ACTH stimulation test reaction

Forum for Addisons and diabetes related issues.

ACTH stimulation test reaction

Postby sadie » Thu Feb 10, 2005 10:43 pm

Hello!

I just had an ACTH stimulation test performed today (250mcg standard test). I did fine during the test but within 2 hours of finishing it, I had horribly sore and cramping leg muscles, felt achy all over, had a bad headache and felt fuzzy/lightheaded. I still feel this way tonite (12 hours later). This severity of symptoms usually happens after I really overexert myself and a trip to the doctor doesn't usually do this to me.

I am not sure what to make of this reaction at all. It doesn't seem that anyone else has a reaction to the test. I don't know if it was unrelated (stress or overdoing it yesterday, etc) or due to the stimulation itself.

I don't have a diagnosis yet, so I worry what this means about me. Has anyone had a negative response to this test? If so, what were your symptoms and your final diagnosis?

Thanks-I know I am being a worry wart. I just so desperately want a diagnosis.
Sadie
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Postby gkardel » Fri Feb 11, 2005 10:47 am

Hi Sadie,

I didn't have any adverse reaction to the ACTH stim test. Depending on results from this test and if your doctor suspects secondary Addisons (pituitary disease), you may have an insulin stimulation test which evaluates the hypothalamic-pituitary-adrenal axis.

Glenn
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Postby SueM » Fri Feb 11, 2005 2:13 pm

Hi Sadie
I had a bad reaction to the test same symptons as you :(
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Postby sadie » Fri Feb 11, 2005 4:44 pm

Hi Sue and Glenn,

Thank you for your responses, it is always good to hear what has happened to others. I am feeling a bit better today but still feel thrown for a loop.

Glenn, I wanted to thank you so much for your creation of this beautiful Board. It is so well-organized and has such good information on it. You attract intelligent posters with good things to say and that is fabulous!
Thank you-I know it is a lot of work to make something like this work and keep up with everyone as well as you do.

Well, I got the results of my stimulation test and it was normal. Normal has been the bane of my existence in my quest for answers. The pre sample was 8.2, 30 minutes: 20.0, 60 minutes: 25.3. I suspected it would be normal (every test I have done during this nightmare has been normal) but it is still somehow disappointing.

I think that I may well have secondary adrenal insufficiency. I am currently scheduled for further testing of my HPA axis in the next few weeks (a low dose ACTH, an Arginine stim for GH and maybe a CRH stim if it can be scheduled). I wonder about hypopituitarism, as my TSH/T4 values are both always low normal and my IGF-1 values are also in the lower end of the range for my age group.

I am a 37 year old female veterinarian who specializes in internal medicine in dogs and cats. I did my residency at a school that specializes in endocrinology, so I have always loved this area of medicine. I find it painfully ironic and incredibly frustrating that I haven't been able to get a diagnosis for myself, even though I really think this is the problem. (I think the doctors have ruled out everything else looking at the hideously long list of diagnostics done on me in the past 2 years.)

I have been lucky enough to recently find an endo who is very responsive (although I travel from Colorado to see him in California) but he still is unsure of the answer. I have faith he will figure it out soon.

My symptoms include severe fatigue, muscle pain and weakness (twitching/cramps, too), some jt. pain, hair loss, thin skin, no weight gain but redistribution of fat so I have a pot belly and thin arms and legs, irritability and depression, insomnia and poor sleep, GI problems including bad bloating and severe heartburn, orthostatic hypotension with dizzy spells and lightheadedness, a constant headache that is often severe, complete loss of libido, flank pain, chest pain with shortness of breath (no one can find a reason for it), and I am always cold-especially my hands and feet. I have a weird gold skin discoloration under my arms, bra-line, neck, inguinal area, waistline, knuckles, knees, and finger tips (pressure points and rub spots) that looks like a strange tan. I originally thought is was "acanthosis nigricans" which happens with insulin resistance but I always have normal insulin levels when tested (3.0 at last check), although my blood sugars are sometimes elevated (160-180 2hr post prandial) and other times normal (less than 120 post-prandial). Don't know what to make of that part.

I was diagnosed with asthma in 2001 and have had several occassions of needing prednisone. My symptoms predated the steroids, but certainly the steroids exacerbated the problems. What I have noticed is that I do really well on steroids (all of my symptoms go away) but then I get sick again as I wean off of them. I've only been on three short courses (7-10 days once a year sort of thing) but I never perk up again, even after one year of being off of them altogether.

I used to work 80 hours a week and run 5-8 miles 3-4x/week. Now I am stuck at home. The more I do, the worse I feel and I have learned that if I just "chill out" I can maintain homeostasis a bit better. I was still out trying to run in September last year but was realizing that it was landing me in bed miserable everytime for 2-3 days...it wasn't worth the price anymore and that makes me so sad.

My husband has also been sick and was diagnosed with a pituitary tumor last year himself. He is on hormone replacement but we haven't found quite the right balance for him yet-I'm wondering what has been missed. We're quite the little hormonal family. It is good from the standpoint that we certainly empathize with each other and have been a strong source of bilateral support. It isn't so good, though, when we crash at the same time---the dog hides under the bed!!

I really like you all and enjoy visiting this Board. I wanted to share my story with you. If you have any thoughts or ideas for me-I'd really love to hear them.

Sadie
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