Doctors have no idea why...

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James

Member
Thank you Nelson for telling me about this site. Hello everyone.

Here's my story. I'm 42 years old, I've got crazy low testosterone and Doc's can't seem to tell me why.


April 2013 - 342 ng/dl (total)
Aug 2013 - 225 ng/dl (total)
Dec 2013 - 182 ng/dl (total) 30.5 pg/ml (free)


Prolactin 5.4 ng/ml - (range 2.5 - 22.5)
PSA .5 ng/ml (range - Less than 4.1 is good...mine is only .5)
Estradiol 12 pg/ml (range 8 - 43)
FSH 6.8 miu/ml (range 1.5 - 12.4)
LH 2.7 miu/ml (range 1.7 - 8.6)
SHBG 24 nmol/l (range 10 - 50)
DHEA 403 ng/dl (range 61 - 1636...wow, that's quite a "normal" range)
Estrogen Total <50 pg/ml (range, less than 130 is good...according to the Doc)
HIV negative
Negative for Hep A, B & C


Doc did liver and kidney bloodwork and says not only is everything fine, but my liver and kindeys are "very strong."
I don't have a Pituitary tumor.
I was diagnosed cancer 11 months ago. I got it early and it didn't spread. I didn't have chemotherapy, but had 6 weeks of Monday - Friday radiation. My PET Ct and all follow up CAT scans, MRI's and bloodwork say the cancer did not spread and I'm as healthy as can be. I actually feel better today than I did prior to being diagnosed.


Since my health scare, I eat an organic plant based diet and exercise consistently. Overall, I feel good. My primary care physician and urologist have absolutely no clue why my testosterone is so low and continues to drop, as they think the above scores are fine. They say my problem is probably "down low" which I think means my testicles. I had an ultrasound of my testicles and that came back normal. They said I have a very minor varicocele and surgery may only increase my total testosterone score by "100 points at the most."


When I was 13, I developed Gynecomastia, but had it surgically removed and it has not come back.


I seem to only have mild symptoms and generally feel ok for a guy with a testosterone level of 182 ng/dl


Does anyone have any idea why my testosterone level are so low?


Thanks for your help.


Jim in Arizona
 
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Defy Medical TRT clinic doctor

paco

Member
I will throw one idea out there to consider. You mentioned you are eating a plant based diet. Does this mean no or very little whole eggs, meat, fatty fish, or whole dairy? If so, you are likely deficient in your cholesterol intake. Given that cholesterol is the precursor to all steroid hormones including testosterone, this can't help your situation.

Also, have you looked into thyroid function (i.e., to see if you are hypothyroid) and sleep disturbances such as sleep apnea? I understand that these can also be contributing factors.
 
Welcome to our site, James and congrats on the NED.
What type of cancer did you have and have you ever taken a 5&#945;-reductase inhibitors?
 

Gene Devine

Super Moderator
Welcome to the forum James.

Using the "edit" button on your original post, can you add the ranges to the labs you posted?
 

James

Member
I had angiosarcoma. Oncologist, PCP, Radiation Oncologist, surgeon...the all say it's a very aggressive type, yet it didn't spread. I had the lump for several years. I was extremely fortunate to say the least. Looking back, it was a blessing because it was what I needed to really make some healthy changes in my life.

I seem to be a mystery. Much like that experience, Doc's can't explain it and they can't explain the low Testosterone score.

I have not had 5a-reductase inhibitors.
 

James

Member
Thanks Paco. That may have something to do with it, as I literally only eat organic fruits/vegetables and occasionally have some nuts/seeds. Again, I feel pretty good overall, just trying to get an answer as to why my score is so darn low. I wonder if my free is actually high, as a percentage of my total?
 
Based on your LH and FSH it doesn’t appear to be a problem “down below” primary. It looks like the problem might be “upstairs” secondary if anything with the low LH but I wouldn’t come to that conclusion with one lab test. Talk with your physician and see if he is willing try a clomid challenge. This would help determining where the problem might be….
 

Gene Devine

Super Moderator
Why are we dismissing simple age related androgen deficiency?

That may very well be the cause.

You're getting older and the androgen pathway is slowing down...pretty normal to be honest.

Nevertheless, get on a good healthy HRT protocol and get better!
 

James

Member
Thanks guys. What's puzzling is that my total is only 182 ng/dl, yet my free is 30.5 pg/ml? Do you guys think this can be a false test? Seems odd that my total is super low, yet my free seems super high...Doc says my total should be around 500 - 700, and doesn't seem to talk much about free. When I research free, it says, for my age (42), it should be 6.8 - 21.5...mine is 30.5! My free is actually high for a 22 year old kid, yet my total is that of a much older guy. This seems to be supported by Nelson's chart for, "What is a normal blood level of testosterone?"
 

Gene Devine

Super Moderator
Free Testosterone is dependent upon Total Testosterone.

Think of it like this; 3% of 100 is 3 and 3% of 1000 is 30.

Percent Free is relative to your total amount.

So while the percent free looks good it's still very low due to your low total amount.

Make sense?
 
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Jeffrey Becker

New Member
James, steroid hormones (including DHEA) in the body are derived from cholesterol - your DHEA numbers looks good enough (I think - really need ref. ranges) so I doubt there is a lack of prohormones for your testosterone production. However, that's not to say there couldn't be other nutrient issues if you are eating too clean. Vit-D, zinc, Vit-C, healthy fats such as coconut and olive oils, magnesium, and many others have all been shown to be important and/or helpful.
 

James

Member
Gene - I think I got it. You're saying that although 30.5 pg/ml for free appears to be strong, it's really not strong because the total is only 182 ng/dl. That same 30.5 for free would be strong if my total was much higher, because the free must be around 3% of the total to be considered a healthy ratio. Because my 30.5 free is significantly higher than 3% of the total (182)...it's not healthy.
 

Gene Devine

Super Moderator
Gene - I think I got it. You're saying that although 30.5 pg/ml for free appears to be strong, it's really not strong because the total is only 182 ng/dl. That same 30.5 for free would be strong if my total was much higher, because the free must be around 3% of the total to be considered a healthy ratio. Because my 30.5 free is significantly higher than 3% of the total (182)...it's not healthy.


You got it correct!

It's why we need to see both Total AND Free Testosterone...and it's here (among other things) that many Docs miss.
 
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