Hey Y'all new guy saying hi.

Hey guys! I've been looking st this site for about 3.months and finally registered last night. I'm 38, 79.5 inches (little over 6'7"), weigh 414 yesterday. I'm obviously very over weight but not as overweight as I was 6 months ago at 470 something. I was an athlete until an injury stopped all that for me. I am a really big guy (18EEEE shoe, 22 inch neck, 58 shoulders, 46 waist at current weight) and when I got in football shape for college I was 335 at about 12-14 BF and felt amazing. I ran, biked, and kickboxed even after my injury until I was 29 when I injured my back. I packed on a ton of weight, became sedentary, gained even more weight, quit chewing tobacco and gained even more weight. Went to doc a year ago which started this weight loss/lifestyle change and I feel much better. I'm also on 1/3 of the bp meds I was on initially, off of all other meds including anxiety meds and am hopeful loosing another 75 lbs will make me able to get off the bp meds.

My test was 135 1 year ago and my doc (who is pro T and knows a ton about it) said he wanted me to change my life, get of of anxiety mess (benzos) and loose as much as I foul in a year and then look into T. Well I got my T tested in the morning fasted, and it was 182 L which is well...bad. So having been an athlete (college O line) I've had my share or trauma to my body specifically testicular and head trauma. I was a catch wrestler back in the day before MMA was a thing and trained Muay Thai which at my size was a big time strain on my body and jointsI've also had a two year operate pain management for my spinal stenosis that was about 7 years ago. I took xanax for 13 years at 3 mgs a day. Off that 7 months and will never take a benzo again!

So back to my doc, (sorry typing this at job site on iPad) he tested a few things 3 days ago:

Test 182
PSA 1.22
LH. 2.7
FSM 1.6

he said he expected these levels as I beat the tar out of myself for so many years and said he wanted an endo to give him the ok before I start test. So here are some questions as I've read a ton of anti endo comments...what is the endo going to test for? Should I give him some values i want tested? If they recommend a clomed restart what do I say since I'm on the borderline age wise (I have kids and no more is no problem) so I can skip. I've been waiting a year already to start T and Imam ready to get to the next level of fitness and weight loss. Thank you all for reading and any all help.
Meds: bystolic 5 mgs (bp beta blocker) cialis 5 mgs (ed had 4-5 years much much better since weight loss)
HCTZ 25 (diuretic) will be off soon with more weight loss Fish oil, D3, CMZinc, baby aspirin,

Welcome to Exclemale. You certainly have had significant challenges reaching this point, congratulations, but there may be some additional ones in your future. You wrote your doctor knows a "ton" about TRT, but he performed a minimal workup - that is puzzling. Moreover, he is sending you to an endocrinologist to complete the workup - assuming a decision is made to start TRT, who is going to manage your care with you?

As as far as testing, you are missing key elements. The following need to be obtained (some of which you have). Test in the morning, preferably fasting.

Total Testosterone
Free Testosterone
SHBG
Estradiol/Sensitive, LC, MS, MS
LH
FSH
TSH
t3, t4, rt3, thyroid antibodies
Prolactin
DHT
DHEA
Cortisol (four-point saliva)
CBC
CMP
PSA


You asked about Clomid and what you should say. That's your decision to make. How old are you? Are you ready for a life-long commitment, as it is for most, that TRT implies?

Hey CoastWatcher thanks so much for your reply. I did say my doc new a ton but I should have said he knows way more than the GP my insurance was willing to pay for. He also does trt in office and allows patients to self inject, and will do ai's and HCG if patient requests. I have had tests done by a few different dr's to rule out heart and other issues. The blood work I had done at these were seen by my GP and he ordered the LH,FSH,PSA, with the T test I requested. He said since I was young and it was so low he wanted me to see an endo before he would start T. I presume they'll check my prolactin since my T was less than 200?? The clomid question is only because I'm young/borderlineage but I would rather just go to test from what I've read on here as my wife and I are done with kiddos. I have no problem injecting T for life as I have had all of the low T symptoms even the outward signs like getting soft, getting very fat even hair below calf and eyebrows thinning and beard is not what it used to be.

