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Author Topic: 29, confused on next course of action.  (Read 3347 times)

Rough

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29, confused on next course of action.
« on: May 10, 2013, 02:54:56 am »
Hey! Going to give as much detail as I can to help anyone who has advice be able to give as much as possible, sorry in advance for the long post. Just don't know what to do at this point of time.

I'm a 29 year old male, about 5'11 ~190 pounds. Definitely got a belly, but work out fairly regularly, and have put on quite a bit of muscle since college. My main issue is simply put, I haven't had sex in a long time. Never get random erections throughout the day. Morning erections are rare. I often feel fatigued throughout the day (although this I a bit more attribute to the desk job and stress of it.) My ex and I broke up years ago, and even then our love life wasn't the best. Had another long time gf before that, but didn't really do much dating besides that. After the last break up, there was a long period of time where I just stayed away from relationships, partly due to other issues that were going on in my life. Dealt with them to a point where they aren't a constant stressor on my mind, and started dating again, even having a few one night stands. It was rare I had success picking up women, but it actually happened from time to time unlike in the past. Unfortunately each time I had no success with erections, which was a huge blow to my mental state, and to the state of the women I was with. That really bummed me out!

Decided to see a therapist for a while, 5-10 sessions or so. It was a great experience, and I really recommend it to anybody who has had any mental issues, even if you don't think they're that serious. It definitely helps clear things up. Anyway, she pointed out some things I didn't realize, and suggested that I get a physical to help put the thought that there was something physically wrong with me at ease. Got a physical (no testosterone test), he said everything came back normal. When I discussed my physical problems he just said it was more along the nerves end, it happens to people, etc.

Things get shitty again in other aspects of life, dealt with them again, and for the past half a year or so have been in a great place. Living situation is great, job is amazing, etc. Decided that maybe what my therapist said was right, it really was a numbers game, and to be much more aggressive and confident in trying to pursue women. This isn't something that I want bothering me for the rest of my life. I did, and it worked. I've had the chance to be intimiate with women more in the past few months than I have my entire life, I notice a lot more attention from the opposite sex just in general day to day comings and goings. I'm not saying this to brag, in fact kind of the opposite, but just to help rule out the fact that I don't see how this can be a mental issue. Feeling that it was for me has basically made it become a mental issue because I've had people blow my problems off so easily! Anyway, despite all this success, the only thing that's changed is that now instead of the problem being how do I get the chance to be alone with a woman, is what do I do once she's there. It's almost like theres a disconnect between my attraction and my body's response, just nothing going on.

Decided to go back to the doctor, was much more explicit and specific about what my physical problems were (I should have done this way, way earlier.) He said that he could see absolutely how that is a huge deal, and ordered more blood work including a testosterone test. Here's the results of those tests that I think are relevant based on my reading so far. (Tests were taken around noon, I realize now that this might affect the results a good bit.)

Testosterone, Adult Male: 364 ng/dL
Sex Hormone Binding Globulin: 18 nmol/L
Testosterone Free, Adult Male: 87 pg/mL
Testosterone, Percentage Free: 2.4%
FOLLICLE-STIMULATING HORMONE: 3.0 mIU/mL
LUTEINIZING HORMONE : 4.43 mIU/mL

In addition I had a COMPREHENSIVE METABOLIC PANEL, URINALYSIS and CBC W/DIFF - everything came back within normal ranges. I'd be happy to specific anything else that would be in those, but I haven't come across any of the terms in there in my readings of the site and it's just a lot of stuff.

The test results came in a few days ago, the doc has a really nice client portal that I can just login to to get all these test results. But since they all came back within normal ranges, he hasn't called me. Basically the question is, what do I do at this point? There are so many complex answers throughout the forum, it's hard for me to tell what the interplay of all the numbers mean. I know that 364 is pretty damn low - but I don't know what that relationship is with all the numbers. And to be honest, even if the doctor was like, ok, here's testosterone injections, I'm not sure that's something I want to do for the rest of my life, the idea of my testicles shrinking and me losing my fertility aren't things that I'm really for. Or maybe I'm being foolish and I'd hugely benefit from it, I don't know, do you have the same side effects from gels / patches?

