Doc wants to put me on TRT .. (labs)
Hello,
I am new here and my doctor is considering putting me on HRT (specifically Testosterone replacement). I am a bit nervous
as I get the feeling she is more experienced with diabetic pathology than most other areas of endocrinology (she is an endo). I would like to share with you a brief medical history and some recent test results.
I am a 27 year old male - 6'1" 176lb nude. My father was a big man and the men on my mother's side of the family were "normal" sized with full beards. I can not grow a beard nor any body hair (other than under my arms and around my genitals). I have an identical twin brother and he has similar problems, but he is somewhat larger than I am and can grow a bit more body hair than I. We are both smaller and less "masculine" than our father and those close to us in our family tree. I have noticed my twin developing slightly faster than I in the past few years. I have never used steroids.
I have almost completely lost my libido and for a number of years experienced an inability to perform sexually at times. My erections are nowhere near as firm as they used to be and I only occasionally wake with an erection. This decline happened after a rather famously tragic relationship
that really got me twisted about. I am not sure how much of this could be psychological. Around this same time, I also lost my lust for life. I no longer feel engaged and I have trouble concentrating. Also, I constantly feel hot and I sweat when others are breaking out the cold weather gear.
This is where I complicate things. I was recently treated for HCV (not fun) and completed therapy successfully two months ago. I must wait a few more months to find out if it worked. This treatment has caused my Thyroid to go a bit crazy. TSH has been all over the place. It is still bouncing around a bit, but has settled some since the cessation of HCV treatment.
I have had gynecomastia for some years and I really do not like it. It has been slowly progressing again for the past year or two. Inferior to my nipples and their surrounding areas, the glands resemble flattened donuts. There is not much glandular tissue directly beneath the nipple, but, as you move further, they begin to become more massive. I have the classic puffy nipple and almost never notice any pain, tenderness, or itchiness (maybe 1-4 times per year).
I had a pituitary MRI done 2 weeks ago and my posterior pituitary probably has a very small adenoma while my anterior pituitary seems to be ok. There was a bit of confusion on the anterior pituitary as the image was not idea. They did not rule out the possible of some malformation and did see a small area of heterogeneity that needs further examination but is not extremely alarming. My Dr. wants to repeat the test in one year. I had my PSA tested and it was normal.
All of the sex hormone test to follow were taken at 8am EST exactly everytime. The TSH was generally taken in the afternoon (3-4pm) unless it is listed on the same date as the sex hormones then it was drawn at 8 am.
Now for test results:
I have a lot more bloodwork, but most of it is more liver specific; although, I am not adverse to sharing it.
I saw my endo today and she prescribed me Androgel at 2.5g per day. I have not started it yet and may not at all. I know this is a rather low dose. I asked her many questions and she directly contradicted most of the information that I spent hours and hours reading
reputable sources to find. If she was not contradictory she was elusive. I have also had brief conversations with doctors that specialize in male HRT and she discounted almost everything they said as well. She said E2 was nothing to worry about and that she would not test for it. She turned down a Clomiphene Stimulation Test as she was fairly certain that I was not primary. She also does not seem to care that we have found little rhyme or reason to my low T levels and jimmy jacked thyroid. 
She is moving soon and I am switching docs. 
I live in Pittsburgh, PA.
Does it seem like a good idea to pursue testosterone replacement therapy (TRT)? I am very concerned. I do not want to exacerbate my existing gynecomastia. Part of me wants to think that testosterone replacement therapy (TRT) is going to reinvigorate me and help me in great ways. There is also another larger part of me that sees this as a potential disaster in the making. I try to stay as well versed as I can in medicine, but I am no doctor.
Feel free to let the jargon fly and know that I value honesty. Thank you for your time.
Hello,
I am new here and my doctor is considering putting me on HRT (specifically Testosterone replacement). I am a bit nervous
as I get the feeling she is more experienced with diabetic pathology than most other areas of endocrinology (she is an endo). I would like to share with you a brief medical history and some recent test results. I am a 27 year old male - 6'1" 176lb nude. My father was a big man and the men on my mother's side of the family were "normal" sized with full beards. I can not grow a beard nor any body hair (other than under my arms and around my genitals). I have an identical twin brother and he has similar problems, but he is somewhat larger than I am and can grow a bit more body hair than I. We are both smaller and less "masculine" than our father and those close to us in our family tree. I have noticed my twin developing slightly faster than I in the past few years. I have never used steroids.
