T Nation

Help with a Unique Medical Condition


Hi, first let me introduce myself, i am 26 years old, 6 feet, 210 pounds.i have been training for the last 14 years.Married for the last two years, no kids.I am a doctor...will be starting my postgraduate training in otorhinolaryngology in a month or two.

        i don't know where to start but i have panhypopituitarism meaning that i am deficient in all the hormones secreted by the ant pituitary (except ACTH in my case) , this is because i had a huge tumor of the pituitary:a macroprolactinoma and it was removed by transsphenoidal approach.

I now take Dostinex 3mg/week for the last 8 months but my prolactin is still very high hovering between 300 -400 ... normal 3-17.i take testosterone 125mg/week and thyroxine 200microgram/day.i do not take growth hormone because it is very expensive (i live in Pakistan,there in no medical insurance here).

      Now my main problems

1:I suffer from absolute chronic erectile dysfunction.Never had a sexual intercourse in life.
2:As you can guess i am an extreme hardgainer, but i cannot use usual anabolic steroids to gain muscle because my prolactin and estrogen jump sky high ,same is the case with testosterone if i increase my dose.
3:My prolactin level is still too high.
so anyone of you have any suggetion what can i do,or take to improve anyone of my problems?


Move to Canada.
Seriously, i was born in pakistan and i know how the health care there is. I visit every once in a while, but if you have a condition where for the rest of your life (probably) you need medical attention, all that extra money used to buy medication can be used to move to canada where you have free health care.

I went back 2 years ago and had food poisoning, and the bill was a few hundred dollars (100 dollars = around 4000-5000 rupees) for just putting me on a drip and telling me to drink water and wait it out. Its better to just save as much money as you can and move to a place where theres free healthcare. I know its not related to your condition but thats just my 2 cents.


You are a "Doctor" and you are asking meatheads about a medical condition which is rare??



First, IV Sodium Thiopental followed by Pancuronium Bromide and finally Potassium Chloride.




Well, I guess he's dead now


His condition is endocrine in nature, his specialty will be ears, nose, throat (ENT). Physicians only get general training until they start their post grad specialty (residency).

Some of the guys here know more about endocrinology than most general practitioners.

Hopefully BushidoBadBoy or one of the others will chime in here.


He exhaust all his appeals?


Why not see an endo then? Why would he not have an endo already based on his condition in the first place?


'Free', Eh? You kill me Ahzaz. I suppose if you're making less then $10,320 a year. And I'll leave my opinions on Government health care for the PWI forum. Nah, fuck it - Ahzaz, any guess on how long of a wait it would be for Transsphenoidal surgery in Canada? How about just getting a pituitary MRI?


I just figured it out....the OP is in a country with Universal Healthcare....so he needs to resort to treatment over the internet!


married 2 yrs and "Never had a sexual intercourse in life"

dude, seriously see some doctors that specialize in this stuff. You for real, christ sake!


come on people lets not turn this thread into something its not .... Thanks.... it seems as if i have exhausted almost every option ,i have met so many endocrinologists , psychiatrists , fertility centers in Pakistan to USA but everyone tells me the same old story. . . and u know bodybuilding drug gurus like the late duchaine had crazy drug theories that sometimes work .... so may be???as a last ditch effort....

interesting story ..the last time i visited my endo(American consultant endo) after he tried every trick of the trade for the last one year tells me why not try some of this and give me a yohimbe mix lol ... at that time i knew that the ball is out of his court and he has not many options left . . . as far as moving to us or canada ... me and my wife both have passed our USMLE 1 and 2 and are eligible for residency(medical training) in the US .... but its a personal decision not to move ...i dont know , i just love my country .


man i am not seeking treatment over here ... i am seeking help , maybe someone can
guide me to something that i havent tried ... i guess its kind of natural ... think for yourself
if u are not getting better your options are drying up fast than what do u do ??.. seek alternate
avenues ... maybe there are better options ... what can i say man




I'll preface this by saying that I'm not certified in jack shit. In a few weeks, I might be an NSCA-CPT. That said, I've been reading essentially everything that I can get my hands on from the NSCA, with a specific focus on endocrinology.

First, any treatment that will get you to a "normal" state will be expensive; thus I recommend a) getting a job at a place with really good insurance, b) moving to the USA if you can pay for your own insurance (we have extremely good care here, but it can get quite costly) or c) moving to a country with socialized health care.

That said, just taking GH won't do a whole lot, a lot of current research is showing that GH that is artificially introduced to the system generally doesn't aggregate with other hormones very well. You generally have to take GH that's artificially aggregated for it to be useful, but this will be damned expensive. For your testosterone problem, you can get some extremely powerful estrogen blockers, but you'll need a complete workup to be approved for them; they're banned substances in all sorts of sports, and thus are highly controlled. There are also prolactin blockers, but they're kind of uncommon since prolactin production in males generally isn't an issue. You'll want to check your levels of progesterone too, it's really closely tied to prolactin and estrogen.

This would all have to be introduced slowly, or you'll trash your immune system and die of a cold or something.

That's all I know. I don't really pay attention to endocrinology topics that aren't related to anabolism. You really should talk to an endocrinologist though... chances are, you could find one that takes an interest in you since you'll need such intense hormone therapy, since he can publish on you. He gets fame, you get a normal endocrine system.


Ever tried hCG? Since it binds to the LH receptor it might help to restore fertility.

My 2 cents. Could get those Leydig cells kicking out some endogenous Test.


thanks xab and ghost ... yeah i have tried hcg ... i take a shot of hcg here and there just
to keep my testicular volume ...and really gh is not on my priority list, i can afford it if
really push it but my serum igf1 is in the normal range(although its not a very reliable test
for gh deficiency) ...

and it wont help me with my libido or prolactin ... although sometime gh
antagonists(octreotide) lower prolactin along with gh but i really dont want to try it... yeah i gotta
try arimidex but they are not available here


and yeah i am taking prolactin inhibitor .. cabergoline (dostinex) 3mg / week ... at least
i do not know of a more potent prolactin inhibitor than cabergoline


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