Blood Work - Hypogonadism - Please Help

[Philec48]

Greetings all, I'm a new member here and this is my first post. I'm looking for advice on how to best tackle my hypogonadism.

Here's some background and blood work info:

Age: 48
Height 5'8"
Weight 148lbs
Not too muscular (I can do about 20 pushups though, some belly fat. Think tadpole with stick legs.

Type II diabetes for last 10 years or so. Well controlled without meds. Last several A1C's have been under 6.0.

Libido: at best is 3 on a scale of 1-10.

Energy: Usually low. A tiny bit better lately since starting on CoQ-10, High potency B-vitamin supplement, L-Carnitine, Fish Oil, Alpha-Lipoic acid, Fenugreek, and a Multivitamin. I think I'll get a zinc/copper combo supplement as well.

Note: If you take extra zinc, be careful as too much will deplete copper and set you up for a stroke or severe spinal condition. I've never been on a long zinc only regimine. Just wanted to pass this info along.

Haven't been to my endo in over a year. Got tired of getting poked by labs and doc and wanted to take a break.

Total T runs between 190 and 300. Free T percent around 2.2%.

Last E2 was 41 (without being on TRT). Doc won't prescribe Arimedex! Tried Dim, but never got a blood test to see if it worked, and not taking it now.

DHEA Sulfate is always high. Last result was 562 on a 45-345 scale.

LH and TSH are always in normal range.

PSA always excellent.

Albumin always around 4.6.

Hematocrit is often greater than 48% even with low T.

Hemoglobin always over 16.

When on T shots, half dose every two weeks (instead of once a month like doc at first suggested), my total T went to 700 and my hematocrit went to dangerous 55%. Even 5% Angrodel elevated my hematocrit.

Had to stop T because of the stroke risk.

Have a lot of dizziness/vertigo, and brain fog. When on T for a while, the vertigo almost completely vanished. Brain fog mostly unaffected.

Never been tested for Progesterone, IGF-1, Cortisol, or HCG - should I be?

Does my situation sound like primary or secondary hypogonadism?

If my LH is normal, will HCG by itself help raise T?

How expensive is HCG, and will Blue Cross/Blue Shield cover it?

Thanks,

Phil

 

[The Matrix]

Greetings all, I'm a new member here and this is my first post. I'm looking for advice on how to best tackle my hypogonadism.

Here's some background and blood work info:

Age: 48
Height 5'8"
Weight 148lbs
Not too muscular (I can do about 20 pushups though, some belly fat. Think tadpole with stick legs.

Type II diabetes for last 10 years or so. Well controlled without meds. Last several A1C's have been under 6.0.

Libido: at best is 3 on a scale of 1-10.

Energy: Usually low. A tiny bit better lately since starting on CoQ-10, High potency B-vitamin supplement, L-Carnitine, Fish Oil, Alpha-Lipoic acid, Fenugreek, and a Multivitamin. I think I'll get a zinc/copper combo supplement as well.

Note: If you take extra zinc, be careful as too much will deplete copper and set you up for a stroke or severe spinal condition. I've never been on a long zinc only regimine. Just wanted to pass this info along.

Haven't been to my endo in over a year. Got tired of getting poked by labs and doc and wanted to take a break.

Total T runs between 190 and 300. Free T percent around 2.2%.

Last E2 was 41 (without being on TRT). Doc won't prescribe Arimedex! Tried Dim, but never got a blood test to see if it worked, and not taking it now.

DHEA Sulfate is always high. Last result was 562 on a 45-345 scale.

LH and TSH are always in normal range.

PSA always excellent.

Albumin always around 4.6.

Hematocrit is often greater than 48% even with low T.

Hemoglobin always over 16.

When on T shots, half dose every two weeks (instead of once a month like doc at first suggested), my total T went to 700 and my hematocrit went to dangerous 55%. Even 5% Angrodel elevated my hematocrit.

Had to stop T because of the stroke risk.

