lowesclubmaker

This board has helped me learn so much - but there is so much more to know. Any thoughts/advice is much appreciated.

I started have weird symptoms in Mid-Nov including what I have seen referred to here as "internal shaking" and sometimes visual tremors. Muscle fatigue, general lethargy, lost 35 pounds, other signs of depression. Treatment with Anti-depressants have helped with the emotional side, but physical aspects have drastically affected my quality of life and ability to do my job.

Shortly after the onset of this I also started experiencing nasty pain in left testicle.

Along the way I've lost all libido/erections (well, couple days in there, usually when the pain was better, but not many).

I think the last time I checked my insurance company's webpage, the gross cost of everything I've had done so far is over $35K (lots more than indicated here - thank goodness for insurance coverage). I've done acupuncture, chiro, even consulted some TMJ specialists - and let me tell you - that is a group of hucksters and charlatans.

GP and Urologist #1 said pain was epididymitis. Did some antibiotics and a scrotal sonogram (normal). Pain went away for several days, then came back. Now on a much longer course of antibiotics (pain has lessened but not gone away). Urologist #2 said he doesn't think it ever was epididymitis - the pain is located in the testicle, not in the epididymitis. His next diagnostic step would be to inject a nerve block (ouch!) and see what happens with the pain. However, as the pain has lessened, it doesn't make sense to do that right now.

While working with Neurologist, I had an MRI that found a pituitary micro-adenoma. I saw a local neurosurgeon who didn't feel it was surgical, but ordered some bloodwork (below), a vision field test (normal) and a pituitary-specific MRI (no change - still there, not impacting the optic chiasm). Surgeon still feels we should just watch it.

Saw endocrinologist who felt I should persue surgical review at University of Virginia (fortunately, only about 2 hours away) as they have one of the best pituitary surgical centers in the world. He also ordered a bunch more bloodwork (below). I think his thought is that with the T levels so low, the LH/FSH numbers should be a lot higher, and that is indicating pituitary issues to him. I've sent off all my info to UVA and am waiting for their thoughts.

I basically pressured the Endo into giving me a script for the patch - hoping to at least get some relief from some of my symptoms and get on with my life while we figure out a longer term plan. He did a rectal check, and ordered a PSA test. I also asked him to test estrogen (which was submitted as total estrogen) as I have seen posts on other boards about guys who's E2 gets too high causing testicle pain that goes away when balance is better. Of course, I don't think I was quite up to speed on Estrogen vs Estradiol and should have been more specific on that.

Still waiting for those results, picked up the patches, but have decided to wait until I hear from UVA in case they need to run more tests which I don't want to mess up by having used the patches.

Bloodwork:
2/13 (ordered by neurologist)
----
Vit B12 571 (200-1100)
cortisol 19.3 (4.3 - 22.4)
prolactin 15.5 (2.0 - 18.0)
TSH 1.9 (.4-5.5)
Magnesium 1.9 (1.5 - 2.5)

2/19 (ordered by neurosurgeon)
----
Andrenocorticotropin 20 (7-50)
Cortisol 10.3 (4.3 -22.4)
T-Total 369 (241-827)
TSH 1.8 (.4-5.5)
Growth Hormone .2 (<10)


2/26 (ordered by endocrinologist)
----
LH 5.3 (1.5-9.3)
FSH 3.0 (1.6 - 8.0)
T-Free 20 (46-224)
T-BioAvail 44 (110 - 575)
T- Total 301 (250-1100)
SHBG 70 (8-46)
cortisol 17.6 (4.3 - 22.4)


So, with all that said:
- Any thoughts about a link between testicle pain and drop in Testosterone?
- If UVA says I am not surgical at this time, considering the bloodwork results below, what further tests need to be done to come up with a treatment plan?
- Can we guess What that plan is likely to be (or better said - what it SHOULD be?)