September 19, 2022
Anyone who has had the privilege of working in healthcare knows one thing...we make for the worst patient. We "know" too much, we have seen too much and the last place we want to be is on the other side of healthcare as a patient. But here I was, white coat syndrome and all waiting for that infamous knock of arrival in my primary care office. I truly have been blessed with a PCP who allows me to manage my own healthcare needs and respects my decisions and is open to discussion. Like many doctors, mine is no different. He came into the room, grabbed a seat on his wheeling stool and asked the open ended question, "what can I do for you today"? Only minor problem with that question, I had no idea why I really was there. Like so many walking this planet, if we don't know something we all turn to the interweb for our daily dose of education...or at least humor. Anyone who takes a deep dive in webMD have probably diagnosed themselves with more diseases and ailments then we can count. Having spent hours looking up my generic symptoms I was convinced that it was either all in my head or that I needed to order a casket for my impending death.
The only thing I knew in that moment was that I didn't want to be there. I didn't want to be a patient having to admit that something was wrong. I failed at sounding educated and just started spilling random symptoms that I thought might spark some interest. Most people who turn to the healthcare system have the expectation of leaving with answers. Unfortunately, many times there are no upfront/immediate answers but instead opens the door to additional testing and specialty care. I was no different and there was no clear answer to my generic/generalized symptoms, so we started with some basic blood work.
WBC: 7.9
RBC: 5.25
HGB: 16.2
HCT: 45
PLATELET: 222
GLUCOSE (NON FASTING): 111
HEM A1C: 5.5
FSH: 5.1
TESTOSTERONE: 181 (240-950)
TESTOSTERONE, FREE: 6.29
ANA SCREEN: NEG
SODIUM: 143
POTASSIUM: 4.0
CHLORIDE: 107
CO2: 28
BUN: 16
CREATANINE: 0.9
Did we find the answer? It actually started to make some sense. Interesting note, low T runs in the family. The normal range is rather large but anything outside of that range should be addressed. At the age of 40 most males find their T levels to be between 350-473. So now I had some decisions to make in regards to treatment. Testosterone Replacement Therapy has been shown to improve numbers and symptoms but unfortunately come with side effects. The other option is to trick the body into naturally making its own Testosterone. Having researched those different options, I chose to see what my body could naturally produce and was prescribed a medication called Clomid (clomiphene).
Clomid is a prescription medication which belongs to a class of drugs known as selective estrogen receptor modulators (SERMS). Interestingly, it was originally developed to treat infertility in women. When it comes to the off-label use for hypogonadism in men, it is used to treat such symptoms to include low sex drive, loss of muscle mass, infertility and depression (winner, winner, chicken dinner). Studies have shown that even within 4-6 weeks of use at a dosage of 25mg can significantly increase testosterone levels by 99.2%. The drug ultimately tricks your body into thinking that your sex hormones (estrogen and testosterone) are lower then they really are. In response the pituitary gland is triggered and releases more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The increase in both of these hormones helps to naturally increase testosterone levels in men.
By the end of September I was well on my way in hopes of finally feeling better...
"I like there to be some testosterone in rock, and it's like I'm the one in the dress who has to provide it" ~ Courtney Love
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