Lever
Lifestyle
- Stress management techniques
- Regular physical activity
- Adequate sleep
Blutwerte · Marker
ACTH
Adrenocorticotropin · Adrenocorticotropes Hormon · Corticotropin
Hormone — StressachseZeitabhängig
- Einheit:
- pg/mL
ACTH quantifies the level of adrenocorticotropic hormone in the blood, reflecting pituitary function and adrenal stimulation.
Reference Ranges
Reference
10–60pg/mL
10
60
LowNormalHigh
Reference
Unit · pg/mLACTH levels are subject to diurnal variation, peaking in the early morning.
Overview
Übersicht
Adrenocorticotropic hormone (ACTH) is a peptide hormone produced by the anterior pituitary gland. It plays a crucial role in the hypothalamic-pituitary-adrenal (HPA) axis, stimulating the adrenal cortex to release glucocorticoids, primarily cortisol, which are vital for stress response, metabolism, and immune function. Clinically, ACTH levels are significant in diagnosing and differentiating conditions such as Cushing's syndrome, Addison's disease, and secondary adrenal insufficiency. Elevated ACTH levels can indicate ACTH-dependent Cushing's syndrome, while low levels may suggest adrenal tumors or exogenous steroid use. For athletes and biohackers, understanding ACTH and its effects on cortisol can be critical for optimizing stress responses and recovery. However, ACTH levels can be influenced by various factors, including time of day, stress, and medications, necessitating careful interpretation of test results. Researchers have found that ACTH levels exhibit diurnal variation, peaking in the early morning and declining throughout the day, which should be considered when scheduling tests.
Klinische Bedeutung
Elevated ACTH levels may indicate Cushing's disease or ectopic ACTH syndrome, while reduced levels can suggest adrenal insufficiency or pituitary dysfunction.
Dynamics
Trend Interpretation
Rising Values
Progressively rising ACTH values may suggest worsening of Cushing's disease or ectopic ACTH production. Re-test in 4 weeks if outside the optimal range.
Falling Values
Progressively falling ACTH values may indicate adrenal recovery or response to treatment.
Re-test Interval
4 weeks if outside optimal range
Etiology
Causes — High & Low
Cause
Elevated Levels
- Cushing's disease
- Ectopic ACTH syndrome
- Adrenal insufficiency
- Stress
- Hypoglycemia
Cause
Low Levels
- Adrenal tumors
- Exogenous steroid use
- Pituitary dysfunction
- Secondary adrenal insufficiency
- Hypopituitarism
Protocol
How to Optimize
Lever
Nutrition
- Balanced diet rich in whole foods
- Adequate hydration
Note:
Consult a healthcare provider before making significant lifestyle or dietary changes.
Testing Guidelines
✓Fasting Not Required
🕐Time-Sensitive
ACTH peaks at 8am; draw at the same time for comparability.
Testing Frequency
Annually for those with adrenal disorders or as needed based on symptoms.
Interfering Factors
- Recent intense exercise
- Stress
- Medications affecting cortisol
Related Peptides & Hormones
Cortisol
hormoneDirectly measures
Open Research Questions
Current research suggests that the relationship between salivary cortisol and plasma ACTH levels is not linear, indicating potential confounders in stress research that remain understudied. Researchers have not yet established optimal reference ranges for ACTH in various clinical contexts, particularly in differentiating between Cushing's disease and melancholic depression. Additionally, unanswered clinical questions include the precise mechanisms by which psychological stressors influence ACTH and cortisol responses across different populations.
42 Research Publications
8,565
Total Citations
5
Human/RCT
58.2
Avg. Influence
2023
Latest
Sort
Filter
01Top
#01
Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research.
Meta-AnalysisInfluence488.0
5931
This meta-analysis reviewed 208 studies on psychological stressors and cortisol responses. Researchers found that uncontrollable tasks with social-evaluative threat elicited the largest cortisol and ACTH changes. The findings challenge the notion that cortisol responds similarly to all stressors.
02Top
#02
Salivary cortisol as a biomarker in stress research.
ReviewInfluence51.0
1905
This study explored salivary cortisol as a biomarker for stress. Researchers observed that salivary cortisol measures may not directly correlate with plasma ACTH and cortisol levels due to various biological factors affecting the hypothalamus-pituitary-adrenal axis.
03Top
#03
Pathophysiology of hypercortisolism in depression.
UnknownInfluence21.0
267
This study investigated the dynamics of ACTH and cortisol in depressed patients, finding that hypercortisolemia is associated with melancholic and psychotic subtypes. Researchers noted increased ACTH secretion regardless of cortisol levels, indicating central HPA axis overdrive in severe depression.
04
#04
Response of the hypothalamo-pituitary-adrenal axis to nicotine.
ReviewInfluence13.0
145
Researchers reviewed the effects of nicotine on ACTH secretion, finding that nicotine stimulates the HPA axis through central mechanisms. The study highlighted the role of brainstem catecholaminergic pathways in mediating this response, suggesting a complex interaction.
05
#05
Canine hypoadrenocorticism: pathogenesis, diagnosis, and treatment.
ReviewInfluence4.0
59
This study examined hypoadrenocorticism in dogs, a condition caused by immune-mediated destruction of adrenal glands. Researchers found that definitive diagnosis requires ACTH stimulation testing to demonstrate low cortisol levels. The prognosis is good with appropriate supplementation.
06
#06
Cushing's disease.
Review
57
This study focused on Cushing's disease, characterized by ACTH hypersecretion from the pituitary. Researchers noted that the initial diagnosis involves documenting hypercortisolism, followed by identifying the cause, typically through selective transsphenoidal resection.
07
#07
Peripheral and prefrontal stress system markers and risk of relapse in alcoholism.
