5'10" 168lbs. Age 35
So January 2015 I was sick for a week and the Dr. did a bunch of blood tests that were all normal except T was low ~ 270 from what I recall. Got better didn't follow up. At least the last 3 years I have had most symptoms of low T except ED. Fast forward to Jan this year and I wasn't feeling good. Bunch of blood tests all normal (liver, thyroid, etc). So in Feb I decided to go to a Dr and bring up the low T thing because I am dead tired and have zero energy. I wake in the morning and yawn all day and by the end of work my head hurts and I feel stick to my stomach. This is constant everyday. So this new Dr. runs tests and here are the results:
LH 2.1 1.70-11.20 (mIU/mL)
FSH 2.2 1.00-42.50 (mIU/mL)
Free Testosterone 13.4 4.3-30.4 (pg/mL)
Testosterone, Total 261 L 332-896 (ng/dL)
So he immediately wants me to go on Androgel. So I decide first to start researching and reading everything. I have read this forum and the stickies multiple times, other forums, the Testosterone for Life book, etc. With this knowledge I have gained (I think I know more than the Dr.'s at this point) I decided to go to a urologist for a second opinion. Didn't think the first Dr. knew enough. So I wait a little over a month and go. He talks about primary, secondary, clomid, all the other stuff. Knows his stuff. Want's more labs. This time the labs show:
Estradiol by TMS 28.8 pg/mL 10.0 - 42.0 pg/mL
Thyroxine Free 1.2 ng/dL 0.8 - 1.7 ng/dL
Sex Hormone Binding globulin 20 nmol/L 11 - 80 nmol/L
Albumin, S/P 4.8 g/dL 3.5 - 5.0 g/dL
LH 3.6 IU/L 1.7 - 8.6 IU/L
FSH 1.7 IU/L 1.5 - 12.4 IU/L
Testosterone, Adult Male 378 ng/dL 300 - 1080 ng/dL
TSH 2.12 mU/L 0.30 - 4.00 mU/L
Prolactin 6.6 ng/mL 2.1 - 17.7 ng/mL
So now my LH and Total T have gone up but FSH is down on this lab test. Which seems odd. So I always think a 3rd opinion would be goog before making a decision so I go to my Internist and talk to him. He wants to check a few other non T related tests like Cortisol, etc. Which is all perfect. He was trying to look for inflammation or something else thinking low T may be a by product of something else going on. Can't find anything.
So it appears I am Secondary. Which means a clomid therapy may work? Internist suggest to maybe try T for 1 month just to see if it helps and doesn't think my natural production would suffer much in 1 month if we need to stop because it's not working. Or I could try Clomid but her says it can take much longer to even see if Low T is the issue. I have also read potential side effects from Clomid.
28.8 E2 seems high to me (most research says 20-22 is perfect). Internist also said I don't need Arimidex (typically for people overweight) unless my E2 goes way up, which is kind of counter to what I have read. He knows I am pretty knowledgable though and is open to trying what I want to do. From everything I have read I think I would prefer injections over Androgel and most people seem to end up on injections anyway. Should I do Clomid for a while just to see? Try T injections for a month to see if it really does fix things?
What are your thoughts? I can give more info or other test results (I have had like 6 blood tests done this year) if needed. Just want to get as much info as I can to make a good educated decision. I can barely function at all at this point and the last 3 weeks my head and eyes are just feeling almost dizzy but not off balance or anything. Completely dead tired and sleep good at night.