Hello, long time lurker here making first post. Tried to provide all relevant info and blood work. Sorry for long post.

I am a 36-year-old morbidly obese man. I currently weigh 396 pounds and am 5í11. I will be having a dexa scan soon to determine my body fat percentage. On December I weighed 521 pounds. I had type 2 diabetes and severe hypertension that was poorly controlled by 3 medications. Iíve dropped this weight very quickly by making a major change to my diet and beginning to exercise. I had never worked out in my life before December.

Iíve got a very long way to go, but some things have improved. I no longer have type two diabetes. My blood pressure is now well controlled by one medication. Before December I could barely walk and climbing a flight of stairs was like attempting Everest. Now I am much more mobile. I exercise regularly six days a week. Currently I walk one to two miles in the morning, in afternoon do one hour of elliptical training or hiking, and one hour of high rep low weight circuit training, and 30-40 minutes of swimming laps. I do this 6 days a week rotating between muscle groups.

Medical Issues and Medications:
∑ Morbid Obesity
∑ Hypertension (controlled by medication Lisinopril 40 mg)
∑ Gout (controlled by medication Uloric 80 mg)
∑ Severe Depression and Insomnia (take Wellbutrin 300, Trazodone 200, Effexor 150). See psychologist once per week, psychiatrist once per month.
∑ Nighttime incontinence/frequent urination Ė (treated by Vesicare 5 mg)
∑ Severe visual problems related to night vision and glare. Have seen ophthalmologist, neuro-ophthalmologist and neurologist. Had MRI, visual field testing, detailed eye scans and photo study. No real findings. Suggested might be due to medications or abnormal migraines.
Low testosterone (Endocrinologist prescribed 200 mg Testosterone Cypionate every 14 days by self injection).

∑ Work with a nutritionist Ė have phone consults every week.
∑ Cut out juices, refined sugars, fast food, regular soda.
∑ Currently consume 2600 calories over 6 meals per day. I eat a lot of vegetables, clean protein, small portions of low glycemic carbs.
∑ Two meal replacement shakes per day.
∑ Roughly 40:40:20 macro breakdown.

∑ Fish Oil
∑ Multivitamin
∑ Probiotic
∑ Digestive Enzymes
∑ Vitamin D 5000 iu

Blood work:
May 26th: PCP blood work plus Testosterone level
Test Name Test Value Reference Range
Total Cholesterol 178 125-200
HDL Cholesterol 39 >=40
Cholesterol/HDL Ratio 4.6 <=5.0
LDL Cholesterol Calculated 99 <130
Triglycerides 181 <150
Protein Total 7.7 6.1-8.1
Albumin 4.4 3.6-5.1
Globulin 3.3 1.9-3.7
Bilirubin Total 0.5 0.2-1.2
Bilirubin Direct 0.2 <=.2
Alkaline Phosphatase 35 40-115
AST 29 10 to 40
ALT 49 9 to 46
WBC 9.1 3.8-10.8
RBC 4.91 4.2-5.8
Hemoglobin 13.3 13.2-17.1
Hematocrit 41.1 38.5-50
MCV 83.7 80-100
MCH 27.2 27-33
MCHC 32.5 32-36
RDW 16.2 11 to 15
Platelet Count 282 140-400
MPV 9.6 7.5-12.5
Total Neutrophils % 66 38-80
Total Lymphocytes % 24 15-49
Monocytes % 7.1 0-13
Eosinophils % 2.5 0-8
Basophils % 0.4 0-2
Total Testosterone 106 250-827
Vitamin D 19 30-100
Fasting Glucose 94 65-99
Sodium 136 135-146
Potassium 4.4 3.5-5.3
Chloride 102 98-110
Carbon Dioxide 27 20-31
Urea Nitrogen 15 7 to 25
Creatinine 0.77 0.6-1.35
Calcium 9.9 8.6-10.3
Uric Acid 5.3 4 to 8
TSH 3.96 0.4-4.5
Hemoglobin A1C 5.4 <5.7

PCP Expanded Hormone Testing 6/5:
LH 1.4 1.5-9.3
Testosterone Total 94 250-1100
Testosterone Free 24.7 46-224
Testosterone Bioavailable 48.6 110-575
SHBG 10 10 to 50
Albumin Serum 4.3 3.6-5.1

Endocrinologist Initial Blood work 6/16:
TSH 5.15 0.4-4.5
T4 6.4 4.5-12
T3 Uptake 33 22-35
Free T4 Index 2.1 1.4-3.8
Prolactin 16.4 2 to 18
Cortisol 17.6 4 to 22
IGF-1 67 53-331

Had first injection of 200mg Test Cypionate on 6/29. Second Injection on 7/13.

Endocrinologist blood work one week after 2nd bi monthly injection - 7/20/17:
Ferritin 115 20-345
Iron 46 50-80
TIBC 347 250-425
Transferin Saturation 13 15-60
FSH 1.2 1.6-1.8
Testosterone 268 250-827

Hormone Replacement:
By late May many things had improved related to my initial weight loss; however, still had zero libido, severe depression and very little energy. Primary care physician ordered initial testosterone level, and then follow up labs. Low LH combined with complex new eyesight issues led PCP to think I had a pituitary tumor. Had MRI with and without contrast Ė no tumor found. Findings were an undersized pituitary. Was referred to endocrinologist.
Endocrinologist is well-respected MD who is in his seventies and has practiced for forty plus years. However, he seems to not do very much Hormone Replacement. Did hormone blood work and then prescribed Testosterone Cypionate 200mg every fourteen days by self-administration.

Have done two injections so far and had blood work one week after second injection. Doctor is pleased with results. Doctor will not change dosage, or allow more frequent injections until next appointment in six months. Will not prescribe HCG or an AI.

∑ Continue weight loss. Ultimate goal weight 175 pounds. For now, would be thrilled to get below 300 in next 6-8 months. This may be too optimistic given that every pound gets harder every day.
∑ Get off of as many medications as possible.
∑ Find right doctor and plan for hormone replacement.

∑ Iíve lurked on this website for a long time. From comparing what is posted here to my doctorís responses to my questions, it seems that my doctor knows very little about HRT. Do you agree, or does the fact that I am still morbidly obese change what would normally be prescribed?
∑ Should I change doctors and if so are there any that you could recommend in Suffolk County on Long Island NY (Port Jefferson)?
∑ If I stick with current doctor should I change schedule of injections to once or twice per week at lower doses? Or should I play by his rules for six months?

I appreciate any advice you can give and for reading such a long post. You guys are a phenomenal resource. Iím not thin skinned; nothing you say will offend me. I know I have a really long way to go.