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Jamo81

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Hi guys, hope all is well.

I eventually managed to get my endo to look closer at my thyroid. If any of you kind experts could give me some feedback it would greatly appreciated.

Briefly, I am 34, in the UK, on Sustanon 250 every weeks since Dec 2014. Had been suffering fatigue, muscle loss, lower back and sciatic nerve problems, concentration issues and mild gastrointestinal discomfort but beginning to feel better slowly. I have a medical condition that caused my testicles not to descend. They are going to be removed due to the risk of cancer, but all they really tell me is that they are not working properly, although it is quite clear that they worked to some degree as Total T has never been recorded as low. I have never suffered with libido or ED problems, they know this.

My most recent blood work did not contain testosterone levels but are posted below. After my last thread I was recommended I get both Free T3 and T4 looked at.

02/06/16

TSH 1.74 mU/L (0.4-4.0) Previous TSH results showed 3.13, 1.19 and 2.21 over the last 17 months.
FREE T3 - 5.9 pmol/L (3.3-6.1)
FREE T4 - 15.7 pmol/L (9.8-18.8)


Also also got tested for Celiac disease, IgA Tissue Transglutaminase <0.1 u/ml (0-3) which I assume is a negative. I believe my issues could be mainly linked to some sort of gastrointestinal problems.

Also had a FBC done but all appears in order there but can post if necessary.

17/11/15

Testosterone 21 nmol/L (8.4-28.7)
This test was carried out at my request right before my injection, so the last day of the 3 weeks. I expected something more comprehensive but this was all i got.

16/10/15

Testosterone 29.4 nmol/L (8.4-28.7)
SHBG 106.1 nmol/L (17.3-65.8 )
Free Androgen Index 27.71 (23.3-103) TSH 2.21 mU/L (0.4-4.0)


07/04/2015 (4 MONTHS INTO THERAPY)

TSH 1.19 mU/L (0.4-4.0)
LH 6.6 U/L (1.0-9.0)
FSH 18.5 U/L (1.0-9.0)
Oestradiol 135 pmol/L (0-150)
Prolactin 204 mU/L (0-350)
Testosterone 38.8 nmol/L (8.4-28.7)
SHBG 87.5 nmol/L (17.3-65.8 )
Free Androgen Index 44.34 (23.3-103)
Total 25-OH Vitamin D 21 nmol/L

25/11/2014 (BEFORE TRT)

LH - 17.9 U/L (1.0-9.0)
FSH - 42.0 U/L (1.0-9.0)
Prolactin - 150 mU/L (0-350)
Testosterone - 20.6 nmol/L (8.4-28.7)
SHBG - 120.4 nmol/L (17.3-65.8 )
Free Androgen Index - 17.11 (23.3-103)

23/09/2014 (BEFORE TRT)

LH - 23.6 U/L (1.0-9.0)
FSH - 46.2 U/L (1.0-9.0)
Prolactin - 664 mU/L (0-350)
Testosterone - 27.0 nmol/L (8.4-28.7)
Cortisol - 649 nmol/L (275-690)
TSH - 3.13 mU/L (0.4-4.0)

25/11/2014 (Before TRT)

LH - 17.9 U/L (1.0-9.0)
FSH - 42.0 U/L (1.0-9.0)
Prolactin - 150 mU/L (0-350)
Testosterone - 20.6 nmol/L (8.4-28.7)

At my most recent appointment with my endo we discussed my testosterone levels. I believe that even though my total T is good throughout, my free T appears to drop quite low in the last week of the 3 weekly Sustanon 250 injection. Which in turn allows my SHBG to elevate and further rob me of free T. I also believe that when my total T drops below around 25nmol/L, my free T dips below the bottom of their reference range. His response was suggesting changing to Nebido, at every 12 weeks. At first I was kind of open too it and left with some level of optimism, but now I don't really think it is the way forward and would rather try and bring the frequency of the Sustanon down to at least every 14 days. I'd like every 10 days as per the norm with the rest of the world but I can't envision me getting that. It's not if I am having any real problems directly linked to low testosterone, but if I am going to be on therapy for the rest of my life I want to get the best out of it.

All in all though, after 3 years of feeling terrible and in decline, 14 or so months on TRT, 8 months on Vitamin D+K2 and magnesium, and around 2 months doing physio for my lower back issues. I think I'm slowly getting better but still feel run down at times.

Cheers,

Jamie
 
Defy Medical TRT clinic doctor
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