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25 y/o Low T, symptoms, labs

Discussion in 'Male Health & HRT' started by largeitalian, Apr 28, 2011.

  1. largeitalian

    largeitalian Member

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    5/29/08
    Free Test: 52 Range 47-244 pg/ml
    Total Test: 245 Range 400-1080 ng/dl

    6/18/08

    Test Free: 103 Range 47-244 pg/ml
    %Free: 2.4 Range 1.6-2.9
    Sex Horm Bnd Glob: 19 Range 11-80 nmol/L
    Total Test: 432 Range 400-1080 ng/dl
    Prolactin: 18.6 Range 2.6-13.1 ng/ml
    LH: 8.5 Range 1.2-8.6 mlu/ml
    FSH: 8.9 Range 1.3-19.3 mlu/ml
    Calcium: 9.3 Range 8.4-10.2
    Glucose: 91 Range 75-99
    Creatinine: 1.2 Range .7-1.3
    BUN: 24 Range 10-25
    Sodium: 138 Range 135-145
    Potassium: 4.3 Range 3.5-5.1
    Chloride: 101 Range 101-111
    CO2: 30 Range 21-32


    7/31/08

    TSH: 4.42 Range .34-5.60
    Free T4: 1 Range .58-1.64
    Prolactin: 34.6 Range 2.6-13.1
    Free Test: 82 Range 47-244
    %Free Test: 2.1 Range 1.6-2.9
    Sex Horm Bng Glob: 24 Range 11-80
    Total Test: 383 Range 400-1080

    9/23/08

    Prolactin: 37.4 Range 2.6-13.1
    Free Test: 127 Range 47-244
    %Free Test: 2.5 Range 1.6-2.9
    Sex Horm Bnd Glob: 17 Range 11-80
    Total Test: 504 Range 400-1080

    Started using cabergoline

    12/3/08
    Free Test: 112 Range 47-244
    Prolactin: 15.8 Range 2.6-13.1
    %Free Test: 2.5 Range 1.6-2.9
    Sex Horm Bnd Glob: 18 Range 11-80
    Total Test: 459 Range 400-1080


    2/4/09
    Prolactin: 32.8 Range: 2.6-13.1


    29 Sep 2010
    Then got some more labs done through privatelabsmd

    LDL-chol....109...[ 0 - 99 ]
    DHEAS...180......[ 211 - 492 ]
    ----------------------------------------
    T4 free.....117......[ 0.82 - 1.77 ]
    RT3..........253......[ 90 - 350 ]
    T3.............2.7.......[ 2.0 - 4.4 ]
    TSH.........2.65.....[ 0.45 - 4.5 ]
    ----------------------------------------
    LH..............7.4......[ 1.7 - 8.6 ]
    T...............469......[ 280 - 800 ]
    SHBG......29.6.....[ 14.5 - 48.4 ]
    ----------------------------------------
    IGF-1.......265.......[ 116 - 358 ]


    Then decided to get a 4x saliva test done

    got cortisol results back

    Morning 8.0 (3.7-9.5)
    Noon 1.0 (1.2-3.0)
    Evening 1.7 (0.6-1.9)
    Night 0.4 (0.4-1.0)


    Then they attached another sheet because I had filled out a symptom list, It listed a list of possible conditions, along with like a point system based on my responses (4 pts severe, 3 points i have this issue sometimes, etc.) it listed:

    Low Androgens (DHEA/Test) 32.9
    Low Cortisol 23.4
    Metabolic Syndrome 23.1
    Hypometabolism 20.8
    High Cortisol 18.8
    Estrogen Dominance/Progesterone Deficiency 16.5
    High Androgens 10.4

    Symptoms:
    Tough to lose fat
    Hard to gain muscle
    erection issues
    no libido
    Foggy memory
    feelin lethargic at times
    tough to wake up in the morning


    As you can see, my prolactin was elevated. My doctor perscribed me cabergoline and it lowered prolactin but the testosterone didnt change, and after I got off it the prolactin went right back up. The doc is attacking the prolactin, however I dont think that is the issue. My LH is high, and from I think I understand that means that my brain is sending my testicles the signal to kick it in gear and its obvious they cant? maybe I have testicular failure? Also DHEA was low, what does this point towards?
     
