Endocrinology Testing in Day Medicine: Adrenal Stimulation Test

These instructions are for Children's Hospital of Philadelphia patients who are scheduled to have their adrenal glands evaluated with an ACTH (Cortrosyn®) stimulation test.

Important information about adrenal testing:

Your child is scheduled to have their adrenal glands tested to learn if they are making and releasing the right amount of hormones. The test involves giving a medicine called ACTH (Cortrosyn) and then measuring the hormone levels in the blood.

Preparing for the test

Instructions for eating for eating and drinking:

• There are no fasting or dietary restrictions for this test. Your child may eat and drink normally.

• Encourage extra fluids for two days before the scheduled appointment. This will help your child feel better and may help the team place the IV more quickly.

Instructions for medicines:

Medicines that contain steroids can affect the test results.

• Your provider will tell you how long before the test to stop inhaled medicine with steroids like fluticasone, budesonide, mometasone, ciclesonide and flunisolide. If you are not sure if your child's inhaled medicine contains steroids, check with your team.

• Contact your endocrine provider if your child must take steroid medicine by mouth within one week of the test. The test may need to be rescheduled. Examples of steroid medicines include hydrocortisone, prednisone, prednisolone and dexamethasone. Check with your team if you are unsure if your child's medicine contains steroids.

• Continue to give other daily medicines as scheduled.

Instructions for the day of testing:

• Adrenal stimulation tests must begin at 7:30 am. They are performed on the Day Medicine Unit located on the 3rd floor of the Buerger Building. Plan to arrive at your scheduled appointment time. Please allow extra time to park and check in.

• Plan for childcare for siblings. Due to safety concerns for patients who may have a compromised immune system and limited space on the unit, Day Medicine cannot accommodate siblings.

• If you need to cancel testing, please notify Day Medicine (215-590-1668) ahead of time so the appointment slot can be offered to another patient.

• Wear short sleeve shirt if possible. If a long sleeve shirt is worn, please be sure it is loose fitting.

What to expect during the test:

• When you arrive, your child will have an IV (intravenous) line placed in the hand or arm. Once this IV is in place, all blood samples needed will be drawn from the IV.

• The test lasts 1-2 hours.

• There is a television in the unit for your child to watch. You may want to bring games, toys, or books to help keep your child occupied.

• ACTH will be given to your child through the IV.

  • There are no expected side effects from this medicine.

• Blood samples will be drawn from the IV at 0, 30, 60 minutes after starting the ACTH.

• After the last blood draw, the IV will be taken out and your child will be sent home.

Instructions following the test:

• Your child may return to school and their normal activities tomorrow.

• They can eat a regular diet.

• Your child should take any medicines on their regular schedule.

• Your endocrinology team will contact you with the test results as they are interpreted, this could take 2-3 weeks.

If you have any questions about the test, call the Day Medicine Unit at (215) 590-1668.

For any other questions or concerns about your child's care, contact the Division of Endocrinology.

Division of Endocrinology and Diabetes

Reviewed on March 1, 2023, by Marissa Kilberg, MD; Andy Calabria MD