The TRT Diaries: 1 Year on T

Its been a year since I started Testosterone Replacement Therapy (TRT) and I’ve seen plenty of changes since then. I can happily say that things have really turned around for the better for me since last summer, when I was truly suffering from those Low Testosterone (Low T) symptoms. In this video, I go over some of the most prominent changes while on T – all from an intersex guy’s perspective.

Click here to catch up or get a re-cap on all my other ‘TRT diaries’ entries!

The TRT Diaries – 4 months on T

TRT method:
AndroGel 1.62% – 2 pump actuations daily (40.5 mg)

Blood test results, taken on December 19, 2014:
Hormonal profile:
Testosterone (T), Total: 1145 ng/dL (higher end of normal; excellent!)
Blood profile:
Hematocrit: 40.7 (fair)
Hemoglobin: 13.0 (low end of normal)
Blood sugar profile:
Glucose: 122 (normal for someone who’s not fasting at the time of a blood draw)
Kidney profile:
BUN: 11 (just about right)
Creatinine: 0.60 (a bit below normal)
eGFR: 141 (normal)
Metabolic profile – minerals, kidney, liver:
Sodium: 138 (normal)
Potassium: 3.8 (normal)
Chloride: 102 (normal)
CO2: 27 (higher end of normal)
Calcium: 9.3 (normal)
Protein, total: 7.7 (normal)
Albumin: 4.8 (normal)
Globulin: 2.9 (normal)
A/G Ratio: 1.7 (normal)
Bilirubin, total: 0.4 (normal)
Bilirubin, direct: 0.1 (lower end of normal)
Alk Phosph, S: 68 (normal)
AST: 32 (normal)
ALT: 60 (a bit above normal)

I’ve been on T for 4 months now and quite a bit has happened. I went to see my Endocrinologist on the 13th, and found out that my T levels have gone up a bit from the last time I had my blood drawn (which was in September). My T levels went up from 1043 to 1145. Additionally, my liver enzymes are 5 points above normal (they went up from the last time). The good news is that they’re not so high as to be concerned about my liver, but I do hope it doesn’t get really, really high and that they start to come down in the next few to several months (this is probably just my body adjusting to the TRT). If  does get to the point where they get out of control, then I will probably need to lower my dose a bit (my biggest fear is going off TRT).

My endo thought that my dosage was probably a little too strong and at one point was actually thinking about lowering the dose a bit. But I told him that I felt great, I felt fine, and that I didn’t want to lower the dose, so he didn’t. However, we will need to keep a close eye on my liver enzymes. I have my next appointment with him in mid-April and my next blood draw in either late March or the first week of April and so we’ll see what happens then.

Now, on to the other changes:

Sexual Function
Some changes have happened in the downstairs area since my last update. I can actually see my whole glans now. The foreskin on my penis can fully retract now, whereas before it only used to retract up to the mid-point of the glans. I never thought I would see this happen. I always thought that not having a cis male-looking glans – and a small glans – was something I was always going to have just because I was intersex. But 4 months on T and I now have a glans that looks just like a cis male’s. Furthermore, my sexual performance has really improved, my confidence has gone up, and my sex drive is more frequent and is very consistent. I really like what’s happening in this department. One more thing: It seems like I have gotten some minor testicular shrinkage (I noticed it earlier in the month). Shrinkage is normal for men on TRT and is only minor – it just means that your body has stopped producing LH (which is what makes the testes grow – at least most of the time).

Voice
My voice has deepened since my 1.5 month update – it really sounds significantly different from before I start T. I’m really starting to love my voice and my social confidence is increasing due to it. I’m becoming less self-conscious about it but I still have some way to go.

Facial/body hair
My facial and body hair is becoming thicker and darker, slowly over time. I’m starting to see thicker hairs on my face. I can’t wait until I’m able to grow a full beard!

Physical Profile
My weight has gone up from 97 ibs to 100 ibs! This is the first time in my life that I’ve cracked 100, I’ve never been able to do that no matter how hard I tried. My biceps and triceps seem to have grown more recently. I can see my six pack a little better now – and without putting very much effort. I either seemed to have shedded a little more fat or my abdominal muscles grew a little (it could go either way). All I know is that they need to grow some more to make them look like they really pop out. Also, I have seen a significant increase in strength since my last update (which I’m very happy about!). From the looks of it, I can go back to working out full time, but I think I’m going to wait an additional 2-3 months before I do so. I’m very happy to see that I’m finally going to be able to get the body I’ve always wanted.

Energy/mood
My energy and mood have really improved. I feel really motivated to do stuff now.

Cognition
I have seen great improvements in my cognition since my 1.5 month update. My word aphaxia has greatly improved. Doing intellectually-demanding stuff is much easier now. I no longer have to struggle with that type of work – I have more patience doing it now. Making music, designs, and other things are much funner now than before T. Learning new things is much easier now – I’m now better able to grasp material that I learn. And lastly, my social confidence keeps going up. Things are going great in this area.

