Serum adrenocorticotropic hormone (ACTH) refers to the measurement of ACTH levels in the bloodstream. It is a laboratory test commonly performed to evaluate the functioning of the hypothalamic-pituitary-adrenal (HPA) axis and assess conditions related to cortisol production.
|Also Known as||Adrenocorticotropic Hormone (ACTH) stimulation test, Cosyntropin (Cortrosyn) stimulation test, Corticotropin test, ACTH stim test , ACTH challenge test, Adrenocorticotropic hormone , Serum Adrenocorticotropic Hormone , Highly-Sensitive ACTH ,Corticotropin , Cosyntropin, ACTH|
|Test Purpose||To help diagnose primary adrenal insufficiency (Addison’s disease) and to detect conditions that affect the pituitary gland (secondary adrenal insufficiency)|
|Test Preparations||No need ay Preparation. Sample To Be Given Between 8–10 A.M.|
|Test Components||ACTH in Plasma|
|Specimen||2 ML (0.5 ML Min.) Plasma From 1 Pre-Chilled Lavender Top (EDTA) Tube. Draw Blood Between 8–10 A.M. Mix Well, Separate And Transfer Plasma IMMEDIATELY Into A Sterile Screw Capped Vial And FREEZE. Ship Frozen. DO NOT THAW.|
|Stability Frozen||4 Weeks|
|Download Report||Download Report|
The symptoms of low cortisol include:
- Weak Muscles
- Weight Loss
- Increased Skin pigmentation in areas not exposed to the sun
- A loss of appetite
- Low blood pressure
- Low blood glucose levels
- Low sodium levels
- High potassium levels
- High Calcium Levels
Why Get Tested:
If you have a high cortisol level, you may have:
- A rounded face
- Fragile, thin skin
- Purple lines on the abdomen
- Weak muscles
- An increased amount of body hair
- High Blood Pressure
- Low Potassium Levels
- High Bicarbonate Level
- High Glucose Levels
Purpose Of The Test (Indications)
- This hormone is estimated in various conditions like Adrenal insufficiency, in Cushing’s syndrome and Acromegaly, etc.
- For the diagnosis of Addison’s disease (level is>1000 pg /ml).
- Its level decreases in Secondary Adrenocortical Insufficiency, Adrenal carcinoma, and adenoma.
- This is the test of the anterior pituitary gland.
- The Patient’s plasma is needed.
- Place blood immediately in ice water and freeze plasma in 15 min.
- The sample should be collected in a prechilled plastic test tube with EDTA or heparin.
- For the diagnosis of Cushing’s syndrome, the sample should be taken between 6 to 11 pm.
- Centrifuge the sample at 4 °C and store at -20 °C immediately within 15 minutes of collection.
- A stressful collection of the blood will raise the level.
- Avoid physical activity 10 to 12 hours prior to taking the sample.
- Stop medication like corticosteroids 48 hours before this test.
- Collect the sample in a chilled plastic vial with EDTA or Heparin.
- ACTH is very labile and requires antiprotease in the collecting vial.
- In the routine, the ACTH level is not measured because it degrades in the plasma.
- Put the patient on a low carbohydrate diet.
- Adrenocortical hormone (ACTH) is produced by the anterior pituitary lobe.
- Corticotropin-releasing-hormone (CRH) is made and released from the hypothalamus and gives rise to the release of ACTH from the pituitary glands.
- ACTH is advised for investigating disorders of the hypothalamic, pituitary and renal system.
- ACTH is secreted by the anterior pituitary gland that signals the adrenal gland to produce steroids (androgens, cortisol, and aldosterone). These are needed for the normal functioning of the body.
- With adrenal insufficiency, the pituitary gland release proopiomelanocortin and ACTH are increased.
- ACTH is unstable in the blood. Most commercial RIA kits are insensitive and nonspecific to measure ACTH.
- 6 to 8 a.m = < 80 pg / mL or <18 pmol /L (SI units).
- 6 to 11 p.m = < 50 pg /mL or <11 pmol /L (SI units).
- or less than 120 pg/ml
Increased ACTH Level Is Seen In:
- Addison disease (primary adrenal insufficiency).
- Ectopic ACTH syndrome.
- Cushing’s syndrome. This is dependent upon the adrenal hyperplasia due to the pituitary gland.
Decreased ACTH Level Is Seen In:
- Secondary adrenal insufficiency is due to pituitary insufficiency.
- Adrenal adenoma or cancer.
- Exogenous steroid administration.
Possible References Used