Doc pushing me onto nebido but unsure

[Robertdublin]

Hi all,
I'm a newbie here so I'll give a bit of I found on myself!

I'm from Dublin Ireland, 33 years old male.

I've had a rough time last few years dealing with low sperm count. My gp sent me for many semen analysis and never really looked Into it too deep. I had complained about the big decrease in semen volume etc to which he told me that's normal with age etc etc...

Anyway to shorten the story, last few months I have been a different man. Tired all the time, no interest in sex, a bit of chest growth with very itchy nipples, very cranky and moody. I went to my gp but was told he is not available for next few weeks but his wife also a gp has stepped in. So I explained everything to her and lone behold, she straight away said my testosterone must lagging. She sent for a full panel and the results came back. Not great at all.
Oestradiol 82pmol/L (male range 82-195 pmol/L)

Prolactin 318 mIu/L (range 56-270 so it's high)

Fsh 2.0 mIu/L ( range is between 1-12 so that's low)

Lh 2.8 mIu/L (range is between 1-9 so its low)

Testosterone 13 mnol/L ( was up at 26 this time last year)

So the prolactin is high and then lh fsh and Oestradiol low, testosterone low too.

So she has said I need to go to an endocrinologist, I'm going public as I'm not insured... In the meantime she wants me to go on nebido and my main concern is that she might be jumping the gun....

What do you think guys? Should I wait up to 8 months to see the public endo or should I just do as she suggests??

It's a big step so I wannabe be sure

Thanks for any advice you can provide

 

[Milton]

Welcome to the site my friend!

 

[Robertdublin]

Thanks! I'll try not to upset folks, I know newbies can be a nuisance lol

 

[Gainjin260]

Is your goal fertility or increased quality of life?

I had identical symptoms before starting testosterone.

 

[IMT staff]

Don't let them put you on a every 10 week injection schedule. Tell them you want to get your injection in smaller doses every 21 days.

Hope this helps.

 

[halfwit]

Ever cycled AAS or use prohormones? Something with your pituitary is off, and it may be suppressed (secondary cause). Any drastic diet changes or perhaps had a sleep study done?

You're technically subclinical for hypogonadism, but the choice to make is whether or not you want to find the root cause or not. It could be as simple as a diet too low in fats, or as drastic as a pituitary tumor.

My .02c

 

[Robertdublin]

Ever cycled AAS or use prohormones? Something with your pituitary is off, and it may be suppressed (secondary cause). Any drastic diet changes or perhaps had a sleep study done?

You're technically subclinical for hypogonadism, but the choice to make is whether or not you want to find the root cause or not. It could be as simple as a diet too low in fats, or as drastic as a pituitary tumor.

My .02c

Thanks for all the replies so far folks

No I have not used any anabolics at all, just train hard and eat right.

The doctor had mentioned that I may have a pituitary issue but also noted that I had epididymo orchitis in my mid 20's and basically one of my nuts may not be firing up at all.

As far as fertility vs life improvement, after years of trying for a child my wife has finally got pregnant so thats a plus.
I'd love to feel more buzz, more energy, have my zest for life back and my insane sex drive back too, even half of it lol

I'm aware that testosterone replacement will not find the problem BUT I wonder if I start on it will the endo still be able to find the underlying issue....

 

[Robertdublin]

Ever cycled AAS or use prohormones? Something with your pituitary is off, and it may be suppressed (secondary cause). Any drastic diet changes or perhaps had a sleep study done?

You're technically subclinical for hypogonadism, but the choice to make is whether or not you want to find the root cause or not. It could be as simple as a diet too low in fats, or as drastic as a pituitary tumor.

My .02c

I've never used steds before and my fat intake pretty much on point

 

[Milton]

I've never used steds before and my fat intake pretty much on point

whats your plan of action mate? always good to have the Irish represent here.

 

[halfwit]

Thanks for all the replies so far folks

No I have not used any anabolics at all, just train hard and eat right.

The doctor had mentioned that I may have a pituitary issue but also noted that I had epididymo orchitis in my mid 20's and basically one of my nuts may not be firing up at all.

