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    Old 05-06-2009, 10:29 AM   #16
    jerryb
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    Re: 28 year-old male with low testosterone and migraines

    I went for my MRI today, and everything went fine. I should get the results of the MRI on Friday most likely.

    I also got copies of some of my lab work today. The first set of tests were run on 3/16 and included a complete metabolic panel and my testosterone serum. Everything on the complete metabolic panel was within normal ranges except for my liver enzymes. AST(SGOT) was 49 IU/L(0-40), and ALT (SGPT) was 55 IU/L(0-55). My total testosterone was one the low side of normal at 253 ng/L (241-827).

    The next set of tests were taken on 4/09 and included a CBC with differential/platelet, renal panel, hepatic function panel, free and total testosterone, FSH and LH, and prolactin. Everything in the CBC, renal panel, and hepatic function panel were within normal ranges. My liver enzymes had decreased to AST (SGOT) 30 and ALT (SGPT) 41. My testosterone however was lower in this second set of tests than in the first. My total T was only 180, and my free T was 6.7pg/ml (9.3-26.5). My LH and FSH were both on the low side of normal; LH was 2.8 mIU/mL (1.5-9.3) and FSH was 2.0 mIU/mL (1.4-18.1). My prolactin was within the normal range at 8.5 ng/mL (2.1-17.7).

    I had one other set of tests run last Wednesday (4/29) which included another CBC, another Complete Metabolic Panel, and a Thyroid Cascade Profile. Everything was normal except my glucose was high at 113 mg/dL (65-99), but the doctor said that may have been due to the fact that I hadn't been fasting. My liver enzymes were even lower on this last test which is probably a sign of my decreased drinking. I now haven't had a drink in 10 days.

    I've also requested my medical records from grad school because I know they checked my T about three years ago and said it was normal. Knowing what I know now, I'll be interested to see what they considered normal.

    I guess one thing to keep in mind about my other T results is that the blood work was taken in the afternoon, so my T probably wasn't at its highest, but they still seem like low results especially for someone my age with my symptoms. Please let me know what you make of my test results. I'll also be interested to discuss these with my endo tomorrow.

     
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    Old 05-06-2009, 12:30 PM   #17
    viper911
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    Re: 28 year-old male with low testosterone and migraines

    Well so far it looks like secondary hypogonadism because your T level , total and free are extremely low for you. You should be in the 500-600 levels.. And your LH AND FSH should be high or high normal.. You're missing iron studies , mercury level, estradiol and estrogen , HIV ., cortisol serum or 24 urine cortisol....I would also consider autoimmune cause : get RF, ANA , sed rate..
    Oh yeah .. Get a semen analysis to check the boys ..

    Keep us updated !
    Good luck dude
    Viper



    These tests sounds like over kill but it's not because you need to find if there's a TREATABLE cause of your pituitary malfunction ..

     
    Old 05-06-2009, 02:34 PM   #18
    jerryb
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    Re: 28 year-old male with low testosterone and migraines

    Thanks, Viper, I'm making a list of things to ask my endo about. They did test my sedimentation rate-Westergen already and it was low at 1 mm/hr (0-15), which I take as a positive sign after reading about it. I just didn't post it before because I didn't know what it meant. Here's the list that I've put together so far (the tests I've already had are underlined):

    Total and Bio-available Testosterone
    Luteinizing Hormone (LH)
    Follicle Stimulating Hormone (FSH)
    Prolactin

    Estrogen and Estradiol
    Cortisol Serum or 24-hour Cortisol Urine Test
    Adrenocorticotropic hormone (ACTH)
    HSBG
    Complete Blood Count w/ Differential
    Complete Metabolic Panel

    Fasting Glucose
    Complete Thyroid Panel (already had a thyroid cascade profile done, which came out normal)
    Rheumatoid Factor (RF)
    Antinuclear Antibody Test (ANA)
    Sedimentation Rate
    Glycosylated Hemoglobin (HgA1c)
    Insulin-like Growth Factors (IGF)
    Mercury Level
    HIV Test
    Semen Analysis

    Just a couple more questions, though. What is HSBG and why is it important? I googled it and didn't come up with anything. And why is IGF important? Just want to know why in case the endo tries to tell me that I don't need to test those things. I think I know the reasons for the other tests.

    Also, Hayfarmer, if you're reading this, I'd like for you to weigh on this as well. I tried to PM you, but I couldn't figure it out.

    Last edited by jerryb; 05-06-2009 at 02:38 PM. Reason: corrected underlined formatting

     
    Old 05-07-2009, 01:32 AM   #19
    viper911
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    Re: 28 year-old male with low testosterone and migraines

    I need to look it up again but if my memory is correct there are certain disease conditions that affects an increase of HSBG the protein that binds testosterone therefore there is less free or bioava testosterone that the body can use.
    Also IGF - 1 is an indirect and better way of measuring growth hormone .. Another pituitary hormone ..please look this up yourself for verification
    Also .. You should check a baseline PSA if your going to start TRT in the future..

