Adrenocorticotropic Hormone (ACTH) Stimulation Test

Name of the Procedure:

Adrenocorticotropic Hormone (ACTH) Stimulation Test

• Common name: ACTH Stimulation Test
• Technical term: Cosyntropin stimulation test

Summary

The ACTH Stimulation Test involves measuring cortisol levels in your blood before and after an injection of synthetic ACTH. It helps diagnose adrenal gland disorders by assessing how well your adrenal glands respond to ACTH.

Purpose

The ACTH Stimulation Test is used to diagnose:

• Adrenal insufficiency (Addison's disease)
• Secondary adrenal insufficiency caused by pituitary dysfunction

The goal is to determine if your adrenal glands produce sufficient cortisol in response to ACTH, indicative of proper adrenal function.

Indications

• Symptoms such as fatigue, muscle weakness, weight loss, and low blood pressure
• Suspected adrenal gland or pituitary gland disorders
• Patients with critical illnesses affecting cortisol levels

Preparation

• Fasting may be required for a few hours before the test.
• Inform your healthcare provider of all medications you're taking; some may need to be adjusted or paused before the procedure.
• No strenuous activities before the test.

Procedure Description

1. Baseline Blood Sample: A blood sample is drawn to measure baseline cortisol levels.
2. ACTH Injection: An injection of synthetic ACTH (cosyntropin) is administered intravenously.
3. Post-Injection Blood Samples: Additional blood samples are taken at intervals (typically 30 and 60 minutes after injection) to measure cortisol levels.

• Tools: Syringes, IV catheter, blood collection tubes
• Anesthesia/Sedation: Not typically required

Duration

The entire test usually takes about 60-90 minutes.

Setting

• The procedure is typically performed in an outpatient clinic or hospital laboratory.

Personnel

• A nurse or lab technician will draw blood and administer the injection.
• A physician or endocrinologist may oversee the test.

Risks and Complications

• Minor risks include discomfort at the injection site or during blood draws.
• Rarely, allergic reactions to synthetic ACTH could occur.

Benefits

• Provides valuable information about adrenal gland function.
• Helps in diagnosing conditions requiring hormone replacement therapy or other treatments.

Recovery

• Post-procedure instructions typically involve resuming normal activities.
• There are usually no significant recovery concerns post-procedure.
• Follow-up appointments may be scheduled to discuss results.

Alternatives

• Other Hormone Tests: These might include different blood tests to measure additional hormone levels.
• Imaging Studies: CT or MRI scans can visualize adrenal or pituitary abnormalities.
• Pros/Cons: While alternative tests can provide supplementary information, they may not offer the direct functional insights an ACTH Stimulation Test provides.

Patient Experience

• The patient might experience mild discomfort from blood draws.
• The injection itself may cause slight discomfort.
• Overall, the procedure is minimally invasive and generally well-tolerated.
• Pain management measures include using a topical numbing agent if necessary.

By understanding and following these guidelines, patients can prepare themselves for an ACTH Stimulation Test, ensuring an accurate diagnosis and effective management of any adrenal-related disorders.