Post by vehementlyalive on Dec 10, 2008 16:40:23 GMT -5
I was wondering if anyone has any advice or input as to what may be going on here. I'm sorry this post is so long, but I'm having trouble distinguishing what is relevant and what is not. I've started to just keep a log of the symptoms and lab work I have if I ever go to see another doctor (it will all be right there). As of now, I'm waiting on the newest results from the latest blood draws I had done last week which consisted of chem, CBC, lipids, kidney function, with free T3, free T4, and DHEA-s. I've kinda put the pieces together a little, and it all looks like a form of hypopituitarism (or several glands shutting down) consisting of adrenal insufficiency possibly with underactive thyroid with a low fasted growth hormone output, but what I don't understand is the high estrogen and high progesterone in the last saliva test. If anyone has any input, it would be greatly appreciated.
Male, 25 y/o, 5'8", 230 lbs, located in GA (if anyone has a good doctor to recommend).
My History
Onset of Symptoms
All life (as long as I can remember): Hypoglycemia, headaches, mild generalized anxiety, OCD, excessively strong immune response (i.e. getting flu-like symptoms for several days from a couple days of 4 hours of sleep in a row).
7 years ago: Hot flashes/hyperhidrosis/heat intolerance, excessive thirst/urination, mild depression, social withdrawal, prehypertension.
5 years ago: Migraines, depression, low libido, irritability, general lethargy, fatigued easily, lack of motivation, panic attacks.
Within the past 2-3 years (earliest to latest): Difficulty concentrating, cognitive decline, memory impairment, brain-fog, cold upon waking, Stage 1 Hypertension, gastritis (which at first presented just as heartburn but progressed into black tarry stools, dark red blood after defecation, etc.), "full" (moon) face, sunken eyes with dark undercoloring (bags under eyes upon waking, goes away after stimulant kicks in), ears feeling like they need to "pop" all the time (pressure inside ears causing sensitivity to loud sounds), salt cravings, hyperpigmentation of skin over bony areas, skinfold creases, scars and some other areas not exposed to sun and tan very easily.
February 2007: Unknown “crisis” of symptoms that persisted for a few days; first 24 hours consisted of extreme migraine, insomnia, restlessness, extreme joint and muscle pain (specifically in the legs, lower back, and shoulders), diarrhea, nausea, cold sweats; forced to drink Gatorade and water and symptoms slowly resolved over the next 72 hours.
August 29th, 2008: ACL hamstring graft reconstruction surgery due to complete tear working out, since then sore joints/muscles without cause (especially legs and shoulders), worsened body composition, excessive/aggressive irritability, chronic fatigue, mood swings, sleep has been affected (waking up earlier than wanting to without cause, inability to fall back asleep, but still feeling extra lethargic upon waking, etc.).
Prescribed Medications
Past Medications: Initially prescribed 5 years ago Zoloft and Clonazepam but didn't react well to the Zoloft, switched to Wellbutrin until a little more than a year ago, then prescribed Adderall XR 40mg ED, dropped Clonazepam for Valium in 2006.
Current Medications: Androgel 5g started 12/08/2008, Dexedrine ER 15mg BID started 11/03/2008, Xanax .5-2mg ED started 02/2008, Lisinopril 20mg ED started 01/2008, Prevacid 30mg started 09/25/2008.
Lab work
11/12/2008: (Saliva test)
Free Cortisol Rhythm
-8am (fasting) 9 nM (13-24) Depressed
-Noon 2 nM (5-10) Depressed
-5pm <1 nM (3-8) Depressed
-11pm <1 nM (1-4) Depressed
Cortisol Burden 13 (23-42) L
DHEA 5 ng/ml (3-10)
Cortisol-DHEA Correlation: Non-adapted, low reserves.
Estradiol (E2) 14 pg/ml (1-3) H
Progesterone 140 pg/ml (5-95) H
Free Testosterone 48 pg/ml (60-110) L
Notes: 15mg Dexedrine ER taken upon rising and around noon, .5mg Xanax taken at 3pm and 9pm due to unmanageable anxiety, Prevacid and Lisinopril taken upon rising.
11/05/2008:
TSH 1.844 uIU/mL (0.450-4.500)
Thyroxine (T4) 7.1 ug/dL (4.5-12.0)
T3 Uptake 38 % (24-39)
Free Thyroxine Index 2.7 (1.2-4.9)
Notes: Fasting, only Lisinopril and Prevacid taken prior to draw.
