functional hypo-pituitary 25 year old/questions about my current HRT regimen

[willy]

so about a year ago, at age 24, i was diagnosed as being functionally hypo-pituitary with no tumor (via MRI). my hormone levels were all well below normal (range). this was not the case all of my life. my senior year in high school i was all state basketball and football and was in excellent health. i felt great. the only minor health problem that i had is that when i was in the 8th grade i developed anemia and was bruising very easily and really badly in football practice (my english teacher was so concerned that she called child services on my parents-no joke-she suspected me of being beaten by my folks) i seemed to get over that (just ignored it i guess) all though i was a late bloomer and after basketball practice i would get so pale and have dark circles under my eyes and get fatigued fairly easily. did not really start puberty until about 16 and then finally at 18 i really came into my own athletically during senior year and that was nice but it was still very late. hell i am 25 and still only shave maybe once a week (and that is on trt therapy). i look like a man in my body though-6"4" 200 lbs. and i have chest hair just no facial hair. so anyway i am getting off subject. then one day when at age 19 (in college) while driving down to school from a weekend at home i got into a terrible car accident on the interstate. it was raining and i lost control of the wheel. luckily i didn't hurt anyone else (i was not under the influence) and i am also very lucky that i didn't die as well. the doc thinks the head trauma (severe whiplash, mild concussion) that i sustained from the accident probably shook my pituitary(from the whiplash) very hard. this makes sense seeing as it was a few months later that i first remember beginning to feel really awful physically. i stopped working out. i was always tired. no motivation for anything at all. no libido. i mean i had sex but it just wasn't the same, especially for a guy that was 20 years old. my relationships went down hill, even with my family. i was just not a nice guy to be around. probably because i was miserable. so i go through the next four years feeling like shit being prescribed effexor 150 mg per day, adderall 90mg per day, inderal/propanolol 60 mg per day (long acting), and depakote 500 mg per day. then at age 24 i finally did something about it. i got off my ass and went to a highly recommended endocrinologist and have been working with him ever since. he is a good guy and i know he is a well respected doctor but i don't think he knows what to do with me. he tells me that he has never seen a case like mine before. he has heard of similar one's but never run into this sort of thing. i have basically been trying to get him to prescribe me my hrt based on swale's trt protocol and he has been open to it. i think as long as i am feeling good and he is not doing anything that he is certain is harmful to me then he will continue to listen to what i have to say. the other side of the coin is that i would feel much more comfortable seeing swale but michigan is hard to do right now. so any way after going through all the necessary preliminary tests the doc starts me gradually on hrt. so a year ago i began taking androgel 10mg (have since switched to test cyp. 100 mg inj. per week-suggested to my doc after reading swale's trt protocol therapy), armour thyroid 60mg daily, hydrocortisone 20mg (cortef) daily, and HGH(Genotropin miniquick .6mg(1.8 IU per day)) and just recently the doc added .25 arimidex every 5 days (my estrogen was a little above range at 69) and nolvadex 20 mg as needed for any swelling or tenderness and gyno prevention. i must admit that since i have been on hrt i feel amazingly better. it's nice to have some energy. enough to even go to a gym again and enjoy exercise like i did as a kid. i have also started to supplement with DIM but i don't know how much i should take or if i should take it with the arimidex and nolvadex. my doc said that he would be alright with adding in the hcg therapy starting out with the minimum dose of 150 i.u. 2 x per week. i just get the feeling that the doc does not know exactly what the hell he is doing. my father is a doctor and i was in med school for a while but dropped out because i just was too damn tired(this was back when i felt like shit). i was just curious what any of you guys had to say about this regimen that i am prescribed i am thinking about trying to make an appointment to see swale or perhaps someone he recommends. it would be a trip to go to michigan although i have not ruled it out. i have just been observing on the board for the past month. a bit afraid to say something. this is my second post. the first one was earlier today. ok thanks and if anyone has some helpful feedback it would be much appreciated.

[mranak]

Wow, 931 words and not a single paragraph break. Not too many capital letters, but that isn't as big an issue.

It would be really nice if you could edit your message and break it up into paragraphs. More people will read it and hopefully you will get more responses.