I have almost completely lost my libido and for a number of years experienced an inability to perform sexually at times. My erections are nowhere near as firm as they used to be and I only occasionally wake with an erection. This decline happened after a rather famously tragic relationship
that really got me twisted about. I am not sure how much of this could be psychological. Around this same time, I also lost my lust for life. I no longer feel engaged and I have trouble concentrating. Also, I constantly feel hot and I sweat when others are breaking out the cold weather gear. This is where I complicate things. I was recently treated for HCV (not fun) and completed therapy successfully two months ago. I must wait a few more months to find out if it worked. This treatment has caused my Thyroid to go a bit crazy. TSH has been all over the place. It is still bouncing around a bit, but has settled some since the cessation of HCV treatment.
I have had gynecomastia for some years and I really do not like it. It has been slowly progressing again for the past year or two. Inferior to my nipples and their surrounding areas, the glands resemble flattened donuts. There is not much glandular tissue directly beneath the nipple, but, as you move further, they begin to become more massive. I have the classic puffy nipple and almost never notice any pain, tenderness, or itchiness (maybe 1-4 times per year).
I had a pituitary MRI done 2 weeks ago and my posterior pituitary probably has a very small adenoma while my anterior pituitary seems to be ok. There was a bit of confusion on the anterior pituitary as the image was not idea. They did not rule out the possible of some malformation and did see a small area of heterogeneity that needs further examination but is not extremely alarming. My Dr. wants to repeat the test in one year. I had my PSA tested and it was normal.
All of the sex hormone test to follow were taken at 8am EST exactly everytime. The TSH was generally taken in the afternoon (3-4pm) unless it is listed on the same date as the sex hormones then it was drawn at 8 am.
Now for test results:
Code:
10/12/2009 (during HCV treatment)
TSH 2.241 0.300-5.000* uIU/mL
11/5/2009 8am
TESTOSTERONE, -
TOTAL LC,MS,MS 215 250-1100* ng/dL
% Free Testosterone 2.11 1.50-2.20*%
Free Testosterone 45.4 35.0-155.0* pg/mL
12/14/2009
TSH 1.291 0.300-5.000* uIU/mL
1/27/2010 (HCV treatment finished on 1/23/2010) 8am
Estradiol, Free 0.15 < OR = 0.45-**PG/ML
Estradiol, % Free 1.70 1.25-1.85*%
Estradiol(E2) Level 9 < OR = 29-* PG/ML
TSH/Thy.Stim.Horm 6.25 0.40-4.50* mIU/L
LH 2.9 1.5-9.3* MIU/ML
FSH 1.9 1.6-8.0* MIU/ML
Prolactin 16.7 2.0-18.0* NG/ML
TESTOSTERONE, -
TOTAL LC,MS,MS 313 250-1100* ng/dL
Free Testosterone 48.0 46.0-224.0* pg/mL
Testosterone, -
Bioavailable 107.1 110.0-575.0* ng/dL
SHBG 25 7-49* nmol/L
Albumin 4.9 3.6-5.1* g/dL
2/3/2010
TSH 3.153 0.300-5.000* uIU/mL
2/24/2010 8am
Cortisol 7.0 4.0-22.0 MCG/DL
ACTH, PLASMA 11 7-50* PG/ML
FREE T4 1.0 0.8-1.8* NG/DL
TSH 4.35 0.40-4.50* mIU/L
IGF-I 236 126-382* ng/mL
Growth Hormone <0.1 <=10.0-** ng/mLI have a lot more bloodwork, but most of it is more liver specific; although, I am not adverse to sharing it.
I saw my endo today and she prescribed me Androgel at 2.5g per day. I have not started it yet and may not at all. I know this is a rather low dose. I asked her many questions and she directly contradicted most of the information that I spent hours and hours reading
reputable sources to find. If she was not contradictory she was elusive. I have also had brief conversations with doctors that specialize in male HRT and she discounted almost everything they said as well. She said E2 was nothing to worry about and that she would not test for it. She turned down a Clomiphene Stimulation Test as she was fairly certain that I was not primary. She also does not seem to care that we have found little rhyme or reason to my low T levels and jimmy jacked thyroid. She is moving soon and I am switching docs. I live in Pittsburgh, PA.Does it seem like a good idea to pursue testosterone replacement therapy (TRT)? I am very concerned. I do not want to exacerbate my existing gynecomastia. Part of me wants to think that testosterone replacement therapy (TRT) is going to reinvigorate me and help me in great ways. There is also another larger part of me that sees this as a potential disaster in the making. I try to stay as well versed as I can in medicine, but I am no doctor.
Feel free to let the jargon fly and know that I value honesty. Thank you for your time.