Have a lot of dizziness/vertigo, and brain fog. When on T for a while, the vertigo almost completely vanished. Brain fog mostly unaffected.

Never been tested for Progesterone, IGF-1, Cortisol, or HCG - should I be?

Does my situation sound like primary or secondary hypogonadism?

If my LH is normal, will HCG by itself help raise T?

How expensive is HCG, and will Blue Cross/Blue Shield cover it?

Thanks,

Phil

Welcome and you are not the only one in the boat being screwed by dr's that do not know what you are doing. If you are located in the north east there is Dr that is well diverse in this field and would be willling to help to look into other factors that are effecting you. He also takes PPO insurance Pm me with details. Do not try to figure this out on your own..

 

[Philec48]

Hello Matrix! I'm in Atlanta, GA. Do you know of any good docs near me that will do the proper testing and prescribing?

Any other members here in Atlanta that can recommend a doc?

My insurance is Blue Cross/Blue Shield FEP.

Thanks,

Phil

 

[The Matrix]

Hello Matrix! I'm in Atlanta, GA. Do you know of any good docs near me that will do the proper testing and prescribing?

Any other members here in Atlanta that can recommend a doc?

My insurance is Blue Cross/Blue Shield FEP.

Thanks,

Phil

I just had a guy from Atlanta come up to see us today and he had same insurance is awesome you can bill the hell out of it as it covers all labs 100%..
If its same one its a military insurance

 

[Philec48]

Atlanta Doc

Am I the only member here that's in the Atlanta area?

Ok people, spill the beans. What doc are you going to that's any good? PM me if you don't want to say it out loud.

I recently got a recommendation for..., but haven't gone to see him yet. I'm going to give my endo one last visit to get some lab work done, and if he doesn't offer any new help, then off to another doc.

Phil

 

[Philec48]

The other day I had one of those light-bulb moments.

I realized that my family doc always listened and ordered blood tests I asked for (back in my pre-hypogonadism days). So...if my endo refuses to do all the labs I asked for and won't start me on some hcg and/or arimidex, I may just fire the endo and let my regular doc take over everything. Of course, he may hesitate stepping on a specialist's toes, but I don't mind if he don't mind.

While I won't recommend this path to others, I'm curious if anyone else has done this?

The reason I'm comfortable with it is because I know the dosages of what to start with (for T, Ardx, and HCG), and what to test for when on them.

Also, can a GP get in trouble for taking over treating a patient for diabetes, hypogonadism, and other endocrine issues? In other words, must a specialist be deferred to even if both GP and patient can manage the health issues safely. I'm just wondering if there are any AMA rules on this sort of stuff.

Thanks,

Phil

 

[JanSz]

The other day I had one of those light-bulb moments.

I realized that my family doc always listened and ordered blood tests I asked for (back in my pre-hypogonadism days). So...if my endo refuses to do all the labs I asked for and won't start me on some hcg and/or arimidex, I may just fire the endo and let my regular doc take over everything. Of course, he may hesitate stepping on a specialist's toes, but I don't mind if he don't mind.
While I won't recommend this path to others, I'm curious if anyone else has done this?

The reason I'm comfortable with it is because I know the dosages of what to start with (for T, Ardx, and HCG), and what to test for when on them.
Also, can a GP get in trouble for taking over treating a patient for diabetes, hypogonadism, and other endocrine issues? In other words, must a specialist be deferred to even if both GP and patient can manage the health issues safely. I'm just wondering if there are any AMA rules on this sort of stuff.

Thanks,

Phil

What you are waiting for.
You know what to do.
If your GP (or any other doctor) will cooperate you have it made.

More or less that is how I operate.
I ask for tests and guide my treatment, my doctor is comming up with scripts.
===========================================

I use once a year my long list on post #44, between blue lines, here:

http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

2-3x a year I do shorter lists.

You are not going to get anything better paying 1000's $$'s,
actually you have a 95% chance that it will not be as good.

