Endocrine dynamic function tests
Stimulate when you suspect deficiency, suppress when you suspect excess. Protocols, cut-offs, interfering drugs and safety for the short synacthen test, insulin tolerance and glucagon tests, dexamethasone suppression, salivary and urinary cortisol, saline suppression, water deprivation and copeptin, the 72-hour fast and the GH suppression OGTT.
Tier 1Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Stimulate when you suspect deficiency; suppress when you suspect excess. A gland that fails to respond to its stimulus is deficient. A gland that keeps secreting despite suppression is autonomous.
- Confirm the biochemistry before imaging. Incidental pituitary and adrenal lesions are common.
- Most tests have assay-specific cut-offs, and many drugs interfere. Read the laboratory's interpretive comment.
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Sources
- Diagnosis and treatment of primary adrenal insufficiency, an Endocrine Society clinical practice guidelineBornstein SR et al., J Clin Endocrinol Metab 2016;101:364-89, 2016 (current, checked November 2026)
- European Society of Endocrinology and Endocrine Society joint clinical guideline: diagnosis and therapy of glucocorticoid-induced adrenal insufficiencyBeuschlein F et al., Eur J Endocrinol 2024;190:G25-G51 and J Clin Endocrinol Metab 2024, 2024
- Consensus on diagnosis and management of Cushing's disease, a guideline updateFleseriu M et al. (Pituitary Society), Lancet Diabetes Endocrinol 2021;9:847-75, 2021
- Primary aldosteronism, an Endocrine Society clinical practice guidelineAdler GK, Stowasser M, Correa RR et al., J Clin Endocrinol Metab 2025;110(9):2453-95, 2025 (current, checked November 2026)
- Comparison of seated with recumbent saline suppression testing for the diagnosis of primary aldosteronismAU/NZStowasser M et al., J Clin Endocrinol Metab 2018;103:4113-24, 2018
- A copeptin-based approach in the diagnosis of diabetes insipidusFenske W et al., N Engl J Med 2018;379:428-39, 2018
- Evaluation and management of adult hypoglycemic disorders, an Endocrine Society clinical practice guidelineCryer PE et al., J Clin Endocrinol Metab 2009;94:709-28, 2009 (current)
- AACE 2019 clinical practice guidelines for management of growth hormone deficiency in adults and patients transitioning from pediatric to adult careYuen KCJ et al., Endocr Pract 2019;25:1191-232, 2019
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy