Got Labs: More Nothing

Considering how sick I am, I am always amazed at how nice things look on paper...lol

Creatine Kinase 55 (33-194)
Lactate 0.57 (.50-2.20)
Pyruvate 0.89 (0.30-1.50)
Copper 87 (70-175)
Ceruloplasmin 25.1 (18-53)

Labs Drawn

I had to make an appointment with the nearby hospital to get my labs done. First they had to order in the perchloric acid needed for the one test (pyruvic acid). This is a reagent that Labcorp doesn't even carry since there is a risk of explosion if it's not handled properly. haha This reagent must be chilled before applied to my blood, so it had to be refrigerated at least 2 hours before I came in. Hopefully everything was done right. It's the same hospital that did my NutrEval test and that worked out well. Thankfully my veins cooperated really well. Man I could not believe it! That lady hit my vein and the blood just came pouring out hahaha I filled up all the vials in no time and without a tourniquet (except for the initial puncture).

My sleep schedule has been off lately. I think it's because I feel so awful during the day, so I tend to want to stay up later and later since it's usually cooler at night thus I feel better...

Now I can start taking supplements again to see what happens. Why do I have this feeling that I'm going to feel like hell this week? lol

I'll be sure to post my results of the tests when I get them. I have no idea how long that might be...Most of the labs are done at the hospital from what I was understanding, so it shouldn't be too long.

Okay I'm Giving This Diet A Go!

I hate to even call it a diet because it is not. It's another lifestyle change.

My husband is on board with me, so that makes it SOOOO much easier!

Here are the foods we will be excluding for the next few weeks to see if I feel any different. I am only excluding foods that were classified as a 2 or 3.

Egg White/Yolk
Gluten
Milk
Strawberry
Tomato
Wheat
Yogurt

Almond
Kidney Bean
Lima Bean
Barley

I can eat cheese, almond, kidney bean, lima bean and barley (no response), but my husband's allergy test showed his response pretty high. Therefore I'm just excluding it from my diet to remove any possible contamination.

That means we have to throw out all opened jars. Jellies, mustard, relish etc. There is most definitely pieces of wheat or gluten in ALL of those jars. I think I'm going to throw out our collander too and get a new one just to be safe. Although I'm not even sure why I'd need to use it if we aren't eating pasta.

No tomatoes really hits me hard. I can't make stuffed peppers anymore! I can't put tomatoes on chicken breasts to spice it up a bit... I can't eat any type of pasta sauce anymore. AHHH! I can't even put tomatoes on my salads and a lot of the canned beans I used to buy have tomatoes in them. There goes a lot of meals we used to eat on a regular basis.

I had a metabolic panel done on Saturday and these are the results!

Glucose 82 (65-99)
BUN 12 (5-26)
Creatinine 0.82 (0.57-1.00)
GFR >59 (>59)
Bun/Creat Ratio 15 (8-27)
Sodium 138 (135-145)
Potassium 4.7 (3.5-5.2) WOOHOO! The new diet and supping IS working!
Chloride 103 (97-108)
Carbon Dioxide 24 (20-32)
Calcium 9.6 (8.5-10.6)
Protein 6.8 (6-8.5)
Albumin 4.6 (3.5-5.5)
Globulin 2.2 (1.5-4.5)
A/G Ratio 2.1 (1.1-2.5)
Bilirubin 0.3 (0.1-1.2)
Alk Phos 53 (25-150)
AST 17 (0-40)
ALT 18 (0-40)

Sadly this tells me that my heart problem IS NOT electrolytes.

Tomorrow is the Tilt-Table test!

More Thyroid Labs

Here are the labs from another hormone doctor. Yes I have a few on-hand...LOL

These labs make even less sense to me. They were done almost exactly 2 weeks later and look at the huge difference.

Note these are NOT free thyroid labs. This doctor doesn't check frees for whatever dumb reason.
T4 6.0 (4.5-12.0)
T3 92 (83-200)
Reverse T3 233 (90-350)

I've never had a Total T3 checked before, so I'm not sure exactly how to interpret this. However usually you want your Free T3 to be near the top of the range and I'm really close to the bottom of the range here. The doctor that ordered this, I'm not sure I am actually going to schedule to see him. I dunno. I'm torn about the whole idea. He has helped me in the past, but money is getting tight with all these medical expenses.

