ACTH lab results. ?!?!

Doc and I suspected Addison's after ruling out thyroid problems. My cortisol level was at a 5, but this was in the afternoon, around 3pm. I hadn't eaten yet that day tho b/c I wanted to make sure I would be able to have a test if needed after my doc appointment. Anyway, doc had me do an acth stim test a few days later. I haven't received the copy back yet, but the nurse at the doc office said my cortisol STARTED at 32.5. After the first injection it went DOWN to 27.68, then after the third injection it went DOWN again to 11.11. What is going on? The starting number seems so high. Normal values are from 4 - 22 from this lab. And then isn't the cortisol suppoesd to go UP after acth injections? Also, I had high cpk values in the first round of tests, so he is having that retested next week. I called to talk to doc, but the nurses are being weird, acting like I'm bothering them. They said doc will call me next week after my cpk tests. I said, NO. I want to talk to doc. They said ok and hung up on me. Am I losing it or is all this weird?

[kjarvis420]

OK. I talked to the doc and he said his lovely nurse read me the results backwards! nice, huh? anyway, my cortisol still was pretty low to start with. he said i'm fine and don't have addison's tho. i said, well what about secondary adrenal insufficiency? he said oh no. that's not a possibility.nothing else would suggest that. but he didn't test anything else besides my tsh (which was good at .72). he wants to test my cpk again. so we'll go that route first and i will come armed with info when i meet with him again on the 9th. this doc is pretty knowledgeable so i was surprised when he just blew me off about secondary adrenal insufficiency. Any pointers???

[KimQ]

Was the 11.11 the baseline cortisol?  Was that in the normal range for the time  of day it was drawn at?  Was there a baseline acth taken?

[kjarvis420]

there was not a baseline acth taken. 11 was the baseline cortisol. it was within the range (4-22), but still on the lower end, suggesting maybe secondary adrenal insufficiency, especially since my cortisol was at 5 the last time it was taken.