Adrenal & Steroid Hormones

Convert plasma aldosterone between ng/dL, pg/mL and pmol/L, with the posture, sodium intake and drug-preparation rules that determine whether the result can be trusted.

Screen for primary aldosteronism from plasma aldosterone and plasma renin activity, and see why the ratio is unreliable without checking the aldosterone alongside it.

Convert a corticosteroid dose to another agent’s equivalent using relative glucocorticoid potency — and see why mineralocorticoid activity does not travel with it.

Convert serum cortisol between µg/dL, nmol/L and ng/mL, and see why the sampling time and the patient’s oestrogen status matter more than the number itself.

Interpret the 08:00 cortisol after a 1 mg overnight dexamethasone suppression test, using both the traditional and the more sensitive modern cut-offs.

Convert DHEA-sulfate between µg/dL, µg/mL and µmol/L, and see why it separates an adrenal from an ovarian source of androgen excess.

Convert plasma free metanephrine between pg/mL, ng/L and pmol/L, and see why the sample must be drawn supine and off interfering drugs before it can be trusted.

Convert plasma free normetanephrine between pg/mL, ng/L and pmol/L, and see why it is more posture-sensitive than metanephrine and points towards extra-adrenal disease.