***NEED ADVICE/OPINIONS ON DR CRISLER'S TREATMENT PLAN***

[JoshNyce]

Its been a while since I have posted, but I thought I would get input from the Anabolic Minds community prior to my next Dr.'s visit. Its been a long 2 years since I started TRT with little to no results from my primary care physician. I decided to bite the monetary bullet and bring in Dr. Crisler, who is very well known on this forum as the "go-to" Dr. for testosterone/hormone related male issues. Basically, here is my background info and my question/concerns for you all:

2 years ago, my initial bloodwork showed that I my total testosterone was in the 640's (not bad/not great) and my free testosterone was a hair under the normal range. Dhea was within range and all other hormone panels were in range as well. I was experiencing some libido issues and all of the other symptoms you would see from someone experiencing low test including major stress from work and other outside factors. My primary Dr. decided to put me on androgel for 2 months after my total free was a hair out of range. I felt a little better on the gel towards the end of the treatment, but after just a few weeks I began to feel even worse. A few months later I drew a lab with an endocrinologist and my total testosterone dropped to 520, everything else was in range according to him. The endocrinologist said that these values were not bad for someone who was placed on TRT and advised that actually being administered Androgel could have suppressed my own natural testosterone. He didn't agree on my primary physician putting me on the androgel in the first place. He did little to help me and said that I was "normal". Since then I have seen a steady decline in total testosterone since then. During this 2 year period, my primary Dr. has had me on and off Androgel a total of 3 times. Its sad to say, but now my total test has consistently seen a slide since then. My Dhea is also out of range as well.

I decided to bring in Dr. Crisler as many of the board members trust in his opinions/knowledge. Dr. Crisler was able to identify severe adrenal fatigue to be a one of the many issues, something that my primary care physician failed to see. He has since decided to put me on hydrocortisone so my adrenals could heal.

My questions to you all is if I was indeed in the mid 600 range and was stressed out all the time, could it have been identified earlier as just severe adrenal fatigue? I have read that experiencing adrenal fatigue can lead to some of the symptoms I was experiencing before; mainly a decreased libido/feeling tired all the time/foul mood, etc. From what I have read Dhea is also related to the adrenals as well. Maybe putting me on androgel and not actually addressing the adrenals was the incorrect thing to do?

Dr. Crisler has now decided to start me on a weekly test cyp injection to get my testosterone in range along with the hydrocortisone to heal my adrenals. My main concern is that we may be suppressing my natural production of testosterone and not actually aiding it with the new regimen. I know my testosterone is already low, but the absolute last thing I want to do is to rely on testosterone shots my entire life. Since I was producing ‘ok’ but not great levels of testosterone prior to all the androgel treatments my primary put me on, maybe the androgel treatments she suggested actually suppressed me more than they actually helped me?

I know you guys are not Dr's, but what other treatments would you guys suggest? Do you think Dr. Crisler is correct for putting me on the test cyp shots? Wouldn't this also kill my own natural production? What is his thinking behind this treatment? I would appreciate the advice. Thanks to all.

-J-

 

[Philec48]

I'm shocked that your first doc put you on Androgel when your total T was 640! Did you have your E2 (estradiol) tested at that time? Ever tested? How about your LH and FSH?

Dr. Crisler would be the best person to answer the questions in your last paragraph. If you like, post all your lab results to see what comments may be offered.

Phil

 

[3djedi]

How did he determine you have adrenal fatigue? Just curious. I would be thrilled to have a 600 t count! Mine was 188…

 

[mqsymth]

You need to check your E2, prolactin, SHBG and bio-available T.

In addition you should check your thyroid hormones, TSH, T4 Free, T3 Free, Reverse T3.

Once you start TRT it's for life so don't start if you can get your pituitary HPTA axis going though other means.

 

[The Matrix]

You need to check your E2, prolactin, SHBG and bio-available T.

In addition you should check your thyroid hormones, TSH, T4 Free, T3 Free, Reverse T3.

Once you start TRT it's for life so don't start if you can get your pituitary HPTA axis going though other means.

This is not rocket science
1) identify probably cause -DR's need to ask right question not focuing so much on hormones. Hormone imbalances are majority a symptoms of the cause.

One patient 24 years old had bad hormone and adrenal profile and wanted TRT. Found out that he was toxic from diet soda. Taper the soda, supported hormone systems with adapotgens ,detoxed him correcting the enzymatic pathway associate with aspartame poisoning. His
brain cleared, libido got better, and hormones rebalanced in 4-5 months . NO HRT. I have had numerous cases of these. Look for the cause not the symptoms.

2) clean the cell matrix get the crap out support enzyatic pathways.
3) exmine adrenals going to thyroid then sex hormones.

There are some time where there has to be HRT but people under 30 by going deeper then most dr body can be rebalanced on its own.

food is thy medicine and medicine is thyr food.

 

[jinxie]

Its been a while since I have posted, but I thought I would get input from the Anabolic Minds community prior to my next Dr.'s visit. Its been a long 2 years since I started TRT with little to no results from my primary care physician. I decided to bite the monetary bullet and bring in Dr. Crisler, who is very well known on this forum as the "go-to" Dr. for testosterone/hormone related male issues. Basically, here is my background info and my question/concerns for you all:

2 years ago, my initial bloodwork showed that I my total testosterone was in the 640's (not bad/not great) and my free testosterone was a hair under the normal range. Dhea was within range and all other hormone panels were in range as well. I was experiencing some libido issues and all of the other symptoms you would see from someone experiencing low test including major stress from work and other outside factors. My primary Dr. decided to put me on androgel for 2 months after my total free was a hair out of range. I felt a little better on the gel towards the end of the treatment, but after just a few weeks I began to feel even worse. A few months later I drew a lab with an endocrinologist and my total testosterone dropped to 520, everything else was in range according to him. The endocrinologist said that these values were not bad for someone who was placed on TRT and advised that actually being administered Androgel could have suppressed my own natural testosterone. He didn't agree on my primary physician putting me on the androgel in the first place. He did little to help me and said that I was "normal". Since then I have seen a steady decline in total testosterone since then. During this 2 year period, my primary Dr. has had me on and off Androgel a total of 3 times. Its sad to say, but now my total test has consistently seen a slide since then. My Dhea is also out of range as well.