    Last edited by a moderator: May 1, 2011
  2. largeitalian

    largeitalian Member

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    the GP i went to yesterday told me that "all the vitamins and pills im taking are what is causing the numbers to show up as they do"

    im taking a multivitamin, d3, fish oil, magnesium, zinc, b3, protein powder. this sound crazy to other people to?
     
  3. CubbieBlue

    CubbieBlue New Member

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    You need a better thyroid panel and another TSH. Antibodies couldn't hurt either. Some thyroid hormone may be all you need.
     
  4. largeitalian

    largeitalian Member

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    can you recommend which tests to get run? i can make a trip to a privatemdlabs.com collection site
     
  5. chilln

    chilln Banned

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    No need for more tests, I found your thyroid tests in the JPEG images, and I transposed them into English and incorporated them into your first post in this tread (I assumed the test date was 29 Sep 2010, ie: the date the results were posted).

    Since your LH is consistently high, yet your testosterone is consietently only midrange, and your cortisol is consitently midrange (to match your low testosterone) this tells us that your hypothalamus and pituitary are working just fine, and your problem is indeed that your testicles are not producing the amount of testosterone your hypothalmus expects.

    While this is bad news from your testicles perspective - they're obvioulsly around 50% defective, it's good news because it means you can "top-up" your testosterone without testicular atrophy.

    ie: you should be able to supplement with a little testosterone, and your testicles should not shrink much if you do this.

    Note that if you supplement with a LOT of extra testosterone, then your testicles will indeed shrink because your hypothalamus will only tolerate your body to have "X" amount of testosterone, and if you drive your testosterone above "X" (which is unknown at this time) then your hypothalamus will reduce LH to very low, and then your testicles will shrink, and then you'll need to supplement with HCG (in addition to your transdermal testosterone supplementation) to maintain your testicles at their current size.

    Note that you are getting some testosterone from your testicles. They are not "completely broken". But they are definitely underperforming.

    With this situation, there's no benefit in attempting a restart. Bummer. You're effectively going to have to supplement with testosterone (and maybe HCG too ?) for the rest of your life.

    Some males in this category discover that when they boost their testosterone, that their progesterone and cortisol start tanking, and they also need to supplement with preg and thyroid hormones too - we can't yet rule this out in your case. Only time will tell whether you're in this category.

    The big deal with that is the cost. Ie: since your testosterone is not yet low enough for you to be considered to be "hypogonadal" therefore I doubt that your insurance will over the cost of your testosterone supplementation, which means you will have to pay for all of your testosterone out-of-pocket. You need to work with your insurance supplier to determine when they will reimburse you for your testosterone expenses.

    .
     
    Last edited: May 1, 2011
  6. largeitalian

    largeitalian Member

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    thank you very much for taking the time to look at all that chilln.

    are you absolutely sure this is the case? like cut and dry no other possibilities?

    if anyone else can chime in, more opinions the better

    thank you again chilln, will donante next time forum needs $$
     
  7. largeitalian

    largeitalian Member

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    looked into the testicular failure symptoms and more info and seem to fit the bill. is there a specific test I can have run to test if it is in fact failure? have a doc that would give me test if i required
     
  8. chilln

    chilln Banned

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    Option a)

    The high levels of LH are triggering the production of pregnenolone-to-make-testosterone, but your adrenals are "stealing" that pregnenolone and diverting it towards the production of cortisol - thus there's not enough pregnenolone being routed to make testsoterone.

    Normally when this situation occurs, then it's obvious because cortisol levels are very high - eg: some of the salivary cortisol metrics show up to be above the maximum of the reference range. Since your cortisol is never above the maximum in the reference range, this is unlikely.

