Re: Daughter's Short Synacthen Test

[Guest guest]

Dear , Remind me what SYNO/SYNO20/SYNO30 stand for, and are

the figures after them the result of each one. If so, what is the reference

range for each of them as there is no way we can tell whether they are at the

bottom, the middle or the top of the range. TSH is too high, it shows that her

pituitary gland recognises that there is insufficient thyroid hormone

circulating in the blood and is secreting thyroid stimulating hormone to tell

the thyroid to start secreting more T4 and T3. The free T4 is only 2 points

from the bottom of the range - where it should be above the middle of the range

for anybody not taking thyroid hormone replacement, so her free T4 should be

somewhere around 19. Also, give us the reference range for FSH

and LH please.

These results are NOT satisfactory and it is important that your

daughter sees an endocrinologist, preferably of your choice. I would write a

letter to the GP setting out all of her symptoms and signs (check those against

the one's in our web site www.tpa-uk.org.uk . List her basal temperature

taken for 4/5 mornings before she gets out of bed. List all the members of her

family who have a thyroid or autoimmune disease. List the thyroid function

tests that have not been done that she needs i.e. free T3 and tests to see

whether she has antibodies to her thyroid. These are TPO and TgAb.

List also the vitamins and minerals you need testing to see

whether any of these are low in the reference range which are associated with

low thyroid. These are: ferritin, vitamin B12, vitamin D3, magnesium, folate,

copper and zinc. She can mention here that if any of these are low, it is a

well known fact that thyroid hormone is unable to be properly utilised at the

cellular level until whatever is low has been supplemented and the level is

raised.

Ask for a referral to an endocrinologist of your choice (I will

send my doctors list to you). You can be referred outside of your area if there

is nobody suitable where you live.

Next, ask for your letter of requests to be placed into your

medical notes and keep a copy for yourself in case you need to refer to it at a

later date - and don't forget to send a copy to the Head of Practice.

Hope this helps.

Luv - Sheila

At long last I have my daughter's SST results. The Paediatrician said that they

were satisfactory.

SYN0 295

SYN30 894

SYN60 999

TSH 2.47 (0.25-5.0) - this has risen, but, she is on iodine

Free T4 14.4 (12-25) - this seems to have come down

FSH (Follicle stimulating hormone) 2.6U/L

LH (Luteinising hormone) <0.1 U/L

[Guest guest]

Hi Sheila and all,

I SYN0 is the first cortisol blood sample taken, SYN30 is the sample taken after

30mins after the cortisol stimulating hormone is given and SYN60 is the sample

taken after 60minutes. No referenece ranges were given for the these. No

reference ranges were given for the LH the following was given for the FSH

Adult female FSH reference ranges:

Follicular 2-17U/L

Ovulatory 5-48U/L

Luteal 1-15U/L

Post menopausal 40-140U/L

I have had some private hormone testing done via a 24Hr urinary test - these are

the results:

Cortisol 49 (58-248)

Aldosterone 38.3 (16.6 -69.3)

Testosterone 5.4 (0.2-0.4)

16-OH Estrone 3.8 (1.7-5.8)

17-OH Progesterone 3.0 (0.7-1.4)

Estriol 46.7 (1.1-9.7)

Oestradiol 26.5 (8.8-237.5)

DHEA 0.1 (<=2.8)

17-OH-Steroid 14.1 (10.2-23.6)

17-keto Steroid total 7.7 (9.9-30.6)

As you can see her hormones are extremely unbalanced.

With the TSH - this when it was first tested was 1.92 (.25-5.0)and T4 was 16.3

(12-25). Since this test was taken I have started to give her iodine - as I

understand it iodine raises TSH temporarily. Would it also have an effect on

free T4.

I have had her free T3 tested privately - this was 6.7 (3.5-7.7)

Thyroglobulin Antibody was 18.8 (0-115)

Thyroid Peroxidase Antibody was 21.7 (<34)

Pituitary Antibodies were negative

The NHS Paediatrician has stated that there is nothing wrong with her endocrine

system therefore she has not made a follow up appointment. We are however,

seeing an opthalmologist at the end of May fro feild of vision tests etc. as out

optician said that there were possible signs of a papillodema on her left optic

nerve. She is still suffering from daily intense headaches.

I have already asked for a second opinion - the GP said that they would not do

it unless the paediatrician said that it was necessary - so I will now have a

fight on to get this - compounded by my daughter's Father writing letters saying

that there is nothing wrong with her - we are divorced and he is autistic. My

sister has offered to come with me as support to see the opthalmologist and GP

if necessary.

I am seeing a private Dr who has been extremely helpful and has already written

to the GP and Paed saying that she looks as though she has Cushings and that the

diagnosis is extensive and that she may need some imaging. I will be taking to

this Dr at the end of May after we have seen the Opthalmologist.

My research suggests that the first SYN0 cortisol test is low and would warrant

HC supplementation.

Sorry this is so long.

I have also since the test started her on Nature-Throid - 1 grain at the moment,

she is having HC cream twice a day and progesterone cream which even though she

is high in this has a profound effect on her moods and how she feels etc.

Thanks for the list of Drs.

Love,

>

> Dear , Remind me what SYNO/SYNO20/SYNO30 stand for, and are the figures

> after them the result of each one.

******* Rest of all the old messages deleted by a kind lovely moderator

********

[Guest guest]

I don't know much but what stood out is:

> 17-OH Progesterone 3.0 (0.7-1.4)

You don't put the units in so it's hard to cross reference against:

http://www.childrensmn.org/Manuals/Lab/UrineStool/051344.asp

(different countries use different units)

i would seek an expert opinion on these results

>

> Hi Sheila and all,

>

> 17-OH Progesterone 3.0 (0.7-1.4)

> Estriol 46.7 (1.1-9.7)

[Guest guest]

> You don't put the units in so it's hard to cross reference against:

http://www.childrensmn.org/Manuals/Lab/UrineStool/051344.asp

Thank you very much for this - the units are the same ug/24h.

I can see I need an expert here. Just need to find one and then persuade the GP

or Paed to refer - may be difficult as they are quite adamant that there is

nothing wrong!

[Guest guest]

are you sure that they're in ug/24h?

who did the lab test, didn't they comment on it?

according to:

http://www.unit2unit.com/index.cgi?number_input=3 & action=mass & initial_unit=1.000\

0000000E-06 & final_unit=1.0000000000E-09

3 ug=3,000 ng?

i checked the archives and your much earlier post said your daughter is 12 i

think? is the range you posted tailored to your daughters age range?

i would definitely get someone good to look at this.

let us know how you get on

chris

>

>

>

> > You don't put the units in so it's hard to cross reference against:

http://www.childrensmn.org/Manuals/Lab/UrineStool/051344.asp

>

> Thank you very much for this - the units are the same ug/24h.

>

> I can see I need an expert here. Just need to find one and then persuade the

GP or Paed to refer - may be difficult as they are quite adamant that there is

nothing wrong!

>

>

>

[Guest guest]

Well it is ug/24hr with a little squiggle on the u.

The test results just highlighted the results which were outside the reference

range. No comments were made. I actually don't have the lab who did them, that

is not on the sheet. I will find out when I speak to the Dr who ordered the test

- that will not be until the end of May though.

> are you sure that they're in ug/24h?

>

> who did the lab test, didn't they comment on it?

Oh dear, it looks like I need a very specialist endocrinologist - one that is

paediatric as well and deals with alot of children my daughter's age. The range

on the link you gave me only goes up to 8years old and then straight into adult

ranges.