Better spend your money on tests and medicines than on endo.
.
.

.
.

 

[Philec48]

Hello JanSz, I believe I will. Got one more appt with the endo. I had just wondered if there were any issues with it that may either have the doc hesitate, or would have him in hot water if he agrees.

I've seen your list of blood tests, and it's very helpful.

Thanks!

Phil

 

[JanSz]

Hello JanSz, I believe I will. Got one more appt with the endo. I had just wondered if there were any issues with it that may either have the doc hesitate, or would have him in hot water if he agrees.

I've seen your list of blood tests, and it's very helpful.

Thanks!

Phil

Phil;
You said that you know this stuff.
I would appreciate if you look at my list of tests and give me some of your comments.

I am not a doctor, may have missed important stuff.

Specially timely for me, I have appointment with my doc in few weeks and he (hopefully) will sign under that list.
He did that before for my last year's version of this list.

.

 

[Philec48]

I've learned a lot here JanSz, but am by no means an expert.

I know the levels where I want to be at for health (not body building), and know what routine I'd like to follow.

What I've learned here seems to suggest to me that I might go on 75mg per week of T, in even doses of 25mg; 1/4 tablet of Ardx 3 times a week, and 175iu of hcg 3 times a week. Of course, this may change depending on adjusting levels of thyroid (I have had hyper levels and may be slightly hypo now), DHEA-S and Cortisol. Of course, I cannot recommend this course of treatment to others, as everyone's health conditions and natural levels vary.

Question I had meant to post before: I know that low dose hcg on TRT can help prevent gonad shrinkage, but can it also help keep one fertile?

Thanks,

Phil

 

[Philec48]

JanSz, I just now looked at your list again. I didn't see T3 or T4 Uptake or FTI (F7). Not sure what the levels of these would imply, but wanted to let you know since you had asked for my comments.

Phil

 

[The Matrix]

The other day I had one of those light-bulb moments.

I realized that my family doc always listened and ordered blood tests I asked for (back in my pre-hypogonadism days). So...if my endo refuses to do all the labs I asked for and won't start me on some hcg and/or arimidex, I may just fire the endo and let my regular doc take over everything. Of course, he may hesitate stepping on a specialist's toes, but I don't mind if he don't mind.

While I won't recommend this path to others, I'm curious if anyone else has done this?

The reason I'm comfortable with it is because I know the dosages of what to start with (for T, Ardx, and HCG), and what to test for when on them.

Also, can a GP get in trouble for taking over treating a patient for diabetes, hypogonadism, and other endocrine issues? In other words, must a specialist be deferred to even if both GP and patient can manage the health issues safely. I'm just wondering if there are any AMA rules on this sort of stuff.

Thanks,

Phil

NO because if there are hormonal imbalances that are corrected some time the diabetes medicine needs to be reduce or stopped. When dealing with Heart and diabetes one always should refer to see your treating dr's to cover ones ass. diabetes and heart issue are always refered to that persons treating physican unless that person wants to become that dr's new patient.

 

[The Matrix]

JanSz, I just now looked at your list again. I didn't see T3 or T4 Uptake or FTI (F7). Not sure what the levels of these would imply, but wanted to let you know since you had asked for my comments.

Phil

t3 and t-4 uptake of FTI are wasted test for thyroid they tell the dr nothing.
The blood could be put by better uses in getting proper thyroid tests.

 

[JanSz]

I've learned a lot here JanSz, but am by no means an expert.

I know the levels where I want to be at for health (not body building), and know what routine I'd like to follow.

What I've learned here seems to suggest to me that I might go on 75mg per week of T, in even doses of 25mg; 1/4 tablet of Ardx 3 times a week, and 175iu of hcg 3 times a week. Of course, this may change depending on adjusting levels of thyroid (I have had hyper levels and may be slightly hypo now), DHEA-S and Cortisol. Of course, I cannot recommend this course of treatment to others, as everyone's health conditions and natural levels vary.

