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Lightheadednes, low BLOOD PRESSURE with low DHEA.

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I'm a 34 yr old white male who is over weight 291 lbs. I have been struggling with lightheadedness and borderline low blood pressure on the (DIA end)on and off for about two years now. Then over the last four months other problems have shown such as fatigue, muscle weakness, some episodes of hypoglycemia, Orthostatic hypotension, palpitations. Had labs done. Results are as follows.
LDL- 62
HDL- 38
TOTAL CHOLESTEROL-124
TRIGLYCERIDES-120
GLUCOSE- 86
CREATINIE- 1.02
SODIUM- 139
POTASSIUM- 4.2
CHLORIDE- 103
CALCIUM- 9.5
CARBON DIOXIDE- 23
MAGNESIUM- 2.1
PHOSPHATE- 3.5
PROTEIN, TOTAL- 7.5
WHITE BLOOD- 5.9
RED BLOOD- 4.92
HEMOGLOBIN- 15.5
HEMATOCRIT- 47.8


TSH- 1.12
T4 FREE- 0.9 NORMAL RANGE (0.8-1.8)
T3 FREE- 3.0 NORMAL RANGE (2.3-4.2)
T3 TOTAL- 79 NORMAL RANGE (76-181)

*PROINSULIN- 81.5 (HIGH)
*GLUTAMIC ACID DECARBOXYLASE 65 AB- 1.1 (HIGH)

*C-PEPTIDE- 5.92 (HIGH)
FSH- 3.6

*INSULIN- 26.1 (HIGH)

*TESTOSTERONE, TOTAL- 155 (LOW)

GLUCOSE TOLERANCE TEST
FASTING SPECIMEN- 85
1-HOUR SPECIMEN- 125
2-HOUR SPECIMEN- 83

Overnight Dexamethasone Suppression Test (LOW DOSE 1mg)
CORTISOL, TOTAL- 0.6

*DHEA SULFATE- 81 (LOW)

ACTH, PLASMA- 9

Could this be an Adrenal Insufficiency?

I was told pre-diabetic due to the high insulin levels.

Does low DHEA happen when given an overnight dexamethasone suppression test?

Also thyroid levels are borderline normal.




Category: Endocrinologist

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Category: Diabetologist
Dr. J Muthukrishnan is online now

Expert:  Dr. J Muthukrishnan replied 4 Days.

Hello,
Thanks for your query at DoctorSpring.com
I understand your concern
You have insulin resistance due to obesity....Glucose tolerance is normal so no diabetes....rest of the reports are normal. Even DHEAS can be low with Dexamethasone.
I hope that is helpful
Feel free to discuss further


Patient replied :

Thank you, for the responce. Would insulin resistance produce symptoms like I am having? Lightheadedness, fatigue, palpataions, brittle nails, muscle weakness, low bp, trouble concentrating.


Expert:  Dr. J Muthukrishnan replied 3 Days.

No. It would not.
Blood pressure needs to be monitored.
Regards.


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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