ACTH stimulation test: MedlinePlus Medical Encyclopedia
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`ACTH stimulation test
`The ACTH stimulation test measures how well the adrenal glands respond to adrenocorticotropic
`hormone (ACTH). ACTH is a hormone produced in the pituitary gland that stimulates the adrenal
`glands to release a hormone called cortisol.
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`How the Test is Performed
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`The test is done the following way:
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`• Your blood is drawn.
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`• You then receive a shot (injection) of ACTH, usually into the muscle in your shoulder. The
`ACTH may be a man-made (synthetic) form.
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`• After either 30 minutes or 60 minutes, or both, depending on how much ACTH you receive,
`your blood is drawn again.
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`• The lab checks the cortisol level in all the blood samples.
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`You may also have other blood tests, including ACTH, as part of the first blood test. Along with
`the blood tests, you may also have a urine cortisol test or urine 17-ketosteroids test, which
`involves collecting the urine over a 24-hour period.
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`How to Prepare for the Test
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`You may need to limit activities and eat foods that are high in carbohydrates 12 to 24 hours
`before the test. You may be asked to fast for 6 hours before the test. Sometimes, no special
`preparation is needed. You may be asked to temporarily stop taking medicines, such as
`hydrocortisone, which can interfere with the cortisol blood test.
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`How the Test will Feel
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`When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a
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`prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.
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`The injection into the shoulder may cause moderate pain or stinging.
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`Some people feel flushed, nervous, or nauseated after the injection of ACTH.
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`Why the Test is Performed
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`This test can help determine whether your adrenal and pituitary glands are normal. It is most
`often used when the doctor thinks you have an adrenal gland problem, such as Addison disease,
`or pituitary insufficiency. It is also used to see if your pituitary and adrenal glands have recovered
`from prolonged use of glucocorticoid medicines, such as prednisone.
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`Normal Results
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`An increase in cortisol after stimulation by ACTH is normal. Cortisol level after ACTH stimulation
`should be higher than 18 to 20 mcg/dL, depending on the dose of ACTH used.
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`Normal value ranges may vary slightly among different laboratories. Some labs use different
`measurements or may test different specimens. Talk to your doctor about the meaning of your
`specific test results.
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`What Abnormal Results Mean
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`This test is helpful in finding out if you have:
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`• Acute adrenal crisis (life-threatening condition that occurs when there is not enough cortisol)
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`• Addison disease (adrenal glands do not produce enough cortisol)
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`• Hypopituitarism (pituitary gland is not producing enough hormones such as ACTH)
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`Risks
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`Veins and arteries vary in size from one person to another and from one side of the body to the
`other. Obtaining a blood sample from some people may be more difficult than from others.
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`Other risks associated with having blood drawn are slight but may include:
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`• Excessive bleeding
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`• Fainting or feeling lightheaded
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`• Hematoma (blood accumulating under the skin)
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`• Infection (a slight risk any time the skin is broken)
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`Alternative Names
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`Tests of adrenal reserve; Cosyntropin stimulation test; Cortrosyn stimulation test; Synacthen
`stimulation test; Tetracosactide stimulation test
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`References
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`Barthel A, Willenberg HS, Gruber M, Bornstein SR. Adrenal insufficiency. In: Jameson JL, De
`Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA:
`Elsevier Saunders; 2016:chap 102.
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`Chernecky CC, Berger BJ. ACTH stimulation test - diagnostic. In: Chernecky CC, Berger BJ, eds.
`Laboratory Tests and Diagnostic Procedures. 6th ed. Philadelphia, PA: Elsevier Saunders;
`2013:98.
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`Stewart PM, Newell-Price JDC. The adrenal cortex. In: Melmed S, Polonsky KS, Larsen PR,
`Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier
`Saunders; 2016:chap 15.
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`Update Date 10/28/2015
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`Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism,
`Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also
`reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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`Page last updated: 28 September 2016
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`https://medlineplus.gov/ency/article/003696.htm
`
`9/30/2016
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