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Doctor insights on: Hydroxycortisol Free 24 Hr Ur

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Can ACTH test rule out Cushing's? ACTH stim. Cortisol levels: T0: 9.1 T30: 16.6 and T60min: 18.6. Should I have 24 hr cortisol levels checked?

Can ACTH test rule out Cushing's?  ACTH stim. Cortisol levels:  T0:  9.1  T30: 16.6 and T60min:  18.6.  Should I have 24 hr cortisol levels checked?

Wrong test: Hi. The ACTH-stim test is not a test for Cushing's. It's a test for adrenal insufficiency, more exactly, PRIMARY adrenal insufficiency. So no, an ACTH-stim test cannot rule out Cushing's. Someone needs to suspect you of Cushing's to order the 24h urine cortisol. We don't have any info to make us suspect Cushing's in you, so we can't say if you SHOULD have a 24h urine cortisol. Your ACTH-stim is nl ...Read more

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How could free testosterone measured by equilibrium dialysis (mayo labs) be over 50% more than calculated free testosterone (issam.Ch)? Data (4/26): tt 533, shbg 41, albumin 4.5, cft 9.7, ft 15

How could free testosterone measured by equilibrium dialysis (mayo labs) be over 50% more than calculated free testosterone (issam.Ch)? Data (4/26): tt 533, shbg 41, albumin 4.5, cft 9.7, ft 15

Lab variation: The calculated free t will depend on how accurately the lab measures each component (total t, shbg, albumin) as well as the algorithm used to do the calculation. The free t by dialysis can be more accurate, as it depends on one test being done correctly. However, labs vary enormously in how well and accurately they can do the test. If the levels are normal, don't fret the details. ...Read more

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Does normal (1.01) "thyroxine (t4) free, direct, s, " normal (0.931) "tsh, " and low (67) "triiodothyronine (t3)" = Synthroid dose good? Or go up/down?

Does normal (1.01) "thyroxine (t4) free, direct, s, " normal (0.931) "tsh, " and low (67) "triiodothyronine (t3)" = Synthroid dose good? Or go up/down?

Thyroid tests: The tsh, and secondarily the ft4, are normally used to guide the dosage of levothyroxine replacement. T3 (liothyronine) is not normally followed for this. There are a number of issues, and you would be best discussing this with your doctor. ...Read more

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Male 61 stress test at 60 max hr197 ex 5 days a wk 30 min stationary bike with avg hr 139, max 160, but 1 min recovery hr of only eg 160-138/150-129 why so low? What's a good hr exercise range for me?

Male 61 stress test at 60 max hr197 ex 5 days a wk 30 min stationary bike with avg hr 139, max 160, but 1 min recovery hr of only eg 160-138/150-129 why so low? What's a good hr exercise range for me?

Healthy heart: The healthier the heart, the faster the heart rate drops down after stopping exercise. It is generally recommended to aim for an exercise heart rate of about 70 percent of maximum. To achieve aerobic fitness, it is better to maintain a more modest target heart rate for 30 minutes or more than to shoot for a higher heart rate for a shorter duration. It sounds like you are doing a great job! ...Read more

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Low vit d, uncontrolled migraines/depression, brain fog despite vyvanse, (lisdexamfetamine) TSH 2.63 goes up with every test t4-14. Constant pain, swollen feet/fingers?

Low vit d, uncontrolled migraines/depression, brain fog despite vyvanse, (lisdexamfetamine) TSH 2.63 goes up with every test t4-14. Constant pain, swollen feet/fingers?

See holistic doc: You need a thorough evaluation by a good doc, ideally with a holistic approach. Get your d levels above 50. Migraines are often triggered by foods, stress, structural imbalances. Check free t3; thyroid rx may help. Vyvanse (lisdexamfetamine) can aggravate headaches ; cause swollen feet. Consider food allergies, environmental toxins, chronic infections including lyme disease etc. See http://bit.Ly/19pettq good luck! ...Read more

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43 yro f tested high for cortisol in afternoon 28 ug/dl After suppression test am cortisol 3.7 and ACTH 2.0 CT showed adrenals normal. Ideas?

43 yro f tested high for cortisol in afternoon 28 ug/dl After suppression test am cortisol 3.7 and ACTH 2.0 CT showed adrenals normal. Ideas?

Cushing's diagnosis: Presumably you have symptoms (weight gain, skin changes, diabetes, etc). Sounds like you had screening tests (?overnight dex) but these tests do not establish the diagnosis. False positives occur with depression, obesity, alcohol consumption. You really need to see an Endocrinologist to get this worked up. If it is Cushing's, 70% is in the pituitary, not the adrenal. ...Read more

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Expected high cortisol results since bipolar, told 3/13 saliva test (1.94 mcg/dl, 11pm) unreliable. 6/13 labs = 8am blood 5.9, dexameth. Supp. (1mg) 0.8, 24 hr free urine 7.1. Why low now if bipolar?

