Explaining An ACTH Test and Addison’s Disease

Photo: Vall d’Hebron Institut de Recerca VHIR

To an outsider, the doctor’s office is a scary and complicated place. There are numerous conditions and terms that are foreign to those outside of the medical field, so shedding light on procedures and conditions helps to make them less scary. Many people may not have heard of an ACTH stimulation test and if administered to them in the doctor’s office, they may what to know more. Learning about this test and why it may be needed can can better prepare you next time you visit the doctor, and is useful general health knowledge.

An ACTH test is performed to see if the adrenal glands are functioning normally, to diagnose Addison’s Disease, or to test for other conditions relating to the adrenal glands. The test is administered by an injection of the hormone ACTH into the adrenal glands, which triggers a release of cortisol into the bloodstream. Cortisol levels are then measured in the body to determine if the adrenal glands are producing cortisol in a sufficient manner. Normally ACTH (adrenocorticotropic hormone) is created in the pituitary gland to stimulate the adrenal glands to release cortisol, which is necessary to increase blood sugar, aid in metabolism, and suppress the immune system.

An ACTH test measures cortisol levels in the body before and an hour after ACTH has been injected. Blood is drawn to measure the cortisol levels. Some people are required to fast before the test is performed. There may some pain because of the needle, but it is not extreme or out of the ordinary for inserting a needle into the skin. An endocrinologist or your general doctor may be able to provide this test. Prices can vary but may be around $100 for the test.

When to take an ACTH test

An ACTH test is usually recommended when when a person is thought to have an irregular amount of cortisol in their system. This can lead to diseases like Cushing’s, hypopituitarism, or Addison’s Disease.

To help diagnose Addison’s Disease, then, the ACTH test is used because the symptoms can be ambiguous. Addison’s disease is caused by damaged adrenal glands and results in a cortisol deficiency in the body. Addison’s can be fatal but sometimes symptoms appear suddenly or are not specific. A few symptoms of Addison’s include abdominal pain, less body hair, fatigue, salt craving, low pressure, and muscle aches. Hyper-pigmentation is another Addison’s symptom, meaning portions of the skin are darkened or discolored. More serious symptoms can also occur such as fainting, extreme pain in the lower back, vomiting, shock, or kidney failure.

Addison’s disease can affect anyone, regardless of gender of age. Normally an autoimmune process, the immune system mistakenly attacking the body, causes Addison’s. Addison’s is sometimes the result of infections, cancer in the adrenal gland, tuberculosis, or bacteria. People suffering from one of these are more likely to contract Addison’s.

Treatment

Treatment for Addison’s normally involves supplementing hormones. The hormone hydrocortisone is often prescribed to help treat symptoms. This tablet can be taken once or twice a day by mouth. Usually most people respond well to treatment and Addison’s becomes a manageable disease. Alternative remedies may include salt or fluid injections.

Addison’s disease can be troubling and stressful. However, when sticking to a treatment plan it becomes easy to control. An ACTH test is one of the first steps in diagnosing Addison’s disease. This test can improve your quality of life, or even save it. An ACTH test is necessary for anyone who may have a cortisol deficiency.

A word of caution regarding Cortisol

Cortisol is important because it is your body’s way of reacting to stressors and returning to homeostasis. But if you are chronically stressed, then your body may be continually producing cortisol, which can have many damaging effects on the body. Some examples of adverse effects include a weakening of the immune system, collagen loss in the skin, osteoporosis, potassium loss, insulin resistance, and an over-secretion of gastric-acid (which facilitates proper digestion).


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