Vitamin D 21.1 (32-100) LOW
Ferritin 33 (10-291) Too low

Taking armour has made both of these tank. I am now supping these hardcore to get them up higher. Ferritin is supposed to be at like 70-90 in order to use thyroid meds properly. /sigh

Glucose 85 (65-99)
BUN 8 (5-26)
Ceratinine 0.80 (0.57-1.00)
eGFR >59 (>59)
BUN/Creat ratio 10 (8-27)
Sodium 141 (135-145)
Potassium 3.7 (3.5-5.2)
Chloride 106 (97-108)
Carbon Dioxide 21 (20-32)
Calcium 9.7 (8.5-10.6)

Got My Thyroid Labs Back

Today I got the labs back from the doctor I saw in Michigan. I have no idea what in the hell is going on with my body.

TSH 0.25 (0.40-4.50)
FT4 0.8 (0.8-1.8)
FT3 752 (230-420) Oh my goodness!
Reverse T3 19 (11-32)

Iron 65 (45-175)
Ferritin 50 (10-291)
Glucose 88 (65-99)
Insulin 14 (<17)
Potassium 4.1 (3.5-5.3) That potassium is finally coming up!

I told the doc to throw in a lipid panel because I've NEVER had one done before.
Total Cholesterol 190 (125-200)
HDL 90 (>= 46)
Triglycerides 44 (<150)
LDL-Cholesterol 91 (<130)
Chol/HDLC ratio 2.1 (<=5.0)

I had EBV at 17, but this doctor wanted to check the antibodies again.

Epstein Barr Virus Early Antigen D AB (IGG) <=0.90 (Negative)
Epstein Barr Virus VCA Antibody (IGM) <=0.90 (Negative)
Epstein Barr Virus VCA Antibody (IGG) 4.53 HIGH
Epstein Barr Virus (EBNA) Antibody (IGG) >5.00 HIGH

Interpretation: Suggestive of past EBV infection.

So...I don't know what is going on with my body. I think it's just really ticked off! On this trip I remember feeling SO tired and didn't feel hyper at all. Apparently though with this lab, I don't know when I'm hyper or hypo. That's been made pretty clear to me now.

I also got my food allergy test back....HAHA Sadly I doubt I'll be cutting back on these foods. Some of the foods that showed are absolutely ridiculous. I have no idea what I'd even eat. Here's what came back with a response.

Blueberry (low)
Broccoli (low)
Cottage Cheese (low)
Corn (low)
Egg Whites (Medium)
Egg Yolks (Very high)
Garlic (low)
Gluten (Medium)
Lemon (low)
Lettuce!! (low)
Malt (low)
Cow's Milk (Very high)
Black Pepper!! (low)
Sweet Potato (low)
White Potato (low)
Soybean (low)
Strawberry!! (Medium)
Tomato!! (Medium)
Wheat (High)
Baker's Yeast! (low)
Yogurt (Medium

I went through every single food we eat in this house and I'm getting at least 1 of these allergens at EVERY meal. I use black pepper, tomatoes, garlic and eat salads a lot. If I can't eat salad then what the heck am I supposed to do? Even some of the gluten free alternatives would be an issue because of corn. These results really just pissed me off more than anything.

Labs Are Back and Call From the Cardiologist

Here's my latest labs:
Meds were as followed-
0 Florinef -I quit this a few weeks ago because I was potassium wasting WAY too much. I was sick of the constant chest pains and muscle cramps.
30mg HC
2 grains of Armour
6.25mg of DHEA
DDAVP when needed
20-60 MEQ's of potassium-If I have chest pains I take more that day

Glucose 84 (65-99) This is good. I've seen it in the 90's and that was a bit concerning
Sodium 136 (135-145) This is from the low aldosterone
Potassium 3.8 (3.5-5.2) Kind of sickening that it's this low still
Chloride 102 (97-108)
Carbon Dioxide 22 (20-32)
B-12 619 (211-911) Kind of surprising it's this high

TSH 0.129 (0.45-4.500) Just 2 weeks ago my TSH was 1.6 on the same dose of Armour? Apparently my pituitary is just taking a nap right now LOL
FT3 3.3 (2.3-4.2) Before treatment I was at 3.1
FT4 1.03 (0.61-1.76) Before treatment I was at 1.29
Reverse T3 310 (90-350) WOW!
DHEA-S 137 (65-380) This was 10 hours after taking 6.25mg of DHEA

So from what I understand it looks like I have a problem converting T4 into RT3 rather than into the active T3 form. My ratio is 0.0106 and it should be 0.020. Most people would say that I need to go on a T-3 only regimen, but I don't know if my doc would be up for that. I'll have to see what he wants to do with this. I feel more hypo than before and my weight gain (even being off the florinef) is still not good. I look more puffy than ever, which I thought was the florinef. Now I'm not so sure!

