Is TRT Right for Me? *Labs Listed*

Hi guys I am new to this website and am in need of your input. I have many symptoms of low testosterone and need to know if trt is the right decision for me. I am treating trt as a last resort so if there are other options for me please let me know. To skip my sob story and see the labs go to the second dotted line below.


So Iâ??m 22 (going to be 23 next month) and have had a left-sided grade 2 varicocele since I was 14-15. I had two ultrasounds of my testes (one at 17, one at 21) and the results showed both nuts being the same normal size. Of course all doctors I saw at the time said varicocele is common and not a big dealâ?¦

I noticed over the past year or so I drop in my sex drive and decided to educate myself a bit more about varicocele surgery, fertility, testosterone, etc. I visited a different urologist and requested a sperm test (this was late Dec. 09). Labs came back terrible, so bad morphology couldnâ??t even be determined. He suggested I do another sperm test at a different facility. I did and it was the same story again (second test was Jan. 20th 2010)â?¦

He recommended surgery which I went through with. It was the conventional inguinal method which was done on Feb. 11 2010. As of now I am completely recovered and back in the gym. I have a script for a third post-op sperm analysis which I am to get done this month.

Besides the varicoceleâ??s decrease in size I have not noticed too many other changes testosterone related. I was so focused on the fertility issues associated with varicocele that I overlooked the testosterone issues and did not get blood work pre-surgery.

I just recently visited my general doc the other week any went over the symptoms below. He said most men with varicocele have â??normalâ?? t-levels. I disagree completely… So he wrote me a script for some blood work and I am to see him May 24th again to review the results.

As of now here are my primary symptoms…
1.) Low sex drive. I can get and maintain an erection but requires work. I almost never get spontaneous erections anymore and morning wood is almost non-existent or weak.
2.) Fatigue during the day
3.) Trouble focusing/concentrating at work (not sure if this is t related or not)
4.) Low facial/body hair
5.) Slight depression at times

I consider myself an active person so I am unsure what lifestyle changes I can make in my life to naturally boost my t-levels.
-Iâ??m at the gym 3-4 times a week (both cardio and lifting).
-I eat pretty good
-I take a daily menâ??s multi-vitamin everyday (GNC Mega Man)
-I donâ??t drink that much
-I donâ??t smoke

The only thing I could see is maybe getting some more sleep each night.


Here are the results from my blood work (blood given 5/7/2010 @ 8:00am) (I was on a 12 hour fast and took my multi-vitamins the day before)

Testosterone: 543 (280-800ng/dl)
Free Testosterone: 14.5 (9.3-26.5 pg/mL)

Cholesterol: 151mg/dL <200mg/dl Normal
200-239mg/dl Borderline High

239mg/dl High

Triglyceride: 89mg/dl <150mg/dl Normal
150-199 Borderline High
200-499 High

499 Very High

HDL Direct: 45mg/dl >59 High
<41 Low

LDL Calculated: 88 No reference given

Prolactin: 12.6ng/mL 1.8-14.4

TSH: 1.803 0.550-4.780 ulU/ML

WBC Count: 4.75 4.13-9.78 thousand/uL

RBC Count: 4.97 3.93-5.64 million/uL

Hemoglobin: 13.9 12.1-17.1 g/dl

Hematocrit: 42.1 35.9-49.6%

MCV: 85 81-97fL
MCH: 28 26.8-34.3pg
MCHC: 33 31.4-37.4 g/dL
RDW: 13.1 11.6-15.1%
Platelet Count: 195 127-372 thousand/uL
SEGS: 50 45-77%
Lymphocytes: 39 14-44%
Monocytes: 8 4-12%
Eosinophils: 3 0-6%
Basophils: 0 0-1%
Nucleated RBCâ??s: 0 no reference
Absol Nuetro: 2.38 1.81-6.82 thousand/uL
Absol Lymph: 1.85 0.67-3.15 thousand/uL
Absol Monocy: 0.38 0.00-1.22 thousand/uL
Absol EOS: 0.14 0.00-0.40 thousand/uL
Absol Baso: 0.00 0.00-0.08 thousand/uL

