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Post by crithium on Mar 13, 2009 20:47:02 GMT -5
Alright, here are my test results from yesterday. That was day 15 of my cycle. I hope that was o.kay!
25-Hydroxy D Total - 45 (25-80 ng/mL) Calcium - 9.8 (8.9-10.1 mg/dl) Phosphorus - 4.3 (2.5-4.5 mg/dl) AM Cortisol - 11 (7-25 ug/dl) Corticotropin (P) - 13 (10-60 a.m. drpg/mL) Insulin-Like Growth Factor - 254 (117-321 ng/mL) LH - 9.6 (Follicular 2.1-10.9 Midcycle 20.0-100 Luteal 1.2-12.9 IU/L) FSH - 7.2 (3.9-8.8 Follicular 4.5-22.5 Midcycle 1.8-5.1 Luteal IU/L) Estradiol,S - 105 (15-350 pg/mL)
Anyone like to help me figure out what they mean? Thanks!
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Post by justaustin on Mar 15, 2009 8:21:26 GMT -5
I responded on the RTH forum.
Laurie
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Post by crithium on Mar 15, 2009 21:00:33 GMT -5
Thanks! My ACTH is low enought for my doc to take it seriously right? It's still in the "normal" range but low enought that they aren't going to tell me I'm fine right? What about the LH, FSH and estradiol? I am not sure where day 15 falls? Is that mid cycle? Do I need to retest? I don't meet with the new endo untill the 27th. I am trying to get in earlier but she hasn't had any cancelations. I can see if my GP will be able to get some info out of her before that but I don't know if it will be any faster. I am battling a nasty cold that just won't go away. I had antibiotics a couple of weeks ago and know the headache and the cough are back so I might have to go back in anyway to see him. Does the fact that I can't get rid of this cold have anything to do with the low cortisol and ACTH?I know colds stick around forever thsi time of year but this one is bad.
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Post by crithium on Mar 15, 2009 23:48:00 GMT -5
Just realized they tested CRH not ACTH right? I realize that corticotropin is what stimulates the pituitary to make ACTH but that doesn't get me the answer I need right? Or is is all interrelated? I was so excited that they finally tested the right thing but now I am mad and confused again!
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Post by Lethal Lee on Mar 16, 2009 3:18:56 GMT -5
I realize that corticotropin is what stimulates the pituitary to make ACTH but that doesn't get me the answer I need right? Or is is all interrelated? I was so excited that they finally tested the right thing but now I am mad and confused again!
Corticotrophin IS ACTH (Adrenocorticotrophin). Yes CRH (Corticotropin Releasing Hormone) is made by Hypothalamus to stimulate ACTH which stimulates Cortisol.
Docs sometimes use synthetic CRH to do a Stim test in order to differentiate between Tertiary AI (lack of CRH) & Secondary AI (lack of ACTH despite good CRH).
Just realized they tested CRH not ACTH right? Nope you had Plasma ACTH tested NOT CRH!!!!
My ACTH is low enought for my doc to take it seriously right? It's still in the "normal" range but low enought that they aren't going to tell me I'm fine right?
AM Cortisol..................11 (7-25 ug/dl) *22% in range AM Corticotropin (P)... 13 (10-60 drpg/mL) *6% in range
Most Docs & 99% Endos will say that "in range" for these are fine & perfectly healthy. They only acknowledge & treat Addisons (Adrenal failure usually result of Adrenal Antibodies) and Cushings (excess Cortisol & ACTH usually as a result of Tumours or Pharmacological steroid dosing).
However reality is optimal is Cortisol top of range (yours is only 11% in range), & ACTH high 40's to mid 50's (yours is only 6% in range). Remember too that you had TOTAL Cortisol tested. You havent tested CBG or Free Cortisol. Saliva measures Free Cortisol.
What about the LH, FSH and estradiol? I am not sure where day 15 falls? Is that mid cycle? Do I need to retest?
LH............9.6 (Follicular 2.1-10.9 Midcycle 20-100 Luteal 1.2-12.9 IU/L) FSH..........7.2 (3.9-8.8 Follicular 4.5-22.5 Midcycle 1.8-5.1 Luteal IU/L) Estradiol..105 (15-350 pg/mL)
Yes day 15 is midcycle. But it really depends on exactly when you ovulate. Supposedly ~day 14 is ovulation but it may vary bewtween individuals & from cycle to cycle.
If it was midcycle then LH is deficient, FSH is elevated & Estradiol looks low.
Yes I suggest you retest day 3 of cycle. Test ALL the following at SAME time note need to be tested 8am after fasting overnight.
•Hormonal Panel (early 8am fasting overnight) includes FSH LH Total Estrogens Estradiol (E2) Estrone *available USA Estriol *available USA Progesterone LH/FSH Ratio
•Androgens Panel (early 8am fasting overnight) includes Testosterone SHGB FAI DHEAS Androstenedione Free Testosterone
Does the fact that I can't get rid of this cold have anything to do with the low cortisol and ACTH?I know colds stick around forever thsi time of year but this one is bad Most definitely. You cant fight back if you dont have the defenses to do so. HypoT will also contribute to lowered immunimty & long recovery times.
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Post by crithium on Mar 16, 2009 19:48:44 GMT -5
Great, so I shouldn't get my hopes up that they will treat me based on those results? Is it low enough that you think they will investigate it further? I was all excited thinking that I finally had something to prove that I needed to be treated. I guess I will have to wait and see what they say. Thanks for the info!
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Post by crithium on Mar 23, 2009 21:28:18 GMT -5
I think this got missed. I know that you are all extra busy with Chris not being able to help. But if you get a chance. My appointment with the endo is on Friday and I am starting to freak out that she is going to blow me off. Any advice?
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Post by justaustin on Mar 24, 2009 15:19:37 GMT -5
"NORMAL AND OPTIMAL ARE NOT EQUAL"
Have a concise outline of what you wish to address when you see your doc. Preface it by reviewing your head trauma and your postpartum hemorrhage and infection with any MRI Findings ( such as partially empty sella). With ALL that, plus symptoms plus low ACTH and low cortisol....supports hypopituitary and need to evaluate all hormones not already tested.
As discussed by Lee and myself...Your Corticotropin hormone (ACTH) is in the dirt. It needs to be in upper 1/3 of range to allow optimal signaling for your adrenals to produce enough cortisol first thing in the morning.
Morning cortisol sucks. Morning cortisol levels between 10 and 20 do not rule out underlying cortisol deficiency. With your terrible ACTH, it's slam dunk!! Or at least should with anyone who has critical thinking skills. Most Endo's do not. Sorry. Between my kids, I've been through 4 endos in the last two years. It's futile.
If your doc doesn't get this, you need to move on. PERIOD!!
Laurie
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