I come to you guys with hat in hand. After lurking here for a while, I decided to create an account and ask for help/advice.
I want to attack my issues the right way and not waste a lot of time with "try this and call us in a few months". I want to find the underlying causes for my problems, not just treat the symptoms. I've read through countless postings and horror stories about how this doctor or that doctor was a complete waste of time. I guess what I really need help with is finding a doctor who is willing to do ALL the necessary tests to try and pinpoint what's going on. I'm in the Triad NC area, but I'm willing to travel, if needed.
I am an avid bicycle racer/enthusiast and thought nothing of riding 250 miles per week while training. After a steady decline starting about 2 years ago, now it's near impossible for me to train more than a few hours a week without severe fatigue problems. I thought I might be over training, so I took off this summer for about 2 months and stayed completely off the bike. It probably hurt me more than it helped. After restarting my training at a very slow pace, I realized that I just wasn't recovering from it. I really enjoy riding/racing, so these issues have seriously dampened my enjoyment of a sport I love.
For a few years, I've had the usual suspects (fatigue issues, low libido, mild depression, long recovery after exercise, weight gain, no motivation).
After speculating that it may be a problem, I have been diagnosed with low T. I started researching the best course of action for TRT and discovered this forum. I've read through the stickies and fear I'm heading down the "dead end" path with my doctor.
My doctor prescribed Axiron 30mg (60mg total dose per day). I asked about injections as I have young daughters and do not want to expose them to a topical medication. Also, I've heard that you don't really get the proper dose using topicals like you do with injections.
My doctor balked at the suggestion (no surprise). I can't fault the guy too much as he told me after my low T diagnosis that he didn't really know very much about TRT protocols. He told me that he would feel more comfortable with me going to an Endo. He's a great Sports Medicine doctor, but TRT is just not his thing and he really seems like he is looking out for my best interests.
Needless to say, I've not started taking the Axiron. I wanted to wait until I found another doctor who would be more open to some of the things I've read here.
My doctor also referred me to have a sleep study to rule out any problems with apnea. I do
get very sleepy during the day and wake up many times at night. I did the study last night
(9-19-12) and I'm awaiting the results.
age - 42
height - 6'1"
waist - 38" (around the navel/love handles)
weight - 196 lbs (steadily increased from 165 in the past 5 years)
body and facial hair - arms/legs thin, lacking on torso, patchy beard
I tend to carry body fat on my chest and around my waist
Health - 10 years ago T level was tested by Uro (trying to have a kid) (353 total - no TRT for men back then, I was told), Kidney stones 1 time, different biking/sports injuries (hand, wrist, shoulder dislocation, and a lot of road rash)
No prescriptions, OTC vitamins only (D3 (2000iu/day), Fish Oil, Niacin, B complex)
Diet - For normal meals/non-training days (5-6 small ones per day), I follow a 60/20/20 plan. 60% Protein (chicken breast, fish, not a lot of red meat), 20% Carbs (mostly green vegetables, beans), 20% fats (olive oil, avocadoes, nuts). Training Days - Probably more like 40/40/20 (I need more carbs for fuel) - Probably 2200 cals per day.
Training - At my peak - 4-5 days/week - Mostly on the bike (cardio), lots of hill repeats
(strength), core, yoga (stretching). Now - 1-2 days/week - More than that kills me.
No testicle pain (they are small though), No fever.
Seldom have morning wood/spontaneous erections. Erections are not as firm.
All labs were drawn on 8-17-2012:
T-Total - 197 ng/dl [348-1197]
T-Free - 7.7 pg/dl [6.8-21.5]
TSH - 1.95 uiU/ml [0.34-5.60]
T4 - 6.9 UG/dl [5.40-12.00]
T3 Uptake - 36.6 % [32-48]
FTI - 6.31 uiU/ml [5.20-12.90]
Vitamin D - 58 ng/ml [30-100]
Ferritin - 325 ng/ml [24-336]
Vitamin B12 - 439 pg/ml [180-914]
Nothing out of the ordinary in the Blood Panel or Urinalysis results.
PSA and DRE - normal
Unfortunately, the doctor did not run E2, LH, FSH, or SHBG. I asked, but as stated above, he is not a TRT guy and felt like I should see an Endo for that.
Should a go ahead and see the Endo? Or does anyone have another suggestion for a doctor in the area (Triad NC) who is "up" on the complete protocol? I just want to find someone willing to even consider the tests and possible medications needed to do this right. Also, someone that is OK with self injections if that's what it comes to.
I've already called a few compounding pharmacies without much luck. The docs they recommended were either not willing to do what is needed or not taking new patients right now.