my acth test results

[locoboy]

acth 18.7 pg/ml

baseline: 15.7 mcg/dl cortisol
30 min 16.7 mcg/dl cortisol
60 min 15.4 mcg/dl

my endo said my results were abnormal and i had to do the test one more time??

[rumpled]

I would say to take your tests to someone else and get another opinion.

Not stimulating or stimulating is the purpose of the test and it seems that you did not, hence the adrenals failed both times.

[locoboy]

so my second results as u can see are different,  and from what i read it says In healthy individuals, the cortisol level should double from a baseline of 20-30 ug/dl within 60 minutes. For example, if the serum cortisol level was 25 ug/dl before the stimulation, it should reach at least 50 ug/dl.     it should double, so what do i do, it says im not healthy if this statement is right but my endo says my adrenals are fine since my baseline is over 20

[locoboy]

My second test.  

Cortisol baseline. 22.6

30 min.  25.6

60. Min.  26.0

He say their normal now.          Now I'm frustrated

[rumpled]

My ACTH is sky high, and I don't have Addison's... :)

Ask your doc if he considers you to be Addisonian or not if it means so much - and see if they ran other pituitary tests. Usually if one is off, others are as well.

[pacaplace]

From all I've read, your basline ACTH of 18.7 isn't all that low and according to the "range" you gave, you weren't at the bottom or under "normal" for that lab. If your cortisol doesn't rise enough during your ACTH Stim test, that "usually" points to adrenal issues. From what I've read, you should have a raise in your cortisol level of "11" during the ACTH stim test and your test looks like your cortisol didn't raise that "11", so I have to agree with Rumple's opinions.

My baseline ACTH is usually less than "5" (range at my lab is 10 -60) and my baseline cortisol levels are consistantly low, usually less that "5", yet one of my 3 ACTH stim tests did raise my cortisol "11" units so the endo said that shows that my adrenals work IF my body was sending the ACTH hormones to my adrenals, which it's not. There's a thing called "isolated-ACTH deficiency".  It's "rare" so it's hard to diagnose.  It is caused by either your pituitary or hypothalamus.  There is another test called the "CRH stimulation" test that can determine if your pituitary or hypothalamus is the culprit for having low ACTH IF it is determined that you actually have low ACTH.

There are a lot of explainations in the Professional Merck Manual.  Here's the link:
http://www.merck.com/mmpe/sec12/ch153/ch153a.html
Hope it helps.

[locoboy]

why would my acth be in the lower end, when acth is low your cortisol should be high, an when acth is high then your cotisl levels would be low