ACTH Stimulation Test Medical Day Care Clinic (Adrenocorticotropic Hormone)

Appointment Information What is an ACTH stimulation test? ACTH is short for adrenocorticotropic hormone. ACTH You have an appointment for an ACTH is a hormone your body produces in the pituitary stimulation test at Humber River gland. ACTH causes the body’s adrenal glands to Hospital’s Medical Day Care Clinic. This release a hormone called . Cortisol has an handout provides information to help you important role in preparing your body for different prepare for your test. types of stress, such as low blood sugar or infection. An ACTH stimulation test uses a synthetic (man- If you have any questions before your made) form of ACTH, called Cosyntropin, to stimulate test, please call the Medical Day Care the adrenal glands. The test will show how well your Clinic at (416) 242-1000 ext. 21300 adrenal glands respond to ACTH. When we give the ACTH, the normal response of the adrenal glands is to Date of Test: DD / MM / YYYY release cortisol and 17-OH , increasing the amount of the hormones in the blood. Time of Test: ______Please arrive 30 minutes before your The pituitary secretes ACTH, which causes appointment to register. the adrenals to release cortisol into the Location: Humber River Hospital, bloodstream. Source: National Institute Medical Day Care Clinic, 2nd floor, of Diabetes and 1235 Wilson Ave., Toronto ON M3M 0B2 Digestive and Kidney Diseases, National Institutes of Health. Wilson Ave. N

Dialysis North Emergency ER e. Dialysis Entrance Entranctran e Entrance Av P P . West Outpatient Why do I need an ACTH stimulation test? .

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Elevators ton Shulman Jane St Your doctor will order this test if they suspect that Mor South Keele St

est your adrenal or pituitary glands are not functioning etherhill Av Entranctran e P W D Portals C B Portals A East East P normally. This may be a sign of Addison’s Disease West P Sir William Hearst Ave. Hwy. 401 or pituitary insufficiency. Your doctor may also use this test to rule out a rare genetic disorder called How to get here: Congenital Adrenal Hyperplasia (CAH). The Medical Day Care Clinic is located on level 2. The closest entrance is Portal C, on How do I prepare for the test? the South side of the building. Take the F 12 to 24 hours before your test, follow your West Outpatient Elevators to the 2nd floor. doctor’s instructions on eating or drinking.

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Form # 005049 © 2018_05 www.hrh.ca What do I bring to the hospital? What are the side effects of the test? F Your health card (OHIP) and a photo ID. SIDE EFFECTS AS WE INSERT THE IV MAY F A list of all medicines you are taking, or the INCLUDE: actual medicines in original containers. • Pain at the IV site Include over-the-counter medicines, herbals and supplements. • Bleeding F If you have known allergies, wear your Medic • Feeling light-headed or dizzy Alert® bracelet while in the hospital. • A hematoma (blood accumulates under the skin) F If you normally use a walker, wheelchair, or cane, please bring it with you to the hospital. SIDE EFFECTS FROM THE COSYNTROPIN ARE RARE, BUT MAY INCLUDE: Please do not bring any valuables. • An allergic reaction How is the procedure done? • Palpitations (fast heartbeats) • Flushing (skin gets red and feels warm suddenly). BEFORE THE TEST: • The doctor will explain the ACTH stimulation test. Please ask your doctor any questions that you During your test, tell your nurse right away might have. We will then ask for your consent to if you are having the following signs of an do the test. allergic reaction:

DURING THE TEST: • Have trouble breathing We will use a short intravenous line (IV line) to give • Feel light-headed you Cosyntropin and take blood samples. The IV • Have nausea (feel like throwing up) line is a thin flexible plastic tube that has a small needle at one end. • Have hives 1. The nurse will use the needle of the IV line to • Feel itchy help the tube get into the vein of your arm. • Have a rash Once in place, we will remove the needle. • Have swelling of your throat, face, mouth, 2. The nurse will draw 1 or 2 tubes of blood from tongue, legs or hands. the IV for blood tests ordered by your doctor. If you have already left the clinic, go to your 3. The doctor will inject Cosyntropin into the IV nearest emergency department right away. and then flush the IV with saline. 4. We will take blood samples every 30 minutes for What can I expect after the test? 2 hours to test the cortisol levels in your blood. Your doctor will let you know when your test AT THE END OF THE TEST: results will be ready and how to book a follow up appointment to discuss your results and next steps. • Your nurse will remove the IV and cover the site with an adhesive bandage (Band-aid®). You can also sign onto the patient portal, My Humber Health at https://myhumberhealth.ca to view your results when ready. Please make sure we have your correct email address.

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