New member questions

[Snowgirl]

Hi, Paige,

Unfortunately, my doc's practice is closed to new patients. Have you tried Janine's Colorado Yahoo group?

http://health.groups.yahoo.com/group/co ... roidgroup/

It sounds like we are in a similar place. I'll be in touch more via PM.

[Snowgirl]

Hi, Chris,

I'm working at the moment on trying to get a better picture of my adrenal function. I finally got my full stim test results back:

Baseline 13.7 range ?
30 min 21.4 range 3.1-22.4
60 min 26.2 range 3.1-22.4
Plasma ACTH 13 range 6-48 (up slightly from last test 10 range 10-60 on 5/30)

I suspect the starting cortisol number is higher than normal because I only got four hours of sleep that night instead of the 6-8 I usually do. I've ordered the 4x saliva panel, but it will be a few weeks before I have those results.

In the meantime, I did the temperature test. My temps ranged from 99-99.23. I'd read that adrenal problems should cause it to swing more, and thyroid issues should cause it to be low. Since that's not the case for me though I clearly have both adrenal and thryoid issues, I'm wondering how accurate you think the temperature test is.

Many thanks.

[Chris Jackson]

You started low, and more than doubled that shows you are secondary. Your acth is very low (fluctuates, next time it might test as 9). If you used a mercury or equivlent thermometer, should be accurate. Digitals are not as accurate, some are pretty off. Your high temp could be an aldosterone problem.

You're welcome,
Chris

[Snowgirl]

Actually, I almost doubled, but not quite. As per your wiki article, am I correct in assuming that means my adrenal capacity for cortisol production has begun to atrophy?

I was using a mercury thermometer. How can low aldosterone cause high temps?

Thanks so much.

[Chris Jackson]

I meant to say not quite doubled, don't know what I was doing. Anyway, close enough. ehh, it's to close to doubing to say atrophy for sure is starting.

If dehydrated, then not enough water is not excreted from sweat and urination which takes heat from the body.

You're welcome,
Chris

[Snowgirl]

Fascinating.

Thanks!

[Chris Jackson]

You're welcome,
Chris

[Snowgirl]

Chris,

I was all set to explain to my doc why I needed to start cortisol when I got the results of my saliva panel back:

8/08 saliva
8 am 25 range 13-24
11 am 3 range 5-10
4 pm 2 range 3-8
11 pm 2 range 1-4
Cortisol Burden 32 range 23-42
DHEA 4 range 3-10
Zone 5

I am completely untreated at this point, so an elevated 8 am cortisol makes no sense, particularly when you consider my ACTH (10 & 13), my pre-stim plasma cortisol (13.7) and how exhausted I am when I get out of bed. I wasn’t under any particular stress that day and slept okay the night before.

For reference, here are my results from the same test four years ago:

5/04 Saliva
7 AM - 14 range 13-24
11 AM - 3 range 5-10
4 PM - 4 range 3-8
11 PM – 1 range 1-4
Cortisol Burden - 22 range 23-42
DHEA - 3 range 3-10
Zone 4

My first question is, how accurate are these tests?

If they are accurate, what should I do about cortisol supplementation? I am assuming I still need it – how do I dose to make sure I don’t get too much?

Thank you so much for your help!

She Who Is VERY Confused…

[Chris Jackson]

You could test the next day or week and come up low across the board. That might have been the only day that month you had a high morning cortisol for all you know. It's also possible the sample wasn't handled properly or the lab screwed up the test. Once in a while, I say retest.

Retest.

I think your group of saliva tests, stim test and ACTH tell it all. Tell your doc you have to take it all in and suspect the morning saliva test could have been an anomaly.

You're welcome,
Chris

[Snowgirl]

Thanks, Chris. It really helps to hear your perspective.

I'll probably ask my doc to test my AM plasma cortisol since that's both covered by my insurance and I can get the results in time for my next appointment in two weeks. Can you tell me:

1. Given the flawed ranges, what numbers to you consider too low and too high?

2. If I do get a second high reading, what would you suggest at that point? Valerie over at the adrenals yahoo group suggested that supping with cortisol could help regulate the uneveness of the rhythem. I'd appreciate hearing your opinion on this, since it's hard for me to imagine not taking cortisol with my ACTH sitting smack at the bottom of the range.

Thank you SO much.

[Chris Jackson]

Cortisol I look for women to be in the mid 20s, men upper 20s to lower 30s. ACTH I look for upper 40s to low 50s in men and women. If your saliva comes back high in the morning again, yes supplementing with cortisol helps with that.

You're very welcome,
Chris

[Snowgirl]

Thanks again, Chris.