dee
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Posts: 30
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Post by dee on Feb 27, 2009 2:10:10 GMT -5
Hi, I've had my ACTH tested for the first time. The labs were as follows:
ACTH 1.5 (2.3 - 10.1 pmol/L) AM Cortisol 313.0 (123 - 626 nmol/L)
My thyroid labs (on 105 mgs Thyroid) were:
TSH 0.00 FT4 11.99 (9 - 24) FT3 5.9 (3.5 - 6.5)
This is after dropping my dose from 120 mgs, where my labs were:
TSH 0.00 FT4 20.12 (9 - 24) FT3 9.2 (3.5 - 6.5)
When I was diagnosed with Hashimoto's in 08, my TSH was 4.86 (0.34 - 4.82).
My prolactin is 'high-ish':
30.6 (6 - 24)
My DHEA was low, when I had it tested a few months back (I'll get the numbers, if required... I'm typing this in bed in the middle of the night...)
To say I haven't felt well for a long time is an understatement; but I know you guys can identify. I should add that the only 'medication' I take is the Thyroid (desiccated). And, my doctor is making an appt to see a specialist about an MRI of the pituitary.
Any advice/observations would be appreciated. Thanks.
Dee
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Post by fractal1 on Feb 28, 2009 14:59:46 GMT -5
Hi Dee, You have secondary AI - ACTH has 'put-on the brakes', when your cortisol is less than the middle of the range. Thyroid hormones look okay... but really, you should go by how you feel and monitoring temperature and pulse. I hope you are taking Armour and not that 'syncrap'? You should also get growth hormone status assessed. To do this, you should get GH, IGF-1 & binding proteins, 24h urinary GH and lipid profile. Also, insulin and glucose wouldn't go astray. I'm glad you're getting a pituitary scan (make sure it's with contrast)... this is really important considering your low ACTH and high prolactin. Cheers
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dee
New Member
Posts: 30
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Post by dee on Feb 28, 2009 17:35:44 GMT -5
Thank you for answering my pleas, Ruth . I'm taking Thyroid (desiccated, natural). So, I have secondary AI... Is there any chance things will change on its own - ie. the ACTH will decide to 'unlock the brakes', and go back to normal? I guess that's where the MRI (with contrast) will come in - to let me know what's going on. I'll write down the tests you suggested, and bring it with me to the specialist. Thanks again for your help. It's a relief to know what to do/what's going on. Dee
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Post by fractal1 on Mar 1, 2009 3:27:39 GMT -5
No worries ;D I'm glad you are taking thyroid extract. Unfortunately, hypopituitarism is not reversible, and it isn't unusual for MRIs to come-up 'normal'. Let us know how you go
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dee
New Member
Posts: 30
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Post by dee on Mar 1, 2009 11:34:42 GMT -5
No worries ;D I'm glad you are taking thyroid extract. Unfortunately, hypopituitarism is not reversible, and it isn't unusual for MRIs to come-up 'normal'. I'm actually wondering if it wasn't the Thyroid replacement that brought my other hormonal imbalances to the forefront. I guess I did it in the wrong order. That's what I've heard (about MRIs being 'normal') - I wonder if it's necessary to have it, then? Probably, to rule out other possibilities... Let us know how you go I'm beginning to suspect Growth Hormone problems, too. After you mentioned it, I did a little looking around; and I sure have most of the symptoms of a deficiency. I'll let you know how it goes. Thanks, again. Dee
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dee
New Member
Posts: 30
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Post by dee on Mar 2, 2009 17:48:33 GMT -5
Just wanted to say that I got my date for my appt with the specialist - June 23. Think it's safe to wait that long? Is secondary adrenal insufficiency something one can put off? Yikes. I look back, and I think I've had signs of hypopituitary all of my life - even as a kid. It's just taken 45 years to get to the 'last straw' phase. So, hopefully a few more months won't hurt. I'm thinking of calling the specialist's office, myself, and asking if they can get me in sooner. Dee
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Post by justaustin on Mar 4, 2009 10:03:22 GMT -5
Dee,
You can always request to be put on the cancellation list. If another patient cancels, they will call you (often times short-notice) to see if you can come in. For them, time is money. Unfilled blocks of schedule time us money loss for them.
Whatever other labs you think you will need(what hasn't been tested at this point). From all your learning and reading here and at RTH..... Have primary doc order. Also have primary doc order the pituitary MRI with and without gadolinium. Be sure the MRI includes views of hypothalmus and pituitary stalk. Tell primary md that appt with specialist isn't until June. That the more info the specialist has at the time of appt, the less time will be lost in workup/diagnosis.
Whatever labs the primary md won't order, you can do yourself if you live in US in any state but NY,NJ,CA and RI.
I suspect that your mildly elevated prolactin is related to hypothyroidism. It's the most common cause. That your low cortisol is preventing ineffective utilization of thyroid hormones. Once Cortisol is replaced and you can optimize thyroid hormone replacment..... Your Prolactin will go down.
Laurie
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Post by justaustin on Mar 4, 2009 10:11:18 GMT -5
Dee, You can always request to be put on the cancellation list. If another patient cancels, they will call you (often times short-notice) to see if you can come in. For them, time is money. Unfilled blocks of schedule time us money loss for them. Whatever other labs you think you will need(what hasn't been tested at this point). From all your learning and reading here and at RTH..... Have primary doc order. Also have primary doc order the pituitary MRI with and without gadolinium. Be sure the MRI includes views of hypothalmus and pituitary stalk. Tell primary md that appt with specialist isn't until June. That the more info the specialist has at the time of appt, the less time will be lost in workup/diagnosis. Whatever labs the primary md won't order, you can do yourself if you live in US in any state but NY,NJ,CA and RI. You can order via healthcheck usa and econolabs. You might have to order via both as they don't have same prices for all labs. I suspect that your mildly elevated prolactin is related to hypothyroidism. It's the most common cause. That your low cortisol is preventing ineffective utilization of thyroid hormones. Once Cortisol is replaced and you can optimize thyroid hormone replacment..... Your Prolactin will go down. Laurie [a href="http://[del:justaustin]"]http://[del:justaustin][/a]
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