Need some help from experienced people, my hormone results

[equel]

Hello there, 27M here.


April last year, I contacted my family doctor cause of low/no libido, very little motivation, no drive and very low libido, I wanted to check my testosterone levels.


We did so, it came back: 9.1nmol (ref range 8.6-35nmol).


He said that I was in reference range so it was no problem, I asked him to be sent to a endocrinologist to be sure, he sent me there.

Some months later, I did blood work for the first meeting with my endocrinologist, It came back:


Testosterone: 5nmol (ref 8.6 - 35nmol)
LH: 6.0 (ref 1.0-10)
FSH: 2.0 (ref 1.0-9)
SHBG: 19nmol (10-50)
Prolactin: 528miu/L (i think)


At the meeting with my endo, I explained my low libido, I couldnt have sex, I had very little energy and my self confidence was down.


She asked me to take my shirt off to check out my muscle mass, I did and she said I had alot of muscle mass so It was weird how my testosterone could be low. I explained that I had been working out for like 10 years, three workouts every week.


She seemed sceptical, but she said she wanted to do a MRI on my hpta cause my prolactin was high, so I had to wait some months for my MRI.


I waited three months, then I did my MRI. Two weeks after I did another blood test checking the hormones yet again.

Today after many months, my endo call me and say, MRI didnt show no tumours, so that was good. My testosterone remained low, this time:


Testosterone: 6.0 (8.6-35nmol)
LH: 6.0 (1.0-10)
FSH: 2.0 (1.0-9)
Prolactin: 280miU/L
SHBG: 20nmol (10-50)




Then she tells me: "Lets be honest now, I do believe you use steroids to push your testosterone down before the blood tests, to get testosterone replacement therapy", I told her I absolutely did not. She told me that I had too much muscle mass to be testosterone deficient and that was very very weird and shouldnt happen.


I told her I built all my muscle mass several years ago when I felt fine, and now I dont build any muscle no more, only maintain. (My muscle mass isnt really super good, I mean I can bench 200lbs for 1 rep).


She told me she didnt believe me and that I probably cheated to get testosterone replacement therapy, but then she told me she could sent me to YET ANOTHER endocrinologist, and that I had to wait for another appointment.






Can anyone make any sense of this? I mean, I know for sure I have never taken any steroids, but Ive read you can have low T yet a decent muscle mass. The problem for me isnt really my body, its that I have no mental strenght no more, like semi-depressed, no libido, cant almost get a boner and I feel no drive for nothing.




Input anyone?

 

[Nelson Vergel]

Wow...run away from her! Although if you are really muscular, what she thought is not unfounded. But the way she said it and the fact that she does not trust you is ground for dismissal from both sides.

 

[zojo360]

Judging from your prolactin levels, there lies a red flag. High prolactin will kill your sex drive. After sex or more specifically, ejaculation, prolactin levels rise causing men to go into the refractory period. You pretty much are done with sex and now looking for food or sleep. If your running around in a state of elavated prolactin, sex would not be such a desire.

Others with way more knowledge hopefully will elaborate.

 

[equel]

Wow...run away from her! Although if you are really muscular, what she thought is not unfounded. But the way she said it and the fact that she does not trust you is ground for dismissal from both sides.

Hello Vergel and thanks for your input.

Well, Im not really that muscular, I mean, Ive been working out since my teens and I barely even bench 225lbs, I guess I could come off as "muscular" to your average 50+ year old female endocrinologist, but compared to other guys who got to the gym frequently Im not big what so ever.

I told her, that you could have normal/decent muscle mass even if ur testosterone was low, but nope, she said if your testosterone was low most of your muscle mass would dissapear.

Ive waited so many months for this, so I was very dissapointed, she didnt even wanna do a "trial period" with testosterone to see if my symptoms dissapeared, she was very sure I had been using anabolic steroids.


So yeah, not quite sure what to do now, she told me she should send me to another specialist but she couldnt say when or how long I had to wait.

 

[equel]

Judging from your prolactin levels, there lies a red flag. High prolactin will kill your sex drive. After sex or more specifically, ejaculation, prolactin levels rise causing men to go into the refractory period. You pretty much are done with sex and now looking for food or sleep. If your running around in a state of elavated prolactin, sex would not be such a desire.

