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The dexamethasone suppression The test (DST) is essentially a doctor’s order to determine how much cortisol is being produced in the urine. This analysis helps to determine if the patient is suffering from a condition called Cushing’s syndrome. There are two types of similar DST tests used by health care providers. You will probably need to take the low-dose test first. This will help prove whether the body is producing very large amounts of cortisol. The physician will still order the highest dose test, which will help demonstrate whether the cortisol buildup is due to a pituitary defect (Cushing’s disease). Repeat for more information. dexamethasone suppression test.
What is this dexamethasone suppression test?
This is a blood test used by medical professionals to diagnose Cushing’s syndrome. Cushing’s syndrome occurs when the pituitary gland does not function properly and produces very large amounts of cortisol. The pituitary gland produces a hormone called adrenocorticotropic hormone or ACTH; there is a negative relationship between ACTH and cortisol. This means that if the pituitary gland produces sufficient amounts, cortisol levels will be low. The dexamethasone suppression This test uses this relationship to measure cortisol levels in the bloodstream.
Dexamethasone is primarily a synthetic steroid hormone and functions in much the same way as cortisol. The physician will give the following instructions you dexamethasone It is less effective in the body. They then determine the potency of this synthetic steroid hormone in the to suppress production of cortisol. An abnormal response is produced. to dexamethasone If the pituitary gland is not functioning properly.
How is the Dexamethasone Suppression Test prepared?
Prior to testing, it may be necessary to stop taking certain medications such as barbiturates, oral contraceptives, corticosteroids, estrogens, tetracyclines, phenytoin, and spironolactone, which are used to treat patients with cirrhosis, heart defects, and kidney disease.
How does a dexamethasone suppression study work?
This test means that a dose of dexamethasone, a potent synthetic glycocorticoid drug, is obtained. After some time, the physician will take blood and use this blood sample to measure the cortisol level in the blood. As mentioned earlier, there are two types of of dexamethasone suppression Testing. Both tests at low doses and tests at high doses can be done at night or over a three-day period. Different labs perform these tests using different methods
- Low dose night: the analysis consists in giving 1 mg of dexamethasone at 8 p.m. and a blood sample the following morning.
- Standard low dose: the analysis consists in collecting a urine sample over 3 days and measuring the cortisol level in the body. 0.5 mg is obtained. of dexamethasone every 6 hours in the direction of the correct 48 hours on the second day.
- Higher doses in the direction of night: get the highest dose (8 mg) of dexamethasone at 11 pm, after which a blood sample is taken at 8 am of the appropriate year.
- Standard high dose: literally the same as the standard low dose test, urine is collected at 2 mg over 3 days of dexamethasone given every 6 hours on the second day and lasts for 48 hours.
Understand the results
There are some differences in the results obtained from different laboratories, but the correct one can still be used as a reference.
1. normal results
During a dexamethasone suppression The test you get dexamethasone This will decrease cortisol levels. These are the sensations usually mentioned by health care providers.
Low Dose
- Overnight: 8 hours plasma cortisol.< 1.8 mcg/dl
- Standard: no urinary decisol on day 3.< 10 mcg/day
High Dose.
- Overnight: >50% decrease in plasma cortisol.
- Standard: >90% decrease in urinary cortisol.
2. abnormal results
If the analysis shows abnormal totals, this may indicate a number of problems including Cushing’s syndrome. Abnormal results can be due primarily to tumors in the pituitary gland that produce ACTH, tumors in the adrenal glands that produce cortisol or tumors in the body.
In this story, if it has not already been produced, it should be tested at a higher dose. This can certainly help indicate that the pituitary gland is not functioning properly or that there are other conditions for abnormal results; an ACTH blood test can elaborate on the specific reason for the high cortisol level.
Even when Cushing’s syndrome is present, different results can be obtained depending on the circumstances causing the problem.
- If you believe that Cushing’s syndrome is the result of an adrenal tumor, you may see little or no change on the low-dose and low ACTH level tests. In that case, a high-dose test is not necessary.
- Low dose testing shows no change, but ACTH levels will be on the high side if the Cushing’s syndrome is the result of an ACTH-produced ectopic tumor, in which case a high dose test would be performed. Indicate change.
- If Cushing’s syndrome is the result of a pituitary tumor, low-dose testing will show little or no change and high-dose normal results will not be indicated. suppression This area is usually a sign of Cushing’s disease.
After dexamethasone suppression testing.
Even if the analysis shows an abnormal pattern, the physician can order a follow-up test to prove that you still have Cushing’s disease. Once the condition is demonstrated, he will offer you specific medications to control the increase in cortisol levels.
In some cases, if the increased cortisol levels are due to a tumor, the physician will ask to determine the pattern of the tumor. As soon as the tumor pattern and the severity of the problem are known, treatment options can be selected. However, if cortisol levels are on the high side due to other disorders, a different treatment may be needed.
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