Advice on testosterone treatment
I have some questions about testosterone treatment protocols. Can someone please help?
If you have a young (<40) year old male with low testosterone, low LH, FSH, DHT- do you just start on testosterone or would it be best to do a clomid stimulation test? I am concerned with pituitary issues that I might be missing- any other workup besides a Prolactin level?
Thanks Jill
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Hi Jill, I don't EVER do
Hi Jill, I don't EVER do stim tests. They are unreliable and dangerous. MRI.
Best
Erika
regarding LH,FSH, testosterone levels
If pituitary is normal on MRI, but have low levels of LH,FSH and testosterone, is further medical evaluation needed? Is it OK to start testosterone replacement in this senario? Conversly if FSH ,LH and testosterone are elevated with a normal pituitary MRI, what would be the next step in this case? Does anyone know of a good resource to address clinical questions such as this? Thank you.
regarding
the the college of endocrine would recommend that an MRI with close inspection to the Sella would be the next step. If no micro adenomas are noted, then the concern for primary pituitary failure. You should still replace the testosterone but you should also manage the cortisol and the thyroid.....for medical liability issues probably a referral to the local endocrinologist is needed.....I have a few patients that have come in with this scenario....most of my young men with hypogonadism did anabolics in high school....
hope that helps
Paul Miranda MD
www.BalancedLifeMD.com
I was after leaving work, I
I was after leaving work, I do not have the energy to do before. I see my blood in about four weeks to get where we are with testosterone levels. www.bio-identical-testosterone.com