scholarly journals Salivary Cortisol: A Better Measure of Adrenal Cortical Function than Serum Cortisol

1983 ◽  
Vol 20 (6) ◽  
pp. 329-335 ◽  
Author(s):  
Ross F Vining ◽  
Robynne A McGinley ◽  
Joseph J Maksvytis ◽  
Kian Y Ho
Keyword(s):  
Salivary Cortisol ◽  
Circadian Variation ◽  
Serum Cortisol ◽  
Normal Pregnancy ◽  
Cortisol Concentration ◽  
Adrenocortical Function ◽  
Cortical Function ◽  
Acth Stimulation ◽  
Non Invasive ◽  
Normal Men

Salivary Cortisol concentration was found to be directly proportional to the serum unbound Cortisol concentration both in normal men and women and in women with elevated cortisol-binding globulin (CBG). The correlation was excellent in dynamic tests of adrenal function (dexamethasone suppression, ACTH stimulation), in normals and patients with adrenal insufficiency, in tests of circadian variation and randomly collected samples. Women in the third trimester of normal pregnancy exhibited elevated salivary Cortisol throughout the day. The relationship between salivary and serum total Cortisol concentration was markedly non-linear with a more rapid increase in salivary concentration once the serum CBG was saturated. The rate of equilibrium of Cortisol between blood and saliva was very fast, being much less than 5 minutes. These data, combined with a simple, stress-free, non-invasive collection procedure, lead us to suggest that salivary Cortisol is a more appropriate measure for the clinical assessment of adrenocortical function than is serum Cortisol.

Reproducibility of the cortisol response to stimulation with a low dose of ACTH(1–24): the effect of basal cortisol levels and comparison of low-dose with high-dose secretory dynamics

1993 ◽  
Vol 136 (1) ◽  
pp. 167-172 ◽  
Author(s):  
S. Crowley ◽  
P. C. Hindmarsh ◽  
J. W. Honour ◽  
C. G. D. Brook
Keyword(s):  
Cortisol Level ◽  
Low Dose ◽  
Standard Dose ◽  
Serum Cortisol ◽  
Cortisol Concentration ◽  
Acth Stimulation ◽  
Basal Cortisol ◽  
Basal Cortisol Level ◽  
Adrenal Response ◽  
Serum Cortisol Concentration

ABSTRACT We compared the reproducibility and repeatability of the acute adrenal response to low doses (90 and 500 ng/1·73 m2) of Synacthen (ACTH(1–24)) with that of the standard dose (250 μg/1·73 m2). We also examined the effect of basal cortisol levels on peak values achieved after stimulation with a low dose. ACTH(1–24) was given to six male volunteers: 90 ng/1·73 m2 twice at 90-min intervals on day 1, and 90 and 500 ng/1·73 m2 once on day 2 and 250 μg/1·73 m2 once on day 3. The rise in serum cortisol concentration with repeated low doses of ACTH was not attenuated (161 ± 49 (s.d.) nmol/l on initial vs 150 ± 41 nmol/l on repeat stimulation; P = 0·5) and this was reproducible (161 ± 49 nmol/l on day 1 vs 148 ± 15 nmol/l on day 2; P = 0·6). A dose of 500 ng ACTH(1–24)/1·73 m2 produced a maximal adrenal response in that the rise in serum cortisol concentration at 20 min was identical with that produced at the same time by the standard dose of 250 μg/1·73 m2. There was a strong positive correlation between the basal cortisol level and peak cortisol concentration after low-dose ACTH stimulation (r = 0·93, P < 0·001) but not between the basal cortisol level and the incremental rise (r= −0·1, P = 0·69). These results suggest that the cortisol response to low-dose ACTH stimulation is reproducible and not attenuated by repeat stimulation at 90-min intervals. The incremental rise in serum cortisol concentration after ACTH stimulation appears constant in these situations and is not influenced by the basal cortisol level. When there is concern that the standard dose may be excessive and mask subtle but important changes in adrenal function, the low dose (500 ng) of ACTH should be used. Journal of Endocrinology (1993) 136, 167–172

scholarly journals Salivary Cortisol Determination in ACTH Stimulation Test to Diagnose Adrenal Insufficiency in Patients with Liver Cirrhosis

