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Cushing's disease is a serious hormonal disorder that causes excessive cortisol production in the body. It is caused by a pituitary tumor that produces too much adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to overproduce cortisol. The Adrenocorticotropic Hormone (ACTH) blood test is the most important test for diagnosing this condition.
Cushing's disease is caused by a benign tumor in the pituitary gland that secretes excessive amounts of adrenocorticotropic hormone (ACTH). This excess ACTH then signals the adrenal glands to produce too much cortisol, the body's primary stress hormone. The pituitary tumor is usually small and non-cancerous, but its hormonal effects can cause significant health problems throughout the body if left untreated.
The Adrenocorticotropic Hormone (ACTH) blood test is the most important test for Cushing's disease because it measures the hormone directly responsible for triggering excess cortisol production. Elevated ACTH levels indicate that a pituitary tumor is driving the condition, distinguishing it from other causes of high cortisol. This test is essential because it helps doctors determine whether the problem originates in the pituitary gland versus the adrenal glands or elsewhere, which directly affects treatment decisions. Additional tests like late-night salivary cortisol or 24-hour urine cortisol may be used alongside ACTH testing for comprehensive evaluation.
You should get tested if you experience unexplained weight gain concentrated in your face, neck, and trunk while your arms and legs remain thin, or if you develop purple stretch marks on your abdomen. Other warning signs include a round, reddened face, persistent high blood pressure, muscle weakness, easy bruising, and mood changes like depression or irritability. Getting tested is especially important if you notice several of these symptoms together, as early diagnosis helps prevent serious complications like diabetes, osteoporosis, and heart disease.
What this means
Your ACTH levels are elevated above the optimal range, which may indicate your pituitary gland is working harder to stimulate your adrenal glands. This could suggest your adrenal glands aren't producing enough cortisol, potentially contributing to fatigue, low blood pressure, or difficulty handling stress.
Recommended actions
Schedule a follow-up with an endocrinologist to investigate potential adrenal insufficiency
Keep a symptom diary tracking energy levels, salt cravings, and blood pressure readings
Prioritize stress management through adequate sleep and gentle exercise
Consider additional testing like cortisol levels to get a complete picture of adrenal function
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