Deviated Septum/Sleep Issues in Relation to T

[LakeGuy81]

36 y/o, diagnosed with low T (250-290) last May. Have been on TRT since last June with mixed results. Just this week saw an ear, nose, throat specialist to possibly do sleep study due to extreme loud snoring and to rule out sleep apnea. During visit, it was discovered I have a pretty severely deviated septum that is causing blockage on both nasal passages. We think it might have been from a head-butt to face I received during a fight in my early 20's and did nothing about. The ENT doc is recommending a complete rhinoplasty at another specialist for me since he says the deviation is past what he can do in his office. ENT said it "doesn't guarantee you have sleep apnea, but it's definitely affecting your breathing during sleep." He said to wait until after nose surgery to do a sleep study. Questions:

1) What lab values on my pre-TRT labs should I look at to maybe see if sleep issues were causing my low T? I was never told what type of hypogonadism I had before TRT started? How do you know?
2) After I get the surgery, should I give my body time to reset with normal sleep patterns to see if my hormones get better naturally? Or maybe try a Clomid restart? Or should I keep plugging along with TRT through all of this?

 

[Systemlord]

I did the sleep study months after starting TRT and no sleep apnea was detected, however I did had a deviated septum for which I had surgery 2 weeks ago and just had my stitches removed a few days ago and breathing seems to be improving slowly. My deviated septum was caused by being smacked round by a huge wave and the pressure I felt while submerged.

A lack of testosterone and estrogen affect sleep tremendously, your brain requires estrogen to function properly and if low sleep can be difficult. Low estrogen can cause morning headaches upon waking. Usually if LH is low this indicated secondary and primary usually sees LH above ranges, which is essentially screaming at the testicles to produce testosterone which will never happen.

Post labs for a more productive conversation, most doctors put guys on terrible protocols that give men a poor impression of what TRT can do for you. Most either end up quitting or find their way here and become more informed than most doctors, we must delegate to our doctors in order to get proper care.

 

[madman]

36 y/o, diagnosed with low T (250-290) last May. Have been on TRT since last June with mixed results. Just this week saw an ear, nose, throat specialist to possibly do sleep study due to extreme loud snoring and to rule out sleep apnea. During visit, it was discovered I have a pretty severely deviated septum that is causing blockage on both nasal passages. We think it might have been from a head-butt to face I received during a fight in my early 20's and did nothing about. The ENT doc is recommending a complete rhinoplasty at another specialist for me since he says the deviation is past what he can do in his office. ENT said it "doesn't guarantee you have sleep apnea, but it's definitely affecting your breathing during sleep." He said to wait until after nose surgery to do a sleep study. Questions:

1) What lab values on my pre-TRT labs should I look at to maybe see if sleep issues were causing my low T? I was never told what type of hypogonadism I had before TRT started? How do you know?
2) After I get the surgery, should I give my body time to reset with normal sleep patterns to see if my hormones get better naturally? Or maybe try a Clomid restart? Or should I keep plugging along with TRT through all of this?

Primary (hypergonadotropic hypogonadism) is caused by testicular failure and one would have low serum testosterone and high LH/FSH concentrations.

Secondary (hypogonadotropic hypogonadism) is caused by defects in the HPTA (hypothalamic-pituitary-testicular axis) and one would have low serum testosterone and low/low normal LH/FSH concentrations.

Lack of sleep can definitely effect ones natty testosterone production negatively to a certain degree.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955336/

Look at your LH/FSH lab values pre-trt.

Posting your pre-trt and trt lab results would be helpful.



https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948422/table/tbl3/





















https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948422/

 

[LakeGuy81]

FSH was 3.9 pre-T but I can't find pre-T LH? My Dr. only orders the minimal of tests, and I'll be switching to another soon. Here are some other lab values for me:

Date	5/9/17	7/20/17	8/29/17	12/14/17
Lab	LabCorp	LabCorp	Vibrant	LabCorp
Weight	213 lbs	213 lbs	213 lbs	215lbs
T Dose	Pre-TRT	100mg/week	100mg/week	100mg/week
Total T	292 ng/dl	745 ng/ml	851 ng/dl	641 ng/dl
Range	348-1197	264-916	348-1379	264-916
Estradiol	22.0 pg/ml	33.8 pg/ml	40.2 pg/ml	33.5 pg/ml
Range	7.6-42.6	7.6-42.6	25.8-60.7	7.6-42.6
PSA	1.2 ng/ml	1.3 ng/ml	1.27 ng/ml	1.3 ng/ml
Range	0.0-4.0	0.0-4.0	0.0-4.0	0.0-4.0
SHBG	24.5 nmol/L	24.1 nmol/L	21.9 nmol/L	22.1 nmol/L
Range	16.5-55.9	16.5-55.9	16.5-55.9	16.5-55.9
Hemoglobin	16.4 g/dl	15.4	17.2	17.1 g/dl
Range	12.6-17.7	12.6-17.7	13.7-17.5	13.0-17.7
Hematocrit	47.9	45.8	47.7	47.9
Range	37.5-51.0	37.5-51.0	40.1-51.0	37.5-51.0
TSH	2.810 uIU/ml	NT	2.21	NT
Range	.450-4.500	NT	.111-4.910	NT
FSH	3.9 mIU/ml	NT	0.2	NT
Range	1.5-12.4	NT	1.5-12.4	NT

View attachment TRT Blood Test Results (Tracking).pdf

 

[madman]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445839/