10/27/2008:
IGF-1 140 ng/mL (116-358)
Cortisol 10.9 ug/dL (3.1-22.4)
Growth Hormone, Serum <0.1 ng/mL (0.0-6.0)
ACTH, Plasma 18 pg/mL (6-48)
Glucose, Fasting 101 mg/dL (65-99) H
Glucose, 1/2 hour 118 mg/dL (65-199)
Glucose, 1 hour 106 mg/dL (65-199)
Glucose, 2 hour 57 mg/dL (65-139) L
Glucose, 3 hour 83 mg/dL (65-109)
Insulin, Fasting 13.5 uIU/mL (0.0-29.1)
Insulin, 1/2 hour 66.5 uIU/mL (0.0-121.9)
Insulin, 1 hour 76.5 uIU/mL (0.0-163.5)
Insulin, 2 hour 13.3 uIU/mL (0.0-145.4)
Insulin, 3 hour 7.7 uIU/mL (0.0-60.5)
Notes: Fasting, first draw at 8am; Lisinopril, Prevacid, Adderall XR and Xanax (the latter 3 not dosed until after labs complete).
9/2/2008:
Testosterone, Serum 185 ng/dL (241-827) L
Testosterone, Free 8.95 ng/dL (5.00-21.00)
% Free Testosterone 4.84% (1.50-4.20) H
FSH, Serum 2.3 mIU/mL (1.4-18.1)
LH, Serum 5.2 mIU/mL (1.5-9.3)
Prolactin 7.3 ng/mL (2.1-17.7)
Notes: On Vicodin, 5-10mg TID, 5 days post surgery. 5 days clean from Adderall (started again the following day); still using lisinopril and xanax.
4/2/2008:
TSH 2.010 uIU/mL (.350-5.500)
Thyroxine T4 6.8 ug/dL (4.5-12.0)
T3 uptake 38% (24-39)
Free Thyroxine Index 2.6 (1.2-4.9)
Testosterone, Serum 287 ng/dL (241-827)
Testosterone, Free 7.8 pg/mL (9.3-26.5) L
Notes: On Lisinopril, Adderall XR, and Xanax (the latter 2 not dosed until after labs drawn).
6/22/2007:
TSH 2.226 uIU/mL (0.350 - 5.500)
Thyroxine (T4) 7.0 ug/dL (4.5 - 12.0)
Triiodothyronine (T3) 137 ng/dL (85 - 205)
Notes: Still on Wellbutrin and Valium.
4/11/2006:
IGF-1 205 ng/mL (116-358)
TSH 1.411 uIU/mL (.35-5.5)
Prolactin 5.7 ng/mL (2.1-17.7)
Test, serum 444 ng/dL (241-827)
Test, Free 13.68 ng/dL (5.0-21.0)
% Free Test 3.08 % (1.0-2.7) H
LH 4.6 mIU/mL (1.5-9.3)
FSH 3.4 mIU/mL (1.4-18.1)
Estradiol 11 pg/mL (0-53)
Notes: 2 months on Wellbutrin and Clonazepam.
2/3/2006:
Testosterone Free 91 pg/mL (34-194)
Testosterone Free+Wkly Bnd 206 ng/dL (84-402)
Testosterone 296 ng/dL (241-827)
Albumin 5.0 g/dL (3.4-5.0)
Sex Hormone Bnd Glob 13 nmol/L (13-48)
Notes: Initial visit to psychiatrist. No medications or supplements except a multivitamin and omega-3 fatty acids.
Other results from the 4/2/2008 labs that were out of the normal ranges (or close to either end of 'normal'), not directly hormone-related...
BUN 27 mg/dL (5-26) H
Total Cholesterol 176 mg/dL (100-199)
HDL 31 mg/dL (40-59) L
LDL 121 mg/dL (0-99) H
T. Cholesterol/HDL Ratio 5.7 (0.0-5.0) H
Iron, Serum 177 ug/dL (40-155)H
Hemoglobin 17.3 g/dL (12.5-17.0) H
Hematocrit 49.7 % (36.0-50.0)
RBC 5.83 x10e6/uL (4.10-5.60) H
WBC 4.6 x10e3/uL (4.0-10.5)
Neutrophils 38 % (40-74) L
Lymphs 49 % (14-46) H
Neutrophils (Absolute) 1.7 x10E3/dL (1.8-7.8) L
Family History
Mother has "Adrenal Fatigue", hypopituitarism/hypothalamic dysfunction and what I suspect is Meniere's Disease due to her dizzy spells, loss of hearing in one ear, intolerance to noise, etc.; her father (my grandfather) was told his whole life he had PTSD and all the associated symptoms (and “it was all in his head") from WW2 which progressively got worse as his life went on, on steroids occasionally for chronic sinus problems, very fair skin (3rd degree sun burns easily), first heart attack at 55, actual cause of death unknown in 70’s; his mother (my great grandmother) had "something" that was fatigue-related among other things that I'm not sure about. Father has hypertension, type 2 diabetes, and dyslipidemia; nothing else known about that side of the family.
