27 and Questions About Current Situation

[GetUpandLift]

Hi everyone,

So I posted in another sub-forum in January of this year and feel like I now need to post in this sub-forum so I apologize if this is the wrong sub-forum.

Cliff Notes of my other thread:

I took 2 Prohormones a year and a half ago and did a proper PCT with Nolva.
I did bloodwork and found out that my testosterone level (free and total) were low. The total was 176 on a 250-1100 scale and free test was 54.3 on a scale of 35-155.

The only reason I went in for the blood test was because I have been feeling extremely tired with no motivation, wanting to sleep all day long, no sex drive, can barely get it up and keep it up, and have terrible anxiety and hallucinations. I have experienced this for several years and didn't ever do anything about it.

So in the other thread on here, I was advised that I didn't do a good enough PCT when I came off of the pro hormones and to do a stronger PCT with nolva/clomid combination for a month. I did those and got my blood reran in March, April, May and now June. My levels are still really low and I feel the exact same.

So I was basically told that if the nolva/clomid didn't work, then I have just always had low testosterone and that's why I have been feeling like this for so many years.

Flip forward to now...

I have been seeing my local family doctor and he is worried about my testosterone level. He had me do the few blood tests and in every one they are still very low (low 200's for total). My prolactin level was a bit high, but has gone down in the last 2 blood tests.

So I was referred to a testosterone doctor. We only had one appointment.

He wasn't too concerned about my low testosterone, but more concerned about the higher prolactin level.

So this specialist had me do two blood tests (one in April and one in June). The prolactin is normal now.

The specialist called and just said that my testosterone is "Normal" with my free testosterone being 9.8 out of 9.3-26.5. My Total testosterone is 202 on a 348-1197 scale.

I also had a lot of other things tested in these blood tests, but everything else was normal with the exception of my cholesterol being a bit higher.

So now I'm kind of stuck, I am 27 and feel the exact same way all day and I have made another appointment with my regular doctor for next week.

What are your guys's opinions on my test level at my age? Obviously the 2 pro hormones that I took didn't mess me up since I have been feeling like this for a long time and I did the proper PCTs and even the one suggested in the other thread and still feel the same with the same test levels.

Please help.

[Joco71]

Find a new doctor!!

[GetUpandLift]

Find a new doctor!!

I realize I should do this, but I like my family doctor, I just don't know if his suggestion to go to this Endocrinologist was the best idea.

I also noticed that the Endo that I went to was also in a building that does diabetes as well so maybe he knows more about that then testosterone problems.

I am going back to my family doctor next week but really need to know what to suggest when I go in. Should I get an ultrasound of my testicles? I remember my family doctor mentioning that before he sent me to the endo. I used to play football, baseball, and basketball and have always been athletic. I don't recall any testicle obstructions and I have been checked for testicular cancer (I went in for a screening because my left testicle has always looked a bit different than the other when it gets hot) and every doctor has always said there is no cancer there.

So what are they looking for in a testicle ultrasound?

I just really need to figure out something soon... I'm drowning.

[GetUpandLift]

So no one can help?

[lovbyts]

Although your free testosterone is more important that total it's still on the low end, especially for your age. Did you do anything to get the prolactin back to normal or did it return on it's own? How long did it take? Did you get a copy of your blood work? If not I would ask for one.

I hear more horror stories with Pro hormones than with Test or anything else. Did you use Clomid also for PCT or just Nolva? You might try another PCT using Clomid also if you did not before.

If he wants to do an ultrasound it wouldn't hurt, always good to know what if anything is happening with the boys

[GetUpandLift]

Although your free testosterone is more important that total it's still on the low end, especially for your age. Did you do anything to get the prolactin back to normal or did it return on it's own? How long did it take? Did you get a copy of your blood work? If not I would ask for one.

I hear more horror stories with Pro hormones than with Test or anything else. Did you use Clomid also for PCT or just Nolva? You might try another PCT using Clomid also if you did not before.

