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Old 06-19-2009, 07:55 PM   #1
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I have stumbled into a bunch of Glucose tests

I was diagnosed with Low Testosterone and during a test my GP slipped in a blood glucose test and it came back as a 104, range 66-99. Slightly high.

More concerning was that my Testosterone was a 105, range 241-829. But that's another story.

I was sent to a Endocrinologist and along with a 2hr (over done) history and physical exam, he ordered a bunch of test. Some were futher testosterone test but one was a crazy glucose test that he said I wouldnt find in any books and that it was a down a dirty way to test for glucose problem like diabetes.

He sent me right out from the appointment and had me eat as many carbs as I could. He emphasized the need to jam as much as I could in. Eat like your life depends on it. So, I ate two full stacks of pancakes, two huge biscuits and gravy, two large hashbrowns and a 32 oz vanilla milkshake. I was told by the Endo that I had to have my blood drawn at EXACTLY 2hr after I stopped eating. So I used my phone's stop watch feature and since the lab in downstairs from his office it was easy and we nailed the time.

Test came back. My testosterone dropped to a 85 and my glucose was 140. That seemed reasonable to me. I just dumped 10lbs of glucose into my system isnt it resonable there will be SOME fluctuation in my glucose. And why just one test. Wouldn't it make sense to test several times afterwards to see how my system is processing the glucose.

I got a call this morning from his assistant and they want to do a different glucose test. This one I have to eat a teaspoon of sugar and piece of bread with each meal for three days then fast for 12hrs and go get tested. Why?

I talked to my diabetic brother (type one) and he said this is all ridiculous. If I had tested 600 after that carbo bomb further testing would make sense. I realize that a 104 fasting is pre-diabetic. Since the second test is not in any book I cant find out much about it. I am overweight but look at my sig. Ironically, during the "history" phase of this visit the Dr asked me what my height and weight was. I was 6"5 and 245. He wipped out a calculator and told me that even then I was obese. Funny thing is, I was around 10% body fat, could run 5+ miles a day and bench pressed 325-350. I wasn't close to obese. I was a rock. With the spine surgeries I have lost 1.5" in height and gained 45lbs. Guess he hasn't read the recent studies that show the BMI index is flawed and too much stock has been put into it.

I feel like I have two houses next to each other. One is one fire (testosterone) and the other has a Cat in a tree (glucose) and the Fire Dept is fixated on the cat and ignoring the fire. All my low T symptoms are raging as he wants to find out the cause of low T before he treats it. I can barely get out of bed. I feel like I am walking through jello all the time. No sex drive and sever ED. Life is no fun and everything is a major challenge.....all symptoms of low T.

Can any diabetic experts lend a hand here. Am I out of line. Is testing a 140 after eating what I did that alarming? Should I proceded with this other test or put my foot down and say, "Hey, treat me for what I was referred here for"

Thanks.
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Old 06-20-2009, 03:19 AM   #2
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Re: I have stumbled into a bunch of Glucose tests

Quote:
Originally Posted by Bilbo View Post
Is testing a 140 after eating what I did that alarming? Should I proceded with this other test or put my foot down and say, "Hey, treat me for what I was referred here for" .
In an Oral glucose tolerance test, they give you a 75g 'load' of glucose and test 2 hours later. If above 140, you are considered to have 'impaired glucose tolerance', some call pre-diabetic, above 200, you are diabetic.

He seems to have his own 'load'. The reason they use a fixed amount of glucose is to be standard. If you hit 140 with the kind of load he gave you, you are not diabetic.

Sounds like he has in own version of the OGTT. Kind of like a home made one. While the load he gave you is greater than 75g, he also gave you stuff that is slower to absorb by your system, so the 140 at 2 hour is probably not even a fair measure. There is fat in there which slows absorption. Pure glucose (not sugar) is used in the standard tests to cause a very quick spike and see the response. Anyway, it is borderline pre-diabetic, never mind diabetic.

For a non diabetic person, whether they give you 75g or 150g of glucose makes little difference.

The other test sounds bogus. He is telling you to take maybe 30g of carbs with every meal. So what ? You certainly take 30g of carbs anyways.

Is he saying there is a link between the glucose levels and the testosterone ?

He doesn't sound like the most scientific of doctors, but maybe he knows some link between the two

I would ask him what the link is. If he is saying there is none, I would move on.

Last edited by itotito; 06-20-2009 at 03:31 AM.

