Going to Endocrinologist today. Are there tests I should ask for?

[zerodarkthirty]

I've been on TRT for nearly a year with very mediocre results. I finally decided to get a referral from my doc and see if an endocrinologist might be able to spot something that is causing my TRT to not work as it should. I want him to rule out bigger issues if any.

Should I ask for an MRI of my brain or perhaps a sonogram of my testicles? I'm a mystery to my GP doc, so hopefully this guy knows something about male hormones and isn't just a diabetes expert. Thanks guys.

[jomamma007]

have him check thyroid, adrenal. MRI's are usually done if you have high prolactin I believe.

A full blood panel would be a start.
• Total Testosterone
• Bioavailable testosterone (aka Free and Loosely Bound)
• Free Testosterone
• SHBG
• DHT (gel users especially pay attention to this)
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• Prolactin
• Cortisol
• Thyroid Panel (complete)
• CBC
• Comprehensive Metabolic Panel
• Lipid Panel
• PSA (age dependent)
• IGF-1, IGFBP-3 (if HGH therapy is being considered)
• Vitamin D

[kelkel]

There's a list of BW in the Finding A Doc Sticky thread that may guide you.
Do you have pre-TRT BW you can take with you to your new doc? That would help greatly if he can review LH, FSH, thyroid, T levels, etc.
Define "TRT not working as it should."
Even if you had an adenoma or varicocele TRT still works. Tell us more.

[zerodarkthirty]

I've had all of the BW taken that you suggested in the stickies and have provided at least 7 separate BW tests to the endo prior to my arrival. When I say "TRT not working" I mean that since starting nearly a year ago I have less energy, generally less libido, brain fog, anxiety (when E2 crashes), etc. I just feel like I have never hit the sweet spot. I feel like I'm either suffering super high E2 or I've crashed my E2.

The way I would describe my experience is that I'm always on an escalator. I hit the perfect spot either on the way up to high E2 symptoms or on the way down to low E2. The BW reflects this instability. Current regimen is test cyp with HCG and Aromasin . I have detailed logs of subjective feeling, and every time I think I have this mystery solved, I guess wrong. The question you always ask is "Why". What is causing my low T? Instead of jumping into TRT, I should have answered this question. A year later, I'm trying to figure out the source of the low T. On paper, my numbers look pretty good now (with the exception of the highly variable E2), but subjectively I feel like poop.

[kelkel]

Damn Zero. Sorry to hear this. Wide ranging E2 can do this. What is your exact protocol? Days, timing, etc.

[zerodarkthirty]

Well let me just say once again that this forum has and continues to be an amazing resource. Thank you and bass and the many others whose knowledge of TRT is beyond most GPs.

I'm currently doing 100 mg test cyp every 5 days; 250 IU HCG every 3 (but I usually just inject daily 100 IU); Aromasin 25 mg once per week. I was taking the Aromasin twice per week and that was too much.

[kelkel]

So why don't you split your dosage to twice per week to help manage E2 even more and then possibly come off Asin totally? Add DIM, Zinc-copper if needed. Main thing is to find balance and consistency. Give you body a chance to be stable and for you to feel better. If you're only going to do 100iu's of HCG it should be daily quite honestly.

[zerodarkthirty]

I might give that a try again. I tried injecting test cyp twice per week and didn't feel like it was helping. To clarify, I am doing the 100 IUs of HCG daily.