Epic Code LAB3077 Thyroid Function Cascade (TSH, reflex to TPO, Free T3, and/or Free T4, if indicated)
Test Name Alias
Thyroid Function Cascade | 6701
Interface Order Alias
11648
Specimen Requirements
Specimen Collection: Blood
Container(s): 4.5 mL Mint Green Top (Lithium Heparin Gel) or 5.0 mL Gold Top (Serum Separator-SST Gel)
Preferred Volume to Collect: 4.5 mL
Minimum Volume to Collect: 4.0 mL
Neonate Volume to Collect: 2.0 mL
Capillary collect ok? Yes
Microtainer acceptable: Yes
Collection Instructions:
- After collection, gently invert tube 8-10 times.
- Specimen should be processed within 2 hours – See Processing Instructions.
PROCESSING INSTRUCTIONS (LAB, OUTPATIENT, OR OFF-SITE COLLECTION)
Processed Specimen: Plasma or Serum
Centrifuge/Spin: Yes
Aliquot: Yes
Processing Instructions:
- Plasma is preferred specimen type
- Green Tube/Plasma: Centrifuge after collection. Minimum volume: 2.0 mL Plamsa
- Gold Tube/Serum: Allow blood to clot for 30 minutes in a vertical position and centrifuge within 2 hours. Minimum volume: 2.0 mL Serum
Transport Temperature: Refrigerate
Specimen Transport Temperature
Refrigerate
Specimen Stability
Ambient: 8 hours
Refrigerated: 72 hours
Frozen: aliquot plasma/serum for longer storage
Laboratory Retention: 72 hours
Reflex Information
Reflex Criteria:
- If the TSH is within the normal range (0.30-5.00 µIU/mL), no further testing will be performed.
- If the TSH is elevated (above 5.00 µIU/mL), a Free T4 and AntiTPO (anti-thyroid peroxidase antibody) will be performed as reflex tests.
- If the TSH is decreased (below 0.30 µIU/mL), a Free T4 will be performed as a reflex test.
- If the TSH is markedly decreased (below 0.10 µIU/mL), and the Free T4 is not increased (not above the upper limit of normal of 1.6 ng/dL), a Free T3 will be performed as an additional reflex test.
Test Frequency
Available daily, usual TAT 1 day.
Reference Range
TSH
0 up to 3 days: 1.00 - 16.00 μIU/mL
3 days up to 1 year: 0.80 - 8.00 μIU/mL
1 year up to 10 years: 0.60 - 6.00 μIU/mL
10 years and up: 0.30 - 5.00 μIU/mL
Free T3
2.0 to 4.4 pg/mL.
Free T4
0 up to 3 days: 1.5 - 3.5 ng/dL
3 days up to 1 year: 0.9 - 2.0 ng/dL
1 year and up: 0.6 - 1.6 ng/dL
TPO
<35.0 IU/mL
Performing Department
Chemistry
Performing Department Laboratory Location
Corewell Health Reference Laboratory, Grand Rapids, MI
Corewell Health Lakeland St. Joseph Laboratory, St. Joseph, MI
Methodology
Method is Roche cobas Electrochemiluminescense Immunoassay.
Patient results determined by assays using different manufacturers for methods may not be comparable.
CPT
84443
CDM Code
3018444301
Epic Test ID
1230101214
LOINC
TSH: 3016-3
Reviewed Date
3/7/2024