Two years ago when my brother had a low-dose ACTH stimulation test done, he had a major reaction and a ’code blue’ was called. On that occasion the ACTH injection was given intravenously (IV) . In Australia it is required that a doctor stays with the ’patient’ for about ten minutes during and following administration of the ACTH injection in the event of an incident. So it can and does happen sometimes.

Since this time, I have been told that Australian protocol now requires ACTH administration to be given intramuscularly (IM), to minimise such reactions. Although ACTH given via IM is a little slower to absorb, it is reputed to be just as effective over the duration of the test.