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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 ...
The dexamethasone suppression test (DST) is used to assess adrenal gland function by measuring how cortisol levels change in response to oral doses or an injection of dexamethasone. [1] It is typically used to diagnose Cushing's syndrome .
An insulin tolerance test (ITT) is a medical diagnostic procedure during which insulin is injected into a patient's vein, after which blood glucose is measured at regular intervals. This procedure is performed to assess pituitary function, adrenal function, insulin sensitivity , [ 1 ] [ 2 ] and sometimes for other purposes.
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.
Schematic of the HPA axis (CRH, corticotropin-releasing hormone; ACTH, adrenocorticotropic hormone) Hypothalamus, pituitary gland, and adrenal cortex The hypothalamic–pituitary–adrenal axis (HPA axis or HTPA axis) is a complex set of direct influences and feedback interactions among three components: the hypothalamus (a part of the brain located below the thalamus), the pituitary gland (a ...
The layers of the adrenal gland differ by function, with each layer having distinct enzymes that produce different hormones from a common precursor. [4] The first enzymatic step in the production of all steroid hormones is cleavage of the cholesterol side chain, a reaction that forms pregnenolone as a product and is catalyzed by the enzyme ...
Insulin tolerance testing is widely regarded as the gold standard for assessing the entire hypothalamic-pituitary-adrenal axis. [2] A high-dose ACTH stimulation test directly evaluates the adrenal secretory reserve, which can be compromised not only in primary adrenal insufficiency but also in long-term ACTH deficiency. [2]
Congenital adrenal hyperplasia, diseases in the production of cortisol; Nelson's syndrome, the rapid enlargement of the ACTH producing pituitary after the removal of both adrenal glands; Adrenoleukodystrophy, can be accompanied by adrenal insufficiency; West syndrome ("infantile spasms"), a disease where ACTH is used as a therapy
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