I would greatly appreciate it if someone could help me understand my son's labs. I have adrenal insufficiency, myself--but his labs confused me. I'm wondering whether I should call the doctor and ask for retesting, and then a stim test?
I had him evaluated due to excessive sweating/body odor, excessive hunger (with no weight gain for over a year, but weight gain has started in the last two months), aggression/rage, excessive crying and unusual fatigue. --My son is 7.
The following have been ruled out: emotional problems, learning disabilities, thyroid, and adenoids removed this year, tonsils no issue in fatigue.
The ped. endo ran the following labs: TSH 5.33 (.30-5.50) mIU/L
Free T4 1.31 (.76-1.70) NG/DL
DHEA-Sulfate (DHEAS) 139 (0-49)
ACTH 31 (5-52) pg/ml
9:13 am Plasma Cortisol 3.0
A.M. 7.0 - 22.0 UG/DL
P.M. 3.0 - 13.0 UG/DL
**Effective March 2010, cortisol results will show an approximate 10% decrease from previous values due to a manufacturer change in standardization of the assay.
If it makes a difference, his TSH was just out of range (5.60, approx.) one month before this test. Free T3 and Free T4 were mid-range normal. All Thyroid antibodies were negative, but had elevated TSI (Graves) antibodies at the age of 2.
The doctor said there were no problems with his adrenals, but they believe he may be in premature puberty because of the high DHEAS. (They said DHEAS are quite elevated when a person is in puberty.) The latter seems logical to me. However, after recently obtaining a copy of his actual results, I'm really wondering about the adrenals.
My understanding is that with AI, his ACTH should be either high or low, correct? The cortisol seems quite low to me, standardization or not. So, I'm confused about whether there is an adrenal problem or not.
Would there be any relationship between the cortisol and DHEAS within the context of AI? --I know my DHEA is almost always low, so my first impression is that it's not related (in this case) to an adrenal problem.
I had been sick with AI for almost 15 years before someone finally diagnosed me, so I don't automatically trust doctors, unfortunately.
Thanks very much for any help you may offer