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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by satsumas on March 22, 2008, at 22:27:53
Am I paranoid to want comprehensive bloodwork done? My dr. once did it a few months ago, looking at standard measures plus heavy metals and thyroid hormones. Everything was in range.
But I'm concerned that my depression could be due to deficits in blood levels of things like:
- dhea
- testosterone
- PEA
- cortisol (excess)What are other things I should get checked that aren't part of standard bloodwork? I'm desperate after not seeing any remission in my depression for years upon years. Lately my mood has slightly improved with Emsam, and I think the feeling of being "slightly" better made me realize how BAD I was feeling for SO LONG. So I now feel super-vigilant about wanting to ensure that nothing nutritional/hormonal is contributing to my depression.
Thanks
Satsumas.
Posted by brooke484 on March 22, 2008, at 23:18:17
In reply to Want to ask doctor to get bloodwork for me, posted by satsumas on March 22, 2008, at 22:27:53
The range for TSH is something like .1-5, but if my TSH is over 3 or if my Free T4 or Free T3 are low I can feel pretty awful. Do you have copies of your labs?
brooke
Posted by yxibow on March 23, 2008, at 4:50:06
In reply to Want to ask doctor to get bloodwork for me, posted by satsumas on March 22, 2008, at 22:27:53
> Am I paranoid to want comprehensive bloodwork done? My dr. once did it a few months ago, looking at standard measures plus heavy metals and thyroid hormones. Everything was in range.
>
> But I'm concerned that my depression could be due to deficits in blood levels of things like:
> - dhea
> - testosterone
> - PEA
> - cortisol (excess)
>
> What are other things I should get checked that aren't part of standard bloodwork? I'm desperate after not seeing any remission in my depression for years upon years. Lately my mood has slightly improved with Emsam, and I think the feeling of being "slightly" better made me realize how BAD I was feeling for SO LONG. So I now feel super-vigilant about wanting to ensure that nothing nutritional/hormonal is contributing to my depression.
>
> Thanks
> Satsumas.Heavy metals are fairly rare unless you've been working in industry or ate lead paint as a kid.
The thyroid sounded reasonable (T3/4 TSH)
But a cortisol test if you want is about what I would take from that list. You have to carry around a jug (they usually only give you one) to urinate in for 24 hours. Any other form of test is unreliable -- cortisol changes constantly from moment to moment so this gives an average.
Yes -- I've done it, you start on a day when you're not busy, like a Sunday possibly, at 8am or the Saturday night before or whatever and keep it by you and make sure not to use the toilet for anything but #2. If they supply you a second container, that's good. Otherwise, you should empty a distilled water bottle, and they will take both containers in. I'm sure your phlebotamist will explain this whole process.
The others seem a bit esoteric, I'm not even sure if there are regular tests. Perhaps testosterone, but these things are also regulated by other organ/gland systems so I don't know if any of them would get to any root cause.
Posted by Phillipa on March 23, 2008, at 12:16:01
In reply to Re: Want to ask doctor to get bloodwork for me » satsumas, posted by yxibow on March 23, 2008, at 4:50:06
Two endos so far and both have done corisol tests with blood draws last was done with the blood drawn over a two hour period. One initial and then one an hour for a total of three. Asked as Mother had Addisons Disease. As far as the T3 T4 was told T3 was not reliable as it also changes hour to hour too. Love Phillipa
Posted by bleauberry on March 23, 2008, at 17:51:03
In reply to Want to ask doctor to get bloodwork for me, posted by satsumas on March 22, 2008, at 22:27:53
I think you are very smart. The opposite of paranoid. You should request all the tests you can afford and maybe even take out a loan or sell something if needed. Tests can give you the picture you are looking for.
BUT...mainstream doctors are not familiar with the tests you need, and they most often incorrectly interpret the results of tests they are familiar with.
I am a firm believer that a vast majority of stubborn psychiatric and health issues are within the categories of...adrenal and/or thyroid and/or mercury/lead. All of these can cause every problem imaginable, especially psychiatric.
Two excellent sources of diagnosis and treatment for adrenals and thyroid are from Dr Rind and Dr Wilson. Google those to see their sites. Wilson also has a good book.
With any test, but especially thyroid, the universal mistake is to believe everything is ok based on lab numbers that are within the so-called "normal" range. One can have "normal" numbers and still feel aweful. The important thing to look at is "optimal", not "normal". Even a 15% deviation from optimal, but still well within normal, can cause a person to feel lousy. Dr Rind goes into this in detail, along with handy graphs to plot your thyroid numbers to see the real picture. It is the relationship of the lab numbers to each other, not the numbers themselves, that tells the story.
For thyroid testing you need four things:
Free T3, Free T4, Total T3, and TSH. Knowing how to compare them to each other paints a clear picture of health or nonhealth. If you can afford it, it would be wise to also check for the thyroid antibodies to see if your thyroid is under autoimmune attack. These tests can be done by any doctor. Don't rely on them to interpret the results though. Come prepared.For adrenal testing, Doctors Data is a good lab. You can find places on the net to order the test yourself through mail, or you can get an integrative/alternative/naturupath to give you the test as they usually have them ready to go in their office. It involves taking a saliva sample 4 times in a 24 hour period to measure cortisol and DHEA, and the Adrenal Stress Index I took also had gluten antibodies test as part of the package. Saliva is a more accurate measure of cortisol than blood or urine. The results require no training to read. You see your cortisol curve on a chart plotted against an upper curve and a lower curve of normal. Test is roughly $125 or so. The lab also gives a good analysis of your results and recommendations for treatment.
