Clinical Biochemistry Test Information

Clinical Biochemistry Department, UCL Hospitals NHS Foundation Trust
CLINICAL BIOCHEMISTRY TEST INFORMATION

Unique document number 411
Document name
Clinical Biochemistry Test Information
Version no.
17
Produced by
Dr Gill Rumsby
Approved by
Dr Gill Rumsby
Date active
May 2014
Date for review

Comments
April 2015
This issue replaces all previous
versions.
UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests
Version 17
May 2014
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Clinical biochemistry test information
GENERAL INFORMATION
GENERAL ENQUIRIES: 020344 79405 (x79405); email: biochemhelpdesk@uclh.nhs.uk
CLINICAL ENQUIRIES: Call the number above and ask for the duty biochemist. Alternatively email dutybiochemist@uclh.nhs.uk and someone will deal with your enquiry (MondayFriday 0900-1700)
REQUEST FORMS: The request forms have an attached bag for insertion and sealing of the blood samples. Request forms should be firmly attached to previously 24-hour urine. It is
strongly advised that requests are restricted to one sample type per form. Request forms must always be fully and legibly completed. The case number, surname, forename and date of
birth must be recorded accurately for all patients. Using patient identification labels is very desirable. The location of the patient with consultants name or approved code must be
included for the return of results. Please clearly state the tests required using their full names or widely accepted abbreviations only. If it is only possible to obtain a small sample, the
order of priority for the tests requested should be indicated. Where special conditions are required for a valid result, information on timing, fasting, protocol and drug doses should be
written on the request form.
LABELLING OF SAMPLES: The Department will NOT analyse samples that have inadequate identification. All specimens MUST be labeled with the surname and two other items of
identification from:
Hospital number
Date of birth
Forename
SAMPLE CONTAINERS: The sample types for each of the tests are included in the tabulated information later.
TEST AVAILABILITY: Not all of the more esoteric tests listed are available within UCLH. Those for which UCLH has to pay to be analysed elsewhere are subject to particular scrutiny and
are likely to be refused unless a clear clinical justification is provided.
Test name beginning with (Ctrl click):
A
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Blood: The main vacutainer tube used is the gold top (SST, clotted blood with gel separator). Others needed for certain tests are: red top (plain clotted blood), , purple top (EDTA
anticoagulant), grey top (fluoride preservative) and green top (lithium heparin anticoagulant). Usually many tests can be done from one sample, eg one 5mL gold top tube is sufficient for
U/E, LFT, bone profile and more. However, the volume stated is that which must normally be sent even if requesting the individual test on its own.
Paediatric samples: the tube top colours given above do not apply to paediatric containers. Usually white tops are plain but other lids will vary with manufacturer. Staff should
familiarize themselves with the preservative content prior to bleeding the patient.
Urine: Random and early morning urine samples should be collected in 50 mL Sterilin containers. Plain containers for 24 hour urine collections are available by ordering from Supplies.
Acidified containers for 24hr urines, containing concentrated hydrochloric acid, are available from Clinical Biochemistry reception. Please check the following Test Information table if
you do not know which type of container is needed.
Faeces: Random samples should be collected in 50 mL Sterilin containers.
CSF: Plain sterile containers from CSSD (grey fluoride tube must be used for CSF glucose)
Sweat: A special collection system is used by the Childrens Outpatients Department at UCLH
Other fluids, Calculi etc: Sterilin or other suitable container.
SAFETY PRECAUTIONS: Please adhere to the instructions, so that the risk to all staff is minimised. There is a legal obligation to observe these precautions.
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Needle Stick Injuries: Current guidelines must be followed so as to avoid stick injuries to those taking, transporting and processing samples. Specimens for analysis must not be sent to
the laboratory in the original syringe. .
Infection Risk: General requirements and good practice:
Do not contaminate the request form with the sample.
Ensure that the container is correctly sealed so that it does not leak in transit.
Do not stick samples to the request form with tape, use the bag.
Dangerous Pathogens
Specimens containing certain viral pathogens (ACDP Category 4) cannot be handled by the laboratory. Do NOT send samples containing or suspected of containing these
pathogens to the laboratory. Phone the Help Desk in advance if in doubt.
Specimens must be regarded as potentially infected if they come from the patient categories below. Only request tests which are essential to the management of these disorders:
Known to be HbsAG positive.
With known or suspected viral hepatitis or with jaundice of unknown cause.
With known AIDS or HIV positive, or relevant risk groups.
Frequently transfused including haemophilia.
Known to be drug addicts.
With known or suspected brucellosis, typhoid or paratyphoid A infection.
With known or suspected tuberculous meningitis (CSF only) or tuberculosis of the urinary or gastrointestinal tract (urine or faecal specimens only).
With known or suspected amoebiasis (faecal specimens only).
With pyrexia of unknown origin (PUO).
Radiation Hazards: Urine (particularly) may be radioactive following imaging / nuclear medicine procedures. Urine collections known or suspected to be highly radioactive must not be sent to
the laboratory. The name of any administered isotope must be stated on all samples of urine on both the first and second day after an imaging procedure. The laboratory monitors samples and
will refer all radiation safety violations back to the requester. Serious violations will be referred to the Radiation Protection Advisor.
TRANSPORT OF SAMPLES: Samples from the main hospital site should be sent by pneumatic tube (PTS) system. Please note some tests require samples to be carried to the laboratory
immediately, with or without other precautions (eg on ice). Routine transport pick-ups cannot not be used for such samples. Other sites collect from designated pick up points.
REQUESTS FOR URGENT ATTENTION: During normal working hours all urgent requests must be arranged personally by the requesting doctor telephoning the Clinical Biochemistry
Help Desk (UCLH ext 79405, or direct dial 0203 44 79405), except where there is prior agreement.
REPORTING RESULTS: Within the laboratory computer system the patient is identified by the case number. As soon as a request is registered in the computer it is listed as PENDING
when viewing on any ward, clinic or departmental terminal. As soon as the result is approved for reporting it is also available on any enquiry computer. Printed reports are not usually issued.
DYNAMIC FUNCTION TESTS: Please see test information and specific test request forms on Insight
http://insight/departments/medicineboard/pathology/biochemicalmedicine/ClinicalBiochemistry/Pages/default.aspx
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CLINICAL BIOCHEMISTRY TESTS

TEST
Acetylcholinesterase
(erythrocyte)
Acid load test
Acid phosphatase, total
SAMPLE REQUIREMENTS
5 mL whole blood purple or
green top
Timed
urine
samples
Follow dynamic test protocol
on intranet
5ml blood gold top tube
ACTH
4ml blood purple top tube

kept
cold,
centrifuged
immediately
Acyl carnitine profile
4 mL purple or green top tube

(paediatrics use orange top
Li/hep tube)
Addictive drug screen

Adrenaline
AFP
AGXT gene analysis (primary
hyperoxaluria type 1)
Alanine aminotransferase
REFERENCE RANGE
See report
2.6 6.2 U/L

<46 ng/L (9am)
4 mL blood purple top tube

Alanine:glyoxylate
aminotransferase
Albumin, serum
20 mg liver (frozen)
Albumin, urine
(Microalbumin)
Alcohol (Medical cases only)
10ml random urine
10-50 IU/L (Male)

10-35 IU/L (Female)
19.10 47.9
mol substrate transformed per hour per mg protein
28 -44 g/L (0 4 Days)
38-54 g/L (4 Days 14 Years)
32-45 g/L (14 -18 Years)
34-50 g/L (>18 Years)
0-2.8 mg/mmol creatinine
2ml blood light grey top tube
Values up to 1 mmol/L may arise endogenously
Version 17
AVAILABILITY / NOTES
All requests reviewed by senior staff. Analysed at Cardiff
Toxicology
Sample requires special or immediate action. Transport to lab
immediately, routine transport not suitable. Urine pH after oral
ammonium chloride
All requests reviewed by Chem Path senior medical or scientific
staff. Not for routine use in prostate cancer see PSA instead.
Analysed at Royal Free Hospital, phone 0207 830 2991
Sample requires special or immediate action. Transfer to lab
immediatey and on ice. Routine transport not suitable. Batched for
analysis on selected days.
N.B. Cannot be requested retrospectively
Analysed at Neurometabolic Unit, 0207829 8716. Results available
within 7 working days
See Drug Screen
See Catecholamines
See Alphafetoprotein
Molecular Urology test. For diagnosis of primary hyperoxaluria
type 1
24 hour availability
Molecular Urology test. For diagnosis of primary hyperoxaluria
type 1
Usually 24 hour availabiity

24 hour availability. Legal limit for driving 17.4 mmol/L
(80mg/dL)
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TEST
Aldosterone, blood
SAMPLE REQUIREMENTS
4 mL purple or gold top tube
Aldosterone, urine
Aldosterone synthase gene
analysis
Alkaline Phosphatase, Total
24h collected in plain bottle

Alkaline phosphatase
Isoenzymes
Alkaline phosphatase,
Placental
5ml blood red top tube
Alkaline phosphatase
CSF
<100 mU/L
5 mL blood green top tube

Patient should be on caffeinefree diet
Random urine
On treatment, plasma oxypurinol <100 umol/L

