43 Years Old and Fighting the Docs

Pharma TRT
1

First, Lets do some administrivia…

age: 43
-height: 5â??9â??
-waist; 34 (Around my belly button Iâ??m 44 inches)
-weight: 194lbs

-describe body and facial hair: Heavy beardâ?¦Some chest hair. Very large Gut

-describe where you carry fat and how changed. My Belly. Over the past 4 years it has grown extensively

-health conditions, symptoms [history]: Aseptic Meningitis, MRSA(Infection reached my testes. Lyme patient (in remission). Recovering from Prescription pill addiction (2 years sober)

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever : Was on Zoloft for several years (Now off of that nasty crap) Voltaren Gel, Prilosec
-lab results with ranges T-Total 3 Tests in the last month
â?¢ 3/25 â?? Total T = 238 ng/dl (240 to 887)
â?¢ 4/10 â?? Total T = 280 ng/dl (240 to 887)
â?¢ 4/12 â?? Total T = 239 ng/dl (240 to 887)

-describe diet [some create substantial damage with starvation diets]
â?¢ Balanced Diet. 3 meals a day nothing special

-describe training [some ruin their hormones by over training]
â?¢ I canâ??t run anymore, Try to lift weightsâ?¦no help. End up too sore to function for the next 3 days or so. I swim (5 laps 50 yard pool)

-testes ache, ever, with a fever? Yes. Figured it was a lasting effect from the MRSA

How have morning wood and nocturnal erections changed: I have neither at this point in my life.

Well, to begin with, I am a Statistician for the executive committee at a R&D company dealing with high level computing. I understand the dynamics of statistical studies and how discreet mathematics can be used to understand complex events. But I’ll be honest, the battle I’ve been having with the medical community at large has me stumped. (But I digress)

So over the last year, I’ve been so tired I can’t exert myself without being literally bedridden for several days after the exertion. I also am functionally blind in my left eye, Docs can’t figure out why. I’ve also had my body degenerate from somewhat normal to a beer gutted fat boy.

I’ve gone to literally 10 different doctors who all say everything is fine…you’re just depressed. In the fall of 2011, I had a clever doc test for Lyme disease…came back positive. I was treated with IV antibiotics for 3 months. Felt some degree of relief…vision got better.

But…In the past 2 months, I have truly fallen apart physically (and mentally for that matter). Same Symptoms as before, with a heaping does of mental degradation. I lose my car…I have to take notes to remind me what I am doing from hour to hour

I went to the infectious disease docs who tested for Lyme again to make sure it came back. They also did a testosterone test…which came back at 220 total, with almost zero free test. I was sent to the a series of endo docs who looked at me and said one of the following

  1. It’s all in your head.
  2. Change your Diet (I did…nothing)
  3. You’re getting old…that’s what happens when you age.
  4. Go see a Headshrinker…

Folks, I have never felt so disheartened in my entire life. Maybe I was crazy. All I know is when I mentioned my low T values, they almost got confrontational. Finally I went to see a Endo that did a series of T tests over time. (see above tests). Out of the 3 tests, 2 came back under the normal range value…He still said he couldn’t treat because in his opinion, My T-levels were normal. He completely dismissed the physical manifestations. (Is that a common theme?)

So, for my own edification. I need some help understanding a few things

  1. Would you all consider my T level to be Low?

  2. Why do different doctors use Different ranges to describe the “Normal” test range. I’ve seen ranges from 220 to 880, to 240 to 920, to 300 to 990. This is important in that they are very rigid if you are inside the “Normal” range

  3. In terms of the range again. Is the range based on a bell curve of tested people and their T-values? Meaning, someone at the edge of the normal range would be considered and outlier?

  4. Are Doctors being driven by insurance providers to not diagnose low T? any kind of evidence, either notional or quantifiable would be wonderful.

Sorry for the long post, I’ve got so much on my mind, Just hoping to find some folks who know what I’m going through. My opinion of the medical community in large has gone directly in the crapper. They act like they are scared to death to make a diagnosis.

