Adrenal question.

[test-one]

Guys, as I sit looking over three months of blood work prepping for my first test injection in the morning I noticed my ACTH is...

ACTH Hormone 42 pg/ml (0-46) 5-Sep-12

But my cortisol is...


CORTISOL 13.4 ug/dL (2.50-25.00) 5-Sep-12

If ACTH is the gas and cortisol is the fire, shouldn't I be blazing.

My main symptoms are anxiety and bad fatigue and weird episodes of hypoglycemia.

Could I be on to something thats moreso adrenal related than testosterone ?

[HRTstudent]

Was it a blood cortisol sample? Blood cortisol readings are notoriously inaccurate.

I would then be interested in know the other adrenal hormones... DHEA-sulfate for example.

[test-one]

Via blood.....and ask and you shall receive.

DHEA-Sulfate 176.8 ug/dL (160.0-449.0) 4-Feb-13

Heres my cortisol over last few months.

CORTISOL 11.30 ug/dL (2.50-25.00) 26-Mar-13
CORTISOL 12.80 ug/dL (2.50-25.00) 31-Jan-13
CORTISOL 9.37 ug/dL (2.50-25.00) 24-Oct-12
CORTISOL 13.4 ug/dL (2.50-25.00) 5-Sep-12

Saliva results will arrive next week.

Thanks HRTstudent for your time.

I would rather not fight Addisons disease.

[thisAngelBites]

Heres my cortisol over last few months.

CORTISOL 11.30 ug/dL (2.50-25.00) 26-Mar-13
CORTISOL 12.80 ug/dL (2.50-25.00) 31-Jan-13
CORTISOL 9.37 ug/dL (2.50-25.00) 24-Oct-12
CORTISOL 13.4 ug/dL (2.50-25.00) 5-Sep-12

Saliva results will arrive next week.

I agree that blood cortisol varies so much it's hard to make something useful out of it. It will be interesting to see the cortisol curve. The symptoms you describe are often those attributed to adrenal fatigue. And if your adrenals are not doing well, it wouldn't be surprising that they are only making a minimum amount of DHEA-s.

[steroid.com 1]

Do you have Progesterone labs?

[test-one]

Do you have Progesterone labs?

Progesterone: 0.3 ng/ml (no reference range given)

Here are the results from the saliva cortisol test.

6:15 am 0.435 range (0.122-1.551)

2:00 pm 0.173 range (less than 0.359)

9:00 pm 0.115 range (less than 0.359)

I had my ACTH stim test this past Monday those results should arrive next week.

Something worth noting is that within 5 minutes of receiving the cortrosyn shot, I became very ill with extreme stomach pain and it felt like my kidneys were being pummeled.

I have been having tremors and shakes since Monday and ended up in the ER with low blood sugar of 60 and a blood pressure reading of 165/105 and Im never over 115/68 (usually lower). Something else worth mentioning is that in the past six months my blood serum cortisol reading has never been over 12.8....well in the ER the score was 25.5 (range 8.7---22.4).

Im scared of taking testosterone for fear of bringing about an adrenal crash.

Most dr's treat Adrenal, Thyroid and Sex Hormones...correct?

Thanks for the replies angel and gdevine.

[Vettester]

Do you have some other HPTA related labs (TSH, Prolactin, LH/FSH)? Any MRI's taken in the anterior region? Anything in your other labs (CBC's & Metabolic in particular) out of the ordinary?

Addison's would be my guess if the HPTA appears to be clear with pathologies.

You quoted
"Most dr's treat Adrenal, Thyroid and Sex Hormones...correct?"

Answer: Most doctors these days barely treat the sniffles. You will need a specialist(s), who really has their "A" game in endocrinology department.

[test-one]

Do you have some other HPTA related labs (TSH, Prolactin, LH/FSH)? Any MRI's taken in the anterior region? Anything in your other labs (CBC's & Metabolic in particular) out of the ordinary?

Addison's would be my guess if the HPTA appears to be clear with pathologies.

You quoted
"Most dr's treat Adrenal, Thyroid and Sex Hormones...correct?"

Answer: Most doctors these days barely treat the sniffles. You will need a specialist(s), who really has their "A" game in endocrinology department.

I should have worded that differently....most competent specialist such as dr Crisler, Shippen and Gordon follow that methodology.

Here is everything over the past few months.






