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HelpTest ID: LH Luteinizing Hormone (LH), Serum
Reporting Name
Luteinizing Hormone (LH), SUseful For
An adjunct in the evaluation of menstrual irregularities
Evaluating patients with suspected hypogonadism
Predicting ovulation
Evaluating infertility
Diagnosing pituitary disorders
Clinical Information
Luteinizing hormone (LH) is a glycoprotein hormone consisting of 2 noncovalently bound subunits (alpha and beta). The alpha subunit of LH, follicle-stimulating hormone (FSH), thyrotropin (formerly known as thyroid-stimulating hormone), and human chorionic gonadotropin (hCG) are identical and contain 92 amino acids. The beta subunits of these hormones vary and confer the hormones' specificity. LH has a beta subunit of 121 amino acids and is responsible for interaction with the LH receptor. This beta subunit contains the same amino acids in sequence as the beta subunit of hCG, and both stimulate the same receptor; however, the hCG-beta subunit contains an additional 24 amino acids, and the hormones differ in the composition of their sugar moieties. Gonadotropin-releasing hormone from the hypothalamus controls the secretion of the gonadotropins, FSH, and LH, from the anterior pituitary.
In both male and female populations, LH is essential for reproduction. In girls and women, the menstrual cycle is divided by a midcycle surge of both LH and FSH into a follicular phase and a luteal phase. This "LH surge" triggers ovulation thereby not only releasing the egg, but also initiating the conversion of the residual follicle into a corpus luteum that, in turn, produces progesterone to prepare the endometrium for a possible implantation. LH is necessary to maintain luteal function for the first 2 weeks. In case of pregnancy, luteal function will be further maintained by the action of hCG (a hormone very similar to LH) from the newly established pregnancy. LH supports thecal cells in the ovary that provide androgens and hormonal precursors for estradiol production. LH in boys and men acts on testicular interstitial cells of Leydig to cause increased synthesis of testosterone.
Interpretation
In both male and female patients, primary hypogonadism results in an elevation of basal follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels.
Postmenopausal LH levels are generally above 40 IU/L.
FSH and LH are generally elevated in:
-Primary gonadal failure
-Complete testicular feminization syndrome
-Precocious puberty (either idiopathic or secondary to a central nervous system lesion)
In female patients:
-Menopause
-Primary ovarian hypodysfunction
-Polycystic ovary disease
In male patients:
-Primary hypogonadism
LH is decreased in:
-Primary ovarian hyperfunction in female patients
-Primary hypergonadism in male patients
FSH and LH are both decreased in failure of the pituitary or hypothalamus.
Report Available
Same day/1 to 3 daysDay(s) Performed
Monday through Sunday
Clinical Reference
1. Kaplan LA, Pesce AJ. The gonads. In: Kazmierczak SC, ed. Clinical Chemistry: Theory, Analysis, and Correlation. 3rd ed. Mosby-Year Book, Inc; 1996:894
2. Dumesic DA. Hyperandrogenic anovulation: a new view of polycystic ovary syndrome. Postgrad Ob Gyn. 1995;15:1-5
3. Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018
Method Name
Electrochemiluminescence Immunoassay
Specimen Type
SerumOrdering Guidance
1. The limit of quantitation for this test is 0.01 IU/L. In pediatric settings where greater analytical sensitivity is required, order LHPED / Luteinizing Hormone (LH), Pediatrics, Serum.
2. The preferred test to confirm menopausal status is FSH / Follicle-Stimulating Hormone (FSH), Serum.
Specimen Required
Patient Preparation: For 12 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 7 days | |
| Frozen | 180 days | ||
| Ambient | 24 hours |
Reference Values
Males
≤4 weeks: Not established
>1 month-≤12 months: ≤0.4 IU/L
>12 months-≤6 years: ≤1.3 IU/L
>6-≤11 years: ≤1.4 IU/L
>11-≤14 years: 0.1-7.8 IU/L
>14-≤18 years: 1.3-9.8 IU/L
>18 years: 1.3-9.6 IU/L
Females
≤4 weeks: Not established
>1-≤12 months: ≤0.4 IU/L
>12 months-≤6 years: ≤0.5 IU/L
>6-≤11 years: ≤3.1 IU/L
>11-≤14 years: ≤11.9 IU/L
>14-≤18 years: 0.5-41.7 IU/L
Premenopausal:
Follicular: 1.9-14.6 IU/L
Midcycle: 12.2-118.0 IU/L
Luteal: 0.7-12.9 IU/L
Postmenopausal: 5.3-65.4 IU/L
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
83002
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| LH | Luteinizing Hormone (LH), S | 10501-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| LH | Luteinizing Hormone (LH), S | 10501-5 |
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.
mml-adrenal-gonad-pituitary