Lab Work Finished | Saw GP | "Prime Candidate" for testosterone replacement therapy (TRT) at age 31 - The journey begins

[forsh]

Lab Work Finished | Saw GP | "Prime Candidate" for TRT at age 31 - The journey begins

I'm still undecided about TRT. I'll leave everything out in the open and honest and will take 100% of opinions and recommendations with weight.

Quick (*edit* happened to not be too quick) back-story: Historically through my youth have been an ectomorph... thin frame, hard to gain weight, felt a bit "prepubescent" but generally "looked good" and had a trim, but skinny, build. I changed up my diet about 8 years ago and have since eaten all-natural/organic and am a vegetarian (no eggs though); I am today a C-level exec, healthy in my book (and on paper other than T) and doc says I'm the spitting image of health. I love to cook and make all of our meals from scratch from our garden and CSA. I count my macros, have my caloric needs detailed for my body, have a great personal coach in Ryan Miller out of Minneapolis of Growth Stimulus Training, and have been training semi-dedicated for 4 years now (much more in past few months). I currently take l-glutamine, BCAAs, citrulline, beta alanine, creatine, epa/dha, multi-vitamins, protein powders (plant based), etc. (I can give doses if necessary).

I am doing well in the gym, though since I'm toning down my bodyfat from 20% (now at 16.9%) the strength isn't as there. I'm fairly fit, but always had a suspicion that I had low T. Went into doc a month ago because I suspected I may have gyno (I have a pea sized lump under my left nipple that is very sensitive if hit); I was diagnosed with gyno but doc thought best left untreated for now. I talked to him about T at that time, and long story short expressed that I wanted complete blood work done, to which he didn't think insurance would all cover (and didn't know of all the tests anyhow). I followed my mother-in-law's advice and went to labdirect.com and ordered all the tests I wanted (will post results below); sure enough, low T. Brought results to doc today as I had the lab work already scheduled (to just check T) and we discussed everything. He was very amazed that I self-diagnosed myself twice and came in with evidence to back it up. He's a very good doc, and is very open to learning (the enthusiastic GP) and seems very excited to help me on my journey here; he did recommend flat-out testosterone replacement therapy (TRT), though he admitted it wasn't his strong area and wanted me to see the youngest-looking endo in the tri-state area (as they'd be more up-to-date on these things). Have that appointment scheduled for two months from now, so I have a bit of time now here to share and glean the wisdom and experience of others.

So without further ado, my stats:

Age: 31
Height: 5'11"
Waist: 33"
Weight: 186
Bodytype and hair growth: Thinner frame, broad shoulders and broad chest, carry fat around mid-section; can grow full beard very easily (and wearing one) though doesn't completely fill in between stache and cheek area (small but noticeable 1" dip)... hairy legs, fair on forearms, and tummy/chest hair
Diet: Morning smoothie (berries, flax seed, hemp seeds, hemp oil, protein powder, kale, etc.), mid-morning ProBar, lunch is typically leftovers, cheese sandwiches/soup or Garden of Life Fit shake, mid-afternoon protein/fit shake, normal home cooked large dinner and one more protein/fit shake at night. Total calories of 2400, 220 carb, 180-200 protein, 70-100 fat (depends on train/rest day).
Training: Growth Stimulus Training (squat day, pull day, push day, press day) focuses on core/compound lifts (squat, deadlift, etc.); this will consume 4 days "per week" and HIIT on another 2. Details can be found easily via Google search.
Erection quality: Have pretty much always had morning/nocturnal erections; not supreme hard all the time.


Lab Results (posted as image to imgur as many tests and much easier): i.imgur.com/sUhx22A.jpg

So thoughts on where I should be starting first; do I have a chance of restarting my natural T production first? I'm not opposed to testosterone replacement therapy (TRT), but realize it's a life decision and I am not opposed to exhausting other options either.

 

[Spunkey71]

I have been on testosterone replacement therapy (TRT) for a month now and attest that it will change your life, it is very difficult to put into words but it has been night and day for me since I started. Whatever you decide I wish you the best of luck which ever decision you make but my personal opinion is that if you are going to live life live it to the fullest!

 

[johnfromeurope]

Spunkey, i know it's difficult to put it into words, but can you somehow describe, what is different? apart from sex drive and better body?

