What Is ACTH? Benefits, Research & Safety
A pituitary hormone that stimulates cortisol production, used diagnostically and therapeutically for various conditions including infantile spasms.
UK summary: UK prescription-only medicine. Synacthen (synthetic ACTH analogue) is used by NHS endocrinology for adrenal-function testing. Prohibited at all times under WADA S2.
Quick Facts
Overview
ACTH — evidence and risk at a glance
Twenty standard modules scored against the Peptide Authority evidence grading methodology. Missing modules indicate the field has not yet been characterised editorially — treat absences as uncertainty rather than reassurance.
01Evidence snapshot
UK prescription-only medicine. Synacthen (synthetic ACTH analogue) is used by NHS endocrinology for adrenal-function testing. Prohibited at all times under WADA S2.
02Human evidence grade
03Preclinical evidence grade
04Regulatory status
- UK: ACTH/cosyntropin (Synacthen) approved for diagnostic use and some therapeutic indications.
- EU: Similar approvals for diagnostic and therapeutic uses.
- Notes: Cosyntropin/tetracosactide (ACTH 1-24) is widely available for diagnostic testing. Repository corticotropin (Acthar Gel) is approved in the US for various conditions including infantile spasms, MS exacerbations, and rheumatic disorders. Availability and indications vary by jurisdiction.
05Approved medical uses
- Synacthen test for adrenal-function evaluation (synthetic ACTH analogue — NHS hospital use).
06Unapproved / promotional claims
- Boost cortisol for energy / performance / training.
- Athletic performance enhancement.
07Common internet claims
- Marketed by some bodybuilding sources as a cortisol boost.
- Sold by research-peptide retailers as ACTH 1-39 or fragments.
08Claim vs evidence
| Claim | Evidence | Human evidence? | Regulatory concern | Safer wording |
|---|---|---|---|---|
| “ACTH boosts cortisol for energy / performance” | E | No | High | Pharmacological cortisol elevation is not a wellness strategy; documented harms with chronic exposure. ACTH is a UK POM used in defined clinical contexts. |
09Safety uncertainty score
Limited human safety data; meaningful uncertainty about rare or long-term effects.
10Known adverse signals
- Pharmacological cortisol elevation: weight gain, mood disturbance, immunosuppression, osteoporosis, hyperglycaemia with chronic exposure.
- Adrenal suppression after prolonged use.
- WADA S2 prohibited.
11Drug-interaction uncertainty
Interaction picture sparse; meaningful uncertainty when combined with other medicines.
12Anti-doping status
13UK legal position
ACTH/cosyntropin (Synacthen) approved for diagnostic use and some therapeutic indications.
14EU legal position
Similar approvals for diagnostic and therapeutic uses.
15What this page cannot tell you
- Whether a grey-market 'ACTH' product contains the labelled compound.
- Long-term consequences of self-administered cortisol elevation.
16Last reviewed
17Citation quality score
18Research gaps
- No legitimate research basis for healthy-adult ACTH self-administration.
19Safer alternatives / established care pathways
- NHS endocrinology referral if adrenal-function concerns are clinical.
- Exercise, sleep, and stress management for energy concerns.
20Doctor discussion prompts
Questions to ask a qualified clinician
These are starter questions you can adapt for a GP, specialist, pharmacist, or anti-doping advisor. The aim is to help you have a better-informed conversation — not to replace one.
- What is the clinical reason ACTH might be relevant for me (vs a routine cortisol test)?
Discovery & History
Mechanism of Action
Researched Benefits
Based on preclinical and clinical research findings:
- 1Effective treatment for infantile spasms/West syndrome (approved)
- 2Diagnostic use in adrenal function testing
- 3Treatment of multiple sclerosis exacerbations
- 4Management of nephrotic syndrome
- 5Anti-inflammatory effects in various conditions
- 6Treatment of rheumatic and inflammatory disorders
Claim vs Evidence
How popular claims about ACTH stack up against the current research, graded using our public evidence grading methodology.
| Claim | Evidence | Human evidence? | Regulatory concern | Safer wording |
|---|---|---|---|---|
| “ACTH boosts cortisol for energy / performance” | E | No | High | Pharmacological cortisol elevation is not a wellness strategy; documented harms with chronic exposure. ACTH is a UK POM used in defined clinical contexts. |
Theoretical Dosing & Protocols
| Theoretical Dosage | Variable by indication; typically 25-250 μg for stimulation tests; higher doses for therapeutic use |
| Frequency | Indication-dependent |
| Duration | Short-term for stimulation tests; variable for therapeutic use |
| Notes | ACTH products (cosyntropin, repository corticotropin) are prescription medications with defined dosing for specific indications. Treatment should be under specialist supervision with appropriate monitoring. |
Administration Routes
Routes studied in research settings (educational only):
- Intramuscular injection (most common)
- Intravenous (diagnostic tests)
- Subcutaneous (some protocols)
| Half-Life | Stability |
|---|---|
| Approximately 10-20 minutes in plasma | Commercial preparations have defined stability; requires appropriate storage |
Safety Profile & Known Risks
Commonly Reported Side Effects
- Fluid retention
- Increased appetite and weight gain
- Mood changes, irritability
- Elevated blood glucose
- Skin changes (acne, increased pigmentation)
- Hypertension
Rare Risks & Concerns
- Adrenal suppression with prolonged use
- Serious infections (immunosuppression)
- Osteoporosis with chronic use
- Psychiatric disturbances
- Cushing syndrome features
Contraindications
- Systemic fungal infections
- Primary adrenal insufficiency
- Scleroderma
- Osteoporosis
- Peptic ulcer disease
- Recent surgery or live vaccination
UK & EU Regulatory Context
🇬🇧 United Kingdom
ACTH/cosyntropin (Synacthen) approved for diagnostic use and some therapeutic indications.
