Addison's :: ACTH Stim Test- What Results Indicate?
Nov 25, 2013
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
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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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I'm a new member to the board but I have found it very useful reading as I have been trying to understand my own hormone imbalances. I was diagnosed with PCOS but I am not done ruling out everything else, yet.
I took the ACTH stim test (high dose) recently to test for NCAH. These were my levels:
Cortisol Levels:
Base: 11.9
30 M: 29.7
60 M: 32.6
17 OHP levels (luteal):
Base: 124
30 M: 112
60 M: 91
In all of my research, healthy women and women with PCOS get elevated levels of 17 OHP during the ACTH stim test. Mine, on the other hand, went down. At an earlier point, during my folicular phase, I took a base 17 OHP that showed me at 35. And another serum cortisol (AM) was at 10.9.
If anyone knows a reason why my 17 OHP would go down so much in response to ACTH, I would really like to know. Also, I've taken several hormone tests before this, so if there are other levels you think are relevant, I might be able to tell you.
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I had an acth stim test about two weeks ago. I have been having a lot of health problems but they had calmed down some on the day of the test and the day before. After the test, everything went to heck, ( body feeling "jerky", involuntary body movements-primarily at night, muscle weakness at times- even causing me to limp around during the day, and lean on the wall one night due to weakness and fatigue, head ache like crazy-especially behind eyes/back of head, problems thinking, among other things). I had those problems before the test but was feeling ok for that 1.5 days then bam. I am wondering what bad effects people have had. Also wondering what all is affected from the stim test (what other parts besides adrenal/cortisol could it have aggravated. I haven't gotten results but don't think they did the test right anyway. I would be afraid to get it again cause how it affected me :(.
ps They recently found a pituitary cyst on my posterior pituitary gland (they said its fine).
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I was just given the ACTH stim test for a morning cortisol level of 9.2. There was a good response from my adrenals, but doesn't this just rule out primary adrenal insufficiency? My signs and symptoms are: worsening fatigue, loss of appetite, weight loss, headaches, pain & pressure in my sinuses ( but no drainage), slight visual changes in my left eye, poor libido, mood swings! My doc said my results were normal and does not intend to work up any further. Shouldn't we do a CRH stim test to rule out a possible pituitary problem?
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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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Is it possible you can have normal liver function tests and a complete blood profile and everything comes back normal but still have liver problems?
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I was recently tested negative for all STDs except herpes type 2 which I have had for years and so wasn't tested. I forgot to tell the doctor I am on Valtrex 500mg daily for suppressive antiviral treatment. Can this have an effect on the results of the tests for gonorrhea, chlamydia, syphilis, HIV, or hepatitis (hepatitis)?
Can I reply on the negative results or do I need retesting after coming off the herpes antiviral medication?
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My husband was diagnosed with iron overload and had the DNA testing done for Hemochromatosis, he has been waiting 7 months now and was told it would be another 4 months til he sees a Dr. to discuss the situation. My question is with waiting this long and not knowing how long before that he had high iron, will this be affecting his organs in a detrimental way.
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How I wish that I'd never been prescribed these horrid drugs. I've found them to be addictive and dangerous and I'm having a lot of trouble getting off them. I have joint and muscle pains, constipation, suffer a dry mouth, throat and eyes now I have raised liver function test results.
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I had a Medtronic spine stim put in me in 2013! Every time I turned it on I got severe burning pain and it would swell up uncontrollably!! Finally on eighth week it exploded!! I ended up in hospital for six days!! After that I have that pain 24/7!! Can't do anything without suffering badly!! Saw all kinds of doctors and they said I needed to try another one!! Against my true feelings I was skeptical and ended up putting it in!! I couldn't even use it due to the severe crippling pain it caused!! Ended up taking it out and after three years of doctors they did an mri looking to see if it burned my spinal cord!! The do to told me that no burn on spinal cord and wants me to put in new nevro hf10 system which I am worried about doing!! The pain is still 24/7!! Pain meds all day long and I still suffer badly!! I am looking for some kind of answers!! I don't know how much longer I can take the pain!! Does anyone know of anyone else that had or has this problem?? I am at my end here!! This is ruining every part of my life!! Lost most of my friends as back so bad I can't go any where!! Not even to dinner,cookout or any kind of event!
