I’m in the LA area. I just found my way to the forum and am blown away by what I am seeing.
I’m 35, low T (150), low LH (2.3) diagnosed as Idiopathic Secondary Hypogonadism. I already had an Endo do a workup on me and even prescribed Androgel. However in the time since the prescription was written and Blue Cross started thinking about approving it, I have been getting educated so I have not started any treatment.
I’m now convinced that I need a doc that’s more tuned in to TRT protocols to do more diagnosing before starting a treatment. My Endo didn’t even order up E2. He also didn’t ask me if I had used Finasteride. WTF. I also have elevated AST/ALT.
I know I can fly to Michigan and see Crisler, which is an option, but I’m thinking in LA there must be someone competent and up to date.
I would suggest seeing an Endo at one of the bigger university hospitals in your area.
I imagine you have discontinued propecia? Is that correct? Also, was your T level 150 while on or off propecia? Is the 150 below the range given for normal…i’m sure it is but just making sure.
I think you are the first person to have T levels lower than the normal value range on this forum. It’s important though to know what the range is and if u were on or off propecia when u had the labs drawn. Also, what time of day were the labs drawn.
Hello and welcome to the forum. First, how did you find the forum? I’m always curious to know.
Also could you share your history with the drug with us? ie… length of time, dosage, side effects experienced while on and after quitting, how long its been since quitting, further treatments, any recovery?
I suggest posting your lab results (with ranges) in the Hormones & Blood tests section so we can have a look, to give our thoughts. Do you have any pre-Finasteride hormone tests, specifically Testosterone?
Although not in LA, Dr Irwin Goldstein is a world-known and respected Urologist with a focus on men’s sexual health and andrology, located in San Diego. It’d be worth the trip to see him, more info - sandiegosexualmedicine.com
Also, Dr Crisler can work with your doctor over the phone, if your doc is open to it.
I’ve been reading the general hypogadism boards and saw a link in someones signature. I was curious and clicked through.
What got me is that my diagnosis is Idiopathic which is the technical term for “We don’t know”. When I saw the elevated ALT/AST that just shook me up. No one seems to know why these would be elevated. No Hep B, no Hep C, no alcohol, etc. Putting together my two seemingly unrelated symptoms made me think that this could be the cause.
I used Proscar for hairloss several years ago. I got the 5 mg as I recall and broke it into pieces. It’s been a while and I don’t remember exactly but I think I only took it for a few months. I noticed the sexual side effects and figured better to be bald I have been off of it for at least 3 years.
My sex drive has been low for years, but declining more in the last year or two so I decided to get a physical.
I don’t have any hormone tests from prior to usage. Really all I have is my current blood work and my symptoms.
I’ll combine both of my two recent tests together. The missing items I know I should have are Estradiol E2 sensitive and maybe SHBG. I’ll get those with the next doc.
I should also add that I weight train and eat protein/low carb. For some reason, the docs like to stick me in the office without telling me to fast first. Thus I think the BUN would probably be closer to normal if I were fasting.
I’m putting a ** near anything out of range.
Glucose 86
Sodium 142
Potassium 3.7
Chloride 101
Carbon Dioxide 27
Anion Gap 14
**UREA Nitrogen 35
Creatinine 1.2
Calcium 9.8
Bilirubin, total 0.3
Protein Total 7.0
Albumin 4.7
Alkaline Phosphotase 82
**Aspartate Aminotransfera 47
**Alanine Aminotransferase 54
Cortisol 15.3
FSH 5.6
LH 2.3
Prolactin 10.5
Thyroxine 6.5
T Uptake 31.0
Adjusted T4 6.7
TSH 1.26
**Testosterone Total 165
**Testosterone Free 20.7
**Testosterone Free 1.25%
Thanks for your message. Yes, I stopped finasteride a few years ago. I could still be wrong and maybe my issues are not caused by it, but I’m seeing low LH, sex drive, ALT/AST elevated and those all match-up.
The T level (165 in one reading, 187 in another) is recent after not being on any drugs. This would be a low level for an 80 year-old, so for 35 I know it’s really out of whack.
I’ll keep you in the loop with what I find and appreciate the support
Regardless of what caused it, it seems like you in fact have secondary Hypogonadism as your T is below the normal range and your LH isn’t spiked high (which would mean primary hypog as u probably well know).
Rather than focusing on what Proscar may have done to you in the past, your efforts are probably best spent on getting treatment for you current condition.
