Saw endo today and confused on next step

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    Saw endo today and confused on next step


    I was referred to an endocrinologist after I had my primary check my testosterone levels. I'm 35 years old and was experiencing fatigue, loss or inability to gain muscle, sleep disturbance, libido issues etc.

    Here are my levels
    Total 389
    Shbg 67.9
    Test free 46
    Test free % 1.2
    Test bioavailable 120

    I was told by the endo today that since I can grow hair on my face and have a beard it can't be that bad. Wtf?! I'm 35 and having ED and a bunch of other symptoms. This is a quality of life issue. His concern is not wanting me to go the TRT route as it is a lifelong treatment option. Instead he gave me Viagra and sent me on my way. Will have new labs and review again is next step. Any advice?

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    Ok first of all your doctor is a jackass for saying that. According to the Endocrine guidelines anything under 300ng/dl is considered hypogonadal. But this is just a number. You are clearly symptomatic. Normal range is 500-800 that's where you want to be. And considering your age you should want to be towards the higher. end. These numbers were put in place so there are guidlines on how to treat. They really make no sense. So a
    Man whose 80 if he's at 330 is good but a man whose 35 with a 330 is good
    As well that's BS. It's all about ins coverage. Your ins won't pay for it if over 300. You will need to pay out of pocket. So injections will be most cost effective over the Gels. Twice weekly is best. Next time you get bloods drawn do late in day. Your test is lowest at that point. Maybe you will get under 300
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    Yeah I had follow up labs and was on a OTC test booster, changed my diet and training and brought my last levels up to the low 400's. Now that makes it even more difficult to get my point across to my doc. I'm going to finish up this OTC stack & test again (in the late afternoon) and hopefully my numbers are more what this guy is looking for to treat. I've looked into other docs that are all cash no insurance. Is that more than likely what I am looking at. Some range from $85-$150 just for first consult. Is that right?

    Any other advice? Am I barking up the wrong tree looking to get TRT with these numbers? From the research I've done it seems like the best option.
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    Get off everything wait 3 weeks then get tested. If your real numbers are in the 3s you should be on something. Even compound pharmacies can make a transdermal gel for cheap. Best thing to do get your hands on some test. Take it for a month or 2 stop get bloodwork. It will shut off your body's own natural production. And you will be super low. Maybe there is a PH that will do the same check on those boards for advice. I know nothing about PH use
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    What would be the risks associated with this? Gyno, atrophy etc? I know most sides are a roll of the dice but I am guessing they would be minimal if I just went that route for a month??
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    As far as I know zero. Your not trying to get super physiologic levels. Just take a liver support supplement if your worried. I am not a doctor. ��
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    Just get off of the test boosters etc for a few weeks. Find out what your real numbers are. No risk, but you will feel like crap.

    If you want to really drive 'em down, have some hard alcohol and stay up all night before the test.

    PH would also work but could have sides. It's hard to know what really is in the PH and to my mind that's cheating a little.
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    Can you post the ranges for your numbers? With the ranges differing so much with labs, it certainly helps paint the picture a little better.
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    Total and free test are definitely low; SHBG is higher than I'd want it, too.

    At your age and if you're willing, TRT is definitely up your alley.

    When I was 26 or 27, my levels were at like 400 and I had an endo offer TRT up to me (I was there for thyroid work lol). I didn't want to pin the rest of my life and want to have kids, so I didn't take it. But whenever I'm ready, I'll definitely go that route to have quality of life.

    Good doctors do exist; they're hard to find, but they do.

    My advice -- talk to some friends at the gym who are your age or older. They likely know of a good doctor who will offer up TRT as an option.
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    You need a much bigger picture than those tests. That is all that would be run years ago when nobody understood TRT. You need a TSH, T3, FreeT3, T4, CBC, and if you can get it- e2.

    You need to understand what is causing your issue and address it instead of just going the easy route and throwing test at it, only to later find out you might not have needed to be on it.

    Post up your ranges for the hell of it, and discuss this with a good endo or doc. Personally, even the worst endo I dealt with knew to order more than that for labs.
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    Thanks for all the great yet varying answers. I will take all into consideration.
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    Quote Originally Posted by kisaj View Post
    You need a much bigger picture than those tests. That is all that would be run years ago when nobody understood TRT. You need a TSH, T3, FreeT3, T4, CBC, and if you can get it- e2. You need to understand what is causing your issue and address it instead of just going the easy route and throwing test at it, only to later find out you might not have needed to be on it. Post up your ranges for the hell of it, and discuss this with a good endo or doc. Personally, even the worst endo I dealt with knew to order more than that for labs.

    What other issues could I be looking at?
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    Could be adrenal issues, thyroid, etc.. I don't know because I am not a doctor, but I am just saying that you owe it to yourself to try to see if it is anything else before committing to TRT or just throwing viagra at it hoping it puts a bandaid on.
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    Looks like what I went through about 5 years ago. Endo was a jackass. Accused me of being on steroids and when I said I never done them he looked at my like a liar and gave me attitude for the rest of the visit. He wanted me to drive to his office every two weeks for a shot. When I asked him about the half life of T and the roller coaster affect it would have he looked at me even more rudely. Doctors who haven't studied TRT don't know how to prescribe it. Probably didn't help that I continued asking questions and asked about arimidex and hcg. But by then he had pissed me off and I wanted to return the favor. Plus he had an intern so I felt it was my duty to reveal his lack of knowledge in the area.

    Not sure where you are from, but there are good doctors out there, go find one that specializes in TRT. It costs me out of my pocket for mine but it's worth it to have a guy who knows what he's doing look my stuff over.
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    Thanks for the reply. I'm from MA. I still haven't done much on this. I've looked into new docs but the fact that they are all cash kills me. However I get it. Still looking to find some resolution.
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    Find a compounding pharmacy in your area. Ask them what docs they use. Book consults.
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    If your from MA there are doctors galore three that come to mind are Andre Guay Endo at Lehey he is a genius andrologist and wrote so many papers on TRT, Abe Morgenteller and Ricardo Munurez who are two urologists who are world renown specialists.
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    You have any luck? I'm about to get my annual physical next week, and am wondering the same about myself. Two years ago my testosterone tested at 3.78 ng/mL.

    At the time I had no idea to get a free test, etc. done. Last year, I had it done again and the doctor only ordered "Testosterone" and it came up at 413.32. I'm curious to see what it is now. I've been curious about PHs myself, but am not sure about going on TRT for life. My sex drive comes and goes, so I might have low T as well.

    Interested to see what you have discovered.
  

  
 

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