Charley shows up at his doctors office complaining of a feeling of weakness, which is getting worse, chronic fatigue and loss of appetite. His weight compared to that of 6 months ago is down about 10 pounds. He denies dieting. After obtaining a complete history, Charley’s physician performs three tests.
1. Analysis of the patients serum cortisol level shows the level is below normal.
2. Synthetic CRH is injected IV the serum collected after this again reveals cortisol levels below normal.
3. Cosyntrin, a synthetic ACTH is injected IV, the serum collected afterwards shows normal levels of Cortisol. Explain where the problem specifically is located. Using the above test results (numbered 1-3) as proof of your answer. Go through each step (1-3) showing what each step proves.
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