TRT Questions

[turborx7s]

Hello all,

It has been a long time since I have been on the forum, work/family has put me into the "just trying to maintain" catagory, that and I'm almost 36...

Anyway, about 3 months ago, I noticed some major changes in myself. Appetite went down, energy tanked, sex drive went to a basic zero (before I was machine, in terms of wanting it daily), and suddenly having trouble getting to sleep. To me, the classic symptoms of Low test. I have only done a single cycle, Test E (500mg/week). Before that I had tried a number of the pro-hormones when I was younger.

I had a little pain in my testicles also, which freaked me out, so I had an ultrasound done. Forgive me, I don't have the correct terminology in front of me, but I have a small cyst on each one, which is apparently the "completely normal" variety, and also I have some "varicose veins on the left one". (This is also where the pain was)

I also had blood drawn, which is attached. From doing some research (with your help) I see that my Vitamin D levels are in the shitter. I will work on that.

All pain is gone, and has been gone for about a month, but the other changes remain a constant.

After all of that, my question - I see my T has dropped to 517, this is about a 500 pt drop from the last time I had BW done, about 4 or 5 years ago.

Which is having the biggest factor? Test or Vit. D? Or a combo of the two?

I have an appt. with an Endo on 2/2, who apparently specializes in low test men.

Thanks as always.

[kelkel]

You're getting older. It's normal for it to drop. I don't see LH & FSH values on your BW which show pituitary function, which would have been nice for you to have baselines. That said, your numbers are still fine. Total T really does not matter. Free T does and your's is in great shape. Free is what works for you.
TSH is good, even though it's a weak indicator of thyroid health, it's still an indicator. Great Chol levels which I'm jealous of. As noted, D level is in the toilet so ramp that up which will in turn help increase your free T level.

Take a look in the Finding A Doc sticky thread for a list of what BW to get and fill in the blanks with what you missed. LH, FSH, Prolactin, Cortisol, full thyroid to include TSH, FT3, FT4, etc. Ask your doc for low dose Cialis as well. It's an extremely healthy thing for males to take without even considering libido, etc.

[turborx7s]

You're getting older. It's normal for it to drop. I don't see LH & FSH values on your BW which show pituitary function, which would have been nice for you to have baselines. That said, your numbers are still fine. Total T really does not matter. Free T does and your's is in great shape. Free is what works for you.
TSH is good, even though it's a weak indicator of thyroid health, it's still an indicator. Great Chol levels which I'm jealous of. As noted, D level is in the toilet so ramp that up which will in turn help increase your free T level.

Take a look in the Finding A Doc sticky thread for a list of what BW to get and fill in the blanks with what you missed. LH, FSH, Prolactin, Cortisol, full thyroid to include TSH, FT3, FT4, etc. Ask your doc for low dose Cialis as well. It's an extremely healthy thing for males to take without even considering libido, etc.

Thanks for the reply. Agreed, I guess my GP didn't understand what I meant when I said "Full Panel". He questioned what I meant, and I replied with "Everything we can test for, I'm interested in." (In hindsight I should have jumped on here first for a refresher.) My cholesterol is mostly due to luck/genes I would say. I still eat pretty clean however.

In your opinion Kel, should I not really pursue TRT and see what raising my D levels would do first/look for another cause behind current feeling of well being?

[kelkel]

Honestly I don't think a doctor would put you on TRT with your levels. A clinic is a different story altogether. Remember, BW is just a snapshot in time and results can vary based on whats going on in your life at the moment, as well as the time of day it was tested. Hormones will vary more with younger guys (you) than with older ones. They should always be tested first thing in the morning as well.

If it were me and insurance covered it there's no harm getting a second opinion from another doctor. Especially if they fill in the blanks on your bloodwork. And be sure to get your own copies to start a personal file. I would definitely jump on Vit D as it can help. It won't be dramatic but it's help regardless. If it gave you a bit more free T then it's worth it to me.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712348/

I'd also be sure to start a low dose Cialis protocol. There's absolutely no reason a doctor would disagree with this unless you suffer from low BP. Other than that it's an extremely healthy thing to take.

[turborx7s]

Honestly I don't think a doctor would put you on TRT with your levels. A clinic is a different story altogether. Remember, BW is just a snapshot in time and results can vary based on whats going on in your life at the moment, as well as the time of day it was tested. Hormones will vary more with younger guys (you) than with older ones. They should always be tested first thing in the morning as well.

If it were me and insurance covered it there's no harm getting a second opinion from another doctor. Especially if they fill in the blanks on your bloodwork. And be sure to get your own copies to start a personal file. I would definitely jump on Vit D as it can help. It won't be dramatic but it's help regardless. If it gave you a bit more free T then it's worth it to me.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712348/

I'd also be sure to start a low dose Cialis protocol. There's absolutely no reason a doctor would disagree with this unless you suffer from low BP. Other than that it's an extremely healthy thing to take.

Sounds good to me Kel. I'm starting with 6000iu/day for the next month. I am going to keep my endo appt for next month, play dumb and have him draw all new labs. As you said, this will help to build a history and allow me to chart some things, as well as see what D dosage does for my levels.

As far as the Cialis, I've been self dosing for the last couple of months, around 5-10mgs, but admittedly not on a daily routine. I will see if he will write me a script.

Thanks again.

[kelkel]

Just complain about lack of interest in sex, libido, etc. Hopefully he'll write it.

[turborx7s]

***Update (if you happen to see this Kel)***

After months of waiting for a 2nd opinion from a Urologist, he didn't seem to have any problem writing the script, and he actually suggested injection vs. patches/creams. (I hope I hid my happy shock)

Anyway, he didn't get into dosage, and I was too stunned and didn't want to appear overly knowledgeable on the subject, so I just said "Great!" and walked out.

He prescribed 400mgs injection every 3 weeks (Test C) and gave me 5 refills. I have already decided to at a minimum turn that into 200mgs/10.5 days, my question is on diminishing returns? Will the eventual shutdown of my system result in lower test readings from the 133mgs/week (avg) versus what my body is doing now? Or will I perhaps get up to the high normal range?

Thank you!