CUSH Tests

Cushing’s Tests

Standard protocol is to start with a 24-hour urine free cortisol (UFC). Depending on the results of the UFC your physician will order tests accordingly. 24-hour Urine free cortisol (UFC) identifies the amount of cortisol in the body during a 24-hour period. It is very important to catch all urine for the 24-hour urine test (If you spill even a small amount the test is void). It is recommended that a urine collection hat or urinal be used. Also, urine should be kept refrigerated and directions followed exactly as your lab or doctor instructed. (Click on the publications button to read / print directions for collecting 24 hour urine.)

Serum blood test for ACTH or cortisol (serum blood cortisol is not always as accurate as urine)

Serum blood test for all pituitary hormones

Dexamethazone Suppression Tests- There are various Dex. test used, low dose, high dose, overnight, 2 day, etc. Dexamethasone often fails to suppress the function of the hypothalamus, pituitary, and adrenal glands in patients with Cushing's therefore helps achieve a diagnosis.

Dexamethasone Suppressed CRH Stimulation - Helps in determining diagnosis of pseudo-Cushing from Cushing syndrome or disease or to identify recurrence of Cushing's.

Salivary Cortisol Test - Shows the cortisol diurnal rhythm.

Inferior Petrosal Sinus Sampling (IPSS) - This test may be recommended if findings on MRI of the pituitary did not reveal a tumor or is inconclusive.

Octreo Tide Scan - This test scans the body for ACTH producing tumors.

MRI Of the Pituitary (with and without contrast) - This is to see if there is a visual pituitary tumor. Pituitary tumors are often not seen on an MRI. Also, it’s good practice to have a neurosurgeon view your film as well as the radiologist.

CT Scan of the Adrenal glands or other organ -This is to see if there are any visual tumors on the adrenal glands or other organs. If the physician suspects Cushing's, it's not usual protocol to search for a tumor on MRI or CT scan prior to having other diagnostic tests. The reason for this is because non-producing (produce no excess hormones) endocrine tumors may be present and these tumors can be harmless. A surgical procedure could be performed to have a non-producing tumor removed and the patient would remain with Cushing's if the ACTH or cortisol producing tumor was located elsewhere in the body

Cushing’s Understanding Support & Help Org. We're a non-profit organization. We're not a medical authority, therefore we do not claim to have medical knowledge. Always consult your doctor or healthcare provider with any medical questions that you have concerning test, treatment, advice, etc. This information is provided as a service to Cushing’s patient's their family and friends and should never be considered as medical advice. It can be printed from this site for personal use only. The information is not to be edited. Using the information for any other reason than mentioned above requires prior written authorization from CUSH.