 
Old 06-20-2009, 03:10 PM   #3
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Re: I have stumbled into a bunch of Glucose tests

itotito,

Thanks for the reply. He isnt so much trying to link low T to diabetes. He has mentioned that people with obesity often have low T. So, he really is chasing two tails here. Like I mentioned before I was sent to him because my testosterone levels were very very very low. My glucose fasting was 104, hardly alarming.

My brother, who has been diagnosed diabetic for 20 years and is very intelligent told me this guy is an idiot and that both tests, the self administered carbo load and the upcoming "eat a tablespoon of sugar and bread with each meal for three days" will tell him nothing. Let me add that the carbo load he had me do he gave little instructions. He just said eat as much pancakes or pasta as I could and test 2 hours later. He didn't say anything about fats, proteins or anything else. Seems really shaky. What is wrong with the normal protocols?

With my low T he is trying to rule out all the possibilities that cause low T beside the ones I already have. The pain meds I take will cause low T and obesity apparently causes it too. I have read that it takes a pretty large dose of opiates to knock ones T into the dirt and I am taking a paltry amount right now: 20mg methadone & 20 mg of Norco for bad days. 2 years ago I was taking 240mg of 24hr time release Mophine and 60mg of morphine sulfate. I tested a 112 then. So I add that up like this. Two similar numbers under two DRASTICALLY different opiate loads...so opiates do not seem to be the issue. So, he is checking out all the other T factors and I am also having a MRI of my Pituitary done next week.

I am going to call his office and talk to his assistant and ask why we are progressing with this other glucose test when Diabetes is unlikely. I am going to push for getting on with the Testosterone issue which is obviously a problem and the reason why I feel horrible 24/7. Numbers do not lie. All my T test have come back drastically low. This glucose issue has distracted him.

I don't know how to address these "home made" tests. They don't seem to be logical and he even admitted that they were not in "the books", were a "down and dirty" way a testing and that he takes a "guerrilla approach" to all of this. All sounds weird to me. The fact that he is the only Endo in town and the nearest is over an hour away has me boxed in.....



Quote:
Originally Posted by itotito View Post
In an Oral glucose tolerance test, they give you a 75g 'load' of glucose and test 2 hours later. If above 140, you are considered to have 'impaired glucose tolerance', some call pre-diabetic, above 200, you are diabetic.

He seems to have his own 'load'. The reason they use a fixed amount of glucose is to be standard. If you hit 140 with the kind of load he gave you, you are not diabetic.

Sounds like he has in own version of the OGTT. Kind of like a home made one. While the load he gave you is greater than 75g, he also gave you stuff that is slower to absorb by your system, so the 140 at 2 hour is probably not even a fair measure. There is fat in there which slows absorption. Pure glucose (not sugar) is used in the standard tests to cause a very quick spike and see the response. Anyway, it is borderline pre-diabetic, never mind diabetic.

For a non diabetic person, whether they give you 75g or 150g of glucose makes little difference.

The other test sounds bogus. He is telling you to take maybe 30g of carbs with every meal. So what ? You certainly take 30g of carbs anyways.

Is he saying there is a link between the glucose levels and the testosterone ?

He doesn't sound like the most scientific of doctors, but maybe he knows some link between the two

I would ask him what the link is. If he is saying there is none, I would move on.
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2 Lumbar Lamies 93 (age 22); Cervical Fusion C4-C6 2004. Lumbar Fusion w/ hardware S1-L4 2007, DDD & stenosis entire spine. super low T. 30mg Methadone BID 10-20mg Norco 4 BT. 2mg Xanax PRN.

 
Old 06-20-2009, 04:59 PM   #4
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Re: I have stumbled into a bunch of Glucose tests

Bilbo..I'm with you, I can't grasp all the glucose testing, as I would kill for your low numbers. His method of testing sounds a bit weird to me as well. I'd have a talk with him and if you don't like his answers, get another opinion and someone who will address the issue your concerned about.

Good luck.

 
Old 06-20-2009, 06:57 PM   #5
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Re: I have stumbled into a bunch of Glucose tests

I would get a second opinion from a reputable doctor and not waste time with the one you are seeing now.

I went to a diabetes specialist who is in diabetes research and a budding nobel prize winner in diabetes at a prestigious medical school where he practices. He did not mention any of the methods of testing like your doctor is having you do.

I do not see the point of overloading your body with carbs over and over. There are more scientific ways of testing for diabetes.