See report
Must be frozen on receipt. Requests are individually reviewed by

senior staff. Analysed at ICH 02079052108
0-6 kIU/L (In hepatoma, a positive diagnosis is only

likely with a level >500 kIU/L)
24 hour availability.
Allergen specific IgE

Allopurinol
Alpha
aminoadipic semialdehyde (antiquitin)

Alphafetoprotein as tumour
marker
Alphafetoprotein, CSF
REFERENCE RANGE
1000-3800 pmol/L (1-3 Months)
400-1500 pmol/L (3-12 Months)
300-1000 pmol/L (1-4 Years)
400-800 pmol/L (4-8 Years)
150-450 pmol/L (8-16 Years)
600-1200 pmol/L (Adult, ambulant)
100-500 pmol/L (Adult, recumbent)
10-50 nmol/24 hours
0-250 IU/L (0-5 Days)
0-449 IU/L (5 -180 Days)
0-462 IU/L (180-365 Days)
0-281 IU/L (1-3 Years)
0-269 IU/L (3-6 Years)
0-300 IU/L (6-12 Years)
0-390 IU/L (Male 12-17 Years)
0-187 IU/L (Female 12-17 Years)
40-129 IU/L (Male >17 Years)
35-104 IU/L (Female >17 Years)
Female
Male
liver <73U/L
<68U/L
Biliary <13U/L
<8U/L
Bone <71U/L
<77U/L
<0.5 U/L (Non-smokers)
<1.5 U/L (Smokers)
Batched for weekly analysis. Steroid Endocrinology test
Batched for weekly analysis. Steroid Endocrinology test

Molecular Urology test. For diagnosis of aldosterone synthase
deficiency
Requests are individually reviewed, results are available in 2 to 4

weeks. Analysed at Royal Free Hospital
1 mL CSF

weeks. Analysed at Northern General Hospital Sheffield, phone
0114-271 5725.
For diagnosis of pineal germinoma.
Requests are individually reviewed. Analysed at Clinical
Biochemistry, Charing Cross 0208846 1415
See RAST
Requests are individually reviewed by senior staff. Analysed at
Guys and St Thomas 02071881266.
<1 kIU/L (Adult)
may be slightly higher in newborn period but less
than 12 kIU/L
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TEST
Alpha-1 antitrypsin, total
SAMPLE REQUIREMENTS
Alpha-1-antitrypsin, faecal
10g stool sample (concurrent

serum AAT sample also
required)
Alpha-1
phenotype
antitrypsin
REFERENCE RANGE
0.9-2.2 g/L (0-6 months)
0.8-1.8 g/L (6 months 1 year)
1.1-2.2 g/L (1-5 years)
1.4-2.3 g/L (5-10 years)
1.2-2.0 g/L (10-15 years)
1.1-2.1 g/L (15-18 years)
Interpretation on report
Requests are individually reviewed by senior staff. Analysed at St

Georges Hospital
Performed automatically if total AAT below 0.9g/L. Analysed at

Northern General Hospital Sheffield, phone 0114 271 5552.
4.0-21.9 nmol/h/mL
Requests are individually reviewed. Must be sent same day for

processing so do not collect on a Friday or at weekends. Analysed
at GOS Enzyme lab. 0207405 9200
Molecular Urology test for diagnosis of 5-reductase deficiency
University Hospital Birmingham, 0121 371 5999
weeks. Tubes available from lab.
Batched for analysis on selected days
Qualitative screen. Requests are individually reviewed, results are
available in 2 to 4 weeks.
N.B. Rarely useful as a screen for metabolic disorders.
See Theophylline
Time to steady state: 1 week (if loaded)
Ideal sampling time: Pre dose
Analysed at West Park, Epsom 01372 734720
24 hour availability. Sample requires special or immediate action.
Transfer to lab immediately, preferably on ice. Routine transport
not suitable
See Acid load test in dynamic function test folder
Requests individually reviewed by senior staff. Results available
within 4 weeks. Analysed at Gt Ormond St 0207 829 8662
Daily
Alpha galactosidase
4mL blood green top

Do NOT collect on a Friday
5 reductase 2 gene analysis

Alpha
subunit
(pituitary
peptide common subunit)
Aluminium
4 mL blood purple top

5 mL blood red or gold top
Amino acids, Blood

Amino acids, Urine
5ml blood green top tube

5ml fresh random urine
Aminophylline
Amiodarone
Amiodarone 0.5-2.0 mg/L

Desethylamiodarone 0.5-2.0 mg/L
Ammonia
56-92 umol/L (0-31 Days)

21-50 umol/L (31 Days -14 Years)
11-32 umol/L (>14 Years)
Ammonium chloride Test

Amylase
Amylase (isoenzymes)

5 mL blood gold top tube
28-100 IU/L
See report
Androstenedione
Angiotensin
converting
enzyme
Anion gap
Antenatal screen (Downs)
1.4 -11.5 nmol/L (Female)

2.0-10.0 nmol/L (Male)
<1.1 nmol/L (Prepubertal)
8-52 U/L
calculation
12-20 mmol/L
5ml blood white top tube
24h availability
<0.4 umol/L (Subjects without CRF)
<2.2 umol/L (Low risk CRF patients)
Calculated from (Na+K)-(Cl+bicarbonate).

Not available from Clinical Biochemistry contact Antenatal
clinic
See individual drugs
Anticonvulsants
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TEST
Anti-mullerian hormone
Antitrypsin - 1
Apolipoproteins, A1 and B
SAMPLE REQUIREMENTS
5 mL blood gold top
5ml blood gold or purple top

tube
Apolipoprotein E phenotype
Apolipoprotein E genotype
4 mL whole blood purple top
Aquaporin 4 antibodies
Arsenic

4 mL blood purple top (plastic
tube) or 20 mL random urine
(preferred)
Aspartate aminotransferase
Barbiturates
Base excess
Bence Jones protein
REFERENCE RANGE
0.95-1.83 g/L (ApoA1 Male)

0.98-2.05 g/L (ApoA1 Female)
0.52-1.05 g/L (Apo B Male)
0.47-0.92 g/L (Apo B Female)
Must be sent without delay. Test not available for fertility issues.
Requests are individually reviewed by senior staff.
See Alpha-1 Antitrypsin
Requests are individually reviewed by senior staff. For specialist
lipid clinic use only. Analysed at Royal Free Hospital, phone
02077940500 bleep 1595 (Duty Biochemist)
Requests individually reviewed by senior staff. Results available in
8 weeks. For specialist lipid clinic use only.
Analysed at University of Wales, Cardiff 02920747747 x8350
Lipid Clinic only.
Analysed at University of Wales, Cardiff 02920747747 x8350
Analysed at the Immunology Dept., Churchill Hospital, Oxford
within 2 weeks. Analysed at Trace metal lab, Guildford 01483
259978. Exclude high seafood diet for 5 days prior to sampling
Approved research studies only
Negative
Plasma: <133.5 nmol/L
Urine: <534 nmol/L
0-37 IU/L (Male)
0-31 IU/L (Female)
See Drug Screen

See Gases
Batched for analysis on selected days. Advisable to send concurrent
blood sample in Red top tube for serum protein electrophoresis
also.
Molecular Urology test
25ml urine (EMU)
None detected in normal subjects
3-beta hydroxysteroid
dehydrogenase type 2
genetics
Beta-2 microglobulin
Bicarbonate (TotalCO2)
Standard bicarbonate
Bile acids (Total)
4 mL purple top tube
Full report issued

0-2.3 mg/L
22-29 mmol/L
<14 umol/L
See Gases
Run weekly. This test is for total bile acids.
Bile acids (for ?primary

metabolic disorder)
Bilirubin, blood, total
2 mL green top (i.e. lithium

heparin) and random urine
Refer to report
Analysed at ICH
Bilirubin, blood, conjugated

Bilirubin,
urine,
bile
pigments
Biotinidase

10ml random urine
0-137 umol/L (<1 day)

0-239 umol/L (1-3 days)
0-20 umol/L (4 days)
0-5 umol/L
Bilirubin is not normally found in urine.
3.9-18.9 nmol/mL/min
For multiple carboxylase deficiency only. Requests individually

reviewed by senior staff. Analysed at GOS
Daily service if received by noon Mon to Fri
Urine- qualitative screen

(Labstix)
5 mL blood green top tube or

serum (minimum 2 mL)
10ml random urine
Version 17
Daily service if received by noon Mon to Fri
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TEST
Blood in faeces
SAMPLE REQUIREMENTS
2g stool sample
REFERENCE RANGE
Negative in normal individuals
BNP see NT-proBNP

Bone Profile
Includes: calcium, phosphate,
alkaline phosphatase,
albumin
Busulphan
CA 15-3
No ref range. Multiple points for investigation of

pharmacokinetics
0-25 KIU/L
CA19-9
0-27 KIU/L
CA125
0-35 KIU/L
Cadmium, blood
4 mL purple top tube (plastic)
<27 nmol/L non-smokers

<53 nmol/L smokers
Cadmium, urine
25 mL random urine
<1.0 nmol/mmol creatinine
Caeruloplasmin
Calcitonin
4ml red top or gold top tube

required ON ICE (see notes)
0.15-0.30 g/L male

0.16-0.45 g/L female
No ref range for <1y
<.4.8 ng/L (female)
< 11.8 ng/L (Male)
Calcium (albumin adjusted)
2.20-2.60 mmol/L
Calcium, urine
24hr urine collected in bottle

with acid
10 mg minimum
0.08-0.79 mmol/mmol creatinine

2.5-8.0 mmol/24h
Random faecal sample
<60 ug/g faeces (not applicable to neonates)
Carbamazepine
Therapeutic range 4-12 mg/L

(please note, units changed to mg/L occurred on
13/8/12)
Carbamazepine (free)
5 mL blood red top tube
Calculus (urinary and other

sites)
Calprotectin (faecal)
Must be prearranged via duty biochemist.

