Guest guest Posted February 16, 2010 Report Share Posted February 16, 2010 Rarely one can have both. I have never seen it.ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done?CE Grim MDOn Feb 16, 2010, at 9:14 PM, Stone wrote:Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2010 Report Share Posted February 17, 2010 Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it. ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done? CE Grim MD On Feb 16, 2010, at 9:14 PM, Stone wrote: Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2010 Report Share Posted February 17, 2010 Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it. ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done? CE Grim MD On Feb 16, 2010, at 9:14 PM, Stone wrote: Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Yes I have heard of this. What you want to do is to go to pubmed and search for Cushing's and PA and see if your data suggests both.Do you look Cushingoid? Google images for Cushings and compare.What are the other tests you NEED?You have a normal diurnal variation of cortisol and do not likely have Cushings. NEVER use one labs normals for another labs results. NEVER!CE GrimOn Feb 17, 2010, at 9:37 PM, Stone wrote:Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it.ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done?CE Grim MDOn Feb 16, 2010, at 9:14 PM, Stone wrote:Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Yes I have heard of this. What you want to do is to go to pubmed and search for Cushing's and PA and see if your data suggests both.Do you look Cushingoid? Google images for Cushings and compare.What are the other tests you NEED?You have a normal diurnal variation of cortisol and do not likely have Cushings. NEVER use one labs normals for another labs results. NEVER!CE GrimOn Feb 17, 2010, at 9:37 PM, Stone wrote:Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it.ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done?CE Grim MDOn Feb 16, 2010, at 9:14 PM, Stone wrote:Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 For my high cortisol they are going to check salivary cortisol. Since my aldosterone is low they have ruled out PA. Dana Sent from my Verizon Wireless BlackBerryFrom: Clarence Grim <lowerbp2@...>Date: Thu, 18 Feb 2010 06:15:12 -0600<hyperaldosteronism >Subject: Re: question about cortisol Yes I have heard of this. What you want to do is to go to pubmed and search for Cushing's and PA and see if your data suggests both.Do you look Cushingoid? Google images for Cushings and compare.What are the other tests you NEED?You have a normal diurnal variation of cortisol and do not likely have Cushings. NEVER use one labs normals for another labs results. NEVER!CE GrimOn Feb 17, 2010, at 9:37 PM, Stone wrote:Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it.ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done?CE Grim MDOn Feb 16, 2010, at 9:14 PM, Stone wrote:Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 For my high cortisol they are going to check salivary cortisol. Since my aldosterone is low they have ruled out PA. Dana Sent from my Verizon Wireless BlackBerryFrom: Clarence Grim <lowerbp2@...>Date: Thu, 18 Feb 2010 06:15:12 -0600<hyperaldosteronism >Subject: Re: question about cortisol Yes I have heard of this. What you want to do is to go to pubmed and search for Cushing's and PA and see if your data suggests both.Do you look Cushingoid? Google images for Cushings and compare.What are the other tests you NEED?You have a normal diurnal variation of cortisol and do not likely have Cushings. NEVER use one labs normals for another labs results. NEVER!CE GrimOn Feb 17, 2010, at 9:37 PM, Stone wrote:Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it.ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done?CE Grim MDOn Feb 16, 2010, at 9:14 PM, Stone wrote:Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Couldn't some meds change cortisol levels? > > > >> > >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other? > >> > >> > >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both... > >> > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Couldn't some meds change cortisol levels? > > > >> > >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other? > >> > >> > >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both... > >> > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Did they recheck this? Waswn't your ratio 30? > > > >> > >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other? > >> > >> > >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both... > >> > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Did they recheck this? Waswn't your ratio 30? > > > >> > >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other? > >> > >> > >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both... > >> > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 You have a great memory Francis. They redid it a couple of weeks ago and my renin went from <0.15 to over 7 Which I think is due to the meds I am on. So things are just confusing the issue at this point. She said since my aldosterone was not over 10 they have ruled out PA. My urine NA and K were were not out of whack either so hopefully we are not covering something up. Dana Sent from my Verizon Wireless BlackBerryFrom: "Francis Bill" <georgewbill@...