2

Your case if frighteningly common. Unless you are on your death bed, endos are about as useless as screen door on a submarine. First to answer your questions:

  1. Yes

2/3. The ranges are usually established by the labs, from distribution of patients. So first of all, you can extrapolate that they are likely skewed to the low end and not representative of the entire population (healthy people dont go get tests done). There is also room for variance on the outskirts of those ranges.

  1. Its not so much the insurance providers, its really the government. With the bullshit inquisition that the government has somehow gotten involved in for sports “cheating” and the like, the drugs are tightly controlled and most docs react too cautionary to be of any use.

Now brass tacks.

You need to read through the stickeys, especially the bloodwork stickey, to find out what tests you need.

You also need to find a doctor that is worth a shit. Go to google and search for compounding pharmacies around you–go to the pharmacy and ask for a recommendation for a doc that prescribes Testosterone (as well as Arimidex/Anastrozole and HCG, if possible).

Your comment about your vision in your left eye stood out to me. This could be caused by a pituitary andenoma (benign tumor) pressing on your optical nerve. The most common of these is a prolactinoma, which raises your prolactin and suppresses your LH/FSH, which means your testicles wont get the signal to produce T. You definitely need prolactin, LH, and FSH tested.

I would also recommend an MRI of your pituitary based on the results of those tests.

Check out the stickeys–its a lot to take in but you sound like a pretty smart dude so you can probably digest it pretty quickily. You will have lots of questions and have a lot of legwork to do.

3

Thanks Bud, Appreciate it. I’ve walked through the stickies excellent information. I’ve actualy had a very complete test suite completed in the three tests mentioned above. Two standout oddities. My Monocyte levels were through the roof. And my vitamin D level was low. Other than the testosterone (free and total) being lowish, everything else is within the reference range.

I’ll dig some more, I think I need to educate myself a little better on how discreet tests are dependant on each other.

Also, I have tests that will be coming back early next week. MRI of Optica nerve and Pituitary…funy you mentioned that…very astute.

Also found a local doc to talk to through the compounding pharm. That’s a very powerful resource. Wjojever put that in the stickies needs a nobel prize.

4

Not sure what monocyte levels indicate (too far into hematology for anyone here to take a stab at I imagine) but Vitamin D definitely needs to come up (as it does for most people).

Get a good bioavailable brand (I use Biotics Emulsified drops I bought off Amazon <–Not an Ad, I just like my product!). Take 15,000 iu (not a typo) per day for a couple weeks, and knock it back down to 6k iu or so per day ongoing.

5

Quick Update.

Went to see the Urologist I found by talking to the local compounding pharmacy (thanks T-Nation for that hint). Holy Hannah, this guy was great! I had already sent over blood work taken from the previous 2 months by the Douchebag Endo’s I’d been seeing (Seriously, how do these people sleep at night) He sat down with me and explained my blood work profile was very similar to that of a 3 month pregnant woman…High estrogen, low T, high thyroid etc…TBPH, I laughed my ass off at this statement…until he produced study profiles from John’s Hopkins and compared my levels to the study results. Very Sobering. Also explains why low t guys pack on gut fat.

The interesting part was the exam. He looked me over, but looked at ridges on my fingernails…the fat levels on my arms and legs. He spent an inordinate amount of time pinching and patting my fat gut…I guess everyone likes to tortures a fat boy (but I digress…again). He also checked my testes, which have varicocele masses on both. Also had cysts from the vasectomy that was performed in 2007. The sad part of all of this is the testicles were all but nonfunctioning. (Soft and atrophied)?could have probably averted this if the docs had been a bit more thorough when I first reported the problem back in 2009. Now they are just lumps of flesh?so sad. I liked my boys
So he explains the complete lack of care the mainstream for profit medical systems engage in…Essentially, there are two aspects in his opinion. 1 - They don’t want to teach the docs what to look for and how to treat because it’s expensive for the provider to perform…thus shrinking their profit margin. And 2 - The Pharmaceutical companies are highly resistant to suggest treatment for some unknown reason (I suspect people get better and don’t need to tak as many pills and such).

All in all, the medical community has let us down

He took one more round of blood work to look at T-4 and T-7? Didn’t truly understand this particular piece of the puzzle. In the middle of researching the issue.

