Hi Chloe
have looked your at recent posts & results
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Sodium (135-145) optimal 144-146
13/10/08 Serum Sodium....122
*severe deficiency.
27/11/08 Serum Sodium.....142
*in range but a little suboptimal 6/01/09 Serum Sodium.....134
Actually 134 is clinically deficient NOT “OK” and far from "optimal"!!!!
27/01/09 Serum Sodium....129
*moderate deficiencyUrine Sodium.........6 *range???
Urine Osmolality...99 (300-1100)
*deficient31/01/09 Serum Sodium.....135
*bottom of range very suboptimal------------------------------------------------------------------
Thyroid Tests31/01/09 TSH...........0.01 (0.1-5.0) *deficient
FT4...........12.4 (9-19) *34% in range
FT3.............4.0 (2.5-6.0) *43% in range
Not to worry..actually I didnt even click that you had. I just looked at the ranges & assumes they matched!! The comments I made about your results still apply!!
Sorry I dont agree your Thyroid is NOT fine!!!!
Your FT4 is
only 34% in range optimal is top 25%
Your FT3 is
only 43% in range optimal is TOP or even a bit over range.
TSH is low despite low in range Frees indicating
likely Hypopituitary problem. Secondary Hypothyroid is caused by lack of TSH signalling from Pituitary.
Also your Lab Ref Ranges are VERY conservative!!
TSH many Labs now use 3.0 as top of range
Free T4 a good Ref range is 9-24 or 10-25
Your FT4 result would be ~23% in this range.
Free T3 a good Ref range is up to 7-8
Your FT3 result would be ~33% in this range
You look Secondary Hypothyroid on your Frees & TSH results
Need to test RT3 & Thyroid Antibodies (TPOAbs & TG Abs)-----------------------------------------------------------------
LFT (Liver Function Test)13/10/08 AST...............29 (10-45)
ALT....less than 3 (5-45)
*undetectable???GGT...............21 (10-70)
ALP................69 (30-100)
Bilirubin............7 (< 20)
27/11/08 AST............. 20 (10-45)
ALT............... 8 (5-45)
GGT............. 23 (10-70)
ALP.............. 65 (30-100)
Bilirubin.......... 6 (<20)
27/1/09AST............. .20 (10-45)
ALT...............12 (5-45)
GGT...............21 (10-70)
ALP...............62 (30-100)
Bilirubin........... 6 (<20)
31/01/09 AST..............21 (10-45)
ALT...............13 (5-45)
GGT..............19 (10-70)
ALP...............68 (30-100)
Bilirubin............6 (<20)
Glad to see that ALT has improved since that deficient result last October!!
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Lipids13/10/08Cholestrol...............6.2 (2.6-5-5)
*slightly elevatedTriglycerates...........0.9 (0.5-2.0)
27/11/08 Cholesterol.............5.0 (2.6-5.5)
Triglycerates..........1.2 (0.5-2.0)
27/01/09Cholesterol.............5.5 (2.6-5.5)
Triglycerates...........0.7 (0.5-2.0)
31/01/09Cholesterol.............4.6 (2.6-5.5)
Triglycerates..........1.8 (0.5-2.0)
Why are only PART of Lipid panel being tested?
Where’s rest of Lipid tests HDL, LDL, CRR??? -----------------------------------------------------------------
Glucose Random (nonfasting) 13/10/08 3.9 (3.6-7.7)
*seems low27/11/08 3.0 (3.6-7.7)
*deficient27/01/09 3.9 (3.6-7.7)
*seems low31/01/09 3.9 (3.6-7.7)
*seems lowWhy is Doc repeatedly testing non-fasting Glucose???
To properly check Blood Sugars
need fasting Glucose, Fasting Insulin & hbA1CIf these are all random (non-fasting) results certainly
suggest pretty severe Hypoglycemia------------------------------------------------------------------
B12 and Folate 13/10/08Vit B12......... >1500 (162-813)
*on Vit B12 IV’sRBC Folate.........361 (137-358)
*excellent-------------------------------------------------------------------
Iron & Iron Studies 13/10/08 Iron.............18 (9-30)
27/11/08
Iron...............8 (9-30)
*deficient27/01/09
Iron..............28 (9-30)
Transferrin.....41 (25-45)
TIBC.............82 (50-90)
Trans Satn....34 (15-45)
Ferritin.........22 (20-150)
*far from optimal of 70-9031/01/09
Iron..............19 (9-30)
*dropped againSorry couldnt disagree more!!! He obviously is ignorant or didnt look at the blood tests properly? Your most recent Iron level was 19 on 31st Jan so has dropped from the 28 result on 27th Jan.
