Labs and Question Requested

[JumpBoot]

Main question - can I turn this around with lifestyle changes (exercise and losing weight) without going on TRT as my Endo's suggest?

Very long story made short - I've seen primary and two different Endo's since January. Both Endo's say I do not need TRT. They say I need to lose weight and diet better. That is all the input I'm given. Problem is I have zero motivation to do it. I know I need to gut-up and do it but I never seem to. Primary put me on an anti-depressant which doesn't seem to be doing anything.

Total T - Jan 239 Mar - 253 Jul 240

Ugly truth:

Stats: Age 51 Height 5'10 Weight 240 with big belly
Very sedentary job and lifestyle. No exercise.
Have been severely sleep deprived for decades.
Moderate alcohol and med abuse.
Medical: Diagnosed with sleep apnea three ago. Use CPAP machine. CPAP is some help not great. Previously had used Ambien years straight. Currently taking Escitalopram.

Symptoms: All the usual Low T symptoms except night sweats. Especially low motivation to do anything. Grumpy and agitated constantly. Low libido. Not the same guy I was four years ago and not nearly as active as my friends in the same age group or even much older.

I've become frustrated with the doctors. I ran the below labs myself.

Test/Actual/Range
Testosterone, Serum 279 348-1197 ng/dL 01
Testosterone,Free 10.71 5.00-21.00 ng/dL 02
% Free Testosterone 3.84 1.50-4.20 % 02
Adult male reference interval is based on a population of lean males
up to 40 years old.
Prolactin 5.3 4.0-15.2 ng/mL 01
Prostate Specific Ag, Serum 1.1 0.0-4.0 ng/mL 01
Vitamin D, 25-Hydroxy 28.2 30.0-100.0 ng/mL
LH 5.4 1.7-8.6 mIU/mL 01
FSH 5.2 1.5-12.4 mIU/mL
Estradiol, Sensitive 11 3-70 pg/mL

Balls appear fine and I have lots of facial/body hair.

I'm sharing all this info in the hopes of getting good feedback but also to, hopefully, help others in my situation. My way of trying to give back I guess.

Thanks to all that provide feedback.

 

[Spunkey71]

You are taking a SSRI which is known to drive test levels into the ground and are also known for causing weight gain. If you think you can live without it then you might want to consider getting off.

 

[Megatron28]

How long have you been on the antidepressant for? I agree it may be worth a try getting off it to see what happens to your testosterone levels.

Have you checked your thyroid? TSH is the lab you want. Hypothyroidism can cause low T.

If neither of those is the issue, you need TRT. You meet the general criteria for TRT laid out by Endocrinologists. You are hypogonadal.

 

[Alpin]

It's not as easy as that to get off SSRI's guys.
The guy obviously feels some symptoms to be taking it.
If you can get off the SSRI...do it.
Problem is low T causes weight gain and makes working out real difficult.
You probably have been hypogonadal a while and it slowly got worse.
Your vit d is low. That plays a role in T production and it improvrs depression.
Test SHBG and Albumin as well next time along with TT.
Escitalopram= Cipralex....no???
This is the new paxil of the SSRIs.....just like paxil was a miracle drug for anxiety when it first came out. Same here with cipralex.

 

[JumpBoot]

I appreciate the replies.

I've only been on the Escitalopram since January. I was prescribed it by my primary to help with my low T symptoms.

The thyroid results are below

Thyroid Panel With TSH
1 of 3TSH 2.450 0.450-4.500 uIU/mL 01
Thyroxine (T4) 6.8 4.5-12.0 ug/dL 01
T3 Uptake 27 24-39 % 01
Free Thyroxine Index 1.8 1.2-4.9

 

[Megatron28]

I appreciate the replies.

I've only been on the Escitalopram since January. I was prescribed it by my primary to help with my low T symptoms.

The thyroid results are below

Thyroid Panel With TSH
1 of 3TSH 2.450 0.450-4.500 uIU/mL 01
Thyroxine (T4) 6.8 4.5-12.0 ug/dL 01
T3 Uptake 27 24-39 % 01
Free Thyroxine Index 1.8 1.2-4.9

What was your TT, LH and FSH prior to the antidepressant?

Thyroid looks OK. Although I am not great at reading thyroid labs.

 

[JumpBoot]

What was your TT, LH and FSH prior to the antidepressant?

I don't think I've ever had it tested before January. I've had the symptoms for years though and they seem to be getting slowly worse.

Oh, when tested in January my T was 240 with a minimum range of 250. Primary referred me to an Endo who tested me 6 weeks later. T came back 253 with a low range of 250. Endo nurse called me and told me I was fine. No discussion on quality of life.

 

[Megatron28]

I don't think I've ever had it tested before January. I've had the symptoms for years though and they seem to be getting slowly worse.

Oh, when tested in January my T was 240 with a minimum range of 250. Primary referred me to an Endo who tested me 6 weeks later. T came back 253 with a low range of 250. Endo nurse called me and told me I was fine. No discussion on quality of life.

So I don't know for certain, but it seems unlikely that the SSRI would have dropped your T to hypogonadal levels in less than a month. Especially since you had the symptoms prior to the SSRI.

I think you need TRT. I would encourage you to read the Basic TRT Overview thread in this forum. It will give you a better sense for what TRT does and involves. You unfortunately will have to look for a new doctor. I get Test prescribed by my primary doc. So you don't have to necessarily go through an endo.


One strategy often employed is o find a local Compounding Pharmacy near you and ask them which docs prescribe Test, AI's and hCG to their patients. You could then call and ask those docs about their protocols. Find one that sounds good and meets your budget or takes your insurance and away you go.