The general outcome of this meeting was I am going to be going on injectable T next Tuesday, with maybe an additional med to control my thyroid.

I know I’m being a little sparse on details…but we all know the test details and what they mean (At least I’ve gotten to the point where I can read the results page) Plus when you find the right doctor who knows how to react to the tests, I think the conversation shifts to description of current physical and emotional baseline so you can measure the impact of treatment…Right?

Anyone else go through this type of event (meeting a doc who knows his business)?

6

What did he say about your possible pituitary andenoma and low Vit D levels?

Looks like you’ve found a pretty good doc.

Though I think some more legwork up front before starting exogenous T would be in order. At least an HCG challenge to see if your atrophied nuts can respond. IMO definitely worth the effort before committing to lifelong TRT. If you have had such a lack of signal to them for so long (due to andenoma or other reasons) HCG may bring them back to life.

7

He went over a MRI from 3 months ago (with contrast) of that portion of my melon. pituitary is intact no tumors or reduced bloodflow. He wrote the vit-d levels off to a southerner moving up north (oklahoma to minnesota) Seems if you are raised down south, you have a greater chance of having low D. Going to continue bringing the d levels up with supplements.

I
ll call today and ask about HCG challenge. MAkes sense to do our due diligence.

8

Time for an update.

Went back to the urologist yesterday. Got results back on my tests pre-injection cycle. I was suprised when he diagnosed me with Hashimoto’s syndrome. Go figure. My thyroid values and inflamation values plus low-t (which was 235 total, 1.2ng/dl, e2 = 65).

So we have decided that TRT is called for in earnest. 200mg once a week to start with. He’s not going to worry about the E2 until 6 weeks have gone by. He also informed me I would most likely put on 10 or so pounds of water weight until they could effectively attack the estrogen.

I have to remember that patience is a virtue. There is no quick fix when it comes to low t and now malfunctioning thyroid.

That is all.

Thanks

9

I think we are now in the age of self treatment. More and more people rely on google to treat themselves. If your testosterone levels are low, there are many avenues to go to treat it. You can try the natural supplement route, you can try the testosterone cream, and/or injectables. All can be purchased over the internet. And contrary to many worries about going to jail, nobody is going to arrest you for simply taking testosterone for yourself.

There will not be cops breaking down your door. law enforement care about people who sell, not people who use. If you need arimidex to control estrogen, buy it yourself. If you need testosterone, in whatever form, by it yourself. To have to go through dr’s, have to go to them everytime you need an injection. And if you don’t see them on a regular basis, they won’t continue with the prescription. Who needs that aggrivation.

10

Are you self-injecting?
200 MG is kind of heavy, the key is to listen to your body and adjust you dosage. You don?t say anything about AI. Look for signs that your nipples are soar of tingly.
I would also try and break up doses to create a steady state. Half-life of Testosterone cypionate is 8 days so 200mg once a week will be a big swing.
Good luck

11

[quote]Splody wrote:
Time for an update.

Went back to the urologist yesterday. Got results back on my tests pre-injection cycle. I was suprised when he diagnosed me with Hashimoto’s syndrome. Go figure. My thyroid values and inflamation values plus low-t (which was 235 total, 1.2ng/dl, e2 = 65).

So we have decided that TRT is called for in earnest. 200mg once a week to start with. He’s not going to worry about the E2 until 6 weeks have gone by. He also informed me I would most likely put on 10 or so pounds of water weight until they could effectively attack the estrogen.

I have to remember that patience is a virtue. There is no quick fix when it comes to low t and now malfunctioning thyroid.

That is all.

Thanks[/quote]

Your E2 is high already almost 3x the recommended value on here. At 200mg this is a high dosage for trt you will see a substantial rise in E2. Not sure why the doctor wants to wait 6 weeks when based on your value now you could be taking an AI let alone after Test Shots.

If you plan on taking 200mg a week do yourself a favour and split it into 2 injections.

Good luck with it but If I was you I would try and get the doctor give you an AI now. If he is prepared to give you an AI in 6 weeks he might as well give it to you now.

12

Self Injecting - Yes. Was given a 10 week supply of injectable T

I’m already going to split the dosage into 2. I think it gives me a better chance to keep a more stable level of T in my body.

