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I would like to find answer to my case ... the story started

 
Bill's Avatar
  • Answered by:Bill
  • LCSW, Consultant, Expert Witness
  • Positive Feedback: 95.4 %
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Customer Question

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I would like to find answer to my case ...
the story started two months ago, I had pain in my right testicle and i had a visit to one Doctor (Urologist) he said the pain is because infection and gave me 3 drugs... he told me that my testicle size is little bit small ... and i asked him why and how and what we can do? He said nothing.
i got very worried about that, i never had any sexual problems before that date i could and i used to have sex with my wife at least 3 times every week during the last 3 years. And i have one daughter 19 months came naturally.
Directly, i had visited another doctor and i told him i want to check my testicles and he did then he said you are normal, then i told him my alarmed note from first doctor, he said we can do ultrasound and confirm it 100% i do agree and i did, the result came back with normal shape and size with 4.01x2.02 (Left) and 4.0x2.31 (right). the case should be closed.
one week later i could not stop thinking of that until i found that my shins and thighs hair are much less than before 3 years, after internet reading i decided to test my testosterone level to make sure everything is normal... i did the first test at 9 PM and the result came back with 191 (normal range 196 - 1000 ) next day morning i visited a third doctor and he said you should do it morning not evening and i had another test with 365 (i did not sleep that night because of worry) doctor said it is normal but i told him this is normal for 80 years old not me (i am 32) he said this is normal and close the case.
i visited another good doctor ... he said we have to do the test morning with relaxed mood and with 8 hours
sleeping to confirm it, after 2 days i tried to be relaxed and i slept well and i have done the test 8:30AM and the result came 531 (254-800) the doctor said it is normal and he asked me to do SA test the result came back with 14.25 M per Mm and 10% A, 20% B and 10% C and 15% D with 30% abnormal he put me on Zinc and L-carniatine for 3 month



The problem started with pain which is gone the day next to first visit and ended up with a huge amount of worries, I am diagnosed with Anxiety 6 years ago and I used to have Health worries but it always gone by test (with 100% normal), this time I have 3 different reading of Testosterone and all of them are not good ( at least as the internet says) and I have low sperm count which one of Low testosterone symptoms, then I have one note from doctor about my testicles, I found that they should be minimum 15 ml (this size is bigger than mine, I have compared with 15ml eye drop)
Now I do not have any sexual problem I have slightly low libido only after my story started and even myself confidence become less. I used to go to gym years ago and still have some muscles. Could be that my testicle suddenly shrunken lately and I will soon get the entire symptom or AM I normal person?
I want to know what the next step get is over my case.
Should I repeat all tests? Or what I have to do now?
i am 32 years old never had any drugs or treatments i am healthy and only suffer from stress and anxiety for the last few years
79.5 kg and 177 Height please advise (sorry for the long story and bad English)
i had also proctaline hermone or something like that (and came back normal)
Is it Health Anxiety?

 

Optional Information:
Person's Gender: Male
Person's Age: 32

Already Tried:
no antis drugs please i never tried and i will never do

Submitted: 290 days and 17 hours ago.
Category: Mental Health
Value: $69
Status: CLOSED
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Expert:  Bill replied 290 days and 16 hours ago.


Bill :

Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I am sorry to hear of your concern about your testosterone level.

Bill :

You are obviously distressed by this and with the tests you have had it appears that you results have been in the "normal range" although the lower end of the complete spectrum. Example: The range of normal being 230 to 780 on a "FASTING" testing and you fall into the 250 range show indicates that you are in the NORMAL range - just not producing as much as you may feel is best.

Bill :

As long as you are within range of normality there is really nothing to have anxiety about although I can understand why this bothers you and other men who have lower levels.

Bill :

I see you are standing by- are you available to chat about this.

Bill :

As I can see you are anxious, and still have concerns about your testicles and the effect that they have on the production of Testosterone and the resulting levels I would suggest for the best piece of mind that you have a Complete Blood work up:

Bill :

Include:

Bill :
  1. Lipid Panel
Bill :
2. Comprehensive Metabolic Panel
Bill :

3. Fasting glucose

Bill :

4.Repeat testesterone

Bill :

5. CBC
6. PSA

Bill :

This should be overseen and ordered by a Medical Specialist in Endocrinology.

Bill :

Endocrinology is concerned with the study of the biosynthesis, storage, chemistry, and physiological function of hormones and with the cells of the endocrine glands and tissues that secrete them.

Bill :

I think that the majority of your concerns are ANXIETY based but there is no harm in having a comprehensive repeat blood work up with and Endocrinologist that can help you find calm with the results of the test..

Bill :

If there is anything wrong the Endocrinologist will make appropriate recommendations and follow your care.

Bill :

Should you have additional questions regarding this, feel free to respond and I will be happy to help.

Bill :

IF YOU DON'T HAVE FOLLOW UP QUESTIONS, I APPRECIATE YOUR POSITIVE RATING SO THAT I RECEIVE CREDIT FOR MY TIME.

