I am 28 years old with severe fatigue. I have high blood pressure as well and take 20mg of lisinopril per day, and have sleep apnea and sleep with a CPAP machine nightly. I was re-titrated in January at 6.0 pressure. I went to my primary care Doctor in January. 2009.
Calcium - 10.3 mg/dl
vitamin D - 14 ng/ml
I was put on vitamin B12 shots, and continue those monthly now, and also was given a weekly vitamin D prescription for 50,000 IU's per week.
My Doctor next texted ionized calcium, and that came back normal. The Doctor then re-ran calcium, and PTH, and calcium was 9.8 this time, with a PTH at 37 pg/ml.
She then tested total testosterone which came back as 225 ng/dl. She ordered an MRI of my brain as well, and that came back as normal.
My Doctor referred me to an endocrinologist.
He ordered a 24 hour urine calcium test which came back at 223 mg/day which he said was normal.
He also tested:
aldosterone - 5.9 ng/dl
renin - 24.5 ng/ml/hr
Plasma metanephrines normal
A.M. testosterone 219 ng/dl
LH 3.8 mIU/ml
FSH 3.6 mIU/ml
I have absolutely no signs or symptoms of low testosterone.
Next, my endo ordered:
Calcium, PTH, and vitamin D again, (after completing my Vitamin D therapy) total serum estrogen, and FSH, LH and prolactin.
Calcium - 9.8 mg/dl
PTH - 25 pg/ml
Vitamin D - 23/ng/ml
total serum estrogen - 133 pg/ml which he said was a bit high...
FHS, LH and prolactin levels were all normal.
I just talked with him again following another round of testing. He said that the total testosterone level is still low, but that the protein that binds the testosterone is also low so he is not concerned about my low total testosterone. My estrodial is slightly elevated.
Basically, he has said at this point that he does not know what is causing my fatigue.
Can you help? Can you see anything here, or suggest anything additionally that I need to try or look for? Thank you in advance... I am really, really frustrated.