San Diego Personal Trainer Rivak Hoffman discusses difficult weight loss due to pituitary and adrenal hyposecretion post resect
Posted Jul 05 2009 9:36pm
Being both a Physician Assistant and a San Diego Personal Trainer has its advantages and disadvantages is regards to working with the difficult weight loss population. My latest endeavor is a 34 year old male attorney who is 3 months post op a very rare brain tumor known as a Cranial Pharyngioma. 0.3/100,000 people will acquire this type. Although his neuro surgery was very successful, the end result of removing the offending tumor left this client with dramatic weight gain, seizures, fatigue, sodium depletion, diabetes insipidous, poor heat regulation, insomnia and bi temporal visual field defects, (due to compression of the optic nerves at the Sella chiasm) pituitary gland suppression and very depressed HGH, prolactin and testosterone levels. All is all this change in body chemistry has left this client 80 pounds heavier!
This is truly a weight loss challenge. The question at hand is how to promote secretion of growth hormone and testosterone through direct stimulation of large muscle groups without over heating the client or intensifying glucose uptake through muscle receptors. With adequate growth hormone secretion and testosterone production the human body will respond through weight loss and a leaner body composition as the metabolism changes.
Another obstacle to weight loss, is augmented by the prescribing of the drug Cortef, which is cortisone. The chief side effects of cortisone are weight gain, water retention, megaphagia, insomnia. It is of my opinion that the attending Endocrinologist titrate the client off of the Cortef and substitute a NSAID (Non Steroidal Anti-inflammatory Drug) In addition I would add a weekly course of HGH to promote Cortisol production.
I am a bit anxious about working with this client, but do realize i am the most qualified San Diego Personal Trainer, who also is a Physician Assistant with a strong enough medical background to keep this client safe and goal oriented. I have much thinking outside the box to do, but will keep everyone posted as time progresses. I have high hopes, and a special interest in this unusual client.