 

[Hoodlum]

Mood, confidence, dominance, energy levels, gains from the gym, libido, feeling like you are a man again

 

[icejosh]

Hoodlum just hijacking this thread but need to run something by you, get me on joshuadavida@yahoo.co.uk

 

[forsh]

Hoodlum just hijacking this thread but need to run something by you, get me on joshuadavida@yahoo.co.uk

Oddly that's all I seem to be getting no matter where I post... all these excellent forums and no one helping by actually looking at the lab results and analyzing; we all know the doctors may not know much so I was really looking forward to having some discussion vis-a-vis the lab results.

I'd appreciate not hijacking my thread :

P.S. Spunky, thanks for the kind words! Glad everything is working out well for you.

 

[halfwit]

Heading off to the gym, but before I go: Looking at those LH/FSH numbers, I'm going to say you have a classic case of primary hypogonadism my friend. No restarts for you, just needle and vial as restarts/clomid/hcg therapies all involve bumping up that LH signal to the testes. As that signal is already there at a decent level, and you are still at 290ng/dL - I don't see any alternative for you.

Two things:
1. Push for injectable testosterone. Gels/Creams/pellets are all honestly crap for the most part.
2. Push for self-injections. Nobody likes to have to visit the doc every week or if you want to optimize your hormone levels, twice a week.
OKAY I lied, three:
3. Make sure your doc keeps up on that estradiol/DHEA/Pregnenolone as they are all important to your health and will invariably change as you supplement with exogenous testosterone.

Gotta run, but hope this gives some food for thought!

My .02c

Edit: Dah, forgot to put in my disclaimer that I'm not a doctor, so take my advice as such.

 

[Spunkey71]

Spunkey, i know it's difficult to put it into words, but can you somehow describe, what is different? apart from sex drive and better body?

Hoodlum hit the nail on the head! My personal experience has been that over the last 5-6 years I have gained over 100 pounds, had no drive for life, had no desire to do anything. I was exhausted all the time, I found it very difficult to get through a regular work day and I work behind a desk. I wanted to exercise and wanted to have a normal life where I was active and social with friends but just didn't have the strength or energy to do so. My boss convinced all of my sales team in the office to join the gym and I thought with the support of my co-workers I would have the motivation and support to make a change but I could not even handle 15 minutes on the bike. My boss and I got to talking and he suggested I get my T level checked and now I am on treatment and I hit the gym 4-5 days a week and am tearing up the weights. I have the energy to run errands and do the things in life I need to do. I have also started hanging out again with friends.

Just a little bit of info to give you an idea

 

[Megatron28]

It is simply the difference of feeling alive again and walking around like a zombie. Living with Low T is no life at all. testosterone replacement therapy (TRT), while not a magic bullet, it a life saver if you need it. Literally a life saver.

 

[Megatron28]

Heading off to the gym, but before I go: Looking at those LH/FSH numbers, I'm going to say you have a classic case of primary hypogonadism my friend. No restarts for you, just needle and vial as restarts/clomid/hcg therapies all involve bumping up that LH signal to the testes. As that signal is already there at a decent level, and you are still at 290ng/dL - I don't see any alternative for you.

Two things:
1. Push for injectable testosterone. Gels/Creams/pellets are all honestly crap for the most part.
2. Push for self-injections. Nobody likes to have to visit the doc every week or if you want to optimize your hormone levels, twice a week.
OKAY I lied, three:
3. Make sure your doc keeps up on that estradiol/DHEA/Pregnenolone as they are all important to your health and will invariably change as you supplement with exogenous testosterone.

Gotta run, but hope this gives some food for thought!

My .02c

Edit: Dah, forgot to put in my disclaimer that I'm not a doctor, so take my advice as such.

Halfwit: While I agree this is a case of hypogonadism, it looks like secondary to me rather than primary. LH of 3.3 and FSH of 3.6 are both on the Low/Normal side of the range. They are far from the "screamingly" high/above normal range.

OP: This doesn't change the fact that you have hypogonadism. But a restart would potentially be a possibility if you are secondary.

Also, any idea what may be causing your high liver numbers? ALT and AST.

P.S. I have included your labs below to make it easier for people to see them.

View attachment 553171

 

[halfwit]

Halfwit: While I agree this is a case of hypogonadism, it looks like secondary to me rather than primary. LH of 3.3 and FSH of 3.6 are both on the Low/Normal side of the range. They are far from the "screamingly" high/above normal range.

