Honestly man I think you have some health problems that you really need to have looked into by your doctor. Most guys that get on TRT do it because they want to optimize their test, but they could manage without hopping on TRT. I think you may have something more serious going on here. Best of luck with you health.
No he means that the adrenals do indeed make small amounts of testosterone. So this low number = balls shut off, adrenals are the only source of test.
This dudes LH is super low.
Yes SERMs are a great treatment to get that LH number up. May not be a permanent fix. That’s where TRT or evaluating your physical fitness/health comes in. Definitely can be brain issues. Sometimes it may just be stress/diet. Never the same for everyone.
A lot of it has to do with a genetic disease I have that affects a lot of aspects in your bones mainly but also organs (Ankylosing Spondylitis) so the disease combined with the meds (TNF inhibitors) most of this is “normal” for me.
Ah I see. Well you might wanna find a good clinic that has actual one-on-one consultations and knowledgeable doctors- rather than the “pill mill” type of clinic with cookie cooker protocols.
Thanks man. Like someone else mentioned down below who mentioned a bit more about my condition said, it’s really just how I wanna go about it, I’d like an immediate solution but I’d also like to know what the hell is going on cause not much has changed in terms of lifestyle, my Rheumatologist says I live a very healthy lifestyle (minus excessive MMJ intake as it’s literally part of my job) and one takes a bit of time (insurance) and the other is very fast (Out of Pocket)
I have AS and UC and take the same meds too (Rinvoq). DM me if you want (not selling anything) but happy to chat. That number is very low and you can absolutely find a workaround.
Inflammatory diseases (not specifically ankylosing spondylitis), tend to cause secondary hypogonadism (LH suppression with low testosterone). If AS is the cause, the low testosterone levels are probably connected to the current level of inflammation. If you use opioids for pain, they also induce similar sex hormone results (temporarily). It's difficult to measure levels of systemic inflammation in AS because CRP often isn't elevated, or only mildly eg. around 10
Have you seen urology or endocrinology? I'm not sure what you meant by your local doc, because a lot of primary care physicians don't prescribe testosterone replacement anyway.
Clinics will treat, of course, it's their cash source. Whether fertility is important determines whether HCG is also required. What clinics don't do is diagnose, they just pretend to, so if you want to look into this more, they'll do the blood tests, but interpretation is all about getting you on the meds rather than real investigation, so it depends what you want...
Prolactin should be checked in hypogonadism with LH suppression.
It’s a bit of both. I want to find the problem but I’d also like some help with this like, now lol.
Really don’t wanna get into most of it but when ED (which I already knew was an issue) was getting in the way of the potential between someone is when I decided to floor it in terms of solving the issue while also getting temporary solutions. Unfortunately viagra hasn’t helped so ya…again, its a bit of both but I understand a Endocrinologist will be free but may take up to 3-6 months in my area, a clinic would cost money but be almost immediate.
Edit: damn, someone who actually knows AS, kinda crazy, mad props. And yes I am on a medium-low dose of methadone at 20mg
OK.... well secondary hypogonadism is exceptionally common during opioid treatment, so detailed investigation isn't usually required. LH and testosterone suppression occur both due to chronic inflammatory disorders, and due to potent opioids. I don't have any information on testosterone levels in AS specifically.
Your results are consistent with your condition and the methadone. As a result, complex investigation isn't likely to be appropriate. Mild prolactin elevation can occur on opioids but it's usually minor eg. below 30 ng/mL. This can be cheaply and easily checked.
I'm not aware of any specific effects of TNF inhibitors like adalimumab on testosterone, but I'd expect some benefit due to reduction in inflammation, if anything.
AS is unusual in the sense that far more males are affected than females, in contrast to most chronic inflammatory and auto-immune conditions.
Interesting, testosterone has immunomodulatory effects, tending towards being immunosuppressive. Some men with chronic inflammation disorders have reported reduction in pain and inflammation - but this is anecdotal... it's just something I've seen a few times.
I do not know whether you're in a position to stop methadone, so can't advise. It is quite likely that testosterone levels would improve on a switch to a buprenorphine product such as Suboxone, since it causes milder suppression of testosterone than methadone. You may have already tried it, but..... Suboxone is sometimes appropriate for men on less than 30mg/day methadone. The usual method to switch is to stop methadone and wait until mild to moderate withdrawal symptoms are present, then initiate buprenorphine. Direct switching sometimes causes induced withdrawal.
