T Nation

Low Levels - Need Advice

T Replacement
#1

First, I would like to say thank you to all of the people who have blasted this place with helpful info. I’m really digging it here.

I’m thirty, and for the past year I have had low testosterone- but didn’t know it till last week. My old doctor never said anything because it was 50 points above the lowest of the â??normalâ?? range. Fast forward to last week and my new psych doctor ordered new labs when I told her I’ve been sleeping excessive amounts and am always tired. I found this site and was looking forward to seeing a specialist.

Turned out, they stuck with an internal med MD (found out when I got there), and all he said was he wants me to get my testosterone rechecked since the one from a week ago was done too late in the day. I told him I wanted my E2 checked as well since that wasn’t ordered on the last set. He told me he wouldn’t know what to do with that information at this point and he felt like it would be a waste of money. I think he meant he wants to wait till the new lab is done for testosterone.

I’m feeling bummed. I was thinking this was clear and easy to get treatment for, but I’m confused at this point. Not sure if I should find a new doctor or play it out. Any suggestions or opinions are welcome.

-30
-5’10
-40
-245lbs
-hair all over and able to grow a beard- bald on top of head
-I carry fat on midsection, especially love handles. Gaining weight.
-No health conditions, symptoms [history]
-NO hair loss drugs or prostate drugs

-Labs
TSH- 1.82
Testosterone Serum- 328
T4- 6.4
T3 Uptake- 23
Free Thyroxine Index- 1.5

*Any other labs worth getting?

-Diet is snacking all day. Gained 15lbs in the last month(felt bad before the weight gain)
-No exercise the last couple weeks, but 2-3 days of weights per week before that.
-testes ache, ever, with a fever? NO
-Morning wood is gone since last year. Loss of libido.

#2

TSH should be near 1.0
T4 should be mid range!!!

Get these labs:
TSH
fT4 - this is a reservoir of free T4 to create fT3
fT3 - this is the active hormone, not bound to a binding protein

Guessing that you are not long term using iodized salt or taking vitamins that list iodine.

Your doc is clueless:

You need to get LH/FSH tested to see if the problem is with your testes or hypothalamus-pituitary. This needs to be done before TRT!

Read these stickies:

  • advice for new guys, note first paragraph, post all labs with ranges,
    – be open to causes, your low T is a symptom

  • thyroid basics
    – check your waking and mid afternoon body temperatures
    – eval your long term intake of iodine from iodized salt or vitamins that list iodine

Please read this post carefully and do not miss any points or action items.

#3

Thanks for the reply. In my first post to this thread I listed most the labs you mentioned. I was thinking that with the lab values it would be a more clear cut response from my doctor, but I feel like I’m getting the run around in some sense.

Thanks for mentioning the iodine stuff. I read up on it some and was surprised to read that there is no iodine in sea salt. I will def skip that in the future. For anyone else who may be reading this and wants more info on iodine supplementation- google orthoiodine protocols.

I had my testosterone labs done this morning- should hopefully have results within three days.

#4

Looking for fT3, fT4 labs, not T3, T4

T3 and T4 bound to thyroid binding hormone is not really what we are interested in.

Please provide lab ranges for the labs that you do have.

#5

They didn’t order those. Shit…

#6

[quote]shinylid wrote:

-Labs
TSH- 1.82
Testosterone Serum- 328
T4- 6.4
T3 Uptake- 23
Free Thyroxine Index- 1.5

[/quote]
New lab results came back:
Testos: 243.20 TestFr: 73

Doctor says I am normal and that’s that. What should I do?

#7

New lab results came back: Testos: 243.20 TestFr: 73
Doctor says I am normal and that’s that. What should I do?

#8

You need to find a doctor who will treat you. Stop wasting time and start making phone calls and look online for such docs in your area.

#9

I have been looking. The dilemma is that most docs will only treat to the “normal” range which from what I’ve read is usually 300. I’m trying to find someone who will get me above the ideal number. I’m in Nashville area.

#10

Update: I mentioned to my GP about not agreeing with his diagnosing me normal due to the fact that most insurance consider levels below 300 to be low, and also that my age is not being taken into account. He has referred me to an endocrinologist.

I spoke with my psych doctor, who is much more educated in hormonal issues due to her own health problems, and she brought up a good point. All my levels T3/T4/fT3/fT4 are low, but my TSH is on the low side of the scale rather than what one would expect. She prescribed me thyroid hormone pills and suggests an MRI to rule out pituitary pathology.

Is it possible that my estrogen is high and my TSH be low at the same time? I want to weigh my options before I start taking the pills.