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If someone has hypogonadism (low serum level of testosterone, low LH and low normal FSH), normal adrenal function, and high levels of IGF-1, what would this normally indicate?
Mild acromegaly?
Tumor that is pressing against the pituitary?Example:
LH/FSH/Testosterone=LOW
Cortisol/ACTH=Normal
TSH=LOW (L-thyroxine)
T4/T3=Normal (l-thyroxine)
IGF-1=HIGH
GH=Low Normal
Prolactin=Abnormal low (No TRH)@avast322 1436 wrote:
If someone has hypogonadism (low serum level of testosterone, low LH and low normal FSH), normal adrenal function, and high levels of IGF-1, what would this normally indicate?
Mild acromegaly?
Tumor that is pressing against the pituitary?Example:
LH/FSH/Testosterone=LOW
Cortisol/ACTH=Normal
TSH=LOW (L-thyroxine)
T4/T3=Normal (l-thyroxine)
IGF-1=HIGH
GH=Low Normal
Prolactin=Abnormal low (No TRH)There is no “normal” indication.
The usual process is that one has to look at the patient first to determine is something is wrong. Then one has to correlate the findings in the history and physical exam with the lab findings.
To go the other way, requires the actual data.
The terms “low” and “high” are relative. It would depend on the patient’s age, condition, and other factors whether or not it is “high” or “low” or neither.
Thus, it would be helpful to have the raw data – the actual numbers, to help determine what possible conditions may be present – i.e. a differential diagnosis.
IGF-1, for example, can be considered high at 400 in an elderly adult, but low in a teenager. Without additional concrete information, an IGF-1 of 400 has no meaning.
I was using the lab ranges given by LabCorp.
For a hypothetical 20 year old male:
ACTH=17 (6-48)
Cortisol=19.4 (5.0-22.0)
TSH=0.039 (0.40-4.50)
T4=0.97 (0.70-1.76)
T3=2.7 (2.3-4.5)
Test, serum=168 (241-827)
Estradiol=23 (<54)
LH=1.3 (1.5-9.3)
FSH=3.2 (1.4-18.1)
GH=0.3 (0.0-6.0)
IGF-1=468(116-258)
IGF-BP3=4.8In addition, “hypothetical” was on Testim 5% for 2 weeks prior to the blood test. None applied that morning. Taking L-thyroxine 0.137 for congenital hypothalamic hypothyroidism (no TRH) plus Advair. I just thought it was so weird that testosterone was so low and IGF-1 and cortisol were so high (comparatively).
DrMariano;1438 wrote:There is no “normal” indication.The usual process is that one has to look at the patient first to determine is something is wrong. Then one has to correlate the findings in the history and physical exam with the lab findings.
To go the other way, requires the actual data.
The terms “low” and “high” are relative. It would depend on the patient’s age, condition, and other factors whether or not it is “high” or “low” or neither.
Thus, it would be helpful to have the raw data – the actual numbers, to help determine what possible conditions may be present – i.e. a differential diagnosis.
IGF-1, for example, can be considered high at 400 in an elderly adult, but low in a teenager. Without additional concrete information, an IGF-1 of 400 has no meaning.
One may want to consider urinary gh 24 hour to get true indication about what is going on
I have seen several people IGF-1 rise when thyroid, testosterone, dhea e2 are normalized.
When one sees low igf-1 then I look to other hormone as possible indicators. E2 in women as well as men plays a huge part in regulating igf-1 signaling (DR M please correct me if wrong). I have seen clinically men with too much adex have low igf-1 level then they start asking about gh replacement. Once you stop adex then igf-1 levels begin to rise dramatically. Ask your self why could your levels be low looking at the integration of nutrients imbalances, hormonal system, immune system, CNS, lifestyles to find the potential problem.
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