Dear All,
Does anyone have any thoughts on the following case?
19 year old lady who has chronic fatigue syndrome. Approx. 1 year ago she was found to have a low cortisol (48nmol/L) – she went on to have a SST with the following results
Baseline cortisol 48 nmol/L, ACTH 15ng/L (ref range <47ng/L at 9am)
30min cortisol 447 nmol/L
60min cortisol 561 nmol/L
There is no clinical or biochemical evidence of hypoadrenalism (not tanned, no postural hypotension, normal sodium and potassium)
MRI of the pituitary was normal as were other pituitary function tests. She was discharged back to her GP on the basis that her low cortisol was due to CFS and that cognitive behavioural therapy would be beneficial.
This lady recently had an episode of dizziness and presented at A&E at a different hospital, where she was found to have a low cortisol (15 nmol/L) and was told that she should be on steroids.
Could this very low cortisol be due to CFS? Any thoughts or suggestions?
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