Test Catalog

Test Id : FL

Fluoride, Plasma

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing accidental fluoride ingestion

 

Monitoring patients receiving sodium fluoride for bone disease or patients receiving voriconazole therapy

Method Name
A short description of the method used to perform the test

Ion-Selective Electrode (ISE)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Fluoride, P

Aliases
Lists additional common names for a test, as an aid in searching

Fl (Fluoride)

Specimen Type
Describes the specimen type validated for testing

Plasma Heparin

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube: Green top (sodium heparin)

Submission Container/Tube: Plastic vial

Specimen Volume: 3 mL

Collection Instructions: Centrifuge and aliquot plasma into a plastic vial. Glass tubes are not acceptable.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

1.2 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Plasma Heparin Refrigerated (preferred) 14 days
Ambient 14 days
Frozen 14 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing accidental fluoride ingestion

 

Monitoring patients receiving sodium fluoride for bone disease or patients receiving voriconazole therapy

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Fluoride induces bone formation by stimulating osteoblasts. Because fluorides increase bone density, they are used in dental preparations and as an antiosteoporotic agent. However, prolonged high exposure to fluoride produces changes in bone morphology consistent with osteomalacia, including prolonged mineralization lag time and increased osteoid thickness. The adverse skeletal effects of fluoride are associated with plasma fluoride greater than 4 mcmol/L. Chronic fluorosis may produce osteosclerosis, periostitis, calcification of ligaments and tendons, and crippling deformities.

 

Prolonged exposure to the fluoride-containing antifungal agent voriconazole can produce high plasma fluoride concentrations and bone changes (periostitis). Several other medicines also contain fluoride are used for treating skin diseases (eg, flucytosine, an antifungal) and some cancers (eg, fluorouracil, an antimetabolite).

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

<4.1 mcmol/L

Interpretation
Provides information to assist in interpretation of the test results

Humans exposed to fluoride-treated water typically have plasma fluoride in the range of 1 to 4 mcmol/L. Those who are not drinking fluoride-treated water have plasma fluoride less than 1 mcmol/L. Plasma fluoride values greater than 4 mcmol/L indicate excessive exposure and are associated with periostitis.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

In solutions of below pH 5, hydrogen ion (H[+]) complexes with the fluoride ion, thus reducing the free fluoride ion concentration and giving a falsely low reading.

 

At higher pH (>9), the hydroxyl ion (OH[-]) will interfere with electrodes, giving a falsely elevated reading.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Cardos VES, Whitford GH, Aoyama H, et al: Daily variations in human plasma fluoride concentrations. J Fluorine Chem. 2008:129;1193-1198

2. Wermers RA, Cooper K, Razonable RR, et al: Long term use of voriconazole, a fluoride containing medication, is associated with periostitis, fluorosis, and fluoride excess in transplant patients. Clin Infect Dis. 2011;52:604-611

3. Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018

4. Agency for Toxic Substances and Disease Registry: Toxicological profile for fluorides, hydrogen fluoride, and fluorine.. US Department of Health and Human Services 2003. Accessed: 03/2020. Available at www.atsdr.cdc.gov/ToxProfiles/tp11.pdf

Method Description
Describes how the test is performed and provides a method-specific reference

The fluoride electrode consists of a single-crystal lanthanum fluoride membrane and an internal reference bonded into an epoxy body. The crystal is an ionic conductor in which only fluoride ions are mobile. When the membrane is in contact with a fluoride solution, potential develops across the membrane. This potential depends on the level of free fluoride ions in solution and is measured against an external constant reference potential with a digital pH/mV meter.(Instruction manual: Fluoride Ion Selective Electrode User Guide. Thermo Scientific; 09/2016)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Tuesday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 7 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

2 weeks

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82735

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports