Re: Re: New member urgently needs help!

[Guest guest]

On Fri, 25 Aug 2006 04:21:58 -0000, you wrote:

>

>

>

>AN MRI OR CT SCAN OF YOUR PITUITARY IS IN ORDER !!!!

He's right. With your prolactin levels that high there is a chance you

have a small prolactinoma. These are usually very small tumors (benign

90% of the time) in the pituitary that increase prolactin. Prolactin

can cause many of the symptoms you mention.

http://www.endocrine.niddk.nih.gov/pubs/prolact/prolact.htm#symptoms

DOn't panic at the word tumor. These are very common and almost always

benign. They usually respond to medication.

Also read the AACE guidelines for more info.

http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf#search=%22aace%20guideli\

nes%20hypogonadism%22

The good news is you may be able to solve this with one medicine

rather than TRT.

>

>IF MR DOCTOR DOESN " T WANT TO FILL THE ORDER GIVE HIS ROYAL HIGHNESS

>THE BOOT !!!!!!!

>

>your health is too important to be made a mockery of!

>

>I was diagnosed at 25 with low T and 6 years later--- getting to the

>bottom of it finally.

>

>All because it took me that many years of booting to find a decent

>doc! lol

>>

>>

>> >

>> > Hi everybody,

>> >

>> > my name is and I am 29 years old. I have been diagnosed

>with

>> > hypogonadism recently after having struggled with the following

>> > symptoms for years:

>> >

>> >

>> > -no morning or nighttime errections

>> >

>> > -generally problems in achieving and maintaining erections not

>to

>> > the point of being unable to have sex, though

>> >

>> > -slight gynecomastia, puffy, enlarged nipples – the strange

>thing

>> is

>> > that at certain times, for example often after getting up in the

>> > morning or after working out this is completely gone, nipples

>are

>> > small then and not puffy anymore but only for a few minutes and

>> then

>> > the slight gyno/puffyness is there again.

>> >

>> > -compromised immune system - catching colds etc. very easily

>> >

>> > -very low self esteem, depression

>> >

>> > I went to an urologist several times in the past because of

>these

>> > problems. The last time about three years ago he took a blood

>> sample

>> > and had my total testosterone, estradiol and prolactin measured

>> > besides thyroid hormones, electrolytes, lipids, liver enzymes

>and

>> > some other blood markers. Thyroid hormones, electrolytes, lipids

>> > were in the normal range, one of the liver enzymes was slightly

>> > elevated. The total testosterone came back in the normal range,

>but

>> > the E2 was slightly below normal range and the prolactin was

>> > slightly above the normal range.

>> > All those things were measured in the doc's own lab in his

>office.

>> >

>> > After having investigated the subject of hormones for a while on

>> the

>> > net and in books I went to the urologist again two weeks ago and

>> > requested a much more complete hormone panel. Below I am listing

>> the

>> > results which I have received last week. I am not listing the

>> > results of the electrolytes, lipids, liver enzymes and other

>blood

>> > markers because those were all perfectly normal except for urea

>> > which was increased but this is most likely due to my very high

>> > protein intake of about 400 grams a day.

>> >

>> > So here are the results (I am listing the lab's reference/normal

>> > ranges in brackets. Please note that some of the scales used

>e.g.

>> > nMol/l might be different from those used by US labs. Hope you

>will

>> > still be able to evaluate the results, though):

>> >

>> > Total Testosterone 283.2 ng/dl (400.0-1200.0)

>> > Free Testosterone 9.0 ng/l (9.0-47.0)

>> > SHBG 1.9 mg/k (0.6-3.5)

>> > Free Androgen Index 15.95 (8.00-65.00)

>> > DHEA-S/Serum 2.7 mg/l (2.0-5.6)

>> > Cortisol 139.6 ng/l (30.0-250.0)

>> > IGF-1 (Somatomedin C) 73.2 nMol/l (9.0-46.0)

>> > LH 1.07 IU/l (2.0-10.0)

