Re: Secondary Hypogonadism Diagnosis

[Guest guest]

Hi cabaretic and Welcome,

If you find out you have a pituitary tumor it's very rare one needs to do

anything with it but watch it. The shots your doing every 2 weeks is very old

we don't do shots this way anymore. What your Dr. is doing is putting you on a

roller coaster ride up after the shot you peak at about the 3rd day after the

shot. Then your levels fall very low by your next shot at every 2 weeks.

It's best to do shots every week most of us do the 2x's per week. Doing this

keeps you more leveled and being on TRT we end up with high levels of Estradiol.

Doing a big shot every 2 weeks a lot of this shot converts into Estradiol E2 and

this undoes any good the TRT is doing for us. If your Dr. did not test this on

your fist set of labs he did this wrong.

I tell men that come here before going on TRT not to go on it until they know

why they are low. Once you start on TRT it is very hard to find out why you

low. In a few men just drinking milk lowered there T levels there are a lot of

things that can lower ones T levels.

And if you find out what it is and fix it your levels can come back up and you

don't need T meds.

Estradiol is made from Testosterone in men if your do labs and find your Total T

levels are low with a low LH and FSH levels this is the message sent from your

pituitary to your testis to tell them to make T. Your Dr.would tell you your

Secondary and order an MRI on your Pituitary. But if he did not test your E2

levels and they are high your labs will look like the above.

E2 is made from Testosterone and your brain can't tell the diff. between them.

So if your E2 levels are high say over 30 best at 20 pg/ml your brain will see

this as high T levels and slow down sending the LH and FSH messages to your

testis and they stop working and if this has been going on for a time they will

even get smaller.

You have a lot of on plate here but your on TRT now it's too late to try and see

if anything is doing this to you other then you being Primary meaning your

testis don't work.

Or your being Secondary meaning your Pituitary is not working I have this

problem my MRI was clean I damaged my Pituitary in an Auto Accident where I had

a head injury. So not all Secondary men have a tumor.

Here is what I feel you need to do is go to www.allthingsmale.com and read TRT:

A Recipe for Success in this are labs you needed and why if your Dr. did not run

them do them. Dr. puts this out there free for you and your Dr. he is

about the best male hormone Dr. out there.

When a Dr. checks ones thyroid they need to also check there Cortisol levels.

If you can post your labs with the units and ranges we can tell you if your Dr.

did enough labs and the right ones to tell if your Thyroid is OK and so on.

My story is long but I need to tell you this the first 5 yrs I was sick I was

told I had every kind of depression there is and I was on every dam AD drug out

there. I had to go along with this crap because I was off work on sick leave

and needed to be under a Dr.'s care to keep my job and get my sick pay. Read my

story the link to it is in this link and read the Heart update.

http://forums.realthyroidhelp.com/viewtopic.php?f=5 & t=9239

I feel I lost 5 yrs of my life on them AD drugs only to find out it was not

Depression or bipolar. All them meds your on I call them cocktails.

----------------------------------------------------

Seroquel is used to treat the symptoms of schizophrenia (a mental illness that

causes disturbed or unusual thinking, loss of interest in life, and strong or

inappropriate emotions.

---------------------------------------------------

Parnate is used to treat depression in people who have not been helped by other

medications.

---------------------------------------------------

Lithium is used to treat and prevent episodes of mania (frenzied, abnormally

excited mood) in people with bipolar disorder (manic-depressive disorder; a

disease that causes episodes of depression, episodes of mania, and other

abnormal moods.

----------------------------------------------------

Propranolol is a non-selective beta blocker mainly used in the treatment of

hypertension. And this can lower your CoQ10 levels and cause you joint and

muscle pain even in some people damage. Dr.'s put people on this for Anxiety.

---------------------------------------------------

Listen are you sure your bipolar have you been told this for many yrs.

I mean WTF your on all this crap and if it's not working and all them meds tells

me it's not working. It just might be your not bipolar but it's low

Testosterone.

I don't like to tell men this but I have been down this dam road pumped up on

all them meds never feeling better and all it was was low Testosterone.

I was on so dam many AD meds I needed to go into a Rehab Hosp. for 90 days to

get off them. Then I went on TRT and was back to work in 30 days after being

off work on sick leave more then I was at work.

DO NOT STOP YOUR MEDS READING THIS SEE A DR. GET A SECOND OPINION.

See if you can get your Dr. the one that put on TRT or your Family Dr. to work

with Dr. to test and treat you over the phone he dose this or drive or fly

out to see him he only needs to see you once to treat you by phone and a lot of

men do this.

If is very hard to find a good Dr. for this problem and what ever you do don't

let a Dr. send you to see an Endo or Uro for this problem they are not good

Dr.'s for this.

I pray this reply helps you and gives you hope anything you need to know about

just ask.

Co-Moderator

Phil

> From: cabaretic <cabaretic@...>

> Subject: Secondary Hypogonadism Diagnosis

>

> Date: Friday, November 26, 2010, 6:51 PM

> Hello Everyone!

