ACTH stimulation test

This episode of Endocrine Deep Dives explores the diagnostic nuances of the adrenocorticotropic hormone stimulation test. We break down how this core dynamic assay differentiates primary adrenal insufficiency from secondary adrenal insufficiency by evaluating cortisol reserve. The discussion covers standard two hundred fifty microgram protocols, limitations in early pituitary disease, and the clinical utility of baseline morning cortisol and dehydroepiandrosterone sulfate. Finally, we analyze critical updates to assay-specific diagnostic cutoffs required by modern monoclonal testing platforms.