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Endocrine investigations and laboratory reference ranges 

Endocrine investigations and laboratory reference ranges
Chapter:
Endocrine investigations and laboratory reference ranges
Author(s):

Gary Butler

and Jeremy Kirk

DOI:
10.1093/med/9780198786337.003.0014
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date: 31 July 2021

While baseline testing may be appropriate in some endocrine disorders (e.g. hyper/hypothyroidism), many hormones are not secreted in a constant fashion (e.g. pulsatile (growth hormone), diurnal (cortisol)), and are also age (IGF-1) and pubertal stage (Luteinizing hormone/follicle-stimulating hormone/testosterone/oestradiol) dependent. In these circumstances, stimulation (or suppression) testing including using hypothalamic/pituitary hormones may be required. Testing can either be performed to identify occult endocrine dysfunction in high-risk groups, or alternatively to confirm (or exclude) endocrine disorders in conjunction with careful clinical assessment. These tests are, however, often complex and difficult to perform, with both false-positive and false-negative results, so careful and appropriate timing and choice of tests is required to ensure optimal outcomes.

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