Laboratory parameters of the 1st order – obligatory laboratory tests.
- Luteinizing hormone (LH).
- Testosterone*
- Androstenedione*
- Dehydroepiandrostenedione (DHEA) or dehydroepiandrostenedione sulfate (DHEAS).
- Sex hormone binding globulin (SHBG)
- Dihydrotestosterone
Note: From the testosterone and SHBG serum concentration, the free androgen index (FAI) can be determined. The FAI is the measure of the proportion of free and therefore biologically active androgens.
2nd-order laboratory parameters-depending on the results of the history, physical examination, and obligatory laboratory parameters-for differential diagnostic clarification.
- 17-Hydroxy-progesterone* – for suspected 21-hydroxylase deficiency (adrenogenital syndrome (AGS); congenital adrenal hyperplasia, CAH).
- Adrenocorticotropic hormone (ACTH) – in suspected Addison’s disease, Cushing’s disease.
- Cortisol – in suspected Cushing’s disease.
- Growth hormone (synonyms: STH; HGH) – if acromegaly is suspected.
- Dexamethasone suppression test (dexamethasone short test) – to differentiate between adrenal and ovarian hyperandrogenemia (to distinguish whether the increase in male hormones originates causally from the adrenal gland or the ovaries).
- Molecular genetic diagnostics – for suspected androgenital syndrome (AGS).
- CA125 (initial marker), CA 72-4, CA 19-9 – for suspected endocrine active ovarian tumor (ovarian tumor).
Notice: * examination in the early follicular phase!
