Varicocele/Adrenal Dysfunction (Hypersynthesis)

[Megazoid]

I would first like to apologize for wasting peoples time here. I don't post here to whine, annoy or start any kind of war. I am purely trying to figure out exactly what happened to me and how to get back on track to where i was. Part of me feels it is important to bring up and address this research publicly so it can hopefully help new members in the future.

My ideal situation would be to get better, stop visiting the boards and get on with life as originally intended. Going to back to having normal energy levels, body, mental, libido and sexual functions. Much of my research is to hopefully reach the point where this will be possible and i will find a treatment protocol that works for me.

I have passed the following information onto Marianco for further help on my situation and to see what he thinks..

I spent some time today researching the link between testicular function and adrenals. Dano and Keaster both experienced testicular atrophy but no sign of varicocele. How much of a link between the adrenals and testicles is there really?

The left-side testicle is linked directly to the blood flow of the adrenal gland/kidney and thus share the same blood supply. Varicocele causes reflux (or back flow) which reduces blood flow out of the adrenal and testicle. Due to this it has been discovered that varicocele causes adrenal hyper synthesis resulting in increased ACTH production, resulting in elevated cortisol and other adrenal cortex hormones. This is one of the potential theory's behind testicular atrophy (and most likely) the cause of hormonal problems in varicocele patients. Considering i suffered severe atrophy on the left side.

low testosterone is explained by elevated cortisol that damages/attacks the testicular tissue thus resulting in the atrophy. The elevated adrenal cortisol production on the left side most likely causes a rebound effect on testosterone production of the leydig cells on that side resulting in lower testosteorne production and weak adrenal fucntion.

Sustained high cortisol levels destroy healthy muscle and bone, slow down healing and normal cell regeneration, co-opt biochemicals needed to make other vital hormones, impair digestion, metabolism and mental function, interfere with healthy endocrine function; and weaken your immune system.

When the adrenals are chronically overworked and straining to maintain high cortisol levels, they lose the capacity to produce DHEA in sufficient amounts. DHEA (the full name is dehydroepiandrosterone) is a precursor hormone to estrogen, progesterone, and testosterone, and is necessary to moderate the balance of hormones in your body. Insufficient DHEA contributes to fatigue, bone loss, loss of muscle mass, depression, aching joints, decreased sex drive, and impaired immune function.

My question here is will adding prednisone/HC help or hinder me in this situation? Will
rectifying this problem of cortisol production with prednisone improve thyroid and testosterone while lowering ATCH production and hopefully resting the adrenals. Could hypothyroidism be caused by weakened adrenal gland function?

I don't crave salt or sugar really, so i am most likely not at the dangerous stage yet of adrenal fatigue but based on my last post it seems i am at the early stage right now.

This makes me wonder why the testosterone didn't work for me. Surely this should have lowered cortisol production by fighting against it? Unless this further aggravated the hypothyroidism symptoms and they still remained giving the on-going problems.

Here is a link to the pubmed articles on varicocele/adrenal dysfunction and hormonal parameters.

http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

Some quotes i feel are important:

"Insignificantly lower levels of testosterone accompanied by significantly
lower levels of dihydrotestosterone, slightly decreased LH but increased
FSH undistinguishable concentrations of cortisol in patients with
varicocele were in agreement with previous findings. Higher levels of an
exclusively adrenal androgen 11 beta-hydroxyandrostenedione in men with
varicocele indicate increased activity of the adrenal cortex.
Significantly higher basal levels of 17 alpha-hydroxyprogesterone in the
patient group (p < 0.001), so far not unequivocally proved, evidence for
suggested decreased enzyme activity of C17-20 lyase in the testis in at
least some of men with varicocele."

"The results of adrenal functional studies demonstrate a significant
tendency to adrenal hypersynthesis of aldosterone and cortisol in patients
with varicocele."

So in theory one of my adrenals at least has went in a state of stress and prednisone should take the load off it and result in increased performance of the left side testicle? DHEA has also most likely been effected due to this.

