For example, if the DHEA value is low, but the etiocholanolone and androsterone are in the middle or upper end of the reference range, total DHEA metabolites would be considered normal. ACTH also stimulates the glucocorticosteroids, cortisone and cortisol. 1 Failure to achieve these expected increases can indicate failure of adrenal reserve capacity. In many cases, the test shows no increase after ACTH injection. Patients showing this pattern are producing at a maximum level and increased stress shows no additional response.
Some patients decrease in the amount of hormones excreted after stimulation.
The adrenals function daily under constant stress due to environmental or physical factors and collapse when the stress is increased. Treatment and dosages can be found in the following references. Jefferies, W., MD Safe Uses of Cortisone , Charles C. Thomas, Springfield, IL, 1981. Meridian's CASA Measures 12 of these steroids, with at least one in each of these categories. Can be especially helpful in more severe cases of environmental illness.