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Variability in Cortisol Level Assay Methods-Reply

Victor S. Fang, PhD
Arch Gen Psychiatry. 1984;41(7):725. doi:10.1001/archpsyc.1984.01790180095018.
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In Reply.—  The response by Drs Rubin and Poland to our review article contained two discrepancies that deserve further comments. Although the human adrenal gland secretes cortisol as the major glucocorticoid, the other glucocorticoids, such as corticosterone, should not be totally ignored. The "excellent specificity of currently available antibodies for cortisol" is attractive for laboratory research, but may be less indicative for clinically assessment of adrenal function. To test adrenal response to dexamethasone for clinical evaluation, the competitive protein-binding assay is obviously a method of choice.Second, while Rubin and Poland disagree with us about the viability of determining the possible assay variability in each individual laboratory, they do extensively describe how they have performed the exact measures to set up their own end point for obtaining proper DST results. We, in fact, did not advocate a "perfect cortisol level determination." We did call attention to the necessity for standardizing the


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