[role model]

Ok since your rambling like a person with ADD, and trying to be your own Dr. again, I think; I just have 1 thing to say.

You've been back from your USA trip now 2 weeks, and your ready to switch things up Already???
Is this what your doing? Are you this impulsive that you cannot give anything a chance. Are you second guessing one of the best Dr. around.

[Megazoid]

Where did i ever second guiess the doctor here? I have more request for Dr Marinaco than any doctor on this planet. Did you read anything i said in the post? I am sick of replying to your posts and being forced to defend an honest post with nothing aggrevating. Why can't you ever give me a break? Just ignore my threads please and let the likes of Phil, love_en, jansz reply to them instead, who are knowledge (and have lived) with hypothyroidism, adrenal fatigue and testosterone issues.. I stated at the stop of this thread that i didn't come to start a war and you instantly jumped in trying to aggreviate some findings i made. I also stated that i sent the information to Dr Marianco (who preivously hasn't dealt specificially with varicocele cases) to get his advice on this (not to change anything).

He wasn't aware of the exact mechinisms before varicocele so i did some research to save him the trouble. I posted it here for others and to get some advice on the adrenal/thyroid link.

[role model]

Your saying test doesn't work for you and you emailing him info, (which by the way is probably as aggravating to him as I am to you) Your questioning the prednisone/HC if it will help or hinder you in this situation? Your talking about salt and sugar and that you don't crave it?
Your turning into a hypochondriac with all your research and thinking yourself into problems and solutions that you don't even have.
PS. Yes I read it and your questioning him!

[cjones]

Hello my fellow insomniac!

Adrenals/thyroid and insulin are all closely tied. You know better than most how I have been effected by severe adrenal insufficiency and I am also curious how reproductive hormones have been effected - can't wait to be on adrenal support to see if I feel like myself again. No matter what way you look at it low cortisol/adrenal insufficiency will effect thyroid even if FT4 is normal then FT3 is likely to be mid to low range and you will more than likely have an elevated TSH above 2.0

Varicocele is known to cause hypothyroidism, TRH is released from the testicles so this would make sense with the dysfunction you have suffered and terrible symptoms

I visited the thyroid uk website and it is widely acknowledged that low adrenal reserve needs taking care of before anything no matter what caused this, just imagine a car then this is your engine to get everything going again

I can see the link between restricted TRH production and hypothyroidism due to the varicocele that has probably stressed your adrenals and the amount of time you have been in this state adrenal support is now more than likely a must to get thyroid hormone into your cells again

You will know this by retesting and ridding symptoms i.e. Free T3, the active hormone should be in the upper 1/3 range due to better conversion from the bodys storage hormone FT4 and improved activity on a cellular level

I don't know if an increased ACTH production and excessive cortisol lead to the atrophy, it could explain if your dhea is low but other things could also. I know too high cortisol i.e Cushings syndrome is usually due to a pituitary or adrenal tumour and steroid abuse the latter we definitely don't have to worry about - acth is usually inhibited by high cortisol. 17-OH progesterone the precursor to cortisol being high usually means congenital adrenal hyperplasia or adrenal tumors, again you would have extreme symptoms with excessive adrenal hormones especially over months and years. I would keep the focus on thyroid and dealing with stressed adrenals first to help this

I think an elevated acth like tsh here will just confirm the gland is struggling due to low thyroid hormone and stressed adrenals. On the same token it is possible to have low cortisol and a normal dhea production so I guess it can be the other way round too but over the amount of time you have had this condition I think you would have shown more adrenal related symptoms especially if it was severely high/low.

