II. Indications

  1. Adrenal Insufficiency evaluation
  2. Serum Cortisol 8am level decreased

III. Technique

  1. Obtain Baseline Labs
    1. Plasma Adrenocorticotropic Hormone (ACTH) Level
    2. Serum Cortisol level
    3. Plasma Aldosterone
    4. Plasma renin activity
  2. Administer cosyntropin (ACTH)
    1. Administer ACTH 250 mcg IV
  3. Repeat Serum Cortisol
    1. Obtain Serum Cortisol at 30 and 60 minutes after IV ACTH

IV. Interpretation

  1. Low Cortisol level (<18 mcg/dl) and high plasma ACTH (>50 pg/ml)
    1. Primary Adrenal Insufficiency
  2. Low Cortisol level (<18 mcg/dl) and low plasma ACTH
    1. Secondary Adrenal Insufficiency

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English adrenocorticotropic hormone stimulation panels, ACTH stimulation panels, adrenocorticotropic hormone stimulation panels (lab test), ACTH stimulation panel