A hypothetical index of hypothalamic-pituitary-adrenal (HPA) axis function.

The short ACTH stimulation test (SST) is commonly used by clinicians to determine the integrity of the hypothalamic-pituitary-adrenal (HPA) axis in cases of suspected adrenal insufficiency. Concern has arisen for under-diagnosis of central hypocortisolism using the standard dose (250 mcg) SST with the recent introduction of low-dose (1 mcg) SST as a potentially more sensitive test for central hypocortisolism. Amidst this uncertainty, I will present a novel index hypothesized to extend the sensitivity of the standard dose SST as an adjunctive diagnostic tool for any level of hypocortisolism.