30 Low Test Labs and MRI done TRT options

[Odin1]

Hello,

Ive had multiple lab works done and had an mri and there isn't anything showing on the MRI. Labs were as follows


3/24/16

CBC With Differential/Platelet
WBC 4.9 3.4-10.8 x10E3/uL 01
RBC 5.08 4.14-5.80 x10E6/uL 01
Hemoglobin 14.6 12.6-17.7 g/dL 01
Hematocrit 43.0 37.5-51.0 % 01
MCV 85 79-97 fL 01
MCH 28.7 26.6-33.0 pg 01
MCHC 34.0 31.5-35.7 g/dL 01
RDW 13.6 12.3-15.4 % 01
Platelets 227 150-379 x10E3/uL 01
Neutrophils 52 % 01
Lymphs 38 % 01
Monocytes 8 % 01
Eos 1 % 01
Basos 1 % 01
Neutrophils (Absolute) 2.6 1.4-7.0 x10E3/uL 01
Lymphs (Absolute) 1.8 0.7-3.1 x10E3/uL 01
Monocytes(Absolute) 0.4 0.1-0.9 x10E3/uL 01
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL 01
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL 01
Immature Granulocytes 0 % 01
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL 01
Comp. Metabolic Panel (14)
Glucose, Serum 78 65-99 mg/dL 01
BUN 21 HIGH 6-20 mg/dL 01
Creatinine, Serum 1.33 HIGH 0.76-1.27 mg/dL 01
eGFR If NonAfricn Am 71 >59 mL/min/1.73 01
eGFR If Africn Am 82 >59 mL/min/1.73 01
BUN/Creatinine Ratio 16 8-19 01
Sodium, Serum 142 134-144 mmol/L 01
Potassium, Serum 4.5 3.5-5.2 mmol/L 01
Chloride, Serum 101 97-108 mmol/L 01
Carbon Dioxide, Total 26 18-29 mmol/L 01
Calcium, Serum 9.7 8.7-10.2 mg/dL 01
Protein, Total, Serum 7.1 6.0-8.5 g/dL 01
Albumin, Serum 5.0 3.5-5.5 g/dL 01
Globulin, Total 2.1 1.5-4.5 g/dL 01
A/G Ratio 2.4 1.1-2.5 01
Bilirubin, Total 0.9 0.0-1.2 mg/dL 01
Alkaline Phosphatase, S 80 39-117 IU/L 01
AST (SGOT) 32 0-40 IU/L 01
ALT (SGPT) 96 HIGH 0-44 IU/L 01
Testosterone , Serum
Testosterone, Serum 268 LOW 348-1197 ng/dL 01
Comment: Comment 01
Adult male reference interval is based on a population of lean males
up to 40 years old.
Luteinizing Hormone(LH), S
LH 2.1 1.7-8.6 mIU/mL 01
FSH, Serum
FSH 1.5 1.5-12.4 mIU/mL 01
1 of 2
Estradiol
Estradiol 18.4 7.6-42.6 pg/mL 01


Component

Your Value

Standard Range

4/5/16

Glucose 78 mg/dL
BUN 21 mg/dL 4 - 21 mg/dL
Creatinine 1.3 mg/dL .6 - 1.3 mg/dL

TSH 1.60 uIU/mL 0.35 - 4.50 uIU/mL


Component

Your Value

Standard Range


Sodium 139 mEq/L 135 - 145 mEq/L
Potassium 3.8 mEq/L 3.5 - 5.1 mEq/L
Chloride 103 mEq/L 96 - 112 mEq/L
CO2 33 mEq/L 19 - 32 mEq/L
Glucose 96 mg/dL 70 - 99 mg/dL
BUN 20 mg/dL 6 - 23 mg/dL
Creatinine 1.25 mg/dL 0.40 - 1.50 mg/dL
Total Bilirubin 1.0 mg/dL 0.2 - 1.2 mg/dL
Alkaline Phosphatase 56 U/L 39 - 117 U/L
AST 24 U/L 0 - 37 U/L
ALT 28 U/L 0 - 53 U/L
Total Protein 6.6 g/dL 6.0 - 8.3 g/dL
Albumin 4.3 g/dL 3.5 - 5.2 g/dL
Calcium 9.3 mg/dL 8.4 - 10.5 mg/dL
GFR 71.84 mL/min >60.00 mL/min

Testosterone 252.90 ng/dL 300.00 - 890.00 ng/dL

4/15/16

Prolactin 4.8 ng/mL 2.1 - 17.1 ng/mL
Reference Ranges:
Male: 2.1 - 17.1 ng/ml
Female: Pregnant 9.7 - 208.5 ng/mL
Non Pregnant 2.8 - 29.2 ng/mL
Post Menopausal 1.8 - 20.3 ng/mL


MRI was completed last week and nothing turned up there.