 
Old 06-20-2009, 08:47 PM   #6
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Re: I have stumbled into a bunch of Glucose tests

I just want to say that I agree with what everyone else has said about this doctor. I've never heard of such idiocy. As Itotito pointed out, there's a reason they do the standard glucose tolerance test the way they do...and that's for consistency and accurate results.

I also think your blood glucose levels don't sound all that bad. The fasting numbers are definitely in the pre-diabetic range, but the only thing that would be done about that now is diet and exercise...and you really do need to start that.
But your other numbers sound pretty okay.

If it were me, I'd travel an hour to see another endocrinologist. This one sounds a bit like a nut to me.

Ruth

 
Old 06-20-2009, 09:26 PM   #7
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Re: I have stumbled into a bunch of Glucose tests

Quote:
Originally Posted by JJ View Post
Bilbo..I'm with you, I can't grasp all the glucose testing, as I would kill for your low numbers. His method of testing sounds a bit weird to me as well. I'd have a talk with him and if you don't like his answers, get another opinion and someone who will address the issue your concerned about.

Good luck.
JJ,
Thanks for taking the time to reply. I really appreciate all of your guy's help. I spend all my time in the pain management and spine forums. Never thought I would be over in the Diabetes. My Brother with Diabetes also said he would kill for my numbers. I am going to request to re-consult with him or at least with his assistant in order to get to the bottom of this. Seem like we are going to such long lengths for a couple of test numbers that put me at pre-pre-diabetic at best. I think he is hung up on my brother being diabetic but he missed the part that my 4 other brothers, 3 who are overweight, are not diabetic. He is also hung up on my weight. Yeah, I had a couple of surgeries and have gotten into a sedentary lifestyle and when you have the low testosterone level I do, well, its hard to get out of bed some days. Everything has gotten twisted around....

I went through 15 years of counseling and antidepressants because I was always down and sad. Now, come to find out, it may have been super low testosterone. And the ED and libido issues that started in my 30's.... I always assumed were side effects of the antidepressants. Being misdiagnosed is a real biitch.
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2 Lumbar Lamies 93 (age 22); Cervical Fusion C4-C6 2004. Lumbar Fusion w/ hardware S1-L4 2007, DDD & stenosis entire spine. super low T. 30mg Methadone BID 10-20mg Norco 4 BT. 2mg Xanax PRN.

Last edited by Bilbo; 06-20-2009 at 09:28 PM.

 
Old 06-20-2009, 10:02 PM   #8
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Re: I have stumbled into a bunch of Glucose tests

Agree with the suggestion to find a better doctor. While the pre-diabetes is a concern, if you can solve the other problems so that you can get back to exercising and getting down to 10% body fat, you will have a much better chance of preventing progression to actual diabetes. On the other hand, if you stay sedentary and high body fat, your risk of progressing to actual diabetes is much higher.

 
Old 06-20-2009, 11:38 PM   #9
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Re: I have stumbled into a bunch of Glucose tests

I appreciate all those who have said to get another Dr but thats a tough thing to do. I live in FAR Northern California and this town in known for bad health care. The Dr I am seeing is the only Endo in town. I am also on Medicare and I doubt the would pay for another consult.

Plus, he isn't just treating me for "possible diabetes". I was referred to him for extremely low testosterone. Every test I have had has be lower than the previous one. I tested 112, 105 and 85 where the range is 241-820. To me this is much more of a concern.

As for dieting and exercise, absolutely right. I actually got down to 259 about a year ago. I was eating nearly perfect and walking as much as possible. Then it seemed like each day it became harder and harder to get going. Within a few weeks the walking was non existent and, while I still eat pretty good, occasionally I eat to much or the wrong things. I did kick the soda habit and still only have one or two a month. My energy and stamina continued to get worse and that prompted me to talk to my GP about low T. After testing a 105 he referred me out to this Endo. I do plan to call me GP and let him know about the "tangent" we have taken. Maybe he can help with the Endo.

Here is the skinny, no pun intended. I need to get my testosterone levels up so I feel better and have energy. Once I find the right Testosterone Replacement Therapy and my levels balance out I can start with an exercise regiment and continue to eat right. That will lower my weight and thus, should reduce my risk for diabetes. One leads to the other and it seems this Endo is going at it backwards.

