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Old 01-05-2009, 07:15 PM   #1
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High/low normal labs...anyone care to take a peek?

I was looking at some past labs and some stuck out to me. I was wondering if anyone would know about these and how they could relate to thyroid/endocrine stuff. Ranges in ().

Pregnenolone 178 (7-188)

Sodium 135 (135-146)
Albumin 5.2 (3.6-5.1)
ACTH plasma 28 (5-27)

AM Cortisol 16.7 (4-22)
AM Cortisol 14.9 (4-22)
These cortisols were taken at different times. I have read something somewher (can't remember now) that anything under 19 is indeterminite for adrenal issues. Those were one one lab draw.

Another that stuck out to me was a plasma potassium that was normal-high at 5.0 (3.5-5.3)

Then there was the 2 hr gtt w/insulin....the 2hr glucose was flagged low because it went down to 55.

Thoughts?

Last edited by one2wonder; 01-08-2009 at 08:40 AM.

 
Old 01-06-2009, 07:14 AM   #2
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Re: High/low normal labs...anyone care to take a peek?

Anybody???

 
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Old 01-08-2009, 08:23 AM   #3
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Re: High/low normal labs...anyone care to take a peek?

Could use some insight on these before I go to doc on Tues...

 
Old 01-08-2009, 08:41 AM   #4
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Re: High/low normal labs...anyone care to take a peek?

Okay! Working on a back log.. vacation.. had to have one.

Pregnenolone 178 (7-188) This is the base hormone that the adrenals use to convert into aldosterone, progesterone, estrogen, DHEA, cortisol.. etc.. you get the picture. Your is a bit high.. so you should in theory have plenty. the issue occurs if you have damage in your synthesis chain and it is not being used to make what you need.

Sodium 135 (135-146)
Albumin 5.2 (3.6-5.1)
Those were one one lab draw. Another that stuck out to me was a plasma potassium that was normal-high at 5.0 (3.5-5.3)
These can be a sign of adrenal issues.

ACTH plasma 28 (5-27)
This is high. Just high but high. By being high it is stating that you are not getting the cortisol/aldosterone that you need. Your cortisol levels are too low for you.

AM Cortisol 16.7 (4-22)
AM Cortisol 14.9 (4-22)
These cortisols were taken at different times. I have read something somewher (can't remember now) that anything under 19 is indeterminite for adrenal issues.
These are not that low.. but the ACTH makes me question and as a result I would try and get a 24 hour cortisol average urine and saliva test. this will let you know how you stack up over a day and see the cortisol rhythm as well.

Then there was the 2 hr gtt w/insulin....the 2hr glucose was flagged low because it went down to 55.
This is a sign of insulin resistance and reactive hypoglycemia. You need an IGF run if it is high you are insulin resistant. It will also require a diet change and taking 500-1000 mg of metformin XR (go for the extended release if it is offered.. less digestive side effect issues) daily. you should also check your estrogen, DHEA, progesterone, testosterone levels. I bet that you are low in the cortisol and such and high in the estrogen/testosterone department. This is textbook PCOS blood work if your hormones show that trend.

MG
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Last edited by mkgbrook; 01-08-2009 at 08:41 AM.

 
Old 01-08-2009, 08:48 AM   #5
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Re: High/low normal labs...anyone care to take a peek?

Quote:
Originally Posted by mkgbrook View Post
Okay! Working on a back log.. vacation.. had to have one.

Pregnenolone 178 (7-188) This is the base hormone that the adrenals use to convert into aldosterone, progesterone, estrogen, DHEA, cortisol.. etc.. you get the picture. Your is a bit high.. so you should in theory have plenty. the issue occurs if you have damage in your synthesis chain and it is not being used to make what you need.

Sodium 135 (135-146)
Albumin 5.2 (3.6-5.1)
Those were one one lab draw. Another that stuck out to me was a plasma potassium that was normal-high at 5.0 (3.5-5.3)
These can be a sign of adrenal issues.

ACTH plasma 28 (5-27)
This is high. Just high but high. By being high it is stating that you are not getting the cortisol/aldosterone that you need. Your cortisol levels are too low for you.

AM Cortisol 16.7 (4-22)
AM Cortisol 14.9 (4-22)
These cortisols were taken at different times. I have read something somewher (can't remember now) that anything under 19 is indeterminite for adrenal issues.
These are not that low.. but the ACTH makes me question and as a result I would try and get a 24 hour cortisol average urine and saliva test. this will let you know how you stack up over a day and see the cortisol rhythm as well.

