Please advise if I do need TRT or diet/nutrition can help.

[dmelniko]

Hi all,

I am 36 year old
Height 6.1
Weight 238
BF 25-26 %


, back in the gym after 5 years and eating mostly a good diet now and lost 6% since than but have stalled for the last 3 weeks (not eating a deficit), not doing any AAS cycles. Went to my general doctor to discuss the low sex drive I am experiencing (wife started to get very unhappy).

here is a snippet of some of my BW :

TSH 1.40 mIu/l
Prolactin 129 mIU/l
Testosterone Total 8.2 nmol/l
SHBG 27.6 nmol/L
Testost. Free Calculated 0.175 nmol/L
Cortisol 8 am (B) 267 nmol/l



Unfortunately my doctor has no experience with TRT at all and has forwarded me to a ENDO but getting to a consultation will take me 2 months via my insurance , or I can go to a private one and have a reimbursement (tho I am only eligible 3 times a year).

So my question is should I try working out more and conducting a healthy life style and check my self again in couple of months or the levels can never go back into a normal range from here?

Thanks in advance,
-D

[powerlifterty16]

Hi all,

I am 36 year old
Height 6.1
Weight 238
BF 25-26 %


, back in the gym after 5 years and eating mostly a good diet now and lost 6% since than but have stalled for the last 3 weeks (not eating a deficit), not doing any AAS cycles. Went to my general doctor to discuss the low sex drive I am experiencing (wife started to get very unhappy).

here is a snippet of some of my BW :

TSH 1.40 mIu/l
Prolactin 129 mIU/l
Testosterone Total 8.2 nmol/l
SHBG 27.6 nmol/L
Testost. Free Calculated 0.175 nmol/L
Cortisol 8 am (B) 267 nmol/l



Unfortunately my doctor has no experience with TRT at all and has forwarded me to a ENDO but getting to a consultation will take me 2 months via my insurance , or I can go to a private one and have a reimbursement (tho I am only eligible 3 times a year).

So my question is should I try working out more and conducting a healthy life style and check my self again in couple of months or the levels can never go back into a normal range from here?

Thanks in advance,
-D

forget the endo, go to a urologist..but look him up online first and make sure he went to a good medical school and has high reviews and call to make sure he does trt, and hcg...ask the endo too.

[dmelniko]

forget the endo, go to a urologist..but look him up online first and make sure he went to a good medical school and has high reviews and call to make sure he does trt, and hcg...ask the endo too.

Looking some up.
Why would it be important if he does HCG ? sorry but my knowledge is still in diapers regarding TRT.

[100%]

Hi all,

I am 36 year old
Height 6.1
Weight 238
BF 25-26 %


, back in the gym after 5 years and eating mostly a good diet now and lost 6% since than but have stalled for the last 3 weeks (not eating a deficit), not doing any AAS cycles. Went to my general doctor to discuss the low sex drive I am experiencing (wife started to get very unhappy).

here is a snippet of some of my BW :

TSH 1.40 mIu/l
Prolactin 129 mIU/l
Testosterone Total 8.2 nmol/l
SHBG 27.6 nmol/L
Testost. Free Calculated 0.175 nmol/L
Cortisol 8 am (B) 267 nmol/l



Unfortunately my doctor has no experience with TRT at all and has forwarded me to a ENDO but getting to a consultation will take me 2 months via my insurance , or I can go to a private one and have a reimbursement (tho I am only eligible 3 times a year).

So my question is should I try working out more and conducting a healthy life style and check my self again in couple of months or the levels can never go back into a normal range from here?

Thanks in advance,
-D

Add lab ranges.

[dmelniko]

Add lab ranges.

Here are the results with ranges:

TSH 1.40 mIu/l 0,50 - 4,80
Prolactin 129 mIU/l 45 - 375
Testosterone Total 8.2 nmol/l 8,4 - 28,7
SHBG 27.6 nmol/L 10,0 - 57,0
Testost. Free Calculated 0.175 nmol/L
Cortisol 8 am (B) 267 nmol/l 118 - 618

[100%]

Your total testosterone is low need more blood work to find out why.
Testosterone Total 8.2 nmol/l 8,4 - 28,7 =236.3 ng/dL range 242-827 ng/dL

[dmelniko]

Your total testosterone is low need more blood work to find out why.
Testosterone Total 8.2 nmol/l 8,4 - 28,7 =236.3 ng/dL range 242-827 ng/dL

Tnx for the reply , here is all the lab work I had done couple of days prior to the ones I posted, which other tests would be needed ?

