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Very high ACTH level but okay hydrocortisone levels

I have addison's disease for the past two years. Recently my ACTH level shot up. I have an ACTH level of 600 which is super high but my Hydrocortisone level is okay. My facial skin has also tanned very much along with a lot of acne over face and upper body. My doctor increased my dose of hydrocortisone earlier which brought my ACTH level down from 1200 to 600. But now the hydrocortisone I am taking is too high 30 mcg per day. Doctor has recommended me to an Ednocrynologist to figure put what is going on. The appointment is in another two months but I am getting worried as to what is going on. Is there anyone who have faced such a problem and if so what did you do.
Thanks a lot.
3 Responses
Avatar universal
COMMUNITY LEADER
What level of HC were you taking before? Did you have the acne before or after the rise?

By HC level ok, what do you mean - do you test on meds - aka a 24 hour urine test?

At 30mg it can give you steroid induced Cushing's so geez, you don't need that on top of AI.

I also have a very high ACTH but I won't let the docs raise my HC super high as I used to have Cushing's and my body was already damaged. Your doc has to look for either a pituitary tumor or other acth-secreting tumor.
Avatar universal
Thanks
Earlier I was taking 15 mug of HC. But my ACTH went very high. The doctor increased my HC in a couple of steps first to 20 then 25 and finally 30. They test the cortisol level by blood test only. The morning of the test I do not take medicine before the test.
I got acne only when my ACTH level was diagnosed as high.
Can one get cushings on top of addisons??  
Avatar universal
COMMUNITY LEADER
You can get steroid-induced Cushing's for sure....

With the high ACTH, it sounds like something is going on in the pituitary - are they planning an MRI? Did your testing show secondary source before?

Usually acne is caused by high cortisol and not just ACTH - and a point in time test at one time of the day is uh... not good enough.

Any other symptoms?
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