How Postures Lead To Fluctuation In Hormonal Levels?

Posted on Fri, 4 Nov 2016

Question: Does the body release certain hormones with change in position such as standing, bending? Or does it release certain hormones with exertion such as going up stairs or incline? I am wondering how cortisol, ACTH, or CRH are effected with these changes in activity.

Also would a cort stim test be able to tell if there is an issue with the pituitary producing acth or does it just test for Addison's disease?

Answered by Dr. Shehzad Topiwala (1 hour later)

Brief Answer:
Hormones

Detailed Answer:
1 Yes, there are certain hormones like aldosterone, renin and catecholamines to name a few, which are affected by posture.

2 Certain hormones are also released on exertion such as epinephrine

3 Stressful conditions like fever or hospitalization cause a significant rise in CRH, ACTH and cortisol

4 There is no such test called Cortisol stimulation test but I reckon you are referring to the ACTH stimulation test. This is used to diagnose adrenal (cortisol) insufficiency. A positive test ie a person failing it, can have either Addison's or a defect in the pituitary ACTH production.
So to answer your question, the test is somewhat non-specific and cannot distinguish between pituitary ACTH problem versus Addison's disease.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (2 hours later)

How would you check if it was a pituitary disorder vs addisons?

Another question...Could iron deficiency or supplementation effect any endocrine hormones? And if someone had an allergic reaction (non anaphylactic) would that effect the hormone levels like cortisol??

Answered by Dr. Shehzad Topiwala (9 hours later)

Brief Answer:
Follow up

Detailed Answer:
1 One way to do so is to check ACTH levels during the 8 am morning cortisol sample which is used as a baseline for the ACTH stimulation test. This is collected before ACTH is injected.
If the morning Cortisol level is less than 6.5 and the ACTH is abnormally high, it generally suggests an adrenal problem ie Addison's, while if ACTH is low/low normal then it is likely to be a pituitary disorder.

However there are technical complexities in the interpretation of this test so other tests are utilized to confirm the diagnosis. For example an MRI of the pituitary is done if a pituitary problem is suspected.

2 Iron deficiency is not known to cause any endocrine problem.

Iron supplementation in excess can lead to Hemosiderosis which can harm the pituitary, testicles and parathyroid glands.

3 If one suffered an allergic reaction in general, the impact on cortisol levels would depend on the degree of stress it causes. So if it were a significant one then it would result in enough stress to the body to raise the cortisol levels temporarily

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (25 hours later)

So for the stimulation tests they always check both cortisol and acth before it?

Then give the acth and check the cortisol levels again?

Could taking melatonin at bedtime effect this test or cortisol levels?

Answered by Dr. Shehzad Topiwala (3 hours later)

Brief Answer:
Second follow up

Detailed Answer:
1 The standard practice is to measure only cortisol at baseline (ie before ACTH injection), and then again at 30 and 60 minutes after ACTH injection.

But it is an option to measure ACTH blood levels at baseline too, in order to get an idea of whether this can be a pituitary / hypothalamus problem versus an adrenal defect

2 To my knowledge, melatonin at bedtime is not known to affect the outcome of this test

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar