Comprehensive Endocrinology Tests and Diagnosis

At PACE Hospitals, we provide advanced endocrinology diagnostic services to accurately evaluate hormone levels and gland function. Using specialized tests and expert assessment, our team identifies endocrine disorders early and ensures precise diagnosis for effective treatment planning.

Blood Tests

Blood glucose tests 

These are the tests that help to evaluate how well the body regulates blood sugar, which is primarily controlled by insulin from the pancreas. A fasting blood glucose test measures the baseline sugar levels after not eating, while the postprandial test checks how the body handles glucose after a meal. HbA1c reflects the average blood sugar over the past 2–3 months. Persistently high levels indicate diabetes or prediabetes, whereas extremely low levels may indicate hypoglycemia or excessive insulin activity. These tests work together to diagnose and monitor illnesses such as type 1 diabetes, type 2 diabetes, and insulin resistance. 

Thyroid function tests 

These tests assess how well the thyroid gland is functioning. T3 and T4 are thyroid hormones that regulate metabolism, while thyroid-stimulating hormone (TSH) from the pituitary controls their production. If T3 or T4 are low and TSH is high, it suggests hypothyroidism (underactive thyroid). If T3 or T4 are high and TSH is low, it indicates hyperthyroidism (overactive thyroid). This combination helps to rule out whether the problem is in the thyroid itself or in the pituitary gland, making it an important diagnostic test for diagnosing disorders such as hyperthyroidism, hypothyroidism, and thyroid dysfunction.

Insulin levels & C-peptide 

These tests help evaluate how much insulin the body is producing and how effectively it is being used. Insulin levels reflect the body's response to glucose, whereas C-peptide signifies natural insulin synthesis. Low insulin and C-peptide levels indicate type 1 diabetes or pancreatic failure, but high levels indicate insulin resistance, which is common in type 2 diabetes and diseases such as PCOS. These tests are particularly useful in differentiating types of diabetes and understanding underlying metabolic issues.

Cortisol & adrenocorticotropic hormone (ACTH)

These tests assess the function of the adrenal glands and their regulation by the pituitary gland. Cortisol is a stress hormone produced by the adrenal glands, and ACTH from the pituitary stimulates its release. Elevated cortisol levels may indicate Cushing’s syndrome, while low levels suggest adrenal insufficiency (which is also called Addison’s disease). Doctors can diagnose diseases associated with stress hormone imbalance by comparing cortisol and ACTH levels to establish whether the disorder originated in the adrenal glands or the pituitary.

Growth hormone (GH) & Insulin-like Growth Factor-1 (IGF-1) 

These tests evaluate growth and metabolic regulation controlled by the pituitary gland. Growth hormone is released in pulses, so its levels may fluctuate, while IGF-1 remains more stable and reflects overall GH activity. Low GH/IGF-1 levels may indicate growth hormone deficiency, leading to short stature in children or fatigue and reduced muscle mass in adults. High levels can suggest conditions like acromegaly (in adults) or gigantism (in children). Together, these tests help confirm abnormalities in growth and metabolism.

Hormones Test

These hormones regulate reproductive function and are controlled by the interaction between the pituitary gland and gonads. 

• Prolactin: This affects milk production, and high levels can cause irregular periods or infertility. 
• Luteinizing hormone and follicle-stimulating hormone: These hormones control ovulation in women and sperm production in men. 
• Sex hormones: These are primary sex hormones responsible for sexual development and function. 
• Abnormal levels can indicate conditions like PCOS, hypogonadism, infertility, delayed puberty, or pituitary disorders. These tests help identify where the hormonal imbalance is occurring and guide treatment.

Calcium, Vitamin D, Parathyroid hormone (PTH) 

Calcium levels show how much calcium is circulating in the blood, while Vitamin D helps in calcium absorption from the gut. PTH controls calcium levels by acting on bones, kidneys, and intestines. Elevated levels of calcium with high PTH indicate hyperparathyroidism, whereas reduced calcium with low Vitamin D may indicate deficiency or bone disorders like osteomalacia. 

Urine Tests

24-hour urine cortisol

This test measures the total amount of cortisol excreted in urine over a full 24-hour period. If the 24-hour urine cortisol level is consistently elevated, it strongly suggests conditions like Cushing’s syndrome, where the body produces excess cortisol. On the other hand, very low levels may indicate adrenal insufficiency (Addison’s disease). This test is especially useful for confirming long-term cortisol imbalance rather than temporary fluctuations.

Urinary catecholamines

This test measures hormones generated by the adrenal glands. These hormones are released during stress and assist in regulating heart rate and blood pressure. Elevated levels of urinary catecholamines (or their metabolites like metanephrines) can indicate rare adrenal tumors such as pheochromocytoma or paraganglioma, which cause excessive hormone secretion leading to symptoms like high blood pressure, sweating, and palpitations. By measuring these hormone levels over time, the test helps detect abnormal overproduction and confirms the presence of such endocrine tumors.

