Steroid Profile

What is a Steroid Profile test?

The steroid profile test is performed to locate genetic disorders, other steroid metabolites, and to understand any adrenal disorders in the body. The steroid profile test is mostly done as a urine test. A blood serum sample can also be taken to determine the results.

What tests are included in the Steroid profile test?

The steroid profile includes the following parameters:

– Adrenal Androgens.
– Androsterone 5alpha.
– Etiocholanolone 5 beta.
– Dehydroepiandrosterone or DHEA.
– 16alpha hydroxy-DHEA.
– Cortisol metabolites.
– 11beta-hydroxyandrosterone.
– 11beta-hydroxyaetiocholanolone.
– Tetrahydrocortisone or THE.
– Tetrahydrocortisol or THF 5 beta.
– Allo THF 5 alpha.
– Alpha Cortolone.
– Beta Cortolone + Beta Cortol.
– Alpha Cortol.

What is the importance of the steroid profile test?

Your endocrinologist or child’s pediatrician may ask you to do a steroid profile test for the following reasons:

– To get a complete picture of your adrenal functions.
– To analyze the estrogen and aldosterone metabolites. Any malfunction of the hormones may get undetected under normal conditions.
– Urine steroid test is helpful in understanding steroid metabolism in neonates.
– To detect abnormal secretions from adrenal glands.

This test can also be ordered to evaluate the following medical conditions such as:

– CAH or congenital adrenal hyperplasia.
– Sex development disorders or DSD.
– Male pseudo-hermaphroditism.
– Adrenal gland disorders.
– Steroid sulfatase deficiency.
– Gonadal tumour.
– Tumors of the steroid cells.
– Premature adrenarche.
– 11 ß-hydroxylase deficiency.
– To diagnose polycystic ovary syndrome or PCOS.

How to prepare for the test?

Precautions before a steroid profile test includes:
– For urine steroid profile test, a complete 24-hour urine sample is collected for adults. For children, random samples are collected.
– In the case of neonates, urine samples can be collected after three days of birth.
– For ambiguous genitalia, a karyotype should be obtained.
– To detect salt-loss in neonates, salt intake should be minimized before the test.
– In the case of hypertension, plasma renin activity or PRA and the plasma aldosterone levels should be checked.
– For a blood steroid profile, fasting may be required as specified by the physician.

How is the test performed?

For urine steroid profile tests, spot urine samples are collected. Random urine samples are collected for children and neonates. The urine should be collected in a 20 mL Sterilin plastic container. For neonates, a minimum of 5 mL of urine sample should be collected.

For the blood steroid profile, the test can be done at home or the nearest laboratory. A technician will visit your home and take a sample of blood.

For blood sample:

– A small patch of skin on the upper part of your arm will be cleaned with an antiseptic solution.

– A tourniquet or elastic band will be tied on the hand to swell up the veins.

– Blood will be withdrawn using a small needle.

– The blood is then collected in a syringe or vial for testing.

– The tourniquet is removed and a band-aid is applied on the puncture site to stop bleeding.

How long does the test take to perform?

Both urine and blood steroid profile tests will take a maximum of 5 minutes to complete. The turnaround time for the steroid profile test is generally 14 days.

How is the urine sample prepared for testing?

Preparation of the urine sample:

– The 24^th urine sample is collected into two 20 mL Sterilin plastic containers.
– No preservatives are used.
– Never overfill the containers with urine.
– Stand in an upright position while urinating.
– Do not put parafilm inside the lid.
– Include all clinical details like age, sex, and other patient details.
– Samples should be kept within 4 to 20 degrees Celsius.

What are adrenal androgens?

Adrenal androgens or AAs are steroid hormones secreted by the adrenal cortex. They are inactive hormones and are not so significant in the case of adult males. However, they play a major role in both sexes before puberty.
– Adrenal androgens include:
– DHEA or dehydroepiandrosterone.
– DHEAS or dehydroepiandrosterone sulfate.
– 11ß-hydroxyandrostenedione.

What is androsterone?

Androsterone sulfate is a weak sex hormone that is produced in the liver through testosterone hormone metabolism. In the testes, it is produced by the progesterone hormone. Like adrenal androgens, androsterone is primarily an inactive hormone and can be metabolized from other androgens such as androstenedione.

What is Etiocholanolone?

Etiocholanolone is one of the steroid hormones which can be detected in the steroid profile urine test. The sulfate salt is the most common form of etiocholanolone present in the urine. It is used to detect adrenal cortex abnormalities, bone marrow function, and neoplastic diseases. Etiocholanolone is a metabolite of the testosterone and androstenedione hormone. It is also known as a ketosteroid and can cause fever and infections like leukocytosis.

What is the importance of DHEA or dehydroepiandrosterone?

DHEA or dehydroepiandrosterone is a steroid hormone and is found in abundance in the human body. It is mostly associated with female fertility. It is a precursor to testosterone and estrogen hormones and is often induced to increase follicular stimulation. DHEA decreases with age. DHEA supplements are often induced for fertility treatment. However, prolonged use of DHEA can cause liver damage or hormone imbalance. DHEA is known to decrease miscarriages and helps in IVF treatments. The supplement should be discontinued after a positive pregnancy test. In the case of PCOS or polycystic ovary syndrome, DHEA supplements can worsen the symptoms.

What is the significance of 16alpha hydroxy-DHEA?

16alpha-hydroxydehydroepaindrosterone is a sulfated steroid metabolite found during pregnancy. The steroid level increases with the progression of the pregnancy. A decline in the metabolite indicates placental sulfatase deficiency or PSD due to low estrogen levels.

What is Androstenetriol?

Androstenetriol is a DHEA steroid metabolite found normally in urine for both men and women. It is associated with growth and is an important marker that shows the adrenarche process or changes in the adrenal glands for both young boys and girls.

What are Intermediates?

Intermediates are secretions or molecules that are released by the adrenal cortex that circulates in the blood. They can be detected in a urine steroid profile test.

What is the importance of cortisol metabolites?

Cortisol metabolites is a steroid hormone produced by the adrenal glands and transported to all parts of the body through blood. It plays a vital role in different bodily functions like:

– Maintaining metabolism.
– Regulating immunity.
– Controls blood sugar levels.
– It has anti-inflammatory components.
– It maintains the salt-water balance in the body.
– Regulates blood pressure.
– It helps in fetal development.

What is 11beta-Hydroxyandrosterone?

An 11beta-Hydroxyandrosterone is a steroid hormone produced by the steroid metabolite androsterone. The hormone is made in the liver through testosterone metabolism.

What is Tetrahydrocortisone (THE) and Tetrahydrocortisol (THF)?

Tetrahydrocortisone and Tetrahydrocortisol are steroid hormones. The ratio between THE and THF are good indicators in understanding thyroid hormone levels and disorders. If THE/THF ratio is high it indicates an elevated thyroid hormone in the blood or hyperthyroidism. A low hormone ratio significantly shows a suppressed thyroid hormone.

What is Beta-Cortol?

Beta-cortol are androgen metabolites normally found in adult urines. Traces of beta-cortol is also found in infant urine. The beta-cortol levels are higher in premenopausal women suffering from leiomyomas than healthy premenopausal women.

Can the steroid profile test be done in infants?

Yes, a steroid profile test can be done in infants to detect adrenal disorders like genetic disorders, poor development of genitalia, DSD or disorders of sex development.