Help me out with a client: Sudden weight gain in lower leg.

[dcfreak]

His IGF-1 is not that high from 3 iu's 5 days a week....but yes maybe a bit of a cut back. I am having him cut his test back to 200...if no results then I will look at cutting the GH.

At 5 months he has run the GH long enough to see results so a short cut back won't hurt the way he looks at all.

I had a similar issue and, for me, it was the GH. I took a short break and that fixed my issue.

*edit- I just saw it is only one leg.

 

[Matty_G]

One leg.

Edema in one leg? How was his hct? Any concern for dvt? Any redness or pain on the affected extremity?

 

[lilhawk]

I thought you said he got labs? Kidney issue would show up in labs, and he would have edema in both legs most likely if it's a kidney issue. Using generic GH could be the culprit unless he has every batch tested. Otherwise a simple trip to the doctor and an ultrasound of the leg will rule out any venous issues such as leaky valves in his legs, which sounds more likely to be the case since it's one leg.

 

[sliderke]

Does it also hurt while walking or so. I had something similar 1,5 year ago. I had an ultrasound and in my case it was a small dvt. My right calf was 2 cm more in diameter. After 3 months on blood thinners it was solved. I would serious take a photo of his leg to rule that out. If it is a dvt and it shoots up to his lungs it can be game over.

 

[Bandern]

Y’all are overcomplicating this. Keep the gh and test where they are and amputate

 

[Ateam2023]

i would have him get an ultra sound on the leg ,a duplex or doppler to rule out deep vein thrombosis idk , just a thought

 

[readalot]

Good to know one leg only. Dont f around with this.

 

[Matty_G]

Also want to add if concern is for dvt, make sure your client isn’t doing anything to further exacerbate and possibly dislodge clot causing PE or stroke….recommend LE duplex as other have mentioned.

 

[BigDadd7]

I thought you said he got labs? Kidney issue would show up in labs, and he would have edema in both legs most likely if it's a kidney issue. Using generic GH could be the culprit unless he has every batch tested. Otherwise a simple trip to the doctor and an ultrasound of the leg will rule out any venous issues such as leaky valves in his legs, which sounds more likely to be the case since it's one leg.

How would generic GH cause one leg to swell and not the other?

 

[Ateam2023]

I thought you said he got labs? Kidney issue would show up in labs, and he would have edema in both legs most likely if it's a kidney issue. Using generic GH could be the culprit unless he has every batch tested. Otherwise a simple trip to the doctor and an ultrasound of the leg will rule out any venous issues such as leaky valves in his legs, which sounds more likely to be the case since it's one leg.

how would generic hgh be the culprit ? Especially in one leg?

 

[Spaceman Spiff]

One leg.

He needs to see a doctor and get off fluid retaining stuff

 

[Spaceman Spiff]

How would generic GH cause one leg to swell and not the other?

Good question. You are absolutely right. Sounds like venous insufficiency mixed with water retention

 

[RockyP]

The unilateral aspect of it makes me think more about DVT than something systemic. Are you certain it is one leg only? Or is there swelling on both legs with one being worse than the other?

Either way, he needs an urgent care visit with labs and likely Lower extremity Doppler to rule out a clot. Venous insufficiency could be asymmetric but unlikely that one leg is totally normal.

Also, it’s best to peel back the PEDs but I would not blame yourself for this. Everyone will blame the test and GH but let’s wait and see what the issue is first.

 

[MrTexas2]

I thought you said he got labs? Kidney issue would show up in labs, and he would have edema in both legs most likely if it's a kidney issue. Using generic GH could be the culprit unless he has every batch tested. Otherwise a simple trip to the doctor and an ultrasound of the leg will rule out any venous issues such as leaky valves in his legs, which sounds more likely to be the case since it's one leg.

He has been going to a TRT clinic and they have not been doing any Kidney labs. The last thing I told him last night was to get to a regular doc/and or get some kidney labs.

 

[MrTexas2]

how would generic hgh be the culprit ? Especially in one leg?

5 months ago I was still using Iron Lion Gh orange tops. I have been with them for years, primarily because their raws were always good, their customer service has always been good and IGF-1 scores for myself and others have been good. I did notice cloudiness in a batch of their GH and also the raws crisis hit. Researching, I saw that cloudiness is not necessarily a sign of bad GH, but it does not look good.

So I dropped back onto this forum (had not been on it for several years) and saw that there was higher purity GH at a better price. Everything I have ordered since has gotten 98% Janoshick purity scores with favorable dimmer scores.

My guy called me to re-up his GH. He ran Iron Lion for a while with no problems, and then Lobsters', which had very high (98% purity scores). I was going to put him on some of the very high concentration GH (24/iu bottle) but then he told me about his water retention issues, so I nixed that idea immediately. The LAST thing he needs right now is more potent G.

 

[MrTexas2]

The unilateral aspect of it makes me think more about DVT than something systemic. Are you certain it is one leg only? Or is there swelling on both legs with one being worse than the other?

Either way, he needs an urgent care visit with labs and likely Lower extremity Doppler to rule out a clot. Venous insufficiency could be asymmetric but unlikely that one leg is totally normal.

Also, it’s best to peel back the PEDs but I would not blame yourself for this. Everyone will blame the test and GH but let’s wait and see what the issue is first.

I think so. Pull back test to 200 mg/week. Maybe stop GH altogether, and yes, I told him to get to a knowledgeable doc immediately. Knowledgable in renal care, which is outside my area of expertise.

And yes, most docs ignorant of TRT/HRT are going to automatically blame PEDS.

I know that this is probably not my fault, but like I said it is troubling still.

 

[RockyP]

I must again interject that it would be bizarre / unlikely for GH related water to retention to be isolated to one lower limb. He needs to be evaluated by a real doctor. Labs, ultrasound, physical exam. Until then, peel back the PED's. If it were me i'd drop test to 100 and stop GH altogether until this is worked up. We don't know what the cause is, but higher than normal test and GH supplementation will not help the issue.

 

[PiscesMoon]

He needs to see a doctor and get off fluid retaining stuff

Agreed.

How is his heart health? @MrTexas2

This may be a venous return issue.

Please take it serious and do not push any major exercise or medications/etc. until he may see a doctor or you get more clarity on possible health conditions.

(Response is based off medical massage therapy evaluation. One leg swelling or showing edema is contraindicated for massage work and the client would be advised to see a doctor first.)

 

[MrTexas2]

Agreed.

How is his heart health? @MrTexas2

This may be a venous return issue.

Please take it serious and do not push any major exercise or medications/etc. until he may see a doctor or you get more clarity on possible health conditions.

(Response is based off medical massage therapy evaluation. One leg swelling or showing edema is contraindicated for massage work and the client would be advised to see a doctor first.)

Agreed, thanks! No heart conditions as far as I know. He seems to have a creatinine score, but no BUN or eGFR.

 

[manbat]

How is his heart health?

I was on this track too. I always suspect heart failure in cases of pedal/lower extremity edema, usually before even thinking about kidneys. A lot of the guys here are probably better informed than me on the topic but a basic 12 lead and echo couldn’t hurt to rule out cardiac involvement.