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Steroid abuse testing

Dear All,
Our endocrinologists are reporting seeing increasing numbers of male patients referred with suspected hypopituitism (low serum testosterone with inappropriately low gonadotrophins). These patients are subjected to lengthy and costly investigation, often including MRI scanning and laboratory studies. However, in a significant proportion of these patients the abuse of exogenous steroids is highly likely and is occasionally admitted by the patient after questioning.

The clinicians would like to screen selected patients in whom steroid abuse is a likely cause of the biochemical abnormalities before undertaking unnecessary investigations, such as an MRI. Does anyone know of such a screening service? Have any other hospitals seen this trend?

Thanks in advance,
Steph

Dr Steph Barber MRCPath
Senior Clinical Biochemist
Nottingham University Hospitals NHS Trust
City Hospital Campus
Nottingham
0115 969 1169 ext 57021


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