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Is Someone's Normal Erythrocyte Sedimentation Rate Associated With The Risk Of Addison's Disease In The Future?

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Posted on Thu, 4 Apr 2024
Question: Hi. If someone's erythrocyte sedimentation rate normal (16), would that mean that they have no chance of having Addison's Disease or is that related at all?

Thank you so much!
doctor
Answered by Dr. Mirjeta Guni (1 hour later)
Brief Answer:
About XXXXXXX disease and ESR;

Detailed Answer:
Hello amd thank you for asking!
High ESR is suggestive for inflamation or infectious disease.
It is not a slecific finding of XXXXXXX disease and it does not hep to diagnose or rule out the pathology.
Synacten stimulation test is the only test that makes the diagnosis.
It may be normal, high or low in XXXXXXX disease.
So, yes, it may be XXXXXXX even though ESR is normal.
Will be a pleasure to answer further questions if needed.
Best wishes,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mirjeta Guni (2 hours later)
Thank you so much, Dr.Mirjeta!

That does bring me to another question. I have not been referred to an endocrinologist yet, but I expect to have a referral to one by my pulmonologist tomorrow. I will list my symptoms below, which coincide with what I have read about Addison's. They became very pronounced on March 3rd and have gotten worse at times since then, the main thing being exhaustion after an activity.

I will also list some lab tests if that's okay.

My question is this - would you advise that I ask my endocrinologist for Addison's testing if he or she doesn't order the test? If you would recommend testing, if my appointment with an endocrinologist is not scheduled soon, should I ask if my primary care would order the test or just wait.

Also:

- Do any of the following symptoms and lab results make you think of another disease/disorder that I should be tested for?

- Would a normal ESR mean that if I have Addison's, it's not autoimmune, since there is no inflammation involved? I read that 80% of Addison's is autoimmune and I have a positive ANA.


My symptoms:

- decreased appetite (especially since March 3rd) and a weight loss mow of 31.5 lbs in 6 months. I am so very thin now. Only 116.5 lbs and 5'8'' tall. A Body Mass Index of only 17.7.
- fatigue and exhaustion. Fatigue is constant but I become extremely exhausted after exertion. Daily activities such as showering are very hard
- much lower than normal blood pressure on an almost daily basis (was in 120s/80s and now it can go to 80s/high 50s
- salt craving (and I suddenly dislike sweets (my favorite - I just think that's strange)
- joint pain (not severe, but definitely there at times)
-muscle weakness (legs and arms)
- diarrhea (usually after exertion - before this, I was chronically constipated for my entire life)
- excessive urination
- intolerance to cold (but, it might be because I'm so thin now!)
- irregular menstral periods (just started being irregular with all of this)
- severe thirst and dehydration (I used to never be thirsty, now I drink water all the time and I am always thirsty - I still have dry mouth and have even had a swollen tongue despite drinking plenty - I am not diabetic)
- dizziness (with exertion mostly, but infrequently when I stand. I have tested for orthostatic hypotension that was not a problem)
- lack of sexual desire

I also have these symptoms, which I don't think would have anything to do with Addison's, but I'm not sure - significant cognitive problems since this started (memory, simple math, recalling words, etc), intermittent fevers (I actually had a fever when my ESR was drawn and it was normal), pain and pressure behind eyes,

I do not have hyperpigmentation of skin like I have seen, but I have had some very small darkened areas that I think of as "age spots" or "freckles" suddenly appear recently.

I have had many labs done. Everything is normal except for low WBC, Neutrophils, & hgb (hgb has always been slightly low and is no lower now than in the past)

My Antinuclear Antibody test was positive (1:80)

My doctor has done a immunoglobulin profile and it is normal. He has also ordered some tests specific to sarcoidosis and Sjogren's and they were fine.

Oh - and my TSH was fine. No T3 or T4 was ordered.

Thank you so much again, for your advice! I apologize for this being long, but my life and abilities have changed dramatically over the last 3 months. I used to be healthy and active - now it makes me so tired to even shower. It's so hard not knowing what is going on with my body or if I will ever feel normal again. So, any help or input that I can share with my doctors is greatly appreciated.
doctor
Answered by Dr. Mirjeta Guni (6 hours later)
Brief Answer: XXXXXXX disease and neuroendocrine tumors to be excluded:

Detailed Answer:
Hi again,
I have gone carefully through your detailed concerns.
Yes, In this situation a synacten stimulation test would be suggested as many of the symptoms correspond to adrenal insufficiency.
You are right, in 80% of cases, primary adrenal insufficiency has autoimmune etiology but it does not mean that ESR should be high (differently from rheumatological autoimmune pathologies).
If XXXXXXX disease will be excluded, than neuroendocrine tumors would be the next to look for.
Hope the information will help.
Best wishes,
Dr.Mirjeta
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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Is Someone's Normal Erythrocyte Sedimentation Rate Associated With The Risk Of Addison's Disease In The Future?

Brief Answer: About XXXXXXX disease and ESR; Detailed Answer: Hello amd thank you for asking! High ESR is suggestive for inflamation or infectious disease. It is not a slecific finding of XXXXXXX disease and it does not hep to diagnose or rule out the pathology. Synacten stimulation test is the only test that makes the diagnosis. It may be normal, high or low in XXXXXXX disease. So, yes, it may be XXXXXXX even though ESR is normal. Will be a pleasure to answer further questions if needed. Best wishes, Dr.Mirjeta