Help Me Interpret this Doctor's Message:

[keninottawa]

Hey all,

I'm 22 years old and secondary hypogonadic. I was on TRT for about one year, ending this February.

Last December, after treatment with Androgel (probably misdiagnosed by the silly Endo that I used to see, she wouldn't attempt to jump-start the HPTA to begin with), I wanted to see if my HPTA would kick back in on its own and went off all treatment for a month. I felt like junk, however, and was put back on injections later that month. My endo later called me and told me that my bloodwork wasn't bad, and that I should taper off the injections altogether. I had my last shot in February.

Since then, I have felt okay, but my strength has been waning and I haven't had a good libido. I went in to my regular doctor for some bloodwork last month, and the results were as follows:

STSH: 2.23 (0.35-5.00 mU/L)
LH: 3.0 (1.0-9.0 IU/L)
FSH: 3.0 (1.0-14.0 IU/L)
Testosterone: 11.1 (8.0-38.0 nmol/L)
Prolactin: 7.0 ( < 18 ug/L)
Free T: 15.9 (40.0-85.0 pmol/L)

These results obviously distressed me, especially when the following letter that my GP received from my old Endocrinologist was revealed to me:

"Lab tests done Dec. 2, 2005 were after he was off testosterone for more than a month and show excellent levels. His pituitary is now responding. High LH-FS may be part of recovery and may return to normal. The results were as follows: Prolactin 5 ug/L; LH 11 IU/L, FSH 20 IU/L; Freet T 14.9 nmol/L (271 pmol/L); Bioavailable T 6.4 nmol/L and SHBG 40 nmol/L.

If LH and FSH remain high, it likely represents some testicular damage and the need for pituitary compensation.

There is no need for him to return to the clinic."

What do you make of that?! My T levels were dead low, but my endo decided to send me away without waiting till my HPTA kicked. in. I have asked my GP to refer me to another endo who might have some advice for me, but I thought I'd turn to you guys first.

What do you think I should do now? Since I am not able nor very willing to go back on prescription meds right now, I am taking Gaspari Novedex XT to see if that will give me a bit of a boost (I know this is seen as silly around here, but I think that every little bit helps).

Any advice is greatly appreciated.

- Ken

[drkinsey]

Originally Posted by keninottawa

Hey all,

I'm 22 years old and secondary hypogonadic. I was on TRT for about one year, ending this February.

Last December, after treatment with Androgel (probably misdiagnosed by the silly Endo that I used to see, she wouldn't attempt to jump-start the HPTA to begin with), I wanted to see if my HPTA would kick back in on its own and went off all treatment for a month. I felt like junk, however, and was put back on injections later that month. My endo later called me and told me that my bloodwork wasn't bad, and that I should taper off the injections altogether. I had my last shot in February.

Since then, I have felt okay, but my strength has been waning and I haven't had a good libido. I went in to my regular doctor for some bloodwork last month, and the results were as follows:

STSH: 2.23 (0.35-5.00 mU/L)
LH: 3.0 (1.0-9.0 IU/L)
FSH: 3.0 (1.0-14.0 IU/L)
Testosterone: 11.1 (8.0-38.0 nmol/L)
Prolactin: 7.0 ( < 18 ug/L)
Free T: 15.9 (40.0-85.0 pmol/L)

These results obviously distressed me, especially when the following letter that my GP received from my old Endocrinologist was revealed to me:

"Lab tests done Dec. 2, 2005 were after he was off testosterone for more than a month and show excellent levels. His pituitary is now responding. High LH-FS may be part of recovery and may return to normal. The results were as follows: Prolactin 5 ug/L; LH 11 IU/L, FSH 20 IU/L; Freet T 14.9 nmol/L (271 pmol/L); Bioavailable T 6.4 nmol/L and SHBG 40 nmol/L.

If LH and FSH remain high, it likely represents some testicular damage and the need for pituitary compensation.

There is no need for him to return to the clinic."

What do you make of that?! My T levels were dead low, but my endo decided to send me away without waiting till my HPTA kicked. in. I have asked my GP to refer me to another endo who might have some advice for me, but I thought I'd turn to you guys first.

