Ok.

I should maybe start by mentioning I have high blood pressure. It seems to be hereditary based on the women of my mother’s side of the family. It effects my sister too, she take three kinds of pills for her BP which only barely work. On my father’s side of the family, there’s a problem with cholesterol build-up that Lipitor doesn’t help, and sometimes people born sterile.

On the other hand, if I exert myself at all, my blood pressure drops quickly. On my last visit to the doctor, it was recorded as falling from 150/? to 60/? from the simple act of walking down the hallway and back. Then my doctor said "oh, that can’t be possible" and wrote a second resting BP on my chart instead. The same doctor who finished the meeting by saying "we aren’t going to help you" and "go find yourself an herbal specialist" :( :(

At the time of the ACTH stim test, I was taking 50mg/day aldactone for my BP. It worked a lot better than the three kinds of pills my sister takes. I told the endo, but he wasn’t listening to anything I said. I couldn’t not take it, because without it my blood pressure goes dangerously high. I’ve researched the effects this might have had on my stim test results.
1) Reduces aldosterone production
2) Increases cholesterol -> pregnenolone conversion, because of #1
3) No effect on 17-alpha-hydroxylase (cyp17) controlled conversions

(*) Theoretically an androgen-blocking effect, but only if I took at least 100-150 mg per day, which I wasn’t.

The test was conducted on day 10 of my cycle. I can tell you the lab results I have. Some of the reports mysteriously disappeared from the hospital’s computer before I could get printouts.

Also, for a dexamethasone suppression test conducted two months later, the entire results disappeared from their computer and have never been found again. All I have to show it ever took place is an empty pill bottle with the endo’s prescription for 1 x 1mg dex pill, and a billing statement from my insurer.

There was other funny business like that, a dna test for CAH mutations that I took and was billed for, but the lab reports were never filed. And when they did a torso ct-scan to check my adrenals for tumours, they also did a pelvic scan and billed my insurance for it, but the pelvic scan pictures were never seen again. In the torso scan, my adrenals looked enlarged at 12cm and 18cm across. Normal is supposed to be with your adrenals so small that they’re barely visible on a ct-scan.

Sorry for rambling, back to the stim test.

17-hydroxypregnenolone
baseline- (missing, was originally told something very low)
60 min - 35ng/dL ;; normal range given as 290-910 ng/dl for *stimulated*
If I hadn’t been taking the aldactone, this might be even lower

17-hydroxyprogesterone
baseline- zero, the report said it was undetectable.
60 min - (missing)
90 min - 121ng/dl ;; no normal range given, but apparently low for stimulated

Renin
baseline- 2.4ng/ml/hour ;; normal range given as 0.65-5.0 ng/ml/hour
If I had primary aldosteronism, my renin should be low
If I had secondary aldosteronism, my renin should be high
I can’t find anything listed for renin levels in the middle

Aldosterone
baseline- 42ng/dl ;; normal range given as 1-16ng/dl for supine, and I had been resting
90 min - 73ng/dl ;; same normal range given as for baseline (??) and I’d remained mostly supine due to passing out from the ACTH.
Due to the aldactone, these readings are probably lower than they would have been

Cortisol
baseline- 14 (no units given) ;; no normal range given
60 min - 35 (no units given) ;; no normal range given
90 min - 53.9 (no units given) ;; no normal range given
I have no way to tell if this is low, high, or whatever. The only thing I can say is that since I was 8 years old I’ve gone through too many years of dehydration and occasional bouts of salt craving.

In addition, when I was prescribed a 1mg tablet of dexamethasone for the supression test two months later, that dex tablet made me feel the healthiest I’ve been since I was 8, for about a whole day and a half.

Other trivia- The ACTH injection made me so woozy I passed out before the test was over.

If the cortisol was low, then I’d suspect something like 17-alpha-hydroxylase deficiency, because both 17-oh-pregnenolone and 17-oh-progesterone are pretty low. If it’s high, I can’t guess what’s wrong, and no one else is saying. Cortisol doesn’t magically appear from nowhere, and there weren’t enough precursors to make it from.

After the stim test, my doctor cut my aldactone dose down to 25mg/day because the endo claimed he couldn’t find anything wrong with my hormone levels and I was probably just being hysterical. The 25mg/day barely keeps my BP down at all, and if I miss a day, I turn red as an apple and my eyeballs feel like they’re going to explode out of my head.