Possible HRT Help & Advice
- 09-28-2007, 11:20 AM
Possible HRT Help & Advice
I really need your help guys, ive recently found out my testosterone was low its 123 and we tested it a few times etc these past 3 weeks. Cause i was feeling tired for years now and they tested me for every disease and it came up negative so i asked for testosterone a few we eks agoto be checkecd and it came back very low.
Long story short, they checked an MRI of pitituary its fine, LH FSH were check and LH is low. Endo says im probally 2ndary with hypogonatropic hypogonadism .
I need you to help me make a decision quickly, today he prescribed as a stimulation test i guess he wants me to give myself 50mg of Testosterone every two weeks with shots to see what happens and if it stimulates the pitituary or anything.
If it doesnt he will let me do shots on a therputic dose and split it up which is good i suppose. I asked him about HGC and Clomid he said it wont work and that the 50mg Testosterone may stimulatte if not i go on therputic dose and i can spilt it up and do it myself.
Should i just get the prescription for the 50mg testosterone and start that? Or should i wait till october 4th to go to another ENDO that i got from the Tune Up report list.
Any recomendations, i like how he will let me do shots i just don't know , if ya'll need any more blood tests ill post them. I don't have e2 or any of that, but i will have cortosil done he wants that checked
thank you everyone, my lfie depends on this
- 09-28-2007, 11:35 AM
50mg every two weeks is not a large amount, and there are many other factors to consider...but it is better than nothing. Bottom line is that you are deficient and need to get into the normal range, either through exogenous or self production.
As I have found you will not be able to fix everything overnight...and it is best to think of this as a journey.
- 09-28-2007, 11:41 AM
I figure the faster we get this small dose testing over the faster we can start the real therapy, he wants me back in a month so ill only get 3 shots of this 50mg
Im so confused tho im too young for all this, to much to comprehend in such a short period, i rather do shots if it comes down to it and this ENDO is willing to let me do it so i guess i should stick to him or find out if the endo from TuneUp report fills shots perscritpinos aswell
More responses are appreciated if anyone is wondering im 17
09-28-2007, 11:43 AM
Bill - NJ
09-28-2007, 11:46 AM
09-28-2007, 12:01 PM
It took me 3 (Three) Dr's to get it right and it sounds like your going to be headed down the same path 50mg every 2 weeks is a waste of time
Also don't be concerned about shots vs gels/creams to start I started on shots with 2 Dr's and now with the 3rd I switched to a compounded cream and I feel much better
Just find a Dr who has experience such as Shippen or Dr John or somebody familiar with TRTand allow them to work the magic
Make sure Dr looks at Thyroid and Adrenals as well it wasn't until I addressed these issues I started to feel better
09-28-2007, 12:02 PM
09-28-2007, 12:03 PM
Im only 17 my mom wants me to decide what to do, should i just get this 50mg Shot prescription. She wants the best for me and i have been reasearching my ass off
09-28-2007, 12:10 PM
09-28-2007, 12:11 PM
09-28-2007, 12:14 PM
09-28-2007, 12:23 PM
I like how he will let me do the shots and will let me spilt the dose up when we find out what works if i do need to start a theraputic doseage. I don't know if i want to drop him, itll probally be hard to find another DR that will prescribe shots let alone let me do the test shots myself
My question is, should i just start these 50mg and get the prescription. Ill check back with him in November to see what happened.
Or is it possible to work with two doctors at the same time idk this other guy may not do shots but the longer i wait to do this little stimulation test the longer itll take to start my real theraphy which it will probally come down too in the end.Im missing out my teen years ive been feeling like **** for near 2 years and missed out on to much.
09-28-2007, 12:28 PM
09-28-2007, 12:37 PM
woah someone just informed me that HGC or clomid is worth a try since im 2ndary.
I will definitly drop this doctor and wait for october 4th i want totry the HGC or clomid to simulate LH
09-28-2007, 12:39 PM
09-28-2007, 01:07 PM
09-28-2007, 01:53 PM
I have some general advice. First, slow down. I know how it feels to want it fixed NOW, but as everyone here will tell you there is no magic bullet. It will take some trial and error.
