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Addison's Disease Message Board


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i have put question marks against the tests i really don't understand.

1 tesosterone
2 SHGB?
3 prolactin
4 androstenedione?
5 DHEAS measurements ( done on basal bloods) ?
6 a DAX ?


Does anyone one know what some of these tests are for or how they are done? My own research on them on the net seems to be getting me confused.
i seem to being tested for some endo abnormality addisons, cushings, endocrine tumors? are there any tests that i should be having or will the results from these give a good indication as to whatneeds further doing. He has also requested an ultra sound of my ovaries and adrenalines but i had one done that was clear six months ago. i am wondering whether to request an mri or ct of this area instead for a more detailed look.

Just to fill you in a bit. my life is hell right now. i have been really sick since January with lots of symptons and just not getting better. My own primary care physisian is just treating this as some slow undiagnosed illness that they will get to the bottom of eventually. unfortunately he does not understand the acute symptons i have been going through. the last week was particularly bad for me. Bang worse symptons around period time. Headache i could not shake for three days followed by going freezing cold all over no pain killers working!! took myself to A and e i was so worried. Follwed by a kind of huge violent mood swing. i did not know what was happening to me. i almost wet myself. Last two day complete nausea. i have been lying in bed trying to read have to put book down every 5 minutes i feel so sick. i have had two or three acute headache attacks like this in the last 6 months. One of them made me collapse completely like someone had suddenly pulled the rug from under my feet. the first attack i had in january is when i ended up going to hospital was having water retention in my face headaches then one night gripping pain in stomach and legs followed i literally became almost paralysed could not move my body and started having breathing problems.
Symptons are still persisting: headaches, sudden body weakness, bad jaw ache, symptons worse lying down, sweating at night, wake feeling i had no sleep, hair loss, weight loss, skin peeling, liquid retention under the skin, breathing problems, sensation of going very cold, acne, what looks like inflammation of some bones?My cheeks suck in badly wheni have severe headache? intermittant visual blurring, heavy delayed periods but always had these. except the periods i never had any of these symptons before Jan !!

im confined to the house for past six months exertion has brought on some bad symptons so trying to take it easy and keep calm. what i can't believe is this complete physical metamorphosis. my face has changed so much my freinds jaw has dropped when they see me and even the photos of me pre xmas compared to now are pretty dramatic. Its the one thing that makes the docs know something is going on!

Ok im pretty desperately sad anxious and depressed cause of all this but im trying NOT to loose my sanity cause i want to get better. these attacks scare the life out of me. i have been sent round the houses trying to get a diagnosis so far. my other basic bloods don't show too much although i have values that are high and out of range that my doc has not adressed yet. High white blood cell count on last three occassions. high neutrophils on last three occassions. Raise in esr. crp high, glucose high once , potassium low on numerous occassions, Growth hormone high igf-1 high. i know that there possibly may be some infection going on with the high white blood cells- i don't know what my doc plans to do to adress this.

im not looking for a diagnosis here. i just can't believe what is happening. sometimes feel my pulse will literally have to stop before someone take this seriosly. my doc is very ready to tell me i have cfs but symptons are so violent and my change in physical appearance so dramatic!! Plus i can't possibly spend the next year lyingin bed thinking i will just get over this?

I posted the story of what happened to me since jan on reasearch board. i want to make docs realise this is urgent and take me seriously.

any advice on dealing with my docs or any precautions i can take in the meantime? at least this new endo thinks something is up and is doing all these tests for me.

thanks zoe
Hey zoe, nice to meet you! My friends call me TK.

I want to first off send my sympathy to you and all your countrymen and women there in the UK regarding the recent bombings in London. I know that in the US we are praying for all of you and keeping you close in our thoughts. I personally, will never forget the support you all showed us after 9/11.

Anyhoo: As for the tests you question, I'm going to post the info I gleaned from the .Net and I'm just going to paste it from my "Scrapbook" that I have in my browser and then I'll kinda add my thoughts to what I posted. K?

(just gotta let you know, I had to break this up into multiple posts, it was a bit long! sorrry :( )

[U]SHGB[/U]
[B]In addition, levels of Sex Hormone Binding Globulin (SHGB) are elevated, which has the effect of decreasing libido, sexual response and energy levels.[/B]

[U]What is Androstenedione?[/U]
[B]Androstenedione is a natural hormone which is a direct precursor to testosterone. [/B]


[B]Recent data regarding the effects of androgen therapy on libido and sexual function in women and the clinical development of a testosterone patch for women raise a number of questions regarding androgen administration in women. We need to better define an androgen deficiency syndrome and differentiate between hormone replacement and pharmacologic use of hormonal therapy. Research is needed to determine in which subsets of women androgen administration is effective. In addition to androgen effects on libido and sexual function, other endpoints, including bone, body composition, cardiovascular risk, breast tissue and brain effects require study. Finally, the long-term safety of androgen therapy in women needs to be established.

