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Is Cortisol Level Of 7.0 A Cause For Concern?
Question: I am 35 old female, a Hashimoto patient , currently taking Atenolol ( for rapid heart rate) and Vitamin D. I feel unwell, can't do my daily activities but all test come back normal :(.
For the past 5 weeks, I started experiencing :
Excessive thirst, excessive urination, pains in lower back, bitter taste in mouth, dizzy spells, extreme fatigue.
Doctor found out I also have orthostasis and my tongue suggests adrenal issues.
Complete blood and urine work and abdominal and pelvic ultrasound came back completely normal.
Just my 8am cortisol was 7.0
Question 1: I developed an ear infection the day after the blood exam, does that affect the level of cortisol in any way?
Question 2: My sodium level is 138 and Potassium 4.6- is this a healthy ratio?
Question 3: do you think I should recheck my cortisol and maybe test other adrenal hormones as well?
Thank you so much for your time
For the past 5 weeks, I started experiencing :
Excessive thirst, excessive urination, pains in lower back, bitter taste in mouth, dizzy spells, extreme fatigue.
Doctor found out I also have orthostasis and my tongue suggests adrenal issues.
Complete blood and urine work and abdominal and pelvic ultrasound came back completely normal.
Just my 8am cortisol was 7.0
Question 1: I developed an ear infection the day after the blood exam, does that affect the level of cortisol in any way?
Question 2: My sodium level is 138 and Potassium 4.6- is this a healthy ratio?
Question 3: do you think I should recheck my cortisol and maybe test other adrenal hormones as well?
Thank you so much for your time
Brief Answer:
Adrenal insufficiency possible
Detailed Answer:
Sorry to learn about your bothersome symptoms.
1 If the ear infection occurred after the blood sample was taken, it should not have significantly affected the cortisol result.
2 Your sodium and potassium levels are fine
3 Your cortisol level is of concern.
When I see someone like you in my practice, I typically order the ACTH Stimulation test. This is a test that helps to confirm whether or not you truly have adrenal insufficiency.
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Adrenal insufficiency possible
Detailed Answer:
Sorry to learn about your bothersome symptoms.
1 If the ear infection occurred after the blood sample was taken, it should not have significantly affected the cortisol result.
2 Your sodium and potassium levels are fine
3 Your cortisol level is of concern.
When I see someone like you in my practice, I typically order the ACTH Stimulation test. This is a test that helps to confirm whether or not you truly have adrenal insufficiency.
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Topiwala,
Thank you so much for your quick and thorough response! I am seeing an endocrinologist-in-training this Wednesday and will definitely mention the ACHT test if he doesn't :).
Besides the adrenal, are there other issues that might be causing my low bp and excessive thirst in particular ?
My MCH is 27.3 and MCHC is 30.5 L ( I almost passed out yesterday , feel pretty dizzy today. Could it be anemia?)
Also, Hemoglobin A1c is 5.6 and Glucose is 87. Shall I worry about diabetes?
Thank you once again!
Thank you so much for your quick and thorough response! I am seeing an endocrinologist-in-training this Wednesday and will definitely mention the ACHT test if he doesn't :).
Besides the adrenal, are there other issues that might be causing my low bp and excessive thirst in particular ?
My MCH is 27.3 and MCHC is 30.5 L ( I almost passed out yesterday , feel pretty dizzy today. Could it be anemia?)
Also, Hemoglobin A1c is 5.6 and Glucose is 87. Shall I worry about diabetes?
Thank you once again!
Brief Answer:
Follow up
Detailed Answer:
Low BP is one of the conditions associated with adrenal insufficiency, as is dizziness. You must take this as an emergency as it can be a threatening condition.
Excessive thirst can be due to diabetes. There are two broad types of diabetes. The A1c test looks for diabetes mellitus. Your result is normal.
The other is diabetes insipidus. Your endocrinologist will evaluate your for this in detail.
Follow up
Detailed Answer:
Low BP is one of the conditions associated with adrenal insufficiency, as is dizziness. You must take this as an emergency as it can be a threatening condition.
Excessive thirst can be due to diabetes. There are two broad types of diabetes. The A1c test looks for diabetes mellitus. Your result is normal.
The other is diabetes insipidus. Your endocrinologist will evaluate your for this in detail.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Topiwala,
I got examined by an endocrinologist today. Blood pressure was 122/82, pulse 98, respiration 16. She didn't want to do the ACTH stimulation test but just repeat the morning cortisol test and see me in 4 weeks :(.
She doesn't think there is enough evidence for adrenal insufficiency because of the very normal blood tests. Also, her explanation for my excessive thirst and urination is that I am prediabetic ( glucose 87 and hemoglobin a1c 5.6), no mentioning of the Inspiditus;nothing about my fatigue and back pain:(
Question 1: do I need additional tests because of these pre-diabetic findings in your opinion?
Question 2: is it possible that I actually have high blood pressure which is reduced to normal because of the Atenolol 25 mg?or can I feel dizzy and blood pressure be normal? If yes, would that be a sign to a different diagnosis?
Question 3: last night my back pain got really severe and fatigue was so bad that I barely dragged my feet to bed. Is there anything I can do to relieve my symptoms ? 4 weeks seem like a very long time..
I got examined by an endocrinologist today. Blood pressure was 122/82, pulse 98, respiration 16. She didn't want to do the ACTH stimulation test but just repeat the morning cortisol test and see me in 4 weeks :(.
She doesn't think there is enough evidence for adrenal insufficiency because of the very normal blood tests. Also, her explanation for my excessive thirst and urination is that I am prediabetic ( glucose 87 and hemoglobin a1c 5.6), no mentioning of the Inspiditus;nothing about my fatigue and back pain:(
Question 1: do I need additional tests because of these pre-diabetic findings in your opinion?
Question 2: is it possible that I actually have high blood pressure which is reduced to normal because of the Atenolol 25 mg?or can I feel dizzy and blood pressure be normal? If yes, would that be a sign to a different diagnosis?
Question 3: last night my back pain got really severe and fatigue was so bad that I barely dragged my feet to bed. Is there anything I can do to relieve my symptoms ? 4 weeks seem like a very long time..
Brief Answer:
Second follow up
Detailed Answer:
1 Based on your A1c, you do not have Pre -diabetes although you seem quite close.
2 If you are dizzy and your BP is normal, then other causes of dizziness must be explored
3 Consult an orthopedic surgeon for the back ache
Second follow up
Detailed Answer:
1 Based on your A1c, you do not have Pre -diabetes although you seem quite close.
2 If you are dizzy and your BP is normal, then other causes of dizziness must be explored
3 Consult an orthopedic surgeon for the back ache
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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