Might be put on TRT/Labwork results/right track?

[lastone]

I originally went to my physician because I was concerned about my growth. I am 20 and suspect that I may be going through delayed puberty, because even at this age I still have the body structure of a 12 year old and get mistaken for one very often. No body hair besides pubic, no facial hair, no underarm hair, very small bone structure, small testicles/genitals. I only started noticing pubic hair and ejaculation around my junior/senior year of high school. Very late huh? I also suspected low testosterone after a lot of research because I do have many, if not all, of the symptoms. And not just slightly, but definitely. Also I wake up more mornings of the week without morning wood then with. Doc says this is very odd, especially at my age.

Had my first appt. at the physician, hoping for a referral to an endo, but he decided to do some lab work first to figure out what may be the problem. I trust him and he sounds like he probably knows his stuff. He also checked my testes and confirmed that they are indeed smaller than average and something to be of concern. I got sent out for fasting labs and here are the results. (I have other readings also so if you need more info just ask. I have the lab report.)

FSH: 4.3 (1.4-18.1 mIU/mL)
LH: 7.9 (1.5-9.3 mIU/mL)
TSH: 4.691 (0.35-4.5 uIU/mL)
Prolactin: 22.8 (2.1-17.1 ng/mL)
Total Test: 686.71 (350-890 ng/dL)
Free T4: 1.55 (.8-1.8 ng/dL)
Free T3: 4.2 (2.3-4.2 pg/mL)

Now he stated that the testosterone was somewhat in range, but suspected maybe a thyroid problem (hypothyroid I think?) This note was written next to the prolactin level and also the Cholesterol level (251 [0-200 mg/dL]) (I'm not sure if the cholesterol was related to this thyroid issue, I just noticed it was written by it.. but it is way high btw). Other similar out-of-ranges were
Triglyceride: 238 (<150 mg/dL)
VLDL Cholesterol (Calc): 48 (0-40)
LDL Cholesterol (Calc):158 (0-99)
I don't know anything about these or if its related/a problem? Do I have high cholesterol or something?

I also got a Bone Age Study and the results came back showing full closure of all growth plates. I found that really odd because I thought there was no way I was completely through with puberty.. They did xray both wrists. So I guess this means I'm done growing after all??

Anyways he sent me for another bloodwork lab, this one taken around 4pm
Free T3: 4.2
Free T4: 1.72
Prolactin: 4.9
TSH: 1.577
Testosterone: 422

Based on this I think I remember him saying that this rules out the thyroid issue. He also stated that test level was still considerably low for my age. (I do understand that test declines throughout the day). He stated this may be an issue and that I may be put on testosterone replacement therapy (TRT), but not until we get one more testosterone reading to be sure it is too low. Just got that so waiting for results.

In the meantime, I've been doing a lot of research on this, concerning low testosterone, testosterone replacement therapy (TRT), and delayed puberty. I am not another stupid kid looking to get testosterone replacement therapy (TRT) from the docs to get jacked. I am aware of the concern regarding my age and being on testosterone replacement therapy (TRT) for the rest of my life. Not something I'm too happy about. I only want what's best for me and whatever will get me out of all these years of not living up to my potential sexually, emotionally, socially, and physically. I have also been working out almost everyday for over a year and have not been seeing the gains like I should be at all.

My main concern is figuring out my suspected delayed puberty issue. It's been too long.

If anyone has any feedback I would greatly appreciate it. Are we (my physician and I) going about this the right track?

 

[lastone]

Also I have never taken any prohormones, test boosters, or any supplements that would mess with my hormone levels. I'm smarter than that. And I have always been aware of my delayed growth issues.

 

[Dreaded Pirate Roberts]

HCG therapy is what you want to push your test levels and to get your balls to drop. Your test is low for you age. Food is your friend. 3J can help you work on your diet in the diet forum.

 

[MoparMuscle]

How about HGH was that tested? You other test results look ok, the late day tests will always come in lower.

 

[lastone]

No I do not believe HGH was tested. Should it have been?

Any other input?

 

[MoparMuscle]

Well if your growth was stunted it could be your HGH not what it should have been during your "growth years" even if its low i am not sure if supplementing it would help thou now that your growth plates are closed.

