TRT help/Suggestions...

[hpylori]

I'll briefly describe my situation:

It all started when I had this hiatal hernia surgery, after the surgery my esophagus was not moving my food into my stomach because of an esophageal spasm in my LES. I was put on a PICC line with TPN feedings for 18 hours a day for about six months. After they took me off the TPN feedings, I noticed my left nipple was getting very sensitive and actually started to grow. So like many people, I got online and read as much as possible about it and contacted my dr. to have blood work done. To make a long story short, he prescribed Tamoxifen and gave me a script for Cypionate 100mg every week. There was some tweaking on both doses after I went in with a list full of questions which I dont think my Dr. was ready for. It's been like six weeks and my nipple seems to be back to normal (i'm still tapering down my Tamoxifen) but my main issue now is that i have more questions or the same questions that didn't get answered. Such as adding HCG on days 5 and 6 for the testicular atrophy, which I can definitely tell my testes are getting softer. After reading even more today I'm wondering if I should find an Endocrinologist to help me with this whole hormone imbalance as opposed to my family Dr. who has been great so far, I mean I feel alot better than where I was when I started. I just dont want to have to tell the Dr what course of action we should take, I want the Dr to tell me. Especially if for some reason my estrogen level has been the culprit this whole time. I'm just kind of lost and really need some guidance. My doc also did a lipid panel on me and said my LDL is high and gave me a script for simvastin which I read earlier that the "statin" group of cholesterol meds may actually raise your estrogen levels. I'm trying to do this right and I'm still young (33) and dont want my hormone levels to be all jacked up. Please advise....

[hpylori]

I guess my real question is: What kinda of doctor would be the best to see to make sure that everything is being done correctly? Endocrinologist?

[starkiller]

Talk to your doctor , tell him you did research and your simvastin may cause increase in estrogen levels, should I test for estrogen levels? Don't be afraid, ask him what you want to know he is the doctor. I felt the same way you did on my initial approach with my doc but, I thought to-myself, how am I to help myself if I do not tell him/her my concerns.

[hpylori]

Starkiller, Thanks for your response! Finally... So here's the thing, I did a lot of reading/research as to why I was feeling the way I was, after being taken off of the PICC line (peripherally inserted central catheters) with TPN (total parenteral nutrition) feedings after about six months. I had no energy, felt mentally slow, sleepy all the time and I can go on and on about my symptoms. So finally I went to my Dr. and told him everything and he ordered "full bloodwork" went I went in for the follow-up I had asked about my testosterone and estrogen levels and he said he didn't order those test and I explained to him why I thought I needed the tests and he ordered them along with a lipid panel just to cover ALL angles. I got a phone call from his nurse who told me that my testosterone levels were in the normal range but that the Dr. thought that it was low (273) and that he wanted me to start on Testosterone shots. I asked the nurse about my Estrogen levels and she said that she didnt seee that he ordered that. You can imagine how I felt, if not, then lets just say I was a wee bit peeved. I asked about having the estrogen levels checked and she said that when we run bloodwork again to remind her and she'll make sure we do it. So I started on the Cypionate which at first, he prescribed it to me for 200mg every 4 weeks. At first I was like ok but after about 10 days I was like something isnt right. So I get online and find this site and start reading from steroid profiles to BB cycles to TRT/HRT dosing to HCG for the testicular atrophy to HGH levels to Anti Estrogens to you name it. So I get a call and they want me to come in to go over my lipid panels so I ask the nurse again over the phone about the 200mg shots every four weeks and she said that they normally deal with older men and that it was usually sufficient for them but being that I was 33 that they would want to get my levels higher than a 65 year old so to take 200mg every two weeks. SO I did but it turned out to be every ten days for the next couple of shots then after reading about half lifes and how testosterone aromatises and blah blah blah I just started doing 100mg every 7 days. I finally went in to go over the lip panel results and after going over all that and him prescribing me simvastin, I asked him, "do we have time to talk about this Testosterone therapy thingy?" With a perplexed face he said sure and I busted out all the notes I had taken on my iphone and started shooting away. I wasnt really asking questions but was basically reading off a "lecture" I had compiled from the research I was doing online and at the end he said "interesting" and I started by saying "so do you think I should take 100 mg every week and he kinda did a little math in his head real quick and said yes, that the levels would be more balanced and I asked about the HCG and he kinda discussed it with himself real quick and said that he'd have to do some research and if need be, we can use it. Well my testes are definitely softer than they've ever been and I'm thinking I need it. The other thing that I'm trying to figure out is why my nipple would be sore after they took me off the TPN feedings, like within 2 weeks or so. WHich was waaayy before I even started the cypionate. That's why I think I should maybe just have been on HCG at first then re-done the blood work and gone from there. SO I might not even need the TRT if I can restart or fix my hormone imbalance. I'm the one who figure out the tamoxifen . I asked for arimidex and he said we should start with the tamoxifen but after reading, they are not the same and do different things. Either way the tamoxifen has worked so far and I'm still tapering down (my idea again). So I'm kinda frustrated that they've had me start on this TRT without really doing the correct bloodwork to see why I'm deficient. Me being on the TPN feedings for so long could have totally messed my cholesterol & hormone levels up. I want to figure out where to go from here, any suggestions? SHould I start over? I want them to test everything. HGH levels and dhea, everything. Is there a specific list of blood tests to have done? If so can someone break them down to me so that I can make a list and call the Dr.s' office tomorrow or as soon as possible to have the blood work done and I'll make sure I get a copy of the results this time since last time was over the phone and I forgot to ask when they gave me my lipid panel results. So where should I start if I'm going to walk my Dr. through this whole thing, holding his hand all the way through? I have no problem telling him what I think and what I feel but how can I get through to him about just wanting my levels to be in a normal range for my age (33). Plus I dont even know what the hell I'm doing but want to make sure things are done correctly so that I can feel myself agin and that is why I was asking what type of Dr. would be the best to see for all of this. It seems soo complicated and I'm still kinda in a fog but am slowly coming out of it. SHoot, you figure at one point, within 11 days, I lost 32 pounds from this whole surgery ordeal. Definitely not fun. Ok I'm starting to ramble....

[hpylori]

Okay I found this so far:

Free testosterone
Total Testosterone
Estrogen/estradiol
PSA
DHEA
DHT
LH
SHBG

Did I forget anything like HGH levels or any other levels I should have checked?