I decided to bring in Dr. Crisler as many of the board members trust in his opinions/knowledge. Dr. Crisler was able to identify severe adrenal fatigue to be a one of the many issues, something that my primary care physician failed to see. He has since decided to put me on hydrocortisone so my adrenals could heal.

My questions to you all is if I was indeed in the mid 600 range and was stressed out all the time, could it have been identified earlier as just severe adrenal fatigue? I have read that experiencing adrenal fatigue can lead to some of the symptoms I was experiencing before; mainly a decreased libido/feeling tired all the time/foul mood, etc. From what I have read Dhea is also related to the adrenals as well. Maybe putting me on androgel and not actually addressing the adrenals was the incorrect thing to do?

Dr. Crisler has now decided to start me on a weekly test cyp injection to get my testosterone in range along with the hydrocortisone to heal my adrenals. My main concern is that we may be suppressing my natural production of testosterone and not actually aiding it with the new regimen. I know my testosterone is already low, but the absolute last thing I want to do is to rely on testosterone shots my entire life. Since I was producing ‘ok’ but not great levels of testosterone prior to all the androgel treatments my primary put me on, maybe the androgel treatments she suggested actually suppressed me more than they actually helped me?

I know you guys are not Dr's, but what other treatments would you guys suggest? Do you think Dr. Crisler is correct for putting me on the test cyp shots? Wouldn't this also kill my own natural production? What is his thinking behind this treatment? I would appreciate the advice. Thanks to all.

-J-

First off, your testerone is not low. Not at all. It's one of the higher values I've seen on this board. I don't know how old you are, but mine was half that at 37, and many on this board are much lower than me.

Your issue seems to be free testosterone, and possibly high E2. I dont think you should be supplementing with test at this point. And even if you were to want to increase total T, hCG and/or arimidex would be the way to go. Your balls work well.

Others will disagree with me, but I think "adrenal fatigue" is way overdiagnosed, and HC WAY overprescribed. Same goes for hypothyroid and Armor. Often times these meds will make us feel better in the short term, but that doesn't mean that's the problem. Most of us would feel good taking methampetamine in small doses for a short while. Get it?

I would encourage you do a lot of research before proceeding down your current path, as I don't think it's the right one. Remove the stress, eat well, sleep well, and make sure E2 and SHBG are optimal, and then go from there.

Good luck.

 

[luclyluciano]

How do you remove Stress. Jump in a casket and wait, my guess?

 

[The Matrix]

How do you remove Stress. Jump in a casket and wait, my guess?

Identify the cause and addess it accordingly what ever it may be (emotional , phyiscal, biological, environmental, dietary)

Since you are being unde Dr J care he would be the one to ask for this information. We can only give imput but our suggestions are not to be substiuted for your treating dr's medical advice.

 

[JoshNyce]

I guess I needed to be a little more clear about my values. At one point they were in the 640 range. From my most current lab (approx 2 months ago) they were in the low 300 range. According to Jinxie, I should propose HCG. Ever since these symptoms one thing that has never changed is the lack of testicular sensitivity to that area. Testes hang high and tight and libido is in the tanker. Would that be something I should propose? I have read of a test cyp coinciding with a HCG protocol. Thoughts? I will have to post my latest bloodwork for you guys to see. But from what I know Dhea is below range and total test and free test are low. E2 has been mentioned by everyone on this blog thus far. What can I expect if E2 is set back in line? In addition, I am really curious to see whether or not my thyroid is functioning correctly as I was told previously that it was fine. Others were curious of my age. I am 27 years old. Appreciate all your feedback thus far. This has been a life wrecker. Especially since my wife and I would like to have kids one day. Many thanks.

 

[JanSz]

dr John is the best there is.
but
even the best doctor can't help you if you are going to be inconsistent in your demands.
First you want doctor to help you
second
you worry that you will have to be on T-shots for life,
make up your mind.

You have to sit down and discuss with dr John your priorities.
You may not realise but you are making contradictory demands.

I think dr John is already making shortcuts just to please you.
He have a patient compliance in mind.

If that was me, I would tell you do do testosterone shots every other day.
-----------------------------------------

When you want to know if you have enough testosterone, you have to look at BAT-BioAvailableTestosterone.

Very often TotalT~600 is nothing to brag about.
If your SHBG is on a high side, you may need TT~1200, twice of what you have now.

...

 

[Philec48]

Yes, ask your doc about T and hcg protocol combo. It may help keep some testicle function/fertility for you, or at least maybe make it not too difficult to become fertile again.

 

[JoshNyce]

dr John is the best there is.
but
even the best doctor can't help you if you are going to be inconsistent in your demands.
First you want doctor to help you
second
you worry that you will have to be on T-shots for life,
make up your mind.

You have to sit down and discuss with dr John your priorities.
You may not realise but you are making contradictory demands.

I think dr John is already making shortcuts just to please you.
He have a patient compliance in mind.

