Doctor insights on:
Aldosterone Cortisol Ratio
ACTH ALDO Cortisol: I have seen two families in which ACTH is the major driver for aldo production. They have the syndrome called GRA (Glucocorticoid Remedial Aldosteronism) caused by a cross over mutation in the genes controlling aldo production so that the major controller of aldo is ACTH. As you are young and making this question if you also have HTN your team should consider this. Many do not have low K. ...Read moreSee 1 more doctor answer
Aldosterone was 2 ng/dL (fasted, early morning, upright) is this normal or low? Does it warrant further testing? Cortisol was high/normal 22.2 mcg/dL
More history: I don't know much about your history or what has caused you to have this testing in the first place so I won't be of much help, BUT the aldosterone level is low and may warrant further testing for Cushing's syndrome, 17-alpha-hydroxylase deficiency,Liddle's syndrome,ectopic ACTH syndrome, or mutations of your mineralcorticoid receptors. You need to talk to your doctor for more direction. ...Read more
Do I have some adrenal issue?
Acth: 80 (7 - 63 pg/ml)
8am cortisol: 535 (138 - 690 nmol/l)
adrenalin: 83 (< 100 pg/ml)
aldosterone: 5.6 (1 - 16 ng/dl)
Not according...: ...To these labs (mildly elevated acth on one specimen does not mean much), but there are others that may be necessary if your symptoms warrant them. ...Read more
Poor correlation: Hi. Oral cortisol (aka hydrocortisone) does not reliably affect ACTH secretion nor aldosterone levels. That is somewhat unfortunate for those of us treated adrenal insufficiency, since determination of proper dose is based solely on clinical response, and not labs. Aldosterone is driven by the renin-angiotensin system bypassing the pituitary. UIHC is excellent, so you have great docs close at hand ...Read more
I was dx'd with CAH 34 years ago. Now I have high cortisol (28) lowered acth (11.2) and almost 0 aldosterone (<1.0). Is this typical of CAH?
Yes: Depending on the type you have, it could be - most commonly the cortisol level is low and there is an elevation of mineralocorticoids like aldosterone. Since there are at least 4 distinct types of CAH, I'd need more information to answer your question. The best way to personally address your questions is to sit down with your endocrinologist and ask for an update on your condition... ...Read moreSee 1 more doctor answer
Very low angiotensin ii, normal ACTH, aldosterone, cortisol and renin? Why angiotensin ii very low if everything else normal? Doesn't make sense?
Data: Need more data. You should see a good endocrinologist. ...Read more
Gluconeogenesis: Hi. In prolonged fasting, cortisol plays an important role in a process the liver uses to make sugar from amino acids called gluconeogenesis. If glycogen (stored sugar) is depleted (happens in less than 24 hours of fasting), and the body cannot make enough new sugar from amino acids, low blood sugar can occur. Aldosterone does not play a role in gluconeogenesis. ...Read more
Without having an instantaneous blood draw, how can one know for sure if their near-death experiences are from adrenal emergencies? (Dangerously low cortisol and aldosterone)?
Low aldosterone ~3, normal renin and cortisol. Which type of adrenal issue and remedy available? Finding out reason for hyperkalemia and low hco3
Hypoaldosteronism: You may have normoreninemic hypoaldosteronism. It can be treated by a daily dose of fludrocortisone, under a physicians care. Could be due to medications or primary adrenal gland failure (zona glomerulosa). Additional tests could confirm this. ...Read more