23 been in limbo with blood results for 25 months ... need input

B

Broshifstalin

New member
As stated I've been through the game in Canada for awhile, I went to my endo on Thursday and after multiple low and borderline results he has stated that since my Total Test is withing range as well as my BioT he sees no reason to treat me, I told him that I would treat myself and he ordered more blood tests which we are going to go over soon but I would very much appreciate the communities help on insight and possible treatment.

In October 2011 I had been complaining about various problems associated with Low T and decided to have it tested, which resulted in my levels being flagged. Anxiety, depression, low libido, poor sleeps, chronic fatigue, gyno in my right nipple and trouble sleeping in addition to no morning wood for a little over 2 years were the main problems.

After an intense amount of tests and trials on antidepressants that made me manic my family GP finally referred me to a known specialist in Toronto in August 2012 who needed more results but eventually put me on clomid for 3 months 25mg Mon/Wed/Fri (ending at the end of January 2013) --- after about 6 weeks my mind fog cleared up, my lifts increased the morning wood was gone everything improved, including my exam marks from that semester due to being able to focus -- Unfortunately he did not think to get levels during this period. It was also in December last year that they found a 3mm mass in my pituitary which is currently still there and will be MRI'ed annually.

In April 2013 I began feeling the anxiety and depression and disinterest towards life creep in addition to the brain fog and lack of morning wood, this was when I got more levels taken which he claimed to be "above what they were before and in range, so it must be a mood disorder" Over the summer I tried further types of antidepressants and mood stabilizers none of which worked or had me feeling as good as the clomid.

My last test in September yielded these results, at the time I was having crazy mood swings - probably attributed to the use of the antidepressant Ciprolex but I was also did not have any body odor, which had always been there before. --- After this test he claimed that everything was ok, and that I'm normal.

My background is an athlete, there has been head trauma and concussions, I rowed and swam competitively through University, currently I sit at 158lb, 8%bf, Weighted pullup 90lb+bodyweight x 7, Deadlift 315x10 and Bench 275x4.
Here are all the bloodtests so far

Oct 7 2011 Range:
Total Test 12.4 (7.6-31.4 nmol/L)
Prolactin 16 (<18)
Free Test 24.7 (31.0-94.0 pmol/L)
sTSH 1.87 (0.35-5.00 mIU/L)
Ferratin 97 (normal 80-300)
Sodium 140 (135-145)
Potassium 4.4 (3.3-5.1 nmol/L)
B12 584 (sufficiency >220pmol/L)
Urate 295 (200-440 umol/L/)

Nov 23 2011
Free Test 40.5 (31.0-94.0 pmol/L)

Feb 6 2012
Free Test 25.4 (31.0-94.0 pmol/L)

May 4 2012
Total Test 10.0 (8.4-28.7 nmol/L)
Free Test 25.4 (31.0-94.0 pmol/L)
Bioav. Test 4.8 (2.0-14.0 nmol/L)

Follitropin(FSH) 4 (2-8)
Lutropin (LH) 4 (2-6)

Sex Hormone Bind. Globulin 33.3 (10-70.0 nmol/L)

July 26 2012
Glucose Fasting 4.8 (3.6-6.0)
Creatinine 104 (62-115)
eGFR 77

Sodium 140 (135-147)
Potassium 4.3 (3.5-5.5)
Total Bilirubin 11 (<22)

Alkaline Phosphase 140 U/L (45-129)
Gamma Glutamyltrynsferase 12 U/L (15-73)

Cholesterol 4.72mmol/L
LDL 2.21mmol/L
HDL 2.06mmol/L
Cholesterol/Hdl ratio 2.3
Triglycerides 0.98mmol/L

Hemoglobin 143 g/L (135-175)
Hematocrit 0.42 L/L (0.40-0.50)
WBC 4.2 xE9/L (4-11)
RBC 4.55 xE12/L (4.5-6)
MCHC 343 (305-360)
MCV 91.6 (80-100)
MCH 31.4 (27.5-33)
RDW 13.3% (11.5-14.5)
Platelet Count 163 (143-400)

Absolute: Neuts 1.4 (2-7.5)
(A) Lympho 2.3 (1-3.5)
(A) Mono 0.4 (0.2-1)
(A) EOS 0.1 (0.0-0.5)
(A) BASO 0.0 (0.0-0.2)

Homocysteine 7.0umol/L (<=15)
TOTAL PSA 0.37ug/L (0.00-4.00)

Lutropin (LH) 2 IU/L (2-6)
Progesterone 2 (<4)

