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  • Do I have Addison's? Some Labs

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    Old 01-03-2006, 09:31 PM   #1
    stiletto23
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    Do I have Addison's? Some Labs

    Hi, my name is Kevin...I'm 30/M, 183lbs, 5'11". I'm going to list some labs, hopefully one of you adrenal guru's can help me. I suspect I have some kind of adrenal problem. I've had low sex drive, fatigue, tightness in chest (I'm asthmatic but drugs havent helped me in a year of treatment), mood swings, irritable, some depression, low motivation, bad insomnia.

    Do I have Addison's you think?? Did my Dr's miss some important tests? The DHEA being low has me concerned and I thought it might point to an adrenal or possibly a pituitary issue and might explain why my testosterone has been low for my age. I'm going to a Endoctrinologist on the 13th.

    I have another set of blood-work that followed up the ANA Titer and I will post those results when I get them from my Dr. They were before the 11-15-05. Thanks for taking the time to look and any guidance would be great!

    11-15-05

    Glucose Fasting 78 - Ref. Range 65-99 mg/dL (Good)
    Cholesterol 183 mg/dL - Ref. Range <200 mg/dL (Decent)
    Triglycerides 503 mg/dL - Ref. Range <150 mg/dL (Way High)
    HDL 34 - Ref Range >39 mg/dL (Low)
    LDL - Cannot be calculated because of triglycerides

    DHEA, Unconjugated 60 ng/dL - Ref Range 180-1250 ng/dL (Low)
    Prolactin - 7.8 ng/mL - Ref. Range 2.0 - 18.0 ng/mL (Ok)
    CBC - All Normal
    Lipayse/Amylase - Normal

    Testosterone, Total 353 - Ref. Range 250-1100 ng/dL (1 week after starting Androgel again but still lower than should be)

    Testosterone % Free 2.0 - Ref Range 1.0 - 3.0 %
    86.7 - Ref Range 35.0 - 155.0 pg/mL

    Estradiol Free .10 - Ref Range .30 - .90 pg/mL (Low)
    Estradiol Free 2.0 - Ref Range 1.66 - 2.11 %
    Estradiol 5 - Ref. Range 10-50 pg/mL (Low)

    Cardio CRP 1.4 - Ref Range - 1.0-3.0 (Avg Risk)
    TSH 3.0 - Ref Range - .4 - 5.5 uIU/mL
    PSA .8 - Ref Range - 0.0 -4.0 ng/mL

    6/2005

    Triglycerides 315
    Cholesterol 179 mg/dL
    HDL 29L
    LDL 87.2
    Ratio 6.2 Undesirable
    T4, Free 1.4 Ref. Range - 0.6 - 1.8
    T3, Free 3.59 Ref. Range - 2.30 - 4.20
    DHEA 4.0 Ref. Range - 1.9 - 7.6
    DHEAS 230 Ref. Range - 80-560 ug/dL
    Complement CH50 101 Ref. Range 60-144
    Rheumatoid Factor <20
    SSA 4 Ref. Range 0-49
    SSB 4 Ref. Range 0-49
    DNA Antibody Negative


    3/12/2005 (Had an absolute ton of bloodwork ordered..mostly off the wall stuff like for ticks and antibodies which came back normal,I will only post anything relevent or not normal here. In January 05 I had 2 pretty bad chest infections in a row. Had antibiotics and a course of prednisone which did nothing basically. Stopped Androgel a month before. I was scared of sterility was afraid of hormone thearapy. Probably a mistake. The tightness in my chest had continued for 2 months which is abnormal for me, that's why I had her do more tests.)

