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lulu2008 06-17-2008 11:29 PM

New here, can you help me with test results?

I just found this board and was hoping someone could help me with a few questions. My doctor recently mentioned that he wanted to test me for Addison's Disease and until that point I had never heard of symptoms have been ongoing for over a year now, but are slowly worsening. I had a baby 14 months ago and ever since then I have been losing weight for no apparent reason (went from 145 the day before I had him to my current weight of 105 in 14 months all the while trying to normal weight has always been between 120-125, I am 5'7 and naturally thin to begin with.) I have been drinking high calorie weight gain shakes, eating everything in sight, purposely not working out, etc. and for the life of me I just can't gain weight. I had my thyroid checked and it showed I had Hypothyroidism, which totally shocked me because I was thinking maybe it was hyper, if anything. Now I am on 25 mcg of Synthroid and my last TSH level was at 1.45. I have been very fatigued, and though some people say its because I have a toddler, I know that is not the reason..I am tired upon waking (after sleeping 8-10 hours straight) and it goes downhill from there. I have been having a lot of nausea, which can sometimes last the whole day, but usually seems to peak in the late afternoon and last till the next morning. I have been having cramps in my stomach, for no apparent reason, along with cramps in my calves and weakness in my legs..if I so much as climb one flight of stairs they feel like lead. I have been having a hard time tolerating heat, and am almost always cold. My hair is falling out and I have some darkening/brown patches on my right foot. I get lightheaded when I stand too long, and have had low blood pressure (90/55) and I have been eating a ton of salt, which I know is not good for me, but I feel like I need it, sometimes salty things are all that appeal to me with the nausea. I have always been very healthy, I am normally an active person, and lately I just can't do the things I want to be doing because I feel so wiped out. The doctor ran some blood tests at 9:00am fasting, but I did take my daily medications which are the Synthroid, Aciphex for acid reflux, and Loestrin 24 which is a birth control pill. My doctor said my labs came back fine but wants me to see an endocrinologist anyway, so the referral is pending approval through my insurance. Here are my lab results..what do you think?
Sorry for the novel :)

ACTH: 18
Cortisol: 20.8
Aldosterone: 25

I have heard that birth control makes your cortisol levels come back unusually high, but mine was still within range..does that mean my levels were really low to begin with?

lulu2008 06-18-2008 09:32 AM

Re: New here, can you help me with test results?
hmmm, maybe there is another board someone can direct me to that can help me out? maybe a busier one or something?

reemu 06-19-2008 04:07 PM

Re: New here, can you help me with test results?
i've never heard of birth control influencing cortisol, but your symptoms sound a lot like mine ( I have addison's) - the brown patch especially. do you have a tan for no reason, or darker scars, or extra freckles? i know that is a key sign of addison's, which can become more extreme after or during the stress of pregnancy. i hope you will go see an endocrinologist.

lulu2008 06-19-2008 05:09 PM

Re: New here, can you help me with test results?
Thank you for your reply!! It is hard to say if I am tan for no reason, because I am olive complected naturally, but my husband was just saying today that I looked really tan so?? I do have dark scars, and a few of my moles look black they are so dark. I am going to my doctor tomorrow to show him the brown patch on my foot and to see if my referral has gone through yet. Can he order the acth stim test or does that have to be ordered from an endo?

mkgb 06-20-2008 01:05 PM

Re: New here, can you help me with test results?
Birth control pills add extra estrogen and progesterone into your system and these will interfere with the cortisol and aldosterone test making them artificialling inflated. You are supposed to be off of BCs for at least 6 weeks before testing cortisol and aldosterone. In addition if you are on beta-blockers you have to be off of them for 4 weeks before aldosterone is a bais free test.

I also doubt they are treating your thyroid properly. Are they only following your TSH?

You need TSH 3rd gen, FT3, Ft4 run. Also you should get tested for Hashimoto's and Graves as well. TPOAb and TGAb = Hashimoto's. TSI and TRAb = Graves. It is possible to have BOTH conditions.

Now have they tested your FT3 levels. If your Ft4 levels are significantly lower than you Ft3 levels then this is a clear sign of over conversion of T4 to T3. This can be a mineral imbalance or too little cortisol in your system (addison's) to halt your T4 conversion.

Other things that can cause your issues are a few fundamental mineral imbalances:
Low Ferritin.
Low B12.
Low Vit D.

These should all be tested.
The lab codes are Ferritin, B12, D-hydroxy or one of the other forms.

If I were you I would stop my BCs for a month and then get your adrenal function retested in 6 weeks time. In the mean time I would make sure my MD is getting a full picture of my thyroid. You can also bounce over and ask about thyroid specifics on the thyroid disorders board. It is a very active and knowledgable. This board is full of knowledge but is a little slower in activity.;)


lulu2008 06-20-2008 10:39 PM

Re: New here, can you help me with test results?
Thank you so much for all your info! You sound very knowledgeable, are you in the medical field? I have had some recent thyroid panels run, here are the results:

T3, Total: 115 (range60-181)
T-3 Uptake:33 (range 22-35%)
T-4, Free: 1.0 (range.8-1.8)
T-4 Total: 6.1 (range 4.5-12.5)
Free T 4 Index (T7): 2.0 (range 1.4-3.8)
TSH 3rd generation: 3.03 (I know this is on the high normal but it was tested since and it was lower)

These labs were drawn 3 months ago, there were two things out of range, one was my BUN/CREATININE ratio, it was 27 (range 6-22) and the other was my carbon dioxide, it was 20.

My doctor called me today and told me that my insurance approved the referral to see the endo, but the soonest he could get me in would be Aug. 6th. I just feel so much worse, more fatigue, more weakness, more nausea and loss of appetite, and my hair is thinning so much I can actually see my scalp in some areas :( I wish there was something sooner, I don't want to feel like this the rest of the summer!

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