ACTH stimulates the adrenal glands to produce cortisol, the body's main stress hormone. Levels follow a daily rhythm, with the highest values in the early morning. Abnormal ACTH can indicate problems at either the pituitary or adrenal level.
This test is used to differentiate between causes of high cortisol (Cushing syndrome from pituitary versus adrenal versus ectopic sources) and low cortisol (primary adrenal insufficiency versus secondary pituitary causes). Results are interpreted alongside cortisol values, often in the morning or as part of dynamic testing such as the ACTH stimulation test. Sample handling is critical — ACTH is unstable and requires chilled transport. Sample type is plasma collected in an EDTA tube on ice.
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