 

[ronnie2010]

Very interesting Post "lastone" I think by the end of this you will be on testosterone replacement therapy (TRT) and will probaly be happier about it in the end. I am no expert in this area but it does sound like you are going about things the right way and are doing your research. I am impressed with that alone. Keep us posted on what happens either way. I am going to keep track of this thread. Good luck to you.

 

[cjw2021]

Lastone, did you edit your post to read a 422 test level instead of 622? I'm pretty sure I read this last night and it said 622.

 

[lastone]

No I edited to fix up some grammar and run on sentences, but I checked again to make sure I got it right. It is 422.

Any other advice/input? I spend everyday doing research and stressing until I can talk to my doctor again. It's miserable.

From what I understand, HGH would have been an option, but now that we found out my growth plates are closed, that rules it out? I still find this so odd; how is it that my growth plates are closed but I still feel like I haven't fully matured and my bones structure feels the same as it did when I started high school??

And then maybe Human Chorionic Gonadotropin (HCG) is another option, to push my own natural test production as opposed to replacing with an exogenous source? I will bring this up with my doc the next time I get a chance to talk to him. In the meantime, I'm just trying to build up more information/options. sigh..

 

[MoparMuscle]

Lastone, did you edit your post to read a 422 test level instead of 622? I'm pretty sure I read this last night and it said 622.

The Am one was 686.7 an the 2nd 4pm one was 422 (PM always read lower).

 

[JOWS6]

Your prolactin level is high. Did he mention a pituitary problem? Any headaches or changes in vision?

 

[lastone]

After the first bloodwork, his first suspicion was a thyroid problem or something because of the high prolactin, so he ordered me to get it retested. After the second results came back, he said it was fine so that ruled out that problem. He said that labs aren't always accurate and can come have errors, so that was the reasoning for the retest. But still, what if it wasn't an just error? Shouldn't we have looked more into why it was so high that one time?

And I do have a history of really bad migraines. Had mri's and whatnot all throughout my childhood, but nothing was ever found. This hasn't been a problem for at least the past 5 years or so though. Averaging probably one or two migraines a year, maybe. I do still get headaches every now and then right now, but I'm pretty sure they are due to little things like not eating right, stress, not getting enough sleep. You know, just normal headaches.

 

[ronnie2010]

After the first bloodwork, his first suspicion was a thyroid problem or something because of the high prolactin, so he ordered me to get it retested. After the second results came back, he said it was fine so that ruled out that problem. He said that labs aren't always accurate and can come have errors, so that was the reasoning for the retest. But still, what if it wasn't an just error? Shouldn't we have looked more into why it was so high that one time?

And I do have a history of really bad migraines. Had mri's and whatnot all throughout my childhood, but nothing was ever found. This hasn't been a problem for at least the past 5 years or so though. Averaging probably one or two migraines a year, maybe. I do still get headaches every now and then right now, but I'm pretty sure they are due to little things like not eating right, stress, not getting enough sleep. You know, just normal headaches.

I would think he would do another head MRI and check your pituitary gland. Just as a precaution to rule this problem out. You could ask about it.

 

[lastone]

I just got back from another appointment and I'm now extremely frustrated. Test came back in the 300s, expected.. I have also concluded this physician doesn't have much knowledge about this whole thing. I brought up the use of HCG and he didn't have much to say about it at all. Said there's no need to even check estrogen levels because if it were high then I would have had more breast/nipple development. My nipples are not developed at all btw, there is nothing behind them to even raise the skin. It's hard to explain but if I run my finger across them, it just sinks in and I feel nothing behind them at all, just really thin skin.

He wanted to send me home with either androgel or testim that day. He refused to even consider injections, even after I brought up the inconvenience, price, efficacy, etc. I told him I know for a fact I will not be able to keep up with it every single day either, as I am often rushed for time, especially in the morning. He just kept bringing up the whole rollercoaster effect. He then offered to send me home with Androderm instead. He told me that I would be put on it for a couple month then taken off, to see if my test production improved. I told him I was convinced it didn't work like that and maybe we should look into HCG also, he didn't agree. I refused both test products in the meantime because I do not want to be put on testosterone replacement therapy (TRT) for the rest of my life if there is another proper solution.