ALBUMIN 4.1 G/DL (3.5-5.0) 26-Mar-13
ALBUMIN 3.8 G/DL (3.5-5.0) 21-Dec-12
ALBUMIN 4.1 G/DL (3.5-5.0) 24-Oct-12

ALKALINE PHOS 72.0 IU/L (40.0-150.0) 26-Mar-13
ALKALINE PHOS 72.0 IU/L (40.0-150.0) 21-Dec-12
ALKALINE PHOS 73.0 IU/L (40.0-150.0) 24-Oct-12

ALT/SGPT 28.0 IU/L (0.0-55.0) 26-Mar-13
ALT/SGPT 30.0 IU/L (0.0-55.0) 21-Dec-12
ALT/SGPT 23.0 IU/L (0.0-55.0) 24-Oct-12

ANION GAP 10.0 RATIO (4.0-34.0) 26-Mar-13
ANION GAP 6.0 RATIO (4.0-34.0) 21-Dec-12
ANION GAP 7.0 RATIO (4.0-34.0) 24-Oct-12

AST/SGOT 23.0 IU/L (5.0-34.0) 26-Mar-13
AST/SGOT 22.0 IU/L (5.0-34.0) 21-Dec-12
AST/SGOT 19.0 IU/L (5.0-34.0) 24-Oct-12

BASO 0.0 10e3/uL (0.0-0.1) 26-Mar-13
BASO 0.1 10e3/uL (0.0-0.1) 21-Dec-12
BASO 0.0 10e3/uL (0.0-0.1) 24-Oct-12

BUN 27.0 mg/dl (10.0-26.0) 26-Mar-13
BUN 26.0 mg/dl (10.0-26.0) 21-Dec-12
BUN 25.0 mg/dl (10.0-26.0) 24-Oct-12

BUN/CREATININE 27.0 RATIO (8.0-36.0) 26-Mar-13
BUN/CREATININE 28.9 RATIO (8.0-36.0) 21-Dec-12
BUN/CREATININE 27.8 RATIO (8.0-36.0) 24-Oct-12

CALCIUM 9.7 mg/dl (8.8-10.4) 26-Mar-13
CALCIUM 9.2 mg/dl (8.8-10.4) 21-Dec-12
CALCIUM 9.4 mg/dl (8.8-10.4) 24-Oct-12

CHLORIDE 104.0 MEQ/L (94.0-112.0) 26-Mar-13
CHLORIDE 106.0 MEQ/L (94.0-112.0) 21-Dec-12
CHLORIDE 106.0 MEQ/L (94.0-112.0) 24-Oct-12

CHOLESTEROL 200.0 MG/DL (140.0-200.0) 26-Mar-13

CO2 26.0 MEQ/L (21.0-32.0) 26-Mar-13
CO2 30.0 MEQ/L (21.0-32.0) 21-Dec-12
CO2 28.0 MEQ/L (21.0-32.0) 24-Oct-12

CORTISOL 11.30 ug/dL (2.50-25.00) 26-Mar-13
CORTISOL 12.80 ug/dL (2.50-25.00) 31-Jan-13
CORTISOL 9.37 ug/dL (2.50-25.00) 24-Oct-12
CORTISOL 13.4 ug/dL (2.50-25.00) 5-Sep-12

CREATININE 1.0 mg/dl (0.6-1.4) 26-Mar-13
CREATININE 0.9 mg/dl (0.6-1.4) 21-Dec-12
CREATININE 0.9 mg/dl (0.6-1.4) 24-Oct-12

DHEA-Sulfate 176.8 ug/dL (160.0-449.0) 4-Feb-13

DIRECT BILI 0.2 MG/DL (0.0-0.6) 26-Mar-13
DIRECT BILI 0.3 MG/DL (0.0-0.6) 21-Dec-12
DIRECT BILI 0.2 MG/DL (0.0-0.6) 24-Oct-12

DIRECT HDL 60.0 MG/DL (45.0-70.0) 26-Mar-13

DIRECT LDL 124.0 MG/DL (50.0-130.0) 26-Mar-13

eGFR 91.5 () 26-Mar-13
eGFR 103.3 () 21-Dec-12
eGFR 103.3 () 24-Oct-12

EOS 0.3 10e3/uL (0.0-0.5) 26-Mar-13
EOS 0.2 10e3/uL (0.0-0.5) 21-Dec-12
EOS 0.2 10e3/uL (0.0-0.5) 24-Oct-12