Glucose 68 mg/dl 70 *(----------------------) 100
Urea (B) 29 mg/dl 17 (---------*------------) 43
Creatinine (B) 0.9 mg/dl 0.67 (---------*------------) 1.17
eGFR greater than 60 ml/min/1.73m²
K+ Potassium (B) 4.4 mmol/l 3.5 (-----------*----------) 5.1
Na- Sodium (B) 139 mmol/l 136 (------*---------------) 146
Ca-Calcium (B) 9.6 mg/dl 8.1 (-------------*--------) 10.4
Cholesterol 211 mg/dL
Triglycerides 126 mg/dl
HDL-Cholesterol 54 mg/dl
Non-HDL Cholesterol 157 mg/dl
LDL-Cholesterol 132.1 mg/dl 0 (-----------------*----) 160
Albumin (B) 4.8 g/dl 3.5 (----------------*-----) 5.2
Vitamin B12 294 pg/ml 211 (--*-------------------) 911
Vitamin D 25 (OH) 22 ng/ml 20 (*---------------------) 100
WBC-Leucocytes 6.7 10*3/micl 4.5 (-------*--------------) 11
RBC-Red Blood Cells 4.99 10*6/micl 4.5 (----------*-----------) 5.5
Hemoglobin 14.6 g/dl 13.5 (-----*----------------) 17.5
Hematocrit 42.8 % 41 (---*------------------) 53
MCV-Mean Cell Volume 86 fl 79 (--------*-------------) 97
MCH-Mean Cell Hemoglobin 29.3 pg/cell 27 (------*---------------) 35
MCHC-M.Cell Hb cont. 34.1 g/dl 32 (-----------*----------) 36
RDW-Red Cell Distri.Width 13.2 % 11.6 (---------*------------) 15
Platelets 397 10*3/micl 150 (-----------------*----) 450
MPV-Mean Platelet Volume 10.8 fl 8.5 (----------*-----------) 12.9
Eosinophils % 3.6 % 0 (------------*---------) 6
Eosinophils # 0.24 # 0 (--------*-------------) 0.6
Basophils # 0.03 # 0 (---*------------------) 0.2
CMV IgG NEGATIVE
CMV IgM (Screen) NEGATIVE

[100%]

You need lh/fsh to start to determine weather you are primary or secondary.

[dmelniko]

You need lh/fsh to start to determine weather you are primary or secondary.

Thanks for your input, anything else which might be missing in my bloodwork?
I'll have my DOC send me to the tests asap.

[100%]

Read this thread http://forums.steroid.com/hormone-re...physician.html

[dmelniko]

Read this thread

Darn need to check my brain as well , have reed that a week ago or so.

Anyways your support is very much appreciated, tyvm again!

[APIs]

Honestly, you may want to try dropping your BF first. It seems you have a decent sized frame already, dropping 10% BF will do wonders. Always did for me in the past. Then go from there. Just a thought...

[powerlifterty16]

Honestly, you may want to try dropping your BF first. It seems you have a decent sized frame already, dropping 10% BF will do wonders. Always did for me in the past. Then go from there. Just a thought...

eh i honestly think that's overraided..my t is the same at 205 as it was at 160.although im hoping my bf isnt much different...my dad also has a big beer gut even though he doesnt drink beer and his t is 412..which isnt great but not terrible for a 56 yr old.

[dmelniko]

Honestly, you may want to try dropping your BF first. It seems you have a decent sized frame already, dropping 10% BF will do wonders. Always did for me in the past. Then go from there. Just a thought...

I went to one of the most respectable endos in my country today, we discussed this matter but he is very skeptic regarding this at my current T levels, also symptoms I am suffering from make me want to do the TRT asap.
He requested from me to do the additional hormone panel tests as "100%" has suggested to define if more lab tests are needed or to continue with the TRT getting them done on Tuesday .
When we discussed treatment options we jumped straight away onto injections since I wouldn't want to take risks gels transferring to my child, he talked about injections which are being admission every 3 weeks and a option called nebido which is done every 3 months, with either option he said a front loading phase would be done.
Anyhow I guess I'll be more smarter after the additional BW.