So CoastWatcher is the endo a waist of time? Is it my docs CYA or should I ask him to perform tests? I've done my best to search these answers but for this I'm stuck. Thanks again fellas and CW!

Daeodon said:

Hey CoastWatcher thanks so much for your reply. I did say my doc new a ton but I should have said he knows way more than the GP my insurance was willing to pay for. He also does trt in office and allows patients to self inject, and will do ai's and HCG if patient requests. I have had tests done by a few different dr's to rule out heart and other issues. The blood work I had done at these were seen by my GP and he ordered the LH,FSH,PSA, with the T test I requested. He said since I was young and it was so low he wanted me to see an endo before he would start T. I presume they'll check my prolactin since my T was less than 200?? The clomid question is only because I'm young/borderlineage but I would rather just go to test from what I've read on here as my wife and I are done with kiddos. I have no problem injecting T for life as I have had all of the low T symptoms even the outward signs like getting soft, getting very fat even hair below calf and eyebrows thinning and beard is not what it used to be.

So CoastWatcher is the endo a waist of time? Is it my docs CYA or should I ask him to perform tests? I've done my best to search these answers but for this I'm stuck. Thanks again fellas and CW!

Click to expand...

I can't answer the question about an endocrinology consultation. Do I think it may be a waste of time? Yes, I do. Do I know that? Of course not.

Where in Texas do you live? If you're in Houston, or the Houston area, you could consult Dr. Larry Lipshultz, a urologist and highly regarded in the field of androgen management. No matter where you live you could seek treatment from either Prime Body or Defy Medical, site sponsors (I'm a patient of neither, but know that they treat many of our members successfully). Both have a web presence - call them and ask them the blunt questions you need to have answers to. Questions about cost, mode of treatment, anything. They won't dodge.

I bring these three practices up, Dr. Lipschultz, Dr. Saya at Defy, and Prime Body, because they will cut through the talk and delays. They know what tests to order, how to interpret them, how to design a protocol, and how to monitor patient progress. That is what you want in a doctor.

Now, you can honour the appointment with the endocrinologist. You might be very pleased with what you discover. But it seems you're being toyed with. Or so it seems to me.

I hope you'll stay in touch and become an active member here at EM.

I'm located here in Houston, TX and would be more than happy to discuss PrimeBody with you and answer any questions you may have.
Feel free to PM me!!

Well crap. I wish I would have brought up the Endo when my GP's nurse called to tell me to see said Endo. I can email my GP on Monday and ask him a question... problem is what is the question? Are you involving a "specialist" to somehow cover your behind? This GP is pricey like so many boutique practices and the money is spent or at least very front loaded. So is my question why an Endo? Can we test these things (CoastWatcher's list) and then get on down the road? I'm in Dallas btw. Thanks for the help guys.

Daedon, welcome to EM! You can get your labs (all or partial) at Discount Labs, top/right click on the screen. Or there's other providers that will do it too.

Nobody can tell you for sure "why" the GP is sending you to the enod, only the GP and Endo know exactly the reason. Could be procedural, or maybe the "CYA" as you alluded, don't know? Maybe ask him for a straight answer on it and possibly he will tell you exactly the rationale behind his thinking.

Keep us posted, thanks ...

Hey thanks for the input and letting me ramble about the doctor guys. I'll email the GP and hopefully I'll get answers. Thanks again Sean and Vettester..I'll keep y'all posted and if I jump to a new dr I'll hit you guys up.

You have made significant progress in terms of your health over the past year. Don't let doctors prolong the TRT decision for much longer.

All the best.

I got my blood work back I ordered that coastwatcher listed . They had a problem with my sample so a few were not done...and the saliva test(s) were not offered. I'll use Discountlabs next time I do all the tests.

