Cortisol Test Results

[Jman12123]

Hi. I asked this over on the Addison's forum too, but wanted to come here to see if I could get additional advice. I’m 28 and have had symptoms of hyperthyroid all of my life including anxiety/nervousness, excessive sweating, rapid increase in heart rate when nervous or doing physical activity, hand tremor, heat intolerance, fatigue, and have always been skinny despite eating a lot. My mom had her thyroid removed when she was young due to similar problems and goiter/tumor so I finally decided to get some blood work done. I’ve gotten to a point where my short term memory is horrible and I am tired with brain fog a lot the time. People have suggested Addison’s Disease, pituitary issues, and resistance to thyroid hormone as potential problems since my FT4 was normal high and my TSH was a bit high relative to the FT4. Here are those thyroid results:

05/11/16
Reverse T3 22.4 (9.2-24.1 ng/dL)
TSH 2.47 (0.45-4.5 uIU/mL)
Free T3 3.5 (2.0-4.4 pg/mL)
Free T4 1.57 (0.82-1.77 ng/dL)
Antithyroglubulin AB (TgAb) < 1 (0.0-0.9 IU/mL)
Thyroid Peroxidase Antibody (TPO) 18 (0-34 IU/mL)
Thyroid Stimulating Immunoglobulin (TSI) 18 (0-139 %)
Thyroxine Binding Globulin (TBG) 13 (13-39 ug/mL)

I took a morning ACTH Plasma test on 06/10/16 and got 34.4 pg/mL in a range of 7.2 - 63.3 which seems to be pretty close to the middle of the range. I took a saliva cortisol/DHEAS test on 06/11/16 and got these results:
DHEAS (Saliva) 8.0 ng/mL 2-23
Cortisol (Saliva) 1.1 L ng/mL 3.7-9.5 (morning)
Cortisol (Saliva) 1.3 ng/mL 1.2-3.0 (noon)
Cortisol (Saliva) 1.3 ng/mL 0.6-1.9 (evening)
Cortisol (Saliva) 1.3 H ng/mL 0.4-1.0 (night)

So from that I’m seeing that I never got the big morning cortisol spike. Since I had a normal morning ACTH the day before the saliva cortisol test does it suggest primary Addison’s? I plan on seeing an endocrinologist soon, but I’ve been holding out because I am not working right now and don’t have insurance so I’m trying to do as much testing as I can in hopes of narrowing down the problem and avoiding additional visits if possible. I’d like to do the ACTH stim test, but haven’t found a place to purchase it online. Any insights or advice is appreciated.

[rumpled]

It is very hard to guage cortisol issue with one test or set of testing. The stim test must be done by a doctor. If you get electrolyte testing, you would have abnormal sodium and potassium readings as well. If those are normal, you can be happy it is not cortisol as it is a salt wasting disease.