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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having dark patches on leg and neck, joint pain, sleep problems, dizziness. Low cortisol and low ACTH. Thyroid and test for anemia scheduled. Further tests?

I am a 42 year old female with many symptoms, dark patch on my leg, back of the neck area, joint pain, extreme exhaustion, sleep problems, no sex drive, tingling in my left hand, dizziness upon standing, chest tightness and stabbing pains that come and go, hair breaking off, acne, petichiea and bruising easily, memory problems and foggy thinking... I m sure there are some I m forgetting. I had a blood test and low cortisol and low ACTH sent me to an Endodrinologist but the ACTH Stim test came back with normal results. I m not sure where to turn the Endocrinolist says she ll check my thyroid and check for anemia (upon my request) but says after that she can t help me. I m not sure where to go for help?
Tue, 21 Jan 2020
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Internal Medicine Specialist 's  Response
Hello,

If ACTH stimulation test is normal, it means your adrenal are okay but they need ACTH to work. ACTH is not available for it is working and answer is that you need to be on very short dose of steroids for lifelong to replace natural cortisol and keep you working. There may be associated androgen deficiency for which you SHOULD first undergo lab test as serum testosterone levels.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Muhammad Faisal Bacha, Internal Medicine Specialist
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Having dark patches on leg and neck, joint pain, sleep problems, dizziness. Low cortisol and low ACTH. Thyroid and test for anemia scheduled. Further tests?

Hello, If ACTH stimulation test is normal, it means your adrenal are okay but they need ACTH to work. ACTH is not available for it is working and answer is that you need to be on very short dose of steroids for lifelong to replace natural cortisol and keep you working. There may be associated androgen deficiency for which you SHOULD first undergo lab test as serum testosterone levels. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist