Penile fracture, low test, and hypothyroidism

[nysportsman89]

I went to the endocrinologist today and got my blood results back. Most of my numbers came back within the "normal range". Only thing that came back below the range was my fsh so he ordered another test for it but I'm not going back to him. It's a good thing I know about websites like this and that doctors aren't always experts and sometimes are way off.

I also got my numbers from some tests I had not long after the penile fracture in 2007.

5/18/2007 time collected 10:22 am at Quest Diagnostics
(this was around a month and a half after the penile fracture)

Total T  331 ng/dL         range at the time was 241 - 827


6/19/2007 time collected 3:46 pm at LabCorp

Free T4  1.05 ng/dL        range 0.92 - 1.53

Total T  236 ng/dL          range 241 - 827

Free T  9.5 pg/mL           no range given lol

LH  1.4 mIU/mL             range 0.5 - 5.3

TSH 3.033 uIU/mL         range 0.370 - 6.000

Prolactin 7.1 ng/mL       range 2.1 - 17.7


So these 2 tests were both within a few months after my injury and to me sound like the secondary hypogonadism already developed, I didn't think my test levels were that low already but now that I think about it I was very tired and sleepy a lot and my energy was pretty bad. Yet my erections were still not that bad that year and continued to be decent until late 2010 when they started getting weaker. 2008 was the year when I really went under a lot of stress for months and months so that stress wasn't the first to cause those kind of numbers. It's confusing that I still had decent libido and erections (although I did notice they weren't as good at they used to be) even though my test levels were that low. My thyroid was better then than it is now so maybe that has a lot to do with it.


So here are my latest results:

3/29/12 time collected 3:08 pm at LabCorp

Total T  377 ng/dL        range 348 - 1197

Free T  14.89 ng/dL      range 5.00 - 21.00

Free T %  3.95 %         range 1.50 - 4.20

LH  1.9 mIU/mL           range 1.7 - 8.6

FSH  0.4 mIU/mL         range 1.5 - 12.4

Free T4  1.23 ng/dL      range 0.82 - 1.77

Free T3  3.6 pg/mL       range 2.0 - 4.4

Estradiol  22.7 pg/mL    range 7.6 - 42.6

SHBG   29.8 nmol/L      range 16.5 - 55.9


I planned on this dr. not helping me lol so I already had another endocrinologist appt with a new one set up in a couple weeks. If he doesn't help me I'll probably go back to the urologist who had prescribed me the clomid and see if he'll try hcg or knows another dr. closer to me who will do the same treatment.

Is my estradiol too high and should my shbg be lower for my t levels to benefit?

I don't know if I was having a good day or my condition improved a little because I thought at 3 pm my t levels would definitely be below the range. Makes me wonder how high it was at 8 am that day. I figured that around late morning my t levels would be in the 300's not the afternoon. Hopefully it's a sign of improvement.

[PeakT]

Two comments:

--You estradiol looks good.  You wouldn't want it much lower if that's what you're asking.  Your T/E ratio isn't too good, but again you don't really want to lower your E too much more.  Read this article by LEF:

http://www.lef.org/magazine/mag2010/may2010_Why-Estrogen-Balance-is-Critical-to-Aging-Men_01.htm

NOTE:  They're trying to sell chrysin imo, which has the side effect quite often of slowing down the thyroid, so take that with a grain of salt.

--Yes, your T levels are still lowish.  One of the issues the good docs look at is:  are you still experiencing classic low T symptoms?  The upper 300's and lower 400's are very hard on some guys.  Still others just fine there with no symptoms whatsoever.  So it's very individual.

[nysportsman89]

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.

thanks. what vits, supps, and aminos are working for you? Also did your pinched nerve or tissue damage go away after getting your T levels up?

Yea, I'm going to look into another ultrasound. Although from my last ultrasound, they detected slight scar tissue (not sure if that was actual scar tissue from the injury or atrophy of nerves/tissues) but it was after I already had some atrophy with the hardening feeling and nerve pain on the left side of the shaft.

It's a difficult thing to describe. I know this much, after it happened on the left side of the shaft it caused pain along the left side of my body and now it's happening on the right side of the shaft and also the right side of my body. So whatever is happening to my penis it's causing these problems to the rest of my body.

It has caused tightness in my arms, neck and lower back on each side now. When I touch the areas, they feel like a rope that's getting tighter. I'm not sure if those are muscles or ligaments or tendons or nerves.

I'm starting to suspect that maybe some of my problems are made worse by mercury I'm exposed to. I have one dental mercury filling. From researching, I believe it's very bad to have these and I'm looking to get it removed.

[spiderman]

To be honest I havent had my T levels checked again but slowly felt I was getting better.
I get a twinge occasionally in the area but I think the tissue repaired itself over time..

As mentioned before you really have to check out and see what works for you (and I think we all change our routine on here) but recently for me...

Aminos- arginine and citrulline also been checking out acetyl l cartinine.
Vits...C, D and multis along with Fish oil...also Coq10..Vit D is the biggy here
Supps/herbs..the most natural and tried and tested ones...Maca, Muira, Ginko, Ginseng..

Been checking out testofen which seems to work...and cut out the sugar!

Don't look too hard into things that might not be related like the filling as you can drive yourself mad looking for reasons..

