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Addison's Disease Message Board
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Old 09-10-2005, 07:38 AM   #1
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dalmatinka HB User
Cortisol and ACTH stim test results, are they normal?

Hi everybody!

I don't have AD but I am suspicious of my adrenals. I had blood cortisol, saliva, urine and most recent ACTH tests done, and every doctor that I went to does not suspect adrenal problem. I will post some results here because I trust you guys more then doctors.

My question is: How do you know if you have a problem. I am also hypo and was not able to take proper dose of thyroid meds, they were giving me terrible anxiety. Since May I was able to increase my dose from 12.5 to 50 mcg and I am working on extra 8 mcg a day. I don't think it will work.
Yesterday I had bad attack, different then before. It felt like I am disappearing, I felt numb, very weak, I did not have energy like I did before from panic attacks. Trouble breathing, of course. It was so scary, I thought I was dying. It lasted forever. I took some klonopin and an hour later my PM dose of T4 and then I felt better.

Could physical work set you off? Before this attack I was working in a yard, which I don't do for the last three years since I haven't bean feeling well.

Over last several months, my symptoms had changed. I have less anxiety, but I don't have energy and I feel more calm and sleepy but not in a healthy way. It's hard to describe (English is not my firs language anyway)

Blood test: AM cortiso 10 (7-25) PM cortisol 18 (2-13)

ACTH stim test: Base 17, 30 min 21, 60 min 20 (7-25)


If there is anybody here who is on thyroid meds with low adrenals, how do you know?
Thank you so very much for taking time to read this.

 
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Old 10-15-2005, 07:20 AM   #2
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Keraly HB User
Re: Cortisol and ACTH stim test results, are they normal?

Dear Dalmatinka,

This is what I see. I wish I were a doctor. But I must tell you only what I've read and been told by others who have Addison's (I do not, but have been trying to learn about it, as I suspect my son has it). Your morning cortisol of 10 is on the low side. Morning is when they'd say it should be the highest for the day! Then your stim test shows a problem. I just got through reading something (a doctor's study) which said that a cortisol test done after stimulation should be double the cortisol before the stim test. Yours was 17, and you only stimmed to 21 after 30 min. and then 20 after 60 min.!! That does NOT constitute doubling.

As for the exertion of working in the yard, it could have done TWO very important things to bother you. Work demands more cortisol of our systems. Your system is obviously not able to provide more when asked (evidenced in the cortisol test, when it only went up from 17 to 21/20! So when you try to exercise, you feel badly. My son has the same thing happen to him. He just says he doesn't feel well, looks very worried, and then says if he keeps working, he will see black spots in front of his eyes, and feel faint. Don't know if this sounds familiar to you. But everyone is different! Secondly, working outside (especially in the heat) can quickly dehydrate anyone with Addison's or adrenal fatigue. Often your sodium will not be high enough, and you may also have low aldosterone, another thing made in the adrenal glands. This low aldosterone will cause you to throw out salt in your urine and not be able to utilize the water you drink to hydrate your body as well! Try drinking some Gatorade next time you feel badly, and see if it helps at all. This will be a test of whether you are dehydrated.

I would suggest you request the following blood tests, if they haven't already been done, and I would suggest you ask for a copy of the results of your ACTH stim test, and take it to another endo to have it analyzed. I do not believe your endo has drawn the correct conclusions from your test results!

Tests: Potassium, Sodium, Renin, ACTH in plasma, aldosterone, renin

These may give you/your doctor more valuable clues. In addition, if you have blood pressure cuff, you may want to try measuring your pulse and blood pressure after you have been lying down for 10 minutes or more. Then stand up carefully and retake these. If your pulse goes up wildly and your blood pressure goes down a few notches, say from 120/70 to 96/54, you may have evidence of low aldosterone and what is called Orthostatic Hypotension, another symptom of Addison's. You may need a med. called Florinef to help you not to get dizzy or dehydrated.

What you mention in the low thyroid mixed with adrenal problems is what's called "Schmidt's Disease" (I'm sorry, the spelling may be off a bit. You may want to look up info on this disease (combo of low thyroid and adrenals) on the web for more info!

Hope you get this message. I notice your message was sent quite a while ago with no reply. Hope you didn't give up! Take care, Tracy

 
Old 10-17-2005, 07:43 PM   #3
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Re: Cortisol and ACTH stim test results, are they normal?

This post has been deleted

Last edited by sadie-mae; 10-18-2005 at 09:50 AM.

 
Old 11-10-2005, 06:45 PM   #4
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dalmatinka HB User
Re: Cortisol and ACTH stim test results, are they normal?

Halo Tracy,

I just red you message and I want to thank you for wonderful explanation. I was suspicious of my adrenals for long time so I didn't give up. I went to another doc yesterday and he agrees that my adrenals need support. He told me to take DHEA 5 mg and try to increase it to 20 over the month. I will start tomorrow, I hop it will help.
Thanks again,

 
Old 11-21-2005, 06:59 AM   #5
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Keraly HB User
Re: Cortisol and ACTH stim test results, are they normal?

Dear Dalmatinka,

I hope you will find relief from the DHEA and help from this physician, as well! ~ Tracy

 
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