If he wants to do an ultrasound it wouldn't hurt, always good to know what if anything is happening with the boys

I used Nolva for my pro cycles but earlier this year I was advised to do Nolva with Clomid and did that as well and my numbers are still the same after the Clomid and Nolva combination from a few months ago.

My prolactin was a little high in april and returned to normal in May and now June. I'm not sure if it had something to do with me being sick at the time of testing or something else.

I have copies of all of my bloodwork. This is the major tests taken at the beginning of June:

FSH- 1.6 (Unknown range)
Prolactin - 11.0 (3.5-19.4 scale)
Cortisol - 26.9 (2.3-19.4)
Free Test - 55.4 (35-155.0)
Total Test- 245 (250-1100)
LH- 1.5 (Unknown)
TSH- 3.42 (.35-4.94)
T4 Free- .9 (.7-1.5)

Some other notes:

Basic Metabolic Panel all numbers normal
Hepatic Function Panel all normal
CBC all normal
Lipid Panel - ldl-P a bit high (1754 on a <1000 scale), small ldl-P high 1590 on a <527 scale)

[kelkel]

Your LH and FSH levels are crap, thus low test levels. So, what's the cause?
Elevated prolactin, cortisol and hypothyroid all will suppress your testosterone levels .
Your prolactin's fine now but you previously stated it was high.
Your cortisol is above range.
Your TSH is way high. Basically high TSH and low (er) T4 can be indicative of hypothyroidism. Naturally you'd want more thorough testing to fully assess this. Consider testing TSH, FT3, FT4, RT3 and antibodies. Hypothyroid causes hypogonadism. Before you say your TSH is in range know that most ranges go up to about 5. A more modern range is .3 - 3.0. Take a look at Stop the Thyroid Madnessâ„¢ - Hypothyroidism and thyroid mistreatment and read up a bit.

Find a doctor that can address these issues first and foremost. When that's done and if levels do not improve consider an MRI of your pituitary for pathologies. Do not jump on TRT and just band aid a problem you may be able to correct.

[GetUpandLift]

Your LH and FSH levels are crap, thus low test levels. So, what's the cause?
Elevated prolactin, cortisol and hypothyroid all will suppress your testosterone levels .
Your prolactin's fine now but you previously stated it was high.
Your cortisol is above range.
Your TSH is way high. Basically high TSH and low (er) T4 can be indicative of hypothyroidism. Naturally you'd want more thorough testing to fully assess this. Consider testing TSH, FT3, FT4, RT3 and antibodies. Hypothyroid causes hypogonadism. Before you say your TSH is in range know that most ranges go up to about 5. A more modern range is .3 - 3.0. Take a look at Stop the Thyroid Madnessâ„¢ - Hypothyroidism and thyroid mistreatment and read up a bit.

Find a doctor that can address these issues first and foremost. When that's done and if levels do not improve consider an MRI of your pituitary for pathologies. Do not jump on TRT and just band aid a problem you may be able to correct.

Hey again,

First off thanks for all of this information. What I don't get is why the Endo said I was fine and my normal doctor's main concern is my higher than normal cortisol but did not mention anything about the TSH, LH, and FSH being messed up since they are considered "in range." So are you thinking that something is up with my thyroid or pituitary gland or both? I just had that appointment and the doctor said he just needs to talk to the endo, but he is thinking that I should just go on that test cream. I don't want to mess up my body if it is something fixable. So how do I bring this up to my doctor and what kind of doctor do I need to see? I can't just be like some guy on the forum said that my levels are within the blood tests range, but are still bad, you know?

Any advice is well appreciated. Thank you so much

[kelkel]

Simply put, most doc's don't know hormones. They're not trained in them in med school. Usually an Endo's specialty is diabetes and metabolic diseases, not hormones. You'd probably be better off with a Urologist. But honestly title doesn't matter, just that they know hormones. Your doc see's test cream as safe and an easy fix and you're out the door. I wonder if he'd treat himself that way?

