Low Test - Advice?

Bigger Stronger Leaner Over 35 Lifter
21

[quote]LittleStrick wrote:
I may be an ananomly, but I didn’t start having T problems until I lost weight. I was going along, seemingly fine. I dropped 110# and within 2 - 3 months I was visiting the doc and getting bloodwork.
While I have no doubt that excessive weight can have a negative impact on T levels, rapid/significant weight loss CAN also affect you. Not necessarily your T levels, but that is one manner in which I was affected.
[/quote]

It’s strange, I was chugging along fine until a few months ago and then I feel like I started falling apart. I strained my left pectoral and took a few weeks off. It’s fine now, but as of two or three months ago, my right shoulder has become increasingly painful. It’s strange. I haven’t really done anything different, diet wise (still on the same diet - calorie wise, although I increased the cals by a few hundred - that I have been for the last year).

I also cut back on caffeine because I realized that I was drinking it in order to mask fatigue and I was having to drink ever increasing amounts. I’d wake up, have two cups of coffee, followed by a rockstar energy drink. About two hours later I’d have 1 or 2 more cups and then I’d have some expresso two more times during the day.

22

[quote]Pangloss wrote:

[quote]LittleStrick wrote:
I may be an ananomly, but I didn’t start having T problems until I lost weight. I was going along, seemingly fine. I dropped 110# and within 2 - 3 months I was visiting the doc and getting bloodwork.
While I have no doubt that excessive weight can have a negative impact on T levels, rapid/significant weight loss CAN also affect you. Not necessarily your T levels, but that is one manner in which I was affected.
[/quote]

It’s strange, I was chugging along fine until a few months ago and then I feel like I started falling apart. I strained my left pectoral and took a few weeks off. It’s fine now, but as of two or three months ago, my right shoulder has become increasingly painful. It’s strange. I haven’t really done anything different, diet wise (still on the same diet - calorie wise, although I increased the cals by a few hundred - that I have been for the last year).

I also cut back on caffeine because I realized that I was drinking it in order to mask fatigue and I was having to drink ever increasing amounts. I’d wake up, have two cups of coffee, followed by a rockstar energy drink. About two hours later I’d have 1 or 2 more cups and then I’d have some expresso two more times during the day. [/quote]

I guess I should also note that the weight loss resulted in my thyroid hormone getting out of whack. So I was having a double whammy. And both were, again, after losing the weight.

I had lost significant weight (67#) years earlier, though, and had no issues.

My wife took the more modern route (and necessary for her) and had gastric bypass (RNY). It set her on an emotional roller coaster for 2 years and counting.

I have no idea if it is just the body trying to adjust to the reduced body mass, if, perhaps, there are hormones stored in fat cells that are only released when those cells are tapped or a combination of the two. But, for some, significant loss can definitely have a negative impact.

23

Is it a temporary thing or will the levels remain depressed indefinitely?

24

[quote]Pangloss wrote:
Is it a temporary thing or will the levels remain depressed indefinitely?[/quote]

I have no idea. I went to the doc in April of last year and found out my T was at 346. I got on Alpha Male, started eating to up good fat and lower SHBG, and got on L-dex (less than a ml/week). It only moved up to 382, by the end of Summer, beginning of Fall. By the beginning of the year, it was up to 426, which, coincidentally is when my thyroid numbers got back in line. So I guess it was improving. But my LH and FSH were low normal. So my body didn’t seem to be trying to produce more.

25

I’m still waiting on the test results - but in the mean time, I was thinking that maybe I should go to a different doctor. I just get these bad vibes from my urologist.

How do I find some expert doctor’s in my area (northern VA)?

26

Some test results:

TESTOSTERONE, TOTAL 2.77
TESTOSTERONE FREE % 2.64 1.1-2.8 %
TESTOSTERONE FREE 73.1 35-155 PG/ML

FSH 3.0 1.6-11.0 MIU/ML
LH 3.2 1.7-8.6 MIU/ML
PROLACTIN 6.78 0.47-18.0 NG/ML

I’m not sure how to read these…

27

What is the reference range for the Total T?

