Doctor is recommending TRT

[Gibrone]

I am 34, 5'11" and usually in the 190-195lb range, I swim 4-5 days/wk before work and 2-3 times a week after work I do push ups/sit ups/kettle bell workouts. While I'm not one who does hardcore exercising I always make an effort to take care of myself. I was into sports throughout high school, and since then I've remained pretty active. I'm currently a mailman with a driving route so my job isn't as physical as it was when I was in the navy or did concrete/construction work prior to that but I am active outside of work so this doesn't make sense. I have never taken any sort of steroid and my doctor recommending this is pretty frighting to me. I was recommended to see a urologist by my doctor due to a pain I've been having in my left testicle. While seeing the urologist (off and on the past few months) he had been looking over my lab work in my record and has had me go have my levels checked a couple additional times and the results have come back at levels he has felt were low both times. He says the pain in my testicle is unrelated to my testosterone being low, there is some sort of surgery he wants to do on my testicle but he says I'll be out of work for around 2 weeks which I can't afford so I'm having to put that off. The pain is something that happens mostly when I do ab exercises but regardless that isn't why I'm posting here so sorry to even bring that up. Back to the reason I am posting, the lab results for my first test were:

256 for total testosterone which the lab says 2 different things, one form says 241-827 is normal and another says 300-1080 is normal
53 for free testosterone which the lab says 47-244 is considered normal

3 months later he wanted to test again, this time he checked for total testosterone again, then added luteinizing hormone and follicle stimulating hormone, I honestly have no idea what those are but the results were

239 total testosterone (he says the number they go by is the document that says 300-1080, not 241-827 but regardless it was low either way this time)
1.9 for LH (lab says 1.2-8.6 is considered normal)
2.4 for FSH (lab says 1.2-19.2 is considered normal)

he started looking at my past lab results because of some topics that got brought up while discussing the testicle issue. It led to him wanting more tests done to confirm what he was suspecting and now he's saying TRT will most likely improve my mood, sleep and also fix those other topics that got brought up in our talks.

I have never taken any sort of steroid, I exercise fairly often. I'm in no way hardcore about it but I'm not a bum so not sure why I would have low T. I read about others who get TRT and they're in the 100's, with me hovering around 250 is it really something I should do? He says 250 is fine for some people but at the same time he says I show symptoms of low T which means 250 might not be ok for me and he'd like to try it. I do have good insurance and they will cover it but it's a lifelong commitment and I still have no children so not sure if I'm ready to shut my testicles down. Do those lab work #'s mean anything to any of you? At 34 it just seems I shouldn't be having issues yet but regardless, he's offering it and insurance will cover it but I'm not sure if I should take the plunge. I'm hoping to get your thoughts/advice. This is my first post here, I just got back from my urologist appointment and got my latest results which is the 239. He wanted me to try TRT so before saying yes I googled it and ended up here to hopefully get advice from those of you that understand it better than me.



Prolactin came back as 11.0 (lab says 2.1-17.7 is normal)

 

[Spunkey71]

I would say you are at the bottom of what is normal, TRT has been great for me and has given me back a quality of life I thought was long in the past. It looks like you have secondary hypogonadism, but I am not an expert. You might be able to do a re-start.

Best of luck!

 

[Alpin]

Why hasn't he tried Human Chorionic Gonadotropin (HCG) or Clomid yet?
If he is recommending TRT...he's a good doc
You can take Human Chorionic Gonadotropin (HCG) while on TRT...it is claimed that it will maintain fertility....as far as guarantees....I'm not sure. I'll let someone else answer.