If that was me, I would tell you do do testosterone shots every other day.
-----------------------------------------

When you want to know if you have enough testosterone, you have to look at BAT-BioAvailableTestosterone.

Very often TotalT~600 is nothing to brag about.
If your SHBG is on a high side, you may need TT~1200, twice of what you have now.

...

Jansz,

I respect your feedback and you have given some of your time to a lot of members on this board. I understand that it may come off as if I am contradicting myself, but this is my thought process. If my bioavailable test was slightly below range prior to all the androgel protocols made by my primary Dr. (off and on for 1 plus years) and now we see even lower values in basically every testosterone category...It leads me to believe that she misdiagnosed me and possibly even hindered my own natural production. What could have been done differently to raise those levels? Everything else was in range before, how could it all go to crap 1 plus years later?

If I am in worse shape then when I first started, what is Dr. Crisler's theory behind putting me on T shots? Wouldn't that just mess up my natural production even further? What other protocols could I bring up to him as possible solutions? What other questions should I pose to him? Maybe I am in denial, but I refuse to give up hope and rely on a synthetic product for the rest of my life. Hope in reversing this trend is all I have right now. Thanks again.

-J

 

[JanSz]

Jansz,

I respect your feedback and you have given some of your time to a lot of members on this board. I understand that it may come off as if I am contradicting myself, but this is my thought process. If my bioavailable test was slightly below range prior to all the androgel protocols made by my primary Dr. (off and on for 1 plus years) and now we see even lower values in basically every testosterone category...It leads me to believe that she misdiagnosed me and possibly even hindered my own natural production. What could have been done differently to raise those levels? Everything else was in range before, how could it all go to crap 1 plus years later?

If I am in worse shape then when I first started, what is Dr. Crisler's theory behind putting me on T shots? Wouldn't that just mess up my natural production even further? What other protocols could I bring up to him as possible solutions? What other questions should I pose to him? Maybe I am in denial, but I refuse to give up hope and rely on a synthetic product for the rest of my life. Hope in reversing this trend is all I have right now. Thanks again.

-J

I am not sitting in dr John's head,
I assume that dr John looked at you, like on any other guy who comes to him,
and is making effort to help you.

He is a very good doctor but he is not miracle maker.

If you listen to dr John advice you will get better.
But to stay in that improved state you will have to do something continously for as long as you want to stay in that improved state.

Once you stop, you will revert to your initial condition or worse.
Most likely it will be worse than initial condition.

Time passes, you are older.
Testicless are stressed (lack of HCG), now will produce less, etc.

Your best chance to get back to the best natural state is;
stop everything, wait 2-3 years for the body to get back to its natural balance, and you have to accept whatever that is .
===========================================

TRT is not like curing broken leg.

Once the bones grows back you are ok, no more attention need.
With TRT you have to tend to it all the time.

==========================================

You could try to improve your situation by tending to adrenals and thyroid,
but it is also something that you would have to tend to indefinitely.
So better give up on that too,

Usually all that mean that, at this time, you not ready to make required effort,
possibly you will give it another try latter.


...

 

[JoshNyce]

I am not sitting in dr John's head,
I assume that dr John looked at you, like on any other guy who comes to him,
and is making effort to help you.

He is a very good doctor but he is not miracle maker.

If you listen to dr John advice you will get better.
But to stay in that improved state you will have to do something continously for as long as you want to stay in that improved state.

Once you stop, you will revert to your initial condition or worse.
Most likely it will be worse than initial condition.

Time passes, you are older.
Testicless are stressed (lack of HCG), now will produce less, etc.

Your best chance to get back to the best natural state is;
stop everything, wait 2-3 years for the body to get back to its natural balance, and you have to accept whatever that is .
===========================================

TRT is not like curing broken leg.

Once the bones grows back you are ok, no more attention need.
With TRT you have to tend to it all the time.

==========================================

You could try to improve your situation by tending to adrenals and thyroid,
but it is also something that you would have to tend to indefinitely.
So better give up on that too,

Usually all that mean that, at this time, you not ready to make required effort,
possibly you will give it another try latter.


...

Hey Jansz,

Dr. Crisler actually hasn't seen me in person. I have just brought him in as a consultant. Unfortunately, thus far I do not feel like he is doing a good enough job for me. Do you know of any good endo's in the Dallas area?

 

[CROWLER]

2) clean the cell matrix get the crap out support enzyatic pathways.

How do you do this?

 

[pmgamer18]

Here is my take on this first your Dr. should not have put you on Androgel with the Total T levels you had. I say this because Androgel if your lucky will only get you up to about 400 on 5 grams some men only see a TT level of 500 on 10 grams of gel. Here is what happens your brain sees the added T in your blood and stops sending the LH and FSH message from your Pituitary to your testis so they slow down making T and all your left with is what the gel is doing so in your case you end up lower.

Now I hate to tell you this but most men that go on TRT and did not need it are on it for life it shuts down your HPTA much like men going on Steroids but they cycle it on and off to keep there Testis working. Your Dr. put you on this Gel and you were shut down to long.

Now for why Dr. John put you on shots he is trying to get your levels up into the upper 1/3 of your labs range doing this will get you tuned up to were you were before you felt sick and went on the gel.

We can talk about what was done wrong all day but this is not going to get you feeling 100% again. You have Adrenal Fatigue and until you fix this if it can be fixed I help a lot of people with this problem and even did a FAQ's about it full of info and dosing evern stress dosing. You can find it in this link.
http://livingnetwork.co.za/hormones/adrenal-fatigue/

I have found a lot of people have been down with AF so long they end up on HC for life. I am Hypopituitary and I am on HC for life my Pituitary does not tell my Adrenals to make enough Cortisol. You can read my story here at this link and my Heart update.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=9239

Dr. John saved my life I would not be here posting to you if it were not for him and I never seen him he helped me on the Forums at MESO when he ran the men's health forum there.

