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  • Interpretation of short syn & insulin tolerance test... help please

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    Old 05-10-2013, 01:58 AM   #1
    ockford2412
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    Interpretation of short syn & insulin tolerance test... help please

    Hi Everyone,

    I am trying to figure out if my problem is pit or adrenal based. My results are as follows:

    Baseline cortisol - 98 nmol (range 130-700)

    Short Syn Test:
    Base Cortisol: 234nmol
    30 mins: 493 nmol
    Range- anything below 550nmol is considered a fail

    ACTH: 16 ng/l

    Insulin Tolerance Test:
    Base cortisol: 89nmol
    15 mins (in hypoglycemic state) 122nmol

    In my opinion my adrenals clearly arent responding as they should when stressed as per the results from the short syn test but it also doesn't look like im sending enough ACTH because my response to the insulin test was also pretty poor?

    Any thoughts would be greatly appreciated because I feel like im going round in circles!

    Thanks in advance

     
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    Old 05-10-2013, 07:55 AM   #2
    ladybud
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    Re: Interpretation of short syn & insulin tolerance test...help please

    Could you post the normal ranges for the ACTH and insulin test results? That would help with interpretation.

     
    Old 05-14-2013, 01:10 PM   #3
    ockford2412
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    Re: Interpretation of short syn & insulin tolerance test...help please

    Hi,

    I wasn't given the ranges for ACTH but have found that 10–60 ng/L is considered a normal range but a healthy person would be towards the top end of the range.

    The adequate cortisol range required during the insulin Test is 550 nmol/L same as the synathen test.

    Thank you

     
    Old 05-14-2013, 01:20 PM   #4
    ladybud
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    Re: Interpretation of short syn & insulin tolerance test...help please

    It appears you failed the insulin test big time. What does your endo say, and do you have a diagnosis yet? It seems this is clearly Addison's according to test results. Have you had anti-adrenal antibodies measured? Addison's is autoimmune and antibodies to the adrenal glands are present in blood.

     
    Old 05-14-2013, 01:31 PM   #5
    ockford2412
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    Re: Interpretation of short syn & insulin tolerance test...help please

    Yep all my antibodies were negative so they pretty much ruled out primary because of my lowish ACTH levels and the antibodies test being fine. I just wonder if its a pit problem and my adrenals are fatigued (I know endos don't believe in this) because it defiantly seems to me that they aren't quite responding as they should and not reaching the required 550 on a stim test is a fail.
    They haven't officially diagnosed me with anything, just stuck me on HC, 20mg a day and told me I would feel much better, I feel better than I did but still pretty shocking most days

     
    Old 05-14-2013, 05:49 PM   #6
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    Re: Interpretation of short syn & insulin tolerance test...help please

    Many people need more than 20 HC a day. Like 25-30mg in divided doses, like 20-5-5 (AM midafternoon, eevening), or 15, 10, 5. It will take a little time to get the dose adjusted right. Low ACTH does indicate a pituitary problem.

     
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