25 year old male sick of being tired. Trying to find an empathetic specialist.

[addwater]

25 year old Aussie here who could really do with some advice from anyone willing to offer wisdom.

I recently underwent a full blood test due to my persistent fatigue, exhaustion, depression, anxiety, lack of overall motivation and libido. I'm utterly sick of feeling exhausted and useless on a daily basis.

It turns out I'm not suffering from any known diseases or illnesses. My Total Testosterone Levels came in at 400ng/dl which I'm told are within normal ranges. I also understand I will probably need to undergo multiple tests to depict a more accurate result.

Further research suggests that at my age my levels should be soaring and that 400ng/dl is only really considered okay if you're an average 80 year old man.

I'm booked in to speak with my doctor tomorrow, from where I'm going to push to speak to a (hopefully understanding) and qualified endocrinologist whom I'll ask for further testing which may lead to TRT injections. I want nothing more than to achieve optimal Testosterone levels.

What I'm really wanting to know is if any of you out there in a similar situation and location can recommend an ideal specialist to speak with.

I live around an hour north of Brisbane, though I'm willing to travel in order to make this happen and change my life.

Any feedback in general pertaining to my situation that I may benefit from I will also be extremely grateful for.

Thank you, guys.

 

[Megatron28]

Give this thread a read.

http://www.steroidology.com/forum/testosterone-replacement-therapy/662394-basic-trt-overview.html

But from everything I have heard, getting on TRT in Australia is difficult.

Can you post your full blood work? Maybe we can spot something that's off.

Have you had a sleep study done to check for things like Sleep Apnea?

What is your height, weight and physical activity level?

 

[addwater]

Give this thread a read.

steroidology.com/forum/testosterone-replacement-therapy/662394-basic-trt-overview.html

But from everything I have heard, getting on TRT in Australia is difficult.

Can you post your full blood work? Maybe we can spot something that's off.

Have you had a sleep study done to check for things like Sleep Apnea?

What is your height, weight and physical activity level?

Sleep Apnea: No

Height: 6'1

Weight: 185lbs

Blood work: imgur.com/a/zgocc

Health: I lift 3 times a week (heavy compound movements) and compliment this with lean meats, lots of protein, veggies and vitamins and minerals.

I've seen how proactive you are on this forum and I'm very grateful for your reply.

 

[Megatron28]

Sleep Apnea: No

Height: 6'1

Weight: 185lbs

Blood work: imgur.com/a/zgocc

Health: I lift 3 times a week (heavy compound movements) and compliment this with lean meats, lots of protein, veggies and vitamins and minerals.

I've seen how proactive you are on this forum and I'm very grateful for your reply.

If I am reading this right, you had your blood work run too late in the day. It looks like you did it around 5 PM. You need to check your Natty Hormone levels first thing in the morning after a good nights sleep. There is a very good chance that your T levels are perfectly normal for your age.

I didn't see any other issues in your blood work, but a lot was missing such as LH, FSH and Prolactin. Your Thyroid seems ok which is often something else that gives your symptoms.

What are you doing to treat your depression? Seeing a psychologist? Any idea as to what is causing you to feel depressed? When I was Hypogonadal (190ng/dl), I remember asking myself if I was depressed. I thought about it and realized I wasn't. I was just so damn tired all the time.

 

[daleb]

I would get your Vitamin D tested as well. Are you on any supplements? If so what are they?

A person with low Vit D will feel like crap.

In America a person can call a pharmacy and ask which doctor prescribes the most testosterone cypionate and find a doctor that way. Im finding in America at least, that urologists tend to be better TRT docs then general practitioners and endocrinologists.

 

[addwater]

If I am reading this right, you had your blood work run too late in the day. It looks like you did it around 5 PM. You need to check your Natty Hormone levels first thing in the morning after a good nights sleep. There is a very good chance that your T levels are perfectly normal for your age.

I didn't see any other issues in your blood work, but a lot was missing such as LH, FSH and Prolactin. Your Thyroid seems ok which is often something else that gives your symptoms.

