ACTH Stimulation Tests

ACTH Stimulation Test in Hyderabad

 Adrenocorticotropic Diagnosis or ACTH is one of the hormones secreted by the pituitary gland that is located at the back of the brain. 

The main function of ACTH is to stimulate the adrenal glands of the kidney to release the two hormones called cortisol and adrenaline. These are also known as epinephrine and they help a person respond to stress. Although the response is done in a healthy way that would support the immune system.  Cortisol is known as the steroid hormone that affects many parts and systems of the body like-

• Circulatory system

• Immune system

• Nervous system

• Bone’s metabolism

• Metabolism of nutrients like carbohydrates, fats, and protein

The nervous and circulatory systems are maintained by the adrenaline hormone that along with the norepinephrine can help one fight against a stressful situation. It gives a response commonly known as a fight or flight reaction.

The ACTH tests are done to judge the same functions; that is know the functioning of adrenal glands. A synthetic portion of ACTH called cosyntropin is injected during the analysis and 2 blood samples are taken: one before the cosyntropin and one after the injection. 

The tests would judge the level of cortisol in blood that would help the doctors at CARE Hospitals to make a fine diagnosis (to know underlying causes) and treatment.

The tests called ACTH stimulation tests can measure the adrenal glands and their reaction with the ACTH in blood and doctors will know the cortisol levels. 

Why ACTH Stimulation Tests are taken?

The ACTH (Adrenocorticotropic Hormone) Stimulation Test is performed to assess how well your adrenal glands are functioning. Specifically, it helps diagnose issues related to adrenal insufficiency, such as Addison's disease or secondary adrenal insufficiency. Here's why the test is taken:

• To evaluate adrenal gland function: The test checks if your adrenal glands are producing enough cortisol, a vital hormone that helps regulate metabolism, blood pressure, and stress responses.
• To diagnose adrenal insufficiency: It helps determine if your adrenal glands are not producing sufficient cortisol due to damage (Addison's disease) or due to a problem with the pituitary gland or hypothalamus (secondary adrenal insufficiency).
• To monitor response to treatment: The test can be used to monitor patients with known adrenal disorders to ensure treatments are working correctly.
• To assess adrenal gland reserve: In cases where the body might be under stress (such as during illness or surgery), this test evaluates if the adrenal glands can respond by producing enough cortisol.

Symptoms of Addison’s Disease and Hypopituitarism  

Conditions like Addison’s disease (adrenal insufficiency), and hypopituitarism (pituitary not working) can be judged with the help of ACTH Stimulation Tests. The signs and symptoms include; 

• Sudden weight loss

• Low blood pressure

• Loss of appetite

• Muscle weakness

• Muscle and joint pain

• Fatigue

• Darkening or discolouration of the skin

• Mood changes

• Depression

• Irritability

There are some symptoms that can be encountered if one has the excess secretion of cortisol-

• Acne

• Round face

• Obesity

• Increased facial hair

• More body hair 

• Menstrual irregularities in females

• Low sex drive in men

The malfunctioning of the adrenal glands are judged on the basis of ACTH Stimulation tests and are further diagnosed to get treated.

Risks Associated with the Test

There are certain risks associated with the test at the time of blood drawn- 

• Lightheadedness

• Infection

• Excessive bleeding

• Fainting

• Hematoma

• Inflammation of the vein where the blood was taken out

People may feel mild pain at the site of injection or a throbbing puncture at the site. A small bruise can be observed but can’t leave long-lasting serious effects.

How the ACTH Simulation Test is Performed 

The diagnosis Through ACTH Stimulation Tests in Hyderabad takes place in the following manner.

• Physical examinations like blood pressure, glucose tests, essentials like fever, pulse rate, chest congestion, and weight examinations are conducted before the final examinations.

• These are called preliminary tests after which the ACTH blood test is conducted to check out other medical conditions- liver, kidney and related functions.

• After the body conditions, the medical history of the person is known to check for any genetic factor that is affecting their symptoms.

