The ACTH stim test can be ordered if a patient shows signs or experiences symptoms that indicate the presence of a condition that results in an abnormal cortisol level. Signs and symptoms of excess cortisol include obesity, a rounded face, muscle weakness, excess body hair, and acne. These can be accompanied by hypertension, high blood sugar, and low potassium levels. Insufficient levels of cortisol can cause muscle weakness, fatigue, weight loss, and a lack of appetite. These can be accompanied by hypotension, low blood sugar, high calcium levels, and high potassium levels. Doctors will order an ACTH stimulation test if these signs and symptoms are present and are not indicative of other conditions.