hCG stim test results - next step?

[DaVinci2]

I did an hCG stim test. Here's how it went

Blood results at the end of August showed test levels at 1.45 (ref range 2.010 - 7.500)
5000iu's administered in the morning after fasting.
3 days later a new blood test was done.
At the end of September (2 months of all TRT) test levels at their highest levels of 4.37 from those test results

I had to use my August blood test because my doctor said that my insurance wouldn't cover 2 blood tests only days apart. That's the reason for using my August tests as a baseline.

My question would be...now what? This means I'm secondary right. Do I need to get an MRI? I know this has already been asked but I wasn't sure what to search for.

[pmgamer18]

Originally Posted by DaVinci2

I did an hCG stim test. Here's how it went

Blood results at the end of August showed test levels at 1.45 (ref range 2.010 - 7.500)
5000iu's administered in the morning after fasting.
3 days later a new blood test was done.
At the end of September (2 months of all TRT) test levels at their highest levels of 4.37 from those test results

I had to use my August blood test because my doctor said that my insurance wouldn't cover 2 blood tests only days apart. That's the reason for using my August tests as a baseline.

My question would be...now what? This means I'm secondary right. Do I need to get an MRI? I know this has already been asked but I wasn't sure what to search for.

Yes you need an MRI on your pituitary and good machine newer one. I am secondary but from a bad head injury it's called Hypopituitary it only took them 23 yrs to figure this out.
http://salmon.psy.plym.ac.uk/year1/stressho.htm

[DaVinci2]

Originally Posted by pmgamer18

Yes you need an MRI on your pituitary and good machine newer one. I am secondary but from a bad head injury it's called Hypopituitary it only took them 23 yrs to figure this out.
http://salmon.psy.plym.ac.uk/year1/stressho.htm

OK. So should my urologist know this? Is there a specific method used in scanning this area with the MRI? And if it is something wrong with that area, what do they do to fix it? Operations? I read the link and it was kind of confusing. Any dummied down versions of this information?

And once this problem is fixed, do your test levels go back up?

[farmerjohn]

Your doctor just needs to order an MRI of the pituitary with and without contrasting agent with a diagnosis of either pituitary adenoma or more likely hypogonadism. The radiologist will know what to look for. If there is a visible adenoma they can do surgery to remove it. Its not likely they will find anything, for most of us they dont. But if they do and you want to pursue the surgery route, you need to find a surgeon who does this a lot and is really good at it. See www.pituitary.org for hospitals you can try. They will also look for empty sella syndrome. You should also be checked for hemochrmoatosis. To do this get all 4 blood iron tests: iron, ferritin, TIBC, and saturation. Hemochromatosis causes the body to abosorb too much iron from food and it can be deposited in your pituitary causing it to malfunction.

Yes you doctor should know all this, especially about the MRI.

On the surgery, it is not always successful but I think you have a decent chance of a cure if youre one of the few where they find an adenoma. You can also check for prolactin level since many (but not all) of the adenomas secrete prolactin.

[pmgamer18]

Originally Posted by DaVinci2

OK. So should my urologist know this? Is there a specific method used in scanning this area with the MRI? And if it is something wrong with that area, what do they do to fix it? Operations? I read the link and it was kind of confusing. Any dummied down versions of this information?

And once this problem is fixed, do your test levels go back up?

Here is a link full of info on getting MRI's done by Lisa.
http://forum.mesomorphosis.com/mens-...light=Ikho1967

[DaVinci2]

Thanks for the replies so far.

As for getting anything done surgery wise, I'm probably gonna have to look very very hard since I'm in Japan. This can be a bitch since TRT isn't that common. My doctor never bothered looking for the cause of my low test levels, I had to. Here are my blood results

WBC----105------43.000-80.000------*100/ul
RBC---- 527------450.000-510.000------*10000/ul
HB------15.4------12.400-17.200------g/dl
HT------46.9------38.000-54.000------%
MCV-----89------83.000-93.000------fl
MCH----29.2------27.000-32.000------pg
MCHC---32.8------32.000-36.000------%
PL-C----29.5------18.000-34.000------*10000/ul

CRP----0.58------0.000-0.400------mg/dl
TP-----6.7------6.500-8.500------g/dl
ALB----4.2------3.500-5.000------g/dl
UA-----7.3------3.200-7.500------mg/dl
BUN----11------7.000-18.000------mg/dl
CRE----0.93------0.500-1.100------mg/dl
NA-----140------137.000-146.000------mg/dl
K------4.6------3.800-5.100------mg/dl
CL-----103------98.000-108.000------mg/dl
BIL-T--0.6------0.200-1.000------mg/dl
AST---48------12.000-40.000------IU/L
ALT---84------10.000-45.000------IU/L
ALP---149------80.000-230.000------IU/L
G-GTP---58------5.000-60.000------IU/L
AMY-S---71------40.000-200.000------IU/L
CK----101------30.000-200.000------IU/L
LDH---350------250.000-500.000------IU/L
CHO---171------130.000-220.000------mg/dl
TG----82------50.000-150.000------mg/dl

LH----3.27------0.300-7.100------mIU/ml
FSH--1.63------1.600-10.600------mIU/ml
PRL--20.13------3.4-16.200------ng/ml

Testosterone----4.37------2.010-7.500------ng/ml (This was 1.45 on the last test)
Estradiol----73------0.000-0.000------pg/ml
Free testosterone----20.4------5.100-19.000------pg/ml

[DaVinci2]

What are the chances that (Percentage wise) of the reasons you listed as being the reason for have secondary hypo? What is most likely, and what is unlikely?

Also, once the problem is fixed, do testosterone levels go back to normal or is treatment in some way still necessary?

AND...reading about Hemochromatosis and empty sella syndrome, are these something I should be worried about? I guess I'm looking for assurance that I will be able to get my testosterone levels back up. I feel like fooking shit...and have for several months now (No TRT)...

[pmgamer18]

From what I understand there are a lot of things that make one Secondary in my case it's from a bad head injury most problems with the pituitary don't require surgery. Now you need to have your cortisol, DHEA-S, Thyroid and Glucose levels checked these can be off. Here is a web site I feel you can go to and get some help on this. Chris runs this site and if he can't help you he will know where you need to go for info.
http://health.groups.yahoo.com/group...pport/messages

[farmerjohn]

Its not likely you have hemochromatosis or a pituitary adenoma or empty sella syndrome. These are just all things you check because they can all lead to more serious issues if they are not diagnosed. Probably about the only one you could recover from if you had it is the adenoma and it is possible after surgery things could get back to normal. Otherwise you are probably looking at being on some TRT regimen for life. You intial T level doesnt look that awful above but your estradiol was really high. Maybe all you need is to reduce the estradiol. You can try DIM plus by Natures way, an OTC supplement or other Rx's like arrimidex. High estrogen (or estradiol) can be a cause of low T also.

[DaVinci2]

Thanks, I appreciate the help guys. My doctor has almost no experience with this so I'm thinking I have to go in with all this information and TELL him what needs to be done.