    Thankfully it's easy to confirm whether this is your situation, by supplementing with some pregnenolone each day. eg: discuss with your medical professional adviser to supplement with a small amount of preg every (say) 4 hours. Frequent preg dosing is necessary because when preg is being "stolen" then it's getting used up faster than you can make it.

    If you discover that frequent pregnenolone supplementation causes your testosterone levels to rise continually for more than a week, then you have confirmed that your high LH and low testosterone is due to "pregnenolone being stolen from your testicles to make cortisol".


    Option b)

    There are several genetic anomalies which can cause the testicles to under-perform. They usually result in a specific enzyme, or a family of enzymes being mostly absent. Since the body has redundant hormone synthesis pathways for most hormones, therefore a missing enzyme (or two) only results in downregulation of a hormone, not the complete absence of a hormone.

    Endocrinologists study all of these genetic anomalies, but their solution is usually the same as ours - to top up, or replace, the hormone which is too low.

    There are very very few solutions where the missing enzymes themselves are replaced.

    Option c)

    Damage to the testicles (eg: sporting injury) or a varicocele (widening of the blood vessels which drain the scrotum) can both contribute.

    I've not heard of a testicle which was mostly repaired after a sports injury. Good luck if this is you.

    A varicocele is usually identified via a manipulation of the scrotum, and then verified by an ultrasound of the scrotum.

    Surgery (removal or modification) is an option for a varicocele. Our members who have had such surgical intervention have continued to boost their testosterone via supplemental means, as the surgery was never sufficient to restore hormones to meet their expectations. You can search this forum for "varicocele" and perhaps PM the members who confirmed they had surgery to address this.

    .
     
    Last edited: May 2, 2011
  9. largeitalian

    largeitalian Member

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    killer information chilln, thanks again

    so what would you recommend as a 1st step? should I go get all those enzymes tested and try to find out if I am lacking one?

    thing is, I dont have insurance as I am self employed. if this is gonna be a long road i would look into getting some, but if its just a string of tests at a private testing site, and supplementing the lacking one, i wouldnt.
     
  10. largeitalian

    largeitalian Member

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    or is there a specific test that tests for testicular failure?
     
  11. JanSz

    JanSz Well-Known Member

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    Failure of producing testosterone when asked to do so?

    Post with ranges:

    totaltestosterone
    LH
    FSH

    -----------------------
    When TotalT is low but LH and/or FSH are high
    testicles are asked to produce but do not do it----->testicular failure or defficiency


    .......................................
     
  12. chilln

    chilln Banned

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    Only an endo who is into research would help you with that. Most endos, and 100% of anti-aging doctors, will simply prescribe you some T.

    We won't help you self medicate no matter how low your bank balance looks.

    Your next moves (in any order) are:
    a) find a medical professional adviser who will help you with the preg test as described above.
    b) find a medical professional adviser who will help you by feeling your scrotuyn for a varicocele, and if he finds one, he'll order up an ultrasound of yoru scrotum, which you will need to pay for.
    c) find a medical professional adviser who will help you by providing you with a prescription for testsoterone, and you will purchase the testosterone.

    If you can't afford these actions then you will need to get yourself a low paying low stress job and take it very easy for the rest of your life.

    Life is cruel. You need to get over the fact that life is cruel, and then get on with living the lifestyle you can afford.

    .
     
  13. JanSz

    JanSz Well-Known Member

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    http://www.privatemdlabs.com/lab_tests.php?view=all



    //////////////////
     
  14. largeitalian

    largeitalian Member

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    Going to lab monday.

    Getting these tests done:

    LH
    Total Test
    FSH
    Pregnenelone

    Should I get any others done? Prolactin? DHEA?

    Do I need the Pregnenelone test?
     
  15. largeitalian

    largeitalian Member

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    bump this up cause i dont have lot of time before i go
     
  16. Audioguy19

    Audioguy19 New Member

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    Might as well get SHBG to see how much of your T is bound up. SHBG might not help you diagnose your testicular function, but it makes sense to get SHBG level whenever getting total T level.
     
