Please Help

[ipi]

I would like to know as what kind a regime I need and if I am primary or secondary...

I heard about TRT and read about and his work in the past 48 hours. Here are my issues: For the last many years I have multiple issues, mostly pains in shoulders, back neck etc. I injure very easily and the recovery is not there... A few years ago I had a very bad reaction to an antibiotic and my muscles and bones were in a miserable condition and during the reaction I hurt my right thigh and somehow the hip. A week ago I was playing with my kids and my right muscle had a lot of pain and was not able to walk for a few days, the pain remains. To cut the story short my doctor found out that I am low on T, and that was the only issue that she found...Here is what my blood work show today:

Results as of 6/15/2015 (Recent)

PSA Ag, Serum 3.1 (0.0-4.0)
Free PSA 16.1 %
Free TTESTOSTERONE, serum 34 (52-280)
Bioavailable TESTOSTERONE, S 114 (95-350)
Bioavailable TESTOSTERONE, % 60.1
TESTOSTERONE, serum 148 (348-1197)
Hemoglobin A1,c 5.8 (4.8-5.6)
Free TESTOSTERONE, (dialysis) 1.8 (1.5-3.2)
Free T4 1.38 (0.82-1.77)
TSH 1.290 (0.450-4.5)
Vit D 41.3 (30-100)
hEMOGLOBIN 16.1
HEMATOCRIT 48



Results as of 12/1/2014

Hashimotos levels a bit higher than normal.
Testosterone,Total,LCMSMS 178 L 250-1100 ng/dL
ESTRONE, LC-MS-MS 28 < OR = 68 pg/mL
Testosterone, Free 54.1 35.0-155.0 pg/mL
ESTRADIOL, FREE 0.21 pg/mL
ESTRADIOL 9 ADULTS: < OR = 29 pg/mL
T4, FREE, NON-DIALYSIS 1.3 0.8-1.8 ng/dL
LH, SERUM 5.1 1.5-9.3 mIU/mL
FSH, SERUM 3.4 1.6-8.0 mIU/mL
TSH 2.04 0.40-4.50 mIU/L
T3, FREE 3.2 2.3-4.2 pg/mL
TESTOSTERONE, FREE 45.5 L 46.0-224.0 pg/mL
TESTOSTERONE, BIOAVAILABLE 91.6 L 110.0-575.0 ng/dL
TESTOSTERONE TOTAL,LCMSMS 178 L 250-1100 ng/dL
SEX HORMONE BINDING GLOBULIN 11 10-50 nmol/L


Results as of 05/24/2014

CBC (INCLUDES DIFF-PLT) QBA
WHITE BLOOD CELL COUNT 6.2 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 5.73 4.20-5.80 Million/uL
Testosterone,Total,LCMSMS 121 L 250-1100 ng/dL
Testosterone, Free 34.6 L 35.0-155.0 pg/mL
HEMOGLOBIN 16.6 13.2-17.1 g/dL
HEMATOCRIT 51.0 H 38.5-50.0 %
Every anti-aging doctor that I called in last 2 days doesn't accept insurance and charges loads of money. What should be the course of action, can my pains go away, I think I am loosing muscles and bone density. My body is a wreck. I am 46 years old.

 

[CoastWatcher]

Welcome to Excelmale.com. You certainly present levles more than consistent with hypogonadism. Some questions...what other medications are you currently taking? Have you a history of anabolic use, or opiate use? Any history of head injury? Did your doctor mention that you psa, while in range,iis on the higher side? History of prostate infection/prostatitis? The more information you can provide, the better the response here will be.

 

[Vettester Chris]

Based on what you presented, your LH looks to be in a pretty decent area. Your total test serum is definitely "LOW". I suspect your situation and diagnosis will probably lean to be in the "Primary" side of it; possibly one or both testicles under-performing. However, that subject needs to be fully reviewed with an exam by a qualified, trained physician.

When you say that Hashimotos levels are higher than normal, what does that mean? Do you have supporting labs with TPO and TgAb? Do you tend get antibody attacks that put you in a hyper-state condition? The current FT4 & FT3 serum levels are mid-range on the reference range, but that could have significant variance swings if Hashis is evident. We also need to compare this with Reverse T3 and the ratio it has to T3.

 

[ipi]

Vettester,

First of all thanks for responding as with the pain level and mood and lack of energy I am so desperate to get better.
One of my levels in the past TPO or TGb were up by about 25 points and those were up for a while. I remember that as a young man I was not very strong as well and I sometimes think that I had low T even in my youth. I got married and have 3 kids now but I used to get hurt easily and aches and pains etc. I also remember that I had MUMPS when I was a kid. In any case, let us say if I have to start from beginning what blood tests should I do before starting TRT?

