ACTH Plasma

Decoding the ACTH Test: Insights for Diagnosis

This is a hormone called adrenocorticotropin, which is also known as corticotropin. It is made in the anterior pituitary gland and tells the adrenal glands, specifically the adrenal cortex, to release cortisol, DHEA, and aldosterone. The ACTH plasma test quantifies the blood's level of ACTH and is used to diagnose ailments such as Addison's disease, Cushing's syndrome, and adrenal tumors. The adrenal cortex is what makes ACTH work to increase the production of cortisol. Cortisol is important for keeping the body's stress response in check and its metabolism in check. By measuring plasma ACTH and cortisol levels, healthcare professionals can assess the functioning of the adrenal glands and identify any abnormalities. Normally, ACTH levels increase when cortisol is low and fall when it is high. In response to a drop in the blood cortisol level, the hypothalamus produces corticotropin-releasing hormone (CRH). This stimulates the production of ACTH by the pituitary, which in turn stimulates the production of cortisol by the adrenal glands, small organs located at the top of each kidney.

The anterior pituitary gland makes and releases the adrenocorticotropic hormone (ACTH). This hormone tells the adrenal glands to make and release cortisol, a steroid hormone that helps the body deal with stress and keep blood sugar, blood pressure, and immune system function in check.

To measure ACTH levels in the blood, a blood sample will be taken from a vein in your upper arm and sent to a laboratory for analysis. A radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA) test determines the ACTH level. These tests check how much ACTH is in the blood, usually shown in picograms per milliliter (pg/mL). They can help find problems with the adrenal glands or the pituitary gland.

What is Adrenal Corticotropic Hormone (ACTH)?

Adrenocorticotropic hormone is secreted in your brain's anterior (front) pituitary gland.

The purpose of ACTH is to keep the adrenal glands' release of the stress hormone cortisol at healthy levels. Cortisol is our body’s natural alarm system. As our body’s primary stress hormone, it works with different parts of the brain to influence our fear, mood, and motivation.

Cortisol is best known for fueling the body’s “fight-or-flight” response in a crisis. But cortisol also has a critical role in a variety of things the body does, like:

• Controlling the sleeping and waking cycle
• Boosting energy levels to handle stress better (and restore normal levels afterward)
• Influences how the body uses carbs, proteins, and fats
• Reducing inflammation
• Regulating blood pressure
• Increasing blood sugar

What Are the Symptoms of High or Low ACTH-Induced Cortisol?

Symptoms of high cortisol can include high blood pressure, obesity, high blood sugar levels, and edema. Low cortisol levels can cause weight loss, fatigue, low blood pressure, and muscle weakness.

ACTH Stimulation Test

The ACTH stimulation test is a medical diagnostic tool used to evaluate the function of the adrenal glands. The test involves administering a synthetic form of Adrenocorticotropic Hormone (ACTH) and measuring the level of cortisol in the blood before and after stimulation. The stimulation test helps to differentiate between primary and secondary adrenal insufficiency. It is also useful in diagnosing disorders such as Cushing's syndrome, Addison's disease, and other hormonal imbalances. The ACTH stimulation test involves minimal risks and discomfort and is an effective method for evaluating adrenal gland function.

What is the ACTH Test?

If you’re experiencing the symptoms of a cortisol imbalance, your healthcare provider may order an ACTH test to measure the levels of both ACTH and cortisol in the blood. The ACTH test, also known as the ACTH stimulation test, will help your healthcare provider detect diseases associated with too much or too little cortisol in the body. Your healthcare provider or endocrinologist will carefully interpret your ACTH test results to determine if there are any abnormalities. Many factors can affect the accuracy of the test, including the recent use of corticosteroids (steroids). Abnormal ACTH test results typically indicate primary and secondary adrenal insufficiency. Your healthcare provider might also perform a physical examination before making a firm diagnosis.

The Adrenocorticotropic Hormone ACTH plasma test checks the function of the adrenal glands and can diagnose a number of diseases that affect these glands. Two tiny, triangular-shaped glands, the adrenal glands, are located at the top of your kidneys and are crucial in producing several hormones, including cortisol and aldosterone. Aldosterone helps maintain salt and water balance, while cortisol helps regulate blood pressure and metabolism.

The pituitary gland, a tiny endocrine gland situated at the base of the brain, is responsible for producing and releasing the hormone ACTH. The main job of ACTH is to induce the release of cortisol from the adrenal glands.

What Conditions Are Diagnosed with the ACTH Test?

The ACTH plasma test quantifies the blood's level of ACTH. A patient's blood is drawn for the test and then sent to a lab for examination. The test findings enable the diagnosis of ailments such as Addison's disease, Cushing's syndrome, and adrenal tumors.

