Trt help??

[TRTony]

Im 23. Got bloods done. In april im 383. 2 weeks ago im 177 at 2pm. Last week im 326 at 8 am. Estrogen is also 70 and lh hormone is 2.1. I have no energy low libido ect. Its bs. Kaiser wont help me say im normal range. Does anyone know where i can fid an endo in the east bay california that wont cost me a lot? Or where to get anythng. Very frusterating time for me.

[xtitan1]

Hey Tony, welcome to the forum. I hope you aren't offended that I kind of re-organized your post as it was a little bit of a run-on stream of thought. Is there any way you can fill in the blanks such as weight, height, reference ranges for those values, as well as which estrogen test specifically you are referring to?

Age: 23
Weight: 147 pounds
Height: 5'6"
Bodyfat: ~16% (all in the mid section, super thin arms and legs)
Exercise: 3 days a week of weight training, 3 days a week of cardio training, and MMA
Diet: 1700 calories a day ( 200g/145g/40g - P/C/F)


Symptoms:

• No Energy
• Low Libido

B/W--

April '12
Total Testosterone: 383

Mid July '12
Total Testosterone: 177 (drawn at 2PM)

Late July '12
Total Testosterone: 326 (drawn at 8AM)
Estrogen: 70
LH: 2.1





The following is from the Finding a TRT physician sticky on initial labwork:

INITIAL LABWORK

Following a good Medical History, which laboratory assays should be run as part of your initial hypogonadism workup? Following is my list, but certainly other specialists in this area run expanded or attenuated panels, per individual clinical experience and expertise. Of note, additional tests which should be included to complete the true comprehensive Anti-Aging Medicine workup (i.e. inflammatory markers, insulin , good and true comprehensive thyroid study, etc.); this chapter is concerned solely with administering TRT. And as always, the panel is tailored to the individual patient. Here they are:

• Total Testosterone
• Bioavailable Testosterone (AKA “Free and Loosely Bound”)
• Free Testosterone (if Bioavailable T is unavailable)
• SHBG
• DHT (perhaps) *Gel user especially pay attention to this.
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• Prolactin
• Cortisol
• Thyroid Panel
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA (age dependent)
• IGF -1, IGFBP-3 (if HGH therapy is being considered)
Vitamin D

[Vettester]

Tony, welcome to the forum, glad you joined.

As xtitan stated, we need your help a little with filling in the blanks, and getting us more familiar with who you are. I have a sticky (New Members) in this forum that will help you with the organizational aspects we are looking for.

Additionally, you should invest the time to read all of our stickies, and most definitely the one at the top with Finding a HRT Doctor. That will give you some ammo in your quest with finding a new physician in your area.

Screw Kaiser!!! Unless you have a fatal condition, they can tend to be worthless for this type of stuff. My first steps of TRT were with Kaiser, and I dealt with an idiot endo who told me that it was illegal for patients to self medicate, and that the only people that use HCG are the ones trying to be like Manny Ramirez. Unless you get an exceptional referral, most of their staff just parrot the lab reference ranges as the gospel.

[TRTony]

Thanks guys.heres more info. 5ft6 148lbs.Started medication like Ritalin and Luvox when i was 8.have no idea if that played in my puberty/hormones.




TSH 1.21 range 0.10 - 5.50 uIU/mL
TESTOSTERONE , ULTRASENSITIVE, LC MS/MS- 326 range 250 - 1100 ng/dL
Testosterone free- 74.5 range 35.0 - 155.0 pg/mL
Prolactin 6 range 2 - 18 ng/mL
LH 2.1 range 1.0 - 12.0 mIU/mL

Nips leak a little when i squeeze them but might be normal with Luvox,hard time gaining mass but store onto fat easier,actually libido is fine i just told doc that it was low and all he gave me was levitra. i do in fact have a lot of mid day low energy and thats when my levels dropped to 177.also since high school i constantly get injuried pretty easily.have a high voice too lol.

there are a few endos out here but they want 200-300 bucks just for a visit and i have no idea if they will even prescribe me anything.

[HRTstudent]

It looks like your nuts might work okay, but your brain is not sending enough signal telling them to work.

While your TSH looks good, it seems to be debateable whether or not TSH is the end-all be-all. Having said that, if you have insurance then the cost of getting your T3 and T4 are worth it, especially if diagnostic labs are covered 100%.

Id also like to check your vitamin D, B12, and ferritin. These are 3 important labs that are reliable, commonly a source of deficiency/problems, and easily corrected.

