My whole story with all test results

[beav7]

Okay, here are all my test results which I still have.

Unfortunately every doc I went tested a different list of hormones so it's not always the same.
Sometimes I went to various doctors in the same year but all different tests are separated.

I want to say a few things about my "story". I was born in 1981 so you see that already at the age of 22/23 when I first got my testosterone tested my levels were already pretty low with my lowest ever being at 259 ng/dl.

Basically I always had a suspicion that something could be wrong with me because I was always pretty weak and already in school I was always the weakest during sports class when it came to stuff where you needed strength. I also didn't grow facial hair until I was 20.
So this already made me think that something's not quite normal. And then I saw something on TV about the correlation between indexfinger/ringfinger length and testosterone which made me think even more that something's wrong cause on both hands my ringfingers are shorter than the indexfinger and they're not only shorter but especially on the left hand the whole finger is thinner and it simply looks weird. Compared to the middlefinger and the indexfinger the ringfinger looks out of place. And that's when I first got my testosterone tested at my GP and the level was already low. I do not have the results of this test anymore but that's when I started going to endocrinologists and they always told me that everything's normal.

I told them that I have ridiculously little strength and also lack muscle mass. I would estimate that I could easily pack on 40lbs in order to look normal. But at the same time I have too much body fat (I'm 6 feet and weigh around 176 lbs) and what's especially striking is that I store a lot of fat on the lower body (thighs,hips,butt) where usually only women store fat. I reported this to the endo and he only told me that this is a good sign because I don't store much fat on the stomach. Yeah, totally good sign. Especially since all men strive to have the body shape of a woman.....
I have virtually almost no muscles on my shoulders and especially on the clavicle and upper chest area there is nothing! If I had boobs I'd have the upper body of a woman.
My upper body looks ectomorphic from the bone structure. I have thin joints. My wrist only has a circumference of 6.3 inches and I also have pretty small hands and also pretty short fingers which is also strange. Usually men who are as tall as me have much bigger hands and longer fingers.My lower body on the other hand looks endomorphic without having the strength of an endomorph. The hip structure is also pretty wide even if I did not have fat they'd still be wide. my actual circumference stats are:

thighs: 24 inches
waiste: 37 inches
hip: at the widest point: 41 inches
neck: 15 inches

I also recently got an ultrasound of the testicles and their size was 14.5 and 14.9 cm³ which I told is normal.

In 2006 I also got an ultrasound of the thyroid which I was told was normal. No knots or anything. The right lobe had a volume of 5.4ml and the left one a volume of 4.7 ml.

I also have a history of working out and trying to put on muscle mass in order to look normal.
I trained on and off. My longest period where I trained continually was over 1 year (from 2006-2007) where I invested a lot into protein powders and creatine and amino acids. I started benchpressing with the empty bar and my best result ever was a few reps with 110lbs! It was simply ridiculous.
Especially the chest and shoulder area was where I hardly made much progress. My best progress was with back exercises. I think my best result on the lat-pull with a narrow parallel grip was being able to use 155 lbs for a set.
What I noticed is that especially at core exercises like deadlift or squats I didn't have much strength. I couldn't DL more than 65lbs and also didn't really do DL because the exercise intimidated me and I was afraid of hurting myself it I tried to increase the weight.

But my body also did not tolerate working out. When I first joined the gym in 2003 I didn't have that many problems with my body. But later when I started working out again in 2006 I got more and more pains and aches in muscles and joints and in 2007 I had to give up because it simply made no sense anymore. All the time I went to the orthopaedist because my knees hurt and I could not even squat down without pain and my wrists also hurt for a long time and then I also got shoulder pain because of an impingement and also the biceps tendon in my armpit started to sting and hurt when I used the biceps and that was basically when I decided that I have to quit.

