lab results

[rrcat]

Total test 366 ( 241-827)
free test 17.5 ( 9.3- 26.5)
lh 2.3 ( 1.5- 9.3)
fsh 3.2 ( 1.4- 18.1)
dhea 190 ( 280- 640)

22 yr/old
I have social anxiety and get nervous easy. Still shy and timid at times. Is this due to the lack of hormones in my blood or do I just need an anxiety reliever?
Thanks for the help

 

[1cc]

I have social anxiety and get nervous easy. Still shy and timid at times. Is this due to the lack of hormones in my blood or do I just need an anxiety reliever?
Thanks for the help

This has definitely got to do with your inability to handle stress as a result of hormone problems. The problem is that once you end up with the anxiety disorder, it then becomes psychological as well. The way to cure this is to first fix your hormones so that you are physically healthy and able to handle stress. Once this is accomplished, then you will be in a position to deal with the psychological aspect, which would involve some counselling and systematic desensitization which you can do on your own.

Looking at your labs, and also your symptoms, it is obvious that you have adrenal insufficiency. In order to be certain, you would need to do an Adrenal Saliva test which you can get done at www.metametrix.com . Do the following test #0243 - Adrenal Stress (Cortisol and DHEA Only) at http://www.metametrix.com/TestServ/default.asp?PageID=21&TabID=25 . Tell them that you only want cortisol and not DHEA, and perhaps they can do it cheaper for you. The price for both is $125 last time I checked.

You DHEA is extremely low, especially for your age. DHEA plays a very important part in helping you cope with stress and giving you energy as well as controlling your blood sugar. It is very likely that you are hypoglycemic and have low blood pressure, is this correct? I suspect that your cortisol is low as well, which the Saliva Test will determine.

Another important test that you need to do is DHT (dihydrotestosterone). This hormone is responsible for male characteristics like aggression, forcefulness.

 

[rrcat]

cortisol- 11.3 ( 3.1-22.4)
glucose 77 ( 65-99)
dht- need to do ( probally low b/c I have very thick hair and little facial hair)

This test was done in the mourning where I felt as good as possible. I know I have adrenal fatigue and feel at times that I am hypoglycemic. My anxiety keeps the bp up. Any suggestions on what to do? Again, thank you guys for all the knowledge yall know.

 

[1cc]

cortisol- 11.3 ( 3.1-22.4)
glucose 77 ( 65-99)
dht- need to do ( probally low b/c I have very thick hair and little facial hair)

This test was done in the mourning where I felt as good as possible. I know I have adrenal fatigue and feel at times that I am hypoglycemic. My anxiety keeps the bp up. Any suggestions on what to do? Again, thank you guys for all the knowledge yall know.

Blood cortisol lab is not accurate - Saliva is the best to use for Cortisol, and they take it at 4 different times during the day so that you will know at what times your cortisol is low.
Get the book "Adrenal Fatigue: The 21st Century Stress Syndrome" by Dr. James Wilson. There is a questionnaire in the book that can be used for diagnosis as well. If you have Adrenal insufficiency, then most of your symptoms could be from that. The good news is that it is very easily treatable and you should start feeling better pretty quick. Low blood pressure is one of the main symptoms, so if your blood pressure is not low, then you definitely need to do the Saliva test to confirm. Taking DHEA will also help tremendously.

Once you get the results of Saliva test and DHT, then you can proceed further. Until then, there is not enough info.

 

[SPE]

--------------------------------------------------------------------------------

You are looking for acth in the upper third part of the range. Cortisol should be at least upper 20's at 8am. This is above the range, but the range is gotten from sick people. It's totally flawed toward the low end.

I can tell from am or pm if there is a problem if obvious enough. The best test to get is the acth stimulation test. This test is the last word on if you have adrenal insufficiency or not. You look for your cortisol value to double after the stim.

If primary AI, your stim won't double, it may go up some or not at all. If secondary, your stim can double, usually from a low number. If seen people report their stim started at 5 and went to 20 and the doc thought that meant the adrenals were superb. This is what happens to most secondaries, they double, triple or more from a low number. I saw one test that sextupled.