I'm staying on 6.25mg of DHEA. That lab isn't that bad in my opinion after 1o hours and don't really feel any benefits at 12.5+ I start to get acne really really bad and my sex drive actually goes down. For whatever reason 6.25mg is my sweet spot as it must completely convert to testosterone.

Today I got a call from the cardiologist's office (well he's an electro physiologist) and I have a feeling that something was seen on the Holter monitor. Maybe I'm making something out of nothing, but I just saw him on Friday and he said we didn't need to do another EKG because I had one from my PCP done a few weeks back. Well his office called and told me that the doc wanted an EKG from me and to call back to schedule this...Hmm. I need to schedule the Tilt Test as well, so I'll have to ask why the sudden change in heart (heh).

Some Blood Work

Here's some blood work I had done. It came back the day I went to the eye doctor, so I haven't been thinking about it much. hehe

I started on 12.5mg of DHEA yesterday on the advice of my doc. Then after 2 weeks take 1/2 tab twice daily.

Electrolyte Panel
Sodium 141 (135-145) Good
Potassium 4.0 (3.5-5.2) Pretty decent
Chloride 104 (97-108)
Carbon Dioxide 24 (20-32)

FT4 1.25 (0.61-1.76) Doc says the range should be 1.0-1.76
FT3 3.4 (2.3-4.2) Mid-range
TSH 2.095 (0.450-4.500) Little high
DHEA-S 24 (65-380) WoW!!

With these thyroid labs, my doc wants me to start on Armour in 2 weeks once I get the DHEA up to 25mg daily. He doesn't want to change 2 things at once, which makes sense.

Something weird that has come up out of no where is this strange pain near my right rib cage. It actually woke me up yesterday morning and was excruciating for about 15 seconds. Then it faded some--thankfully. It MIGHT be a pulled muscle, but I'm going to give it some time to see what happens. I have been doing some painting in the house, so it's definitely possible. heh I don't know why my muscles are so weak if that's the case.

Tonight my eye is not good. Very strange with lights near my peripheral vision, but I'm going to hang in there unless a shower of floaters come up out of no where. If that's the case I'll be calling the emergency number.

More Blood Work and HC

I got my blood results back finally and here's what it said.

More of nothing...
21-Hydroxlyase Antibodies <1.0--(<1.0)
Antiadrenal Antibodies, Quant Negative--(Negative))
IGF-1 214--(116-358) Doc said this was a little low
17-alpha-Hydroxyprogesterone 104 (30-100 Follicular) Doc said this isn't high enough to worry about.

I guess I should be thankful that my body isn't attacking my adrenal glands, but...I am back to not understanding WHY my adrenals aren't working. Maybe it's just mercury toxicity? I wanted to know the reason, so that I could move on with my life. I have this condition yet no doctor can pinpoint the reason...

There is some good news.
The doctor had me start on 30mg of hydrocortisone on Thursday and it's really helping. In combination with the florinef, I can already tell a difference in my heat intolerance. While I'm not completely better yet, it must have been 85 in our house yesterday and I felt pretty good. I was extremely thirsty all day yesterday and just kept a filled Berkey water bottle next to me. It helped to keep me hydrated.

My sleep on the other hand has been absolutely terrible. I keep waking up at night, hot, sweating and extremely thirsty. Sometimes I have to use the bathroom too. Is this low aldosterone, low cortisol or do I really have diabetes insipidus? At this point, I have no idea. I haven't been taking my DDAVP recently because I wanted to see what the florinef would do for me. I'm still not sure.

Yesterday I didn't feel as good as the first day, but I'm hoping the irritability was just PMS...lol All and all I am very pleased. I am trying to wake up at a more "normal" time, so my HC doses are right. Unfortunately today I woke up around 9AM, but that' isn't too bad considering our sleep schedule used to be really screwed up waking up at 8PM and going to sleep when most folks are eating lunch.

I think I might be getting some low potassium symptoms (chest pains, irregular heart beats, leg cramps), so I self-ordered some blood work through econolabs.com. I ordered a CBC with differential and a CMP (comprehensive metabolic panel) to check my blood counts, liver enzymes and electrolyte balance. As I was writing this I checked my email and the requisition form was sent to me email already! That was really fast.

I'll have to wait and get this checked on Tuesday because Monday morning we have to go to court and I'm already nervous about it.

ER Blood Work

I finally got the blood work back from the ER visit at the end of December and there are 3 things on there that were interesting.

Here's all of the results. Remember I went in there with chest pains, so they did all the cardiac and blood clot tests. I know nothing about those to be honest.

