Adrenal Insufficiency Testing: ACTH and Cortisol Blood Levels
In patients suspected of having an
addisonian crisis, the doctor must begin treatment with injections of salt, fluids, and glucocorticoid hormones immediately. Although a reliable diagnosis is not possible while the patient is being treated for the crisis, measurement of blood ACTH and cortisol during the crisis and before glucocorticoids are given is enough to make the
adrenal insufficiency diagnosis.
Once the crisis is controlled and medication has been stopped, the doctor will delay further adrenal insufficiency testing for up to 1 month to obtain an accurate diagnosis.
Adrenal Insufficiency Testing: Imaging Tests
Once a diagnosis of adrenal insufficiency has been made, x-ray exams of the abdomen may be taken to see if the adrenals have any signs of
calcium deposits. Calcium deposits may indicate
tuberculosis (TB). A tuberculin skin test also may be used.
If secondary adrenal insufficiency is the cause
(see Causes of Adrenal Insufficiency), doctors may use different imaging tools to reveal the size and shape of the pituitary gland. The most common imaging used for adrenal insufficiency testing is the CT scan, which produces a series of x-ray pictures giving a cross-sectional image of a body part. The function of the pituitary gland and its ability to produce other hormones also are tested.
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