17 OH Progesterone Test

17 OH progesterone means an endogenous (formed within the body) progesterone steroid hormone. 17 OH progesterone is a progesterone-related hormone. This hormone is part of the process of the biosynthesis of steroids. 17 OH progesterone is neither the raw material nor end product of the biosynthesis. Yet, it is essential for the process.

The adrenal glands produce the hormone 17 Hydroxyprogesterone (17 OH progesterone).

Adrenal glands are pairs of small endocrine glands. Each kidney has one on top of it. 17 OH progesterone is converted to cortisol with the help of specific enzymes or proteins.

Cortisol is produced in smaller amounts all of the time. The production of cortisol increases under stressful conditions. Cortisol levels rise under both physical and emotional stress. It also has a role in regulating the metabolism and the immune system.

People who lack the necessary enzymes may develop cortisol deficiency. Cortisol deficiency results in the accumulation of 17 OH progesterone in the blood.

Congenital adrenal hyperplasia (CAH) is a disorder characterised by high amounts of 17 OH progesterone. It is a glandular disorder in which the adrenal glands are unable to produce enough cortisol. In congenital adrenal hyperplasia, the production of male sex hormones known as androgens is increased.

Both male and female children can be born with congenital adrenal hyperplasia. It can cause ambiguous genitalia, pubic hair and acne in young children.

Later in life, the disease can manifest itself in less prominent ways. Excessive body hair and a deeper voice are common symptoms of congenital adrenal hyperplasia.

Congenital adrenal hyperplasia can cause dehydration or shock in newborns. Both of these are life-threatening illnesses. As a result, every newborn's initial medical evaluation should include a 17 OH progesterone test. The 17 OH progesterone is used for the diagnosis of congenital adrenal hyperplasia.

When a young child, teenager or adult exhibits some of the characteristic symptoms of congenital adrenal hyperplasia, a doctor will usually request a 17 OH progesterone test. The earlier the congenital adrenal hyperplasia is detected and treated, the fewer are the chances of complications.

The results of the 17 OH progesterone test are based on analysis of blood samples. Usually, blood is extracted from a vein of the arm commonly. In a newborn screening test, a heel pad prick is considered to collect blood spots on NBS paper.

The collection of the blood sample can be at a hospital or laboratory. For more specific instructions, consult the endocrinologist or children specialist doctor. The evaluation of 17 OH progesterone procedures is done at laboratories having special equipment.

Congenital adrenal hyperplasia, Nonclassical adrenal hyperplasia, Adrenal tumours, Ovarian tumours

17 OH progesterone is used for the diagnosis of

• Congenital adrenal hyperplasia
• Adrenal tumours
• Non-classical adrenal hyperplasia
• Hyperandrogenism
• Precocious puberty
• Ovarian tumours

This test is prescribed for infants with congenital adrenal hyperplasia.

Congenital adrenal hyperplasia is a genetic condition that affects the adrenal gland. It is frequently performed on infants whose outer genitals do not resemble a boy or a girl when they are born.

All newborns should get a 17 OH progesterone test. However, anyone who gets symptoms of congenital adrenal hyperplasia later in life should consider getting tested.

This test can also detect patients who acquire congenital adrenal hyperplasia symptoms later in life, a condition known as non-classical adrenal hyperplasia.

The child specialist (paediatrician) will suggest a test for the 17 OH progesterone in infants with symptoms:

• Unclear genitals (nor male or female)
• Pubic hair (hairs near the genitals)
• Acne (pimples)
• Weakness
• Not showing interest in eating food
• Dehydration
• Low blood pressure
• Vomiting
• Listlessness, lack of energy (lethargy)
• Failure to thrive

All the above symptoms indicate the 17 OH progesterone positive results in newborns.

The endocrinologist advises 17 OH progesterone test in young girls and adult girls with the following symptoms:

• Irregular periods
• A deep voice (manly voice)
• The genitalia has both male and female appearance, but characteristically male.
• Excessive hair growth
• Hirsutism (facial hair)
• Early hair growth in the pubic and armpit area in young girls.
• Infertility in women

The endocrinologist advises 17 OH progesterone test in young boys and adult boys with the following symptoms:

• Early-onset of puberty (as early as age 2 or 3 years)
• Early appearance of secondary sexual characteristics like beard, hair on chest and around genitals.
• A deep voice in young boys
• A masculine body (well-defined muscles)
• A large penis
• Small testicles
• Infertility

The 17 OH Progesterone test is applicable in males and females. The doctor will ask for this test in infants, newborns, toddlers, children and young adults with symptoms of cortisol deficiency.