Others with way more knowledge hopefully will elaborate.

Hello
Thanks for your response.

Yes my prolactin was somewhat above the range the first time I tested, thats why she wanted to do a MRI on me. But the second time, prolactin was within range and the MRI didnt show any tumours so ..

 

[ERO]

Wow - that doctor is truly a piece of work! Fire her and seek help elsewhere. If you are in the USA, Defy Medical or Prime Body are both site sponsors and come highly recommended. Also, as a guideline, your regular GP or Endo are typically the worst resources for TRT (of course there are exceptions) even if they treat you, it is quite often with a protocol that is destined to fail. You need a dedicated TRT clinic like Defy Medical to truly get cutting edge treatment.

 

[Vince Carter]

Reminds of the guy that reported his Dr looked at his hairy chest and told him he was fine.

 

[Dr Justin Saya MD]

Agree with others, run away from her and find another doctor.

She doesn't understand her own area of medicine (endocrinology)...if you were taking exogenous testosterone to "falsely" drive down your testosterone in an attempt to game the system your LH WOULD BE LOW/SUPPRESSED. This indicates a lack of basic understanding of the HPTA. To be honest, even if she would offer you treatment you likely would have poor results simply due to her poor understanding/knowledge in this area.

 

[equel]

Is this a correct statement of her?

"If the problem was the testicles, your LH would go into overdrive and produce LH way over the range".

Cause thats what she said when I suggested I was primary, that my balls somehow didnt work (or work optimally).

 

[Dr Justin Saya MD]

If you were very strongly and EXCLUSIVELY primary hypogonadal, then LH will typically run high. Truth is, in medicine we do not typically see "textbook" cases of 100% primary or 100% secondary...most are a combo of both, perhaps with one being predominant. With your LH already at 6 with such a low concurrent testosterone level, I would put you more on the PRIMARY end of the spectrum.

 

[Gene Devine]

Adenoma's can be so small sometimes that they don't shop up well on an MRI; it happens.

The high Prolactin combined with suppressed testosterone serum levels still point to a Adenoma in my opinion.

She should have prescribed a low dose of Cabergoline to get your levels to mid range and see how you feel in a few weeks.

High serum prolactin levels will suppress testosterone production in which is your case.

 

[equel]

Adenoma's can be so small sometimes that they don't shop up well on an MRI; it happens.

The high Prolactin combined with suppressed testosterone serum levels still point to a Adenoma in my opinion.

She should have prescribed a low dose of Cabergoline to get your levels to mid range and see how you feel in a few weeks.

High serum prolactin levels will suppress testosterone production in which is your case.

Hi
I dont get it, my prolactin is now 300 on a range of 100-450, Im not so high anymore, my first reading was around 500. So prolactin is now 300 but test is still very low.

 

[Vince Carter]

Most of the reference ranges I see are something lets say between 1 and 30 (Im just making conversation, not fact). In that scale we would want to be around a 5, upwards of 10 is perhaps where you're getting high(er) Prolactin. I don't know how to convert your test numbers.
Of note when you test for Prolactin...don't have sex or ejaculate for 24 if not 48hrs prior.

 

[equel]

Had an email consulation with a doc today.

M.D.,Ph.D, Associate Professor
Senior Clinical Consultant
Specialist Physician in Diabetology, Endocrinology and Internal Medicine Department of Medicine

Basicly he told me that my testosterone of readings 9, 5, and 6 were completely normal and could mean I had "good genetics and good androgen receptors", so I didnt need more.

Soul draining? yea

 

[CoastWatcher]

Had an email consulation with a doc today.




Basicly he told me that my testosterone of readings 9, 5, and 6 were completely normal and could mean I had "good genetics and good androgen receptors", so I didnt need more.

Soul draining? yea

Yep. I initially consulted someone who held an endowed chair in endocrinology at one of the medical schools here in the city where I live. He wasn't as disconnected from reality as the fellow you reference, but he was of no help whatsoever. It happens over and over...