Now your libido is not up because your on TRT and have AF your Estradiol levels will go up on this and you need to test this on your next set of labs Dr. John will do this anyway.

If your high he will give you arimidex to get it down and your libido will come back in time. I had some bad ED problems do to High Estradiol levels and getting them down fixed this problem.

As you get your adrenals supported talk to Dr. John about try to jump start your body to make your own T he is the best at this and it is worth a try. I know a few men that were on TRT that did not need it and he got them started again.

First you need to look deep into why your stressing your adrenals fix your life style so they get bettter then try a jump start.

 

[JoshNyce]

Thanks PMGamer,

The last thing I want to do is to rely on testosterone shots for the rest of my life. Especially since I am in my mid twenties. Do you think he should have suggested a restart protocol first prior to supplementing with a these test shots? I know he's the 'expert', but why try external testosterone again prior to starting up my own T first?

 

[ItsHectic]

Here is what happens your brain sees the added T in your blood and stops sending the LH and FSH message from your Pituitary to your testis so they slow down making T and all your left with is what the gel is doing so in your case you end up lower.

I just want to point out that this is not definite.

After 3 years on testogel my FSH and LH are a little lower than before treatment and my TT level is just a little bit higher, about a year ago my TT level was much higher and my FSH and LH were much lower.

 

[The Matrix]

Thanks PMGamer,

The last thing I want to do is to rely on testosterone shots for the rest of my life. Especially since I am in my mid twenties. Do you think he should have suggested a restart protocol first prior to supplementing with a these test shots? I know he's the 'expert', but why try external testosterone again prior to starting up my own T first?

If i were you this is what I would do.
Since i consult with Dr O in your case as many other's one should not questions the good dr's judgements.

Here is what I would have done
1) rule out primary secondary (clomid challenge)
2) look at lifestyle, nutritoin, hidden stressors, food allergies, gut dysbiosis (finding alot more candida in males), sleep patterns, heavy metals
3) Look at your thyroid and adrenals indeptly -20 mgs of cortef is not going to hurt any one ...Studys done with given 10 mgs before giving a speech made a person more energetic and confident.

Being in texas your vitamin D levels is in the crapper as every texan that has came up to see us has been ..Chalk up florida too.

Go slow and see if you respond to clomid then treat thyroid/adrenals and back fill with all the necessary building blocks to make hormones so when you stop the clomid you have a strong foundation to come off so you have a greater chance of success.

i just have a different approach which has worked great in the past.

 

[JoshNyce]

If i were you this is what I would do.
Since i consult with Dr O in your case as many other's one should not questions the good dr's judgements.

Here is what I would have done
1) rule out primary secondary (clomid challenge)
2) look at lifestyle, nutritoin, hidden stressors, food allergies, gut dysbiosis (finding alot more candida in males), sleep patterns, heavy metals
3) Look at your thyroid and adrenals indeptly -20 mgs of cortef is not going to hurt any one ...Studys done with given 10 mgs before giving a speech made a person more energetic and confident.

Being in texas your vitamin D levels is in the crapper as every texan that has came up to see us has been ..Chalk up florida too.

Go slow and see if you respond to clomid then treat thyroid/adrenals and back fill with all the necessary building blocks to make hormones so when you stop the clomid you have a strong foundation to come off so you have a greater chance of success.

i just have a different approach which has worked great in the past.

Thanks Matrix, I will suggest the clomid approach to him. Would I continue to use hcg as well since I still want to try to get the "boys" back to proper size and function? How much clomid/what would the dosage be from your experience? Would clomid be the only substance used? Currently, I am using Hydrocortisone, would Cortef work the same way or be better than the HC? Thanks for the help. I appreciate it.

 

[The Matrix]

Thanks Matrix, I will suggest the clomid approach to him. Would I continue to use hcg as well since I still want to try to get the "boys" back to proper size and function? How much clomid/what would the dosage be from your experience? Would clomid be the only substance used? Currently, I am using Hydrocortisone, would Cortef work the same way or be better than the HC? Thanks for the help. I appreciate it.

With Dr J the man knows his stuff thats for sure...
With cortef in our experience after 4-5 weeks this may reveal hypothyroidism so what we do is recheck the thyroid 5-6 weeks after starting the cortef to see if there is a drop. We also have people take cortef 1 hour before the blood draw to see if their TSH drops. Normally with cortef in >80% of cases their also needs to be thyroid support to get full response. We have not had any people that are doing good just on cortef its self. Not saying it can not happen.
I would check vitamin D because that can make HCG work even better.
Again discusss your options with your DR and see what he thinks is the best route. Sometime being on hcg may stmulate and get you going again.
We have a few people on HCG therapy they love it but they are over 30 years old.

Best of luck

 

[pmgamer18]

It is hard to say without seeing labs all of them. Men that have low T do to a health problem if they can find out what the Problem is and treat it there T levels go back up. One guy I talked to had a low grade infection in his tooth they did a root canal on the tooth some yrs. ago but did not get all the nerve out. He started feeling fatigue and like he was depressed and when his Dr. tested his testosterone levels they were low.

His Dr. wanted to treat the low T and this guy wanted to know why he was this low. So he seen a Diff. Dr. and this Dr. seen in his labs that it looked like he has an infection some where. He talked about things that were done before his getting sick and the Root Canal was the last change.

