This Is MS Multiple Sclerosis Knowledge & Support Community

so, i am seeing my GP on the 29th and i am going to ask for lots of labwork:
CBC
sed rate
ANA
uric acid (just curious since it is connected with zinc deficiency)
zinc
magnesium
vit D
copper
b vitamins

i want the sed rate and the ANA because when i was dx'd with MS there was never any sort of exclusion process that happened. i got my MRI results back and i was diagnosed clinically definite, yet diagnosing criteria states that MS is a dx of exclusion. i'm not saying i don't have it but i would at least like to have other things ruled out. also, i requested those labs because it occurred to me recently that my grandmother had sjogrens. also, my hands and feet have been wickedly cold and its really starting to get annoying. they are always cold (especially my feet) unless i am just waking up in the morning (totally relaxed state) or i have applied heat to them to warm them. these are the only times my feet are not freezing. i recently went to a hot spring and my feet burned white hot getting in (water was about 105) turned white, turned bright red, then the nailbeds went blue. classic reynauds. my feet tingled painfully the whole time in the water afterwards. i would like to find out if i do in fact have reynauds as this is often associated with lupus. also, one of the medications used to treat reynauds is ACE inhibitors, captopril in particular and i have read some about thier potential benefit for treating MS as well.

are there any additional labs/questions/etc i should include when i see my doctor?

thanks

sounds good. from where i sit just make sure the uric acid, zinc, mag, d, copper, and vits are serum tests. yes rbc are considered better but there's not as much research available for comparison.

Well, if you are inviting others to impose their own ms theories on you, I'd say ask for a cortisol and aldosterone test. Even if high cortisol and aldosterone don't cause ms, they aren't good for you and should be managed. Btw, high aldosterone causes the same physical symptoms that would inspire your doc to prescribe an ace inhibitor. Unfortunately, aldosterone finds a way around ace inhibitors after a bit.

I hope you get some good info!

Darnit. I should have asked for uric acid too. Good thinking, petunia!

it's fun to know uric acid

To know Pee is to love Pee.

Bender wrote:To know Pee is to love Pee.

Lol! I'll have one of what she's drinking!

anonymoose,

about cortisol and aldasterone...these are stress hormones, are they not? i ask because last spring i was dx'd with central serous retinopathy (CSR). in women its much less common (and it seems not all that common even in men) and the risk factors include stress and steroid use. i did have 2 rounds of low dose steroids about a year before (1st round started at 80 mg then tapered off, second round started at 40mg then tapered off) and a third round of high dose oral decadron (140 mgs!!! for 3 days) about 6 months before but none around the time of the diagnosis. the retinal specialist considered the steroid rounds non-contributory. i was under an extraordinary amount of stress around the time of my diagnosis with CSR though. i wonder if these hormones were a factor in developing it... if my GP is willing i will get tested for it.

so high levels of these hormones can cause the awful frozen feet?

stress also causes a loss of minerals such as magnesium, which helps circulation and is linked to raynauds too.

i did a search on magnesium and csr and found this:

Quantifying corneal endothelial cell death
"Central serous chorioretinopathy after inhaled steroid use for post-mycoplasmal bronchospasm"

that's interesting given that your specialist thought the steroids were non contributory. the link doesn't clarify if there's a magnesium connection but i thought it was also interesting that the steroids were used to control spasm.. i'd be very curious re magnesium status in that patient..

i know that i used to feel chronic high anxiety before i started working on nutrition. magnesium is one nutrient i have had to spend a lot of time on. and i am much less stressed as a result. so wrt stress hormones and magnesium i went study hunting and found these:

Aldosterone Secretion in Magnesium-Deficient Rats
http://endo.endojournals.org/content/80/5/969.short
"Decreased muscle potassium and increased sodium in rats made magnesium deficient suggested the possibility of increased aldosterone secretion. Muscle and plasma electrolytes and secretion of aldosterone and corticosterone in magnesium-deficient rats were compared with the same values in pair-fed controls. Aldosterone secretion by the magnesium-depleted animals was increased, while corticosterone secretion was decreased. Altered steroid secretion adequately explains the altered sodium and potassium metabolism."

