I need some help!!!

theodore1983 · Apr 5, 2017

Hello, Im 33 yo male and I have had a rough time lately. In early November I was having testicular pain and in the general area. After many trips to the Doctors/ER all they could find was some minute varicose. By this time I was so worked up my PCP prescribed me with Ativan. I had several family issues come up during that time as well which were very stressful. The ativan did not seem to help. I was on it for 2.5 months with a 3 week taper. I have been off of it for 6 weeks now. I had many issues while on it and off of it. I am still having issues with brainfog, insomnia, energy, drive to do things, anxiety/depression, appetite and poor sex drive. I have been using sleeping aides off and on a very low doses. I have not used them for a few weeks now and my sleep is still not what it used to be. I also saw a psychiatrist during that time and did not think i was a candidate for an anti-pyscotic which was good news to me. I have also been going to therapy once a week since this all started and it doesn’t seem to help but it is nice to talk to someone without criticism. After being off the ativan and still feeling symptoms I started to find that my symptoms were symptoms with low-t. I then sought out an endocrinologist. I had all the proper blood work done as follows. My PCP did prescribe me Testim I have not used it yet due to the end saying hold off until the test results come back. What would you guys suggest??? I was thinking about clomid first??? Dosage?? AI?? I need help. I meeting with a urologist as well tomorrow.

REE T4 1.33 ng/dL 0.82 - 1.77 ng/dL
HEMOGLOBIN A1C 5.7 % 4.8 - 5.6 %
Vitamin D,25-Hydroxy,Serum 49.8 ng/mL
TSH 2.690 uIU/mL 0.450 - 4.50 uIU/mL
FSH 3.1 mIU/mL 1.5 - 12.4 mIU/mL
LH 1.6 mIU/mL 1.7 - 8.6 mIU/mL
PROLACTIN 7.2 ng/mL 4.0 - 15.2 ng/mL
TESTOSTERONE, TOTAL 267 ng/dL 1st test
TESTOSTERONE, TOTAL 222 ng/dL 3 days later
VITAMIN B12 527 pg/mL 211 - 946 pg/mL
CORTISOL - AM 15.9 ug/dL
TSH PM 3.770 uIU/mL 0.450 - 4.50 uIU/mL

All my other blood work came back normal.

CoastWatcher · Apr 5, 2017

Welcome to Excelmale. It certainly appears that you may be dealing with secondary hypogonadism. Given your age, a Clomid protocol should certainly be considered, but two key values for both a Clomid protocol and a standard TRT protocol are not reported: estradiol/sensitive (LC, MS/MS) and SHBG. Do you have those results? Does your doctor have experience managing patients on Clomid?

theodore1983 · Apr 5, 2017

I apparently did not have those test ran. She seemed to be very knowledgeable when discussing it with her. I am meeting with her on Friday and my urologist tomorrow to get two opinions. What should I be looking for?

ERO · Apr 6, 2017

At your young age, I would definitely try Clomid as a first step. See if that can raise your T levels, if not use T injections only as your your second choice. The thing is it takes a skilled Doc to get Clomid to work in a lot of cases - it can be tricky.