Here is a recent pic fully relaxed...
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And another back in April before my cut...
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And another back in April before my cut...
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First doc appt. since low T results
- Thread starter S2Q26
- Start date
Alpin
New member
You in the U.S. ?
How long are the wait times to see one?
I doubt your doc is aware that most endos are useless when it comes to male hormones.
Jimstigator
New member
Wonderful. I think in the meantime I might do my homework with prescribers in my area so at least I have some options if things don't go well.
When calling compounding pharmacies, is it as simple as just saying I have hypogonadism and I'm looking for doctors well versed in treating it and asking what doctors in the area are prescribing testosterone (or nolvadex/Clomid since it looks like I'm secondary)?
Alpin
New member
In Canada you could wait anywhere from 3-6 months to see a specialist.
Megatron28
Moderator
correct, secondary hypogonadism. I can't remember. Have you checked your TSH and Prolactin yet? Get that done asap.
You should try a restart before going on TRT. See if you can get your HPTA working again. Call your primary to see if he can get you started. Waiting a month to start treatment is too long.
Alpin
New member
And endos take their sweet time before putting anything down on paper. Labs, re do labs, etc
I had gotten my TSH-O level tested which was 1.86 (0.4 - 4.0).
The Endo is sending me blood work to get done before my appointment, so I am not sure if that will include prolactin. The woman from the Endo's office said I should get my blood drawn a week before my appointment, and at 8:00am because they will be testing my a.m cortisol. I told her I just got my a.m cortisol tested along with a bunch of other stuff, but she said since I have to wait a month they want current blood work. I should get the blood panel in the mail Monday so I'll see what they are testing.
I talked to my primary care office this morning. They just said that unfortunately a month is the norm to see endo's and that its going to be status quo until you have that appointment for treatment. I want to fix this, its tough having to play the waiting game.
Hey guys, I was fortunate enough to see the Endocrinologist sooner than they scheduled me this past week. As a reminder I have had two blood panels taken through my GP.
Back on June, 26th they were:
TT: 159 (300-1100)
FT: 25.6 (no range given)
TSH-O - 1.86 (0.4 - 4.0)
Back on July, 14th they were:
TT: 217 (300-1100)
FT: 40.1 (no range given)
FSH: 3.8 (1.5-12.4)
LH: 1.7 (1.7-8.6)
Cortisol a.m: 13.6
My appointment with the Endo didn't go very well. He asked me why I had requested my testosterone levels to be checked in the first place. I ran through my symptoms, the two major ones being lack of energy and awful libido. It was tough talking to him because he would almost cut me off when I was talking to him, jumping to conclusions almost as if he already knew what he wanted to say.
Once he found out that with my job I work night shifts every 9 days he said that is why my testosterone is low***8230; because I can't get into a sleep cycle. I certainly know that my sometimes lack of sleep during night shifts and stress of the the job doesn't help my cause, but i'm not sure if its the root cause. Plus unfortunately its not something I will ever be able to change.
When talking about my libido, he asked how long I have been married as if saying that its normal in relationships***8230; but I haven't been married long at all. He said that if it continues to be a problem he can prescribe me viagra or cialis. I didn't understand that, nor will I take any because its not so much the ability to have sex, but rather having the drive. I was able to conceive a child recently. He blames it all on fatigue.
I played dumb and asked a lot of questions I knew the answers to just to get a feel for if he would be a good doctor that would treat me. When I asked him based on the blood work I had done already, if that indicated secondary hypogonadism, he said that secondary is caused by lesions on the pituitary gland, but he didn't feel an MRI was necessary yet. He said he didn't really trust the lab that my GP used for they are notorious for getting false positives. So he gave me a another blood panel to get in August before I see him next time mid month. The panel includes:
Complete ********* panel
Cortisol, a.m.
