By Alfred J. Plechner, D.V.M.

When your healthcare professional finds an elevated cortisol level in a patient, the usual suggestion is to say to the pet owner or patient, "Let’s do an injection of ACTH to further stimulate the layer that is over producing this cortisol, and see if this high level of cortisol will be even higher”.

The assumption, based upon the original blood test, indicates an elevated cortisol but is it active or defective or bound?

Before you allow your health care professional to do this ACTH stimulation test, you need to ask your healthcare professional, if this is an active cortisol or an inactive cortisol?

A blank look will not suffice!

How then does your healthcare professional determine this?

At very least, when the original test is done, a Complete Blood Test, should also be done.

The reason for doing this, is to record the number and the differential of the white blood cells.

It is believed that active or inactive cortisol will have an effect on the lymphocytes and the eosinophils, which will be present in the white blood cell differential etc.

If the cortisol is active, there may be an absence or real deficiency of eosinophils and lymphocytes.

If both of these cells are present, even in a reduced state, the cortisol may still not be active.

Obviously if my syndrome is checked, and the cortisol is active, the total estrogen will be below 20 mgs % in a male dog, cat or horse or below 30 mgs % in a female dog, cat or horse.

If the cortisol is inactive, the total estrogen will be higher than 25 or 35 depending on the sex of the patient..

Remember, that your major laboratories are not doing total estrogen, and that is why I use this lab, and I am not financially involved with this laboratory.

All they are doing is running my blood findings accurately.

Unfortunately this laboratory happens to be the only veterinary laboratory at this time that is qualified to provide accurate test results.

Please remember, for accurate results, the blood sample must remain in a cooled state before and after running.

To identify this problem, please go to www.drplechner.com for the proper test to be done and the laboratory that will provide accurate results.

You might persuade your healthcare professionals to put pressure on their local laboratories, in order to find out why they do not have the equipment or staff to do this test or just not enough interest to do the test, because even with their lack of financial gains and with their inabilities to even do the tests, it might cost a patient their life.

As you now realize that if measures are taken to reduce the high cortisol levels you or your pet are producing and there is no recognition whether the high level cortisol is active or inactive, could be put you and your pet into a dangerous health situation.

If this is a true high-level cortisol, then standard therapy may treat the problem correctly, but please realize that what is not known is whether the high level of cortisol is active or inactive and I personally believe the ACTH stimulation test should never be done before an eosinophil and lymphocyte count is done.

These are just some of my thoughts.

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