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Box 4.1 Pre‐analytical requirements for accurate endocrine testing Patient preparation:

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 Prior fasting may be requiredGlucoseLipidsCalcium

 Dietary restrictions may be neededOral glucose tolerance testAdequate carbohydrate intake required the day before5‐Hydroxyindoleacetic acid (5‐HIAA)Avocados, bananas, pineapples, plums, walnuts, tomatoes, kiwi fruit and aubergine (eggplant) should be avoided

 Exercise restrictions may be neededOral glucose tolerance test

 Prior medication may be needed or should be avoidedOvernight dexamethasone suppression testDexamethasone is taken at midnight before the testSynacthen testExogenous steroids should be withheld for at least 8‐h prior to the test

 Attendance at a particular time0900 for serum cortisol and testosterone0800–1000 for aldosterone–renin ratio

 Posture/stressAmbulant for 30 min for plasma aldosteroneRested for 30 min for plasma catecholamines

 Other investigationsAvoidance of rectal examination prior to PSA measurement.

Essential Endocrinology and Diabetes

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