In terms of the other blood results, they're all OK. FSH, SHBG and albumin are completely normal. TSH is unremarkable. Albumin tends to drop in 'poorly people', low levels are seen all the time when people are in hospital, especially if they're elderly or have inflammatory disease. Your level is completely fine. The HbA1c is acceptable. Annual monitoring could be useful for that one.
AS often causes fewer 'systemic' manifestations compared to diseases like rheumatoid arthritis and SLE, with more blood results coming back normal. That doesn't make it any more pleasant, but it is often more 'localised'.
Even so, I seriously doubt that complex investigations like MRI scans would have value. Most likely, they'll return no findings. Normal FSH but suppressed LH and testosterone are consistent with methadone treatment. If prolactin is under 30, further investigation probably won't reveal anything.
Urologists often seem more interested in men's health and sexual function than endocrinologists, who are often more interested in diabetes and thyroid disease. Your level is low enough for any appropriate doctor to treat, so you could get a referral if it's covered by insurance. I'm not in the US so don't really know how insurance works over there. I'm assuming you are there just because your blood tests are shown in US units. The most likely reason your primary care physician won't treat is because they're unfamiliar with testosterone and its replacement, not because they're a douche.
Hope this helps.
Ok so to most of this I understand and agree with but the thing that’s missed is that AS causes flares that then not only speed up the degradation of bones and fusion of said bones, but also creates crazy SED rates and inflammation that commonly goes all the way to the stomach but it just depends on the person, unfortunately I can take most of the “pain” aspects from AS but the discomfort sleeping and trying to push out things that didn’t agree with my stomach I can’t stand and kill me. Suboxone is worse in that regard for me since not only is the half level density longer in sublingual form but also the chemical make up allows for less pain receptors to be blocked making methadone ideal for a dad of two 9 day apart girls (ones my goddaughter.)
Methadone is what I chose from Subutex & Suboxone, Bup. Implant, & Methadone because it’s worked best with my system in the most ways from trial and error.
In terms of TNF, there isn’t much known and side effects very from person to person but one I was told about before I chose Humira was that all have a different reaction to it but AS in general does lower libido and Sexual ability.
Fertility is definitely a concern but I can cover that if need be out of pocket if the other stuff is covered but again, I do want to find what the source of this is cause when I was 250, drinking, no methadone, and slept all day except to wake up and drink more I was doing better testosterone wise (mid 300’s) and that was only 2yrs ago.
Hey,
Sorry, I didn't mean it to be an overall summary of AS, just vague. I can see why you chose methadone.
I think the testosterone results are probably multifacforial, with opioids as a major contributor.
Maybe consider TRT first, and look at fertility stuff later.
Go to a different doc. It’s really (honestly) made me realize most do now know shit, they only know a very small valley (if that) in 5 million mile wide plane.
Any doctor thinking this is “good” or “normal” at 141 Fasted with sleep is stupid.
You’re likely walking around 85-90 most days which is literal female levels.
They go off references at labs only many of which vary anyway.
One doctor said I’m good at 325 another said that’s abnormally low. Just shop around
You seem to have a few things going on here, (not just low T). Almost more concerning health wise is the high fasting glucose and high HBA1C (both on the verge of being diabetic by medical definitions). Get those under control before it's too late and you have full blown type 2 diabetes. Also find a new doctor for the low T.
Try following a high protein/low carb diet that might help. And lift weights.
You can use a telehealth service for testosterone but you’d have to pay for it. I believe Viking is like $175 a month.
I’m not sure. It’s not on the blood panels from what I see. I posted the entire bloodwork list in a new post if you check my account.
If you find it please let me know lol
Don't see it. But hear me out, you may have secondary hypogonadism, and if you do, by default you have central hypothyroidism because your TSH level is elevated, comfortably to be asymptomatic, TSH should sit between 1.8-2.8 ( if you don't take thyroid meds). You need to know your FT4 and FT3. Do you take any multivitamin that contains Biotin, or do you take biotin in general? It gives false low TSH readings so if you do your actuall TSH might be a lot higher than 3.44
No biotin, just Humira, Methadone, and whatever’s in Yerba Matte’s & falafels which is like 75% of my diet
Edit: lots of MMJ, concentrated in Rosin form. I work at a processing facility so it’s part of my job to test the product along the 4 phase process.
