Understanding The Dexamethasone Suppression Test

A simple explanation of why you would do a dexamethasone suppression test and how to interpret the results.
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DISCLAIMER: This video is for education and entertainment only, and is not medical advice. This video should NOT be used for medical advice or to guide clinical practice. The Zero to Finals content should not be used in any way to guide medical decision making. Zero to Finals takes no responsibility for any actions taken or not taken based on the information provided. Local and national guidelines and senior clinicians are there to help you make decisions, not CZcams videos. If you need medical advice or information, seek it from an appropriately trained and licenced doctor or healthcare provider that can address your individual needs. Zero to Finals cannot guarantee the accuracy of information in this video. Please highlight any errors you notice in the comments below - thank you.

[@chrisnjoku2777]

Who is here after watching this video some months back and feeling like they have 'finally' understood the DMST and will never forget it only to come back to watch it again.

[@ZeroToFinals]

haha! I made the video and I still have to come back to remind myself. It is a tricky topic

[@saleemullah4991]

🖐️🖐️

[@qwertyuioparya]

No

[@alviyt6627]

I am here for the same reason 😂

[@iknowthatiknownot]

Me

[@lawyerdoctor]

Brilliant. You explained this test 100% better than the pharm professor at my medical school. I was confused and now I understand, thank you!

[@amandamccrary9773]

I really couldn't get this through my head until now. Thank you.

[@ZeroToFinals]

glad to help!

[@rmacd]

I've gone through 3 years of medical school and it's literally taken me this video for everything to click into place

[@billkuo1]

My notes on steps with dexamethasone suppression test (with Fahad's input)
• 1 mg of dexamethasone (low dose suppression test) is given at 10pm at night and blood levels of cortisol and ACTH are measured at 9am next morning
• If the person have normal CRH-ACTH-cortisol function, ACTH would be suppressed via negative feedback
• low ACTH -> low cortisol
• Blood test would show low cortisol
• If blood test show normal or elevated cortisol levels, it indicates Cushing syndrome, ACTH should then be measured (note: measure cortisol first because measuring ACTH first cannot rule out Cushing syndrome)
• If Cushing syndrome is caused by primary causes, Cortisol would remain high, but ACTH will react to suppression ie. Low ACTH in adrenal adenoma, or exogenous steroids
• If syndrome is caused by excess ACTH: Cushing disease (pituitary adenoma), or ectopic ACTH in paraneoplastic syndromes in SCLC, ACTH will remain high or normal
• In this case, high dose suppression test is used where 8mg of dexamethasone is given at 10pm and ACTH is measured next morning
• High dose dexamethasone is able to suppress ACTH release from the pituitary, therefore, low ACTH would mean pituitary adenoma / Cushing disease (cortisol would be low as well because ACTH is low)
• ACTH remaining high would mean it is not released at the pituitary, and ectopic ACTH would be likely

[@joleneong8173]

you are a legend!! this saved my life!!

[@zwenyinyihtun6988]

The best one

[@Callmeperrys]

Finally after years of studying this I get it

[@trafficjon400]

Dexamethasone tortured my life for over 6 years now? 1 injection for Swelling from a product effected my adrenal Cortisol very badly by still shaking while waking and told my cortisole is sopposed to react with waking but is not. it takes the life out of a person and waking in hell . if your a believer in God dexamethasone will take the belief away for sure when you feel like your in hell unexplainable. ENDOCRINOLOGIST i dare not to see because they don't really know the correct levels of treating with this hormone. Any body abused and have emotional problems better keep far from Steroids Corticasteroids that induce PTSD or any kind of fear will be doubled in Severity.

[@jehangiri6]

Once the Low Dose Dexamethasone Suppression Test is positive , the next step is to measure Serum ACTH levels , if the are low , its either exogenous steroid (most common cause) or Adrenal adenoma , you do not need to do High dose suppression in this situation. However if Serum ACTH is high after a positive low dose suppression , then you do High dose suppression test to determine whether its Cushing Disease (Cortisol Suppressed) or Lung Cancer(Cortisol Unchanged ). I like your channel though , from Pakistan.

[@ZeroToFinals]

Thanks for your comment Fahad. You are right!

[@faisalhaqparast357]

Now i understood from your comment

[@LostSmiler]

legend man. Thanks

[@adamjohnzon]

very helpful, thanks!

