25yrs, 5 labs, pre endo please help :)

[fritzer]

Just got another (5th) blood panel in mail today haha. going to see endo tuesday. I am seeing some things that trouble me, prolactin going normal to high in cycles (leaky nips), low T going up and down, and the last thing is the low DHEA and high cortisol. Please give me your input on what treatment Rx the doctor should do and why (medically/scientifically)

would like to arm myself with some knowledge and know whether he is a good/bad doctor for me. will talk to him about conferring with crisler.

not overweight, was 230lbs, 8%, 6'5... maybe fatter/lazier now. but great diet, etc. high fiber. but going to look closely to eat very low GI, etc etc to correct the insulin. Past septic shock and mumps 3yrs ago. had leaky nips last year and had breast gland removed earlier this year.

some of you have commented before on my testosterone tests, thank you. After the 5 sets of tests I would like opinions and some whys, rxs, etc. thanks so much :blushing:

Red= Out of Range
Blue = I'm Worried

Fasting Glucose (mmol/l)[3.4-5.4]--> (1) 5.1 (2) 5.3 (3) 4.8
Fasting Insulin(ug/L)[<10] --> 1) 27

2Hr Glucose Tolerance Test
Start- Glucose 4.8 Insulin 15
1Hr- Glucose 7.8 Insulin 89
2Hr- Glucose 1.9 Insulin 14

Fasting Insulin (3) (pmol/L)[<120] --> 41 ??-normal 2 weeks later - ??

HbA1c--> 5.1 %

Magnesium (mmol/L)[0.65-1.05]--> 0.85
Serum Ferritin (ug/L)[20-300]: --> 232
Calcium (mmol/L)[2.10-2.55] --> 2.43
Vitamin B12 (pmol/L)[180-740]--> 622
Folate (nmol/L)[>7.6] --> 33.3
Vitamin D (nmol/L)[50-200] --> 57

Full Blood Count: All Good
Liver Values: All Good but a raised ALT on three tests.
Albumin (g/L)[33-48] --> 1) 46 2) 44
Alkaline Phosphatase (U/L)[30-130] --> 87

CRP (mg/L)[0.0-8.3] --> 6.3

TSH (mIU/L)[0.4-3.50] --> (1) 1.63 (2) 1.9 (3) 1.6 (4) 1.99
Free T3 (pmol/L)[2.7-5.7] --> (1) 5.8 (2) 4.2 (3) 5.9
Free T4 (pmol/L)[10-20] --> (1) 17 (2) 11.1 (3) 18

Progesterone (nmol/L)[0-3.0] --> 1.1
Cortisol (nmol/L)[120-580] --> (1) 595 (2) 532 (3) 644
DHEA-S (umol/L)[2.2-15] --> (1) 3.3 (2) 2.9
start of adrenal fatigue?

Estradiol (pmol/L)[<160] --> (1) 106 (2) 51 ??? huge drop ???

LH (U/L)[2-10] --> (1) 6.1 (2) 4.1
FSH (U/L)[1.5-13] --> (1) 2.4 (2) 2.0

Testosterone (nmol/L)[11.5-35] --> (1) 6.4 (2) 7.9 (3) 8.9 (4) 8.2 5) new range [8.0-29] 10.3 ???- am i normal now ???
ranges are men 16-150 years old

Free Testosterone with test 2 (pmol/L)[20-120]: 27.1

SHBG (nmol/L)[15-50] --> (1) 11 (2) 12 (3) 15.1 (4) 25 ??- what is happening, insulin + shbg going normal- ???

Prolactin (1) (mIU/L)[85-500] --> 133
Prolactin (2) (ng/mL)[2.0-16.0] --> 13.5
Prolactin (3) (ug/L)[0-15] --> 21

 

[The Matrix]

Just got another (5th) blood panel in mail today haha. going to see endo tuesday. I am seeing some things that trouble me, prolactin going normal to high in cycles (leaky nips), low T going up and down, and the last thing is the low DHEA and high cortisol. Please give me your input on what treatment Rx the doctor should do and why (medically/scientifically)

would like to arm myself with some knowledge and know whether he is a good/bad doctor for me. will talk to him about conferring with crisler.

not overweight, was 230lbs, 8%, 6'5... maybe fatter/lazier now. but great diet, etc. high fiber. but going to look closely to eat very low GI, etc etc to correct the insulin. Past septic shock and mumps 3yrs ago. had leaky nips last year and had breast gland removed earlier this year.

some of you have commented before on my testosterone tests, thank you. After the 5 sets of tests I would like opinions and some whys, rxs, etc. thanks so much :blushing:

Red= Out of Range
Blue = I'm Worried

Fasting Glucose (mmol/l)[3.4-5.4]--> (1) 5.1 (2) 5.3 (3) 4.8
Fasting Insulin(ug/L)[<10] --> 1) 27

2Hr Glucose Tolerance Test
Start- Glucose 4.8 Insulin 15
1Hr- Glucose 7.8 Insulin 89
2Hr- Glucose 1.9 Insulin 14

Fasting Insulin (3) (pmol/L)[<120] --> 41 ??-normal 2 weeks later - ??