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Lara Albert ◽  
Joaquím Profitós ◽  
Jordi Sánchez-Delgado ◽  
Ismael Capel ◽  
José Miguel González-Clemente ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Adrenal Insufficiency ◽  
Salivary Cortisol ◽  
Serum Cortisol ◽  
Stimulation Test ◽  
Decompensated Cirrhosis ◽  
Acth Test ◽  
Acth Stimulation Test ◽  
Acth Stimulation ◽  
Cirrhotic Patients

Purpose. The prevalence of adrenal insufficiency (AI) in patients with decompensated liver cirrhosis is unknown. Because these patients have lower levels of cortisol-binding carrier proteins, their total serum cortisol (TSC) correlates poorly with free serum cortisol (FC). Salivary cortisol (SaC) correlates better with FC. We aimed to establish SaC thresholds for AI for the 250 μg intravenous ACTH test and to estimate the prevalence of AI in noncritically ill cirrhotic patients. Methods. We included 39 patients with decompensated cirrhosis, 39 patients with known AI, and 45 healthy volunteers. After subjects fasted ≥8 hours, serum and saliva samples were collected for determinations of TSC and SaC at baseline 0’(T0) and at 30-minute intervals after intravenous administration of 250 μg ACTH [30’(T30), 60’(T60), and 90’(T90)]. Results. Based on the findings in healthy subjects and patients with known AI, we defined AI in cirrhotic patients as SaC-T0< 0.08 μg/dL (2.2 nmol/L), SaC-T60 < 1.43 μg/dl (39.5 nmol/L), or ΔSaC<1 μg/dl (27.6 nmol/L). We compared AI determination in cirrhotic patients with the ACTH test using these SaC thresholds versus established TSC thresholds (TSC-T0< 9 μg/dl [248 nmol/L], TSC-T60 < 18 μg/dl [497 nmol/L], or ΔTSC<9 μg/dl [248 nmol/L]). SaC correlated well with TSC. The prevalence of AI in cirrhotic patients was higher when determined by TSC (48.7%) than by SaC (30.8%); however, this difference did not reach statistical significance. AI was associated with sex, cirrhosis etiology, and Child-Pugh classification. Conclusions. Measuring SaC was more accurate than TSC in the ACTH stimulation test. Measuring TSC overestimated the prevalence of AI in noncritically ill cirrhotic patients.

Reversible megaoesophagus in a dog with isolated glucocorticoid-deficient hypoadrenocorticism

2020 ◽  
Vol 8 (1) ◽  
pp. e001055
Author(s):  
Darren Kelly
Keyword(s):  
Complete Resolution ◽  
Clinical Signs ◽  
Serum Cortisol ◽  
Cortisol Concentration ◽  
Adrenocorticotrophic Hormone ◽  
Acth Stimulation ◽  
Serum Aldosterone ◽  
History Of ◽  
Acth Concentration ◽  
Serum Cortisol Concentration

An eight-year-old, female, neutered labradoodle was presented for investigation of a three-week history of lethargy and regurgitation. Two sets of conscious thoracic radiographs, performed approximately two weeks apart, revealed the presence of megaoesophagus. Serum cortisol concentration (pre-adrenocorticotrophic hormone (ACTH) and post-ACTH stimulation), serum aldosterone concentration post-ACTH stimulation and plasma endogenous ACTH concentration confirmed the diagnosis of isolated glucocorticoid-deficient hypoadrenocorticism. Following glucocorticoid supplementation, rapid resolution of the clinical signs was reported, and repeated conscious thoracic radiographs one week later showed complete resolution of the megaoesophagus.

