29 years old checking in

[db84]

Hello everyone - I'm 29 years old and started TRT in Feb with Gels than switched to injectable cypionate.
Here is my story:
Jan 2014 -
First Test lab result: 234
Second Test: 185

My urologist put me on Fortesta, 4 pumps a day.
After 2 weeks I had allergic reactions and my skin was very irritated. Called my doctor and I was told that is the only option I had and injectable was not an option to me...

Long story short, I switched doctors!!!! Went to a male hormone clinic in Boston and the new doctor is above and beyond fantastic!!! He does listen to all I have to say and put me on 100mg a week of cypionate. After 8 weeks on cypionate (100mg) he adjusted the dose to 140mg a week.

Here is my current lab test (4/17/2014):
Test Total: 340 (240-950 reference)
Free Test: 15 (9-30 reference)
SHB: 16 (10-57 rnmol/L)
HCT: 47.1 (41-53%)
PSA Screen: 0.74 (<4 ng/mL)
Estradiol: 14 (8-43 pg/mL)
FSH: 0.2 (1.5-12.4 mIU/mL)
LH: 0.1 (1.7-8.6 mIU/mL)

Just a little about myself, I'm 5'8 and currently at 205 lbs (17.5" neck, 31 waist). I do work out 3 times a week and sometimes a little more.

My doctor wants to see my testosterone higher and I have another follow up in 10 weeks.

Any advice? Suggestions?

 

[HarryCat]

Is the estradiol test you had done the "sensitive estradiol", or just the standard one? For men the sensitive is what is recommended.

Did your Dr. talk about adding in HCG to preserve your fertility? It also has many other benefits, see:https://www.excelmale.com/forum/thr...se-Testicular-Shrinkage-and-Improve-Sex-Drive.

 

[db84]

Not sure if the estradiol test is the sensitive. The lab results and the lab request doesn't say anything.
I'm not interested keeping fertility, got a vasectomy done last year.

 

[Gene Devine]

Why is a 29 year old man who is otherwise healthy on Testosterone Therapy???

At 29 years of age you should be peaking with endogenous Testosterone.

Your LH/FSH serum levels are tanked and why you are hypogonadal so there is something compromising your HPT axis.

I would want to WHY first and foremost before going on any TRT protocol. There are any number of pathologies that can cause this to happen.

Have you had any head trauma in the past or taking any medications or done any AAS in the past?

With serum levels so low would suggest a pathology or some medical history that has caused this to happen.

What were you diagnosed with BEFORE going on TRT?

 

[db84]

Why is a 29 year old man who is otherwise healthy on Testosterone Therapy???

At 29 years of age you should be peaking with endogenous Testosterone.

Your LH/FSH serum levels are tanked and why you are hypogonadal so there is something compromising your HPT axis.

I would want to WHY first and foremost before going on any TRT protocol. There are any number of pathologies that can cause this to happen.

Have you had any head trauma in the past or taking any medications or done any AAS in the past?

With serum levels so low would suggest a pathology or some medical history that has caused this to happen.

What were you diagnosed with BEFORE going on TRT?

Thanks for the input Gene... I don't know why this did happen!
My lab tests before TRT was as low as 185... I was not taking any medications that could put me at levels so low.
Doctor told me that stress and other life events can create this... And I never had any head trauma.
Was just weird...
My doctor told me that now on TRT, my FSH and LH should be 0.

 

[Gene Devine]

Did they run full tests on your Thyroid?

Did they test your Prolactin serum levels?

Have you ever used anabolic steroids in the past?

So many questions and tests BEFORE hormone replacement.

BTW, if it were lifestyle and stress those things can be corrected without Testosterone replacement.

TRT is for life man and not a 6 month type of thing.

 

[db84]

Did they run full tests on your Thyroid?

Did they test your Prolactin serum levels?

Have you ever used anabolic steroids in the past?

So many questions and tests BEFORE hormone replacement.

Never used any steroids and I had my thyroid checked in the past, no issues.
My next lab work is in 10 weeks and Prolactin is included this time.

 

[Gene Devine]

Never used any steroids and I had my thyroid checked in the past, no issues.
My next lab work is in 10 weeks and Prolactin is included this time.

IMO you need to rule out every medical possibility first and foremost; 29 years olds with serum levels of an 80 year old isn't right...something is wrong.

Stress and lifestyle can put some downward pressure on serum levels but at 234 and 185 says something is very wrong in my opinion.

I don't know what "no issues" means re your thyroid. If you have your thyroid labs, and by this I mean all labs beyond TSH, can you post them?

Prolactin will tell you if you possibly have an adenoma as well.

Have you had your testicles thoroughly examined as well?

 

[db84]

IMO you need to rule out every medical possibility first and foremost; 29 years olds with serum levels of an 80 year old isn't right...something is wrong.

Stress and lifestyle can put some downward pressure on serum levels but at 234 and 185 says something is very wrong in my opinion.

I don't know what "no issues" means re your thyroid. If you have your thyroid labs, and by this I mean all labs beyond TSH, can you post them?

Prolactin will tell you if you possibly have an adenoma as well.

Have you had your testicles thoroughly examined as well?

I don't have my thyroid labs that I did few years ago, but doctor told me everything was fine (including cholesterol , iron, and all routine checks). Btw about a year ago I got my thyroid levels checked again, I'll try to find the labs ...

Since last year I had 3 urologist and all of them checked my testicles , before and after my vasectomy. I was told it is fine.

