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Old 02-18-2005, 03:16 PM   #1
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IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

I have told my "story" previously on the boards, but to re-cap... I have been seeing my dr because of classic hypo T symptoms, and he ran a TRH test, which was low. He referred me to an endo, and he ran a slew of tests... here are the results:

2 Tests in Question:
- IGF-1 : 125 (182-780) low
- Cortisal: equivical? Don't really know more about this one....

The dr. wants to do a Insulin Tolerance Test in the hospital if my insurance approves it.... but I am curious what the remaining labs might mean:

TSH - .76 (.34-5.6)
FT4 - .8 (.6-1.6)
FT3 - 5.2 (2.4-6.8)
The following have ranges according to me being mid-cycle
FSH - 6.1 (5-22) low-ish, but "normal"
LH - 8.7 (24-105) low
Prolactin- 17.18 (1.39 - 24.2)
Esterdial - 72 (94-508) low
17-Hydroxyprogesterone - 59 (100-250)
These two have ranges according to being pre-menopausal:
Free Testosterone - 7.4 (1-8.5)
Total Testosterone - 36 (15-70)

After she read these to me, I questioned her as to why my endo wrote these off as "normal" if at least 3 of them are lower than the lab range for being mid-cycle!?! He may not have remembered us discussing that I was mid-cycle in my appointment, but wouldn't he at least ask before declaring them "normal" ?????
BTW- I have been dealing with infertility for the last 1 1/2 years, with one miscarriage, so obviously I am very curious about these low labs......

Anyway, any advice is welcome!! How is this all connected? Is there a different board I should post this on???? How is my low-ish Thyroid connected to the rest... is it pituitary or hypothalamus? My dr. doesn't seem to think so!?!?!?

 
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Old 02-21-2005, 07:23 PM   #2
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

The pain is right about my pelvic bone, but on the sides.... it almost feels like the pain is in my hip bones, but I know it isn't. I tired to describe it to my OB/GYN, and when he did the lap, he was trying to find ednometriosis, but I told him the pain wasn't in the middle like that....needless to say he didn't find any...
Sometimes (as in like 1-2 times every few weeks) I get a sharper pain higher up on my side... right about at my waist or so. This is seperate from the other pain, and don't know if it's related.

I wondered if it might be adrenal pain, but my endo pretty much ruled it out, so who knows. he wasn't really even listening, grrr.....

I guess I also assumed the adrenals were higher up than the top of the pelvis... I'll ****** it so I don't sound like such an idiot!!haha

 
Old 02-22-2005, 12:13 PM   #3
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Looking at lab reports now....

Cortisol Random 12.9

Reference range for 8am speimen: 4.2-38.4
Reference range for 4pm specimen: 1.7-16.6

I had this blood taken about 7am I believe.....
anyway on his report he said "equivicable" and listed it as a test that caught his attention along with the IGF-1... but it looks like it's in the normal range, right? He also wrote something un-readable on the copy of the lab report I got.... "Need Chart" maybe?? Not sure...... Anyway I just turned in my 24 hour unrine specimen for free cottisol today.....

As far as the pain goes... I specifically asked the endo if it could be adrenal pain, and he said something like "no, you wouldn't ever feel that".....
hmmm....

 
Old 02-22-2005, 03:39 PM   #4
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Another random question:
I had a severe head trama (I have about a half inch scar on the very top of the bridge of my nose from the stiches) that happened when I was about 15 or 16, and looking back that was about the time I started struggling with weight gain, depression, periods out of wack, etc.... I was swimming in an indoor/outdoor pool of a hotel and came up for air on the glass partition, passed out in the water where a freind pulled me out, I came too not to long after but bled alot and was pretty delirous after I came too though ... on the way to the ER I was making no sense... I had a goosegg the size of TEXAS on my forehead, and for a teenage girl that in itself was tramatizing! haha
Anyway, that is the only head injury I can think of, but it was pretty major.

My question is: Do I mention it to my endo or is he going to think I am completely ridiculous? He has pretty much said that he doesn't put too much stock it the TRH test I had done that showed a problem with my hypothalamus. I mentioned it, and he said it was very rare, and that since an MRI I had done on my whole brain came out fine, I shouldn't worry. So I guess he is on a different path with these new tests, so do I go back and mention the hypothalamus again? Or am I just going crazy?!?!

Thanks Chris for all your help, I really appreciate it!

