Went to Urologist Today - Your Thoughts Please

[davidrn]

If you can afford it go to discountedlabs.com and order your own test as a back check (unless you are in one of the back woods states that will not allow to do that).

There is no law against traveling across state lines for labs. Myself, I went with the slip, in Massachusetts,( a state that doesn't allow self testing) and the topic never came up, the slip has a Florida MD name on it.

 

[johnt]

If you can afford it go to discountedlabs.com and order your own test as a back check (unless you are in one of the back woods states that will not allow to do that).

Yes, I plan on doing so in next few weeks. I really think there has to be a lab error. Hopefully I will be wrong and it will come back in the 500 range again.

 

[johnt]

So the last time I had my labs run was several months ago (see post #22 and #26 in this thread). I decided to go to a doctor that specializes in TRT (appointment in a couple of weeks) so I can finally make a decision whether I want to go on TRT, etc. He ordered my blood work, below is a partial screen shot of the results. The Estradiol Test is the regular assay not Sensitive. Estradiol came back at less than 5.0. How the heck is that possible? Over the years my estradiol has ranged from 17.5 - 19.8.

I was on a 17 hour fast when I had blood drawn at 10AM. I am 5'8", 173 pounds so I have some fat on me...need to lose 10 pounds, and I am 47 years old. Would love your thoughts on the blood work.

 

[johnt]

Here is the SHBG Results

 

[CSI007]

I bet you feel like crap with those numbers. Low free T and low E2 made me feel horrible. I can't tell you what to do, but starting TRT is not the end of the world - I dragged my feet for a while trying everything else first. Had I known none of it would have worked I would have started injecting right away.

 

[FeelingLost]

subing to this thread.
Very interesting post johnt thanks for sharing your journey. I look forward to hearing what your PCP or urologist says with those numbers.
I believe many here would say you are in a E2 crash (hell on earth) This would be my focus. Are you still taking the Clomid?
From my very limited understanding of the side effect of low E2 for an extended period of time can lead to male osteoporosis. IMO that is way worse than lowT.
Clomid is an Estrogen Blocker?

 

[johnt]

I was looking up the symptoms of low e2 and many of them match the ones I listed in my first post on this thread. Lately I have been urinating a lot, I do drink a lot of water, and constantly thirsty which also appears to be another symptom of low e2. @feelingLost, I take a multi-vitamin, D3, Fish Oil, Vitamin C, DHEA 25Mg, Green Tea, and Vitamin for eye health (AREDS 2). My diet has been pretty clean and recently started intermittent fasting where I fast 16 hours and eat during 8 hour window. Have no idea why my e2 would be so low.

 

[CSI007]

Your E2 is low because your T is very low. You need T to make E2. At the levels you are at there is nothing you can do outside of some kind of TRT/HCG mono-therapy that will work.

 

[johnt]

Your E2 is low because your T is very low. You need T to make E2. At the levels you are at there is nothing you can do outside of some kind of TRT/HCG mono-therapy that will work.

In 2011 when Total T came back at 377, E2 was 17.5. In 2014 when T came back at 628, e2 was 19.8. In 2016 when T came back at 544, e2 was 19. Now 2017, I would not think e2 would drop so low because I am at 406.

I emailed doctors office and asked if I should retest estradiol or do sensitive blood test prior to my appointment in a couple of weeks. Nurse said no need and to wait until doc reviews. At that time, he may decide to retest. Thought about it and I do not want to wait. I just ordered E2 Sensitive Test through discountedlabs. I am going to have blood drawn tomorrow on a fast. Curious what it comes back at.

I have been doing Intermittent Fasting. I wonder if that would crash e2.

 

[Will Brink]

A couple of weeks ago, I went to my Primary Doctor for physical. I complained of following symptoms:

Fatigue, Irritability, Moments of Sadness, Anxiety, etc. I asked about having T checked. After some push back the doc agreed to run only Total T, which came back at 266. The docs assistant called to give me results and said I am within normal range. I am 46 years old.

I went ahead and made an appointment with a Urologist (I have a PPO so no referral needed). Funny thing is the day before my appointment my Primary Doc calls (two weeks after my original results) to say that after further review she thinks my T is too low but would like to re-run blood work including Free T and if comes back low to discuss treatment options. I declined her request since I had a Urologist appointment.

