Post by Lethal Lee on Dec 8, 2008 22:18:33 GMT -5
Hi Chris,
Just got last of DH's Lab results (except 21-OH Abs still pending).
Current supps history & results are here
forums.realthyroidhelp.com/viewtopic.php?f=11&t=9418&p=73540#p73540
He is on no meds but some supplements as outlined in link. He used to be on Zocor (Statin) & DHEA/Testosterone Troche but has been off for at least 4 years.
His Salivary am Cortisol was too low but otherwise fine.
Blood 9am Cortisol was fine however he had to drive to town for testing & was kept waiting for AN HOUR before blood drawn (got there at 8am) blood drawn at 9am. I assume Salivary Cortisol is better indicator & that he has AI based on that & symptoms?
ACTH was suboptimal.
Prolactin is only 20% in range.
All his Androgens are very low & FSH & LH are low too he badly needs HRT for DHEA & Testosterone. Estradiol looks OK (according to Phil).
He is Hypo (suboptimal Frees) with elevated Thyroid Abs so has Hashis as well. He also has high RT3 but will probably start with NTH (Aussie Armour) & see how that goes before considering T3 only meds.
Aldosterone is low in range & Renin is mid range. Sodium was top of range 145 & Potassium close to ideal at 4.7. He has no obvious low Aldo symptoms.
He has very high Ferritan 439 but tests negative for Hemochromatosis so dont know WHY it is high. He drinks 5-6 cups of Coffee a day too (but not on days tested) which blocks Iron uptake. He is NOT on any Iron supps at all.
Homocysteine is elevated probably due to suboptimal B12 & Folate levels. Just started him on sublingual B12, multi-B & active Folinic Acid now so hopefully that will come down. His hsCRP, Fibrinogen & ESR are fine though. Has some positive ANA & past exposure to EBV.
His Total Cholesterol & LDL are a little elevated but not much. Needs higher HDL & less LDL. We have good fats at home (organic butter, Coconut Oil) so I'm not too worried about these levels.
Fasting Insulin & Glucose are within range but Ratio shows borderline for Insulin Resistance.
Vit D is pretty good but we have supped that for some time.
Liver & Kidney tests are pretty good with only Chloride slightly elevated.
Questions
1/ Do you think he looks Hypopit? Low ACTH & am Salivary Cortisol, low Aldo, midrange Renin, low Androgens & LH/FSH, but high in range Potassium?
2/ Is an ACTH Stim needed?
3/ Does he look like he needs HC?
4/ I want to get IGF-1, GH & IGFBP-3 tested do you agree is needed?
5/ Obviously needs Testosterone & DHEA do you agree? Is there any problem doing that? I dont think he will do HCG injections & I dont know if even available here. He doesnt need to worry about fertility (is 52 & had a Vasectomy years ago) so testicle shrinkage is not a concern then is it?
6/ Although his Aldo is low he doesnt appear to have any obvious Salt wasting symptoms? I will start him on basic Salt supping though anyway.
I will be taking him to see my Doc who did authorise ACTH Stim for myself & Twins. Would really like your opinion on above.
Just got last of DH's Lab results (except 21-OH Abs still pending).
Current supps history & results are here
forums.realthyroidhelp.com/viewtopic.php?f=11&t=9418&p=73540#p73540
He is on no meds but some supplements as outlined in link. He used to be on Zocor (Statin) & DHEA/Testosterone Troche but has been off for at least 4 years.
His Salivary am Cortisol was too low but otherwise fine.
Blood 9am Cortisol was fine however he had to drive to town for testing & was kept waiting for AN HOUR before blood drawn (got there at 8am) blood drawn at 9am. I assume Salivary Cortisol is better indicator & that he has AI based on that & symptoms?
ACTH was suboptimal.
Prolactin is only 20% in range.
All his Androgens are very low & FSH & LH are low too he badly needs HRT for DHEA & Testosterone. Estradiol looks OK (according to Phil).
He is Hypo (suboptimal Frees) with elevated Thyroid Abs so has Hashis as well. He also has high RT3 but will probably start with NTH (Aussie Armour) & see how that goes before considering T3 only meds.
Aldosterone is low in range & Renin is mid range. Sodium was top of range 145 & Potassium close to ideal at 4.7. He has no obvious low Aldo symptoms.
He has very high Ferritan 439 but tests negative for Hemochromatosis so dont know WHY it is high. He drinks 5-6 cups of Coffee a day too (but not on days tested) which blocks Iron uptake. He is NOT on any Iron supps at all.
Homocysteine is elevated probably due to suboptimal B12 & Folate levels. Just started him on sublingual B12, multi-B & active Folinic Acid now so hopefully that will come down. His hsCRP, Fibrinogen & ESR are fine though. Has some positive ANA & past exposure to EBV.
His Total Cholesterol & LDL are a little elevated but not much. Needs higher HDL & less LDL. We have good fats at home (organic butter, Coconut Oil) so I'm not too worried about these levels.
Fasting Insulin & Glucose are within range but Ratio shows borderline for Insulin Resistance.
Vit D is pretty good but we have supped that for some time.
Liver & Kidney tests are pretty good with only Chloride slightly elevated.
Questions
1/ Do you think he looks Hypopit? Low ACTH & am Salivary Cortisol, low Aldo, midrange Renin, low Androgens & LH/FSH, but high in range Potassium?
2/ Is an ACTH Stim needed?
3/ Does he look like he needs HC?
4/ I want to get IGF-1, GH & IGFBP-3 tested do you agree is needed?
5/ Obviously needs Testosterone & DHEA do you agree? Is there any problem doing that? I dont think he will do HCG injections & I dont know if even available here. He doesnt need to worry about fertility (is 52 & had a Vasectomy years ago) so testicle shrinkage is not a concern then is it?
6/ Although his Aldo is low he doesnt appear to have any obvious Salt wasting symptoms? I will start him on basic Salt supping though anyway.
I will be taking him to see my Doc who did authorise ACTH Stim for myself & Twins. Would really like your opinion on above.