My daughter is once again in the hospital with vomiting, nausea, headache, and extreme stomach pain. The endo did another cortisol blood stim test. He did it in the late afternoon. Her baseline was 3. At 30 minutes it was 6, and at 60 minutes it was 28. Can someone help me interpret this. The endo said her adrenals are responding appropriately. She has so many adrenal symptoms and we are so confused.
He did the test at the wrong time - the test should be done in the morning.
However, she did stim - so that is why the doc said that. But a person can respond when they are still on the verge of failure - so she may still be teetering between where the adrenals can put out a bit, but are not healthy.
Has the doc run other testing like sodium, potassium and other cortisol testing - and adrenal testing like aldosterone, renin, antibodies, etc? Any imaging?
She had a Pituitary MRI and it was normal. Her Potassium is on the low side so they've been giving her that every day. He said he will repeat the stim test to look at her 17 Hydroxyprogesterone when she's out of the hosp. and at her baseline. So far, he hasn't mentioned anything about aldosterone, renin, or antibodies. What other tests, if any, would you suggest?
17 Hydroprogesterone is a precursor hormone to cortisol.
Usually sodium and potassium work hand in hand but if she is in the hospital on IV (usually saline) the IV may be keeping here sodium levels in normal ranges maybe low normal? and if she is like some of us, we drop in both Na and K. I know I do.
Antibodies check on the source of the problem - and if they don't think the problem is cortisol, it can sometimes be an issue with the renin/aldosterone hormones - it can cause problems with potassium and blood pressure - so it is worth checking. I don't know (or remember - sorry this storm is wonking me out) all the details on your daughter - but full checks on the adrenal and pituitary would be prudent. Was the MRI read by a surgeon? Was it dynamic?
The MRI was Dynamic. Not sure if it was read by a surgeon. I know her potassium is always low in the Hosp bc they're always supplementing her with it. Not sure about her sodium. She just got home from the Hosp last night and now making another appt with the endo.
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