Aa
stomach pain
i was originally diagnosed with central hypothyroidism and secondary adrenal insufficiency. i had low levels of both cortisol and ACTH--both almost at the bottom of the range----cortisol was 6.3--range 5-25 and ACTH was 9 range 6-58.cortisol was drawn, non-fasting at 10:25 in the morning. acth was drawn, also nonfasting at 11:52. since these were just screening tests, but looked suspicious because of how low they were, my endo ordered an ACTH stim test. i had a shot of kenalog in each heel a few days after my cortisol and ACTH were tested. 18 days later, i had the acth stim test done. my levels were:
baseline cortisol 2.4--range 5-25
baeline ACTH 5 --range 5-27
these levels were drawn at 8:10 am--and i was fasting. the lab recieved both samples at 8:12
after stimulation agent was injected, my first draw was at 8:50 and recieved in the lab at 8:52
my cortisol level was 9.5
the next draw was done at 9:20 and recieved at the lab at 9:24
my cortisol level was 11.6
the lab report read as follows:
Peak cortisol level greater than 20ug/d. Peak value is more important than incremental change. The incremental change may not be seen at times of stress, when the adrenal output of cortisol is already maximally stimulated by endogenous ACTH.
Dexamethasone suppression
Below basal values.
i loooked up the info on kenalog injections, most information talked about adrenal suppression being a possibility and needing to lower your levels gradually after being on it for an extended time--but i had only been given a one-time injection in each heel.
I finally found something that talked about one-time injections. it is said that it is usually short-lived in the body--but can last 30-40 days. My doctor said it was highly unlikely that the shots would have shut my adrenals down. obviously there is no way of knowing if it was out of my system in the shorter period of time or if it was in my system for the longer period of time. however, it does seem to make sence that even if it was in my system for the longer period of time, that the effects would be wearing down after 18 days and not staying at their full affect.
obviously, it would have been better, if we had known the possibility of it still being in my system, it would have been better to put the stim test off--but we can't change what was done. It was apparent that my cfortisol and ACTH were already low before the injections, which indicated a posible pituitary problem. The stim test, if correct, verified a pituitary problem.
I had a Free T4 and a TSH done before i was sent to the endocrinologist.
Free T4 was .87 with range of .71-1.85
TSH was .87 with range of .45-4.67
I was being tested because i needed carpal tunnel surgery and doc wanted to make sure that low thyroid or low B-12 was not causing the carpal tunnel symptoms. B-12 was flagged high at greater than 1000 with a range of 193-982.
My orthoped felt that my thyroid was too low, even though it was still in the normal range and told me to have my regular doc look at the test results. he took one look at it and said it was normal.
what neither doc noticed, was that BOTH the FreeT4 and the TSH were at the low end of normal---they did not catch that my TSH should have been at the high end of normal if my Free T4 was at the low end of normal---the first indication that i could possibly have a pituitary problem.
all of this was started in october of 2008--endo tested my free T3 at 2.7 with a range of 2.4-4.2. i was put on 30 mgs of armour thyroid in nov 2008. Follow up testing showed low DHEA, low testosterone,(both bioavailable and free) and i tested high for sex hormone binding globulin and over 1100 for estrogen.
obviously i was having multiple endocrine issues. i was put on 25 mgs DHEA and on testosterone cream. adrenal testing was not done until may and june of 2009 and i was put on 30 mgs of hydrocortisone after those tests came back low.
trying to make my already long story short, another endo decided my adrenals were shut down by the shots in my heels and pulled me off the HC---he did not make any note that he had seen that my ACTH and cortisol were both nearly bottomed out before i recieved the shots.( my armour had been raised to 60 mgs after i had been switched to levothyroxine and cytomel because of a shortage of armour--one doc didn't see that a low Free T4 and low TSH was a red flag and tried to normalize my TSH and i ended up with my thyroid too low--thus, the 60 mgs of armour when another doc picked up that my thyroid was too low.)
i am now completely off of hydrocortisone and for some reason my family doc took over filling my armour in october or 2011 and lowered it to 30 mgs--no one knows why--there is no reason in my medical file or any note about it at the pharmacy. i was not aware it had been lowered. however, for some reason, the month my thyroid was dropped and my cortisol was down to 5-10 mgs a day, i started getting the shakes and my heart was pounding, so i cut my thyroid in half for a month--then returned it to 30 mgs with no problems.