 

[Megatron28]

I am 34, 5'11" and usually in the 190-195lb range, I swim 4-5 days/wk before work and 2-3 times a week after work I do push ups/sit ups/kettle bell workouts. While I'm not one who does hardcore exercising I always make an effort to take care of myself. I was into football, wrestling and track throughout high school, and since then I've remained pretty active. I'm currently a mailman with a driving route so my job isn't as physical as it was when I was in the navy or did concrete/construction work prior to that but I am active outside of work so this doesn't make sense. I have never taken any sort of steroid and my doctor recommending this is pretty frighting to me. I was recommended to see a urologist by my doctor due to a pain I've been having in my left testicle. While seeing the urologist (off and on the past few months) he had been looking over my lab work in my record and has had me go have my levels checked a couple additional times and the results have come back at levels he has felt were low both times. He says the pain in my testicle is unrelated to my testosterone being low, there is some sort of surgery he wants to do on my testicle but he says I'll be out of work for around 2 weeks which I can't afford so I'm having to put that off. The pain is something that happens mostly when I do ab exercises but regardless that isn't why I'm posting here so sorry to even bring that up. Back to the reason I am posting, the lab results for my first test were:

256 for total testosterone which the lab says 2 different things, one form says 241-827 is normal and another says 300-1080 is normal
53 for free testosterone which the lab says 47-244 is considered normal

3 months later he wanted to test again, this time he checked for total testosterone again, then added luteinizing hormone and follicle stimulating hormone, I honestly have no idea what those are but the results were

239 total testosterone (he says the number they go by is the document that says 300-1080, not 241-827 but regardless it was low either way this time)
1.9 for LH (lab says 1.2-8.6 is considered normal)
2.4 for FSH (lab says 1.2-19.2 is considered normal)

he started looking at my past lab results because of some topics that got brought up while discussing the testicle issue. It led to him wanting more tests done to confirm what he was suspecting and now he's saying testosterone replacement therapy (TRT) will most likely improve my mood, sleep and also fix those other topics that got brought up in our talks.

I have never taken any sort of steroid, I exercise fairly often. I'm in no way hardcore about it but I'm not a bum so not sure why I would have low T. I read about others who get testosterone replacement therapy (TRT) and they're in the 100's, with me hovering around 250 is it really something I should do? He says 250 is fine for some people but at the same time he says I show symptoms of low T which means 250 might not be ok for me and he'd like to try it. I do have good insurance and they will cover it but it's a lifelong commitment and I still have no children so not sure if I'm ready to shut my testicles down. Do those lab work #'s mean anything to any of you? At 34 it just seems I shouldn't be having issues yet but regardless, he's offering it and insurance will cover it but I'm not sure if I should take the plunge. I'm hoping to get your thoughts/advice. This is my first post here, I just got back from my urologist appointment and got my latest results which is the 239. He wanted me to try testosterone replacement therapy (TRT) so before saying yes I googled it and ended up here to hopefully get advice from those of you that understand it better than me.



Prolactin came back as 11.0 (lab says 2.1-17.7 is normal)

Here's a little background. Your testicles make testosterone. They get a signal from your pituitary that tells them when to start making it. Your pituitary is able to recognize when your body has enough testosterone or when it needs more.

There are two types of Hypogonadism - Primary and Secondary. Primary is when you testicles are not functioning properly. No matter how much your pituitary tells them to make testosterone, they are damaged and unable to. Secondary is when your pituitary is not working properly. It doesn't recognize that your body needs more testosterone and it doesn't send a signal to your testicles to make more.

You have Secondary Hypogonadism. They way I can tell is by looking at your LH and FSH. When LH and FSH are either below normal or normal that means your pituitary is not telling your testicles to make more testosterone despite the fact that you have Low T. If your LH and FSH were above normal, that would mean your pituitary is "yelling" at your testicles to make more testosterone; but they cannot.

Most guys feel pretty damn shitty when their TT (Total Testosterone) gets below 300. I was at 200 and all I wanted to do was sleep. I was too tired to even want to have sex with my younger and attractive wife. :-(

Just for the record, you have been on steroids (e.g. testosterone) your entire life. Even when you were a developing fetus. Testosterone is what makes you a man. Literally. Unfortunately, your body cannot produce it naturally right now at the required levels to feel good and be healthy. You need to replace your testosterone by injecting it from a bottle. There are serious health issues with long term low testosterone, such as coronary problems.