This test is prescribed to infants for congenital adrenal hyperplasia. The 17 OH progesterone test is routinely performed as part of newborn screening to detect congenital adrenal hyperplasia.

It is advised for infants whose outer genitals do not resemble those of a boy or a girl when they are born.

The repetition of the 17 OH progesterone test is required to screen for congenital adrenal hyperplasia in older children before symptoms develop. The repetition of the test is essential in cases diagnosed as 17 OH progesterone positive. Repetition of the test is determined basis of clinical judgement.

The test is also used to confirm congenital adrenal hyperplasia diagnosis in adults who are already experiencing symptoms.

The frequent repetition of 17 OH progesterone evaluates the success of treatment if someone is diagnosed with 21-hydroxylase insufficiency.

• In infants

Infants do not require fasting for this test. Make sure the child is dressed loosely and comfortably for ease of sample collection. A simple heel prick is sufficient to get a blood sample. The 17 OH progesterone procedure might be slightly painful for newborns.

• In young adults

To ensure accurate results, one needs to fast for at least 8 hours before the 17 OH progesterone test.

The doctor may also advise stopping any ongoing medications temporarily.

The results of 17 OH progesterone will take days to weeks depending upon the laboratory.

Before the Test

Prior to undergoing the 17 OH progesterone test, it is essential to fast for A to B hours beforehand. This fasting period is crucial in order to obtain accurate test results. Therefore, it is advisable to consult a physician before taking any test to know if there are any specific restrictions to be followed.

During the Test

A phlebotomist will draw blood from a vein in your arm for the sample. Your experience will likely involve:

• Disinfecting the site where the needle will be inserted with an antiseptic.
• Wrapping a tourniquet around your arm to make the veins more visible.
• Inserting a disposable needle into the vein to collect the blood. This process may cause minor discomfort from the needle and could take a few seconds.
• Placing the sample in a small container or test tube labelled with your test information.

After the Test

Once the Blood Sample is Collected:

• Applying a bandage to the site where the needle was inserted to prevent any bleeding.
• You may feel slightly sore or lightheaded, which is normal and nothing to be concerned about. You may be advised to rest for a few minutes.
• Contact your doctor if you experience any bleeding, discomfort, or rashes at the puncture site.

The 17 OH progesterone test measures the following parameters

• Higher levels of 17 OH progesterone (means 17 OH progesterone positive results).
• Low levels of 17 OH progesterone (means 17 OH progesterone negative results).

The 17 OH progesterone test only includes these two variables. This estimation provides insight into cortisol deficiency.

The readings will be within normal limits if there is no congenital anomaly involving adrenal glands. 17 OH progesterone levels need repetition to track hormonal therapy in diagnosed cases of congenital adrenal hyperplasia.

The 17 OH progesterone normal range is as follows:

•  17 OH progesterone normal range in adults: 0- 16.8 ng/mL

Seek medical advice in case 17 OH progesterone range is above or below the normal.

Hormone therapy and progesterone supplements may be beneficial in conditions with an altered 17 OH progesterone chart.

Do not self medicate under any circumstances. Hormone therapy and progesterone supplements have side effects.

The normal values and reference ranges of the test may vary from lab to lab. Please refer to the ranges mentioned in the report and consult a doctor to understand the interpretation of lab reports.

Many factors influence the 17 OH progesterone reports. The variables include age, sex and testing methods. The variables can make identifying between positive and negative test results challenging.

The time of the test is significant because the 17 OH progesterone chart is affected by physical and psychological shifts throughout 24 hours. The blood is collected at a specific point during the female menstrual cycle.

High levels of 17 OH progesterone reports indicate congenital adrenal hyperplasia.

• In infants, 17 OH progesterone values between 2,000 to 4,000 ng/dL indicate congenital adrenal hyperplasia.
• In adults, 17 OH progesterone values above 200 ng/dL indicate congenital adrenal hyperplasia.

High levels of 17 OH progesterone may also suggest the presence of an adrenal tumour.

The adrenal tumour can influence hormone levels as well. Additional testing may be required to detect the exact cause of elevated 17 OH progesterone values.

The results of the 17 OH progesterone test may differ slightly between laboratories. Corticosteroids and birth control tablets may also affect the 17 OH progesterone test results.

Consult with the doctor to interpret the 17 OH progesterone test results.

False-positive results have been reported with 17 OH progesterone testing, particularly the newborn screening test. Other tests such as renin activity in the blood, androstenedione and testosterone guide for confirming the diagnosis.