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Addison's Disease Message Board


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Hi - thanks so much for your help. I was started on HC before having a ACTH stim test done. I was d/c of HC just 24 hours prior to a non-fasting ACTH test. I have found out that being off HC just 24 hours is not long enough. Even after HC has been cleared from your blood, it still remains in your tissues with a 1/2 life of 24 hours. So after 24 hours, 1/2 of the cortisol is still present. (could you tell me how this would effect my results - i still have traces of brain fog - sorry).

I have been treated for hypothyroid for about 8 years. i have had symptoms of addisons for just as long including hyperpigmention. my adrenal symptoms got problematic over four years ago. i had to stop working over three years ago because i was so exhausted, had severe brain fog that i felt like i was drugged, would sleep all day,....
Now that i have started HC, i am getting my life back. Yeah.

since my endo doesnt have a clue about what these results mean, in light of the fact that i still had HC in my system, and didnt fast (are you suppost to? i know you are for the GH which i didnt - no one told me to fast - how could this effect the results?)

Below are my results.

11/26/2002

Cortisol total - 5.3 (4.00 - 22.00) morning
DHEA S 47 (44-352)



3/2004 - Started 20 mg HC per day



7/22/04

ACTH - 30.9 (0.0 - 70.0)

Cortisol 23.6 (5.0 - 25) (was not told to fast - very stressed out that morning - in lots of pain - could barely drive to the test - so myserable)

30 min. 30.6 (5.0 - 25)
60 min. 32.1 (5.0 - 25)

GH 2.92 (0 -10)
IGF - 1 194.0 (101 - 303)
FSH 7.93
PROLACTIN 10.30 (1.90 - 25.00)


TSH 1.91 (0.40 - 4.00)
FREE T4 0.98 (0.60 - 1.80)
FREE T 3 2.46 (1.80 - 4.20)


i actually have no clue how fasting would have changed these results - could you tell me?

the endocrinologist looked at my ACTH stim test results and other hormone levels and said i was fine - and felt that because i was doing much better on the HC i should stay on it -


THANKS SO MUCH FOR ANY INSIGHT YOU CAN SHARE ON THESE RESULTS - THANK YOU SO MUCH - I AM SO HAPPY I FOUND THIS BOARD - THANKS

RAMIE :jester:
Hi Chris,

thanks for responding to my last post. I'm really glad you picked up on my thryoid stuff. Almost 3 years ago i saw Dr. Richard Shames (he wrote the book on thryoid power) and he switched me from synthroid to levoxyl - not sure why - but at that time, i was under replaced and as you pointed out, i still am not up to par yet!

Thanks for commenting on my base cortisol of 23 and that it was higher 24 hours previous to the stim test - i agree. I think my baseline cortisol is closer to 5.3 as was measured previous to the stim test.

i only went and got the stim test because i had started HC and was talking with people on another addisons board and they all told me that taking HC before having a stim test and proper diagnosis was dangerous - now i cant get a proper diagnosis because the endocrinologist i saw for the stim test i dont believe knows anything about addisons disease - for instance, he didnt measure my aldosterone or renin levels - and when i asked about an adrenal antibody test for autoimmune, he told me there was no such thing. I also found out from NADF that i didnt need to be taken off the HC in the first place as the ACTH test could have been done while on the HC as long as the endo gave me dexamethasone as cortisol relacement while i was being tested. Apparently dexamethasone allows ACTH stimulation testing without affecting or interfering with the measurement of serum cortisol levels.

Anyway, thanks for your feedback on all of this. It has been very helpful to me as it confirms my own perceptions.

Stay Well,
Ramie -

ps - do you have addisons?
Dear Chris -

Thanks for responding to my last post - I am a little confused. What is dexamethasone? The NADF said to take this during the ACTH test. So now I'm a little confused.

I do have some questions about pituitary stuff but will post this later.

Sorry to hear about your endo troubles. What meds are you on?

Stay well and thanks again for your help.
Ramie
Dear Chris,

Thanks so much for all your help. You have really helped me to clarify my concerns. I wanted to run a theory by you about the results of my ACTH stim test (results on included in my first post on page 1). I believe that my baseline cortisol was as high as it was because i had been on HC for several months and had only DC it 24 hours prior to this blood draw. Because it remains in your system at 1/2 24 hours after d/c, my baseline cortisol level was what it was - normal range. However, as you pointed out, it i had been off of it longer, over time my level would of approached the 5.3 cortisol level taken a year prior to staring HC.

I also wonder that because my thyroid levels are on the low end of normal, that i didnt metabolize the HC as quickly as someone whose thyroid was functioning more normally - does this make sense??

also, what thyroid meds do you suggest i be on? if i start amour do i continue on lex and cytomel? thanks.

looking forward to hearing back from you.

Ramie
Dear Chris,

Thanks so much for all your help. You have really helped me to clarify my concerns. I wanted to run a theory by you about the results of my ACTH stim test (results on included in my first post on page 1). I believe that my baseline cortisol was as high as it was because i had been on HC for several months and had only DC it 24 hours prior to this blood draw. Because it remains in your system at 1/2 24 hours after d/c, my baseline cortisol level was what it was - normal range. However, as you pointed out, it i had been off of it longer, over time my level would of approached the 5.3 cortisol level taken a year prior to staring HC.

I also wonder that because my thyroid levels are on the low end of normal, that i didnt metabolize the HC as quickly as someone whose thyroid was functioning more normally - does this make sense??

also, what thyroid meds do you suggest i be on? if i start amour do i continue on lex and cytomel? thanks.

looking forward to hearing back from you.

Ramie
DEAR CHRIS :angel:

I HAVE NO INTENTIONS OF TRYING TO "SWAY" THE ENDO - ITS JUST THAT THIS UNINFORMED ENDO HAS SENT A LETTER (WITHOUT MY INFORMED CONSENT I MIGHT ADD :nono: ) TO MY PRIMARY STATING THAT I HAD A NORMAL ACTH TEST AND SHOULD CEASE HC -

WHAT I WANT TO DO IS WRITE THE ENDO AND SHARE CONTRADICTING INFO TO HIS INTERPRETATION OF MY TEST RESULTS WITH A CC TO MY PRIMARY - MY PRIMARY WAS THE ONE WHO STARTED ME ON HC - NOW THE ENDOS LETTER AND MY "NORMAL" TEST RESULTS (DUE TO IMPROPER ADMINITRATION OF THE ACTH TEST - ACCORDING TO THE NADF I SHOULD HAVE BEEN OFF HC ANYWHERE FROM 3 TO 14 DAYS BEFORE TESTING AND ON CORTISOL REPLACEMENT SUCH AS DEX INSTEAD) ARE ALL PART OF MY MEDICAL RECORD AND I WOULD LIKE SOMETHING IN MY RECORD THAT EXPLAINS WHAT IT ALL MEANS SINCE NONE OF THE MDS KNOW -

DOES THIS MAKE SENSE NOW?

I WILL SEND YOU MY PIT RESULTS BECAUSE I THINK THE ENDO MISSED THE BOAT ON THIS TOO

IN THE MEANTIME, I AM REALLY LOOKING FORWARD TO SEEING AN D.O. - THANK YOU SO MUCH FOR RECOMMENDING THIS -

STAY WELL.
RAMIE :jester:





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