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Possible Addison's

Hello. I’m 28 and have had symptoms of hyperthyroid all of my life including anxiety/nervousness, excessive sweating, rapid increase in heart rate when nervous or doing physical activity, hand tremor, heat intolerance, fatigue, and have always been skinny despite eating a lot. My mom had her thyroid removed when she was young due to similar problems and goiter/tumor so I finally decided to get some blood work done. I’ve gotten to a point where my short term memory is horrible and I am tired with brain fog a lot the time. People have suggested Addison’s Disease, pituitary issues, and resistance to thyroid hormone as potential problems since my FT4 was normal high and my TSH was a bit high relative to the FT4. Here are those thyroid results:

05/11/16
Reverse T3 22.4 (9.2-24.1 ng/dL)
TSH 2.47 (0.45-4.5 uIU/mL)
Free T3 3.5 (2.0-4.4 pg/mL)
Free T4 1.57 (0.82-1.77 ng/dL)
Antithyroglubulin AB (TgAb) < 1 (0.0-0.9 IU/mL)
Thyroid Peroxidase Antibody (TPO) 18 (0-34 IU/mL)
Thyroid Stimulating Immunoglobulin (TSI) 18 (0-139 %)
Thyroxine Binding Globulin (TBG) 13 (13-39 ug/mL)

I took a morning ACTH Plasma test on 06/10/16 and got 34.4 pg/mL in a range of 7.2 - 63.3 which seems to be pretty close to the middle of the range. I took a saliva cortisol/DHEAS test on 06/11/16 and got these results:

DHEAS (Saliva) 8.0 ng/mL 2-23
Cortisol (Saliva) 1.1 L ng/mL 3.7-9.5 (morning)
Cortisol (Saliva) 1.3 ng/mL 1.2-3.0 (noon)
Cortisol (Saliva) 1.3 ng/mL 0.6-1.9 (evening)
Cortisol (Saliva) 1.3 H ng/mL 0.4-1.0 (night)

So from that I’m seeing that I never got the big morning cortisol spike. Since I had a normal morning ACTH the day before the saliva cortisol test does it suggest primary Addison’s? I plan on seeing an endocrinologist soon, but I’ve been holding out because I am not working right now and don’t have insurance so I’m trying to do as much testing as I can in hopes of narrowing down the problem and avoiding additional visits if possible. I’d like to do the ACTH stim test, but haven’t found a place to purchase it online. Any insights or advice is appreciated.
2 Responses
Avatar universal
COMMUNITY LEADER
I had answered this and it disappeared. Let's see if it comes back with another reply.
Avatar universal
COMMUNITY LEADER
Nope. Dang. Hate that... Okay sorry I did see you answer before and reply but reply is lost.
Basically one test is not good enough to know if you have an issue, but yours appear to be more Cushing's than Addison's. The symptoms do overlap.  AI is a salt wasting disease and you would have wonky sodium and potassium readings.

Most doctors won't take "order your own" tests so...
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