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Mike93082

New Member
Hello everyone! I am a 38 year old married male. Since about 25 years old I have had slow onset of little issues that have become worse and worse. I am wondering if it's low testosterone. I just don't feel like the person I used to be. I used to love taking the boat out on the weekends. I loved doing yard work and other activities. I enjoyed date night with the wife and we had a great sex life. I have next to no sex drive now.

A urologist tested me roughly 6 years ago. My testosterone was roughly 460. He said trt therapy wouldn't benefit me.

Here is the list of meds I take

20mg Ritalin 3 times daily for concentration
20mg celexa daily for depression
Wellbutrin twice daily for depression
10mg Ambien to sleep at night
Generic viagra for sex. I really don't use since I have no drive

I have also been putting on weight for the last two years and don't really know why. The extra weight makes everything even harder. I look at food and the scale jumps. I am also irritable a lot more. I get overwhelmed easily and get agitated. I feel like the character Walter from Jeff Dunham. I also strangely don't feel hunger sensations much anymore. I will eat, but I don't get that feeling like wow! I am hungry for some dinner.

I had my testosterone tested again at the end of November. It was around 9:45 in the morning. My level was 177ngl. I thought that was a bit low. The nurse on the phone said I am normal. Anything over 175 is a normal reading.

I need opinions from people getting treated for low testosterone.
 
Defy Medical TRT clinic doctor

Systemlord

Member
Anything over 175 is a normal reading.
This is untrue, anything under 300 qualifies for TRT according to the endocrine guidelines. Your previous labs showing of 460 doesn't begin to inform anyone of T status, the Free T and SHBG are needed to see where the active portion of testosterone sits.

Some of the medications your currently taking can cause low-T, mainly the Celexa and Ambien. Stopping either of these medicine may or may not see your testosterone recover.

I don't understand how anyone in the medical community could believe 177 is normal when the referance ranges bottom out at 264 ng/dL (264-916 ng/dL) and to top it off the Free T was never measured.

You're dealing with incompetent doctors that don't have a clue how to properly diagnose a testosterone deficiency.
 
Last edited:

Mike93082

New Member
This is untrue, anything under 300 qualifies for TRT according to the endocrine guidelines. Your previous labs showing of 460 doesn't begin to inform anyone of T status, the Free T and SHBG are needed to see where the active portion of testosterone sits.

Some of the medications your currently taking can cause low-T, mainly the Celexa and Ambien. Stopping either of these medicine may or may not see your testosterone recover.

I don't understand how anyone in the medical community could believe 177 is normal when the referance ranges bottom out at 264 ng/dL and to top it off the Free T was never measured.

You're dealing with incompetent doctors that don't have a clue how to properly diagnose a testosterone deficiency.
That is pretty much how I feel.

I am alive. But I feel dead at the same time. I have setup an appointment with a new urologist on Friday. I just have a feeling it will be another one of those. Well you are in the normal range.

I guess getting older just sucks lol
 

Systemlord

Member
That is pretty much how I feel.

I am alive. But I feel dead at the same time. I have setup an appointment with a new urologist on Friday. I just have a feeling it will be another one of those. Well you are in the normal range.

I guess getting older just sucks lol

You might have to seek private care to get TRT because I'm afraid the medical community is way behind on sex hormones therapies. The treatment protocols are out dated and a lot of doctors seem unwilling to improve upon leaving men worse off than pre-treatment.
 

Cataceous

Super Moderator
If your total testosterone is regularly below 200 ng/dL then your free testosterone is almost certainly low too. Unless you're quite lucky, no local doctor is going to be very helpful. Raising your testosterone to normal levels by whatever method—weaning off meds, trying enclomiphene, TRT, etc.—should be a step in the right direction. But don't expect a cure-all. It's a journey that requires much patience; there's a lot of trial and error because there's no formula for getting it perfect the first time.

The simplest thing to do if you're U.S.-based is to check out Defy Medical. They are among the best out there in dealing with this sort of thing.

Sure, getting older sucks, but at least we now have some tools to fight back with.
 

Mike93082

New Member
You might have to seek private care to get TRT because I'm afraid the medical community is way behind on sex hormones therapies. The treatment protocols are out dated and a lot of doctors seem unwilling to improve upon leaving men worse off than pre-treatment.
What roughly is the cost of private?
 