I tend to stick to Vits and aminos at the moment with the occasional herb as I think you can overload...

I think your body given the correct nutrients heals..it may take time but it happens...the most important thing i see for youself is to get checked out properly at the hospital as its causing nerve problems with the rest of your body which aint good...so you really need proper treatment before you do anything else.

All the best

[PeakT]

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.

Why don't you post a thread on this.  Sounds like an interesting topic that might help some guys out?

[nysportsman89]

Two comments:

--You estradiol looks good.  You wouldn't want it much lower if that's what you're asking.  Your T/E ratio isn't too good, but again you don't really want to lower your E too much more.  Read this article by LEF:

http://www.lef.org/magazine/mag2010/may2010_Why-Estrogen-Balance-is-Critical-to-Aging-Men_01.htm

NOTE:  They're trying to sell chrysin imo, which has the side effect quite often of slowing down the thyroid, so take that with a grain of salt.

--Yes, your T levels are still lowish.  One of the issues the good docs look at is:  are you still experiencing classic low T symptoms?  The upper 300's and lower 400's are very hard on some guys.  Still others just fine there with no symptoms whatsoever.  So it's very individual.

Yea I'm still experiencing symptoms. What numbers do I use to determine my T/E ratio? Total T and Estradiol?

Is my SHBG good or is it too high? I think my Free T should be a little higher along with obviously my Total T.

Also do you think my DHEA should be higher? From my blood test 2/24/12:

DHEA 194 ng/dL        range 31 - 701

Thanks for all the advice PeakT

[PeakT]

Well, I would not sweat calculating your T/E ratio.  Here's some basic info about it though:

http://www.peaktestosterone.com/Testosterone_Estrogen_Ratio

The bottom line, though, for middle-aged and above males is that we just need to get our estradiol in a good range - not too high and not too low - and maximize our T.  Imo men do best with testosterone between 500-700 based on emails that I receive.  However, there is considerable variability with that and, as I've mentioned, some men are just great in the low 400's without apparent symptoms or health consequences.

So here's the bottom line imo:

1) You want to get your T to the point where you are symptom free.  You must look at things like weight gain and mental fog as well.
2)  Again, you want your estradiol in a reasonable range - not too high or low.
3)  You want your free T between 1.5-2.5%, ideally 2%.  If your testosterone is lowish and your free T is 1.5%, that could be an issue.
4)  Make sure your thyroid is okay.

Imo if you follow the above three rules, you don't need to directly worry about SHBG.  Now it's true that SHBG is a factor in the above, but it's quite variable and the above three have been studied more.  In addition, if you correct the above three, all the rest will generally take care of itself.

If you can get yourself in these ranges, along with a good diet, exercise and maybe a few of the important supplements, you are going to dramatically improve your quality of life. 

You don't want to be just surviving - you want to be thriving...

[nysportsman89]

Is DHEA an important factor? So it's better to have 3.95% free T at least for now considering I have a low total T.

I heard of a blood test for bioavailable T. Is this much different than free T?

[PeakT]

Well, it's probably not good to be deficient and, of course, you are on the lowish side.  However, DHEA research is very interesting and quite a contrast with testosterone.  Whereas testosterone therapy has produced strong, noticeable and provable benefits in the research, DHEA has been much more questionable. 

In the case of DHEA, it really hasn't done as well as anticipated.  The results have been rather lackluster overall:

http://longevity.about.com/od/researchandmedicine/a/DHEA.htm

Talk to your doc, though - I'm not a researcher!  For example, they tied low levels of DHEA to many conditions.  However, what you always have to do is test to see if giving the molecule actually helps with what you think it will and that has not been too successful to date anyway.

Also, there was a big controversy that it might cause prostate cancer.  However, most of what I have read is that the opposite is most likely true, i.e. that DHEA actually protects against prostate (and many other kinds of) cancer. 

Here's a couple of int'g articles on the prostate cancer issue:

http://www.lef.org/magazine/mag2004/mar2004_cover_dhea_02.htm

http://www.vrp.com/hormone-support/dhea-dehydroepiandrosterone-is-dhea-contraindicated-in-men-with-benign-prostatic-hypertrophy-bph-or-prostate-cancer

I have read that testosterone therapy will lower DHEA somewhat and that some docs will even give supplemental DHEA because of it.  Creams are preferred I believe.

Some of the anti-aging docs also give some DHEA to help improve libido, mood and so on.  But, again, it has not proven to be the panacea that everyone thought 15 years ago...

[nysportsman89]

Yea I think DHEA is important for normal test levels. Is bioavailable t more important to measure than free t?

[PeakT]

Yea I think DHEA is important for normal test levels. Is bioavailable t more important to measure than free t?

Bioavailable testosterone is actually the ideal but from what I have heard is not commercially available for the regular Joe like you and me at this time.

[nysportsman89]

oh ok. So I went a few weeks ago to the neurologist and I asked him about my latest brain mri which was in Sept. and he said the hypothalamus and pituitary looked fine, no tumors or anything.

I think my pituitary is working correctly because my TSH is on the high end of the normal range (which sounds like my thyroid isn't quite right) but my hypothalamus must not be working correctly since my LH and FSH are low. It means not enough GnRH is being produced. From all the chronic stress I've dealt with, the excess cortisol is probably what caused the GnRH production to slow. The question is what can boost GnRH?