Possible Interaction: Hydrocortisone and Adrenocorticotropic Hormone

“A minority of subjects developed blunted adrenocorticotropic hormone –stimulated release of cortisol.”

“In conclusion, the large interindividual variation in ACTH levels most likely indicates varying sensitivity to cortisol with a need for individualized dosing schemes.”

“Mean basal cortisol (μg/dl) and ACTH (pg/ml) levels were higher in hyperthyroidism ( cortisol : 10.7 ± 0.7; ACTH: 21.5 ± 2.9) compared to controls (cortisol: 8.1 ± 0.7; ACTH: 13.5 ± 1.8).”

“After administering the substance cortisol and ACTH levels were enhanced during the total night compared to placebo.”

“Cerebrospinal fluid cortisol was 10-fold higher with ACTH treatment (n = 26), but was unchanged with oral steroid treatment (n = 18) or no treatment (n = 25).”

“A logarithmic dose-response relationship between the dose of ACTH administered and plasma cortisol concentration was found.”

“In this case, also ACTH levels were signi~cantly decreased (from 9.6 (1.7) to 5.2 (1.3) pmol/L; P > 0.01) together with urinary cortisol (from 781 (194) to 372 (165) nmol/d; > 0.01).”

“The undiminished concentration of ACTH in the presence of elevated cortisol levels suggests that blockade of MR shifts the set point for cortisol feedback inhibition of the HPA axis toward higher cortisol levels.”

“The median cortisol level at 1 and 2 h after administration of ACTH was significantly lower in infants from multiple gestations than in singletons.”

“At the level of 24-h ACTH rhythmicity, cortisol withdrawal enhanced the daily rhythm in ACTH secretory burst mass by 29-fold, elevated the mesor by 16-fold, and delayed the acrophase by 3.4 h from 0831 h to 1154 h (each P < 10(-3)).”