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Doctors' Answers to "Frequently Asked Questions" - ACTH

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

ACTH Stimulation Test
Question: What are the risks or dangers, if any, of the ACTH rapid stimulating test on a person with adrenal insufficiency?

Answer: There should be no risk of the ACTH test. ACTH is a hormone produced by the pituitary(a gland at the base of the brain between your eyes). ACTH stimulates the adrenals on a daily basis to produce adrenal hormones. This test is merely testing the response of the adrenal gland to ACTH production. I have performed this test at least 3 - 400 times and have never had a problem with the usual doses called for in most diagnostic protocols. There are several basic endocrine textbooks available in any medical school library which can give your more specifics.

Question: My reproductive endocrinologist performed an ACTH blood test. After taking dexamethasone the night before, my reproductive endocrinologist took blood, injected me with ACTH, and took blood an hour later. While waiting for an hour, I developed a terrible mid-to-lower back ache and fatigue in my arms and legs. I've been experiencing this for four days, plus tingling in my forearms and legs! Have you ever heard of bad reactions from ACTH? Do you have any guesses why it would happen?

Answer: ACTH or adrenocorticotropin is a hormone naturally produced by the pituitary gland. This gland is located at the base of the brain between your eyes and about the center of the brain. It is commonly called "the master gland". ACTH causes the release of cortisol from the adrenal glands and is usually released by the pituitary in a pulse-like manner. The test that you describe is somewhat confusing. When dexamethasone is given the night before, it is to measure the suppression of cortisol by the adrenal glands. This is usually to diagnose overproduction of cortisol by the body. ACTH is usually given to diagnose the exact opposite problem - inadequate production. I cannot think of a reason to give both dexamethasone and ACTH in the same diagnostic protocol. Since ATCH is a hormone which your body produces, reactions are extremely rare. Possibly you are having a reaction to the other ingredients in the ACTH vial.

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