Went Cold Turkey - Starting Over - Need Guidance

[InThePines76]

Hi all,

As some of you may have read in my previous posts, I have had a misadventure in TRT and possible misdiagnosis, or rather, no attempt to find underlying cause. To sum it up for those who havent read the other posts, please read the firs posting here before proceeding:

HRT / Low T dilemma. Very confused. Help!

For those who dont want to read it, here is a synopsis:

At first testing: had low normal T levels (420ish (241-850)). Was tested later and also had low normal FSH and LH levels (3.0 and 2.8). Prolactin was ok at 5.2 (3.0-30.0) I had thyroid tested, and dont know what the number was but the Uro said it was OK. But he also said a T level of 400ish is great for a 30 year old, so who knows.

Had/have moderate ED, almost total lack of libido (before all this I was VERY high drive/function), difficulty concentrating/remembering, low physical energy, lack of motivation and would get VERY tired (like I was drugged) a couple times a day, especially immediately after stressful events. I also seem to get sick more often, but maybe it is coincidence. Also got/get sharp headaches that only last a few seconds (also maybe unrelated.. just put it here for posterities sake)

Doctor slapped me on TRT (Androgel) without doing any further tests. (The LH/FSH etc was done way down the road, after the first round of androgel did no good) The lowest dosage only brought my levels to 250.. so he put me on the highest dosage (10mg), which only brought levels to 358.
I was on low dosage for about a year. I stayed on the highest dosage for about 4 months.

Long story short... after becoming very frustrated at the lack of results, and the doctors complete lack of willingness to test other parameters, I quit TRT about four weeks ago. It is not as bad as I expected. What weak erections I could get before have completely diminished to nothing, but other than that, I feel about the same as before quiting, which isnt great.

So my questions about starting from square 1 are:

1) Should I see Urologist (I have been through three) or Endo (havent tried one yet)? (I cant afford to go to Dr John)

2)Can anyone suggest, or help me find a urologist or endo in any of the major Texas metro areas (Houston/Dallas/Austin) that will work with me and treat the patient instead of the number? I have had horrible luck and found only docs who dont want to do any detective work. I can't afford to go see Dr. John. I have seen Dr. Light in Houston (bigshot endo), and he said it was all in my head, and to not waste his time.

3)Could my low-normal FSH and LH indicate a HPTA / HPA (same thing?) problem?

4)If it is something like in #3, could it have been brought on by a 5-8 year period extreme, nonstop stress and lack of sleep? (For the record: Stress is gone. Have great life now other than these problems)

5)I know this may be outlined in the "TRT:Recipe" or other technical writings, but what tests should I have done first and foremost? I understand that the answers are probably elsewhere in the forums, and I have read most of the posts, but I find most of them very confusing. If someone could give me a short list of the unabbreviated names of tests to do (and why would also help), I would be most appreciative. I have 100% insurance coverage for a few months. I only have that period of time to do all testing that needs done. It will cover anything from xrays/mri to bloodwork, if the doctor orders it.

Thanks in advance for your replies. You guys have been extremely helpful and knowledgable.

[JanSz]

Originally Posted by InThePines76

Hi all,

As some of you may have read in my previous posts, I have had a misadventure in TRT and possible misdiagnosis, or rather, no attempt to find underlying cause. To sum it up for those who havent read the other posts, please read the firs posting here before proceeding:

HRT / Low T dilemma. Very confused. Help!

For those who dont want to read it, here is a synopsis:

At first testing: had low normal T levels (420ish (241-850)). Also had low normal FSH and LH levels (3.0 and 2.8). Prolactin was ok at 5.2 (3.0-30.0) I had thyroid tested, and dont know what the number was but the Uro said it was OK. But he also said a T level of 400ish is great for a 30 year old, so who knows.

Had/have moderate ED, almost total lack of libido (before all this I was VERY high drive/function), difficulty concentrating/remembering, low physical energy, lack of motivation and would get VERY tired (like I was drugged) a couple times a day, especially immediately after stressful events. I also seem to get sick more often, but maybe it is coincidence. Also got/get sharp headaches that only last a few seconds (also maybe unrelated.. just put it here for posterities sake)

Doctor slapped me on TRT (Androgel) without doing any further tests. The lowest dosage only brought my levels to 250.. so he put me on the highest dosage (10mg), which only brought levels to 358.
I was on low dosage for about a year. I stayed on the highest dosage for about 4 months.

