Guidelines of patient preparation for blood collection for hormonal analysis

  1. On the day before taking blood for hormonal studies, physical exercises, stress, physiotherapy procedures, administration of pharmaceuticals (with the exclusion of cases of pharmacological therapy prescribed by a physician; in this case the decision to suspend medication shall be made by the consulting physician), administration of oral contraceptives, drinking alcoholic beverages and eating fatty food shall be excluded. Immediately before the test, smoking is forbidden.
  2. Standard blood sampling is performed in the morning, on an empty stomach (no less than 8 to 12 hours after the previous intake of food), in a procedure room, in a sitting or lying position, in a physiologically calm state, from an ulnar vein, following all the aseptic and antiseptic regulations. Prior to blood sampling, the patient shall rest for 15 minutes.
  3. If thyroid gland function studies are performed during a period when thyroid gland hormone drugs are administered, they shall commence 24 hours after the last intake of the drug. Two to three days before blood sampling, administration of pharmaceuticals containing iodine shall be suspended.
  4. When testing for ACTH, it is recommended to collect a blood sample in the morning (7:00 to 9:00), into a vial containing EDTA (sampling material -- blood plasma). This requirement is due to the fact that reference values for the hormone were estimated for this period.
  5. When testing for cortisol, blood shall be sampled before 10:00.
  6. When studying sex hormones in women during the reproductive period, the referral shall state the date and time of blood sampling, the day and phase of the menstrual cycle, or -- in case of pregnancy -- the gestational age.
  7. When studying sex hormones in women during the reproductive period: on day 3 to 5 of the menstrual cycle (FSH, LH, estradiol, prolactin), on day 21 of the menstrual cycle (it is advisable to test for progesteron as late as in the second half of the menstrual cycle, that is, on day 20 to 23 of the regular 28-30-day cycle).
  8. Comprehensive studies (multiple tests performed over a single sample) are more informative.
  9. To ensure higher accuracy and better interpretation of results, the tests are recommended to be perform not once, but repeatedly over some time. Repeated tests shall be performed at the same time of day, two to three week later. Analysis of results of studies performed over time is more informative, from both diagnostic and prognostic point of view.
  10. If the study must be performed during the course of a pharmaceutical therapy, the referral shall state the name of the pharmaceutical and the time of its latest administration.
  11. Quality of study and accuracy of results are dramatically impaired if hemolysis and hyperlipemia-affected samples are used.
  12. Tests for testotsteron and dehydroepiandrosterone (DHEA-S) shall be performed only subject to relevant clinical indications (signs of hirsutism, androgenital syndrome, etc.). It is recommended to perform these studies during the first patient’s visit (e.g., on day 3 to 5 of the cycle after it was noticed).
  13. In cases of infertility, the above tests are mandatory. This also includes a mandatory assessment of thyroid gland function.
  14. During the menopause, it is not effective to perform progesteron, cortisol, testosteron and dehydroepiandrosterone (DHEA-S) level tests (unless there are clinical indications).
  15. If it is impossible to collect samples for hormone testing at specific days of the cycle, it is best not to perform sampling since the analysis would be absolutely non-diagnostic.