Now having said that, there are somethings you could look into before starting TRT.

- You could try a restart. This is where you take certain medications, like Clomid, to get your HPTA going again. Sometimes it can work. Depends on how long you have been hypogonadal and what is causing it. You should discuss this option with your doctor.

- Check your thryoid. Get a full panel run.

- Have a sleep study done to make sure you don't have sleep apnea. This can lower testosterone levels.

 

[halfwit]

Looks like secondary hypogonadism to me in my non-doctor opinion. Have they checked your pituitary gland for tumors or any irregularities? Did the urologist say what the pain in your testicle could be? Don't punish yourself too much by the way; there are TONS of things in our environment that can cause this to happen to otherwise healthy men, many of which are still being researched.

Edit: Damn, nice reply Megatron! And to think I was trying to keep it short and sweet haha.

 

[Megatron28]

Looks like secondary hypogonadism to me in my non-doctor opinion. Have they checked your pituitary gland for tumors or any irregularities? Did the urologist say what the pain in your testicle could be? Don't punish yourself too much by the way; there are TONS of things in our environment that can cause this to happen to otherwise healthy men, many of which are still being researched.

Edit: Damn, nice reply Megatron! And to think I was trying to keep it short and sweet haha.

I am sitting at my computer tonight with its full keyboard. Much easy to type on it than it is with a tablet which I usually use.

 

[halfwit]

I am sitting at my computer tonight with its full keyboard. Much easy to type on it than it is with a tablet which I usually use.

Haha, you definitely nailed it imo. I have tried to reply using my phone, and with my sausage-like fingers, that's one heck of an exercise in futility.

 

[Alpin]

Looks like secondary hypogonadism to me in my non-doctor opinion. Have they checked your pituitary gland for tumors or any irregularities? Did the urologist say what the pain in your testicle could be? Don't punish yourself too much by the way; there are TONS of things in our environment that can cause this to happen to otherwise healthy men, many of which are still being researched.

Edit: Damn, nice reply Megatron! And to think I was trying to keep it short and sweet haha.

He is similar to me...
My LH was 3 IU/L with FSH 2 IU/L T.T 265-291 ng/dl but with 0.25 mg ADEX E3D though...
Never ventured to stay off the ADEX completely for a long period... past 10 days...my belly was even more bloated...more fatigue...zero erections....
T.T. was same from 3 months after testosterone replacement therapy (TRT) was discontinued...all the way to present at 16 MONTHS later...
Couldn't get over 291 ng/dl. Trained hard for 4 months...dropped 18 pounds of weight and no increase in T.T.
I don't think clomid would of done any miracles...
Arimidex does a lot of what Clomid does with stimulating natural LH

 

[Gibrone]

Most guys feel pretty damn shitty when their TT (Total Testosterone) gets below 300. I was at 200 and all I wanted to do was sleep. I was too tired to even want to have sex with my younger and attractive wife. :-(

I wish I could sleep.. I have gotten pretty depressed lately and I wake up in the middle of the night to pee and I start getting hit with crazy anxiety and can't get back to sleep. I have issues getting an erection and sometimes keeping an erection is a hassle as well, those were those other topics he and I talked about that I mentioned, I'm sure you understood so no real reason to hide it.

- Check your thryoid. Get a full panel run.

I go see the Dr again later this month and that's when he is going to want to see if I made up my mind about starting TRT. I wanted to research it first before committing with it being a lifelong thing. Is that thyroid check something he should have done? I do remember something with thyroid being checked with my general practitioner and I remember everything being in the normal range but I can't remember exact #'s. Maybe he didn't check it since he seen the # from my previous test before seeing him and he knows that isn't an issue?

- Have a sleep study done to make sure you don't have sleep apnea. This can lower testosterone levels.