December 29, 2008
PT TEST 10.7--(9-12)
INR 1.1--(0.9-1.2)
PTT TEST 28.7--(20-35 seconds)
D-Dimer 0.51--(0.54-2.09) LOW But it states this underneath-
"To maximize the negative predictive value for the purpose of ruling out DVT or PE, a cutoff value of less than 1.0 is used.

A D-Dimer of less than 1.0 and otherwise normal patient history equals a low probability of DVT or PE. At levels below 1.0 the negative predictive value for DVT and PE approaches 100%.

Conversely, a value of 1.0 or greater cannot be used for the diagnosis of DVT or PE without the use of radiological procedures. IF a D-Dimer is great than 1.0, the investigation should be continued as clinically indicated."

Troponin I 0.00--(0-0.3)

Glucose 99--(70-99) Very high?
Bun 8--(7-22)
Creatinine 0.9--(0.5-1.3)
Bun/Creat 8.9--(8-27)
Sodium 142--(136-147)
Potassium 3.5--(3.6-5.3) LOW...
Chloride 107--(98-110)
CO2 Content 24--(22-34)
Anion Gap 11--(2-12)
Calc Osmol 281--(269-297)
Calcium 9.8--(8.7-10.7)
T Bili 0.5--(0.1-1.2)
ALK Phos 65--(30-128)
SGPT (ALT) 58--(5-47) HIGH again?
SGOT (AST) 36--(5-40) High normal
Total Protein 8.0--(6-8.4)
Albumin 4.7--(3.3-5.1)
Globulin 3.3--(1.8-4.2)
A/G Ratio 1.4--(1.0-2.5)

WBC 5.5--(3.8-10) Best I've ever seen my counts
RBC 4.95--(3.88-5.11)
HGB 14.1--(11.5-15.7)
HCT 40.8--(36.3-47%)
MCV 82.4--(84-101.1) LOW again
MCH 28.5--(27-34)
MCHC 34.6--(30.5-35)
RDW 12.5--(11-15.5)
PLT 256--(130-400)
MPV 10.4--(8-11.1)
Neutrophil# 2.83--(1.6-6.7)
Lymphocyte# 2.1--(0.9-3.1)
Monocyte# 0.34--(0.11-1.0)
Eosinophil# 0.2--(0.0-0.5)
Basophil# 0.0--(0.0-0.2)
Neutrophil% 51.7--(43.6-74.5)
Lymphocyte% 37.6--(15.5-44.5)
Monocyte% 6.2--(3.6-12)
Eosinophil% 3.8--(0-6) First time I've seen this normal in 2-3 years.
Basophil% 0.7--(0-2)

Chest X Ray at ER
CLINICAL DATA: Chest Pain
TWO-VIEW CHEST

History: A 24-year-old female with chest pain.

Comparison Studies: None

Findings: The lungs are free of consolidation, congestion, or effusions. The cardiac silhouette is not enlarged. There are no hilar or mediastinal abnormalities.

IMPRESSION No acute pulmonary disease.

The elevated ALT is interesting. That means my ALT was elevated for the entire month of December. It hasn't been checked since then, so I don't know if it's still elevated. I will definitely be bringing this up to Dr. L. My research into ALT tells me that unlike some of the other liver indicators which might be a metabolic problem somewhere else down the line, ALT specifically means damage or inflammation in the liver. The cells die and then leak into the bloodstream. Obviously there is some cell death in everyone, since the range is 5-47. Now it doesn't mean its serious, but the fact that I don't drink alcohol, take OTC pain pills or prescription drugs tells me it needs investigated further. Now if it's not elevated anymore, then I'll just assume it was from the DMSA and move on. But if it's still elevated now, then I might refer myself to another doc. I just like to make sure everything is clear here. I'm 24 years old and certainly want to keep my liver healthy as long as possible! I've seen a few medical websites that say celiac can cause high ALT.

The low potassium doesn't surprise me. Well actually it does a little because I was actively trying to raise it then. And low potassium can cause chest pains, so I might have gone to the ER because of low K! haha That makes me laugh a little inside.

The high glucose worries me. My last fasting blood draw in March was creeping up into the 90's and I certainly don't need diabetes to worry about on top of everything else.

In other news, the itching has been back. Not as severe as it used to be, but I am worried it will continue to get worse. It's the same spots as before...

Some Answers for the Labs

Well I had 2 of the most knowledgeable people online that I know give me their opinions on my lab results.

