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  • Title: Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency.
    Author: Hägg E, Asplund K, Lithner F.
    Journal: Clin Endocrinol (Oxf); 1987 Feb; 26(2):221-6. PubMed ID: 3311477.
    Abstract:
    A basal plasma cortisol value taken in a physically unstressed state in 68 patients with or without hypothalamic-pituitary-adrenocortical disease was compared with the maximal plasma cortisol concentration during an insulin tolerance test. There was a strong positive correlation between the values. Basal cortisol levels above 300 nmol/l (RIA method) almost excluded ACTH-cortisol insufficiency and those below 100 nmol/l strongly suggested dysfunction. A repeated basal cortisol estimation within a month was especially valuable in categorizing patients with levels between 100 and 200 nmol/l. We suggest that a basal cortisol measurement may be used as a first laboratory test in patients evaluated for possible hypothalamic-pituitary-adrenocortical insufficiency; in many patients, this approach obviates more sophisticated and expensive testing.
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