Then there was the 2 hr gtt w/insulin....the 2hr glucose was flagged low because it went down to 55.
This is a sign of insulin resistance and reactive hypoglycemia. You need an IGF run if it is high you are insulin resistant. It will also require a diet change and taking 500-1000 mg of metformin XR (go for the extended release if it is offered.. less digestive side effect issues) daily. you should also check your estrogen, DHEA, progesterone, testosterone levels. I bet that you are low in the cortisol and such and high in the estrogen/testosterone department. This is textbook PCOS blood work if your hormones show that trend.

MG
MG, you've really helped me understand this stuff....thanks so much! I have been dx w/PCOS. My fsh/lh ratio was off and an ultrasound I had in Nov confirmed string of pearls in one ovary. The holistic doc said my estrogen & testos. were high and progest. was low wh. which is why he put me on the progesterone pill. I had an IGF-1 drawn twice. First one was flagged high. Second was in normal range. 24 hr urine cortisol was 24.6 (4.0-50)

On the 2hr ogtt w/insulin, the only thing that was flagged was that 2hr low glucose...what other numbers (in regards to the insulin) could indicate IR??

Off the subject a tad, but I went to get the ultrasound for my ovaries b/c of what they ended up dx as a burst cyst....those things freakin hurt!

Last edited by one2wonder; 01-08-2009 at 08:59 AM.

 
Old 01-08-2009, 09:01 AM   #6
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Re: High/low normal labs...anyone care to take a peek?

Given the PCOS dx and gtt results I would push for the glucophage. It helped me A LOT. Changing my diet and eatting habits also helped. My diet restrictions SUCK! But I feel better when I eat on plan and schedule. I miss my sodas and chocolate. *sniff*

Having PCOS I can relate. I do not know if I have had a cyst burst yet, but I have been laid low due to uterine/ovary cramps and pain for days at a time before. Heck I have RXN muscle relaxers for those times. When my adrenals and thyroid were really screwed up I was having 2-3 periods a month. That really was a PAIN.

I am glad that I could help. Having Hashimoto's, Graves, hypoadrenalism, PCOS, and IR means I have personal interest and experiencce to draw from.. then add an OB SIL and SIL with diabetes. my mom and four aunts, and six cousins with thyroid AIs, and a mixed pot of adrenal and diabetes.. well we talk gripe and learn a lot from each other. So I am extended our knowledge to here.. Share and share a like no?

MG
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Old 01-08-2009, 09:05 AM   #7
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Re: High/low normal labs...anyone care to take a peek?

Aw crap...there goes my fav coffee......Would IR throw off my adrenals as well as T4/T3 conversion???
What about what is really bugging me....horrible fatigue, no motivation, no libido (both of these not decreased...NONE... zilch nada) is that related to IR? I thought that there were specific formulas to determine IR (HOMA and QUICKI) that is used when you take the oggt with insulin. I couldn't figure them out with my numbers. I am just too dang tired! I also thought that the insulin numbers had to be at a certain level within that test before calling it IR. Also, I thought that IR can be related to adrenal probs too?

I also run really low bp....I've been eating some salt a few times a day to try and keep bp higher.

I am not overweight...would the glucophage cause me to lose too much? Sorry...I am just tired of being tired and want to be like my normal self...I miss myself

Last edited by one2wonder; 01-08-2009 at 09:22 AM.

 
Old 01-08-2009, 11:18 AM   #8
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Re: High/low normal labs...anyone care to take a peek?

Well let's summarize IR first for those reading and confused...
What is IR? IR stands for Insulin resistance. This is a condition in which our base cells become resistant to the hormone, insulin and do not process sugar in the blood efficiently.

What causes IR? Here is the tricky no straight answer explaination. Insulin resistance may be part of the metabolic syndrome, and associated with the development of heart disease. Insulin resistance precedes the development of type 2 diabetes and is considered a pre-diabetic state. Insulin resistance is alsoassociated with many other medical conditions including fatty liver, arteriosclerosis, acanthosis nigricans, skin tags, and reproductive abnormalities in women (PCOS).
Factors that make IR worse. IR is aggravated in obese people and the medical conditions above. Certain ethnic groups are at higher risk as well: Latino, African-American, Native American, and Asian-American. My Great grand fathers were Cherokee and 1/2 Apache maybe that is a factor. I look scotch-irish though.

