Best Way to Go About geting Low T treated?

[brkemmerer]

Hello.  I'm a 29 year old male, 6 feet tall, 255lbs, who has been doing extensive research lately on Low T.  I have NUMEROUS symptoms:
-Lack of facial hair/inability to grow a beard
-Intermittent pain in right testicle that comes and goes
-Poor mood/moody.  Lack of interest in just about everything.  Indifferent.
-Mild sporatic depression/general sense of hoplessness
-Non existent libido (the Mrs. is getting antsy for improvements as her drive is very high)
-Low energy/aversion to do things
-Easily gain weight (packed on 20lbs since mid-May)
-General diet isn't horrible.  I eat as healthily as possible, trying to stay at or around 2500 calories/day, 200gprotein
-Inability to concentrate
-Gyno symptoms (I actually have a mammogram scheduled for early August)
-Rarely get morning wood

The list continues, but I could go on and on...

I went to the doctor and had my levels tested and inquired SPECIFICALLY about HRT/TRT and he only ordered tests for total T, which came back at 360 which, of course, is in the "Normal Range".  So I called and asked for a referral to an Endo and now the GP wants to sit down and speak with me about it again.  I've also called to see a Urologist, but there are only 14 in the region who my insurance works with and they're pretty booked up.

Any advice will be greatly appreciated!  Right now, the way I see things, and based on the research I've done, I'd like to first try a course of Clomid and HCG to see if that helps increase my T levels without having injections.  Not that I'm anti-injections, but because I want to have kids in the near future (semen analysis tomorrow actually to see if there are problems in that dept.) and I know TRT can muck that up.

The GP I saw didn't ask any questions really.  I mentioned TRT and he added it to the generic blood work order and shook my hand and off I went!  Again, ANY advice will be greatly appreciated!

[brkemmerer]

DrKaul,

Thank you for your input.  Much of my frustration at this time stems from my PCP NOT testing for free test or binding hormone levels at all.  ONLY total test which is in the "Normal Range" if you adhere to the basic "all men fit in this range" theory and NOT the age ranges.  I've seen medical journals which show that healthy 30 year olds should have total test close to 700, and the 5th percentile still had total T of 395...I wouldn't be concerned with any of this if my symptoms did not exist.  However, since they do, I'm not accepting "Normal" as a solution.  I'm sure you can empathize with my position!

Thank you for your input! It has affirmed my initial position that more thorough testing is required and a specialist (or two) should be consulted.

[S. Kaul, MD]

Hi there!

Well, without knowing the relevant clinical details or a detailed clinical evaluation it would be difficult to comment specifically on the situation. I would agree that the symptoms described could be related to low testosterone levels, however since the total testosterone has come in the normal range further testing such as free testosterone may be suggested. Also issues at the receptor level and other causes such as other hormonal/ endocrine issues, micronutrient deficiencies, metabolic causes, medication side effect may need to be considered and evaluated for. I would suggest considering a detailed evaluation by an internist and an endocrinologist at this time. After a specific cause is identified, it can be managed accordingly.
Hope this is helpful.

Take care!