New to forum testosterone help

[Work4life]

43 male 5ft7 181lbs and in generally good physical health. In the last year I have noticed a dramatically decline in energy, mood swings (easily irritated), a non existent libido, and a feeling of brain fog when performing tasks. I decided to see my doctor who did a blood panel work up on me. All were in the normal range including the "reference range" testosterone work ups. My free testosterone was 7.55 within the range of 4.46 to 17.1. And my total testosterone was 302 within the range of 240 to 950.

I did my research to find out that "reference ranges" were samplings based on total of all tests done at that lab and not the broad spectrum charts for average men. In researching those charts it seems I have the levels of an 85 yr old man? I sought out my physician once again who stuck by his decision that said while my tests were low normal they were still normal and would not recommend any testosterone treatments...

...so While living a healthy lifestyle I am now told medically I am normal but with all these symptoms still existing? I know nothing about how to increase testosterone through self medication means..

what if anything can I do?

 

[CoastWatcher]

43 male 5ft7 181lbs and in generally good physical health. In the last year I have noticed a dramatically decline in energy, mood swings (easily irritated), a non existent libido, and a feeling of brain fog when performing tasks. I decided to see my doctor who did a blood panel work up on me. All were in the normal range including the "reference range" testosterone work ups. My free testosterone was 7.55 within the range of 4.46 to 17.1. And my total testosterone was 302 within the range of 240 to 950.

I did my research to find out that "reference ranges" were samplings based on total of all tests done at that lab and not the broad spectrum charts for average men. In researching those charts it seems I have the levels of an 85 yr old man? I sought out my physician once again who stuck by his decision that said while my tests were low normal they were still normal and would not recommend any testosterone treatments...

...so While living a healthy lifestyle I am now told medically I am normal but with all these symptoms still existing? I know nothing about how to increase testosterone through self medication means..

what if anything can I do?

Welcome to Excelmale. You have discovered that "in range" and "normal" are not necessarily the same thing. When it comes to androgens it is almost NEVER the same thing. Can you provide a little more information? What other blood work was performed? Thyroid (TSH, T4,T3, RT3)? SHBG? LH and FSH? Estradiol/Sensitive Test? Those, at a minimum, are critically important for assessing hypogonadism.

What medicines and supplements are you taking? History of opiate or anabolic steroid use? How much sleep do you get every night? Do you have/might you have sleep apnea?

 

[Sean Mosher]

Definitely time for your to call PrimeBody or Defy, both endorsed by this board.
They will take good care of you.

 

[Work4life]

I believe just a basic blood panel with testosterone at my request....don't know how to scan but here is what I got...

glu-neg
ket-neg
sg- >= 1.030
ph- 5.0
blo- neg
nit- neg
leu-neg
pro-neg
cre-300 mg
sodium 136
potassium 3.9
chloride 109
carbon dioxide 23
anion gap 6
blood nitrogen 23 (high)
creatine 0.95
glucose 97
calcium 8.9
tsh 3.07
hemotocrit 46.2%
hemoglobin 15.6 g/dl
mchc 33.8 g/dl
total wbc 6.5
Granulocyetes 3.2
lymphs+monos 3.3
platelets 340
free testosterone 7.55
testosterone total 302

beyond knowing I am not dead I have no idea what that all means.....as for the other questions. I have a regular sleeping schedule 7 to 8 hours a day. I do not, nor been diagnosed with sleep apnea, I have never smoked or drank. I consume moderate caffeine. I have never tried steroids.

i take 10mg ambian to ensure I stay asleep.
i take 200mg co q 10

I have not taken other supplements. No offense to the sponsors of this board, but I have the general stance that most supplements advertised are nothing more then high priced snake oil. I have researched testosterone supplements and have found a multitude of official looking articles and medical journal sites that are simply advertising to sell commissioned products...that being said due to the dangers and risks I am willing to test a natural supplement over shooting myself up in the arm with real testosterone that I don't know how to use

 

[CoastWatcher]

I believe just a basic blood panel with testosterone at my request....don't know how to scan but here is what I got...

