3 "borderline" cortisol stim tests, am I ok?

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Last December my OBGYN ordered a bunch of hormone tests due to some strange female cycles. Several of them were lower than normal, so she sent me to the Endocrinologist, who wanted to do a cortisol stimulation test, I think because of the very low DHEA result (31.1 mcg/dL; normal range is  57.3-279.2). So she did one stim test in early January, and my results were:

0 min 4.99;

30 min 15.2;

60 min 20.2

She called this borderline but just into "normal" so she asked if I wanted to go get a second opinion at the university hospital. I said ok, and they did another test a month or two later, and the results were borderline again -

0 min 4.7

60 min 19.2

(they didn't do a 30min one there)

So the university hospital sent me back to my endo and recommended testing again in 2-3 months to see if my numbers go more clearly one way or another. So last week my results were:

0 min 5.81

30 min 14.32

60 min 16.61

My Endo called with the results and said it looks like everything's fine, and she wouldn't recommend testing again unless I get more symptoms. I don't understand how this one is "fine," unless she just means there's nothing a lot more conclusive than the other two tests. I had read that baseline cortisol should be above 6, so I can see how I'm close on that. But I also thought by 60 minutes it was supposed to get above 20, and I'm getting a lower and lower result each time I test (20, then 19, now 16). Is that not a big deal?

It's not that I WANT to have Addison's of course. It's just that with the numbers borderline, and so many hormones below normal (DHAS, Prolactin, testosterone, thyroid - thyroid they have been treating since 2007, but I keep having to increase the dosage) shouldn't they do SOMETHING? I have all the symptoms (taken from NIH website):

"Chronic, or long lasting, fatigue

muscle weakness

loss of appetite

weight loss

abdominal pain

nausea

vomiting

low blood pressure that drops further when a person stands up, causing dizziness or fainting

irritability and depression

craving salty foods

hypoglycemia, or low blood sugar

headache

sweating

irregular or absent menstrual periods

in women, loss of interest in sex"

I definitely think it's good that they have been willing to do the cortisol test 3 times. Do you think the results are really "ok"? Is there anything else that I should ask to have tested?

Thanks so much in advance!

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11 Replies

  • Posted

    Clearly your not feeling well, Thyroid and Adrenals work together if one is low it will leach from the other which will eventually cause problems,  you need to try and stabalise your thyroid, easy to say I know as I used to have that problem. If you cannot stabalise them then you you need to look at diet, I know people think aww god diet thats rubbish, I know this because  I was one of those that said it, unfortunatly it can work especially for cases like yours to stop you going down the route of your cortisol levels getting lower and lower.
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    • Posted

      Hmm that is interesting. Even if we don't know why my thyroid is getting lower and lower, it sounds like maybe the other hormones were just low because I needed a higher dose of thyroid medicine. I have been on the higher dose for about 6 weeks now, but they haven't re-tested the other hormones. I still feel about the same though. Should I ask to have the other hormones re-tested, not just the cortisol test? It sounds like the docs are assuming that they are still low and aren't acting on that anyway, so I'm not sure if it would help anything.

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    • Posted

      Yes you will need thyroids checked and if they are come back low,  then up your dose of thyroid meds again until  they are coming back as a normal reading, then once that happens retest Cortisol..

      If your thyroids come back normal/High then retest Cortisol,  if your Cortisol is Low at this point then you know it is not your Thyroid leaching from adrenals, it would be a good idea to maybe speak to your doctor about maybe doing a cortisol saliva test. This will help see what your levels are through the day i.e morning, afternoon early evening and late evening. They should show Morning-Highest  Cortisol levels , Then the afternoon and so on,  going lower and lower through the day the lowest point being in the evening.  

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    • Posted

      Thanks Kenzii... That is in fact what happened - She tested my thyroid levels the same day as the cortisol test (prior to the cortisone injection) and the thyroid level was normal this time (after upping the dose of thyroid meds about 6 weeks ago), but the cortisol numbers were still borderline. She hasn't tested the DHAS or the other hormones (prolactin, testosterone) since early January though, not sure if that matters. I will ask about that and the saliva test next time I talk to her.

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  • Posted

    I recognize most of the symptoms  you describe.  I went to a naturepath who gave me hydrocortisol and other.  I suggest you look for alternative healers.
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    • Posted

      Please don't advise people to go to self-appointed quacks. Naturopathy "means exactly what I want it to mean, no more and no less!" (Alice in Wonderland). Practitioners just prey on the gullible. Imaginary 'medicines' only cure imaginary diseases (unless there is a lucky and unpredictable placebo response).

      Taking steroids [such as hydrocortisone] without very good reason and follow-up is dangerous in itself and may hide a very real underlying condition.

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    • Posted

      Judging without knowing, Roddy.  My nature path is an MD, who prefers the more gentle ways of healing.  I have profited from his knowledge enormously.  Tests were done and finally I was on my way to a better life.  Adrenal problems take apparently long to diagnose.  The established medical world couldn't find what was ailing me.  My nature path came highly recommend even by the conservative medical world. 

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    • Posted

      You were lucky to get a real MD (and the treatment he gave you was entirely conventional) and I'm pleased for you that it has worked. There is ample evidence that people get better and faster if the doctor has time to listen - see "placebo response". [Obviously not an underfunded NHS GP practice, then!]

       

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  • Posted

    I too had your symptoms and my cortisol registered at 1.....consistently for a 24 hr. period....my dr. put me on hydrocortisone in the morning and at noon. What an awful drug. I have gained 40 lbs and all of it in my stomach, face and back. I do not even resemble myself. I also agree that it masks other symptoms. Please....do not go on steroids unless you're 100% sure you need them. 

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    • Posted

      Interestingly, hydrocortisone for me was (is) wonderful! I went from just dragging along to being top of the world. Yes, I gained a little weight at first but finally had the energy to exercise it off without being exhausted for a week afterards.  But the reason HC worked in my case was that my natural cortisol was almost non-existent, so taking the tablets just brought me up to normal baseline.

      I've read a number of cases like yours where people have just ballooned and nothing will get rid of it, so I'm not suggesting for a minute that you can "just pull yourself together and get some exercise".  That's not how it works. I know that I've been one of the lucky ones (eventually).

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