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Family Physician
Family Physician, Doctor
Category: Medical
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Experience:  Emergency Medicine and Family Practice for over 26 years
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I have a question about infectious disease pathogens that I

Customer Question

I have a question about infectious disease pathogens that I think may be somewhat esoteric. Are the experts available for this type of question?
The question is: What, if any bacteria, viral or other infectious agents are known to aromatize testosterone (or androgens more generally) to estrogens? Such that such an infectious agent would likely thrive in androgen rich environments and might cause a higher level of estrogen in the bodily fluid (say serum measurements) of the person who is infected?
Submitted: 1 year ago.
Category: Medical
Expert:  khagihara replied 1 year ago.

There are no pathogens producing aromatase. What is the reason you are asking the question?

Customer: replied 1 year ago.
The question pertains to a long medical history of epido-orchitis of infectious origin (unknown which specific organisms were involved) which led to hypogonadism. The subject has been put on replacement testosterone. But when put on testosterone rather than getting better the subject then exhibits signs of internal stress (fatigue, myalgia, joint pain, high cortisol etc). Checks of the pituitary are negative, most blood work within normal range, except adipose phosphapate which I'd marginally (not exremely) low. wbc, rbc etc on the lower side but not below the range. Some indication of hemolyzed blood and leuco in Urine. The testosterone is high now, but the estradiol also increased very fast. Anyway, it seemed plausible that all of these could be explained if the infection is still there, and if the infection thrived more in a testosterone rich environment and if in some way, estogens are generated in this process either directly or as part of the body trying to adjust to the stress
Customer: replied 1 year ago.
Sorry on additional sign of stress subject is experiencing is high BP and losing weight. This is a person with low BMI, 5'10" male, 155 lbs. Full cardiac workup done including nuclear stress. No known reason for all these symptoms apart from aforementioned history.
Expert:  khagihara replied 1 year ago.

If the serum testosterone concentration is subnormal, supranormal serum LH and FSH concentrations (normal range for both about 1 to 8 mIU/mL in most laboratories) indicate primary hypogonadism, and values that are not supranormal indicate secondary hypogonadism. You said checks of the pituitary were negative. That means he has secondary hypogonadism.

Customer: replied 1 year ago.
When I say Pituitary checks are negative, I mean the MRI shows no abnormality. At baseline, T is subnormal, but LH/FSH are ALSO low but not subnormal. This is the first indication that the case is not cookie cutter. When the subject is put on T replacement, T goes up to normal and LH/FSH goes subnormal, almost zero. This is not surprising since LH/FSH were already low to begin with. So, if the hypogonadism is secondary as you postulate, but, MRI does not show abnormality and T therapy appears to be creating other problems, (which likely means the T therapy is not the true solution, there is some other real problem that the body is trying to tell) ,where to go from here given this history? What can be the hidden problem that is presently unseen, but is mediating dsyfunction first in the HPG (and now also HPA) axis.
Expert:  khagihara replied 1 year ago.

How were the prolactin, cortisol at 8 AM, free thyroxine (T4), Fe, transferrin in the blood?