What Should I Ask of the Endo?

[keninottawa]

Hello all,

This post is in the 'adrenal protocol' thread, but since it's really a different subject which I'd like to get feedback for, I thought it warranted a new thread.

After a couple of years off of TRT, I'm looking to go back to a new endo and find out what's wrong with me. I didn't have a good experience with my old doc, but I feel as though I can at least somewhat fix whatever it is that ails me.
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I don't think I am hypothyroid per se; I've had constipation ever since I've been faced with hormonal problems, and I do have dry and irritated skin, but I'm the type that has trouble gaining weight (as opposed to the opposite) and my metabolism seems fine. Of course, there might be something indeed wrong with my thyroid (as the consipation indicates), and I want to have it checked when I next see an endo this summer.

Just curious -- what should I ask from my endo when Inext see him/her? I've already been on TRT, and I know that this alone won't help me. I want to take a holistic approach to my endocrine system and address the crux of my problem. I've had a pituitary MRI done before, and it turned up negative, so I'm OK there. And my pituitary did respond to SERMs, Phil; the LH and FSH did not stay high after I ceased SERMs, though.

Here are my symptoms:
- Very low libido
- Difficult maintaining muscle mass
- Low energy
- Brain fog
- Constipation and other occasional digestive problems
- Puffy face
- Low facial hair growth (I'm 23 and cannot grow a beard)
- General malaise
- Dry and irritated skin

And the bloodwork I've had done over the past few years have indicated:
- Below range/at lower threshold T and Free T
- Very low FSH, LH, and low E2
- Apparently high TSH values (in the mid-2's)
- Normal Ferratin
- Normal Prolactin

After I came off of TRT in late 2005, my LH and FSH were through the roof:
- LH 11 IU/L
- FSH 20 IU/L
Free T and T were still low, and SHGB was at 40 nmol/L. My then-endo reported that this might've been part of recovery and "may return to normal". She said that there "is no need for him to return to the clinic".

Thank goodness I didn't stay on with her!

My issue is that I don't know what to ask of the endo when I see him/her. I know that standalone TRT will not do me any good, and that I might need some other form of intervention. I'm currently working to fix my adrenals (although I don't suspect very bad AF); you can read about that in the 'Adrenal Protocol' thread. Any input you guys can provide is greatly appreciated.

- Ken

P.S.: I'm going to Germany for ten days, so I might not be able to answer, but still appreciate feedback!

[hardasnails1973]

First question I ask people when I see them is
"What can we do to help you" and they begin explaining their problems. A good endo will listen and not jump down your thrroat giving the impression that he medical expert. Trust me i have put several endos and psychologist in there place and made them think twice. The best thing to do with endos is play stupid and see how they react to your reason you are there and then when they are done start firing away. I love playing with shrinks especially knowing that I have studied some neurochemistry of the brain as well as when i get board I read the DSM . I have helped freinds out with presentations for their post grad presentations for psychlogy. I do beleive each one of us has some form of mental issue (not that your a loon), but areas in our developemnt that could be imporved and from exploring psychology it does make one more aware of our behaviors and who we really are. The ultimate intervention is a place where one can heal mind, body, and also spirit, but a few of them exist.

With your appoitment with endo be honest explain how you are feeling and tell him every thing else is fine in your life.. If he trys to sway you from your symptoms and starts asking how your life is going you mention you have been stressed. Trust me red flags are going to go up.. Every Dr I went to previous to one I have now as soon as I mentioned yes I had a little stress at work or relationship is alittle unsteady. It was a trip to see head doc.