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Test Code LI Lithium Level

Additional Codes

Cerner

NextGen

Lithium Level

Lithium Level

Alternate Name(s)

Li

Lithium carbonate

Li2CO3

Useful For

Lithium carbonate (Li2CO3) has been found to be of value in the treatment of manic-depressive psychosis (bipolar); it has a calming effect upon the manic stage and is frequently given as a therapeutic measure to forestall possible attacks.

The serum Li+ level of patients receiving this drug is usually monitored weekly during the early phase of treatment. Lithium is also measured to diagnose a potential overdose. Symptoms of lithium intoxication include sluggishness, drowsiness, muscle weakness, and ataxia.

Methodology

Colorimetric (reflectance spectrophotometry).

Patient Preparation

Samples should be drawn approximately 12 hours after the last dose of lithium.

Collection Instructions

Standard phlebotomy practices.

Specimen Requirements

Container

Specimen Type

Tube

Serum

 or 

SST

 or  or 

 

Stability

Storage

Temperature

Stability

Room Temperature

18-28°C

≤ 8 hours

If separated within 4 hours

Refrigerated

 2-8°C

≤ 24 hours

If separated within 4 hours

Frozen

≤-18 °C

≤ 6 months

Rejection Criteria

Gross Hemolysis

Result Reporting and Reference Values

Reported in mmol/L.

Age

Low

High

Critical Low

Critical High

12 Hour Post dose

0.6

1.2

N/A

1.5

Reflex Testing

None

Limitations

  • Ortho reports a bias with the following:
    • Methylparaben at 150 mg/dL has a -0.17 mmol/L bias
    • N-acetylcysteine at 180 mg/dL has a -0.15 mmol/L bias
    • Hemoglobin at 100 mg/dL has a +0.04 bias
  • Ortho reports no significant effect with the following: 
    • Lipemia up to 800 mg/dL
    • Bilirubin up to 40 mg/dL
  • The following interpretive data is visible to the practitioner:
    • N-acetylcysteine creates a negative bias of approximately 15% at the therapeutic lithium level.