You're 27 years old. Barring a pathology (pituitary adenoma) all effort should be to find the issue and correct it. When I previously said elevated cortisol, prolactin and hypothyroidism will suppress testosterone levels , I should have added that their mechanism of action is by suppressing LH function so you understand why it's important to resolve those issues.

How do you bring this up? You don't with your current doctor. Find another one. Start searching any way possible. Tell us what state (if in the U.S.) you live in and maybe someone here can point you in the right direction. You can also google "A4M Doctor Finder" and see what pops up.

[GetUpandLift]

Simply put, most doc's don't know hormones. They're not trained in them in med school. Usually an Endo's specialty is diabetes and metabolic diseases, not hormones. You'd probably be better off with a Urologist. But honestly title doesn't matter, just that they know hormones. Your doc see's test cream as safe and an easy fix and you're out the door. I wonder if he'd treat himself that way?

You're 27 years old. Barring a pathology (pituitary adenoma) all effort should be to find the issue and correct it. When I previously said elevated cortisol, prolactin and hypothyroidism will suppress testosterone levels , I should have added that their mechanism of action is by suppressing LH function so you understand why it's important to resolve those issues.

How do you bring this up? You don't with your current doctor. Find another one. Start searching any way possible. Tell us what state (if in the U.S.) you live in and maybe someone here can point you in the right direction. You can also google "A4M Doctor Finder" and see what pops up.

I definitely don't want a quick fix. I am not even a fan of those creams. If I were to do TRT, I would want to do injection based with HCG so I know it is working right and I don't have to worry about rubbing off on my girlfriend or any of my family members.

I am in Indianapolis, Indiana. My doctor said that there is a hormone doctor around where I live, but he said that he doesn't take insurance and usually will just want my money so I'm skeptical about going to him. Plus I have talked to their office and I know that they only do creams, gels, patches, and the pellet treatment. I know they do not do injections.

Do you have any suggestions for doctors in my area? So you're saying that if something is wrong with my pituitary gland then it is not fixable? If something was wrong with it like a tumor, do you have to go through surgery to get it removed? If I had a pituitary gland tumor, wouldn't it show up on a cat scan? I have had all kinds of cat scans done in the past year because of some sinus issues I have been having for awhile.

Also, if I go on TRT and do not fix the true cause (damaged testicle, messed up pituitary gland, etc) will it shorten my life and put me at risk for other bad things?

I just cannot live like this... I have no energy what so ever, I want to sleep all day, I can barely even have sex with my girlfriend, I am never sexually interested, it is hard to keep an erection, etc etc.. I just need to get this fixed and I haven't heard back from my family doctor that was supposed to call me last Monday.. I don't want to keep bothering him if he is just going to give me the cream anyways...

I really need to know what my next steps should be.. I tried that A4M doctor finder and nothing popped up in my area.

Please help. I am really suffering over here.

[kelkel]

You need to try and find the problem and fix it before anything else, imho.
Dr. Crisler, arguably one of the best TRT docs in the country is in Michigan. Drive north. Only one appt is required in person then they can be virtual.
Pituitary adenomas are not that uncommon. I have one. Rare that surgery is needed. Usually just meds depending on what issue they cause. An MRI would reveal it.
It will not shorten your life span. Just improve your health and vitality.

Look up Dr. John Crisler and call his office.

[GetUpandLift]

You need to try and find the problem and fix it before anything else, imho.
Dr. Crisler, arguably one of the best TRT docs in the country is in Michigan. Drive north. Only one appt is required in person then they can be virtual.
Pituitary adenomas are not that uncommon. I have one. Rare that surgery is needed. Usually just meds depending on what issue they cause. An MRI would reveal it.
It will not shorten your life span. Just improve your health and vitality.

Look up Dr. John Crisler and call his office.

Should I get an MRI of my pituitary gland before going all the way to Michigan? That's over 5 hours away from me. Does anything in my bloodwork even show that my pituitary gland isn't functioning properly? I realize my prolactin level and cortisol level were a bit out of whack with the prolactin being normal now, but do you think that is from taking a pro hormone last year? It was epistane and tr3n combination.

