Do I have Cushings?

jonko

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Here is my most recent labs just as a reference:
Tot Testosterone: 233. Range 249-846
Free Testosterone: 5.3. Range 7.2-23
LH: 0.1. Range 1.7-8.6
FSH: 0.1. Range 1.5-12.4
Estradiol: 45.11. Range 7.6--42

Alc1 5.7. Non diabetes
Random Insulin: 11. Range 6-27
Vitamin D: 22.7. Range 32-100
Hydroxprogesterone: 14. Range ?
Pregnenolone: 29. Normal less then 139

Cholesterol: 152
Triglycerides: 149
HDL: 35
LDL: 95
Chol/HDL Ratio 4.3
LDL Particle Size 20.3 (Type B Small)
LDL Particle Total 1558 (high). Should be under 1000
Small LDL Particle 925
HDL Particle Count: 26.6
HDL Large Particle 1.3

hs CRP 3.2
Billirubin 1.3 Range 0-1.0 HIGH

HGB 17.8. Range 12.3-17
WBC 6.62 range 3.4 -11.8
RBC 5.94 range 4.2 -5.9
IGF-I (somatomedin-C) 76. Range 94-267
Thyroxine Free (FT4): .79 range.93-1.70

Insulin 11 range 6-27
Vit B12 719 range 211-911
Sedimentation rate 3. Range under 21
Folic acid >24 range >4
progesterone .56 range .20-1.49
Prolactin 13. Range 4-15
Ferritin 130 range 22-322
IGF I Somotomin C 76 and the Range is 94 - 267

SO I went to this NEW endo that is in my plan at AETNA. He happens to be the top guy and the only endo at Mt Sinai in NYC who does TRT.

I bring him copies of my most recent blood work form 2 weeks ago. He does an exam.
He says we need to get to the root of why you have low T. He claims that the only way to do that is for me to stop all T for about 3 months in order for my body to reset. Fo rexample, he said the the LH and FSH being almost non existent for me is normal, for a guy coming off Androgel. I was off Androgel one week when I did this blood. I asked him why so long, 3 months, can we do 1 month, he claims that 3 months is better, BUT if I feel really crappy we can just resume T now. So basically its my choice.

He said I was probably on too high a dose of Gel for my body. My T was up to 785 on 4 pumps a day. He thinks thats why I had trouble sleeping, high blood pressure, and high HCT and RBC. He said he would start at a small dose and monitor as we increase.

I am feeling like crap. Im thinking of going a couple more weeks then beginning again.
He gave me a script for new blood work, he said to try to wait 3 months, but if I cant just go anytime.
The script he wrote is for 8 am cortisol, total and free T, TS4, T41, IGF01, Estradiol, LH and FSH, and some other stuff I cant rad.

Now he also gave me a referral for a pituitary MRI !! That has me a little concerned. My prolactin was normal, but my IGH was low and he said I could still have a pit tumor with the growth hormone being low.
I noticed he was inspecting me for the signs of Cushings. I am overweight, my face is a little red (always has been) and after reading the symptoms I realize I have alot of stretch marks on my abdomen, had em for years.
Now I am freaking out that Im going to die from Cushings!

Im 5'11 weight 235, I was 250 a month ago. I have been bouncing between 235 and 250 ALL MY LIFE, im 46. I read with cushings there is sudden weight gain, large amounts of weight gain.

My wife pointed out I have always had lots of stretch marks from weight loss and gain. And I have been dieting for the last three weeks, due to my elevated cholestrol. I lost the15 pounds in the last 3 weeks by avoiding most carbs and grains. Also, stopping the androgel has normalized my blood pressure and Im probably not retaining water as much.
I dont have the fat hump between the shoulder blades. But I do kind of have a round face, some days redder then others.
I also have life long anxiety and panic, and depression.

I dont know why the first doc didnt check my cortisol levels with the blood test above, he checked everything else!

So in summation, my fears are:

1-DO I have Cushings? (everything I read about cushings says its fatal)
2-Should I really wait 3 months with no gel?
 
