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DrSocial has the highest follow-up attention to your concerns

    • Moderator
    • 1957 posts
    July 3, 2014 5:50:11 AM PDT

    Do you suffer from dizziness, lack of energy, or back pain?

    If so leave your information:

    Age: to closet 5 years for adults?

    When did it start?

    How often does it occur?

    Your medications?

    Your surgeries (general?

    Recreational drugs?

    Cigarettes?

    Number of beers /day?

    Medical conditions in family?

    Do you have fevers, chills, nausea or vomiting?

    List any other information you like to share and you will receive personalized attention. According to the Journal of American Medical Association, high value care and (high value information), come from smaller hospitals. Bigger isn't always better. In addition DrSocial personally follows up with your case if you any additional concerns. When you talk to a doctor here, you can expect to see them again, not hear that they are too busy to talk to you until next month. Leave your health and medical questions for the highest level of follow-up attention of all ask doctor websites. I look forward to hearing from you. -BrettMD


    This post was edited by DrSocial Admin at August 15, 2014 2:22:39 AM PDT
    • Moderator
    • 1957 posts
    July 3, 2014 5:57:52 AM PDT
    If less than 18, please use the age in years,
    Please do not mention your legal name, but use an online identifier.

    At DrSocial you will receive follow-up and not simply find a new doctor each time to whom you have to explain your concerns again.
    • 21 posts
    August 12, 2014 8:24:46 PM PDT
    Hi my name is twinjaffe I'm concern my cortisone level was 1.3 I've been taking prednisone and solu-medrol for severe asthma I take morphine and oxycodone wod that have any effect in my cortisol level,
    • Moderator
    • 1957 posts
    August 13, 2014 2:49:22 AM PDT

    Thank you kindly for your question. 
    Legal disclaimer: we do not have a doctor- relationship and we cannot give specific instructions of care to you, but we can give you our best effort to find high quality information that you can consider. If we are wrong, or you don't like what we say, feel free to leave a message and let us know how we can improve the quality of service. In addition, we encourage other people in the community to contribute their knowledge to the questions that are asked.
    This information is public, please do not give any identifying information. For example, if you have a rare disease, and had a rare surgery, please simply state "back surgery," and if needed we can explore that further. If your neighbor or best friend reads this, will be they be able to identify you based on the information given? If yes, please remove the information or change it slightly.
    BAD example: I live in Boston, Dr. Patel at MGH hospital diagnosed me with a schwannoma tumor last month, then I traveled to Tokyo and taught English for a year.
    Acceptable example: I live in the United States, Had a tumor & surgery, then I traveled abroad for work.

    -----

    Please change your name, and please do not tell us your real name. 

    Please tell me a bit more about whether this cortisone level was 1.3

    1. Just to double check, was it "cortisol," or "cortisone"?

    2. what time of day was it.?

    3. Was it from the blood or the urine.?

    4. Can you type out exactly what was in the laboratory report. Without your name or birth day or other identifiable numbers. There are several different types of tests that quantify your steroid level. Some give more precise information than others. For eample. Was the test 

    Taking exogenous steroids can decrease endogenous steroid production from the adrenals.

    To answer your question, YES, taking steroids can suppress the adrenal production of "cortisol".

    ---

    I look forward to hearing from you. 

    Please see the image as it talks about a few of the measurements. What specific test did you have done?

    Also if you could please write down the small letters after your lab result that would probation help me better answer your question.

