Please help with my results!

[Elle1987]

Hello, I recently had my hydro day curve and my cortisol levels came back as 266 at 9am, 67 at 12pm, 67 at 4pm and 157 at 5pm. I was simply sent these results, told to stay on the same meds and I can't get an answer for the reference range. If anyone has ANY idea of how to even roughly interpret these and whether they are high, low or normal I would be soooooooooo grateful!!!

[silverfox7]

I am assuming your doctor hasn't got the range but try ringing the hospital. The ranges will help people to comment.

[LAHs]

Elle, we will need the units and the ranges. These tests are often quoted in nmol/L and a typical low result in these units is:

7am 14 (13-24)nmol/L,

Noon 3 (5-10)nmol/L,

4pm 5 (3-8)nmol/L, and

11pm 1 (1-4)nmol/L

If you can get your ranges you can see where you are on the normal scale without knowing the units. Those were mine, btw, kind of low everywhere.

[monty6 in reply to LAHs]

Think you have unit range incorrect

[LAHs in reply to monty6]

Those are the units in which my cortisol was measured. Those were my results. You and I are probably on different continents. In the US we have nmol/L and I believe they also use ng/dL. I am interested though in what are the units that give 3 digit results, what are they?

[LAHs in reply to monty6]

Well Monty, I thank you for pointing that out. I am a fanatic for units and when it's me that's got them wrong I really freak out. The lab where I had my tests gave me the units "nM". I e-mailed them and asked what was "M", they e-mailed back and said "Mols/L", hence my post above. Well, they were wrong and you were right!

I skimmed through a few papers on this subject and I conclude that my readings must be in mcg/dL. Making my results: 276,100,138,20, again, low on any scale.

[monty6 in reply to LAHs]

Yes on the low side. The Short synacthen test is fine for testing adrenal glands but useless in diagnosis of Secondary adrenal inefficiency because of a Pituitary gland problem, not producing sufficient ACTH. Usually because of a Pituitary gland tumor. Have you had a MRI.

What was Your ACTH RESULT with the Synacthen test.

[monty6 in reply to LAHs]

Glad I can help you. If first result is less than 500nmo/l need further investigation for Secondary adrenal inefficiency. Usually due to a pituitary gland tumor.

I'm struggling to get a diagnosis but Endos seem reluctant to acknowledge Symptoms nausea, loss of weight, Fatigue and depression. Best of luck.

[Granny56]

labtestsonline.org.uk/

This website might help you

[headinjuryhypo]

Your basal cortisol level at 266 falls into the 'grey area' where dynamic testing is warranted. Below 100 you are adrenal-insufficient, and above 500 you are definitely OK. Show your doctor either the Wikipedia entry on 'hypopituitarism' or this paper: Thorogood N, Baldeweg S E, Pituitary Discorders: an overview for the general physician, Symposium on the Head and Neck, BJHM, April 2008 Vol 69 No 4. "A morning cortisol value below 100 nmol/L indicates adrenal insufficiency. Cortisol values of 500 nmol/L or greater are consistent with an intact hypothalamic-pituitary-adrenal axis. The values in between do not exclude secondary adrenal insufficiency and dynamic testing is therefore warranted."

Dynamic testing: don't rely on the short synacthen test which misses 2 cases in every five annals.org/article.aspx?art... Push if you can for the insulin stress test which is unpleasant and not recommended if you have heart problems or seizures, but it is the 'gold standard' and you can trust it.

[headinjuryhypo]

PS I should have said that the above post is all about *secondary* adrenal insufficiency i.e. caused by the pituitary or the hypothalamus. The short synacthen test is fine if you're just testing the adrenal glands themselves.

[monty6]

I have a pituitary gland tumor resulting in a Macroprolactinoma and acromegaly. I had Short synacthen test with cortisol of

356nmol/l and ACTH Of 26 ug/l. No references ranges supplied for either result. Don't think I'm Barking up the wrong tree for a diagnosis of Secondary adrenal inefficiency, but don't understand results. Any help appreciated.

[Heloise]

Elle, simply put, your morning level should be close to the top and each one should taper down to the end which should be close to the low end of the range. If it goes higher at any other point, it is considered a problem.

[monty6 in reply to Heloise]

Abnormally high Cortisol is Cushions disease opposite to Addisons

[Heloise in reply to monty6]

Do you mean Cushing disease?

[monty6 in reply to Heloise]

Obviously