Plots, plots, plenty of plots

December 11, 2008 at 10:04 am Leave a comment

Well, yesterday was my birthday and I have a long post and a couple of presents for you.

First of all, an easy plot: the evolution of my IGF-1

igf1

As you can see, shaded in yellow is  the normal range (for my age). Let me tell you a short story: IGF-1 was in the normal range until mid-2007.  That year, in april, I went to a random german endo to have the bloodwork done my spanish endo asked for. The guy did the bloodwork and sent me a letter with the results. There it says: IGF and GH extremely high but no visible signs of acromegaly but doesn’t say how high is “extremely high”. And so what? Did I have to wait until I got an extremely large nose to get the diagnosis? Luckily I happened to go to another endo (my actual one) in Germany later that year (december). In a bloodwork to determine the causes of my lack of period she saw, I guess, the same extremely large values of  IGF-1 (566 ng/ml) and GH (10 ng/ml), did diagnose acromegaly (despite the lack of visible signs) and started all the paperwork and tests for the surgery.

In the plot you see IGF-1 was high before surgery and then, normal. Totally normal.

The reason why I had low IGF-1 values with extremely high GH remains unknown. Some endos have suggested my GH is a rare form of GH molecule that doesn’t really work (but then, why did I grow up? I’m a girl, 1.70m (~5’7) , so I’m not small…)

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The second present is a more complicated and funnier looking plot:
the evolution of my GH.

Let me explain it first: I’ve plotted all GH values I have. Some correspond to GTT (oGTT) tests, some don’t. And to make things more complicated, some GTT tests lasted longer than others (this means, there are more columns). So, for each blood test you get a number of columns: only one?: no GTT; more than one?: GTT (the times where blood is drawn are coded in rainbow colours). Besides, I wrote some bubbles with extra explanations in an attempt to make it easier to read.

So, for instance, take 04-2008, that was one day before surgery. There are two columns: red is basal GH (~18) and green is GH 60 minutes after drinking the sugar. Now, take 06-2008, there are four columns, and according to the colour scale, those correspond to basal, 30 min, 60 min and 120 min after the glucose intake.

I know it can get a little complicated, so don’t hesitate to ask questions.

gh and ogtt

Normal range after glucose intake in a GTT test: below 2.

So, what can we see here? All the time before surgery, my GH was high. Extremely high, and didn’t want to go to normal range no matter how much glucose I drank. Yet, IGF-1 was in the normal range, so there was no reason to worry, it remained like that for 5 years.

Then, something happened (we don’t know what), IGF-1 was suddenly over the limits. GH was still behaving “normally” (for me), meaning “high” and “no suppression”. But as you know:
IGF-1 and GH over the limits + no suppresion = acromegaly.

I had the chickpea removed in april 2008 and since then, GH has been in the normal range and has performed great in GTT tests (I’m very proud of it). Three remarks to be made (and two bubbles in the graph).

  • Right after surgery, GH dropped but not enough, that led to a panic attack (more or less: why did I undergo the surgery? it didn’t work!!). Even though I shaded in yellow a “normal range” (the normal range I see when I get the results of my blood tests) GH should remain anywhere below 2 (or better, below 1). It doesn’t really matter, but after glucose intake it has to drop below 2 (or better, below 1).
  • In july 2008 I happened to have two tests done,  and these tests happened to show a GH 30 minutes after glucose intake higher than the basal (normal, fasting) value. Why? because GH is associated with stress and I felt really, really sick after drinking the solution, I was trying to remain calm but I felt terribly sick. This feeling eventually disappeared after a while and GH dropped as it should.
  • The isolated peak in september. Well, you know, never trust isolated GH values. They are not reliable and lead to a lot of non-useful worrying.

Well, that was it. This evening I’ll learn what happened to my thyroid gland and why are the nodules growing. Is that related to an acromegaly I don’t have anymore?

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Entry filed under: Evolution. Tags: , , , .

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