Adrenal Function

[sandymbme]

I am being seen in my PCP's office on monday to evaluate my adrenal function. We did salivary cortisol tests and apparently the findings were signifigant. She won't discuss them over the phone. So I have seen some mentions of adrenal surges, etc., and wanted to know if anyone had ant insight to share? I am a little nervous about the results, but also kind of excited. If they could find something dramatically wrong that is treatable, I could potentially regain some health. And as much as my condition has disintegrated, I would give anything for some improvement!

[Broken_Shell]

Were these pm salivary cortisols or samples taken throughout the day? Let us know when you find out what the abnormalities were.

~ Broken Shell

[flop]

I had salivary testing for cortisol and DHEA levels last year (4 samples over a day). My results showed that I had moderate to severe adrenal fatigue. The thinking is that when my body was stressed by POTS my adrenals would put out a surge of cortisol and adrenaline to cope with the physical stress. Eventually the body can't keep up with the demand for cortisol and the adrenals can't cope so your cortisol levels drop. I am taking various supplements including Siberian Ginseng to help to support my adrenal glands. My practitioner told me that if my adrenal fatigue was worse that I would have needed to take steroids.

Flop

[ramakentesh]

Yeah i think the end result of most mechanisms of POTS would result in some sort of exhaustion of the adrenals.

[EarthMother]

I did one of those 4-spit-a-day adrenal tests a few years back and repeated it this spring. Results were almost identical. My adrenals seem to be fine. A tad low perhaps in the morning but still within the "normal" range. I have also had the ACTH push done twice in the last dozen years ... most recently last summer to rule out Addison's disease. I was nervous about the ACTH push -- they shoot you up and watch to see what happens. But my body seems to be able to handle a rush of hormone just fine. Well duh! I get rushes all the time on my own and my body does just fine kicking into high gear. lol

Good luck on your office visit. Its important to know how each of these pieces fall into place!

[sandymbme]

I had the test where they took 4 samples throughout the day. My cortisol was fine all day until the last sample when it fell out of normal range. What my PCP found VERY interesting was that my progesterone was "freakishly low" and my testosterone was very low. She said the hormone results were adrenal precursors and that my results indicated adrenal fatigue. So she is going to start me on natural progesterone and DHEA. I will keep everyone updated on how it goes!

[tilly]

I did one of those 4-spit-a-day adrenal tests a few years back and repeated it this spring. Results were almost identical. My adrenals seem to be fine. A tad low perhaps in the morning but still within the "normal" range. I have also had the ACTH push done twice in the last dozen years ... most recently last summer to rule out Addison's disease. I was nervous about the ACTH push -- they shoot you up and watch to see what happens. But my body seems to be able to handle a rush of hormone just fine. Well duh! I get rushes all the time on my own and my body does just fine kicking into high gear. lol

Good luck on your office visit. Its important to know how each of these pieces fall into place!

I am to have a test call the short synachthen test is this the same thing ? .... i have been so scared in case it makes my tachy worse ... my cardio says he wanted to rule out addisons disease .... what is the difference with the ACTH and the chewing test ? why would i be having the injection ....

can you choose which one you have ... does it give the same results ??? ...

tilly

[futurehope]

Tilly,

I can tell you what I know but I'm not a doctor. I had a cosyntropin stimulation test. They take a reading of your adrenal output before the test, then inject you. Then you wait a specified time, I think 30 minutes, and they retest your adrenal output. A normal result is that your adrenals react appropriately and increase their output after stimulation. Adrenals normally work by being stimulated by another hormone called ACTH which is produced by our pituitary gland. I think the stim test is to see if your adrenal response is appropriate to a simulated pituitary hormone.

The salivary test does not require external stimulation. They are measuring your cortisol output throughout the day, say at 8 AM, 12 PM , 4 PM and 11 PM. To do this, they test the amount of hormone in your saliva.

They expect a normal rhythm and change throughout the day within a normal range.

Anyone out there, please correct me if I'm wrong. Thanks.

[flop]

Tilly is right.

Usually the pituitary releases ACTH (Adrenocorticotropic hormone) which is the chemical signal for the adrenals to release the stress hormone cortisol.

The Short Synacthen Test (SST) (Synacthen = synthetic ACTH) is used to detect Addison's disease (adrenal failure).

In the SST they take a baseline Cortisol level (usually at 9am) and then give an IM injection of Synacthen which should stimulate the adrenal glands. They then take another blood cortisol level 30 or 60 minutes later (depending on the hospital's protocol).

The cortisol level should be much higher on the second blood sample. If the cortisol doesn't rise enough it would suggest Addison's disease. Addison's disease is a very serious life-threatening condition that causes low blood pressure - it needs urgent treatment with replacement steroids.

The Short Synacthen Test does NOT test for adrenal fatigue - it is not sensitive enough for that. Many doctors don't recognise adrenal fatigue as a medical problem. Adrenal fatigue is not life-threatening and doesn't usually progress to adrenal failure but it does leave you feeling exausted and unwell! (I have adrenal fatigue diagnosed on 4x salivary cortisol samples and have had a normal SST).

Flop

[sandymbme]

Thanks so much for all the input! I am going to talk to my doc about whether she thinks testing for addison's would be reccomended at this point. She felt the flourinef compensated to a degree for the cortisol results, but the fall throughout the day definitely suggested adrenal fatigue. She was quite concerned about the hormonal results, just because they were so far out of range. I pick up the scrip for the progesterone tomorrow, we'll see what happens....

[flop]

I forgot to say that the same pre-hormone is used to make both cortisol and some of the female hormones like DHEA-S. When the adrenals are struggling to make cortisol they pinch all the resources from the female hormones and turn them into cortisol.

Flop