ADDISON'S - primary v secondary & ACTH test

[hoss19]

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i have consulted a few sources to get this straight and i still can t figure it out. Let me know if i have this straight....

In PRIMARY addison's there is a problem with the adrenal cortex, so cortisol is DOWN but ACTH is UP (thus the extra pigmentation)

In SECONDARY addison's there is problem with hypothalamus / ant. pituitary so CORTISOL is also DOWN due to ACTH being DOWN.

In the ACTH stimulation test, exogenous ACTH is administered. If cortisol goes UP, the problem is SECONDARY, due to the faulty hypothalamus/ant. pituitary. If there is no change in cortisol levels, then the Dx would be PRIMARY, becasue the ACTH has no effect on the damaged adrenal cortex.

*if this is right let me know. If so, then first aid book has it all f*cked up, but they've been pretty good so far....annoying....

thx in advance

 

[Instatewaiter]

i have consulted a few sources to get this straight and i still can t figure it out. Let me know if i have this straight....

In PRIMARY addison's there is a problem with the adrenal cortex, so cortisol is DOWN but ACTH is UP (thus the extra pigmentation)

In SECONDARY addison's there is problem with hypothalamus / ant. pituitary so CORTISOL is also DOWN due to ACTH being DOWN.

In the ACTH stimulation test, exogenous ACTH is administered. If cortisol goes UP, the problem is SECONDARY, due to the faulty hypothalamus/ant. pituitary. If there is no change in cortisol levels, then the Dx would be PRIMARY, becasue the ACTH has no effect on the damaged adrenal cortex.

*if this is right let me know. If so, then first aid book has it all f*cked up, but they've been pretty good so far....annoying....

thx in advance

So yes, primary the adrenals dont work. So the pituitary tries to make the cortex make more cortisol by secreting ACTH (cortisol down causing ACTH up)

Secondary the pituitary doesn't work so it is not secreting ACTH and so the adrenals don't make enough cortisol (ACTH down casuing cortisol down)

In the stimulation test giving ACTH will only work if the adrenals work. In primary they don't work. In secondary they work (the problem is pit/hypothal). So, giving ACTH will make cortisol increase in secondary, it will not make it increase in primary.

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[joefosho315]

i have consulted a few sources to get this straight and i still can t figure it out. Let me know if i have this straight....

In PRIMARY addison's there is a problem with the adrenal cortex, so cortisol is DOWN but ACTH is UP (thus the extra pigmentation)

In SECONDARY addison's there is problem with hypothalamus / ant. pituitary so CORTISOL is also DOWN due to ACTH being DOWN.

In the ACTH stimulation test, exogenous ACTH is administered. If cortisol goes UP, the problem is SECONDARY, due to the faulty hypothalamus/ant. pituitary. If there is no change in cortisol levels, then the Dx would be PRIMARY, becasue the ACTH has no effect on the damaged adrenal cortex.

*if this is right let me know. If so, then first aid book has it all f*cked up, but they've been pretty good so far....annoying....

thx in advance

this is all correct. 👍

 

[life easy]

This is all true.....And it is also true that first aid has given it all messed up .It has pretty more mistakes.

 

[hoss19]

THX to all for your help....