Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

130 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Do 11-deoxycortisol levels indicate adequate ACTH reserves?

Answered by
Dr.
Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2120 Questions

default
Posted on Wed, 12 Sep 2018 in Thyroid Problem and Hormonal Problems
Question: Hello. 10 years ago I was diagnosed with Cushing's Disease. An acth-producing adenoma was removed from my pituitary gland. Later I underwent a radiation procedure. I ended up being hypo pituitary.

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?
doctor
Answered by Dr. Mirjeta Guni 46 minutes later
Brief Answer:

Some more info needed.

Detailed Answer:

Hi,

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.
Above answer was peer-reviewed by : Dr. Kampana
doctor
default
Follow up: Dr. Mirjeta Guni 14 minutes later
Yes, I have many tests scheduled.

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.

Ty
doctor
Answered by Dr. Mirjeta Guni 11 minutes later
Brief Answer:

About 11-deoxycortisol:

Detailed Answer:

Hi,

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.

Take care

Regards,
Dr Mirjeta Guni, Endocrinologist
Above answer was peer-reviewed by : Dr. Kampana
doctor
premium_optimized

The User accepted the expert's answer

Share on