Analysed at GOS
24 hour availability. For monitoring breast cancer treatment
Not suitable as a screening test
24 hour availability. For monitoring pancreatic carcinoma
24 hour availability. For monitoring carcinoma of the ovary
within 2 weeks. Analysed by Trace Metal lab, Guildford 01483
259978
within 2 weeks. Analysed by Trace Metal lab, Guildford 01483
259978
Change in reference range 08/03/2013
immediately on ice (must be separated and frozen within one hour
of draw). Routine transport not suitable. Requests are individually
reviewed, results are available in 2 to 4 weeks. For monitoring
medullary carcinoma of the thyroid.
Minor ref range change noted 16/1/13
Analysed at Charing Cross Hospital 0203383 5914
Ref range change March 2014
Usually 24 hour availability
Molecular Urology test. Analysed daily
Requests are individually reviewed by senior staff.

Analysed at Clinical Biochemistry, Kings 02032993856
Usually 24 hour availability. Ideal sampling time: pre dose. Time to
steady state 2-4 weeks (initiation), 3-4 days (dose change)
Batch assay, includes total carbamazepine. Analysed at the
Pharmacology and Therapeutic unit, Chalfont 01494 601 423
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TEST
Carbamazepine epoxide
Carbon dioxide Total
Carbon dioxide pCO2
Carbohydrate
deficient
transferrin
SAMPLE REQUIREMENTS
REFERENCE RANGE
<2.6%
0-3.4 ug/L
Carbon monoxide
Carcinoembryonic
(CEA)
antigen
Cardiac enzymes
Carnitines, see acyl carnitine
Carotene, beta
Catecholamines, urine
5mL blood gold top tube

(protect from light)
with acid
Catecholamines, plasma
Please note: no longer
recommended. See plasma
metanephrines
Noradrenaline <53 nmol/mmol creatinine

Adrenaline <15 nmol/mmol creatinine
Dopamine <338 nmol/mmol creatinine
Reference ranges are for adults.
Paediatric reference ranges are available contact
Neurometabolic laboratory or see their online
handbook
See report
C1 esterase inhibitor
(immunological assay)
0.15 0.35 g/L
C1
esterase
(functional)
40-150%
urine
<0.03 mg/mmol
inhibitor
Ceramide trihexosides
Batch assay, includes total carbamazepine. Analysed at the
Pharmacology and Therapeutic unit, Chalfont 01494 601 423
See Bicarbonate
See Gases
Requests are individually reviewed by senior staff. Results
available within 2 weeks. Available for patients of Dr Bradley T15
and PPW patients only.
Analysed at Kings 0203299 3856
See Gases. No service in Biochemistry, refer to ITU for analysis on
blood gas machine
24 hour availability. For monitoring carcinoma of the colon /
rectum
see Creatine Kinase
For patients with documented low vit A concentrations.
Requests are individually reviewed. Analysed at St Helier 0208
2962804
Batched for analysis on selected days (includes adrenaline,
noradrenaline and dopamine)
Not routinely available. Plasma mets are more sensitive and

specific
immediately on ice. Routine transport not suitable. Should only be
requested if urine cannot be collected for catecholamines, and only
with prior agreement of Clin Biochem senior medical or scientific
staff
Analysed at Royal London 02032460380
weeks. Request C3 and C4 concurrently.N.B. If C4 normal,
deficiency is unlikely.
Analysed at Birmingham Heartlands Hospital 0121 424 2105
weeks. Request C3 and C4 concurrently.N.B. If C4 normal,
deficiency is unlikely.
Analysed at Sheffield Northern 0114 271 5552
Requests are individually reviewed. For dx and monitoring of
Fabrys. Analysed at ICH
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TEST
Chitotriosidase
SAMPLE REQUIREMENTS
5 mL light green top or purple
top
REFERENCE RANGE
<150 nmol/h/mL
Chloride, blood
Chloride, sweat
High

Sweat
Special collection containers
are issued only via the lab
Low
98-107 mmol/L
<40 mmol/L (Normal)
40-60 mmol/L (Equivocal)
>60 mmol/L (Positive)
<5.0 mmol/L
0.9-1.5 mmol/L (Male)
1.2-1.7 mmol/L (Female)
< 3.0 mmol/L
2.3-9.0 KU/L
4 mL blood purple top. Use

plastic cannula and/or second
draw. Discard first 10 mL
Fasting and rapid separation
required
MHRA/2010/33 cut-off of 7ppb corresponds to 134

nmol/L chromium
Citrate
24hr urine collected in plain

bottle or bottle with acid, or
10ml random urine
0.60-4.8 mmol/24 hour (Male)

1.30-6.0 mmol/24 hour (Female)
0.04-0.33 mmol/mmol creatinine (Male)
0.11-0.55 mmol/mmol creatinine (Female)
Clobazam + metabolite
Clonazepam
Clozapine (Cliozail)

Special request form required
See report
Cobalt
MHRA/2010/33 cut-off 7 ppb corresponds to 119

nmol/L
Cholesterol Total
Cholesterol (HDL),
density lipoprotein
Cholesterol (LDL),
density lipoprotein
Cholinesterase
Chorionic Gonadotrophin
Chromium
Chromogranin
Ciclosporin
Calculated from other results (Friedewald formula)
Chromogranin A <60 pmol/L

Chromogranin B <150 pmol/L
Dependent on patient type, dose route and clinical
application.
Requests are individually reviewed. For monitoring of Gauchers
disease
Analysed at Gt Ormond St Hospital 02072429789 x2114
Sample requires special or immediate attention. Transfer to lab
immediately, routine transport not suitable.
Version 17

weeks
Inhibition studies will be reported where relevant
Analysed at Cardiff Toxicology
See HCG
For metal-on metal hip replacement monitoring.
weeks. Analysed at Guildford
Fasting sample. See gut hormones
Sample requires special or immediate attention. Transfer to lab
immediately, routine transport not suitable.
Same day service if received by noon Monday to Friday and by
10.00 Saturday and Sunday. Ideal sampling time: pre dose
Molecular urology test. Batched for analysis on selected days
Analysed at the Pharmacology and Therapeutic unit, Chalfont

01494 601 423
01494 601 423
Predose sample
Refer to Novartis monitoring service 08457698269
Analysed at Kings (0203299 3856)
For metal on metal hip replacement monitoring. Requests
individually reviewed, results are available in 2 to 4 weeks.
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TEST
Collagen type 1 cross-linked
C telopeptide (CTX)
SAMPLE REQUIREMENTS
Fasting, rapid separation
REFERENCE RANGE
(Children males and females)
<1 month
0.44-2.27 ug/L
1month -1year
0.20-2.31
1-9 years
0.15-0.82
Males
9-14y
0.23-1.24
14-17y
0.24-1.73
17-19y
0.10-0.79
Females
9-11y
0.30-1.0
11-13y
0.33-1.7
13-15y
0.14-1.20
15-19y
0.05-0.58
Sample must be sent to lab without delay for separation.
Requests individually reviewed. Analysed at Norfolk and Norwich
Adult Males and pre-menopausal Females (20-50y)

0.1-0.5 ug/L
Collagen type 1 N-telopeptide
(see NTX)
Complement (C3 and/or C4)
Copper
Cortisol
C-peptide
C-Reactive Protein

5ml blood white top tube
or
bottle
(LiHep accepted for paediatric
samples only)
bottle
5ml blood gold or red top
tube ON ICE
(and 2mL light grey top tube
for concurrent glucose level)
C3 0.90-1.80 g/L
C4 0.10-0.40 g/L
11 20 umol/L

Requests individually reviewed, results are available in 2 to 4
weeks. White top tubes are available from lab.
Analysed at Guildford, 01483 259978
<0.9 umol/24h
Paediatric reference ranges differ
Midnight <140 nmol/L
0900 140-700
0-250 nmol/24h
Urines are batched for analysis on selected days
260-650 pmol/L (Fasting)

immediately on ice with concomitant glucose and insulin.
Routine transport not suitable. All requests reviewed by senior
staff. Investigation of spontaneous hypoglycaemia. Glucose level
must always be measured at same time.
Analysed at Royal Surrey Hospital, 01483406715
0-3.2 mg/L (0-2 Days)

0-1.6 mg/L (2-8 Days)
0-5.0 mg/L (>8 Days)
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TEST
Creatine
guanidinoacetate
and
Creatine kinase Total

