Within range baseline cortisol but failed Acth testing! What to do?

[Yennn]

I have had three short synacthen test carried out. First baseline 251 (240-600) rise 395 >430nmol acth 4 >20mu/l.

Second baseline 377 rise 423 acth 6

Doctors says it was borderline sick day rule only of HC. I questioned why as I didnt meet the minimum requirements to the response!

Their answer was to do a third one

Got my results today by post

Baseline 256 rise 314 the letter said it was satisfactory and no further investigation required! Satisfactory? Its the worse out the three. They also cancelled my next appointment. So I can’t even discuss this wihj them.

Additional blood work

aldosterone 130 Range (130-800)

renin 41.01 <52 igf-1 196 (72-259)

Are these results normal? Do I need to be on HC daily? And why aren’t my adrenals meeting cut off? Can anyone help me?

X

[SlowDragon Administrator]

Looking at previous posts, your vitamin D has been low and no recent vitamin tests

Vitamin D is actually not a vitamin but a pre steroid, and very important

How much vitamin D have you been supplementing?

When was it last retested?

Ferritin was also rather low in previous posts. Been retested recently?

Did you look at trying Levothyroxine

[Yennn in reply to SlowDragon]

Hey there,

I spoke to my doctor about Levo and she said all my thyriod was normal no need for thyroid meds. I can post my results again if u need? Regards vitamin d I asked my doc she said the lab declined and said that it was within range last time can only recheck in a years time I will need to purchase a test from medi checks.

🙏🏽

[SlowDragon Administrator in reply to Yennn]

Getting full Thyroid and vitamin testing would be good idea via Medichecks

[Yennn in reply to SlowDragon]

I wish i had added that in the last time

Do these results look ok for thyriod ?

Tsh 2.01 (0.27-4.20)

Ft4 16.30 (12-22)

FT3 4.22 (3.10-6.80) TBA 33.90 (0.00-115.00)

TPA 9.0 (0.00-34.00)

[SlowDragon Administrator in reply to Yennn]

FT3 looks low

Low FT3 can be an issue often diagnosed as fibromyalgia

[Yennn in reply to SlowDragon]

A rheumatologist checked me that I didn’t react to the pressure point test, and have no muscle pains.

Would trialling t3 help at all? Low dose at 3mcg?

[Yennn in reply to SlowDragon]

Forgot to mention tt3 was 1.1 (0.9-2.7)

[SlowDragon Administrator in reply to Yennn]

Possibly better to trial levothyroxine first

It’s much easier on adrenals

[Yennn in reply to SlowDragon]

Levo is that a mix between t4/t3? Sorry I don’t know much on medication and if my doc isn’t prescribe what can I do as I asked her about that previously .

[helvella in reply to Yennn]

"Levo" is short for "levothyroxine" - which is T4.

[SlowDragon Administrator in reply to Yennn]

You need to test vitamin D and get vitamin D levels up to at least 80nmol by supplementing

Suggest you just test vitamin D via NHS postal kit - £29

vitamindtest.org.uk

Better You vitamin D mouth spray is good as avoids poor gut function

Improving vitamin D can help adrenals - it’s actually more of a hormone than a vitamin, its a pre-steroid

Good quality daily vitamin C to help support adrenals

Look up adrenal cocktail on stop the thyroid madness website

Then get thyroid retested 6-8 weeks later as early as possible in morning and fasting

[Hidden]

The suggested response to the SST should be doubling the base level cortisol level within the hour, yours hasn't done that. Is the Endo experienced with adrenal/pituitary issues as it doesn't sound as though he is? Sadly many Endo's don't have experience of these issues so it's important to find one that does. If you contact the Pituitary foundation they should be able to point you to an Endo in your area that is conversant with adrenal/pituitary issues.

[Yennn in reply to Hidden]

The endo is an adrenal “specialist” 3 endos all day the above results are normal as baseline is within range.

That’s a great idea Pauline thanks

Would you know the number to call?

I tried to call the nurse helpline but always got a voice recording.

[Hidden in reply to Yennn]

Pituitary foundation: 0117 370 1320