Question about ACTH test...

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Question about ACTH test...

Postby kvscheufler » Sat Apr 17, 2010 9:09 pm

Can someone tell me if it's normal to feel absolutely nothing during your ACTH test? I thought the purpose of the test was to put you into 'fight or flight' mode. The only thing I felt was a desire to go to sleep, nothing more. Is that normal? I've been suffering from many different symptoms since my son was born almost a year ago and I cannot find a diagnosis. I feel as if I'm slowly dying and nobody is listening to me. My hair is falling out, I sweat all the time (my poor family feels like they are playing freeze out), I bruise easily,have extreme fatigue, I was diagnosed with Hashimoto's, the list goes on and on. While my thyroid levels are under control, my symptoms are NOT improving! If I don't find an answer soon, I worry what is going to happen to me. Thanks in advance for your time.
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Re: Question about ACTH test...

Postby gkardel » Sun Apr 18, 2010 10:37 pm

The purpose of the ACTH stim test is to see how cortisol production responds to the increased ACTH. If you have primary adrenal insufficiency, your pre test ACTH levels would be very high and cortisol levels would be low and not increase that much after the ACTH injection.

Treating hypothyroidism with undiagnosed adrenal insufficiency will increase the intesity of the AI symptoms. Thyroid hormone increases metabolism which increases demand for cortisol.

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Re: Question about ACTH test...

Postby PeterR » Thu Jul 07, 2011 5:05 pm



May I add a question about ACTH Stimulation Test please? I have had a Stimulation test but what I do not understand is that my baseline ACTH level was not taken despite my having diagnosed Hypopituitarism and also low Hypothalamus hormones such as CRH. My Cortisol levels in the morning and so baseline for stimulation test are below hospital range. I have recently seen hospital laboratory test results where my DHEA-S was 1.1uMol/L [Hosp range for males 5 - 13 umol/L]. A home Adrenal Function Urine Test suggested Adrenal Fatigue and see my GP. I have been suffering from exhaustion and chronic fatigue, craving salt such as by having peanut butter etc. My Adrenal glands respond to the ACTH stimulation and incresae greatly after 30-60minutes but we had no level for ACTH which I expected to be low as reported when I was first diagnosed as Hypopituitary, many years ago. Surely without measuring the ACTH base level it is not possible to say if it is Seconday/Tertiary Adrenal Fatigue merely that the actual Adrenal glands function??

Best wishes,

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Re: Question about ACTH test...

Postby laura90815 » Wed Jul 13, 2011 6:44 pm

I have to tell you all that i truly believe that the test results lag far behind the symptoms of this disease- which means that I think many people with early addison's disease have normal looking labs despite having horrible symptoms for years. this was the case with my 11 yr old son who has been diabetic since he was five years old. Around 8 yrs of age he started having many "adrenal' symptoms- chronic fatigue, severe nausea, vomiting, complete inability to tolerate activity without getting sick, hot flashes, sweating, severe weakness- i could go on and on- we were sent to every specialist there was -the whole time I knew it was his poor adrenal function. He had a positive adrenal antibody test but the problem being that he kept 'passing " the acth/cortisol stim tests. Finally after much fighting- we went to an adrenal specialist who suggested doing a "low dose" stim test. he failed this miserably- started on steroids(very low dose) and is like a new boy. He played kickball with his friends on the playground for the first time in 3 yrs and didnt get sick! he wants to eat again- has energy like kids should have- it is like a miracle! Having addisons is still a balancing act and we still have some rough days but for the most part- it is good again. I am a pediatric nurse and feel lucky that i had some knowlege to fight for my son- it shouldnt have to be this way. I now suggest to everyone I know going thru this to ask for a "low dose" cortisol stim test- the results are much more accurate. Out acth levels are still normal as the disease has not progressed all the way yet- but know that he does not make enough cortisol to function normally. Sorry this is so long- just feel very passionate about people having to suffer needlessly because there are so few md's that even understand this disease. Good luck to u all- keep up the fight!!!!
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Re: Question about ACTH test...

Postby PeterR » Thu Jul 14, 2011 2:23 pm

Dear Laura

Thank you so much for taking the time to respond and share your own experience and that of your Son. I hope he is doing so much better nowdays?

Oh yes, I am familiar with similar stories although not within Adrenal Dysfunction but surrounding Pituitray and related endocrine illness and diagnosis.

What I am trying to confirm and pin down is the protocol for the ACTH / Synthacin Test as I have had 2 tests but not one ACTH Baseline test despite hospitals being aware I have both Pituitary and Hypothalamus conditions were my hormones are LOW/Hypo.

My own understanding of the test is that if the Cortisol levels greatly incarese after stimulation then the Adrenal Reserve is functioning. However, as my Cortisol is always below normal range when tested as baseline we need the Pituitary ACTH level to find that is also low to diagnose Secondary Adrenal Dysfunction. As my Hypothalamus also produces low hormones CRH is low.

I have all the symptoms and a Canadian Adrenal Fatigue Test (Urine titration to find percentage of sodium chloride) indicates Adrenal Fatigue and states "Contact your GP for advice". However, this test kit from 2010 is still awaiting canadian and US (FDA) approval.

Once again - Thanks!

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