An adrenocorticotropic hormone test measures the level of adrenocorticotropic hormone (ACTH) in the blood to check for problems with the pituitary gland and adrenal glands .
ACTH is made in the pituitary gland in response to the release of another hormone, called corticotropin-releasing hormone (CRH), by the hypothalamus. In turn, the adrenal glands then make a hormone called cortisol, which helps your body manage stress. Cortisol is needed for life, so its levels in the blood are closely controlled. When cortisol levels rise, ACTH levels normally fall. When cortisol levels fall, ACTH levels normally rise.
Both ACTH and cortisol levels change throughout the day. ACTH is normally highest in the early morning (between 6 a.m. and 8 a.m.) and lowest in the evening (between 6 p.m. and 11 p.m.). ACTH levels may be tested in the morning or evening if your doctor thinks that they are abnormal. Cortisol levels are often measured at the same time as ACTH.
ACTH is released in bursts, so its levels in the blood can vary from minute to minute. Interpretation of the test results is hard and often requires the skill of an endocrinologist.
Why It Is Done
A test to measure ACTH is done to check for:
- A problem with the adrenal glands or pituitary gland. A high level of ACTH and a low level of cortisol (or low ACTH and high cortisol levels) could be caused by a problem with the adrenal glands. Low levels of ACTH and cortisol could be caused by a problem with the pituitary gland.
- Overproduction of ACTH. This may be caused by an overactive pituitary gland, or sometimes by a tumor in the lung. In response, the adrenal glands release too much cortisol (one form of Cushing's syndrome).
How To Prepare
You may not be able to eat or drink for 10 to 12 hours before an ACTH test. Your doctor may ask you to eat low-carbohydrate foods for 48 hours before the test. Be sure to ask your doctor if there are any foods that you should not eat.