>Date: Thu, 18 Feb 2010 15:32:57 -0000<hyperaldosteronism >Subject: Re: question about cortisol Did they recheck this? Waswn't your ratio 30?> >> >>> >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other?> >>> >>> >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both...> >>> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 You have a great memory Francis. They redid it a couple of weeks ago and my renin went from <0.15 to over 7 Which I think is due to the meds I am on. So things are just confusing the issue at this point. She said since my aldosterone was not over 10 they have ruled out PA. My urine NA and K were were not out of whack either so hopefully we are not covering something up. Dana Sent from my Verizon Wireless BlackBerryFrom: "Francis Bill" <georgewbill@...>Date: Thu, 18 Feb 2010 15:32:57 -0000<hyperaldosteronism >Subject: Re: question about cortisol Did they recheck this? Waswn't your ratio 30?> >> >>> >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other?> >>> >>> >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both...> >>> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 One of my sisters had Pancreatitis and likes cows. She was on the feeding tube for quite some. The renin of 7 must be near the high side of the lab range if not over it. > > > > > >> > > >> Do any of you also have a high cortisol and ACTH level? I have had > > >> three cortisol tests and only one has been high when I was feeling > > >> really bad and before low salt diet. I'm wondering if the possible > > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > > >> independent of each other? > > >> > > >> > > >> I have some symptoms and tests that point to Cushings and some > > >> symptoms and tests that point to PA. Is it possible to have both? I > > >> know salt has something to do with both... > > >> > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 One of my sisters had Pancreatitis and likes cows. She was on the feeding tube for quite some. The renin of 7 must be near the high side of the lab range if not over it. > > > > > >> > > >> Do any of you also have a high cortisol and ACTH level? I have had > > >> three cortisol tests and only one has been high when I was feeling > > >> really bad and before low salt diet. I'm wondering if the possible > > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > > >> independent of each other? > > >> > > >> > > >> I have some symptoms and tests that point to Cushings and some > > >> symptoms and tests that point to PA. Is it possible to have both? I > > >> know salt has something to do with both... > > >> > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 You have an awesome memory!! I think my cozaar is really messing up my readings but they didn't take me off meds prior to testing. I just hope they are correct in their assumptions that I don't have PA. Dana Sent from my Verizon Wireless BlackBerryFrom: "Francis Bill" <georgewbill@...>Date: Thu, 18 Feb 2010 16:30:07 -0000<hyperaldosteronism >Subject: Re: question about cortisol One of my sisters had Pancreatitis and likes cows. She was on the feeding tube for quite some. The renin of 7 must be near the high side of the lab range if not over it. > > >> > >>> > >> Do any of you also have a high cortisol and ACTH level? I have had > > >> three cortisol tests and only one has been high when I was feeling > > >> really bad and before low salt diet. I'm wondering if the possible > > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > > >> independent of each other?> > >>> > >>> > >> I have some symptoms and tests that point to Cushings and some > > >> symptoms and tests that point to PA. Is it possible to have both? I > > >> know salt has something to do with both...> > >>> > >> > >> > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 You have an awesome memory!! I think my cozaar is really messing up my readings but they didn't take me off meds prior to testing. I just hope they are correct in their assumptions that I don't have PA. Dana Sent from my Verizon Wireless BlackBerryFrom: "Francis Bill" <georgewbill@...