Expected high cortisol results since  bipolar, told 3/13 saliva test (1.94 mcg/dl, 11pm) unreliable. 6/13 labs = 8am blood 5.9, dexameth. Supp. (1mg) 0.8, 24 hr free urine 7.1. Why low now if bipolar?

No clear relation: There is no clear relationship known between bipolar disorder and cortisol levels. While a number of studies have shown a correlation between cortisol levels and mood disorders these studies are not always conclusive and not always replicated. ...Read more

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2 min bike - BP little high HR 77. 30 min intense body exer. BP lower but HR 155. 45 min later DR took BP and HR Higher. Dr took twice and same. ?

2 min bike - BP little high HR 77. 30 min intense body exer.  BP lower but HR 155.  45 min later DR took BP and HR Higher.  Dr took twice and same. ?

Review with doctor: The heart rate gain is appropriate for strenuous exercise at your age. If the HR remained high for 45 minutes, it may reflect dehydration from the exercise, especially if you weight decreased at the time. You should review the information with the doctor whom you saw. ...Read more

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Taking lorazepam for ovr a month 1 mg 3-4 times a day rapid hrt rate tsh 0.01 Syn med adj.3 wks -no lorazepam now for 24 hrs hrt rt ok too much loraz?

Taking lorazepam for ovr a month 1 mg 3-4 times a day rapid hrt rate tsh 0.01 Syn med adj.3 wks -no lorazepam now for 24 hrs hrt rt ok too much loraz?

Reformulate question: One would need to clarify if you meant your TSH is 0.01. In general, people tend to develop tachicardia when they stop the Lorazepam abruptly. At your age, this dose might affect your memory, although that is usually mild, if there is no previous memory impairment. I would suggest you discuss these issues with your precribing physician. Usually, a common dose is 2 mg daily. ...Read more

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My free T4 is 1.5 and T3 is 2.7 and TSH 2.29 while currently on syn. 50mcg. Having fast heart rate and insomnia. Endo wants to add cytomel (liothyronine). Good?

My free T4 is 1.5 and T3 is 2.7 and TSH 2.29 while currently on syn. 50mcg. Having fast heart rate and insomnia. Endo wants to add cytomel (liothyronine). Good?

Depends: It depends on the doctor. My opinion would be to try a different type of levothyroxine first. If you are on generic, you could go to brand synthroid or tirosint. People absorb these metabolic medicines differently, and a different type might normalize your T3 (liothyronine) (which is pretty close anyway). ...Read more

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Just diagnosed w/ low cortisol (10) on. 24 hr. urine test . Dr. prescription Hydrocortisone tab 5mg in am and 2.5mg noon. Will this make weight issue worse?

Just diagnosed w/ low cortisol (10) on. 24 hr. urine test . Dr. prescription Hydrocortisone tab 5mg in am and 2.5mg  noon. Will this make weight issue worse?

Endocrinologist ck: you are too young to take cortisone tab. must see a good endocrinologist and get all hormones checked including pitutiary ( parent gland) find the cause pl donot delay. ...Read more

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ACTH challenge done10am, baseline ACTH less than 5, cortisol is at 8 (mayo range) symptoms of Adrenal fatigue, Autoimmune, pots. Tests still needed?

ACTH challenge done10am, baseline ACTH less than 5, cortisol is at 8 (mayo range) symptoms of Adrenal fatigue, Autoimmune, pots. Tests still needed?

What test?: Are you asking whether the ACTH challenge is needed after it has been done? This is best discussed with your endocrinologist who can explain to you the rationale behind his request. ...Read more

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Tsh with reflex free T4 1.09, free T4 1.00 t3 (liothyronine) total 91 .Feel horrible very weak, hair falling, weight gain endo and GP said I'm fine no further tests?

Tsh with reflex free T4 1.09, free T4 1.00 t3 (liothyronine) total 91 .Feel horrible very weak, hair falling, weight gain endo and GP said I'm fine no further tests?

Thyroid: The lab numbers look OK. Weight gain is no good for you as you know. Please go online and look up the many articles a bout food. My favorite is "NuVal" - look it up. Also consider seeing an athletic trainer. ...Read more

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24 hours urinary free cortisol level(3 samples) is high,but acth (blood)is normal.Have I got Cushing's syndrome or these values depends to my obesity?

24 hours urinary free cortisol level(3 samples) is high,but acth (blood)is normal.Have I got Cushing's syndrome or these values depends to my obesity?

Depends on the level: but it's a reason to get a simple ultrasound to look at adrenals and ovaries. (a slight elevation of the cortisol is not very specific and while correlating with obesity which causes which gets ...tricky. A BIG elevation of it pretty much has to be from overproduction by the adrenals). ...Read more

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