I feel like my Endo is wasting my time

JOWS6

I am banned!
I'm back! I decided to take a break from this whole ordeal and enjoy my summer for a lil' bit. For those of you who don't know, I was on Chip's protocol for 4 weeks and didn't feel any better. I eventually stopped because I was feeling dizzy one day and went to the ER where they found my blood pressure 204/107. They recommended I stop the TRT and undergo TRT again with someone who can monitor my progress.

Anyway, long story short: Noticed decreased libido January 2010, diagnosed with low testosterone June 2010 and have been researching since then. I didn't like some of the doctors/endocrinologists I've seen before and finally decided to see this endocrinologist as referred to me by a family friend who is a doctor. I have been supplying him with my previous labs that confirm hypogonadotropic hypogonadism along with his own lab testing, an MRI of my pituitary that shows no abnormalities from my previous doctor.

My first visit we drew blood to establish some baseline numbers. He tested a lot of other stuff too like Vitamin B and Dopamine levels through a 24-hour urine test (happy to report that my Dopamine levels came back at the upper third of the range. I was always worried I was in a state of SSRI-induced down-regulation of dopamine levels from extra serotonin.) Anyways, he called me to come in and try a GnRH stimulation test. Fine. Tests came back today that my FSH and LH increased. Now he wants to try a Clomid test.

Really? Doesn't that seem redundant? Either way, if the Clomid does or doesn't work, in the end, I would be placed on TRT the way I see it. I'm getting really aggravated as weeks are passing by, I'm eager to feel better and instead of talking about a TRT plan he wants to perform another test. The nurse said he wants me to schedule a bone density scan and an ultra-sound of my kidneys later as well.

Opinions? Thoughts?
 
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The clomid attempt at a restart, at least he is more open minded then most endo's currently out there. But it rarely works IMO from what I have seen people discuss and post about online.

You could see if you can find a willing doctor to monitor you WHILE you use chip.

If TRT alone is not helping you, there is likely other underlying issues.
 
he called me to come in and try a GnRH stimulation test. Fine. Tests came back today that my FSH and LH increased. Now he wants to try a clomid test.

GnRH is a substance produced by the hypothalamus that stimulates the pituitary glands to produce FSH ,LH
as it was introduced to your body and successfully increased FSH, LH levels, this means that your pituitary can produce LH and FSH ,,, the problem is with your hypothalamus

I'm not sure why he prescribed clomid but as a medical student I think your endo is a textbook and he really knows what he's doing
 
I'm back! I decided to take a break from this whole ordeal and enjoy my summer for a lil' bit. For those of you who don't know, I was on Chip's protocol for 4 weeks and didn't feel any better. I eventually stopped because I was feeling dizzy one day and went to the ER where they found my blood pressure 204/107. They recommended I stop the TRT and undergo TRT again with someone who can monitor my progress.

Anyway, long story short: Noticed decreased libido January 2010, diagnosed with low testosterone June 2010 and have been researching since then. I didn't like some of the doctors/endocrinologists I've seen before and finally decided to see this endocrinologist as referred to me by a family friend who is a doctor. I have been supplying him with my previous labs that confirm hypogonadotropic hypogonadism along with his own lab testing, an MRI of my pituitary that shows no abnormalities from my previous doctor.

My first visit we drew blood to establish some baseline numbers. He tested a lot of other stuff too like Vitamin B and Dopamine levels through a 24-hour urine test (happy to report that my Dopamine levels came back at the upper third of the range. I was always worried I was in a state of SSRI-induced down-regulation of dopamine levels from extra serotonin.) Anyways, he called me to come in and try a GnRH stimulation test. Fine. Tests came back today that my FSH and LH increased. Now he wants to try a Clomid test.

Really? Doesn't that seem redundant? Either way, if the Clomid does or doesn't work, in the end, I would be placed on TRT the way I see it. I'm getting really aggravated as weeks are passing by, I'm eager to feel better and instead of talking about a TRT plan he wants to perform another test. The nurse said he wants me to schedule a bone density scan and an ultra-sound of my kidneys later as well.

Opinions? Thoughts?
when you say gnrh stim did he administer Triptorelin 100mcg to do this???
 
Bone density test and kidney scan? lol. Well shit I've PMed you how to fine tune the protocol. My body is one of the most sensitive when it comes to drugs or supplements and I've fine tuned it to handle this, so I don't see why you can't. The high BP thing goes away and can be solved with magnesium and whatnot. Not everyone even gets that - depends on you. Go ahead and perform a clomid restart test to rule out if you have primary testicle failure - which it sounds like you must have if your dopamine and LH are already high. But maybe they are not high if you are claiming your doc is using clomid to increase LH. And maybe the SSRI induced mutation of the dopaminergic neurons is beyond just "dopamine levels", and mutates them at the receptor level. But the easiest way to tell if that's the case is just to look at your baseline LH levels since that is the end result.

WHAT IS YOUR BASELINE LH LEVEL before clomid?
 
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First off Jow, there's got to be something wrong w/ your cardiovascular system.. That BP would be my main concern right now if I were you! I doubt very much that 4 weeks of low dose test injections would bring your BP up like that..
But that aside this is a good case for us all to learn from..
Can you post your LH & Fsh level and ranges before and after the stim test?
Did he test to see if the increase in LH increased your test level?
Damn Jow! Your a tough patient man.. Chip must be pulling his hair out bc of you LOL.. Go ahead and get a doc to monitor you, but you can monitor your health also..
Go get a blood pressure machine and get regular labs done.. Also, go see a cardiologist to get a stress test
 
Thanks guys. My plan is to stick with Chip's protocol when I am all settled and steady with my dosage and what not. My family and I decided it would be best to have an endo monitor me while I go back on. My insurance is about to run out the 24th of September so I'm trying to get the most out of it.

I guess there was some confusion but my LH and FSH levels were very low not high. The doctor said the stimulation test (Leuprolide) boosted the gonadotropins to normal levels. I don't have the results on me because he told me over the phone.

I'm think the high blood pressure was due to several things though. I'm sure the TRT bumped it a bit and I believe my anxiety kicked in and exacerbated the problem spiking my blood pressure to those numbers. I don't think my cardiovascular system is wack as it's consistently around 125/80.
 
Just because your dopamine levels are high doesn't mean that the neurons aren't fucked up from the long term SSRI use making your pituitary lazy.
 
Jow, If you get a spare minute shoot me a PM as I do not have enough post yet to PM you. Include an email address if possible? I have a few questions for you since my BP is running high as well and I'm interested in your progress...
Thanks,
 
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