 
Old 02-28-2005, 07:43 AM   #5
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Here is another bit of info for you about PCOS in realtion to some tests:

Growth hormone, produced by the pituitary gland, is a typical example of this. While growth hormone may have some direct action on tissues, many of growth hormone's actions are the result of another hormone like substance produced under the stimulus of growth hormone. This other hormone like substance is called Insulin Like Growth Factor - I (ILGF-I). ILGF-I is a substance found all over the body and, in keeping with this discussion, happens to be stimulated by insulin. People with elevated insulin levels will therefore have increased amounts of ILGF-I.

It also turns out that ILGF-I also stimulates ovarian androgen production. As you can now begin to see, the story is beginning to unfold. An overweight teenage girl who becomes insulin resistant will begin to produce increased amounts of ILGF-I which in turn stimulates increased amounts of ovarian androgen production. This increased ovarian androgen production interferes with the normal maturation of the controlling clock in the central nervous system that ultimately gives most women regular menstrual cycles. If this "clock" does not develop a normal cyclic rhythm, the women's menstrual cycle remain irregular. Androgens are known to interfere with this process.


So reading this, I am even more confused, because my IGF-1 test was low... lower than the normal range not elevated like this states in realtion to PCOS?!?! Now I am even more confused... any ideas?

 
Old 03-10-2005, 08:52 PM   #6
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Gracesufficient,

I came across this thread and it caught my eye. I am a 25 y/o female and I have recently been diagnosed with Hashimoto's and growth hormone deficiency. The growth hormone deficiency is most likely the result of head trauma (damage to the pituitary) that I had almost 10 years ago in a car accident.

I am trying to find someone that can do a TRH stimulation test, but my current endo insists that they are no longer available. Where did you have yours done?

Thanks,
kmac

 
Old 03-10-2005, 09:32 PM   #7
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Hi Kmac,

I saw your thread just now and had something to share with you that I just learned...I thought you might find it useful and an easier solution than doing a TRH stimulation test.

My husband was just diagnosed panhypopituitary (all of his pituitary has shut down). We suspected his thyroid issues were also from his pituitary, but in his case his TSH was somewhat elevated, so it confused matters. It turns out that the pit can be failing but you can still put out hormones-just not enough to get the job done...and sometimes (as in my husband's case) the TSH isn't biologically active-it is damaged. So it makes the patient look like they have primary thryoid problems, instead of pituitary issues.

There is a simple test to see if your hypothyroidism is central or not. It turns out that TSH has a diurnal rhythm, like many hormones do. It has a low point in the late afternoon and high point late at night. Our endocrinologist (a very well respected pituitary specialist in California) told us that a measure of TSH at 5pm and again at midnite (same day) can tell you if you have pituitary hypothyroidism. For normal people, the value should increase by 1.5-2x. My husband's only just barely increased by 1.5 and he has no enlargement of his thyroid, so his doc diagnosed central hypothroidism. I do not know how supplementation of thyroxine would affect this test-it may be you have to be off meds for some period of time to know...?

The TRH stimulation test is frustratingly unreliable-the results just don't always equate to the disease. And, as you are discovering, because of that it is really hard to find someone to do it.

Maybe you could share this with your doctor and they could start with this test. (Look up thyroid physiology on the web and you'll find references to this test) Knowing if you have central disease will really help your doctor to better manage your thyroid disease. (Using free T4 instead of TSH levels)

Hope that will help, let us know what happens!
Sadie

 
Old 03-11-2005, 11:53 AM   #8
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Thanks so much, Sadie! I might have to run this one by my endo to see if she is willing to do it. It is such a battle to try and get things done...

Thanks again and hope that your husband is doing well. He's fortunate to have such a supportive wife!

kmac

 
Old 03-13-2005, 12:09 PM   #9
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Quote:
Originally Posted by gracesufficient
IGF-1 : 125 (182-780) low
- Cortisal: equivical? Don't really know more about this one....

The dr. wants to do a Insulin Tolerance Test in the hospital if my insurance approves it.... but I am curious what the remaining labs might mean:
Cortisal: equivical ==> the test was inconclusive

So, hit on the head, pretty much all the hormones low or below, symptoms of adrenal pain (strange side, back pains), infertility, top end prolactin......all that says pituitary problems. You need the insulin test ASAP.

The IGF1 and random cortisol tests are meaningless. You can't diagnose deficiency from them.

Keep a detailed diary about how you are feeling and how your condition is damaging your life. Then take the diary to your doc and demand action. If they refuse, move to another doc and mark the previous one down for the lawsuit.