I was one that double from a low number and my endo kicked me out the door. Actually went from 10 to 19 (4pm) so didn't double. A few months later, a stim done by another doc at 10 am, started at 20 and went to 24. By then my adrenals had atrophied from lack of acth.

I have seen many people who were diagnosed secondary and then when they no longer were able to stim from the atrophy, the doc thought he made a mistake and diagnosis them as primary.

No matter what the doc says get mine and other opinions on those tests.

If AI then you need to stay away from caffeine.

You might want to get this book, easily gotten on EBAY.

Adrenal Fatigue The 21st century Stress Syndrome James L. Wilson
N.D.,D.C.,Ph.D. (I and others consider this book the bible for the adrenals. 350 pages. 16 pages on diet, 20 pages on Addison's. Everyone with an adrenal problem should have this book)

Chris.

I think you are fine with the cortisol serum test. As you can see by Chris's response to another thread, your cortisol is WAY too low for the am. Cortisol should be in the mid-upper 20's in the morning. Your results indicate adrenal insufficiency. I would recommend getting a serum ACTH and ACTH Stimulation test to further confrim. Chris, anything to add?

 

[rrcat]

I am also pissed about my total test. Reading on here I see that my test level should be twice as high than it is. Do you think my total test is lowered b/c my adrenals are not working or b/c I am not producing enough testosterone my adrenals get stressed more easily? Hopefully that makes sense. I'll go back and get dht and the acth checked. I might as well get e2 also. Anything else? I'll let you know asap. You guys are a real help.

 

[SPE]

Not sure about the relationship between low cortisol and low t. I'd be interested to know as well as I'm in the same boat. I did start TRT 7 months ago, but that only seemed to lower my cortisol more. Not fun when you are on thyroid meds as well.

 

[1cc]

I think you are fine with the cortisol serum test.

I had blood cortisol levels above the top of the range and yet when I did Saliva test it showed that my cortisol levels were low.

The following is from the book "Adrenal Fatigue: The 21st Century Stress Syndrome" by Dr. James Wilson page 83:

Regarding Saliva Cortisol testing:

"It is the best single lab test available for detecting adrenal fatigue and has several advantages over other lab tests in determining adrenal hormone levels."

For the rest of the passage, please read the book (it's too long to type).

 

[1cc]

I am also pissed about my total test. Reading on here I see that my test level should be twice as high than it is. Do you think my total test is lowered b/c my adrenals are not working or b/c I am not producing enough testosterone my adrenals get stressed more easily? Hopefully that makes sense. I'll go back and get dht and the acth checked. I might as well get e2 also. Anything else? I'll let you know asap. You guys are a real help.

You will have a heck of a time getting an endocrinologist to agree to do an ACTH challenge test. If you do the Saliva test, then you don't need to do the ACTH challenge test, and you'll be saving yourself a ton of time and aggravation. An ACTH challenge consists of the doctor taking a baseline cortisol blood sample, then injecting you with ACTH which is supposed to stimulate your Adrenals to produce cortisol, after 30 minutes he takes another blood sample which should show cortisol levels double what baseline was. This is done in the endocrinologists office, and they are not keen to do this type of thing from my experience.

When your endocrine system gets out of wack, the whole endocrine system is affected. So, it is possible that your low T could be because of bad thyroid function, or some other unbalanced endocrine problem. All of the hormones work together and complement each other. Testosterone plays a part in cortisol metabolism.

A few other tests you should do (also check swale's labs that he runs sticky for a comprehensive list):

Thyroid:
TSH
Free T3
Free T4

Adrenals:
DHEA
Cortisol (Saliva)

Testosterone:
Total T
Free T
DHT

Estradiol
Prolactin
IGF-1

 

[love_en]

Congratulations on taking the first step and demanding answers. Were you like this all of your life? I suffered with low T until the age of 33. Now I am reexamining the idea that my adrenal output is adequate. It falls within the reference range, but anyone who takes those as gospel has a paper suppository coming to them. Reference ranges are not derrived from healthy and vigorous individuals, those numbers are the highest and lowest values from people sick enough to get bloodwork done.