I am in the process of seeing a new doc and have already had a bunch of blood drawn for a bunch of tests--things that have never been tested before. however, i wake up and with the first deep breath i take i get a stabbing pain in my gut that really hurts. I had this pain while on HC for awhile, but it got better with a PPI. I am not taking any meds that should be hurting my stomach like this. it gets better after i have gotten up and eaten something, but i can't figure out what is causing it.
does this have anything to do with low thyroid or low cortisol?--or am i having another unrelated problem that should be checked out?
I'm really sorry about the long explaination--and i know that some of you have already heard most of my story--especially rumpled--but i had organized all my medical tests, doc visit reports,and pharmacy records, so i was able to find actual dates and draw times and test results--i thought it might help someone to be able to help me figure things out a little better. it is obvious that i have a complicated endocrine issue going on.
the new doc is testing my cortisol serum levels, my free cortisol and my cortisol binding globulin. he wanted to do a 24 hour urine cortisol, but because we are not located near a facitlity where it can be done easily, he decided to go with the other cortisol tests.
My emotions are all over the place and i have no desire to do anything, and not alot of energy--but i have alot of joint and muscle pain and i have trouble sleeping unless i drug myself with everything i think i can get away with.
i also did the axillary basal temps--i was 97.4, 97.2, 96.4 and another 97.2 or 4. too low to be normal.
i'm impressed if you got to the end of this---any thoughts?
baseline cortisol 2.4--range 5-25
baeline ACTH 5 --range 5-27
these levels were drawn at 8:10 am--and i was fasting. the lab recieved both samples at 8:12
after stimulation agent was injected, my first draw was at 8:50 and recieved in the lab at 8:52
my cortisol level was 9.5
the next draw was done at 9:20 and recieved at the lab at 9:24
my cortisol level was 11.6
the lab report read as follows:
Peak cortisol level greater than 20ug/d. Peak value is more important than incremental change. The incremental change may not be seen at times of stress, when the adrenal output of cortisol is already maximally stimulated by endogenous ACTH.
Dexamethasone suppression
Below basal values.
i loooked up the info on kenalog injections, most information talked about adrenal suppression being a possibility and needing to lower your levels gradually after being on it for an extended time--but i had only been given a one-time injection in each heel.
I finally found something that talked about one-time injections. it is said that it is usually short-lived in the body--but can last 30-40 days. My doctor said it was highly unlikely that the shots would have shut my adrenals down. obviously there is no way of knowing if it was out of my system in the shorter period of time or if it was in my system for the longer period of time. however, it does seem to make sence that even if it was in my system for the longer period of time, that the effects would be wearing down after 18 days and not staying at their full affect.
obviously, it would have been better, if we had known the possibility of it still being in my system, it would have been better to put the stim test off--but we can't change what was done. It was apparent that my cfortisol and ACTH were already low before the injections, which indicated a posible pituitary problem. The stim test, if correct, verified a pituitary problem.
I had a Free T4 and a TSH done before i was sent to the endocrinologist.
Free T4 was .87 with range of .71-1.85
TSH was .87 with range of .45-4.67
I was being tested because i needed carpal tunnel surgery and doc wanted to make sure that low thyroid or low B-12 was not causing the carpal tunnel symptoms. B-12 was flagged high at greater than 1000 with a range of 193-982.
My orthoped felt that my thyroid was too low, even though it was still in the normal range and told me to have my regular doc look at the test results. he took one look at it and said it was normal.
what neither doc noticed, was that BOTH the FreeT4 and the TSH were at the low end of normal---they did not catch that my TSH should have been at the high end of normal if my Free T4 was at the low end of normal---the first indication that i could possibly have a pituitary problem.
all of this was started in october of 2008--endo tested my free T3 at 2.7 with a range of 2.4-4.2. i was put on 30 mgs of armour thyroid in nov 2008. Follow up testing showed low DHEA, low testosterone,(both bioavailable and free) and i tested high for sex hormone binding globulin and over 1100 for estrogen.
obviously i was having multiple endocrine issues. i was put on 25 mgs DHEA and on testosterone cream. adrenal testing was not done until may and june of 2009 and i was put on 30 mgs of hydrocortisone after those tests came back low.
