Test | Strengths | Drawbacks |
---|---|---|
Insulin tolerance test | 1. Very high sensitivity 2. Assessment of ACTH and GH axes | 1. Requires experience and medical supervision 2. Labour intensive and time consuming 3. Contraindicated in ischemic heart disease and seizure disorders 4. Hypoglycaemia not always achieved 5. Unpleasant for patients |
Glucagon stimulation test | 1. Assessment of ACTH and GH axes 2. Can be used in cases where ITT is contra-indicated | 1. Nausea in up to 30Â % cases 2. False positive (fail) rate 8Â % 3. Time consuming |
Short synacthen (corticotropin) test | 1. Simple and well tolerated 2. Can be used in cases where ITT is contraindicated 3. Reliably excludes clinically significant ACTH deficiency | 1. Does not assess GH axis 2. Unreliable if recent pituitary insult e.g. surgery, apoplexy 3. Theoretical concerns of false negative (pass) rate (when compared with ITT) |