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Addison's Disease Message Board

Addison's Disease Board Index

I have been working on a similar diagnostic problem myself. If you have a low ACTH (even though endos say it is normal, it is low normal, and certainly not optimum), and your AM cortisol is low, tho not bottom range, (say 10-15), and your DHEA-s is at the bottom range, you are looking at secondary AI.

Now, in the mainstream texts (from what I have read), the Stim test is used to gauge adrenal reserve. It is only in cases where the administered ACTH fails to produce a sufficient response from the adrenals, will mainstream drs say you have secondary AI. By this time, your adrenals have atrophied or something and are unable to produce cortisol.

However, there are other drs and practitioners out there who realize that it is not necessary for a patient to progress to this stage before treatment. The mere fact that the patient is no longer producing appropriate ACTH, even though the adrenals COULD function, is in and of itself a condition.

I have seen this condition discussed in terms of "HPA axis failure", or "dysfunction". I have also seen this condition called "mild" secondary AI.

I found a lot of lit concerned with critical care and appropriate cortisol rise in patients - what an optimum level is in stress and illness, etc. Well, I think that since your HPA axis is impaired due to deficient ACTH, that in a severe illness or surgery, perhaps you would not reach the optimum level (to sustain life, for instance). I am not sure it is a deadly as Addisons in terms of not being able to produce cortisol.

I have seen places on the web which discuss secondary AI, and related hypopituitary concerns (as deficient ACTH is thought to be one part of being hypopituitary), but I learned most of what I know from reading what I can on the web from medical abstracts, and some complete text articles.

I decided I wanted to go to a practitioner who recognizes my condition and is willing to treat it with HC. I am done with mainstream drs and endos who think everything is "normal"

This is the third time in the past year I have had to go off my thyroid meds due to intolerance. I am finally convinced that this is the step I need to take. I do not take it lightly, since HC is nothing to mess around with. But, at this point I have no other options.

I just went off my thyroid meds again a little over two weeks ago, so I hope my brain is not too out of commission and that my explanation is fairly clear. :cool:

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