ACTH and adrenal glands awakening in GCA - PMRGCAuk

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ACTH and adrenal glands awakening in GCA

Iwillwin123
Iwillwin123

Why is synthetic ACTH not used to trigger the adrenal glands into reawakening after a long suppression due to steroid treatment in GCA . At levels of around 4 mg when there is resistance experienced in normal functioning of the adrenals , would not synthetic ACTH stimulate the adrenals ?

Does anyone have information about this ?

Regards and TIA

1 Reply
PMRpro
PMRproAmbassador

Because that isn't how it works. The trigger for the whole HPA set up to produce cortisol in the morning is a very low level of cortisol on the blood at midnight, Using synthetic ACTH to wake up the production of cortisol by the adrenal gland is a bit like using jump leads to get the car going when the battery is flat - next time you have to use them again even though the fuel tank is full. All the test shows is whether the adrenals are capable of producing cortisol when stimulated, not whether they are actually doing so - there is a large number of steps required to get to that stage and any one of them may be non-functional so the trigger doesn't reach its destination.

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