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Sorry to hear about your problem?
Since how long you have these symptoms?
What are your current medicines ?
What kind of neuropathy you have ?
What other investigations other than VIT D levels,cortisol and GF has been done ?
What is the normal lab reference in your cortisol report ?
Thanks for the information
Have your doctors did an MRI brain as well?
Your symptoms does suggest a possibility of Addison disease as it can lead to low cortisol and blood glucose while high potassium and low sodium. An ACTH stimulation test will be helpful in diagnosis. Secondly some of your features points that there may be some autoimmune disease which is causing such symptoms. SLE is a possibility considering mouth ulcers,kidney and brain involvement and a work up for SLE will also be helpful. A CT scan of the abdomen to look for any mass or adenoma in adrenal will be further helpful. In autoimmune diseases like SLE due to impaired immunity the infection rates is generally high. So I would suggest that your doctor should work you up on these two possibilitis.
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Yes if ACTH stimulation test is normal then it rules out adrenal insufficiency
The nodules in the lung also need evaluation. A CT scan will be helpful. CT scan can tell if there are features suggestive of a tumor or its just a benign lesion but for confirmation biopsy is required.
Low cortisol can be due to pitutitary dysfunction, use of various drugs including steroids
Photosensitivity is also a feature seen in autoimmune diseases like SLE so a work up is required
That's good if there was nothing of concern on CT scan . MRI is usually a very sensitive test and detects such mass lesions of pituitary .
If adrenal insufficiency is detected than you will need to get it treated with steroid replacement therapy.
Your symptoms should improve if replacement is adequate . Your symptoms should improve and your metabolic profile should normalize.
An increase in baseline cortisol value of 7mcg/dl or more and value must rise to 20mcg/dl or more in 30 and 60 minutes sample.
For SLE you need a screening test called ANA as it is positive test in 90-95 cases. Further more specific but less specific test include ENA profile and anti-dsDNA levels.
Cortisol is main hormone involved in glucose metabolism and in the stressful conditions to fight with stressful conditions
As I mentioned Addison and an autoimmune disease sould be my first thought in such a case
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anything else to ask ?
SLE and most other autoimmune diseases are treated by Rheumatologist. It depends which organ is most effected as some autoimmune diseases are treated by neurologist like MS
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