bostonusa2009's story

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#201

Ok check this out, I found something even more interesting. A moderator on a Adrenal mb just mentioned to me that my baseline ACTH number should have doubled from the baseline blood draw to, which by the way is supposed to be 20-30 ug/dl not the measly 12.6 ug I registered.

So it should double to about 50 ug/dl within the first 60 minutes. Anything less than that indicates adrenal insufficiency. Mine didn’t even double from my baseline number of 12.6. It should have gone over 25 minimum.

I did a simple google search and did not search more than 5 minutes. Here Wikidpedia states the same. The baseline should be 20-30 and it should reach a minimum of 50 ug/dl.

en.wikipedia.org/wiki/ACTH_stimulation_test

So then this would indicate I have adrenal fatigue as well all thought, not an issue with the pituitary. Possibly our adrenals are so fatigued, they simply need to rest and repair the damage. I will try to pull up a little more information regrading all of this.

I think the 8:00 test range for my 24 hour Quest Diagnositc test is inaccuate.

I just logged out of my account here and read one more paragraph on the wiki article.

This is the direct quote from that site, “The baseline cortisol level in people with adrenal insufficiency is usually near 15 ug/dl.” Mine was 12.6 Granted this was back in March.

How many other ACTH test results to we have on this site?

Interpretation for secondary adrenal insufficiency

If the Pituitary is the problem(secondary adreanl insuf) the ACT may dramatically increase the baeline value. So the answer is no, secondary adrenal insufficiency is not likely the problem.

#202

Hmm

  1. there are mainly 2 versions of acth stim test use. they are basicly the same only the dose is the difference. You do not know wich one you did yet do you? thats why i asked if it said on the test what dosage was used. Even if you did the regular test your values did double more or less so i dont c whats changed.

  2. Doubling from baseline seem to be what many websites recommend as a valid increase. Yet my doctor says he promise my rise in cortisol about 60% increase from a mid level cortisol baseline is perfectly normall and he c it all the time. This may not mean much to us as many docs consider very low in range as normal whilst we c it as close to the worst result possible.
    After searcing bit on pubmed i came to about the same conclusions that my doctor told me. Namely that most published articles concluded that if your test result after stim test came out higher than x (think x was about 660 nmol/l if i remember correctly) you could pretty much exclude adrenal failure.

  3. If you examine the doubling from baseline idea, it has flaws initself imo. If you are allrdy under stress or have a high cortisol baseline with high acth allrdy in the blood the extra acth injected is bound to have less of a dramatic effect on the cortisol output then the same dose would to someone with no stress and lower baseline cortisol / acth in the blood before injection. Its abit like saying that your testis should double after injecting a certain amount of hcg whilst if they are allrdy under high output from lh the extra hcg would not bump the T production in the same manner as if they were producing very little to start with. Dunno if that was a good explanation but hopefully you understand what i meant.

  4. The guy you talked to at an adrenal forum says the baseline cortisol should be atleast 20. Well again i say this is where you have to make up your mind. Who and what do you belive to be true when it comes down to baseline cortisol readings? The range we have here is about 300-1000 as normal. I was at 350 on one test only to find i was about 990 on the next… This tells us something of why the ranges look like the do imo.

edit: Dont get me wrong im not even sure about my own adrenal situation, i still have doubt as to their status otherwise i wouldent be doing the new tests im ordering. im just passing along info ive found thats all!

#203

I don’t know, but I check and find out exactly what the dosage was.

Please, post links when stating information. You used several different numbers and don’t have any direct verifiable sources for your information. Maybe it’s valid, but really how can we get anything accomplished here if we have to question stuff that you are posting.

I used the moderator as a starting point and then researched, verified and posted links that confirmed his statements. You really addressed none of the points that I made, all of which were backed up by a reliable website.

Go back and address the points that I made with counter points and links to well respected sources for information. I’m truely looking to get to the bottom of this, what is the point of posting if you’re too lazy to prove any of your points.

