Androstenedione, Serum

Casandra

Casandra Test Code MC14673Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID ANSTCPT Code 82157

Androstenedione, Serum

Clinical Use

Use

The test for androstenedione is primarily used in the diagnosis and differential diagnosis of hyperandrogenism, congenital adrenal hyperplasia (CAH), and premature adrenarche. It is intended to be used in conjunction with the measurement of other sex steroids and androgenic precursors such as testosterone, 17-alpha-hydroxyprogesterone (OHPG), 17 alpha-hydroxypregnenolone, dehydroepiandrosterone sulfate (DHEA-S), follicle-stimulating hormone (FSH), and luteinizing hormone (LH), among others. The test helps monitor CAH treatment by evaluating androgen levels, which can guide therapeutic modifications. Elevated levels of androstenedione may indicate increased androgen production from adrenal or gonadal sources, and pronounced elevations can suggest the presence of androgen-secreting tumors.

Special Instructions

This test should be considered alongside initial workups that include total and bioavailable testosterone measurements. Depending on those results, additional assays such as sex hormone-binding globulin (SHBG) and other androgenic steroids may be necessary. Accurate diagnosis often requires additional tests, especially when dealing with complex conditions like premature adrenarche or congenital adrenal hyperplasia.

Limitations

The diagnostic utility of the androstenedione test can be limited in conditions of partial or complete adrenal or gonadal failure, where levels may be low. Androstenedione supplements can result in elevated serum levels, potentially confounding the interpretation. Drug-induced changes in androstenedione levels are possible but usually not significant enough to cause diagnostic confusion. However, how these changes relate to established normal ranges is often unclear.

Test Details

New York Approved