>> > FSH 3.70 IU/l (2.0-10.0)

>> > Prolactin 13.02 ng/ml (1.0-11.0)

>> > E2 9.20 ng/l (10-35)

>> > T3 96 ng/dl (70-200)

>> > T4 5.6 ng/dl (4.5-12.0)

>> > TSH 1.18 mU/l (0.20-4.00)

>> >

>> > This time only LH, FSH, Prolactin and E2 were determined in the

>> docs

>> > own lab. Everything else was done by an outside lab. As E2 and

>> > prolactin are pretty much the same as three years ago (E2 was

>below

>> > 9.0 and prolactin at 19.69 back then) and my symptoms are still

>the

>> > same today as they were back then, this leads me to believe that

>> the

>> > docs lab made a mistake when determining the total testosterone

>> > three years ago. I just can't imagine that my total testosterone

>> can

>> > drop from 890 (three years) ago to 283 (today) without a change

>of

>> > sypmptoms.

>> >

>> > O.K. so as I see it these hormone measurements explain my

>symptoms

>> > pretty well except for the gyno maybe. I just don't know how a

>> lower

>> > than average E2 level and a prolactin level that is just

>slightly

>> > above normal range would cause gyno (although it is just a

>slight

>> > case).

>> >

>> > Regarding the cause of these hormone levels from what I have

>read

>> > there are basically three possible explanations:

>> >

>> > -pituitary tumor

>> >

>> > -damaged pituitary due to an accident. A few years ago I was

>> > involved in a car crash in which my forehead heavily crashed on

>the

>> > steering wheel.

>> >

>> > -as I just recently learned from Ken Gildner's post in this

>forum

>> >

>( /message/35497)

>> > hypogonadism might also be caused by extreme weight loss. Well,

>I

>> > need to explain this a little bit more. I have always been

>> extremely

>> > skinny up until the age of about 18. Back then I started weight

>> > lifting and eating as much as I could and this way went from 130

>> lbs

>> > to 260 lbs in about two years, although a lot of the weight

>gained

>> > was fat. However as a result of the massive eating I had

>developed

>> a

>> > fatty liver and so I stopped the weightlifting, went on a diet

>and

>> > went down to about 180 lbs again. Then two years ago I pretty

>much

>> > repeated the process, went to 260 lbs once again, got health

>> > problems and went down again. I need to mention that I never,

>ever

>> > touched steroids or prohormones in my life!

>> >

>> > -one last thing I need to mention because I don't know if this

>> might

>> > also have anything to do with my problems is that at age 4 I had

>> > meningitis.

>> >

>> > The problem I have is that I am living in a very rural area of

>> > Germany and there really isn't any knowledgeable doctor around.

>The

>> > urologist I am seeing right now is also treating bodybuilders

>who

>> > take steroids and therefore does have some knowledge on the

>human

>> > endocrine system but as he admitted he really does not

>understand

>> my

>> > case. Therefore he contacted another doc who is supposed to be

>an

>> > expert and discussed my case. The plan this guy came up with is

>to

>> > give me HCG shots twice weekly for several weeks in order to see

>if

>> > my testes respond by producing testosterone thus finding out if

>the

>> > testes still work. If they do work he recommended using clomid

>to

>> > stimulate the pituitary.

>> >

>> > Now once again based on what I have read I see several problems

>> with

>> > this approach:

>> >

>> > -As my LH is low but there is still some testosterone around,

>> > although it is very low doesn't this already indicate that the

>> > testes are still working? As I have read if the testes were not

>> > working LH should be high and not low (provided the pituitary is

>> not

>> > dead)

>> >

>> > -I am really scared that by taking HCG I will permanently damage

>my

>> > pituitary, provided it is still functioning somewhat right now.

>> >

>> > -I already have below normal E2 levels. Clomid is supposed to

>> reduce

>> > E2 levels. The doc says that this will not be a problem but I

>> really

>> > fear that taking clomid in my situation will further drive E2

>> levels

>> > down and thus cause even greater problems.

