Help/recommendations w/andropause symptoms

Discussion in 'Men's Health Forum' started by bcfromfl, Dec 12, 2012.

  1. #1
    bcfromfl

    bcfromfl Junior Member

    Sorry for the long post. I've been haunting these forums, and it seems like there are some knowledgable folks here.

    I'm 51, and have been in good health most of my life until about 2006. At that time started struggling with GI issues, first IBS, then reflux. The past twelve months other symptoms have escalated, and really snowballed since this summer.

    - chronic, never-ending low-grade headache, that becomes migraine ~8x per month. Only responds to triptans...Maxalt MLT works best.
    - joint and muscle pains, especially in hips and thighs. Limp when I walk. Neck pops and crackles when I turn my head, and pinches nerves painfully.
    - "brain fog," lack of clarity, memory issues, difficulty concentrating. (Serious!)
    - lack of motivation, loss of interest in normal activities or sex, apathy
    - lack of restful sleep, wake up still tired
    - weakness and fatigue, loss of strength and muscularity, muscles turned to mush
    - sensitivity to cold
    - puffy face and eyes
    - occasional vision problems

    I've had extensive tests. MRI scan of head was negative for abnormalities, ultrasound of thyroid was unremarkable, and thyroid blood panel was normal. Other blood tests showed some deficiencies. D3 @ 34 (30-100ng/mL) and pregnenolone @ 28 (13-208ng/dL). 24-hour saliva test indicated perhaps some things out of range, and an atypical curve that doesn't start declining until noontime. But the endocrinologist said that perhaps that's normal for me, since I tend to be a night person.

    I'm somewhat confused by the estrogen and testosterone tests, because when I look online for more info, it seems that there are different standards and ranges posted. My total T came in at 851 (250-1100ng/dL), DHT at 51 (16-79ng/dL), and free T at 84.2 (35.0-155.0 pg/mL). Total estrogen at 88 (<130pg/mL), progesterone at <0.5 (<1.4ng/mL), prolactin at 11.1 (2.0-18.0ng/mL), and estradiol at 22 (<=39pg/mL).

    Based upon these numbers, my endocrinologist recommended supplementation of the following:

    - D3 4,000 iu
    - pregnenolone 50mg
    - DHEA 25mg
    - Dim 150mg

    Over a week later, I have noted absolutely no benefit at all from these supplements. As a matter of fact, after 35 years of weightlifting (from age 10 to 45...no energy since then), and trying just about every supplement there is (no steroids), I have never once noted any significant benefit from any supplement. The past few weeks as I have read ad nauseum just about anything on the web about T supplementation or estrogen/SBHG inhibition, what stands out to me is that everything seems to "work" in vitro, but not in vivo. At best, some note anecdotal benefit to some herbal supplements, but that they can also cause headaches. Not risking that!

    The endocrinologist also had me do a 6-day course of prednisone as a diagnostic tool, to help indicate if my problems are endocrine or auto-immune. There was some benefit to the prednisone, most notably in eliminating most of my neck symptoms. However, it caused severe sleeplessness, something that I can ill-afford, as well as very loud thumping of my heart for several days.

    Low T can cause inflammation, which could be the root of many of my symptoms. My headaches in particular are due to either my brain swelling against my skull, or elevated spinal fluid pressure. The efficacy of the vasoconstrictors proves this. But by the numbers, I don't really seem to have low T. What I'm wondering, though, is if the raw numbers don't really indicate a problem on their own...but if there has been a big change. Like, if my free T was always in the 80-90 range, maybe it's technically low, but fine for me. However, if I was normally 125-150 and dropped to 80, that would be a problem. Unfortunately, I don't have that baseline information. I also wonder if low T or SBHG issues could affect the strength of involuntary muscles...and perhaps be behind the reflux -- as that is due to weak lower esophageal sphincter pressure.

    I'm not looking for medical advice, per se, but hopefully someone here can provide some insight, or suggest a different tack. I used to be able to spend hours composing music using complicated software...I can't even do a simple crossword puzzle any more.

    Thanks!

