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Author Topic: first post, and my levels - Varicocele surgery update - and CLOMID  (Read 60533 times)

PeakT

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Re: first post, and my levels
« Reply #30 on: February 21, 2012, 01:17:25 am »
Well, that's actually very good about the pituitary.  However, the osteo issue is something to take very seriously, especially considering you are 43. 

So two q's for you:

1.  Have you had an estrogen reading?  Imo you don't want that too low or too high. 
2.  Have you had a Vitamin D reading?  Low Vitamin D levels could contribute, although I don't think it would be a root cause, to your low T levels and would also make your bone loss worse.  Look at the study below on seniors and how a relatively low dose of Vitamin D (and Calcium) help with bone mass:

http://www.nejm.org/doi/full/10.1056/NEJM199709043371003

Again, you've got to really take that low T and probably low E seriously.  However, you really need to get an expert involved, especially with the fertility involved.  Many fertility docs are really good at just these kind of issues.  Remember that docs have many tools in their arsenal besides just straight HRT.  Here are a few examples (and these can be used jointly):

1.  HCG. http://jcem.endojournals.org/content/45/6/1211.short
2.  Bromocryptine.  Can't remember if your prolactin levels were somewhat raised, but, if so, this is sometimes used.
3.  Arimidex.  http://www.peaktestosterone.com/How-To-Increase-Testosterone-Naturally See #5.  (Your E is probably already low, so I doubt this would be used solo.)
4.  Clomid.  http://www.peaktestosterone.com/Clomid_Testosterone  (Your E is probably already low, so I doubt this would be used solo.)

Now these can have side effects and there are issues with each.  But these could be used short term while you are trying to conceive.  I can't advise you on that, of course, except to say that you need to find an expert that works with this day in and day out and has built up quite a bit of expertise.
« Last Edit: February 26, 2012, 05:02:53 am by PeakT »
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

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Re: first post, and my levels
« Reply #31 on: February 21, 2012, 01:34:45 pm »
thanks for the thoughts Peak.

I'm not sure if estrogen was a part of my last tests. So you're saying my estrogen level is too low? i thought less estrogen the better.

Does estrogen fall into FSH and LH levels? my FSH level in january was 2.6 on a scale from 1.5-12.4. My LH level was 5.2 on a normal scale of 1.7-8.6.

My vitamin D was fine a couple years ago when i had it checked. It was above mid-range. And since then, i've taken between 1,000 and 2,000iu of D every day. I could have it checked again, but i don't suspect that's any issue.

I'll look further into your research to see what else i can about lower estrogen? i don't suppose i have to worry about my IPA beer then, eh? (ie i have the opposite of too much estrogen, which the hops gives you)

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Re: first post, and my levels
« Reply #31 on: February 21, 2012, 01:34:45 pm »


PeakT

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Re: first post, and my levels
« Reply #32 on: February 21, 2012, 02:16:56 pm »
I didn't mean to imply that you for sure have an estrogen issue, but imo you should get it checked.  Something is causing the bone loss and low T guys very often have bone loss due to the corresponding low T. 

I give a little coverage to this subject here:

http://www.peaktestosterone.com/Do_Men_Need_Estrogen

Btw, this is very common.  About a fifth as many men have osteo as women.  But that's still a very high number!
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

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Re: first post, and my levels
« Reply #33 on: February 24, 2012, 04:39:56 pm »
thanks again Peak. Sorry for what could be a dumb question, but if i have low E, should i *not* eat a ton of broccoli or other known e-blocker things? i'm sort of confused on all this.

i'll be heading to the endo to discuss all this, but of course he'll probably blow off these homeopathic questions...i don't know - i shouldn't say that, he's been pretty aggresive so far, so that's great.

I'm looking at my bone density results now, which came in the mail with greater explanation:

the one region that seems a concern (though as you saw, he sort of blew it off in his email), is the "AP Spine" portion. it was 0.942, and normal level in "young" is -1.4. Age adjusted normals -1.2. Not exactly sure how to read those, but the "classification" is "osteopenic."

hmm. wonder if that's part of the reason i have mild to at times a bit more extreme low back pain? it's mostly an annoyance, but wow i pray it doesn't get worse. My mom has a history of back problems, so it could be hereditary too. It's also the reason i take NSAIDs and such, which i know are not great for T, but what the hell else am i supposed to do? they really help the pain.

