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Weight gain, hyperpigmentation, joint aches, IBS. Had a cortisol and acth test. Ordered for another test at the same time

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General & Family Physician
Practicing since : 2001
Answered : 8479 Questions
Hi, I recently had a cortisol and acth test. The test was performed at 8:31am. Basically, the tests were high-normal, and my endo is ordering another cortisol and acth test. On the test, he wrote that the lab should be collected at 8:00am. How important is it to have the test performed at 8:00am? The lab order was faxed to me, and it's takes a couple of days for my endo to return my call. I've left a message with the nurse, but I know he's very, very busy.

Previous test results:

Cortisol 16.3 (2.3 - 19.4) mg/dl
ACTH 60.6 (7.2 - 63.3) pg/dl

Recent unexplained weight gain of 15 lbs in 21 days, fatigue, hyperpigmentation, joint aches, IBS, and several other symptoms...

Thank you!
Posted Sat, 18 May 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Michelle Gibson James 1 hour later
HI, thanks for using healthcare magic

ACTH is released from a part of the brain called the pituitary, it stimulates the release of cortisol.

ACTH and cortisol levels vary in an endogenous circadian rhythm. This means it is released a particular cycle over a 24 hr period.
The peak release is between 6 am and 9 am then it declines and reach the lowest between 11 pm and 2 am.

Because your values were high normal your doctor suggested a slightly earlier time so that it would be more likely be taken at the peak release.
Most persons recommend taking the sample at 8 am so it is important to take it at this time so that he or she can determine if your peak value is above the norm.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: Weight gain, hyperpigmentation, joint aches, IBS. Had a cortisol and acth test. Ordered for another test at the same time 6 minutes later
Thank you so much for the detailed answer! I'll convey this to the lab and schedule my appointment accordingly.

Thanks again!
Answered by Dr. Michelle Gibson James 34 minutes later
You are welcome, feel free to ask anything else
Above answer was peer-reviewed by
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