Upcoming Appt Johns Hopkins Lab Values

[let_her_flicker]

HI all - going to JHU for evaluation.

Local endocrinologist has made a diagnosis of Idiopathic secondary hypogonadism.

Here are some lab values:

Without HRT:

FSH 5.8

LH 4.0

Prolactiin 11.0

Total Testosterone 203

Dr. noted inappropriately NORMAL LH/FSH

Cortisol test was done normal right in mid range. MRI of brain for pit. gland normal

When using Androgel (10g) my Total Testosterone has measured from 449 (2005) and exercising to a low of 287 (2008).

Are there any important questions I should ask the expert or any other tests we should look at? I know I have never been tested for Free Testosterone. I am pretty sure the Dr. at JHU will. BTW - never did any performance enhancing drugs. Just thought I would throw that into the mix.

Thanks in advance for any help. I will probably go with shots or implants. The reason is I have no energy, tired, moody, depression, and have no get up and go. I used to be a fairly well trained athlete.

[biceps72]

[quote=let_her_flicker;591985]HI all - going to JHU for evaluation.


When using Androgel (10g) my Total Testosterone has measured from 449 (2005) and exercising to a low of 287 (2008).

??????? and exercising to a low = 287????? I am confused????

[let_her_flicker]

I have been on Androgel from 2005 to present. The dose then was 2.5g of Androgel for testosterone deficiency. I was put on it because testosterone was 240 and I was 50 yrs old. The excercising means I was riding my bicycle at least 10 to 20 miles everyday.

Androgel was increased in 2006 to 5g. Then in 2007 to 10g. My lowest testosterone was 198 and that was when I was off HRT to get a baseline for the TT and FSH/LH.

Sorry for the confusion.

[JanSz]

Originally Posted by let_her_flicker

I have been on Androgel from 2005 to present. The dose then was 2.5g of Androgel for testosterone deficiency. I was put on it because testosterone was 240 and I was 50 yrs old. The excercising means I was riding my bicycle at least 10 to 20 miles everyday.

Androgel was increased in 2006 to 5g. Then in 2007 to 10g. My lowest testosterone was 198 and that was when I was off HRT to get a baseline for the TT and FSH/LH.

Sorry for the confusion.

How long have you been of Androgel when you were preparing for LH test?


Being on Androgel (10g) and getting Total Testosterone=449 (2005)
and 287

mens that you are not responding well to Androgel.

You should have been steady at 900-1100
-------------------

Often thyroid problem is the culprit.
Then Adrenal Fatigue is not far behind, thel chlesterol, metabolc problems, glucose, etc.
Since you are 53yo now,
it is a good time to get good once over.

For myself (I am 68yo) that mean, blood test per my list on post #44
Jan's BloodTest April13/2007 - Page 2

done at Quest Diagnostic, blood drawn at Quest.
-------
I also do NutrEval test at Genova Diagnostics.

Skip all supplements, viatamins, etc for a one month or more, before that test.

Diagnostic Laboratory Testing for Wellness & Preventive Medicine - Genova Diagnostics

NutrEval - Diagnostic Laboratory Testing for Wellness & Preventive Medicine - Genova Diagnostics

http://www.genovadiagnostics.com/fil...FMV_Report.pdf

[let_her_flicker]

Thanks Jan I will mention a more detailed testing of Thyroid. My last thyroid test was done in Jan 2008 and it was normal. I was off all Androgel for 5 days when doctor checked LH/FSH. I currently do not take supplements or vitamins. I will print out testing page and ask doctor about it.

[let_her_flicker]

Had a choice to go to 15g of Androgel or come off HRT completely and wait three months before having tests done. The reason is they do not know if it is primary or secondary hypogonadism. The problem is I shave every other day, have not lost body hair and according to the little measuring device, my testicles are normal. I told her I had notice a decrease in size and firmness.

I chose the latter and she will run a brand new set of tests:

Total and Free Testosteone

FSH LH prolactin

TSH and Free Thyroid

She will evaluate the data and go from there.

[JanSz]

Originally Posted by let_her_flicker

Had a choice to go to 15g of Androgel or come off HRT completely and wait three months before having tests done. The reason is they do not know if it is primary or secondary hypogonadism. The problem is I shave every other day, have not lost body hair and according to the little measuring device, my testicles are normal. I told her I had notice a decrease in size and firmness.

