New to the site. Current symptoms and findings. What should I expect?

[mtndude]

Realized this post was a bit long. I've summarized up top. Details further down.

QUICK VERSION:
Been feeling like crap for 3 months. Have had numerous expensive doc / specialist appointments, imaging scans, blood tests, and more tests, tests, testsssss etc with normal results.
I saw doc on last Thursday and has some blood tests. I think i might have some results that could point me to a possible cause as to why im feeling the way I do..

Abnormal results:
Vitamin D - 23 (normal 30-80)
Testosterone - 71 (normal 240-870)

I saw my results online. Have yet to actually talk to a doc for next steps. Waiting on them to call me back.
Any advice on next steps??




DETAILED VERSION:
Hello - I'm a 38y/o married, father of 4 here looking for some confirmation, experience and/or guidance.
Sorry if this is a long post.
Been feeling like crap since June 2nd, 2019. Prior to this date, i had been normal, healthy and active my entire life.

Started as what seemed to be a stomach bug on June 2nd, turned into gastritis/duodenitis/gi inflammation. Treated that and lost ~30lbs from June to mid-july 2019 from inability to eat from gastritis pain and the anxiety that comes with having gastritis and not eating much.
Had been biopsied during gastric scopes and results were negative for autoimmune or bacterial causes. Suspected Ibuprofen as the cause. (Just prior to gastritis, i had a real stressful time, some stitches and some alcohol over a couple days is all)

I've had a number of weird symptoms since the gastritis healed. I've also had a ton of doctor and specialist visits and a ton of labs, imaging, cultures, and scope tests. The past few months has cost me a small fortune in my attempt to find the source of my issues so i can hopefully back to normal again.

Within the past couple weeks, I had a couple new issues pop up, so i saw my doc last Thursday 8/29. He was reluctant to run more tests since all of my previous tests keep coming back normal, but i got him to run them anyways.
He ran CBC, CMP, B12, Vitamin D, Parathyroid and testosterone.
A friend i had recently reconnected with told me a story of how he had some issues for years, then they found he was Low-T - this is the only reason i mentioned to the doc to test for this.

With how crappy i've been feeling, i expected all labs to come back with near organ failure or cancer or something. Nope, labs came back normal with the exception of the following which were abnormal:
Vitamin D - 23 (normal range 30-80)
Serum testosterone - 71 (normal range 240-890)

Here are the symptoms ive been experiencing:
- Bouts of dehydration - Never had this before all this started. Sometimes i get hot and shaky. Have to constantly drink water and gatorade it seems. Used to be able to drink a few cups of water a day, work and sweat have a couple beers and i would be fine.
- Frequent peeing - Used to pee 2 or 3 times a day maybe, depending on how much water i drank. I also wake up in the middle of the night having to pee. I used to be able to sleep through the night.
- Dry eyes/mouth - Never had before all this started. Started shortly after endoscopy/colonoscopy June 24th.
- What i can only describe as "hot flashes". I can suddenly get real hot starting in my face, head, ears, neck and it flows through my entire body. My skin just gets hot/burning. I dont get red or sweaty. Feels awful when it happens.
- Dry, sensitive skin - Before all this, i used to sweat all the time and i was always oily, which was normal for me.
- I sunburn realllllly easy now - Started a couple weeks ago, I used to be able to work outside, all day in the direct sun and never an issue. Now my skin burns fast as hell.
- Insomnia - I can usually fall asleep at night, but i usually wake up at 2-3am and cant get back to sleep for a few hours. I used to be able to sleep all damn night.
- Lethargic, tired, depressed, unmotivated, anxiety, bummed out - I used to be a goal setter and wake up in the morning ready to knock out projects in the house or at work. I rarely ever watched TV because i always had some project in progress. I used to ride my bike 5-10 miles a few times a week. Now i try and i get up the street and back and i feel tired.
Now I just dont have that drive or energy. I have anxiety because i dont know what the hell is going on in my body, i feel depressed because i dont know why i cant go back to normal and i feel like i'm gonna die in 6 months. (i know, sounds dumb).
- Gastro stuff - Alternating diarrhea and near constipation. Stomach aches, etc. Used to be fine and consistent with the occasional upset. Seems like one extreme or the other in my guts anymore.
- Difficult to focus/concentrate - Have a technical job, and its been getting more difficult as these past couple months have rolled by. Hard to think some times.
-Morning wood - This is a rare occurrence. Seemed to slow down a couple years ago. Thought was related to being in my 30's.
- Weak, tired muscles - Last fall, I built a 12x16 carrying all the raw materials myself, cutting, nailing, screwing, painting, etc. I spent days outside, after my full time job building that thing and I felt great after a good days work. Also worked on finishing my basement framing earlier this year and felt great. This is how I always would feel. Now i cant imagine putting in that effort. My leg muscles feel tight and weak at times, and my arm muscles feel weak other times. comes and goes.
I'm 6'3" and was 270lbs of "get it done!" now it feels like i'm a 6'3" 250lb weakling.
I feel like i have a v8 engine running on low oil and only 4 cylinders some days when i used to be able to fire all cylinders and work all day.

