Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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To review the available literature on the low-dose cosyntropin stimulation test (CST) for the diagnosis of primary and secondary adrenal insufficiency in both nonstressed and acutely ill patients. ⋯ The 1-microg CST with a cortisol level determined at 30 minutes after stimulation, with use of a cutoff level of 18 to 20 microg/dL in nonstressed patients and less than 25 microg/dL or an increment of less than 9 microg/dL from baseline in critically ill patients, is the best test that is currently available for establishing the diagnosis of secondary adrenal insufficiency.