28

I sent my doctor an email asking for clarification. I don’t know what the range was.

It looks like I’m square in the middle for the free testosterone % (2.64 Range: 1.1-2.8%) and free testosterone (73.1 Range: 35-155 PG/ML). Is that good?

29

%FT is good, which implies lower SHBG, which implies that E2 is lower range. No serum E2 labwork?

FT has different ranges for different labs. So one cannot compare easily. Mid range for range shown, but the ranges are often age adjusted. So are you mid range against youthful levels? The lab appears to be this:
http://www.questdiagnostics.com/hcp/intguide/EndoMetab/EndoManual_AtoZ_PDFs/Testosterone_LCMSMS.pdf

The range is for ages 18–>69. What a crock of shit that is; lumping the results of young men and old men. The objectives of HRT are the restoration of youthful levels. So there is no age adjustment of ranges as they lump young and old together at Quest.

30

The email from my doctor was that the test results were within normal levels, which doesn’t tell me anything.

I think the first testosterone number is the same range as before (1.75-7.81 Ng/mL), but I can’t tell for certain.

I read online that you take that number and multiply it by 100 to determine the dL, so my number would be 277 now. Which I think is low still.

I asked the doc to explain the numbers and an RN responded to my email with the numbers are within normal range. That makes me uneasy.

Does anyone know of a knowledgeable Dr. to go to in NoVa? I’m currently with Kaiser (health plan).

31

[quote]KSman wrote:
%FT is good, which implies lower SHBG, which implies that E2 is lower range. No serum E2 labwork?

FT has different ranges for different labs. So one cannot compare easily. Mid range for range shown, but the ranges are often age adjusted. So are you mid range against youthful levels? The lab appears to be this:
http://www.questdiagnostics.com/hcp/intguide/EndoMetab/EndoManual_AtoZ_PDFs/Testosterone_LCMSMS.pdf

The range is for ages 18–>69. What a crock of shit that is; lumping the results of young men and old men. The objectives of HRT are the restoration of youthful levels. So there is no age adjustment of ranges as they lump young and old together at Quest.[/quote]

What is SHBG?

32

Nova where?

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Northern Virginia, in fairfax, specifically.

34

I sent the urologist’s RN another email asking if my results were normal for a 31 year old male. She responded that “The testosterone results falls within the normal range for adult men.”

35

Are there any scholarly journals that indicate that low testosterone (200-350) is a significant health concern? My primary care physician is siding with the urologist saying that 2.77 is ‘normal’.

Urgh…

36

[quote]Pangloss wrote:
… so my number would be 277 now. Which I think is low still.
[/quote]

It’s abnormally low.

37

In my first visit to my doctor, he said “I don’t like seeing anyone under 400.”

38

[quote]Pangloss wrote:
Are there any scholarly journals that indicate that low testosterone (200-350) is a significant health concern?

Urgh…[/quote]

Yes.

39

[quote]Pangloss wrote:
I sent the urologist’s RN another email asking if my results were normal for a 31 year old male. She responded that “The testosterone results falls within the normal range for adult men.”[/quote]

And COMPETENT doctors don’t just go by lab values. They go by symptoms. I don’t feel like myself if my value is under 600, and my doctor respects this. That’s why I’m regularly kept at 700 to 1000.

40

I think I’m screwed. My Primary Physician has sided with the urologist - saying that he said my levels were ‘normal’. I have a test again in two months and during that time I’m going to take it easier on the cardio and perhaps eat a few hundred more calories on the chance that maybe I’ve been overtraining.

I don’t know what I’m going to do if it comes back low still, since it seems both my doctors now think it’s no problem EVEN THOUGH my primary physician put in a perscription for testosterone after my first blood results (I kind of freaked out and then she referred me to this urologist).

I’m trying to educate myself in this matter though. I think I need to figure out a compentent doctor in northern virginia. I’m just not entirely sure how to do so.