Creatine kinase
Isoenzyme
Creatinine

MB
Creatinine clearance
CRF test
CRP
Cryoglobulins
CSF profile (CSF protein and

glucose)
CSF IgG
CSF lactate
SAMPLE REQUIREMENTS
5 mL blood green top tube or
urine
Must be sent on ice

or
REFERENCE RANGE
Plasma creatine: 10-100 umol/L
Plasma guanidinoacetate: 0.8-3.1 umol/L
Urine creatine
0-4y 6-1200 umol/mmol
4-12 17-720 umol/mmol
>12y 11-240 umol/mmol
urine guanidinoacetate
0-15y 4-220 umol/mmol
>15y 3-78 umol/mmol
38-204 IU/L (Male)
26-140 IU/L (Female)
0-4.9 ug/L (Male)
0-2.9 ug/L (Female)
21-75 umol/L (0-60 Days)
15-37 umol/L (60-365 Days)
21-36 umol/L (1-3 Years)
46-70 umol/L (11-13 Years)
50-77 umol/L (13-15 Years)
66-112 umol/L (Male >15 Years,)
49-92 umol/L (Female >15 Years,)

bottle
bottle
and
Follow dynamic function test
protocol
7.0-21.0 mmol/24h
Reference range for adults only
70-152 ml/min
5ml blood Red top tube

maintained
at
37C
For cryofibrinogen include
maintained at 37C
0.5 ml CSF plain tube
(gold top/gel is not suitable)
and
0.5ml CSF light grey top tube
In normal subjects no cryoproteins are present.
CSF lactate 1.1-2.4 mmol/L
For inherited disorders of creatine deficiency only
All requests reviewed by senior staff.
Analysed at Cambridge Biochemical Genetics
Blood Cortisol after injecting CRF
CSF protein 0.13-0.40g/L
See C-Reactive Protein

immediately, while maintaining sample at 37C. Routine transport
not suitable. Batched for analysis on selected days
NB 37C is blood temperature. Do NOT put blood samples into hot
water.
Includes appearance, protein and glucose
See Oligoclonal proteins
Version 17
May 2014
Page 13 of 31
TEST
Cyclosporin, see ciclosporin
Cystic fibrosis genotyping
SAMPLE REQUIREMENTS
REFERENCE RANGE
4 ml blood purple top tube
Cystine/homocystine, Urine,
Screen
Cystine/homocystine, Urine,
Quantitative
Cystine/homocystine, Blood
Dehydroepiandrosterone
sulphate (DHEAS)
7-Dehydrosterols
Deoxy-cortisol, 11
10ml urine (EMU)
Not detected
Originator must refer patient directly to Regional Genetics Lab at

Gt Ormond St. We do not forward samples.
Molecular urology test Batched for analysis on selected days

bottle
41-415 umol/24h
Full report issued

0.4-13.4 umol/L (Male)
0.26-11.0 umol/L (Female)

Dexamethasone suppression
test

protocol
Diazepam

(predose)
Digoxin
Random urine
5mL gold /red top tube
Dihydrotestosterone (DHT)
5ml blood Red top tube
Diuretic screen
Dopamine
Drug Screen:
Addiction
See Drug screen, diuretic

Drugs
of
25ml random urine
Drug Screen : Diuretic Screen
25ml random urine
Drug Screen: Laxative Screen
25ml random urine
Note: change of units implemented 16/7/12
Results available in 7 days

For diagnosis and monitoring of 11-hydroxylase deficiency only.
Requests are individually reviewed by Clin Biochem senior
medical or scientific staff
Analysed at Royal London 02032460383
Blood Cortisol after oral dexamethasone. See DFT information
Blood and urine Cortisol after prolonged (4-6 days) stepped-dose
dexamethasone
Requests individually reviewed by senior staff.
Analysed at Cardiff Toxicology
24 hour availability. Ideal sampling time: at least 6 hours (may be
up to 24 hours) after last dose, oral or iv. Time to steady state:
7days
<0.27 prepubertal
<0.6 nmol/L (Adult Female)
0.32-1.64 nmol/L (Adult Male)
Requests are individually reviewed by Clin Biochem senior

medical or scientific staff. Analysed at Royal London
02032460383
7-13 nmol/L (9am)
0.9-2.0 ug/L (0.5-1.0 ug/L in heart failure)
See Catecholamines
Screens for:
Opiates
Cocaine
Methadone
Benzodiazepines
Amphetamines
Barbiturates
Cannabis
Requests are individually reviewed.
Negative

weeks
Analysed at Epsom
Version 17
May 2014
Page 14 of 31
TEST
Drug Overdose
Samples
Drug
Overdose:
toxicology screen
Save
Urgent
SAMPLE REQUIREMENTS
25ml random urine with
5ml blood red top tube and
5ml blood Red top tube and
2ml blood Light grey top tube
eGFR
Calculation
Elastase (faecal)
1g (almond-size lump) faeces

in plain pot
Electrophoresis
Proteins
Electrophoresis
Proteins
ELF test
Serum
Urine
REFERENCE RANGE
Interpret with regard to UK CKD guidelines

www.renal.org/CKDguide/ckd.html
>200 ug/g normal
<5-100 ug/g indicates severe pancreatic insufficiency
100-200 ug/g indicates moderate insufficiency
Urgent screening must be agreed with a senior member of the

laboratory staff. Full clinical details and all current drug treatments
will be required. It is very unusual for urgent toxicology to be
clinically useful. See also Paracetamol, and Salicylate
Calculated from creatinine in all patients >18y.
weeks
Analysed at Gt Ormond St 02078297806
25ml urine (EMU preferred)

See also Bence-Jones Protein
Referred out test. For Camden & Islington CCG only
For interpretation see C&I algorithm
Ethanol
See Alcohol
Ethosuxemide
5 mLblood red top tube
Everolimus
Fatty
acids,
(includes C15-22)
The laboratory will store these samples to be available for the
Coroner
essential

01494 601 423
Requests are individually reviewed. Analysed at Analytical
Toxicology Unit, St Georges 0208 7679686
weeks
Analysed at West Park Hospital 01372734724
weeks
Analysed at Gt Ormond St 02074059200 x5225
01494 601 423
24 hour availability. Iron + IBC preferred as first line tests for
anaemia
Requests individually reviewed by senior staff.
Analysed at Royal Hallamshire Hospital, 0114 2713905
Fatty Acids (Long chain fatty

acids)
Felbamate
Ferritin
Flecainide
5 mL blood gold top tube or

green top
Predose sample
See report
Male 30-400 ug/L

Female 13-150 ug/L
Version 17
May 2014
Page 15 of 31
TEST
Follicle stimulating hormone
(FSH)
SAMPLE REQUIREMENTS
REFERENCE RANGE
Male: 1.5-12.4 IU/L
Female:
3.5-12.5 IU/L (Follicular)
4.7-21.5 IU/L (Mid cycle)
1.7-7.7 IU/L (Luteal)
25.8-134.8 IU/L (Post menopausal)
Normal 0.8-1.44
Fractional Phosphate
Reabsorption

Free light chains (serum)
Free T3
Free T4
Fructosamine
Gabapentin
Galactose-1-phosphate
0.1-0.57 umol/g Hb
Galactose-1-uridyl phosphate
Normal 20.2-46.4 umol/h/g Hb

Carrier: 10.2-21.4 umol/h/g Hb
Affected: 0.2-3.9 umol/h/g Hb
Gamma-glutamyl transferase
(GGT)
20-183 IU/L (0-30 Days)

20-155 IU/L (31 days to 3 months)
10-130 IU/L (3- 6 months)
10-71 IU/L (Male)
6-42 IU/L (Female)
Gases
2ml blood
(heparin syringe on ice)
NOT AVAILABLE IN
BIOCHEMISTRY
Free kappa 3.3-19.4 mg/L

Free lambda 5.7-26.3 mg/L
Kappa:lambda ratio 0.26-1.65
4.0-6.8 pmol/L
12.0-22.0 pmol/L
215-264 umol/L (Non-diabetic)
264-320 umol/L (Well-controlled)
320-476 umol/L (Poorly controlled)
Requires serum and urine creatinine and phosphate results.

