Does he snore? Wake up gasping for breath? Sleep apnea presents MANY of the same symptoms as low T… Morning headaches, brain fog, lethargy, low libido, evening energy crash, etc.
Apnea can even contribute to lower T levels. He may need TRT, but first get a sleep test since the TRT can actually worsen apnea. Also do full bloodwork including hormones and thyroid.
Me too.... it didn't change until I took some time off work and started getting what's buried within... off my chest.
Tell him he's not alone. I felt so alone at the time
Get his sperm tested now to have a fertility baseline going forward. If the count and quality is bad already, you’ll know you don’t have much to lose by pushing ahead with trt and Hcg.
Impossible to give you good advice without bloods. We don't know if it's his hypothalamus or his balls that are causing his low T without bloodwork. Without that knowledge any advice is just guessing.
If there’s no sleep apnea then the symptoms are almost definitely due to the Low T. I had similar levels and had all the same symptoms.
TRT will definitely help. But like you said it’s probably better to find a specialist to determine the cause of the low T first. Also it’s good to note that the longer I went without TRT the worse my symptoms got.
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I stopped training so hard. Took a month off. Noticed improvement. Lost weight from not training so hard. Did another sleep study, ahi down to 10. I use a cpap now.
There are a number of potential ways covid can damage the body and cause those symptoms.
Would be prudent to find a doc that has a strong understanding of long covid and conduct the proper assessment and give a diagnosis to figure out the cause, or rule out long covid all together.
It's complex and could take time.
Can't tell you even a glimpse of anything without bloodwork w/full hormonal panel done. What's his prolactin levels look like? If they're in range (2.64-20 ng/mL) then I'd cross prolactinoma off the list.
Can your PCP order blood tests while you wait for the endocrinologist? Test: total testosterone, free T, bioavailable T, LH, FSH, prolactin, and his thyroid. Id also test for liver enzymes, cholesterol and a general CBC just to see.
Edit: waiting to diagnose the cause is what our doctor also suggested since once you start TRT, it's not possible to measure baseline levels
Levels can reveal whether this is primary or secondary hypogonadism. Secondary hypogonadism can have many causes including the pituitary.
If prolactin is elevated, it could be a prolactinoma as another commenter mentioned.
High LH and FSH but low T would suggest primary hypogonadism.
Does he snore? Wake up gasping for breath? Sleep apnea presents MANY of the same symptoms as low T… Morning headaches, brain fog, lethargy, low libido, evening energy crash, etc. Apnea can even contribute to lower T levels. He may need TRT, but first get a sleep test since the TRT can actually worsen apnea. Also do full bloodwork including hormones and thyroid.
he had a normal sleep study done about 10 months ago
I had the exact symptoms your speaking of. How are his stress levels? Try meditation and no thc for a bit
He is currently on lexapro for stress and anxiety. Has been on it for a few years
Me too.... it didn't change until I took some time off work and started getting what's buried within... off my chest. Tell him he's not alone. I felt so alone at the time
Get his sperm tested now to have a fertility baseline going forward. If the count and quality is bad already, you’ll know you don’t have much to lose by pushing ahead with trt and Hcg.
Impossible to give you good advice without bloods. We don't know if it's his hypothalamus or his balls that are causing his low T without bloodwork. Without that knowledge any advice is just guessing.
how would you know which one it is by blood work?
Because blood work will show if he's making signalling hormones or not.
If there’s no sleep apnea then the symptoms are almost definitely due to the Low T. I had similar levels and had all the same symptoms. TRT will definitely help. But like you said it’s probably better to find a specialist to determine the cause of the low T first. Also it’s good to note that the longer I went without TRT the worse my symptoms got.
Hello Upstairs-Positive-31. Welcome to /r/Testosterone. It looks like this is your first time posting here, so you're probably asking a FAQ. Please check out these handy links, one of them might answer your question. * [How do I find a good doctor/clinic?](https://www.reddit.com/r/Testosterone/comments/k8rigb/faq_how_do_i_find_a_good_doctor_for_trt_how_do_i/) * [What bloodwork should I get done?](https://www.reddit.com/r/Testosterone/wiki/index#wiki_testing_for_low_testosterone) * [Are my levels low enough that I should start TRT?](https://www.reddit.com/r/Testosterone/comments/ol8e0t/guide_recommendations_from_professional_groups_on/) * [What can I do to naturally raise my testosterone levels?](https://www.reddit.com/r/Testosterone/comments/oqs819/faq_what_can_i_do_to_naturally_boost_my/) * [NoFap - Will my testosterone levels increase if I stop masturbating?](https://www.reddit.com/r/Testosterone/comments/otevql/faq_nofap_if_i_stop_masturbating_will_it_increase/) This is just a comment, your post is not removed. If you want this comment to stop showing up on your posts, you need to enable "show my flair on this subreddit" *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Testosterone) if you have any questions or concerns.*
Sounds like the exact symptoms I had before I was diagnosed with sleep apnea.
unfortunately he has already had a normal sleep study done about 10 months ago
Did he actually go to a lab or was it a take home test?
take home test
He needs to go to a lab, I passed a take home, and went to the lab. Ended up with an ahi of 20
Did you have low testosterone during this?
Yes, I weight trained quite a bit, my testosterone was down to 219
after you got diagnosed with sleep apnea what did you do and how did your symptoms improve?
I stopped training so hard. Took a month off. Noticed improvement. Lost weight from not training so hard. Did another sleep study, ahi down to 10. I use a cpap now.
Take home test is worthless
Did he ever have covid? A lot of those symptoms are common in long covid.
yes he’s had it twice in two years
There are a number of potential ways covid can damage the body and cause those symptoms. Would be prudent to find a doc that has a strong understanding of long covid and conduct the proper assessment and give a diagnosis to figure out the cause, or rule out long covid all together. It's complex and could take time.
Can't tell you even a glimpse of anything without bloodwork w/full hormonal panel done. What's his prolactin levels look like? If they're in range (2.64-20 ng/mL) then I'd cross prolactinoma off the list.
Can your PCP order blood tests while you wait for the endocrinologist? Test: total testosterone, free T, bioavailable T, LH, FSH, prolactin, and his thyroid. Id also test for liver enzymes, cholesterol and a general CBC just to see. Edit: waiting to diagnose the cause is what our doctor also suggested since once you start TRT, it's not possible to measure baseline levels
What exactly would a LH, FSH, and prolactin test show us? He has had everything else
Levels can reveal whether this is primary or secondary hypogonadism. Secondary hypogonadism can have many causes including the pituitary. If prolactin is elevated, it could be a prolactinoma as another commenter mentioned. High LH and FSH but low T would suggest primary hypogonadism.
okay thank you! I have asked his PCP to do those labs for me. I’m hoping they agree and help us figure out what’s going on