Aa
guide pl
In my latest Glucagon stimulation test it shows low Growth hormones and low cortisol, then Insuline tolerance test was done which shows low levels like 0.6 of growth hormones and cortisol normal as said by Endocrinologist. She aranged MRI of brain//sella -pituoitary on urgent bases, doctor also asked for TB test..Having obs sleep apnea-non compliance of CPAP, Endocrinologist explained that she can not do any thing due to obs, sleep apnea. Pain on center part of head is bothering, vision some times blurry, ESR always from 25 to 38 for last three years. Micro haematuria reason not find so far, IgM is low.All signs and symtoms are there of severe adult growth hormones .
Dont know what to do. Results are very confusing.
Dont know what to do. Results are very confusing.
MEDICAL PROFESSIONAL
Hi KKCAL,
Thank you for your for your post, I appreciate your concern. I will try to go through your question step by step but feel free to give feedback or provide additional information during our discussion. Growth hormone deficiency has been linked with numerous causes, including idiopathic (no know causes), benign pituitary tumors including carniopharyngioma and pituitary adenomas, sarcoidosis, and infectious causes, amongst numerous other things. I think that following up with your MRI appointment would be helpful as the radiologists can detect any tumors that may explain these findings. Do you ever have double vision in addition to your blurry vision? Your ESR (a non-specific marker of inflammation) is elevated for an adult. An elevated ESR in itself does not tell us a specific cause to the inflammation and needs to be looked at in context. Often this value is used to determine how well your treatment is doing in controlling whatever is causing the inflammation. IgM is one of the antibodies circulating in our system to help combat infection. A decreased value may occur as a primary (with no underlying cause) or secondary (due to another underlying condition). Secondary causes are much more common and have been associated with malignancy, autoimmune diseases, gastrointestinal diseases, and immunosuppressive treatments. Some patients are asymptomatic while others can suffer from infections. Microhematuria (when the urine contains small amounts of blood not seen with the naked eye) has been associated with urinary tract infections, medications, vigorous exercise, underlying kidney diseases, and rarely cancer. Is there a reason why you're not compliant with your CPAP? Obstructive sleep apnea can be a very serious condition. I hope that you find this information useful and I would be more than happy to answer any additional questions or provide further clarification.
Best wishes,
John Irlam
Thank you for your for your post, I appreciate your concern. I will try to go through your question step by step but feel free to give feedback or provide additional information during our discussion. Growth hormone deficiency has been linked with numerous causes, including idiopathic (no know causes), benign pituitary tumors including carniopharyngioma and pituitary adenomas, sarcoidosis, and infectious causes, amongst numerous other things. I think that following up with your MRI appointment would be helpful as the radiologists can detect any tumors that may explain these findings. Do you ever have double vision in addition to your blurry vision? Your ESR (a non-specific marker of inflammation) is elevated for an adult. An elevated ESR in itself does not tell us a specific cause to the inflammation and needs to be looked at in context. Often this value is used to determine how well your treatment is doing in controlling whatever is causing the inflammation. IgM is one of the antibodies circulating in our system to help combat infection. A decreased value may occur as a primary (with no underlying cause) or secondary (due to another underlying condition). Secondary causes are much more common and have been associated with malignancy, autoimmune diseases, gastrointestinal diseases, and immunosuppressive treatments. Some patients are asymptomatic while others can suffer from infections. Microhematuria (when the urine contains small amounts of blood not seen with the naked eye) has been associated with urinary tract infections, medications, vigorous exercise, underlying kidney diseases, and rarely cancer. Is there a reason why you're not compliant with your CPAP? Obstructive sleep apnea can be a very serious condition. I hope that you find this information useful and I would be more than happy to answer any additional questions or provide further clarification.
Best wishes,
John Irlam
Today appointment done with Endocrinologist, she came out with opinion that pituitary is ok and fine, she is not ready to do any of further assessment like dynamic MR or Genetic test,.