  17. largeitalian

    largeitalian Member

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    k leaving town for the lab, this is what I am having tested. key tests are in bold, the rest are just extras thrown into privatelabs packages.

    If anyone thinks there is anything else I should be getting done, let me know and I will add it while on road

    Prolactin
    Pregnenelone
    Progesterone

    Percent of saturation;
    serum iron;
    total iron binding capacity;
    unsaturated iron binding capacity;
    Ferritin, serum;
    Prostate-Specific Antigen (PSA), Serum;
    Cholesterol, total; high-density lipoprotein (HDL) cholesterol;
    low-density lipoprotein (LDL) cholesterol (calculation);
    triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation); Hematocrit;
    hemoglobin;
    mean corpuscular volume (MCV);
    mean corpuscular hemoglobin (MCH);
    mean corpuscular hemoglobin concentration (MCHC);
    red cell distribution width (RDW);
    percentage and absolute differential counts;
    platelet count;
    red cell count;
    white blood cell count;
    Estradiol, Sensitive;
    Hemoglobin (Hgb) A1c;
    Cardiac C-Reactive Protein, High Sensitivity;
    IGF-1;
    Thyroxine-Stimulating Hormone (TSH);
    Gamma Glutamyl Transpeptidase (GGT);
    Insulin;
    A:G ratio; albumin, serum;
    alkaline phosphatase, serum;
    ALT (SGPT);
    AST (SGOT);
    bilirubin, total;
    BUN;
    BUN:creatinine ratio;
    calcium, serum;
    carbon dioxide, total;
    chloride, serum;
    creatinine, serum;
    globulin, total;
    glucose, serum;
    potassium, serum;
    protein, total, serum;
    sodium, serum;
    Luteinizing Hormone(LH);
    Testosterone, Serum ;

    Sex Hormone binding Globulin, serum;
    Color, appearance, specific gravity, pH, protein, glucose, ketones, occult blood, leukocyte esterase, nitrite, bilirubin, and urobilinogen.
    Follicle-Stimulating Hormone (FSH), serum;
    Magnesium, serum;
    Thyroxine (T4) Free, Direct;
    Dehydroepiandrosterone Sulfate (DHEA).
     
  18. Saladin

    Saladin Banned

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    I was not going to post but could not resist. I am being 100% serious. In islamic culture when a man cant make a woman pregnant they do many things - one is unani medicine but the other i have hardly talked about is wet cupping. Now wet cupping is interesting as it cleans / sucks all the stagnated blood around and in your testicles allowing for improved circulation and guess what mjority men impregnate their wives shortly after procedure.

    The human body does not just break down and stop working without a cause, usually it will be a simple problem to fix such as improving circulation etc etc removal of waste and stagnated blood that impairs circulation. However this same person would be diagnosed as primary over here and told his tecticles just dont work, why? we dont know, they just stopped working the doctors will say. But why? why stop working whenthere is no known injury etc. Noone can tell you, however in islamic medicine the issue is beleioved usually to be due to stgnated blood and thus testicles working efficiently. I had cupping done, one of my atrophied testciles for 10 years after steroid use plumped up to full size, i had varicoclees around it an dthey are gone too. I did unani medicine as well but i know the cupping is what boosted my left testicle and rid my varicoceles.

    Just something to consider, why would testicles just stop working? But doctors cant give you the answer for sure, usually if there has been no injury, the common culprit is stagnated and bad blood causing inefficiency. Even with injury cupping helps as it promotes helaing removal of stagnation etc etc.

    Take for what its worth, a different take on primary hypogonadism from a different culture / medicine system. TCM use wet cupping as well.
     
    Last edited: May 15, 2011
  19. diesiel

    diesiel Active Member

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    They also stone homosexuals in islamic culture
     
  20. Saladin

    Saladin Banned

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    What has that got to do with cupping to relieve primary hypogonadism.
     

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