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Adrenocorticotropin (corticotropin, ACTH) is a hormone released from the pituitary gland. It stimulates the adrenal cortex to produce glucocorticosteroids, and to a lesser extent – aldosterone, androgens and estrogens. The test is performed in the diagnosis of the adrenal cortex (insufficiency, hyperfunction) and in the differentiation of vitiligo. The material needed for the test is serum.
It increases the melanotropic activity of skin pigment cells, leading to the appearance of a pigment in them.
Corticotropin, ACTH – when do we do?
We perform the ACTH hormone test in the following cases:
1. Diagnostics of adrenal insufficiency – suspected damage to the pituitary gland (in the course of cancer, after irradiation, in the course of inflammation), hypothalamus (cancer, trauma, hemorrhage) or adrenal cortex.
2. Diagnostics of hyperadrenocorticism – suspicion of a neoplastic adrenal change (if the diagnosis is suggested by the presence of obesity, hirsutism, hypertension, diabetes, osteoporosis) or excessive production of ACTH in the pituitary gland or in neoplastic tissue.
3. Administration of exogenous glucocorticosteroids.
4. Differentiation of vitiligo.
Corticotropin, ACTH – a method of examination
Material needed for the ACTH test: serum.
Preparation for the test: fasting (at least 8 hours); after bedtime (the ACHT level is highest in the morning).
The course of the study: one-time blood sampling from a vein in the arm.
Time to wait for the result: 1 Day.
Standard: in the morning 5,5–17,8 pmol/l (25–80 ng/l); in the evening hours the concentration is 50% lower.
Comments: The effect of ACTH is to increase the release of steroid hormones (cortisol) from the adrenal glands – stress hormones that allow you to survive the threat. The release of ACTH from the pituitary gland takes place in a daily rhythm – the highest concentration of cortisol (ACHT) is therefore observed in the morning. Then the body prepares itself to undertake normal activities after waking up. The morning peak of ACTH secretion is influenced by the corticoliberin released from the hypothalamus.
Characteristics of hyperfunction and insufficiency of the adrenal glands
There are two types of hyperadrenocorticism:
- primary: disorders in the adrenal cortex itself (adenoma, hyperplasia, cancer),
- secondary: excessive ACTH secretion by the pituitary gland.
Adrenal insufficiency – there are two types:
- primary (Addison’s disease): damage to the adrenal glands reduces the secretion of corticosteroids,
- secondary: decreased ACTH secretion by the pituitary gland
Corticotropin (ACTH) level – reading the results
In patients with symptoms of hyperadrenocorticism and elevated serum cortisol levels:
- a lowered ACTH level means primary overactive adrenal glands
- elevated ACTH meanssecondary overactive adrenal glands.
Sometimes additional tests are recommended to give you a complete idea of the causes of these symptoms.
- dexamethasone test;
- corticoliberin test;
- synactene test.
The ACTH test is one of the most important tests to help distinguish between overactive and underactive adrenal glands.
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