I Looked on his site and it seems like they don't take insurance either :/.

I also remembering you saying something about my thyroid? Is there something wrong with that? I just want to get all of the tests prior to going up 5 hours to see a doctor. I am in college and work full time and it is rare that I have a day off to get a vacation day like that.

[kelkel]

I'm not saying you have an adenoma, I said "barring a pathology."
IMHO step one is full BW.

I mentioned your thyroid as your TSH is high and hypothyroidism will cause hypogonadism. Yes, your TSH is "in range" on that scale but it's basically an old scale. Newer scales are .3 - 3.0 and anything over 2 should be looked at. TSH by itself is a weak indicator of thyroid health but it's still an indicator and in your case you should look further. Consider TSH, FT3, FT4, RT3 and Antibodies.

[bullshark99]

Get, your concerned and rightfully so. Dump the family Dr, you can go see him next time you have a sore throat. Now is not the time to be worrying about a 5 hr drive or needing to spend some money.
The response you received from Kel ^^^ is probably one of the best most accurate, complete that anyone can give you on a forum. Call the number on the banner and see where the closet location is, even if you need to fly in if you don't want to make the 5 hr drive.
The point is, your family Dr doesn't know what to do, go see someone that does.

[GetUpandLift]

I'm not saying you have an adenoma, I said "barring a pathology."
IMHO step one is full BW.

I mentioned your thyroid as your TSH is high and hypothyroidism will cause hypogonadism. Yes, your TSH is "in range" on that scale but it's basically an old scale. Newer scales are .3 - 3.0 and anything over 2 should be looked at. TSH by itself is a weak indicator of thyroid health but it's still an indicator and in your case you should look further. Consider TSH, FT3, FT4, RT3 and Antibodies.

When I got bloodwork through my doctor, it was really cheap. Is there a way that I can give him a list of everything I want done in a blood test and he send out for it?

What would be a full list of what I need done knowing what I have already had done on blood work?

I would just rather go through insurance with blood tests since I have it and it is cheap to do. They use Labcorp at my local office, but I think I have to have an order from a doctor to do so.

I also noticed I have a testosterone .com center in Chicago so that would be another option at some point as well if all options have been used around my area.

Can you look at this website and tell me if this would be a good doctor to go to? They specialize in hormones and my doctor recommended his office to me. I think they only accept cash and no insurance. I think I also mentioned before that they do not do anything with injections. They highly recommend the pellets that get inserted into your lower back and absorb over time. Is that a good option if I have to have TRT? It is either that the gel, cream, or patch. I think they mostly use the pellets though
Their website is De Wester Treatment and Research Center Dr De Wester Treatment and Research Center in Indianapolis.

I'm just not sure if that local hormone doctor will actually try to figure out the cause of my low T versus just putting me on TRT immediately. That's what I'm most scared of.

Get, your concerned and rightfully so. Dump the family Dr, you can go see him next time you have a sore throat. Now is not the time to be worrying about a 5 hr drive or needing to spend some money.
The response you received from Kel ^^^ is probably one of the best most accurate, complete that anyone can give you on a forum. Call the number on the banner and see where the closet location is, even if you need to fly in if you don't want to make the 5 hr drive.
The point is, your family Dr doesn't know what to do, go see someone that does.

I definitely value Kel's advice more than anyone on this forum and really want to get all of this figured out. It really doesn't seem like my doctor cares. I called him yesterday seeing what the plan of action was going to be and he told me that he still hasn't heard back from the endo and needs his opinion first .. and that endo was terrible to say it lightly. I just want to get all of the bloodwork done ahead of time so I can actually figure out if I am going to need TRT or treatment for the pituitary gland or thyroid.

[kelkel]

Read through my prior posts again, everything is there. I strongly urge you to contact Crisler unless you can find another doc of that caliber in your area who will address the issue and not band aid it. Examples of BW is in the Finding A Doc sticky. Know that you won't have to make multiple trips to Crisler. Only one.