You have no sex drive due to the psychotropic medications and the low range testosterone. Those are quite a few medications. Whoever is prescribing them should have suggested a good therapist and some cognitive behavioral therapy. This is more than likely what’s killing your libido. A PCP or even a psychiatrist should have started there with you rather than all those medications. That’s where you need to start, weaning off some and hopefully all these medications while adding some CBT interventions.

Do not come off these alone, as it is dangerous. Have a psychiatrist help, one that believes in psychotherapy. There is no magic pill for you and throwing testosterone into this mix of psychotropic meds is not the answer. You will need to commit to a program that includes CBT, solid sleep, good diet, and exercise. You’re at an age where you are settling into the habits that can make or break the rest of your life. Do this now and don’t short change yourself or your wife by taking the lazy way out and throwing more meds into the mix. Get off everything and see what your baseline is. Judiciously add meds as a last resort. Meds, and even TRT, should not be the go to strategy.
 

Mike93082

New Member
You have no sex drive due to the psychotropic medications and the low range testosterone. Those are quite a few medications. Whoever is prescribing them should have suggested a good therapist and some cognitive behavioral therapy. This is more than likely what’s killing your libido. A PCP or even a psychiatrist should have started there with you rather than all those medications. That’s where you need to start, weaning off some and hopefully all these medications while adding some CBT interventions.

Do not come off these alone, as it is dangerous. Have a psychiatrist help, one that believes in psychotherapy. There is no magic pill for you and throwing testosterone into this mix of psychotropic meds is not the answer. You will need to commit to a program that includes CBT, solid sleep, good diet, and exercise. You’re at an age where you are settling into the habits that can make or break the rest of your life. Do this now and don’t short change yourself or your wife by taking the lazy way out and throwing more meds into the mix. Get off everything and see what your baseline is. Judiciously add meds as a last resort. Meds, and even TRT, should not be the go to strategy.
This is good advice. But without sounding like a smartass. It's basically cooker cutter type advice.

I would love to get a good night's sleep without meds. I would love to feel better without any meds.

I am just trying to find the root of my problem and to stop masking the symptoms. Talk therapy can help you get something off your chest that is bothering you. But a doctor told me that it really does nothing for someone suffering from a condition of the body. It's like a diabetic trying to talk to their body about blood sugar levels.

I am really hopeful about my appointment on Friday. From everything I have read. Low T causes every symptom o suffer from. And having a level of 177 in the morning is horrible. There are 85 year old men that are higher.
 

rlm55

New Member
"I am just trying to find the root of my problem and to stop masking the symptoms."

That's what the meds are doing. This is the state of our health care system right now. Doctors and pharma are the only ones benefiting in terms of $. I agree with the poster who said to work at getting off the meds as much as possible. Clean up diet and improve lifestyle (exercise, sleep, etc) and then see where you are. Then if you are still feeling poorly do the blood panels to see where you hormones are. Also, I would think an endocrine doc would be better than a urologist but even then they can be "by the numbers" as well.
 

Mike93082

New Member
"I am just trying to find the root of my problem and to stop masking the symptoms."

That's what the meds are doing. This is the state of our health care system right now. Doctors and pharma are the only ones benefiting in terms of $. I agree with the poster who said to work at getting off the meds as much as possible. Clean up diet and improve lifestyle (exercise, sleep, etc) and then see where you are. Then if you are still feeling poorly do the blood panels to see where you hormones are. Also, I would think an endocrine doc would be better than a urologist but even then they can be "by the numbers" as well.
I think you are spot on. It's far more profitable to prescribe multiple meds. Also more profitable to see patients more often and order testing.

I didn't get prescribed this all at once. Just over the years as things get worse. More and more is added. I am just at the point of saying enough is enough, what is the problem? I want to feel like my old self. Diet and exercise is great. But it's not the fix for low testosterone.
 

madman

Super Moderator
"I am just trying to find the root of my problem and to stop masking the symptoms."

