JImlow, more on Adrenal insufficientcy

[ShannieK]

HI again.  Well I posted a question to you not too long ago about the whole Adrenal thing and was concerned about Cushings disease, In which after checking, I have all the symptoms.  However, I did not realize that my doctor did not include the findings of my 24 hour urine for cortisol levels, evidentally that came back low at 9.4.  Since she received these results after my last ones, I just received notice by mail today, that she wants to see me sooner because she said I have a high ACTH and a low cortisol level, she said that suggests adrenal insufficientcy.  I'm confused that's the other direction now.  I now am suppose to fast tonight, and she is retesting my cortisol, ACTH and now adrenal antibodies, and then wants me back in 2 weeks.  Now what does all this mean?  Do you know?  What kind of path am I looking at now?  Low Cortisol levels look like low blood pressure and low blood glucose, weight loss, ets,   I have high blood pressure, high blood glucose and am overweight, and have a hard time losing.  I have antibodies that can be attacking my adrenal gland now, am I understanding this right?  Any comment would be great.  Researched so much on Cushings, but the fact that I may have a problem with the other now,  Any comment?  Thanks Shannon

[Jimlow]

ShannieK, That is amazing! To tell you the truth, adrenal insufficiency might be a better diagnosis than Cushings because they don't have to do surgery usually to remove a tumor, they just give you hormone replacement medication. I's hard to believe how so many of us go through these yo-yo type revelations about our hormones. First we think they are too high, then too low but it's no-ones fault, especially when they are doing all the right tests, like they are with you.  I know it is strange and I hope AR, reads this too, plus posts back to me on my other ones to him but sometimes adrenal insufficiency will result in high blood pressure and sometimes low (low more common). I know this from reading soooo many websites on the subject. I think it depends on the "cause". If it is caused by chronic stress, I believe it causes the high BP and weight gain but if it is glandular such as in Addison's, weight loss is the result and low BP but HERE AGAIN, this might not be true with each person! I can't help but to be intrigued by this because it seems like a mystery. I do know chronic stress can cause high cortisol levels, that eventually crash, once the adrenals can no longer keep up the demand, causing adrenal exhaustion. People with anxiety disorders and depression, typically have "high cortisol" levels, whereas, people with Chronic Fatigue Syndrome and Fibromyalgia, have "low cortisol" levels. Many Dr.s even believe both these disorders are a result of burnout of the "HPA Axis" (Hypothalamous, Pituitary, Adrenal). Other Dr.s believe they are variations of thyroid disorder because CFS and FM are more common in thyroid patients than any other group of people! I didn't mean to rattle on, but this low adrenal thing has some amazing connections to it. Some websites state that about 10% of hypothyroid patients have co-existing adrenal insufficiency. Another one said 25% (1 in 4) Hashi's patients will get another co-existing condition, adrenal insufficiency being in that list of possibles. I hope Dr.s start tying some of this together soon for all of us!
Shanon, I will be VERY interested to know what your "adrenal antibodies" reading is, when results come back. This is the very test I am thinking about getting myself!

[Jimlow]

I meant to put this on the above post but it makes since that your ACTH would be high with adrenal insufficiency because it is like the TSH going high to stimulate our thyroids. Sometimes with Cushings these hormones all go too high because of a tumor in the pituitary but with low-adrenal it may go high simply because the pituitary senses "not enough cortisol".

[ar1281a]

mmmm

This is interesting as I'm going thru somethign similar now, trying to find out what's wrong with me. The stress piece is rather interesting as my body went thru a very stressing situation due to the allergic reaction and it could've acted as a trigger for somethign else, or simply my body just needs time to re-adjust and heal.
My Dr is ruling out primary adrenal insiffciency (Addison's disease) by testing for antibodies. However, in my case, there aren't any more tests that can be done until I'm off the prednisone. In the meantime, I've been feeling so bad for over two weeks that I don't even remember how feeling good feels like. This situation with my low blood pressure and even lower when standing is discouraging. It's interesting that your blood pressure is high...mmmm, we'll see.
I guess I can only wait to find out about results and hope to feel better. One question, have u noticed that u need to drink a lot of water? I do, otherwise I start feeling dizzy again, with increased heart rate as my heart is trying to compensate drop in blood pressure.

[Jimlow]

Hey Guys,
AR, I thought I would respond to your question about water (hydration). Here's a whole other area I researched back when trying desperately to find answers; Orthostatic Intolerance, is considered a type of "Dysautonomia". This just means dis-regulation of the involuntary nervous system (autonomic N.S.). There are differnt types of these dysautomonias, such as one actually called P.O.T.S.(postural orthostatic tachycardia syndrome).
ISN'T IT AMAZING, how many different variations of reasons for symptoms!? This is one reason I became somewhat frustrated when researching but I'm beginning to believe most of these so-called disorders have the same root causes. I believe it is dis-regulation of the HPA Axis, due to something that gets into the axis and disrupts it. Either autoimmune responses, severe trauma and other serious diseases that put great stress on the adrenals/& body! Stress is not just mental, it is also physical and sometimes the combination of both. Even positive stress I believe can cause adrenal fatigue because our bodies can't tell the difference between good and bad stress. It could be that if our adrenals are weakened, by the stress of thyroid disease, it makes them more suceptable to autoimmune attack or the non-autoimmune type adrenal insufficiency too.
Even Dr.s haven't tied all these things together yet and I certainly don't have anywhere near the knowlege they do but there are so many things that seem to be connected.
AR, the Dysautonomia sites I've been to, recommended drinking lots of water, to help with blood volumn etc...

[ShannieK]

HI, I go in tomorrow, like I mentioned for an adrenal antibody test.  So if this comes back positive, than does that mean I have Addisons disease?  Very confusing.  I guess because I have all the symptoms of overproduction.  I wonder, if I am present for auto antibodies again on the adrenal gland.  Ya know with the Hashimoto's I bounce back and forth from hyper to hypo symptoms because of the attack on my thyroid.  I'm wondering if antibodies attacking my adrenal gland may cause the same effects in symptoms.  Jimlow, I appreciate you sharing your knowledge in this area, because I'm new to this.  Been sick for so long and have been attributing all of my ailments to the Hashi's, I wonder once this is taken care of how much better I might feel.  Dr's wondered why I still always felt so terrible, when my TSH levels were looking pretty good.  I did also see a statistic that said that 65% of patients with Adrenal Insufficiency, also Have Hashimoto's.  Dr's now are thinking that I may not have suffered a Thyroid Storm back last October, but now possibly an adrenal crisis,  During that time my TSH and other tests came back pretty normal, so this was perplexing to them. She bets now, that if the proper cortisol levels were tested at that time, we would have found the problem.   I was in the middle of some serious stress when I ended up in there, so It all makes better sense now.  Thanks again for commenting.  Dr.  wants to see me sooner now, on Aug 16th.  This is when she'll review my tests that I will get tomorrow.  Wish me luck.  I"m not sure how lucky I will be, but I agree, I would rather take a replacement med instead of surgery and such.  Thanks Shannon

[ar1281a]

Shanniek, I wish you the best of luck with your test. Mine came back negative thank God! but I still feel really bad with my low blood pressure & lower blood pressure when standing + increased hear rate, I'm starting to wonder if there's something more serious going on and it seems that's taking forever!
JimLow, thanks for the info, I can't imagine what's wrong with me, I just know that's been almost three weeks now and I don't feel a bit better.