Re: Dr Hollander Visit/Labs

[Guest guest]

> Ferritin: 33 (10-220)

> Iron, Serum: 153 (35-145)

> Unsaturated IBC: 179 (155-300)

> Calculated Total IBC: 332 (250-450)

> Calculated % Iron Sat: 46 (20-50)

I've not seen iron labs posted that look like this - a very low

ferritin and yet your serum iron is really high, over range, and your

% iron sat is high in range. Maybe someone will comment on that.

> DHEA Sulfate: 96 (35-430)

At least for my doc, this is really low. He wants of 2000-3000 for

females. Yours would be 960 on an equivalent scale. Are you taking

compounded, pharmaceutical DHEA or otc type?

> TSH: .3 (.3-5.1)

> Free T3: 2.5 (2.3-4.2)

> Free T4: .86 (.73-1.95)

Free T3 and Free T4 are very low in range, no matter what your TSH

says - IMHO this is an issue. Ratio of Free 3/(Free T3 + Free T4) =

27% if lab values are equalized, which is what my doc looks at. You

are within his target range of 25-30%. Maybe you are not on enough

Armour yet. How long have you been at 2 grains? Were you ever on more

than 2 grains? Did you have any problems getting to the 2 grains?

Yes, we'd like to see the a.m. cortisol. My doc doesn't do any all

day testing. He only does the 8am test.

Did you have results for female hormones?

Thumbs down, way down, on her attitude about adrenals and not acting

like you were in the room. Boo! Hiss!

Sara

[Guest guest]

Your low Ferritin and DHEA could be partly responsible for your symptoms, the dizziness and the palps. What kind of Iron supplement are you taking? The salt cravings could be adrenal. I'm concerned you'll have trouble raising your Armour until these are a lot higher.

I didn't see a B12. Do you have that? That's important too.

