Needing some direction with TRT......

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    Needing some direction with TRT......


    Hi everyone,
    Been reading a lot here, and all over trying to get a good handle on this but I need some help. Here's my story......

    12/2/2012

    OK so I have been having loss of libido issues for a long time now, and have been discussing it with my Dr for over 18 months. Originally he said that it was mental, and that things like these come and go. About 6 months later I went back (March 2011) and told him that I was still having the issues of just not wanting sex often if at all. I asked him to check my test levels and he agreed too. Two weeks later I got a call from the Dr's office saying everything was fine, so I figured it must be diet related. I hired a nutritionist (that works with bodybuilders, powerlifters, etc) and followed his diet plan to the letter. No improvement in libido, but lifts to do go up since it seems I was under eating for a awhile. I called the dr's office and asked for copy of the test after doing some reading here. (I also started adding 10,000 IU's of Vit D per day after reading here) Test levels came back at 343ng/dl on a scale of 249-869 ng/dl. Go back to the Dr and ask for all the test that were listed on here. Explaining that I have been having symptoms of low sex drive, tired in the afternoons, I fight to stay away around 5 pm when leaving work no matter how much sleep I get. A lot of nights I then have a lot of trouble falling asleep, and general fogginess on a lot of days no matter how much sleep I get or food I eat. I asked him why he wouldn't say the 343 is low and he said because it's in "range". He does test me again, but not for everything I ask. Here's what he tested for and the results....

    Test Result Flag Units Reference Interval
    Glucose, Serum 86 mg/dl 65-99
    BUN 30 High mg/dl 6-20
    Creatinine, Serum 1.12 mg/dl .76-1.27
    eGFR 88 ml/min/1.73 >59
    BUN/Creatinine Ratio 27 High 8-19
    Sodium/Serum 137 mmol/L 135-145
    Potassium, Serum 4.3 mmol/L 3.5-5.2
    Chloride, Serum 97 mmol/L 97-108
    Carbon Dixoide 25 mmol/L 20-32
    Calcium 9.7 mg/dl 8.7-10.2
    Protien, Serum 7.6 g/dl 6.0-8.5
    Albumin,Serum 4.7 g/dl 3.5-5.5
    Globulin,Total 2.9 g/dl 1.5-4.5
    A/G Ratio 1.6 1.1-2.5
    Bilirubin, Total .4 mg/dl 0.0-1.2
    Alkaline Phosphates 85 IU/L 25-150
    AST (SGOT) 43 High IU/L 0-40
    ALT (SGPT) 36 IU/L 0-55

    FSH and LH
    LH 2.8 mIU/ml 1.7-8.6
    FSH 2.0 mIU/ml 1.5-12.4

    Testosterone, Free and Total

    Testosterone, Serum 382 ng/dl 348-1197
    Free Testosterone 9.4 pg/ml 8.7-25.1

    TSH 1.470 uIU/ml .450-4.5
    Prolactin 4.3 ng/ml 4.0-15.2

    When I finally get the test in it takes 3 calls to get the Dr to call me back. He says that everything is fine, and that nothing should require anymore action. That it is more than likely depression related. I explain I have nothing to be depressed about and my life is about as good as it gets at the moment. Great woman, great kids, good job, no money worries, etc. He continues to say it's all in range and I ask how is the testosterone in range for a guy that eats right, works out, and is only 31? He stands by his in range theory and says he can refer me to a urologist because outside of the lab standards he doesn't have anything to go by on where my testosterone levels should be. I agree and on to the urologist we go.....

    Finally get an appointment at the Urologist, and he states that everything is in range as well, and that it might be depression related. I explain again that I have nothing to be depressed about, and asked again how my numbers could be normal, and he says that Testosterone, Serum really doesn't mean much as a number goes, and that my free test is normal ?? low normal.

    He explains that what he will do is prescribe me a new Testosterone gel that goes under your arm for a month, and if I see improvement then he is willing to look further into it and go with shots. He says he is strongly against TRT as is shuts down your pituitary. When I mentioned HCG his response was, We don't do that here. It's hard to come by, and there are no dosing protocols?. He actually seemed a little irritated I mentioned it. When I explained that I had been reading about other people with Low Testosterone issues and explained some of what I read he quickly rubuttled that most of the information online is by Bodybuilders (and that some online docs will prescribe test to someone with 600 test scores as long as they get paid), and that test levels in the 800 range would could yeild liver damage. He went to the extent to ask the opinion of another dr on my test levels and they said they would look at depression before testosterone.

