Test ID: LSDU
Lysergic Acid Diethylamide (LSD) Confirmation, Urine
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Confirming use of lysergic acid diethylamide
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ADULT | Adulterants Survey, U | No | Yes |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
An evaluation to detect the presence of adulterants will be performed and reported at no additional charge.
See Adulterant Survey Algorithm in Special Instructions.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
LSDU/81743: Immunoassay Followed by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Confirmation with Quantitation
ADULT/29345: Spectrophotometry (SP)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Plastic, 60-mL urine bottle
Specimen Volume: 20 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. No specimen substitutions.
2. No STATS are accepted for this procedure.
3. For situations where chain-of-custody is required, a Chain-of-Custody Kit (Supply T282) is available. For chain-of-custody information, see COCH/9426 Chain-of-Custody Processing.
4. Additional drug panels and specific requests are available. Call Mayo Medical Laboratories at 800-533-1710 or 507-266-5700.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 72 hours |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Lysergic acid diethylamide (LSD) is an extremely potent psychedelic ergot alkaloid derived from the fungus, Claviceps purpurea(1). The drug LSD binds to serotonin receptors in the central nervous system and acts as a serotonin agonist.
The clearance half-life of LSD averages 3 to 4 hours. It takes 5 to 7 half-lives to clear 98% of a drug dose. Therefore, the presence of LSD greater than the lower limit of quantification (LOQ; cutoff concentration) indicates exposure to LSD within 1 day.(2)
LSD is metabolized to 2-oxo-3-hydroxy-LSD, which is present at concentrations 16 to 43 times higher than LSD, and is likely to be present in urine for up to 4 days after last exposure.(3,4)
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.
Negative
Positives are reported with a quantitative LC-MS/MS result.
Cutoff concentrations:
IMMUNOASSAY SCREEN
<0.5 ng/mL
LSD BY LC-MS/MS
<0.5 ng/mL
2-OXO-3-HYDROXY-LSD BY LC-MS/MS
<5.0 ng/mL
Interpretation Provides information to assist in interpretation of the test results
Lysergic acid diethylamide (LSD) exposure is confirmed if LSD is present >0.5 ng/mL or if 2-oxo-3-hydroxy-LSD is present >5.0 ng/mL.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
The liquid chromatography-tandem mass spectrometry (LC-MS/MS) test is not subject to any known interference.
Positive immunoassay screening results should be considered presumptive due to documented cross-reactivities with the lysergic acid diethylamide reagent antibody.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Babu KM, Ferm RP: Hallucinogens. In Goldfrank's Toxicologic Emergencies. Edited by Flomenbaum, Goldfrank, Hoffman, Howland, Lewin, and Nelson. 8th edition. New York. McGraw-Hill Book Company, 2006 pp 1202-1211
2. Baselt RC: Lysergic Acid Diethylamide. In Dispositition of Toxic Drugs and Chemical in Man, Edited by RC Baselt. 8th edition. Foster City, CA. Biomedical Publications, 2008 pp 871-874
3. Johansen SS, Jensen JL: Liquid chromatography-tandem mass spectrometry determination of LSD, ISO-LSD, and the main metabolite 2-oxo-3-hydroxy-LSD in forensic samples and application in a forensic case. J Chromatogr B Analyt Technol Biomed Life Sci 2005;825:21-28
4. Klette KL, Anderson CJ, Poch GK, et al: Metabolism of lysergic acid diethylamide (LSD) to 2-oxo-3-hydroxy LSD (O-H-LSD) in human liver microsomes and cryopreserved human hepatocytes. J Anal Toxicol 2000;24:550-556
Method Description Describes how the test is performed and provides a method-specific reference
Specimens are screened by immunoassay. All specimens are also confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS. (Unpublished Mayo method)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Wednesday
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
80299
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 5851 | Immunoassay Screen | 19528-9 |
| 20668 | LSD-by LC/MS/MS | 20542-7 |
| 21328 | 2-oxo-3-hydroxy-LSD by LC/MS/MS | 45185-6 |
| 20679 | Interpretation | 69050-3 |
| 21171 | Chain of Custody | In Process |
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