Estradiol-17 BETA <70pmol/L (<150)

Total Test 11.1 nmol/L (8.4-28.7)
FREE TEST 32.8 pmol/L (31-94)
DHEA-S 7.2umol/L (7.6-17.4)

8AM Cortisol 579 nmol/L (NO STANDARD VALUE LISTED)

May 2013
Total Test 16.6 nmol/L (8.4-28.7)
Bioav. Test 8.8 (2.0-14.0 nmol/L)


September 2013

Total Test 14.0 nmol/L (8.4-28.7)
FSH 3 IU/L (range 2-8)
LH 2 IU/L (range 2-6)
 
Welcome, If I read that right you stated you have a 3mm mass in my pituitary, I am not an expert but I believe that can cause low T.

I hope things work out for you!
 
Sounds like you are pretty much in the same situation as when you last posted. But now you know you responded well to the restart attempt. It seems like your options are to try a restart again and perhaps be more aggressive with it, or hop on TRT.

Did you ever get the sleep study done? Eating better? Still not going back to your overtraining ways?

Why won't your docs treat you? You have a pituitary tumor and Low T. What more do they want?
 
I've Been eating better and have had the over training fixed, the 3mm tumor he says is usually nothing and would have shown up in the hormone panels as being off -- so he doesn't think there is anything wrong. The total testosterone was a 14 in September, so he says he has never treated anybody in range... which does not look good on my part. In addition he brings up the bioavaiable testosterone test in may being in the upper half of the normal range (even while my total was a ~450)

I would like to try a restart and be more aggressive with it, when he told me that he would see me in 6 months and try a blood test again I said I was doing it myself -- so he ordered more on the spot (Boiavaiable, TotalT, Feratin, Prolactin, FSH, LH, Cortisol, AUH, TSH, FreeT4) --- but he says he isn't comfortable doing anything-- I will add those results as soon as they come in.

My question is I've read cashout's system, he had a level of 800 before he started slipping... with my case we don't have any results that are that high --- could the same "restart" work for me or would it be a hopeless case since there is no evidence of my system ever running at full capacity without a drug like clomid?

Also my FSH and LH are never in the high range in any of the tests they showed up, being on the edge of range in the last September checkup -- is this evidence that its the pituitary and perhaps the tumor preventing adequate production, and could I use it when talking to him? And is it possible to experience LowT symptoms with a super low Total T level and moderate bioavaiable level?
 
Broshifstalin said:
I've Been eating better and have had the over training fixed, the 3mm tumor he says is usually nothing and would have shown up in the hormone panels as being off -- so he doesn't think there is anything wrong. The total testosterone was a 14 in September, so he says he has never treated anybody in range... which does not look good on my part. In addition he brings up the bioavaiable testosterone test in may being in the upper half of the normal range (even while my total was a ~450)

I would like to try a restart and be more aggressive with it, when he told me that he would see me in 6 months and try a blood test again I said I was doing it myself -- so he ordered more on the spot (Boiavaiable, TotalT, Feratin, Prolactin, FSH, LH, Cortisol, AUH, TSH, FreeT4) --- but he says he isn't comfortable doing anything-- I will add those results as soon as they come in.

My question is I've read cashout's system, he had a level of 800 before he started slipping... with my case we don't have any results that are that high --- could the same "restart" work for me or would it be a hopeless case since there is no evidence of my system ever running at full capacity without a drug like clomid?

Also my FSH and LH are never in the high range in any of the tests they showed up, being on the edge of range in the last September checkup -- is this evidence that its the pituitary and perhaps the tumor preventing adequate production, and could I use it when talking to him? And is it possible to experience LowT symptoms with a super low Total T level and moderate bioavaiable level?
Click to expand...

Low T coupled with Low/Normal LH and FSH = Secondary Hypogonadism
Low T coupled with High LH and FSH = Primary Hypogonadism

You are secondary. And given the pituitary tumor I would say we probably know why. Lots of guys - I think they say something like 20% - have slow growing small pituitary tumors that never cause problems or have to be removed. But since you have Low T, it very well may be affecting you.

To answer your question about not seeing high LH and FSH, you will not. That would mean your pituitary is working fine but your testicles are not responding. Unfortunately, your pituitary doesn't recognize that you are low on T and crank up the LH signal sent to your testicles.

I would look for a new doc that has experience with restarts. Obviously the clomid was working for you. Give it another shot. And if it doesn't hold this next time when you go off it you will probably need TRT. Another option is having the tumor removed sand see if that helps. They can usually just go up your nose to do that when they are small.
 