• When you are all set and asked for the diagnosis of ACTH Stimulation Tests, you’ll be required to submit a blood sample.

• It is taken to measure the blood cortisol levels and is further used as a baseline against which other comparisons would be made. It is conducted twice for the same reason.

• A synthetic portion of ACTH called cosyntropin is given as an injectable to the bloodstream where it would induce adrenal glands to produce cortisol. 

• An hour is required for the doctor to judge the reaction and further, he would take a second blood sample. These would give your cortisol levels in the blood. It is judged by the time the body took to react. 

• The samples of ACTH stimulation tests are further tested for their cortisol levels and the results can come up within a week or two.

• Your doctor can conduct the insulin-induced hypoglycemia test, along with the imaging tests to confirm a diagnosis.

• Doctors will know whether you’re having Addison’s disease or hypopituitarism.

How to Prepare for the Test

• You might need to reduce your physical activity and consume foods rich in carbohydrates 12 to 24 hours prior to the test. 
• In some cases, fasting for 6 hours before the test may be required. However, no specific preparation is needed in certain situations. 
• You could also be instructed to pause medications like hydrocortisone, as they can affect the results of the cortisol blood test.

How the Test will Feel

• When the needle is inserted for the blood draw, some individuals experience moderate pain, while others may only feel a prick or slight sting. Mild bruising or throbbing may occur afterward, but it usually subsides quickly.
• The injection into the shoulder can cause moderate discomfort or a stinging sensation.
• After receiving the ACTH injection, some people may feel flushed, anxious, or nauseous.

Normal and Abnormal Results

• Normal Results: After ACTH stimulation, an increase in cortisol levels is expected. Usually, cortisol levels should rise above 13 to 14 mcg/dL (358 to 386 nmol/L), depending on the cortisol test and ACTH dose used. Normal ranges may vary slightly between laboratories, as some labs use different units or test different samples. It's important to discuss your specific results with your healthcare provider for accurate interpretation.
• Abnormal Results: Abnormal results from this test can indicate conditions such as:
  • Acute adrenal crisis, a life-threatening condition due to insufficient cortisol.
  • Addison's disease, where the adrenal glands produce too little cortisol.
  • Hypopituitarism, where the pituitary gland is not producing enough hormones, including ACTH.

Treatment 

• Treatment is further given to correct the hormonal level of steroid hormones.

• If the blood cortisol levels are below the range, stimulation is assigned as low. 

• People may suffer from conditions like an acute adrenal crisis, Addison’s disease, or hypopituitarism.

• Although for these testing is mainly advised by the doctors to prescribe a suitable treatment.

Common treatments involve

Medications 

• Hydrocortisone (Cortef), prednisone or methylprednisolone to replace cortisol given in the form of injectable.

• Fludrocortisone acetate to replace aldosterone.

• Corticosteroids are given in the form of hydrocortisone (Cortef) or prednisone (Rayos). These will replace the adrenal because of an adrenocorticotropic hormone (ACTH) deficiency.

• Levothyroxine (Levoxyl, Synthroid, others) are given to cure the low thyroid hormone levels.

• Sex hormones

• Growth hormones 

• Fertility hormones 

Surgery

A periodic CT or MRI scan can be done to know the status of the pituitary tumour (if found in the tests) and would know the other related reasons.
It can involve surgery to remove such growth with the help of radiation treatments.

Why choose CARE Hospitals in India?

CARE Hospitals is one of India’s best multi-specialty hospitals, dedicated to providing incomparable and evidence-based health treatment. 

We are a prominent and integrated healthcare institution with many Centers of Excellence for super specialties such as heart surgery, CT surgery, neurology, cancer, liver, multi-organ transplants, bones and joints, nephrology, spine surgery, mother and child, and fertility.

Our hospital is regarded as one of the best hospitals in India due to its modern facilities and services. We have multispecialty hospitals that are well-equipped with fully functional medical beds, an intensive care unit/operation theatre, mobile ultrasound, X-ray, 2D echo, and other critical care services for critically ill patients.