Got an appointment with a Dr. What do I need to ask.

[MBB]

I managed to get an appointment with a hormone doctor at the end of December. Usually these particular hormone doctors won't treat males under 35 y.o (I'm 24), fortunately I was able to plead my case and the doctor agreed to see me. Just wondering what blood tests, etc. to ask for. Also looking for any advice on what to be prepared for, etc.

 

[Megatron28]

Have you had any labs run yet? Do you know if you have Low T (confirmed by labs)?

 

[MBB]

Had total test tested, at 392 ng/dl (that's at 8:30am), plus have all the symptoms of low T. But the GPs here (Australia) are soo ignorant that they completely disregard symptoms.
I'm fairly certain my low T is in part due to acne meds I took mid teens which functions by suppressing the pituitary hormone levels.

 

[Megatron28]

From everything I have seen other guys go through in Australia, you will be hard pressed to get on testosterone replacement therapy (TRT) with TT of 392.

For labs, you should reconfirm the TT result. Have the following checked:

LH
FSH
Prolactin
Estradiol
Metabolic Profile Panel
CBC
Thyroid Panel (not just TSH, get full panel)
Vitamin D
Lipid Panel
Anemia Panel
Vitamin B12


At your age, ask your doc to try a restart protocol if your LH and FSH are low or normal. Also called post cycle therapy (pct), but don't use that term with your doc. This would consist of clomid or Human Chorionic Gonadotropin (HCG). A restart tries to get your pituitary working again.

If your LH and FSH come in high, it may indicate there is a problem with your testicles. That would be an indication to consult an urologist.

Here is some more reading you can do on hypogonadism.

https://aace.com/files/hypo-gonadism.pdf

Let us know how it goes and post your lab results when you get them.


Also, this is important. Ask to have a sleep study done. Tell the doc that people tell you that you snore loudly. Things like sleep apnea can really affect your T. And look at your diet and lifestyle. Everything can impact your T. But like you said, maybe your acne meds had an impact. Hard to say.

Good luck.

 

[MBB]

Will definitely post results as I get them.
Diet and lifestyle are dialled in quite well (8 hours sleep a night, no drinking or smoking, weight training, good nutrition and supplementation).
Have thought about getting a sleep study, so will definitely push for one.

 

[Megatron28]

What supplements you taking or took in the past? Anything like prohormones?

 

[MBB]

What supplements you taking or took in the past? Anything like prohormones?

Nah nothing like that. All supplements I've taken are just stuff you can get from the health food store, like wpi, bcaas, creatine, multi's, fish oil, etc, etc.

 

[MBB]

Got results back from some recent blood work.
View attachment 554885View attachment 554886View attachment 554887View attachment 554888View attachment 554889

The elevated Vit D is easy to rectify, was dosing 8000 iu a day, will just cut that to 4000 iu. What's got me baffled though is the low LDL, I get plenty of saturated fats in my diet.

The T is low (not surprised at all), but was reading somewhere that testosterone is made from cholesterol. So could my low LDL be contributing to my low T?

 

[MBB]

Sorry, not all images would fit in one post.
View attachment 554890View attachment 554891View attachment 554892

 

[bushleaguechew]

Got results back from some recent blood work.
View attachment 554885View attachment 554886View attachment 554887View attachment 554888View attachment 554889

The elevated Vit D is easy to rectify, was dosing 8000 iu a day, will just cut that to 4000 iu. What's got me baffled though is the low LDL, I get plenty of saturated fats in my diet.

The T is low (not surprised at all), but was reading somewhere that testosterone is made from cholesterol. So could my low LDL be contributing to my low T?

I didn't see a value for LDL or HDL, only total cholesterol, which is a little low. That could contribute to low T, but it is definitely not a primary cause. Incorporate some more egg yolks into your diet.

 

[MBB]

I didn't see a value for LDL or HDL, only total cholesterol, which is a little low. That could contribute to low T, but it is definitely not a primary cause. Incorporate some more egg yolks into your diet.

Your right. Not sure where I got low LDL from.

Not sure why cholesterol would be low though. I eat plenty of fatty meats - chicken thigh, regular beef mince, pork mince, coconut oil.

 

[Megatron28]

Got results back from some recent blood work.
View attachment 554885View attachment 554886View attachment 554887View attachment 554888View attachment 554889

The elevated Vit D is easy to rectify, was dosing 8000 iu a day, will just cut that to 4000 iu. What's got me baffled though is the low LDL, I get plenty of saturated fats in my diet.

The T is low (not surprised at all), but was reading somewhere that testosterone is made from cholesterol. So could my low LDL be contributing to my low T?

That's a lot of pics to look at to see your labs! Kind of hard to go through them all. Anyhow:

You appear to have Secondary Hypogonadism. In the USA, we measure testosterone in ng/dl. You are at 271. That's about where you normally would be when you get into your 100's. Couple your low Testosterone with Low/Normal LH and FSH is how I arrived at the secondary diagnosis. More details on this are outlined in the previous link I gave you.

