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-   -   Can anyone help interpret these labs? (https://www.healthboards.com/boards/addisons-disease/578388-can-anyone-help-interpret-these-labs.html)

Rodney99 02-11-2008 06:01 PM

Can anyone help interpret these labs?
 
I had my adrenals checked and there are some strange things going on. Can anyone help shed some light on these labs?

I am a forty year old male

all labs drawn at 8:00 am

Aldosterone serum 7.3 reference upright 7-30
cortisol serum 18 reference 8.0-19
DHEA 498 reference 160-800
Dheas 195 reference 88-305
acth <5.0 reference 6-48
plasma renin activity 94 reference upright 70-330


does is seem that my aldosterone is too low? I have postural tachycardia as well as Lyme. Will aldosterone this low cause symptoms?

rumpled 02-12-2008 08:30 AM

Re: Can anyone help interpret these labs?
 
Were your ACTH and renin done in chilled, lavendar-toped tubes, spun immediately (while you were there) or plopped in a bin? If not, then those results are, well, not accurate. ACTH and renin degrade at room temp in mere minutes so if not handled well and frozen promptly, that is perhaps why your ACTH was so low.

Is your blood pressure high or low? That will tell you if the renin is accurate or not. (High renin is low BP if I get it right, I get confused - if someone else chimes in and knows better, that is fine)

Now, your cortisol is getting to the high side for an 8am draw... You should get that checked again as that may start to look like Cushing's. I had Cushing's with all normal ACTH readings and mine was pituitary against all the normal stuff.

Your doc was running some pretty good stuff... but I think the lab techs messed it up - run it again and watch them like a hawk... ice ice ice. 8am it super important as is fasting.

Primary hyperaldosteronism (Conn’s syndrome)
High Aldosterone
Normal Cortisol
Low Renin

Secondary hyperaldosteronism
High Aldosterone
Normal Cortisol
High Renin

Cushing’s syndrome
Low-normal Aldosterone
High Cortisol
Low Renin

Adrenal insufficiency (Addison's disease)
Low Aldosterone
Low Cortisol
High Renin

Pituitary disease
Normal Aldosterone
Low Cortisol
Normal Renin

Rodney99 02-12-2008 12:54 PM

Re: Can anyone help interpret these labs?
 
Thanks rumpled. I'm not sure about how my samples were handled. It is probably the case with the acth. I'm most concerned about the aldosterone being low as it could explain why I have postural tachycardia. Do you think my borderline low aldosterone could cause symptoms? I'm 6'2 and 190# so I would think my aldosterone would need to be higher. Thanks in advance.

rumpled 02-13-2008 09:37 AM

Re: Can anyone help interpret these labs?
 
I had Cushing's and I was tachy... Cushing's effects the adrenal glands and your hormones there. I had to take florinef which is a aldosterone replacement. Most of the time, Cushing's patients have high bp but there are the odd ones like me that have the low BP so it can happen.
I would ask them to scan your adrenals, and get more cortisol tests. Now, my adrenals looked postitively brilliantly unremakable on MRI and CT (with contrast) and my reports were glowingly normal... yet when the surgeon went in there, those puppies were HUGE. Again, I know this has happened to many of my friends (I only hang out with the best). Better yet, my post-op CTs still say they are normal. Now that is a feat! :D

I suggest more endocrine work ups...

Rodney99 02-13-2008 06:34 PM

Re: Can anyone help interpret these labs?
 
your levels must be more out of whack than mine. I mean technically all mine are in normal ranges. What were your levels?

rumpled 02-14-2008 12:04 PM

Re: Can anyone help interpret these labs?
 
I am post op pituitary and post op bilateral adrenalectomy - so aside from a nice ACTH of 1801 (4-27), I am just hunky dory. Not.
I was a cyclical pituitary cushing's specimen - which meant that I would have a normal test, an abnormal test, a normal test... and if I tested when I felt great, I would test abnormally and if I tested when I felt horrid, they would be normal. Go figure. So I was my own worst enemy and of course, as soon as an endummy sees a normal test, they pronounce you as FINE even though you look like death.
My tests never got horrible - but now in retrospect, we have found that I have another disease. It was being hidden by the Cushing's - and probably treated by it - but I have a muscle disease as well so as soon as my huge adrenals came out, my shoulders froze and my ability to walk became curtailed. So my body was chewing up the excess cortisol as it was. Lucky me to get two freaky rare diseases in one lifetime. I am waiting to find out what this next one is.

I just advise you that you do not need to have all the symptoms to have cushing's so if you are suspicious - please be persistent in getting help.


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