From: Holly Jagger <[log in to unmask]
Does anyone know what a low anion gap could mean?
I'm not sure the variation in TSH is significant. There's a diurnal
variation so it could be caused by time of day, and I'm not sure it's supposed to be
constant. If for no other reason if you change from a relaxed schedule to a
busy one, you probably require more Thyroid hormone, which I would think would
mean your TSH might go up a bit. Also, some medications do affect TSH,
including corticosteroids. Corticosteroids tend to lower TSH artificially, and I
think if you check out drug info for prednisone it lists that as a side effect.
Do you think your thyroid is treated adequately? Many people need their TSH
to be around 1. I like mine to be completely suppressed. It's easier to
breathe.
For concern about bones, which you should have, when on corticosteroids do a
search on Dr. John Lee and progesterone. It's informative, he started
treating people with a natural progesterone cream and found it reversed their
osteoporosis.
Also, many people have been found to be low in Vitamin D, which you get from
sunshine. People on corticosteroid should take particular care about this,
and Vitamin D does control calcium level.
Also interesing is one of the side effects of forinef -
http://www.rxlist.com/cgi/generic/fludro_ad.htm
Most adverse reactions are caused by the drug's mineralocorticoid activity
(retention of sodium and water) and include hypertension, edema, cardiac
enlargement, congestive heart failure, potassium loss, and hypokalemic alkalosis.
So, this could cause your low anion gap. Maybe too large a dose?
From my notes, I don't know the source.
ANION GAP (Sodium + Potassium - CO2 + Chloride) - An increased measurement is
associated with metabolic acidosis due to the overproduction of acids (a
state of alkalinity is in effect). Decreased levels may indicate metabolic
alkalosis due to the overproduction of alkaloids (a state of acidosis.) Optimal
reading is about 9.
I've got some info on alkalosis below. I don't know how well your thyroid is
treated, but it's typical for those with low thyroid to have low carbon
dioxide per Langer "Solved the Riddle of Illness." My CO2 was low before thyroid
treatment. Ray Peat also talks a lot about CO2, oxygen and hypothyroidism. It
can just be caused by rapid breathing, I know in high school anatomy we all
timed how many breaths we took per minute, and mine was a lot higher than
anyone else's. Whether that was caused by hypothyroisim or not, I don't know.
I'm not sure how it comes into play, but for a while I was drinking a
teaspoon of apple cider vinegar and honey in my water, along with a drop of Lugol's
Iodine Solution. It was recommended among other places in "Vermont Folk
Medicine" by DC Jarvis MD. A drop of Lugol's Solution, but not the ACV and honey ,
is recommended today by Dr. David Derry, a doctor who did a lot or research on
iodine, cancer and the thyroid. However, the concoction made me very tired.
I blamed the Lugol's Solution, but after reading James Wilson's "Adrenal
Fatigue" he explained that those with low adrenals need a lot of salt, and should
avoid too much potassium. So, I can take the Lugol's Solution, without
additional fatigue by itself. And even though I don't crave salt like I did before I
went on Cortef, I started adding a lot to my food.
http://www.merck.com/mrkshared/mmanual_home2/sec12/ch159/ch159c.jsp
Alkalosis
Alkalosis is excessive blood alkalinity caused by an overabundance of
bicarbonate in the blood or a loss of acid from the blood (metabolic alkalosis), or
by a low level of carbon dioxide in theblood that results from rapid or deep
breathing (respiratory alkalosis).Metabolic alkalosis develops when the body
loses toomuch acid or gains too much base. For example, stomach acid is
lostduring periods of prolonged vomiting or when stomach acids aresuctioned with a
stomach tube (as is sometimes done in hospitals). Inrare cases, metabolic
alkalosis develops in a person who has ingestedtoo much base from substances such as
baking soda (bicarbonate of soda). In addition, metabolic alkalosis can develop
when excessive lossof sodium or potassium affects the kidneys' ability to
control theblood's acid-base balance. For instance, loss of potassium
sufficientto cause metabolic alkalosis may result from the use of diuretics
orcorticosteroids.Respiratoryalkalosis develops when rapid, deep breathing
(hyperventilation) causestoo much carbon dioxide to be expelled from the bloodstream. The most
common cause of hyperventilation, and thus respiratory alkalosis, is anxiety.
Other causes of hyperventilation and consequent respiratory alkalosis include
pain, cirrhosis, low levels of oxygen in the blood,fever, and aspirin
overdose (which can also cause metabolic acidosis(see Section 12, Chapter 159
)).Symptoms and Diagnosis
Alkalosis may cause irritability, muscle twitching,muscle cramps, or no
symptoms at all. If the alkalosis is severe,prolonged contraction and spasms of
muscles (tetany) can develop.A sample of blood taken from an artery shows that
the blood is alkaline.Treatment
Doctors usually treat metabolic alkalosis by replacing water and electrolytes
(sodium and potassium) while treating the underlying cause. Occasionally,
when metabolic alkalosis is verysevere, dilute acid in the form of ammonium
chloride is giveni ntravenously.With respiratory alkalosis, usually the only
treatment needed is slowing down the rate of breathing. When respiratory alkalosis
is caused by anxiety, a conscious effort to slow breathing may make the
condition disappear. If pain is causing the person to breathe rapidly, relieving the
pain usually suffices. Breathing into a paper (not a plastic) bag may help
raise the carbon dioxide level inthe blood as the person breathes carbon dioxide
back in after breathing it out.
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Skipper
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