ACTH Stimulation Test Results. Help!

[Charbt]

As a background, I have Hashimoto's Thyroiditis, for which I just began treatment. A few weeks ago, prior to treatment, I had an ACTH Stimulation Test run, the results of which are as follows:

Cortisol Basal 19.6 ug/dL
Cortisol Reference Range: AM = 3.4-26.9, PM = 0.9-15.8
Cortisol 30 min 26.7
Cortisol 60 min 21.2

Please note, this test was started at around 9:30-10:00 a.m. However, what does these results mean, if anything?  I've heard that upon stimulation, your Cortisol level is supposed to double, which mine did not.  Is that true?

[bellis5]

What if my endo thought I had cushings and gave me 1mg dex and my cortisol came back 1mcg/dl. I have hashimotos and pcos. But the lastest thyroid panel showed a tsh of .499 it was just 7 six months ago. I'm still sick Alot and really tired my body aches it's so hard for me to do anything with out getting exhausted.

[bellis5]

What if my endo thought I had cushings and gave me 1mg dex and my cortisol came back 1mcg/dl. I have hashimotos and pcos. But the lastest thyroid panel showed a tsh of .499 it was just 7 six months ago. I'm still sick Alot and really tired my body aches it's so hard for me to do anything with out getting exhausted.

[rumpled]

Your doc gave you the dex suppression test. Technically you suppressed and to a silly doc, you failed, but to a good doctor, that should be a test of location, not exclusion - it more indicated a pituitary source (IF you have it) as no one test can rule Cushing's in or out - so your doc did you no favor.

You need more testing. That one alone is not enough and does not do enough - even the guidelines say do two or three different tests. The docs tend to do this one as they think it is easy (hah) but I failed ALL dex tests and my pathology shows I have it and know many people in my boat.

Get copies of all your testing - and find a decent doc.

[brianakristen7]

mommabear0689
,
I know this is an old thread. But I was curious how you are currently doing? You sounded like you are going through exactly what I am going through. My cortisol, dhea and other hormones keep coming up low but I stimulate normal on the acth stem test! I just became hypothyroid as well. my primary put me on HC and I FINALLY HAD MY LIFE BACK for the first time in years! but then...he upped the dose and my cortisol ended up too high and made me sick again (after about 2 months of being on it). I was so freaked out that I got off the steroids but then I just got sicker. My endo does not want to diagnose me with adrenal insufficiency bc I stimulate ok even though my hormone levels are too low. !!! I am going to get into a doctor who does work in bioidentical hormones and adrenals and see what he says. But I really need help and I would love to here how things turned out for you and if the HC is keeping you well. Thank you so much!

[freeinjesus]

Sounds very similar to my life the last4years.acth test showed 20.1 and then 30 min later 20.2...what should that indicate? Have a previous tramatic past for years ..then twin pregnancy changed something in me...praise Jesus the trauma is over.now im trying to get my life back and be a mommy to my 7kiddos.

[rumpled]

The doc may see it as a failure as you did not double but some docs have a magic number that you may have hit... You dropped so the doc should take that as a failure in my layman opinion.

I hope you get on replacement meds and feel better soon.