Then he went back to the Dr. that did the Root Canal and they opened it up and seen it was infected pulled the tooth and his Testosterone levels came back up.

Men low on T do to using Steroids should try a Jump Start and keep trying being on TRT for life sucks.

Thanks PMGamer,

The last thing I want to do is to rely on testosterone shots for the rest of my life. Especially since I am in my mid twenties. Do you think he should have suggested a restart protocol first prior to supplementing with a these test shots? I know he's the 'expert', but why try external testosterone again prior to starting up my own T first?

 

[The Matrix]

It is hard to say without seeing labs all of them. Men that have low T do to a health problem if they can find out what the Problem is and treat it there T levels go back up. One guy I talked to had a low grade infection in his tooth they did a root canal on the tooth some yrs. ago but did not get all the nerve out. He started feeling fatigue and like he was depressed and when his Dr. tested his testosterone levels they were low.

His Dr. wanted to treat the low T and this guy wanted to know why he was this low. So he seen a Diff. Dr. and this Dr. seen in his labs that it looked like he has an infection some where. He talked about things that were done before his getting sick and the Root Canal was the last change.

Then he went back to the Dr. that did the Root Canal and they opened it up and seen it was infected pulled the tooth and his Testosterone levels came back up.

Men low on T do to using Steroids should try a Jump Start and keep trying being on TRT for life sucks.

Again look for cause not just the symptoms.
It takes alot of detective work but it can be found.
Dr's are just some times to lazy to dig.

 

[JoshNyce]

Again look for cause not just the symptoms.
It takes alot of detective work but it can be found.
Dr's are just some times to lazy to dig.

Thanks Matrix for all of your advice. It's been six weeks and I have followed the Dr's protocol of 250iu of hcg (2x/week) and 1ml of once every week. What I have noticed is that even with the injections my libido, mental state, and overall well being are still in the crapper. I am beginning to realize that there is some type of underlying issue that has not been addressed yet. In general, what I have noticed is anytime I start getting stressed out these symptoms tend to occur. My body doesn't react well to any type of stress even with the test shots and hcg/ Hydorcort protocol. In my opinion, you could put me on all the testosterone in the world..but still all my symptoms would not go away until the underlying issue is addressed. I am probably going to print out the recommendations you have mentioned in previous posts just so that I may open up other possibilities for Dr. C to look at. I am also considering making an appointment with a well known Dr. here in my area who specifically treats adrenal fatigue and disorders. Where is your clinic located and what type of patients do you normally see? Are you a Dr. as well?

-J-

 

[The Matrix]

Thanks Matrix for all of your advice. It's been six weeks and I have followed the Dr's protocol of 250iu of hcg (2x/week) and 1ml of once every week. What I have noticed is that even with the injections my libido, mental state, and overall well being are still in the crapper. I am beginning to realize that there is some type of underlying issue that has not been addressed yet. In general, what I have noticed is anytime I start getting stressed out these symptoms tend to occur. My body doesn't react well to any type of stress even with the test shots and hcg/ Hydorcort protocol. In my opinion, you could put me on all the testosterone in the world..but still all my symptoms would not go away until the underlying issue is addressed. I am probably going to print out the recommendations you have mentioned in previous posts just so that I may open up other possibilities for Dr. C to look at. I am also considering making an appointment with a well known Dr. here in my area who specifically treats adrenal fatigue and disorders. Where is your clinic located and what type of patients do you normally see? Are you a Dr. as well?

-J-

I am not a Dr, but I do consult with Drs when they are stuck banging their heads against the wall. and make recommendations on what areas to look into when HRT is not working such as thyroid adrenals and lifestlye, nutritoinal issues, gut, heavy metals and hidden infections, genetic mutations,ect Dr J is awesome about hormone replacement that is his bread and butter such as shippen they have a good understanding. A couple of shippen guys Ideal with as well and he has them tuned up on hormones perfectly, but they still do not feel right. After digging around I found food allergies, gut issues and few other things that when corrected there was a significant improvement in symptoms despite HRT. I have a client from dr Brownsteiin and he is totally baffled I am looking in to things alittle deeper. REmember I am just making suggestions or recommendation no way changing meds or prescribing anything. I have worked with many dr's patients tell them to follow physican's order as directed

 

[JoshNyce]

I am not a Dr, but I do consult with Drs when they are stuck banging their heads against the wall. and make recommendations on what areas to look into when HRT is not working such as thyroid adrenals and lifestlye, nutritoinal issues, gut, heavy metals and hidden infections, genetic mutations,ect Dr J is awesome about hormone replacement that is his bread and butter such as shippen they have a good understanding. A couple of shippen guys Ideal with as well and he has them tuned up on hormones perfectly, but they still do not feel right. After digging around I found food allergies, gut issues and few other things that when corrected there was a significant improvement in symptoms despite HRT. I have a client from dr Brownsteiin and he is totally baffled I am looking in to things alittle deeper. REmember I am just making suggestions or recommendation no way changing meds or prescribing anything. I have worked with many dr's patients tell them to follow physican's order as directed

Hey Guys,

So I have another appointment coming up with Dr. Crisler and my General Family Doc this coming Monday. I wanted to get some feedback on my blood work from Quest to get an idea on what types of questions I need to ask Dr. Crisler. I wanted to check my thyroid as I read that being put on TRT prematurely or without good reason can affect thyroid hormone levels. I really feel that I was misdiagnosed in the beginning when my testosterone levels weren't exactly in the dumps (mid 600's). There must have been signs of adrenal fatigue that they did not pick up on and other hormonal imbalances that could have been addressed without using synthetic testosterone. As I stated before, my history suggests that the Dr's that I have been working with have not been addressing the underlying issue or could have further complicated my situation. That issue is yet to be determined. But with your help, I hope to address them this coming Monday. Please see below for blood work. I would appreciate suggestions on what questions I should ask both Dr's and what steps you all think need to be taken. Thanks.

