What you need to know about an ACTH test

Has your doctor told you to have an ACTH test? You might be a little nervous when you hear the name. You might be thinking, "What kind of strange test is this?" But there's no need to be afraid. It's a very simple blood test. Today, we'll talk about the ACTH test, why it's done, and how to prepare for it in a very simple way that you can understand.

Simply put, what is ACTH?

Okay, let's think of it this way. Your body is like a big company. There are a lot of important things going on in this company.

• The Main Manager: Right under your brain, there's a little gland about the size of a small pea. We call this the pituitary gland. This is the main manager of our story.
• The Message: This manager, the pituitary gland, sends out a special message. That message is what we call ACTH (Adrenocorticotropic hormone).
• The Worker: This ACTH message goes directly to two small glands on top of your kidneys. We call them the adrenal glands. These are the workers of our story.
• The Product: Upon receiving the ACTH message, these adrenal glands produce a very important hormone called cortisol.

So ACTH is the hormone that tells us to make cortisol. This cortisol hormone is very important for our bodies. It helps us control our blood pressure , respond to infections properly , and help us break down the sugars, fats, and proteins in the food we eat into energy .

Do you understand now? If your doctor suspects that there is something wrong with this system, he will ask you to take a blood test to check your ACTH and cortisol levels.

Why would a doctor recommend this test?

The ACTH test is not usually done alone. It is almost always done in conjunction with a cortisol test. This is because the symptoms we experience when ACTH levels are high or low are directly related to changes in cortisol levels.

Now let's see what these characteristics are.

By looking at these symptoms and testing your ACTH and cortisol levels, your doctor can determine if you have any of the following conditions:

• Cushing's syndrome: High levels of cortisol in the body.
• Addison's disease: Very low cortisol levels in the body.
• Whether there is a tumor in the pituitary gland or elsewhere .
• Whether your pituitary or adrenal glands are functioning poorly.

How to prepare for the test?

To get an accurate result from this test, you need to do a little preparation. Follow these steps exactly.

• Steroids: If you are taking steroids (e.g. Prednisolone), you will need to stop taking them about 48 hours before the test. These medications can affect the results. However, never stop taking them without first consulting your doctor. He or she will advise you on this.
• Food and Drink: Your doctor may tell you not to eat or drink anything after midnight the night before the test. Sometimes, they will also tell you to limit foods high in carbohydrates (starches) for about two days beforehand.
• Good sleep: Get a good night's sleep the night before the test.
• Exercise: Avoid strenuous exercise 12 hours before the test.
• Stress: Try to relax as much as possible. Avoid excessive stress for 12 hours before the test.

How to do the test and the risks

This is very simple. Just like a normal blood donation, a nurse will take a small sample of blood from a vein in your arm.

Because our hormone levels change throughout the day, your doctor may order blood tests once in the morning and again in the evening . ACTH levels are usually highest around 8 a.m. and then decrease toward evening. This double check helps your doctor get a complete picture.

After the blood is drawn, the sample is immediately placed on ice and sent to the laboratory.

The risks are just the normal risks of getting blood drawn with a needle. That means a little pain at the needle site, a little bruising, or, very rarely, an infection.

How to understand the results?

The values ​​on your test report may vary slightly from one lab to another. Results also vary depending on the time the blood was drawn.

Normally, ACTH levels in a healthy adult are between 10-50 pg/mL (picograms per milliliter) at around 8 a.m. By nightfall, this drops to less than 5-10 pg/mL.

But don't jump to conclusions based on these numbers. Other factors may affect your results.

• The way you slept the night before the test.
• The stress you are under.
• Whether you are pregnant or on your period.
• Some medications you take (e.g. hormones, insulin, steroids).
• A recent physical accident or trauma.
• Whether the blood sample was collected properly and stored on ice.

Your doctor will compare the ACTH report with the cortisol report and match it with your symptoms to reach a final conclusion. If there is an abnormality in your ACTH level, he or she may order additional tests to determine the exact cause.

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