Question I had meant to post before: I know that low dose hcg on TRT can help prevent gonad shrinkage, but can it also help keep one fertile?

Thanks,

Phil

IIRC there have been reports of fertilization even on very low (2x250iu)/week dose

When one is low on testosterone, there is few possibilities to get remedy.
Starting with adding testosterone either injectable or transdermal is always wrong, but it happens 99% times.

Using Arimidex is a sign of desperation, use it only as a remedy of last resort.

You may want to peruse my thread (the one with list of tests).


I have summarized most importang goals and I post them from time to time.

My own Goals
DHEAs(500-640)mcg/dL(13.55-17.34)µmol/L------------------major player, 95% time overlooked
Progesterone(0.9-1.2)ng/mL
Pregnenolone(> 100ng/dL)
Estradiol, Ultrasensitive(25-29)pg/mL
Estrone, LC/MS/MS (23244X)
do not use Anastrozole if possible or minimize its use
BATest(342, 460-575)ng/dL------------stay around 342 if you need AI to control E2
DHT(60-90)ng/dL
RT3 in lower half of range, TotalT3 in upper 1/3 range
FreeT3~400pg/dL
Body temperature (97.8° - 98.2°F) (36.56° - 36.78°C); (36.6-37C)(97.9-98.6F)
.
.

 

[Philec48]

Is Myocin a good alternative to Ardx?

 

[Philec48]

Sorry, meant to say "Myomin".

 

[Philec48]

Went to endo today. After faxing requested labs to doc's nurse one week before blood was drawn, it was placed in chart and IGNORED. Didn't even test thyroid levels knowing that I had been hyperthyroid before! Doc reluctantly agreed to order my requested labs and send me to an outside lab (they usually do their own labs in-house), but tried to scare me with the cost. I told him to put the proper ICD9 codes and there'd be no problem.

Total T was 323. Have been off TRT for at least 2 years. My usual level range is 199-low 300's.

Reluctantly he agreed to prescribe T-Cyp, but at 50mg per month! I think that may do more harm than good.

Needless to say, I've made my decision. He'll never see me as a patient again.

On top of that, had to wait 1.5 hours past my appt time, and got not even a simple "sorry".

After my next labs in a week or so, I have another doc lined up.

Feel a little better now after venting.

Phil

 

[agent8]

honestly

for get the doctor and use CJC-1295 (DAC-GHRH) at 1mg/wk and exemastane at 12.5mg/day. It is superb to HCG, etc......

 

[DT5]

test is low. im 26 and in your test range.there are docs who will treat you without questions. if youknow what to do with the meds, then you just need a script. many ways to do that legally, so PM myself, or anyone else working with a good clinic (even if they are not in the same state) most just do phone /bloodwork consults over the phone.

 

[The Matrix]

test is low. im 26 and in your test range.there are docs who will treat you without questions. if youknow what to do with the meds, then you just need a script. many ways to do that legally, so PM myself, or anyone else working with a good clinic (even if they are not in the same state) most just do phone /bloodwork consults over the phone.

Look for the cause and not the symptoms. If you are underage of 30 with proper testing on can estabilish it TRT is really necessary or just a bandiad like SRRI for depression.

Dr's do not look deep enough to find the cause.
Simple things are often the most over looked. I have helped people that could not sleep for years in matter of few weeks with out an supplements just by doing one simple thing that required no money. Once that was done they slept like baby.

If you provide us where you are located we will be glad to recommend dr's in that are via PM

 

[Philec48]

Saw my GP a few days ago. He gave me no grief at all about running my requested labs. Should have the results Mon or Tues.

 

[JanSz]

Saw my GP a few days ago. He gave me no grief at all about running my requested labs. Should have the results Mon or Tues.

If your results come back in couple days I doubt that you did too many tests.

I have to wait 2-3 weeks to get all results from my list.
.
.