Please note all volumes stated are the minimum required to perform the analysis once.
Blood volumes refer to whole blood.
This replaces earlier versions of this protocol:
Note: There are separate protocols for the investigation of Neonatal/Childhood Hypoglycaemia and Developmental delay. Sample requirements for these protocols may be different from those listed below (click here).
If details suggest contacting extension 7704, note that this extension is only available from 9 am to 5:30 pm Monday to Friday. Outside of these hours bleep 293.
Test | Test Information |
ACTH | 2 ml EDTA – fill paediatric bottle (light purple) to line. Must be in iced water. Mark URGENT. In lab within 10 mins. Contact 7704 before sending sample |
Acyl carnitine (MCAD screen) | 0.5 ml lithium heparin or Guthrie card (minimum 2 full blood spots) Note: if both blood amino acids and acyl carnitines are requested, fill in two Guthrie cards |
Adrenaline | Not routinely offered. Discuss with duty biochemist ext 7704 if absolutely necessary (i.e patient does not produce any urine). Refer to urine metadrenalines. 2 x 2ml lithium herapin on ice to lab immediately. Contact 7704 before sending sample |
Adrenal androgens | See 'Androgen profile' below |
AFP/HCG | 1 ml in plain (red top) or SST |
Aldosterone | 4 ml lithium heparin. Sample must reach lab within 2 hrs of collection |
Alkaline phosphatase (Alk. Phos) |
See 'Calcium' below |
Alk. Phos (bone specific) | 2ml in plain red top |
Amino Acid | For full quantitative amino acid profile send 0.5 ml lithium heparin to lab within 3 hrs of collection. For a qualitative screen send 4 blood spot on neonatal screening card (minimum 2 full blood spots). Note: if both blood amino acids and acyl carnitines are requested, fill in two Guthrie cards |
Ammonia | 0.5 ml lithium heparin on ice to lab immediately. Contact ext 7704 before sending sample |
Androgen profile | Includes DHEA, Androstenedione, Testosterone & SHBG. 2 ml plain red top or SST. Also offered individually |
Androstendione | 2 ml in plain red top or SST |
Arginine- Vasopressin | Not routinely offered. Discuss with duty biochemist ext 7704. 2 ml lithium heparin on ice to lab immediately. Contact ext 7704 before sending sample |
Biopterin | Four blood spots on Guthrie neonatal screening card. If the phenylalanine levels suggest non-classical PKU then send 0.4 ml of blood in lithium heparin tube. Sample must reach lab within 1 hr of sampling. |
Biotinidase | 1 ml lithium heparin, to lab within 1 hr |
Calcium, phosphate & Alk. Phos |
0.6 ml lithium heparin |
CK (creatine kinase) | 0.6 ml lithium heparin |
Cortisol | 1 ml in plain red top |
11-deoxycortisol | 2 ml lithium heparin or plain (red top) or EDTA or SST |
DHEA (Dihydroepiandrostenedione) | 2ml plain red top or SST |
Dihydrotestosterone | 2 ml blood in SST or plain (red top) |
Electrolytes & osmolality | Includes Na, K, urea & creatinine. 1 ml lithium heparin or SST |
Free fatty acids | 1.2 ml lithium heparin on ice to lab immediately. Contact ext 7704 before sending blood (volume includes B-hydroxybutyrate) |
G6PD (Glucose-6-phosphate dehydrogenase) | 0.5 ml EDTA or lithium heparin |
Glucagon | 0.4 ml EDTA on ice to lab immediately. Contact ext 7704 before sending blood |
Glucose | 0.4 ml lithium heparin. Note: If there is likely to be a delay of more than 1 hr before sending sample to lab put sample in fluoride/oxalate tube |
Growth hormone | 1.5 ml serum SST or plain (red top) |
HbA1c | 1 ml EDTA |
ß-hydroxybutyrate | See Free fatty acids |
Insulin/C-peptide | 0.5 ml lithium heparin to lab immediately. Contact ext 7704 before sending blood. Also send fluoride oxalate (grey top) sample for glucose. If for hyperinsulinism state clearly on request form |
IGF-1 | 2 ml SST or plain (red top) |
Islet cell antibodies | 1.2 ml plain (red top). This is an Immunology department test |
ß-HCG & alphafetoprotein (AFP) | 1 ml plain (red top) or SST |
