Tuesday, May 17, 2011

Health Update

I finally have a formal diagnosis for the hypogonadism, sort of. It is now believed that persistent abdominal fat is keeping hormonal levels from staying regulated. Due to frequent exercise and weight lifting, every other portion of my body is more-or-less in good shape. A pharmacist I spoke to yesterday postulated that Seroquel, one of my bipolar medications, may be the culprit here. Getting off Seroquel isn't feasible right now, especially since its properties as a sedative keep me asleep all night long. Along with other chronic conditions, I've also been a heavy insomniac for the past several years. It would be fantastic if other ways of treating it were discovered.

To keep testosterone levels high, I've still been relying on weekly intramuscular injections. Those will continue for the next couple months, at least, after which I'll have a decision to make. I've also been simultaneously taking a medication to prevent the conversion of testosterone to estradiol (estrogen). I'll soon have a choice between testosterone replacement therapy or taking an estrogen blocker. Right now, estradiol levels are too low. The aromatase inhibitor, Femara, that I was taking before is too strong. Men do need to have a certain estradiol concentration that is somewhere between 20 and 30. My last level was around 2. I've now been prescribed a somewhat weaker inhibitor called Arimidex.

Diet also has a role to play, but it's still uncertain what restrictions or limitations that means for me. Like so much about this condition, trial and error is the only method available to me. I've been off dairy completely for the past three weeks, though I've fallen off that wagon a couple times. I do feel a bit better but somehow, I'm not quite sure this is the silver bullet for which I've been praying. In time, I hope that better, more effective medications are discovered for everything. This is all so inexact and frustrating, but the treatment for bipolar as well as for hypogonadism is primitive compared to other illnesses and ailments.

Emotional lability describes what hormonal shifts produce in me. Namely, I find I cry quite easily and unexpectedly, and that my moods shift constantly. I haven't had bouts of anger, but I have had periods of time where I've felt completely out of control. Those with a history of abuse often seek some degree of control, since the thought of not having it is distressing. I don't have a formalized diagnosis of emotional lability. I don't neatly fit the profile, but not striking the optimum hormonal balance has produced similar symptoms in me. I tend to go into emotional vomit mode as a means of reasserting control, but with the exception of one outbreak, I've been okay.

I will need to follow up with an endocrinologist periodically for a while. Years, likely. So now my treatment moves somewhere on the axis between active and continuing care. But what's one illness, more or less?

No comments: