Specimen Information and Medication

COLLECTION: Whole blood in sodium citrate tubes. Not chilled, not centrifuged.

SPECIMEN STABILITY: Up to 48 hours at room temperature.

REJECTION CRITERIA: Blood sample is over 48 hours old; improper collection vials or method. Immunosuppressant medication taken within previous 3 weeks (see below)

LOW LYMPHOCYTE RECOVERY: In some instances it may not be possible to test for all the requested metals due to low lymphocyte recovery. The laboratory will prioritise testing according to the exposure information provided on the test request form and for the most frequently allergenic metals. You may number or place * next to the metals that are key. Patients will only be charged for the metals tested.

Causes of low lymphocyte recovery are beyond the control of either the phlebotomist or the laboratory and may include:

  • Recent or ongoing viral infection (cold or influenza)
  • Extended transit times (over 48 hours), ensure that directions on sample collection leaflet are followed
  • Extreme temperatures in transit
  • Automimmune disorders such as lupus or RA
  • Low levels of certain vitamins including B12 and folic acid


IMMUNOSUPPRESSANT MEDICATION: MELISA measures immune response so any drug that suppresses this response may affect results. This is not an exhaustive list and patients should check with their health care professional to see if any of their current medication has an immune suppressant effect. Patients must speak with their healthcare professional before stopping any prescribed medication.
In certain cases, where it is not possible to cease medication we have incidences of patients with successful test results. It may be useful to send extra blood (1-2 tubes) to ensure that sufficient lymphocytes can be recovered – please consult with MELISA in advance. A reduced fee may be charged if the results are “non-evaluable” due to reduced immune reactivity, as the test will have been set up as normal.

Strong effect – avoid ideally for 3 weeks prior to testing

  • Prednisone/ Prednisolone
  • Dupixent
  • Deltasone
  • Orasone
  • Azathioprine and DMRDs
  • Cortisol
  • Dexamethasone
  • Methotrexate
  • Anti malarials
  • Cosentyx
  • Cyclosporine and Tacrolimus
  • Neoral
  • Sandimmune
  • SangCya
  • Opiods – Long term use at high levels
  • Oral hydrocortisone
  • Methylprednisolone
  • Triamcinolone
  • Hydroxychloroquine (Plaquenil)


Possible Mild effect – if possible avoid the morning of the blood draw

  • Anti depressants
  • Anti histamines
  • TCH – medical marijuana
  • Finasteride
  • NSAIDs