What causes high ACTH levels?
Jason
My ACTH Level was 80 pg/mL (reference range 7 to 69.
I do NOT have a tumor on my pituitary gland and do NOT have an Ectopic
tumor in my lungs. What else can cause ACTH levels to be higher than
normal?
Thanks in advance,
deT notsuH
So, if the more complex things like ectopic (while lungs are the most
common source, that doesn't mean the ONLY source) and pituitary tumors
have been ruled out, I can well imagine that Addison's ain't it either.
Otoh, stress will raise ACTH as well, and we just know that you are NOT
under any stress. I presume you did the suppression test, right? What
were the results? Borderline? And the cortisol and/or DHEA results?
If all of those are "normal" whatever that means, then you might be looking
at a "false" reading from something as easy as bad timing. ACTH is
pulsatile, meaning it has spikes during the day. For that reason,
multiple samples are *required*, spaced out in time (30min?). If this
is just a single reading, I'd say fuggedaboudit. But timing could
also be reflected if you have insulin resistance. Insulin will
stimulate ACTH secretion. Timing here might be in relation to when/
what you ate before the test. Blood sugar readings might provide a
clue. Are you running a fever? Pyrogens will increase ACTH. If they
are external, then it suggests infection, so a WBC with differential
might help. Internal ones are things like cytokines (interleukins or
TNF), which are part of the immune system. But again, fever is the
clue here, and easily ruled out. Lastly, and another one easy to rule
out, is conflict with a drug you might be taking. Obviously insulin.
How about vasopressin used in treatment of diabetes insipidous? But
the clue is to check ANYTHING else you might be taking.
--
deT notsuH bass-ackwards ude.hcimu@pcird
Pick-up line for the hypo brain-fogged dating scene:
"Pardon me, but do I come here often?"
Jason
<pcird*BACKWARDS*@hcimu.ude> wrote:
> The obvious answer would be primary adrenal hypofunction (aka Addison's).
> So, if the more complex things like ectopic (while lungs are the most
> common source, that doesn't mean the ONLY source) and pituitary tumors
> have been ruled out, I can well imagine that Addison's ain't it either.
> Otoh, stress will raise ACTH as well, and we just know that you are NOT
> under any stress. I presume you did the suppression test, right? What
> were the results? Borderline? And the cortisol and/or DHEA results?
> If all of those are "normal" whatever that means, then you might be looking
> at a "false" reading from something as easy as bad timing. ACTH is
> pulsatile, meaning it has spikes during the day. For that reason,
> multiple samples are *required*, spaced out in time (30min?). If this
> is just a single reading, I'd say fuggedaboudit. But timing could
> also be reflected if you have insulin resistance. Insulin will
> stimulate ACTH secretion. Timing here might be in relation to when/
> what you ate before the test. Blood sugar readings might provide a
> clue. Are you running a fever? Pyrogens will increase ACTH. If they
> are external, then it suggests infection, so a WBC with differential
> might help. Internal ones are things like cytokines (interleukins or
> TNF), which are part of the immune system. But again, fever is the
> clue here, and easily ruled out. Lastly, and another one easy to rule
> out, is conflict with a drug you might be taking. Obviously insulin.
> How about vasopressin used in treatment of diabetes insipidous? But
> the clue is to check ANYTHING else you might be taking.
>
Thanks, I have NOT had the suppression test and my doctor did not even
mention such a test. My guess is that stress may be playing a role since I
have lots of stress in my life. I suffer from panic attacts. My DHEA
levels and most of the my adrenal hormones are very low. Do you think it
is possible that I may have an ectopic turmor somewhere in my body?
Thanks for your post.
Jason
deT notsuH
With this additional (essential) info, no, I wouldn't be pursuing an
ectopic tumor. And I wouldn't be doing a suppression test, either.
If the ACTH result has been repeated, and I mean as I nodeT with
multiple samples serially on the same day, and DHEA and cortisol levels
are indeed low, then back to the "easy" explanation that this is
Addison's. That means the low-dose stimulation test is what is
called for. As if I have a clue, not being a doctor and all....
P.S. FWIW, an interesting funfact is that the "panic" adrenal
hormones, adrenaline/epinephrine and noradrenaline/norepinephrine,
come from the adrenal medula, or the innards of the adrenal glands.
They require the cortex (outer) hormones, namely cortisol in order
to be formed.
Jason
<pcird*BACKWARDS*@hcimu.ude> wrote:
Thanks for your post. Based upon your posts and what I have read in other
sources, the most likely cause of my high ACTH levels is a disfunction in
the hypothalamus pituitary-adrenal feedback loop. The adrenal cortex,
unable to produce adequate cortisol, causes prolonged release of ACTH. I
found this information on page 80 of the Dec/2008 issue of the "Townsend
Letter" (www.townsendletter.com). I'll ask my doctor about low-dose
stimulation test.
Thanks again,
jason