Adrenal hormones high

Doc is doing 24 hour urine and dexamethasone pill what is she looking for adrenal prob?

Iam in florida use quest labs

Hello Jean:

Yes, 24 hour urine is to see the amount of cortisol put out in a 24 hour period. It is a very good test to see how much is in your urine in that time period.  The Dexamethasone tablet you take allows them to 'shut off " the adrenal gland and then check by a few blood level draws for your cortisol level.  They sometimes need to check and draw blood at different times of the day.

Some people may have a tumor on the gland and it can secrete the hormone also, so it tells the doctor if you have a problem.

I had this done when they were testing me for Cushing's syndrome.  It is a good test and will help the doctor rule out any adrenal problems.

I hope this helps, Shelly

Ask for your labs after it is done.  Keep a copy in your records. I am in the USA also and I trust your lab results.

Shelly

Thank you so much for the info. I shake in morning at 8 am when I get up I guess it's the high cortisol it stops about 10 am. 

Would cushings have shown up in an ANA screen panel?

Would cushings have shown up in an ANA screen panel?

Would cushings have show up in a ANA panel?

Also  my Dhea is 147 range is 12-133 for a person that's 69 like me they say it would be ok to 200 quest labs is it ok? 

Hello Jean: 

The ANA test is good for Lupus, Hashimoto's, Rheumatoid Arthritis, and Sjogren's.  It is looking for antibodies only. 

The Cushing's Test is a blood draw test over a period of 24 hours with you taking the Dexamethasone tablet to "shut off" your adrenal gland.  It also can be detected from the 24 hour urine test.  They can tell by that and it is easier.   I hope this helps.

Hello Jean:

Normally DHEA levels decrease around age 30 or so in women. Your level is a little high for your age, and I wonder if you have an adrenal tumor that is making extra hormone.  They can see that on a CAT with dye and I would ask for that test.  have you had that done?

Keep me posted, sorry for the delay in answering.  Shelly

No haven't had cat yet doing urine and dexa pill this week first. Can an adrenal tumor be removed with levels returning to normal? Will three be no further problems from the tumor? Will my thyroid meds work more efficiently.? Can this tumor cause my bad fatigue? 

Hello Jean:

I have an adrenal tumor and did the above tests you are going to do.  My tumor is not making any extra hormone and was less than 1 inch big.

The problem with these tumors is if they are in an area like the adrenal cortex of the gland and then they would have to remove the whole  gland!  you can live with one gland but since I was not having any symptoms I decided not to have it removed.  Mine was found by accident when they were doing a CAT scan for a kidney stone.

Yes, they can remove it -depending where it is as a single tumor. If your cortisol is high, it would be wise to remove it and yes, it can cause problems like Cushing's Syndrome.  It can make you feel awful  and fatgue goes along with that syndrome.  There is a related link to thyroid disease and adrenal gland problems. Yes, extra cortisol is going to interfere with your thyroid meds.

Ask your doctor to order a CAT scan with dye, to see what is going on. Let me know how the Dex test came out.  I guess the next step would be to image it after your blood work.  I had an endocrine surgeon who ordered my imaging.

Shelly

Does the urine test and dexa pill test show a better true level of the cortisol? 

Hello  Jean:

Yes, the Dexa tablet and 24 hour urine collection test are very good tests to see what your TRUE cortisol level is.  Since the tablet will "Shut off" for a short time your adrenal gland and if you are making too much it will be in your urine.  I did it also.  You must get all your urine in the time period.  If it comes back high, you may have a tumor there.  Let me know how it goes.

Shelly

I will let you know when I get results back. 

Hello Jean:

Okay, I hope all goes okay. Thinking of you,

Shelly

I may not find out til next Monday thank you 

jean

Don't know if I told you but I have shakey hands when I get up at 8 am. Til 10 am. Is it the cortisol. Can't figure this out.

Hello Jean:

Shaking can come from a myriad of things.  You could have low blood sugar episodes or it could be related to your medication for thyroid as it is absorbed in your body, or your adrenal gland maybe producing too much cortisol and the bodies reaction.

It is hard to say, but keep a log of it and at what times it happens, since it may be helpful to your doctor to know.

Shelly

Thanks Shelly nothing from doc yet. Jean

Shelly what med finally worked for your thyroid? I was thinking if it turns out that this is only thyroid and I don't convert well how would armour med work for me better? Does it convert better for people? This synthyroid and cytomel is not working for me. 

Hello Jean:

When I was in my  mid 20's I was on synthroid that was 1987.  However I was on a small dose and my TSH was still low.  I woud get heavy cramps and loose bowels maybe 7 times in a day from Synthroid.  Doc put me on Thyrolar and still TSH T3 & T4  would be bad.  So he switched me to Armour Thyroid and it was good until it was hard to get at my local pharmacy, so I am on just T3 - Cytomel.  It made me feel the best, and I was not tired anymore and my T3 level was good and so was TSH.  I have hardly any T4.  I just can't absorb it well and convert it to useable T3.

