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Posted 9/16/2024 1:19 PM (GMT -5)
I know this isn't about Lyme but it might be Lyme related? I can't see any adrenal insufficiency forum on Healing Well so I thought if there is anyone here with adrenal insufficiency then they might be able to help.

Following on from my latest thread re recent blood test results... I also have low cortisol levels and I'm about to do an ACTH stimulation test. Does anyone know if that comes back 'normal', this means that you don't have primary adrenal insufficiency, is that correct?

And does anyone know what tests would then see if you have secondary adrenal insufficiency? ACTH blood test, aldosterone blood test, DHEA blood test, insulin tolerance test, glucagon stimulation test? Should all of these be completed? Or just some of them? Are there any others which are important?

My LH, FSH, Oestradiol, Prolactin were all normal. TSH above optimal but within range, T4 slightly low and T3 below optimal but within range. Testosterone was high and SHBG slightly high.

Any input would be appreciated, thank you!

Editing this to ask if anyone knows of a UK specialist for adrenal insufficiency? bc I'm unsure about my current endocrinologist. thanks!

Post Edited (pinkblossom) : 9/17/2024 4:07:04 AM (GMT-4)

Posted 9/17/2024 7:00 AM (GMT -5)
I have suspected Adrenal problems on my end for some time. Sometimes "high".....other times "low".
Remember - Lyme is a Multi-System infection, and can cause secondary Adrenal problems.
Posted 9/17/2024 10:38 AM (GMT -5)
Hi rob thank you, that makes sense

Have you done any testing to see how your adrenals are doing? If so which tests? Thanks
Posted 9/17/2024 11:49 AM (GMT -5)
IMO shoemaker’s CIRS theory is still rather applicable when it comes to adrenal issues. Just not so much the treatment to reverse it.

There’s different angles the adrenals can be looked at from. Not many of which are cut and dry answers. One I didn’t see you mention was pregnenolone - which is like a grandparent hormone to a lot else downstream - some see a “pregnenolone steal” where one hormone takes the available pregnenolone leaving not enough available for another.

I experimented with some adrenal glandulars early on. My thinking was if adrenals are causing a major issue I can simulate healthy adrenal function and assess symptom shifts. I found some very mild benefit at times but I saw it as a secondary issue that I wasn’t going to supplement my way out of like that.
Posted 9/17/2024 11:51 AM (GMT -5)
These infections do stress your adrenals, and can worsen an existing adrenal problem.

An ACTH stimulation test and insulin tolerance test give similar results, so usually you would do one or the other. Often you want to do one of these together with a 17-hydroxyprogesterone test. 17-hydroxyprogesterone is a cortisol precursor which can accumulate due a genetic disorder in 1% to 2% of the population, which results in inadequate cortisol production (primary adrenal insufficiency).

Also if your adrenals are stressed it can increase your homocysteine, particularly if you also have MTHFR deficiency.

If you have unstable blood sugar then you probably want to test for that separately.

This thread describes some of the symptoms of adrenal insufficiency:
https://www.healingwell.com/community/default.aspx?f=30&m=4329764
Posted 9/17/2024 12:43 PM (GMT -5)
quite a lot of lymies tend to end up with disrupted cortisol rhythms

normally - its meant to peak in the morning to help you get going and then taper off through the day

but a lot of people with lyme get this reversed making mornings v hard and days offset - sometimes completely reversed

so as well as testing total cortisol ( too high / too low etc ) - its important to know what the cycle is like - ie is it arriving at the right time - which the total cortisol or morning cortisol tests cannot establish - needs a 4 point salvia test

the other thing worth a mention is that some doctors think that "adrenal fatigue" may be a misnomer and that its now emerging that many of these people actually have cortisol resistance - the idea being much like insulin resistance in type 2 diabetics - where the body is making enough - but the cells have grown resistant to it due to high levels historically
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