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Addison's Disease Message Board


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Okay, this is [I]weird[/I].

The Endo ordered another ACTH Stim test on me, (because I guess the first one and the 24-hour saliva panel were "unreliable" or something).

I went in on Tuesday to do the test, and just got a copy of the results today.

Check this out -

[ACTH Stim Test Results - 7/22/08 9:50a]
Baseline Cortisol: 10.7 ug/dL
Baseline ACTH: 77 pg/mL (7-69) - High
30 min Cortisol: 17.6 ug/dL (>20) - Low

(wait for it ...)

60 min Cortisol: 16.3 ug/dL (>20) - Low([I]er than the 30 min[/I])

(and get ready for the big finale ...)

90 min Cortisol: [B][i]11.4[/i][/B] ug/dL (>20) - Low ([I]almost back to baseline[/I])

[SIZE="7"]!?!?![/SIZE]

I thought the Cortisol level was supposed to keep going up on the 90 minute draw instead of tapering off after the 30 mark.

Anyone have a clue as to what is going on?

Am I just resistant to my own ACTH?

Is this some sort of abnormal genetic disease?

Possibly the effects of long-term anal probing from alien abductions? (far fetched, but at this point nothing would suprise me...)

They did do this one intra-muscular (shot in the arm) instead of IV, but I thought that wasn't supposed to make a difference.

Any insight would be greatly appreciated.
I've read an Endo guide from a reference lab (Q**** Diagnostics), and it looks like for people with healthy adrenals their cortisol goes up even until the 90 min draw.

Does the fact that my 90 min reading almost goes back down to my baseline show just how empty my adrenal reserves are?

Also, is my ACTH really that high, or is it just saying my Pit knows I need more Cortisol, but doesn't feel it's in a crisis mode (yet) so it just "raises it's voice" instead of "screaming"? I thought I've read about folks w/ full on Addi's saying their ACTH was in the several hundreds, so is a 77 really that bad?

I was thinking Primary AI as well, but my Endo wasn't convinced from the first set of tests. I had a high DHEA(S) (461 on a 110-370 scale) and my Aldosterone didn't seem too low (7.4 on a 4.0-31.0 scale), so I guess it didn't look like a clear picture of AI.

My appoitment isn't until the middle of August, so I guess I just get to sit on my thumbs and wait to hear what tests the Endo wants to run next.

From the numbers, does this look like a "Bad" case of physiological Primary AI, or does it just look like the effect of being in a stressful "impossible situation" dealing with my wife's chronic health issues and my own learning/vocational/social/emotional difficulties (on top of kids who suffer from a little bit from both sides) for years?





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