Figure 1.

Biochemical evaluation of suspected adrenal hypercortisolism. Assessment of hypercortisolism, based on biochemical assays, should include a degree of clinical suspicion to reduce the likelihood of false-positive results. *DST, dexamethasone suppression test; to be used as a unique, first-line screening test in the absence of overt signs and/or symptoms of hypercortisolism. **Repeat every 6 months if clinically suggestive of hypercortisolism. ACTH, adrenocorticotropic hormone; CRH, corticotropin-releasing hormone; DHEAS, dehydroepiandrosterone sulfate; LNSC, late-night salivary cortisol; UFC, urinary-free cortisol.