For Care Providers

Adrenal

The Meridian Valley Laboratorie's ADRENAL STEROID ANALYSIS measures the most adrenal steroids of any adrenal cortical analysis available. It also captures the entire 24-hour output, the "entire picture," rather than just single-moment-in-time "snapshot" analysis.

As every medical student knows, the adrenal cortex synthesizes dozens of steroids, "organized" in three broad categories, glucocorticoids, mineralocorticoids, and adrenal androgens. Meridian's CASA Measures 12 of these steroids, with at least one in each of these categories. Most other tests of adrenal cortical function measure only ONE hormone, the glucocorticoid cortisol, thus missing completely potential problems with the rest of the adrenal cortex!

In accounting for the entire 24-hour output, Meridian's CASA also avoids misdiagnosing individuals whose diurnal adrenal secretion rhythm isn't what "the textbook" says it should be. Certainly,24-hour urine collections are "more difficult" ... but proper instruction in the importance of accurate collection by caring physicians who want the best in accuracy for their patients can overcome this obstacle! And Meridian stands behind its policy of "when in doubt, repeat at no-charge."

Done with recommended ACTH stimulation, the Meridian ADRENAL STEROID ANALYSIS offers the best and most comprehensive adrenal steroid analysis currently available.

Urinary Steroid Profile by Gas Chromatography - Mass Spectrometry
Profile includes all of the following:

Androsterone	Etiocholanalone	Dehydroepiandrosterone
Cortisol	Cortisone	Aldosterone
Pregnanetriol

Clinical Situations Where Urinary Steroid Profiles May Prove Useful:
Breast Lesions, Anorexia Nervosa, Hypertension, Emotional Stress, Adrenal Insufficiency, Idiopathic Hirsutism, Carcinomas, Endocrine Disorders, Rheumatoid Arthritis, 5-Alpha-Reductase Deficiency, Etc.

Can be especially helpful in more severe cases of environmental illness. (Make sure to screen ACTH or Cortrosyn for allergy before doing stimulation tests.)

Two books which may be especially helpful:
SAFE USES OF CORTROSONE, by William Jeffries, M.D., Charles CThomas, Springfield, Illinois (1981)
HYPOADRENOCORTICISM, by John Tintera, M.D., (available by request through Meridian Valley Clinical Lab)

REFERENCES:
I . Clin. Chem. Act. 67, 287 (1976)
2. J. Chrorn-togr. 1 26,161(1 976)
3. Act Endocrinol. 103,101(1983)
4. J. Clin. Endocrtnol. Metab 48, 976 (1976)
5. C.H.L. Shaclcleton, N.F. Taylor and J. W. Honour, An Atlas of Gas Chromotographic Profiles Neutral Urinary Steroids in Health and Disease. Packard-Becker, Delft, The Netherlands, 1980.
6. J. Chromatogr. 158, 313 (1978)
7. Acta. Endocrinol. 90,133 (1979)
8. Am. J. Med. 62, 170 (1977)
9. J. Clin. Endocrtnol. Metab. 50, 786 (1980)
10. Israel J. Chem. 16, 7 (1977)
11. J. Chromatogr. 145. 359 (1978)
12 J. Cbrom~tou. 112, 581 (1975)
13. Lancet 2, 395 (1971)
14. Nature 235, 220 (1972)
15. J. Chromatogr. Biiomed. Appl. 146, 364 (198)
16. J. Chromatogr. Biorned. Appl. 146, 381(1978)

ADDITIONAL INFORMATION
Pre/Post Adrenal Stimulation	Adrenal	Thyroid Panel	Serum DHEA
Methods for the Determination of Steroid Hormones