Useful for monitoring treatment with synthetic hormones and treatment of hyperthyroidism. Total T4 levels offer a good index of thyroid function when the thyroid-binding globulin is normal and nonthyroidal illness is not present.
Useful for monitoring whole blood tacrolimus concentration during therapy, particularly in individuals coadministered CYP3A4 substrates, inhibitors, or inducers. Also useful for adjusting dose to optimize immunosuppression while minimizing toxicity, and for evaluating patient compliance.
Alternative, second-level test for suspected increases or decreases in physiologically active testosterone indications. Useful in the assessment of androgen status in cases with suspected or known sex hormone-binding globulin-binding abnormalities, the assessment of functional circulating testosterone in early pubertal boys and older men, the assessment of functional circulating testosterone in women with symptoms or signs of hyperandrogenism with normal total testosterone levels, and the monitoring of testosterone therapy or antiandrogen therapy in older men and in females.
Useful for evaluation of men for possible hypogonadism, precocious puberty, idiopathic hirsutism, and male-to-female transgender disorders. Also useful for the evaluation of women with hirsutism, virilization, oligoamenorrhea, and testosterone deficiency, and the evaluation of infants with ambiguous testosterone deficiency, ambiguous genitalia, or virilization. Useful in the diagnosis of androgen-secreting tumors.
Serum
Red (1)
None
None
REFRIGERATE (4 Days)
7 Days
Liquid Chromatography-Tandem Mass Spectromentry (LC-MS/MS)
Useful for evaluation of men for possible hypogonadism, precocious puberty, idiopathic hirsutism, and male-to-female transgender disorders. Also useful for the evaluation of women with hirsutism, virilization, oligoamenorrhea, and testosterone deficiency, and the evaluation of infants with ambiguous testosterone deficiency, ambiguous genitalia, or virilization. Useful in the diagnosis of androgen-secreting tumors.
The recommended second-level test for suspected increases or decreases in physiologically active testosterone. Useful in the assessment of androgen status in cases with suspected or known sex hormone-binding-globulin-binding abnormalities, the assessment of functional circulating testosterone in early pubertal boys and older men, the assessment of functional circulating testosterone in women with symptoms or signs of hyperandrogenism but normal total testosterone levels, and the monitoring of testosterone therapy or antiandrogen therapy in older men and in females.
Serum
Red (2)
None
None
REFRIGERATE (21 Days)
7 Days
Liquid Chromatography Tandem Mass Spectrometry, Calculation, Spectrophotometry, Immunochemiluminescent Assay
Alternative, second-level test for suspected increases or decreases in physiologically active testosterone. Used in the assessment of androgen status in cases with suspected SHBG-binding abnormalities, the assessment of functional circulating testosterone in early pubescent boys and older men, and in women with symptoms or signs of hyperandrogenism with normal testosterone levels. Also used for monitoring of testosterone therapy in older males and females.
Useful in the assessment of an antibody response to the tetanus toxoid vaccine, which should be performed at least 3 weeks after immunization. An aid to diagnose immunodeficiency.
Useful for the extensive and economical diagnosis and classification of hemoglobinopathies or thalassemia (including complex disorders), the evaluation of microcytosis, and the diagnosis of hereditary persistence of hemoglobin (HPFH).
Whole Blood & Serum
EDTA (3) & SST (1)
None
None
Must draw both serum and whole blood. Send whole blood specimens in original tubes, DO NOT ALIQUOT.
Useful for detection of individuals with low thiopurine methyltransferase (TPMT) activity who are at risk for excessive myelosuppression or severe hematopoietic toxicity when taking thiopurine drugs, and for the detection of individuals with hyperactive TPMT activity who have therapeutic resistance to thiopurine drugs and may develop hepatotoxicity if treated with these drugs.
Plasma
EDTA (2)
None
None
Abstain from the following for at least 48 HR prior to collection: naproxen (Aleve), ibuprofen (Advil, Motrin), ketoprofen (Orudis), furosemide (Lasix), sulfasalazine (Azulfidine), mesalamine (Asacol), olsalazine (Dipentum), mefenamic acid (Ponstel), trimethoprin (Proloprim), methotrexate, thiazide diuretics, and benzoic acid inhibitors.
REFRIGERATE (6 Days)
7 Days
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Useful in detecting or excluding the presence of heparin or heparin-like anticoagulants (which act by enhancing antithrombin's inhibition of thrombin and other procoagulant enzymes) when used in conjunction with reptilase time (RT) in evaluating unexplained prolonged clotting times. Also useful in identifying the cause of a prolonged prothrombin time, activated partial thromboplastin time, or dilute Russell viper venom time when used in conjunction with the RT and fibrinogen assay.
Plasma
Lt. Blue (1)
None
None
Fasting preferred (12 HR). Spin TWICE and freeze plasma within 4 hours of collection.
Useful for differentiating thyroid autoimmune disorders from nonautoimmune goiter or hypothyroidism, for aiding in treatment for patients with subclinical hypothyroidism, and for aiding in the diagnosis of Hashimoto disease, postpartum thyroiditis, neonatal hypothyroidism, and Graves disease.
Serum
SST (1)
Plasma
Green (1) Lithium Heparin
REFRIGERATE (72 Hours)
CMIA
86376, 86800
Thyroglobulin and Thyroid Peroxidase Antibodies, TPO and Thyroglobulin, Thyroperoxidase Ab and Thyroglobulin
Useful for aiding in the diagnosis of thyroid autoimmune disorders, for differentiating thyroid autoimmune disorders from nonautoimmune goiter or hypothyroidism, and for deciding whether to undergo treatment for subclinical hypothyroidism.
