stim test-no go!! - Addison's Disease Message Board

jen77 · 04-15-2008, 10:06 AM

Hi just need someone to talk to. yesterday the endo called me and said i needed a stim test. so today went for it, but no one could cannulate me, i hadthree doctors tying it in over an hour (total of 12 times) so you can imagine how stressed i was by then. Anyway endo decided to leave it and just do a baseline cortisol not atch, aldosterone or anything else. and he remarked at least after all that i will be stressed enough to show a normal level to rule out addisons!
do you think that my veins were collapsing as a sign of addisons i am constantly getting dehydrated as my results show (also i have very slow ability to concentrate my urine so endo told me to cut down on my fluid intake)? About 6months ago iwas hard to get blood off but certainly not this bad- they actually said it is not possible to cannulate therefore what happens when i feel worse (today i felt relatively ok by that i mean i could walk from the car park to the room and not faint).
Anyway the stim test is abandoned and they wont do this now and are going to base the diagnosis on a cortisol that has been taken under extreem stress and say that it is normal. i dont know what to do im loosing faith rapidly with this lot, cant they see that not being able to start the test indicates something, if the stim test is the total test to diagnose addisons what do i do, im not getting any better? please post back, thanks.

sparkles916 · 04-20-2008, 07:35 AM

My endo had trouble with the cannula too. She ended up giving my the cortosyn via IM (intramuscular). I was freaking out, since I did not know whether this could upset the results of the stim test. I later did a search on the web and found out that the IM is a perfectly acceptable method of cortosyn administation ----at least according to the standard med literature I read ---others here may know more from experience.

At the least, it seems your drs should have known this

and been able to complete your test.

I can't answer your other concerns, but my impression is that drs of this sort are not interested in scientific validity of tests such as this, since they seem to feel often, that such tests are unneccesary and second to compaining patients who have a lot of somatic complaints and blame their endocrine function.

Was there anything specific which originally prompted your dr to order the stim test?

My test was less than valid, since the lab "forgot" to draw my ACTH in the morning when my AM cortisol was drawn. It was just ridiculous. The dr is like "oh, well, we don't really need that".

rumpled · 04-20-2008, 01:31 PM

Sorry you had such a bad experience...
Having bad veins is not diagnostic of addison's though... tons of those with cushing's (the polar opposite of addison's) have the exact same issue so... it happens.
It does help to hydrate well for a few days before the test so you have the best chance of getting a cannula in... that being said, if the stupid lab is not going to draw all the necessary tests, it is a bunk anyway.

Lots of times they can use smaller needles, warm packs etc...

The urine is a separate issue but should be looked at.

I have had to resort many times to looking up the protocol for tests before I go in, print it off and make sure it is followed. I tick them off but... I have had many tests goofed up and it contributed to the over decade length of time it took to get diagnosed with Cushing's as the ACTH kept coming back low due to lab error! It has to be chilled when drawn, spun immediately and frozen promptly or it is invalid.

brandy68 · 04-20-2008, 03:59 PM

my son cannot concentrate his urine, he has diabetes insipidus, due to damage to back part of his pituitary gland.Has your endo mentioned this at all? diabetes insipidus means that without meds, any fluid that goes in your body comes straight back out again. It doesnt stay in the body long enough to concentrate, my sons wee is clear and odorless.

I was also told by my sons paediatrician to reduce his fluid intake, this was before my sons diagnosis. Its something that you just cant do with someone if they have DI, because of dehydration.

I do hope you get some answers soon and start to feel better

jen77 · 04-21-2008, 07:31 AM

Thank you all for replying. Well firstly i have just been to see the endo today for the results of the cortisol result- suprise it was normal according to him (result 20.5 after over an hour of stabbing me with needles) therefore there is no need to try a stim tests again, or do atch or any other hormones.
With regard to being unable to cannulate me they were using peadiatric cannulas and had my hands and feet warmed in hot water but they soon go cold again.
They said that a stim test would be done as a last resort to rule out addisons (symptoms weakness, faintness, hypoglycaemia, cant exercise otherwise i collapse, cold, nauseaus especially in the morning) and now they have got that one random cortisol they are saying that that is as usefull as the stim test to rule it out. Anyway endo has said to keep doing normal things and to try and put more weight on (i am on 3000 calories a day anyway and since december have lost 7lb)
With regard to my frequent urination thirst etc, the endo did a prolonged water dep test i finally managed to just about concentrate my urine after 20hours fasting, therefore when i drink i am constantly going to the loo. Endo therefore ruled out diabetes insipidus from that and said to reduce my fluid intake but since ive done that i feel dreadful (dry mouth and tongue is cracking/sore, lightheaded, and of course thirsty)
I just dont know where or what to do I guess all i can do is wait! What do you think? thanks