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DHEA/ESTRAD/FSG/PROGEST/PREGNEN/TESTOST/VIT D

Test Code

321148X

Includes

ESTRADIOL (E2); FOLLICLE STIMULATING HORMONE (FSH); PROGESTERONE; DHEA SULFATE; PREGNENOLONE LC/MS/MS; TESTO, FREE AND TOTAL, LC/MS/MS; VITAMIN D, 25-HYDROXY, LC/MS/MS

Preferred Specimen(s)

(21675) PREGNENOLONE LC/MS/MS
RT
0.5 ML SERUM COLLECTED IN A RED-TOP TUBE (NO GEL)
(138525) DHEA SULFATE
SR
1 ML SERUM
(11290) ESTRADIOL (E2)
SR
3.0 ML SERUM

NOTE: DO NOT ADD ON ESTRADIOL TESTING TO A BARRIER GEL
SPECIMEN OLDER THAN 72 HOURS. ESTRADIOL BINDS TO BARRIER
GEL CAUSING DECREASED VALUES.
(11170) FOLLICLE STIMULATING HORMONE (FSH)
SR
1 ML SERUM
(11250) PROGESTERONE
SR
1 ML SERUM

NOTE: DO NOT ADD ON PROGESTERONE TESTING TO A BARRIER GEL
SPECIMEN OLDER THAN 72 HOURS.
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
RT
1.0 ML
SERUM COLLECTED IN A RED-TOP TUBE (NO GEL)
(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
RT
PATIENT PREPARATION:
FASTING PREFERRED, BUT NOT REQUIRED

0.5 ML SERUM

INSTRUCTIONS:
COLLECT BLOOD IN A STANDARD RED-TOP SERUM VACUTAINER
TUBE. ALLOW BLOOD TO CLOT AT ROOM TEMPERATURE. CENTRIFUGE
AND SEPARATE THE SERUM FROM THE CELLS IMMEDIATELY.
ALTERNATIVELY, COLLECT BLOOD IN AN SST, ALLOW TO CLOT
AT ROOM TEMPERATURE, CENTRIFUGE AND REMOVE FROM THE GEL
WITHIN 48 HOURS.

Minimum Volume

(21675) PREGNENOLONE LC/MS/MS
0.2 ML
(138525) DHEA SULFATE
0.5 ML
(11290) ESTRADIOL (E2)
3.0 ML
(11170) FOLLICLE STIMULATING HORMONE (FSH)
0.5 ML
(11250) PROGESTERONE
0.5 ML
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
1.0 ML
(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
0.3 ML

Alternative Specimen(s)

(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
SERUM SEPARATOR (SST)

Transport Container

(21675) PREGNENOLONE LC/MS/MS
RED TOP
(138525) DHEA SULFATE
SERUM SEPARATOR (SST)
(11290) ESTRADIOL (E2)
SERUM TRANSPORT TUBE
(11170) FOLLICLE STIMULATING HORMONE (FSH)
SERUM TRANSPORT TUBE
(11250) PROGESTERONE
SERUM TRANSPORT TUBE
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
RED TOP
(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
PLASTIC TRANSPORT TUBE

Transport Temperature

(21675) PREGNENOLONE LC/MS/MS
REFRIGERATED
(138525) DHEA SULFATE
REFRIGERATED
(11290) ESTRADIOL (E2)
ROOM TEMPERATURE
(11170) FOLLICLE STIMULATING HORMONE (FSH)
ROOM TEMPERATURE
(11250) PROGESTERONE
ROOM TEMPERATURE
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
ROOM TEMPERATURE
(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
ROOM TEMPERATURE

Specimen Stability

(21675) PREGNENOLONE LC/MS/MS
ROOM TEMPERATURE: 2 DAYS
REFRIGERATED: 7 DAYS
FROZEN: 1 YEAR
(138525) DHEA SULFATE
ROOM TEMPERATURE: 72 HOURS
REFRIGERATED: 7 DAYS
FROZEN: 28 DAYS
(11290) ESTRADIOL (E2)
ROOM TEMPERATURE: 7 DAYS
REFRIGERATED: 7 DAYS
FROZEN: 6 MONTHS
*DO NOT ADD ON ESTRADIOL TESTING TO A BARRIER GEL SPECIMEN
OLDER THAN 72 HOURS.
(11170) FOLLICLE STIMULATING HORMONE (FSH)
ROOM TEMPERATURE: 7 DAYS
REFRIGERATED: 7 DAYS
FROZEN: 28 DAYS
(11250) PROGESTERONE
ROOM TEMPERATURE: 3 DAYS
REFRIGERATED: 1 WEEK
-20 DEG. C: 1 YEAR
-70 DEG. C: NOT PROVIDED
*DO NOT ADD ON PROGESTERONE TESTING TO A BARRIER GEL
SPECIMEN OLDER THAN 72 HOURS.
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
ROOM TEMPERATURE: 7 DAYS
REFRIGERATED: 7 DAYS
FROZEN: 24 MONTHS
(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
ROOM TEMPERATURE: 21 DAYS
REFRIGERATED: 21 DAYS
FROZEN: 21 DAYS

Methodology

(21675) PREGNENOLONE LC/MS/MS
EXTRACTION, CHROMATOGRAPHY, RADIOIMMUNOASSAY
(138525) DHEA SULFATE
IMMUNOASSAY
(11290) ESTRADIOL (E2)
EIA
(11170) FOLLICLE STIMULATING HORMONE (FSH)
CHEMILUMINESCENCE
(11250) PROGESTERONE
CHEMILUMINESCENCE
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
LC/MS/MS, EQUILIBRIUM DIALYSIS
(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
LIQUID CHROMATOGRAPHY, TANDEM MASS SPECTROMETRY