Today, I went to Urologist and met with the Nurse Practitioner. He said Total T is low and my symptoms also are consistent with Low-T. However, he wants to run the following blood tests first:

Free and Total T, FSH, LH, Prolactin, and Estradiol.

They could not draw blood at the office because they said I needed to fast. I didn't think you needed to fast for this blood work. Is fasting the norm for hormone levels?

I asked what they would typically recommend for treatment assuming low T is confirmed. He mentioned giving me a pill, I think Clomid (used a different name) to try to get my testes to put out more Testosterone. This would be first step to see if I respond well. He said for someone my age sometimes that is all that is needed. If that does not work then Gel or Injections of T along with HCG to avoid testicle shrinkage.

What are your thoughts so far on the direction of the Urologist?

He's already ahead of most, so you're ahead of the curve already. Next will be how/if he chooses to treat it, but sounds worth following his instructions until he gives you a reason not to.

- Will @ BrinkZone.com

 

[johnt]

@will brink Please see post #43 and #44. Would be interested to read your thoughts on the latest labs.

 

[Vince Carter]

@johnt re: your labs in post 43 I'd re-run those, one it's the wrong test anyway and too it's an absurd result.

 

[johnt]

@johnt re: your labs in post 43 I'd re-run those, one it's the wrong test anyway and too it's an absurd result.

@Vince Carter You think I should re-run Total T and Free T as well or just the Estradiol? I have appointment tomorrow at Labcorp for Estradiol Sensitive test.

 

[johndoesmith]

@Vince Carter You think I should re-run Total T and Free T as well or just the Estradiol? I have appointment tomorrow at Labcorp for Estradiol Sensitive test.

I think you should. If you only run E2, and it comes back at 12 8-35 range, but you have no idea where total test is, how would you interpret that? What if it's 20?

Low E2 is one hell on earth that I went through and wouldn't want to do again.

Your doctor sounds like he's sort of informed, but his reluctance to retest a result that seems questionable is concerning in my opinion.

 

[lowe2sucks]

As a contrast, years ago, I was referred to a urologist for low T; one test was even below 200. He had me take my shirt off to examine me, saw that I had chest hair, and said that I was fine.

lol what a moron...

 

[Will Brink]

@will brink Please see post #43 and #44. Would be interested to read your thoughts on the latest labs.

As Vince said, worth re running. When you see a result that does not make sense, best to assume simple lab error of some kind. I had a guy in his 60s come back with a TT of 1500 once. I had him retest and it came back a number you'd expect for his age etc. It was a lab error. Being in the low "normal" range, doc may or may not decide to treat.

 

[FeelingLost]

I think you should. If you only run E2, and it comes back at 12 8-35 range, but you have no idea where total test is, how would you interpret that? What if it's 20?

Low E2 is one hell on earth that I went through and wouldn't want to do again.

Your doctor sounds like he's sort of informed, but his reluctance to retest a result that seems questionable is concerning in my opinion.

I wonder if this reluctance to retest is the doc worrying an insurance will drop his practice if he asks for too many tests too close together? Getting on an insurances companies network (approved list) is pretty important theses days.

 

[Vince Carter]

Ive had that talk with Drs and nurses and it's more like hey I'm paying for it what do you care...and it's just blank stares or "not medically necessary". Thank god for Nelson and discountedlabs.

 

[johnt]

@FeelingLost I am self-pay going to a doctor that specializes in TRT. I have not yet had my first appointment. They ordered the initial labs so I guess the doctor wants to first sit and review them at our first meeting. I did have blood drawn today for E2 Sensitive through discountedlabs.com. The process was quick and easy. I hope to have the results in next few days so I can take it with me to my first appointment. I did not re-run all the tests as that would be too expensive since I recently dropped $300 on getting my blood work completed.

 

[CSI007]

@FeelingLost I am self-pay going to a doctor that specializes in TRT. I have not yet had my first appointment. They ordered the initial labs so I guess the doctor wants to first sit and review them at our first meeting. I did have blood drawn today for E2 Sensitive through discountedlabs.com. The process was quick and easy. I hope to have the results in next few days so I can take it with me to my first appointment. I did not re-run all the tests as that would be too expensive since I recently dropped $300 on getting my blood work completed.

With laborp its the luck of the draw on getting this test back quickly. One time I did it and had it back in 2 days. The most recent test took 8 days to get the results.