The Matrix

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Before thinking you are going to die take a deep breath and relax
with the results you posted there are no markers for cushings. I do not know where you are coming up with this conclusion. Most likely you have been reading too much and going to give your self a heart attack. In order to confirm cushings you need certain medical criteria which none of these test provide. More likely you have some insulin resistance and other issues which need to be properly evaluated. Most likely your diet is horrendous, need lifestyle adjuStments, poor sleep hygiene just to name a few before even looking at hormonal imbalances. So just take a chill pill for a bit till proper evaluationS are made before wanting to go jumping off bridges
you have high estrogen and coming off androgel was not a smart idea causeing your hormones to go in a tail spin. Please get with a proper good dr who knows what the hell they are doing because ur current one does not.
 

jonko

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I know I know, I read too much online and imagine the worse. I was just surprised he ordering a pit MRI so soon, based solely on low GH.
Well, this will be my third doctor in my quest.
I agree about my hormones going into a tailspin. I think ill gom2 more weeks then have that blood test done and gomback to see him to get back on the gel.

Know any good docs in NY?
 
The Matrix

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I work with one outside philadelphia who is up to date on latest information on HRT and health related issues. you CRP is high potentially indicating inflammation and increase heart disease. Your dr should be chesking homocysteine levels as well.
 

jonko

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Homocysteine is actually good. I didn't bother to include it above because it was normal
 
The Matrix

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Homocysteine is actually good. I didn't bother to include it above because it was normal
must be >5 and < 7.5-8 to be considered healthy.
 

DragonRider

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He says we need to get to the root of why you have low T. He claims that the only way to do that is for me to stop all T for about 3 months in order for my body to reset.
And that's not reason enough for you why?

I asked him why so long, 3 months, can we do 1 month, he claims that 3 months is better, BUT if I feel really crappy we can just resume T now. So basically its my choice.
Because that's how long it takes to normalize your hormones and get a true reading of pre TRT hormone levels.

Now he also gave me a referral for a pituitary MRI !! That has me a little concerned. My prolactin was normal, but my IGH was low and he said I could still have a pit tumor with the growth hormone being low.
He wants to examine every possibility and that has you concerned, again, why?

I noticed he was inspecting me for the signs of Cushings.
Now I am freaking out that Im going to die from Cushings!
Seriously? Is there anything you don't overreact to??? Do you understand this is really not normal?

I also have life long anxiety and panic, and depression.

1-DO I have Cushings? (everything I read about cushings says its fatal)
2-Should I really wait 3 months with no gel?
Don't take this the wrong way, but many of your problems could be solved by some counseling

Question 2 (above) Yes, you should follow this doctors advice. He seems like he is very concerned on your behalf and trying to help.
 

jonko

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I know, I am a hypochondriac. BUT many of these emotional and anxiety based problems vanished with TRT! Now off the gel I feel very unstable
 
Gutterpump

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Know any good docs in NY?
I'm from NYC, but have had very little luck with local DR's.

Matrix and Dr O are great though if you want to travel, otherwise I recommend anti-aging clinics if you're willing to somewhat monitor your own progress / protocol.
 

jonko

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I actually found a pretty good anti-aging specialist in Westchester. So far may confidence in him is good. He is out of network for most insurance. Google maze labs in ny and you can check it out
 
The Matrix

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Best of luck keep us posted.
 

pmgamer18

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If I were you I would run from this Endo in the past 30 yrs that I have been on TRT the first 23 of them I seen 7 Endo's each one told me I needed to stop TRT for a time any where from 2 weeks to 3 months. Each time I did this I ended up off work on sick leave and each time all them Dam Endo's ever found was how dam sick they made me. Today I now know there is no such thing as stopping TRT for a Base Line set of labs. When your on TRT your brain sees the T in your body and stops telling your Testis to make more by not sending the LH and FSH meassages to your testis. And Stopping TRT after being on it about 8 to 12 weeks your not going to start back up again.

Each Endo that did this to me never got it right each one telling me I am Primary meaning my Testis don't work well eight yrs ago I went on HCG with Dr. John's help doing 500 IU's 3x's / week. After doing this 8 week and at the time my TRT was doing 150 IU's of Depo T every week. My TT levels doubled so I am not Primary I am Secondary today I know them Endo's are full of crap you can't come off TRT and do labs to tell why your low. And each time you stop it takes longer to get leveled again.