ESTRADIOL 31.60 pg/ml () 27-Dec-12
ESTRADIOL 27.90 pg/ml () 25-Oct-12

FREE T3 3.830 pg/mL (1.800-4.200) 26-Mar-13
FREE T3 3.840 pg/mL (1.800-4.200) 31-Jan-13

FREE T4 1.290 ng/dl (0.800-1.900) 26-Mar-13
FREE T4 1.130 ng/dl (0.800-1.900) 31-Jan-13

Free Testosterone (Direct) 6.6 pg/mL (8.7-25.1) 4-Feb-13
Free Testosterone(Direct) 7.1 pg/mL (8.7-25.1) 26-Dec-12
Free Testosterone(Direct) 7.3 pg/mL (8.7-25.1) 26-Oct-12


FSH 2.730 uIU/mL () 26-Mar-13
FSH 3.080 uIU/mL () 27-Dec-12
FSH 3.020 uIU/mL () 13-Nov-12
FSH 3.50 uIU/mL () 5-Sep-12

GLUCOSE 90.0 mg/dl (70.0-100.0) 26-Mar-13
GLUCOSE 59.0 mg/dl (70.0-100.0) 21-Dec-12
GLUCOSE 86.0 mg/dl (70.0-100.0) 24-Oct-12

HCT 46.3 % (43.5-53.7) 26-Mar-13
HCT 47.1 % (43.5-53.7) 21-Dec-12
HCT 47.5 % (43.5-53.7) 24-Oct-12

HGB 15.0 g/dL (14.1-18.1) 26-Mar-13
HGB 14.6 g/dL (14.1-18.1) 21-Dec-12
HGB 14.9 g/dL (14.1-18.1) 24-Oct-12

INDIRECT BILI 0.3 MG/DL (0.0-1.0) 26-Mar-13
INDIRECT BILI 0.3 MG/DL (0.0-1.0) 21-Dec-12
INDIRECT BILI 0.4 MG/DL (0.0-1.0) 24-Oct-12

LH 1.710 mIU/mL () 26-Mar-13
LH 2.830 mIU/mL () 27-Dec-12
LH 2.070 mIU/mL () 13-Nov-12
LH 2.90 mIU/mL () 5-Sep-12

LYM 2.0 K/UL (0.6-4.1) 26-Mar-13
LYM 1.8 K/UL (0.6-4.1) 21-Dec-12
LYM 1.7 K/UL (0.6-4.1) 24-Oct-12

MCH 30.3 pG/cell (28.0-32.0) 26-Mar-13
MCH 29.3 pG/cell (28.0-32.0) 21-Dec-12
MCH 29.7 pG/cell (28.0-32.0) 24-Oct-12

MCHC 32.5 g/dL (32.0-36.0) 26-Mar-13
MCHC 31.0 g/dL (32.0-36.0) 21-Dec-12
MCHC 31.3 g/dL (32.0-36.0) 24-Oct-12

MCV 93 fL (80-97) 26-Mar-13
MCV 94 fL (80-97) 21-Dec-12
MCV 95 fL (80-97) 24-Oct-12

Mono 0.5 10e3/uL (0.1-1.1) 26-Mar-13
Mono 0.5 10e3/uL (0.1-1.1) 21-Dec-12
Mono 0.5 10e3/uL (0.1-1.1) 24-Oct-12

MPV 9.8 fL (0.0-99.8) 26-Mar-13
MPV 10.4 fL (0.0-99.8) 21-Dec-12
MPV 11.1 fL (0.0-99.8) 24-Oct-12

NEU 2.4 10e3/uL (1.8-6.7) 26-Mar-13
NEU 2.4 10e3/uL (1.8-6.7) 21-Dec-12
NEU 2.1 10e3/uL (1.8-6.7) 24-Oct-12

PCT 0.2 % () 26-Mar-13
PCT 0.2 % () 21-Dec-12
PCT 0.2 % () 24-Oct-12

PDW 23.0 10(GSD) () 26-Mar-13
PDW 22.5 10(GSD) () 21-Dec-12
PDW 23.7 10(GSD) () 24-Oct-12

PLT 157 K/uL (145-450) 26-Mar-13
PLT 166 K/uL (145-450) 21-Dec-12
PLT 153 K/uL (145-450) 24-Oct-12

