Penile fracture, low test, and hypothyroidism

[nysportsman89]

In 2007, when I was 18, I suffered a penile fracture (blunt trauma to an erect penis). I was masturbating and being too rigorous and I heard a popping sound along with intense pain and bruising. I was so embarrassed about the circumstances of what my family and friends would think if they found out so I didn't go to the doctor or hospital and was hoping it would heal by itself. 

I was so foolish not to because I realize (now) it's a medical emergency. When it happened, there was a little blood in my urine if I remember correctly, I know it wasn't continuous blood in the urine so I don't think I did any major damage to my urethra.  Certain details I don't remember because it was so terrible and I just wanted it to go away. I was in a lot of pain for a week or two after especially in my back. After it happened I had intense burning in my back. It was a sharp burning pain. I think it must have been either my kidneys or adrenals that were affected because of some problems I have now which I'll get to later. I was also tired all the time, feeling like I needed more sleep in order to function.

After a few months, I still had pain and I finally told my parents and went to a urologist. He did an exam and didn't think anything was abnormal but did say I have Peyronie's disease which I knew I had before the penile fracture. He referred me to an endocrinologist who did tests, I think it was a blood test..(I'm gunna call and check now that I think about it) but I remember him saying it was "normal" which at the time I believed. So my problems continued and I've seen many urologists since then that said they didn't see anything wrong and it healed on it's own. Two different ones did a penile ultrasound and said I had normal numbers for blood flow.

After seeing many urologists, one said yea there's definitely scar tissue and said I should go to a university hospital since they try different methods of treatment. My insurance didn't cover these at the time but now a few years later they do so at the end of last year I went and they did a penile ultrasound and determined I had slight scar tissue but everything else seemed normal. They also did a blood test for testosterone and prolactin which the dr. said were in "normal range".

I know this is a lot to read, so I still have more to post about but I didn't want way too much all at once. 

[nysportsman89]

So throughout the past few years I noticed I wasn't getting angry at anything, ever. Not even if my favorite sports teams lost or other things that used to bother me. I've had a feeling of indifference. It took me this long to figure out my testosterone must be low. Around a year ago one of the urologists I saw gave me a blood test and said I have hypogonadotropic hypogonadism. At the time I was about to go on a vacation and when I came back I was feeling hopeless like it doesn't matter what I do so I didn't really look into it. He had prescribed Clomid but I was afraid of the side effects and didn't use it.

Finally late last year I was thinking about what this dr. said again and researched it and read about the effects of low testosterone and it brought me here. I'm pretty sure I also have hypothyroidism, my hands are always cold along with a few other symptoms.

So now I went back to the endocrinologist who I saw back in 2007, looking to get a new blood test to check my total and free testosterone, free t4, free t3, follicle stimulating hormone, luteinizing hormone, estradiol, and shbg. I'll post the results when I get them in a few weeks. I have the results from a few other blood tests I had from the past couple of years but I'll post those tomorrow, it's getting late here.

[PeakT]

Sorry to hear about all the struggles.  Of course, I think you are very wise to get all the numbers pulled again.  You really don't want to ignore low testosterone (or thyroid) depending on the level as it can increase your risk for many nasty medical conditions as you probably know from reading on my site.

Hang in there and realize that almost everything can be healed if you work at it and are diligent...

[nysportsman89]

I should mention I have depression, I've had it before my injury. Although, it got really bad around a year after the injury for a number of reasons and I had a ton of stress which lasted for a long time. So I wasn't sure if that caused less production of testosterone or the injury itself did it or a combo.

I'm under the impression right now that my problems are either from my hypothalamus or pituitary (I plan on getting an mri to check both) plus my thyroid. Some other things about my health:
I'm tall and skinny but after the injury, I started getting stomach fat and also I don't get that much exercise like I should. My energy level is bad, I feel like I need a lot of sleep to function. Also my vitamin D level is low but I'm taking a supplement for it.

[nysportsman89]

I should get my latest test results next week but I have some old ones from the past few years. Oh and my hdl cholesterol is too low and I think it's because of the other problems I'm having..