DHEA, LC/MS/MS
DHEA Sulfate
FSH
IGF 1
LH
Prolactin
TSH
T4 Free
Testosterone Free/Total/Bio
Thyroid Peroxid
When talking about possible treatments, he only mentioned Gel and that he would put me on it if needed for a few months to get my levels up then take me off of it. He said that once starting testosterone therapy i would be "screwed"***8230;.. I guess because I would have to take it forever? He just seemed generally condescending and negative about it. I also asked him where he thinks my total test levels should be at 30 years old and he said there was no specific amount, but as long as I was in the range of 300-1000. When I asked him about doing a "restart" all he said was that if I had a lesion on the gland they could prescribe me medication to shrink it? I didn't know what he was talking about but he didn't mention the use of climid or nova to restart my HPTA axis.
So overall, I don't think it went too well. I am going to get the blood work done because it has a number of things I have not tested for and I will see him a second time to see what he says.
I'm one for opinions guys, thanks for the help.
Back on June, 26th they were:
TT: 159 (300-1100)
FT: 25.6 (no range given)
TSH-O - 1.86 (0.4 - 4.0)
Back on July, 14th they were:
TT: 217 (300-1100)
FT: 40.1 (no range given)
FSH: 3.8 (1.5-12.4)
LH: 1.7 (1.7-8.6)
Cortisol a.m: 13.6
My appointment with the Endo didn't go very well. He asked me why I had requested my testosterone levels to be checked in the first place. I ran through my symptoms, the two major ones being lack of energy and awful libido. It was tough talking to him because he would almost cut me off when I was talking to him, jumping to conclusions almost as if he already knew what he wanted to say.
Once he found out that with my job I work night shifts every 9 days he said that is why my testosterone is low***8230; because I can't get into a sleep cycle. I certainly know that my sometimes lack of sleep during night shifts and stress of the the job doesn't help my cause, but i'm not sure if its the root cause. Plus unfortunately its not something I will ever be able to change.
When talking about my libido, he asked how long I have been married as if saying that its normal in relationships***8230; but I haven't been married long at all. He said that if it continues to be a problem he can prescribe me viagra or cialis. I didn't understand that, nor will I take any because its not so much the ability to have sex, but rather having the drive. I was able to conceive a child recently. He blames it all on fatigue.
I played dumb and asked a lot of questions I knew the answers to just to get a feel for if he would be a good doctor that would treat me. When I asked him based on the blood work I had done already, if that indicated secondary hypogonadism, he said that secondary is caused by lesions on the pituitary gland, but he didn't feel an MRI was necessary yet. He said he didn't really trust the lab that my GP used for they are notorious for getting false positives. So he gave me a another blood panel to get in August before I see him next time mid month. The panel includes:
Complete ********* panel
Cortisol, a.m.
DHEA, LC/MS/MS
DHEA Sulfate
FSH
IGF 1
LH
Prolactin
TSH
T4 Free
Testosterone Free/Total/Bio
Thyroid Peroxid
When talking about possible treatments, he only mentioned Gel and that he would put me on it if needed for a few months to get my levels up then take me off of it. He said that once starting testosterone therapy i would be "screwed"***8230;.. I guess because I would have to take it forever? He just seemed generally condescending and negative about it. I also asked him where he thinks my total test levels should be at 30 years old and he said there was no specific amount, but as long as I was in the range of 300-1000. When I asked him about doing a "restart" all he said was that if I had a lesion on the gland they could prescribe me medication to shrink it? I didn't know what he was talking about but he didn't mention the use of climid or nova to restart my HPTA axis.
So overall, I don't think it went too well. I am going to get the blood work done because it has a number of things I have not tested for and I will see him a second time to see what he says.
I'm one for opinions guys, thanks for the help.
Megatron28
Moderator
One thing your doc is right about is that lack of quality sleep can absolutely affect your testosterone level. You should do everything in your power to make sure you are getting plenty of quality sleep -- even changing jobs if necessary.
