Have you ever felt a little strangely tired, suddenly gained or lost weight, or had a change in skin color? At a time like this, if a doctor told you, "Let's do an ACTH test," you might be a little nervous. "What kind of test is that?" You might be wondering. Don't worry. This is a routine blood test that is often done to check the hormones in our body. Today, we'll talk about everything in a very simple way that you can understand.
Simply put, what is ACTH?
Our body is an amazing machine. Each part of it communicates with each other through chemical messages called "hormones." Imagine that
the pituitary gland, which is the size of a pea and is located at the base of our brain, is like the chief manager in a large office. This manager releases a special message called
ACTH (Adrenocorticotropic hormone) . This message goes directly to the
adrenal glands, which are like two caps on top of our kidneys. These adrenal glands are like a factory. Once the ACTH message comes from the pituitary gland, this factory produces the essential hormone called
cortisol .
So, why is this hormone cortisol important to us?
Cortisol is not just a hormone. It has a very important function in our body.
- Helps control your blood pressure .
- It gives the body the strength to fight infections effectively .
- It helps us break down the sugar , fat , and protein in the food we eat and produce energy .
- Helps the body manage stress.
Now you understand how important this system is? If the ACTH message from the pituitary gland increases, the adrenal glands produce more cortisol. If ACTH decreases, cortisol production also decreases. If a doctor has doubts about the functioning of these two glands, that is, if he wants to know whether the ACTH or cortisol levels are high or low, he will order this ACTH test.
Importantly, the ACTH test is usually done at the same time as the cortisol test , as the functions of these two hormones are related.
What kind of symptoms is this test performed for?
The symptoms caused by an imbalance of the ACTH hormone are directly related to the increase or decrease in the cortisol hormone. Let's see what these symptoms are.
Symptoms of elevated cortisol levels due to increased ACTH
| Weight gain | Fat deposits, especially around the face, back of the neck, and shoulders. |
| Skin changes | The appearance of pink or purple stretch marks on the stomach, thighs, and breasts. |
| Weakening | Muscle weakness and frequent extreme fatigue. |
| Other features | Even a small wound turns blue quickly, acne increases, unwanted hair growth in women, and high blood pressure. |
Symptoms of low cortisol levels due to low ACTH
| Weight loss | Losing weight despite eating well. |
| Digestive system problems | Frequent nausea, vomiting, stomach cramps, and diarrhea. |
| Skin changes | Darkening (blackening) of the skin in some areas, especially the elbows and knees. |
| Other features | Frequent feelings of extreme fatigue, dizziness, and cravings for salty foods. |
Based on these symptoms, your doctor may suspect that you have a condition such as
Cushing's syndrome (increased cortisol),
Addison's disease (decreased cortisol), or a tumor in the pituitary gland or elsewhere. This ACTH test is very important to confirm that suspicion.
How should you prepare before the test?
Since this is a blood test, there is no need for much preparation. However, there are several things that can affect the results of the test. Therefore,
it is very important to follow the doctor's instructions exactly.
- Steroids: If you are taking any steroid medications, your doctor may ask you to stop taking them about 48 hours before the test. These medications can completely change the results.
- Food and Drink: You may be asked to fast from midnight the night before the test. You may also be asked to limit your carbohydrate ( starch ) intake .
- Exercise and stress : Avoid excessive exercise or unnecessary stress 12 hours before the test. These things can affect hormone levels.
- Get a good night's sleep: Get a good night's sleep the night before. Even lack of sleep can affect hormones.
- Inform your doctor about all medications: Be sure to tell your doctor about all medications (Western, Ayurvedic, Sinhala), vitamins, and supplements you are taking.
How to do the test and the risks
This is a very simple procedure. Just like a blood sample, a nurse will take a blood sample from a vein in your arm. But there's something special here. Our ACTH and cortisol levels change depending on the time of day.
ACTH levels are usually highest around 8 a.m. and
lowest at night . So, if your doctor wants to get a complete picture of your hormones, they may take blood samples once in the morning and again in the evening or at night. After the blood is taken, the samples are immediately placed on ice and sent to the lab. This is because ACTH is a hormone that can be destroyed quickly. As for the risks, there are the usual risks of any blood test. There may be some soreness where the needle was inserted, some bruising, and very rarely, infection. There's nothing to worry about.
How to understand the results?
The results of your report may vary slightly from lab to lab. The average ACTH level for a healthy adult, measured at 8 a.m., should be between 10 and 50 picograms per milliliter (pg/mL). However,
don't be a doctor and just make your own decisions based on the report . There are many other factors that can affect these results.
- Did you sleep well the day before the test?
- Were you stressed?
- Other medications you are taking (e.g. insulin, hormone pills).
- If it's a woman, the day of her menstrual cycle.
- A recent accident or trauma.
- Whether the blood sample was collected properly, stored on ice, and stored.
With all of this in mind, your doctor will look at both your ACTH results and your cortisol results together. They won't make a decision based on just one result. If your ACTH level is high and your cortisol level is also high, that means one thing. If your ACTH level is high and your cortisol level is low, that means another thing. So, once you get your results, take them with you to see your doctor. He or she will be the one who will take all of this into account and tell you exactly what your condition is and what to do next. They may also order more tests to confirm these results.
Take-Home Message
- The ACTH test is a blood test that measures a hormone released by the pituitary gland in our brain. It can also determine the function of the adrenal glands.
- This test is usually done along with a cortisol hormone test.
- A doctor may recommend this test if you have symptoms such as unexplained weight changes, excessive fatigue, or skin changes.
- It is very important for the accuracy of the results to follow the doctor's instructions (regarding diet, medication, and exercise) exactly before the test.
- After receiving the test report, do not draw your own conclusions based on the values. Be sure to show the report to your doctor for an accurate analysis and advice.
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