Acth Stimulation Test

[schamsjj]

Hi everyone,

I just got the results of my ACTH stimulation test and was wondering your thoughts.

Results

cortisol

21 ug/dl baseline

26 ug/dl after 30 min

12 ug/dl after 60 min

The nurse said it looked fine, but everything I read on this states that the cortisol level should double from baseline. Do any of you have any knowledge of this??

Thank you!

Jared

[kluesyk]

When I was diagnosed with Adrenal Insufficiency 3 years ago, my ACTH stim test started very low 3.9 and stimmed to 6.1 in 60min. I believe anything below 10 was abnormal.

I know they want you to double in a hour, but it is very strange that you dropped after the 30min increase. I know they told me if I stimmed to 20 that would be great, so maybe they are looking at the fact that you started at a decent level.

The stim test made be feel very bad. Chest pain, left side adrenal/kidney area pain, felt like I had been punched in the stomach, nausea and shaking, so I knew something was not right.

The nurse before the test told me it would make me feel great......

3years after the Addison's diagnosis,now I have POTS. Don't know if it is related.

[schamsjj]

Whoops! The labs came back backwards and I posted them that way!

Cortisol

12 baseline

21 30 min

26 60 min

So hopefully this is normal since they doubled!

[shoegal]

what time of day did you have it done? looks like it was fine though

[schamsjj]

I had it done in the morning, I was kind of hoping this test would find something. but at least I ruled another thing out.

[shoegal]

I had it done in the morning, I was kind of hoping this test would find something. but at least I ruled another thing out.

if it was 8am 12 isn't the highest but within the range. may be worth having more AM cortisol tests done

[Birdlady]

Honestly I think this looks decent, but I agree the 12 is a little low for a baseline. I personally wouldn't bother with more AM cortisol results unless of course insurance covers it. I don't see any reason to waste more money on them though. The STIM test is the "gold standard" for adrenal function output. It is possible you have HPA axis dysregulation where the body isn't sending out enough ACTH in times when it should. During a stim test they inject you with a huge amount of ACTH (250mg) that the body would never produce in normal conditions. Some say it is too stimulating and gives passing results even if someone's adrenals are just beginning to fail.

This is worth reading and I think most of us probably have HPA axis dysregulation rather than Addison's. Obviously there are some of us on here who do, but generally speaking this is more common.

http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2265.2001.01373.x/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+4+June+from+10-12+BST+for+monthly+maintenance

Did you happen to get ACTH checked before the injection? This would give you more information.