doctor in this story
I put down my lassitude to growing older and did not make an issue of it to my health care providers. But a week after my annual physical my family doctor, Neil Fruman (of Lafayette CA) called me into his office. He'd noticed some unusual variations in my metabolic levels.
Decreases in testosterone and other hormone levels come with the territory for a man passing age 60, but Dr. Fruman wasn't ready to attribute the fluctuations he saw to the usual causes. Instead, he sent me to an endocrinologist who put me through a slew of tests, including a morning-long one to determine whether I was experiencing growth hormone deficiency. (As adults we require tiny amounts of growth hormone (GH) each day to keep our overall metabolism functioning normally.)
As it turned out, I was critically deficient -- not only in GH but all the other hormones, including testosterone, the thyroid-related hormones, and so on.
After an MRI my specialist diaognosed me with a rare autoimmune disorder called hypophysitis. What triggers it is unknown, but what happens is your autoimmune system attacks your pituitary gland, throwing its delicate workings into chaos and calling a halt to the production of virtually all the body's hormones. (Hormone-producing glands like the thyroid take their orders from the pituitary gland, and if it isn't working properly, no thyroid hormones are produced.)
My specialist put me on a range of prescription hormone supplements and within a few months my natural energy had returned. Over the intervening years I've learned to micro-adjust my dosage so my levels are exactly where they should be for someone my age. I've lost the excess weight and returned to my sport, and life is once again enjoyable.
Ninety percent of the time, hormonal deficiencies and autoimmune diseases like hypophysitis go undiagnosed. The result is earlier mortality, usually due to heart-related issues. And maybe worse, the undiagnosed patient endures a reduced quality of life that, after age 60, some caregivers casually attribute to aging.
Thanks to Dr. Fruman's sharp eye, and his reluctance to write off my metabolic anomalies merely as the consequence advancing years, I have been given my life back.
Through this experience I've learned the importance of having a top-notch family doctor. These men and women are our first line of defense in the fight against not just the major diseases, but the less well known ones as well.
Primary care physicians should not be interchangeable. In my case, because I've been his patient for quite a few years, the odds were improved that Dr. Fruman would spot something unusual. Thus began the series of medical decisions that have restored my health.
I suppose the moral of my story is that one of the best ways to stay healthy is to form a long-time relationship with a primary care doctor whose judgment you trust. If you're past 50, get a checkup every year, stay active, and don't let anybody tell you that life become less enjoyable as you get older. And don't suffer in silence!