[@fahadafridi8173]

sher ye sher

[@davidoconnor4028]

made everything so much clearer, thank you

[@meliketopaloglu3308]

Oh wow, you are making everything so easy , thank you so much, I did not even have internet during my medical school , I wish I had and watched you 🙌🏼

[@s101077]

🙌🏼

[@krisshassebrock7518]

Finally I'm getting the answers to my questions!! Thank you so very much

[@ZeroToFinals]

No problem, glad to help Kriss

[@abifarinopeyemi1688]

This was broken down to bits and really helpful. Thank you.

[@ZeroToFinals]

Glad it was helpful!

[@iqrakanwal6438]

Best explanation of Dexamethasone Suppression Test I have ever come across.
Cheers.

[@ZeroToFinals]

Wow, that great feedback!

[@Shubham-td9yz]

This was easy to understand.... thanks for making it crystal clear 😇

[@amymunro1419]

This is such a great explanation of the test - thank you!

[@leenahmed147]

The summary at the end was so helpful, Thank you!

[@reemabdelhay3497]

Amazing video.. I can’t believe that I understand it finally.. lots of love and support.. keep up the good work 🎉❤

[@funmiade575]

I am truly enjoying these videos. Thank you so much.

[@ZeroToFinals]

Thanks again. I'm going to keep making them!

[@KrissAstronomist]

A great explanation, thank you!

[@champikasam]

Thanks for the detailed explanation. keep up the good work!

[@ZeroToFinals]

Will do!

[@deevanshirathore2730]

Thank you so much, was super confused and now all clear mind, thank you

[@marcotayala]

Nice vídeo, very interesting and educational. Now I understand better this system.

[@amanchauhan7934]

Simple, to the point and perfect

[@Dj2anime]

Awesome explanation! It was simple and easy to follow - I can actually wrap my head around it now :D

[@preeshillashibchurn3847]

Finallyy a video that helped me to understand DMST.. thank you..very helpful😊

[@ZeroToFinals]

no problem Preeshilla, glad you liked it!

[@lightadetoun796]

Wow! As clear as you cam ever have it!!! Brilliant 👍. Thank you very much

[@adissabooz7131]

Muchas gracias, súper práctico y explícito!!! I like it

[@sameeragunasekara2785]

Nicely & simply explained 👍thank you

[@safayounis2762]

Awesome video, helpful and to the point! thank you

[@user-sw6hl1dd2x]

I just cant really believe l understood it specially after all these years of graduation.. Really thank u so much

[@stalinthomas8187]

Simplified the test in a beautiful way.... Congrats

[@ZeroToFinals]

Thanks!

[@Bambii348]

Thank you, made it so easy to understand!

[@kmysl2219]

Perfect explanation. Thank you!

[@keanutax4951]

This is a very good and simple video, thanks!!

[@ZeroToFinals]

Thanks Keanu!

[@muhammadyaqoob877]

Your way of teaching is outstanding

[@ZeroToFinals]

Thank you!

[@34.muhammadhusnulhakimibin76]

''Wah thank you, already include the summary in my slide this week for my presentation on pituitary gland pathology to my beloved students from Malaysia'' -Dr. Asawari Sant.

[@kyizinthant6097]

Thank u. You make it easier to understand. ❤️

[@ZeroToFinals]

Thanks, I'm glad to have helped

[@robinhall3426]

Excellent video and explanation!

[@ayameziane2172]

tysm for this amazing clear explanation !!

[@abdulazizalhowaish2692]

Thank you for the video, it's very helpful to understand the dexamethasone suppression test.

[@ZeroToFinals]

glad to help!

[@SBASAK25071996]

amazing!! understood at one go! brilliant teaching❤

[@ikhlas9569]

Thank you sooooo much!!!! very well explained!!

[@AhmedHassan7807]

Thank u so much. Finally, I understood it.❤❤

[@Wanos-zw9sf]

OmG thank you sooooo much I was dying with this test .. you r my hero . Thanks alot

[@wafawiwi460]

this was very helpful thank you

[@felipevergara4894]

Thanks you very much, very clear your video, it help to understand very good diferents tests, cheers from Arngentina.

[@reemsulaiman6796]

this video saved my life. thank you so much

[@trafficjon400]

Steroid Dexamethisone put many in a dark place of sevier Depression. a very nice Girl on You tube is still suffering from this 4 years and suicidal. Cushings and all the symtems these horible steroids can cause.

[@moeyousef9006]

thanks for the video
it was really helpful

[@biiiaNcaXD]

Thanks for this! Great video!

