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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18667
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have been experiencing extreme fatigue all day every day

Customer Question

I have been experiencing extreme fatigue all day every day muscle weakness and joint pain back pain
I have lived a very stressful life last couple years I think maybe adrenal problems
I have already tested all major diseases no positive or bad cbc
I tested around 400 on two separate testosterone test I'm 33 male
I just tested cortisol was 8.0 at 330 pm
I also already tested my thyroid tsh was 1.2 which I would think is good.
I'm waiting on results for t3 and t4 test for thyroid
What are your thoughts on cortisol level. It was taken by blood test?
I am sending a spit test in to lab on cortisol later this week.
Could I be feeling these symptoms for adrenal glands with that kind of reading ?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.

Hello from JustAnswer.

This cortisol level is normal, but assessing adrenal function can be difficult. In someone that has a low cortisol on most days may have an increase in cortisol on certain days related to acute illness or other physical or emotional stress. So, a single normal cortisol reading in someone with other findings that raise concern about adrenal insufficiency is not sufficient to exclude the diagnosis. There are a couple of options on how to proceed in someone with clinical suspicion of possible adrenal insufficiency. First, it would be fine to simply check cortisol levels on multiple days. It also would be reasonable to avoid testing on days with a greater amount of physical or emotional stress. The ultimate test that can be done if adrenal insufficiency is suspected would be an ACTH stimulation test, which measure the amount of increase in cortisol level in response to ACTH.

Yes, a TSH of 1.2 is perfect.

Of course, there are many different condition that can cause fatigue, and with associated muscle weakness and joint pain, the other major category that should be considered would be various inflammatory or autoimmune disorders. The initial evaluation would be generic tests for inflammation, such as a sed rate or C-reactive protein, and tests for the more common autoimmune disorders, such as an ANA and RF.

If I can provide any further information, please let me know.

Expert:  Dr. D. Love replied 2 years ago.

Please let me know ifI can provide any clarification.