She accept that it may have tiny stuff in pituitary but without any decision. She ruled out that obesity/center weight has any link with low growth hormones at all. she is after to reduce weight, confused that how to reduce weight? non tolerance to exercise. I explained to her that in case MRI comes out with no tumor then you should do further testing like ferritin and genetic test,.
She explained that TSH is not hormone of pituitary at all. for low TSH, does such opinion is worth to accept or not. she told that because I am taking synthyroid ,it is ok. does this can accept.
Only opinion she explained is worth to accept that due to low testosterone ,my prolactin and FSH goes high , for high LH she told she is not worried for this, for cortisol low and DHEAS low she does not have any clue.
She ruled out reason of center headache is of low growth hormones does this is worth to believe.
Please guide with your knowledge ,I know you can do.
she told that asymmetry of pituitary is normal, she takes this as tiny stuff.
She accept that it may have tiny stuff in pituitary but without any decision. She ruled out that obesity/center weight has any link with low growth hormones at all. she is after to reduce weight, confused that how to reduce weight? non tolerance to exercise. I explained to her that in case MRI comes out with no tumor then you should do further testing like ferritin and genetic test,.
She explained that TSH is not hormone of pituitary at all. for low TSH, does such opinion is worth to accept or not. she told that because I am taking synthyroid ,it is ok. does this can accept.
Only opinion she explained is worth to accept that due to low testosterone ,my prolactin and FSH goes high , for high LH she told she is not worried for this, for cortisol low and DHEAS low she does not have any clue.
She ruled out reason of center headache is of low growth hormones does this is worth to believe.
Please guide with your knowledge ,I know you can do.
she told that asymmetry of pituitary is normal, she takes this as tiny stuff.
Sir, MRI done,
please do read report at
https://www.dropbox.com/s/b54eec5qzlx14p7/photo.JPG
Very confusing, you can please mention for this
please do read report at
https://www.dropbox.com/s/b54eec5qzlx14p7/photo.JPG
Very confusing, you can please mention for this
MEDICAL PROFESSIONAL
Thanks for the update KKCAL. When is your second opinion? Did you have your MRI on December 12th?
Thanks, you are correct - asking for second opinion.
We are in such health system where we need this. Nothing has been heard from Endocrinologist. I may wrong that these may not carry thorough knowledge and expertise of their subject. still to depend on those.
We are in such health system where we need this. Nothing has been heard from Endocrinologist. I may wrong that these may not carry thorough knowledge and expertise of their subject. still to depend on those.
MEDICAL PROFESSIONAL
Hi KKCAL,
I'm all in favor of patients asking for a second opinion, I don't think it hurts at all, and if nothing else I think it helps bring piece of mind that we're doing the right thing. I'm happy to hear that the chest X-ray was negative. I think you're doing the right thing by reporting that your headache is getting worse. I'm looking forward to hearing the results of the MRI.
Thanks,
John
I'm all in favor of patients asking for a second opinion, I don't think it hurts at all, and if nothing else I think it helps bring piece of mind that we're doing the right thing. I'm happy to hear that the chest X-ray was negative. I think you're doing the right thing by reporting that your headache is getting worse. I'm looking forward to hearing the results of the MRI.
Thanks,
John
TB doctor ruled out TB on the bases of chest Xray yesterday, no skin test was done.
Headache center part is bothering, I call Endocrinologist office for this -in case she want to increase dose of synthroid , present taking 0.50 mcg, dont know when she will reply.
Now turn of MRI 12 DEC.
Thanks
Headache center part is bothering, I call Endocrinologist office for this -in case she want to increase dose of synthroid , present taking 0.50 mcg, dont know when she will reply.
Now turn of MRI 12 DEC.
Thanks
TB doctor ruled out TB on the bases of chest Xray yesterday, no skin test was done.
Headache center part is bothering, I call Endocrinologist office for this -in case she want to increase dose of synthroid , present taking 0.50 mcg, dont know when she will reply.
Now turn of MRI 12 DEC.
Thanks
Headache center part is bothering, I call Endocrinologist office for this -in case she want to increase dose of synthroid , present taking 0.50 mcg, dont know when she will reply.
