Very Low Testosterone But Without Loss of Libido?

[Frosty]

I've been reading through the articles here as well as the threads on the forum and haven't really found what I need yet so thought I should ask.

A little background: About a year and a half ago, I started getting turned away when trying to donate blood because my diastolic BP (the bottom number) was > 100. I also noticed that my energy levels dropped considerably. I was 49 years old at the time.

I figured that it was because a few pounds had crept on so I tried losing some weight. I never really had trouble losing weight in the past (keeping it off was the problem) but this time it was a real struggle. I would lose around 10 pounds and then it would just stop. That 10 pounds wasn't enough to reverse the symptoms I was having.

As of this month, I finally admitted defeat and went to my doctor. Instead of losing over that time, I had slowly been putting more weight on, despite ongoing efforts to lose weight. I am 5'11" and about 220 lbs, so about 50 lbs overweight now. Thyroid problems run in my family so I thought maybe mine was crapping out and causing the problems.

I talked to my doctor and he ordered up some tests. He decided to throw the total testosterone test on there at the last moment but I didn't think it was that because I didn't really have an issue with libido or ED.

When the tests came back, my TSH was out of range high and my T4 was low normal. I suspect Hashimoto's since I am Celiac and seem prone to autoimmune issues but he didn't order the antibodies test to know for sure. The shocking thing though was my Total T came in at 144 ng/dL, less than half the bottom of the normal range (291 - 739).

When I started reading here and other places about people with low t, it seems that all of them have low libido and/or ED, and that was with readings higher than mine. I don't have that. Libido is high enough to be a pest to my wife, I get morning wood 3-4 times a week and erections are fine. I mean, it's not like I'm 18 anymore with respect to the sex drive and orgasms take a bit longer than they used to but all in all, everything seemed okay in that department.   

So, is it possible to be normal at that low or is it pointing to a different issue that is showing as low t? The doctor gave me a prescription for Androgel but it's $100 a month and that is a bit steep (I got a kid in college and another that will be next fall; gotta conserve where I can). I also have a low dose levo prescription for the hypothyroid.

I feel that I am in a bit of a Catch-22 scenario with the weight. All of this would probably improve if I could lose the weight but it's all actively working against losing weight. The crushing fatigue that has developed doesn't help either.

Any help or insight would be appreciated.

[PeakT]

Welcome to the board.

Here are a few quick comments:

--Doing well at 144, eh?  Okay, that's a new one!  I have seen someone in here in the 200's with totally normal sexual function.  I think what may be going on is that you low SHBG - you don't know until you pull the number of course - and that this effectively give you more free testosterone.  Regardless, I can't explain how well you are doing with low of testosterone!

--You should pull your estradiol with an appropriate test.  It is very possible you are low and experiencing bone loss.  Don't panic, but it's definitely something to check with T that low imo.

--I don't know how overweight you are, but your low testosterone could potentially be due to the extra pounds if you are 50+ pounds overweight:

http://www.peaktestosterone.com/testosterone_weight_loss

--Also, if you are cutting calories right now, that can bump up your TSH and lower your testosterone quite significantly.

[Frosty]

Thanks for the quick reply.

I see my doctor again March 2 and am going to ask for a fuller panel of tests. I am debating whether to start the Androgel now or wait until I get a new set of tests.

I definitely wasn't cutting calories before the tests, thanks to the holiday season. I am trying to lose weight now though and it is sloooow.

I think that sleep apnea may be at the root of these problems. I've always snored but my wife tells me it's worse now and I stop breathing and then gasp pretty frequently. I was going to do a sleep study last April but there was a snafu with my insurance. It is straightened out now so hope I can get a sleep study and then treated soon.

[VinnAY]

Me personally, I wouldn't start on Testosterone so long as you're happy with your sexual function. I agree the need for more tests but it doesn't sound like you have a problem other than some stubborn weight and BP. I'd concentrate on those though its a common low T symptom, stubborn weight.
I kind of look at hormone replacement as a symptom issue vs the number and you're not complaining of but one symptom.

[Regulus]

I don't fully understand how this all works, but I can tell you that for almost all of my adult life (I'm 46 now) I had many symptoms of low T.   Really bad inability to concentrate, bad anxiety and depression, etc.  Could not put on muscle mass no matter how hard I tried.

But, until relatively recent to my diagnosis, I had no problem with sexual function.  I did not have super-high libido, but still was well within normal, and had no ED at all.   Didn't have morning wood, ever, but never had a problem when needed.   I eventually started to have some ED and lost libido, which led to my diagnosis.   But ... no real problems despite the fact that I am certain that I was low.

