Low Testosterone Discussion

[CoastWatcher]

Natural.

I am probably going to have to find a new endocrinologist because I am almost certain that when I have my follow-up, she will probably neglect the E2 levels because she said my first test was normal. Can low E2 cause a lack of muscle and more importantly strength? Poor sleep quality? Brain fog, memory problems, cognitive issues?


Edit: I am curious why LH is high.

Wasn't your initial testosterone reading less than half of this most recent one? When was that first blood draw conducted?

 

[Hoss91]

Wasn't your initial testosterone reading less than half of this most recent one? When was that first blood draw conducted?

Blood was drawn at 3PM for the first test, so I suspect that is the reason why the discrepancy exists. Even if levels decrease throughout the day, is it normal for people to have their testosterone decrease to that of a person with hypogonadism?

 

[CoastWatcher]

Blood was drawn at 3PM for the first test, so I suspect that is the reason why the discrepancy exists. Even if levels decrease throughout the day, is it normal for people to have their testosterone decrease to that of a person with hypogonadism?

The attached study indicated that in men in their 30s there was a 25% reduction in testosterone levels over the course of the day. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681273/

 

[Hoss91]

I am 25, not 30. Not much of an age difference anyways. This has been going on my whole life.

So then it is normal for men to go in and out of a state of hypogonadism. I find that is abnormal.

 

[johndoesmith]

I am 25, not 30. Not much of an age difference anyways. This has been going on my whole life.

So then it is normal for men to go in and out of a state of hypogonadism. I find that is abnormal.

I don't think it's normal. Anything that causes symptoms meets the definition of abnormal.

Most studies I've seen on the diurnal variation of healthy men have them above normal even at their lowest so if that answers your question.

Problem is, finding a doctor to treat you with decent levels of total testosterone.

 

[Hoss91]

I don't think it's normal. Anything that causes symptoms meets the definition of abnormal.

Most studies I've seen on the diurnal variation of healthy men have them above normal even at their lowest so if that answers your question.

Problem is, finding a doctor to treat you with decent levels of total testosterone.

Can I conclude that I do not have low testosterone?

1) I need to have that sleep study done. If I have sleep apnea, then all of this will be solved.
2) E2 may describe the cognitive problems, but does not explain why I cannot add muscle or even get stronger. Perhaps it is just who I am, and I will never accept that unfortunately.
3) I should probably go for a bone density scan to determine if the low e2 are causing bone issues.

 

[Hoss91]

Update: Sleep study won't happen until March 3rd, so I will have to delay my follow-up with the endocrinologist.

If my E2 levels are dangerously low, has anyone had successful with E2 treatment? I am assuming the testosterone levels are normal, and not really a cause of anything (except the inability to get bigger and stronger). I don't even know anymore, haha.

 

[johndoesmith]

Update: Sleep study won't happen until March 3rd, so I will have to delay my follow-up with the endocrinologist.

If my E2 levels are dangerously low, has anyone had successful with E2 treatment? I am assuming the testosterone levels are normal, and not really a cause of anything (except the inability to get bigger and stronger). I don't even know anymore, haha.

Okay, so I don't think you have low TESTOSTERONE, but I do think you have low E2. They are similar, but not the same, in their symptoms.

Low E2 will prevent many of the needed lifestyle changes to build muscle, IMO, for example feeling like shit all the time will ruin workouts and overall sleep quality. There is suspicion in the steroid community that crashed E2 prevents muscle gain.

Go for a bone density scan, can't really hurt I imagine!

E2 isn't given to cisgendered males, and might even cause more problems, 1. because of the negative feedback loop thus lowering testosterone and 2. gynecomastia concerns. It'd be too easy for a doctor to be sued if the pt develops gyno.

Really, the only way to raise E2 is to raise testosterone, and your body is trying to do that. The bottleneck appears to be your testes, but the issue there is that testosterone is at a decent level. It'd be tough to get a doctor to treat you with your testosterone levels.

I can be entirely incorrect here, but I truly think you have low E2 symptoms, and that that is your problem.

Dr Saya can you comment on this?

 

[Dr Justin Saya MD]

Okay, so I don't think you have low TESTOSTERONE, but I do think you have low E2. They are similar, but not the same, in their symptoms.

Low E2 will prevent many of the needed lifestyle changes to build muscle, IMO, for example feeling like shit all the time will ruin workouts and overall sleep quality. There is suspicion in the steroid community that crashed E2 prevents muscle gain.

Go for a bone density scan, can't really hurt I imagine!

E2 isn't given to cisgendered males, and might even cause more problems, 1. because of the negative feedback loop thus lowering testosterone and 2. gynecomastia concerns. It'd be too easy for a doctor to be sued if the pt develops gyno.

Really, the only way to raise E2 is to raise testosterone, and your body is trying to do that. The bottleneck appears to be your testes, but the issue there is that testosterone is at a decent level. It'd be tough to get a doctor to treat you with your testosterone levels.

I can be entirely incorrect here, but I truly think you have low E2 symptoms, and that that is your problem.

Dr Saya can you comment on this?

Slammed at the moment fellas, so haven't read entire thread. However, if not already, supplementing to get DHEA sulfate levels up to 400-500 range can offer a boost to estradiol if needed.