When i work out, my back feels great. Guess i should just keep working out more :)
« Last Edit: February 24, 2012, 05:00:24 pm by starry »

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Re: first post, and my levels
« Reply #33 on: February 24, 2012, 04:39:56 pm »


PeakT

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Re: first post, and my levels
« Reply #34 on: February 24, 2012, 06:02:24 pm »
Couple of quick comments:

NSAIDs are incredibly hard on the GI track and many other systems of the body.  If you have to, you have to, but some people think they are without side effects or long term issues and that is simply not the case.  It's always a trade off.

Many natural things lower pain btw and can often help considerably.  And, yes, it's counterintuitve, but usually exercise helps back pain. I also have lower back pain and find that, oddly enough, if I stop lifting it gets much worse. Talk to your doc though - not everyone is the same.

Broccoli isn't really known for raising or lowering E significantly.  What it is known for is shifting "bad estrogen metabolites" to "good estrogen metabolites."  Now, if you are low E, none of that is really terribly relevant.

Again, though, discuss with your doc the fact that if your E is below about 20, you're going to have osteo problems.  I'm sure he knows that, but make sure he has a plan in place that makes sense to you.

Osteopenia is based on your bone reads.  From what I have seen, it's usually given at bone mass levels greater than osteoporosis.  So, in your case, it's most likely kind of analagous to having prediabetes before you have full-fledged diabetes, i.e. the osteopenis, if you are low E, could be a warning of further bone loss in the future.  Again, talk to your doc though and find out if the things that the osteopenia is due to something unrelated and let us know if you have time...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

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Re: first post, and my levels
« Reply #35 on: February 24, 2012, 06:20:54 pm »
Btw, there is some interesting research looking at icariin as a possible bone builder.  Here is just one example:

http://www.cmj.org/periodical/abstractlist.asp?titleid=LW200725502860409988
"Icariine stimulates proliferation and differentiation of human osteoblasts by increasing production of bone morphogenetic protein 2"
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

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Re: first post, and my levels
« Reply #36 on: February 24, 2012, 09:27:05 pm »
Thanks Peak...super helpful.


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Re: first post, and my levels
« Reply #37 on: March 05, 2012, 02:12:30 pm »
i head into the endo tomorrow, but i've been reading more about test supplementation and "family planning," and yes reading more about how injections/gels of test are not good if you're planning to have a kid/trying to have a kid.

skimmed through a book by Dr. Abraham Morgentaler, who really seems to know test. He talks about giving things like Clomiphene Citrate and/or Anastrozole for types like me, who might be thinking of kids now/near future...ie, not giving straight up testosterone.

Peak (or anyone else happening to read this) - any experience or knowledge on these solutions? Based on what you've seen of my results above any questions i should ask my endo about these? (beyond the obvious question to him of "should i take this?")

thanks for any thoughts from anyone.

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Re: first post, and my levels
« Reply #38 on: March 05, 2012, 04:09:45 pm »
I've given a little coverage to this here:

http://www.peaktestosterone.com/Clomid_Testosterone

Not that many docs have experience with these kind of things, so you have to find the right one.  At this point, it's more art than science one might say.  Fertility docs, sports-medicine, anti-aging, some endos - you really just have to ask around to find someone who's got the experience.

Btw, steroid users are usually very knowledgeable on all of this because so many of them have 1) shut off their natural testosterone production accidently, 2) often over-aromatize during cycles and 3) use SERMs to add "additional horsepower".  Most of them are doing permanent, long term damage to themselves, but the best and brightest can be quite knowledgeable at least...
« Last Edit: March 05, 2012, 04:15:56 pm by PeakT »
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

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Re: first post, and my levels
« Reply #39 on: March 06, 2012, 04:23:47 pm »
Thanks Peak....just got back from endo.

He agreed that Clomid would be a good try, given my situation. He's going to refer me to someone who's an expert.

So we'll see how that does. Will be anxious to do a blood test checking my levels in a month or two.

Also said "not overly concerned" on bone density, even though i pressed him on it. I mean, he did say he wouldn't want to see it any lower, but he didn't seem to concerned. Well, i guess that's what the Clomid could do, right? (increase bone density when/if the Clomid raises my test)

Guess i'll check back on on my progress in awhile...

