Test Results - Low T - High LDL and Liver function

Discussion in 'Men's Health Forum' started by jinnj, Feb 2, 2006.

  1. #1

    jinnj Junior Member

    Test Results !HELP! - Low T - High LDL and Liver function

    Good day all. I've been a lurker on here for some time and i just wanted to start out saying thanks for all the information i've been able to gain from everyone else's experience. (Sorry, this might be a bit long winded)

    Heres my deal. I'm a 26 year old male. I've had symptons of low T for a very long time. I finally got the nerve to start making doctors appointments about 2 years ago. This was the start of the struggle. The few i got to test for T i was very borderline on the results. Earliest test came back with T levels of about 292 ng/Dl on a ref scale of 241-827. All docs told me i'm in range and that i'm fine. Problem is i wasn't fine.

    For as long as i can remember i've been fairly depressed, have anxiety issues, etc. Physically i have no sex drive at all, gynocomastica, absolutely no facial hair or chest hair (Do have hair on legs, underarms, etc). Always tired, never motivated to do anything. Same old song and dance many of us know well.

    I finally found a doctor that knows what he is talking about. He had the full scope of tests run and here's some results (tests taken at about 8am):

    testosterone - 420 ng/Dl Range 241-827
    LH - 3.4 mIU/Ml Range 1.5 - 9.3
    FSH - <0.3 mIU/ML Range 1.4 - 18.1 (Was flagged as low on test result)
    ILGF-1 - 134 ng/ML Range 116-358
    TSH - 1.205 uIU/mL Range .350 - 5.5
    T4 - 1.24 ng/dl Range .61 - 1.76
    prolactin - 9.9 Range 2.1 - 17.7
    DHEA-Sulfate - 263 ug/dL Range 280-640 (Was flagged as low)
    Estradiol - 16 pg/mL Range 0 - 53

    He immedialty flagged this as secondary hypogonadism. I was incredibly relieved. I finally knew that all this time i was right, something was wrong based on the super low FSH levels. He gave me a clomid stimulation test and my levels shot up to 1101 but i didn't feel any different.

    I told my doc that I was concerned with fertility. He understood. He then said he'd like to give me 400mg of Testosterone cyprionate just to see how i feel with that. When i say i've never felt better in my life was an understatement. I had energy, my mood was great, i wanted to have sex! Then it wore off obviously after about a week or so.

    I told my doc that this was for me. I needed to feel like this all the time now that i know it was possible. Then he hit me with the bad news. Apparently my liver functions(SGPT) were way elevated and my cholesterol was as follows:

    Total 292 range 100-199
    Triglycerides 246 - Range 0 - 149
    HDL 47 - Range 40 - 59
    VLDL - 49 Range 5 - 40
    LDL - 196 Range 0 - 99

    I had an MRI done of my liver and it turns out I have a fatty liver. My doc told me that he cannot continue any TRT issues until i get the cholesterol/liver issues straightend out. This is almost 10 months ago. I've changed my diet, i exercise as much as i can (I'm too damned tired all the time to really make a good go at it).

    What can i do? My wife is about to give birth to our first child in a few months and i barely have enough energy to drag myself out of bed in the am and make it to work let alone help my wife take care of a newborn. I have an appointment with my doc again at the end of Feb to have more bloodwork done to see where i stand. If i still cannot do TRT i'm considering just doing it on my own as i cannot live like this much longer without doing SOMETHING.

    My next step in my mind is make an appointment with SWALE and deal with the 13 hour drive out to see him (I'm in the Philadelphia area).

    What do you guys think?

    Thanks for listening to my long post and any thoughts you can provide. Just knowing other people out there are going through/have gone through what i'm dealing with makes it somewhat easier to stomach.

    Thanks again!

    Last edited: Feb 2, 2006
  2. #2

    ASaxon Junior Member

    I’m a little confused...what was your cholesterol before your TRT test? Is your doctor blaming your cholesterol results on TRT? Since you’ve been eating right and exercising as much as you can over the past nine months I assume you’ve had recent liver tests that still show elevated liver function values? If not you need to get another test to see if your liver comes back to normal.

    I also have a fatty liver (NASH they call it) and generally the way it is diagnosed is either by biopsy (not usually done except when cirrhosis is suspected) or imaging (Ultrasound, MRI, etc.). For me I had an Abdominal Ultrasound that showed a mildly enlarged liver and the doctor said that if I started eating right and exercising and my liver function tests came back to normal range then he’d suspect fatty liver disease (or NASH.) Well, I exercised and ate right and my liver function did come back down to normal so without further tests he suspects either fatty liver or some liver toxicity that occurred that has since corrected. Now my liver function results are in the low end of normal instead of the high end so I guess I’m doing okay now. I’ve added Milk Thistle to my daily supplement intake and that combined with a low-fat diet and exercise (three days a week) which all have seemed to help.

    As to your cholesterol...do you just have high cholesterol in general and need to be on a cholesterol lowering medication? Why can’t he just treat the cholesterol issues with a statin type of drug and keep you on TRT?

    So a little confused, perhaps you’re issues are over his level of knowledge and you need to go see other specialists for your other issues. Perhaps you should get a referral to a cardiologist for your cholesterol issues and a Gastroenterologist for your liver issues and see what they say.

