I've been reading through as much as I can but would appreciate it if some of the more knowledgeable here could check my lab results and point out anything I should be aware of. For instance the Crisler document says what things should be tested, but doesn't say what the ideal result is (high # or low#).
I'm a 42 year old male with Crohn's disease. Used to be very ill, was on high dose of prednisone for 4 years, now the Crohn's is much more under control and I've been off prednisone since 2002. Since stopping the prednisone I've been exhausted all the time. I've been active because with the Crohn's under control I feel a lot better, but it's all been by force of will.
I broke a rib (somehow while lifting) and got a DEXA scan showing osteopenia (just under full osteoporosis). I saw several doctors and finally an endocrinologist.
Every doctor assumed the bone density problems were from either Crohn's disease or the prednisone use, but the endocrinologist was willing to run a testosterone test.
TSH, 3rd Generation 1.88 range 0.40-4.50 mIU/L
T4 total 6.8 range 4.5-12.5 ug/dL
T3 uptake 32 range 22-35 percent
T4, free, calculated 2.2 range 1.4-3.8 Units
T3 total 100 range 97-219 ng/dL
Testosterone Total 152 range 260-1000 ng/dL
Testosterone %free 1.8 range 1.0-2.7 percent
Testosterone free 27.9 range 50.0-210.0 pg/mL
Follow up tests:
FSH and LH
LH 2.4 range 1.5-9.3 mIU/mL
FSH 1.5 range 1.6-8.0 mIU/mL
Prolactin 3 range 2.0-18.0 ng/mL
Estradiol 50 range <= 54 pg/mL (no idea if this was a sensitive test)
This got me a pituitary MRI which as near as I can understand didn't show any tumors.
I don't see the endocrinologist until Jan 26 and I'd like to be prepared as best as possible.
Looking at symptoms of low testosterone listed on wikipedia, I've been complaining about most of them since 2002 when I finally weaned myself off prednisone. Every doctor told me they were just symptoms of Crohn's.
I had been on prednisone, usually between 20mg/day and 60 mg/day from 1998 to 2002.
I had peaks while hospitalized (4 hospitalizations of about 10 days each) of around 150mg/day or more.
As near as I can understand, prednisone can also shut down the pituitary just like anabolic steroids do. Can anyone confirm or deny this?
I want to make sure I know everything I need to say to the doctor and everything I should hear back from them. I've already suffered a lot of unnecessary bad stuff at the hands of doctors.
Get my testosterone up to a good level. Number-wise, I'd like to have some idea what number I'm shooting for so that I don't just have a doctor who's satisfied to get me up to 260.
Watch the Estradiol. As near as I can tell, that should be more like 22 instead of 50. Crisler's document says this can sometimes come down on it's own. I'm thinking I'll want to make sure the Dr. is going to monitor it and is willing to add an aromatase inhibitor if needed.
I want to both maintain testicular size and function to be able to have kids one day. So I should insist on HcG right from the start, right?
If possible, I'd like to not lose my hair. It is last on the list, but I'm the only male in my family (both mother & father side) with hair. As I understand it, this is related to DHT levels, which my doctor has not tested. If this is going to possibly be affected by raising testosterone, would Rogaine be an appropriate thing to start?
Are there any other options that anyone would suggest? Like I saw a thread where Bill Roberts was discussing using letrozole for someone with low testosterone, but the details were all way too over my head.
There seem to be some tests recommended by Crisler that haven't been run yet - SHBG, DHT, Cortisol, CBC, CMP, Lipid, PSA, IGF-1. How vital are these - are they worth insisting on?
If you see anything else in my bloodwork that I should be aware of to be prepared for seeing my Dr. on the 26th, please let me know. I'd appreciate the help.
For some of the long story leading up to this, you can read my previous post before I knew about the low testosterone levels.