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Addison's Disease Message Board


Addison's Disease Board Index


What time were the tests taken? That is significant.

The body's normal rhythm should be at its highest at around 8am. It should fall to roughly half that amount by 4pm (the lab ranges usually show time periods from 8-10 and 2-4). Ranges are wide and doctors that are not experienced can just look at what is *normal* and not see what is really wrong so at least your doctor is seeing that you possibly have an issue with your diurnal rhythm. Another good test is at midnight, where cortisol should be at its lowest and some with Cushing's will be high.

A variety of tests should be performed and you should keep in mind that they differ is both how and what. Blood tests are testing serum cortisol and are point in time tests so you may or may not be high at the time of the test. Saliva tests are point in time, but test free cortisol. Urinary Free Cortisol tests are done over a long period - usually 24 hours or 10 hours and will tell you if your cortisol was raised in that average. The pitfalls for that, for me, for instance, is that I was so high and then so low, that the lows cancelled out my high and I was largely average or just barely high. Another pitfall of free cortisol is that some people "bind" free cortisol through no fault of their own (and some drugs and even estrogen does this) so that no matter how high they really are, free cortisol will not spill so a test call cortisol binding globulin is useful but only a few specialty labs carry it and good doctors know about it.

One test should not rule you in or out. Dexamethasone suppression tests should not rule you in or out. I suppressed on every test and had confirmed Cushing's disease. Get many tests to know the source of your disease. It is not straightforward.

I had both pituitary and adrenal surgery. I have Hashimoto's too.
Saliva tests are recognized as valid tests and with a doctor's order and diagnsosis code, insurance should pay. The ones my doctors order are usually by ACL labs or esoterix labs (which is owned by *******).
If you read up on the protocols for testing, many of them include saliva testing. Your test was done a bit too late to really be accurate and hopefully your doctor will re-do your testing. Get to the lab a lot earlier next time and try to get an 8am fasting draw next time.
Thanks for the wishes...I have a lot going on.





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