Do 11-deoxycortisol levels indicate adequate ACTH reserves?
My cushing's symptoms have returned, and I am going to have a lot of testing.
My 11-deoxycortisol (serum) level was in the lab's normal range. I believe this means that I have adequate ACTH reserves. Does this also mean that I must be producing acth on my own again?
Some more info needed.
11 deoxycortisol is not the only lab exam that confirms or rules out an overproduction of ACTh and cortisol.
You need to check ACTH and free urinary cortisol at the 24-hour urine.
The fact that 11 deoxy is within the normal ranges is a good news.
If you have other blood tests, please attach them.
Hope I have answered your query. Let me know if I can assist you further.
Would you expect a hypo pituitary patient to have a normal result on the 11-deoxycortisol? That is a different way of asking same question.
Yes, it may be normal as it is not a sensitive test. Administering metyrapone 2 to 3 gr) at midnight and measuring 11 deoxycortisol and cortisol the next day at 8.00 am would be a sensitive test to rule out overproduction of ACTH.
The urine metabolites of deoxycortisol (17 -hydroxycorticosteroids) are also more sensitive than 11 deoxycortisol in plasma.
As I mentioned before, it is a good news but is not the most sensitive in your case.
Hope I have answered your query.
Dr Mirjeta Guni, Endocrinologist