04/02/2010 time collected 12:25 pm  at Labcorp

Total Cholesterol: 142 mg/dL   range 100 - 199

Trigs:  87 mg/dL          range 0 - 149

HDL Cholesterol: 42 mg/dL   range >39  although it says for a reduced risk factor for coronary heart disease to have >59 mg/dL

LDL Cholesterol:  83 mg/dL     range  0 - 99

TSH:  2.76 uIU/mL         range 0.450 - 4.500

Creatinine 1.02 mg/dL     range 0.76 - 1.27




11/30/2010  time collected 10:05 am at Quest Diagnostics

Creatinine 0.7 mg/dL        range 0.5 - 1.5

TSH, sensitive 2.77 mIU/mL         range 0.35 - 5.50

PSA total  0.38 ng/mL                range 0.00 - 4.00

FSH 0.5 mIU/mL                        range 1.5 - 12.4

Luteinizing hormone  2.3 mIU/mL        range 1.7 - 8.6

Prolactin 10.2 ng/mL                 range 4.6 - 21.4

Estradiol 26 pg/mL                    range 7.6 - 42.6

Vitamin D, 25-hydroxy  24.2 ng/mL       range 25 - 80

Total T 313 ng/dL          range 250 - 1100

Free T 79.5 pg/mL          range 35.0 - 155.0




02/18/2011 time collected 11:58 am at Labcorp

Total T 241 ng/dL         range 249 - 836

Free T 6.1 pg/mL          range 9.3 - 26.5

Vitamin D, 25-hydroxy   26.8 ng/mL     range 32.0 - 100.0


11/03/2011 time collected 8:28 am at Labcorp

Total T  480 ng/dL            range 348 - 1197

Prolactin 8.2 ng/mL           range 4.0 - 15.2



02/24/2012 time collected 11:13 am at Labcorp

Creatinine  0.91 mg/dL         range 0.76 - 1.27

Total Cholesterol 135 mg/dL   range 100 - 199

Trigs 109 mg/dL      range 0 - 149

HDL Cholesterol 39 mg/dL      range >39   again it said it's recommended to have >59

LDL Cholesterol 74 mg/dL       range 0 - 99

DHEA 194 ng/dL        range 31 - 701

Total T 289 ng/dL       range 348 - 1197

TSH 3.89 uIU/mL        range 0.450 - 4.500

Vitamin D 25-hydroxy  35.2 ng/mL      range 30.0 - 100.0

T4  5.6 ug/dL           range 4.5 - 12.0

T3  132 ng/dL          range 71 - 180

Progesterone 0.6 ng/mL     range 0.2 - 1.4

Estrogens, total  64 pg/mL   range 40 - 115

[PeakT]

Sorry to be so slow to respond.  Crazy day yesterday!

Okay, so let's start with the fact that you have very low testosterone. Both your free and your total are very ugly.  Can you tell me what your doctors said?

Anything below about 350 or 375 can really cause guys major issues.  Nasty things can start happening:  mood starts going down and eventually depression starts setting in.  Insulin starts rising.  You head towards borderline anemia.  And, to make matters worse, the inside of your penis begins to atrophy leading to various degrees of venous leakage.  Libido plummets and erectile dysfunction sets in.  And that really helps out the ol' depression, eh? 

All of this is what I document in my book Low Testosterone by the Numbers and I've chatted with literally hundreds of guys with the same story.

Then you go to the doc and he/she says, "You're fine.  What's your problem?  You in the normal range.  It's got to be all in your head."  So you limp around in

Also, how much Vitamin D are you taking?  How many IU?

I can't advise you whether or not to go on HRT, but all of the following are known to help significantly with depression and mood:

1) HRT (testosterone therapy)
2) Fish oil (omega-3's)
3) Exercise
4) Vitamin D

If you get these under control, you might very well be a completely new person.  It's very hard to function when your testosterone hits a certain level.  Been there!

[nysportsman89]

Well for 2 of those testosterone tests where I had 313 and 241, it was from one doctor who had prescribed me Clomid, but I never tried it because I didn't know much about it and was afraid of the side effects. I never got to talk to him after those 2 tests though, when I went the last time to his office the nurse saw me instead because of an emergency or something and I never went back again. At that time, I never looked into low t really so I didn't think it was the problem but now I wish I did.

I'm thinking I should still try Clomid as one option maybe. I don't know if I'll go back to that doctor since it's far from where I live.

The test that said I had 480, that doctor said I was "normal". That reading was at 8:30 in the morning where it usually peaks so I knew when he said that, it didn't make sense.

