Feedback Loop: Adrenocorticotropic Hormone (ACTH)
Authors: Rhiannon Brett Reviewers: Andrea Kuczynski Bernard Corenblum* * MD at time of publication
Posterior Pituitary Gland
ADH
–
–
–
Hypothalamus
CRH
+
Anterior Pituitary Gland
ACTH, MSH, other hormones produced from POMC
ACTH
+
Adrenal Cortex
Activate ACTHR
Activate cAMP Activate PKA Activate Zona Fasciculata
Cortisol
Abbreviations:
CRH: Corticotropin Releasing Hormone
ADH: Anti-diuretic Hormone
ACTH: Adrenocorticotropic Hormone
MSH: Melanocyte Stimulating Hormone
POMC: Pro-Opiomelanocortin
ACTHR: ACTH Receptor
cAMP: Cyclic Adenosine Monophosphate
PKA: Protein Kinase A
DHEA(S): Dehydroepiandrosterone (sulfonated form) F: Female
M: Male
Excess: hirsutism, acne, oily skin, oligo- or amenorrhea, virilization in F
Deficiency: symptoms not typically seen due to gonadal production
Note:
Activate Zona Reticularis Activate Zona Glomerulosa
(minor effect)
Excess: central obesity, hirsutism, violaceous striae, weakness
Deficiency: weight loss, fatigue, weakness, nausea/vomiting, diarrhea
DHEA(S) Aldosterone
Specific to primary adrenal insufficiency: ↑ pigmentation, hyperkalemia
• Virilization is a red flag for an androgen- secreting tumor
Legend:
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications
Published October 2, 2018 on www.thecalgaryguide.com