OP: This doesn't change the fact that you have hypogonadism. But a restart would potentially be a possibility if you are secondary.

Also, any idea what may be causing your high liver numbers? ALT and AST.

P.S. I have included your labs below to make it easier for people to see them.

View attachment 553171

The reason I believe it to be primary is that those are actually pretty (from what I've seen) average numbers for LH/FSH. It's when one of them is at the very bottom that I would (in my non-doctor opinion) suspect secondary. Sure, hopping on clomid might pump that LH up to 10mIU, but that's such a low test value I bet it won't do much for him. Who knows though, I'm definitely not a doctor and most certainly am not infallible.

 

[forsh]

Thanks all for the responses, they are really appreciated!

I just received my results from a second lab for testosterone (the doc only measured TT, Serum this time) and that came back as 410 on a scale from 154-1488; he wrote in a letter that he cannot explain the differences between my DirectLabs 290 and this 410, but said regardless of off-the-chart low and on-the-chart low, he'd still like me to continue on and seek treatment. My appointment with the endo is in October.

Thoughts on this different result?

Megatron, the doc said the ALT and AST were meaningless since I was fasting?

 

[Megatron28]

Thanks all for the responses, they are really appreciated!

I just received my results from a second lab for testosterone (the doc only measured TT, Serum this time) and that came back as 410 on a scale from 154-1488; he wrote in a letter that he cannot explain the differences between my DirectLabs 290 and this 410, but said regardless of off-the-chart low and on-the-chart low, he'd still like me to continue on and seek treatment. My appointment with the endo is in October.

Thoughts on this different result?

Megatron, the doc said the ALT and AST were meaningless since I was fasting?

Different labs have different normal ranges. There can be error in their equipment or procedure that needs to be accounted for statistically. So they adjust the normal ranges for this. Think about you bathroom scale. Does it give the same answer as your docs scale? Probably not. But as long as it is consistent you can tell if you are gaining or losing weight.

 

[forsh]

Just returned from the endo, but was not very impressed (and that's not based on the result he gave): I do not have low testosterone

He was your typical "I know best" though he clearly never dealt with men's hormone issues before (I don't have a lot of options in the area, and had to drive an hour to see him)... my GP is great, and he chose this endo only because he was the youngest one in a 60 mile radius, so he thought that would be the best chance to get one that was up on the latest. I may have to drive the 4 hours to Minneapolis/St. Paul to see someone else (if anyone has any endo/uro recommendations for that area, please tell!).

Unfortunately, the endo more or less accused me (without outright stating it, and I did call him out on it, nicely) that my symptoms of gyno in the left breast and low testosterone were due to steroid/pro-hormone use; I let him know kindly that while I wasn't against using such things on a moral level, I in fact have never used either. At that point, he had pretty much made up his mind though... I like to be as forthright and honest as possible at the beginning, especially with a doctor who is bound by privacy laws anyways, and brought in the list of supplements I use:

Multi-Vitamin
Resveratrol
FYI Restore: Enzymes like Bromelein and Protease
FYI Ultra: Glucosamine HCI
L-Arginine
L-Ornithine
L-Lysine
BCAAs
L-Glutamine
Revirsatol V2: S.E.R.M. Matrix Proprietary Blend, 7-Methoxy-2-phenyl-chromen-4-one, Ellagic Acid 95%, Estrogen Modulation Matrix (EMM) Proprietary Blend , Indole 3 Carbinol, Long Jack 100:1, Trans Resveratrol
Tropinol XP: Feadogia Agrestis, Epimedium, 25R-Dione Spirost-4-Ene, 6-Dion, Potassium Nitrate, Coleus Forskohlii
Beta-Aline
Citrulline Malate
DAA (D-Aspatic Acid)
Creatine
DIM: Diindolymethane and N-Acetylcysteine

He was very concerned with the Revirsatol and blamed the gyno on that??? I kindly let him know I only started that two weeks ago and the gyno started 3 months ago.

Anyhow, he said there was an enzyme I could take that is used for breast cancer to deal with the gyno, but that I don't need it at this time as it wasn't a concern; fine. Unfortunately he completely blew off my symptoms of libido, energy, etc. and said there could be a lot of reasons for that, but it wasn't low testosterone. Thankfully, he did state that if I wanted to put my mind at ease, he'd right out another lab request to test TT (he stated I did not need to test LH, FSH, etc. again as those were not time-sensitive) as he said the test that showed 290 was taken at an improper time of day (2PM, which I agree with) and that the latest test by the GP was taken at a proper time (10am, and that was the 410 result I posted about earlier).

