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Test Code ACTH Adrenocorticotropic Hormone (ACTH), Plasma

Reporting Name

Adrenocorticotropic Hormone, P

Useful For

Determining the cause of hypercortisolism and hypocortisolism

Specimen Required

Patient Preparation: 12 hours before this blood test do not take multivitamins or dietary supplements containing biotin or vitamin B7, which are commonly found in hair, skin, and nail supplements and multivitamins.

Collection Container/Tube: Ice-cooled, lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Morning (6 a.m.-10:30 a.m.) specimen is desirable.

2. Collect with a pre-chilled EDTA tube and transport to the laboratory on ice.

3. Spin down in a refrigerated centrifuge within 2 hours and immediately separate plasma from cells.

4. Immediately freeze plasma.

Seattle Children's Hospital Note:

Collect 2 mL whole blood in an ice-cooled Lavender top.

Processing note: Ambient centrifuge acceptable as long as sample is spun down right away.

Specimen Type

Plasma EDTA

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma EDTA Frozen (preferred) 28 days
  Refrigerated  3 hours
  Ambient  2 hours

Day(s) and Time(s) Performed

Monday through Friday; 5 a.m.-12 a.m., Saturday; 6 a.m.-6 p.m.

Seattle Children's Hospital Note:

TAT: 3 - 5 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Method Name

Electrochemiluminescence Immunoassay

Method Description

Testing is performed on the Roche Cobas e601. The Roche adrenocorticotropic hormone (ACTH) assay is a sandwich, electrochemiluminescence immunoassay that employs a biotinylated monoclonal ACTH-specific antibody and a monoclonal ACTH specific antibody labeled with a ruthenium complex. ACTH in the specimen reacts with both the biotinylated monoclonal ACTH-specific antibody and the monoclonal ACTH-specific antibody labeled with a ruthenium complex, forming a sandwich complex. Streptavidin-coated microparticles are added and the mixture incubates allowing the newly formed sandwich complex to become bound to the solid phase via the biotin streptavidin interaction. The reaction mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode. Application of voltage to the electrode induces the chemiluminescent emission, which is then measured.


The assay employs two monoclonal antibodies specific for ACTH (9-12) and for the C-terminal region (ACTH 36-39). Due to common antigenic structure, the antibodies recognize intact biologically active ACTH 1-39 and the ACTH precursors pro-opiomelanocortin (POMC) and pro-ACTH.(Package insert: ACTH, Roche Diagnostics, V 9.0, 2016-10)

Reference Values

7.2-63 pg/mL (a.m. draws)

No established reference values for p.m. draws

Pediatric reference values are the same as adults, as confirmed by peer reviewed literature.


Petersen KE: ACTH in normal children and children with pituitary and adrenal diseases. I. Measurement in plasma by radioimmunoassay-basal values. Acta Paediatr Scand 1981;70:341-345


For SI unit Reference Values, see

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
ACTH Adrenocorticotropic Hormone, P 2141-0


Result ID Test Result Name Result LOINC Value
ACTH Adrenocorticotropic Hormone, P 2141-0

Reject Due To


Mild OK; Gross reject


Mild OK; Gross OK







If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

General Request Form (T239) (

Oncology Test Request Form (T729) (