Growth Hormone elevated, DHEA, and tumor growth

[free2be]

I see there has been some discussion on the forum about the controversy about hormones and the growth of tumors. This seems to be  without a definitive answer. My situation may be a bit different. Since seeing an endocrinologist for what turned out to be adrenal insufficiency (Addison's Disease), they also found the my growth hormone (GH) is elevated. This does not seem to be disease related as tests have ruled out certain abnormalities; however, my primary care provider indicated that DHEA (and testosterone) replacement can show up as (or mimic) elevated growth hormones. I have been on hormones including DHEA for years. The endo indicated the DHEA is too high and now that the GH has shown up elevated I am wondering if this could be, at least in part, the cause of the somewhat rapid growth of my AN. The endocrinologist did say that there have been indications that GH can cause tumor growth.

As of last Friday, I have been advised to treat the AN. I have had the doc take me off of the DHEA and really wonder about waiting a few months to see if the growth stops.

Any insight on growth hormone and ANs would be greatly appreciated.

Thanks,
Connie

[free2be]

Donnalynn,

Yes, what I have been taking are bioidentical hormones. Please tell me your thoughts!

Thanks,
Connie

[sweet t]

i also take bio-identical hormones - estrodial 2mg daily and prometrium 10 days out of the month.  i would be extremely interested in knowing if there is a correlation and/or anybody's experiences with it.

[jerseygirl]

Hi, Connie,

Sorry you have such a tough situation! My understanding from what you wrote is that you don't take GH but it shows up elevated perhaps because of DHEA but that might not be an accurate result also because of DHEA. I am just reiterating so you can correct me if I am wrong. One of my sons takes GH replacement for delayed puberty so I researched the matter in detail.

ANs have been found to have estrogen, progesterone and cortisol (stress hormone)  receptors, however, not all AN tumors have receptors to begin with. Some tumors have no identifiable receptors and, because ANs that have been removed are not routinely tested for them, it is impossible to say with certainty the percentage of ANs that do/do not have any kind of receptors. None of the ANs have been found to have testosterone receptors. Tumors that have any receptors theoretically grow larger and faster in the presence of those hormones but estrogen by itself even without a receptor will do that, too. That is why pregnancy and puberty are considered times of rapid and aggressive tumor growth. If you take supplementation, by the way, bioidentical hormones tend to be less implicated in tumor growth than regular HRT.

Stress, especially extreme and chronic, where a lot of cortisol is released, also increases tumor growth, and that includes any tumor - benign or malignant. In Addison's disease there not enough cortisol (that is why you take hydrocortsisone), so it looks like cortisol secretions are not the cause of your AN growth.

I have read reports that GH can make existing tumors grow and supplementation, like my son's, questionable if the child had any kind of cancer. However, it is not prohibited and depends on doctor opinion. In addition, GH declines greatly with age and most ANs and cancers occur in the second half of life. This fact makes me wonder. I would think it is prudent to get a "normal" GH test perhaps by lowering DHEA amount but  I wouldn't go any further than this because Addison's disease can make you very very sick and kill you faster that any AN.

All in all, I would continue with your Addison's disease treatment and focus either on AN removal via surgery or stopping its growth via radiation. Patients usually get steroids after most AN treatments and I am not sure how it would affect you given your Addison's diagnosis. ANs tend to have growth spurts followed by periods of no growth so it is possible that is what you had. Incidentally, if you get surgery, you can request the tumor to be analyzed for the presence of estrogen, progesterone and cortisol receptors as part of the regular pathology eval.

I will answer your PM in a few minutes. Good luck with everything and keep us posted.

                      Eve

[free2be]

Thanks, Eve. That's a lot of information. It seems you understand the GH/DHEA relationship. It is enough to make me wonder, but perhaps too late to make a difference. I may wait a while before treatment and see how the tumor acts off of the DHEA. I do have to contact my endocrinologist and see what his thought on one of these procedures is, given the Addison's. Ain't life fun!

Connie

[jerseygirl]

Connie,

I did not mean to imply that your Addison's disease makes AN treatment impossible, I just said that it may make post-op management and recovery process more complicated. Actually, pituitary patients frequently have all their hormones out of whack, including GH. They get their tumors removed and post-op period is different than for AN patients but nonetheless they and their doctors get through it successfully, so medical profession has the right knowledge and experience. Pituitary tumor removal is nowadays done mostly endoscopically, so any surgeon who does pituitary tumor removal as well will understand issues related to hormones and Addison's disease. I would ask how your post-op or recovery period will be different than any other AN patient. Please, consult more than one neurosurgeon because you would be surprised how different their opinions can be! In the unlikely event that you a poor surgical risk, they will refuse to operate or you will hear "Yes, I can do it, but... you don't want me to do it because outcome in your case will be bad." I had a few of those. Again, it is extremely unlikely to happen to you, so think positive!

                              Eve

[free2be]

Thanks Eve. I am definitely going to get other input and discuss with endo. They are wondering if I do have a pituitary tumor also. The MRI for the AN showed possibly a little something, but they didn't do close cuts of that area; so, the jury is still out. If I have another #%^&$$! tumor in my head I'll...oh, heck I don't know what. Too much to ponder.

Thanks for the information and positive vibes.

Connie

[Wwoodian]

My GH levels are high, and I was just diagnosed with a pituitary tumor.  I'm of the belief that the pituitary tumor was the catalyst for the AN.  About 5 years ago I had what I called a "Hormone Event" because my hormones went crazy, which I'm sure now was from the Pituitary tumor.  Have you had an MRI of your pituitary? I'm just wondering about all of these women with AN's who have also had early menopause--if there is a connection between a pituitary tumor and an AN?

[free2be]

My GH levels are high, and I was just diagnosed with a pituitary tumor.  I'm of the belief that the pituitary tumor was the catalyst for the AN.  About 5 years ago I had what I called a "Hormone Event" because my hormones went crazy, which I'm sure now was from the Pituitary tumor.  Have you had an MRI of your pituitary? I'm just wondering about all of these women with AN's who have also had early menopause--if there is a connection between a pituitary tumor and an AN?

Interesting that you ask. They were supposed to incorporate a pituitary scan with the AN MRI, but failed to do any close cut images. The radiologist who looked at the MRI said there wasn't anything in the Pituitary, but from what I understand they are usually very small and would require the close cuts to be sure there was not one there. Waiting for Endocrinologist to decide if want yet another MRI to be sure.

Are we having fun YET?!