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TERRENCE H

New Member
Hello fellas,

My name is Terrence I am 50 years old. I am really hoping to find good information to help me with my situation.

A little about me. I was diagnosed as diabetic sometime in the fall of 2010. At that time my weight was about 270... and my a1c was in the 7 range. I did have some minor changes in erections that didnt seem like a big deal at the time. I could still do the do when I wanted to. The diabetes diagnosis scared the crap out of me so I really changed my diet.. went on insulin and my weight dropped down to 227 after about 6 months. At that point I had almost no need for quick acting insulin, only using the longer acting form at night before bedtime. My erections came more frequently and were (for lack of a better term) better. I was separated from my wife and lived by myself for the most part at this time. I say this because the dietary thing was easier when I lived by myself as there was nobody bitching about the fact that most of the time I ate the exact same thing all of the time. I looked at food at that point as a simple necessity of life that I had to have. One day a week I would eat anything I wanted one time. It kept me sane.. lol.

So I moved back home with my family about a year after starting the diabetes thing. My diet changed cause there is less freedom regarding diet when living with three other people. I lost my health insurance due to job change and basically my ability to treat my diabetes. My weight creeped up slowly about 10 lbs and that is where I am today as well. That was 5 years ago.


Along the way I aged of course and I started having erection problems meaning they become less frequent and not as firm. But I could still do the do. Somewhere in the middle they got fewer and farther between and the morning wood went away. I really never thought much of it until the dude would no long work at all. I could still climax during fellatio or masturbation but rarely got erect enough to do the do with my wife.

When I got insurance back about a year ago I went to the dr. I had started having some stinging pain in my ankles and feet and feared diabetic nerve damage. My diabetes was raging out of control and back on insulin I went. I went for a boatload of tests for diabetic nerve damage, which I did not have, but it was discovered that I have a narrowing of the nerve canal between l4 and l5 which they all thought should be causing me pain but it does not. This was discovered because when they shocked my lower back on one side it did not transmit back down to my feet. To this day I dont feel this is creating an unusual issue (ive had intermittent back pain all of my life). I digress. I underwent imaging tests in my carotid to check for blockage and nothing was found, I had a nuclear stress test which the results did not create any panic from the Dr. I went on high pressure blood pressure meds (lisinopril with htcz) and statins for cholesterol as well as something else for cholesteral called vesepa. The doctor was dismissive at this time about my erection problems stating that I could not deal with that until blood pressure, glucose and cholesterol were addressed to see what would happen.

So a few months pass, I go to the doctor for follow up blood work. This was late mid januray. My a1c dropped down to 6.5 my cholesterol and trigs were just a tad high. The doctor was estatic. So he gives me a daily prescription for cialis. We tested for Testerone and I was about 280 total. I didnt know enough to have him test for free Test or estriadol at that time. when the results came back He prescribed 1 ml of 200 mg/ml cypianate IM once a week. So I started taking the injections on Tuesday mornings. I found that I was feeling sharper, with more energy rather quickly. But by friday not so much. I never would say that I felt Bad but just not as much. This was early Feburary.

I became very curious at this time and started spending a bunch of my free time researching medications, erection issues etc.... I found this and a bunch of other places on the net and started gathering and processing information. I have a friend who told me that the once a week shot was too much and that I would be on a roller coaster of ups and downs and that I would lose a lot of testerone from it getting turned into estrogen. Early in this process I had a few perhaps 3 episodes where I woke up in the middle of the night miserable with "hot flashes" feeling really hot and sweaty. I started getting better erections but they were not very firm and would go away during intercourse. I read that these were possible signs of high estrogen, so after reading about subq cypionate injections and at the suggestion of my friend I started taking my testerone at the rate of 20 mg daily subq. I have been doing this daily for about a month. The night sweat thing stopped, the ups and downs stopped and for a point in time the good old morning wood made a comeback. during that time I actually had a couple of daytime erections for no reason. I thought " I am back in the game" but this was short lived and they never got fully hard and would still go away once intercourse was started. I am not waking up in the mornings with a boner as much anymore and the intercourse is about the same. Lately my wife has not been feeling so well so we have not attemped it. Id say about 2-3 weeks. btw during this time I learned about c0q10 and started taking it to help with issues caused by statins.

