T Nation

Primary Hypogonadism - Advice Needed

Good Morning,

I am 24 years old and am 95% confident that I have primary hypogonadism. I’ve had one testicle removed due to testicular torsion and the other one was undescended until age 13 so I believe that there will be no therapy that will “jump start” the remaining testicle so I believe TRT/HRT will have to be a lifelong solution for me.

At age 20 - after having the torsion surgery - I was prescribed Androgel, but never pursued it because I did not realize the scope of the role hormones play. Now, at 24; my lack of libido is brutal and I definitely feel like I need some sort of treatment.

My numbers when tested at 20:
test f + t 345 ng/dl - ref range 400 to 1080
sex binding glob 22 nmol/l - ref range 13 to 71
test free 76.2 pg/ml ref range 47 to 244
test f + t (% free test) 2.2% ref range 1.6 to 2.9
fsh @ 21.7
lh @ 9.6

I have a scheduled appointment with an endocronologist on June 11th to have the following tests:

Total Testosterone
Bioavailable Testosterone (AKA “Free and Loosely Bound”)
Free Testosterone (if Bioavailable T is unavailable)
DHT
Estradiol (specify the Extraction Method, or “sensitive” assay for males)
LH
FSH
Prolactin
Cortisol
Thyroid Panel
CBC
Comprehensive Metabolic Panel
Lipid Profile

My question is - the endo. I am going to is not a noted expert in HRT, but her office is very close to my work and I figure at worst case I get the bloodwork done and then if I don’t like what she’s perscribing - I take it to another doctor. I live/work in Manhattan so there has to be some very good doctors in this area (if you know if any, I’d love the advice!) But mainly, from what I’ve read Test Cyp injections are superior to Androgel. If I can’t get her to perscribe me the injections - should I be looking for another doctor? Based on the number I’ve given and my situation - does anyone have any advice? At this point, the appointment is so close and I fully believe that HRT will improve the quality of my life that I’m kind of just constantly thinking bout it - so I want to go into the office with the most information possible so I can try to convince her what I feel is best based on others experience with similar #'s.

Thanks and sorry for the long post. Any help, links, advice, support would be greatly appreciated.

Spend the time until the appointment learning as much as you can about hormones and TRT.

Start with Dr. Crisler’s protocols and work out from there.

http://www.allthingsmale.com/publications.html

Good luck!

[quote]happydog48 wrote:
Spend the time until the appointment learning as much as you can about hormones and TRT.

Start with Dr. Crisler’s protocols and work out from there.

http://www.allthingsmale.com/publications.html

Good luck![/quote]

This is good advice and if the gels work for you then thats great go with them. However a lot of guys don’t have a lot of luck with them. Also Endo’s are not the best it seems for HRT

Thanks for the advice guys - I have definitely done my fair share of research at his site and its been very helpful.

I am hopeful that worst case if the endo lacks knowledge about HRT, then maybe she may be able to provide a good referral for me as well to see a doctor that I may not have been able to get an appointment with - so that’s always a plus too.

Looking forward to feeling better!