Evaluation of the three hour metyrapone test in adults.
The prolonged metyrapone test is used to assess the hypothalamic-pituitary-adrenal axis. The dynamic responses of cortisol, ACTH and 11-deoxycortisol over the 3 h of the single morning dose metyrapone test have been examined in fourteen normal adult subjects. In every case there was a rapid, sustained fall in cortisol, but the resultant ACTH responses were extremely variable and in two subjects did not exceed values obtained during the control studies. The rise in 11-deoxycortisol was also variable and in several instances occurred without any significant elevation in ACTH. In these cases, the rise in 11-deoxycortisol may be due to a normal level of production of steroids with a shift from cortisol to 1-deoxycortisol induced by the metyrapone. Thus, the hypothalamic-pituitary-adrenal axis may not be adequately tested, and this together with the high incidence of unpleasant side effects, makes the 3 h oral metyrapone test unsatisfactory for routine use in adults.
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D003350:Cortodoxone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D008797:Metyrapone / Q000009:adverse effects; D010912:Pituitary-Adrenal Function Tests; D010913:Pituitary-Adrenal System / Q000502:physiology*; D012016:Reference Values
D000324:Adrenocorticotropic Hormone; D003350:Cortodoxone; D006854:Hydrocortisone; D008797:Metyrapone