Either way, it sounds like diet and exercise can be huge helps, whether or not I decide to try and do hormone therapy. My diet definitely isn't the best right now. I've just exercised and ate much better in the past, and I still had the same problem, I'd hate to become a health nut for half a year, lose 20 pounds, and be like, great, the same problem. I'm not sure that's enough of an answer. But, I could try to get more aggressive on this health stuff, and retest in 3 months and see if there's any effect? Or should I just be like, doc, prescribe me ED meds? I've never taken them, I don't know how effective they would be.

I noticed that one of the doctors who's mentioned on the forums is close enough to me that I could go see him, it might be a better idea to have him check me out and see what he thinks of the blood work. I'm just basically at a major crossroads and don't know what I should do, I just know standing by idly isn't an option at this point. I've lost relationships that I've wanted to become something because of this, I just don't feel right on.

This probably seems really depressing and negative, although it does really REALLY suck, everything else in my life is pretty awesome. I have awesome family and friends. I can feel down from time to time but in general I'm pretty damn happy. I have a great job, people think I'm awesome.., it's just this one area of my life that's just stuck. If anyone has been down the same road, or sees similarities that they've been able to get to, or even a simple, hey, your bloodwork shows that blahblahblah, that'd be amazing and awesome. Thanks very much.


Sam

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Re: 29, confused on next course of action.
« Reply #1 on: May 10, 2013, 03:31:33 am »
You mentioned stress alot, so get your cortisol numbers checked also.   You might want to check Thyroid and Iron levels.   Your very young so those numbers could be low, but for a good comparison you really want to have them checked first thing in the morning.

If your adrenals are crapping out on you and and assuming am tests could be a bit higher, you might be able to get your T levels back in shape just through improved health, i.e. weight loss, exercise, diet meditation etc.  Hows your sleep?   You  might consider doing a self evaluation for a varicocele also.  Do you feel a dull sense of pain in your boys?  Get out a ruler and measure your testicles to see if one is smaller than another.

Just remember, it takes committment to get yourself back in shape.  There really are no magic bullets but it is good you are paying attention to what your body is telling you.  It took me until about 40 to realize shit starts breaking down if you dont take care of it.

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Re: 29, confused on next course of action.
« Reply #1 on: May 10, 2013, 03:31:33 am »


PeakT

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Re: 29, confused on next course of action.
« Reply #2 on: May 10, 2013, 05:21:07 am »
Sorry to respond so late and sorry to hear about the problems.

Well, first of all, you are having a lot of classic low testosterone symptoms of course.  And, then, after a few bad bedroom experiences, that just doubles the issues. 

So your underlying question is:  "do I have low testosterone?"

Well, of course, you do and you can see that from this page here:

http://www.peaktestosterone.com/Testosterone_Levels_Male

Furthermore, LabCorp's new range threshold is right around your #, but, unfortunately, many doctors are still using the old levels for hypogonadal which are usually between 260 and 280 ng/dl. 

So, again, you've got the testosterone of an 80 year old and not even a healthy one and so no wonder you are struggling.

Now I have to add a very important comment though:  some men in the 300's do just fine.  They have no idea they even have low testosterone.  Their sex life is okay and libido is decent, etc.  This is why symptoms are so important:  it's very individual and multfactored. 

Still other men are absolutely miserable in the 300's - been there - and going on HRT is life-changing wonderful experience for them.  Again, it very much depends.

Now the question is:  what do you do about it?  Well, I can't really advise you exactly what to do when it comes to HRT and a controlled substance and so on.  But let me explain your options as I see it and what I have seen on this forum:

--You can try to solve this naturally, i.e. with lifestyle changes.  Now, if you lose quite a bit of weight, say 50+ pounds, it is very possible to dramatically increase your testosterone - double or more.  There's no guarantees, but it could happen.  The reason is that if the free estrogen to free testosterone ratio falls low enough, then you can induce a kind of secondary hypogonadism.  Now what if you lose 25 or 30 pounds?  Well, that will give you a nice drop in estradiol and an increase in testosterone but it may be the quantum leap that you might want.  However, there may be other things you can address such as sleep and so on that may help a bit as well.

