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Old 07-15-2005, 05:50 AM   #1
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what are these tests my endo is sending me for?

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

 
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Old 07-17-2005, 11:07 AM   #2
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Re: what are these tests my endo is sending me for?

zoe,

I read your post the other night and spent a lot of time researching those tests you put question marks next to. I have some information for you. And I WILL post it here today. I just wanted to let you know that I found some answers for you, however, my research does not replace the answers your Endo can give you. My BEST advice is to call and speak at least with the nurse to find out what exactly they are testing you for. Also, I know a lot of hospitals have a "Nurse Line" that may help you.

I just didn't want to think we had forgotten you. I myself am new to thyroid issues. I had an ultrasound done that found a couple of lesions that are believed to be benign. My Rheumy ordered the test and I don't see her 'til August, so I imagine she'll send me to an Endo, if not, I'll insist, as I want my libido tested. I already know I have a free testosterone level of 4 which is very low, so I'm going to ask about hydrocortisone or possibley testosterone in low doses.

Anyway, I'll tell you more about me and my situation later. But I'm having a bit of a bad day here today, so I don't have the energy to post my findings now, but I have them saved in my "scrapbook" and I WILL post them for you. So don't despair. K? I was reading some posts and saw yours and it caught my eye. I like to research things. Matter of fact, while researching your questions, I learned something about one of my conditions which is CFS.

Check back okay?

Question, are you a female or a male? OOPS, never mind, I just re-read your post, and saw the word ovaries! That answers that question! You seem to understand that these tests are common for adreanal insufficiency, as well as Addisons. But don't jump to conclusions yet, k?

Hang in and I'll post what I found and you can match it up with what you found.

I did find a website that is good for you to poke around and actually do a search on that website for some of these words you have ? marks after.

www.endo-society.org

Check it out, it's got a lot of good info regarding the endocrine system, it also has a search feature that will pop up articles and reports from the National Library of Medicine, which is a great resource for all kinds of information. I THINK it's the National Library of Medicine! LOL Yes, Yes, it is, I just checked. You can also find a lot of info there. The Endocrine Society deals with hormones and all the glands that produce them, so they have good info there also.

I'm pretty sure I can post the .org websites here.

I truly want to help you, I saw your post in a couple different places, and I believe that by helping you, I help myself. I DO know how you feel. I am kinda "up in the air" now as far as my Thyroid goes. My test results have a little note on them stating that the doc, my Rheumy, needs to see me, but I haven't heard from her. I have an appt the first week in August with her, and like I told the nurse at the office when I picked up my copy of the test, "She knows where I'm at!". So I guess I'm not critical! LOL But I would like to KNOW what the results mean. If I have lesions on my Thyroid that weren't there a couple years ago, well, I'm just a "wee" curious as to why they are there now! LOL

Don't worry my friend, we are all here for you and anything I can do to help just an incy bit, I will.

Check back okay?

Hugs to you,
tk

P.S. I usually post on the Fibromyalgia forum and the Pain Management forum, so if you are curious about me, you can just search my username and check out some of my posts. I'm not a busy body, well, not too bad! And I'm not a nut case! LOL I just like helping folks when I can. Did you check out the Research forum, see if anyone there can help you. Maybe the moderator of the Research forum can help you. From what I understand she's been through a lot of cancer type testing, so she may have some good info for you as far as a foundation to begin your search. But, like I said before, talking with the doc is always, IMO the best way to go.
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Old 07-18-2005, 11:08 AM   #3
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Re: what are these tests my endo is sending me for?

Hello good spirit,
Thank you so much for your post. It is so lovely that people really do care! and i don't know but some how knowing about other people makes me feel not alone. im going to check out your previous posts so i can see if i can maybe help you in any way at all. even if its just to say hello and let you know im there too.

Ha ha. You may have seen my posts on more than one board thats cause well i don't know what the hell is happening to my body really. i can place it as being hormonal or possible some wierd immune thing. it may have been related to a wierd drug reaction i had back in jan. Who knows yet. Just hanging in to find out. Its wierd that the body just goes bizerk isn't it? You just want to say to your own body stop it behave will you. I have done some research on those tests and found some stuff just geuss wanted to know from any veterans what they all meant in non medical language.

