The paired endocrine glands that are located above the kidneys and in close proximity to them are the adrenal glands. They perform important functions in the human body: regulation of metabolic processes, adaptation to stressful and adverse life situations. Regulates the work of these endocrine glands directly the nervous system. Composition of the adrenal glands: cortical and medulla. The latter, in turn, produces catecholamine hormones: norepinephrine and adrenaline. The cortical substance, more precisely, only some of its cells, is connected in one system with the hypothalamus and pituitary gland, forming corticosteroids (aldosterone and cortisol).
Types of hormones tested
What are the adrenal hormone tests?
- Check for total cortisol. Cortisol is a steroid hormone of the adrenal cortex. Functions: a protective reaction of the body to starvation or stressful situations, participates in the regulation of most metabolic processes, is responsible for the production of adrenocorticotropic hormone and corticoliberin.
- Checking for dehydroepiandrosterone sulfate. This hormone is synthesized by the cortex of the glands in question. The human body uses it to produce estrogen (in women) and testosterone (in men). High levels of the estrogen hormone in the blood are very dangerous during pregnancy: it leads to miscarriage or threatens to prematurely terminate the pregnancy process.
- Aldosterone Its adrenal cortex cells are produced. The task is to adjust the water-salt (the presence of sodium, chlorine and potassium) balance of the body by affecting the kidney channels, adjusting the total amount of fluid in the body as a whole. It is also an informant of blood pressure.
Symptoms detected on their own and possibly indicating a problem
Some symptoms that may indicate problems with the functional functioning of the adrenal glands and showing that you need to see a doctor:
- An abnormally increased amount of hair on the body, coarsening of the voice.
- The appearance of blue-black spots in the palate and gums, hyperpigmentation of the skin.
- Vitiligo - noticeable bright spots appear on the skin.
Reasons to get tested for total cortisol
An analysis of the adrenal hormone cortisol is recommended when:
- Unreasonable muscle weakness.
- Hirsutism.
- Abnormally active pigmentation of the skin.
- Suspicion of Itsenko-Kuching syndrome and Addison's disease.
- Osteoporosis.
- Early sexual development.
- Oligomenorrhea.
Reasons to get tested for dehydroepiandrosterone sulfate
Tests for adrenal hormones, and specifically for dehydroepiandrosterone, are necessary in the following cases:
- At 12-15 weeks of pregnancy, a feto-placental complex was diagnosed.
- Adrenogenital symptom.
- Late or delayed puberty.
- Adrenal cortex tumor.
- Hypertrophy of the fetus.
- The producing tumor.
- Inability to bear a child (not an isolated case of miscarriage).
Reasons for testing for aldosterone
A blood test for adrenal hormone aldosterone must be passed if you suspect:
- Enhanced production of this hormone.
- Adrenal insufficiency.
- Tumor, tissue adenoma in the adrenal cortex.
- Orthostatic hypotension.
- Hyperplasia (rapid cell growth).
- Regular high blood pressure that cannot be controlled.
Which analysis to take
Specifically, which tests to take adrenal hormones, prescribed by the attending physician (therapist or endocrinologist). During a general examination, a patient is interviewed, blood pressure is measured, an additional examination is prescribed, if necessary, ultrasound, CT or MRI. And only then the doctor writes out a direction for the delivery of urine and blood and advises which laboratory should be contacted. In the direction the name of the adrenal hormone analysis for women and men to be passed will already be indicated. If you plan to visit a paid clinic, you can familiarize yourself with the laboratory work schedule and price list in advance, as well as book an analysis in advance. The clinic can tell you what the name of the adrenal hormone test performed in this institution is called. Usually all comprehensive information about him is given.
Standard variations in the names of adrenal hormone assays:
1. To test the hormone cortisol:
- Small and large dexamethasone sample.
- Test with ACTH (adrenocorticotropic hormone).
- Test with insulin hypoglycemia.
2. What analysis needs to be passed on the adrenal hormone - aldosterone:
- Basal levels of aldosterone and renin.
- Orthostatic march test.
3. On adrenal androgens:
- Basal Dehydroepiandosterone (DEA) Level.
- 17-hydroxyprogesterone.
- Sample with ACTH.
4. On catecholamines:
- Blood Metanephrins.
- Metanephrins in the urine.
- Urinary excretion of vanilla-mandelic acid.
Rules for preparing the body for testing for total cortisol
If you plan to analyze the hormone of the adrenal cortisol, then in advance, the day before going to the clinic, you need to abandon active heavy physical exertion and smoking. It is strongly recommended that you do not take oral contraceptives or hormonal medications at least 24 hours before going to the laboratory. If there is a course of taking other medicines, it is better to play it safe and check with the attending endocrinologist if taking these medicines will affect the result of laboratory tests.