It really was years for me playing around with different ones to see what works. I have a good GP and he looks at my symptoms and not just blood levels.  He was the one who figured it out, for me. Endo's just wanted Synthroid....LOL. 

Armour is a good drug, and some say you can find it over the Internet.  Check and see if your local pharmacy carries it.  I liked it, and it may work better on you. It is natural dessicated hormone.

I hope this helps.  Shelly

Just update can't have MRI til July 30 th symptoms are miserable trying to hang on here til then. Cortisol came back high in urine and blood tests. 

Hello Jean:

I am sorry to hear this!  Hang in there!  I am glad you will have an MRI though.  It sounds to me, like a tumor on your adrenal gland and it is making extra hormone in your body.  It is common to have a tumor but it is not good when the tumor acts like the gland and makes extra cortisol.

Please let me know what the MRI finds out.  Sorry for the delay in answering.  Be well, Shelly

So if the tumor acts like the adrenal gland do they have to take out the adrenal gland? You sound like it's more the adrenals than the pituary then right? Your going by the dexa test and the 24 hour urine tests being over range right? 

Hello Jean:

I have a tumor also on my adrenal gland.  When they did a CAT scan on my kidney, looking for a stone, they saw the tumor on my left adrenal gland.  I did the 24 hour urine and it was a little high for cortisol.  Blood was okay.  My tumor was under an inch and so far not functioning.

It is common to get a tumor on the gland, the problem is where on the gland it is the tumor, and if it is "functioning" and making extra hormone.  Mine was very small and not yet functioning. 

Yes, most of the time they have to remove the whole gland which sits on top of your kidney.  The good news is you have 2 of them, bad news is, you may or may not make enough of your adrenal hormones if one is removed.  However, if the tumor is doing it, it would be best to remove it.  I believe it is a tumor, more than Pituitary Gland.  We grow things in our bodies as we age.  You will know for sure after your MRI and I hope it all goes well.

Keep me posted.  Shelly

Hi

 thanks for explaining this info to me so fast really helps. I hate feeling so sick. Between the thyroid and now the high cortisol this is not fun! Need to get rid of this fatigue. Ty again jean

Hello Jean:

No problem, we all are in the same boat.  I am so glad to be able to help in any way I can.  It is nice to have this forum and to reach out and hear from people who have our conditions.  When I first got Hashimoto's thyroid disease there was no Internet and no support groups.

If you need to have it out, I think you will feel better in the future.  Thank God for modern medicine and having good imaging.  Be well, Shelly

Thank you so much for your kind words I really appreciate it. I will see my endo on Wednesday will see what she has to say about all my blood and urine tests. Then July 30 MRI. I will let you know what she has to say thanks again. 

My endo just changed my appointment til august 21 I am not waiting that long going to see if my GP can cat scan my adrenals next week fed up with these docs who think patients who are so sick can wait on them 

Hello  Jean:

Any doctor can order an MRI or CAT scan.  Please see an Endocrine Surgeon.  I saw one because they are the doctors who can operate if needed.   This doctor is both a Endo and a surgeon.

Have your GP refer you to an Endocrine Surgeon.  Also call your Endocrinologist up and ask to be placed on a wait list in case anyone cancels an appt. with him, you would like to see him earlier.

Please tell the receptionist you are not well and have high levels of cortisol and would like to have an earlier appt. and to be put on a wait list or can they fit you in earlier than August 21.

If needed see if you can see another Endo in your area.  You really need the Endo-surgeon.  Keep me posted.  Shelly

Yes my GP has many contacts in our area he should know a good one if it is adrenals . I am so mad over this. Seeing GP Wednesday. Telling him what's been going on and bringing all my blood tests to him too. Ty jean

Can they see adrenal tumors with a cat scan?

Hello Jean:

Yes, a CAT scan with dye can show it but an MRI  is much, much better!  They need to see the way a tumor is orientated on your adrenal and a clearer picture is gained from an MRI.  I had both.  My CAT scan found the tumor by accident, looking for a kidney stone.  I later did an MRI of it. 

The better the picture the more accurate the diagnosis will be.  They need to measure the length and see how it is attached, etc...

Any doctor can order an MRI or CAT scan.  Tell your GP, what is going on.  Keep me posted.  Shelly

Shelly is there any medicine to lower the cortisol while I am waiting for the MRI to be done?

Hello Jean:

The Dexa Tablet can "Shut off" the gland and it's hormone in a temporary timed period.  I guess you could ask your GP if you could take it, (maybe every other day), to help reduce your high levels. It is not used that way normally.  It is normally used for a blood test to get the so called true level.  It is really hard to stop the gland on a long term basis.  They do surgery as a permanent solve.  Ask your GP, if anything can be done in the short term. Let me know, Shelly

Shelly is there anybody on here that's going thru this that I could talk to?

