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    Old 12-01-2006, 06:26 PM   #1
    Ivoryz00's Avatar
    Join Date: Oct 2006
    Location: Louisville, KY
    Posts: 55
    Ivoryz00 HB User
    Question Addison's Disease Test and Exercise

    I'm not totally sure just yet if I have Addison's Disease, but I'm in the middle of getting a second opinion from another endo doctor who's willing to help me.

    The new endo doctor I saw only took blood from me. Is this enough to test me for Addison's Disease? I thought I was suppose to have something injected in me (ACTH stimulation test)? However, I took a look at the paper work and saw multiple areas she looked into, including thyroid, Cortisol, ACTH, and diabetes.

    Also.....I'm a little concered about my quality of life if it turns out that I have Addison's. I used to be heavily into health and fitness (bodybuilding in particular), and recieved my B.A. in Exercise Physiology last year. All of that was put on hold after I became sick last winter. Poor appetite along with nausea and extreme fatigue have been my biggest problems. I wanted to know if exercising and bodybuilding will still be possible to do if I indeed have Addison's Disease? Will proper treatment bring some sort of normalcy, even if I can't work out anymore? Thank you.

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    Old 12-03-2006, 09:13 AM   #2
    Join Date: Feb 2004
    Posts: 342
    WandaB HB User
    Re: Addison's Disease Test and Exercise

    Your new endo doctor did not do the ACTH test since you had no injection. Waste of your time & blood. This is why we, as the patient, have to take partial control of what goes on with testing & treatment. The tests you need are below. Be sure they do the ACTH test correctly. Go over it with them first. Baseline draw, shot, draw at 30 & 60mins.

    I know of many who continue with their exercise. Mountain bike riding, mountain climbing, marathons & etc. Might take a bit extra cortisol replacement just as a normal body would produce extra.

    Proper treatment for addisons is the key to feeling well. Problem is most endos only know what they read in the book & that isn't enough. If you are diagnosed & put on replacement meds, post the type, amount & schedule here so others can help you.

    Diagnostic Testing for Addison's Disease

    TEST 1: Electrolyte profile:

    OBJECT: To determine if the patient exhibits a normal serum (blood) sodium and potassium levels.

    THE TEST: A blood draw followed by automated determination of sodium and potassium levels as well as other standard blood markers.

    NORMAL RESULT (will vary somewhat from lab to lab): Sodium 135-150 mEq/L; Potassium 3.5-5.2 mEq/L

    PRIMARY ADDISONIAN: Will show significantly below normal values of sodium and a elevated (above normal) levels of potassium.

    REASON FOR ABNORMALITY: Low or no production of aldosterone from the adrenal cortex. This steroidal hormone regulates our mineral balance and is called a mineralocorticoid. Primary Addisonians lose sodium and retain potassium. Abnormal values here, in additon to physical signs and symptoms, require the next test.

    TEST 2: The ACTH stimulation test:

    OBJECT: To determine if the patient's adrenal glands can respond to the ACTH message from the pituitary to increase cortisol production in the adrenal cortex.

    THE TEST: The test is usually given first thing in the morning when normal cortisol levels are highest. Blood is withdrawn from the patient to establish a baseline (No instructions regarding necessity for fasting). The patient is given 250 micrograms (ug) of ACTH (Cortrosyn, Cosyntropin, or Synacthen) by injection in saline at one time. Blood is drawn at 30 minutes and/or 60 minutes and the serum cortisol level is determined.

    NORMAL RESULTS: Normal pre-injection levels of cortisol are 5-25 ug/dL (138-690 nmol/L). The value should double at 30-60 minutes with a minimum of 20 ug/dL (552 nmol/L). PRIMARY ADDISONIAN: There will be no or little increase in cortisol levels upon ACTH injection. Notes: It is stated in several places that a single test of cortisol levels, or even 24 h urinary levels of cortisol and its metabolites, are NOT DIAGNOSTIC! In the normal individual cortisol levels are seen to pulse. Low cortisol production in either the serum or the urine after ACTH stimulation is diagnostic of Addisons disease.

    SECONDARY ADDISONIAN (Pituitary malfunction): Low cortisol production can be seen if the patient has "functional adrenal cortical atrophy" due to prolonged absence of normal ACTH secretion. This type of patient would not show the typical hyper-pigmentation of primary Addisons.

    REASON FOR ABNORMALITY: Due to autoimmune, or other destruction of enzymatic (biocatalytic) machinery of the adrenal gland, there is no response to ACTH and no production of cortisol and other adrenal steroids necessary for life. If this test gives normal results and the patient has other signs and symptoms then one of the following tests is required.

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