    Kind regards, 

    -BrettMD


    This post was edited by DrSocial Admin at August 15, 2014 2:32:17 AM PDT
    • 21 posts
    August 14, 2014 8:47:01 PM PDT
    Hi there the test was done before 8:00 am it was drawn blood, cortisol - am 1.3 low ug/dl reference interval 6.2-19.4 also immunoglobulin E Toatal 242 high iu/ml reference interval 0-100 I'm bruising,very tierd fatigue,nausea,and a lot of body pain mostly joint and severe swelling both feet I am 44 years of age I do not smoke any more I use to quite x 2 weeks ago. Thank u so much
    • 21 posts
    August 14, 2014 8:56:57 PM PDT
    I seem to be sweating a lot also and yes I have a lot of back pain and neck pIn I have so e neck problems been diagnosed with nerve problems in my neck also with retrolithisis and in my lower back I have facet, bulging disc I have only had gallbladder surgery and and adhesion that's all,and sorry the test is cortisol I spelt it wrong the very first time thank u very much for ur help
    • 21 posts
    August 14, 2014 9:03:46 PM PDT
    My back problems have been going on for the past 15 years and no I do not drink alcohol nor use any recreational street drugs I want to thank you very much for ur answers and help thank you very much
    • Moderator
    • 1957 posts
    August 14, 2014 9:10:06 PM PDT

    Hello F,

    Thank you for the reply.

    1. It appears that your cortisol is low. It seems reasonable that the steroids may be contributing to that. 

    2. Did you discuss the lwo lab results with your doctor?

    3. Have you ever had these lab tests done before? how are they different now

    4. Have you had your thyroid hormone checked before?

    5. Do you think that you may be suffering from too many exogenous steroids? With the bruising. Perhaps there are other medicines such as omalizumab that may help. 

    6. What type of doctor did you see? 

    7. Have you ever seen an allergist before?

    8. What about a pulmonologist?

    9. when did your pain in your joints start?

    10. what is your temperature

    11. Heart rate?

    12. Do you work the night shift, and sleep during the day?

    13. There are different types of cortisol. The following information is from uptodate. Please download it as it is copyright, and I may need to further redact it. It is already redacted, and I believe that I am using selected material that qualifies for exemption under "fair use," of copyright. However, I do not know with certainity.. I am doing this of my own accord, and drsocial pays me, but does not and is not able to oversee me. Therefore, if there are any copyright concerns, please E-mail: brett@drsocial.org

    I look forward to hearing from you.

    Kind regards,

    -BrettMD

     

    MEASUREMENT OF SERUM CORTISOL — Cortisol has been measured in serum by several methods. Although many of them are no longer in routine use, the important assays are mentioned to permit one to interpret the older literature.

    Methods of measurement

    Porter-Silber chromogens — Serum cortisol was first measured by assay of Porter-Silber chromogens (17,21-dihydroxy-20-ketosteroids, referred to as 17-hydroxycorticosteroids, or 17-OHCS) [1]. This method is no longer used.

    Competitive protein-binding assay — This assay uses competition for binding sites on cortisol-binding globulin (CBG, or transcortin) to quantify cortisol . Its advantage is lack of drug interference; its disadvantage is that prednisolone and several endogenous steroids, some of which may be increased in pregnancy, adrenal carcinoma, congenital adrenal hyperplasia, and after administration of adrenal enzyme inhibitors, bind to CBG and falsely elevate serum cortisol values. Interfering steroids can be removed before assay by solvent partition or thin layer chromatography (TLC).

    Fluorometric assay — This assay exploits the fluorescence of 4-11-beta, 21-dihydroxy-3,20-ketosteroids (11-hydroxycorticosteroids, or 11-OHCS) in sulfuric acid and alcohol [4]. Cortisol and corticosterone are detected by this assay; potent synthetic glucocorticoids are not. Its advantages are simplicity and relative specificity; its disadvantage is that spironolactonequinine,quinidine, niacin, and benzoyl alcohol also fluoresce in those solvents and therefore falsely elevate cortisol values.

    Radioreceptor assay — This assay uses the type II glucocorticoid cytosol receptor as a cortisol-binding agent [5]. Its advantage is its specificity for bioactive steroids, including synthetic glucocorticoids; its disadvantage is the limited supply and instability of the receptor. As a result, this assay is not widely available.

    Radioimmunoassay — Radioimmunoassays for cortisol use polyclonal or monoclonal antibodies that are raised to a cortisol analogue that has been conjugated to a protein carrier. Each antibody is characterized in terms of its affinity and crossreactivity with other endogenous or exogenous steroids found in serum. Antibody, labeled cortisol tracer, and cortisol standard are used to perform the assay. The results are dependent upon the specificity of the antibody used in the assay. Both liquid-phase and solid-phase assays of requisite sensitivity and specificity are widely available in reference laboratories and in kit form. Serum total cortisol is measured.

