Specimen Collection Guide
Complete instructions for ordering practitioners on patient preparation, blood collection, specimen handling, packaging, and shipping requirements for the PBMC Intracellular Toxin Assessment.
Collection Protocol — Step by Step
- ●Patient should fast for a minimum of 4 hours prior to blood draw (water is permitted).
- ●Avoid vigorous exercise for 24 hours before collection — exercise mobilizes lipophilic toxins from adipose tissue and can transiently alter intracellular levels.
- ●No dietary supplements containing high-dose antioxidants (vitamin C > 1g, NAC, glutathione) for 48 hours before draw — these can interfere with oxidative stress markers used in EIS interpretation.
- ●Patients currently undergoing active chelation therapy should pause chelation for a minimum of 7 days before collection to obtain a true steady-state intracellular burden measurement.
- ●No dietary restrictions beyond fasting — standard diet is appropriate.
- ●Collect 2 × 10 mL EDTA (purple/lavender top) vacutainer tubes — 20 mL total whole blood.
- ●EDTA is the only acceptable anticoagulant. Heparin, citrate, and serum separator tubes are NOT acceptable — they interfere with PBMC isolation density gradient.
- ●Standard venipuncture technique. Invert tubes 8–10 times immediately after collection to ensure adequate mixing with EDTA.
- ●Label tubes with patient name, date of birth, collection date and time, and order number.
- ●Do NOT centrifuge the blood. Ship as whole blood.
- ●Keep blood at room temperature (18–25°C / 64–77°F) after collection. Do NOT refrigerate or freeze whole blood.
- ●Refrigeration causes irreversible PBMC damage and will result in insufficient cell viability for analysis.
- ●Gently invert tubes every 30 minutes if there will be a delay before packaging.
- ●Specimen must be shipped within 4 hours of collection to arrive at the laboratory within 24 hours.
- ●Complete the requisition form and place in the biohazard bag with the specimen.
- ●Place tubes in the provided absorbent specimen bag and seal.
- ●Place the sealed specimen bag inside the secondary rigid container (provided in the collection kit).
- ●Wrap the secondary container with the provided bubble wrap or foam insert.
- ●Include a room-temperature gel pack (NOT a frozen ice pack) in the outer shipping box to buffer temperature fluctuations.
- ●Place the completed requisition form in the document pouch on the outside of the shipping box.
- ●Seal the outer shipping box with tamper-evident tape.
- ●Use the pre-paid FedEx Priority Overnight shipping label included in the collection kit.
- ●Drop off at a FedEx location or schedule a pickup before the daily cutoff time (typically 5:00 PM local time).
- ●Do NOT ship on Fridays or the day before a federal holiday — specimens arriving on weekends cannot be processed.
- ●Acceptable shipping days: Monday through Thursday only.
- ●International shipments: contact the laboratory for country-specific requirements and IATA P650 compliance documentation.
| Panel | Standard TAT | Rush TAT |
|---|---|---|
| Standard PBMC Toxin Panel (HRMS + EIS) | 7–10 business days | 4–5 business days (rush fee applies) |
| Heavy Metals Only (ICP-HRMS) | 5–7 business days | 3–4 business days (rush fee applies) |
| Mycotoxin Panel (LC-HRMS) | 7–10 business days | 4–5 business days (rush fee applies) |
| PFAS Panel (LC-HRMS) | 7–10 business days | 4–5 business days (rush fee applies) |
| Full Comprehensive Panel (all classes) | 10–14 business days | 7–10 business days (rush fee applies) |
| EIS Only (cellular function) | 3–5 business days | 2–3 business days (rush fee applies) |
Specimens that meet any of the following criteria will be rejected and a new collection will be required. Practitioners will be notified by phone and email within 2 hours of specimen receipt if rejection criteria are met.
- ✗Incorrect tube type (heparin, citrate, serum separator — only EDTA is accepted)
- ✗Specimen refrigerated or frozen prior to shipment
- ✗Specimen received more than 48 hours after collection
- ✗Specimen shipped on Friday or the day before a federal holiday
- ✗Insufficient volume (less than 15 mL whole blood)
- ✗Tubes not inverted after collection (visible clotting)
- ✗Requisition form missing or incomplete (patient name, DOB, ordering physician, test ordered)
- ✗Specimen leaked during transport (secondary container compromised)
- ✗Hemolyzed specimen (visible red discoloration of plasma layer after centrifugation at lab)
Results are delivered securely through the Cell Biology Lab practitioner portal. Ordering practitioners receive an email notification when results are available. Reports are available as PDF downloads and include all HRMS quantification data, EIS frequency profiles, Toxin Burden Scores, and Organ System Risk Assessment.
Cell Biology Lab provides complimentary 30-minute result interpretation consultations with a clinical toxicologist for all ordering practitioners. To schedule, contact the laboratory after receiving results. Written clinical interpretation notes are also included with every report.
Patient copies of reports can be released directly to patients upon written authorization from the ordering practitioner. Patient-facing summary reports (simplified language, no raw data) are available upon request.
All raw HRMS data files (mzML format) are retained for 10 years and are available to ordering practitioners upon request. This enables retrospective analysis and comparison with future specimens from the same patient.
Collection kits are provided at no charge to registered ordering practitioners and include all required tubes, packaging materials, biohazard bags, requisition forms, and pre-paid FedEx overnight shipping labels.