Test Name Result Reference Range

TSH, 3RD GENERATION 1.19 .40-4.50 mIU/L
T4, FREE 1.1 0.8-1.8 ng/dL
T3, TOTAL 79 76-181 ng/dL
T3 UPTAKE 38 22-35%
ESTRADIOL ULTRASENSITIVE 16
DHEA, LC/MS/MS 389 61-1636 ng/dL
FSH 3.4 1.6-8.0 mIU/mL
LH 3.8 1.5-9.3 mIU/mL
TESTOSTERONE, TOTAL 373 241-827 ng/dL

 

[jinxie]

Hey Guys,

So I have another appointment coming up with Dr. Crisler and my General Family Doc this coming Monday. I wanted to get some feedback on my blood work from Quest to get an idea on what types of questions I need to ask Dr. Crisler. I wanted to check my thyroid as I read that being put on TRT prematurely or without good reason can affect thyroid hormone levels. I really feel that I was misdiagnosed in the beginning when my testosterone levels weren't exactly in the dumps (mid 600's). There must have been signs of adrenal fatigue that they did not pick up on and other hormonal imbalances that could have been addressed without using synthetic testosterone. As I stated before, my history suggests that the Dr's that I have been working with have not been addressing the underlying issue or could have further complicated my situation. That issue is yet to be determined. But with your help, I hope to address them this coming Monday. Please see below for blood work. I would appreciate suggestions on what questions I should ask both Dr's and what steps you all think need to be taken. Thanks.

Test Name Result Reference Range

TSH, 3RD GENERATION 1.19 .40-4.50 mIU/L
T4, FREE 1.1 0.8-1.8 ng/dL
T3, TOTAL 79 76-181 ng/dL
T3 UPTAKE 38 22-35%
ESTRADIOL ULTRASENSITIVE 16
DHEA, LC/MS/MS 389 61-1636 ng/dL
FSH 3.4 1.6-8.0 mIU/mL
LH 3.8 1.5-9.3 mIU/mL
TESTOSTERONE, TOTAL 373 241-827 ng/dL

T3 looks low. Maybe cytomel. Should be higher given TSH. Given low LH and FSH, and lowish T, you may have a pituitary problem, and you look secondary hypo, tho you say your TT used to be 600. Looks like something got screwed from being on T. Did you do a PCT? Did you abruptly stop and then get tested. I havent read this thread and only responded because you sent me a PM. But I dont know you. Sorry, this is all the time I have. Good luck and I hope it resolves. You're seeing a doctor, so you are best to ask him. If he sees this, you may end up getting fired.

 

[pmgamer18]

I still stand by my other replies.
1. Your Dr. should not have put you on Testosterone meds with a level of TT at 600 and free T means nothing it's only 3% of all the T in your body. So a low FT only means in your case your TT is bound up and he only need to do some more testing to see why it was bound up like high levels of SHBG or every high Estradiol.

2. Tell Dr. J you don't what to be on TRT for like ask if he plains on trying a restart when you get your Adrenals fixed.

3. Your thyroid looks low not that you have your Adrenals supported you can try going on natural dessicated thyroid we can't get Armour so ask for this it the best there is out there.
http://www.erfa-sa.com/thyroid_usa.htm
Or
http://www.universaldrugstore.com/medications/Thyroid/60mg

4. Remind Dr. J that your TT levels before TRT were in the 600's.

I am hoping Dr. J is try to fix your Adrenals and now your Thyroid then he will try taking you off TRT so your body can make it's own. I can't say if this will work you need to take to him about it.

 

[JanSz]

Hey Guys,

So I have another appointment coming up with Dr. Crisler and my General Family Doc this coming Monday. I wanted to get some feedback on my blood work from Quest to get an idea on what types of questions I need to ask Dr. Crisler. I wanted to check my thyroid as I read that being put on TRT prematurely or without good reason can affect thyroid hormone levels. I really feel that I was misdiagnosed in the beginning when my testosterone levels weren't exactly in the dumps (mid 600's). There must have been signs of adrenal fatigue that they did not pick up on and other hormonal imbalances that could have been addressed without using synthetic testosterone. As I stated before, my history suggests that the Dr's that I have been working with have not been addressing the underlying issue or could have further complicated my situation. That issue is yet to be determined. But with your help, I hope to address them this coming Monday. Please see below for blood work. I would appreciate suggestions on what questions I should ask both Dr's and what steps you all think need to be taken. Thanks.

Test Name Result Reference Range

TSH, 3RD GENERATION 1.19 .40-4.50 mIU/L
T4, FREE 1.1 0.8-1.8 ng/dL
T3, TOTAL 79 76-181 ng/dL
T3 UPTAKE 38 22-35%
ESTRADIOL ULTRASENSITIVE 16
DHEA, LC/MS/MS 389 61-1636 ng/dL
FSH 3.4 1.6-8.0 mIU/mL
LH 3.8 1.5-9.3 mIU/mL
TESTOSTERONE, TOTAL 373 241-827 ng/dL

T3, TOTAL 79 76-181 ng/dL

You have very very low T3
It should be 2x that much.
Likely you have very high rT3
-------------------------------
You need overall (with lots of details) checkup.
Minerals, vitamins, other
Adrenals
Thyroid
-------------------------------

FSH 3.4 1.6-8.0 mIU/mL
LH 3.8 1.5-9.3 mIU/mL
TESTOSTERONE, TOTAL 373 241-827 ng/dL

Your pituitary do not care that your Testosterone is low

This is two strikes against pituitary.