    Other immunoassays — Variations on radioimmunoassays using fluorescent, chemiluminescent, and other labels in place of radioisotopic labels, and two-site antibody designs (one antibody is bound to a solid substrate, the other carries the radioactive or other label, and the steroid forms a bridge between them) have similar sensitivity and specificity and are available for use in automated analyzers. The results, like those of radioimmunoassay, are dependent upon the specificity of the antibody used in the assay.

    Structurally-based assays — In contrast to antibody-based assays, structurally-based assays (HPLC, mass spectrometry) are highly specific for the cortisol molecule; they also can measure synthetic steroids ]. The development of high-throughput techniques to simultaneously measure multiple samples makes these labor-intense assays feasible for commercial use ]. This method separates cortisol from other steroids and steroid metabolites; cortisol is then measured fluorometrically or spectrophotometrically 

    Normal values — The serum cortisol concentration normally reflects that of corticotropin (ACTH) and therefore has circadian rhythmicity (. Normal values vary with the particular assay. The following values are representative of an average radioimmunoassay; those obtained by competitive protein binding assay would be similar, and fluorometric assay results are about 3 mcg/dL (85 nmol/L) higher 

    In normal subjects serum cortisol concentrations are higher in the early morning (about 6 AM), ranging from 10 to 20 mcg/dL (275 to 555 nmol/L). Serum cortisol concentrations range from 3 to 10 mcg/dL (85 to 275 nmol/L) at 4 PM, and the concentrations are lowest, less than 5 mcg/dL (140 nmol/L), one hour after the usual time of sleep .

    Interpretation — Cortisol secretion is episodic and the normal ranges are broad. A single serum value, if it falls within the normal range, is inconclusive. An individual can have partial pituitary or adrenal insufficiency but maintain plasma ACTH and serum cortisol concentrations within their respective normal ranges. For these reasons, stimulation or suppression testing should be performed when there is doubt. Nevertheless, samples drawn at the appropriate time for th


    This post was edited by DrSocial Admin at August 15, 2014 2:51:51 AM PDT
    • 21 posts
    August 15, 2014 7:16:56 AM PDT
    Hi dr Brett thank you so much for ur reply,yes I have seen a pumonologist for asthma I was diagnosed last year with severe always in and out of hospitals every month he finally sent me to see an allergist and she is the one that had the blood work done she referred me to an endocronologist but they can't see me untill x 3 months what worries me is that the allergist ms told me it was fatal then I went to see the pumonologist reviewed the tests and he told he different he told me u either have a tumor in ur head or ur abdomen so how do u think I feel yes doctor I've been takining thyroid medication and still have my thyroid they test it every 6 months about my pulse it has always run high and also it's very difficult for me to sleep at night I've tried everything my joints in my wrists and feet have been hurting more and more every month the pain gets worse un top of my neck and back pain I've also not used that I sweat a lot but a lot, I would like to thank u so much for ur time and ur energy in helping people out u are a gifted angel that god has sent to us I hope u have a good day thank you again doctor
    • Moderator
    • 1957 posts
    August 15, 2014 4:14:23 PM PDT

    Hi F,

    Thank you for reply. 

    If I were you I would feel concerned, confused. Personally I am a bit angry that the medical system does not and has not given patients all of their medical records. This is getting better though. 

    Do you have a primary care physician? You are seeing multiple specialists. 

    Questions. 

    1. Do you have all of your medical records? This is essential. It is criminal that hospitals and clinics do not give patients their medical records right away. The argument is: "the patient may not understand what I write."... 

    my reply: They might look it up, ask another person, have better, more coordinated medical care, and not be kept in the dark.

    2. Do you have a primary care doctor?

    2a. Send them all of your records from each of the specialists. labs, imaging etc. 

    2b. Obtain a copy of the records yourself and bring them to see your primary care doctor.

