To rule out suspected MTP/LCHAD in an adult patient born after the initiation of newborn screening, should the acylcarnitine profile blood test be completed with the patient in a well-fed or fasted state? The patient presented to an outpatient lab following an 8-hour fast for the blood draw. But the lab turned the patient away and insisted the test be completed an hour after eating a full meal. If the patient in is a period of relative wellness the day prior to the test, and intends to endure only an 8-hour fast to avoid a further increase in symptoms, should he/she eat breakfast before the blood draw? Thank you in advance for your input.