I felt like he wasn't really liking the fact that I've been doing so much research and trying to question his knowledge and decisions. It wasn't my intention, but maybe to him it seemed like I thought I knew more than he did.. Eventually he decided that we will get a second opinion before proceeding but said of all the Endos in town, he would only recommend sending me to one certain pediatric endo because apparently she is the most likely to know about the whole delayed puberty issue. I don't think talking to this female endo is going to go any better for me at all, once I even do get to talk to her, probably over month or two away. But maybe she knows more about the endocrine and hormone system..

At this point I am so frustrated I can't think about anything else. I can't sleep, I can't study, all this worrying is just depressing me. I really hope you guys understand my frustration and can help me with some more input. Please.

Do you think a high estrogen level during puberty was what caused my growth plates to close? I just read a couple articles (anabolicminds.com/forum/steroids/29803-growth-plate-closure.html) and am now convinced that is why, and that now it is too late to fix this. I have a young and small face/body, tiny hands and feet, very thin bone structure, and A LOT of butt fat storage.

So should I be pushing for HCG and Aromatase inhibitor (AI) or testosterone replacement therapy (TRT) or both? Dread Pirate Roberts, you said HCG to push my testicles to drop. Any other people want to chime in on this? They definitely have not grown or dropped like they should be. I would say they're just barely bigger than large grape size; it's embarrassing. Most of the day they're sucked up against my body as if I just jumped in cold water.

Living in a college/beach town I am going to be devastated if I am going to have to go another summer looking like a 12 year old boy, being in my senior year. My growth plates are confirmed closed. Tell me WHY I should not look into doing a proper cycle and PCT? If I can't change certain things, the least I want is to be able to look good with my shirt off. Almost two years of working out and my gains are nowhere near what it should be. All I want is for once in life to have normal self esteem. I can't take another year, waiting for all these appointments are not doing anything but racking up my bills.

Chip, I know you have a lot of knowledge in this. Is there anything you can do with giving me advice, since I know I'm probably not eligible to work with you

 

[JOWS6]

It's understandable to be frustrated. Most of us, including me, have been in your shoes; we understand where you are coming from.

http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

Click on that link. It is the American Association of Clinical Endocrinology's guidelines for the treatment and diagnosis of hypogonadism. Tell him/her you want to be treated following these guidelines. If they still refuse, ask why, refer back to this source and point out his fallacies. If they still have their nose in the air, see someone else.

The above link explains HcG, Clomid and everything.

 

[ronnie2010]

Good idea not listening to that doctor. He wanted you to try out testosterone replacement therapy (TRT) for a few months and then take you off to see if your levels improved?? LOL they are not going to improve....putting synthetic Test into your body will not improve your own production. Matter of fact it will supress it. Im sure your dosages are reasonable so it won't do it as much as say a "user" but still.......Stupid for the Doctor to even think that.

I know this won't fix your problem....but in the meantime (while you are waiting for your Endo Doctor) make sure your diet is on point. Eat alot! You gotta eat alot to grow. Keep it fairly clean but eat a ton of it. There are some great stickys here about diet. Also keep working out with the best intensity you can but don't overtrain. If your levels are that low I am sure your body also doesn't recoop well. Overtraining is the enemy to alot of smaller guys. Easy to do really. Keep the sets minimal and the reps low but train intense. Man I am feeling your pain now.
Like I said I know this won't fix your problem but it won't hurt it either. Please keep us all posted.

 

[CHIP WADOWSKI]

I just got back from another appointment and I'm now extremely frustrated. Test came back in the 300s, expected.. I have also concluded this physician doesn't have much knowledge about this whole thing. I brought up the use of Human Chorionic Gonadotropin (HCG) and he didn't have much to say about it at all. Said there's no need to even check estrogen levels because if it were high then I would have had more breast/nipple development. My nipples are not developed at all btw, there is nothing behind them to even raise the skin. It's hard to explain but if I run my finger across them, it just sinks in and I feel nothing behind them at all, just really thin skin.

