Low Testosterone. Please Take a look at my blood Work.

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    Low Testosterone. Please Take a look at my blood Work.


    Hello

    Im 24 years old, ive had ED for 4 years. I didnt start any hormone replacement for Low T yet.

    The symptoms I feel is low energy, fatigue, depressed, anxiety low sex drive, weak erections, don't feel that happy, most of the time don't feel well being. I also do have problems dealing with stress, I get stressed very easily. I do get morning erections once in a while. I have trouble working so I really need to get treatment, I hate feeling like this

    When i was younger i use to drink alcohol, smoke cigarettes, smoke marijuana and did cocaine for a year. I believe this might have caused the problem of low testosterone. I’ve completely stopped all of these bad habits two years ago.

    Ive been seeing an Endo.

    Can someone please take a look at my test results and please give me some advice on what I should do.

    Taking 3PM by my family doctor
    ---------------------------------------------------------------------------------------
    First Test: 02/26/08
    Testosterone: 218 (350-1030)
    ---------------------------------------------------------------------------------------

    Taken 8AM
    Second Test: 03/24/08 (Seen Endo)
    Testosterone, Serum Total: 239 ng/dL (350-1030) My Level Is LOW
    % Free Testosterone 2.6 (1.5 -3.2)
    Free Testosterone 62 pg/mL (52-280)

    Prolactin, Serum 22 ng/mL
    Normal Level Should be 3-18

    Cortisol 6.6 (This is LOW)
    Normal Level Should be 8.0 – 19 at 8:00 AM

    SHBG 20 nmol/L (20-60)
    FSH 3.7 (1.4-18.1)
    LH 6.0 (1.5 - 9.3)
    TSH 4.230 (0.350 – 5.500)
    IGF-1 298 (155-432)
    T3 Uptake 32 (24-39)
    Thyroid Peroxidase 13 (0-34)
    Antihyroglobulin Ab <20 (0-20)

    Taken 8AM
    ---------------------------------------------------------------
    Third Test: 04/09/08

    Testosterone Free With SHBG: 220 (350-1030)
    Testosterone, Serum (Total) 220 (350-1030)
    %Free Testosterone: 2.1 (1.5-3.2)
    Free Testosterone: 46 (52-280)
    SHBG: 20 (20-60)
    Ironc And TIBC
    IronBind Cap(TIBC): 315 (250-450)
    UIBC: 233 (150-375)
    Iron, Serum: 82 (40-155)
    Iron Saturation 26 (15-55)
    Cortisol: 10.0 (8.0-19)
    Estradiol: 0.90 (0.8-3.5)
    Prolactin: 22 (3-18)
    LH: 4.8 (1.5-9.3)
    FSH: 2.7 (1.4-18.1)
    -------------------------------------------------------------------
    Can someone please explain my Semen Analysis?
    My Doctor said it seems normal
    Semen analysis:

    Appearance: Light gray to white (Gray-White)
    Total Volume: 0.5 (>2.0 mL) Is my total volume low?
    Sperm Concentration 141.5 (>or=20.0 Million/mL)
    Motility 56 (>or 50%)
    Semen Morphology 48 (>or30%)
    Time of Motility: 298 Minutes
    Leukocytes: None Seen (None Seen)
    Red Blood Cells: None Seen (None Seen)

    4-18-08
    Started Taking Parlodel (Bromocriptine) To reduce prolactin level.

    Taken 9AM
    6-15-08 (Still taking Bromocriptine)
    Testosterone Free With SHBG: 350
    Prolactin is under control

    Taken 9AM
    7-15-08 (Still taking Bromocriptine)
    Testosterone Free With SHBG: 315

    I will be tested in sept 01 again.

    My Endo wants to check if he needs to higher the dosage of the parlodel. I also got a prescription for 6 month refill so it seems like i'll be on this med for a while.


    So it looks like Parlodel (Bromo) raised my testosterone 95-130 points after 4 months of taking parlodel.

    I could say that I do feel a little better from taking this medicine. But Still don’t notice a big change.

    Im thinking maybe prolactin is not the real problem? My level was slightly elevated. That can cause a big drop in testosterone?

    So im confused on what to do. Should I continue seeing the endo? He said 315-350 is good but I tried to explain to him in 24 and shouldn’t I be in the upper 25th range. (600-700)

    My other question is who is a good candidate for a “restart” with clomid. Would it be a good idea for me?

    Thanks.