So in answer to the bioavailable T levels, with Low FSH/LH, LowT and "acceptable BioT" -- it still is possible to suffer from the effects of hypogonadism, its just so hard to get a doc in Canada -- even with the first 4 blood tests it took 6 doctors and 2 specialists to find the one who was willing to admit something was not right. I want to have my facts straight when I talk to this endo on the phone in a couple days, and if he does not I will try tamoxifen while I look for another endo --- since I am secondary, would I need to add HCG or would it be of little help in this scenario?
 
Broshifstalin said:
So in answer to the bioavailable T levels, with Low FSH/LH, LowT and "acceptable BioT" -- it still is possible to suffer from the effects of hypogonadism, its just so hard to get a doc in Canada -- even with the first 4 blood tests it took 6 doctors and 2 specialists to find the one who was willing to admit something was not right. I want to have my facts straight when I talk to this endo on the phone in a couple days, and if he does not I will try tamoxifen while I look for another endo --- since I am secondary, would I need to add HCG or would it be of little help in this scenario?
Click to expand...

Bioavailable T is influenced by lots of things such as your thyroid, SHBG levels at the time, albumin, estradiol, etc. It is interesting to look at, but I think Total Testosterone should be your point of focus. You need a certain level of testosterone in your body to function normally. Hypogonadism has a host of co-morbidities associated with it. Heart disease for example.

There are different approaches to restarts. I can't advise you on the best one for you. You really need to work with an experienced doctor. And get a second opinion on the pituitary tumor.
 
I just got my newest levels from the 22 of November @8:20AM

Total Testosterone- 17.9nmol/L (8.4-28.8)
SHBG - 29.0 nmol/L (10-70)
Bio T - 9.5nmol/L (3.6-11.2)
FSH - 3 (2-8)
LH - 3 (2-6)
Total Prolactin - 16ug/L (2-18)



Thytropin (sensitive TSH) - 1.58mIU/L (0.3-4.00)
Free T4 - 14pmol/L (9-23)

Adrenocortocotropic Hormone - 13.5pmol/L (<14)
Cortisol - 613nmol/L (170-720)



Besides the Low LH/FSH does this mean that testosterone is not the cause of my problems then, and to look elsewhere for answers?
 
Lh/fsh fluctuate a lot throughout the day. I would just look at your numbers on them and say they are mid to normal. You test results are fine. Is this set of labs with drugs of any kind?
 
No no drugs at all, I've increased training again the month leading up to the blood work(4-5 hours a day) otherwise, it seems that the initial hypogonadism has been fixed with continuation of the symptoms...
 
interesting...
you were on nothing with this recent blood work ?
you're losing weight and gaining muscle I take it ?
any sleep study done
I went to an endo like you did bro...same attitude and my T.T. was lower at 9nmol/L and ON ADEX E3D 0.25 mg...
ADEX raises BIO T a bit and lower SHBG and E2.
 
Looking at your labs looks like you use Gamma Dyna Care. They are the best lab out there now.
Stay away from CML. Their Total T levels range from: 6-27 Nmol/L. Just so you know... 6 Nmol/L = 173 ng/dl. Any doc that has a man as his patient at 173 ng/dl and consider it "normal" should lose their medical license imo. Gamma use to have their Total T levels ranging: 8-38 Nmol/L when I used them in 2007. They brought them down to 31.4 Nmol/L.
All labs brought down heir ranges. Ridiculous. Short change the public from a hormone that is so vital to well being.
 
There have been no drugs since the restart last november - febuary, when i get stressed I go to the gym, so its been 2 a days now for a month leading up to that 2-2.5 hours each time... way to much time in the gym, I do have less bodyfat now my strength is starting to get scary. The other day I noticed the start of feathering in my Vastus Lateralis, which I'm attributing to high stress.

No sleep study done - they have been getting upset with me trying to say T is an issue anymore, I can tell you I'm up quite a bit at night and never feel very refreshed though.
 
You must log in or register to reply here.

Similar threads

B
Need some opinions after first Cycle of Test
Replies
2
Views
1K
casanovaaa
casanovaaa
G
Need advice from someone that really know what to do.
Replies
17
Views
1K
casanovaaa
casanovaaa
S
Lab Results - Very high T?
Replies
8
Views
1K
Mycelium
Mycelium
M
Bloodwork complete/Need recommendations
Replies
2
Views
1K
mullins1
M
G
Help With Doctors Decision
Replies
10
Views
2K
scorob777
scorob777
Back
Top