Test ID: FL
Fluoride, Plasma
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
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)
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.
Collection Container/Tube: Green top (sodium heparin)
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
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 | Mild OK; Gross OK |
| Lipemia | Mild OK; Gross OK |
| Icterus | Mild OK; Gross Reject |
| 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 |
|---|---|---|
| Plasma Heparin | Refrigerated (preferred) | 14 days |
| Ambient | 14 days | |
| Frozen | 14 days |
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 >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).
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.
0.0-4.0 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 <1 mcmol/L. Plasma fluoride values >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, 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.
Specimen must be sent in a plastic vial.
Clinical Reference Provides recommendations for further 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
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 Electrodes, Cambridge, MA, Orion Research)
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.
Tuesday; 8 a.m.
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.
82735
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 |
|---|---|---|
| 8641 | Fluoride, P | 14726-4 |
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