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Possible Nonclassic Congenital Adrenal Hyperplasia ?

Discussion in 'Optimal Labs' started by Chipdouglas, May 7, 2019.

  1. Chipdouglas

    Chipdouglas New Member


    I can help - if you now have the files stored in some location on your computer. you can rick click any of those files and select «open with» in the menu. You'll be given a few choices, but Microsoft Word might not be one of those. Click «show more apps.» Keep doing this until you can click Microsoft Word. Once there, you'll see a check box - by checking that box, you can create an association with .Word files, so that next time, this process will be automatic.
     
  2. Chipdouglas

    Chipdouglas New Member

    Umm, I think I might have come across as being in a hurry. I'm not. I've been dealing with these issues for 20 years - so I must be a very patient guy.
     
  3. Chipdouglas

    Chipdouglas New Member

    JanSz - I just wanted to say that I'm waiting until you've seen my other labs and then I'll comment/respond on what you wrote/asked yesterday. No rush though, take as much time as needed.
     
  4. JanSz

    JanSz Gold

    if i would save them locally I assume that i would be able to open them.
    But I would rather open them without saving them first.
    Computer asks me what program to use to open them,
    it does not suggest word or excel
    but
    it lets me tell it what to use.
    I just do not know where those programs are located.
    (And they are not under programs (as I would expect).
    thisPC>Windows(C:)>Program Files
    not there
    .. upload_2019-5-8_18-34-1.png
     
    Last edited: May 8, 2019
  5. Chipdouglas

    Chipdouglas New Member

    JanSz,

    What iteration of Windows are you using ?
    I understand what your problem is, as I've just reproduced the same issue on my end.

    If you're current OS version is Windows 10, then at bottom left of screen, where it says «type here to search», just type in «Microsoft Word» and it'll be displayed in the search results. Once you can see the icon, right click on it and choose «open file location».

    Let me know whether this helped.
     
  6. JanSz

    JanSz Gold

    I think it may be because the files were created no but Microsoft office but Apache OpenOffice




    upload_2019-5-8_20-9-33.png
     
    Chipdouglas likes this.
  7. JanSz

    JanSz Gold

  8. JanSz

    JanSz Gold

  9. JanSz

    JanSz Gold

  10. Chipdouglas

    Chipdouglas New Member

    JanSz - thank you for taking care of this. I appreciate it.

    The reason I decided on starting a thread about my case, was because I saw you were a forum member. Now, others are absolutely welcome to chime in as well.

    The MD who diagnosed me, is the man who wrote this book : https://www.amazon.ca/Optimize-Your...erre+cloutier&qid=1557363856&s=gateway&sr=8-3

    His diagnosis (i.e. NCAH) is possible, but in posting about it, I wanted to see differential diagnoses suggestions. While I'm certainly not ignorant about hormones, I don't feel as confident as you are around this topic.

    So, elevated PRL is possibility and so is low ALP and low vitamin D. Regarding insulin, you underscored, meaning you find that it could be lower than that.

    You asked whether I get muscle cramps - I don't, but my K+ has gone up since the workup I posted. I've only posted relevant blood works.

    Again, I'm sorry if I came across as being in a hurry. Such misunderstandings are common on the web. After all, we don't really know one another. However, just know that I'm highly appreciative of any help - thanks again !

    I forgot to bring up HCY which isn't optimal. I'm forgetful these days...
     
    Last edited: May 8, 2019
    JanSz likes this.
  11. Chipdouglas

    Chipdouglas New Member

    An interesting observation : I've been taking Thorne's Betaine HCL & pepsin for ~ 2 weeks. I've experienced severe bloating for so many years. Hypochlorhydria has never been looked into (i.e. breath test). Nevertheless, I thought I'd give the above a try. After about a week, libido began to improve. Either things are improving through increased nutrients absorption, thus increased functions OR I'm being helped by betaine through improved methylation.

    It might also be benefiting my NAFLD. My latest liver panel shows there's no more NAFLD. However, there's a good chance an abd. ultrasound would show otherwise.

    I also have less bloating after meals.
     
  12. Chipdouglas

    Chipdouglas New Member

    Here's an old blood workup that was done at PATH Medical in NYC. The reason I'm posting this ? While I was at the clinic, I was stressed out and my workup shows a pattern of stress - that is, hormones are all over the place.

    What I find to be interesting, was that both DHEA and progesterone were off the chart high and DHEA-sulfate was high normal. Cortisol however, was slightly below mid-range. Cortisol is made from progesterone. What is interesting is that even under much less stress (i.e. while in my hometown), I show the same pattern - that is, high progesterone, normal cortisol and high normal DHEA-S.

    Hypothesis : Since cortisol is made from progesterone. Is the elevated (backlog ?) progesterone the result of a less functional 21-hydroxylase enzyme ?

    Or is the normal cortisol while under stress merely the result of the antiglucocorticoid effect of DHEA ? But then, why is the adrenal pattern the same under both severe stress and mild or no stress ?



