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The ACTH test (also called the cosyntropin, tetracosactide, or Synacthen test) is a medical test usually requested and interpreted by endocrinologists to assess the functioning of the adrenal glands' stress response by measuring the adrenal response to adrenocorticotropic hormone (ACTH; corticotropin) or another corticotropic agent such as tetracosactide (cosyntropin, tetracosactrin; Synacthen ...
Low-dose and high-dose variations of the test exist. [4] The test is given at low (usually 1–2 mg) and high (8 mg) doses of dexamethasone, and the levels of cortisol are measured to obtain the results. [5] A low dose of dexamethasone suppresses cortisol in individuals with no pathology in endogenous cortisol production.
The timing of these changes also varies by substance. Levels of serum cortisol, prolactin, and ACTH peak immediately after the end of stress induction, but salivary cortisol peaks 10 minutes later and hGH peaks 40 minutes later. These effects were found in more than 70% of the participants. [1] Heart rate is also an indicator of stress.
Urinary free cortisol can also be measured, but are not necessary for diagnosis. [2] To determine the origin of dysfunction, the ACTH stimulation test is the best initial test as it can differentiate between primary and secondary adrenal insufficiency. [2] If cortisol levels remain low following ACTH stimulation, then the diagnosis is primary ...
Test results should, therefore, always be interpreted using the reference range from the laboratory that produced the result. [57] [58] [59] An individual's cortisol levels can be detected in blood, serum, urine, saliva, and sweat. [60]
Evocative/suppression testing refers to a class of tests performed where one substance is measured both before and after the administration of another substance to determine if the levels are stimulated ("evocative") or suppressed.
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