Amy,

 

I have primary adrenal insufficiency (addison's disease) plus
hypothyroidism. 

 

My thought is that with cortisol running that low, you must first have
adrenal workup.  A competent endocrinologist with adrenal experience, must
run a blood level ACTH.  (it is done at 8 AM, the time is important due to
the peak of cortisol and ACTH in the body, as you've probably read).  If
blood level is elevated, then a synthactin (acth) stimulation test must be
done.  Please insist on it.  Do  not let anyone put you on steroids for any
reason, til you get a doctor to run stim. Testing.  Too many people have
missed that step, have been diagnosed for life, when they did not have
primary insufficiency.  

 

If on the other hand, ACTH is low, have you been on steroids or had steroid
shots or inhalers in the past?  If so you could be secondary AI.  A very
slow taper off steroids helps keep the pituitary from shutting down.

 

Either way, thyroid numbers will be off.  You must address adrenal first, to
avoid complications.

 

Hope this makes sense, feel free to write privately if necessary.

 

Regards,

Holly


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