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    Holy sh*t dude looking at your story is almost like looking at mine except I am 26 and overweight and your levels are a little different. Anyway in my opinion the three things that standout to me from your blood work are prolactin, estradiol, and cortisol. You are managing your prolactin so that is not so much of an issue. Estradiol causes the same side effects when high and low. Not sure but yours looks low? I don't know. Your cortisol is low so it might suggest something with your adrenal glands. Maybe adrenal fatigue. I too wonder if a slightly elevated prolactin level can cause that big of a drop in test levels. Mine is slightly elevated too. Did you tell the endo all of your symptoms? If you did just tell him if you are still having them. That in it's self should show that level is not sufficient. Alot of people will tell you if you have not done a cycle then no clomid will not help you, but there are a couple guys who have had success with a restart on clomid like lean guy. So my suggestion is to keep trying to find out what is wrong and avoid hrt as long as possible. One last thought your Lh and Fsh are about mid range which is good considering your test levels. It points toward secondary also with your sperm count primary is probably ruled out. JMHO


    Good Luck.
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    TSH 4.230 (0.350 – 5.500)

    you are hypothyroid. check the aace guidelines on treating thyroids. their recommended upper limit for screening hypothyroidism is 3. you are 4.23. to me its a no brainer. Hypothryoidism is a cause of hypogonadism. Before you consider T therapy, get your thyroid levels balanced. why? because its possible that once your thyroid is in check, your testosterone will bounce back to normal w/o exogenous supplementation.
    •   
       

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    Quote Originally Posted by stevie345 View Post
    TSH 4.230 (0.350 – 5.500)

    you are hypothyroid. check the aace guidelines on treating thyroids. their recommended upper limit for screening hypothyroidism is 3. you are 4.23. to me its a no brainer. Hypothryoidism is a cause of hypogonadism. Before you consider T therapy, get your thyroid levels balanced. why? because its possible that once your thyroid is in check, your testosterone will bounce back to normal w/o exogenous supplementation.

    I told my Endo that isnt my TSH high and i might have Hypothyroidism but he said it is in normal range and not to worry. The Endo was also saying My testosterone is good. He said he should be around 350.

    So i should find a different doctor? right. I was thinking of seeing Dr. Shipper Or Dr. Crisler. So for the thyroid problem do you think the doctors i mentioned would be able to help me out with that also? Or what kind of doctor can i see for the thyroid problem?

    Thanks
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    Quote Originally Posted by jon671 View Post
    Holy sh*t dude looking at your story is almost like looking at mine except I am 26 and overweight and your levels are a little different. Anyway in my opinion the three things that standout to me from your blood work are prolactin, estradiol, and cortisol. You are managing your prolactin so that is not so much of an issue. Estradiol causes the same side effects when high and low. Not sure but yours looks low? I don't know. Your cortisol is low so it might suggest something with your adrenal glands. Maybe adrenal fatigue. I too wonder if a slightly elevated prolactin level can cause that big of a drop in test levels. Mine is slightly elevated too. Did you tell the endo all of your symptoms? If you did just tell him if you are still having them. That in it's self should show that level is not sufficient. Alot of people will tell you if you have not done a cycle then no clomid will not help you, but there are a couple guys who have had success with a restart on clomid like lean guy. So my suggestion is to keep trying to find out what is wrong and avoid hrt as long as possible. One last thought your Lh and Fsh are about mid range which is good considering your test levels. It points toward secondary also with your sperm count primary is probably ruled out. JMHO


    Good Luck.
    Thanks for reply. It really sucks at our age we have to suffer with this kind of problem. Im thinking its mainly my fault because of smoking, drinking..etc I really changed my life style now. I dont drink or smoke.

    I told endo all my symptoms but he mainly focusing on prolactin. I guess i will need to find an expert doc to help me out, who understands and treats these kind of problems.

    I didnt know low Estradiol can cause those symtoms, thanks will def look into that, also the cortisol.

    What kind of doc are you seeing at the moment?
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    Quote Originally Posted by HQProperty View Post
    Thanks for reply. It really sucks at our age we have to suffer with this kind of problem. Im thinking its mainly my fault because of smoking, drinking..etc I really changed my life style now. I dont drink or smoke.

    I told endo all my symptoms but he mainly focusing on prolactin. I guess i will need to find an expert doc to help me out, who understands and treats these kind of problems.

    I didnt know low Estradiol can cause those symtoms, thanks will def look into that, also the cortisol.

    What kind of doc are you seeing at the moment?
    Same as you bother an endo. So far not so good. Tests, tests, and more tests every time same thing your okay, but we should retest to confirm. I see him again in two days and if he dosen't treat me I'm gonna drop him and look for a urologist. My prolactin is about where yours is at too a little above normal range, but he wanted to retest to "confirm". I'm sick of seeing him. He doesn't do anything but look at my test results, tell me I'm fine, examine my junk and my stomach, order retest and schedule another appointment. At least your endo is attempting to treat you mine isn't doing much at all. Also you should check on the thyroid like stevie345 mentioned. I am new to this so I guess I missed it.

    http://sci.tech-archive.net/Archive/.../msg00074.html

    where I got my info
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    Quote Originally Posted by HQProperty View Post
    I told my Endo that isnt my TSH high and i might have Hypothyroidism but he said it is in normal range and not to worry. The Endo was also saying My testosterone is good. He said he should be around 350.

    So i should find a different doctor? right. I was thinking of seeing Dr. Shipper Or Dr. Crisler. So for the thyroid problem do you think the doctors i mentioned would be able to help me out with that also? Or what kind of doctor can i see for the thyroid problem?

    Thanks
    I am in the same boat as well man..

    My TSH was like 5.2 or so, and this **** endo didn't want to treat me.. Also my total test was like 350..

