Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Thyroid/Adrenal/Pituitary
About This Forum:

Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Thyroid/Adrenal/Pituitary

I have all the symptoms of hypothyroidism:  gaining weight, losing hair, tired, cold, dry skin, etc.  I have seen 3 endos and thyroid values are in the normal range (TSH 2.382; total T3 130; total T4 6.9).  Thyroid peroxidase is 178.3 / thyroglobulin antibody 129.1 so am taking Armour Thyroid (1.5 grains) daily.  This is having no effect on my symptoms.  Interestingly, when I get extremely stressed (fight or flight) (only happened twice in my life), I start dropping weight & fluid & feel much better, despite eating & exercising the same.  Last time this occurred was 2001 when I lost 18 lbs. When the stress leaves, the weight comes back, despite eating and exercising the same.  I am now up to 146 lbs. and gaining.  I do not eat enough to maintain my weight and I exercise and am generally very active.  

ACTH stim test - I’ve read from reputable source:  “. . . many patients with secondary adrenal insufficiency are missed because most doctors see doubling or more from a low base cortisol value with low ACTH being okay or even great, not recognizing this indicates low ACTH production.”  I have also read regarding baseline values, “A healthy ACTH value should be just into the upper third of the range (assuming a range of 10-60).”    My baseline ACTH was 7.  My baseline cortisol was 16.7 and on the test, and a little more than doubled during the course of an hour.  Doesn't this indicate a pituitary or hypothalamus problem?

DHEA is high, baseline 687.  Endo did dexamethasone suppression test -  pushed my ACTH to <5 and cortisol 1.0L, abnormally low according to the range. Put on .25 mg of Dexamethasone, but once DHEA was 1041, on Dexamethasone.  Two endos told me to get off of it if it wasn’t helping prevent hair loss so I am not taking it now.  

Should I see yet another endo?  I know I've got a big problem, but no one seems to want to run it down.  This problem has taken the joy out of life for me.  
Related Discussions
97953_tn?1193367871
ACTH stim was completely normal -- not adrenal insufficiency in my mind, but discuss with your endo.  And the dex supp test was normal -- so not Cushings.

The TSH is in the target range for hypothyroid treatment, so at this point, may need to consider that the symptoms may not be due to thyroid.  The symptoms of hypothyroidism have many other causes.  Once the endocrine work-up is complete (which it may be), then a general internal medicine re-evaluation may be necessary.
Blank
Continue discussion Blank
This Forum's Experts
97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
This is Driving Your Emotional Eati...
Jul 02 by Roger Gould, M.D.Blank
5856747_tn?1403352282
Blank
Sleep Apnoea
Jun 28 by Andrew John Rynne, MDBlank