low/normal cortisol -low normal ATCH

[Reembow]

so I just got the results for my cortisol am test, reference range 100-535, mine is 207,

As for an ATCH test I have done months ago, my number is 3.37, reference range 1.03-10.73

Should I be worried ?

[JumpJiving]

Reembow For low cortisol questions, I recommend asking in the Facebook group at facebook.com/groups/1759489... as that group specialises in low cortisol conditions.

Was the test done in the UK with results coming from a UK lab? What were the units on the two tests?

In the UK, NICE guidelines (see nice.org.uk/guidance/ng243/... ) say for an early morning (8-9am) cortisol blood test result of 150 nmol/L to 300 nmol/L the following:

"Recognise that the probability of adrenal insufficiency is uncertain.

Consider repeating the serum cortisol test.

If it remains at this level, seek endocrinology advice or referral".

So, unless you have clear symptoms of adrenal insufficiency, they would normally run the cortisol test again at some undefined date in the future. TBH, on typical UK ranges, 207 is low but not scarily low. It would raise an eyebrow of an endo, but wouldn't cause panic.

Do you have symptoms of adrenal insufficiency? Did you prepare for the test? (no steroids on the morning of the test and ideally none for 24 hours prior to the test, no opioids prior to the test, no HRT or OCP for 6 weeks beforehand, no biotin, ashwagandha, liquorice or grapefruit). Strictly speaking, the literature says that transdermal HRT is ok, but anecdotally people report that it makes a difference so should be avoided prior to the test.

[Reembow in reply to JumpJiving]

Hi Jumpliving!

Thank you for the Facebook recommendation!

The tests were done in Saudi and the units are the following : 3.37 pg/ml for the ATCH

And 207 Nmol/l for the cortisol

The reason why I am considering some sort of issue is the fact that for the past couple of years I’ve been getting really strange dizzy spells, like the ones you get when you stand up suddenly. But for me this is happening sometimes even when I am walking. I realize the need for salt in my diet so I try to add salt to sort of counter these feelings. I also get this strange feeling in the morning as if my body wants me get up even if I still feel want to sleep because it somehow feels uncomfortable to be in a lying position any longer (blood pressure, or circulation maybe ) I also get blurry vision at times and tintinutis. I sometimes think it’s pots and I wonder if it has started after Covid. I am now having dumping like symptoms when I eat and this is why the investigation began

[JumpJiving in reply to Reembow]

 Reembow I don’t even know what dumping means, but all of the other symptoms that you listed above can be (directly or indirectly) low cortisol, particularly if the wanting to get up is typically 3-4am

[redhead41 in reply to JumpJiving]

Silly question- do I put Facebook.cpm/groups/1759489 into the Facebook search? Assuming this is correct, it just took me to the NZ thyroid group. I am looking for help with low cortisol throughout the day (dutch test), ACTH just below the reference range. Weight gain, but not Addison.

[TiggerMe Ambassador in reply to redhead41]

If you go to JumpJiving's reply above and click on the blue writing (link) on the second line it takes you to the page

[redhead41 in reply to TiggerMe]

Thank you

[SlowDragon Ambassador]

Looking at your other posts

Low B12 is this pernicious anaemia

Are you on B12 injections or daily B12

If injections, how frequently

What other vitamin supplements are you taking

if taking B complex or any supplements containing biotin you need to stop these 5-7 days before blood tests

You need vitamin D, folate and ferritin levels tested

Have you been tested for autoimmune thyroid disease also called Hashimoto’s

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

[Reembow in reply to SlowDragon]

Hi @slowdragon!

Thank you for your kind response. So basically I do not have pernicious anemia but I was so low that the Dr I went to treated it as such. I am now not taking any b12 shots in a consistent manner, but I do check every so often to see if I am in need.

I was taking a multivitamin but as you stated I stopped it around a week before. So no supplementation at this time. My ferritin levels have always been low and have never gone up with oral supplementation. I was just out on a IV iron regimen and so far have had two infusions. This was a few months ago. I have not tested for autoimmune thyroid disease. I have also not tested for anything thyroid for a long while. I will definitely try to get tested. Hopefully things will clear up soon

[SlowDragon Ambassador in reply to Reembow]

Unless you’re vegetarian or vegan low vitamin levels are frequently associated with low thyroid levels

Ideally improve vitamin levels first then test thyroid

Recommend you get FULL thyroid and vitamin testing

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Post all about what time of day to test

healthunlocked.com/thyroidu...

edited as realised you are not in U.K.

[Reembow in reply to SlowDragon]

Thank you slowdragon !

my ESR is 47 and the range is up to 30. Does that mean anything ?

[SlowDragon Ambassador in reply to Reembow]

High ESR often linked to hypothyroidism

redcliffelabs.com/myhealth/...

[Reembow in reply to SlowDragon]

Hi 🤍 so the doctor wants me to do an ACTH stimulation test. Do you think it’s a reasonable demand ?