Other
I have seen a modest increase in acne. I get it on my face, neck, back, chest, and upper arms – but mostly on my face.

I really love what’s happening with my body. I’m very excited to see what’s going to be happening 2 months from now (on my 6th month).

I guess that’s all for now. I’ll provide my next update probably in April (after I go see my Endocrinologist). I’m still working on my video blog version of my TRT updates. Not sure when I’ll get it completed (things are a bit hectic around here) but I’ll let you all know when I make it.

See you all next time!

The TRT Diaries – 1.5 months on T

TRT method:
AndroGel 1.62% – 2 pump actuations daily (40.5 mg)

Blood test results, taken on September 26, 2014:
Testosterone (T), Total: 1043 ng/dL
Estradiol (E2), Ultrasensitive LC/MS/MS: 20 pg/mL
ALT: 33 U/L
AST: 24 U/L

This is my 1.5 (1 1/2) months (and 6.4 weeks) on T update. Quite a bit has happened over the last 6 weeks and I’ll go over that in a bit. But first, I’m going to discuss the results from my latest blood test.

As you can see above, my T levels have gone up dramatically, while my E2 levels have dramatically gone down. I’m still shocked at the results from the test. For the first time in my life, I have normal hormone levels! I never thought I would get T levels this high, and E2 levels this low, this soon! Before, my T levels were an abysmal 29, now they’re a stunning 1043! My E2 levels before where an astronomical 251, now they’re a youthful 20! These levels are actually normal for a guy my age, and supposedly, compared to my peers, I’m in the 95th percentile in T levels. The average T levels for my peers are around 600 to around 700 (50th percentile), so this means that I beat most of my peers in T levels! (And to think that before I was basically below the 5th percentile!)

I actually made a more modest prediction on where my T and E2 levels where going to be at this point. I predicted that my T levels were going to be around 600-800, and my E2 levels around 40-100. This surpassed my expectations big time and I’m completely ecstatic about it. I really think that my healthy lifestyle habits helped me get to this point, and if that’s the case then it just shows you how much of a difference lifestyle habits can make. A lot of my peers have unhealthy lifestyle habits and I think that explains why the average T levels for them are around 600-700. Because I’m on a low dose of T and my levels are on the high end of normal, this probably shows us all that I’m a hypoexcreter of T as opposed to a hyperexcreter (this means that I metabolize T slowly).

I think that these T and E2 levels are my sweet spot, since I’m not feeling any side-effects. In fact, I feel great! I didn’t realize that I would respond to AndroGel this well – this has also taken me by surprise.

I also got my liver enzymes checked (which you can see above) and they have gone up a bit from the last time. My ALT is actually on the high-normal side now, while my AST is now in the middle. I’m not sure what this all means but I’ll do some more research on it.

Now, on to the other stuff:

Sexual Function
My sex drive seems to have improved over my last TRT Diaries entry. I feel like its at its highest/best yet. It has definitely gotten more consistent. I have gotten morning wood every single day since the morning after I started T. I now wake up every morning fantasizing about sex and itching to have it. Not only that but I also fantasize about sex – as well as great-looking women and their body parts – throughout the day. Before T, I’ve constantly struggled to so (it was inconsistent) and only thought about that stuff occasionally, but now its girls and sex all the time. The mild ED (Erectile Dysfunction) I had while Low T is completely gone now.

Voice
My voice seems to be getting deeper about every two weeks or so. I have noticed a different sound and feel to it from the last time. Not only that but, it also seems to have started cracking (again). I’m recording my voice to keep track of the changes and I have noticed a difference from the past two weeks and a pretty big difference since I first started T. Since my voice is finally starting to deepen, I’m actually feeling more comfortable with it and less self-conscious about it – I’m starting to hate it less, which means I’m actually starting to like it!

Facial/body hair
My facial and body hair seem to be getting more numerous and slightly darker from the last time. I’m wondering when I’ll start seeing darker, thicker hairs. Really excited to get more visible facial hair and grow a beard (so I’ll look a little bit older and because I always wanted to grow one)!

Physical Profile
Slowly, maturely, my body keeps increasing in body and lean mass. When I weighted myself at the end of September, I was back to 91 pounds When I went to visit my Endocrinologist on Friday, I found out that I now weigh 97 pounds! I’m really happy about this. This is the first time in my life that I’ve weighted that much. I’m guessing that by the time I go visit my PCP (which will be in November or December), I’m probably going to be 108, 109, or 110 (I’ll no longer be underweight). My guess is that after one year on T, I’ll be anywhere from 135-150 (with most of it being muscle, of course). I’ll finally be able to fill my clothes out! I have recently gotten back to my regular fitness routine, although I’m still easing into it. I’m now “lifting heavy things” (right now, its mostly bodyweight exercises) 3 times a week again.

