Symptoms & next steps

[zojo360]

Have you thought of taking a break from lifting? Giving your body some rest perhaps? With the stress and anxiety you have, add in a psychotropic medication (lexapro), a month or so of easy does it could possibly give your body and mind a nice break. Imho.

 

[FreeRangeYeti]

For years I never took any real time off. About 10 years ago, I started programming deloads into the workouts to help me heal. That and the low load / high volume pump workouts where I never loaded up the muscles, but did enough to stretch and pump blood into the tissues combined with cardio and stretching, and I was good. Lately, I have started to take more time off. Down from 6-7 days to 4, and 2 of the 4 days programmed with higher intensity and the other 2 for recovery. I have also had more injuries in the past two years than in the previous 25. I had a quervain's sprain in my left wrist, a pulled left groin, and a torn left rotator cuff. I've rehabbed all of them, and I'm lifting much lighter than I have in the past and still not recovering. I feel like more time off will only cause more atrophy. In fact, after each week I have taken off, even with yoga and calisthenics, my joints ache. As long as I keep lifting, I feel pretty good, just struggle with the issues above.

 

[Dr Justin Saya MD]

"They don't do anything until you go under 175"...

SIGH...where do they come up with this stuff? That's like saying I'm not going to treat your diabetes until your hemoglobin A1C is >12 (and your kidneys, arteries, and nerves are trashed)!

 

[johndoesmith]

"They don't do anything until you go under 175"...

SIGH...where do they come up with this stuff? That's like saying I'm not going to treat your diabetes until your hemoglobin A1C is >12 (and your kidneys, arteries, and nerves are trashed)!

We're not treating your heart attack until your pulse is 0.

 

[FreeRangeYeti]

LOL, it is ridiculous what the doctors here and insurance make you go through. My father is 74, and his T was taken multiple times, all under 100. Had every symptom, and we had to pay out of pocket for a month before the insurance would cover him. His quality of life has changed in such a dramatic way that he seems like a new man. Its like I have my father back from my teen years!

 

[FreeRangeYeti]

I researched my insurance company and HAP does cover testosterone replacement, which just confuses me as to why my levels need to be so low (<175) before they will consider treating. Is there something I am missing? It seems like from my multiple low T symptoms as well as my years of labs all showing levels at the bottom of the range, they should be able to treat. Why won't they even diagnose?

This isn't me trying to load up on AAS. If I wanted to do this illegally, I could. I am going to do this for my health and to remain compliant with the law. I would not put myself of my family at risk!

 

[Dr Justin Saya MD]

I researched my insurance company and HAP does cover testosterone replacement, which just confuses me as to why my levels need to be so low (<175) before they will consider treating. Is there something I am missing? It seems like from my multiple low T symptoms as well as my years of labs all showing levels at the bottom of the range, they should be able to treat. Why won't they even diagnose?

This isn't me trying to load up on AAS. If I wanted to do this illegally, I could. I am going to do this for my health and to remain compliant with the law. I would not put myself of my family at risk!

There may be a silver lining...unfortunately even if they DID treat you, it would likely be substandard care and then you would have other issues to deal with. "Not treating until levels are below 175" reflects a general lack of understanding of the importance of adequate/optimal testosterone levels for longterm health and quality of life. You should seek a more understanding (and more knowledgable) provider to work WITH you as opposed to against you. Best of luck and that's awesome news about your father...good for him!

 

[FreeRangeYeti]

I am going to contact Defy and get an opinion. The comments and help from this site has been far and away more than I have received from all of the doctors I have already visited put together. I have one question though. Prior to getting new labs, should I start taking everything OTC that is supposed to help to see how much it changes vs. the labs I already have? I already take Choline Bitartrate, boron, zinc, and I have read that saw palmetto, pygeum, and grape seed extract could help. Should I start taking these?

 

[johndoesmith]

I am going to contact Defy and get an opinion. The comments and help from this site has been far and away more than I have received from all of the doctors I have already visited put together. I have one question though. Prior to getting new labs, should I start taking everything OTC that is supposed to help to see how much it changes vs. the labs I already have? I already take Choline Bitartrate, boron, zinc, and I have read that saw palmetto, pygeum, and grape seed extract could help. Should I start taking these?

Probably not. Get labs, and go from there, adding in a ****tail of random supplements is only going to cause questions to pop up if one of your test results is out of range.

 

[DaveK22]

Do some research on saw palmetto before using. Some claim that it can cause permanent hormonal damage similar to PFS.

https://www.google.com/search?q=saw+palmetto+pfs&ie=utf-8&oe=utf-8

 

[Dr Justin Saya MD]

^^ Agree with both above^^

Saw palmetto is generally better tolerated than finasteride (i.e. less risky), but does have 5-alpha reductase inhibitory effect nonetheless.

 

[Gene Devine]

^^ Agree with both above^^

Saw palmetto is generally better tolerated than finasteride (i.e. less risky), but does have 5-alpha reductase inhibitory effect nonetheless.

I've stayed away from it for just that reason; it can have PFS effect from my research as well.

 

[Dr Justin Saya MD]

The 5-alpha reductase inhibitory effect is seen even at commonly used doses of 160-320mg, and likely increases in a dose-dependent manner.

A few interesting reads:

http://www.jstage.jst.go.jp/pub/html/AY03S050_en.html;jsessionid=81630A849A7EB84FD9A7F5FA3482C636

"supercritical CO2 extract used in trials (Sabalselect® - a saw palmetto extract) has been tested for its actions on rat 5α-reductase where it was found that two constituent fatty acids, oleic acid and lauric acid, inhibited the activity of this enzyme with IC50 values of 54.3-54.5µg/mL and 66.2-67.6µg/mL respectively
( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4002402/ )

An interesting read on plant derived anti-androgens:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693613/#!po=51.3158

Many don't know that GREEN TEA can actually cause 5-alpha reductase inhibition (i.e. lowering DHT).

