Vitamin B6 (Pyridoxal 5 Phosphate) (Sendout)

Interpretation

Method

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Reference Range

Units: mcg/L

Female		Male
Age	Range	Age	Range
0-	5-50	0-	5-50

Effective date: 07/01/2015

Ref. Range Notes

Reference ranges were established using healthy fasting volunteers who abstained from vitamin supplementation for 24 hours prior to collection. Vitamin supplementation and nonfasting may result in elevated plasma vitamin concentrations.

Interpretation:Levels for fasting individuals falling in the range of 3 to 30 mcg/L for pyridoxic acid (PA) and 5 to 50 mcg/L for pyridoxal 5-phosphate (PLP) are indicative of adequate nutrition.

The following are interpretative guidelines based upon PLP and PA results:If PLP is >100mcg/L; or -If PLP is >100 mcg/L and PA is < or =30, the increased pyridoxal 5-phosphate is suggestive of hypophosphatasia. Consider analysis of serum alkaline phosphatase isoenzymes (ALKI/Alkaline Phosphatase, Total and Isoenzymes, Serum) and urinary phosphoethanolamine (AAPD/Amino Acids, Quantitative, Random, Urine).

• If PLP is >100 mcg/L and PA is 31 to 100 mcg/L; or PLP is 81 to 100 mcg/L and PA is < or =30 mcg/L, the increased pyridoxal 5-phosphate is likely related to dietary supplementation; however a mild expression of hypophosphatasia cannot be excluded. Consider analysis of serum alkaline phosphatase isoenzymes (ALKI / Alkaline Phosphatase, Total and Isoenzymes, Serum) and urinary phosphoethanolamine (AAPD / Amino Acids, Quantitative, Random, Urine).
• If PLP is 51 to 80 mcg/L or PLP is 81 to 100 mcg/L and PA is >30; or PLP is >100 mcg/L and PA is > 100 mcg/L, the elevated pyridoxal 5-phosphate is likely due to dietary supplementation.

Interferences and Limitations

Cautions: Vitamin supplementation and non-fasting may result in elevated plasma vitamin concentrations.

References

• Mayo Clinical & Interpretive Information: Pyridoxal 5-Phosphate, Plasma

Ordering & Collection

Specimen Type

Blood

Collection

Patient Preparation: Fasting-overnight (12-14 hours). Infants-draw prior to next feeding. Patient must not ingest vitamin supplements for 24 hours before the specimen is drawn.

Collection:

Collect 3 mL Blood in GREEN top (Sodium or Lithium Heparin) tube. Wrap in foil after collection to protect from light.

• Also Accepted: Lime PST (wrapped in foil after collection)

Handling Instructions

Outside Laboratories: Centrifuge sample in a refrigerated centrifuge and transfer plasma to an amber (light-protected) vial within 2 hours of collection. Freeze light-protected plasma at -20°C while awaiting shipment. Transport on dry ice.

Stability: Frozen (Required): 29 days; Refrigerated: Unacceptable; Ambient: Unacceptable.

Reject Due To: Sample not light-protected. Gross hemolysis, lipemia, or icterus okay.

Quantity

Requested: 1 mL plasma in an amber (light-protected) vial
Minimum: 0.5 mL plasma in an amber (light-protected) vial

Processing

Receiving Instructions

SMART Container Information:

Tube Received	SMART Routing
Foil-wrapped Sodium Hep Green Top	GF (GRNFOIL)
Foil-wrapped Lithium Hep Green Top	GF (GRNFOIL)
Foil-wrapped Lime PST	PSDARK (PSTDARK)

Centrifuge sample in a refrigerated centrifuge and transfer plasma to an amber (light-protected) vial (Mayo Supply T915) within 2 hours of collection. Freeze light-protected plasma at -20°C.

• Note: Whole blood samples that are received without foil/not light-protected may still be processed for testing, as long as they are centrifuged and the plasma transferred to a light-protected aliquot within 2 hours of blood draw.

Sendouts:

• Order Mayo Test: PLP
• Interfaced: Yes [Interface: 601; Worksheet: MAFZ]

Stability: Frozen (Required): 29 days; Refrigerated: Unacceptable; Ambient: Unacceptable.

Reject Due To: Plasma not light-protected. Gross hemolysis, lipemia, or icterus okay.

Misc Sendout

Performance

Lab Department

Sendouts Mayo Lab (FZ)(MAFZ)

Frequency

Performed: Monday through Thursday, Saturday, Sunday. Report Available: 1-4 days from sample receipt at Mayo Clinic Labs.

Available STAT?

No

Performing Location(s)

Sendout	Mayo Clinic Laboratories (Superior Drive) 800-533-1710 3050 Superior Drive NW Rochester, MN 55901

Billing & Coding

CPT Codes

84207

LOINC

30552-4

Interfaced Order Code

UOW3036

Interfaced Result Code

UOW3036