ACTH Stimulation Test Results. Help!

[Charbt]

As a background, I have Hashimoto's Thyroiditis, for which I just began treatment. A few weeks ago, prior to treatment, I had an ACTH Stimulation Test run, the results of which are as follows:

Cortisol Basal 19.6 ug/dL
Cortisol Reference Range: AM = 3.4-26.9, PM = 0.9-15.8
Cortisol 30 min 26.7
Cortisol 60 min 21.2

Please note, this test was started at around 9:30-10:00 a.m. However, what does these results mean, if anything?  I've heard that upon stimulation, your Cortisol level is supposed to double, which mine did not.  Is that true?

[mommabear0689]

I'll try to make this short. In late December, i started getting sick. Dizziness, elevated heart rate,nausea. Since then Ive been hospitalized 4 times, with more symptoms surfacing. Extreme fatigue, lower back/pelvic/hip, and knee aches, unexplained fevers, anorexia with weight loss. Heat intolerance. The sun hurt my eyeballs, excessive sweating, low blood pressure, muscle weakness. I was so fatigue, and could not sleep. Day or night. Night I would wake up every 2 hours. I craved salty foods, and sweets. Excessive urination, abdominal pain, diarrhea, headaches, and short term memory loss, concentration, and brain fog. I thought i was dying in those 9 months. My sister had to take care of my kids, because I did not have the strength. I could not even take care of myself. Basic care was a chore for me.(brushing teeth, shower, dressing) I was just to exhausted. I stayed out of the sun, I wore dark sunglasses if I had to go somewhere. I lost my job. Im sure Im missing something. But anyways, all my test, and labs came back normal. I thought I was going crazy. Well not excatly normal. My potassium would run low (which I blamed on the fluids they dumped on me) my magnesium stayed low. My Iron was low, as was my calcium, and Vit D. My TSH was .317, .946. my last TSH in the hospital was.317. My free T4 was.90, .80. My T3 was2.5, and 2.6.My Aldosterone was <1.0. My cortisol levels were 4.47, and 5.19. My PD sent me to a rheumatoidologist, he wanted to diagnosis me with Chronic Fatigue syndrome. I excepted that, as to me thinking I was crazy. But that's when I started the excessive sweating. I went to an Endo, he did the stimulation test; my basal cortisol was actually 13.91. But we were running late, I had a cold, and I was very nervous. After the 60 minute mark, my Cortisol was 24.68. He also did an Ultrasensitive TSH on me, and it was .85, T4 was .90. This is were is gets complicated, the test was done on a Friday morning, all my symptoms were gone, after that injection. I mean everyone of them. I went back to him on Monday, and I told him. I was actually crying, because i had just enough to remind me of what my life was before. He automatically put me on HC. I have done more in the past 2 weeks, than I did in 9 months. My problem  is, he said my stimulation test was normal, but since the steroids help, he knows its something. OK something really? He has ordered no more test, and to F/U in 2 months. What is going on, does anyone know? I was put on steroids twice a day, told to get an alert bracelet, and it's something!! Please help me, Im dying to know what is wrong with me. I do go to my PD tomorrow, and I found an Endo at the Cleveland Clinic that specializes in AD. Please tell me what you guys think... Thank you.

[mommabear0689]

I also have problems with my vision on certain days. Other days it is fine. Please help..

[rumpled]

I would think that low calcium - which could be a parathyroid issue could be significant (it should never ever be low) and the low D goes with that - both of those could account for many of your symptoms.

There could also be a separate problem with the aldosterone and the cortisol - and you can have a normal test and still be sick - the adrenals can be on the verge of failure. Craving salt is a tip off that you have probably low cortisol.

Did you get any imaging or any adrenal antibodies - any ACTH?

[mommabear0689]

Thank God you answered. I just went through all my labs. No they did not do an ACTH, and no imaging on my adrenals. They did do a thyroid uptake scan which was normal. MRI stated pit. was normal. The Endo said he thought I might me ACTH, because I felt so much better after the stimulation test. He left me on HC, because he believes its something. But did not order anymore test. So Im on HC twice a day, suppose to get a medical alert bracelet; and he believes its something really?

[mommabear0689]

I also had a complete hysterectomy at 31. Im on HRT. I also have gastroparesis. Not sure if that has anything to do with it.

[mommabear0689]

i just researched parathyroid, just dont sound like what i have. I went back over my labs, my calcium was only low a couple of times. They did not ever put me on a supplement for that. Im on Magnesium, Iron, and Vit D. supplements per MD. I don't know, Im just starting to get down. 9 months, 4 hospital stays, 10000 test later; I still dont know anything, except HC makes me feel better. I just want answers. Im not a A=C person. I have to know what B is. THank you for your time.