Intralymphocyte Free Magnesium in Patients With Primary Aldosteronism
http://hyper.ahajournals.org/content/35/1/113.short
"It is known that hyperaldosteronism has been associated with magnesium deficiency, yet there are no data on the intracellular concentration of ionized magnesium ([Mg2+i]) in subjects with primary aldosteronism (PA). ... In subjects with PA, [Mg2+i] was significantly lower than that in NCs"

mmpetunia wrote:anonymoose,

about cortisol and aldasterone...these are stress hormones, are they not? i ask because last spring i was dx'd with central serous retinopathy (CSR). in women its much less common (and it seems not all that common even in men) and the risk factors include stress and steroid use. i did have 2 rounds of low dose steroids about a year before (1st round started at 80 mg then tapered off, second round started at 40mg then tapered off) and a third round of high dose oral decadron (140 mgs!!! for 3 days) about 6 months before but none around the time of the diagnosis. the retinal specialist considered the steroid rounds non-contributory. i was under an extraordinary amount of stress around the time of my diagnosis with CSR though. i wonder if these hormones were a factor in developing it... if my GP is willing i will get tested for it.

so high levels of these hormones can cause the awful frozen feet?

Yes, cortisol and aldosterone are stress hormones. I am completely unfamiliar with CSR but have read that steroids (and naturally released cortisol) can cause the hippocampus to atrophy, leading to poor function and hpa axis dysregulation. An explanation with supporting studies/papers are here http://www.thisisms.com/forum/general-d ... 21459.html

High levels of aldosterone, a vasoconstrictor, can cause hypertension, which is often associated with frozen feet and fingers. Some threads on aldosterone http://www.thisisms.com/forum/chronic-c ... 21244.html and http://www.thisisms.com/forum/general-d ... 21331.html Warning: A lot of not very well organized random info in those! I researched backwards starting with a hunch.

I wish I had had my cortisol and aldosterone tested before I did my antibiotic stint. I have no idea what they were doing "naturally." If you are interested in working with your hpa axis dysregulation (if you have it), you get to start fresh with good numbers! I'm jealous!

Let us know how the appt goes.

I, too, will take you up on your invitation for suggestions of lab tests, Meagan.

I think #1 the "fasting blood insulin test" is the most important and one of the least expensive tests (Do not confuse this with the glucose test that is used to diagnose diabetes.); the optimal result should be 3 UU/ML or lower. I suspect insulin involvement and resulting insulin resistance in skeletal muscles are responsible for MS symptoms. I believe the raw sensation in my feet and legs is actually due to caustic insulin damaging the inside of my blood vessels (and not initially the nerves). This may account for my cold extremities as well.
As for steroids which are often prescribed for MS, they are glucocorticosteroids and elevate blood sugar; they temporarily engage or tie up the excess insulin. In my opinion, this is the mechanism that explains MS symptom improvement with Solu-Medrol or other steroids. During steroid use, the pancreas MAY reset to secrete a proper amount – adequate to handle glucose, but not an excessive amount. (Solu-Medrol has not been effective for me. My pancreas chronically secretes TOO MUCH insulin.)

#2 Cortisol also elevates blood sugar and the body produces more insulin in response. I agree with Anonymoose that this is a good one to test.

I think this imbalance of the hormone insulin causes other hormone imbalances – possibly thyroid hormones. #3 The thyroid hormone levels (TSH, Free T4, Free T3, Total T3, Reserve T3, and antithyroid antibodies) should be tested- many diagnosed with MS are later found to have a thyroid problem instead of MS . Brittle or thinning hair (hair loss) is one of the signs of a problem in the thyroid gland (underactive thyroid a.k.a. hypothyroidism). Other symptoms can include feeling tired (unrelenting fatigue), cold all the time, memory loss, brittle nails, leg swelling, constipation, loss of the outer third of eyebrows, difficulty losing weight because of slow metabolism. A simple home test can also indicate underactive thyroid: a person takes her basal body temperature (in the morning before getting out of bed) every morning for a week and if it is consistently below 98°, she may have an underactive thyroid. I recently came across the following information: "Many medications also slow down the thyroid and also cause iodine deficiency. Lithium and corticosteroids [Solu-Medrol and prednisone] are thyroid-slowing and should be used sparingly if at all."

There you have my suggestions: #1 fasting blood insulin test; #2 cortisol tests; #3 thyroid hormone tests for TSH, free T4, free T3, total T3, reserve T3, and antithyroid antibodies.
Please let us know how it goes.

according to lab reports all tests were normal. i am picking up copies of labs tomorrow and will post results for additional feedback. thank you all for your input.

How frustrating! No leads. Silver lining...at least MS hasn't messed up everything.