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ACTH stiumulation test
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ACTH stiumulation test

Endo ordered ACTH stimulation test due to low cortisol of 6.8. On test day the base line was 7 and after 60 minutes it was 25.8, would this result indicate Secondary Adrenal Insufficiency?
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Did you have any side effects from the ACTH injection??? I am having mine next Monday.....
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657231_tn?1390151580
I think the doctor is going to say you have AI - the magic number being 34.
You would have had to had a concurrent test of CRH to determine source - that being adrenal (primary) or pituitary (secondary). I don't see a single ACTH reading so a source is not possible to say.
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Avatar_f_tn
ACTH results the week before was 14. Not sure if they ran CRH test or not. I was told the Cortisol test was going to take 1 -2 weeks for the results, but that was posted in 2 days, so not sure if still waiting for additional results or not. Endo has been out of the office, but I will contact her tomorrow.
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657231_tn?1390151580
It would have been a CRH stim test. I don't know if they did that test so source is not determined. Treatment is still the same. Your ACTH was not that low so your source was likely primary.
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1263014_tn?1318036297
Did you have any side effects from the ACTH injection??? I am having mine next Monday.....
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657231_tn?1390151580
I have only had the CRH test - I got some flushing from that.
Someone will have to chime in on the ACTH test.

Good luck on the testing!
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Avatar_f_tn
When I had my ACTH Stimulation test they warned me there might be a tightening sensation in my gut (there was, but it's not as bad as it sounds), and some mild nausea. I think there are other potential side effects, but I didn't have any. They went away within minutes - very brief.


Best of luck!!
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Avatar_m_tn
My daughter had the ACTH test. She said the feeling of cortisol flow made her alert like she hadn't felt in years. Instantly!

But it made her tired for a few days. It makes your adrenal glands work hard.

If you DON'T get any response, that means adrenals are not putting out cortisol when your body needs it.
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Avatar_f_tn
I had a cortisone test done before and my level to start was 50 so the endo sent me for a ACTH test short sint. He then wrote to me and said no need to be seen again. I didn't even know my results of the ACTH. I've been suffering for the last 2 year with fatigue, weAkness, stress, sickness and stomach cramps I've lost 3 jobs over it I've picked up shingles, had pneumonia and I get Ill constant i just want to know whAts wrong there must be something wrong for my levels to be so low In the first place anyone recommend something or tell me what it could be cause the doctors are hopeless!!!
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657231_tn?1390151580
Call the office and ask for a copy of the tests. Once you get a copy, look at them - often docs read them wrong - so you may be able to go to another doctor. Also, you may pass the test even if you are sick but you may fail soon but the doc may just be a numbers guy - so just get a copy from the doc or the lab and find another doctor.
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Avatar_m_tn
I had the ACTH test, baseline 28.7, 30 minutes later 25.1,  60 minutes later 28.4
Endo sad this was just fine???? Dont seem to find any results like this on the net.
Time for second opond????
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657231_tn?1390151580
Well, you started in a normal range, and you stayed in normal range. You really should have either dipped or gone up given the stim agent - but you just stayed the course, again, in the normal range. So they are going to call it normal. In fact, by my labs, that is a high reading - so I am not sure what lab you are using.

However, you can be borderline and drop later - so if your doc is smart, he will monitor and re-do the test... but few are smart!
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Avatar_m_tn
Hi, Was a ACTH stim test with a reference range Adult 4.0-22.0
Thought it was high but the Doc she said it was just fine.
Had other blood work done 6/010 and my cortisol was 5.44 on a scale of 8.7-22 but that blood work was taking at 7.40 PM. showed that to the other doc and he sent me for the stim test and to see this Endo who said it was just fine.
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657231_tn?1390151580
What are the symptoms? There is an entity called cyclical Cushing's - it would cause high and low cortisol - so you would get the worst of both worlds. High cortisol and low cause fatigue (*****!) and have a lot of weird things that cause you to have weird blood pressure issues and glucose issues - but not everyone.

I had it - and I know others that some get super low and some super high and super low. Have you lost a ton of weight, or gained? Have you had any other cortisol, ACTH or any other pituitary testing? Other hormones? Thyroid?
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Avatar_m_tn
Fatigue, Shakey (shaky), Anxiety, Go into low blood sugar, very easy to get on a adrenalin rush.
Thyroid shows good 1.87 on a scale of .34-4.82
Feels like i drank two pots of coffee.
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657231_tn?1390151580
Has the doc run any other tests or cortisol at any other time other than morning?
Has your weight gone up or down? Any tan? Crave salt? Do you feel like all the cars are coming at you?
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Avatar_m_tn
She is running a test for Adrenal function cant remember what it was. this all started after two weeks of the Tx for hep c, Interferon Alpha 2b
That is one bad drug looking for something to cure. And i only did it for two weeks, was fine before.
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657231_tn?1390151580
So your immune function is impaired as well?
Does she think your cortisol is high or low? I ask as some of your symptoms sound like high cortisol rather than low. ACTH is an easily botched test - was the tube chilled? Put in the centrifuge right away? You only had one test for cortisol - blood - what about urine, saliva? They should also test you several times to see you over time.
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Avatar_m_tn
She said i was just fine? said it was good i started off that high  baseline 28.7, 30 minutes later 25.1,  60 minutes later 28.4  ACTH stim test with a reference range Adult 4.0-22.0
Thought if i was normal i would start in that range then go up. Urine comes back fine. Don't know what they did with the blood after they took it. I'm i missing something here, When they give you a ACTH test what is it checking for? no more cortisol testing or saliva.
lab work done at Quest
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Avatar_m_tn
What I understand is that is my cortisol level being simulated by the cosyntropin they injected in me.
Think I better get another Endo. going to see other doc who sent me to her, I'll see what he says. been complaining about the pain in my back for a year now. didn't know the adrenals were on top of you kidneys. maybe that's why I thought me kidneys where hurting? thinks to think about.
just check labs didn't run urine cortisol test
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657231_tn?1390151580
ACTH is released by the pituitary to tell the adrenals to release cortisol - so a good doctor will test both all the time as both need to working in sync for the body to be correctly. It is a feedback loop - so if the adrenals do not work, ACTH rises to try to force the adrenals to release more or if the pituitary is impaired, both are low as the adrenals don't know any better!

I think they are just judging you on the normal baseline - the test is supposed to cause a rise in cortisol but that did not happen however you were already normal...
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Avatar_f_tn
OK my fasting am cortisol level was a 0.3 .....I have been having some weird symptoms like I have had a migraine for almost 3 weeks now and I get dizzy really easy and confused feeling kinda like I am lost I can be in the store and its like I black out but I don't pass out I just forget everything like what I was there for and my lips get really tingly its so scary is this normal I am terrified I feel like I am dying anyone else ever have these symptoms?
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657231_tn?1390151580
What is your sodium? What is your blood pressure?
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Avatar_f_tn
I did the TX Hepc 1 year ago it was very hard and I became type 1 diabetic and now getting low cortisol test results also, It trashed me.  My test today came in and it shown my base line cortisol was 6.8 or>5 and the cortisol 1 hr. was at 19.3 or >20 no idea what that means. I'm just in the same shape sounds like.
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