Are you doing these Iron/Ferritin tests early am fasting~12 hours?If not then Iron results in particular are NOT reliable indicator of Iron levels. Also if on
Iron supps they should be STOPPED minimum 3 days before testing!!!
Ferritin is LESS volatile than Serum Iron & is preferred test of Iron STORES for that reason. However still should be tested fasting early am.
In addition your CBC results ARE showing
Iron Anaemia (deficient/very low Hematocrit & Hemaglobin)!!!!!
Good Iron/Ferritin levels are needed for Thyroid Hormones too.
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CBC13/10/08HB....................125 (115-165)
MCV................ 93.1 (80-98)
27/11/08 HB...................119 (115-165)
*low in rangeHCT..............0.348 (0.37-0.47)
*deficientMCV...............94.7 (80-98)
MCH...............32.5 (27-33)
MCHC..............344 (310-360)
PLTS...............449 (150-400)
*elevatedRBC................3.67 (3.8-5.8)
*deficientRDW...............13.6 (<14.5)
WBC................ 8.0 (4.5-11)
Neuts..............2.94 (1.8-7.7)
Lymphs............3.92 (1.0-4.8)
*high in rangeMonos.............0.71 (0.2-0.8)
*high in rangeEos.................0.40 (0.04-0.4)
*top of rangeBaso................0.06 (0-0.1)
27/1/09HB...................112 (115-165)
*deficientHCT................0.34 (0.37-0.47)
*deficientMCV................94.9 (80-98)
MCH................31.2 (27-33)
MCHC...............329 (310-360)
PLTS................443 (150-400)
*elevatedRBC.................3.59 (3.8-5.8)
*deficientRDW................13.7 (<14.5)
WBC................10.6 (4.5-11)
Neuts...............6.99 (1.8-7.7)
*high in rangeLymphs.............3.05 (1.0-4.8)
Monos..............0.37 (0.2-0.8)
Eos..................0.15 (0.04-0.4)
Baso................0.05 (0-0.1)
www.drkaslow.com/html/blood_cell_counts.htmlDeficient Hemoglobin (HB) Optimum values adult female are 135 to 145
HB is decreased in:
-Digestive inflammation (with hidden or obvious blood loss) as might occur with parasites, colitis, hemorrhoids, etc.
-Free radical pathology.
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Adrenal Cortical hypofunction -Hereditary anemia(s)
-Hemodilution (pregnancy, edema)
-Blood loss (lung, gastrointestinal/hemorrhoids/ulcers/colitis, uterine/menses, in urine via kidneys, hemorrhage)
-Deficiency (
protein malnutrition,
Iron, Copper, Vitamin C, Vitamin B1 (thiamine), Folic Acid, B12)
-Chronic disease (liver, kidney, rheumatoid arthritis, Carcinoid, etc.)
-Bone marrow insufficiency (infiltration with tumor or tuberculosis, toxic or drug induced hypoplasia)
Deficient Red Blood Count (RBC)Optimal values adult female are 4 to 4.5
HCT is decreased in:
-
Iron deficiency (should see a low MCV)
-
Vitamin B6, B12, and/or Folic Acid deficiency (should see a high MCV )
-Chronic Disease (Liver dysfunction (liver function tests might show abnormalities, Kidney dysfunction (chemistry tests and the BUN, creatinine may be abnormal).
-Hereditary anemia(s).
-Free radical pathology.
-Toxic metals.
-Catabolic Metabolism
Deficient Hematocrit (HCT)Optimum values are adult female is 39% to 45%.
The conditions associated with decreased HCT are the same as for HB
In addition, it has been suggested that a reduced HCT may indicate low Thymus function.
Elevated Platelets (Thrombocytosis)Optimum values: 230to 400
Platelets are often increased in:
1) Reactive
(i)
Infection (ii) Acute blood loss
(iii) Disseminated carcinoma
(iv) Splenectomy
(v) Various free radical pathologies (tissue damage, chronic inflammation, surgery)
2) Thrombocythemia
(i) Polycythemia Vera
(ii) Myeloproliferative Disorders
(iii) Chronic Granulocytic Leukemia
(iv) Hemolytic anemia(s)
(v) Myelosclerosis
(vi) Essential (without known cause)
Neutrophils, Lymphocytes, Monocytes, Basophils high in range.