ADRENOCORTICAL FUNCTION IN THE AUSTRALIAN BRUSH-TAILED POSSUM TRICHOSURUS VULPECULA (KERR)

1973 ◽  
Vol 58 (1) ◽  
pp. 97-109 ◽  
Author(s):  
KHIN AYE THAN ◽  
I. R. McDONALD
Keyword(s):  
Cortisol Concentration ◽  
Adrenocortical Function ◽  
Metabolic Clearance ◽  
Cortisol Secretion ◽  
Trichosurus Vulpecula ◽  
Degree Polynomial ◽  
Acth Stimulation ◽  
Peripheral Plasma ◽  
Ether Anaesthesia ◽  
Secretion Rates

SUMMARY The peripheral plasma concentration and secretion rate of cortisol in the conscious marsupial brush-tailed possum Trichosurus vulpecula (Kerr) was investigated under basal conditions and during maximal corticotrophin (ACTH) stimulation. Cortisol concentration in peripheral plasma was 0·92 ± 0·48 (s.d.) μg/100 ml in males, and 1·01 ± 0·57 in females. It was lowest at 08.00 h, when the possums were asleep and not easily aroused. Although there was a high variance, a third degree polynomial fitted the data plotted against time over 24 h at the 95% level of confidence, indicating a diurnal periodicity. Ether anaesthesia, porcine and synthetic (24 amino acids) ACTH caused plasma cortisol concentrations to rise to maxima of no more than 7 μg/100 ml. The dose-response curve to ACTH indicated a maximum response at 0·12 i.u./kg/h with a potency of approximately 1/6 that found in sheep and 1/20 that found in man. Cortisol secretion rates in non-stimulated possums were 2·71 ± 1·01 μg/kg/h in males and 4·32 ± 1·74 in females. They increased during maximal ACTH stimulation to 6·24 ± 1·58 μg/kg/h in males, and 13·28 ± 7·82 in females. Metabolic clearance rates were lowest in animals not accustomed to repeated blood sampling and rose in subsequent experiments. It is concluded that the adrenal cortex of Trichosurus, like that of eutherian mammals, responds to changes in activity, stressful stimuli and ACTH, but quantitatively, the responses to these stimuli are very much lower.

scholarly journals Pseudohypoadrenocorticism in a Siberian Husky with Trichuris vulpis Infection

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Stephanie Car ◽  
Catriona Croton ◽  
Mark Haworth
Keyword(s):  
Laboratory Tests ◽  
Serum Cortisol ◽  
Final Diagnosis ◽  
Cortisol Concentration ◽  
Acth Stimulation Test ◽  
Acth Stimulation ◽  
Sodium Potassium ◽  
Increased Sensitivity ◽  
Entire Male ◽  
Trichuris Vulpis

An entire male Siberian Husky presented for diarrhoea, weakness, inappetence, and collapse following a six-day period of illness. On clinical examination the dog displayed vasoconstrictive circulatory shock, dehydration, and melena. Laboratory tests revealed a marked hyponatraemia, hyperkalaemia, and a decreased sodium/potassium ratio of ≤ 12.4. The baseline and poststimulation serum cortisol concentrations were markedly elevated following adrenocorticotropin hormone (ACTH) stimulation test, yielding 712 nmol/L and 706 nmol/L, respectively. The elevated cortisol concentration excluded hypoadrenocorticism. A concurrent Trichuris vulpis (whipworm) infection was also identified. The dog was treated with supportive care including fenbendazole and recovered uneventfully. The final diagnosis was Trichuris vulpis infection with secondary pseudohypoadrenocorticism. This case report further supports a previous observation that the Siberian Husky breed may have an increased sensitivity to infection with Trichuris vulpis and development of pseudohypoadrenocorticism.

scholarly journals Determination of salivary cortisol in donkey stallions

2018 ◽  
Author(s):  
MICAELA SGORBINI ◽  
Francesca Bonelli ◽  
Alessandra Rota ◽  
Christine Aurich ◽  
Natascha Ille ◽  
...  
Keyword(s):  
Enzyme Immunoassay ◽  
Salivary Cortisol ◽  
Circadian Variation ◽  
Cross Reactivity ◽  
Commercial Enzyme ◽  
Standard Curve ◽  
Non Invasive ◽  
Detectable Concentration ◽  
Commercial Enzyme Immunoassay

