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ACTH STIMULATION

By Alfred J. Plechner, D.V.M.

When your healthcare professional finds an elevated cortisol level in a patient, the usual suggestion is to say to the pet owner or patient, "Let's do an injection of ACTH to further stimulate the layer that is over producing this cortisol, and see if this high level of cortisol will be even higher".

Before this is done, you need to ask your healthcare professional, if this is an active cortisol or an inactive cortisol? A blank look will not suffice!

How then does your healthcare professional determine this?

At very least, when the original test is done, a Complete Blood Test, should also be done. The reason for doing this, is to record the number and differential of the white blood cells. It is believed that active or inactive cortisol will have an effect on the lymphocytes and the eosinophils, which will be present in the white blood cell differential etc. If the cortisol is active, there may be an absence or real deficiency in both of these cells. If both of these cells are present, even in a reduced state, but are still present, the cortisol may not be active.

Obviously if my syndrome is checked, if the cortisol is active, the total estrogen will be below normal. I the cortisol is inactive, the total estrogen will be high. Remember, that your major laboratories are not doing total estrogen, and that is why I use the lab I use, and have no affiliation with this lab. They happen to be, "the only game in town", at this time. Possibly you might persuade your healthcare professionals to put pressure on their local laboratories, and find out why they do not have equipment or staff to do this test or just not enough interest to do the test, because of lack financial gain, even though their inability could cost a patient their life.

As you now realize, if measures are taken to reduce the high inactive cortisol, you or your pet could be put into a dangerous health situation.

If this is a true high level cortisol, then standard therapy may treat the problem correctly. But please realize, before there is the realization, that the high level of cortisol is active or inactive, I personally believe the ACTH stimulation test should not be done.

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