Glucose Randm: 99 65-140 mg/dL
Sodium: 140 136-145 mmol/L
Potassium: 4.2 3.5-5.3 mmol/L
Chloride: 103 100-108 mmol/L
Carbon Dioxide: 27 23-33 mmol/L
Anion Gap (Calc): 10 8-16 mmol/L
Bun: 13 5-25 mg/dL
Creatinine: 1.1 0.5-1.4 mg/dL
Calcium: 9.3 8.3-10.1 mg/dL
Bili, Total: 0.74 0.20-1.00 mg/dL
ALK Phosphatas: 95 50-136 U/L
ALT (SGPT): 31 0-65 U/L
AST (SGOT): 15 0-45 U/L
Albumin: 4.4 3.5-5.0 g/dL
Protein, Total: 7.8 6.4-8.2 g/dL


According to Mens Hormonal Healthâ??s website my T-levels are on par with a man in his 60â??s. I asked my doctor for estrogen levels in my tests but he said that wasnâ??t necessaryâ?¦ I meet with him in about a week and was wondering what I should be voicing to him at that appointment. I’m not looking to become superman but a decent sex drive and better mood would be nice.

I would greatly appreciate any input.

Thanks

Your doctor is a fool for not testing estrogen. High E2 level can cause almost all of the problems you’ve mentioned.

The downside (or upside) is that your test is pretty high for most docs to feel comfortable prescribing T to a 23 yr old.

INSIST that you get your estradiol (E2) level tested with an extra sensitive test. If he says no. Say you’ll be taking your business to another doctor.

IF e2 is above the ideal range bringing it to the normal range may increase your T level.

Your prolactin is also fairly high. High prolactin can wreak havoc on ones libido and capability for erection. But I dont know enough about that to give any advice.

Are you taking any supplements. drugs, etc.? Any OTC testosterone booster usage such as tribulus, etc? I felt about the same way you do when my free T was at your level [I am 22 btw]. I was functional but my wood and sex drive was questionable and I just felt tired and unfocused with a tendency towards depression. Then I messed around with OTC testosterone boosters and now I have flat out hypogonadism. So for now, take my advice, and don’t do any self-medicating of any kind.

Are you under a lot of stress? In school? What’s your gym schedule like? These factors alone can send T levels to less than optimal levels. You appear to be OK right now, but I would definitely keep an eye on it.

Docs are not going be helpful, but if they are, in this case jumping into TRT would not be a good idea.

You need to reduce the negative effects of estrogen and prolactin on your HPTA. You may need to do some things on your own.

Suggest that you get E2 tested on your own via LEF.org, see products and blood tests.

You also need LH and FSH to know what is going on.

Tell me about your height, waist size and weight, where you carry fat and how that has been changing.

You may need some HMG to try to recover your fertility. So you are zero viable sperm now? How has the size of your testes changed, original, worst and at this point in recovery.

When a doctor says “normal”, they are mostly useless.

Thanks for the responses guys…

BONEZ217: I will be pushing to get my estrogen, SHBG, and DHT tested this coming appointment. If my doc refuses to test these I will be doing an online script from privatemdlabs.com… How can I bring E2 down naturally? Right now I take GNC Mega Man multivitamens (once a day) and Uni-liver with every meal. Addtiotanlly this week I began a low GI diet.

Chemman: I am just taking GNC Mega Man multivitamis and Uni-Liver supplements. I have not self-medicated with any OTC testosterone… I’m not too stressed at this point. I’m out of college but admit I could use some better/longer sleep. I mean yea I guess I’m ok but things could def be better. I can no longer get wood with mental pictures of girls/sex which really sucks.

KSman: What changes should I make in your opinion? I will request my doc to test estrogen, SHBG, and DHT. If he refuses I will do it myself with an online script at privatemdlabs.com… I am 5’11 162 lbs and waist size of 34’. I dont carry much fat I have been working out since I was 16 so I’m in good shape. My left testicle is slightly smaller than my right buy not by much. I will not be able to give an update on sperm info until I get my new sperm test done (this test will be post surgery…

Visited my doctor today to discuss my blood work. The only thing that concerned him was my high prolactin level [prolactin 12.6 ng/mL (1.8-14.4)]. He is having me get an MRI on my pituitary gland so see if there are any issues there. Did some research on high prolactin levels in men and it seems this could be the cause of a lot of my symptoms. He told me there are no natural ways to lower prolactin levelâ?¦ if there are issues with my pituitary gland it seems my options are surgery or dopamine-producing medication that would lower the prolactin levels.

My doctor was pretty open to suggestions and agreed to do more blood testing. Hereâ??s what my next blood lab will test.

Prolactin (again)
Elevated Prolactin
Serum Cortisol
Estradiol
DHT
SHBG

MRI (Pituitary)

Iâ??ll post the results when theyâ??re done.