Maybe related to allergy, bacterial, fungal or viral infection, underlying inflammation, Adrenal Insufficiency. Some Meds may cause high/elevated values too
Would be good to test these inflammatory markers Homocysteine, CRP, hsCRP, ESR, Fibrinogen-----------------------------------------------------------------
Serum Cortisol am optimal is top of range31/1/09 9am ...........379 nmol/L (150-700)
*suboptimal only 42% in rangeYes definitely!!!!! Nicotene raises Cortisol see. Is a form of “self medication” for those folks with Adrenal & Thyroid issues. Thats why its so addictive & difficult to quit!!!! Not to mention affects on Liver & Lungs!!!!!!!
Nicotene & Cortisolforums.realthyroidhelp.com/viewtopic.php?f=2&t=7104&st=0&sk=t&sd=a&hilit=smokesIs your result 479 or the 379 originally posted 9th Feb?Sorry cant agree with your Doc there either. The fact that your 9am Cortisol was only 42% despite the fact that you had been awake from 3 am & that you were smoking DOES indicate a big problem!!! It should have been much higher.
Strongly recommend
test Serum ACTH & 8am Cortisol (fasting no meds ciggs till after blood draw)Also strongly recommend
Salivary ASI (4 x Cortisol & DHEAS)Aussie Labs doing this are by Pathlabs(you can request kit) or ARL(Doc must request) both located in Melbourne they mail kits out & you mail back samples.
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Urine Test 27/01/09Sodium.....................6
*range???Osmolality............... 99 (300-1100)
*deficientAre the results for osmolality 99 or 991?I assume its the first so is deficient in view of comments made?
Note your Urea, Urate, Sodium & Glucose are all low so deficient osmolality not surprising
www.rnceus.com/renal/renalosmo.htmlSodium, blood urea nitrogen, and blood glucose levels are major factors in determining serum osmolality.
Decreased urine osmolality (hypoosmolality) levels are seen in:
-Sodium loss due to diuretic use and a low salt diet
-
Hyponatremia -
Adrenocortical insufficiency -
SIADH -Excessive water replacement/overhydration/water intoxication
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Decreased serum Uric Acid (Urate) & low Urea levels are usually associated with an increase in plasma volume such as with SIADH
www.rnceus.com/course_frame.asp?exam_id=13&directory=renalA decreased BUN may be seen in:
-Liver failure
-Malnutrition
-Anabolic steroid use
-Overhydration, Which can result from prolonged intravenous fluids
-Pregnancy (due to increased plasma volume)
-Impaired nutrient absorption
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SIADHBecause Urea is synthesized by the liver, severe liver failure causes a reduction of Urea in the blood. Just as dehydration may cause an elevated BUN, overhydration causes a decreased BUN. When a person has "syndrome of inappropriate anti-diuretic secretion" (SIADH), the anti-diuretic hormone (ADH) responsible for stimulating the kidney to conserve water causes excess water to be retained in the bloodstream rather than being excreted into the urine. SIADH can cause the BUN level, along with other important substances, to decrease because the fluid volume of the bloodstream may significantly increase.
I think your Doc may very well be right!!!! I also suggested possible SIADH caused by your Meds in my earlier post to you on 16th Feb.
The longer on a Med the greater the risk of side effects.
All these Meds are also very hard on your Liver & would be stressing it a lot. This likely affects ability to process meds, affects ability to detox, affects Liver Enzymes, (AST results), FT3 is processed in Liver, active Vit D is processed by Liver.
The Somac as I pointed out is very bad on your Stomach (Sodium, Chloride) & affects absorption of food, nutrients (B12, Calcium), meds & supps. Kidneys (Urate, Urea) is likely affected by the meds too.
Note in order to DX SIADH Hypothyroid & Adrenal Insufficiency has to be excluded as well as medication side-effects.
Note Fibromyalgia & CFS are common “symptoms” of Adrenal & Thyroid issues (I too had these Dxs as well as some others). As are Liver Enzyme irregularities, high Cholesterol, Iron Anaemia, Vit D & B12 deficiencies, other nutrient & mineral deficiencies.
Migraines too are often related to Aldosterone, Sodium/Potassium deficiencies & imbalances.
Many get dx’ed with these “symptoms” and put on meds for them without Docs actually dxing & treating the underlying cause. They end up on a multitude of meds to treat the symptoms & often the long term effects & side effects actually worsen the situation.
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