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Addison's Disease Message Board


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I will be seeing a new ObGYn, who specializes in reproductive endocrinology. She wants to have some related hormone tests performed, and I don't want to mess up the validity of results. I am taking 5 mg pregnenolone MWF, and have been for a month. Prior to that on another drs advice, I was taking 10 mg DHEA MWF, but then decided to go back to Pregnenolone. I also am taking two tables of Isocort (+ approx 5 mg cortisol?) daily.

I am still looking into secondary adrenal issues, but am at a dead end at the moment, treatment-wise. No one so far has permitted me to do a trial of HC. :confused:

I am a little over 42 years of age, have been sick since my early 20s. I have posted here before, but am pasting below tests etc for reference.

I am now on 37.5 mcg of thyroxine and 5 mg cytomel after resuming my thyroid meds for 10 weeks, after a 4 week period of no thyroid meds in order to get a new baseline and because of my "intolerance" of meds, which I really suspect were/are failing adrenals under the strain of the thyroid meds. :confused::confused:

Any suggestions welcome on how I can achieve a god status quo for an accurate assessment of my reprod hormones - which should be low as already evidenced in my October saliva test....but as we know, not all drs consider saliva tests "real".
_________________________________________________-
Feb 2008

[U]Stim test[/U]: AM = 14.5, 30 min = 31.7 and 60 min = 33.6. No ACTH drawn as lab error.

Earlier ACTH = July 07 ACTH 11 (5-27)

__________________________________________________

My saliva test from October 2007 indicated the following:

Cortisol

7-8AM 15 (13-24)
11-noon 3 (5-10) depressed
4-5PM 4 (3-8)
11-mid 2 (1-4)

It says I am maladapted Phase II
____________ _________ ______

DHEA 1 (3-10) LOW
_________ _________ _________

hormones (in context of time of period)

borderline low:
F testosterone 7 (borderline low 5-7; normal 8-20pg/ml)
Androstenedione 97 (borderline low 75-124pg/ml)
Estrdiol 8 (luteal 7-20pg/ml) my phase at time
Estriol 14 (cycling female (12-25 pg/ml)

high:
progesterone (very elevated) 837 (luteal 65-500pg/ml)
________________________________________
2/08/08 [U] 4 weeks NO[/U] thyroid meds (living hell~!):(:mad:

Na 140 (135-148)
K 4.0 (3.5-5.5)
Ca 8.6 (8.5-10.6)
Protein 6.1 (6.0-8.5)
Creatinine .8 (.5-1.5)
Albumin 3.8 (3.5-5.5)

[COLOR="Blue"]DHEA-S[/COLOR] 40 (32-240)


[COLOR="Magenta"]TSH[/COLOR] 5.121 (.35-5.5)
[COLOR="Magenta"]FT4 [/COLOR] 1.04 (.61-1.76)
[COLOR="Magenta"]FT3 [/COLOR] 2.8 (2.3-4.2)

[COLOR="Blue"]PTH[/COLOR] 33 (12-65)

TPO ab <10 (0-34)
antiTG ab <20 (0-40)

________________________________________________


1/8/2007 (“intolerant” of thyroid meds, sought medical attention – severe dizziness, severe somnolence, elevated heart rate etc. - was on 30 mg Armour, tapered down due to intolerance, went on 22 mcg thyroxine for a week)

Na 137
K 3.9
Chl 102
CO2 23
Protein 7.2
Alb 4.0
Cal 8.8
Creatinine .6

[COLOR="Magenta"]TSH[/COLOR] 1.75 (.35-5.50)
[COLOR="Magenta"]FT4[/COLOR] 1.49 (.89-1.80)
_______________________________________________

NO thyroid meds for 2 weeks (no changes to diet, supplements etc) [note CA, NA and K all back up from 7/12/07 ER visit)

08/02/07

Na 140 (135-146)
K 4.4 (3.5-5.3)
Ca 9.1 (8.6-10.2)
Protein 6.3 (6.2-8.3)
Creatinine .7 (.5-1.2)
Albumin 4.2 (3.6-5.1)

___________________________________________________
7/12/07 (“intolerant” of thyroid meds, sought medical attention – severe dizziness, elevated heart rate etc. - had switched over from 88mcg thyroxine to 45 mg Armour )

Calcium 8.6 ( 8.5-10.5)
Sodium 136 (136-145)
K 3.6 (3.5-5.1)
Protein 6.4 (6.4-8.2)
Creatinine .6 (.6-1.7)
Albumin 3.6 (3.4-5.0)

[COLOR="Magenta"]TSH[/COLOR] - .86 (.35-5.50)
[COLOR="Magenta"]T4[/COLOR] 8.7 (4.5-11.0)
[COLOR="Magenta"]T3[/COLOR] uptake 39.5 (22.5-37.0) [B]H[/B]
Wow! This is a lot. How did they start you with thyroid meds.. at what level? Have they done an uptake scan or biopsy. By your antibodies you are negative for Hashimoto's.. but there is a chance of false negatives.

As to the rest... wow.. that is a lot.

