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  • hyperpigmentation w/ normal ACTH

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    Old 05-11-2008, 09:09 AM   #1
    octorus
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    hyperpigmentation w/ normal ACTH

    Question- I have definite hyperpigmentation - dark areas and all over tan. I have been reading that this is caused by excess ACTH. The one ACTH test that I had showed normal levels.
    I haven't had the stim test, nor has my dr. mentioned it. He has done a 2nd ACTH and is scheduling a CT of adrenals.
    He diagnosed addison's but didn't specify anything about secondary vs primary.
    Is the ACTH test good for determining the type of insufficiency?
    Should I bother asking for a stim test?

     
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    Old 05-11-2008, 11:57 AM   #2
    Hormoneman
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    Re: hyperpigmentation w/ normal ACTH

    Do ask for the stim test with serum acth. Low acth sometimes causes tanning. Actually it's the MSH that ACTH breaks down into that causes tanning. For some reason that isn't known, low acth can sometimes breakdown into a lot of MSH. I look at ACTH of 30 or less as being likely secondary. I see ACTH of upper 50's and for sure into upper 60's or more as being primary AI.

     
    Old 05-12-2008, 10:17 PM   #3
    octorus
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    Re: hyperpigmentation w/ normal ACTH

    My 1st ACTH was 18.
    Won't the stim test be normal with secondary?
    Getting diagnosed has been so difficult. I thought the hard part would be over but I'm 1 week with a diagnosis, sick every second of the day, too weak to do much of anything and still not receiving medication.
    I'm constantly dehydrated and dizzy. I seem to be getting worse every day. I feel like I can't wait much longer while they do more testing but I guess I have to do what I have to do.
    Thank you so much for the reply. That information helps quite a bit and I will pass it along to my dr.

     
    Old 05-13-2008, 09:57 AM   #4
    rumpled
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    Re: hyperpigmentation w/ normal ACTH

    Was your ACTH test done properly? Was it in a chilled tube? Was it lavender? Was in spun while you were sitting there or tossed in the bin to spin later in a batch?

    If not chilled - it will be lower...
    If not lavender - it will be lower...
    If not spun immediately - it will be lower....

    Lab error zapped my results early on until I learned that the techs were not handling my samples correctly. ACTH (and renin) degrade in a matter of minutes) at room temp so if they wait, well, your sample is toast.

    Just a thought. Also, ACTH pulses in the blood so it could just be a matter of timing.

     
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