Is ncmslippin right that hapless Keith has gonad problems? What you people have to understand is that morbid obesity can alter the hormones in the body and things go haywire afterwards. Seems Keith might have more problems than he is aware of. Yet the experts here are insisting he just has to cut down on the calories.
Most of the time I am right at work as lab tests confirm my physical observations of my patients. As a physician you always want to have all the information about the patient to make the best professional decision possible. That includes physical examinations, family history, talking to family and loved ones, MRI and CT scans and more importantly lab results to make the best decision possible.
Being obese can cause hormanal changes but not usually to that degree. My best educated guess is that Keith is suffering Hormonal problems due to suppression of the adrenal glands from high doses or prolonged doses of Glucocorticoids. Mainly Hydrocortisone or Methylprednislone due to his spider bite.
Hydrocortisone is a very important human glucocorticoid. It is essential, and it regulates or supports a variety of important immunologic, cardiovascular, metabolic, and homeostatic functions.Glucocorticoid
s have some serious side effects if taken long-term, including weight gain, glaucoma, osteoporosis and psychosis, especially when used at high dosage. The most serious side effect occurs after the adrenal glands cease natural production of cortisol
The bite of the brown recluse spider can result in a painful, deep wound that takes a long time to heal. Fatalities are extremely rare, but bites are most dangerous to young children, the elderly, and those in poor physical condition. When there is a severe reaction to the bite, the site can erupt into a "volcano lesion" (a hole in the flesh due to damaged, gangrenous tissue). The open wound may range from the size of an adult's thumbnail to the span of a hand. The dead tissue gradually sloughs away, exposing underlying tissues. The sunken, ulcerating sore may heal slowly up to 6 to 8 weeks. This is usual, but not when the patient has a "reaction' to the spiders venom.
In Keiths case. He had a reaction to the venom. When there is a severe reaction to the bite, the site can erupt into a "volcano lesion" (a hole in the flesh due to damaged, gangrenous tissue). The open wound may range from the size of an adult's thumbnail to the span of a hand. This is very dangerous and may result in the removal of the effected limb. Standard procedure is to give high doses of Methylprednisolone or Hydrocortisone.These synthic hormones have some serious side effects if taken long-term, including weight gain, glaucoma, osteoporosis and psychosis, especially when used at high dosage. The most serious side effect occurs after the adrenal glands cease natural production of cortisol. Glucocorticoids suppress cell-mediated immunity. They act by inhibiting genes that code for the cytokines IL-1, IL-2, IL-3, IL-4, IL-5, IL-6, IL-8 and IFN-γ, the most important of which is IL-2. Smaller cytokine production reduces T cell proliferation.
Glucocorticoids do, however, not only reduce T cell proliferation, but also lead to another well known effect called glucocorticoid induced apoptosis. The effect is more prominent in immature T cells that still reside in the thymus, but also affect peripheral T cells.
Glucocorticoid drugs currently being used act nonselectively, so in the long run they may impair many healthy anabolic processes that may take weeks,months, or even years to recover from. Use of high-dose Glucocorticoids for more than a week begins to produce suppression of the patient's adrenal glands because the exogenous glucocorticoids suppress hypothalamic corticotropin-releasing hormone (CRH) and pituitary adrenocorticotropic hormone (ACTH). This can play havoc on a persons bodily functions as well as hormone function.
My professional advice would be to see a endocrinologist and then a urologist. Endocrinologists do not like to prescribe TRT therapy but they will help out with his Adrenal problems if they exist.
Now this is my best educated guess I may be wrong without having the proper information as listed above, but it could not hurt to get checked out.