halcyon
Senior Member
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- 2,482
I'm looking for some advice on possible further hormone testing.
A few months into my illness I decided I needed to see an endocrinologist to rule out any problems there. After an arguably incomplete workup I was told everything was normal and in my naivety I assumed I had covered that base and moved on.
A few months later I finally got my hands on the actual lab work and saw that there were actually abnormal results. My prolactin level was elevated, my testosterone levels were borderline low, and I had elevated urine volume on a 24 hour urine test. I've since had more lab work that showed my prolactin level is even higher and my free testosterone is now actually low.
From what I have read a minimally elevated prolactin level would be inconsistent with a pituitary problem and white blood cells can release prolactin as well so ongoing immune activation like I seem to be experiencing could be enough to explain the rise. I've also read that prolactin inhibits FSH and LH which could explain the low testosterone levels. Unless I'm missing something here, I'm happy enough leaving this alone and pursuing the apparent chronic infection(s) causing the immune activation in hopes that will resolve the elevated prolactin.
The other symptoms that I am worried about I now realize are probably endocrine in nature. Though not as severe as the first few months I was sick, I'm experiencing frequent urination and thirst, a need to eat every 2-3 hours otherwise I start to feel hypoglycemic, mineral deficiencies (sodium, potassium, and magnesium to a lesser degree), and random adrenaline rushes. In addition almost every doctor that looks at my metabolic panel blood tests says I look like I'm dehydrated. I drink a ton of water all day long.
The following tests were done and were normal:
8AM cortisol, serum - 17.9 mcg/dL (4.0 - 22.0)
8AM ACTH, serum - 25 pg/mL (6-50)
Fasting glucose - 87 mg/dL (65-99)
Hemoglobin A1C - 5.0% (<5.7)
TSH - 1.210 uIU/mL (0.450 - 4.500)
T4 - 9.1 ug/dL (4.5 - 12.0)
T3 uptake - 32% (24-39)
Free thyroxine index - 2.9 (1.2 - 4.9)
Given my ongoing symptoms I believe I should test the following:
24 hour saliva cortisol
DHEA
Aldosterone + renin
Vasopressin
Can anyone think of anything I missed?
A few months into my illness I decided I needed to see an endocrinologist to rule out any problems there. After an arguably incomplete workup I was told everything was normal and in my naivety I assumed I had covered that base and moved on.
A few months later I finally got my hands on the actual lab work and saw that there were actually abnormal results. My prolactin level was elevated, my testosterone levels were borderline low, and I had elevated urine volume on a 24 hour urine test. I've since had more lab work that showed my prolactin level is even higher and my free testosterone is now actually low.
From what I have read a minimally elevated prolactin level would be inconsistent with a pituitary problem and white blood cells can release prolactin as well so ongoing immune activation like I seem to be experiencing could be enough to explain the rise. I've also read that prolactin inhibits FSH and LH which could explain the low testosterone levels. Unless I'm missing something here, I'm happy enough leaving this alone and pursuing the apparent chronic infection(s) causing the immune activation in hopes that will resolve the elevated prolactin.
The other symptoms that I am worried about I now realize are probably endocrine in nature. Though not as severe as the first few months I was sick, I'm experiencing frequent urination and thirst, a need to eat every 2-3 hours otherwise I start to feel hypoglycemic, mineral deficiencies (sodium, potassium, and magnesium to a lesser degree), and random adrenaline rushes. In addition almost every doctor that looks at my metabolic panel blood tests says I look like I'm dehydrated. I drink a ton of water all day long.
The following tests were done and were normal:
8AM cortisol, serum - 17.9 mcg/dL (4.0 - 22.0)
8AM ACTH, serum - 25 pg/mL (6-50)
Fasting glucose - 87 mg/dL (65-99)
Hemoglobin A1C - 5.0% (<5.7)
TSH - 1.210 uIU/mL (0.450 - 4.500)
T4 - 9.1 ug/dL (4.5 - 12.0)
T3 uptake - 32% (24-39)
Free thyroxine index - 2.9 (1.2 - 4.9)
Given my ongoing symptoms I believe I should test the following:
24 hour saliva cortisol
DHEA
Aldosterone + renin
Vasopressin
Can anyone think of anything I missed?