I don't know what tests you have had done, but I would NOT start T therapy until you have exhausted the other possibilities. Once you start, you're numbers will change and it's not possible to get a good baseline blood test. In other words if you haven't had everything tested yet, you need to do that before you start.
This takes me to my next point -- post ALL of your blood results. We'll tell you what is missing. We may also find something insightful that your doctor has missed.
Lastly, I don't know about the low-dose T. I have not heard of this. AFAIK, this would only stimulate you to make less endogenous T. I could be wrong.
Also, tell us more about the history of your condition. Did you have normal puberty and sexual development? Have you always had low T, or is this recent?
10-02-2007, 01:56 PM
About me, well im 17 basically this all started almost 3 years ago, my mom took me to the doctors because she mainly was concerned because i had lost alot of weight and i just wasnt feeling quite up energized. The doctors saw i had high AST ALT liver enzymes and for the past 2 years i have gone to
many different doctors, gotten a liver biospy and been tested for every disease and disorder that would affect the liver. The only thing we found out was that i was defficient in Zinc in July.
About 1 month ago still clueless and running in circles i had begged my doctor to run tests on Testosterone since i was again going for more blood work to check the liver enzymes and see if my Zinc Values went up with the Zinc supplementation they wanted me to go on.
Needless to say the first red flag came up on 9/4/07 , here is the bloodwork for that
Testosterone % Free
The endo then called in for LH,FSH,Prolactin and Testosterone so i got those results back on 9/15/2007 and that is the most recent test results Testosterone.
6.6(In range)1.6-8.0 miu/ml
ProlactionI don't understand this but
Stages of Puberty & Prolaction is is stage IV-V 2.8-11.0
123L ng/dl -----200-800
After that day i went to the first endo and got an MRI of the Pitituary Gland It is fine. Then recently went to the endo like i mention and he prescribed Testosterone at 50mg one every two weeks to stimulate my body(i know he was wrong so i droped him)
He also said i am 2nd Hypogandism, my LH is low but everything else appears to be working. Its funny also how my testosterone lowered on the 2nd blood test of it considering same time/place.
Also i have gotten TSH,T4 Total T3 Uptake and t4 Free and they are all within range except my t4 is low
T4 is 5.1L on a scale of 5.6-4.9
This is all I have of the horomonol bloodwork, i may be getting cortosil done since the old endo wanted that done. The new one on Thursday i shall see what he says, im hopeing he prescribes HGC or Clomid i think my HPTA just needs some type of kick in the ass.
My liver enzymes AST-ALT are/always have beeen high most recent blood results they went down from 110-120 to this
here are some other things that stick out/are always like that. Ive seen specialists for blood,liver,gastro, everyone is puzzled as to why the liver enzymes are high oh well.I am also slightly anemic for some odd reason. Trust me ive gone to so many different areas they don't know why numbers are like this, mabey the low testosterone affects it all in me
My diet is incredible , ive also gone to nutritionists who are amazed at the varitey and cleanness of my diet. I dont drink or do drugs never have, i just feel like **** all the time and have almost no life because of it
WBC is low
Carbon Dixiode is low
RBC is low
Hemoglobin is low
Hematocrit is low
Bun/Creatine Ratio is high
Urea Nitrogen is high
Im just going to need research to bring to the doctors to put me on HGC or Clomid i think that option will help the most. I don't want to do TRT. I think dieting during childhood may have caused this shutdown and it just never started up again.
I lost 85lbs btw.
10-02-2007, 03:18 PM
How much do you weigh now?
Are you eating light/clean to be "ripped"?
(Calorie restriction reduces LH and thus T)
Tell us more about what you eat?
Do you have cholesterol numbers?
Besides Zinc, what supplements are you using?
Do you drink green tea?
Last edited by MarkLA; 10-02-2007 at 03:21 PM. Reason: added two more questions
10-02-2007, 03:29 PM
Jan's BloodTest April13/2007
I suggest that you start with Genova's:
(GDX - Metabolic Analysis Profile) including (GDX - Cellular Energy Profile)
then go to Quest and do all on the list for blood test,
There are other tests on that list,
go additionally for
ONE Optimal Nutrition Evaluation
On my last vist, my doc mention that the future is in
He have not given me any details at this time, just told me to Google on that.
gene-snp - Google Search
You are 17yo.
