Laboratory recommendations
This includes: Haematology, biochemistry, hormones, serology, immunology, PCR and coagulation tests.
Most blood parameters are subject to daily fluctuations and are affected by food, stress and physical activity.
Main general clinical requirements
- Fasting: strictly on an empty stomach in the morning (from 7:00 to 11:00). The fasting period must be 8 to 12 hours (up to 14 hours for a lipid profile and triglycerides). Completely avoid fatty, spicy and fried food and alcoholic drinks the day before.
- Drinking: on the morning of the test, only small amounts of plain still water are allowed. Tea, coffee, juices and other drinks must be completely excluded. Check any special restrictions for a glucose test with the laboratory.
- Rest and stress: avoid physical exertion (running or climbing stairs) and emotional excitement before the procedure. It is recommended that you sit quietly in the treatment room for 10–15 minutes before specimen collection.
- Smoking: do not smoke for at least 1–2 hours before the test.
- Medicines: agree with your treating doctor when to have blood taken while taking medicines and after stopping them (particularly antibiotics and anticoagulants). If a medicine cannot be stopped, make sure you tell the registration staff its exact name and dose.
- Physiotherapy: blood must not be taken immediately after an X-ray, fluorography, ultrasound, physiotherapy procedures or a rectal examination.
Specific requirements for individual tests
Glucose tolerance test (БХ.008): performed strictly in the morning on an empty stomach. For 3 days before the test, maintain your usual diet without restricting carbohydrates and keep up your usual physical activity. During the test (for 2 hours after taking glucose), the patient must remain completely at rest, must not smoke or walk around, and must avoid exertion.
Thyroid hormones (TSH, T3, T4, anti-TPO): if you take thyroid medication (L-thyroxine or Euthyrox), blood must be taken strictly before your morning dose. For 2–3 days before the test, stop taking medicines and vitamins containing iodine and biotin (vitamin B7), as agreed with your doctor, because high doses of biotin distort TSH test results.
Reproductive hormones (FSH, LH, oestradiol, progesterone, testosterone, prolactin, AMH, SHBG and DHEA): testosterone and DHEA tests must be taken strictly before 11:00 in the morning (at the morning concentration peak). In women, sex hormone tests (FSH, LH, prolactin, testosterone, DHEA and SHBG) must be taken strictly on days 2–5 of the menstrual cycle unless the doctor specifies other days. Progesterone is usually tested on days 21–23 of the cycle. Prolactin and cortisol require complete emotional calm and are tested no earlier than 2–3 hours after waking.
Aldosterone (ИМ.091): secretion of this hormone depends on body position. Before blood collection, the patient must remain continuously in the position prescribed by the doctor (upright, standing or sitting, or horizontal, lying down) for at least 2 hours. Immediately before the needle is inserted, sit quietly for 15–20 minutes. Discuss stopping diuretics with your doctor 10–14 days beforehand and maintain a stable level of salt in your diet.
Ferritin (ИМ.044): reflects the body’s iron stores. If you take iron supplements, discuss with your treating doctor whether a break of 7–14 days before the test is needed. Important: ferritin is an acute-phase protein. If you have a cold, an acute respiratory viral infection, a high temperature or a flare-up of inflammation, tell your doctor and agree on the timing of the test.
Natriuretic peptide (NT-proBNP) (ИМ.039): completely avoid intense physical activity and sports for 1 day before the test (any muscular overexertion temporarily raises this marker of heart failure).
Coagulation tests (КГ group): blood must be taken strictly before the next dose of anticoagulants (heparin, warfarin, aspirin, Xarelto, etc.), or the exact time the medicine was taken must be recorded and reported to the registration staff.