Primary hypogonadism

[Martin Shenfield]

Gday Rip,

After perusing the boards and reading a few different situations, it occurred to me that my chronic back pain, crazy broken leg, bad mood, lack of strength etc etc may be caused/not helped by low testosterone. Coupled with the fact that I had two undescended testicles as a child (one surgically fixed and the other left to be retractile for some bizarre reason) I thought I would ask my doctor to test me.

He did and I got 475ng/DL total which he said was fine. Obviously didn't test anything else. I wasn't happy so found a way to order my own blood test with the appropriate stuff.

My best results are:
36 years old.
Total test - 533ng/DL
Free test - 373pmol/l I don't know that unit you US guys normally use.

My shbg was in range. Thyroid was fine. Kidney function was checked and fine. Doctor didn't say anything during physical exam.

The only actual anomaly is my FSH level was 19 U/L with the reference range being 1-8.
LH was 5 with the same range.

So given my history, high FSH level do you think I should give TRT a crack? It's hard to get here in Australia but I can get it private script. At least at the moment anyway.

I assume that I do have primary hypogonadism but for some reason my Test levels are not horrible and my LH level is within range. I guess the balance between everything is what is a problem for me.

Obviously I can't thank you enough because I wouldn't have even found this out without you doing what you do, so figured I should give you the final say.

[Mark Rippetoe]

I don't want the final say. This is your situation, not mine. If it were me, I'd try to elevate my test and see how I felt, which is the only way to know.

[Jason Donaldson]

Martin, are you in the US? If so, I think Wittmer Rejuvenation Clinic still does a free initial consult. They're good folks, and can help you figure things out holistically.

Diagnosing hypogonadism is more about symptoms than numbers. The biological picture is more complex than just serum levels - the blood tests don't measure testosterone sensitivity, for example.

[FrankNJ]

Consider the info in this video before making a possible one way decision. The inconvenience of 50 years of biweekly injections should make you pause and first re-examine your lifestyle (sleep, diet, exercise, alcohol, etc.).
https://www.youtube.com/watch?v=mwgJVimtq-g

[Martin Shenfield]

Thanks Rip,

I think that is my plan. Give it 3-6 months , find an appropriate dose and then I can make a full decision from there.

I at least seem to have found a decent clinic here, guy has done some talks with Dr.Nichols in the past.

Thanks for continuing to give me useful guidance.

[Martin Shenfield]

Martin, are you in the US? If so, I think Wittmer Rejuvenation Clinic still does a free initial consult. They're good folks, and can help you figure things out holistically.

Diagnosing hypogonadism is more about symptoms than numbers. The biological picture is more complex than just serum levels - the blood tests don't measure testosterone sensitivity, for example.

Negative. I'm in the penal colony also known as Australia. I got in touch with one of the only clinics here that is recommended. They are going to give me TRT. My symptoms all fit, but I also got diagnosed with Autism a few years back so some things could be attributed to that. However, I now how much of that is attributed to a clearly out of balance hormonal profile.

Consider the info in this video before making a possible one way decision. The inconvenience of 50 years of biweekly injections should make you pause and first re-examine your lifestyle (sleep, diet, exercise, alcohol, etc.).
https://www.youtube.com/watch?v=mwgJVimtq-g

I may seem stupid, but do you think that I wouldn't have examined my lifestyle before this point?

I watched the video and it doesn't really help me. My testosterone level is okay, my other hormone level is clearly high. That indicates primary hypogonadism as far as I know, and I'm just lucky my levels a not worse. But I still have tiredness, poor mood, lack of concentration, motivation, low muscle mass, body fat increase(granted I tried to put on weight because I was underweight for a long time), low strength, poor recovery(which shouldn't be occurring because I don't have to do anything else other than train really), chronic back pain and freak bone trauma.

My diet is normal, I don't eat a lot of take out, I have too many energy drinks because I have no energy. I train the way I'm supposed to train. I rarely drink alcohol, don't smoke, don't take any medications.

How many more symptoms do I need to have before somebody actually does something for me instead of saying I'm fine?

If there was another option I'd take it but doing nothing leaves my kids and wife with an almost useless dad and husband.

I asked Rip because he's usually right.

[FrankNJ]

. I may seem stupid, but do you think that I wouldn't have examined my lifestyle before this point?

Martin,
Apologies, I intended no insult. Given that you provided no details (height, weight, training, mental history, etc.), I have no idea whether you examined your lifestyle before this point, but I'm glad to hear that you did. We have a few good physicians (i.e. Wittmer) in the US prescribing TRT who will ask a battery of questions in an attempt to rule out all other causes. However, we also have a significant amount of charlatans (one near me) that will take full advantage of people who have not looked at all options. I assume that the rest of the world is no different, so just providing a word of caution. In any case, I wish you the best of luck and hope to hear back on the results.

[Martin Shenfield]

Martin,
Apologies, I intended no insult. Given that you provided no details (height, weight, training, mental history, etc.), I have no idea whether you examined your lifestyle before this point, but I'm glad to hear that you did. We have a few good physicians (i.e. Wittmer) in the US prescribing TRT who will ask a battery of questions in an attempt to rule out all other causes. However, we also have a significant amount of charlatans (one near me) that will take full advantage of people who have not looked at all options. I assume that the rest of the world is no different, so just providing a word of caution. In any case, I wish you the best of luck and hope to hear back on the results.

All good. Was an overreaction on my part. I'll blame the hormones.

Here, we have GP's who don't know anything. The guy I saw suggested I try Clomid first which is nuts considering I already have high FSH and borderline LH. Which has been confirmed by two separate blood tests. Even the studies I read say that I'd be a non responder.

We have very few clinics and I found what is supposed to be the best one. The bad ones get shut down by our government rapidly. So do the good ones sometimes.

Yes I was a bit brief but I have posted before so didn't bother listing my history.

Believe me, I was hoping there was another way but from everything I can read, the only way to suppress FSH is TRT, and having a high FSH is the same as having low Test in terms of symptoms.

I've ordered TRT but will follow up with GP again before starting.

[Phill]

Does the clinic do online consults Martin?

[Jason Donaldson]

Negative. I'm in the penal colony also known as Australia.

Ah, right - please forgive me, as I should have remembered that from your posts about training your, as y'all say, mum. And my condolences on conditions there.

I got in touch with one of the only clinics here that is recommended. They are going to give me TRT. My symptoms all fit, but I also got diagnosed with Autism a few years back so some things could be attributed to that. However, I now how much of that is attributed to a clearly out of balance hormonal profile.

I'm glad to hear you're able to get on TRT - looking forward to hearing more good news for you. Well done taking charge of difficult providers, sir.