Now turn of MRI 12 DEC.
Thanks
Great ,I will update you.Sir, Endocrinologist is of opinion that she can not start growth hormone replacement therapy due to sleep apnea,
what do you think for this, upto which level she is correct, or I can go for second opinion . What do you think I can ask for Endo doctor who is specialize in Pituitary .
Regards
what do you think for this, upto which level she is correct, or I can go for second opinion . What do you think I can ask for Endo doctor who is specialize in Pituitary .
Regards
MEDICAL PROFESSIONAL
Hi KKCAL,
Thanks for the information. Happy to hear the news of your HIV testing. I'm interested to see if anything is found on the MRI. I'm still trying to link your hormone levels and sleep apnea, nothing so far but I'll keep digging. Let us now how the MRI goes and stay in touch.
Happy Holiday,
John
Thanks for the information. Happy to hear the news of your HIV testing. I'm interested to see if anything is found on the MRI. I'm still trying to link your hormone levels and sleep apnea, nothing so far but I'll keep digging. Let us now how the MRI goes and stay in touch.
Happy Holiday,
John
on December 12. 2013. HIV 1 & 2 negative.
MEDICAL PROFESSIONAL
Hi KKCAL,
I see, thank you for the clarification on the lymph nodes. I don't know how to relate the hormone levels to the sleep apnea, I'll have to do some reading and see if I can come up with some ideas. I think that the TB evaluation would be a good idea. Have you ever been tested for HIV? Also, when is your MRI scheduled for?
Stay in touch,
John
I see, thank you for the clarification on the lymph nodes. I don't know how to relate the hormone levels to the sleep apnea, I'll have to do some reading and see if I can come up with some ideas. I think that the TB evaluation would be a good idea. Have you ever been tested for HIV? Also, when is your MRI scheduled for?
Stay in touch,
John
What do you mean by lymph nodes comes and goes? Means lymph nodes- swelling in neck comes and goes, infection is catching very frequently, last 4-5 months have taken two courses of antibiotic. frequently stiffness in neck is feeling
Family doctor also hv started TB evaluation. Appointment is on 28 Nov,before that I will do Xray as per requirement of TB clinic.
OK, gollowing are results-
Hemoglobulin A= O.972
Hemoglobulin A2=0.028
Hemoglobulin F=0.000
Haptoglobulin 2.38 g/L ,,
CD3==2.965 10E9/L,, HIGH
CD4/CD8==0.78,, CD3%==71%,,
CD3+CD4+ (%)=34%,, LOW
CD3+CD4+=1.188 10E9/L
CD3+CD8+(%)=42% HIGH
CD3+CD8+=1.515 10E9/L HIGH
MRI is on 12 Dec,2013.
Endocrinologist puts whole blame- on Sleep apnea, how come this growth hormone deficiency comes, even cortisol is also on low side as per glucagon stimulation test.
You can please guide
Hemoglobulin A= O.972
Hemoglobulin A2=0.028
Hemoglobulin F=0.000
Haptoglobulin 2.38 g/L ,,
CD3==2.965 10E9/L,, HIGH
CD4/CD8==0.78,, CD3%==71%,,
CD3+CD4+ (%)=34%,, LOW
CD3+CD4+=1.188 10E9/L
CD3+CD8+(%)=42% HIGH
CD3+CD8+=1.515 10E9/L HIGH
MRI is on 12 Dec,2013.
Endocrinologist puts whole blame- on Sleep apnea, how come this growth hormone deficiency comes, even cortisol is also on low side as per glucagon stimulation test.