First off, the lab ranges Quest Diagnostics use are pathetic. The one lady suggest I get everything retested on Day 3 of my cycle at Labcorp or some other lab. I'm still thinking about what I will do. If I had known that Quest's lab ranges were so terrible, I would have gone to labcorp for these. Ugh...I feel like all the effort I put into this was for nothing. I don't want to pester Dr. Goldstein again AND my biggest fear is that the insurance company will deny it the 2nd time around! The blood work would have cost about $2500 out of pocket!

The lab ranges specifically for cortisol, ACTH, IGF-1 were awful. The one lady said that the IGF-1 result looks terrible, but with the really weird lab range she has no idea how to interpret it! My growth hormone is very low too, but I know some people say this isn't accurate because it goes out in pulses. Who knows. Considering I'm only 24 years old, it should be pretty high IMO.

Secondly, they both say that my results clearly indicated secondary adrenal insufficiency because of the low potassium, low sodium and low renin. My low aldosterone goes along with all of this.

Thirdly, serum cortisol is both free and bound so I can't compare saliva results to blood results. For some reason I have a lot of bound cortisol (which can't be used by the body) and a very small amount of free cortisol (that can be used by the body). One lady suggested testing Total & Free cortisol and CBG in the blood, but only Quest Diagnostics can do this! haha

The one lady asked me a bunch of questions, but I have yet to hear back from her. She was wondering why my saliva progesterone was so high and thought I was taking HRT for it! I had to set her straight on that.

Fourthly, regardless whether it is primary or secondary, I am definitely hypothyroid according to both women. No surprise there either, but I wish I understood why I go through weird cycles.

In addition to the lab results, today I went up 5 pounds now 130#. I couldn't even make this up! I ate about 800 calories, went for a short walk and yet up and up I go. At around 7:30PM I just about collapsed from fatigue. Obviously caloric intake has nothing to do with this weight gain, so I'm just going to eat whatever I want. Since my fasting glucose was kind of high, I didn't buy any sweets this week. I want to see how I feel without the chocolate! heh

I am itchy tonight and definitely didn't have any wheat, so I don't know what in the hell is going on. I might have to take a benadryl at this point so I can sleep. Zyrtec tends to keep me up for some reason.

Feeling Pretty Lost, Depressed

I got the lab results back and I am lost. I feel everything I've researched has failed me. Nothing is making sense anymore. My labs are just insane contradicting my saliva results! If any of you have any suggestions, idea or thoughts please leave me a message. These past 2 days I've been extremely depressed. I don't think I'm ever going to get better now.

I'm still waiting for a reply on the hormone support forum to see what they think. I posted on the naturalthyroidhormones yahoo group and they think I could have Hashi's even though the antibodies aren't showing OR that my pituitary is going through cycles. I think these are two very good ideas that I need to consider. I know that I go through cycles, but I can't figure out what is happening. Unfortunately there isn't a commercially available lab to check for pituitary antibodies. If there were I'd be begging to have them checked.

Since I got these labs, I started to chelate. Today is day 2 of Round 10. I am using 25mg of DMSA every 4 hours and have been doing good. Actually I haven't had any symptoms at all, but we'll see how I do tomorrow when I stop.

Here's the test results! I know nothing about sex hormones, so I can't even comment on those.

Basic Metabolic Panel
Glucose-------------91 (70-99) Seem rather high considering I was fasting.
Bun------------------10 (7-22)
Creatinine----------0.8 (0.5-1.3)
Bun/Creat----------12.5 (8-27)
Sodium-------------139 (136-147) Low Normal
Potassium----------3.7 (3.6-5.3) Low Normal
Chloride------------104(98-110)
CO2 Content-------28 (22-34)
Anion Gap----------7 (2-12)
Calc Osmol---------276 (269-297)
Calcium-------------9.5 (8.7-10.7)

Aldosterone--------6 (<=28) Very Low
Renin----------------2.4 (0.65-5.0) This isn't the salt fasting range.
Cortisol-AM---------26.7 (3.7-19.4) HIGH!
ACTH----------------37 Female (5-27) HIGH!
DHEA-S-------------215 (45-320) My doc wrote in the range he uses (150-250)
TSH------------------3.804 (.35-4.94) This result was the most shocking!
Free T4-------------0.9 (0.7-1.5) Low normal
Free T3-------------3.0 (1.71-3.71) The lab range changed from last time. It used to be (2.3-4.2)
TGA-----------------<20 (<20) I wish this lab would test to 0. If this is a 19, then I have Hashi's.
TPO-----------------<10 (<35)

Sex hormones were tested on Day 21 of my cycle.