May have a legal problem with gene testing, there are some kind legal restrictions, may have to wait till 18th birthday.
10-02-2007, 04:41 PM
I eat lots of meat like tuna,beef,TONS of liver,vegetables,whole grains,dairy,lots of whole eggs etc never dirty, my maintece is 2200 and im averageing 2500 calories for weekly avrg. Im very sedenatry workout full body 3x a week for 30 mins or less so i don't burn alot.
Im only on Zinc right now nothing else, i don't currently drink green tea but i used to drink it alolt.
I did not take supplements to lose weight, and ive been feeling like this forever.
10-02-2007, 04:58 PM
10-02-2007, 05:27 PM
I've been told you need saturated fat to absorb cholesterol. We don't see cholesterol numbers yet from you. This may not be an issue but you have to have the numbers to know. Cholesterol is the raw material which your hormones are made out of. Your cholesterol can be too low. This is also part of my problem. My cholesterol is 130. It needs to be 160-180 or so. I'd think with the liver, beef, eggs you would be ok on this.
People are saying Zinc (50 or so), Magnesium and B6 are useful for T. I am taking these. Taking more Zinc is potentially dangerous as it depletes copper.
The calories sound probably OK. There is a risk in not eating enough. It makes sense -- evolution doesn't want you making babies in a time of famine.
10-02-2007, 05:38 PM
Since your LH is low personally I would try HCG first or clomid especially since your only 17. They both will stimulate LH to make your body produce it's own Testosterone. Have no idea why your doctor would think adding in 50mg of T will get your body to start up, makes no sense. HCG or clomid on the other hand is another story but outside T will only shut your system down.
Why are you stuck on shots? Do you know Dr. John prefers Transdermals?
10-02-2007, 05:42 PM
Sorry if you already posted this but have you been tested for diabetes? i.e. High blood sugar This will definitely cause a sudden drop in weight and energy levels. I dropped 20lbs in 2 weeks. Some other symptoms that go along with it are vision problems and needing to pee a lot.
10-02-2007, 06:03 PM
Yes ive been checked for diabaties, like ive said this has been going on for 2 years they checked just about everything expect hormones like testosterone.
I eat plenty of cholesterol probally more then anyone i know and have been, plenty of zinc from foods _ supplement zinc at 50mg that the docotor wanted me on, i feel the same even tho zinc lvls rose. I don't have cholestrol lvls checked, the docotors probally wont check that option off since they will probally say its not necessary to check at my age.
I had to argue with them to sign the form off to request testosterone get checked. If i hadnt i would still be going in circles.
The old endro prescribed shots i don;t know why he is ovbiously an idiot so i dropped him.
I do not want to start TRT unless it is absoultly necessary and if it is a must i would rather shots but for now, HGC or Clomid for sure to try first hopefully it will work at getting my body to produce T naturally again.
What should i say when i go to the new Endocronoligist, ive nvr met him mabey he knows about HGC or not idk yet
10-02-2007, 06:24 PM
10-02-2007, 06:29 PM
10-02-2007, 06:41 PM
Also, FWIW - I'm also trying to find the underlying cause of my condition. I got tested for Neurotransmitters.
You can add testosterone. That's a "fix" but then you have issues like your LH drops, nuts shrink, etc. T is kind of the end result of a series of hormonal signals.
So you try to address it earlier in the system by taking HCG. Great, so now your nuts produce the T and don't shrink. However, LH will also be suppressed.
Clomid (JanSz suggestion) tries to go earlier in the system again. You're telling your brain that you have less Estrogen/Testosterone, so the hypothalmus then signals the pituitary which signals the nuts. When you shut off the Clomid, you'll quite possibly revert back to normal and Clomid is not considered safe for "permanent" therapy. It could work. People on steroids use it to restart their systems after artifically suppressing them with steroids.
