Hi Mamabear. Looks like you need the ITT or Arginine test (see in
"More stickies" in Supplement site "Simulation Test Stickies"

Keep in mind young children have lower cortisol than adults, I think
their ACTH is higher. So looks like his ACTH is pretty low, cortisol
I don't know what it should be for a child as young as him, but
probably to low. That his renin is so low helps support that he's
secondary AI. Sodium and potassium ranges he has are what adults are
given. That his sodium is that low I would expect him to have
trouble with salt wasting (excessive sweating and urination, hard to
handle heat, craves salty food like potato chips). His potassium
looks low and would match with secondary. In adults, the range of
4.0-4.3 as having a 70% chance of secondary AI.

I look for a TSH of 2.5 in very young children, so his is very high.
He needs free T4, yes his T3 is pooling because of lack of cortisol.
That he seems to have a combo of Primary hypothyroid and secondary
adrenal insufficiency, I think it is likely he has Hashimotos
(antibody attack on thyroid). Get TPO and Tga thyroid antibodies
tested. I see the combo of hashi's/secondary AI quite often in
adults. I haven't seen one instance where primary hypo with secondary
AI did not involve hashi's.

It only takes on low pit hormone to be hypopituitary. I don't know
how young before an acth stim may not be given, but ask about giving
him one. If he is secondary AI, he will likely double or more on the
stim which is what secondaries do. See the article I wrote on "ACTH
stimulation test" on Wikipedia which will explain secondary AI results
in more detail. I bet you've read it already, but I'll put it up for
others benefit.

You're welcome,
Chris


--- In Hypopituitary_Support@yahoogroups.com, "laurel6123"
<laurel.parker@...> wrote:
>
> Hi Chris-I'm MamaBear from RTH.
>
> (Had a stim that went 3.62x, low sodium/potassium, aldo of 10, renin
> was .7 when done salt fasting. anything else you want a refresher on
> for this?)
>
> I got my HGH back;
>
> <1ng/mL with a range of 0-10
>
> 28 year old female
> meds-
> 80 mcgs T3 for RT3 issues
> 30 mgs HC
> sea salt
> NuSalt (KCl supplement)
> B12
>
> I have my 2 year old sons results back for aldo/renin, Na/K, AM
> cortisol, etc-would you be interested in looking at them? I'll throw
> them up to save time. If you would, I'd be grateful, if not, that's
> cool.
>
> 2 years old, male
> DOB 10/17/06
>
> These were done fasting, at 9:30 AM
> ACTH 17 pg/mL 0-46
> AM Cortisol 9.8 ug/mL 4.3-22.4
> Aldosterone 4 ng/dL 7.0-93.0
> Renin 3.5 ng/dL 13-36 ng/mL
> Sodium 134 133-145
> Potassium 4.1 3.7-5.5
> TSH 4.05 .5-5.0 (crap range)
>
> ferritin 2 ng/mL 20-350
> Free T3 4.8 pg/mL 2.3-4.2
>
> I'm primarily concerned about pit function, which looks valid to me,
> as a 2 year old should have a higher ACTH level than that, AND a high
> AM cortisol. Na and K look off to me, his iron is low, and he
> appears to be pooling his T3. TSH is too high, indicating
> hypoT....but I'm not sure if he's truly hypoP or not since his TSH is
> responding.
>
> Thoughts?
>
> Thanks Chris!
>