Fatigue symptoms vanished right after Synacthen test, but test showed sufficient cortisol levels. What is going on?

[Tomchr]

A couple of weeks ago, my mother had an unilateral adrenalectomy due to slightly raised adrenaline levels. Weeks afterwards she has felt very unwell, very tired, no initiative, anxious, no appetite, weak, at loss for words, dizzy, stomach aches and very obstipated. All these symptoms appear to be at their worst every day in the evening, around 21:00-00:00, like clockwork.

Suspecting adrenal fatigue she underwent a Synacthen test yesterday.

Her base line (pre) cortisol was 237 nmol/l. Post (30 min.) cortisol was 471 nmol/L, suggesting no adrenal fatigue.

However, ALL SYMPTOMS disappeared when the post Synacthen test measurement was performed. I observed, that she was very happy, showed plenty of stamina and appetite and had none of the above mentioned symptoms all day. Her condition improved completely.

We have not yet discussed the matter with the endocrinologist. I am wary that the endo will conclude that the blood test shows no sign of adrenal fatigue and do nothing, even though the administered drug (cosyntropin) improved her condition without any doubt.

Any suggestions?

[McPammy]

something similar happened to me when I had a short synacthen test. My cortisol level was very low and I live with Hashimotos. I was taking levothyroxine T4 medication at the time. I could barely walk. I had to be taken into the hospital in a wheel chair. I felt so weak. I went through the procedure of the synacthen test. My partner and myself couldn’t believe the transformation after the test. I walked out, nearly skipping. I felt great. I couldn’t believe it. When I got home I even mowed the lawn. I hadn’t been able to do that in months. Next day I was back to square one unable to walk properly. I believe the stimulation of my ACTH boosted everything for that one day. But I can’t confirm that. My results from the synacthen test was normal so no adrenal issues. And I was cast aside by the NHS. No further investigation. What! I thought. There was something I was short of for sure. Finally after joining this site I was advised to see a private only endocrinologist. I did and within 2 consultations I was diagnosed as a very poor converter of levothyroxine T4 to the most important hormone T3. I could only convert 8%. I was privately prescribed liothyronine T3 along with liquid levothyroxine T4. Oh boy oh boy what a huge difference and relief. All along my issue was too low T3. Once my body had the T3 I was walking normally and had the energy to do mostly anything. It felt nothing short of a miracle to me. A few week later I had a series of blood tests and my cortisol had shot up from a low 69 under range to 450. Since it’s stable around 275 it’s checked every 3 months now. Have you had your mothers T3 checked and to see if she is converting from T4 well enough. I also did the DIO2 gene test which came back positive. That was the reason I was barely converting. I was glad to find out what was wrong and why it was wrong. Going private only was my saviour.

[arTistapple in reply to McPammy]

Read your bio too. Very inspirational! Especially with all the talk about Adrenal fatigue on the forum at the moment. It’s all very confusing to me. Thank you.

[Tomchr in reply to McPammy]

Thank you very much for sharing your experience. Just as predicted, the endocrinologist phoned and informed her that the synacthen test had showed normal levels, thus no adrenal fatigue and no need for hydrocortisone to support her levels throughout the day. She had taken a large cup of coffee at times when her symptoms were bad and that had helped her get through. Next day, her symptoms returned and she was anxious once again to go outside her home. My mother has been suffering from hyperthyroidism and her T4/T3 levels have been completely floored due to taking thiamazole daily for the last 5 month. I think that we are going to try to get her T3 levels up again by tapering off her thiamazole medication. I am considering giving her B-Complex, C vitamins and possibly magnesium to strengthen her adrenals.