    In the end he did prescribe me Axiron gel. 60Mg day under the arms. I am to go back in a month and tell him if my symptoms have improved or not, and we will go from there.


    3/14/2012


    I tired the Axiron for a month and it dropped my T levels to 271.

    DR agreed to let me self inject test, and I am doing 50 twice a week. Once on Sunday, and once on Wed.

    Got tested again a month later when I was only doing one shot per week. Tested the day before pin, and it was 383. Dr said this was good since I was going to pin again on the following day.

    Overall I am feeling better, and the brain fog is gone. Sex is better, but my drive still isn't what I wish it was. About the 3rd week into the shots I felt better than I have in a long time and that slowly has gone away. I still feel better than I did just not as well as I think I'd like to.

    When I questioned my Dr (urologist) about E2 and HCG. He promptly stated "We don't test for that here, and we don't prescribe HCG either." Told me he could refer me to an Endo (that would possibly prescribe HCG), but it would be 3 months. He also stated since I was lean I shouldn't have E2 issues since it hides in fat. I told him there was no need to refer because I was worried that it wouldn't do any good anyway as I have read on here Endo's seem to be worse that Uro's.

    Now I am about 2.5 months in on the shots and I am having these issues:

    Horrible Acne on my back and chest. Cystic type like I had as a teenager. Never had chest acne before so that's new (not really cystic on chest).

    Sleepy during the day at times. Quick 15 minute nap fixes the problem, but really cant do that at work.

    Sex drive not quite where I'd think it should be. Never really actively "in the mood" without some visual/physical stimulation.

    I'd try to get another Dr but my insurance only allows be 4 co-pays per year so I already have foot the bill on a lot, and I know how hard it is to find one that's knowledgeable.

    Any Suggestions? Or anyone know a Dr near Rock Hill, SC that is good?

    Thanks!
    Craze

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    Quote Originally Posted by craze_1980 View Post
    Hi everyone,
    Been reading a lot here, and all over trying to get a good handle on this but I need some help. Here's my story......

    12/2/2012

    OK so I have been having loss of libido issues for a long time now, and have been discussing it with my Dr for over 18 months. Originally he said that it was mental, and that things like these come and go. About 6 months later I went back (March 2011) and told him that I was still having the issues of just not wanting sex often if at all. I asked him to check my test levels and he agreed too. Two weeks later I got a call from the Dr's office saying everything was fine, so I figured it must be diet related. I hired a nutritionist (that works with bodybuilders, powerlifters, etc) and followed his diet plan to the letter. No improvement in libido, but lifts to do go up since it seems I was under eating for a awhile. I called the dr's office and asked for copy of the test after doing some reading here. (I also started adding 10,000 IU's of Vit D per day after reading here) Test levels came back at 343ng/dl on a scale of 249-869 ng/dl. Go back to the Dr and ask for all the test that were listed on here. Explaining that I have been having symptoms of low sex drive, tired in the afternoons, I fight to stay away around 5 pm when leaving work no matter how much sleep I get. A lot of nights I then have a lot of trouble falling asleep, and general fogginess on a lot of days no matter how much sleep I get or food I eat. I asked him why he wouldn't say the 343 is low and he said because it's in "range". He does test me again, but not for everything I ask. Here's what he tested for and the results....

    Test Result Flag Units Reference Interval
    Glucose, Serum 86 mg/dl 65-99
    BUN 30 High mg/dl 6-20
    Creatinine, Serum 1.12 mg/dl .76-1.27
    eGFR 88 ml/min/1.73 >59
    BUN/Creatinine Ratio 27 High 8-19
    Sodium/Serum 137 mmol/L 135-145
    Potassium, Serum 4.3 mmol/L 3.5-5.2
    Chloride, Serum 97 mmol/L 97-108
    Carbon Dixoide 25 mmol/L 20-32
    Calcium 9.7 mg/dl 8.7-10.2
    Protien, Serum 7.6 g/dl 6.0-8.5
    Albumin,Serum 4.7 g/dl 3.5-5.5
    Globulin,Total 2.9 g/dl 1.5-4.5
    A/G Ratio 1.6 1.1-2.5
    Bilirubin, Total .4 mg/dl 0.0-1.2
    Alkaline Phosphates 85 IU/L 25-150
    AST (SGOT) 43 High IU/L 0-40
    ALT (SGPT) 36 IU/L 0-55

