Hormones

Female hormones

Requesting of female hormone measurement is common in primary care. The tests that are carried out are highly dependent on clinical details and the interpretation of results are likewise highly dependent on the clinical scenario. Please provide clinical details otherwise the correct tests may not be carried out.

FSH
LH
Oestradiol (E2)
Prolactin
Progesterone
SHBG
Testosterone
Androstenedione
DHEAS
17OHProgesterone


Click on the link below for a summary chart.





Adrenal hormones


Cortisol

Adrenal failure results in a low cortisol which can present as tiredness.
Check 9am cortisol if Addisons disease suspected. Discuss result with Dr Rob Lord as endocrine referral for a short synacthen test may be required.

Overproduction of cortisol results in Cushings Syndrome which may present with a range of symptoms including hirsutism, hypertension and changes to skin, soft tissue, muscle and bone. Check 24hr urine cortisol and consider endocrine referral for dexamethasone suppression tests. Discuss with Dr Rob Lord.


Renin and aldosterone

Primary hyperaldosteronism (Conns Syndrome) can cause hypertension. A clue may be a persistently low potassium in the U+E results with no other obvious cause.
Check renin and aldosterone (requires a lithium heparin - orange top - blood bottle taken at the hospital and to lab asap) and supply details of any antihypertensive medication with the request.


Metanephrines and Catecholamines

Overproduction of catecholamines (adrenaline / noradrenaline) by a phaeochromocytoma may result in difficult to control hypertension. Check three 24hr urine collections for   metanephrines / catecholamines. The urine bottles contain an acid preservative and need to be collected from the hospital.