adrenal cortex antibodies - early stages Addison's

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adrenal cortex antibodies - early stages Addison's

Postby lucy » Tue Jul 22, 2008 2:07 am

Hi

I'm just wondering if any of you with diabetes and addison's were ever tested for adrenal cortex antibodies? If so were you positive or negative? Also for anyone with diabetes/hypothyroidism, did you addison's come first or second to those other illnesses and how did it present?

I have type 1 diabetes (for 10 years) and this year was diagnosed with autoimmune hypothyroidism. Since commencing thyroid hormone replacement, I have some symptoms of addison's (tanning despite bad weather; weakness; abdominal pain; dehydration; craving for salt and fluid; recurrent infections that I never seem to recover from). I recently had an 9am cortisol blood test, however as this showed up high-normal, my endo will not pursue further tests for addison's.

In the initial stages of my other endocrine diseases, my pancreas and thyroid spurted out excessive amounts of hormones (resulting in episodes of hypoglaecemia and hyperthyroidism) before they started to fail. I understand that most Addison's is not diagnosed until people are at a life-threatening stage of the disease.

Would having adrenal cortex antibodies tested be an early way to catch the disease before it becomes full-blown? Is it possible to have a high-normal AM serum cortisol in the early stages?

THanks
Lucy
:D
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Re: adrenal cortex antibodies - early stages Addison's

Postby gkardel » Wed Jul 23, 2008 9:05 am

Hi Lucy,

With type 1 diabetes and autoimmune hypothyroidism, you're definitely at a higher risk for Addisons. How old are you? Do you have any family history of autoimmune conditions? The symptoms you mentioned can be associated with Addisons. Others to look for are weight loss, low blood pressure and decreased insulin requirements and hypoglycemia. When hypothyroidism is diagnosed before Addisons, a very dangerous scenario can present so you need to be very careful. When hypothyroidism is treated in someone with undiagnosed Addisons, cortisol requirements will increase and the body will be unable to meet these requirements. Addisons symptoms will increase in intensity and risk of an Addisons Crisis will increase. This is what happened to me. My hypothyroidism was diagnosed 8 months before Addisons and over this time I started to have very bad hypoglycemic events even after cutting my insulin dosing in half. I was lucky to have survived this period.

You should check out this article and show it to your endo: http://www.medscape.com/viewarticle/460531_1. Your endo's concern for you having Addisons should be high. A 9am cortisol is definitely not the best way to diagnose Addisons. You should have an ACTH stimulation test and also be tested for adrenal cortex autoantibodies. Here's an article on this: http://edrv.endojournals.org/cgi/content/full/23/3/327.

Glenn
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