>> >

>> > According to my doc the so called expert said that based on my

>> > hormone levels a tumor can be excluded to 99.9% and therefore

>there

>> > is no need to perfrom an MRI. I am not so sure on this, though.

>He

>> > also said the extremely high IGF-1 levels is nothing he would

>worry

>> > to much about. The high IGF-1 level along with the raised

>prolactin

>> > level might simply be due to high stress levels.

>> >

>> > O.K. this is basically all information I can think of right now

>> that

>> > might be relevant to my situation. My doc wants to start the HCG

>> > shots this week so any input before actually beginning the

>> treatment

>> > is highly appreciated.

>> >

>> > Sorry for the lengthy post, guys! I am just so scared and

>desperate

>> > right now. I just don't wanna risk having something screwed up

>that

>> > cannot be fixed anymore because my doc is simply trying things

>> > without having a real clue about what he is doing.

>> >

>> > Thanks for going through this and for all your help!

>> >

>> >

>>

>

>

>

>

>

>

________________

I am human; nothing in humanity is alien to me.

Terence

[Guest guest]

Dan yes I read the book on Adrenal Fatiuge dam good bood but Dr.'s don't care

about it. So you sould like your on the right track good luck as we all need

it. And if you need any thing just ask.

Phil

d_probst76 <d_probst76@...> wrote:

Hi,

first of all thanks to everybody for taking the time to read through

my lengthy post and providing such great answers!

I have been quite depressed the past few weeks after having found

out about my condition, the possible implications thereof and not

getting real help from my doctor. But know that I know that I am not

alone with my problem, that there are people out there who have gone

through the same that I am facing now and who are willing to help

and share their experience I actually feel much better!

To answer Jack's and Dan's question on how much HCG my doc was going

to use:

I called him this week and he said that he had planned on using 5000

I.U. per shot, as I already had mentioned two times per week. And

no - this is not a typo it's really 5000 I.U. two times a week and

not 500! I searched the net a bit these days and found that for just

testing the testicles (which is what my doc wanted to do)a single

shot of HCG is sufficient, you do not have to use it for several

weeks. The protocol recommended for this purpose by the German

sociecty of urologists and several German university hospitals for

example, is taking baseline testosterone levels twice right before

the shot. Then administering 5000 I.U. of HCG and thereafter taking

testosterone levels again at the 24, 48, and 72 hour mark. That's

all. No need to take HCG for several weeks for testing purposes

only. I told this to my doc and after arguing for a while he agreed

to do it this way, although he said the single testosterone

measurement we have taken a few weeks ago is sufficient, therefore

there is no need to measure it again twice before the shot and he

also wants to measure it just once after the shot at the 48 hour

mark. He said the protocol as I described it above is for clinical

studies only. Before I told him about it he didn't even know that

protocol, though and he actually is a member of that German society

of urologists that put out the recommendation!

To Phil:

Thanks a lot for the book recommendation and all the links you

provided. I will order the book and read through all the links on

the weekend. I actually feel that I might suffer from adrenal

fatigue. I have already ordered the book " Adrenal Fatigue: The 21st

Century Stress Syndrome " by L. , which is considered the

standard text on the subject. Maybe you know it. In case you don't,

here is Dr. 's website, very informative:

http://www.adrenalfatigue.org

I have always been the extremely nervous kind of guy, worrying about

everything all the time and I am also very prone to getting stretch

marks when gaining weight. These might all be symptoms of constantly

high cortisol ultimately leading to adrenal fatigue. I know that a

single static measurement like the one that was taken during my

blood work doesn't say much about the actual cortisol levels and

adrenal functioning. The problem is cortisol saliva tests are not

available in Germany and I would have to order one from the UK or

USA.

I also have contacted Dr. Crisler as per your suggestion Phil

(thanks again for pointing me in his direction), and just today I

have faxed him the necessary forms along with the results of my

blood work. I will let everybody know what his opinion is on my case.