I do have sleep apnea in my family so it is something I had checked out (around 6 months ago), I do have sleep apnea but the Dr said it's very mild and shouldn't cause issues yet. He said I don't need a cpap (although I do qualify for one if I wanted it) or mouthpiece, he recommended I just learn to sleep on my left side since whenever I was on my left side during the study I breathed fine so I have since learned to do that.

Did the urologist say what the pain in your testicle could be?

I have some epididymitis and a varicoceles things, I forget which one caused the pain but I have been prescribed 2 antibiotics for it now and he said best bet since those didn't work is to do some sort of surgery once hernia is ruled out. He can't detect it but wants to do some sort of ultrasound to be certain but the lady who does that wasn't in yet so I go back in a week or so to have it done. I have pretty much taken him at his word on what's wrong and and just follow his advice

 

[Spunkey71]

I knew I had sleep apnea but I didn't think I had it that bad because I was always so worn out and could fall asleep at the drop of a hat and slept hard when I slept. Once I learned that it was low T that was causing me to feel that way I started testosterone replacement therapy (TRT) and my doctor really encouraged me to have my apnea checked. What I learned is that my fatigue from low T was masking the true severity of my aleep apnea and now that my test levels are higher I feel great but my quality of sleep has diminished greatly. I finally got tested and I have severe sleep apnea and will be picking up my cpap machine tomorrow.

I have been doing a lot of reading and it seems it is very common for low T symptoms to mask sleep apnea symptoms so it might be of benefit to go ahead and get the cpap machine if you already qualify (if your insurance will pay for it as they are expensive) and this might just be the difference.

 

[halfwit]

I have some epididymitis and a varicoceles things, I forget which one caused the pain but I have been prescribed 2 antibiotics for it now and he said best bet since those didn't work is to do some sort of surgery once hernia is ruled out. He can't detect it but wants to do some sort of ultrasound to be certain but the lady who does that wasn't in yet so I go back in a week or so to have it done. I have pretty much taken him at his word on what's wrong and and just follow his advice

Wow, I'm surprised you have such low LH/FSH values then. Varicoceles are a very common cause of hypogonadism; I'm surprised they haven't investigated further into this as a root cause. In some men, fixing these has been known to restore testosterone production. Again, I'm not a doctor, and I would definitely leave this in the hands of trained professionals, but I would also do some research on this so you can bring it to their attention.

I knew I had sleep apnea but I didn't think I had it that bad because I was always so worn out and could fall asleep at the drop of a hat and slept hard when I slept. Once I learned that it was low T that was causing me to feel that way I started testosterone replacement therapy (TRT) and my doctor really encouraged me to have my apnea checked. What I learned is that my fatigue from low T was masking the true severity of my aleep apnea and now that my test levels are higher I feel great but my quality of sleep has diminished greatly. I finally got tested and I have severe sleep apnea and will be picking up my cpap machine tomorrow.

I have been doing a lot of reading and it seems it is very common for low T symptoms to mask sleep apnea symptoms so it might be of benefit to go ahead and get the cpap machine if you already qualify (if your insurance will pay for it as they are expensive) and this might just be the difference.

Dude, you're going to be very happy once you get used to your Darth Vader mask. It is definitely a game-changer.

 

[3J]

i really think people over play the "on testosterone replacement therapy (TRT) cant have kids" bit.. i know a ton of guys who have been able to reproduce on trt.. shit pro level guys have kids

 

[bushleaguechew]

He is similar to me...
My LH was 3 IU/L with FSH 2 IU/L T.T 265-291 ng/dl but with 0.25 mg ADEX E3D though...
Never ventured to stay off the ADEX completely for a long period... past 10 days...my belly was even more bloated...more fatigue...zero erections....
T.T. was same from 3 months after testosterone replacement therapy (TRT) was discontinued...all the way to present at 16 MONTHS later...
Couldn't get over 291 ng/dl. Trained hard for 4 months...dropped 18 pounds of weight and no increase in T.T.
I don't think clomid would of done any miracles...
Arimidex does a lot of what Clomid does with stimulating natural LH

Arimidex does not stimulate LH. I know exactly where you got that idea, from the mechanism of clomid, but it doesn't work that way.