I eat a normal amount of iodized salt and have not noticed anything sexually to be concerned with.

I was heavy into power lifting over the last year and have slowly declined into a state where I am not able to recover from my workouts and haven't lifted recently due to the recovery time that is required to bounce back. The tests were taken when I was still lifting steady.

I'm 6'0 195 pounds probably between 12-17% body fat. I eat based on my macronutrient requirements depending on my goals.

My doctor has already agreed to prescribe Test c and wanted to do some weird 14 day 200/ml deal but agreed to allow me to self inject weekly instead. I'm not sure if he has read the information about hcg but that is a battle I'm prepared to fight next week when I go talk to him and start out the TRT.

Thank you so much for the stickies because it really helps me explain myself to him without sounding like a crazy person. My questions for you guys are this, I'm obviously secondary hypogonad but what could be causing it? Does anything from my testing jump off the page at your or could I just be low and need to get on the TRT train and get better? My brother and father both are low and have been for years. That was initially the reason I went and got checked out.

If my doctor will only do TRT without HCG should I head out and try to find someone who will? I'm not prepared to lost my testicle function at this point in my life.

These are all the tests he has ordered for me so far.

If there are other tests or more info you need me to provide to answer my questions I'm willing to get all that. Thanks so much for the awesome resource.

[Odin1]

Sorry for the self bump. I had an extra question after reading more about hpta restart. Do my tests indicate serms might be able to bump me up without long term trt? Also can someone explain in simple terms why clomid and Nolvadex both are run together?

[Mr.BB]

Have you done steroid cycles before?

No vit D test?

Have you done ultrasound for varicoceles?

On doing testicular ultrasound I would advice on full abdominal and prostate ultrasound.

[kelkel]

Any history or head trauma?

[Odin1]

No head trauma. I took a pretty hard shot to a testicle back in middle school and it's really sensitive. I doubt my doctor will order ultrasounds for my prostate and testicles since my tests indicate secondary but I can ask.

I've never ran any cycle or anything. I honestly can't even do creatine because it gives me headaches.

[kelkel]

Well, if you ruled out thyroid, prolactin, cortisol, trauma, had a negative MRI and still show signs of being secondary then it's possible it's idiopathic. Are there any med's you're on that can impact your T levels? .

[Odin1]

I'm one of those people that doesn't take much medicine. I take ibuprofen occasionally due to headaches but that's about it. The reason I noticed is because I basically stopped recovering from work out And started getting headaches, foggy, and super bad fatigue every day. My legs feel like I worked out yesterday and I've been put of the gym for 2 weeks for the first time in years. Is a restart possible if I just have a weak ass pituitary? I'd really like to just restart this bitch and not be on trt for life. Thanks Kel

[kelkel]

Anythings possible. Clomid would be a strong consideration to see if your pituitary responds to the stimulation, plus it won't shut you down like exogenous test will. A viable first step I would think in your situation. Then you'd have to come off to see how much (if any) of the stimulation holds. I'd also be curious if anything was missed on their interpretation of your MRI. If it did not hold and all other avenues were exhausted, I'd choose actual testosterone as the therapy of choice.


Outcomes of clomiphene citrate treatment in young hypogonadal men. - PubMed - NCBI

Testosterone supplementation versus clomiphene citrate for hypogonadism: an age matched comparison of satisfaction and efficacy. - PubMed - NCBI

[Odin1]

I hope they didn't miss anything. The did a pretty extensive mri with contrast so if they missed something it had to be tiny. I already got some test c so I'm going to go that route and talk to him about hcg and the opton of clomid and Nolvadex instead. I think I'm going to have to teach him or get him to read the studies. Any advice to get the guy interested in reading those studies you guys share?