Salivary cortisol provides information about free plasma cortisol concentration and salivary sampling is a non-invasive well-tolerate procedure. The aim of this study was to validate a commercial enzyme immunoassay for the determination of salivary cortisol in donkeys. Saliva samples were collected in 4 donkey stallions on thirteen non-consecutive days at 8:30 AM to avoid circadian variation. Animals were already accustomed to be handled. Saliva was collected by using a swab inserted at the angle of the lips, placed onto the tongue for 1 min and returned into a polypropylene tube. Tubes were centrifuged and at least 1 ml of saliva was aspirated from each sample and frozen at −20° C until analysis. A commercial enzyme immunoassay kit without extraction was used for determination of cortisol in saliva. Median cortisol concentrations with minimum and maximum value were calculated. Recovery of cortisol standard in donkey saliva was 107.9% and serial dilution of donkey saliva samples with assay buffer resulted in changes in optical density parallel to the standard curve. Cross-reactivity of the antiserum was 10.4% with 11-deoxycortisol, 5.2% with corticosterone, 0.4% with 11-deoxycorticosterone, 0.2% with cortisone and <0.1% with testosterone, progesterone and estradiol. The intra-assay coefficient of variation was 10.7%, the inter-assay variation was 8.0% and the minimal detectable concentration was 0.01 ng/ml. The results of the present study demonstrate the validity of a commercial kit to determine the concentration of cortisol in donkey saliva, as already reported in other species.

scholarly journals ACTH stimulation test (250 μg): is salivary cortisol an alternative to serum cortisol?

2016 ◽  
Author(s):  
Lara Albert ◽  
Olga Gimenez-Palop ◽  
Ismael Capel ◽  
Gonzalez-Clemente Jose Miguel ◽  
David Subias ◽  
...  
Keyword(s):  
Salivary Cortisol ◽  
Serum Cortisol ◽  
Stimulation Test ◽  
Acth Stimulation Test ◽  
Acth Stimulation

The measurement of glucocorticoid concentrations in the serum and faeces of captive African elephants (Loxodonta africana) after ACTH stimulation : research communication

2000 ◽  
Vol 71 (3) ◽  
Author(s):  
S.K. Stead ◽  
D.G.A. Meltzer ◽  
R. Palme
Keyword(s):  
Preliminary Investigation ◽  
Serum Cortisol ◽  
Blood Collection ◽  
Sample Collection ◽  
African Elephants ◽  
Acth Stimulation ◽  
Non Invasive ◽  
Faecal Glucocorticoid Metabolites ◽  
Faecal Samples ◽  
Cortisol Metabolites

Conventionally, the assessment of adrenal responses to stress relies on blood sample collection. However, blood collection from animals is impossible without restraint or immobilisation that influences results. This study was undertaken to validate recently established enzyme immunoassays that measure faecal glucocorticoid metabolites in elephants, and to perform a preliminary investigation into the biological relevance of this non-invasive method for use in assessing the degree of stress in this species. Four juvenile African elephants were injected i.m. with 2.15 mg synthetic adrenocorticotrophic hormone (Synacthén, Novartis, Switzerland). Blood and faecal samples were collected over 4 h and 7 d respectively. Concentrations of serum cortisol and faecal cortisol metabolites were determined using immunoassay. Variability of basal and peak values in blood and faeces was observed among the elephants. After ACTH injection, serum cortisol concentrations increased by 400-700 %. An 11-oxoaetiocholanolone enzyme immunoassay (EIA) proved best suited to measure cortisol metabolites (11,17-dioxoandrostanes) when compared to a cortisol and corticosterone EIA in faecal samples. Concentrations of faecal 11,17-dioxoandrostanes increased by 570-1070 %, reaching peak levels after 20.0-25.5 h. Greater levels of glucocorticoid metabolites were measured in faecal samples from elephants kept in small enclosures compared to levels in the faeces of animals ranging over a larger area. The results of this preliminary study suggest that non-invasive faecal monitoring of glucocorticoid metabolites is useful in investigating adrenal activity in African elephants.

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