endocrinologist

[newman29]

What should an appointment with an endocrinoligist for low testosterone include.?

[doctornee medical]

Hi
Thanks for the post!

I am not sure about your age. However in a case of a low testosterone level, the gonads and secondary sexual characteristics are examined to see if they have developed. A sperm count is done to see the status. Testosterone level is tested along with if need be thyroid and pituitary status to know other causes of low testosterone .
Please let me know if there is any thing else and do keep me posted. Take care!

[newman29]

thank you so much for your reply.  my appointment is thursday.




thanks for the reply.  my appointment is thursday.

[bjamin1775]

My husband has been fighting a low testosterone level for some time now.  He has seen an endo who has diagnosed him with hypothyroidism. He has been receiving treatments of Synthroid and Androgel.  Unfortunately, as his TSH levels go up, his T levels are going down:
DATE     T TSH
12/20/2006  222 3.397
2/5/2007   182 n/a
5/12/2007    251 4.74
8/28/2007   240 4.139
12/10/2007  388 3.849
3/18/2007   273 3.909
6/16/2008   170 2.888
9/17/2008   n/a 2.382

He is now taking 112mcg of Synthroid daily along with Androgel.
His PSA came back negative.
He does not have any ED symptoms, but his testicles have reduced in size.
He has low energy (from a man who was always on the go), sweats, memory problems (from a man who had an impressive memory), has had a few dizzy episodes, has been having continuous headaches for the last several months and is starting to have some breathing problems.
Any advice would be greatly appreciated.

[doctornee medical]

Hi
Thanks for keeping me posted!

The thyroid hormones need to be monitored well. The dose which will suit him well can only be arrived by a trial and error method along with clinical judgement.

“The hormone that exists in the serum may initially be bound to a protein that allows it to be transported in the body. This protein is called sex hormone binding globulin (SHBG). The total testosterone consists of two forms of testosterone; one is bound to SHBG and the other is free-circulating testosterone unattached to serum proteins.

In conditions such as hypothyroidism and cirrhosis, measurement of the total testosterone level may be normal but the patient may have symptoms of low testosterone. In these conditions, the SHBG is increased and this decreases the amount of testosterone that is available for use. The opposite is true where SHBG is decreased and the free testosterone levels are high. This situation is seen in men with obesity and hypothyroidism; these men have normal amounts of testosterone available for use by the body but the serum testosterone level is decreased. Saliva or urine test results are considered a good representation of free hormone levels.

Because SHBG is known to be decreased in cases of hypothyroidism, obesity and acromegaly, and increased in hyperthyroidism and estrogen therapy, it is necessary to measure the free biologically-active testosterone in these conditions, when total testosterone can be misleading. If testosterone is low, a full hormonal evaluation consisting of LH (luteinizing hormone), prolactin, FSH and TSH may be recommended.

Once it has been determined that the testosterone level is low, measuring the LH can help determine the cause. This separates the patients who have testicular disease from those who have diseases of the pituitary gland, the master gland that sits at the base of the brain and essentially controls many bodily functions. A low testosterone level may indicate an elevated prolactin level as well - a condition known as a hyperprolactinoma. Elevated prolactin can decrease testosterone levels by decreasing the secretion of the hormone that tells the testicle to produce testosterone.”

Refer: http://www.diagnose-me.com/treat/T12335.html

Please let me know if there is any thing else and do keep me posted. Take care!