I have been pretty bad the last week. and im sorry you are too!! im going to check out your posts so i can give you a more helpful response. im 28 from london and my name is zoe. so nice to meet you any how.

xx

 
Old 07-19-2005, 07:22 AM   #4
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Re: what are these tests my endo is sending me for?

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 )

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

What is Androstenedione?
Androstenedione is a natural hormone which is a direct precursor to testosterone.


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.


The Test

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?

How is it used?
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.


When is it ordered?
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.


What does the test result mean?
NOTE: 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.

Is there anything else I should know?
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.

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

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

CONTINUED ON NEXT POST
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Old 07-19-2005, 07:23 AM   #5
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Re: what are these tests my endo is sending me for?

CONTINUED


Thyroidal Antibodies I assume your doc is testing both adrenal antibodies as well as Thyroid antibodies. I couldn't find too much listed on the Adrenal antibodies, but here is a whole list of the Thyroid antibodies! Lots eh?
Thyroid Hormone Nuclear Receptor Antibodies
* Thyroid Hormone Nuclear Receptor-alpha 1 / beta 1 Antibodies
* Thyroid Hormone Nuclear Receptor-beta 1, A / B Domain Antibodies
* Thyroid Hormone Receptor Antibodies
* Thyroid Hormone Receptor (beta) Antibodies
* Thyroid Hormone Receptor a1 / a2 Antibodies
* Thyroid Hormone Receptor Ab 4 Antibodies
* Thyroid Hormone Receptor alpha 1 Antibodies
* Thyroid Hormone Receptor alpha 1 / 2 Antibodies
* Thyroid Hormone Receptor alpha 1, 2 Antibodies
* Thyroid Hormone Receptor Alpha 2 Antibodies
* Thyroid Hormone Receptor Alpha-1 Antibodies
* Thyroid Hormone Receptor beta Antibodies
* Thyroid Hormone Receptor Beta-1 Antibodies
* Thyroid Hormone Receptor beta-2 Antibodies
* Thyroid Iodide Transporter (TIT) Antibodies
* Thyroid Peroxidase Antibodies
* Thyroid Peroxidase (TPO) Antibodies
* Thyroid Stimulating Hormone Antibodies
* Thyroid Stimulating Hormone (TSH) Antibodies
* Thyroid Stimulating Hormone (TSH) a Antibodies
* Thyroid Stimulating Ho
rmone (TSH) Alpha Antibodies
* Thyroid Stimulating Hormone (TSH) b Antibodies
* Thyroid Stimulating Ho


rmone (TSH) Beta Antibodies
* Thyroid Stimulating Hormone (TSH) intact Antibodies
* Thyroid Stimulating Hormone Alpha (hTSH-a) Antibodies
* Thyroid Stimulating Hormone alpha (TSH a) Antibodies
* Thyroid Stimulating Hormone alpha (TSHa) Antibodies
* Thyroid Stimulating Hormone beta (hTSH-b) Antibodies
* Thyroid Stimulating Hormone Beta (hTSH-Ŗ) Antibodies
* Thyroid Stimulating Hormone beta (TSHb) Antibodies
* Thyroid Stimulating Hormone Receptor Antibodies
* Thyroid Stimulating Hormone, beta (TSHb) Antibodies
* Thyroid Stimulating Hormone, intact (TSHintact) Antibodies
* Thyroid Stimulating Hormone-Beta (TSH-b) Antibodies
* Thyroid Transcription Factor Antibodies
* Thyroid Transcription Factor 1 (TTF-1) Antibodies
* Thyroid, Lung Epithelial Marker (TTF-1) Antibodies
* Thyroid-Stimulating Hormone Antibodies


immunoglobulin I threw this in there because Ig readings are very common when testing certain protiens and antibodies

