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Secondary Hypogonadism - Should I get a second opinion?

I have been struggling with weight loss for 10+ years. My new doctor ordered a testosterone test and my results came back "low".  I was referred to an endocrinologist, and I did not have a good rapport with her and did not feel as though she understood the years of effort I have put into trying to keep my weight down.  After tests, she did not recommend testosterone treatment.

Height: 5'7"
Weight: 209lbs
Age: 33

Test 1: 267 ng/dl  (8:57am)
Test 2: 290 ng/dl (10:12am)
Test 3: 333 ng/dl (7:54am)

Other tests related to the pituitary gland (same day as test 3):
FSH: 3.1 mIU/mL

From my research, these numbers can be considered as Secondary Hypogonadism depending on what reference range the lab/doctor use.  If diagnosed, I can be treated with Clomiphene Citrate which would increase testosterone without the typical negative effects of testosterone replacement therapy.

From what I read, I strongly feel as though the treatment would help me, but of course, I am biased and looking for a solution to my weight and low energy problems. To be crystal clear, I know this will not solve everything, I understand I will need to keep working at eating well, and exercising.

What do you think, should I seek a second opinion? Should I try to discuss more with my current endocrinologist even though I don't feel a good rapport?

1 Responses
15695260 tn?1549596713
Hello and welcome to MedHelp's forums.  Thanks for your question.  It's important to trust your doctor.  It can be hard at times when it is a specialty that seems to be limited in terms of the number of doctors that are available to do that kind of work and endocrinology is one of those in which there always seems to be more patients than doctors.  But if you can, then yes.  It's advisable to seek a second opinion from a doctor you feel more comfortable with.  It may or may not change the outcome but then you will at least have confidence in your plan of action.

It would be really important to rule out any underlying reasons for issues of low testosterone and if they diagnosed you with secondary hypogonadism.  They would look for issues such as diabetes ,issues with your pituitary gland, what medications you are taking.  In general, being obese can cause it as well.  We are happy you work on your weight maintenance program and think that is terrific!  Keep that up.  But it must be said that primary and secondary hypogonadism can both be congenital.  

If hormone replacement therapy is warranted it's the typical treatment for this.  Your numbers are still within normal but at the low range, which is 290 to 1,100 ng/dl.

Here is some information: https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881

If you are dissatisfied with your previous doctor, by all means, get a second opinion.  Let us know how it goes.  Best of luck to you.
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