My most recent drawing at 289, the nurse called with the results and said it was low and to get it checked in 6 months.

The thing I'm concerned about too is my thyroid messing up my recovery, I'm not sure if I get my t levels back with hcg therapy if that will last and also fix my thyroid or my thyroid won't allow it to last. Also my adrenals, if I screwed them up with the penile fracture, like I said when it happened there was sharp burning pain in that area of my back but idk if it was my adrenals or kidney. Maybe it was just an infection that cleared up and hopefully not major damage. I need to get all of the endocrine glands working together at the same time.

I don't want to use HRT. I first wanna try hcg therapy. I'm hoping to restart normal production. Maybe clomid would do it if hcg therapy doesn't. I take 1,000 IU of vitamin D.

You're right about atrophy in the penis. It's been terrible. The tissue has hardened in some areas. First on my left side of the shaft, and when that happened it caused pain and it's affected nerves because nerves up and down the left side of my body started feeling pain and loss of some sensation. It's hard to describe but along my arm, leg, hand, foot, abdomen, lower back, chest and up to my neck it feels like nerves contracting or shrinking in length and would get tighter and contract after masturbating. It has to be from the nerves in my penis. It's starting to happen on the right side of my penis and consequently the right side of my body. The left side happened less than a year ago and it seemed more drawn out with the contraction and now the right side seems to contract faster.

Maybe it's not the nerve itself that hardened in the penis and instead the muscles and they are touching the nerve, idk. I hope I can reverse that and soften those hard areas once I get my test levels back up. I hope it's not permanent damage.

[PeakT]

Quick comment:  I should have been more careful in my wording.  The studies show that venous leakage can be largely recovered from (generally) once testosterone is restored.  So I didn't to sound overly ominous.  It's almost like watching a plant wither in a drought and then watering it again and it reblooms.  So, overall, it's usually not a true "scar tissue" situation that can't be restored.

The feedback system you are talking about there doesn't surprise me.  Low T atrophies the nerves and connective tissues within the penis.  However, there are interesting examples of nervous system feedback, such as neurocardiology, that are reminscent of what you are talking about there.

[nysportsman89]

you mean some of this might be related to my brain and heart which is affecting the nervous system?

When I masturbate now, the nerve pain seems to get worse and cause more nerve contracting throughout my body and cause more hardening in areas of my penis. So I'm thinking I shouldn't have any sexual stimulation until my test levels go back up.

I'm supposed to get my latest results Tuesday and hopefully my Dr. agrees to try hcg or clomid or something.

Do my numbers seem to indicate insulin resistance? I do have some belly fat.

[PeakT]

I'm not sure what would cause what you are talking about.  Venous leakage is simply subtle changes in the  internals of the penis.  You can't really "feel" it.  You basically just notice it when during any rompin' and rollin' because you either have trouble achieving or maintaining an erection.

What you're describing reminds me of a guy who felt he had some nerve damage from a mole removal at the base of his penis.  But, no, I don't know of a mechanism as to how all of that would happen.  Good question for a knowledgeable doc who is willing take a few minutes to talk to you.

Btw, there are many great things about your numbers.  Congrats on them. 

There is really no great way to test for insulin resistance unless you are a researcher. For a normal "Joe" like you and me, it's a little tougher.  Normally you look for symptoms of Metabolic Syndrome and sometimes you can get a clue from a fasting glucose test.

But the best way is to test by dropping any excess weight, increase your exercise (without overtraining) and go to low glycemic load meals.  If this makes a dramatic difference in how you feel and the belly fat starts melting, then you've got your answer.

[nysportsman89]

from my 2/24/12 blood test I had glucose done while fasting. From researching, they call it fbg for fasting blood glucose but on my results it's labeled glucose serum but it must be the same thing. mine was:

Glucose, serum  89 mg/dL       range 65-99


I was wondering, how bad did your t levels get?

[spiderman]

Hi there...I'm the guy Peak T is referring to that had the potential nerve damage...check my posts..

A few points

1) If you had depression before the injury chances are your T will have been dropping like a stone anyway. After the injury the combo of the two will have put you down to the lowest of the low.
I had a similar experience after my trauma but was unaware of what was up as I had no knowledge at the time of T levels, depression etc...