[kelkel]

Depends on the doc whether he's receptive to the info or not. Some just don't want to hear from a patient. I'd print out some studies and get them to him. If he's receptive to them great, if not you've got your answer.

TRT and HCG = yes. If choosing clomid as a form of TRT then nolva is not necessary. Do not run HCG along side serms as it's counter-productive.

[Odin1]

Great thanks wish me luck for Friday

[Odin1]

Asked my doc about hpta restart with clomid and about adding hcg to trt and he referred me to an endo... So more doctor visits are in my future yay. He also gave me my first injection 200 ml testosterone cypionate and the next one is scheduled in wait for it 14 days.... Wow he wants to inject me 2 times before allowing me to do it myself. I run a team of people at work but apparently it takes 2 injections before we trust someone to inject themselves. I feel like this week km going to feel better and then next week I'll drop way back down to shit levels then back up so hopefully this endo comes up with something better.

[Mr.BB]

If you want to try hpta restart you shouldnt have taken testosterone shot, it will only make the delay and make the restart more difficult.

[InternalFire]

Depends on the doc whether he's receptive to the info or not. Some just don't want to hear from a patient. I'd print out some studies and get them to him. If he's receptive to them great, if not you've got your answer.

TRT and HCG = yes. If choosing clomid as a form of TRT then nolva is not necessary. Do not run HCG along side serms as it's counter-productive.

While in the same note, may I ask a question, if I run clomid for few months as a monotherapy, how long should I give a rest for my body before introducing HCG or would it be little to no benefit of it after clomid administration? Thanks and apologies for hijacking thread

[Mr.BB]

While in the same note, may I ask a question, if I run clomid for few months as a monotherapy, how long should I give a rest for my body before introducing HCG or would it be little to no benefit of it after clomid administration? Thanks and apologies for hijacking thread

The question would be why HCG after clomid?

If the clomid doesnt work you need bloodwork to see if its secundary or primary, if LH doesnt raise its secundary (your pituitary is "broken") and HCG can be used, if LH raises but test doesnt its primary and HCG will be useless.

[InternalFire]

Want to exhaust all options before I do what I set out to do self-trt. Docs are useless where I live so options are very limited and I have to think for myself. If clomid helps and after wo testing I ran hcg for some time and after all I did testing I thought it be sufficient to identify if I at least have some hope and if not then all cards be open on the table. I also dont know how will this bw will work for me since Im over 250km away from the nearest lab that agreed to do private bloods for me which really sucks.

So in theory if LH and test raises from clomid whats then?

[Mr.BB]

So in theory if LH and test raises from clomid whats then?

Means you have secundary hypogonadism. If everything is ok with your thyroid and pituitary you might want to continue with low dose clomid, some ppl do it.

Self-TRT is a difficult path make sure you have the tools and knowledge to do it. It would be easier to consult with a urologist/andrologist describing your low T symptoms and request TRT, in Europe he would most likely prescribe you nebido after some testing, its not so difficult.

[Odin1]

If you want to try hpta restart you shouldnt have taken testosterone shot, it will only make the delay and make the restart more difficult.

Well it took me over a month of getting tested and feeling like total ass to get this far and the endo doesn't have any appointments for about month so I went for it. It's only been about 12 hours since the test cyp and I feel like 100 times better. Is that possible for it to work that fast?

[annonemoose]

Anythings possible. Clomid would be a strong consideration to see if your pituitary responds to the stimulation, plus it won't shut you down like exogenous test will. A viable first step I would think in your situation. Then you'd have to come off to see how much (if any) of the stimulation holds. I'd also be curious if anything was missed on their interpretation of your MRI. If it did not hold and all other avenues were exhausted, I'd choose actual testosterone as the therapy of choice.


Outcomes of clomiphene citrate treatment in young hypogonadal men. - PubMed - NCBI

Testosterone supplementation versus clomiphene citrate for hypogonadism: an age matched comparison of satisfaction and efficacy. - PubMed - NCBI

Very good advice.

I'd ask the endocrinologist for an IGF-1 if you have not already had one. If you test below the first sigma a gh stimulation test might not be a bad idea.