Adrenal Insufficiency?

[texas_grandma]

Hi all! I'd appreciate any advise/info you have! I'm thinking I have adrenal insufficiency (and so does my primary) and have an appt with an endo in a couple of months
My previous labs reference range is 6.2 - 19.4...all are am cortisol
July 2014 - 18
Sept 2014 - 14.7
Nov 2014 - 9
Mar 2015 - 7
I feel like poop in general, but in particular, I feel like I'm moving through mud. I have to force myself to do anything, which makes going to work a real struggle, and the back aches are a real drag too.
When I'm reading up on this stuff though, I keep finding that potassium is high and salt is low...but in my last labs, both of mine were kissing the top of the reference range, so now I'm even more confused.

This is all new to me, so any input would be greatly appreciated!

P.S. If it makes any difference, I also have Hashimoto's. I'm on combo T4 and T3. While my T4 is low (We're ok with that since it's the inactive form anyways), my T3 is at the bottom of the reference range, but my TSH is below it...def suppressed

[texas_grandma]

Just a thought...maybe I have more of a pituitary issue than adrenal...?

[texas_grandma]

Well, I don't know if the ACTH results are accurate, but here they are...and it looks like my cortisol went up...

Am Cortisol - 8.7 (4-22)
ACTH - 6 (6-50)
Aldosterone - 4 (< or = 28)

sooooo guess I still wait for the endo and hopefully he will do some tests and not just tell me that there's nothing wrong with me and send me on my way.

[rumpled]

Yes... Sadly they are not common and not usually not right as a result.  I rarely get an accurate ACTH. Mine is in the thousands and it can drops by hundreds so I don't see how people in normal or slightly abnormal ranges can even hope to get a near accurate reading.

They just won't spin the ACTH right away.

[texas_grandma]

Well, I went for a blood draw (ordered by my PCP). She ordered thyroid labs and Tg and TPO antibodies...not sure why she did this, never had the Tg drawn, but my TPO are always high.

She also ordered an ACTH and Aldosterone, but I could tell that the tech didn't draw those often...if ever...so I hope she got the collection right.
All told, she drew 4 serum separator tubes and one EDTA tube.

I know that the TPO test takes almost a week, so I won't know anything until they're all complete, but at least, since it's Quest (and not the lab my dr uses), I'll get the results on my app as soon as they're ready.

[rumpled]

Waiting is never fun.

[texas_grandma]

No worries!  
I guess I'll find out more in August (surely he'll order tests and have them back by then). I'm just not good with waiting :p

[rumpled]

Aw maybe I was confusing you with another post... Sorry!

Usually with secondary your ACTH is zero and there would be no skin darkening.

[texas_grandma]

I do have another question...and I realize that there's no way for you to know for sure...but even though I'm thinking secondary AI, I do wonder what else would cause my skin issues. Mainly the conjoined big freckle looking things on my temple and the dirty looking darkness (with some white blotches) under my jaw and down my neck.

I'm normally very fair skinned, in fact my legs and the tops of my feet practically glow in the dark...lol...but my neck, of all places, seems to be sort of tanned...ish. It's not even, it's more blotchy

Just curious, I know (hope) I'll be getting some answers this summer, but yeah...

[texas_grandma]

This is the only thread I've made, so that's weird...

My PCP has asked if I want some more labs to see where I stand now...since I still have over a month before I see the endo. I should be getting paperwork for that this week, but I'm sure she'll only check thyroid, cortisol and maybe another CBC.

[rumpled]

Lol... You have to be careful with words around here.

It may be the renin/aldosterone is keeping the levels high and that is why you don't crave.

I see you are posting under two threads. It gets too confusing for me so I will only reply here.

[texas_grandma]

huh...ok, so I guess that's a bad word?? Maybe 'stinks' is better

[texas_grandma]

I don't know what that is. This is all new to me.

I don't want to borrow trouble, so I'm trying to take things one step at a time...but I'm really not that patient...lol...waiting to see the endo is a real test of my patience!

Looking back at my previous labs concerning the sodium and potassium, I really don't see any kind of trend. The last time that they were both closer to the low end of the reference range was back in 2013, when I was first diagnosed as hypothyroid.

With my sodium level as 'high' as it is, I don't crave salt...in fact, I don't crave anything! I even lost my slight sweet tooth about 3 months ago...I haven't even touched my fav dark chocolate. I've lost about 8 lbs in the last month or so...which is a lot when you're hypo...and thin to start with! I do try to eat a protein bar (my last BUN was really low) but I can't always get even that down....this just all really kinda ***** :/

[rumpled]

It is odd that both sodium and potassium were on the high side...


You may have a renin/aldosterone issue.  

[texas_grandma]

As I mentioned above, my appt with an endo is in a couple of months. Also, in my last CBC, both sodium and potassium were kissing the top of the reference range.

No, I haven't had a STIM test yet, that will probably happen when I see the endo at the end of July.

[rumpled]

Have you seen an endo! Had a stim test? What about sodium or potassium tests?