It is known as Addison's disease when the adrenal glands do not produce enough cortisol and aldosterone. This condition manifests itself in a number of ways, including exhaustion, weight loss, low blood pressure, and skin darkening. An overabundance of cortisol in the blood causes Cushing's syndrome, which manifests as symptoms like weight gain, high blood pressure, and muscle weakness. The overproduction of cortisol or other adrenal hormones by adrenal tumors can result in a variety of symptoms. In addition, individuals with congenital adrenal hyperplasia, a condition in which the adrenal gland cannot produce cortisol and aldosterone at typical rates due to a birth defect, can also experience these symptoms.

Because the blood levels of ACTH can show whether the adrenal glands are working normally or not, the ACTH plasma test is used to identify various diseases, such as Cushing's disease. For instance, in Addison's disease, the pituitary gland tries to stimulate the adrenal glands to make more cortisol, which causes the blood levels of ACTH to be elevated. Because the adrenal glands are already making too much cortisol and do not require additional stimulation, the levels of ACTH in the blood are often low in Cushing's disease.

The ACTH plasma test can also be used to check how well certain disorders are being treated. Consider a patient who is receiving replacement cortisol medication for Addison's disease. If so, external sources of cortisol would cause a decrease in the blood's ACTH concentration.

The ACTH plasma test can identify and track problems involving the pituitary gland and detect and monitor conditions involving the adrenal glands. The pituitary gland produces and releases several hormones, including ACTH. Infertility, irregular menstruation, and decreased sex drive are just a few signs that can occur if the pituitary gland is not working correctly.

It's crucial to remember that other tests are available to diagnose problems with the pituitary and adrenal glands in addition to the ACTH plasma test. In addition to the ACTH plasma test, these diseases may also be diagnosed with additional tests such as the cortisol test, the aldosterone test, the 24-hour urine cortisol test, and the test for secondary adrenal insufficiency. The ACTH plasma test is an important tool for diagnosing adrenal disorders, including primary adrenal insufficiency, as outlined in the practical guidance provided by Arup Consult (2021).

An easy and risk-free test that can reveal important details regarding the adrenal and pituitary glands' operations is the ACTH plasma test. To decide on the best course of therapy, it is crucial to go over the test results with a healthcare professional.

Conclusion

In conclusion, the ACTH plasma test is a diagnostic procedure used to determine how well the pituitary and adrenal glands are operating and assess the adrenal glands' functioning.

More information: Aldosterone, Renin, and ACTH

 

List of Statements and References

1. The anterior pituitary gland makes and tells the adrenal glands to release cortisol, DHEA, and aldosterone.

   • Reference: Mayo Clinic Staff. (2022). ACTH (adrenocorticotropic hormone) blood test. Mayo Clinic. Link

2. The ACTH plasma test quantifies the blood's level of ACTH and is used to diagnose ailments such as Addison's disease, Cushing's syndrome, and adrenal tumors.

   • Reference: National Adrenal Diseases Foundation. (n.d.). The ACTH test. NADF. Link

3. Cortisol is important for keeping the body's stress response in check and keeping metabolism in check.

   • Reference: Hormone Health Network. (2020). Cortisol. Endocrine Society. Link

4. In response to a drop in blood cortisol level, the hypothalamus produces CRH.

   • Reference: National Library of Medicine. (2021). Cortisol blood test. MedlinePlus. Link

5. A radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA) test determines the ACTH level.

   • Reference: ARUP Laboratories. (2021). Adrenocorticotropic Hormone (ACTH). ARUP Consult. Link

6. Symptoms of high cortisol can include high blood pressure, obesity, high blood sugar levels, and edema.

   • Reference: The Cleveland Clinic. (2021). High cortisol symptoms. Cleveland Clinic. Link

7. Low cortisol levels can cause weight loss, fatigue, low blood pressure, and muscle weakness.

   • Reference: American Association of Clinical Endocrinologists. (2019). Adrenal Insufficiency. AACE. Link

8. The ACTH stimulation test is a medical diagnostic tool used to evaluate the function of the adrenal glands.

   • Reference: National Health Service (NHS). (2019). Short synacthen test (SST). NHS. Link

9. Abnormal ACTH test results typically indicate primary and secondary adrenal insufficiency.

   • Reference: EndocrineWeb. (2020). Adrenal Insufficiency (Addison's Disease). Link

10. The ACTH plasma test can identify and track problems involving the pituitary gland.

    • Reference: Lab Tests Online. (2020). ACTH. AACC. Link