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The overnight dexamethasone suppression test checks to see how taking a steroid 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 makes less adrenocorticotropic hormone (ACTH), the adrenal glands make less cortisol. Dexamethasone, which is like cortisol, lowers the amount of ACTH released by the pituitary gland. This in turn lowers the amount of cortisol released by the adrenal glands.
After a dose of dexamethasone, cortisol levels often stay very high in people who have Cushing's syndrome. Sometimes other conditions can keep cortisol levels high during this test. Examples include major depression, alcoholism, stress, obesity, kidney failure, pregnancy, and uncontrolled diabetes.
The night before the blood test, you will take a dexamethasone pill. The next morning, the cortisol level in your blood will be measured. If your cortisol level stays high, Cushing's syndrome may be the cause.
An ACTH test is sometimes done at the same time as the cortisol test.
This test is done to check for Cushing's syndrome. It is a condition in which large amounts of cortisol are produced by the adrenal glands.
You will not be able to eat or drink anything for 10 to 12 hours before the morning blood test.
Be sure to tell your doctor about all the medicines you take, even over-the-counter ones. Many medicines can change the results of this test. You may be asked to stop taking some medicines for 24 to 48 hours before your blood is drawn. These medicines include birth control pills, aspirin, morphine, methadone, lithium, monoamine oxidase inhibitors (MAOIs), and diuretics.
Talk to your doctor if you have any concerns 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?).
The night before the test (usually at 11:00 p.m.), you will swallow a pill that contains 1 milligram (mg) of dexamethasone. The next morning (usually at 8:00 a.m.), you will have a sample of your blood drawn. Take the pill with milk or an antacid. This can help prevent an upset stomach or heartburn.
The health professional taking a sample of your blood will:
Sometimes a more complete dexamethasone suppression test may be done. For this test, you will take up to 8 pills over 2 days. Then the cortisol levels in your blood and urine will be measured.
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.
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 checks for Cushing's syndrome. In this condition, large amounts of cortisol are produced by the adrenal glands. Test results are usually ready in a few days.
An abnormal test result may mean that more tests are needed. A normal test result means that you do not have Cushing's syndrome. This syndrome can be hard to diagnose. So if the test results aren't clear or if they don't help explain your symptoms, you may be referred to see an endocrinologist.
These numbers are just a guide. The range for "normal" varies from lab to lab. Your lab may have a different range. Your lab report should show what range your lab uses for "normal." Also, your doctor will evaluate your results based on your health and other factors. So a number that is outside the normal range here may still be normal for you.
Cortisol level is less than 5 micrograms per deciliter ( mcg/dL) or less than 138 nanomoles per liter ( nmol/L).
High cortisol levels may be caused by:
You may not be able to have the test, or the results may not be helpful, if:
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.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Other Works Consulted
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders. Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
ByHealthwise Staff Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine Kathleen Romito, MD - Family Medicine Alan C. Dalkin, MD -
Current as ofMarch 15, 2018
Current as of:
March 15, 2018
E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Alan C. Dalkin, MD -
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