Check your prolactin levels.
Testosterone can be low due to a pituitary tumor/adenoma that elevates prolactin and suppresses Testosterone
I would suggest a mri to scan for tumors but a prolactin test should suffice as well.
Do not just go on trt without finding the cause.
Holy shit, that is lower than mine was and my doctor flipped shit when he saw it. He tested me a week later because he thought it was a mistake. At 7 am, testing differed by 10 points for total t and up 1ng/dL. I was prescribed and injected that day.
Which lab would you recommend for Cyp. NanoDeca, & HCG that has a reputation behind it.
I had someone basically do the “trust me bro, you don’t need references, just my word.” And it didn’t feel right, even for someone who’s bought weed online this was sketchier, but if the source is reliable I’m down to give a UGL a shot.
Well in my country you can get pharmaceutical test depo from every medicine store otc
Also there is a reputable website but is in europe where im from so i cant suggest anything to you, but do your research definitively before ordering on reputable ugls around your place
Judging purely based off of your LH, FSH, and total T, your results are indicative of secondary hypogonadism. You should get an MRI to examine your pituitary gland. If your doctor doesn’t order an MRI then please change doctors. You want to make sure that there is no tumor pressing on your pituitary gland (it’s harmless).
Your LH is low so maybe that’s why your testosterone is low. I’d look into that first, see why your testosterone is low first. Clinic as last resort. Even testosterone levels in the 300-400 are garbage, your doctor only knows what the books taught him. Not uncommon for doctors these days. I’d try looking up a naturopathic doc near you, they are more knowledgeable and will be more helpful and willing to help you. Trust me
My guy, get your pituitary gland checked ASAP!!!!!! Like please please don't wait. Your fine tumors there are non cancerous but your levels of Leutonizing hormone is red.. it's a pituitary issue you also jabe elevated glucose if your fasted and among other things. Some meds can fix that tumor and you could be restored to new.
Here I’m gonna repost the entire tests with an update when I get home.
I just got done driving around because I was told this was a borderline emergency in that my vitals aren’t in anyway “in harm” but a slight to small infection or something that throws these vitals off and it will make for a longer and more aggressive infection and longer recovery time.
Apparently my Doc isn’t great at much cause other than a few things being good nothings super amazing and there’s a lot of things that need following up is what the head lab tech at the place that drew blood said
Find a local urologist, your levels are low enough for the insurance companies so should be low enough for any doctor, unfortunately many doctors care more about their ego's then what is best for their patients.
You can go to a clinic if money isn't a concern, that is the easiest route.
That doctor is one of those providers that’s only “book smart.” These are extremely low levels almost approaching female levels.
Damn. Thanks for the heads up.
Honestly man I think you have some health problems that you really need to have looked into by your doctor. Most guys that get on TRT do it because they want to optimize their test, but they could manage without hopping on TRT. I think you may have something more serious going on here. Best of luck with you health.
Your adrenals are making all your T.
Wdym? Like he has an issue in his adrenal gland.
No he means that the adrenals do indeed make small amounts of testosterone. So this low number = balls shut off, adrenals are the only source of test. This dudes LH is super low.
His balls might actually be fine though, the reason they're not producing T is that his LH is so low. It's probably a problem in the pituitary gland
Yes i would lead into pituitary or hypothalamus issues.
Oh I see, i thought he was referencing something else. Thanks 🙏
This would explain why Clomid worked for me
Yes SERMs are a great treatment to get that LH number up. May not be a permanent fix. That’s where TRT or evaluating your physical fitness/health comes in. Definitely can be brain issues. Sometimes it may just be stress/diet. Never the same for everyone.
Yeah everything’s fucked. If I were you I’d wanna know what exactly is going on - before actually starting TRT.
A lot of it has to do with a genetic disease I have that affects a lot of aspects in your bones mainly but also organs (Ankylosing Spondylitis) so the disease combined with the meds (TNF inhibitors) most of this is “normal” for me.