With either thyroid or adrenal, symptoms alone can be highly diagnostic without any testing at all. Dr Rind has all the symptoms on a chart easy to see if you have them, if you are adrenal, thyroid, or a mixture of both. The testing can merely confirm what looks obvious, or rule it out to look at something else that causes the same symptoms.
Metal toxicity is not so easy. Mercury exposure can be measured in blood for about 72 hours, after which it has embedded itself into glands and brain where it won't show in blood or urine. One can be highly toxic and yet have clean blood. An excellent source of info is PHd Andrew Cutler's book Amalgam Illness. Written with a lot of physician language, but easy for us to understand as well. In a google search you can find excerpts and archives of previous web discussions that cover a lot of what is in the book. After symptoms, the next stop is a hair analysis. I forget which lab does it, Cutler goes over it, but the test covers all the metals including obscure things like Lithium. Here again though, it is not the numbers themselves, but the pattern that paints the picture. Mercury and lead leave telltale patterns in the metals found in your hair, patterns that are not common to anything else. For example, with me, mercury and lead were both elevated with scattered but fairly normal essential metals. That was an easy no brainer diagnosis. But if someone had done this test a year later, like I did a retest, the result showed practically zero mercury zero lead and zero anything else in my hair. That pattern has mercury written all over it, as mercury displaces the movement of metals, including itself. Anyway, get the hair sample done, via net or integrative doc. It's about $125 or so. If you have trouble interpretting the readings, experts at Frequent Dose Chelation forum on Yahoo can tell you what your hair says. If you have not had amalgams in your life, I would suspect your toxic exposure is not a major concern. With amalgams at any time in your life, toxic exposure is highly likely.
Other tests can be helpful but are more expensive and the problems they identify are usually a result of adrenal/thyroid/metals. A common one would be delayed food intolerances. Gluten is the biggest culprit, followed by things like dairy, shellfish, corn, soy, nuts. Can a food reaction cause depressive spectrum disorders? Anxiety? Bigtime. The thing is, because we eat the offending food all the time, we have no idea it is causing a flood of toxins in our blood going to the brain. I mean, we've been eating this particular food forever, right? I had no idea I was gluten intolerant until my adrenal stress test came back...part of the package was a gluten antibody test and I was highly positive on it. Little did I know all the foods with gluten were poisoning me.
The tests you need...adrenals, thyroid, metals, should cost total $400 or less. That's cheap to get a huge picture of what's going on.
> Am I paranoid to want comprehensive bloodwork done? My dr. once did it a few months ago, looking at standard measures plus heavy metals and thyroid hormones. Everything was in range.
>
> But I'm concerned that my depression could be due to deficits in blood levels of things like:
> - dhea
> - testosterone
> - PEA
> - cortisol (excess)
>
> What are other things I should get checked that aren't part of standard bloodwork? I'm desperate after not seeing any remission in my depression for years upon years. Lately my mood has slightly improved with Emsam, and I think the feeling of being "slightly" better made me realize how BAD I was feeling for SO LONG. So I now feel super-vigilant about wanting to ensure that nothing nutritional/hormonal is contributing to my depression.
>
> Thanks
> Satsumas.
Posted by yxibow on March 25, 2008, at 14:14:05
In reply to Re: Want to ask doctor to get bloodwork for me, posted by bleauberry on March 23, 2008, at 16:51:03
Well... I can't change people's opinions on amalgam theories, they're not based by any accredited dental organization, people have had "meter readings" done by non FDA approved devices, and even have had their fillings pulled out which actually causes -more- mercury to be released in the body.
The amalgam prevents more cavities from happening than the plastic, though I've had both. Yes, I can be made fearful about amalgams but the truth is that if I don't have them on some cavities, I'm much more susceptible to disease than epoxy. An amalgam is just that, two metals permanently held in place, an alloy.So I stand by that you're more likely to get mercury toxicity by eating certain fish or fish oil.
And this is also can be causation without correlation. We don't really know about the newsbites of aluminum and Alzheimer's. Aluminum is the third most abundant element and the most abundant metal on this planet and is present in traces in sand, definately a part of clay, mica, and other base rocks.
The same thing goes for lead, silver contains 1% lead typically on this planet, and traces of mercury can be found in a lot of places.
Blood tests for cortisol, even when given several hours apart are not as reliable as a 24 hour urine test. This averages the changes over the day.
Nonetheless, yes, blood tests are given in some circumstances at 8 and 4pm apart, but there are reasons for both tests and I would suspect if there is anything amiss with the blood test a urine test would be ordered.
Posted by satsumas on March 26, 2008, at 12:36:13
In reply to Re: Want to ask doctor to get bloodwork for me, posted by brooke484 on March 22, 2008, at 23:18:17
> The range for TSH is something like .1-5, but if my TSH is over 3 or if my Free T4 or Free T3 are low I can feel pretty awful. Do you have copies of your labs?
>
> brookeHi brooke, my Free T4 is 1.1 (range says 0.6 - 1.6) and my TSH is 1.07 (range says 0.4 - 4). Doctor didn't seem to think these numbers meant my thyroid was disfunctioning.
Posted by Phillipa on March 26, 2008, at 20:13:36
In reply to Re: Want to ask doctor to get bloodwork for me, posted by satsumas on March 26, 2008, at 12:36:13
According to my endo here he feels that 1-2 TSH is right on new lab values I was told. But mine went really low .0 something and I then became hyper. Still says free T3 changes rapidly through the day and just read thyroid panels should be taken in the am mine are always in the late afternoon???? Phillipa
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