[powerlifterty16]

I went to one of the most respectable endos in my country today, we discussed this matter but he is very skeptic regarding this at my current T levels, also symptoms I am suffering from make me want to do the TRT asap.
He requested from me to do the additional hormone panel tests as "100%" has suggested to define if more lab tests are needed or to continue with the TRT getting them done on Tuesday .
When we discussed treatment options we jumped straight away onto injections since I wouldn't want to take risks gels transferring to my child, he talked about injections which are being admission every 3 weeks and a option called nebido which is done every 3 months, with either option he said a front loading phase would be done.
Anyhow I guess I'll be more smarter after the additional BW.

makes me sick these idiots get so much respect..most respected endo? every 3 week injections?

he is a moron.

[dmelniko]

makes me sick these idiots get so much respect..most respected endo? every 3 week injections?

he is a moron.

powerlifterty16 , he was discussing this in a swift context... but what I recall he mentioned doses of 100mg each week or 250mg each 20 days is the normal regime of treatment but will be adjusted as needed to elevate (thats either for cypionate and enanthate).
For nebido the normal regime is every 12 weeks.

Why the big hate for endo's , my guy comes with a very impressive background.

[powerlifterty16]

powerlifterty16 , he was discussing this in a swift context... but what I recall he mentioned doses of 100mg each week or 250mg each 20 days is the normal regime of treatment but will be adjusted as needed to elevate (thats either for cypionate and enanthate).
For nebido the normal regime is every 12 weeks.

Why the big hate for endo's , my guy comes with a very impressive background.

i have a big ahte for doctors in general, because getting trt has been near impossible unless i want to go to someone who has no idea what they are doing and wants tons of cash.

[dreadnok89]

Ya every 3 weeks is a roller coaster. Majority of endos know nothing trt. What good is it if this country renown endo only knows about diabetes. Not being dicky

[EverettCD]

forget the endo, go to a urologist..but look him up online first and make sure he went to a good medical school and has high reviews and call to make sure he does trt, and hcg...ask the endo too.

I second this statement. My Dr is top notch & stays current with TRT protocols. When I found him thanks to HRTSTUDENT & another guy here that I can't remember it was like stepping into a new world. It makes all the difference in the world to be treated by a Dr that specializes in TRT & fertility for men.

Sent from my iPhone that was manufactured in a sweat shop in China

[m_donnelly]

We'd all prefer to raise our test levels without medical intervention. But, sometimes that just won't happen because of the severity of the hormone imbalance.

I've fought to drop weight over the last decade and its gone the opposite direction. I've just kept putting on weight. I'm a former competitive natural bodybuilder and powerlifter with a double bachelors in human development so I know what I'm doing.

But, the low test levels just make it impossible to strip off weight.

[laser]

I was somewhat in the same boat. I was scoring at the low end of my T range. Then about a year later it hit me like a ton of bricks. So much fatigue it was a task to do daily hygiene. I praise my wife for helping me through this tough time, and taking on the big load. She got me to the DOC, they did all kinds of labs, over, and over, had every test done, doppler, heart stress test/with contrast, etc...expensive stuff to....after it was all said, and Done they billed my Ins over 40k. I still felt just as bad even more exhausted after all the testing.
I went and found a TRT doc, and my T was so low, embarrassing to even post the results. I am kinda pissed they overlooked the Obvious.....

Although I do have a good primary Doctor. I did not know what her reaction was going to be, but when I went over the test results with her, told her I am on TRT, she was happy for me. Then I find out she is very knowledgeable about male hormones, and totally went over everything with me. If in the future, if I wanted she would have no prob with treatment for me. It feels good to have everyone in the loop.

I hope these little experience stories help you out..good luck

[powerlifterty16]

I was somewhat in the same boat. I was scoring at the low end of my T range. Then about a year later it hit me like a ton of bricks. So much fatigue it was a task to do daily hygiene. I praise my wife for helping me through this tough time, and taking on the big load. She got me to the DOC, they did all kinds of labs, over, and over, had every test done, doppler, heart stress test/with contrast, etc...expensive stuff to....after it was all said, and Done they billed my Ins over 40k. I still felt just as bad even more exhausted after all the testing.
I went and found a TRT doc, and my T was so low, embarrassing to even post the results. I am kinda pissed they overlooked the Obvious.....

Although I do have a good primary Doctor. I did not know what her reaction was going to be, but when I went over the test results with her, told her I am on TRT, she was happy for me. Then I find out she is very knowledgeable about male hormones, and totally went over everything with me. If in the future, if I wanted she would have no prob with treatment for me. It feels good to have everyone in the loop.

