36 years old lab help please

[etma]

Hi I am 36 and had been having the usual low t symptoms for a while. I lift regularly and eat well. At my last yearly physical I asked to have my t checked and it came back at 288 on a range of 270-1070. Of course gp said it was normal but sent me to a urologist since I had symptoms. The Uro sent me for more labs. This was about two weeks later. Here are those results.


3RD GN TSH 1.952 (0.350-5.500)
LH 1.8 (1.5-9.3)
Prolactin 5 (2-17)
Estradiol 11.8 (0.0-39.8)
Total Test 247 (270-1070) Down from 288 two weeks prior
SHBG 41.5 (17.3-65.8)
Free Test 42.6 (48.2-169.6)
Bioavailable Testos 93.1 (113.1-397.7)


The test went down quite a bit in those two weeks. From what I have read it seems like this would be considered secondary hypogonadism. Should my next step be to get and mri? I have to admit Im pretty nervous about the cause being my pituitary. Also to add I have two children. I know the doctor had ordered fsh as well but the lab did not report it so I think the woman who put the info into the system may have missed it.

 

[Dreaded Pirate Roberts]

Welcome

 

[Megatron28]

It would be good to get your FSH checked too. But it does look like you have Secondary Hypogonadism. Your prolactin is fine, which indicates you most likely don't have a pituitary tumor, but the only way to know for certain is a with an MRI. Not all pituitary tumors cause high prolactin. For what it is worth, I had an MRI done when I got my diagnosis of Low T. I slept better at night not having to worry about a possible tumor.

Your options are to try and restart your natural T production again or being testosterone replacement therapy (TRT). Sometimes you will hear restarts referred to as dynamic therapy or post cycle therapy (pct). Depending on your medical history it may or may not work.

TRT will definitely work, but you go on it for life. Don't get me wrong, if you need it, testosterone replacement therapy (TRT) is a life saver. But I would prefer to have my natty T back too normal if I could.

You don't want to do nothing and stay at your current TT levels. There are long term health risks and obviously the immediate symptoms you are feeling.

So what is your medical history. This might help determine whether or not trying a restart is worth while? Weight? Height? Sleep apnea? Sleep quality? Diet? Head trauma? Diseases? Etc.

P.S. your estradiol is low. That's not good either. That contributes to fatiguem ED, joint pain. Are you taking anything that might lower your E, such as B-6 or Zinc?

 

[etma]

Thanks. There is just something about the pituitary being in my head that makes it so much worse to think about. I really want to get to the root of the problem first. Always been healthy weight is 180 about 15% bf. No history of disease have had one serious concussion. Diet is good have my macros tuned in and sleep quality is surprisingly good well was good but I have been getting a little stressed about this situation. I know the estradiol is low which is surprising since I carry a little fat in my chest but Im guessing it's low because everything else is as well. Things actually seem balanced just low.

 

[etma]

So my Uro referred me to this doctor who I think is great. I was thinking I was going to have to find and Endo when my Uro called last weekand told me who he wanted me to see. It turns out there is this group of seven doctors a mix of internists Urologists Endo's a surgeon and a psychologist who have a mens health clinic right in one of our big hospitals. They specialize in fertility and all things man. I had my appt today with the doc. He was very thorough asking a ton of questions and kept checking to see what my questions were. He uses a variety of treatments and is not just set on one course. He did set me up with a MRI just to cover all bases. What I liked is that he said at my age he would treat me with a number of 400 or lower. We are going to start treatment after my MRI and a couple more blood labs. He wants to start with Clomid for a few weeks and see how that goes. I asked about HCG and he is open to it but wants to start with Clomid. What is the main difference between the two and has anyone had luck with clomid? I may have misunderstood him but from what I gather Clomid can actually stimulate the pititary to release real LH. So that is the start and if we start test he is fine with me doing my own injections at home. Im still a bit stressed about the MRI but I feel relieved I'm not going to have to go on this massive doctor search.

 

[Spunkey71]

Sounds like you have some knowledgeable doctors there, many doctors will not even consider Clomid or HCG.