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Addison's Disease Message Board


Addison's Disease Board Index


I have posted previously but still have many unanswered questions.
I am 39 yo dx. with Premature Ovarian Failure on high levels of hormone replacement.
Symptoms:
Fatigue
dizzy/vertigo 24/7
muscle aches
decreased excercise tolerance
daily headaches temples with pressure behind eyes
numbness/tingly in extremeties
new motion sickness
extreme light sensitivity
daily nausea

ACTH Stim test
Pre cortisol 6.2
Post 20

Labs
Prolactin 5.7 ng/ml (2-20)
TSH .93 miu/l (.4-5.0)
Free t3 344 pg/dl (230-420)
Free t4 1.3 ng/dl (.8-1.8)
IGF1 208 ng/ml (126-291)
Cortisol 14 mcg/dl (4-22)
ACTH 7 pg/ml (5-27)
24UFC 27.8 mcg/24 (4-50)

Questions:
1. How accurate is the ACTH stim test? And what is the "proper procedure"?

First of all, I keep reading that this test should not be done on Estrogen replacement as Estrogen raises CBG thus raises total cortisol levels. Secondly, when I had this test done, they had me running all over the hospital. To the lab for 1st draw, upstairs for iv injection, back to lab 5 minutes before 2nd draw. Also, I have read so much conflicting info regarding the appropriate post levels. Anywhere from 18-22, and have read that secondary will usually double or more and even pass. I have also read many posts here where people had to have 2 or 3 stim tests before it showed AI.

2. What is the normal levels for ACTH? Even though the lab lists 5-27 for an am draw, my endo says my 7 is actually low and is now thinking seconadary AI. He actually wants me to go on a 2 weeks trial of hydrocortisone and if it helps, then he will do more testing.

3. What would be the next step in testing for SAI?

4. If I start the steroids, how long would it take to notice a difference?

I have seen many specialists over the past 8 months and many tests. They have it narrowed down to either this SAI or some type of positional vertigo, which I will be tested for next week. The only thing that they are thinking though, is that POF and AI often go together. Vertigo would not be a cause for the POF. I do have a strong family history of endocrine disorders though no one with adrenal problems. Mostly thyroid, growth hormone and diabetes.

I appreciate any info and insights you might have. I have been sick for 8 months and am completely tired of it.

Thanks.





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