Discussions By Condition: I cannot get a diagnosis.

PLEASE HELP :: Weight Gain, Orthostatic Hypotension w/ HBP/HR, Central Obesity Acne

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: tpd0090
  • August 26, 2009
  • 11:21 PM

Hopefully someone out there can help. Not only me, but my doctors seem to be stumped as well. My blood work, urine, and salivary workups are all over the place and at times contradict each other. One test may support a diagnosis of one thing, while another something else.

Between a Pheochromocytoma or Cushing's Syndrome -- no one is really sure what's going on. Imaging Studies on both the Abdomen and Pituitary (both with and without contrast) came back 'normal'.

Let's start with the symptoms:

Low Sex Drive (Testosterone is on the lowish side at 368... no one seems to see a problem with that?)
Round Face
Hot Sweats
Feeling Hot All The Time
Intolerance to Excercise
Muscle Spasms
Central Obesity
Thicker or more visible body and facial hair (hirsutism)
Decreased libido
Low Muscle Mass
Red Face
Buffalo Hump (Fat Buildup Between Shoulders)
Inability to Focus
Extreme Fatigue
Heart Palpitations
Trouble Getting Full Night's Rest
Orostatic Hypotension
Abnormal Heart Rhythym

Now, Let's look at the workups that I've been tested for:

Cushing's Syndrome
(seems to be most promising of all)
Addison's Disease
... I'm sure others.

Now To My Urine Lab Work:
Test Name Result Unit Range
Cortisol,Free,Urine 33.8 mcg/gcreat 1.3-27.5
Creatinine,24 Hour Urine 2.27 g/24h 0.63-2.50
Cortisol,Free,24 Hour Urine 76.8 mcg/24h 4.0-50.0
Cortisol,Free,Urine Results Not Available
Creatinine,24 Hour Urine 1.81 g/24h 0.63-2.50
Cortisol,Free,24 Hour Urine 90 mcg/24h 4.0-50.0
Cortisol,Free,Urine 31.2 mcg/gcreat 1.3-27.5
Creatinine,24 Hour Urine 2.63 g/24h 0.63-2.50
Cortisol,Free,24 Hour Urine 83.8 mcg/24h 4.0-50.0
Cortisol,Free,24 Hour Urine 93.8 mcg/24h 4.0-50.0
Creatinine,24 Hour Urine 2.41 g/24h 0.63-2.50
Cortisol,Free,24 Hour Urine 52.5 mcg/24h 4.0-50.0
Creatinine,24 Hour Urine 2.13 g/24h 0.63-2.50
Epinepherine, 24 Hr Urine 9 mcg/24h 2.0-24.0
Norepinephrine, 24 Hr Urine 84 mcg/24h 15-100
Dopamine,24Hr Urine 367 mcg/24h 52-480
Catecholamines, Total 93 mcg/24h 26-121
Creatinine,24 Hour Urine 3.22 g/24h 0.63-2.50
Metanephrine 187 mcg/24h 25-222
Normetanephrine 709 mcg/24h 40-412
Metanephrines,Total 896 mcg/24h 94-604

Now, let's look at my blood work:

Test Name Result Unit Range
Aldosterone 4.3 ng/dl 3.0-10.0
Plasma Renin Activity 1.8 ng/ml/h 0.6-4.3
Cortisol AM 1.3 mcg/dL <1.8
Adrenocorticotropin Hormone (ACTH) < 5 pg/mL 7.0-50.0
Total Testosterone 368 ng/dl 262-1593
Free Testosterone 12.3 ng/dl 7.4-22.6
Luteinizing Hormone (LH) 2.9 U/L 1.0-9.0
Follicle-Stimulating Hormone (FSH) 2.4 U/L 5.0-15.0
17 OH Progesterone 130 ng/dl <200
Sodium 140 mmol/L 135-146
Glucose 93 mg/dl 65-99
11-Desoxycortisol 132 ng/dl 12-158
Sex Hormone Binding 10 mmol/L 13-71
Albumin, Serum 4.2 g/dL 3.7-4.7
Sodium 137 mmol/L 135-144
Total CO2 29 mmol/L 21-31
Creatinine 0.66 mg/dL 0.90-1.40
Alanine Aminotransferase 45 U/L 6-41
Cortisol, Serum (AM) 1 mcg/dL <=1.8mcg/dL
Dexamethasone Level 319 ng/dL 140-295
Metanephrine, LC-MS-MS <25 pg/mL <=57
Normetanephrine, LC-MS-MS 103 pg/mL <=148
Total Metanephrine, LC-MS-MS 103 pg/mL <=205

Now on to the salivary cortisols....

Test Name Result Unit Range
Salivary Cortisol 0.06 mcg/dL < OR = 0.09
Salivary Cortisol 0.05 mcg/dL < OR = 0.09
Salivary Cortisol 0.05 mcg/dL < OR = 0.09

Reply Flag this Discussion
Thanks! A moderator will review your post and it will be live within the next 24 hours.

Signs of a Psoriasis Flare

Know the five types of psoriasis and how to spot flares.

How Diabetes Medications Affect Your Appetite

Newer diabetes treatments can suppress appetite and aid weight loss.

What to Do For Dry Mouth

Try these tips to get your salivary glands back into action.

The Painkiller – Constipation Connection

Constipation is a common side effect of opioid and narcotic pain medicines.

9 Signs of Sensitive Skin

Is it sensitive skin or something else?