Checking your Prolactin will help indicate if there is a tumor or lesion in your pituitary. That is why we keep telling you to demand that it be checked. Don't be so passive. In the end though, only an MRI will let you know definitively.
Going on gel for a few months and then stopping will only make your problems worse. Do not do this under any circumstances. When your doc said that once you go on TRT you are screwed, he was talking about shutting down your HPTA. The longer you take exogenous testosterone, the harder it is to get your HPTA working again if you go off. This APPLIES to gels too. Exogenous test is exogenous test when it comes to shutting down your HPTA.
Checking your Prolactin will help indicate if there is a tumor or lesion in your pituitary. That is why we keep telling you to demand that it be checked. Don't be so passive. In the end though, only an MRI will let you know definitively.
Going on gel for a few months and then stopping will only make your problems worse. Do not do this under any circumstances. When your doc said that once you go on TRT you are screwed, he was talking about shutting down your HPTA. The longer you take exogenous testosterone, the harder it is to get your HPTA working again if you go off. This APPLIES to gels too. Exogenous test is exogenous test when it comes to shutting down your HPTA.
Hey guys,
Just got done meeting with my endocrinologist. My third round of blood work came in and he says everything looks normal now. To remind you guys, my total test levels were 159 back in June when I got them tested during my physical because I hadn't been feeling well. My GP put me in for more blood work in July and my total test came back 217. I was referred to an endocrinologist and he put me in for more blood work on August 5th which showed total test at 348. Below I will post all of my blood work results.
Do my most current results show that I am in good shape now? My total test was 348 (range 250-1100). He didn't mention anything about my free levels or bioavailable levels but when I got home and looked close they seem to be just barely in range. I will say that I did have a ton of stress over this past year which i'm sure didn't help anything. Recently I have been feeling a little better and stress levels are down. Could this be why my test levels have increased a little over the past three months? Are my levels normal and acceptable for a 30 year old?
My endo said he didn't want to treat me since I was in range, and had me schedule an appt. for the new year to check levels again. Can you guys please look at my most current blood work and let me know how it looks?
June, 26th were:
TT: 159 (300-1100)
FT: 25.6 (no range given)
TSH-O - 1.86 (0.4 - 4.0)
July, 14th are:
TT: 217 (300-1100)
FT: 40.1 (no range given)
FSH: 3.8 (1.5-12.4)
LH: 1.7 (1.7-8.6)
Cortisol a.m: 13.6
Most recent August, 5th were:
Total Test: 348 (250-1100)
Free Test: 53.3 (46-224)
Test Bioavailable: 114.2 (110-575)
TSH: 1.64 (0.4-4.5)
Thyroid Peroxidase: 1 (<9 IU/mL)
SHBG: 26 (10-50)
Albumin serum: 4.7 (3.6-5.1)
IGF-1: 178 (53-331)
Z Score: 0.3 (-2-+2)
DHEA: 432 (61-1636)
DHEA Sulfate: 192 (85-690)
FSH: 4.3 (1.6-8)
LH: 2 (1.5-9.3)
Prolactin: 6.6 (2-18)
Cortisol a.m: 15.5 (4-22)
Just got done meeting with my endocrinologist. My third round of blood work came in and he says everything looks normal now. To remind you guys, my total test levels were 159 back in June when I got them tested during my physical because I hadn't been feeling well. My GP put me in for more blood work in July and my total test came back 217. I was referred to an endocrinologist and he put me in for more blood work on August 5th which showed total test at 348. Below I will post all of my blood work results.
Do my most current results show that I am in good shape now? My total test was 348 (range 250-1100). He didn't mention anything about my free levels or bioavailable levels but when I got home and looked close they seem to be just barely in range. I will say that I did have a ton of stress over this past year which i'm sure didn't help anything. Recently I have been feeling a little better and stress levels are down. Could this be why my test levels have increased a little over the past three months? Are my levels normal and acceptable for a 30 year old?