Because the ovaries and adrenals are the primary sources of androgens in women, disease or iatrogenic

intervention which compromises the function of these glands may result in hypoandrogenemia. Bilateral oophorectomy has been demonstrated to result in a 60% reduction in serum testosterone in premenopausal women and a 50% decrease in postmenopausal women, suggesting that the ovaries produce approximately half of circulating testosterone in women, with the other half derived from adrenal precursors. In contrast, more than 90% of DHEAS is produced by the adrenal glands. Therefore, bilateral oophorectomy and/or adrenal insufficiency result in a marked diminution in circulating testosterone, with a reduction in DHEAS also observed in women with adrenal insufficiency. Women with hypopituitarism, particularly those with both hypoadrenalism and hypogonadism, have severe androgen deficiency, including decreased testosterone, free testosterone, androstenedione and DHEAS. Medications that suppress ovarian function, such as oral contraceptives, and those that suppress adrenal function, including glucocorticoids, also reduce androgen levels in women. Oral estrogens, even at low doses, reduce free testosterone by increasing SHBG levels.

Our studies on the developmental function of the neurosteroid dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEAS) indicates that they are distinct neurosteroids: DHEA stimulates axonal growth from specific populations of neocortical neurons while DHEAS stimulates dendritic growth from those cells. DHEA, but not DHEAS, also affects differentiation of hindbrain cholinergic neurons.[/B]

[U]The Test[/U]

1.How is it used?
2.When is it ordered?
3.What does the test result mean?
4.Is there anything else I should know?

[U]How is it used?[/U]
[B]DHEAS levels are not routinely measured. Unless you have symptoms that warrant its use, you will most likely never have a DHEAS test done. DHEAS, testosterone, and several other androgens are used to evaluate adrenal function and to distinguish between androgen secreting adrenal conditions from those that originate in the ovary or testes. DHEAS can be measured to help diagnose adrenocortical tumors (tumor in the cortex of the adrenal gland), adrenal cancers, and adrenal hyperplasia (which may be congenital or adult onset) and to separate them from ovarian tumors and cancers.

Concentrations of DHEAS are often measured, along with other hormones such as FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovarian syndrome (PCOS) and to help rule out other causes of infertility, amenorrhea, and hirsutism.

DHEAS levels may be ordered, along with other hormones, to investigate and diagnose the cause of virilization in young girls and precocious puberty in young boys.
[/B]

[U]When is it ordered?[/U]
[B]DHEAS may be ordered, along with other hormones, whenever excess (or more rarely deficient) androgen production is suspected and/or when your doctor wants to evaluate your adrenal gland function.

It may be measured when a woman presents with symptoms such as: hirsutism, alopecia (hair loss), amenorrhea, infertility, acne, increased muscularity, and decreased breast size. It may also be ordered when a young girl shows signs of virilization, such as hirsutism, a deep voice, or when a female infant has ambiguous genitalia wherein the clitoris is overgrown, but the internal female organs usually appear normal.

DHEAS may also be measured when young boys show signs of precocious puberty - the development of: a deeper voice, pubic hair, muscularity, and an enlarged penis well before the age of normal puberty.[/B]

[U]What does the test result mean?[/U]
[B][U]NOTE:[/U] A standard reference range is not available for this test. Because reference values are dependent on many factors, including patient age, gender, sample population, and test method, numeric test results have different meanings in different labs. Your lab report should include the specific reference range for your test. Lab Tests Online strongly recommends that you discuss your test results with your doctor. For more information on reference ranges, please read Reference Ranges and What They Mean.

Low levels of DHEAS may be due to adrenal dysfunction or hypopituitarism - a condition that causes decreased levels of the pituitary hormones that regulate the production and secretion of adrenal hormones. Normal DHEAS levels, along with other normal androgen levels, may indicate that the adrenal gland is functioning normally, or (more rarely) that the adrenal tumor or cancer present is not secreting hormones. Normal levels of DHEAS may be seen with PCOS, as this disorder is usually related to ovarian androgen production (primarily testosterone).

Elevated levels of DHEAS, in conjunction with elevations in such tests as 17-ketosteroids (which measures androgen metabolites in urine) and 17-OH progesterone may indicate an adrenocortical tumor, adrenal cancer, or adrenal hyperplasia. Increased levels of DHEAS usually indicate the need for further testing to pinpoint the cause of the hormone imbalance, but do not often stand alone for diagnostic purposes.
[/B]
[U]Is there anything else I should know?[/U]
[B]DHEAS levels are normally high in both male and female newborns. They drop sharply shortly after birth, then rise again during puberty. DHEAS concentrations peak after puberty, and then, like other male and female hormones, the levels tend to decline as we age.[/B]

[U]DAX-1[/U]
[B]DAX-1 is the gene responsible for adrenal hypoplasia congentia in humans. (a protien) dosage-sensitive sex reversal = DAX-1[/B]

[U]X-linked[/U]
[B]adj : relating to genes or characteristics or conditions carried on the X chromosome; "an X-linked mutation" [syn: X-linked][/B]

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