 
Old 03-14-2005, 09:50 AM   #10
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Quote:
Originally Posted by orion
So, hit on the head, pretty much all the hormones low or below, symptoms of adrenal pain (strange side, back pains), infertility, top end prolactin......all that says pituitary problems. You need the insulin test ASAP.

Just logged back on the boards and saw your reply Orion - Thanks so much!
I actually had the ITT (Insulin Tolerance Test) done Friday. It went ok, although I am not sure the resident watching me knew what he was doing! But we will have to wait and see what the results are. Do you know much about this test? There are a few concerns my husband and I had, such as the fact that the resident dr that oversaw the test gave me a huge dose of "sugar" (can't remember the medical term... not glucose, but.... ???) anyway once my blood sugar dropped down to 38, he gave me that shot almost immediatly. I asked if it would affect the results but he said no, but he didn't seem to know what he was doing. Anyway I guess we will just have to wait and see what happens....I should get the results soon.

 
Old 03-14-2005, 09:11 PM   #11
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Quote:
Originally Posted by gracesufficient
Just logged back on the boards and saw your reply Orion - Thanks so much!
I actually had the ITT (Insulin Tolerance Test) done Friday. It went ok, although I am not sure the resident watching me knew what he was doing! But we will have to wait and see what the results are. Do you know much about this test? There are a few concerns my husband and I had, such as the fact that the resident dr that oversaw the test gave me a huge dose of "sugar" (can't remember the medical term... not glucose, but.... ???) anyway once my blood sugar dropped down to 38, he gave me that shot almost immediatly. I asked if it would affect the results but he said no, but he didn't seem to know what he was doing. Anyway I guess we will just have to wait and see what happens....I should get the results soon.

Once your blood sugar is low enough the test is pretty much over and giving you sugar just made sure you didn't go into crisis...it's normal.

I've had the test 4x so I know a bit about it (first 3 were inconclusive).

 
Old 03-15-2005, 06:21 AM   #12
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Quote:
Originally Posted by orion
Once your blood sugar is low enough the test is pretty much over and giving you sugar just made sure you didn't go into crisis...it's normal.

I've had the test 4x so I know a bit about it (first 3 were inconclusive).
Whew... four times! I am hoping mine isn't inconclusive, because my hospital was so "fumbly" as they did it. Another question we had was how long they were supposed to take blood after my blood sugar dropped? They took blood every 15 minutes for about 2 hours before my blood sugar FINALLY dropped, and then gave the sugar shot right away, then took blood for another hour and 15 minutes in 15 minute increments. Sound right? I am sure it is, but it is a teaching hospital and the resident they had on duty was pretty much useless when it came to the test - he kept having to call up to my normal endo and ask him what to do next... then half the time it felt like he was guessing...

 
Old 03-15-2005, 09:02 AM   #13
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Quote:
Originally Posted by gracesufficient
Whew... four times! I am hoping mine isn't inconclusive, because my hospital was so "fumbly" as they did it. Another question we had was how long they were supposed to take blood after my blood sugar dropped? They took blood every 15 minutes for about 2 hours before my blood sugar FINALLY dropped, and then gave the sugar shot right away, then took blood for another hour and 15 minutes in 15 minute increments. Sound right? I am sure it is, but it is a teaching hospital and the resident they had on duty was pretty much useless when it came to the test - he kept having to call up to my normal endo and ask him what to do next... then half the time it felt like he was guessing...
Yep sounds about right. It's a rare test so it isn't surprising that most docs don't know the details.

 
Old 03-15-2005, 10:10 AM   #14
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

That's kinda what I figured.. if you don't mind me asking, what did your results show? are you Male or Female?
I am having trouble finding any females who might have a pituitary malfunction. I am interested in knowing how it effected their fertility in the long run and if any became pregnant on their own after they were on drug therapy.

Just curious! Thanks!

 
Old 03-15-2005, 11:01 AM   #15
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Re: IGF-1? LH/FSH? Thyroid? ... posted this to thyroid board, thought I would here too!

Hi Grace,

I don't have pituitary disease but I thought I did for a while (prior to normal test results!) I did alot of reading about fertility stuff, because my husband and I both very much want a child, too. It turns out that of all of the different fertility problems you can have, pituitary failure is the easiest to get around. You will have to potentially (depends of if you make LH/FSH or not) take injectable hormones to make you ovulate but it is very do-able. You should be managed by a high-risk OB but that doesn't mean you'll have any issues. Lots of pit patients have kids!! : )

Sadie

Last edited by sadie-mae; 03-15-2005 at 11:02 AM.

 
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