Hi Michelle,

We try to keep the androgens in the high-normal range.  I understand that some docs are comfortable with out of reference range results as long as bone age is good and there are no signs of progressive virilization.  If advanced bone age is a problem, the doc will probably want to keep androgens well within normal reference range.

17-OHP alone doesn’t cause problems – androgens do.  They generally go hand in hand, with high 17-OHPs resulting in high androgens.  This is not always as clear-cut as it would appear.  17-OHP varies widely during the day, so the results are highly dependent on the circumstances surrounding the blood draw (time of day, before or after meds, stress level).

In the past, we’ve had high 17-OHPs and low androgens, as well as low 17-OHPs and high androgens.  Since we began dosing to mimic circadian rhythm, our labs have been consistent every time.

One final note - you mentioned the reference range for pre-pubertal girls.  If your daughter is showing signs of puberty, her reference range for androstenedione would be higher (regardless of age).

LauraK