I chose the latter and she will run a brand new set of tests:

Total and Free Testosteone

FSH LH prolactin

TSH and Free Thyroid

She will evaluate the data and go from there.

Your doc does not know much, it is going to be tough.
You are not going to get much out of the extra 5grams of Androgel.
Other than it does not work for you it is also wery expensive plus it raises your DHT that you may need or may not need.

Do not test for FreeTestosterone, it is not only useless, worst, it is misleading, you will have up hill battle arguing with her, specially if it comes back within range.
It may come anywhere, it is totally erratic.

Testing LH and FSH while you are on Androgel, or if you stopped Androgel for a few days,
it is also useless.

Free Thyroid is non specific.

If you are able, have these tests done:
==================================
TotalTestosterone
SHBG
Albumin
Prolactin
DHEAs
Dihydrotestosterone
Estradiol Ultrasensitive

Ultrasensitive TSH
T3 Free
T4,Free
reverse T3 (rT3)
Thyroid Peroxidase and Thyroglobulin Antibodies (7260X)
==================================

There is a need for quite few other tests to be done, but I am not sure if you will be able to get them out of her.

Just in case look at my list, post #44
Jan's BloodTest April13/2007 - Page 2

You may want to read thru all 4 pages of that thread, also this thread:

JanSz-Metabolic Analysis and Cellular Energy

[let_her_flicker]

Jan,

Sorry I did not make it clear. I am discontinuing all use of Androgel for 3 months and will get the above tests done. She said you have to be off Androgel for 3 months to get an accurate reading. If nothing is conclusive, I will mention to her the other tests you recommended.

Thanks for your input.

[JanSz]

Originally Posted by let_her_flicker

Jan,

Sorry I did not make it clear. I am discontinuing all use of Androgel for 3 months and will get the above tests done. She said you have to be off Androgel for 3 months to get an accurate reading. If nothing is conclusive, I will mention to her the other tests you recommended.

Thanks for your input.

You already know that Androgel is not working for you.
There is 99.9% chance that it goes for all other types of transdermal t delivery.
She is not going to find out anything new about you by witholding Androgel for 3 months.
For sure she is going to put you thru suffering.
We have a Phill around here. He is on TRT for 23years.
Number of times, when he was changing doctors, he was put thru this STUPID withdrawal period.
All it did is made him suffer.
No new information.
He learned better but it had to be the hard way.

You can still do all the tests just skip LH and FSH.

.
If you want to know if you are primary or secondary do HCG stimulation.

Stop Androgel.
Do HCG 1250iu/E3D
test 2 - 3 months latter.
You may want to test earlier.
You may want to increase HCG up to 10000iu/week average
Monitor TT, SHBG, (E2-ultrasnsitive), DHT

If you do produce increased amount of testosterone on initial dose it is encouraging, give a time, testicles need time to build up.
If you do not see increased amount of testosterone, you are primary, add DepoTestosterone as need to achieve FreeT(160-300), higher is better, do not go over 300.
.
.
There are other aspects of TRT, and other aspects to health.
,
,
,

[hardasnails1973]

Originally Posted by let_her_flicker

Jan,

Sorry I did not make it clear. I am discontinuing all use of Androgel for 3 months and will get the above tests done. She said you have to be off Androgel for 3 months to get an accurate reading. If nothing is conclusive, I will mention to her the other tests you recommended.

Thanks for your input.

SO you are going to feel like shit and spend another year or so getting back to feeling 1/2 of what you are now. Your dr needs to make adjustment while on TRT not stopping it all together. I would seek another dr ASAP..
You do not need to be off androgel for 3 months. The shit starts to clear out of your system in 10-14 days. I have been there and so many others have as well so this information is invalid and scarey. Why not just switch to compunded gel and solve the issue then retest in 3 weeks to see if levels have changed. For many people androgel sucks and its a royal pain in the ass to deal with. A compunded testosterone gel with good carrier will get through any skin increasing test levels.

[let_her_flicker]

Thanks Hardasnails for the recommendation. Just curious, what is an example of a compounded gel or should I just go for the shots?

I will call Slovey and find out how long Androgel takes to clear from your system.

If you are right about feeling like shit, it is going to be another Long School Year as I teach middle school. I definitely need to be on top of things.

Thanks,

Hop