ACTH is a pituitary hormone that stimulates the production of cortisol from the adrenal glands. Cortisol levels are usually highest between 6 and 8 a.m. and at the lowest around 11 p.m.
Cortisol is the hormone that is released during stress. It essentially revs up your body so you can handle the stress you are encountering. One of the types of stress you can experience is physiological stress, or negative things that are happening within your metabolism such as low blood sugar or high blood sugar.
ACTH levels vary during the day. If it’s too high or too low, you may be diagnosed with Cushing’s syndrome. If it’s too high, you may have Addison disease, or if too low, you may have a low functioning pituitary.
Normal Ranges for ACTH in pg/mL:
Adults/children: 7.2-63 pg/mL
Females 5-27 pg/mL Males 7-50 pg/mL
Prepuberty: 7-28 pg/mL
Postpuberty: 2-49 pg/mL
These values are for morning draws, not evening draws.
Decreased levels of ACTH are seen in the following conditions:
- Congenital ACTH deficiency
- Skull fracture that causes a traumatic brain injury
- Hypophysitis, either autoimmune or drug-induced
- Hypothalamus diseases from infections
- Pituitary adenoma
- Infection of the pituitary
- Radiotherapy of the pituitary
- Hemorrhage of the pituitary
- Sella turcica lesions
- Pituitary corticotroph disease
- Glucocorticoid medication
High levels of ACTH may result from any of the following conditions:
- Cushing’s disease (pituitary adenoma)
- Non-pituitary tumor
- Anorexia nervosa
- Primary adrenal insufficiency (called Addison disease)
- Congenital adrenal hyperplasia
- 21-hydroxylase or 17-alpha-hydroxylase deficiency
- 3-beta-hydroxysteroid dehydrogenase deficiency
- Cholesterol side-chain cleavage enzyme deficiency
- Nelson syndrome (patients with Cushing’s disease that have had adrenal glands removed)
- Those who have developed human antimouse antibodies or heterophilic antibodies
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