Testing For Adrenal Disorders And Addison's Disease

[jump]

Hello all,

I am seeing my PCP this week, and I want to ask her about addison's and/or adrenal insufficiency again, since I have pretty much all the symptoms, and I also have autoimmune thyroid disease and gluten intolerance, all of which often go hand in hand with adrenal problems.

The last time I asked her about adrenal issues, she said that if anything was wrong with my adrenal glands then I would have a potassium abnormality in my routine yearly blood work, so she did not run any further tests. I know from reading here that a potassium level alone doesn't diagnose or rule out adrenal problems.

So what tests should I ask her to do, to rule out adrenal issues?

Thanks!

[firewatcher]

For accuracy, you need to see an endocrinologist for adrenal testing. A PCP's lab and staff are not usually equipped or qualified to perform an adrenal stimulation test.

[sue1234]

For Addison's disease, a fasting morning cortisol, pretty much right around 8:00 a.m. IF you can get her to add in an ACTH, that would be a good extra to run.

The big test to see how your adrenals respond would be the cortrosyn stimulation test. It takes, I think, 1 1/2 or two hours. It will see if your adrenals respond well enough to stress.

I have found lately that doctors might not think to run things on their own, but have been pretty receptive to my requests for specific testing.

I recently had a highish potassium(gyn test). I'll have to ask my endo.

[Dizzysillyak]

http://www.adrenalfatigue.org/what-is-saliva-testing.html

Has anyone here tried the saliva test ? I'm not big on getting injections of something that my body might not like. One of the reports I read said that some people have reactions to this ...

[Birdlady]

Here's what you can have done. A PCP won't be able to order all of these though.

These need done at 8am, fasting. If you smoke, you'll likely raise both of these levels since smoking raises cortisol.

AM Cortisol

ACTH

CBG (cortisol binding globulin) This way you can calculate your free cortisol.

ACTH stimulation test with a baseline ACTH (this will need ordered by an endo most likely)

4X saliva cortisol test (you can self-order these online, but mainstream doctors won't like these)

The problem with all of these tests is that the results are open for interpretation. The lab ranges are way too large. For instance, Labcorp where I had my AM cortisol tested says that anything in between 4.3-22.4 is "Normal". I can tell you if your AM cortisol is 4.3 that is NOT normal at all. That's the problem with endocrine disorders. You need to find a doctor who doesn't just look for the "H" or the "L" next to the lab numbers.

Another thing...There are a lot of medications out there that will make total cortisol levels appear to be normal. I don't have a list of those meds handy, but they are common ones like Metformin and Lipitor.

Good luck...getting an addison dx is quite difficult even if you have it...

[MamaTrain]

I was shocked to see my saliva cortisol results when I first had them done. My doctor who is a regular MD but uses naturpathic care said she feels it's the best way to test. Adrenal issues can be complex. I read the book Adrenal Fatigue and it was very helpful to me. Hope you get some answers and SOON!!!

KC

[Tessa]

Hi Jump

For any further information on tests for adrenal disorders, the following links will be very useful.

http://www.stopthethyroidmadness.com/aldosterone/

http://hotzehwc.com/attachments/wysiwyg/2/...Cortisol101.pdf

Good luck!

I hope they find your problem and prescribe the right treatment.

Love

Tessa

[Birdlady]

Checking your adrenal function is absolutely important. I just don't want people to think it's a magical cure. The yahoo groups and forums that discuss adrenal fatigue told me that I'd be better once I was put on HC/florinef, but that has not happened. My HR's are actually getting worse these days.

SO...While I think it's a good thing to rule out, I don't want to put this idea out there that it's a guaranteed fix!!

@TrainBoysMomRocks

My saliva results were scary too! It was no wonder I never wanted to get up in the morning. lol

[jump]

Hi all,

Thanks for the advice. My doctor's appointment went well - I felt like she really took my fatigue seriously, which was good.

BUT she wants me to do a sleep study instead of testing my adrenal function.

Also, I realized from reading the links you all posted, that I'm already doing half of what I would need to do anyway if my adrenals were off - I'm taking florinef and using seasalt. The florinef and seasalt have helped considerably. So part of me wonders, is it really important to also test cortisol? And would my results come back normal anyway, because of the florinef?

Thanks again for the help!

jump

[Dizzysillyak]

Checking your adrenal function is absolutely important. I just don't want people to think it's a magical cure. The yahoo groups and forums that discuss adrenal fatigue told me that I'd be better once I was put on HC/florinef, but that has not happened. My HR's are actually getting worse these days.

SO...While I think it's a good thing to rule out, I don't want to put this idea out there that it's a guaranteed fix!!

@TrainBoysMomRocks

My saliva results were scary too! It was no wonder I never wanted to get up in the morning. lol

Great advice here ... It's great that some treatments work for some people. I see this all the time on the gluten free boards ... Some people feel great just by giving up gluten but going GF didn't solve all my problems. Neither did the Paleo diet or the host of supplements I'm taking. I still feel 1000% times better than I did though ...

I think it's a good idea to keep in mind that while trying to solve our health problems is a worthy venture, our bodies are unique and what one person needs isn't always what our bodies need. Nutritional, saliva and stool testing is great for determing some of this though ..

I consider myself fortunate to have run into several people who didn't just heal by going GF. Watching their day to day struggles and all the research that they did, gave me the courage to try this myself. Not to mention how great the internet and message boards are for learning ...