Lab results - your inputs needed.
- 04-22-2007, 03:28 PM
Lab results - your inputs needed.
Hello All 1
I am 30 years old and I have suffered from depression during the past decade. I haven't taken antidepressants much since they dont help me. Despite all that I have had no issues with libido or erectile dysfunction until like 2 years ago. When I was around 28 , I first noticed low libido and then pain in the joints and then general weakness and loss of muscle. I had no idea I could be low on T until I read an article. Went to a doc. ,the only test I got done was total T :
Total T : 160 ng/dL (300 - 1000)
My doctor recommended T injections. I have taken the following dosages:
50 mg - 02/22/07
250 mg - 02/26/07
250 mg - 03/05/07
250 mg - 03/05/07
There was one month break since I was travelling and couldnt take shots.
250 mg - 04/05/07
250 mg - 04/12/07
250 mg - 04/19/07
(I have taken 6 x 250 mg shots and 1 x 50 mg shot) in three months with little improvement in my condition. My testicles have reduced to 1/3 of size I had when i was 28 years old. There was shrinkage before I took the shots and also after I took the shots. However I just found out that I needed to get other tests done before I could jump on the HRT bandwagon.
How long should I wait before I get the whole spectrum of testing done again and how should I go about it. Please help !!!
- 04-22-2007, 07:58 PM
Wow your as low as I was but I was 40 when this happened. It's to bad you did not have more testing to find out why your low. I hate to say this but I came off TRT 7 times when I was sent to see Endo's each of the 7 I have seen took me off meds to test what they call a base line test. Each time I had my blood work with me and each one would not even look at it. All they found out taking me off TRT and meds for anywhere from 4 weeks to 4 months was how dam sick they made me.
And still each one missed way I was low. I read Dr. John's TRT: A Recipe for Success and his HCG Update 2 yrs. ago and told my Dr. I need to get off gels and try this. I sent to shots 100mgs every week then to 150 mgs every week. My levels were still on the low side. I asked my Dr. to add HCG and he told me it will not do any good because I am Primary. I got a post from Dr. John on how it would still help even if one is primary.
I started on HCG doing 500 IU's 3 times a week after my 15th shot we tested and my Total T levels doubled. So here after all these yrs. some 23 of them being told I am primary I find out I am secondary do to a bad auto accident some 24 yrs. ago. I am Hypopituitary. Looking back on my labs the tests were screaming this yet all the Dr.'s I have seen missed this. Dr. John would not have missed this because he does testing and interviewing until he finds out why your low.
All you can do is test your DHEA, Cortisol, Thyroid, IGF-1 and Glucose to see if your low normal. Get on some HCG or do stimulation test to see if your levels jump why up to see if your primary or secondary.
Go to Dr. John's site and read TRT: A Recipe for Success and his HCG update and get the tests he has in this.
If you find your Primary meaning your testis don't work good enough to keep your levels up. Do TRT at the dose it takes to get your levels up into the upper 1/3 of your labs range for a young man for both Total and Free T. And keep your Estrediol "E2" down between 10 to 30 best at 20 if your SHBG is mid range. Doing this will bring back your energy and your sex life.
If your Secondary test every thing that has to do with the Pituitary and treat the low ones.
Don't do shots this big all it does is raise your E2 levels and kill your sex life.
I hope you never did drugs or Steroids this is a whole different ball park in treatment.
04-22-2007, 08:32 PM
Thanks for replying. I don't drink . I don't smoke. Never did steroids. How long should I wait to get the lab work done again (considering i have been taking shots )to actually dind out what's wrong ?
04-22-2007, 08:46 PM
04-22-2007, 08:48 PM
You have not been on the shots all that long but why stop for testing you have no guarntee the tests would be good. Go to the AACE Guildlines and read about the HCG Stimulation test. Try this or see if your Dr. will work with Dr. John over the phone or come to MI and see him. There just are not a lot of good Dr.'s like him.
04-22-2007, 08:53 PM
This is what I was wondering. Don't you think my shots would have raised my total T and conmsequently lowered FSH and LH. So if I was to test now , that test would not indicate if I am primary or secondary due to change in hormonal values as a result of shots. I was under the impression that if I wait for sometime so that my values come to what they actually are in my body and then get a test done so that the test is indicative of what's really wrong.
Too bad my doc didnt tell me anything abt it when I started.
04-22-2007, 09:01 PM
This is the problem you will not know if your LH and FSH will come back up to what they were before you went on shots. So to me the best thing you can do is a HCG Sim. test if your levels go way up on this then your are seconday if not you are primary. This to me is your best bet going on TRT your brain seen the T in your blood and stopped sending the LH and FSH messages to your testis. I was off TRT for 4 months and my LH and FSH never came back up to my first test before starting TRT I was lucky that they checked it first. So going by myself and others I have talked to you don't know if your LH and FSH will come back to what it was before doing the shots. It's a dam shame this happens and it happens a lot most Dr.'s only know about low T because they get there info from the drug reps.
04-22-2007, 09:23 PM
Okay .. so here is my thought .
I will get the simulation test done to see if I am primary or secondary.
I am also going to stop the shots beacuse it doesn't change the way I feel (I was off shots as I was travelling for one month ..no difference between now and then) .
3. I will check my total T again . Just to baseline how much these shots have raised my total T . (Will assume that FSH and LH went down a little bit 'cus of increase in T)
4. Go to an endocronologist and have him evaluate me again.
My problem is that I am in India so I can't contact Dr. John. I was a student at univ in US , untill my problems forced me to come back home as it was getting difficult on my own. So I will just have to do with what's available here and probabaly advice of good people like yourself will keep me going.
Your thoughts on my plan of action ?
04-22-2007, 09:32 PM
This sounds like it's the best you can do. The reason you did not feel all the good on the shots is I feel your Estradiol levels went way up this happens when you big doses of T. Best to do 100mgs a week what kind of T was it. I use Depo T and do 50mgs every 3 days this helps keep my Estradiol down I do he shots my self using a small 27g 1ml x 1/2" lg. needle into my thigh. If you do test again get your Estradiol tested a test for men if you can. When my Estradiol went up I lost my sex life.
04-22-2007, 09:34 PM
Do not stop T shots but spilt them and do them twice weekly or every 3rd day. Do the blood draw on the day of T shot, right before the shot.
Post results here.
You should get HCG shots to keep the size of testicles and use any native testosterone that they are able to produce.
04-22-2007, 09:43 PM
what is the problem in stopping the shots ? I do think I am secondary as I had no libido /erection issues until I was 28 (on top of severe depression that i went through ) . If i remain on shots , wouldn't my body's ability to make T go down ?
04-22-2007, 10:03 PM
Any doctor that have a licence and is willing to write you scripts for testing and medication according to consultation with Dr John.
Your Dr in India will be a go between you and Dr John.
He will receive instructions from Dr John on what to do.
Go to Dr John's website, there are instructions on what to do.
I suggest that when testing blood, do first wery complete test that would cover many possible angles.
Follow up tests do not have to be that broad.
This aproach my be helpful in zeroing on the problem faster.
Many people do piecemeal tests, finding a problem takes forever.
We have an example of it now.
You got Total T tested and shots prescribed.
That screved up your HPTA axis, it will be a hard to undo it.
That is why I think that you should continue with T add HCG and leave question of primary or secondary for latter. The HCG will keep you testis active.
04-23-2007, 05:01 PM
Then if you get HCG 250IU/EOD or 100IU/day that would make you testis work. You can save yourself a shock, taper down yout T slowly. Make this a two months program, retest on end, see where you are at.
Check at least your BioavailableT and E2.
If you are able go for longer list.
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