Pellets are a last resort for anyone. You have much less of an ability to titrate dosing and in my opinion it's used and billed as a medical procedure so there's a profit incentive. If that's the only course of treatment this doc does then it's not about the patient, he's just maximizing his profit margin.

Just don't accept being put on TRT until you are satisfied everything that could cause it has been ruled in or out. You are in charge of your health, not your doctor. He's there to help and guide you.

[GetUpandLift]

Are there any other options than this Crisier guy? I have read horror story after horror story on the internet about this guy and the office. It seems like he just keeps running tests and tests and nothing is covered by insurance. You can't talk to physical people most of the time and they want to charge all of these extra fees to talk to him. I don't have a lot of extra money so I need more options. Is there anything in Indiana? That is unfortunate my local hormone place in Indianapolis mainly does the pellets.

It has been a month now and still haven't heard back from my family doctor in regards to any of this...

The days keep going by and I feel like a zombie walking around since I am soooooo tired all day long.. My sex drive is non-existent and my girlfriend thinks that it is her fault..

I am just drowning and need other options.. Dr. John Crisler doesn't sound like the best option for a college student like me with limited funds.. Sure I want to find the route of the problem but I have already done 6 blood tests in the last few months and need to figure something out soon.. I just don't know who to turn to now...

Chicago is about 5 hours away and has a LowT.com Center, but again, they will probably just bandaid the problem. I really want this fixed. If I have to be put on TRT, I want it done right with HCG and I know not a lot of docs will do that now a days.

Can anyone help that is near Indianapolis or can you point me in any other direction here?

Thanks

[kelkel]

Google A4M Doctor Finder and search for one using your area or zip code.

[GetUpandLift]

Which one do I choose? There are a million in the Indianapolis area and some are like Gynocologists and stuff. Can you search 46227 and see if you can find one that looks legit? I also typed in Low T center and there are a lot in my area. Is that an option to go to one of those?

Thanks again

[kelkel]

A lot did come up. I can't really just pick one for you. Go through a few of the names and google them. Narrow it down and then call their office with a couple questions for the staff to see if they fit your criteria. Don't waste your time with blind appointments.

I googled "testosterone replacement doctors in Indianapolis" and got a lot of hits.

[Thyroid_cursed77]

Find a new doctor!!

Really, why be rude? If you would have read what he wrote, or at least had a fifth grade reading comprehension ability, then you would have read he has been to the doctor. I'm not trying to be too serious, but the guy is asking for help, be legit.

[Thyroid_cursed77]

I realize I should do this, but I like my family doctor, I just don't know if his suggestion to go to this Endocrinologist was the best idea. I also noticed that the Endo that I went to was also in a building that does diabetes as well so maybe he knows more about that then testosterone problems. I am going back to my family doctor next week but really need to know what to suggest when I go in. Should I get an ultrasound of my testicles? I remember my family doctor mentioning that before he sent me to the endo. I used to play football, baseball, and basketball and have always been athletic. I don't recall any testicle obstructions and I have been checked for testicular cancer (I went in for a screening because my left testicle has always looked a bit different than the other when it gets hot) and every doctor has always said there is no cancer there. So what are they looking for in a testicle ultrasound? I just really need to figure out something soon... I'm drowning.

Yourproblem is like millions of others, the stupid medical systems does things silly like. They use the low of everyone, which makes no one sense. An 80 year old guys normal and yours is different. Anyways, I hope for the best. It's the same reason I'm going on cycle. I know longer want to have a disadvantage just because my T is low. You just have to figure out what works for you, and be smart about it.