>Date: Thu, 18 Feb 2010 16:30:07 -0000<hyperaldosteronism >Subject: Re: question about cortisol One of my sisters had Pancreatitis and likes cows. She was on the feeding tube for quite some. The renin of 7 must be near the high side of the lab range if not over it. > > >> > >>> > >> Do any of you also have a high cortisol and ACTH level? I have had > > >> three cortisol tests and only one has been high when I was feeling > > >> really bad and before low salt diet. I'm wondering if the possible > > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > > >> independent of each other?> > >>> > >>> > >> I have some symptoms and tests that point to Cushings and some > > >> symptoms and tests that point to PA. Is it possible to have both? I > > >> know salt has something to do with both...> > >>> > >> > >> > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 yes but if they dont need to be measured then dont measure them.On Feb 18, 2010, at 8:34 AM, Francis Bill wrote:Couldn't some meds change cortisol levels? > >> >>> >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other?> >>> >>> >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both...> >>> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 yes but if they dont need to be measured then dont measure them.On Feb 18, 2010, at 8:34 AM, Francis Bill wrote:Couldn't some meds change cortisol levels? > >> >>> >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other?> >>> >>> >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both...> >>> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Seems to me that the urine K was low so not DASHing?CE Grim MDOn Feb 18, 2010, at 9:48 AM, cowdoc@... wrote:You have a great memory Francis. They redid it a couple of weeks ago and my renin went from <0.15 to over 7 Which I think is due to the meds I am on. So things are just confusing the issue at this point. She said since my aldosterone was not over 10 they have ruled out PA. My urine NA and K were were not out of whack either so hopefully we are not covering something up. DanaSent from my Verizon Wireless BlackBerryFrom: "Francis Bill" <georgewbill >Date: Thu, 18 Feb 2010 15:32:57 -0000<hyperaldosteronism >Subject: Re: question about cortisol Did they recheck this? Waswn't your ratio 30?> >> >>> >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other?> >>> >>> >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both...> >>> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Seems to me that the urine K was low so not DASHing?CE Grim MDOn Feb 18, 2010, at 9:48 AM, cowdoc@... wrote:You have a great memory Francis. They redid it a couple of weeks ago and my renin went from <0.15 to over 7 Which I think is due to the meds I am on. So things are just confusing the issue at this point. She said since my aldosterone was not over 10 they have ruled out PA. My urine NA and K were were not out of whack either so hopefully we are not covering something up. DanaSent from my Verizon Wireless BlackBerryFrom: "Francis Bill" <georgewbill >Date: Thu, 18 Feb 2010 15:32:57 -0000<hyperaldosteronism >Subject: Re: question about cortisol Did they recheck this? Waswn't your ratio 30?> >> >>> >> Do any of you also have a high cortisol and ACTH level? I have had > >> three cortisol tests and only one has been high when I was feeling > >> really bad and before low salt diet. I'm wondering if the possible > >> PA caused higher levels of cortisol and ACTH? Or possibly they are > >> independent of each other?> >>> >>> >> I have some symptoms and tests that point to Cushings and some > >> symptoms and tests that point to PA. Is it possible to have both? I > >> know salt has something to do with both...> >>> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Sometimes doctors check it because they don't know what else to do. Since so many doctoes don't understand PA they don't look for it. > > > > > > > >> > > > >> Do any of you also have a high cortisol and ACTH level? I have > > had > > > >> three cortisol tests and only one has been high when I was > > feeling > > > >> really bad and before low salt diet. I'm wondering if the > > possible > > > >> PA caused higher levels of cortisol and ACTH? Or possibly they > > are > > > >> independent of each other? > > > >> > > > >> > > > >> I have some symptoms and tests that point to Cushings and some > > > >> symptoms and tests that point to PA. Is it possible to have > > both? I > > > >> know salt has something to do with both... > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 Sometimes doctors check it because they don't know what else to do. Since so many doctoes don't understand PA they don't look for it. > > > > > > > >> > > > >> Do any of you also have a high cortisol and ACTH level? I