URL of this page: https://medlineplus.gov/lab-tests/adrenocorticotropic-hormone-acth/

Adrenocorticotropic Hormone (ACTH)

What is an adrenocorticotropic hormone (ACTH) test?

This test measures the level of adrenocorticotropic hormone (ACTH) in the blood. ACTH is a hormone made by the pituitary gland, a small gland at the base of the brain. ACTH controls the production of another hormone called cortisol. Cortisol is made by the adrenal glands, two small glands located above the kidneys. Cortisol plays an important role in helping you to:

  • Respond to stress
  • Fight infection
  • Regulate blood sugar
  • Maintain blood pressure
  • Regulate metabolism, the process of how your body uses food and energy

Too much or too little cortisol can cause serious health problems.

Other names: Adrenocorticotropic hormone blood test, corticotropin

What is it used for?

An ACTH test is often done along with a cortisol test to diagnose disorders of the pituitary or adrenal glands. These include:

  • Cushing's syndrome, a disorder in which the adrenal gland makes too much cortisol. It may be caused by a tumor in the pituitary gland or the use of steroid medicines. Steroids are used to treat inflammation, but can have side effects that effect cortisol levels.
  • Cushing's disease, a form of Cushing's syndrome. In this disorder, the pituitary gland makes too much ACTH. It is usually caused by a noncancerous tumor of the pituitary gland.
  • Addison disease, a condition in which the adrenal gland doesn't make enough cortisol.
  • Hypopituitarism, a disorder in which the pituitary gland does not make enough of some or all of its hormones.

Why do I need an ACTH test?

You may need this test if you have symptoms of too much or too little cortisol.

Symptoms of too much cortisol include:

  • Weight gain
  • Buildup of fat in the shoulders
  • Pink or purple stretch marks (lines) on the abdomen, thighs, and/or breasts
  • Skin that bruises easily
  • Increased body hair
  • Muscle weakness
  • Fatigue
  • Acne

Symptoms of too little cortisol include:

You may also need this test if you have symptoms of hypopituitarism. Symptoms will vary depending on the severity of the disease, but may include the following:

  • Loss of appetite
  • Irregular menstrual periods and infertility in women
  • Loss of body and facial hair in men
  • Lower sex drive in men and women
  • Sensitivity to cold
  • Urinating more often than usual
  • Fatigue

What happens during an ACTH test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You may need to fast (not eat or drink) overnight before testing. Tests are usually done early in the morning because cortisol levels change throughout the day.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Results of an ACTH test are often compared with the results of cortisol tests and may show one of the following:

  • High ACTH and high cortisol levels: This may mean Cushing's disease.
  • Low ACTH and high cortisol levels: This may mean Cushing's syndrome or a tumor of the adrenal gland.
  • High ACTH and low cortisol levels: This may mean Addison disease.
  • Low ACTH and low cortisol levels. This may mean hypopituitarism.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about an ACTH test?

A test called an ACTH stimulation test is sometimes done instead of an ACTH test to diagnose Addison disease and hypopituitarism. An ACTH stimulation test is a blood test that measures cortisol levels before and after you've received an injection of ACTH.

References

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  2. Lab Tests Online [Internet]. Washington D.C.; American Association for Clinical Chemistry; c2001–2019. Adrenocorticotropic Hormone (ACTH); [updated 2019 Jun 5; cited 2019 Aug 27]; [about 2 screens]. Available from: https://labtestsonline.org/tests/adrenocorticotropic-hormone-acth
  3. Lab Tests Online [Internet]. Washington D.C.; American Association for Clinical Chemistry; c2001–2019. Metabolism; [updated 2017 Jul 10; cited 2019 Aug 27]; [about 2 screens]. Available from: https://labtestsonline.org/glossary/metabolism
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  7. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-–2019. Hypopituitarism: Symptoms and causes; 2019 May 18 [cited 2019 Aug 27]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/hypopituitarism/symptoms-causes/syc-20351645
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2019 Aug 27]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  9. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. ACTH blood test: Overview; [updated 2019 Aug 27; cited 2019 Aug 27]; [about 2 screens]. Available from: https://ufhealth.org/acth-blood-test
  10. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. ACTH stimulation test: Overview; [updated 2019 Aug 27; cited 2019 Aug 27]; [about 2 screens]. Available from: https://ufhealth.org/acth-stimulation-test
  11. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Hypopituitarism: Overview; [updated 2019 Aug 27; cited 2019 Aug 27]; [about 2 screens]. Available from: https://ufhealth.org/hypopituitarism
  12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: ACTH (Blood); [cited 2019 Aug 27]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=acth_blood
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Adrenocorticotropic Hormone: Results; [updated 2018 Nov 6; cited 2019 Aug 27]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/adrenocorticotropic-hormone/hw1613.html#hw1639
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Adrenocorticotropic Hormone: Test Overview; [updated 2018 Nov 6; cited 2019 Aug 27]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/adrenocorticotropic-hormone/hw1613.html
  15. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Adrenocorticotropic Hormone: Why It Is Done; [updated 2018 Nov 6; cited 2019 Aug 27]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/adrenocorticotropic-hormone/hw1613.html#hw1621

The medical information provided is for informational purposes only, and is not to be used as a substitute for professional medical advice, diagnosis or treatment. Please contact your health care provider with questions you may have regarding medical conditions or the interpretation of test results.

In the event of a medical emergency, call 911 immediately.