He wanted to send me home with either androgel or testim that day. He refused to even consider injections, even after I brought up the inconvenience, price, efficacy, etc. I told him I know for a fact I will not be able to keep up with it every single day either, as I am often rushed for time, especially in the morning. He just kept bringing up the whole rollercoaster effect. He then offered to send me home with Androderm instead. He told me that I would be put on it for a couple month then taken off, to see if my test production improved. I told him I was convinced it didn't work like that and maybe we should look into Human Chorionic Gonadotropin (HCG) also, he didn't agree. I refused both test products in the meantime because I do not want to be put on testosterone replacement therapy (TRT) for the rest of my life if there is another proper solution.

I felt like he wasn't really liking the fact that I've been doing so much research and trying to question his knowledge and decisions. It wasn't my intention, but maybe to him it seemed like I thought I knew more than he did.. Eventually he decided that we will get a second opinion before proceeding but said of all the Endos in town, he would only recommend sending me to one certain pediatric endo because apparently she is the most likely to know about the whole delayed puberty issue. I don't think talking to this female endo is going to go any better for me at all, once I even do get to talk to her, probably over month or two away. But maybe she knows more about the endocrine and hormone system..

At this point I am so frustrated I can't think about anything else. I can't sleep, I can't study, all this worrying is just depressing me. I really hope you guys understand my frustration and can help me with some more input. Please.

Do you think a high estrogen level during puberty was what caused my growth plates to close? I just read a couple articles (anabolicminds.com/forum/steroids/29803-growth-plate-closure.html) and am now convinced that is why, and that now it is too late to fix this. I have a young and small face/body, tiny hands and feet, very thin bone structure, and A LOT of butt fat storage.

So should I be pushing for Human Chorionic Gonadotropin (HCG) and Aromatase inhibitor (AI) or testosterone replacement therapy (TRT) or both? Dread Pirate Roberts, you said Human Chorionic Gonadotropin (HCG) to push my testicles to drop. Any other people want to chime in on this? They definitely have not grown or dropped like they should be. I would say they're just barely bigger than large grape size; it's embarrassing. Most of the day they're sucked up against my body as if I just jumped in cold water.

Living in a college/beach town I am going to be devastated if I am going to have to go another summer looking like a 12 year old boy, being in my senior year. My growth plates are confirmed closed. Tell me WHY I should not look into doing a proper cycle and PCT? If I can't change certain things, the least I want is to be able to look good with my shirt off. Almost two years of working out and my gains are nowhere near what it should be. All I want is for once in life to have normal self esteem. I can't take another year, waiting for all these appointments are not doing anything but racking up my bills.

Chip, I know you have a lot of knowledge in this. Is there anything you can do with giving me advice, since I know I'm probably not eligible to work with you

No, but you se when you bust your fucking ASS creating the MAXIMUS NATION, i just NKOW that someone will step and throw you a bone. I havent busted my ass building a TEAM so we can wander as individuals!

 

[cjw2021]

Call Chip, don't even mess around with the expense of time, money, and energy, trying to get your doc to give you a sub par protocol.

 

[CHIP WADOWSKI]

The power of the MAXIMUS NATION is that the larger this team grows tge more resources we have to help otheres that i nay not directly be cable to help or even educatude do to legal constraints, but tgere will be veteren members of the nation that are allowed to speak of experiences and results without doing anything wrong. That is not praticining medicing without a license, that is simple conversation. "MAY THE MAXIMUS NATION" CONTINUE TO THRIVE!

 

[cjw2021]

I'm sure more members would speak if they weren't so busy plundering the booty. Chip's entire protocol is cheaper than one compound another anti aging doc was charging me for, and cheaper than all of my copays if I used insurance...and it works! And there is flexibility, unlike every other doc. One size does not fit all. Some people have different levels of enzyme activity...etc. Biological individuality has been completely abandoned by the medical textbooks in favor of a humanless approach to treatment. If that's your cup of tea, go to your doc and get a shot every 2 weeks where you will feel like shit almost the entire time, if you make it that far. As for your case, SHBG could be high as well.