Adrenal Insufficiency Support Group

Hi!

I have a real good friend whose son has been struggling with fatigue for quite some time. They did some blood work this week and his cortisol was high. Sent them home with nothing...no explanation...except it was stress and nothing to do for it.

She took him to a holistic doctor and she did swab cortisol tests. She doesn't understand anything. The holistic doctor put him on all kinds of vitamins: Pantothenic acid/Ascortic Acid/Biotin/Phosphaitdyl serine.

I told her about my forum and said I would see if anyone knew about HIgh cortisol.

Her son's cortisol numbers were:

8 am 46

12 pm 14

5 pm 12

10 pm 5

DHEA is 16

Not sure what these mean.

Thanks for any help and information I could pass onto her.

Hey, all I know about numbers is my endo said my cortisol should have reached 20 during the stimulation test, and my highest number was 8. So his early morning number is more than double what they wanted to see mine achieve during stimulation. What kind of doc said not to worry? Was it an endo? Yes it can go up for stress, but how old is he? How much stress would he have to be under? That just seems awfully high. But outside of what I "should have had", I don't know anything more. I hope they get his issues figured out soon.

There's always the possibility of Cushing's Disease. Mom needs to know this and keep a watchful eye and not trust the endo totally! Does he have any Cushings-type symptoms - large belly, round face, for example?

Deb

Stress can triple cortisol levels easily, even the notion of testing counts as stress... By itself the 8AM number might be a good example of that.

Was blood sugar also tested? If so what as it? Consistent high cortisol raises BSL.

Any particular pattern to the fatigue? ie time of day, concurrency with food etc, Of course stress can also be a symptom of rather than just a reason for. Any cushingoid symptoms?

Any old blood tests prior to the stress/fatigue available?

Bob

Thanks guys! I will pass on this information to her. I know she did not see an endo...this was just his regular doctor that initially said he had high cortisol levels and told her it was just stress. The holistic doctor did the saliva swab cortisol test.

I have developed a serious pet peeve about PCP's who make decisions like that. Someone on my IBS board (which I hang out on still, because that was my diagnosis for years) had his PCP tell him "sometimes we just get something, we don't know why, then it will go away on its own". He has debilitating diarrhea, is missing work, can barely leave the house, in chronic pain, etc, for MONTHS!

If he were mine, I would want an endo to tell me that it's nothing to worry about. But I've had too many doctors over the years who thought they knew everything, even if it were outside their specialties. That's why it takes an average of years to diagnose some of these illnesses, in my opinion.

There must be a test they can do for Cushings that won't be possibly incorrect because of the stress of just the test, isn't there?

I think your friend should take her son to an endo for a full work up. I don't think that GP's (general practitioners, here in Canada...probs same as PCP) are specialized enough to know what to even test for! Endo referral for sure.

The problem is of course the tree structure of expertise. A PCP is suppose to be smart enough to determine the specialty needed. Fatigue could be neurological for example with no noticeable blood pathology abnormalities. The problem for the PCP is that they get a lot of people who arent "really" sick. To counter this you have to have your arguments ready in advance. Things like "has been going for 6 months now and not getting any better despite the wait". You have to give yourself credibility in the eyes of the doctor. State some rational scientific stuff and dont leave it open ended.

I personally dont think the cortisol numbers by themselves are that bad. Fatigue is only one symptom that has been mentioned so I dont think a trip to the endo is warranted just yet. Of course the PCP should have done a lot more! The ranges for AM vs PM are 6.2-19.4 μg/dL & 2.3-11.9 μg/dL (Labcorp) so the 8AM and 5PM are more or less out of range.

Lorajoy, Is your friends son really stressed? I mean apart from being from the illness itself! The fatigue could even be the unsuccessful fight of an infection (cortisol will also be high) but other parts of the blood test should have shown that up.

Need more information! I really think though that at this stage he needs a smart and committed PCP, not so much an endo..

Cushings test - High and low dose dexamethasone suppression test done. ACTH and Cortisol measured. This determines what bit is broken (ie pit, adrenals or eptopic)

My view only!

Bob

Great advice Bob~where I'm from my GP would never do those tests! He would say that he's 'not comfortable probing further'...BUT I'm thinking it's more due to the 'referal and get paid as you refer' system!

Hi Lorajoy,

I've been researching tonight and just had to register

to join so I could reply to you.

Have you researched Lyme Disease and co-infections?

My 16 yr old is now being treated. Symptoms started

almost 5 years ago. Fatigue being one of the first.

Clueless doctor, many tests. Finally now on long

road to recovery.

It might be good for you to read from Lyme group here, start researching. You never know!

Good luck!!

Post edited by: momOfLymeTeen, at: 02/25/2011 11:04 PM

Her chiropractor suggested checking out Lyme after

treating her for adrenal issues for months with not

much change.

Post edited by: momOfLymeTeen, at: 02/25/2011 11:14 PM