Opinions and experience please, don't know what to do..

[Benjammin]

Hey guys,

I'm a fit, physically healthy 23 year old male and got my lab back confirming a free testosterone level of "29.9" on a scale of "31-94."

Needless to say I feel like complete shit in lots of ways, especially mentally, but I won't bore you with the symptoms as i'm sure you all know what they are.

Anyways, I've got an appointment with "Dr. Larry Komer" in Burlington Ontario who apparently is a testosterone replacement therapy (TRT) guru and he runs "Masters Mens Clinic" - his treatment centre.

The only problem is that the appointment is 8 months away and I honestly cannot imagine waiting that long feeling the way I do. My life is awful and I need to find out if testosterone replacement therapy (TRT) is the answer.

Now, I also have an appointment with a endocrinologist tomorrow morning that was booked prior to me getting an appointment with Dr. Komer.

So my concern is:

1. Should I try to get treatment from the endo?

2. If I do, i'm concerned that she won't know how to monitor my hormones as proper as Dr. Komer will and that she may simply prescribe it and be done with me, possibly putting me on a hellish hormonal roller coaster.

3. If I show up at Dr. Komer's appointment 8 months from now already on testosterone replacement therapy (TRT), will he feel I did something wrong and not treat me? Or will he take me in understandingly and tweak all of my levels appropriately because he specializes in testosterone replacement therapy (TRT) not thinking anything of it?

I don't know what to tell you guys, I feel absolutely awful and on the one hand want to see if this treatment works ASAP and on the other want to get the treatment done properly by a renowned specialist in TRT.

Who knows maybe the blood tests that the endo will conduct will show my levels on the low end of normal in which case she probably won't treat me anyways because she is an endo.

However Dr. Komer believes in optimal levels and therefore i'm assuming will be pro TRT.

Any thoughts, experience and opinions will be GREATLY appreciated.

I don't know how much longer I can go on feeling the way I do.

Ben

 

[300winmag]

Well I would see the endo nothing to lose. Free testosterone is not reall an indicator that you have a Test problem and need treatment and being a 29 and being that little out of range may not be enough to send out an alarm, your more or less looking at total testosterone. Many endos do testosterone replacement therapy (TRT) and do it great so I wouldnt be scared there. Either way the endo should be able to give you a whole picture of your endocrine system and what else might be going on, it may not be a test problem. Your best best bet is to get all the blood test done and see where you sit. Get whole blood panel done, to include, total test, estrodial, LH, FSH, cholesterol, thryoid function, PSA, iron, blood sugar, and get a cortisol jug test. It may also be advisable to get an MRI of your pituatary to check for a tumor on that(dont worry not cancerous) but can indicate a low T problem. I would also throw in testing for hepatitus and HIV as you never know. I would start there. But unless something is massively wrong and at your age I dont know how many docs are going to put you on testosterone replacement therapy (TRT), I would just be prepared for that.

If that is the case you have to look at your lifestyle which you should check it out anyways. 1. Sleep; regular 7-9hours every night, going to bed and waking up the same time. 2. Diet at least 3 meals a day, healthy meals not monsters for breakfast, and snacks or small meals in between. 3. Alcohol intake or other recreational drugs. 4. All perscriptions you might have and what some side effects are, also check your supplements, they are good and I use them but many people poison themselves with them. 5. Mental disorders or issues, might need a shrink if you do, first step is being honest with yourself if you really have a problem. 6. Working out, are you working out at least 3-4 times a week to include some cardio, a mild weight lifting regimen of throwing up a few weights is not the best work out, or are you active in general, or do you sit on the couch alot? 7. Sex life may want safely engage in one if you do not have one as there are many benefits to it,including feeling better.

But really being lethargic can be chaulked up to many things and I wouldnt necessarily point to low test levels out of the gate. But I wouldnt hold off thinking this other doc is going to scold you or you are on the wrong path. At least going to the endo can rule out some stuff at a minum. And if you do start on something and dont want to go all haywire the basics of testosterone replacement therapy (TRT) is usually a shot once every 7 days and usually consist of testosterone cyponate or ethanate and the average is 100-150mg per 7 days, there are some variations but that is the norm per say. Some guys going on Human Chorionic Gonadotropin (HCG) to help maintain fertility to keep their balls bigger as most people experience some shrinkage from testosterone, the average for this is probably 500-1000IUS over a week sometimes every other day or every three days. Than some guys take an anti estrogen at .25mg to 1mg every week, sometimes at every other day or twice a week. Again these are roughly the norms so you should fall into these somewhere. Test also comes in gels and patches, which for a lot of guys specially younger do not work, so possibly expect to be put on these first. Keep in mind Human Chorionic Gonadotropin (HCG) is usually not covered by insurance and can be costly anywhere from 120-200 bucks a vial which can last 2-3 months.

At your age you may want to look at Clomid and doing a Clomid restart first, this might be the best best and cure the problem. Also testosterone replacement therapy (TRT) can affect your ability to have children which may not be important but will later trust me. But Human Chorionic Gonadotropin (HCG) can mitigate this and also coming off testosterone replacement therapy (TRT) most guys are able to have children, but there is a risk you wont be able to or will have difficulty. But before you start any testosterone replacement therapy (TRT) be sure to have a spermanalysis done to get a baseline, and probably do another one 6-12 months in to see where you are at.


be sure to look at all options, I am only 30 and started testosterone replacement therapy (TRT) a year ago, its been great, but let me tell you and most would agree it is a pain in the arse, I would much rather go the next 50-60 years without having to needle myself every week multiple times.