Progesterone------12.5 (3.3-26.0) Luteal Gotta love that my saliva results were >1000!
Estradiol------------182 (48-309) Luteal
Testosterone,Total---20 (2-45)
Testosterone,%,Free---1.07 (0.50-2.00%)
Testosterone,Free----2.1 (0.1-6.4) My doctor wrote in the range he uses (3.2-6.4) Low
Prolactin-------------15.9 (3.0-30) Luteal
LH----------------------6.8 (0.5-16.9) Luteal
FSH--------------------2.7 (1.5-9.1) Luteal
IGF-1------------------53.5 (13-73)
Growth Hormone----0.7--(<=10.0)

Getting Through the Mid-Day Slump

MMMmmmmmMMMMmmmm...
Image Courtesy of: FreeDigitalPhotos.net

I know a lot of you out there self-medicate like me with chocolate, sweets, coffee, tea or even cigarettes to get you through the mid-day slump. Thankfully I don't smoke!

Today I can't have any caffeine, so I'm going crazy. I'll be the first one to admit that I have a caffeine problem. It's how I live my life and without it I feel completely lost. I'm really having a hard time keeping my eye balls open! haha But I must persevere. Normally at this time, depending upon what time I woke up, I would have a small cup of tea or coffee. Then at around 4PM, I lay down for about 45 minutes and then force myself to get up.

I thought well I could make something tasty to eat, but there is nothing exciting in our house at the moment. With both of us being sick for a week with the flu, a lot of our produce went bad! Our refrigerator was soo stinky once my sense of smell came back. I had to throw out a lot of food, so now we are really really low.

The place where I normally have my blood work done at, were unable to draw the IGF-1. So...I had to go to the hospital to get it done. /sigh They are doing a lot of construction up there, so the lab has been "closed". I showed up there and saw a lot of people considering it was "closed". The lady there, although she was very very nice, she obviously doesn't deal with many patients with small veins. I told her you have to tighten the band as tight as possible making it pinch my skin. She just kept telling me that that's not how they are trained and that she is not allowed to keep the band on longer than 1 minute. She kept saying the words patient comfort blah blah blah. I just kept telling her it won't work because my veins are small and in the end you'll make me uncomfortable with all the jabs.

Well after 2 jabs she tells me that they are trained not to jab more than twice and to make the 2nd one work. After 2 jabs patient comfort goes way down...No crap! During all of this, she randomly says to me, "How are you doing?" and in a tiny, high pitched voice, I let out a "OK".

To get all 4 vials, I was squeezing my fist as tight as possible and I convinced her to leave the band on. Thank goodness. The last vial took a long time to fill and we only needed 4. I've gone in to those places needing 9 vials with no problems at all. Obviously her following the rules didn't work out too well with me. It took her breaking them to get the blood out of me.

Sadly, I'm probably going to have to see her to get the renin and ACTH drawn. I still have to call the lab to see if they can do those in the outpatient center. My God, I hope so. I can't stand going to the hospital and that lady really was not that good. The women at the outpatient center are incredible. I haven't had a bad experience yet...Though I shouldn't speak too soon.

Preparing For Labs/Saliva Test

Well here we are at day 21 of my cycle. I have finally recovered from the flu too.

I started fasting at 8PM tonight for the blood work tomorrow! Tomorrow is a big day for blood work. I am having the following drawn as close to 8AM as possible.

DHEA-Sulfate
Free & Total Testosterone
Progesterone
Estradiol
LH
FSH
Prolactin
IGF-1
GH

I've never had a lot of these things tested, so I'm very curious.

Before I go, I need to fill the first vial with saliva for the cortisol test. This is a lot harder than it sounds. I'll have to dig in the refrigerator for something I can sniff to produce saliva. Another way to make saliva is just to try yawning over and over again. It's funny how many times you'll actually yawn and produce a TON of saliva.

I took another week off of violin/voice because of the saliva test. The one for 3-4PM would have been a problem since it is during my lessons and the drive back home. I wasn't about to collect saliva in their bathroom...

I am unable to eat chocolate, onions, garlic, cabbage, and cauliflower/broccoli and unable to drink coffee, tea, and other caffeinated drinks tomorrow. I'll have to constantly remind myself of this tomorrow.

These were the results of my first saliva test I had done through this company during the summer of '07.
07:00 - 08:00AM 6 Depressed (13-24 nM)
11:00 - Noon 5 Normal (5-10 nM)
04:00 - 05:00PM 2 Depressed (3-8 nM)
11:00 - Midnight 2 Normal (1-4 nM)

Cortisol Burden: 15 (23 - 42)

DHEA Dehydroepiandrosterone 4 Normal Adults (M/F):3-10 ng/ml

It's was pretty terrible...We'll see how things look now.