    -Bruce
     
  2. #2
    BBC3

    BBC3 Well-Known Member

    It's not andropause. It's more like u paused on the couch too long. Do the wirk and your body will respond. At test to a lazy party and you got an ugly crasher at best. And don't tell me you are active and nothing's changed. Write it all down and you will find a trend. But good newz. The company making Twinkees is closing shop in Texas. E'anhhh, that SAMs club brand is Better anyway. Anyone notice the cupcakes with the cream center dint cause the same heartburn..!?!???
     
  3. #3
    bcfromfl

    bcfromfl Junior Member

    Thank you, BBC3, for responding to my post (I think?) Unfortunately, you've made some accusations that just aren't true. I eat a good, solid diet, albeit vegetarian, and have never had a Twinkie (not "Twinkee") in my entire life, no lie. I am 6'1" and currently weigh 185.

    GERD is nothing to joke about. I had TIF surgery in August of 2011, which was successful in reducing some of my symptoms, but not the airway symptoms. I was a professional singer working on my first CD, but the reflux has taken my voice away.

    I understand that there is a temptation to say something to try to be funny, especially to the "new kid on the block" because it gives one some status amongst peers.

    This is serious business to me, and your joke wasn't welcome.
     
  4. #4
    Dr JIM

    Dr JIM Well-Known Member

    Specifically what are your questions?
    1) I AM CURIOUS ABOUT X
    2) WHY IS MY X UP OR DOWN
    ETC
     
  5. #5
    bcfromfl

    bcfromfl Junior Member

    Hi Dr Jim --

    My endocrinologist has indicated that I have an estrogen/free T imbalance, and the blood tests show a couple of borderline deficiencies. The treatment she has suggested doesn't seem to be resolving the symptoms, and I admit I don't understand enough about this to ask the right questions.

    I know there are dozens of different blood tests, of which I have already had many. Are there some specific ones that may help identify what's behind what I've outlined in my OP? I've tried to learn as much as I can about all this, which is new to me, but as I've noted, I can't concentrate very well any longer.

    If I, in fact, do have an est/free T imbalance, why isn't the Dim helping? Or, is that just another supplement to add to the fuzzy science behind stuff like Chrysin? Why would pregnenolone be low? Is that somehow tied to D3? If I do have to go to hormone replacement, is there a better way of approaching what's going on, at least perhaps to assist in diagnosing?

    Sorry...that's about the extent of what I can figure out to ask.

    -Bruce
     
  6. #6
    Dr JIM

    Dr JIM Well-Known Member

    -First borderline deficiencies does NOT mean deficiencies!

    -Second you seem preoccupied with lab tests detailing the etiology of your problem, when a very detailed history and physical is more likely to be revealing.

    - Third lab ranges are norms are accurate within a confidence interval between 95-98%, so there is room for error.

    -Fourth, because of number three, diagnostic accuracy of most labs is directly proportional to the number of signs and symptoms a patient has which are consistent with the particular disease under investigation.

    -Fifth because you signs and symptoms are so nonspecific AND an extensive investigation failed to uncover an organic causation a formal neuro-psychiatric evaluation should be strongly considered, if not already performed, as the next step BASED ON THE INFORMATION PROVIDED

    Regards
    :)
     
    idmd likes this.
  7. #7
    LW64

    LW64 Well-Known Member

    Your overall pattern of symptoms sound like CLASSIC food allergy-type problems (goddamn GRAINS giving you auto-immune problems): IBS, headache/migraine, joint pain, and generally feeling enervated and like shit.

    You eat a vegetarian diet and come down with all kinds of GI/GERD/auto-immune/allergy-like issues.

    Please consider: Maybe its your diet.
     
    Last edited: Dec 13, 2012
    idmd likes this.
  8. #8
    Michael Scally MD

    Michael Scally MD Doctor of Medicine

    As far as "andropause," there is NO confusion. You do NOT have andropause/LOH.
     
  9. #9
    bcfromfl

    bcfromfl Junior Member

    Thank you, Dr. Jim, for your points. I don't have any psychiatric issues, and the neurological issues are directly correlated to the headaches/inflammation ...which can be severe.

    Your belief contradicts what I have found elsewhere, and from the endocrinologist -- that lab results at the low limits of ranges can be problematic. I will keep what you say in mind, although I have nothing else to go on. At the risk of implying a preoccupation with lab results, like I said, that's all I have...plus what the endo has said and prescribed. I began with my GP, who referred me to the endo.

