Cause of low acth and low cortisol in the am? my stim test results:acth -5.2, and cortisol- 2.4 before injection then 60minutes from injection cortiso

Possible pituitary : I am assuming your post-stimulation cortisol was also low. If so, some possibilities are use of corticosteroids (prednisone, hydrocortisone for example as well as cortisone shots in joints or for an epidural), chronic pain medication use and pituitary dysfunction. Having said that, it is unusual for there to be isolated ACTH deficiency- usually there are other pituitary hormones that are deficient