ACTH Stimuluation Test

[spinn]

I was in the hospital the other day with a high fever and once that subsided, they did an ACTH Stimulation Test as I mentioned my adrenal issues.

I have read that this test is supposed to be given between 7-10 AM, after 8 hours of fasting. Is this correct? I was given the test beginning at 330 PM, approximately two hours after eating.

Additionally, how accurate a gauge of adrenal health is this test?

 

[spinn]

No thoughts on this?

 

[Ozzie]

spinn -- while time of day for ACTH stim test may have an effect on baseline cortisol values (before receiving the ACTH), the stimulation aspect of the test shouldn't be affected very much and you will still get lots of good information (e.g., adrenal reserve). You can always do the blood test (am and pm) and/or the 4xday saliva test at another time and in fact this might be better given you will be outside the hospital environment (i.e., your cortisol values may actually be more representative of a 'typical' day).

 

[spinn]

Thanks Ozzie......that makes sense.

My DR is very good with adrenal fatigue but relies almost entirely on clinical diagnosis with almost no testing.

I am hoping the results will give me some valuable information. I felt nothing when they administered the ACTH. I expected some sort of reaction but received almost none.

 

[Ozzie]

Spinn -- you're very welcome. One other item i forgot to mention and if an ACTH serum test wasn't performed with your ACTH stim test (mine wasn't a couple of years ago), you may want to get this done at another time with your cortisol blood draws. Good information can be gleaned from this as well -- for example, if your am cortisol is low and your serum ACTH is high, this could very well point to some degree of (primary) adrenal fatigue/failure and you will have narrowed the problem down to your adrenals vice your pituitary. If your ACTH serum, however, is low and your cortisol is low, this may very well point to secondary adrenal failure/fatigue (although not necessarily solely secondary -- possibly primary as well and the ACTH stim test will ferret out this part of the puzzle).

 

[spinn]

Got the test results.............not sure what to make of them but here they are:

Cortisol AM (taken at 330 PM) I believe this is baseline 7.63 range 5-25
30 minutes post cortisol 25.41
60 minutes post cortisol 26.69

So the cortisol production went up by nearly a factor of 4.

Also remember these were done starting at 330, 2 hrs after eating. My research indicates they are to be given between 7-10 AM, after fasting for 8 hours.

 

[MetalMX]

You said you did this test after you had a high fever...

I wouldn't do any cortisol related testing if i just had a high fever that would create whacky test results every single time.

I had an ACTH stim test which was testing for addison's disease which was normal few months ago also done in the PM about 3 or so. They didn't ask me to come in fasting.

Although for a dexamethasone suppression test you need to come in the morning fasting for accurate results after you take a 1mg pill of dexamethasone at midnight and then your ACTH and cortisol levels are measured at about 8am.