 

[FreeRangeYeti]

Oh no! I have been on saw palmetto, which was a PCP recommendation for some of the same reasons in the thread you sent over. I think they believe that it would not cause lasting harm because the source is natural and not pharmaceutical! I am stopping taking that right now.

 

[johndoesmith]

Oh no! I have been on saw palmetto, which was a PCP recommendation for some of the same reasons in the thread you sent over. I think they believe that it would not cause lasting harm because the source is natural and not pharmaceutical! I am stopping taking that right now.

Hemlock is natural. It most certainly caused Socrates some harm.

Of course, that is an exaggeration, but natural ! = safe.

Many many medicines are from plants, and they are extracted and purified for pharmaceuticals. You wouldn't think the same thing about a drug from the pharmacy.

 

[FreeRangeYeti]

I think what was more concerning was that I was told to take it by my physician without any discussion of sides.

In talking to a doc here, he was asking about how I carry as much muscle mass as I do without supporting testosterone. My last dexascan had me at 210 lbs. lean mass and 68 lbs. fat. He contends that my problem may be more cortisol related driving the increased estrogen production. Does anyone have any ideas on that? I looked at my labs, and I don't see anything specific for ACTH. They tested the T3 & T4 that I listed in the thread above.

Could an elevated cortisol level from all the stress I have been going through be a reason why my test is low and my E2 is high, or does that not make sense? I am trying to get an idea of what labs to have my doc run before consulting with Defy or anyone else. I don't want to go to TRT if there is another route to try first. I have always been an anxious, Type A person prone to anxiety, but I haven't until the last few years had trouble recovering from workouts, needing more sleep, lacking motivation, lower sex drive, etc.

 

[CoastWatcher]

I think what was more concerning was that I was told to take it by my physician without any discussion of sides.

In talking to a doc here, he was asking about how I carry as much muscle mass as I do without supporting testosterone. My last dexascan had me at 210 lbs. lean mass and 68 lbs. fat. He contends that my problem may be more cortisol related driving the increased estrogen production. Does anyone have any ideas on that? I looked at my labs, and I don't see anything specific for ACTH. They tested the T3 & T4 that I listed in the thread above.

Could an elevated cortisol level from all the stress I have been going through be a reason why my test is low and my E2 is high, or does that not make sense? I am trying to get an idea of what labs to have my doc run before consulting with Defy or anyone else. I don't want to go to TRT if there is another route to try first. I have always been an anxious, Type A person prone to anxiety, but I haven't until the last few years had trouble recovering from workouts, needing more sleep, lacking motivation, lower sex drive, etc.

Defy is not a TRT mill. They can, and will, investigate all aspects of your health - including cortisol, thyroid, estradiol, all that you're anxious over and, certainly, testosterone (obviously that will include the appropriate testing). I'd simply ask them to work with you now to sort out all the issues you have. They can answer the questions you're coming here with, and act on them, much more capably than we can.

 

[FreeRangeYeti]

Update - Stopped using saw palmetto due to research provided by the team here. Now I have a persistent ache in the testicles worse on the right than the left. Sort of the same feeling as when they are struck by a graze and you get that sick feeling. Also have intermittent pain in the prostate area. Wonderful.

I have tried to use my PCP & Urologist to help with figuring out my symptoms. I asked my doctor to help with the labs since those are covered by my insurance, and he won't even discuss the LS/MS/MS sensitive E2 test because it doesn't come up in his lab selections & he works at St. John Providence hospital, and he doesn't feel comfortable. I even sent him the codes for Labcorp & Quest diagnostics and then emailed the hospital lab myself. I have one more shot with the urologist on Thursday and I'm just going to go out of pocket with Defy. Tough to budget when I'm already dropping $600/month on HMO medical, but since they won't help, I'm left without a choice.

Thanks everyone. I'll post an update after I get this sorted out.

 

[CoastWatcher]

Update - Stopped using saw palmetto due to research provided by the team here. Now I have a persistent ache in the testicles worse on the right than the left. Sort of the same feeling as when they are struck by a graze and you get that sick feeling. Also have intermittent pain in the prostate area. Wonderful.

I have tried to use my PCP & Urologist to help with figuring out my symptoms. I asked my doctor to help with the labs since those are covered by my insurance, and he won't even discuss the LS/MS/MS sensitive E2 test because it doesn't come up in his lab selections & he works at St. John Providence hospital, and he doesn't feel comfortable. I even sent him the codes for Labcorp & Quest diagnostics and then emailed the hospital lab myself. I have one more shot with the urologist on Thursday and I'm just going to go out of pocket with Defy. Tough to budget when I'm already dropping $600/month on HMO medical, but since they won't help, I'm left without a choice.

Thanks everyone. I'll post an update after I get this sorted out.

I'm sorry you're dealing with the sort of frustration and professional insecurity that so many of us have encountered. You can test the sensitive estradiol yourself, no doctor's order necessary, at www.discountedlabs.com. All blood work is performed by LabCorp. I use them, lots of us do. Results emailed to you.

 

[FreeRangeYeti]

Thanks Coastwatcher. This has been a real pain to deal with. I'm at this point not sure what to do. I was able to get some updated labs, and I would welcome anyone's opinion on the next steps given all discussion above on symptoms.
Labs: View attachment FREERANGEYETI Labs 1-25 and 1-9.pdf