Concerns Regarding Hormonal Health
To provide some background, I just celebrated my 17th birthday yesterday and I stand at approximately 6 feet tall, weighing in at 185 pounds. I am currently prescribed medications for my autism and ADHD, including lisdexamfetamine and risperidone ratiopharm. I find myself questioning whether these treatments might be influencing my hormonal balance. One of my primary concerns involves my physical development. It seems that my penis has not experienced any growth in size, both in length and girth, since early childhood. Despite this, I do not encounter any functional issues and I experience significant libido. My voice has deepened somewhat, yet it remains higher than that of my peers. I have developed a minimal amount of armpit hair and went through a normal growth spurt. While I do have some acne on my face, it’s more pronounced on my back, likely a genetic factor. Additionally, I have not noticed any facial hair growth at this point. Another worry pertains to my strength levels. I have been attending the gym with some regularity for the past two years, but I find my strength is surprisingly below average for someone with that experience. For instance, my bench press maximum is about 110 pounds. I've worked hard to transform my health—having lost around 60 pounds due to a calorie deficit combined with an increase in physical activity, progressing from 240 pounds to my current weight of 185. However, I still carry some extra weight, particularly around my abdomen, and I have noticeable gynecomastia, but I believe this is linked to my previous obesity rather than an underlying condition. This brings me to my worries about possibly having low testosterone levels or even a potential case of Klinefelter syndrome, which is quite frightening to me. A year ago, I underwent a blood test, though unfortunately, it didn't include a testosterone level assessment. However, my mineral and vitamin levels were normal, indicating I don’t have any deficiencies in those areas.
Answers (1)
4/3/2025, 2:20:48 PM
OpenHealth AI
It’s understandable that you have concerns about your hormonal health and physical development, especially given your unique circumstances. At 17, many changes are still occurring, and it's common for these to vary from person to person.
Main Points:
- Growth and Hormonal Development: It’s normal for growth patterns and hormonal development to differ significantly among adolescents. Your experiences with body hair, voice changes, and gym performance are all part of this process.
- Medications: Lisdexamfetamine and risperidone can have various effects on weight, metabolism, and overall growth, but they don’t typically cause major hormonal disruptions for most teens.
- Strength and Body Composition: Strength development and fat distribution can vary widely and are influenced by factors like genetics, physical activity level, and nutrition.
Explanation:
- Hormonal Development: Puberty and hormonal changes can extend into the late teens. Variations in the timing and progression of these changes, including penis size, voice depth, body hair, and strength levels, are normal.
- Medications: Your medications have effects that could influence appetite, energy levels, or mood, which might impact your motivation to maintain physical fitness. However, growth concerns typically arise from hormonal levels, not directly from these medications.
- Gynecomastia: The presence of some breast tissue in young males is also quite common during puberty, especially following significant weight loss, and often resolves over time.
Next Steps:
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Monitoring Changes: Keep track of your physical and emotional changes over the next several months. Pay attention to any new developments in hair growth, voice changes, or body composition.
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Healthy Habits: Continue focusing on balanced nutrition and a consistent workout routine. Combine strength training with cardiovascular exercises for better body composition and strength development.
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Consider Testing: Although a prior blood test didn’t include testosterone, it may be worthwhile to consult with a healthcare provider about undergoing a hormonal evaluation. This can provide clarity on your testosterone levels and help address concerns about conditions like Klinefelter syndrome.
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Consult with a Professional: Since you have specific concerns about your growth and development, consider seeking advice from a healthcare professional specializing in adolescent health or endocrinology for a thorough evaluation.
Remember, many young adults experience similar uncertainties as they develop, and addressing these with a supportive professional can provide reassurance and clarity. You’re taking proactive steps by reflecting on these changes, and that’s an important part of your journey towards understanding your health better.
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Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.