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#440007 08/01/08 10:49 AM
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Hi everyone, this is my first post here, Ilike this site, its easy to navigate. I have been doing my research on this giant thyroid/ adrenal puzzle just like everyone else has been and I'm confused on what is THE definitive test to rule out pituitary problems. Is it the stim test, the blood test or urine maybe I just can't remember due to brain fog! It seems the more I read the more confused I get. I wish I could defrag my brain! Any thoughts pleease. Thank you.

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rangersmom541,

Welcome!
The "ACTH Stimulation" test rules out true, full blown adrenal insufficiency but doesn't catch cases of adrenal fatigue, when the cortisol circadian rhythm can be off, so that cortisol (major adrenal hormone) levels fall sooner in the day when they are supossed to or they start out low in the mornings and increase toward evening (opposite of what's suppossed to happen). This is better found through saliva testing that takes several samples in a 24 hour period. Pharmaices carry these test kits by ZRT Labs, Inc. or they can be ordered direct from them online: www.salivatest.com .
Urine cortisol to test adrenal function, is usually done to detect overproduction (Cushing's Disease) but some Dr.s do use it to test for low adrenal cortisol.

One test I know of for pituitary function, when it is suspected to be off due to a tumor or other cause, is one called the "Glucagon test". It also gauges the pituitary's response to being stimulated by this hormone.

If you have full blown adrenal insufficiency ruled out or is not suspected to begin with, saliva cortisol tests are the most accurate for detecting adrenal fatigue.


Jim Lowrance
Thyroid Health
JimLow - #440065 08/01/08 03:05 PM
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Thank you Jim , I have had the saliva test done , I wont get into all the results (I don't type very fast) but my cortisol burden was 15. I know that is bad. Correct me if I'm wrong but I thought the reason for the stim test was to rule out the pituitary as the cause of adrenal problems

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Your Welcome.

With the ACTH Stim Test, they inject a patient with the same hormone into the blood stream that normally comes from the pituitary gland. ACTH stands for "Adrenocorticotropic Hormone" and it takes CRH "Cortitropin Releasing Hormone" sent from the hypothalamus to get the pituitary to release ACTH for stimulating the adrenal glands.
If they test the pituitary itself they will blood measure the amount of ACTH in the blood stream and compare it to normal values but with adrenal testing, they are measuring how well the adrenals react to the ACTH hormone. If they react well, that's when they might test to see if the pituitary is sending out enough ACTH. If it is not, then they would diagnose the adrenal insufficiency as "secondary". When it's a problem with the adrenal glands (not responding to ACTH), they call it "primary" adrenal insufficiency.
Most cases of primary are autoimmune adrenalitis and when enough destruction of the adrenal cortex (outer region) takes place, it is referred to as Addison's Disease. I believe 90% of the cortex being destroyed is when full blown adrenal insufficiency takes place. The inner region of the adrenals is called the medulla and it regulates adrenaline and nor-adrenaline, while the cortex is where cortisol comes from.

Last edited by JimLow - Thyroid Health; 08/02/08 09:52 PM.

Jim Lowrance
Thyroid Health

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