Addison's :: ACTH Stim Test- What Results Indicate?
I am being tested for Addison's Disease and just received the below test results. I don't see my endo until 12/4/13, and wondered what the results might indicate. Any thoughts?
Historically I presented with low Cortisol and High ACTH.
* After a Dexamethasone Suppression test my blood cortisol was less than 1mcg (whatever that means)
* 17 Alpha Hydroxyprogesterone was 849
* ACTH Stim test results:
Baseline- 10mcg
30 min.- 13mcg
60 min.- 15mcg
CTH Stimulation Test Results - Cortisol Decrease
By way of background I have typical cushing's symptoms but my early labs including 24 hour urine were normal. So of course doctors have been dismissive. I had a brain MRI for tinnitus and convinced the radiologist to include the pituitary and a microadenoma was found. Now doctors are taking me seriously thank goodness. I had a an ACTH stimulation test a couple of days ago and these are the results posted online:
Base cortisol 42.0
30 min cortisol 26.0
60 min 49.2
Normal range for morning (test done at about 9 am): 6.2-19.4
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I have so many Addison's symptoms, and in March my AM cortisol was 8.75, so low-normal. I was sure I would have a diagnosis after my ACTH stim test. Unfortunately, I've hit another dead end. Here are my results:
8am baseline reading - 12.82 ug/dl
30 Min after injection - 20.88
60 Min after injection - 24.44
I was stressed about the procedure to begin with. Then the nurse who drew my blood could not hit my vein and it was a very painful process as she continued hunting for it. It hurt so much I was almost in tears. This happened for the first two draws, and then I finally asked for a different nurse for the third draw. She hit my vein with no problems as most do since I have very prominent veins. I was so upset. Also, they had me walking back and forth between the lab and the waiting area after each blood draw.
Is it possible that my results were skewed by these factors?
I experienced an adrenaline rush shortly after being injected with the ACTH, and until about 5pm my heart was pounding pretty hard and I felt lightheaded. Is this normal?
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I am 38 Year Old male, Have been an athlete and or worked out since the age of 12 (super active). For the last 10 years or so I have been super fatigued/tired, don't recover well from exercise, terrible reactive hypoglycemia, muscle twitches, tan year round (i used to be white/pail as could be, now I carry at tan year round) short temper, sleep like crap. I can't seem to handle heat or a ton of direct sun. I will get sick for a day or 2 nauseous/fatigued/headache (it is not water usually i will drink 2 liters of water while out hiking for the afternoon.
I have taken 3 different Saliva cortisol test and all 3 looked the same, cortisol was in the tank upon waking and slowing rose throughout the day. The complete opposite of what it should look like. I finally talked my doctor into doing an ACTH Stim test. I have only got back the Cortisol results at this point, But they are very interesting??
From all that I have read on intercepting ACTH results your baseline Cortisol should double at 60 minutes. According to this test is should be >18 at 60 minutes I only rose 8!!! Please see results below.
Baseline Draw- 19.7, Standard > 5
30 Minute Draw- 26.4, Standard >7 Above Baseline Result, JUST UNDER BY .3
60 Minute Draw- 27.7, Standard >18 Above Baseline Result, 10 UNDER THE BARE MINIMUM IT SHOULD HAVE RISEN!!!
I am a little confused on how to interpret these results?? Like I said I should have the rest of the numbers in a few days.
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I was just wondering what comes after a cortisol stim test for diagnosing Addison's Disease ?
I had 2 Cortisol stim tests done one in the afternoon and one in the early morning .
Afternoon test read 2.8 out of 5-15
Morning test read 3.8 out of 5-25 Both low
Do i now have a Acth test done to see if its the adrenals glands or Pituitary or Hypothalamus Producing such low cortisol ?
I have abdominal cramping , hot flashes , constipation . tired , weak and major weight loss 35 + pounds in 8 months .
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