I Just Don't Know What to Do Anymore

Pharma / TRT Testosterone Replacement
1

Hello guys. I’m male 26, 158, 6’2’’ currently not working or studying due to trying to solve this issue. I currently have a microadenoma of 3.2 centimeters. I already went to the top endocrinologist (2) here where i live and I also went to United states to meet a “highly” recognized endo. 2 of the endos where I currently live did not treat me due to my age, the third one was the one who wanted an mri for the pituitary gland (before even doing a full lab of my hormones, yes we didn’t know my prolactin level). when we found out I had a tumor he did not know what to do, so he called an hospital around here who haves students of endocrinologist and supposedly good endos too. so i had to wait 2 months to have an appointment because the last endo wanted to treat me with viagra since he did not know what to do. when the appointment arrived she went thro all my labs and determined to do more labs since my acth was a bit high. she wanted to check saliva and orine cortisol so she can clear cushing disease out. i asked whats her treatment with my current lab test and she said testosterone injection either once every two weeks or once a week. heres the catch, she doesnt measure e2 and doesnt care about shbg. so i went to the doctor in Florida (yes i had to pay a lot for this) and basically he just said" well buddy i can offer clomid, gel, hcg or test injection" i said in my mind wtf! he doesnt measure e2 and doesnt care about shbg! wtf im here lost, hopeless. so i said give me hcg and he prescribed me with 1000 iu 3 days a week for 6 weeks and retest. i said wow, but i started the protocol and 3 injections in and i feel lost, anxiety, depression, i dont know what to do. this is making me extremely bloated (from the three injections) im losing weight fast and its giving me insomnia.

anyways, i need advice, opinion on what to do. I truly don’t even want to keep doing this protocol with this guy since he just told me to choose and doesnt measure e2. i can already feel estrogen spiking in my body.

recent labs with ranges:
TT: 184 range 250-1100
FT: 23.9 range 35-155
SHBG: 57 and i had one at 79
T4: 1.1 range .9-2.2
FSH: 1.6 range 1.6-8
LH: .9 range 1.5-9.3
cortisol (urine): 93 range 4-50
Insulin growth hormone : Imgur: The magic of the Internet
sperm count: 5 million.
acth: 63
cortisol: 21
microadenoma of 3.9 mm in the left posterior.
cholesterol 132 range starts at 131
prolactin: 9.1 range 2.1-17.5

thats all i have recently. i literally don’t know where to go.should i just go with the hcg protocol and see what happens? i read about it here and ksman recommends 250 iu but im at 1000 and i can already feel it badly in my system (ugh bloating). im thinking of reducing it (on my own) to 500 atleast. im scared about the lydig cells and other hormones with this high dose.

symptoms: ED, low sperm count, insomnia, depression, anxiety, hard to gain muscle, hard to concentrate, no libido, no motivation, feeling cold all the time and constipation.

this is how i look: Zoinks! You've taken a wrong turn. photo taken 2 months ago but i look 2 pounds lighter than that.

diet: 2800 calories
high carb fat and moderate protein
strength training 3 days a week and cardio 2. other than that i walk 1 hour daily and sedentary

my heart pulse is at 38. did an mri of heart and other tests and nothing wrong. doctors dont want to treat other things until i fix test.

2

Are you sure? You mentioned 3.9mm later in your post. Has to be that.
Regardless, it appears to be non-functioning. That’s too much hCG. I’d combine TRT with a lower dose of hCG. You’ll need follow-up MRI, though pituitary microadenomas usually do not progress. I’m not certain, but since it is not producing prolactin you may not be a candidate for medical treatment (cabergoline) of surgery.

It does not sound like you are getting help from any of the doctors (neuros or TRT docs) you have seen. I would keep looking. Good luck.

3

I warned you it’s going to be like this everywhere you go, same old, same old. You’re wasting your time with insurance doctors, they will never prescribe an AI until there is a standard of care model for TRT.

1 Like
4

Imgur

sorry its 3.9mm. thats the thing. i can’t keep looking because i can’t keep flying all around U.S to find a doctor ;/ so should i just reduce hcg or try defy? last question tho, how do you know if tumor is not active since i have low lh and fsh combined with low test? pituitary tumor does not only secrete prolactin. they also squeeze acth, lh and fsh

5

I just don’t know much about defy. altho, the last endo told me that low lh, high shbg and low t is a sign of anorexia? i mean im 158 6’2’'. he looked me and said i had muscle and not skinny tho. i looked online and low test combine with low lh might be from malnourish? since idk if my tumor is active or not

6

What good is all that muscle if you feel like a tired old man?

7

Prolactin level is not high.

8

yea i mean tumor is not doing anything to prolactin but my lh and fsh are both low which might be caused by tumor. its just not only prolactin

9

Yes.

10

i also would like to know if im actually secundary hypogonism since my doctor didnt diagnose me. well he said hypogonadism

11

Your secondary, LH is low.

12

i noticed this too, heres the catch. last doc told me i was low lh might be due to anorexia (when i already have a tumor lulz) but he said i looked healthy and muscular so how else will i have low lh he told me. then i wanted to check it out and low lh can be indeed be low due to anorexia? i mean i im 6’2” 160 tho

13

Even if you somehow managed to increase LH your SHBG is be sure to see that you get none of the testosterone. When liver is stressed SHBG increases and it’s almost certain SHBG will remain elevated. It’s thought that diets low in protein in elderly men may lead to elevated SHBG levels and decreased testosterone bioactivity.

Strange your doctor is ignoring your labs, ignoring symptoms and chasing physical appearance and yet comes to his absurd conclusion. This is basic childlike thinking, likely because he is unable to interpret labs values so he makes things simple, hormones aren’t simple, they are complicated therefore most will be unable to make any sense of them.

14

thanks a lot for the info sysrem! so like i said im planning to go defy. can i do everything via cellphone and web or do i need to go to tampa (is it a must?) to see him? i dont think i can afford going to tampa now

15

Defy does LOTS of business via the phone.

16

thanks! lastly last doctor was concern about my growth hormone being so low and asked for a growth hormone stimulation test. do you think they fix this issue too? i have not check

17

I think you should get the growth hormone stimulation test and get it through insurance, growth hormone can be expensive, then get TRT through Defy. Yes you can use your cellphone for Defy consults.

18

dude, stop messing around with insurance drs, they have no clue about trt. Go to an online clinic where they have vast experience with trt. You should be on 200mg testosterone injections every week. 50 units of hcg twice a week and an estrogen blocker. Youre feeling messed up cause youre not fixing your biggest problem, the lack of testosterone. Yes its scary and confusing but try the doses of what i just said and I bet you will feel like life is worth living again. Low testosterone is a serious disease affecting many men and its sad that theres not more drs out there that know what theyre doing

19

i did my research and you seem to be correct. like i said im aiming to go defy.

20

I have a question. with current labs how do i exactly know if tumor is harming my hormones? still trying to figure out if its active or not