    Take care and write back if you have updates or questions

    VIPER

     
    Old 05-07-2009, 03:43 PM   #20
    jerryb
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    Re: 28 year-old male with low testosterone and migraines

    Just another update, I saw the endocrinologist today. We mainly just talked about my symptoms and possible causes, and then I had more blood taken to re-check my testosterone levels. The endo seemed like a nice guy, but didn't seem to think that some of my most troubling symptoms such as the anxiety and dizziness would be caused by low T. He also said that after we look at the MRI and get the new tests results back that he might want to start me on TRT. I told him then that I was concerned about doing TRT because of the potential for testicular atrophy, but he told me that the dosages that would be prescribed to get me into the normal T range would not cause atrophy. I didn't argue with him at this point since we aren't starting treatment yet anyway. I've got a follow-up appointment with him next Friday, so we should have the lab results and the MRI to talk about then and hopefully a better idea of what might be causing this, and then I'm going to talk to him about possibly doing hCG and/or clomid prior to TRT.

    Another interesting footnote, I got a copy of my medical records from three years ago when I also had my T checked. I went to the doctor then for the same sexual problems, low libido and weaker erections. He checked my T and told me it was normal, but I never knew the actual levels, but now I do. Then my total T was 728 ng/dL (250-1100) and free T was 171.8 pg/mL (35-155), so it definitely doesn't look like it was testosterone deficiency that was causing my problems then. It seems strange that I would have been experiencing similar problems then though as well, and for my T to have dropped that much in less than three years.

     
    Old 05-07-2009, 04:06 PM   #21
    crack97
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    Re: 28 year-old male with low testosterone and migraines

    Didn't you have the MRI two days ago? They should have the results by now.

    I have many of the same symptoms as you. Light headedness, tired, decreased libido, headaches, muscle aches. I also have an elevated resting heart rate (around 85-95), which was masked for a while due to the beta blocker I was on.

    I'm starting to think it may be a cortisol issue in addition to the low T...or I may just be chasing my tail again.

     
    Old 05-08-2009, 12:41 PM   #22
    jerryb
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    Re: 28 year-old male with low testosterone and migraines

    My endo called today and said that the MRI was normal. It's a relief to know that they didn't find anything abnormal, but in a way, it's also disappointing that we don't know what's causing my low T. I guess I'll just have to wait until my next appointment with the endo in a week, check out my latest blood tests, and then discuss other possible causes with him.

     
    Old 05-09-2009, 08:25 PM   #23
    barcafan
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    Re: 28 year-old male with low testosterone and migraines

    Make sure you get an ULTRA SENSITIVE estradiol test done. The regular one is for females and is totally useless.

    also get

    SHBG
    Total/free T4
    Total/free T3
    TSH
    Cortisol, 4x day, SALIVA (Blood cortisol is useless).
    DHEA


    I'm in the same boat as you man. I'm 20 years old, Testosterone is 520~ (not as low as yours, but way too low for my age). Free t is ****** too. I get no morning errections ever (Do you?) I was also getting the symptoms you described....

    Things like: Lightheadedness(Sometimes very harsh --subsided now)
    Feeling 'slow', like it takes more time to process information
    Back/knee tightness especially upon awakening
    Soreness lasting longer than before
    Gyno

    Good luck, let us know how it goes. Try and get those tests i mentioned.

     
    Old 05-10-2009, 08:50 PM   #24
    jerryb
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    Re: 28 year-old male with low testosterone and migraines

    Thanks for the reply, barcafan. I'm sorry to hear about the problems you're having. At 28, I thought I was too young to be dealing with an issue like this, so I can only imagine what it would be like to deal with this at 20.

    To answer your question about morning erections, I do still get them occasionally, but much less frequently than I did a few years ago. I think sometimes now that they may be due to my bladder pushing on the prostate because after I urinate, they usually go away (unfortunately).

    I also know what you mean about feeling slow. I got my masters degree two years ago, but sometimes I feel like I'm not as smart as I was in high school. I have a lot of trouble at times thinking of the right word to use.

    One thing that put me off about my endocrinologist is that when I told him about all of the symptoms that I've been having and asked him if they could be related to low T, he seemed to discount all of them except the sexual symptoms and the headache. And while those symptoms have definitely eroded my quality of life, I think the light-headedness and anxiety have been the most difficult problems to deal with on a daily basis. Sometimes they get so bad that they impair my driving. I found some research that does indicate that someone with my T levels could see improvement in their anxiety due to therapy, so hopefully that will improve for me with treatment.

     
    Old 05-10-2009, 11:07 PM   #25
    viper911
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    Re: 28 year-old male with low testosterone and migraines

    Hey guys ! What's going on with all us young guys havng low t?
    Is it environmental or some type of toxins we haven't isolated or is it some type of infection we don't know about .. I have done a lot of reading on low t and specifically secondary hypogonadism and it seems like there is not a lot of knowledge on the subject .. Doctors don't know .. Drug companies just want us to use testost replacement for life .. Gels injections patches or pellets .. It's for life everybody .. So it's up to everyone to help yourself and find out what's going on.. What we do know in secondary hyogonadism is that for some reason the pituitary has malfunctioned and is not responding to the low t level. I believe the pituitary had either malfunctioned at a histologic level or it's simply shut down in response to something else .. eg. Toxins , chemicals , injury or in response to someother hormonal imbalance..