Carol

>> Well, back from seeing Dr Hollander (endo) for the low aldosterone level.> Ss I suspected, she wasn't willing to do much. She wouldn't give me> Florinef even as a trial just to see as she said I didn't need it. My> sodium levels were normal so obviously I didn't have a problem there she> said and I didn't need the drug.> > And she said low aldosterone by itself doesn't exist (like it seems I have -> nothing else was out of range...renin was normal, potassium was normal and> sodium was normal). And it might not - maybe it was a lab error, I don't> know. So she talked all about Cushing's and 's and wanted to know> how I even arrived at getting these tested because it's so rare. I> explained how I was learning more about adrenals and thyroid connection and> how I'd been on adrenal supplements trying to help my adrenal fatigue (which> she said medically doesn't exist - of course) and I'd heard about getting> those levels tested so that's why I had Dr Owens do that. She looked more> at my mom than me which annoyed me. I bring her along to most of my> appointments but she's not here to make the decisions, *I AM*. I'm not a> child, I'm clearly an adult. She's just there for moral support and because> she wants to hear first hand what is going on. So that kind of pissed us> both off.> > Anyway, she said we should do a 24 hour urine test to check for cortisol and> aldosterone and something else...forgotten. And then I'm to go back and do> the ACTH stem test to verify everything is behaving as it should. Which it> probably will.> > She didn't have a negative reaction to the Armour. I gave her my history> there and how I did horribly on straight T4 and once on the Armour, had an> immediate positive reaction. She seemed fine with it and said my thyroid #s> were good so I was doing good there (HA! not quite...but I don't want her> touching my thyroid meds so I left the subject alone). I told her I was> still feeling about 50-60% though. I was working full time again but that's> about as far as my body would allow. I was pushing myself to do that most> of the time and afterwards I was pretty much out of energy. I have no> social life because I never feel up to going anywhere. And before she could> even *utter* the word antidepressant, I told her I was NOT depressed. I> knew something was medically not right with me and my emotions were good> (and they are, mostly). So she laughed a little and said "Good, ok" and the> subject was dropped.> > So I figured why not have these 2 tests performed, just to rule it out> completely. I made the trouble to make the appointment and drive all the> way out there, might as well go all the way. Clearly something else is> still wrong with me and she recognized that I do have the symptoms of low> aldosterone (dizziness, heart palps, salt cravings), she just couldn't> believe it actually was truly low (or something) with everything else being> normal. So they gave me the jug to do the urine test and are going to call> me to schedule the other.> > She didn't exactly dismiss me but I still felt extremely frustrated over the> whole thing. Not too shocking really as I don't expect much else from an> endocrinologist. Interesting lady. Nice enough and she did have me> undress (would have shaved if I'd known that! It's been over a week! *g*)> and she poked all around me but said all looked good. I was fairly> impressed that she went that far. You're lucky if they even look up at you> most of the time.> > I did manage to get them to make me a copy of my labs from Dr Owens office> while I was there as I still haven't managed to get Ron on the phone. Also,> I'm at 120 mg Armour and .5 ML Testosterone cream and various supplements,> including DHEA (50 mg). Oh she did ask me to stop taking the DHEA for about> 3 days prior to the stem test as she's wondering if maybe that could be> suppressing the aldosterone. Not that I feel the DHEA is doing anything for> me anyway - clearly, I take more of it, my numbers decrease which puzzles Dr> Owens. I mentioned that to this lady and she didn't have anything to say on> that.> > Anyway, labs were done at about 11 am (fasting):> > Vitamin D, 1, 25-Dihydroxy: 54 (15-75)> > Aldosterone: <1.6 (4-31)> > Renin: 1.8 (.5-4.0)> > Glucose: 83 (65-100)> > BUN: 18 (8-25)> > Creatinine: .6 (.6-1.3)> > Sodium: 140 (133-146)> > Potassium: 3.9 (3.5-5.3)> > Chloride: 104 (97-110)> > Carbon Dioxide: 27 (18-30)> > Calcium: 9.3 (8.5-10.5)> > Ferritin: 33 (10-220)> > Magnesium: 1.8 (1.3-2.3)> > Iron, Serum: 153 (35-145)> Unsaturated IBC: 179 (155-300)> Calculated Total IBC: 332 (250-450)> Calculated % Iron Sat: 46 (20-50)> > DHEA Sulfate: 96 (35-430)> > Testosterone: 51 (14-76)> > Sex Horm Bind Globulin: 98 (18-144)> Calc Free Testosterone: .4 (.3-1.6)> > TSH: .3 (.3-5.1)> Free T3: 2.5 (2.3-4.2)> Free T4: .86 (.73-1.95)> > Thoughts??> > Jul>

[Guest guest]

Well, that's my Iron supplement of choice. :-) If your consistent with it it will go up. And I think it's essential to being able to raise your Armour.

With B12 I think higher is better.

I take a prescription DHEA, but much smaller dose and mine's gone up real consistently. Had to cut back the dose a little due to side effects.

I know nothing about Aldosterone, sorry, can't help there.

Carol

> > Your low Ferritin and DHEA could be partly responsible for your symptoms,> > the dizziness and the palps. What kind of Iron supplement are you taking?> > The salt cravings could be adrenal. I'm concerned you'll have trouble> > raising your Armour until these are a lot higher.> >> > I didn't see a B12. Do you have that? That's important too.> >> > Carol>

[Guest guest]

DHEA (also progesterone and pregnenalone) can be problematic for hypo/hashi folks. It is a pro-hormone which converts to other hormones. Hypo folks are notoriously poor at converting a variety of hormones. Why? Chemical reactions take place a specific temperatures. If your temps are low, those conversions may be incomplete. The high serum iron coupled with the low ferritin could be the result of having taken your iron within 48 hours of your blood draw or it could be this temperature effect again. DHEA can be had from a compounding pharmacy in capsules or a cream. With the OTC product, you never know what you are

really getting. That aldosterone level could be lab error. I am mainly concerned about your Free T3 and Free T4 in the lower half of their ranges, as well as your ferritin. Jul wrote: Well, back from seeing Dr Hollander (endo) for the low aldosterone level. Ss I suspected, she wasn't willing to do much. She wouldn't give me Florinef even as a trial just to see as she said I didn't need it. My sodium levels were normal so obviously I didn't have a problem there she said and I didn't need the drug. And she said low aldosterone by itself doesn't exist (like it seems I have - nothing else was out of range...renin was normal, potassium was normal and sodium was normal). And it might not - maybe it was a lab error, I don't know. So she talked all about Cushing's and 's and wanted to know how I even arrived at getting these tested because it's so rare. I explained how I was learning more about adrenals and thyroid connection and how I'd been on adrenal supplements trying to help

