SO confused over these labs!

[kjarvis420]

Years ago I was told I had hashimotos, but it wasn't bad enough to treat. I didn't know any better so I didn't go any further with it until recently when my symptoms have worsened. I found a new doc who is supposed to be great with this stuff. So he tested me for all kinds of junk a few weeks ago. My tsh was great at .72. My thyroid peroxidase antibodies were under 10 (doesn't say the specific number). If I'm not mistaken, that all looks great. Right? But my cortisol level was at a 5, but this was in the afternoon, around 3pm. I hadn't eaten yet that day tho b/c I wanted to make sure I would be able to have a test if needed after my doc appointment. Anyway, doc had me do an acth stim test a few days later. I haven't received the copy back yet, but the nurse at the doc office said my cortisol STARTED at 32.5. After the first injection it went DOWN to 27.68, then after the third injection it went DOWN again to 11.11. What is going on? The starting number seems so high. Normal values are from 4 - 22 from this lab. And then isn't the cortisol suppoesd to go UP after acth injections? Also, I had high cpk values in the first round of tests, so he is having that retested next week. I called to talk to doc, but the nurses are being weird, acting like I'm bothering them. They said doc will call me next week after my cpk tests. I said, NO. I want to talk to doc. They said ok and hung up on me. Am I losing it or is all this weird?

[Mark Lupo, M.D.]

any cortisol level at/above 17 ANY time during the testing means you don't have an adrenal problem.

[kjarvis420]

OK. I talked to the doc and he said his lovely nurse read me the results backwards! nice, huh? anyway, my cortisol still was pretty low to start with. he said i'm fine and don't have addison's tho. i said, well what about secondary adrenal insufficiency? he said oh no. that's not a possibility.nothing else would suggest that. but he didn't test anything else besides my tsh (which was good at .72). he wants to test my cpk again. so we'll go that route first and i will come armed with info when i meet with him again on the 9th. this doc is pretty knowledgeable so i was surprised when he just blew me off about secondary adrenal insufficiency. What's your opinion???