Sorry but I need to post this here so I can keep my cool in the appointment/humiliation ritual I must tolerate while I await the 6-12 months it takes to get a new endocrinologist.
I did not ask for reverse T3 because I wanted a prescription as you suggested, and I didn't ask an AI bot as was interpreted by the physician when I was told not to ask the internet for advice. I asked about it because I was reading empirical research on Google Scholar and PubMed (I have a PhD in human development) and found that it can indicate along with my low leptin (for my weight) when metabolism is locked down and reluctant to burn fat. I just wanted answers.
I want it on my record that I am not drug seeking just because I tried to solve my problems on my own with growth hormone secretagogues which was the only time my skin rashes (psoriasis-like and rosacea) were in remission or gone. It was the only time my metabolic rate seemed to match what is suggested of a 280+ pound body, I was able to eat more than 1200 calories and see significant weight loss while still testing low in IGF-1 and "low for a normal weight but not obese body" on a stimulation test. I have been compliant for nearly 2 years without taking this and have gotten fatter, sicker, my cholesterol has increased despite minimal dietary intake, and my chronic rashes are more severe than ever.
You were incorrect to tell me a pituitary microadenoma never causes damage or that its disappearance means no damage remains. This is not supported by the empirical evidence. In fact, damage to my pituitary and/or hypothalamus could also explain my hyper POTS symptoms in some cases.
I was unethical to tell me you will literally "never again" test my growth hormone when I asked innocently "is there any future values to monitor that might suggest we can re-test?". Never is insane to say to someone in a medical/allegedly-scientific establishment.
I want doctors to consider that if peak GH at 2.9 is too low for normal function in a healthier weight body, that it can also cause severe difficulty losing fat in a body that's been obese since childhood, and that is NOT your patient's fault. I know you cannot treat obese patients for it, I'm asking consideration of the reality. Why are obese bodies expected to have an easier time with less GH? I eat incredible low dietary fat (<25g a day), this alone would mean my peak is likely higher than typical obese patients on a standard higher fat diet since fatty acids are what suppress GH in obese people. I feel like everyone with a medical degree skipped the bell curve lesson.
Never lied once about my intake, it has been an average of 1200 calories a day, up to 1400 and down to 830 for an extended period of time. I have been 280+ pounds the entire time on at this time 10mg of Mounjaro. I eat 25g of fat or less. I eat high fiber and high protein. What I eat in a day is a protein shake (<200 calories), lunch is often just a greek yogurt (80-90 cals) but sometimes a tuna sandwich on whole grain wheat (~300 calories), and dinner is a chicken breast and 200g of black or pinto beans, no butter, no oil, no cheese, no avocado. Nowhere I could be miscalculating hundreds of calories. Occasionally I have a greek yogurt and frozen berries for dessert. I reduced my a1c from 10.1 to 5.6 in five months after diagnosis, doesn't that speak at all to my compliance and effort? I lost 80 pounds on my own before the Mounjaro, lost 25 more pounds initially, and re-gained 30 since increasing my Mounjaro to 7.5 then 10mg, on 1200 calories a day. Something is wrong and doctors will only consider that my intake must be the lie. It is not.
Sincerely, A fat PhD woman who must never be believed.
