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Suggest Treatment For Tiredness And Muscle Weakness Along With Low Testosterone Levels

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Posted on Mon, 21 Nov 2016
Question: had low T more than 4 years ago , I feel always tired and muscle week ,,, In the morning i never wake up refreshed or warm as I used to in order to have my morning woods . My doctor prescribed me clomid... my level went u to 750 but I still don't feel a big difference . still tired .

I would like my convo to be private plz.
doctor
Answered by Dr. Shehzad Topiwala (44 minutes later)
Brief Answer:
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.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (11 minutes later)
yes clomid .
I took all those blood work , the only thing that came above normal was my ash 5.06 and I took tirosint for it .At the beginning I was feeling great with it but then was falling back where I was . do u think I should change that ? should I stop taking clomid ?
doctor
Answered by Dr. Shehzad Topiwala (21 hours later)
Brief Answer:
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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (17 minutes later)
what would u prescribe for low T?
doctor
Answered by Dr. Shehzad Topiwala (9 minutes later)
Brief Answer:
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
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (21 minutes later)
Ok I feel always the cold and mostly in my lower legs ... does low T give these symptoms ?
doctor
Answered by Dr. Shehzad Topiwala (21 hours later)
Brief Answer:
Third follow up

Detailed Answer:
No.To my knowledge, this has not been reported in published literature
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (16 minutes later)
It's thyroid symptom though
doctor
Answered by Dr. Shehzad Topiwala (20 minutes later)
Brief Answer:
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.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
I read t 4 by itself does not work for certain patients ... did u ever experienced that ?
doctor
Answered by Dr. Shehzad Topiwala (10 hours later)
Brief Answer:
Fifth follow up

Detailed Answer:
Although I have not experienced this, it has been known to be reported by some patients
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest Treatment For Tiredness And Muscle Weakness Along With Low Testosterone Levels

Brief Answer: 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.