"Does anyone know if excess androgens could cause an oxygen problem in bones leading to marrow abnormality? "
Yes, how about this: "Androgens correlate with increased erythropoiesis in women with congenital adrenal hyperplasia" 2017
(though oxygen doesn't seem central to the mechanism)
...and re DHEAS: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624825/
"Congenital Adrenal Hyperplasia"
"...really expected EPO would be high but it wasn’t"
Well, I was thinking it was a direct effect not mediated by EPO. So I found this:
Androgens correlate with increased erythropoiesis in women with congenital adrenal hyperplasia 2017
"The mechanism by which androgens promote erythropoiesis is not established.1, 14 There are conflicting results on the effect of testosterone on erythropoietin, the major regulator of erythropoiesis. Some studies have suggested that testosterone increases the erythropoietin production,1, 15 while others found no evidence to support these findings.6, 16 Other possible mechanisms by which testosterone might induce erythropoiesis include a direct effect on bone marrow hematopoietic stem cells by stimulating insulin‐like growth factor 1 and erythrocyte colony‐forming units,17 and increasing intestinal iron absorption and incorporation into erythrocytes.14"
However, that leads to only a 1975 rabbit study - but still it's something, right?
"Or if I had a tumor the whole time if that could lead to this."
Probably there would have been some sign of that, since 2012. Whether on CBC or blood smear, or else some bump/tumor somewhere besides the marrow popping up. Its possible but not very likely.
Usually in a blood cancer the marrow gets invaded from the original primary site which is outside the marrow - not starting in marrow.
What blood test results are you waiting for?
At this point, a malignancy seems the least likely cause.
"Ana pos at one point."
That's usually not helpful, it's more like a fishing expedition when stymied. But just out of curiosity: what was the titer on the ANA? 1:40 or 1:80?
Here's a good Discussion section on the mechanism, in an FFT:
Is the haematopoietic effect of testosterone mediated by erythropoietin? The results of a clinical trial in older men 2012
(the result is "no")
At this point, it looks that having non-elevated EPO isn't anything to be considered relevant.
All in all, I'd be looking at a bone marrow biopsy as the chance to rule out malignancy. Then you can focus on the real cause of the problem.
Feel free with any followup questions :)
You've got a lot going on. One thing that stands out to me is the PGD2. Do you randomly get skin flushing? Have many bad allergies, or react really badly to bee stings or heat? No anaphylaxis episodes, right?
I don't know why they want a bone scan rather than a BMB, but that seems to say they are not so worried about a cancer.
PGD2 comes from mast cells. There are mast cell disorders such as MCAS, which produce a wide variety of mystery symptoms. Then again, PGD2 is also made in the brain.
It's not usual to be tested for prostaglandins.