As far as fertility vs life improvement, after years of trying for a child my wife has finally got pregnant so thats a plus.
I'd love to feel more buzz, more energy, have my zest for life back and my insane sex drive back too, even half of it lol

I'm aware that testosterone replacement will not find the problem BUT I wonder if I start on it will the endo still be able to find the underlying issue....

Yeah, your blood work points towards something else. If you had an issue with your testes, one would expect to see a huge amount of LH with a low testosterone. As your LH itself is on the lower side, this would point to something else shutting it down.

Just to be sure; this draw was done in the morning, right?

Finding a cause when you're on nebido is tricky at best. How do you know you've fixed it if you're suppressed from the testosterone injections? Even worse, the nebido itself can permanently shut your pituitary off.

As someone that has been on TRT for around six years, I can say that it's AMAZING. However, if you're not certain, and you want to identify what is doing this to you (you may not find out) - I'd hold off.

Edit: Whoa, I didn't know epididymo orchitis could cause hypogonadism. I still think you would see a huge LH value, but I hadn't really looked into it much before.

Hypogonadotropic hypogonadism (low testicular function and low testosterone) can occur as a result of testicular atrophy, which is observed in 30-50% of the patients
Sterility occurs in 7-13% of all affected patients

 

[Robertdublin]

Yeah, your blood work points towards something else. If you had an issue with your testes, one would expect to see a huge amount of LH with a low testosterone. As your LH itself is on the lower side, this would point to something else shutting it down.

Just to be sure; this draw was done in the morning, right?

Finding a cause when you're on nebido is tricky at best. How do you know you've fixed it if you're suppressed from the testosterone injections? Even worse, the nebido itself can permanently shut your pituitary off.

As someone that has been on TRT for around six years, I can say that it's AMAZING. However, if you're not certain, and you want to identify what is doing this to you (you may not find out) - I'd hold off.

Edit: Whoa, I didn't know epididymo orchitis could cause hypogonadism. I still think you would see a huge LH value, but I hadn't really looked into it much before.

The first Draw was done around 8am, that had the low lh oestriadol and fsh.

Second draw was done around 4pm, prolactin was still high and testosterone was at 13mnol

The bloods taken Tuesday were done at 11.30am and results are due next Wednesday or Thursday...

I think I will hold off on the trt. The only thing I'll say, if I end up needing trt well endocrinologists in Ireland are cavemen when ut comes to this shit and thankfully I have a gp that is open minded.

I'd prefer to find out if it's a pituitary growth firstly.

Damn, I was planning to run test enth @600mg for 12 weeks along side hcg and exemestane....

Probably a good thing that I didn't lol

 

[Batmann]

Yeah, your blood work points towards something else. If you had an issue with your testes, one would expect to see a huge amount of LH with a low testosterone. As your LH itself is on the lower side, this would point to something else shutting it down.

Just to be sure; this draw was done in the morning, right?

Finding a cause when you're on nebido is tricky at best. How do you know you've fixed it if you're suppressed from the testosterone injections? Even worse, the nebido itself can permanently shut your pituitary off.

As someone that has been on TRT for around six years, I can say that it's AMAZING. However, if you're not certain, and you want to identify what is doing this to you (you may not find out) - I'd hold off.

Edit: Whoa, I didn't know epididymo orchitis could cause hypogonadism. I still think you would see a huge LH value, but I hadn't really looked into it much before.

You have 1000 ng/dl right? Why do you think it is AMAZING?

 

[halfwit]

You have 1000 ng/dl right? Why do you think it is AMAZING?

I don't like feeding trolls, and I recognize your posting style. But as others may have the same question, I'll humor you.

If you can imagine your life normally being what it is, minus the energy to do anything productive, lack the drive to improve yourself, forget what you were going to do because you're so sleepy all the time, forget women exist, put on body fat regardless of what you eat (or how much even), become anxious and depressed just thinking about walking outside, and finally giving up on living life - that's hypogonadism in a nutshell.

It's living hell.

Your body shuts down, your metabolism starts to decline, and you essentially become a zombie.

That was me for many years because doctors didn't know what to look for, and hormone therapy was never an idea. I had a total testosterone of 120ng/dL, and life was empty.

