Results from beginning of April. Waiting for results from testosterone levels rechecked end of April.
Results from updated testosterone levels taking last week. It dropped.
Looks like you did not go to light training before the labs to see if AST/ALT would go down.
Were you fasting for Glucose=109?
If so, you are getting to be a diabetic.
A1C lab work will provide a more precise measure of that.
Low thyroid function makes this worse, as well as low T.
Cortisol is low if done at 8AM.
fT4 is good
How many times have I asked for oral body temperatures?
Iron and ferritin are low.
CBC and hematocrit would reflect more on that.
Your hematocrit and RBC were low earlier
Are you a vegetarian?
Low ferritin can impede T4–>T3
You may have a GI bleed and an occult blood test would resolve that.
While Bio-T was not “low”, it is variable as the FT component changes a lot by the hour as T is released in pulses and FT has a very short half life. Because of that, TT is often a better measure of T status. For guys on TRT, FT levels are steadier and if injecting often, any single Ft lab result is quite representative of FT levels.
Your endo seems to be floundering.
I did not go light to reduce AST/ALT because I am on my last month of by bulking phase and have to lift heavy. The levels reduced to half of what they initially were and doctor said it looks fine.
I was not fasting for glucose. Had a bit of sugar post workout before the appointment a hour prior. Definitely not going diabetic.
Cortisol levels are from 8AM. Woke up 4AM that morning.
I do not have an oral thermometer but will be picking one up soon. I know you’ve told me several times. I apologize.
I am not vegetarian.
I called my endo today to discuss the latest lab results. He told me they are low for my age but he kept insisting it was “boarder line low.” I flat out told him that I’ve taken the total testosterone test 4 times in the last 4 months and they’ve all showed up low and haven’t improved. I said my priority is correcting this problem. He said “you will lose your fertility but that is your problem.” I brought up incorporating HCG and he first asked if I could afford it then said I would need to take it 3x a week. He said he is willing to let me try HCG for a month and see if it raises my levels. I told him what about HCG with testosterone and he told me we can discuss this next week. I believe he wants me to use just HCG. Is this a bad idea? Won’t this put my estrodial level extremely high? Would it be wise to try HCG monotherapy first and see if it increases my test levels before moving forward to adding testosterone with it? Frustrating process. I believe at this point he knows I need TRT but doesn’t want the liability of me losing fertility. I may just have to tell him exactly what I want.
I think that 8AM cortisol=9.4 would be making you feel slow. But 4 hours after waking up make the lab useless for such conclusions. So lets assume that cortisol is good.
Doc does not know the difference between hCG and $HGH$.
If 250iu hCG SC EOD gets great T levels, go with that.
Using large amounts of hCG is an expensive way to make T, so T+ low dose hCG is better than expensive high dose hCG that may create E2 problems. Try hCG for 4 weeks then do labs while still taking it and after injecting that day.
Just a quick update. I had my appointment this morning and he is starting to take the situation a bit more seriously as he realizes it’s an issue. Says he is stumped because he looked deeper into all my labs and all my other hormones are in check. Ordered an MRI to look at the pituitary and wrote me a prescription for Clomid. Going to give 25mg ED for 30 days a try then retest. Told me that he is on my team and will help me get the issue resolved. He is not opposed to HCG or other treatment but wants to try less damaging processes first before going that route.
My only concern here is he only requested the bio available testosterone levels for my next labs in 1 month. He did not request esteodial e2. I am not quite sure what the protocol is going to be. Is 30 days of Clomid supposed to restart my HPTA and I would stop taking the medication? Is it a long term solution to avoid TRT? He was very quick with me this morning he already knew he wanted to prescribe it. I have a follow up in 30 days and thats when my last dosage is.
Bit of an update. MRI scan came back with no signs of any issues in the pituitary. I am currently on week 5 of Clomid but retested at week 3. My results came back as
Free Testosterone: 815 (348-1197 range) (From 261)
Bioavailable: 438 (128-430) (From 132)
My endo said that I had an incredible response to Clomid at only 25mg per day and told me to stop taking it. Going to have me retest again in 3 months (sooner if I start feeling bad again). Is 5 weeks sufficient time for HPTA restart using Clomid? I was under the impression it needs to be 8-12 weeks. I am a little nervous stopping the medication as I have finally started to feel normal again. He did mention that we now know that we don’t need to go down the testosterone route and we have a tool to use in case it drops again.
You MUST slowly taper off of clomid as your E2 is probably high. If you stop clomid quickly, your HPTA will see the E2 and shutdown. Do not expect doctors to understand such dynamics. You need to understand by reading the stickies: major learning curve.
I did read the stickies that’s why I asked. What I’ve done is tapered the dosage to 12.5mg per day for the last 3 days (since I was told to stop it). I am thinking of doing that for another 4 days then drop it to 6.25mg for 5 days. Would that be sufficient?