Traditional ACTH Stimulation Test


Diagnosis of adrenal insufficiency

1. Baseline serum cortisol and ACTH levels
2. Inject 250 mcg cosyntropin (ACTH) intravenously or IM
3. 30 and 60 minute cortisol levels

A rise in cortisol level to greater than 18 ug/dl within 60 minutes demonstrates a normal result. A rise in cortisol to less than 18 ug/dl demonstrates an abnormal response. If the adrenal glands do not adequately stimulate to cosyntropin (ACTH), the patient has suppressed adrenal glands. An elevated baseline ACTH level suggests primary adrenal failure.