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Post by mastaaussie on Mar 24, 2009 20:34:26 GMT -5
took son to a pituitary specialist last friday. he ordered a bunch of labs. a hand xray to see sons growth plate and an MRI (we are doing that tomorrow. we wont hear back from the specialist for a while. Can you look at my sons labs and give me some input. he has had 2 testosterone tests done using different labs. testosterone test done on 03/12/09 shows son has low testosterone. test done yesterday show he is within range. im new to all of this. he has some thyroid antibodies, but not enough to be diagnosed with anything. he isnt on any thyroid meds just supplements that are mentioned in his journal. Thanks.... Masta forums.realthyroidhelp.com/viewtopic.php?f=11&t=11624
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Post by fractal1 on Mar 26, 2009 4:36:28 GMT -5
Hi Masta, Thanks for the link to the journal . 1. ACTH putting-on the breaks well before cortisol peaks suggest secondary AI. 2. RE first blood draw - I'm told that testosterone is highest in the morning, but I still wouldn't expect it to drop below range by afternoon. LH and FSH are pulsatile, so there's a chance that the blood just happened to be drawn at the 'wrong' time. hardasnails over at RTH might have something to say about that. 3. Elevated TSH + Antibodies = Hashi's. In fact, he's even outside of the conservative conventional TSH range (see below). Brabant et al (2006). Is there a need to redefine the upper normal limit of TSH? European Journal of Endocrinology. 154, 633-637. Mild forms of hypothyroidism - subclinical hypothyroidism - have recently been discussed as being a risk factor for the development of overt thyroid dysfunction and for a number of clinical disorders. The diagnosis critically depends on the definition of the upper normal limit of serum TSH as, by definition, free thyroxine serum concentrations are normal. Cut-off levels of 4-5 mU TSH/l have been conventionally used to diagnose an elevated TSH serum concentration. Recent data from large population studies have suggested a much lower TSH cut-off with an upper limit of 2-2.5 mU/l but application of strict criteria for inclusion of subjects from the general population studies aiming at assessing TSH reference intervals (no personal or family history of thyroid disease, no thyroid antibodies and a normal thyroid on ultrasonography) did not result in an unequivocal upper limit of normal TSH at 2.0-2.5 mU/l. When summarizing the available evidence for lowered upper TSH cut-off values and their potential therapeutic implications there is presently insufficient justification to lower the upper normal limit of TSH and, for practical purposes, it is still recommended to maintain the TSH reference interval of 0.4-4.0 mU/l. Classifying subjects with a TSH value between 2 and 4 mU/l as abnormal, as well as intervening with thyroxine treatment in such subjects, is probably doing more harm than good.
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Post by mastaaussie on Mar 26, 2009 10:08:44 GMT -5
are there any medical journal that states if you have antibodies with a elevated TSH = hashis?
im seeing a good doctor. my son will be going in next week to see him also. he is nice and is willing to work with his patients. he prescribes armour and doesnt look at the TSH he looks at the FT4 and mainly FT3 .
he knows allot about hormones. ive seen him twice myself. insurance doesn't cover him, so he is quiet expensive.
i had my son do a 4 x saliva cortisol test over 24hr period kit yesterday. results should be about 2 weeks.
Labcorp: the first test 03/12/09 with low testosterone was done after lunch. son was very stressed. its seems like he has a panic attack with every lab draw. he was lying down for that test. (using a male range)
Hospital Lab: the 2nd test 03/23/05 with normal testosterone was a 8am fasting test different lab than the 1st test. he wasn't as anxious and was sitting up. (using a womens and childrens range).
i asked my doctor about the different testing labs. labcorp having the low range and the hospital labs having son in normal range.
he said labcorp is more reliable, they have better equipment. so i guess... i will ask my doctor to do one more labcorp test next week in the morning to get a better picture of whats going on.
i can get all my labs covered at 100%. is there any other tests that should be done or re-ran to check to see if he has other problems?
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Post by fractal1 on Mar 26, 2009 14:52:24 GMT -5
The 'technical' term is sub-clinical hypothyroidism. TSH is ignored when dosing thyroid, but not in diagnosis. It sounds like your doctor is up with things, so he should know this. Vanderpump MPJ, Tunbridge WMG: The epidemiology of thyroid diseases. In Braverman LE, Utiger RD (eds): Werner and Ingbar's The Thyroid: A Fundamental and Clinical Text, ed 7. Philadelphia, JB Lippincott-Raven, 1996, pp 474-482 . In Tunbridge and Vanderpump (2000) Endocrinology and Metabolism Clinics of North America. 29.
"Most clinicians (at the nanolevel) treat subjects who have raised serum TSH concentrations and positive thyroid antibody tests even if symptoms are absent, provided that no contraindication is present, in view of the annual risk for hypothyroidism of approximately 5%."
Let us know when saliva cortisol results are in. Panic attacks are common when someone has low cortisol and faced with some stressor. Stress also affects sex hormones and can result in secondary hypogonadism, which is resolved by adrenal support. The first step is to get your sons adrenals supported IMHO. Then I would have another comprehensive set of labs run. Adrenals must always be treated before thyroid. Cheers
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