Need some assistance...

[CubbieBlue]

Ok all, so I am having some hormonal issues and am not knowing where to go next! After lurking here for awhile I am hoping someone here can offer me some insight.

My story:
23 year old male

After a cocaine overdose 2 years ago I have dealt with fatigue and palpitations. Checked out clean by multiple doctors. Started to have numerous panic attacks and palpitations continued. Finally about 5 months ago I got a doctor that checked my test levels. My levels are consistently in the extreme low normal range, like 250. He offered testim. I tried it for a day, read about it online, and scared myself off it. Went to an endo to see what he had to say about it. Discovered my TSH was slightly elevated and that I had a multi-nodular goiter. He prescribed 100mcg Synthroid and Androgel. Started synthroid, but the Androgel gave me horrible palpitations, racing heart, tremors, etc. so I have stopped. On the Synthroid I am feeling about 50% better than I was previously. (Oddly enough) slower heart rate, less anxiety, feel more energetic, etc.

Endo will give me shots, but I do not know if he will treat with HCG or anything else. He never tested me for E2 or any of that other stuff.

Here is where I am now (about 4 months on synthroid):
Goiter still there, but shrunk a little with the 100 mcg synthroid. I ask him why I have it, says I am not so much hypothyroid, (odd because the synthroid has made me feel alot better) but just have the nodules, probably genetic. Still have low test levels, says he doesn't know why my test is low. Little improvement on that front. Still get alot of fatigue, headaches, and general malaise. I am going to get my adrenals tested tomorrow (blood, not saliva) to see how they are doing. He ordered those after my bugging him.

My question:
What the hell should I do? I have found an integrative medicine doc in my area that is new and says she treats hormonal balance problems, but she is cash only, and I don't know if I can afford $300.00 plus tests to see her. Plus, who knows if she will tell me something I haven't heard yet.

Should I start on the TRT shots? Should I buy some isocort off the internet and see if that does anything? I would like to try armour and my doc will prescribe, but with this shortage and the new formulation is it worth it? Would a synthroid/cytomel combo be worth a shot? Is there anything I can push my doctors on to figure out why my test levels are low?

Sorry for the long first post. Hopefully somebody here has got some insight!

Thanks guys

[Crazy Crew]

To get an informed responce you need to list all of your labs

[CubbieBlue]

I will be able to post thyroid labs tomorrow, other than that I need to wait until I get new results, hopefully within a week.

Like I said though, Test levels consistently very low normal.

[CubbieBlue]

Also, does anyone have any idea WHY my test could be low? Can I find and treat the underlying cause or am I stuck with TRT?

[BBC3]

Cocaine stimulates norepinephrine and dopamine to incredible extremes. If you were a cronic long term user it is very possible that you now have low levels. It could have caused damage to the nerve sheathing related to the dopamine and norepinephrine receptors thus causing these problems to a two-pronged effect. I AM SAYING ALL THIS BECAUSE APPARENTLY THERE IS A RELATIONSHIP BETWEEN THESE TWO BRAIN HORMONES/CHEMICALS AND TESTOSTERONE LEVELS. I am not yet familiarized with it enough to elaborate. I recently researched this when studying the long term effects of amphetamines (Adderall specifically). It apparently causes these same problems. The information that I read stated that the damage to the nerve receptors did seem to repair its self in 6 months plus time. But the degree of "normalcy" is in question due to the fact that the receptors grow back differently and branched off to more of them as well. You may have developed more receptors to accomodate all the NE & Dop at a minimum, thus now leaving you with insufficient levels. MY POINT IS, perhaps you shoud try starting with some wellbutrin at 300mgs / day for a while and see if this helps. Do some googling on amphetamine and cocaine effects on dopamine and NE and check this out. inform yourself and present to your endo / doc. At a minumum, a dopamine and NE problems seem to be the most likely culprets based on your info. Check into it. FYI, I would also be sure and research doctors through your networks and find some for a second opinion. Doctors are just another sect of our population which is full of idiots and assholes. Anyone with a memory can pass enough tests to be a doc. It doesn't mean they know shit about applying it, or even give a shit about you. As with most intraverts, they are so poor at dealing with people, they would rather spend 30 minutes hiding in the toilet rather than have to interact with other people........

