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ACTH blood test
Serum adrenocorticotropic hormone; Adrenocorticotropic hormone; Highly-sensitive ACTH
The ACTH test measures the level of adrenocorticotropic hormone (ACTH) in the blood. ACTH is a hormone released from the pituitary gland in the brain.
How the Test is Performed
Blood sample is needed
Venipuncture is the collection of blood from a vein. It is most often done for laboratory testing.
How to Prepare for the Test
Your doctor will likely ask you to have the test done early in the morning. This is important, because cortisol level varies throughout the day.
You may also be told to stop taking medicines that can affect the test results. These medicines include glucocorticoids such as prednisone, hydrocortisone, or dexamethasone.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.
Why the Test is Performed
The main function of ACTH is to regulate the steroid hormone cortisol. Cortisol is released by the adrenal gland . It regulates blood pressure and blood sugar.
Adrenal gland
The adrenal glands are two triangle-shaped glands. One gland is located on top of each kidney.
This test can help find the causes of certain hormone problems.
Normal Results
Normal values for a blood sample taken early in the morning are 9 to 52 pg/mL.
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
A higher-than-normal level of ACTH may indicate:
-
Adrenal glands not producing enough cortisol (
Addison disease
)
Addison disease
Addison disease is a disorder that occurs when the adrenal glands do not produce enough hormones.
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Adrenal glands not producing enough hormones (
congenital adrenal hyperplasia
)
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia is the name given to a group of inherited disorders of the adrenal gland.
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One or more of the endocrine glands are overactive or have formed a tumor (
multiple endocrine neoplasia type I
)
Multiple endocrine neoplasia type I
Multiple endocrine neoplasia (MEN) type I is a disease in which one or more of the endocrine glands are overactive or forms a tumor. It is passed do...
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Pituitary is making too much ACTH (
Cushing disease
), which is usually caused by a non-cancerous tumor of the pituitary gland
Cushing disease
Cushing disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ACTH). The pituitary gland is an organ of...
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Rare type of tumor (lung, thyroid, or pancreas) making too much ACTH (
ectopic Cushing syndrome
)
Ectopic Cushing syndrome
Ectopic Cushing syndrome is a form of Cushing syndrome in which a tumor outside the pituitary gland produces a hormone called adrenocorticotropic hor...
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A lower-than-normal level of ACTH may indicate:
-
Pituitary gland not producing enough hormones, such as ACTH (
hypopituitarism
)
Hypopituitarism
Hypopituitarism is a condition in which the pituitary gland does not produce normal amounts of some or all of its hormones.
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Tumor of the adrenal gland
that produces too much cortisol
Tumor of the adrenal gland
Cushing syndrome due to adrenal tumor is a form of Cushing syndrome. It occurs when a tumor of the adrenal gland releases excess amounts of the horm...
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Risks
Veins and arteries vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
References
Ferri FF. Cushing's disease and syndrome. In: Ferri FF, ed. Ferri's Clinical Advisor 2016 . Philadelphia: PA Elsevier Mosby; 2016:385-386.
Melmed S, Kleinberg D. Pituitary masses and tumors. Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 9.
Stewart PM, Newell-Price JDC. The adrenal cortex. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 15.
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Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
-
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Review Date: 10/28/2015
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