Energy/mood
My mood is still good and my energy is still high. Its definitely gotten more consistent. I definitely feel more motivated to do stuff now and its only going get better over time. I also seem to be more of a morning person now, whereas before I wasn’t.

Cognition
My cognition just keeps improving – and I just know that its only going to get better over time. I can definitely retain information much better now and I can also focus much easily now. Brain fog also seems to be completely gone now. I’m actually now back to making and learning more about music (as well as design and other stuff) and its going along great! I feel like my confidence in all sorts of stuff is slowly, maturely going up.

Appetite
Appetite is still up! Still not really experiencing any bloating (major bloating, at least).

Other
My acne seems to have modestly increased. The good news is that its not a huge issue (at least yet).

I’m very pleased by how all of this is going. This is definitely one of the best decisions I’ve ever made. I’m very excited to see what’s up ahead.

I guess that’s all for now. I’ll see you all next time!

P.S. Before I left my endo’s office, I got new prescription for AndroGel (same dosage and delivery method) for the months of November and December. However, hours after I left my endo’s office, I realized that I will need a new prescription for T in December for the months of January and February (I will be filling it out somewhere at the end of December – before New Year’s). I’m not going to see my endo again until January 9, and I’m hoping that I can get a new prescription without going to his office (by doing it electronically or by fax, or by my PCP prescribing it under my endo’s direction). This is something that’s going to have me anxious come December because I will be out of T by the time I go see my endo, and I really don’t want to go back to being Low T. Hopefully, everything will work out just fine – we’ll see what happens. Also, my next blood draw will be in December, and this is where I’m going to get my blood cells checked.

Lastly, I will be uploading my first video blog on YouTube hopefully by the end of the month. I’m currently busy shooting it. I will share that video (along with future videos) here when I upload it.

The TRT Diaries – 2 weeks on T

It’s been 2 weeks since I started T (this is my 15th day) and I have seen quite a bit of changes. Most of the changes have been neurological. I haven’t really seen any physical changes. I’ve only seen a few and they have been minor (at least most of them), compared to the neurological changes (all of this is expected during this time). My guess is that that will change during the 3rd week. For the record, I’m on Androgel 1.62% and I take 40.5mg (2 pumps) daily (every morning).

With that said, here are the following changes that I’ve noticed since first going on T:

Sexual Function

My sexual function (libido and potency) has made a big improvement. My sex drive is much more consistent. Whereas back then I only thought about sex occasionally, I’m now thinking about sex much more frequently (as in everyday). I seem to be taking greater pleasure in it (that is, I seem to be feeling it more), I seem to be more “ready” (if you know what I mean), and I seem to be paying even greater attention to visual stimuli. I first started to notice an elevation in my libido about an hour after I took my first dose of T – when I had my first sexual urge in weeks. The following morning, I noticed a return of my morning erections (which I had not had in a few months until then), and they have been consistent since then (I’m now waking up with morning wood everyday). My penis has also grown a bit – it looks a little more thicker than before, and its more sensitive than it was before. I’m very curious to see how much it grows after a few years go by. Lastly, my orgasms are more intense and my semen seems to be increasing in volume. I’m really surprised by how quickly my sexual function has improved. This is something that I didn’t expect to happen so soon – and I’m enjoying it!

Voice

My voice hasn’t changed yet – I still sound like Justin Bieber. My guess is that it’ll start changing very soon. I’m nearing the point were I’m going to start seeing changes in my voice. This is something that I’m most excited about and the most impatient about. I’m very self-conscious about my voice – which is the reason why I tend to avoid talking to people – because its not the manly voice I should have, so I’m really, really eager for it to start changing (or should I say, resume changing).

Facial/body hair

My facial hair seems to be growing back a bit quicker. It seems like there’s some more hair starting to grow in certain parts of my body (although its still scanty). I also seem to have increased peach fuzz. I’m assuming that I’ll start seeing thicker, darker hairs growing in during the 3rd or 4th week. I can’t wait to finally have visible facial hair!

Physical Profile

My muscles seem to have gotten more firmer than before. They seem to have gotten a tiny bit bigger and I seem to be filling out some areas of my body that were just skin and bones before. I seem to have gained a little weight – I checked myself on a scale and I’m almost back to being in the 90s (supposedly, I’m 89 ibs now). My weight has always been unstable (its always been mostly in the 80s), and supposedly it won’t start stabilizing until I’m anywhere from 6 to 12 months on T. I really can’t wait for that to happen, I’m tired of being underweight and looking like a weakling. My strength also seems to have increased (I tested myself out). I am, however, going to a wait a little bit before I resume my fitness routine (about 3 months). My goal is to get bigger and stronger, as that is more of my thing (it’ll make me look like I mean business). I’m really excited to be able to put muscle on more easily, as well as getting back to my regular fitness routine.

