What to do after failing to raise testosterone naturally

[notsure]

Well I started looking around to get better educated and just decided to post my story to get some feedback from the community. I am a 42 yr old male that about five years ago started to notice a lack of energy and a loss of strength (comparing my old workout charts with current ones). I also started gaining weight. I started to work out a bit more intense but after a hard workout I would need a week to recover… extremely sore. Anyways about three years ago I finally decided to get my T measured and lo and behold it was low, around 201 ng/dL. Around the same time I started to have sporadic “hot flashes”. Just out of nowhere just started sweating and feeling hot. My DR told me I needed to lose weight because my excess fat was converting into estrogen. So I started to be a bit more diligent about my diet and exercise regime to no avail. On the contrary, I actually continued to gain weight at a rate of about 8 lbs a year.

I went to see an Endocrinologist and we did a bunch of blood test, FSH a bit high but found no real cause to low T (still had low T) so the answer was about the same. Eat better, work out and my T will improve. Nothing was changing so I went to see an Urologist. Ran a bunch a bloodwork and again everything else (other than my T levels) seem fine (FSH still a bit high around 10). He put me on Clomid but after two months I really did not feel a change. My T levels did go up to about the 500’s. He discussed the possibility of TRT but told me to think about it because it was a lifelong decision.

I wasn’t ready to commit for life without trying one more time to really work at my diet and exercise. Well that has been a real struggle trying different things and I have not lost any weight (actually continued to gain), my energy levels are still really low, the “hot flashes” occur every now and then (couple episodes a month), seem a bit moody and libido seems to be dropping (rare morning erections). Again not sure if this is just normal aging, but I’m really not that old.
So again tried one more time about four months ago to really find out what is causing Low T and ran a bunch of blood work again, even had an MRI for the pituitary. MRI came back normal and blood work as before. FSH high at 11.5 MIU/ML but T was lower at 139 ng/dl.

At this point I don’t know the real cause of my Low T.

Will it be possible to lose weight (if this is the real cause since I don’t know what is causing it) and increase the number to natural levels for my age (it does not seem possible).

Why did Clomid increased levels to about 530 ng/dl but I felt no difference.

Should I just go ahead and start TRT? My problem is should I commit knowing that is a lifelong decision when based on DR’s it appears all I have to do is lose weight, which I have not been able to. For the record I’m about 50 lbs overweight at this point.

Think this might be it and I just have to accept that I will be injecting myself at least once a week for the rest of my life.

Thoughts? Thanks!

 

[ERO]

Before you commit, I recommend scheduling a consult with Defy Medical. They won't up-sell you or twist your arm to get on TRT if it is not right for you. If it is right for you, they have no monthly or yearly fees and they have two of the top TRT doctors in the country to work with you to get on track to feel good again.

 

[CoastWatcher]

Welcome to Excelmale. You have something working in your favour that many of our members, when they joined us, didn't: a doctor who isn't rushing you into TRT with a dated protocol. That said, you have questions that aren't being answered - do have any additional labs to post - estradiol on the sensitive scale, thyroid values, prolactin, LH? A good doctor is the most important variable in a successful TRT protocol and Defy Medical (I am not a patient, but respect their work) is who I'd urge you to consider. If you live in the US they are available to you; the telemed model works.

Please post up any additional information you have. All the best.

 

[Steve Williams]

I am in a similar situation. Over the past few years, I have been gaining weight and losing strength, stamina, and libido. I fund out that my T was low about 18 months ago. I changed my diet and increased my excercise. I was able to lose about 10 lbs, but it was a struggle to keep it off. After a solid effort of trying to raise my T naturally, I decided to get on TRT. It IS a lifetime decision, but my quality of life has greatly improved. I have more energy, faster recovery, frequent night time erections, and a much better sex life. I am losing weight, and gaining muscle.

You are right to be diligent in your investigation. I wish you the best and want you to know that if you choose to go on TRT, it has a lot of benefits, specifically areas where you are concerned. I don't regret going on T.

 

[GA8314]

Hard to say why you didn't feel appreciable benefits in the 500's range. Many have said that the biggest subjectively perceived benefits occur around 800-900.

Yes, you should get a proper work up. Yes, you should make sure something more sinister is going on.

But, chances are you are simply one of the many many men in their 40's showing signs of hypogonadism. Theories abound as to why, and surely obesity (but many many other factors as well) may be contributing to your low natural Testosterone level. However, the bottom line is that you will likely ultimately be on TRT.

If I were you I would also begin thinking about a mindset that you should want to be OPTIMAL. That surely means different things (subjective priorities) to different people, but we're not all that different. If you need testosterone, then you need testosterone. Shoot for an optimal level which you will come to discover with weeks or months of tweaking based upon how you feel and labs.

The benefits that I've achieved via T optimization (I'm 41) are very very tangible. I believe it has helped me in every single way in my life. That being said, I've also modified many lifestyle factors such as diet, exercise, and other things. But, sometimes if you are LOW T, making those modifications can be difficult.

It's true that you may be theoretically able to modify lifestyle and have improved testosterone production and utilization. But, it's also true that you may need to optimize your Testosterone in ORDER to make those changes, and to make the decisions which require change and require energy, confidence, and determination. If you have brain fog and depression, or are fatigued and lacking motivation, then how are you expected to hit the gym and clean up your diet?

If you need to optimize your T, then get with a physician who knows what he or she is doing and don't look back.

Just my 2 cents.