This is all at 10 am fasted:

Glucose 94. 70-99mg/dl

SHBG 32.1. 16.5-55.9 nmol/L

LH. 2.7. 1.2-8.6 IU/L

FSH. 1.6 1.5-12.4 IU/L

TSH. 5.55 (high). 0.40-4.10 UIU/ML

T3. 3.1. 2.4-4.2 PG/ML

T4. 1.04. .80-1.7 NG/DL

RT3. 13.2. 9.0-27. NG/DL

Prolactin. 13.1. 4.0-15.2 NG/ML

DHT. Receipt of improper specimen

DHEA Sulfate 266. 103-446 UG/DL

DHEA Non Sulfate. 3.1. 1.5-9.2 NG/ML

Cortisol. 15.3. (AM) 4.8-19.5 UG/DL

CBC All available if needed

Hematocrit. 46.0. 37.0-49.0 %

CMP

PSA. 1.22. <4.00 NG/ML

Estridiol 17.0. <60.7PG/ML

Estridiol Ultrasens. 15.0. 10.0-42.0 PG/ML

testosterone 182. 300-1080

Nothing seems to jump out at me except TSH (5.55 .40-4.10UIU/ML). Maybe my hematocrit is high for pre trt labs 46.0?

I started TRT 15 days ago (My protocol is .25 ml of test cypionate 200mg every 3.5 days) and I have noticed a few great things already. First, I'm much less anxious which is worth the price of admission by itself!. My libedo was strong but it's even stronger now. Me erections are just a bit stronger but the past week I've woken up with a half erection and that has not happened in 5 years maybe. My penis is more sensitive which is great as it was noticeably less sensitive the past few years. I have started sweating more and It smells different...maybe like when I was younger?. Not doing HCG yet but am open to it as well as an anti estrogen although I don't need it yet. I forgot to mention I have osteopenia that they discovered with a chest CT which put me over the trt edge. My estradiol is 15.0 ultra sensitive test. Would that contribute to osteopenia? I am going to the endo tomorrow (told my wife I would since my TSH is high) but I have armed myself with the info I think I need to make the consultation not make me take any steps backward. Any recommendations about what to ask the endo or tests to order are greatly appreciated.

Thanks so much for reading my journey so far and for all tips and advice!

Went to the Endo today with the high TSH value and he bascially said let's watch this for six months since we don't know how long it's been high and i recently started trt. My BP is elevated yesterday and today to the point I called my GP and he added a bit more bystolic (beta blocker) for a total of 7.5 mgs per day. I've been on double that when I was my heaviest plus clonodine so I'm not going to fret. My wife commented yesterday about my smell and she says she like it I'm not going to overthink that either. I feel strong the past few days and my erections are notably stronger. I'm going to cut the cialis to 2.5 mgs a day from 5 and see if I can maintain the same quality. I feel a bit silly writing all of this as I have had no comments but I'm going to trust the process. Does anybody else use a diuretic or did you start using one when they got on trt? Thanks!

Daeodon said:

Went to the Endo today with the high TSH value and he bascially said let's watch this for six months since we don't know how long it's been high and i recently started trt. My BP is elevated yesterday and today to the point I called my GP and he added a bit more bystolic (beta blocker) for a total of 7.5 mgs per day. I've been on double that when I was my heaviest plus clonodine so I'm not going to fret. My wife commented yesterday about my smell and she says she like it I'm not going to overthink that either. I feel strong the past few days and my erections are notably stronger. I'm going to cut the cialis to 2.5 mgs a day from 5 and see if I can maintain the same quality. I feel a bit silly writing all of this as I have had no comments but I'm going to trust the process. Does anybody else use a diuretic or did you start using one when they got on trt? Thanks!

Click to expand...

Your question about a diuretic - are you asking if anyone uses them for blood pressure control?

CoastWatcher said:

Your question about a diuretic - are you asking if anyone uses them for blood pressure control?

Click to expand...

Yes is anybody taking for blood pressure control and/or to mitigate water retention. My GP has me on HCTZ (patassium sparing diuretic) to keep water retention in check as I loose weight and I have noticed i have some water weight back since starting trt. I don't mind since the trt should help me loose fat weight faster but I thought it was worth mentioning I feel the water and wondered how guys dealt with it. Thanks!