Help - lost and don't know where to turn.

[Dawgy]

Hey everyone. 22 year old male here and I'm in a sticky situation where I don't know where to turn. Essentially, I've got no libido, have zero secondary sexual characteristics (body hair/facial hair = basically non-existent), and just generally feel like garbage with no energy and being run down.

I was diagnosed primary hypogonadal by a primary care physician after lab work (see below) and an MRI ruling out any issues in my head. Physician recommended TRT, but my he was incredibly insistent upon doing the Androgel route. I personally would prefer injections since I don't have to do it every day and I've read they're generally more effective. Reluctantly, he agreed to allow this but I had to go to his office for it. This wouldn't be a problem but it got to the point where I was going to his office weekly and waiting upwards of 1.5hrs for an injection. I've no issues of injecting myself but he refuses to allow it.

On top of this, he was doing the throw T at it approach and doing nothing else. Just general reading here tonight seems to point that this was a horrible approach. I opted to see an endo, who completely blew me off and told me I was fine.

I continued treatment with my GP because it made me feel so much better. However, my main concern was seeing my lab work after doing this doctor's treatment.

Before treatment, he ordered these labs, processed by Labcorp:

LH 4.8 [1.7-8.6]
FSH 2.4 [1.5-12.4]
Total T 244 [348-1197] flagged as low
Free T 5.5 [9.3-26.5] flagged as low
Prolactin 20.5 [4.0-15.2] flagged as high

After doing the injections he reassess levels:

Total T >1500
Free T >53

So, he wasn't closely monitoring me and put me in super crazy high range. I'm assuming the labs say > because they don't go past that limit. I don't know what to do. I obviously have a problem but he won't change in his approach. Endos tell me I'm fine when I'm very clearly not. I don't know what to do. I live in West Virginia, so the availability of doctors is a bit iffy. While I do live in the city with the best healthcare, I don't know where to turn...

I would greatly appreciate any advice. Not being treated now is a nightmare. I feel like garbage. Thanks for any advice you guys could give me. I just want to get fixed!

[Dawgy]

Hate to be a bumper but I spoke with the doc who started this initial treatment and he's sorta beating around the bush. Not sure what's wrong with me here and still feeling kinda lost. Anyone perhaps able to interpret these results and give me some advice on how to proceed? I hate feeling so broken. Bleh.

[SD3000]

Your going to need to state your dosage of test cyp IM's for sure before you get help. It should be in the 100-200 range but if your off the charts then the dosage could be ridiculously high or something else, but need to know your dosage first to rule that out.

[steroid.com 1]

Your high Prolactin serum levels and low Testosterone production indicates a pituitary tumor (prolactinoma -a small pituitary tumor) and for someone you age with these symptoms is not unusual.

You need to know that sometimes these tumors can be so small they don't show up on a MRI.

You need to get your Prolactin levels down and drugs like Cabergoline can and will do that.

I would look for a second opinion on the tumor if it were me.

[Dawgy]

SD3000: I believe he was doing 1cc/200mg per week, which my understanding is pretty high.

gdevine: When I went to see the endo, I actually saw the nurse practitioner (to get in sooner) who told me that their labs have a lower reference range and that I would be fine under their labs. That was sorta a red flag to me. She also said prolactin being in that level wasn't of concern. I'm attempting to see the actual doctor - is this advisable?

Would you agree that there is indeed something wrong? Tired of being told I'm fine when I feel like crap and other information dictates otherwise. :/

(Sorry I couldn't quote you directly for better formatting - spam filter said no)

[Dawgy]

Alright, so I finally obtained the labs performed by the endocrinologist's office. These are drastically different, can anyone offer some insight?

LH 0.3 [1.4-8.6] L
FSH 1.1 [1.0-18.0] Borderline low
T 359 [240-950] This lab has a lower range, but I'm borderline low if you compared to the other lab.
Prolactin 8.2 [3-13]

This crap is confusing as hell. How should I interpret this and how should I proceed? I'm attempting to see the actual endo doc and not the nurse practitioner but it make take a very long time to get in.

[kelkel]

These labs are current, correct? If so, your in HPTA shutdown and your LH/FSH will bottom out.
T is still low. Labcorp range is 348 - 1197. When was BW pulled relative to your injection?
Prolactin-better.
I agree with GD.

[Dawgy]

These labs are current, correct? If so, your in HPTA shutdown and your LH/FSH will bottom out.
T is still low. Labcorp range is 348 - 1197. When was BW pulled relative to your injection?
Prolactin-better.
I agree with GD.

This blood work was pulled in August, a month after I stopped the injections at their request to give them labs. Was this even enough time to let the injections die off and not alter the labs?

I haven't been on anything since and just sorta let it go since they told me I was fine. That said, I still feel like garbage. I'm attempting to get another appointment with the actual doctor and not the nurse practitioner, but apparently I have to jump through a million hoops to change providers. On top of this, to see the actual endo, it's going to be a massively long-ass waiting list.

I had more labs drawn from another doctor a week ago today, and received roughly the same T levels. He read it over the phone and I forget the exact number but I think it was around the 360s as well. No idea on the LH/FSH since he didn't read them to me. They're currently in the mail to me for my own review.

Any advice on how I should proceed?

And thanks for all the advice provided thus far. It's greatly appreciated.

[kelkel]

This blood work was pulled in August, a month after I stopped the injections at their request to give them labs. Was this even enough time to let the injections die off and not alter the labs? No. Especially without some form of pct.

I haven't been on anything since and just sorta let it go since they told me I was fine. That said, I still feel like garbage. I'm attempting to get another appointment with the actual doctor and not the nurse practitioner, but apparently I have to jump through a million hoops to change providers. On top of this, to see the actual endo, it's going to be a massively long-ass waiting list. don't just see an endo. Read the Finding a Doc Sticky for tips on finding a doctor

I had more labs drawn from another doctor a week ago today, and received roughly the same T levels. He read it over the phone and I forget the exact number but I think it was around the 360s as well. No idea on the LH/FSH since he didn't read them to me. They're currently in the mail to me for my own review.Post them when you get them

Any advice on how I should proceed? Yes, begin searching for competent doc and don't stop until you find one. Read that sticky and use the search engines. You need to be treated on how you feel, not just by a number on a chart

And thanks for all the advice provided thus far. It's greatly appreciated.

In bold above.

[Dawgy]

In bold above.

Fantastic. Thanks for your insight. I'll begin the search and post the results in this thread once I receive them.

Slight edit: It seems some of those links in that initial post are censored? I assume this is because I am a new member?