#204

Boston,

I think the point here is that because your Cortisol nearly doubled after synthetic ACTH was given to you indicates that your Adrenals are reacting fine to ACTH (stress). So you dont have ‘adrenal failure’.

Now the question is are they fatigued? Because you had a low reading (12) to start with could indicate adrenal fatigue? This is where you have to take a call. Do you want to go with the blood test, which says you had a low normal morning reading or the Saliva test which says you have a good reading or just simply go and get a morning serum test again.

#205

Wtf!?

Im not typing in this thread to prove anything, infact i think theres a very good chance adrenal issues could be the reason we are in this situation. Like i said before im not even sure of my own adrenal status. Im trying to help you gather info but you think im lazy cause i havent got an extra day to dig up the findings i did over a year ago when i was in the same situation?

edit:

You are thinking of taking adrenal supps yet your research is based on wiki and an adrenal forum. You dont even know that you did an acth test and you seem to have done little research into this field. You are calling me lazy for not doing your job for you, i think its quite the opposite to be truthfully. I think you are lazy.

Alltho im sure an adrenal forum help alot of ppl i would not take their word for beeing the absolute truth. If i were you i would do as much research as i could to form my own oppinon instead of putting my trust on other ppls advice including mine.

ncbi.nlm.nih.gov/pmc/articles/PMC548394/

In the test, an intravenous (or intramuscular) injection of 250 μg of synthetic ACTH (tetracosactrin) results in release of preformed cortisol from adrenal stores, which is measured in the serum 30 (and/or 60) minutes later and compared with the baseline concentration. An abnormal response (a serum cortisol peak below 550 nmol/L or an increment of less than 200 nmol/L from baseline or both) identifies adrenal insufficiency but cannot distinguish Addison’s disease (primary adrenal failure) from secondary hypo-adrenalism

Your approx peak result in the same units = 634
Your approx increase in the same units = 303

Your results are actually very close to mine alltho my baseline was slightly higher and my increase slightly lower.

#206

Why are you getting so emotional there is no need to take things personally. We’re all here for the same reason, to get better. I brought up valid points backed up by reliable data. You addressed none of those points directly. It’s like you didn’t even bother to read any of it, yet argued with the basic premise. How can we can we get to the bottom of anything if we guess and try to say,"I think it’s this, “It’s supposed to be that”.

This website has enough muddied posts with guessing and unfactual information. If you’re going to try to make a point, back it up. That’s all I’m saying. Not, “I think I read somewhere” or “The range we have here is about 300-1000 as normal” Back those points up with reliable sources, otherwise your post is not going to help anyone. It simply adds more information that’s not reliable.

#207

I was reading your thread with interest as i think it applied to my situation aswell. I tried to give you the information i had best i could in order for you to make an educated dissicion about what to do in regards to treatment.

Instead of asking for a source or discussing it you are saying im lazy because you dont get the info served on a plate. If i had it the info at hand and it was just a matter of copy and paste i would have done so. I do not however have the articles similar to link above stored anywhere on my computer i just remember reading them. So the only way for me to provide this info again would be to the same reasearch again. Then instead of not trying to gather the potential information yourself you call me lazy.

I guess it was somewhat an emotional response i dont like beeing called lazy when im trying to help, nothing else.

And if you cant even trust my word for that the ranges where i live for cortisol is approx 300-1000 then why am i even typing here…

#208

Call it a truce, We are way off of the important topic at hand. I don’t think it’s going to do either of us any good. We’ll just agree to disagree.

#209

Sure.

So how are you feeling on hc?

If you could share frequently id like to hear about it.

Cheers!

#210

I’ve only been on for 4 days. I feel much more energetic in the morning. After the first day I felt a difference the following morning, but thought maybe it was the placebo thing. No question I feel more energetic, awake, mentally sharp and alert. I worked out at the gym a couple of times this weekend and thought I felt better exercising as well. My muscles seem to respond better, no popping joints or strange sounds.

