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Cortisol Stimulation Test

Additional Codes

Epic# -

LAB6114

 

Cerner name(s):

  • Cortrosyn Stimulation Battery
  • Cortrosyn Stimulation
  • Cortisol Stim

Performing Lab(s)

Memorial-Belleville & Memorial-Shiloh

Methodology

Quantitative Chemiluminescent Immunoassay

Specimen Requirement (s)

Specimen Type: plasma (preferred) or serum

Container/Tube:   mint green LiHep tube (preferred),  red top or SST (yellow or marble)

Specimen Volume:     5 mL

Specimen Minimum Volume:  1 mL

 

Collection Instructions:

1.   Draw specimen at 0- minutes

2.    Administer Cortrosyn 250 mcg intravenous (or intramuscular) at 0-minutes after drawing specimen.

3.    Draw additional specimens at 30- and 60-minutes.

4.     Label all specimens appropriately (corresponding draw times.)

5.     Send all specimens to the laboratory together.

 

Additional Information:

1. Draw times are required on each specimen and request form for processing.

2. Prednisone and prednisolone can interfere with this assay by causing a false-positive reaction.

3. Test performed is Cortisol, Plasma.

Day(s)/Shift(s) Test Set Up and Turnaround Time

Sunday through Saturday

Hours: 24 hours

 

Turnaround Time:

STAT: No

Routine: less than 8 hours from receipt.

Transport and Stability

Transport temperature: Ambient to lab

 

Analyte Stability: 

Ambient: 1 week

Refrigerated: 5 days

Frozen: 3 months

Interpretive Data

Interpretive Data
Reference Values
Cortisol cutoff of 14-15 ug/dL for cortrosyn stimulation testing.
Lack of normal response can be seen in both primary and secondary adrenal failure. Some patients with secondary adrenal failure have normal response to cortrosyn. If pituitary disease is known or strongly suspected e.g. after pituitary surgery), the cortrosyn test alone should not be relied on to exclude adrenal failure.
 
Literature References:
Javorsky BR, Raff H, Carroll TB, et al. New cutoffs for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation using specific cortisol assays. J Endocr Soc. 2021;5(4):bvab022.
Carson JLP and Gronowski AM. New cutoffs for the biochemical diagnosis of Adrenal insufficiency after ACTH stimulation using specific cortisol assays. J. Endocrine Soc 2021;5:1-2.

Current interpret data was last revised 07/25/24