To betaine_hcl:

I have read alot about Cabergoline and it seems to be a good drug in

case of a prolactinoma with little side effects in most patients. So

I think an MRI is culprit for me. I definitely need to convince my

doc to send me for an MRI. Thanks also for the information on

Androxal. I will investigate that on the net.

To answer your question. Yes I do think that I am stressed. As I

wrote in my response to Phil above I am the nervous and worrysome

kind of person who easily gets stressed out about anything, however

I am uncertain if that will raise my IGF-1 level that much. I have

although thought about acromegalia but I do not show the physical

signs of it, at least not so far. Acromegalia might once again point

into the direction of a pituitary tumor, though.

My prostate seems to be fine according to the physical examination

the doc performed. However I had no prostate markers like PSA

measured, yet.

To manraj2005 and retrogrouch:

I have a suspicion why that doctor is refusing to send me to an MRI.

In Germany every doc has a certain " budget " he is allowed to put out

in prescriptions and allocations in a quarter of a year. If he

spends more than he is allowed to do in a quarter he will be fined

by the health insurances. An MRI is a rather expensive diagnostic

method and at the end of August the end of another quarter is

rapidly approaching. You can do the math...

Again many thanks for all the great feedback, guys! I will keep you

updated on my case.

>

> Hi everybody,

>

> my name is and I am 29 years old. I have been diagnosed

with

> hypogonadism recently after having struggled with the following

> symptoms for years:

>

>

> -no morning or nighttime errections

>

> -generally problems in achieving and maintaining erections not to

> the point of being unable to have sex, though

>

> -slight gynecomastia, puffy, enlarged nipples – the strange thing

is

> that at certain times, for example often after getting up in the

> morning or after working out this is completely gone, nipples are

> small then and not puffy anymore but only for a few minutes and

then

> the slight gyno/puffyness is there again.

>

> -compromised immune system - catching colds etc. very easily

>

> -very low self esteem, depression

>

> I went to an urologist several times in the past because of these

> problems. The last time about three years ago he took a blood

sample

> and had my total testosterone, estradiol and prolactin measured

> besides thyroid hormones, electrolytes, lipids, liver enzymes and

> some other blood markers. Thyroid hormones, electrolytes, lipids

> were in the normal range, one of the liver enzymes was slightly

> elevated. The total testosterone came back in the normal range,

but

> the E2 was slightly below normal range and the prolactin was

> slightly above the normal range.

> All those things were measured in the doc's own lab in his office.

>

> After having investigated the subject of hormones for a while on

the

> net and in books I went to the urologist again two weeks ago and

> requested a much more complete hormone panel. Below I am listing

the

> results which I have received last week. I am not listing the

> results of the electrolytes, lipids, liver enzymes and other blood

> markers because those were all perfectly normal except for urea

> which was increased but this is most likely due to my very high

> protein intake of about 400 grams a day.

>

> So here are the results (I am listing the lab's reference/normal

> ranges in brackets. Please note that some of the scales used e.g.

> nMol/l might be different from those used by US labs. Hope you

will

> still be able to evaluate the results, though):

>

> Total Testosterone 283.2 ng/dl (400.0-1200.0)

> Free Testosterone 9.0 ng/l (9.0-47.0)

> SHBG 1.9 mg/k (0.6-3.5)

> Free Androgen Index 15.95 (8.00-65.00)

> DHEA-S/Serum 2.7 mg/l (2.0-5.6)

> Cortisol 139.6 ng/l (30.0-250.0)

> IGF-1 (Somatomedin C) 73.2 nMol/l (9.0-46.0)

> LH 1.07 IU/l (2.0-10.0)

> FSH 3.70 IU/l (2.0-10.0)

> Prolactin 13.02 ng/ml (1.0-11.0)

> E2 9.20 ng/l (10-35)

> T3 96 ng/dl (70-200)

> T4 5.6 ng/dl (4.5-12.0)

> TSH 1.18 mU/l (0.20-4.00)

>

> This time only LH, FSH, Prolactin and E2 were determined in the

docs

> own lab. Everything else was done by an outside lab. As E2 and

> prolactin are pretty much the same as three years ago (E2 was

below

> 9.0 and prolactin at 19.69 back then) and my symptoms are still

the

> same today as they were back then, this leads me to believe that

the

> docs lab made a mistake when determining the total testosterone

> three years ago. I just can't imagine that my total testosterone

can

> drop from 890 (three years) ago to 283 (today) without a change of

> sypmptoms.

