T Nation

Appointment with the Endourologist, but I have Concerns

Update: The urologist told me my levels are probably around 500, or 600 but the test was done too late in the day. He gave me two slips to have two testosterone tests done a week a part. He told me he didn’t want to put me on TRT due to the side effects and if my T levels come back low, he’ll send me to a endourologist that he knows; however he wouldn’t recommend TRT treatment. I asked him about clomid and he told me it’s usually only given to guys that still want kids. I also asked him about testing estrodiol and he told me that they don’t test for that and there’s no need for testing for that when testing for low testosterone. Yeah, I know…Anyway, the only thing being tested is testosterone and free testosterone levels. I had one of the tests done yesterday and after the other one is done, I’m going to call his office and get the results. I’ll post the results here when I get them.

My results are back. Total T levels are 344 and Free T is 86 (35-100) range. So, I guess I need to see a better doctor, since he insists I’m in the “normal” range.

Re confirm FT range please ?

The doctor told me my free testosterone was at 86 out of a 35-100 range. He didn’t go on another further, except to tell me I’m in the “normal” range. Maybe he meant 8.6 out of a 3.5 to 10.0 range??? I don’t know.

Please ask them to fax/email your results. This is a range I’ve never seen before and not making much sense.

They just left for the day. I’ll have to call Monday.

Yes, you need to get them and post. You haven’t posted labs . We need labs to try and interpret. How are your symptoms?

Well, he only wanted to test for Total T and Free T and nothing else. He told me to call him, so he’d give me results. I think my best option is to see an Endourologist. I mean this guy told me there was no reason to test estrogen. The trouble is, I don’t know how to find a good endourologist. When I search online, they’re just group with urologists.

I have my original lab work done by my primary care doctor. I posted it, but can repost it here; however it also does not contain estrogen levels. No doctor I have seen has wanted to test estrogen levels, or cortisol.

First you need just the labs, if you can afford out of pocket, there are private labs. Do not focus on your numbers. First, please indicate your symptoms. TT can be high/low on different occasions. Your symptoms should drive treatment. I know plenty of guys with TT of 400 or less but asymptomatic.

FT if range by whatever mechanism is correct, ft levels seem very good relative to your TT. if accurate, could mean low shbg, which clears TT faster from blood hence could be misleading. Bio-t and FT are good measures for t production.
Symptoms at end of the day are all that matters.

High anxiety, in fact I am diagnosed with an anxiety disorder. Now, I don’t know if that’s what caused low T, or the other way around. Also, I cannot go below 22% bodyfat. It doesn’t matter what my calories, or macros are, it doesn’t matter if I do HIIT. Also, I am always tired. Even on the days where I get plenty of rest, I don’t really like to move around a lot. Keep in my, I recently had flat foot surgery, but even before the surgery I was like this. I have mood swings and go weeks at a time where my mood is low. I’m always upset for the most part and I can never relax. I don’t have an issue with libido though, in fact it’s quite high. High estrogen maybe?

I was given anti-depressants until I was about 22 when I stopped taking them. I’m wondering if that messed me up. Oh and I’ve had some gyno since I hit puberty.

Yes, it could be a lot of things. It could be your anxiety that is the problem. I had mood problems, possibly due to low T but my libido has been tanked for so many years I barely remember when I was normal in that sense.

However, my point is, whatever that was the cause for my mood problems and anxiety got better with lifestyle changes to a very good degree, I still have mood problems which makes sense with low T, but it became a lot better without any medication or likes.

What that Infers to me, whether correct or incorrect I don’t know but Is that your anxiety shouldn’t be so high with just T levels and should be manageable. Well I guess it’s different for everyone.

Do get a complete set of labs as suggested in the stickies, only then we you and people on here understand what the issue could be. It could be a lot of things, maybe it’s thyroid, maybe it’s T, it could be both. Maybe it’s anxiety that’s the main culprit. Good libido suggests the problem is not just T.

Should I go try and see a specialist first, or get labs done first? Also, how do I find a private lab and what do I tell them? I’ve never had lab work done without a doctor’s referral. Also, how expensive would it be?

That depends on where you reside! I’m not a U.S resident, getting labs is easy and cheap in my country. So I got all my labs first then found a doctor so that I can feed him facts and not let him tell me I’m all okay. Plus in my country, doctors are not bound by insurance companies as much as some other countries, insurance in my country only covers surgeries and other physical treatments and not hormone replacement and likes. Doctors operate privately and are reasonably available. I have my doctor on iMessage and is available when I need him.

Well, if I can’t find a good doctor all I can think of is taking an OTC AI.

There’s no OTC AI. You dont even know your E2 number so reducing something which has more chances of being low than high is not a good idea.

Right. Well, thank you.

I just found a guy that deals with testosterone deficiency. I’m going to call his office Monday. He’s the only one listed in my area that’s close. It looks like he specifically specializes in men’s fertility. Taken from his ad:

" By advocating for men’s health, educating patients about their conditions and their long term implications, and working closely with couples’ reproductive endocrinologists and other providers, we can ensure that each couple reaches their family goals"

I hope he helps me.

Fertility related endos are your best bet for help. i found my doctor, after various failed attempts by looking at infertility related doctors. He’s an andrologist who specialises in infertility. He was quite knowledgable.