I went to the dr a few months ago because of progessively worsening symptoms of extreme tiredness, loss of concentration, hair loss, cold hands/feet, lightheadness that used to be only when I got up in the morning but now seems to be all day long, low blood pressure upon standing to name a few. My dr thought it was my thyroid but after my thyroid tests came back normal, she had no thoughts on what could be wrong.
Orig thyroid tests are
Thyroxine 9.3 (4.5 - 14.0)
T Uptake 33 (31.0 - 39.0)
Ultra TSH 0.992 (.4 - 4)
FTI 3.1 (2.0 - 4.0)
I then went to see an endo who is suspicious of an adrenal issue. He reran my thyroid tests and also did a cortisol/acth test. The results of those tests are:
Thyroxine 8.4 (4.5 - 12.0)
T Uptake 27 (24.0 - 39.0)
Ultra TSH 1.57 (.4 - 4)
FTI 2.3 (1.2 - 4.9)
Triiodothyronine 152 (83 - 200)
8 am cortisol 15.4 (4.3 - 22.4)
8 am acth 12 (6 - 48)
I also had a 4x salivary test done with the following results:
8am .17 (.025 - .6)
noon .22 (<.01 - .33)
4pm .07 (.01 - .2)
midnight .12 (<.01 - .09)
Do any of these tests give an indication of what might be going on with me? All the tests seem to be within range except for the midnight saliva test. Thanks!
Your ACTH test is missing some pieces. Have you heard of the ACTH Stimulation test? Here is a link: http://www.acthstimulationtest.com/interpretation.
Basically, you get an ACTH and Cortisol draw around 8:00am like you had. Then you are injected with ACTH. Then you get a cortisol draw at 30min and again at 60min. The values from 0min to 60min should at least double. The range of resting cortisol that your lab shows is quite broad. Normally, at least 18 to start is more on the normal side. Your ACTH seems somewhat low and could suggest secondary adrenal insufficiency. This is where the pituitary is supposed to stimulate the adrenals by releasing ACTH to tell them to produce Cortisol. If the adrenals are not working well, then you will see a very high resting ACTH level, and low rises at 30min and 60min. This is why a stimulus is necessary. If ACTH is injected, and there is no appreciable rise it means that the Adrenals are weak. Anyhow, you can read about this on the link above.
Thanks for the info about the stimulation test. So far, my dr hasn't mentioned this one but I have an appt with him tomorrow and it'll be the first one I've had with him to go over the results I posted.
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