Question about Addison's

Just a quick question for someone out there. My Dr. is testing me for Cushing's because of the list of symptoms I have almost all of them! I have done a 24 hour urine cortisol (still waiting for the results of that) and an overnight low dose dexamethasone. Those results came back showing my cortisol was low. I know with Cushing's it should have been high right? All I could find on the web was for a low cortisol is Addison's. With that I read that you lose weight but I have gained around 60 pounds in the last year. When my Dr gets my urine results back he is going to call me but I am just curious about all of this. My rheumatologist has dx me with MCTD and "some kind of autoimmune arthritis" but my pcp is just convinced something else is going on and so he is the one pursuing all these other things.

[PlateletGal]

You're right... a low cortisol result could be due to Addison's disease, but also Chronic Fatigue Immune Dysfunction Syndrome. In addition, stress can also cause a low cortisol (adrenal fatigue)

Can you list all of your symptoms ?

[nanascraps]

I just got an e-mail from my pcp and my 24 hour urine cortisol came back at 53 witht he values being 0-50. He is forwarding it on to my Endo (she takes care of my diabetes) to see if she thinks there is something to be concerned about. Here are my symptoms:

Weight gain, especially in the
upper body
• Rounded face and extra fat on
the upper back and above the
collarbones
• High blood sugar (diabetes)
• High blood pressure
(hypertension)
• Muscle loss and weakness
• Thin, fragile skin that bruises
easily
• Purple-red stretch marks
• Depression and difficulties
thinking clearly
• Too much facial hair in women
• Irregular or absent menstrual
periods and infertility
• Reduced sex drive
excess sweating

I know a lot of these symptoms are ver general ones that could totally be something else it just seems I have them all.

[PlateletGal]

Your symptoms sound a lot like Cushing's Syndrome, but if I remember right... people with Cushing's usually have a high cortisol level.  Anyway, here's a link and list of symptoms that go along with Cushing's.


Symptoms  

Abdomen that sticks out and thin arms and legs (central obesity)
Acne or skin infections
Backache
Collection of fat between the shoulders (buffalo hump)
Hair growth on the face
Headache
Impotence (men)
Menstrual cycle stops (women)
Mental changes
Purple marks on the skin of the abdomen, thighs, and breasts
Round, red, and full face (moon face)
Thin skin with easy bruising
Weakness
Weight gain (unintentional)
Other symptoms that may occur with this disease:

Bone pain or tenderness
Fatigue
High blood pressure
Muscle atrophy
Red spots on the skin
Skin blushing or flushing

http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/000410.htm

[PlateletGal]

Here is some information also on PCOS.

symptoms of polycystic ovary syndrome (PCOS)?

Not all women with PCOS share the same symptoms. These are some of the symptoms of PCOS:

infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
infertility (not able to get pregnant) because of not ovulating
increased hair growth on the face, chest, stomach, back, thumbs, or toes—a condition called hirsutism (HER-suh-tiz-um)
ovarian cysts
acne, oily skin, or dandruff
weight gain or obesity, usually carrying extra weight around the waist
insulin resistance or type 2 diabetes
high cholesterol
high blood pressure
male-pattern baldness or thinning hair
patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
skin tags, or tiny excess flaps of skin in the armpits or neck area
pelvic pain
anxiety or depression due to appearance and/or infertility
sleep apnea—excessive snoring and times when breathing stops while asleep

http://www.4woman.gov/faq/pcos.htm#e

[rumpled]

You can have a low or normal cortisol test and have Cushing's.

The reasons can be as follows. You can have a high Cortisol Binding globulin. Lab error. You are cyclical. You are taking a medication that is binding the free cortisol (such as estrogen) so that a free cortosol test will be inaccurate. Or it can be a combination of any of the above.

I had Cyclical Pituitary Cushing's and my tests were all over the place. It took a lot of testing. The dex test is not a test of exclusion. I will fail all dex tests but my pathology will tell you I really have the disease. It does that for a lot of people. You need to see an expert who knows what he/she is doing and knows how to test and to do a lot of it. One test just will not do it.

Plus I had Cushing's, PCOS and a myriad of other things - just because you have one disease unfortunately does not mean you do not have another and the Cushing's does trump all others. You do not get better until that one gets resolved.

[nanascraps]

I always wondered if I had PCOS also. You would think my endo would question all these symptoms but she really concentrates just on my diabetes. I am having so many complications with that. I have been a type 1 diabetic for almost 14 years now and last week had to have laser surgery on my eye due to advanced diabetic retinopathy. They are doing my other eye in a month.

[rumpled]

Perhaps you should ask for more testing? PCOS is LH/FSH and testosterone with abnormal ratios as well as cysts on the ovaries.But they need to rule out other diseases first - and those would cause diabetes...
http://www.aafp.org/afp/20030401/practice.html
A concentration just on one thing, while not looking for the source may not be the best for you.
Get copies of all your testing as well.

[nanascraps]

Thanks for that link! I go back to the Dr next month so I am priniting out that page and I am going to ask her about it. Thanks again!

[SarahB79]

Weight gain, especially in the
upper body
• Rounded face and extra fat on
the upper back and above the
collarbones
• High blood sugar (diabetes)
• High blood pressure
(hypertension)
• Muscle loss and weakness
• Thin, fragile skin that bruises
easily
• Purple-red stretch marks
• Depression and difficulties
thinking clearly
• Too much facial hair in women
• Irregular or absent menstrual
periods and infertility
• Reduced sex drive
excess sweating

I have every one of those symptons along with my prolactin producing pituitary tumor, hashimotos, diabetes, high blood pressure & depression diagnosises.   Looks like some more testing is in order.

[rumpled]

Do try to find a specialist who has treated Cushing's in the past, as well, make sure you have copies of all your tests (labs, MRIs, other tests) and even pictures that can show progression.
It may take a couple of doctors unless you are lucky to find a good fit and a doctor that will test test test and get to the source of the issue(s).

[xxseetherxx26]

Hi; I've been progressively getting weaker and weaker for over a year now. I feel really nauceous all the time and very dizzy and faint. I passed out a little over a month ago and had to go to the E.R. but they just said it was an episode of syncope. I've also been feeling extremely exhausted, to the point where I'm barely able to stay awake now; because it has gotten worse. I also tremor all day long, and my feet twitch. I feel really irritable a lot; and it has been confirmed that I have orthostatic hypotension (my heartbeat is 80 bpm at rest; then from sitting to standing it jumps to 130 bpa everytime I stand up) but the doctors don't know what's causing it. I went to an endocrinologist two weeks ago and had a cortisol test: the dr. sent a letter to my house and said my results seemed normal, yet he put me on Florinef and said to come back after a month of taking that. I have since been feeling even worse and I've been having tenderness and stabbing pains on both the upper left and right sides of my abdomen that radiates to my back. My knuckles on my hands have also started to hyperpigment. I have also been losing weight no matter how much I increase my food intake.
Something has to be wrong but I don't know what it is?

[healthyliving67]

My first cortisol test came back at 2.1
was then referred for a stim test, results below

The stim test- baseline first serum was at 4.7 ug/dl 11am
IM  injection of coysyntropin at 1130 AM

1200 pm- 2nd serum draw - 14.0 ug/dl

1230 pm -3rd serum draw- 20.01 ug/dl


I need to note that I am on 5 mg a day of prednisone for over a year.
I take 2.5 mg in am , and 2,5mg in evening
The doc did not have me fast prior , nor have me free of the prednisone for 24-48 hrs prior to doing the stim test.
they advised me to take my daily meds as normal.

Any thoughts or interpretation on these results?