Comprehensive 24-Hour Urinary Steroid Hormone Panels

COMPREHENSIVE PANEL OF TESTS

• Adrenal Hormones
  • Precursor: PREGNENOLONE
  • Glucocorticoid: CORTISOL, CORTISONE
  • Mineralocorticoids: ALDOSTERONE
  • Adrenal sex steroid precursors: DEHYDROEPIANDROSTERONE (DHEA) ETIOCHOLANOLONE, ANDROSTERONE
• Sex hormones: ESTRONE, ESTRADIOL, ESTRIOL, PREGNENEDIOL (progesterone metabolite), TESTOSTERONE
• CREATININE

OPTIONS AVAILABLE

Testing can be tailored to include adrenal hormones only, sex hormones only, or both.

• Adrenal steroids: DHEA, cortisone, cortisol, pregnenolone, aldosterone, etiocholanolone, androsterone
• Sex hormones: DHEA, estrone, estradiol, estriol, pregnenediol, testosterone, etiocholanolone, androsterone

INDICATIONS

• Breast lesions
• Anorexia nervosa
• Hypertension
• Emotional stress
• Adrenal insufficiency
• Idiopathic hirsutism
• Carcinoma
• Endocrine disorders
• Chronic fatigue syndrome
• Fibromyalgia
• Rheumatoid arthritis
• 5-alpha reductase deficiency
• Monitoring liver detoxification
• Bioidentical Hormone Replacement Therapy

CLINICAL APPLICATIONS

• Adrenal gland functional assessment–ACTH Adrenal Stimulation Test
  • Thorough assessment of adrenal functional capacity can be achieved by conducting 24-hour urinary assays before and after (PRE AND POST) adrenal stimulation with adrenal cortico-tropic hormone (ACTH)
• Hormone – related cancer prevention
  • New concept involves ratio between two estrone metabolites: 2-hydroxyestrone and 16alpha-hydroxyestrone.
  • Decreased 2/16alpha ratio is associated with increased risk for breast and cervical cancer.
  • The 2/16alpha ratio is not part of the standard hormone assay, but may be included as an added service.
• Liver detoxification
  • 24 – hour urinary estrogens can sensitively monitor liver detoxification capacity.
  • Elevated urinary estrogens have been noted in normally-cycling women with a history of exposure to liver stress (excess exposure to xenobiotic compounds).
  • Liver support interventions induce normalizing effect on urinary estrogen levels.
  • This phenomenon is also noted in peri- and post-menopausal women who have used Premarin and switched to “tri-estrogen” therapy with less-than-optimal relief.

BIOCHEMICAL BASIS

• Steroid hormones are prepared for excretion by metabolic processes in the liver.
• Liver enzymes reduce unsaturated bonds and add hydroxyl groups.
• Conjugation with sulfate (sulfation) renders the converted molecules more water-soluble.
• 20% – 30% of these compounds are secreted into the bile and excreted in the feces.
• The remaining 70% – 80% are released into the bloodstream.
• The kidneys filter out the metabolites and excrete them in the urine.

ADVANTAGES

• Increased accuracy because the 24 – hour test transcends the circadian fluctuation of hormone levels.
• Urinary hormone levels reflect normal physiologic processes.
• Meridian Valley adrenal test panel includes at least one hormone from each of the three categories of adrenal hormones-glucocorticoids, mineralocorticoids, and adrenal androgens-to ensure a comprehensive evaluation of adrenal cortical function.

ANALYSIS TECHNIQUES USED

Gas chromatography, mass spectrometry

COLLECTION KIT CONTENTS

1 – Requisition form            
1 – Instruction sheet1 – Urine collection cup            
1 – Urine jug w/ boric acid preservative2 – 30 mL urine vials
1 – Ice pack1 – Biohazard bag
1 – Styrofoam container1 – UPS next day air pack
1 – UPS next day air bill

SPECIAL NOTES

• Read collection and shipping instructions thoroughly before starting.
• Freeze ice pack upon receipt.
• When shipping specimens to lab — Send MONDAY through THURSDAY only. Deliveries are NOT ACCEPTED on Saturday or Sunday.
• Please call lab for holiday hours before collecting and shipping specimens to ensure timely receipt and processing.
• If two tests are required, such as a hormone panel and NTx, an additional vial is required.
• Pre- / peri-menopausal women with normal 28-day cycle should collect between days 18-22.
• If cycle is normally 21 days, collect between days 15-17.
• If cycle is normally 35 days, collect between days 25-29.
• If there is no cycle or if it is irregular, collect when convenient.
• Start collection at any convenient time of day.

Learn More About 24 Hour Urine Hormone Tests