11-Deoxycortisol (Blood)

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Auckland Te Toka Tumai

Test Guide

11-Deoxycortisol (Blood)

Testing Laboratory

Auckland Te Toka Tumai | Auckland Hospital

Department

Chemical Pathology

Delphic Registration Code (Alpha Code)

DCOT

Test Code (Numeric Code)

0146

Laboratory Handling

Phlebotomy

4 mL Plain Blood (Prefered), 4 mL Adult EDTA Blood, 1mL Paediatric Microsample Blood, 1mL Paediatric Micro-EDTA Blood

Transport

Send refrigerated up to 4 days.Send frozen if more than 4 days.

Separating

Centrifuge and aliquot - 500uL. Freeze. Place in HPLC rack in freezer 36

Laboratory

LabPLUS High Performance Liquid Chromatography

Sample Stability

Room temperature up to 24 hours. Refrigerated up to 4 days. Freeze if more than 4 days

Synonyms

Deoxycortisol, 11-Deoxycortisol

Turnaround Time

1 week

Place in HPLC rack in freezer 36

Specimen Type

Plasma
Serum

Specimen Requirements

Tube/Container Type:

Preferred

Plain (Red Top)

Acceptable

EDTA (Lavender Cap)

Preferred Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Plain(Microtainer)

Acceptable

EDTA (Microtainer)

Preferred Sample Volume (ml)

Pre-testing Requirements

Overnight metyrapone stimulation test (30mg/kg orally, max 3g) taken at 2300-2400hr.

Additional Specimen Information

Sample:
Serum - Plain
EDTA Plasma
(SST and Heparin tubes are NOT suitable)

Sample Preparation:
Centrifuge and aliquot - 500uL
Freeze
Place in HPLC rack in freezer 36

Sample Stability:
Room temperature up to 24 hours
Refrigerated up to 4 days
Freeze if more than 4 days

Transport to LabPlus:
Send refrigerated up to 4 days
Send frozen if more than 4 days

Any queries please contact Section Leader/Technical Specialist SCP - Chromatography

Diagnostic Use

Measurement of 11-deoxycortisol is mostly performed in one of two clinical settings:

Congenital Adrenal Hyperplasia: 11-deoxycortisol is raised in 11-hydroxylase deficiency, an uncommon inherited enzyme defect in steroidogenesis. This enzyme is the final enzymatic step in the synthesis of cortisol. In affected patients the lack of cortisol feedback stimulation of pituitary ACTH secretion leads to increased ACTH stimulation of steroidogenesis, with increased levels of 11-deoxycortisol, the final intermediate before the block. Levels of 11-deoxycortisol are not raised in patients with the most common form of congenital adrenal hyperplasia, 21-hydroxylase deficiency (which affects the step before 11-hydroxylase).

Metyrapone test: This test is used in the evaluation of suspected insufficiency of the hypothalamic-pituitary-adrenal axis. However, it does not clearly distinguish between primary/secondary causes in possible combined deficiency, and carries the rare potential risk of precipitating adrenal crisis in primary adrenal insufficiency. This test should only be requested by an Endocrinologist. See related information under metyrapone test entry.

Measurement may also uncommonly be performed to test the degree of chronic enzyme block in patients with adrenal tumours on long-term metyrapone treatment to block the production of excess cortisol (as medical therapy for Cushing’s syndrome).

Interpretation

Following the administration of metyrapone (30mg/kg at 11PM), 11-deoxycortisol normally increases the next morning. A normal response is a rise in 11-deoxycortisol to at least 200nmol/L, with a fall in cortisol to <200nmol/L indicating adequate enzyme block. Failure of the 11-deoxycortisol to rise to >200nmol/L indicates secondary adrenal insufficiency (assuming the cortisol is <100nmol/L).

Reference Intervals

Unstimulated Reference Intervals:

Age Group	Age Category	Reference Interval (nmol/L)
Premature	26-28w	3.2 – 39.7
Premature	29-36w	2.0 – 13.1
Term neonate	Day 3-8	0.7 – 34.6
	Day 13-15	0.70 – 3.6
	Day 16-29	0.5 – 4.7
Full term	1-5 mo	0.3 – 5.8
	6-11m	0.3 – 8.0
	1-3 years	0.2 – 7.1
	4-6 years	0.2 – 8.4
>6 years	Male (Frederiksen, Kunz)	< 3
>6 years	Female	< 2.2

Overnight metyrapone stimulation test (30mg/kg orally, max 3g) taken at 2300-2400hr.

If 0800-0900hr plasma cortisol the next morning is <200nmol/L, metyrapone inhibition of cortisol synthesis and subsequent ACTH stimulation has been adequate.

11-deoxycortisol >200 nmol/L -normal (adequate hypothalamic/pituitary response)

<200 nmol/L -secondary adrenal insufficiency

Test Method

Liquid chromatography mass spectrometry (LCMS)

Limitations / Interference

The method does not cross-react with 11-deoxycorticosterone, which is converted to corticosterone in the mineralocorticoid pathway leading to the synthesis of aldosterone. This pathway may also be stimulated with an enzyme deficiency or block of 11-hydroxylase. It also does not cross-react with corticosterone or 21-deoxycortisol, other closely related metabolites in steroid synthesis pathways.

Uncertainty of Measurement

20% at 2 nmol/L, 10% at >10 nmol/L

Last updated: 06/05/2026

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Testing Laboratory

Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Phlebotomy

Transport

Separating

Laboratory

Sample Stability

Synonyms

Turnaround Time

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Pre-testing Requirements

Additional Specimen Information

Aliquot Instructions

Sample Type

Transport to Lab

Additional Referral/Aliquot Information

Diagnostic Use

Interpretation

Reference Intervals

Test Method

Limitations / Interference

Uncertainty of Measurement

Contact Information

Enquiry Form

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11-Deoxycortisol (Blood)

Overview

Testing Laboratory

Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Phlebotomy

Transport

Separating

Laboratory

Sample Stability

Synonyms

Turnaround Time

Specimen

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Pre-testing Requirements

Additional Specimen Information

Referral

Aliquot Instructions

Sample Type

Transport to Lab

Additional Referral/Aliquot Information

Clinical Information/Test Method

Diagnostic Use

Interpretation

Reference Intervals

Test Method

Limitations / Interference

Uncertainty of Measurement

Contact Information

Contact Information

Enquiry Form

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