    FSH and LH
    LH 2.8 mIU/ml 1.7-8.6
    FSH 2.0 mIU/ml 1.5-12.4

    Testosterone, Free and Total

    Testosterone, Serum 382 ng/dl 348-1197
    Free Testosterone 9.4 pg/ml 8.7-25.1

    TSH 1.470 uIU/ml .450-4.5
    Prolactin 4.3 ng/ml 4.0-15.2

    When I finally get the test in it takes 3 calls to get the Dr to call me back. He says that everything is fine, and that nothing should require anymore action. That it is more than likely depression related. I explain I have nothing to be depressed about and my life is about as good as it gets at the moment. Great woman, great kids, good job, no money worries, etc. He continues to say it's all in range and I ask how is the testosterone in range for a guy that eats right, works out, and is only 31? He stands by his in range theory and says he can refer me to a urologist because outside of the lab standards he doesn't have anything to go by on where my testosterone levels should be. I agree and on to the urologist we go.....

    Finally get an appointment at the Urologist, and he states that everything is in range as well, and that it might be depression related. I explain again that I have nothing to be depressed about, and asked again how my numbers could be normal, and he says that Testosterone, Serum really doesn't mean much as a number goes, and that my free test is normal ?? low normal.

    He explains that what he will do is prescribe me a new Testosterone gel that goes under your arm for a month, and if I see improvement then he is willing to look further into it and go with shots. He says he is strongly against TRT as is shuts down your pituitary. When I mentioned HCG his response was, We don't do that here. It's hard to come by, and there are no dosing protocols?. He actually seemed a little irritated I mentioned it. When I explained that I had been reading about other people with Low Testosterone issues and explained some of what I read he quickly rubuttled that most of the information online is by Bodybuilders (and that some online docs will prescribe test to someone with 600 test scores as long as they get paid), and that test levels in the 800 range would could yeild liver damage. He went to the extent to ask the opinion of another dr on my test levels and they said they would look at depression before testosterone.

    In the end he did prescribe me Axiron gel. 60Mg day under the arms. I am to go back in a month and tell him if my symptoms have improved or not, and we will go from there.


    3/14/2012


    I tired the Axiron for a month and it dropped my T levels to 271.

    DR agreed to let me self inject test, and I am doing 50 twice a week. Once on Sunday, and once on Wed.

    Got tested again a month later when I was only doing one shot per week. Tested the day before pin, and it was 383. Dr said this was good since I was going to pin again on the following day.

    Overall I am feeling better, and the brain fog is gone. Sex is better, but my drive still isn't what I wish it was. About the 3rd week into the shots I felt better than I have in a long time and that slowly has gone away. I still feel better than I did just not as well as I think I'd like to.

    When I questioned my Dr (urologist) about E2 and HCG. He promptly stated "We don't test for that here, and we don't prescribe HCG either." Told me he could refer me to an Endo (that would possibly prescribe HCG), but it would be 3 months. He also stated since I was lean I shouldn't have E2 issues since it hides in fat. I told him there was no need to refer because I was worried that it wouldn't do any good anyway as I have read on here Endo's seem to be worse that Uro's.

    Now I am about 2.5 months in on the shots and I am having these issues:

    Horrible Acne on my back and chest. Cystic type like I had as a teenager. Never had chest acne before so that's new (not really cystic on chest).

    Sleepy during the day at times. Quick 15 minute nap fixes the problem, but really cant do that at work.

    Sex drive not quite where I'd think it should be. Never really actively "in the mood" without some visual/physical stimulation.

    I'd try to get another Dr but my insurance only allows be 4 co-pays per year so I already have foot the bill on a lot, and I know how hard it is to find one that's knowledgeable.

