Blood draw
Pregnenolone
Pregnenolone; precursor of steroid hormones.
€ 125,00
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Hormones · Blood
Pregnenolone
The first step in making steroid hormones from cholesterol; mainly meaningful when testing for a rare adrenal disorder.
At a glance
- Measured in blood
- In 1 test panel
- Check the preparation
Explanation
Pregnenolone: what is measured?
Pregnenolone is made from cholesterol in the adrenal glands, the ovaries or testes, and in small amounts in the brain. It is the common precursor of progesterone, cortisol, aldosterone, DHEA and the sex hormones, and has hardly any effect of its own. Production in the adrenal gland is controlled by ACTH from the pituitary gland. As a result, the value follows a daily rhythm and is highest in the early morning.
What can it detect?
- A clue to a disorder in the first steps of hormone production in the adrenal gland, in addition to cortisol, ACTH and 17-hydroxyprogesterone
- Use of pregnenolone or DHEA supplements
Result
What does the result mean?
Pregnenolone too high
A raised value is often due to the time of the blood draw (the value is highest early in the morning), stress or illness, or the use of pregnenolone or DHEA supplements. The value is higher during pregnancy. In a rare congenital disorder of an adrenal enzyme (a form of congenital adrenal hyperplasia, CAH), pregnenolone can build up because the next step in production does not work properly; this goes together with abnormalities in cortisol and other adrenal hormones.
Pregnenolone too low
A low value is often due to a blood draw later in the day or to the use of corticosteroids (tablets, inhaler, nasal spray, skin cream or injection), which suppress the body's own production. With reduced function of the adrenal glands or the pituitary gland, pregnenolone is also low, but then it is mainly cortisol that is abnormal and there are symptoms such as severe tiredness, weight loss and low blood pressure. A low value without symptoms says little. The idea that stress 'steals' pregnenolone at the expense of the sex hormones has not been proven.
After an abnormal result
With an abnormal value, the GP looks at symptoms, medicines and supplements. With symptoms that fit an adrenal disorder, a morning cortisol measurement follows, with ACTH and 17-hydroxyprogesterone if needed, and if an abnormality is confirmed, referral to an internist-endocrinologist. An abnormal pregnenolone without symptoms usually does not lead to further tests.
Reliability
How reliable is the test?
The meaning of a single pregnenolone value has been little studied, and there are no agreed cut-off values outside research into rare adrenal disorders. The result is mainly meaningful when it is assessed together with cortisol, ACTH and other adrenal hormones, sometimes after an ACTH stimulation test. As a measure of 'hormone balance', energy or aging, pregnenolone is not supported by evidence.
What can affect the result?
- Time of day: the value follows the daily rhythm of the adrenal gland and is highest in the early morning.
- Corticosteroids lower the value; pregnenolone and DHEA supplements raise it.
- Immunoassays can react with related steroids; a measurement with mass spectrometry is more accurate. Results from different laboratories are therefore hard to compare.
- Stress, illness and pregnancy temporarily change the value.
Preparation
- Have your blood taken in the morning, because the value falls during the day.
Who it is for
Who is the test useful for?
Useful for
The result is most meaningful with a specific question about a congenital disorder in the production of adrenal hormones, together with other adrenal hormones. Not suitable as a measure of 'hormone balance', stress, tiredness or aging, or for choosing a supplement. In people without symptoms, a single value says little.
How common is it?
The severe form of congenital adrenal hyperplasia is diagnosed in 12 to 15 children a year in the Netherlands, nowadays usually through the heel prick test; the forms in which pregnenolone builds up are a small and very rare part of these. Reduced function of the adrenal glands is rare. How often an abnormal pregnenolone occurs in people without symptoms is not known.
Maastricht UMC+, Department of Endocrinology, and the GP brochure on adrenal diseases (Bijniervereniging NVACP)
Drawbacks and risks
- An abnormal value without symptoms can cause unnecessary worry about the adrenal glands and unnecessary further tests.
- A 'low' value is sometimes used as a reason to take pregnenolone or DHEA; this is not supported by evidence, and DHEA is on the doping list.
Get tested
Pregnenolone: test panels
Pregnenolone is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results