Energy/mood

My energy has increased, and my mood has improved. My mood swings are gone and I have become more patient with things and people. All of these things seemed to have happened during the first day. Not only that but the mild anxiety I was dealing with also seems to have disappeared (I noticed my anxiety lifting shortly after taking my first dose). I actually now feel like talking to people a bit more. I seem to have less social anxiety and feel more confident in talking to people, and I seem to be more open to socializing. The only thing holding me back would have to be my voice (again, I’m self-conscious about my voice).

Cognition

My cognition has dramatically improved. My reaction times are quicker, I can remember things better, I can focus more better and more clearly, and I have more energy and patience to do intellectually-demanding tasks. Perhaps the best part of all is that my creativity seems to have gone up. Things are coming to me much more easily than before. Right now, I’m getting back into the groove of making/playing music, designing, and the like. I must say that I’m having more fun making/playing music and designing than I did back when I was Low T. I seem to be getting more ideas now, I’m getting ideas more easily, and are more motivated to organize them and act upon them. I seem to be able to improvise more easily now, whereas back then I had a really hard time doing so. It seems like learning/practicing my skills while being Low T is starting to pay off. The cognitive changes/benefits is something that I’m really enjoying as well.

Appetite

My appetite has increased. I’m getting hungry more often and my portions have grown in size. I noticed this change on the evening of my first dose. I’ve also noticed that the bloating I used to have after every meal seems to have subsided. I guess this just shows that high Estrogen causes bloating (and it also shows that my E levels have decreased).

Other

My Gynecomastia seems to be improving, but its just the beginning. We’ll have to wait and see how much its reduced in several months (or a year from now).

All of these changes happened during the first week (the first 5 days it seems). I haven’t really seen any more changes during the second week (its become pretty boring now). I’m sure (and I’m hoping) that I’ll be seeing more changes during the third week.

I’m guessing that my T levels are now anywhere from 500-700. My goal is to get my T levels in the optimal range, between 700 and 1,000. For my E2 levels, my guess is that they’re now in the 40-100 range. My goal is to get them anywhere between 20 and 40, with 25-30 being my preferred spot. I have my next blood draw on the 26 and my next appointment with my Endocrinologist on October 10, so I won’t know until then (I might need to increase my dose by one pump on my next appointment). I also won’t know if I have to increase my dose until then.

One thing I’m trying to do to further improve my health and aid my recovery from Low T is to incorporate (more like re-incorporate) more good dietary fats into my diet, as I’m am pretty deficient in them. This has always been a trouble spot for me since I’m not buying my own food and I need to scrap up the money to buy them, but I’m going to work towards that. I’m also going to work towards getting back to being fully Primal (I’m partly Primal right now – because of my financial situation). Getting more good dietary fats will further increase my energy levels and make them more sustained.

I’m very happy with the changes I have seen. I’m even more amazed at how fast the expected first changes happened. I’m really looking forward to seeing what’s going to happen next. I feel great and, like I said before, I’m never going back to being Low T ever again!

I’ll be posting another TRT update either in 2 more weeks or on the last day of this month or the first day of October. I’ll see ya’ll again next time!

Finally Got T!

…Well, almost (I’ll get to that a bit later).

On Tuesday, August 19, I went to see my Endocrinologist for the 3rd time. I predicted that this time around I was finally going to get my first prescription for Testosterone (T). I was pretty anxious about the outcome of all this but I knew because I had been preparing for this during these last 2 months, I felt like I was finally prepared enough to finally get T (unlike the other time around, when I was just getting started on fixing my legal stuff) so I felt more confident this time around. I was a little anxious, but at the same time I was excited.

After a humiliating ‘defeat’ last time around (due to a lack of preparedness on my part), and after a very crushing denial to see an Endocrinologist by my former insurance this month last year, I can finally say that I got my hands on T! My endo was very open to giving me T but the legal stuff (not updating my gender with social security, ID, and my insurance sooner) is what made things difficult the last time around – and why he couldn’t prescribe me T. I spend the last 2 months sorting this stuff out and I can proudly say that all that hard work paid off.

When I got my 1st prescription for T, I felt very happy, excited, and pumped. But most of all, I felt a huge sigh of relief. This is has been such a big journey with huge ups and downs. Its been an emotional roller coaster that I can finally and happily say has finally come to an end. I’ve had to face denials of coverage, incompetent practitioners & insurance providers, and inconsistent identity documents, all while dealing with the dreaded symptoms of Low T (which made it even more challenging). Yeah, its not easy being intersex – especially when people don’t really know what intersex really is and when there are little to no protections for intersex folks like myself. It is especially not easy being both intersex and transgender (in my case, an intersex guy who was misassigned female at birth).

My endo prescribed me Androgel 1.62%. The best part? I didn’t even need to ask for it – he just said he was going to put me on Andogel and that’s it! (Love my endocrinologist!) I’ll be on 2.5g (2 pumps) of it initially, afterwards my doctor and I will gradually increase the dose until I finally arrive at a dose that I’m comfortable with (this will take about a year to do). Since T has very profound effects on the brain, it is important to start out with a low dose when starting TRT for the first time, so I’m cool with this initial low dose (the brain is practically the first organ to recover from the effects of Low T).