    BTW, did the doctor do a Free testosterone or Bioavailable Testosterone? What about SHBG? Those would really give you a good idea as to where you are in relation to Testosterone. A high SHBG, which I guess is possible if you’re liver function tests are high, would definitely cause a problem with how much Free, or bioavailable, testosterone you have even if your Total T was normal.

    Just something to think about...
    Last edited: Feb 2, 2006
  3. #3

    jinnj Junior Member

    No he isn't implying the liver/cholesterol issues were from the TRT. Apparently they were that high when he did the initial bloodwork. My last bloodwork a few months back showed the liver functions going down, so its a start. He has me on Zetia for my cholesterol and like i said i have an appointment on Feb 20-something.

    Funny you should mention, the doc i'm seeing is actually a cardiologist. Apparently he wound up with hypogonadism quite a few years back himself and through treating himself he learned the ins and outs.

    Yes he did Free and SHBG. See below (These are the most recent test results i have my hands on, from around 3/2005)

    SHBG: 24 nmol/L - Range 13-71
    testosterone, Serum 249ng/dL - Range 241-827
    Free Testosterone(Direct) 9.1pg/mL - Range 9.3 - 26.5
    LH 4.7mIU/mL Range 1.5 - 9.3
    FSH 1.7 mIU/mL - Range 1.4 - 18.1
  4. #4

    pmgamer18 Junior Member

    Wow first a clomid stimulation test then a 400 mg. shot of T. I can't under stand why he did not test your liver and cholesterol first before trying this. Or did I read this wrong and he did and still gave you a big shot like this. I feel it is criminal messing with T meds. like this with out testing you to see why you are low. He should have done a MRI on your Pituitary Gland first. Maybe you do need to come here to MI and see Dr. John.
  5. #5

    jinnj Junior Member

    Sorry, i should have included that. He DID do a pituitary gland initially which results showed no tumors or anything. The next thing he did after seeing my fsh so low was a clomid stim test which did raise my T levels through the roof. I complained to him i felt no different after about 2 weeks on Clomid so he as he put "Empirically" gave me a 2cc of testosterone Cyprionate.
  6. #6

    pmgamer18 Junior Member

    Then it looks like your Dr. can work with you. What if you tried hcg only to make your Testis make t what or would this be a problem with your liver.
  7. #7

    jinnj Junior Member

    I don't know. I'm just getting so frustrated. Its a matter of i've felt what it was like to feel "normal" when I was loaded on T the times i gotten shots. Almost makes me want to just break down and cry to think about how different my whole teenage years would have been if things had been "normal".

    Anyone know how much a visit with SWALE would cost? I know my insurance won't cover much if anything as he wouldn't be considered an "In Network" doc. My next step if my doc cannot or will not help me is drive out and see swale.

    Thanks again.

  8. #8

    cpeil2 Junior Member

    He doesn't take insurance. You have to pay him up front and then get reimbursed by your insurance carrier. He charges $200.00 for the initial visit. Followup visits and "virtual office visits" are $50.00. You also have to factor in the cost of intial and followup labs. It adds up if your insurance won't cover it.

    But it sounds like the doc you're working with is pretty knowledgeable. This is something that takes awhile. It isn't the kind of thing where one day you decide you need TRT and the next day you have a prescription.
  9. #9

    Vforcer2 Junior Member

    Free t3 and T4 should be checked as well as Cortisol levels if your energy levels are such an issue. I am starting to wonder if Hypothyroidism and Adrenal Fatigue actually causes some of these cases of Hypogonadism.
  10. #10

    ASaxon Junior Member

    Interesting, it sounds like your doc is a good one, he’s done all the right tests it seems and that alone is hard to get a doc to do in t first place. There’s no guarantee that Dr. John would treat you with TRT given the same test results so that would be a gamble too. I’m curious why you haven’t learned why your doctor is concerned about TRT given your test results. You should understand the risks that he is concerned with before you go off and self admin TRT. It could be a life-or-death decision for all we know. I know why certain blood work is important to keep under control (like Hemocrite and obviously PSA) but I don’t fully understand how liver function plays into the equation. I guess it’s because the testosterone is metabolized by the liver to produce bio-identical serum testosterone and if you’re liver is already struggling then putting the extra stress of TRT might cause more damage. I’m not sure about hcg but if it avoids the liver it may help some but too high a dose and you’re testicles will become damaged so that’s probably not an option unless combined with TRT.

    I guess I’d ask your doctor and become very clear on why he doesn’t want to do TRT right off the bat. It sounds like he’s trying to solve your other problems so he can give you TRT safely.

    You may want to see a Gastroenterologist about your liver though, as far as I know they’re the ones that have the specialization on how to treat liver problems. You’re cholesterol should be getting under control with your medication so perhaps that will be a thing of the past soon.

    Just remember this all takes time. It’s taken me four years of tests after 10 years of progressive suffering before I even found what was wrong with me. Everyone wants to be cured yesterday and that’s natural, but you should make sure you do it safely or what’s the point. You can do it safely and live a normal lifespan or you can do it recklessly and be dead in 5 or 10 years which would be terrible if you have children or other responsibilities. Patience might be the call to make in your situation. Regardless, you should be getting the knowledge to make that decision from your doctor so you truly understand the risks.
    Last edited: Feb 3, 2006

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