Get pituitary MRI.

Pituitary MRI should be your first next step.

Have you ever been hit in the nose/head, specially the part that eye glasses rest?

==================================================
If you have your LH & FSH prior to your use of external testosterone, it may help to evaluate your chance on restart.

If your SHBG is ~15 and restart succesfull, you may think of living like that.
If your SHBG is high, no sense of spending energy on restarting because you would always have low BAT naturally. Sub-optimal.
==================================================

This is your first post where you post lab results.

Post all your lab results for the last 5 or more years.

////

To get information do these tests:

My long list on post #44 here:
between the blue lines
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

RheinLabs 24hr urine test
Spectracell-5000 (all available micronutrients and lipids)
Fatty Acid Analysis at Genova Diagnostics
Perspective at Genova Diagnostics

//////

 

[pmgamer18]

Jan he is on T shots you can't test LH and FSH to tell if there is a pituitary problem on TRT it slows the messages down from the pituitary when the brain sees the T shots in the blood. One needs this tested before going on TRT after being on TRT you can't tell. All one can do is try a Clomid or HCG stim. test to see if testis work it they do then look at the Pituitary.

T3, TOTAL 79 76-181 ng/dL

You have very very low T3
It should be 2x that much.
Likely you have very high rT3
-------------------------------
You need overall (with lots of details) checkup.
Minerals, vitamins, other
Adrenals
Thyroid
-------------------------------

FSH 3.4 1.6-8.0 mIU/mL
LH 3.8 1.5-9.3 mIU/mL
TESTOSTERONE, TOTAL 373 241-827 ng/dL

Your pituitary do not care that your Testosterone is low

This is two strikes against pituitary.

Get pituitary MRI.

Pituitary MRI should be your first next step.

Have you ever been hit in the nose/head, specially the part that eye glasses rest?

==================================================
If you have your LH & FSH prior to your use of external testosterone, it may help to evaluate your chance on restart.

If your SHBG is ~15 and restart succesfull, you may think of living like that.
If your SHBG is high, no sense of spending energy on restarting because you would always have low BAT naturally. Sub-optimal.
==================================================

This is your first post where you post lab results.

Post all your lab results for the last 5 or more years.

////

To get information do these tests:

My long list on post #44 here:
between the blue lines
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

RheinLabs 24hr urine test
Spectracell-5000 (all available micronutrients and lipids)
Fatty Acid Analysis at Genova Diagnostics
Perspective at Genova Diagnostics

//////

 

[JoshNyce]

Jan he is on T shots you can't test LH and FSH to tell if there is a pituitary problem on TRT it slows the messages down from the pituitary when the brain sees the T shots in the blood. One needs this tested before going on TRT after being on TRT you can't tell. All one can do is try a Clomid or HCG stim. test to see if testis work it they do then look at the Pituitary.

Just to clarify guys, I have been off of the test cyp shots and hcg for a little over a month now. I am currently only on HC for my adrenals. I will try to post my old lab results when I go to the Dr's office on Monday. Thanks for all the feedback. I'll pm you guys when I get back on Monday afternoon. Will let you all know what Dr. J recommends. I know he's considered very "knowledgeable" on this forum...but every time we speak on conference call he makes me feel like another number...I am considering a second opinion if my issues linger. 2 years of going back and forth and spending close to 2k in medicine and Dr's visits is ridiculous without any results. Thanks again guys.

-J

 

[pmgamer18]

Did Dr. J take you off the shots or did you stop on your own.
I see your body is trying to come back but one still can't go by LH and FSH after being on TRT. Talk to Dr. J about a restart see if he can't get your body making T again.

 

[JanSz]

Jan he is on T shots you can't test LH and FSH to tell if there is a pituitary problem on TRT it slows the messages down from the pituitary when the brain sees the T shots in the blood. One needs this tested before going on TRT after being on TRT you can't tell. All one can do is try a Clomid or HCG stim. test to see if testis work it they do then look at the Pituitary.

Phil,
he shows
FSH 3.4 1.6-8.0 mIU/mL
LH 3.8 1.5-9.3 mIU/mL

Blood must have been drawn prior to T shots, (or long after), while on T-shots those numbers would have been close to zero.

Those LH & FSH numbers produced

TESTOSTERONE, TOTAL 373 241-827 ng/dL

Not much to get excited about.


So he is shutdown from previous T use and not able to get to his old 600.

My question is, is it worth to get him to 600 naturally.
That is why I asked about SHBG.
..........

............

 

[pmgamer18]

Yes a lot of men have seen Dr. J that were put on TRT and did not need it and he got them started again. Some men were shut down from steroid use but others there dam Dr. shut them down. I have 3 men at the H2 forum that were shut down from being on TRT one got off it and just took arimidex to get his levels back up. One other one came for a different forum and when on gels because he was fatigued his levels were up there past 600 near 700 he stopped TRT on his own took some time but his levels are now back up. And they are doing fine.

This is why I tell men don't go on TRT until you know why your low. I know on guy thought he would eat more healthy and was drinking a lot of SOY MILK everyday ended up with low T from the SOY MILK. He come to the forum at Yahoo because he felt he was to young to be on TRT it took time posting to him but as soon as he said he is now a health nut and drinks a lot of SOY MILK that was it.

