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Have hypoglycemia. Feeling fatigue, lightheaded and headache. Test showed low BP. Any solution?

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General Surgeon
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I would like help understanding my labs. I have been very fatigued with headaches and lightheadedness. I also experience hypoglycemia. My B/P can get very low. I had a Cortisol Stimulation test ordered by a hematologist. During that particular test, they forgot to take my ACTH level but my b/p before the test was 84/42 and cortisol was 9.1. After the injection the cortisol went to 23.1 and my b/p went to a normal range. I also felt great for a few hours. The Dr. called me back in to get the ACTH (that was forgotten) another morning. That particular test showed that my ACTH was 8.0 and my cortisol was 3.7. Please help me understand these low normals and if it could be causing my fatigue, h/a's and low b/p. Side note: My b/p can be within a normal range, but I still feel horrible so I don't think the low b/p is the only reason for feeling sick. Also, I'm not a runner which I know can contribute to lower b/p.
Posted Thu, 25 Apr 2013 in General Health
 
 
Answered by Dr. Hari Charan Perigela 3 hours later
Hi
As per your test results,you have adrenal insufficiency.
Low BP,fatigue are due to this only.
You need do take Hydrocortisone / Methyl Prednisolone under supervision and advice of qualified ENDOCRINOLOGIST.
Please consult and proceed accordingly.
Wish you good health
Regards
Above answer was peer-reviewed by
 
Follow-up: Have hypoglycemia. Feeling fatigue, lightheaded and headache. Test showed low BP. Any solution? 6 hours later
Thank you
What kind of adrenal insufficiency? Would it be secondary (Pituitary) since both the ACTH and Cortisol are low?

Are there other tests that should be done to find out the cause? Isn't secondary adrenal insufficiency quite uncommon?

What diagnostic testing should I request.

Thanks again,
 
 
Answered by Dr. Hari Charan Perigela 2 hours later
Hi
As per your reports in query,it is secondary adrenal insufficiency
Secondary adrenal insufficiency is common.
You can go for CRH stimulation test.In secondary adrenal insufficiency,if there is no ACTH response ,Pituitary is the cause and if there is delayed response,then Hypothalamus is the cause.
Other tests like X XXXXXXX abdomen,Ultrasound abdomen,CT scan and MRI to know the size and shape of Pituitary gland.
Get thoroughly investigated and proceed accordingly.
Wish you good health
Regards
Above answer was peer-reviewed by
 
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