 

[Vettester Chris]

Totally agree with what Gene is saying. Would really like to know what LH & FSH baseline labs were prior to starting TRT? Did your doctor run ALL necessary thyroid labs, or did he just do a few, which fell in range, and then told you they're fine? It sounds like you switched doctors for a reason, and now that you're in the thick of treatment with a new physician, a full, comprehensive thyroid profile would be in order. Also, thanks for joining!

 

[db84]

Totally agree with what Gene is saying. Would really like to know what LH & FSH baseline labs were prior to starting TRT? Did your doctor run ALL necessary thyroid labs, or did he just do a few, which fell in range, and then told you they're fine? It sounds like you switched doctors for a reason, and now that you're in the thick of treatment with a new physician, a full, comprehensive thyroid profile would be in order. Also, thanks for joining!

Hey thanks! I found a thyroid lab from 2012, it is below.
Both of my urologists working on my T issue, none of them checked for thyroid problems. They just looked at all my previous lab tests from the past years.
I decided to switch doctors because the gel wasn't working for me, my skin was very irritated and I was told that was the only option available to me.
This website is very informative, big help!!!

2012/03/12

thyroid stimulating hormone, serum

2.42

u[iU]/mL

0.27-4.20

 

[Gene Devine]

Hey thanks! I found a thyroid lab from 2012, it is below.
Both of my urologists working on my T issue, none of them checked for thyroid problems. They just looked at all my previous lab tests from the past years.
I decided to switch doctors because the gel wasn't working for me, my skin was very irritated and I was told that was the only option available to me.
This website is very informative, big help!!!

2012/03/12

thyroid stimulating hormone, serum

2.42

u[iU]/mL

0.27-4.20

This is just a TSH lab and is not accurate in determining thyroid function.

You are mid range which is okay but not ideal.

Anything over a two is suspect and anything over a 3 requires further evaluation.

That fact that you are hypogonadal and a mid two on TSH would have the astute Physician ordering a complete Thyroid work up.

You need to know that Hypothyroidism can and will cause Hypogonadism.

If I were you, I'd want to get a full Thyroid work up done.

 

[db84]

This is just a TSH lab and is not accurate in determining thyroid function.

You are mid range which is okay but not ideal.

Anything over a two is suspect and anything over a 3 requires further evaluation.

That fact that you are hypogonadal and a mid two on TSH would have the astute Physician ordering a complete Thyroid work up.

You need to know that Hypothyroidism can and will cause Hypogonadism.

If I were you, I'd want to get a full Thyroid work up done.

I will ask for a full Thyroid lab work. I may schedule a visit with my primary care.
Now that I'm on TRT, can this affect my thyroid lab work?

 

[Gene Devine]

I will ask for a full Thyroid lab work. I may schedule a visit with my primary care.
Now that I'm on TRT, can this affect my thyroid lab work?

No, TRT will not effect Thyroid labs.

You need a complete work up including:

Free T4
Free T3
Reverse T3
Antibodies

Vette will probably tell you even more but the 4 labs above will tell you the story.

Get Prolactin as well to rule out an Adenoma.

 

[db84]

No, TRT will not effect Thyroid labs.

You need a complete work up including:

Free T4
Free T3
Reverse T3
Antibodies

Vette will probably tell you even more but the 4 labs above will tell you the story.

Get Prolactin as well to rule out an Adenoma.

THANKS AGAIN!!! I will mention it to my doctor!
One more question, since I started TRT my weight is going up and down between 200 and 213. Is this normal? I've only been on injectable about 2 months.

 

[Gene Devine]

THANKS AGAIN!!! I will mention it to my doctor!
One more question, since I started TRT my weight is going up and down between 200 and 213. Is this normal? I've only been on injectable about 2 months.

Some men retain some water when they start IM injections so this may be one reason. After some time this will reside and not be an issue.

Also, men start to gain more lean muscle mass so weight gain like this is normal.

Make sure to keep an good eye on Estrogen levels as well.

 

[Vettester Chris]

Gene took the words out of my mouth. The TSH lab can be quite misleading and should never be used as the primary tool to diagnose the thyroid productivity. On the antibodies, there are two different ones, TPO and TgAb. Both are autoimmune assays, but one checks it against the enzyme, "Peroxidase", and the other against the "Thyroglobulin" protein. Many doctors will get one, but not the other. Look into getting both.

 

[db84]

Some men retain some water when they start IM injections so this may be one reason. After some time this will reside and not be an issue.

Also, men start to gain more lean muscle mass so weight gain like this is normal.

Make sure to keep an good eye on Estrogen levels as well.

Checked my weight again like I do every Sunday and today is 197

 

[db84]

Here is another update, just a little over 3 months in TRT and my weight now is 195. Currently taking 140mg of cypionate a week.
When I started TRT I was at 205 and I went all the way up to 215. I do work out between 2 - 4 times a week, but I do my best to work out at least 3 times a week and I do eat healthy.

 

[db84]

Hello everyone. Just got my new lab results. (7/8/14)
Testosterone Total 842 (240-950 ng/dL )
Testosterone Free 32 (9-30 ng/dL)
Sex Hor. Binding 19 (10-57 nmol/L)
Estradiol 59 (8-43 pg/mL)
FSH 0.2 (1.5-12.4mIU/mL)
LH 0.1 (1.7-8.6 mIU/mL)
Prolactin 26.9 (4-15 ng/mL) - doctor is concerned about this one
HCT 47.3 (41-53%)

Overall I feel great, taking 140mg of cypionate a week. My weight is at 192lbs and I'm very active at the gym (at least 3 times a week)

My doctor is concerned about my Prolactin levels, he ordered another labs today and depending on the results I may need to do a MRI... lets see...