[Thyroid_cursed77]

Simply put, most doc's don't know hormones. They're not trained in them in med school. Usually an Endo's specialty is diabetes and metabolic diseases, not hormones. You'd probably be better off with a Urologist. But honestly title doesn't matter, just that they know hormones. Your doc see's test cream as safe and an easy fix and you're out the door. I wonder if he'd treat himself that way? You're 27 years old. Barring a pathology (pituitary adenoma) all effort should be to find the issue and correct it. When I previously said elevated cortisol, prolactin and hypothyroidism will suppress testosterone levels, I should have added that their mechanism of action is by suppressing LH function so you understand why it's important to resolve those issues. How do you bring this up? You don't with your current doctor. Find another one. Start searching any way possible. Tell us what state (if in the U.S.) you live in and maybe someone here can point you in the right direction. You can also google "A4M Doctor Finder" and see what pops up.

If you have been finding an endocrinologist who doesn't know hormones, something is very wrong. Endocrinologist specifically treat people who suffer from hormone imbalances, glands of the endocrine system. They try to restore normal balance of the hormones, which included Cancers of the endocrine glands, Over- or - under-production of hormones, thyroid diseases, Metabolic disorders, Lack of growth, menopause, diabetes, osteoporosis, cholesterol problems, hypertension, and Infertility. The endocrinologist is the hormone expert, if you have one who isn't, then that's a problem. Having said that, like with much of medicine, there are goofy ways they do things, treating the thyroid can be one of them.

[kelkel]

Well, that's the text book definition of what an endocrinologist is and possibly the problem as well. Meaning hormones, more specifically testosterone related problems just don't seem to be in the forefront of their focus. In my experience, and that of many of the members here over the years, endo's have not been the go to profession. Simply put, the doc's title doesn't matter, just that they know hormones and treat you as a person, not a number.

Not sure I understand how treating the thyroid is goofy? And based on your name I'm betting you're already quite aware of that.

[Thyroid_cursed77]

Well, that's the text book definition of what an endocrinologist is and possibly the problem as well. Meaning hormones, more specifically testosterone related problems just don't seem to be in the forefront of their focus. In my experience, and that of many of the members here over the years, endo's have not been the go to profession. Simply put, the doc's title doesn't matter, just that they know hormones and treat you as a person, not a number. Not sure I understand how treating the thyroid is goofy? And based on your name I'm betting you're already quite aware of that.

Treating the thyroid isn't goofy, how many of them go about treating the thyroid, can very well be asinine. Yea, I've had a bs thyroid for a few years now. I've had both hyper and hypo active thyroid. I agree that bad endocrinologist are horrible at their job, but tech they should put the entire endocrine under focus. When I get tested for TSH levels, they run the whole gambit of hormone test. But I agree, they don't stress test levels enough at all. The problem with how they treat the thyroid is they treat it like they don't want you to heal, but be dependent on hormone treatment the rest of your life. I found out that too late. I hadn't realized the root cause of most thyroid issues we're iodine in our diets. The Japanese really don't have the endocrine problems we do, because they get sufficient levels of iodine. In a few remote nations where the daily iodine intake is less than 25 micrograms per day, that is where we find the most severe forms of hypothyroidism including cretinism-the really horrible version. The worldwide problem of iodine deficiency is much worse than many realize. 1/5 the world's population lack proper levels of iodine, with some studies showing high levels of thyroid problems. That is goiters, higher infant mortality, infertility, impaired growth, and a lot hypothyroidism. What sucks is iodine deficiency leads the world in preventable mental deficiency. In Asian nations where seaweed or dulse is eaten in high quantity, it's much better. A study found that the Japanese, who consume large quantities of kombu, a seaweed, take in more than 200 milligrams of iodine per day. Much more than is needed. Although there is a 10 percent incidence of thyroid enlargement or goiter, they are at much lower rates than nations who don't get enough. My point is, this isn't even considered in Western endocrinology. I should have attempted to treat the cause before I got put into a cycle of never ending hormonal adjustments.

[kelkel]

Agree with your first sentence.
I actually take low dose Iodine.
Cretinism! Wow. No one speaks of that anymore.
What are your thoughts on stopthethyroidmadness.com?