Hello Jean:

Try and post a new post under Adrenal Gland on this forum.  Right now you are on the Thyroid forum.  This is a British web forum and we both are in the USA.  I know some of the ladies talk about Adrenal issues but go look under  "A" on the index.  I am sure there are others on here just maybe not on this thyroid forum.  I hope this helps, Shelly

Shelly

  did you have any reactions to contrast dye after your MRI?

Hello Jean:

No I had no reaction to the dye.  When they are going to do the dye, it feels warm from Head to Toe.  It goes very quickly in your  IV port or IV line, and it is painless other than the warmth.  It is short lasting and well worth it.  After the MRI you should drink lot's of water to flush your system.  You do have to stay still while the MRI is going.  I hope this helps.  Did you see if you can be on the wait list for the Endo? Shelly

No pituary tumor but she wants me to redo the 24 hour urine and dexa blood draw don't know why not do adrenals 

Hello Jean:

I knew it was not your pituitary gland....LOL.  I think your doctor wants to make sure the first 24 urine was not a fluke.  Doctors like to have 2 blood tests that are abnormal.   It helps them prove to your insurance company, that you have a real problem!  Sometimes they have to show your file to your insurance company for approval of an MRI or for futher diagnostic work.    Do it again, I am sure it will be high.

She should order a CAT scan or MRI of your adrenal glands.  Keep pushing for that!  I am sure she will.

I only had to do the 24 hour test twice, blood once.  I am sure you have a growth on the adrenal gland.  I think the growth is creating extra hormone (cortisol) in you.

It is common for thyroid people to have cysts or tumors on our adrenal glands.  keep me posted on what happens.  Don't worry it will be solved soon.

XO, Shelly

Yes I am going to push for the adrenals to be tested need relief soon have absolutely no motivation due to fatigue it's awful ty so much for your input. 

Hello Jean:

I am sure your MD will order CAT or MRI of adrenal glands.  If you can send a fax or e-mail to your doctor requesting it.  That way it gets in your file.  They have to keep a copy of any requests or letters etc...Kindly say "you believe the problem is with your adrenal gland and it needs to be imaged."

Any MD can order an MRI or CAT in the USA.  I hope this helps. Shelly

Ty Shelly working on the doc. 

Hi shelly

   Still waiting to see doc on Friday going to ask for a cat scan of adrenals. Redid 24 hour urine and dexa pill test came back high normal lower than the overrange last month. Why do you think it did that? Still having bad fatigue spells. 

Sounds like you need to put the request in writing before you go to see the doc.

Hello Jean:

I am so glad you have a CAT scan scheduled. Well, the 24 hour test still was high.  Glad it was "high Normal" but it still is coming out on the high side, so I still think you have a tumor or a growth that is producing extra cortisol.  I am hoping the CAT scan shows something, so you can know for sure.  The fatigue is related to this.  Let me know when it comes back or what the doctor thinks when you see him on Friday.

I was thinking about you today. XO Shelly

Yes I sent it to my portal at her office

I will Shelly I still shake at 8-10 am every morning

Hello Jean:

Make sure to let the doctor know this.  I am sure you told them. Thank God for imaging today, and I know it will show what is going on with the gland. Keep us posted. XO Shelly

I will let you know ty for all your help. You have been so helpful to me. God bless

Well went to see the doc. 

1-- she wants me to get MRI disc to look at it. 

2-- wants me to have a PET scan full body.

Do pet instead of cat to rule out any cancer . Then maybe a nasal tube thing to look at pituary don't know it's called. 

Shelly I just found out the ACTH test wasn't done right at lab. They were supposed to use a chilled tube then spin and freeze the blood draw. Should I have it done again?  

Hello Jean:

Yes, that is a good idea to get your imaging and make sure you keep the disc and let them "burn" one - if they need to keep it.  Most hospitals will give you first one for free, then they charge up to $25.00 or more for extra's.  So make sure you get it back in case you need to see a surgeon.

PET scan is a good test and will tell if the growth is cancerous, and yes, do it, since you need to know that!  It could be cancerous and it is very important to know early so it cna be treated correctly. The scan does not hurt but they have a special contrast.

I know they can image your brain area via a nasal scope and my hubby had one done for polyps that were near his brain.  I would also agree that it is wise to do that.  It is amazing what they can see on imaging and it helps to diagnose you correctly and if a surgeon needs to do surgery they would need it.  It may be called stereotatic imaging.

Yes, repeat the ACTH if needed.  Lab people make mistakes and if your doctor needs that test, then I would redo it.