One more question I also read that low E2 can cause osteoporosis and mine is 9 (Estrodial), do you agree coz I feel like bones a tearing apart.

 

[Tom Larabee]

ipi,

First let me welcome you to EM.

Second please read this to know what blood tests that should be run.

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

That is the basics, Chris may suggest others but the above is a good starting point.

Tom

 

[ipi]

Good question.

I used to go to urologists for burning of urine which I now think was due to some muscular issues coz of weak muscles in my Gut/lower abdomen area and doctors gave me Cipro thinking it was prostatitis which actually tanked my Ts further and I had a strong reaction to it, one being the hip and shoulder issue. I personally think that it was low Ts that got exposed further after taking Cipro. 3 years ago I decided to go to a medical research facility (George Washington University) and met a top urologist. At that time I had the burning while urinating and server aches and pains and he did a DRE and got a sample of the liquid that comes out during DRE and evaluated it under a microscope and he cleared me, there was nothing. And he asked me to be on an excercise program to loose weight which I couldn't coz of no strength. So my PSA is high but there is no evidence at least till the last time I did a DRE about 3 years ago. I used LDN and bio identical Ts for a few months but didn't use it for enough time I believe. My wife is a HYPO and has hashimotos and she swears by LDN, she can't live without it. LDN seems to be a cusre for MS, Thyroid etc.....I have not used any drugs, never drank, never a smoker etc....but had high stress in the last 15 years.

 

[ipi]

Tom,

tHANKS MUCH .... You seem to be in the VA area. Is there a decent doctor that I can go to that understands this whole business and TRT?

 

[Tom Larabee]

ipi,

I don't know of one here. I am a patient of Defy Medical, specifically because I couldn't find one that could meet my needs. I do look around periodically at Endo's and Uro's, so if I come across one I will post it in the reviews.

 

[ipi]

Tom, Do you I have to fly to Defy to see a doctor there as I think its in Miami?

 

[ERO]

No, Defy works with you via phone and email - I use them as well and recommend them to anyone. They have good prices and most importantly, they understand TRT.

 

[CoastWatcher]

Tom, Do you I have to fly to Defy to see a doctor there as I think its in Miami?

Defy Medical uses an innovative, telemedicine approach to patient care. There is a link to their site from Excelmale. There are a lot of members who rely on the doctors at Defy for patient care. I am not a patient, but have spoken to them in the past. Very helpful, patient-focused. Consider calling them with your questions.

 

[Tom Larabee]

What ERO and Coast said.

 

[MG123]

I have to disagree with Chris' assessment of primary. With your testosterone being so low I would expect your LH to be spiking if you were primary. I would lean towards secondary in my opinion.

 

[Vettester Chris]

I have to disagree with Chris' assessment of primary. With your testosterone being so low I would expect your LH to be spiking if you were primary. I would lean towards secondary in my opinion.

His LH is > 5.0!! My LH was 2.3 at one time and pulling out test serum in the 280ng/range.

If his LH is 5.1mIU and it's pulling a 178ng/dl total serum, what do you figure, maybe a 10mIU on his LH to get to 300ng/dl??? 5.1mIU on LH would have put me in the 600ng/dl range, as my Leydigs are healthy! The HPTA doesn't always "spike" with gonadotropin levels over the top, especially when there's the case of one (1) testicle that is under-performing.

 

[Vettester Chris]

OP, YES, E2 will play a significant role on the health of your bones, nails, hair, as well as your immune system and much more. It's such a crucial hormone to keep balanced.

 

[CoastWatcher]

OP, YES, E2 will play a significant role on the health of your bones, nails, hair, as well as your immune system and much more. It's such a crucial hormone to keep balanced.

To this point, my estradiol was almost non-measurable when I first presented. I was rushed into a bone density scan where, to my frustration, it was shown that I had very,very mild osteopenia. My most recent scan, two years later, shows that I am holding my own - with solid estradiol levels. It is a critical hormone for men.

 

[Vettester Chris]

To this point, my estradiol was almost non-measurable when I first presented. I was rushed into a bone density scan where, to my frustration, it was shown that I had very,very mild osteopenia. My most recent scan, two years later, shows that I am holding my own - with solid estradiol levels. It is a critical hormone for men.

CW, thanks for sharing! I think a lot of men underestimate the value of healthy estrogen levels. Good show!

 

[ipi]

Chris

After looking at my estrogens a what do you think? And let me ask one question if I were to start today what should my regime look like, the most conservative approach? A mix of HCG and T injections or just HCG with some estrogen blockers?