View attachment 554896

Your estradiol is very low too. A recent New England Journal of Medicine study outlined that men with low estradiol have a lot of health problems and they pack on the fat. Have you been gaining weight for a while? How tall are you and what do you weigh?

I wouldn't cut back your vitamin D too much. You are just a little high. Maybe try 6000 iu's per day.

Low cholesterol can impact your testosterone. You really should get a full lipid profile run. Total cholesterol doesn't tell much of the story. I'm guessing that your HDL is going to be very low.

You can probably ease up a bit on the B12 supplementation.

Were you dehydrated when you had your labs run? Your urea was high.

---------------------------------------------------------------------------

I think you should be talking to an endo about trying a restart or going on TRT. Don't let them put you on gels if you go the TRT route. Injections work best. But if I were you I would give a restart a try first.

 

[MBB]

That's a lot of pics to look at to see your labs! Kind of hard to go through them all. Anyhow:

You appear to have Secondary Hypogonadism. In the USA, we measure testosterone in ng/dl. You are at 271. That's about where you normally would be when you get into your 100's. Couple your low Testosterone with Low/Normal LH and FSH is how I arrived at the secondary diagnosis. More details on this are outlined in the previous link I gave you.

View attachment 554896

Your estradiol is very low too. A recent New England Journal of Medicine study outlined that men with low estradiol have a lot of health problems and they pack on the fat. Have you been gaining weight for a while? How tall are you and what do you weigh?

I wouldn't cut back your vitamin D too much. You are just a little high. Maybe try 6000 iu's per day.

Low cholesterol can impact your testosterone. You really should get a full lipid profile run. Total cholesterol doesn't tell much of the story. I'm guessing that your HDL is going to be very low.

You can probably ease up a bit on the B12 supplementation.

Were you dehydrated when you had your labs run? Your urea was high.

---------------------------------------------------------------------------

I think you should be talking to an endo about trying a restart or going on TRT. Don't let them put you on gels if you go the TRT route. Injections work best. But if I were you I would give a restart a try first.

I've not been packing on fat as I keep my diet pretty good, though it has seemed to be creeping on - particularly in the mid section. I just had my height measured and am 181cm (I think that's about 6 foot) and am 83-85 kg.

The Vit D's I have are in 4000 iu tabs. So should I do 2 one day, 2 the next or just cut it to 4000iu a day?

At the moment I'm taking a folic acid supp 2x a day that has 25 MCG of Vit B-12, should I cut that to 1x a day?

As I have constant dry mouth/thirst it feels like I'm always at least a little dehydrated, despite the fact that I drink plenty of water.

 

[Megatron28]

I've not been packing on fat as I keep my diet pretty good, though it has seemed to be creeping on - particularly in the mid section. I just had my height measured and am 181cm (I think that's about 6 foot) and am 83-85 kg.

The Vit D's I have are in 4000 iu tabs. So should I do 2 one day, 2 the next or just cut it to 4000iu a day?

At the moment I'm taking a folic acid supp 2x a day that has 25 MCG of Vit B-12, should I cut that to 1x a day?

As I have constant dry mouth/thirst it feels like I'm always at least a little dehydrated, despite the fact that I drink plenty of water.

Do you always have an urge to piss? And when you do piss, does it always come out clear -- no yellow color? That might be a sign that you need more water.

Vitamin D is cheap. You could just buy more.

For B12, do a search on essential supplements that was posted by Austinite. He did quite a write up on recommended supplements and doses, included B12.

 

[MBB]

Do you always have an urge to piss? And when you do piss, does it always come out clear -- no yellow color? That might be a sign that you need more water.

Vitamin D is cheap. You could just buy more.

For B12, do a search on essential supplements that was posted by Austinite. He did quite a write up on recommended supplements and doses, included B12.

Go to the toilet frequently, aside from first thing in the morning urine is very clear.

 

[Megatron28]

Go to the toilet frequently, aside from first thing in the morning urine is very clear.

Maybe you have that Dry Mouth affliction.

 

[MBB]

Maybe you have that Dry Mouth affliction.

That was one of the well noted side effects of the acne meds I took mid teens. Just can't believe I'm still suffering with it.

 

[Alpin]

Your labs don't look terrible bro...
FSH is relatively high...LH is up there too. T is not optimum for your age though.
I like your way of thinking with supplementing B12 and Vit. D...
these are things we could easily take care of...even with Low T.
And we all should!

 

[MBB]

Your labs don't look terrible bro...
FSH is relatively high...LH is up there too. T is not optimum for your age though.
I like your way of thinking with supplementing B12 and Vit. D...
these are things we could easily take care of...even with Low T.
And we all should!

Yeah, pretty much everything I can be doing to naturally raise test, I'm doing. That's probably why for the most part my labs are quite good. Just the T that's the problem.

I'm actually quietly optimistic about the future. Once I can get my T levels up, I should be feeling quite good.