Adrenal Washout Test Calculation

Baseline Cortisol (μg/dL)

Cortisol level before dexamethasone

Post-Dexamethasone Cortisol (μg/dL)

Cortisol level after dexamethasone

Dexamethasone Dose (mg) 1 mg (Overnight test) 2 mg (48-hour test) 8 mg (High-dose test)

Test Duration Overnight (8-10 hours) 48-hour test High-dose test

Patient Age

Age in years

Gender Select gender Male Female Other

Clinical Suspicion Select suspicion Cushing's Syndrome Adrenal Adenoma Pituitary Adenoma Ectopic ACTH Other

Calculate Washout Results Reset

About Adrenal Washout Test

The adrenal washout test (dexamethasone suppression test) evaluates the hypothalamic-pituitary-adrenal axis and helps diagnose Cushing's syndrome.

Normal Reference Ranges:

• Morning Cortisol: 6-23 μg/dL
• Afternoon Cortisol: 2-14 μg/dL
• Overnight Test: <1.8 μg/dL
• 48-hour Test: <1.8 μg/dL
• High-dose Test: <5 μg/dL

Interpretation Guidelines:

• Normal Suppression:
• • Cortisol <1.8 μg/dL
• • Suggests normal HPA axis
• Incomplete Suppression:
• • Cortisol 1.8-5 μg/dL
• • May indicate Cushing's
• No Suppression:
• • Cortisol >5 μg/dL
• • Strongly suggests Cushing's

Cushing's Syndrome Causes:

• ACTH-Dependent:
• • Pituitary adenoma (Cushing's disease)
• • Ectopic ACTH production
• ACTH-Independent:
• • Adrenal adenoma
• • Adrenal carcinoma
• • Adrenal hyperplasia

Test Limitations:

• • False positives in stress, illness
• • False negatives in mild Cushing's
• • Drug interactions
• • Obesity can affect results
• • Depression may cause false positives

Follow-up Testing:

• • 24-hour urinary free cortisol
• • Late-night salivary cortisol
• • ACTH measurement
• • CRH stimulation test
• • Imaging studies (MRI, CT)
• • Inferior petrosal sinus sampling

Clinical Symptoms:

• • Weight gain (central obesity)
• • Moon face
• • Buffalo hump
• • Purple striae
• • Hypertension
• • Diabetes mellitus
• • Osteoporosis
• • Muscle weakness
• • Menstrual irregularities
• • Hirsutism

Professional Resources:

• • Endocrinologist
• • Pituitary specialist
• • Adrenal specialist
• • Neurosurgeon (if pituitary)
• • General surgeon (if adrenal)