High ACTH but normal cortisol - reasons??

[oca3]

Does anyone know what may be the cause/s of elevated ACTH (100.1) with normal cortisol? I just had the ACTH Stim Test and again the results are the same, but I have yet to hear why this may be the case?
Any help is greatly appreciated.

[TheLightSeeker]

You're welcome!

Consider checking thyroid function (not serum thyroid hormone levels) by getting Free T3, Free T4 and reverse T3 checked.

Also check for nutritional and vitamin deficiencies, specially vitamin D levels which should be 50ng/ml-70ng/ml or higher if you have VDR gene mutation.

Vitamin B12 have UMMA levels tested, which will indicate the bioavailable B12 (Methylocobalamin).Regular blood  tests only indicate cobalamin B12
which is meaningless, if it does not get converted to methylocobalamin,
plus the so-called  B12 normal ref. ranges are far too low in N. America.

Magnesium is low in the majority of people, that is tissue levels and not serum!
I do every other day a transdermal magnesium oil application - leave on for 30 minutes to absorb and then shower.

Hope this helps,
Niko

[oca3]

Thank you. I've never asked a question before so I did not know how to phrase it. :)

The baseline cortisol was 20.8 before csyntropin (normal is 6.2-19.4)
After 30 minutes it was 21.6 (normal peak >20 mg/dl)
After 60 minutes it was 22.7 (normal peak same as above)

ACTH level was 100.1 pg/ml (normal range is 7-53 pg/ml).

The only thing I see if slightly elevated cortisol at baseline and elevated ACTH.

The doctor has ruled out adrenal insufficiency, but we need to explore other avenues. I'm trying just to figure out which avenues need to be explored!

Thank you again!

[rumpled]

There can be ACTH secreting lesions in lung or elsewhere. Usually the ACTH is higher but with no cortisol, that is what I would guess.

[oca3]

Thanks rumpled. I just had my ACTH retested and it was 489.7 pg/dl this time. Cortisol was higher end of normal.

I'm getting ready to retest 24 hour urine cortisol, ACTH, and saliva.

I have pretty significant hyper pigmentation, vitiligo and other issues. I sure hope we can get to the bottom of this soon and get on the road to recovery.

[TheLightSeeker]

If your ACTH was 10 pg/ml-300 pg/ml (I don't know what measure of units
your ACTH level was) then after a Csyntropin stim test your cortisol level
( Serum or Plasma @ 0, 30 and 60 minutes)
was >20 μg/dL which is considered normal, then there's really nothing indicative of anything out of balance.
If your ACTH levels were over 300 pg/ml then adrenal failure would be considered likely.
Unfortunately you have not given specific information regarding units of measure and normal ranges and I hope the information I offered you helps.
You should call the doctor's office to get your results, regardless.
If you wish, let us know about your symptoms.
Best wishes,
Niko