Mood Is Improvement

My mood has been a little better these past 2 days. I was really depressed and agitated last week and I'm glad that it is finally moving on. I think it was because I weaned myself off of the cortef a little faster than what's recommended. Obviously, I really need it, but I HAVE to wait. Dr. Goldstein agreed to order all of the blood work. There has been a slight change in plans. I believe I may be going to see a doctor near Scranton, PA. I may in fact cancel the appointment with the endo at the end of March. The doctor in PA is supposed to be really good with hypopituitary problems. He requires a lot of the blood work I requested from Dr. Goldstein. Since he is about 5 1/2 hours away from me, I want to make sure I have everything in order.

I just need to stop by Dr. Goldstein's office and pick up the papers when I go in for a B 12 shot next week... My legs and feet have been tingling again, which is always a sure sign for me.

Tomorrow I have the gynecologist appointment. I think I can go, but we'll have to see. /sigh

Blood Work Before Seeing the Endo

I jumped on a hypopituitary forum and asked what type of blood tests I should have done BEFORE seeing an endo.

Here is what I was told to get:

Cortisol, AM
ACTH, AM
Aldosterone
Renin
Sodium
Potassium
LH (Luteinizing Hormone)
FSH (Follicle-Stimulating Hormone)
Prolactin
IGF-1 (Insulin-like growth factor)
GH (Growth Hormone)
DHEA-S
Saliva Cortisol Test (Redo)

These tests will tell me whether or not my adrenal fatigue is caused by a pituitary problem. It will also tell me whether or not I have a deficiency in the other pituitary hormones. This way I can walk into that endo's office with a good understanding of what is and what is not occurring. He can't give me the run around.

I've got a headache for some reason. Going to lie down for a bit.

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.

Blood Work and Ultrasound--Done

I got the blood work done on Wednesday night. I got the ultrasound done this morning. She had me turn my head to the right, so she could do the left lobe. Just looked like gray stuff to me. With 1 really dark spot, but I don't even know where she was on my neck. It was probably the carotid artery.

This is what a normal thyroid ultrasound looks like...It's like another language.

When I was done, I told my husband it looked like a snail was in my neck. We both laughed. We'll probably get the results Monday (I'll be calling the doctors to give them a slight nudge). The blood work will definitely be done Monday. In fact it may have been ready today, but I didn't feel like bothering Dr. Goldstein. He's been really good to me recently. He's gone out of his way to make sure I get the appropriate tests done and I am very happy about that.

I was not going to get the ultrasound before the blood work came back, but I reconsidered. Even if my results were "normal" in the back of my mind I'd be wondering why it changed so rapidly. With the blood work and ultrasound we will know exactly what is going on or what is NOT going on. Possible goiter? Nodule? We will know soon.

2 days ago I did a LOT of singing. Since taking voice lessons, I've been trying to practice a lot. Getting better at hitting high notes with ease and being able to sing long phrases. Well I overdid it. Yesterday I woke up with a chest pain. It was really weird. It hurt when I exhaled, when I laughed and if I let my lungs get too empty. Today it is much better. I didn't sing AT ALL yesterday, which was hard for me. I sing all the time even without knowing. There is definitely still a little bit of pain, but way better. Obviously I pulled some sort of muscle in there! Leave it to me to pull a muscle in my chest.

New Bloodwork Results---Truly Unbelievable

I am sort of at a loss for words with these new blood work results. Something is just not right with me, but apparently no one knows...Right now I am pretty fuming, so please excuse any frustration in this post.

I actually got these results from Goldstein (I had the lab send them to him as well) because the other doctor's office I went to is NOT cooperating with me. I contacted them on Monday with no call back. I called them, Tuesday and Wednesday too. Finally someone called me, but the message was NOT relayed to the doctor (about the lymph nodes in my groin) and my blood work was NEVER faxed to me. What is with doctor offices these days? My goodness, if the doctor had taken 1 look at my results, I think she would have called.

As a reminder I had the following tests done:
CBC (no differential)
Comprehensive Metabolic Panel (CMP)
T4
TSH
CMV IgG AB (Titres)
Sed Rate (ESR)

CBC-All of my blood counts were normal...Wow what an improvement from 2 weeks ago where my white blood cell counts were 3,800. They were 4,900 this time. Unbelievable! There is no differential, so I do not know what my neutrophils or eosinophils are this time around.

CMP-Showed elevated liver enzymes at 60. Specifically the ALT. Now they aren't THAT high, but what in the world is causing this? I use no OTC pain relievers and I don't drink.

