Overnight Dexamethasone Suppression Test
The overnight dexamethasone suppression test checks to see how taking a corticosteroid medicine (called dexamethasone) changes the levels of the hormone cortisol in the blood. This test checks for a condition in which large amounts of cortisol are produced by the adrenal glands (Cushing's syndrome).
Normally, when the pituitary gland make less adrenocorticotropic hormone (ACTH), the adrenal glands make less cortisol. Dexamethasone, which is like cortisol, decreases the amount of ACTH released by the pituitary gland, which in turn decreases the amount of cortisol released by the adrenal glands.
After taking a dose of dexamethasone, cortisol levels often stay abnormally high in people who have Cushing's syndrome. Sometimes other conditions (such as major depression, alcoholism, stress, obesity, kidney failure, pregnancy, or uncontrolled diabetes) can keep cortisol levels from going down after taking a dose of dexamethasone.
The night before the blood test, you will take a pill containing dexamethasone. The next morning, the cortisol level in your blood will be measured. If your cortisol level remains high, Cushing's syndrome may be the cause.
An ACTH test is sometimes done at the same time as the cortisol test.
Why It Is Done
An overnight dexamethasone suppression test is done to check for a condition in which large amounts of cortisol are produced by the adrenal glands (Cushing's syndrome).
How To Prepare
You will not be able to eat or drink anything for 10 to 12 hours before the morning blood test.
Many medicines can change the results of this test. Be sure to tell your doctor about all the nonprescription and prescription medicines you take. You may be asked to stop taking some medicines (such as birth control pills, aspirin, morphine, methadone, lithium, monoamine oxidase inhibitors [MAOIs], and diuretics) for 24 to 48 hours before your blood is drawn.
Talk to your doctor about any concerns you have about the need for the test, its risks, how it will be done, or what the results will mean. To help you learn about this test and how important it is, fill out the medical test information form(What is a PDF document?).
How It Is Done
The night before the test (usually at 11:00 p.m.), you will swallow a pill containing 1 milligram (mg) of dexamethasone. The next morning (usually at 8:00 a.m.), a health professional will draw a sample of your blood. Take the pill with milk or an antacid to help prevent an upset stomach or heartburn.
The health professional drawing blood will:
Sometimes a more extensive dexamethasone suppression test may be done. For this test, you will take up to 8 dexamethasone pills over 2 days and then the cortisol levels in your blood and urine will be measured.
How It Feels
The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.
Risks of a blood test
There is very little chance of a problem from having a blood sample taken from a vein.
The overnight dexamethasone suppression test involves taking a dose of a corticosteroid medicine called dexamethasone to see how it affects the level of a hormone called cortisol in the blood. This test screens for Cushing's syndrome, a condition in which excess amounts of cortisol are being produced by the adrenal glands. Test results are usually available in a few days.
An abnormal test result may mean that further testing is needed to identify Cushing's syndrome. Likewise, a normal test result means that you do not have Cushing's syndrome. Cushing's syndrome can be hard to diagnose, so an endocrinologist should be consulted if test results are uncertain or if the test results do not help explain your symptoms.
The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.
High cortisol levels may be caused by:
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
Some people may quickly process (metabolize) the dose of dexamethasone. In these people, cortisol levels will not drop unless a higher dose of the medicine is given.
What To Think About
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