Male, 25 y/o, 5'8", 230 lbs, located in GA (if anyone has a good doctor to recommend).
My History
Onset of Symptoms
All life (as long as I can remember): Hypoglycemia, headaches, mild generalized anxiety, OCD, excessively strong immune response (i.e. getting flu-like symptoms for several days from a couple days of 4 hours of sleep in a row).
7 years ago: Hot flashes/hyperhidrosis/heat intolerance, excessive thirst/urination, mild depression, social withdrawal, prehypertension.
5 years ago: Migraines, depression, low libido, irritability, general lethargy, fatigued easily, lack of motivation, panic attacks.
Within the past 2-3 years (earliest to latest): Difficulty concentrating, cognitive decline, memory impairment, brain-fog, cold upon waking, Stage 1 Hypertension, gastritis (which at first presented just as heartburn but progressed into black tarry stools, dark red blood after defecation, etc.), "full" (moon) face, sunken eyes with dark undercoloring (bags under eyes upon waking, goes away after stimulant kicks in), ears feeling like they need to "pop" all the time (pressure inside ears causing sensitivity to loud sounds), salt cravings, hyperpigmentation of skin over bony areas, skinfold creases, scars and some other areas not exposed to sun and tan very easily.
February 2007: Unknown “crisis” of symptoms that persisted for a few days; first 24 hours consisted of extreme migraine, insomnia, restlessness, extreme joint and muscle pain (specifically in the legs, lower back, and shoulders), diarrhea, nausea, cold sweats; forced to drink Gatorade and water and symptoms slowly resolved over the next 72 hours.
August 29th, 2008: ACL hamstring graft reconstruction surgery due to complete tear working out, since then sore joints/muscles without cause (especially legs and shoulders), worsened body composition, excessive/aggressive irritability, chronic fatigue, mood swings, sleep has been affected (waking up earlier than wanting to without cause, inability to fall back asleep, but still feeling extra lethargic upon waking, etc.).
Prescribed Medications
Past Medications: Initially prescribed 5 years ago Zoloft and Clonazepam but didn't react well to the Zoloft, switched to Wellbutrin until a little more than a year ago, then prescribed Adderall XR 40mg ED, dropped Clonazepam for Valium in 2006.
Current Medications: Androgel 5g started 12/08/2008, Dexedrine ER 15mg BID started 11/03/2008, Xanax .5-2mg ED started 02/2008, Lisinopril 20mg ED started 01/2008, Prevacid 30mg started 09/25/2008.
Lab work
11/12/2008: (Saliva test)
Free Cortisol Rhythm
-8am (fasting) 9 nM (13-24) Depressed
-Noon 2 nM (5-10) Depressed
-5pm <1 nM (3-8) Depressed
-11pm <1 nM (1-4) Depressed
Cortisol Burden 13 (23-42) L
DHEA 5 ng/ml (3-10)
Cortisol-DHEA Correlation: Non-adapted, low reserves.
Estradiol (E2) 14 pg/ml (1-3) H
Progesterone 140 pg/ml (5-95) H
Free Testosterone 48 pg/ml (60-110) L
Notes: 15mg Dexedrine ER taken upon rising and around noon, .5mg Xanax taken at 3pm and 9pm due to unmanageable anxiety, Prevacid and Lisinopril taken upon rising.
11/05/2008:
TSH 1.844 uIU/mL (0.450-4.500)
Thyroxine (T4) 7.1 ug/dL (4.5-12.0)
T3 Uptake 38 % (24-39)
Free Thyroxine Index 2.7 (1.2-4.9)
Notes: Fasting, only Lisinopril and Prevacid taken prior to draw.
