II. Indications
- Adrenal Insufficiency evaluation
- Serum Cortisol 8am level decreased
III. Technique
- Obtain Baseline Labs
- Plasma Adrenocorticotropic Hormone (ACTH) Level
- Serum Cortisol level
- Plasma Aldosterone
- Plasma renin activity
- Administer cosyntropin (ACTH)
- Administer ACTH 250 mcg IV
- Repeat Serum Cortisol
- Obtain Serum Cortisol at 30 and 60 minutes after IV ACTH
IV. Interpretation
- Low Cortisol level (<18 mcg/dl) and high plasma ACTH (>50 pg/ml)
- Primary Adrenal Insufficiency
- Low Cortisol level (<18 mcg/dl) and low plasma ACTH
- Secondary Adrenal Insufficiency