Hi Gals,
Well Dr. Rind thinks all of my problems are secondary, even though all of my pit hormone levels came back perfectly normal. He based his thinking solely on the fact that my TSH and FT4 were both low last time...I tried to explain that those labs were drawn exactly 2 weeks after a dose change (thanks for the info Ashley!) and that my TSH was high pre-diagnosis, also that I had a goitre.
I told him about the newfound anti-parietal cell antibodies, which happen with Hashi's and primary AI, reminded him of my aldosterone/renin and Na/K pre-diagnosis, hyperpigmentation, etc. I also have vitiligo which happens in Polyglandular Syndrome, and an enlarged thymus which happens with primary Addison's.
He was insistent about pituitary hypofunction I think because of the Lyme coming back positive. I know Lyme can disrupt the HPA axis and affect the pit, but I believe that based on my labs and history, these problems are clearly primary. For me it probably doesn't matter, but it's important to differentiate these for the sake of my immediate family members (twin sister especially).
I didn't have a chance to ask him about many things, aldosterone/renin included. To be completely honest, it was not a particularly enlightening meeting and in some ways was bizarre. I did find through reading that renin should be drawn in the early morning, upon rising if possible. The renin drops steadily through the day, moreso if you're on your feet (which I was that day). It doesn't seem like Florinef actually replaces aldosterone - it's just a substitute. I guess this is why many endos don't even check aldosterone to dose Florinef, only renin.
If I find out more about the renin stuff, I'll let you know. Thanks for the info and the link!
Leigh
I've been starting each day with a glass of salt water and am managing on 0.05mgs of Florinef/day only. I may even try alternating days without any, but last time that didn't go so well.
