Just started TRT, My Story, your thoughts please!

[FeelingLost]

I just got my TT results back. This is the only test my doctor ordered this time around. This test was done on the 8th morning after last injection and before I injected that day. I have been injecting since the beginning 100MG every 7 days, but the past 3 weeks I switched to every 8 days due to the hassle of filling prescriptions on time. This is a 8 day trough. Thoughts?

[TD="class: nameCol srchbl"]Testosterone,Total[/TD] [TD="class: valueCol"]738 ng/dL[/TD] [TD="class: rangeCol"]264 - 916 ng/dL[/TD]

[TD="class: srchbl, colspan: 3"]Adult male reference interval is based on a population of healthy nonobese males (BMI <30) between 19 and 39 years old. Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.[/TD]

Im Stopping TRT. I went to an Endocrinologist today, shesaid to stop TRT. Getting a new panel of blood tests done tomorrow morning to confirm her suspicions of Adrenal Insufficiency as the cause of my symptoms. I now become a statistic of those who quit in less than 1 year. What is a person to do? Everything she said to me makes sense. I need to follow the doctor’s advice or I am wasting her time and my time. I made it 4 ½ months lol.

This is good news, right? I know nothing about Adrenal Insufficiency I sure hope her diagnosis is correct. I hope you will still visit and let us know how you new treatment is going.

 

[ratbag]

Im Stopping TRT. I went to an Endocrinologist ,Getting a new panel of blood tests done

This in it's self is a waste of time. Blood tests do not show adrenal insufficiency they only show autoimmume addisons disease. Mainstream medicine doesn't acknowledge insufficiency anywhere. You have to see a hormone specialist and then you have to get saliva tests 4x diurnal to determine the insufficiency. Anything other than a saliva test is useless. Your endo will give you a serum cortisol lab and it'll show in range and maybe even low but bet you $10. that she'll say your fine and that isn't the problem when it most likely is.

 

[Deleted member 17030]

This in it's self is a waste of time. Blood tests do not show adrenal insufficiency they only show autoimmume addisons disease. Mainstream medicine doesn't acknowledge insufficiency anywhere. You have to see a hormone specialist and then you have to get saliva tests 4x diurnal to determine the insufficiency. Anything other than a saliva test is useless. Your endo will give you a serum cortisol lab and it'll show in range and maybe even low but bet you $10. that she'll say your fine and that isn't the problem when it most likely is.

Here are the labs she ordered. I couldn't go this morning because she wants them done while fasting. So I fast tonight and go 7AM Wednesday morning. The scary part is, you may be right and I haven't totally decided to throw in the towel on the TRT. She is not my doctor for that. Play it by ear. Next TRT shot not due till Sunday anyway. I value your opinion.

 

[ratbag]

yup that is a cortisol serum. It's good to test aldosterone that may be an issue for you but aldosterone labs are slow... as I recall sometimes 3 weeks before they are in. Or perhaps that only where I live.

 

[blackebob]

What were the indicators that caused her to tell you you need to stop trt totally?

If you're not getting good results at the doctor you should probably post on here your location and ask for referrals, or just link up with the Defy.

No such thing as to much "wood", unless its a climber.

 

[Deleted member 17030]

What were the indicators that caused her to tell you you need to stop trt totally?

If you're not getting good results at the doctor you should probably post on here your location and ask for referrals, or just link up with the Defy.

No such thing as to much "wood", unless its a climber.

I just thinks she don't like it. She first said she doesn't put patients on TRT, then caught herself and backtracked and then said she does do TRT but she don't put patients on TRT whose initial labs were only "low normal". At the time my initial labs were:

349 (348-1197)

But since then (3 months later) Lab Corp has reduced the interval to 264-916, so according to her, I'm not or wasnt low at all. But the Eurologist who started me on TRT said I was low based on the numbers and symptoms, thus he started the TRT.