    ************************************

    Thank you, LW64, for your suggestion. I actually began considering this a few weeks ago, but any information available on the web is so suspect because of all the quacks and others trying to swindle dollars from gullible folks, that I was left unable to learn anything that I could trust. I have had no diet changes over the years, which would make such a condition -- if true -- to be some sort of "adult onset" condition.

    On a lark, I did get a bottle of bladderwrack because of its purported benefit in this regard. It does ease the constipation I seem to be experiencing (probably as a result of the Gaviscon tablets for the reflux), and the only other thing I noted was odd. On the third or fourth day in a row of taking it, I would start bolting awake after ~2 hours every night. I stopped and repeated this a couple of times to verify, which made me start suspecting the iodine...which began the thyroid testing. That proved to be a dead-end. So, I am nowhere with this.

    The only thing I understand about intestinal food allergies is that they are notoriously difficult to diagnose. If allergies don't appear immediately like they do in some (kiwis, peanuts, etc.), then they are subtle, and perhaps don't appear with any degree until days after ingestion, which then makes tracking backwards nearly impossible. Also, food ingredients on labels are not always easily translated.

    The only other conclusion I've come to is that the GMOs developed by Monsanto, if the claims are true with respect to allergies, are not healthy for the welfare of consumers. That said, I don't consume any GMO soy or corn (I checked with the manufacturers of the possible foods I eat), so I am not otherwise affected.

    ******************************

    Thank you, Michael, for your input. I said, "andropause symptoms" in the subject line of this thread to quickly identify what I am experiencing...as they are typical symptoms. I understand that this also seems like a claim of diagnosis, but I didn't mean to imply this. However, this has been the claim of both doctors I have seen, and I admit I don't have a solid understanding of it all.

    Thanks again, all of you, for your thoughts. I will try to move forward with your suggestions.

    -Bruce
     
  10. #10
    LW64

    LW64 Well-Known Member

    Nothing you describe here is sufficient to rule out what I'm suggesting. It can take many years of eating a grain-laden diet before the signs and symptoms appear.

    What about WHEAT?

    Bruce, wheat has been a Frankenfood for the last 40 years:

    My letter to the Wall Street Journal: It’s NOT just about gluten | Track Your Plaque Blog

    "1) The gliadin protein of wheat has been modified by geneticists through their
    work to increase yield. This work, performed mostly in the 1970s, yielded a form
    of gliadin that is several amino acids different, but increased the
    appetite-stimulating properties of wheat. Modern wheat, a high-yield, semi-dwarf
    strain (not the 4 1/2-foot tall “amber waves of grain” everyone thinks of) is
    now, in effect, an appetite-stimulant that increases calorie intake 400 calories
    per day. This form of gliadin is also the likely explanation for the surge in
    behavioral struggles in children with autism and ADHD.

    2) The amylopectin A of wheat is the underlying explanation for why two slices
    of whole wheat bread raise blood sugar higher than 6 teaspoons of table sugar or
    many candy bars. It is unique and highly digestible by the enzyme amylase.
    Incredibly, the high glycemic index of whole wheat is simply ignored, despite
    being listed at the top of all tables of glycemic index.

    3) The lectins of wheat may underlie the increase in multiple autoimmune and
    inflammatory diseases in Americans, especially rheumatoid arthritis and
    inflammatory bowel diseases (ulcerative colitis, Crohn’s)."



    Give up ALL GRAINS (especially wheat but all the others too) for 15 days.

    Monitor how you feel - it will be extraordinarily DIFFICULT as you will experience withdrawal cravings, but do it anyway. Then get back to us.
     
    Last edited: Dec 13, 2012
  11. #11
    bcfromfl

    bcfromfl Junior Member

    Thank you again, LW64 -- you've given me an awful lot to think about, and I appreciate your understanding of this. So hard to find good info on this outside of "fringe medicine!" I respect your qualifications, and your passion.

    As I mentioned, I've actually been thinking in this direction for a while, but trying to be open to all possibilities as well. What started me considering this was one of my endoscopies in early 2011 found moderate eosinophilic esophagitis (counts of 10-14 per HPF), and I was prescribed a swallowed corticosteroid to manage this. After a little over a year I stopped the prescription because of side-effects, and had already eliminated all tree nuts from my diet as a precaution. Before then I had consumed perhaps a cup daily of cashews or almonds.