    My recommendation is as follows: avoid testost replacement .. Unless you can not figure out the cause,. In order to find the cause do the battery of lab test to get a better picture of your pituitary.. Include tests to rule out diabetes , autoimmune disease, ironoverload , zinc deficiency, infections ... Remove all possible toxins by eating only natural stuff .. Eliminate all alcohol , sodas , preservatives , processes meats , canned foods .. Etc ..

    I will write more of my thoughts on this subject later..

    Just remember once you start testosterone replace.. Your testes and pituitary will shut down !!!

     
    Old 05-11-2009, 09:07 AM   #26
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    Re: 28 year-old male with low testosterone and migraines

    Sometimes it's just your genetics to lower testosterone at a very early age. You gotta understand that we're the outspoken minority here. I've always thought that it was my taking finasteride that somehow increased my estradiol Receptor sensitivity, which downregulated myTestosterone. But my LH/FSH are low normal, so maybe it is a pituitary thing. I'm still in range though for T (About Mid point)

    You can always add HcG in with your testosterone. That way your nuts wont atrophy. Add in some PCT to keep your E2 in check, and you should be fine.

    I do agree you need to get ALLLLLLL tests done, and hope they're covered by insurance. Comprehensive Adrenal and thyroid tests are the most important, along with B vitamin / Mineral Deficiencies. And most important of all, get yourself to a competent HRT doctor (Crisler/Shippen). Those guys took care of alot of hypogonadal people. I think you should also try to live a more clean life, good sleep, good exercise, good relationships with people and with nature.



    And remember dude, if ALL your blood comes back normal except for the Testosterone, dont think of Testosterone replacement as a failure, if it can get you back to feeling how you SHOULD feel, then its definitely a success story even if its for life. Why live at a lower quality of life if you shouldn't have to?

    Last edited by barcafan; 05-11-2009 at 09:08 AM.

     
    Old 05-11-2009, 05:41 PM   #27
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    Re: 28 year-old male with low testosterone and migraines

    I've come across some interesting articles while researching low T, including some that claim that it's increasingly common for men to suffer from low T. I've seen a number of theories for why this is, but I can't find them now or remember all of them. So even though we're a minority, unfortunately we're a

    In my particular case, if I had to guess, I'd blame my lifestyle for my low T. I've mentioned before that I've been a heavy drinker (about 24 beers a week) for five or six years. I'm also a smoker, and that can also decrease your T levels. This experience has made me seriously reconsider my lifestyle choices. I'm not sure my low T could solely be attributable to those things, but I'm sure they haven't helped.

    I also keep finding things that I do that may have a negative effect on my T. For instance, I like to drink grapefruit juice in the morning, but I just read that grapefruits raise your estrogen. I also drink 2-3 cups of coffee in the morning, and I read today that caffeine can raise your cortisol levels.

    Just thinking about when my symptoms first appeared, I think stress may have shut down my HPG. It all started to happen shortly after I graduated from grad school. It took me four months to find a job after graduation, I had to move multiple times after my lease ran out, then just the stress of adjusting to a new job and a new city might have overtaxed my system. This really makes me interested in clomiphene (clomid) therapy. I found some good journal articles about clomiphene and low T today. Just search for "clomiphene testosterone production" and there should be some good results at the top of the page.

     
    Old 05-11-2009, 06:16 PM   #28
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    Re: 28 year-old male with low testosterone and migraines

    Lifestyle definitely contributes, and it may be alot of little things that you do (Whether or not you're aware of them) that can seriously accumulate over time and start damaging you! Certainly the heavy drinking and smoking are the biggest factors here.

    Advice: Don't self-medicate, make sure you do it under a doctors supervision.

     
    Old 05-11-2009, 06:21 PM   #29
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    Re: 28 year-old male with low testosterone and migraines

    also, do you have any gyno?

     
    Old 05-11-2009, 07:24 PM   #30
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    Re: 28 year-old male with low testosterone and migraines

    I've never been diagnosed with gynecomastia by a doctor, but it seems to me like I've had some fatty breast tissue around my nipples ever since I was a teenager. Not sure it's gynecomastia or not, but I've had it prior to having low T or any other problems. I remember hearing about it several years ago before I had any sexual dysfunction or other low T symptoms and wondering if I might have it. I think it might have been caused by puberty and just never have gone away.

    The only sort of self-medication I've done, if you can call it that, is taking multi-vitamins and l-arginine (already had it to help with the ED, and read somewhere that it decreased estrogen or cortisol). I have changed my diet slightly to add more cruciferous vegetables like broccoli and cauliflower because they are supposed to help increase your T. I haven't had a drink in 15 days to also see if I see any improvement from not drinking. It's just been frustrating since it took so long to get an appointment with an endo, and then the appointment seemed to go by so quickly that I didn't get a chance to ask a lot of questions.

    Last edited by jerryb; 05-11-2009 at 07:25 PM.

     
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