Usually 24 hour availability.
Only available for private patients or samples endorsed by
Haematology consultants.

weeks
Only for monitoring diabetic control in patients with an abnormal
haemoglobin (invalidating HbA1c)
Analysed at East Surrey Hospital 01737768511 x1691
01494 601 423
Requests individually reviewed. Results available in 5 weeks.
Analysed at GOS 02072429789 x2509
For investigation of prolonged conjugated jaundice.
Please do not request on Friday or over weekend.
Requests individually reviewed. Results available in 5 weeks.
Analysed at GSTS 020 7188 2591
Results unreliable unless at least 120 days post transfusion
This test NOT AVAILABLE within Clinical Biochemistry Lab do

NOT transport sample to lab. Take directly to ITU or A/E. Note for
safety, needle MUST be removed before transporting sample.
Version 17
May 2014
Page 16 of 31
TEST
Gastrin (Fasting essential)
SAMPLE REQUIREMENTS
2 X 4ml blood purple top tube
ON ICE (see notes)
Glucagon (Fasting essential)
4ml blood Purple top tube (see

notes)
<50 pmol/L
Glucose

or
or
3ml blood Light grey top tube
protocol
3.9-5.8 mmo/L

with acid
Glucose (oral) tolerance test

Glycated
(HbA1c)
haemoglobin
Glycolate
Glycosaminoglycans
mucopolysaccharides)
Glyoxylate reductase
REFERENCE RANGE
<40 pmol/L
2.2-3.9 mmol/L
Not detected
For interpretation see dynamic function test protocol
Blood and urine glucose after 75g oral load
4.0-6.0 % total Hb
20-42 mmol/mol (IFCC)
Batched for analysis on selected days. For monitoring established

diabetes.
140-620 umol/24hr
Glycolate/creatinine (umol/mmol)
Under 1 y: 1-49
1-4y: 2-54
5-11 y: 1-68
>12y: 14-57
Molecular Urology test. Batched for analysis on selected days.
(see
Gonadotrophins
GRHPR
gene
(Primary
Growth Hormone (GH)
Sample requires special or immediate action (see Guidance note
#19). Transport to lab immediately, on ice. Requests are
individually reviewed, results are available in 2 to 4 weeks Off
Omeprazole for 2 weeks; H2 blockers for 3 days and antacids for 1
day.
Analysed at Charing Cross 0203383 5914
immediately, on ice. Requests are individually reviewed, results are
available in 2 to 4 weeks.
Analysed at Charing Cross
See Mucopolysaccharides
20mg liver biopsy, frozen
49-213 nmol NADP formed/min/mg
Full report issued
Pulsatile secretion means that random sampling has

little value
A random value >6.7 ug/L tends to exclude GH
deficiency
Molecular Urology test For diagnosis of primary hyperoxaluria

type 2
See FSH and LH
Version 17
Batched for analysis on selected days.
May 2014
Page 17 of 31
TEST
Gut hormones
SAMPLE REQUIREMENTS
2x5mL purple top tubes on
ice.
Patient must be fasting and off
treatment (see notes)
Haptoglobin
HbA1c
HCG
REFERENCE RANGE
VIP <30 pmol/L
Pancreatic polypeptide <300 pmol/L
Gastrin <60 pmol/L
Glucagon <50 pmol/L
Somatostatin <150 pmol/L
Chromogranin A <60 pmol/L
Chromogranin B <150 pmol/L
0.3-2.0 g/L
0-3 IU/L
HCG, CSF
HCG, pregnancy test
1 mL CSF
5ml random urine
<1 IU/L (adult)
HDL cholesterol
Samples require special or immediate action (see Guidance note
#19). Transport to lab immediately, on ice. Requests are
individually reviewed, results are available in 2 to 4 weeks For
gastrin must be off Omeprazole for 2 weeks; and H2 blockers for 3
days. Includes gastrin, glucagon, somatostatin, pancreatic
polypeptide, VIP, chromogranin A and B.
Analysed at Charing Cross 0203383 5914
See Glycated haemoglobin
Not out of hours. For ?ectopic out of hours, send blood in gold top
tube for HCG
(A&E and some wards carry supply of Clearview Easy pregnancy
testing strips)
24h availability
0.9-1.5 mmol/L (Male)

1.2-1.7 mmol/L (Female)
Refer to report
Hexosaminidase (Tay Sachs)
5-HIAA

bottle (acid containing bottle
is also suitable)
0-4.9 umol/mmol creatinine
Requests are individually reviewed by senior staff, results available

within 2-4 weeks. Analysed at Gt Ormond St 02074059200 x5076
Full report issued
Request Urine Catecholamines

2 mL green top (heparin) or

orange top paediatric tube
mmol/L (adults <200 umol/L, infants <400 umol/L)
11-hydroxylase genetics
Hydroxycholecalciferol
Hydroxyprogesterone (17)
Full report issued
5 mL gold, red or green top

tube
17-hydroxysteroid
dehydrogenase type 3
genetics
IGF1, see insulin like growth
factor
5 days M+F <3.0 nmol/L

16y M + F <4.0 nmol/L
>16 y M <5.0 nmol/L
>16 y F <5.0 nmol/L (result may be higher in luteal)
Carriers for 21-hydroxylase deficiency may show
higher values
Full report issued
HMMA
HOGA1
gene
(primary
3-hydroxybutyrate
(blood
ketones)
Version 17
As part of investigation for unexplained hypoglycaemia in

children
Note change in units from 1/08/2013
See Vitamin D
Steroid Endocrinology test. Daily analysis. Preliminary results on
urgent samples can be available same day of sample receipt with
confirmation by 1100 next day. Urgent samples should first be
discussed with senior staff and arrive in the lab by 1100
May 2014
Page 18 of 31
IGF1BP3
TEST
SAMPLE REQUIREMENTS
5 mL blood gold or red tube
REFERENCE RANGE
0-2y 0.5-2.9 mg/L
3-4 y 0.8-3.4 mg/L
5-6y 1.0-3.8 mg/L
7-8y 1.1-4.3 mg/L
9-10y 1.3-4.6 mg/L
11-12y 1.6-5.0 mg/L
13-14y 2.1-5.3 mg/L
15-16y 2.5-5.4 mg/L
17-18y 2.4-5.4 mg/L
19-20y 2.3-5.3 mg/L
21-40y 1.7-5.2 mg/L
41-60y 1.3-4.8 mg/L
61-80y 0.7-4.4 mg/L
>80y 0.5-4.3 mg/L
Immunofixation
Immunoglobulins G, A, M
Immunoglobulin D
2.3-14.1 g/L (IgG 0-1 Years)

4.5-9.2 g/L (IgG 1-4 Years)
5.0-14.6 g/L (IgG 4-7 Years)
5.7-14.7 g/L (IgG 7-10 Years)
7.0-16.0 g/L (IgG >10 Years)
0-1.0 g/L (IgA 0-4 Years)
0.3-3.0 g/L (IgA 4-10 Years)
0.5-3.6 g/L (IgA 10-14 Years)
0.5-3.5 g/L (IgA 14-20 Years)
0.7-4.0 g/L (IgA >20 Years)
0-1.5 g/L (IgM 0-4 Years)
0.2-2.1 g/L (IgM 4-10 Years)
0.3-2.4 g/L (IgM 10-14 Years)
0.2-2.6 g/L (IgM 14-20 Years)
0.4-2.3 g/L (IgM >20 Years)
2-100 kU/L
Immunoglobulin E (total)
Immunoglobulin
(IgG subclasses)
subclasses
See Paraprotein typing and quantitation

<15 kU/L (0-1 Years)

<200 kU/L (9-15 Years)
<100 kU/L (>15 Years)
Age specific for each sub-class. See report
Requests individually reviewed by senior staff. Analysed at
Guildford 01483406715
Version 17
Rarely required.
Analysed at Northern General
Requests are individually reviewed by senior staff, results available

within 3 weeks.
Analysed at Northern General, 0114 271 5552
May 2014
Page 19 of 31
TEST
SAMPLE REQUIREMENTS
Inhibin B
Insulin

(and 2mL light grey top tube
for concurrent glucose level)
Insulin antibodies
Insulin-like Growth Factor 1
(IGF1)
Insulin tolerance test

protocol
5 mL blood red or green top.
Urine (random)
Calculation
Iodine
Ions difference
Iron and Iron
Capacity (IBC)
Binding
Iron, Urine
Ketones (qualitative)
Ketones (blood), see
hydroxybutyrate
Labstix
Lactate
REFERENCE RANGE
Males: 25-325 ng/L
Females:
day 3 <273 ng/L
Otherwise <341 ng/L
2.6-24.9 mIU/L
Refer to report
2m-5y
6-8y
9-11y
12-15y
16-20y
21-24y
25-40y
41-50y
51-60y
61-75y
Female
4.4-22.3
10.4-31.7
11.4-51.9
24.5-66.3
34.8-61.2
19.4-43.2
16.1-39.8
12.6-35.5
12.9-33.0
11.8-28.6
Units nmol/L
Male
3.6-14.8
7.1-26.8
11.1-32.3
15.0-64.8
32.1-62.6
24.4-52.0
16.3-39.3
11.6-31.3
12.2-30.0
12.7-29.3
available within 3 weeks.
Analysed at Charing Cross 0208 846 1415
24 hour availability. For investigation of spontaneous
hypoglycaemia. Glucose level must always be measured at same
time.
Request are individually reviewed by senior staff. Analysed at
Royal Surrey County Hospital, 01483 259978
Change of method to Diasorin on 18/12/2012
Glucose, Cortisol and Growth hormone after injecting insulin

(hazardous)
Requests are individually reviewed
Analysed at Southampton
See Anion gap
10.6-28.3 umol/L (Iron Male)

6.6-26.0 umol/L (Iron Female)
41-77 umol/L (IBC)
Saturation 20-50% (Male)
Saturation 15-50% (Female)

bottle

weeks.
Analysed at Guildford, 01483259978
24 hour availability. See also Labstix
10ml random urine

3-
These sticks are widely available for local clinical use includes
pH, Protein, Blood, Glucose, Ketones, etc
24 hour availability. Sample must be transported to the lab
immediately.
0.5-2.2 mmol/L
Version 17
May 2014
Page 20 of 31
TEST
Lactate dehydrogenase
SAMPLE REQUIREMENTS
REFERENCE RANGE
Females 135-214 IU/L
Males 135 -225 IU/L
Children ( up to 15) 120 300 IU/L
Lamotrigene
5 mL blood red top
Laxative Screen
Random urine, 20 mL
Negative
LDL Cholesterol
Lead (inorganic)
4ml blood Purple top tube
Up to 3.5 mmol/L
< 0.5 umol/L (Normal)
>3.0 umol/L (Toxic)