What are you doing to treat your depression? Seeing a psychologist? Any idea as to what is causing you to feel depressed? When I was Hypogonadal (190ng/dl), I remember asking myself if I was depressed. I thought about it and realized I wasn't. I was just so damn tired all the time.

The test was carried out at approximately 11am, despite what the records may suggest. It was after a reasonable nights sleep.

You're right about a lot of the fundamental levels missing in the test. As per a helpful guide on *****, I'm going to ask my GP to be re-tested and to check for the following levels:

- Testosterone , total
- Testosterone, bioavailable
- Testosterone, free
- Estradiol (sensitive assay)
- Steroid Hormone Binding Globulin
- Follicle Stimulating Hormone (FSH)
- Luteinizing Hormone (LH)
- Dihydrotestosterone (DHT)
- Complete Blood Count (CBC)
- Prostate Specific Antigen (PSA)
- Blood Chemistry Panel
- Me(t)abolic Panel

In terms of my depression, I don't know that there's anymore I can do. I've already tried SSRI's among other drugs. All of that in conjunction with exercise, sleep and diet makes me think that I'm unfixable. Unless of course my testosterone levels are to blame.

I'm certainly not suicidal or overly hating life, I'm just so fucking unmotivated it hurts. Nothing excites me, I have no drive to do anything. So it's not depression as in I'm unhappy, sad or suicidal, I'm just exhausted and unexcited all the time.

 

[Megatron28]

The test was carried out at approximately 11am, despite what the records may suggest. It was after a reasonable nights sleep.

You're right about a lot of the fundamental levels missing in the test. As per a helpful guide on *****, I'm going to ask my GP to be re-tested and to check for the following levels:

- Testosterone , total
- Testosterone, bioavailable
- Testosterone, free
- Estradiol (sensitive assay)
- Steroid Hormone Binding Globulin
- Follicle Stimulating Hormone (FSH)
- Luteinizing Hormone (LH)
- Dihydrotestosterone (DHT)
- Complete Blood Count (CBC)
- Prostate Specific Antigen (PSA)
- Blood Chemistry Panel
- Me(t)abolic Panel

In terms of my depression, I don't know that there's anymore I can do. I've already tried SSRI's among other drugs. All of that in conjunction with exercise, sleep and diet makes me think that I'm unfixable. Unless of course my testosterone levels are to blame.

I'm certainly not suicidal or overly hating life, I'm just so fucking unmotivated it hurts. Nothing excites me, I have no drive to do anything. So it's not depression as in I'm unhappy, sad or suicidal, I'm just exhausted and unexcited all the time.

11am is too late in the day. It really needs to be first thing in the morning -- like 8am.

Have you met with a psychologist?

Check FSH and Prolactin too.

 

[Graeme]

The Australian rules on TRT are that to qualify under the PBS (Pharmaceutical Benefits Scheme) you need to meet the following criteria:

• Have a total testosterone level below 6 nmol/L (173 ng/dL).
• Be seen by an endocrinologist or urologist, and have the problem confirmed.

I don't know what the situation is with accessing TRT privately in Australia. The PBS guidelines apply to subsidised treatment, but a doctor could possibly issue a private script.

Given that the PBS caps prescriptions costs to $38, and injectible testosterone costs a bit less than that, it won't make a lot of difference to the patient's pocket. Androgel is (I believe) around $70 or $80, so that becomes more expensive.

There's also the issue that the more general TRT guidelines I've seen put the cut-off points for treatment at:

• Total testosterone below 350 ng/dL (12 nmol/L)
• Free testosterone (calculated) below 6 to 8 ng/dL. (210 to 280 pmol/L)

The lower bound of free T is a bit of a grey area. So unless the OP has a high SHBG level, it might be hard for a mainstream practitioner to prescribe treatment. In which case you'd be looking at finding an integrative doctor, and probably paying $200 or $300 per appointment and blood tests.

The problem is probably depression as the symptoms the OP are suffering from are consistent with dysthymia.

