Test Code LITH Lithium, Serum
Useful For
Monitoring therapy of patients with bipolar disorders, including recurrent episodes of mania and depression
Evaluating lithium toxicity
Method Name
Colorimetric
Reporting Name
Lithium, SSpecimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Draw blood 8 to 12 hours after last dose (trough specimen).
2. Serum gel tubes should be centrifuged within 2 hours of collection.
3. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
Additional Information: Peak serum concentrations do not correlate with symptoms.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 7 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Reject Due To
Gross hemolysis | Reject |
Clinical Information
Lithium alters the intraneuronal metabolism of catecholamines by an unknown mechanism. It is used to suppress the manic phase of manic-depressive psychosis.
Lithium is distributed throughout the total water spaces of the body and is excreted primarily by the kidney.
Toxicity from lithium salts leads to ataxia, slurred speech, and confusion. Since the concentration of lithium in the serum varies with the time after the dose, blood for lithium determination should be drawn at a standard time, preferably 8 to 12 hours after the last dose (trough values).
Reference Values
Therapeutic: 0.5-1.2 mmol/L (trough concentration)
Critical value: >1.6 mmol/L
There is no relationship between peak concentration and degree of intoxication.
Interpretation
The therapeutic range for lithium has been established at 0.5 to 1.2 mmol/L. Within this range, most people will respond to the drug without symptoms of toxicity. However, response and side effects are individual. Lithium concentrations and side effects can increase with the loss of salt and water from the body, which can occur with a salt-free diet, excessive sweating, or an illness that causes vomiting and diarrhea. A variety of prescribed drugs, over-the-counter medications, and supplements can also increase, decrease, or interfere with the concentrations of lithium.
Cautions
No significant cautionary statements
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 dayPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
80178
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
LITH | Lithium, S | 14334-7 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
LITH | Lithium, S | 14334-7 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.