Introduction / Questions

[Ethan]

Hello all;

My name is Ethan from NJ and I am 22 years old...

I figured I would just jump right into my questions and concerns here and see if anyone can help me at all.

Slowly but surely, over the past few months I have been having erectile dysfunction issues, and my sex drive is decreasing quite noticeably. I also am often quite tired...
I went to the doctor for a regular physical and mentioned my issues to him...he seemed reluctant to test for testosterone because he mentioned TRT is not covered by most insurance companies and would be a waste. He did take bloodwork and ran tests and mentioned it all came back "normal". He mentioned it might be a thyroid issue because my hair is starting to thin as well.
But the results came back normal for thyroid as well, only thing was low Vitamin D.

I should mention that in the February of 2015, I was sick in the hospital for a week because of a mix of CMV, pancreatitis, and mono...but these issues did not exist last year, quite the opposite if anything.
Maybe my issues are simple, and my hair is thinning because it is common in men, and I am tired because I work a lot, and exercise and might need more rest, and the difficulty with erections and low libido is psychological? But it has noticeably decreased lately...and I am getting desperate.

Does anyone have any suggestions? Maybe other specific questions to ask my doctor? Anything I can try or take? Any help would be very much appreciated...Thank you!!!

 

[PAUL-E]

Welcome to ExcelMale, I would get your blood work and post your results with ranges "NORMAL" does not mean a whole lot around here just because your "in range" doesn't mean that your levels are appropriate for your age.

 

[Someguy]

It's becoming fairly well known that testosterone and/or thyroid levels in the "normal" lab reference ranges aren't optimal. You can still be low enough to have symptoms if you're fairly low but still within the "normal" range. Many doctors aren't aware of this and just send you on your way if you're within the range. I'd get copies of the actual lab result numbers for testosterone and thyroid and post them here.

 

[Vince]

Check out Nelson's discount labs, see if they are affordable for you? It's a good way to get the labs you need.

 

[PAUL-E]

Check out Nelson's discount labs, see if they are affordable for you? It's a good way to get the labs you need.

Blood Tests Needed Before and During Testosterone Replacement Therapy

https://www.excelmale.com/forum/sho...e-and-During-Testosterone-Replacement-Therapy

 

[Ethan]

It's becoming fairly well known that testosterone and/or thyroid levels in the "normal" lab reference ranges aren't optimal. You can still be low enough to have symptoms if you're fairly low but still within the "normal" range. Many doctors aren't aware of this and just send you on your way if you're within the range. I'd get copies of the actual lab result numbers for testosterone and thyroid and post them here.

Got it..What specifically should I ask tested when I get bloodwork taken?
For test levels, I need total and free, correct? What about thyroid?

 

[Ethan]

Got it..What specifically should I ask tested when I get bloodwork taken?
For test levels, I need total and free, correct? What about thyroid?

 

[CoastWatcher]

Got it..What specifically should I ask tested when I get bloodwork taken?
For test levels, I need total and free, correct? What about thyroid?

At a minimum: Total and free testosterone/LH/FSH/SHBG/Estradiol (sensitive)/TSH/T3, T4, rt3/DHT/CBC/PSA

 

[PAUL-E]

I would also add CMP and you could do a IGF-1 for a baseline but its not really needed.

 

[Ethan]

At a minimum: Total and free testosterone/LH/FSH/SHBG/Estradiol (sensitive)/TSH/T3, T4, rt3/DHT/CBC/PSA

I am new to this so I am just checking...I should ask the doctor for all of those things specifically? All 12 or so separately?
Do I need to go to the general physician and request for bloodwork, or is there an easier way?
I really appreciate everyones help, I am new to all of this.

 

[Someguy]

All of those that Coastwatcher listed are what a good doctor would require to get a good overall picture before starting you on TRT.

If you just want a quick and dirty overview to see whether your problems are likely caused by testosterone or thyroid issues you could get a good idea with just total testosterone, free testosterone, estradiol (sensitive), and TSH.

You can try to get your doctor to order these and give you copies of the results so they'll (hopefully) be covered by insurance. Be aware that it's difficult to get doctors to understand the need for the SENSITIVE estradiol test and order the right test.

Alternatively, you could order and pay for the tests yourself through discountedlabs.com. They'll email you requisitions to print out and bring in to a nearby Labcorp location. Labcorp draws your blood, and you get results by email in a week or so.

If you post your lab results here you'll get sime opinions on whether it's worthwhile for you to seek out a knowledgeable doctor for TRT or thyroid evaluation.

 

[Ethan]

I went onto the discountedlabs.com and they do not serve customers in NJ...
any other options like this?

Also, the Estradiol (sensitive) and TSH covers thyroid correct? And free/total covers test?

 

[Someguy]

A small number of states outlaw patients ordering their own blood tests. Unfortunately, it looks like yours is one of them. Sorry.

Free/total test covers test. Estradiol covers a form of estrogen that can cause low-t like symptoms if it's off. TSH gives an overview of your thyroid function. You could potentially leave out the estradiol (sensitive) test if you need to save money or your doc won't order it. Free and total Testosterone plus TSH will give a pretty good idea of whether you're barking up the right tree.

 

[Ethan]

If I ask my doctor to test "complete panels" for both test and thyroid...will he be willing and will this cover everything you all have mentioned?

 

[Vettester Chris]

I went onto the discountedlabs.com and they do not serve customers in NJ...
any other options like this?

Also, the Estradiol (sensitive) and TSH covers thyroid correct? And free/total covers test?

Ethan, welcome to EM! Glad you joined!! On the thyroid, get the full picture. T3 can be pooling, which could make the TSH lab look "normal", and there's a myriad of other factors that could be in play that will make testing TSH "only" a poor choice for trying to assess your thyroid.

Start with TSH, but you also need Free T3, Free T4, Reverse T3, and if you never checked antibodies get the TPO & TgAb drawn. Patients with autoimmune disorders will look great going by their TSH ... Don't rely on it exclusively or it can come back to bite you!