01494 601 423
Analysed at West Park, Epsom 01372 734720
See Cholesterol
weeks
available within 2 weeks. Analysed at Trace Element lab,
Guildford 01483 259978
01494 601 423
FSH, LH after injecting LHRH
Lead, urine (organic)
20 mL random urine or 5 mL
paediatric urine
Levetiracetam
5 mL blood red top
LHRH test

protocol
5 mL gold top tube
13-60 IU/L
Restricted use. For ?acute pancreatitis, use amylase
See individual components

0-0.3 g/L
0.6-1.0 mmol/L (at lower end for maintenance
therapy and the elderly)

Usually 24 hour availability. Time to steady state: 4 7 days. Ideal
sampling time: 12h after night time dose (trough level). Urgent
analysis usually available for overdose cases. Do NOT use light
green top tube lithium heparin anticoagulant.
1.7-8.6 IU/L (Male)

2.4-12.6 IU/L (Follicular)
14.0-95.6 IU/L (Mid cycle)
1.0-11.4 IU/L (Luteal)
7.7-58.5 IU/L (Post menopausal)
Lipase
(Trial use only)
Lipid profile (fasting)
Inc:Cholesterol ,
Triglycerides, HDLchol,
LDLchol, & Chol/HDL ratio
Lipoprotein (a)
Lithium
Liver profile
Inc:
Albumin, Bilirubin,
Alkaline
Phosphatase, ALT
Luteinising hormone (LH)
Macroprolactin
Magnesium
Magnesium, Urine

24 h urine collected in bottle
with acid
<0.1 umol/24h or see report if random
N.B. Assay change from 4/4/2011 with significant change in ref
range
Assayed weekly. Routinely assessed if prolactin >700

0.6-1.0 mmol/L
2.5-8.5 mmol/24h
Version 17
May 2014
Page 21 of 31
TEST
Mannose binding lectin
SAMPLE REQUIREMENTS
4 mL blood purple top (plastic
canula or if using needle,
discard first 10 mL)
5 mL gold top tube
Mercury (inorganic)
25 ml random urine
Mercury (organic)
Metanephrines, plasma

2 x 4 mLpurple top tubes,
ON ICE
Metanephrines, urine
24h urine (acid collection or

can be acidified on receipt in
lab)
Manganese
Methotrexate
Methylmalonic acid
2 mL gold/purple/green top
tube
Methylhistamine
10 mL random urine
REFERENCE RANGE
Refer to report
0-5y: 0.6-4.0 mg/L
>5y: 1.0-4.0 mg/L
<50 nmol/L
<30 nmol/L
Normatanephrine 120-1180 pmol/L
Metanephrine 80-510 pmol/L
3-methoxytyramine <180 pmol/L
Refer to report
umol/L
Dependent on patient type and dose route.
Normal: up to 0.29 umol/L
0.30-0.74 umol/L suggests B12 deficiency
>0.74 umol/L consistent with overt B12 deficiency
Microalbumin
Microglobulin (2)
Mucopolysaccharides
5ml random fresh urine
Individual reports given
Muscle enzymes
Mycophenalate
Myoglobin
5 ml blood gold top

10ml random urine
10 mL random urine
<1y : 2-27 U/mmol

1-5y 2-22 U/mmol
5-10y 2-10 U/mmol
10-16y 2-12 U/mmol
NAG
(N-acetylglucosaminidase),
urine

Patient should have refrained from vigorous exercise, excessive
nicotine, coffee and
Daily service, including Saturday and Sunday. Sample must be
received before 2pm.
Analysed in Neurometabolic Unit 020344 84716
Two timed samples (2h and 24h post event) required. Keep at 4
degrees until sent to lab.
available within 4 weeks.
Analysed at Northern General 0114 2715552.
See also Tryptase
See Albumin, urine
See Beta-2 Microglobulin
weeks
Analysed at Gt Ormond St, 0207829 8662
See Creatine Kinase
For suspicion of toxicity. Analysed at St Georges 02087679686
Qualitative stix test. Usually daily service. CK is a more sensitive
marker of muscle damage
Requests individually reviewed by senior staff. Analysed at Gt
Ormond St 02078298662. Usually requested with retinal binding
protein.
0-2.8 mg/mmol creatinine
Requests are individually reviewed by senior staff
Analysed at Northern General
weeks.
For cases of suspected exposure to mercury vapour or inorganic
mercury salts
Sample must be sent to lab immediately. Routine porter is not
suitable.
Version 17
May 2014
Page 22 of 31
TEST
Non-esterified fatty acids
(NEFA)
Neurone specific enolase
SAMPLE REQUIREMENTS
1 mL heparinised blood
(green top tube); orange
paediatric tube
5 ml blood gold top
Noradrenaline
NT-proBNP
5 ml blood gold top
NTX
(collagen
telopeptide)
Occult blood
Oestradiol
Olanzapine
N-
REFERENCE RANGE
0.1-0.6 mmol/L
For investigation of hypoglycaemia
<12.5 ug/L

within 1 week. Analysed at Northern General 0114 2715552
See Catecholamines, Urine
For primary care and Heart Hospital use ONLY.
Requests from other sources should contact the duty biochemist
<47 pmol/L normal

47-236 pmol/L raised (echocardiography within 6
weeks)
>236 pmol/L high (echocardiography within 2 wks)
20 mL random urine, ideally

2nd morning void collected
between 8-11am
Organic acids (screen)

Orotate
Urine (random)
<5 umol/mmol creatinine
Osmolality

5ml random urine
285-295 mosmo/kg
300-900 mosmo/kg
Oxalate, Plasma
<10 umol/L (Non-fasting)
http://guidance.nice.org.uk/CG108/QuickRefGuide/pdf/English

within 4 weeks. Analysed at St Marys.
For monitoring patients on bisphosphonates suggest 3-6 monthly
intervals
See Blood (faeces)
Male: 44-146 pmol/L

Female:
46-607 pmol/l (Follicular)
315-1828 pmol/l (Mid-cycle)
161-774 pmol/l (Luteal)
<201 pmol/l (Post menopausal)

preferred, gold top can be
used
1ml CSF Plain tube with
5ml Urine fresh random
Oligoclonal proteins (CSF)

Kings College 02032998656
Neuroimmunology test

weeks
Requests are individually reviewed. Results are available in 3-4
weeks
usually 24 hour availability
Molecular Urology test. Sample requires special or immediate

action. Transport to lab immediately, on ice. Routine transport not
suitable.
Version 17
May 2014
Page 23 of 31
TEST
Oxalate, Urine
SAMPLE REQUIREMENTS
with acid
Oxcarbazepine
Oxygen
Pancreolauryl Test
Paracetamol
10-30 mg/L
and
No paraprotein present.

01494 601 423
See Gases
Test withdrawn
Analyse ONCE ONLY at 4 12 hours after the overdose (state
time of overdose)
and
25 mL urine (EMU preferred)
Individual report issued
See Bence-Jones Protein
1.6-6.9 pmol/L
24 hour availability. Samples must be transported to the laboratory

within 2 hours of venepuncture
Cannot be added retrospectively
Blood catecholamines before and after pentolinium suppression
Paraprotein
typing
quantitation, Serum
Paraprotein
typing
quantitation, Urine
Parathyroid hormone
Pentolinium Test
pH Blood
pH Urine
REFERENCE RANGE
100-460 mmol/24 hour
(adults, for children correct for BSA)
Ox/cre ratio:
Infants < 1 year 4 98 umol/mmol
1 4 years 4 72
5 11 years 3 71
> 12 years 1 38
Light
green
top
tubes
protocol
Phenobarbitone
5mL fresh random urine

transported to lab immediately
Phenobarbitone (free level)
Phenytoin
Phenytoin (free)
Molcular Urology test. Batched for analysis on selected days
See Gases
See Acid load test or Labstix
13/8/12)

13/8/12)

01494 601 423
Usually 24 hour service Ideal sampling time: (oral) Pre-dose, (IV)
6 hours post-dose. Time to steady state: (oral) 2 4 weeks on
initiation, 7 days on change of dose, (IV) 6 hours
01494 601 423
See Acid Phosphatase
See Alkaline Phosphatase
Phosphatase
Usually 24 hour availability. Ideal sample time: pre dose. Time to

steady state: 3 weeks
Version 17
May 2014
Page 24 of 31
TEST
Phosphate
Phosphate
Phytanate
SAMPLE REQUIREMENTS

with acid
Phytosterols
5 mL blood green or red top

tube
Piracetam
Pituitary Function Test

Porphobilinogen, Urine
(for screening & quantitation)

protocol on intranet
25mL random fresh urine
Protect sample from light
Porphyrins, Urine
(for screening & quantitation)
25mL random fresh urine

Porphyrins, Blood
4mL blood purple top tube

Porphyrins, Faeces
Faeces (fresh random)