Of all the men I have talked to at the forums I only met one guy that had a good Endo the rest are not anygood the ones in the USA.
Here is my most recent labs just as a reference:
Tot Testosterone: 233. Range 249-846
Free Testosterone: 5.3. Range 7.2-23
LH: 0.1. Range 1.7-8.6
FSH: 0.1. Range 1.5-12.4
Estradiol: 45.11. Range 7.6--42

Alc1 5.7. Non diabetes
Random Insulin: 11. Range 6-27
Vitamin D: 22.7. Range 32-100
Hydroxprogesterone: 14. Range ?
Pregnenolone: 29. Normal less then 139

Cholesterol: 152
Triglycerides: 149
HDL: 35
LDL: 95
Chol/HDL Ratio 4.3
LDL Particle Size 20.3 (Type B Small)
LDL Particle Total 1558 (high). Should be under 1000
Small LDL Particle 925
HDL Particle Count: 26.6
HDL Large Particle 1.3

hs CRP 3.2
Billirubin 1.3 Range 0-1.0 HIGH

HGB 17.8. Range 12.3-17
WBC 6.62 range 3.4 -11.8
RBC 5.94 range 4.2 -5.9
IGF-I (somatomedin-C) 76. Range 94-267
Thyroxine Free (FT4): .79 range.93-1.70

Insulin 11 range 6-27
Vit B12 719 range 211-911
Sedimentation rate 3. Range under 21
Folic acid >24 range >4
progesterone .56 range .20-1.49
Prolactin 13. Range 4-15
Ferritin 130 range 22-322
IGF I Somotomin C 76 and the Range is 94 - 267

SO I went to this NEW endo that is in my plan at AETNA. He happens to be the top guy and the only endo at Mt Sinai in NYC who does TRT.

I bring him copies of my most recent blood work form 2 weeks ago. He does an exam.
He says we need to get to the root of why you have low T. He claims that the only way to do that is for me to stop all T for about 3 months in order for my body to reset. Fo rexample, he said the the LH and FSH being almost non existent for me is normal, for a guy coming off Androgel. I was off Androgel one week when I did this blood. I asked him why so long, 3 months, can we do 1 month, he claims that 3 months is better, BUT if I feel really crappy we can just resume T now. So basically its my choice.

He said I was probably on too high a dose of Gel for my body. My T was up to 785 on 4 pumps a day. He thinks thats why I had trouble sleeping, high blood pressure, and high HCT and RBC. He said he would start at a small dose and monitor as we increase.

I am feeling like crap. Im thinking of going a couple more weeks then beginning again.
He gave me a script for new blood work, he said to try to wait 3 months, but if I cant just go anytime.
The script he wrote is for 8 am cortisol, total and free T, TS4, T41, IGF01, Estradiol, LH and FSH, and some other stuff I cant rad.

Now he also gave me a referral for a pituitary MRI !! That has me a little concerned. My prolactin was normal, but my IGH was low and he said I could still have a pit tumor with the growth hormone being low.
I noticed he was inspecting me for the signs of Cushings. I am overweight, my face is a little red (always has been) and after reading the symptoms I realize I have alot of stretch marks on my abdomen, had em for years.
Now I am freaking out that Im going to die from Cushings!

Im 5'11 weight 235, I was 250 a month ago. I have been bouncing between 235 and 250 ALL MY LIFE, im 46. I read with cushings there is sudden weight gain, large amounts of weight gain.

My wife pointed out I have always had lots of stretch marks from weight loss and gain. And I have been dieting for the last three weeks, due to my elevated cholestrol. I lost the15 pounds in the last 3 weeks by avoiding most carbs and grains. Also, stopping the androgel has normalized my blood pressure and Im probably not retaining water as much.
I dont have the fat hump between the shoulder blades. But I do kind of have a round face, some days redder then others.
I also have life long anxiety and panic, and depression.

I dont know why the first doc didnt check my cortisol levels with the blood test above, he checked everything else!

So in summation, my fears are:

1-DO I have Cushings? (everything I read about cushings says its fatal)
2-Should I really wait 3 months with no gel?
 

jonko

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If I were you I would run from this Endo in the past 30 yrs that I have been on TRT the first 23 of them I seen 7 Endo's each one told me I needed to stop TRT for a time any where from 2 weeks to 3 months. Each time I did this I ended up off work on sick leave and each time all them Dam Endo's ever found was how dam sick they made me. Today I now know there is no such thing as stopping TRT for a Base Line set of labs. When your on TRT your brain sees the T in your body and stops telling your Testis to make more by not sending the LH and FSH meassages to your testis. And Stopping TRT after being on it about 8 to 12 weeks your not going to start back up again.

