New protocol from doctor...need thoughts

[CubbieBlue]

I was on synthroid for a few months and I still felt very hypo on it. Lots of brain fog and cold hands/feet.

If there was a pituitary adenoma I assume they would treat it in one of the following ways:
Pituitary Tumors Treatment - Mayo Clinic

Both my pcp and the hrt guy want me to try my regimen for a few months to see how I feel on it..

At this point I don't know what to do. I am apt to try it and see how I feel. My doc says that with the HcG I can come off and just go back to how I was before, in his words: "I will not hurt you."

Without any treatment (or with just Synthroid) I am horribly anxious all the time, have freezing cold hands and feet, and am tired and sluggish. Tried SSRI's, did nothing. Tried therapy did nothing.

What else can I try besides this?

 

[Michael Scally MD]

I was on synthroid for a few months and I still felt very hypo on it. Lots of brain fog and cold hands/feet.

You are contradicting yourself. In an earlier post, you state the synthroid worked. Which is it?

If there was a pituitary adenoma I assume they would treat it in one of the following ways:
Pituitary Tumors Treatment - Mayo Clinic

ARE YOU INSANE OR WHAT??? this is exactly what I explained as the Cascade Effect. There is no reason for an MRI. I can only hope for your sake it is negative. If it is positive and you do any of the Mayo suggestions (surgery/drugs), you are crazy (and so are the doctors). Hey.- it is your life.

Both my pcp and the hrt guy want me to try my regimen for a few months to see how I feel on it..

At this point I don't know what to do. I am apt to try it and see how I feel. My doc says that with the HcG I can come off and just go back to how I was before, in his words: "I will not hurt you."

Without any treatment (or with just Synthroid) I am horribly anxious all the time, have freezing cold hands and feet, and am tired and sluggish. Tried SSRI's, did nothing. Tried therapy did nothing.

What else can I try besides this?

This is plain nuts! hCG treatment for what??? We are on different pages. Let me know the results when all is said and done. I will be right, but I can learn.

My email: mscally@alum.mit.edu

 

[CubbieBlue]

E-mail sent

 

[LeanGuy]

This is plain nuts! hCG treatment for what??? We are on different pages. Let me know the results when all is said and done. I will be right, but I can learn.

My email: mscally@alum.mit.edu

Why is it nuts to use HCG for secondary hypogonadism? "I will be right" sounds pretty arrogant.

 

[hardasnails1973]

Why is it nuts to use HCG for secondary hypogonadism? "I will be right" sounds pretty arrogant.

For secondary hypogonadism I would look for the root cause and then supplement with clomid to see if he would restart while back filling with nutrients needed to make the hormones as well as balancing thyroid/adrenals to give that person a greater chance of starting on their own. If clomid gave a good response but did not hold affter restart then I start them on HCG untill their body did not respond. If vitamin D, E levels are low HCG or clomid may not respond since these are needed for help body to respond to LH. I have also helped alot of men to restart through not only chemistry, but identiying the cause of the issue. Feel free to pm me. or email me hardasnails1973@comcast.net

 

[CubbieBlue]

MRI negative.

Will report back with one month results of regimen.

 

[Michael Scally MD]

MRI negative.

Will report back with one month results of regimen.

You still have to ask, what were they going to do if positive?
That worries me, but I am glad for the outcome.

A central and key question to ask for any test or study, will the result determine a treatment decision. If not, the test is worthless and possibly dangerous. Far too many doctors order tests for the sake of looking smart, appearing to act, and delay. Eliminating the number of tests for these reasons alone could easily reduce healthcare costs by billions of dollars.

In your case, a positive result would have lead to inappropriate and harmful therapy. It turned out, this time, okay.

Ask questions - Demand answers.

 

[CenDS]

From your prior post: "No visual problems, and a normal prolactin. Both him and my PCP agree a normal prolactin w/ my below normal FSH cannot rule out an adenoma or anything similar."

They are wrong! They do not know what they are doing! I can guarantee that if you challenge them to supply literature support, they won't. I do not recommend this course since most docs are ego challenged.

Here is a critical question: If the MRI did show an adenoma, what would they do????? Have you thought of that? This is dangerous since your docs are fools. But, hey it is your brain, not mine. Hopefully the MRI is negative (10% of all people have adenomas). And if positive, hopefully, they do nothing in which case why do the freaking MRI.

this post is somewhat concerning but there is some truth and some caution that needs to be said. Today Neurosurgeons ( yes I am one) rarely treat microadenomas. They usually will only consider transsphenoidal resections for patients with bitemporal hemianopsia or those who have had pituitary apoplexy (small or large bleeds) Most of the microadenomas I have seen clinically are null cell tumors that require sequential imaging and following clinically. If the adenoma secretes any hormone and it is not causing chasmal compression (cranial nerve two) then the tumor is general sent to the endocrinologist for medical treatment. Even an adenoma secreting prolactin can handled now medically. The toughest ones to deal with are the ones that cause Cushings Syndrome but thankfully they are very rare. I have had to operate on several and they are nightmarish to get completely resected because the tumor tends to be very small and the clinical syndrome tends to be rather problematic from a clinicial and prognostic stand point.

The point about ten percent having adenoma is really not well supported any longer. Its dogma from years ago but newer studies using late generation MRI show that the number are quite a bit lower. Most adenomas are also null cell non secreters. Thirty yrs ago it was common to see massive adenoma and there was a ton more surgeries.............these days the endocrinologist catch them earlier and they are able to shrink them medically with many antagonists based upon what the tumor secretes.

Surgery for this tumor has fallen off a rock since the advent of MRI scanning in the early 90's

 

[CenDS]

For secondary hypogonadism I would look for the root cause and then supplement with clomid to see if he would restart while back filling with nutrients needed to make the hormones as well as balancing thyroid/adrenals to give that person a greater chance of starting on their own. If clomid gave a good response but did not hold affter restart then I start them on HCG untill their body did not respond. If vitamin D, E levels are low HCG or clomid may not respond since these are needed for help body to respond to LH. I have also helped alot of men to restart through not only chemistry, but identiying the cause of the issue. Feel free to pm me. or email me hardasnails1973@comcast.net

old advice.....only reason to choose clomid over nolvadex is price. Nolvadex is a better anti estrogen drug and has fewer side effects clinically. The estrogen “blocking” properties of Clomid appear to be slightly weaker than Nolvadex in comparison however, which is why it is not usually thought of as an equal substitute for estrogen maintenance.

 

[hardasnails1973]

NO one uses nolvadex as antiestrogen drug any more that is old school.
If one thing clomid should be used as an antiesrogen drug then they are really a newbie or really been misinformed

So is nolvedex better at stimulating LH then clomid? Then why don;t dr use it more often to jump start the testoseorne production?