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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for sleeplessness

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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Mon, 28 May 2018 in Thyroid Problem and Hormonal Problems
Question: I cannot seem to figure a way to get over not sleeping (maybe adrenal insufficiency) with good diet and B 5, iodine, dhea, adrenal cortex, multi already in place
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Answered by Dr. Shehzad Topiwala 2 hours later
Brief Answer:
Hormone tests

Detailed Answer:
Sorry to learn about your bothersome symptoms.

Adrenal insufficiency typically does not cause loss of sleep.

I see you are aware of the fact that the blood cortisol tests to screen for the possibility of adrenal insufficiency is to draw the blood sample before 8 am. I understand your point about the post-9 am blood sampling and also that you are really awake much earlier than 8 am. So I agree with you that the test is less reliable in excluding this diagnosis.
So discuss with your doctor about another test to check the adrenal status called ACTH stimulation test. This can even be done randomly during the daytime, such as your doctors' office in regular office hours.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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