    3. What did your allergist tell you was fatal?

    4. What did your pulmonologist tell you was not fatal?

    5. When were you told you have a tumor?

    6. Have you ever had an MRI of the brain? 

    7. When are you going to see your primary care doctor? 

    7b. Did you discuss your low cortisol with your pulmonologist? What did they say? Did he think you may be on too much steroids? 

    8. What did your physician say about your dose of steroids? 

    9. What did your allegist say about your dose of steroids?

    10. Do you think you are on too high of a dose of steroids? 

    11. Do you think that your skin changes may be related to the steroids? 

    I look forward to hearing from you.

    -BrettMD

     

    -----

    Dear Dr. Social Admin, I would like to suppy this user with a link to our app forum that contains other websites and resources that are useful or may be useful. However, it is very difficult to find the search forum button. I want to search the forum but it is not easy. Please add a search forum button to every page. Thank you kindly. 


    This post was edited by DrSocial Admin at August 23, 2014 10:02:02 AM PDT
    • 21 posts
    August 17, 2014 8:24:00 AM PDT
    Dr Brett I answered all of the questions to u 1 thru 11 did u not recieve them. Faith
    • Moderator
    • 1957 posts
    August 17, 2014 9:16:34 AM PDT

    Hi F, 

    I apologize for the numbering. 

    Questions. 

    30. Do you have all of your medical records? This is essential. It is criminal that hospitals and clinics do not give patients their medical records right away. The argument is: "the patient may not understand what I write."... 

    my reply: They might look it up, ask another person, have better, more coordinated medical care, and not be kept in the dark.

    31. Do you have a primary care doctor?

    32a. Send them all of your records from each of the specialists. labs, imaging etc. 

    32b. Obtain a copy of the records yourself and bring them to see your primary care doctor.

    33. What did your allergist tell you was fatal?

    34. What did your pulmonologist tell you was not fatal?

    35. When were you told you have a tumor?

    36. Have you ever had an MRI of the brain? 

    37. When are you going to see your primary care doctor? 

    38. Did you discuss your low cortisol with your pulmonologist? What did they say? Did he think you may be on too much steroids? 

    39. What did your physician say about your dose of steroids? 

    40. What did your allegist say about your dose of steroids?

    41. Do you think you are on too high of a dose of steroids? 

    42. Do you think that your skin changes may be related to the steroids? 

    Please remember that this is public forum. If you tink someone may identify you by the given information, then please change it or remove it. 

    I look forward to hearing from you.

    Kind regards, 

    -BrettMD


    This post was edited by DrSocial Admin at August 23, 2014 10:00:50 AM PDT
    • 21 posts
    August 18, 2014 7:44:03 AM PDT
    Dr Brett I have answered questions 30 to 42 have not heard anything from u sorry if I seem to be conserned maybe it got least and to tell u the truth I'm not very good at computers at all I can rely and write a letter but pasting and stuff like that I don't know another thing that I haven't told u within this month my teeth have broken and that was just by eating cereal. Within the past 10 years I have crowns on all my teeth I do take calcium also. Thank u very much have a good day
    • Moderator
    • 1957 posts
    August 18, 2014 8:09:53 AM PDT

    Greetings F,

    I did not receive your reply to questions 30 to 42. 

    43. When is your next doctor appointment? 

    44. Have you considered going to the Emergency room? 

    45. Do you know who the president of the united states is, what day of the week it is, what day of the month it is?

    I look forward to hearing from you. 

    Kind regards, 

    -BrettMD


    This post was edited by DrSocial Admin at August 23, 2014 9:59:38 AM PDT
    • 21 posts
    August 19, 2014 4:17:56 AM PDT
    Okay I sent you another tex but I guess your not receiving it, the answers are very long what I did is I went to my out box and just re sent it to you buy I'm seeing you have not recieved it I'll re write it to you again you asked me who was the president Obama is the president today is august the 19th 2014 its 4:16 am and it should be Tuesday early in the am also doctor is there any way I could send you something with out it being public ? Thank u so much your an angel
    • Moderator
    • 1957 posts
    August 19, 2014 5:03:43 AM PDT

