adrenocorticotropic hormone

adrenocorticotropic hormone test (ACTH),usage, risks, procedures, indications and results

introduction of adrenocorticotropic hormone test

The adrenocorticotropic hormone test (ACTH) measures cortisol production and adrenal gland function. It diagnoses adrenal illnesses including Addison’s disease and Cushing’s syndrome.

Cosyntropin, a synthetic version of adrenocorticotropic hormone (ACTH), promotes cortisol production in the test. Healthcare personnel supervise the process at a clinic or hospital.

Before cosyntropin, the adrenocorticotropic hormone test measures baseline cortisol levels using a blood sample. Then, synthetic adrenocorticotropic hormone is injected into a muscle or vein. After 30–60 minutes, another blood sample is collected to evaluate adrenocorticotropic hormone -induced cortisol levels.

Cortisol levels before and after adrenocorticotropic hormone injection assist assess adrenal gland response. Adrenal insufficiency, such as Addison’s disease or secondary adrenal insufficiency, may be indicated by abnormal cortisol levels or adrenocorticotropic hormone stimulation. However, high cortisol synthesis following adrenocorticotropic hormone test treatment may indicate hyperfunctioning adrenal glands like Cushing’s disease.

The adrenocorticotropic hormone test helps diagnose and treat adrenal problems. However, you must contact a healthcare expert for particular information, preparation instructions, and test results interpretation.

purpose and importance of adrenocorticotropic hormone test

 The ACTH test helps diagnose and treat adrenal gland diseases. The adrenocorticotropic hormone test test’s main goals and significance are:

ACTH tests adrenal function. It assesses adrenal gland cortisol production, which regulates metabolism, immunological response, and stress. Adrenal insufficiency or hyperfunction may cause elevated cortisol.

ACTH tests may identify adrenal problems. It can distinguish between primary adrenal insufficiency (Addison’s disease), where the adrenal glands don’t produce enough cortisol, and secondary adrenal insufficiency, where the pituitary gland or hypothalamus doesn’t produce enough adrenocorticotropic hormone.

Adrenal insufficiency may be caused by autoimmune illnesses, infections, drugs, or other problems. adrenocorticotropic hormoneactivation of the adrenal glands may help determine the reason. This data is essential for therapy and management decisions.

Adrenal gland dysfunction patients may utilise the adrenocorticotropic hormone test to track therapy progress. Regular ACTH testing help verify that hormone replacement treatment for Addison’s disease patients with glucocorticoids such hydrocortisone maintains cortisol levels.

Adrenal problem therapy choices depend on adrenocorticotropic hormone test findings. Healthcare providers may propose hormone replacement treatment, prescription adjustments, or other diagnostic testing based on test findings.

The adrenocorticotropic hormone test helps doctors measure adrenal function, identify adrenal illnesses, distinguish primary from secondary adrenal insufficiency, monitor medication efficacy, and make treatment choices. It aids adrenal gland-related patient diagnosis, treatment, and optimisation.

Procedure of adrenocorticotropic hormone test

adrenocorticotropic hormone, or cosyntropin stimulation, tests are performed as follows:

Preparation: Your doctor may offer instructions before the test. These guidelines may include fasting before the test, avoiding drugs that affect cortisol levels, and disclosing any medical conditions or prescriptions. Carefully follow these directions.

A baseline blood sample is taken to start the test. A sterilised needle and syringe are used to take blood from your arm. This sample measures baseline cortisol before adrenocorticotropic hormone stimulation.

adrenocorticotropic hormone Administration: After the baseline blood sample, cosyntropin, a synthetic adrenocorticotropic hormone, is delivered. Cosyntropin is commonly injected intramuscularly or intravenously. Your doctor will use the right method.

Waiting Period: After receiving cosyntropin, you will be instructed to relax for 30–60 minutes. The adrenocorticotropic hormone stimulates cortisol production during this delay.

After stimulation, another blood sample is taken. A sterilised needle and syringe will be used to take blood from a vein. This sample measures ACTH-stimulated cortisol levels.

The ACTH test is complete after collecting the post-stimulation blood sample. A lab will analyse baseline and post-stimulation blood samples for cortisol levels. The data will aid adrenal gland assessment and diagnosis.

The ACTH test technique depends on the healthcare practitioner, test purpose, and patient conditions. Consult your doctor for precise, situation-specific recommendations.

Indications of adrenocorticotropic hormone test

In certain cases, the ACTH (cosyntropin stimulation) test may be recommended:

Suspected adrenal insufficiency: The test is often done. Adrenal insufficiency causes exhaustion, weight loss, low blood pressure, and electrolyte abnormalities. The ACTH test checks adrenal cortisol production.

Monitoring Glucocorticoid Replacement Therapy: Adrenal insufficiency patients commonly receive hydrocortisone or other glucocorticoids. The ACTH test can assess therapy efficacy and ensure that the prescription glucocorticoids maintain cortisol levels.

