My adrenal function has been sluggish with cortisol levels taking almost one year to return to the "normal" range, albeit the lower end of normal. My endo decided to further evaluate the HPA axis.
Last week, I was given 3000 of Metypirone at midnight to block adrenal function. At 07:30 the following morning, blood was checked for cortisol, ACTH and 11-Deoxy-cortisol.
ACTH : 398.0 (58.1 pg/ml prior to test) ref range <46.8
Cortisol : 4.0 (8.2 ug/dl prior to test) ref range 3.44-22.45)
Morning: 07:00-09:00 5.25-22.45
Early evening 15:00-17:00 3.44-16.76
11- Deoxy cortisol 117 (0.18 ng/ml prior to test) ref range <,0.33
I was told by the doctor in hospital, that the Metypirone would block my adrenal function overnight but will have worn off by the morning therefore there should be a spike in cortisol levels noted between 06:00-08:00 to demonstrate that my adrenal glands have recovered and are functioning.
Another doctor in the same hospital contradicted this explaination stating that a low cortisol was expected in the morning because the glands have been suppressed. Now I don't know who to believe.
According to the drug company's SPC, another blood sample should have been drawn at 16:00 to check the cortisol response. It was drawn but it only included electrolytes as my potassium was too low.
I've never had a problem with ACTH, only with cortisol. Can anyone shed more light on these results?