Sample: Collect blood in the morning, in ice immersed EDTA tube (serum is not suitable). Separate 1 mL of plasma in refrigerated centrifuge and freeze immediately. Store frozen at -20°C in plastic tubes. Transport frozen specimen to the laboratory in dry-ice following collection.
Requirements: Because of possible strong side effects of cosyntropin this test should be performed in a center with adequate medical emergency support. Follow physicians complementary particular indications.
Dose: Cosyntropin 250 μg I.V. or I.M.
Range: Cortisol level is measured 30 and 60 min after ACTH stimulator administration (See insert of the cosyntropin for details)
Remarks: The ACTH stimulation test assesses the functional integrity of the adrenal glands and their sensitivity to ACTH stimulation with Cosyntropin (Synacthen®, Cortrosyn®), a synthetic ACTH-homologue peptide: patients with primary adrenal insufficiency fail to reach significant high serum cortisol levels after ACTH stimulation.