PEAK TESTOSTERONE

Why Do We Need to Self-Test?

One of the things that strikes some men as very odd when they first show up at my site and forum is that I am such a strong advocate for self-testing.  The confusion may stem from the fact that they may assume I am encouraging them to be their own doctor, and that is simply not the case.  What I am trying to get everyone to at least consider is testing all the items that your physician should have tested but didn't because a) he/she is being cost conscious, b) he/she is not well-trained in that hormones, nutrition, etc. or c) he/she is not up on the latest research.  Why is this important?  Because not testing can get you hurt or killed in many cases.

Think I'm being dramatic?  I actually believe that I am understating the situation, and I'm going to show you just a few examples from my own life and some of the men on The Peak Testosterone Forum that will help you understand why I believe this is so important:

1.  HomocysteineI have never had homocysteine pulled in my life as far as I know.  This is simply incredible:  elevated homocysteine lowers nitric oxide and can accelerate heart disease, which is mostly related to arterial plaque, something I cover in my page on Erectile Dysfunction and High Homocysteine.  High homocysteine can also indicate one of the debilitating and fairly common SNP's (gene issues) that many men struggle with:  dual homozygous MTHFR.  High homocysteine is also associated with cancer, Alzheimers and many other conditions.  So why would you not pull homocysteine?  This is a $50 test that could save you a lot of needless suffering and potentially keep you around for a few more holidays.

2. C Reactive Protein (CRP).  This is another big gun.  High CRP is associated with heart disease, erectile dysfunction and many cancers and autoimmune diseases.  Yet I have had this pulled one time in my entire adult life!  I would guess that there are 200 studies clearly showing the importance of CRP, and yet it is usually not part of a physical.  This is just nonsensical and should be pulled fairly regularly, especially since it is about $35. 

3. Thyroid Panels.  Did you know that low thyroid function causes symptoms very similar to low testosterone?  And hypothyroidism is just about as common as hypogonadism, and I see it all the time on The Peak Testosterone ForumTo evaluate if you are hypothyroid, along with your symptoms of course, one would need (at a minimum) TSH, free T3, free T4, rT3 and antibodies.  Yet what do the great majority of docs pull still?  TSH and maybe T4 if you're lucky.  This makes absolutely no sense because a) a large percentage of hypothyroid men have a conversion problem from T4 into T3 and b) Hashimoto's is the most common form of hypothyroidism and you need antibodies to properly diagnose it.  Again, I never had a full thyroid panel in spite of having some hypothyroid symptoms off and on.  I have had TSH pulled a few times, which is miserable test by itself, and T4 I think once.  Again, if you don't pull these numbers, ain't no one gonna probably do it!  (You can get a 20-30% boost often in your testosterone if you correct hypothyroidism.  See my page on Testosterone and Thyroid Function.)

4. Low Estradiol Doesn't Matter?  Here is what one of our forum members wrote:

"Hi All - went to a famous endo today and the visit was very disappointing. He felt my T was low but normal and it should not be the cause of my symptoms. He said extradiol is a female hormone and its good that its low." [1]

This is dangerous advice as best.  The poster's signature reveals that his estradiol was tested at below 10 pg/ml!  NOTE:  13.9 pg/ml is the theshhold that I have read where bone loss typically occurs.  This man, if he had taken this endocrinologists advice, would probably have ended up with osteopenia in a couple of years.  By the way to add insult to injury, or injury to insult, this doctor prescribed a bunch of relaxants to him!

The point of this story is the great majority of physicians simply do not realize that estradiol is VERY important to men - just as important as testosterone in terms of sexual function per recent research.  You don't want it too high nor too low - just like with all the other hormones!  So the great majority of you out there will have to pull this number yourself if you want it monitored.  (Be sure to use the appropriate LC-MS/MS test if you do.)

5. LH and FSH Are Females Hormones??  This one made me laugh:  one of our forum member relayed the following story:

"So here's a story about my friend. Ever since I got diagnosed with high prolactin then I had low T he wanted to check his level's out as well. So he finds a random doctor through his insurance. He goes in and tells the doc he wants to do a checkup. He tells the doc my story about having low t and my symptoms and the doctor tells him " You are not your friend." My friend then asks the doc to check his testosterone levels and the doctor says he "doesn't do illegal practices". Since when is getting your testosterone checked an ilegal practice? lol."

So the doctor only runs my friends basic blood work like thyroid and checks for cholesterol. My friend gets his results and he found out he has high triglycerides. So my friend goes back to the doc and finally convinces him to get his testosterone checked out. The doc finally says yes. My friend asks him what about lh and fsh. The doc tells him to not worry about it as those are female hormones. lol True story. " [2]

Rest assured, LH and FSH are NOT female hormones.  In us men LH triggers testosterone production and FSH sperm.  Furthermore, men with low testosterone should have their LH and FSH pulled, because these values can provide clues as to whether the problem is with the testes or in the brain (pituitary or hypothalamus).  Again, great and potentially helpful information is provided at a very reasonable cost.

To this day, I have never had my LH or FSH pulled as far as I know.  I have no idea whether I am primary or secondary. If I had it to over again, I would have pulled those numbers myself, but I just didn't understand things at that time.

CAUTION:  I always recommend men take their numbers to a knowledgeable doc or naturopath.  Take the extra time and maybe pay cash for someone who will be thorough and who understands the latest research. Some men have tremendous knowledge about health and hormones and want to self-treat.  I don't think that's a good itdea:  it's very easy to miss something important or critical and so get someone (good) who does this for a living. 

CONCLUSION:  There are many other hormones that have a solid record in helping some men out:  DHEA and cortisol come to mind.  Think of the horrendous irony that these are not examined when you consider the following facts:

1. Laboratory testing costs for your doctor (and for you) have dramatically dropped in the last 10 years.  You can pull many critical labs now without a doctor's order for less than $25, something I cover in my page on Testosterone Labs.

2. Research is just pouring out of the research labs and universities and we now know much, much more about anti-aging, healthy lifestyles and the health markers that go along with them.

I discussed hormones above, but you also have blood sugar / insulin tests, genetic testing, cardiovascular testing, all of which can literally save your neck if your physician does not pull it.  Remember:  physicians feel that they are only responsible for acute care.  The system simply does not have the money for monitoring and prevention.  That leaves one person to step in:  YOU!