The main problem seems to be thyroid hormone not getting used by the body on a cellular level. There can be enough thyroid hormones circulating in the blood to give a “normal” reading but if the hormones are not getting into the cells then you will be hypothyroid. Another good reason for saliva testing because this is on an intercellular level that is extremely accurate

An interesting thing is the body makes mucopolysaccharides in normal quantities. When the thyroid is malfunctioning, they are mass-produced. These mucopolysaccharides infiltrate into all the connective tissues and cause many problems i.e. joint pains and muscular pains. You are right to be concerned about those symptoms because severe hypothyroidism can put you in an early grave if left untreated

Hope this helps clear things up a bit and you get your results soon enough for your meds and feeling better

[troubledfinuser]

Originally Posted by cjones

Hello my fellow insomniac!

Adrenals/thyroid and insulin are all closely tied. You know better than most how I have been effected by severe adrenal insufficiency and I am also curious how reproductive hormones have been effected - can't wait to be on adrenal support to see if I feel like myself again. No matter what way you look at it low cortisol/adrenal insufficiency will effect thyroid even if FT4 is normal then FT3 is likely to be mid to low range and you will more than likely have an elevated TSH above 2.0

Varicocele is known to cause hypothyroidism, TRH is released from the testicles so this would make sense with the dysfunction you have suffered and terrible symptoms

I visited the thyroid uk website and it is widely acknowledged that low adrenal reserve needs taking care of before anything no matter what caused this, just imagine a car then this is your engine to get everything going again

I can see the link between restricted TRH production and hypothyroidism due to the varicocele that has probably stressed your adrenals and the amount of time you have been in this state adrenal support is now more than likely a must to get thyroid hormone into your cells again

You will know this by retesting and ridding symptoms i.e. Free T3, the active hormone should be in the upper 1/3 range due to better conversion from the bodys storage hormone FT4 and improved activity on a cellular level

I don't know if an increased ACTH production and excessive cortisol lead to the atrophy, it could explain if your dhea is low but other things could also. I know too high cortisol i.e Cushings syndrome is usually due to a pituitary or adrenal tumour and steroid abuse the latter we definitely don't have to worry about - acth is usually inhibited by high cortisol. 17-OH progesterone the precursor to cortisol being high usually means congenital adrenal hyperplasia or adrenal tumors, again you would have extreme symptoms with excessive adrenal hormones especially over months and years. I would keep the focus on thyroid and dealing with stressed adrenals first to help this

I think an elevated acth like tsh here will just confirm the gland is struggling due to low thyroid hormone and stressed adrenals. On the same token it is possible to have low cortisol and a normal dhea production so I guess it can be the other way round too but over the amount of time you have had this condition I think you would have shown more adrenal related symptoms especially if it was severely high/low.

The main problem seems to be thyroid hormone not getting used by the body on a cellular level. There can be enough thyroid hormones circulating in the blood to give a “normal” reading but if the hormones are not getting into the cells then you will be hypothyroid. Another good reason for saliva testing because this is on an intercellular level that is extremely accurate

An interesting thing is the body makes mucopolysaccharides in normal quantities. When the thyroid is malfunctioning, they are mass-produced. These mucopolysaccharides infiltrate into all the connective tissues and cause many problems i.e. joint pains and muscular pains. You are right to be concerned about those symptoms because severe hypothyroidism can put you in an early grave if left untreated

Hope this helps clear things up a bit and you get your results soon enough for your meds and feeling better

I saw mega post this b4 to. Where did u guys get the information that TRH is beeing produced in the testicles? Why would the testicles be sending a signal to the pituary to release TSH, i fail to c this connection?

Please tell me where u found/got this information.

Thx in advance.

[cjones]

Thyroid hormone is important for libido, sperm production and other hormones. The testes release TRH that can go to the pituitary and make it release TSH that in turn causes the thyroid gland to release thyroid hormone. Marianco mentions this in the TRT sticky subject high T but no libido and other factors involved

A better explanation: Thyroid Releasing Hormone (TRH) A peptide hormone synthesized in the hypothalamus and passed through the hypophyseal portal venous system. In the anterior pituitary, TRH stimulates synthesis and release of Thyrotropin (TSH)

[cjones]

