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17 OH Progesterone

Hormone/ Element
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Report in 12Hrs

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nofastingrequire

No Fasting Required

Details

Measures adrenal hormone levels for CAH screening

₹499₹1,045

52% OFF

17 OH Progesterone Test Information Guide

  • Why is it done?
    • Test Purpose: Measures 17-hydroxyprogesterone (17-OHP), a precursor hormone in the adrenal cortex steroid synthesis pathway. This test detects abnormalities in cortisol and aldosterone production, primarily used to screen for and diagnose congenital adrenal hyperplasia (CAH).
    • Primary Indications: Newborn screening for CAH; evaluation of ambiguous genitalia in newborns; assessment of virilization or signs of androgen excess in children and adults; investigation of irregular menstrual cycles, infertility, or hirsutism in females; preoperative evaluation for adrenal surgery; monitoring treatment response in CAH patients.
    • Timing: Performed as part of routine newborn screening programs (typically 24-48 hours after birth); in adolescents and adults, typically ordered during early morning hours to capture peak cortisol levels; may be performed at specific times during menstrual cycle in females for diagnostic accuracy.
  • Normal Range
    • Reference Values: Newborns: <200 ng/dL (6 nmol/L) or <400 ng/dL depending on laboratory; Children (prepubertal): <200 ng/dL; Adults (follicular phase in women): 20-200 ng/dL (0.6-6 nmol/L); Adult males: 20-100 ng/dL (0.6-3 nmol/L); Reference ranges vary significantly by laboratory and assay method used.
    • Units of Measurement: Nanograms per deciliter (ng/dL) or nanomoles per liter (nmol/L); conversion factor: 1 ng/dL = 0.03 nmol/L.
    • Result Interpretation: Normal: Values within laboratory-specific reference range indicate adequate adrenal function; Elevated (>200-400 ng/dL depending on age/sex): May indicate CAH or other adrenal disorders; Borderline elevated: Requires confirmatory testing with ACTH stimulation test; Low: May indicate adrenal insufficiency or secondary hypogonadism.
    • Abnormal Meaning: Elevated values suggest impaired cortisol synthesis due to enzyme deficiencies in the adrenal pathway, most commonly 21-hydroxylase deficiency accounting for 90-95% of CAH cases.
  • Interpretation
    • Elevated Results (>200-400 ng/dL): Strong indicator of congenital adrenal hyperplasia, particularly 21-hydroxylase deficiency; accumulation of 17-OHP results from blocked cortisol synthesis pathway; severity of elevation correlates with enzyme deficiency severity; may require confirmatory ACTH stimulation test for definitive diagnosis.
    • Mildly Elevated Results (120-200 ng/dL): Borderline or carrier status; may indicate mild CAH or late-onset form; requires follow-up testing and clinical correlation; ACTH stimulation test recommended to clarify diagnosis; may represent heterozygous carrier without clinical disease.
    • Normal Results: Generally excludes classic CAH; rules out significant adrenal enzyme defects; normal adrenal steroid synthesis and regulation; may still require other diagnostic testing if clinical suspicion remains high.
    • Factors Affecting Results: Circadian rhythm (peak in early morning); menstrual cycle phase in females; stress levels; illness or acute illness can elevate levels; medications including glucocorticoids (suppress levels), oral contraceptives, and androgens; timing of sample collection relative to medication administration; age and pubertal development; laboratory method and reference ranges used.
    • Clinical Significance: Critical screening marker for newborn CAH detection enabling early treatment initiation; highly sensitive for classic CAH forms (>99%); specificity improved with ACTH stimulation testing; essential for predicting associated androgen excess and salt-wasting potential; helps guide hormone replacement therapy decisions; poor predictor of phenotype severity.
  • Associated Organs
    • Primary Organ System: Adrenal glands (zona fasciculata and reticularis); hypothalamic-pituitary-adrenal (HPA) axis; the test measures steroid production in the adrenal cortex.
    • Associated Conditions - Abnormal Results: Congenital Adrenal Hyperplasia (CAH), primarily 21-hydroxylase deficiency; 11β-hydroxylase deficiency (second most common); 3β-hydroxysteroid dehydrogenase deficiency; polycystic ovary syndrome (PCOS) with androgen excess; adrenal tumors (adenomas or carcinomas) producing excessive androgens; secondary hyperandrogenism with disrupted cortisol synthesis.
