Interpreting acth stimulation test results.....

Forum for Addisons and diabetes related issues.

Interpreting acth stimulation test results.....

Postby HELENA » Fri Apr 12, 2013 3:51 am

Hello,

I am struggling to find out what blood test numbers indicate a case of Addison's disease / adrenal insufficiency

Wikipeadia says:
In healthy individuals, the cortisol level should double from a baseline of 20-30 µg/dl within 60 minutes. For example, if the serum cortisol level was 25 ug/dl before the stimulation, it should reach at least 50 µg/dl.
Interpretation for primary adrenal insufficiency and Addison's disease
The baseline cortisol level in people with adrenal insufficiency is usually near 15 µg/dl. An ACTH stimulation test that raises the cortisol concentration to 20 µg/dl would support the diagnosis of primary adrenal insufficiency. In Addison's disease, baseline cortisol is well below 10 µg/dl and rises no more than 25 percent.

However I have also found other websites which indicate that cortisol levels in the range of (5-20ug/dl) are normal.
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My results are as follows.

Random cortisol taken at 10am: 10.1
Baseline acth stim test: 20.0 rising to 27.9 60 mins later (total rise of 39%)

Low sodium
High potassium
Low folate
low ferritin
high bilirubin
high bone turnover
Kidneys and creatinine (49) - Normal - my kidneys are functioning brilliantly at higher than 90%

Serum calcium appears normal however I have a number of large calcium deposits in my earlobes.

I am a type 1 diabetic with frequent hypoglycaemia (up to 5 or more times daily - yet my total daily dose of insulin is only 17 units)
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Please could someone let me know about the cortisol levels that would indicate adrenal problems. My results did not double upon stimulation. Any ideas why reference ranges differ with some saying 5ug/dl is normal and others saying 20ug/dl is normal?

The adrenaline rushes I experience are unbareable. Everything makes me jump out of my skin and I can't calm down for hours.

Many thanks Helena
HELENA
 
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