Suspected Cushing’s Syndrome: Cortisol overproduction characterises this condition. ACTH stimulation of the adrenal gland may help diagnose Cushing’s syndrome. ACTH may not raise cortisol levels in Cushing’s syndrome.

The ACTH test evaluates the HPA axis, which includes the hypothalamus, pituitary gland, and adrenal glands. It assesses their communication and hormone production and regulatory problems.

The ACTH test can assess adrenal responsiveness and cortisol production in critically unwell individuals. This helps diagnose adrenal dysfunction and determine whether essential situations need corticosteroid medication.

Based on patient symptoms, medical history, and other diagnostic information, trained healthcare practitioners should order and interpret the ACTH test. The healthcare practitioner and patient’s condition determine the indications.

Types of adrenocorticotropic hormone test

Two primary ACTH tests exist:

The standard ACTH test uses synthetic ACTH (cosyntropin) to activate the adrenal glands and assess cortisol response. The test evaluates baseline cortisol levels before and after ACTH stimulation (typically 30 to 60 minutes). Comparing cortisol levels helps detect adrenal insufficiency and other illnesses.

High-Dose ACTH Test: This test uses more synthetic ACTH (cosyntropin) than the conventional ACTH test. It’s utilised to distinguish Addison’s illness from secondary adrenal insufficiency. Despite high ACTH doses, the adrenal glands cannot generate enough cortisol in primary adrenal insufficiency. Secondary adrenal insufficiency responds well to a greater ACTH dosage, indicating a pituitary or hypothalamic issue.

These two ACTH assays examine adrenal gland function, diagnose adrenal insufficiency, distinguish primary from secondary, and assess adrenal gland responsiveness to ACTH stimulation.

The ACTH test utilised depends on the healthcare provider’s preferences, the test’s goal, and the patient’s clinical circumstances. Healthcare practitioners base test selection on clinical judgement and patient diagnostic requirements.

Risk of adrenocorticotropic hormone test

Any medical test has dangers, but the ACTH test is typically safe. Talk to your doctor before the test. ACTH test risks include:

Discomfort and Bruising: Getting baseline and post-stimulation blood samples may hurt. The injection site may bruise.

Allergic responses to synthetic ACTH (cosyntropin) used in the test are infrequent. Inform your doctor if you are allergic to ACTH or similar drugs.

Dizziness or fainting: Some people faint during or after blood collection. Inform the healthcare provider if you have fainted during blood draws before.

Synthetic ACTH may cause hormonal imbalances. The test should resolve this short-term impact.

Medication Interference: Some medicines may affect ACTH test findings or adrenal gland response to ACTH stimulation. Before the test, tell your doctor about any drugs, supplements, and herbal therapies.

Adrenal Crisis (Rare): ACTH may lower cortisol levels rapidly in those with severe adrenal insufficiency or adrenal crisis. In significantly reduced adrenal function, this is unusual but a worry.

Remember that the ACTH test is done under medical supervision, and doctors can handle any difficulties or side effects. The exam will be continuously monitored to guarantee your safety.

Before the ACTH test, address any concerns or adverse effects with your doctor.

Results of adrenocorticotropic hormone test

Healthcare professionals examine the patient’s symptoms, medical history, and other diagnostic tests when interpreting ACTH test findings. General criteria for ACTH test findings and their significance:

After ACTH injection, cortisol levels should rise considerably. This shows that ACTH activation stimulates the adrenal glands to release enough cortisol.

Abnormal Response (Low Cortisol): Adrenal insufficiency may result from low cortisol following ACTH treatment. Adrenal insufficiency may be primary (Addison’s illness) or secondary. The reason may need further testing and clinical examination.

After ACTH stimulation, cortisol levels may rise excessively. Cortisol overproduction causes Cushing’s syndrome. The reason and treatment need more investigation.

To provide a complete diagnosis, ACTH test results should be evaluated with other clinical findings, symptoms, and diagnostic testing. Healthcare professionals are essential for interpreting data and developing treatment plans.

Your doctor knows your medical history and can explain your ACTH test findings. They can provide you the best interpretation and treatment advice.


The ACTH test, commonly known as the cosyntropin stimulation test, evaluates adrenal gland function and diagnoses adrenal diseases. Synthetic ACTH (cosyntropin) stimulates the adrenal glands and measures cortisol response. A healthcare practitioner must interpret ACTH test findings due to numerous reasons. The ACTH test yields these generalisations:

Normal Response: ACTH treatment raises cortisol levels considerably. This shows that ACTH activation stimulates the adrenal glands to release enough cortisol.

Abnormal Response (Low Cortisol): Adrenal insufficiency may result from low cortisol following ACTH treatment. Additional testing and clinical assessment are needed to establish the adrenal insufficiency type and aetiology.

