Dr. Grey AI

Cosyntropin (Cortrosyn/Synacthen)

Peptide

Cosyntropin is a synthetic ACTH(1-24) peptide. FDA-approved for diagnosis of adrenocortical insufficiency. The 250mcg ACTH stimulation test is the gold standard diagnostic test. Meta-analysis shows 97% sensitivity at 95% specificity for primary adrenal insufficiency. Less immunogenic than full ACTH due to absence of amino acids 25-39. Half-life 15 minutes with peak cortisol at 30-60 minutes.

Quick Answer

What it is

Cosyntropin is a synthetic ACTH(1-24) peptide. FDA-approved for diagnosis of adrenocortical insufficiency.

Key findings

  • Grade A: Diagnostic Sensitivity (Primary AI) (Hypoadrenalism)
  • Grade A: Diagnostic Accuracy (Secondary AI) (Hypoadrenalism)
  • Grade A: Cortisol Stimulation (Hypoadrenalism)

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

⚠️ Research Notice

This peptide information is for educational and research purposes only. Peptides may not be FDA-approved for human use and may only be legally available for research purposes. Consult qualified healthcare professionals before considering any peptide compounds.

ℹ️ Quick Facts: Cosyntropin (Cortrosyn/Synacthen)

Quick Facts: Cosyntropin (Cortrosyn/Synacthen)

  • Best Evidence:Grade A
  • Conditions Studied:1
  • Research Outcomes:7
  • Grade A Findings:4
  • Grade B Findings:1
  • Key Effect:Hypoadrenalism
A4
B1
C1
D1
1 conditions · 7 outcomes

Detailed Outcomes

A
Diagnostic Sensitivity (Primary AI)
97% sensitivity at 95% specificity for primary adrenal insufficiency. Meta-analysis of multiple studies confirms high diagnostic accuracy.
large↑Improves
A
Diagnostic Accuracy (Secondary AI)
57-61% sensitivity for secondary AI. Better for ruling in than ruling out. Low-dose (1mcg) may be superior (AUC 0.94 vs 0.85).
moderate↑Improves
A
Cortisol Stimulation
Normal response: cortisol ≥18 mcg/dL (500 nmol/L) at 30-60 minutes. Reliable stimulation of adrenal cortex in healthy individuals.
large↑Worsens
A
Safety Profile
Less immunogenic than natural ACTH. Rare hypersensitivity reactions. Well-tolerated diagnostic procedure used for decades.
large↑Improves
B
Kidney Function
23 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.
moderate↑Improves
C
Immune Function
3 human trials support this finding. Human clinical trial data available.
small↑Improves
D
Blood Glucose Control
2 human trials support this finding. Human clinical trial data available.
small↓Improves

Research Citations (32)

Examining aldosterone plasma concentration alterations post-ACTH stimulation in healthy subjects: a systematic literature review and meta-analysis on ACTH's role in aldosterone secretion.
(2024)
PMID: 39052132
Salivary corticosterone measurement in large-billed crows by enzyme-linked immunosorbent assay.
(2023)
PMID: 36418081
New Cutoffs for the Biochemical Diagnosis of Adrenal Insufficiency after ACTH Stimulation using Specific Cortisol Assays
(2021)
PMID: 33631762
Cortisol levels in blood and hair of unanesthetized grizzly bears (Ursus arctos) following intravenous cosyntropin injection.
(2021)
PMID: 33978314
Cosyntropin for the Treatment of Refractory Postdural Puncture Headache in Pediatric Patients: A Retrospective Review.
(2020)
PMID: 31789828
Pitfalls in the interpretation of the cosyntropin stimulation test for the diagnosis of adrenal insufficiency
(2019)
PMID: 30855285
Diagnostic accuracy of basal cortisol level to predict adrenal insufficiency in cosyntropin testing: results from an observational cohort study with 804 patients
(2017)
PMID: 28938409
Total and free cortisol levels during 1 μg, 25 μg, and 250 μg cosyntropin stimulation tests compared to insulin tolerance test: results of a randomized, prospective, pilot study.
(2017)
PMID: 28730418
ACTH Stimulation Tests for the Diagnosis of Adrenal Insufficiency: Systematic Review and Meta-Analysis
(2016)
PMID: 26649617
Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline
(2016)
PMID: 27270475