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Help with results

They look to be in range (other than cortisol) but wanted to make sure these ranges weren't strict, like for example, being in the far end, but still in range, might still indicate a problem

Renin Activity, Plasma 2.84 ng/mL/hr
Adult Normal Salt Intake:
Upright 1.31 - 3.95
Supine 0.15 - 2.33

Salt Excretion
(Na mEq/24 hr):
(No idea what these ranges mean or what's a result)
Na= 0 - 30 8.82 - 23.86
Na= 30 - 75 4.09 - 7.73
Na= 75 - 150 1.44 - 2.80
Na= >150 0.39 - 1.31

ACTH, Plasma 8.4 pg/mL 7.2-63.3

ACTH reference interval for samples collected between 7 and 10 AM.
(Blood was taken after 3pm)

Cortisol - PM 30.8 ug/dL 2.3-11.9 HIGH

DHEA-Sulfate 222.0 ug/dL 84.8-378.0

Aldosterone 2.0 ng/dL 0.0-30.0

I am taking birth control, which I think may effect cortisol. I'm wondering if I should get off it.

I am also hypothyroid, and my thyroid symptoms is what lead to the test. I think my endo thinks I'm over medicated based on the high cortisol reading, even though my symptoms were the same before I was ever treated for hypothyroidism.
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Avatar universal
The only think I saw was renin, so hopefully the fludrocortisone will help. It should raise your BP and keep you from being lightheaded.
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Avatar universal
These are July's results, taken at 3 in the afternoon. I asked about a 24hr saliva, but he claimed that they weren't able to test that, but offered a 24hr urine, which I did. These are the results with me off birth control and me on 88mcg of synthroid:

Cortisol, F, ug/24hr, Urine
23 ug/24 hr 0-50

Cortisol, F, ug/L, Urine
9 ug/L

Renin Activity, Plasma
4.58 ng/mL/hr
Adult Normal Salt
Intake:
Upright 1.31 - 3.95
Supine 0.15 - 2.33

Sodium
136 mEq/L 136-145

T3, Free (FT3)
3.9 pg/mL
2.0-4.4

T4, Free
1.67 ng/dL 0.80-1.80

TSH
0.035 uIU/mL L 0.400-4.000

Aldosterone
12.4 ng/dL 0.0-30.0

Cort. Bind. Glob. (CBG)
3.1 mg/dL 1.7 - 3.1

Cortisol, Serum LCMS
8.1 ug/dL
8:00 AM 8.0 - 19
4:00 PM 4.0 - 11

Free Cortisol, Serum
0.21 ug/dL
8:00 AM: 0.2 - 1.8

Percent Free Cortisol, Serum
2.6 %
8:00 am: 2.3 - 9.5

Cortisol - PM
9.9 ug/dL
2.3-11.9

So cortisol supposedly looks fine. So does this test rule out such a problem? I brought up my issue about having borderline aldosterone, and he prescribed half a tablet of fludrocortisone (.5mcg). I was surprised that the test showed the level as being pretty good, but I had already gotten the prescription, and I've noticed an improvement. I'm not as sensitive to the light as much (photophobia). I still hafta wear a hat outside, but rarely ever indoors. Also, I'm hardly ever light headed anymore, which I didn't think was related, but I guess so.

My FT3 and FT4 is the highest it's ever been, so with the low TSH, my synthroid dose was lowered to 75.
Helpful - 0
Avatar universal
There is a "sheehan's syndrome" when a woman loses too much blood during birth and the pituitary kinda wilts after. A person may become hypo pit or panhypopit.

Many of those with Cushing's get pre-eclampsia with pregnancy.

Hopefully it is just your thyroid.
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Avatar universal
Well, I had a cesarean, so I assume yes, and was told to take iron supplements for anemia, although I was told to take them for months before the delivery too. I also remember bleeding for 8 solid weeks. I guess that's normal.

This was back in August of 2012. I had preeclampsia, which had only just been linked in the medical field with hypothyroidism soon after. I still had high blood pressure when they released me. In fact, it was so bad, that I was seeing fireworks inside the elevator. I just wanted to go home so bad, that I just didn't tell anyone until later.

That following night, first night back from the hospital, I woke up at 4 in the morning with excruciating pain in my head. It grew in intensity and then quickly diminished. I had never in my life had a migraine, and as far as headaches go, never felt anything like this, as it wasn't on the outside like a normal headache. It was located in a very specific region, much more inside, and center, if just focusing on the right hemisphere. Anyway, the pain was bad enough that I actually thought about calling 911, except, as quickly as it grew in intensity did it diminished. Basically the worst of it was what woke me up, and I was experiencing it calming down.  I remember that it was good enough that I went to the bathroom, and then went back to sleep.

My 2 week check up looked good. Normal blood pressure/healing. Lost 30 pounds. I didn't have time to talk about that incident. Looking back, I think I just was passing a blood clot, and was just lucky that it did pass.

Anyway, any symptom that I could blame on adrenals occurred years before pregnancy and diagnosis of hashimoto's. I mean, it's possible that it might be pituitary, but I'm thinking that this is just the result of years of being autoimmuned hypo and untreated. Agree?
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Avatar universal
Did you have any bleeding with your birth? I ask as sometimes that causes a pituitary issue.
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Avatar universal
I'm taking synthroid. Antibodies were tested. I have hashimoto's, so my hypothyroidism is due to it being auto immune.

My TSH was in the normal range for more than a decade despite having symptoms. Pregnancy finally aggregated it enough to finally show.
Helpful - 0
Avatar universal
Cushing's is pretty complex. There are a couple of meds out there for treatment now - some short terms, some work best on men due to side effects.

I had to have pituitary surgery (you have to address the source) then my adrenals were removed.

BTW that TSH may indicate actually that you have central hypothyroidism... my TSH is fairly similar post op pituitary. Again pointing to the pituitary.

Dosage of what? Are you on replacements?
Helpful - 0
Avatar universal
Thank you so much for the reply. Didnt think anyone was going to answer. Yes, the blood was taken at 3pm. Did your level go down once you found a dose that worked for you? How long did it take? I started having hypo symptoms around 1998. But I didn't get photophobia until about 2007. That's an adrenal symptom, correct?

I don't have another appointment until July. Not sure what he plans on testing then. He didnt say anything at all about the high cortisol, just said that my thyroid levels were a little high, and cut back my dosage. These were my thyroid level results:

TSH 0.018 uIU/mL 0.400-4.000
Free T4 1.36 ng/dL 0.80-1.80
Free T3 3.3 pg/mL 2.0-4.4

Based on TSH alone, it looks like I'm hyper, not hypo, but FT4 and FT3 are both in the middle of the range. (They were much lower before I self medicated). Internet researching, high cortisol shows up as a sign of hypERthyroidism, and isn't mentioned at all as it being one for hypO, despite your body being in a chronic state of stress.
Helpful - 0
Avatar universal
What time was the cortisol taken?

If 3pm, sadly the doc did you no favors... it is high, but most docs are going to ignore as it is not a time that is diagnostic. You have to test at 8am, or midnight, when cortisol levels are well known to be highest and lowest respectively. However, once you have more levels under your belt, this may help establish a pattern.

Often those with elevated cortisol are hypothyroid. I was.
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