Recent Bloodwork - Road to TRT

[cleanEG]

Hi Everyone,

It's been a long time since I've posted, however I would like to start a thread on this journey and obtain some valuable information along the way. Back in 2006 I ran a cycle of 500mg Test Enanthate and 400mg of EQ in an effort to self medicate because my DR at the time was not responsive to TRT. This was documented in a thread I started back in 2006.

After the cycle, my test levels remained in the "normal" category for quite some time afterwards with the use of tribulus and another supplement called "free test". I've noticed that my test levels have been dropping further and further and the symptoms of low test are all there again. I started doing extensive bloodwork again with an Endo and here are the results:

Blood Test Results:


Total Testosterone 231 Range (249 - 836) ng/Dl
SHBG 18.13 Range (14.5-48.4) nmol/L
LH 1.4 Range ( 1.5 - 9.3 ) mIU/mL
FSH 2.4 Range( 1.6 - 8.0 ) mIU/mL
Estradiol 27.0 Range( <39 ) pg/mL
TSH 1 Range (.35 - 4.0) uIU/mL
Free T4 1.3 Range (.8 - 1.5) ng/dl
T3 109 Range (58 - 159) ng/dl


GLUCOSE, FASTING 90 70 - 99MG/DL


Lipid Panel
[TABLE="class: t1"]
[TR]
[TD="class: td1"]CHOLESTEROL[/TD]
[TD="class: td2"]138[/TD]
[TD="class: td3"]<200[/TD]
[TD="class: td4"]mg/dL[/TD]
[/TR]
[/TABLE]
[TABLE="class: t1"]
[TR]
[TD="class: td5"]TRIGLYCERIDE[/TD]
[TD="class: td6"]52[/TD]
[TD="class: td7"]<150[/TD]
[TD="class: td8"]mg/dL[/TD]
[/TR]
[TR]
[TD="class: td5"]HDL[/TD]
[TD="class: td6"]52[/TD]
[TD="class: td7"]>/=40[/TD]
[TD="class: td8"]mg/dL[/TD]
[/TR]
[TR]
[TD="class: td5"]LDL CALCULATED[/TD]
[TD="class: td6"]76[/TD]
[TD="class: td7"]<100[/TD]
[TD="class: td8"]mg/dL[/TD]
[/TR]
[TR]
[TD="class: td5"]CHOLESTEROL/HIGH DENSITY LIPOPROTEIN[/TD]
[TD="class: td6"] 2.7[/TD]
[TD="class: td7"]<5.0[/TD]
[TD="class: td8"][/TD]
[/TR]
[/TABLE]


Liver Function:


ALKALINE PHOSPHATASE 114 20 - 125UNITS/L
BILIRUBIN, TOTAL 0.80 .1 - 1.0MG/DL
ALT 20 17 - 63UNITS/L


(January 2006 - Pre-Cycle)

Total Testosterone History: (Range 249 - 836 ng/dL)

Total Testosterone - 373 241-827 ng/dl
Free Test - 108.8
% Free test - 2.92 Range 1.1 - 2.8

(Post Cycle)


11/2007 445
7/2008 552
7/2010 391
5/2011 336
9/2011 551
11/2012 325
1/2013 231

Based on these results my Endo has suggested an MRI of my pituitary based on my low LH, low FSH and low Testosterone levels as the next step. Classic signs of Secondary Hypogonadism. He then wants to recheck my test levels in 12 weeks to see if TRT is needed.

My initial thought is that my first and only cycle kickstarted my natural production for a while. I thought about doing that again, but at 35 years old I doubt it will work.

My thyroid looks normal, but any other thoughts? I'd like to find the real cause of my low T before just jumping into TRT for the rest of my life. Thanks!

 

[PaulBlack]

Wouldn't a doctor or endocrinologist be your absolute safest and best bet at answering your questions?
Outside factors such as job or life stresses and all kinds of things can play a role in body/brain/chemical functions, but to try and pinpoint exacts without professional help is IMO probably not the best choice.

 

[vassille]

What do you eat everyday?
run through your daily meals pls
Cholesterol that low may look good on paper but im not sure how good is for hormone production.
Seems like your pituitary works at times but not all the time.

 

[BJE]

I think it's a good idea to find out why you are low, especially at your age. I started TRT at about 46, and my endo didn't think it was worth investigating a cause because, he said, that at my age low testosterone is pretty normal.

 

[PaulBlack]

he said, that at my age low testosterone is pretty normal.

Certainly agree. As we age and hit middle age and up, it regresses. Maybe some slower and or faster than others, but comparing yourself to how "you" felt in your earlier ages, seems always to be true.
It seems more science that comes out too, about exogenous estrogens in all kinds of stuff, is not a very good thing either.

 

[cleanEG]

What do you eat everyday?
run through your daily meals pls
Cholesterol that low may look good on paper but im not sure how good is for hormone production.
Seems like your pituitary works at times but not all the time.

On average (without dieting) my average meal plan is the following:

Meal1 - protein powder, almond milk and cup rolled oats blended
Meal2 - 3 eggs scrambled, slice of cheese, slice of wheat toast, half an avocado
Meal3 - 1 cup of yams or brown rice, 6 oz of chicken or ground turkey, cup of vegetables
Meal4 - 2 rice cakes with 2 TBSP of peanut butter
Meal5 - post workout shake
Meal6 - 1 cup of yams or brown rice, 6 oz of chicken or ground turkey, cup of vegetables

Sometimes I'll substitue meat with gardein or morning star vegeterian substitute. On the weekends I'm not as strict and I'll go out to eat for some mexican food, italian, sushi, indian food...etc.