Potassium
Potassium, Urine

or acid bottle or 10 ml
random urine
Pregabalin
REFERENCE RANGE
1.45-2.91 mmol/L (0-10 Days)
1.45-2.16 mmol/L (10 Days-2 Years)
1.45-1.78 mmol/L (2-13 Years)
0.87-1.45 mmol/L (>13 Years)
13-42 mmol/24h
0-10 umol/L
See Fatty acids, long chain
Refer to report
Requests are individually reviewed by senior staff. Sample requires

immediate action. Transport to lab immediately, routine transport
not suitable. Analysed at Institute of Child Health, Prof Clayton
02079052664
01494 601 423
Blood glucose, cortisol, growth hormone after iv insulin
(hazardous)
immediately, protected from light. Usually daily service for screen
if received by noon Mon to Fri.
Quantitation if required at University Hospital of Wales
02920743565
immediately, protected from light. Usually daily service for screen
if received by noon Mon to Fri.
Quantitation if required at University Hospital of Wales
02920743565
immediately, protected from light. Requests are individually
reviewed, results are available in 2 to 4 weeks.
Analysed at University Hospital of Wales 02920743565
immediately, protected from light. Requests are individually
reviewed, results are available in 2 to 4 weeks.
Analysed at University Hospital of Wales 02920743565
3.5-5.1 mmol/L
25-125 mmol/24h

01494 601 423
Version 17
May 2014
Page 25 of 31
Pregnancy
Urine
TEST
test Routine,
Pregnancy test ?Ectopic

See HCG
Primary hyperoxaluria
genetics, see AGXT, GRHPR,
HOGA1
Primidone
Procollagen type I
aminoterminal peptide
(P1NP)
SAMPLE REQUIREMENTS
5 mL random urine
REFERENCE RANGE
Urine samples from non-pregnant females generally
contain <10 mIU/mL hCG. On the first day of the
missed period the levels of maternal hCG are
normally 50-250 mIU/mL. The minimum detection
limit of the strip is 25 mIU/mL.
Reported as: not detected or Positive
5mL blood purple top or gold

top tube
Adult male (19-65) 20-76 ug/L
Procollagen III peptide
Progesterone
0-2y M 10-50, F 10-50 ug/L

2-4y M 5-15, F 5-15 ug/L
5-10y M 5-10, F 5-10 ug/L
11-14y M 5-10, F 8-15 ug/L
15-19y M 8-20, F2-8 ug/L
20-65y M 1.7-4.2, F 1.7-4.2 ug/L
0.7-4.3 nmol/L (Male)
Female:
Follicular 0.6-4.7 nmol/L
Periovulatory 2.4-9.4 nmol/L
Luteal 5.3-86.0 nmol/L
Post menopausal: 0.3-2.5 nmol/L
Progesterone 17OH
Prolactin
Prostate specific antigen
Protein, Total

0.5ml CSF Plain tube
bottle or 10 ml random urine
Pre Menopausal Women (19-50) 19-69 ug/L

(Paediatric reference range available and will be
shown on reports)

within 4 weeks. Analysed at Northern General 0114 271 5552
See Hydroxyprogesterone, 17
86-324 mIU/L (Male)

102-496 mIU/L (Female)
NO RANGE (Female)
0-1.4 ug/L (Male 0-40 Years)
0-3.1 ug/L (Male 50-60 Year)
0-4.4 ug/L (Male >70 Years)
63-83 g/L
0.13-0.4 g/L
0-13 mg/mmol creatinine
Protein selectivity
See Phenobarbitone
For monitoring bone resorption.
Restricted availability
Analysed at Norfolk and Norwich
See Electrophoresis, Urine protein
Version 17
May 2014
Page 26 of 31
TEST
PTH
PTHrP (PTH related peptide)
SAMPLE REQUIREMENTS
See parathyroid hormone
5 mL blood collected in prearranged special tube
Purines, plasma
Purines, urine
24h urine in plain bottle
Pyruvate, blood
45-150 umol/L
Quetiapine
Add 1 volume blood to 1

volume 0.8M perchloric acid
(available from lab). Mix
vigorously before sending to
lab.
Quinine
Refer to report
Rast
5 mL gold top tube
Normal or negative grade is 0-0.35
Reducing substances
10ml random fresh urine
Negative results with urine samples from healthy

individuals.
Renin
4 mL blood purple top tube.
4-12 nmol/l/hr (1-3 months)

2-6 nmol/l/hr (3-12 months)
2-5.5 nmol/l/hr (1-4 years)
1-4 nmol/l/hr (4-8 years)
0.6-2.2 nmol/l/hr (8-16 years)
1.2-4.4 nmol/l/hr (ambulant adult)
0.5-2.2 nmol/l/hr (recumbent adult)
<1 week 3.0-967 ug/mmol cre
1wk-6 mo: 1.5-448 ug/mmol
6mo-2y : 2.7-103 ug/mmol
2-5y : 4.5-89 ug/mmol
5-10y : 5.0-41 ug/mmol
10-16y : 3.9-32 ug/mmol
Steroid Endocrinology test
Sample requires immediate

transfer to laboratory. Routine
transport not suitable. DO
NOT send on ice.
Retinol binding protein
Riboflavin, see Vitamin B2

Salicylate
10 mL random urine, must be

frozen quickly
REFERENCE RANGE
Refer to report
Special collection procedures apply. Please call the laboratory

(send away test reviewer) to discuss this test request prior to taking
blood.
Analysed at Norwich, 01603 287945
Refer to report

Patients should be on caffeine free diet
Only required for the investigation of lactic acidosis.
Analysed in Neurometabolic lab.
Contact lab for special tubes required (020344 83818)
50-200 ug/L

Kings College 02032994133
Kingspath
Sample time: Ideally pre 4th IV dose
Specific allergen must be stated. Non specific requests will not be
sent.
Immunology test
Requests individually reviewed by senior staff. Analysed at GOS,

0207 829 8662
Usually requested with NAG
Version 17
May 2014
Page 27 of 31
TEST
SCC antigen (squamous cell
ca antigen)
Sco1 gene analysis
Sco2 gene analysis
Selenium
SAMPLE REQUIREMENTS
Sertraline
4 mL blood purple top tube or

white top tube
Serum amyloid A
Not routinely available
Sex
Hormone
Globulin (SHBG)
Binding

5 ml blood white top tube
samples only)
REFERENCE RANGE
0-1.8 ug/L
Full report given
Full report given
At birth: 0.48-1.19 umol/L
0-6m :0.36-0.46 umol/L
6m-2y :0.32-0.63 umol/L
2-15y :0.57-0.9 umol/L
>15y: 0.89-1.65 umol/L
16-55 nmol/L (Male <50)

19-83 nmol/L (Male 50)
27-146 nmol/L (Female <50)
22-142 nmol/L (Female 50)
12-20ng/mL at trough or 4-12 ng/mL if on
28yclosporine aswell (trough sample)
Sheffield 0142715552
Molecular urology test
Requests individually reviewed by senior staff. Analysed at Trace
Element Lab, Guildford 01483 259978
For compliance
Requests individually reviewed by senior staff. Analysed at Cardiff
Toxicology 029 2071 6893
If ?AA amyloidosis, contact National Amyloidosis centre at Royal
Free Hospital.
Ref range change 5/8/13
Sirolimus (rapamycin)
4 ml blood purple top tube
Sodium
135-145 mmol/L

Harefield 01895 828967
Trough level preferred. 24h post dose +/- 4h
Sodium, Urine

or acid bottle or 10ml random
urine
40-220 mmol/24h
Usually 24hr availability
24h urine collected in plain

bottle or random sample from
child (minimum 10 mL)
5 mL blood green top tube,
protect from light
Full report given
Steroid Endocrinology test
Squamous cell antigen (see

SCC)
Steroid profile
Sterols
Stone
Sugars, Urine
Sugars, Faecal
10mL fresh random urine
5g stool sample (walnutsized),

transported to lab
immediately
Requests individually reviewed by senior staff. Analysed at ICH

(Prof Peter Clayton) 02079052664.
Samples require special or immediate action. Transport to lab
immediately, routine transport unsuitable.
See Calculus
weeks.
N.B. Sugar must be in the diet to be detected
Analysed at Gt Ormond St., 02074059200 x5225
weeks.
N.B. Sugar must be in the diet to be detected
Full report given

Full report given
Full report given
Version 17
May 2014
Page 28 of 31
TEST
Sulphite,
urine
sulphocystine)
Sulphonylureas
(or
Surf1 gene analysis

Sweat test
Synacthen test
SAMPLE REQUIREMENTS
Urine, send to lab on ice
immediately after collection
5mL gold top (preferred) or
random urine
REFERENCE RANGE
Refer to report
Negative
Full report given
Tacrolimus

protocol
Tay Sachs
Testosterone
See hexosaminidase
Thallium
2 x 4 mL purple top tube or 30

mL random urine
Theophylline
5.0-13.0 mg/L (< 1 month)

10.0-20.0 mg/L (>1 month)
Note change of units implemented from 16/7/12
Thiamine, see Vitamin B1

6 Thioguanine nucleotides
(6TGN)
Thiopentone
TGN therapeutic range 200-400 pmol/8x10e8 RBC

MeMP levels >5700 pmol/8x10e8 RBC reported to
increase risk of hepatotoxicity
Refer to report
Thiopurine
transferase (TPMT)
methyl
Dependent on clinical application.
Same day service if received by 10.00 on weekdays and Sunday,