10/27/2008:
IGF-1 140 ng/mL (116-358)
Cortisol 10.9 ug/dL (3.1-22.4)
Growth Hormone, Serum <0.1 ng/mL (0.0-6.0)
ACTH, Plasma 18 pg/mL (6-48)
Glucose, Fasting 101 mg/dL (65-99) H
Glucose, 1/2 hour 118 mg/dL (65-199)
Glucose, 1 hour 106 mg/dL (65-199)
Glucose, 2 hour 57 mg/dL (65-139) L
Glucose, 3 hour 83 mg/dL (65-109)
Insulin, Fasting 13.5 uIU/mL (0.0-29.1)
Insulin, 1/2 hour 66.5 uIU/mL (0.0-121.9)
Insulin, 1 hour 76.5 uIU/mL (0.0-163.5)
Insulin, 2 hour 13.3 uIU/mL (0.0-145.4)
Insulin, 3 hour 7.7 uIU/mL (0.0-60.5)
Notes: Fasting, first draw at 8am; Lisinopril, Prevacid, Adderall XR and Xanax (the latter 3 not dosed until after labs complete).
9/2/2008:
Testosterone, Serum 185 ng/dL (241-827) L
Testosterone, Free 8.95 ng/dL (5.00-21.00)
% Free Testosterone 4.84% (1.50-4.20) H
FSH, Serum 2.3 mIU/mL (1.4-18.1)
LH, Serum 5.2 mIU/mL (1.5-9.3)
Prolactin 7.3 ng/mL (2.1-17.7)
Notes: On Vicodin, 5-10mg TID, 5 days post surgery. 5 days clean from Adderall (started again the following day); still using lisinopril and xanax.
4/2/2008:
TSH 2.010 uIU/mL (.350-5.500)
Thyroxine T4 6.8 ug/dL (4.5-12.0)
T3 uptake 38% (24-39)
Free Thyroxine Index 2.6 (1.2-4.9)
Testosterone, Serum 287 ng/dL (241-827)
Testosterone, Free 7.8 pg/mL (9.3-26.5) L
Notes: On Lisinopril, Adderall XR, and Xanax (the latter 2 not dosed until after labs drawn).
6/22/2007:
TSH 2.226 uIU/mL (0.350 - 5.500)
Thyroxine (T4) 7.0 ug/dL (4.5 - 12.0)
Triiodothyronine (T3) 137 ng/dL (85 - 205)
Notes: Still on Wellbutrin and Valium.
4/11/2006:
IGF-1 205 ng/mL (116-358)
TSH 1.411 uIU/mL (.35-5.5)
Prolactin 5.7 ng/mL (2.1-17.7)
Test, serum 444 ng/dL (241-827)
Test, Free 13.68 ng/dL (5.0-21.0)
% Free Test 3.08 % (1.0-2.7) H
LH 4.6 mIU/mL (1.5-9.3)
FSH 3.4 mIU/mL (1.4-18.1)
Estradiol 11 pg/mL (0-53)
Notes: 2 months on Wellbutrin and Clonazepam.
2/3/2006:
Testosterone Free 91 pg/mL (34-194)
Testosterone Free+Wkly Bnd 206 ng/dL (84-402)
Testosterone 296 ng/dL (241-827)
Albumin 5.0 g/dL (3.4-5.0)
Sex Hormone Bnd Glob 13 nmol/L (13-48)
Notes: Initial visit to psychiatrist. No medications or supplements except a multivitamin and omega-3 fatty acids.
Other results from the 4/2/2008 labs that were out of the normal ranges (or close to either end of 'normal'), not directly hormone-related...
BUN 27 mg/dL (5-26) H
Total Cholesterol 176 mg/dL (100-199)
HDL 31 mg/dL (40-59) L
LDL 121 mg/dL (0-99) H
T. Cholesterol/HDL Ratio 5.7 (0.0-5.0) H
Iron, Serum 177 ug/dL (40-155)H
Hemoglobin 17.3 g/dL (12.5-17.0) H
Hematocrit 49.7 % (36.0-50.0)
RBC 5.83 x10e6/uL (4.10-5.60) H
WBC 4.6 x10e3/uL (4.0-10.5)
Neutrophils 38 % (40-74) L
Lymphs 49 % (14-46) H
Neutrophils (Absolute) 1.7 x10E3/dL (1.8-7.8) L
Family History
Mother has "Adrenal Fatigue", hypopituitarism/hypothalamic dysfunction and what I suspect is Meniere's Disease due to her dizzy spells, loss of hearing in one ear, intolerance to noise, etc.; her father (my grandfather) was told his whole life he had PTSD and all the associated symptoms (and “it was all in his head") from WW2 which progressively got worse as his life went on, on steroids occasionally for chronic sinus problems, very fair skin (3rd degree sun burns easily), first heart attack at 55, actual cause of death unknown in 70’s; his mother (my great grandmother) had "something" that was fatigue-related among other things that I'm not sure about. Father has hypertension, type 2 diabetes, and dyslipidemia; nothing else known about that side of the family.