Sexy man with a Buffalo hump..

Question

Hi very busy Drs. Real quick-me 44, hiv+ since 1999, eat great-fish/chicken protein, good carbs,brown rice,whole grains,vegs. work out 3x wk. Currently undet./t-cell-1200+. on viread,viramune,epivir( last 8-12mos. for this regimine)and androgel. healthy as a horse. own a busy cafe and have good friends. Weight 159# 5'10. Had some moderate fat loss all over-through the years. last winter had bioalcamid injections for face in Mexico-very happy! But I have a small hump at the base of my neck that draws too much attention (from my mind) :) Two questions: I read on this site where a woman rubbbed androgel on her hump 2x daily for 30 days and had a massage on it every 10 days and it seemed to dissappear-why would that happen? Q:#2 if BH is a sign of severe cortisol overload ( by stress) do any drugs for depression or anxiety work? are there cortisol reduction meds.i may have mild depression or more mild compulsive thinking? thank you! paul @ prince0297103@yahoo.com(people may contact me about my bioalcamide results:) ps. how can one support this site?

Answer

I have no experience with use of local testosterone/massage for treatment of buffalo hump. Use of systemic topical testosterone is under study for that -results should be available soon from the ACTg study. The cortisol dysregulation theory for lipodystrophy/mitochondrial dysfunction (popularized I believe by a Dutch group) is intriguing but not widely accepted. I am unaware of any way to safely decrease cortisol dysregulation as a possible treastment that has been proven effective. You already are on a relatively low risk for fat problems HIV regimen. Exercise and diet may help minimize the problem. Growth hormone or growth hormone releasing factor are also being studied for treatment of buffalo hump in the setting of treated HIV infection. Removal of buffalo humps by a plastic surgeon also has provided some variable relief for patients. KH