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The hormone of the anterior pituitary gland in the human body is adrenocorticotropic hormone, also known as ACTH or corticotropin. With its help, mobilization occurs in the human body in cases of stress, the body gets the opportunity to adapt in critical situations, metabolic processes and the work of many endocrine glands are maintained normally. The main function of corticotropin is to stimulate the adrenal glands to produce corticosteroid hormones such as cortisol, sex hormones such as estrogen and androgen, and catecholamines such as adrenaline and norepinephrine.
Adrenocorticotropic hormone in women’s health
Corticotropin is secreted in the body cyclically throughout the day. Its maximum concentration in the blood is found at 4-6 o’clock in the morning, and the minimum – from 18 to 23 o’clock. Hormone fluctuations during the day directly depend on the wakefulness of a woman. Also, ACTH increases significantly during severe stress and slightly during pregnancy and menstruation.
After the age of 45, 60% of people experience deviations in the normal amount of ACTH due to hormonal fluctuations, as well as during pregnancy or during menopause. To accurately determine the concentration of this hormone, it is necessary to donate venous blood for immunoradiometric analysis.
Due to its peptide nature, the hormone ACTH is capable of producing many biological effects. It consists of 39 amino acid residues, which determines the complexity of its structure. Among the main functions of the hormone, experts call the stimulation of the formation of proteins and adrenal nucleic acids, an increase in the synthesis of cortisol, an effect on the synthesis of mineralocorticoids, the activation of androgen precursors, an increase in the synthesis of cholesterol, and a melanocyte-stimulating effect.
Prolonged exposure to corticotropin causes hypertrophy of the adrenal cortex, and, as a result, an increase in the concentration of those hormones that are produced by the adrenal glands (testosterone, estrogen, progesterone, cortisol). When the production of cortisol is mobilized in the human body, processes such as increased blood flow to muscle organs and tissues, an increase in blood glucose, which increases muscle energy, activation of anti-allergic, anti-inflammatory and anti-stress actions, are triggered.
In addition to the above positive qualities, cortisol can also have a negative effect:
- depressing immunity by lowering antibodies and lymphocytes in the blood;
- reducing muscle mass by increasing the processes of protein breakdown;
- slowing down digestive processes and inhibiting cognitive thinking.
In medicine, mineralocorticoids are commonly referred to as hormones that can regulate metabolic mineral processes. One of these hormones – aldosterone – contributes to the development of inflammation in the body, disrupts the excretion of potassium and sodium salts in the urine, which often leads to hypertension. A second mineralocorticoid, deoxycorticosterone, has a similar effect.
When androstendinone and dihydroepiandrostenedione (androgen precursors) are activated in the body, the level of male hormones in the female body increases, which often manifests itself in menstrual irregularities, increased oily skin, hair growth in atypical places, impaired ovarian function.
With increased synthesis of cholesterol in the body, the walls of cells, nerve fibers are strengthened, the level of vitamin D increases. The melanocyte-stimulating effect promotes the production of melanin, which leads to saturation with the color of the skin, hair and iris.
In addition to all of the above, the ACTH hormone affects brain cells, improving memory and the ability to perceive information.
It should also interact productively with other hormones:
- prolactin, responsible for the productivity and growth of the mammary gland, menstruation;
- somatotropin, responsible for the activation of growth processes in children;
- vasopressin, which increases circulating vascular volume and affects pressure and vascular tone.
Female germ cells do not show sensitivity to ACTH, but it enhances the action of other hormones of the anterior pituitary gland, which affects the functioning of the ovaries, the processes of ovulation and the regularity of menstruation.
It is especially important to monitor the level of ACTH in adolescents, since hormonal fluctuations in a given period of time lead to the formation of infantilism, or an advance in the physical development of girls, late onset of menstruation, and other pathologies. An increased level of adrenocorticotropic hormone in adulthood provokes a decrease in the level of female and an increase in male sex hormones in the body, which leads to ovarian dysfunction and infertility.
Indications for hormone testing
Direct indications for a test for the level of adrenocorticotropic hormone in the female body are:
- long-term use of various glucocorticoids;
- hypertension;
- adrenal hyperplasia, monitoring the course of therapy after surgical treatment of the adrenal glands or pituitary gland;
- chronic fatigue syndrome;
- adrenal adenomas;
- early puberty;
- adrenal insufficiency;
- hyperpigmentation of the skin, acne in adolescence;
- Itsenko-Cushing’s disease;
- osteoporosis.
Elevated hormone levels
As noted above, with a prolonged increase in the content of ACTH in the body, hyperplasia of the adrenal cortex occurs and the secretion of their hormones increases. An excess of hormones in the body can cause multiple changes in all internal processes of the body, as well as in appearance. The patient in this case may experience fatty deposits in the face and neck, on the abdomen and back. At the same time, on the back, fat deposits are formed in the region of the seventh cervical vertebra, which visually creates the effect of the so-called “climacteric hump” in a woman. At the same time, the patient’s arms and legs remain (or become) too thin. The skin turns red, acquiring a bluish tint. Often, women over 25 begin to overcome acne, a marble pattern becomes clearly visible on the skin. Stretch marks appear on the abdomen and spider veins appear, and on the hands the skin becomes much thinner.
