Got a medical question? Let me stretch my brain.

As for growth hormone and testosterone therapies....sorry I have been delayed on putting this up....paste excuse here....

The whole issue of hormone supplementation is fairly muddled and has not been yielding many strong answers.

I was at a talk by an endocrinologist last week and he flattly denied that "andropause" existed in any great capacity.

He admitted that the hormones decreased in concentration, he confirmed that some men do experience a syndrome of pathologically decreased hormone levels that manifest itself with concrete symptoms and consequences that should be treated. But he stated that the large scale supplementation of the aging male population with testosterone was probably a distaster in the making.

For the most part I would agree with him, but include the the evidence isn't strong one way or the other. Testosterone therapies do not increase the cholesterol (for a while it was presumed the opposite), do increase endurance, bone density, mental performance etc etc. But, there could be a whole slough of bad side-effects that we may not have the experience to see them clearly yet (liver failure, cancers, heart disease [though this may swing either way]) etc.

The situation at this point, to the extent of my knowledge, is similar for HGH. It really sounds intriguing. There is established conditions that are thought to be the result of low levels of HGH, of course. And, there is a tendency for it to drop with age. But a distinct condition due to this gradual "natural" decrease has been hard to characterize, and the treatment of it may have hidden dangers we are not fully aware of yet. Some consequences that are currently understood include liver dysfunctions, arthitis-like joint problems, diabetes, sleep disturbances, nerve and eye problems.

But, this is not really an adequate review of this topic. When you get into the "meat of the issue" much of it seems to be lead by specialist conjecture, opposing interpretations and lack of consensus. That is usually a good sign that we don't really know enough about it to make reliable practice decisions at this time.

Hope that isn't to "limp" of an answer....its the best I have at this time.

Cheers

J

[bonjing]

Thanks for the answers John and Rabid not the answer I was hoping to hear , but better than me screwing up or getting an infection in my ear . Back to the pillow over the head method.

[Tenor CS]

Here's a question for Dr. John:

I went to the emergency room on Monday morning.

My symptoms: dizziness, pounding heart, nausea (vomited twice), weakness, especially in the legs - felt like I was going to pass out.

I have a history of high blood pressure (take 20mg Lisinopril per day) and hypothyroidism (take .75 mg levothyroxine per day). No diabetes.

I was admitted. They ran 4 EKG's over 48 hours, all normal. Blood tests were mostly normal, high WBC count (14-ish). Head CT scan showed no abnormalities. Chest X-ray was normal.

The on-call doc's diagnosis was labyrinthitis. They gave me 4 doses of methylprednisolone, 6 hours apart. Also, given an rx for meclizine, every 8 hours for the dizziness.

Questions:

1. The next day, my blood tests showed a much higher WBC count, in the 21-22 range. Could that be caused by the steroids? I have always had high WBC counts, and no one can seem to figure out why. About a year ago, a hemotologist ran all kinds of tests on me, including C-Reactive Protein, Sedimentation Rate, and some others, and nothing screamed "cancer" at her.

2. I have been getting EXTREMELY short of breath and heart pounding after the mildest exertion. Sometimes just even standing up causes it. Walking up a flight of stairs is murder right now. It's a little better this morning, but still worrisome. I was in school yesterday and was late to classes because I literally could not make it across campus in 15 minutes without stopping. Full disclosure: I am morbidly obese, 5'8" and about 380 lbs. But this shortness of breath and heart pounding is 10 times worse than anything I've gotten used to just being a fat guy. Could the shortness of breath and heart pounding also be caused by the steroids? How dangerous is it? At what point should I seek medical attention for it?

Thank you

Sorry for not seeing this earlier, I have been away with the military alot over the last month and a half.

First off, the steroids could be responsible for the leukocytosis (elevated WBC) and this could be a relatively quick response (as it is believed that the steroids affect the adherence of the WBC to the blood vessel walls, making it look like they have suddenly increased). However, I would expect this to subside quickly and thus should not be present in further blood work.

I would have a hard time excluding cardiac syndromes in the face of your story, without "casting eyes upon you" myself. Mind you, it is completely in keeping with a viral syndrome (run of the mill virus) that resulted in a labrynthitis. I would expect the shortness of breath on exertion and palpitations to be in support of this (as well as a million more dangerous things).

The yard-stick I would use to determine whether to seek further care would be that a) it isn't resolved already, considering this was over a week ago when you wrote this or b) if it continued to get worse (decreasing levels of activity resulting in similar symptoms, or symptoms getting worse at a standard activity level.

Beyond that, providing they did a reasonably-full cardiac work up, considered clots in the lungs, clots in the brain, narrowings of the carotid arteries, pneumonia and aortic artery conditions (and it seems like they probably did, considering these conditions doesn't necessarilly mean throwing every study imaginable at them....maybe just being reasonably certain you don't fit the MO of such things), I would say they would likely catch all the dangerous stuff.

I hope this helps, but considering this was a week ago you posted, I imagine you aren't in need of my help anymore.

[Tenor CS]

Thanks for your reply, Dr. John. I feel fine now

My BIL is an ER doc and he told me pretty much what you said.