    TSH 2.880 0.27-4.2 uIU/mL
    RPR Non-Reacti NON REACTIVE
    TESTOSTERONE,TOT.,S. 184 LO SEE BELOW
    TESTOSTERONE, FREE, SE 6.3 SEE BELOW
    LH 0.7 LO SEE BELOW
    FSH 2.2 SEE BELOW
    PROGESTERONE 1.09 HI SEE BELOW
    PROLACTIN, SERUM 1.8 LO SEE BELOW
    ESTRADIOL (NON-PREG.) 21.40 SEE BELOW
    CRP <0.3 <0.5 MG/DL
    E.SEDIMENTATION RATE 2 M<21/F< mm/hr
    FIBRINOGEN 283 200-400 mg/dl
    DHEA 18.8 HI 0.2-9.8 ng/dl
    ALUMINUM, SERUM 12 HI 3-9 ug/L
    LEAD, BLOOD 1 SEE BELOW
    DHEA-SULFATE 491 SEE BELOW
    MERCURY, BLOOD (3) 2.0 SEE BELOW
    SEX HORM, BIND. GLOB. 17.6 SEE BELOW
    CORTISOL, RANDOM 16.4 4-32 ug/dl
    IGF-1 (SOMATOMEDIN C) 126.0 SEE BELOW
    PREGNENOLONE (19) See below SEE BELOW
    CADMIUM, BLOOD (3) <0.5 <5.0 mcg/L
    HOMOCYSTEINE 12.06 SEE BELOW
    IGF-BP3 (19) See below SEE REPORT
    DIHYDROTESTOSTERONE (3) 12.3 LO SEE REPORT
    IMMUNE DEF.PANEL (CDC) See below

    Reference ranges for the above tests right below :

    Prolactin Male 4.6-21.4 ng/ml
    FSH 1.5-12.4 mIu/ml
    LH 1.7-8.6 mIu/ml
    PROGESTERONE 0.2-1.4 ng/ml
    DHEA-SO4 men age 30-39 (120-520) ug/dl
    TESTOSTERONE,TOTAL 280-800 ng/dl
    TESTOSTERONE, FREE men age 20-39 (8.8-27.0) pg/ml
    ESTRADIOL 7.63-42.59 pg/ml
    HOMOCYSTEINE 3.7-13.9 umol/L
    IGF-1 men age 31-40 (109-307) ng/ml
    SHBG male 13-71 nanomols/L
    IGFBP-3 31-70 y (1.9-3.6) mg/L
    DIHYDROTESTOSTERONE 16.0-66.0 ng/dl
    MERCURY WHOLE BLOOD < 5.0 ug/L
    LEAD, BLOOD 0-25 ug/dl
    PREGNENOLONE <20-150 ng/dl
     
    Last edited: May 9, 2019
    JanSz likes this.
  13. JanSz

    JanSz Gold

    upload_2019-5-9_20-55-47.png
     
  14. Chipdouglas

    Chipdouglas New Member

    To provide a clear answer to my above hypotheses, a Cortrosyn test needs to be run.

    JanSz : Have you ever come across cases of men with CAH/NCAH ? Personally, on the discussion boards I've been a member of over the last 15+ years, I've yet to come across a case.
     
  15. JanSz

    JanSz Gold

    No I did not.
    In a way I am glad that we have this discussion.
    On dr Crisler's board I opened a thread on CAH.
    That helped me in better understanding steroid hormones.
    CAH is about anomalies from conception on.
    Someone directed me to the guys & lesbian websites where they deal with their steroid hormones, but at the time I did not benefited much from what they had.

    My problems started at the time I stopped working 1997, (company sold). I was 57yo, have not worked since.
    Very high stress afterward. I am sure it was my time to get NCAH.

    I see two foundations.

    www.caresfoundation.org
    www.crccares.org

    They may have bulletin board with some info.
    If you find something useful there, please let me know.
    =======================================================================================

    https://www.caresfoundation.org/what-is-cah/non-classical-cah/


    upload_2019-5-10_8-5-25.png

    ==========================================================================


    upload_2019-5-10_8-9-6.png
     
    Chipdouglas likes this.
  16. JanSz

    JanSz Gold

    So far, in this area the best test would be to get:

    https://dutchtest.com/shop/

    You may even get some advice that may be new to you.

    I suspet that you have
    overacting 5aR
    and Propecia, Proscar or Avodart may give you some relief.
    That test will tell you where you are.


    https://dutchtest.com/resource/dutch-complete-male-sample-report/
    https://dutchtest.com/wp-content/uploads/2016/11/DUTCH-Complete-Male-Sample-Report-01_24_19.pdf



    upload_2019-5-10_8-12-9.png
     
    Last edited: May 10, 2019
    Chipdouglas likes this.
  17. Chipdouglas

    Chipdouglas New Member

    What do you mean by «give you some relief» ? Do you mean relief from anxiety ?
     
  18. JanSz

    JanSz Gold

    First you have to find out where that dial points. Then you may think about options to adjust.
    The methylation dial may tell you also about another part of your status.

    upload_2019-5-10_17-9-51.png
     
  19. Chipdouglas

    Chipdouglas New Member

    JanSz : I agree with what you posted above - this is a first step. What I meant though was, can elevated dihydrotestosterone cause anxiety ? I remember having a conversation with Dr. Romeo Mariano on this topic - he said that DHT is a very calming signal.

    In this text, there are both mechanisms that might lead to anxiety, but also anxiolysis.
    https://area1255.blogspot.com/2013/06/exclusive-what-how-of-dht.html
     
  20. JanSz

    JanSz Gold

    Wonder when this guy wrote that article.
    He talks about DHT.
    There is no DHT.
    There are 5a-DHT and 5b-DHT
    and someplace I heard that 5b-DHT is actually estrogen.

    I hope that he (without knowing it) talks about 5a-DHT.
    In your case I am suspecting that when you have a lots of DHT actually most of it is 5b-DHT.

    Dihydrotestosterone : 2015 ( [male 20-49 yo] 217 - 1650) PMOL/L

    Doing DUTCH test would possibly clarify something.
    ---
    this does not help
    Progesterone has also been done twice : both tests were above upper limit.

    High progesterone make for no erection, have to be just right, similarly with E2.
    ---
    With prolactin in upper limit, penis have no chance to stand up

    As to prolactin, I’ve seen it about mid range on one test and another time it was in near the upper limit of normal.
    ---
     

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