Google Bignoknow, and take a look at his YouTube channel. He's a depressive who was diagnosed with low T (somewhere around 280), and even when running a high TRT dose (180 - 200 mg / week), he's still having rough weeks.

There seem to be a lot of people with low-normal testosterone levels who view TRT as magic bullet to fix their mood problems, and I'm not convinced it will. It can be used as a treatment, and is particularly effective for low level depression, but the best fix is going to be through talking therapies, such as CBT.

I'm struggling with depression, and not on TRT. I'm also in Australia, so know a bit about the system.

 

[addwater]

11am is too late in the day. It really needs to be first thing in the morning -- like 8am.

Have you met with a psychologist?

Check FSH and Prolactin too.

Thanks.

I'll ensure my subsequent tests are much earlier.

I've spoken with Psychologists before, though I never derived much value or progression from the interactions.

I'll keep you updated as to how I go with further tests and also my discussions with my GP / Specialist.

 

[addwater]

The Australian rules on TRT are that to qualify under the PBS (Pharmaceutical Benefits Scheme) you need to meet the following criteria:

• Have a total testosterone level below 6 nmol/L (173 ng/dL).
• Be seen by an endocrinologist or urologist, and have the problem confirmed.

I don't know what the situation is with accessing TRT privately in Australia. The PBS guidelines apply to subsidised treatment, but a doctor could possibly issue a private script.

Given that the PBS caps prescriptions costs to $38, and injectible testosterone costs a bit less than that, it won't make a lot of difference to the patient's pocket. Androgel is (I believe) around $70 or $80, so that becomes more expensive.

There's also the issue that the more general TRT guidelines I've seen put the cut-off points for treatment at:

• Total testosterone below 350 ng/dL (12 nmol/L)
• Free testosterone (calculated) below 6 to 8 ng/dL. (210 to 280 pmol/L)

The lower bound of free T is a bit of a grey area. So unless the OP has a high SHBG level, it might be hard for a mainstream practitioner to prescribe treatment. In which case you'd be looking at finding an integrative doctor, and probably paying $200 or $300 per appointment and blood tests.

The problem is probably depression as the symptoms the OP are suffering from are consistent with dysthymia.

Google Bignoknow, and take a look at his YouTube channel. He's a depressive who was diagnosed with low T (somewhere around 280), and even when running a high TRT dose (180 - 200 mg / week), he's still having rough weeks.

There seem to be a lot of people with low-normal testosterone levels who view TRT as magic bullet to fix their mood problems, and I'm not convinced it will. It can be used as a treatment, and is particularly effective for low level depression, but the best fix is going to be through talking therapies, such as CBT.

I'm struggling with depression, and not on TRT. I'm also in Australia, so know a bit about the system.

Yeah, Noa is great.

He's actually what educated me in the first place about TRT. You're right in saying he's not out of the woods, but he has come a long way since being suicidal and experiencing panic attacks daily.

I'm nowhere near that level of depression, but my relationship, lifestyle and career ambitions are just non-existent. Along with energy and confidence.

I'll see how I go with treatment here in Aus, if it's as bad as everything is saying it as, and I'm consistently showing low levels in conjunction with symptoms, I won't hesitate in getting as educated as possible and self-medicating while having a doctor monitor my levels.

Life is too short to feel like a sack of shit. I'm willing to roll the dice.

 

[Graeme]

Unless you've got a seriously low free testosterone level, or a chronic condition (such as Klinefelter's Syndrome), I think that you're going to struggle to get onto TRT through a regular GP in Australia.

It might be worth getting cortisol levels checked. Around 50% of depressives hypersecrete it, and it drives down testosterone. Get that sorted, and you might feel better.

**** page. Otherwise look for an integrative practice. ****

Good luck.

 

[Graeme]

The links got stripped out of my last post:

• 
  ****No outside links to non-sponsors*******
  No idea of what any of these guys are like, so caveat emptor.

 

[rl212]

does anyone know a good doctor in Sydney aus that will prescribe trt. my test level was 5.9 and has been around this number on 3 separate blood tests.