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About two months ago, I had mentioned to my personal trainer that I was feeling very tired with low blood pressure. This had been going on for a couple months, on and off every couple of weeks. He mentioned that it could be cortisol-related.
I went home and did a lot of researching about the issue and found that I matched a lot of the symptoms of low cortisol. I went in to see my doctor a couple days later. When I mentioned that I thought it was low cortisol, he said that the adrenal glands usually do the job and that it probably wasn't that. He tried to prescribe me anti-depressants which I declined, and then ran a few blood tests, along with an AM only cortisol test (it was about 11AM).
The test came back with a level of 17 mg/dL of cortisol taken at 11AM. However, he said my blood sugar was 54 which was very low. Also, my Vitamin D was below normal ranges. Some other counts were off, but nothing that really pointed to anything that could be causing what I was feeling.
I took a multivitamin for a few weeks. I had also been congested in the back of my throat for two months, so I went back to see the doctor if he could do anything about that. He determined it was a sinus infection, and prescribed Cefuroxime for two weeks to get rid of the congestion. I asked if that could help my fatigue to which he said it could help.
So I finished the two week round of antibiotics, and now it's two weeks later and I still feel horrible. Here's the main things that I am experiencing. I really don't feel depressed and feel like I enjoy life a lot.
- Inability to wake up for work. I wake up around 9AM, and feel like I haven't slept at all. I previously had to wake up around 5AM to get everything done in the morning
- Feeling of drowsiness through the morning, up until noon. Sometimes like today it will last all day.
- Extremely low blood pressure while standing. This starts around 2PM every day and lasts until around 5PM. I usually don't fall down and just black out, but recently I fell because after standing up and injured my knee.
- Fluctuations in appetite, I will eat a TON of food with out gaining any weight (5-6 meals a day), but I exercise a lot so this isn't super concerning. My weight is constant.
- Itchy red eyes when I wake up
- Exhaustion when sitting, feels like I should lay down but not low blood pressure
- Hypoglycemia, my blood sugar is really low in the mornings, and then again in the evenings before dinner. Between that it feels fine but I don't do regular testing on this to know for sure.
Also I am 20 years old male and a competitive cyclist. I eat very healthy foods (although a lot to keep up my activity). I live at a high altitude (7,400ft).
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I am 38 and have Hypothyroidism. I recently had a cortisol test and my initial results came back at a level of 210. I was told that the normal range was 150 - 650 ( or thereabouts ) and as my test was at 9am these levels should be much higher.
I have been refereed to see a hormone specialist but am just curious to know if anyone had an initial level of 210 at peak time and didn't have Addison's. Or, indeed they did have it?
Could it be adrenal fatigue? which is why I went to the drs as I read about on a thyroid website.
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My daughter is taking hydrocortisone for primary Addison's due to Pheochromocytoma. Does anybody know if she should be taking something to help prevent osteoporosis??
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I'm wondering what the "typical" dose is for fludrocortisone? I've been taking .1 mg for past several years, but doesn't seem like it's doing anything. I'm thirsty all of the time, and am consuming liquids all day it seems ... and yes, I add sea salt to my water. Could it be that this gets worse the longer you live with the condition, and so may require more of the med to help with sodium retention? I'm clearly not retaining extra water weight as I'm extremely thin (87 lbs). My doctor doesn't seem to have a clue and just tells me to keep drinking water. I pretty much don't rely on doctors anymore with this condition. I've grown tired of educating them about Addison's/ Adrenal Insufficiency. So I figured I would ask here and see what others take and if anyone has had to increase their fludrocortisone.
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What was your cortisol level when you were diagnosed with Addison's? I'm guessing it was 0.
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