Metyrapone test
How the test is performed:
Metyrapone is given at 11 p.m. in a single dose or in 4 doses over a period of 24-hours. Blood is drawn at 8 a.m. for measurement of serum cortisol and ACTH. A 24-hour urine sample may be collected for measurement of 17-OCHS (a metabolic product of cortisol).
How to prepare for the test:
The health care provider may advise you to temporarily discontinue drugs that may affect the test. Drugs that can affect metyrapone test measurements include chlorpromazine and corticosteroids. Birth control pills and other estrogen-containing medications can also cause false-positive results.
Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performed:
The test is used to determine whether the pituitary gland is functioning properly. Metyrapone inhibits an enzyme (steroid 11-beta hydroxylase) involved in the synthesis of the steroid hormone cortisol (that is, it converts 11-deoxycortisol to cortisol). The resulting fall in serum cortisol levels normally stimulates the pituitary to secrete ACTH, which then attempts to stimulate the adrenal cortex to synthesize cortisol. Since the enzyme is inhibited, 11-deoxycortisol accumulates and eventually appears in the blood and urine.
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