Last bloods, Waiting Endo News

[bebeav]

Hi guys,

By the time i'm waiting for the Endo to call back about result i'd like some opinion.

What would you do with this kind of result curiously??

First TT checked at 12.9 nmol (october 2016) and now 13.5nmol
Between both i cleaned my diet ,totaly stop drinking and tried to get the best sleep so i could to see what would be my best result.


More details

-TT 13.5 nmol (6-27 nmol/l)
-Albumine 41 g/l (35-50 g/l)
-SHBG 40.9 nmol/l (14 - 90 nmol)
-FSH 4 U/L (2-12 u/l)
-LH 2 U/L (2-9 u/l)


So calculated Free T and Bio
-Free 0.245 nmol/l (no range it was calculated by myself)
-Bio 5.5 nmol/l (no range it was calculated by myself)

For those who don't know, 31 y/o, T1D (Last hb 6.0), bunch of low T symptoms

 

[trn450]

Your total T is low-normal (borderline even), your FSH and LH are also very low-normal (borderline). While that may not trigger a hypogonadism diagnosis for some people, I personally think it looks to be fairly suggestive of testosterone deficiency of central origin.

SHBG is fairly solidly in the normal range. And, sure, decreasing it could free up some T, but the reality is it doesn't look like your brain is talking to your testicles very effectively.

Of course, the information provided to your physician and the discussion you two have in person (along with physical exam, etc) provide insight none of us on this forum will have into your situation and nobody here is in a position to provide a diagnosis. However, if I were evaluating myself (a universally bad idea, lol) I would get the MRI pituitary protocol to make sure there are no pituitary adenomas (standard of care, very small # of cases), work to try to improve those levels through lifestyle and nutritional supplementation, and if lifestyle and nutritional optimization failed to work, then consider therapy.

Key questions:
- How is your sleep?
- Do you drink alcohol? If so, how much and how often?
- Do you do any recreational drugs?
- Do you take pain killers?
- How is your stress level (work/home/etc)?
- Has your thyroid function been evaluated? (TSH/T3/fT3/T4/fT4/rT3)

 

[bebeav]

I'm trying to post an answer but it keep saying that i'm not allowed. (post denied. and i can't find where's the problem)

So i'll go short.

I'll see by the time what she'll do, and be sure to let her know the MRI route (if she doesn't go this way at first).

Thx for pointing this out.

And for lifestyle habit i really tried to get this to the best i could in the last 6 months.

For info

-Sleep is good, but wake up tired
-No more alcohol since 4 months
-No recreative d r u g s
-No Pain killers exept couple ibuprofen sometimes for headache
-I greatly reduced stress level in the last 6 months
-For Thyroid it's a bit more complicated, doc doesn't want to run more test than tsh anf free t4 cause Tsh was between 1.25 and 1.60 on the last 3 tests and FT4 came out Low-Normal so she doesn't want to investigate more than this.

 

[kisaj]

Always post ranges when posting up any numbers.

 

[trn450]

I'm trying to post an answer but it keep saying that i'm not allowed. (post denied. and i can't find where's the problem)

So i'll go short.

I'll see by the time what she'll do, and be sure to let her know the MRI route (if she doesn't go this way at first).

Thx for pointing this out.

And for lifestyle habit i really tried to get this to the best i could in the last 6 months.

For info

-Sleep is good, but wake up tired
-No more alcohol since 4 months
-No recreative d r u g s
-No Pain killers exept couple ibuprofen sometimes for headache
-I greatly reduced stress level in the last 6 months
-For Thyroid it's a bit more complicated, doc doesn't want to run more test than tsh anf free t4 cause Tsh was between 1.25 and 1.60 on the last 3 tests and FT4 came out Low-Normal so she doesn't want to investigate more than this.

Looks like you're doing a lot of the right stuff. With all of that in order and T levels low, if she is dismissive of your concerns I'd immediately get to a second opinion.

 

[The Matrix]

So your sleep sucks which can be causing majority of low t symptoms. Research and clinical experiences shows if you do not sleep you do not heal. First things to address it proper circaden pattern, by looking at why you are not waking up feeling refreshed. I would clean up lifestyle and work on identifying any other stress in your life. Mainly focus on what you are doing from 7 pm on one will probably find their answers. With out e2 labs are useless. Shbg is on the high side should be 20-30 as heathy ranges. First of all if you are over in U.K. Or EU with measures and endo are completely in the dark ages. I work with the most well respected hospital in London and they know very little about hormones .. That's going to change as I am scheduled to go over there to start educating practitioners with in next 3-6 months. Start with basics then go from there. Often it's something simple over looked totally unrelated to hormones. If you are in UK your profile fits many of the male mold issues I am finding in cases over there. Stop focusing on hormones and look at the bigger picture problem with modern medicine tend to look on one dimensional plan not three dimensional. If you do not have a doctors I have a colleague in EU that may be willing to help. With out detailed history, labs and symptoms it's just a ? shoot

 

[Mr.TT]

Check your TWO D3 levels..... for much better sleep. https://www.youtube.com/watch?v=xF24xmJQK1k
Add sublingual Methyl B12 for energy.