That's what the meds are doing. This is the state of our health care system right now. Doctors and pharma are the only ones benefiting in terms of $. I agree with the poster who said to work at getting off the meds as much as possible. Clean up diet and improve lifestyle (exercise, sleep, etc) and then see where you are. Then if you are still feeling poorly do the blood panels to see where you hormones are. Also, I would think an endocrine doc would be better than a urologist but even then they can be "by the numbers" as well.
$$$
 

madman

Super Moderator
Hello everyone! I am a 38 year old married male. Since about 25 years old I have had slow onset of little issues that have become worse and worse. I am wondering if it's low testosterone. I just don't feel like the person I used to be. I used to love taking the boat out on the weekends. I loved doing yard work and other activities. I enjoyed date night with the wife and we had a great sex life. I have next to no sex drive now.
A urologist tested me roughly 6 years ago. My testosterone was roughly 460. He said trt therapy wouldn't benefit me.
Here is the list of meds I take

20mg Ritalin 3 times daily for concentration
20mg celexa daily for depression
Wellbutrin twice daily for depression
10mg Ambien to sleep at night
Generic viagra for sex. I really don't use since I have no drive

I have also been putting on weight for the last two years and don't really know why. The extra weight makes everything even harder.
I look at food and the scale jumps. I am also irritable a lot more. I get overwhelmed easily and get agitated. I feel like the character Walter from Jeff Dunham. I also strangely don't feel hunger sensations much anymore. I will eat, but I don't get that feeling like wow! I am hungry for some dinner.

I had my testosterone tested again at the end of November. It was around 9:45 in the morning. My level was 177ngl. I thought that was a bit low. The nurse on the phone said I am normal. Anything over 175 is a normal reading.

I need opinions from people getting treated for low testosterone.
A urologist tested me roughly 6 years ago. My testosterone was roughly 460. He said trt therapy wouldn't benefit me.

Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Although a TT 460 ng/dL may seem sub-par unfortunately we have no idea what your SHBG is let alone more importantly where your FT level sits.

You would have needed more complete blood work!



Forget 6 years ago and as of now, this is where you are at!

Here is the list of meds I take

20mg Ritalin 3 times daily for concentration
20mg celexa daily for depression
Wellbutrin twice daily for depression
10mg Ambien to sleep at night
Generic viagra for sex. I really don't use since I have no drive

I have also been putting on weight for the last two years and don't really know why. The extra weight makes everything even harder.


*I had my testosterone tested again at the end of November. It was around 9:45 in the morning. My level was 177ngl. I thought that was a bit low. The nurse on the phone said I am normal. Anything over 175 is a normal reading.



All these medications (anti-depressants) you are on can have a negative impact on driving down your testosterone let alone lack of quality sleep and excess weight gain (adipose tissue).

Regardless with a horribly low TT 177 ng/dL it is a given that your FT will be absurdly low.

Again you would need to have a full set of labs done to see the overall picture and even then it would be much more sensible to see where your levels truly sit without being on all the medication but unfortunately it is much easier said than done.

In an ideal situation, we would want to see where your hormone levels sit off of all the medications.

Even then with such horribly low levels, it is doubtful that your T levels would improve drastically and you would most likely fair better seeking out therapy to treat your hypogonadism as having healthy testosterone levels are critical and will have a big impact on energy/mood/libido/erectile function/recovery.

Keep in mind that trt is no cure-all and it is not a given that you will experience a substantial improvement in mood/energy/libido/erectile function as much more is involved such as healthy thyroid/adrenals let alone diet/lifestyle will have a big impact on your overall well-being.


This is what you would want when it comes to blood work!

Screenshot (3164).png



When it comes to testing TT/FT/e2 it is critical to use the most accurate assays.

TT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).

The pre-trt male hormone/wellness panel includes these assays.
 

Vince

Super Moderator
 
This is good advice. But without sounding like a smartass. It's basically cooker cutter type advice.

I would love to get a good night's sleep without meds. I would love to feel better without any meds.

I am just trying to find the root of my problem and to stop masking the symptoms. Talk therapy can help you get something off your chest that is bothering you. But a doctor told me that it really does nothing for someone suffering from a condition of the body. It's like a diabetic trying to talk to their body about blood sugar levels.

I am really hopeful about my appointment on Friday. From everything I have read. Low T causes every symptom o suffer from. And having a level of 177 in the morning is horrible. There are 85 year old men that are higher.
You may think it is cookie cutter advice. Your opinion. I have been a psychotherapist and have worked in mental health and psychiatric hospitals in the Boston area since 1997. You can do what you want, but some one needs to tell you what you don’t want to hear. You want a quick fix, but have you tried anything I suggested? Was it a psychiatrist or your primary care doctor? If it was, he is working out of his scope of practice and threw a pill at you because he is not trained to deal with issues like yours.

