Very high ACTH level but okay hydrocortisone levels

[sonny_01]

I have addison's disease for the past two years. Recently my ACTH level shot up. I have an ACTH level of 600 which is super high but my Hydrocortisone level is okay. My facial skin has also tanned very much along with a lot of acne over face and upper body. My doctor increased my dose of hydrocortisone earlier which brought my ACTH level down from 1200 to 600. But now the hydrocortisone I am taking is too high 30 mcg per day. Doctor has recommended me to an Ednocrynologist to figure put what is going on. The appointment is in another two months but I am getting worried as to what is going on. Is there anyone who have faced such a problem and if so what did you do.
Thanks a lot.

[rumpled]

You can get steroid-induced Cushing's for sure....

With the high ACTH, it sounds like something is going on in the pituitary - are they planning an MRI? Did your testing show secondary source before?

Usually acne is caused by high cortisol and not just ACTH - and a point in time test at one time of the day is uh... not good enough.

Any other symptoms?

[sonny_01]

Thanks
Earlier I was taking 15 mug of HC. But my ACTH went very high. The doctor increased my HC in a couple of steps first to 20 then 25 and finally 30. They test the cortisol level by blood test only. The morning of the test I do not take medicine before the test.
I got acne only when my ACTH level was diagnosed as high.
Can one get cushings on top of addisons??  

[rumpled]

What level of HC were you taking before? Did you have the acne before or after the rise?

By HC level ok, what do you mean - do you test on meds - aka a 24 hour urine test?

At 30mg it can give you steroid induced Cushing's so geez, you don't need that on top of AI.

I also have a very high ACTH but I won't let the docs raise my HC super high as I used to have Cushing's and my body was already damaged. Your doc has to look for either a pituitary tumor or other acth-secreting tumor.