Adrenal Cortex

All relevant functional tests are explained with a detailed presentation of indications, contraindications, side effects, test preparation, framework conditions, specific instructions for the actual test execution, and the interpretation of test results. Specific normal ranges and cut-off values are always provided, even for special situations (gender, age, BMI, puberty phases, cycle phases, acute illnesses, medications, etc.). A special feature is the emphasis on test preparation, execution, and interpretation, as well as the interdisciplinary nature. Adrenal cortex diseases are discussed in terms of functional test diagnostics, categorized by zona reticularis, zona fasciculata, and zona glomerulosa. This chapter is of eminent importance for endocrinological diagnostics per se and is characterized by many different, sometimes very demanding test procedures, up to and including adrenal vein catheterization. Drug interactions and the interpretation of test diagnostics play a practically relevant role, as does the distinction between screening, confirmation, and localization tests. The chapter covers all dexamethasone suppression tests, free cortisol in urine, midnight cortisol, ACTH test, all aldosterone-based test procedures, saline stress test, orthostasis test, captopril test, fludrocortisone test, detailed considerations of the aldosterone-renin ratio, androgens, and androgen suppression test.