Question: I had the acth stimulation test done and my morning cortisol level was 15.7mcg/DL then increased to 26 at 30 minutes and 26.1 at 60 minutes. Is this normal?

I had read online the normal cortisol level should be 20-30 but the lab I got it at says the "normal range" AM cortisol is 6.7 to 22.6 mcg/dl. So wouldn't my level be normal? But the fact that it didn't double means I have adrenal insufficiency?

IF one of your patients had this test result what would your next step be?

I had to ask my doctor to order this test and I don't see him until December for follow up. I feel absolutely awful and I just want to figure out why so I can fix it
Also could the test be effected if I am sick? I am getting over a respiratory infection.

I don't even know where to begin. I have been having been having a lot of symptoms for the past 1.5 years. I have been having palpitations, fatigue, weakness, shortness of breath and have to take deep breaths a lot. The past couple of months I began having episodes of flushing, tremors, irritability. I had one slightly elevated plasma metanephrines the other was normal (They tested me for a Pheo and was negative). The episodes last less than 30 minutes, and after the episodes I get so tired, like I could just fall asleep. The past couple weeks I have been getting episodes of extreme weakness and sometimes I have tingling in my legs. Sometimes when that happens I have flank discomfort, or lower abdominal/groin discomfort. Sometimes I feel really sick when standing (palpitations, sob) and feel better when lying down. The episodes are so random. I have had a pulmonology workup (only thing abnormal was low DLCO on PFTs), cardiac workup (only thing abnormal was a "flat blood pressure response" on exertion, and an "exaggerated" heart rate response to activity (especially stairs and inclines). I have seen a psychiatrist and he said he does not believe it is psych and that it is medical and suggested and endocrine problem. I have gradually cut down my activity over the past year because I just can't keep up. Some days I spend the day laying down. Some days I feel ok and can do things. Although I never have a day without symptoms. My TSH and CBC is normal. My weight is normal. I am a RN and I know how ridiculous all my symptoms sound. I sound crazy. Nothing makes sense and I am losing my mind trying to figure this out. I do not know what else to do, but I can't keep living like this.

I forgot to mention that when I took dexamethasone and prednisone for another condition I felt SOOO much better. I actually went to the gym! However, when I had tried the Medrol pack and it did not seem to help. My menstrual cycle has been normal. I do have another 24 hour urine collection ordered.

Would the 5 HIAA urine test for the same thing? I have that ordered. Could there still be a problem with my pituitary gland even though the cortisol test was normal? I did not get the ACTH level back yet