What to ask the doctor? Very low T caused by accutane + other potential factors
I'm seeing my Endo tomorrow finally. I am hoping to finally get some treatment for extremely low Testosterone levels. Here are my may 25th 2015 results for reference:
Testosterone Total: 2.3 nmol/L range: 8 - 32
SHBG 34 nmol/L range: 11-78
Testosterone, Bioavailable (calc): 1.0 nmol/L range: 4-17
Estradiol: <37 pmol/L range: 40-162
And here is a test 1 year ago from may 27th 2014:
Free Testosterone 28 range: 31 -94 pmol/L
ACTH 2 <10 pmol/L
Cortisol AM 191 range: 170-540nmol/L -other times turned out 70, and 200,
Total testosterone 12.6 range: 7.6- 31.4 nmol/L
LH 2 2-9 IU/L
FSH 4 2-12 IU/L
Prolactin 8 <18ug/l
Norepinephrine 1.2 0.8-3.4 nmol/L
Epinephrine <0.1 <0.8 nmol/L
Estradiol 57 <157 pmol/L
And previous random TSH tests indicated: 5.01, 3.4, 5.6, and various ranges between 3.2 - 5. I have not TSH tested in the past few months. Hashimoto antibodies were tested and are <10 so that is ruled out.
My Symptoms: I basically been very anhedonic, depressed, withdrawn, unmotivated, disinterested, no sex drive, social withdrawl, low energy, poor memory, uncomfortable physical anxiety on and off, poor stamina and easily drained after physical activity, carrying anything usually causes me to feel dehydrated or dreadfully worn out, irritability, brain fog, poor memory, sleep inconsistencies, hypoglycemia, prone to fungal infections, pains and tightness and possible inflammation in my neck, peripheral circulation issues, dark circles under my eyes, collagen loss and notable wrinkles around my eyes, thin skin, poor wound healing, slightly yellow skin on my face.
I am early 30's. Thin composition. 5'7, 130. Low body fat aside from my legs and butt and slightly on belly.
I want to test LH , FSH, Free T, Total T, Estradiol, Cortisol, T3, Prolactin, and hope I can possibly get a Pituitary MRI but unlikely with this doc.
Somehow I will need to convince him that low cortisol issues can be a real problem. He feels if the worthless ACTH stimulation test works then my adrenals must be perfectly healthy. I'd love to be able to try low dose Cortef/hydrocortisone but what can you do.
At least he won't be able to deny the T results.
Here I am hoping for the best... it has been over a decade struggle with low hormones.
Any advice would be greatly appreciated!
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Update: I been losing weight. 122. I haven't even been paying attention to it. Been also having symptoms of low cortisol such as really harsh stress responses, palpitations in bed, bad physical anx, insomnia, lot of inflammation in back and neck, very bad depression, and low blood sugar swings.
Are there any sites which sell hydrocortisone/cortef? Unlikely he will give it to me.
My diet btw is fairly clean. I don't eat any junk food for past several months. No fried foods. I eat whole grains, fish, low sugar cereals, chicken, beef, pork, eggs, salads and veggies. I do not drink and avoid drug use.
Full panel? What would that include?
@alex, it sounds like you're in a slow spiral downward. but no one sees it but you. I give you props for getting on these forums and asking questions!
Forgive me if my question I'm about to ask comes off as if I'm being critical to you. I'm not. I have your back! I add this to simply see if this could help. So to be blunt, do you have any underlying stress that could be affecting your health? (For example: Bad relationship? Bad work environment? Spiritual/religious issues that you need to sort out? These sorts of things are HUGE in regards to physical health.)
As you surely know, AAS or TRT won't help you with these kinds of problems. Therapy, counseling, a new job, a new city, a new friend group, etc, will be the proper therapies.
However, if it's a case of, "everything in my life is fine EXCEPT my damn health," then you are certainly doing the right thing by seeking advice here. You're not alone! We're all here to help.
So, to those with experience, anyone with any advice or input for @alextoronto999, please reply!
opticxat 5,7 132 pounds he should see how the low test is effecting you! doctors these days man.. find a new endo immediately.Youll find someone to help you and youll never look back!
Baldur2630Doctors and Endos may be well intentioned, but you have to remember that they have ALL been brainwashed in medical school. It isn't in the interest of the medical profession hierarchy to have healthy people. They are taught to treat the symptoms.
Two examples : my wife asked for a blood test and gave the doc a list of what tests she wanted. They REFUSE to test for either total or free testosterone. They have been taught that women don't have testosterone, which is just total bollocks. Even when I gave him half a dozen articles I had printed out for him such as http://www.nature.com/ijir/journal/v17/n5/full/3901334a.html and https://www.womensinternational.com/pdf/testosterone.pdf he looked at me as though I was crazy and shook his head in disbelief.
My so-called endocrinologist agreed that I needed testosterone, but he didn't even know what testosterone injections were available, because he had never prescribed it and I wasn't eligible anyway because of my age (74) and the fact that I had high Total Testosterone, but almost zero Free Testosterone.
I have blood tests every 6 months and I have to almost threaten my doctor, to get the complete tests that I require. THEY DONT WANT TO KNOW! The MEDICAL PROFESSION IN GENERAL WOULD RATHER HAVE YOU SICK AND KEEP YOU ON EXPENSIVE MEDICATION WHICH HAVE SIDE EFFECTS WORSE THAN THE DISEASE,
Honestly there is not.much to say if your endo is not convinced, shbg is in the normal range. Get a second opinion and change your diet as you said you had higher numbers when you were taking those supps. Try cutting out any shit in your diet and eat healthy for 4 weeks then get bloods again. no drinking and drugs either. You might be surprised or your 2nd opinions says otherwise. Post your full panel so we can see all the numbers.
From the looks of it, you should only need to tell him what you typed here. Be honest as theres NO reason to keep you off TRT with these numbers and symptoms. If he says otherwise....Id find a different doc.
@sensimiagi, GREAT advice. I'm currently following that advice in my own life.
Those test results from a year ago were better because I was taking Royal Jelly, and Ginkgo for raising T + pituitary support. But since then I have developed a bad reaction to royal jelly so I cannot really take it anymore. Likely due to underlying Candida.
The hormone benefits of royal jelly are very very real but side effects may be undesirable for some such as worsening of brain fog at certain times of day and blood sugar flux.