    I got a new DR who hopefully will treat me.. If not, i am off to see Crisler as well. Which sucks because my INS won't help me.
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    Quote Originally Posted by imprezivr6 View Post
    I am in the same boat as well man..

    My TSH was like 5.2 or so, and this **** endo didn't want to treat me.. Also my total test was like 350..

    I got a new DR who hopefully will treat me.. If not, i am off to see Crisler as well. Which sucks because my INS won't help me.
    That endo should be reported to the MEDICAL BOARD because that is malpractice. The new ranges have been lowered to under 5 for TSH. I would put report him seriously. Other people on here will agree. I am also speaking from both a patient and practioner stand point.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Quote Originally Posted by The Matrix View Post
    That endo should be reported to the MEDICAL BOARD because that is malpractice. The new ranges have been lowered to under 5 for TSH. I would put report him seriously. Other people on here will agree. I am also speaking from both a patient and practioner stand point.
    As I mentioned in another thread......why arent we doing more of this?

    If everyone reported their endo when he committed malpractice, he would be in hearings so often he would lose his malpractice....I mean practice.
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    Quote Originally Posted by The Matrix View Post
    That endo should be reported to the MEDICAL BOARD because that is malpractice. The new ranges have been lowered to under 5 for TSH. I would put report him seriously. Other people on here will agree. I am also speaking from both a patient and practioner stand point.
    Do you have any more specific info on how to go about that?

    He tested TSH and T4 and a bunch of other stuff related to my "low test".

    TSH-5.07 Ref range-.45-4.5

    T4-1.5 Ref range .8-1.7

    My last T3 results were.

    35.2 Ref range 23.4-42.7

    He said i didn't need treatment because my T4 was fine..
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    Hey HQproperty what dose of bromo are you taking? Any sides? My endo gave me 2.5mg tablets and said to split it in half and take once a day. He wants to start on a small dose and up it if it works. My prolactin was only a little out of range much like yours. Do you have any vision issues? How bout libido and ed issues did they improve when on bromo? I am considering clomid too. I retest again in a month and I will ask when I see my endo again. If it works and then drops back down again I am going to ask about HCG.
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    Quote Originally Posted by jon671 View Post
    Hey HQproperty what dose of bromo are you taking? Any sides? My endo gave me 2.5mg tablets and said to split it in half and take once a day. He wants to start on a small dose and up it if it works. My prolactin was only a little out of range much like yours. Do you have any vision issues? How bout libido and ed issues did they improve when on bromo? I am considering clomid too. I retest again in a month and I will ask when I see my endo again. If it works and then drops back down again I am going to ask about HCG.
    Im also taking half a tablet of the 2.5MG. Im taking the generic form called parlodel.(bromo)
    Its been 4 months and he didnt up my dosage but i have to go tomorrow for a blood test. For the past week i feel like crap like i did before i started taking bromo. I think my dosage needs to be increased, it feels like its not working anymore.

    When i started taking Bromo after 1 month i started feeling a little better. like i would get more better morning erections, i was in a better mood, anxiety almost disappeared, also energy levels was a bit better. but now all is being reversed. I feel like total crap, cant even work. I feel like i should just increase the dosage but i will just wait till i see the doc. It might be something else making me feel like this.

    I could say that taking bromo helped me it increased my testosterone around 75-100 points something like that. My erections were a bit better but not that much to make a real change with the ED.

    Bro i think the best thing to do is if you have the money & time to see either dr.shippen or dr.crisler. That is what i am going to do. I will call and make an appointment with 1 of them. I hear endos are not that good with treating these kinds of problems. They usually just say your fine even if its in the normal range. Im in the normal range for a 100 year old LOL.

    take the bromo and try to look into someone who specialises in treating this condition. I also want to try to restart if the doctor gives me that option.

    good luck.
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    Quote Originally Posted by HQProperty View Post
    Bro i think the best thing to do is if you have the money & time to see either dr.shippen or dr.crisler. That is what i am going to do. I will call and make an appointment with 1 of them. I hear endos are not that good with treating these kinds of problems. They usually just say your fine even if its in the normal range. Im in the normal range for a 100 year old LOL.

    take the bromo and try to look into someone who specialises in treating this condition. I also want to try to restart if the doctor gives me that option.

    good luck.
    I am kinda outta luck there. I live way to far away and it would cost a couple grand just to get there. I am hoping to find someone locally to treat me. I am gonna wait and see what happens with the bromo, then if it isn't that good I am gonna ask about clomid (to confirm secondary). I want to stay away from external test if it is possible so my last resort will be HCG alone. My FSH and LH levels are similar to yours and I have gotten my wife pregnant last year (she miscarried) so I think my testes are working. Also my insurance from what I have been told will not cover test or hcg. Hcg is cheaper as if I did test I would probably need hcg to prevent testicular atrophy and arimidex to control e2. I think a regimen of hcg and arimidex would cost me under $100 a month as long as I have insurance to cover my bloodwork and doctor visits. I mean if it works and there is nothing wrong with my balls why fix something that is not broken. I am going to a sleep center to check if there are any problems there and I am trying to lose weight. I want to avoid HRT as long as possible, but I am getting tired of feeling like doo doo.

    Good luck.
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