I’m ramping up the dose from a starting point of 2.5mg in the morning. I am following the protocol for what, stopthethyroidmadness.com recommends for beginning on cortisol for adrenal fatigue. There are also recommendations for adding thyroid meds and how to ween off once your adrenals have healed.

Day 1-3: 2.5 mg first thing in the AM (2.5 mg total)
Day 4-6: 2.5 mg first thing, 2.5 mg in four hours (5 mg total)
Day 7-9: 2.5 mg first thing; 2.5 mg in four hours; 2.5 mg in four hours (7 1/2 mg total)
Day 10-12: 5 mg first thing; 2.5 mg in four hours; 2.5 mg in four hours (10 mg total)
Day 13-16: 5 mg first thing; 5 mg in four hours; 2.5 mg in four hours; 2.5 mg bedtime (15 mg total)
Day 17-20: 10 mg first thing; 5 mg in four hours; 2.5 mg in four hours; Bedtime 2.5 mg (20 mg total)

stopthethyroidmadness.com/adrenal-info/how-to-treat/

I’ll post any other positive or negative things I notice.

#211

Hello

Any updates?

Id like to hear how you are doing on hc more regularly if possible.

Thanks!

#212

I caught a pretty bad cold. I didn’t want to confuse the way the cold was making me feel with the effects of using HC.

So after the first few days, I felt a little crappy for a couple of days. I did some research and this part of the normal process of your body adjusting to HC. The moderators that I spoke with on Thyroid and Adrenal forums confirmed the same.

After those two bad days, I have felt great from morning until the end of the day. I have incredible amount of energy and am incredibly focused. I have tons of ambition and my memory is great. I have been on the HC for about 4 weeks.

Exercising feels easier and more enjoyable, wether its a walk, a run, or lifting weights. I was thinking about it yesterday. I feel since I started taking the HC, I enjoy every aspect of my life more, except one.

One thing is still not right and that’s the sexual piece. The only change I have noticed is my nuts don’t sag, but I’m not sure that’s from the HC. My plan is to take the HC and get my temperature stabilzed. Then I will introduce Armour & maybe additional T3 for the high RT3 that I know I have. Stay on both until needed and eventually ween off.

The key is you need to make sure you cortisol level is right before introducing the Thyroid meds. This has been the most productive 3 weeks of work I have had in several years. I have been working incredibly hard and been very focused. I need to be checking my body temp 4 x per day and getting my daily avg, so that I know when I am ready to introduce the Thyroid meds. I haven’t been doing this like I should be, because of my work.

For those guys that are reading this and haven’t been following along, improving adrenal & thyroid problems can help with getting sex hormones in line with where they should be. A couple of months ago, I was taking Armour and felt libido urges, so I am optimistic once I am ready to introduce Armour there is a chance that can help resolve some of the sexual issues.

The only bad thing is that I caught a cold and it might be partially because of using the HC. The drug bottle says it may hinder your ability to fight off infections. I still have a little cold now, but even when the cold was at it’s worst I felt a ton better than without the HC. I’ll take that toss off any day of the week.

#213

Interesting you should mention the cold. I got sick a few weeks ago and was more intellectually and creatively productive than I’d been in a while.

Are you having problems with tight muscles and have you noticed improvement from the cortisol?

#214

Martin,

I was having problems with stiff muscles. I recall it being rather difficult to bend over to pick something up on the ground. I noticed stiffness when exercising. I couldn’t squat down as low as used to.

I have had a big improvement in this area. I will say that my joint still pop from time to time. I know we though Cortisol might eliminate that problem. Maybe it takes longer to get rid of that one.

#215

I just got the results of new blood panel done on Thursday of last week.

I was taking Hydrocortisone 20mg per day & Vit D only prior to taking this blood test.

