Adrenal Insufficiency :: Interpret ACTH STIM Test Results


Feb 17, 2016

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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Adrenal Disorders :: Cortisol Stim Test And Then ACTH Test ?

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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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

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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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Adrenal Insufficiency :: ACTH Test Bad Side Effects

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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Adrenal Insufficiency :: Cortisol Low After Doing Dexamethasone Test

My Cortisol level after doing dexamethasone test is below normal at 1.2

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Hormones :: 17 OHP Went Down In Response To ACTH Stim?

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 just got my blood drawn at 8 am for my cortisol levels were at 1.2 is this low?

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Adrenal Insufficiency :: Low Cortisol Of 1.1 - Hashimoto's?

I just had a AM cortisol lab of 1.1. Over the last 6 months I have been told I have Hashimotos.

What does this mean?

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Is a 0.6 cortisol level dangerous?

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Adrenal Insufficiency :: How High Cortisol Levels Can Go?

How high do very high cortisol numbers go?

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Adrenal Insufficiency :: Skin Feels Constantly Like It Is On Fire?

I have been fealing very hot the past 4-5 months, occasional headaches, sweating, heart palpitations. My skin feels constantly like it is on fire. I got my cortisol tested via saliva testing, all seem to drop on the normal range, but the morning level seems pretty low? Isn't it supposed to be the highest during the morning? Heres the results:

7-8AM: 1,87 nmo/l (1,38-15,7)
12-13PM: 8,55 nmo/l (0,55-9,94)
16-17PM: 4,1 nmo/l (0,55-6,62)
22-23PM : 1,18 nmo/l (0,55-3,59)

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Having cold chills, then horrible sweating. This goes on all day for me. I could not stay in grocery store to the cold, but by the time I arrived home, I was covered with sweat. The sweat is like you just came out of the shower.I have increased my fluids and am drinking diet decaf ice tea. This is especially when I am on the first dose 20 mg hydrocortisone. But it happens all day, and at night, I wake up sweating. Then, I get cold.

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Are there any side effect of taking vitamins(e.g. vitamin D+calcium) for long time as 3 months or more.

Does "Omeprazole 20mg" cause any harmful effect in long term use ?

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Morning Cortisol Level Of 9.2 - CRH Stim Test?

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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These are the exact results shown on my endo's site:  
MAY 19: 3p ACTH   19 NL; CORTISOL 21.1  ; 21 HYX AB NEG; RENIN 3.48 NL; ALDO 12 NL; NA 139 NL; DHEA-S 153 NL

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So, in order to wipe the slate clean and start afresh with my care, I have since changed doctors and will be asking for the following at my first appointment:

Sex hormone profile - not just the testosterone, FSH, LH and prolactin my endocrinologist carried out but I would like to include the ones she has *missed* - the oestrogen, estradiol and progesterone. I am sure there are others in there...

Full mineral/vitamin profile - but excluding the folate, Vitamin D and Vitamin B12 which were done recently and including a full iron panel.

Repeat thyroid test - why oh why am I experiencing hypothyroid symptoms AFTER I take the Levothyroxine? When I reported this to my previous doctor they have told me they will end my script for Levothyroxine since they are under the impression I get no ill effects without the medication! Are they right?

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Base cortisol 42.0
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