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Addison's Disease Message Board

Addison's Disease Board Index

7:00 am Cortisol 0.10 mcg/dL (0.04-0.56 is normal)
12:00 pm Cortisol 0.14 mcg/dL (0.04-0.56 is normal)
5:00 pm Cortisol 0.15 mcg/dL (<0.15 is normal)
10:00 pm Cortisol 0.07 mcg/dL (<0.09 is normal)

You can't diagnose adrenal insufficiency with simple blood tests, you need some kind of stimulation test to determine your maximum cortisol output. I suggest you ask for a visit with an endocrinologist. If he refuses then I would ask for the refusal in writing and then find another doctor; turns out not all doctors were created equal.

It is suspicous that your morning cortisol is lower than noon and 5pm. One day's readings don't mean much, but based on that result further investigation is needed.

The ranges you give differ from many I have seen:

7-9am 0.27-2.06 mcg/dL
11-1pm 0.03 - 0.77
3-5pm 0.03 - 0.56
10-12am 0.03 - 0.50

I don't see how the normal range would be the same for 7am and noon. It is well known that cortisol should rise dramatically within 2 hours of waking. Given these other ranges and the fact you have symptoms, you are deficient, at least on that morning. I would use a different lab for the next tests.

Other symptoms: morning backache that goes away as the day progresses, unrefreshing sleep, salt craving, low exercise capacity and blood pressure that drops when you stand up. Do you have any of these?

Normally low cortisol makes it very easy to get to sleep, and to sleep a long time. When you wake up you are unrefreshed and feel a few more hours would do the trick, but it doesn't. Consequently your inability to sleep at night runs contrary to low cortisol; of course you may easily have other problem that are related to low cortisol.

I would get blood tests for thyroid, prolactin, LH, FSH, DHEAS. DHEAS is normally very low if you have low cortisol. The other tests help determine the cause of the low cortisol.

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