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Addison's Disease Message Board


Addison's Disease Board Index


Weird ranges...
Jun 16, 2004
Finally I received copies of the lab sheets from my endo visit. When I looked at the ranges for the ACTH stim test, I realized they looked a bit odd. For cortisol baseline, the range went from 2.3 to 19.4, and for the 1-hour cortisol, it just said something like "over 20.0". That would mean that a person starting at 2.5 and tripling or quadrupling their value to 7.5 or 10.0 would fail the test, and another person starting at 18.9 and going to 20.1 would pass it?? What do you make of that?

Also, when I asked my referring doctor about my values (15.8 going up to 23.8) and mentioned that I had read in a book that the baseline should have doubled, I was told that it depended on the type and dosage of the stimulation drug used, so basically what I had read wasn't relevant in my case. Can those tests really differ so much between clinics??

Thank you very much in advance for any ideas you might have! :)
Re: Weird ranges...
Jun 16, 2004
[QUOTE=crowgirl]Finally I received copies of the lab sheets from my endo visit. When I looked at the ranges for the ACTH stim test, I realized they looked a bit odd. For cortisol baseline, the range went from 2.3 to 19.4, and for the 1-hour cortisol, it just said something like "over 20.0". That would mean that a person starting at 2.5 and tripling or quadrupling their value to 7.5 or 10.0 would fail the test, and another person starting at 18.9 and going to 20.1 would pass it?? What do you make of that?

Also, when I asked my referring doctor about my values (15.8 going up to 23.8) and mentioned that I had read in a book that the baseline should have doubled, I was told that it depended on the type and dosage of the stimulation drug used, so basically what I had read wasn't relevant in my case. Can those tests really differ so much between clinics??
[/QUOTE]

Basically all labs use Synacthen as the stimulating agent instead of real ACTH. Real ACTH is not stable enough to be used for this. This is why the test is often (correctly) referred to as a Synacthen stimulation test. But even though virtually all labs use Synacthen they use different dosages which results in different cortisol reactions. Dosages commonly used are 100, 250, 500 and 1000 microgramm. Without knowing what the dosage was you were given it is impossible to say anything about your results. It also has been found that lower dose synacthen stimulation tests are actually more accurate than higher dose stimulation tests since they provide less stimulation to the adrenal gland so that less severe cases of adrenal insufficiency can be picked up as well.

It seems kind of odd that you were just given a "over 20.0" value by the lab. But again, more information would be needed to find out the reason for that. You, for example, did not specify a unit for the cortisol measured, but there are different ways of measuring it!
Re: Weird ranges...
Jun 17, 2004
That's interesting! Yes, I think I remember the nurse mentioning that name for the drug. I have no idea about the dosage I was given, though, and the lab sheet doesn't say either.

Sorry about the units; that should have been micrograms per deciliter. The ranges I mentioned were just the reference ranges given on the lab sheet, including the "over 20.0 mcg/dl" for the 1-hour value. My actual values were 15.8 mcg/dl for the baseline and 23.8 mcg/dl for the 1-hour cortisol.





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