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I had to go for my second blood test for lithium levels this morning.  They took 4 big vials and wanted a urine sample.  Last time I was getting my yearly blood tests as well so it was expected.  This time I was not expecting a vampire drawing or a urine sample.  Anybody know if that is normal?  My understanding from my GP was that it was one vial for lithium.

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It certainly sounds as though they were doing more than just a lithium blood level check - are you absolutey sure your doctor didn't request that they run a repeat of all the standard tests?  My pdoc usually requests checks of my thyroid and kidney function at the same time as a lithium level, and they tend to draw 2-3 vials for that.  I can't recall ever having had more than one vial taken for a single lithium test.

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I'm honestly not sure what he ordered.  I'm kinda stumped on the urine sample.  I asked the lab tech what the urine sample was for and she said "urinalysis".  Well, no shit.  What kind of urinalysis???  But she didn't say.  I have no idea.  I mean if they were doing a drug test, wouldn't they just use the 3 quarts of blood?  ...  just griping now.  :)

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I'm wondering now if it has something to do with my therapist.  I was telling her about a breakthrough symptom when I switched from the depakote to the lithium.  She said she felt like she should tell my dr about it because it could be a seizure.  I'm more inclined to think it's brain cooties but she's the therapist.  I guess the extra vials of blood and the urine could be for that?  I thought that required EEG but..I'm not a doctor.

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You probably had a full workup done. Only a couple of teaspoons of blood.  You probably had two gold serum tubes that had clot activators in them.  They will take a sample of that to test your lithium levels.

These Gold Serum tubes some times they are a mottled red top - they will do a CMP, BMP,lipid panel, renal function panel, electrolytes, thyroid, creatinine.... you name it!!!!

 

I am guessing that you also had a lavender colored tube. RBC (red blood count) , WBC,  platelet function, hemoglobin etc.tests are performed from blood that was collected in this tube.

 

Your 4th tube may have either been a gray tube - which sometimes they do glucose test using this sample, but not always - or you could have had this tested using samples from the serum tubes.

 

The other thought is that it could have been a green tube, which takes care of chemistry tests - pretty much a lot of the things that I mentioned with the gold/red tubes.

 

SO it looked like a lot of blood, but it really wasn't.

 

Bottom line, I think your Dr. has ordered a full workup.

 

FYI - a phlebotomist ( I am currently an unemployed on)  have to fill those tubes to a certain level - most of the time it is not a big deal as they are vacuum sealed.  But if not filled properly, it can mess up the blood to chemical ratio.  This can mess up your tests!

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I'm wondering now if it has something to do with my therapist.  I was telling her about a breakthrough symptom when I switched from the depakote to the lithium.  She said she felt like she should tell my dr about it because it could be a seizure.  I'm more inclined to think it's brain cooties but she's the therapist.  I guess the extra vials of blood and the urine could be for that?  I thought that required EEG but..I'm not a doctor.

probably just testing your liver function if you are on Depakote - requires a blood test and uses the same vial as lithium.

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So even tho I had the full workup including everything like cholesterol and a1c last week, they need to do some of that again this week because of the dose change?  I'm completely new to this.

do you have a copy of your most recent labs - from last week?  perhaps the lithium, kidney, liver stuff.  Some labs know exactly how much blood they will need to run tests. It could be protocol to take a little more to test, or your Dr. wants to retest.  I don't know, I can't really hop inside their head.

 

At any rate - rest assured that this is normal and do ask for a copy of your most recent lab result so you know where things are at.

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