Long story short... after becoming very frustrated at the lack of results, and the doctors complete lack of willingness to test other parameters, I quit TRT about four weeks ago. It is not as bad as I expected. What weak erections I could get before have completely diminished to nothing, but other than that, I feel about the same as before quiting, which isnt great.

So my questions about starting from square 1 are:

1) Should I see Urologist (I have been through three) or Endo (havent tried one yet)? (I cant afford to go to Dr John)

2)Can anyone suggest, or help me find a urologist or endo in any of the major Texas metro areas (Houston/Dallas/Austin) that will work with me and treat the patient instead of the number? I have had horrible luck and found only docs who dont want to do any detective work. I can't afford to go see Dr. John. I have seen Dr. Light in Houston (bigshot endo), and he said it was all in my head, and to not waste his time.

3)Could my low-normal FSH and LH indicate a HPA problem?

4)If it is something like in #3, could it have been brought on by a 5-8 year period extreme, nonstop stress?

5)I know this may be outlined in the "TRT:Recipe" or other technical writings, but what tests should I have done first and foremost? I understand that the answers are probably elsewhere in the forums, and I have read most of the posts, but I find most of them very confusing. If someone could give me a short list of the unabbreviated names of tests to do (and why would also help), I would be most appreciative. I have 100% insurance coverage for a few months. I only have that period of time to do all testing that needs done. It will cover anything from xrays/mri to bloodwork, if the doctor orders it.

Thanks in advance for your replies. You guys have been extremely helpful and knowledgable.

Do the blood tests listed below after you are about eight weeks from quitting Androgel.
If you are using any thing else (medicines, supplements) keep it steady for about four weeks.
Some people do not respond to transdermals, they have to do shots.
What counts is a blood level of T and not how much Androgel you put on you.
When you need T, you have to deliver it and make sure it got there.
When you (eventually) will get back to using testosterone shots, do not even try any more than every three days to keep T levels relatively steady. Weekly injections cause too much ups and downs.
Since you will be starting fresh (sort of) you may want to do any treatment in certain sequence and wait to see your reaction to it..
Adrenals
thyroid
sugar/insuline
estrogens
progesterone
LH/FSH replacement with HCG and or Dermacrine
testosterone
============================
Use quest diagnostics, print list and ask doctor to attach list below to a script, that should be least painfull way (to a doctor). Ask doctor to request that the results be send via e-mail.

Complete metabolic Panel
Hepatic Function Panel
Lipid Panel
CBC

Total Estrogens
estrone
Estradiol, sensitive
Progesterone
Pregnenolone
Total Testosterone
Free Testosterone (calculated)
Bio-available Testosterone (calculated)
Albumin
sex hormone–binding globulin (SHBG), serum
DHT (dihydrotestosterone)
Hematocrit
prolactin, serum
FSH (3rd Generation)
LH
Thyroid Stimulating Hormone (TSH)
Free (T3) triiodothyroxine
Free T4
Total T4
Total T3
DHEA Sulfate
Cortisol, AM/PM
SOMATOMEDIN C (IGF-1)
IGF-BP3
C-reactive protein (high-sensitivity)
Fibrinogen
Hemoglobin A1C
Lp(a) lipoprotein
Bilirubin
AST (SGOT)
ALT(SGPT)
VLDL
Homocysteine
Insulin, fasting
Glucose, plasma
Magnesium
Vitamin D, 1, 25-Dihydroxy
Folate
Vitamin A
Ferritin
B12, selenium, zinc, copper
Free PSA
FreePSA/Total PSA
aldosterone
Estradiol, Bioavailable

[JanSz]

Interview doctors using this sources:


http://www.osteopathic.org/directory.cfm

http://www.thyroid-info.com/index.htm

[pmgamer18]

JanSz has given you some good info but you do need to test for Adrenal fatigue if you can't afford a lot of tests. Then do TT, FT, LH, FS, TSH, FT3, FT4 and morning Cortisol fasting. What I am looking for is if your Primary or Secondary. For low Testosterone or Thyroid.