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The adrenal glands can be evaluated in several different ways and more than one of these may be required to fully understand the nature of the problem. Conventional physicians routinely test for adrenal function by measuring the levels of the adrenal hormone cortisol. Alternatively, a 24-hour cumulative urine test can be done which will show how much cortisol was secreted during that period. This test, while very useful, does not reveal any information about the adrenal output at any specific time.
Some consider two 24-hour urine samples, one before and one after the ACTH injection, to be the best method of testing for adrenal weakness. It can differentiate adrenal disease (altered response to ACTH ) from pituitary disorders (altered production of ACTH). As plasma cortisol levels increase, ACTH secretion is suppressed; as cortisol levels decrease, ACTH increases.
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