I began to worry about why my erections were not coming back as I had expected. Did my estrogen crash, to I have not enough free testosterone, so I did more studying. I learned that the diruetic in my high blood pressure meds can cause erection problems.

This leads me to my current situation. I am to see the doctor tommorow and I am looking for tips on how I should lead the conversation to keep us on the right path. What blood tests in particular I should have him run, will my insurance cover those... etc. I am thinking I was to stop the diuretics, have him run total t, free t, estridiol test and ask about hcg.


Am I missing anything, wrong about stuff or lacking some information that I should know right now. I would appreciate any and all information I can get.


Thanks guys,

Terrence
 
Defy Medical TRT clinic doctor

CoastWatcher

Moderator
Welcome to Excelmale. We hope you'll be an active member.

Without detailed labs, far more than total testosterone, we are simply guessing (as is any doctor). What test result do you have? Can you post them, along with the reference ranges? If you haven't had a full workup for hypogonadism, these tests are essential.

Total Testosterone
Free Testosterone
Estradiol/Sensitive, LC, MS/MS
LH, FSH
Prolactin
TSH
t3, t4, rt3, thyroid antibodies
PSA
CBC
CMP
DHT
DHEA-S
 
Last edited:

Leesto

Active Member
Terrence, wow you have a lot of stuff going on. First thing I would do, learn about low carbs and​ diabetes. This thread may help. https://www.excelmale.com/forum/showthread.php?4276-What-happens-to-the-carbs

I second what Vince said. My HbA1C was at 13.5 at one point. A combination of meds brought it down to about 8.5 but I could never quite get below that. A low carb diet brought it down to 5.9 and I am now off insulin and other diabetes meds except for 2000 mg of Metformin per day. Sugars and starches and grains will do you in if you are Type II diabetic.
 

TERRENCE H

New Member
I have at home my last blood test. I can post them later. Thanks for the test info.. I'll discuss it with the doctor. Hopefully we can run those tommorow with the other normal stuff.
 

TERRENCE H

New Member
Welcome to Excelmale. We hope you'll be an active member.

Without detailed labs, far more than total testosterone, we are simply guessing (as is any doctor). What test result do you have? Can you post them, along with the reference ranges? If you haven't had a full workup for hypogonadism, these tests are essential.

Total Testosterone
Free Testosterone
Estradiol/Sensitive, LC, MS/MS
LH, FSH
Prolactin
TSH
t3, t4, rt3, thyroid antibodies
PSA
CBC
CMP
DHT
DHEA-S


You mentioned these tests. I found a list of tests linked to this site from discount labs called trt male hormone wellness followup panel. It does not list a lot of the things you mentioned, can you shed some light on that for me. I know I think I read that LH goes away after trt like I have been on since Feb. So should I be doing that one? Also I think I will ask the Doctor about hcg based on some of the information I have gathered on here. What do you think?

Thanks
 

CoastWatcher

Moderator
You mentioned these tests. I found a list of tests linked to this site from discount labs called trt male hormone wellness followup panel. It does not list a lot of the things you mentioned, can you shed some light on that for me. I know I think I read that LH goes away after trt like I have been on since Feb. So should I be doing that one? Also I think I will ask the Doctor about hcg based on some of the information I have gathered on here. What do you think?

Thanks

I was providing you with a list of tests that my own doctor believes are essential for working up a patient who may be presenting with hypogonadism. It is one most doctors would order, or should.

If you are planning to pay for testing on your own, as many of us do, you can save a bit of money by relying on the tests at Discounted Labs, but it will be missing some information. Your LH and FSH are likely suppressed if you have been on TRT for two months. Were they measured earlier? Do you know if you're a case of primary or secondary hypogonadism?
 