2) IMO at your age the chances of getting your T to reasonable levels without some external help are slight, so Clomid might be a good start. You should be way up near the 700 mark at least and no supps will get you there.
I have struggled and was extremely low but over the last few years but was brought back to life with this site advice, and experimenting using different supps and vits etc...still improving as I go

3)Your thyroid can be sorted with medication. My friend had hypo, tired all the time etc but is fine now but on medication for life.....no effect on T levels.
Depression makes you tired anyaway so you might not have a problem. Your body wants to shut down and heal itself automatically if it has issues...(I used to fall asleep at the drop of a hat after going to comfortable surroundings during my peak anxiety times a few years ago)

 4) Feed your penis fresh blood...arginine and citrulline help massively, fresh blood heals damaged tissues...but I would restrain from the mastubation bit and allow healing...just get him hard for the blood flow instead.
The good news is you have had an ultrasound and bloodfow is normal. When you start to heal the internal tissues and get your T up again you should feel so much better..

5) More good news...The fact you have nerve pain indicates that they are ok..so may just be the scar tissue to be fixed...and it can

Stick in ..you can only get better..we have all been there... good luck

[PeakT]

Great comments. 

As usual, I'll add my cautions though:  citrulline and arginine are very powerful for many middle-aged men, but some men may be at risk, so read this:

http://www.peaktestosterone.com/Herpes_Arginine

[nysportsman89]

Hi there...I'm the guy Peak T is referring to that had the potential nerve damage...check my posts..

A few points

1) If you had depression before the injury chances are your T will have been dropping like a stone anyway. After the injury the combo of the two will have put you down to the lowest of the low.
I had a similar experience after my trauma but was unaware of what was up as I had no knowledge at the time of T levels, depression etc...

2) IMO at your age the chances of getting your T to reasonable levels without some external help are slight, so Clomid might be a good start. You should be way up near the 700 mark at least and no supps will get you there.
I have struggled and was extremely low but over the last few years but was brought back to life with this site advice, and experimenting using different supps and vits etc...still improving as I go

3)Your thyroid can be sorted with medication. My friend had hypo, tired all the time etc but is fine now but on medication for life.....no effect on T levels.
Depression makes you tired anyaway so you might not have a problem. Your body wants to shut down and heal itself automatically if it has issues...(I used to fall asleep at the drop of a hat after going to comfortable surroundings during my peak anxiety times a few years ago)

 4) Feed your penis fresh blood...arginine and citrulline help massively, fresh blood heals damaged tissues...but I would restrain from the mastubation bit and allow healing...just get him hard for the blood flow instead.
The good news is you have had an ultrasound and bloodfow is normal. When you start to heal the internal tissues and get your T up again you should feel so much better..

5) More good news...The fact you have nerve pain indicates that they are ok..so may just be the scar tissue to be fixed...and it can

Stick in ..you can only get better..we have all been there... good luck

When I was depressed before the injury, I didn't notice any drop. My libido seemed fine and wasn't having erection problems. The ultrasounds I had were a few years ago when I was still able to get erections kinda okay still so the blood flow now is probably not as well as it was then even. I should mention I'm 23.

The trauma you mention, is this from a mole removal or did you also have an injury to your penis?

Do you happen to know the medicine your friend used for hypothyroidism?

I agree I will need some external help to get my numbers up. Did you use any hrt/hcg/clomid or just supps and vits?

[spiderman]

Hi again...No injury just the small op that affected me...
Not sure if nerve was pinched or slight tissue damage at the time...

My T levels were taken about a year and a half down the line at a time where I couldn't have been any lower and came back about 350...I am convinced that they are up round the 450- 500 mark now as I don't have most of the symptoms of low T any more.

Don't know the medicine but it is standard issue for people with hypothyroidism. They trial you to see how much is going to be the correct dosage as the levels of hypothyroidism vary.

I just used supps and vits. Lots of experimenting like most of us on here and cycling the supps..but as it turns out the vits and aminos for me seem to be far more effective than most of the supps other than a couple of exceptions. I would be inclined to take optimum amounts along with what you can on top of any outside therapy....careful with the aminos though.

Recommend you get another ultrasound to as it sounds like you have more tissue problems now and they could be identified....For info and just to give you hope ..my man was cold and limp when flaccid at one stage but he is now warm and full and bigger again ..its the blood flow thing for sure.