>

> I'm posting here to see if I can get some additional

> information about my condition.  This is a bit of a

> lengthy request, so I'll try to keep it to the point.

>

> Around a month ago I visited my GP to have treated what I

> thought was a severe sinus infection.  I felt very

> fatigued, had difficulty placing words in conversation, and

> simply could not think clearly.  The lack of clear

> thinking is what was most problematic for me.  In

> addition, I'd had problems processing blood sugar and found

> myself growing so tired after consuming carbohydrates or

> sugars that I had to lie down for an hour or so. 

>  

>

> My health has been poor the past six months.  I've

> gotten one bad cold after another, then had a severe

> outbreak of psoriasis.  I didn't even know I had it

> until visiting a dermatologist, and have been taking Vitamin

> D to keep subsequent outbreaks away. 

>

> Returning to the sinus infection, my doctor also ran blood

> work to check on my thyroid and determine my testosterone

> level.  My thyroid was fine but my testosterone level

> was low.  I was then immediately prescribed Androgel,

> though the prohibitive cost caused me to switch recently to

> testosterone shots every two weeks.  I've been on

> testosterone now for four weeks, but recognize that T takes

> a way to build up and that it's not likely I'll feel

> significant effects for a while longer.

>

> A week ago, an MRI was conducted to rule out a pituitary

> tumor or other brain abnormality.  I am waiting on the

> results now and will know by the first of next week. 

> My prolactin level has been slightly high sometimes, but not

> terribly concerning.  I also haven't had severe mood

> swings, as is typical with a tumor, so I've been told. 

> If I do have a pituitary tumor, I know that it will be

> treated with medications.  I also have bipolar disorder

> and take Seroquel, Parnate, Lithium, and Propranolol. 

> Would my medication regimen have to be modified if I took an

> additional medication to shrink a proloactinoma or related

> tumor?

>

> If I don't have a tumor, I've been told I'll have some sort

> of endocrine disorder.  That will require a visit to an

> endocrinologist, of course.  I'm wondering what I

> should expect with that visit, should that be the case, what

> sort of endocrine disorder it could be, and how it would be

> treated.   

>

> At this point, I'm trying not to worry and hoping I'll find

> answers beyond medical case studies.  Anyone who can

> provide any insight or answers is most appreciated.

>

>

>

> ------------------------------------

>

>

[Guest guest]

Thank you, .

To start with the easiest answer first, I am unfortunately bipolar. I've been

diagnosed for nearly fifteen years but the meds are fortunately very helpful.

I've had to deal with mental illness way longer than hypogonadism. So no need

to worry, I'd never come off my medications for any reason unless a psychiatrist

said so. I've long since accepted that I'm going to have to take them for the

rest of my life.

The reason I mentioned all the medications I'm on is that I've read that

anti-psychotics like Seroquel have been known to create pituitary tumors---the

ones that secrete prolactin. I was taking Rogaine for hair loss until I read

that Rogaine also could produce a prolactinoma. All of this stuff seems to be

interrelated somehow.

My doctor originally prescribed the gel form of testosterone. I'd still be on

AndroGel except for the fact that my insurance company wouldn't cover it beyond

one month and I can't afford to buy it out of pocket. She then considered

prescribing the patch, but that wasn't covered, either. The only thing that my

insurance will cover is injection form. I'm supposed to inject 1 mL every 14

days.

Based on what I've heard from you, I may supplement the shots with the remaining

AndroGel I have left. I believe I have Nine (9) 5g packets left.

I'll take a look at the website you suggested, in the meantime.

I appreciate your help.

.

[Guest guest]

Hello, . One thing that caught my attention was the mention of elevated

prolactin. I don't advise discontinuing your meds if they are helping, but it

is documented in clinical studies, case histories, and other sources that SSRI

antidepressants, MAOI antidepressants, antipsychotics, and related medications

can elevate prolactin

(http://en.wikipedia.org/wiki/Prolactin#Conditions_associated_with_elevated_prol\

actin_secretion). Two qualifying candidates you mentioned are

Parnate/tranylcypromine & Seroquel. For Parnate/tranylcypromine, see: a)

tranylcypromine's role in raising prolactin in the presence of tryptophan

administration- (http://www.ncbi.nlm.nih.gov/pubmed/4033356),

tranylcypromine's ability to raise prolactin in specific dopamine deficient

conditions like Parkinson's Disease-

(http://www.parkinsons-information-exchange-network-online.com/drugdb/129.html),

& c) tranylcypromine's ability to raise prolactin on its own, canceling out the

effects of bromocriptine (bromocriptine normally decreases prolactin by

increasing dopamine, but the administration of tranylcypromine while on

bromocriptine diminishes the effect of bromocriptine, leaving prolactin levels

elevated if bromocriptine dose is not

increased)-(http://www.drugs.com/mmx/tranylcypromine-sulfate.html). For

Seroquel, refer to wikipedia article on prolactin above.

