Cah Panel 3
Cah Panel 3 is a multi-marker blood test panel for adrenal steroid pathways, cortisol balance, and related hormones—useful for complex endocrine patterns.
This panel bundles multiple biomarker tests in one order—your report explains how results fit together.
Cah Panel 3 is a lab panel, meaning you get multiple hormone and adrenal steroid markers from one blood draw. It is designed for situations where a single cortisol value (or a single androgen value) does not explain your symptoms or your prior lab pattern, and you need to see how the steroid pathway is behaving as a whole.
Do I need this panel?
You may consider Cah Panel 3 if your symptoms or prior labs point toward an adrenal or steroid-hormone pathway issue and you keep running into “one number doesn’t explain it.” Common reasons include persistent fatigue, dizziness or low blood pressure symptoms, unexplained weight change, acne or unwanted hair growth, irregular periods, low libido, or mood and sleep disruption—especially when basic thyroid and iron testing has already been addressed.
This panel is also reasonable if you have a history of congenital adrenal hyperplasia (CAH), are being evaluated for possible nonclassic CAH, or you are monitoring treatment that affects steroid production (for example, glucocorticoids, certain anti-androgen approaches, or fertility-related hormone therapy). It can help clarify whether your results fit a pattern of altered cortisol production, altered androgen production, or a shift in precursor hormones upstream of those endpoints.
Because this is a multi-marker panel, it is most useful when you plan to interpret results as a pattern rather than chasing a single “high” or “low” flag. Your results should support clinician-directed care and shared decision-making, not self-diagnosis or medication changes on your own.
This panel uses standard blood-based immunoassay and/or mass spectrometry methods depending on the specific analyte; reference ranges and optimal targets can vary by lab and clinical context.
Lab testing
Order Cah Panel 3 through Vitals Vault
Schedule online, results typically within about a week
Clear reporting and optional clinician context
HSA/FSA eligible where applicable
Get this panel with Vitals Vault
Vitals Vault helps you order advanced lab panels and then make sense of the full report in plain language. With a pathway-style panel like Cah Panel 3, the value is not just getting numbers—it is understanding how the markers relate to each other (precursors → intermediates → end hormones) and what patterns are most consistent with stress physiology, medication effects, or inherited enzyme differences.
After you test, you can use PocketMD to organize your results into a coherent story: what looks like a cortisol production issue versus a timing issue, what looks like androgen excess versus altered binding proteins, and which follow-up questions are worth asking before you repeat labs or consider dynamic testing.
If you are tracking a known condition or treatment, repeating the same panel over time can be more informative than switching to a different set of markers each draw. Trend data helps you see whether changes are real or just day-to-day variation.
- One blood draw can capture multiple adrenal and sex-steroid pathway markers
- Designed for pattern interpretation (not single-number guessing)
- PocketMD can help you summarize results and plan next steps to discuss with your clinician
- Useful for retesting to track trends over time
Key benefits of Cah Panel 3
- Shows adrenal steroid pathway patterns across precursors, cortisol-related markers, and androgens in one panel.
- Helps evaluate possible classic or nonclassic CAH patterns when symptoms and basic labs are inconclusive.
- Adds context to cortisol results by pairing them with upstream and downstream steroid markers.
- Supports treatment monitoring when therapies can shift steroid production (for example, glucocorticoids or anti-androgen strategies).
- Reduces overinterpretation of a single flagged value by highlighting consistent multi-marker patterns.
- Can clarify whether androgen-related symptoms are more consistent with adrenal contribution versus other causes.
- Creates a baseline you can repeat to assess direction of change rather than relying on a one-time snapshot.
What is the Cah Panel 3 panel?
Cah Panel 3 is a blood test panel that measures multiple hormones involved in adrenal steroid production and related androgen pathways. Instead of focusing on one hormone, the panel looks at several points along the steroid “assembly line,” where cholesterol is converted into glucocorticoids (like cortisol), mineralocorticoids (like aldosterone-related pathways), and androgens (like DHEA-S, androstenedione, and testosterone).
This matters because many endocrine questions are not answered by a single endpoint hormone. If an enzyme step is slower (as in some forms of congenital adrenal hyperplasia), precursor hormones can build up and “spill” into other pathways. The result can be a recognizable pattern: certain precursors rise, downstream products may be low or normal, and androgen markers may be elevated.
A panel approach is also helpful because cortisol biology is complicated. Cortisol varies by time of day, sleep, illness, and medications. A single morning cortisol can be normal even when your broader steroid pattern suggests altered regulation, and a single low value can be misleading if timing, binding proteins, or acute stressors are not considered.
Your clinician may use this panel as part of a broader evaluation that can include electrolytes, renin/aldosterone testing, thyroid markers, glucose/insulin markers, and—when appropriate—dynamic testing (such as ACTH stimulation) rather than relying on one baseline blood draw.
What do my panel results mean?
