Months later loads of tests what do I do now

[Rodax]

So a while back I posted about how my Thyroid was off and my Testosterone was low (200s <350-1000>). By about April, my thryoid levels were fine, but my testosterone levels were still in the low 200s. My GP wants to send me to a urologist, not an endocrinologist. I called an Endo and the Earliest appt they had was early August. I'm supposed to see the Urologist my gp referred me to tomorrow. Last month however I went to one of those lowt centers that aceepted my insurance and they ran my test along with LH, FSH, and PSA. When I talked to the Dr. there he basically said that the best course to go would not be full on Testosterone therapy because I would shutdown and eventually I want kids one day, so he suggested HCG therapy. Anyway, I'll post my results below...I'm just looking for thoughts, opinions, tips, what to expect etc.... At some point a med friend was telling me they might suggest I get an MRI and I was kinda thrown by that. He said that it's pretty strange for a 30 year old to be that low. Anything is greatly appreciated guys

Total Test
257 ng/dL <350-1000>

PSA
.40 ng/ml (Normal range <4.0 ng/ml)

LH
4.3 miU/mL <1.7-8.6>

FSH
3.3 miU/mL <1.5-12.4>

[bass]

its really hard to tell you anything without BW, you need to do a complete male hormone panel, and yes an MRI to rule out pituitary tumors.

[HRTstudent]

an MRI is not necessarily a bad idea... but its up to you really unless your doc had other reasons.

the most common reason we see on this forum is elevated prolactin, which may indicate a prolactinoma. it's not super rare, nor is it a death-sentence like some form of invasive bone cancer.

the most important thing you can do at this point is simply get a repeat testosterone measure to rule out things. do the test in the early morning and don't workout for at least a couple days prior.

a level in the 200's is low, but that doesn't necessarily mean you are beyond Rx help. this has been talked about a lot on this forum and there are some good threads on it from last year. check those out.

also, if you are trying to conceive in the next year or 2 I would personally advise against going on testosterone. it's actually one of a very, very small list of contraindications to starting testosterone therapy . it won't necessarily make you infertile, but fertility is all about increasing your odds.

[powerlifterty16]

your lh and fsh are on the lower side, so hcg therapy is a good idea. Why didnt you take the low t clinic up on their offer?

urologists are better than endos for trt.

[Trific]

After being on this forum for awhile it doesn't seem at all strange for a 30 year old to have low test, looks like it will be more common all the time especially with TRT getting more common.

[Rodax]

HRTstudent- have been getting repeat T tests, and they are consistently between 220-260. hopefully no tumors and I do want to conceive at some point which is why I don't want to go on TRT for that reason.

powerliftery - the low t clinic no longer offered HCG therapy at their site, the doc there was going to refer me to a place that did -but never heard back from him. See the forums on here are split about who to go to, some say uros others endos, just curious as to why.

Trific - but testosterone that low?

[powerlifterty16]

im 23 and have a level of 339...had a level of 277 at 19

[Rodax]

I never had my testosterone checked until now because I never thought about it. I figured I went through puberty (late bloomer) and it never came to mind. I mean it would explain why I never really gained when I would go hard for 6 months and then just get flustered and give up. It wasn't until about 6 months ago when this girl and I were messing around and just nothing happened down there that I thought something was wrong. Anyway yeah I can only confirm that I've had low testosterone for at least 6 months.

[Rodax]

Went to Urologist today, getting Prolactin levels checked. The remark that kinda threw me was when he was checking my balls for lumps etc, and he says "Have you noticed any change in size with your testicles? Because they don't seem like they are small, they seem normal or average sized" I told him yeah because they felt like they shrank/ they used to feel bigger (fuller?), but now I'm like it might be mental thinking my balls shrank. Anyway, I'll find out Wednesday whether my prolactin levels are elevated. He basically said I need to go see an endo if the test comes back elevated...Or I could get an MRI after that but i still need to see an Endo The earliest opening in my area was Mid August for an endo.

He also said that starting TRT right now shouldn't negatively effect my sperm count... I dunno I always was under the impression that it would reduce my counts... Part of me wonders if HCG therapy would have any benefit because of what he said....

I'll post here when I find out. In the mean time, any thoughts or input?

[Rodax]

GOOD NEWS! Prolactin was normal! so...guess I have secondary hypogonadism. Going to see an Endo Thursday, was thinking about going with HCG and/or Clomid with anastrozole therapy, any thoughts?

[powerlifterty16]

what does normal prolactin have to do with secondary?
what was the number and range?

[Trific]

Another thought would be nolvadex .

clomid vs nolvadex

[Rodax]

Powerliftery prolactin levels can be attributed to low testosterone if they are above the norm bc it will cause suppression, which can also mean that the person has prolactinomas. I dunno the normal range or where I fell, they just called to let me know the results and I will pick up the results tomorrow.

Really trific nolvadex ? I'll run it by the endo Thursday when I see him in the morning and see what he thinks. Thanks for the suggestion!

[Trific]

That thread seemed to say do both clomid and nolvadex if you can...if you want to choose only one then do the nolvadex.

LowT Mike says restarting on HCG will work too.

Not sure which would be the best...guys that run cycles seem to run the HCG only during the cycle and then clomid and nolvadex during PCT (restart).

Here's some more info:

http://www.steroid.com/Nolvadex.php

http://www.steroid.com/Clomid.php

[Rodax]

Well the Endo only wants to put me on Clomiphene 25mg ed and then see where that goes... I told him about Nolva and Clomid or just Nolva and he was like well using the clomid solely is what has shown him results and is what he has seen from who he studied under as well...

So I pose this questionto the board, should I just go spring for some Nolva and then tell him after the fact or...do the clomid solo and hope for the best under his watch? I am open to any and all suggestions, but if you have something to point out/to specifically, can you link it here or PM me so I can bring it up to my Endo?

[HRTstudent]

Well the Endo only wants to put me on Clomiphene 25mg ed and then see where that goes... I told him about Nolva and Clomid or just Nolva and he was like well using the clomid solely is what has shown him results and is what he has seen from who he studied under as well...

So I pose this questionto the board, should I just go spring for some Nolva and then tell him after the fact or...do the clomid solo and hope for the best under his watch? I am open to any and all suggestions, but if you have something to point out/to specifically, can you link it here or PM me so I can bring it up to my Endo?

listen to your doctor.

he is right. clomid is widely studied for exactly what you're trying to do. tamoxifen is far less studied. not only that, but clomid works. if anything, I might even ask him what he thinks about starting at 25mg every other day.

[Rodax]

Hey HRT Student, Yeah well that's my plan unless someone can convince me otherwise. Funny you mentioned 25mg eod bc he said that's what he's had to do in some bc they just bounced back so quick, one guy went from low 200s to 1800 total test inside of a month. I'm going to get labs in about 6-8 weeks and then see where I am. I just told him that I want to have kids one day and so before going on TRT I'll do everything I can before resorting to it bc I want to have kids at some point down the road. He seemed pretty ok with it and gave me a year script of 50mg ed but told me to start at 25mg ed. It's cheaper to buy a 30 day supply of clomid - comes out to about $24 a month with his plan, $48 for a month supply of 50mg ed which I shouldn't ever have to take. I'm pretty psyched to just feel normal again I guess?