30, Jul, 2018
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Adrenal Gland Hormones and Interpretation

Written by on Monday, 30 July 2018 11:10
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Adrenal Gland Hormones and Interpretation Adrenal Glands

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Adrenal Glands

Why is this test performed?

This hormone test is evaluated in different conditions, such as Hyperaldosteronism, Cushing's syndrome and Virilizing syndrome.

Lab tests for various adrenal abnormalities

Primary Adrenal Insufficiency (Addison's disease):

This is due to the diseases of the gland.

  • Level of sodium in serum is low.
  • Cortisol level is decreased.
  • Glucose level is decreased.
  • ACTH level is raised.
  • Potassium, calcium, and blood urea level are raised

Adrenal Hyperfunction leads to:

  • Increased level of Aldosterone causes Hyperaldosteronism.
  • Increased level of Cortisol causes Cushing's syndrome.
  • Increased level of Androgens causes Virilizing syndrome.

Primary Hyperadrenalism:

  • Level of Cortisol is raised.
  • ACTH level decreases.

Secondary Hypoadrenalism (secondary or tertiary Adrenal insufficiency):

This is due to external factors which lead to under activity of the glands.

  • ACTH level is low.
  • Cortisol level is decreased.

Adult adrenogenital syndrome:

  • There is an elevated level of:
    1. Urine 17-ketosteroids
    2. DHEA
    3. ACTH
  • There is a decreased level of:
    1. Cortisol

Congenital Adrenal Hyperplasia:

  • Decreased level of:
    1. Cortisol
    2. Aldosterone
  • There is an elevated level of:
    1. ACTH
    2. Androgens level

Primary Hyperaldosteronism (Conn's syndrome):

  • There is a decreased level of:
    1. Renin
    2. Potassium
    3. No response to aldosterone suppression test
  • There is an elevated level of:
    1. Serum sodium
    2. Aldosterone urine and blood

Cushing's syndrome:

  • There is an elevated level of Glucose, Sodium, and Cortisol.
  • There is no diurnal variation of ACTH and it is absent.
  • There is a decreased Potassium level.

Collection of sample

For the estimation of Adrenal Gland Hormones, patient's serum is needed. The 24-hour urine sample is also collected along with blood sample.

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For the estimation of Cortisol level, patient's serum is required. 24-hour urine sample is also collected in a plastic container containing boric acid. The serum is stable for 2 days if kept at 2° to 8° C.

For catecholamines (Epinephrine and Norepinephrine), plasma in EDTA or heparin is needed. The sample is transported along with an ice-pack, centrifuged immediately at 4° C, and plasma is separated. Plasma is freeze until the test is run. 24-hour urine sample may also be collected in a plastic container containing 6 ml of 20% HCl and refrigerate during collection.

Estrogen can be estimated in serum. The blood sample is collected in a plain test tube, centrifuged immediately, serum is separated and refrigerated until the test is performed. 24-hour urine sample is also collected in a plastic container containing boric acid.

Aldosterone test can be done from the plasma (EDTA, citrate or heparin). Patient's blood serum may also be used for the test. Patient must be upright for 2 hours before the sample is taken. 24-hour urine sample is also collected in a plastic container containing boric acid.

Precautions before performing the Adrenal gland tests

  • Fasting blood sample is required.
  • Avoid herbal medicines and any medication which interfere with the test.
  • Avoid nuclear scan before this test.
  • Avoid exercise or physical activity.
  • Reduce the stress before performing this test.
  • Aldosterone AM sample is higher than PM.
  • Cortisol highest level is 8 AM and >50% less at 8 PM.

Normal Values

  • Plasma Epinephrine <50 pg/mL
  • Norepinephrine 110 to 410 pg/mL
  • Cortisol serum 5 to 20 µg/dL
  • Urine cortisol (free) 20 to 90 µg/ day
  • Aldosterone (recumbent) 50 to 150 ng/L
  • Aldosterone (upright) 150 to 300 ng/L

Estrogen

  • Male 20 to 80 pg/mL
  • Female Luteal phase 160 to 400 pg/mL
  • Follicular phase 60 to 200 pg/mL
  • Postmenopausal <130 pg/mL
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Last modified on Monday, 30 July 2018 13:18
Read 301 times
  • Dayyal Dg.
  • Clinical laboratory professional specialized to external quality assessment (proficiency testing) schemes for Laboratory medicine and clinical pathology. Author/Writer/Blogger

Dayyal Dg.

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Clinical laboratory professional specialized to external quality assessment (proficiency testing) schemes for Laboratory medicine and clinical pathology. Author/Writer/Blogger

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