Endo Visit--12/30/11--good news?

[lboston]

As I have been discussing on the forum, I was diagnosed by a referred urologist as having hypogonadism with a TT reading of 192ng/dl. I was prescribed 200mg test cyp E2W, which I modified to 100mg EW per many your advice. I have been following that protocol from about 11/20 until today when I met a new doctor, that I asked my GP to refer me to, based on his reputation for being one of the better urologists in the Louisville, KY area.

He looked at the bloodwork performed at the request of the urologist (who admittedly had little involvement/ experience in HRT), which included TT, FSH, and LH. The endo said given my age of 27 (and the fact that I had no physical signs of Low T as I have quite a bit of muscle mass, plentiful body and facial hair, as well as "normal" sized testes) he did not feel this was looked in to deep enough before making a final conclusion or diagnosis. He also checked for gyno, which I am free of.

He recommended that I stop the Testosterone Therapy immediately and get a new, more extensive blood work-up done 4 weeks from now, allowing the exogenous test to be fully free from my system, which he would ensure measured what he felt was more than likely my problem--that being the amount of bound/ free test in my system not being used.

I agreed with him that at 27 I hardly want to depend on testosterone therapy to maintain a healthy lifestyle. To me it is hardly work sacrificing fertility amongst other things. He mentioned that he is not ruling test therapy out completely, but does think I have better, more suitable options given my current age and physical features--and normal LH, FSH ranges, etc...

He did say that if test therapy was truly warranted then he would ensure it was done in such a way to maintain my fertility--I am assuming he means the use of HCG or something similar. He said he regularly works in conjunction with a local fertility specialist who is a urologist to treat men.

I hope through his more in depth approach I can fine some answers as to why I exhibit many of the fatigue, libido symptoms of Low T, without actually having to maintain therapy for a long period of time. I was thoroughly impressed by him as he did not rush me at all (we talked for nearly 40 minutes and he answered all my questions, even took the time to draw diagrams).

The tests he is ordering to be performed 4 weeks from now--as far as I can tell by the poor carbine copy--are:

CMP
Lipid Panel
TSH
FT4
TT
SHBG
LH
FSH
Prolactin
Insulin
Cortisol
IGF-1

Any one have any thoughts or opinions? I always appreciate the feedback and I am thankful to be able to discuss these sort of issues with you all.

-LB

 

[The Matrix]

As I have been discussing on the forum, I was diagnosed by a referred urologist as having hypogonadism with a TT reading of 192ng/dl. I was prescribed 200mg test cyp E2W, which I modified to 100mg EW per many your advice. I have been following that protocol from about 11/20 until today when I met a new doctor, that I asked my GP to refer me to, based on his reputation for being one of the better urologists in the Louisville, KY area.

He looked at the bloodwork performed at the request of the urologist (who admittedly had little involvement/ experience in HRT), which included TT, FSH, and LH. The endo said given my age of 27 (and the fact that I had no physical signs of Low T as I have quite a bit of muscle mass, plentiful body and facial hair, as well as "normal" sized testes) he did not feel this was looked in to deep enough before making a final conclusion or diagnosis. He also checked for gyno, which I am free of.

He recommended that I stop the Testosterone Therapy immediately and get a new, more extensive blood work-up done 4 weeks from now, allowing the exogenous test to be fully free from my system, which he would ensure measured what he felt was more than likely my problem--that being the amount of bound/ free test in my system not being used.

I agreed with him that at 27 I hardly want to depend on testosterone therapy to maintain a healthy lifestyle. To me it is hardly work sacrificing fertility amongst other things. He mentioned that he is not ruling test therapy out completely, but does think I have better, more suitable options given my current age and physical features--and normal LH, FSH ranges, etc...

He did say that if test therapy was truly warranted then he would ensure it was done in such a way to maintain my fertility--I am assuming he means the use of HCG or something similar. He said he regularly works in conjunction with a local fertility specialist who is a urologist to treat men.

I hope through his more in depth approach I can fine some answers as to why I exhibit many of the fatigue, libido symptoms of Low T, without actually having to maintain therapy for a long period of time. I was thoroughly impressed by him as he did not rush me at all (we talked for nearly 40 minutes and he answered all my questions, even took the time to draw diagrams).

The tests he is ordering to be performed 4 weeks from now--as far as I can tell by the poor carbine copy--are:

CMP
Lipid Panel
TSH
FT4
TT
SHBG
LH
FSH
Prolactin
Insulin
Cortisol
IGF-1

Any one have any thoughts or opinions? I always appreciate the feedback and I am thankful to be able to discuss these sort of issues with you all.

-LB

Estradiol 4021x from quest.
SHBG

I think hes on the right track, but needs to have more education on how to proper assess hormonal levels in order to prevent people from sliping through the cracks. I applaud him for not being so gung ho on testosterone, and if he's open minded I be glad to speak to him. I do this on a daily basis..