She did admit that the TRT had nothing to do with my current low Cortisol / ACTH issues, but that in her opinion I should stop TRT anyway.

 

[Deleted member 17030]

I also told her I got my Potassium tested last week. She asked me what doctor did that and I told her no doctor, I just went and got it tested and she asked how and I told her about Discounted Labs. She said she had never heard of that. I told her you could get any labs you wanted. She said what do you do if it comes back bad? I said I guess you find a doctor.

I wanted to tell her what Feeling Lost said in another thread, to then just go buy your meds from India, but guess what she is lol. A scarf wearing Punjabi speaking Indian lol. She seemed nice enough though.

 

[Deleted member 17030]

Here she is, she actually spoke English very well. That just gripes my ass when people cant speak the English f#cking language clearly.

https://www.wellstar.org/physicians...aspx?pid=3bc05fff-1168-4ce5-9944-7e14fa77a018

 

[blackebob]

I am not going to defend a Doctor I do not know, and I have ran across some crappy ones. She might be closed minded about new input, and I have two in my history that come to mind. It seems like you will be fighting an up hill battle to convince her. She has earned the title though, perhaps you should just find a different Doc?

She probably has spent the night telling her Pakistani relatives how she should have told you to go order your meds from India.

 

[Deleted member 17030]

I am not going to defend a Doctor I do not know, and I have ran across some crappy ones. She might be closed minded about new input, and I have two in my history that come to mind. It seems like you will be fighting an up hill battle to convince her. She has earned the title though, perhaps you should just find a different Doc?

She probably has spent the night telling her Pakistani relatives how she should have told you to go order your meds from India.

That's going to happen anyway by default as she told me in advance that she will be going out on maternity leave soon and a new doctor will be taking over her patients.

So I go in the morning to get the labs done and will see how that turns out and what course she advises based on the lab results. The TRT really has nothing to do with this, she just told me I should stop it, and I may, or may not.

If my cortisol is currently as low as it was 2 months ago, and I have no reason to believe it would have gone back up, then I have a serious issue I need to have figured out there. That's probably whats been wrong with me for a long time.

I will follow up when I know something. ​

 

[ratbag]

What was the result of your potassium? Also you can get the the saliva tests from Discountedlabs.com on your own and not have to wait for some physician to figure it out.

 

[Deleted member 17030]

My Potassium from Discounted Labs, taken about 2 1/2 weeks ago was 3.7 (3.5 - 5.2) So it was low normal.

I went to Wellstar Lab today and had 6 vials of blood drawn lol. And you are right, the Aldersterone tests is done at some lab in California, where other blood tests are done locally so the Aldersterone test will take several days like you stated. I should have some of my labs back Thursday.

I do like how the web portal works with Wellstar, they email me when the tests results are posted at the same time the doctor gets them. So we shall see.

 

[ratbag]

Perhaps wait for the aldosterone result before you do saliva. If aldosterone is good then u have no choice but to pursue the saliva labs. Then all doubt will be eliminated.

 

[Deleted member 17030]

My blood tests came in today of interest is that my Prolactin is high, what does that mean and what can I do about it?

[TD="class: nameCol srchbl"]Prolactin[/TD] [TD="class: valueCol"]21.3 ng/mL[/TD] [TD="class: rangeCol"]4.0 - 15.2 ng/mL[/TD]

 

[ratbag]

High prolactin usually suggests a benign tumor on your pituitary. Typically next step is a MRI

 

[FeelingLost]

My blood tests came in today of interest is that my Prolactin is high, what does that mean and what can I do about it?

[TD="class: nameCol srchbl"]Prolactin[/TD] [TD="class: valueCol"]21.3 ng/mL[/TD] [TD="class: rangeCol"]4.0 - 15.2 ng/mL[/TD]

What about your other numbers? When my prolactin was above range my E2 was as well. I was given Anastrozole .125 EOD and in 5 weeks both E2 and prolactin were in range. Prolactin was back in single digits.