 

[Benjammin]

Well I would see the endo nothing to lose. Free testosterone is not reall an indicator that you have a Test problem and need treatment and being a 29 and being that little out of range may not be enough to send out an alarm, your more or less looking at total testosterone. Many endos do testosterone replacement therapy (TRT) and do it great so I wouldnt be scared there. Either way the endo should be able to give you a whole picture of your endocrine system and what else might be going on, it may not be a test problem. Your best best bet is to get all the blood test done and see where you sit. Get whole blood panel done, to include, total test, estrodial, LH, FSH, cholesterol, thryoid function, PSA, iron, blood sugar, and get a cortisol jug test. It may also be advisable to get an MRI of your pituatary to check for a tumor on that(dont worry not cancerous) but can indicate a low T problem. I would also throw in testing for hepatitus and HIV as you never know. I would start there. But unless something is massively wrong and at your age I dont know how many docs are going to put you on testosterone replacement therapy (TRT), I would just be prepared for that.

If that is the case you have to look at your lifestyle which you should check it out anyways. 1. Sleep; regular 7-9hours every night, going to bed and waking up the same time. 2. Diet at least 3 meals a day, healthy meals not monsters for breakfast, and snacks or small meals in between. 3. Alcohol intake or other recreational drugs. 4. All perscriptions you might have and what some side effects are, also check your supplements, they are good and I use them but many people poison themselves with them. 5. Mental disorders or issues, might need a shrink if you do, first step is being honest with yourself if you really have a problem. 6. Working out, are you working out at least 3-4 times a week to include some cardio, a mild weight lifting regimen of throwing up a few weights is not the best work out, or are you active in general, or do you sit on the couch alot? 7. Sex life may want safely engage in one if you do not have one as there are many benefits to it,including feeling better.

But really being lethargic can be chaulked up to many things and I wouldnt necessarily point to low test levels out of the gate. But I wouldnt hold off thinking this other doc is going to scold you or you are on the wrong path. At least going to the endo can rule out some stuff at a minum. And if you do start on something and dont want to go all haywire the basics of testosterone replacement therapy (TRT) is usually a shot once every 7 days and usually consist of testosterone cyponate or ethanate and the average is 100-150mg per 7 days, there are some variations but that is the norm per say. Some guys going on HCG to help maintain fertility to keep their balls bigger as most people experience some shrinkage from testosterone, the average for this is probably 500-1000IUS over a week sometimes every other day or every three days. Than some guys take an anti estrogen at .25mg to 1mg every week, sometimes at every other day or twice a week. Again these are roughly the norms so you should fall into these somewhere. Test also comes in gels and patches, which for a lot of guys specially younger do not work, so possibly expect to be put on these first. Keep in mind HCG is usually not covered by insurance and can be costly anywhere from 120-200 bucks a vial which can last 2-3 months.

At your age you may want to look at Clomid and doing a Clomid restart first, this might be the best best and cure the problem. Also testosterone replacement therapy (TRT) can affect your ability to have children which may not be important but will later trust me. But HCG can mitigate this and also coming off testosterone replacement therapy (TRT) most guys are able to have children, but there is a risk you wont be able to or will have difficulty. But before you start any testosterone replacement therapy (TRT) be sure to have a spermanalysis done to get a baseline, and probably do another one 6-12 months in to see where you are at.


be sure to look at all options, I am only 30 and started testosterone replacement therapy (TRT) a year ago, its been great, but let me tell you and most would agree it is a pain in the arse, I would much rather go the next 50-60 years without having to needle myself every week multiple times.

Hey 300winmag,

Thank you kindly for your exceptionally detailed response.

I want to add that:

-I have a healthy diet

-My job gives me plenty of exercise and I also go to the gym approx 3 times a week as well as play hockey and golf when I feel up to it

-I regularly get 8 hours of sleep a night and still wake up feeling exhausted

-I have no prescriptions

-I rarely ever drink

-supplements include fish oil, 2000 iud vitamin d, vitamin c, magnesium, B multi vitamin

-I have plenty of sex with my girlfriend but it's really only for her sake and I feel like im quite literally just "going through the motions".. I could just as easily not have sex because I just don't have a sex drive

-In fact I lead an exceptionally healthy lifestyle for someone my age I have to say

Also, Low T can mimic mental illness and i've done a lot of research suggesting that the "range" for testosterone is arbitrary and outdated and should be conducted by age.

Since I am only 23 years old I am in the "peak" of what my testosterone will ever be and I have to say it is VERY alarming to discover that my free testosterone is out of range low.

My total testosterone came back at "12.1" on a scale of "6-27." I'm not really sure what that is converted to in ng/dl but it is in the lower half of the range and that concerns me because this is the best my testosterone will ever read.

All I can say is that I am miserable, irritable, angry, I get hot flashes, I cannot focus, I have no motivation, no sex drive, anxious, depressed, and generally just do not care about anything and wouldn't even bother getting out of bed in the morning if I didn't have to.

At 23, with a healthy life style, it very much feels to me like there is something that is off, and from all my research my levels are in fact quite low for my age.

It's all I really have to hope for at this point.

Ben