The Role of Steroids in Adrenal Insufficiency

The pituitary gland produces ACTH, which then goes down and tells the adrenals to produce cortisol. Long-term steroid suppresses the whole HPA axis. So we're giving a horse kick in the form of an ACTH shot. The numbers you want to hit is above 14 for the post-stimulation cortisol,. And then above 18 is absolutely reassuring.