Endocrine: what to test?

[Springbok1988]

Hello everyone,
I have had some symptoms that have been getting worse as time has gone on. I'm not exactly sure how to describe it but I'll try my best. It feels like my body is dead inside. It's not just fatigue but the feelings in my body. When something scares or surprises me, I don't get a rush of adrenaline. If something exciting happens, there is no rush. My memory has gotten worse, it's been harder to concentrate, my libido is completely gone, and my muscle pain has gotten worse.
I saw an endocrinologist about 7 months ago when this first started and he tested:
Cortisol, morning: High
ACTH: Lower side of normal
IGF-1: Normal
Testosterone: Normal
Because of the difference between the cortisol and ACTH he ordered a dexamethasone suppression test which came back normal.
I am wanting to go back and ask for more testing but I don't know what to ask for. I was thinking about pregnenolone or DHEA and catecholamines. Any other ideas?
I haven't yet had a doctor who has run anything beyond basic testing for me unless I have asked so I always like to go in prepared with some avenues of exploration. Thank you in advance!

 

[SWAlexander]

Hello everyone,
I have had some symptoms that have been getting worse as time has gone on. I'm not exactly sure how to describe it but I'll try my best. It feels like my body is dead inside. It's not just fatigue but the feelings in my body. When something scares or surprises me, I don't get a rush of adrenaline. If something exciting happens, there is no rush. My memory has gotten worse, it's been harder to concentrate, my libido is completely gone, and my muscle pain has gotten worse.
I saw an endocrinologist about 7 months ago when this first started and he tested:
Cortisol, morning: High
ACTH: Lower side of normal
IGF-1: Normal
Testosterone: Normal
Because of the difference between the cortisol and ACTH he ordered a dexamethasone suppression test which came back normal.
I am wanting to go back and ask for more testing but I don't know what to ask for. I was thinking about pregnenolone or DHEA and catecholamines. Any other ideas?
I haven't yet had a doctor who has run anything beyond basic testing for me unless I have asked so I always like to go in prepared with some avenues of exploration. Thank you in advance!

Hi Springbok1988
these are the tests I had and an MRI to see if there is a tumor near the pituitary gland.
I addition you may ask for X-ALD gene test (ABCD1) and a lab test VLCFA (very long chain fatty acid).
Adrenocorticotropic Hormone (ACTH)
https://medlineplus.gov/lab-tests/adrenocorticotropic-hormone-acth/

 

[Pyrrhus]

When something scares or surprises me, I don't get a rush of adrenaline.

Yeah, my autonomic system's "flight-or-fight" reflex is gone...

I don't know if this interests you, but here is a thread that talks about anhedonia, derealization, and related descriptions:
https://forums.phoenixrising.me/threads/cfs-and-emotional-blunting-not-able-to-cry.80694/

 

[SWAlexander]

Here is my last Endo Test for this year:

This is the reason I mentioned Cortisol many times in conjunction with ME/CFS

Low Cortisol:
Low levels of cortisol can cause weakness, fatigue, and low blood pressure. You may have more symptoms if you have untreated Addison's disease or damaged adrenal glands due to severe stress, such as from a car accident or an infection. These symptoms include sudden dizziness, vomiting, and even loss of consciousness.

Low ACTH
Secondary adrenal insufficiency happens when the pituitary gland fails to produce adequate amounts of ACTH, leading to a lack of cortisol production by the adrenal glands and thus low cortisol levels. Causes of secondary adrenal insufficiency may include: Autoimmune disease. Pituitary tumors or infection. ACTH deficiency can either be congenital or acquired, and its manifestations are clinically indistinguishable from those of glucocorticoid deficiency. Symptoms include weight loss, lack of appetite (anorexia), muscle weakness, nausea and vomiting, and low blood pressure (hypotension).

High Aldosterone
What are the symptoms of hyperaldosteronism?
Weakness.
Tingling feelings.
Muscle spasms.
Temporary paralysis.
Extreme thirst.
Frequent urination (having to urinate often)

Low Renin: Conn syndrome:
What is Conn's syndrome?
Primary aldosteronism (also called Conn's syndrome) is a rare condition caused by overproduction of the hormone aldosterone that controls sodium and potassium in the blood.
The signs and symptoms associated with Conn's Syndrome (primary hyperaldosteronism) include
low potassium in the blood (causing frequent urination),
muscle cramps and heart palpitations (feeling your heart racing).
These symptoms include fatigue, anxiety, depression, headache, and memory difficulties.
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC1955008/