So I'm at kind of a loss... I simply want to find out the truth. If I don't have low T, great, and this endo could be very correct; I'm just concerned about how he came to the conclusion, and his quick write-off... it would probably be best to hear a yay or nay from someone I trust, which is the difficult part.

Any thoughts on all of this?

 

[forsh]

Oh, so I have the lab now to take TT and hCG.

I'm curious if I should take this right away tomorrow AM, or stop any of those above supplements first? I like to stay natural and I realize the Reverisatol and Tropinol XP, while not even PH, are somewhat leaving the territory of natural (depending on how you look at it); would it be best to stop those first for say a week, as they'd give a wrong conclusion in any way?

 

[halfwit]

Oh, so I have the lab now to take TT and hCG.

I'm curious if I should take this right away tomorrow AM, or stop any of those above supplements first? I like to stay natural and I realize the Reverisatol and Tropinol XP, while not even PH, are somewhat leaving the territory of natural (depending on how you look at it); would it be best to stop those first for say a week, as they'd give a wrong conclusion in any way?

Sounds like the endo has seen one too many T-booster ads and actually believes reservatrol is going to do something. Sure, it might bump you up 10 points, but it's not going to cause gynecomastia. I would drop them all but the vitamins and see how things go. Why the "natural" aromatase inhibitors?

 

[IMT staff]

Halfwit: While I agree this is a case of hypogonadism, it looks like secondary to me rather than primary. LH of 3.3 and FSH of 3.6 are both on the Low/Normal side of the range. They are far from the "screamingly" high/above normal range.

OP: This doesn't change the fact that you have hypogonadism. But a restart would potentially be a possibility if you are secondary.

Also, any idea what may be causing your high liver numbers? ALT and AST.

P.S. I have included your labs below to make it easier for people to see them.

View attachment 553171

Thanks thats why I did not look at them before

 

[Alpin]

My LH was 3 IU/L & FSH 2 IU/L all this time....T.T. between 265-291 ng/dl
LH went up to 4 IU/L and FSH still 2IU/L... T.T. 273 ng/dl
ADEX won't help raise my Natty T either...

Use to be at LH 5 IU/L and produce 582 ng/dl...before I messed with TRT.(was told to go on T therapy...had undiagnosed highly severe sleep apnea)
Can't get those numbers back and being off for 16 months too.

 

[forsh]

Just got my TT checked again this morning at 8am, and got the results back this afternoon:

686 ng/Dl | Normal Range 199-1586

So that is really good! However, I'm now very confused as to why I ever had the 290 score? Anything to take away from this?

I guess in the end, I know these test boosters work????... however I really wish it was easier to measure myself more easily (weekly, or even monthly) as there are no DirectLabas or anything within a 4-hour radius. What if my test numbers are typically low, and these test boosters are working, but "masking" it and therefore I'm treating in an uncontrollable sense (i.e. no insurance-covered TT checking labs on a routine basis)?

Would anyone of you attribute to these much higher and normal numbers to Tropinol XP?

 

[Kevin1974]

Spunkey, i know it's difficult to put it into words, but can you somehow describe, what is different? apart from sex drive and better body?

From my perspective, testosterone replacement therapy (TRT) is a difference maker not because of the secondary effects it has on the physical body, but because of the psychological impact it has. Prior to starting Hormone Replacement Therapy (HRT) the first time, I had no motivation, desire, interest, etc. in the things I used to enjoy (even though I was prescribed an anti-depressant and stimulant). Two months after starting my Hormone Replacement Therapy (HRT) the first time, things were certainly different. Simply put, my quality of life improved dramatically. It was a life-saver because I was not in a good place mentally or emotionally. Friends and relatives even noticed that I no longer had a "short-fuse".

Unfortunately, I had to quite my Hormone Replacement Therapy (HRT) protocol the first time around after only 6-months due to financial reasons. I did not have the $$$ to continue paying the clinic in FL that I was using.

Fast forward 2-years and I'm a month into my return to HRT. Things are just starting to improve slightly for me from the mental and emotional perspective. I know from my previous experience that it will only continue to improve over the next 3-months or so.

Moral to the story...be patient with it. You may not realize the improvement at the time, but I guarantee positive changes will occur.