When several markers in the panel are low
A “low pattern” across Cah Panel 3 often means multiple steroid outputs are lower than expected for your situation—such as lower cortisol-related markers alongside lower adrenal androgen markers. This can happen with certain medications (especially glucocorticoids), with suppression of the hypothalamic-pituitary-adrenal (HPA) axis, or during recovery from illness or prolonged stress where your body is downshifting output. Interpretation depends heavily on timing of the blood draw, symptoms, and whether upstream precursors are also low (suggesting overall reduced production) versus elevated (suggesting a bottleneck at a specific enzyme step). If your results show broad lows, it is usually more useful to ask “what is suppressing the pathway?” than to focus on one isolated value.
When the panel shows a balanced, internally consistent pattern
An “optimal” panel pattern is less about one perfect number and more about internal consistency: precursors are not disproportionately elevated, cortisol-related markers fit the timing of the draw, and androgen markers align with your sex, age, and clinical context. In this pattern, the steroid pathway does not look like it is being forced down an alternate route, and there is no obvious signal of excess precursor buildup. If you still have symptoms, a balanced panel can be helpful because it shifts the next step toward other contributors (sleep, thyroid, iron status, insulin resistance, inflammation, medications, or mental health) rather than repeatedly retesting the same adrenal markers without a new hypothesis.
When several markers are high or precursors are disproportionately elevated
A “high pattern” can look different depending on which parts of the pathway are elevated. If upstream precursors (such as 17-hydroxyprogesterone) are high relative to downstream products, it can suggest a bottleneck pattern that may be seen in CAH-related physiology and is often evaluated further with clinical history and, when appropriate, dynamic testing. If adrenal androgen markers (such as DHEA-S or androstenedione) are high, the pattern may align with androgen-excess symptoms like acne, hair changes, or cycle disruption, but you still need context from other hormones and from the degree of elevation. If cortisol-related markers are high, acute stress, poor sleep, pain, illness, and certain medications can be major drivers—so the most important question becomes whether the elevation is persistent and pattern-consistent or a one-time snapshot.
Factors that influence Cah Panel 3 results
Steroid hormones are sensitive to timing and context. Time of day, sleep quality, recent illness, intense exercise, pain, and psychological stress can shift cortisol-related results. Medications and hormones can strongly affect the panel, including glucocorticoids (which can suppress ACTH-driven production), oral estrogen (which can change binding proteins and alter total hormone measurements), androgen therapy, some anticonvulsants, and certain supplements. Menstrual cycle phase, pregnancy, and postpartum status can also change baseline expectations. Finally, the most common interpretation mistake is treating each marker as independent; this panel is meant to be read as a pathway, where the ratio and relationship between precursors and end hormones often matters more than a single flagged result.
What’s included in this panel
- 11 Deoxycortisol
- 17 Hydroxyprogesterone
- 18 Hydroxycorticosterone
- Aldosterone, Lc/Ms/Ms
Frequently Asked Questions
Is Cah Panel 3 one test or multiple tests?
It is a lab panel. You get multiple hormone and steroid markers reported together from one blood draw, so you can interpret the adrenal steroid pathway as a pattern.
Do I need to fast for this panel?
Fasting is not always required for steroid hormones, but your ordering instructions matter because some companion markers (and your overall plan for the draw) may be affected by food, caffeine, or timing. If you are combining this panel with metabolic labs, fasting is commonly recommended. Follow the collection instructions you receive with your order.
What time of day should I get Cah Panel 3 drawn?
Timing can change interpretation, especially for cortisol and ACTH. Many clinicians prefer a morning draw (often around 8 a.m.) for baseline comparisons, but the “best” time depends on your symptoms, sleep schedule, and what question you are trying to answer. If you work nights or have an atypical sleep pattern, tell your clinician so results are interpreted appropriately.
How is this different from a salivary cortisol test?
Salivary testing is often used to look at diurnal (across-the-day) cortisol patterns, while this panel is a blood-based snapshot that also includes multiple steroid pathway markers beyond cortisol. If your main question is daily rhythm, saliva or other timed approaches may be more informative; if your question is pathway mapping (precursors and androgens), a blood panel can be a better fit.
Can this panel diagnose congenital adrenal hyperplasia (CAH)?
This panel can support evaluation by showing patterns that may be consistent with CAH physiology (for example, elevated precursor hormones), but diagnosis typically requires clinical correlation and may involve confirmatory testing such as an ACTH stimulation test and/or genetic evaluation depending on the case.
Why do I have one high value when everything else looks normal?
Single outliers are common in hormone testing. Timing, recent stress, sleep disruption, supplements, and medications can shift one marker without changing the overall pathway. A useful next step is to look for consistency: do related markers move in the same direction, and does the pattern repeat on a properly timed retest?
Is it better to order these hormones individually instead of as a panel?
If you already have a clear, narrow question (for example, monitoring one known abnormal marker), individual tests can be efficient. If your situation is complex or you are trying to understand the pathway, a panel can be more cost- and time-effective because it reduces the risk of missing the key upstream or downstream marker that explains the pattern.