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17- Hydroxyprogesterone

Also Known As: 17-OHP, 17-OH Progesterone, Progesterone-17-OH.

What Is A 17-Hydroxyprogesterone Test?

The 17-Hydroxyprogesterone Test measures the amount of 17-Hydroxyprogesterone in your bloodstream. 17-OHP is a hormone generated by your adrenal glands, i.e., the two glands located on top of your kidneys. These adrenal glands are also responsible for producing other hormones like cortisol. Cortisol plays a significant role in maintaining blood pressure, blood sugar, and other immune system functions. The enzyme 17-Hydroxyprogesterone is yielded as a part of the process of producing cortisol in the body.

17-OHP is also known as a derivative of cholesterol. It is not considered an active steroid hormone but a precursor that can be converted into active hormones. Low cholesterol levels can increase the level of pituitary hormones stimulating adrenal growth and hormone production. The adrenal gland increases in size and leads to adrenal hyperplasia when it happens. This increased activity and size do not block cortisol production; the 17-Hydroxyprogesterone is produced in excess and causes severe health concerns.

Due to this reason, the 17-Hydroxyprogesterone test is vital for the diagnosis of a rare genetic disorder called congenital adrenal hyperplasia or CAH. A genetic modification or mutation prevents your adrenal gland from making adequate cortisol in this condition. When your adrenal glands work harder to generate more cortisol, they, in turn, lead to the formation of an extra 17-OHP along with certain male sex hormones in the body. CAH can lead to abnormal development of sexual characteristics and sex organs. The symptoms may range from mild to severe, but if not treated properly, more serious forms can result in serious complications such as arrhythmia, dehydration, and low blood pressure.

What Is The Test Used For?

The 17-Hydroxyprogesterone test is usually used to screen congenital adrenal hyperplasia, i.e., CAH. Your doctor can also ask for other related tests to diagnose and monitor this medical condition.

  • For Screening Purposes

This test is routinely ordered as an integral component of newborn screening against detection of CAH due to 21-hydroxylase deficiency. The 17-Hydroxyprogesterone test is sometimes also used to screen for congenital adrenal hyperplasia in adults before symptoms appear or for the confirmed diagnosis in people with acute symptoms.

  • For Diagnostic Purposes

The measurement of the 17-Hydroxyprogesterone enzyme in the blood can also help diagnose CAH in older children and adults showing a milder or late-onset form of the disease.

  • For Monitoring Purposes

If you are diagnosed with 21-hydroxylase deficiency, this test can be used along with plasma renin activity and testosterone test to monitor the efficacy of the treatment plan.

  • To Rule Out Congenital Adrenal Hyperplasia

This test is sometimes performed with other hormone tests to help rule out this medical condition in women with symptoms like irregular periods and excessive facial/ body hair. It also includes those women with suspected polycystic ovarian syndrome and infertility.

Why And When Do You Need A 17-Hydroxyprogesterone Test?

Your baby will be required to undergo the 17-Hydroxyprogesterone test, usually within 1 to 2 days after birth. It is because this test for CAH is now a legal requirement as a part of newborn screening methods. A simple blood test is performed during the screening to check for a wide range of serious diseases. Older children and adults might also need to go through this test if they have symptoms related to congenital adrenal hyperplasia. The symptoms might differ from one person to another depending upon the severity of the disorder, age, and gender.

The most severe form of congenital adrenal hyperplasia usually shows up after two to three weeks of birth. If you are baby did not receive standard newborn screening; they may need to undergo a 17-Hydroxyprogesterone test for one or more of the following symptoms:

  • Dehydration
  • Genitals that are not clearly female or male, i.e., ambiguous genitalia
  • Abnormal heart rhythms or arrhythmia
  • Vomiting and other feeding issues

Older children can develop symptoms after puberty. In girls, the symptoms are:

  • Enlarged clitoris
  • Early appearance of pubic or arm hair
  • Irregular menstrual periods or no periods at all
  • Deep voice
  • Excessive hair on body and face

In boys, the symptoms include:

  • Early puberty or precocious puberty
  • Enlarged penis

In adult males and females, the symptoms are:

  • Severe acne
  • Infertility or the inability to get pregnant or get the partner pregnant

What Kind Of Sample Is Required For The Test?

This test involves taking a small sample of your blood for testing. The blood is usually drawn from a vein/artery in your hand or in the bend of the elbow. The healthcare provider will first clean the area with an antiseptic during the test and then tie an elastic band around your arm. Once they find a vein, they will insert the needle and collect enough blood according to your doctor's orders. After enough blood has been drawn, the blood sample will be sent to the laboratory for analysis.

Do You Need To Prepare For The Test?

Before the 17-hydroxyprogesterone test, your doctor or health care provider may ask you to stop eating and drinking for a few hours. If you are taking any medications, consult with your doctor first as only they can guide you regarding the effect of those medicines on your test results. When taking your child for the test, it is wise to put them in comfortable and loose clothes so the lab technician can handle and perform the blood test properly.

Are There Any Risks To This Test?

This blood test carries a few risks. You might experience slight bruising or soreness around the area where the needle was inserted. However, the symptoms are mild and go away quickly. Some other risks include:

  • Excessive bleeding
  • Dizziness and fainting
  • Blood accumulating under the skin called a hematoma
  • Infection at the puncture site

What Do The Test Results Mean?

If the test results show higher levels of 17-hydroxyprogesterone, it means that your child has congenital adrenal hyperplasia. Usually, excessively high levels indicate a more severe condition, whereas moderately high levels represent a milder form. If you or your child is being treated for this condition, low levels of 17-hydroxyprogesterone enzyme in the test results mean that the treatment plan is efficiently working. The treatment options include medicines to replace missing cortisol and even surgery to change the appearance and function of your genitals.

Related Tests: Total T4 (Total Thyroxine), Anti-Müllerian Hormone Test, DHEA Sulfate Test

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