I saw Dr. Goldstein yesterday and I will need to call an endo to get some of these fancy tests done. In order to check whether this is my pituitary causing the slight hypothyroidism, I'll need a TRH stimulation test which Goldstein does not do. I found an endo literally right down the road from me that specializes in pituitary disorders. He sounds about as good as any other I found online.
Part of me just wants to "forget" that I have diabetes insipidus, but that might not work to my advantage. If I already have a pituitary problem he would be more willing to check my pituitary hormones. Dr. Goldstein told me that he will take me off of DDAVP for a specific time frame and redo EVERYTHING including the water deprivation test. UGH...NO! I can't wait to have heart palpitations and dizziness upon standing. The water deprivation test is pure hell. Dr. Goldstein was saying that if my diabetes insipidus isn't full blown, he will probably take me off of the DDAVP. WTF?! I already know mine isn't full blown because some days my pituitary works and other days it doesn't. Let's hope it is a really bad day for me when I go in for these tests. Some days even with my medicine, my urine is very dilute (clear). Sorry that might have been a little too much info!
UPDATE: I called the endo and the soonest they can see me is March 31st. In the meantime, I will continue to chelate and do what I've been doing.
I recently joined the Natural thyroid hormone yahoo group. I doubt I'll post much on it, but it is nice to see others talk about their hypo problems. You must join to see any messages.
Showing posts with label secondary hypothyroidism. Show all posts
Showing posts with label secondary hypothyroidism. Show all posts
Tuesday, January 6, 2009
Tuesday, December 30, 2008
Blood Work, ER and More!
Last evening I decided to go to the ER. The pain started to move more to my back. The wait wasn't too bad despite how busy it was and I was happy with the doctor. At least he didn't call me a heroin addict!
Everything was checked. More X-rays, blood work, and an EKG. He said it was a muscle and to give it another 4-7 days to get better. That's what I'm going to do. I may even cancel my voice lesson for Monday. If it is a muscle apparently I really messed mine up. It has been 13 days today with this chest pain and it still hurts. At least I know it is NOT my lungs, a blood clot, heart problems or a broken rib. I am much more relaxed about it since I know I won't be dropping dead from it.
Today I got my blood work results from Dr. Goldstein and it is not good.
TSH-0.097 VERY LOW
T4- 6.5 (lower than optimal but within lab normal range)
FT3- 2.6 (lower than optimal but within lab normal range)
TSI- <20 OK
TPOAb -<10 OK
With a completely clean thyroid ultrasound and this blood work, it looks like my pituitary isn't working. I'm not completely sure how it all works yet (still researching) but this will quickly cause my thyroid to become hypo. When a hypothyroid is caused by the pituitary it is called Secondary or Central Hypothyroidism. This is exceedingly rare, but with my history of diabetes insipidus doesn't really surprise me. I found a website that said, "Central hypothyroidism is a rare disorder with a prevalence of 0.0002% to 0.005%". If this is referring to the US population, (if I did my math right) that means 600-15000 people have been diagnosed with it. Remember diabetes insipidus is also rare at about 1 in 25,000 people. That is about 12,000 people in the general public. For comparison, primary hypothyroidism (including the autoimmune ones) has a prevalence of 0.8% or about 2.4 million people.
There is another test that can be performed to accurately diagnosis this and that is called a thyrotropin-releasing hormone stimulation test. This will help to distinguish between tertiary (hypothalamus defect) or secondary (pituitary defect) hypothyroidism. An absent or blunted response means secondary. An exaggerated response means tertiary. I don't know if Dr. Goldstein is up for this challenge. I will also need EVERY pituitary hormone checked including LH, FSH, ACTH, PRL, GH etc. Since I had a MRI back in February, I'm not concerned about a tumor. However this does worry me a little because the part of the pituitary that controls the anti-diuretic hormone is on the opposite side where TSH is controlled. That means my entire pituitary gland is being affected. Either it is a large tumor or the mercury after all.
Everything was checked. More X-rays, blood work, and an EKG. He said it was a muscle and to give it another 4-7 days to get better. That's what I'm going to do. I may even cancel my voice lesson for Monday. If it is a muscle apparently I really messed mine up. It has been 13 days today with this chest pain and it still hurts. At least I know it is NOT my lungs, a blood clot, heart problems or a broken rib. I am much more relaxed about it since I know I won't be dropping dead from it.
Today I got my blood work results from Dr. Goldstein and it is not good.
TSH-0.097 VERY LOW
T4- 6.5 (lower than optimal but within lab normal range)
FT3- 2.6 (lower than optimal but within lab normal range)
TSI- <20 OK
TPOAb -<10 OK
With a completely clean thyroid ultrasound and this blood work, it looks like my pituitary isn't working. I'm not completely sure how it all works yet (still researching) but this will quickly cause my thyroid to become hypo. When a hypothyroid is caused by the pituitary it is called Secondary or Central Hypothyroidism. This is exceedingly rare, but with my history of diabetes insipidus doesn't really surprise me. I found a website that said, "Central hypothyroidism is a rare disorder with a prevalence of 0.0002% to 0.005%". If this is referring to the US population, (if I did my math right) that means 600-15000 people have been diagnosed with it. Remember diabetes insipidus is also rare at about 1 in 25,000 people. That is about 12,000 people in the general public. For comparison, primary hypothyroidism (including the autoimmune ones) has a prevalence of 0.8% or about 2.4 million people.
There is another test that can be performed to accurately diagnosis this and that is called a thyrotropin-releasing hormone stimulation test. This will help to distinguish between tertiary (hypothalamus defect) or secondary (pituitary defect) hypothyroidism. An absent or blunted response means secondary. An exaggerated response means tertiary. I don't know if Dr. Goldstein is up for this challenge. I will also need EVERY pituitary hormone checked including LH, FSH, ACTH, PRL, GH etc. Since I had a MRI back in February, I'm not concerned about a tumor. However this does worry me a little because the part of the pituitary that controls the anti-diuretic hormone is on the opposite side where TSH is controlled. That means my entire pituitary gland is being affected. Either it is a large tumor or the mercury after all.
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