Hi Susan,

17-OHP has been shown to be an unreliable single indicator of control in CAH, for just the reasons that have been discussed here.  See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7212759&dopt=Abstract among others.

Does your doc also order an androgen test, such as androstenedione or testosterone?  This gives a better indication of overall control.  Keeping down androgens is one of the main goals of treatment for most women, so it makes sense to give heavy weight to this result anyway. 

Better yet, ask for a 24-hour urine collection.  This will give you a picture of the entire day.  Ask the doc to check for pregnanetriol (metabolites of 17-OHP) and 17-ketosteroids (metabolites of the androgens).  Then you can really compare apples to apples, and no needle sticks!

17-OHP results also vary depending on where you are in your menstrual cycle.  If I recall correctly, they are lowest around day 3 after the onset of menstruation, then cycle up to a peak around the time of ovulation.  That’s another variable to add in to this frustrating mess!

LauraK