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Re: first post, and my levels
« Reply #40 on: March 06, 2012, 04:34:01 pm »
I believe what he's thinking is that if you can get the T up, then estrogen will follow and that will improve your situation.  But I would definitely follow up with a lot of questions on that.  Go see another doc if he can't answer your q's and, in the meantime, make sure u are getting ample Vit D, Mg and exercise.

fyi:  The book Wheat Belly echoes what quite a few experts are saying, although I don't know that it's proven, that a net acid load will leach out bones and wheat is one of the prime culprits.  Most guys don't have to worry about that too much, but the book is an interesting read anyway.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

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Re: first post, and my levels
« Reply #41 on: March 06, 2012, 05:01:05 pm »
thanks. When he emails me the referral, i will double check that that is what he was thinking (regarding T and E).  i'm unsure of all the questions i should ask.

When you say mg do you mean magnesium? is there alot of that in whey protein? i just do a 20gram scoop a day of "natural whey."

if not, i guess i'll buy a bottle of mag

PeakT

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Re: first post, and my levels
« Reply #42 on: March 06, 2012, 05:08:27 pm »
Yes, magnesium.  Here's a great chart:

http://healthyeatingclub.com/info/books-phds/books/foodfacts/html/data/data5d.html

I would ask him how he is going to monitor and build your bone mass and why he is not concerned with it.  While it's true you don't have full fledged osteoporosis, it seems strange to not make sure on an ongoing basis that you are moving in the right direction. 

Also, don't forget that there is a lot of good evidence that resistance/strength/weight training can increase bone mass in men (at least with adequate androgen/estrogen levels):

http://onlinelibrary.wiley.com/doi/10.1359/jbmr.1997.12.4.656/full
http://www.springerlink.com/content/388648p731u75p4m/
« Last Edit: March 26, 2012, 04:21:15 am by PeakT »
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

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Re: first post, and my levels
« Reply #43 on: March 07, 2012, 10:43:51 pm »
just to add another depressing layer to this, i just did the home SpermCheck Fertility test to test for normal or low sperm count. Provided i did it correctly, which i think i did, it came back "negative" - ie, low. Ouch....The reading means that my sperm count is less than 20 million per millimeter.

I'm a little depressed now...i think that the Clomid that the endo or his referral is going to give me for low test is what they provide for male infirtility as well...

wow...i'm just wondering how much the two issues are related.

my wife gets home in an hour - great news to greet her with :(

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Re: first post, and my levels
« Reply #44 on: March 10, 2012, 04:44:11 am »
ok, real progress today for me....went to Mens Health Boston (yes Peak, where the Dr. Morgentaler, who wrote that book, practices). He's like a rock star i think, and doesnt even take patients. Saw a colleague of his, and he was great.

Unlike the endo, he *was* concerned with my bone density, and immediate did another bone scan on the spot. He also did my blood again, and right away, based on my levels from the endo, said "we need to get that test level up."

Here's the bigger breakthrough: he did something the endo either didn't think to do, or just didn't know about. He had me drop trou. Why didn't that happen before? He immediately found a varicocele on the left side of my testicles.

He said that could very well have something to with my low sperm count, and even part of my low testosterone. So, we are going to talk more about tackling that. He wants my blood results back, and wants a hospital to do a full sperm analysis (he was dumbfounded by my home test - they just hit the market). And March 21, we will plan our full attack.

So:

1.) surgery for varicocele? i would assume

2.) attacking the low test/bone density. He quickly ordered me to take 500 milligram of calcium, and to up my vitamin D intake (already take 2000 iu). For low T, three options - anastozole, which he won't recommend, given the low bone density. Peak, as you said, he believes my E is low so that's not a good option. Next is Clomid, which i think we'll try. Though it doesn't always take care of low T symptoms, even if it raises T. Not sure i get that.  The third was something i can't remember now, but its a THREE TIMES a week injection. Sounds like the most powerful method, but most intrusive.

Finally - quick, decisive, and plan of attack style appointment. I feel better knowing that the varicocele could be the answer. don't feel excited to have surgery on that area, even minor, but what are you gonna do...just want to get it over with.

Ok, just thought i'd update.

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Re: first post, and my levels
« Reply #44 on: March 10, 2012, 04:44:11 am »