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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 31234
Experience:  Over 20 yrs of Family Practice
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My 12 year old son has problems with low sodium level. His

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My 12 year old son has problems with low sodium level. His body does not keep enough of his sodium that he gets dehydrated easily. They have gotten his sodium levels up to 130 today, we are in the hospital due to er visit yesterday for his second admission of dehydration. My question is what is the Cortisol test that they are going to do in the morning going to tell us and what number is XXXXX range for Cortisol?
Chattanooga, TN
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Chip replied 5 years ago.
First can I ask if any of this has been discussed with you by the doctors?
Customer: replied 5 years ago.
Yes but its hard to undestand when they use the medical terminology.
Expert:  Dr. Chip replied 5 years ago.
OK--is the cortisol test the only test they're going to run? Are they planning to do an ACTH stimulation test, too? Have they considered an MRI of the brain? You mentioned dehydration--is that because he's urinating a lot?
Customer: replied 5 years ago.
I think she said they were going to do the ACTH stimulation test also. The last time we were here they did a ct scan of his brain and it was normal, they also did a ct scan yesterday of his abdomen due to his complaint of pain. He had been vomiting on and off since Friday morning, got him to dr office yesterday morning and they sent us to the hospital to get fluids back in him. So now he has been getting fluids since yesterday around 12 and he got to eat around 830 last night, and he is feeling good. He got the dehydration for his vomiting due to excessive athletic play. Does that make sense?
Expert:  Dr. Chip replied 5 years ago.
Yes, it does. Tell me when the first occurrence was and have both times been in situations where he had vomiting or diarrhea or other reasons for being dehydrated?
Customer: replied 5 years ago.
The first occurance happened the last week of February and we were admitted to hospital on March 2 until March 5. Both times for vomiting and fatigue, no diarrhea in either case. He is actually a little constipated but they have given hime something for that.
Expert:  Dr. Chip replied 5 years ago.
And how did they determine that something more was going on other than hyponatremia from vomiting?
Customer: replied 5 years ago.
they really didnt until this last episode. They really thought the first occurance was just part of him having a stomach virus and he would not have another problem. But now it has happend for the second time and it was not brought on by a stomach virus. The first occurance showed his cortisol normal, but now it is showing not normal like i think she said it was 2.8. So now they want to test his cortisol in the morning and i am wondering on what is the correct number to be looking for and if it is low what would be the next step in fixing/treating the problem.
Expert:  Dr. Chip replied 5 years ago.
Well, depending on the lab, the normal range is somewhere in the 6 to 23 area, so he is definitely low. So they're considering that he has Addison's disease--weak adrenal glands. Is that your understanding?
Customer: replied 5 years ago.
yes but with that his skin is not darke and the dr stated that he would not have any cortisol at all?? So would the hypnotremia be causing the cortisol to be low and could his Cortisol come up on his own?
Expert:  Dr. Chip replied 5 years ago.
Sorrry--are you saying the doctor said that to have Addison's the cortisol level would have to be zero?
Customer: replied 5 years ago.
that is the way i took it when she said it.
Expert:  Dr. Chip replied 5 years ago.
No, the adrenal glands don't have to have shut down completely to cause Addison's signs and symptoms. The ACTH test is to see if they respond to stimulation and can increase cortisol levels. It would be the low cortisol that caused the hyponatremia and not the other way around. Addison's is easily treated with hydrocortisone and Florinef orally. As to whether his adrenal glands will someday recover and function normally, that's not likely but with proper treatment, he can live a normal and healthy life otherwise.
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