I also have depression and a low libido which I think has never really been high but I think that it has gotten weaker compared to the past. I also have the impression that my strength has also decreased compared to the past. I can't even do 1 regular push up. Recently I tried to do just one push up and I couldn't even bear the weight on my wrists because they directly started to hurt! (I also had a hand MRI a few years ago because of wrist pain and it showed nothing).

What do you guys think is wrong with me? Could it be something genetic like klinefelter?
I never had a sperm test and I'm also not keen on knowing what would come out of it. I'm also not planning at all to have children because I wouldn't want to have a child when then has the same crap.

2002

TSH: 1.14 mU/l (Norm: 0.35-4.5)
FSH: 4 U/l (Norm: 1-12)
STH (GH): < 0.5 ng/ml (Norm: 0,1-7)
IGF-1: 272 ng/ml (Norm: 114-492)
prolactin: 115 mU/l (Norm: 59-619)

2003

FSH: 8,2 U/l
LH: 11,3 U/l
prolactin: 0 ng/ml
TSH: 1,27 mU/l
DHEA: 2415 ug/l
estradiol: < 73.4 pmol/l
testosterone: 15 nmol/l


2003

testosterone: 328 ng/dl (Norm: 250-1000)
DHT: 44 ng/dl (Norm: 25-65)
DHEA: 1160 ng/dl (Norm: < 750) *
17-hydroxypregnolone 980 ng/dl (Norm: < 350) *

TSH: 1.58 mU/l (Norm: 0,35-4,50)
anti-TPO: 10 IU/ml (Norm: < 60)
FSH: 5 U/l (Norm: 1-12)
ACTH: 22 pg/ml (Norm: 9-52)
STH (GH): 1 ng/ml (Norm: 0.1-7)
FT4: 11.4 ng/l (Norm: 8,9-17,6)
FT3: 3.3 ng/l (Norm: 2.3-4,2)
LH: 2.6 U/l (Norm: 0.5-12)
prolactin: 186 mU/l (Norm: 59-619)
parathormone: 19.4 pg/ml (Norm: 6-40)

* kidney MRI was normal, was told that elevated levels were due to stress


2003

aldosterone 11 ng/dl (Norm: 2-10)
DHEA 320 ng/dl (Norm: 200-750)
testosterone 259 ng/dl (Norm: 250-1000)
DHT: 32 ng/dl (Norm: 25-65)


2005

LH: 4.4 IU/l (Norm: 1.7-8.6)
SHGB: 20 nmol/l (Norm: 16-65)
Free Androgen Index: 22 (Norm: 4-32)
testosterone: 4.5 ug/l (Norm: 2.8-8)


2005

TSH: 1.19 mE/l
fT4: 12.8 pmol/l
T3: 1,4 nomol/l
serum cortisone: 230nmol/l
testosterone: 12 nmol/l
SHBG: 18 nmol/l
Free Androgen Index: 67,8

2006

Testo ng/ml 3.55 (Norm: 2.6-15.9)
SHBG nmol/l 26 (Norm: 13-71)
Free Androgen Index 48%
IGF1 ng/ml 235 (Norm:115-358)

TSH 1.72 (Norm: 0.4-2.5)
fT4 pmol/l 16.7 (Norm: 10.3-24.5)
fT3 pg/ml 3.1 (Norm: 1.8-5.2)

LHRH TEST:

LH 1.25 mU/ml (start)
LH 18.5 mU/ml (after 30 minutes)

FSH 4.7 mU/ml (start)
FSH 7.67 mU/ml (after 30 minutes)


2007

Prolactin: 12 ug/l (Norm: 4-15)
LH: 2.2 IU/l (Norm: 1.7-8.6)
FSH (follicle stimulating hormone): 3.7 IU/l (Norm: 1.5-12)
E2 estradiol: 26 ng/l (Norm: 7.6-43)
testosterone: 4.0 ug/l (Norm: 2.8-8)
SHGB: 28 nmol/l (Norm: 16-65)
Free Androgen Index: 14 (Norm: 4-32)
DHEA: 2.9 mg/l (Norm: 1.5-5.1)
beta-human-choriongonatropin: <0.6 IU/l (Norm: <2)
FT4: 16 pmol/l (Norm: 12-22)
FT3: 4.63 pmol/l (Norm: 3.4-6.8)
TSH: 1.36 mIU/l (Norm: 0.4-3.8)
AFP: 2.2 kIU/l (Norm: < 5.8)

