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Taking regular cortisone injections for nerve blocks.Have joint pain, hypothyroidism ,weakness, reduced sex drive. Suggestions ?

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General & Family Physician
Practicing since : 2007
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hi, i have been having regular cortisone injections and nerve blocks to treat disc and nerve problems in my neck and back ( every 3 months over the last yr and half). I had the last injection approx 5 months ago and literally overnight i started to feel generally very unwell and have not been right since that day. I am always tired, have difficulty sleeping! ,experience joint pain,and muscle weakness; iv started to put alot of fat on and lose muscle. but the biggest problem is that i have totally lost my sex drive and find it almost impossible to maintain an erection and have hypogonadism. My GP has only recently took my symptoms seriously and requested blood tests. The tests have shown that i have slight hypothyoidism for which i have been given levothyroxine 100mg daily,( free T4 10.6, TSH 58.0 , TPO are high at 1,300). Also my Testosterone is low at 6.0, FSH was 2.3 , LH 2.8 and Prolactin 179. My Calcium is also low but vit D and parathyroid are ok. My GP has referred me to a urologist? I might be totally wrong but i think i have Acquired H/H, and possibly adrenal fatigue due to the constant admin of corticosteroids and constant use of Oromorph over the last 1.5 years. Is this possible? and if so, can you suggest what path to take to get better and regain my sexual function, and basically get my life back on track, thanks!
Posted Wed, 18 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Mohammed Tauseef 14 hours later

Thank you for the query.

I would like to know few more things which would help me in suggesting you better:

1.) Does anybody else in your body have similar symptoms?
2.) Do you have pink or purple stretch marks on your skin?
3.) Do you get frequent headache?
4.) Do you have increased frequency of Urination, especially in the night?

Your History suggests you have Cortisol induced Cushing's Syndrome. Kindly get yourself examined by a Endocrinologist so that he/she may examine you and run few tests like,

1.) Bloodwork.
2.) Urinalysis.
3.) Saliva test. Normally Cortisol levels drop by evening. In Cushing's syndrome, higher cortisol levels in saliva in the evening can help diagnose Cushing's syndrome.
4.) CT/MRI Scan of Pituitary and Adrenal glands to rule out tumors.

Your Doctor will also try to rule out other causes with similar symptoms with comprehensive and detailed Physical examination. Once the cause for this is confirmed, you will be treated accordingly.

Your Doctor will start tapering the dose of cortisol injections, by reducing the dosage of the drug over a period of time, while still adequately managing your disc prolapse condition. The other treatment options include Surgical removal of Adrenal glands. Your Doctor will be able to explain it to you, which treatment suits your condition.

Follow these lifestyle modifications:

1.) Eat healthy nutritious balanced diet which should include fresh fruits and XXXXXXX leafy vegetables.
2.) Do moderate exercise like Brisk walking for 30 to 40 Minutes daily, 5 days a week. This will keep your Blood Pressure and weight under fairly good control.
3.) Make sure you're getting enough calcium and vitamin D, through your Diet. You could get a Dietitian's help.
5.) Avoid stress, practice relaxation techniques like yoga and meditation.
6.) Have hot baths and apply heat pads, to your joints which ache. This will soothe them and alleviate your Fatigue, bodyache, muscleache and Joints pain.
7.) Avoid alcohol and smoking, if you do.
8.) Stick to your treatment plan and go for regular follow up.

Hope I have answered your query, I will be available to answer your follow up queries.

Above answer was peer-reviewed by
Follow-up: Taking regular cortisone injections for nerve blocks.Have joint pain, hypothyroidism ,weakness, reduced sex drive. Suggestions ? 3 hours later
Thankyou for your reply! further info:

There is no family history of anything similar. can cushings really cause all of the other hormone problems? I do have some pinky/purple stretch marks near my arm pits, groin and bottocks which i have had for some time. I have very bad headaches, which sometimes end up being migraines. there is barely a day goes by where i dont get a headache even if its just for an hour or so. I have noticed that i am urinating more often but its usually through the day that i notice it more, but i suppose my day is quite long when im only managing 3-4 hours sleep per night. I forgot to mention that i had a hypo whilst at work, i started to feel very unwell and my blood sugar was 2.0 despite eating regularly throught the day. but the fasting glucose result just comes back fine everytime. My recent ALT level was also high at 106, which cant be explained, so my GP is sending me for a liver ultrasound? and like previously mentioned she has referred me to urology? should I ask to be sent to an endocrinologist instead? I couple of months ago they decided to do an MRI brain because i had some neuro deficit in my arms but it turned out to be cord compression so they have taken c5/c6 disc out and them symptoms have disappeared. I went to see the neurologist for a follow up and he said that he thinks there is possibly a problem with a vein somewhere in my brain, but needs to XXXXXXX with the radiologist to confirm anything. but he didnt seem too worried at all, and was most likely goin to refer me back to orthos. I understand that there is alot going on but i dont think my GP knows where to start. can they do all of the tests i might need, its just that its already taken 3 weeks just to get the blood results that i have told you about. would it be a better idea to go private to a specialist? and can they do all of the tests or does it have to be my GP? sorry for the essay! thankyou
Answered by Dr. Mohammed Tauseef 2 hours later

Thank you for writing back to me.

Your symptoms are suggestive of Cushing's Syndrome. Yes, an Endocrinologist will be the best person to evaluate you as you have hormonal imbalance noted in the blood tests..

It is hard to plan a treatment without proper physical examination and thorough evaluation.

I encourage you to discuss with your physician and plan a referral to an endocrinologist.

In the meanwhile, follow my advice given in the previous reply.

Hope my answer is helpful.

Wish you Good Health.

Dr. Mohammed Tauseef.
Above answer was peer-reviewed by
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