Dead End w/ Docs -- Low T

Pharma / TRT Testosterone Replacement
1

-Age: 29
-Height: 5’9
-Waist: 34
-Weight: 190
-Describe body and facial hair: Can only grow bits of facial hair above and under lip and a little on chip. No chest hair, a little hair on arms and legs
-Describe where you carry fat and how changed: Majority of fat stomach/love handles…
-Health conditions, symptoms [history]:
I donated a kidney about 8 years ago, single one is working fine. Had a vasectomy about 4 years ago.
-Diet: Pretty much vegetarian with seafood maybe once every other week, sometimes once a week. Get protein from “fake” meat sources (boca, etc).
-Training: Lift 3x a week, cardio 3x a week
-Testes don’t ache, ever
-Morning wood doesn’t exist anymore; nocturnal sometimes

Best way to describe what I’m feeling is like crap all the time. I wake up fatigued and stay that way pretty much all day. I feel foggy, forgetful, aggitated, unmotivated, low labido, depressed, anxious at times…probably more, but that’s all I can think of right now.

Test Results

VITAMIN D, 25-HYDROXY 24 ng/mL 20-100
TSH (Thyroid Stimulating Hormone) 2.318 uIU/mL 0.320-5.500

SHBG
SEX HORMONE BINDING GLOBULIN, MASS 22 nmol/L 10 to 50
Testosterone
Testosterone, TOTAL 341 ng/dL 250-1100
Testosterone free 79.4 pg/mL 35.0-155.0

White Blood Cell Differential
Neutrophils auto count 2.6 thous/mm3 1.5-7.5
Lymphocytes, automated count 1.9 thous/mm3 0.8-3.5
Monocytes, automated count 0.4 thous/mm3 0.0-1.0
Eosinophils, automated count 0.2 thous/mm3 0.0-0.4
Basophils, automated count 0 thous/mm3 0.0-0.2
Neutrophils %, automated count 51.4 %
Lymphocytes %, automated count 38.1 %
Monos %, auto 7.1 %
Eosinophils %, automated count 3.2 %
Basophils %, automated count 0.2 %

Chemestry Panel
Sodium 143 mEq/L 135-145
Potassium 4.2 mEq/L 3.5-5.0
Chloride 108 mEq/L 98-109
CO2 28 mmol/L 20-31
BUN 10 mg/dL 23-Jul
Creatinine 1.2 mg/dL 0.6-1.3
GLUCOSE, RANDOM 102 mg/dL 60-200

Liver Function Panel
Total Protein 7.2 g/dL 6.3-8.0
Albumin 4.4 g/dL 3.5-5.0
Bilirubin, total 0.6 mg/dL 0.1-1.5
Bilirubin, conjugated 0.2 mg/dL <=0.3
ALKALINE PHOSPHATASE 93 IU/L 45-129
ALT 41 IU/L May-50
AST 43 IU/L May-40

Cortisol, Serum, Timed
Time post dose: 1055
Cortisol 15.8 ug/dL

CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL
WBC’s, automated count 5 thous/mm3 3.5-10.5
RBC, auto 5.21 mill/mm3 4.25-6.00
Hgb 15.7 gm/dL 12.9-18.3
Hct, auto 45.6 % 37.0-53.0
MCV 87.5 fl 80.0-100.0
MCH 30.1 pg 26.0-35.0
MCHC 34.4 gm/dL 31.0-37.0
RDW, ratio, RBC, Qn, auto 12.4 % 0.0-17.0
Platelets, automated count 219 thous/mm3 150-450

Prolactin
Prolactin 6.9 ng/mL

LH (Luteinizing Hormone)
LH 4.4 mIU/mL

FSH (Follicle Stimulating Hormone)
FSH 1.9 mIU/mL

Cholesterol
Actual Cholesterol = 141
HDL Cholesterol = 36

Estradiol PENDING
DHEA-S PENDING

What drugs, Rx or OTC. What supplements?
Animal Pak

Any exposure to chemicals, fumes etc?
None

2

Please post lab ranges. Your TSH suggests thyroid may be an issue and you need to start taking Vitamin D. I would suggest 10000iu a day Vitamin D until you get it up near 70-80 then you may be able to maintain at 5000iu a day. Read the stickies.

3

You can edit your post with [Edit] in the bottom RH corner.

LH changes a lot during the day. FSH is steadier and a better indicator of your status. FSH=1.9 is low.

Cholesterol data? You need to fast for that and then you can get fasting glucose.

Get DHEA-S and E2 [estradiol]

Read the advice for new guys sticky and note the first point. Post body temperatures and iodine sources.

Thyroid problems can lower T levels. Both have similar symptoms. We are looking to see if you have an iodine deficiency, because if you do that can be fixed with a one time Iodine Replenishment [IR] and then adequate dietary intake [vitamins, iodizes salt, kelp etc].

What drugs, Rx or OTC. What supplements?

Any exposure to chemicals, fumes etc?

4

So I switched insurance and since this post I have started TRT. I do injections, currently 300mg every 3 weeks. After reading a bit, I realize I need to change this to twice a week or at a minimum once a week. I got some labs done a few weeks ago and my TT was 933, up from 501 about a year ago. As a result she changed my dose to 200mg every 3 weeks and I’ve felt like shit. I told her this so she changed me back to 300mg.

Also, after doing some reading, I realized that I need to get a lot more tests done. I brought E2 up to her and she said they don’t test for E2 for TRT. Sign I need to run and find a new doc. Anyone know a good doc in the Denver region?

Last, my TSH has went from 2.xx to 3.23. She says it’s in their normal range…I can post results from tests I’ve had her do, although I’m going to ask her to do the below tests and I’ll post the results as soon as I can. Is there anything else I should add to the list? I’ll take my temp and post that as well. When should the below tests be done in regards to my TRT injections?

-TT (Total Testosterone)
-FT (Free testosterone) or bio-T
-E2 (basic LabCorp serum E2 test or Quest Sensitive 4021x. DO NOT USE Quest ULTRASENTIVE)
-Prolactin
-DHT (Dihydrotestosterone)
-FSH (Follicle Stimulating Hormones)
-PSA (Prostate-Specific Antigen)
-DHEA-S
-T3, free
-T4, free

5

-TT (Total Testosterone)
-FT (Free testosterone) o
-E2 (basic LabCorp serum E2 test or Quest Sensitive 4021x. DO NOT USE Quest ULTRASENTIVE)
-Prolactin
-DHT (Dihydrotestosterone)
-PSA (Prostate-Specific Antigen)
-DHEA-S
TSH
-T3, free
-T4, free
CBC with hematocrit [HTC]

See the 2nd post in the one sticky in this thread and follow these links:

  • advice for new guys
  • protocol for injections
  • thyroid basics
  • finding a TRT doc

You did not reply to my earlier posts!