First off, thank you for everyone who posts on these forums. I have learned a lot of valuable information from going through theses posts as well as the books I am in the process of reading.
I'm 42 years, 5’9”, 175lb, exercise some but could be more
Like many of you, I was having low energy/brain fog/loss of libido among other symptoms. It started so long ago that I don’t remember when it started. I had gone to doctor three times over the past 3 years complaining of these symptoms. Each time they tested to see if I was anemic and then said I was probably just stress, anxiety, and depression. They wanted to put me on a SSRI to help. Since I didn’t think that was the issue I never went on them.
Fast forward to four weeks ago. I went in with the same symptoms and just told the new doctor that something isn’t right. No matter how much I sleep, I am always rundown. She again tested to see if I was anemic which came back negative but she also ordered other tests including testosterone. I went back two days later to find out I had low levels of vitamin D (8.9 ng/mL), B12 (172 pg/mL) and testosterone (168 ng/dL). She said all three of those could have me feeling rundown and didn’t know how I was functioning. I already knew I had low vitamin D as I was diagnosed with osteoporosis about 10 years ago. I could not tolerate any of the osteoporosis drugs so I have pretty much just been on calcium and vitamin D but I guess it wasn’t enough. I wish the doctor 10 years ago would have thought to check my testosterone levels at that time as I wonder how it could be related.
I also found out I had high cholesterol/triglycerides and my liver enzymes were high. She put me on a 50,000 IU of vitamin D weekly, monthly B-12 injections, and fenofibrate for the cholesterol/triglycerides. She said she was not knowledgeable enough to treat me for the testosterone and referred me to a urologist.
I met with the urologist last week. He went through the standard questions and an overview the different treatment options. He said some work better than others depending on your body chemistry, said I should do some research to see which method I am most comfortable with and we could discuss them in more detail when I came back for my follow up. He ordered blood work and said the insurance company usually requires two low samples taken around the same time before they would approve anything.
The first test from a week ago (8:50am) came back at 178 ng/dL. He also tested for other things and everything came back within the acceptable range except for ALT was still high. There were some at the high and low end of the ranges though (Estradiol, Prolactin, AST)
I just had the second testosterone test a week later at 9am and it came back at 334 ng/DL. I was not expecting to see it almost double. Keep in mind I have not had my follow up visit to discuss any of the test results and what they mean. That is in another 2 weeks.
Questions I have:
Any other advice you have would be greatly appreciated. I have been reading so much over the past three weeks as I want to make an informed decision. I'll include the blood results I have below in case it will help.
8/13/18 (GP):
8/30/18(Urologist):
9/6/18 (Urologist):
I'm 42 years, 5’9”, 175lb, exercise some but could be more
Like many of you, I was having low energy/brain fog/loss of libido among other symptoms. It started so long ago that I don’t remember when it started. I had gone to doctor three times over the past 3 years complaining of these symptoms. Each time they tested to see if I was anemic and then said I was probably just stress, anxiety, and depression. They wanted to put me on a SSRI to help. Since I didn’t think that was the issue I never went on them.
Fast forward to four weeks ago. I went in with the same symptoms and just told the new doctor that something isn’t right. No matter how much I sleep, I am always rundown. She again tested to see if I was anemic which came back negative but she also ordered other tests including testosterone. I went back two days later to find out I had low levels of vitamin D (8.9 ng/mL), B12 (172 pg/mL) and testosterone (168 ng/dL). She said all three of those could have me feeling rundown and didn’t know how I was functioning. I already knew I had low vitamin D as I was diagnosed with osteoporosis about 10 years ago. I could not tolerate any of the osteoporosis drugs so I have pretty much just been on calcium and vitamin D but I guess it wasn’t enough. I wish the doctor 10 years ago would have thought to check my testosterone levels at that time as I wonder how it could be related.
I also found out I had high cholesterol/triglycerides and my liver enzymes were high. She put me on a 50,000 IU of vitamin D weekly, monthly B-12 injections, and fenofibrate for the cholesterol/triglycerides. She said she was not knowledgeable enough to treat me for the testosterone and referred me to a urologist.
I met with the urologist last week. He went through the standard questions and an overview the different treatment options. He said some work better than others depending on your body chemistry, said I should do some research to see which method I am most comfortable with and we could discuss them in more detail when I came back for my follow up. He ordered blood work and said the insurance company usually requires two low samples taken around the same time before they would approve anything.
The first test from a week ago (8:50am) came back at 178 ng/dL. He also tested for other things and everything came back within the acceptable range except for ALT was still high. There were some at the high and low end of the ranges though (Estradiol, Prolactin, AST)
I just had the second testosterone test a week later at 9am and it came back at 334 ng/DL. I was not expecting to see it almost double. Keep in mind I have not had my follow up visit to discuss any of the test results and what they mean. That is in another 2 weeks.
Questions I have:
- Is it normal to see such a large fluctuation in testosterone from one week to the next and what could have caused the jump (1st-168, 2nd-178, 3rd-334)?
- Will this latest testosterone result that now is in the “acceptable range” cause insurance not to approve treatment?
- The doctor did not test for free testosterone or SHBG which I think I am going to ask so that I have a baseline. Any others I should have tested?
- Should I wait for the vitamin D, B-12, cholesterol, and liver enzymes to get into the normal range before starting TRT?
- I’m considering seeing an endocrinologist to do more thorough testing for thyroid/pituitary. Do you think this would be beneficial?
Any other advice you have would be greatly appreciated. I have been reading so much over the past three weeks as I want to make an informed decision. I'll include the blood results I have below in case it will help.
8/13/18 (GP):
8/30/18(Urologist):
9/6/18 (Urologist):
