He got here to my workplace out of kinds, on the lookout for solutions to his medical points. As a 30-year-old, he had been experiencing fatigue, melancholy, low intercourse drive and erectile dysfunction for 8 years! Realizing that the typical younger male thinks about intercourse each 10 minutes throughout waking hours and ever so hardly ever fails to have an erection, I used to be very involved for him and took his signs very critically. He had seen his main care supplier, an endocrinologist and a neurologist earlier than me. He was given antidepressants, psychotherapy and different remedies to no avail. This led to a analysis of low testosterone and subsequent therapy with testosterone injections. Like a recharged Energizer® bunny, testosterone alternative revived him fully, making him really feel “completely higher in each method.” All good. But, he sat in entrance of me questioning whether or not or not he must take testosterone for the remainder of his life, perhaps 60+ years! He was extra anxious about how he would keep fertile when he discovered that testosterone remedy acts as a contraceptive.
The Backside of Issues
I’m a “root-cause” man. By determining why issues occur, you could have the perfect probability for remedy. The straightforward query right here is: What should be blamed for the testosterone drain on this younger man, and will or not it’s reversed? So, I went to work.
His medical historical past was a clean slate for danger, together with no pot or different drug use, no premature stress, and no sleep apnea or weight problems. His bodily examination was additionally unremarkable with regular testicle measurement and no varicoceles. The discovering of regular sized testicles instructed me that no matter occurred to his testosterone occurred after puberty and was not a lifelong downside of testicular failure. His blood work confirmed no diabetes, anemia, prolactin or thyroid points, all of which might be related to low testosterone.
However then I noticed it, deep inside his bundle of laboratory research: his blood counts had been excessive. He was polycythemic. However why? Effectively, simply being on testosterone may do that, however he wasn’t taking excessive sufficient, anabolic doses of testosterone. Then, I stumbled on blood checks taken earlier than he began testosterone and, lo and behold, he was polycythemic then too. Bingo! The analysis: hemochromatosis.
A Bloody Illness
Hereditary hemochromatosis is attributable to a mutation in a gene that controls the quantity of iron your physique absorbs from meals. It happens in 1 of each 200-300 individuals and is discovered way more typically in males than ladies. Due to this gene defect, extra iron is absorbed after which will get saved in physique organs just like the liver, pancreas and spleen. Over time, the saved iron causes scarring and organ harm that will result in liver illness, diabetes and coronary heart failure. Infertility, erectile dysfunction and low testosterone are additionally penalties of hemochromatosis. And, left untreated, it may be deadly.
You’ll by no means guess the way it’s handled: Bloodletting (now generally known as therapeutic phlebotomy). Bloodletting, or draining of a affected person’s blood to stop or remedy illness, was the commonest medical process carried out by surgeons from antiquity till the late nineteenth century, a span of over 2,000 years. And it nonetheless has utility as we speak. Does it remedy hemochromatosis? No, however it prevents harm to organs by maintaining iron from accumulating in them and ends in an basically regular lifespan.
So, this root trigger evaluation paid off handsomely. I requested this younger man to think about donating blood frequently. I additionally took him off of the testosterone injections and began him on clomiphene citrate capsules to push his “lazy” pituitary more durable to make extra of his personal testosterone ranges. On this method, we maintained his regular (excessive) high quality of life that he loved whereas on testosterone with out utilizing testosterone; he now additionally enjoys good sexual well being and is fertile, and we added a number of extra years to his life. We’ve executed what Hippocrates, the Father of Drugs, ordered us to do: “Declare the previous, diagnose the current, foretell the long run.” And that, my associates, is the hat trick of nice medication!
The put up Case Report: Illness Inflicting Low Testosterone: Look and You Shall Discover appeared first on The Turek Clinic.