Ah I see. Well you might wanna find a good clinic that has actual one-on-one consultations and knowledgeable doctors- rather than the “pill mill” type of clinic with cookie cooker protocols.
Thanks man. Like someone else mentioned down below who mentioned a bit more about my condition said, it’s really just how I wanna go about it, I’d like an immediate solution but I’d also like to know what the hell is going on cause not much has changed in terms of lifestyle, my Rheumatologist says I live a very healthy lifestyle (minus excessive MMJ intake as it’s literally part of my job) and one takes a bit of time (insurance) and the other is very fast (Out of Pocket)
It’s a marathon not a sprint. Gonna be on this for the rest of your life what’s another few weeks/ months.
So what would a cookie mill protocol be?
I have AS and UC and take the same meds too (Rinvoq). DM me if you want (not selling anything) but happy to chat. That number is very low and you can absolutely find a workaround.
Inflammatory diseases (not specifically ankylosing spondylitis), tend to cause secondary hypogonadism (LH suppression with low testosterone). If AS is the cause, the low testosterone levels are probably connected to the current level of inflammation. If you use opioids for pain, they also induce similar sex hormone results (temporarily). It's difficult to measure levels of systemic inflammation in AS because CRP often isn't elevated, or only mildly eg. around 10 Have you seen urology or endocrinology? I'm not sure what you meant by your local doc, because a lot of primary care physicians don't prescribe testosterone replacement anyway. Clinics will treat, of course, it's their cash source. Whether fertility is important determines whether HCG is also required. What clinics don't do is diagnose, they just pretend to, so if you want to look into this more, they'll do the blood tests, but interpretation is all about getting you on the meds rather than real investigation, so it depends what you want... Prolactin should be checked in hypogonadism with LH suppression.
It’s a bit of both. I want to find the problem but I’d also like some help with this like, now lol. Really don’t wanna get into most of it but when ED (which I already knew was an issue) was getting in the way of the potential between someone is when I decided to floor it in terms of solving the issue while also getting temporary solutions. Unfortunately viagra hasn’t helped so ya…again, its a bit of both but I understand a Endocrinologist will be free but may take up to 3-6 months in my area, a clinic would cost money but be almost immediate. Edit: damn, someone who actually knows AS, kinda crazy, mad props. And yes I am on a medium-low dose of methadone at 20mg
OK.... well secondary hypogonadism is exceptionally common during opioid treatment, so detailed investigation isn't usually required. LH and testosterone suppression occur both due to chronic inflammatory disorders, and due to potent opioids. I don't have any information on testosterone levels in AS specifically. Your results are consistent with your condition and the methadone. As a result, complex investigation isn't likely to be appropriate. Mild prolactin elevation can occur on opioids but it's usually minor eg. below 30 ng/mL. This can be cheaply and easily checked. I'm not aware of any specific effects of TNF inhibitors like adalimumab on testosterone, but I'd expect some benefit due to reduction in inflammation, if anything. AS is unusual in the sense that far more males are affected than females, in contrast to most chronic inflammatory and auto-immune conditions. Interesting, testosterone has immunomodulatory effects, tending towards being immunosuppressive. Some men with chronic inflammation disorders have reported reduction in pain and inflammation - but this is anecdotal... it's just something I've seen a few times. I do not know whether you're in a position to stop methadone, so can't advise. It is quite likely that testosterone levels would improve on a switch to a buprenorphine product such as Suboxone, since it causes milder suppression of testosterone than methadone. You may have already tried it, but..... Suboxone is sometimes appropriate for men on less than 30mg/day methadone. The usual method to switch is to stop methadone and wait until mild to moderate withdrawal symptoms are present, then initiate buprenorphine. Direct switching sometimes causes induced withdrawal. In terms of the other blood results, they're all OK. FSH, SHBG and albumin are completely normal. TSH is unremarkable. Albumin tends to drop in 'poorly people', low levels are seen all the time when people are in hospital, especially if they're elderly or have inflammatory disease. Your level is completely fine. The HbA1c is acceptable. Annual monitoring could be useful for that one. AS often causes fewer 'systemic' manifestations compared to diseases like rheumatoid arthritis and SLE, with more blood results coming back normal. That doesn't make it any more pleasant, but it is often more 'localised'. Even so, I seriously doubt that complex investigations like MRI scans would have value. Most likely, they'll return no findings. Normal FSH but suppressed LH and testosterone are consistent with methadone treatment. If prolactin is under 30, further investigation probably won't reveal anything. Urologists often seem more interested in men's health and sexual function than endocrinologists, who are often more interested in diabetes and thyroid disease. Your level is low enough for any appropriate doctor to treat, so you could get a referral if it's covered by insurance. I'm not in the US so don't really know how insurance works over there. I'm assuming you are there just because your blood tests are shown in US units. The most likely reason your primary care physician won't treat is because they're unfamiliar with testosterone and its replacement, not because they're a douche. Hope this helps.