TERRENCE H

New Member
@coastwatcher

I have insurance and they have paid for all of the blood tests I have had to have to far have cost me nothing. I am looking at the last set of tests that I had on 1.31.17. I cannot scan them here at home.

results as follows:

cbc was run...

wbc 11.4 range of 3.4-10.8
rbc 4.78 range of 4.14-5.8
hemoglobin 15.9 reange of 12.6-17.7
hematocrit 44.4 range of 37.5-51.0
mcv 93 range of 79-97
mch 33.3 range of 26.6-33.0
mchc 35.8 range of 31.5 -35.7
rdw 14.0 range of 12.3-15.4
platelets 287 range of 150-379
neutrophils 68 no range specified
lymphs 25 no range specified
monocytes 5 no range
eos 2 no range
basos 0 no range
neutrophils (absolute) 7.7 range of 1.4-7.0
lymphs absolute 2.9 range of .07-3.1
monocytes absolute .06 range if 0.1-0.9
bos absolute 0.2 range of 0.0-0.4
baso absolute 0.0 range oof 0.0-0.2
immature granulocytes 0 no range
ubbatyre grabs (abs) 0.0 range 0.0-0.1
tsh is 2.74 range is 0.45-4.50
psa serum is 0.5 range is 0.0-4.0

there is more stuff but im not sure if its part of what you are asking about.

what do you think.
 

TERRENCE H

New Member
testerone serum was 202 with a range of 348-1197
lh and fsh not measured. free testerone not measured im unfamiliar with the primary and secondary hypogonadism term so I guess I dont know.
 

CoastWatcher

Moderator
You received a poor, a very poor, workup. That's not your fault, it happens to so many men who - in perfectly good faith - turn to their doctor for help and don't receive it. I don't know that you'll ever achieve success working with your current physician. We can offer referrals, but it may require you to pay for services directly. Where in Texas do you live?
 

CoastWatcher

Moderator
west houston.... i 10 corridor basically

Locally, you could consult Dr. Larry Lipschultz, a Houston-based urologist, with an excellent reputation. There are two, well regarded national practices (both are site sponsors), Prime Body and Defy Medical. All three, Dr. Lipschultz, Defy, and Primw Body, have a web presence. Call Defy and Prime Body and ask as many blunt questions as you can,money are fee for service providers, but they don't hide or dodge questions (particularly on cost matters). Dr. Lipschultz may take insurance, you will have to inquire.

Any of those named above will steer you in the right direction. We have many members who are patients of Prime Body and Defy, and Dr. Lipschultz is a highly regarded practitioner (and a friend of Nelson Vergel). You deserve better care.
 

TERRENCE H

New Member
Thanks for that Vince. I am not really having too many questions about the diabetes part of my situation. I have that pretty well controlled with diet control. I have been limiting my carbs for the most part to vegetables. I typically eat about 3-6 oz of chicken breast usually or some other kind of meat with about 1/2 cup or so of usually mixed vegetables and a salad at each meal. I may snack on something like carrots, apples, or some ham slices I often carry in between. my glucose readings for all events are about 119.8 for this week, 123.2 for the last month and 125.9 for the last 3 months. I am down about 7 lbs in the last two weeks since I got really picky about the diet stuff. like I said before I will have a free for all food day for one meal, once a week.

the rest of the time I keep what I eat fairly steady without a lot of variations. This has always worked for me in the past. another 10-15 lbs and I will probably no longer need to use insulin regularly. when I did that before I pretty much stayed in the green zone on glucose all the time as long as I did not eat stuff that I know will cause a spike. I know that is coming because a few times in the last month I have had to seek out something to raise my glucose as it would drop low (below 80) which is not a big deal for me but below 70 and I start having symptoms that I do not like.

I am hoping to get my weight down to about 210 which I have not seen in a long time. 26 lbs to go as of this morning. Wish me luck.

Terrence
 
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