🇪🇺 European Union
Similar approvals for diagnostic and therapeutic uses.
Clinical Studies Summary
Adrenal insufficiency following systemic glucocorticoid therapy: a systematic review and meta-analysis.
AI is frequent following systemic GC use, with considerable variability. Tapering regimens and delayed testing post-cessation appear to reduce the observed prevalence. No specific GC regimen reliably prevents AI.
Cushing's disease and negative MRI: a single-center series, systematic literature review, and meta-analysis.
Consent to participate: Informed consent was obtained from all individual participants included in the study. Clinical trial number: Not applicable.
Adrenocorticotropic Hormone versus Prednisolone for Infantile Epileptic Spasms Syndrome: A Systematic Review and Economic Evaluation.
There is insufficient evidence to determine whether ACTH or prednisolone is better in the short-term regimen of IESS. ACTH may have more advantages in improving the long-term outcome of IESS. In China, a prednisolone regimen of IESS has a lower cost within 14 days.
Efficacy and tolerability of magnesium sulfate in children with infantile epileptic spasms syndrome: A systematic review and meta-analysis.
The combination of ACTH and MgSO₄ is more effective than ACTH monotherapy in achieving seizure control in children with IESS. Additionally, it is associated with a reduced risk of certain adverse events, such as hypertension.
Hypothalamic-pituitary-adrenal axis dysfunction in children with ADHD: A systematic review and meta-analysis.
ADHD may exhibit a consistent pattern of HPA-axis hypoactivity, affecting both basal secretion and stress responsiveness, whereas ACTH, CAR and HCC appear preserved. The effect is strongest in the ADHD-HI subtype and when cortisol is measured in blood, indicating a subtype-specific and matrix-dependent neuroendocrine phenotype.
Corticotherapy versus adrenocorticotropic hormone for treating West syndrome: a systematic review and meta-analysis.
The significant heterogeneity between studies restricts the analysis, emphasizing the need for additional research to assess the best WS treatment option. The Author(s).
Registered Trials & Regulatory Status
15 of 29 completed trials have never posted results. Unreported trials are not neutral: results that go unpublished are more often negative ones.
A Phase 2 Study to Evaluate the Effects of ASP5541 in Participants With Prostate Cancer
Status: Recruiting · 218 participants · Astellas Pharma Global Development, Inc.
Conditions: Prostate Cancer, Metastatic Castration-Resistant Prostate Cancer, Metastatic Hormone Sensitive Prostate Cancer
A Study to Evaluate Cortisol Reserve in Response to Adrenocorticotropic Hormone (ACTH) Stimulation Test Following Baxdrostat Treatment Compared to Placebo in Participants With Uncontrolled Hypertension
Status: Completed · 48 participants · AstraZeneca
Conditions: Uncontrolled Hypertension
Diagnosis of Adrenal Insufficiency in Liver Cirrhosis Patients
Status: Unknown · 50 participants · Seoul National University Hospital
Conditions: Adrenal Insufficiency, Liver Cirrhosis
Study of Adrenocorticotropic Hormone on Children With Frequent Relapse or Steroid-dependent Nephrotic Syndrome: a Prospective, Multicenter, Randomized，Open-label Clinical Trial.
Status: Recruiting · 140 participants · Mao Jianhua
Conditions: Nephrotic Syndrome in Children
A Study of SNP-ACTH (1-39) Gel in Patients With Primary Membranous Nephropathy
Status: Recruiting · 148 participants · Cerium Pharmaceuticals, Inc.
Conditions: Primary Membranous Nephropathy
SPI-62 as a Treatment for Adrenocorticotropic Hormone-dependent Cushing's Syndrome
Status: Completed · 26 participants · Sparrow Pharmaceuticals
Conditions: Cushing's Syndrome I, Cushing Disease Due to Increased ACTH Secretion, Cortisol Excess
Effect of CRH on Duodenal Markers and Gastric Sensorimotor Function
Status: Completed · 20 participants · Universitaire Ziekenhuizen KU Leuven
Conditions: GI Motility Disorder
Adrenocorticotropic Hormone (ACTH) for Post-op Inflammation in Proliferative Vitreoretinopathy (PVR)
Status: Completed · 11 participants · Johns Hopkins University
Conditions: Proliferative Vitreoretinopathy
Comparison of Intramuscular and Intravenous ACTH Stimulation Test in Normal Volunteers
Status: Withdrawn · Johns Hopkins University
Conditions: Adrenal Insufficiency
ACTHAR Therapy for Central Nervous System Sarcoidosis
Status: Withdrawn · The Cleveland Clinic
Conditions: Sarcoidosis
Clinical Efficacy of H.P. Acthar Gel 80 U/ml to Improve the Signs and Symptoms in Subjects With Dry Eye Disease
Status: Completed · 19 participants · Toyos Clinic
Conditions: Dry Eye Disease
Adrenocorticotropic Hormone in Membranous Nephropathy
Status: Completed · 5 participants · Icahn School of Medicine at Mount Sinai
Conditions: Membranous Nephropathy
Adverse event reports (FDA FAERS)
Not applicable: no licensed product contains this peptide, so it is not reported through FAERS. This is an absence of surveillance, not evidence of safety.
Source: ClinicalTrials.gov and openFDA. Updated automatically.
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View at SupplierFrequently Asked Questions
Questions to ask a qualified clinician about ACTH
These are starter questions you can adapt for a GP, specialist, pharmacist, or anti-doping advisor. The aim is to help you have a better-informed conversation — not to replace one.
- What is the clinical reason ACTH might be relevant for me (vs a routine cortisol test)?
UK regulatory & safety context
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