Table 1.
Summary of Patient Test Results
| Test | Initial | Weeks After Initial Presentation |
Reference Interval | Method | Biotin Interferencea | |||
|---|---|---|---|---|---|---|---|---|
| 3.5 | 4 | 10 | 12 | |||||
| Pituitary | ||||||||
| ACTH pg/mL | 8.3 (L) | 6.6 (L) | <5.0 (L) | 7.2–63 (am draws) | Sandwich IA, Roche cobas e601 | Yes | ||
| FSH mIU/mL | 5.1 | 4.8 | 10.1 | Follicular 1.9–11.6, luteal 1.4–9.6 | Sandwich IA, OCD Vitros5600 | Yes | ||
| Postmenopausal 21.5–131.0 | ||||||||
| LH mIU/mL | 1.8 | 1.4 | 7.8 | Follicular 2.6–12.1, luteal 0.8–15.5 | Sandwich IA, OCD Vitros5600 | Yes | ||
| Postmenopausal 13.1–86.5 | ||||||||
| IGF-1 ng/mL | 73 (z score: 1.04) | 44–227 (age matched) | LC-MS, LDT | No | ||||
| Prolactin ng/mL | <1.0 (L) | <1.0 (L) | 1.5 (L) | 3.0–19.0 | Sandwich IA, OCD Vitros5600 | Yes | ||
| TSH mIU/mL | 0.06 (L) | 0.09 (L) | 0.06 (L) | 0.6–3.3 | Sandwich IA, OCD Vitros5600 | Yes | ||
| TSH mIU/mL | 1.1 | 0.3–4.3 | Sandwich IA, Beckman Coulter UniCel DXI 800 | No | ||||
| Thyroid | ||||||||
| Free T3 pg/mL | 4.01 | 4.10 | 4.07 | 2.71–6.16 (age matched) | Sandwich IA, OCD Vitros5600 | No | ||
| Free T4 ng/dL | 1.02 | 1.24 | 0.97 | 0.7–1.4 | Sandwich IA, OCD Vitros5600 | No | ||
| Adrenal | ||||||||
| Cortisol µg/dL | 115 (H) | >123 (H) | 26.2b (H) | 2.9 | Before 10 am: 4.5–22.7, after 5 pm: 1.7–14.1 (LDST < 1.8 μg/dl)c | Competitive IA, OCD Vitros5600 | Yes | |
| Cortisol, salivary ng/dL | <50 | 11 pm–12 am: <100 | LC-MS/MS, LDT | No | ||||
| Cortisol (free), urine µg/24 h | 25 | 3.5–45 | LC-MS/MS, LDT | No | ||||
| DHEA-sulfate µg/dL | 21.1 | 28.9 | 18–244 (age matched) | Competitive IA, IMMULITE 2000 | No | |||
| Androstenedione ng/dL | 23 (L) | 38 | 30–200 | LC-MS/MS, LDT | No | |||
| Gonadal | ||||||||
| Total testosterone ng/dL | 232 (H) | 184 (H) | 13.8 | 6–77 | Competitive IA, OCD VITROS 5600 | Yes | ||
| Total testosterone ng/dL | 15 | 11 | 8–60 | LC-MS/MS, LDT | No | |||
| Free testosterone ng/dL | 0.20 | 0.13 | 0.06–0.95 | Equilibrium dialysis, LC-MS/MS, LDT | No | |||
| Other | ||||||||
| Biotin ng/mL | 38 | 3 | Undefined | LC-MS/MSd, LDT | No | |||
| SHBG nmol/L | 51 | 18–144 | Sandwich IA, IMMULITE 2000 | No | ||||
Conversion factors to International System of Units (SI). ACTH: 0.2 pmol/L; IGF-1: 1.0 µg/L; free T3: 1.5 pmol/L; free T4: 12.9 pmol/L; cortisol: 27.6 nmol/L; cortisol, urine: 2.8 nmol; dehydroepiandrosterone-sulfate: 0.03 µmol/L; testosterone/androstenedione: 0.035 nmol/L; free testosterone: 34.7 pmol/L; FSH/LH/TSH: 1.0 IU/mL.
Abbreviations: DHEA, dehydroepiandrosterone; H, above the upper reference limit; IA, immunoassay; L, below the lower reference limit; LC-MS, liquid chromatography tandem mass spectroscopy; LDST, low-dose dexamethasone suppression test; LDT, laboratory-developed test; OCD, Ortho Clinical Diagnostics.
Test contains biotin-based reagents and is susceptible to biotin interference.
am cortisol for low-dose dexamethasone suppression test.
Low-dose dexamethasone suppression test am cortisol <1.8 µg/dL (<49.7 nmol/L), per Endocrine Society clinical practice guidelines.
Research use only.