I just had an MRI last week (finally) so I'm looking forward to the results. If the MRI comes back without any pituitary issues, then he suggested I get bloodwork done again in May. I get the impression that he's not willing to really find the root cause and just send me on my way or prescribe TRT if I remain low after the next test.

 

[cleanEG]

I think it's a good idea to find out why you are low, especially at your age. I started TRT at about 46, and my endo didn't think it was worth investigating a cause because, he said, that at my age low testosterone is pretty normal.

I have a feeling that my Endo feels the same way which really sucks....

 

[vassille]

On average (without dieting) my average meal plan is the following:

Meal1 - protein powder, almond milk and cup rolled oats blended
Meal2 - 3 eggs scrambled, slice of cheese, slice of wheat toast, half an avocado
Meal3 - 1 cup of yams or brown rice, 6 oz of chicken or ground turkey, cup of vegetables
Meal4 - 2 rice cakes with 2 TBSP of peanut butter
Meal5 - post workout shake
Meal6 - 1 cup of yams or brown rice, 6 oz of chicken or ground turkey, cup of vegetables

Sometimes I'll substitue meat with gardein or morning star vegeterian substitute. On the weekends I'm not as strict and I'll go out to eat for some mexican food, italian, sushi, indian food...etc.

I just had an MRI last week (finally) so I'm looking forward to the results. If the MRI comes back without any pituitary issues, then he suggested I get bloodwork done again in May. I get the impression that he's not willing to really find the root cause and just send me on my way or prescribe TRT if I remain low after the next test.

Diet is on point, actually better than most ppl and seems that your cholesterol is naturally set around that number. See what the MRI shows first before you dig deeper.
I think your cholesterol should be at least 150 or a little higher. SInce you have this issue is worth eating some more good fats and saturated fats to increase it and see if that makes a difference. Your liver just may not have enough raw material to make enough cholesterol OR your body uses a lot of it. In any case dont be afraid to have a steak, pork, butter to get the machinery churning again.

 

[cleanEG]

MRI came back with a perfectly normal/healthy pituitary. Just as I suspected, my Endo wants to wait 3 months and do bloodwork again to see if my levels are still below normal. I asked if any further tests can be done to determine the root cause of my low T levels and he said no other tests are needed. I may get a second opinion from another Endo in the network - hopefully someone that wants to investigate further.

 

[BJE]

MRI came back with a perfectly normal/healthy pituitary. Just as I suspected, my Endo wants to wait 3 months and do bloodwork again to see if my levels are still below normal. I asked if any further tests can be done to determine the root cause of my low T levels and he said no other tests are needed. I may get a second opinion from another Endo in the network - hopefully someone that wants to investigate further.

It's good your pituitary is normal, but I don't understand waiting three months to test again as though doing nothing is going to increase your testosterone level.

 

[vassille]

MRI came back with a perfectly normal/healthy pituitary. Just as I suspected, my Endo wants to wait 3 months and do bloodwork again to see if my levels are still below normal. I asked if any further tests can be done to determine the root cause of my low T levels and he said no other tests are needed. I may get a second opinion from another Endo in the network - hopefully someone that wants to investigate further.

You can get a second opinion but I did a lot of research into pituitaries abnormalities and if it's just not working right or laizy there is nothing to fix that internally..like there is nothing to fix type I diabetes either if the cells are shot. You seem to show a trend of low signals from pituitary which results in low test levels.
However, do some research of all the signals coming from pituitary and check to see if there is a trend or is just LH and FSH. There are other hormones affected by pituitary. Give that a shot.

here is a link that may be of some help
Invalid Link Removed

 

[cleanEG]

You can get a second opinion but I did a lot of research into pituitaries abnormalities and if it's just not working right or laizy there is nothing to fix that internally..like there is nothing to fix type I diabetes either if the cells are shot. You seem to show a trend of low signals from pituitary which results in low test levels.
However, do some research of all the signals coming from pituitary and check to see if there is a trend or is just LH and FSH. There are other hormones affected by pituitary. Give that a shot.

I just wanted to provide an update on this thread. I took your advice and started to consume more egg yolks and EFAs. Here is the latest test results:

5/25/2013

LH - 3.7
FSH - 3.6
Total Testosterone: 393.8

LH and FSH both went up as a result as well. I'm going to stay on this diet and have a lipid panel done in a few weeks to check those levels to confirm my cholesterol is higher. Thanks again for the information and suggestion....

 

[vassille]

I just wanted to provide an update on this thread. I took your advice and started to consume more egg yolks and EFAs. Here is the latest test results:

5/25/2013

LH - 3.7
FSH - 3.6
Total Testosterone: 393.8

LH and FSH both went up as a result as well. I'm going to stay on this diet and have a lipid panel done in a few weeks to check those levels to confirm my cholesterol is higher. Thanks again for the information and suggestion....

You welcome!
How do you feel?

 

[cleanEG]

I feel pretty good and my libido has definitely increased as a result. Unfortunately I havent been able to workout as much due to a shoulder impingement I'm rehabilitating so I couldnt really comment on strength gains. I'm putting TRT on hold for a while to see if I can maintain these levels on my own.

 

[vassille]

Cool sounds like you def have seen improvement.
Since you still recovering try not to go to often to the gym and go too hard. Prob not going to the gym has helped you in a way. Just go light on the workouts.