I’m predicting that I’ll be back to working on my career – as well as my resuming my regular fitness regimen – in about 2-3 months, or even earlier (like after 2 weeks). I’m very excited to return to work as I am dying to work on and put out new music and designs, as well as start playing live shows! I’m also very excited to return to my regular fitness regimen and finally start bulking up!

I went over to Rite Aid this morning to fill out my prescription but unfortunately they were out of Androgel. The good news is that they will have more in stock by tomorrow at 2pm. But since my insurance doesn’t have Androgel on their drug formulary (or drug list, as its also called), my local Rite Aid has sent my endo a Prior Authorization notice which he will need to fill out and send back to them (hopefully he’s already done it by now), who will then send the form to my insurance so they can cover it. This takes about 24 hours (or 2 days) to process. So if my endo and local Rite Aid fills and sends the notice today, I should be able to pick up my T either Friday afternoon or Saturday morning and start TRT on Sunday morning (if not, then early next week). We’ll have to wait and see how this turns out (I’m sure everything will go well). I’ll keep you all updated!

The TRT Diaries – Pre T, Part 2

I had my 2nd appointment with my Endocrinologist on Tuesday (June 3rd). This is where I got the results from the blood draw I had back in mid-May. I had quite a bit of work done (I had to get blood drawn to 8 tubes!), and the results show that:

Comprehensive Metabolic Panel:
Glucose: 93 mg/dL
Urea Nitrogen (BUN): 11 mg/dL
Creatinine: 0.58 mg/dL
eGFR Non-Afr. American: 130 mL/min/1.73m2
eGFR African American: 151 mL/min/1.73m2
BUN/Creatinine Ratio: 18.9
Sodium: 141 mmol/L
Potassium: 3.5 mmol/L
Chloride: 104 mmol/L
Carbon Dioxide: 23 mmol/L
Calcium: 9.7 mg/dL
Protein, Total: 8.0 g/dL
Albumin: 4.9 g/dL
Globulin: 3.1 g/dL
Albumin/Globulin Ratio: 1.6
Bilirubin, Total: 0.3 mg/dL
Alkaline Phosphatase: 63 U/L
AST: 14 U/L
ALT: 10 U/L

Hormone Panel:
Estradiol, Ultrasensitive LC/MS/MS: 251 pg/mL
17 Hydrodyprogesterone, LC/MS/MS: 81 ng/dL
Androstenedione, LC/MS/MS: 215 ng/dL
DHEA, LC/MS/MS: 471 ng/dL
Dihydrotestosterone, LC/MS/MS: 18 ng/dL
DHEA Sulfate: 338 mcg/dL
FSH: 4.0 mIU/mL
LH: 22.9 mIU/mL
Prolactin: 15.2 ng/mL
T4, Free: 1.1 ng/dL
TSH: 1.27 mIU/L
Testosterone, Free: 2.6 pg/mL
Testosterone, Total, LC/MS/MS: 29ng/dL

CBC (Includes DIFF/PLT):
White Blood Cell Count: 8.1 Thousand/uL
Red Blood Cell Count: 4.31 Million/uL
Hemoglobin: 12.9 g/dL
Hematocrit: 39.5%
MCV: 91.7 fL
MCH: 29.9 pg
MCHC: 32.6 g/dL
RDW: 13.5%
Platelet Count: 192 Thousand/uL
MPV: 97 fL
Absolute Neutrophils: 5840 cells/uL
Absolute Band Neutrophils: DNR cells/uL
Absolute Metamyelocytes: DNR cells/uL
Absolute Myelocytes: DNR cells/uL
Absolute Promylocytes: DNR cells/uL
Absolute Lymphocytes: 1110 cells/uL
Absolute Monocytes: 494 cells/uL
Absolute Eosinophils: 616 cells/uL
Absolute Basophils: 41 cells/uL
Absolute Blasts: DNR cells/uL
Absolute Nucleated RBC: DNR cells/uL
Neutrophils: 72.1%
Band Neutrophils: DNR%
Metamyelocytes: DNR%
Myelocytes: DNR%
Promyelocytes: DNR%
Lymphocytes: 13.7%
Reactive Lymphocytes: DNR%
Monocytes: 6.1%
Eosinophils: 7.6%
Basophils: 0.5%
Blasts: DNR%
Nucleated RBC: DNR/100 WBC

So as you can all see from that extensive list, I had a lot of work done, but I think it was well worth it (and is required for successful TRT). Now, lets go over some of the numbers on the list. Be warned that this is going to be a pretty lengthy post, since there’s quite a bit to cover, so get ready to devote quite a bit of time to reading this.