Each Endo that did this to me never got it right each one telling me I am Primary meaning my Testis don't work well eight yrs ago I went on HCG with Dr. John's help doing 500 IU's 3x's / week. After doing this 8 week and at the time my TRT was doing 150 IU's of Depo T every week. My TT levels doubled so I am not Primary I am Secondary today I know them Endo's are full of crap you can't come off TRT and do labs to tell why your low. And each time you stop it takes longer to get leveled again.

Of all the men I have talked to at the forums I only met one guy that had a good Endo the rest are not anygood the ones in the USA.
Wow very interesting! Funny how all the endos say the same thing, stop for a few weeks. Well I had some new things since then. I went to a local anti- aging doc and he said it was crazy to stop too! I was off Androgel for 3 weeks and felt like crap!!! He put me bacon and ran some blood, this was one week ago.problem is, he is expensive, and out of network on insurance. The office visits aren't so bad, but he owns his lab, believe it or now. And the lab also is non insurance and it's costly. I think I am going to tell him that is he refuses to use a regular lab like quest I can't come anymore.

I am back on T one week now, but I still feel crappy. Well, I'm a little better then completely off the gel, but I'm not feeling like I was when I was on this dose a few months ago (5 grams a day). My morning wood has returned again, BUT it's not rock hard wood like it was, it's a semi hard, if that makes any sense.

Thoughts?

Going back in 3 weeks to check levels. Maybe Testim?
 

pmgamer18

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Yes this Dr. is about the money and you need this like you need a hole in your head if he will not read your labs from Quest he is takeing your money. WTF is with them you have a health care plain that covers labs and if he will not use it he is not anygood. Most of them Dr.'s have there own labs that are not covered because they are not any good and can't get approved by BCBS or such.

What size shot are you doing and how much I find men do better doing shot 2x's / weeks with HCG the day before it. If you go back on Testim do 10 grams per day to keep your levels up and check your Estradiol if high over 20 pg/ml get it down using Indolplex/DIM or Arimidex even Aromasin let me know if you need this I can tell you how to take it do you don't go to low. If your not getting good Rem Sleep wood your to high on Estraidol. I gage my levels by my Rem Sleep wood if I lose it I am going to high. Or if I am taking some thing to keep Estraidol down and I go to low I will lose Rem Sleep wood and get ED so bad you can't get it up taking Viagra.
Wow very interesting! Funny how all the endos say the same thing, stop for a few weeks. Well I had some new things since then. I went to a local anti- aging doc and he said it was crazy to stop too! I was off Androgel for 3 weeks and felt like crap!!! He put me bacon and ran some blood, this was one week ago.problem is, he is expensive, and out of network on insurance. The office visits aren't so bad, but he owns his lab, believe it or now. And the lab also is non insurance and it's costly. I think I am going to tell him that is he refuses to use a regular lab like quest I can't come anymore.

I am back on T one week now, but I still feel crappy. Well, I'm a little better then completely off the gel, but I'm not feeling like I was when I was on this dose a few months ago (5 grams a day). My morning wood has returned again, BUT it's not rock hard wood like it was, it's a semi hard, if that makes any sense.

Thoughts?

Going back in 3 weeks to check levels. Maybe Testim?
 

jonko

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I'm from NYC, but have had very little luck with local DR's.

Matrix and Dr O are great though if you want to travel, otherwise I recommend anti-aging clinics if you're willing to somewhat monitor your own progress / protocol.

To revisit this old thread, one year latter and Im not much better.
Been on the pellets for about 6 weeks. I feeling more flushed and having more mood swings then before.
Even though total T is up to 900
Im beginning to wonder if I have an undiagnosed thyroid problem (see labs above)
Im also not too happy with my bilirubin staying in the high end of the range. For the last year its ten hovering between .08 and 1.3
Gutterpump; since you live near me, you find any good docs local lately?

Lastest labs form the doctor who only does labs in house:
Total T 905
Free T 108
E2 62

A1C 4.9
Glucose 95
Creatnine 1.0
Bilirubin 1.1
Albumin 4.9
ALT 36
AST 19
Hemoglobin 18.1

Total Cholestrol 235
HDL 33
LDL 170
Trig 111








 

deadliftin

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Firstly...
Can't make any judgement on your thyroid as you list one value that is a year old. Metabolism changes hourly

Secondly. ... You have other problems. That seem to stem from lifestyle. ---- overweight
Estrogen is high mostly because of the body fat your carrying.
Strip the fat, the estrogen should trend down, but the pellet is going to influence that as well. But give yourself a fighting chance. Lose the weight

