ACTH

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What is an adrenocorticotropic hormone (ACTH) test?

This test measures the level of adrenocorticotropic hormone (ACTH) in the blood. ACTH is a hormone made by the pituitary gland, a small gland at the base of the brain. ACTH controls the production of another hormone called cortisol. Cortisol is made by the adrenal glands, two small glands located above the kidneys. Cortisol plays an important role in helping you to:

Respond to stress

Fight infection

Regulate blood sugar

Maintain blood pressure

Regulate metabolism, the process of how your body uses food and energy

Too much or too little cortisol can cause serious health problems.

Other names: Adrenocorticotropic hormone blood test, corticotropin

What is it used for?

An ACTH test is often done along with a cortisol test to diagnose disorders of the pituitary or adrenal glands. These include:

Cushing's syndrome

, a disorder in which the adrenal gland makes too much cortisol. It may be caused by a tumor in the pituitary gland or the use of steroid medicines. Steroids are used to treat inflammation, but can have side effects that effect cortisol levels.

Cushing's disease

, a form of Cushing's syndrome. Cushing's disease is usually caused by a noncancerous tumor of the pituitary gland. The tumor makes too much ACTH. This causes the adrenal glands to make too much cortisol.

Addison disease

, a condition in which the adrenal gland doesn't make enough cortisol.

Hypopituitarism

, a disorder in which the pituitary gland does not make enough of some or all of its hormones.

Why do I need an ACTH test?

You may need this test if you have symptoms of too much or too little cortisol.

Symptoms of too much cortisol include:

Weight gain

Buildup of fat in the shoulders

Pink or purple stretch marks (lines) on the abdomen, thighs, and/or breasts

Skin that bruises easily

Increased body hair

Muscle weakness

Fatigue

Acne

Symptoms of too little cortisol include:

Weight loss

Nausea and vomiting

Diarrhea

Abdominal pain

Dizziness

Darkening of the skin

Salt craving

Fatigue

You may also need this test if you have symptoms of hypopituitarism. Symptoms will vary depending on the severity of the disease, but may include the following:

Loss of appetite

Irregular menstrual periods and infertility in women

Loss of body and facial hair in men

Lower sex drive in men and women

Sensitivity to cold

Urinating more often than usual

Fatigue

What happens during an ACTH test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You may need to fast (not eat or drink) overnight before testing. Tests are usually done early in the morning because cortisol levels change throughout the day.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Results of an ACTH test are often compared with the results of cortisol tests and may show one of the following:

High ACTH and high cortisol levels: This may mean Cushing's disease.

Low ACTH and high cortisol levels: This may mean Cushing's syndrome or a tumor of the adrenal gland.

High ACTH and low cortisol levels: This may mean Addison disease.

Low ACTH and low cortisol levels. This may mean hypopituitarism.