I am so sorry that you have this problem.  I hope it is not cancer.  I do think you have growths that are causing this high cortisol.  I am glad you did the CAT and prior MRI.   Let me know when you are scheduled for your tests.   XO Shelly

Shelly

do you think my ACTH level 53 range--6-50 is really that high to be concerned about cancer?? Or is she just covering all bases?

If I have just an adrenal tumor will it produce both cortisol and ACTH  and give me high levels in both?

Hello Jean:

I would say you are a little over the normal ranges.  I think it is a "growth" and that it is making extra cortisol.  Most adrenal growths are non-cancerous.   Cancer is quiet and many people do not even know they have it.  How was your other blood work?  Sodium & RBC's tend to go off of normal when you have a cancerous tumor.  If they are okay, that is a big help.

It is wise to rule out Cancer.  Why not?  So I agree with looking at it that way. 

Any growth could produce or be functioning like your adrenal tissue and give you extra of both Cortisol & ACTH.  I do agree with looking at it via the PET Scan, as that will let you know and give yo peace of mind.  When is the PET Scan scheduled for?  XO Shelly

Ty will let me know next week. My sodium and RBC's are fine.  I will let you know when my pet is going to be. Ty again jean

 

Shelly 

does this mean my midnight cortisol is to low?

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Dear Jean97781:

The highest ranges tend to be early morning and mid morning times of course without exceeding the so called "Normal Range."   It looks that way from your results, that it is too low.

When did you get set up for the PET Scan?

XO, Shelly

Haven't heard about an appointment yet. What does the to low at midnight mean do you know?

Dear Jean:

It normally is low-ish during sleep hours, then in early a.m. it builds a higher amount.  The next highest should be mid morning.

Maybe the adrenal gland is damaged somehow and it is causing it to not produce enough even during the low hours. The adrenal gland could be intermittenly working, over producing in a.m. and sort of too low at times.

It really needs to be looked at for a growth or for damaged areas. 

XO Shelly

 

Ok thanks Shelly I am going to call her office tomorrow thank you

Dear Jean:

Another problem that can make it too high in morning and maybe too low at night, is a condition called "Cushing's Syndrome".  You can also have it as an intermittenly condition.  An Endocrinologist would know about this more. 

XO,  Shelly

Hi Shelly 

having a PET scan next Tuesday finally. My repeat ACTH test came back normal. Midnight saliva cortisol normal. Will let you know when pet comes back. Jean

Dear Jean:

Oh that is good news.  Please let me know when it comes back.  I will send you via a Private message my e-mail.  XO Shelly

Hi shelly

 had my PET scan this morning. Will hear wed or Thursday. I lost your e-mail address could you send again? 

Jean,  I will PM you.

Shelly

Well since synthyroid and cytomel is not working I am going to try armour thyroid med I feel so miserable right now and hypo. Cortisol is back to normal. I don't know what my doc will start me out on since I have been on 75 t4 and 5t3. Will ask her tomorrow. 

Jean

Armour Thyroid is good.  Give it a try. Well I used to take it and it does work and it comes in different amts. Your doctor will know the right amount to start at. 

I am glad the cortisol came down, that is great news.  Let's try the Armour Thyroid out and see how you do.

Keep me updated, Shelly

Shelly

i am on arm our 60 is it normal to have ups and downs when first starting? It's day 4 on arm our. 

Hello Jean:

Armour thyroid is a natural made from a pig's gland thyroid med.  It can take 6 weeks to see a level stabilize.  It takes the body a while to adjust and then if the level is still low, it can be adjusted.

XO, Shelly

I. Have been on the armour now five days the last three days I have woke up with depression take my 60 mg at 8:30 am by 1 pm the depression is gone til next morning also wake up with shakes an hour after I take pill the shakes stop this evening after dinner I got a cold feeling tho it's 78 in house is this all from adjusting levels? 

The armour is working for me it's only 8 days but feel better mentally and morning shakes are gone brain fog too so I am progressing so glad.

Hello Jean:

That is wonderful news. Armour is a great thyroid med.  Glad to know it is working.  Keep us all posted.

XO< shelly>

Hi shelly

i am on armour 60 for 18 days is it to early to look for increased energy?

 

Hello Jean:

It normally takes about 6 to 8 weeks to see a new level.  Then you should have your blood drawn and from there it may be increased to a larger dose if the blood shows low.

Hang in there, you have a bit more to go. 

Shelly

Ty ShellyShelly

Hi shelly

been on the armour for 88 days the 60 bumped to 90 the last 45 days feel so much better on it than the synthyroid and cytomel it's much more stable too. 

Hello Jean:

Happy New Year!  Oh that is great news. Armour Thyroid id a wonderful med and has been around way before Levo. I was on it in the early 1990's but since I have a T4 converting problem, I just am on T3 Cytomel.  However this is wonderful news!

Keep in touch and if anything comes up just ask. It is good to know you feel much better.

XO, Shelly