Continual low cortisol but good on ACTH stim test

[kjoanderson]

I have been having a hard time getting diagnosed. My Endo is very traditional and tends to look at normal ranges only.

My current Thyroid tests are as follows:

TSH 0.564 ug/dL [.45 - 4.5]
T4 0.78 ng/dL [.82 - 1.77]
T3  3.0 pg/mL [2.0 - 4.4]

My Cortisol Urine is

Cortisol,Urine  5 - no reference
Cortisol, Urine 24 hrs - 15 [10 - 55]

ACTH Stim Test

Cortisol 1 AM (Base) -  5.9 [6.2 - 19.4] Low
Cortisol 2 30 Min - 30.3
Cortisol 3 60 Min 33.1
Cortisol 4 90 Min 37.5

ACTH Serum Test 13.5 [9.0 - 64.0]

I am exhausted, I have been off thyroid medicine for over 6 weeks now....I have extensive (at least 5)  thyroid nodes which are exhibiting normal 6 hr iodine uptake (I think the score was about 10% after 6 hours).

I am suspecting I have a pituitary issue with low TSH and ACTH and that both are making secondary thryoid and adrenal problems....but now the Dr wants to put me on a low dosage prednisone and see what happens and ignore the thyroid as my TSH is in "normal" ranges. I have been bedridden 80% of the day and sleeping a lot.

My prolactin was normal so he said no pit tumor or anything.


I am about to lose my job and my sanity if something is not figured out. I have fatigue, brittle nails, 13 lb weight gain in the 6 weeks off thryoid meds, constipation, sinus trouble, foggy head.

I feel like I need to find another Dr...this will make number 8 is 2 years.

Kelly

[kjoanderson]

Yes, I posted to three forums on Thyroid, Pit, and adrenal as it had to do with all three...to see if anyone had a similar experience.

[rumpled]

You posted the exact same thing, different title, in the brain/pit tumors community...