I hope these little experience stories help you out..good luck

doing hygiene rituals is a chre for me too im lazy to the max.

[dmelniko]

Well my additional blood work just came in.

LH - Luteinizing Hormone 7.9 IU/l 1,0 - 9,0 .(........*.).
FSH 13.3 IU/l 1,40 - 18,1 .(......*...).

What do I make out these ?

[powerlifterty16]

Well my additional blood work just came in.

LH - Luteinizing Hormone 7.9 IU/l 1,0 - 9,0 .(........*.).
FSH 13.3 IU/l 1,40 - 18,1 .(......*...).

What do I make out these ?

your balls are dead..trt is your only option

[dmelniko]

your balls are dead..trt is your only option

so no HPTA restarts might help here?

[dmelniko]

I was somewhat in the same boat. I was scoring at the low end of my T range. Then about a year later it hit me like a ton of bricks. So much fatigue it was a task to do daily hygiene. I praise my wife for helping me through this tough time, and taking on the big load. She got me to the DOC, they did all kinds of labs, over, and over, had every test done, doppler, heart stress test/with contrast, etc...expensive stuff to....after it was all said, and Done they billed my Ins over 40k. I still felt just as bad even more exhausted after all the testing.
I went and found a TRT doc, and my T was so low, embarrassing to even post the results. I am kinda pissed they overlooked the Obvious.....

Although I do have a good primary Doctor. I did not know what her reaction was going to be, but when I went over the test results with her, told her I am on TRT, she was happy for me. Then I find out she is very knowledgeable about male hormones, and totally went over everything with me. If in the future, if I wanted she would have no prob with treatment for me. It feels good to have everyone in the loop.

I hope these little experience stories help you out..good luck

Really sucks you went trough so much trouble before getting a correct treatment, hopefully my path will go smoother, thanks for sharing your experience much appreciated!

[powerlifterty16]

so no HPTA restarts might help here?

nothing to restart, you're already functioning fine, your balls arent responding.

[dmelniko]

We'd all prefer to raise our test levels without medical intervention. But, sometimes that just won't happen because of the severity of the hormone imbalance.

I've fought to drop weight over the last decade and its gone the opposite direction. I've just kept putting on weight. I'm a former competitive natural bodybuilder and powerlifter with a double bachelors in human development so I know what I'm doing.

But, the low test levels just make it impossible to strip off weight.

Can definately say the same, BF stripping for me looks like a endless nightmare, in the past I would pack on 10-15 pounds when going on to a vacation (drinking , eating junk a lot of sleepless night etc) and than hitting the gym and stripping it off as fast as 1-2 months without even following a strict diet.

Now with age and those darn low T levels things seem to be impossible. It amazes me that I stopped consuming alcohol and cigarettes completely 2 years ago (because I did not want to be the dad smoking a cigarette over the head of my son and I cant drink and not having a smoke in the hand) and things just went down the road all together.

[dmelniko]

nothing to restart, you're already functioning fine, your balls arent responding.

ohh well ... guess I'll be on the needle soon .. The levels show primary hypogondasim I assume?

[powerlifterty16]

ohh well ... guess I'll be on the needle soon .. The levels show primary hypogondasim I assume?

yup..use insulin needles, wont feel it

[dmelniko]

yup..use insulin needles, wont feel it

umm ok ...

[powerlifterty16]

umm ok ...

ok sorry or helping...

[dmelniko]

ok sorry or helping...

Sorry didn't meant to sound in a bad way, your help is very much appreciated thank you.

[dmelniko]

My endo called today after he saw the lab results and told me to do an MRI.
Thoughts?

EDIT:
This he added in his follow up letter to me:

14/8/13
Follow-up

Results of LH and FSH show the following: LH 7.9, FSH 13.3. Both are in the high-normal range.

Interpretation: if the patient has primary hypogonadism, FSH and LH should be above normal. While it may be that the values have risen from baseline, they still are within the normal range.
Therefore, the possibility of secondary hypogonadism must be excluded. Of note, prolactin and TSH are normal, indicating that TSH and prolactin secretion have not been affected.

Suggestions:
1. Repeat Prolactin, TSH, T3 and T4
2. Obtain level of IGF-1 (to assess GH secretion)
3. Obtain MRI of the brain, to assess the anatomy of the pituitary and hypothalamus