TSH 1.62 (0.35-5.50)
T4 total 8.62 (4.5-10.9)
T3 total 105 (60-181)
Free T4 1.1 (0.9-1.8)
Free T3 3.21 (2.3-4.2)
Estradiol 15.57 (12-52)
Cortisol 17.1 (A) (4.3-22.4)

Vit D25 137 (25-80)

Total Testosterone 669 (240-950)
Free Testosterone 14.7 (9-30)
IGF-1 140 (98-261)

What I think is most surprising is the Estradiol & Vit D. I have probably done about 13 blood tests over the past year on these hormones and I never saw the E2 lower than 30.

I had wanted to get it lower. Now I wonder if the Hydrocortisone may have caused this. Other than the HC, I haven’t done anything differently. Strange thing is though, I have no improvement in sexual sides. I had read most guys that lowered their estradiol should have an improvement in morning wood.

Also, My Vit D is now too high. I was taking about 20k of the Vit D3. My doctor wants me to stop it entirely, but I’m fearful it will drop back down to nothing if I do that.

This test also produced one of the best Free Testosterone levels in a while. It’s certainly far from ideal, but it is moving in the right direction.

I have had an improvement in sense of well being and an improvement in energy since starting the HC, so the blood results confirm what I feel.

#216

The vit D could be explained by the supplementation but I am more apt to think that it’s increased due to HC interrupting whatever was tanking the levels. Have you had any temporary changes in libido? How are the popping joints now?

#217

Can you guys do me a favor and explain the significance of Vitamin D to this whole puzzle? I see it mentioned repeatedly over this site, but cannot understand how it figures into our situations.

I have low total T, low free T, low DHT, low LH, low FSH, and elevated prolactin. My estradiol, TSH, and SHBG are within normal ranges. One of the endrocrinologists I saw tested my Vitamin D, and that was also within normal ranges.

Compared to other guys on here, I feel somewhat fortunate that prolactin and testosterone (and the driving sex hormones) are the only hormonal anomalies that I have to worry about managing (at least the ones that I know about).

Also, I’ve read several comments throughout this website in regards to alcohol consumption and liver problems post-Propecia. I feel like I can echo those sentiments to a certain extent, as I have totally lost the taste for alcohol since this ordeal began. It wasn’t obvious to me while this was going on at the time, but looking back on it I clearly began to cut back on its consumption out of habit. I suppose the pros of beer drinking like the “buzz” began to be overtaken by cons such as a depressed physical state, so I just stopped doing it.

#218

Hey Martin,

That’s interesting, I guess that’s a possibility that the HC pushed the Vit D up as well. I think have been taking the Vit D for about 2.5 months. I didn’t have another blood test done of the Vit D during the period of time, so it’s impossible to know what caused it.

No change in libido at all. My joints still pop ocassionally, but it has improved. I still think the strangest thing is the drop in Estrogen, but no improvement sexually. How’s your situation going?

#219

You’re right, I mentioned the estrogen at least in my mind in the last reply, looks like it didn’t get to the screen. I don’t think I’m cogent enough to comment intelligently right now. I’ll update my situation in my thread.

#220

Boston are you still on HC? If so, how are you feeling? I’m about to start taking it tomorrow, and my adrenal reading from 24 hour test are much much worse then yours, so I’m pretty confident that I’ll see at least a big of an improvement as you.

I read how you had gotten a cold during the first few days, did you increase your dosage, because according to STTM.com that is what you’re suppose to do.

I see that you used the 20 day step program thing, which is probably what you should be doing since your adrenals arent nearly as bad as mine. For myself Im going to see my doc tomorrow to discuss If I should be doing the 2nd one mentioned in this link where you start off taking 20mg’s a day. I believe this is the better choice for me. What do you think?

my test levels can be found in my story:

stopthethyroidmadness.com/adrenal-info/how-to-treat/

viewtopic.php?f=4&t=4232