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  • ACTH stimulation: Normal basal, abnormal response

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    Old 04-22-2009, 05:54 PM   #1
    JoJo24
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    Exclamation ACTH stimulation: Normal basal, abnormal response

    Hello all,

    I am new here and i am looking for advice on my recent ACTH stimulation results. First of all, the test was performed pretty late in the morning (10:30am) so my values are more elevated than usual. That being said, my readings were as follows:

    Basal: 25.6 ug/dL (reference range 4.3-22.4)
    30min: 28.7
    60min: 29.3

    The lab sheet says that approximate doubling of basal level is usual normal response and that obviously did not happen. My endocrinologist said that it does not matter, since my basal was so high, she does not mind that doubling did not occur with the stimulation. I understand this rules out primary adrenal insufficiency but how about secondary?

    My endo is great and has helped me a lot with my endocrine conditions but something just does not stick here. I looked at the Merck manual and on PubMed as i am in the scientific community and it says the same thing about doubling even though it does not specify whether this should be the case in high basal values as well.

    So my question is, has anyone had this type of readings? Could they suggest secondary adrenal insufficiency and depletion of cortisol reserves, i.e. even though ACTH is available, the adrenals cannot pump out more cortisol because the reserves are depleted.

    I went through a horrible health phase for 4 months where I almost thought I was dying. I am out of it now even though no-one figured out exactly what was going on back then, and my ACTH stimulation test was performed on the end tail of this period.

    Any thoughts are very welcome. Thank you for your help.

    Last edited by JoJo24; 04-22-2009 at 05:56 PM.

     
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