CBT is not talk therapy alone. When done right, it has measurable goal. It takes time and effort. At 38, you got the time. The question is whether or not you want to put in the effort. Over 40% of men on SSRIs have low libido. Same with Ritalin and ambien. But, of course, I’m sure your doctor told you all this.
 

gerardo

Member
Hello everyone! I am a 38 year old married male. Since about 25 years old I have had slow onset of little issues that have become worse and worse. I am wondering if it's low testosterone. I just don't feel like the person I used to be. I used to love taking the boat out on the weekends. I loved doing yard work and other activities. I enjoyed date night with the wife and we had a great sex life. I have next to no sex drive now.

A urologist tested me roughly 6 years ago. My testosterone was roughly 460. He said trt therapy wouldn't benefit me.

Here is the list of meds I take

20mg Ritalin 3 times daily for concentration
20mg celexa daily for depression
Wellbutrin twice daily for depression
10mg Ambien to sleep at night
Generic viagra for sex. I really don't use since I have no drive

I have also been putting on weight for the last two years and don't really know why. The extra weight makes everything even harder. I look at food and the scale jumps. I am also irritable a lot more. I get overwhelmed easily and get agitated. I feel like the character Walter from Jeff Dunham. I also strangely don't feel hunger sensations much anymore. I will eat, but I don't get that feeling like wow! I am hungry for some dinner.

I had my testosterone tested again at the end of November. It was around 9:45 in the morning. My level was 177ngl. I thought that was a bit low. The nurse on the phone said I am normal. Anything over 175 is a normal reading.

I need opinions from people getting treated for low testosterone.
I've been through it all. It is not easy to leave all these medications. I'll tell you something. If you have a good and stable financial life and have the courage to overcome yourself, you can and can be sure that you don't find many experts who will really help you. I was afraid and I still have to take all these drugs because I can't stop working where I stress. I do my Trt and I take it slowly and touch life because it is worth it. Good luck and get started on your Trt.
 

Acer97

Member
Hello everyone! I am a 38 year old married male. Since about 25 years old I have had slow onset of little issues that have become worse and worse. I am wondering if it's low testosterone. I just don't feel like the person I used to be. I used to love taking the boat out on the weekends. I loved doing yard work and other activities. I enjoyed date night with the wife and we had a great sex life. I have next to no sex drive now.

A urologist tested me roughly 6 years ago. My testosterone was roughly 460. He said trt therapy wouldn't benefit me.

Here is the list of meds I take

20mg Ritalin 3 times daily for concentration
20mg celexa daily for depression
Wellbutrin twice daily for depression
10mg Ambien to sleep at night
Generic viagra for sex. I really don't use since I have no drive

I have also been putting on weight for the last two years and don't really know why. The extra weight makes everything even harder. I look at food and the scale jumps. I am also irritable a lot more. I get overwhelmed easily and get agitated. I feel like the character Walter from Jeff Dunham. I also strangely don't feel hunger sensations much anymore. I will eat, but I don't get that feeling like wow! I am hungry for some dinner.

I had my testosterone tested again at the end of November. It was around 9:45 in the morning. My level was 177ngl. I thought that was a bit low. The nurse on the phone said I am normal. Anything over 175 is a normal reading.

I need opinions from people getting treated for low testosterone.
177 is extremely hypogonadal anything under 300 is hypogonadism the range keeps lowering. Females have up to 75 test keep that in mind
 

Mike93082

New Member
I've been through it all. It is not easy to leave all these medications. I'll tell you something. If you have a good and stable financial life and have the courage to overcome yourself, you can and can be sure that you don't find many experts who will really help you. I was afraid and I still have to take all these drugs because I can't stop working where I stress. I do my Trt and I take it slowly and touch life because it is worth it. Good luck and get started on your Trt.
I will say this. I am not hooked on anything. I don't have any withdrawals if I miss anything.

I have had the pharmacy run out of ritalin for 4-5 days and 0 withdrawal. The other meds are the same as well... There are times when you just can't get by the pharmacy. Or I have been sick with the flu for days without taking anything.

