-describe body and facial hair: Very hairy all over.
-describe where you carry fat and how changed: Mostly around the abdomen. Do have a buffalo hump and moon-like face.
-health conditions, symptoms [history]: Actually haven’t really had many problems with cholesterol or blood pressure or diabetes despite my weight. Just always been very fat. Have had long-standing mood problems such as depression and anxiety however. Would also say I have chronic exhaustion. Also some memory issues.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Adderall, Namenda, Wellbutrin.
-lab results with ranges
Sorry no ranges, got them over the phone
-describe diet [some create substantial damage with starvation diets]:
I certainly overeat, and mostly don’t eat very clean. I know a lot about what a healthy diet looks like, I just don’t have time/money/energy to cook and eat clean in the amounts my appetite demands. And when I try to deny the sheer amount I just feel even more like shit.
-describe training [some ruin there hormones by over training]:
Did Starting Strength a few years ago with a friend, and got to the point I was squatting 300, but with a wideish stance, and my knee started hurting and my friend went back to school, and I didn’t follow through from there. Pretty sedentary at the moment.
-testes ache, ever, with a fever? No
-how have morning wood and nocturnal erections changed: nonexistant
After long feeling unwell about myself, and wanting to better understand myself, and do whatever it takes to get to where I want to be, I finally found myself in the office of an endocrinologist a little over a month ago. I’ve been trying to educate myself about what has been found since then, and this forum has been of help. I’m posting here hoping to get advice, or maybe a sanity check.
So far we have found that I have hypogonadism and azoospermia. So far in response he is prescribing me HCG. I’ve brought up an AI and so far he is non-committal, but I plan to press more for one. I also am not clear why HCG and not HMG since I believe the cost would be the same with my insurance. No actual T replacement has been mentioned, I take it because it itself would have a neutral or negative effect to what is currently the primary goal of restoring fertility?
I also think that the amount of HCG may be much larger than would be optimal. Currently he is prescribing 2000IU EOD, which I haven’t started yet. Wednesday is the day I go in next to talk to him, and have a nurse show me how to inject. Isn’t that a lot? I also haven’t confirmed this, but I think he wants me to take it IM instead of SubQ. I seem to get the impression there is no good reason for this?
Also I will be bringing up Cushings to him. Mostly going off of Male Hypogonadism - Genitourinary Disorders - Merck Manuals Professional Edition which I came across wanting to learn about hypogonadism I found the suggestion to test for Cushing’s if their is clinical suspicion. I had never heard of it, but at the moment I feel, ehm, that clinical suspicion would be warranted. So I’m wanting to be tested for that. But I’m worried that I could be turning into too much of a hard case for this endo.
I did also have an accident as a child in which I fell off a swing set and landed on my testicles. I was happy presuming that was the cause of all of this, but I wouldn’t suspect that would itself explain the full list of Cushing’s symptoms.
Any advice or suggestions? Should I smile and nod at 2000IU HCG EOD and lower the dose to something more reasonable? Is there any reason to delay starting HCG until Cushing’s is confirmed or ruled out? Should I refuse to take gonadotropins without an AI? Should I insist on HMG instead of or as an adjunct to HCG? Is there something I’m missing?
Thanks in advance for your attention to my case.