 

[lboston]

Estradiol 4021x from quest.
SHBG

I think hes on the right track, but needs to have more education on how to proper assess hormonal levels in order to prevent people from sliping through the cracks. I applaud him for not being so gung ho on testosterone, and if he's open minded I be glad to speak to him. I do this on a daily basis..

Thanks, Matrix...

He did order SHBG, but I'm not sure about the estrodial. The carbon copy receipt that I got was hard to read!

I may mention that to him on my next visit at the end of January.

Do you think he is taking the right approach to see why I have low total T, but show no physical signs of low T?

 

[The Matrix]

I just.like a more aggressive approach from Drs

 

[pmgamer18]

You might luck out you have only been on TRT a little over 5 weeks so with luck you will go back to the levels you were before TRT. I say this because going on TRT your brain sees the Testosterone in your blood and it stops sending the LH and FSH from your bain to your Testis and whey slow down from making Testosterone.

Men on TRT 8 weeks or longer stopping TRT to do what Endo's call Base Line labs does not work they are shut down and stopping TRT all most of them do is Crash. I was sent to see Endo's in the last 30 yrs I have been on TRT and it was 7 of them each one took me off TRT and all they found out was how dam sick they made me.

Dr.'s need to look deeper before putting men on TRT try to find out why one is low and see if it can be fixed doing this your body will start back making it's own Testosterone.

All 7 Endo's I see were not up on low Testosterone and after taking to a lot of men on the forums most say the same thing Endo's are not good Dr.'s to see for low Hormones.

I pray this all works out for you I was on TRT 23 of 30 yrs not feeling 100% because Dr.'s kept telling me I am Primary meaning my Testis don't work.

Seven yrs. ago I figured out I am Secondary meaning my Pituitary is not working not telling my body to make hormones. Just before I got sick 30 yrs ago I had a head injury and this is what damaged my Pituitary now I treat all my low in range hormones and I feel better.

I pray this works for you and you find out why your so low.

 

[lboston]

You might luck out you have only been on TRT a little over 5 weeks so with luck you will go back to the levels you were before TRT. I say this because going on TRT your brain sees the Testosterone in your blood and it stops sending the LH and FSH from your bain to your Testis and whey slow down from making Testosterone.

Men on TRT 8 weeks or longer stopping TRT to do what Endo's call Base Line labs does not work they are shut down and stopping TRT all most of them do is Crash. I was sent to see Endo's in the last 30 yrs I have been on TRT and it was 7 of them each one took me off TRT and all they found out was how dam sick they made me.

Dr.'s need to look deeper before putting men on TRT try to find out why one is low and see if it can be fixed doing this your body will start back making it's own Testosterone.

All 7 Endo's I see were not up on low Testosterone and after taking to a lot of men on the forums most say the same thing Endo's are not good Dr.'s to see for low Hormones.

I pray this all works out for you I was on TRT 23 of 30 yrs not feeling 100% because Dr.'s kept telling me I am Primary meaning my Testis don't work.

Seven yrs. ago I figured out I am Secondary meaning my Pituitary is not working not telling my body to make hormones. Just before I got sick 30 yrs ago I had a head injury and this is what damaged my Pituitary now I treat all my low in range hormones and I feel better.

I pray this works for you and you find out why your so low.

Thanks for the reply--I greatly appreciate it. You think having only been on TRT for 5 weeks I should be fine with the "cold turkey" stop the endo ordered? My main concern is no loss of LH and FSH.

I have been having some pain in my testicals from time to time recently--hopefully that's nothing to be concerned with.

 

[pmgamer18]

One way to tell is if your LH and FSH come back very low lower then your first tests before TRT if this happens and your Estraidol levels are under 30 pg/ml your body did not come back or start up again. And what the Endo is trying to do will not work if your shut down there is no way to tell why your low. You can do some things to tell if your Primary or Secondary like a Clomid or HCG Stim. test.

 

[lboston]

One way to tell is if your LH and FSH come back very low lower then your first tests before TRT if this happens and your Estraidol levels are under 30 pg/ml your body did not come back or start up again. And what the Endo is trying to do will not work if your shut down there is no way to tell why your low. You can do some things to tell if your Primary or Secondary like a Clomid or HCG Stim. test.

Thank you- hopefully the bloodwork at the end of January will be good news. Prior to starting TRT, both LH and FSH were normal.

I am not sure if he is testing estradiol or not--I know he is looking at a whole host of things with this next set of labs and does not suspect primary.

I still pretty rough at tired though, but 4 weeks of feeling that way is worth it if it can help find some underlying cuases.