I just need this Dr. to focus on what I was referred to him for and not this wild goose chase he is one. I have no problem picking up the phone and TELLING a Dr. (through his assistant) how things are going to proceed. I just needed to confirm that these "glucose tests" were crap and that my numbers didn't warrant the goose chase.

Thanks for all the replies. Excellent help and it gives me confidence to have a discussion with my Dr's office and push them back on track.

Thank You.





Quote:
Originally Posted by tjlhb View Post
Agree with the suggestion to find a better doctor. While the pre-diabetes is a concern, if you can solve the other problems so that you can get back to exercising and getting down to 10% body fat, you will have a much better chance of preventing progression to actual diabetes. On the other hand, if you stay sedentary and high body fat, your risk of progressing to actual diabetes is much higher.
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2 Lumbar Lamies 93 (age 22); Cervical Fusion C4-C6 2004. Lumbar Fusion w/ hardware S1-L4 2007, DDD & stenosis entire spine. super low T. 30mg Methadone BID 10-20mg Norco 4 BT. 2mg Xanax PRN.

 
Old 06-21-2009, 06:48 AM   #10
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Re: I have stumbled into a bunch of Glucose tests

Bilbo, you are most welcome for any suggestions or advice given. I always hung out on the high cholesterol and BP site, never thought I would be on this board either, but it happens. Right now my Dr. is having me buy a meter and start testing, as the last 2 times my sugar levels were high, 122 and 126.

She is not a Dr. that panics, so we are taking it one step at a time, as she knows I have been under tons of stress lately, haven't had a decent routine for a year, all due to trying to work around hubby's cancer testing. Seems I no sooner get on track and we are spending very long days at the VA hospital for his procedures, some days I am there for 10-13 hrs. Naturally I just grab any old thing from the caf to eat, lose much needed sleep and at times actually get depressed, so I know where your coming from. Thankfully friday we got a good report, now maybe I can finally get back on track.

The problem that needs to be addressed more is the low T, but this guy is totally hung up on the glucose numbers, so now your getting aggravated and depressed, neither of which are good. Kind of makes you want to just toss in the towel, been there myself. Talk to your GP and tell him/her that this other Dr. is not putting you at ease and seems to be dancing around the T problem and pushing tests for your sugar which I'm sure he will agree is not your biggest problem at all. Hopefully your GP will either consult with this new Dr. or refer you to someone else and get to the root of the T problem, then maybe you can get yourself back on track.

I wish you tons of luck and hope things start to go in the right direction. Keep us posted, and don't give up!!! Good luck.

 
Old 06-21-2009, 08:03 AM   #11
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Re: I have stumbled into a bunch of Glucose tests

Quote:
Originally Posted by Bilbo View Post
I appreciate all those who have said to get another Dr but thats a tough thing to do. I live in FAR Northern California and this town in known for bad health care. The Dr I am seeing is the only Endo in town.
Based on the city listed in your profile (Redding), that appears to be true... monopolies are not good for the customer.

Can you get to Chico or even Sacramento?

Last edited by tjlhb; 06-21-2009 at 08:04 AM.

 
Old 06-21-2009, 09:41 AM   #12
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Re: I have stumbled into a bunch of Glucose tests

Hey JJ,

Thanks for you great reply. Sorry to here of your travails and hope all works out the best it can. When my Dr's assn't called it was 8 ish AM and I had barely slept the night before. So, because I was out of it, I didn't have the chance to challenge the numbers nor the next next test. When I did fully wake I called back and left a message that I wanted a copy of my blood test and had some questions and I was very stressed. I felt blindsided. They are a busy office so I wasn't surprised that I did not hear from her. I do expect a call on Monday of they will be getting a more stern call from me. I will also be calling my GP and get him up to speed.

Like you said, when I talked to the assistant and then fully woke up and was able to focus on what happened I was really mad and wanted to quit. I had a tests done with this blood work and they gave me two numbers: Glucose and Testosterone (after I asked for it). What about the other Testosterone tests like Free T, Bioavailible T, percentage of free T, LH, FSH, TSH, Prolactin and Cortisol. Maybe more but that is all I remember. Those numbers are very important and nothing was said about them. Does that mean they are fine or are they waiting until I see the Endo again in a month to go over all this.

All I know is, unless they have a really convincing reason for further glucose testing, I am done with that and I want my T results so I can start therapy.

Thanks for you help JJ. I will be thinking of you and your hubby. That is a lot to deal with.

Take care.

