Thyroid, adrenals, or both

[wonderone]

Dr. Lupo:

Thanks in advance for your help.  I am going to a new endo this week.  My questions are below labs.  I was dx in Dec 2007 w/hashis (have antibodies).  On synthroid, tried t3/t4 combo and several different doses...I crave salt, have some dark splotchy skin, fatigue which gets worse as day progresses and with activity, and no adrenaline (esp when it would be expected).
Testing from May 2009:  (each of these levels are lower than when previously tested except for ACTH which was 11 last time too)

Cortisol,AM     14.7    (4-22)
ACTH              11       (5-27)
Aldosterone     11       (4-31)

1)  Can these same antibodies attack the adrenal glands?
2)  Can you tell me what testing is appropriate to test adrenals?
3) I am wondering if an ACTH Stimulation would be appropriate, thoughts?

[Mark Lupo, M.D.]

ACTH and cortisol are normal - no evidence of adrenal insufficiency or need for ACTH stim test based on this.
The thyroid levels are ok and you have already tried T4/T3 combos, so there is not likely more to do in this regard either.

[wonderone]

The only other thing was my total t3 which was 1pt above the low normal 98  (97-219)

[wonderone]

I forgot to mention that quite a bit I get dizzy when I stand up and I have no appetitie.  I have to be reminded to eat.