ACTH Stimulation Test For 17 OH progesterone 3 samples Test in UAE

ACTH Stimulation Test for 17-OH Progesterone (3 Samples) in Dubai and across the UAE to evaluate adrenal function and diagnose congenital adrenal hyperplasia (CAH), particularly 21-hydroxylase deficiency. This dynamic test measures 17-hydroxyprogesterone (17-OHP) levels before and after synthetic ACTH injection, offering a definitive assessment of adrenal steroid production. Results available within 10–12 days.

Overview

The ACTH Stimulation Test for 17-OH Progesterone is a specialized diagnostic procedure used to assess adrenal gland response and detect congenital adrenal hyperplasia (CAH), the most common form being 21-hydroxylase deficiency. During the test, a baseline blood sample is taken, followed by an injection of synthetic ACTH (cosyntropin), with two additional blood draws at 30 and 60 minutes post-injection. This three-sample protocol provides a clear picture of how the adrenal glands produce 17-OHP under stimulation. The test is highly sensitive for diagnosing both classic and non-classic CAH. Results are typically available within 10–12 business days.

Why You Need This Test

• Diagnose congenital adrenal hyperplasia (CAH), especially non-classic CAH in adolescents and adults.
• Evaluate unexplained hirsutism, acne, or irregular periods in women.
• Investigate precocious puberty or ambiguous genitalia in infants and children.
• Confirm suspected 21-hydroxylase deficiency when baseline 17-OHP is borderline.
• Differentiate CAH from polycystic ovary syndrome (PCOS).
• Assess adrenal steroidogenesis in patients with infertility or androgen excess.
• Available at certified endocrinology centers across Dubai, Abu Dhabi, Sharjah, and all Emirates.

Symptoms & Risk Factors

Common Symptoms

• In Females: hirsutism (excess hair), acne, irregular or absent periods, infertility.
• In Males: early puberty, rapid growth, enlarged penis, low fertility.
• In Infants: ambiguous genitalia (girls), salt-wasting crises, vomiting, dehydration.
• In Children: accelerated growth, early pubic hair, advanced bone age.
• In Adults: symptoms often mimic PCOS, leading to misdiagnosis.

Risk Factors

• Family history of CAH or consanguinity (parents are blood relatives).
• Being of certain ethnic backgrounds (e.g., Ashkenazi Jewish, Hispanic, Yugoslav).
• Unexplained androgen excess without PCOS features.
• Infertility with elevated androgens.
• Newborn screening flagged abnormal 17-OHP (follow-up testing required).
• History of adrenal incidentaloma or hormonal imbalance.

How the Test Works

The ACTH stimulation test evaluates how your adrenal glands respond to adrenocorticotropic hormone (ACTH), which triggers cortisol and androgen precursor production. In CAH, enzyme defects cause a buildup of 17-OH progesterone.

• Step 1 — Baseline Blood Draw: first sample taken before ACTH injection.
• Step 2 — ACTH Injection: cosyntropin (synthetic ACTH) administered intramuscularly or IV.
• Step 3 — Post-Stimulation Samples: blood collected at 30 and 60 minutes after injection (total of 3 samples).
• Step 4 — Lab Analysis: each sample tested for 17-OH progesterone, cortisol, and sometimes androstenedione.
• Step 5 — Results: comprehensive report issued within 10–12 days.

This test is considered the gold standard for diagnosing non-classic CAH when baseline levels are inconclusive.

Sample Type

• We take: 3 blood samples (serum) collected over 60 minutes
• Volume: 1–2 mL per sample (child) or standard adult tubes
• Tubes: serum separator tubes (SST), kept on ice if delayed processing
• Timing: baseline, +30 min, +60 min after ACTH injection
• Fasting: not required, but morning testing preferred (circadian rhythm affects hormones)
• Note: must be performed in a clinical setting with trained staff and emergency support available

Risks & Safety

• Minimal risk — mild pain or bruising at injection site.
• ACTH is safe — synthetic and well-tolerated; allergic reactions are rare.
• No long-term side effects from the test itself.
• Safe for children, adolescents, and adults when supervised.
• Contraindicated only in patients with known severe allergy to cosyntropin.

Result Interpretation

Normal Range

• Baseline 17-OHP: <100 ng/dL (varies by lab and age)
• Peak post-ACTH: <400 ng/dL (non-classic CAH unlikely)
• Normal response shows moderate rise in 17-OHP with adequate cortisol production

Elevated Levels

• Peak >1,000 ng/dL: strongly indicates non-classic 21-hydroxylase deficiency
• Peak 400–1,000 ng/dL: possible CAH — consider genetic testing and clinical correlation
• May also be seen in:
  • Classic CAH (in untreated children)
  • Adrenal tumors or PCOS (mild elevation only)

Low or Normal Levels

• Suggests:
  • Other causes of androgen excess (e.g., PCOS, insulin resistance)
  • Functional ovarian hyperandrogenism
  • Exogenous steroid use suppressing adrenal function

Consequences if Untreated

• In Women: infertility, worsening hirsutism, menstrual dysfunction, metabolic syndrome.
• In Men: reduced sperm count, early balding, adrenal rest tumors.
• In Children: stunted adult height due to early bone maturation.
• Pregnancy risks: potential miscarriage or virilization of female fetus if mother has CAH.
• Psychosocial impact: anxiety, low self-esteem due to physical changes.

Factors Affecting Test Results

• Medications: glucocorticoids, oral contraceptives, spironolactone can suppress 17-OHP.
• Time of day: testing should be done in the morning (AM) when ACTH is highest.
• Menstrual cycle: best performed in the early follicular phase (days 2–5).
• Recent illness or stress may alter hormone levels.
• Poor sample handling or delayed processing can degrade hormones.
• Lab variability: use of different assays can affect reference ranges.

FAQs

Limitations

• Must be performed in a medical facility with trained personnel.
• Results require clinical correlation — not all elevated 17-OHP means CAH.
• May miss mild or partial enzyme deficiencies.
• Not useful for monitoring treatment — baseline 17-OHP is used instead.
• False negatives possible if patient is on glucocorticoids or OCPs.

Book Your ACTH Stimulation Test for 17-OH Progesterone Today

Don’t let undiagnosed CAH affect your health — get a definitive answer for androgen excess, infertility, or ambiguous symptoms.

• 3-Sample ACTH Stimulation Protocol (Available in Dubai, Abu Dhabi, Sharjah & All Emirates)
• Detailed Hormonal Report in 10–12 Days
• Price: AED 700
• ✅ Endocrinologist-Recommended | Gold Standard for CAH Diagnosis
• 💉 Safe, Supervised Testing Environment
• 🔒 Confidential Results & Physician Reporting