That probably covers the majority of how ive been feeling.
Now my big questions are:
- Can so low of testosterone level (71) cause the symptoms I am feeling?
- Has anyone else with low-T felt similar symptoms i've listed?
- I suspect my doc will refer me to an endocrinologist. Are there other next steps I should push for to get faster, more accurate treatment?
- Could my weight loss during my gastritis lack of food intake phase contributed to this?

I wonder if low-T could be a cause for my issues or if there is something else causing the low-T.
A lot of my symptoms seem to align with Thyroid issues, but my labs seem OK for the thyroid.

All I know is that I want to be back to my normal, active, healthy self and i'm tired of feeling so run down and crappy. Our summer was wasted because i felt like junk the whole time.
So many missed opportunities to travel and make memories with the family. Bums me out thinking about it. I want to go back to doing active stuff with my family.

Anyways, If anyone could share their thoughts, ideas, experiences or guidance, I would really appreciate it.
Thanks for reading.

 

[S1W]

Most of us here are not doctors, and it seems as if you may have multiple issues that cause you to feel the way you do. I cannot comment on how your GI issues are affecting you, though it seems likely that they are.

However, with a TT of 71 at age 38, yes, you are most definitely a candidate for TRT and you will more than likely benefit from it.

You are correct that your GP will likely refer you to an endo. With your levels as low as they are, your insurance will likely cover it, too. The downside to this is that most docs, endos included, do not focus on male hormones and some of the treatment protocols we see described here range from simply outdated to absolutely terrible.

You might seriously consider skipping the hassle of all of that and paying out of pocket with one of the site sponsors.

TRT is no panacea, though with almost rock bottom levels like yours it may be. For reference, I was in the mid 300s TT pre-treatment and it made a difference for me. But you still have to eat well, sleep well, exercise, and generally take care of yourself.

Your treatment options are basically compounded cream, applied daily, and injections, which you can self-administer as frequently as daily or as infrequently as 1x/week. A knowledgeable doc will help decide which might be best for you. They each have pros and cons, and if you're doing this for life odds are good that you'll experiment with protocols and try both. That said, cream will start working more quickly and is much easier to dial in, and if you're just interested in seeing if TRT makes a difference for you, you might consider starting out with cream. Believe me, you'll have plenty of time to try all manner of protocols if you decide at some point you want to switch to injections, etc.

Though your doc might recommend you start with an AI and HCG, IMHO you should start out on T only, see how that feels for you and get that dialed in, and go from there, only adding in other drugs if you need them. Don't be shy to just tell them that if they recommend other drugs - gotta be your own advocate.

This site is a great resource - best of luck.

 

[Systemlord]

Sometimes i get hot and shaky.

Low estrogen can cause these symptoms, my sisters after menopause experience hot flashes all the time. I had digestive issues after my testosterone crashed (120 ng/dL) do to withdrawing of benzo for 30 years, all your health problems are more likely the result of low testosterone.

If you are expecting your endocrinologist to understand male sex hormone therapies, you're in for a rude awakening. None of my endocrinologist's I saw specialize in TRT, they actually claim online to specializes in thyroid and diabetes and nowhere does it mention TRT.

The treatment protocols for TRT are outdated, 200mg every 2 weeks is shown to cause estrogen dominance is most men, yet this is the standard of care for TRT nationwide. We see most endo's refuse estrogen testing for men on TRT, this test is critical.

SHBG is another important one, this is the centerpiece of any sex hormone evaluation, it's the balance between Total T and the free portion of testosterone, Free T which is where the rubber meets the road.

Your SHBG is probably very low, something I see often when Total T is this low which pretty much dictates your TRT protocol to very frequent injections, which is daily injections using insulin syringes.

You should also be looking at the thyroid hormones, TSH, Free T4, Free T3, Reverse T3 and antibodies. I would suggest you find a private doctor that specializes in this area of medicine and not some doctor that only prescribes TRT on occasion.

You want a doctor that prescribes daily basis, who knows who to play this hormone game.