jon
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Posts: 3
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Post by jon on Mar 2, 2009 3:38:48 GMT -5
Hi everyone, two years ago I was diagnosed with Adrenal Insufficency, GH Deficiency, Hypothyroidism, Immune deffiency, insulin resistance, and hypogonadism. I have been taking bio-identical hormone replacement, for two years with some success. The TSH was 5.4, so that was clearly not pituatary, but I am wondering about the rest? For the thyroid, I have been taking 100mcg. SRT3, but my rT3 is going up, not down. I inject HGH, and cypionate/progesterone/zinc. Been on a low carb high protien diet for 8 years, to keep the insulin resistance in check. The fro Adrenal insuffiecency I took cortisol fro the first 6 months, then was tapered off, seems to be coming back, since I slept all day, and now can't get to sleep... The doctor nevr came up with a reason for having these conditions, he more intersted in just replacing the hormones. What would be the best approach to find out if the cause is hypo- pituatary, or some other cause? Are there tests I can take without going off the hormones that I am taking? Thanks much! Jon
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Post by fractal1 on Mar 2, 2009 14:59:18 GMT -5
Hi Jon and Welcome , Hypogonadism and GH deficiency would suggest hypopituitarism. Could you post your labs so I can have a look at them? Please include date they were taken, the medication you were on, if you were fasting, and the time of day they were taken. Important labs include: LH FSH Total testosterone Free or Bioavailable testosterone Estradiol (sensitive) Prolactin SHBG DHT ACTH cortisol DHEA or DHEAS IGF-1 IGF-BP3 Thyroid Antibodies B12, iron, ferritin Lipid Profile CMP (comprehensive metabolic panel), which includes: - glucose - calcium - Albumin - Total Protein - Electrolytes (sodium, potassium etc.) - BUN (blood urea nitrogen) - Creatinine - ALP (alkaline phosphatase) - ALT (alanine amino transferase, also called SGPT) - AST (aspartate amino transferase, also called SGOT) - Bilirubin Are you taking thyroid extract (amour)? Cheers
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jon
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Posts: 3
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Post by jon on Mar 2, 2009 18:37:44 GMT -5
4/4/07 before treatment fasting LH not tested FSH Not tested Total testosterone 145 ng/dl Free or Bioavailable testosterone 34.8 pg/mL Estradiol (sensitive) 17 13-54 pg/mL Prolactin not tested SHBG not tested DHT not tested Insulin 13 uIU/mL
ACTH not tested cortisol free and total 8 mcg/dL 5-21 mcg/dL cortisol free LC/MS/MS 0.26 .07-0.93 mcg/dL DHEA or DHEAS
IGF-1 182 ng/mL 86-220 IGF-BP3
Thyroid Antibodies <10 <35 IU/mL Free T3 329 230-420pg/mL reverse T3 0.22 0.11-0.32 B12, not tested iron, not tested ferritin 50 0.0-0.6 MG/DL Lipid Profile: chol. total 205 mg/dL 100-199 Triglycerides 372 mg/dL 0-149 HDL 28 mg/dL 40-59 VLDL 74 mg/dL 5-40 LDL 103 mg/dL 0-99 T Chol/HDL ratio 7.3 ratio .0--5.0
CMP (comprehensive metabolic panel), which includes: - glucose 86 65-99 mg/dL - calcium 8.9 8.5-10.6mg/dL - Albumin 4.7 3.6-5.1 g/dL - Total Protein 7.1 6.2-8.3 g/dL - Electrolytes (sodium, potassium etc.) - BUN (blood urea nitrogen) 16 5-26 mg/dL - Creatinine .7 mg/dl 0.5-1.5 - ALP (alkaline phosphatase) 79 40-115U/L - ALT 48 9-60 U/L - AST 23 10-35U/L - Bilirubin .1 <or=0.2 mg/dL
This is all the testing I had, before starting hormone replacement.
