Yes Roscoe88 but also, don’t you think he should still Request T.R.T therapy for Hormone Restoration with dangerously low levels that low 100 ng/dl.
Not at this point.
If it’s a prolactinoma, it’s removal would likely correct test issues. Again, his endo may have other ideas. But I’d wait to speak with him before self medicating.
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This means if we have low TT and low shbg then low TT will act as high free testosterone . That’s amazing
Hey Roscoe, appreciate the replies.
What should I say to my Endo? Should I tell him about the raised prolactin or I think that TRT would be the best way forward? or should I not say anything and let him judge. Obviously he would know more about this area than I, but I think I know enough to add input. Is it a good idea or would it put him off the whole idea?
You won’t have to hard sell this endo on your testosterone numbers, 146 ng/dL is lower than most 90 year olds. You really need to push hard for frequent injections regardless of the type of testosterone used, most of what you inject in excreted into the urine in a very short amount of time.
If you go above 500 ng/dL or 18 nmol/L you will have problems with excess estrogen. This is why Nebido is not a good idea, you will start out high (estrogen) and end up very low by the time the shot wears off. Ethanate 5-10mg daily first choice and Sustanon smaller doses 2-3 injections per week for second choice.
Your test results are indicative of a prolactinoma or other pituitary adenoma. You need a pit MRI.
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@physioLojik Yeet I thought the same thing, but if he had a prolactinoma wouldn’t his LH and FSH be in the dirt? I am of understanding (though I could be wrong) that a prolactinoma or other type of pituitary adenoma would supress GnRH therefore tanking LH and FSH.
@kc1997 go with physiolojiks advice on the pit MRI. he’s by far the most knowledgeable member on this forum but I’m curious, you say you’ve been checked for Hashimoto’s, but have you ever had a thyroid Pannell done to rule out hypothyroidism, how is your liver function? Are you on any prescription medication you would be comfortable sharing on this forum? #fluoxetine #derp. How are your overall stress levelzzzzz
Thank you for the straightforward response, i appreciate it as I just want to know how to go abot this. I’ve felt these symtoms for a long time and at first I thought everyone felt like this and thought that I was just weak compared to them. Then my doctor said I had depression which made a lot of sense. As a young child I was always constantly anxious and depressed. I also had this feeling of a tight band around my head 24/7. Doctor prescribed me amitriptyline, gabapentin, tricylic antidepressants and then fluoxetine (prozac). Obviously not all together at once, but none of them helped… Looking back at old photos of me as a child, my eyebrow was thinning noticeably at the edge and I guess thats a symptom of Hypothyroidism? I dont know.
My stress levels are always high about things that really shouldnt matter at all. Its like im paralyzed by the constant worry and stress that I get even more stressed due to not having the mood or the energy to do combat whatever stresses me.
Thank you brother, hope my endo can see that
Edit: also i hope he is competent in hormonal issues… I’ve read up on Endos especially in the UK and it seems like a crapshoot. Given my age aswell i dont know what to expect really
I take fluoxetine for depression and have a for a long time, I’m finally weaning off of the medication as being able to bodybuild again and having adequate testosterone levels has been so helpful my depression practically dissapeared overnight (despite what doctors said would happen, many believed the ability to bodybuild wouldn’t make much of a difference). I am an extreme hyper CYP3D6 metabolizer (tested) therefore I require a very high dose of fluoxetine as my body burns through it (it was 60mgs a DAY, currently 40mg)… It def helps with anxiety and depression if you legitimately have it, I don’t understand why people bash these medications, sure they’re over prescribed but for people who legitimately need them it can be a god send… That being said I don’t think I required anti depressants as fluoxetine never particularly helped me as my depression was caused by chronic pain and low T, not chemical imbalance. Fluoxetine can cause elevated prolactin. As to gabapentin, I tried that, as well as lyrica (pregabalin) for chronic pain, neither did jack shit but both turned me into an absolute zombie for a while, it negatively affected my schoolwork and I stopped being able to remember simple things like where to sit in class or peoples names, it sucked… (I’m telling you these stories so you can feel more comfortable posting on here as many others have been in similar situations or have taken similar medications). While these medications are a godsend for those whom it helps, I didn’t have a good experience with them.
As to you anxiety, do you have any diagnosis such as generalized anxiety disorder, OCD, panic disorder etc. I don’t give out advice on medications but I am of general belief that for occassional bouts of severe anxiety a benzodiazepine can be used (occasionally) and they can help, however I could be wrong. I have a family member who takes one every time they go on a flight as they get anxious on planes, this allows them to be calm and sleep through the flight.
As to endocrinologists, it isn’t a doctors fault if they are uneducated on testosterone replacement, I see it this way
- medical school doesn’t typically teach testosterone replacement therapy, and when they do it isn’t taught in detail
- Prescribing guidelines for TRT and AAS in general are very out-dated and innefficient, and prescribing guidelines are a go to for help on how to prescribe medication
- Doctors have to remember so much knowledge, it really is an amazing profession and you must be very intelligent/ academic to be able to become a doctor, most issues doctors are worried about are life threatening issues (heart attack, high blood pressure, cancer etc.) and while hypogonadism can be life threatening over the long term, it isn’t up at the front in the medical communities “to do” or “cure” list, therefore it does get put in the backburner. Doctors use what is known as the sick care model and it is efficient in keeping people ALIVE, not optimal and this isn’t a bad thing as the budget for public health systems is spread very thin, therefore it wouldn’t make sense to dump a bunch of the money on TRT when we have people dying from cancer, HIV and other terminal illnesses.
- If you can afford it go private, many private doctors specialising in testosterone replacement therapy will strive to optimalise your health, and they don’t have to deal with irritating insurance companies
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