So I am happy to say I don't have any addiction to them.
 

gerardo

Member
I will say this. I am not hooked on anything. I don't have any withdrawals if I miss anything.

I have had the pharmacy run out of ritalin for 4-5 days and 0 withdrawal. The other meds are the same as well... There are times when you just can't get by the pharmacy. Or I have been sick with the flu for days without taking anything.

So I am happy to say I don't have any addiction to them.
These are medicines that need to be removed gradually and with the help of your doctor. Do not think that you will not have withdrawal because relapses can be worse. There is no use for very little time. The important thing is that you feel good. Supplementation and Trt I think it will help you because your testosterone is low. Also check all of your hormones so you can have a balance. Good luck. U will make it.
 
I will say this. I am not hooked on anything. I don't have any withdrawals if I miss anything.

I have had the pharmacy run out of ritalin for 4-5 days and 0 withdrawal. The other meds are the same as well... There are times when you just can't get by the pharmacy. Or I have been sick with the flu for days without taking anything.

So I am happy to say I don't have any addiction to them.
You need a lot of education and the fact that you weren’t told or were even aware that these meds destroy libido shows that you have not done your homework and blindly followed some guys advice simply because he is a doctor. Not all doctors can treat everything and, as I noted, if the prescriber is not a psychiatrist, or even worse, if you are getting these from multiple prescribers, you are flying blind. Now you are looking for help on an Internet forum. You need experts who are going to be hands on and even be willing to tell you what you don’t want to hear.

TRT is not a guarantee of your libido coming back. Your med regimen is more than likely killing libido and still May event if testosterone levels are good. Also, at 38, body chemistry changes due to biology, lack of activity, and your libido can also be impacted by attraction to your partner.

What’s our lifestyle like? Do you workout regularly and engage in some kind of resistance work to build muscle mass? Weight? Body fat levels? What’s your relationship like with you wife like, especially when it come to sexlife?

Sorry to be so straightforward with you, but if you don’t want honesty and support then this may be the wrong place on the internet to ask for help. Anything other than being straight up with you is, in my opinion, disrespectful to you and I’d rather run the risk of hurting your feelings over giving you useless advice.
 

Mike93082

New Member
I ha
177 is extremely hypogonadal anything under 300 is hypogonadism the range keeps lowering. Females have up to 75 test keep that in mind

You need a lot of education and the fact that you weren’t told or were even aware that these meds destroy libido shows that you have not done your homework and blindly followed some guys advice simply because he is a doctor. Not all doctors can treat everything and, as I noted, if the prescriber is not a psychiatrist, or even worse, if you are getting these from multiple prescribers, you are flying blind. Now you are looking for help on an Internet forum. You need experts who are going to be hands on and even be willing to tell you what you don’t want to hear.

TRT is not a guarantee of your libido coming back. Your med regimen is more than likely killing libido and still May event if testosterone levels are good. Also, at 38, body chemistry changes due to biology, lack of activity, and your libido can also be impacted by attraction to your partner.

What’s our lifestyle like? Do you workout regularly and engage in some kind of resistance work to build muscle mass? Weight? Body fat levels? What’s your relationship like with you wife like, especially when it come to sexlife?

Sorry to be so straightforward with you, but if you don’t want honesty and support then this may be the wrong place on the internet to ask for help. Anything other than being straight up with you is, in my opinion, disrespectful to you and I’d rather run the risk of hurting your feelings over giving you useless advice.
What you are saying is blunt, but that is ok.

It's hard to have a relationship when you are depressed and don't really care about sex at all. Celexa and wellbutrin were prescribed. The wellbutrin actually brought my drive back to normal and maybe a little more than that.

My relationship with my wife is solid. We have been married 13 years and together 16 years. We have a 13 year old daughter who has a good attitude and does well in school. We don't make a lot of money. But at the same time we have no mortgage/rent, no loans/credit cards, no car notes. We have a nice emergency fund and investments So relationship and money are ok.

My weight has been steadily climbing over the last 7-8 years. Years before that, I maintained a good weight without much thought. I am at 270. I look at food and the scale jumps. I don't eat perfect, but I don't eat much. One of the odd symptoms over the last few years is that I don't really feel the hunger sensations. I hear people say what's for supper? I am starving over here...bi might eat a small plate but feel no joy from it. I will even get asked is that all you are going to eat?!??!
 
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