Abstract
Adrenocorticotropic hormone stimulation testing is used to diagnose adrenal insufficiency. Synthetic adrenocorticotropic hormone (cosyntropin) is administered, and cortisol levels are checked at baseline, 30 minutes, and 60 minutes. A peak cortisol threshold of 18 μg/dL is considered passing. In 2019, many cortisol assays shifted to more sensitive methods, resulting in lower cortisol values, which suggest modification of passing thresholds. We reviewed pass/fail rates by time point/threshold in 186 consecutive patients for cosyntropin stimulation tests using new assays and found that interpreting the results with a suggested lower threshold of 14 μg/dL shows significantly higher pass rates and, likewise, suggests the 60-minute assay adds minimal benefit.
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