Table 2.

Results of the multiple-dose metyrapone test

	Before a		After b			Delta c	CAI Cutoff d
	ACTH (pmol/L)	Cortisol (nmol/L)	ACTH (pmol/L)	Cortisol (nmol/L)	11-deoxycortisol (nmol/L)	ACTH (pmol/L)	11-deoxycortisol (nmol/L)
Median	3.5	325.5	37.7	70.0	440.1	33.4	<230
Range	1.3–16.2	126.0–764.0	2.8–132.0	28.0–213.0 e	247.8–694.0	-1.4–118.9

Abbreviation: CAI, central adrenal insufficiency.

^a Before metyrapone administration. ^b After metyrapone administration. ^c Increase in ACTH after metyrapone administration. ^d 11-deoxycortisol cutoff for diagnosis of CAI. ^e In 2 patients, the day 2 morning cortisol was above the cutoff of 200 nmol/L, namely 213 and 211 nmol/L. Although this was suggestive of inadequate inhibition of 11-β hydroxylase, it still provoked an adequate increase of 11-deoxycortisol (298.2 nmol/L and 425.3 at day 2), showing function of the HPA axis was normal.