--You did have the blood draw in the early am, right?

--You can try to boost testosterone directly through HRT.  This is a big subject and so you'll have to ask more questions, but my quick summary is that this would very likely help you if done properly.  (There is lot of mismanaged HRT out there.)  However, you have to realize it will more than likely hammer your fertility and you have a lifetime of expense and time associated with it.  There are potential sides and certain risks also. 

Sam - the poster above - is debating all of this right now, so he's a great source on the pros and cons.  He has tried to cure some of his symptoms by working on his adrenals, fixing a varicocele, etc. and has had some successes along the way. 

I tend to like HRT, because I have seen it make such an incredible difference for many men.  And, so far, the studies look good, but none of us has a crystal ball to definitely say its safe in all men all the time.  There are undoubtedly some bugs to work out and here are some interesting things to think about:

http://www.peaktestosterone.com/Testosterone_Risks

But, that said, you should read anonymous' story and some of these threads for the "miraculous side of HRT" when you get a chance:

 https://www.peaktestosterone.com/forum/index.php?topic=654
 https://www.peaktestosterone.com/forum/index.php?topic=638
 https://www.peaktestosterone.com/forum/index.php?topic=433.0
 https://www.peaktestosterone.com/forum/index.php?topic=416.30
 https://www.peaktestosterone.com/forum/index.php?topic=997.0
 https://www.peaktestosterone.com/forum/index.php?topic=999.0
 https://www.peaktestosterone.com/forum/index.php?topic=1343.0
 https://www.peaktestosterone.com/forum/index.php?topic=638.0
 https://www.peaktestosterone.com/forum/index.php?topic=513.120

Again, there's no guarantees though.  Some guys write in and say:  when am I going to feel anything.  That's pretty rare if it's well done HRT, but it does happen.

--You can try to boost testosterone through non-HRT methods (HCG Monotherapy or Clomid). 

There are a lot of pros and cons around each of these and you really need to let us know what you are thinking and, of course, discuss it with a smart doc to figure out the game plan.

--And, yes, it is possible that none of your issues have anything to do with testosterone.  It's probably not endothelial with a young guy like yourself though.  But any number of things can affect erections, including a lot of bike riding for example, lower back injuries, certain medications, depression, past Propecia usage and so on.  So you have to be thorough as well and look into everything.
« Last Edit: May 10, 2013, 05:23:49 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.

raym

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Re: 29, confused on next course of action.
« Reply #3 on: May 10, 2013, 05:29:55 am »

Either way, it sounds like diet and exercise can be huge helps, whether or not I decide to try and do hormone therapy. My diet definitely isn't the best right now. I've just exercised and ate much better in the past, and I still had the same problem, I'd hate to become a health nut for half a year, lose 20 pounds, and be like, great, the same problem. I'm not sure that's enough of an answer. But, I could try to get more aggressive on this health stuff, and retest in 3 months and see if there's any effect? Or should I just be like, doc, prescribe me ED meds? I've never taken them, I don't know how effective they would be.

Hello,
  Just wanted to comment on the above.  I've got 15 years on you, plus my low t is probably a combination of opiate based plus diet and weight, so our situations are not exactly parallel.  Over the last 4.5 months I've dropped 70 pound via diet and exercise and while I've seen mark able improvements in attitude, stamina and overall health, I still am dealing with the low t, ED and some other stuff.  I still want to lose 25 more pounds or so, but I've made some pretty drastic life changes.

I am not trying to discourage you, but am urging you to find the underlying reason for your health issues.  Yes, I think diet and exercise are incredibly important, but you should continue to pursue all the medical related reasons for your condition.

Ray

Peak Testosterone Forum

Re: 29, confused on next course of action.
« Reply #3 on: May 10, 2013, 05:29:55 am »


PeakT

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Re: 29, confused on next course of action.
« Reply #4 on: May 10, 2013, 06:32:42 am »
Over the last 4.5 months I've dropped 70 pound via diet and exercise ...

Kudos...
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.

Peak Testosterone Forum

Re: 29, confused on next course of action.
« Reply #4 on: May 10, 2013, 06:32:42 am »