Thursday, August 12, 2010

A Health Update

It's been a while since I've written about my health... basically because I didn't have much to say, except it was getting worse.

Last year, we discovered that I had extremely low testosterone (about 10% of normal levels), high cortisol, low thyroid hormones, and high estrogenic hormones (which aggravate all of the above).

This contributed to my rapid weight gain over the past few years, as well as loss of energy, fatigue, lack of focus etc...

I went on hormone therapy to try and balance it out, but the therapy I was on didn't work. We discontinued the therapy, and decided not to start any new therapies until after we moved, and I found a new doctor.

In the mean time, my symptoms have been getting worse... much worse actually; more have appeared, and they've become more distinct.

At this point it has become clear, that I have some kind of LHPA axis disorder; meaning there is a malfunction somewhere in my limbic, hypothalamic, pituitary, or adrenal systems, or in how they interact.

The problem is, there are literally hundreds of identified disorders, and a bunch of other non classified disorders, all in that space.

In particular, the symptoms I have, were looking very much like Cushings syndrome... That's extremely worrisome.

You don't gain 160lbs in four years (plus losing and then gaining back 72lbs, 46lbs, and 34lbs you lost in three different periods of under 1800 calorie a day diet and high exercise for a total of over 300lbs weight gain) on a 2400-2800 calorie diet, without something being profoundly wrong with you.

Run a metabolic calculator for my weight and bodyfat percentage, and I should be burning 3600 calories a day even if I was SLEEPING all 24 hours every day...

That means on my normal diet (and I log everything I put into my mouth. I know exactly how much I'm eating every day) I should be losing a pound every 3-4 days. Instead I'm either sitting still or gaining, depending on the week; and most of the weight is right on my gut, my face, and my back and shoulders (I've developed the "Buffalo Hump" and "moon face" characteristic of several LHPA axis disorders including Cushings).

There are a number of other symptoms I've been experiencing that I wont go into right now, except to say they are extremely unpleasant, and are effecting my life in a very negative way.

Of course it might NOT be Cushings, it might be any number of other problems, or a combination of problems which result in the same symptoms.

So Monday I went in for my next diagnostic appointment, and then Tuesday morning I had 17 different blood tests (6 vials, including one which had to be chilled).

The first round of tests came back today, and the good news is, though my cortisol is very high, it's not high enough to be Cushings.

The bad news is, of course, we have no idea what the problem is now.

There are still a number of other tests waiting to come back, which might help sort this stuff out, but they're not likely to produce any kind of definitive diagnosis.

The funny thing is, for a guy who's 200 pounds overwieght, and has screwed up hormones, I'm otherwise pretty damn healthy.

Look at the basics here:

BP: 122/80
RHR: 74
Total cholesterol: 191 (high normal. Over 200 is borderline problematic)
HDL/LDL: 39/131 (borderline. It's better if the hdl is 40+ and ldl is 130-)
Fasting blood sugar: 120 (high normal. 90-110 is normal 120-125 is borderline pre-diabetic. Above 125 is prediabetic, above 140 is diabetic).

For someone my size, that's frikken incredible. Unfortunately, my cholesterol and blood sugar are considerably worse than they were 9 months ago when I last had them tested (30 points higher on cholesterol, and 10 on blood sugar)... which is very much not incredible.

So it's clear that things are getting worse. Also I think it's clear that the high blood sugar and cholesterol are a symptom not a cause (for example glucose tolerance and high cholesterol are caused or worsened by high cortisol and low testosterone).

The worst thing is though, all of these issues are a self reinforcing circle. The effects of each problem worsen the effects of other problems and cause a third set of problems all of which worsen the original problem etc...

I go back in in three weeks for another round of diagnostics. They'll probably do a glucose and insulin tolerance study, and 5 day 8am fasting and 4pm fed endo study, to check my hormone and glucose levels in response to time, food, stimulus etc...

Most likely the doc is going to want to put me on a statin, metformin, and injectible testosterone instead of the androgel I was on before. I'm OK with the metformin, as I REALLY want to avoid diabetes, and I'm hoping the injectible T will work better than the gel did, but I'm NOT going on a statin.

There are just too many problems with those statins.... and Frankly, for most people taking them, they don't help very much, and they aren't really necessary. More of doctors covering their asses against the "just in case" heart attack, and drug companies pushing them hard because they are big profit centers.

I just wish I knew what was actually wrong with me... what was causing this.