IMHO - addressing things as early in the system as possible is the way to a more natural, less problematic treatment so I agree with JanSz approach, but I also have another suggestion. I'm still working through this, so I don't know if it will work or not, but...
I got tested for neurotransmitters. The idea here is that these regulate your brain, which after all your pituitary and hypothalmus are parts of. Several neurotransmitters came up low, including norepinepherine which regulates LH release. I'm currently taking some supplements which are supposed to support the Neurotransmitters as well as eating more cholesterol (raw material). I do feel a little better. I get tested in a couple of weeks and will have a full report then :-)
Oh, and yes, finding a doctor with a clue is VERY difficult. Most could not explain what I explained above, or would not take the effort to figure it out for you. Prescribing T is a very easy answer.
10-02-2007, 07:44 PM
10-03-2007, 03:06 PM
Your Dr. has this back ass words you don't do a Stim. test with a low does of testosteone all this will do is shut you down even more. I don't see that you eat a lot of SOY if you do this can bring down your LH and cause low testosterone but you would need to drink a Gal. of Soy milk a day or more. Still you can have high Estradiol do to your liver problems and if your high enough your brain will think this is Testosterone and stop send the messages LH to your testis to make more testosterone. The only Stim. test I know of is HCG or Clomid read the AACE Guildlines at this link.
There are a lot of things that can cause your T levels to go down this low and Liver problems are one of them. Bottom line your 17 and you need to get a second opininn from a different Dr. and not an Endo they are not good Dr.'s for TRT.
Can you see your family Dr. and ask him if he will help Dr. John to test and treat you over the phone. Go to www.allthingsmale.com and get in touch with him. He dose this with your family Dr. for a lot of men. You have not felt good for some time a little more time will not kill you best to be safe the sorry.
10-04-2007, 08:24 AM
The Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 6 1995-2010
Copyright © 2006 by The Endocrine Society
Conclusions: We recommend making a diagnosis of androgen deficiency only in men with consistent symptoms and signs and unequivocally low serum testosterone levels. We suggest the measurement of morning total testosterone level by a reliable assay as the initial diagnostic test. We recommend confirmation of the diagnosis by repeating the measurement of morning total testosterone and in some patients by measurement of free or bioavailable testosterone level, using accurate assays. We recommend testosterone therapy for symptomatic men with androgen deficiency, who have low testosterone levels, to induce and maintain secondary sex characteristics and to improve their sexual function, sense of well-being, muscle mass and strength, and bone mineral density. We recommend against starting testosterone therapy in patients with breast or prostate cancer, a palpable prostate nodule or induration or prostate-specific antigen greater than 3 ng/ml without further urological evaluation, erythrocytosis (hematocrit > 50%), hyperviscosity, untreated obstructive sleep apnea, severe lower urinary tract symptoms with International Prostate Symptom Score (IPSS) greater than 19, or class III or IV heart failure. When testosterone therapy is instituted, we suggest aiming at achieving testosterone levels during treatment in the mid-normal range with any of the approved formulations, chosen on the basis of the patientís preference, consideration of pharmacokinetics, treatment burden, and cost. Men receiving testosterone therapy should be monitored using a standardized plan.
10-04-2007, 11:40 AM
Found a good endo guys. He is willing to work with me and after i get the blood tests he ordered we will try out to see if Clomid will fix the HPTA
He imo finnaly was the only doctor to order good blood tests heres some of what he put down i especially like the Complete Metabolic panel , hopefully it will tell us more on whats up. When i get these results ill post them and hopefuly some of you guys can help me make better decisions aswell when the time comes
Complete Metablolic Panel
Cortisol,Free,24 hour urine
IRON AND IRON BINDING CAP
VITAMIN 12 + fOLATE
10-04-2007, 02:31 PM
but you are missing lots of good info that you would got if you were able to make yor doc just print my complete blood test on his office stationary and sign it.
It would take less time for him, he just ask his nurse.
I e-mail my request to my doc and that is what he is doing, printing everything out and I am out of his face in 2 minutes.
My list is on post #44
Jan's BloodTest April13/2007
10-04-2007, 02:47 PM
I don't know if we can change the Quest blood script now and once these results get if nothing stands out in i think ill be going on Clomid & i will ask about HCG if its ok.
