Brief Answer:
If all normal the diagnoses is Idiopathic edema

Detailed Answer:
Hello,

Thank you for using Healthcaremagic to post your health query.
I read carefully your question and I understand your concern.

Fluid retention can be from many things, but all those causes would show in the labs you have already done.
Especially the kidney and the hormonal levels are important, but I see you have followed them carefully with your local doctor.

After all those causes are ruled out, the diagnoses is Idiopathic edema which will be needed to be kept under control with the use of medicines like Furosemid or Spirolactone.

What I would advise is that you try to have an active lifestyle. If you are able, try doing fast walking almost every day and if possible running at lest 3-5 times/week.
Of course, try to avoid alcohol, salt in your diet, and carbonated beverages, so you would limit from your diet the unnecessary fluids.

Hope this is helpful.
Let me know if you need more clarifications.

Regards,
Dr. Papaqako

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Brief Answer:
D-Dimer values are within normal limits.

Detailed Answer:
Hello,

Thank you for the follow up question.

The name Idiopathic means that no cause can be found. So that diagnoses is decided when all the other possible causes have been ruled out and when nothing is found, then it is idiopathic. Every problem has a possibility of causes and there is always a range of Idiopathic cause that cannot be found.

Anyway, the doctors who have all your medical data of physical exam and lab tests, will be able to tell what is missing and what else needs done to cover all the many causes of edema.

Also, about D-dimer: That value you have is normal.
The normal range of values is less than 250 mcg/L or less than 1.37 nmol/L. So your values will change but as soon as they are less then this values, then it is normal and it is nothing to worry about.

The cough after an pneumonia can last for weeks, but also chronic causes of cough need to be ruled out like post nasal drip, a cough from medications, smoking, other causes. You will need a follow up at your local doctor for that so they can check your lungs and make sure that they are clear.

I hope that I have helped you and that have clarified you somehow.
Let me know if you have other questions or concerns.

Regards,
Dr. Papaqako

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Brief Answer:
The level of Prolactin, ACTH and cortisol may be the cause.

Detailed Answer:
Hello,

Here are my thoughts about your blood test results:
- You have no diabetes (or if you have, it is well controlled).
- Your thyroid levels are not controlled well. You will need to increase the dose of Levothyroxine in order for the hypothyroidism to be controlled.
- The low level of Vit D is not a problem. But if you want you can take Vit D supplements and calcium, when you will be in menopause or start them if you are already in menopause.
- The high prolactin is not significant in that value. But you will need to discover its cause- why your gland is producing more of that hormone. Also, it gets more serious combined together with ACTH. These, and low cortisol, may be causes of your edema. Your endocrinologist will need to rule out other tests to understand the causes of those changes.

Hope this helps. Let me know if you have other questions or concerns.

Regards,
Dr. Papaqako

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Brief Answer:
High Aldosterone is surely a cause of fluid retention.

Detailed Answer:
Hello,

This other test definitely helps a lot to understand the cause of edema and fluid retention.
There is surely a connection between the high TSH, high Prolactin, low ACTH and Aldosterone. They are all related with problems in the adrenal gland.

Aldosterone levels alone are high in these cases:
- Primary aldosteronism (Aldosterone is produced more in the gland)
- In renal artery stenosis or reninoma (a problem with the kidneys)
- In malignant hypertension (in people who have very very high blood pressure)
- In pseudohypoaldosteronism type 1: meaning mostly congenital problems.
- In heart failure, cirrhosis and nephrotic syndrome, in which edema is associated with relative intravascular hypovolemia (your doctor will understand and rule this out by doing some urine tests)
- If you were receiving already Furosemid when you did the test, or preparations containing progesterone or drospirenone (contraceptive pills).

What I want to emphasize though, is that if the test of Aldosterone has been done correctly, and with the avoidance of the stimulants of Aldosterone, then for sure this is the cause of the fluid retention that you have. By discovering where from it is coming and treating it, you would have treated the edema.

Hope that all this medical stuff makes sense. I tried to say it in as simple words as possible, but let me know if you need anymore clarifications.

Regards,
Dr. Papaqako

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