is my ‘endo’ a complete nutcase?

[PRPR]

‘Guys,

I posted my full bloods last week + a few of you added your input, for which I’m grateful 🙂 On Friday I caught up with my endo + we had a frankly disturbing chat. I post my full results for you again-

TSH – 2 (0.5 – 5) ****When tested 2 weeks ago this was 2.8 (0.1 -4)****

Free T4 – 15.6 (10-25)

Total T3 – 1.82 (1.1 – 2.8)

Total Testosterone – 13.3 (8.6 – 56)

SHBG – 31.6 (13-71)

LH – 3.8 (1-8)

FSH – 1.9 (<11)

Estrogen – 121 (<130)

Prolactin – 379 (<300)

Cortisol (24 hour urine) – 299 (<320)

As discussed previously, there are clearly one or two issues here – very low testosterone (I’m only aged 31 btw), low LH and FSH, raised prolactin, borderline Estrogen and cortisol. Some of you suggested the T4 and T3 are suspect also as they fall outside the top 1/3 of the range.

The endo said he found everything ‘absolutely normal’ apart from the testosterone which he conceded is in his words ‘a little bit on the low side’ (he also said that even men with a score of 8 on the ref range of 8-56, would ‘still have adeqaute sexual function’).

He thinks I ‘might’ be suffering with ‘idiopathic hypogonadism’. He doesnt wish to run any further tests or do an MRI. His ‘treatment’ consists of a 2 month course of Testogel to ‘see what happens’.

Is this guy a complete tit or is there some credence in what he says?

Thanks as always
PRPR

[hardasnails1973]

@PRPR 1885 wrote:

‘Guys,

I posted my full bloods last week + a few of you added your input, for which I’m grateful 🙂 On Friday I caught up with my endo + we had a frankly disturbing chat. I post my full results for you again-

TSH – 2 (0.5 – 5) ****When tested 2 weeks ago this was 2.8 (0.1 -4)****

Free T4 – 15.6 (10-25)

Total T3 – 1.82 (1.1 – 2.8)

Total Testosterone – 13.3 (8.6 – 56)

SHBG – 31.6 (13-71)

LH – 3.8 (1-8)

FSH – 1.9 (<11)

Estrogen – 121 (<130)

Prolactin – 379 (<300)

Cortisol (24 hour urine) – 299 (<320)

As discussed previously, there are clearly one or two issues here – very low testosterone (I’m only aged 31 btw), low LH and FSH, raised prolactin, borderline Estrogen and cortisol. Some of you suggested the T4 and T3 are suspect also as they fall outside the top 1/3 of the range.

The endo said he found everything ‘absolutely normal’ apart from the testosterone which he conceded is in his words ‘a little bit on the low side’ (he also said that even men with a score of 8 on the ref range of 8-56, would ‘still have adeqaute sexual function’).

He thinks I ‘might’ be suffering with ‘idiopathic hypogonadism’. He doesnt wish to run any further tests or do an MRI. His ‘treatment’ consists of a 2 month course of Testogel to ‘see what happens’.

Is this guy a complete twit (not tit) or is there some credence in what he says?

Thanks as always
PRPR

If you had sex before the draw that could also answer the reason for elevated prolactin.
Elevated prolactin is usually sign of low tissue response from the thyroid, zinc deficeincy, b-6.
I would also have an evaluation with adrenal salvia profile done to verify how your cortisol are effected during the day. The guy also did the wrong estrodial essay as well because most likely that is for a women not a man.

I would start with proper evaluation of adrenals to see if you are able to see if you are getting a tissue response from the thyroid itself. Then I would have a total t4 done with reverse t3, ft3,TPO,TGAB to rule out hashimotos and other thyroid issues. This dr missed half the boat when it comes to proper evaluation of things. Your shbg is really high resulting in decreased bio T which is making your symptoms of low testoseteron worse then what it appears. I would look to see if you are primary or secondary with a clomid challenge to see if you body will respond to the signal. If it does then proper nutritional support (good EFA ratio) and giving the building block it needs to help hormone production. While the back filling is going on you can do the clomid to retrain the HTPA to start sending the signal again. If after 8 weeks with 3 week off peroid you do not start up then you can use HCG instead of TRT.

[PRPR]

Hi,

Thank you for your help 🙂

I have a few quick queries following your advice-

1.Any idea why my SHBG is so high? any medication/supplement I can take to return it to a better level?

2. If I were to take the testogel he has prescribed would this be the wrong thing to do? My understanding is that testogel shuts down the body’s normal production of Test – which I dont really want to do!

3. How much clomid would I need to take per day? and is it available to buy online without a prescription?

Thanks
PRPR

[hardasnails1973]

@PRPR 1889 wrote:

Hi,

Thank you for your help 🙂

I have a few quick queries following your advice-

1.Any idea why my SHBG is so high? any medication/supplement I can take to return it to a better level?

2. If I were to take the testogel he has prescribed would this be the wrong thing to do? My understanding is that testogel shuts down the body’s normal production of Test – which I dont really want to do!

3. How much clomid would I need to take per day? and is it available to buy online without a prescription?

Thanks
PRPR

First rule out primary or secondary via MRI and also clomid challenge.
So why do you want to shut down your own because you may not be getting the signal.
If you are not secondary and primary then yes .

Correcting the adrenals and thyroid has been shown in our practice to stimulate testosterone production rather well as wel as control estrodial in the process.

My gut instinct is that you are low on nutrients and out of balance with your building blocks which is resulting in hypothyroidism resulting in elevated prolactin levels.

Do not do clomid challlege on your own be under dr’s care and properly monitored

SHBG is influence by diet via low fat high fiber, low protein intake, progesterone, dhea, cortisol, gh , testosterone, estrogens (may be elevated 16 and 4 hydrox)

Where are you orginally from?
If you are from USA please reference Dr Mariano on west coast, my self and DR O on east, and Dr Crisler in mid west. Those are the top 3 in my book.

[AlexanderDenmark]

looking at the range for SHBG, his is about midrange. Dosn’t look high at all. why do you consider it high?

[PRPR]

Thanks 🙂 I’m in the UK – my GP is total garbage + definitely wouldn’t consider actually prescribing me any drugs like clomid etc. They’d be very happy to give me 10 different anti depressants though 🙁

[AlexanderDenmark]

yes, we all have that experience unfortunately.

[AlexanderDenmark]

Stay away from the antidepressants though.

[Author]

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