You are smart to get the addt’l labs drawn prior to any treatment. Most of your labs regarding HypoG don’t need to come while fasting (unlike glucose and BUN/Creatine). I would get the E2 to find out if in fact you have high Estradiol which is telling your brain ur T levels are fine (as HPTA is not able to distinguish between Estradiol and T). Most secondary patients have close to 0 for LH and not a low value like urs that’s within the normal range (even low like yours). It may very well be that HPTA is working but is just not reading the field properly. You do mention low carb/high protein diet and working out…are u by chance in great shape?..or do you have estrogen dominance like symtpoms (belly fat, flabby chest…all while having a toned body everywhere else)?
When’s the next appt for ur missing labs? Very interested to see how it comes back. Everything I say above is very vague information. A medical profesional is the best source of information for diagnosing and treatment of any kind.
Thanks, yes I agree it’s probably best just to focus on treatment. It really seems like it’s the same either way – try to restart HPTA or failing that just add T and try to keep the LH from going to zero. Once I get a new doc and the remaining tests, I’ll go move forward with that.
I was hoping to avoid sringes, but if I have to do so then I will just do it.
I’m not sure I’d say great shape, but very good
I’m < 180pounds, lean. I’m running twice a week, lifting weights on the other days. I don’t have any signs of estrogen dominance, but I’m not convinced that I would need to show them. I have beard growth, etc. but my T is below range too.
Of course, well I still appreciate the ideas and support. I don’t have the next appt because I’m still trying to figure out what provider to see. I know I can order them myself, but figure it might be better to wait in case they have some other tests that they want to add. This is priority#1 for me between doing my work, so I expect it do be in the next few days if they’ll fit me in.
I’m always weary of ordering labs on line by collecting urine samples and sending them in. Who knows how effecient they are? I’m sure they’re accreddited but I much rather rely on labs that are used by Professional MDs and where the labs are drawn in person from the techs. These are the same labs and processes used to treat the rest of the patient world.
Hopefully you can get moving on this quickly so it won’t consume your mind. Glad to hear you are able to stay active and keep working out. Keep up the good spirit.
I think you’re gonna be fine once you find a treatment regimen. You are the only person on here with T levels so low…which suggests you are in fact deficient of Testosterone so replacing it will be effective.
Unfortunately, the hormone tests are pretty expensive (I already looked into it, since my doctor refused to believe there was any reason he should test my hormone levels at the age of 29, despite all of the problems I’ve been having)
Since I am starting a new job and not yet on healthcare, I may just have to use this system for liver function panel (less than $50 to have tested)… I had ALT/AST levels TWICE the normal amount (about 100 each) when I went to the ER feeling like I was dying (and was diagnosed with a panic attack, though the elevated enzyme levels confused them… they chalked it up to the moderate alcohol consumption I had been doing, and/or the exercise workup I had done.) When tested a week or two later, it was back to normal so they had no more concerns, though in retrospect I really wish I’d had at least an ultrasound (if not a CT or liver biopsy) to be well aware of any possible permanent damage. The problem with ALT/AST tests is that they only indicate recent trauma to the liver… so once you are recovered from that, your levels will be back to normal even though you could still have severe damage, even chronic liver disease or cirrhosis.
Now I rarely drink (and in small doses when I do…) and I take zero medications, other than some milk thistle (for protecting my liver, just in case), GABA (if I need to ward off this finasteride-induced anxiety), and DIM (to help regulate estrogen), all of which seem to be going well but…
I am starting to have strange abdominal discomfort/aches off and on, especially in my upper right quadrant – directly where my liver is. So I am anxious to get that checked out, but the doctors don’t seem too concerned about it or anxious to look at it.
This worries me a bit, in light of everything. It’s possible finasteride significantly shortened my lifespan, which is somewhat saddening. I’ll be happy if I can make it into my 60’s.
These liver enzyme levels are not that high (just barely above the max for “normal” range) so probably not a lot to be worried about there, though it’s possible some inflammation or damage occurred. When mine spiked they were TWICE the normal maximum level. And even that is considered a “mild elevation”, I believe. When they look for significant issues, it often shows up in the 100’s… or even up to 1000!
It is my understanding that your levels could have occurred if you:
Had a beer
Recently lifted some weights or even went for a jog
Took any medication that could have strained your liver (such as Tylenol or an antibiotic)
That’s the dumbest statement I’ve ever heard. Trust me, if you have Liver Disease or Cirrhosis of the liver you will have elevated ALT/AST numbers…along with Jaundice like appearance.
I have been off of it for at least 3 years.