T Nation

First Post and In Need of Some Help


#1

Background on myself, 37 now and was diagnosed w/ hypogonadism about a year ago or so. Dr. said it was stress as I was in a bad marriage(it will finally be over Oct.19th!) and my occupation is high stress as well.-----I had several cycles under my belt before I got married(cause of the poor functioning nuts?).

Depressed, no motivation at all, hated work, got fat with hypertension(@348lbs!), no concertration....all I wanted to do is sit on the couch and watch TV and eat and for no one to mess with me and everyone telling me I needed to be on antidepressants(the cure for everything)
Anyway, first T level was 120 and 1st Dr put me on Androgel 1pk/day said we will check it in a month or two, meanwhile some energy, tender nips and hot flashes.

2nd lab was 192 upped it to two packs and rechecked and it would not go up past 200. Still felt like crap. Moved and went to new Dr who changed to T-cyp 200 every 2-3 weeks. Much better with a little more energy but I could feel the swings of T & E as my moodswings. I tried to get her to up it and she would not(I am glad now see below) with level of 225 telling me it was in range.(I am a big dude 6'3 and now about 270)

Am am due to see her again and I want to talk her into an AI(or other things if anyone has any ideas) as I have freaking sore ass nipples and my weight seems to fluctuate up and down 15 to 20lbs(T cyp water retention?)...I am active in the gym again with cardio and weights, feel the drive to do stuff but the motivation is still not there.

I dont have any hypertension issues anymore, I know how to eat clean from experience....and also my nuts even back in the day remained walnuts and now they are the size of large almonds!....I also have no problems getting wood or feeling the need to want to get it on but the performance is just not there like it used to be.(I also want to have more children eventually and worrying about sterility)

The Dr. has pretty much given me all I have asked for but wont make any changes without evidence and I need help with what I should ask for and what to tell her. Also a what labs to ask for as I am sure estrogen is up among other things.

I am sorry for the long post, I have lurked for a while and tried to piece things together from this post or that but end up confused or overwhelmed in how I should approach my physician. Should I just go see one of the Anti-aging docs?(I am in Houston)
Thanks brothers for all your help.


#2

Everything is wrong.

You need to read this first:
http://tnation.tmuscle.com/free_online_forum/sports_body_training_performance_bodybuilding_senior/trt_protocol_for_injections?pageNo=0#3188713

One guy [selectively?] printed this for his doc and was able to implement all of the basic recommendations.

and get this book:

Injecting very 2-3 weeks is insane and only proves that your doc has only read old material and does not have the commons sense to see how wrong that is. It is malpractice as it is doing you harm.

An AI will not make things better as the AI drug needs to match your T levels which are all over the map.

You are a transdermal T non-absorber. That and the other info that you have provided convinces me that you probably have hyperthyroidism. Google that and read the symptoms.

Get on google earth and focus on your region, enter [compounding pharmacy] in the "fly to" box and explore the web sites of the hits. Look for references to male HRT, hypogonadism info and offers or referrals and health surveys that they will evaluate for you. Pick a place that seems to have it's act together and phone up, ask for pharmacist to talk to who can provide a doctor referral. Discuss your needs for a doctor who works with insurance companies... most age management type places do not. Explain that you suspect hypothyroidism as well. You also need to have some idea about what all of this is worth to you in terms of a budget for out of pocked costs.

You need hCG SC 250iu EOD to preserve your testicles. There is no other option.

You need to look at your Rx and OTC drugs for endocrine disruptors. Your pituitary may be damaged from a blow to the head [any accidents in the time frame of onset of your problems?] or a growth [adinoma aka tumor]. A growth on or near the pituitary gland can press on the optic nerves that are right there. You need to report any visual field changes or loss of peripheral vision. This will not include age related need for corrective glasses.

If you have an adinoma, your could have one that produces prolactin. That can repress T production and cause depression as well as other problems like gyno. It is also possible to have multiple problems affecting adrenals and GH release as well.

If you have newly onset myopia or increased myopia, that can be symptom of thyroid problems as well.

Test E2, not total estrogens and use serum testing, not saliva.
Test LH&FSH in the early morning [8AM] -need to know if problem is in the testes or pituitary.
Test prolactin
Test TSH, free T3, free T4

If your energy crumbles when faced with conflict or stress, you may have weak adrenals. Are you avoiding any situations or people who stress you out? Some social withdrawal and passivity is often seen with simple hypogonadism as well.

PM me with med and drug history or other sensitive info that you do not want posted here.

Your hormones probably have cause some of your relationship problems and personality shifts.

You might respond to hCG+AI.

T+AI+hCG