glu-neg
ket-neg
sg- >= 1.030
ph- 5.0
blo- neg
nit- neg
leu-neg
pro-neg
cre-300 mg
sodium 136
potassium 3.9
chloride 109
carbon dioxide 23
anion gap 6
blood nitrogen 23 (high)
creatine 0.95
glucose 97
calcium 8.9
tsh 3.07
hemotocrit 46.2%
hemoglobin 15.6 g/dl
mchc 33.8 g/dl
total wbc 6.5
Granulocyetes 3.2
lymphs+monos 3.3
platelets 340
free testosterone 7.55
testosterone total 302

beyond knowing I am not dead I have no idea what that all means.....as for the other questions. I have a regular sleeping schedule 7 to 8 hours a day. I do not, nor been diagnosed with sleep apnea, I have never smoked or drank. I consume moderate caffeine. I have never tried steroids.

i take 10mg ambian to ensure I stay asleep.
i take 200mg co q 10

I have not taken other supplements. No offense to the sponsors of this board, but I have the general stance that most supplements advertised are nothing more then high priced snake oil. I have researched testosterone supplements and have found a multitude of official looking articles and medical journal sites that are simply advertising to sell commissioned products...that being said due to the dangers and risks I am willing to test a natural supplement over shooting myself up in the arm with real testosterone that I don't know how to use

No one here is suggesting you inject testosterone on your own without the supervision of a doctor. Nor are we urging you to run out and purchase hundreds of dollars of supplements in a possibly misplaced hope of correcting a problem that has yet to be diagnosed fully. I don't believe you will find any of our sponsors fall into that category. Excelmale is sponsored by two medical practices, practices that include some of the leading androgen specialists in the United States, a laboratory offering direct testing to men (and women) so they can get some idea of what it is they are dealing with in terms of their health, compounding pharmacies, and authors. No one is hustling snake oil.

As far as your blood work, it is radically incomplete. It would appear you had a CBC, a CMP, and the two testosterone tests. Your testosterone is low, without doubt, and would certainly suggest that TRT might well be called for...but not until additional blood work helps distinguish between primary and secondary hypogonadism - to start.

https://www.excelmale.com/forum/showthread.php?5823-ExcelMale-com-Guide-to-Testosterone-Replacement

This is a good introduction to hypogonadism. The site is loaded with good information that can lead you into a deeper understanding of the issue. Other than telling you all was well, what did your doctor suggest?

 

[Work4life]

Definitely did not try and insult with my prior posts in regards to this site or anyones level of commitments and suggestions. I appreciate the help offered. My general practicianer seems to be similar to a lot of frustrated patient doctors-does a couple of general tests and goes by the sliding scale given and determines actions from that. From my results classified as his normal, my doctor will not be progressing any further in this area of testing. He did not recommend anything concrete besides continue with my dietary,sleep,workout schedule and continue with my 200mg coq 10. He hinted at Paxil to see if depression but dismissed that quickly as well as 😄allergy involvement.😄.?.ha..

Someone gave me a bottle of testa freak?- or something like that from gnc to try....looks like it is suppose to last a month, I guess I will try it out since it's free. I just want my energy, libedo, and especially my mood to get back to somewhat normal......

 

[Vince]

Work4life, Welcome to ExcelMale. If you post the area you live, maybe someone can help you find a doctor. It definitely looks like your testosterone is way too low. Nelson has a post on labs you need before starting TRT and after you started. https://www.excelmale.com/forum/sho...-After-Initiation-of-Testosterone-Replacement also you can run labs through, Nelson's http://www.discountedlabs.com/

 

[CoastWatcher]

Definitely did not try and insult with my prior posts in regards to this site or anyones level of commitments and suggestions. I appreciate the help offered. My general practicianer seems to be similar to a lot of frustrated patient doctors-does a couple of general tests and goes by the sliding scale given and determines actions from that. From my results classified as his normal, my doctor will not be progressing any further in this area of testing. He did not recommend anything concrete besides continue with my dietary,sleep,workout schedule and continue with my 200mg coq 10. He hinted at Paxil to see if depression but dismissed that quickly as well as allergy involvement..?.ha..

