First doc appt. since low T results

[S2Q26]

Hey guys,

This is my first post. I have been reading through posts including "basic trt overview" trying to educate my self.

I am 30 years old and had a physical last week. I decided to get my total test, free test, and thyroid tested along with the usual blood panel. My results where:

Total Testosterone: 159 (Range is 300 -1,000 ng/dL)
Free Testosterone: 25.6 (Doesn't give me a range online)
TSH-O - 1.86 (Range is 0.4 - 4.0 mIU/L)

The doctor who I saw for my physical isn't my usual doctor. When I had asked her to get these tests, she shook her head saying that it is a waste of money.. I was a young man and looked muscular. I persisted so she said ok. Sure enough my test levels are low. When she called me with the results she just said that my test levels were low but since I didn't mention any symptoms she didn't worry about it. I didn't mention any symptoms at the visit because I was embarrassed to talk about my sex life etc, especially if my test levels ended up being fine. She also isn't my usual doctor and I didn't get a good feeling from her. My results certainly explain a lot with how I have been feeling for quite sometime.

I called and scheduled another appointment with my usual doc coming up this week to discuss the blood work results. Can you guys let me know if I am missing anything that I should talk about or bring up?

I am going to be very open and honest and let her know about the problems I have been having with libido, energy etc.. I feel like every symptom of hypogonadism, I have. From what I have read, the next step is to figure out if I have Primary hypogonadism (testicles aren't functioning properly) or secondary hypogonadism (Pituitary gland not functioning properly). This is done by getting more blood work to check LH and FSH levels correct?

My question is, are the LH and FSH levels something a primary care doctor will order? What if my doctor has no clue what I am talking about? Should I ask to be referred to a urologist or a endocrinologist? Is there anything else I should ask for as part of more blood work?

I am bummed out I have this problem, but I also feel lucky I found it and hopefully its something I can fix. Thank you guys in advance for taking the time to help.. I appreciate it very much.

 

[Mprtz]

That is quite low. What time of day was the test taken?

How is it that you remain muscular with such low levels of T? One of the main things that alerted me to my dropping levels was losing muscle despite continued working out.

Definitely get LH and FSH, and make sure you have a doctor that understands these issues. Get as much bloodwork as you can BEFORE you take (if you take) that first shot - you can never go back and get that information.

Don't jump on TRT based on a single test result at age 30, it's a huge committment!

 

[Megatron28]

Sounds like you have been doing your homework. Get the blood work I listed in the overview done. Go over your entire medical history with your doc and be honest - except if you have used AAS in the past.

Get a sleep study done if you have not previously. That can cause Low T.

Let us know how it goes. And check in with us for a second opinion before you make any decisions. We can help you out.

 

[Alpin]

Those are castrate levels of T.
I don't have any confidence in this dr. You saw. I'd be interested in seeing her protocols for treating this.
What time of day did you do these tests?

 

[Want2FeelGood]

That is quite low. What time of day was the test taken?

How is it that you remain muscular with such low levels of T? One of the main things that alerted me to my dropping levels was losing muscle despite continued working out.

Definitely get LH and FSH, and make sure you have a doctor that understands these issues. Get as much bloodwork as you can BEFORE you take (if you take) that first shot - you can never go back and get that information.

Don't jump on TRT based on a single test result at age 30, it's a huge committment!

From my experience you can be muscular and have low Testosterone. I am. Granted I have spent my entire life doing physical activity including the Military. Maybe your muscles develop sensitivity to having low T? Not sure, but having muscles doesn't mean you have adequate Testosterone.

 

[S2Q26]

That is quite low. What time of day was the test taken?

How is it that you remain muscular with such low levels of T? One of the main things that alerted me to my dropping levels was losing muscle despite continued working out.

Definitely get LH and FSH, and make sure you have a doctor that understands these issues. Get as much bloodwork as you can BEFORE you take (if you take) that first shot - you can never go back and get that information.

Don't jump on TRT based on a single test result at age 30, it's a huge committment!

Thanks for replying,

My blood was taken at around 8:30-9:00 in the morning after fasting all night after dinner. About looking muscular, I guess its pretty subjective but I can post up a picture if it will help? I have recently cut my weight down from 198lbs to 180lbs over the past 4 months.

I will be sure to ask for my LH and FSH levels when I talk to the doctor. Thanks again for the advice mprtz

 

[S2Q26]

Sounds like you have been doing your homework. Get the blood work I listed in the overview done. Go over your entire medical history with your doc and be honest - except if you have used AAS in the past.

Get a sleep study done if you have not previously. That can cause Low T.

Let us know how it goes. And check in with us for a second opinion before you make any decisions. We can help you out.

Thanks for the advice Megatron. I will be sure to get that blood work done. I have never used any AAS or any drugs my whole life. I will ask about getting a sleep study done. There have been times I wake up at night and talk out loud/ sleep walk in the room before realizing what i am doing before going back to bed. This is usually when I am stressed out. My wife says I haven't done that in a while though. Unfortunately I also work a job where I work night shifts and I'm woken up through out the night to go on calls which will never change.

Thank you again for helping me, I really appreciate it.

 

[S2Q26]

Those are castrate levels of T.
I don't have any confidence in this dr. You saw. I'd be interested in seeing her protocols for treating this.
What time of day did you do these tests?

Yeah that is what I have been told about the 159 TT. Tests were done at 8:30-9:00 in the morning fasted.