SOY in men looks to the brain like it's Estradiol and the brain thinks the Estradiol is Testosterone and his LH and FSH was why down do to SOY.

 

[JoshNyce]

Just to clarify guys, I have been off of the test cyp shots and hcg for a little over a month now. I am currently only on HC for my adrenals. I will try to post my old lab results when I go to the Dr's office on Monday. Thanks for all the feedback. I'll pm you guys when I get back on Monday afternoon. Will let you all know what Dr. J recommends. I know he's considered very "knowledgeable" on this forum...but every time we speak on conference call he makes me feel like another number...I am considering a second opinion if my issues linger. 2 years of going back and forth and spending close to 2k in medicine and Dr's visits is ridiculous without any results. Thanks again guys.

-J

Yes a lot of men have seen Dr. J that were put on TRT and did not need it and he got them started again. Some men were shut down from steroid use but others there dam Dr. shut them down. I have 3 men at the H2 forum that were shut down from being on TRT one got off it and just took arimidex to get his levels back up. One other one came for a different forum and when on gels because he was fatigued his levels were up there past 600 near 700 he stopped TRT on his own took some time but his levels are now back up. And they are doing fine.

This is why I tell men don't go on TRT until you know why your low. I know on guy thought he would eat more healthy and was drinking a lot of SOY MILK everyday ended up with low T from the SOY MILK. He come to the forum at Yahoo because he felt he was to young to be on TRT it took time posting to him but as soon as he said he is now a health nut and drinks a lot of SOY MILK that was it.

SOY in men looks to the brain like it's Estradiol and the brain thinks the Estradiol is Testosterone and his LH and FSH was why down do to SOY.

PmGamer,

To clarify your prior post, I actually stopped the use on my own when I noticed that my nipples were getting sensitive. On top of that I wasn't seeing any improvements mentally or sexually from being on the test shots, so I decided to stop. I'm very surprised Dr. J didn't try a restart protocol before putting me on trt, but I didn't figure to challenge his knowledge at the time. He told me that I was "sick" and needed to get my adrenals back in line while bringing my testosterone to the upper range. I just don't think my General Practitioner and Dr. J have been thorough enough in looking at all possible angles..thats what makes me the most frustrated, oh well. I'll bring up what everyone has mentioned thus far this Monday. I appreciate all the help and feedback from everyone. Much respect.

-J

 

[pmgamer18]

I know what Dr. J was trying to do your adrenals were bad and he was trying to treat them and get your T levels up so they were not stressing your Adrenals even more. Now that you stopped TRT ask him to try to jump start you.

A lot of dam good Dr.'s like Dr. Marianco will try to treat Adrenals and Thyroid first to see is Testosterone levels will come back up on there own.
http://www.definitivemind.com/forums/index.php
But these men were very low on there T levels. You were not and like I said your Dr. should not have put you on TRT with a level of 600.

So now all you can hope for is that Dr. J can get you jump started again if not you will end up needing TRT for life.

 

[may19th2001]

Sounds excellent dude.
I hope that you can get your normal numbers back, I have been on HRT for a few years since my early 20's and natural was always better.
More of a raging sex drive it is close HRT but it is just not the same as your natural system driving itself at its peak.
I hope all goes well with your visit.

Just to clarify guys, I have been off of the test cyp shots and hcg for a little over a month now. I am currently only on HC for my adrenals. I will try to post my old lab results when I go to the Dr's office on Monday. Thanks for all the feedback. I'll pm you guys when I get back on Monday afternoon. Will let you all know what Dr. J recommends. I know he's considered very "knowledgeable" on this forum...but every time we speak on conference call he makes me feel like another number...I am considering a second opinion if my issues linger. 2 years of going back and forth and spending close to 2k in medicine and Dr's visits is ridiculous without any results. Thanks again guys.

-J

 

[may19th2001]

I would say with a good Bioavailable testosterone along with a decent number in the 600's it would be worth it on the Labcrop scale I was natural from mid 600's to mid 800's this was in my late teens early 20's, before hormones got all jacked up.
It was miserable but I would say it may be very well worth keeping his numbers natural in the 600's if them would have been close to his natural normal numbers anway.

 

[spstriken]

Hi Jinxie

I have been reading your posts with great interest and now wants to have some help from you. first few questions if you don't mind to answer.

1-what was the reason for your hypogonadism?
2- how is going your HCG monotherapy, I am assuming you are just on HCG only.
3-do you feel over time you HCG dosase has decreased? if yes what might be the reason.

4-have you checked your LH and FSH recently, some say on HCG these values go down, some claim HCG actually bring these valuse up.


about me, I became hypo just 12 months ago , when used Saw palmetto for my hairloss

If you want you can start new thread for me so that other people can benefit from our discussion.

I thank you in advance for your time and help.

regards

sps

 

[The Matrix]

Hi Jinxie

I have been reading your posts with great interest and now wants to have some help from you. first few questions if you don't mind to answer.

1-what was the reason for your hypogonadism?
2- how is going your HCG monotherapy, I am assuming you are just on HCG only.
3-do you feel over time you HCG dosase has decreased? if yes what might be the reason.

4-have you checked your LH and FSH recently, some say on HCG these values go down, some claim HCG actually bring these valuse up.


about me, I became hypo just 12 months ago , when used Saw palmetto for my hairloss

If you want you can start new thread for me so that other people can benefit from our discussion.

I thank you in advance for your time and help.

regards

sps

If one examined the case I am sure you that there were other factors at play and not just a simple supplement as the main contributing factor. It may have contributed slighly, but total was coincidental.