Need advice on how to get PCP to work with me for my low test.

[SkinnyMike42]

Saw my PCP a few months ago for a general physical plus blood tests. I had him throw testosterone on there. The results came back 313 ng/dl total test.

I really need something to get these levels where they should be....

I have the following symptoms...

1) Sex drive just about gone, although thankfully "my guy" still works just as well as when I was 20.

2) I am very lethargic 24/7 and my motivation/passion for anything has dropped significantly. I have to force myself to do anything, including the gym. I sleep 9+ hours a night and never feel energized...like ever.

3) Mental fog. I notice a huge difference lately in how fast I can figure things out at work. I am a software developer and I am taking about double the time to finish projects as before. I have no focus at work lately.

4) Gym strength. It is really down, but this could also be from me going on a cut recently. However, my bench has gone from 225 for 10-12 to only 5-6 reps. A cut shouldn't have done that, seeing as I only lost 12 lbs.


I called my PCP and made an appointment for Tuesday. Why? Because all the endos in my area don't have appointments for fucking 6-8 months, so I am giving my PCP another shot. He didn't bat an eye at my 313 total test and said it was within normal levels. Technically, he is correct, but I feel this is very low for someone who is 28. That combined with the other symptoms leads me to believe I need to get those levels up.

With that being said, my symptoms also mirror that of depression, but low test and depression symptoms are pretty damn close to each other, so how do I figure that out? I had one bout with depression briefly during my highschool years and nothing since, but doesn't everyone?

Just looking for advice on how to handle things with my PCP. Anyway I can convince him to put me on something?

[jeffro]

Im am not a MD but I will throw a few things out there. Why do you think your S/S are caused by lower test? I say lower because your reading is within normal limits, albeit on the lower end of normal. The S/S you are describing could be attributed to numerous other issues, to say its low T is kind of a shot in the dark IMO.
A few other questions:
1. Were any of your other lab values abnormal, what about thyroid?
2. Do you have test values from previous labs that can justify your test has decreased. i.e. 2 years ago your test was 500, now its 313. If not, your test might have always been at these levels.
3. How hard was your “cut”? A fast cut can make you feel like crap IMO.
4. When was the last time you took a break from the gym? Every once in a while it could be beneficial to take a break, both physically and mentally.
5. Did your S/S start before or after you leaned of your “low T” levels? I ask because the power of suggestion is very real. For example, you think you have low T and all of a sudden you start thinking “Im tired” “Im weak” “I can’t think at work”

All I am saying is, you might be jumping to conclusions on this. Rule out the simple things first, then consider other reasons for your S/S. Hope that helps.

[steel1970]

Im am not a MD but I will throw a few things out there. Why do you think your S/S are caused by lower test? I say lower because your reading is within normal limits, albeit on the lower end of normal. The S/S you are describing could be attributed to numerous other issues, to say its low T is kind of a shot in the dark IMO.
A few other questions:
1. Were any of your other lab values abnormal, what about thyroid?
2. Do you have test values from previous labs that can justify your test has decreased. i.e. 2 years ago your test was 500, now its 313. If not, your test might have always been at these levels.
3. How hard was your “cut”? A fast cut can make you feel like crap IMO.
4. When was the last time you took a break from the gym? Every once in a while it could be beneficial to take a break, both physically and mentally.
5. Did your S/S start before or after you leaned of your “low T” levels? I ask because the power of suggestion is very real. For example, you think you have low T and all of a sudden you start thinking “Im tired” “Im weak” “I can’t think at work”

All I am saying is, you might be jumping to conclusions on this. Rule out the simple things first, then consider other reasons for your S/S. Hope that helps.

All very good questions, but imo, regardless of the level being "in normal range", for a 28 ear old, that seems very low to me. I know for sure that he would feel MUCH better if his levels were a few hundred points higher. How do I know this? Because mine were a bit lower than his and as soon as my levels went up I felt tremendously better......and I felt better prior to even knowing that my levels went up, and I was using black market test due to my doctor being a dick....So I self medicated.....and did not use alot, at all.....

IMO, you need to just ask your doc, and if he's a douchebag, then find another one. Check around your gym and ask some of the older guys if they are on TRT....Find out who they see for it.....endos are VERY hard to get in to see for some reason. Maybe this should be a career path we should all look into, as it certainly seems as if there is a severe shortage of them...lol. Long story short, if you feel certain enough that you have issues due to your test be on the lower end, don't take no for an answer like I did. Seek out a good doctor who has your best interest at heart.....Lower test is just as much of a health concern as just about any other serious ailment, and the symptoms are very silent.....

[SkinnyMike42]

A few other questions:
1. Were any of your other lab values abnormal, what about thyroid?
Everything was VERY good
2. Do you have test values from previous labs that can justify your test has decreased. i.e. 2 years ago your test was 500, now its 313. If not, your test might have always been at these levels.
I do not have any other tests to back it up
3. How hard was your “cut”? A fast cut can make you feel like crap IMO.
Not a very hard cut at all. Went from 220 to 208 in a couple of months. Dieted using carb cycling. This actually made me feel better than I was before because I was eating much better
4. When was the last time you took a break from the gym? Every once in a while it could be beneficial to take a break, both physically and mentally.
Just coming off a 9 day vacation. I feel even worse from not being in the gym.
5. Did your S/S start before or after you leaned of your “low T” levels? I ask because the power of suggestion is very real. For example, you think you have low T and all of a sudden you start thinking “Im tired” “Im weak” “I can’t think at work”
I have had symptoms like this basically the entire year. Well before I got my test levels checked. It just seems to be getting worse and worse. The best way I can describe it is that I feel "foggy" all the time. No amount of sleep..no amount of supplements..no amount of anything helps me

[Sammich]

Your PCP should not be involved in HRT. You very much need to see an endocrinologist for that. Family care Drs. simply do not have the training nor experience to treat hormonal problems like that.