POTASSIUM 4.1 mg/dl (3.5-5.5) 26-Mar-13
POTASSIUM 4.3 mg/dl (3.5-5.5) 21-Dec-12
POTASSIUM 4.2 mg/dl (3.5-5.5) 24-Oct-12

PROGESTERONE 0.3 ng/ml () 31-Jan-13

PROLACTIN 6.67 ng/mL (2.50-17.00) 24-Oct-12
PROLACTIN 7.7 ng/mL (2.50-17.00) 5-Sep-12

PSA 0.81 ng/mL (0.09-4.00) 31-Jan-13

RBC 4.97 M/UL (4.69-6.13) 26-Mar-13
RBC 4.99 M/UL (4.69-6.13) 21-Dec-12
RBC 5.01 M/UL (4.69-6.13) 24-Oct-12

RDW 12.9 % (11.5-14.8) 26-Mar-13
RDW 12.0 % (11.5-14.8) 21-Dec-12
RDW 12.7 % (11.5-14.8) 24-Oct-12

Sex Horm Binding Glob, Serum 29.9 nmol/L (16.5-55.9) 4-Feb-13

SODIUM 140.0 mg/dl (130.0-149.0) 26-Mar-13
SODIUM 142.0 mg/dl (130.0-149.0) 21-Dec-12
SODIUM 141.0 mg/dl (130.0-149.0) 24-Oct-12

T. TESTOSTERONE 318.00 ng/dL (270.00-1730.00) 26-Mar-13
T. TESTOSTERONE 229.00 ng/dL (270.00-1730.00) 1-Feb-13
T. TESTOSTERONE 337.00 ng/dL (270.00-1730.00) 21-Dec-12
T. TESTOSTERONE 421.00 ng/dL (270.00-1730.00) 25-Oct-12


TOTAL BILI 0.5 MG/DL (0.2-1.3) 26-Mar-13
TOTAL BILI 0.6 MG/DL (0.2-1.3) 21-Dec-12
TOTAL BILI 0.6 MG/DL (0.2-1.3) 24-Oct-12

TOTAL PROTEIN 6.8 G/DL (6.3-8.1) 26-Mar-13
TOTAL PROTEIN 6.5 G/DL (6.3-8.1) 21-Dec-12
TOTAL PROTEIN 6.5 G/DL (6.3-8.1) 24-Oct-12

TRIGLYCERIDES 75.0 MG/DL (30.0-150.0) 26-Mar-13

TSH 1.570 uIU/mL (0.400-4.000) 26-Mar-13
TSH 1.890 uIU/mL (0.400-4.000) 31-Jan-13

WBC 5.2 K/UL (4.5-10.5) 26-Mar-13
WBC 5.0 K/UL (4.5-10.5) 21-Dec-12
WBC 4.5 K/UL (4.5-10.5) 24-Oct-12

Uric Acid 5.7 md/pl (2.6-7.2mg/pl) 5-Sep-12

This is overkill but here is everything.

I was under the impression most Addison suffers have cortisol averaging around 2. I also understand there is a primary and secondary diagnosis of Addison's as well.

Do we have members with Addison's here?

Thanks for anyone who takes the time to respond.

[thisAngelBites]

Ok, your first and highest salivary cortisol is in the lowest third of the range. Docs will say it's fine, but for myself I know that figure would not optimal. I've never seen a salivary test that only stipulates that the later values be beneath a certain figure, because there is a point obviously when it is too low. Maybe someone else will comment. But at least you do have a proper physiologic pattern, i.e. highest cortisol in the morning and continually decreasing during the day.

Your bloods don't really point towards Addisons. The cortisol levels, whilst they don't tell us a lot, were not low at all (unless perhaps you are terrified of physicians or blood draws and think perhaps you had an extreme stress response that would explain these not being very low). Your sodium levels look good, so no hyponaetremia. Your potassium levels look good, so no hyperkalemia. Those are both some of the most common signs in bloods of adrenal insufficiency.

Your lowish blood pressure (usually) could be a sign of Addison's however, as is the hypoglycemia, altho the blood glucose tests they did didn't reflect that at the time they were taken. Are you off food? or have you been losing weight? Any signs of hyperpigmentation (hand creases, underarm creases or in mouth or inside of cheeks)?

On the other hand, your reaction to the ACTH test does sound somewhat like an adrenal crisis except for the high blood pressure. I wish I knew more so that I could have something more helpful to tell you.

I know very little on the interplay between sex hormones and adrenals, so again, I hope someone else with more knowledge can help.