10-04-2007, 03:04 PM
It would help you to pick up what is important.
To me SHBG is important.
My story you can access here:
Jan's BloodTest April13/2007
Just to repeat for 1000th time, doctors are more often cluless than right, if you like your life, spend time looking into what makes it tick.
In 2002 head of sex dept in major hospital in NYC (basically) told me to go and die, my days are over.
Today I am still ticking and bothering wife for more sex than she is willing to give me, no thanks to doctors.
Read protocols on
The Life Extension Foundation: Disease Prevention And Treatment Protocols
10-04-2007, 03:08 PM
JanSz can use your SHBG to calculate the appropriate dose of T if you ever go that route. SHBG high or low levels can lead you to finding underlying causes sometimes. SHBG should be balanced with estradiol. And finally, it's a good idea to get a baseline of SHBG to see how T therapy affects it (again, if you go that route).
This is how I understand the importance of SHBG as I have been taught by JanSz and Hardasnails. You guys correct me if I'm wrong or add to whatever I missed.
10-18-2007, 08:45 PM
Just go blood test results in doctor wants more done before we do anything here they are . My zinc is finnaly normal
Ill only post certin things that are high or low or near low. Surprisingly my AST & ALT are actully the lowest they have been EVER since ive been getting blood tests!
my Estradiol,is pretty low but normal range. Well at least i don't have an assload of estrogen flowing. Cortosil is insane, anyway here it is.FSH somewhat high, LH is dead.
Estradoil, Ultra Sensitive- 9 Refrence 5-45 pg/ml
Testosterone, Total- 159 Low
Vitamin b12 Serum- 1147 VERY HIGH Refrence 260-935
SHBG-36 Normal Refrence 11-71 nmol/L
Testosterone Free-17.5 Normal Refrence 4.0-100.0 pg/ml
Testosterone Bioavaiable-39.9 Normal Refrence 8.0-210.- ng/dl
Cortisol, Free, 24HR Urine-113.4 VERY High Refrence 5.0-50.0 ug/24Hr
IGF-1==167 Refrence 152-668 ng/ml(**** im borderline)
Carbon Dioxide-18 LOW Refrence 21-33 mmol/L
Urea Nitrogen-28 HIGH Refrence 6-22
AST- 27 NORMAL(YAY FIRST TIME EVER)
ALT- 53 High
RBC- 3.38 LOW Refrence 4.10-5.70 mill/mcl
Hematocrit-34.5 LOW Refrence 36.0-49.0%
MCV-102.2 HIGH Refrence 78.0-98.0 fl
MCH-35.8 High Refrence 25.0-35.0
FSH-8.5 High Refrence 1.6-8.0
LH-.9 VERY LOW Refrence 1.5-9.3
Here is what he wants to do again,
LH Serum(Gel Barrier Tube)
Testosterone, Total Serum
Creatinine,24 HR Urine
SHBG Serum(Gel barrier tube)
Testicular Hypofunc NEC
ABN Liver Function Study
Mineral Deficiency NEC
10-18-2007, 11:23 PM
Testosterone and estrogen is low, ie low hormones.
When you are ready to start testosterone injections make sure your dose is big enough.
Start with 180mg/week, divide dose, use e3d schedule.
and do not rush with using any AI, wait for blood test.
Jan's BloodTest April13/2007
10-19-2007, 01:43 PM
BUN is elevated - this could be stress, not enough fluid or very high protein intake.
RBC indices, Hct and Hgb show a mild anemia. The elevated MCV (mean cell volume) suggests that the anemia results from a nutritional deficiency - either B12 or folate.
This is puzzling since your blood level of B12 is very high, and you said that you are careful with your diet. Didn't you say you ate a lot of liver? That would account for the elevated B12.
Liver disease can also cause this type of RBC change, and your ALT is elevated. But the elevation is slight. Generally, with any kind of liver disease, ALT is elevated to several times the normal value.
I wish I had more constructive information, but I don't. Your doc may have a very good explanation for these results. If he doesn't, a hematology consult might be in order.
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