have > > had > > > >> three cortisol tests and only one has been high when I was > > feeling > > > >> really bad and before low salt diet. I'm wondering if the > > possible > > > >> PA caused higher levels of cortisol and ACTH? Or possibly they > > are > > > >> independent of each other? > > > >> > > > >> > > > >> I have some symptoms and tests that point to Cushings and some > > > >> symptoms and tests that point to PA. Is it possible to have > > both? I > > > >> know salt has something to do with both... > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 IMHO 24 hr urinary free cortisol is best-if you can collect a good urine that is. Indeed our standard screening pacage for new HTN included this and a catecholamine test for pheo as well.So we got Na, K, aldo, cortisol, E and NE and creatinine all in one urine. Saves lots of time and money if indicated. Indication is drug resistant HTN. On Feb 18, 2010, at 8:23 AM, cowdoc@... wrote:For my high cortisol they are going to check salivary cortisol. Since my aldosterone is low they have ruled out PA. DanaSent from my Verizon Wireless BlackBerryFrom: Clarence Grim <lowerbp2mac>Date: Thu, 18 Feb 2010 06:15:12 -0600<hyperaldosteronism >Subject: Re: question about cortisol Yes I have heard of this. What you want to do is to go to pubmed and search for Cushing's and PA and see if your data suggests both.Do you look Cushingoid? Google images for Cushings and compare.What are the other tests you NEED?You have a normal diurnal variation of cortisol and do not likely have Cushings. NEVER use one labs normals for another labs results. NEVER!CE GrimOn Feb 17, 2010, at 9:37 PM, Stone wrote:Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it.ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done?CE Grim MDOn Feb 16, 2010, at 9:14 PM, Stone wrote:Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2010 Report Share Posted February 18, 2010 IMHO 24 hr urinary free cortisol is best-if you can collect a good urine that is. Indeed our standard screening pacage for new HTN included this and a catecholamine test for pheo as well.So we got Na, K, aldo, cortisol, E and NE and creatinine all in one urine. Saves lots of time and money if indicated. Indication is drug resistant HTN. On Feb 18, 2010, at 8:23 AM, cowdoc@... wrote:For my high cortisol they are going to check salivary cortisol. Since my aldosterone is low they have ruled out PA. DanaSent from my Verizon Wireless BlackBerryFrom: Clarence Grim <lowerbp2mac>Date: Thu, 18 Feb 2010 06:15:12 -0600<hyperaldosteronism >Subject: Re: question about cortisol Yes I have heard of this. What you want to do is to go to pubmed and search for Cushing's and PA and see if your data suggests both.Do you look Cushingoid? Google images for Cushings and compare.What are the other tests you NEED?You have a normal diurnal variation of cortisol and do not likely have Cushings. NEVER use one labs normals for another labs results. NEVER!CE GrimOn Feb 17, 2010, at 9:37 PM, Stone wrote:Dr. Grim, I have not had 24 hr urinary cortisol and many other tests needed as of yet because I just recently got health insurance so now just beginning testing phase. I had the first cortisol and ACTH tests when I was feeling bad and the results were cortisol high at 26.1 and ACTH high at 49. The reference range given was 5-27 for adult. The next cortisol was when I was feeling ok at 18.25 in a.m. and 4.68 in p.m. Then I was feeling a lot of chest pressure and feeling bad so we tested again and cortisol was 18.99 and ACTH was 53. But the lab's reference range was 10-60 as normal for in a.m. so it didn't show up as high here. But on Medlineplus the range was 9-52. You say it is very rare to have both PA and Cushings. Could there be a possiblity in MEN I or II where there are multiple tumors on endocrine glands? Have you heard of this? Re: question about cortisol Rarely one can have both. I have never seen it.ACTH and cortisol have a striking day night difference and are very labile. I prefer to do 24 hr urinary free cortisol. But you have to collect all urine. Has this been done?CE Grim MDOn Feb 16, 2010, at 9:14 PM, Stone wrote:Do any of you also have a high cortisol and ACTH level? I have had three cortisol tests and only one has been high when I was feeling really bad and before low salt diet. I'm wondering if the possible PA caused higher levels of cortisol and ACTH? Or possibly they are independent of each other? I have some symptoms and tests that point to Cushings and some symptoms and tests that point to PA. Is it possible to have both? I know salt has something to do with both... Quote Link to comment Share on other sites More sharing options...
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