Someone gave me a bottle of testa freak?- or something like that from gnc to try....looks like it is suppose to last a month, I guess I will try it out since it's free. I just want my energy, libedo, and especially my mood to get back to somewhat normal......

Let me ask a question. If the over the counter testosterone "boosters" worked wouldn't all of us on a testosterone replacement protocol be using them rather than a medically-managed program of injections?

Where red do you live? We may be able to offer a referral to a doctor in your area or to one of the national practices, Defy Medical or Prime Body.

 

[Nelson Vergel]

Work4life

Most educated doctors would treat you with your total T value (under 350 ng/dL)

Where do you live?

I would not take any over the counter testosterone booster since none works and some may even put a burden on your liver.

Are you sleeping well? Anything that happened a year ago when symptoms started to happen? Young children, stress at work, etc?

I ask guys a lot of questions since anyone should get deeper into low lab values and see if there are any cofactors in life style or medication interactions. Here is my health questionnaire http://testosteronewisdom.com/pdfs/HealthFormNvergel_V1.pdf

 

[Dr Justin Saya MD]

He hinted at Paxil to see if depression but dismissed that quickly as well

Typical....if you're only tool is a hammer you see every problem as a nail.

SSRIs block RE-UPTAKE of serotonin in the neural synapse, thus falsely (and temporarily) elevating levels in the synapse. The body then responds to this over time by actually DOWN-REGULATING the actual production of neurotransmitters (serotonin)...creating a true deficiency in these neurotransmitters and exacerbating the problem.

It never crosses these physician's minds that perhaps (OFTEN) a HORMONAL deficiency is the root cause of the neurotransmitter/psychological symptoms. Thus, an anti-depressant medication is NOT treating the root cause, but is only a bandaid and a very poor and temporary bandaid at that (often further suppressing HPTA - ie making the root problem actually worse- and exacerbating symptoms via direct side effects such as weight gain, further reduction in libido, anorgasmia, etc).

The big Pharma drug reps (understandably so) don't teach them that when they come in to their office, buy them lunch, and "pitch" the benefits/merits of anti-depressant treatment. I see FAR too many patients (male and female) coming to me on anti-depressant/anxiety medications that likely could have been completely avoided with appropriate hormonal balancing.

 

[Nelson Vergel]

I agree and disagree with Dr Saya on antidepressants. I agree that a hormonal profile should be performed in all depressed patients (to a minimum testosterone total and free, free T4 and free T3, AM cortisol, DHEA, and in women add estrogen). But antidepressants can have profound effects as a temporary fix while counseling, hormone balance, stress reduction and coping mechanisms are improved. Zoloft saved my life twice and I took it for 3 months every time. SSRI's break the vicious cycle of obsession. Bad thoughts and negative self talk happen but they do not simmer inside your head.

 

[Dr Justin Saya MD]

I agree and disagree with Dr Saya on antidepressants. I agree that a hormonal profile should be performed in all depressed patients (to a minimum testosterone total and free, free T4 and free T3, AM cortisol, DHEA, and in women add estrogen). But antidepressants can have profound effects as a temporary fix while counseling, hormone balance, stress reduction and coping mechanisms are improved. Zoloft saved my life twice and I took it for 3 months every time. SSRI's break the vicious cycle of obsession. Bad thoughts and negative self talk happen but they do not simmer inside your head.

The problem is, Nelson, about 95% of the docs out there DON'T view it as a temporary treatment. If you improve and are doing better (even if the improvement may have been due to other temporary factors) the doc will usually assume the anti-depressant worked and is needed and will KEEP THE PATIENT ON IT INDEFINITELY (and this is where the biggest problem lies). Most patients that I've seen get off of anti-depressant/anxiety meds were only because they were their own advocate and pushed their physician to wean off of the drug (knowing you I assume you fell into this category). Of course there are some instances of "responsible" SSRI prescribing physicians, but certainly the exception rather than the rule. I see many guys/gals coming in to me in their 30's - 40's already having been on anti-depressant/anxiety meds for 5-10+ years without even a trial of weaning. Simply unacceptable (but sure makes the drug companies happy).