What do you think I should do now? Since I am not able nor very willing to go back on prescription meds right now, I am taking Gaspari Novedex XT to see if that will give me a bit of a boost (I know this is seen as silly around here, but I think that every little bit helps).

Any advice is greatly appreciated.

- Ken

Your endo is incompetent. High LH and FSH are not part of recovery. During HRT, LH and FSH are driven to zero, which is a normal part of HPTA suppression. Upon cessation of HRT, LH and FSH gradually increase, eventually reaching their steady-state values prior to the commencement of HRT. There are occasions when something catastrophic happens during the time a patient is on HRT, and consequently, recovery is prolonged . A high LH is generally a sign of primary failure rather than an indicator that recovery is in progress. What were your levels before you started your treatment.

Ninety percent of HRT patient's under an endo's care tell similar war stories. I have been to two endos, and I can honseslty say that both endos were toxic, each in his own way. If I were you, I would find an ant-aging doctor ASAP!

[keninottawa]

My levels were dirt-low immediately prior to treatment, but I was a regular, completely testosterone-laden teenager until I experienced an athletics-related eating disorder at age 19.

[keninottawa]

I should note that my LH and FSH levels were not high prior to TRT, and they aren't high now. Upon cessation of external androgen therapy, isn't it normal for LH and FSH to increase in an effort to signal the testes to supercompensate for the immediate decrease in T?

[pcgizzmo]

Originally Posted by keninottawa

Hey all,

I'm 22 years old and secondary hypogonadic. I was on TRT for about one year, ending this February.

Last December, after treatment with Androgel (probably misdiagnosed by the silly Endo that I used to see, she wouldn't attempt to jump-start the HPTA to begin with), I wanted to see if my HPTA would kick back in on its own and went off all treatment for a month. I felt like junk, however, and was put back on injections later that month. My endo later called me and told me that my bloodwork wasn't bad, and that I should taper off the injections altogether. I had my last shot in February.

Since then, I have felt okay, but my strength has been waning and I haven't had a good libido. I went in to my regular doctor for some bloodwork last month, and the results were as follows:

STSH: 2.23 (0.35-5.00 mU/L)
LH: 3.0 (1.0-9.0 IU/L)
FSH: 3.0 (1.0-14.0 IU/L)
Testosterone: 11.1 (8.0-38.0 nmol/L)
Prolactin: 7.0 ( < 18 ug/L)
Free T: 15.9 (40.0-85.0 pmol/L)

These results obviously distressed me, especially when the following letter that my GP received from my old Endocrinologist was revealed to me:

"Lab tests done Dec. 2, 2005 were after he was off testosterone for more than a month and show excellent levels. His pituitary is now responding. High LH-FS may be part of recovery and may return to normal. The results were as follows: Prolactin 5 ug/L; LH 11 IU/L, FSH 20 IU/L; Freet T 14.9 nmol/L (271 pmol/L); Bioavailable T 6.4 nmol/L and SHBG 40 nmol/L.

If LH and FSH remain high, it likely represents some testicular damage and the need for pituitary compensation.

There is no need for him to return to the clinic."

What do you make of that?! My T levels were dead low, but my endo decided to send me away without waiting till my HPTA kicked. in. I have asked my GP to refer me to another endo who might have some advice for me, but I thought I'd turn to you guys first.

What do you think I should do now? Since I am not able nor very willing to go back on prescription meds right now, I am taking Gaspari Novedex XT to see if that will give me a bit of a boost (I know this is seen as silly around here, but I think that every little bit helps).

Any advice is greatly appreciated.

- Ken

You might find a Dr. that will let you try HCG. I don't know that it would work though as your LH/FSH is already elevated.

I know you don't want to take T replacement but man if you need it you need it. I am 36 and don't want to take shots twice a week either but it sure as hell beats the alternative of feeling like hammered dog poop. Low T also affects your health in the long run. You are young and supposed to be full on energy and vigor. Don't miss out on your youth because you don't want to take T replacement. There are lots of guys that would like to have a little boost in the T area at your age. Drop the Endos and look for an anti-aging Dr. or someone that at least knows about T replacement and is not just saying they know about it.