You can please guide
MEDICAL PROFESSIONAL
Hi KKCAL,
Thank you for the additional information. I'm not a sleep medicine expert so I will have to defer on that one along with the medications for depression and sleeping pills. Leukoaraiosis is a somewhat nonspecific finding on MRI so I'm not sure what to make of that in the context of your health problems. If you could provide me with the numbers of your CD3/CD4/CD8 counts I'm curious as to what they are. I'm not sure what the CRP of 6.7 means other than it's another sign of inflammation, elevated levels have been associated with connective tissue diseases, heart attacks, infections, inflammatory bowel disease, lupus, rheumatoid arthritis, and tuberculosis along with other causes. What do you mean by lymph nodes comes and goes? I'd be interested to know how what your endocrinologist thinks of all of these numbers and what's going on, I'm having a hard time making sense of all of it. When is the MRI of your sella turcica/pituitary scheduled for?
Thank you for the additional information. I'm not a sleep medicine expert so I will have to defer on that one along with the medications for depression and sleeping pills. Leukoaraiosis is a somewhat nonspecific finding on MRI so I'm not sure what to make of that in the context of your health problems. If you could provide me with the numbers of your CD3/CD4/CD8 counts I'm curious as to what they are. I'm not sure what the CRP of 6.7 means other than it's another sign of inflammation, elevated levels have been associated with connective tissue diseases, heart attacks, infections, inflammatory bowel disease, lupus, rheumatoid arthritis, and tuberculosis along with other causes. What do you mean by lymph nodes comes and goes? I'd be interested to know how what your endocrinologist thinks of all of these numbers and what's going on, I'm having a hard time making sense of all of it. When is the MRI of your sella turcica/pituitary scheduled for?
Reason for Non compliance of CPAP, sleep doctor started depression medicine Venlafexin from 37.5 mg and then 75 mg, also put me on Zopiclone sleep pills, every time he is changing pressure, he never give thought for surgery option, he never evaluate level and location of obstruction, he is accepting that I have narrow airway breath. after 15-20 minutes got struckoff.
I dont know why depression and sleep pills were started, presently not taking these. I can send my Glucagon stimulation and Insuline tolerance test results as per e,mail, CD 4 was also done -some blocks of CD3//CD4//CD8 are high and some are low.
Pain in center part of head is bothering, yes some time double vision is experiencing, while stepping up stairs in home itself feeling tired and weak. belly weight is there. About 4 years back MRI shows leukoaraiosis, done in india,in Canada they will not follow up this MRI,
Hemoglobulin A= O.972
Hemoglobulin A2=0.028
Hemoglobulin F=0.000
Haptoglobulin 2.38 g/L
Iron 10 , ESR from 25 to 35.
Vit D is low, Hemoglobulin 131, RBC =4.4
Lymph nodes comes and goes, IgM is low. CRP is 6.7.
you will see please that there must be some underlying prob.
Sometimes body gets warm after 1-2 hours gets normal.
Pedal edema-swalling on ankles,legs.
Waiting for your guide
I dont know why depression and sleep pills were started, presently not taking these. I can send my Glucagon stimulation and Insuline tolerance test results as per e,mail, CD 4 was also done -some blocks of CD3//CD4//CD8 are high and some are low.
Pain in center part of head is bothering, yes some time double vision is experiencing, while stepping up stairs in home itself feeling tired and weak. belly weight is there. About 4 years back MRI shows leukoaraiosis, done in india,in Canada they will not follow up this MRI,
Hemoglobulin A= O.972
Hemoglobulin A2=0.028
Hemoglobulin F=0.000
Haptoglobulin 2.38 g/L
Iron 10 , ESR from 25 to 35.
Vit D is low, Hemoglobulin 131, RBC =4.4
Lymph nodes comes and goes, IgM is low. CRP is 6.7.
you will see please that there must be some underlying prob.
Sometimes body gets warm after 1-2 hours gets normal.
Pedal edema-swalling on ankles,legs.
Waiting for your guide
You are reading content posted in the Pathology: Diagnostic Forum
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
In this latest Missouri Medicine article, Richard J Weachter, MD, details the pros and cons of new blood thinner drug Dabigatran (Pradaxa).
Are there grounds to recommend coffee consumption? Recent studies perk interest.
Salt in food can hurt your heart.
Get answers to your top questions about this common — but scary — symptom
How to know when chest pain may be a sign of something else