    Any Suggestions? Or anyone know a Dr near Rock Hill, SC that is good?

    Thanks!
    Craze
    You need to find out the reason why this is happening to you and correct it at the source of the problem. As noted before testosterone and other hormones imbalances majority are just expressions of a much greater issues. Many Dr I am finding out that HRT is just a bandaid in many cases which is now being show that not looking at the entire person may be masking dangerous health risks.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Any Idea on where to start looking?
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    Also forgot to mention. Had a Vasectomy 3 years ago after my son was born. My symptoms have gotten progressively worse over the last few years. Could this be a reason?
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    Quote Originally Posted by craze_1980 View Post
    Any Idea on where to start looking?
    With out having detailed medical and personal history which is usually involves personal and confidential information it would be impossible ...
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Do you have any DR's that you recommend in my area? Rock Hill, SC about 30 mins south of Charlotte NC.
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    Quote Originally Posted by craze_1980 View Post
    Do you have any DR's that you recommend in my area? Rock Hill, SC about 30 mins south of Charlotte NC.
    Nope down in that region they are not too swift...
    GEtting snipped can cause LOW TESTOSTERONE ...see it in several cases I worked with in the past. Question are you primary or secondary?
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Well I don't really know how to answer that. My LH and FSH came back within range and so did my PSA. I didnt have any physical shrinkage before starting trt, and when the dr checked he said my testes were normal size. Sorry if that doesn't help.
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    Quote Originally Posted by craze_1980 View Post
    Well I don't really know how to answer that. My LH and FSH came back within range and so did my PSA. I didnt have any physical shrinkage before starting trt, and when the dr checked he said my testes were normal size. Sorry if that doesn't help.
    It goes much deeper then just that..much deeper
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    The only other test I had ran were for a life insurance policy and they said that everything came back great. Cholesterol, sugar, etc. Can you point me in the direction of what I am missing?
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    Quote Originally Posted by craze_1980 View Post
    The only other test I had ran were for a life insurance policy and they said that everything came back great. Cholesterol, sugar, etc. Can you point me in the direction of what I am missing?
    goto my thread "lab testing getting to the core" find all you need there. Again one needs to look at the underlying pathology to know where to begin to evaluate.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Okay I read the stickies and found that I can have the labs done for about $200 since my DR won't request them for me. As soon as I have the cash I am going to have the test done. I did go ahead and have my E2 tested and wanted an opinion on results.
    I attached an image showing the results. Any help would be greatly appreciated !

    Well I couldn't get it to upload so here are the results:

    Estradiol, Sensitive (Result) 22 pm/ml Range 3-70 pm/ml

    Male
    0 - 6 yrs 0-15
    7 - 10 yrs 0-15
    11-12 yrs 0-40
    13-14 yrs 0-45
    >15 yrs 3-73
    Last edited by craze_1980; 03-20-2012 at 04:55 PM. Reason: Image wouldn't show
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    Quote Originally Posted by craze_1980 View Post
    Okay I read the stickies and found that I can have the labs done for about $200 since my DR won't request them for me. As soon as I have the cash I am going to have the test done. I did go ahead and have my E2 tested and wanted an opinion on results.
    I attached an image showing the results. Any help would be greatly appreciated !

    Well I couldn't get it to upload so here are the results:

    Estradiol, Sensitive (Result) 22 pm/ml Range 3-70 pm/ml

    Male
    0 - 6 yrs 0-15
    7 - 10 yrs 0-15
    11-12 yrs 0-40
    13-14 yrs 0-45
    >15 yrs 3-73
    Just today i just got invited to come see a state of the art facility to help them with stream lining some things. I will flying to Greensboro NC in the next week or so, Dr is wonderful and very open minded about things unlike others. She Has great southern personality. Pm me for information

    e2 sensitive is bogus. I was at 16, 25, 14 and still had symptoms tested quest 4021 and had upper 50's. i was totally symptomatic for months and was driving me crazy thing it was thyroid or adrenal related when it was inacurate e2 for close to a year. I have switch all the Dr I work with to the Roche method 7-42 for lab corp or 4021 e2 for quest. I have nothing but positive feed back and Drs thanking me for bringing it their attention. if you read about this current trend on forums well you know where the source is
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
  

  
 

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