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Dose–response relationship between plasma ACTH and serum cortisol in the insulin–hypoglycaemia test in 25 healthy subjects and 109 patients with pituitary disease

OBJECTIVE: The insulin hypoglycaemia test (IHT) is believed to be the most reliable test for evaluating the entire hypothalamo–pituitary–adrenal (HPA) axis. The lower limit for the normal peak serum cortisol response has been reported to be between 500 and 580 nmol/l. Reference levels for a normal plasma ACTH response have not been reported recently.