 

[DucBase]

I was probably near my peak of physical fitness when my T levels crashed. Me and my doc both dismissed T level based on that but it turned out to be the culprit.

Good news is that it's easily treatable. I've had really great results so far (only 6 weeks in). I wish I would have done it a long time ago. Libido, energy and stamina are no longer an issue. Even during my squat days I just don't seem to run out of energy now. Mentally I'm in a much better place as well...this part can't be overstated. I'm a much happier guy now.

Good luck with it.

 

[S2Q26]

I was just looking over some the basic trt overview thread. When I request for more blood work to figure out whats going on should I just ask for TT, LH, and FSH?

Or since I'm getting blood drawn ask to get more things tested?

 

[Alpin]

Yeah that is what I have been told about the 159 TT. Tests were done at 8:30-9:00 in the morning fasted.

Read my new thread.
At 180 TT now....lol

 

[S2Q26]

Read my new thread.
At 180 TT now....lol

Wow, 180 almost as bad as my 159. Good luck with everything.

 

[S2Q26]

Hey guys, doctor appointment is tomorrow so I jus want to make sure. Should I ask for any other blood work to be done other than TT, LH, and FSH?

 

[Megatron28]

Hey guys, doctor appointment is tomorrow so I jus want to make sure. Should I ask for any other blood work to be done other than TT, LH, and FSH?

See post #3 again.

 

[S2Q26]

^ Oh thats right sorry.. Thanks again Megatron,

I had my appointment with my GP today. I thought it went well. She agreed my testosterone is very low and said the first step is more blood work to find out if it is primary or secondary. The blood work she ordered includes Total Test, Free Test, FSH, LH, and Cortisol. She said that they refer out to endocrinologists sooner than later so she was going to call me today with who they were going to refer me to. She asked if I knew of anyone I would want to go to but I had no idea. I did tell her that I would prefer one who was well versed in treating low T.

I got a call from the office a little while ago with the endo's name. They said that they send all of my blood work to the endocrinologist's office and then they contact me to schedule the appointment. Unfortunately the doctor is on vacation this week, so it will be mid to the end of next week until I hear from them.

I googled the doctor and I am a little worried because I didn't see anything said about him treating low testosterone. Just diabetes for the most part. Ratings were across the board.

Can you guys give me advice on what to do? Should I just go to this endo and see if he is good? If I did need to find a better doctor to treat me how would I do that? Call compounding pharmacies and ask for the physicians names who are prescribing the most testosterone? Should I do that anyways and have my GP send me to that doctor instead?

Thanks as always for taking the time to help me guys.

 

[Megatron28]

^ Oh thats right sorry.. Thanks again Megatron,

I had my appointment with my GP today. I thought it went well. She agreed my testosterone is very low and said the first step is more blood work to find out if it is primary or secondary. The blood work she ordered includes Total Test, Free Test, FSH, LH, and Cortisol. She said that they refer out to endocrinologists sooner than later so she was going to call me today with who they were going to refer me to. She asked if I knew of anyone I would want to go to but I had no idea. I did tell her that I would prefer one who was well versed in treating low T.

I got a call from the office a little while ago with the endo's name. They said that they send all of my blood work to the endocrinologist's office and then they contact me to schedule the appointment. Unfortunately the doctor is on vacation this week, so it will be mid to the end of next week until I hear from them.

I googled the doctor and I am a little worried because I didn't see anything said about him treating low testosterone. Just diabetes for the most part. Ratings were across the board.

Can you guys give me advice on what to do? Should I just go to this endo and see if he is good? If I did need to find a better doctor to treat me how would I do that? Call compounding pharmacies and ask for the physicians names who are prescribing the most testosterone? Should I do that anyways and have my GP send me to that doctor instead?

Thanks as always for taking the time to help me guys.

I would ask them to check TSH and Prolactin if it isn't too late.

Most endo's treat diabeties for the most part. Unfortunately it is hard to find good ones that know TRT, but you have to play the game. Some endos can be persuaded by showing them medical studies though. So for example, if you get on TRT and need and AI you can show them studies to sway them (sometimes).

 

[hiram1st]

I'm in the same boat. Had blood work done the other day when I have results I will post them for review and advice. I went with a list of what I wanted to be tested for explaining my symptoms and he asked well can you get an erection does it last. I was like yes but have a lot of symptoms the suggest possible low t and that's what I wanted to be tested for he made me feel like I was looking for drug he filled out the test order said he was doing all the necessary test and wrote in free testosterone I think everything was covered. Just made me feel even worse about myself.

Will keep you posted

 

[cybrsage]

My doctor, after I told him about my bad run in with the endos, sent me to a urologist (actually is the one he uses himself - talk about a great referece!). A urologist can do everything with regards to TRT that an endo can do and they are not as stuck up. My test level was 153 on one test and 155 on another...

 

[S2Q26]

I would ask them to check TSH and Prolactin if it isn't too late.

Most endo's treat diabeties for the most part. Unfortunately it is hard to find good ones that know TRT, but you have to play the game. Some endos can be persuaded by showing them medical studies though. So for example, if you get on TRT and need and AI you can show them studies to sway them (sometimes).

Okay Megatron, I will try and get those added. I guess I will see how the endo goes and in the meantime maybe look for doctors who are prescribing in CT.

 

[S2Q26]

Keep us posted and good luck with everything hiram