 

[Vince]

notsure, Welcome to ExcelMale. I definitely would try to lose weight first. The best way to lose weight is diet and exercise. For me it's low carb, resistance exercise and walking. Diet does have to come first, I see a lot of overweight people always exercising but never losing weight.

 

[Steve Williams]

notsure, Welcome to ExcelMale. I definitely would try to lose weight first. The best way to lose weight is diet and exercise. For me it's low carb, resistance exercise and walking. Diet does have to come first, I see a lot of overweight people always exercising but never losing weight.

It may not be that simple. Before TRT, it took me 15 months of diet and exercise to lose (and keep off) 10lbs. I literally could not lose weight. After starting TRT, I have lost an additional 17 lbs in 3 months. I was stuck on a vicious cycle of fat encouraging amitorization to E2 and E2 causing my body to store more fat.

That said, I have discovered that cheeseburgers are like kryptonite to me. They are, at best, an occasional indulgence and must be followed with a few days of very clean eating. Proper diet is definitely the majority of the weight loss battle.

 

[Vince]

It may not be that simple. Before TRT, it took me 15 months of diet and exercise to lose (and keep off) 10lbs. I literally could not lose weight. After starting TRT, I have lost an additional 17 lbs in 3 months. I was stuck on a vicious cycle of fat encouraging amitorization to E2 and E2 causing my body to store more fat.

That said, I have discovered that cheeseburgers are like kryptonite to me. They are, at best, an occasional indulgence and must be followed with a few days of very clean eating. Proper diet is definitely the majority of the weight loss battle.

I know we are all different, eating for some has psychological benefits. When I gave up carbs, I was then able to control my eating.

 

[salasman]

Just a couple of points relating to lifestyle changes as a natural way to raise T levels.

1. adequate sleep with consistency (i'm guilty of training hard, eating well, but not going to bed at the right time); lack of sleep definitely influences hormone levels.

2. saturated and unsaturated fats in the diet; fats are our friend (in the right amounts) and certainly influence hormones production

3. finally, maca root powder has a positive impact on the endocrine system; though I haven't conducted my own lab experiments, I feel it contributes to my well-being; there are peer-review studies on maca root benefits, so worth considering.

 

[CoastWatcher]

Just a couple of points relating to lifestyle changes as a natural way to raise T levels.

1. adequate sleep with consistency (i'm guilty of training hard, eating well, but not going to bed at the right time); lack of sleep definitely influences hormone levels.

2. saturated and unsaturated fats in the diet; fats are our friend (in the right amounts) and certainly influence hormones production

3. finally, maca root powder has a positive impact on the endocrine system; though I haven't conducted my own lab experiments, I feel it contributes to my well-being; there are peer-review studies on maca root benefits, so worth considering.

Each of these points is on the money. In my opinion, trying to clean up sleep habits - if they are out of whack - is something that is frequently easy to do, with a bit of discipline, and can pay huge dividends.

 

[notsure]

Thanks for the responses. I'll respond to some of the questions and comments.

I'm in Houston and I prefer to deal with someone local, but I'm looking into Defy Medical and will give them a call
Monday to see what they have to say and how things work.

I have checked my estradiol (not sure if on the sensitive side), prolactin, and LH and all in normal range.

As far as dieting and exercising that is what I have been trying, low carb, high fat diet, etc but nothing sticks. I'll lose a few pounds and gain it all back and some as soon as I cheat for one day or a couple of meals.

I have never tried the maca root. Will look into it.

So I guess this is a who came first chicken or the egg type of deal...Low T then fat or fat and then Low T. My numbers are pretty low so I'm not sure loosing weight will increase my T numbers from 150 to the 600+.

Has anyone on this forum been on TRT for a few months, lost the weight, and then got off TRT to see if they could restore optimal levels naturally now that "fat" is not the issue?

 

[GA8314]

Thanks for the responses. I'll respond to some of the questions and comments.

I'm in Houston and I prefer to deal with someone local, but I'm looking into Defy Medical and will give them a call
Monday to see what they have to say and how things work.

I have checked my estradiol (not sure if on the sensitive side), prolactin, and LH and all in normal range.

As far as dieting and exercising that is what I have been trying, low carb, high fat diet, etc but nothing sticks. I'll lose a few pounds and gain it all back and some as soon as I cheat for one day or a couple of meals.

I have never tried the maca root. Will look into it.

So I guess this is a who came first chicken or the egg type of deal...Low T then fat or fat and then Low T. My numbers are pretty low so I'm not sure loosing weight will increase my T numbers from 150 to the 600+.

Has anyone on this forum been on TRT for a few months, lost the weight, and then got off TRT to see if they could restore optimal levels naturally now that "fat" is not the issue?

Again, I'm in the camp that believes we aren't exactly sure why so many men find themselves in the low T category. Modern stress, poor diet, environmental factors (some known and likely many unknown), obesity etc.

Sure, fix those and you will likely improve your overall health including T levels. But, will this be a tangible benefit? Yes, it will be, but I'm not sure this is going to significantly improve your T. Overall, you'll be much better off, but it's likely your Testosterone production won't ramp up to anywhere close to optimal.

I believe a lot of guys experience a decline in T which PRECIPITATES other declines in health. Behaviors change. Under appreciating this is a mistake. So, at some point you have to stop worrying about the "why". There are plenty of docs out there willing to help you optimize your hormonal milleu.

Optimize the T, and make other behavioral changes discussed above. But, making those changes will be easier with an optimal T. Please realize this.

 

[Vettester Chris]

OK, your baseline FSH was 10, but what was your baseline LH?