Adrenal hormones high

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Morning cortisol --25.9-- range--4-22

ACTH--53---range--6-50

i have hashis and diabetes 2 low estrogen am 69 yrs female do I have an adrenal problem? My vit D level is 44 my vit B-12 is 358 doc is doing vit deficiency labs. I am worried because when I try to raise my thyroid meds they don't seem to help and I get more fatigued. 

Tsh2.38

ft3--2.7

ft4--1.1

i know I need more than the 68.5 synthyroid that I am on because of fatigue. Some help needed for the high cortisol and ACTH is it a adrenal problem?? Called docs office and they never get back to me. Need to know now please help . 

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  • Posted

    Hello Jean:

    I am an RN - Nurse and live in the USA.  Our blood cortisol reference range in USA is 7-28. So you would not be considered High here.  You are slightly over in your UK ref. range of 4-22.  I am ssuming this is blood level and not a 24 hour urine collection sample.

    Your T4 is low and should be 4.5 to 11.2 and maybe you are not able to take LEVO and make T3 enough.   Ask your MD for another type of thyroid med.  Are you taking it an hour before meals?  Maybe you should try Armour Thyroid.  It is NDH. Your TSH is okay but I willrely on your symptoms.

    As long as your estrogen is low you should not see cortisol levels go haywire.  How about your mineral panel, potassium, iron, magnesium, etc...that all has to be okay for Levo (synthroid), to work well.

    Meds like Dilantin, or epilepsy drugs can spike your cortisol levels.  Try a different thyroid med, as our bodies are complex sometimes a pill stops working well, and I had to go through a bunch of them.  I suffer with Hashimoto's and was on Armour for years.  I was unable to take LEVO. I was not converting T4 into T3 well.

    I hope this helps  Be well - Shelly

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    • Posted

      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

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    • Posted

      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

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    • Posted

      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. 
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    • Posted

      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? 
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    • Posted

      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.

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    • Posted

      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

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    • Posted

      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? 
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    • Posted

      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

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    • Posted

      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

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    • Posted

      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.
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    • Posted

      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

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    • Posted

      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. 
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    • Posted

      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

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    • Posted

      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
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    • Posted

      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

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    • Posted

      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? 
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    • Posted

      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

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    • Posted

      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

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    • Posted

      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

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    • Posted

      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. 
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    • Posted

      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 
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    • Posted

      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

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    • Posted

      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
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    • Posted

      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

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    • Posted

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

      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

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    • Posted

      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

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    • Posted

      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

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    • Posted

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

      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

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    • Posted

      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. 
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    • Posted

      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

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    • Posted

      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. 

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    • Posted

      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

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    • Posted

      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

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    • Posted

      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?  

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    • Posted

      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

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    • Posted

      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?

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    • Posted

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

      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

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    • Posted

      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

       

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  • Posted

    Ref range

    8-10 am 0.04- 0.56

    4-6pm  < or = 0.15

    10-11pm

    < or = 0.09

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  • Posted

    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

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  • Posted

    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

     

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  • Posted

    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

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  • Posted

    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

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  • Posted

    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

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  • Posted

    Hi shelly

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

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  • Posted

    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. 
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  • Posted

    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

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  • Posted

    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. 

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  • Posted

    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

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  • Posted

    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? 
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  • Posted

    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.
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  • Posted

    Hello Jean:

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

    XO< Shelly

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  • Posted

    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

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  • Posted

    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. 

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  • Posted

    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 

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