I'm a 38yr old male. I've been seeing an endocrine doctor after suffering a head injury several months ago. At first, I thought my symptoms were the result of the head injury but had some blood work done after exhibiting symptoms below. Lab results came in and my total testosterone is 200ng/dL. Everything I've read indicates that this is low. My doctor is really dragging his heals and has not recommended any therapy. He keeps ordering more tests. I feel he's concentrating on the numbers but not hearing my symptoms. Is it time to switch docs? Is this something my general practioner should be able to handle?
Again, I know the head injury complicates it as they think I bumped my pituitary. However, physically, I have healed.
My symptoms:
1.) General apathy - no desire to do things I once loved, like hobbies. Just exist, pretty much eat and sleep
2.) Extreme fatigue - sleep 10-12 hrs per night w/o feeling rested
3.) Lower libido - Still desire to have sex but am ok if I don't. No interest in porn (my wife is probably happy).
Doc's response: Your SHBG and Total T are low so lose some weight. Free T is low but within normal no treatment. When I asked about my symptoms his response was go to my general practitioner and have my anti-depressants and Cialis dosage increased. I'm pulling my hair out. No matter what he's fired...
Typical dumb *** doc response.......you are showing classic symptoms of low T and labs support it.
Doc doesn't know how to read them and is just relying on the ranges. He doesn't know how to treat you so he is passing you off to primary to drug you up on anti-depressants and a cialis that won't work well if T is too low.
Run don't walk and find a good anti-aging doc who treats low T regularly.
Good news. Met with a new endocrinologist. It took him about 5min to diagnose me with low T based on my test results and write an RX. Hopefully this will make a difference....
He did order some additional tests. Since I experienced a TBI, he's concerned I injured my pituitary gland so their going to run several tests to confirm. The net outcome is that I'll still need HRT. However, the good news is that if the pituitary heals, it may be short term (1-2yrs).
Head Injurys can definitely cause what you have.....I suspect mine is of similar nature as I have taken quite a few blows to head in a very active life.
The reality is however once you go on TRT its not something you typically come off of. To say well I'll do it for a year or two and when I heal I'll stop is nice....but not realistic. How will you know you've healed? Only way is to come off TRT and after a year or more you will be completely shut down do to its suppression of any natural production. Also if you haven't been taking HCG to keep testes alive they will be the size of dried rasins and the chance that they respond to your now healed Pit gland sending out adequate LH and FSH signals is doubtful.
Bottom line would be better to investigate all avenue other than TRT prior to going on it and if you do feel you need to then plan that it might be for life and if you do want to try to come off, and even if you don't, take HCG to keep the boys from dying off.
Your FSH and LH aren't horrible....so signal to testes should be yielding better results. By comparsion my LH and FSH were half of yours and I was around 300 total T.
It is important to remember however that its not your number today but what it was prior. Meaning if you were 800 like me and dropped to 300 thats worse then if you were 400 and dropped to 180 like you.
Regardless.....it would appear that your testes aren't reacting to the LH and FSH signals getting to them. Might be worth trying some HCG mono-therapy and see if your T levels rise from the artifically higher signal to testes that they would create.