my adrenal fatigue (which she said medically doesn't exist - of course) and I'd heard about getting those levels tested so that's why I had Dr Owens do that. She looked more at my mom than me which annoyed me. I bring her along to most of my appointments but she's not here to make the decisions, *I AM*. I'm not a child, I'm clearly an adult. She's just there for moral support and because she wants to hear first hand what is going on. So that kind of pissed us both off. Anyway, she said we should do a 24 hour urine test to check for cortisol and aldosterone and something else...forgotten. And then I'm to go back and do the ACTH stem test to verify everything is behaving as it should. Which it probably will.She didn't have a negative reaction to the Armour. I gave her my history there and how I did horribly on straight T4 and once on the Armour, had an immediate positive reaction. She seemed fine

with it and said my thyroid #s were good so I was doing good there (HA! not quite...but I don't want her touching my thyroid meds so I left the subject alone). I told her I was still feeling about 50-60% though. I was working full time again but that's about as far as my body would allow. I was pushing myself to do that most of the time and afterwards I was pretty much out of energy. I have no social life because I never feel up to going anywhere. And before she could even *utter* the word antidepressant, I told her I was NOT depressed. I knew something was medically not right with me and my emotions were good (and they are, mostly). So she laughed a little and said "Good, ok" and the subject was dropped.So I figured why not have these 2 tests performed, just to rule it out completely. I made the trouble to make the appointment and drive all the way out there, might as well go all the way. Clearly something else

is still wrong with me and she recognized that I do have the symptoms of low aldosterone (dizziness, heart palps, salt cravings), she just couldn't believe it actually was truly low (or something) with everything else being normal. So they gave me the jug to do the urine test and are going to call me to schedule the other. She didn't exactly dismiss me but I still felt extremely frustrated over the whole thing. Not too shocking really as I don't expect much else from an endocrinologist. Interesting lady. Nice enough and she did have me undress (would have shaved if I'd known that! It's been over a week! *g*) and she poked all around me but said all looked good. I was fairly impressed that she went that far. You're lucky if they even look up at you most of the time.I did manage to get them to make me a copy of my labs from Dr Owens office while I was there as I still haven't managed to get Ron on the

phone. Also, I'm at 120 mg Armour and .5 ML Testosterone cream and various supplements, including DHEA (50 mg). Oh she did ask me to stop taking the DHEA for about 3 days prior to the stem test as she's wondering if maybe that could be suppressing the aldosterone. Not that I feel the DHEA is doing anything for me anyway - clearly, I take more of it, my numbers decrease which puzzles Dr Owens. I mentioned that to this lady and she didn't have anything to say on that.Anyway, labs were done at about 11 am (fasting):Vitamin D, 1, 25-Dihydroxy: 54 (15-75)Aldosterone: <1.6 (4-31)Renin: 1.8 (.5-4.0)Glucose: 83 (65-100)BUN: 18 (8-25)Creatinine: .6 (.6-1.3)Sodium: 140 (133-146)Potassium: 3.9 (3.5-5.3)Chloride: 104 (97-110)Carbon Dioxide: 27 (18-30)Calcium: 9.3 (8.5-10.5)Ferritin: 33 (10-220)Magnesium: 1.8 (1.3-2.3)Iron, Serum: 153

(35-145)Unsaturated IBC: 179 (155-300)Calculated Total IBC: 332 (250-450)Calculated % Iron Sat: 46 (20-50)DHEA Sulfate: 96 (35-430)Testosterone: 51 (14-76)Sex Horm Bind Globulin: 98 (18-144)Calc Free Testosterone: .4 (.3-1.6)TSH: .3 (.3-5.1)Free T3: 2.5 (2.3-4.2)Free T4: .86 (.73-1.95)Thoughts??Jul

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

[Guest guest]

> DHEA (also progesterone and pregnenalone) can be problematic for hypo/hashi

> folks. It is a pro-hormone which converts to other hormones. Hypo folks are

> notoriously poor at converting a variety of hormones. Why? Chemical

> reactions take place a specific temperatures. If your temps are low, those

> conversions may be incomplete.