In addition to external signs of an overabundance of certain hormones, internal problems of the body may also occur, indicating this. The patient develops hypertension, palpitations become more frequent, painful sensations arise in the heart, dystrophy processes begin in muscle tissues. The body is weakened and becomes susceptible to infectious or viral diseases. Often, the pathological condition is aggravated by problems with bone tissue, which can be expressed in the destruction of teeth, the occurrence of pathological fractures in the spine, and bone pain.
In blood tests, often in such cases, there is an increase in sugar levels, as patients’ insulin sensitivity decreases. The interaction of ACTH with other adrenal hormones leads to an increase in male sex hormones in the body or hyperandrogenism, which, in turn, leads to a failure of the menstrual cycle, a decrease in sexual desire, a complete absence of menstruation and infertility.
With a high concentration of ACTH in adolescence, precocious puberty may begin, which will be externally characterized by the appearance of hair in the armpits and pubis, atrophy of milk teeth, the onset of menstruation at the age of 8 years, and accelerated growth.
If ACTH readings in the body increased for a short time, this will not affect the appearance or health of a person. However, a prolonged and strong increase in this hormone may indicate Addison’s disease caused by primary adrenal insufficiency – an autoimmune process of adrenal damage, when the level of cortisol is critically reduced due to a decrease in the sensitivity of the adrenal glands to ACTH, and the level of ATKH increases by 2-2,5 times . At the same time, the woman becomes irritable, she has no appetite, but nausea, vomiting does not stop, she overcomes low blood pressure and menstruation disorders.
In the case of pituitary adenoma, an increase in ACTH leads to hypertension, obesity of the body and face with thin limbs, and menstrual disorders. There is an increased concentration of adrenocorticotropic hormone in Nelson’s syndrome (when the adrenal glands are removed), in the case of tumors of the adrenal glands, ectopic ACTH syndrome, as well as in stressful situations for the body, for example:
- pregnancy;
- severe infections;
- surgical operations;
- injuries and burns;
- bleeding, hypothermia, pain syndromes;
- states of fear, other strong emotions;
- when taking certain medications, following a low-carbohydrate diet;
- when changing time zones.
Decrease in ACTH
A prolonged decrease in the level of adrenocorticotropic hormone indicates a malfunction of the pituitary and hypothalamus functions, hypofunctions of the adrenal glands and thyroid gland. These processes reduce metabolic functions in the body, which is expressed outwardly in hyperpigmentation of the skin, a sharp and significant weight loss, disorders in the digestive processes, hypoglycemia (lowering blood sugar), hypotension, weakness, mental disorders, hypogonadism (lowering the level of female genital hormones, accompanied by the absence of menstruation for more than 6 months, underdevelopment of the genital organs during puberty).
At the same time, if the indicator of adrenocorticotropic hormone in the body is not reduced for long, this does not affect health in any way. If the lack of ACTH becomes noticeable, doctors begin to diagnose diseases such as infectious or traumatic lesions of the pituitary or hypothalamus, accompanied by adrenal insufficiency, inflammatory processes in the pituitary gland, autoimmune lesions of the pituitary gland, tumors in the adrenal glands or pituitary gland.
Also, the natural production of adrenocorticotropic hormone can be suppressed by drugs such as amphetamines, lithium carbonate, dexamethasone, hydrocortisone, ethanol, cryptoheptadine, calcium gluconate.
Preparation for the test for ACTH
The external influence on the level of the hormone in question is very strong, often various manifestations from the outside can contribute to the fact that temporarily ACTH will not be within its own norm. An increase in ACTH is caused by stressful situations, changes in time zones, excessive physical exertion, injuries, smoking and alcoholism, infections, ultrasound or fluorography. In the presence of these factors, it is better not to take an analysis for ACTH in the next 5-10 days.
Also, on the eve of the study, it is not recommended to take glucocorticoids, metopyrone and insulin. It is necessary to come for an analysis at 8 in the morning, since the hormone is dependent on the time of day, and its medical standards were focused precisely on this time. Eating or smoking on the day of the test is not recommended, you can only drink clean water. Before taking blood directly from a vein, the patient needs a 30-minute rest. For women, it is important to take an analysis of adrenocorticotropic hormone on the 6-7th day after the onset of menstruation.
If a woman is pregnant, her performance may slightly exceed the generally accepted norm. Different laboratories may detect different levels of ACTH in the same patient. At the same time, an excess of the norm by 1,5 times is considered pathological, but the final diagnosis and conclusion about the norms can only be made by the attending endocrinologist, based on the picture of the disease.