    Greetings F,

    Therefore I ask that you go here http://drsocial.org/forms/contact

    Kind regards,

    -BrettMD

    ------------------

    My cell phone is no longer active. I was unable to pay my cell phone bill secondary to having to sue the medical board. If you would like to know more about the Medical Board's

    1. unethical & unprofessional conduct including fraud x6 

    2. reprimanding good medical care 

    3. reprimanding the prevention of patient harm

    4. Reprimanding the reporting of patient harm without investigating

    5. Failure to identify clinical incompetence.

    6. Clinical incompetence and failure to exercise medical knowledge expected of all physicians such as the ability to find the cardiology clinical practice guidelines.

    7. Refusal to investigate clinical incompetence from complaints filed in 2011, 

    then please see http://bit.ly/MedBoardFraud

    Dear F, I would prefer to not know your identity. I value patient safety. I reported repeated failure of the department to be compliant with the privacy laws. However, I was treated as a liar by a physician who recently lied under oath to the judge about probation and remediation being the same thing. Therefore I ask that you go here http://drsocial.org/forms/contact

     


    This post was edited by DrSocial Admin at August 23, 2014 9:59:11 AM PDT
    • 21 posts
    August 19, 2014 5:54:09 AM PDT
    (30) Hi doctor Brett the only medical records I have is the lab work that my allergist gave me.
    (31) I don't have any appt to see my primary care till x 2 months but she never gets involved with my treatments from my specialists she refers me out for that.
    (32) when I went in and she told me allergist the results are abnormal she told me that having a cortisol being at 1.3 was fatal, that I needed to see an endocronologist at that time I was very nervous she also told me me that I should start taking prednisone 40 mg a day and that if I stopped it I would die!!!! I did not know what cortisol even was nor ment, she did explains that it rarely happens to people that taking to much prednisone the cortisol level gets low, so I started taking prednisone but I didn't understand why if by taking prednisone that would happen to me and I asked her and she said if I stopped one dose of prednisone then I could die!!!!! That all inside my organs have shut down so I needed to take prednisone, I really still didn't understand why I should take so much prednisone and such a high dose I have not stopped it since then till now my face feet arms legs joint a are very swollen and very painful even my pinkies on my feet are very swollen I'm bruising a lot and severe left upper back pain, feet pain joint pain each day that goes by it hurts more and more. Leaving the doctors office allergist I decided to call my pumonologist and they told me that they could not see me any time soon so I told them that it was criticle to be seen asap that I had abnormal labs they still said no!!!!so then I decided to just go and so I did I spoke to the assistant and she brought me in I explained to her the situation and the doctor came in my pumonologist I explained to the doctor that they would not fit me in not even in urgent matters and I also told him that the allergist he reffered me to had drawn my blood and that my cortisol level was 1.3 and my theophylline level was low very low and that the allergist upped my theophylline to x2 a day and gave me 40 mg of prednisone every day till I see an endocronologist the pumonologist told me you either have a tumor in your head or in your abdomen he said I want u to lower ur prednisone to 10 mg a day untill u see an endocronologist he was so busy pumonologist that's all he said till today his office has not called me. He did not even suggest having an MRI done of my head nor abdomen so I left his office and thought to my self , well really he should have ran all these tests himself, well really he should have he's the one that gave me all these meds and persxribed them to me. I then called my allergist leaving the pumonologist and explained to her that he wanted me to take 10 mg of prednisone Nd she said no do not what ever u do do not lower ur prednisone so I stayed at 40 mg of prednisone because if my pumonologist was so carless in checking my blood work which he should have then maybe he does not know he is doing or maybe he just does not care he rushes from one patient to another always very busy it's like the more people he can see the more money he will make that's a very sad feeling to have till today no one has ordered an MRI at all, my allergist told me that the endocronologist can't see me till x 3 months from today
    • 21 posts
    August 19, 2014 5:57:20 AM PDT
    (37) I do not have an appt with my primary till x2 months from today she is booked up and can't see me she also can't refer me to any specialist till she sees me as a matter of fact today they called me to re schedule my appt that she won't be in either when I was soppose to go in and see her but I explained to the nurse the I needed to see he asap.
    • 21 posts
    August 19, 2014 6:04:19 AM PDT
    (38) I did not well he did not give me a chance to go over the labs with the pumonologist all he said was u either have a brain tumor or and abdomen one and that I needed to see an endocronologist and he walked out when his nurse walked in she said we will call u as soon as I get the appt the pumonologist told me to only take 10 mg of prednisone not the 40 mg that the allergist gave me the doctor rushed back out and never came back in when I walked out to the waiting room they told me they would get a hold of me with an appt since then I have not heard from him nor his office I have also called his office and they tell me they still don't have any appt for me.
    • 21 posts
    August 19, 2014 6:10:25 AM PDT
    (39) my primary doctore has not said any thing about my prednisone use because she has not seen me yet
    • 21 posts
    August 19, 2014 6:19:15 AM PDT
    (40) I did tell my allergist that the pumonologist told me to drop prednisone to 10 mg and she told me no no it is very critical to stay at 40 thatbi could die if I did not take one dose and she also upped my Theophlne x2 a day and to my knowledge I think that my pumonologist should have been more care full and caring and been checking all my blood work because he was the one prescribing it to me, instead of him rushing room to room and seeing a lot of patients makes me think that he really does not care he only thinks of how much money he can get and that is a very sorry thing to say but very true !!!!!!
    • Moderator
    • 1957 posts
    August 19, 2014 6:23:35 AM PDT

