I couple weeks ago I saw my endo who wanted to do some blood work. I've been on florinef for 2 years due to chronic hypotension, plus orthostatic hypotension. He was concerned because my BP has decreased even more over time, now averages 80/50. He also was concerned as I've been having low blood sugar lately and have lost a lot of muscle mass. He ran some tests after I saw him and this morning his secretary called me and told me I needed to start Cortisone Acetate. I asked her what the issue was, but she said the doctor was out of the country for the week and just left a note for me to start this medication immediately. She did give me my results though:
Serum Glucose: 2.6 (range 4 - 7) <-- LOW
Serum Sodium: 134 (range 135 - 145) <-- LOW
Serum Cortisol: 360 (range 190 - 750)
Serum ACTH: 18 (range 2 - 10) <-- HIGH
24 hour urine free cortisol: 42 (range 55 - 250) <-- LOW
I'm not sure what to make of these results. From what I can see online high ACTH and low cortisol means Addison's, but why is my serum cortisol normal and urine low? I read online that when your sugar is low, your cortisol should see a spike to higher levels, could this mean my cortisol is inappropriately low?
I want more information as to why I should take these meds and I don't want to start them without it, but the secretary says he had told her to ensure I start it today. Can anybody help me interpret why he wants me to start this?