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Addison's Disease Message Board


Addison's Disease Board Index


Hi

I really could do with some help. I've just been to the Drs and she said that all my basic tests were normal - liver, kidney, thyroid etc.

I asked her about Addison's and she said that my sodium and potassium levels were normal. The only tests that can be done here (UK) involve having to stay in hospital and she says that as nothing has shown on the bloods, she wouldn't be able to request them.

I showed her my armpits which have gone yellowish brown colour (in the last 4 weeks). Also around my waist line is developing a lightly tanned look - my belly hasn't seen the sun for about 15 years so it can't be a proper tan!!

So just wondering:

a) does the normal sodium/potassium exclude Addison's
b) is there anything that would cause the skin colour changes


I can get a saliva cortisol and DHEA test done privately - do you think I should get that done and would it be sensitive enough to pick anything up?

Thanks
Rachel
You can't diagnose Addison's disease with blood tests for sodium, potassium, cortisol or DHEA unless of course you are almost dead! The only way is one of the provocative tests that stimulate your adrenal glands and looks for cortisol production.
Rachel,
Here is the test you need. It must be done correctly. When I had this test they did the draw to establish a baseline, also draws at 30 & 60 minutes.


TEST 2: The ACTH stimulation test:

OBJECT: To determine if the patient's adrenal glands can respond to the ACTH message from the pituitary to increase cortisol production in the adrenal cortex.

THE TEST: The test is usually given first thing in the morning when normal cortisol levels are highest. Blood is withdrawn from the patient to establish a baseline (No instructions regarding necessity for fasting). The patient is given 250 micrograms (ug) of ACTH (Cortrosyn, Cosyntropin, or Synacthen) by injection in saline at one time. Blood is drawn at 30 minutes and/or 60 minutes and the serum cortisol level is determined.

NORMAL RESULTS: Normal pre-injection levels of cortisol are 5-25 ug/dL (138-690 nmol/L). The value should double at 30-60 minutes with a minimum of 20 ug/dL (552 nmol/L). PRIMARY ADDISONIAN: There will be no or little increase in cortisol levels upon ACTH injection. Notes: It is stated in several places that a single test of cortisol levels, or even 24 h urinary levels of cortisol and its metabolites, are NOT DIAGNOSTIC! In the normal individual cortisol levels are seen to pulse. Low cortisol production in either the serum or the urine after ACTH stimulation is diagnostic of Addisons disease.





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