ACTH Cortisol test enquiry

[smilingjane]

Afternoon all

I had an ACTH test done at the request of my GP because my early morning blood cortisol test was 133 (ref 113 - 532).

I am attaching 2 pages of results. The consultant says I'm fine but I want to run it past folk on here because I'm not so sure. I certainly don't feel fine.

I don't understand page 1 that states ACTH Roche Method * 15.

I have searched the Internet and cannot see anything about * 15 in ACTH results.

I understand that the ACTH test is solely testing for Addisons, (I think?)

My first blood test, before I was injected with something to stimulate the adrenal glands was 243 (ref - 133 - 537).

So presumably there is a cut off, ie 133 for that first blood test that would suggest Addison and I was 243.

Does anyone out there know anything about this ACTH test? Has anyone else had a low result like me and been offered any treatment?

Lastly, do you think these results would come under Adrenal Insufficiency?

And the * 15 on page 1 of my results, What does that mean?

Thanks do much for any shared knowledge or experience

Jane

[Thyb]

I can't make out the blood results After the ACTH test..I've had 1. Xx smilingjane

[Thyb]

Was the ACTH test carried out at 16:38pm? I think that's what it says on attached photo?ACTH needs to be carried out between 8-9am because cortisol drops throughout the Day?

Plus you should have been told to stop taking medications that can affect test results. E.g. Prednisolone, hydrocortisone, dexamethasone xx

[smilingjane in reply to Thyb]

Hi Thyb

Thanks for getting back.

No, it was a 9.30 am ACTH The result I underlined was the 9.30 one, then 30 mins and 60 mins.

Maybe it was written up at 16.38?

I wasn't taking any of the meds to be stopped before the test.

What were your results? Also I cannot understand what the * 15 means?

I have heard/read that Levo affects Cortisol, so I suppose that's the answer?

All so confusing.

🙄

[humanbean in reply to smilingjane]

I think the confusion is between the time the test was carried out and when the report was printed. The fact it was printed at 4.38 pm is irrelevant.

[humanbean]

Take a look at this link :

imperialendo.co.uk/Bible201...

It is referred to as the "Endocrine Bible", and it describes preparation, methods, and interpretation for any test done in a hospital Endocrinology Department.

If you look at pages 68 - 70 it describes a Short Synacthen Test and, given the results you've been given it looks like that was what you were given.

A common problem is that, in order to save money, doctors don't request an ACTH test, they only request that cortisol testing is done.

If you look at this link it explains what goes wrong in Primary, Secondary, and Tertiary Adrenal Insufficiency.

en.wikipedia.org/wiki/Adren...

If ACTH is not tested I don't think they would be able to diagnose Secondary or Tertiary Adrenal Insufficiency even if you have it.

With cortisol having been tested three times they could have diagnosed Primary Adrenal Insufficiency, but I don't think you have it given that your cortisol did rise quite substantially. But please note I am NOT a doctor, nor do I have any medical training.

Given that your cortisol was really quite low at the beginning of the test but your cortisol did rise once stimulated, it suggests that you may have "adrenal fatigue" - but never say that to a doctor because they consider it to be rampant pseudoscience / quackery.

The difference between Primary Adrenal Insuffiency (PAI) and Adrenal Fatigue (AF) is that in PAI the adrenal glands have been attacked and mostly or completely destroyed by autoimmune disease. They won't regenerate, and there is no treatment that will make them produce sufficient cortisol for good health again. The only solution to PAI is to replace the cortisol the adrenal glands can't produce.

AF involves the adrenal glands not working very well, but they are repairable and their cortisol production can be improved with the right treatment. The right treatment would involve all of the things that we talk about on this forum all the time - optimise thyroid hormones and nutrients, improve gut health, get enough exercise (but not too much), eat a good diet, and get enough sleep.

[smilingjane in reply to humanbean]

Humam Bean ... THANK YOU.

What you are saying makes utmost sense alongside other things I have recently read.

They felt obliged to give me the ACTH test because my saliva and 9am blood tests I did privately were low.

I feel reassured and will continue with the recommended nutrients, diet and optimising my thyroid hormones.

So much seems to be down to thyroid health.

Thank you so much for the links too.

Information is power. I love HU and I love the wonderful people that respond with such insightful knowledge.

🤗

[humanbean in reply to smilingjane]

You might find this thread, and the links within it, of some interest.

healthunlocked.com/thyroidu...

I wonder if you have ever tried adrenal glandulars? They usually come as "whole adrenal" or "adrenal cortex" only. The "whole adrenal" products will have adrenaline in, and this doesn't suit everyone.

[smilingjane in reply to humanbean]

Thank you 😊Will check that out

[radd]

smilingjane,

The ACTH Roche Method is the type of test as there are various used, for example investigations into certain tumors by assessing levels of ACTH precursors (I think).

ACTH is volatile in that it degrades quickly and has to be put on ice, then a chilled centrifuge used to separate plasma within a certain time frame. I think the *15 could mean within 15 minutes. 

[smilingjane in reply to radd]

Hi RaddAhhh ... interesting, makes sense

Thank you 😀

[radd in reply to smilingjane]

As hb says your adrenals had a good response to the injection.

Have you got the other page's results to post?

[smilingjane in reply to radd]

Sorry. I thought I had sent both.

blood test results