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Doctor insights on: Adrenal Insufficiency Acth

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Dx with adrenal insufficiency, before acth test could be done, sent to ER was given IV steroids. Doc does blood work often looking at cortisol levels, but should she still do the acth test?

Dx with adrenal insufficiency, before acth test could be done, sent to ER was given IV steroids.  Doc does blood work often looking at cortisol levels, but should she still do the acth test?

ACTH test: In addition to doing the acth test and seeing an endocrinologist, it would be important to know why you developed addisons. Autoimmune adrenal? Adrenal hemmorhage? Pituitary? ...Read more

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Dr. David Geffner
254 doctors shared insights

Addison's Disease (Definition)

Chronic adrenal insufficiency. You may consult this site for more information on this topic. http://www.mayoclinic.org/diseases-conditions/addisons-disease/home/ovc-20155636 For good health - Have a diet rich in fresh vegetables, fruits, whole grains, milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Drink enough water daily, so that your urine is mostly colorless. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any ...Read more


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I show symptoms of adrenal insufficiency. I did an acth plasma test which showed 25.00 and serum cortisol that showed 145ng?

I show symptoms of adrenal insufficiency. I did an acth plasma test which showed 25.00 and serum cortisol that showed 145ng?

ACTH stim: I don't understand the units of measure for either acth or cortisol. If there is any question of addison's disease i would expect a very elevated acth level. Secondary adrenal insufficiency concern might merit a low/hi dose acth stim test. If you have secondary adrenal insufficiency you may also need a MRI of your brain and pituitary in addition to looking into other pituitary hormone deficiency. ...Read more

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Dr. Ira Katz Dr. Katz
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On a ACTH stimulation 3 time point base number 8, 30 min =23.5, 60 min = 39.6 does this suggest secondary adrenal insufficiency?

Dr. Ira Katz Dr. Katz
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Not Enough Info: The baseline of 8 mcg is a borderline morning value and normal in the evening. The time of the day, ACTH value, reason for the test, how long the condition has been present for are all important. If it is secondary adrenal insufficiency it is likely new in onset. This test does completely rule out primary adrenal insufficiency though. ...Read more

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Would acth and cortisol be low or high with adrenal insufficiency?

Cortisol: Would be low. Acth would be high if it were an adrenal cause; low if it was a pituitary cause. ...Read more

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Acth stim test for secondary adrenal insufficiency. What to expect? Feel better if positive? Feel worse if negative? And why?

Maybe 2: For secondary adrenal insufficiency we will sometimes do a lo/hi dose acth test using two doses to elicit a response from adrenals. The Insulin tolerance test is another good way to determine cortisol insufficiency as well as gh deficiency which can be seen with acth deficiency. If you're deficient in acth you'll get steroid replacement which will make you feel better. ...Read more

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Low cortisol. Low acth but normal stimulation test. Could I still have secondary adrenal insufficiency?

Yes: Without more information, I can not say for sure you have it, but this is essentially the def of secondary adrenal insufficiency. Secondary AI is a condition where the adrenal gland still has function, but is not being told to produce cortisol by the pituitary gland. There are other tests, but initial dx usually made by low baseline cortisol with ACTH injection causing nl cortisol by adrenal gland ...Read more

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After acth stimulation test confirms adrenal insufficiency does it always need to be treated and/or followed up and how often?

Yes: Adrenal insufficiency means that your body is not able to produce enough steroids. Depending on the cause of adrenal insufficiency, you can be deficient in more than one steroid (cortisol and/or aldosterone). Your body needs these hormones, so it is important to follow-up with your dr. The frequency depends on how stable the disease is for the patient. ...Read more

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Can adrenal insufficiency cause terrible lightheaded spells w/ fogginess? If so, which condition? I'm having acth stim test.

Yes indeed: There are other, more common causes, especially if the picture does not otherwise suggest addisonism. I agree with the decision to have an acth stimulation test as part of your workup, though there are many other causes. I trust cerebrovascular disease has also been considered. ...Read more

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Is adrenal insufficiency after pituitary tumor removal permanent? How long before most usually gain pituitary function for acth back?

Sometimes: It is really quite variable when the pituitary function restarts after the operation. It often depends on how much was removed. Unfortunately, sometimes it is permanent. Check with your neurosurgeon for more details. ...Read more

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Serum cortisol 145 ng/ml and acth plasma 25.00. I'm showing strong symptoms of adrenal insufficiency mainly skin bronzing. What domy results indicate?

Units of measure: Cortisol level is completely normal for a random morning sample and not suggestive of adrenal insufficiency. Acth units of measure are missing. Is this pmol/l or pg/ml? Even in extremely rare cases of acth resistance, nearly all patients are cortisol deficient. But your cortisol result is fine for morning random. Other things can cause bronzing like certain medication and hemochromatosis. ...Read more

Dr. Krishna Kumar
129 doctors shared insights

Addisonian Crisis (Definition)

Addisonian or acute adrenal crisis is a life-threatening condition that occurs when there is not enough cortisol, a hormone produced by the adrenal glands. It can manifest with fatigue, nausea, poor appetite, fever, joint pain, fatigue, coma, or seizure. Addison's disease is usually treated ...Read more


Dr. Ana Adelstein
142 doctors shared insights

Adrenocorticotropic Hormone (Definition)

It is one of several pituitary hormones - acth for short (the others control the thyroid gland, gonad glands, and others) that controls adrenal gland function in primarily making the hormone called cortisol (not to be confused with "adrenaline"), though the adrenal gland also ...Read more