Imaging studies

Ultrasound 

Ultrasound provides images of endocrine glands (thyroid and ovaries), helping doctors assess their structure. The thyroid gland can detect nodules, enlargement, inflammation, or cysts, which may suggest conditions like thyroiditis, thyroid nodules, or cancer. In the ovaries, it helps to identify features like multiple small follicles seen in polycystic ovary syndrome or ovarian cysts. While it does not assess hormone levels, it does reveal important structural information that aids in diagnosis in conjunction with blood tests. 

Computed tomography/ magnetic resonance imaging

These imaging techniques give detailed cross-sectional images of internal organs and are especially useful for identifying tumors or abnormalities in endocrine glands such as the pituitary, adrenal glands, and pancreas. For example, an MRI of the brain can detect pituitary tumors causing hormone imbalances (like excess prolactin or growth hormone), while a CT scan can identify adrenal tumors responsible for excess cortisol or catecholamines. These scans help locate the exact source of hormone overproduction or deficiency, which is essential for diagnosis and treatment planning.

Dual-Energy X-ray Absorptiometry (DEXA scan) 

The DEXA test, or bone density test, measures bone mineral density and is primarily used to diagnose osteoporosis or osteopenia. Many endocrine disorders, such as thyroid imbalance, parathyroid disorders, or long-term cortisol excess, can weaken bones. A low result indicates increased fracture risk and may point toward underlying hormonal issues affecting calcium and bone metabolism.

Radioactive iodine uptake (RAIU) test

This test is used to evaluate how well the thyroid gland is functioning by measuring its ability to absorb iodine, which is essential for producing thyroid hormones. In this test, a small and safe amount of radioactive iodine is given through the mouth, and the amount taken up by the thyroid gland is measured after a few hours or a day. If the uptake is high, it usually implies hyperthyroidism, particularly Graves' disease, in which the thyroid is overactive and produces too many hormones. If the uptake is low, it may suggest thyroiditis or excess hormone intake, where the gland is not actively producing hormones.

Stimulation/Suppression Tests

Oral glucose tolerance test (OGTT)

This test evaluates how effectively the body processes glucose over time. After fasting, a measured glucose drink is given, and blood sugar levels are checked at intervals (after 2 hours). In a healthy person, insulin brings glucose levels back to normal. If glucose levels remain elevated, it indicates diabetes or impaired glucose tolerance (prediabetes). If insulin levels are high but glucose is still elevated, it suggests insulin resistance, commonly seen in type 2 diabetes or PCOS. Thus, OGTT helps detect early abnormalities in glucose metabolism.

Dexamethasone suppression test

This test checks how well the body regulates cortisol production. Dexamethasone is a synthetic steroid that normally suppresses cortisol release through negative feedback. If cortisol levels do not decrease after taking dexamethasone, it suggests abnormal cortisol overproduction, such as in Cushing’s syndrome. This helps identify whether the excess cortisol is due to adrenal tumors, pituitary disorders, or other causes.

ACTH stimulation test

This test assesses how well the adrenal glands respond to stimulation. A synthetic form of ACTH is given, which should trigger the adrenal glands to produce cortisol. If cortisol levels fail to rise adequately, it indicates adrenal insufficiency. This test helps confirm whether the adrenal glands are functioning properly and distinguishes between primary adrenal failure and problems related to the pituitary.

Specialized Tests

Autoantibody tests

These tests detect antibodies produced by the immune system that mistakenly attack the body’s own endocrine glands. In conditions like Hashimoto’s thyroiditis, antibodies like anti-TPO or anti-thyroglobulin target the thyroid, leading to reduced hormone production. Another condition is Graves’ disease, where different antibodies stimulate the thyroid excessively, causing hyperthyroidism. 

Genetic testing

Genetic tests analyse DNA to identify inherited mutations or predispositions to endocrine disorders. These are especially useful for diagnosing rare or familial conditions such as multiple endocrine neoplasia (MEN syndromes), congenital adrenal hyperplasia, or inherited forms of diabetes. Specific gene mutations can assist in confirming a diagnosis, forecasting disease progression, and guiding therapy decisions. It can also be used to screen family members who may be at risk, enabling early monitoring and prevention of complications.

Take the next step with confidence,
Consult our endocrinologists for a free second opinion.

At PACE Hospitals, we are committed to providing our patients with the best possible care, and that includes offering second medical opinions with super specialists for treatment or surgery. We recommend everyone to get an expert advance medical second opinion, before taking decision for your treatment or surgery.