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What Are the Functions of Cortisol and ACTH?

ACTH tests, or adrenocorticotropic hormone tests, are used to measure the responsiveness of the adrenal glands. ACTH is a naturally occurring hormone that is produced in the pituitary gland, which controls the release of cortisol (also called hydrocortisone). Cortisol is a steroidal, adrenal hormone that helps reduce inflammation. In general, as cortisol levels rise, ACTH levels fall, and vice versa. The many different functions of the two hormones can produce a variety of negative effects, as can the ACTH test itself.

  1. Normal Levels

    • It is normal for the body to produce an increased amount of cortisol after ACTH stimulation. According to the National Library of Medicine website, the cortisol to blood ratio in your body--if the body is functioning is properly--should be 18 to 20 micrograms per deciliter or higher after stimulation. However, levels that are considered "normal" will vary slightly from laboratory to laboratory, so ask your doctor for an interpretation of your results.

    High Cortisol Levels

    • High cortisol levels can sometimes be an indication of Cushing's disease (also known as hypercortisolism and Cushing's syndrome), which is usually caused by the formation of a tumor in the pituitary gland. The disease is characterized by obesity in the upper body, specifically around the face and neck. However, according to WebMD, if the high cortisol levels are also associated with high levels of ACTH, it could be an indication that ACTH is being produced outside of the pituitaries (which may also be the result of cancer).

    Low Cortisol Levels

    • According to WebMD, if low cortisol levels in a patient are associated with high ACTH levels, this could indicate Addison's disease, which is characterized by lethargy, low blood pressure, skin discoloration, and progressive red blood cell death (anemia). If the low levels of cortisol are associated with low levels of ACTH, it may indicate hypopitiutarism: a condition wherein the pituitary gland is unable to secrete enough hormones. In younger patients, hypopitiutarism can cause dwarfism, while in older patients, premature aging can occur.

    Drug Interactions

    • Medicines that act similar to cortisol, like corticosteroids (which are commonly used to treat inflammation), can alter your cortisol/ACTH levels. According to Cigna.com, lithium carbonate, amphetamines, and insulin can also alter your cortisol/ACTH levels. If you suffer from continuous bleeding following an ACTH test, this could the result a bleeding disorder, or the result of taking blood-thinning medications such as warfarin or aspirin, according to WebMD.

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