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Endocrinology

Toxicology

Update to Vitamin D Testing

Effective February 28th, 2023, Vitamin D 25-Hydroxy Level (25-OH Vitamin D) [LAB535] will be replaced by 25-Hydroxyvitamin Level D2 and D3 [LAB1230925]. Send out testing for 25-Hydroxyvitamin D2 and D3, Serum [LAB1230428] to Mayo will be discontinued. The testing methodology will change from an immunoassay to liquid chromatography-mass spectrometry.

The new test will include concentrations for

  • 25-hydroxyvitamin D2
  • 25-hydroxyvitamin D3
  • 25-hydroxyvitamin D Total

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Chemistry

Updates: Chemistry Reference Ranges

Effective August 2, 2022, reference ranges for the below tests will be updated to better align with the vendor’s recommendation and with Spectrum Health Lakeland Laboratory. Please click on the links below and scroll to the Reference Range field to see the updated ranges.

Lithium Level [LAB29]

PTH Intact [LAB108]

IgM Level [LAB72]

IgA Level [LAB73]

CA 125 Level [LAB155]

C4 Complement Level [LAB151]

C3 Complement Level [LAB152]

Albumin Level [LAB45]

Transferrin Level [LAB133]

Questions or inquiries may be directed to the “Contact Us” link above.

Chemistry, General Information

Test Update: Thyroglobulin Antibody

Effective immediately, Thyroglobulin Antibody will be performed at Spectrum Health Reference Laboratory (SHRL, Grand Rapids, MI) and will no longer be a sendout to Mayo Clinical Laboratories. Collection instructions and other information may have changed, please visit the lab catalog for more information.

Thyroglobulin Tumor Marker will continue to be a sendout. If a Thyroglobulin Antibody is ordered with a Thyroglobulin Tumor Marker, then the Thyroglobulin Antibody will automatically be canceled as Mayo Clinic Laboratories will perform the Thyroglobulin Antibody as well as the Tumor Marker.

For questions and inquiries, please use the “Contact Us” link above.

 

TEST INFORMATION

New test: Thyroglobulin Antibody [LAB1230840] 

Former test: Thyroglobulin Antibody, Serum [LAB1230457]

Mentioned Test: Thyroglobulin, Tumor Marker, Serum [LAB864]

Education & Training, General Information, Test Utilization

Appropriate Thyroid Peroxidase Antibody Ordering

The most conclusive evidence for using thyroid peroxidase antibody (TPO) is predictive in nature when evaluating possible subclinical hypothyroidism. If this test is positive, hypothyroidism occurs at a rate of 4.3% per year versus 2.6% per year when the antibody is negative. While this scenario does not cover all clinical indications for ordering TPO, there is no definitive evidence that repeat TPO testing provides additional information.1

Based on this information the ordering of TPO within Spectrum Health is being modified. If the test is ordered more than once on a patient, a screen will appear in EPIC indicating the following: “This test should typically only be resulted once per lifetime. The duplicate checking indicates that this patient has already had this testing performed. Please see chart review for results.” This is not a “hard stop” but providers will need to click “Continue” to proceed with the order. Continue Reading