Abnormal Response (Excessive Cortisol): If cortisol levels rise excessively following ACTH stimulation, it may suggest Cushing’s syndrome. The reason and treatment need more evaluation.

A healthcare expert should interpret ACTH test findings based on the patient’s medical history, symptoms, and other diagnostic information. Test findings assist adrenal gland dysfunction diagnosis, therapy, and management.

Consult your doctor if you have questions regarding your ACTH test findings. They can explain things clearly and help you decide on additional testing or treatment.


Q: Why is ACTH tested?
A: The ACTH test evaluates adrenal gland function, diagnoses adrenal illnesses such adrenal insufficiency, distinguishes primary from secondary adrenal insufficiency, monitors therapy efficacy, and guides treatment choices.

How is ACTH tested?
A: The ACTH test measures cortisol before and after synthetic ACTH (cosyntropin) activation. Blood samples measure cortisol response.

Q: Do ACTH tests need fasting?
ACTH tests don’t need fasting. Your doctor may give you pre-test diet and medication restrictions. Follow your doctor’s recommendations.

Q: Is the ACTH test safe?
A: The ACTH test is typically safe, however it might cause blood collection pain, needle bruises, allergic responses (rare), and hormonal imbalances. Talk to your doctor.

Q: ACTH test duration?
A: The ACTH test usually takes 1 to 2 hours, including the waiting time.

Normal ACTH test results indicate?
A: Normal ACTH tests demonstrate a considerable cortisol rise following stimulation. This shows adrenal gland health.

What does an abnormal ACTH test mean?
A: Abnormal ACTH test findings without considerable cortisol rise may suggest adrenal insufficiency. Adrenal insufficiency type and cause need more testing.

Can medicines affect ACTH test results?
A: Some drugs affect ACTH test findings. Before the test, tell your doctor about any drugs, supplements, and herbal therapies.

These are some frequent ACTH test questions. Consult your healthcare practitioner for more specific inquiries or concerns.

Myth vs fact

Myth: ACTH testing hurts.
Fact: The baseline and post-stimulation blood samples may be uncomfortable, but the test is not unpleasant. Individual sensitivity and test-giver expertise affect discomfort.

Myth: ACTH testing requires fasting.
ACTH tests do not need fasting. Follow your doctor’s diet and drug restrictions.

Myth: ACTH may identify adrenal problems.
The ACTH test measures adrenal gland function and cortisol responsiveness. It may suggest adrenal insufficiency, but further testing and clinical assessment are required to confirm the type and cause.

Myth: ACTH exclusively detects adrenal insufficiency.
Fact: The ACTH test is used to diagnose adrenal insufficiency, differentiate between primary and secondary adrenal insufficiency, monitor glucocorticoid replacement therapy, evaluate HPA axis function, and assess cortisol response in critical illness.

Myth: The ACTH test alone diagnoses adrenal problems.
Fact: The ACTH test helps diagnose adrenal problems, although further tests and clinical examination are typically needed. These may include imaging, hormone testing, and a complete medical history and physical.

Myth: ACTH findings are usually clear.
Fact: A doctor must examine the patient’s clinical appearance, symptoms, medical history, and other diagnostic tests to interpret ACTH test findings. To diagnose and treat, results should be considered alongside additional data.

Your doctor should answer any ACTH test questions and offer correct information.


ACTH (Adrenocorticotropic Hormone): A pituitary hormone that causes the adrenal glands to release cortisol.

Damage to the adrenal glands causes Addison’s Disease, which reduces cortisol production.

Baseline: Cortisol levels before synthetic ACTH delivery in the ACTH test.

Cushing’s Syndrome: Cortisol overproduction caused by tumours or corticosteroid overuse.

Cortisol: An adrenal hormone that regulates metabolism, immunological response, and stress response.

Cosyntropin: A synthetic ACTH used in ACTH tests to stimulate adrenal glands and measure cortisol response.

Diagnostic Test: A test performed to diagnose a medical ailment or evaluate a biological system or organ.

Endocrine System: The glands that release hormones into the circulation to control physiological activities.

Glucocorticoids: Stress, immunity, and metabolism-regulating hormones.

Hypothalamus: Signals the pituitary gland to release hormones.

Hormones: Chemicals generated by glands that regulate physiological processes.

HPA Axis: The brain, pituitary gland, and adrenal glands control cortisol synthesis and release via a complicated feedback system.

Hypercortisolism: Cortisol overproduction, as in Cushing’s syndrome.

Synthesis: Chemical production, like hormone production.

Suppression Test: A test that suppresses a biological system or organ to evaluate it.

Corticosteroids: Anti-inflammatory and immunosuppressive drugs that imitate cortisol.

Electrolyte Imbalances: Abnormal amounts of minerals (electrolytes) including sodium, potassium, and calcium may impact many biological activities.

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