Weight loss and dizziness in a 29-year-old man

Results of appropriate testing return and show the following:

Blood:

Test (units)	Result	Results (SI Units)
CBC:
WCC (cells/mcL)	11,800 cells/mcL	11.8 x 109/L
Hemoglobin (g/L)	14.0 g/dL	140 g/L
Platelets (mcL)	245,000/mcL	245 x 109/L
Glucose (mmol/L)	75.6 mg/dL	4.2mmol/L

Serum:

Na+	130 mEq/L	130 mmol/L
K+	6.2 mEq/L	6.2 mmol/L
Urea nitrogen (BUN)	42 mg/dL	14.9 mmol/L
Creatinine (mg/dL)	2.5 mg/dL	221 micromol/L
9 AM cortisol	1.8 mcg/dL [49 nmol/L]	Normal 6.5-22.5 mcg/dL [180-620 nmol/L]
LFTs and amylase	Normal
TSH (mU/L)	0.9 mU/L	Normal 0.35-5.5 mU/L
FT4 (ng/dL)	1.6 ng/dL [18.4 pmol/L]	Normal 0.9-1.7 ng/dL [10.5-20 pmol/L]

Venous blood gas

Test (units)	Result	Results (SI Units)
pH	7.32	Normal 7.35-7.45
HCO3-	18 mEq/L	18 mmol/L
Lactate (mmol/L)	12.6 mg/dL [1.4 mmol/L]	Normal < 15 mg/dL [< 1.7 mmol/L]

Test (units)	Result
Urine dipstick	Negative
Chest x-ray	Normal