From the Guidelines
No, cortisol and Adrenocorticotropic hormone (ACTH) are not the same thing. They are distinct hormones with different origins and functions in the body. Cortisol is a steroid hormone produced by the adrenal glands, located on top of the kidneys. It's often called the "stress hormone" because it's released during stressful situations and helps regulate metabolism, reduce inflammation, and assist with immune function. ACTH, on the other hand, is a peptide hormone produced by the pituitary gland at the base of the brain. ACTH's primary role is to stimulate the adrenal glands to produce and release cortisol. This relationship is part of the hypothalamic-pituitary-adrenal (HPA) axis, a complex feedback system that helps maintain hormonal balance in the body. When cortisol levels in the blood are low, the pituitary releases more ACTH to signal the adrenal glands to produce more cortisol. Conversely, when cortisol levels are high, ACTH production decreases. Understanding this distinction is important in diagnosing conditions like Cushing's syndrome or Addison's disease, which involve abnormalities in cortisol production.
The distinction between cortisol and ACTH is crucial in clinical practice, as it guides the diagnosis and management of various endocrine disorders. For instance, in primary adrenal insufficiency, cortisol levels are low, and ACTH levels are high, whereas in secondary adrenal insufficiency, both cortisol and ACTH levels are low 1. The relationship between cortisol and ACTH is also important in the diagnosis of Cushing's disease, where a high cortisol level is accompanied by a high ACTH level 1.
In terms of diagnosis, the measurement of cortisol and ACTH levels can help distinguish between different types of adrenal insufficiency. For example, a low cortisol level with a high ACTH level suggests primary adrenal insufficiency, while a low cortisol level with a low ACTH level suggests secondary adrenal insufficiency 1. The use of dynamic tests, such as the corticotropin-releasing hormone (CRH) test, can also help confirm the diagnosis of Cushing's disease 1.
Key points to consider:
- Cortisol and ACTH are distinct hormones with different origins and functions.
- The relationship between cortisol and ACTH is part of the hypothalamic-pituitary-adrenal (HPA) axis.
- Understanding the distinction between cortisol and ACTH is important in diagnosing conditions like Cushing's syndrome or Addison's disease.
- The measurement of cortisol and ACTH levels can help distinguish between different types of adrenal insufficiency.
- Dynamic tests, such as the CRH test, can help confirm the diagnosis of Cushing's disease.
From the FDA Drug Label
The pharmacological effect of Metopirone is to reduce cortisol and corticosterone production by inhibiting the 11-beta-hydroxylation reaction in the adrenal cortex. Removal of the strong inhibitory feedback mechanism exerted by cortisol results in an increase in adrenocorticotropic hormone (ACTH) production by the pituitary
Cortisol and ACTH are not the same thing. Cortisol is a hormone produced by the adrenal cortex, while Adrenocorticotropic hormone (ACTH) is a hormone produced by the pituitary gland that stimulates the production of cortisol. The drug label describes the relationship between cortisol and ACTH, where the reduction of cortisol production leads to an increase in ACTH production due to the removal of the inhibitory feedback mechanism exerted by cortisol 2.
From the Research
Cortisol and ACTH: Understanding the Difference
- Cortisol and Adrenocorticotropic hormone (ACTH) are two distinct hormones that play crucial roles in the human body.
- ACTH is a hormone produced by the pituitary gland that stimulates the adrenal glands to produce cortisol 3, 4.
- Cortisol is a steroid hormone produced by the adrenal glands that helps the body respond to stress, regulates blood sugar levels, and aids in the metabolism of fat, protein, and carbohydrates.
Relationship Between Cortisol and ACTH
- The levels of cortisol and ACTH are closely related, as ACTH stimulates the production of cortisol 5, 6.
- In Cushing's disease, the levels of both cortisol and ACTH are often elevated, leading to symptoms such as weight gain, hypertension, and glucose intolerance 3, 4.
- However, in some cases, the levels of ACTH and cortisol may not be directly correlated, as seen in patients with ectopic ACTH syndrome 6.
Medical Treatment of Cushing's Syndrome
- Ketoconazole, an adrenal-blocking drug, is often used to treat Cushing's syndrome by inhibiting the production of cortisol 3, 4, 7.
- The use of ketoconazole can lead to a decrease in cortisol levels, but its effect on ACTH levels is less clear, with some studies suggesting a slight decrease in ACTH levels 4.
- Combination therapy with drugs that target the corticotropic adenoma, such as pasireotide and cabergoline, and low-dose ketoconazole may be a rational approach to achieve biochemical control in Cushing's disease 7.