I don't feel cold anymore (unless the temperature in the room is cold)

but I haven't done my actual temps because I don't have a mercury

thermometer and I believe you need one to accurately test? I haven't

looked into trying to locate one yet.

> The high serum iron coupled with the low ferritin could be the result of

> having taken your iron within 48 hours of your blood draw or it could be

> this temperature effect again.

I can't recall but I think I took it the night before. I didn't know

I shouldn't. Will remember that next time.

> DHEA can be had from a compounding pharmacy in capsules or a cream. With the

> OTC product, you never know what you are really getting.

On my list to talk to Dr Owens about. Thanks!

> That aldosterone level could be lab error.

Maybe - just seems coincidental since I have the symptoms (or at least

3 of them - salt craving, extreme dizziness upon standing and heart

palps) but I suppose those could be because of the other stuff and it

really was a lab error. Just frustrating beyond belief. Silly me for

thinking " finally, a blood test actually shows what my symptoms

show?? " Should have KNOWN that wasn't going to do me any good. *g*

> I am mainly concerned about your Free T3 and Free T4 in the lower half of

> their ranges, as well as your ferritin.

Me too. But the 2 grains has pushed my heart rate already up past 80.

I'm not sure I could tolerate another increase yet without it going

higher. I start feeling uncomfortable when it hits 90.

*sigh*

[Guest guest]

One comment on the cortisol urine test. In my opinion that is only good

for testing for Cushings. The 24 hour urine test will normalize your

cortisol values over the 24 hour period. It will not show adrenal

fatigue. You could be low in the morning and high at hight (like me)

and the urine test will be dead square in the normal range. If you have

high cortisol during most of the day, then you have a chance of it

proving Cushings, but even people with cyclic Cushings will show normal

24 hr urine cortisol when they are way out of range at night.

The 8AM Cortisol blood draw will show where you are at that time. At

8AM your Cortisol should be at its highest. A lot of people with

Adrenal Fatigue have low to very low 8AM Cortisol reading. A 24 hour

salivary Cortisol test will show you your entire cycle. Some test take

5 samples and others take 4 samples.

Pat

> > DHEA (also progesterone and pregnenalone) can be problematic for

hypo/hashi

> > folks. It is a pro-hormone which converts to other hormones. Hypo

folks are

> > notoriously poor at converting a variety of hormones. Why? Chemical

> > reactions take place a specific temperatures. If your temps are low,

those

> > conversions may be incomplete.

>

> I don't feel cold anymore (unless the temperature in the room is cold)

> but I haven't done my actual temps because I don't have a mercury

> thermometer and I believe you need one to accurately test? I haven't

> looked into trying to locate one yet.

>

> > The high serum iron coupled with the low ferritin could be the

result of

> > having taken your iron within 48 hours of your blood draw or it

could be

> > this temperature effect again.

>

> I can't recall but I think I took it the night before. I didn't know

> I shouldn't. Will remember that next time.

>

> > DHEA can be had from a compounding pharmacy in capsules or a cream.

With the

> > OTC product, you never know what you are really getting.

>

> On my list to talk to Dr Owens about. Thanks!

>

> > That aldosterone level could be lab error.

>

> Maybe - just seems coincidental since I have the symptoms (or at least

> 3 of them - salt craving, extreme dizziness upon standing and heart

> palps) but I suppose those could be because of the other stuff and it

> really was a lab error. Just frustrating beyond belief. Silly me for

> thinking " finally, a blood test actually shows what my symptoms

> show?? " Should have KNOWN that wasn't going to do me any good. *g*

>

> > I am mainly concerned about your Free T3 and Free T4 in the lower

half of

> > their ranges, as well as your ferritin.

>

> Me too. But the 2 grains has pushed my heart rate already up past 80.

> I'm not sure I could tolerate another increase yet without it going

> higher. I start feeling uncomfortable when it hits 90.

>

> *sigh*

>