Re: Cortisol and ACTH stim test results, are they normal?
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