 

[CoastWatcher]

Most patients that I've seen get off of anti-depressant/anxiety meds were only because they were their own advocate and pushed their physician to wean off of the drug...Of course there are some instances of "responsible" SSRI prescribing physicians, but certainly the exception rather than the rule. I see many guys/gals coming in to me in their 30's - 40's already having been on anti-depressant/anxiety meds for 5-10+ years without even a trial of weaning. Simply unacceptable (but sure makes the drug companies happy).

This mirrors my own experience with SSRIs. They were a good, and necessary tool, but the doctor who prescribed them actually told me that I'd be taking them for life and that there was no reason to even discuss the matter. Again, we have to be our own, informed advocate.

 

[Work4life]

This mirrors my own experience with SSRIs. They were a good, and necessary tool, but the doctor who prescribed them actually told me that I'd be taking them for life and that there was no reason to even discuss the matter. Again, we have to be our own, informed advocate.

Whew...I feel like a kid who walked up to a group of scientists for a can of coke or Pepsi which ever they think is better..after days of hypothesizing the molecular cohesion of each product the scientists offered the kid their result only to find the kid had died of thirst (or his head exploded...which ever offered a more comical graphic)......

 

[Work4life]

Work4life

Most educated doctors would treat you with your total T value (under 350 ng/dL)

Where do you live?

I would not take any over the counter testosterone booster since none works and some may even put a burden on your liver.

Are you sleeping well? Anything that happened a year ago when symptoms started to happen? Young children, stress at work, etc?

I ask guys a lot of questions since anyone should get deeper into low lab values and see if there are any cofactors in life style or medication interactions. Here is my health questionnaire http://testosteronewisdom.com/pdfs/HealthFormNvergel_V1.pdf

to answer a few questions. Yes I am sleeping well. Nothing tramatic has happened over the last year other then me turning 43. I have been told by others that supplements are garbage because they are absorbed through digestion and never make it to the bloodstream for effect. Also been told that supplements do work for people with low t due to some mineral deficiency causing normal t not to be produced. If your normal 43 yr old body says I am only putting out 300 t levels then supplements will do nothing.

i live in north western ohio

 

[Dr Justin Saya MD]

Whew...I feel like a kid who walked up to a group of scientists for a can of coke or Pepsi which ever they think is better..after days of hypothesizing the molecular cohesion of each product the scientists offered the kid their result only to find the kid had died of thirst (or his head exploded...which ever offered a more comical graphic)......

LOL. Work4life, despite what your physician says you DO have low testosterone levels + symptoms...as others have advised already, it appears you need a new doctor that is more open-minded in evaluating/diagnosing/treating hormonal abnormalities. MOST importantly - educate yourself thoroughly on this forum regarding the "ins and outs" of hormonal evaluation/treatment so that you will empower yourself as your own advocate (and will be able to DETERMINE if your physician is guiding you in the right direction). That is the single best piece of advice I can offer.

 

[PAUL-E]

welcome to excel male! I would also agree that your testosterone is low however with a TSH of 3.07 it might be worth checking free T3 free T4 reverse T3. hypothyroidism can cause low testosterone if I'm not mistaken. for future reference anytime you post lab work you should include reference ranges because different labs use different ranges(it will help us help you).

 

[Work4life]

Since my primary already tested and diagnosed I will have to check with insurance on how they handle second opinions and treatments... I have a sneaking suspicion that out of pocket for tests and possible replacement therapy is expensive if left to be paid out of pocket..

 

[CoastWatcher]

Since my primary already tested and diagnosed I will have to check with insurance on how they handle second opinions and treatments... I have a sneaking suspicion that out of pocket for tests and possible replacement therapy is expensive if left to be paid out of pocket..

Many ExcelMale members finance their TRT on a cash/pay as you go basis. Far too few doctors understand androgen replacement therapy and those that do tend to practice outside the restrictions that modern American medicine place on physicians. Finding an in-network doctor on top of things is a challenge. The costs may not be as steep as you imagine.