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Do 11-deoxycortisol Levels Indicate Adequate ACTH Reserves?
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?
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?
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.
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
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
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
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
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
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Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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