>

> O.K. so as I see it these hormone measurements explain my symptoms

> pretty well except for the gyno maybe. I just don't know how a

lower

> than average E2 level and a prolactin level that is just slightly

> above normal range would cause gyno (although it is just a slight

> case).

>

> Regarding the cause of these hormone levels from what I have read

> there are basically three possible explanations:

>

> -pituitary tumor

>

> -damaged pituitary due to an accident. A few years ago I was

> involved in a car crash in which my forehead heavily crashed on

the

> steering wheel.

>

> -as I just recently learned from Ken Gildner's post in this forum

> ( /message/35497)

> hypogonadism might also be caused by extreme weight loss. Well, I

> need to explain this a little bit more. I have always been

extremely

> skinny up until the age of about 18. Back then I started weight

> lifting and eating as much as I could and this way went from 130

lbs

> to 260 lbs in about two years, although a lot of the weight gained

> was fat. However as a result of the massive eating I had developed

a

> fatty liver and so I stopped the weightlifting, went on a diet and

> went down to about 180 lbs again. Then two years ago I pretty much

> repeated the process, went to 260 lbs once again, got health

> problems and went down again. I need to mention that I never, ever

> touched steroids or prohormones in my life!

>

> -one last thing I need to mention because I don't know if this

might

> also have anything to do with my problems is that at age 4 I had

> meningitis.

>

> The problem I have is that I am living in a very rural area of

> Germany and there really isn't any knowledgeable doctor around.

The

> urologist I am seeing right now is also treating bodybuilders who

> take steroids and therefore does have some knowledge on the human

> endocrine system but as he admitted he really does not understand

my

> case. Therefore he contacted another doc who is supposed to be an

> expert and discussed my case. The plan this guy came up with is to

> give me HCG shots twice weekly for several weeks in order to see

if

> my testes respond by producing testosterone thus finding out if

the

> testes still work. If they do work he recommended using clomid to

> stimulate the pituitary.

>

> Now once again based on what I have read I see several problems

with

> this approach:

>

> -As my LH is low but there is still some testosterone around,

> although it is very low doesn't this already indicate that the

> testes are still working? As I have read if the testes were not

> working LH should be high and not low (provided the pituitary is

not

> dead)

>

> -I am really scared that by taking HCG I will permanently damage

my

> pituitary, provided it is still functioning somewhat right now.

>

> -I already have below normal E2 levels. Clomid is supposed to

reduce

> E2 levels. The doc says that this will not be a problem but I

really

> fear that taking clomid in my situation will further drive E2

levels

> down and thus cause even greater problems.

>

> According to my doc the so called expert said that based on my

> hormone levels a tumor can be excluded to 99.9% and therefore

there

> is no need to perfrom an MRI. I am not so sure on this, though. He

> also said the extremely high IGF-1 levels is nothing he would

worry

> to much about. The high IGF-1 level along with the raised

prolactin

> level might simply be due to high stress levels.

>

> O.K. this is basically all information I can think of right now

that

> might be relevant to my situation. My doc wants to start the HCG

> shots this week so any input before actually beginning the

treatment

> is highly appreciated.

>

> Sorry for the lengthy post, guys! I am just so scared and

desperate

> right now. I just don't wanna risk having something screwed up

that

> cannot be fixed anymore because my doc is simply trying things

> without having a real clue about what he is doing.

>

> Thanks for going through this and for all your help!

>

>