Reference or Target Ranges

Comment 2:

A rise from the baseline of at least 7 ug/dL to 10 ug/dL of cortisol, reaching at least 18 ug/dL at 60 minutes post stimulation effectively rules out primary adrenal insufficiency and suggests that adrenal suppression is minimal. A blunted or absent response suggests some level of secondary adrenal insufficiency (cortical atrophy or significant suppression.) If a subnormal response is obtained with an elevated baseline ACTH level, the patient has primary adrenal insufficiency or a form of ACTH unresponsiveness. A subnormal response with a low baseline ACTH level suggests CRF (corticotrophin releasing factor) and/or ACTH deficiency of hypothalamic and/or pituitary origin. Prior administration of estrogens, spironolactone, cortisone, and hydrocortisone (cortisol) can all interfere with the ACTH stimulation test by causing abnormally high baseline cortisol levels.