T Nation

31, 130 Total T, Veterans Affairs Doc, Labs Included


#1

So I just found out about a week ago my total t levels are low. Going to endocrine next Friday the 25th. A little background about me. I’m now 31. Served in the army for 7 years. Started lifting during my first deployment in 2007. I’ve always had a VERY hard time putting weight on. Although my genetics are amazing when it comes to muscle. I’ve been diagnosed with complex PTSD, TBI and a few other things. After I quit drinking almost two years ago my sex drive went to zero. Along with a myriad of low t related symptoms. My doctor and I just attributed it to my PTSD. Now we know it’s low t and will be looking into trt. From what I’ve read around here endocrine docs are not the best. So I’m trying to get good information to bring to get the best results. My primary care said they’ll probably put me on the gel. I’m not down with gel or patches or basically anything other than IM. Any links to research for IM over the others is appreciated. Here’s a little more of my info along with my lab work.

Age-31
Height- 5’6"
Weight-140(up to 170 when training frequently)
Body hair-light body hair, patchy beard
Testes- no pain
Mood- depressed, anxious, fatigued
Libido- none
Get cold easily- yes
Dry skin- yes
Use iodized salt- yes
Sea food- no
Exposure to chemicals- yes
Hair loss drugs- no
Rx & OTC- hydrocodone 5mg/ acetometaphine 325mg 3x daily




#2

The gels are a waste of time unless needles really freak you out, they cramp your lifestyle since you can even swim, workout or come into contact with children for up to 4-5 hours. Interesting how doctors prescribe the most ineffective, most costly treatments first, I’ll never look at doctors the same again. When one gel failed they would give me another, I just kept claiming they were irritating my skin and only then did they give me the IM injections. You really want to inject twice a week to keep you levels super stable, don’t settle for bi weekly injections!

Your levels are very similar to where mine were, 119 ng/dL, however your SHBG is a little better though!


#3

I saw that your taking vicodin 3 times a day. Opiates, long term, are known to cause low testosterone. Also have you ever taken any other meds for the PTSD? I have used benzos off and on over the last 10 years since my deployment (2007 also) but I drank as well, and it has definitely raised my SHBG and I did have lower total testosterone also. You want to inject sub-q, twice a week. There’s all the info in the stickies.


#4

Oh also, VA will RX the shots, and let you do them at home, if you ask. Tell them gel isn’t an option because of small children.


#5

I’ve been taking the norco for about 2years now. I was on a whole bunch of meds for the ptsd fora year. Don’t think any benzos although I was taking around 18 different meds that really messed me up.

This is good news for me as I have a 5year old and a 3month old.


#6

Good luck bro, keep us posted.


#7

Got these new labs. Total t went up. Seems weird to me as my symptoms have been worsening. The only difference between these labs and the last was the time of test. First was at around 2 pm and these were 0700. Should these numbers change so significantly? I do normally feel better in the morning compared to afternoon. Also, my docsays the get the other T levels by doing some calculation with these labs. This was his answer whenI asked to see my bio available and free T. Just doesn’t seem right to me. Is he blowing smoke up my ass?


#8

When not on exogenous testosterone, you have to check T levels at around 8 in the AM, because this is when they peak. Yes, later in the day it will be lower, so that makes sense. You can calculate free testosterone by using the Total, SHBG, and Albumin. There is a calculator online, just type in Free Testosterone Calculator.

This is where doctors are retarded when it comes to testosterone being on the low end. Ok so you have 300-400 Total test, at 8AM, but as the day goes on, these numbers go down, so what are you at 4pm? 200? 100? . When you try and explain this to a endo, or doc, some will get it, and some will say “Well you are in normal limits” “Your normal” Which is complete garbage.


#9

This is almost exactly what was said. Basically my symptoms don’t mean shit. My first labs don’t mean shit. Said he would give me Viagra. Ok, So how will that help my libido? Fatigue? My overall sense of feeling like a man? I honestly knew this would happen as almost every time I’ve come to the va with multiple symptoms (sometimes an actual diagnosis) I’m told they won’t do anything and to basically just deal with it. I’m rambling on now because I’m super pissed. The only thing good that came of this was a possible referral outside the va.


#10

Do you have the ability to use VA choice? OK so here is the plan, I had the same issue as you, borderline low T, had to have my Psychiatrist also recommend it for me. That helped. But mostly going over my symptoms and stressing how I was losing muscle, no motivation, no libido. I told them it was causing relationship problems with my wife. Told them it was affecting my mental well-being. So basically, don’t give up. If you don’t like that doctors response, get another doctor. Keep pressing the issue.

Eventually they will say “Ok well we will send you to ENDO for a consult” Endo will probably be more understanding of your “symptoms” even though your test is “Normal”. Also explain that to them, guide them into the question. Say “So my testosterone peaks at 8 in the morning right?” “So doesn’t that mean that later in the day, it is lower, and possibly in the “not normal” range?” If they don’t agree, they’re ignorant. Keep pushing though. If nobody listens, ask to speak with a patient advocate, and tell them your mental health is being affected.


#11

I don’t believe I can use va choice as the long beach va is just up the road from me (Huntington beach). I think the outside referral will be through tricare which will severely limit my options.

This was my endo that told me these things. He said specifically the pharmacy will not provide medication with my numbers. I know that if I continue to push I’ll eventually get treatment. I’m just not ok waiting two years (this was how long it took to get pain meds for my diagnosed back condition). As of this moment I plan on starting trt on my own and hoping to get either a referral to a decent doc that will listen, or paying out of pocket for one.

I had another lab done this morning and will go back again in the afternoon. Curious to see thedifference. Until then if anyone has recommendations of docs in the oc area it would be appreciated. I’ll also check the threads.


#12

Well, one side of that is, if you start self treating, once you are no longer producing, you can retest at the VA and you will be low enough for them to treat you. Not ideal but, hey, they will pay for it.


#13

Haha I didn’t even think of that. I started running proprionate yesterday. I know it’s not ideal for trt but it was readily available. I’ve also contacted a few docs to pay out of pocket. Shit is expensive but if it works it’s worth it to save my marriage (and sanity).


#14

yea dude, so like I said, run it for a few months or whatever, stop taking it for a while, its gonna suck but then get retested. Make sure you have all your labs and stuff ordered before you stop taking the TRT. Good luck.


#15

So good news has finally come my way. Been running 200mg of proprionate a week. Basically all my symptoms are gone. Got set up with a TRT doc that will have me running 200mg of cyp a week, with anastrozole mixed in (waiting on response for actual dose), and 50 units (possibly 100) of hcg on day of injection and third day after. I’ll update with correct dosage as I was given a sample calendar that says to refer to medication vial for exact dosing. Does this protocol sound about right?


#16

1cc of test cyp per week
.5 mg of anastrozole per 1cc
100 units hcg per week

Doc would like 1 test injection per week. I was thinking of splitting it into two. Is 100 units of hcg a week going to be sufficient? I’ve seen most run 250 / week.


#17

Congrats dude! That’s great news. Those numbers look about right, check the stickes for the exact protocol. Definitely doing twice a week is preferred. It helps keep the spikes down which keeps e2 down.

I don’t know exact protocol because currently I do 80mg a week with no HCG or AI. Only DIM.

Glad your feeling better man.