So YES, life at 1000ng/dL is AMAZING in every single facet possible. There is a cost for this in upkeep, but I will gladly pay it until the day I die.

I personally think you're making the right decision Robert. It's much easier to track things down before you add something to the mix that will change test results.

 

[Robertdublin]

I don't like feeding trolls, and I recognize your posting style. But as others may have the same question, I'll humor you.

If you can imagine your life normally being what it is, minus the energy to do anything productive, lack the drive to improve yourself, forget what you were going to do because you're so sleepy all the time, forget women exist, put on body fat regardless of what you eat (or how much even), become anxious and depressed just thinking about walking outside, and finally giving up on living life - that's hypogonadism in a nutshell.

It's living hell.

Your body shuts down, your metabolism starts to decline, and you essentially become a zombie.

That was me for many years because doctors didn't know what to look for, and hormone therapy was never an idea. I had a total testosterone of 120ng/dL, and life was empty.

So YES, life at 1000ng/dL is AMAZING in every single facet possible. There is a cost for this in upkeep, but I will gladly pay it until the day I die.

I personally think you're making the right decision Robert. It's much easier to track things down before you add something to the mix that will change test results.

It's hard to know what to do but I'll wait. I just hope the man boobs don't get worse lol

 

[Mr.Port]

find out issue. but test undec is very good for hrt and big in euro. not soo much in USA i think they only use cyp for hrt there.
I would not pin less then every month for a while and then go by bloods for dose and how often, but i would make sure you look at everything before going on hrt..

 

[Batmann]

I don't like feeding trolls, and I recognize your posting style. But as others may have the same question, I'll humor you.

If you can imagine your life normally being what it is, minus the energy to do anything productive, lack the drive to improve yourself, forget what you were going to do because you're so sleepy all the time, forget women exist, put on body fat regardless of what you eat (or how much even), become anxious and depressed just thinking about walking outside, and finally giving up on living life - that's hypogonadism in a nutshell.

It's living hell.

Your body shuts down, your metabolism starts to decline, and you essentially become a zombie.

That was me for many years because doctors didn't know what to look for, and hormone therapy was never an idea. I had a total testosterone of 120ng/dL, and life was empty.

So YES, life at 1000ng/dL is AMAZING in every single facet possible. There is a cost for this in upkeep, but I will gladly pay it until the day I die.

I personally think you're making the right decision Robert. It's much easier to track things down before you add something to the mix that will change test results.

If hormone therapy was never an idea, how did you know you have low T?

 

[gruntwerk]

If hormone therapy was never an idea, how did you know you have low T?

Because he researched and advocated for himself, rather than going off the doctors input only.

 

[Robertdublin]

Because he researched and advocated for himself, rather than going off the doctors input only.

It was kind of obvious that something g was wrong considering my semen volume had halved, man boobs started showing up even though I was eating in a caloric deficit, not being able to get out of bed without being dragged out, the major decline e in my work performance due to feeling stoned all day at my desk....

If I was desperate for trt I'd simply get some test enth, steroids are easily available here in Dublin.

 

[Robertdublin]

So the doc just got in touch to say my most recent bloods show my testosterone @ 429 compared to 380 in the l previous test that was done.

From my research that's not too bad at all but she is still pushing me to go on trt, says it will make big improvement to my general health as I have alot of low t symptoms etc etc...

Maybe I should just bite the bullet and do as she says?

What you think guys??

 

[halfwit]

So the doc just got in touch to say my most recent bloods show my testosterone @ 429 compared to 380 in the l previous test that was done.

From my research that's not too bad at all but she is still pushing me to go on trt, says it will make big improvement to my general health as I have alot of low t symptoms etc etc...

Maybe I should just bite the bullet and do as she says?

What you think guys??

FSH and LH improve too?

You have to remember that the MOST IMPORTANT thing here is how you feel. If you feel fantastic, then I'd skip it. If you feel off, and like something is missing, you can move forward. I'd personally still want to see if there's a cause myself, but that choice is ultimately up to you.

Just remember, starting TRT is something that can't be undone very easily, if at all. It turns off your natural production, and trying to turn it back on may not work.

HOWEVER, it (as I mentioned above) can drastically change your life for the better if needed.