T4-8.9 This is in the reference range.

TSH-This one actually made my jaw drop........ 0.01 WTF! Holy shite, I went from Goldstein saying I may have slight hypothyroidism to super crazy hyperthyroidism? Or maybe it is my pituitary? I haven't taken iodine for about 4 weeks and I was only taking 1 tab a day. Even Goldstein says this amount is completely healthy and normal to take. The people in Japan consume more iodine than this in a single day... Once again, complete loss for words. What makes NO SENSE is that my T4 is normal. In true hyperthyroidism, T4 should be elevated too. I am thinking my pituitary has finally called it quits.

CMV Titres-No active CMV which includes EBV! Yay! This made me so happy. I am at 0.91 which is 0.01 away from saying I am completely NEGATIVE for antibodies. The fact that I had EBV and it is showing this low is amazing to me.

Potassium- Low at 3.5 What the hell is wrong with me. Why is my potassium always low...damnit I have made it a mission to get this higher too with NO luck whatsoever.

Sed Rate- Normal at 3. Range is 0-20.


Now I have no idea what is going on with me. /sigh These results truly make me even more frustrated and confused as to what's up. I may call Goldstein tomorrow to see if he'll look at these for me. The thyroid numbers are totally jacked. I may need to start taking Armour at this rate.

Complete Break From Detoxing

If you are following my blog, I bet most of you have already assumed this. However, I am taking a complete break from all detoxing until everything else can be either ruled out or diagnosed. A little part of me is "missing" the detox, but my body needs a long break. I'll never know if the mild neutropenia was caused by the DMSA.

I now recommend everyone to get a full blood workup before starting the Cutler detox. You should have kidney, liver, thyroid and adrenal function checked, and a CBC with differential. Adrenal function is usually better tested with a saliva test. This way you have a good starting point. If you never get these done and then 3 months into the detox, your liver starts acting up, you won't know what caused what and may quit the detox indefinitely. Sometimes the liver, kidneys are working at just enough pace that they don't cause you problems until it is stressed more than normal. Detox is stress no matter how "gentle" of an approach you take.

This week I will be calling my doctor (today actually) to see what the results of the blood work were and where we go from here. I will definitely get them faxed over to me as well. I'd like to see an ENT to have him/her check my lymph nodes out. This is what they do on a regular basis, so they will have a better feel (pun intended) of what the lymph nodes should look like. I would like to have my groin lymph nodes examined too, but I don't think an ENT would do that.

/sigh
All of this is so frustrating!

First Labs Came Today

Well I got the first labs today in the mail from Goldstein. Thank you Goldstein!

There is some interesting things on here that honestly concern me even more...I have noticed that the lab references are a lot different at this new place. Some results say things are "normal" because the lab ranges are WAY too big. In other instances, the lab references seem too short. I don't understand why there could be such huge difference.

I've converted some of the numbers so that the numbers from the government site(s) match the numbers here.

WBC is 3,800 wbc/mcL Pretty Low
Neutrophil # 1.38 Very Low
Neutrophil % 36.9 Very Low
Eosinophil # 400 cell/mcL High
Eosinophil % 9.3 Very High

I have mild neutropenia which slightly increases your risk of infection. Is this from the DMSA? I must be very careful about who I am around and where I go. My body also has low WBC, so if I get some sort of illness I could find myself in the hospital. High eosinophils usually mean allergies, but I have had elevated eosinophils for over a year.

None of the doctors ever seem concerned including Goldstein. If he would have looked on my prior CBC's that I brought to him, he would see that it's ALWAYS been high. He put some notes on my paper saying that the rashes are from an allergic reaction.

Rather than give Butler Hospital's lab references which seem really outdated, I'll give you what our government recognizes as normal. (Oh my, I can't believe I'm looking at a .gov site for accuracy LOL. Remember this day because it will be the last!)

• WBC normal references-4,500-10,000 white blood cells/mcL (cells per microliter) Some places say 3,500-10,000. I don't understand how there is such a huge difference.
  
• Eosinophil normal count references-Less than 350 cells/mcL (cells per microliter)
• Neutrophil normal count references-varies by website-Greater than ~1.50-7.50X10 9th power.
  
• Eosinophil % references-varies by website-One range says 0-3%, another says 0-6%
  
• Neutrophil % references-45%-70% of WBC
  

The previous lab showed I was low on their range when my WBC was 4,600. While this hospital says 3,800 is normal! Talk about a huge difference! Which one is right?

I guess I will call the doctor and forward these to her. Then she can compare them to the one I just had drawn the other day when those results come in.