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For several years I've had a ton of unexplained symptoms and have been very poorly and getting worse, although having recently gone through and checked the side-effects of the meds I'm on, some of my symptoms could be caused by the meds!
I was seen by an endocrinologist at my local hospital in September who discharged me without doing the ACTH stimulation test, even though my morning cortisol (I got there before 9am but due to the queue my bloods weren't taken until 10.30am) was 290 and the guidelines say the ACTH test should be done if it's below 400.
My GP agreed to refer me to another hospital and said in the letter that my cortisol was 290 and asked them to do the ACTH stimultation test. I went there before Christmas at 8.30am to have some blood tests, which included cortisol and ACTH but not the ACTH stimulation test, so I'm not sure if they've made a mistake or if it's normal to check the ACTH.
I've got an appointment with a consultant on 3 January. Assuming my cortisol is still below 400, I think they'd still need to do the ACTH stimulation test regardless of what the ACTH result was, as the guidelines make no mention of the ACTH test being a substitute for the ACTH stimulation test.
I paid for a private TFT test in June, as my GP said he could only order the TSH, not the Free T4 and T3, which seem to rule out a thyroid problem:
TSH 2.33 (0.27-4.20) IU/L
T4 Total 112.5 (64.5-142.0) nmol/L
Free T4 18.31 (12-22) pmol/L
Free T3 6.13 (3.1-6.8) pmol/L
Anti-thyroidperoxidase abs 7.6 (<34) kIU/L
Anti-thyroglobulin Abs 12.5 (<115) kU/L
My local hospital did some tests again in September, including some related to the pituitary gland as the consultant thought that might be the problem rather than my adrenal gland, which came back (I don't have their reference ranges)
Free T4 19.5
Free T3 5.6
Testosterone 10.9 (this was 22 in May!)
LFT and full blood count normal
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