Saw an endocrinologist today at Kaiser. Apparently unless you have a disease that is causing Low T you are more than likely a depressed, stressed out, insomniac.
In a nutshell, he indicated that their are lots of people walking around with T numbers in the 200's with Free at the lower end of normal that are just fine. There seems to be an attitude that the test results create the condition in the patients mind and that HRT is just too dangerous unless there is a disease state.
I did get him to agree that even though my Adrenal responded to ACTH they hadn't run enough tests to conclusively determine my pituitary wasn't functioning properly. He then proceeded to tell me 3 stories. 1) About a clinical study done on a bunch of marines before and after boot camp and that after boot camp their T levels were lower. i.e. My exercise is contributing my low T. (Ok, how come my T numbers are identical to 6 months ago when I was a couch potato. 2) A group of sedentary college students who's T levels were lower do to diet and lifestyle and then 3) a study linking low T to stress, depression and lack of sleep.
In other words, HRT is treating the symptoms not the cause and I should focus on improving my sleep habits. He ordered FHS, LH, Estradiol T, Free and Total, T4 Free, IGF-1, Cortisol-AM, SHBG, Vit. D and asked me to take them in the am after a good nights sleep. He also refused to test DHEA saying he didn't think it would tell him anything of value.
Wow. Well, I hardly know where to begin. First of all, there is a chance you're overtraining and some of what the endo says are right. But here is what makes no sense to me:
You clearly have hypogonadal testosteronal levels, right?
And you have many classic symptoms, such as mental fog, anxiety, etc.
I don't you've discussed the sexual aspects such as libido, morning erections, etc. But I would guess there aren't up to par, right?
Well, how can he assume that testosterone will not help you? That's just weird. You have classic symptoms and a low reading that is below the abyssmally low lab scales. I mean what else does he want??
What I'm asking is what WOULD his criterion for giving testosterone? My interpretation of his answer is that there is no such criterion.
Anyway, I've been there and many other guys on the board as well.
And here is another question for the doc: has he ever seen anyone double or triple their testosterone through lifestyle changes. As I've mentioned, we've seen this with massive weight loss. But just sleep improvements - no way...
But it would be a good question to ask him. I think he's thinking that if you can boost your testosterone to 320, you'll be fine though...