    • Associated Conditions - Dependent Effects: Elevated androgens causing virilization; genital ambiguity in genetic females; hypertension and hypokalemia (salt-wasting forms); hypoglycemia and shock (acute crises); oligomenorrhea or amenorrhea; infertility; male-pattern baldness; acne; hirsutism in females.
    • Potential Complications if Untreated: Adrenal crisis with cardiovascular collapse and death in salt-wasting CAH; chronic hypertension and cardiovascular disease; impaired fertility and sexual dysfunction; psychological distress from virilization; stunted growth or accelerated bone age; testicular adrenal rest tumors in males; metabolic complications including insulin resistance.
    • Other Affected Organ Systems: Reproductive system (virilization, menstrual dysfunction); kidneys and cardiovascular system (salt-wasting, hypertension); skeletal system (accelerated bone age); brain (stress response abnormalities); immune system (altered cortisol regulation).
  • Follow-up Tests
    • Confirmatory Testing: ACTH (cosyntropin) stimulation test - gold standard for confirming CAH diagnosis; measures 17-OHP response to exogenous ACTH challenge; baseline cortisol and 17-OHP followed by samples at 30-60 minutes post-ACTH administration; helps differentiate classic from non-classic CAH forms.
    • Related Hormone Panels: Serum cortisol (baseline); adrenocorticotropin hormone (ACTH); testosterone and androstenedione (androgen assessment); dehydroepiandrosterone sulfate (DHEA-S); electrolytes including sodium and potassium (for salt-wasting assessment); plasma renin activity (aldosterone evaluation).
    • Additional Diagnostic Testing: Genetic testing for CYP21A2 mutations (confirms CAH diagnosis); pelvic ultrasound (for adrenal or ovarian assessment); abdominal MRI or CT imaging (if adrenal tumor suspected); bone age radiographs (in children); glucose tolerance testing; lipid panel.
    • Monitoring Tests for Established CAH: Periodic 17-OHP measurement for therapy optimization (every 6-12 months initially, then as clinically indicated); morning cortisol and ACTH levels; androgen levels (testosterone, androstenedione); growth parameters in children; bone density assessments; metabolic screening including insulin and glucose; blood pressure monitoring.
    • Specialized Tests: 24-hour urine cortisol and metabolites; midnight salivary cortisol (for circadian assessment); dexamethasone suppression test (if atypical presentation); fertility assessment and gonadotropin testing; immunological screening in neonates with CAH.
    • Monitoring Frequency: Newborns: If initial screening elevated, repeat testing at 10-14 days for confirmation; Treatment initiation phase: monthly to every 3 months; Stable maintenance: every 6-12 months or as clinically indicated; During stress (illness, surgery): more frequent monitoring required; Adolescents approaching adulthood: transition care with ongoing assessment.
  • Fasting Required?
    • Fasting Status: NO fasting required - the 17-OHP test can be performed non-fasting; food and drink do not significantly affect hormone levels.
    • Timing Requirements: Early morning sampling (7-9 AM) strongly recommended to capture circadian peak; collect before 10 AM when possible for accurate baseline values; consistent timing crucial for serial comparisons and therapy monitoring.
    • Medication Considerations: Continue all regular medications unless specifically instructed otherwise; glucocorticoids (dexamethasone, prednisone, hydrocortisone) suppress 17-OHP levels and should be taken as prescribed with timing noted; avoid new glucocorticoids within 24 hours before test if possible; oral contraceptives may affect results and timing should be documented; other adrenal medications should be continued on regular schedule.
    • Patient Preparation Instructions: Arrive in early morning (7-9 AM if possible); remain calm and avoid strenuous exercise for 30 minutes before collection (stress and activity elevate cortisol pathway); dress appropriately for comfort during phlebotomy; inform healthcare provider of any acute illness or stress (can temporarily elevate levels); notify provider if currently hospitalized or on intensive medical support.
    • Special Circumstances: Newborn screening: collected via heel stick on filter paper card 24-48 hours after birth; no special preparation needed; Female patients: menstrual cycle phase should be documented (preferably follicular phase); baseline specimen collection should precede ACTH stimulation test by appropriate interval; patients with acute illness or trauma may have temporarily elevated values requiring repeat testing after recovery.

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