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What Does Increase In Hydrocortisone Levels Indicate?
Question: Ive just had my blood resukts from my GP. My cortisone level is 50mmol/l (normal range 150-400) i have already been diagnosed with addisons disease 22 years ago and i am currently in a dose of hydrocortisone 20mg am and 10mg pm. My GP has ordered a repeat test. Could it just be that my hydrocortisone needs increasing or could it be anything else?
Brief Answer:
Addisons
Detailed Answer:
Your dose of hydrocortisone is just fine as it it represents a standard dose, although recent guidelines recommend slightly lower doses such as a total of 20mg, to avoid complications from excess hydrocortisone over time.
However, individualized dosing is best, based upon how the symptoms and signs of adrenal insufficiency, along with help from laboratory parameters.
A blood cortisone level is not particularly useful to assessing dose requirements. Cortisone gets eventually measured in the blood as cortisol.
Are you sure your blood sample was specifically cortisone or cortisol. The standard blood test is that of serum cortisol.
Regardless, it is not of much value in determining in/adequacy of hydrocortisone replacement. It is best judged by clinical signs such as pulse and blood pressure among other things. Blood tests like sodium and potassium help in some way too.
Endocrinologists are best trained to manage this condition which can sometime present challenges to handle
Addisons
Detailed Answer:
Your dose of hydrocortisone is just fine as it it represents a standard dose, although recent guidelines recommend slightly lower doses such as a total of 20mg, to avoid complications from excess hydrocortisone over time.
However, individualized dosing is best, based upon how the symptoms and signs of adrenal insufficiency, along with help from laboratory parameters.
A blood cortisone level is not particularly useful to assessing dose requirements. Cortisone gets eventually measured in the blood as cortisol.
Are you sure your blood sample was specifically cortisone or cortisol. The standard blood test is that of serum cortisol.
Regardless, it is not of much value in determining in/adequacy of hydrocortisone replacement. It is best judged by clinical signs such as pulse and blood pressure among other things. Blood tests like sodium and potassium help in some way too.
Endocrinologists are best trained to manage this condition which can sometime present challenges to handle
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry i meant to type serum
Cortisol not cortisone. Ive been feeling extremely tired of late and when I encounter a very stressful situation it completely wipes me out. If these levels are low and this is a standard dosage of hydrocortisone what else would i need to do in order to restore my energy levels as this is effecting my life way more than it ever has done and i want to get back to being myself
Cortisol not cortisone. Ive been feeling extremely tired of late and when I encounter a very stressful situation it completely wipes me out. If these levels are low and this is a standard dosage of hydrocortisone what else would i need to do in order to restore my energy levels as this is effecting my life way more than it ever has done and i want to get back to being myself
Brief Answer:
Follow up
Detailed Answer:
I see.
When I see someone like you in my practice, I order the following tests in addition a thorough physical examination:
CBC
Electrolytes
Kidney function tests
Liver function tests
25 hydroxy vitamin D levels
TSH
Free T4
Thyroid auto antibodies
Problems in any of the above can cause symptoms that you are experiencing
Follow up
Detailed Answer:
I see.
When I see someone like you in my practice, I order the following tests in addition a thorough physical examination:
CBC
Electrolytes
Kidney function tests
Liver function tests
25 hydroxy vitamin D levels
TSH
Free T4
Thyroid auto antibodies
Problems in any of the above can cause symptoms that you are experiencing
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
All thise tests cane back in the normal range. As i spoke to you last week and i got a full screen the oy ones that wernt i. The normal range were the serum cortisol and ahct? 1.1
Brief Answer:
Second follow up
Detailed Answer:
You probably mean ACTH, and not ahct.
The result appears to be on the lower side.
Regardless, it is best to go by clinical signs, as per the discretion of the treating endocrinologist.
Ask your doctor to screen you for celiac disease. It can cause symptoms directly, in addition to lowering absorption of the hydrocortisone that you are taking.
Occasionally it is associated with addisons disease. A good start is a simple blood test for anti-tissue transglutaminase antibodies and anti-endomysial antibodies. It gets more complex once these screening tests are positive, in order to confirm the diagnosis
Second follow up
Detailed Answer:
You probably mean ACTH, and not ahct.
The result appears to be on the lower side.
Regardless, it is best to go by clinical signs, as per the discretion of the treating endocrinologist.
Ask your doctor to screen you for celiac disease. It can cause symptoms directly, in addition to lowering absorption of the hydrocortisone that you are taking.
Occasionally it is associated with addisons disease. A good start is a simple blood test for anti-tissue transglutaminase antibodies and anti-endomysial antibodies. It gets more complex once these screening tests are positive, in order to confirm the diagnosis
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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