Screening for Adrenal Insufficency


Dear George Chrousos I m Dr. ibrahim mokhtar endocrinologist working in king khalid hospital , najran area , saudi arabia i want to ask can i use synactin depot formulation for screening of adrenal insufficiency since aquouse synactin for iv use in always not avaible in our hospital ? the formula avalable is synactin depot 1 mg . i usuallu take 1/4 of thw ampoule amd inject it im and measure serum cortisol after 1 h . if this is not valid what alternative test can i use for screening of adrenal insufficiency in our settimng ? thank u very much .


You should obtain also a 2 hour blood sample for cortisol. 1 hour may not be enough for IM ACTH to cause maximal cortisol response.Best regards!George P. Chrousos, MD, MACP, MACE, FRCP (London)