[@NehaShaikh21]

Thank you so much
Really couldn't get it until now

[@jaredwainwright4621]

what a wonderful video. this med student thanks you

[@mycah1993]

Thank you! You're the best!

[@almostawhisper1990h]

Very helpful! Thank you so much ❤

[@chogabykyu]

Thank you so much for this.

[@ak3143]

great explanation, thank you!!

[@dewisartika9990]

thank you so much, so helpful!!

[@muhammadwali203]

Awesome explanation!

[@wobbyyy]

Thank you for this video!

[@Arpit4063]

Very comprehensive video. 👍

[@fatimab6064]

Thank you great job!

[@wangharry1893]

Very helpful! 非常有幫助

[@natarajumididoddi5985]

Lot clearer.big thanks

[@TahmidRahman]

Really good explanation !

[@lukwagonicholas1305]

Thank you Dr. Tom.

[@hanhane0]

thank you so much for this! really helpful

[@ZeroToFinals]

Glad to help

[@inaduttagupta5747]

Made me understand so well ❤

[@betrugerzbovorni2443]

thank you. loved it!

[@sashwattarenia258]

excellent explanation

[@blastoff2moon429]

Really helpful thank you so much 🙏

[@halimasaleh6870]

thank you may god bless y'all

[@darkmoon3646]

Thankyou man, may god bless u!

[@rachaelk196]

Thanks for this upload. Very helpful

[@ZeroToFinals]

Glad to help

[@Halamaya_biker]

Love your explanation thank you ❤️

[@ZeroToFinals]

Thanks! I'm glad it helped

[@ManuSidhuMD]

Incredibly clear, informative, helpful and easy to understand - perfectly explained. Thanks very much.

[@michaelgilman4068]

Tom, thank you. I so appreciate your instruction. Will you please explain how a high dose of Dexamethasone affects an a pituitary tumor? Why would the tumor "care"? Is it that the suppression of CRH from hypothalamus and ACTH from normal pituitary gland cells result in a net reduction.of ACTH and there a reduction in cortisol? And when you say cortisol is "reduced" does this mean less than it's initial high level but perhaps still > normal, does it mean a < normal level? Thanks again.
Michael Gilman PA-C, Cape Cod. Massachusetts

[@sadiasiddiqi6011]

Great job!

[@As-ht5rw]

Crystal Clear. Thank you.
When I saw over 7min I skipped to a shorter video...then to another shorter video then..... another shorter video as.
I have not clearly been convinced that I understood it... So I went back to your video....
I would have saved time by listening to my gut feeling and just watched your video. It was crystal clear. Thank you.💌

[@m.eldadar617]

very helpful, thanks

[@hichembennaoum8871]

that guy is my new superhero ! ..god bless u !

[@ZeroToFinals]

awesome!

[@reznof2011]

What a lovely explanation

[@ZeroToFinals]

thanks johnny!

[@williamwang9536]

this is amazing thanks so much

[@haniehrezaei7914]

Wooow,great. As a nurse I couldn't get it until I watched this video

[@abdoomni]

Thanks .. made it simple

[@drosmanzahmil1130]

Best explanation 😍keep it up

[@GujjuDoctor]

YOU are amazing. Thank you. Love From INDIA :)

[@azahgabralla4876]

Thank you

[@CS-kb6by]

Best explanation on the internet

[@ZeroToFinals]

wow, thanks!

[@AnitAPescadO97]

super clear sos un capo gracias

[@freddiespinoza]

Excellent!

[@khaoulabouchene]

Thank you so much

[@naihouyly2683]

Thanks for your good explanation

[@ZeroToFinals]

Glad it was helpful!

[@iamthebestyesyes]

Thanks its really mean to me

[@FaisaloOZ]

Brilliant Mate Brilliant 👍👍👍

[@jediknightsharma9861]

What effect does low dose test have on ectopic ACTH or adrenal adenoma?

[@mushchannel6925]

There is no one better than Tom!!!

[@ZeroToFinals]

Haha thanks 😊

[@isamararriagada2351]

You are the best !!! All understood :)

[@ZeroToFinals]

Thanks Isamar!

[@dnrevan778]

Thank you!

[@bindu3384]

Thank you somuch 🐙🙏🏼

[@smilyyyflower175]

Big thanks 🙏🏼

[@alhornz]

awesome job cheers

[@daliahassawi4435]

great job, thanks!

[@trafficjon400]

Suicides are high from injecting this drug.

[@sowshanmostafa3671]

Beautiful!