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Old 09-09-2009, 06:43 PM   #1
Junior Member
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Join Date: Oct 2008
Location: USA
Posts: 42
Masta HB User
17yr sons ACTH stim results and more

Looking forward to your input.

son has an excessive peeing problem. suffers from anxiety. do you think he would do well on some Cortef (HC) and Florinef? if so what dosage?

Even though sons baseline cortisol looks good (porbably due to major stress of the test) his labs did not double after the stim.

08/26/09 ACTH stim test (low dose 0.001mcg Cortrosyn via I.V)
08:09am - Baseline Cortisol = 22.1 ug/dL
08:57am - ACTH stim injected
09:26am - 30mins draw cortisol = 29.4 ug/dL
09:57am - 60mins draw cortisol = 30.9 ug/dL
10:27am - 90mins draw cortisol = 30.9 ug/dL
Baseline ACTH = 24 (6 to 55 pg/mL)

He salt fasted for 24hrs, food and fluid fasted for 8hrs before the test. He sat upright for the test. Test taken 8:50am)
Renin = 1.6 (0.5 to 4.0 ng/mL/hr) Upright
Aldosterone = 4.6 (4.0 to 31.0 ng/dL) Upright
Aldosterone/Renin Ratio = 2.9 (<=25.0) (Its says an Aldosterone Renin Ratio is greater than 25 suggestive of hyperaldosteronism)
Arginine Vasopressin Hormone = 1.4 (0 to 4.7 pg/mL)

DHEAS = 262 (45 to 385 ug/dL)
17-OH Progesterone = 136 (24 to 192 ng/dL) Male 16-17yrs
21- OH Antibodies = < 0.2 (0 to 1.0 U/mL)

Ionized Calcium Serum = 1.25 (1.20 to 1.38 mmol/L)
Phosphorus = 2.8 (2.7 to 4.7 mg/dL)
PTH Intact = 16 (15 to 75 pg/mL)
Calcium for PTH: 9.2 (8.5 to 10.7 mg/dL)

Was on 1 grain Armour. Did not take it the morning of the test.
TSH (3rd Generation) = 0.99 (0.50 to 4.40 uIU/mL)
Free T3 = 3.4 (2.9 to 4.2 pg/mL)
Free T4 = 0.71 ( 0.54 to 1.85 ng/dL)

CMP
Na = 140 (137 to 146 mmol/L)
K = 4.9 (3.4 to 4.7 mmol/L) High
CI = 102 (98 to 109 mmol/L)
CO2 = 30 (19 to 28 mmol/L) High
Anion Gap (Na Cl CO2) = 8 (3 to 16 mmol/L)
Glucose = 81 (60 to 115 mg/dL)
BUN = 13 (8 to 21 mg/dL)
Creatinine = 0.79 (0.42 to 0.90 md/dL)
Ca = 9.3 (8.8 to 10.7 mg/dL)
Prot = 7.6 (6.3 to 8.6 g/dL)
Alb = 4.5 (3.4 to 5.3 g/dL)
Bili Total = 0.7 (0.2 to 1.3 mg/dL)
Alk Phos = 87 (65 to 260 U/L)
ALT = < 6 (10 to 40 U/L) Low
AST = 37 (15 to 45 U/L)

ESR = 0 (0 to 15 mm/h)
hs-CRP = 0.3 (0.0 to 2.5 mg/L)

03/24/09 TAP Free Cortisol Rhythm Test Done by Diagnos-Techs

6am-8am: 17 normal (range 13-24nM)
11am-12pm: 4 depressed (range 5-10nM)
4pm-5pm : 5 normal (range 3-8nM)
10pm-12am: 3 normal (range 1-4nM)
Cortisol burden: 29 (range 23-42)

 
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Old 06-07-2011, 07:07 PM   #2
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Join Date: Oct 2010
Location: Plains Pa
Posts: 21
confused34 HB User
Re: 17yr sons ACTH stim results and more

Hello Masta,
How long has this peeing issue been a problem?
With excessive urination, i would have expected a much lower sodium level. As you stated the baseline Cort is good which is probably allowing him to hold on to his Sodium. The Metyrapone stimulation tests is something you might want to look into to rule out 2nd Ai. What is his Blood pressure? Have they checked his Catecholamines via urine or blood?
Good luck

 
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