Quote from: KayXo on April 28, 2016, 12:22:27 PM
How are you so sure it's not stress related? Stress can increase prolactin and adrenal output. The changes that follow such a major intervention can be quite stressful, more than one may admit or be conscious about.
What are your prolactin and testosterone levels? What are you taking right now(omit doses)? Did you take cyproterone acetate and/or non bio-identical hormones? Perhaps you have a prolactinoma...Did you do an MRI scan? Cyproterone has been associated with prolactinomas in transsexual women.
Stress may cause this AND/OR the withdrawal of an anti-androgen post-op with a lesser dose of E because the very weak action of androgens previous to the op upregulated androgen receptors and increased your sensitivity to androgen such that now you respond strongly to even low levels or just that now, compared to pre-op, androgen action is stronger.
Cushing's syndrome is when the adrenal gland is hyperactive. Dexamethasone does the opposite and is more akin to Addison's disease.
What were her TSH levels?
Like you I started suspecting a cortisol condition such as cushings.
I personally suspect to this day that perhaps cyproterone acetate may have long-term, permanent effects in some on their adrenal gland functioning, even after withdrawal. Some studies have shown it to suppress adrenal function.
Androgens give energy. Perhaps your symptoms are due to lack of E. Or a prolactinoma as migraine is one of the symptoms and I remember reading a woman who had a prolactinoma who was feeling extreme fatigue and had migraines. She also reported galactorrhea (lactation) and breast pain.
I think it's important to remain objective and be open to all possibilities. Not to jump to conclusions too quickly. See what doctors have to say and perhaps get a second and third opinion.
Hi Kay!
As usual your knowledge is appreciated by me and hopefully others! This may sound weird but If we lived near each other I would love to go to dinner or coffee literally just to discuss endocrinology.
Anyway. More info on the matter, I was put on dostinex after several blood tests over the course of 2 years kept coming with hyperprolactinemia. I did have an MRI done in January and only a week ago today did I get the results and there is an adenoma (benign Tumor)
I do have an inclination to believe that the androgen receptors may have sensitised to a degree Kay you might be onto something there.
Androgen levels after GRS are (in international measuring system UK,Canada) T: 1.1nmol/L free androgen index: 0.6
These results are very similar to preop levels if ever so slightly higher.
I did take cypro for a length of time, and i did lactate but salid issues started before i Was Ever on cyproterone, also my identical twin did not tKe cyproterone and she ended up with prolactinemia as well, except for the fact that they did not find a prolactinoma in her MRI, although microprolactinomas can't be seen in MRI's if they are below a certain size (I think below 5mm). I long suspected the cyproterone as it also has mild glucocorticoid properties Kay, the first endo really didn't seem to think so but the endo I'm seeing tomorrow is a trans specialist he might have better input, as you see tho all the evidence points at not being the cyproterone now.
Dexamethasone suppresses adrenals Kay, if she had addysons it would probably kill her... I do not know her thyroid results, my Tsh is fine t3 is within range on the low side and t4 within range near the high end of the range. My sister says all her tests keep coming back fine! Apart from prolactin she's also on dostinex for it now.
I take estradiol bioidentical
I should receive the DHEA-S test results soon.
Other symptoms I have been suffering are also but not limited to:
Hot flushes
Dehydration (always thirsty) (after GRS intensified but present before)
A definite activation of follicles in my body along with some itchinessand I am one of the most hairless people you would ever meet...(after GRS)
I do have thin skin and stretch marks (cushing's?) and a Round face I actually had lips to reduce my big double chin!! (Before GRS)
Clammy/sweaty skin (after grs)
High lipid profile
Foggy thinking (after GRS)
Unable to concentrate (after GRS)
Irritable (I can't hardly stand the sight of my bf he is suffering for it too) (after GRS)
(Some of these symptoms started pre GRS and intensified after, some of them appeared after GRS)
Other possible reasons:
FSH and LH raised from being at 0 after GRS as they are supposed to. ( any relation? LH possible adrenal stimulator?)
Now I have been diagnosed with a pituitary Tumor it is possible that it is producing too much ACTH as well as prolactin (first endo does want to investigate at least some basic tests for cortisol acth and DHEA-S) like I said tho cushings can be very hard to diagnose and I have been advised by the pituitary foundation to request 3-4 days of free urinary tests . As cushings can often be cyclical and people that don't have the obvious "hormonal look" often have this type of cushings.
Another possibility is another benign Tumor in my adrenal glands, although these are rRe, my sister having the same issues could indicate a genetic condition of benign glandular tumors (hopefully not the case)
Again. Stress can contribute. But some of the changes are too intense and my lifestyle hasn't changed significantly in that manner and I did consider the physical stress from surgery, but again it not all started after surgery, some symptoms I had and intensified, others altogether started from there.
I did do a small at home test of sorts. I took a half a tablet of my cyproterone left over from before GRS and, it did reduce some of my symptoms, the ones that would be related to androgens for about a day. That finding along with test results showing female levels of active androgens leads me to believe it's DHEA-S, which is an inactive androgen that activates into T and DHT only once it has reached the skin.
Kay what are your thoughts on the prostate being left behind post GRS and its role in regards to androgens?
Will be back when I find out more!