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Post by echidna on Apr 23, 2009 19:37:37 GMT -5
Hi, new here as only recently finding l may or may not be hypopituatry? lm just wondering... recent test results showed my TSH (0.74) had dropped, as had my T3 & T4. l also found l had low aldosterone, and was advised my progesterone and oestrogen were also low (cortisol and dhea already known to be low and are being treated as is my thyroid now (note - was not taking thyroid extract at time of or prior to testing)). My doctor has since sent me a referral for a CT scan of the pituatry. FSH and LH were not tested this set of pathology but l found earlier test results for these which were: S FSH (testing 1) 6.0 IU/L, (testing 2) 5.2 IU/L & S LH (testing 1) 6.7 IU/L, (testing 2) 3.3 IU/L. There are no reference ranges given, but l gather these are all fine? If this is the case, do you think this rules out hypopituatry? As l mentioned these were not retested in last lot of pathology, my ACTH and renin have never been tested. My doctor put on my CT scan referral, suspected hypopituatry. She plans to retest LH & FSH and test ACTH next pathology. Any feedback would be greatly appreciated. H
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Post by justaustin on Apr 23, 2009 20:40:45 GMT -5
Welcome!
First off, dynamic pituitary MRI with and without gadolinium will be better than a CT scan. Most hypopit patient's have "normal " pituitary appearances. The exception to this would be say an adenoma, deviated pit stalk, partially empty or empty sella.
So, you are saying that your initial thyroid testing (before any/if thyroidhormone replacement) is low normal/normal TSH and low free thyroid hormone levels?
For sex hormones: you need individual sex hormones with LH/FSH on day 3 or day 21(my docs likes day 21) of your cycle. If sex hormones are low and LH/FSh are low...this points to hypopit.
You need morning cortisol with morning ACTH and DHEA-S. Unfortunately, you can't test these while taking cortisol, extracts,glandulars,Dhea,progesterone. Your ACTH WILL be low if you test while taking cortisol/cortef/hydrocortisone.... Shuts down the ACTH. If you want reliable results, you need to slowly wean off cortisol by no more than 2.5mg/week. Be off cortisol for a minimum of 2 weeks prior to re- testing. This allows your HPA axis to reset.
Testing aldosterone and renin: Should restrict salty/processed foods for 24 hours. Sit for two hours prior to testing. May walk to car and to lab. Do on day 3 of cycle. Restricting sodium allows aldosterone to rise to it's potential. Do as close to 8am as possible. Have sodium and potassium tested at the same time.
Do yourself a huge favor. Get copies of all your labs. Please post the lab results with reference ranges,such as a column format, as printed on results sheet. Include any meds taken at time of labs(from memory). Include how you were feeling.
Laurie
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Post by echidna on Apr 24, 2009 18:35:30 GMT -5
Thanks Laurie, forgive my first posting here, lm not sure how l expected you to be able to work from the minimal and ambiguous information l posted. l am working on no sleep for about 3-days now (change in medications having an unwelcome side effect!) so lm not thinking very straight! l will set up a medical page for myself with all lab results/symptoms/medications after lve had my CT scan. lts unfortunate that this is not the ideal scan to have, but l'll go ahead with it as it will be a while before l have another appointment with my doctor. Thanks again for the info. H
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Post by fractal1 on Apr 24, 2009 23:15:20 GMT -5
Hi H, Just to put your mind at rest. I think . CT scans will help to rule out anything major or life threatening and there isn't a long waiting list. The disadvantage it that you don't get as much detail and it's not the healthiest of scans... i.e. not really something you'd want to get done more than once. ps if you're starting florinef, it's REALLY important that you start with 1/4 of a tab and hold for at least four days before raising by another quarter.
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