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Dr. Andrew Rynne

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Does ACTH level lab test for child consist of single or several secretion?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 10827 Questions

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Posted on Thu, 27 Dec 2012 in X-ray, Lab tests and Scans
Question: Dear Dr,

In an ACTH level lab test for child, does this consist of one single secretion or does it consist of several secretions resulting in a certain 'levels?

And how many pulses of adrenal testosterone does take place in the early morning ?

I hope i make sense, this is very important to me,

thanks and Best Regards,
XXXXXXX
doctor
Answered by Dr. Michelle Gibson James 14 hours later
Hi, thanks for using healthcare magic

ACTH is released from the pituitary gland and then promotes the release of cortisol from the adrenal glands

ACTH levels are normally highest in the morning (between 6 to 9 am) and lowest in the evening (6 to 11 pm), it begins to rise again about 2-3 am.
Normally it is released in pulses from the pituitary , about 40 pulses in a 24 hr period, with the greater release in the morning hours as stated previously. Normally only one sample is taken, there is an expected range for both the peak and low times of the day.Once the sample is taken it is compared to expected levels for that time period.

With regard to testosterone, most is secreted by the testes (95%) but a small amount may result from secretions from the adrenal glands.The adrenal gland secretes adrenal androgens which are male hormones, with a small amount of testosterone. The other androgens are converted to testosterone outside of the adrenal gland. The secretion at the adrenal is mediated by ACTH and it is secreted synchronously with cortisol (the hormone released from the adrenal in response to ACTH) in terms of its rhythm.
None of the studies indicate specifically how many pulses occur during the morning or evening, I am sorry about that.

I hope this information helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James 7 hours later
Thank you Dr XXXXXXX for the advice,

i have one final queston, why is it that several secretions of hormones need to take place over sevral days before any effect is seen or visible.


Can low dose testosterone pulses produced in a single day cause effects such as hair growth? Or is the hair growth only visible after several days of production?

Thanks and Regards,
XXXXXXX
doctor
Answered by Dr. Michelle Gibson James 5 hours later
Hi,

With regard to the hair growth, testosterone is associated with growth of facial hair, axillary , pubic,chest,leg hair and can , in some persons, be associated with baldness.
It would take several days for hair growth to be apparent.

In terms of the first part of the question, it takes a while for the human body to respond to most types of hormones, only a few situations such as an adrenal crisis would an almost immediate response.

Feel Free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James 42 hours later
Thank you for you advice Dr XXXXXXX

I would like to ask further question. I understand that gonadarche starts two around two years after adrenarche. Does the increased adrenal androgen production in adrenarche lead to or affect the maturation of HPG axis?
I read somewhere that HPA maturation during adrenarche leads to HPG maturation after approx 2 years in a boys. What is the reason for this, is it due to cortisol secretion?
Best Regards,
XXXXXXX
doctor
Answered by Dr. Michelle Gibson James 4 hours later
Hi

Puberty starts as a result of increased levels of GnRH which is a hormone that is released from the hypothalamus.
GnRH is released in a pulsatile fashion from the hypothalamus, it stimulates the pulsatile release of the hormones FSH (follicle stimulating hormone ) and LH (luteinizing hormone) from the pituitary.
During childhood, there is inhibition of GnRH release and after a period this inhibition is reduced and GnRH levels increase.


Although there appears to be a time link between adrenache and gonadarche, the two are not actually linked, they are two separate events.
Adrenarche is independent of gonadarche .It is caused by maturation of a part of the adrenal cortex which results in an increase in adrenal androgens, the increase in the blood levels of the adrenal androgens start at age 5 or 6 and typically manifest about 2 yrs later.
At this present time the reason or the initiating factor for adrenarche is presently not known.

Hope this is helpful to you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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