I am certain those other symptoms were caused by low T, because they all went away once I started TRT, and have not returned.   And, when I first started and was still building up to a full dose, I had some T reads in the high 200's to low 300's, and had no difficulty with any of those symptoms, so I must have been lower than that. 

I cannot explain why I did not have the sexual issues until the very end, or why I did not have them for most of my low T time.   All I can say is that I don't think testosterone is the only thing involved, and that how everything else plays into it is not well understood.   So, while it sounds like you are at an unusual extreme on this, I don't think it is at all implausible that you could have very low T and not have sexual symptoms.

[PeakT]

Thanks for the quick reply.

I see my doctor again March 2 and am going to ask for a fuller panel of tests. I am debating whether to start the Androgel now or wait until I get a new set of tests.

I definitely wasn't cutting calories before the tests, thanks to the holiday season. I am trying to lose weight now though and it is sloooow.

I think that sleep apnea may be at the root of these problems. I've always snored but my wife tells me it's worse now and I stop breathing and then gasp pretty frequently. I was going to do a sleep study last April but there was a snafu with my insurance. It is straightened out now so hope I can get a sleep study and then treated soon.

Sure and what Vit D, zinc, etc.  Check out these:

http://www.peaktestosterone.com/tests_before_hrt

And hypothyroidism can also lead to low testosterone.  So I think you have a lot of checking to do.

Again, get that estradiol checked.  Since you're overweight, that might not be an issue, but I think it's important to check.

[Frosty]

Thanks for all the replies.

I don't fully understand how this all works, but I can tell you that for almost all of my adult life (I'm 46 now) I had many symptoms of low T.   Really bad inability to concentrate, bad anxiety and depression, etc.  Could not put on muscle mass no matter how hard I tried.

But, until relatively recent to my diagnosis, I had no problem with sexual function.  I did not have super-high libido, but still was well within normal, and had no ED at all.   Didn't have morning wood, ever, but never had a problem when needed.   I eventually started to have some ED and lost libido, which led to my diagnosis.   But ... no real problems despite the fact that I am certain that I was low.

This is my worry if I don't treat it - that I'll seem to be fine and then hit a wall.

Sure and what Vit D, zinc, etc.  Check out these:

http://www.peaktestosterone.com/tests_before_hrt

And hypothyroidism can also lead to low testosterone.  So I think you have a lot of checking to do.

Again, get that estradiol checked.  Since you're overweight, that might not be an issue, but I think it's important to check.

I'll request the other tests when I see the Dr next. I did have my Vit D tested and I was really low - 25 ng/mL. When I last had it checked five years ago, it was 98 ng/mL, so I've let it slip badly. I've started Vit D supps so I hope that it will be on the mend.

I've decided to go ahead and try the AndroGel since I already have it but at half dose for now. When I see the doctor March 2 and get the next round of tests, I'll adjust accordingly based on the new results.

[PeakT]

Why half the dose?  The old Androgel, before they increased the concentration to 1.62, used to either do nothing or actually lower testosterone quite often.  However, the new strength did help.  What I'm concerned about is that you'll make things worse potentially.  So, if you do half a dose, I highly encourage you to measure you testosterone soon and make sure you are doing what you think you are doing.

You can test yourself very inexpensively here at one of these:

http://www.peaktestosterone.com/testosterone_labs

By the way, you know straight HRT lowers fertility, right?

[Frosty]

By the way, you know straight HRT lowers fertility, right?

So did my vasectomy 8 years ago.  Fertility isn't really an issue at this point in my life.

I'll stay on top of the testing.

The half dose for now is just to make sure I tolerate it. I have a lot of allergies/sensitivities so have to be careful. I've had bad experiences with topical treatments in the past. So far today, the skin where I applied the AndroGel is a little prickly/itchy but no rashes or anything yet.

[PeakT]

By the way, you know straight HRT lowers fertility, right?

So did my vasectomy 8 years ago.  Fertility isn't really an issue at this point in my life.

I'll stay on top of the testing.

The half dose for now is just to make sure I tolerate it. I have a lot of allergies/sensitivities so have to be careful. I've had bad experiences with topical treatments in the past. So far today, the skin where I applied the AndroGel is a little prickly/itchy but no rashes or anything yet.

Understood.  I believe it is still made from soy, so some of the proteins could be in there theoretically I guess in case you have a soy allergy.