Urine osmolality - is this reference range right?

[picante]

The symptoms listed here are exactly what I have, minus the bedwetting (thank goodness): http://www.webmd.com/diabetes/guide...etes-insipidus-symptoms-causes-and-treatments

I didn't know I was drinking that much until I did the urine collection and recorded my fluid intake. But it's already less severe than it was in June when I did that. I think the Byron White antiviral formula made it worse.

So unfortunately, the endo will probably want to do a water restriction test, which sounds like a good way to become severely dehydrated.

some stupid things I did like taking garlic oil for detox

What's the deal with garlic? I just put a tiny bit of fresh garlic in a potato salad last week, and I can't tolerate it. It makes my bloatation/gut pain worse. I know it can move mercury, but why do you think it brought back your polyuria?

 

[Violeta]

My lab results follow:
Serum calcium is always between 9.6 and 10.0 mg/dL [8.7-10.2] and that's with no supplemental Ca.

May 2012 Parathyroid, intact 23 pg/mL [15-65]
May 2012 Calcium (ionized) 5.1 mg/dL [4.5-5.6]
May 2016 ADH 0.8 pg/mL [0-4.7] (Ahem. Zero is within range?!! Are they including dead people?)
June 2016 Osmolality, Urine: 250.0 mOsmol/kg [ 0 - 289.9] which my ND says is LOW, and they must have screwed up on the range, which usually starts at 300.
Since I have polyuria, I take a lot of potassium, because I pee a lot out. My blood levels always look normal.

The only thing he measured today was urine specific gravity, and I don't have that result yet. Since I have an appointment with the endocrinologist in a week, he didn't order anything else.

So he also wonders about diabetes insipidus, but my guess is it would be neurogenic if I do have it.

With low ADH, yes, that would be neurogenic.

What lab did you use

@Gondwanaland when you had hyperinulinemia, were you experiencing low blood sugar? Grains and a couple of other foods give me polyuria, too. So does dairy.

I started drinking coconut water yesterday and taking more sodium ascorbate, didn't have any corn or hummus, got some relief. I was going at least 20 times a day! for a couple of days.

 

[Violeta]

This might be what it is about garlic. The TRPV1 receptor. I don't yet know why it's over responsive in some people, but I'm wondering if it has something to do with pathogenic load along with extracellular calcium.

What's in the Byron White antiviral formula, that may have some TRPV1 agonists in it, too.


http://www.ncbi.nlm.nih.gov/pubmed/15916949

 

[Violeta]

Although I don't yet know what this means, I see that the TRPV1 receptor is involved in the vasopressin thing.

http://www.nature.com/nrneph/journal/v11/n10/fig_tab/nrneph.2015.89_F2.html

 

[Gondwanaland]

were you experiencing low blood sugar?

I don't know.

@picante I think you should ask your endo to redo PTH testing, and to be as thorough as possible. In this context, you could convince him to get an insulin assay as well, for as long as you can picture yourself waiting at the lab (5 hour assay?). Some people just have the craziest results that just don't fit any pattern, like a normal insulin curve and dramatic drops in glycemia from the 2nd hour on. He will have to be a very good endo to interpret crazy results, or refer you to a specialist.

 

[Gondwanaland]

but why do you think it brought back your polyuria?

I don't know. I have a similar effect from Taurine. I think that, among other things, it induces hypoglycemia, it is very diuretic.

 

[Violeta]

Maybe you already realize that there can be an infection cause, but here's some information if you're interested.

http://www.biotoxinhelp.com/cirs-and-low-msh.html

 

[picante]

Thanks, Violeta. I'm pretty sure fluctuating leptin levels and cytokine levels are part of my gut problems and probably the source of my neck pain. Leptin also functions as a cytokine, but I'm very unclear about that.

I couldn't get my ND to order any leptin tests; he sent me to the state employees' clinic to ask for them. The PA there didn't want to order any leptin testing; she referred me to this endo that I'm going to see Aug. 1st.

The trouble is, I don't know what to ask for. Leptin is the satiety hormone (not the hunger hormone, as that link says). When I'm having a lot of bloatation (as I have been lately), I feel really full before I've eaten much, and I get the helium-balloon tummy. It's very tight, like a drum. It's called typanites or meteorism. It also makes me groggy. Histamine can cause it, but that's an awake hormone; it wouldn't make me groggy.

I'm starting to think I have mast cell activation syndrome. I don't think the endo is going to know much about that.

 

[Violeta]

Thanks, Violeta. I'm pretty sure fluctuating leptin levels and cytokine levels are part of my gut problems and probably the source of my neck pain. Leptin also functions as a cytokine, but I'm very unclear about that.

I couldn't get my ND to order any leptin tests; he sent me to the state employees' clinic to ask for them. The PA there didn't want to order any leptin testing; she referred me to this endo that I'm going to see Aug. 1st.

The trouble is, I don't know what to ask for. Leptin is the satiety hormone (not the hunger hormone, as that link says). When I'm having a lot of bloatation (as I have been lately), I feel really full before I've eaten much, and I get the helium-balloon tummy. It's very tight, like a drum. It's called typanites or meteorism. It also makes me groggy. Histamine can cause it, but that's an awake hormone; it wouldn't make me groggy.

I'm starting to think I have mast cell activation syndrome. I don't think the endo is going to know much about that.

I don't know much about leptin, but from what I read at selfhacked.com, even if you did get it checked, there is more than one reason why it could go either high or low.

I hope you can find out what's going on! Keep us posted.

 

[picante]

Next chapter: The Recalcitrant Endocrinologist

I saw him today, bringing all the lab results I thought he might want to evaluate the possibility of diabetes insipidus, which my ND thought was a good possibility.

He looked at the Urine Osmolality result and my fluid intake/output I had recorded. He looked at ADH and said "I never order ADH". On the same page was Hg A1c, glucose, triglycerides, and the chemistry numbers.

He said, "What would happen if we locked you in this room without any water?" I replied that I would still need to pee, and looked around for a bathroom. And that if it was for a long time, I'd get very unwell, depending on the neck spasms and migraines. In which case I would need potassium and other minerals.

He explained that the osmolality test I already did was not in controlled conditions. He does it repeatedly as part of a water deprivation test to see what happens to osmolality as urine concentration goes up. (That was the useful bit to me.)

I said, waving each paper at him, "Do you want to look at:
Aldosterone? -- No.
Histamine? -- No.
Parathyroid? -- No.
Calcitonin? -- No.
Cortisol? -- No. Do you have any thyroid tests?

I told him I have loads of thyroid tests, but didn't bring them because I didn't want to get sidetracked. (My ND warned me that my thyroid treatment of T3 + dessicated thyroid would derail the whole conversation, and we would never talk about the polyuria, LOL.)

So he explained a teeny bit about how thyroid hormone regulates the kidneys. And that I didn't really seem like the diabetes insipidus patients, who are severely ill. And that I should stop taking so much potassium and magnesium and other diuretic things.

And that he would order a water deprivation test. I said, "But you're dubious that it's diabetes insipidus."
"Yes, but there are enough indications to make it worth testing. You might be a very borderline case."

Input, anybody? I'm thinking this is a waste of energy and money, and a good way to make myself sick for a few days.