Thyroid Cancer / Nodules & Hyperthyroidism Forum
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

Gland issue? Tests?

Hello Doctor Mark Lupo,

Some history:

My TSH, Free T3, and Free T4 are all in-range.  The TSH went slightly high, out-of-range; retested in-range.  Some family history of thyroid cond. and my symptoms.

As for my adrenals, I've had the serum cortisol, ACTH, sodium, and potassium tests.

My symptoms seem hypoadrenal and possibly hypothyroid.

Mainly:  1) mental fatigue (with poor attention, memory, concentration, retention, etc.) with ADHD and other learning disabilities. 2) Physical fatigue (times of low blood pressure, feeling "lazy," poor motivation, easily winded-feeling, unrefreshed, need to sleep long hours, unalert until late morning/afternoon, naps, brief sleep interuptions, post nasal drip, etc.) 3) Easily stressed, affecting mental/emotional/physical, twice even leading to brief agitation and atypical psychosis.  I take things too seriously/defensive.  Sometimes anxiety.

I had a cortisol serum test of 10.6 ug/dl, morning.  **Emedicine said this is indeterminate or suggestive of adrenal insufficiency.  In my teens, my cortisol was said to be low.  A hair mineral analysis showed the most advanced stage of adrenal exhaustion.

My ACTH was on the high-normal end of the range.

Vyvanse for ADHD helps me some with energy.

What tests would best prove even mild underfunctioning adrenal glands?

I've been wondering about these tests, in addition to the others:

ACTH Stimulation Test
Catecholamines Test
insulin-induced hypoglycemia test
24 hour cortisol -- urine, or blood, or saliva

As for the BLOOD SERUM version of the 24 hour cortisol, is this test widely available?

How do the blood, saliva, and urine for 24 hour cortisol compare in effectiveness?  Do they test the exact same substances?

What symptom('s) could my doctor use to order such adrenal tests?  And what might I point out to my doctor to convince him to do some of those tests?

Thank you tremendously.

2 Responses
97953 tn?1440868992
Would see a general endocrinologist to guide you through this.
Usually an ACTH stim test would be the best way to exclude adrenal insufficiency.
Avatar universal
Doctor Lupo,

I've come across many kinds of this test.

Short, rapid; high-dose, low-dose; long, prolonged; four-hour, eight-hour, two-day.

Which do I need, especially if my case is mild?

Thank you.
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Here’s how your baby’s growing in your body each week.
These common ADD/ADHD myths could already be hurting your child
This article will tell you more about strength training at home, giving you some options that require little to no equipment.