As far as taking an AI, I’ve got a call into the doc right now.

RogueV - I understand that sentiment. Went through the whole thought process when I was getting the run around with the endo docs. I’ve tried diet changes, Suppliments, every other day sexual escapades(the wife is a good sport, but not that good of a sport) nothing caused that T level to move more than 25 points +/-

13

Update:

Was having all kinds of wierdness after starting my injections. Talked to the doc last week. We agreed to split the doseage into 2 shots. No big deal. But this last Sunday, out of the blue I grew moobs…I was rather emotional…and for the life of me, I couldn’t get myself in gear. I could sleep for hours. So on monday I called the doc and said "Something is going on that sounds like this(I told him my symptoms)

I went in for blood work that afternoon.

He called back yesterday to tell me my E2 had gone up to 72 and my T levels were still around 290 total and my free T was .89 pg/mL. He called in a script of Arimidex (.5mg daily until he sees me in the middle of june).

So to me (and correct me if I’m wrong) it looks as if the Testosterone is being converted to E2? and this E2 is binding to receptors enough as to block testosterone from binding. And to top it off, there isn’t enough T avalible to bind effectively.

Right?

To me, this finding the balance process is physicly and emotionaly trying. Is is normal for folks to go through this kind of battle?

Also, Today I hit a nerve in my thigh when doing the self injection…holy Hannah…very hurty…and who knew a leg could jump like that. How the heck do you avoid that particularly wonderful experience? (I changed the needle and moved about a half inch to the left and the injection went fine…but The curse words are still on the tip of my tongue)

Thanks in advance,

Splody

14

T and E2 do not occupy the same receptors.

Your E2 is overriding the benefits of T.

What were your T levels when you got them checked with E2 =72?

You do not grow boobs “out of the blue” it was most likely water weight and not gyno.

15

Total T-level was 292.

Yeah, it was most likely water (I’ve put on 17 pounds since the first injection).

16

And for the record…“Boobs out of the blue” just sounds fricken funny as hell.

17

[quote]Splody wrote:
Update:

Was having all kinds of wierdness after starting my injections. Talked to the doc last week. We agreed to split the doseage into 2 shots. No big deal. But this last Sunday, out of the blue I grew moobs…I was rather emotional…and for the life of me, I couldn’t get myself in gear. I could sleep for hours. So on monday I called the doc and said "Something is going on that sounds like this(I told him my symptoms)

I went in for blood work that afternoon.

He called back yesterday to tell me my E2 had gone up to 72 and my T levels were still around 290 total and my free T was .89 ng/mL. He called in a script of Arimidex (.5mg daily until he sees me in the middle of june).

So to me (and correct me if I’m wrong) it looks as if the Testosterone is being converted to E2? and this E2 is binding to receptors enough as to block testosterone from binding. And to top it off, there isn’t enough T avalible to bind effectively.

Right?

To me, this finding the balance process is physicly and emotionaly trying. Is is normal for folks to go through this kind of battle?

Thanks in advance,

Splody[/quote]

This doctor of yours goes from 1 extreme to another. First it was no AI now it is .5mg daily which is a lot.

It has always been said to start on a lower dose and if needed increase. Good news is you have a script and can dose as you want. Check out the stickies what is recommended as a starting dose and then adjust from there.

I think you could maybe try .5mg E3d and adjust as necessary.

Or take the .5mg daily but be prepared for the consequences if you drop your e2 down too much. Some people are over responders and can get by on very low doses weekly.

18

Yep, read that in the stickies. I may dial it back to 3 times a week.

Thanks.

So does everyone go through these events when first starting TRT? I’ve been reading like mad, but there isn’t a lot of posts from guys just starting.

19

Your T levels were 292 while on injections? That doesn’t make any sense.

How many injections had you done up to that point? How long after your last injection was your blood draw? Are you performing them intramuscularly or subcutaneously? What sort of needle?

Something is amiss here.

20

4 injections so far. 3 200mg, 1 100mg. Intramuscular (thigh)

Last blood Draw was on Monday(4/7). Last injection was 100mg on Sunday(4/7)