Cortisol Stimulation

Cosyntropin Stimulation

Evaluation of possible primary or secondary adrenal insufficiency, as well as disorders of adrenal steroid biosynthesis, such as congenital adrenal hyperplasia .

Although it may make more physiologic sense to perform the test during the nadir of endogenous ACTH production (around midnight) it is usually performed at 8:00-9:00 AM for ease of collection and comparison to normative data that was collected during that time-frame.

Serum

Red, Li-heparin plasma

SST

SST - The patient may have a fat-free meal prior to testing.Draw blood for baseline cortisol. Inject cosyntropin 250 mcg IM or IV (if IV, dilute cosyntropin in 2-5 mL of sterile saline and inject over two minutes). If intramuscularly, 250 mcg for patient weight of greater than or equal to 37 pounds. If intravenously, dilute the cosyntropin in 2 mL to 5 mL of normal saline and inject over two minutes. Samples for analysis are collected 30 minutes and 60 minutes after administration of the cosyntropin. 

Please note: the collection of the 30-minute sample is at the physician's discretion.

Serum:
25 hours at 20-25˚C
4 days at 2-8˚C
12 months at -20˚C. Freeze only once.

Prior administration of estrogens, spironolactone, cortisone, and hydrocortisone (cortisol) can all interfere with the ACTH stimulation test by causing abnormally high baseline cortisol levels.

Electrochemiluminescence immunoassay ECLIA

0-2 days

Monday-Saturday

82533
82533

A rise in cortisol level to greater than 18 μg/dL of cortiso within 60 minutes demonstrates a normal result. A rise in cortisol to less than 18 ug/dL demonstrates an abnormal response.

Incyte Diagnostics

41407-8, 26530-6, 26528-0