    ANA - Positive - 1:80
    FSH - 1.1 - Ref. Range (Males) .9 - 15.0 (low side)
    LH - 4.3 - Ref. Range (Males) 1.3 - 12.9 (low side)
    Testosterone - 397.3
    Testosterone Free - 75.1 Ref. Range 47.0 - 255.0
    IgE - 122.6 Ref. Range 5- 158 (Normal)


    9/19/2004 (Went to Dr. for low libido and some Gastro issues I was having, feeling same as described above really minus the chest tightness. Was on no medications at this time. After this I was put on Androgel and used it until the next blood test)

    Comprehensive Metabolic Panel - Normal
    CBC - Normal
    Cholesterol 201
    Triglycerides 415
    HDL 32
    LDL - Cannot compute
    TSH - 3.3
    H. Pylori - 1.0 - Negative
    Testosterone Total - 256 ng/dL
    Testosterone Free - 2.5%
    Sex Hormone Binding Globulin - 15 - Ref Range 13-71 nmol/L

    Last edited by stiletto23; 01-05-2006 at 08:34 AM. Reason: Added labs

     
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    Old 01-04-2006, 10:17 AM   #2
    Hormoneman
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    Re: Do I have Addison's? Some Labs

    Hi Kevin. I know something about your tests, so I'd like to give my opinion.

    HDL cholesterol (a hormone) is a good indicator of sex hormone levels. If total testosterone is low, free testosterone will be low (this is true I'd say at least 96% of the time. What time were your tests and did you take the androgel the morning of the tests?


    Androgel doesn't help most men. It hasn't been long enough to see if the androgel will help you (a lot of damage has been done from low T, so takes time). If you are taking enough androgel, your tests should have been higher and you may need an increase, check with your doc. Is possible androgel might not work for you. 3 months is more than enough time to see if it will work for you assume you are getting enough of it. Testosterone Cypionate (injectable) has a better sucess rate than androgel.

    Most docs especially endos (most of them view it as putting you on the juice, not so at all) don't know enough about how to treat low testosterone in men. Testosterone therapy can raise estrogen levels which is desired, but estrogen can go to high in T therapy. In men estrogen is usually ignored. Since high estrogen has most of the same symptoms of low testosterone, it's important that estrogen be monitored. Testosterone has to work with proper levels of E2. Testosterone is converted to E2 via the Aromatase enzyme, I almost fell over that you were tested for Estradiol, rarely is done in men unfortunately.

    In my opinion your E2 is low likely because you testosterone is low. Don't let the doc give you an aromatase inhibitor. This inhibits E2 which you don't need in my opinion. I've seen some report AI given when their E2 is low, AI makes E2 lower. Some docs think the lower the better, not the case at all.

    Symptoms of low E2, low libido, brain fog, erectile dysfunction, dry skin.


    Estradiol Free .10 - Ref Range .30 - .90 pg/mL (Low)


    Estradiol Free 2.0 - Ref Range 1.66 - 2.11 %


    Estradiol 5 - Ref. Range 10-50 pg/mL (Low)

    Your estradiol is very low in my opinion, but testosterone therapy should raise that, but you don't want to go to high.


    Learn about the use of HCG in testosterone therapy. Testerone therapy tends to shrink the testes. They just wither and atropy. HCG usually keeps this from happening.


    Your FSH and LH are low in my opinion (no testosterone therapy when these were done, right?) and suggest to me your hypogonadism may be secondary (hypopituitary).


    Since DHEA is regulated by ACTH in the pituitary, is possible your DHEA is low because of low ACTH, but this is not always the case. Did you forget to post cortisol tests. If you haven't had cortisol testing yet, I think you do need to push for it. Asthma, especially if hard to treat, is a big adrenal insufficiency (low cortisol) symptom. I had asthma for several years (after bad pneumnia which is devestating to the adrenal glands) and nothing helped me except prednisone, but with cortisol replacment asthma is gone.

    What was your sodium and potassium levels on the CBC? (give ranges). These can give indication of possible low aldsterone.

    Your TSH being at 3 looks to high to me. For men I like to see around 2. Man or woman, anyone I've seen with TSH that high had hypo symptoms.
    TSH is a pituitary test and you can't tell for sure exactly what the thyroid is doing by TSH alone. You need to ask for these thyroid tests.

    Free T3
    Free T4
    Thyroid antibody testing including TPO

    Any other test isn't worth much, like the total tests.

    I've never seen someones tests where LDL and triglycerides can't be figured together. LDL is usually high in hypothyroidism.

    When you get these tests back post them on the Healthboards thyroid board. Lots of knowledgable people there. Also look into what the symptoms of hypothyroid are.

    Investigate what anti-biotics do to the flora in the gut. Antibiotics mess up a lot of people to cause candida which can lead to leaky gut syndrome. Getting my hormones treated, don't get sick anymore and so no need for antibiotics. Hormones are the foundation of the immune system.