Useful as second-order testing for autoimmune thyroid disease (including: Differential diagnosis of etiology of thyrotoxicosis) in patients with ambiguous clinical signs or contraindicated (eg, pregnant or breast-feeding) or indeterminate thyroid radioisotope scans. Aids in the diagnosis of clinically suspected Graves disease (eg, extrathyroidal manifestations of Graves disease: endocrine exophthalmos, pretibial myxedema, thyroid acropachy) with normal thyroid function tests, and in determining the risk of neonatal thyrotoxicosis in a fetus of a pregnant female with active or past Graves disease. Useful in the differential diagnosis of gestational thyrotoxicosis versus first-trimester manifestation or recurrence of Graves disease, and for assessing the risk of Graves disease relapse after antithyroid drug treatment.
Determination of thyroxine-binding globulin levels is particularly useful for cases in which total thyroid hormone levels do not correlate with the thyrometabolic status, most commonly with pregnancy or the use of contraceptive steroids.
Useful for evaluating individuals with IgA deficiency, patients suspected of having celiac disease (including patients with compatible clinical symptoms), patients with atypical symptoms, and individuals at increased risk (family history, previous diagnosis with associated disorder, positivity for HLA DQ2 and/or DQ8). Useful as a screening test for dermatitis herpetiformis, in conjunction with the endomysial antibody test, and for monitoring adherence to gluten-free diet in patients with dermatitis herpetiformis and celiac disease.
Serum
SST (1)
None
None
REFRIGERATE (48 Hours)
4 Days
Enzyme-Linked Immunoassay
83516
Celiac Disease, Coeliac Disease, tTG, Transglutaminase, Tissue Transglutaminase Ab IGG
Useful as an evaluating patients suspected of having celiac disease, including patients with compatible clinical symptoms, patients with atypical symptoms, and individuals at increased risk (family history, previous diagnosis with associated disorder, positivity for HLA DQ2 and/or DQ8). Useful as a screening test for dermatitis herpetiformis, in conjunction with the endomysial antibody test, and for monitoring adherence to gluten-free diet in patients with dermatitis herpetiformis and celiac disease.
Serum
SST (1)
None
None
REFRIGERATE (7 Days)
4 Days
Enzyme-Linked Immunoassay
83516
Celiac Disease, Coeliac Disease, tTG, Transglutaminase, Tissue Transglutaminase Ab IGA
Useful for the determination of immune status of individuals to the rubella virus following vaccination or prior exposure, as an indication of past or recent infection with Toxoplasma gondii, cytomegalovirus, or herpes simplex virus (HSV), and to distinguishing between infection caused by HSV types 1 and 2, especially in patients with subclinical or unrecognized HSV infection.
Used for quantitative detection of specific IgM antibodies to TORCH. Positive result for TORCH IgM indicates possible acute infection with TORCH. Negative result indicates no serological evidence of infection with TORCH. False negative can be due to immunosuppression or due to low/undetectable level of IgM antibodies. A suspected diagnosis of acute TORCH infection should be confirmed by PCR analysis or repeat test after 10-14 days.
Aides in assessing liver function and evaluation of a wide range of disease affecting the production, uptake, storage, metabolism, or excretion of bilirubin. Aides in monitoring the efficacy of neonatal phototherapy.
Useful for the diagnosis and treatment of a variety of diseases involving the liver, kidney, or bone marrow, as well as other metabolic or nutritional disorders.
Useful as an aid to resolve discrepant results between screening treponemal (eg, enzyme immunoassay [EIA], multiplex flow immunoassay) and nontreponemal (eg, rapid plasma regain) assays.
Serum
SST (1)
Plasma
EDTA (1)
REFRIGERATE (5 Days)
5 Days
Particle Agglutination
86780
Treponema pallidum, RPR, Rapid Plasma Reagin, Syphilis, T. Pallidum
Testing for hyperthyroidism in patients with low thyroid-stimulating hormone values and normal thyroxine levels. Used to diagnose triiodothyronine toxosis.
Serum
SST (1)
Plasma
Green (1)
REFRIGERATE (6 Days)
CMIA
84480
T3, Total T3, T3 Suppression, Triiodothyronine, Thyroid Function
Used when assessing mast cell activation, which may occur as a result of anaphylaxis or allergen challenge, and for assessing patients with systemic mastocytosis or mast cell activation syndrome.
Useful as a recommended first-line test for detection of thyrotropin receptor (TSHR) antibodies, and used in the following situations: differential diagnosis of etiology of thyrotoxicosis in patients with ambiguous clinical findings and/or contraindicated (eg, pregnant or breast-feeding) or nondiagnostic thyroid radioisotope scans, diagnosis of clinically suspected Graves disease (eg, extrathyroidal manifestation of Graves disease include endocrine exophthalmos, pretibial myxedema, thyroid acropachy) in patients with normal thyroid function tests, determining the risk of neonatal thyrotoxicosis in a fetus of a pregnant female with active or past active Graves disease, differential diagnosis of gestational thyrotoxicosis versus first trimester manifestation or recurrence of Graves disease, and assessing the risk of Graves disease relapse after antithyroid drug treatment.
Serum
SST (1)
None
None
Allow serum to clot at room temperature for 1 hour before spinning and pouring off.