Human
42
This study assessed stress system markers in alcohol-dependent patients. Researchers found that a high cortisol to ACTH ratio during neutral states predicted relapse risk, indicating its potential as a peripheral marker of brain dysfunction.
08
#08
Cushing syndrome: update on testing.
Review
35
This review provided an update on the diagnosis of Cushing syndrome. Researchers highlighted the importance of late-night salivary cortisol and prolactin measurement in distinguishing between types of ACTH-dependent Cushing syndrome.
09
#09
Circulating microRNA Expression in Cushing's Syndrome.
UnknownInfluence1.0
21
This study characterized circulating microRNA profiles in Cushing's syndrome patients. Researchers identified distinct profiles between ACTH-dependent and independent subtypes, with miR-182-5p being significantly upregulated in Cushing's disease, suggesting its potential as a biomarker.
10
#10
Exogenous Cushing Syndrome Caused by a "Herbal" Supplement.
Case ReportInfluence1.0
20
Researchers reported two cases of exogenous Cushing syndrome linked to an over-the-counter herbal supplement. They found that hidden glucocorticoids in supplements can complicate diagnosis and management.
Clinical Trials (15)
15
Total Trials
628
Total Enrolled
Evaluation of Positron Emission Tomography (PET) With [18F]FET for the Detection of ACTH-Secreting Corticotroph Pituitary Neuroendocrine Tumors.
NCT07463625RECRUITING
Sponsor
Hospices Civils de Lyon
Enrollment
20
Started
2023
Primary outcome
[18F]FET PET Performance for Localizing Corticotroph Pituitary Adenomas
Cushing DiseaseACTH-producing Pituitary Tumour
Use of CXCL9 as a Biomarker of Acthar Efficacy
Sponsor
University of California, San Francisco
Enrollment
2
Started
2022
Primary outcome
Number of Participants That Show a Decrease in Blood CXCL9 Levels by 50%
Sarcoidosis
Implications of Different Analgesic Models on Inflammatory Markers After Laparoscopic Cholecystectomy
NCT04609033COMPLETED
Sponsor
Assiut University
Enrollment
110
Started
2020
Primary outcome
postoperative level of ACTH hormone
Perioperative Pain
Comparison of Intramuscular and Intravenous ACTH Stimulation Test in Normal Volunteers
Sponsor
Johns Hopkins University
Enrollment
0
Started
2019
Primary outcome
peak serum cortisol
Adrenal Insufficiency
A Study of Acthar Gel Alone or With Tacrolimus to Reduce Proteinuria in Fibrillary Glomerulopathy Patients
Sponsor
NephroNet, Inc.
Enrollment
34
Started
2019
Primary outcome
The change in UP/CR ratio with treatment of Acthar gel 80 units subcutaneous 2 times a week alone
Fibrillary Glomerulonephritis
Effects of ACTHAR on Advanced MRI Surrogate Markers of Disease Activity and on Comprehensive Immune Signature During MS Relapses
Sponsor
University of Chicago
Enrollment
5
Started
2016
Primary outcome
Change in T1 Lesion Relaxation Time
Multiple Sclerosis
Biomarker Expression in Patients With ACTH-Dependent Cushing's Syndrome Before and After Surgery
NCT02922257COMPLETED
Sponsor
Corcept Therapeutics
Enrollment
26
Started
2016
Primary outcome
Gene expression levels
Cushing's Syndrome
Treatment of CNS Sarcoidosis With H.P. Acthar Gel
Sponsor
University of Maryland, Baltimore
Enrollment
4
Started
2016
Primary outcome
Karnofsky Performance Status (KPS) Score
CNS Sarcoidosis
The Effect of Corticotrophin (ACTH) in Combination With Methotrexate in Newly Diagnosed Rheumatoid Arthritis Patients
Sponsor
Gaylis, Norman B., M.D.
Enrollment
20
Started
2013
Primary outcome
Change From Baseline in Clinical Disease Activity Index (CDAI) Score
Rheumatoid Arthritis
NeSST2: The Development of a Noninvasive Short Synacthen Test
Sponsor
Sheffield Children's NHS Foundation Trust
Enrollment
12
Started
2012
Primary outcome
Peak plasma cortisol concentration (Cmax)
Adrenal Suppression
Acthar for Treatment of Proteinuria in Diabetic Nephropathy Patients
Sponsor
Mallinckrodt
Enrollment
34
Started
2012
Primary outcome
Percent Change in Estimated Glomerular Filtration Rate (eGFR) at Visit 12
Diabetic Nephropathy
Stress Level and the Relationship With IVF Outcomes.
NCT02638662COMPLETED
Sponsor
Weill Medical College of Cornell University
Enrollment
276
Started
2010
Primary outcome
Biomarkers Cortisol and adrenocorticotropic hormone ACTH.
Infertility
Effect of Calcipotriol Plus Hydrocortisone Ointment on the Adrenal Hormone Balance and Calcium Metabolism in Patients With Psoriasis Vulgaris on the Face and Skin Folds
Sponsor
LEO Pharma
Enrollment
33
Started
2008
Primary outcome
The Adrenal Response to the ACTH Challenge Test Defined as the Serum Cortisol Concentration Obtained After 30 and 60 Minutes
Psoriasis Vulgaris
Remifentanil and Stress Hormones Response
NCT03378674COMPLETED
Sponsor
Catholic University of the Sacred Heart
Enrollment
50
Started
2008
Primary outcome
ACTH levels changes
Stress Response
Rosiglitazone in Treating Patients With Newly Diagnosed ACTH-Secreting Pituitary Tumor (Cushing Disease)
Sponsor
Jonsson Comprehensive Cancer Center
Enrollment
2
Started
2007
Primary outcome
Number of Responders
Cushing's Disease
Publication Trend
Research publications about ACTH over time
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