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Pituitary Problems, Low T - Seeking Advice

Hey everyone, first time posting.

35 year old male with pituitary adenoma (8mm diameter on last MRI), I actually caught this because I was having a hard time building muscle so I started getting blood work done. Still trying to diagnose what if any hormones are being produced in excess by this tumor, its like a puzzle I am trying to figure out. I am not completely confident in the doctors that I have been working with. I will post some bloods below, but long story short is that I lift 6 days a week (close to a 2x body weight squad and deadlift), eat clean, don’t drink, and a casual cannabis user. Having a very hard time building muscle (5’8” 155# 13% BF) as you can see from the lab results testosterone and associated hormones have been deteriorating. As you would expect my mood is poor, I have no interest in things, lost my job, etc.

The Dr. was thinking possible GH secreting tumor because of elevated IGF-1, but I don’t necessarily agree. I am not about to have surgery if I don’t need it. Here are some labs, any insights?

7/18/2017
SHBG – 22nmol/L
Total test – 364 ng/dl
Free test - 9.1 ng/dl
Bio avail test – 213ng/dl
FSH – 2.9mIU/ml (range 1-12)

2/19/2018
SHBG – 28nmol/L
Total test – 289ng/dl
Free test - 6.2ng/dl
Bio avail test – 146ng/dl
FSH – 2.4mIU/ml (range 1-12)
LH = 1mIU/ml (range 0-12)

3/20/2018
TSH, Sensitive – 2.54uIU/ml (range .3-4.5)
T3, free – 2.2pg/ml (range 1.7-3.7)
T4, free – 0.9ng/dl (range 0.7-1.5)
ATCH – 13 (range 7-69)
Cortisol – 14.1mcg/dl
Prolactin – 7.1ng/ml (range 3.5-19.4)
SHBG – 21nmol/L
Total test – 193ng/dl
Free test - 4.7ng/dl
Bio avail test – 109ng/dl
FSH – 2.4mIU/ml (range 1-12)
LH = <1mIU/ml (range 0-12)

5/25/2018
SHBG – 31nmol/L
Total test – 221ng/dl
Free test - 4.4ng/dl
Bio avail test – 103ng/dl

6/11/2018
IGF-1 – 346ng/ml (range 83-241)
GH – 0.07ng/ml (range .05-3)

9/7/2018
IGF-1 – 341ng/ml (range 83-241)
GH - 0.4ng/ml (range .05-3)

I’m a little confused because your GH shows low at the ranges posted, but your IGF-1 is high? Your LH has been steadily declining which would make sense if you have a pituitary issue (fatigue) but I would expect to see the liver REDUCE IGF-1 production with the lower GH readings? Do you have any other tests stating GH? Do you know what it was historically? How was your GH tested?

Both of my GH tests were fasted morning blood tests. I have not done a glucose sensitivity test yet. Maybe I will do one in the future, I am not sure. I am going in for another round of blood work on 10/22, testing testosterone again, GH, IGF-1, plus a bunch of different additional things. I will post updates. The current theory is that I caught this adenoma very early on and that GH will continue to go up with time. Right now it feels like I will be unable to live like this very much longer. Low T sucks big time. I have access to good quality Cyp. I am seriously considering just administering TRT to myself and saying screw these doctors - doing thorough research first though.

Forgive me if I get anything wrong here, I am an engineer who is teaching himself everything about the endo stystem.

I think that your testing may be faulty. The following pasted info is how I understand GH testing…

Not sure that a doctor could properly rule out or diagnose something based on a serum snapshot test.

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Don’t feel like the Lone Ranger here bud. Seems to be the status quo in Hormone therapy knowledge.

to accurately measure GH you need a stim test. they inject you with Glucagon or similar and then measure your levels every 30min over 4 hours :grinning:

Here are the tests that I am getting on 10/22 - this may answer your liver question.

basic metabolic panel
GH
IGF-3
IGF-1
Liver panel
Testosterone panel
Brain MRI (I am holding off on this for another few months)
(I will be asking about a GH glucose test next appointment)

I agree that a serum snapshot test for GH is not adequate, especially when she was talking about pituitary gland surgery based on this test alone! And this is one of the reasons why I am changing doctors…seems like this is a basic thing she was overlooking.