Hello there.
I was wondering if anyone can help. Sorry there is alot of lab information here
This close friend has had the same issues as me in the past . Chronic side effects from medications.
So at first she saw a doctor for the first time in years, that would do some blood testing and said everything was normal (which of course was not). The doctor also only did TSH and free T4 so we are getting a full profile done. (TSH was 0.58 low and free T4 was 1.2 (0.9-1.8) pretty meaning less. (so we are getting a full thyroid profile done).
With everything we have not rested so far.
She has the MTHFR C677T reduced enzyme activity genotype.
Anyway Blood tests.
RBC 4.66 M/uL (range 3.8-5.2) (optimal 4.0-4.5) ( a little high but OK)
MVC 90 fL (range 80-95) Good
HGB 14.4 g/DL (range 11.7 - 15.5) Good
MCH 31 pg (range 26-34) Good
MCHC 34 g/dl (range 31-36) Good
Platelet Count 375 (range 140-440 K/uL) Good
RDW 12.2% (range 10-15.5%) Good
drkaslow.com/html/blood_cel...
Sodium 139 mmol/ml (range 133-145 mmol/ml) Optimal 142 (a little low but Good)?
Potassium 4.1 mmol/ml (range 3.5-5.5) Optimal 4.2 or higher (a little low but Good)
Calcium 9.4 mg.DL (range 8.4-10.6) Good
Creatinine 0.6 (0.5 - 1.2) BUN 8 (6.22) ALT 26 (5-40) AST 24 (10-37) Kidneys and Liver Good
Previous tests Liver was a little high but have come back to normal.
MORE IMPORTANT TESTS
These tests were done. Symptoms of high anxiety (we both have had/are having akathisia reaction which is anxiety on steroids), No menstrual cycle, Menorrhagia (heavy menstrual bleeding)
BLOOD
Cholesterol 171 (110-200 mg/dl) Good
HDL 43 (40-59 mg/dl) OK
LDL 82 (50-99 mg/dl) OK
VLDL 45 (8-30 mg/dl) HIGH
Triglyceride 227 (40-149 mg/dl) HIGH
Hemoglobin A1C 4.8% (4.8-5.7) Borderline Low - Not diabetic
Average Glucose 90 (91-123 mg/dl) LOW (suspicious!)
17 OH Progesterone 25 ng/dl (no range) OK But oddly Low reading
DHEA-S 652.6 mg/ml (84.8-378.0) VERY HIGH
Estradiol 29 ng/dl (no range) VERY LOW
Testosterone 62 ng/dll (3-41) HIGH
FSH mIU/ml 6.0
LH mIU/ml 6.9
Good but not ovalating properly and had an Overary Cyst 6 months ago.
Prolactin 18.1 (4.8-23.3 mg/ml) Good
TSH 0.58 (0.27-4.2)
Free T4 1.2ng/ml (0.9-1.8)
OK So I suspected Adrenal Fatigue, Hypothyroidism of so sort and we both suspected POCS.
So I ordered the saliva test, we have ordered a thorough thyroid test, and we ordered a glucose fastening test (and B12 as for some reason this was not on the thyroid test)>
Estradiol is lower than the optimal range (1.5-3.3) expected for a young premenopausal woman. Low estradiol is common with anovulatorycycles and irregular menstrual cycles. Progesterone is low consistent with anovulatory cycles and/or a luteal phase deficiency. Low progesterone contributes to estrogen dominance symptoms (e.g., mood swings, fibrocystic breast changes and breast tenderness, water retention, and weight gain) as well as to estrogen imbalance symptoms (e.g., hot flashes, night sweats). Therapies that support and induce ovulation would likely be beneficial (i.e. cyclic progesterone, Vitex agnus castus).
Testosterone is within normal range but symptoms are more characteristic of HIGH androgens. Testosterone at normal levels is often moreandrogenic (increases acne and facial/body hair) when estrogens or progesterone are low as both have anti-androgenic properties (note that patient is premenopausal and estrogen and progesterone are lower than expected for luteal phase of the menstrual cycle). Consider other hormonal imbalances that may contribute to low levels of estradiol and progesterone (low thyroid, high cortisol, recent use of contraceptives).
