Spooby
Member
@Michael Scally MD what do you think of my hormones? Thanks for your input if you have any
MESO-Rx
Anabolic Steroids
Possible tumor?
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Spooby
Member
Seeing a doc today... probably getting some medications and a brain scan scheduled. They got me in right away... I'm a nervous wreck. My social life's gone to shit
Is there a danger to having a MRI to rule out a pituitary tumour when found to have hypogonadotropic hypogonadism? Would you like to have unnecessary brain surgery or put on a drug for no reason? In almost every clinical situation, there is absolutely no need for a MRI. The indication for a MRI is clear. In hypogonadotropic hypogonadism, a MRI is performed only under the clinical context where there are central mass symptoms (visual disturbance, headaches, etc.) and an elevated prolactin.
New protocol from doctor...need thoughts
New protocol from doctor...need thoughts
@Spooby your clinical history of unexplained breast enlargement and sexual dysfunction point to an elevated prolactin level. You didn't say whether you have nipple discharge which would raise further the likelihood of elevated prolactin. This was confirmed by your labs which also showed your TT, FT and e2 levels were normal.
You do NOT have hypogonadotropic hypogonadism. You almost certainly have a pituitary prolactinoma. Compression of your pituitary stalk or a structural issue in your hypothalamus are also possible but less likely. Only some form of brain imaging study, preferably a MRI scan with and without contrast, can delineate these issues. It would be a grave medical error in judgement not to obtain an MRI in your situation.
Whenever there is strong clinical suspicion of a pituitary mass it also would be a grave error in medical judgment not to obtain an MRI. If one waits until compression of the optic chiasm by a pituitary mass is sufficiently severe to cause bitemporal hemianopsia in the visual fields there is a significant risk of permanent visual damage. The optic fibers do not necessarily regenerate once the chiasm is decompressed.
Get the MRI as soon as possible. Although it may be possible to regulate your prolactin level using medication(s) a large tumor would need to be addressed through surgery or radiation therapy. A small mass could perhaps safely be followed for evidence of growth using periodic MRIs. The good news is your situation appears readily treatable. Hope there is reassurance in that for you.
I do not understand the intent of either post in this thread by @Michael Scally MD. I certainly hope he concurs with what I've written here. In addition I'm sure he simply overlooked ever offering empathy for your situation and/or best wishes for a rapid return of your good health. Intentionally or habitually omitting words of concern for a fearful patient seeking answers about a serious condition would be most unseemly of anyone calling himself a physician. It certainly is not in keeping with my training and practice.
I do agree that brain imaging is not necessarily indicated in all cases of hypogonadism but that discussion is not relevant in your case.
Keep us posted. Still have you in my thoughts and best wishes. Things will get better.
You do NOT have hypogonadotropic hypogonadism. You almost certainly have a pituitary prolactinoma. Compression of your pituitary stalk or a structural issue in your hypothalamus are also possible but less likely. Only some form of brain imaging study, preferably a MRI scan with and without contrast, can delineate these issues. It would be a grave medical error in judgement not to obtain an MRI in your situation.
Whenever there is strong clinical suspicion of a pituitary mass it also would be a grave error in medical judgment not to obtain an MRI. If one waits until compression of the optic chiasm by a pituitary mass is sufficiently severe to cause bitemporal hemianopsia in the visual fields there is a significant risk of permanent visual damage. The optic fibers do not necessarily regenerate once the chiasm is decompressed.
Get the MRI as soon as possible. Although it may be possible to regulate your prolactin level using medication(s) a large tumor would need to be addressed through surgery or radiation therapy. A small mass could perhaps safely be followed for evidence of growth using periodic MRIs. The good news is your situation appears readily treatable. Hope there is reassurance in that for you.
I do not understand the intent of either post in this thread by @Michael Scally MD. I certainly hope he concurs with what I've written here. In addition I'm sure he simply overlooked ever offering empathy for your situation and/or best wishes for a rapid return of your good health. Intentionally or habitually omitting words of concern for a fearful patient seeking answers about a serious condition would be most unseemly of anyone calling himself a physician. It certainly is not in keeping with my training and practice.
I do agree that brain imaging is not necessarily indicated in all cases of hypogonadism but that discussion is not relevant in your case.
Keep us posted. Still have you in my thoughts and best wishes. Things will get better.
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A caveat: My use of the term "patient" above is intended in its original derivation of "one who suffers." My intent was not to imply a doctor-patient relationship in medicolegal terms is established by offering insight into conditions, laboratory results, or the findings from imaging studies within an anonymous internet forum. Making all definitive diagnostic assessment(s) and establishing treatment plan(s) are the responsibilities of an appropriately licensed physician or nurse practitioner who with the individual's informed consent has personally obtained/examined the individual's history, physical findings and pertinent testing results, has reviewed these with the individual and has sought the individual's input regarding a preferred course of action to address any evident problems and concerns.
Spooby
Member
You are very correct, thank you for your time. My pcp looked at my medical history and my blood work and was very concerned after I mentioned I'm having issues focusing my eyesight lately and have headaches, she put me on first priority, should be getting an MRI this week, getting scheduled with an endo soon as well, they're doing it for me and calling me with the appointment times and so forth today. I'm very worried but... if this isn't cancer, I can fight through it. I've gotten through a lot of bullshit lately with life circumstances even with this tumor destroying me mentally, still got through it all. Can't wait to have it out of nee and return to being a fucking machine again. I miss being shredded and feeling well... I guess I can't remember a time I've felt better than the time I was on tren/test and I was using cabergoline. No wonder I felt so good... two doctors now, both have heavy suspicion this tumor has been here for some time and has been the bane of my existence for quite awhile. I'm on top priority for the MRI to start with.. I'll keep you guys updated still... soon as this is all over with I'm gonna get in the best damn shape of my life and get healthy. This is the third time in my short lived life I've been faced my the contemplation of my own mortality. I'm tired of feeling like shit too. This tumors gotta go. It's gotta go ASAP.
