had a follow up visit with my Endo today to discuss if I should take another blood test to see if SHBG levels would go down. She advised against another test because she's seen too many ppl get into this loop of testing and re testing, especially now that there is no difficulty now with ED. However she changed her tune immediately when I presented her my April 5th T and free T levels (for some reason I didn't have these with me on my first visit to her on May 6th and I forgot to mention to her that I had them back at home). Well, when I showed her that my free T was low, she immediately said that is usually one sign of hypogonadism. She then went to re-examine the T and free T results from my May 6th blood test and realized (!) the free T was relatively low compared to the total T (the latter shooting way up from my April 5th blood test). Again, a sign of hypogonadism. I could actually see the light bulb go on in her brain, making a connection
Herewith are her notes from today:
"The patient is interested in learning whether he has experienced an adverse drug effect from prior use of Propecia. He probably is not will to rechallenge himself with Propecia, but might interpret an improvement of hormone levels as suggestive of a drug effect. A lingering effect after drug interruption would be likely to occur, if hormonal effects upon SHBG are observed, so that normalization might require some weeks. A reasonable hypothesis might be that high estrogen levels in the past could have driven the elevation of SHBG, such that, for a given testosterone level, the free testosterone would be low. However, areas of silence or uncertainty in the medical literature exist, such that we do not have evidence from controlled trials to support this interpretation as an expected consequence of treatment with Propecia. At the request of the patient, and to be assured as to whether he does or does not have abnormal endogenous estrogen production (which would require a search for cause), now that he has been off of Propecia since April 7, 2011, we are ordering: FSH, LH, estradiol, estrone, testosterone, fee testosterone, and SHBG. Endogenous estrogen overproduction could signify a medical illness or tumor. Therefore, the tests are medically indicated."
