A Comparison between the 1- g Adrenocorticotropin (ACTH) Test, the Short ACTH (250  g) Test, and the Insulin Tolerance Test in the Assessment of Hypothalamo-Pituitary-Adrenal Axis Immediately after Pituitary Surgery

2000 ◽  
Vol 85 (10) ◽  
pp. 3713-3719 ◽  
Author(s):  
H. S. Dokmetas
Keyword(s):  
Pituitary Surgery ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Acth Test ◽  
Adrenal Axis ◽  
Insulin Tolerance ◽  
Pituitary Adrenal Axis

The Insulin Tolerance Test and the Ovine Corticotrophin-Releasing Hormone Test in Episodic Cluster Headache

Cephalalgia ◽  
1991 ◽  
Vol 11 (6) ◽  
pp. 269-274 ◽  
Author(s):  
Massimo Leone ◽  
Boris M Zappacosta ◽  
Sergio Valentini ◽  
Anna M Colangelo ◽  
Gennaro Bussone
Keyword(s):  
Cluster Headache ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Releasing Hormone ◽  
Autonomic Responses ◽  
Adrenal Axis ◽  
Insulin Tolerance ◽  
Basal Cortisol ◽  
Episodic Cluster Headache ◽  
Pituitary Adrenal Axis

Clinical observations indicate a central nervous system, probably hypothalamic, involvement in cluster headache pathogenesis. In order to investigate the supposed hypothalamic involvement in cluster headache, we followed the hypothalamic-pituitary-adrenal axis and autonomic responses to the insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache patients, both during remission and during the cluster period. The study revealed increased basal cortisol levels in all cluster patients. A blunted cortisol response to ovine corticotrophin-releasing hormone, in spite of a normal ACTH surge, was subsequently found in both illness phases. These findings suggest hypo-thalamic-pituitary-adrenal axis hyperactivity in both cluster phases. Furthermore, reduced ACTH and cortisol responses after insulin challenge were also observed in both remission and cluster period patients; a reduced norepinephrine surge was seen only in the cluster period. Taken together, these results suggest a hypothalamic involvement in the altered neuroendocrinological and autonomic responses found in our patients.

Clinical insights into the safety and utility of the insulin tolerance test (ITT) in the assessment of the hypothalamo-pituitary-adrenal axis

2008 ◽  
Vol 69 (4) ◽  
pp. 603-607 ◽  
Author(s):  
Francis M. Finucane ◽  
Aaron Liew ◽  
Evan Thornton ◽  
Barbara Rogers ◽  
William Tormey ◽  
...  
Keyword(s):  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Adrenal Axis ◽  
Insulin Tolerance ◽  
Pituitary Adrenal Axis
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