    EoE can also be a response to reflux, so the jury is out for the cause in my case.

    An endoscopy in November of 2011 found lesser concentrations, but now I'm considering more of what you propose. I know what EoE symptoms feel like after being there, and I don't feel that way now, but I don't discount that there might be a more insidious cause. I'm trying to wrap my head around all this, because my diet is already very restricted and bland, and I don't have a lot of variety. To eliminate all grains for two weeks is going to be a challenge.

    I will try. Thank you again for your help!

    -Bruce
     
  12. #12
    LW64

    LW64 Well-Known Member

    You're welcome.

    Think olive oil and olives, avocado, coconut, and any/all of your favorite vegetables and low-sugar fruit (blackberries, blueberries, raspberries, strawberries) as substitutes for wheat when you get the urge.

    Let us know how it goes.
     
  13. #13
    Donzi

    Donzi Junior Member

    from now on if u want answers. ask a direct question. 1-2 sentences Do Not continue to write novel's
     
  14. #14
    bcfromfl

    bcfromfl Junior Member

    I hear you, Donzi -- except that the more information I give, the more relevant response (hopefully) I might get. OR...what if there might be someone else reading out there, who might find help for themselves in a more detailed thread? Respectfully, how would I condense something as complex as diagnosing symptoms, or getting suggestions of alternate possibilities, in one or two sentences?

    I realize you are being sarcastic, but novels...really? :confused:
     
  15. #15
    bcfromfl

    bcfromfl Junior Member

    I'd like to take this opportunity to thank LW64 for your suggestion to try a gluten-free diet. It's now 19 days later, and while I'm not symptom-free yet, enough of the symptoms have decreased to the point that I think it's safe to say I have an intolerance. Most of the joint pain is gone and I can walk usually without a limp now, with some joint crepitations remaining. My headaches haven't snowballed into migraines in a few days, and I haven't had to resort to the Maxalt prescription I don't like to use. I still have the chronic, low-grade headache, and cognition/memory issues, but they seem to be slowly improving. (I was able to play some things on the piano today, that I wouldn’t have even been able to do yesterday.) My lung function is vastly improved, and I’m drawing much more air in each breath. The pops and rattles in my trachea and bronchial tubes are lessening. I was in a bad way, and I guess I can’t expect to completely recover from this quickly.

    I have to admit that I’m angry, too, because I’ve been to eight GI doctors over a space of three years, trying to solve this reflux problem, and not ONE mentioned diet, let alone a food intolerance…in spite of having all the symptoms laid in front of them. I also had a confirmed diagnosis of eosinophilic esophagitis (from three separate biopsies performed during upper endoscopies), which is an immune reaction. All they wanted to do is experiment with prescriptions and kick me out the door. There’s a letter brewing inside of me to the American Board of Gastroenterology.

    I also discovered, almost by accident, an intolerance to casein…and apparently it’s common to have both intolerances. I was trying to make up the raw calories lost as a result of the gluten-free diet, and had picked up Myoplex and Muscle Milk pre-mixed meal replacement drinks. I had a strong reaction, and found that they’re loaded with casein. I suppose the possibility exists that I’m false-positive for casein as a result of gluten hypersensitivity, but I will move forward as if I’m intolerant of both. I’ll need to do some experimentation in the future to see if I need to be totally gluten/casein free, or can have small amounts of each. There is nothing fun about this diet!

    I didn't experience any withdrawal symptoms indicative of cravings. It hasn't been a linear path, however, and my symptoms have increased and decreased during these past two weeks +.

    Of special interest to this board is the connection between food intolerance and TRT. I found several references to men on TRT, who were able to discontinue after going gluten free. I was not on TRT, but I can tell you that, either by way of the histamine or glutein/casein molecules binding to receptors and blocking them, or the inflammation process inhibiting the expression of hormones from the brain or other glands and causing imbalance, there is a substantial androgenic effect. The pressures inside my skull were, at times, enormous.

    I know many here are consuming large quantities of whey and casein products, and I would suggest some investigation. These food intolerances are subtle at first, but insidious the way they inhibit/destroy normal function. It’s not easy to substitute for these supplements, I know, especially with heavier demands on the body from weightlifting. Caveat emptor.