 

[CoastWatcher]

Slammed at the moment fellas, so haven't read entire thread. However, if not already, supplementing to get DHEA sulfate levels up to 400-500 range can offer a boost to estradiol if needed.

Of course, here in Canada, a prescription is necessary for DHEA. It would be worth raising this with your doctor.

 

[Hoss91]

Slammed at the moment fellas, so haven't read entire thread. However, if not already, supplementing to get DHEA sulfate levels up to 400-500 range can offer a boost to estradiol if needed.

DHEA sulfate? How do I test my DHEA sulfate? Dr. Saya, what is your opinion on my situation?

@Coastwatcher - I'll probably have to look up your endocrinologist recommendation here in Ottawa as the endocrinologist I saw said my E2 levels (the first blood test) were normal.

Can anyone share experiences with the Dr. Andrew Patterson? http://www.peakmenshealth.com/home. Or any other recommendations for me to look into? (Not that I don't trust you Coastwatcher )

 

[CoastWatcher]

DHEA sulfate? How do I test my DHEA sulfate? Dr. Saya, what is your opinion on my situation?

@Coastwatcher - I'll probably have to look up your endocrinologist recommendation here in Ottawa as the endocrinologist I saw said my E2 levels (the first blood test) were normal.

Can anyone share experiences with the Dr. Andrew Patterson? http://www.peakmenshealth.com/home. Or any other recommendations for me to look into? (Not that I don't trust you Coastwatcher )

You should always gather as many opinions as you can. Unfortunately, Dr. Patterson's not accepting new patients at this point. His practice was overwhelmed by the demand for TRT doctors who knew their stuff. His website explains the situation. You are in Ottawa, right? I'll speak to my doctor and see if she has any ideas. As for testing DHEA, here is the test at LifeLabs. http://tests.lifelabs.com/Chemistry/D/DEHYDROEPIANDROSTERONE-SULFATE.aspx?s=1

 

[Hoss91]

You should always gather as many opinions as you can. Unfortunately, Dr. Patterson's not accepting new patients at this point. His practice was overwhelmed by the demand for TRT doctors who knew their stuff. His website explains the situation. You are in Ottawa, right? I'll speak to my doctor and see if she has any ideas. As for testing DHEA, here is the test at LifeLabs. http://tests.lifelabs.com/Chemistry/D/DEHYDROEPIANDROSTERONE-SULFATE.aspx?s=1

Hey CoastWatcher,

I saw your reply, and forgot to reply to it when I said to myself that I would reply later... oops.

To everyone who still follows this thread:

My follow-up appointment is tomorrow. I will bring up the low E2 and inquire as to why my LH is high, yet testosterone is normal. Well, within the normal range. Is there anything else I should bring up? Should I push to get my thyroid antibodies checked to rule out any thyroid problems?

 

[CoastWatcher]

Hey CoastWatcher,

I saw your reply, and forgot to reply to it when I said to myself that I would reply later... oops.

To everyone who still follows this thread:

My follow-up appointment is tomorrow. I will bring up the low E2 and inquire as to why my LH is high, yet testosterone is normal. Well, within the normal range. Is there anything else I should bring up? Should I push to get my thyroid antibodies checked to rule out any thyroid problems?

It certainly wouldn't hurt to check your thyroid antibodies. You are going to request DHEA-S levels be checked?

 

[Hoss91]

It certainlynwpuodnt hurt,mans makes excellent sense, to check your thyroid antibodies. You are going to request DHEA-S levels be checked?

Yes. I am pretty sure when I brought it up last time, she dismissed the idea.

To inquire:

- E2 levels
- High LH
- DHEA - S
- Thyroid antibodies

 

[CoastWatcher]

Yes. I am pretty sure when I brought it up last time, she dismissed the idea.

To inquire:

- E2 levels
- High LH
- DHEA - S
- Thyroid antibodies

That's a good list. Do I remember that she wanted to hold your estradiol below 60 (on the standard test, in light of the sensitive test's unavailability)?

 

[Hoss91]

That's a good list. Do I remember that she wanted to hold your estradiol below 60 (on the standard test, in light of the sensitive test's unavailability)?

She said that if it is below 60, "we're good".

 

[CoastWatcher]

She said that if it is below 60, "we're good".

That's probably not unreasonable.

 

[Hoss91]

That's probably not unreasonable.

I understood that my E2 was deadly low though?

Edit: I forgot - E2 tests in Canada over estimate the E2 levels. Most recent was 66, so it is probably lower. So I guess that is probably not an issue either. Hmm.

 

[CoastWatcher]

I understood that my E2 was deadly low though?

Edit: I forgot - E2 tests in Canada over estimate the E2 levels. Most recent was 66, so it is probably lower. So I guess that is probably not an issue either. Hmm.

It's always going to be a guessing game, to a certain extent, when one is forced to rely on the standard test. Typically, the standard estradiol test over reports...except when it doesn't. This is where symptom monitoring is so critical. I got the sense from your earlier post on the topic that she moved quickly past your estradiol concerns. At least she was aware that estradiol monitoring is important. Far too many Canadian doctors are clueless on the topic.

It would be nice to see higher estradiol in your situation. Hence, the DHEA question.