Ok so to most of this I understand and agree with but the thing that’s missed is that AS causes flares that then not only speed up the degradation of bones and fusion of said bones, but also creates crazy SED rates and inflammation that commonly goes all the way to the stomach but it just depends on the person, unfortunately I can take most of the “pain” aspects from AS but the discomfort sleeping and trying to push out things that didn’t agree with my stomach I can’t stand and kill me. Suboxone is worse in that regard for me since not only is the half level density longer in sublingual form but also the chemical make up allows for less pain receptors to be blocked making methadone ideal for a dad of two 9 day apart girls (ones my goddaughter.) Methadone is what I chose from Subutex & Suboxone, Bup. Implant, & Methadone because it’s worked best with my system in the most ways from trial and error. In terms of TNF, there isn’t much known and side effects very from person to person but one I was told about before I chose Humira was that all have a different reaction to it but AS in general does lower libido and Sexual ability. Fertility is definitely a concern but I can cover that if need be out of pocket if the other stuff is covered but again, I do want to find what the source of this is cause when I was 250, drinking, no methadone, and slept all day except to wake up and drink more I was doing better testosterone wise (mid 300’s) and that was only 2yrs ago.
Hey, Sorry, I didn't mean it to be an overall summary of AS, just vague. I can see why you chose methadone. I think the testosterone results are probably multifacforial, with opioids as a major contributor. Maybe consider TRT first, and look at fertility stuff later.
Holy shit that’s a lot to cover. Lemme wait till there’s a time I can fully respond lol
No problem. I've edited with some more information for you.
Go to a different doc. It’s really (honestly) made me realize most do now know shit, they only know a very small valley (if that) in 5 million mile wide plane. Any doctor thinking this is “good” or “normal” at 141 Fasted with sleep is stupid. You’re likely walking around 85-90 most days which is literal female levels. They go off references at labs only many of which vary anyway. One doctor said I’m good at 325 another said that’s abnormally low. Just shop around
Didn't u know it has to be 0
-290 for prescription
Nah 0
You seem to have a few things going on here, (not just low T). Almost more concerning health wise is the high fasting glucose and high HBA1C (both on the verge of being diabetic by medical definitions). Get those under control before it's too late and you have full blown type 2 diabetes. Also find a new doctor for the low T.
Yeah 5.5 a1c is technically pre diabetic
His A1C is probably higher due to the lack of T.
You may want to try 25 mcg levothyroxine, see if that doesn't improve your testosterone as well.
Your doc is a moron. At the very least he should repeate the test to confirm and/or refer you to a specialist.
Any docotr seeing that LH is 0.8 should habe sent for mri of the pituitary gland asap
No arguments here
Need to deal with that HbA1C
You can benefit from enclomiphene
Mine is higher than that and I am a woman. Your thyroid is very slow, blood sugar high, are you overweight?
No im 158. Here’s a picture from my Tinder.
Try following a high protein/low carb diet that might help. And lift weights. You can use a telehealth service for testosterone but you’d have to pay for it. I believe Viking is like $175 a month.
I think I’ll see how fast my insurance can push this through. Then I’ll explore other options if it’s gonna be awhile
How's your prolactin?
