Misdiagnosed as "Adult ADD" ; baseline labs -- starting TRT

[Atlman65]

Hi Guys,

I actually went to a psychiatrist for symptoms of "brain fog / can't focus"; irritability; poor sleep, fatigue, anhedonia, low libido and was dignosed with adult ADHD. Started taking Adderall. This seemed to help some but amphetamines will wake anyone up. While reading an adult ADHD message board I clicked a banner ad for TRT and saw all of my symptoms as symptom of low T. Thinking "what would be more likely at age 50 -- newfound ADHD or low T"? I got tested and had the following results:

Free Testosterone 4.7 ( 7.2-24)
Testosterone 430 (348-1197)
Estradiol 12.9 (7.6-42.6)
HCT 38
Cholesterol 189
PSA 0.4

I thought I would be disqualified by testosterone of 430 but the doc said the free T is what really matters and I would be a perfect candidate. I must have high steroid binding globulin (not measured)

He is starting me out on 2 doses of 250mg HCG on day 1 and 2 followed by 100mg of testosterone-cypionate on day 3 (weekly injections) (I am 5ft 11 in, 168lbs, 15% body fat, vegetarian diet)

I received my first injections of HCG and testosterone in the office and I must say I have felt Euphoric which I know is something that won't last as my body acclimates (unfortunately). Also more hungry and craving more protein than I typically eat. I will get tested and have meds adjusted (including aromatase inhibitor if needed) in October.

What do you guys think. Am I on the right track? Do you think most would have treated based on my low normal total T? From what I have read I am wondering if I should be doing HCG 3 x weekly and / or splitting testosterone to twice weekly. Am I being over / under treated or do you think this is a good start?

Thanks in advance

 

[3J]

there we go.. youre a vegeterian?

 

[Milton]

Hi Guys,

I actually went to a psychiatrist for symptoms of "brain fog / can't focus"; irritability; poor sleep, fatigue, anhedonia, low libido and was dignosed with adult ADHD. Started taking Adderall. This seemed to help some but amphetamines will wake anyone up. While reading an adult ADHD message board I clicked a banner ad for TRT and saw all of my symptoms as symptom of low T. Thinking "what would be more likely at age 50 -- newfound ADHD or low T"? I got tested and had the following results:

Free Testosterone 4.7 ( 7.2-24)
Testosterone 430 (348-1197)
Estradiol 12.9 (7.6-42.6)
HCT 38
Cholesterol 189
PSA 0.4

I thought I would be disqualified by testosterone of 430 but the doc said the free T is what really matters and I would be a perfect candidate. I must have high steroid binding globulin (not measured)

He is starting me out on 2 doses of 250mg HCG on day 1 and 2 followed by 100mg of testosterone-cypionate on day 3 (weekly injections) (I am 5ft 11 in, 168lbs, 15% body fat, vegetarian diet)

I received my first injections of HCG and testosterone in the office and I must say I have felt Euphoric which I know is something that won't last as my body acclimates (unfortunately). Also more hungry and craving more protein than I typically eat. I will get tested and have meds adjusted (including aromatase inhibitor if needed) in October.

What do you guys think. Am I on the right track? Do you think most would have treated based on my low normal total T? From what I have read I am wondering if I should be doing HCG 3 x weekly and / or splitting testosterone to twice weekly. Am I being over / under treated or do you think this is a good start?

Thanks in advance

what kind of protein you getting into your system?

 

[Atlman65]

I actually love meat but gave it up in Aug 2014 due to cholesterol in 240's range and it dropped to 170's to low 180's with this single diet change.

 

[Atlman65]

Not enough!! Probably 60- 80g /day max. Will have to make some changes as I have been very hungry and craving protein a lot more than usual. I have been eating protein bars / shakes between meals.

 

[3J]

its also likely why your test levels were so low

 

[Atlman65]

I had not thought about my low protein diet messing with my testosterone but I just did a quick literature search and you are absolutely right 3J. I improved my cholesterol at the expense of basically developing hypogonadism. I will probably continue TRT for now (it feels good) but will have to seriously re assess the vegetarian thing. The diet has hurt my progress in the gym too. Here is a link to a sentinel article:
press.endocrine.org/doi/pdf/10.1210/jcem.85.1.6291

 

[3J]

veggie dieting is crap imo...

but im biased.. i love meat lol

 

[B_Doc]

This is interesting to me as I feel I'm going through same thing however only mid 30s. I had some emergency surgery when I was 16 on my boys. Never had body hair and started loving hair at age 18... I've been reluctant to get tested. But like you I was told it was depression and add. Thinking I guess its time to get a test for my t levels. Absolutely no libido either. And yea, I eat meat. 5'8 172lbs but a small belly past few years I can't shake.

Anyways, thanks for sharing this I think it's time for me to go to doc.

 

[Mprtz]

Depending on HDL and the presence of other risk factors, a total cholesterol of 240 is not a reason for a drastic lifestyle change IMO.

 

[halfwit]

Depending on HDL and the presence of other risk factors, a total cholesterol of 240 is not a reason for a drastic lifestyle change IMO.

Just wait for all the patents on the statins expire; I bet chol "the boogeyman" esterol gets a revamp, and is found to be in a completely different light.


Oh, I have ADHD AND am on TRT.

 

[Atlman65]

Hi B Doc --
I recommend getting checked by someone who does it all the time. Your primary care doc will likely look at one number -- the total testosterone with a strict cut off. A specialist (or TRT clinic) will likely consider the "big picture" -- symptoms, total testosterone, free testosterone etc. I'm from ATL and plenty of options. I'm also prior military.

 

[Atlman65]

I hear you. I have relatively high HDL (64-67), no risk factors. I was just trying to avoid cholesterol meds as I thought this would be more drastic than diet / exercise. As it turned out, I fixed my chol at the expense of my endocrine system and mental well being.

 

[Atlman65]

I hear you. I have relatively high HDL (64-67), no risk factors. I was just trying to avoid cholesterol meds as I thought this would be more drastic than diet / exercise. As it turned out, I fixed my chol at the expense of my endocrine system and mental well being.

 

[3K1W]

I'm in the same exact boat. I've been on Adderall for a couple of years now. It barely helps. I finally found out that low T can cause what I'm feeling so I went to the doctor. I got my results back today and my free T is .05 ng/ml. I cannot wait to get on TRT and ditch the Adderall!

 

[Atlman65]

3K1W--Sounds like we are starting this journey together. Had my first injection on Monday. Felt better on Tues than I ever have (much more significant improvement than Adderall). Keep us posted on your progress.

 

[3K1W]

I just got my follow up today. The doctor prescribed 100mg Test Cyp per week. I have to go to his office for the first four injections and after that I get to inject myself. My Test is 190 ng/dl. He doesn't have a goal number in mind other than "over 300" .
I got the prescription called in, but the pharmacy has to order it. That sucks so bad, because I can't wait to get started.

 

[Atlman65]

Thanks for the update
Consider 250 mcg HCG twice weekly to maintain testicular size and fertility. There is an app called TRT analyzer that will help you track improvement in symptoms day by day and relative to medication dosage. This may help with your titration. Read a lot and be your own advocate with the doc. Make sure he follows your estrogen as well. Good luck!