<immunology> A specific protein substance that is produced by plasma cells to aid in fighting infection. Some immunoglobulins (gamma globulin) take part in various immune responses of the body to bacteria or foreign substances (allergens, tumour or transplanted tissue). Examples include IgG, IgM, IgA, IgD and IgE.

autoantibody FYI

Antibody that reacts with an antigen that is a normal component of the body. Obviously this can lead to some problems and autoimmunity has been proposed as a causative factor in a number of diseases such as rheumatoid arthritis.

antigens

Substances which are capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibodies or specifically sensitised T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulates, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (epitopes) combines with antibody or a specific receptor on a lymphocyte.

au∑to∑an∑ti∑bod∑y This is the definition of an "AUTOantibody". An antibody that reacts with the cells, tissues, or native proteins of the individual in which it is produced.

OKAY! These are some excerpts from various sources, one being the webiste I listed in my original post, and the definitions are simply taken from the online Medical Dictionary.

There are some references to "gonads" (male glands) and "x-linked" substance which basically deals with the X Chromosone. I don't know what relevance the "x-linked" tests have for women but I'm sure your doc would know. It seems to me when I was reading that some of these tests that indicate an "x-linked" result runs the gammet of both men and women. Know I know that "gonads" deal with the men! LOL

I'm thinking that your doc is looking for some kind of Adrenal Insuffinciency disorder, Thyroid Dysfunction, Addisons, or some other hormonal disfunction i.e. glandular like your ovaries, putitary etc.

We women have testosterone, and it plays a heavy part in our libido. Men's and women's testosterone reading numbers are entirely different. I think we range from 1 - 15 (????) I know mine is low at a 4. I have my test somewhere! LOL While men's numbers are in the hundreds.

Have you been complaining of low libido or any of the symptoms that accompany Adrenal Insufficiency disorder, Thyroid dysfunction (either hyper, hypo or one of the many other Thyroid dysfunctions? Obviously your doc is looking for something hormonal that may be caused by a glandlular malfunction. Which will cause your whole system to totally misfire! It simply goes wacko when our hormones or glands are not working in sync. I recently had an ultrasound on my Thyroid where they found two lesions. I'm awaiting a referral to an Endo now. It is a long and tricky process to nail down exactly why you feel "badly".

Be patient. Ask the doc lots of questions. Get your test results. I see someone else has given you a good website to get your labs read. Take your test to your doc and go over them TOGETHER. IMO that is the best way to understand your labs. They are so confusing! But if you go along with your doc line by line it does make things clearer. If something is "flagged" or "borderline" ask about it! Look over your test before you see the doc. Highlight any "flags" or "borderline" numbers. The normal range readings will always be within the parenthises, i.e. (.80, 2.35) Any number before these parenthises that falls within this range is considered "normal", although you may be borderline high or borderline low, if so ASK about it!
i.e.
T4 Free 1.2 (.80-1.8) The numbers before the () is your result, the
T-3 Free 317 (230-420) numbers within the () are the "normal" range
TSH 1.32 (.40-5.5) for that particular test.

I hope this helps more than confuses you! LOL
I'm happy to help if I did, great, if not, well, I DID learn something about getting my DHEA tested regarding my Chronic Fatigue Syndrome and that
hydrocortisone may help my libido!

Good luck zoe and keep us posted okay. Find ONE board to post your results on though! LOL That way I don't have to hunt you down! LOL

Hugs,
tk
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Old 07-24-2005, 02:35 PM   #6
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Re: what are these tests my endo is sending me for?

Hi again tk,

I don't think my endo is testing my thyroid as he has not requested any thyroid tests! so im just going to go to a primary care physisian and ask them for thyroid panel again and antibodies to graves and hahys.


My specailist wrote to my primary care physisian and requested he did all these test for me and then send them to him. My primary care doc omitted dheas a Dax and androtesosterone and prolactin though!! I can't believe it!!
I asked for more pain killers too and he prescribed me an anti depressant without telling me- im fuming angry honestly. im getting a private doc and getting it paid for!!

Jes good luck with your thyroid how came you discovered that?

Zoe x

 
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