TECHNICAL BULLETIN

☒NEW TEST ☐TEST CHANGE NOTIFICATION DATE: JUNE 1, 2020 EFFECTIVE DATE: JUNE 1, 2020 ACTH Stimulation Test Panel (ACTHSTIM)

In order to streamline the adrenocorticotropic hormone (ACTH) stimulation procedure for the evaluation of adrenal function, Northwell Health Laboratories offers a new test panel consisting of one plasma ACTH concentration to be measured at baseline, and of three serum levels to be obtained at baseline, and at 30 and 60 minutes after an ACTH analog (Cosyntropin or equivalent) intravenous injection:

Test Timing Container/Tube Specimen Transport Tube Label Temperature 1.5 mL of EDTA Frozen: plasma (0.3 mL specimen is not Before minimum) ACTH Baseline Lavender-top tube stable at injection Centrifuge, ambient separate and temperature freeze plasma ASAP Before Cortisol Baseline injection 1 mL of serum 30 min after Cortisol 30 min Gold Top tube (0.3 mL minimum) Refrigerated injection Centrifuge and separate 60 min after Cortisol 60 min injection Record the date and time of collection on the tube and, if not indicated, the test names: ACTH Baseline, Cortisol Baseline, Cortisol 30 min, or Cortisol 60 min

This test cannot be performed at a Patient Service Center because it requires intravenous injection by a physician or other qualified medical professional.

The test report will include the following interpretive comment: Morning (preferably around 8 AM) specimens are required. The ACTH stimulation test requires expert administration and interpretation.*

Test Order: ACTHSTIM

*Burgos N, Ghayee H,Singh-Ospina N [June 2019] Pitfalls in the interpretation of the cosyntropin stimulation test for the diagnosis of , Current Opinion in & Diabetes and Obesity; 26,3:139-145 doi: 10.1097/MED.000000000000047

If you have any questions, please contact Client Services at (516) 719-1100.