2011

testosterone (centaur): 8.4 nmol/l (Norm: 8.4-29)
LH: 2.7 IU/l (Norm: 1.5-9.3)
fT4: 11.3 pmol/l (Norm: 7.5-23)
TSH: 1.29 mU/l (Norm: 0.4-4)
fT3: 4.7 pmol/l (Norm: 3.3-6.1)
cholesterol: 116 mg/dl (Norm: < 200)

2011

SHBG: 28 nmol/l (Norm: 16-65)
LH: 2 IU/l (Norm: 1.7-8.6)
DHEA: 900 ng/dl (Norm: 300-850)


-----

Since I don't live in the USA I do not have access to endocrinology experts who are willing to help people like me. All endos I have been to were totally arrogant and sucked and even made fun of my concerns about low testosterone and heart attacks.
When I had already given up the hope I found a doctor who is willing to help me but he's not an endocrinologist.
Currently my therapy looks like this: I apply half of a testogel sachet every day. I'm on day 7 now and feel nothing. I cannot sense any physical or mental effects.
He wants to see if I can use a low-dose of testosterone gel without shutting down my own production and this way getting more testosterone. He said that injections would make no sense at all for someone like me who still has an own production and that injections, especially depot injections, were awful for someone like me.
The doc said that I should continue with tteh gel for a few weeks and if I do not notice any positive effects from the gel then this means that testosterone is not my problem and I guess that the therapy will then be over and that's it then.
He also said that since I have a rather high free androgen index and rather low SHBG my levels aren't really bad. But how does this help me when I have a high FAI and do not profit from it?
I don't understand this. But I'm worried that the gel won't work for me and then I'm again without any ideas what to do next. I am also really tired of going to doctors and seeking help. I had already given up on seeking help for my low testosterone when I found this doctor.

 

[Structure]

Certainly a karyotype and a semen analysis wouldn't hurt. It would definitely help add some more pieces to the puzzle. The karyotype would indicate if you had Klinefelters. Your testicle size (~15 cc) is small enough to indicate that you are quite possibly infertile.

That's what I would get if I were you. Neither is prohibitively expensive. If you did have Klinefelter's syndrome, it would be good to know; it's a lot easier to get treatment when you've got a proper diagnosis...

 

[beav7]

If my testicles are small then why did he tell me that they are totally normal and not even small within the normal range?!

And who could draw blood to do such a test? I mean what if the doctor refuses to do one? My GP definitely wouldn't do this and I also don't know if any endocrinologist would do this since they all said I'm fine.

And why exactly would the treatment be easier? I mean what exactly would be different if I had the levels I have and at the same time have klinefelter or not? The endocrinologist who did the LHRH test wrote that the test shows that I don't have hypogonadism because the test worked. If I had klinefelter then would I not also have hypogonadism? And would the LHRH test not have shown this?
I really don't know if I'd want to get a gene test because if it really came back with a negative result then it would only drag me down even more and then I'd feel even more miserable.

 

[DragonRider]

Estradiol was high in 2003. Needs to be tested again even if you have to pay for it yourself. Look at it as an investment in your health.

 

[beav7]

Estradiol was high in 2003. Needs to be tested again even if you have to pay for it yourself. Look at it as an investment in your health.

In 2003 I wasn't given an exact number. My lab results only stated < 73.4 pmol/l. I interpreted this to mean that my level was below 73.4 but that they did not measure the exact number which is kind of strange.

