I've discovered a bilateral carotid body paraganglioma recently. In order to investigate the possibility of a feocromocitom, due to family historic, doctors asked for some tests. I'm having a hard time to understand the meaning of my results. Here are the facts:
1. I have no symptoms;
2. I've had ultrasound, tomography and magnetic resonance of my neck and abdomen and the results were:
2.1 The confirmation of both paragangliomas;
2.2 Nothing to be seen on my abdomen, and more specifically nothing on my adrenal glands.
3. I've taken blood and 24h urine tests:
- ACTH: less than 5pg/ml (I've taken the test twice)
- Aldosterone: 17,1 ng/ml (Taken twice as well)
- Catecholamines (plasmatics and urinaries): All within range, near median (Taken twice as well);
- Metanephrines urinaries - All within range, near median (Taken twice as well);
- VMA: 4.7 mg/24h and 4.0mg/24h;
- Cortisol: 10.2 mg/dL (collected about 11am, 3~4h after I woke up)
- Urea: 20mg/dL 40mg/dL and 51 mg/dL; (1 month apart from each exam)
- Red and white cells: All fine;
- Sodium, calcium, potassium, phosphorus: All fine;
- Creatinine: 0.91mg/dL and 0.85mg/dL.
So, I have two main questions:
1. How can my ACTH be so low and other factors be normal and I have no symptoms, such as fatigue?
2. Should I have other exams? Which ones?