My total T was not far from yours, feel much better on 125mg enanthate per week. I am planning on getting at least the saliva cortisol test done. I have been told that even walking from the car into the lab to have blood drawn skews the numbers. 4 saliva samples taken when I am home sounds better. I have no hang-ups about being on prednisone and fludrocortisone if needed. As is, I inject myself with T once a week and HCG twice a week.
I wish you the best in finding a doctor who will take your poor health seriously.

I do not wish for the return of the "good old days". But I have personal experience with doctors playing with symptom masking drugs instead of getting to the bottom of their patient's suffering. It is all too easy to send you on your way with an antidepressant and a Viagra.

 

[Chrisgj2]

Good job SPE. Yes, if you know how to interpret around those flawed ranges, then is a good test. 11 is a very low value for an am and you really do need an acth stim along with an ACTH serum. From looking at your pituitary tests (low FSH and LH) and low DHEA, I would bet your ACTH is low and that would make you secondary adrenal insufficient and hypopituitary (your low FSH and low LH alone has made you hypopituitary).

If your doc won't give you the acth stim, then run to an osteopath (DO). DO's are very good with adrenals, endos very bad . Most DO's know the ranges are very flawed, endos love to say your are in range so you are fine, even though you have classic symptoms and are dying .

Do you have any tanning you didn't get from the sun (may be year round) and or hair loss on your shins? Email me and I'll send you an adrenal insufficiency symptom list.

Chris

I think you are fine with the cortisol serum test. As you can see by Chris's response to another thread, your cortisol is WAY too low for the am. Cortisol should be in the mid-upper 20's in the morning. Your results indicate adrenal insufficiency. I would recommend getting a serum ACTH and ACTH Stimulation test to further confrim. Chris, anything to add?

 

[1cc]

I have no hang-ups about being on prednisone and fludrocortisone if needed.

Hydrocortisone is better than prednisone, if you ever need to use these. You will need to use Hydrocortisone more frequently than prednisone, but it is worth it for the benefits.

 

[love_en]

I have researched the pros and cons of hydrocortisone vs prednisone. It is true that a replacement dose of hydrocortisone <30 mg is safe. Can't say the same about prednisone. Also, prednisone has less mineralcorticoid activity. I am just not crazy about needing a pill 3X per day. Take that back, I once said that I would not be sticking a needle into my thigh every week. Not feeling like total crap changed my thoughts on that.

 

[Chrisgj2]

30 (max dose) or less is safe. 7 1/2 mg of prednisone (max dose) is the equivlent and is also safe.

Chris

 

[1cc]

Hydrocortisone is supposed to work better than prednisone for psychological symptoms of cortisol deficiency.

 

[Chrisgj2]

Hydrocortisone works for 80% who take it. It has a half life of 1 to 8 hours. If your body uses half of it in 8 hours then hydro will do well for you. If your body uses half in 1 hour, then you won't get much if any benefit from it. Prednisone has a longer half life of about 16 hours.

I was tried on 30 mg of cortef (brand name of hydrocortisone) for a month and I felt absolutely nothing, no benefit from it. I was switched to Methylprednisolone (a bit stronger than prednisone) and that did the trick.

True, you do want the cortef / hydro as it matchs best the chemical make up of natural cortisol. I was very disapointed that cortef didn't help me.

Chris

 

[love_en]

One more observation. I remember feeling quite well after the ACTH injection raised my cortisol to 38. The weakness and fatigue went away, only to return the next morning. I mentioned this to the endo. He passed that off as most of the patients getting the stim test say the same thing. Makes me wonder how many cases of adrenal insufficiency he has missed over the years.

 

[Chrisgj2]

From what I've seen others report, most feel nothing. My own doc told me once in a very great while someone will tell him they felt much better after the stim. Not sure, but i think most don't feel it because the increased cortisol isn't reaching receptors. May be because with the lower cortisol some or many receptors have gone to sleep.

You can't go by whether someone feels something from the test are not to judge if they are adrenal insufficient.

What was your base (starting) cortisol?

Chris

 

[love_en]

Base was 26.8 1 hour before ACTH. If that was my base, shouldn't i have seen 50 1 hour later?

 

[Chrisgj2]

Doubling is what they look for yes, but maybe your body needs to be at a base of 35, maybe higher. No way to know of course. Did you have an acth serum (this test will have a range of 10 - 60 usually)?

Chris