If you are worried about fertility you can take HCG to keep things going. You might want to also look into banking sperm before beginning.

Paul

[farmerjohn]

Originally Posted by keninottawa

I should note that my LH and FSH levels were not high prior to TRT, and they aren't high now. Upon cessation of external androgen therapy, isn't it normal for LH and FSH to increase in an effort to signal the testes to supercompensate for the immediate decrease in T?

LH and FSH should increase and the fact that they are not high indicates you probably have secondary. Definitely try HCG first at your age. If HCG alone works you can take T and HCG at the same time. You can't live like this with such a low T level forever. You will be miserable and it will cause other health problems eventually. Give up on the dumb ass endo's and euros and find an anti aging doc or someone who specializes in this area.

Your SHBG seems pretty high especially for someone young. This makes it harder to get an appropriate Free T level to feel right. I dont know what makes SHBG high.....just commenting on it.

Actually you could also try clomid to see if that works even before HCG. Also since you appear to be secondary you should get a pituitary MRI and blood iron tests to rule out hemochromatosis.

I would like to know more about what you think caused this at your age. Whats your theory on it?

[keninottawa]

I've had a pituitary MRI and it turned up negative. Also, my estrogens aren't high any more, they were only that way when I stopped Androgel last year.

How can I find an anti-aging doc in Canada or a doctor who is willing to administer HCG? I asked my last Endo for a cycle of HCG/clomid/nolva and they just gave me a stunned look.

Thanks, folks.

[greyowl]

Originally Posted by keninottawa

I've had a pituitary MRI and it turned up negative. Also, my estrogens aren't high any more, they were only that way when I stopped Androgel last year.

How can I find an anti-aging doc in Canada or a doctor who is willing to administer HCG? I asked my last Endo for a cycle of HCG/clomid/nolva and they just gave me a stunned look.

Thanks, folks.

www.mastersmensclinic.com is probably the best anti-aging docs in Canada. They're experts in HRT, including the use of HcG. The first visit costs $150 over and above OHIP ($90 if you can a written referral from another doc). Too bad Hamilton is so far away from Ottawa. Don't know any anti-aging docs in Quebec.

Whatever you do, resist the temptation to self-diagnose and self-medicate yourself. Home-made HRT will land you in the shit even faster than going untreated, I guarantee it.

[keninottawa]

I know self-diagnosis isn't a good thing, but when I told the endo that I didn't need long-term TRT and that I would like my HPTA to kick in, at first she told me this was not possible, then upon reading my bloodwork results she phoned me up and told me I was right after all. Evidently, this was not the most encouraging of signs.

Judging by my numbers, do you think that my HPTA will kick in naturally over time without the use of HCG or further TRT?

Also, I had my last bloodwork done immediately following a workout (I workout and get my labs done right on campus, go figure)... Does this alter the results?

Thanks again, everyone!

[cpeil2]

Originally Posted by keninottawa

I know self-diagnosis isn't a good thing, but when I told the endo that I didn't need long-term TRT and that I would like my HPTA to kick in, at first she told me this was not possible, then upon reading my bloodwork results she phoned me up and told me I was right after all. Evidently, this was not the most encouraging of signs.

Judging by my numbers, do you think that my HPTA will kick in naturally over time without the use of HCG or further TRT?

Also, I had my last bloodwork done immediately following a workout (I workout and get my labs done right on campus, go figure)... Does this alter the results?

Thanks again, everyone!

Some docs have you refrain from sexual activity and heavy exercise for 24 hours before getting blood drawn for hormone testing.

[keninottawa]

Okay. I'll be sure to have my future labs done on my morning off...

Just out of curiousity, would a heavy workout before a blood test increase or decrease the results for T? From what I understand, T levels drop off after a workout (your system is depleted) and spike several hours afterwards as your body supercompensates.

[keninottawa]

Also, would supplementation with ZMA be a waste of money for me? I seem to have come across conflicting reports about this supplement.