But I have a number from and there it's not that high:

E2 estradiol: 26 ng/l (Norm: 7.6-43)

Btw, what about E1 and E3? Do they not matter? Why do they only test E2?

 

[EasyRider]

Estradiol was high in 2003. Needs to be tested again even if you have to pay for it yourself. Look at it as an investment in your health.

2003: 73 pmol/L is not high.

It's just people from the US here often think in their values without paying much attention to what's actually written.

It's about 20 pg/ml and upper limit is usually about 206 pmol/L or 56pg/ml. Which is perfectly normal btw.

 

[beav7]

2003: 73 pmol/L is not high.

It's just people from the US here often think in their values without paying much attention to what's actually written.

It's about 20 pg/ml and upper limit is usually about 206 pmol/L or 56pg/ml. Which is perfectly normal btw.

Thanks for the info. But on my paper it has this "<" and I don't think that this is a typo. In 2002 it's the same with STH:

STH (GH): < 0.5 ng/ml (Norm: 0,1-7)

It looks like they didn't measure the exact number. I really don't know what the sense of this is. Below 0.5 can mean a lot. It could be 0.49 or 0.01.

 

[DragonRider]

2003: 73 pmol/L is not high.

It's just people from the US here often think in their values without paying much attention to what's actually written.

It's about 20 pg/ml and upper limit is usually about 206 pmol/L or 56pg/ml. Which is perfectly normal btw.

I saw the value, somehow I figured it incorrectly. I thought it translated to 44pg. Even though 56pg may be in range, most men on TRT cannot function sexually over 30pg. I can't function till I get down to around 15pg/dL, but I have low SHBG.

 

[DragonRider]

Thanks for the info. But on my paper it has this "<" and I don't think that this is a typo. In 2002 it's the same with STH:

STH (GH): < 0.5 ng/ml (Norm: 0,1-7)

It looks like they didn't measure the exact number. I really don't know what the sense of this is. Below 0.5 can mean a lot. It could be 0.49 or 0.01.

I see what you are saying. They didn't say that was your value, they just said it was under the top of the limit.

 

[zkt]

I think if I were you I would just forget about my endogenous sex hormone production and increase the gel dose, while keeping an eye on E2, and see what happens. A little HGH would probable be very helpful with the joint problems. E2, E1 and E3 are all introconvertable forms of estrogen. But E2 is more easily measured and reflects the concentration of the other forms.

 

[Structure]

If my testicles are small then why did he tell me that they are totally normal and not even small within the normal range?!

And who could draw blood to do such a test? I mean what if the doctor refuses to do one? My GP definitely wouldn't do this and I also don't know if any endocrinologist would do this since they all said I'm fine.

And why exactly would the treatment be easier? I mean what exactly would be different if I had the levels I have and at the same time have klinefelter or not? The endocrinologist who did the LHRH test wrote that the test shows that I don't have hypogonadism because the test worked. If I had klinefelter then would I not also have hypogonadism? And would the LHRH test not have shown this?
I really don't know if I'd want to get a gene test because if it really came back with a negative result then it would only drag me down even more and then I'd feel even more miserable.

Not all doctors see eye-to-eye when it comes to treating with testosterone; a lot of doctors think it is unnecessary. If you haven't figured this out from your own experiences, reading others' experiences on this forum will make this point clear.

This attitude changes when you have been concretely diagnosed (e.g. when you receive a positive genetic test result). To put it bluntly, many of these doctors that would have previously dismissed you will suddenly see you as having a "real" problem, and will be willing to give you treatment.

As you have pointed out, if patient A has the same bloodwork and responds in the same way to tests as patient B, then they should be receiving the same treatment. If the world was perfect, this is how it would work. But if patient B has received a diagnosis of Klinefelter's syndrome, he is much more likely to get treatment than patient A.

To be fair to the doctors, it should be mentioned that there is a lot of normal variation out there in the male population. This can make it challenging to figure out if someone actually has a testosterone related medical problem that needs treatment. If you have a genetic disorder that is known to cause testosterone-related medical problems, this challenge becomes trivial, and the decision to treat is much easier.