Bill :

-THANK YOU-

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Customer replied 290 days and 16 hours ago.

hi Dr and thanks..

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Customer replied 290 days and 16 hours ago.

yes i can chat

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Customer replied 290 days and 16 hours ago.

Comprehensive Metabolic Panel is done too and normal

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Expert:  Bill replied 290 days and 16 hours ago.

ASHRAF- I did not see that you had entered chat- I apologize- Please continue the conversation here if you have additional questions.

Thanks

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Customer replied 290 days and 16 hours ago.

i had visit to one Endocrinology with all above tests
he refused to repeat the T level and said there is no reason to repeat a normal result, i told him i am really concern but he said no need

the problem that i am 24 hours busy searching and thinking of the same problem, my life is stopped i am doing nothing else thinking of normal ranges and medical information i have read tones of articles i got confused even now i could not trust Drs ... every year i had similar problem MRI Blood tests and other expensive tests
this time i could not know if it is the Anxiety or its real problem
that is why i asked you and not Endocrinology

Accepted Answer

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Expert:  Bill replied 290 days and 15 hours ago.

I completely understand and appreciate your follow up information.

I wanted to make sure that you had seen an Endocrinologist as they are the best to rule out medical issues.

Therefore, you are most likely dealing with an anxiety based issue which become a more pronounced problem with what is commonly referred to as Hypochondria:

Hypochondria and Anxiety Disorders:
"Many patients with anxiety disorders suffer from medically unexplained bodily symptoms. Patients are often preoccupied with how their body is functioning and may catastrophically misinterpret normal physical sensations. Anxiety disorders such as generalized anxiety disorder, panic disorder, and even depression, are often associated with hypochondriacal complaints. There is an overall agreement that hypochondria and panic disorder are related, but the exact nature of the relationship remains unclear. Both disorders involve many similarities, including hyper-focus on body sensations and overuse of health services."

"Hypochondria has some overlapping similarities to obsessive-compulsive disorder, most notably obsessive concerns about bodily harm and contamination. "Obsessive rumination" is a prominent symptom for many patients with hypochondriasis, and fears of being infected or contaminated are also prominent with OCD. This raises the question of whether hypochondriasis should be viewed as an OC spectrum disorder, an illness closely related to OCD."

"The difference between hypochondria and OCD, however, is that hypochondriacs fear having a disease while people with OCD fear getting a disease. Even so, both groups have obsessions, compulsions to check, and are not convinced by repeated reassurance."

Source:http://www.brainphysics.com/hypochondriasis.php

Ashraf- This, like most all anxiety related disorders is treatable and usually requires and SSRI Class medication to remove the pre-occupation in addition to some brief Cogntive Behavioral Therapy.

If I were you, I would make and appointment with a Psychiatrist who can assess this and provide appropriate therapeutic intervention. This is something that is not to be embarrassed or shamed about and with treatment you should respond favorably with full recovery from the worries that have taken control of your life.

I would suggest you contact:

Dr Abraham Aju

Villa NoXXXXX
Near Mid Mac Round About
Al-Soudan Area
Doha, QATAR
Telephone: 00974 44365051
website: http://www.drajusclinic.com/Default.aspx

DR. Auj has extensive background in treating anxiety and obsessive thinking disorders.
I am sure he will be able to help you.

Should you have any problems making a connection or getting an appointment let me know and I will he happy to search other resources for you.

In the meantime- I am attaching a link with helpful information from Harvard Medical School related to anxiety disorders and their treatment.

http://helpguide.org/mental/anxiety_self_help.htm

http://helpguide.org/mental/generalized_anxiety_disorder.htm

My Best,
Bill


I appreciate your POSITIVE RATING-

-Thanks-

Expert TypeLCSW, Consultant, Expert Witness
Category: Mental Health
Pos. Feedback: 95.4 %
Accepts: 3641
Answered: 7/7/2012

Experience: 30 years treating individuals, couples, families with mental health and substance abuse prob's

Ask this Expert a Question >
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Customer replied 290 days and 15 hours ago.

Thanks for your Time and clear answers... i will first visit Endocrinologist and if everything with me is fine i will contact Dr.Auj

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Expert:  Bill replied 290 days and 14 hours ago.

Very Good Ashraf-

Always feel free to contact me if I can be of further assistance.

Best Regards, Bill

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Customer replied 288 days and 16 hours ago.

how i could rate your service?

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Expert:  Bill replied 288 days and 15 hours ago.

Ashraf-

You should see a rating screen with 5 choices. Bad-Excellent.


Please remember to ONLY rate my answer when you are 100% satisfied. IF you feel the need to rate "Poor Service" or "Bad Service", please STOP and reply to me via the REPLY TO EXPERT button with the issue you have. I will be happy to continue further and do everything I can to provide you with the service you seek.

Best, Bill

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Expert:  Bill replied 286 days and 14 hours ago.

Hi-
I am a bit confused- You rated poor service- and it always my goal to exceed expectations?

Please explain or if there is anything else I can do to increase your satisfaction.

Best, Bill


 
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