[ab037]

The advice you got from Kel is as good as it gets OP. Dr Crisler is "THE" DR to have for TRT. His protocols and blogs are what other TrT doctors follow. I wish I was close enough to see him. With that being said I had to drive 6hrs to see a prominent TrT Dr in SoCal.
Now if your insurance is PPO you can see Dr Crisler, and have him right up whatever BW he wants, your ins should pay for labs as well as the Dr visit, this is fairly common. As far as he meds, your probably going to have to pay out of pocket for your Test cyp and HCG . Pretty common for most ins to not cover those

[GetUpandLift]

I just wanted to update everyone .... So after a lot of thought, more blood work, and consultation with another TRT local specialist, he started me on TRT today...

He is an elderly man with a lot of experience and seemed to know his hormones and treatments very well. He is local to my house as well so I can go see him once a week for my injection.

Since I'm only 27, he has also prescribed HCG and I will take it once a week.

The only thing I do not know yet is what doses of everything he is putting me on. He just directed the Nurse to give me the injection today so hopefully it is the right dosing.

What dosing should I have for Test and HCG? Does he need to prescribe anything else other than these two things? This is all he has mentioned so far.

I got injected in my right hip and it is still sore 11 hours later.. Is this normal? I didn't feel a thing when the needle went in, but it is definitely sore from the injection..

I feel comfortable with this doctor and know I am in good hands. Please advise, thank you.

[GetUpandLift]

No one?

[bullshark99]

Call the office and ask what the dosage is, you should of asked while you were there. You will need BW done in 4-6 weeks specifically to check estrogen to see if you need an A.I.
You will find out real quick if this Dr is truely knowledgable....

[GetUpandLift]

Call the office and ask what the dosage is, you should of asked while you were there. You will need BW done in 4-6 weeks specifically to check estrogen to see if you need an A.I.
You will find out real quick if this Dr is truely knowledgable....

I have my next appointment next Wednesday so I'll find out then. So some people just do not need an AI, while others do?

What do you mean by that last statement about him being knowledgable? Can you expand on that a bit? My hip is still pretty sore and it has been a couple of days now. Is this normal?

[GetUpandLift]

I went back to the doctor today and every level except total testosterone is in the normal ranges. I'm taking 140mg of test (lower dose) to see how I respond to that the next few weeks and then I'll do more blood work. I haven't gotten my HcG in the mail yet so I'm not sure what that dosing is yet.

[Mr.BB]

So, what's the cause?
Elevated prolactin, cortisol and hypothyroid all will suppress your testosterone levels .
Your prolactin's fine now but you previously stated it was high.
Your cortisol is above range.
Your TSH is way high. Basically high TSH and low (er) T4 can be indicative of hypothyroidism. Naturally you'd want more thorough testing to fully assess this. Consider testing TSH, FT3, FT4, RT3 and antibodies. Hypothyroid causes hypogonadism. Before you say your TSH is in range know that most ranges go up to about 5. A more modern range is .3 - 3.0. Take a look at Stop the Thyroid Madnessâ„¢ - Hypothyroidism and thyroid mistreatment and read up a bit.

Find a doctor that can address these issues first and foremost. When that's done and if levels do not improve consider an MRI of your pituitary for pathologies.

You're 27 years old. Barring a pathology (pituitary adenoma) all effort should be to find the issue and correct it. When I previously said elevated cortisol, prolactin and hypothyroidism will suppress testosterone levels, I should have added that their mechanism of action is by suppressing LH function so you understand why it's important to resolve those issues.

Pituitary adenomas are not that uncommon. I have one. Rare that surgery is needed. Usually just meds depending on what issue they cause. An MRI would reveal it.

I'm not saying you have an adenoma, I said "barring a pathology."
IMHO step one is full BW.

I mentioned your thyroid as your TSH is high and hypothyroidism will cause hypogonadism. Yes, your TSH is "in range" on that scale but it's basically an old scale. Newer scales are .3 - 3.0 and anything over 2 should be looked at. TSH by itself is a weak indicator of thyroid health but it's still an indicator and in your case you should look further. Consider TSH, FT3, FT4, RT3 and Antibodies.

Read through my prior posts again, everything is there.

No comments....