A screening procedure for adrenocortical insufficiency, utilizing (synthetic a 1-24 adrenocorticotropic hormone [ACTH] and a cortisol-binding globulin technique for serum cortisol, has been evaluated in normal subjects and in patients with primary and secondary adrenal insufficiency. Cosyntropin is injected by vein, and a serum cortisol concentration 60 minutes later is compared with a sample removed just prior to the cosyntropin administration. A clear separation of normal subjects from those with adrenal insufficiency is achieved.
Speckart PF, Nicoloff JT, Bethune JE. Screening for Adrenocortical Insufficiency With Cosyntropin (Synthetic ACTH). Arch Intern Med. 1971;128(5):761-763. doi:10.1001/archinte.1971.00310230091007