NOT Saturday. Ideal sampling time: pre dose.Time to steady state:
special protocols are required
7.6-31.4 nmol/L (Male >18Y)

0-1.8 nmol/L (Female)
Refer to report
High: >150 mU/L

Normal: 68-150 mU/L
Low: 20-67 mU/L
Deficient: <10 mU/L
N.B. change in units from 6/8/10
<5ug/L (When TSH fully suppressed and with no
recurrence.)
Thyroglobulin
Thyroid Hormones, inc. TSH

and FT4
Thyroid receptor Ab (TrAb)
Index <20 is normal
0.27-4.20 mIU/L

12.0-22.0 pmol/L
Thyroid
Stimulating
Hormone
Thyroxine (Free-T4)
Tiagibine
For sulphite oxidase/molybdenum cofactor deficiency
Guildford 01483406715
See Chloride
Blood cortisol after injecting ACTH (Synacthen)

Usually 24 hour availability. Ideal sampling time: Pre dose or
(Oral Rapid release) 2 4 h post or (Oral Slow release) 8h
after dose or (IV infusion) 6h after start. Time to steady state:
(Oral) 2 days.
Restricted use only. For non-compliance or failure to respond to
azathioprine. Requests are individually reviewed by senior staff.
Analysed at GSTS (purine lab) 02071888008
For assessment of non responsive to azathioprine
Request individually reviewed by senior staff. Analysed at GSTS
020 7188 8689
Request individually reviewed by senior staff. Results available
within 1 week. Analysed at Birmingham City Hospital.
0121 5075353
Results unreliable unless at least 120 days post transfusion
For monitoring diagnosed thyroid carcinoma only
Analysed in house from November 2012
See individual tests
Requests individually reviewed. Analysed at Royal Victoria
Newcastle. 01912824559
01494 601 423
Version 17
May 2014
Page 29 of 31
Topimirate
TEST
SAMPLE REQUIREMENTS
Total CO2
Toxicology screen
5 mL random urine
Transferrin, Blood
Transferrin, CSF
Transferrin)
Transaminase
TRH test
REFERENCE RANGE
(Asialo-
See Alanine aminotransferase

TSH after injecting TRH. This test is rarely required now that
sensitive TSH assays are available
Triglyceride (fasting)
<2.3 mmol/L
Tri-iodothyronine (Free-T3)
Trimethylamine (TMA)

Random urine, acidify on
receipt in the lab
Troponin T
4.0-6.8 pmol/L
Urine TMA 2.5-10.9 umol/mmol creatinine
Urine TMA-n-oxide: 17.0-147.0 umol/mmol
Ratio TMA/oxide: 0.05-0.21
0-0.014 ug/L
Trypsin, immunoreactive
Guthrie card (blood spot)
<60 ug/L whole blood
Tryptase
5 mL blood
top tube
2-14 ug/L
TSH receptor
(TRAb)
antibodies
gold or purple
5 mL blood gold top
Urate (uric acid), Blood
Urate (uric acid), Urine
24 h urine collected in plain

bottle
Urea, Blood
Urea, Urine
Urobilinogen
24 h urine collected in plain

bottle or 10 ml random urine
<1.0 U/L negative

1.0-1.5 U/L borderline
>1.5 U/L positive
266-474 umol/L (Male)
175-363 umol/L (Female)
1.2-5.9 mmol/24h
Request individually reviewed by senior staff. Analysed at Sheffield
Childrens Hospital 0114 271 7445
24 hour availability. Sample should not be taken before 12 hr after
onset of chest pain
0-0.04 ACS unlikely
0.04-0.09 possible ACS. Suggest cardiology opinion
0.1 Probably ACS
Request individually reviewed by senior staff. Analysed at
Addenbrookes Hospital, 01223257130.
For the diagnosis of cystic fibrosis up to 6 weeks of age
Samples must be taken <1h, 3 and 24h after the anaphylactic
event.
Give time post event on the form.
weeks.
Analysed at Sheffield Northern 01142715552
To predict neonatal thyrotoxicosis in pregnancy.
Requests individually reviewed by senior staff. Analysed at RVI,
Newcastle 0191 282 4559
1.4-4.3 mmol/L (0-1 Year)

1.7-8.3 mmol/L (>1 Year)
170-580 mmol/24h
Urea may be used to determine if a wound drain fluid is urine
Daily service if received by noon on Mon to Fri
Negative in normal patients.
01494 601 423
See Bicarbonate
Rarely sent for analysis. Users requiring addictive drug screen,
please request specifically
Not available. Request Iron + IBC instead.
See Asialo-transferrin, nasal fluid, See Neuroimmunology tests.
Version 17
May 2014
Page 30 of 31
Valproate
TEST
SAMPLE REQUIREMENTS
Very long chain fatty acids,

see fatty acids
Vigabatrin
Vitamin A
REFERENCE RANGE
<100 mg/L
13/8/12)

01494 601 423
Transport to lab immediately, protected from light. Batched for
analysis on selected days.
Analysed in Neurometabolic Unit
Sample must be frozen as whole blood
1.05-2.27 umol/L
Vitamin B1 (thiamine)
Vitamin B2 (riboflavin)
5ml blood red/gold top tube

2 mL purple top.
2 mL purple top
Vitamin
B6
phosphate)
2 mL purple top. Protect from

light
15-73 nmol/L
Vitamin D, 25-OH
5ml blood red or gold top tube
Vitamin D 1,25 (calcitriol)

(EDTA and heparin also
acceptable)
5ml blood red/gold top tube
<25 nmol/L is 25-OH Vitamin D deficient

25-50 nmol/L is insufficient 25-OH vitamin D
>200 nmol/L consider reducing vitamin D dose
43-143 pmol/L
(pyridoxal
Vitamin E
Vitamin K
VMA (HMMA)
Water deprivation test
White cell enzymes
66-200 nmol/L
174-471 nmol/L
11.5-46.4 umol/L
Not offered, see notes

protocol
Unseparated 5 mL light green
tube
Full interpretative report given
Zinc
5mL TEKLAB (white top)

tube
samples only)
11-18 umol/L
Zinc (urine)
Urine, 24h. Collect into acid

washed container
4.5-9.0 umol/24h
Zonisamide
Usually 24 hour availability. Ideal sampling time: pre dose. Time
to steady state: 3 days

Requires rapid transport to the lab. Requests are individually
reviewed, results are available in 2 to 4 weeks
Analysed at Norfolk and Norwich
Analysed in Neurometabolic unit
Transport to lab for immediate separation and freezing.
Measured indirectly by International Normalised ratio (INR)
No longer available, see Catecholamines, Urine
Osmolality during water deprivation and after DDAVP (hazardous)
weeks.
Analysed at Gt Ormond St. 02077626751
Requests individually reviewed. Analysised by University of

Surrey, Guildford
01494 601 423
Version 17
May 2014
Page 31 of 31

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Clinical Biochemistry Department, UCL Hospitals NHS Foundation Trust

CLINICAL BIOCHEMISTRY TEST INFORMATION

Clinical Biochemistry Test Information

Date for review

UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests

Clinical biochemistry test information

UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests

UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests

UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests

CLINICAL BIOCHEMISTRY TESTS

4ml blood purple top tube

Acyl carnitine profile

4 mL purple or green top tube

Addictive drug screen

2.6 6.2 U/L

4 mL blood purple top tube

10ml random urine

10-50 IU/L (Male)

2ml blood light grey top tube

Values up to 1 mmol/L may arise endogenously

5ml blood gold top tube

UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests

Usually 24 hour availabiity

24h collected in plain bottle

5ml blood gold top tube

5ml blood red top tube

5 mL blood green top tube

On treatment, plasma oxypurinol <100 umol/L

Must be frozen on receipt. Requests are individually reviewed by

5ml blood gold top tube

0-6 kIU/L (In hepatoma, a positive diagnosis is only

Allergen specific IgE

aminoadipic semialdehyde (antiquitin)

5ml blood gold top tube

Batched for weekly analysis. Steroid Endocrinology test

Requests are individually reviewed, results are available in 2 to 4

Requests are individually reviewed, results are available in 2 to 4

UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests

10g stool sample (concurrent

Requests are individually reviewed by senior staff. Analysed at St

Performed automatically if total AAT below 0.9g/L. Analysed at

Requests are individually reviewed. Must be sent same day for

4mL blood green top

5 reductase 2 gene analysis

4 mL blood purple top

Amino acids, Blood

5ml blood green top tube

5ml blood gold top tube

Amiodarone 0.5-2.0 mg/L

4ml blood purple top tube

56-92 umol/L (0-31 Days)

Ammonium chloride Test

5ml blood gold top tube

5ml blood gold top tube

5ml blood gold top tube

1.4 -11.5 nmol/L (Female)

5ml blood white top tube

Calculated from (Na+K)-(Cl+bicarbonate).

UCL Hospitals NHS Foundation Trust / Clinical Biochemistry tests

5ml blood gold or purple top

5 mL blood purple top tube

4 mL whole blood purple top

5ml blood gold top tube

0.95-1.83 g/L (ApoA1 Male)