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ACTH Stim question
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ACTH Stim question

I had an ACTH stim test today (started at 11:00). My endo says I have no adrenal issues, but I thought it was supposed to double if your adrenals are healthy.

10:50am CORTISOL 21.0 mcg/dl [5.0-25.0]

11:50am CORTISOL *30.6 mcg/dl [5.0-25.0]
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4 Comments Post a Comment
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649848_tn?1357751184
I don't know that we have anyone here, that's really well versed in adrenal; you might want to ask your question in the adrenal forum.
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Avatar_n_tn
What are your symptoms?

What are your thyoid lab numbers and ranges?

What other tests have you done that give you reason to suspect you have adrenal issues?  

I am in the same boat as you.

Does your lower back hurt?
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1139187_tn?1355710247
I have had this test too.  Did you have the one where they take your blood, then inject you, and then check your blood an hour later?

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1756321_tn?1377771734
Is there a reason why the ACTH test was done at 11am? Ideally the ACTH test is done around 8am.

The following is my basic guide on how to interpret your ACTH stimulation results that i have put together from reading various websites.

*Healthy adrenal function:

Cortisol levels double from a normal base cortisol range within 60 minutes.  

*Primary adrenal insufficiency:

Cortisol levels do not double from the low base cortisol range within 60 minutes.  ACTH will be at the top of the range or above range.

*Secondary adrenal insufficiency:

Low base cortisol range can double, triple, quadruple within 60 minutes.  ACTH will usually be in the bottom half of the range to the very bottom, but not usually below the range.

*Mild primary adrenal insufficiency (low adrenal reserve):

A normal baseline cortisol range with a subnormal response to ACTH stimulation.

*Mild secondary adrenal insufficiency:

A low or low normal baseline cortisol range with a normal response to ACTH stimulation.

NOTE: If a person is unwell, the diagnosis of adrenal insufficiency cannot be excluded by a serum cortisol level.

***

"Medical thinking has polarized on the subject of adrenal function, so that, in the minds of most doctors, a person is either in a normal condition or has Addison’s Disease (complete adrenal failure) with no possibility for middle ground. This polarization came about in the early days of treatment with adrenal steroids, the 1950s, when cortisone and hydrocortisone became available. Doctors did not know the proper dosages, guessed too high, got serious side effects and became phobic about the use of adrenal steroids. To allay their fears of disaster, they created a kind of myth that patients were only allowed to have complete failure of the adrenals or nothing at all.  If this were the case, and a person shows up with complete failure of the adrenals (Addison’s Disease), naturally the only thing to do would be to treat with adrenal steroids.

If failure is not complete, the patient is defined as “normal” and not treatable. In this manner, the fear of being sued for inducing the side effects associated with abnormally large doses of, for example, cortisone is taken away by the fact that no one receives this therapy except the patient who has complete adrenal failure. In that strange world, it is is better to have complete adrenal failure than to have partial adrenal failure — because in that case a person at least receives treatment." - Excerpt from Adrenal Fatigue by Ron Kennedy, M.D.
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