Adrenal Disorders :: Cortisol Stim Test And Then ACTH Test ?
Nov 7, 2014
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 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 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 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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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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My Cortisol level after doing dexamethasone test is below normal at 1.2
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I was diagnosed Hashimotos this year.
Here are my adrenal stress test results:
Sample 1 - 3.4 (12-22)
Sample 2 - 6.1 (5.0-9.0)
Sample 3 - 4.8 (3.0-7.0)
Sample 4 - 3.2 (1.0-3.0)
DHEA:Cortisol Ratio - 2.62 (within range)
Latest thyroid function test results:
TSH - 2.50 (0.2-4.2)
Free T3 - 4.6 (3.9-6.7)
Free T4 - 15.7 (12-22)
Apparently my doctor says these are normal, yet when I am taking the Levothyroxine my Free T3 drops and my hypothyroid symptoms return. Am I missing something or am I the only one in the world with this problem? I presume the latter.
I am currently dairy and gluten free and my fatigue and constipation have cleared up since on the diet, however I retook my Levothyroxine and within 2 hours I was constipated. The only change I had made was retaking the Levothyroxine but I did increase my fluid intake, too. The reaction I had from the medication is making me doubt the benefits of it. Or could I be undermedicated at 125mcg? The nurse taking my blood last time said 125mcg is a lot for a little person like me to be taking!
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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I have Addison's disease for 10 years. Every once in awhile I feel very run down and sort of out of it if that makes sense? For the past 4 days I am having a hard time staying awake. I cannot stay up for more than 2 hours at a time and have just basically slept the days away. I have a headache and feel nauseated on top of this. A couple times I have even felt dizzy. I have been doing a lot of reading (while I am awake) on the subject of addisonian crisis and was just wanting to see what some other people think that have gone through this. I have doubled my meds but it hasn't helped yet. Although I just started that yesterday.
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I am concerned about my test I have had recently...my blood pressure is a little low and when I am sleeping it is dropping to 81/51. My cortisol is 357 at a 9.00 in the morning. I have been having some very bizarre symptoms.. I started with sudden dizziness and numbness in my arms 6 months ago they tested me for stroke tia but it was clear.. then the symptoms started to get worse fatigue, pains in my legs, back pain, feeling sick, dizziness just feeling generally unwell... does any on no what is normal for the cortisol level is at 9.00 in the morning.. I think they are testing me for addison disease.
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I had my AM cortisol tested and it came out high. I did the blood test while fasting about 1 hour after I woke up.
My AM cortisol: 33.7 (normal range 6.2-19.4)
Could the high cortisol be the cause of my symptoms:fast heart rate (gets worse with exertion), sweating, and 15 pound weight loss, trouble sleeping?
I was researching it online and my symptoms seem to fit more with those with low cortisol than high cortisol. I've been to 5 doctors and went to the ER once because I've been feeling so terrible the past 4 months. My AM cortisol is the first thing to come out abnormal. All thyroid, liver, etc. tests come out perfectly within the normal range.
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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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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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First off, I am a 30 year old female, and I've had an array of crazy symptoms for years and have gone undiagnosed (well, misdiagnosed with fibromyalgia and chronic fatigue syndrome). I've also been diagnosed with hypothyroidism, PCOS, Endometriosis, and autonomic dysfunction. My symptoms range from debilitating fatigue, hormonal symptoms, dizziness and fainting, and inability to keep a pregnancy. Over the years, I have had consistently low levels of cortisol, but now things are changing. My 8:00 am cortisol level is 2.1, and my 1:00pm is 21. It went from low to high in my results. They were suspecting secondary adrenal insufficiency before due to the consistently low levels, but with that new afternoon level, I am really confused. Also, I have extreme fatigue in the early morning (have to drag myself out of bed) but I get a giant boost of energy at night and have trouble getting to sleep. My NP thought the cortisol levels could explain that, and she gave me a prescription for Cortef in the morning and sent me to the Vitamin store to pick up Phosphorylated Serine and Adrenal Adaptogens to control the nighttime level. She didn't address why this could be happening, and I was worried about taking the Cortef with those high afternoon levels, so I recently switched to an endocrinologist who repeated the afternoon test. I've just looked at the results online and it is high again. I'm so confused.
