Diagnosis of PCOS without an ultrasound is not... sound. I would say that it is not valid.
Twitching is another issue and requires different tests. It is not part of a pituitary tumor - that is neuro-muscular. But no doc looks at an eye twitch and sees anything. They see a tic. Sorry. You will just get BFD - benign fasculations disease unless testing shows something else. I hope it is just that.
Let us know what Dr. Swift says.
Yeah I don't understand how he say that I have PCOS and didn't do an ultrasound. I don't understand how every year just about I was tested for PCOS, Im not saying that I don't got it but I am not ready to rule out Cushings along with it. He also stated before that my tumor was not the cause of my left eye twitching which I think is bull...the eye is not the only thing that twitch my arms, legs and now my upper lip and upper part of my nose between my eyes. It don't take a Dr to tell me that my muscle twitches is not normal. Only other test that he order after he got my labs was the suppression test. Unfortunley, being in the military going to another Dr is not as easy as it is for the civilians. He told me that I will still be deploying and I leave in November. I will be gone at least 12 to 18 months which means that I will have to wait to I get back to the states, before getting a second opinion. Which really *****, so now I am deploying worrying about my life in more than one way.So now I am just going to how to lean and depend on God for my health and safety while deployed. I go back to the Dr tomorrow so I will give you an update of what he says. I can't lie...I wouldn't mind having some more of that dexa stuff because everyday all day with headaches was killing me. I will post again tomorrow and let you know what Dr Stupid says
Yes, he is using the dexa test to say you are a-ok!
The PCOS thing is bogus. I happened to have PCOS AND Cushing's (nice, not) so even so, one does not rule out the other, and the guideline for PCOS do say that one must rule out Cushing's which he feels that he has done (in reality, he has not) with the dexa test.
My opinion, for what it is worth, is to take your tests and zip on over to another doctor who knows what they are doing. Is that an option?
You feel better as dex lasts a long time - the steroids are making you feel good. BTW, when it wears off, you may feel worse... sorry!
With the large amount of urine, did he want to test for ADH, or anything along those lines - are you always thirsty?
Yes the range was the 4.0 - 50.0 and I tested at 62.4. Another thing that puzzle me is the amount of urine that I collected (tv=2600). But I don't understand how he can say that I have PCOS and have not did one ultrasound. I got my somatodedin test results today and it was 301 (range 138-410). I really don't believe that he will be truthful with me so that is why I went and got the my lab results myself. What do I need to ask him? Why is it that after the dexamethasone test did my headaches decrease greatly...not understanding the test and pill but I am glad that I have had very few headaches this week. However I know that it should not be use to confirm cushing's (I think just the location or something like that) I got this gut feeling that he is going to use the dexa test to say that I don't have it and I believe the magic number is 1.8 and mine was 1.1 so if it was supress it was not by much.
You did not give ranges, so it is hard to tell exactly what is going on... but UFCs usually cut off at 34 or 50 in most labs in the US.
Yes, your doctor is ignoring you because he thinks the dex suppression test is a test of exclusion, in other words, since you got a 1.1 after taking dex that he can safely rule out Cushing's. He is wrong as he is not an expert. I forget what the magic # is but what it really means is that it is pituitary source.
This is from an endocrinology book - and in reality - 98% of my Cushie buds, suppressed and had it. It was the docs that were not reading the test and the patient correctly. No test is perfect.
" 1. Background
1. Two stage testing described below will miss cases
2. The low dose (1 mg) test is not adequately sensitive
2. Indications: Cushing's Disease Screening
1. Second line test
2. Start with 24-hour Urinary free cortisol level
3. Mechanism
1. Test measures adrenal gland response to ACTH
2. ACTH should decrease in response to Dexamethasone
3. Decreased ACTH should result in decreased Cortisol
4. Failure for cortisol to suppress suggests 2 causes
1. Pituitary gland ACTH over-produced or
2. Adrenal gland cortisol over-produced
4. Protocol
1. Step 1: Draw Serum Cortisol at 4 pm on day 1
2. Step 2: Patient takes Dexamethasone 1 mg at 11 pm day 1
3. Step 3: Draw Serum Cortisol at 8-9 am on day 2
5. Interpretation (Based on Serum Cortisol on day 2, 8 am)
1. AM Serum Cortisol <5 mcg/dl (especially if 5 mcg/dl
1. Cushing's Disease
2. Repeating with Dexamethasone 8 mg determines site
1. Adrenal gland source will not suppress
2. Pituitary source will suppress "
Is it possible to have a non-hormone producing pituitary tumor and then have high testosterone levels.