Hormones
Androstandiol-glucuronide
Breakdown product of the strong male hormone DHT; an indirect measure of the action of male hormone in the skin and hair.
Everything about this testWhat it measures
In the skin and hair follicles, testosterone is converted into dihydrotestosterone (DHT), the strongest form of male hormone. When DHT is broken down, androstanediol is formed, which the body links to glucuronic acid so that it can be removed via the kidneys. This linked form (androstanediol glucuronide, also 3-alpha-diol-G) is stable in the blood and was seen as a measure of the action of male hormone in the skin. Later research showed that a large part of it comes from the liver and the adrenal glands, and not only from the skin.
- Conversion of male hormone in the skin, in women with excess hair growth (hirsutism) or acne
- Use of testosterone or anabolic substances
- The effect of medicines that block the conversion to DHT, such as finasteride or dutasteride
High
In women, a raised value may fit excess hair growth or acne, whether or not due to PCOS; however, in many women with excess hair growth the value is normal, and vice versa. Overweight and the use of testosterone, DHEA or anabolic substances raise the value. Men naturally have higher values than women. Without symptoms, a raised value has little meaning.
Low
A low value fits the use of medicines that block the conversion of testosterone to DHT, such as finasteride or dutasteride, and hormonal contraception or anti-androgens. In men, a low value can go together with a low testosterone. After menopause and at an older age, the value is naturally lower. A low value on its own causes no symptoms.
If your result is abnormal
With excess hair growth or acne and an abnormal value, the GP usually has testosterone and SHBG measured and looks at the periods and at signs of PCOS. With rapidly developing masculinization or a strongly raised testosterone, referral follows to a gynecologist or an endocrinologist (internist specializing in hormones). An abnormal value without symptoms usually does not lead to further testing.
Reliability
Androstanediol glucuronide has limited predictive value. The link with excess hair growth is weak: the value overlaps strongly between women with and without symptoms, and there are no agreed cut-off values. To show too much male hormone, the Dutch PCOS guideline advises calculated free testosterone as the first step, possibly supplemented with androstenedione and DHEA-S; these say more when there is an abnormality. Excess hair growth itself is diagnosed with a physical examination.
Limitations
- Hormonal contraception, anti-androgens and 5-alpha-reductase inhibitors (finasteride, dutasteride) lower the value; for hormone testing, the PCOS guideline advises stopping hormonal contraception for at least 3 months.
- Testosterone, DHEA and anabolic substances raise the value.
- The value depends on sex, age and body weight; reference values differ per laboratory and measurement method.
How common is this
Excess hair growth occurs in about 5 in 100 women; the most common cause of too much male hormone is PCOS. How often an abnormal androstanediol glucuronide occurs in people without symptoms is not known.
Who is this useful for
The result is at most meaningful as an addition in women with excess hair growth or acne, alongside testosterone, SHBG and, if needed, androstenedione and DHEA-S, which say more when there is an abnormality. Not suitable as a measure of 'hormone balance', hair loss or muscle building. In people without symptoms, a single value says little.
Downsides and risks
- A raised value without symptoms can cause unnecessary worry or unnecessary hormone testing; a normal value does not rule out too much male hormone.
Sources
Always discuss an abnormal result with your GP. If a result is strongly abnormal, we try to reach you as soon as possible. Read your result yourself as well and contact your GP if in doubt. A test does not make a diagnosis. Read more about risks and results