    It’s important to make this point clear: Other than the IBS, which I could manage by limiting insoluble fiber, I did not have “digestive issues,” or any other symptom that would directly indicate food intolerance. GERD is a mechanical weakness of the LES, and not a digestive complaint.

    The following link is more in-depth, and makes some interesting points and observations. The FailSafe diet is not gluten or casein-free, however. Gluten and Casein A link on this page to betacasein.org, which, among a lot of additional information, summarizes a study where beta caseins were shown to weaken gastrointestinal force in dogs…might be extrapolated to GERD in those who are sensitive. It’s too early for me to claim any benefit here.

    Thank you again, for your help. I am in your debt!
     
  16. #16
    Dr JIM

    Dr JIM Well-Known Member

    Credit earned is credit deserved, fine work LW, especially since eosinophilia has a well established association with "chronic allergies" and parasitic infections in particular.

    I'll be the first to recognize most DOCs have a paltry understanding of diet and it's association with disease processes.

    Nonetheless doctors practice patterns are generally learned as a consequence of patient interactions, preferences and/or bias.

    Consequently most patients prefer a PILL for every condition since minimal effort is involved! Ergo dietary limitations because of enzymatic deficiencies are RARELY chosen over less cumbersome alternatives.

    The examples are protean such as; obesity-caloric restriction, ASCVD - fatty food restriction, DM - simple carb restriction etc .

    In fact many patients would opt for immune suppressive therapy once a diagnosis of "allergies " is confirmed rather than avoiding the offending agent altogether AND restrict one's lifestyle, lol!

    Admittedly, a G.I. PHYSICIAN whom overlooks the significance of eosinophilia and it's relationship to GI "allergies" in a patient with obvious gastrointestinal complaints should receive a mandate from the STATE BOARD requiring said physician to attend CME instruction for continued licensure, IMO!

    Please enlighten your DOC's and continue GI follow up for your chronic GERD, because of it's association with "Barrett's esophagus" AND the potential for malignant transformation.
    :)
     
  17. #17
    techlogik

    techlogik Junior Member

    eosinophilic esophagitis is not a function/results of reflux.

    There are studies that show taking acid reduces does nothing for the EoE condition. Search for it yourself. My gastro doc always wants me to take acid reducers claiming it will help the condition, it never has. Only eliminating foods from my diet, or dealing with flare ups that seem to have no cause is the only thing I've done that has helped reduce symptoms. I've had this condition for 5yrs now. Maybe longer, but diagnosed then.

    Food allergies are the most probably cause of the conditions. Flovent, and more recently, flonase, are the only options for dealing with the symptoms.

    The only other thing is to find what you are allergic too food wise, go on an elimination diet and see if it helps your condition.

    Then, if elimination does it solve it, then just dealing with flare ups with meds is about all you can do. As you know, there is no cure like many allergies, except if you are able to isolate something that is setting it off.



     
    Last edited: Jan 1, 2013
  18. #18
    bcfromfl

    bcfromfl Junior Member

    I wanted to add some more thoughts and observations to this thread, in case something here might be useful for others.

    I inadvertently "challenged" the diet two days ago, when I ignorantly ate some refried beans that had a small amount of cheese on top. I thought that the small amount, with the larger volume of accompanying food, would be safe for me. It was not. All the symptoms came back with a vengeance, and I am still struggling 48 hours later. This absolutely boggles my mind, because before these symptoms escalated, I never had troubles with foods!

    From the link I posted above, the author says, "In my experience people with pale skin, red hair and/or freckles appear to be more likely to be affected by gluten and casein." I have red hair and fair skin, although no freckles. Also, I have found some speculation about the connection between celiac/sprue and scoliosis. I was diagnosed with scoliosis when I was 17. Gluten sensitivity/intolerance, among other things, affects bone and joint health by way of auto-immune response as well as calcium metabolism.

    If I understand correctly what the author is saying in the article linked above, the opioid-like peptides in casein and gluten bind to several types of receptors, and may affect the response to pain and medication. I'd like to include my own observation, that when the symptoms are at their worst, and I take a strong medication like Fioricet w/codeine or Lortab (or even ibuprofen, for that matter), the benefit is much reduced. This may be because the receptors for these medications are already blocked. I mention this, because many on this board are on various medications, that may not be providing them the benefits they are hoping for, or expecting.

