Testosterone replacement therapy (TRT) at 21? (with bloods)

[bloz]

TRT at 21? (with bloods)

Contemplating whether or not I should begin TRT. Long story, I'll try and keep it short. Went to an endo 3 years ago and had a blood workup because I had very low libido and childhood gyno. Prolactin came back slightly above normal, total test was low-normal at 470ng/dl (250-1100). Dr. ran an MRI, discovered I had a pituitary micro-adenoma measuring 3mm. Said there was nothing wrong with me and sent me on my way.

So I went to see another endo, did a more complete workup and said I was normal, but we should monitor the adenoma to see what happens. Still didn't solve my libido/ED issues.

Couple years later when I was 20 I decided to do a PH cycle, thinking wtf I got nothing to loose anyway. Stupid idea. took 4 months to recover with proper post cycle therapy (pct). At this point libido and general feeling of well being was worse then before the cycle. So then I did another PH cycle and had to stop 2 weeks into it due to side effects. I started HCG, nolva, clomid, adex PCT proper dosages/duration etc. Its been 6 months since ending PCT and I'm not sure I'll ever come back, even to the low level of libido and/or test level I had before.

Right now I am having depression, mood swings, night sweats, hot flashes, weak libido, ED problems, extreme hunger, generally feel like shit.

I explained what I did and how I'm feeling to my endo and he said based on my current labs I am "normal" and don't require treatment. I have been to a urologist before that said I should be put on testosterone replacement therapy (TRT) immediately and this will solve all my problems. I didn't follow up because i wasn't sure that was the right decision at the time, now I'm reconsidering. On top of it, it's impossible to really differentiate if all of this is being worsened or cause by the pituitary adenoma or if it's just from my own stupidity. As a side note, I did have blood work during PCT which I can post up if necessary.

If someone could please help me make some sense of these results I would appreciate it, I'm about to jump on testosterone replacement therapy (TRT) as I don't want to feel like shit for the rest of my life.

Current Important Lab values:

RDW: 15.1H (11-15%)

Total Test: 433 (250-1100)
Free: 80.4 (46-224)
Bioavailable: 168.9 (110.0-575.0)
SHBG: 21 (10-50)
Albumin, Serum: 4.6 (3.6-5.1)
Androstenedione: 241H (50-220)
DHT: 19 (16-79) Seems very low

FSH: 8.1 H (1.6-8.0)
LH: 3.5 (1.5-9.3)
Estradiol: <15 (<=39) Not a male specific assay, seems low
DHEA Sulfate: 295 (110-510)
Estrogens, tot, serum: 53 (<=130) Seems low

 

[theguy9129]

your t is low but not crazy low that could get better with eat sleep and working out, now your e is low. Maybe a low dose of T would be enough to spike your t levels a little and your E levels.

 

[bloz]

your t is low but not crazy low that could get better with eat sleep and working out, now your e is low. Maybe a low dose of T would be enough to spike your t levels a little and your E levels.

Thanks, but that doesn't do anything to explain why this is happening. I've been working out for 4 years, diet is fine. Sleep is shitty nothing I can do about that. If I'm going to shut myself down for the rest of my life I'd like to know why my body isn't working.

 

[RedLang]

Have you check thyroid? Full panel including rt3?
Seems you have adequate androstenedione just not converting to testosterone. Sometimes this can can be caused by an insulin resistance etc diabetes.
Is this a one off test of do you have multiple tests with sames values? You will def want to get the sensitive e2 as well. That one is not a good guide at all.
Hows your cholesterol?

 

[Megatron28]

Why can't you do anything about getting enough good-quality sleep? Seems like that would potentially make a huge difference in how you feel.

I don't know much about pituitary adenomas, but my understanding is that it is fairly common for lots of people to have them but they never cause any sorts of problems or worsen. Kind of like lots of people can have slow-growth prostate cancer that will never harm them. Is this what the doctors are saying is your case?

 

[bloz]

Have you check thyroid? Full panel including rt3?
Seems you have adequate androstenedione just not converting to testosterone. Sometimes this can can be caused by an insulin resistance etc diabetes.
Is this a one off test of do you have multiple tests with sames values? You will def want to get the sensitive e2 as well. That one is not a good guide at all.
Hows your cholesterol?

I dont have any insulin issues. Fasting glucose was 77. I have multiple tests with total T levels of 394, 470, 520, and 430 respectively. My second to last blood test was while on HCG clomid and nolva in January. Total T was 933, LH was 8.3 and FSH was 11.3. All of which I would assume demonstrate that I do not have primary hypogonadism. But all the values dropped as soon as i got off of everything. Cholesterol was a couple years ago, total cholesterol was 150.

I'm having cholesterol, thyroid, prolactin, cortisol, and igf tested this week. My doc never orders t3 for some reason, any reason a problem wouldn't show up in tsh or t4? Ill post up results when I have them

Why can't you do anything about getting enough good-quality sleep? Seems like that would potentially make a huge difference in how you feel.

I don't know much about pituitary adenomas, but my understanding is that it is fairly common for lots of people to have them but they never cause any sorts of problems or worsen. Kind of like lots of people can have slow-growth prostate cancer that will never harm them. Is this what the doctors are saying is your case?

The lack of sleep is really beyond my control I haven't been able to stay asleep more than 6 hrs 7 tops for the last few years.

You're right in that pituitary adenomas are fairly common, but they are known to cause hyper or hypo hormonal problems. Most Dr.'s wont really do anything if they aren't growing, mine has shown to stable in size. The thing is there is no way to prove that it's not cause causing problem which is why I am concerned.

 

[Megatron28]

I would be concerned too if I had a pituitary adenoma!

Have you tried doing a sleep study? Can't poor sleeping cause a lot of the same symptoms one experiences with Low T?

 

[RedLang]

Having high fsh and lh would suggest primary. Those numbers are slightly elevated. Your T levels arent too bad which is why i asked about thyroid. Although symptoms are relative to the person, so it could quite possibly be testosterone also.

Basically T4 gets converted into t3, which is the active hormone that controls metabolism and other endocrine systems cells need. You can have perfectly normal t4 levels but still have t3 issues. Rt3 is antogonistic to t3 and can compete for same receptors.

Your symptoms point to either one. What is your current physicians diagnosis?

 

[RedLang]

I would be concerned too if I had a pituitary adenoma!

Have you tried doing a sleep study? Can't poor sleeping cause a lot of the same symptoms one experiences with Low T?

Yes it most certainly can. It does do it directly ( testosterone is produced at different stages of the sleep cycle) , but also through a chain of hormonal events starting with sleep deprivation.

Sleep study would definately be a must imo.