As far as getting depressed about a positive genetic test goes: yeah, I agree. It is depressing. But the fact of the matter is that it doesn't change what your body is doing. And keeping your head in the sand is just plain stupid. If you do have a genetic issue, you should just face it, accept it, treat it, and move on. I've been there myself, and I had to do exactly this. Yeah, it was depressing, but what am I going to do, kill myself? No, you accept it, you learn about it, you treat it, and you move on.

Regarding testicular volume and fertility: there are plenty of studies out there relating testicular size and infertility. Among other things, one consistency stands out: reduced testicular volume is associated with infertility. Here is one study relating testicular volume and infertility (and varicocele): ScienceDirect - Fertility and Sterility : Semen profile, testicular volume, and hormonal levels in infertile patients with varicoceles compared with fertile men with and without varicoceles In this study, infertile men with varicocele had an average testicular volume of 18 cc. Fertile controls averaged around 23 cc. (See also [ame=http://en.wikipedia.org/wiki/Orchidometer]Orchidometer - Wikipedia, the free encyclopedia[/ame])

The reason your doctor isn't concerned is because your testicular size is only slightly reduced; I've seen a bitesticular volume of 30 cc (or 15 cc per testicle) used as the statistical threshold to screen for infertility in at least one study (see table below, from Ferlin A, Vinanzi C, Garolla A, Selice R, Zuccarello D, Cazzadore C, Foresta C (November 2006). "Male infertility and androgen receptor gene mutations: clinical features and identification of seven novel mutations". Clin. Endocrinol. (Oxf) 65 (5): 606–10.).

You should just get it checked and put the issue to rest one way or another. For all you know, you've got an issue that can be treated.

In the table below, 1452 infertile men were examined. 75% of infertile men without AR mutations had a bitesticular volume of < 30 cc. (A similar percentage was found in infertile men with AR mutations --- this isn't relevant to your situation; I just happened to have this paper because of previous research I did on AR mutations.)

 

[beav7]

@ zkt

Where am I supposed to get HGH? No doctor would give me HGH. After years I have found a doctor who was willing to prescribe me testosterone gel.

I also don't want to shut down my own production. I don't even know if I will stay on the gel. I mean if the gel doesn't make me feel better at all why should I put up with this crap and apply this every morning? This is already starting to really bother me because when I have to do something every day then it puts pressure on me. I don't like that. I'd rather get an injection every few weeks and then not have to worry about applying gel and what also sucks about the gel is that you don't know how well it gets absorbed and if you apply it correctly and so on. There are simply too many things involved which can go wrong and also having to weigh 2.5g gel is also a real pain in the ass! The sachets don't even contain exactly 5g this means if I take 2.5g on the first day then I get less on the next day.

@ structure

I also thought that my balls are rather small and he was almost astonished that they were that "big" and kept talking about how my balls aren't small at all. Why the hell is the saying this when I don't even have 15ml³? I have been to various urologists and noone ever told me that my balls are too small I don't understand this. I thought that doctors would tell you if something's wrong.

I'm also not sure if having klinefelter would really change much. I doubt that those endos who I have been to would be more willing to help. One endo told me even if I had testosterone levels under 200ng/dl then I'd still not get TRT. He said TRT is only for those who have a high pitch voice or those who have problems with fertility!

How exactly would the treatment differ from somebody who has klinefelter and has the same levels which I have and somebody who does not have klinefelter with the same levels?
Would it still come down to getting exogenous testosterone and that's it? Or would a klinefelter patient get something else? I'm asking myself if testosterone gel doesn't help me then what else should I get? If the gel doesn't show any effect then injections probably also wouldn't be much different.

And even if I found the right treatment then this wouldn't change my bone structure and all that.
It's not like if you get it treated then suddenly you start looking normal and masculine.