Management and treatment: There is a genetic component so some people may not be able to win out with a life-style change. You may however be able to stave off diabetes by managing your insulin resistance with diet, exercise, and medication.

Aw crap...there goes my fav coffee......Would IR throw off my adrenals as well as T4/T3 conversion???
So what is your favorite coffee? Coffee is too bitter for me. Sodas are my evil caffeine source. IR can have a big effect on you metabolic processing power, over all energy level and more. If you can not process you sugar effectively your cells and muscles live in a state of energy deprivation. Now I would think that your PCOS is having a higher impact on your adrenal function. By PCOS causing a shunt in the adrenal processing system and pushing toward excess estrogen and testosterone synthesis the rest is short changed. You can manage this some with progesterone supplementation. Some do well with this others have to take cortisol and treat the source. Many can get by with a half dose this way. 10 mg of HC versus a full 20-25.

What about what is really bugging me....horrible fatigue, no motivation, no libido (both of these not decreased...NONE... zilch nada) is that related to IR?
This sounds more like low cortisol too me. I started my cortisol and with in a couple of days my husband was getting nervous. I had the look that I get when I stalk someone during martial arts... I was thinking about wrestling.. just the home behind closed door kind. Treating the adrenal issue helped cure all you listed completely except for fatigue. Adding the glucophage helped resolve the lingering fatigue issues and stopped my serious muscle cramping issues. my potassium levels are up in normal range again as well. But this is me.. my body chemistry is in its own class.

I thought that there were specific formulas to determine IR (HOMA and QUICKI) that is used when you take the oggt with insulin. I couldn't figure them out with my numbers. I am just too dang tired! I also thought that the insulin numbers had to be at a certain level within that test before calling it IR. Also, I thought that IR can be related to adrenal probs too?

There is no simple test or check list that can be followed to determine IR beyond a doubt. You have to look at symptoms and trends. The fact that you have PCOS and have shown a reactive hypoglycemic trait in your GTT is one of the strong indicators of IR. Adding that you have had an elevated IGF documented and you have all you need to get an IR diagnosis.

So when trying to diagnose IR in a perfect world your MD may/should suspect the IR syndrome before you and then test you accordingly.
If you have some of the following you are at risk:
1) Family history: parents or siblings who have type 2 diabetes, hypertension, or cardiovascular disease. (Grandmother and Aunts)
2) Health: Obesity or overweight (BMI - body mass index- above 25). Concentration of fat around the waist than around the hips (an apple shape) - (All me despite exercise and dieting)
3) Age: greater than 40 years (I am 33 so I don't factor here)
4) Pregnancy issues: Gestational diabetes (I had borderline liver and kidney failure during my Pregnancy.. my blood sugar was supposedly fine)
5) polycystic ovary syndrome (PCOS) (ME!)
6) Pre-diabetes (This can be AI diabetic trait or blood glucose level trend determined, once IR is established you are a pre-diabetes candidate)
7) Heritage: Latino, African-American, Native American.

So if you have certain factors it should be looked into. Your PCOS is the biggest factor for you.

I also run really low bp....I've been eating some salt a few times a day to try and keep bp higher. These are signs of electrolyte imbalance which is closely tied to adrenal imbalance.. low cortisol.

I am not overweight...would the glucophage cause me to lose too much? Sorry...I am just tired of being tired and want to be like my normal self...I miss myself i am not sure. I lost a whooping 2 pounds on my Metformin. It did stop the gain. Now I have to lose the rest by getting my thyroid hormones up and being more active. Some people lose weight on a glucophage others do not. It will depend on your body chemistry. Treating the IR will allow you to eat more normally and give you added energy.

Besides Metformin (Glucophage) there are other medications that people use successfully. Actos and Avandia are both FDA approved to treat the insulin resistance that occurs with type 2 diabetes as well. You do have options and you will have to wwait and see what your MD recommends you try. I have done well on metformin XR, and have not had the nasty diarrhea side effects that I was warned about. My weight also hasn't melted off either.. soooo maybe I should try one of the others. I am giving the MF a chance since my muscle and energy issues have improved. I am pretty sure it is a low thyroid hormone issue that is the last nail in my hypoT tummy tub.

MG
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