Parameter Patient preparation
FT3 and FT4 No specific preparation
T3 Withhold : steroids, propra-nolol,
cholestyramine
Growth hormone Restrict food & fluids (ex-cept
plain water) 8-10 hrs before test;
quiet & resting
1 hr before test. Sampling at 6-8
AM on 2 consecutive days
PTH: intact PTH, Overnight fasting
N-terminal frag-
ments, C-terminal
fragments
Cortisol Maintain normal Na+ diet
3 days before test; fasting & limit
physical activity for 10-12 hrs
before test, with-hold: estrogen,
androgens, phenytoin 48 hrs
before test, relax and recumbent
30 mi-nutes before test
Falsely increased
Heparin
Clofibrate, estrogens, T3,
methadone, progestins
Oral contraceptive, estrogens,
arginine, L-dopa, insulin, hy-
poglycemia, starvation, fasting,
amphetamines, ß-adrenergic
blockers
Estrogens (oral contra-ceptive,
pregnancy), obesity, stress;
severe hepatic or renal disease
(disturb hormone cata-bolism)
Falsely decreased
Ethionamide,FFA,heparin,
iodides, Lithium, methimazole,
phenylbutazone, methylthio-
uracyl, phenytoin, propranolol,
propylthiouracyl,reserpine,salycil
ates (high dose), steroids,
sulfonamides
Cortisol, phenothiazines, hy-
perglycemia, obesity
Androgens, phenytoin (caused
decrease cortisol binding pro-
teins)
Affect the results
Hemolysis
Hemolysis
Radioactive agents,
Hemolysis, exercise,
sleep, stress, nutritio-
nal status may cause
inaccurate interpre-
tation
Failure to fast (too short
or too long), hemolysis
Hemolysis
1
 Parameter Patient preparation
Free Cortisol Not to restrict food or fluids;
(urine) avoid stressful situations, li-mit
physical exercise; collect 24-hrs
urine specimen
Insulin Fasting 10-12 hrs before test;
withhold: corticotrophin,
corticosteroid, oral contra-
ceptive, thyroid supplement,
epinephrine,; relaxed & re-
cumbent 30 minutes before test
C-peptide *Indirectly measure insulin
(Connecting secretion in the presence of
peptide of insulin) circulating insulin antibody.
Determine ß-cell function.
Endogenous insulin: C-pep-tide
(higher levels)
Fasting blood Fasting 8-12 hrs before test,
glucose may drink plain water; stop
(LAB.ACT. II) OAD/ insulin or any drugs until
blood is drawn
Fasting Urine Fasting 8-12 hrs before test,
glucose may drink plain water (small
amount); stop OAD/ insulin or
any drugs until urine is
collected (Have the patient
void, give her/him a drink of
water. After 30-45 minu-tes,
collect the second vo-ided
morning urine)
Falsely increased
Reserpine, phenothiazines, morphine,
amphetamines, oral contraceptive,
danazol, aldac-tone, pregnancy,
prolonged steroid therapy
Steroids; dextrose infusion;
anesthesia; stress; infection; caffeine;
nicotine,; total paren-teral nutrition;
diuretics; estro-gen; phenytoin,
pregnancy
Acute tubular necrosis; niacin;
phenothiazines; asparaginase;
carbamazepine; NH4Cl, thia-zides;
dextrothyroxine; lithium carbonate
Falsely decreased Affect the results
Dexamethasone, ethacrynic acid,
thiazides, ketoconazole
Failure to fasting &
limit activity; type I
DM (high level of
insulin antibody), not
transporting samples on
the ice; hemolysis
Insulin; alcohol; anabolic
steroids; insulin, OAD, ß-adre-
nergic blockers; delayed mea-
surement/ sampling
Tetracycline; levodopa; ascor-bic
acid; phenazopyridine; me-
thyldopa; salicylate
2
 Parameter Patient preparation Falsely increased Falsely decreased Affect the results
2 hrs post meal Diagnosis: Take balance meal Acetaminophen (GOD-PAP or ß-adrenergic blockers, amphe-
blood glucose after fasting samples are taken, hexokinase methods), HCT, tamines, ethanol, clofibrate,
(LAB.ACT. II) and then fasting for the next 2 thiazides, furosemide, triamte- insulin, OAD, MAO-inhibitor,
hours rene,oral contraceptive, benzo- delayed measurement/ sam-
diazepines, phenytoin, phenol- pling
Follow-up: continue OAD/ thiazines, lithium, epinephrine,
insulin, take balance meal after arginine, phenolphthalein, dex-
fasting samples are taken, and trothyroxine, diazoxide, nicoti-nic
then fasting for the next 2 hours acid (large doses), cortico-
steroids; sample is drawn < 2
hours after meal (too early)
Oral Glucose
Tolerance Test
(LAB.ACT. II)

1. Henry JB; Clinical Diagnosis and Management by Laboratory Method; 19th ed 1996; W.B. Saunders Co
2. Wallach J; Interpretation of Diagnostic Tests; 7 th ed. 2000, Lippincott Williams & Wilkins, Wolters Kluwer Co.
3. Breuninger CM, Wittig P; Diagnostics- An A to Z Guide to Laboratory Tests and Diagnostic Procedures; 2001, Springhouse Corp, Pennsylvania
4. Gaedeke MK, Laboratory and Diagnostic Tests Handbook, 1996, Addison-Wesley, The Benjamin/Cummings Publishing Co