Half-dead at 21: What do I ask the endocrinologist?

[NotDeadYet]

At age 19, I had an enormous loss of physical ability. I had a significant loss of energy and crippling joint pain that interfered with most daily activity. I was diagnosed with "chronic fatigue", and told that I was screwed for life and ought to get used to it. I was encouraged to excercise, but pain and fatigue aside, I found that significant physical exertion left me light-headed, almost as if I was not breathing enough oxygen; the worst occurrence involved me collapsing on the Stairmaster, getting up, and realizing five minutes later my knee was bleeding and making a mess. Sex drive was, needless to say, nil.

I'm 21 now. The pain isn't an issue anymore, but the fatigue has left me unable to do much of anything. It's not worth living like this.

Recently, a doctor noted a low-ish testosterone level - ~300, I think - and prescribed a testosterone cream. For a few weeks, I was feeling better; while not a full recovery, I was definitely improving. However, not long after I found myself worse than when I had started, and for good reason - testosterone levels were lower than ever.

I'm seeing an endocrinologist on Thursday. Due to the combination of loss of genital function and high associated estrogen levels without an AI, I'm more than a little nervous about the prospect of more testosterone replacement. However, clomid and most AIs aren't officially approved for this sort of treatment. I'm new to the whole subject of steroid replacement - where do I go from here?

EDIT:
Further relevant information
-No prior steroid abuse.
-Have had problems with physical fitness well before onset of chronic fatigue.
-DHEA was tried; lead to severe moodiness. Could be estrogen related?

 

[The Matrix]

At age 19, I had an enormous loss of physical ability. I had a significant loss of energy and crippling joint pain that interfered with most daily activity. I was diagnosed with "chronic fatigue", and told that I was screwed for life and ought to get used to it. I was encouraged to excercise, but pain and fatigue aside, I found that significant physical exertion left me light-headed, almost as if I was not breathing enough oxygen; the worst occurrence involved me collapsing on the Stairmaster, getting up, and realizing five minutes later my knee was bleeding and making a mess. Sex drive was, needless to say, nil.

I'm 21 now. The pain isn't an issue anymore, but the fatigue has left me unable to do much of anything. It's not worth living like this.

Recently, a doctor noted a low-ish testosterone level - ~300, I think - and prescribed a testosterone cream. For a few weeks, I was feeling better; while not a full recovery, I was definitely improving. However, not long after I found myself worse than when I had started, and for good reason - testosterone levels were lower than ever.

I'm seeing an endocrinologist on Thursday. Due to the combination of loss of genital function and high associated estrogen levels without an AI, I'm more than a little nervous about the prospect of more testosterone replacement. However, clomid and most AIs aren't officially approved for this sort of treatment. I'm new to the whole subject of steroid replacement - where do I go from here?

EDIT:
Further relevant information
-No prior steroid abuse.
-Have had problems with physical fitness well before onset of chronic fatigue.
-DHEA was tried; lead to severe moodiness. Could be estrogen related?

Need to find out why not supplement with T right off the bat which most Dr do because they need to WORK to get to the bottom of things. Giving T gel off the bat is the easy way out. I just roll my eyes when I hear this from people I see in the clinic. I just had a case yesterday of an older lady, who severe fatigue, cloidy thinking, barely function. She had been going to a clinic for Chronic fatigue for over a year and half. I had a meeting with her Dr, and after 1.5 years her Dr never looked at the obvious, but had her on every hormone in the book. I asked if her ferrrtitin levels or adrenals have been checked? He gave me a frazzled look. REplied "NO, but that would be a great idea, we can go ahead and check that" I mentioned about the nutra eval then his eyes really perked up. "excellent", Idea" he note. It was very hard to keep my composure and had to bite my tongue because here the poor lady has spent over a year and half (been there 4 times in the whole peroid of time going) and they did not see the obvious. Later he mention he had a case where they look at number of variables then finally it came down to a simple iron deficiency which was hidden. Point is look for the root cause do not treat symptoms ...

 

[NotDeadYet]

Saw endocrinologist yesterday. Took me off low-dose hormone supplementation (50mg/day testosterone), said to wait a month for further tests.

Can anyone help me understand the full range of relevant tests? I understand basic testosterone levels and the testosterone-like steroids, but I get a bit lost when it comes to the estrogen-type hormones. I'd like to run a full test.

Also, can anyone comment on the combination of clomid/nolvadex? The endo mentioned that if nothing else could be found, she'd refer me to a urologist who deals with these drugs frequently. As I understand, clomid stimulates testosterone production, while nolvadex prevents conversion into estrogen.

Incidentally, I have been tested for malnutrition by a particularly clever physician. The vitamin D deficiency isn't an issue, it seems.

 

[The Matrix]

Still need to evaluate further...

 

[fanzdslpwr1]

refer you to a urologist! Its the Endo doc that is supposed to specialize in hormones! Keep faith dude. I am sure Matrix will lead you in the right direction.

 

[The Matrix]

refer you to a urologist! Its the Endo doc that is supposed to specialize in hormones! Keep faith dude. I am sure Matrix will lead you in the right direction.

Endo are diabetic Dr's not true hormone specialist, urologist people have better luck with dealing with hormones. Need to find out reason WHY not supplement with more drugs not at this time. Or supplement you get you feeling good then Dr should look for deeper issues. You have better luck getting being struck by lighetning to find an endo to even attempt it...

 

[fanzdslpwr1]

wow Urologist are suppose to specialize. My uro doc was giving me 1 injection a month. He should of known better!

 

[The Matrix]

wow Urologist are suppose to specialize. My uro doc was giving me 1 injection a month. He should of known better!

in majority of cases they are better then endos, I do seem more flexiblity in urologists. It really depends on the person and what mood they are in that day..

 

[fanzdslpwr1]

I remember when I went to a Endocrinologist/Fertility expert and he said that my test levels being in the 200s at about age 27 was fine. Go figure.

 

[The Matrix]

I remember when I went to a Endocrinologist/Fertility expert and he said that my test levels being in the 200s at about age 27 was fine. Go figure.

go check out the new ranges for TT men at age of 70
TT 195 is the bottom range they might as well hand them a gun instead of asking for a slow and miserable death..

 

[fanzdslpwr1]

thats how I felt at the time!

 

[The Matrix]

thats how I felt at the time!

You are in jersey ...hint hint..

 

[fanzdslpwr1]

How much $ out of pocket?

 

[The Matrix]

How much $ out of pocket?

hit me in PM