Latest bloodtest 11/21/08 fasting with no meds LH not tested FSH not tested Total testosterone 612 ng/dL 250-1100 Dose every other day: Cyponate/Progesterone 20 units injected Free or Bioavailable testosterone 180 pg/mL 35-155 Estradiol (sensitive) not tested Prolactin not tested SHBG not tested DHT not tested
ACTH Not tested cortisol 15.9 mcg/dL 4.6-20.6 Cortisol free .73 mcg/dL .07-0.93 mcg/dL DHEA or DHEAS not tested
IGF-1 276 HGH dose: 15 units a dayIGF-BP3 not tested
Thyroid Antibodies not tested Free T3 339 230-420 pg/dL Dose: SRT3 100mcg. once a day Reverse T3 24 ng/dL 11-32 B12, iron, ferritin Not tested Lipid Profile chol. total 205 mg/dL 100-199 Triglycerides 143 mg/dL 0-149 HDL 29 mg/dL 40-59 LDL 135 mg/dL 0-99 T Chol/HDL ratio 6.7 ratio .0--5.0 CMP (comprehensive metabolic panel), which includes: - glucose 95 mg/dL 65-99 mg/dL - calcium 9.3 mg/dL 8.6-10.2mg/dL - Albumin 4.7 3.6-5.1 - Total Protein 7.0 6.2-8.3 g/dL - Electrolytes (sodium, potassium etc.) sodium 140 135-146 mmol/L Potassium 4.8 3.5-5.3 mmol/L - BUN (blood urea nitrogen) "normal Range" - Creatinine - ALP (alkaline phosphatase) 71 40-115 U/L - ALT 33 9-60 U/L - AST 24 10-35 U/L - Bilirubin not tested
Vitamin D total 37 ng/mL 20-100 Vitamin D3 32 Vitamin D2 5
I am also taking DHEA, Melatonin (as sleep aid), Immune-booster (Miatake D fraction) Miatake SF fraction fro blood sugar, and a niacine suppliment for the cholesterol. Also my Basal temp. adv. 96.6 Jon
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Post by fractal1 on Mar 3, 2009 21:14:19 GMT -5
Hi Jon, Sorry about the delay. Without pituitary hormones being tested, I cannot tell you if you have hypopituitarism. Hi rT3 may be due to low cortisol. Your cortisol was initially very low. I cannot understand why your doctor didn't retest on more than the one occasion after you tapered off it. It would be good to get AM ACTH and cortisol tested as soon as you can. Also, thyroid hormone use can be affected by ferritin and B12 levels - so testing these wouldn't go astray. HGH can interfere with blood sugar levels. What time of the day are you taking it? Cheers
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jon
New Member
Posts: 3
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Post by jon on Mar 4, 2009 2:08:27 GMT -5
I am going back for my 4 month check-up next month, he has the coritsol test ordered for that. I will ask him about the Pituatary tests, and see if I can get them ordered. There is a very good Pituatary dept. at UCLA, so if there is any indication of Pituatary probems, I can go there. I have recieved B12 injections from this doctor in the past, so he must be aware of the need, even though he didn't test for it... Maybe due to being a vegitarian for 30 years? I have been concerned about HGH raising my blood sugar, as I am pre-diabetic. I take the injections in the morning, that is what the doctor recommended. I do feel like I am sliding back to chronic fatique, my Basal body temp was down to 96.2 this morning. Just crashed again this evening for a 3 hour nap. But as they say down under, "Bob's your uncle!" Take care, and thanks for the info! Jon
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Post by fractal1 on Mar 4, 2009 16:23:16 GMT -5
No worries Jon, I rarely ate meat or eggs (like once every two months) for 6 years and my B12 levels were really good. So ya never know. Notably, iron, ferritin and B12 can make a massive difference to your ability to utilize thyroid hormone. When you go to the endo, try to get all the labs I've listed in my first reply. These should be done fasting and around 8am (no later than 9am). Try to get blood drawn from the same lab for consistency and get a copy of them sent to you. Good luck and let us know how you get on. Cheers
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