    Greetings F, Thank you for the very detailed reply. I am sorry that you have had such a frightening experience. Here is some information. Please let me know if you think it is helpful.

    Please let me know if you think that this is similar to what you are experiencing. 

    1. http://www.mayoclinic.org/diseases-conditions/addisons-disease/basics/causes/CON-20021340

    2. http://www.webmd.com/cancer/tc/secondary-adrenocortical-insufficiency-topic-overview

    3. Please consider going to this website, entering your information. it will ask you many questions. and give you a differential diagnosis. Please consider letting me know what the differential diagnosis is after going through each of the questions.

    http://sharecareapp.com/

    4. Do you know why your teeth are breaking? Are you on a medicine for your bones? 

    5. What was your calcium level when last checked?

    6. Do you brush your teeth?

    7. What is your heart rate? 

    8. What is your blood pressure? 

     

     

    I look forward to hearing from you. 

    Kind regards,

    -BrettMD


    This post was edited by DrSocial Admin at August 23, 2014 9:57:58 AM PDT
    • 21 posts
    August 19, 2014 6:33:19 AM PDT
    (41) how do I feel? I feel very bad as a matter of fact I have had so much depression that I never use to cry now I cry and I'm very sensitive over everything all the time I feel like a Ping pong bouncing from one side to anotherlike if neither of them could care less because if this is true or half true they sat this is they should have gotten on this ASAP and not wait till 2 1/2 months for an appt since then. Also I've been sweeting severe I mean severe and severe swelling and pain I take my pain pills which I've taken a little more because of all the pain I can't stand my upper back left pain either. I'm very faustrated and lost and that's why I have asked for help from u or any one that cod help me!!!!!!!!! I appreciate ur help I really do like I said ur not even my doctor and I have never met u and u seem to care more than them like I said and I feel u seem like an angel that just came in my life. I want to thank u again and again. Faith
    • Moderator
    • 1957 posts
    August 19, 2014 8:49:03 AM PDT
    Hi F,

    Have you thought about going to the Emergency Room?

    Please let me know if that's something you have considered. Do you have someone to take you?

    Please consider keeping me updated.

    Kind regards,
    -BrettMD
    • 21 posts
    August 19, 2014 12:34:17 PM PDT
    Hi dr Brett question is that u on the pic? Yes I brush my teeth at least 4 times a day I take calcium 600 mg for the past 3 years one of my front tooth fell last month and got it fixed and it was coastly now like I said another one fell. I asked u earlier if there's a different way I could send u something but not public