 

[pmgamer18]

You need to test Estraidol try a Quest labs test #4021 if your over 30 pg/ml it can keep your LH and FSH levels down to the brain high Estraiod E2 looks like high Testosterone and your brain will slow down sending LH and FSH when Estraidol is high. Estradiol is made from Testosterone and your brain can't tell the diff. Your levels might get up high from being on TRT 5 weeks so check this.

 

[The Matrix]

If.your balls are hurting body is craving lh which is.probably.low.before start hrt. In guys on hrt adding in hcg helps this tremendously. Question is i do.not thing you.needed.in the first place but drs will.not dig for answer. Medical.professionals.i.have spoken with who are open minded learned alot and now others are.benefiting from it. By end of 2012 I plan to.have a huge referral.system with drs who are not.just into.hormones but treating the whole.person. Just because i do.not.have a medical.degree does.not.meani can not.be a fascilator to change how drs may actually resolve.their patients issues .

 

[lboston]

You need to test Estraidol try a Quest labs test #4021 if your over 30 pg/ml it can keep your LH and FSH levels down to the brain high Estraiod E2 looks like high Testosterone and your brain will slow down sending LH and FSH when Estraidol is high. Estradiol is made from Testosterone and your brain can't tell the diff. Your levels might get up high from being on TRT 5 weeks so check this.

I would like to get it checked, but I'm not sure how to do this. In Kentucky, where I am, all doctors have to order labs tests.

Is coming off TRT of 100mg test cyp a week likely to cause estrogen issues?

I feel like absolute sh!t today...today wouldve been the day I injected for the week. Sure hope coming of and getting all these labs done will prove worth it.

 

[The Matrix]

I would like to get it checked, but I'm not sure how to do this. In Kentucky, where I am, all doctors have to order labs tests.

Is coming off TRT of 100mg test cyp a week likely to cause estrogen issues?

I feel like absolute sh!t today...today wouldve been the day I injected for the week. Sure hope coming of and getting all these labs done will prove worth it.

Still think.drs are chasing labs then dealing with root cause. I see it.all.the time kind of.disturbing ..

 

[lboston]

Been roughly 2 days since when I should've taken my weekly shot of test cyp and I feel VERY sluggish, foggy headed, and NO libido whatsoever.

Is it possible to feel this way after coming off TRT of 5 weeks?

 

[The Matrix]

Been roughly 2 days since when I should've taken my weekly shot of test cyp and I feel VERY sluggish, foggy headed, and NO libido whatsoever.

Is it possible to feel this way after coming off TRT of 5 weeks?

Usually with Dr's I suggest people come off HRT when all the metabolic and enzymatic pathways are properly addressed. This can take up to 4 months to properly acheive. The end result is increased success rate of people holding or actually making the clomid be able to do its job more effectively .

 

[lboston]

Usually with Dr's I suggest people come off HRT when all the metabolic and enzymatic pathways are properly addressed. This can take up to 4 months to properly acheive. The end result is increased success rate of people holding or actually making the clomid be able to do its job more effectively .

Thanks Matrix. The new endo I am seeing just wanted me to stop cold turkey b/c he felt the urologist I was seeing wasn't monitoring properly or assessing need for HRT properly.

 

[pmgamer18]

After being on TRT over 30 yrs. seeing all kinds of Dr.'s I found Endo's to be very bad Dr.'s for low T and I have seen 7 of them each one took me off TRT to do what they call Base Line set of labs.

Each time they did this to me all they found out was how dam sick they made me and it was so bad I would not work. And still the got it wrong. You can't go on TRT over 8 weeks and stop flat out and do labs to see why your low your shut down your LH and FSH is not going to go back to what they call Base Line levels.

After all this they each told me I am Primary yet 7 yrs ago trying HCG doing 500 IU's 3x's / week with Depo T shots at 150 mgs / week my levels on HCG after 8 weeks. My Total T levels doubled telling my new Dr. I am Secondary. I have been a Mod on forums for men's low T and talked a lot of men that say the same thing I say Endo's and Uro's are not good Dr.'s for low Testosterone.

And there is no such thing as taking someone off TRT and doing labs in 4 , 6 even 12 weeks finding out why they have low T.

Just find a Dr. that treats a lot of men for this problem.

Thanks Matrix. The new endo I am seeing just wanted me to stop cold turkey b/c he felt the urologist I was seeing wasn't monitoring properly or assessing need for HRT properly.

 

[lboston]

Do you happen to know of any for the Louisville, Ky area?

 

[The Matrix]

Do you happen to know of any for the Louisville, Ky area?

No I do not.
Taking men off HRT should be done in a controlled matter not just drop the rug from underneath them. Suggest Dr's to try a restart after as little as 2 weeks from men who are on HRT wanting to get off. Again other variables are evaluated before they are discontinued. As Phil said you do not stop cold turkey with out proper precautions. Even 5 weeks that enough for your own production to shut down since plasma levels are reached.