    I've always been skeptical about the diagnoses of "chronic fatigue syndrome" and "fibromyalgia," as these are more designations of a categorization/collection of symptoms rather than a description of a causal factor. Knowing what I do now, I'd suggest further investigation into food intolerance than separate, "new" diseases. If I can speculate a bit, I think there is an eagerness from doctors to "discover" and author studies on new conditions, adding new papers to their curriculum vitae, as well as pharmaceutical manufacturers to come out with new drugs to treat these new illnesses. Pharma often seeks out, and pays doctors to do studies that support drugs in development for "new" conditions. Perhaps the human body isn't quite as complicated as medical science tries to convince us.

    I have concerns going forward about how I'm going to maintain a healthy diet, because there are no specialty health food stores nearby. I don't like to think much about what I eat, and had settled into a few daily choices that are easy for me to prepare. That will no longer be the case, and having never given much thought to this, don't have good ideas about what I should keep on hand in the house. I don't like to cook, and all the recipes I'm finding for this diet require more preparation time than I'm in favor of. Also, it appears that many manufacturers, attempting to jump on the gluten-free bandwagon, are offering a host of junk foods instead of healthy alternatives. I don't want to replace an otherwise good diet, albeit one containing gluten and casein, with junk.

    Limiting the types of foods I eat introduces the possiblity of more deficiencies, and while I put little stock in the benefit of vitamin/mineral supplementation, I may have to concede a bit in this direction.

    Hope something here is helpful.

    -Bruce
     
  19. #19
    Dr JIM

    Dr JIM Well-Known Member

    Suffice it to say, the association between GERD and EoEs is UNKNOWN.

    Although some contend chronic espphageal reflux "exposes" the lamina propria to allergen, (protein in this instance), mediating the "antigen-antibody cascade" with eosinophil migration as one component.

    However it is known, that up to 5% of patients with GERD also have EoEs on biopsy.

    Even more important is the diminution of eosinophilic infiltration upon the initiation of PPI therapy!

    Consequently, at present the diagnosis of EoEs should only be made AFTER several months of PPI therapy, especially in those patients whom lack the clinical features of EoEs.

    Relevant signs and symptoms of EoEs are; a history of atopic disease (hay fever, asthma, Allergic Rhinitis, eczema, food or drug allergies) dysphagia, food impaction, age of onset less than 45 years AND minimal complaints of "heart burn".

    Since there is a general concensus, EoEs is caused by a yet ill defined "allergic" pathophysiologic process, those whom are formally diagnosed with this condition warrant further investigation by a BOARD CERTIFIED allergy immunologist.
    :)
     
  20. #20
    bcfromfl

    bcfromfl Junior Member

    Thanks for your comments, Dr. Jim. I wasn't officially diagnosed with EoE until I was 48...when I had the upper endoscopies investigating my GERD. The differences in symptoms between EoE and GERD are subtle, but I can tell. The GI doctors I saw insisted that since mine was "moderate," that it was most certainly a reaction to reflux. I now know better!

    On the subject of PPIs, I never had a bad headache in my entire life until I was prescribed PPIs in the fall of 2009 through the first few months of 2010. All of the different formulations caused debilitating, excruciating "10" headaches, which persisted for two weeks after ceasing the medications. At this point, I had formed a tolerance to H2 blockers. So, the PPIs were the next course of action, although I just couldn't tolerate them. It's important to note that PPIs and H2 blockers don't stop reflux...they just eliminate most of the acid component. They are now discovering that pepsin, which is another component of reflux but not controlled with meds, may be much more damaging especially to those with airway symptoms, or LPR. My symptoms are concentrated in the airway, and even before my surgery, only noted heartburn occasionally.

    I generally don't believe in coincidences, and I wonder if there was something about this failed PPI therapy that triggered a propensity for the headaches. Certainly, as my gluten/casein intolerance escalated, that also causes headaches on its own...but the connection here is disturbing.

    I was prescribed Pulmicort for the EoE, but discontinued because after a year, my face was becoming noticeably puffy. I never had other allergies historically, except for a mild reaction to cat dander that I grew out of quickly.

    -Bruce
     

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