Mix of symptoms and test results please help
Posted , 4 users are following.
Ok I will try not to make this long bear with me.
Age 34
Sex Female
Previous health issues
Emergency c section 2014
History of little or no periods
Endometrial ablation
Tubal (no clamps)
Gallbladder dysfunction (9%)
Colon polyps
Ovarian cysts
Thyroid nodules (1 non diagnostic not removed)
All symptoms really started after my pregnancy or got worse during and after.
Fatigue
Muscle soreness
Trouble sleeping
Tired all the time
Headaches daily
Nausea
Pain in abdomen
Occasional vomiting (usually morning)
No sex drive
Thirsty always
Peeing all the time (5-6times at night)
Light headedness
Dry skin
Dry mouth etc
Here are tests I have had done
Date taken 12/11/2017
Tsh 1.20uIU/mL
(Lab range 0.34-5)
Previous lab results from 2014 til now are 0.54, 0.29, 0.51
Date taken 12/11/2017
Free T4 0.87ng/mL
(Lab range 0.60-1.80)
Previous results from 2014 til now are 0.96, 0.85, 1.11
Date taken 12/11/2017
Total T3 78ng/mL
(Lab range 87-190)
Only time measured
Acth stim test was done previously on 10/30/2017
Results were
No baseline acth was taken
Cortisol baseline 3.1mcg/dL
30 min 20.2mcg/dL
60 min 23.3mcg/dL
(Lab range 3.0-30.0)
He said I was normal so I pitched a fit lol and got him to test pituitary and my acth. Did not notice he again did take take acth and cortisol together. These were all tested 12/11/2017 also
Acth blood test 57pg/mL
(Lab range 5-46pg/mL)
ILGF-1217ng/mL
(Lab range 41-246pg/mL)
FSH 7.9mIu/mL
LH 11.8mIu/mL
Estradiol 39pg/mL
Progesterone 1.3ng/ml
Because I have no periods and never really did maybe one a year I understand interpreting those last ones is impossible so I did not bother with the lab ranges. I can add them if someone feels them necessary.
See my doctor at end of January but I have zero confidence in him. The little I have gathered in the internet tells me the fact that he jumped start to a stim test with no base line acth and then said I was fine. When I tell him he couldn't fully understand it with out the acth he agreed to further testing but left out the cortisol! So I now know I have high acth but no idea what my cortisol is doing. Again I know nothing here.
Any help interrupting so I can guide my doctor would be great.
OR if any one is South East Michigan area knows of a good endocrinologist pleas let me know.
0 likes, 11 replies
Roddy999 jenniferarcs
Posted
This is blind leading the blind time but "Thirsty always; Peeing all the time (5-6times at night)" might point to Diabetes Insipidus (not 'ordinary' diabetes, D. Melitus), which is a symptom of malfunction in one of the many functions of the pituitary. Your pituitary does lots of clever things [see Wikipedia] and a malfunction can understimulate or overstimulate any, some or all of them. DDAVP controls it but you need to know what it is happening because it might be a signpost to the root cause of the other problems.
Synacthen [synthetic ACTH] mimics the messenger hormone that the pituitary sends to the adrenals to prod them to produce cortisol. So you should always have some ACTH in your blood, more if your are ill. So a synacthen (stimuation) test should start from baseline cortisol followed by a resample again maybe 30 minutes later to check that a reasonable cortisol response has happened.
jenniferarcs Roddy999
Posted
If your ACTH is high to start and my coritsol is on the lowest end of normal, with the amount of acth injected it could still cause a response from adrenals that are exhausted but still functioning. Usually causing it to rise 5x or more than level of cortisol you started with.
Am I completely off here?
kim22986 jenniferarcs
Posted
I am going through very similar surprise surprise. I have a pit tumor , hashimotos, my thyroid has been hyper for 8 was my t4 high t3 getting up there. NO SLEEP AT ALL every night 2 o’clock hear racing bp through the roof. Gaining weight in mid section dry dry skin . If your ACTH is high there seems to be one of 3 reasons. Medication that has cortisol in it. Tumor on adrenal or tumor on pituitary. Keep on this you can not let this go. I will let you know they are looking into Cushing disease.
Roddy999 kim22986
Posted
I'm sure you know this but just in case anyone else is reading:
One may think of the pituitary as working like a central heating thermostat: too hot, turn off the boiler, too cold, turn it on. A faulty thermostat could leave the boiler always on or leave it always off (or worse still, on/off at random for no good reason). A faulty boiler can ignore the signals from the thermostat.
So a normal pituitary will identify low cortisol and release ACTH into the bloodstream to prompt normal adrenals into making some. There are similar systems to manage thyroid, testes, breast-milk, HGH and more,
Medication with cortisol should cause low ACTH. Otherwise I agree with all you say.
kim22986 Roddy999
Posted
Roddy999 kim22986
Posted
No idea I'm not a doc. But I hope your travel insurance covers you - unless you have a large trust fund you don't want to end up in hospital in the US. Your insurance is likely to be invalidated if you travel while an investigation is under way.
kim22986 Roddy999
Posted
kim22986 jenniferarcs
Posted
Around hyper. Your ACTH was high as
Well. Are you gaining weight in your
Mid section? Are you waking up at the same
Time every night ? How is your
Blood pressure?
jenniferarcs kim22986
Posted
No weight gain been 100lb my whole life. Not sure on the times I wake up. Blood pressure of child always had been they use the child cuff on me. I'm getting a referral to another endo.
kim22986 jenniferarcs
Posted
courtnay26 jenniferarcs
Posted
there is something called Sheehan's syndrome
that can happen post birth
it is sort of like growth of an existing pituitary tumor
Because you have no periods, your thyroid seems a
bit wonky but I am not an expert
this could definitely indicate an
existing pituitary disorder
you have to be careful with all the testing
Look up dynamic endocrine tests
I try to avoid these because they can
can your tumor to grow more
Anyways
good luck