[SkinnyMike42]

Your PCP should not be involved in HRT. You very much need to see an endocrinologist for that. Family care Drs. simply do not have the training nor experience to treat hormonal problems like that.

Even for something like hCG injections or a run of clomid?

[steel1970]

Even for something like hCG injections or a run of clomid?

Some PCP's do have some knowledge....but Sammich is correct in that you should see an endo...but like you stated, you'll probably hafta wait for 6 months to a year to get in. In my area alot of Chiros are involved with the anti aging trend, and they know doctors they can refer you to for hormonal issues. That might be something to look into also if you can't get in to see an endo before you're in your 40's.....It's not anything that can be handled overnite though....

[SkinnyMike42]

May seem like a dumb question...

Should I run some anti-depressants to see if they help? Not sure why I would be depressed (life is going well) but I would like to rule it out.

My theory is that low T is making me feel like shit all the time thus causing me to feel depressed.

[steel1970]

That's way outta my realm. I don't understand depressions at all. My wife takes daily meds for it but I don't know what the hell her problem is. It started with her and hormone issues. IMO just like Sammich said that PCP's don't have the knowledge to figure out TRT issues, I think they prob have less knowledge about depression issues. There was no testing done or anything when my wife got meds. She went in, said she thought she was depressed, and he prescribed her meds. She sees him every 6 months and he checks her heart and lungs and gives her another script.....That's it.....she's now dependant on the meds somehow, as if she runs out for more than a day or so, she has terrible mood swings and feels like she's going thru withdrawal of some sort, with headaches, lack of patience, etc.......I would be careful going that route....

[SkinnyMike42]

Yeah not going that route, holy fuck. Maybe he can refer me to an Endo who doesn't have a 12 month waiting period. Or at the very least, give me a script for a full hormonal profile so I can take that with me to the Endo to save the pointless visit where all he does is write me a script.



When I was depressed in HS I knew WHY I was depressed and went to see a Psych for a few months. I fixed myself with no meds because I knew what my issue was.

Now I feel depressed, but only because I feel like SHIT all the time.

[Sammich]

Even for something like hCG injections or a run of clomid?

I believe so, yes. PCPs will (usually) have ZERO knowledge of using those drugs for that purpose. Also see my response below...

May seem like a dumb question...

Should I run some anti-depressants to see if they help? Not sure why I would be depressed (life is going well) but I would like to rule it out.

My theory is that low T is making me feel like shit all the time thus causing me to feel depressed.

^^ THAT is what makes me think you would want to see an endocrinologist. There are all sorts of hormonal reasons why you might have a low sex drive and feel depressed. Not only that, but being depressed WILL make you have no sex drive and feel like shit all the time. If you want to explore the hormonal side, I would suggest getting a workup by an endo. For the other stuff, you might want to start by seeing some sort of mental-health specialist (therapist, psychiatrist, psychologist, etc.) just to talk to. A lot of the time simply talking it out will help and you won't need medications to aid you.

[SkinnyMike42]

I believe so, yes. PCPs will (usually) have ZERO knowledge of using those drugs for that purpose. Also see my response below...



^^ THAT is what makes me think you would want to see an endocrinologist. There are all sorts of hormonal reasons why you might have a low sex drive and feel depressed. Not only that, but being depressed WILL make you have no sex drive and feel like shit all the time. If you want to explore the hormonal side, I would suggest getting a workup by an endo. For the other stuff, you might want to start by seeing some sort of mental-health specialist (therapist, psychiatrist, psychologist, etc.) just to talk to. A lot of the time simply talking it out will help and you won't need medications to aid you.

Thanks. Anyone know any Endos in the Jersey/PA/DE area?

I called a few and all are booked for life.

[DaveEboy]

First of all ... "look on the happy side of life" is one sure way to start getting over depression. Not trying to say depression is mental only ... But a positive outlook can change everthing. Think about what you are thinking about. Positive thinking can be powerful. Make a list of all the great things in life that you have and are thankful for.

Dont take drugs just for the sake of taking drugs. Thats a dangerous rip current to get caught up in and often is only a band aid.

I know what low test feels like ... At 40 mine tested at 365.

Try herbal alternatives if you dont want to turn to testosterone therapy just yet at a young age. Fenugreek, vitex, longjack (tongkat ali) and a host of others. Only buy high quality herbs though ... I am personally not a big fan of fancy name 'test' boosters that are just overpriced 'proprietary blends' of low dose herbs

Maybe l carnitine tartrate and boron, zinc with the test boosting herbs

Ginseng is good to boost overall well being, and it boosts nitric oxide levels

I'd def go with some vitamin d and a minimum of 1 Tbsp flax seed oil per day too, both to help your low T

[steel1970]

Thanks. Anyone know any Endos in the Jersey/PA/DE area?

I called a few and all are booked for life.

I'm telling you, I think Breck needs to look in on this for his career change....Breck, do you have 12-15 years of your life to spare so we here at IM could have a worthy endo to visit? This is def the career change you were looking for if you can spare all that time....lol

[dakoose]

What time of day did you get tested initially?

Later in the day test levels are low.....I has numbers down in the 200's with free levels even worse the first time I got tested but when I went in the second time I did it first thing in the morning and my numbers were better than normal.

And if you can't get in with an endo, try a Urologist....that's what I did when the next available appointment with an Endo was, best case scenario, two months away.

Additionally, my Uro told me that there is research showing that just like test fluctuates throughout the day, it can also have high's and low's throughout the course of a calendar year and that it is normal to, at times, have short phases with low T.