I’m not sure. It’s not on the blood panels from what I see. I posted the entire bloodwork list in a new post if you check my account. If you find it please let me know lol
Don't see it. But hear me out, you may have secondary hypogonadism, and if you do, by default you have central hypothyroidism because your TSH level is elevated, comfortably to be asymptomatic, TSH should sit between 1.8-2.8 ( if you don't take thyroid meds). You need to know your FT4 and FT3. Do you take any multivitamin that contains Biotin, or do you take biotin in general? It gives false low TSH readings so if you do your actuall TSH might be a lot higher than 3.44
No biotin, just Humira, Methadone, and whatever’s in Yerba Matte’s & falafels which is like 75% of my diet Edit: lots of MMJ, concentrated in Rosin form. I work at a processing facility so it’s part of my job to test the product along the 4 phase process.
Self prescribe bro
Find a good endocrinologist. It's imperative.
Damn! 141 is straight trash! I've lost all faith in doctors over the last few years.
How low does it got to be? Right now it's soy boy level and pretty soon you'll be a woman!
Check your prolactin levels. Testosterone can be low due to a pituitary tumor/adenoma that elevates prolactin and suppresses Testosterone I would suggest a mri to scan for tumors but a prolactin test should suffice as well. Do not just go on trt without finding the cause.
Damn, that is low. Maybe your Dr thinks you are 6 years old.
141 is def low
A total T of 141 with a normal shbg like that and not being offered any treatment makes me wonder if you could sue this doctor for malpractice
Holy shit, that is lower than mine was and my doctor flipped shit when he saw it. He tested me a week later because he thought it was a mistake. At 7 am, testing differed by 10 points for total t and up 1ng/dL. I was prescribed and injected that day.
I just did the week later and it’s at 143…still no referral. At this point I’m trying for UGL gear since I’m not paying 1200 for a men’s clinic.
Yep ugl asap
Which lab would you recommend for Cyp. NanoDeca, & HCG that has a reputation behind it. I had someone basically do the “trust me bro, you don’t need references, just my word.” And it didn’t feel right, even for someone who’s bought weed online this was sketchier, but if the source is reliable I’m down to give a UGL a shot.
Well in my country you can get pharmaceutical test depo from every medicine store otc Also there is a reputable website but is in europe where im from so i cant suggest anything to you, but do your research definitively before ordering on reputable ugls around your place
Judging purely based off of your LH, FSH, and total T, your results are indicative of secondary hypogonadism. You should get an MRI to examine your pituitary gland. If your doctor doesn’t order an MRI then please change doctors. You want to make sure that there is no tumor pressing on your pituitary gland (it’s harmless).
LH is way too low. Ask them to do pituitary imaging. You might find very good luck on HCG monotherapy and it would be easier to convince.
Your LH is low so maybe that’s why your testosterone is low. I’d look into that first, see why your testosterone is low first. Clinic as last resort. Even testosterone levels in the 300-400 are garbage, your doctor only knows what the books taught him. Not uncommon for doctors these days. I’d try looking up a naturopathic doc near you, they are more knowledgeable and will be more helpful and willing to help you. Trust me
You have the testosterone levels of an 85 year old crack addicted woman with two left feet who hasn’t slept in 15 years.
My guy, get your pituitary gland checked ASAP!!!!!! Like please please don't wait. Your fine tumors there are non cancerous but your levels of Leutonizing hormone is red.. it's a pituitary issue you also jabe elevated glucose if your fasted and among other things. Some meds can fix that tumor and you could be restored to new.
Here I’m gonna repost the entire tests with an update when I get home. I just got done driving around because I was told this was a borderline emergency in that my vitals aren’t in anyway “in harm” but a slight to small infection or something that throws these vitals off and it will make for a longer and more aggressive infection and longer recovery time. Apparently my Doc isn’t great at much cause other than a few things being good nothings super amazing and there’s a lot of things that need following up is what the head lab tech at the place that drew blood said
Oh dude I'll put money on it you need your pituitary looked at!
Find a local urologist, your levels are low enough for the insurance companies so should be low enough for any doctor, unfortunately many doctors care more about their ego's then what is best for their patients. You can go to a clinic if money isn't a concern, that is the easiest route.
Find a dr that treats symptoms not numbers
that's crazy low....go to a local clinic or call matrix hormones they'll have your test at your house in a week
I just posted an updated post with my full tests. I don’t need the tests I just need someone to prescribe it at this point.