Post by kikkie2004 on Mar 6, 2009 7:34:23 GMT -5
Hi
Firstly, thanks for this great site to the moderators and all the other contributors.
I have been to an endo with blood tests, and he has diagnosed 'partial Addison's'.
According to me, it's secondary adrenal insufficiency, with maybe slightly atrophied adrenal glands.
When I told him so, he lost his temper and shouted at me that I read too much on the internet, that isolated ACTH deficiency is very rare and that the rest of my pituitary hormones are OK (which they are) and that the treatment was the same anyway.
So could someone please shed some light?:
The results of my ACTH stim test was as follows:
(I had been taking 17.5 mg hydrocortisone for some months before this test, but didn't take it on the day)
Cortisol at base: 225 nmol/l
after 30 min: 408 nmol/l
after 60 min: 472 nmol/l
Androgens at base (different day)
DHEAS 2.06 Range 2.68 - 9.23 umol/L
T-Testosterone 0.45 Range 0.22 - 2.9 nmol/L
Free testosterone 2.11 Range 3.5 - 29.5 pmol/L
The reason why I think it's secondary adrenal insufficiency is based on a baseline ACTH test that was done two years ago.
It was done at 16:00 in the afternoon:
ACTH 2.7 Range 1.1 - 13.2 pmol/L (2.7 is 12 pg/ml)
Corresponding cortisol: 122 nmol/L (Range: PM samples < 276 nmol/L
There was also an ACTH done that same morning, the values were:
ACTH: 4.3 Range 1.1 - 13.2 pmol ? (2.7 is 19 pg/ml)
Corresponding cortisol: 324 Range 184 - 618 nmol/L
Also, when I had the ACTH stim test, I felt fantastic for days afterwards. My chronic fatigue, ADHD (without the H), depression and hypoglycemia were all greatly reduced.
I wish I could just have an ACTH injection every few days and I would be fine.
Also, I had been taking a synthetic T4/T3 pill based not on low free thyroid hormones or high TSH, but on symptoms of hypothyroidism (and prior slightly elevated antibodies to the thyroid, which on subsequent testing had fallen within the range again).
So my last thyroid test came back as:
Free T4 17.1 Range 7.2 - 16.4 pmol/L
Free T3 4.9 Range 3.8 - 6.0 pmol/L
S-TSH < 0.1 Range 0.37 - 3.5 mIU/L
Should I take a lower dose of this?
(Prolactin 9.5 Range 3.3 - 26.7 ug/L)
Cycle day 1:
(FSH 6.6 IU/L )
After my insisting, the endo also prescribed a testosterone depot. I an just worried about other hormones such as DHEA and growth hormone and progesterone etc.
Many thanks for any reply
Kikkie
Firstly, thanks for this great site to the moderators and all the other contributors.
I have been to an endo with blood tests, and he has diagnosed 'partial Addison's'.
According to me, it's secondary adrenal insufficiency, with maybe slightly atrophied adrenal glands.
When I told him so, he lost his temper and shouted at me that I read too much on the internet, that isolated ACTH deficiency is very rare and that the rest of my pituitary hormones are OK (which they are) and that the treatment was the same anyway.
So could someone please shed some light?:
The results of my ACTH stim test was as follows:
(I had been taking 17.5 mg hydrocortisone for some months before this test, but didn't take it on the day)
Cortisol at base: 225 nmol/l
after 30 min: 408 nmol/l
after 60 min: 472 nmol/l
Androgens at base (different day)
DHEAS 2.06 Range 2.68 - 9.23 umol/L
T-Testosterone 0.45 Range 0.22 - 2.9 nmol/L
Free testosterone 2.11 Range 3.5 - 29.5 pmol/L
The reason why I think it's secondary adrenal insufficiency is based on a baseline ACTH test that was done two years ago.
It was done at 16:00 in the afternoon:
ACTH 2.7 Range 1.1 - 13.2 pmol/L (2.7 is 12 pg/ml)
Corresponding cortisol: 122 nmol/L (Range: PM samples < 276 nmol/L
There was also an ACTH done that same morning, the values were:
ACTH: 4.3 Range 1.1 - 13.2 pmol ? (2.7 is 19 pg/ml)
Corresponding cortisol: 324 Range 184 - 618 nmol/L
Also, when I had the ACTH stim test, I felt fantastic for days afterwards. My chronic fatigue, ADHD (without the H), depression and hypoglycemia were all greatly reduced.
I wish I could just have an ACTH injection every few days and I would be fine.
Also, I had been taking a synthetic T4/T3 pill based not on low free thyroid hormones or high TSH, but on symptoms of hypothyroidism (and prior slightly elevated antibodies to the thyroid, which on subsequent testing had fallen within the range again).
So my last thyroid test came back as:
Free T4 17.1 Range 7.2 - 16.4 pmol/L
Free T3 4.9 Range 3.8 - 6.0 pmol/L
S-TSH < 0.1 Range 0.37 - 3.5 mIU/L
Should I take a lower dose of this?
(Prolactin 9.5 Range 3.3 - 26.7 ug/L)
Cycle day 1:
(FSH 6.6 IU/L )
After my insisting, the endo also prescribed a testosterone depot. I an just worried about other hormones such as DHEA and growth hormone and progesterone etc.
Many thanks for any reply
Kikkie