    Over all is very impressive to me the amount of testing your doc did on your hormones. I don't recommend endos. They have very poor track records with hormones and I haven't seen anyone say they werereally helped by one. I consider endos diabetes doctors. I always recommend osteopaths as your chance of success is much better with them than any other kind of doc because as a group they are very good at treating the thyroid and adrenals, know the ranges are flawed and put symptoms above numbers. Unfortuanately, most osteopaths are not up on the lastest protocols of treatment of mens hormones. You'll have to do quite a bit of digging and asking around to find a doc that knows how it's properly done.

    Get the cortisol tests and check back.


    PS. I did a lot editing of this post while you were on Healthboards, so you might want to reread.

    Last edited by Hormoneman; 01-11-2006 at 07:44 PM.

     
    Old 01-04-2006, 10:53 AM   #3
    stiletto23
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    Re: Do I have Addison's? Some Labs

    Thanks very much for the info. I believe I have the T3+T4 results in another set of bloodwork that I just don't have a copy of. I will post them as soon as I can. I have NEVER had my cortisol levels checked. My life has been kind of filled with stress for various reasons over the last 6-8 years so who knows how that has played a part in all of this. I have less stress now though which is good but my chemicals are all still messed up it seems or the way I handle stress and illness has always been messed up because of hormones??

    About the Estradiol, that one and DHEA I chose to test because I read to have it checked in the book "Testosterone Syndrome". My Dr. got mad at me for checking them but I did read that they were important to monitor. My general Dr. said he didnt know what to make of the low DHEA which didn't make me feel too good. Anyways, thanks again for the advice. I will try to get the ACTH and Cortisol checked ASAP.

    -kevin

     
    Old 01-04-2006, 11:07 AM   #4
    Hormoneman
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    Re: Do I have Addison's? Some Labs

    Good job on what you've done so far. Know that if you get opinions (I can also give) of your thyroid tests matching with hypo, you must test your cortisol and treat that first if it is needed (of course test cortisol regardless). If you treat just your thyroid and your cortisol is low, is good chance the thyroid med will build up and you could get symptoms of hyperthyroid. Cortisol helps break down the T3.

    If you have been through enough stress, your cortisol could be low from that or your cortisol could be low first then cause stress.

    Testosterone Syndrome is an excellent book. That is poor of that doc to be upset that you are doing research. Those docs that think you should totally rely on them and not try to help yourself are usually not good at helping people with hormone problems.

    "...or the way I handle stress and illness has always been messed up because of hormones??"

    Very likely, yes. Most docs don't know to look for hormone deficiencies, namely low thyroid and low cortisol when their patient is sick all the time.

    Your welcome

    Last edited by Hormoneman; 01-04-2006 at 11:14 AM.

     
    Old 01-05-2006, 08:36 AM   #5
    stiletto23
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    Re: Do I have Addison's? Some Labs

    Hormoneman, I added my 6/2005 bloodwork to the first post. I was on Prednisone in October, do you think that would lower my DHEA that much? About the time the 6/2005 blood tests were taken, I was feeling better. The only change was that it was summer time. I am usually healthier when the weather is good. No idea why. I will post the Cortisol and ACTH as soon as I get them. Thanks!

    Last edited by stiletto23; 01-05-2006 at 08:39 AM.

     
    Old 01-05-2006, 04:50 PM   #6
    Hormoneman
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    Re: Do I have Addison's? Some Labs

    Those aren't even the same DHEA tests, but yeah, your DHEA may have gone down some since cortisol replacement suppesses ACTH and ACTH is what regulates DHEA. If you stopped the prednisone before November I would expect you DHEA to be back to where it was, but if your AI is secondary, then after cortisol replacement is ended, your ACTH could end up being even lower then before and might not go back to the level it was. This lowered ACTH could bring down DHEA more.

    Why you do better in the summer may be because low cortisol as well as low thyroid can make you very sensitive to the cold. The stress of the cold can cause cortisol to fall even further, which can cause asthma to worsen. Again, asthma is a very big AI symptom. The winter was extremely hard for me until I started cortisol replacement.

     
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