Since I have been on an AI current ly .125 M/T I have never had a prolactin reading in double digits.

 

[Deleted member 17030]

[TD="class: nameCol srchbl"]DHEA Sulfate[/TD] [TD="class: valueCol"]38.1 ug/dL[/TD] [TD="class: rangeCol"]48.9 - 344.2 ug/dL[/TD]

This is low, not sure what this is or means.

 

[Deleted member 17030]

[h=2]Comments from the Doctor's Office[/b]

Results as discussed on the phone:

- morning cortisol level was normal but low normal and given recent events leading to hospitalization there is concern for adrenal insufficiency (in response specifically to stress/illness) - this is likely related to years of getting steroid injections for the psoriasis
- potassium level is normal off the potassium supplementation
- as discussed on the phone, I would like to obtain an ACTH stimulation test to evaluate the cortisol production by the adrenals further

https://www.ucsfhealth.org/tests/003696.html
- A1c - test for prediabetes/diabetes shows prediabetes - this indicates an increased risk of diabetes - lifestyle/dietary changes to limit sweets. Sugars, carbohydrates and exercise for weight loss is recommended
- renin and DHEAS levels are low, aldosterone is low normal - all produced by the adrenal glands
- prolactin level is high - please have additional labs drawn either this week or next week to evaluate this further (no fasting needed)
- - please send me your dermatologist's information so I can discuss results with them
​

 

[ratbag]

Looks like you have HPTA dysfunction. Of course mainstream medicine looks for a reason but we know lots of people have varying stages of this. If he's saying low normal then you know for sure you are far away from optimal and you are definitely feeling the effect of it being so low. This is the problem with the ranges used in mainstream medicine. The low values are so low they are stupid. People feel bad long before it gets that low. So because you are in range you are pronounced fine! So if DHEA, cortisol and Aldosterone are low I bet you so is your progesterone. I had pretty much the same problem with all my hormones... bottom of range but just in range. All the endos I saw said your fine and nothing wrong with you, suck it up! Only after I saw a hormone specialists and got put on cortisol, florinef, thyroid and TRT did I come out of the fog. Anyways I'm sure there are dead people who likely have higher ranges than we do.

 

[Deleted member 17030]

Looks like you have HPTA dysfunction. Of course mainstream medicine looks for a reason but we know lots of people have varying stages of this. If he's saying low normal then you know for sure you are far away from optimal and you are definitely feeling the effect of it being so low. This is the problem with the ranges used in mainstream medicine. The low values are so low they are stupid. People feel bad long before it gets that low. So because you are in range you are pronounced fine! So if DHEA, cortisol and Aldosterone are low I bet you so is your progesterone. I had pretty much the same problem with all my hormones... bottom of range but just in range. All the endos I saw said your fine and nothing wrong with you, suck it up! Only after I saw a hormone specialists and got put on cortisol, florinef, thyroid and TRT did I come out of the fog. Anyways I'm sure there are dead people who likely have higher ranges than we do.

You post exactly sums up how I feel.

Tomorrow I go to the hospital to have a ACTH Stimulation test ordered by my Endo. I feel like this is just another long dark lonely highway to no where. But since the insurance approved it, I might as well.

I finally got my TRT Euro to refill my prescription. This joker has been on spring break the past 2 weeks. Thinks he is still a teenager or something. Good to go for 5 months.

I have reduced my TRT from 100mg every 7 days to 80mg every 7 days. Since my script was for the previous 100mg, I should not run out of medicine early this way either.

My doctor and I reduced my TRT with my agreeing to it because I believe that a 736 trough taken not 7 but 8 days after last injection was higher than I want to be at.

So off to discounted labs in 6 weeks to see where I am there with the full test panel, then see Euro again in 3 months. So that's where I am at currently.

I will follow up after I get the results of the ACTH stimulation test.