Comprehensive Protocol for Endocrine Hormone Level Testing

Pre-analytical Considerations

Timing of Collection

• Collect samples at appropriate times based on hormonal circadian rhythms
• Morning cortisol: 7:00-9:00 AM
• Thyroid hormones: Consistent time of day
• Reproductive hormones: Days 2-4 of menstrual cycle for females

Patient Preparation

1. Fasting Requirements

   • 8-12 hours fasting for most hormone tests
   • Water consumption permitted
   • Morning medications held until after collection

2. Documentation

   • Current medications
   • Time of last dose
   • Menstrual status/cycle day
   • Recent acute illness

Specimen Collection Protocol

Blood Collection

1. Materials Required

   • Appropriate collection tubes (SST, EDTA, etc.)
   • Labels and requisition forms
   • Collection supplies

2. Collection Procedure

   • Verify patient identity
   • Label tubes before collection
   • Follow standard venipuncture protocol
   • Record collection time

Specimen Handling

• Process within 2 hours of collection
• Centrifuge at appropriate speed/time
• Aliquot if required
• Store at recommended temperature

Analysis Parameters

Common Hormone Panels

1. Thyroid Function

   • TSH
   • Free T4
   • Free T3

2. Reproductive Hormones

   • FSH/LH
   • Estradiol
   • Testosterone
   • Progesterone

3. Adrenal Function

   • Cortisol
   • ACTH
   • DHEA-S

Quality Control

Internal Controls

• Run controls with each batch
• Monitor Levy-Jennings charts
• Document QC results

External Quality Assurance

• Participate in proficiency testing
• Document corrective actions
• Regular calibration verification

Reporting and Interpretation

Result Validation

• Review reference ranges
• Check critical values
• Assess delta checks

Documentation Requirements

• Time of collection
• Processing details
• Analytical parameters
• QC results