Blood glucose, lactate, are followed every 4 minutes.
ECG, an orthostatic blood pressure test and a the ergo-spirometry test are performed before the subject is asked to do the exercise test, a cycling maximum test. A venous catheter is used for blood sampling during the exercise. They are asked not to eat for 6 hours or drink any coffe during the day before the test. A subgroup of study subjects are invited to perform an ergo-spirometri test followed by the exercise test at the hospital. A link to the survey, expected to take 30 - 60 minutes to complete, is mailed to to the subjects.
Investigate if psychological and somatic stress symptoms are related to the epinephrine production capacity.ĭiagnostic Test: physical exercise as a standardized high intensity exercise test Behavioral: Stress vulnerabilityĪfter written informed consent study subjects, patients and controls, are invited to fill in a web based survey with the validated questionnaires. Correlate the results to severity of disease, CYP21A2 genotype. Assess stress vulnerability and anxiety using validated questionnaires. Analyse the epinephrine/adrenalin production in patients with CAH using measurements of epinephrine and metanephrine in blood, during an exercise test. We aim to investigate if the deficient epinephrine production can be confirmed and if it is related to the increased level of anxiety and vulnerability to stress that we observe in the patients. This may render various types of difficulties in the individual's life. Glucocorticoid treatment and stress dosing cannot compensate fully during physical stress neither for the reaction to psychological stress. Stress dosing is essential in situations of increased physical stress such as infections with fever for example. Individuals with CAH have an increased risk of developing hypoglycemia because both cortisol and epinephrine are important counter regulatory hormones. 
This can be correlated to the CYP21A2 genotype and is most pronounced in the classic forms. Individuals with CAH produce lower levels of epinephrine (adrenalin) than controls. Why Should I Register and Submit Results?.
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