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Dr. K.
Dr. K., Board Certified MD
Category: Medical
Satisfied Customers: 3995
Experience:  Board certified with experience in primary care.
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Dear DoctorMy question is adrenal endochrinologist.My

Resolved Question:

Dear Doctor
My question is for an adrenal endochrinologist.
My basal (early follicular phase) prednisolone is elevated (10nmol/l ) and will not fall to zero. Day 21 progesterone normal indicating ovulation. Initially it was thought that it was related to failure of corpus luteal regression but has remained unchanged for 4 cycles. Menstrual cycles regular 28 days but spotting intermenstral spotting occurs occasionally.
Is the elevated progesterone adrenal and do you believe in the so called "pregnenolone steal"? Is the high basal progesterone relevant with respect to endometrial development and fertility. Does it require any treatment - eg prednisolone, oestrogen or DHEA supplementation?
Thanks for your advice
IKS
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Phil, MD replied 1 year ago.
still need help?
Customer: replied 1 year ago.

I cant see your response

Customer: replied 1 year ago.

My question is for an adrenal endochrinologist.
My basal (early follicular phase) prednisolone is elevated (10nmol/l ) and will not fall to zero. Day 21 progesterone normal indicating ovulation. Initially it was thought that it was related to failure of corpus luteal regression but has remained unchanged for 4 cycles. Menstrual cycles regular 28 days but spotting intermenstral spotting occurs occasionally.
Is the elevated progesterone adrenal and do you believe in the so called "pregnenolone steal"? Is the high basal progesterone relevant with respect to endometrial development and fertility. Does it require any treatment - eg prednisolone, oestrogen or DHEA supplementation?

Expert:  Dr. Phil, MD replied 1 year ago.
I will opt out for you.
You do need an endocrinologist
Customer: replied 1 year ago.

OK thanks

Is there an endochrinologist that my question can be forwarded to?

Expert:  Shantal-Mod replied 1 year ago.
Hi,
I’m a moderator for this topic. It seems the professional has left this conversation. This happens occasionally, and it's usually because the professional thinks that someone else might be a better match for your question. I've been working hard to find a new professional to assist you right away, but sometimes finding the right professional can take a little longer than expected.
I wonder whether you're OK with continuing to wait for an answer. If you are, please let me know and I will continue my search. If not, feel free to let me know and I will cancel this question for you.
Thank you,
Shantal
Customer: replied 1 year ago.

I'm happy to wait

Expert:  Dr. K. replied 1 year ago.
Hello there. If you are trying to conceive you do not need an endocrinologist, you need an infertility specialist. There is no such thing as an adrenal endocrinologist.
There are really no known consequences of elevated progesterone. That being said, it can be due to congenital adrenal hyperplasia. There is a form of this disease that presents in late teens or early adult hood and is called "late onset" You can see either an endocrinologist or infertility specialist for diagnostic testing. Treatment is usually with steroids, dexamethasone. I doubt that this is what you have.
Customer: replied 1 year ago.

Thanks. The problem is I've posed this question already to 3 fertility doctors. I dont have a residual corpus luteum cyst. I understand follicular phase progesterone is adrenal in origin. Therefore if my elevated progesterone is adrenal - then why is it high? I'm sure I don't have CAH as I have no features of testosterone xs.

My initial question related to "pregnenolone steal". Is this a recognised condition or a load of rubbish? Ie would the high follicular phase progesterone indicated that I'm producing less estrogrogen and hence endometrium will not develope adequately?

Thanks

Expert:  Dr. K. replied 1 year ago.
You do not have to have testosterone excess to hav CAH late onset. Sometimes it is only found due to infertility. Pregnenolone steal is a load of rubbish and only written about by the lay public. The elevated baseline progesterone really should not be contributing to your infertility at all.
Dr. K., Board Certified MD
Category: Medical
Satisfied Customers: 3995
Experience: Board certified with experience in primary care.
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