Laboratory Studies

Because the symptoms in this case are fairly nonspecific, tests were carried out to evaluate pituitary, thyroid, and adrenal status. 
                                           Patient            Reference
TSH (S)                                   3.2 uU/ml           0.7 - 7.0
T3, Total (S)                             160 ng/dl            75 - 200
T4, Total (S)                             6.2 µg/dl            4.6 - 12
Prolactin (S)                              14 ng/ml       Nonpreg.  <20
LH, mid-follicular (S)                      6 mU/ml              5 - 20
FSH, mid-follicular (S)                    10 mU/ml            2.6 - 16
Cortisol
    24:00 (S)                              37 ug/dl                  <5
    08:00 (S)                              49 ug/dl              5 - 25
ACTH, 08:00 (P)                           135 pg/ml                <100
Cortisol (24 hr urine)                    160 ug                20 - 90
17-OH-Corticosteroids (24 hr urine)      11.9 mg                  3 - 8
17-Ketosteroids (24 hr urine)            18.8 mg                 5 - 15

(S = serum specimen)

Questions

  1. How would you interpret these results?
  2. What test would you want to carry out next?