Adrenocorticotropic hormone & bull; hello healthy

Definition

What is adrenocorticotropic hormone?

The adrenocorticotropic hormone (ACTH) test is a test used to check the function of the anterior pituitary gland and look for causes of Cushing's syndrome (overproduction of cortisol) and Addison's disease (underproduction of cortisol).

ACTH is an important hormone produced by the anterior pituitary gland. First, the hypothalamus releases Corticotropin (CRH). Then, ACTH stimulates adrenocorticotropics to produce cortisol. CRH and ACTH will be disturbed if the cortisol level in the blood is very high.

Two possible causes of Cushing's syndrome:

First, the ACTH level is high. Tumors produce ACTH that is inside or outside the pituitary gland, usually in the lungs, thymus, pancreas or ovaries.

Second, adrenal or carcinoma causes excess cortisol production. This occurs when a patient with Cushing's syndrome has ACTH levels below the normal range.

The causes of Addison's disease are also divided in two. First, if the ACTH level is high, it may be caused by adrenal disorders. Such disorders include bleeding, autoimmune surgical removal of congenital enzyme deficiency adrenal or adrenal suppression caused by prolonged use of exogenous steroids. Second, if the ACTH level is lower than the normal range, hypopituitarism may be the cause of the disease.

This suggests that the diurnal variation in ACTH is closely related to cortisol levels. The night sample rate (8-10pm) is usually equal to half or two-thirds of the afternoon sample (4-8 am). This diurnal variation doesn't apply if you have a disease (especially a tumor) that affects the pituitary gland or the adrenal glands. Just like tumors, stress can mess with diurnal variations.

When should I take adrenocorticotropic hormone?

Your doctor will recommend this test if you show signs and symptoms of excess or underproduction of cortisol.

Symptoms of lowering cortisol include:

• weight loss drastically
• low blood pressure
• loss of appetite
• muscles feel weak
• pain in muscles and joints
• darkened skin
• disposition
• discomfort

Symptoms of an increase in cortisol include:

• acne
• round face
• obesity
• changes in hair thickness and hair growth on the face
• irregular menstrual cycle in women

Precautions & warnings

What should I know before taking adrenocorticotropic hormone?

Some of the factors that can affect the test results include:

• stress (injury, pyrogens, or hypoglycemia) and pregnancy can lower ACTH levels
• the latest imaging method (imaging method) by radiation.
• medications can increase ACTH levels, including aminoglutethimide, amphetamines, estrogen, ethanol, insulin, metyrapone, spironolactone, and vasopressin
• Corticosteroids can also lower ACTH levels

Observe warnings and precautions before undergoing this treatment. If you have any questions, please consult a doctor for further information and instructions.

Process

What should I do before taking adrenocorticotropic hormone?

Your doctor will explain the whole set of tests. On the night before taking the test, you must fast first.

Tell your doctor if you have sleep problems, as this can affect the level of cortisol in the blood. With normal sleeping habits, ACTH levels are highest between 4-8 in the morning. Meanwhile, the lowest ACTH level is around 9pm.

It is recommended that you wear short-sleeved clothing to make the process of taking a blood sample from your hand easier.

How does the adrenocorticotropic hormone process?

The medical personnel in charge of drawing your blood will take the following steps:

• wrap an elastic belt around your upper arm to stop blood flow. This makes the blood vessel under the bundle enlarge making it easier to insert the needle into the vessel
• clean the area to be injected with alcohol
• inject a needle into a vein. More than one needle may be required.
• Insert the tube into the syringe to fill it with blood
• untie the knot from your arm when enough blood is drawn
• sticking gauze or cotton on the injection site, after the injection is complete
• apply pressure to the area and then put a bandage on

What should I do after taking adrenocorticotropic hormone?

Some people may feel pain when the needle is inserted into the skin. But for most people, the pain will fade away when the needle is right in the vein. Generally, the level of pain experienced depends on the nurse's expertise, the condition of the blood vessels, and the person's sensitivity to pain.

After going through the blood draw process, wrap your hands with a bandage. Press the vein lightly to stop the bleeding. After doing the test, you can carry out your activities as usual. The medical professional will place the sample into the ice water and immediately send it to the laboratory. ACTH is a stable peptide in plasma so it must be stored at -20 ° C to prevent decomposition which could reduce the accuracy of the results.

If you have any questions regarding the test process, please consult your doctor for further instructions.

Explanation of the Test Results

What do my test results mean?

Normal

Normal range:

Morning: <80 pg / ml or <18 pmol / L (SI unit).

Evening: <50 pg / ml or <11 pmol / L (SI unit).

Abnormal

The index goes up

The causes of the increase in ACTH include:

• Addison's disease (Primary adrenal insufficiency)
• Cushing's syndrome (dependent adrenal hyperplasia)
• ectopic ACTH syndrome
• stress
• adrenogenital's syndrome (congenital adrenal hyperplasia)

Index goes down

The causes of decreased ACTH include:

• secondary adrenal insufficiency (hypopituitarism)
• Cushing's syndrome
• adrenal gland tumor or glandular cancer
• steroid use

The results of this test will be combined with other test results including a physical exam. You can discuss directly with your doctor before and after getting the test results for a more accurate diagnosis.

The normal range for an adrenocorticotropic hormone test may vary depending on the laboratory you choose. Discuss with your doctor if you have any questions about your test results.