Originally Posted by CubbieBlue

Also, does anyone have any idea WHY my test could be low? Can I find and treat the underlying cause or am I stuck with TRT?

[CubbieBlue]

Interesting thoughs BBC3, I was not really a long term chronic user, but a midly heavy user or about 6 months. Interesting stuff though. I have tried 3 months of Lexapro, which seemed to help a little bit while I was on it, but some of the side effects seemed to be too much, and I was worried about reports I have heard regarding long term memory loss with long term use. I got my blood work done this morning, I will report back with my lab results and hopefully you folks will have somewhere to guide me.

[CubbieBlue]

OK here are my thyroid lab results w/ lab ranges in ( ):


TSH: 1.06 (.04-4.0)
Total T4: 9.84 (4.5 - 12.5 ug/dl)
Free T4: 1.99 (.9-1.9 ng/dl)
Free T3. 3.04 ( 1.5-4.1 pg/ml)
TPO Ab <10.0 (<35 IU/mi)
IGF I 302 ng/ml (116-358)

[BBC3]

Acute episodes of high doses and long term use render the same result. A rubber band can only stretch for so long, or so far and then it does not work as well, or it is broken.

FYI, I am currently taking LExapro for first time. Its pretty mild stuff. I dont think there are any real long term memory issues with SSRIs, however, when you get about 15 years older, you will wish you had some.....

Originally Posted by CubbieBlue

Interesting thoughs BBC3, I was not really a long term chronic user, but a midly heavy user or about 6 months. Interesting stuff though. I have tried 3 months of Lexapro, which seemed to help a little bit while I was on it, but some of the side effects seemed to be too much, and I was worried about reports I have heard regarding long term memory loss with long term use. I got my blood work done this morning, I will report back with my lab results and hopefully you folks will have somewhere to guide me.

[CubbieBlue]

I am still waiting for my adrenal function test but I have decided to give my PCP a call on Monday and get an appointment regarding my low testosterone.

I want to show him the AACE guidelines to treating hypogonadism to see if he will check my FSH/LSH to see if my pituitary needs to be checked. Is there anything else I should specifically ask him to check? What can I point him towards to get on board with the HCG? Can I do testosterone shots without HCG and have a shot at being fertile at some point in the future? I say shots because I previously attempted Androgel and suffered high anxiety for some reason from it. Testim seemed to work but I hate the smell of the shit.

Would anyone have any ideas why I did suffer the anxiety symptoms from Androgel in the past? That kind of irked me and my endo had no answers. I tried it for about 4 days and it got to the point where I had to stop because I thought I was going to pass out.

Thoughts?

[BBC3]

You are gonna have to find a doc with a set on him to write you HCG. It is simply not common protocal for issues other than fertility and BC/BS says no no. We want to please out masters after all. Cant have them cutting us off. But you have one thing right, I would not endeavor on any kind of testosterone supplementation without supporting the boys. Also I am not sure the difference between AG and testcream, but I have read that it depends on where you apply as to what you get. meaning if you put it on your nuts you are more likely to get DHT and if you put it on a fatty area like the belly you are more likely to get estrogens. I have also read that these creams kick in within a few hours which may be responsible for your rash reaction. you would probably be better off with injectible cypionate.

Still you need to resolve the possible cause to your problem. If you get your thyroid under control, then all of your testosterone related issues may be gone...

Originally Posted by CubbieBlue

I am still waiting for my adrenal function test but I have decided to give my PCP a call on Monday and get an appointment regarding my low testosterone.

I want to show him the AACE guidelines to treating hypogonadism to see if he will check my FSH/LSH to see if my pituitary needs to be checked. Is there anything else I should specifically ask him to check? What can I point him towards to get on board with the HCG? Can I do testosterone shots without HCG and have a shot at being fertile at some point in the future? I say shots because I previously attempted Androgel and suffered high anxiety for some reason from it. Testim seemed to work but I hate the smell of the shit.

Would anyone have any ideas why I did suffer the anxiety symptoms from Androgel in the past? That kind of irked me and my endo had no answers. I tried it for about 4 days and it got to the point where I had to stop because I thought I was going to pass out.

Thoughts?