DHEAS is high-normal for the expected age range High DHEAS may be associated with high androgen symptoms (loss of scalp hair, increased facial/body hair, acne).
Cortisol is within normal range in the morning and at noon, but rises to a high level in the evening and high-normal at night. Higher evening/nightcortisol indicates either some form of adrenal stressor(s) that is increasing adrenal gland synthesis of cortisol or supplementation with a glucocorticoid (eg. hydrocortisone used as an anti-inflammatory or some other cortisol analogue used for treating allergies or asthma) or adrenal adaptogen that increases adrenal cortisol synthesis (eg. herbal medications such as licorice or ginseng), The most common stressors include: psychological stressors (emotional), physical insults (injury, pain, diseases), chemical exposure (environmental pollutants, excessive medications), hypoglycemia (low blood sugar), and pathogenic infections (bacterial, viral, fungal). Acute situational stressors (e.g., anxiety over unresolved situations, coming home from work to a stressful situation.) can also result in a transient increase in evening/night cortisol levels, which is a normal response to the stressor. Chronic high evening/night cortisol is commonly associated with sleep disturbances, fatigue, depression, weight gain in the waist, bone loss, and anxiety. This condition can also impair the actions of other hormones such as insulin and thyroid, causing symptoms of their deficiency, even though the levels of these hormones may be within normal range (i.e., insulin resistance and thyroid deficiency).
Suspicion of Insulin Resistance???
So we did a Glucose Fasting Test.
11.5 uIU/mL )fasting. Fasting: 2.0-19.6
154 uIU/mL after 30 minutes. 30 Minutes Post Glucose: 6.0-86.0
60 Minutes Post Glucose: 8.0-112.0
90 Minutes Post Glucose: 5.0-68.0
VITAMIN B12
466 (pg/mL) Range: 200-1100
OK after all this i am now pretty convinced we have a PCOS issue with Insulin Resistance, Adrenal Fatigue (phase 6 now 3D) and a Thyroid issue, the new panel will tell us everything.
Insulin Resistance test fail. I am not keen on Metformin especially as the Vitamin B12 is lower and needs supplimenting maybe with methyl folate or 5-MTHF not Folic acid anyway.
However I have read and seen alot of good things for POCS with Myo-nositol and D-chiro-inositol. Again only i have heard and read but not experienced is 2000mg Myo-inositol with 50mg of D-chiro-inositol, or even just 500mg of D-chiro-inositol to begin with. I think adrenal support wiill help here too?
Any other suggestions would be most welcome here.
I did the adrenal fatigue Dr Peatfield protocol years ago, as I too had low cortisol with high testeterone and DHEA but being male (and maybe ignorant) didnt bother with the others.
Still I found 20mg a day with hydrocoritsol worked really well before starting on NDT thyroid (Take 2 grains in summer 3 grains in winter).
But we might as well start treatment now (as the thyroid results will take a couple of weeks at least anyway), but I was just wondering based on the results above what you would do?? Any suggestions??
If you think Cortef is a good idea here (can someone PM me where to get it in the States. I know where to get it here but oddly enough comes from the States and wont deliver domestically). Is the newer Ortho Molecular Products Adren-All Capsules any good? They contain a good mix of Bovine adrenal 220mg, as well as They both have Vitamin A, Vitamin C,Vitamin E,Niacin,Vitamin B6, Vitamin B12 and Pantothenic Acid. They both have Eleuthero root, Rhodiola Root, Schizandra Berry Extract and licorice Root Or Adrenavive iii, Or is this not strong enough and hydrocotrisol is needed (which would be my prefered option unless we cannot get it.
I am never sure about Progesterones and oestrogens as they can be addictive, which is why it can be very difficult for some women to stop their prescriptions, but I could be over reacting here, or is that needed here despite DHEA-s and testosterone being high
Then we could introduce the thyroid (depending on the results 2 to 3 months time.
Sorry for the long post and thanks for your help.
Russ
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