If you look at my (Total) Testosterone levels above and if you remember the results from my last blood test, you’ll see that my T levels have actually gotten worse. My T levels from last time was 36. This time around its 29 (ouch!) (I think that a cold/cough that I had during that time might have contributed to my lower T levels this time around). My Free T levels are low too (obviously). My Estradiol (E2) levels have also gotten worse. My levels from the last blood test was 192. This time around its 251 (yikes!).

My FSH levels haven’t changed much from the last time. Although it seems like my FSH has dropped a bit from the last time (from 5.3 to 4.0). This isn’t surprising as my my low T levels and high E2 levels are very likely compromising my fertility (my FSH also seems to be on the low side). Plus, my T levels dropped a bit and my E2 levels went up from the last time, so its only natural that my FSH would drop as result of this. This time around I was able to get my LH levels checked. The result I got was 22.9. This is a high number and is very typical of somebody with 17B-HSD, as well as a male with primary hypogonadism (high LH is an indication of primary hypogonadism). This is something I was expecting – I guessed that it would happen and I was right.

This time around, I also got my Androstenedione (A) checked. The result? 215. This is pretty high and is just above normal (normal is under 151 – although just like every other hormone range, there is no definite range). This, along with low T levels and high E levels, is very typical of somebody with 17B-HSD (characterized by a high A:T ratio, in my case 215:29) – and I’m betting that the number would be higher if I had taken an HCG stimulation test.

I got my Dihydrotestosterone (DHT) checked this time around as well. The result was 18. This is a low number (it needs to be 30-85), but seems normal for someone with my T levels (29). Obviously, the T:DHT ratio (mine is 29:18) isn’t high enough to indicate 5-Alpha Reductase Deficiency. I knew that the result would be something like this, and this indicates that I was right about having 17B-HSD.

My Prolactin fortunately wasn’t ultra high (which I knew), so there’s nothing indicating a possible tumor 😀 (something my Endo was worried about). However, my Prolactin is on the high-normal side, almost above normal – which isn’t surprising considering the fact that I have Gynecomastia. But the good thing is that it’ll be easy to manage and get it to be lower – more towards the middle of the scale.

My white and red blood cell counts are in range, although it looks like my RBC is on the lower end of normal (does not seem uncommon with Low T). My Hemoglobin and Hematocrit seem to be on lower end of normal (which is normal for Low T guys) – . The rest of the numbers from this blood draw are all in range (except for a couple or so, which are slightly above normal, but not a big deal). My Thyroid is all good (which I suspected). Although, my Creatinine is below normal. Additionally, Glucose seems to be on the high end of normal (which I don’t think is surprising for a guy with Low T). My Liver and Kidneys also appear to be working well.

The only results I didn’t get back was from the Sex Chromosome test – this was due to an error. I really have no problem with that. I don’t need a Chromosome test to tell me I’m 46,XY – my physical characteristics tell me that, as well as the results from my bloodwork (but really, why should it matter? Here’s a very insightful article that deals with this). I don’t plan on re-taking that test, simply because of the fact that the evidence that I have already tells me that I’m biologically male. I don’t need this test to ‘validate’ me (I rather take a semen analysis). I know what I am and I know how my body works – it is after all, my body, and nobody knows my body better than me. Intersex people are already medicalized enough and this just contributes to it, in my opinion.

See, the thing that bothers me about this is that they’re (the medical establishment) are trying to mythologize us and basically are trying to tell us that either we don’t exist or that we are ‘hermaphrodites’ (with two sets of working testes and ovaries). I mean, if the testes are palpable down there, despite the fact that the person (in this case, that would be me) has ‘ambiguous’ genitalia, then that should tell you that there are no ovaries – especially if those “lumps” are adult-sized (i.e. adult-sized testes). I mean, what else could they possibly be? Its humanly impossible to have a working set of testes and a working set of ovaries. I think that right there should tell you something. All in all, I don’t care what my chromosomes are because it doesn’t matter (and chromosomes actually don’t matter).

Now at this point, you may be asking yourself why I’m putting a spotlight on the ‘medical’ side of intersex, if I’m against the medicalization of intersex. The answer is because I want people to see that intersex folks have differing hormonal (and other) profiles, even within their own variations (if that makes any sense). This also helps people to see that overall, intersex people tend to be healthy just like everyone else, and that when it comes to health, we basically face the same challenges like everyone else. I’m simply educating people on this stuff in a way everyone can understand (I’m trying to make everyone understand how diverse intersex and everyone else’s bodies really are). The rest of this series will be focusing more on my treatment of and recovery from Low Testosterone – from the perspective of an intersex person :D. Overall, this shows that we’re no more different from non-intersex people, and that’s the message I’m trying to get across here.