 

[corvettels3]

Are you taking any pain meds? Lack of sleep could be the issue. This is the time your body repairs itself. No sleep = no repair (mind and body). Good luck brother..

 

[Spunkey71]

Dude, you're going to be very happy once you get used to your Darth Vader mask. It is definitely a game-changer.

When I did the second nite of the sleep study and they had me wear the mask I slept like I had not slept before. I woke up so refreshed I could not believe it. The past week and a half waiting for my cpap machine has been murder because I now know what a good nights sleep feels like and I am so needing it again.

 

[halfwit]

When I did the second nite of the sleep study and they had me wear the mask I slept like I had not slept before. I woke up so refreshed I could not believe it. The past week and a half waiting for my cpap machine has been murder because I now know what a good nights sleep feels like and I am so needing it again.

Oh man, totally remember that week as I waited to get back down to get my mask fitted. TOTALLY worth the wait though.

 

[Gibrone]

Hearing you guys talk about how great the cpap is I'm thinking I'm going to order one. The place that did my sleep study said if I choose to get one they want to have me try different masks/do another sleep study which is a $75 copay and the cpap I think insurance only covers 70-80% which still leaves a lot of $ out of pocket. My body must be falling apart, it seems like I've been spending a lot on it lately.

Wow, I'm surprised you have such low LH/FSH values then. Varicoceles are a very common cause of hypogonadism; I'm surprised they haven't investigated further into this as a root cause. In some men, fixing these has been known to restore testosterone production. Again, I'm not a doctor, and I would definitely leave this in the hands of trained professionals, but I would also do some research on this so you can bring it to their attention.

I'll definitely bring it up when I see him. It turns out he wants to have my total testosterone checked one more time so I'm going to do that tomorrow. The only thing on the lab order is total testosterone. I guess in order for my insurance to be willing to cover testosterone replacement therapy (TRT) I have to have 2 consecutive tests show me as low and they have to be before 10AM. I'm not hopeful, my last test of 239 was around 9 so I don't think time of day really matters.

Are you taking any pain meds? Lack of sleep could be the issue. This is the time your body repairs itself. No sleep = no repair (mind and body). Good luck brother..

I don't take pain meds even when they're prescribed. Some family members have had problems with addiction so I've always avoided taking that stuff. I'm pretty anti-medicine unless a Dr sais I "need" to take something like an antibiotic for something specific.







I really appreciate all of your guys' posts/advice

 

[Spunkey71]

I'll definitely bring it up when I see him. It turns out he wants to have my total testosterone checked one more time so I'm going to do that tomorrow. The only thing on the lab order is total testosterone. I guess in order for my insurance to be willing to cover testosterone replacement therapy (TRT) I have to have 2 consecutive tests show me as low and they have to be before 10AM. I'm not hopeful, my last test of 239 was around 9 so I don't think time of day really matters.

Time of day absolutely matters, your test level is the highest right after you wake up, it goes down throughout the day.

 

[Gibrone]

Time of day absolutely matters, your test level is the highest right after you wake up, it goes down throughout the day.

that came across wrong, what I was meaning is I figure I'll still be low since I was at 239 the last time I checked and it was early then. I'm guessing it'll be low again is all. I'll be stopping in to have it done before I start work. I leave to go hunting Thursday so if the result doesn't come in before then (guessing it won't) I wont be able to share the new # with you guys until Tues/Wed when I get back

 

[WhiteDog]

i really think people over play the "on testosterone replacement therapy (TRT) cant have kids" bit.. i know a ton of guys who have been able to reproduce on trt.. shit pro level guys have kids

When my Doc said i have low t and placed me on testosterone replacement therapy (TRT), i asked him if i could still have kids, his reactions was, well lets just say very negative. He asked me "your not planning to have any are you".

I have scheduled an appointment at the clinic to have my swimmers checked. I hope your right my man, id be shattered if i cant have kids...