My endo said he didn't want to treat me since I was in range, and had me schedule an appt. for the new year to check levels again. Can you guys please look at my most current blood work and let me know how it looks?
June, 26th were:
TT: 159 (300-1100)
FT: 25.6 (no range given)
TSH-O - 1.86 (0.4 - 4.0)
July, 14th are:
TT: 217 (300-1100)
FT: 40.1 (no range given)
FSH: 3.8 (1.5-12.4)
LH: 1.7 (1.7-8.6)
Cortisol a.m: 13.6
Most recent August, 5th were:
Total Test: 348 (250-1100)
Free Test: 53.3 (46-224)
Test Bioavailable: 114.2 (110-575)
TSH: 1.64 (0.4-4.5)
Thyroid Peroxidase: 1 (<9 IU/mL)
SHBG: 26 (10-50)
Albumin serum: 4.7 (3.6-5.1)
IGF-1: 178 (53-331)
Z Score: 0.3 (-2-+2)
DHEA: 432 (61-1636)
DHEA Sulfate: 192 (85-690)
FSH: 4.3 (1.6-8)
LH: 2 (1.5-9.3)
Prolactin: 6.6 (2-18)
Cortisol a.m: 15.5 (4-22)
Megatron28
Moderator
TT of 350 with low Free T and Low Bioavailable T is still considered hypogonadal. If you have symptoms of Low T you should show these blood work results to a different doctor that is more upnto date on TRT.
That's a nice jump in TT in short time. Did you make any lifestyle or diet changes during this short time that possibly could have affected the outcome?
I can commiserate about the doctors. Seems nuts that the primary would would send you for labs when they should know the Endo would want their own. And the fact the Endo is willing to put you on HRT for a month then take you off conflicts with almost everything I've read on the subject.
I went thru the same crap. On one Endo visit, total T came back at 253 with a minimum range of 250. Endo nurse called me and told me I was fine. When I questioned her on it, she assured me my T would go up as the day went on. Ridiculous.
Best of luck.
I can commiserate about the doctors. Seems nuts that the primary would would send you for labs when they should know the Endo would want their own. And the fact the Endo is willing to put you on HRT for a month then take you off conflicts with almost everything I've read on the subject.
I went thru the same crap. On one Endo visit, total T came back at 253 with a minimum range of 250. Endo nurse called me and told me I was fine. When I questioned her on it, she assured me my T would go up as the day went on. Ridiculous.
Best of luck.
Thanks for taking the time to reply guys.
Only changes in my lifestyle were back in June when I got the total of 159 I upped my calories to maintenance level ( I had been dieting before) and also stress I was having with family problems has gotten better which I know can have a big impact. I do notice I feel better now than I did three months ago. It's suck wondering if I can feel even a lot better is I were where I should be a my age.
I think what I will do is give it a couple monts to see how I'm feeling and if nothing changes I will schedule an appt. with either my endo to have the blood work done earlier than December which is when I'm scheduled next.
In concerned about my free and bio levels though. Are these as important as total test? My GP said she would be happy to refer me to another endo for a second opinion if I want, do you guys think I should do this since my total test has been increasing Or wait and see how I'm feeling?
Only changes in my lifestyle were back in June when I got the total of 159 I upped my calories to maintenance level ( I had been dieting before) and also stress I was having with family problems has gotten better which I know can have a big impact. I do notice I feel better now than I did three months ago. It's suck wondering if I can feel even a lot better is I were where I should be a my age.
I think what I will do is give it a couple monts to see how I'm feeling and if nothing changes I will schedule an appt. with either my endo to have the blood work done earlier than December which is when I'm scheduled next.
In concerned about my free and bio levels though. Are these as important as total test? My GP said she would be happy to refer me to another endo for a second opinion if I want, do you guys think I should do this since my total test has been increasing Or wait and see how I'm feeling?
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