HbA1c--> 5.1 %

Magnesium (mmol/L)[0.65-1.05]--> 0.85
Serum Ferritin (ug/L)[20-300]: --> 232
Calcium (mmol/L)[2.10-2.55] --> 2.43
Vitamin B12 (pmol/L)[180-740]--> 622
Folate (nmol/L)[>7.6] --> 33.3
Vitamin D (nmol/L)[50-200] --> 57

Full Blood Count: All Good
Liver Values: All Good but a raised ALT on three tests.
Albumin (g/L)[33-48] --> 1) 46 2) 44
Alkaline Phosphatase (U/L)[30-130] --> 87

CRP (mg/L)[0.0-8.3] --> 6.3

TSH (mIU/L)[0.4-3.50] --> (1) 1.63 (2) 1.9 (3) 1.6 (4) 1.99
Free T3 (pmol/L)[2.7-5.7] --> (1) 5.8 (2) 4.2 (3) 5.9
Free T4 (pmol/L)[10-20] --> (1) 17 (2) 11.1 (3) 18

Progesterone (nmol/L)[0-3.0] --> 1.1
Cortisol (nmol/L)[120-580] --> (1) 595 (2) 532 (3) 644
DHEA-S (umol/L)[2.2-15] --> (1) 3.3 (2) 2.9
start of adrenal fatigue?

Estradiol (pmol/L)[<160] --> (1) 106 (2) 51 ??? huge drop ???

LH (U/L)[2-10] --> (1) 6.1 (2) 4.1
FSH (U/L)[1.5-13] --> (1) 2.4 (2) 2.0

Testosterone (nmol/L)[11.5-35] --> (1) 6.4 (2) 7.9 (3) 8.9 (4) 8.2 5) new range [8.0-29] 10.3 ???- am i normal now ???
ranges are men 16-150 years old

Free Testosterone with test 2 (pmol/L)[20-120]: 27.1

SHBG (nmol/L)[15-50] --> (1) 11 (2) 12 (3) 15.1 (4) 25 ??- what is happening, insulin + shbg going normal- ???

Prolactin (1) (mIU/L)[85-500] --> 133
Prolactin (2) (ng/mL)[2.0-16.0] --> 13.5
Prolactin (3) (ug/L)[0-15] --> 21

I get checked for sleep apnea, Since improper sleep patterns can affect insulin function
You fall into category of metabolic syndrome which may be highly linked to thyroid, adrenal, e2, and or testosterone imbalances.

One may also look for heavy metals as well such as mercury from fillings and even lyme disease..

 

[fritzer]

igf-1 i normal\no sleep apnoea

 

[fritzer]

#1: if you were my endo what Rx would you do and why?


just in:
IGF-1 (nmol/L)[17-42] --> 33
ACTH (pmol/L)[0-12] --> 6.5

 

[weierstrass]

#1: if you were my endo what Rx would you do and why?


just in:
IGF-1 (nmol/L)[17-42] --> 33
ACTH (pmol/L)[0-12] --> 6.5

If I were your endo, I would tell you that everything looks normal, tell you that I want to recheck your levels in a few months, offer you some depression medication, take your money, and drive off in my Lexus. Why you ask? Because I'm an endocrinologist and that's what I do.

If I wasn't an endo, I would prescribe testosterone, preparation of your choose, based on your borderline low free testosterone and symptoms, along with HCG to prevent testicular atrophy. I would then refer you to a good gastroenterologist to check your liver. The hyperinsulinemia and high ALT/AST ratio is indicative of liver disease.

If you did have a problem with your liver, it would explain your low free testosterone and the gyno you experienced. Gyno is a very common occurrence among men with liver disease. Some doctors believe it is due to a low free testosterone to free estradiol ratio, but there is contradictory evidence (e.g. estradiol is not usually elevated in liver disease). However, the feminization liver disease patients experience resolves itself upon testosterone administration. Have you been experiencing an other sort of feminization. Are you carrying your fat around your hips, thighs? Do you have cellulite?

The last thing that needs to be addressed is your prolactin levels. Something is going on there. I would run one more prolactin test and see what shows up.

Don't worry about your cortisol levels. I'm guessing the cortisol test was a blood draw and not urine or saliva. If so, it is practically worthless except in the extreme cases. The only true way to tell is urine or saliva.

Good luck and don't get too upset when the endo does what I described above. Hopefully, you'll be one of the lucky few and find a decent caring doctor.

 

[fritzer]

ALT was 59 (8-40) and 108 (1-60)

- sometimes i take benedryl (2 times a week, 100mg) to sleep if it is important, could that do it?

-i store fat in belly and love handles, but because of high thyroid i miss a meal or two and it goes really fast

-Feminine symptoms were my previous gyno, and leaky nipples sometimes on and off



What do you think about cortisol constantly being high and causing increase glucose in the blood = increase insulin secretion = insulin resistance over time
just something i thought might be it

 

[weierstrass]

ALT was 59 (8-40) and 108 (1-60)

- sometimes i take benedryl (2 times a week, 100mg) to sleep if it is important, could that do it?

-i store fat in belly and love handles, but because of high thyroid i miss a meal or two and it goes really fast

-Feminine symptoms were my previous gyno, and leaky nipples sometimes on and off



What do you think about cortisol constantly being high and causing increase glucose in the blood = increase insulin secretion = insulin resistance over time
just something i thought might be it

You really have no way of telling if cortisol is a problem or not without first having a urine or saliva test. Right now, you have no idea what your cortisol levels are like. Tell the doctor that you would like to rule out Cushing's disease with a urine test since your cortisol serum came back high.

Unless you are taking very very very large doses of benedryl each night, it is not the cause of your high ALT's. There is something else going on with your liver. You really need to see a good gastroenterologist/hepatologist to see what is the cause. There are some minor things that could be the problem (fatty liver), and there are some not so minor illnesses as well (autoimmune hepatitis). Do you have a history of autoimmune problems or does it run in your family? Anybody with liver problems or strange ailments? Have you ever had your copper levels checked?

 

[fritzer]

yeah grandpa addisons, mom grave's.
no liver history though. I will talk to my endo about this... that i want cortisol saliva x3, urinary estradiol, urinary GH, and more liver tests... if high again = gastro

 

[bomb402]

Get your liver checked out - those numbers are no joke.