Suggest Treatment For Tiredness And Muscle Weakness Along With Low Testosterone Levels
I would like my convo to be private plz.
low T
Detailed Answer:
Sorry to learn about your bothersome symptoms.
Regarding keeping this correspondence private, you will have to request the moderators of the forum directly.
If I am not mistaken, you are referring to clomiphene when you write climid, a likely typo for clomid. Clomid is generally not prescribed by most endocrinologists to men.
Other potential reasons for your symptoms need to be explored such as thyroid condition and vitamin D deficiency.
It is also important to know your baseline T levels before you started clomid.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Total Testosterone
SHBG (Sex Hormone Binding Globulin)
FSH (Follicle Stimulating Hormone)
LH (Leutinizing Hormone)
Prolactin
(But if a test called Free Testosterone is available in your laboratory and if they use Equilibrium Dialysis as the method, then there is no need to check Total Testosterone and SHBG)
None of these tests require any fasting but must be done before 10 am in the morning.
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Follow up
Detailed Answer:
I understand you are concerned about your TSH reading. It potentially indicates a mildly under-active thyroid problem called Hypothyroidism.
Whether or not you need thyroid medicine for life, is a complex decision. In order to make this diagnosis accurately as to whether you have a permanently under-active thyroid, a thorough in-person evaluation is required. Perhaps you can consider a blood test for Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
If your thyroid antibodies are positive, it is quite likely you will need your thyroid medication for life.But I typically do not start thyroid medication like tirosint for a TSH for 5.06, except in select circumstances.
Regarding clomid, I advised you of my stance. I do not prescribe clomid to men
Second follow up
Detailed Answer:
After a comprehensive evaluation to confirm the diagnosis of testosterone deficiency and its cause, I would aim to treat the cause provided it was a reversible one.
If not, I would treat with one of the following two options only depending on the individual circumstance:
1 Testosterone
2 hCG
Third follow up
Detailed Answer:
No.To my knowledge, this has not been reported in published literature
Fourth follow up
Detailed Answer:
Yes it is. However if the thyroid blood test results are normal, with an appropriate dose of tirosint, then one cannot attribute feeling cold to the thyroid problem.
Fifth follow up
Detailed Answer:
Although I have not experienced this, it has been known to be reported by some patients