PTH is good suggesting that the paratyroids are functioning even if the thyroid is not.

You need to back off the pregnenolone. For some reason your not converting the levels sufficiently up the chain.. too much is never good.

TSH 5.121 (.35-5.5)
FT4 1.04 (.61-1.76) This is 37% of normal range.
FT3 2.8 (2.3-4.2) This is 26% of normal rnage. You are just outside of balanced so one would expect cortisol to be in normal limits at the time of this blood work.

You use some DHEA supplementation. Max you want to take a day accorning to my MD is 20 mg. You will want to check this with your MD. 10 mg is the starting dose.

Are you trying to get pregnant? If so note that you are going to have to get into the 60-80% of range to eliminate the chance of the hypoT T4 levels causing cognitive issues in the first 12 weeks for the fetus. I am having issues getting my FTs up in the optimal 60-80% of normal range myself.

It does look like you could use a boost in your aldosterone and cortisol as well as the other natural hormones. Have they tried boosting the ACTH to see if the adrenals respond accordingly? It is looking like the pituitary gland isn't up to snuff. But I am NOT an expert. I wish you well and will be interested in what the MDs determine to do. I am about to get the full hormonal evaluation next week as well. Time to see how my first 4 weeks of cortisol have been treating me. Ugh!

This is a roller coaster ride and a half.
MG
[QUOTE=mkgbrook;3544433]Wow! This is a lot. How did they start you with thyroid meds.. at what level? Have they done an uptake scan or biopsy. By your antibodies you are negative for Hashimoto's.. but there is a chance of false negatives.MG[/QUOTE]

Started treatment on 2006 with a 5.1 TSH. Obtained old medical records, saw I was 4.5 in 1995.....:mad: Started on 50 mcg. Dr said i "was in range" with a 2.9 TSH after 2 months. Went to new dr, went up to 100 mcg thyroxine. Wanted to try armour, went to new dr. Switched to 45 mg. Then had ER visit. Struggled from mid summer last year till Dec to optimize, and ended up "intolerant" (somnolence, elevated HR, severe dizzness, nausea, visual disturbances, anxiety) in December. Went to ER in Jan2008. Saw endo Jan 2008 took me off all meds till mid Feb. Then had Stim Test with endo. Results "normal". Saw new dr, put me back on 30 mg Armour and recommended the DHEA. No biopsy, no uptake. Just a scan.

[QUOTE=mkgbrook;3544433]PTH is good suggesting that the paratyroids are functioning even if the thyroid is not. MG[/QUOTE]

Had this done as my calcium is pretty low, but has flucuated for no apparent reason....

[QUOTE=mkgbrook;3544433]You need to back off the pregnenolone. For some reason your not converting the levels sufficiently up the chain.. too much is never good.MG[/QUOTE]

I only started it recently - between the DHEA and Preg, it has been no more than two months.

[QUOTE=mkgbrook;3544433]TSH 5.121 (.35-5.5)
FT4 1.04 (.61-1.76) This is 37% of normal range.
FT3 2.8 (2.3-4.2) This is 26% of normal rnage. You are just outside of balanced so one would expect cortisol to be in normal limits at the time of this blood work.MG[/QUOTE]

These results are from when I was off all meds earlier this year[B]! No[/B] Isocort, DHEA, or Pregnenolone. I actually felt ok toward the end of the four week no meds period, and better than I feel now that I am back on low dose....but having a hard time tolerating them AGAIN:(:confused:

[QUOTE=mkgbrook;3544433]You use some DHEA supplementation. Max you want to take a day accorning to my MD is 20 mg. You will want to check this with your MD. 10 mg is the starting dose.MG[/QUOTE]

I felt ok on the DHEA, but decided that maybe Pregnenolne was a better course of action becasue of its further precursor status, thus, helping female hormones and hopefully cortisol levels.

[QUOTE=mkgbrook;3544433]Are you trying to get pregnant? If so note that you are going to have to get into the 60-80% of range to eliminate the chance of the hypoT T4 levels causing cognitive issues in the first 12 weeks for the fetus. I am having issues getting my FTs up in the optimal 60-80% of normal range myself.MG[/QUOTE]

I have not ruled it out, but between my physical struggles - chronic fatigue, etc etc, and mental troubles - lots of anxiety and depression - much better now since hypo has been somewhat treated, tho not optimally.

I wish I would figure out whether there is a secondary adrenal issue here....I know there is more to my illness than the thyroid, since I long ago would have been on a full replacement dose "like everyone else" and felt fine:mad:

[QUOTE=mkgbrook;3544433]Have they tried boosting the ACTH to see if the adrenals respond accordingly?MG[/QUOTE]

I wish...I was lucky to get the Stim. Do they do the CRH very often? I may try asking my endo...

[QUOTE=mkgbrook;3544433]It is looking like the pituitary gland isn't up to snuff. MG[/QUOTE]

this is what some other web persons have postulated. I wish I could find out. Well, maybe the obgyn tests will shed some light on things.

Best of luck with your tests!:) Thanks so much for responding. I am super stuck with this medical mystery, and less than helpful doctors. :cool:





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