Cortisol levels

[Overton25]

I was on steroids three years ago for adrenal insufficiency but it got better in around seven months. I have been feeling very tired again and recently had a blood test to check my cortisol levels which the endocrinologist said was unsatisfactory and I went for an acth test which I passed. How accurate is this test? Is it possible to still fell rotten if I passed the test?

[greygoose]

It's accurate, if doctors know how to interpret it. Thing is, it's not a pass or fail test. It's to find out why your cortisol is low. Is it because your adrenals are malfunctioning or is it a pituitary problem. But they seem to ignore that part.

Do you have your results and ranges?

If you had adrenal insufficiency it usually doesn't go away. Or was it adrenal fatigue? Not the same thing, but both result in low cortisol. How do you know it got better?

[Overton25 in reply to greygoose]

They repeated the test after seven months of steroids and it was fine. No numbers on the test they just said I passed it. It was adrenal insufficiency I had caused by an o eta give thyroid which levels are now ok. I just don’t understand how I’m still feeling crap. Thanks

[greygoose in reply to Overton25]

Well, without any numbers to go by, neither do I, I'm afraid.

[greygoose in reply to Overton25]

They repeated the test after seven months of steroids and it was fine.

If you had adrenal insufficiency and you'd been on steroids for seven months, the test results were fine because you were taking the steroids. Not because your adrenals had recovered. I don't think these doctors know very much about adrenals.

My guess is that your adrenal insufficiency has returned and that's why you're feeling bad. 'Passing' the ACTH test does not mean that your adrenals are going to suddenly recover and start making adequate cortisol again.

What they mean by 'pass' is that the adrenals reacted to being injected with the stimulus and produced more cortisol. But what it also means is, the adrenals are not getting the stimulus they need on a daily basis and therefore cannot make enough cortisol: Secondary Adrenal Insufficiency. So, that means that your pituitary is malfunctioning. This is not going to change just because you've had the ACTH test. The pituitary is going to continue malfunctioning so your adrenals are going to continue being incapable of making enough hormone. And I only wish that doctors understood that.

[tattybogle in reply to greygoose]

"It was adrenal insufficiency I had caused by an o eta give thyroid which levels are now ok. I just don’t understand how I’m still feeling crap. "

is that supposed to say 'overactive thyroid ' Overton25 ? ... or underactive ?

whichever ~ it would be a good idea to get hold of these ' now ok ' thyroid blood tests and post them here ... and also to give us a bit more detail about the history of your thyroid issue.

some GP's opinions on what constitutes 'now ok' thyroid results can be very unknowledgeable .

[Dino40]

Did you have a SST test where they measure your cortisol and then artificially inject you to try and stimulate your adrenals and then take another blood test at 30mins and then at 60mins?

[Overton25 in reply to Dino40]

Yes I did and I passed the test

[Dino40 in reply to Overton25]

I just wondered as you mentioned ACTH test and not a SST test. It would be good to try and find the numbers. It can be that artifically your adrenals can respond when artifically stimulated but not naturally.