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Author Topic: New here  (Read 331 times)

USMC

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New here
« on: May 26, 2022, 12:48:04 pm »
First post! 57 years old with the usual symptoms (no sex drive, ED, and weight gain are primary). Doctor was blaming beta blockers, but finally agreed to a testosterone test x2:

Testosterone - 241 ng/dl
SHBG - 25 nmol/l
Albumin - 3.9
Free Testosterone - 225 pmol/l
Bioavailable Testosterone - 138 ng/dl
LH - 3.6
FSH - 6.8

My doctor has referred me to a urologist which I see next month.

I'm looking forward to reading posts here and learning about my newest condition  :)

Any guesses as to what the urologist is going to do??

« Last Edit: May 26, 2022, 01:24:45 pm by USMC »

Cataceous

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Re: New here
« Reply #1 on: May 27, 2022, 11:33:57 am »
Welcome! Your numbers are suggestive of secondary hypogonadism. It's hard to predict what any given urologist will do, but here are some things he should do: Measure testosterone a second time to confirm it's low. This should be done around 8-10 am. In addition, prolactin and estradiol should be tested. Other possible tests are discussed here. The thyroid hormones are worth checking to ensure there's not concomitant hypothyroidism.

The point of the extra testing, aside from confirming hypogonadism, it to rule out treatable underlying causes. For example, either elevated prolactin or elevated estradiol can cause hypogonadism. If your hypogonadism is idiopathic, i.e. with unknown causes, then you would likely be given the option of testosterone replacement therapy. Typical options include transdermal testosterone and testosterone injections. I would urge you to look into testosterone nasal gel as a first-line treatment. The name brand is Natesto, and Empower Pharmacy also makes a version that is less expensive. Conventional TRT is more likely to cause side effects, especially testicular atrophy and infertility. This is due to the complete suppression of your own testosterone production. The nasal gels have the large advantage of adding on to your own production instead of replacing it. This allows your body to function more like normal than if the whole HPTA feedback system is shut down.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 60, Ht: 5'10", Wt: 154 lbs
Protocol: 3.2 mg TE subQ qd, 2.4 mg TP subQ qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

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Re: New here
« Reply #1 on: May 27, 2022, 11:33:57 am »


USMC

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Re: New here
« Reply #2 on: May 27, 2022, 02:53:17 pm »
Great info, thank you! I see I should have mention I had 2 tests. 1st one was 271, the next a week later was the 241. The 2nd test they tested FSH and LH.. not sure why the doc didnít request prolactin or estriadol (spelling) .. thanks again
« Last Edit: May 27, 2022, 02:57:51 pm by USMC »

ghce

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Re: New here
« Reply #3 on: June 09, 2022, 09:43:12 am »
Seconded as to what Cat has said, possibly a head MRI to check out the pituitary gland though even if they see something not much they can do but it may highlight a reason for them to take more interest.
Prolactin as well as Testosterone are affected by this gland but most doctors seem to neglect the importance of it, a quick google will show some of the bad effects if it too elevated.
Fair to almost certain that its secondary hypogonadism, LH is a good predicter and whilst yours isn't flat lined with those T numbers it should be trying harder to boost your T indicating a feedback loop problem.
Please let us know how you get on.
Age:60, Height 6' 3" weight 100KG
2014 Androderm Patches
2014-2016 Oral Andriol 160mg Daily
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 
Reference Range Adult males  1000-6000 pmol/L

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Re: New here
« Reply #3 on: June 09, 2022, 09:43:12 am »


USMC

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Re: New here
« Reply #4 on: June 09, 2022, 03:32:55 pm »
BTW, is it relevant to the urologist that I did a cycle of steroids 35 years ago? I was in my early 20s in the Marine Corps and at the time it was the thing everyone was doing. As stupid as that sounds, it is what it is... Anyway, like I said, is it relevant?

Great site here, thanks for your time.. and I will certainly update you after my visit.

Cataceous

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Re: New here
« Reply #5 on: June 09, 2022, 03:53:38 pm »
If you returned to normal function after the steroid cycle then it's of little relevance all these years later; it may or may not be a contributor to the current dysfunction, but it doesn't affect anything with respect to treatment.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 60, Ht: 5'10", Wt: 154 lbs
Protocol: 3.2 mg TE subQ qd, 2.4 mg TP subQ qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

USMC

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Re: New here
« Reply #6 on: June 10, 2022, 08:01:22 pm »
Thanks CAT.. that's what I figured. I'll let you guys know how it goes... I'm hoping there's not going to be a bunch of hoops to jump through :)

USMC

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Re: New here
« Reply #7 on: June 24, 2022, 09:18:13 pm »
1st Urology appt. today. NP prescribed me Cialis @ 5mg / day or more before sexual activity. 80mg of testosterone / 40mg twice per week subcutaneously. I am required to have training before testosterone can be prescribed. That appt. is in a month due to their backlog.. getting there!

Cataceous

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Re: New here
« Reply #8 on: June 25, 2022, 06:25:00 pm »
Not a bad starting point for conventional TRT. But I still think testosterone nasal gel is a safer first treatment.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 60, Ht: 5'10", Wt: 154 lbs
Protocol: 3.2 mg TE subQ qd, 2.4 mg TP subQ qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

USMC

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Re: New here
« Reply #9 on: June 27, 2022, 12:28:30 am »
That's not on their list.. they had injections (regular and long term), patches, gels, and pellets. They had other things if I was interested in fertility, which I am not.

Cataceous

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Re: New here
« Reply #10 on: June 27, 2022, 01:45:56 pm »
There are plenty of publications showing the efficacy of Natesto. But many clinics are behind the times, not offering the most modern treatments.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 60, Ht: 5'10", Wt: 154 lbs
Protocol: 3.2 mg TE subQ qd, 2.4 mg TP subQ qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

Peak Testosterone Forum

Re: New here
« Reply #10 on: June 27, 2022, 01:45:56 pm »