Estradiol is worth getting a baseline, but the chances of it being your problem are not likely.

Do you want to go on TRT or are you willing to consider other options?

Are you planning on having kids in the next 2 years?

[kelkel]

Agree with above. Schedule an MRI to rule in/out pituitary issues. Begin supplementing with vit D immediately if not already doing so. It will improve your free T level.

[TRTony]

o ya i forgot estrogen is 70. i get vit d in orange triad.

[redhawk01]

Orange triad only has 1000iu's per 6 cap dose. Need to take at least 5k.

[HRTstudent]

o ya i forgot estrogen is 70. i get vit d in orange triad.

Without the lab work I can't say what your blood level is. If you're getting 1k IU per day with little to no sun, you're probably on the low normal end.

Was your estrogen test the sensitive/ultrasensitive test? What was the range on this test?

[TRTony]

Wait i need more vitamin d? And i will get te estro when i get home. Range was dumb ass like it said it was ok to be up to 130!!

[TRTony]

Estrogen 70 range is <=130 - pg/mL

[TRTony]

Any more input?

[TRTony]

Also i drink 2 glasses of milk a day. What does that bring vitamin d up to?

[kelkel]

Vitamin D essentially will lower your SHBG level (SHBG binds T) which in turn will allow more free Test for use. Free T is what does the work for us.

[xtitan1]

http://ods.od.nih.gov/factsheets/Vit...hProfessional/

^Thought that was pretty thorough

[steroid.com 1]

At 23 years of age you are in the tank and all over the place.

Tell us more about yourself like health, body fat, diet, work out schedule, life style...

You need to find a Physician who can set you straight as something is amiss.

[TRTony]

Thanks guys. How much more d do i need if i take orange triad and milk? Im 23 5ft6 147lbs. Id say 16 percent bodyfay. All in mid section. Super thin arms and legs. I do 3 days of weights and 3 days of cardio. Get in 1700 cals a day 40 fat 30fiber 145 arbs and 200 protein. Sunday night is cheat night. Beer and pizza. Also do mma

[HRTstudent]

There were many questions asked in this thread that are still unanswered. Don't fixate too much on the vitamin D just add it to your next blood work and take it from there.

[TRTony]

I honestly think my doc is done witj me as he thinks my levels are "fine"

[xtitan1]

Tony,

You need to focus in and get the help you need. Your main priority is to get those labs that are referenced in the 'Finding a TRT Physician' sticky (I also copied the list in my second post of this thread). If this guy refuses to give you follow-up tests, you should be done with him, not the other way around!

Furthermore, given your symptoms and that you are low-normal at a young age (mid 300s where lower limit is 250, all at age 23), you are not "fine." Find a doctor who will get the blood work done (advice on that also in the previously mentioned sticky), and post the results back here. I know how frustrating this can be, you just need to shrug off the people who are not going to help you. The faster you do, the faster you can move on to the ones that can. Don't let anyone get in your way.

P.S. - I updated my second post with the additional information you provided

[Vettester]

^^ Solid advise coming from a 24yo new member! Keep up the good work, xtitan!!

[TRTony]

U guys are awesome. This is all. Have.


-April Testosterone . 383 ng/dl
-Estrogen.70 pg/ml
-Prolactin.6 ng/ml
-July 2pm Testosterone. 177ng/dl
-July 2pm Free Test.29.2pg/ml
-TSH-1.21 uiu/ml
-Glucose.99 mg/dl
-LH.2.1 miu/ml
-July 8am Testosterone.326ng/dl
-July 8am Free Test.74.5pg/ml

Its bullshit. My doc put in a refferal to endo at Kaiser. And Endo got back to him and said "u had 2 notmal draws. We dont need to see u" and i also called the cheapest place i could find locally and asked. "what are your guys ranges? My test is 326 and i have low energy and injury problems. Would i be a candidate for therapy? If so i will book an appt" the girl said. "you would have to come see the doctor. " wtf. 105 bucks just to TALK to the ****ing doctor!?

[TRTony]

Ps god bless people like u guys who actually care for me. I hope one day to be the one giving advice and help to others. Actually scratch that. I hope one day doctors will actually get a ****ing clue about this real issue and actually start helping people.

[TRTony]

So im probably going to be reduced to buying from some guy. He said he has Sust 300 10ml for 95. Then for 120 i get 20 days of HCG and 30 days of Nolva. Id inject 1cc a week of Sust. He reccomended 2 shots a week but i only want it for TRT purposes.