Conditions for obtaining an accurate bioassay for dehydroepiandrosterone
24 hours before the blood donation process for dehydroepiandrosterone, you need to refuse to take the following drugs:
- Dexamethasone.
- Hydrocortisone.
- Prednisone.
- Diprospan.
- Estrogen.
- Contraceptive pills.
If, for justified reasons, the ability to refuse the above medicines is not available in whole or in part, then during the direct test of the adrenal hormone, you should inform the nurse who is collecting blood for biochemical analysis, what kind of medications were taken for the last day and in what quantity.
Aldosterone - how to prepare for analysis
To obtain the correct result of the study of the hormone, the following measures are necessary:
- For a fortnight before the laboratory assessment, you need to monitor the use of salt - it should neither exceed nor underestimate the usual rhythm of using this product in everyday life.
- If a person is sick at the time of blood or urine donation, then it is better to postpone the procedure for analyzing adrenal hormones at the time of full recovery in order to avoid artificially low results.
- 24 hours before the test, it is strongly recommended that you wait for heavy physical or emotional stress.
- It is necessary to consult with your doctor and cancel for a while the reception of those medications that can affect the exact results of the analysis.
Established standards
The level of normal blood data on the content of cortisol:
- Up to 16 years of age - 83-580 nmol / L.
- Older than 16 - 138-635 nmol / L.
It should be borne in mind that the presence of cortisol in the body has significant fluctuations during the day: the maximum readings are from 4 to 8 in the morning, the minimum are from 21 to 3 hours.
For dehydroepiandrosterone:
- The norm of the result of the analysis for women of the adrenal hormone, called estrogen, is 810–8991 nmol / l.
- The male norm (testosterone) is 3591–11907 nmol / L.
Aldosterone is normal at: 35 - 350 pg / ml.
Excess and lack of cortisol in the body
Indications of cortisol can be observed above the established norm for diseases:
- Itsenko-Cushing's disease;
- hyperthyroidism;
- carcinoma;
- virilizing adrenal hyperplasia;
- low blood sugar;
- decreased kidney function;
- tumors in the adrenal glands;
- in the course of pregnancy;
- while taking contraceptives orally;
- in case of stress or depression;
- with obesity;
- against the backdrop of alcoholism.
Indications below the norm are observed in such pathological conditions:
- panhypopituitarism;
- adrenogenital syndrome;
- hypothyroidism;
- if the indicators decreased during the course of pregnancy, then this indicates signs of the development of an early type of toxicosis;
- cirrhosis of the liver;
- impaired synthesis of adrenal corticosteroids;
- hepatitis;
- insufficient production of hormones by the adrenal glands (with Addison's disease).
Deviation from the norms of the concentration of the hormone dehydroepiandrosterone in the body
When dehydroepiandrosterone is in excess:
- Pregnancy.
- Thermal stress.
- Long starvation.
- Primary aldosteronism (with Cohn syndrome).
- Hemangiopericytoma of the kidneys.
- Heart failure.
- Cirrhosis and formed ascites.
- Nephrotic syndrome (signs are severe edema and noticeable changes in the indications of a biochemical blood test).
- Hemorrhage provoking hypovolemia.
- Bartter's Syndrome.
Lack of hormones from the pituitary-adrenal system department is observed with the following pathologies:
- Addison's Disease (only if there is no diagnosis of hypertension).
- When diagnosed with hypertension, the produced corticosterone is above normal, diabetes mellitus, Turner disease, alcohol poisoning.
- A large amount of eating table salt.
- Adrenogenital Syndrome.
- During pregnancy - arterial hypertension.
Regulatory abnormalities as a result of analysis for the presence of aldosterone
Excessive aldosterone shows:
- The presence of pregnancy.
- Thermal stress.
- Prolonged hunger.
- Hemangiopericytoma of the kidneys.
- If aldosteronism is primary, then Cohn syndrome.
- Hepatic cirrhosis accompanied by formed ascites.
- Adrenal hyperplasia on both sides during false primary aldosteronism.
- Hypovolemia provoked by hemorrhage.
- Heart failure.
- Bartter's Syndrome.
- A complex pathological nephrotic syndrome accompanied by very noticeable edema and changes in certain biochemical blood readings.
The amount of hormone produced is below the established norm:
- If hypertension has not been diagnosed with Addison's disease.
- A large amount of edible salt.
- If hypertension is present, then with increased production of corticosterone, diabetes mellitus, alcohol poisoning, Turner’s disease.
- With arterial hypertension, which appeared during pregnancy.
- Due to adrenogenital syndrome.
The timing of obtaining the finished results of the analysis for adrenal hormones is an average of 1-2 days.
Treatment appointment
After receiving all the results of an examination of the adrenal glands, the attending physician prescribes treatment according to the type of pathology that caused the lesion and the degree of functional impairment. The main goal of the prescribed treatment is to eliminate the root cause of the detected problem.