Quote:
Originally Posted by JJ View Post
Bilbo, you are most welcome for any suggestions or advice given. I always hung out on the high cholesterol and BP site, never thought I would be on this board either, but it happens. Right now my Dr. is having me buy a meter and start testing, as the last 2 times my sugar levels were high, 122 and 126.

She is not a Dr. that panics, so we are taking it one step at a time, as she knows I have been under tons of stress lately, haven't had a decent routine for a year, all due to trying to work around hubby's cancer testing. Seems I no sooner get on track and we are spending very long days at the VA hospital for his procedures, some days I am there for 10-13 hrs. Naturally I just grab any old thing from the caf to eat, lose much needed sleep and at times actually get depressed, so I know where your coming from. Thankfully friday we got a good report, now maybe I can finally get back on track.

The problem that needs to be addressed more is the low T, but this guy is totally hung up on the glucose numbers, so now your getting aggravated and depressed, neither of which are good. Kind of makes you want to just toss in the towel, been there myself. Talk to your GP and tell him/her that this other Dr. is not putting you at ease and seems to be dancing around the T problem and pushing tests for your sugar which I'm sure he will agree is not your biggest problem at all. Hopefully your GP will either consult with this new Dr. or refer you to someone else and get to the root of the T problem, then maybe you can get yourself back on track.

I wish you tons of luck and hope things start to go in the right direction. Keep us posted, and don't give up!!! Good luck.
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2 Lumbar Lamies 93 (age 22); Cervical Fusion C4-C6 2004. Lumbar Fusion w/ hardware S1-L4 2007, DDD & stenosis entire spine. super low T. 30mg Methadone BID 10-20mg Norco 4 BT. 2mg Xanax PRN.

 
Old 06-21-2009, 10:11 AM   #13
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Re: I have stumbled into a bunch of Glucose tests

Bilbo...I fully understand your frustration. I had a Dr. once that I couldn't get a straight answer from, or he was always too busy to talk and answer questions..I dumped him. Now I have learned when I have blood work done, I tell my Dr. to have a copy sent to me, or if I visit her, she has her assistant make me a copy.

Having faith in your Dr. is 99% of the healing, so I question everything and she knows I research everything. Fortunately she likes that idea.

Your right, just having certain numbers tossed at you does not give the full picture, you want a clear answer. Call the GP and tell him...Hey, this other guy is not easing my mind, I need more info. and also ask why all the glucose testing.

Thanks about hubby, we got a clean bill of health friday, NO cancer showing. As exhausted as I was, I felt like someone took 50lbs. off my shoulders. Been a VERY long year and a half for both of us.

Keep pushing for answers, and I send you my best wishes.

 
Old 06-21-2009, 12:45 PM   #14
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Re: I have stumbled into a bunch of Glucose tests

Yes I can travel. but I hate to sound like a pessimist but it can backfire.

Back when I was having problems with my neck I had a similar situation to what I have now. I went to UC Davis and the care was worse. They got fixated on my neck and upper back problems being a shoulder (rotator cuff) problem. They referred me out to Eric Heiden for a shoulder exam. The 5 time Olympic speed skater was an arrogant @%$ and talked me into a shoulder scope. After the scope was clean he had the "nerve" to tell me (exact quote) "it gave me a chance to practice my technique".

My GP sent me to Stanford and some how, though a paperword error, I ended up at a Stanford "clinic" and got some really shoddy care. You have to weed through the lackeys to find the good ones. I am going to give this current guy the chance to answer my questions and tell me his plan. If it still sounds like BS I will talk to my GP and see about another route. Urologist also can treat low T but the 1st choice is an Endo. We'll see.


Quote:
Originally Posted by tjlhb View Post
Based on the city listed in your profile (Redding), that appears to be true... monopolies are not good for the customer.

Can you get to Chico or even Sacramento?
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Old 06-21-2009, 09:38 PM   #15
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Re: I have stumbled into a bunch of Glucose tests

I think the issue here isn't so much diabetes it's your hormone imbalance. And if a urologist will get you results, definitely go that route.

I have the opposite problem -- I have (well HAD) high testosterone levels. My GP was actually able to treat the problem and my levels are normal now, although she was able to get me into see an endo in a couple weeks.

As everyone has said: find a new endo, or even go to the urologist. You're not going to feel better until your immediate problem is under control (the hormone imbalance). I know I did -- I feel 100% better now my testosterone levels are in check (although i WILL admit I miss the insanely high sex drive I had when the levels were high :P).

 
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