This is noteworthy as you seek to find out what's up with your pituitary, if you

and your doc find future need to decrease prolactin itself, and how to commence

with treatment. Though one cannot escape addressing bipolar disorder, in many

case, depression itself is due to or exacerbated by low testosterone.

~Xian

>

> Hello Everyone!

> ....

>

> A week ago, an MRI was conducted to rule out a pituitary tumor or other brain

abnormality. I am waiting on the results now and will know by the first of next

week. My prolactin level has been slightly high sometimes, but not terribly

concerning. I also haven't had severe mood swings, as is typical with a tumor,

so I've been told. If I do have a pituitary tumor, I know that it will be

treated with medications. I also have bipolar disorder and take Seroquel,

Parnate, Lithium, and Propranolol. Would my medication regimen have to be

modified if I took an additional medication to shrink a proloactinoma or related

tumor?

>

> If I don't have a tumor, I've been told I'll have some sort of endocrine

disorder. That will require a visit to an endocrinologist, of course. I'm

wondering what I should expect with that visit, should that be the case, what

sort of endocrine disorder it could be, and how it would be treated...

>

>

[Guest guest]

You have described many symptoms of low thyroid and the fact that you're

bipolar is a strong one. According to Dr. Romeo no, a

physician/psychiatrist, bipolar can be caused by too low T4 levels. You

said your thyroid was " fine, " but does that simply mean in range?

Bottom of range is quite often hypothyroid. You cannot use TSH to

define your thyroid status, since that is a pituitary hormone, not a

thyroid hormone. Free T4 should be mid-range, total T4 above mid-range.

Free T3 and total T3 should be 60% of range or higher. You need T3 AND

T4 measurements, because many people don't convert to T3, and your body

needs that just as much as T4. Some docs only measure T4 so you have to

specifically ask for these labs.

Lithium and beta blockers like Propranolol lower thyroid function.

Here's a post from Dr. no's site you might find interesting:

http://www.definitivemind.com/forums/showthread.php?t=361 & highlight=bipo\

lar

Barb

>

> Hello Everyone!

>

> I'm posting here to see if I can get some additional information about

my condition. This is a bit of a lengthy request, so I'll try to keep

it to the point.

>

> Around a month ago I visited my GP to have treated what I thought was

a severe sinus infection. I felt very fatigued, had difficulty placing

words in conversation, and simply could not think clearly. The lack of

clear thinking is what was most problematic for me. In addition, I'd

had problems processing blood sugar and found myself growing so tired

after consuming carbohydrates or sugars that I had to lie down for an

hour or so.

>

> My health has been poor the past six months. I've gotten one bad cold

after another, then had a severe outbreak of psoriasis. I didn't even

know I had it until visiting a dermatologist, and have been taking

Vitamin D to keep subsequent outbreaks away.

>

> Returning to the sinus infection, my doctor also ran blood work to

check on my thyroid and determine my testosterone level. My thyroid was

fine but my testosterone level was low. I was then immediately

prescribed Androgel, though the prohibitive cost caused me to switch

recently to testosterone shots every two weeks. I've been on

testosterone now for four weeks, but recognize that T takes a way to

build up and that it's not likely I'll feel significant effects for a

while longer.

>

> A week ago, an MRI was conducted to rule out a pituitary tumor or

other brain abnormality. I am waiting on the results now and will know

by the first of next week. My prolactin level has been slightly high

sometimes, but not terribly concerning. I also haven't had severe mood

swings, as is typical with a tumor, so I've been told. If I do have a

pituitary tumor, I know that it will be treated with medications. I

also have bipolar disorder and take Seroquel, Parnate, Lithium, and

Propranolol. Would my medication regimen have to be modified if I took

an additional medication to shrink a proloactinoma or related tumor?

>

> If I don't have a tumor, I've been told I'll have some sort of

endocrine disorder. That will require a visit to an endocrinologist, of

course. I'm wondering what I should expect with that visit, should that

be the case, what sort of endocrine disorder it could be, and how it

would be treated.

>

> At this point, I'm trying not to worry and hoping I'll find answers

beyond medical case studies. Anyone who can provide any insight or

answers is most appreciated.

>

[Guest guest]

I just heard back from the GP. Due to red tape stupidity, my MRI records were

not transferred until yesterday. It's a long, frustrating story. Sometimes

HIPPA laws end up protecting the patient from knowing the results of a test!

In any case, the MRI apparently looks fine except for one area. I was told that

I could have a very small tumor (less than 2 cm in diameter), but additional

tests with an endocrinologist are necessary to know for sure. So, I'm getting a

referral at some point next week.

I'm also supposed to meet with the GP on the 13th to determine where the course

of treatment goes from here. Hopefully I won't have to wait too long to visit a

specialist and have more answers. Beyond that, however, I suppose I'm in

wait-and-see mode.