Lab results from endo? I'm confused.

[RussianRocket]

I asked my endo to fax me the test results for reference. I suspected adrenal fatigue because of my salival analysis revealed very low cortisol. He said everything was OK and refused to get me any HC.

FWIW, I cannot for the life of me find any reference ranges for the results he gave me. Can anybody help me out? I am a 19yo male.

FSH: 2.1 U/L

LH: 3 UI/L

Test: 11.95 nmol/L

Bioavaiable test: 6.4 nmol/L


estradiol: 80 pmol/L

cortisol AM: 456 nmol/L

TSH: 1.61 mU/L

His reply to my request of HC:

"I do not think that hydrocortisone would help you. The cortisol level was normal when I measured it in your blood last January. This test is reliable and exclude adrenal insufficiency. Taking hydrocortisone for more than 3 weeks could put your adrenal gland to rest and you could become corticodependant."

[RussianRocket]

Converted my total T to ng/dL which gives me around 340.

most reference ranges from what I read, start at 300 at the bottom. But for christ's sake I'm NINETEEN years old!

What do you guys think????

My main symptoms are severe brain fog and lethargy. It's been this way since puberty and it's been getting gradually worse. Erections and such are "OK".

[zkt]

Id have to convert most of those to units im familiar with. Can say that youre at about the 30 th percentile of the population in T level. Better to be in the high normal range. A single cortisol measureemnt doesnt mean shit. Dr should know that. need 24hr urine coetisol test or 4 point saliva test.

[RussianRocket]

Originally Posted by zkt

Id have to convert most of those to units im familiar with. Can say that youre at about the 30 th percentile of the population in T level. Better to be in the high normal range. A single cortisol measureemnt doesnt mean shit. Dr should know that. need 24hr urine coetisol test or 4 point saliva test.

Like I said I did do the 4 point saliva test and the results concluded that my cortisol was extremely low.

Is it worth it, in your opinion, trying to convince my endo to address the cortisol issue or even the testosterone issue?

He basically thinks everything is fine at this point.

[Mmartin]

In my experience visiting approximately 30 doctors over the past 4 years I have found endocrinologists to be, without a doubt, the most arrogant of medical professionals. This wouldn't be so bad except for the fact that they were also often the most ignorant (at least regarding hypogonadism). I've been in the same position; at the age of 18 I was doing "the rounds" in a miserable attempt to find an open, caring doctor who didn't have his/her head up their ass. I have many memories of visiting doctors, asking them a point-blank question regarding symptoms or treatment, and having them completely and utterly ignore whatever I had just said, moving on to something else entirely. At least half of the doctors I saw did this. Perhaps it was my youth, and perhaps I came off as arrogant being only 18 and attempting to direct my treatment, but regardless it was a humiliating experience every time.

My advice: Find a new doctor.

[RussianRocket]

I find the hardest part in this is I feel so guilty asking for a referral and being told left and right that there is nothing to treat. It really is going against the grain in every sense and the journey certainly is hard and frustrating.

Are my numbers indicative of treatment being an option? The problem is I don't understand them...

[JanSz]

Originally Posted by Mmartin

In my experience visiting approximately 30 doctors over the past 4 years I have found endocrinologists to be, without a doubt, the most arrogant of medical professionals. This wouldn't be so bad except for the fact that they were also often the most ignorant (at least regarding hypogonadism). I've been in the same position; at the age of 18 I was doing "the rounds" in a miserable attempt to find an open, caring doctor who didn't have his/her head up their ass. I have many memories of visiting doctors, asking them a point-blank question regarding symptoms or treatment, and having them completely and utterly ignore whatever I had just said, moving on to something else entirely. At least half of the doctors I saw did this. Perhaps it was my youth, and perhaps I came off as arrogant being only 18 and attempting to direct my treatment, but regardless it was a humiliating experience every time.

My advice: Find a new doctor.

Good advice.
i would add:
do not feel guilty.
----------------------------------
Get list of 10 doctors using links below, inerview their nurses first:

http://www.thyroid-info.com/index.htm

http://www.osteopathic.org/directory.cfm

[RussianRocket]

thank you... I live in Canada! It's IMPOSSIBLE to find any resources!

Originally Posted by JanSz

Good advice.
i would add:
do not feel guilty.
----------------------------------
Get list of 10 doctors using links below, inerview their nurses first:

http://www.thyroid-info.com/index.htm

http://www.osteopathic.org/directory.cfm

[Mmartin]

I live in Canada as well, in Vancouver. If you live in Vancouver I can give you the name of a doctor who will work with you and is more amenable to changing treatment with patient input. If not, one of the great things about Canada is that you can see many, many doctors without it costing a penny (apart from travelling costs and time itself). This was the only way for me to find the amazing doctor I now work with - going from clinic to clinic searching. After 4 years the journey is over.

[RussianRocket]

On average, how many new doctors would you see a month? And what would you tell them about your condition and if asked how many previous endos you had seen? Were you honest in your approach?

Could you give me some pointers?

Thanks!

[Mmartin]

I have no idea how many doctors I saw per month. I just kinda went whenever I had the energy to face another doctor.

I was never asked how many doctors I had seen, though I was told on numerous occasions "If you refuse to see just me as a doctor, then I will no longer treat you."