A1c. Is moderately high. You are prediabetic , or insulin resistance prone. Meaning diabetes is around the corner for you .
You need to clean up your diet...drop fast food entirely, lose the sugar, reduce dramatically the processed foods. All of these are just plain bad for you.
Paleo diet is a clean diet to follow, Even the south beach diet will help. But what ever diet focus you choose... You have to follow it like a religion. End of story there. Cheating on a diet will lead to more cheating and then falling off the wagon happens

Thirdly ... Which is associated with all the other issues... Your lipids... Cholesterol.
Your LDL. - bad cholesterol .....is high. Good...low. This related to your diet? Unlikely.
Your vap profile that you listed last year... The particle size test tells me that your bad cholesterol is truly bad
( bad cholesterol is broken down into fluffy and heavy. When you look at the bad cholesterol and have more fluffy ones , it basically means a false positive ...the particles are just big and float around in the blood stream But if they are heavy one meaning this truly bad because these guys sink in the blood and create plaque.. They Are the killers)
So mix in overweight , ( I am going to assume you have high bld pressure) , high cholesterol , and prediabetes... All add up to serious down the road or on the road ..heart attack. Being on trt , has the potential to increase your blood thickness... Next possible stop is a stroke.

Brother, you need to stop throwing money at blood tests, doctors and. Investment in a crossfit membership and drop the weight... I have sneaking feeling that your going to feel a lot better.
 

deadliftin

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Oh yeah... Ever have a vitamin d level done? If your vit d is low ... Cholesterol goes up..
 
The Matrix

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Leptin resistance and other imbalance I am sure exist, but one needs more data to come to some what of a conclusion. Your cholesterol readings are more of insulin resistance then anything.

To revisit this old thread, one year latter and Im not much better.
Been on the pellets for about 6 weeks. I feeling more flushed and having more mood swings then before.
Even though total T is up to 900
Im beginning to wonder if I have an undiagnosed thyroid problem (see labs above)
Im also not too happy with my bilirubin staying in the high end of the range. For the last year its ten hovering between .08 and 1.3
Gutterpump; since you live near me, you find any good docs local lately?

Lastest labs form the doctor who only does labs in house:
Total T 905
Free T 108
E2 62

A1C 4.9
Glucose 95
Creatnine 1.0
Bilirubin 1.1
Albumin 4.9
ALT 36
AST 19
Hemoglobin 18.1

Total Cholestrol 235
HDL 33
LDL 170
Trig 111









 

jonko

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Oh yeah... Ever have a vitamin d level done? If your vit d is low ... Cholesterol goes up..
Yes last year I had a Vit D test and it was low, 22.
But you say I'm pre-diabetic?
My A1C is only 4.9
I have actually lost 25 pounds the lsat couple month cutting out a lot of carbs and processed foods.
This new doc just pushes T pellets, doesn't seem to be interesed in getting to the root of the matter.
Im thinking I should just go back to the endo I initially visited last year
 
bad rad

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Congrats on losing some more weight. Your next stop really should be a nutritionist, being overweight will lead to all the health issues dragonrider posted. With the T levels you have from TRT you can make very quick progress once the diet is correct for you.

I would discuss your estrogen levels too, being elevated leads to some really nasty side effects.
 
The Matrix

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Congrats on losing some more weight. Your next stop really should be a nutritionist, being overweight will lead to all the health issues dragonrider posted. With the T levels you have from TRT you can make very quick progress once the diet is correct for you.

I would discuss your estrogen levels too, being elevated leads to some really nasty side effects.
Success for your wellbeing depends on the lifestyle and proper choices you make from now one..
Correcting the vitamin D should help to lower the prolactin as the thyroid will be able to function much better. This will help to start ones metabolism in the right direction resulting in the reduction of body fat along with proper eating, exercise, and stress management.
Optimal vitamin levels are 70-90 on the average when supplemented your at 20 something. Correcting the simple imbalances will result in profound effects on multiple systems. Your e2 is elevated which can also drive prolactin up which needs to be proper managed through an AI or changes in dietary intake. Some people are over weight not because of choice but as I mentioned excessive inflammation which can come from multiple factors which need to be addressed other words people hit a brick wall no matter what they do they can not break. Once you evaluate the GI tract make adjustements then weight starts to fly off up to 6-10 lbs in matter of a weeks time. Its ashame how much the Gi tract is over looked in traditional medicine.
 
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