trying to make my already long story short, another endo decided my adrenals were shut down by the shots in my heels and pulled me off the HC---he did not make any note that he had seen that my ACTH and cortisol were both nearly bottomed out before i recieved the shots.( my armour had been raised to 60 mgs after i had been switched to levothyroxine and cytomel because of a shortage of armour--one doc didn't see that a low Free T4 and low TSH was a red flag and tried to normalize my TSH and i ended up with my thyroid too low--thus, the 60 mgs of armour when another doc picked up that my thyroid was too low.)
i am now completely off of hydrocortisone and for some reason my family doc took over filling my armour in october or 2011 and lowered it to 30 mgs--no one knows why--there is no reason in my medical file or any note about it at the pharmacy. i was not aware it had been lowered. however, for some reason, the month my thyroid was dropped and my cortisol was down to 5-10 mgs a day, i started getting the shakes and my heart was pounding, so i cut my thyroid in half for a month--then returned it to 30 mgs with no problems.
I am in the process of seeing a new doc and have already had a bunch of blood drawn for a bunch of tests--things that have never been tested before. however, i wake up and with the first deep breath i take i get a stabbing pain in my gut that really hurts. I had this pain while on HC for awhile, but it got better with a PPI. I am not taking any meds that should be hurting my stomach like this. it gets better after i have gotten up and eaten something, but i can't figure out what is causing it.
does this have anything to do with low thyroid or low cortisol?--or am i having another unrelated problem that should be checked out?
I'm really sorry about the long explaination--and i know that some of you have already heard most of my story--especially rumpled--but i had organized all my medical tests, doc visit reports,and pharmacy records, so i was able to find actual dates and draw times and test results--i thought it might help someone to be able to help me figure things out a little better. it is obvious that i have a complicated endocrine issue going on.
the new doc is testing my cortisol serum levels, my free cortisol and my cortisol binding globulin. he wanted to do a 24 hour urine cortisol, but because we are not located near a facitlity where it can be done easily, he decided to go with the other cortisol tests.
My emotions are all over the place and i have no desire to do anything, and not alot of energy--but i have alot of joint and muscle pain and i have trouble sleeping unless i drug myself with everything i think i can get away with.
i also did the axillary basal temps--i was 97.4, 97.2, 96.4 and another 97.2 or 4. too low to be normal.
i'm impressed if you got to the end of this---any thoughts?
I don't know which one he ordered--but i called yesterday to see if maybe i should ask the doc if i can use a regular collection jug and she said she had checked and it has to be the one with the boric acid wash--I've never done this before, so i don't know anything about it---i just can't figure out why it is taking so long to get the stupid thing shipped here. when they had to order the tubes they came in alot faster.
do you have a locallab you take your samples to? i wonder if i have to have the collection jug with boric acid because mine has to be shipped to a lab in oregon--we don't have anyplace local.
my joints are hurting me so bad--i am taking mobic 2X a day and it is not improving this time. i don't know if it is weather changes or low thyroid and cortisol problems--i just know i hurt all over. i tried to work outside theother day when it was warm, but i was hurting in places that don't even normally hurt---my ankles, my pinky, my wrist and hand bones are really hurting on the right side. i am gettting this pain really deep inside my hip joint, it will make my leg ache on down the thigh sometimes. i wonder if this could be a sciatic nerve problem. it hurts alot when i bend over right in the crease where my leg bends in the back. i don't usually have this many joints hurting at once.
my joints are hurting me so bad--i am taking mobic 2X a day and it is not improving this time. i don't know if it is weather changes or low thyroid and cortisol problems--i just know i hurt all over. i tried to work outside theother day when it was warm, but i was hurting in places that don't even normally hurt---my ankles, my pinky, my wrist and hand bones are really hurting on the right side. i am gettting this pain really deep inside my hip joint, it will make my leg ache on down the thigh sometimes. i wonder if this could be a sciatic nerve problem. it hurts alot when i bend over right in the crease where my leg bends in the back. i don't usually have this many joints hurting at once.
Yes, I go to the local lab. Even when I mailed in my samples to Texas, I froze them. No preservative. I have done other tests in a plain jug (I keep a supply at home - how sad is that) and they add the preservative if they need it... The acid comes in a little bottle. I am such an experienced lab rat. Add it, shake it and done. They only take a small sample of the jug anyway - they typically will not ship the jug - just a small representative sample - that is why people who do multiple jugs have to make sure they mix all the jugs together before they take the sample and not just sample one jug (lab error!).
The weather changes always hurt me.
The weather changes always hurt me.
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