Hello

[SomeG]

Hello

New to this forum and wanted to say hello.

I'm a 40 year old guy who has been going through a maze of doctors for the past few months.

I originally went to my primary care doctor complaining of chronic fatigue, low mood, low sex drive,insomnia, high stress, inability to concentrate.. and going to the gym more hasn't helped half as much in many of these departments as it used to. Essentially, I felt 'broken down' and asked for a full set of blood tests, including testosterone.

My results included a 250 ng/dl total testosterone level, but I was told that it was normal!

I pushed a little, and got her to refer me to and endocrinologist. Although my total T re-tested at 443 ng/dl then (a month after the first test), I had prolactin levels at 19.9 ng/mL (noted as high but is not being treated, only told to come back in several months). Essentially, I have been diagnosed as normal by the endocrinologist.

As an aside, before the endocrinologist tested a drop of my blood, he gave me a long shpiel about how much he hates prescribing testosterone, and, if anything, would only consider Clomid to restore T levels.

With a little more pushing, I finally got my primary care doctor to refer me to a male health clinic, where I know, even before I go, that I will be given a fair hearing for my ills.

My appointment is in a week, and I cannot wait to try ANYTHING. I cannot deal with this chronic fatigue, inability to concentrate, and general malaise.



Is my situation all too common on here?? Do female hormonal issues go as untreated in doctors' offices as male ones seem to be?



By the way, I've already done some reading and really appreciate the resources here, and will continue to do so.

 

[Vettester Chris]

Glad you joined, thanks for posting. I'm with you 110% on the frustration with your doctor, and the lack of knowledge on diagnosing and treating your low test. Although, there was some puzzling variance between your two total serum results, I think someone needs to be digging a little deeper with you on this.

Also, don't put the weight of all your symptoms on testosterone with thinking that is the one and only factor to address. With what you have described, it could be a combination of several things, including thyroid, adrenals (cortisol, DHEA), E2, D3, vitamins & nutrients, etc. When you get with the clinic, look at the complete picture, otherwise many symptoms will just linger even though your testosterone might be optimal.

 

[SomeG]

Also, don't put the weight of all your symptoms on testosterone with thinking that is the one and only factor to address. With what you have described, it could be a combination of several things, including thyroid, adrenals (cortisol, DHEA), E2, D3, vitamins & nutrients, etc. When you get with the clinic, look at the complete picture, otherwise many symptoms will just linger even though your testosterone might be optimal.

Thanks for your ideas. You may be right. I'm pretty indifferent about what the solution is. I just want one.

I did get a high cortisol (blood) test- (50% above normal), but that was followed up with a 24 hour urine test that showed my cortisol to be completely normal (dead center in normal range). Also, my TSH was at the very top of what was listed as 'normal' (3.73 ulU/mL ) and there is a significant history of hypo and hyper thyroidism running throughout my family (3 or 4 siblings have one version of thyroid dysfunction or another).

Oh yeah, I don't even know what my estradiol level is-- I think the endo tested for this, but I don't see it listed on my lab results.

honestly, I think my primary care and endo just wanted to re-test me on everything until I got something normal-- just so they would not have to treat me!

Lastly, I would love to get a full set of vitamin and supplement recommendations from a doctor who knows his/her stuff. I would be perfectly willing to take any number of supplements, but feel like there are so recommendations out there that may or may not get me anywhere. I've heard good things about taking extra vitamin D, Ashwaganda, B6, and Zinc, but I'd love to hear what the mens health doctor would suggest as a regimen. Also, DHEA might be an issue, but I don't want to take any until I have solid guidance on this.

 

[Vettester Chris]

If you can post your labs we can provide some comments. Having a TSH value > 3.0 is something that will catch my eyes, even if it turns out to be sub-clinical hypo. However, that lab alone can't tell you what is really taking place with your thyroid activity. Some people have a TSH reading of 1.0, but can have inadequate levels of thyroid hormone. If you can get Free T4, Free T3, Reverse T3 & Antibodies (TPO & TgAb), I will give you my thoughts.

 

[SomeG]

Chris,

Thanks for your response, and sorry for the late reply.

Although I do remember that my total test dipped back down to just under 350 ng/dl in December, I don't have my most recent labs from my urologist handy at the moment, so until I get a hand on those, I was wondering if I could ask a few general questions - rather than specific bloodwork related ones.

As hanging onto fertility for a couple more years is somewhat important to me, I decided to go the 'safer' route of HCG Monotherapy versus the exogenous testosterone route (or even the Test + HCG +AI route that seems to be the generally favored options on a lot of online boards.) . I decided against clomid because I saw that many journals noted its average 'ceiling' for testosterone levels seemed to be in the 600s or so. If HCG monotheraphy doesn't work, I will try the 'triplecast' of Test + HCG + AI)

Seeing this study nudged me to agree with the doctor's suggestion of HCG monotherapy http://meeting.neaua.org/abstracts/2014/17.cgi

For me, I am not super worried about the fitness/muscle growth issues, as I am 6' 175 lb and fit (wiry muscly and relatively flat stomach). I am more concerned with addressing the fatigue/lethargy/ low mood that I've had over the past few years.

Two weeks into HCG monotheraphy (1500 IU 3 x/week) ,I've done my share of lurking in this and many other TRT related boards on these issues, and I am still interested in hearing more about the following questions.

-- How long will it take for something to happen, symptom-wise, and how much change should I expect?

(two weeks in, and I am just starting to get some improvement in some of the fatigue-related issues, but I am not a raring to go guy. Also, although I am getting more toned at the gym, I am not a beast, lifting any more weight than usual)

-- How worried should I be about estrogenic /estradiol effects?

(I have seen lots of posts about this issue online, and I was told that an AI could be prescribed if things came up, but it was not prescribed up front). Also, I saw this study and wondered what everyone's thoughts are.. http://www.jurology.com/article/S0022-5347(12)02172-6/fulltext#sec0015



I will post my latest labs (right before therapy started) and the ones I have upcoming at the 5 week mark.

Thanks for being interested, by the way. This board has made me feel less isolated about my low T situation.