I think you can all see from my blood draw results that I’ve got the green light to go on T. Unfortunately, there’s another hurdle I have to get through before I can get T: I need to update my gender with the Social Security Administration (SSA) before I can get T. The reason for this is because my Endo said that because my gender on my insurance (which is connected to my Social Security number/records) is still female, I need to provide proof that I got therapy for Gender Dysphoria (GD) – this will also require changing the diagnosis from Hypogonadism to GD. I need to provide my Endo the notes from that therapy session I had with my then-psychologist, so he can submit them to my insurance company, so they can approve my TRT. If can’t track them down, then I will need to go to therapy for GD all over again, and I will not have that (I mean, why do I need to do this again? I’ve been living as a man for 2 years now with great results). This has already consumed a lot of my time (I’ve started this journey early last year), and I just want to get this over with so I can go back to living my life.

Getting those notes has already proven difficult to do. This is obviously already wasting my time. So as a solution to this problem, I made an appointment to see my Primary Care Physician (PCP) on Monday morning. Hopefully, everything goes well and I get my note to take to my local SSA office later that same week. I personally think everything’s going to go well. My PCP is very understanding and laid-back, so I trust him with this (as he was going to do it the first time around but unfortunately ran out of time). But, I’m still going to be a bit cautious – I don’t want to get my hopes up only to have them crushed. Hopefully with this done, my Endo will be able to keep the Hypogonadism diagnosis (he’ll have to or else the insurance company will think I’m a TransWoman and deny my request to cover my TRT) – since I won’t have to go through that ordeal with my insurance – and make my next appointment to finally get my 1st prescription for T very soon.

I’ll keep everyone posted on this situation. Expect an update on this on or after Monday.

The TRT Diaries – Pre T

Hormone Levels (as of October 2013):
Testosterone (T; Total T): 36 ng/dL (Total Joke!)
Estradiol (E2): 192 pg/mL (Ugh! Don’t even get me started on this one!)
FSH: 5.3 mIU/mL (I’m fertile, yay!…Well, sort of.)

So as you can see, low T levels and high E2 levels are normal for someone who has 17b-HSD [type 3] (17 beta-Hydroxysteroid Dehydrogenase Deficiency [Type 3]). I wouldn’t be surprised if my LH levels were high (but actually doesn’t need to be) and if my Androstenedione levels were also high (again, doesn’t actually need to be – especially since I’m experiencing the other signs of 17b-HSD). I’m considering getting my LH and Androstenedione levels checked out during my next blood draw (as well as other important things for TRT like red blood cell count). If my A:T ratio is high (that is, if I have high Andro levels and low T levels), then I definitely have 17b-HSD. But then again, I probably don’t need to do this as all the signs point toward 17b-HSD. But even with that in mind, I do plan on getting genetic testing a bit later in the future to confirm this and to see what type of mutation I have on that gene (out of mere curiosity). Its also possible that I could have low LH levels because it turns out that excess E production in males shuts down LH production which in return shuts down T production (and so you end up with T levels normal for women and castrated males).

As for the FSH levels: these are typically high in 17b-HSD (as well as in 5-ARD [5-alpha Reductase Deficiency] – which is basically 17b-HSD’s sibling since they’re so similar to each other), mostly because of undescended testes. However, they can be normal (and even low), as in my case. This seems to mostly come from people with descended testes (as in my case). Even with normal FSH levels, its very likely that my fertility is compromosied because of low T levels and high E levels. It also seems like its on the lower side of the normal range, and combined with all these other numbers, its pretty clear fertility is compromised.

One more thing about T and E levels in 17b-HSD: T levels don’t need to be low and E levels don’t need to be high. They can actually be normal (for both T and E) or low (in the case of E), while T levels can be high (less common but possible). All this depends on your genetics. All this is why genetic testing is far more reliable than endocrine testing.

Voice: My voice is kinda low (but not deep yet) – its about the equivalent of a Transsexual male 2 months on T. I sound like a teenage boy who’s just starting puberty (because that’s pretty much where I still am right now, lol). Its been this way since my voice first cracked on New Year’s Day 2002 (I was 11 and a few months away from turning 12).

Facial/body hair: I actually have hair in my upper lip, chin, sides, chest, and abdomen (I already have hair in my legs and arms). However, the hairs are so light and thin (or in other words, scanty) that you can only see them with a magnifying glass (that is, if you have bad eyesight) and in a well-lit room – or outside during the day, if the weather permits (I can actually see my hairs with just a mirror).

Body build: I currently weigh anywhere from 88-91ibs. As you can see, I’m pretty underweight for a 5’4″, 23 year old man, who should be weighing anywhere from 108-140ibs. I’ve been struggling with my weight since I was a teen. I didn’t know why back then but now I do – it turns out low T makes weight management difficult. Additionally, my chest size is 31-31 1/2 inches, bicep size is 8 inches, neck size is 12 1/2-13 1/2 inches, and I have body fat percentage of anywhere from 11-14% (my six pack almost shows!) and a body mass index of 14-16 inches. All of this makes me look and feel like a kid (or even wrose, a girl), and I’m not very happy about it. I’m fit, but my muscles aren’t huge yet (I want to achieve that ripped look).