Performing Laboratory

Quest Diagnostics
3714 Northgate Blvd
Sacramento, CA 95834

Setup Time

(11290) ESTRADIOL (E2)
3RD SHIFT
(11170) FOLLICLE STIMULATING HORMONE (FSH)
3RD SHIFT
(11250) PROGESTERONE
3RD SHIFT

Setup Days

(21675) PREGNENOLONE LC/MS/MS
MON - FRI
(138525) DHEA SULFATE
TUES - SAT
(11290) ESTRADIOL (E2)
MON - FRI
(11170) FOLLICLE STIMULATING HORMONE (FSH)
MON - FRI
(11250) PROGESTERONE
MON - FRI
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
MON - SUN

Report Available

(21675) PREGNENOLONE LC/MS/MS
4 - 5 DAYS
(138525) DHEA SULFATE
3 - 4 DAYS
(11290) ESTRADIOL (E2)
24 HOURS
(11170) FOLLICLE STIMULATING HORMONE (FSH)
24 HOURS
(11250) PROGESTERONE
24 HOURS

Clinical Significance

(138525) DHEA SULFATE
DHEAS IS THE SULFATED FORM OF DHEA AND IS THE MAJOR ANDROGEN
PRODUCED BY THE ADRENAL GLANDS. THIS TEST IS USED IN THE
DIFFERENTIAL DIAGNOSIS OF HIRSUTE OR VIRILIZED FEMALE
PATIENTS AND FOR THE DIAGNOSIS OF ISOLATED PREMATURE
ADRENARCHE AND ADRENAL TUMORS. ABOUT 10% OF HIRSUTE WOMEN
WITH POLYCYSTIC OVARIAN SYNDROME (PCOS) HAVE ELEVATED DHEAS
BUT NORMAL LEVELS OF OTHER ANDROGENS.
(11290) ESTRADIOL (E2)
MEASURING THE CIRCULATING LEVELS OF ESTRADIOL IS IMPORTANT
FOR ASSESSING THE OVARIAN FUNCTION AND MONITORING FOLLICULAR
DEVELOPMENT FOR ASSISTED REPRODUCTION PROTOCOLS. ESTRADIOL
PLAYS AN ESSENTIAL ROLE THROUGHOUT THE HUMAN MENSTRUAL
CYCLE. ELEVATED ESTRADIOL LEVELS IN FEMALES MAY ALSO RESULT
FROM PRIMARY OR SECONDARY OVARIAN HYPERFUNCTION. VERY HIGH
ESTRADIOL LEVELS ARE FOUND DURING THE INDUCTION OF OVULATION
FOR ASSISTED REPRODUCTION THERAPY OR IN PREGNANCY. DECREASED
ESTRADIOL LEVELS IN FEMALES MAY RESULT FROM EITHER LACK OF
OVARIAN SYNTHESIS (PRIMARY OVARIAN HYPOFUNCTION AND
MENOPAUSE) OR A LESION IN THE HYPOTHALAMUS-PITUITARY AXIS
(SECONDARY OVARIAN HYPOFUNCTION). ELEVATED ESTRADIOL LEVELS
IN MALES MAY BE DUE TO INCREASED AROMATIZATION OF ANDROGENS,
RESULTING IN GYNECOMASTIA.
(11170) FOLLICLE STIMULATING HORMONE (FSH)
THIS TEST IS USEFUL IN THE DIFFERENTIAL DIAGNOSIS OF
PITUITARY AND GONADAL INSUFFICIENCY AND IN CHILDREN
WITH PRECOCIOUS PUBERTY.
(11250) PROGESTERONE
LEVELS INCREASE SHARPLY DURING THE LUTEAL PHASE OF THE
MENSTRUAL CYCLE. THE LEVEL INCREASES FROM 9 TO 32 WEEKS
OF PREGNANCY.
(138350) TESTO, FREE AND TOTAL, LC/MS/MS
HELPFUL IN ASSESSING TESTICULAR FUNCTION IN MALES AND
MANAGING HIRSUTISM, VIRILIZATION IN FEMALES.
(23805) VITAMIN D, 25-HYDROXY, LC/MS/MS
MEASUREMENT OF SERUM 25-OH VITAMIN D CONCENTRATIONS PROVIDE
A GOOD INDEX OF CIRCULATING VITAMIN D ACTIVITY IN PATIENTS
NOT SUFFERING FROM RENAL DISEASE. LOWER THAN NORMAL 25-OH
VITAMIN D LEVELS CAN RESULT FROM A DIETARY DEFICIENCY, POOR
ABSORPTION OF THE VITAMIN OR IMPAIRED METABOLISM OF THE
STEROL IN THE LIVER. A 25-OH VITAMIN D DEFICIENCY CAN LEAD
TO BONE DISEASES SUCH AS RICKETS AND OSTEOMALACIA. ABOVE
NORMAL LEVELS CAN LEAD TO HYPERCALCEMIA. THIS ASSAY EMPLOYS
LIQUID CHROMATOGRAPHY TANDEM MASS SPECTROMETRY TO
INDEPENDENTLY MEASURE AND REPORT THE TWO COMMON FORMS OF
25-HYDROXY VITAMIN D: 25OH D3 - THE ENDOGENOUS FORM OF THE
VITAMIN AND 25OH D2 - THE ANALOG FORM USED TO TREAT 25OH
VITAMIN D3 DEFICIENCY.

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

LOINC assignment is based on a combination of test attributes, including the method used by the performing laboratory. For tests not performed by Quest Diagnostics, codes are assigned by the performing laboratory.

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