Other things to think about in relation to this are that low thyroid hormone causes a reduced release of gonadotrophins from the pituitary gland that are hormones which stimulate testosterone and semen production. TRH will also increase and stimulate prolactin in hypothyroidism that will contribute to sexual dysfunction

[MacDonnell]

Dave,

Before you get your mind all worked up again, I'd forget about the current path you seem to be leading yourself down. It's good to bring this stuff up to Dr. M, but didn't you already discuss your varicocele problem with him out in Monterey? What did he say then? You need to give the new meds time to work first. His plan is to do this for 6 weeks, right? Then retest? Like I said, and what Role Model is saying makes perfect sense, let Dr. M be the doctor. Stick with his program and, depending on how you're feeling, how your tests look, etc., he will either abandon things, increase dosages, change direction, etc. You have to let him be your doc. now though, okay?

Mac

P.S. - I will PM in response to the questions you had in your recent PM.

[jaydee]

Megazoid, as others have mentioned I think you need to give the good doctor a chance to help you. Last thing you want to do is become a pain in the ass by second guessing him especially this early in the game. You flew to the other side of the world to see him, so I think that shows that you really do trust his judgement.

I truelly think that indecisiveness and to a point, being a little paranoid and negative is a side effect of hormonal issues and thats what I think is partly going on here. You just need to take a deep breath and try and chill out. Dr M will get to the bottom of it, just give him a chance. If he cant, THEN I would start suggesting things.

The only other time I would second guess a doctor is if there is a chance of irriversible damage that is blatantly obvious like mega doses of hcg or somthing.....otherwise you just need to be patient with him even though that is hard somtimes.

[pmgamer18]

Megazoid did you start your meds yet if so how are you doing.

[Megazoid]

Phil in about an hour or so i am going to phone the hospital in the states regarding the blood work. I haven't heard a thing yet and it's pissing me off somewhat. Didn't want to start anything until i have these (in case my adrenals really aren't that bad). I also sent away my 4x salivia tests today, so should have the results back in a few weeks.

[JanSz]

Originally Posted by Megazoid

Phil in about an hour or so i am going to phone the hospital in the states regarding the blood work. I haven't heard a thing yet and it's pissing me off somewhat. Didn't want to start anything until i have these (in case my adrenals really aren't that bad). I also sent away my 4x salivia tests today, so should have the results back in a few weeks.

Why have you went to a hospital for the test???

Have not you read numerous posts on
Quest Diagnostic being the only one that counts and
LabCorp being (possibly) second best.

When I did my testing at hospital
they
1. did not draw blood for all test, I had to come second time for blood draw

2. They did not tested everything that was requested, another trip for blood draw

3. they misplaced some of the results

4. I did not started talking about quality of the tests itself yet

5. and all this was about wery short test
.
.
6. they sub-contracted some tests, just try to locate those

[Megazoid]

JanSz, when i was in the states i went to the local hospital for the tests because LabQuest (Or Quest Diagnositics) wouldn't accept me because i wasn't from the US. My local address was in Scotland, not the states. They refused to take me as a patient (or take blood work). I was forced to goto the hospital where this "law" dosen't exist and they can do the blood work.

[role model]

Originally Posted by JanSz

When I did my testing at hospital
they
1. did not draw blood for all test, I had to come second time for blood draw

2. They did not tested everything that was requested, another trip for blood draw

3. they misplaced some of the results

4. I did not started talking about quality of the tests itself yet

5. and all this was about wery short test.
.
6. they sub-contracted some tests, just try to locate those

Dang, sounds like a night mare, and to think your paying top dollar for this service.

I was just at the Dr for bad right knee pain thats been getting worse for 2 months.
I waited almost 2 hrs past my appt time he came in and seen me for 5 minutes and sent my to PT to do exercises and charged me $125. for absolutely nothing except ruing my day.
What a freaking moron, I demanded another Dr. with my ins. and got one.
They actually sent me to a knee specialist who worked for the Cinn Bengals at one time. He took x-rays, gave me 2 cortizone shots in my knees and said if this dosen't work to come back and do an MRI.