Physical performance: Yeah, that has gone down drastically. My recovery is a total joke (I take a very long time to recover) and my stamina has declined. My muscles are still pretty fatigued from my previous workout (which was a very long time ago). I have had to really cut down on working out/exercising because of that (plus, I don’t really have the energy to do that stuff anyways). I really miss working out. I really can’t wait to get over this stupid low T and go back to doing that. Before my regular workouts were interrupted, I could do 50-100 pushups, 36-40 pullups and chinups, 45-75 second planks, and 50-100 squats – all in 1 cycle, as well as and 8-15 sec sprints in a few minutes (I’m following the Primal Blueprint Fitness regime). I could also lift up to 50 ibs (I do compounded workouts).

Energy: Don’t even get me started on this one. My energy levels are a joke. I’m constantly fatigued. I can barely get through a whole day. I even have had to reduce the hours I work, and take more days off as a result, since I don’t have much energy to do stuff. Its affecting other parts of my daily life too – I probably don’t need to say anymore, as I’ve pretty much already said it all. Basically, survival is my only goal. Everything else is a chore. I just wish I didn’t have to feel this way. But you know who I really feel bad for? The people around me. I feel like I’m neglecting them.

Mood: I have a case of “Dr. Jekyll/Mr. Hyde Syndrome”. My moods fluctuate pretty often. I get irritable pretty easily. I have no patience for people who get on my nerves. I feel like like a walking zombie (which is a common statement made by men with low T). Additonally, I don’t seem to be really “grasping” life – I feel like like its just going by…I literally just “exist”, I’m not really “living” life (this is also a common statement made by men with low T). Additonally, my anxiety levels seem to have gone up (which has always been this way), but there’s nothing that’s really incapacitating (in other words, I don’t have an anxiety disorder). Apparently, this is common with men who have not just low T but also high E – there’s evidence that high E levels cause anxiety in men.

Cognition: I feel like low T is affecting my cognition quite a bit, especially my concentration and verbal performance (which has always been a weak spot for me because I’m a visual-spatial thinker/learner). I actually seem to have this thing called “anomic aphasia” (or “word selection anomia”, or “dysnomia”), which is apparently a side effect of low T (but particularly very low T levels, such as mine). From what I’ve read, I should see improvement on that in about 2-3 months after starting T, and that includes my overall cognitive dysfunction. My performance at work has taken a huge hit – I can barely concentrate on my work and it takes a long time to get me into the “flow” of things. All this stuff isn’t good, as my career is intellectually demanding – so I gotta have a sharp mind and low T isn’t giving me that. Additionally, my memory is lagging a bit as well. Overall, this stuff is a huge pain in the ass.

Libido/Potency: My libido is inconsistent (or in other words, its a mess). I only think about sex occassionally (its not as frequent as it should be), and I have pretty long refractory periods – during these times, I have a hard time getting an erection (which I heard is common during these periods…more on that here). My morning/nocturnal erections are infrequent as well. Same goes for spontaneous erections. Not only that but, they don’t seem as firm as they should be. In addition, my semen volume is very low and at times I have a sort of watery semen – at least at times (these two things are very common with 17b-HSD and 5-ARD – and of course, Low T).

Appetite: I don’t think my appetite is as big as it should be. This is probably because of my lack of energy, which also means that I’m not moving around very often. All this translates into reduced need for caloric energy, resulting in a lowered appetite. I’ve done research on this, and I’ve also seen it in myself – whenever I more around more, I get more hungry and so forth. Low T seems to be messing up my metabolism (which isn’t surprising). The good news is that I will get higher energy levels, and as a result, a bigger appetite when I go on HRT.

Other: Some other stuff I think I should mention is that my bone structure is that of a male – which means that I have wide shoulders and narrow hips, my fat distribution is that of a male (I have no fat around my hips, buttocks, and tights), and I get hot flushes (common with very low T and high E levels) – which seem to be more noticeable in warmer weather. Not only that, but I also have a severe case of Gynecomastia (which is typical for people with 17b-HSD to have). Additonally, I seem to have a bit of imnsonia, which I’ve been dealing with for a long time.

As you can see, low T is making me pretty miserable. This is not a great way to live life and I definitely do not want to live like this anymore – I’m so freaking tired of it. I shouldn’t have to go through this, especially since I’m in my 20s. I just hope I’m on T soon (and I’ll be taking an Aromatase Inhibitor as well, so I hope to be on that soon too). I’m going to got visit the Endocrinologist for the very first time (I got a new insurance provider) on Tuesday (5/13) and hopefully I walk out of that endo’s office with a prescription in my hand by the end of the visit on that morning. I just want to get this over with so I can go back to living my life. Being sick sucks and you’re just not really alive if you’re low T. I want this out of my life now!