Endo follow up today - not sure what to think
 

My endo is hard to get into. I saw him at the end of May and just today had my follow up. My labs were fine, but said I hydrate too much (I'm diluting my urine).

Now, I did also just have my physical with my primary care doctor last week, and those levels were a bit interesting. Most notably, my IR is back. Unforunately, my PC doc didn't seem to care too much about that and refused to increase my metformin even though I thought it was a good idea. I've been on 500 mg ER for years and as far as I can tell, it's not doing bupkiss. After a lot of begging, I did convince him to let me try phentermine. He put me on 15mg. So far, it has NOT decreased my hunger or increased my energy. Today is my 4th day on it.

So, I told my endo about the met and how the other doc won't increase it, and he said that's crap, and increased me to 2000 mg (gradual increase over the next few weeks). Also told him about the phentermine. He briefly suggested I'm a compulsive overeater, and I assured him that's not the case. I eat very healthily, I'm just ALWAYS hungry. Then I brought to his attention that I've gained about 10 lbs since I saw him three months ago. He looked over his charts and goes "Woah. That's not right!" and then looked back further - turns out I'm gaining weight just as fast as I said I was (duh!). 142 on Jan 20th, 153 on May 25th, and 165 today.

He has decided to test me for cushings.

That's where I'm confused. I mean, My PCOS diagnosis has been mostly based on symptoms. At the time of diagnosis, I was overweight, I did have cysts, and I had too much testosterone, but that was 7 years ago. Everything has been basically normal on tests since then, yet my symptoms have continued. I have fatigue, excessive thirst, rapid weight gain and trouble losing weight, purple stretch marks, easy bruising, acne, facial and abdominal hair, extreme hunger, anxiety, infertility, and irregular menses.

There are some inconsistencies, though. I tend to gain weight mostly in my hips, thighs, and butt, and only get a tummy when I get really heavy. I don't have "moon face." I don't have a "buffalo hump." I don't have skinny, muscle-wasted limbs.

I don't know what to expect. Part of me wants it to be Cushings so I have something to treat, you know? Then I wonder, if it is Cushing's, does that negate the PCOS diagnosis?

If it's not Cushing's, and the met doesn't help me lose weight, he wants to try me on Byetta, which makes me nervous.

So, any thoughts - on the results, on Cushings, on taking phentermine, increased met, and byetta? I'm lost here - any input helps!