to carrier proteins in the blood - it is only the free, or unbound, T4 that is active in the body, which is measured in this test. Free T4 is the less active of the two main thyroid hormones. To have an impact on your cells it needs to convert to the more active T3 when your body needs it.
Folate - serum Folate is a B vitamin which acts as a coenzyme in the metabolism of amino acids. It is also vital for the synthesis of purines and pyrimidines which are essential for DNA synthesis and red cell formation. Folate is also especially important during the first trimester of pregnancy so if you are thinking of becoming pregnant it is important to make sure your folate levels are normal.
Vitamin B12 - active Vitamin B12 is important for production of red blood cells which carry oxygen around the body. B12 is also involved in metabolism and the nervous system and prolonged lack of vitamin B12 may cause nerve damage. Although Vitamin B12 is almost entirely found in animal-based foods, many vegetarian and vegan products, especially plant milks are now fortified with Vitamin B12.
Vitamin D Although called a vitamin, vitamin D is actually a hormone which is activated by sunshine on your skin. Vitamin D is essential for bone strength as it helps your intestines absorb calcium. However, it is thought that vitamin D also plays an important role in immune function, as well as in many chronic diseases and mental health. Many people in the UK have low levels of vitamin D with symptoms including muscle weakness, mood swings and fatigue. People who have dark skin, as well as those who don't spend much time outdoors are particularly at risk of low vitamin D. Small amounts of vitamin D can be obtained from food, especially oily fish, eggs and any food which has been fortified with vitamin D. If you are deficient in vitamin D you are unlikely to be able to improve your levels by food alone.
White cell count White Blood Cell (WBC) Count measures the number of white blood cells in the blood. White blood cells are key to your body's immune system. They fight infections and protect your body from foreign invaders such as harmful germs and bacteria. Additionally, they produce many antibodies and memory cells to protect you from further infections with the same germ.
Neutrophils Neutrophils are the most abundant type of white blood cell in the body and are responsible for helping your body fight infection. When a germ is initially detected by the body, neutrophils are the defence system which go out and attack the germ before any of your other white blood cells. When neutrophils are low you can be more vulnerable to illness and infection.
Lymphocytes Lymphocytes are a type of white blood cell which fight bacterial and viral infections. They are the subset of white blood cells involved in the more specific response to infections, which can identify and differentiate between different foreign organisms that enter the body. As well as fighting infection, they produce antibodies and memory cells to help to prevent future infections from the same germ. Lymphocytes include T cells, B cells and natural killer cells.
Monocytes Monocytes are a type of white blood cell that surround and destroy germs and dead or damaged cells from the blood. The heat and swelling that you feel when a body part is inflamed, for example after a cut on your finger, is caused by the activities of these cells.
Eosinophils Eosinophils are a type of white blood cell that are responsible for removing parasitic infections and regulating inflammation to mark an infected site. They also play a role in allergy and in asthma.
Basophils Basophils are a type of white blood cell that protect your body from bacteria and parasites such as ticks. They also play a role in allergic reactions.

How to prepare
for your test?

Special Instructions

Prepare for your Ultimate Performance Blood Test by following these instructions. Please take your sample before 10am. If you have an unusual sleep pattern (eg shift worker) then take this test within 2 hours of waking. Take this test when any symptoms of short-term illness have settled. Avoid heavy exercise for 48 hours beforehand. Avoid fatty foods for eight hours before your test, you do not need to fast. Take this test two to five days after the start of your period, ideally on day three. It can be taken any time if you do not have periods. Hormonal contraception can affect the results of this test. Taking a break from this and waiting for your periods to restart before your blood test will give more accurate results. Corticosteroid medication can affect this test, ask your doctor whether to stop before testing. If you use hormone gels, pessaries, patches, or tablets, we strongly recommend selecting a venous sample to minimise contamination sometimes seen with finger-prick tests. Otherwise, administer any hormone supplements using gloves, and make sure your fingers have not been in contact with hormone supplements for at least four weeks before taking the test. Hormones can be absorbed deep within the skin even after minimal contact and remain there for weeks despite vigorous handwashing. You should take this test before you take any medication or vitamin/mineral supplements. Do not take biotin supplements for two days before this test, discuss this with your doctor if it is prescribed. Do not take vitamin B12 for two weeks prior to this test. If your B12 is prescribed ask your doctor whether to stop.

Frequently asked questions

Does this test measure high levels of testosterone?

 Most testosterone tests set an upper detection limit of 52 nmol/L. If your result is higher than this, the lab will attempt a second measurement to get an actual reading, providing there is enough sample volume available.