Myth: UFC’s are the Gold Standard for Cushing’s testing

[~MaryO~]

Myth: UFC’s are the Gold Standard for Cushing’s testing

 

Fact: UFC stands for Urinary Free Cortisol. In layman's terms this test assesses cortisol by collecting urine for 24 hours. It was once thought that this was the gold standard and the end all and be all in terms of assessing Cushing's in a patient. What we now know is that this is not necessarily true.

 

Though this test is helpful in assessing for Cushing's in some patients, not all patients have positive labs with this test, even if they DO, in fact, have Cushing's. There are various theories as to why. Cyclical Cushing's patients also tend to report having a lower prevalence of positive UFCs in their test batteries.

 

Cushing's experts understand that the most effective way to test for Cushing's, especially in cases where it is suspected that the patient is cycling, is to administer multiple test measures across an extended period of time. 

 

The following links may be helpful: 

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2978784/

 

http://home.comcast.net/~staticnrg/Cushing's/LimitationsSC_UFC_dex_mildCS.pdf

 

http://survivethejourney.blogspot.com/2008/08/when-gold-standard-becomes-tarnished.html

[Trix]

Thank you for this. I am undergoing testing, my endo thinks it's cyclical Cushing's, but they don't have much experience with this 'very rare' form here in NZ. So, they are relying on UFC to cinch the diagnosis. I have had one raised UFC out of about 10, one unsupressed dex test, 3 raised salivary cortisols out of about 10. All the raised tests are mildly raised, hence the difficulty in arriving at a firm diagnosis. They are expecting highly elevated UFCs...

[capples1998]

Thank you for this post! I have done two UFC's and only one was mildly elevated. My Dr however marked on my chart as 'normal' even though it was beyond the reference range for normal of the lab. I guess he only likes easy diagnosis with 300 and over UFC'S. Anyway since I have this new info maybe my new Endo can help me. Great share. Thanks Again!