 

[zkt]

Where to get HG I cannot say. But I will tell you that Google is your friend in this matter.
Some men seem to require higher T levels than most; even when everything else is normal. Maybe due to CYP450 enzyme activity variations - maybe due to some, as yet, unrecognized AR deficiencies. Definitely not the course for a guy who thinks that applying a little gel is a big hassle.

 

[beav7]

What do you mean with higher levels? Higher than the physiological maximum of 1000ng/dl?
In order to get so high I'd have to use much more gel and then my own production would definitely shut down which I don't want. I'd rather not make it shut down.
And also if you shut down your own production then the testicles will start to shrink, right? How small do they get? Do they get stabilize at a certain size or do they get smaller continually?

 

[zkt]

Well now I guess if you let things go to hell they would keep on shrinking. I`ve heard of pea sized. But the point is: you dont let things go to hell. You take control of the situation and do whatever is required to make the best of the hand you were dealt.

 

[beav7]

You mean if you go on permanent TRT then you still need hcg or clomid to keep the balls from shrinking too much?

And how can I take control of the situation when I am not a doctor and cannot treat myself? If I cannot find a doctor who knows how this shit works then I'm screwed.

 

[beav7]

I read a bit about klinefelter and one site said that klinfelter patients hardly have any body hair. My legs are pretty hairy does this mean if you've hair you're fine? And I also read that klinefelter patients have certain changes in the testicles would an experienced urologist not see this on an ultrasound? Damn this whole stuff is really dragging me down.

 

[Structure]

Klinefelter's syndrome is a very common problem. Around half of all men with this extra chromosome will have no symptoms at all, so you can't really rely on physical descriptions to determine whether or not you've got it. Unfortunately, the test is the only way to know for sure. Lucky for you, the test is not that expensive.

ZKT has good points; life deals us a hand, and (cliche as it sounds) we have two choices: sink or swim.

Like everyone else here, I had a really hard time getting my own situation under control. I had a lot to learn, I had many doctors to butt heads with, but eventually, I figured it out. Part of figuring it out was to learn about what I thought was happening, and part of it was finding a way to get tested. Once I diagnosed myself, I did not have any more trouble getting doctors to listen to me.

Some conditions are a real hassle to treat. But here again it is true that you have only yourself to rely on to take care of you (the adage comes to mind: "You are your own reward."). The more effective the treatment, the less you mind putting up with the treatment's overhead.

I haven't investigated Klinefelter's in any detail, so I don't know if treatment consists of more than T. I would guess that treatment varies, depending on the severity of the symptoms, and that a good endocrinologist could tailor treatment to your needs. Having this diagnosis will definitely affect your treatment because, to doctors, it is a reassurance that you actually need treatment.

 

[beav7]

From the experiences which I made with endos so far it really would not suprise me at all if, even if I had something like this, they just said something like: So what? You've been living with this for 30 years. There is no need to intervene now and change anything especially since you produce own testosterone.

And what shall I say then? I mean what shall I even demand? That they pump me full with testosterone in order to look all jacked or that they give me enough testo to get rid of the female fat distribution pattern? What if there's simply nothing which could be fixed?

 

[AndyD]

y

From the experiences which I made with endos so far it really would not suprise me at all if, even if I had something like this, they just said something like: So what? You've been living with this for 30 years. There is no need to intervene now and change anything especially since you produce own testosterone.

And what shall I say then? I mean what shall I even demand? That they pump me full with testosterone in order to look all jacked or that they give me enough testo to get rid of the female fat distribution pattern? What if there's simply nothing which could be fixed?

Testosterone isn't going to make you "look all jacked". Diet and weight training is what makes one "look all jacked". Now that you understand that...

Here's what you do...consider your symptoms and not what the lab results say. If you're happy with your life and how you function as a guy then you might be better off doing nothing as you said it yourself, you've lived with it for a long time so why screw up how your body naturally wants to be...