Dana
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Posts: 85
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Post by Dana on Mar 15, 2009 16:04:43 GMT -5
Dana, I think that some of your labs suggest you being hypopit. Your low aldosterone and low renin is common with hypopituitary folks. Your lowish sodium and potassium point to this as well. The renin I believe (from what I've read) is also impacted by suboptimal thyroid function and low growth hormone. Your IGF-1 is a crap range. Your growth hormone is the pits. I think I would retest ALL your labs on day 3 with a different lab. I'm not sure that the initial lab can be trusted. That is a crap range for ACTH. I'm going to beg my doc to let me redo these and this time I'll go with labcorp. It's actually WAY easier to get to and doesn't involve having to go the hospital, which I despise! Everything was covered by my insurance. You know what is frightening though? This would have cost someone without insurance about $2500 to have done! How sick is that? If you have to pay out of pocket, do so. You can order via econolabs and/or healtcheckusa. Econolabs has the best price for aldo/renin. Healthcheck has best price for thyroid panel II. Compare with the two and pick/choose. Both contract with labcorp. You can go on one day with both requisitions...they can do it all. Been there done that. The cortisol range is a crap range too. Your cortisol could be semingly great first thing in the morning, but could TANK thereafter. Serum cortisol doesn't reflect binding. Again, I would retest. Have your husband drive you to avoid stress. I thought the lab ranges were terrible too. It just shows you that endocrine disorders are an epidemic, but they keep lowering ranges. Basically from what I'm seeing, your thyroid, adrenal, pituitary can't be working at all to be dx properly. Your TSH being variable with low free thyroid homones could be due to Hashi's antibodies. The antibody ranges tell us nothing of your actual antibody levels. My antibodies are "negative" but I have thyroid ultrasound findings consistent with Hashi's(hypoechoic nodules and heterogenous appearance/texture). Unfortunately my thyroid ultrasound was pretty normal. This ultrasound was done when my TSH was <0.01, so I thought it would show something! The only thing it said different on there was this "The thyroid gland demonstrates relatively homogeneous echogenicity and acoustic texture, this measures approximately 1 mm. No nodules or cysts are seen." When was the last time you have had your pit MRI'd? Probably time for repeat scan with and without gadolinium. You need help with your low aldosterone(strongly suspected with symptoms and salt cravings). Remind me again...what was your saliva cortisol? Laurie My last MRI was February of '08. I actually just got the scans from the hospital last week and was planning on bringing them with me to the endo. I'm just not sure what I'm going to do though. That endo will see these results and probably just laugh at me. My saliva cortisol was terrible! That's what I can't get. Why would Total cortisol be so much higher than free cortisol in saliva? Does that mean anything in particular? Feb '09 (new test) > > 07:00- 8:00 AM-------5 Depressed (13-24 nM) > > 11:00- NOON----------9 Normal (5-10 nM) > > 04:00- 5:00----------2 Depressed (3-8 nM) > > 11:00-Midnight-------2 Normal (1-4 nM) > > Cortisol Burden-----18 (23-42) > > DHEA-----------------4 Normal (3-10 ng/ml) Thanks for getting back to me on these. I truly appreciate your help!
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Post by Lethal Lee on Mar 16, 2009 2:49:44 GMT -5
Why would Total cortisol be so much higher than free cortisol in saliva? Does that mean anything in particular?
Free Cortisol can be measured in blood in USA. Dont know why Docs keep doing only TOTAL Cortisol. Quest does Total & Free Cortisol and Transcortin (Cortisol Binding Globulin aka CBG).
No different to looking at Testosterone. Its the FREE not the TOTAL Testosterone that counts. Testosterone is bound by Sex Hormone Binding Globulin (SHBG) you can have great Total Testosterone but lousy Free Testosterone if SHBG is high or elevated.
For Thyroid TOTAL T4 & T3 is bound by Thyroid Binding Globulin (TBG) which is why we test the FREE T4 & T3.
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Dana
New Member
Posts: 85
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Post by Dana on Mar 16, 2009 11:12:31 GMT -5
Well I told the doc what to order, so I guess it's my fault. I think I'm going to hold off on getting anymore labs until I see the doc in PA. See what he says about everything. That's the reason I even ordered all these labs in the first place. The thought of paying out of pocket for all of these labs when I already pay almost 200 a month for insurance makes me sick. haha I just hope the doc in PA puts diagnosis codes on the lab work or I won't be getting anything done with him.
Lee I answered your questions in response to my post on the adrenal yahoo group, but that post is rapidly getting buried over there. I'd love to hear your responses.
Thanks to both of you!
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Dana
New Member
Posts: 85
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Post by Dana on Mar 17, 2009 13:23:43 GMT -5
I just wanted to describe what I've been feeling lately.
These past 2-3 days I feel insane. I feel like I could cry at any moment. My husband and I were going to go target shooting and I couldn't do it today. My lower back is really hurting (I assume adrenal) and when I look in the mirror, I don't see me. My face looks so bloated and I've gained about 8 pounds in the past week! I have no idea what is going on, but I feel like I've lost all hope. My husband is really getting annoyed with me and I can't blame him. Any type of stress whether it be grocery shopping or target shooting gets me all shaky and out of control feeling.
I don't know how much longer I can take all of this. Maybe if I go into an adrenal crisis I might be taken seriously! Is it sad or crazy that I'm hoping for one to occur? LOL
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Post by justaustin on Mar 17, 2009 16:59:05 GMT -5
Dana, I'm sending you a PM. Please check your messages.
Laurie
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Dana
New Member
Posts: 85
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Post by Dana on Mar 20, 2009 21:55:56 GMT -5
I have another random question. I don't know which moderator is more knowledgeable with DI.
Do you any of you know what a "normal" antidiuretic hormone result/lab range would be while under a 12 hour water deprivation? I've been questioning my dx for a long time and wonder if my low aldosterone is the reason why I am so thirsty and urinate a lot.
Thanks!
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Post by justaustin on Mar 21, 2009 8:10:26 GMT -5
Do you have your old labs from when you were diagnosed with DI? If so, please post.
Some folks have low aldo and low ADH. It can require finesse with treatment, but not impossible.
Dr. L will be able to help you sort this out.
Laurie
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Dana
New Member
Posts: 85
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Post by Dana on Mar 21, 2009 11:03:53 GMT -5
I have the ADH result and the BMP from the test. The urine stuff I don't have for some reason. The "normal" range on ADH is ridiculous, so take it for what it's worth. I don't have full blown drinking 10 gallons of water a day. I consider mine partial DI, which is a lot harder to dx and most endos won't dx it at all! It's all or nothing for them!
Glucose-------81------(70-110) BUN-----------20-------(7-22) Creatinine---0.9-------(0.5-1.3) Bun/Creat---22.2------(8-27) Sodium-------139------(136-147) Potassium---3.4-------(3.6-5.3) LOW Chloride-----106-------(98-110) CO2----------21---------(22-34) LOW Anion Gap---12---------(2-12) High side Calc Osmo---279-------(269-297) Calcium------10---------(8.7-10.7) Osmolality----296------(275-300)
ADH------------2.3------(1-13.3 PG/ML, 2.5 PG= 1 uU)
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