medical baseline


Posted by shewhoknows (me) on Oct 15 2010 at 4:12 PM

shewhoknows >> fitness

FPFL (Final Phase Fat Loss) cares about hormones and nutrients in the body so I figure it'd be good to establish my baseline before I actually begin.  While I probably won't retest these in the future, it's still nice to have them noted here just in case.  Also, once I finally choose some supplements - if I mange to stay on them - this might come in handy.

I'll start with medical conditions, because I know they are the cause, or caused by, or at least related to a lot of the measurements below.

  • degenerative joint disease (disc at L4-L5 has annular tear and is completely dehydrated)
  • fibromyalgia
  • adrenal fatigue (see the cortisol stuff below)
  • kidney stones (in the mid-2000s I had 13 at one time, but generally hovered around 7-8)
  • vitamin-d deficiency (recurring every 6-8 months)
  • polycystic ovarian syndrome (PCOS)
  • huge ovarian cysts (1-2 every month, often 7+ cm)
  • premenstrual dysphoric disorder (PMDD - like PMS x1000)
  • infertility (I don't produce eggs it seems - even on Clomid and the LH shot)
  • irritable bowel syndrome (IBS)
  • insulin resistance
  • hypoglycemia
  • lactose intolerant
  • allergic to shellfish (maybe "sensitive" is a better word, because I can eat some, just not a lot)
  • stage-4 acne (came up 2 years ago... and who the fuck knows where it came from since I've never had acne before!)
  • bad knees (no specific diagnosis, just severe pain behind kneecaps if I use 'em too much)
  • insomnia (my whole life it's taken me 1-2 hours minimum to fall asleep)
  • bipolar (been ok for 10+ years)
  • carpal tunnel in both wrists
  • high pulse/dystolic (due to medications I finally quit, but the numbers haven't gone all the way back down)

Did I miss any?  Be glad I didn't get into medication allergies. :D

According to my nephrologist, my body is stealing the calcium from my bones and teeth to make kidney stones.  My teeth are extremely weak (and always have been) and at one time I was in the ER every 3 months to pass one. Yay. Oh.. and in Feb this year they found more. Goodie.

Both of my parents have high blood pressure and are diabetic.  My whole family is overweight (probably "obese" but I don't want to use that term around my family).  Dad had a heart attack in his 40s. 


Lab Test Results

These are lab results from the past 2 years.  I can't - won't - say they're current as of right-now-this-very-minute, but nothing much has changed between the tests and now, so they're probably still fairly accurate, crappy as they are.  My pithy comments will be in purple text.

12/8/2009 ordered by ob/gyn
12/9/2009 ordered by rheumatologist
1/28/2010 ordered by gastroenternologist
6/24/2010 ordered by my primary doc



Description 1/28/2010 6/24/2010 Reference
TSH, 3rd Gen 0.944 0.99 0.40 - 4.50
T4, Free   0.8 0.8 - 1.8
T3, Free   264 230 - 420
Magnesium   2.3 1.5 - 2.5

T4, FREE is kinda borderline, but there's not a big range and doc says it's fine.



Description 12/8/2009 12/9/2009 1/28/2010 6/24/2010 Reference
Urea Nitrogen (BUN) 12   12 11 7 - 25
Sodium 139   141 142 135 - 146
Protein, Total 6.9 6.6 7.0 6.8 6.2 - 8.3
Potassium 4.3     4.9 3.5 - 5.3
Glucose 82   68 90 65 - 99
Globulin 2.6   2.5 2.8 2.2 - 3.9
Creatine 0.54   0.64 0.60 0.58 - 1.06
Creatine/BUN Ratio 22   19 N/A 8 - 27
Chloride 99   102 108 98 - 110
Carbon Dioxide 24   26 23 21 - 33
Calcium 9.5   9.5 9.2 8.6 - 10.2
Bilirubin, Total 0.3 0.3 0.2 0.4 0.2 - 1.2
Bilirubin, Direct   0.08     0.00 - 0.0
AST 22 19 17 15 10 - 30
ALT 12  14  10  8  6 - 40
Alkaline Phosphatase  90  82  80  84  33 - 115
Albumin/Globulin Ratio  1.7    1.8  1.4  1.0 - 2.1
Albumin  4.3  4.0  4.5  4.0  3.6 - 5.1


Primary did say my creatine is a bit low, and in Dec 09 it was low on the actual measurement as well.



Description 12/8/2009 Reference
25-Hydroxy 23.1 ng/mL 32.0 - 100.00 ng/mL

I've been fighting a recurring Vitamin D deficiency since late-2007.  I fix it and 6-8 months later it comes back.  This time I caught it early; the first time I think the measurement was 12.



I don't think the CBC matters here so I didn't add any of them.


Adrenal Stress Index - 5/27/2010 ordered by new gyn


TAP - Free Corisol Rhythm

Description Result Reference
6am - 8am 2 - Depressed 12 - 24 nM

Decreased morning cortisol, <13 nM, is suggestive of marginal HPA (Hypothalamic-Pituitary-Adrenal) performance. Normal rhythms exhibit highest coritsol value for the day at 7-8am.

11am - 12pm 6 - Normal 5 - 10 nM

No remarks for normal, but to me it appears to be on the low side of normal.

4pm - 5pm 16 - Elevated 3 - 8 nM
10pm - 12am 5 - Elevated 1 - 4 nM

An elevated night free cortisol value may be associated with insomnia, and caused by a stress response to an emotional or mental situation, nocturnal hypoglycemia, or chronic pain and overt/hidden inflammation.

