Hi CKL,

I helped to write that book you are talking about and I’d like to reassure you that there is probably nothing for you to be upset about!!

Please look at p. 123. This says that ACTH is one of the hormones that a doctor can test as part of routine monitoring. In this situation, you would NOT inject cortrysn! The doctor is just trying to see if medication doses are adequate.

This sounds like what your doctor just did...she is running a routine blood test to assess your son’s level of control. (I am sure she also measured other hormones such as 17-ohp, andro, testosterone, etc.)

An ACTH stim test is done for a DIFFERENT reason. When you do a stim test, the main purpose is not really to look at levels of ACTH, it is to see how the body RESPONDS to high levels of ACTH. That is why you inject cortrysn...you are PURPOSEFULLY trying to increase the levels of ACTH, so you can see how the other adrenal hormones respond.

Again, these are two different tests, used for two different reasons.

For more info on the ACTH stim test, please see p. 83, question 2. Also, the bottom of page 79. From all you have said about your son’s situation, it does not appear that he is one of the borderline cases the stim test is usually reserved for.

Please talk to your doctor further...I am sure she will be able to further clarify the situation. But, again, please realize that there are different reasons for looking at ACTH, and not all of them involve the stim. test.

Best Wishes,
Carol (aka C Y Hsu)