 

[bebeav]

Thx trn450,
and just found that my blurr vision on my left eye seems to be more like a double vison on the horizontal axis. Going deeper to get into the MRI way i think.

 

[trn450]

Thx trn450,
and just found that my blurr vision on my left eye seems to be more like a double vison on the horizontal axis. Going deeper to get into the MRI way i think.

No problem. I also realized I forgot to ask if you're overweight and/or snore. Sleep apnea is a huge issue that would mean getting adequate hours of poor quality.

 

[bebeav]

trn450 : No snoring at night, and i'm around 180lbs for 5'8" with near 4 visible abs loll i would say around 15% bf.

By now most bloods tests done always bring low-normal range hormones level, so i really start to think that the pituiary may be the culprit.
The Matrix : I'm in Qc, Canada. and by now i really think my habbit are the best i can do with my familly(2 kids)/work/workout/foods/sleep. i you i can give more detail but i think i'm on a good way on those one and stress level are the lowest i ever got since many years the only thing bogging me for now is those bloods/symptoms i got now

 

[trn450]

trn450 : No snoring at night, and i'm around 180lbs for 5'8" with near 4 visible abs loll i would say around 15% bf.

Ah, okay. I was 15% in that pic in my avatar, so if you're around there, too, I find sleep apnea of the obstructive type unlikely. Although, some people do have "central" sleep apnea, but usually they're noted to snore, etc.

Now, there may be a central hypogonadism, but that doesn't necessarily mean there is a pituitary adenoma. Those are fairly rare. The MRI is just a precaution. On this forums, I'd guess that prior AAS use is the primary cause of central hypogonadism. If you've ever done AAS or many of the OTC "pro-hormones" (which are steroids, anybody who says anything otherwise doesn't know what they're talking about) those can cause permanent HPGA suppression. My personal belief is that the number of cases of this are far greater than previously thought. I've checked a number of old lifting friends' labs, and quite a number of them have evidence of testosterone deficiency along with symptoms. OTC orals are the common link between us all.

I used SuperDrol and a number of others in the early to mid 2000s. As a result, I totally killed my HPGA and I could never recover it. It put me through hell. The anxiety, depression, etc. that came on insidiously was the absolute worst part. Painful gyno, erectile dysfunction. poor recovery, etc. sucked, but was nothing compared to the mental hell I was in. I wasn't "educated" at this point, so it took a couple years of intermittent visits to the physician to figure out what was going on. Nobody, myself included, thought to check the testosterone values of a 20-something kid with pretty good muscles on him. lol

 

[bebeav]

trn450 I never done any OTC oral or AAS, i was here more in TRT intention.

I just called my endo this morning to let her know about MRI and the receptionist said she's on her departure on maternity leave and 2 others endo will separate her patients list.

So i'm still there waiting to get an answer from one of them by now.

 

[The Matrix]

Canada is in the same boat as UK
Only doctor I trust in Canada is in Calgary Canada. Very few come close.
Ontario good look finding an open minded endo as I have not found one yet. I have client's come across to states to get blood work done stay over night then go back after the labs. Kind of sad it has to do be that way. Again as others have mentioned with out detailed history one may be treating synonyms vs root cause ..

 

[bebeav]

ok so got an answer from the other endo today, she said everything was ok, everything is in range so she won't do anything further.
This one ain't gonna be easy.

Monday i got an appointment with my familly doc, so i'll ask her if it would be possible to check for pituitary adenoma by the bloods results i got and hope for the best.

that damn double vision on my left eye is really bugging me, combined with those bloods

Thanks all

 

[The Matrix]

This could also be a blood sugar/insulin issues

 

[bebeav]

The Matrix i really think bs/insulin isn't in relation with this case.

I know when i go little higher than normal i can feel a bit more sluggish, but i can say i keep this in range as much as i can and maybe a bit too mush if i listen to my endo.

i really keep a good eye on my bs, i check it approx 7-8 times per day. try to wake up around 7 mmol, get it around 6mmol at lunch and between 8-11mmol 2 hour after lunch ( she doesn't like to see my between 7-9 mmol 2 hours after lunch cause i'm working at a labor job) last hba1c was at 6.0%

 

[bebeav]

oh and i met my optometrist today and he'll try to get me an appointment as soon as possible with my ophthalmologist so we can check this double vision problem more in depth

 

[trn450]

The labs definitely didn't technically qualify as hypogonadal by the book, so I'm not surprised about that part. But, any physician or other healthcare provider who knows you're having double vision owes you more than a "you're fine".

I hope the ophthalmologist is more helpful with that particular problem.

Regarding the T levels, you'll probably have to just keep watching those over time. If they are on their way toward hypogonadism (as could be argued as a reasonable possibility given the FSH/LH being low in the context of low-normal testosterone values), you'll pick it up if you check every several months or so.