Cortisol Load 29 23 - 42

The cortisol load reflects the area under the cortisol curve. This is an indicator of overall cortisol exposure, where high values favor a catabolic state, and low values are a sign of adrenal deterioration.

Circadian Cortisol Profile (they put in a graph, but I can't draw that here so a bar graph will have to do)

    1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
HIGH   X X X X X X X X X X X X X X X X X X X X X X X X  
ME   X X                                              
LOW   X X X X X X X X X X X X X                        
HIGH   X X X X X X X X X X                              
ME   X X X X X X                                      
LOW   X X X X X                                        
HIGH   X X X X X X X X                                  
ME   X X X X X X X X X X X X X X X X                  
LOW   X X X                                            
HIGH   X X X X                                          
ME   X X X X X                                        
LOW   X                                                

It's not as easy to see in a bar graph, but in the point graph it's pretty obvious that my rhythm is exactly the opposite of what it should be.  Go figure.


DHEA or Dehydroepiandrosterone

Description Result Reference
 Pooled Value 8 - Normal Adults (M/F): 3 - 10 ng/mL

Cortisol-DHEA correlation is in "Zone 2 - Adapted with DHEA slump"

This zone represents an elevated cortisol stress response coupled with a normal DHEA level. The lack of DHEA elevation is due to a stress-induced diversion of its steroid precursor (Pregnenolone) towards cortisol production. This relative DHEA deficit is pro-catabolic, and without restorative measures, will become an overt DHEA deficiency.

Going by the accompanying image, I'm well in the range (as above) but there is another set of horizontal marks at 6 and 10 - I'm at 12 or so.  It doesn't describe these anywhere.  I also don't understand what "Pooled Value" means, since that number 8 couldn't come from any of the cortisol measurements listed earlier.  So I'm a little fuzzy on what this means.

I have PCOS, which is supposed to increase DHEA is my "normal" level actually lower than this and the PCOS makes it artificially high?  DHEA is also supposed to go down as you age, so I should be roughly 25% less than what I was 10 years ago.  I honestly have no clue wtf this one means, but I know a "DHEA Deficiency" is bad.


INS - Insulin

Description Result Reference
Fasting <3 Normal: 3 - 12 uIU/mL
Post-Prandial <3 - Depressed Optimal: 5 - 20 uIU/mL

Depressed Non-Fasting insulin within 4 hours after meal. This may be caused by a small carbohydrate load in the preceding challenge meal or a reduction in pancreatic insulin release or synthesis. Consider a closer examination of challenge meal composition to rule out pre-diabetic tendencies.

Insulin activity is affected by the stress and cortisol responses. Chronic stress with cortisol elevation antagonizes insulin, and may cause functional insulin resistance. Furthermore, chronic hypercortisol causes hyperinsulin responses to carbohydrate intake. Chronic insulin resistance and overproduction lead to pancreatic exhaustion.

The Fasting result is borderline on the low side, but I have yet to figure out what this means.  The Post-Prandial, or Non-Fasting, is low and indicates hypoglycemia. (duh)  I have both hypoglycemia and insulin resistance - it is possible to have both, but it's completely screwed up.  Basically your body overreacts... or something...

I can almost guarantee that I had a large carb load in the meal. I love carbs (bread and pasta in particular) and often eat a lot.  :D



Description Result Reference
17-OH Progesterone 15 - Depressed Adults:
    Optimal: 22 - 100 pg/mL
    Borderline: 101 - 130 pg/mL
    Elevated: >130 pg/mL

Can you say super-depressed? 

It doesn't give any remarks about this, but I wish it did.  I don't quite know what to do with this info.


MB2S - Total Salivary SIgA

Description Result Reference
SIgA 15 - Depressed Normal: 25 - 60 mg/dL
    Borderline: 20 - 25 mg/dL

Again, super-depressed.

A depressed mucosal SIgA may be attributed to one or more of the following reasons:
1 - Excessive chronic cortisol output causes reduction in SIgA production due to low counts of SIgA immunocytes.
2 - A short imbalance in sympathetic to parasympathetic activity rapidly inhibits SIgA release from the mucosal immunocytes for several hours.
3 - Chronic deficits in cortisol and/or DHEA levels.
4 - Possible systemic defecit in capacity to produce IgA - an inherited problem.



Description Result Reference
 Gliadin Ab, SIgA  4 - Negative   Borderline: 13 - 15 U/mL
    Positive: >15 U/mL

This is a test for gluten allergy, which I do not have.  It was also tested on 1/28/2010 and the results were in the middle (2.0, 1.0, and 0 ) of the "negative" range (0 - 10)


DHEA & Testosterone - blood test

Now, that new GYN had also done a blood test on Cycle Day 3 (supposedly premium time).

Description Result Reference
DHEA 31.7 98 - 340
Testosterone 7 6 - 82

I don't know the units on either - I'm guessing ng/dL, but that office is the only place that puts the reference range of DHEA at 98-340; everywhere else shows it as 130-980 ng/dL.  Still, it's low as all get-out, and the testosterone, while techinically within range, is also kinda on the low side.

I also came out very anemic, but I don't know the actual measurement.  A blood test later on (in the middle of my cycle) showed no anemia - which I already knew; I'm only anemic when I'm.. um.. demonstrating my feminity - but at that time I'm very anemic.


That's the end! 

If you know what you're talking about, either medically for one of the conditions or measurements, or fitness-ly with the measurements - or I guess fitness-ly with the conditions - please feel free to comment.



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