Adrenocorticotropic Hormone Deficiency

Adrenocoticotropic hormone (ACTH) is a hormone that is secreted by the frontal lobe of the pituitary gland. This hormone is responsible for the production of cortisol and corticosterone, which are glucocorticoid hormones, by the adrenal cortex. The amount of ACTH released by the pituitary gland is itself determined by a hormone called corticotrophin-releasing hormone (CRH) produced by the hypothalamus on receiving nervous impulses. Adrenocorticotropic hormone deficiency is a very rare and one of the most dangerous of endocrine problems. It can lead to symptoms like an abnormal decrease in the level of blood sugar (hypoglycemia), low blood pressure, weakness and fatigue, pronounced weight loss and a loss of ancillary body hair. The patient is typically unable to engage in any sort of vigorous physical activity and is found to be intolerant towards insulin on medical examination. ACTH deficiency may be part of a larger problem caused by an underactive pituitary gland, a condition referred to as hypopitutarism, or it may occur as an isolated condition too, though the former case is more common than the latter. Sometimes an insufficient supply of blood to the pituitary gland, inflammation of the gland or the formation of a tumor may also result in this problem. Since the pituitary gland determines the functioning of the other glands in the body, a deficiency of ACTH may lead to other hormonal problems in the body. Consequently, the symptoms of the condition may not be very specific and it may take some time for the root cause of the problem to be accurately diagnosed. The problem has been found to affect the elderly more often. In some serious cases, it may cause delirium and prove fatal.

An ACTH test is recommended for those who have been suffering from any of the aforementioned symptoms for some time. It has to be remembered that ACTH level in the blood vary according to the time of the day when it is tested, being the highest in the early hours of the morning. Thus, a number of samples ought to be taken at different times of the day. Also, the patient should not eat or drink anything the night before the day s/he is tested for ACTH. Depending on the diagnosis, treatment is recommended. If the cause of the problem is an unusual growth of cells in the pituitary gland, the problem is sorted through surgery or proton beam radiation. More commonly, hydrocortisone supplements are administered to the patient.