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
I will say, I do have INTENSE dehydration and sodium loss that has caused me to become a neurological patient as well, and I down 2-3 32 oz Powerades a day and consume probably 10-15 times the normal sodium consumption levels as my neurologists have suggested in order to keep my from getting dizzy and passing out all the time, so that may explain why my sodium level looks fine. But that cortisol... how could it start the morning off low and end up high later in the day? Does anyone else have any experience with this?
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i had my period last june 9 2014, then on june 27 and 28 i had a light spotting.den, i felt something's wrong with me..there's a feeling or slight symptoms of a pregnant woman..a boobs are tender to touch and painful..my body feel hot like i was having a light fever..than july 1 i take a pregnancy test and shows positive but faint line.. then, july 2 to 8 i got again spotting.. and goes away.. july 14 i took another pregnancy test shows again positive faint line.. i went to my ob july 18 just to know her what's happening on me. i had that light spotting again..and in transvaginal ultrasound shows that there was a thickening of the lining tells me that i am positive. 5 to 6 weeks, but i have a cyst considered benign.nothing to worry about she said. she gave me medicine duphaston good for 10 days, and i'm going to come back for a follow up appt. on july 28. again the spotting continues sometimes light bleeding, sometimes full on my liners. another medicine duphaston gud for 5 days she gave me because on the ultrasound she saw only thickening of the linings and the baby wasn't developing. then, this day august 1 i came back for the final appt, i took a blood test and shows negative. transvaginal ultrasound shows again the lining on my ovary.
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I am male 30 years old Indian. Had a protected vaginal sex with one girl with unknown HIV status during 11th of August 2013 for 3 times after that I had a foreplay without protection keeping pennis on her vagina without Inserting / penetration into the vagina for 5 minutes but during that event my foreskin pulled back. I am totally convinced on my protected vaginal sex and bit worried on my unprotected foreplay and believing that some of the vaginal precum fluids may entered through my urethra. My anxiety starts since I got mild fever (38 degree) on September 9th 2013 exactly 28th day evening which exists for one night after putting antibiotic injection after two days I faced fatigue exists for 2 days and after 2 days I had mild sore throat with dry mouth exists for one day and after 3 days I faced diarrhea 2 times a day and exists for 3 days.. all these days I got small red spots rashes 10 - 20 no's which on my shoulders and mild night sweats which only on my neck and hand elbows 1 hour after I slept. But I never faced fever on these days expect the day -1. Never faced swollen glands and swollen lymph nodes up to now.
I am totally worried and got anxious and had a Standard HIV antibody rapid test for HIV -1 & 2 on my 53 th day ( i.e.: Oct 4th 2013 - 7.5 weeks from my possible exposure date) and it came as non-reactive,
I took western blot test on my 58th day again it came as negative..
But from Oct 5th I am getting small rashes on my hand and in shoulders and in legs and some of them in legs are itching...
1) Kindly advise me will my 7.5 weeks standard antibody negative & negative western blot test at first day of my 9th week (ie : 9/10/2013) will likely to change positive on my 12th week standard antibody (HIV 1 & 2) testing.
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I have a question I took a oral swab home test today 5 year post exposure condom broke. The exposure was anal sex. My question is i had a few sips of water prior to the test due to dry mouth is my negative result false or not conclusive?
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What happens when you don't pass the 1 hr glucose test, they just called me and told me I didn't pass it and have to go back again next week...
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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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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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I have what seems to be classic Balanitis. It seems to come and go. The glands of my penis look puffy and shiny when I am erect. This condition has been with me for about 5 years now and nobody seems to be able help me. One of the many doctors I have seen gave me a C-Reactive Protein test to test for infection in my body and nothing came up. Is this normal for Balanitis? Unfortunately I have to have an erection to show the puffiness of my penis glans and that is difficult when you're standing in front of a doctor.
Should balanitis show up in a C-Reactive protein test and how on earth can I get rid of this problem. I've used every anti fungal cream in the world as well as a myriad of other creams and nothing will cure it. It's starting to take a psychological effect on me. Please help.
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