I was always honest about my condition and brought a copy of all of my previous bloodwork. Basically I told them about my symptoms and when they began occuring. Some doctors laughed me out of their office, accused me of lying, told me it was all in my head or said I was just trying to obtain steroids. Don't let this get you down, and NEVER feel guilty. Eventually you'll find a good doctor.

Do not be overly aggressive or rude, but do remain firm and confident in your belief that you require treatment (which your lab results definitely indicate is required). If a doctor is rude or completely unwilling to assist you, simply leave. Get up, say "thank you" (or not) and leave. It's not worth the effort to fight and the "M.D." always wins because they hold all of the cards. Sadly there is nothing you can do besides go from doctor to doctor, explaining your case and hoping that they are knowledgeable and willing to work with you in creating a treatment protocol. It is time consuming, exhausting and - at least for myself - emasculating, but it is necessary.

I have not personally gone the alternate route, but if one wishes to they can obtain essentially all of the medication necessary for treatment through illicit means (with little or no risk).

[zkt]

Sorry but all I see re. cortisol is "cortisol AM: 456 nmol/L"
what was the result of the 4 point test ?
you can look up normal ranges at quest diagnostics and wikipedia

[Mmartin]

By the way, I completely forgot to mention that you can just go and buy hydrocortisone cream at Safeway or any local grocery store/pharmacy. It'll be about half of the strength of prescribed HC, but it works just the same. 1/4 of a teaspoon of prescription-strength (1%) HC is approximately 10mg of HC, and most OTC HC preparations are 0.5% (at least in Vancouver).

This still does not resolve your low testosterone, however (I'm assuming your range is 10-30nmol/L for total testosterone, as mine is).

[pmgamer18]

I need the ranges my Bioavaiable was 199 range 110 to 576 ng/dl and I am dam low. You are Secondary and you need a MRI done on your Pituitary.
Here is a list of Dr.'s most are for thyroid that do armour but most that are on Armour have low cortisol levels.
CANADA
1) Dr. Andy Brockway in Ontario (also practices in London–see below)

Prescribes natural thyroid, whether Armour or the canadian brand, may even do compounded.

2) Dr. Barry Breger, MD; 1141, Boulevard Saint-Joseph Est, Montréal, QC H2J 1L3 Tel. 514-277-1141

He helped a patient get on as much thyroid as she needed. Put her on OrthoAdapt for adrenals, but she was going to ask for HC. He is both a Naturopath and an MD. Goes by how the patient feels and likes the patient to be involved in their treatment. Not covered by Medicare, but will give a naturopathic visit receipt so insurance companies may cover his costs. First visit long: 1 1/2 hours are with his assistant and the other 1 1/2 is with him. There is a thorough and long questionnaire to fill out before the appointment.

3) See Susanne’s website list of Canadian doctors: http://www.geocities.com/thyroide/docs-Canada.html

4) The following doctors come from a Compounding Pharmacy list and these doctors are likely to prescribe the canadian “Thyroid”.

Doctors Working with Bio Identical Hormones

In GTA:

Dr. Sonya Kustka; 3910 Bathurst Street; 416-636-7018; Covered by OHIP
Dr. Kathleen Kerr; 1849 Yonge Street; 416-489-4445; Covered by OHIP
Dr. Heather Tick; 984 Bay Street; 416-944-9008; Covered by OHIP
Dr. Mary Danylak; 89 Rowhampton Avenue; 416-322-3515; Covered by OHIP
Dr Alvin Pettle; 3910 Bathurst Street; 416-633-5077; $$$$$$$$$$$$$$$$$$$$
Dr. Zoltan Rona; 1366 Younge Street; 416-920-9241
Dr. Paul Jaconello; 751 Pape Aveune #201; 416-463-2911
Dr. Joseph Krop; 6517A Mississauga Road; 905-816-9657
Dr. Elaine Chin; 101 Queensway W. Suite 304; 905-270-8318
Dr. Corman-Wood; 2000 Credit Valley Rd. #302; 905-828-7055

Outside Toronto

Dr. Willian Van Hoogenhuize; Bradford Ontario; 905-775-2976
Dr. Dosaj; Madoc ON; 613-473-4272
Dr. Leyton; Kingston; 613-542-5663

I hope this helps you call and ask questions first before going in and I do feel you are Secondary.

Originally Posted by RussianRocket

I asked my endo to fax me the test results for reference. I suspected adrenal fatigue because of my salival analysis revealed very low cortisol. He said everything was OK and refused to get me any HC.

FWIW, I cannot for the life of me find any reference ranges for the results he gave me. Can anybody help me out? I am a 19yo male.

FSH: 2.1 U/L

LH: 3 UI/L

Test: 11.95 nmol/L

Bioavaiable test: 6.4 nmol/L


estradiol: 80 pmol/L

cortisol AM: 456 nmol/L

TSH: 1.61 mU/L

His reply to my request of HC:

[RussianRocket]

Here are my results with the reference ranges. I just got them. There is more (T4, T3) But I have to call the lab for that so I don't have it yet.

Please guys, take a moment and check these out and let me know.


FSH: 2.1 U/L 1.4 - 18.1

LH: 3 UI/L 1.5 - 9.3

Test: 11.95 nmol/L 10 - 30

Bioavailable test: 6.4 nmol/L 3.5 - 18.8

estradiol: 80 pmol/L 55 - 198

cortisol AM: 456 nmol/L 165 - 850

TSH: 1.61 mU/L 0.27 - 4.2