17 hydroxy-progesterone | 0.6 ml lithium heparin |
Lactate | 0.5 ml into fluoride/oxalate (grey) (or lithium heparin) on ice to lab immediately. Contact ext 7704 before sending blood |
Leptin | Not routinely offered. Please discuss with duty biochemist ext 7704. 3 ml SST – patient’s height & weight must be stated on request form |
LFTs (liver function tests) | Includes albumin, ALT, Alk. Phos, total protein, total bilirubin. NOTE: If infant under 3 months old requires a split-bilirubin please make it clear on the request form 0.6 ml lithium heparin |
LH/FSH | 1 ml plain red top or SST or lithium heparin |
Oestradiol | 0.6 ml plain red top or SST or lithium heparin |
Osmolality | See electrolytes above |
Osteocalcin | 1.2 ml EDTA to lab immediately. If possible send two EDTA tube with 1 mL of blood each. Contact ext 7704 before sending blood |
PTH (Parathormone) | 0.5 ml in EDTA tube. Measure calcium at the same time |
P1CP | No longer offered by reference lab. Please request P1NP (see below) |
P1NP | Minimum volume 3 ml (red top) |
Porphyrins | 5-10 ml EDTA. Protect from light with aluminium foil. For urine and faeces see urine section below. |
Progesterone | 1ml plain red top or SST or lithium heparin |
Proinsulin | Not routinely offered. Contact ext 7704 before sending blood. 2ml lithium heparin on ice to lab immediately |
Prolactin | 1ml plain red top or SST or lithium heparin |
Pyruvate | Test not offered |
Renin | 2 ml lithium heparin. Sample must reach lab within 2 hr of collection |
SHBG (Sex hormone binding globulin) | See androgen profile |
Testosterone | 1ml plain red top or SST |
Thyroglobulin | 1.5ml plain red top |
Thyroid hormones | 1ml serum SST or lithium heparin |
Tyrosine | 0.6 ml lithium heparin to lab immediately or 2 blood spots on neonatal Guthrie screening card |
Vasopressin | See arginine vasopressin above |
Vitamin D (25-OH) | 2.5 ml serum SST or 2 ml lithium heparin |
Vitamin D (1-25 OH) | Not routinely offered. Please contact ext 7704 before taking sample. 2.5 ml serum SST or 2 ml lithium heparin |
Very long chain fatty acids | 1 ml EDTA or lithium heparin |
White cell enzyme Screen | 5 ml lithium heparin, to lab within 1 hr. It is essential that this test is arranged with the duty biochemist (ext 7704) before taking sample. Sample has to be sent to Great Ormond Street the same day. Do not collect samples on Fridays |
All urine samples should be collected into plain containers without preservative.
Test | Test Information |
Amino-acids | Random collection, minimum 2 ml no preservative, send to lab same day |
Catecholamines | Refer to Metadrenalines below |
Cortisol (Urinary free cortisol) | 24h collection – plain container |
Metadrenalines | Ideally 24 hr collection on acid preservative (bottle obtained from biochemistry lab). In neonates & children, random collection, minimum volume 5ml, to lab immediately as it has to be acidified ASAP (otherwise metadrenalines break down) |
Mucopolisaccharides | Random collection, minimum 5 ml, to lab on day of collection |
Osmolality | Random collection, minimum volume 1ml |
Organic acids | Random collection, minimum volume 3ml to be sent to laboratory within 3 hrs of collection |
pH | Random collection, send to lab immediately |
Porphyrins | Random collection. Minimum volume 1 ml. Protect from light with aluminium foil |
Reducing substances | At least 1 mL random urine, to arrive in the laboratory within 3 hours of sample voiding |
Steroid profile | Ideally timed collection, preferably 24 hrs, no preservative. Alternatively random collection, minimum volume 10 ml |
All faecal samples should be collected into plain universal containers without preservative.
Test | Test Information |
Porphyrins | 5-10 g of faeces, protected from light with aluminium foil |
Reducing Substances | At least 1 g of faeces, to arrive in the laboratory within 3 hrs of colleciton |