[mranak]

90mg of Adderall/day? Damn.

Anyway, sounds like you have a decent endo. What's your free testsoterone like?

The Nolvadex might elevate your serum testosterone and throw everything off. You shouldn't need it at all with proper TRT.

Hell, your endo sounds like such a good guy I'm sure we would love to know what area you are in incase any other guys need a good endo in your area.

Glad you found the root cause of your problems. You're on the right path!

[willy]

Thanks for taking the time to read my post. Yes i realize that 90 mg of adderall is a ridiculously high dose. I developed such a high tolerance for it and now I believe I realize why. Because of my hypo-pituitary disorder the adrenal glands were not releasing sufficient amounts of cortisol. Perhaps the reason that i felt the need for this much adderall was because it (in a round about way) forced my body to release cortisol by putting me in a state of "fight or flight". possibly compromising my testosterone supply (explains why still low on 10 mg androgel per day) in order to find a way to manufacture cortisol.

[willy]

I don't quite understand why using some nolvadex-20 mg on a temprorary basis every now and then along with low dose arimidex would throw things out of balance by raising serum testosterone. How much is it going to raise the test? I am only on 100 mg cyp. per week. Have not started hcg yet but plan to. Overall estradiol levels were 69. Not sure what free test levels were. Didn't Swale say in his protocol that he even likes for his guys to keep some nolvadex on hand in case of "nipple issues"?

[mranak]

Actually, I guess the the Nolvadex might not affect you that much seeing as your pituitary isn't very functional. In others, it blocks negative feedback to the HPTA and can ultimately raise serum testosterone too high.

I still don't think you need the Nolvadex, but maybe it isn't that big'a'deal.

[Axl]

It seems to mee you have a good endo. Maybe he is not up to date on all matters, but then again: which endo is? I would dtick with him and maybe ask SWALE or another doctor for a second opinion. I know I wouldn't have lost that much time if I had done that before...

Keep reading and asking questions. I can't help you in this specific case...you are using meds that I am not familiar with...

[willy]

Thanks Axl. I would be very interested in getting a second opinion from a doctor as highly regarded as SWALE. Would the best way to go about doing so be to post a thread asking him a direct question? or email him? I was considering writing him a letter? I am getting some bloodwork done tomorrow so I will want to see how those results come back.

[Vforcer2]

90 mg of Adderall per day............WOW, you WILL fry the receptors out in your brain and be on mood enhancing drugs the rest of your natural life.

I couldn't bear to read that entire post, so just skimmed it. I would advise you to find a highly qualified Naturopath Physician that can help you with natural remedies and dietary changes. All those pharmaceuticals will do is screw you up for life. Some people do need them, but MOST do not.

[earthdog]

Originally Posted by Vforcer2

I would advise you to find a highly qualified Naturopath Physician that can help you with natural remedies and dietary changes. All those pharmaceuticals will do is screw you up for life. Some people do need them, but MOST do not.

What? He is hypopituitary. He's already screwed up.

Willy, it sounds to me like you are on the right track. The one thing I want to caution is that Swale has stated that it's impossible to get accurate E readings when you are taking a SERM such as Nolvadex. Maybe it would be a better idea to up the Arimidex slightly and go off the Nolva, then retest. You might have to increase the Arimidex and retest a couple of times to get it right.

I know that DIM has helped some guys here, but it did nothing for me; in fact, I think it screwed me up worse. I'll know more about that after my next labs.

[willy]

thanks earthdog. i appreciate the feedback. i certainly don't want to mess up the estrogen reading on my bloodtests. i will quit the nolvadex for a few days and postpone my blood test till friday. i could go ahead and take a .25 mg arimidex tomorrow morning and see where that puts me at for friday.

[willy]

the only the problem is that i feel ok on nolvadex but whenever i start taking the arimidex i feel like crap. is that because my estrogen has gone too low?

[stat1951]

Originally Posted by willy

the only the problem is that i feel ok on nolvadex but whenever i start taking the arimidex i feel like crap. is that because my estrogen has gone too low?

That is very possible (E2 too low and making you "feel like crap").

Larry