Hypothalamus–pituitary–adrenal axis evaluation in patients with hypothalamo–pituitary disorders: comparison of different provocative tests

Abstract

Neither MET nor ACTH test can be considered completely reliable for the diagnosis of secondary hypoadrenalism, when compared with ITT that remains the best test. Either MET or ACTH stimulation test, at both high and low dose, show an overall similar reliability, provided that appropriated cut-off values were considered; testing with very low ACTH doses seems to be misleading.