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Why is it that low levels of circulating cortisol can be accompanied by excessive levels of...

Why is it that low levels of circulating cortisol can be accompanied by excessive levels of ACTH in some individuals and be accompanied by normal levels of ACTH in others?

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Answer #1

Cortisol has a negative feedback effect on ACTH secretion from anterior pituitary.

So low level of cortisol will remove the negative feedback on anterior pituitary leading to increased production of ACTH.This is seen in Addison's disease .

If there is damage to pituitary or some other cause due to which there is hypopituitarism ; ACTH level is low and cortisol level is also low.

The level of ACTH depends on the responsiveness of pituitary to the inhibitory effect of cortisol .If it is less sensitive ACTH level will not increase even though cortisol is low.Bug usually this condition is not found often.

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