Fasting, 8am. It is a regular blood test but unless the lab knows how to do it correctly (chilled EDTA tube, spun immediately, frozen promptly after spin) the test can appear lower than it actually is if the tech does not know how to do it or the tube it put in the bin to wait for processing or *coagulation*...
A proper pituitary MRI is with a without contrast - and dynamic... you doc is not doing you any favors... Pays to go to an experienced place too. There is some skill involved to get the contrast in while the images are taken. Then the radiologist and surgeon can see the uptake - smaller tumors are seen that way.
Good about the bones!
Finally! I got my doctor to give me an ACTH test but he didn't say much about it. When is the best time to take it? What is the process? Do I need to fast? Will it be uncomfortable. I also got a head MRI to check for pituitary tumors but it wasn't ordered with any kind of injection or dye. Should I ask for that? thanks.
To rumpled: Yes I think I have already done a bone density test and it came back fine.
The bone scan is easy, you lay on an open table while a little scanner angles over you making a zzzzz zzzzz sound... bone scans are called DEXA usually.
Usually they cannot due to the magnet according to a post in the brain community...
I did get a bone density scan a year ago for my whole body but it wasn't called a DEXA as far as I know.
Even with the newer MRIs they are still scary lol. I wonder if they can administer general anesthetics.
Sorry to be the bearer of bad news - but better than getting more sick... the cortef would have ironically added to your fatigue.
The newer 3T machines have a larger opening. Ask your doc for a sedative before the MRI and have someone drive you there. Just get a good, dynamic MRI.
Have you had a DEXA scan ever?
Thanks Rumpled...sigh...its just so frustrating and you hope that this little cortef pill will help. I might have to go and get a second opinion. Man, I don't like MRIs. The last time I went in one I had to get out half way through.
How has the doc looked for tumors? It can be very difficult to look for tumors. I had one of my hide for 12 years, while the other changed sizes. MRIs slice in 3mm so pit tumors can fall between the slices, the radiologist can miss it etc. My adrenal imaging was read as normal and they were 3 to 4 times the size of normal (and scans afterward said they were normal too!) and this happened to other people too.
It takes lab testing to find the source and really good imaging and surgeons need to look at the scans. They can typically find more than the radiologists as these lesions are tiny... and they know what to look for.
Cortef does not block cortisol at all - it is a cortisol replacement. It would add to the cortisol. I take cortef to replace my cortisol.
from what I have read..people do use Cortef to sort of block cortisol too, no?
Well thats the problem..I don't seem to have anything that is causing the rise of cortisol...no tumors and such..
Why oh why is he putting you on cortef when you have elevated cortisol readings??? Do you want to throw fuel on to fire?
Were they saliva tests - and you were on birth control pills? Saliva is free cortisol. The estrogen in the birth control binds free cortisol - making the tests appear lower than they are...
There are a lot of side effects to cortef. If you don't need it and you take it - it will actually raise your inflammatory markers, not lower them. Your tests already read as Cushing's and to take corticosteroids on top of that is rather strange since Cushing's is too much cortisol aka the equivalent of corticosteroids.
Fatigue is a huge part of Cushing's. Your adrenals are wired but tired - the resolution is to find the source of the cortisol and remove it.
forgot to add I will be tapering off antidepressants slowly and hope it won't affect how the Cortef works.